COVID-19 PANDEMİSİ SIRASINDA SUNULAN TELESAĞLIK HİZMETİNİN PSİKOLOJİK GELİŞİM DÜZEYLERİ ÜZERİNE DEĞERLENDİRİLMESİ

Yıl 2023, Cilt: 86 Sayı: 2, 166 - 175, 30.03.2023

Sevgi Canbaz , Nuray Özgülnar , Meryem Merve Ören , Eliz Oyman Kuman , Esra Karaca , Duygu Acar Karagül , Selma Karabey , Ayşe Emel Önal , Şadiye Selin Duruş , Alpay Medetalibeyoğlu , Mustafa Oral Oncul

https://doi.org/10.26650/IUITFD.1218085

Öz

Amaç: COVID-19 pandemisi travmatik bir olay olarak kabul edilmektedir. Bu çalışmanın amacı, İstanbul Tıp Fakültesi‘nde COVID-19 olduğu varsayılan veya şüpheli/doğrulanmış bir COVID-19 hastası ile yakın temasta bulunan sağlık çalışanlarına sunulan telesağlık hizmetlerinin tanıdan bir yıl sonra pandemi yönetimi, aşılama ve psikolojik gelişim üzerine etkilerini incelemektir. Gereç ve Yöntem: Kohort tipindeki bu çalışmada, 6 Nisan-31 Temmuz 2020 tarihleri arasında telesağlık hizmeti ile uzaktan izlenen COVID-19/riskli temaslı 237 çalışan dahil edildi. İlk olarak telesağlık hizmeti ile 21 gün boyunca takip edildiler. İkinci olarak, bir yıl sonra çevrimiçi bir anketi doldurmaları için telefonla arandılar. Katılımcıların 94’ü (%39,7) anketi doldurdu. Anket, son bir yılda yaşanan pandemi ile ilgili zorluklar ve Travma Sonrası Büyüme Envanteri (PTGI) ile ilgili soruları içeriyordu. Bulgular: Çalışmada 234 çalışandan 172’si (%73,5) ve 164’ü (%70,1) sırasıyla birinci ve ikinci doz COVID-19 aşısı yaptırdı. Psikolojik desteğe ihtiyaç duymayan çalışanların benlik algısı ve toplam puanlarındaki PTGI değişimi, psikolojik destek almayan/ alamayanlara göre anlamlı derecede daha düşüktü (sırasıyla p=0,007 ve p=0,016). Kişisel koruyucu ekipmanı (KKD) daha dikkatli kullanan çalışanların KKD kullanma şeklini değiştirmediklerini ve bazen dikkatsiz olduklarını bildiren çalışanlara göre; PTGI benlik algısı puanı (p=0,005), yaşam felsefesi (p=0,014), kişilerarası ilişkiler (p=0,011) ve toplam puanı (p=0,004) anlamlı olarak daha yüksekti. Sonuç: Çalışmamızın sonuçları, sağlık çalışanlarının pandeminin neden olduğu olumsuzlukların yanı sıra olumlu yönlerini de görerek, travma sonrası büyümenin gerçekleştiğini ortaya koymaktadır.

Anahtar Kelimeler

Kohort, COVID-19, psikolojik büyüme, telesağlık hizmeti, aşılama

THE EVALUATION OF TELEHEALTH SERVICES DURING THE COVID-19 PANDEMIC ON LEVELS OF PSYCHOLOGICAL GROWTH

Öz

Objective: The COVID-19 pandemic is considered a traumatic event. The aim of this study was to examine the effects of telehealth services offered at the Istanbul University, Istanbul Faculty of Medicine to health workers with presumed COVID-19 or close contact with a suspected/confirmed COVID-19 patient on pandemic management, vaccination, and psychological growth at one year after diagnosis. Materials and Methods: The cohort study included 237 employees with COVID-19/risky contact who were monitored remotely via a telehealth service provided between April 6 and July 31, 2020. First, they were followed up for 21 days with the telehealth service. Second, they were invited by phone to complete an online questionnaire and 94 (39.7%) of them participated. The questionnaire included questions about pandemic-related difficulties experienced during the last year and the Posttraumatic Growth Inventory (PTGI). Results: Of the 234 employees, 172 (73.5%) and 164 (70.1%) had the first and second doses of the COVID-19 vaccine, respectively. Employees who did not need psychological support had significantly lower PTGI change in self-perception and total scores than those who did not/could not receive psychological support (p=0.007 and p=0.016, respectively). Employees who used personal protective equipment (PPE) more carefully had a significantly higher PTGI self-perception score (p=0.005), life philosophy (p=0.014), interpersonal relationships (p=0.011), and total score (p=0.004) than employees who reported that they did not change how they use PPE and were sometimes careless. Conclusion: The results of our study suggest that health workers are showing evidence of posttraumatic growth by seeing the positives as well as the negatives caused by the pandemic.

Anahtar Kelimeler

Cohort, COVID-19, psychological growth, telehealth service, vaccination

Kaynakça

• 1. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J of Autoimmun 2020;109:102433. [CrossRef] google scholar
• 2. Çetintepe SP, İlhan MN. COVID-19 Salgınında Sağlık Çalışanlarında Risk Azaltılması [Risk reduction in healthcare workers in the COVID-19 outbreak]. J Biotechnol and Strategic Health Res 2020;1(Özel Sayı):50-4. [CrossRef] google scholar
• 3. Occupational Safety and Health Administration (OSHA). COVID-19-hazard recognition. 2021 October 27 (cited 2021 Sep 08). Available from: URL: https://www.osha.gov/ coronavirus/hazards google scholar
• 4. Tarquinio C, Brennstuhl MJ, Rydberg JA, Bassan F, Peter L, Tarquinio CL, et al. EMDR in telemental health counseling for healthcare workers caring for COVID-19 patients: A pilot study. Issues Ment Health Nurs 2021;42(1):3-14. [CrossRef] google scholar
• 5. Taylor S. The psychology of pandemics: preparing for the next global outbreak of infectious disease. 1st ed. Newcastle: Cambridge Scholars Publishing; 2019. google scholar
• 6. Tedeschi RG, Calhoun LG. The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 1996;9(3):455-71. [CrossRef] google scholar
• 7. Chen R, Sun C, Chen JJ, Jen HJ, Kang XL, Kao CC, et al. A Large-Scale survey on trauma, burnout, and posttraumatic growth among nurses during the COVID-19 pandemic. Int J Ment Health Nurs 2021;30(1):102-16. [CrossRef] google scholar
• 8. Oginska-Bulik N, Zadworna-Cieslak M. The role of resiliency and coping strategies in occurrence of positive changes in medical rescue workers. Int Emerg Nurs 2018;39:40-5. [CrossRef] google scholar
• 9. Koch S. Home telehealth-current state and future trends. Int J Med Inform 2006;75(8):565-76. [CrossRef] google scholar
• 10. Ören MM, Özgülnar N, Canbaz S, Karabey S, Önal AA, Öncül MO. An integrated care model based on hospital and home during the Covid-19 pandemic: telehealth. J Ist Faculty Med 2021;84(5):526-32. [CrossRef] google scholar
• 11. Directive on telehealth service implementation procedures and principles. Ministry Approval dated 26.03.2015 and numbered 38110390/010.04/644. (cited 2021 Sep 08). Available from: URL:https://www.noroloji. org.tr/TNDData/Uploads/files/telesaglikservisi%20 uygulamaesasveusulleri129075.pdf. google scholar
• 12. Fisk M, Livingstone A, Pit SW. Telehealth in the context of COVID-19: changing perspectives in Australia, the United Kingdom, and the United States. J Med Internet Res 2020;22(6):e19264. [CrossRef] google scholar
• 13. Republic of Turkey, Ministry of Health. Guidelines for COVID-19 (SARS-CoV-2 infection) scientific committee study. 2020 Apr 13. (cited 2021 Sep 08). Available from: URL: https://hsgm.saglik.gov.tr/depo/birimler/goc_sagligi/ covid19/rehber/COVID-19_Rehberi20200414_eng_ v4_002_14.05.2020.pdf. google scholar
• 14. Bökesoy I, Karabulut GH. Akrabalık ve genetik danışmanlık. Turkiye Klinikleri J Pediatr Sci 2005;1(2): 30-5. google scholar
• 15. Tedeschi RG, Calhoun LG. The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 1996;9(3):455-71. [CrossRef] google scholar
• 16. Kağan M, Güleç M, Boysan M, Çavuş H. Hierarchical factor structure of the Turkish version of the posttraumatic growth inventory in a normal population. TAF Prev Med Bull 2012;11(5):617-24. [CrossRef] google scholar
• 17. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020;8(4):420-22. [CrossRef] google scholar
• 18. Republic of Turkey, Ministry of Health. COVID-19 (SARS-CoV-2 infection) healthcare professionals guide, scientific committee study. 2020 January (cited 2021 Sep 08). Available from: URL: https://hsgm.saglik.gov.tr/depo/ haberler/ncov/2019-nCov_Hastal_Salk_alanlar_Rehberi.pdf google scholar
• 19. Centers for Disease Control and Prevention. Coronavirus (COVID-19): symptoms of coronavirus. Centers for Disease Control and Prevention. 2020. (cited 2021 Sep 08). Available from: URL: https://www.cdc.gov/coronavirus/2019-ncov/ symptoms-testing/symptoms.html google scholar
• 20. Fathi M, Vakili K, Sayehmiri F, Mohamadkhani A, Hajiesmaeili M, Rezaei-Tavirani M, et al. The prognostic value of comorbidity for the severity of COVID-19: A systematic review and meta-analysis study. PLoS One 2021;16(2):e0246190. [CrossRef] google scholar
• 21. Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its impact on patients with COVID-19. SN Compr Clin Med 2020;2(8):1069-76. [CrossRef] google scholar
• 22. Centers for Disease Control and Prevention. About Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. 2020. (cited 2021 Sep 08). Available from:URL: https://www.cdc.gov/ coronavirus/2019-ncov/ about/ google scholar
• 23. Wu X, Kaminga AC, Dai W, Deng J, Wang Z, Pan X, et al. The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis. J Affect Disord 2019;243:408-15. [CrossRef] google scholar
• 24. Zhao Y, Cui C, Zhang K, Liu J, Xu J, Nisenbaum E, et al. COVID19: A Systematic approach to early identification and healthcare worker protection. Public Health 2020;19(8):205. [CrossRef] google scholar
• 25. Oran DP, Topol EJ. The proportion of SARS-CoV-2 infections that are asymptomatic: A systematic review. Ann Intern Med 2021;174(5):655-62. [CrossRef] google scholar
• 26. Honigsbaum M, Krishnan L. Taking pandemic sequelae seriously: from the Russian influenza to COVID-19 long-haulers. Lancet 2020;396(10260):1389-91. [CrossRef] google scholar
• 27. Ministry of Health, General Directorate of Public Health, Vaccine Portal. Risk group vaccinations, retrieved. 2021(cited 2021 Sep 08). Available from: URL: https://asi.saglik.gov.tr/asi-kimlere-yapilir/liste/32-mesle%C4%9Fe-ba%C4%9Fl%C4%B1-riskler-nedeniyle-a%C5%9F%C4%B1lama.html google scholar
• 28. Sallam M. COVID-19 vaccine hesitancy worldwide: a concise systematic review of vaccine acceptance rates. Vaccines 2021;9(2):160. [CrossRef] google scholar
• 29. Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr 2020;14(5):779-88. [CrossRef] google scholar
• 30. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry 2009;54(5):302-11. [CrossRef] google scholar
• 31. Kang L, Ma S, Chen M, Yang J, Wang Y, Li R, et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain Behav Immun 2020:87:11-7. [CrossRef] google scholar
• 32. Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, et al. The Lancet Commission on global mental health and sustainable development. Lancet 2018;392(10157):1553-98. [CrossRef] google scholar
• 33. Vazquez C, Valiente C, García FE, Contreras A, Peinado V, Trucharte A, et al. Post-Traumatic growth and stress-related responses during the COVID-19 pandemic in a national representative sample: The role of positive core beliefs about the world and others. J Happiness Stud 2021;22(7):2915-35. [CrossRef] google scholar