Kaygı Sarmalı: Sağlık Kaygısı Olan Bireylerin Kişisel Deneyimlerinin Nitel Bir İncelemesi

Öz

Hipokondriya bu semptoma sahip bireylerin ‘gerçek’ bir hastalığın yokluğunda fiziksel şikayetler yaşamaları bakımından beden-zihin problemine dair tartışmaların merkezinde yer almaktadır. Bu çalışmanın amacı da hipokondriyak şikayetleri olan bireylerin ‘hastalıklarını’ ya da bu konudaki kaygılarını nasıl deneyimlediklerini araştırmaktır. Ayrıca, bu kişilerin özellikle doktorlarla olmak üzere onay arayışında oldukları kişilerle ilişki kurma biçimleri anlaşılmaya çalışılmıştır. Araştırmanın katılımcıları, 19-55 yaşları arasındaki sağlık kaygıları yüksek olan 14 kişiden oluşmaktadır. Çalışmanın verisi yüz yüze yapılan yarı-yapılandırılmış görüşmeler aracılığıyla toplanmıştır. Katılımcıların öznel deneyimlerini çalışmak için sistematik bir yaklaşım sunan Yorumlayıcı Fenomenolojik Analiz yöntemi kullanılmıştır. Sonuç olarak dört üst tema ortaya çıkmıştır ve bu temalar ‘sağlık kaygısına yapılan nedensel atıflar: ‘halledilmemiş bir mesele olarak kayıp’, ‘semptomun girbadına sürüklenmek’, ‘deneyimlerini adlandırması ve belirsizliği ortadan kaldırması için bir uzmana yapılan sonsuz çağrı’ ve ‘her şerde bir hayır vardır: hasta olmanın/hasta hissetmenin faydaları’ şeklindedir. Bu çalışmanın sonuçları hem ruh sağlığı çalışanları hem de diğer sağlık çalışanları için önemlidir çünkü uzmanlar tarafından yapılan fiziksel-psikolojik bozukluk ayrımının sağlık kaygısı olan kişilerin gerçekleriyle uyuşmadığı görülmektedir. Bu kişilerin semptomlarının başlangıcıyla ilişkilendirdikleri bir kayıp deneyiminin ön plana çıkması da bu kişilerle çalışırken kayıp konusu üzerinde durmanın önemine işaret etmektedir. Ayrıca katılımcıların sağlık durumları ile ilgili kendilerine verilen bilgilerin rahatlatıcı etkisinin kısa vadeli olduğu ve “hastalıklarının ne olduğuna” dair süregiden bir arayışları olduğu gözlemlenmiştir. Bu nedenle de uygulanan tedavilerin odağında bedensel belirtilerin ciddi bir duruma işaret etmediği bilgisinin kişilere verilmesinin işe yaramayacağı düşünülmüştür. Sonuç olarak hipokondri hastaları ile çalışan terapistlerin, hasta ile terapötik bir ittifak kurduktan sonra, bu kişilerin kendilerinde ne olduğunu bilme isteklerinin sürekliliğini anlamalarına yardımcı olmaları gerektiğini söylemek mümkündür.

Anahtar Kelimeler

• Hipokondriya
• sağlık kaygısı
• somatizasyon
• yorumlayıcı fenomenolojik analiz

A Helix of Anxiety: A Qualitative Analysis of the Personal Experiences of Individuals with Health Anxiety

Öz

Hypochondria is at the center of debates about the mind-body problem in that those individuals with this symptom experience physical complaints in the absence of ‘real’ illness. The study examined how individuals with hypochondriac complaints experience their ‘illnesses’ or anxiety about it. Also, how they establish their interpersonal relationships with the people they get reassurance, especially with physicians, was understood. The sample consisted of 14 individuals with high health anxiety, and their ages were between 19-55 years old. The data were collected through face-to-face semi-structured interviews. The Interpretative Phenomenological Analysis method, which offers a systematic approach to study participants’ subjective experiences, was used. As a result, four superordinate themes emerged: ‘Causal attributions of health anxiety: Loss at the core as unfinished business,’ ‘Being drawn into a vortex of symptoms,’ ‘Endless calls to experts for naming own experiences and eliminating uncertainty,’ and ‘Every cloud has a silver lining: Benefits of being/feeling ill.’ The findings are important for both mental and physical health professionals working with these individuals since the experts’ physical-psychological distinction does not correspond with the reality of those people. The prominence of a loss experience that these people associate with the onset of their symptoms also points to the importance of dwelling on the issue of loss while working with these people. In addition, it was observed that the information given to the participants about their health status had a short-term relaxing effect, and they had an ongoing search for “what their illnesses are.” For this reason, it was thought that providing information that the physical symptoms do not indicate a serious situation at the focus of the treatments applied would not work. In conclusion, it is possible to say that therapists working with patients with hypochondria should help them understand the continuity of their desire to know what is happening in them after establishing a therapeutic alliance with the patient.

Anahtar Kelimeler

• Hypochondriasis
• health anxiety
• somatization
• interpretative phenomenological analysis

Kaynakça

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