Sağlık ve Eğitim Sistemleri Arasında Yeni Bir Köprü: Okul Temelli Konsültasyon

Öz

Bu çalışma, çocukların sağlık ve eğitim ihtiyaçlarını karşılamak amacıyla eğitim ve sağlık sistemleri arasında kurulması gereken işbirliğini konu almaktadır. Özellikle kronik hastalıklar, DEHB, uyku bozuklukları ve kanser gibi sağlık sorunlarının eğitim üzerindeki etkilerine odaklanan çalışmada, okul temelli konsültasyonun önemi vurgulanmaktadır. Biyopsikoeğitimsel Model çerçevesinde okul psikolojik danışmanlarının “tıbbi iletişimci” rolü ile pediatristler ve diğer sağlık uzmanlarıyla etkili işbirliği yapabilmesi önerilmektedir. Bu bağlamda, çok disiplinli konsültasyon sürecinin çocukların akademik, psikolojik ve sosyal gelişimlerine bütüncül katkı sağlayabileceği ifade edilmektedir. Çalışma, Türkiye bağlamında sağlık-eğitim entegrasyonuna yönelik hem uygulayıcılara hem araştırmacılara hem de politika yapıcılara yönelik özgün ve somut çözüm önerileri sunmaktadır.

Anahtar Kelimeler

• Konsültasyon
• Sağlık
• Eğitim
• Pediatri
• Okul-temelli Konsültasyon

A New Bridge Between Health and Education: School-Based Consultation

Öz

This study addresses the necessity of establishing collaboration between the education and healthcare systems to meet children’s health and educational needs. Focusing particularly on the educational impacts of chronic illnesses, ADHD, sleep disorders, and cancer, the study emphasizes the significance of school-based consultation. Within the framework of the Biopsychoeducational Model, it is proposed that school counselors assume the role of "medical liaison" to facilitate effective collaboration with pediatricians and other healthcare professionals. In this context, it is argued that a multidisciplinary consultation process can contribute holistically to children’s academic, psychological, and social development. The study offers original and practical recommendations for practitioners, researchers, and policymakers regarding the integration of health and education systems, particularly within the context of Türkiye.

Anahtar Kelimeler

• Consultation
• Health
• Education
• Pediatry
• School-based Consultation

Kaynakça

1. Alenezi, S., Hamed, M., & Alquraini, T. (2022). Findings of a multidisciplinary assessment of children referred for possible neurodevelopmental disorders. Behavioral Sciences, 12(12), 509. https://doi.org/10.3390/bs12120509
2. Aslan, A. M. (2022). Okul temelli konsültasyon eğitim programının okul psikolojik danışmanlarının konsültasyon öz‑yetkinlik düzeylerine etkisi (Yayımlanmamış doktora tezi). Gazi Üniversitesi, Eğitim Bilimleri Enstitüsü, Ankara.
3. Aslan, A. M., & Güven, M. (2019). Okul psikolojik danışmanlarının ailelerle yürüttükleri konsültasyon çalışmaları. Turkish Psychological Counseling and Guidance Journal, 9(52), 109-148.
4. Aslan, A. M., & Güven, M. (2022). Vaka ve araştırma örnekleriyle psikolojik danışma ve rehberlikte konsültasyon. Ankara: Anı Yayıncılık.
5. Bacaro, V., Carpentier, L., & Crocetti, E. (2023). Sleep Well, Study Well: A Systematic Review of Longitudinal Studies on the Interplay between Sleep and School Experience in Adolescence. International Journal of Environmental Research and Public Health, 20(6), 4829. https://doi.org/10.3390/ijerph20064829
6. Beale, I. L. (2006). Scholarly literature review: Efficacy of psychological interventions for pediatric chronic illnesses. Journal of Pediatric Psychology, 31(5), 437–451. https://doi.org/10.1093/jpepsy/jsj079
7. Bedir, Y., Gündoğdu, F., Şişman, F. N., & Ergün, A. (2020). Relationship between sleep quality and emotion-behavior problems in adolescents. Turkish Journal of Sleep Medicine. https://doi.org/10.4274/jtsm.galenos.2020.46220
8. Bergman, A. S., & Fritz, G. K. (1985). Pediatricians and mental health professionals: Patterns of collaboration and utilization. American Journal of Diseases of Children, 139, 155–159. https://doi.org/10.1001/archpedi.1985.02140040053026

9. Boff, L. M., McGuire, A. L., & Raphael, J. L. (2021). Hospital-based education for hospitalized children: Current practice and future direction. Hospital Pediatrics, 11(5), e75-e77. https://doi.org/10.1542/hpeds.2020-004556
10. Borrell-Carrio, F., Suchman, A. L., & Epstein, R. M. (2004). The biopsychosocial model 25 years later: Principles, practice, and scientific inquiry. Annals of Family Medicine, 2, 576–582. https://doi.org/10.1370/afm.245
11. Bradley-Klug, K. L., Grier, E. C., & Ax, E. E. (2006). Chronic illness. In G. G. Bear & K. M. Minke (Eds.), Children’s needs III: Development, prevention, and intervention (pp. 857–869). National Association of School Psychologists.
12. Bradley-Klug, K. L., Sundman, A. N., Nadeau, J., Cunningham, J., & Ogg, J. (2010). Communication and collaboration with schools: Pediatricians’ perspectives. Journal of Applied School Psychology, 26, 263–281. https://doi.org/10.1080/15377903.2010.518583
13. Bootzin, R. R., & Stevens, S. J. (2005). Adolescents, substance abuse, and the treatment of insomnia and daytime sleepiness. Clinical Psychology Review, 25, 629–644. https://doi.org/10.1016/j.cpr.2005.04.007
14. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
15. Brown, M. B., & Bolen, L. M. (2003). School-based health centers: Strategies for meeting the physical and medical needs of children and families. Psychology in the Schools, 40, 279–288. https://doi.org/10.1002/pits.10084
16. Brown, M. B., & Bolen, L. M. (2008). The school-based health center as a resource for prevention and health promotion. Psychology in the Schools, 45(1), 28–38. https://doi.org/10.1002/pits.20276
17. Brown, M. B., Bolen, L. M., Brinkman, T. M., Carreira, K., & Cole, S. (2011). A collaborative strategy with medical providers to improve training for teachers of children with cancer. Journal of Educational and Psychological Consultation, 21(2), 149–165. https://doi.org/10.1080/10474412.2011.571478
18. Chesno-Grier, B., & Bradley-Klug, K. L. (2011). Collaborative consultation to support children with pediatric health issues: A review of the biopsychoeducational model. Journal of Educational and Psychological Consultation, 21(2), 88–105. https://doi.org/10.1080/10474412.2011.571522
19. Çil, İ., Tokat, M. A., Türkan, Y. S., & Doğan, N. (2014). Temel eğitim kurumlarında e-rehberlik ve danışmanlık karar destek sistemi. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi, 29(29-2), 34-56.
20. Çakır, G., & Altay, N. (2021). Kronik hastalığı olan çocukların bakımında okul hemşiresinin görev ve sorumlulukları. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 14(1), 55-61. https://doi.org/10.46483/deuhfed.730452
21. Demirkan, A. K., & Semiz, U. B. (2025). Investigating ADHD symptoms and sleep disturbances in young adults: A cross-sectional study. Nature and Science of Sleep, 1615-1627. https://doi.org/10.2147/NSS.S537569
22. Di Padova, M., Pettoello-Mantovani, M., & Dipace, A. (2024). School in the hospital, the key role of an educating community. Global Pediatrics, 9, 100204. https://doi.org/10.1016/j.gpeds.2024.100204
23. Farmer, J. E., Clark, M. J., & Marien, W. E. (2003). Building systems of care for children with chronic health conditions. Rehabilitation Psychology, 48(3), 242–249.
24. Farmer, J. E., & Clippard, D. (1995). Educational outcomes in children with disabilities: Linking hospitals and schools. Neurorehabilitation, 5, 49–56. https://doi.org/10.3233/NRE-1995-5105
25. Fottland, H. (2000). Childhood cancer and the interplay between illness, self-evaluation and academic experiences. Scandinavian Journal of Educational Research, 44, 253–273. https://doi.org/10.1080/00313830050154494
26. Ghosh, S., & Rezazadeh, S. M. (2011). Consultation with pediatricians in the management of attention-deficit/hyperactivity disorder. Journal of Educational and Psychological Consultation, 21(2), 118–132. https://doi.org/10.1080/10474412.2011.571477
27. Gormley, M. J., Allen, J. P., & Jimerson, S. R. (2024). Advancing consultation and family, school, and community collaboration. School Psychology Review, 53(2), 115–122. https://doi.org/10.1080/2372966X.2024.2325294
28. Guttu, M., Engelke, M. K., & Swanson, M. (2004). Does the school nurse-to-student ratio make a difference? Journal of School Health, 74(1), 6–9. https://doi.org/10.1111/j.1746-1561.2004.tb06593.x
29. Hatunoğlu, A., & Hatunoğlu, Y. (2006). Okullarda verilen rehberlik hizmetlerinin problem alanlar. Kastamonu Education Journal, 14(1), 333-338.
30. Haylı, Ç. M., Kösem, D. D., & Felek, E. (2023). Investigation of the relationship between perceived stress and sleep hygiene in high school students. Sleep Medicine Research, 14(3), 135–140. https://doi.org/10.17241/smr.2023.01788
31. Hopkins, L. J. (2015). Hospital-based education support for students with chronic health conditions. Australian Health Review, 40(2), 213-218. https://doi.org/10.1071/AH15032
32. Işıktekiner, F. S., & Altun, S. A. (2011). Hastane okullarındaki sorunlar ve yaşantılar. Education and Science, 36(161).
33. Jalali, R., Khazaei, H., Paveh, B. K., Hayrani, Z., & Menati, L. (2020). The Effect of Sleep Quality on Students’ Academic Achievement. Advances in Medical Education and Practice, 11, 497–502. https://doi.org/10.2147/AMEP.S261525
34. Jiliberto, F. & Zárate Alva, N. (2025) Influencing factors in-hospital school education: Exploring the context from the teacher’s perspective. Continuity in Education, 6(1), 1–21. https://doi.org/10.5334/cie.126.
35. Johnson, M. P., Lubker, B. B., & Fowler, M. G. (1988). Teacher needs assessment for the educational management of children with chronic illness. Journal of School Health, 58(5), 232–235. https://doi.org/10.1111/j.1746-1561.1988.tb05871.x
36. KAÇUV. (2021). Hastane sınıfı öğretmenleri için kolaylaştırıcı rehber. Kanserli Çocuklara Umut Vakfı. https://kacuv.org/wp-content/uploads/2021/04/Hastane-Sinifi-Ogretmenleri-icin-Kolaylastirici-Bir-Rehber-1.pdf
37. KAÇUV. (2019). Arkadaşım Kanser: Peki şimdi ne yapmalı? Kanserli Çocuklara Umut Vakfı. https://kacuv.org/arkadasim-kanser/
38. Kates, N. (2002). Shared mental health care: The way ahead. Canadian Family Physician, 48, 853–861. Katz, E. R., Varni, J. W., Rubenstein, C. L., Blew, A., & Hubert, N. (1992). Teacher, parent, and child evaluative ratings of a school reintegration intervention for children with newly diagnosed cancer. Children’s Health Care, 21, 69–75. https://doi.org/10.1207/s15326888chc2102_1
39. Keeton, V., Soleimanpour, S., & Brindis, C. D. (2012). School-based health centers in an era of health care reform: Building on history. Current problems in pediatric and adolescent health care, 42(6), 132-156. https://doi.org/10.1016/j.cppeds.2012.03.002
40. Kjolhede, C., Brunner, W. M., & Sipple, J. W. (2025). School-based health centers and school attendance in rural areas. JAMA Network Open, 8(5), e2510083-e2510083. https://doi.org/10.1001/jamanetworkopen.2025.10083.
41. LeBaron, S., & Zeltzer, L. (1985). Pediatrics and psychology: A collaboration that works. Journal of Developmental & Behavioral Pediatrics, 6, 157–161.
42. Lewien, C., Genuneit, J., Meigen, C., Kiess, W., & Poulain, T. (2021). Sleep-related difficulties in healthy children and adolescents. BMC pediatrics, 21(1), 82. https://doi.org/10.1186/s12887-021-02529-y
43. Li, J., Chen, Y., Herold, F., Logan, N. E., Brown, D. M., Haegele, J. A., ... & Zou, L. (2025). Linking 24-hour movement behaviour guidelines to core symptoms and school engagement of youth with moderate/severe ADHD. Journal of Affective Disorders, 372, 422-430. https://doi.org/10.1016/j.jad.2024.12.039
44. Madan-Swain, A., Fredrick, L. D., & Wallander, J. L. (1999). Returning to school after a serious illness or injury. In R. T. Brown (Ed.), Cognitive aspects of chronic illness in children (pp. 312–332). Guilford Press.
45. Martínez‐Santos, A. E., Fernandez‐De‐La‐Iglesia, J. D. C., Sheaf, G., & Coyne, I. (2021). A systematic review of the educational experiences and needs of children with cancer returning to school. Journal of advanced nursing, 77(7), 2971-2994. https://doi.org/10.1111/jan.14784
46. MEB (2020). Rehberlik ve Psikolojik Danışma Hizmetleri Yönetmeliği. Resmî Gazete, Sayı: 31213.http://orgm.meb.gov.tr/meb_iys_dosyalar/2020_08/14231603_Rehberlik_ve_Psikolojik_DanYYma_Hizmetleri_YonetmeliYi_2.pdf
47. MEB (2024a). Hastane sınıfları uygulama kılavuzu. https://orgm.meb.gov.tr/meb_iys_dosyalar/2025_01/22121833_12175726_hastanesinifiuygulamakilavuzu.pdf
48. MEB (2024b). 2023–2024 eğitim-öğretim istatistikleri açıklandı. https://www.meb.gov.tr/2023-2024-egitim- ogretim-istatistikleri-aciklandi/haber/34977/tr
49. MEB (2025a). Bilgilendirme Raporu 2024. https://orgm.meb.gov.tr/meb_iys_dosyalar/2025_02/26163736_bilgilendirmeraporu20243.pdf
50. MEB (2025b). Dikkat Eksikliği ve Hiperaktivite Bozukluğu Kılavuzu. https://orgm.meb.gov.tr/meb_iys_dosyalar/2025_01/31172148_dikkateksikligivehiperaktivitebozuklugu.pdf
51. Molu, B., Ücel, B., & Ogulteğin, A. (2024). Sleep hygiene education of senior undergraduate nursing students. Journal of Turkish Sleep Medicine, 11(1), 52–59. https://doi.org/10.4274/jtsm.galenos.2023.03371
52. Moseley, L., & Gradisar, M. (2009). Evaluation of a school-based intervention for adolescent sleep problems. Sleep, 32, 334–341. https://doi.org/10.1093/sleep/32.3.334
53. Owens, J. A. (2009). Neurocognitive and behavioral impact of sleep disordered breathing in children. Pediatric Pulmonology, 44, 417–422. https://doi.org/10.1002/ppul.20981
54. Owens, J. A., & Dalzell, V. (2005). Use of the “BEARS” sleep screening tool in a pediatric residents’ continuity clinic: A pilot study. Sleep Medicine, 6, 63–69. https://doi.org/10.1016/j.sleep.2004.07.015
55. Öğütlü, H., Kütük, Ö. M., Tufan, A. E., Akay, A. P., Gündoğdu, Ö. Y., & Ercan, E. S. (2024). Detect consensus report on ADHD among Turkish youth. Frontiers in Psychiatry, 15:1372341. https://doi.org/10.3389/fpsyt.2024.1372341
56. Pace, T. M., Chaney, J. M., Mullins, L. L., & Olson, R. A. (1995). Psychological consultation with primary-care physicians: Obstacles and opportunities in the medical setting. Professional Psychology: Research and Practice, 26, 123–131.
57. Parmaksız, İ., & Gök, A. (2018). Okul psikolojik danışmanlarının psikolojik danışma ve rehberlik hizmetlerinin yürütülmesinde karşılaştıkları güçlükler. Mehmet Akif Ersoy Üniversitesi Eğitim Fakültesi Dergisi, (47), 247-265. https://doi.org/10.21764/maeuefd.359595
58. Parrillo, E., Petchler, C., Jacobson, L. A., Ruble, K., Paré-Blagoev, E. J., & Nolan, M. T. (2024). Integrative review of school integration support following pediatric cancer. Journal of Cancer Survivorship, 18(2), 325-343. https://doi.org/10.1007/s11764-022-01276-y
59. Perlis, M. I., & Smith, M. T. (2008). How can we make CBT-I and other BSM services widely available? Journal of Clinical Sleep Medicine, 15, 11–13. https://doi.org/10.5664/jcsm.27071
60. Pinquart, M., & Teubert, D. (2012). Academic, physical, and social functioning of children and adolescents with chronic physical illness: a meta-analysis. Journal of pediatric psychology, 37(4), 376. https://doi.org/10.1093/jpepsy/jsr106
61. Power, T. J., DuPaul, G. J., Shapiro, E. S., & Parrish, J. M. (1995). Pediatric school psychology: The emergence of a subspecialty. School Psychology Review, 24(2), 244–257. https://doi.org/10.1080/02796015.1995.12085765
62. Power, T. J., & Blom-Hoffman, J. (2003). The school as a venue for managing and preventing health problems: Opportunities and challenges. In R. Brown (Ed.), Handbook of pediatric psychology in school settings (pp. 57–68). Erlbaum.
63. Power, C., Freeman, N. C., & Costello, S. (2022). ADHD Assessment Recommendations for Children in Practice Guidelines: A Systematic Review. Psych, 4(4), 882-896. https://doi.org/10.3390/psych4040065
64. Rodrigue, J. R. (1994). Beyond the individual child: Innovative systems approaches to service delivery in pediatric psychology. Journal of Clinical Child Psychology, 23(4), 32–39.
65. Rynard, D. W., Chambers, A., Klinck, A. M., & Gray, J. D. (1998). School support programs for chronically ill children: Evaluating the adjustment of children with cancer at school. Children’s Health Care, 27, 31–46. https://doi.org/10.1207/s15326888chc2701_3
66. Segool, N. K., Mathiason, J. B., Majewicz-Hefley, A., & Carlson, J. S. (2009). Enhancing student mental health: Collaboration between medical professionals and school psychologists. NASP Communiqué, 37, 1–4.
67. Selekman, J., Shannon, R. A., & Yonkaitis, C. F. (2019). School nursing: A comprehensive text. FA Davis.
68. Shaw, S. R., & Brown, M. B. (2011). Keeping pace with changes in health care: Expanding educational and medical collaboration. Journal of Educational and Psychological Consultation, 21(2), 79–87. https://doi.org/10.1080/10474412.2011.571549
69. Shaw, S. R., & McCabe, P. C. (2008). Hospital-to-school transition for children with chronic illness: Meeting the new challenges of an evolving health care system. Psychology in the Schools, 45, 74–87. https://doi.org/10.1002/pits.20280
70. Shaw, S. R., Glaser, S. E., & Ouimet, T. (2011). Developing the medical liaison role in school settings. Journal of Educational and Psychological Consultation, 21(2), 106–117. https://doi.org/10.1080/10474412.2011.571479
71. Shaw, S. R., & Woo, A. (2008). Best practices in collaboration with medical professionals. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology-V (pp. 1707–1719). National Association of School Psychologists.
72. Skirrow, P. (2025). Practice Standards for the Assessment of ADHD: A Synthesis of Recommendations From Eight International Guidelines. Journal of the New Zealand College of Clinical Psychologists, 35(1), 96-116. https://doi.org/10.5281/zenodo.16743965
73. Sokol, R. L., Heinze, J., Doan, J., Normand, M., Grodzinski, A., Pomerantz, N., Scott, B. A., Gaswirth, M., & Zimmerman, M. (2021). Crisis interventions in schools: A systematic review. Journal of School Violence, 20(2), 241-260. https://doi.org/10.1080/15388220.2021.1879098
74. Soleimanpour, S. (2020). School-based health centers: At the intersection of health and education. The Journal of Adolescent Health, 67(3), 317–318. https://doi.org/10.1016/j.jadohealth.2020.05.009
75. Stille, C. J., Primack, W. A., McLaughlin, T. J., & Wasserman, R. C. (2007). Parents as information intermediaries between primary care and specialty physicians. Pediatrics, 120, 1238–1246. https://doi.org/10.1542/peds.2007-1112
76. Sürücü, Ö. (2019). Dikkat Eksikliği Hiperaktivite Bozukluğu. Ankara: Bilgi.
77. Taras, H. L., Frankowski, B. L., McGrath, J. W., Mears, C., Murray, R. D., & Young, T. L. (2001). The role of the school nurse in providing school health services. Pediatrics, 108(5), 1231-1232.
78. Tekcan, P., Çalışkan, Z., & Kocaöz, S. (2020). Sleep quality and related factors in Turkish high school adolescents. Journal of Pediatric Nursing, 55, 120-125. https://10.1016/j.pedn.2020.07.020
79. Tonbul, Y., & Altınhan, N. (2019). Hastane okullarindan hastane siniflarina geçişle birlikte ortaya çikan sorunlarin okul yöneticilerinin ve öğretmenlerin görüşleri üzerinden incelenmesi. Milli Eğitim Dergisi, 48(224), 381-396.
80. Tuzgöl-Dost, M. (2020). Okul psikolojik danişmanlarina göre ilkokullardaki rehberlik ve psikolojik danişma hizmetlerinin durumu ve sorunlari. Elektronik Sosyal Bilimler Dergisi, 19(76), 1673-1690. https://doi.org/10.17755/esosder.715029
81. Varni, J. W., Katz, E. R., Colegrove, R., & Dolgin, M. (1993). The impact of social skills training on the adjustment of children with newly diagnosed cancer. Journal of Pediatric Psychology, 18(6), 751–767. https://doi.org/10.1093/jpepsy/18.6.751
82. Volpe, R. J., Heick, P. F., & Guerasko-Moore, D. (2005). An agile behavioral model for monitoring the effects of stimulant medication in school settings. Psychology in the Schools, 42(5), 509–523. https://doi.org/10.1002/pits.20088
83. Wahyu, M. D., Sugimoto, A., Zain, E., Parawansa, F. B. P., Kasahara, H., Yoshinaga, K., & Egawa, J. (2025). Quality appraisal of clinical practice guidelines for attention deficit hyperactivity disorder: a systematic review using the appraisal of guidelines for research and evaluation (AGREE II) instrument. Frontiers in Psychiatry, 16, 1576538. https://doi.org/10.3389/fpsyt.2025.1576538
84. Wendt, R. N., & Zake, J. (1984). Family systems theory and school psychology: Implications for training and practice. Psychology in the Schools, 21, 204–210. https://doi.org/10.1002/1520-6807(198404)21:2<204::AID-PITS2310210212>3.0.CO;2-Z
85. Witko, K. D., Bernes, K. B., & Nixon, G. (2005). Care for psychological problems: Collaborative approach in primary care. Canadian Family Physician, 51, 799–801.
86. Wodrich, D. L., & Landau, S. (1999). School psychologists: Strategic allies of the contemporary practice of primary care pediatrics. Clinical Pediatrics, 38, 597–606. https://doi.org/10.1177/000992289903801005
87. Zins, J. E., & Wagner, D. I. (1997). Health promotion. In G. G. Bear, K. M. Minke, & A. Thomas (Eds.), Children’s needs II: Development, problems, and alternatives (pp. 945–954). National Association of School Psychologists.