Psychosocial Aspects of Rehabilitation in Neurodegenerative Diseases and Fields of Approach

Abstract

Psychosocial health is a concept included in definition of health by World Health Organization and corresponds to state of emotional and social well-being. In the context of neurological disorder, psychosocial health refers to social reintegration and psychological adjustment. Studies reporting that neurological diseases are associated with negative psychosocial health outcomes such as a decrease in the quality of life, a decrease in ability to establish and maintain social relationships, and an increase in high levels of depression, stress and anxiety have increased in recent years. Therefore, it is important to consider programs and interventions that can improve the psychosocial health of people with neurodegenerative diseases. Currently, it is not clear which psychosocial approaches can produce definitively positive results. The aim of this study is to examine how being an individual with Multiple Sclerosis and Parkinson's, which are the most common neurodegenerative diseases in the clinic, affects psychosocial health in the rehabilitation process and the existing evidence-based psychosocial approaches. For this purpose, a descriptive review was prepared by scanning English and Turkish articles with keywords on psychotherapeutic, psychosocial and mindfulness-based interventions and stress management, published in the determined databases in the last 10 years. Studies have shown that psychosocial approaches such as interventions for acquisition of social integration and adaptive coping strategies, cognitive and social behavioral therapy methods, concentration and movement-based mind-body exercises are effective in rehabilitation of neurodegenerative diseases. These approaches were reported to have benefits in reducing anxiety, depression and fatigue, improving sleep quality and quality of life, relationships, employment, level of participation, motivation and self-efficacy in exercise and physical activity, improving physical functions, facilitating difficult and personal experiences and adaptation to new life in rehabilitation processes and more evidence-based studies are needed.

Keywords

• Multiple sclerosis
• Parkinson
• psychosocial interventions
• rehabilitation

Nörodejeneratif Hastalıklarda Rehabilitasyonun Psikososyal Yönleri ve Yaklaşım Alanları

Öz

Psikososyal sağlık, Dünya Sağlık Örgütü'nün sağlık tanımı içerisinde yer alan bir kavram olup duygusal ve sosyal açıdan iyi olma halini kapsamaktadır. Nörolojik bozukluk kapsamında psikososyal sağlık ise sosyal bütünleşme ve psikolojik uyumu ifade eder. Nörolojik hastalıkların yaşam kalitesinde, sosyal ilişkiler kurma ve sürdürme yeteneğinde azalma ve yüksek depresyon, stres ve kaygı düzeylerinde artış gibi olumsuz psikososyal sağlık sonuçları ile ilişkili olduğunu bildiren çalışmalar son yıllarda artış göstermektedir. Bu sebeple nörodejeneratif hastalığı olan kişilerin psikososyal sağlığını iyileştirebilecek müdahaleler üzerinde düşünmek önemlidir. Günümüzde hangi psikososyal yaklaşımların kesin olarak olumlu sonuçlar verebileceği açık değildir. Bu çalışmanın amacı klinikte en sık karşılaşılan nörodejeneratif hastalıklar olan Multiple Skleroz ve Parkinson’lu bir birey olmanın rehabilitasyon sürecinde psikososyal sağlığı ne yönde etkilediğini ve kanıta dayalı mevcut psikososyal yaklaşımları irdelemektir. Bu amaçla, belirlenen veri tabanlarında son 10 yılda yayınlanan psikoterapötik, psikososyal ve farkındalık temelli müdahaleler, stres yönetimi ile ilgili anahtar sözcükler ile İngilizce ve Türkçe makaleler makaleler taranarak tanımlayıcı bir derleme hazırlandı. Yapılan çalışmalarda sosyal bütünleşmenin ve uyumlu başa çıkma stratejilerinin kazanılmasına yönelik müdahaleler, bilişsel ve sosyal davranışçı terapi yöntemlerinin, konsantrasyon ve hareket temelli zihin beden egzersizlerinin uygulanması gibi psikososyal yaklaşımların nörodejeneratif hastalıkların rehabilitasyonunda etkili olduğu görülmüştür. Bu yaklaşımların anksiyete, depresyon ve yorgunluğu azaltmada, uyku kalitesi ve yaşam kalitesini, ilişkileri, istihdamı, egzersiz ve fiziksel aktiviteye katılım düzeyi, motivasyonu ve öz-yeterliliğini artırmada, fiziksel fonksiyonları iyileştirmede, yaşanan zor ve kişisel deneyimleri ve yeni yaşama adaptasyonu kolaylaştırmada faydaları olduğu ve daha fazla kanıta dayalı çalışmalara ihtiyaç olduğu bildirilmiştir.

Anahtar Kelimeler

• Multiple skeroz
• Parkinson hastalığı
• Psikososyal müdahaleleri
• Rehabilitasyon

Kaynakça

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