A Self-Care Deficiency Syndrome: Self-Neglect

Abstract

Self-neglect is the individual's failure to show the necessary attention and care in his own care. Self-neglect manifests itself as non-adherence to treatment, failure to maintain personal and environmental hygiene, and maladaptive health behaviours. At the global level, although self-neglect is frequently seen especially in the elderly population, it is seen in all age groups and especially in disease groups where disability is in question and their caregivers. Self-neglect, which is divided into two categories as intentional and unintentional, is an important cause of morbidity and mortality. Failure to maintain accepted self-care standards caused by self-neglect threatens not only personal but also public health and well-being and increases the burden of health services and health care costs. Self-neglect is difficult to detect because individuals are isolated and do not have the risk of directly harming themselves. Due to reasons such as non-compliance with current treatment, ineffective health management, these individuals' access to the health system is disrupted and the diagnosis and intervention of self-neglect is delayed because they only apply to health services in emergencies. Health professionals working in the field of public health and mental health, especially community mental health professionals, have important responsibilities for the diagnosis and intervention of self-neglect.

Keywords

• self-care
• self-neglect
• mental health
• intervention

Bir Öz Bakım Eksikliği Sendromu: Öz-İhmal

Öz

Öz-ihmal, bireyin kendi bakımında gerekli dikkat ve özeni göstermemesidir. Öz-ihmal tedaviye uyumsuzluk, kişisel ve çevresel hijyeni sürdürememe, uyumsuz sağlık davranışları şeklinde kendini göstermektedir. Küresel düzeyde, öz-ihmal özellikle yaşlı nüfusta sıklıkla görülmekle birlikte her yaş grubunda ve özellikle yeti yitiminin söz konusu olduğu hastalık grupları ve bakım verenlerinde karşılaşılmaktadır. İstemli ve istemsiz olarak iki kategoriye ayrılan öz-ihmal önemli bir morbidite ve mortalite nedenidir. Öz-ihmalin neden olduğu kabul gören öz-bakım standartlarının sürdürülememesi yalnızca kişisel değil toplum sağlığı ve refahını tehdit etmekte ve sağlık hizmetlerinin yükünü ve sağlık bakım maliyetlerini de arttırmaktadır. Bireylerin izole ve doğrudan kendilerine zarar verme riski taşımamaları nedeniyle öz-ihmalin tespiti güçtür. Mevcut tedaviye uyumsuzluk, sağlığı etkisiz yönetme gibi nedenlerle bu bireylerin sağlık sistemine girişleri aksamakta ve yalnızca acil durumlarda sağlık hizmetlerine başvurmaları nedeniyle öz-ihmalin tanılanması ve müdahalesi gecikmektedir. Öz-ihmalin tanılanması ve müdahalesi için özellikle toplum ruh sağlığı profesyonelleri başta olmak üzere halk sağlığı ve ruh sağlığı alanında çalışan sağlık profesyonellerine önemli sorumluluklar düşmektedir.

Anahtar Kelimeler

• öz bakım
• öz-ihmal
• ruh sağlığı
• müdahale

Kaynakça

1. Barry MM, Jenkins R. (2007) Mental health promotion within mental health services. In Implementing Mental Health Promotion (Eds. MM Barry, AM Clarke, I Peterson, R Jenkins): 505-562. Oxford, Churchill Livingstone.
2. Braye S, Orr D, Preston-Shoot M (2011) Conceptualising and responding to self-neglect: the challenges for adult safeguarding. J Adult Protect, 13:182-193.
3. Braye S, Orr D, Preston-Shoot M (2014) Self-Neglect Policy And Practice : Building An Evidence Base For Adult Social Care. London, Social Care Institute for Excellence.
4. Burnett J, Regev T, Pickens S, Prati LL, Koko, A, Moore J et al. (2008) Social networks: A profile of the elderly who self- neglect. J. Elder Abuse Negl, 18:35-49.
5. Choi NG, Kim J, Asseff J (2009) Self-neglect and neglect of vulnerable older adults: reexamination of etiology. J Gerontol Soc Work, 52:171-187.
6. Cotton MA, Johnson S, Bindman J, Sandor A, White IR, Thornicroft G et al. (2007) An investigation of factors associated with psychiatric hospital admission despite the presence of crisis resolution teams. BMC Psychiatry, 7:52.
7. Day MR (2010) Self-neglect: A challenge and a dilemma. Arch Psychiatr Nurs, 24:73-75.
8. Day MR, Leahy-Warren P (2008a) Self-neglect 1: Recognising features and risk factors. Nursing Times, 104:26-27.

9. Day MR, Leahy-Warren P (2008b) Self-neglect 2: Nursing assessment and management. Nursing Times, 104:28-29.
10. Day MR, Leahy-Warren P Mccarthy G (2016) Self-neglect: ethical considerations. Annu Rev Nurs Res, 34:89-107.
11. Day MR, Mccarthy G (2016) Self-neglect : Development and evaluation of a self-neglect (SN-37) measurement ınstrument. Arch Psychiatr Nurs, 30:480-485.
12. Dong X, Simon M, Fulmer T, Beck T, Hebert L, Dyer C et. al. (2009) Elder self-neglect and abuse and mortality risk in a community-dwelling population. JAMA, 302:517-526.
13. Dong X, Simon M, Beck T, Evans D (2010a) A cross-sectional population-based study of elder self-neglect and psychological, health, and social factors in a biracial community. Aging Ment Health, 14:74-84.
14. Dong X, Simon MA, Wilson RS, Mendes DE, Leon CF, Rajan KB, Evans DA (2010b) Decline in cognitive function and risk of elder self‐neglect: Finding From The Chicago Health Aging Project. J Am Geriatr Soc, 58:2292-2299.
15. Dong X, Simon MA, Evans DA (2012a) Prospective study of the elder self-neglect and ED use in a community population. Am J Emerg Med, 30:553-561.
16. Dong X, Simon MA, Evans DA (2012b) Prevalence of self-neglect across gender, race, and socioeconomic status: Findings from the chicago health and aging project. Gerontology, 58:258-268.
17. Dong X, Simon MA (2013) Association between elder self-neglect and hospice utilization in a community population. Arch Gerontol Geriatr, 56, 192-198.
18. Dong X, Simon M, Evans D (2013) Elder self-neglect ıs associated with ıncreased risk for elder abuse in a population: Findings from the chicago health and aging project. J Aging Health, 25:80-96.
19. Dong X (2016) Sociodemographic and socioeconomic characteristics of elder self-neglect in an us chinese aging population. Arch Gerontol Geriatr, 64:82-89.
20. Dong X (2017) Elder self-neglect: Research and practice. Clin Interv Aging, 12:949-954.
21. Dyer CB (2005) Neglect assessment in elderly persons. J Gerontol A Biol Sci Med Sci., 60:1000-1001.
22. Dyer CB, Goodwin JS, Pickens-Pace S, Burnett J, Kelly A (2007) Self-neglect among the elderly: a model based on more than 500 patients seen by a geriatric medicine team. Am J Public Health, 97:1671-1676.
23. Dyer CB, Kelly PA, Pavlik VN, Lee J, Doody RS, Regev T et al. (2008) The making of a self-neglect severity scale. J Elder Abuse Negl, 18:13-23.
24. Franzini L, Dyer C (2008) Healthcare costs and utilization of vulnerable elderly people reported to adult protective services for self-neglect. J Am Geriatr Soc, 56:667-676.
25. Gibbons S (2006) Primary care assessment of older adults with self-care challenges. J Nurse Pract, 2:323-328.
26. Gibbons S, Lauder W, Ludwick R (2006) Self-neglect: A proposed new NANDA diagnosis. Int J Nurs Terminol Classif, 17:10-18.
27. Gibbons SW (2009) Theory synthesis for self-neglect: A health and social phenomenon. Nurs Res, 58:194-200.
28. Hansen MC, Flores DV, Coverdale J, Franzcp AE, Burnett J (2016) Correlates of depression in self-neglecting older adults: A cross-sectional study examining the role of alcohol abuse and pain in increasing vulnerability. J Elder Abuse Negl, 28:41-56.
29. Iris M, Ridings JW, Conrad KJ (2010) The development of a conceptual model for understanding elder self-neglect. Gerontologist, 50:303-315.
30. İlhan B, Bahat G, Saka F, Kılıç C, Oren MM, Karan MA (2020) A new screening tool for self-neglect in community-dwelling older adults: IMself-neglect questionnaire. Aging Male. 23:388-395.
31. Johnson YO (2015a) Elder self-neglect : Education is needed. Home Healthc Now, 33:421-424.
32. Johnson YO (2015b) Home care nurses’ experiences with and perceptions of self-neglect. Home Healthc Now, 33:31-37.
33. Kelleci M, Doğan S, Ata EE, Avci D, Sabancioğullari S, Başeğmez F et al. (2011) Ideas regarding psychotropic drug use among inpatients in a psychiatry clinic and after their discharge from the hospital with follow-up by telephone. Journal of Psychiatric Nursing, 2:128-135.
34. Lauder W, Scott P A, Whyte A (2001) Nurses’ judgements of self-neglect: A factorial survey, Int J Nurs Stud, 38:601-608.
35. Lauder W, Roxburgh M (2012) Self-neglect consultation rates and comorbidities in primary care. Int J Nurs Pract, 18:454-461.
36. Lee M, Kim K (2014) Prevalence and risk factors for self-neglect among older adults living alone in south korea. Int J Aging Hum Dev, 78:115-131.
37. Leenaars AA (2010) Edwin S. Shneidman on suicide. Suicidology Online, 1:5-18.
38. Mason K, Evans T (2020) Social work, inter-disciplinary cooperation and self-neglect: exploring logics of appropriateness. Br J Soc Work, 50:664-681.
39. Melekis K. (2017) Self-Neglect: A Statewide Assessment In Vermont. In Self-Neglect in Older Adults: A Global, Evidence-Based Resource for Nurses and Other Healthcare Providers. (Eds. MR Day, G McCarthy JJ Fitzpatrick): 231-239. New York: Springer Publishing Company.
40. Menninger KA (1985) Man against himself. Psychohist Rev, 13:9-14.
41. Miller PH (2008) Gelişim Psikolojisi Kuramları. (Çeviri Ed. B. Onur) Ankara, İmge Kitapevi Yayınları.
42. Naik DA, Lai MJ, Kunik EM, Dyer BC. (2008) Assessing capacity in suspected cases of self-neglect. Geriatrics, 63:24-31.
43. Ortiz N, Lamdan R, Johnson S, Korbage A (2009) Caregiver status:A potential risk factor for extreme self-neglect. Psychosomatics, 50:166-168.
44. O'Connor K. (2017) Self-neglect: An Isssue in Acute Care (In Self-Neglect in Older Adults: A Global, Evidence-Based Resource for Nurses and Other Health Care Providers (Eds. MR Day, G McCarthy, JJ Fitzpatrick): 114-130. New York: Springer Publishing.
45. Özmete E, Duru S, Yıldırım H (2018) Elder self-neglect scale: The adaptation study into Turkish. Anadolu Psikiyatri Derg, 19:87-95.
46. Pavlou MP, Lachs MS (2008) Self-Neglect in older adults: A primer for clinicians. J Gen Intern Med, 23:1841-1846.
47. Reed GP, Leonard VE (1989) An analysis of the concept of self-neglect. ANS Adv Nurs Sci, 12:39-53.
48. Reyes-Ortiz CA, Burnett J, Flores DV, Halphen JM, Dyer CB (2014) Medical implications of elder abuse: Self-neglect. Clin Geriatr Med, 30:807-823.
49. Rosen T, Lien C, Stern ME, Bloemen EM, Mysliwiec R, Mccarthy TJ et al. (2017) Emergency medical services perspectives on identifying and reporting victims of elder abuse, neglect, and self-neglect. J Emerg Med, 53:573-582.
50. Yu M, Gu L, Jiao W, Xia H, Wang W (2019) Predictors of self-neglect among community-dwelling older adults living alone in China. Geriatr Nurs, 40:457-462.