Osteoporozda Stresin Psikososyal Boyutlarının İncelenmesi: Sistematik Bir Derleme

Öz

Osteoporoz, çoğu zaman yaşlanmanın kaçınılmaz bir sonucu olarak görülerek göz ardı edilen ve sessizce ilerleyen bir hastalıktır. Ancak hastalığın kemiklerde oluşturduğu hasar ve bununla ilişkili karşılaşılan sorunlar sebebiyle stres bu süreçteki kritik bileşenlerden birisidir. Stresin osteoporoz ile ilişkisini irdeleyen çalışmalarda genellikle stresin biyolojik perspektiften ele alındığı dikkat çeker. Ancak az da olsa stresin psikososyal yönüne değinenlerin de olduğu görülmektedir. Mevcut çalışma bu az sayıdaki araştırmayı yöntemsel ve bulgusal olarak ele almayı amaçlamaktadır. Bu çalışmada PRISMA ilkeleri izlenerek sistematik derleme yöntemi benimsenmiştir. Osteoporoz hastalarının stres yaşantılarını psikososyal açıdan ve orijinal bir araştırma deseniyle ele alan çalışmalar derlemeye dahil edilirken bunu subjektif ölçeklerle ölçmeyen, hastalık grubuna değil farklı örneklemlere odaklanan çalışmaların ise dışlanmasının ardından yedi çalışma derlemede yer almıştır. Bu çalışmaların büyük bir kısmı kadınlarda algılanan yüksek düzeyde stres, düşük sosyal destek ve uzun süreli psikolojik sıkıntının kemik mineral yoğunluğu kaybı ve kırık riskinde anlamlı artışla ilişkili olduğunu bulgulamıştır. Ayrıca araştırmalarda stres osteoporozu doğrudan biyolojik sistemlerde yarattığı disfonksiyonla ve dolaylı olarak riskli davranışlara sebep olmasıyla etkileyebildiği ortaya konmaktadır. Sonuç olarak, osteoporozun yalnızca biyomedikal değil, aynı zamanda psikososyal bir hastalık olarak ele alınması gerektiği gözden kaçmamalıdır. Psikososyal stresin osteoporoz hastalarında değerlendirilmesi ve müdahale stratejilerine entegre edilmesi hem önleyici sağlık hizmetleri hem de hasta yaşam kalitesi açısından büyük önem taşıdığı düşünülmektedir.

Anahtar Kelimeler

• Osteoporoz
• psikososyal stres
• biyopsikososyal kuram.

Examining the Psychosocial Dimensions of Stress in Osteoporosis: A Systematic Review

Abstract

Osteoporosis is a silently progressing disease that is often disregarded as an inevitable consequence of ageing. Stress is critical for osteoporosis as it inflicts damage on bones and related issues. Studies exploring the link between stress and osteoporosis mostly focus on the biological, but a few studies have touched on the psychosocial perspective. The study aimed to examine these studies in terms of methodology and outcomes. A systematic review was conducted following the PRISMA guidelines. Studies that addressed the stress of osteoporosis patients from a psychosocial perspective and with an original research design were included, while did not measure with subjective scales and focused on different samples rather than the clinical group were excluded; finally, seven studies were analysed. Most of these indicated high perceived stress, low social support, and prolonged psychological distress in women were related to a significant increase in bone mineral density loss and fracture risk. Also, studies showed that stress can influence osteoporosis directly, through causing dysfunctional biological systems, and indirectly, by prompting risky behaviours. Hence, these results underline the need to conceptualise osteoporosis not only as a biomedical but also as a psychosocial issue. Assessing the psychosocial stress for osteoporosis patients and integrating it into intervention strategies is considered crucial for preventive healthcare and patients' quality of life.

Keywords

• Osteoporosis
• psychosocial stress
• silent disease
• biopsychosocial model

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