Kanıta Dayalı Bir Psikiyatrik Rehabilitasyon Uygulaması: Hastalık Yönetimi ve İyileşme

Yıl 2021, Cilt: 13 Sayı: 3, 462 - 477, 30.09.2021

Rüveyda Yüksel Hülya Arslantaş

https://doi.org/10.18863/pgy.801117

Öz

Hastalık Yönetimi ve İyileşme (HYİ) iyileşme odaklı yaklaşımı temel alan bir program olarak tasarlanmış müfredat tabanlı bir psikiyatrik rehabilitasyon uygulamasıdır. Son yıllarda iyileşme kavramına ilişkin yapılan tanımlamaların klinik iyileşme ve kişisel iyileşme olmak üzere iki şekilde ele alındığı görülmektedir. 2002 yılında ABD’de ruh sağlığı hizmet sunumunun geliştirilmesi için kurulan komisyon ruhsal sağlık sisteminin kapsamlı bir dönüşüm yapması gerektiği yönünde bir çağrıda bulunmuştur. Bu dönüşümün bir parçası olarak komisyon; ruh sağlığı uzmanlarının tedavi konusunda geleneksel, hiyerarşik karar vermektense hasta ve ruh sağlığı profesyonelleri ile hastanın ruh sağlığı tedavisi ile ilgili işbirliğine dayalı karar vermesine doğru bir geçiş önermiştir. Ayrıca, ruhsal hastalığın tedavisi için kanıta dayalı uygulamalara erişimin geliştirilmesinin önemine vurgu yapmıştır. Hastalık Yönetimi ve İyileşme Programı (HYİP), bireylere psikiyatrik bozukluklarını nasıl yöneteceklerini öğretmek için ampirik olarak desteklenen yöntemleri içeren bir müdahale programı olarak geliştirilmiş ve standartlaştırılmıştır. HYİP kronik ruhsal hastalığı olan bireylere hastalık yönetiminin öğretilmesi üzerine yapılan araştırmaların kapsamlı bir incelemesinden yola çıkarak geliştirilmiştir. Kontrollü 40 çalışmanın gözden geçirilmesiyle hastalık yönetiminin geliştirilmesi için ampirik olarak desteklenen beş yöntem/strateji tanımlanmıştır. Bunlar: psikiyatrik bozukluklar ve tedavisi hakkında psikoeğitim, ilaç uyumunu artırmada bilişsel-davranışçı yaklaşımlar, nüksleri önleme eğitimi, baş etme becerileri eğitimi ve sosyal desteği geliştirmek için sosyal beceri eğitimidir. Bu makalede hastalık yönetimi ve iyileşme odaklı programın ortaya çıkışı, programın işleyişi ve hastalık yönetimi ve iyileşme ile ilgili araştırma örneklerinden söz edilecektir. Derlemenin ülkemizde Hastalık Yönetimi ve İyileşme Programının ruh sağlığı hizmetleri kapsamında uygulanması ve yürütülmesine yol gösterici katkı sağlaması düşünülmektedir.

Anahtar Kelimeler

Kanıta dayalı, Psikiyatrik Rehabilitasyon, Hastalık Yönetimi ve İyileşme

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

YOK

An Evidence-Based Psychiatric Rehabilitation Implementation: Illness Management and Recovery

Öz

Illness Management and Recovery (IMR) is a curriculum based psychiatric rehabilitation intervention which is designed as a program on the basis of a recovery-oriented approach. In recent years, the definitions suggested on the term, recovery, has been seen to be discussed in two ways; clinical recovery and personal recovery. The committee constituted with the aim of developing the mental health service provision in the USA in 2002, issued a call for the necessity for the mental health system’s comprehensive transformation. As a part of this transformation, the committee suggested a move towards mental health specialists’ making decisions related to patient’s mental health treatment in a collaboration with the mental health professionals rather than making conventional, hierarchical decisions. The significance of providing access to evidence-based applications for the treatment of mental illnesses was also stressed. Illness Management and Recovery (IMR) was developed and standardized as a treatment program which comprises empirically supported methods in order to train individuals how to manage their psychiatric disorders. IMR was developed on the basis of an extensive investigation of the researches upon teaching illness management to individuals with chronical mental illnesses. Having reviewed 40 controlled studies, in order to develop illness management, five empirically supported methods/strategies were determined. These are psychoeducation on psychiatric disorders and their treatments, cognitive behavioral approaches on drug compliance, training of preventing relapses, coping skills, and social skills training for developing social support. In this review, the birth of illness management and recovery-oriented program, the process of the program, and research related to illness management and recovery will be depicted. It is expected that the review will instructively contribute to practice and execution of Illness Management and Recovery Program within the scope of mental health services in Turkey.

Anahtar Kelimeler

Evidence-based, Psychiatric rehabilitation, Illness Management and Recovery

Proje Numarası

YOK

Kaynakça

• 1. Achieving the Promise: Transforming Mental Health Care in America. Pub no SMA03-3832. Rockville, Md, Department of Health and Human Services, President’s New Freedom Commission on Mental Health, 2003.
• 2. Anthony WA (1993) Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4):11-23.
• 3. Bartholomew T, Kensler D (2010) Illness management and recovery in state psychiatric hospitals. American Journal of Psychiatric Rehabilitation, 13(2):105-125.
• 4. Bartholomew T, Zenchner M (2014) The relationship of illness management and recovery to state hospital readmission. J Nerv Ment Dis, 202(9):647-650.
• 5. Beentjes TAA, van Gaal BGI, Goossens PJJ, Schoonhoven L (2015) Development of an e-supported illness management and recovery programme for consumers with severe mental illness using intervention mapping, and design of an early cluster randomized controlled trial. BMC Health Serv Res, 16(1):20.
• 6. Brummer JA (2014) Barriers of using illness management and recovery with adults with severe mental illness.
• 7. Dalum HS, Korsbek L, Mikkelsen JH, Thomsen K, Kistrup K, Olander M et al. (2011) Illness management and recovery (IMR) in Danish community mental health centres. Trials, 12(1):195.
• 8. Dalum HS, Waldemar AK, Korsbek L Hjorthoj C, Mikkelsen JH, Thomsen K et al. (2018) Illness management and recovery: Clinical outcomes of a randomized clinical trial in community mental health centers. Plos One, 13(4):e0194027.
• 9. Davidson L (2010) PORT through a recovery lens. Schizophr Bull, 36(1):107-108.
• 10. Department of Health, Mental Health, Drugs and Regions Division, State Government of Victoria. Framework For Recovery-Oriented Practice. 2011.
• 11. Department of Health, Mental Health, Drugs and Regions Division, State Government of Victoria. Framework For Recovery-Oriented Practice, 2011.
• 12. Färdig R, Fredriksson A, Lewander T, Melin L, Mueser KT (2016) Neurocognitive functioning and outcome of the Illness Management and Recovery Program for clients with schizophrenia and schizoaffective disorder. Nord J Psychiatry, 70(6):430-435.
• 13. Färdig R, Fredriksson A, Melin L, Lewander T (2012) Symptom severity and outcome of the Illness Management and Recovery (IMR) program for schizophrenia and schizoaffective disorder.
• 14. Färdig R, Lewander T, Melin L, Folke F, Fredriksson (2011) A randomized controlled trial of the illness management and recovery program for persons with schizophrenia. Psychiatr Serv, 62(6):606-612.
• 15. Fujita E, Kato D, Kuno E, Suzuki Y, Uchiyama S, Watanabe A et al. (2010) Implementing the illness management and recovery program in Japan. Psychiatr Serv, 61(11):1157-1161.
• 16. Garber-Epstein P, Zisman-Ilani Y, Levine S, David R (2013) Comparative ımpact of professional mental health background on ratings of consumer outcome and fidelity in an Illness Management and Recovery Program. Psychiatric Rehabilitation Journal, 36(4):236-242.
• 17. Gingerich S, Mueser KT (2005) Illness management and recovery. In Evidence-Based Mental Health Practice: A Textbook. (Eds RE Drake, MR Merrens, DW Lynde):395-424. New York, NY: Norton.
• 18. Gingerich S, Mueser KT (2010) Illness Management and Recovery Implementation Resource Kit (Revised ed.). Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.
• 19. Hasson-Ohayon I, Roe D, Kravetz S (2007) A randomized controlled trial of the effectiveness of the illness management and recovery program. Psychiatr Serv, 58(11):1461-1466.
• 20. Hasson-Ohayon I, Roe D, Kravetz S (2008) The psychometric properties of the illness management and recovery scale: Client and clinician versions. Psychiatry Research, 160(2):228-235. 21. Jensen SB, Dalum HS, Korsbek L, Hjorthoj C, Mikkelsen JH, Thomsen K et al. (2019) Illness management and recovery: one-year follow-up of a randomized controlled trial in Danish community mental health centers: long-term effects on clinical and personal recovery. BMC Psychiatry. 19(1):65.
• 22. Leamy M, Bird V, Le Boutillier C, Williams J, Slade M (2011) Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6):445-452.
• 23. Levitt AJ, Mueser KT, Degenova J, Lorenzo J, Bradford-Watt D, Barbosa A et al. (2009) Randomized controlled trial of illness management and recovery in multiple-unit supportive housing. Psychiatr Serv, 60(12):1629-1636.
• 24. Mueser KT, Corrigan PW, Hilton DW, Tanzman B, Schaub A, Gingerich S et al. (2002). Psychiatr Serv, 53 10):1272-1284.
• 25. Mueser KT, Deavers F, Penn DL, Cassisi JE (2013) Psychosocial treatments for schizophrenia. Annu Rev Clin Psychol, 9:465-497.
• 26. Mueser KT, Gingerich S, Salyers MP, McGuire AB, Reyes RU, Cunningham H (2005) Illness management and recovery (IMR) scales, Measuring the promise: A compendium of recovery measures. (Eds TMPA Campbell-Orde, J Chamberlin, J Carpenter, HS Leff):32-35. Cambridge, MA: Human Services Research Institute.
• 27. Mueser KT, Gingerich S. (2002) Illness Management and Recovery Implementation Resource Kit. Rockville, Md, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.
• 28. Mueser KT, Meyer PS, Penn DL, Clancy R, Clancy DM, Salyers MP (2006) The Illness Management and Recovery program: rationale, development, and preliminary findings. Schizophrenia Bulletin, 32(suppl 1):732-743.
• 29. Roe D, Hasson-Ohayon I, Salyers MP, Shlomo K (2009) A one year follow-up of illness management and recovery: Participants’ accounts of its impact and uniqueness. Psychiatr Rehabil J, 32(4):285-291.
• 30. Salyers MP, Godfrey JL, McGuire AB, Gearhart T, Rollins AL, Boyle C (2009) Implementing the illness management and recovery program for consumers with severe mental illness. Psychiatr Serv, 60(4):483-490.
• 31. Salyers MP, McGuire AB, Kukla M, Fukui S, Lysaker PH, Mueser KT (2014) A randomized controlled trial of illness management and recovery with an active control group. Psychiatr Serv, 65(8):1005-1011.
• 32. Salyers MP, McGuire AB, Rollins AL, Bond GR, Mueser KT, Macy VR (2010) Integrating assertive community treatment and illness management and recovery for consumers with severe mental illness. Community Ment Health J, 46(4):319-329.
• 33. Salyers MP, Rollins AL, Clendenning D, McGuire AB, Kim E (2011). Impact of Illness Management and Recovery programs on hospital and emergency room use by Medicaid enrollees. Psychiatric Services, 62(5):509-515.
• 34. Shepherd G, Boardman J, Slade M (2008) Making recovery a reality, Sainsbury Centre for Mental Health, London.
• 35. Slade M (2009) 100 ways to support recovery: a guide for mental health professionals. London: Rethink View Article.
• 36. Tan CHS, Ishak RB, Lim TXG, Marimuthusamy P, Kaurss K, Leong JY (2017) Illness management and recovery program for mental health problems: reducing symptoms and increasing social functioning. J Clin Nurs, 26(21-22):3471-3485.
• 37. The President’s New Freedom Commission on Mental Health. Report to the president, 2003. 38. Thoreson A (2012) The outcomes of illness management and recovery on severe mental illness: a client’s perspective. Journal of International Social Issue, 1:53-69.
• 39. van Langen WJM, Beentjes TAA, van Gaal BG, Nijhuis-van der Sanden MWG, Goossens PJJ (2016) How the Illness Management and Recovery Program enhanced recovery of persons with schizophrenia and other psychotic disorders: A Qualitative Study. Archives of Psychiatric Nursing, 30(5):552-557.
• 40. Whitley R, Gingerich S, Lutz WJ, Mueser KT (2009) Implementing the Illness Management and Recovery Program in community mental health settings: Facilitators and Barriers. Psychıatrıc Services, 60(2):202-209.