Araştırma Makalesi
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Analysis of the Illness Narratives of the Young Cancer Patients on the Basis of Empowerment Approach

Yıl 2009, Cilt: 20 Sayı: 2, 69 - 88, 15.10.2009

Öz

The purpose of this research is to investigate empowerment approach in social work in a sample of young cancer patients and to analyze the illness process from the eyes of individuals. The research method was chosen as qualitative approach. Cancer patients frequently deal with the problems of loss of control and powerlessness, and examining the issue of cancer based on empowerment is to be seen very meaningful and useful for the in-depth analysis of the problem. In the stage of the data collection of the research, the participant observation and in-depth interview techniques were used for discovering power resources and understanding the conceptualization of empowerment of young cancer patients. The dynamics of empowerment process were identified in detail through in-depth interviews with 20 individuals. In order to analyze empowerment process of cancer patient, disempowering or empowering dynamics that were lived in physical, psychological, emotional and spiritual dimensions (internal - intrapersonal) and family system, professional system (intervention – medical treatment), and especially societal and cultural contexts (external – interpersonal) were considered as interrelated and different variables.  Five main attributes of cancer experience in the context of empowerment approach were revealed as the result of the thematic analysis of data. These are as follows; empowerment as the process of change of thought, empowerment as the process of increasing and protecting of belief, empowerment as the process of interaction, empowerment as the process of acquiring knowledge and skills, and empowerment as the process of control. Functioning of each of the five themes differentiates with respect to the needs of individual and nature of his/her illness. The main reason of this differentiation is related to empowerment approach that it is a dynamic conceptual design. Different power dynamics create different effects in every single individual’s inner world. In conclusion, this study puts forth the need of restructuring the relationships that are based on power and authority in this society into patient-centered with various concrete proposals.


Kaynakça

  • Andrykowski, M., Lykins, E. ve Floyd, A. (2008) “Psychological Health in Cancer Survivors”. Seminars in Oncology Nursing, 24(3), 193-201.
  • Appelbaum, S., Hebert, D. ve Leroux, S. (1999) “Empowerment: Power Culture and Leadership - a Strategy or Fad for the Millenium?”. Journal of Workplace Learning: Emp-loyee Counseling Today, 11(7), 233-254.
  • Askheim, O. P. (2003) “Empowerment as Guidance for Professional Social Work: An Act of Balancing on a Slack Rope”. European Journal of Social Work, 6(3), 229-240.
  • Aslan, Ö., Sekmen, K., Kömürcü, Ş. ve Özet, A. (2007) “Kanserli Hastalarda Umut”. C.Ü. Hemşirelik Yüksekokulu Dergisi, 11(2), 18-24.
  • Bandura, A. (1997) Self-Efficacy: The Exercise of Control. New York: W.H. Freeman and Co.
  • Barker, R. L. (1999) The Social Work Dictionary (4th ed.). Washington DC: NASW Press.
  • Beser, N. ve Öz, F. (2003) “Kemoterapi Alan Lenfomalı Hastaların Anksiyete Depresyon Düzeyleri Ve Yaşam Kalitesi”. C.Ü. Hemşirelik Yüksekokulu Dergisi, 7(1), 47-58.
  • Bleyer, A., O’Leary, M., Barr, R. ve Ries, L. A. G. (2006). Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age, Including Seer Incidence and Survival: 1975-2000. Bethesda: National Cancer Institute, NIH Pub.
  • Boehm, A. ve Staples, L. H. (2002) “The Functions of the Social Worker in Empowering: The Voices of Consumers and Professionals”. Social Work, 47(4), 449-460.
  • Bulsara, C., Ward, A. ve Joske, D. (2004) “Haematological Cancer Patients: Achieving a Sense of Empowerment by Use of Strategies to Control Illness”. Journal of Clinical Nursing, 13(2), 251-258.
  • Chang, L., Li, I. ve Liu, C. (2004) “A Study of Empowerment Process for Cancer Patients Using Freire’s Dialogical Interviewing”. Journal of Nursing Research, 12(1), 41-49.
  • Chesney, B. K. ve Cheslar, M. A. (1993) “Activism through Self-Help Group Membership. Reported Life Changes of Parents of Children with Cancer”. Small Group Research, 24(2), 258-273.
  • Erci, B. (2007) “Attitudes Towards Holistic Complementary and Alternative Medicine: A Sample of Healthy People in Turkey”. Journal of Clinical Nursing, 16, 761-768.
  • Foster-Fishman, P. G., Salem, D. A., Chibnall, S., Legler, R. ve Yapchai, C. (1998) “Empirical Support for the Critical Assumptions of Empowerment Theory”. American Journal of Community Psychology, 26(4), 507-536.
  • Freire, P. (2003) Ezilenlerin Pedagojisi (Dilek Hattatoğlu ve E. Özbek, Trans. dördüncü baskı ed.). İstanbul: Ayrıntı Yayınları.
  • Gibson, C. H. (1991) “A Concept Analysis of Empowerment”. Journal of Advanced Nursing, 16(3), 354-361.
  • Gibson, C. H. (1995) “The Process of Empowerment in Mothers of Chronically Ill Children”. Journal of Advanced Nursing, 21(6), 1201-1210.
  • Gilbar, O. ve Zusman, A. (2007) “The Correlation between Coping Strategies, Doctor-Patient/Spouse Relationships and Psychological Distress among Women Cancer Patients and Their Spouses”. Psycho-Oncology, 16(11), 1010-1018. doi: Doi 10.1002/Pon.1168
  • Gray, D. ve Doan, B. (1990) “Empowerment and Persons with Cancer: Politics in Cancer Medicine”. Journal of Palliative Care, 6, 33-45.
  • Gustavsson-Lilius, M., Julkunen, J. ve Hi-etanen, P. (2007) “Quality of Life in Cancer Patients: The Role of Optimism, Hopeless-ness, and Partner Support”. Quality of Life Research, 16(1), 75-87.
  • Gutierrez, L. M. (1990) “Working with Wo-men of Color - an Empowerment Perspective”. Social Work, 35(2), 149-153.
  • Gutierrez, L. M. (1994) “Beyond Coping: An Empowerment Perspective on Stressful Life Events”. Journal of Sociology and Social Welfare, 21, 201-219.
  • Gutierrez, L. M., Parsons, R. J. ve Cox, E. O. (1998) Empowerment in Social Work Practice. Pacific Grove, CA: Brooks-Cole.
  • Gültekin, Z., Pınar, G., Pınar, F., Kızıltan, G., Doğan, N., Algıer, L.ve Diğ. . (2008) “Akciğer Kanserli Hastaların Yaşam Kaliteleri Ve Sağ-lık Bakım Hizmet Beklentileri”. Uluslararası Hematoloji-Onkoloji Dergisi, 18(2), 99-106.
  • Hardy, C. ve Leiba-O’Sullivan, S. (1998) “The Power Behind Empwerment: Implications for Research and Practice”. Human Relations, 51(4), 451-483.
  • Hughes, A., Gudmundsdottir, M. ve Davies, B. (2008) “Exploring Spirituality in Urban Poor Living with Advanced Cancer”. Oncology Nursing Forum, 35(3), 535-535.
  • Işıkhan, V. (2007) “Kanser Ve Sosyal Des-tek”. Toplum ve Sosyal Hizmet, 18(1), 15-29.
  • Işıkhan, V., Kömürcü, Ş., Özet, A. ve diğ. (2005) “The Status of Alternative Treatment in Cancer Patients in Turkey”. Cancer Nur-sing, 28, 355-362.
  • Jones, P. S. ve Meleis, A. I. (1993) “Health Is Empowerment”. Advances in Nursing Science, 15(3), 1-14. Manii, D. ve Ammerman, D. (2008) “Men and Cancer: A Study of the Ne-eds of Male Cancer Patients in Treatment”. Journal of Psychosocial Oncology, 26(2), 87-102. doi: Doi 10.1300/J077v26n02_06
  • Mok, E. (2001) “Empowerment of Cancer Patients: From a Chinese Perspective”. Nursing Ethics, 8(1), 69-76.
  • Mondros, J. ve Wilson, S. (1994) Organizing for Power and Empowerment. New York: Columbia University Press.
  • Özkan, S. (2002). Kanser Hastasında Psikiyatrik Ve Psikososyal Destek. In H. Onat ve M. N. Molines (Eds.), Kanser Hastasına Yak-laşım Tanı, Tedavi Ve Takipte Sorunlar (pp. 345-354). İstanbul: Nobel Tıp Kitabevleri.
  • Page, N. ve Czuba, C. E. (1999) “Empower-ment: What Is It?”. Journal of Extension, 37(5), 24-32.
  • Payne, M. (1997) Modern Social Work Theory. London: Macmillan Press.
  • Pınar, G., Algıer, L., Çolak, M. ve Ayhan, A. (2008) “Jinekolojik Kanserli Hastalarda Yaşam Kalitesi”. Uluslararası Hematoloji-Onkoloji Dergisi, 18(3), 141-149.
  • Pinderhughes, E. B. (1983) “Empowerment for Our Clients and for Ourselves”. Social Casework-Journal of Contemporary Social Work, 64(6), 331-338.
  • Ritchie, J. ve Lewis, J. (2003) Qualitative Research Practice a Guide for Social Science Students and Researchers. London: Sage Publications.
  • Sontag, S. (2003) Metafor Olarak Hastalık Aids Ve Metaforları (O. Akınhay, Trans.). İs-tanbul: Agora Kitaplığı.
  • Spreitzer, G. M., Kizilos, M. A. ve Nason, S. W. (1997) “A Dimensional Analysis of the Relationship between Psychological Empowerment and Effectiveness, Satisfaction, and Strain”. Journal of Management, 23(5), 679-704.
  • Thomas, K. ve Velthouse, B. (1990) “Cognitive Elements of Empowerment: An Interpretive Model Intrinsic Task Motivation”. Academy of Management Review, 15(666-681).
  • Thompson, S. C. (1981) “Will It Hurt Less If I Can Control It? A Complex Answer to a Simple Question”. Psychological Bulletin(90), 390-404. Vachon, M. (2008) “Meaning, Spirituality, and Wellness in Cancer Survivors”. Seminars in Oncology Nursing, 24(3), 218-255.
  • Vaughan-Adams, N. (2007) “Psychological Symptoms in Women with Breast Cancer”. Oncology Nursing Forum, 34(2), 570-573.
  • Zimmerman, M. A. (1995) “Psychological Empowerment: Issues and Illustrations”. American Journal of Community Psychology, 23(5), 581-599.

GENÇ KANSER HASTALARININ HASTALIK ANLATILARININ GÜÇLENDİRME YAKLAŞIMI TEMELİNDE ANALİZİ

Yıl 2009, Cilt: 20 Sayı: 2, 69 - 88, 15.10.2009

Öz

Bu makalede, sosyal hizmet mesleğinde Bu araştırmanın amacı, sosyal hizmette güçlendirme yaklaşımını genç kanser hastaları örneğinde irdelemek ve hastalık sürecini bireylerin gözüyle çok yönlü analiz etmektir. Araştırma yöntemi olarak niteliksel yaklaşım seçilmiştir. Kanser hastaları, hastalık süresince sıklıkla kontrol kaybı ve bunun neden olduğu güçsüzleşme sorunu yaşamaktadırlar ve kanser konusunun güçlendirme yaklaşımı temelinde ele alınması, konuyu derinlemesine analiz edebilmek bakımından son derece anlamlı ve yararlı görülmektedir. Çalışmanın veri toplama aşamasında, genç kanser hastalarının güçlendirme kavramsallaştırmalarının anlaşılması ve güç kaynaklarının keşfedilmesi için katılımcı gözlem ve derinlemesine görüşme tekniklerine başvurulmuştur. 20 bireyle yapılan derinlemesine görüşmeler yoluyla, güçlendirme sürecinin dinamiklerinin ayrıntılı olarak tanımlanması söz konusu olmuştur. 

Kanser hastasının güçlenme sürecini analiz edebilmek için, fiziksel, psikolojik, duygusal ve tinsel boyutlarda (içsel – kişisel) yaşanan güçsüzleştirici veya güçlendirici dinamiklerin yanı sıra, aile sistemi, profesyonel (müdahale-tedavi) sistem ve özellikle toplumsal ve kültürel bağlamlar (dışsal - kişiler arası) birbirleriyle ilişkili ve farklı değişkenler olarak dikkate alınmıştır. Araştırmanın uygulama süreciyle elde edilen verilerin tematik analizi sonucunda, kanser deneyiminin güçlendirme yaklaşımı bağlamında beş temel özelliği ortaya çıkmıştır. Bunlar; düşünsel değişim süreci, inancı artırma ve koruma süreci, etkileşim süreci, bilgi-beceri kazanma süreci ve kontrol sürecidir. Beş temadan her birinin işleyişi bireyin gereksinimlerine ve hastalığının doğasına göre farklılık göstermektedir. 

Bu durumun temel nedeni, güçlendirme yaklaşımının dinamik bir kavramsal tasarım olmasıdır. Farklı güç dinamikleri her bireyin iç dünyasında farklı etkiler yaratmaktadır. Son tahlilde bu çalışma, güç ve yetki ilişkilerine dayalı bu toplumda, kanser bağlamında bu ilişkilerin hasta merkezli olarak yeniden kurgulanması gerektiğini çeşitli somut önerilerle ortaya koymaktadır.

Kaynakça

  • Andrykowski, M., Lykins, E. ve Floyd, A. (2008) “Psychological Health in Cancer Survivors”. Seminars in Oncology Nursing, 24(3), 193-201.
  • Appelbaum, S., Hebert, D. ve Leroux, S. (1999) “Empowerment: Power Culture and Leadership - a Strategy or Fad for the Millenium?”. Journal of Workplace Learning: Emp-loyee Counseling Today, 11(7), 233-254.
  • Askheim, O. P. (2003) “Empowerment as Guidance for Professional Social Work: An Act of Balancing on a Slack Rope”. European Journal of Social Work, 6(3), 229-240.
  • Aslan, Ö., Sekmen, K., Kömürcü, Ş. ve Özet, A. (2007) “Kanserli Hastalarda Umut”. C.Ü. Hemşirelik Yüksekokulu Dergisi, 11(2), 18-24.
  • Bandura, A. (1997) Self-Efficacy: The Exercise of Control. New York: W.H. Freeman and Co.
  • Barker, R. L. (1999) The Social Work Dictionary (4th ed.). Washington DC: NASW Press.
  • Beser, N. ve Öz, F. (2003) “Kemoterapi Alan Lenfomalı Hastaların Anksiyete Depresyon Düzeyleri Ve Yaşam Kalitesi”. C.Ü. Hemşirelik Yüksekokulu Dergisi, 7(1), 47-58.
  • Bleyer, A., O’Leary, M., Barr, R. ve Ries, L. A. G. (2006). Cancer Epidemiology in Older Adolescents and Young Adults 15 to 29 Years of Age, Including Seer Incidence and Survival: 1975-2000. Bethesda: National Cancer Institute, NIH Pub.
  • Boehm, A. ve Staples, L. H. (2002) “The Functions of the Social Worker in Empowering: The Voices of Consumers and Professionals”. Social Work, 47(4), 449-460.
  • Bulsara, C., Ward, A. ve Joske, D. (2004) “Haematological Cancer Patients: Achieving a Sense of Empowerment by Use of Strategies to Control Illness”. Journal of Clinical Nursing, 13(2), 251-258.
  • Chang, L., Li, I. ve Liu, C. (2004) “A Study of Empowerment Process for Cancer Patients Using Freire’s Dialogical Interviewing”. Journal of Nursing Research, 12(1), 41-49.
  • Chesney, B. K. ve Cheslar, M. A. (1993) “Activism through Self-Help Group Membership. Reported Life Changes of Parents of Children with Cancer”. Small Group Research, 24(2), 258-273.
  • Erci, B. (2007) “Attitudes Towards Holistic Complementary and Alternative Medicine: A Sample of Healthy People in Turkey”. Journal of Clinical Nursing, 16, 761-768.
  • Foster-Fishman, P. G., Salem, D. A., Chibnall, S., Legler, R. ve Yapchai, C. (1998) “Empirical Support for the Critical Assumptions of Empowerment Theory”. American Journal of Community Psychology, 26(4), 507-536.
  • Freire, P. (2003) Ezilenlerin Pedagojisi (Dilek Hattatoğlu ve E. Özbek, Trans. dördüncü baskı ed.). İstanbul: Ayrıntı Yayınları.
  • Gibson, C. H. (1991) “A Concept Analysis of Empowerment”. Journal of Advanced Nursing, 16(3), 354-361.
  • Gibson, C. H. (1995) “The Process of Empowerment in Mothers of Chronically Ill Children”. Journal of Advanced Nursing, 21(6), 1201-1210.
  • Gilbar, O. ve Zusman, A. (2007) “The Correlation between Coping Strategies, Doctor-Patient/Spouse Relationships and Psychological Distress among Women Cancer Patients and Their Spouses”. Psycho-Oncology, 16(11), 1010-1018. doi: Doi 10.1002/Pon.1168
  • Gray, D. ve Doan, B. (1990) “Empowerment and Persons with Cancer: Politics in Cancer Medicine”. Journal of Palliative Care, 6, 33-45.
  • Gustavsson-Lilius, M., Julkunen, J. ve Hi-etanen, P. (2007) “Quality of Life in Cancer Patients: The Role of Optimism, Hopeless-ness, and Partner Support”. Quality of Life Research, 16(1), 75-87.
  • Gutierrez, L. M. (1990) “Working with Wo-men of Color - an Empowerment Perspective”. Social Work, 35(2), 149-153.
  • Gutierrez, L. M. (1994) “Beyond Coping: An Empowerment Perspective on Stressful Life Events”. Journal of Sociology and Social Welfare, 21, 201-219.
  • Gutierrez, L. M., Parsons, R. J. ve Cox, E. O. (1998) Empowerment in Social Work Practice. Pacific Grove, CA: Brooks-Cole.
  • Gültekin, Z., Pınar, G., Pınar, F., Kızıltan, G., Doğan, N., Algıer, L.ve Diğ. . (2008) “Akciğer Kanserli Hastaların Yaşam Kaliteleri Ve Sağ-lık Bakım Hizmet Beklentileri”. Uluslararası Hematoloji-Onkoloji Dergisi, 18(2), 99-106.
  • Hardy, C. ve Leiba-O’Sullivan, S. (1998) “The Power Behind Empwerment: Implications for Research and Practice”. Human Relations, 51(4), 451-483.
  • Hughes, A., Gudmundsdottir, M. ve Davies, B. (2008) “Exploring Spirituality in Urban Poor Living with Advanced Cancer”. Oncology Nursing Forum, 35(3), 535-535.
  • Işıkhan, V. (2007) “Kanser Ve Sosyal Des-tek”. Toplum ve Sosyal Hizmet, 18(1), 15-29.
  • Işıkhan, V., Kömürcü, Ş., Özet, A. ve diğ. (2005) “The Status of Alternative Treatment in Cancer Patients in Turkey”. Cancer Nur-sing, 28, 355-362.
  • Jones, P. S. ve Meleis, A. I. (1993) “Health Is Empowerment”. Advances in Nursing Science, 15(3), 1-14. Manii, D. ve Ammerman, D. (2008) “Men and Cancer: A Study of the Ne-eds of Male Cancer Patients in Treatment”. Journal of Psychosocial Oncology, 26(2), 87-102. doi: Doi 10.1300/J077v26n02_06
  • Mok, E. (2001) “Empowerment of Cancer Patients: From a Chinese Perspective”. Nursing Ethics, 8(1), 69-76.
  • Mondros, J. ve Wilson, S. (1994) Organizing for Power and Empowerment. New York: Columbia University Press.
  • Özkan, S. (2002). Kanser Hastasında Psikiyatrik Ve Psikososyal Destek. In H. Onat ve M. N. Molines (Eds.), Kanser Hastasına Yak-laşım Tanı, Tedavi Ve Takipte Sorunlar (pp. 345-354). İstanbul: Nobel Tıp Kitabevleri.
  • Page, N. ve Czuba, C. E. (1999) “Empower-ment: What Is It?”. Journal of Extension, 37(5), 24-32.
  • Payne, M. (1997) Modern Social Work Theory. London: Macmillan Press.
  • Pınar, G., Algıer, L., Çolak, M. ve Ayhan, A. (2008) “Jinekolojik Kanserli Hastalarda Yaşam Kalitesi”. Uluslararası Hematoloji-Onkoloji Dergisi, 18(3), 141-149.
  • Pinderhughes, E. B. (1983) “Empowerment for Our Clients and for Ourselves”. Social Casework-Journal of Contemporary Social Work, 64(6), 331-338.
  • Ritchie, J. ve Lewis, J. (2003) Qualitative Research Practice a Guide for Social Science Students and Researchers. London: Sage Publications.
  • Sontag, S. (2003) Metafor Olarak Hastalık Aids Ve Metaforları (O. Akınhay, Trans.). İs-tanbul: Agora Kitaplığı.
  • Spreitzer, G. M., Kizilos, M. A. ve Nason, S. W. (1997) “A Dimensional Analysis of the Relationship between Psychological Empowerment and Effectiveness, Satisfaction, and Strain”. Journal of Management, 23(5), 679-704.
  • Thomas, K. ve Velthouse, B. (1990) “Cognitive Elements of Empowerment: An Interpretive Model Intrinsic Task Motivation”. Academy of Management Review, 15(666-681).
  • Thompson, S. C. (1981) “Will It Hurt Less If I Can Control It? A Complex Answer to a Simple Question”. Psychological Bulletin(90), 390-404. Vachon, M. (2008) “Meaning, Spirituality, and Wellness in Cancer Survivors”. Seminars in Oncology Nursing, 24(3), 218-255.
  • Vaughan-Adams, N. (2007) “Psychological Symptoms in Women with Breast Cancer”. Oncology Nursing Forum, 34(2), 570-573.
  • Zimmerman, M. A. (1995) “Psychological Empowerment: Issues and Illustrations”. American Journal of Community Psychology, 23(5), 581-599.
Toplam 43 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sosyoloji (Diğer)
Bölüm Makaleler
Yazarlar

Tarık Tuncay Bu kişi benim

Yayımlanma Tarihi 15 Ekim 2009
Gönderilme Tarihi 15 Ağustos 2009
Yayımlandığı Sayı Yıl 2009 Cilt: 20 Sayı: 2

Kaynak Göster

APA Tuncay, T. (2009). GENÇ KANSER HASTALARININ HASTALIK ANLATILARININ GÜÇLENDİRME YAKLAŞIMI TEMELİNDE ANALİZİ. Toplum Ve Sosyal Hizmet, 20(2), 69-88.