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Yıl:2013; Cilt: 14; Sayı: 2>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2013;14(2):108-114
Bolu toplum ruh sağlığı merkezi hizmetlerinin şizofreni hastalarındaki yaşam kalitesi, yetiyitimi, genel ve sosyal işlevsellik üzerine etkisi: Bir yıllık izlem sonuçları
H Ensari, BK Gültekin, D Karaman, A Koç, AF Beşkardeş
Bolu İzzet Baysal Ruh Sağlığı ve Hastalıkları Hastanesi, Bolu
Amaç: Dünyada yeti yitimi ve erken ölüme en sık yol açan 10 hastalıktan beşi psikiyatrik bozukluklardır. Şizofreni, yaşam kalitesi, sosyal işlevsellik ve yeti kaybına yol açan önemli psikiyatrik bozukluklardan biridir. Son yıllarda şizofreni hastalarının tedavisinde ilaç tedavisiyle birlikte ruhsal toplumsal tedavi yaklaşımlarının da oldukça yararlı olduğu ortaya çıkmıştır. Bu çalışmada Türkiye’de ilk defa Bolu’da kurulan Toplum Ruh Sağlığı Merkezi’nde şizofreni hastalarına yönelik verilen hizmetlerin yaşam kalitesi, yeti yitimi, genel ve sosyal işlevsellik üzerine etkisi araştırılmıştır. Yöntem: Çalışmaya 15 Ağustos 2009-15 Ağustos 2010 tarihleri arasında Bolu İzzet Baysal Ruh Sağlığı ve Hastalıkları Hastanesi’ne bağlı olarak açılmış olan Toplum Ruh Sağlığı Merkezi’ne düzenli olarak gelen 30 hasta alındı. Katılımcılara Toplum Ruh Sağlığı Merkezi’ne ilk kayıt oldukları zaman ve bir yıllık düzenli izleme sonrasında Şizofreni Hastaları İçin Yaşam Niteliği Ölçeği, İşlevselliğin Genel Değerlendirmesi Ölçeği, Sosyal İşlevsellik Ölçeği ve Yeti yitimi Değerlendirme Çizelgesi uygulandı. Sonuçlar: Bolu Toplum Ruh Sağlığı Merkezi’ne bir yıl düzenli gelen şizofreni hastalarının izleme sonrası yaşam kalitesinin tüm alan puanlarında istatistiksel olarak anlamlı artış saptandı. Yeti yitim puanının 44.8±7.7'den 27.6±6.3'e düştüğü görüldü. Katılımcıların başlangıçta genel işlevsellik puanı 29.2±10.7 iken; 1 yıl sonra 58.7±11.5 puana yükseldi. Sosyal işlevsellik ölçeğinin tüm alt puanlarında başlangıca göre istatistiksel olarak anlamlı bir artış saptandı. Tartışma: Türkiye’de ilk kez açılmış olan Bolu Toplum Ruh Sağlığı Merkezi Hizmetleri’nin şizofreni hastalarının yaşam kalitesini artırmada, yeti kaybını azaltmada ve işlevselliklerini artırmada oldukça yararlı olduğu bulundu. Toplum ruh sağlığı merkezlerinin tüm Türkiye’ye yaygınlaştırılması ve işlevselliklerinin artırılmasının faydalı olacağı düşünüldü.
The effects of the service of community mental health center on the patients with schizophrenia - evaluation of quality of life, disabilities, general and social functioning- a summary of one year follow-up
Objective: In the world, 5 out of 10 diseases that cause disability and early death are psychiatric diseases. Schizophrenia is one of the most important diseases that cause loss in quality of life, social skills and general abilities. In recent years, psychosocial treatment approaches have become more popular and have been understood as more useful in addition to biological treatment in patients with schizophrenia. In this study, we aimed to evaluate the effects of the rehabilitation services on the schizophrenic patients over the effects of quality of life, disabilities, general and social functioning in Turkey’s first constructed Community Mental Health Center (CMHC) in Bolu. Methods: A total of 30 schizophrenia patients who came regularly to the center between 15 August 2009 and 15 August 2010 were included in the study. The scales ‘Quality of Life for Patients with Schizophrenia’, ‘Global Assessment of Functioning’, ‘The Social Functioning Scale’, ‘World Health Organization-Disability Assessment Schedule’ have been applied to the patients at their first admittance to the center and after one year regular attendance to the center. Results: Highly significant increases have been determined in the patients in all the areas of Quality Of Life, after 1 year regular participation to the rehabilitation activities of the CMHC. Disability measures were 44.8±7.7 in the beginning and have decreased to 27.6±6.3. The measures in the Global Assessment Of Functioning were 29.2 ± 10.7 at the beginning and 58.7±11.5 after one year follow up. In all the subscales of Social Functioning Scale, significant increases have been determined after one year regular follow up when compared with the initial measures. Discussion: It was found that Bolu Community Mental Health Center which is founded for the first time in Turkey is helpful in increasing life quality of patients with the diagnosis of schizophrenia, decreasing loss of ability and increasing functionality. It was thought that becoming widespread of community mental health centers throughout Turkey and increasing their functionality would be beneficial.

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