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Yıl:2019; Cilt: 30; Sayı: 3>> Özet
TAM METİN
Türk Psikiyatri Dergisi; 2019;30(3):180-190
Şizofreni Hastalarının İhtiyaçları ve Öngörülebilirliği
AB Uygur, AE Danacı
Alaaddin Keykubat Üniversitesi, Antalya
Amaç: Bu çalışmada amacımız, şizofreni hastalarının ihtiyaçlarını tespit etmek ve bu ihtiyaçlar ile ilişkili sosyodemografik ve klinik değişkenleri belirleyebilmektir. Yöntem: Çalışma, DSM-IV-TR tanı ölçütlerine göre, şizofreni tanısı olan 94 hasta ve bakım verenleriyle gerçekleştirilmiştir. Hastaların ihtiyaçları, hem hasta hem de bakım veren görüşlerini yansıtan Camberwell İhtiyaçları Değerlendirme Ölçeği (CİDÖ) temel alınarak değerlendirilmiştir. Veri toplama aracı olarak, CİDÖ’ye ek olarak, Pozitif ve Negatif Sendrom Ölçeği, Calgary Şizofrenide Depresyon Ölçeği, Bireysel ve Sosyal Performans Ölçeği, Şizofreni Hastaları için Yaşam Niteliği Ölçeği ve Algılanan Aile Yükü Ölçeği kullanılmıştır. Bulgular: ‘Psikotik belirtiler’ en çok tespit edilen ihtiyaç olarak öne çıkarken, ‘Para ve ilişkiler’ ise, hastaların en mağdur oldukları ihtiyaçlar olarak belirlenmiştir. Kadın olmak, evli olmak, toplum içinde yaşamak, lise ve üstü eğitim düzeyine sahip olmak; daha az ihtiyaçla ilişkili bulunmuştur. Hastaların tespit ettiği ihtiyaçların 45,1, karşılanmayan ihtiyaçlarınsa %23,4’ü öngörülmüştür. Hastalara göre, ‘Calgary Şizofrenide Depresyon Ölçeği ve Algılanan Aile Yükü Ölçeği’; bakım verenlere göreyse, ‘PANSS-Pozitif Belirtiler Ölçeği’ anlamlı yordayıcılar olarak dikkat çekmektedir. Sonuç: Şizofreni hastaları için sadece belirtileri hedef alarak yapılan tedaviler yetersiz kalmaktadır. Tedavi planlaması hastaların ihtiyaçlarına odaklanılarak yapılmalı ve tedavinin merkezinde hastaların tespit ettiği ihtiyaçlar olmalıdır. ‘’İhtiyaç tespiti’’ sadece tedavinin planlanmasında değil aynı zamanda toplum akıl sağlığı hizmetlerinin planlanmasında ve hizmetlerin etkinliğinin arttırılmasında önemli katkı sağlayacaktır.
Needs of Patients with Schizophrenia and Their Predictors
Objective: The aim of this study was to explore the needs of patients with schizophrenia and to determine the sociodemographic and clinical variables associated with these needs. Method: The study was carried out with 94 patients diagnosed with schizophrenia and their primary caregivers. The diagnoses were established based on DSM-IV-TR (American Psychiatric Association 1994) criteria. The patients’ needs were evaluated with the Camberwell Assessment of Needs Scale (CAN), which reflects both the patient and the caregiver views on needs and problems. In addition, the Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, the Personal and Social Performance Scale, the Quality of Life Scale for Schizophrenia and the Perceived Family Burden Scale were used as data collection tools. Results: ‘Psychotic symptoms’ stood out as the most prevalent need to be met. ‘Money’ and ‘intimate relations’ were determined as the needs that the patients suffered most from. Being female, being married, living with families, having high school or higher education were found less associated with the needs. The variables explained 45.1% of the variance in predicting needs and 23.4% in predicting unmet needs. The Calgary Depression Scale for Schizophrenia and Perceived Family Burden Scale were significant predictors for patients and the PANSSPositive Symptoms Scale for caregivers. Conclusion: Any treatment targeting solely the symptoms proves to be insufficient for patients with schizophrenia. Treatment planning should focus on the needs of patients and the needs identified by patients should be at the center of the treatment. A ‘needs assessment’ will make an important contribution not only to the planning of individual treatments but also to the planning of a community mental health services scheme and increasing its effectiveness.

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