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Yıl:2017; Cilt: 7; Sayı: 4>> Özet
Psikiyatride Güncel; 2017;7(4):338-346
Örselenmiș hastaya poliklinik koșullarında yaklașım
Z Oğlağu
İstanbul Eğitim ve Araștırma Hastanesi
Dünya her geçen gün daha çok şiddetin, çatışmanın ve örseleyici olayın yaşandığı bir yer haline gelmekte iken ruh sağlığı uzmanları olarak bizlerin omuzladığı yük de günbegün artmaktadır. Fiziksel ve ruhsal olarak örseleyici nitelikteki bir olay, her bireyde ruhsal etkilenmeye veya aynı ağırlıkta/ özellikte etkilenmeye neden olmamakla birlikte, bazı belirti kümelerine oldukça sık rastlanır. Birçok gelişmiş ülkede örselenmiş hastalar ile çalışan özelleşmiş ve deneyimli merkezler bulunurken, kitlesel ve kişilerarası şiddetin oldukça sık görüldüğü ülkemizde bu merkezlerin sayısı bir elin parmaklarını geçmeyecek kadardır. Bu yazıda, çoğumuzun çalıştığı poliklinik koşullarında hemen her gün karşılaş- tığımız travmatik olay yaşamış/örselenmiş hastalar ile çalışmanın bazı ayrıntıları kısaca ele alınmaya çalışılmıştır. Öncelikli olarak çocukluk çağı istismarı, cinsel saldırı, yakın partner şiddeti, işkence, savaş, mültecilik ve göç, doğal afetler, kitlesel şiddet, yabancıdan fiziksel şiddet, iş kazaları, trafik kazaları, taşımacılık kazaları, yaşamı tehdit eden hastalıklar, tıbbi durumlar ve yanıklar, acil durum çalışmaları vb. örseleyici durumlardan ve bunların insan üzerindeki etkilerinden söz edilecek, daha sonra genel görüşme ilkelerine ilişkin bilgi ve deneyim paylaşılacak, yapılması gerekenler kadar yapılmaması gerekenler hakkında da önerilerde bulunulacak ve bir olgu örneği verilecektir. Poliklinik koşullarında travma mağdurları ile çalışmak zorlayıcı, yorucu ve çoğu zaman yıpratıcı olmakla birlikte imkansız değildir. Mahremiyet, güvenlik, eşduyum ve yeterli işbirliği varlığında birçok mağdurun iyileşmesine tanıklık etmek mümkün olmaktadır.
Clinical approach to trauma survivors at outpatient unit conditions
With each passing day, as the world is becoming more of a place where violence, conflict and traumatizing events are common, the burden that we shoulder as mental health experts increase day by day. A physically and/or psychologically traumatizing event does not psychologically affect every individual to the same extent. However, some symptom clusters are seen commonly after trauma. While many developed countries have specialized and experienced centers working with traumatized patients, in our country, where mass and interpersonal violence are frequent, one can count the number of these centers on the fingers of one hand. In this paper, some details of working with trauma survivors are summarized. Firstly, traumatizing conditions such as childhood abuse, sexual assault, close partner violence, torture, war situations, displacement, asylum and immigration, natural disasters, occupational accidents, traffic accidents, transportation accidents, life threatening diseases, medical conditions and burns, emergency work and their effects on humans will be mentioned. Then knowledge and experience on general interviewing techniques will be shared including suggestions about what to do and what not to do. A short case discussion will follow. Working with survivors of trauma in outpatient clinic conditions is challenging, tiring, and often impractical, although not impossible. It will be possible to witness the recovery of many survivors in the presence of confidentiality, security, empathy and adequate co-operation.

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