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Yıl:2020; Cilt: 11; Sayı: 3>> Özet
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Psikiyatri Hemşireliği Dergisi; 2020;11(3):239-250
Hemşirelik girişimi olarak hayvan destekli uygulamaların kullanımı: Sistematik derleme
Ş Demiralay, İ Keser, S Çaynak
Akdeniz Üniversitesi, Antalya
GİRİŞ ve AMAÇ: Hemşirelik bakımının planlamasında “Hemşirelik Girişimleri Sınıflaması” kullanılır. Bu sınıflamada yer alan bir girişim olan hayvan destekli uygulama, dünyada yaygın olarak kullanılan ancak ülkemizde kullanımı sınırlı bir tedavi yöntemidir. Günümüzde çeşitli gruplarda destek amaçlı uygulanan hayvan destekli uygulamalar, sağlığı koruma ve geliştirmeyi sağlayan, uygulanan diğer tedavilere ek bir müdahale seçeneğidir. Bu sistematik derlemede, hemşirelik girişimi olarak hayvan destekli uygulamaların kullanıldığı randomize kontrollü çalışmaların incelenerek, hayvan destekli uygulama prosedürü ve yapılan müdahalelerin etkilerinin belirlenmesi aynı zamanda konu hakkında literatüre katkı sağlaması amaçlanmıştır. YÖNTEM ve GEREÇLER: Konuyla ilgili yıl sınırlaması yapılmadan, veri tabanları incelenmiş ve 1985 çalışmaya ulaşılmıştır. CINAHL, Cochrane Central, Medline/ Pubmed, Web of Science, Science Direct’te “animal assisted therapy” or “animal assisted therapies” or “pet therapy” or “pet therapies” and “nursing”, YÖK Ulusal Tez Merkezi ve ULAKBİM elektronik veri tabanlarında ise, “hayvan destekli uygulama”, “hayvan destekli terapi” ve “hemşirelik” anahtar kelimeler kullanılarak tarandı. Dahil edilme kriterlerine uyan 6 randomize kontrollü çalışma araştırma kapsamına alındı. Çalışmalar örneklem özellikleri, araştırmada kullanılan hayvan türü, uygulama merkezi, kullanılan ölçüm araçları ve elde edilen sonuçlar açısından değerlendirildi. BULGULAR: Yayınların tamamı son altı yıl içinde yapılmıştı. Randomize kontrollü çalışmalarda örneklemin %66.66’sını yaşlıların, %16.67’sini yetişkinlerin, %16.67’sini ergenlerin oluşturduğu saptandı. Çalışmaların, yaşlı bakımevi (%33.33), hastane (%33.33), gündüz yaşlı bakım merkezi (%16.67) sağlık merkezi ve hastaneler (%16.67) gibi farklı kurumlarda gerçekleştirildiği, müdahale programları kapsamında canlı hayvan olarak köpek, robotik evcil hayvan, insansı robot ve robotik evcil hayvanın kullanıldığı tespit edildi. Yapılan müdahalenin etkinliğini değerlendirmek için farklı ölçüm araçlarının kullanıldığı görüldü. Hayvan destekli uygulamaların, stresi, analjezik ilaç kullanımını azalttığı, yaşam bulgularını olumlu yönde etkilediği, ruhsal bozuklukların tedavisinde diğer tedavilere destek sağladığı, benlik saygısını, sosyal etkileşimi ve yaşam kalitesini arttırdığı saptandı. TARTIŞMA ve SONUÇ: Çalışma sonuçları, hemşirelik müdahalesi olarak kullanılan hayvan destekli uygulamaların etkin bir müdahale yöntemi olduğunu ortaya koymaktadır. Ancak, hayvan destekli uygulamaların etkinliğini ortaya koyan randomize kontrollü çalışmaların sınırlı olduğu, ülkemizde ise henüz yapılmış bir çalışma olmadığı tespit edilmiştir. Hemşirelik girişimi olarak hayvan destekli tedavinin uygulanacağı çalışmaların yapılması ve çalışma sonuçlarının literatüre kazandırılmasının önemli olduğu düşünülmekte ve hemşirelik araştırmalarında hayvan destekli uygulamalara daha fazla yer verilmesi önerilmektedir.
The use of animal-assisted practices as a nursing intervention: A systematic review
INTRODUCTION: The Nursing Interventions Classification is used for planning nursing care. Animal-assisted practices, an intervention within this classification, is a treatment method that is widely used around the world. However, its use is limited in Turkey. Animal-assisted practices, which are used to support various groups today, constitute an intervention option in addition to medical treatments, ensuring health protection and promotion. This systematic review aims to analyze the randomized controlled studies that used animal-assisted practices and to determine the effects of this procedure and the interventions made, thereby contributing to the literature. METHODS: The databases on this subject were analyzed without any limitations on the publication year, and a total of 1,985 studies were accessed. The search was made using the keywords “animal assisted therapy,” “animal assisted therapies,” “pet therapy,” “pet therapies,” and “nursing” in the CINAHL, Cochrane Central, Medline/Pubmed, Web of Science, and Science Direct; and the keywords “hayvan destekli uygulama,” “hayvan destekli terapi,” and “hemsirelik” in the electronic databases of the National Thesis Center of the Council of Higher Education and the ULAKBIM. Six randomized controlled studies that met the inclusion criteria were included in the study. These six studies were evaluated in terms of the characteristics of their samples, the animals used, the place of the practice, the measurement tools, and their results. RESULTS: All studies were conducted in the last six years. In the randomized controlled studies, the sample comprised 66.66% old people, 16.67% adults, and 16.67% adolescents. The studies were conducted in elderly care centers (33.33%), hospitals (33.33%), elderly day care center (16.67%), and healthcare centers and hospitals (16.67%); they used dogs (as live animal), robotic pets, and humanoid robots within the scope of the intervention programs. They used different measurement tools to evaluate the effectiveness of the intervention. Animal-assisted practices were found to reduce stress and the use of analgesics, positively affect vital signs, support other treatments for mental diseases, and increase self-esteem, social interaction, and quality of life. DISCUSSION AND CONCLUSION: The results of this study showed that animal-assisted practices were an effective nursing intervention. However, it was found that randomized controlled studies indicating the effectiveness of animal-assisted practices were limited, and that no studies have been conducted in Turkey on this subject. It is suggested that studies should be conducted which use animal-assisted treatment as a nursing intervention, the results of which would further contribute to the literature. It is recommended that animal-assisted practices should be included more in nursing studies.

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