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Yıl:2010; Cilt: 1; Sayı: 1>> Özet
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Psikiyatri Hemşireliği Dergisi; 2010;1(1):33-38
Kişilik Bozuklukları ve Hemşirelik Girişimleri - Bölüm I
N Eren
İstanbul Üniversitesi İstanbul Tıp Fakültesi,
Kişilik, bireyin her işlevinde otomatik olarak kendini gösteren, kolayca değişmeyen, büyük ölçüde bilinçdışı olarak kazanılmış davranış örüntüleri, algılama ve düşünme biçimleridir. Kişiliğin sağlıklı bir biçimde gelişip olgunlaşması, genetik, ailesel, çevresel birçok faktörden etkilenen, karmaşık, bazen risklerle dolu yaşam süreçlerinden geçerek gerçekleşir. Bu süreçler boyunca yaşanan eksiklikler/travmalar/bozukluklar, ruhsal yapıyı oluşturan birçok parçanın bütünleşmesini (integration) engelleyerek, kişiliğin yapılanmasında bozuklukların gelişmesine yol açabilir. Kişilik bozukluklarının tedavisinde psikoterapi esas olmak üzere, ilaç ve gerektiğinde hastane tedavisi birlikte kullanılır ve genellikle iyileşme uzun bir süreci kapsar. Sık hastaneye yatış gerekebilir. Yataklı servislerde kişilik bozukluğu gösteren hastalarla çalışmak, tüm tedavi ekibi ve 24 saat bakım vermekte olan hemşireler için zorluklar içerir. Bunların en başında ?terapötik çerçeveyi? (nerede, ne zaman ve ne kadar süreyle görüşüleceği, hastanın ve terapistin üzerlerine düşen görevler gibi anlaşmaları içeren, tedaviyle ilgili düzenlemeler tarafından yaratılan psikanalitik/psikoterapötik ortam) korumakta yaşanan sorunlar gelir. Hemşireler bu hastalara özgü geliştirdikleri bakım planları ile çerçeveyi koruyarak terapötik ilişkiyi oluşturabilirler. Bu derleme, kişilik bozukluğu gösteren hastalarla çalışan hemşirelere ve psikiyatri hemşireliği öğrencilerine rehber oluşturmak üzere iki bölüm olarak planlanmıştır. Birinci bölümünde, kişilik bozuklukları, klinik görünüm ve tedavi süreçleri, ikinci bölümde ise en sık görülen hemşirelik tanıları, hedefler ve hemşirelik girişimleri hakkında bilgi verilmesi amaçlanmıştır.
Personality Disorders and Nursing Interventions - Part I
Personality is, for the most part, unconsciously acquired behavioral patterns and manner of perception and thought. It manifests itself automatically in every function of the individual and does not change easily. The healthy development of personality passes through complicated and sometimes risky processes that are affected by a number of factors, such as genetic, family and environmental factors. The deficiencies, traumas and disorders that are experienced during these processes may cause disorders in personality development by hindering the integration of many parts that constitute psychological structure. The treatment of personality disorders involves, primarily, psychotherapy, but medication and, if necessary, hospitalization together with medication might be employed. The recovery in general is a long process. Frequent hospitalization might be necessary. Working with inpatients with psychological disorders has its own drawbacks for the psychiatric team and nurses who provide for their full-time care. The foremost of these is the difficulties faced in maintaining the therapeutic framework, which is the psychoanalytic/psychotherapeutic environment created by the treatment arrangements and involving the agreements regarding the duties of the patient and the therapist, and the place, time and duration of interviews. Nurses can foster this therapeutic relationship by special patientbased care plans that also maintain the framework. This review contains two parts that are intended to guide the nurses who work with patients with personality disorders and the psychiatric nursing students. In the first section, we aimed to provide information on personality disorders, the clinical features and treatment process. The second part addresses the most frequently seen nursing diagnoses, goals and nursing interventions.

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