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İlk Atak ve Kronik Psikoz Hastalarının Bakım Verenlerinin Duygu İfadelerinin Karşılaştırılması

Year 2022, Volume: 15 Issue: 1, 13 - 21, 15.01.2022
https://doi.org/10.46483/deuhfed.841324

Abstract

Giriş: Bakım verenlerin duygu ifadesinin değerlendirilmesi ruhsal hastalığın sorumluluğunu alan aile bireyinin nasıl etkilenebileceğinin tespit edilmesi ve nüksün önlenebilmesi için önemlidir. Amaç: Araştırma, ilk atak ve kronik psikoz hastasına bakım verenlerin duygu ifadesi düzeylerini karşılaştırmak amacıyla tanımlayıcı kesitsel yapılmıştır. Yöntem: Araştırma, Kasım 2017-Kasım 2018 tarihleri arasında iki üniversite, bir eğitim araştırma ve bir ruh sağlığı hastalıkları hastanesinin psikiyatri polikliniklerinde yürütülmüştür. Araştırmanın örneklemini ilk psikoz atağı hastasına bakım veren 68, kronik psikoz hastasına bakım veren 70 kişi oluşturmuştur. Veri toplamada Duygu İfadesi Ölçeği (DİÖ) kullanılmıştır. Verilerin değerlendirilmesinde, sayı ve yüzde dağılımı, ki kare, fisher exact test ve bağımsız gruplarda t testi kullanılmıştır. Bulgular: İlk psikoz atağı hastasına bakım verenlerin duygu ifadesi puanlarının ortalaması ile kronik psikoz hastasına bakım verenlerin duygu ifadesi puanlarının ortalaması arasında anlamlı fark bulunmamıştır (t = 1.91, p = .058). Bakım verenlerin duygu ifadesi alt boyutlarından eleştirel yorumlar/düşmanlık (p = .104), duygusal aşırı meşguliyet (p = .240) boyutlarında anlamlı bir fark saptanmamıştır. Sonuç: Çalışmada, ilk psikoz atak ile kronik psikoz hastasına bakım verenlerin duygu ifadesi puanlarının hem toplam puan hem de eleştirel yorumlar/düşmanlık alt boyutları ve duygusal aşırı meşguliyet alt boyutları benzerdir. Bu sonuçlar ilk psikoz atak hastalarının bakım verenlerinin hastalığı deneyimleme süresinin kısa olmasına rağmen duygu ifadelerinin, kronik ruhsal hastalığı olan bireylerin bakım verenleri ile benzer olduğunu göstermektedir. İlk psikoz hastalarının bakım verenlerinin erken psikoz programları gibi müdahale programları ile güçlendirilmesi ve baş etme becerilerinin geliştirilmesi önemlidir. İlk psikoz atağı sürecinde başlatılacak aile müdahale programlarının hastalığın ilerleyen süreçlerinde yüksek duygu ifadesinin azalmasını sağlayabilir. Ayrıca ilk atak ve kronik psikoz hastalarının bakım verenlerin ruhsal hastalığı olan aile bireylerine tutum ve yaklaşımlarının derinlemesine inceleneceği kalitatif çalışmalar önerilmektedir. 

References

  • 1. Townsend M. Ruh sağlığı ve psikiyatri hemşireliğinin temelleri kanıta dayalı uygulama bakım kavramları, 6.Baskı. Ankara: Akademisyen Kitabevi; 2016: 335-377.
  • 2. Tüzer V, Zincir S, Basterzi AD, Aydemir Ç, Kısa C, Göka E. Şizofreni hastalarında aile ortamı ve duygu dışavurumunun değerlendirilmesi. Klinik Psikiyatri 2003;6:198-203.
  • 3. Ventura J, Subotnik KL, Guzik LH, Hellemann GS, Gitlin MJ, Wood RC et al. Remission and recovery during the first outpatient year of the early course of schizophrenia. Schizophr Res 2011;132(1):18–23.
  • 4. Martens L, Addington J. The psychological well-being of family members of ındiviiduals with schizophrenia. Soc Psychiatr Epidemiol 2001;36:128-133.
  • 5. Magana SM, Garcia JIM, Hernandez MG, Cortez R. Psychological distress among Latino family caregivers of adults with schizophrenia: the roles of burden and stigma. Psychiatr Serv 2007;58:378-384.
  • 6. Perlick DA, Rosenheck RA, Miklowitz DJ, Chessick C, Wolff N, Kaczynski R et al. Prevelance and correlates of burden among caregivers of patients with bipolar disorder enrolled in the systematic treatment enhancement program for bipolar disorder. Bipolar Disord 2007;9:262-273.
  • 7. Askey A, Gray R, Gamble C. Family work in first-onset psychosis: a literature review. Journal of Psychiatric and Mental Health Nursing 2007;14:356–365.
  • 8. Poon AWC, Curtis J, Howard A, Ward PB, Lappin JM. Health of carers of young people with early psychosis: a biopsychosocial approach. Australian Social Work 2019;72(3):260-273.
  • 9. Gerson R, Wong C, Davidson L, Malaspina D, McGlashan T, Corcoran C. Self-reported coping strategies in families ofpatients in early stages of psychotic disorder:an exploratory study. Early Intervention in Psychiatry 2011;5:76-80.
  • 10. Barrowclough C, Hooley JM. Attributions and expressed emotion: a review. Clin Psychol Rev 2003;23:849-880.
  • 11. Wearden AJ, Tarrier N, Barrowclough C, Zastowny TR, Rahill AA. A review of expressed emotion research in health care. Clin Psychol Rev 2000;20:633-666.
  • 12. Hooley JM, Campbell C. Control and controllability: beliefs and behaviour in high and low expressed emotion relatives. Psychological Medicine 2002;32:1091-1099.
  • 13. Patterson P, Birchwood M, Cochrane R. Preventing the entrenchment of high expressed emotion in first episode psychosis: early development attachment pathways. Australianand New Zealand Journal of Psychiatry 2000;34:191-197.
  • 14. Tüzer V, Zincir S, Basterzi AD, Aydemir Ç, Kısa C, Göka E. Şizofreni hastalarında aile ortamı ve duygu dışavurumunun değerlendirilmesi. Klinik Psikiyatri 2003;6:198-203.
  • 15. Sellwood W, Tarrier N, Quinn J, Barrowclough C. The family and compliance in schizophrenia: the influence of clinical variables, relatives' knowledge and expressed emotion. PsycholMed 2003;33(1):91-96.
  • 16. Tomlinson E, Onwumere J, Kuipers E. Distress and negative experiences of the caregiving relationship in early psychosis: does social cognition play a role? Early Intervention in Psychiatry 2013;8:253-260.
  • 17. Hooley JM. Expressed emotion and relapse of psychopathology. Annual Review of Clinical Psychology 2007;3:329-352.
  • 18. Hooley JM, Hiller JB. Personality and expressed emotion. J Abnorm Psychol 2000;109:40-44.
  • 19. McDonell MG, Short RA, Berry CM, Dyck DG. Burden in schizophrenia caregivers: impact of family psycho education and awareness of patient suicidality. FamProcess 2003;42(1):91-103.
  • 20. Meneghelli A, Alpi A, Pafumi N, Patelli G, Preti A, Cocchi A. Expressed emotion in first-episode schizophrenia and in ultra high-risk patients: Results from the Programma 2000 (Milan, Italy) Psychiatry Research 2011;189:331-338.
  • 21. Jorge RJ, Cogo-Moreira H, Araripe Neto AG, Chaves AC. Psychological morbidity is the main predictor of quality of life among caregivers of individuals in first-episode psychosis: data from a year-long longitudinal study in Brazil. Brazilian Journal of Psychiatry 2019;41(5):403-410.
  • 22. Breitborde NJ, Lopez SR, Wickens TD, Jenkins JH, Karno M. Toward specifying the nature of the relationship between expressed emotion and schizophrenic relapse: the utility of curvilinear models. Int JMethodsPsychiatrRes 2007;16:1-10.
  • 23. Patel M, Stanhope V, Solomon P. Bridging the gap: using micro sociological theory to understand how expressed emotion predicts clinical outcomes. Psychiatr Q 2007;78:117-128.
  • 24. Resmi Gazete. Hemşirelik hizmetleri yönetmeliği (2011, 25 Mart) Sayı:27885. 2011.
  • 25. Sadiq S, Suhail S, Gleeson J, Alvarez-Jimenez M. Expressed emotion and the course of schizophrenia in Pakistan. Soc Psychiatry Psychiatr Epidemiol 2017;52:587-593.
  • 26. Sagut P, Çetinkaya Duman ZÇ. A comparison of burden on caregivers of patients with first episode psychosis and chronic psychosis. Archives of Psychiatric Nursing 2016;30(6):768-773.
  • 27. Bachmann S, Bottmer C, Jacob S, Kronmu¨ller KT, Backenstrass M, Mundt C et al. Expressed emotion in relatives of first episode and chronic patients with schizophrenia and major depressive disorder-a comparison. Psychiatry Research 2002;112:239-250.
  • 28. Amerikan Psikiyatri Birliği. Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı. Beşinci Baskı. Ertuğrul Köroğlu. Ankara: Hekimler Yayın Birliği; 2014.
  • 29. Berksun OE. Şizofrenide aile faktörü: duygu ifadesi ölçek geliştirmeye uyarlama denemesi. Ankara Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı Uzmanlık Tezi; Ankara 1992.
  • 30. Karancı AN, İnandılar H. Predictors of components of expressed emotion in major caregivers of Turkish patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2002;37:80-88.
  • 31. Çetinkaya Duman ZÇ, Kuşçu MK, Özgün S. Şizofreni hastalarına bakım verenlerin duygu ifadelerini belirlemede camberwell aile görüşmesi ile duygu ifadesi ölçeğinin karşılaştırılması. Nöropsikiyatri Arşivi 2013;50:301-305.
  • 32. Çetinkaya Duman Z, Aştı N, Üçok A, Kuşcu MK. Şizofreni hastalarına ve ailelerine ‘bağımsız ve sosyal yaşam becerileri topluma yeniden katılım programı’ uygulaması, izlenmesi. Anadolu Psikiyatri Dergisi 2007;8:91-101.
  • 33. Lim YM, Ahn Y. Burden of family caregivers with schizophrenic patients in Korea. Appl Nurs Res 2003;16:110-117. 34. Carrà G, Cazzullo CL, Clerici M. The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia, findings from an Italian population. BMC Psychiatry 2012;12:140.
  • 35. Breitborde NJK, Lo´pez SR, Kopelowicz A. Expressed emotion and health outcomes among mexican-americans with schizophrenia and their caregiving relatives. The Journal of Nervous and Mental Disease 2010;198(2):105-109.

A Comparison of Expressed Emotion in Caregivers of Patients with First-Episode Psychosis and Chronic Psychosis

Year 2022, Volume: 15 Issue: 1, 13 - 21, 15.01.2022
https://doi.org/10.46483/deuhfed.841324

Abstract

Background: Evaluating the emotional expression of caregivers is important in order to determine how the family member who takes the responsibility of mental illness can be affected and to prevent relapse. Objectives: This research has been done as descriptive cross-sectional with the aim of comparing to expressed emotion levels of caregivers on the first episode and chronic psychotic patient. Methods: The research was conducted in two university hospitals and psychiatry polyclinics of one training research hospital with a mental health and illnesses hospital between November 2017 and November 2018. The people (68) taking care of the first episode psychotic patients and the people (70) who are caregiver of chronic psychotic patients has formed sample of the research. Expressed Emotion Scale (EES) has beeen used in data collection. Number and percentage distribution, chi square, fisher exact test and t test analysis have been used on assessment phase. Results: Significant differences haven’t been found between avarage points (17.22 ± 4.92) of expressed emotion of people caregivers of first episode psychotic patient and avarage points (18.96 ± 5.71) of expressed emotion of people caregivers of chronic psychotic patients (t = 1.91, p = .058). There is no significant differences of caregivers expressed emotion between critical comment/hostility (p = .104) on low state and emotional over-involvement (p = .240) on low state. Conclusion: In this study, expressed emotion points of caregivers of first episode psychotic patients are similar with the sub dimensions of critical comments/hostility low state and emotional over-involvement. These results show that although the caregivers of first psychosis patients have a short time to experience the disease process, their expressed emotions are similar to the caregivers of individuals with chronic mental illness. It is important to strengthen the caregivers of first psychosis patients with intervention programs such as early psychosis programs and to develop coping skills. Family invervention programs, which will be initiated during the first episode psychosis process, can reduce the expression of high emotions in the later stages of disease. In addition, qualitative researchs that first episode psychotic and chonic psychotic patients’ caregivers’ manners and approachments toward family member who has mental illness can be examined deeply are suggested. 

References

  • 1. Townsend M. Ruh sağlığı ve psikiyatri hemşireliğinin temelleri kanıta dayalı uygulama bakım kavramları, 6.Baskı. Ankara: Akademisyen Kitabevi; 2016: 335-377.
  • 2. Tüzer V, Zincir S, Basterzi AD, Aydemir Ç, Kısa C, Göka E. Şizofreni hastalarında aile ortamı ve duygu dışavurumunun değerlendirilmesi. Klinik Psikiyatri 2003;6:198-203.
  • 3. Ventura J, Subotnik KL, Guzik LH, Hellemann GS, Gitlin MJ, Wood RC et al. Remission and recovery during the first outpatient year of the early course of schizophrenia. Schizophr Res 2011;132(1):18–23.
  • 4. Martens L, Addington J. The psychological well-being of family members of ındiviiduals with schizophrenia. Soc Psychiatr Epidemiol 2001;36:128-133.
  • 5. Magana SM, Garcia JIM, Hernandez MG, Cortez R. Psychological distress among Latino family caregivers of adults with schizophrenia: the roles of burden and stigma. Psychiatr Serv 2007;58:378-384.
  • 6. Perlick DA, Rosenheck RA, Miklowitz DJ, Chessick C, Wolff N, Kaczynski R et al. Prevelance and correlates of burden among caregivers of patients with bipolar disorder enrolled in the systematic treatment enhancement program for bipolar disorder. Bipolar Disord 2007;9:262-273.
  • 7. Askey A, Gray R, Gamble C. Family work in first-onset psychosis: a literature review. Journal of Psychiatric and Mental Health Nursing 2007;14:356–365.
  • 8. Poon AWC, Curtis J, Howard A, Ward PB, Lappin JM. Health of carers of young people with early psychosis: a biopsychosocial approach. Australian Social Work 2019;72(3):260-273.
  • 9. Gerson R, Wong C, Davidson L, Malaspina D, McGlashan T, Corcoran C. Self-reported coping strategies in families ofpatients in early stages of psychotic disorder:an exploratory study. Early Intervention in Psychiatry 2011;5:76-80.
  • 10. Barrowclough C, Hooley JM. Attributions and expressed emotion: a review. Clin Psychol Rev 2003;23:849-880.
  • 11. Wearden AJ, Tarrier N, Barrowclough C, Zastowny TR, Rahill AA. A review of expressed emotion research in health care. Clin Psychol Rev 2000;20:633-666.
  • 12. Hooley JM, Campbell C. Control and controllability: beliefs and behaviour in high and low expressed emotion relatives. Psychological Medicine 2002;32:1091-1099.
  • 13. Patterson P, Birchwood M, Cochrane R. Preventing the entrenchment of high expressed emotion in first episode psychosis: early development attachment pathways. Australianand New Zealand Journal of Psychiatry 2000;34:191-197.
  • 14. Tüzer V, Zincir S, Basterzi AD, Aydemir Ç, Kısa C, Göka E. Şizofreni hastalarında aile ortamı ve duygu dışavurumunun değerlendirilmesi. Klinik Psikiyatri 2003;6:198-203.
  • 15. Sellwood W, Tarrier N, Quinn J, Barrowclough C. The family and compliance in schizophrenia: the influence of clinical variables, relatives' knowledge and expressed emotion. PsycholMed 2003;33(1):91-96.
  • 16. Tomlinson E, Onwumere J, Kuipers E. Distress and negative experiences of the caregiving relationship in early psychosis: does social cognition play a role? Early Intervention in Psychiatry 2013;8:253-260.
  • 17. Hooley JM. Expressed emotion and relapse of psychopathology. Annual Review of Clinical Psychology 2007;3:329-352.
  • 18. Hooley JM, Hiller JB. Personality and expressed emotion. J Abnorm Psychol 2000;109:40-44.
  • 19. McDonell MG, Short RA, Berry CM, Dyck DG. Burden in schizophrenia caregivers: impact of family psycho education and awareness of patient suicidality. FamProcess 2003;42(1):91-103.
  • 20. Meneghelli A, Alpi A, Pafumi N, Patelli G, Preti A, Cocchi A. Expressed emotion in first-episode schizophrenia and in ultra high-risk patients: Results from the Programma 2000 (Milan, Italy) Psychiatry Research 2011;189:331-338.
  • 21. Jorge RJ, Cogo-Moreira H, Araripe Neto AG, Chaves AC. Psychological morbidity is the main predictor of quality of life among caregivers of individuals in first-episode psychosis: data from a year-long longitudinal study in Brazil. Brazilian Journal of Psychiatry 2019;41(5):403-410.
  • 22. Breitborde NJ, Lopez SR, Wickens TD, Jenkins JH, Karno M. Toward specifying the nature of the relationship between expressed emotion and schizophrenic relapse: the utility of curvilinear models. Int JMethodsPsychiatrRes 2007;16:1-10.
  • 23. Patel M, Stanhope V, Solomon P. Bridging the gap: using micro sociological theory to understand how expressed emotion predicts clinical outcomes. Psychiatr Q 2007;78:117-128.
  • 24. Resmi Gazete. Hemşirelik hizmetleri yönetmeliği (2011, 25 Mart) Sayı:27885. 2011.
  • 25. Sadiq S, Suhail S, Gleeson J, Alvarez-Jimenez M. Expressed emotion and the course of schizophrenia in Pakistan. Soc Psychiatry Psychiatr Epidemiol 2017;52:587-593.
  • 26. Sagut P, Çetinkaya Duman ZÇ. A comparison of burden on caregivers of patients with first episode psychosis and chronic psychosis. Archives of Psychiatric Nursing 2016;30(6):768-773.
  • 27. Bachmann S, Bottmer C, Jacob S, Kronmu¨ller KT, Backenstrass M, Mundt C et al. Expressed emotion in relatives of first episode and chronic patients with schizophrenia and major depressive disorder-a comparison. Psychiatry Research 2002;112:239-250.
  • 28. Amerikan Psikiyatri Birliği. Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı. Beşinci Baskı. Ertuğrul Köroğlu. Ankara: Hekimler Yayın Birliği; 2014.
  • 29. Berksun OE. Şizofrenide aile faktörü: duygu ifadesi ölçek geliştirmeye uyarlama denemesi. Ankara Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı Uzmanlık Tezi; Ankara 1992.
  • 30. Karancı AN, İnandılar H. Predictors of components of expressed emotion in major caregivers of Turkish patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2002;37:80-88.
  • 31. Çetinkaya Duman ZÇ, Kuşçu MK, Özgün S. Şizofreni hastalarına bakım verenlerin duygu ifadelerini belirlemede camberwell aile görüşmesi ile duygu ifadesi ölçeğinin karşılaştırılması. Nöropsikiyatri Arşivi 2013;50:301-305.
  • 32. Çetinkaya Duman Z, Aştı N, Üçok A, Kuşcu MK. Şizofreni hastalarına ve ailelerine ‘bağımsız ve sosyal yaşam becerileri topluma yeniden katılım programı’ uygulaması, izlenmesi. Anadolu Psikiyatri Dergisi 2007;8:91-101.
  • 33. Lim YM, Ahn Y. Burden of family caregivers with schizophrenic patients in Korea. Appl Nurs Res 2003;16:110-117. 34. Carrà G, Cazzullo CL, Clerici M. The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia, findings from an Italian population. BMC Psychiatry 2012;12:140.
  • 35. Breitborde NJK, Lo´pez SR, Kopelowicz A. Expressed emotion and health outcomes among mexican-americans with schizophrenia and their caregiving relatives. The Journal of Nervous and Mental Disease 2010;198(2):105-109.
There are 34 citations in total.

Details

Primary Language Turkish
Subjects Nursing
Journal Section Research Articles
Authors

Damla Bayrak This is me 0000-0001-8219-7406

Zekiye Çetinkaya Duman 0000-0002-7447-874X

Publication Date January 15, 2022
Published in Issue Year 2022 Volume: 15 Issue: 1

Cite

APA Bayrak, D., & Çetinkaya Duman, Z. (2022). İlk Atak ve Kronik Psikoz Hastalarının Bakım Verenlerinin Duygu İfadelerinin Karşılaştırılması. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 15(1), 13-21. https://doi.org/10.46483/deuhfed.841324

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