Bipolar bozukluk hastalarına verilen psikoeğitim sonrası yaşam kalitelerinin ve işlevselliklerinin değerlendirilmesi
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Date
2020
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Amaç: Bu çalışmanın amacı bipolar bozukluk tanılı hastalara verilen psikoeğitimin; hastaların işlevselliklerine, yaşam kalitelerine, sosyal destek algılarına, yaşam olayları ile başa çıkma becerilerine ve tedavi uyumlarına etkisini araştırmaktır. Yöntem: Kesitsel nitelikteki bu çalışma 2019-2020 yılında Hatay'da yaşayan 18 yaş üzeri bipolar bozukluk hastalarına yapıldı. Çalışmaya 01 Aralık 2019-01 Şubat 2020 tarihleri arasında Mustafa Kemal Üniversitesi Sağlık Uygulama ve Araştırma Hastanesi (HMKÜSUAH) psikiyatri polikliniğine ve servisine başvuran ve dahil edilme kriterlerini sağlayan,-DSM-5'e göre bipolar bozukluk tanısı almış hastalar çalışmaya alınmış olup 42 kişiye ulaşıldı. 42 hastanın tümümün sosyodemografik verileri alındı; plazma ilaç düzeyleri kaydedildi ve ölçekler verildi. Hastalara Bipolar İşlevsellik Ölçeği, WHOQOL-BREF Yaşam Kalitesi Ölçeği, Morisky İlaç Uyum Ölçeği verildi. Hastalar psikoeğitime davet edildi; 42 hastadan 31 hasta psikoeğitime katılmayı kabul etti. Psikoeğitimden 3 ay sonra hastalara (n=31) aynı ölçekler tekrar verildi, en son bakılan plazma ilaç düzeyleri ve bu zaman zarfında olan yeni ataklar, ilaç değişimleri vb. klinik gelişmeler kaydedildi. Bulgular: Araştırmamızdaki 31 hastanın %45,2'si kadın, %54,8'i erkekti. Hastaların yaş ortalaması 34,06±10,2 idi. Hastaların ortalama hastalık süresi 10,26±9,44, ortalama hastalık başlangıç yaşı 23,81±7,71 ve aldıkları ortalama psikiyatrik tedavi süresi 8,10±6,47 yıldı. Hastaların ortalama YMRS puanı 2,61±1,25, ortalama HAM-D puanı 4,19±2,18 ve ortalama CGI-S puanı 4,26±0,51 idi. Hastaların %67,7'si lityum, %16,1'i valproik asit ve %16,1'i hem lityum hem valproik asit kullanmaktaydı. Psikoeğitim öncesi tedaviye uyumlu olmayan 20 hastadan 19'unun (%95,0) psikoeğitim sonrası tedaviye uyumlu hale geldikleri tespit edildi (p<0,001). Psikoeğitim öncesi hastaların Yaşam Kalitesi Anketi'nden aldıkları puan ortalaması 38,61±9,22 iken psikoeğitim sonrası ise 46,81±6,65 olduğu görüldü (p<0,001). Bipolar Bozukluk İşlevsellik Ölçeği'ne göre hastaların psikoeğitim sonrası işlevsellik düzeylerinin psikoeğitim öncesine göre anlamlı düzeyde yüksek olduğu tespit edildi. (p<0,001). Sonuçlar: Hastaların yaşam kalitelerinde; psikolojik sağlıkta ve sosyal ilişkilerde anlamlı derecede yükselme saptandı. Hastaların (damgalanma hissi, içe kapanıklık, ev içi ilişkiler, sosyal ilişkiler) işlevselliklerinde artış, intihar düşüncelerinde, hastaneye yatış süresi ve sayısında azalma saptandı. Hastaların tedavi uyumlarında ve etkin dozda ilaç kullanım oranlarında artış görüldü.
Aim: The aim of this study is psychoeducation given to patients diagnosed with bipolar disorder; to investigate the effect of patients on their functionality, quality of life, perceptions of social support, their ability to cope with life events, and treatment compliance. Methods: This cross-sectional study was conducted in Bipolar Disorder patients over 18 years of age living in Hatay in 2019-2020. Patients who applied to the psychiatry outpatient clinic and clinic of Mustafa Kemal University Health Practice and Research Hospital (HMKÜSUAH) between 01 December and 1 February 2020 and who met the inclusion criteria,were diagnosed with bipolar disorder according to DSM-5 andreached 42 people.Sociodemographic data of all 42 patients were obtained; plasma drug levels were recorded and scales were given. The patients were given Bipolar Functionality Scale, Whoqol-Bref Quality of Life Scale, Morisky Drug Compliance Scale. Patients were invited to psychoeducation; 31 of 42 patients participated in psychoeducation. The patients (N: 31) were given the same scales 3 months after the psychoeducation, the last viewed plasma drug levels and new attacks during this time, drug changes, etc. clinical advances were made. Results: 45,2% of the 31 patients in our study were women and 54,8% were man. The mean age of the patients was 34,06 ± 10,2. The mean disease duration of the patients was 10,26 ± 9,44, the average age of was 23,81 ± 7,71 and the mean duration of psychiatric treatment was 8,10 ± 6,47 years. The mean YMRS score of the patients was 2,61 ± 1,25, the average HAM-D score was 4,19 ± 2,18 and the average CGI score was 4,26 ± 0,51. 67,7% of patients use lithium, 16,1% use valproic acid and 16,1% use both lithium and valproic acid. It was found that 19 (95,0%) of 20 patients who were not compatible with pre-psychoeducation treatment became compatible with post-psychoeducation treatment (p <0,05). While the average score of the patients before the psychoeducation from the Quality of Life Questionnaire was 38,61 ± 9.22, it was found to be 46,81 ± 6,65 after the psychoeducation (p <0.05). According to the Bipolar Disorder Functionality Scale, the levels of functionality of patients after psychoeducation were found to be significantly higher than that of pre-psychoeducation. Conclusion: In the quality of life of patients; there was a significant increase in psychological health and social relations. There was an increase in the functionality of patients (stigma, introversion, in-home relationships), there was a decrease in Suisidal thoughts, hospitalization time and number. An increase was observed in patients' compliance and effective dose drug use. Key words: Bipolar Disorder, psychoeducation, quality of life, functionality, drug compliance the levels of functionality of patients after psychoeducation were found to be significantly higher than that of pre-psychoeducation. Conclusion: In the quality of life of patients; there was a significant increase in psychological health and social relations. There was an increase in the functionality of patients (stigma, introversion, in-home relationships), there was a decrease in Suisidal thoughts, hospitalization time and number. An increase was observed in patients' compliance and effective dose drug use. Key words: Bipolar Disorder, psychoeducation, quality of life, functionality, drug compliance
Aim: The aim of this study is psychoeducation given to patients diagnosed with bipolar disorder; to investigate the effect of patients on their functionality, quality of life, perceptions of social support, their ability to cope with life events, and treatment compliance. Methods: This cross-sectional study was conducted in Bipolar Disorder patients over 18 years of age living in Hatay in 2019-2020. Patients who applied to the psychiatry outpatient clinic and clinic of Mustafa Kemal University Health Practice and Research Hospital (HMKÜSUAH) between 01 December and 1 February 2020 and who met the inclusion criteria,were diagnosed with bipolar disorder according to DSM-5 andreached 42 people.Sociodemographic data of all 42 patients were obtained; plasma drug levels were recorded and scales were given. The patients were given Bipolar Functionality Scale, Whoqol-Bref Quality of Life Scale, Morisky Drug Compliance Scale. Patients were invited to psychoeducation; 31 of 42 patients participated in psychoeducation. The patients (N: 31) were given the same scales 3 months after the psychoeducation, the last viewed plasma drug levels and new attacks during this time, drug changes, etc. clinical advances were made. Results: 45,2% of the 31 patients in our study were women and 54,8% were man. The mean age of the patients was 34,06 ± 10,2. The mean disease duration of the patients was 10,26 ± 9,44, the average age of was 23,81 ± 7,71 and the mean duration of psychiatric treatment was 8,10 ± 6,47 years. The mean YMRS score of the patients was 2,61 ± 1,25, the average HAM-D score was 4,19 ± 2,18 and the average CGI score was 4,26 ± 0,51. 67,7% of patients use lithium, 16,1% use valproic acid and 16,1% use both lithium and valproic acid. It was found that 19 (95,0%) of 20 patients who were not compatible with pre-psychoeducation treatment became compatible with post-psychoeducation treatment (p <0,05). While the average score of the patients before the psychoeducation from the Quality of Life Questionnaire was 38,61 ± 9.22, it was found to be 46,81 ± 6,65 after the psychoeducation (p <0.05). According to the Bipolar Disorder Functionality Scale, the levels of functionality of patients after psychoeducation were found to be significantly higher than that of pre-psychoeducation. Conclusion: In the quality of life of patients; there was a significant increase in psychological health and social relations. There was an increase in the functionality of patients (stigma, introversion, in-home relationships), there was a decrease in Suisidal thoughts, hospitalization time and number. An increase was observed in patients' compliance and effective dose drug use. Key words: Bipolar Disorder, psychoeducation, quality of life, functionality, drug compliance the levels of functionality of patients after psychoeducation were found to be significantly higher than that of pre-psychoeducation. Conclusion: In the quality of life of patients; there was a significant increase in psychological health and social relations. There was an increase in the functionality of patients (stigma, introversion, in-home relationships), there was a decrease in Suisidal thoughts, hospitalization time and number. An increase was observed in patients' compliance and effective dose drug use. Key words: Bipolar Disorder, psychoeducation, quality of life, functionality, drug compliance
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Keywords
Psikiyatri, Psychiatry, Bipolar Bozukluk, psikoeğitim, yaşam kalitesi, işlevsellik, ilaç uyumu.
