Care of Individuals with Special Needs in the Surgical Process

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. Mevlüde KARADAĞ
Gazi Üniversitesi Hemşirelik Fakültesi, Cerrahi Hastalıkları Hemşireliği AD, Ankara, Türkiye
Article Language: TR
Günümüzdeki gelişmeler ve bunların yarattığı değişim, cerrahi girişimi en son başvurulan tedavi yöntemi olmaktan çıkararak, rutin olarak uygulanan tedavi hâline getirmiştir. Cerrahi işlem, kontrollü bir travma olup hasta üzerinde birçok olumsuz etkiye de neden olabilmektedir. Cerrahi hastasının bakımı, hastanın cerrahi kliniğine kabulünden başlayarak; ameliyathanenin içinde, ameliyattan çıkıştan hastanın evine taburcu edilmesine kadar devam eden uzun bir süreci kapsamaktadır. Cerrahi hemşireliği ameliyatın başarısını etkileyen, sürekli değişen ve dinamik bir hemşirelik dalıdır. Başarılı bir cerrahi hemşiresi; ameliyata gereksinim duyulan hastalıklar ve buna eşlik eden süreci, hastaların bu stresli duruma tepkilerini ve sonuçlarını değerlendirmeyi, cerrahi işlem ile ilgili gelişebilecek riskleri ve alınabilecek önlemleri ve hasta ve ailesinin psikososyal gereksinimlerini de kapsayacak şekilde bakım verebilme yeteneğine sahip olmalıdır.

Cerrahi girişim; bireyler için karmaşık ve stresli, özellikle anestezi sırasında savunmasız bir konumda oldukları, bireye özgü özel gereksinimlerin ortaya çıktığı bir süreçtir. Cerrahi bakımın niteliği, yalnızca fizyolojik sonuçlar üzerinde değil, aynı zamanda bireyin psikososyal uyumu, yaşam kalitesi ve uzun dönem sağlık çıktıları üzerinde de belirleyici rol oynamaktadır. Özel gereksinimi olan bireylerin cerrahi süreçteki bakımının özgün boyutlarının ele alınması, bilimsel, etik ve toplumsal açıdan zorunlu hâle gelmiştir.

Özel gereksinimli olmak bireyleri; her yaş grubunda, tüm kültürlerde ve sadece fiziksel olarak değil duygusal, ruhsal ve sosyal açıdan da etkileyen önemli bir süreçtir. Özel gereksinimli bireyler, savunmasız konumda olup diğer bireylere göre daha kötü sağlık durumu ve sonuçları için daha büyük risk altında olan nüfuslar olarak tanımlanır. Genellikle, savunmasız nüfusların sağlık hizmetlerine erişimi ve kaynakları sınırlıdır; bakım sağlandığında sağlık hizmetlerinin kalitesi eşit olmayabilir, bu da daha kötü sağlık sonuçlarına katkıda bulunur. Özel gereksinimli bireylerin cerrahi ortamlarda bakımı, sağlık çalışanları için birçok zorluk oluşturmaktadır. Bu hastaların cerrahi işlemle ilgili sağlık sorunları dışında, benzersiz fiziksel, fizyolojik ve psikolojik gereksinimleri vardır. Cerrahi ekip üyeleri; bu hasta grubunun bakımını uygun şekilde yönetmek için eş zamanlı durumlar hakkında kapsamlı bir bilgiye sahip olmalı, tüm özel sorunlarını dikkatli şekilde ele alacak şekilde kapsamlı değerlendirebilmelidir. Çok farklı ilişkisel ve bilişsel sorunları olan hastaların cerrahi süreçteki bakım yönetimi, tüm hastane yatış sürecini olabildiğince konforlu ve daha az travmatik hâle getirmek için dikkatlice planlanmalıdır. Güvenli, konforlu, özel gereksinimlere göre uyarlanmış ve mümkün olduğunca az travmatik olan özel bir perioperatif sürecin sağlanması gerekir. Aynı zamanda, olası komplikasyonları en aza indirmek için gerekli tüm önlemler alınmalıdır.

Özel gereksinimli bireyler sağlık hizmeti ve bakımı alırken; sahip oldukları sorunlardan kaynaklanan ya da sağlık bakım hizmeti kapsamında yer alan yetersizliklere bağlı olarak, sağlık bakımına erişmekle ilgili bazı sorunlarla karşı karşıya kalabilmektedir. Nitekim literatürde bu bireylerin sağlık hizmetlerine erişiminde yaşadıkları zorluklar, bakım süreçlerinde karşılaştıkları engeller ve standart protokollerin yetersizliğine sürekli vurgu yapılmaktadır. Özellikle cerrahi süreçteki bakımın bütüncül olarak ele alınmadığı, kapsamlı kaynakların sınırlı olduğu görülmektedir. Çoğu çalışma ya belirli bir engel grubuna odaklanmakta ya da cerrahi sürecin yalnızca tek bir aşamasını incelemektedir. Bu kitap; özel gereksinimli bireylerin cerrahi süreçte yaşadığı zorluklara dikkat çekmek, sağlık profesyonellerine bilimsel bilgi ve kanıta dayalı uygulama önerileri sunmak, öğrencilere klinik uygulamalarda rehberlik sağlamak, bütüncül, eşit ve birey merkezli bakım anlayışının gelişimine katkı sağlamak amacıyla hazırlanmıştır.

Bu kitabın hazırlanmasında katkı sağlayan ve emeği geçen değerli yazarlara; Türkiye Klinikleri baş editörüne, yazı işleri servisine, tüm Türkiye Klinikleri çalışanlarına ve özel gereksinimli bireylerin ailelerine en içten teşekkürlerimi sunarım. Kitabın; özel gereksinimi olan bireylerin cerrahi bakım sürecinde karşılaşılan güçlüklerin anlaşılmasına, bilimsel temelli çözüm yollarının geliştirilmesine ve sonuç olarak bu bireylerin yaşam kalitesinin artırılmasına katkı sağlamasını diliyorum.

Saygılarımla.

Prof. Dr. Mevlüde KARADAĞ
Editör
Gazi Üniversitesi Hemşirelik Fakültesi, Cerrahi Hastalıkları Hemşireliği AD, Ankara, Türkiye
Current developments and the changes they create have transformed surgical intervention from a last resort to a routine treatment. Surgery is a controlled trauma and can have numerous negative effects on the patient. Care of a surgical patient encompasses a long process, starting with the patient's admission to the surgical clinic, continuing in the operating room, and continuing until the patient is discharged home. Surgical nursing is a constantly evolving and dynamic branch of nursing that impacts the success of surgery. A successful surgical nurse must possess the ability to provide care that encompasses the conditions requiring surgery and the accompanying processes, assessing the patient's reactions and outcomes to this stressful situation, the risks associated with the procedure and the precautions that can be taken, and the psychosocial needs of the patient and their family.

Surgery is a complex and stressful process for individuals, particularly during anesthesia, when they are in a vulnerable position and uniquely characterized by their needs. The quality of surgical care plays a decisive role not only in the physiological outcome but also in the individual's psychosocial adjustment, quality of life, and long-term health outcomes. Addressing the unique dimensions of surgical care for individuals with special needs has become scientifically, ethically, and societally imperative.

Being special needs is a significant process that affects individuals across all age groups, across all cultures, and not only physically but also emotionally, spiritually, and socially. Individuals with special needs are defined as vulnerable populations at greater risk for poor health outcomes than other individuals. Vulnerable populations often have limited access to and resources for healthcare; when care is provided, the quality of care may be uneven, contributing to poorer health outcomes. Caring for individuals with special needs in surgical settings presents numerous challenges for healthcare professionals. Beyond the health concerns associated with the surgical procedure, these patients have unique physical, physiological, and psychological needs. To appropriately manage the care of this patient group, surgical team members must possess a comprehensive understanding of concurrent conditions and be able to comprehensively assess all their unique concerns. The surgical care of patients with a wide range of relational and cognitive challenges must be carefully planned to make the entire hospital stay as comfortable and less traumatic as possible. A special perioperative process that is safe, comfortable, tailored to specific needs, and as minimally traumatic as possible must be provided. At the same time, all necessary precautions must be taken to minimize potential complications.

Individuals with special needs may face certain challenges accessing healthcare, whether due to the challenges they face while receiving healthcare or due to inadequacies within the healthcare system. Indeed, the literature consistently emphasizes the difficulties these individuals face in accessing healthcare, the obstacles they encounter during the care process, and the inadequacy of standardized protocols. It is particularly evident that comprehensive resources lack a holistic approach to surgical care. Most studies focus on a specific disability group or examine only a single phase of the surgical process. This book was prepared to highlight the challenges experienced by individuals with special needs during the surgical process, to provide scientific knowledge and evidence-based practice recommendations to healthcare professionals, to guide students in clinical practice, and to contribute to the development of a holistic, equitable, and person-centered approach to care.

I would like to thank the valued authors who contributed to the preparation of this book; I extend my sincere gratitude to the editor-in-chief of Türkiye Klinikleri, the editorial team, all Türkiye Klinikleri employees, and the families of individuals with special needs. I hope this will contribute to understanding the challenges faced by individuals with special needs during surgical care, developing scientifically based solutions, and ultimately improving the quality of life for these individuals.

Sincerely.

Prof. Dr. Mevlüde KARADAĞ
Editor
Gazi University Faculty of Nursing, Department of Surgical Diseases Nursing, Ankara, Türkiye

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