ISSN 1302-6631
 

Original Research (Original Article) 


Psychodramatic group therapy on Alzheimer patients’ caregiver relatives

Gülfizar Sözeri Varma, Nalan Kalkan Oğuzhanoğlu, Figen Çulha Ateşci, Nursel Karagöz, Ferda Apa.

Abstract
Objective: The objective of the study was to provide support to Alzheimer’s disease (AD) caregiver in coping with the difficulties of acquiring knowledge on the disease and of providing care to the patient. The effects of psycho-dramatic group therapy on the mental symptoms and care burden were examined. Methods: Patient relatives who participated in the Denizli Alzheimer Association activities also took part in the study. Psychiatric examinations of the participants were carried out prior to group therapy, sociodemographic data form and scales were applied. A total of 11 sessions for the first group and 12 second for the second group were carried out as 1 day per week for a period of 2-2.5 hours. A total of 11 individuals completed the first group and 9 individuals completed the second group. Hospital Anxiety Depression Scale (HAD), Caregiver Burden Inventory (CBI) were applied before and after group therapy. Results: All participants of the first group were female with an age interval of 46-65 years. They were all children of the patients excluding two participants and majority was high school-university graduates. It was determined after group therapy that HAD total and anxiety scores, CBI total and social burden scores decreased. The age interval of the second group participants was 53-83 years and the only male member was also the oldest individual to take part in the study. They were all spouses of the patients excluding two members and all were primary school graduates save for 1 literate member. No statistically significant difference was observed between the scale scores before and after group therapy. It was observed when the two groups were evaluated together that there were statistically significant decreases in HAD and total anxiety scores, CBI total score but that there were no changes in the other scores. Group studies started with the establishment of group rules, going over the expecta-tions from groups and warm-up games. Psychodramatic techniques were used to gamify issues such as the symp-toms of the disease, frequently experienced behavioral problems, difficulties related with caregiving and methods for coping with them, things that can be experienced as the disease progresses, communication problems within the family, inability to ask for help regarding caregiving, placing in a care center. Participation to the groups was regular and the members were quite supportive. Patient relatives had the opportunity to share the difficulties they experience as well as to express their emotions. Conclusion: Psychoeducation on AD caregiver relatives reduces anxiety symptoms and care burden in addition to providing mental support. Our results lead us to think that when caregivers are spouses of the patients, they feel the burden of caregiving more since they are also elderly and that they cannot benefit sufficiently from sources of support.

Key words: Alzheimer disease, caregiver, caregiver burden, depression, anxiety



Alzheimer hastasına bakım veren yakınlarında psikodramatik grup terapisi

Ozet
Amaç: Bu çalışmada, Alzheimer hastası (AH) yakınlarına hastalıkla ilgili bilgilenme ve bakım vermenin getirdiği güçlüklerle baş etmede destek sağlanması amaçlanmıştır. Psikodramatik grup terapisinin bakım veren hasta yakın-larında ruhsal belirtiler ve bakım yükü üzerindeki etkileri araştırılmıştır. Yöntem: Çalışmaya Denizli Alzheimer Derneği etkinliklerine katılan hasta yakınları katılmıştır. Grup terapisi öncesi katılımcıların psikiyatrik muayeneleri yapılmış, Sosyodemografik Veri Formu ve ölçekler uygulanmıştır. Haftada bir gün, 2-2.5 saat olmak üzere birinci grupta 11, ikincisinde 12 oturum yapılmıştır. Birinci grubu 11, ikincisini 9 kişi tamamlamıştır. Grup terapisi öncesi ve sonrası Hastane Anksiyete Depresyon Ölçeği (HADÖ), Bakım Veren Yükü Ölçeği (BVYÖ) uygulanmıştır. Bulgular: Birinci gruba katılanların tamamı kadın olup yaş aralığı 46-65 yıldı. İki üye dışında hastaların çocuklarından oluşu-yordu, çoğunluğu lise/üniversite mezunuydu. Grup terapisi sonrası HADÖ toplam ve anksiyete puanlarının, BVYÖ toplam ve sosyal yük puanlarının azaldığı belirlendi. İkinci gruba katılanların yaş aralığı 53-83 yıldı, tek erkek üye çalışmaya katılan en yaşlı bireydi. İki üye dışında hastaların eşlerinden oluşuyordu, okuryazar olan bir üye dışındak-iler ilkokul mezunuydu. Grup terapisi öncesi ve sonrası ölçek puanlarında anlamlı farklılık saptanmadı. İki grup birlik-te değerlendirildiğinde, grup terapisi sonrasında HADÖ toplam ve anksiyete puanlarında, BVYÖ toplam puanında anlamlı azalma olduğu, diğer puanlarda değişiklik olmadığı belirlendi. Grup çalışmaları tanışma, grup kurallarının oluşturulması, gruptan beklentilerin gözden geçirilmesi ve ısınma oyunlarıyla başladı. Hastalık belirtilerinin neler olduğu, sık karşılaşılan davranış sorunları, bakımla ilgili güçlükler ve baş etme yolları, hastalık ilerlediğinde neler yaşanabileceği, aile içi iletişim sorunları, bakımla ilgili yardım isteyememe, bakımevine yatırma gibi konular psiko-dramatik teknikler kullanılarak oyunlaştırıldı. Gruplara katılım düzenli, üyeler oldukça destekleyiciydi. Hasta yakın-ları yaşadıkları sorunları paylaşma ve duygularını ifade etme olanağı buldu. Sonuç: AH bakım veren yakınlarında ruhsal eğitimin yanı sıra ruhsal destek sağlanması anksiyete belirtilerini ve bakım yükünü azaltmaktadır. Sonuçları-mız, bakım veren eşler olduğunda kendileri de yaşlı olan bu bireylerin bakım yükünü daha fazla hissettiklerini ve destek kaynaklarından yeterince yararlanamadıklarını düşündürmektedir.

Anahtar Kelimeler: Alzheimer hastalığı, bakım veren, bakım veren yükü, depresyon, anksiyete


 
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Pubmed Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa. [Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]. Anadolu Psikiyatri Derg. 2018; 19(6): 567-576. Turkish. doi:10.5455/apd.293867


Web Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa. [Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]. http://www.anadolupsikiyatri.net/?mno=293867 [Access: October 21, 2018]. Turkish. doi:10.5455/apd.293867


AMA (American Medical Association) Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa. [Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]. Anadolu Psikiyatri Derg. 2018; 19(6): 567-576. Turkish. doi:10.5455/apd.293867



Vancouver/ICMJE Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa. [Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]. Anadolu Psikiyatri Derg. (2018), [cited October 21, 2018]; 19(6): 567-576. Turkish. doi:10.5455/apd.293867



Harvard Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa (2018) [Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]. Anadolu Psikiyatri Derg, 19 (6), 567-576. Turkish. doi:10.5455/apd.293867



Turabian Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa. 2018. [Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]. Anatolian Journal of Psychiatry, 19 (6), 567-576. Turkish. doi:10.5455/apd.293867



Chicago Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa. "[Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]." Anatolian Journal of Psychiatry 19 (2018), 567-576. Turkish. doi:10.5455/apd.293867



MLA (The Modern Language Association) Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa. "[Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]." Anatolian Journal of Psychiatry 19.6 (2018), 567-576. Print.Turkish. doi:10.5455/apd.293867



APA (American Psychological Association) Style

Gulfizar Sozeri Varma| Nalan Kalkan Oguzhanoglu| Figen Culha Atesci| Nursel Karagoz| Ferda Apa (2018) [Psychodramatic group therapy on Alzheimer patients’ caregiver relatives]. Anatolian Journal of Psychiatry, 19 (6), 567-576. Turkish. doi:10.5455/apd.293867





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