Partner ilişkisinde sorun yaşayan üniversite öğrencilerinde sosyal öğrenme temelli psikososyal müdahalenin travma sonrası büyümeye etkisi
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Araştırma partner istismarına uğrayan üniversite öğrencilerine yönelik Sosyal Öğrenme Temelli Psikososyal Müdahalenin (SÖTPM) travma sonrası büyümeye etkisini değerlendirmek amacıyla yürütülmüştür. Yöntem: Randomize kontrollü araştırmada 2x5'lik split-plot desen kullanılmıştır. Araştırmanın evrenini 371 öğrenci hemşire oluşturmuştur. Örneklem grubu iki aşamada belirlenmiştir. Partner istismarına uğrayan, evli olmayan, istismara uğradığı partnerinden ayrılan, ayrılığın üzerinden bir ay ya da daha uzun süre geçen, Olayların Etkisi Ölçeği-Gözden Geçirilmiş'den (OEÖ-G) 24 ve üzerinde puan alan 50 öğrenci ilk aşamadaki örneklem grubunu oluşturmuştur. İkinci aşamada 50 öğrencinin online psikososyal müdahale için uygunluğu, Kısa Semptom Envanteri (KSE), İntihar Olasılığı Ölçeği (İOÖ), Somatoform Disosiyasyon Anketi (SDA) ve riskli alkol-madde kullanımı, ilaç dışı psikiyatrik tedavi alma ve psikiyatrik ilaç kullanımını sorgulayan soru formu kullanılarak değerlendirilmiştir. Değerlendirmeler sonucunda uygun bulunan 39 öğrenci için randomizasyon gerçekleştirilmiştir. Toplam 35 öğrenci, 17 girişim ve 18 kontrol grubu olmak üzere araştırmayı tamamlamıştır. Sosyal Öğrenme Kuramı ve bilişsel davranışçı yaklaşımlara göre oluşturulan SÖTPM, videokonferans yöntemi ile girişim grubundaki öğrencilere bireysel ve online olarak uygulanmıştır. SÖTPM haftada bir oturum olmak üzere, her biri en fazla 120 dakika süren toplam sekiz oturumda tamamlanmıştır. SÖTPM'nin etkisini değerlendirmek için tüm öğrencilere zaman serisi noktalarında (ön test, son test, 1. ay izlem, 3. ay izlem ve 6. ay izlem) OEÖ-G ve Travma Sonrası Büyüme Envanteri (TSBE) uygulanmıştır. Ek olarak girişim grubunda danışan ve danışmanın terapötik ittifak düzeylerini belirlemek için, Terapötik İttifak Ölçeği-Danışan (TİÖ-Danışan) ve Terapötik İttifak Ölçeği-Danışman (TİÖ-Danışman) kullanılmıştır. Verilerin analizinde tanımlayıcı istatistikler, ki kare analizi, tekrarlı ölçümlerde varyans analizi, Pearson korelasyon analizi ve Bonferroni düzeltmesi uygulanmıştır. Bulgular: Araştırma sonuçları zaman serisi içerisinde gruplar bazında değerlendirildiğinde, girişim grubunda OEÖ-G toplam (F=14.901, p<0.05) ve yeniden yaşama (F=9.445, p<0.05), kaçınma (F=8.660, p<0.05), aşırı uyarılma (F=10.611, p<0.05) alt boyut puan ortalamalarında kontrol grubuna oranla istatistiksel olarak anlamlı şekilde daha fazla düşüş yaşandığı görülmüştür. Grupxzaman etkileşimi açısından OEÖ-G alt boyut etki büyüklüklerinin 0.208 ile 0.243 arasında değiştiği, toplam puan etki büyüklüğünün ise 0.311 olduğu belirlenmiştir. Girişim grubunda TSBE toplam (F=150.801, p<0.05) ve kendilik algısında değişim (F=136.877, p<0.05), yaşam felsefesinde değişim (F=44.170, p<0.05), ilişkilerde değişim (F=79.879, p<0.05) alt boyut puan ortlamalarında kontrol grubuna oranla istatistiksel olarak anlamlı şekilde daha fazla artış yaşandığı belirlenmiştir. Grupxzaman etkileşimi açısından TSBE alt boyut etki büyüklüklerinin 0.572 ile 0.806 arasında değiştiği ve toplam puan etki büyüklüğünün ise 0.820 olduğu belirlenmiştir. Girişim grubunda TİÖ-Danışan ile TİÖ-Danışman puan ortalamaları arasında pozitif yönde anlamlı ilişki bulunurken (p<0.05), TİÖ-Danışan ve TİÖ-Danışman puan ortalamaları ile zaman serisindeki OEÖ-G ve TSBE puan ortalamaları arasında anlamlı bir ilişki bulunmamıştır (p>0.05). Sonuç: Online olarak uygulanan SÖTPM'nin travma sonrası stres düzeyini azaltmada ve travma sonrası büyüme yaşanmasında etkili olduğu ve bu olumlu etkilerin uzun dönem izlemde devam ettiği görülmüştür. Ülkemizde üniversite öğrencileri de dahil olmak üzere toplumun tüm kesimlerinde, partner istismarının yol açtığı travmaya yönelik online psikososyal müdahalelerin yürütülmesine ihtiyaç bulunmaktadır. Bu sebeple, SÖTPM'nin partner istismarı nedeniyle travma yaşayan bireylerin ihtiyaçlarına göre uyarlanması; yüz yüze ve online yöntemlerle eş zamanlı uygulanarak etkisinin karşılaştırılması önerilmektedir. SÖTPM'nin etkisinin altı aydan daha uzun süreli izlemlerle değerlendirilmesi ise müdahalenin kanıt düzeyinin artmasına katkı sağlayabilir.
Aim: The study was conducted to determine the impact of Social Learning-Based Psychosocial Intervention (SLPI) on post-traumatic growth for university students who were abused by their partners. Method: A 2x5 split-plot design was used in the randomized controlled study. The study population consisted of 371 undergraduate nursing students. The sample group was determined in two stages: 50 students, (i) who were abused by their partners, (ii) who were unmarried (iii) who separated from abuser partner (iv) who have been living apart from their partners for a month or more after the breakup, and (v) those who scored 24 or more on the Impact of Event Scale-Revised (IES-R) constituted the first sample group in the first stage. In the second stage, eligibility of 50 students for online psychosocial intervention was determined, using a Brief Symptom Inventory (BSI), Suicide Probability Scale (SPS), Somatoform Dissociation Questionnaire (SDQ) and a questionnaire investigating risky alcohol-substance use, recieve non-drug psychiatric treatment and psychiatric drug use. As a result of the evaluations, randomization were applied to 39 students who were eligible. A total of 35 students completed the research, including 17 intervention and 18 control groups. It was applied to the students in the intervention group individually and online method, using SLPI videoconferencing method developed based on the Social Learning Theory and cognitive behavioral approaches. SLPI was completed in eight sessions, each of which lasted at most 120 minutes once a week. To evaluate the efficiency of SLPI, the IES-R and Posttraumatic Growth Inventory (PGTI) were applied to students within time series points (pretest, posttest, 1st-month follow-up, 3rd-month follow-up, and 6th month follow-up). In addition, the Therapeutic Alliance Scale-Advisee (TAS-Advisee) and The Therapeutic Alliance Scale-Advisor (TAS-Advisor) were used to determine the therapeutic alliance level of the advisee and advisor in the intervention group. In the analysis of the data, descriptive statistics, chi-square analysis, in repeated measurements analysis of variance, Pearson correlation analysis, Bonferroni correction were used. Results: When the results of the research were evaluated on group basis within the time series, it was found that there was a significant decrease in the subscale mean scores and total mean score in the intervention group compared to the control group: the IES-R (F=14.901, p<0.05) and intrusion (F=9.445, p<0.05), avoidance (F=8.660, p<0.05), hyperarousal (F=10.611, p<0.05). In terms of groupxtime interaction the IES-R subscale effect sizes scores was found to range from 0.208 to 0.243, and the total score effect size was found 0.311. It was found that there was a significant increase in the subscale mean scores and total mean score in the intervention group compared to the control group: the PGTI (F=150.801, p<0.05), change in self-perception (F=136.877, p<0.05), change in life philosophy (F=44.170, p<0.05), change in relationships (F=79.879, p<0.05). In terms of groupxtime interaction the PGTI subscale effect sizes scores ranged from 0.572 to 0.806 and the total score effect size were found 0.820. In the intervention group, while there was there was a significant positive correlation between the mean scores of the TAS-Advisee and TAS-Advisor (p<0.05), no significant correlation was found between the mean scores of TAS-Advisee and TAS-Advisor with the mean scores of IES-R and PGTI within the time series (p>0.05). Conclusion: It was observed that the online practice of SLPI is effective in reducing the level of post-traumatic stress and experiencing post-traumatic growth, and these positive effects continue in the long-term follow-up. In our country, Turkey, there is need to conduct online psychosocial interventions for trauma caused by partner abuse among all segments of society, including university students. For this reason, it is recommended to adapt the SLPI according to the needs of individuals experiencing for trauma caused by partner abuse and to determine its efficiency by conducting simultaneously face-to-face and online comparative studies. Evaluation the effectiveness of SLPI with follow-ups longer than six months may contribute to increasing the level of evidence for the intervention.
Aim: The study was conducted to determine the impact of Social Learning-Based Psychosocial Intervention (SLPI) on post-traumatic growth for university students who were abused by their partners. Method: A 2x5 split-plot design was used in the randomized controlled study. The study population consisted of 371 undergraduate nursing students. The sample group was determined in two stages: 50 students, (i) who were abused by their partners, (ii) who were unmarried (iii) who separated from abuser partner (iv) who have been living apart from their partners for a month or more after the breakup, and (v) those who scored 24 or more on the Impact of Event Scale-Revised (IES-R) constituted the first sample group in the first stage. In the second stage, eligibility of 50 students for online psychosocial intervention was determined, using a Brief Symptom Inventory (BSI), Suicide Probability Scale (SPS), Somatoform Dissociation Questionnaire (SDQ) and a questionnaire investigating risky alcohol-substance use, recieve non-drug psychiatric treatment and psychiatric drug use. As a result of the evaluations, randomization were applied to 39 students who were eligible. A total of 35 students completed the research, including 17 intervention and 18 control groups. It was applied to the students in the intervention group individually and online method, using SLPI videoconferencing method developed based on the Social Learning Theory and cognitive behavioral approaches. SLPI was completed in eight sessions, each of which lasted at most 120 minutes once a week. To evaluate the efficiency of SLPI, the IES-R and Posttraumatic Growth Inventory (PGTI) were applied to students within time series points (pretest, posttest, 1st-month follow-up, 3rd-month follow-up, and 6th month follow-up). In addition, the Therapeutic Alliance Scale-Advisee (TAS-Advisee) and The Therapeutic Alliance Scale-Advisor (TAS-Advisor) were used to determine the therapeutic alliance level of the advisee and advisor in the intervention group. In the analysis of the data, descriptive statistics, chi-square analysis, in repeated measurements analysis of variance, Pearson correlation analysis, Bonferroni correction were used. Results: When the results of the research were evaluated on group basis within the time series, it was found that there was a significant decrease in the subscale mean scores and total mean score in the intervention group compared to the control group: the IES-R (F=14.901, p<0.05) and intrusion (F=9.445, p<0.05), avoidance (F=8.660, p<0.05), hyperarousal (F=10.611, p<0.05). In terms of groupxtime interaction the IES-R subscale effect sizes scores was found to range from 0.208 to 0.243, and the total score effect size was found 0.311. It was found that there was a significant increase in the subscale mean scores and total mean score in the intervention group compared to the control group: the PGTI (F=150.801, p<0.05), change in self-perception (F=136.877, p<0.05), change in life philosophy (F=44.170, p<0.05), change in relationships (F=79.879, p<0.05). In terms of groupxtime interaction the PGTI subscale effect sizes scores ranged from 0.572 to 0.806 and the total score effect size were found 0.820. In the intervention group, while there was there was a significant positive correlation between the mean scores of the TAS-Advisee and TAS-Advisor (p<0.05), no significant correlation was found between the mean scores of TAS-Advisee and TAS-Advisor with the mean scores of IES-R and PGTI within the time series (p>0.05). Conclusion: It was observed that the online practice of SLPI is effective in reducing the level of post-traumatic stress and experiencing post-traumatic growth, and these positive effects continue in the long-term follow-up. In our country, Turkey, there is need to conduct online psychosocial interventions for trauma caused by partner abuse among all segments of society, including university students. For this reason, it is recommended to adapt the SLPI according to the needs of individuals experiencing for trauma caused by partner abuse and to determine its efficiency by conducting simultaneously face-to-face and online comparative studies. Evaluation the effectiveness of SLPI with follow-ups longer than six months may contribute to increasing the level of evidence for the intervention.
Açıklama
Anahtar Kelimeler
Partner İstismarı, Travma Sonrası Büyüme, Sosyal Öğrenme, Bilişsel Davranışçı, Online, Psikososyal Müdahale, Partner Abuse, Post-Traumatic Growth, Social Learning, Cognitive-Behavioral, Online, Psychosocial Intervention
