Çocuk ve Ergenlerde Kronik Böbrek Hastalığı ve Transplantasyon Sürecinde Konsültasyon-Liyezon Psikiyatrisi
Özet
Kronik böbrek hastalığı uzun süren tedavi süreçleri ve fiziksel/psikososyal etkileri nedeniyle çocuklar ve aileleri için önemli bir stres kaynağıdır. Araştırmalar, bu hastalarda depresyon, anksiyete ve uyum bozukluğu gibi psikiyatrik problemlerin sağlıklı akranlarına kıyasla daha sık görüldüğünü göstermektedir. Transplantasyon sürecinde ise çocukların psikiyatrik değerlendirmesi kritik bir rol oynar. Nakil öncesinde hasta ve ailesinin motivasyonu, tedaviye uyumu ve psikososyal risk faktörleri değerlendirilmelidir. Nakil sonrası ise tedaviye uyum, kaygı ve depresyon belirtileri takip edilerek psikososyal destek sağlanmalıdır. Özellikle diyaliz sürecinde olan çocukların akademik ve sosyal işlevsellikleri için okula devamlılık ve sosyal desteğin artırılması önerilmektedir. Psikotrop ilaç kullanımında ise farmakokinetik değişiklikler göz önünde bulundurulmalıdır. Bu kapsamda, multidisipliner bir yaklaşımla çocuk ve ailelerin hem fiziksel hem de psikososyal ihtiyaçlarının desteklenmesi büyük önem taşımaktadır.
Chronic kidney disease, with its prolonged treatment processes and physical/psychosocial effects, is a significant source of stress for children and their families. Research indicates that psychiatric problems such as depression, anxiety, and adjustment disorders are more common in these patients compared to their healthy peers. In the transplantation process, psychiatric evaluation of children plays a critical role. Before transplantation, the motivation of the patient and family, treatment adherence, and psychosocial risk factors should be assessed. After transplantation, treatment adherence, anxiety, and depressive symptoms should be monitored, and psychosocial support should be provided. Particularly for children undergoing dialysis, maintaining school attendance and enhancing social support are recommended to improve academic and social functioning. When using psychotropic medications, pharmacokinetic changes must be considered. In this context, a multidisciplinary approach is essential to support both the physical and psychosocial needs of children and their families.
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