Kardiyopulmoner Hastalıklarda Kinezyofobi
Özet
Kinezyofobi, bireylerin ağrı ya da dispne gibi semptomlara bağlı olarak fiziksel aktiviteden irrasyonel biçimde kaçınmasına neden olan patolojik bir korkudur ve kardiyopulmoner hastalıklarda önemli bir biyopsikososyal engel olarak öne çıkmaktadır. Ağrıyla ilişkili kinezyofobi hareketin yeniden ağrıya ya da yaralanmaya yol açacağına dair inançlarla şekillenirken, dispneyle ilişkili kinezyofobi ise bireyin solunum sıkıntısını tetikleyebilecek aktivitelerden kaçınmasına neden olur. Her iki durum da fiziksel inaktivite, yaşam kalitesinde azalma ve rehabilitasyona düşük katılım ile sonuçlanmaktadır. Kardiyopulmoner hastalıklarda kinezyofobi gelişiminde yaş, cinsiyet, sosyal destek, egzersiz öz-yeterliği, anksiyete düzeyi, komorbiditeler ve sağlık profesyonelleriyle etkileşim gibi çok sayıda psikososyal faktör rol oynamaktadır. Ağrıyla ilişkili kinezyofobinin değerlendirilmesinde Tampa Kinezyofobi Ölçeği ve Kalp için Tampa Kinezyofobi Derecelendirmesi öne çıkarken, dispneyle ilişkili kinezyofobinin değerlendirilmesinde Nefes Darlığı İnançları Anketi yaygın olarak kullanılmaktadır. Kinezyofobinin etkin bir şekilde yönetilmesi kardiyopulmoner rehabilitasyonun vazgeçilmez bir bileşeni olup, temel hedef hastaların fiziksel aktiviteye yönelik irrasyonel korkularını azaltarak, güvenli ve sürdürülebilir bir katılım sağlamaktır. Kinezyofobi yönetiminde yer alan bilişsel-davranışçı yaklaşımlar, fiziksel ve manuel terapiler, kombine bilişsel ve egzersiz müdahaleleri ile egzersiz ve solunum kas eğitimi gibi çok bileşenli stratejiler, yalnızca semptomatik iyileşmeyi değil, aynı zamanda bireyin öz-yeterliliğini ve psikososyal adaptasyonunu artırmayı da hedeflemektedir. Kardiyopulmoner hastalıklarda kinezyofobinin erken tanılanması ve bütüncül yaklaşımlarla yönetilmesi, hem klinik prognozu iyileştirmede hem de fiziksel aktiviteye güvenli katılımı destekleyerek yaşam kalitesini artırmada kritik rol oynamaktadır.
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