Afet ve Kriz Durumlarında Kronik Hastalıklarda Bakım Sürekliliği
Özet
Kronik hastalıklar, düzenli izlem, sürekli tedavi, ilaç ve tıbbi malzemelere erişim ile uzun dönemli öz yönetim desteği gerektirir. Afet ve krizler sağlık hizmetlerini, tedarik zincirlerini, ulaşımı, iletişimi ve yaşam koşullarını bozarak kronik hastalıkların kontrolünü güçleştirebilir. Bu durum özellikle yaşlı, engelli, birden fazla kronik hastalığı bulunan, yaşamı sürdürücü tedavilere bağımlı olan ve sosyal desteği sınırlı bireylerde ciddi komplikasyonlara yol açabilir. Bu bölümde afetlerin kronik hastalık yönetimine etkileri, bakım sürekliliği kavramı ve bakımın sürekliliğini belirleyen faktörler ele alınmıştır. Afet öncesi hazırlık, afet sırasındaki temel hizmetlerin sürdürülmesi ve afet sonrasındaki uzun dönemli izlem; diyabet, hipertansiyon ve kardiyovasküler hastalıklar, kronik böbrek hastalığı, KOAH ve astım özelinde incelenmiştir. Ayrıca hemşirenin risk değerlendirmesi, eğitim, klinik izlem, bakım koordinasyonu, psikososyal destek, etik karar verme ve savunuculuk rolleri değerlendirilmiştir. Kronik hastalıklarda bakım sürekliliğinin sağlanması, yalnızca ilaç teminine değil; bireyselleştirilmiş hazırlık, erişilebilir sağlık kayıtları, koordineli hizmet sunumu ve uzun dönemli izleme dayanmaktadır. Bu nedenle kronik hastalık bakımı, afet yönetiminin hazırlık, müdahale ve iyileştirme aşamalarının tamamına bütünleştirilmelidir.
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