{"id":3001,"date":"2023-10-17T08:59:27","date_gmt":"2023-10-17T08:59:27","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=3001"},"modified":"2025-11-04T09:16:11","modified_gmt":"2025-11-04T09:16:11","slug":"acceptance-and-commitment-therapy-a-promising-approach-for-those-living-with-long-covid","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/tr\/2023\/10\/acceptance-and-commitment-therapy-a-promising-approach-for-those-living-with-long-covid\/","title":{"rendered":"Kabul ve Kararl\u0131l\u0131k Terapisi: Long COVID ile ya\u015fayanlar i\u00e7in umut verici bir yakla\u015f\u0131m"},"content":{"rendered":"<p><strong>Amy Barradell , Leicester NHS Trust \u00dcniversite Hastanesi<\/strong><\/p>\n<h2>Long-COVID sizin i\u00e7in ne anlama geliyor?<\/h2>\n<p>Coronavir\u00fcs 2019&#8217;a (COVID-19) yakalanan bir grup insan, akut enfeksiyonun ard\u0131ndan 4 haftadan fazla bir s\u00fcre boyunca zay\u0131flat\u0131c\u0131 semptomlar ya\u015famaya devam etti. Genellikle hem fiziksel (\u00f6rne\u011fin nefes darl\u0131\u011f\u0131, yorgunluk) hem de psikolojik (anksiyete, bili\u015fsel bozukluklar gibi) <a href=\"https:\/\/www.thelancet.com\/journals\/lanres\/article\/PIIS2213-2600(21)00383-0\/fulltext\">belirtiler <\/a>bildirdiler. Bu semptomlar\u0131 ya\u015fayanlar buna \u2018Long-COVID&#8217; diyor.<\/p>\n<p><!--more--><\/p>\n<h2>Tecr\u00fcbelerime g\u00f6re\u2026<\/h2>\n<p>Long-COVID klini\u011finde \u00e7al\u0131\u015fmak bana, insanlar\u0131n yeni semptomlar\u0131n\u0131 (ve semptomlar\u0131n\u0131n sonu\u00e7lar\u0131n\u0131) kabul etmekte zorland\u0131klar\u0131n\u0131 ve bunun da \u00f6z y\u00f6netim stratejilerinin \u00f6n\u00fcnde bir engel olu\u015fturdu\u011funu g\u00f6sterdi. Long-COVID&#8217;den \u00f6nce neler yapabileceklerine ve te\u015fhis koyulduktan sonra hayatlar\u0131n\u0131n olumsuz y\u00f6nde nas\u0131l de\u011fi\u015fti\u011fine odaklan\u0131yorlar. Bu, deneyimsel ka\u00e7\u0131nmay\u0131 (duygular, d\u00fc\u015f\u00fcnceler, an\u0131lar ve bedensel duyumlar gibi istenmeyen i\u00e7sel deneyimleri bast\u0131rma giri\u015fimi veya arzusunu) ve insanlar\u0131n semptomlar\u0131n i\u015flevi yerine semptomlar\u0131n bi\u00e7imine odaklanma e\u011filimini g\u00f6sterir (\u00f6rne\u011fin, ki\u015finin davran\u0131\u015f\u0131n\u0131 de\u011fi\u015ftirmesi i\u00e7in sinyal veren beden). Bu, insanlar\u0131n deneyimlere a\u00e7\u0131k olmad\u0131klar\u0131n\u0131 ve an\u0131 ya\u015famaktan \u00e7ekindiklerini g\u00f6steriyor.<\/p>\n<p>Ayr\u0131ca, Covid-19 nedeniyle hastaneye kald\u0131r\u0131lan <a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2021.03.22.21254057v2\">ki\u015filerin y\u00fczde 25&#8217;inden fazlas\u0131nda <\/a>taburcu olduktan 6 ay sonra da depresyon belirtileri devam ediyor. Depresyon, <a href=\"https:\/\/www.mindwell-leeds.org.uk\/myself\/exploring-your-mental-health\/depression\/what-keeps-depression-going\/\">aktiviteden ka\u00e7\u0131nmayla (bir durumdan<\/a> ka\u00e7\u0131nmakla) ba\u011flant\u0131l\u0131 oldu\u011fu i\u00e7in insanlar\u0131n de\u011ferleriyle ba\u011flant\u0131l\u0131 davranmad\u0131\u011f\u0131n\u0131 g\u00f6sterir.<\/p>\n<h2>Long-COVID&#8217;de psikolojik esnekli\u011fin rol\u00fc<\/h2>\n<p><a href=\"https:\/\/www.ijpsy.com\/volumen10\/num1\/256.html\">Kabul ve Kararl\u0131l\u0131k Terapisinin <\/a>(ACT) temel prensibi psikolojik esnekli\u011fi art\u0131rmakt\u0131r. Terapi s\u00fcreci \u00fc\u00e7 temel s\u00fcrece dayan\u0131r: (1) deneyime a\u00e7\u0131k olmay\u0131 te\u015fvik etmek, (2) an\u0131n fark\u0131nda olmak ve (3) de\u011ferlerine uygun davran\u0131\u015flar geli\u015ftirmek. Yukar\u0131da a\u00e7\u0131kland\u0131\u011f\u0131 gibi Long-COVID ile ya\u015fayan insanlarda bu s\u00fcre\u00e7lerin dengesinin bozuldu\u011fu g\u00f6r\u00fclmektedir, dolay\u0131s\u0131yla bunlar\u0131n ele al\u0131nmas\u0131 \u00f6nemlidir. Bu nedenle ACT, insanlar\u0131n ya\u015fad\u0131klar\u0131 zorluklarla olan ili\u015fkilerini de\u011fi\u015ftirmelerine (yani deneyimsel ka\u00e7\u0131nmalar\u0131n\u0131 azaltmalar\u0131na), yeni bir &#8216;normal&#8217; kabul etmelerini sa\u011flamalar\u0131na (yani \u015fimdiki ana ili\u015fkin fark\u0131ndal\u0131klar\u0131n\u0131 art\u0131rmalar\u0131na) ve onlar\u0131 kendileri i\u00e7in \u00f6nemli olan davran\u0131\u015fsal de\u011fi\u015fiklikler yapmak (\u00f6rne\u011fin de\u011ferlerine uygun eylemlerde bulunmak) i\u00e7in motive edip g\u00fc\u00e7lendirmelerine yard\u0131mc\u0131 olmak i\u00e7in kullan\u0131labilir. Long-COVID&#8217;de ACT <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34931160\/\">halihaz\u0131rda ilerleme kaydediyor,<\/a> kat\u0131l\u0131mc\u0131lar sa\u011fl\u0131k durumlar\u0131n\u0131n iyile\u015fti\u011fini, hala COVID ile ilgili s\u0131k\u0131nt\u0131 ya\u015fad\u0131klar\u0131n\u0131 ancak genel psikolojik sorunlarla (kayg\u0131 gibi) daha iyi ba\u015f edebildiklerini hissettiklerini bildirdiler.<\/p>\n<h2>Long-COVID klini\u011finde ACT kullan\u0131m\u0131: Jo ile Tan\u0131\u015f\u0131n<\/h2>\n<p>Jo ile ilk tan\u0131\u015ft\u0131\u011f\u0131mda semptomlar\u0131 d\u00fczenli olarak n\u00fcksediyordu. \u0130smimin gizli kalmas\u0131n\u0131 sa\u011flamak i\u00e7in Jo, Long-COVID klini\u011finde birlikte \u00e7al\u0131\u015ft\u0131\u011f\u0131m bir\u00e7ok farkl\u0131 insan\u0131 temsil ediyor. En zorlay\u0131c\u0131 semptomlar\u0131, g\u00fcnl\u00fck aktiviteleri \u00e7ok zorla\u015ft\u0131ran nefes darl\u0131\u011f\u0131 ve yorgunluktu. Jo, semptomlar\u0131n s\u00fcrekli tekrarlamas\u0131ndan korkuyordu ve bunlar\u0131 a\u011f\u0131rla\u015ft\u0131racak her \u015feyden ka\u00e7\u0131nmak (yani deneyimsel ka\u00e7\u0131nma, \u015fimdiki andan ka\u00e7\u0131nma) i\u00e7in bilin\u00e7li \u00e7aba g\u00f6steriyordu. Onu mutlu eden ve hayat\u0131na anlam katan faaliyetlere \u00e7ok az zaman ay\u0131r\u0131yordu (yani de\u011ferlerine uygun eylemlerden ka\u00e7\u0131n\u0131yordu).<\/p>\n<p>Seanslar\u0131m\u0131zda ACT&#8217;in her bir s\u00fcrecini ele ald\u0131k:<\/p>\n<ul>\n<li><strong>Bili\u015fsel ayr\u0131\u015fma <\/strong>(d\u00fc\u015f\u00fcncelere kap\u0131lmak veya inanmak yerine d\u00fc\u015f\u00fcnceleri fark etmek ve d\u00fc\u015f\u00fcncelerin gelip gitmesine izin vermek) &#8211; d\u00fc\u015f\u00fcnceler\/duygular ile ger\u00e7ek deneyimler aras\u0131nda ayr\u0131m yapmak (bunlar\u0131n mutlaka ayn\u0131 olmas\u0131 gerekmez!)<\/li>\n<li><strong>\u015eimdiki anla temasa ge\u00e7mek <\/strong>\u2013 \u015fimdiki andaki duyusal deneyimleri anlamland\u0131rmak i\u00e7in fark\u0131ndal\u0131k stratejileri benimsemek.<\/li>\n<li><strong>De\u011ferlerinizi ke\u015ffetmek<\/strong>&#8211; ya\u015famlar\u0131nda onlar i\u00e7in \u00f6nemli olan alanlar\u0131 belirlemek.<\/li>\n<li>K<strong>ararl\u0131 eylemlerde bulunmak: D<\/strong>e\u011ferleriyle uyumlu davran\u0131\u015fsal hedefler belirlemek<\/li>\n<li><strong>Ba\u011flam olarak benlik <\/strong>\u2013 &#8216;g\u00f6zlemleyen benlik&#8217; ile temas kurmak ve d\u00fc\u015f\u00fcncelerini onlara hapsolmadan uzaktan (yani daha do\u011fru bir perspektiften) bakmak.<\/li>\n<li><strong>Kabul etmek <\/strong>\u2013 kontrolleri d\u0131\u015f\u0131nda olan \u015feylerle m\u00fccadele etmeyi b\u0131rakmak ve kontrolleri dahilinde olanlara (yani kendi davran\u0131\u015flar\u0131na) yeniden odaklanmak.<\/li>\n<\/ul>\n<p>\u0130kinci seansta Jo, kendine temel de\u011ferleriyle uyumlu iki davran\u0131\u015f hedefi belirledi. <a href=\"https:\/\/www.mindtools.com\/a4wo118\/smart-goals\">SMART hedefler <\/a>geli\u015ftirebilmesi i\u00e7in <a href=\"https:\/\/motivationalinterviewing.org\/understanding-motivational-interviewing\">motivasyonel g\u00f6r\u00fc\u015fme tekniklerini <\/a>kulland\u0131m.<\/p>\n<p>Jo, d\u00f6rt hafta sonra hedeflerine ula\u015ft\u0131\u011f\u0131n\u0131 bana gururla s\u00f6yledi. Ayr\u0131ca g\u00fcnl\u00fck ya\u015fam\u0131na \u00e7e\u015fitli fark\u0131ndal\u0131k aktiviteleri de katm\u0131\u015ft\u0131 (\u00f6rne\u011fin, ak\u0131\u015ftaki yapraklar egzersizi, \u015f\u00fckran g\u00fcnl\u00fc\u011f\u00fc ve 5 dakikal\u0131k yoga). Psikolojik esnekli\u011finin artt\u0131\u011f\u0131n\u0131 (ki\u015fi psikolojik olarak esnek oldu\u011funda, deneyimledi\u011fi anl\u0131k k\u0131sa vadeli duygular yerine de\u011ferlerine ve kendi temel inan\u00e7lar\u0131na g\u00f6re kararlar verir), depresyon belirtilerinin azald\u0131\u011f\u0131n\u0131 ve seanslar d\u0131\u015f\u0131nda kendini y\u00f6netme konusunda g\u00fcveninin artt\u0131\u011f\u0131n\u0131 belirtti.<\/p>\n<h2>Long-COVID&#8217;li ki\u015filerle \u00e7al\u0131\u015fan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 i\u00e7in \u00f6neriler:<\/h2>\n<ol>\n<li><strong>Biyopsikososyal de\u011ferlendirmenin \u00f6nemini unutmay\u0131n <\/strong>&#8211; Ki\u015finin Long-COVID semptomlar\u0131n\u0131n karma\u015f\u0131kl\u0131\u011f\u0131n\u0131 ve bu semptomlar\u0131n sonu\u00e7lar\u0131n\u0131 anlamak, hasta merkezli y\u00f6netim stratejilerini belirlemenin temelidir. \u201cEn \u00e7ok zorland\u0131\u011f\u0131n\u0131z semptom nedir?\u201d gibi sorular sormaktan \u00e7ekinmeyin; \u201cNefes darl\u0131\u011f\u0131n\u0131z\u0131n\/yorgunlu\u011funuzun\/zihin bulan\u0131kl\u0131\u011f\u0131n\u0131z\u0131n\u2026 ya\u015fam\u0131n\u0131za etkisi nedir?\u201d; \u201cNefes darl\u0131\u011f\u0131\/yorgunluk\/zihin bulan\u0131kl\u0131\u011f\u0131 ya\u015fad\u0131\u011f\u0131n\u0131zda akl\u0131n\u0131zdan hangi d\u00fc\u015f\u00fcnceler ge\u00e7iyor\u201d?<\/li>\n<li><strong>Psikolojik esnekli\u011fi \u00f6l\u00e7\u00fcn <\/strong>\u2013 Kabul ve Kararl\u0131l\u0131k Terapisi s\u00fcre\u00e7lerinin Kapsaml\u0131 de\u011ferlendirmesi ( <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2212144716300229\">CompACT <\/a>), ki\u015finin bildirdi\u011fi psikolojik esnekli\u011fin h\u0131zl\u0131 ve ge\u00e7erli bir \u00f6l\u00e7e\u011fidir. Psikolojik esnekli\u011fin hangi s\u00fcre\u00e7lerinin art\u0131r\u0131lmas\u0131 gerekti\u011fini h\u0131zl\u0131 bir \u015fekilde belirleyebilir ve tedavi stratejisini buna g\u00f6re planlayabilirsiniz (\u00f6rne\u011fin, de\u011ferli eylemlerden ka\u00e7\u0131n\u0131yorlarsa, temel de\u011ferlerinin ne oldu\u011fu \u00fczerine \u00e7al\u0131\u015f\u0131p SMART hedefler belirlemelerine yard\u0131mc\u0131 olabilirsiniz).<\/li>\n<li><strong>Fark\u0131ndal\u0131k egzersizleri yapt\u0131r\u0131n <\/strong>\u2013 fark\u0131ndal\u0131k egzersizleri, insanlar\u0131n psikolojik esneklik temellerini olu\u015fturmalar\u0131na yard\u0131mc\u0131 olmak i\u00e7in ACT&#8217;te olduk\u00e7a faydal\u0131 olabilir. Ki\u015finin zorland\u0131\u011f\u0131 konuya ba\u011fl\u0131 olarak uygun bir egzersiz sunabilirsiniz, bunlardan baz\u0131lar\u0131:\n<ol>\n<li>Bili\u015fsel ayr\u0131\u015fma \u2013 <a href=\"https:\/\/www.youtube.com\/watch?v=r1C8hwj5LXw\">Deredeki yapraklar<\/a><\/li>\n<li>\u015eimdiki anla temas \u2013 <a href=\"https:\/\/www.youtube.com\/watch?v=CBYhuhSiO8Q\">5 \u015feyi<\/a> fark edin<\/li>\n<li>Ba\u011flamsal benlik \u2013 <a href=\"https:\/\/www.youtube.com\/watch?v=nBPPr1hsbMM\">Sahne <\/a><a href=\"https:\/\/www.youtube.com\/watch?v=nBPPr1hsbMM\">metaforu<\/a><\/li>\n<\/ol>\n<\/li>\n<li><strong>G\u00fcncel kan\u0131ta dayal\u0131 bulgular\u0131 takip edin <\/strong>\u2013 Bir\u00e7ok sa\u011fl\u0131k probleminde oldu\u011fu gibi, Long -COVID ile ilgili bilimsel bulgular s\u00fcrekli olarak geli\u015fmektedir, bu nedenle literat\u00fcr\u00fc ve klinik uygulama k\u0131lavuzlar\u0131n\u0131 takip etti\u011finizden emin olun. ACT kan\u0131tlar\u0131 giderek art\u0131yor!<\/li>\n<li><strong>Kendinize bakmay\u0131 ihmal etmeyin \u2013 <\/strong>Long-COVID hastalar\u0131yla \u00e7al\u0131\u015fmak zor olabilir, bu nedenle d\u00fczenli s\u00fcpervizyon almay\u0131 veya g\u00fcvendi\u011finiz biriyle bilgi payla\u015f\u0131m\u0131 yapmay\u0131 ihmal etmeyin. Bu sadece spesifik vaka analizleri i\u00e7in de\u011fil, hastalarla \u00e7al\u0131\u015f\u0131rken psikolojik sa\u011fl\u0131\u011f\u0131n\u0131z\u0131 da yard\u0131mc\u0131 olur.<\/li>\n<\/ol>\n<p>[<em>\u0130ngilizce asl\u0131ndan \u00e7eviren: Ulusal Edit\u00f6r Selen \u00d6zbek, MSc]<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Amy Barradell, University Hospitals of Leicester NHS Trust If I were to say to you, Long-Covid, what would that mean to you? A sub-set of people that contracted Coronavirus Disease 2019 (COVID-19), have continued to experience debilitating symptoms for [&hellip;]<\/p>\n","protected":false},"author":9,"featured_media":3034,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[38,58,13,36,56],"tags":[],"class_list":["post-3001","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-acceptance-and-commitment-therapy","category-covid","category-interventions","category-mental-health","category-public-health"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"tr","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":true,"content":true,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false},"hr":{"title":false,"content":false,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":false,"content":false,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"fr":{"title":true,"content":true,"excerpt":false},"gr":{"title":false,"content":false,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":false,"content":false,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":false,"content":false,"excerpt":false},"ro":{"title":false,"content":false,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/posts\/3001","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/comments?post=3001"}],"version-history":[{"count":28,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/posts\/3001\/revisions"}],"predecessor-version":[{"id":4545,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/posts\/3001\/revisions\/4545"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/media\/3034"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/media?parent=3001"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/categories?post=3001"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/tr\/wp-json\/wp\/v2\/tags?post=3001"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}