Pandemi Süreçlerinde Jinekolojik Kanserlere Yaklaşım
Özet
COVID-19 pandemisi, jinekolojik kanser hastalarının tanı, tedavi ve takip süreçlerinde ertelenme ve iptallere yol açarak sağlık sistemi üzerinde büyük bir yük oluşturmuştur. Kanser hastaları, düşük bağışıklıkları nedeniyle yüksek riskli grupta yer almış, bu süreçte cerrahi, kemoterapi ve radyoterapi protokollerinde değişiklikler meydana gelmiştir. Yapılan çalışmalar, uygun koruyucu önlemler alındığında jinekolojik kanser cerrahilerinin güvenle gerçekleştirilebileceğini ve perioperatif mortalite oranlarının oldukça düşük olduğunu göstermektedir. Pandemi süreci, hastaları yalnızca fiziksel olarak değil; anksiyete, depresyon, belirsizlik ve sosyal izolasyon gibi psikolojik ve sosyal yönlerden de olumsuz etkilemiştir. Jinekolojik kanser türlerine göre (over, endometriyum, serviks, vulva, vajina) aciliyet sınıflamaları yapılarak tedavi zamanlamaları önerilmiş ve klinikte bulaş riskini azaltmak için hasta/refakatçi kısıtlamaları uygulanmıştır. Sürecin holistik bir yaklaşımla yönetilmesinde ve semptom kontrolünde hemşirelik bakımı kritik bir rol oynamaktadır. Bu dönemde hastaların bilgiye erişimini sağlamak, takipleri sürdürmek ve psikolojik destek sunmak amacıyla teletıp ve uzaktan bakım uygulamalarının kullanımı ön plana çıkmıştır. Sonuç olarak, pandemi döneminde multidisipliner yaklaşımlarla hastaların yaşam kalitesini artırmak hedeflenmiştir.
The COVID-19 pandemic has placed a significant burden on the healthcare system, leading to delays and cancellations in the diagnosis, treatment, and follow-up processes of gynecological cancer patients. Due to their compromised immunity, cancer patients were classified as a high-risk group, resulting in alterations to surgical, chemotherapy, and radiotherapy protocols. Studies indicate that when appropriate protective measures are implemented, gynecological cancer surgeries can be safely performed, with perioperative mortality rates remaining remarkably low. The pandemic has adversely affected patients not only physically but also psychologically and socially, triggering anxiety, depression, uncertainty, and social isolation. Treatment timing recommendations were established by classifying urgency across various gynecological cancer types (ovarian, endometrial, cervical, vulvar, vaginal), and restrictions on patients and companions were enforced to minimize transmission risks in clinics. Nursing care plays a critical role in symptom management and managing the process through a holistic approach. To ensure patients' access to information, maintain follow-ups, and provide psychological support during this period, the utilization of telemedicine and remote care applications has become prominent. Consequently, it is aimed to enhance patients' quality of life during the pandemic through multidisciplinary strategies.
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