Bulaşıcı Olmayan (Kronik) Hastalıklardan Korunma
Özet
Bulaşıcı olmayan hastalıklar (BOH), uzayan insan ömrüyle birlikte küresel çapta artış gösteren ve dünya genelindeki ölümlerin %71'inden sorumlu olan en önemli sağlık sorunlarındandır. Kardiyovasküler hastalıklar, kanser, kronik solunum yolu hastalıkları ve diyabet en sık görülen BOH'lar arasında yer almaktadır. Bu hastalıkların gelişiminde tütün ve alkol kullanımı, sağlıksız beslenme, metabolik sendrom ve yetersiz fiziksel aktivite gibi değiştirilebilir risk faktörleri doğrudan etkilidir. Nitekim Türkiye'deki ölümlerin %86'sının da BOH kaynaklı olduğu tahmin edilmektedir. Bu kronik süreçlerin önlenmesi ve yönetilmesinde, hastayla ilk temas noktası olan Birinci Basamak Sağlık Hizmetleri (BBSH) kritik bir öneme sahiptir. Bütüncül ve kişi merkezli bir bakım modelinin uygulanabilmesi için disiplinler arası iş birliği şarttır. Bu kapsamda ergoterapistler, bireylerin anlamlı günlük aktivitelere katılımını sağlayarak yaşam tarzı ve davranış değişikliklerini destekler. Fizyoterapistler; yönetim, değerlendirme, eğitim ve savunuculuk rolleriyle kas-iskelet sistemi hastalıklarını yöneterek maliyet etkin çözümler sunar. Hemşireler ise biyomedikal bakımı, hasta eğitimini ve bakım koordinasyonunu üstlenerek özellikle savunmasız popülasyonların sağlık hizmetlerine erişimini kolaylaştırır. Sonuç olarak, BOH yükünün hafifletilmesi, sağlık profesyonellerinin BBSH ekibindeki rollerinin geliştirilmesine ve disiplinler arası etkin bir iletişimin kurulmasına bağlıdır.
Non-communicable diseases (NCDs), also known as chronic diseases, have escalated globally alongside increased life expectancy, currently accounting for 71% of all deaths worldwide. Cardiovascular diseases, cancers, chronic respiratory conditions, and diabetes represent the most prevalent NCDs. The development of these diseases is heavily influenced by modifiable behavioral risk factors, including tobacco and alcohol consumption, unhealthy diets, metabolic syndrome, and physical inactivity. In Turkey, NCDs are estimated to be responsible for 86% of total deaths. Primary Health Care (PHC), as the first point of contact in the healthcare system, plays a vital role in preventing and managing these chronic conditions. Achieving a holistic and person-centered care model requires robust interprofessional collaboration. Within this framework, occupational therapists foster lifestyle and behavioral modifications by enabling participation in meaningful daily occupations. Physiotherapists deliver cost-effective interventions for musculoskeletal disorders through their distinct roles as managers, evaluators, collaborators, educators, and advocates. Nurses enhance biomedical care, patient education, and care coordination, thereby facilitating healthcare access for vulnerable populations. Ultimately, mitigating the global burden of NCDs depends on advancing the specific roles of these health professionals within primary care teams and optimizing interdisciplinary communication.
Referanslar
Organization WH. Noncommunicable diseases 1 June 2018 [Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
Bernell S, Howard SW. Use your words carefully: what is a chronic disease? Frontiers in public health. 2016;4:159.
Üner S, Balcılar M, Ergüder T. Türkiye hanehalkı sağlık araştırması: bulaşıcı olmayan hastalıkların risk faktörleri prevalansı 2017 (STEPS). Dünya Sağlık Örgütü Türkiye Ofisi, Ankara. 2018.
Allen L, Williams J, Townsend N, Mikkelsen B, Roberts N, Foster C, et al. Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review. The Lancet Global Health. 2017;5(3):e277-e89.
Organization WH. The world health report 2002: reducing risks, promoting healthy life: World Health Organization; 2002.
Thakur J, Garg R, Narain J, Menabde N. Tobacco use: a major risk factor for non communicable diseases in South-East Asia region. Indian Journal of Public Health. 2011;55(3):155.
Wagner K-H, Brath H. A global view on the development of non communicable diseases. Preventive Medicine. 2012;54:S38-S41.
Rehm J, Hasan OS, Imtiaz S, Probst C, Roerecke M, Shield K. Alcohol and noncommunicable disease risk. Current Addiction Reports. 2018;5(1):72-85.
Hyseni L, Atkinson M, Bromley H, Orton L, Lloyd-Williams F, McGill R, et al. The effects of policy actions to improve population dietary patterns and prevent diet-related non-communicable diseases: scoping review. European Journal of Clinical Nutrition. 2017;71(6):694-711.
Olatona F, Onabanjo O, Ugbaja R, Nnoaham K, Adelekan D. Dietary habits and metabolic risk factors for non-communicable diseases in a university undergraduate population. Journal of Health, Population and Nutrition. 2018;37(1):1-9.
Lee I-M, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219-29.
Yücel H, Uysal U. “Pilates-based mat exercises and parameters of quality of life in women with type 2 diabetes”. Iranian Red Crescent Journal. 18(3): e21919, 2016.
Richards NC, Gouda HN, Durham J, Rampatige R, Rodney A, Whittaker M. Disability, noncommunicable disease and health information. Bulletin of the World Health Organization. 2016;94(3):230.
Armbrecht E, Shah A, Schepman P, Shah R, Pappadopulos E, Chambers R, et al. Economic and humanistic burden associated with noncommunicable diseases among adults with depression and anxiety in the United States. Journal of Medical Economics. 2020;23(9):1032-42.
Poole JL, Gashytewa C, Sullivan AT. Activity limitations, participation, and quality of life in American Indians with and without diabetes. Occupational Therapy in Health Care. 2016;30(1):58-68.
Griffith LE, Raina P, Levasseur M, Sohel N, Payette H, Tuokko H, et al. Functional disability and social participation restriction associated with chronic conditions in middle-aged and older adults. J Epidemiol Community Health. 2017;71(4):381-9.
Örgütü DS. Bulaşıcı olmayan hastalıkların önlenmesine ve kontrolüne ilişkin küresel eylem planı 2013-2020. Cenevre, İsviçre: DSÖ Doküman Üretim Servisi. 2013.
Akman E, Tarım M. Türkiye ve İngiltere Sağlık Sistemleri: Birinci Basamak Sağlık Hizmetleri Karşılaştırması. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi.6(2):303-16.
Smith K, Day M, Muir S, Dahl-Popolizio S. Developing Tailored Program Proposals for Occupational Therapy in Primary Care. The Open Journal of Occupational Therapy. 2020;8(1):1-13.
Therapists CAoO. Occupational Therapy and Primary Health Care Primary Health Care - Fact Sheet2021.
Muir S. Occupational therapy in primary health care: We should be there. American Journal of Occupational Therapy. 2012;66(5):506-10.
Özkan E. Ergoterapide Okupasyonun Anlamı. Bölüm 2. Sayfa: 3-14. In: Aktivite Temelli Ergoterapi, Ed. H.Yücel, Hipokrat Kitabevi, 2020, ISBN: 978-605-7874-81-8.
OTD MEF, OTD AJL, Sherry Muir M, Carol Siebert M. The role of occupational therapy in primary care. The American Journal of Occupational Therapy. 2014;68:S25.
Dahl-Popolizio S, Doyle S, Wade S. The role of primary health care in achieving global healthcare goals: Highlighting the potential contribution of occupational therapy. World Federation of Occupational Therapists Bulletin. 2018;74(1):8-16.
Jordan K. Occupational therapy in primary care: positioned and prepared to be a vital part of the team. American Journal of Occupational Therapy. 2019;73(5):7305170010p1-p6.
Rexe K, Lammi B, von Zweck C. Occupational therapy: Cost-effective solutions for changing health system needs. Healthcare Quarterly. 2013;16(1):69-75.
Fritz H, Cutchin MP. Integrating the science of habit: opportunities for occupational therapy. OTJR: occupation, participation and health. 2016;36(2):92-8.
Dufour SP, Brown J, Deborah Lucy S. Integrating physiotherapists within primary health care teams: perspectives of family physicians and nurse practitioners. Journal of Interprofessional Care. 2014;28(5):460-5.
Deslauriers S, Toutant M-E, Lacasse M, Desmeules F, Perreault K. Integrating physiotherapists into publicly funded primary care: a call to action. Physiotherapy Canada. 2017;69(4):275.
Dufour SP, Lucy SD, Brown JB. Understanding physiotherapists' roles in Ontario primary health care teams. Physiotherapy Canada. 2014;66(3):234-42.
Spurlock WR, Brown SC. When Disaster Strikes: The Role of the Family Nurse Practitioner in Providing Primary Health Care. The Intersection of Trauma and Disaster Behavioral Health: Springer; 2021. p. 207-14.
Torrens C, Campbell P, Hoskins G, Strachan H, Wells M, Cunningham M, et al. Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies. 2020;104:103443.
Grant J, Lines L, Darbyshire P, Parry Y. How do nurse practitioners work in primary health care settings? A scoping review. International Journal of Nursing Studies. 2017;75:51-7.
