Publication: Genç yetişkinlerde psikosomatik belirtilerin karma metodoloji ile incelenmesi
Abstract
Bireyin içinde bulunduğu sistemde algıladığı fiziksel, biyolojik ya da sosyal bir stres faktörü organizmanın dengesini bozabilmektedir. Stres faktörünü artıran nedenlerin başında aile yapısı, sosyal çevre, sosyo- ekonomik veya kültürel düzeyi gelebilir. Tehdit olarak algılanan bu durumun yarattığı endişe kişide bedensel yakınmalara neden olmakta, bu da organik nedenle açıklanamayan ve somatizasyon olarak adlandırılan fiziksel belirtileri ortaya çıkarabilmektedir. Bu çalışma ile genç yetişkinlerin deneyimledikleri somatik belirtilerin karma metodoloji ile incelenmesi amaçlanmıştır. Bu amaç doğrultusunda karma yöntem araştırmalarından açımlayıcı sıralı desen kullanılmış, araştırmanın nicel aşamasında ilişkisel tarama yöntemi, nitel aşamasında ise yorumlayıcı fenomenolojik analiz yaklaşımından faydalanılmıştır. Araştırmanın nicel aşamasında 18-45 yaş aralığında İstanbul ilinde yaşayan 597 gönüllü genç yetişkin ile araştırma gerçekleştirilmiştir. Nitel aşamada ise Somatizasyon Ölçeği’nden 17 üzeri puan alan ve araştırmaya katılmayı kabul eden 12 genç yetişkin ile araştırma sürdürülmüştür. Araştırmanın nicel aşamasında, çalışmaya dahil olan genç yetişkin bireylere; Şar, Öztürk ve İkikardeş (2012) tarafından Türkçe uyarlamasının geçerlik ve güvenirliği sağlanan ‘Çocukluk Çağı Travma Ölçeği’; Sapmaz ve Doğan (2013) tarafından Türkçe versiyonunun geçerlik ve güvenirlik çalışması sağlanan ‘Bilişsel Esneklik Envanteri’ ve son olarak Dülgerler tarafından geçerlik ve güvenirlik çalışması yapılan ‘Somatizasyon Ölçeği’ ile araştırmacı tarafından oluşturulan ‘Kişisel Bilgi Formu’ kullanılmıştır. Araştırmanın nitel aşamasında ise araştırmacı tarafından oluşturulan ‘Görüşme Soruları’ kullanılmıştır. Araştırmadan elde edilen nicel veriler, SPSS 22 ve MPLUS istatistik analiz edilmiş, elde edilen veriler ve oluşturulan model, yapısal eşitlik ile sınanmıştır. Daha sonra nitel aşamada yorumlayıcı fenomenolojik analiz basamakları takip edilerek somatizasyon puanları yüksek çıkan bireylerle görüşmeler yapılmış, katılımcıların somatizasyon deneyimlerine yönelik algıları ele alınmıştır. Nitel verilerin içerik analizi MAXQDA gerçekleştirilmiştir. Araştırmanın sonucunda, nicel bulgular incelendiğinde çocukluk çağı travmaları ile somatizasyon arasında doğrudan bir ilişki bulunurken bu ilişkide alternatifler ve kontrolün (bilişsel esnekliğin) tam aracı bir etkisi olduğu görülmüştür. Nitel aşamada yapılan analiz sonucunda bireyin deneyimlediği psikosomatik belirtilerin kaynağında bireysel, çevresel ve küresel etkenlerin yanında aile ilişkileri ve iş yaşamı olduğu görülmüştür. Bireyin bu iv belirtileri deneyimlerken duygu ve düşünceleri ile gündelik yaşamına ve kişilerarası ilişkilerine yansımalarının da olumsuz yönde olduğu ortaya çıkmıştır. Aynı zamanda psikosomatik belirtiler yaşayan katılımcıların bedensel durumlarını anlamlandırmada farkındalıklarının arttığı görülmektedir. Katılımcıların psikosomatik belirtilerle baş etme süreçleri incelendiğinde destek arama ve iyi oluş aktivitelerinin ön plana çıktığı, bunların yanında kaçınma, rekreatif aktiviteler, kendine ve davranışa yönelme gibi baş etme yöntemlerinin kullanıldığı görülmektedir.
A physical, biological, or social stress factor that the individual perceives in the system can disrupt the balance of the organism. Family structure, social environment, and socioeconomic or cultural level can be the reason that increases the stress factor of an individual. The anxiety created by this situation, which is perceived as a threat, causes physical complaints in the person. This can reveal symptoms called somatization, which organic reasons cannot explain. This study aimed to examine the somatic symptoms experienced by young adults with a mixed methodology. For this purpose, explanatory sequential design from mixed method research was used, the relational model was used in the quantitative stage, and interpretive phenomenological analysis approach was used in the qualitative phase of the research. In the quantitative phase of the research, the research was carried out with 597 volunteer young adults aged 18-45 years living in Istanbul. In the qualitative stage, the study was carried out with 12 young adults who received a score above 17 on the Somatization Scale and agreed to participate in the research. In the quantitative phase of the study, young adult individuals were included in the study; 'Childhood Trauma Scale,’ the validity and reliability of which were provided by Şar, Öztürk, and İkikardeş (2012) in its Turkish adaptation; The 'Cognitive Flexibility Inventory,’ the validity and reliability of the Turkish version of which was provided by Sapmaz and Doğan (2013), and the 'Somatization Scale,’ the validity and reliability of which was studied by Dülgerler, and the 'Personal Information Form,’ which the researcher created, were used. In the qualitative phase of the research, 'Interview Questions' created by the researcher were used. Quantitative data obtained from the research were analyzed with SPSS 22 and MPLUS statistical program, and the obtained data and the created model were tested with the structural equation. Then, in the qualitative stage, interviews were conducted with individuals with high somatization scores by following the interpretative phenomenological analysis steps, and the participants’ perceptions about their somatization experiences were discussed. Content analysis of qualitative data was carried out with the MAXQDA program. As a result of the study, when the quantitative findings were examined, it was seen that there was a direct relationship between childhood traumas and somatization, while alternatives and control (cognitive flexibility) had a mediating effect in this relationship. As a result of the analysis made at the qualitative stage, it was seen that the source of the vi psychosomatic symptoms experienced by the individual was family relations and work life, as well as individual, environmental and global factors. It has been revealed that while the individual experiences these symptoms, his feelings, thoughts, and reflections on his daily life and interpersonal relationships are also negative. At the same time, it was observed that the awareness of the participants who experienced psychosomatic symptoms increased in making sense of their bodily states. When the participants' coping processes with psychosomatic symptoms were examined, it was seen that activities such as seeking support and well-being activities came to the fore, and coping methods such as avoidance, recreational activities, and self-directedness and behavior were used.
A physical, biological, or social stress factor that the individual perceives in the system can disrupt the balance of the organism. Family structure, social environment, and socioeconomic or cultural level can be the reason that increases the stress factor of an individual. The anxiety created by this situation, which is perceived as a threat, causes physical complaints in the person. This can reveal symptoms called somatization, which organic reasons cannot explain. This study aimed to examine the somatic symptoms experienced by young adults with a mixed methodology. For this purpose, explanatory sequential design from mixed method research was used, the relational model was used in the quantitative stage, and interpretive phenomenological analysis approach was used in the qualitative phase of the research. In the quantitative phase of the research, the research was carried out with 597 volunteer young adults aged 18-45 years living in Istanbul. In the qualitative stage, the study was carried out with 12 young adults who received a score above 17 on the Somatization Scale and agreed to participate in the research. In the quantitative phase of the study, young adult individuals were included in the study; 'Childhood Trauma Scale,’ the validity and reliability of which were provided by Şar, Öztürk, and İkikardeş (2012) in its Turkish adaptation; The 'Cognitive Flexibility Inventory,’ the validity and reliability of the Turkish version of which was provided by Sapmaz and Doğan (2013), and the 'Somatization Scale,’ the validity and reliability of which was studied by Dülgerler, and the 'Personal Information Form,’ which the researcher created, were used. In the qualitative phase of the research, 'Interview Questions' created by the researcher were used. Quantitative data obtained from the research were analyzed with SPSS 22 and MPLUS statistical program, and the obtained data and the created model were tested with the structural equation. Then, in the qualitative stage, interviews were conducted with individuals with high somatization scores by following the interpretative phenomenological analysis steps, and the participants’ perceptions about their somatization experiences were discussed. Content analysis of qualitative data was carried out with the MAXQDA program. As a result of the study, when the quantitative findings were examined, it was seen that there was a direct relationship between childhood traumas and somatization, while alternatives and control (cognitive flexibility) had a mediating effect in this relationship. As a result of the analysis made at the qualitative stage, it was seen that the source of the vi psychosomatic symptoms experienced by the individual was family relations and work life, as well as individual, environmental and global factors. It has been revealed that while the individual experiences these symptoms, his feelings, thoughts, and reflections on his daily life and interpersonal relationships are also negative. At the same time, it was observed that the awareness of the participants who experienced psychosomatic symptoms increased in making sense of their bodily states. When the participants' coping processes with psychosomatic symptoms were examined, it was seen that activities such as seeking support and well-being activities came to the fore, and coping methods such as avoidance, recreational activities, and self-directedness and behavior were used.