Animasyon Terapisinin Dikkat Eksikliği ve Hiperaktivite Bozukluğu Olan Çocuklarda Dikkat ve Dürtüsellik Seviyelerine Etkisi

BELEN Ö., Effect of Animation Therapy on Attention and Impusivity Levels of Children With Attention Deficit and Hyperactivity Disorder, Hacettepe University Graduate School of Health Sciences Occupaitonal Therapy Program Master Thesis, Ankara 2019. Attention Deficit and Hyperactivity Disorder (ADHD) is the most frequent disorder seen in childhood. The disorder is characterized with three main symptoms: inattention, hyperactivity and impulsivity. This study is planned to investigate the effects of animation therapy on the main sypmtoms of ADHD. 48 children between age of 6-12, diagnosed by a psychiatrist, on medication for ADHD and receiving therapy from Hacettepe University Occupationa Therapy Department and Special Education and Rehabilitation Centers in Ankara province were included. After a simple randomization process, children were seperated into two groups of 24 children as study group and control group. Study group received animation therapy for 10 weeks, 1 session per week, in addition to their medical and special education treatment. Control group continued their routine medical treatment and special education. Conners Parents Rating Scale Revised, Conners Teacher Rating Scale Revised, The Scales for Diagnosing ADHD-Home and The Scales for Diagnosing ADHD-School forms are used to measure the symptom levels of children. Statistically significant decrease was seen on the symptoms of ADHD for both groups after 10 week of study process (p<0.01). Sypmtom levels decrease in study group after 10 week animaton therapy were significantly more than control group (p<0.05). It is recommended that further studies would better assess the effects of animation therapy on unmedicated children to observe isolated effects of animation therapy. Also, levels of quality of life and skills in different functional domains like social, academic and family areas must be assessed beside the main symptoms,İÇİNDEKİLER ONAY SAYFASI iii YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI iv ETİK BEYAN v TEŞEKKÜR vi ÖZET vii ABSTRACT viii İÇİNDEKİLER ix SİMGELER VE KISALTMALAR xi ŞEKİLLER xii TABLOLAR xiii 1.GİRİŞ 1 2. GENEL BİLGİLER 3 2.1. Tanım 3 2.2. Tarihçe 3 2.3. Epidemiyoloji 4 2.3.1. Prevalans 4 2.3.2. Eşlik Eden Tanılar 7 2.3.3. Prognoz 8 2.4. Etiyoloji 8 2.4.1. Genetik 9 2.4.2. Nörobiyoloji 9 2.4.3. Çevresel Faktörler 12 2.5. Tanı ve Değerlendirme 13 2.6. DEHB Esas Belirtileri 19 2.6.1. Dikkatsizlik 19 2.6.2. Dürtüsellik 20 2.6.3. Hiperaktivite 21 2.7. DEHB’in Çocuk Üzerindeki Etkileri 21 2.7.1. Akademik Problemler 22 2.7.2. Sosyal Problemler 24 2.7.3. Ailesel Problemler 26 2.7.4. Diğer Problemler 27 2.8. Tedavi 28 2.8.1. İlaç Tedavisi 30 2.8.2. Farmakolojik Olmayan Müdahaleler 30 2.9. DEHB’de Ergoterapi 31 2.9.1. DEHB Olan Çocuklar İçin Belirleyici Uygulama Modeli 31 2.9.2. DEHB’e Yönelik Ergoterapi Yaklaşımları 33 2.10. Animasyon ve Animasyon Terapisi 35 3. BİREYLER VE YÖNTEM 38 3.1. Bireyler 38 3.2. Değerlendirme 40 3.2.1. Sosyodemografik Bilgiler 40 3.2.2. Semptom Seviyelerinin Belirlenmesi 40 3.3. Yöntem 45 3.4. İstatistiksel Analiz 47 4. BULGULAR 48 4.1. Çocukların Sosyodemografik Özellikleri 48 4.2. Çocukların DEHB Semptom Seviyeleri Ölçümlerine Ait Bulgular 49 4.2.1. Grupların Çalışma Öncesi Semptom Seviyelerinin Karşılaştırılması 49 4.2.2. Çalışma Öncesi ve Sonrası Semptom Seviye Farklarının Grupların Kendi İçlerinde Karşılaştırılması 52 4.2.3. Çalışma Öncesi ve Sonrası Semptom Seviye Farklarının Gruplar Arasında Karşılaştırılması 55 5. TARTIŞMA 58 6. SONUÇ VE ÖNERİLER 65 7. KAYNAKLAR 67 8. EKLER 80 Ek 1. Etik Kurul Onayı 80 Ek 2. Katılımcı Ebeveyn Onam Formu (Çalışma Grubu) 81 Ek 3. Katılımcı Çocuk Onam Formu (Çalışma Grubu) 82 Ek 4. Katılımcı Ebeveyn Onam Formu (Kontrol Grubu) 83 Ek 5. Katılımcı Çocuk Onam Formu (Çalışma Grubu) 84 Ek 6. Sosyodemografik Bilgiler Formu 85 Ek 7. Conners Anababa Dereceleme Formu-Yenilenmiş 86 Ek 8. Conners Öğretmen Dereceleme Formu – Yenilenmiş 88 Ek 9. DEHB Tanı Ölçeği: Ev Formu 90 Ek 10. DEHB Tanı Ölçeği: Okul Formu 92 Ek 11. Orijinallik Raporu 94 Ek 12. Dijital Makbuz 95 9. ÖZGEÇMİŞ 96BELEN Ö., Animasyon Terapisinin Dikkat Eksikliği ve Hiperaktivite Bozukluğu Çocuklarda Dikkat ve Dürtüsellik Seviyelerine Etkisi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü Ergoterapi Yüksek Lisans Tezi, Ankara, 2019. Dikkat eksikliği ve hiperaktivite bozukluğu (DEHB) çocukluk çağında en sık karşılaşılan nörogelişimsel bozukluktur. Dikkatsizlik, hiperaktivite ve dürtüsellik olmak üzere üç ana semptom ile karakterizedir. Bu çalışma, animasyon terapisinin DEHB’in üç ana semptomu üzerinde açığa çıkardığı etkileri incelemek amacıyla planlandı. Çalışmaya Hacettepe Üniversitesi Ergoterapi Bölümü’nde ve Ankara ili içerisinde çeşitli özel eğitim ve rehabilitasyon merkezlerinde tedavi almakta olan, bir psikiyatr tarafından DEHB teşhisi konulmuş ve ilaç tedavisi almakta olan 6-12 yaş aralığında 48 çocuk dahil edildi. Basit rastgeleleştirme yöntemi ile çocuklar 24’er kişilik çalışma ve kontrol gruplarına ayrıldı. Çalışma grubuna, aldıkları tedavilere ek olarak haftada 1 seans olmak üzere 10 haftalık animasyon terapisi uygulandı. Kontrol grubu ise rutin tedavi süreçlerine devam etti. Çocukların DEHB semptom seviyelerinin ölçümünde; Conners Anababa Dereceleme Ölçütü Yenilenmiş-Uzun, Conners Öğretmen Dereceleme Ölçütü Yenilenmiş- Uzun, DEHB Tanı Ölçeği – Ev formu ve DEHB Tanı Ölçeği – Okul formu kullanıldı. On haftalık animasyon terapisi sürecinin sonunda elde edilen bulgulara göre, her iki grubun da semptom seviyelerinde istatistiksel olarak anlamlı olacak derecede azalma görüldü (p<0,01). Ayrıca çalışma süreci sonunda, çalışma grubunun semptom seviyelerinin, kontrol grubundaki çocuklara göre, istatistiksel olarak anlamlı olacak seviyede daha fazla düştüğü görüldü (p<0,05). İleriki çalışmalarda, animasyon terapisinin etkinliğinin daha iyi incelenebilmesi için ilaç kullanmayan çocuklarda değerlendirilmesi ve semptomların yanında, yaşam kalitesi ve sosyal iletişim, akademik ve aile gibi farklı alanlardaki becerilerin değerlendirilmesi önerildi

Adaptation and validation of Turkish version of musculoskeletal pain intensity and interference questionnaire for musicians

Adaptation and validation ofTurkish version of musculoskeletal painintensity and interference questionnaire formusiciansBS Akel, Ö BelenHacettepe University, Ankara, Turkey. Objective: There are certain pain questionnaires orscales that are translated and adapted to Turkish;however, we observed an absence of an assessmenttool to examine pain in Turkish-speaking musicians.The Musculoskeletal Pain Intensity and InterferenceQuestionnaire for Musicians (MPIIQM) evaluated notonly the severity of pain, but also the impact of pain onquality of life and the experience of playing the instrument. The aim of this study was to translate and adaptthe MPIIQM in Turkish; and to test its validity and reliability for Turkish-speaking musicians whom havepain and pain-related music-playing issues.Methods: The MPIIQM was translated into Turkish bytwo independent native Turkish speakers. Translationswere compared for inconsistencies and aggregatedinto a single Turkish version. This version then alsowas back-translated into English by two independentnative English speakers. After the back-translationswere compared for inconsistencies and aggregatedinto a single form, the final English version and the original questionnaire were also compared for inconsistencies. Finally, the original English questionnaireand the Turkish questionnaire was reviewed by abilingual team, to check for the errors of interpretation and nuances that might have been missed. TheTurkish questionnaire was finalized after consensus.The study was conducted on 60 professional musicians whom had pain-related playing issues. TheMcGill Pain Questionnaire and Disabilities of Arm,Shoulder and Hand questionnaire (DASH) were alsoadministered, within an interval of 7 days (retest).Instrument test-retest reliability was assessed withthe interclass correlation coefficient (ICC) and withthe Pearson’s correlation coefficient.Results: Translation and back-translation revealedno major difficulties. Reliability of the Turkish versionof the questionnaire was very good, with high consistency and reproducibility. The MPIIQM Turkish versionshowed a high correlation with the DASH and McGillquestionnaires.Conclusions: In conclusion, the results displayed thatthe Turkish version of the MPIIQM is a reliable andvalid region-specific version and proper for use onmusicians. It seemed to be a reliable, consistent andvalid instrument in evaluating the pain intensity andimpact of pain on musicians.</p

Adaptation and psychometric testing of the Turkish evaluation of daily activity questionnaire in people with rheumatoid arthritis

Purpose: The aims were to translate the Evaluation of Daily Activity Questionnaire (EDAQ) into Turkish, then test validity and reliability in people with rheumatoid arthritis (RA) in Turkey. Material and Methods: Phase 1: The EDAQ was forward and backward translated, culturally adapted following cognitive debriefing interviews with participants with RA (n = 10) and finalized by an expert committee. Phase 2: Participants (n = 215) completed a questionnaire including the EDAQ, Health Assessment Questionnaire (HAQ), and Short-Form 36 v1 (SF-36v1). Two weeks later, the EDAQ was again completed for test–retest reliability (n = 82:38%). Internal construct validity was assessed using Rasch analysis. Internal consistency, concurrent validity, and test–retest reliability were assessed. Results: Following cultural adaptation, one item was removed, and examples increased or changed. Cronbach’s α values were 0.71 − 0.93 for all EDAQ domains, that is, acceptable to good. The EDAQ met Rasch model requirements for fit (excellent construct validity: p > 0.05). Concurrent validity was moderate to strong for most EDAQ domains with HAQ (rs 0.49–0.81) and SF-36-v1 Physical Function (rs 0.42–0.70). There was excellent test–retest reliability for all domains (ICC (2,1): 0.95–1.00). Conclusion: The Turkish EDAQ is a valid, reliable measure of daily activity ability for use in practice and research with Turkish speakers with RA