Turkiye Klinikleri Journal of Medical Ethics-Law and History

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Periton Diyalizinin Tarihsel Süreci ve Hemşirelik
Historical Process of Peritoneal Dialysis and Nursing
Gizem GÖKTUNAa, Gülşah GÜROL ARSLANb, Dilek ÖZDENb
aHemşirelik Bölümü, Hemşirelik Esasları AD, Dokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü,
bHemşirelik Esasları AD, Dokuz Eylül Üniversitesi Hemşirelik Fakültesi, İzmir, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2019;27(2):148-54
doi: 10.5336/mdethic.2018-63956
Article Language: TR
Full Text
ÖZET
 Tarihsel süreç içerisinde periton boşluğu ile ilgili bilinen en eski kayıtlara MÖ 3000 yılında yazılan Ebers Papyrus'ta rastlanmaktadır. Antik dönemde ise Galen, abdomeni ayrıntılı olarak gözlemlemiş, 1740'lı yıllarda ise periton lavajı fikri ortaya çıkmıştır. Alman klinik araştırmacı Georg Ganter, 1923 yılında, kadın bir hasta üzerinde periton diyalizini uygulamıştır. Bu uygulama insanda periton diyalizi uygulamasının başlangıcı olarak kabul edilmiştir. Böbrek yetmezliği olan hastanın bakımı ise hemşirelik literatüründe 1915 yılı gibi erken bir dönemde tartışılmaya başlanmasına rağmen, 1915-1950 yılları arasında çok az çalışma bulgusuna rastlanmaktadır. Hemşireler, peritoneal kateterin yerleştirilmesinde hekime yardımcı olmuşlar, sonrasında da diyaliz işleminin takip edilmesi ve sürdürülmesini sağlamışlardır. Boen, 1964 yılında, periton diyalizi için otomatik bir cihaz geliştirmiştir. Bu cihaz sayesinde diyaliz makinesi hasta çağrı sistemine entegre edilmiş ve hemşirelerin, zaman yönetimiyle ilgili sorunu çözülmüştür. Yetmişli yılların sonunda periton diyalizi, gerekli olan ekipmanlara kolaylıkla ulaşılabilmesine rağmen, kronik böbrek yetmezliği için en az kullanılan tedavi şekli olarak kalmıştır. Bu tarihlerde periton diyalizi programı çok az merkezde yürütüldüğünden, hemşire eğitimleri "talep üzerine" gerçekleştirilmiştir. Türkiye'de ilk kez İstanbul Florence Nightingale Hemşirelik Yüksekokulunda 1992 yılında Türk Nefroloji Diyaliz ve Transplantasyon Hemşireleri Derneği kurulmuştur. Günümüzde ise nefroloji hemşireleri, fiziksel ve psikososyal bakımın yanı sıra, pek çok konuya yönelik diyaliz hastalarına eğitim ve danışmanlık sağlamaktadırlar. Ayrıca, Türkiye'de sürekli ayaktan periton diyalizi ilk kez Ankara Tıp Fakültesi ve Cerrahpaşa Tıp Fakültesinde 1985 yılında uygulanmıştır. Bu çalışmada, literatür doğrultusunda periton diyalizi ve periton diyalizi hemşireliğinin tarihsel gelişiminin incelenmesi amaçlanmıştır.

Anahtar Kelimeler: Periton diyalizi; hemşirelik tarihi; diyaliz tarihi; tıp tarihi
ABSTRACT
 In the historical process, the earliest known records related to peritoneal cavity are found in Ebers Papyrus written in 3000 BC. In ancient times, Galen, observed the abdomen in details; and in the 1740s the idea of peritoneal lavage emerged. German clinical researcher Georg Ganter applied peritoneal dialysis on a female patient in 1923. This application was accepted as the beginning of peritoneal dialysis in human. Although the care of patients with renal insufficiency has been discussed in the nursing literature as early as 1915, there is a little amount of research findings between dates of 1915-1950. The nurses assisted the physicians in the placement of the peritoneal catheter, afterwards, they ensured that the dialysis process was followed and maintained. Boen developed an automatic device for peritoneal dialysis in 1964. Thanks to this device, the dialysis machine has been integrated into the patient call system and the problem of time management of nurses has been solved. At the end of the seventies, although the necessary equipment could be easily accessed peritoneal dialysis still remained the least used treatment modality for chronic renal failure. Since the peritoneal dialysis program was carried out at very few centres, nurse trainings were carried out "on demand." In Turkey, for the first time, Turkish Nephrology Dialysis and Transplant Nurses Association was established in 1992 at Istanbul Florence Nightingale School of Nursing. Nowadays, nephrology nurses provide training and counseling to dialysis patients for many issues as well as physical and psychosocial care. Furthermore, in Turkey at the Ankara Faculty of Medicine and Cerrahpasa Faculty of Medicine continuous ambulatory peritoneal dialysis was applied for the first time in 1985 for the first time. The aim of this article is to examine the historical development of peritoneal dialysis and peritoneal dialysis nursing in accordance with the literature.

Keywords: Peritoneal dialysis; history of nursing; history of dialysis; history of medicine
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