{"id":1052,"date":"2018-09-18T06:33:00","date_gmt":"2018-09-18T06:33:00","guid":{"rendered":"http:\/\/practicalhealthpsychology.com\/?p=1052"},"modified":"2025-11-04T14:35:03","modified_gmt":"2025-11-04T14:35:03","slug":"1052","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/cz\/2018\/09\/1052\/","title":{"rendered":"Co se d\u011bje s l\u00e9ky doma?"},"content":{"rendered":"<p><strong>Kerry Chamberlain,\u00a0Massey University, Auckland, Nov\u00fd Z\u00e9land<\/strong><\/p>\n<p>Co d\u011blaj\u00ed lid\u00e9 s\u00a0l\u00e9ky, jakmile si je p\u0159inesou dom\u016f? Na takovou ot\u00e1zku se zat\u00edm pokusilo odpov\u011bd\u011bt jen m\u00e1lo v\u00fdzkumn\u00fdch prac\u00ed. P\u0159esto je d\u016fle\u017eit\u00e1, proto\u017ee v\u011bt\u0161inu l\u00e9k\u016f lid\u00e9 u\u017e\u00edvaj\u00ed ve sv\u00fdch v\u00a0dom\u00e1cnostech a jejich u\u017e\u00edv\u00e1n\u00ed si hl\u00eddaj\u00ed sami. L\u00e9ky na p\u0159edpis jsou regulovan\u00e9 a po jejich p\u0159edeps\u00e1n\u00ed a vyzvednut\u00ed se p\u0159edpokl\u00e1d\u00e1, \u017ee budou u\u017e\u00edv\u00e1ny podle instrukc\u00ed. Lid\u00e9 maj\u00ed p\u0159\u00edstup k \u0161irok\u00e9 \u0161k\u00e1le voln\u011b prodejn\u00fdch p\u0159\u00edpravk\u016f (nap\u0159. proti bolesti), alternativn\u00edch p\u0159\u00edpravk\u016f (nap\u0159. homeopatika) a dal\u0161\u00edch se zdrav\u00edm souvisej\u00edc\u00edch prepar\u00e1t\u016f, kter\u00e9 l\u00e9ky p\u0159ipom\u00ednaj\u00ed (nap\u0159. potravn\u00ed dopl\u0148ky, probiotick\u00e9 n\u00e1poje). Je nutn\u00e9 br\u00e1t v\u00a0\u00favahu, \u017ee mo\u017enosti p\u0159\u00edstupu k\u00a0jednotliv\u00fdm druh\u016fm l\u00e9k\u016f se mohou <a href=\"http:\/\/ps.psychiatryonline.org\/doi\/pdf\/10.1176\/ps.62.5.pss6205_0459\">v\u00a0r\u016fzn\u00fdch zem\u00edch<\/a> zna\u010dn\u011b <a href=\"http:\/\/www.nature.com\/articles\/1002089.pdf\">li\u0161it<\/a>.<\/p>\n<p><!--more--><\/p>\n<p>V\u0161echny druhy l\u00e9\u010div jsou tak\u00e9 komplexn\u00edmi <a href=\"http:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/136345930100500403\">soci\u00e1ln\u00edmi objekty<\/a> a byla by chyba je pova\u017eovat pouze za l\u00e9ka\u0159skou technologii ur\u010denou (p\u0159i spr\u00e1vn\u00e9m u\u017e\u00edv\u00e1n\u00ed) k l\u00e9\u010db\u011b \u010di zm\u00edrn\u011bn\u00ed zdravotn\u00edch obt\u00ed\u017e\u00ed.<\/p>\n<p>Efektivita l\u00e9k\u016f mezi u\u017eit\u00edm d\u00e1vky a odezvou se m\u016f\u017ee velmi li\u0161it.<\/p>\n<p>N\u011bkter\u00e9 (nap\u0159. paracetamol) maj\u00ed vysok\u00fd terapeutick\u00fd pom\u011br (tz. jsou snadno tolerov\u00e1ny v\u00a0r\u016fzn\u00fdch d\u00e1vk\u00e1ch), zat\u00edmco jin\u00e9 (nap\u0159. levotyroxin) maj\u00ed terapeutick\u00fd pom\u011br n\u00edzk\u00fd (tzn. jen mal\u00fd rozd\u00edl v\u00a0d\u00e1vkov\u00e1n\u00ed m\u016f\u017ee v\u00e9st k\u00a0selh\u00e1n\u00ed l\u00e9\u010dby a\/nebo k z\u00e1va\u017en\u00fdm ne\u017e\u00e1douc\u00edm \u00fa\u010dink\u016fm).<\/p>\n<p>V\u0161echna l\u00e9\u010diva maj\u00ed tak\u00e9 n\u011bjak\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky, a to bu\u010f m\u00edrn\u00e9, v\u011bt\u0161inou u\u017eivatel\u016f nepost\u0159ehnuteln\u00e9, nebo siln\u00e9 a potenci\u00e1ln\u011b z\u00e1va\u017en\u00e9.<\/p>\n<p>Jak se l\u00e9ky li\u0161\u00ed ve sv\u00fdch \u00fa\u010dinc\u00edch, tak se li\u0161\u00ed i tolerance jedinc\u016f k l\u00e9\u010div\u016fm, kter\u00e1 se nav\u00edc m\u016f\u017ee <a href=\"https:\/\/ps.psychiatryonline.org\/doi\/pdf\/10.1176\/ps.62.5.pss6205_0459\">m\u011bnit v\u00a0\u010dase<\/a> opakovan\u00fdm u\u017e\u00edv\u00e1n\u00edm l\u00e9ku.<\/p>\n<p>M\u00e1me z\u00e1sadn\u00ed d\u016fkazy, \u017ee pouze polovina p\u0159edepsan\u00fdch l\u00e9k\u016f je <a href=\"https:\/\/www.annualreviews.org\/doi\/abs\/10.1146\/annurev-pharmtox-011711-113247\">u\u017e\u00edv\u00e1na<\/a> <a href=\"http:\/\/primarycare.imedpub.com\/medication-nonadherence-identified-at-home-a-systematic-review-and-metaanalysis.php?aid=19318\">v\u00a0souladu s\u00a0pokyny<\/a>.<\/p>\n<p>To se d\u011bje <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0277953604006069\">z\u00a0r\u016fzn\u00fdch d\u016fvod\u016f<\/a>, kdy svou roli hraj\u00ed i zku\u0161enosti s\u00a0vedlej\u0161\u00edmi \u00fa\u010dinky, obavy ze z\u00e1vislosti \u010di p\u0159esv\u011bd\u010den\u00ed o <a href=\"https:\/\/www.bmj.com\/content\/345\/bmj.e3953.short\">onemocn\u011bn\u00ed<\/a>, medikaci a l\u00e9\u010db\u011b.<\/p>\n<p>Abychom pochopili, jak\u00fd smysl p\u0159ikl\u00e1daj\u00ed lid\u00e9 l\u00e9k\u016fm ve sv\u00fdch ka\u017edodenn\u00edch \u017eivotech, podnikli jsme v\u00fdzkum v 55\u00a0c\u00edlen\u011b vybran\u00fdch dom\u00e1cnostech ze \u010dty\u0159 velkom\u011bst nap\u0159\u00ed\u010d Nov\u00fdm Z\u00e9landem. Zaj\u00edmala n\u00e1s nejen adherence k\u00a0u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f, ale p\u0159edev\u0161\u00edm <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1111\/1467-9566.12041\">zp\u016fsob, jak\u00fdm obecn\u011b lid\u00e9 s\u00a0l\u00e9ky v\u00a0dom\u00e1cnostech nakl\u00e1daj\u00ed, <\/a>kde r\u016fzn\u00e1 l\u00e9\u010diva uchov\u00e1vaj\u00ed, a po\u017e\u00e1dali jsme je o vytvo\u0159en\u00ed seznamu l\u00e9\u010div, kter\u00e1 maj\u00ed doma.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>N\u011bkter\u00e9 hlavn\u00ed v\u00fdstupy v\u00fdzkumu:<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Ve v\u0161ech dom\u00e1cnostech se vyskytovala a u\u017e\u00edvala \u0161irok\u00e1 \u0161k\u00e1la r\u016fzn\u00fdch druh\u016f l\u00e9\u010div \u2013 na p\u0159edpis, voln\u011b prodejn\u00fdch a alternativn\u00edch. Jejich um\u00edst\u011bn\u00ed bylo organizovan\u00e9 a z\u00a0hlediska u\u017e\u00edv\u00e1n\u00ed d\u016fle\u017eit\u00e9. Spole\u010dn\u00e1 l\u00e9\u010diva byla uchov\u00e1v\u00e1na ve spole\u010dn\u00fdch prostor\u00e1ch (kuchyn\u011b a ob\u00fdv\u00e1ky), osobn\u00ed medikace v\u00a0soukrom\u011bj\u0161\u00edch prostorech (lo\u017enice, koupelny) a pro\u0161l\u00e1 medikace byla skladov\u00e1na mimo (ve sk\u0159\u00edn\u00edch a na p\u016fd\u00e1ch). Um\u00edst\u011bn\u00ed l\u00e9\u010div odr\u00e1\u017eelo <a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S1353829210001760\">rodinn\u00e9 vztahy a zp\u016fsoby p\u00e9\u010de o zdrav\u00ed<\/a> v\u00a0dom\u00e1cnostech.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Ch\u00e1p\u00e1n\u00ed a u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f se mezi \u00fa\u010dastn\u00edky velmi li\u0161ilo, od <a href=\"http:\/\/www.medanthrotheory.org\/read\/2020\/forms-of-resistance-to-medications-within-new-zealand-households\">odporu<\/a> k\u00a0u\u017e\u00edv\u00e1n\u00ed, p\u0159es r\u016fzn\u00e9 odli\u0161n\u00e9 formy compliance (spolupr\u00e1ce na l\u00e9\u010db\u011b), upravov\u00e1n\u00ed si a roz\u0161i\u0159ov\u00e1n\u00ed medikace, a to podle typu l\u00e9\u010diva a onemocn\u011bn\u00ed.\n<ul>\n<li>Nap\u0159\u00edklad n\u011bkte\u0159\u00ed se specificky vymezovali v\u016f\u010di antibiotik\u016fm: <em>\u201eNerad beru antibiotika\u2026 antibiotika by se m\u011bla \u0161et\u0159it pro mimo\u0159\u00e1dn\u00e9 situace.\u201c<\/em><\/li>\n<li>U\u017eivatel\u00e9 psychofarmak si sni\u017eovali d\u00e1vkov\u00e1n\u00ed kv\u016fli vedlej\u0161\u00edm \u00fa\u010dink\u016fm a obav\u00e1m ze z\u00e1vislosti: <em>\u201eCht\u011bl jsem fungovat jako plnohodnotn\u00fd \u010dlen spole\u010dnosti\u2026 aby se mi ulevilo, musel jsem se vyka\u0161lat na medikaci.\u201c<\/em><\/li>\n<li>Lid\u00e9 u\u017e\u00edvaj\u00edc\u00ed alternativn\u00ed p\u0159\u00edpravky m\u011bli v\u0161eobecn\u011b odpor ke klasick\u00fdm l\u00e9\u010div\u016fm: <em>\u201eRad\u011bji to zkus\u00edm p\u0159echodit nebo zkus\u00edm jakoukoliv jinou alternativu, ne\u017e abych bral l\u00e9ky.\u201c<\/em><\/li>\n<li>Jin\u00ed si upravovali d\u00e1vkov\u00e1n\u00ed podle symptom\u016f: <em>\u201eP\u0159edepsali mi vy\u0161\u0161\u00ed d\u00e1vku, ale rozhodl jsem se, \u017ee to zkus\u00edm co nejv\u00edce sn\u00ed\u017eit.\u201c<\/em><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Ka\u017edodenn\u00ed zach\u00e1zen\u00ed s\u00a0l\u00e9\u010divy se \u0159\u00eddilo t\u00edm, jak lid\u00e9 vn\u00edmali jejich hodnotu a m\u00edsto ve spole\u010dnosti. Nesoulad a zmatek vznikal tam, kde strach a \u00fazkost vyvolan\u00e1 marketingem a p\u0159\u00edb\u011bhy v m\u00e9di\u00edch dok\u00e1zaly v\u00a0lidech navodit pocit \u201enep\u0159irozenosti\u201c a ztr\u00e1ty kontroly. Naopak ur\u010dit\u00fd \u0159\u00e1d p\u0159in\u00e1\u0161ela l\u00e9\u010diva, kdy\u017e byla vn\u00edm\u00e1na jako obnova rovnov\u00e1hy. N\u011bkdy L\u00e9\u010diva vyvol\u00e1vala etick\u00e9 ot\u00e1zky, jestli\u017ee byla vn\u00edm\u00e1na jako \u201enutn\u00e9 zlo\u201c vy\u017eaduj\u00edc\u00ed zv\u00fd\u0161enou bd\u011blost p\u0159i u\u017e\u00edv\u00e1n\u00ed, nebo kdy\u017e si jejich u\u017e\u00edv\u00e1n\u00ed a svou nemoc lid\u00e9 spojovali s\u00a0p\u0159edstavou \u201e<a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0277953614001671\">mor\u00e1ln\u011b selh\u00e1vaj\u00edc\u00edho<\/a>\u201c nemocn\u00e9ho \u010dlov\u011bka \u010di stigmatizovan\u00e9ho selh\u00e1vaj\u00edc\u00edho t\u011bla neboli identity, kterou je t\u0159eba kontrolovat\/zvl\u00e1dnout.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Laickou automedikaci nevid\u00edme jako iracion\u00e1ln\u00ed chov\u00e1n\u00ed nebo v\u00fdsledek neinformovanosti, ale sp\u00ed\u0161e jako sv\u00e9bytnou logiku, vych\u00e1zej\u00edc\u00ed z \u201e<a href=\"http:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/09505430902885631\">laick\u00e9 farmakologie<\/a>\u201c, kde se pacient\u016fv postoj k\u00a0l\u00e9\u010div\u016fm zakl\u00e1d\u00e1 na jeho zdravotn\u00edm stavu a osobn\u00edm narativu (vn\u00edm\u00e1n\u00ed a interpretaci) ohledn\u011b vlastn\u00edho zdrav\u00ed. Tato laick\u00e1 farmakologie ovliv\u0148uje a m\u011bn\u00ed zp\u016fsob u\u017e\u00edv\u00e1n\u00ed medikace v\u00a0dom\u00e1cnostech pacient\u016f uveden\u00fdmi v\u00fd\u0161e zp\u016fsoby a <a href=\"http:\/\/www.rsap.org\/article\/S1551-7411(16)30105-X\/\">v\u00a0mnoha ohledech<\/a> n\u00e1m poskytuje chyb\u011bj\u00edc\u00ed pohled na <a href=\"http:\/\/www.routledge.com\/Self-Medication-and-Society-Mirages-of-Autonomy\/Fainzang\/p\/book\/9781138213944\">u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f<\/a>. L\u00e9\u010diva v\u00a0dom\u00e1cnostech maj\u00ed sv\u016fj vlastn\u00ed <a href=\"http:\/\/www.cambridge.org\/nz\/academic\/subjects\/anthropology\/social-and-cultural-anthropology\/social-lives-medicines?format=PB&amp;isbn=9780521804691#rv4svbKmxj0d6dGZ.97\">soci\u00e1ln\u00ed \u017eivot<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Doporu\u010den\u00ed:<\/strong><\/p>\n<ul>\n<li>Psychologov\u00e9 by ve sv\u00fdch prax\u00edch nem\u011bli u\u017e\u00edv\u00e1n\u00ed medikace vn\u00edmat pouze z\u00a0biomedic\u00ednsk\u00e9 perspektivy ve smyslu adherence (ochota spolupracovat s\u00a0l\u00e9ka\u0159i na\u00a0l\u00e9\u010db\u011b); m\u011bli by tak\u00e9 rozum\u011bt tomu, \u017ee u\u017e\u00edv\u00e1n\u00ed l\u00e9\u010div m\u00e1 i svou soci\u00e1ln\u00ed str\u00e1nku, a podle toho postupovat.<\/li>\n<li>U\u017e\u00edv\u00e1n\u00ed l\u00e9\u010div m\u016f\u017eeme l\u00e9pe porozum\u011bt ze situa\u010dn\u00ed perspektivy s\u00a0ohledem na m\u00edsto a \u010das a na to, jak je zasazeno do ka\u017edodenn\u00edho \u017eivota. Praktici v\u00a0oblasti psychologie zdrav\u00ed, kte\u0159\u00ed cht\u011bj\u00ed intervenovat do u\u017e\u00edv\u00e1n\u00ed medikace, mus\u00ed nejprve probrat a rozkr\u00fdt pacientovo chov\u00e1n\u00ed, a pak poskytnout poradenstv\u00ed v\u00a0souvislosti se soci\u00e1ln\u00ed a kontextu\u00e1ln\u00ed dynamikou, kter\u00e1 m\u00e1 vliv na ka\u017edodenn\u00ed u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f pacientem.<\/li>\n<li>Praktici v\u00a0oblasti psychologie zdrav\u00ed by se m\u011bli o u\u017e\u00edv\u00e1n\u00ed medikace s\u00a0pacienty otev\u0159en\u011b bavit a pokusit se sv\u00e1 doporu\u010den\u00ed p\u0159izp\u016fsobit pacientovu ch\u00e1p\u00e1n\u00ed nemoci, jeho nahl\u00ed\u017een\u00ed na medikaci a jej\u00ed hodnotu, a zkusit vymyslet, jak mohou b\u00fdt zp\u016fsoby u\u017e\u00edv\u00e1n\u00ed medikace za\u010dlen\u011bny do jeho ka\u017edodenn\u00edho \u017eivota.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><em>P\u0159eklad: Ren\u00e1ta \u010cerm\u00e1kov\u00e1<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Kerry Chamberlain,\u00a0Massey University, Auckland, New Zealand What do people do with medications once they enter the home? Surprisingly, limited research has attempted to answer that question. Yet, it is important \u2013 most medications are consumed at home under the [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":1110,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[26],"tags":[],"class_list":["post-1052","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medication-adherence"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"cz","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":true,"content":true,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":true,"content":true,"excerpt":false},"hr":{"title":false,"content":false,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":true,"content":true,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"fr":{"title":true,"content":true,"excerpt":false},"gr":{"title":true,"content":true,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":false,"content":false,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":true,"content":true,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":false,"content":false,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":true,"content":true,"excerpt":false},"ro":{"title":true,"content":true,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":false,"content":false,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/1052","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/comments?post=1052"}],"version-history":[{"count":10,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/1052\/revisions"}],"predecessor-version":[{"id":4622,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/1052\/revisions\/4622"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/media\/1110"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/media?parent=1052"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/categories?post=1052"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/tags?post=1052"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}