{"id":2243,"date":"2021-07-14T14:02:35","date_gmt":"2021-07-14T14:02:35","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=2243"},"modified":"2025-11-04T14:10:04","modified_gmt":"2025-11-04T14:10:04","slug":"if-medicine-is-a-team-game-patients-should-play-too-a-psychological-perspective-on-patient-engagement","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/cz\/2021\/07\/if-medicine-is-a-team-game-patients-should-play-too-a-psychological-perspective-on-patient-engagement\/","title":{"rendered":"Pokud je medic\u00edna t\u00fdmov\u00e1 hra, tak by pacienti m\u011bli tak\u00e9 hr\u00e1t: psychologick\u00e1 perspektiva zapojen\u00ed pacient\u016f do l\u00e9\u010dby"},"content":{"rendered":"<p><strong> Graffigna, Universit\u00e0 Cattolica de lSacro Cuore, It\u00e1lie<\/strong><\/p>\n<p>K\u00a0efektn\u00edmu fungov\u00e1n\u00ed zdravotnick\u00e9ho syst\u00e9mu je zapot\u0159eb\u00ed, aby zdravotn\u00edci po celou dobu spolupracovali a koordinovali sv\u00e9 \u00fasil\u00ed. Jin\u00fdmi slovy, k\u00a0dosa\u017een\u00ed \u00fasp\u011bchu vy\u017eaduje medic\u00edna t\u00fdmovou spolupr\u00e1ci. Pokud s\u00a0t\u00edmto principem souhlas\u00edme, pak by p\u0159i aplikov\u00e1n\u00ed t\u00e9to sportovn\u00ed metafory m\u011bli b\u00fdt pacienti sou\u010d\u00e1st\u00ed hr\u00e1\u010dsk\u00e9ho t\u00fdmu!<\/p>\n<p>Koncept zapojov\u00e1n\u00ed pacienta je d\u016fle\u017eitou sou\u010d\u00e1st\u00ed zlep\u0161ov\u00e1n\u00ed efektivity a udr\u017eitelnosti zdravotn\u00ed p\u00e9\u010de.<\/p>\n<p><!--more--><\/p>\n<p>Co znamen\u00e1 zapojen\u00ed pacienta?<\/p>\n<p><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/252269\">Zapojen\u00ed pacienta<\/a> vn\u00edm\u00e1 jedince nikoli jako pouh\u00e9 \u201ep\u0159\u00edjemce p\u00e9\u010de\u201c, ale vid\u00ed je jako st\u011b\u017eejn\u00ed akt\u00e9ry v\u00a0pl\u00e1nov\u00e1n\u00ed a poskytov\u00e1n\u00ed zdravotn\u00ed p\u00e9\u010de. Je to proces, ve kter\u00e9m jsou lid\u00e9 skute\u010dn\u011b aktivn\u011b zapojeni do\u00a0ur\u010dov\u00e1n\u00ed relevantn\u00edch bod\u016f p\u00e9\u010de. To znamen\u00e1 do rozhodov\u00e1n\u00ed o faktorech, kter\u00e9 ovliv\u0148uj\u00ed jejich \u017eivot, do vytv\u00e1\u0159en\u00ed a implementov\u00e1n\u00ed opat\u0159en\u00ed, pl\u00e1nov\u00e1n\u00ed, vytv\u00e1\u0159en\u00ed a poskytov\u00e1n\u00ed slu\u017eeb, a p\u0159ij\u00edm\u00e1n\u00ed opat\u0159en\u00ed vedouc\u00edch k dosa\u017een\u00ed zm\u011bn chov\u00e1n\u00ed a \u017eivotn\u00edho stylu. Pro tento proces jsou z\u00e1sadn\u011b d\u016fle\u017eit\u00e9 psychologick\u00e9 postoje, motivace, pocity a p\u0159ipravenost pacient\u016f zapojit se do zdravotn\u00ed p\u00e9\u010de.<\/p>\n<p>Na\u0161e skupina v roce 2017 navrhla a v\u011bdecky ov\u011b\u0159ila psychosoci\u00e1ln\u00ed r\u00e1mec pro diagnostiku a podporu zapojen\u00ed pacient\u016f: <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6056150\/\">Model zapojen\u00ed pacienta.<\/a> Tato nov\u00e1, v\u011bdecky zalo\u017een\u00e1 psychologick\u00e1 teorie si klade za c\u00edl vysv\u011btlit, jak se vyv\u00edj\u00ed zapojen\u00ed pacienta z\u00a0jeho perspektivy. Model zapojen\u00ed pacienta popisuje zapojen\u00ed jako dynamicky se vyv\u00edjej\u00edc\u00ed proces, ve kter\u00e9m m\u016f\u017ee pacient objevit sv\u00e9 schopnosti k dosa\u017een\u00ed osobn\u00edch projekt\u016f a zam\u011b\u0159en\u00ed na c\u00edl \u2013 i p\u0159es \u017eivot s\u00a0nemoc\u00ed.<\/p>\n<p>Model zd\u016fraz\u0148uje pacientovu osobn\u00ed volbu p\u0159i zm\u011bn\u011b p\u0159\u00edstupu ke zdravotn\u00edmu syst\u00e9mu. Z\u00a0pasivn\u00edho p\u0159\u00edjemce se st\u00e1v\u00e1 partnerem a spolutv\u016frcem zdravotn\u00ed p\u00e9\u010de. Tato zm\u011bna rol\u00ed dynamicky p\u016fsob\u00ed na v\u00fdvoj jeho adaptace a resilience. Pln\u00e9 zapojen\u00ed pacienta je v\u00fdsledkem souboru emo\u010dn\u00edch a motiva\u010dn\u00edch sil, vedouc\u00edch k\u00a0p\u0159er\u00e1mov\u00e1n\u00ed zdravotn\u00edho stavu a identity\/role pacienta. To je z\u00e1sadn\u00ed pro dodr\u017eov\u00e1n\u00ed l\u00e9\u010dby, sebe\u0159\u00edzen\u00ed a \u00fasp\u011b\u0161n\u00e9 udr\u017een\u00ed zm\u011bn v chov\u00e1n\u00ed a \u017eivotn\u00edm stylu.<\/p>\n<p>Model zapojen\u00ed pacienta je slo\u017een ze \u010dty\u0159 f\u00e1z\u00ed. Zdravotnick\u00fd person\u00e1l m\u016f\u017ee podpo\u0159it zapojen\u00ed pacienta b\u011bhem ka\u017ed\u00e9 f\u00e1ze:<\/p>\n<ul>\n<li>F\u00e1ze 1: Zatemn\u011bn\u00ed. V\u00a0t\u00e9to f\u00e1zi pacienti poci\u0165uj\u00ed zranitelnost, kter\u00e1 je spojena s\u00a0kritickou situac\u00ed, obvykle s\u00a0diagn\u00f3zou. Zdravotn\u00edci by m\u011bli poskytnout pacientovi emocion\u00e1ln\u00ed podporu a pomoci mu s\u017e\u00edt se s\u00a0jeho nov\u00fdm zdravotn\u00edm stavem. D\u016fraz by m\u011bl b\u00fdt kladen na rozvoj nov\u00e9ho zam\u011b\u0159en\u00ed pacienta a kontrolu nad nemoc\u00ed. Jin\u00fdmi slovy, pacienti mohou b\u00fdt podpo\u0159eni v\u00a0pocitu, \u017ee jejich \u010diny vedou k\u00a0efektivn\u00edmu zdravotn\u00edmu managementu.<\/li>\n<li>F\u00e1ze 2: Vzru\u0161en\u00ed. V\u00a0t\u00e9to f\u00e1zi maj\u00ed pacienti ji\u017e z\u00e1kladn\u00ed pov\u011bdom\u00ed o sv\u00e9m zdravotn\u00edm stavu, ale m\u00e1lo toho v\u011bd\u00ed o efektivn\u00edm zvl\u00e1d\u00e1n\u00ed. V\u00a0t\u00e9to f\u00e1zi je obvykl\u00e9, \u017ee pacienti odejdou z\u00a0p\u00e9\u010de. Zdravotn\u00edci se v\u00a0t\u00e9to situaci st\u00e1vaj\u00ed z\u00e1sadn\u00edm referen\u010dn\u00edm bodem. Mus\u00ed pacienty podporovat ve zvl\u00e1d\u00e1n\u00ed a managementu nemoci, a tak sni\u017eovat po\u010det jejich odchod\u016f.<\/li>\n<li>F\u00e1ze 3: Sr\u016fst. V t\u00e9to f\u00e1zi pacienti obvykle p\u0159ijali svou nemoc a p\u0159ekonali hlavn\u00ed psychologick\u00e9 pot\u00ed\u017ee, spojen\u00e9 s n\u00e1stupem nemoci. Zdravotn\u00edci mohou pacient\u016fm pom\u00e1hat udr\u017eet jejich adaptivn\u00ed, zdrav\u00e9 chov\u00e1n\u00ed i b\u011bhem stresov\u00e9 nebo atypick\u00e9 situace.<\/li>\n<li>F\u00e1ze 4: Eudaimonick\u00fd projekt. V\u00a0t\u00e9to posledn\u00ed f\u00e1zi jsou pacienti zcela obezn\u00e1meni se svou\u00a0 nemoc\u00ed a jej\u00edmi dopady. Zm\u011bnili sv\u00e9 zvyky a \u017eivotn\u00ed styl v\u00a0souladu s\u00a0n\u00e1roky l\u00e9\u010dby a za\u010d\u00ednaj\u00ed b\u00fdt akt\u00e9ry v\u00a0dosa\u017een\u00ed pozitivn\u00ed a uspokojuj\u00edc\u00ed kvality \u017eivota, p\u0159esto\u017ee \u017eij\u00ed s\u00a0chronickou nemoc\u00ed.<\/li>\n<\/ul>\n<p>P\u0159echod od\u00a0pasivn\u00edho p\u0159\u00edstupu k\u00a0efektivn\u00edmu a aktivn\u00edmu chov\u00e1n\u00ed a\u00a0k managementu zdrav\u00ed je zalo\u017een na komplexn\u00edm procesu vytv\u00e1\u0159en\u00ed smyslu a zpracov\u00e1n\u00ed vlastn\u00ed identity. Subjektivn\u00ed a n\u011bkdy iracion\u00e1ln\u00ed vn\u00edm\u00e1n\u00ed, kter\u00e9 lid\u00e9 o sob\u011b maj\u00ed, a jedine\u010dn\u00fd pohled, kter\u00fdm hodnot\u00ed kvalitu sv\u00e9ho \u017eivota, jsou &#8211; podle na\u0161eho n\u00e1zoru &#8211; z\u00e1sadn\u00ed oblasti, kter\u00e9 umo\u017e\u0148uj\u00ed zah\u00e1jen\u00ed procesu zapojen\u00ed. Zdravotn\u00edci mohou tyto poznatky za\u010dlenit do sv\u00fdch vlastn\u00edch model\u016f zapojen\u00ed v re\u00e1ln\u00e9m \u017eivot\u011b.<\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5487073\/\">Uk\u00e1zalo se, \u017ee navrhovan\u00fd model zapojen\u00ed pacient\u016f do \u0159\u00edzen\u00ed zdrav\u00ed<\/a> p\u0159edpov\u00edd\u00e1 ur\u010ditou \u00farove\u0148 dodr\u017eov\u00e1n\u00ed l\u00e9ka\u0159sk\u00fdch doporu\u010den\u00ed a podpory pacient\u016f v sebe\u0159\u00edzen\u00ed. Psychosoci\u00e1ln\u00ed hledisko v definov\u00e1n\u00ed a m\u011b\u0159en\u00ed zapojen\u00ed pacient\u016f je p\u0159\u00edslibem v\u00fdrazn\u00e9ho zlep\u0161en\u00ed na\u0161eho pochopen\u00ed, jak lid\u00e9 m\u011bn\u00ed svou roli a jak se rozhoduj\u00ed pro v\u011bt\u0161\u00ed zapojen\u00ed do zdravotn\u00ed p\u00e9\u010de.<\/p>\n<p>Stru\u010dn\u011b \u0159e\u010deno, pocit emocion\u00e1ln\u00ed kontroly jednotlivc\u016f nad nemoc\u00ed a p\u00e9\u010de o sebe hraje z\u00e1sadn\u00ed roli v tom, jak dob\u0159e se dok\u00e1\u017eou s nemoc\u00ed vyrovnat. \u010c\u00edm l\u00e9pe sv\u00fdm emoc\u00edm a rol\u00edm porozum\u00ed, t\u00edm v\u011bt\u0161\u00ed maj\u00ed mo\u017enost \u00fa\u010dinn\u011b se zapojit do zdravotn\u00ed p\u00e9\u010de. Zdravotn\u00edci hraj\u00ed kl\u00ed\u010dovou roli v\u00a0ka\u017ed\u00e9 z t\u011bchto prom\u011bn, od diagn\u00f3zy a\u017e k\u00a0tomu, \u017ee se pacient stane pln\u011b informovan\u00fdm a anga\u017eovan\u00fdm jednotlivcem, aktivn\u011b zapojen\u00fdm do zdravotn\u00ed p\u00e9\u010de o sebe.<\/p>\n<p><strong>Praktick\u00e1 doporu\u010den\u00ed:<\/strong><\/p>\n<ul>\n<li><strong>Posouzen\u00ed zapojen\u00ed pacient\u016f: <\/strong><a href=\"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2015.00274\/full\">\u0160k\u00e1la zapojen\u00ed pacienta<\/a> m\u016f\u017ee pomoci systematicky m\u011b\u0159it zapojen\u00ed nap\u0159\u00ed\u010d klinick\u00fdm prost\u0159ed\u00edm a poskytuje \u010dasov\u00e9 r\u00e1mce za \u00fa\u010delem pl\u00e1nov\u00e1n\u00ed personalizovan\u00fdch strategi\u00ed a intervenc\u00ed na jejich podporu.<\/li>\n<li><strong>Budovat d\u016fv\u011bru: <\/strong>Pou\u017e\u00edvejte personalizovanou komunikaci (nap\u0159. komunikaci pacient-doktor, ve\u0159ejnou komunikaci, komunikaci v soci\u00e1ln\u00edm marketingu), kter\u00e1 je v\u00a0souladu s\u00a0m\u011b\u0159en\u00fdmi \u00farovn\u011bmi zapojen\u00ed pacienta.<\/li>\n<li><strong>Otev\u0159en\u00e1 kultura zdravotn\u00ed p\u00e9\u010de: <\/strong>L\u00e9ka\u0159sk\u00e9 prost\u0159ed\u00ed a vzd\u011bl\u00e1v\u00e1n\u00ed by se m\u011blo zam\u011b\u0159it na vytv\u00e1\u0159en\u00ed vzd\u011bl\u00e1vac\u00edch program\u016f, kter\u00e9 poskytuj\u00ed zdravotnick\u00fdm pracovn\u00edk\u016fm pot\u0159ebn\u00e9 znalosti, komunika\u010dn\u00ed a vztahov\u00e9 dovednosti k podpo\u0159e zapojen\u00ed pacient\u016f.<\/li>\n<li><strong>Podporujte nad\u0161en\u00ed pacient\u016f: <\/strong>Pom\u00e1hejte pacient\u016fm d\u00edvat se na sv\u011btl\u00e9 str\u00e1nky. Podpora optimistick\u00e9ho p\u0159\u00edstupu, kter\u00fd vyhled\u00e1v\u00e1 pozitiva, m\u016f\u017ee pomoci lidem odd\u011blit n\u011bkter\u00e9 \u0161patn\u00e9, demotivuj\u00edc\u00ed zpr\u00e1vy, kter\u00e9 mohou ovlivnit motivaci k\u00a0zapojen\u00ed.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>[Translated by Krist\u00fdna Anna \u010cern\u00edkov\u00e1]<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Healthcare professionals along the whole care journey must collaborate and coordinate their efforts for healthcare systems to function effectively. In other words, medicine requires teamwork to be successful. If we agree on this principle, then \u2013adopting a sports metaphor \u2013the patient too should be considered a player in the team!<\/p>\n","protected":false},"author":1,"featured_media":2268,"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":[43],"tags":[],"class_list":["post-2243","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-engagement"],"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":true},"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":false,"content":false,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":true,"content":true,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":false,"content":false,"excerpt":false},"ro":{"title":false,"content":false,"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":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/2243","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\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/comments?post=2243"}],"version-history":[{"count":36,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/2243\/revisions"}],"predecessor-version":[{"id":4573,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/posts\/2243\/revisions\/4573"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/media\/2268"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/media?parent=2243"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/categories?post=2243"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/cz\/wp-json\/wp\/v2\/tags?post=2243"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}