{"id":3001,"date":"2023-10-17T08:59:27","date_gmt":"2023-10-17T08:59:27","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=3001"},"modified":"2025-11-04T09:16:11","modified_gmt":"2025-11-04T09:16:11","slug":"acceptance-and-commitment-therapy-a-promising-approach-for-those-living-with-long-covid","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/cz\/2023\/10\/acceptance-and-commitment-therapy-a-promising-approach-for-those-living-with-long-covid\/","title":{"rendered":"Terapie p\u0159ijet\u00ed: Slibn\u00fd p\u0159\u00edstup pro ty, kte\u0159\u00ed \u017eij\u00ed s dlouh\u00fdm pr\u016fb\u011bhem COVID<\/strong>"},"content":{"rendered":"

Amy Barradell, University Hospitals of Leicester NHS Trust<\/p>\n

Kdy\u017e \u0159eknu “long-COVID\u201d, co to pro V\u00e1s znamen\u00e1?<\/strong><\/p>\n

Skupina lid\u00ed, kte\u0159\u00ed onemocn\u011bli Onemocn\u011bn\u00edm zp\u016fsoben\u00fdm koronavirem 2019 (COVID-19), nad\u00e1le trp\u00ed zat\u011b\u017euj\u00edc\u00edmi p\u0159\u00edznaky, p\u0159etrv\u00e1vaj\u00edc\u00ed d\u00e9le ne\u017e 4 t\u00fddny po akutn\u00ed infekci. \u010casto uv\u00e1d\u011bj\u00ed jak fyzick\u00e9 p\u0159\u00edznaky (nap\u0159. du\u0161nost, \u00fanava), tak psychick\u00e9 p\u0159\u00edznaky (nap\u0159. \u00fazkost, kognitivn\u00ed poruchy). Ti, kte\u0159\u00ed tyto p\u0159\u00edznaky<\/a> pro\u017e\u00edvaj\u00ed, to naz\u00fdvaj\u00ed \u201eLong-COVID\u201c.<\/p>\n

<\/p>\n

Moje zku\u0161enost\u2026<\/strong><\/p>\n

Pr\u00e1ce na Long-COVID klinice mi uk\u00e1zala, \u017ee lid\u00e9 maj\u00ed probl\u00e9m p\u0159ijmout sv\u00e9 novou situaci (a n\u00e1sledky t\u011bchto p\u0159\u00edznak\u016f), co\u017e jim br\u00e1n\u00ed v\u00a0adaptaci a p\u0159ijmut\u00ed nov\u00fdch strategi\u00edch sebe\u0159\u00edzen\u00ed. Zam\u011b\u0159uj\u00ed se na to, co dok\u00e1zali d\u011blat p\u0159ed \u201eLong-COVIDem\u201c a jak se jejich \u017eivot zhor\u0161il od diagn\u00f3zy. To nazna\u010duje vyh\u00fdbav\u00e9 chov\u00e1n\u00ed (tj. pokus nebo touhu potla\u010dit necht\u011bn\u00e9 vnit\u0159n\u00ed pro\u017eitky, jako jsou emoce, my\u0161lenky, vzpom\u00ednky a t\u011blesn\u00e9 pocity) a tendenci lid\u00ed soust\u0159edit se na formu p\u0159\u00edznak\u016f nam\u00edsto funkce p\u0159\u00edznak\u016f (tj. t\u011blesn\u00e9ho sign\u00e1lu k zm\u011bn\u011b chov\u00e1n\u00ed). Ukazuje to, \u017ee lid\u00e9 nejsou otev\u0159eni nov\u00fdm zku\u0161enostem a vyh\u00fdbaj\u00ed se \u017eit\u00ed v p\u0159\u00edtomn\u00e9m okam\u017eiku.<\/p>\n

Nav\u00edc, v\u00edce ne\u017e 25 % lid\u00ed<\/a>, kte\u0159\u00ed byli hospitalizov\u00e1ni s COVID-19, m\u00e1 trval\u00e9 p\u0159\u00edznaky deprese i 6 m\u011bs\u00edc\u016f pot\u00e9, co byli propu\u0161t\u011bni z nemocnice. Jeliko\u017e je deprese spojena s\u00a0vyh\u00fdbav\u00fdm chov\u00e1n\u00edm<\/a> (tj. nedostatku energie zapojen\u00ed se do situace), to ukazuje na to, \u00a0\u017ee lid\u00e9 se mo\u017en\u00e1 neanga\u017euj\u00ed v\u00a0p\u0159\u00ednosn\u00fdch aktivit\u00e1ch.<\/p>\n

Role psychick\u00e9 flexibility u Long-COVID<\/strong><\/p>\n

Psychick\u00e1 flexibilita p\u0159edstavuje mechanismus p\u016fsoben\u00ed Terapie p\u0159ijet\u00ed (ACT).<\/a> Zahrnuje t\u0159i pil\u00ed\u0159e terapie: (1) podporov\u00e1n\u00ed otev\u0159enosti ke zku\u0161enostem, (2) uv\u011bdom\u011bn\u00ed si p\u0159\u00edtomn\u00e9ho okam\u017eiku a (3) zapojen\u00ed se do p\u0159\u00ednosn\u00fdch aktivit. Jak bylo uvedeno v\u00fd\u0161e, u lid\u00ed \u017eij\u00edc\u00edch s\u00a0Long-COVID se tyto pil\u00ed\u0159e zdaj\u00ed b\u00fdt nevyv\u00e1\u017een\u00e9, a proto je jejich \u0159e\u0161en\u00ed d\u016fle\u017eit\u00e9. ACT lze proto vyu\u017e\u00edt k tomu, aby lid\u00e9 zm\u011bnili vztah, kter\u00fd maj\u00ed ke sv\u00fdm pot\u00ed\u017e\u00edm (tj. sn\u00ed\u017eili vyh\u00fdbav\u00e9 chov\u00e1n\u00ed), buduj\u00ed sv\u00e9 p\u0159ijet\u00ed nov\u00e9ho \u201enorm\u00e1lu\u201c (tj. zv\u00fd\u0161ili uv\u011bdom\u011bn\u00ed si p\u0159\u00edtomn\u00e9ho okam\u017eiku), motivovali se a aby usilovali o zm\u011bny chov\u00e1n\u00ed, kter\u00e9 jsou pro n\u011b d\u016fle\u017eit\u00e9 (tj. zapojili se do p\u0159\u00ednosn\u00fdch aktivit). ACT p\u0159i Long-COVID ji\u017e dosahuje pokrok\u016f<\/a>, \u00fa\u010dastn\u00edci hl\u00e1sili zlep\u0161en\u00fd wellbeing, st\u00e1le pro\u017e\u00edvali \u00fazkost spojenou s COVID, ale c\u00edtili se schopn\u011bj\u0161\u00ed zvl\u00e1dat obecnou psychickou z\u00e1t\u011b\u017e (jako je \u00fazkost).<\/p>\n

Pou\u017eit\u00ed ACT na klinice pro Long-COVID: P\u0159edstavuji Jo<\/strong><\/p>\n

Kdy\u017e jsem se poprv\u00e9 setkal s Jo, za\u017e\u00edval\/a pravideln\u00e9 relapsy p\u0159\u00edznak\u016f. Za \u00fa\u010delem uchov\u00e1n\u00ed anonymity p\u0159edstavuje Jo \u0161k\u00e1lu lid\u00ed, se kter\u00fdmi jsem pracoval na klinice pro Long-COVID. Jejich nejv\u00edce zat\u011b\u017euj\u00edc\u00edmi p\u0159\u00edznaky byla du\u0161nost a \u00fanava, co\u017e znesnad\u0148ovalo b\u011b\u017en\u00e9 denn\u00ed aktivity. Jo se b\u00e1l(a) t\u011bchto atak p\u0159\u00edznak\u016f a aktivn\u011b se sna\u017eil(a) vyhnout v\u0161emu, co by je mohlo zhor\u0161it (tj. vyh\u00fdbav\u00e9 chov\u00e1n\u00ed, vyh\u00fdb\u00e1n\u00ed se p\u0159\u00edtomn\u00e9mu okam\u017eiku). V\u011bnoval(a) m\u00e1lo \u010dasu \u010dinnostem, kter\u00e9 mu(j\u00ed) p\u0159in\u00e1\u0161ely radost a smysl (tj. vyh\u00fdb\u00e1n\u00ed se zapojen\u00ed do hodnotn\u00fdch akc\u00ed).<\/p>\n

V\u00a0na\u0161ich spole\u010dn\u00fdch setk\u00e1n\u00ed jsme se v\u011bnovali v\u0161em komponent\u016fm ACT:<\/p>\n