{"id":1123,"date":"2019-01-07T23:58:43","date_gmt":"2019-01-07T23:58:43","guid":{"rendered":"http:\/\/ehps.easyall.org\/php\/?p=1123"},"modified":"2025-11-04T14:33:59","modified_gmt":"2025-11-04T14:33:59","slug":"patient-talk-what-the-doctor-clearly-says-and-the-patient-clearly-does-not-understand","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/lt\/2019\/01\/patient-talk-what-the-doctor-clearly-says-and-the-patient-clearly-does-not-understand\/","title":{"rendered":"Paciento kalba: K\u0105 gydytojas ai\u0161kiai sako, o pacientas \u2013 ai\u0161kiai nesupranta"},"content":{"rendered":"<p><strong>Anne Marie Plass, University Medical Center of G\u00f6ttingen, Germany<\/strong><\/p>\n<p><em>Prie\u0161 kiek laiko dermatolog\u0117, psoriaz\u0117s (l\u0117tinio odos sutrikimo) specialist\u0117, dirbanti universiteto ligonin\u0117je, pasiskund\u0117 man, kad daugelis pacient\u0173 nesilaiko terapinio re\u017eimo, net ir tada, kai yra nustatytas bendras tikslas ir abipusiai priimtinas sprendimas. \u00a0<\/em><\/p>\n<p><!--more--><\/p>\n<p>Abipusiai priimtinas sprendimas apibr\u0117\u017etas kaip \u201eb\u016bdas, kai klinicistas ir pacientas sutaria d\u0117l tinkamiausi\u0173 fakt\u0173, esant b\u016btinumui <u><a href=\"https:\/\/www.bmj.com\/content\/341\/bmj.c5146.long\">spr\u0119sti<\/a>\u201c<\/u>, kai yra pasirinkimas dviej\u0173 ar daugiau gydymo b\u016bd\u0173, arba \u012f gydym\u0105 yra \u012ftraukta daugiau asmen\u0173. Abi pus\u0117s, pacientas ir gydytojas, dalyvauja medicininio <u><a href=\"https:\/\/en.wikipedia.org\/wiki\/Shared_decision-making_in_medicine\">sprendimo pri\u0117mimo procese<\/a><\/u>, \u00a0pacientas yra palaikomas svarstant variantus, darant informuotus pasirinkimus, siekiant norimo rezultato. Abipusiai priimtin\u0173 sprendim\u0173 svarba did\u0117ja <u><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17485749\">sveikatos prie\u017ei\u016bros praktikoje<\/a><\/u>, kai daugelis specialist\u0173 bando galimai daugiau nuveikti <u><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20947577\">paciento labui<\/a><\/u>. Ypa\u010d d\u0117l to, kad toks bendravimas su pacientu gali pagerinti terapijos re\u017eimo laikym\u0105si ir pasitik\u0117jim\u0105.<\/p>\n<p>Svarbiausia, kad abipusiai priimtas sprendimas, remiasi abipusiu supratimu ir <u><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15150208\">pagarba<\/a><\/u>. Gydytojas ir pacientas yra lygiaver\u010diai sprendimo pri\u0117mimo dalyviai, abu prisideda prie sprendimo, \u012fne\u0161dami \u012f pokalb\u012f savo ekspertiz\u0119 ir patyrim\u0105. Tokiu b\u016bdu, paslaugos teik\u0117jas \u012fne\u0161a medicinines \u017einias ir patyrim\u0105, o pacientas (-\u0117) prisideda savo \u017einiomis ir savo asmeninio gyvenimo patyrimu.Ta\u010diau tai lengviau pasakyti, nei padaryti. Daugelis sveikatos prie\u017ei\u016bros specialist\u0173 tvirtina, kad jie \u201ejau tai daro\u201c, o <u><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20393104\">paciento patirties apklaus\u0173<\/a><\/u> duomenys rodo, kad <u><a href=\"https:\/\/www.bmj.com\/content\/341\/bmj.c4989.long\">daugeliu atveju taip n\u0117ra.<\/a><\/u><\/p>\n<p><em>Dermatolog\u0117, su kuria kalb\u0117jau, \u012fpratusi nespr\u0119sti apie pacient\u0105 viena\u0161ali\u0161kai, bet apie labiausiai tinkan\u010di\u0105 terapij\u0105 spr\u0119sti kartu. Ta\u010diau, ji visi\u0161kai nesupranta, kod\u0117l jos pacientai n\u0117ra motyvuoti naudoti vaistus kaip yra paskirta, net ir tada, kai paskyrimas buvo suderintas su pacientu. Apra\u0161ydama, kaip ji \u012fgyvendina abipusiai priimt\u0105 sprendim\u0105 kasdien\u0117je klinikin\u0117je praktikoje, ji pasak\u0117, kad per \u0161i\u0105 konsultcij\u0105, jie kartu nuspr\u0119s apie gydym\u0105 ir kartu aptars \u012fvairius gydymosi b\u016bdus. \u00a0<\/em><\/p>\n<p>Kartais pacientams reikia laiko, kad suvokt\u0173 nauj\u0105 informacij\u0105 ir apgalvot\u0173 savo asmenin\u012f pasirinkim\u0105, dar iki priimant nauj\u0105 sprendim\u0105. Tai ypa\u010d svarbu, nes j\u0173 ateities b\u016bsena yra neai\u0161ki ir jie turi pagalvoti apie pasekmes, kuri\u0173 iki \u0161iol jie nebuvo <u><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/184205\">\u00a0patyr\u0119<\/a><\/u>. Pasi\u016blius spr\u0119sti kartu, kai kurie pacientai gali jaustis nusteb\u0119 ar nejaukiai d\u0117l pasirinkimo kas jiems yra geriausia. Pacient\u0173 <u><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3010418\/\">i\u0161ankstinis <\/a><\/u>\u00a0informavimas paie \u012fvairius gydymo b\u016bdus ir apie numatom\u0105 j\u0173 dalyvavim\u0105 sprendim\u0173 pri\u0117mime, gali pagerinti bendr\u0105 sprendimo <u><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0738399105000546?via%3Dihub\">veiksmingum\u0105<\/a><\/u>.<\/p>\n<p><em>Dermatolog\u0117, siekdama pad\u0117ti savo pacientams nuspr\u0119sti apie geriausiai j\u0173 l\u016bkes\u010dius atitinkan\u010di\u0105 terapij\u0105, si\u016blo laukiam\u0105 pager\u0117jim\u0105 \u012fvertinti procentais. Pavyzd\u017eiui 10 proc. arba 20 proc. Po to, kai pacientas pasirenka jam tinkamiausi\u0105 procent\u0105, dermatolog\u0117 paai\u0161kina kokia terapija arba gydymas bus reikalinga, siekiant tokio pager\u0117jimo, taip \u012ftraukdama pacient\u0105 \u012f sprendimo pri\u0117mimo proces\u0105. \u00a0Nepaisant viso to, jos pacientai, vis tiek nesilaiko terapinio re\u017eimo, nors jie patys pasirinko geriausi\u0105 sprendim\u0105, tinkant\u012f j\u0173 konkre\u010diai situacijai. A\u0161 jos paklausiau, ar ji mano, kad jos pacientai supranta 20, 30 procent\u0173 prasm\u0119 ir ar jie taip pat spr\u0119st\u0173 ir apie kit\u0173 asmen\u0173 pager\u0117jim\u0105.<\/em><\/p>\n<p>Dal\u012f <u><a href=\"http:\/\/www.theguardian.com\/healthcare-network\/2014\/jul\/01\/impact-medical-jargon-patient-centred-care\">sunkum\u0173<\/a><\/u> sudaro sveikatos prie\u017ei\u016bros specialist\u0173 polinkis <u><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0020748915000619?via%3Dihub\">naudoti kalb\u0105<\/a><\/u>, kuri geriausiai suprantama j\u0173 kolegoms. Medicininiai terminai gali b\u016bti sud\u0117tingi ir akivaizdu, kad <u><a href=\"https:\/\/www.telegraph.co.uk\/news\/health\/news\/10909421\/Nearly-half-of-patients-do-not-understand-medical-language.html\">beveik pus\u0117 vis\u0173 pacient\u0173<\/a><\/u> sunkiai juos <u><a href=\"http:\/\/www.bmj.com\/content\/320\/7233\/484?fromsource=nelm;%20www.tandfonline.com\/doi\/abs\/10.3109\/09638288.2013.793409\">supranta<\/a><\/u>. \u017dargonas ir abstrakt\u016bs terminai sukuria \u012fvairias interpretacijas, o tai atitolina pacient\u0105 nuo to supratimo, kurio siekia specialistas. Ir dar, yra pakankamai \u012frodym\u0173, kad vertinamieji terminai klausimynuose, taip pat gali b\u016bti klaidingai suprasti ir <u><a href=\"https:\/\/www.telegraph.co.uk\/news\/health\/news\/10909421\/Nearly-half-of-patients-do-not-understand-medical-language.html\">gali neatitikti siekiamo tikslo.<\/a><\/u> \u017dmon\u0117s klausimyne gali nurodyti, kad jie nepaj\u0117gia nueiti 500 metr\u0173, bet pokalbyje atskleid\u017eia, kad jie gali vaik\u0161\u010dioti po parduotuv\u0119 valand\u0105 ir daugiau.<\/p>\n<p><em>A\u0161 atsakiau dermatologei, kad paiento vietoje a\u0161 nor\u0117\u010diau, nusta\u010dius galutin\u012f terapijos tiksl\u0105, j\u012f u\u017etvirtinti paspaud\u017eiant rank\u0105 ar d\u0117v\u0117ti mar\u0161kin\u0117lius primenan\u010dius susitarim\u0105. Ji pa\u017evelg\u0117 \u012f mane ir prad\u0117jo juoktis, sakydama, kad tai teisinga, bet ji pati apie tai nepagalvojo. Ir dar, ji nesuprato, kad i\u0161ankstinis paciento informavimas apie sprendimo pri\u0117mimo proces\u0105, gali padidinti proceso veiksmingum\u0105. <\/em><\/p>\n<p>Gyvybi\u0161kai svarbu, kad sveikatos prie\u017ei\u016bros specialistai pagalvot\u0173 apie savo gydomus pacientus ir pasitikrint\u0173 kaip pacientai supranta gydym\u0105. Tai neapsiriboja tik tais pacientais, kurie ma\u017eai ra\u0161tingi (apie sveikat\u0105), bet ir visi pacientai gali pasinaudoti ai\u0161kia ir tikslia informacija, pa\u0161alinus \u017eargono kalb\u0105. Be to, gydytojui svarbu bendrauti, tokia kalba, kuri pacientui yra \u012fprasta, ir perteikti mint\u012f, \u017eod\u017eiais, kuriuos paccientas gali panaudoti savo kalboje.<\/p>\n<p>Praktin\u0117s rekomendacijos:<\/p>\n<ul>\n<li>Paciento \u012fsitraukimo \u012f sprendimo pri\u0117mimo proces\u0105 padidinimas, gali pagerinti terapijos re\u017eimo laikym\u0105si ir gydymo veiksmingum\u0105.<\/li>\n<li>Visada bandykite i\u0161reik\u0161ti mint\u012f paciento \u017eod\u017eiais, kuriuos jis gali panaudoti (venkite medicininio \u017eargono).<\/li>\n<li>Atminkite, kad nors jums visi\u0161kai ai\u0161ku tai k\u0105 j\u016bs sakote, kitas asmuo gali suprasti klaidingai. Tad, visada pasitikrinkite ar pacientas jus teisingai suprato.<\/li>\n<li>Skirkite pacientui laiko priimti nauding\u0105 ir lengvai suprantam\u0105 informacij\u0105, \u012fsitikinkite, kad esate pasiruo\u0161\u0119s svarbiai konsultacijai.<\/li>\n<li>I\u0161 anksto supa\u017eindinkite pacient\u0105, ko i\u0161 jo tikit\u0117s bendrai priimant sprendimus.<\/li>\n<\/ul>\n<p><em>Translated by Antanas Gostautas<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Anne Marie Plass, University Medical Center of G\u00f6ttingen, Germany Sometime ago a dermatologist who works as a psoriasis (a chronic skin disorder) -specialist in a university hospital, complained to me about many patients who do not adhere to the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1190,"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":[28],"tags":[],"class_list":["post-1123","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-communication"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"lt","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\/lt\/wp-json\/wp\/v2\/posts\/1123","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/comments?post=1123"}],"version-history":[{"count":30,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/posts\/1123\/revisions"}],"predecessor-version":[{"id":4620,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/posts\/1123\/revisions\/4620"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/media\/1190"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/media?parent=1123"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/categories?post=1123"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lt\/wp-json\/wp\/v2\/tags?post=1123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}