{"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\/lv\/2019\/01\/patient-talk-what-the-doctor-clearly-says-and-the-patient-clearly-does-not-understand\/","title":{"rendered":"Saruna ar pacientu: ko \u0101rsts skaidri un gai\u0161i saka, bet pacients skaidri un gai\u0161i nesaprot"},"content":{"rendered":"

Anna Marija Plasa (Anne Marie Plass), Getingenes Universit\u0101tes Medic\u012bnas centrs, V\u0101cija<\/strong><\/p>\n

Pirms k\u0101da laika dermatolo\u0123e, kas str\u0101d\u0101 par psori\u0101zes (hroniska \u0101das slim\u012bba) speci\u0101listi universit\u0101tes slimn\u012bc\u0101, man s\u016bdz\u0113j\u0101s par daudziem pacientiem, kuri neiev\u0113ro noz\u012bm\u0113to terapiju, lai gan ir bijis kop\u012bgi noteikts m\u0113r\u0137is un l\u0113mums par \u0101rst\u0113\u0161anu.<\/em><\/p>\n

<\/p>\n

Kop\u012bga l\u0113muma pie\u0146em\u0161ana tiek defin\u0113ta k\u0101 “pieeja, kur\u0101 kl\u012bnicisti un pacienti dal\u0101s ar lab\u0101kajiem pieejamajiem pier\u0101d\u012bjumiem, saskaroties ar l\u0113muma pie\u0146em\u0161anas uzdevumu”; parasti to izmanto, kad ir pieejamas divas vai vair\u0101k \u0101rst\u0113\u0161anas iesp\u0113jas vai iesaist\u012bta vair\u0101k nek\u0101 viena persona. Gan pacienti, gan \u0101rsti piedal\u0101s medic\u012bnisk\u0101 l\u0113muma pie\u0146em\u0161anas proces\u0101, un pacienti tiek mudin\u0101ti izskat\u012bt visas iesp\u0113jas ieg\u016bt l\u0113mumam nepiecie\u0161amo inform\u0101ciju, lai sasniegtu v\u0113lamos rezult\u0101tus. Kop\u012bga l\u0113muma pie\u0146em\u0161anas politika vesel\u012bbas apr\u016bp\u0113 ie\u0146em arvien liel\u0101ku lomu, jo daudzi profesion\u0101li vesel\u012bbas apr\u016bpes sniedz\u0113ji cen\u0161as dar\u012bt visu iesp\u0113jamo, lai uzman\u012bbas centr\u0101 b\u016btu pacients. Jo \u012bpa\u0161i t\u0101d\u0113\u013c, ka \u0161\u0101da veida sarunas ar pacientu var uzlabot terapijas iev\u0113ro\u0161anu un uztic\u0113\u0161anos.<\/p>\n

Pamat\u0101 kop\u012bga l\u0113muma pie\u0146em\u0161ana ir balst\u012bta uz savstarp\u0113ju sapratni un cie\u0146u. \u0100rsts un pacients ir l\u012bdzv\u0113rt\u012bgi partneri \u0161aj\u0101 proces\u0101 \u2013 abi dod savu ieguld\u012bjumu l\u0113mum\u0101, sarun\u0101 daloties ar sav\u0101m zin\u0101\u0161an\u0101m un pieredzi. Vesel\u012bbas apr\u016bpes sniedz\u0113js dal\u0101s ar sav\u0101m medic\u012bnas zin\u0101\u0161an\u0101m un pieredzi, pacients \u2013 ar sav\u0101m zin\u0101\u0161an\u0101m un personisko pieredzi. Tom\u0113r to ir viegli pateikt, ne tik viegli izdar\u012bt. Lai gan daudzi vesel\u012bbas apr\u016bpes speci\u0101listi apgalvo, ka “vi\u0146i t\u0101 jau dara”, dati no pacientu pieredzes apsekojumiem liecina, ka parasti tas t\u0101 nav.<\/p>\n

Dermatolo\u0123e, ar kuru es run\u0101ju, nem\u0113dza pie\u0146emt l\u0113mumus pacientu v\u0101rd\u0101, bet gan kop\u0101 ar pacientiem pie\u0146\u0113ma l\u0113mumus par to, k\u0101da terapija vi\u0146iem atbilstu vislab\u0101k. T\u0101p\u0113c vi\u0146ai nebija izprotams, k\u0101p\u0113c vi\u0146as pacientiem pietr\u016bka motiv\u0101cijas lietot tabletes, k\u0101 noteikts, lai ar\u012b terapija bija noz\u012bm\u0113ta saska\u0146\u0101 ar pacientu personiskaj\u0101m izv\u0113l\u0113m. Aprakstot, k\u0101 vi\u0146a \u012bsteno kop\u012bgo l\u0113mumu pie\u0146em\u0161anas procesu ikdienas kl\u012bniskaj\u0101 praks\u0113, vi\u0146a teica, ka, tikl\u012bdz pacienti atn\u0101k uz viz\u012bti, vi\u0146a tos inform\u0113, ka \u0161\u012bs viz\u012btes laik\u0101 vi\u0146i kop\u0101 izlems par terapiju, un t\u0101p\u0113c kop\u012bgi apspried\u012bs da\u017e\u0101das terapeitisk\u0101s iesp\u0113jas. <\/em><\/p>\n

Da\u017ereiz pacientiem ir nepiecie\u0161ams laiks, lai izp\u0113t\u012btu jauno inform\u0101ciju un apdom\u0101tu personisk\u0101s izv\u0113les, pirms vi\u0146i pie\u0146em jaunu l\u0113mumu. Tas ir \u012bpa\u0161i svar\u012bgi tad, kad vi\u0146iem nav zin\u0101ms, k\u0101 var att\u012bst\u012bties slim\u012bba, un vi\u0146iem, iesp\u0113jams, j\u0101dom\u0101 par izn\u0101kumu, ko vi\u0146i nekad nav piedz\u012bvoju\u0161i. Ja pacientiem tiek pied\u0101v\u0101ta loma l\u0113muma pie\u0146em\u0161an\u0101, da\u017ei pacienti var justies p\u0101rsteigti vai satraukti visu izv\u0113\u013cu priek\u0161\u0101, un vi\u0146iem var tr\u016bkt p\u0101rliec\u012bbas par to, kur\u0161 l\u0113mums var\u0113tu b\u016bt vislab\u0101kais. T\u0101p\u0113c kop\u012bga l\u0113muma pie\u0146em\u0161anas efektivit\u0101ti var\u0113tu uzlabot, ja pacientiem jau iepriek\u0161 b\u016btu zin\u0101ms, ka vi\u0146i tiks mudin\u0101ti piedal\u012bties l\u0113muma pie\u0146em\u0161an\u0101, un vi\u0146iem jau iepriek\u0161 b\u016btu zin\u0101ms, k\u0101das ir iesp\u0113jam\u0101s \u0101rst\u0113\u0161anas alternat\u012bvas.<\/p>\n

Lai pal\u012bdz\u0113tu saviem pacientiem izlemt par terapiju, kas vislab\u0101k atbilstu vi\u0146u personiskaj\u0101m izv\u0113l\u0113m, \u0161\u012b dermatolo\u0123e k\u0101 iesp\u0113jamos m\u0113r\u0137us nor\u0101d\u012bja procentus, piem\u0113ram, 10\u00a0% vai 20\u00a0% uzlabojumu. P\u0113c tam, kad pacients bija izv\u0113l\u0113jies procentu\u0101lo daudzumu, dermatolo\u0123e paskaidroja, k\u0101da terapija un z\u0101les b\u016btu nepiecie\u0161amas, lai sasniegtu \u0161o m\u0113r\u0137i, t\u0101d\u0113j\u0101di akt\u012bvi iesaistot pacientu l\u0113mumu pie\u0146em\u0161anas proces\u0101. Neskatoties uz to, vi\u0146as pacienti joproj\u0101m neiev\u0113roja terapiju, lai gan vi\u0146i pa\u0161i bija izv\u0113l\u0113ju\u0161ies terapijas variantu, kas vislab\u0101k atbilstu vi\u0146u personiskajai situ\u0101cijai. Es vi\u0146ai jaut\u0101ju, vai pacienti saprata, ko noz\u012bm\u0113 20\u00a0%, 30\u00a0% u.\u00a0tml. uzlabojums, un vai vi\u0146i pa\u0161i ar\u012b t\u0101 izteiktos, citiem st\u0101stot par v\u0113lamo simptomu atvieglo\u0161anu.<\/em><\/p>\n

Viens no probl\u0113mas aspektiem ir vesel\u012bbas apr\u016bpes profesion\u0101\u013cu rakstur\u012bg\u0101 tendence lietot valodu, kas ir saprotama tikai kol\u0113\u0123iem. Medic\u012bnas valoda var b\u016bt sare\u017e\u0123\u012bta, un pier\u0101d\u012bjumi liecina, ka gandr\u012bz pusei no pacientiem ir gr\u016bt\u012bbas to uztvert. Medic\u012bnas \u017eargons un abstraktie j\u0113dzieni m\u0113dz rad\u012bt pamatu pla\u0161am interpret\u0101ciju kl\u0101stam, kas var iev\u0113rojami at\u0161\u0137irties no t\u0101, ko apr\u016bpes sniedz\u0113ji bija dom\u0101ju\u0161i. Turkl\u0101t daudzi pier\u0101d\u012bjumi liecina, ka izv\u0113rt\u0113tie \u0101rst\u0113\u0161anas aspekti var tikt pamat\u012bgi p\u0101rprasti vai kaut k\u0101 cit\u0101di nov\u0113rt\u0113ti, t\u0101p\u0113c iecer\u0113tais paliek nesasniegts. Anket\u0101s pacienti var ierakst\u012bt, ka nesp\u0113j nostaig\u0101t 500 metrus, bet turpm\u0101kaj\u0101 sarun\u0101 var atkl\u0101ties, ka vi\u0146i vair\u0101k nek\u0101 stundu staig\u0101 pa lielveikalu.<\/p>\n

Es speci\u0101listei atbild\u0113ju, ka, ja es b\u016btu paciente, es v\u0113l\u0113tos, lai k\u0101 terapijas m\u0113r\u0137is tiktu nor\u0101d\u012bta mana atg\u016bt\u0101 sp\u0113ja dro\u0161i paspiest roku vai uzvilkt ap\u0123\u0113rbu ar \u012bs\u0101m piedurkn\u0113m, vai taml\u012bdz\u012bgi. Vi\u0146a skat\u012bj\u0101s uz mani un s\u0101ka smieties, sakot, ka man ir taisn\u012bba, bet vi\u0146a nekad pati to neb\u016btu iedom\u0101jusies. Vi\u0146a ar\u012b nebija iedom\u0101jusies, ka pacienta iepriek\u0161\u0113ja inform\u0113\u0161ana par l\u0113muma pie\u0146em\u0161anas procesu var\u0113tu rad\u012bt efekt\u012bv\u0101ku rezult\u0101tu.<\/em><\/p>\n

T\u0101d\u0113\u013c ir vit\u0101li svar\u012bgi, lai vesel\u012bbas apr\u016bpes speci\u0101listi uzman\u012bgi dom\u0101tu par pacientiem, kurus vi\u0146i \u0101rst\u0113, un \u0146emtu v\u0113r\u0101 to izpratni, k\u0101da ir pacientu r\u012bc\u012bb\u0101. Tas attiecas ne tikai uz person\u0101m ar ierobe\u017eotu vesel\u012bbas prat\u012bbu \u2013 visi pacienti b\u016btu ieguv\u0113ji, ja tiktu izteikta skaidra un prec\u012bza inform\u0101cija, un tiktu samazin\u0101ts \u017eargons. Turkl\u0101t ir \u0101rk\u0101rt\u012bgi svar\u012bgi, lai \u0101rsti lietotu t\u0101du valodu, pie kuras pacienti ir pieradu\u0161i, un izteiktos ar v\u0101rdiem, kurus pacienti lieto ikdien\u0101.<\/p>\n

Praktiski ieteikumi:<\/p>\n