{"id":1371,"date":"2019-09-07T08:13:33","date_gmt":"2019-09-07T08:13:33","guid":{"rendered":"http:\/\/practicalhealthpsychology.com\/?p=1371"},"modified":"2025-12-01T08:37:13","modified_gmt":"2025-12-01T08:37:13","slug":"raising-weight-in-a-consultation","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/lv\/2019\/09\/raising-weight-in-a-consultation\/","title":{"rendered":"Liek\u0101 svara probl\u0113ma konsult\u0101cij\u0101s"},"content":{"rendered":"

D\u017eeina Ogdena (Jane Ogden), Sari Universit\u0101te, Apvienot\u0101 Karaliste<\/strong><\/p>\n

Konsult\u0101cij\u0101s run\u0101t par svaru nav vienk\u0101r\u0161i. Ir pacienti, kuriem ir moko\u0161i gr\u016bti izdzird\u0113t v\u0101rdus “jums vajadz\u0113tu zaud\u0113t svaru”, ko vi\u0146iem pasaka ikreiz, kad vi\u0146i apmekl\u0113 \u0101rstniec\u012bbas iest\u0101di, neatkar\u012bgi no t\u0101, k\u0101d\u0101 nol\u016bk\u0101 vi\u0146i ieradu\u0161ies \u2013 iekaisis kakls, dzemdes kakla uztriepe vai ba\u017eas par potenci\u0101lu sirds probl\u0113mu. Var b\u016bt t\u0101, ka da\u013ca \u0161\u0101du pacientu visu m\u016b\u017eu ir jutu\u0161i stigmatiz\u0113tu attieksmi no medi\u0137iem un uzskata, ka <\/span>visi piev\u0113r\u0161 uzman\u012bbu vi\u0146u \u0137erme\u0146a apm\u0113riem<\/span><\/a> un vair\u0101k nekam. Savuk\u0101rt citi, iesp\u0113jams, nekad nav uztv\u0113ru\u0161i savu svaru k\u0101 probl\u0113mu, un var justies aizvainoti vai p\u0101rsteigti, ja k\u0101ds s\u0101k run\u0101t par to, ka vi\u0146u svars ir palielin\u0101ts. Da\u017ei cilv\u0113ki vienk\u0101r\u0161i nev\u0113las dzird\u0113t neko par savu svaru un blo\u0137\u0113 izdzird\u0113to inform\u0101ciju, nosprie\u017eot: “ko j\u016bs visp\u0101r saprotat \u2013 j\u016bs esat par tievu \/ par resnu \/ par jaunu \/ par vecu” vai “zin\u0101tnieki m\u016b\u017edien kaut ko pazi\u0146o un p\u0113c tam to noliedz”. T\u0101p\u0113c, run\u0101jot par svaru, r\u016bp\u012bgi j\u0101seko tam, KAD, K\u0100 un KO j\u016bs sak\u0101t pacientam ar lieko svaru.<\/span><\/p>\n

<\/p>\n

KAD<\/b><\/p>\n

Cilv\u0113ki m\u0113dz lielu da\u013cu dz\u012bves pavad\u012bt, it k\u0101 b\u016btu saliku\u0161i pirkstus aus\u012bs, un vi\u0146iem m\u0113dz b\u016bt neticama sp\u0113ja nedzird\u0113t to, kas tiek teikts. Pirmais pa\u0146\u0113miens, kas pal\u012bdz k\u013c\u016bt “dzird\u012bg\u0101kiem” \u2013 izv\u0113l\u0113ties sarunai piem\u0113rotu br\u012bdi. Run\u0101jot par svaru, ir labi par\u0101d\u012bt <\/span>svara saist\u012bbu ar k\u0101du konkr\u0113tu probl\u0113mu<\/span><\/a>. Tie var b\u016bt, piem\u0113ram, noteikti simptomi \u2013 elpas tr\u016bkums vai loc\u012btavu s\u0101pes, noteiktas diagnozes \u2013 cukura diab\u0113ts vai paaugstin\u0101ts asinsspiediens, noteikti dz\u012bves cikla posmi \u2013 vecuma tuvo\u0161an\u0101s vai pensijas vecuma iest\u0101\u0161an\u0101s, vai k\u0101das noteiktas darb\u012bbas, kas pacientam k\u013cuvu\u0161as apgr\u016btino\u0161as, piem\u0113ram, k\u0101p\u0161ana pa k\u0101pn\u0113m, b\u0113rna n\u0113s\u0101\u0161ana uz rok\u0101m vai kurpju auklu sasie\u0161ana. \u0160ie <\/span>pam\u0101co\u0161ie br\u012b\u017ei<\/span><\/a> sp\u0113j piespiest pacientus “iz\u0146emt pirkstus no aus\u012bm”, t\u0101p\u0113c ieteicams izmantot jebkuru atbilsto\u0161u situ\u0101ciju, lai run\u0101tu par lieko svaru konkr\u0113t\u0101 saist\u012bb\u0101 ar pacienta s\u016bdz\u012bb\u0101m.\u00a0<\/span><\/p>\n

K\u0100<\/b><\/p>\n

Tom\u0113r ar \u012bst\u0101 br\u012b\u017ea atra\u0161anu vien nepietiks! K\u0101dus v\u0101rdus izmantot? Vai teikt: “resnums”, “palielin\u0101ts svars”, “liekais svars”, “aptauko\u0161an\u0101s”? Vai izv\u0113l\u0113ties netie\u0161u valodu, vispirms pajaut\u0101t: “K\u0101 b\u016btu, ja m\u0113s parun\u0101tu par j\u016bsu svaru?” Varb\u016bt tie\u0161s un noteikts nor\u0101d\u012bjums: “Jums nepiecie\u0161ams zaud\u0113t svaru!” ir pareiz\u0101ks? Par to joproj\u0101m notiek diskusijas, bet pier\u0101d\u012bjumi <\/span>di\u0113tas psiholo\u0123ijas<\/span><\/a> p\u0113t\u012bjumos liecina, ka medi\u0137iem nereti ir v\u0113l gr\u016bt\u0101k run\u0101t par \u0161o tematu nek\u0101 pa\u0161iem pacientiem. Vesel\u012bbas apr\u016bpes speci\u0101listiem ir j\u0101run\u0101 par lieko svaru, pat ja vi\u0146i v\u0113l\u0113tos no \u0161\u012b jaut\u0101juma izvair\u012bties. V\u0101rds “aptauko\u0161an\u0101s” var pacient\u0101 izrais\u012bt \u0161oku, bet zin\u0101ms \u0161oks (ta\u010du ne p\u0101rm\u0113r\u012bgs!) var b\u016bt itin noder\u012bgs. Katrs pacients ir at\u0161\u0137ir\u012bgs, katrs vesel\u012bbas apr\u016bpes speci\u0101lists ir at\u0161\u0137ir\u012bgs, un katrai sarunai, kas notiek starp diviem cilv\u0113kiem, ir sava dinamika. T\u0101d\u0113\u013c lab\u0101kais laiks un veids, k\u0101 run\u0101t ar konkr\u0113to pacientu, ir atkar\u012bgs no t\u0101, kas vislab\u0101k atbilst \u0161im pacientam attiec\u012bgaj\u0101 situ\u0101cij\u0101. Sarunai vajadz\u0113tu izdoties, ja teiktaj\u0101 b\u016bs j\u016btams siltums un emp\u0101tija. Sarunas uzs\u0101k\u0161anai var\u0113tu noder\u0113t, <\/span>piem\u0113ram<\/span><\/a>, jaut\u0101jums: “Vai j\u016bs apzin\u0101ties, ka liekais svars var paaugstin\u0101t asinsspiedienu?”, jo tas sasaista svaru ar konkr\u0113tu vesel\u012bbas probl\u0113mu. Labs sarunas ies\u0101kums var\u0113tu ar\u012b b\u016bt fr\u0101ze: “Svara samazin\u0101\u0161ana var pal\u012bdz\u0113t atvieglot muguras s\u0101pes”, jo t\u0101 pied\u0101v\u0101 svara samazin\u0101\u0161anu k\u0101 atrisin\u0101jumu noteiktai probl\u0113mai. P\u0113c tam, kad saruna ir s\u0101kusies, uzman\u012bgi ieklausieties atbildes reakcij\u0101 un piel\u0101gojiet turpm\u0101ko sarunu izdzird\u0113tajam. Tas pal\u012bdz\u0113s nostiprin\u0101t labas attiec\u012bbas ar pacientu, kas var noder\u0113t n\u0101kotn\u0113, sekm\u0113jot pacienta n\u0101kam\u0101s viz\u012btes un turpm\u0101ko diskusiju taj\u0101s. Apvienotaj\u0101 Karalist\u0113 \u0161\u0101du pieeju pal\u012bdz att\u012bst\u012bt iniciat\u012bvas “Vesel\u012bgas sarunas” (<\/span>Healthy conversations<\/span><\/a>) un “Katrai kontakta reizei ir noz\u012bme” (<\/span>Making every contact count<\/span><\/a>).\u00a0\u00a0<\/span><\/p>\n

KO<\/b><\/p>\n

Saruna ir ies\u0101kta, bet \u2013 ko dar\u012bt p\u0113c tam? Par ko \u012bsti ir j\u0101run\u0101? Tas, k\u0101 saruna risin\u0101sies, var noteikt, cik veiksm\u012bgi cilv\u0113kam izdosies zaud\u0113t svaru. Sarunai j\u0101notiek t\u0101, lai pacients saprastu, ka <\/span>liekais svars patie\u0161\u0101m ir probl\u0113ma<\/span><\/a>; lai vi\u0146\u0161 notic\u0113tu, ka <\/span>svars ir saist\u012bts ar vi\u0146a dz\u012bvesveidu<\/span> (resp., tas galvenok\u0101rt ir atkar\u012bgs no pacienta uzved\u012bbas, nevis g\u0113niem, hormoniem, z\u0101l\u0113m vai politikas \u2013 lai k\u0101di ar\u012b b\u016btu pacienta uzskati); lai iedvesmotu pacientu veikt izmai\u0146as; lai mudin\u0101tu pacientu uztic\u0113ties un apmekl\u0113t \u0101rstu n\u0101kamaj\u0101s viz\u012bt\u0113s; un sagatavotu vi\u0146u nepiecie\u0161amaj\u0101m izmai\u0146\u0101m.\u00a0<\/span><\/p>\n

Svara mazin\u0101\u0161ana ir ilgtermi\u0146a pas\u0101kums. Par svara mazin\u0101\u0161anu noteikti ir j\u0101run\u0101. Bet par to j\u0101run\u0101 uzman\u012bgi, un j\u0101iev\u0113ro KAD, K\u0100 un KO, lai \u0161is ilgtermi\u0146a pas\u0101kums neizg\u0101ztos, pirms v\u0113l s\u0101cies.<\/span><\/p>\n

Praktiski ieteikumi<\/b><\/p>\n