{"id":761,"date":"2017-11-22T11:52:03","date_gmt":"2017-11-22T11:52:03","guid":{"rendered":"http:\/\/practicalhealthpsychology.com\/?p=761"},"modified":"2025-11-04T14:43:32","modified_gmt":"2025-11-04T14:43:32","slug":"very-brief-interventions","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/lv\/2017\/11\/very-brief-interventions\/","title":{"rendered":"\u013boti \u012bsa termi\u0146a intervences vesel\u012bbas uzved\u012bbas izmai\u0146u sekm\u0113\u0161anai vesel\u012bbas apr\u016bpes iest\u0101d\u0113s"},"content":{"rendered":"<p><strong>St\u012bvens Sutons, Kembrid\u017eas universit\u0101te, Lielbrit\u0101nija<\/strong><\/p>\n<p>Liela m\u0113roga probl\u0113mas prasa liela m\u0113roga risin\u0101jumus. V\u0113r\u0161an\u0101s pret \u2018liel\u0101 \u010detrinieka\u2019 uzved\u012bbu (mazkust\u012bba, sm\u0113\u0137\u0113\u0161ana, p\u0101rm\u0113r\u012bga uztura daudzuma un alkohola lieto\u0161ana) prasa izm\u0113r\u0101mas intervences, kuras var pielietot lielam cilv\u0113ku skaitam, lai noz\u012bm\u012bgi ietekm\u0113tu sabiedr\u012bbas vesel\u012bbu. Viena no daudzsolo\u0161\u0101m pieej\u0101m ir \u012bstermi\u0146a interven\u010du izmanto\u0161ana, ko var\u0113tu lietot vesel\u012bbas apr\u016bpes iest\u0101d\u0113s str\u0101d\u0101jo\u0161ie profesion\u0101\u013ci. Piem\u0113ram, Lielbrit\u0101nij\u0101 <a href=\"https:\/\/www.nice.org.uk\/guidance\/ph44\">Nacion\u0101lais Vesel\u012bbas apr\u016bpes izcil\u012bbas instit\u016bts (The National Institute for Health Care Excellence) prim\u0101r\u0101s apr\u016bpes \u0101rstiem iesaka<\/a> (\u0123imenes \u0101rstiem) sniegt individu\u0101li piel\u0101gotus, \u2018\u012bsus\u2019 ieteikumus par fizisko aktivit\u0101ti pieaugu\u0161ajiem, kuri nav fiziski akt\u012bvi, un n\u0101kamaj\u0101s tik\u0161an\u0101s reiz\u0113s\/apmekl\u0113jumos to turpin\u0101t \u0161\u0101dus ieteikumus sniegt.<\/p>\n<p><!--more--><\/p>\n<p>\u012astermi\u0146a interven\u010du <a href=\"http:\/\/bjsm.bmj.com\/content\/50\/7\/408\">efektivit\u0101te ir pier\u0101d\u012bta<\/a>, tom\u0113r \u0161o publik\u0101ciju interpret\u0113\u0161an\u0101 probl\u0113mas rada tas, ka termini \u2018\u012bsie ieteikumi\u2019 \u201evai \u012bstermi\u0146a intervences\u201d tiek defin\u0113ti at\u0161\u0137ir\u012bgi. Piem\u0113ram, viens no p\u0101rskatiem nosaka, ka \u012bso ieteikumu snieg\u0161ana ilgst \u201cmaz\u0101k par 30 min\u016bt\u0113m vai tie tiek sniegti vien\u0101 sesij\u0101 (pie\u013caujot, ka p\u0113t\u012bjuma rezult\u0101tu m\u0113r\u0137a sasnieg\u0161anai nepiecie\u0161ama tikai viena papildu tik\u0161an\u0101s)\u201d. Daudzas \u012bstermi\u0146a intervences tom\u0113r ir p\u0101rlieku garas, lai t\u0101s iek\u013cautu \u0123imenes \u0101rstu ikdienas kl\u012bniskaj\u0101 praks\u0113 \u2013 pacientu pie\u0146em\u0161an\u0101, t\u0101p\u0113c m\u0113s fokus\u0113jamies uz t\u0101du \u2018\u013coti \u012bsa\u2019 termi\u0146a interven\u010du izstr\u0101di un izv\u0113rt\u0113\u0161anu, kas tiek defin\u0113tas k\u0101 viena sesija un nav gar\u0101kas par 5 min\u016bt\u0113m, un ir v\u0113rstas uz fizisk\u0101s aktivit\u0101tes sekm\u0113\u0161anu. \u0160\u012bs \u013coti \u012bsa termi\u0146a intervences var izmantot da\u017e\u0101d\u0101s vesel\u012bbas apr\u016bpes iest\u0101d\u0113s, bet savas intervences m\u0113s esam izstr\u0101d\u0101ju\u0161i Nacion\u0101l\u0101 Vesel\u012bbas dienesta (National Health Service, NVD) Vesel\u012bbas p\u0101rbau\u017eu programmai (Health Check Programme) Anglij\u0101. Intervences ietvaros pieaugu\u0161ie vecum\u0101 no 40 l\u012bdz 74 gadiem, kuri nav iek\u013cauti slim\u012bbu re\u0123istr\u0101, vienu reizi piecos gados tiek uzaicin\u0101ti veikt asinsvadu p\u0101rbaudi. Vairums no \u0161\u012bm p\u0101rbaud\u0113m notiek prim\u0101raj\u0101 apr\u016bp\u0113 un t\u0101s veic m\u0101sas un m\u0101su pal\u012bgi. T\u0101 ir potenci\u0101li ide\u0101la iesp\u0113ja miljoniem cilv\u0113ku sniegt \u013coti \u012bslaic\u012bgu intervenci vesel\u012bbas uzved\u012bbas izmai\u0146u sekm\u0113\u0161anai.<\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25887643\">Interven\u010du<\/a> izstr\u0101dei m\u0113s izmantoj\u0101m iterat\u012bvo pieeju, kombin\u0113jot pier\u0101d\u012bjumus un ekspertu viedok\u013cus no daudziem avotiem, tai skait\u0101 \u2013 sistem\u0101tiskiem p\u0101rskatiem, konsult\u0101cij\u0101m ar ieinteres\u0113to grupu p\u0101rst\u0101vjiem, kvalitat\u012bviem p\u0113t\u012bjumiem, resursu izmaksu apl\u0113s\u0113m un grupu diskusij\u0101m. M\u0113s preciz\u0113j\u0101m sevi\u0161\u0137i \u012bsa termi\u0146a interven\u010du saturu <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23512568\">uzved\u012bbas izmai\u0146as tehnikas kontekst\u0101<\/a>. Piem\u0113ram, <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27350131\">m\u016bsu \u013coti \u012bs\u0101 termi\u0146a intervence, kur\u0101 izmatots pedometers<\/a>, iek\u013cauj devi\u0146as da\u017e\u0101das uzved\u012bbas izmai\u0146u tehnikas, tai skait\u0101 \u2013 m\u0113r\u0137u noteik\u0161anu, darb\u012bbas pl\u0101no\u0161anu un uzved\u012bbas pa\u0161kontroli. T\u0101s tika \u012bstenotas, izsniedzot dal\u012bbniekiem pedometrus un So\u013cu karti, vienlaikus sniedzot mutisku instrukciju: \u201cKatru ned\u0113\u013cu jums j\u0101nosaka sev m\u0113r\u0137is noiet noteiktu so\u013cu skaitu, piem\u0113ram, 6000 so\u013cus dien\u0101, un p\u0113c tam katru dienu varat pierakst\u012bt, cik so\u013cus esat nostaig\u0101jis, un skat\u012bties, k\u0101 sasniedzat savu m\u0113r\u0137i\u201d. M\u0113s izstr\u0101d\u0101j\u0101m ar\u012b tr\u012bs stundu treni\u0146a sesiju un rokasgr\u0101matu \u0101rstiem.<\/p>\n<p>\u013boti \u012bsa termi\u0146a intervences, kas balst\u012btas uz \u0161\u0101d\u0101m tehnik\u0101m, ir j\u0101no\u0161\u0137ir no vienk\u0101r\u0161as \u2018ieteikumu snieg\u0161anas\u2019. Ieteikumi parasti iek\u013cauj aicin\u0101jumus veikt izmai\u0146as un inform\u0101ciju par mazkust\u012bguma kait\u012bgumu vai ieguvumiem no fizisk\u0101s aktivit\u0101tes. Kaut gan tas ir svar\u012bgi, b\u016btu noder\u012bgi iek\u013caut ar\u012b t\u0101das tehnikas k\u0101 m\u0113r\u0137u izvirz\u012b\u0161ana un pa\u0161kontrole, kas izstr\u0101d\u0101tas, lai pal\u012bdz\u0113tu cilv\u0113kiem main\u012bt savu uzved\u012bbu.<\/p>\n<p>M\u0113s par\u0101d\u012bj\u0101m, ka ir iesp\u0113jams iek\u013caut \u013coti \u012bsa termi\u0146a intervences vesel\u012bbas p\u0101rbau\u017eu programm\u0101 un to akcept\u0113 gan \u0101rsti, gan pacienti. M\u016bsu s\u0101kotn\u0113jie efektivit\u0101tes v\u0113rt\u0113jumu rezult\u0101ti bija \u013coti daudzsolo\u0161i. Balstoties uz objekt\u012bvi izm\u0113r\u0101mu fizisko aktivit\u0101ti, izmantojot akselerometru, <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27716297\">uz pedometru balst\u012bt\u0101 \u013coti \u012bsa termi\u0146a intervenc\u0113<\/a> tika noteikta 73% efektivit\u0101tes iesp\u0113ja (piem\u0113ram, fizisk\u0101s aktivit\u0101tes pieaugums, sal\u012bdzinot ar grupu, kam netika veikta intervence). Tom\u0113r, kad p\u0101rbaud\u012bj\u0101m \u0161o \u013coti \u012bsa termi\u0146a intervenci pla\u0161\u0101k\u0101 p\u0113t\u012bjum\u0101 (N=1007), tika konstat\u0113ta tikai neliela pozit\u012bva ietekme uz objekt\u012bvi izm\u0113r\u0101mo fizisko aktivit\u0101ti tr\u012bs m\u0113ne\u0161u laik\u0101, kas nebija statistiski noz\u012bm\u012bga. Tom\u0113r ekonomisk\u0101 izv\u0113rt\u0113juma rezult\u0101ti liecina, ka ir 60% iesp\u0113ja, ka ilgtermi\u0146\u0101 intervence ir rentabla, sal\u012bdzinot ar NVD veiktu vesel\u012bbas p\u0101rbaudi bez \u0161\u0101das intervences. T\u0101tad, veikt \u013coti \u012bsa termi\u0146a intervenci ir lab\u0101k nek\u0101 nedar\u012bt neko.<\/p>\n<p>Ir iesp\u0113jams palielin\u0101t \u013coti \u012bsa termi\u0146a interven\u010du efektivit\u0101ti, iek\u013caujot taj\u0101s papildu komponentus. Izaicin\u0101jums ir to paveikt, p\u0101rlieku nepalielinot izmaksas. Viena no pieej\u0101m ir kombin\u0113t \u013coti \u012bsa termi\u0146a kl\u0101tienes tik\u0161anos ar \u2018digit\u0101lo\u2019 intervenci, kas pacientam nodro\u0161ina past\u0101v\u012bgu atbalstu uzved\u012bbas izmai\u0146u veik\u0161an\u0101. Kl\u0101tienes un digit\u0101l\u0101s komponentes izmanto\u0161ana var b\u016bt efekt\u012bv\u0101ka nek\u0101 katra no \u0161\u012bm komponent\u0113m atsevi\u0161\u0137i. \u0160\u0101du intervences modeli m\u0113s izmantoj\u0101m, lai palielin\u0101tu <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4309513\/\">sm\u0113\u0137\u0113\u0161anas atme\u0161anas bie\u017eumu<\/a> prim\u0101raj\u0101 apr\u016bp\u0113 \u012bstenot\u0101 intervenc\u0113 sm\u0113\u0137\u0113t\u0101jiem, kur\u0101 digit\u0101lo komponenti veidoja 90 dienu individu\u0101li piel\u0101gotas teksta \u012bszi\u0146as, kas tika s\u016bt\u012btas uz sm\u0113\u0137\u0113t\u0101ja mobilo t\u0101lruni.<\/p>\n<p><strong>Ieteikumi<\/strong><\/p>\n<ul>\n<li>P\u0113t\u012bjumos ir g\u016bti pier\u0101d\u012bjumi par <em>\u012bstermi\u0146a <\/em>interven\u010du efektivit\u0101ti uzved\u012bbas, piem\u0113ram, sm\u0113\u0137\u0113\u0161anas vai fizisk\u0101s aktivit\u0101tes izmai\u0146u sekm\u0113\u0161anai, tom\u0113r daudzas no \u0161\u012bm intervenc\u0113m ir p\u0101r\u0101k ilgsto\u0161as, lai t\u0101s var\u0113tu iek\u013caut parast\u0101 pacienta konsult\u0101cij\u0101 praks\u0113.<\/li>\n<li>Apsveriet iesp\u0113ju aizst\u0101t \u0161\u0101das intervences ar <em>\u013coti \u012bsa termi\u0146a<\/em> intervenc\u0113m, kas nav ilg\u0101kas par piec\u0101m min\u016bt\u0113m! Pier\u0101d\u012bjumi par \u0161\u0101du interven\u010du efektivit\u0101ti ir v\u0101j\u0101ki nek\u0101 par \u012bstermi\u0146a intervenc\u0113m, tom\u0113r lab\u0101k \u012bstenot \u0161\u0101das intervences nek\u0101 t\u0101s ne\u012bstenot visp\u0101r.<\/li>\n<li>T\u0101 viet\u0101 lai \u2018vienk\u0101r\u0161i sniegtu ieteikumu\u2019, veiciet \u013coti \u012bsa termi\u0146a intervenci, iek\u013caujot vienu vai vair\u0101kas uzved\u012bbas izmai\u0146u tehnikas. Piem\u0113ram, var\u0113tu b\u016bt noder\u012bgi ieteikt pacientam kontrol\u0113t\/nov\u0113rot savu uzved\u012bbu vai izstr\u0101d\u0101t specifisku darb\u012bbas pl\u0101nu, uzrakstot, kad, kur un k\u0101 vi\u0146i palielin\u0101s savu fizisko aktivit\u0101ti vai izvair\u012bsies no k\u0101rdino\u0161\u0101m uzkod\u0101m.<\/li>\n<li>Iesp\u0113jams \u0101tri inform\u0113t par noder\u012bgiem resursiem (piem\u0113ram, viedt\u0101lru\u0146a aplik\u0101cij\u0101m vai n\u016bjo\u0161anas nodarb\u012bb\u0101m tuvu dz\u012bvesvietai), un tas var sekm\u0113t intervences ietekmi. Noder\u012bgi ir iepl\u0101not atk\u0101rtotu viz\u012bti\/tik\u0161anos.<\/li>\n<li>Nov\u0113rt\u0113jiet ikviena kontakta noz\u012bmi! Katru reizi, kad redzat pacientu, jums ir potenci\u0101la iesp\u0113ja kaut ko pateikt par nepiecie\u0161am\u012bbu main\u012bt uzved\u012bbu. Profesion\u0101\u013ci, kuri izmanto \u013coti \u012bsa termi\u0146a intervences daudziem pacientiem, g\u016bst iesp\u0113ju noz\u012bm\u012bgi ietekm\u0113t sabiedr\u012bbas vesel\u012bbu.<\/li>\n<\/ul>\n<p>Tulkoja: Gunta Freimane, Krist\u012bne M\u0101rtinsone<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Stephen Sutton, University of Cambridge, England Large-scale problems require large-scale solutions. Tackling the \u2018Big 4\u2019 behaviours (physical inactivity, tobacco use, excessive consumption of food and alcohol) requires scalable interventions that can reach large numbers of people to achieve a [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":778,"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":[13],"tags":[],"class_list":["post-761","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-interventions"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"lv","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":false,"content":false,"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":false,"content":false,"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":false,"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\/lv\/wp-json\/wp\/v2\/posts\/761","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/comments?post=761"}],"version-history":[{"count":24,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/posts\/761\/revisions"}],"predecessor-version":[{"id":4638,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/posts\/761\/revisions\/4638"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/media\/778"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/media?parent=761"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/categories?post=761"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/tags?post=761"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}