{"id":975,"date":"2018-07-30T14:59:54","date_gmt":"2018-07-30T14:59:54","guid":{"rendered":"http:\/\/practicalhealthpsychology.com\/?p=975"},"modified":"2025-11-04T14:37:31","modified_gmt":"2025-11-04T14:37:31","slug":"self-regulation-from-theory-to-practice-supporting-your-patients-goals-for-change","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/lv\/2018\/07\/self-regulation-from-theory-to-practice-supporting-your-patients-goals-for-change\/","title":{"rendered":"Pa\u0161regul\u0101cija: no teorijas uz praksi jeb k\u0101 atbalst\u012bt pacientu uzved\u012bbas p\u0101rmai\u0146as"},"content":{"rendered":"

Stans Mass (Stan Maes) un Veronika De Huhta (V\u00e9ronique De Gucht), Leidenes Universit\u0101te, N\u012bderlande<\/strong><\/p>\n

P\u0113d\u0113jo desmitga\u017eu laik\u0101 indiv\u012bda loma vesel\u012bbas apr\u016bpes sist\u0113m\u0101 ir main\u012bjusies: k\u0101dreiz t\u0101 bija medic\u012bnisk\u0101 re\u017e\u012bma iev\u0113ro\u0161ana, kas ietv\u0113ra paklaus\u012bbu, bet tagad \u2013 pa\u0161p\u0101rvald\u012bba, kas noz\u012bm\u0113 atbild\u012bbas uz\u0146em\u0161anos par savu vesel\u012bbu un slim\u012bbas kontroli. Izmai\u0146u process aizvien turpin\u0101s un ir att\u012bst\u012bjies l\u012bdz idejai par pa\u0161regul\u0101ciju \u2013 sistem\u0101tisku procesu, kas ietver personisku vesel\u012bbas m\u0113r\u0137u nosprau\u0161anu un uzved\u012bbas pa\u0161regul\u0113\u0161anu \u0161o m\u0113r\u0137u sasnieg\u0161anai. \u0160\u012b pa\u0161regul\u0101cijas procesa nep\u0101rtraukt\u012bbu labi ilustr\u0113 \u0161im rakstam pievienotais z\u012bm\u0113jums \u2013 senais t\u0113ls “ouroboros” \u2013 gredzen\u0101 satinusies \u010d\u016bska, kas aprij pati savu asti.<\/p>\n

<\/p>\n

Pa\u0161regul\u0101cija notiek posmveid\u012bgi. Pirmais posms: izpratne par m\u0113r\u0137i un m\u0113r\u0137a nosprau\u0161ana, otrais: akt\u012bva r\u012bko\u0161an\u0101s, lai m\u0113r\u0137im tuvotos, tre\u0161ais: m\u0113r\u0137a sasnieg\u0161ana un sasniegt\u0101 st\u0101vok\u013ca uztur\u0113\u0161ana vai atrais\u012b\u0161an\u0101s no konkr\u0113t\u0101 m\u0113r\u0137a. Apl\u016bkosim \u0161os posmus, izmantojot piem\u0113ru par k\u0101du v\u012brieti, v\u0101rd\u0101 D\u017eons, kur\u0161 piedz\u012bvojis sirdsl\u0113kmi.<\/p>\n

Pirmais posms<\/strong><\/p>\n

Pirmaj\u0101 posm\u0101<\/em> indiv\u012bdam j\u0101apzin\u0101s un j\u0101nosaka re\u0101listiski un personiski noz\u012bm\u012bgi vesel\u012bbas izmai\u0146u m\u0113r\u0137i. Piem\u0113ram, ja D\u017eonam k\u0101ds pajaut\u0101tu: “Ko jums noz\u012bm\u0113tu atvese\u013co\u0161an\u0101s?”, vi\u0146\u0161 var\u0113tu atbild\u0113t, ka vi\u0146am svar\u012bgas ir pastaigas dab\u0101 kop\u0101 ar mazb\u0113rnu. T\u0101d\u0113\u013c pirmais solis, ko D\u017eons var\u0113tu spert ce\u013c\u0101 uz atvese\u013co\u0161anos, b\u016btu ap\u0146em\u0161an\u0101s uzs\u0101kt \u012bsas pastaigas pa apkaimi. \u013boti svar\u012bgi, lai \u0161\u0101di m\u0113r\u0137i b\u016btu pa\u0161a nosprausti un re\u0101listiski, \u0146emot v\u0113r\u0101 t\u0101 br\u012b\u017ea st\u0101vokli, jo tas rada atbild\u012bbas izj\u016btu, un \u0161\u0101di m\u0113r\u0137i ir viegl\u0101k sasniedzami, sal\u012bdzinot ar citu izvirz\u012btajiem m\u0113r\u0137iem indiv\u012bdam. Lai pal\u012bdz\u0113tu nospraust personiskos m\u0113r\u0137us nemotiv\u0113tiem indiv\u012bdiem, var izmantot da\u017e\u0101das motiv\u0113jo\u0161u p\u0101rrunu metodes.<\/p>\n

Otrais posms<\/strong><\/p>\n

Otrajam posmam<\/em> rakstur\u012bga m\u0113r\u0137tiec\u012bga darbo\u0161an\u0101s, lai paveiktu to, ko indiv\u012bds ap\u0146\u0113mies. Tas ir posms, kur\u0101 j\u0101savieno apzi\u0146a (piem., nodoms) ar r\u012bc\u012bbu. \u0160im nol\u016bkam ir vajadz\u012bgs konkr\u0113ts un p\u0101rdom\u0101ts r\u012bc\u012bbas pl\u0101ns, kur\u0101 prec\u012bzi nor\u0101d\u012bts, kad, kur un k\u0101 r\u012bkoties. M\u016bsu piem\u0113r\u0101 tas var\u0113tu b\u016bs \u0161\u0101ds: “S\u0101kot no n\u0101kam\u0101s ned\u0113\u013cas, es kop\u0101 ar sievu katru pirmdienu, tre\u0161dienu un piektdienu trijos p\u0113cpusdien\u0101 ar k\u0101j\u0101m do\u0161os uz tuv\u0113jo p\u0101rtikas veikalu.” Ir pier\u0101d\u012bts, ka pietiekami detaliz\u0113ti r\u012bc\u012bbas pl\u0101ni veicina fizisko aktivit\u0101\u0161u, vesel\u012bga uztura un citu ar vesel\u012bbas uzved\u012bbu saist\u012bto m\u0113r\u0137u sasnieg\u0161anu.<\/p>\n

Svar\u012bgu lomu m\u0113r\u0137a sasnieg\u0161an\u0101 veic tr\u012bs regul\u0113jo\u0161ie meh\u0101nismi. Pirmais no tiem ir atgriezenisk\u0101 saite<\/em>, kas ietver progresa uzraudz\u012bbu un nov\u0113rt\u0113\u0161anu. Piem\u0113ram, var\u0113tu pal\u016bgt, lai D\u017eons raksta piez\u012bmes par to, k\u0101 vi\u0146am ir veicies, izpildot savu ap\u0146em\u0161anos. Tad rezult\u0101tus kop\u0101 ar D\u017eonu var\u0113tu izanaliz\u0113t, konstat\u0113jot, ka vi\u0146am ir pan\u0101kumi, vai identific\u0113jot probl\u0113mas, kas n\u0101kotn\u0113 j\u0101p\u0101rvar. Otrais meh\u0101nisms saist\u012bts ar gaid\u012b\u0161anas vai paredz\u0113\u0161anas procesiem<\/em>, kas ietver izn\u0101kuma prognozi (t.i., cilv\u0113ka priek\u0161statu par to, kas notiks, ja vi\u0146\u0161 r\u012bkosies) un pa\u0161efektivit\u0101ti (t.i., vai cilv\u0113ks uzskata, ka ir sp\u0113j\u012bgs veiksm\u012bgi r\u012bkoties). Gan izn\u0101kuma prognozi, gan pa\u0161efektivit\u0101ti sekm\u0113 veiksm\u012bgi piem\u0113ri, pan\u0101kumi ce\u013c\u0101 uz m\u0113r\u0137i un iedro\u0161in\u0101jums. T\u0101d\u0113\u013c b\u016btu v\u0113lams, lai kl\u012bnicisti pal\u012bdz\u0113tu pacientiem iepaz\u012bties ar cilv\u0113kiem, kuri ir veiksm\u012bgi sasniegu\u0161i l\u012bdz\u012bgus m\u0113r\u0137us, t\u0101d\u0113j\u0101di palielinot m\u0113r\u0137a sasnieg\u0161anas iesp\u0113jas un nodro\u0161inot indiv\u012bdiem iesp\u0113ju sa\u0146emt atbalstu ce\u013c\u0101 uz savu m\u0113r\u0137i. P\u0113d\u0113jais meh\u0101nisms ietver kontroles procesu aktiviz\u0113\u0161anu<\/em>, lai atbalst\u012btu centienus sasniegt m\u0113r\u0137i pat tad, ja ce\u013c\u0101 st\u0101tos konkur\u0113jo\u0161i m\u0113r\u0137i vai k\u0101di citi \u0161\u0137\u0113r\u0161\u013ci. Novirz\u012b\u0161an\u0101s no pa\u0161a nospraust\u0101 m\u0113r\u0137a, piem\u0113ram, k\u0101da dz\u012bves notikuma iespaid\u0101, var negat\u012bvi ietekm\u0113t m\u0113r\u0137a sasnieg\u0161anu. Progresa tr\u016bkums m\u0113r\u0137a sasnieg\u0161an\u0101 (t.i., neveiksme) bie\u017ei saist\u012bts ar\u012b ar negat\u012bvu noska\u0146ojumu. Ja atgad\u0101s kas taml\u012bdz\u012bgs, b\u016btu labi D\u017eonam pal\u012bdz\u0113t tikt gal\u0101 ar emocij\u0101m un p\u0101rvar\u0113t neveiksmes, iem\u0101coties t\u0101s uztvert k\u0101 m\u0101c\u012bbu stundas.<\/p>\n

Tre\u0161ais posms<\/strong><\/p>\n

Tre\u0161ais posms<\/em> attiecas uz m\u0113r\u0137a sasnieg\u0161anu, sasniegt\u0101 st\u0101vok\u013ca uztur\u0113\u0161anu vai atrais\u012b\u0161anos no konkr\u0113t\u0101 m\u0113r\u0137a. M\u0113r\u0137a sasnieg\u0161ana nenoz\u012bm\u0113 beigas, dr\u012bz\u0101k gan \u2013 jaunu s\u0101kumu. Indiv\u012bdus var iedro\u0161in\u0101t izvirz\u012bt jaunus m\u0113r\u0137us, lai laika gait\u0101 saglab\u0101tu sasniegtos pan\u0101kumus. Tom\u0113r, ja izr\u0101d\u012bjies, ka pa\u0161noteiktais vesel\u012bbas m\u0113r\u0137is nav sasniedzams, bie\u017ei vien pr\u0101t\u012bg\u0101k ir atteikties no \u0161\u012b m\u0113r\u0137a un izv\u0113l\u0113ties citu m\u0113r\u0137i, kam b\u016btu viegl\u0101k tuvoties. M\u016bsu piem\u0113r\u0101 D\u017eons var\u0113tu vai nu turpin\u0101t ies\u0101kt\u0101s fizisk\u0101s aktivit\u0101tes, vai nospraust jaunu m\u0113r\u0137i, piem\u0113ram, ap\u0146emties katru dienu iziet \u012bs\u0101 pastaig\u0101 ar suni. Pa\u0161efektivit\u0101tes un soci\u0101l\u0101 atbalsta veicin\u0101\u0161ana ir svar\u012bgi faktori sasniegto pan\u0101kumu notur\u0113\u0161an\u0101.<\/p>\n

Daudzi p\u0113t\u012bjumi apliecina pa\u0161regul\u0101cij\u0101 balst\u012btu uzved\u012bbas p\u0101rmai\u0146u interven\u010du efektivit\u0101ti k\u0101 veseliem cilv\u0113kiem, t\u0101 pacientiem ar hronisk\u0101m slim\u012bb\u0101m, piem\u0113ram, svara samazin\u0101\u0161anai 2.\u00a0tipa cukura diab\u0113ta gad\u012bjum\u0101, fizisku aktivit\u0101\u0161u veicin\u0101\u0161anai artr\u012bta pacientiem, p\u0101rmai\u0146\u0101m dz\u012bvesveid\u0101 sirds rehabilit\u0101cijai, un darba un atp\u016btas l\u012bdzsvaro\u0161anai, \u0101rst\u0113jot hroniska noguruma sindromu.<\/p>\n

\"\"
Att\u0113l\u0101: pa\u0161regul\u0101cijas cikls.<\/figcaption><\/figure>\n

Praktiski ieteikumi <\/em><\/strong><\/p>\n

1) Pal\u012bdziet pacientam noformul\u0113t personisko p\u0101rmai\u0146u m\u0113r\u0137i saist\u012bb\u0101 ar attiec\u012bgo vesel\u012bbas probl\u0113mu (piem.: “Ko jums noz\u012bm\u0113tu atvese\u013co\u0161an\u0101s?”). \u0160iem m\u0113r\u0137im j\u0101b\u016bt konkr\u0113tiem, indiv\u012bdam noz\u012bm\u012bgiem, ne p\u0101r\u0101k viegliem, ne p\u0101r\u0101k gr\u016btiem, un sasniedzamiem ierobe\u017eot\u0101 laikposm\u0101.<\/p>\n

2) Pal\u012bdziet pacientam izstr\u0101d\u0101t r\u012bc\u012bbas pl\u0101nu, uzdodot jaut\u0101jumu, kad, kur, k\u0101 un cik ilgi pacients darbosies attiec\u012bb\u0101 ar m\u0113r\u0137a sasnieg\u0161anu.<\/p>\n

3) Pal\u016bdziet, lai pacients izveido “m\u0113r\u0137a k\u0101pnes”, kas defin\u0113tu patst\u0101v\u012bgi izv\u0113rt\u0113jamus so\u013cus pak\u0101peniskai m\u0113r\u0137a sasnieg\u0161anai.<\/p>\n

4) Palieliniet pacienta pa\u0161efektivit\u0101ti, past\u0101stot par citiem, kuri sasniegu\u0161i l\u012bdzv\u0113rt\u012bgus m\u0113r\u0137us; iedro\u0161inot pacientu un uzslav\u0113jot vi\u0146u par pan\u0101kumiem ce\u013c\u0101 uz m\u0113r\u0137i. M\u0101ciet, k\u0101 tikt gal\u0101 ar \u0161\u0137\u0113r\u0161\u013ciem, un k\u0101 r\u012bkoties recid\u012bva gad\u012bjum\u0101.<\/p>\n

5) Atbalstiet izvirz\u012bto m\u0113r\u0137i, un pal\u012bdziet pacientiem to p\u0101rveidot viegl\u0101k sasniedzam\u0101 form\u0101, ja izr\u0101d\u0101s, ka eso\u0161aj\u0101 form\u0101 m\u0113r\u0137is nav sasniedzams.<\/p>\n

Tulkoju\u0161as And\u017eela Ber\u0137e un Krist\u012bne M\u0101rtinsone <\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

By Stan Maes & V\u00e9ronique De Gucht, Leiden University, Netherlands Over the last decades, the role of individuals within the healthcare system has evolved from \u2018compliance with medical regimens\u2019, implying obedience; to \u2018self-management\u2019, denoting responsibility for the control of one\u2019s […]<\/p>\n","protected":false},"author":1,"featured_media":1029,"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":[24],"tags":[],"class_list":["post-975","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-self-regulation"],"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":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\/lv\/wp-json\/wp\/v2\/posts\/975","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=975"}],"version-history":[{"count":31,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/posts\/975\/revisions"}],"predecessor-version":[{"id":4627,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/posts\/975\/revisions\/4627"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/media\/1029"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/media?parent=975"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/categories?post=975"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/lv\/wp-json\/wp\/v2\/tags?post=975"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}