Pentru a r\u0103spunde la astfel de \u00eentreb\u0103ri a\u021bi putea s\u0103 \u00eentreba\u021bi direct persoanele implicate, dar este mai bine s\u0103 observa\u021bi direct comportamentul \u00een momente critice pentru a evita probleme de biasare sau uitare. Dezvoltarea tehnic\u0103 permite monitorizarea comportamentelor cu ajutorul smart phone-ului putem de exemplu s\u0103 vedem ce se petrece \u00een timp real. Un studio de tip n-of-1 ne ajut\u0103 s\u0103 r\u0103spundem la astfel de \u00eentreb\u0103ri.\u00a0<\/span><\/p>\n Studiile de tip n-of-1 sunt utile c\u00e2nd o problem poate s\u0103 fie evaluat\u0103 cu <\/span>m\u0103sur\u0103tori repetate<\/span>, pentru a vedea schimbarea \u00een timp.\u00a0 Astfel putem s\u0103 descriem problema \u0219i s\u0103 vedem dac\u0103 se \u00eembun\u0103t\u0103\u021be\u0219te sau nu \u00een timp. Sau putem s\u0103 introducem o nou\u0103 interven\u021bie sau tratament pentru a vedea dac\u0103 are efectul scontat. Cea mai simpl\u0103 metod\u0103 de evaluare este un trend de observa\u021bii ca \u00een graficul din imaginea de mai jos. Acesta este un pas important \u00een analiza n-of-1. Adi\u021bional, exist\u0103 metode de <\/span>analiz\u0103 statistic\u0103<\/span> pentru studiile de tip n-of-1. Metode mai complexe sunt \u00een curs de dezvoltate (de ex. <\/span>Metode de a analiza schimbarea dinamic\u0103<\/span>).\u00a0<\/span><\/p>\n <\/p>\n Utilizarea studiului n-of-1 pentru a evalua o problem\u0103<\/b><\/p>\n Un studiu poate s\u0103 fie elaborate pentru a evaluarea severitatea sau frecven\u021ba unei probleme \u00een timp. \u00cen figura 1 nivelul anxiet\u0103\u021bii variaz\u0103 \u00een timp, dar putem s\u0103 identific\u0103m o tendin\u021b\u0103. C\u00e2nd am \u00eenregistrat \u0219i prezen\u021ba la munc\u0103, tendin\u021ba observat\u0103 este o diferen\u021b\u0103 \u00eentre weekend \u0219i cele cinci zile lucr\u0103toare. Acest fapt ne indic\u0103, c\u0103 persoana este mai anxioas\u0103 la munc\u0103 dec\u00e2t acas\u0103. Acest fap teste util atunci c\u00e2nd opt\u0103,m pentru un tratament optim pentru pacient. De exemplu, dac\u0103 evalu\u0103m dispozi\u021bia pe parcursul zilei pentru o personan\u0103 muribund\u0103 ne ajut\u0103 s\u0103 observ\u0103m tendin\u021bele care ajut\u0103 la ameliorarea depresiei. Informa\u021biile culese cu studii n-of 1 merg dincolo de simpla descriere a problemei \u0219i ajut\u0103 s\u0103 explic\u0103m ce observ\u0103m. Uneori practicienii au o teorie despre de au observant \u0219i acest tip de studio ajut\u0103 s\u0103 testeze c\u00e2t de bine explic\u0103 teoria ceea ce au observat. \u00cen cazul persoanei muribunde, putem s\u0103 monitoriz\u0103m g\u00e2ndurile \u0219i activit\u0103\u021bile pentru a confirma teoria c\u0103 dispozi\u021bia este influen\u021bat\u0103 de g\u00e2nduri \u0219i g\u00e2ndurile critice sunt associate cu activit\u0103\u021bile de diminea\u021b\u0103.\u00a0<\/span><\/p>\n Figura 1:<\/b> utilizarea studiului N-of-1 pentru a descrie o problem\u0103: nivelul anxiet\u0103\u021bii cu albastru \u0219i zilele lucr\u0103toare cu ro\u0219u <\/span>pe parcursul a 24 de zile<\/span><\/i><\/p>\n Utilizarea studiilor n-of-1 pentru a evalua \u00eembun\u0103t\u0103\u021birea sau \u00eenr\u0103ut\u0103\u021birea unei probleme \u0219i factorii determinan\u021bi\u00a0<\/b><\/p>\n Problemele pot s\u0103 se \u00eembun\u0103t\u0103\u021beasc\u0103 sau \u00eentr\u0103ut\u0103\u021beasc\u0103 datorit\u0103 unor factori ca de exemplu o \u00eenmorm\u00e2ntare, o nunt\u0103, a \u0219tire media, \u00eenchiderea unei fabrici sau chiar vremea.\u00a0 Figura 2 este o repezentare ipotetic\u0103 a unui caz \u00een care o problem\u0103 medical\u0103 ca viroza a fost intensificat\u0103 \u00een s\u0103pt\u0103m\u00e2na de dup\u0103 o \u0219tire TV legat\u0103 de problem. Acest fapt sugereaz\u0103 c\u0103 intensificarea nu a fost determinat\u0103 de o epidemie \u0219i c\u0103 pe viitor, serviciile medicale pot anticipa o intensificare a consulta\u021biilor dup\u0103 ce viroza ajunge o \u0219tire la televizor. O analiz\u0103 de tip n-of-1 a statisticilor din spitalele britanice a ar\u0103tat efectele unui eveniment sportiv- a existat o cre\u0219tere a intern\u0103rilor pentru evenimente cardiace asociat\u0103 cu un meci important de fotbal \u00een timpul cupei din 1998.\u00a0<\/span><\/p>\n Figure 2:<\/b> utilizarea studiilor n-of-1 pentru a surprinde efectul unui eveniment<\/span>: <\/b>sunt aproximativ 40 de consulta\u021bii pe zi pentru viroz\u0103 \u00eenainte de emisiunea TV (vezi s\u0103geata albastr\u0103)<\/span><\/i> dup\u0103 care urmeaz\u0103 o intensificare a num\u0103rului de consulta\u021bii<\/span><\/i><\/p>\n Using n-of-1 studies to assess whether an intervention or treatment is having the desired effect<\/b><\/p>\n N-of-1 methods may be used in <\/span>the development of new interventions<\/span><\/a>, including clinical and policy interventions.\u00a0 In the hypothetical example in figure 3, an obese patient is snacking approximately 7 times per day;\u00a0 following the intervention indicated by the red arrow (possibly self-monitoring of snacking), snacking quickly reduces to\u00a0 2 times per day.<\/span><\/p>\n Similar methods can be used to study a nation\u2019s <\/span>smoking<\/span><\/a>\u00a0 and assess the impact of policy changes such as the smoking ban in public places, e.g., <\/span>how national policy affects smoking<\/span><\/a>.<\/span><\/p>\n A good example of the practical use of N-of-1 methods to evaluate the effect of an intervention was reported by practitioners in a hospital district.\u00a0 They assessed the problem of delay in reporting adverse events for the period from 2001 to 2006 and found that, while delay varied, it was problematic for their patient safety programme and did not show signs of improvement over time. In 2007 and 2008 a program to recognise good performance was introduced which led to reduction in the delays for subsequent years and shows <\/span>how such recognition improved timely reporting<\/span><\/a>.\u00a0<\/span><\/p>\n Figure 3: <\/span>Using n-of-1 studies to assess the effect of intervention:\u00a0 <\/b>the first 15 days shows the frequency of snacking self-monitoring starting at day 16 (shown by the red arrow) results in reduced snacking<\/span><\/i>\u00a0<\/b><\/p>\n Provoc\u0103ri\u00a0<\/b><\/p>\n Colectarea de date este o provocare. M\u0103sur\u0103torile repetate sunt o dificultate \u0219i pot rezulta \u00een date lips\u0103. Dezvolt\u0103rile tehnologice ofer\u0103 posibilitatea s\u0103 utiliz\u0103m telefonul mobil sau sensori pentru a culege date mai u\u0219or.\u00a0<\/span><\/p>\n Recomand\u0103ri practice<\/b><\/p>\n Translated by Dr. Irina Catrinel Cr\u0103ciun<\/span><\/i><\/p>\n![\"\"](\"https:\/\/practicalhealthpsychology.com\/wp-content\/uploads\/2019\/10\/Figure-1.png\")
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