{"id":4947,"date":"2026-06-21T23:59:26","date_gmt":"2026-06-21T23:59:26","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?post_type=module&p=4947"},"modified":"2026-09-10T09:33:10","modified_gmt":"2026-09-10T09:33:10","slug":"module-1","status":"publish","type":"module","link":"https:\/\/practicalhealthpsychology.com\/sk\/module\/module-1\/","title":{"rendered":"Prehliadame vysokorizikov\u00fdch pacientov s COVID-19? Ako zlep\u0161i\u0165 v\u010dasn\u00fd z\u00e1chyt v klinickej praxi"},"content":{"rendered":"

Autori: Astin Sokang, Universitas Kristen Krida Wacana, Indon\u00e9zia; Triana Kesuma Dewi, Universitas Airlangga, Indon\u00e9zia; Yuhang Zhu, Shandong Second Medical University, \u010c\u00edna; Gill ten Hoor, Maastricht University, Holandsko\u00a0<\/strong><\/p>\n

U mnoh\u00fdch dospel\u00fdch sp\u00f4sobuje COVID-19 iba mierne sympt\u00f3my, napr\u00edklad <\/span>\u00fanavu, ka\u0161e\u013e alebo mierne zv\u00fd\u0161en\u00fa teplotu<\/span><\/a>. U \u013eud\u00ed s ur\u010dit\u00fdmi diagn\u00f3zami v\u0161ak m\u00f4\u017ee infekcia vies\u0165 k hospitaliz\u00e1cii alebo k z\u00e1va\u017en\u00fdm komplik\u00e1ci\u00e1m. V\u010dasn\u00e1 identifik\u00e1cia t\u00fdchto pacientov je v\u0161ak k\u013e\u00fa\u010dov\u00e1, preto\u017ee lie\u010dba je naj\u00fa\u010dinnej\u0161ia vtedy, ke\u010f sa za\u010dne kr\u00e1tko po n\u00e1stupe pr\u00edznakov.<\/span><\/p>\n

Aktu\u00e1lne d\u00e1ta<\/span><\/a> konzistentne ukazuj\u00fa, \u017ee riziko z\u00e1va\u017en\u00e9ho priebehu COVID-19 narast\u00e1 s vekom a pri pr\u00edtomnosti chronick\u00fdch ochoren\u00ed ako s\u00fa kardiovaskul\u00e1rne ochorenia, diabetes, obezita, chronick\u00e9 ochorenia p\u013e\u00fac, onkologick\u00e9 ochorenia \u010di oslabenie imunity. Z\u00e1va\u017en\u00e9 n\u00e1sledky hrozia hlavne star\u0161\u00edm dospel\u00fdm a\u00a0osob\u00e1m s viacer\u00fdmi chronick\u00fdmi ochoreniami.<\/span><\/p>\n

Naj\u00fa\u010dinnej\u0161ou formou predch\u00e1dzania z\u00e1va\u017en\u00fdm n\u00e1sledkom s\u00fa antivirotik\u00e1, ak sa nasadia do piatich dn\u00ed od objavenia pr\u00edznakov. R\u00fdchly z\u00e1chyt vysokorizikov\u00fdch pacientov je v\u0161ak z\u00e1sadn\u00fd, aj neskor\u0161\u00ed za\u010diatok lie\u010dby m\u00f4\u017ee pom\u00f4c\u0165 zranite\u013en\u00fdm skupin\u00e1m s\u00a0dlh\u0161ou dobou replik\u00e1cie v\u00edrusu.<\/span><\/p>\n

Pre\u010do niekedy prehliadame vysokorizikov\u00fdch pacientov?<\/strong><\/p>\n

Napriek jasn\u00fdm klinick\u00fdm odpor\u00fa\u010daniam nedok\u00e1\u017eeme v\u017edy v\u010das identifikova\u0165 vhodn\u00fdch pacientov, ktor\u00fdm by sme mali \u010do najr\u00fdchlej\u0161ie poda\u0165 lie\u010dbu. V\u00a0klinickej praxi sa \u010dasto viac zameriavame na z\u00e1va\u017enos\u0165 sympt\u00f3mov ne\u017e na rizikov\u00e9 faktory. Pacientom s miernymi pr\u00edznakmi sa \u010dasto \u010falej nevenujeme, aj ke\u010f s\u00fa u\u00a0nich pr\u00edtomn\u00e9 faktory zvy\u0161uj\u00face pravdepodobnos\u0165 komplik\u00e1ci\u00ed.<\/span><\/p>\n

Riziko navy\u0161e \u010dasto tvor\u00ed kombin\u00e1cia viacer\u00fdch stredne z\u00e1va\u017en\u00fdch faktorov, nie jednej v\u00fdrazne rizikovej dispoz\u00edcie. <\/span>Odpor\u00fa\u010dania<\/span><\/a> zd\u00f4raz\u0148uj\u00fa, \u017ee riziko z\u00e1va\u017en\u00e9ho priebehu v\u00fdznamne zvy\u0161uje po\u010det komorbid\u00edt , \u010do znamen\u00e1 potrebu hodnoti\u0165 celkov\u00fd profil rizika \u2013 napr\u00edklad kombin\u00e1ciu vy\u0161\u0161ieho veku, hypertenzie a\u00a0nadv\u00e1hy \u2013 namiesto izolovan\u00e9ho posudzovania jednotliv\u00fdch faktorov.<\/span><\/p>\n

Probl\u00e9mom je aj \u010dasov\u00fd tlak v pre\u0165a\u017eenom klinickom prostred\u00ed. Lek\u00e1ri sa \u010dasto rozhoduj\u00fa na z\u00e1klade obmedzen\u00fdch inform\u00e1ci\u00ed ako s\u00fa ne\u00fapln\u00e9 anamn\u00e9zy alebo zdravotn\u00e1 dokument\u00e1cia, ktor\u00e1 dostato\u010dne neupozor\u0148uje na relevantn\u00e9 rizikov\u00e9 faktory. \u013dahko tak prehliadneme d\u00f4le\u017eit\u00e9 sign\u00e1ly, najm\u00e4 ak rizikov\u00e9 faktory nie s\u00fa okam\u017eite vidite\u013en\u00e9.<\/span><\/p>\n

Na to, kto dostane v\u010dasn\u00fa starostlivos\u0165, vpl\u00fdvaj\u00fa aj \u0161truktur\u00e1lne a behavior\u00e1lne bari\u00e9ry. <\/span>V\u00fdskum po\u010das pand\u00e9mie<\/span><\/a> uk\u00e1zal, \u017ee etnick\u00e9 men\u0161iny a socioekonomicky znev\u00fdhodnen\u00e9 skupiny \u010delili vy\u0161\u0161\u00edm mieram infekcie, hospitaliz\u00e1cie aj \u00famrt\u00ed na COVID-19. Tieto rozdiely \u010diasto\u010dne s\u00faviseli s nerovn\u00fdm pr\u00edstupom k zdravotnej starostlivosti a lie\u010dbe.<\/span><\/p>\n

Samotn\u00ed pacienti m\u00f4\u017eu tie\u017e odklada\u0165 vyh\u013eadanie pomoci. Mnoh\u00ed predpokladaj\u00fa, \u017ee mierne pr\u00edznaky znamenaj\u00fa n\u00edzke riziko, alebo si neuvedomuj\u00fa, \u017ee lie\u010dba je naj\u00fa\u010dinnej\u0161ia, ak je zah\u00e1jen\u00e1 v\u010das. Bez jasn\u00e9ho usmernenia zo strany lek\u00e1rov a zdravotn\u00edkov m\u00f4\u017eu t\u00edto pacienti pr\u00eds\u0165 pr\u00edli\u0161 neskoro na to, aby bola lie\u010dba efekt\u00edvna.<\/span><\/p>\n

\u00dalohu m\u00f4\u017eu zohr\u00e1va\u0165 aj zmeny vo vn\u00edman\u00ed rizika v priebehu \u010dasu. V skor\u0161\u00edch f\u00e1zach pand\u00e9mie viedlo vy\u0161\u0161ie uvedomenie si rizika k opatrnej\u0161iemu pr\u00edstupu. Ako sa situ\u00e1cia zlep\u0161ovala, mierny priebeh p\u00f4sobil menej z\u00e1va\u017ene, \u010do mohlo zni\u017eova\u0165 motiv\u00e1ciu systematicky hodnoti\u0165 riziko \u2013 u pacientov aj zdravotn\u00edckych pracovn\u00edkov.<\/span><\/p>\n

Ako m\u00f4\u017ee behavior\u00e1lna veda podpori\u0165 lep\u0161iu identifik\u00e1ciu<\/strong><\/p>\n

Na prv\u00fd poh\u013ead sa m\u00f4\u017ee probl\u00e9m javi\u0165 ako \u010disto klinick\u00fd. Behavior\u00e1lna veda v\u0161ak pon\u00faka praktick\u00e9 n\u00e1stroje, ktor\u00e9 m\u00f4\u017eu pom\u00f4c\u0165 konzistentne identifikova\u0165 vysokorizikov\u00fdch pacientov. Lek\u00e1ri \u010dasto pracuj\u00fa pod vysokou kognit\u00edvnou z\u00e1\u0165a\u017eou. Zjednodu\u0161enie rozhodovania pomocou pripomienok a kontroln\u00fdch zoznamov m\u00f4\u017ee zn\u00ed\u017ei\u0165 z\u00e1vislos\u0165 od pam\u00e4ti a intu\u00edcie t\u00fdm, \u017ee pom\u00e1ha systematick\u00fd hodnoti\u0165 k\u013e\u00fa\u010dov\u00e9 rizikov\u00e9 faktory. V\u010dasn\u00fa identifik\u00e1ciu m\u00f4\u017ee podpori\u0165 aj elektronick\u00e1 zdravotn\u00e1 dokument\u00e1cia (ak je k dispoz\u00edcii). Automatick\u00e9 upozornenia na pacientov so zn\u00e1mymi rizikov\u00fdmi faktormi, ako s\u00fa vy\u0161\u0161\u00ed vek, chronick\u00e9 ochorenia alebo oslaben\u00e1 imunita, m\u00f4\u017eu okam\u017eite upozorni\u0165 na potrebu pos\u00fadenia vhodnosti lie\u010dby.<\/span><\/p>\n

Jasn\u00e1 komunik\u00e1cia o riziku a v\u00fdzname v\u010dasnej lie\u010dby m\u00f4\u017ee podpori\u0165 skor\u00fa identifik\u00e1ciu. Ak pacienti rozumej\u00fa svojmu riziku, je pravdepodobnej\u0161ie, \u017ee bud\u00fa kontaktova\u0165 zdravotn\u00edcke zariadenie kr\u00e1tko po pozit\u00edvnom teste namiesto odkladania starostlivosti a\u017e do zhor\u0161enia sympt\u00f3mov.<\/span><\/p>\n

Cielen\u00e9 ot\u00e1zky (napr\u00edklad: \u201e\u010co by v\u00e1m mohlo skomplikova\u0165 r\u00fdchly za\u010diatok lie\u010dby?\u201c) alebo vyjadrenie ob\u00e1v o\u00a0dostupnosti starostlivosti m\u00f4\u017eu pom\u00f4c\u0165 odhali\u0165 skryt\u00e9 bari\u00e9ry. Napr\u00edklad v\u0161eobecn\u00e1 rada typu \u201eMali by ste nav\u0161t\u00edvi\u0165 lek\u00e1ra\u201c b\u00fdva menej \u00fa\u010dinn\u00e1 ne\u017e konkr\u00e9tne usmernenie: \u201eMali by sme si e\u0161te do konca t\u00fd\u017ed\u0148a zarezervova\u0165 term\u00edn vy\u0161etrenia; ak potrebujete, pom\u00f4\u017eem v\u00e1m n\u00e1js\u0165 vhodn\u00e9 zariadenie.\u201c<\/span><\/p>\n

Implicitn\u00e9 predsudky m\u00f4\u017ee zmierni\u0165 aj snaha o\u00a0vedom\u00e9 reflektovanie. Jednoduch\u00e9 ot\u00e1zky, napr\u00edklad \u010di by ste rovnak\u00e9 odpor\u00fa\u010danie alebo rozhodnutie o lie\u010dbe dali aj in\u00e9mu pacientovi s\u00a0rovnak\u00fdm klinick\u00fdm profilom, m\u00f4\u017eu zni\u017eova\u0165 ne\u00famyseln\u00e9 rozdiely pri poskytovanej starostlivosti.<\/span><\/p>\n

Z\u00e1ver<\/strong><\/p>\n

Zlep\u0161enie identifik\u00e1cie vysokorizikov\u00fdch pacientov s COVID-19 si nemus\u00ed vy\u017eadova\u0165 rozsiahle syst\u00e9mov\u00e9 zmeny. \u010casto posta\u010duj\u00fa men\u0161ie \u00fapravy klinick\u00fdch postupov, skr\u00edningov\u00fdch procesov a komunika\u010dn\u00fdch strat\u00e9gi\u00ed. Kombin\u00e1ciou klinick\u00fdch odpor\u00fa\u010dan\u00ed a poznatkov behavior\u00e1lnej vedy m\u00f4\u017eu zdravotn\u00edcki pracovn\u00edci zabezpe\u010di\u0165, aby boli vysokorizikov\u00ed pacienti v\u010das rozpoznan\u00ed a promptne pos\u00faden\u00ed z h\u013eadiska lie\u010dby. V kontexte COVID-19 aj bud\u00facich infek\u010dn\u00fdch ochoren\u00ed m\u00f4\u017eu tieto mal\u00e9 zlep\u0161enia klinickej praxe pom\u00f4c\u0165 predch\u00e1dza\u0165 z\u00e1va\u017en\u00fdm priebehom a potenci\u00e1lne zachra\u0148ova\u0165 \u017eivoty.<\/span><\/p>\n

Praktick\u00e9 odpor\u00fa\u010dania<\/strong><\/p>\n

    \n
  1. Pou\u017e\u00edvajte kr\u00e1tky skr\u00edningov\u00fd kontroln\u00fd zoznam rizikov\u00fdch faktorov pri vy\u0161etreniach pacientov s COVID-19<\/strong>
    \n<\/span>Pri ka\u017edom vy\u0161etren\u00ed pacienta s pozit\u00edvnym testom alebo sympt\u00f3mami COVID-19 r\u00fdchlo zhodno\u0165te be\u017en\u00e9 vysokorizikov\u00e9 faktory ako s\u00fa vy\u0161\u0161\u00ed vek, kardiovaskul\u00e1rne ochorenia, diabetes, obezita, chronick\u00e9 ochorenia p\u013e\u00fac, onkologick\u00e9 ochorenia alebo imunosupresia. M\u00f4\u017eete zn\u00ed\u017ei\u0165 riziko prehliadnutia zranite\u013en\u00fdch pacientov, najm\u00e4 ak m\u00e1te ve\u013ea vy\u0161etren\u00ed za sebou.<\/span><\/li>\n
  2. Zoh\u013ead\u0148ujte kumulat\u00edvne riziko, nielen jednotliv\u00e9 faktory<\/strong>
    \n<\/span>Pacienti \u010dasto maj\u00fa viacero stredne z\u00e1va\u017en\u00fdch rizikov\u00fdch faktorov namiesto jednej zjavnej vysokorizikovej diagn\u00f3zy. Pri posudzovan\u00ed vhodnosti antivirot\u00edk zoh\u013ead\u0148ujte celkov\u00fd rizikov\u00fd profil vr\u00e1tane veku, komorbid\u00edt a klinick\u00e9ho kontextu.<\/span><\/li>\n
  3. Uprednostnite r\u00fdchle pos\u00fadenie v r\u00e1mci terapeutick\u00e9ho okna<\/strong>
    \n<\/span>Skor\u00e1 lie\u010dba COVID-19 funguje naj\u00fa\u010dinnej\u0161ie kr\u00e1tko po objaven\u00ed pr\u00edznakov. Nastavte si jasn\u00e9 postupy tak, aby sa vysokorizikov\u00fdch pacientov s pozit\u00edvnym testom podarilo r\u00fdchlo vy\u0161etri\u0165 a\u00a0pos\u00fadi\u0165 vhodnos\u0165 lie\u010dby. Napr\u00edklad ich objedn\u00e1vajte e\u0161te v\u00a0ten de\u0148, nastavte tri\u00e1\u017ene postupy, alebo nastavte automatick\u00e9 upozornenia v elektronickej zdravotnej dokument\u00e1cii.<\/span><\/li>\n
  4. Komunikujte riziko jasne a proakt\u00edvne<\/strong>
    \n<\/span>Pacienti s chronick\u00fdmi ochoreniami si nemusia uvedomova\u0165, \u017ee maj\u00fa zv\u00fd\u0161en\u00e9 riziko z\u00e1va\u017en\u00e9ho priebehu COVID-19. Vysvetlite, ako konkr\u00e9tne zdravotn\u00e9 \u0165a\u017ekosti ovplyv\u0148uj\u00fa riziko, a povzbudzujte pacientov, aby po pozit\u00edvnom teste alebo objaven\u00ed sympt\u00f3mov neodkladne kontaktovali zdravotn\u00edcke zariadenie.<\/span><\/li>\n
  5. \u0160tandardizujte rozhodovanie o lie\u010dbe<\/strong>
    \n<\/span>\u0160tandardizujte rozhodovanie pomocou algoritmick\u00fdch tri\u00e1\u017enych postupov a klinick\u00fdch sk\u00f3rovac\u00edch syst\u00e9mov, aby sa zn\u00ed\u017eila z\u00e1vislos\u0165 od subjekt\u00edvnej intu\u00edcie a heurist\u00edk. Pred rozhodnut\u00edm, \u017ee pacient nepotrebuje \u010fal\u0161ie vy\u0161etrenie alebo lie\u010dbu, sa na okamih zastavte a polo\u017ete si ot\u00e1zku: \u201eUrobil(a) by som rovnak\u00e9 rozhodnutie pri inom pacientovi s rovnak\u00fdm zdravotn\u00fdm profilom?\u201c Tak\u00e1to \u0161trukt\u00farovan\u00e1 reflexia m\u00f4\u017ee pom\u00f4c\u0165 zni\u017eova\u0165 ne\u00famyseln\u00e9 rozdiely v starostlivosti a podpori\u0165 rozhodovanie zalo\u017een\u00e9 na klinickej potrebe.<\/span><\/li>\n<\/ol>\n

    Prelo\u017eil: Radom\u00edr Masaryk<\/strong><\/p>\n

    Odborn\u00e1 korekt\u00fara: Alexandra Bra\u017einov\u00e1<\/strong><\/p>\n","protected":false},"featured_media":5168,"template":"","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false},"class_list":["post-4947","module","type-module","status-publish","has-post-thumbnail","hentry"],"translation":{"provider":"WPGlobus","version":"3.0.6","language":"sk","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","sr","fi","et","sv","tr","uk","hi","sw","ta"],"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":false,"content":false,"excerpt":false},"da":{"title":false,"content":false,"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":false,"content":false,"excerpt":false},"it":{"title":false,"content":false,"excerpt":false},"ja":{"title":false,"content":false,"excerpt":false},"kr":{"title":true,"content":true,"excerpt":false},"lv":{"title":false,"content":false,"excerpt":false},"lt":{"title":false,"content":false,"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":false,"content":false,"excerpt":false},"ro":{"title":false,"content":false,"excerpt":false},"ru":{"title":false,"content":false,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"sr":{"title":true,"content":true,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"et":{"title":true,"content":true,"excerpt":false},"sv":{"title":true,"content":true,"excerpt":false},"tr":{"title":true,"content":true,"excerpt":false},"uk":{"title":false,"content":false,"excerpt":false},"hi":{"title":true,"content":true,"excerpt":false},"sw":{"title":true,"content":true,"excerpt":false},"ta":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t