{"id":5017,"date":"2026-06-21T23:57:16","date_gmt":"2026-06-21T23:57:16","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?post_type=module&p=5017"},"modified":"2026-08-24T19:02:20","modified_gmt":"2026-08-24T19:02:20","slug":"module-3","status":"publish","type":"module","link":"https:\/\/practicalhealthpsychology.com\/sk\/module\/module-3\/","title":{"rendered":"Prevencia komplik\u00e1ci\u00ed COVID-19 u vysokorizikov\u00fdch pacientov prostredn\u00edctvom zmeny spr\u00e1vania"},"content":{"rendered":"

Autori: David Simons, Pennsylvania State University, USA; Ay\u015feg\u00fcl Bak\u0131r, Hacettepe University, Turecko; Johanna Nurmi, University of Helsinki, F\u00ednsko\u00a0<\/strong><\/p>\n

COVID-19 sa dnes \u010dasto opisuje v minulom \u010dase a v\u00fdlu\u010dne ako respira\u010dn\u00e9 ochorenie. COVID-19 v\u0161ak na\u010falej predstavuje ak\u00fatnu syst\u00e9mov\u00fa z\u00e1\u0165a\u017e pre organizmus, najm\u00e4 u vysokorizikov\u00fdch pacientov s u\u017e existuj\u00facimi kardiovaskul\u00e1rnymi, metabolick\u00fdmi, imunitn\u00fdmi alebo respira\u010dn\u00fdmi komorbiditami. Hrozbu nepredstavuje iba samotn\u00fd v\u00edrus, ale aj kask\u00e1da fyziologickej dekompenz\u00e1cie, ktor\u00fa m\u00f4\u017ee spusti\u0165.<\/span><\/p>\n

Ako zdravotn\u00edcki pracovn\u00edci pozn\u00e1me klinick\u00fd priebeh. Pacient s chronickou ob\u0161truk\u010dnou chorobou p\u013e\u00fac (CHOCHP) alebo interstici\u00e1lnym ochoren\u00edm p\u013e\u00fac \u010del\u00ed v\u00fdrazne zv\u00fd\u0161en\u00e9mu riziku syndr\u00f3mu ak\u00fatnej respira\u010dnej tiesne (Acute Respiratory Distress Syndrome, ARDS). <\/span>Tento probl\u00e9m e\u0161te zhor\u0161uj\u00fa metabolick\u00e9 ochorenia<\/span><\/a>; u pacientov so zle kontrolovan\u00fdm diabetom alebo z\u00e1va\u017enou obezitou vytv\u00e1ra chronick\u00fd n\u00edzkostup\u0148ov\u00fd z\u00e1pal a existuj\u00faca endoteli\u00e1lna dysfunkcia podmienky pre hyperinflama\u010dn\u00fa reakciu organizmu. V d\u00f4sledku toho m\u00f4\u017ee syst\u00e9mov\u00fd z\u00e1pal vyvolan\u00fd COVID-19 \u013eahko vies\u0165 k dekompenzovan\u00e9mu srdcov\u00e9mu zlyhaniu, rozsiahlej mikrovaskul\u00e1rnej tromb\u00f3ze alebo ak\u00fatnemu po\u0161kodeniu obli\u010diek.<\/span><\/p>\n

U imunokompromitovan\u00fdch pacientov vytv\u00e1ra dysregulovan\u00e1 imunitn\u00e1 odpove\u010f a pred\u013a\u017een\u00e9 vylu\u010dovanie v\u00edrusu vysoko rizikov\u00e9 prostredie pre sekund\u00e1rne bakteri\u00e1lne infekcie, ktor\u00e9 m\u00f4\u017eu r\u00fdchlo zhor\u0161i\u0165 klinick\u00fd stav. Z\u00e1rove\u0148 pozorujeme zv\u00fd\u0161en\u00fd v\u00fdskyt neurologick\u00fdch komplik\u00e1ci\u00ed vr\u00e1tane <\/span>ak\u00fatnej encefalopatie<\/span><\/a> a <\/span>del\u00edria<\/span><\/a>. Tieto komplik\u00e1cie s\u00fa obzvl\u00e1\u0161\u0165 devastuj\u00face u star\u0161\u00edch dospel\u00fdch, ke\u010f\u017ee \u010dasto sp\u00f4sobuj\u00fa n\u00e1hly a v\u00fdrazn\u00fd pokles schopnosti zvl\u00e1da\u0165 be\u017en\u00e9 denn\u00e9 aktivity (Activities of Daily Living, ADL), \u010do vedie k strate samostatnosti, potrebe urgentnej hospitaliz\u00e1cie a pred\u013a\u017eenej intenz\u00edvnej starostlivosti.<\/span><\/p>\n

Z\u00e1\u0165a\u017e t\u00fdchto komplik\u00e1ci\u00ed m\u00e1 \u0161ir\u0161\u00ed dosah ne\u017e len na samotn\u00e9ho pacienta. Ke\u010f star\u0161\u00ed \u010dlovek strat\u00ed svoju funk\u010dn\u00fa \u00farove\u0148 v d\u00f4sledku del\u00edria alebo sa u imunokompromitovan\u00e9ho pacienta rozvinie sekund\u00e1rna bakteri\u00e1lna pneum\u00f3nia, nejde len o kr\u00e1tkodob\u00fa hospitaliz\u00e1ciu. T\u00edto pacienti vy\u017eaduj\u00fa komplexn\u00e9 urgentn\u00e9 intervencie, multidisciplin\u00e1rny mana\u017ement a \u010dasto aj dlhodob\u00fa rehabilit\u00e1ciu. To n\u00e1sledne vytv\u00e1ra tlak na cel\u00fd zdravotn\u00edcky syst\u00e9m. Jednotky intenz\u00edvnej starostlivosti a geriatrick\u00e9 oddelenia sa zap\u013a\u0148aj\u00fa, pl\u00e1novan\u00e9 v\u00fdkony sa odkladaj\u00fa a kontinuita starostlivosti o pacientov s in\u00fdmi chronick\u00fdmi ochoreniami sa nar\u00fa\u0161a.<\/span><\/p>\n

Dlhodob\u00fd tlak spojen\u00fd s mana\u017ementom t\u00fdchto preventabiln\u00fdch zhor\u0161en\u00ed zdravotn\u00e9ho stavu a komplikovan\u00fdm prep\u00fa\u0161\u0165an\u00edm pacientov, ktor\u00ed n\u00e1hle stratili svoju samostatnos\u0165, m\u00f4\u017ee z\u00e1rove\u0148 prispieva\u0165 k syndr\u00f3mu vyhorenia a mor\u00e1lnemu zraneniu zdravotn\u00edckych pracovn\u00edkov. <\/span>Mor\u00e1lne zranenie<\/span><\/a> ozna\u010duje hlbok\u00fd pocit vn\u00fatorn\u00e9ho konfliktu vznikaj\u00faci v situ\u00e1ci\u00e1ch, ke\u010f \u010dlovek kon\u00e1 sp\u00f4sobom, ktor\u00fd je v rozpore s jeho etick\u00fdmi alebo profesion\u00e1lnymi hodnotami. <\/span>Syndr\u00f3m vyhorenia<\/span><\/a> naopak predstavuje kombin\u00e1ciu pracovn\u00e9ho stresu, emocion\u00e1lneho vy\u010derpania, pochybnost\u00ed o vlastnej kompetentnosti a produktivite a tendencie k medzi\u013eudsk\u00e9mu di\u0161tancovaniu. Mor\u00e1lne zranenie aj vyhorenie m\u00f4\u017eu zvy\u0161ova\u0165 \u00farove\u0148 \u00fazkosti, depresie a somatick\u00fdch sympt\u00f3mov a z\u00e1rove\u0148 negat\u00edvne ovplyv\u0148ova\u0165 bezpe\u010dnos\u0165 pacientov, z\u00e1mer opusti\u0165 profesiu a celkov\u00fa kvalitu zdravotnej starostlivosti.<\/span><\/p>\n

Behavior\u00e1lny most<\/b><\/p>\n

Rozdiel medzi miernym po\u010diato\u010dn\u00fd priebehom infekcie a hospitaliz\u00e1ciou sa d\u00e1 vysvetli\u0165 spr\u00e1van\u00edm. Pre\u010do vysokorizikov\u00ed pacienti odkladaj\u00fa vyh\u013eadanie pomoci alebo odmietaj\u00fa skor\u00fa antiv\u00edrusov\u00fa a imunomodula\u010dn\u00fa lie\u010dbu pr\u00e1ve v \u010dase, ke\u010f je naj\u00fa\u010dinnej\u0161ia?<\/span><\/p>\n

Psychologick\u00fd v\u00fdskum nazna\u010duje, \u017ee pacienti \u010dasto nespr\u00e1vne odhaduj\u00fa svoje riziko v skor\u00fdch f\u00e1zach ochorenia. Imunosuprimovan\u00fd pacient m\u00f4\u017ee poci\u0165ova\u0165 mierny ka\u0161e\u013e a predpoklada\u0165, \u017ee ide o be\u017en\u00fa infekciu horn\u00fdch d\u00fdchac\u00edch ciest, pri\u010dom si neuvedomuje, \u017ee \u010dasov\u00e9 okno na prevenciu komplik\u00e1ci\u00ed sa r\u00fdchlo uzatv\u00e1ra. Podobne star\u0161\u00ed \u010dlovek v skorom \u0161t\u00e1diu del\u00edria nemus\u00ed by\u0165 schopn\u00fd realisticky pos\u00fadi\u0165 svoje zhor\u0161ovanie alebo akt\u00edvne presadzova\u0165 svoje potreby zdravotnej starostlivosti.<\/span><\/p>\n

K oneskoreniu m\u00f4\u017eu vies\u0165 aj kognit\u00edvne a\u00a0emo\u010dn\u00e9 skreslenia vo vn\u00edman\u00ed rizika. Napr\u00edklad pacient so srdcov\u00fdm zlyh\u00e1van\u00edm m\u00f4\u017ee normalizova\u0165 boles\u0165 sp\u00f4soben\u00fa COVID-19, preto\u017ee je zvyknut\u00fd na chronick\u00fa boles\u0165 na hrudn\u00edku. Riziko m\u00f4\u017ee <\/span>popiera\u0165<\/span><\/a>, preto\u017ee je zahlten\u00fd zvl\u00e1dan\u00edm novej hrozby, alebo m\u00f4\u017ee prejavova\u0165 <\/span>optimistick\u00e9 skreslenie<\/span><\/a> \u2013 najm\u00e4 ak s\u00fa pr\u00edznaky spo\u010diatku mierne \u2013 a neuvedomova\u0165 si, \u017ee patr\u00ed do vysokorizikovej skupiny.<\/span><\/p>\n

V\u00e1hanie s lie\u010dbou je \u010dast\u00fdm javom. Pacienti m\u00f4\u017eu ned\u00f4verova\u0165 nov\u00fdm liekom, minimalizova\u0165 svoje sympt\u00f3my, aby neboli \u201ena pr\u00ed\u0165a\u017e\u201c, alebo sa c\u00edti\u0165 zahlten\u00ed predstavou orient\u00e1cie v komplikovanom zdravotn\u00edckom syst\u00e9me.<\/span><\/p>\n

Na preklenutie tejto medzery nesta\u010dia len klinick\u00e9 vedomosti. Ak chceme zn\u00ed\u017ei\u0165 po\u010det preventabiln\u00fdch hospitaliz\u00e1ci\u00ed, chr\u00e1ni\u0165 pacientov a z\u00e1rove\u0148 zachova\u0165 kapacitu zdravotn\u00edckych slu\u017eieb, mus\u00edme behavior\u00e1lnu vedu prirodzene integrova\u0165 do ka\u017edodenn\u00fdch konzult\u00e1ci\u00ed. Potrebujeme presun\u00fa\u0165 pozornos\u0165 od pas\u00edvneho poskytovania medic\u00ednskych inform\u00e1ci\u00ed k akt\u00edvnej podpore zmeny spr\u00e1vania pacientov a ich opatrovate\u013eov.<\/span><\/p>\n

Vyu\u017e\u00edvan\u00edm konkr\u00e9tnych <\/span>techn\u00edk zmeny spr\u00e1vania<\/span><\/a> (Behaviour Change Techniques, BCT) mo\u017eno vysokorizikov\u00fdch pacientov a ich podporn\u00e9 siete posilni\u0165 tak, aby konali e\u0161te pred rozvojom z\u00e1va\u017en\u00fdch komplik\u00e1ci\u00ed. Tak\u00fdto proakt\u00edvny pr\u00edstup men\u00ed pacientov a ich bl\u00edzkych z pas\u00edvnych prij\u00edmate\u013eov starostlivosti na akt\u00edvnych \u00fa\u010dastn\u00edkov monitorovania vlastn\u00e9ho zdravotn\u00e9ho stavu, \u010do v kone\u010dnom d\u00f4sledku pom\u00e1ha chr\u00e1ni\u0165 kapacitu zdravotn\u00edckeho syst\u00e9mu.<\/span><\/p>\n

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

Na zn\u00ed\u017eenie z\u00e1\u0165a\u017ee spojenej s komplik\u00e1ciami COVID-19 integrujte do konzult\u00e1ci\u00ed s vysokorizikov\u00fdmi pacientmi a ich opatrovate\u013emi tieto tri behavior\u00e1lne techniky zalo\u017een\u00e9 na d\u00f4kazoch:<\/span><\/p>\n

    \n
  1. Spolupracujte na vytvoren\u00ed individualizovan\u00e9ho \u201ekr\u00edzov\u00e9ho pl\u00e1nu\u201c pre pr\u00edpad ochorenia<\/b><\/li>\n<\/ol>\n

    Vyhnite sa v\u0161eobecn\u00fdm odpor\u00fa\u010daniam typu \u201eOzvite sa, ak sa budete c\u00edti\u0165 hor\u0161ie\u201c. Vysokorizikov\u00ed pacienti \u2013 a najm\u00e4 opatrovatelia star\u0161\u00edch dospel\u00fdch s rizikom del\u00edria \u2013 potrebuj\u00fa presn\u00e9 a objekt\u00edvne klinick\u00e9 sp\u00fa\u0161\u0165a\u010de.<\/span><\/p>\n

    Ako to aplikova\u0165:<\/i><\/b> Spolo\u010dne vytvorte konkr\u00e9tny pl\u00e1n. Pri respira\u010dn\u00fdch a kognit\u00edvnych rizik\u00e1ch definujte jasn\u00e9 sp\u00fa\u0161\u0165a\u010de: \u201eAk satur\u00e1cia kysl\u00edka klesne pod 92 % ALEBO ak si v\u0161imnete n\u00e1hlu zm\u00e4tenos\u0165 \u010di probl\u00e9my pri be\u017en\u00fdch denn\u00fdch \u010dinnostiach, okam\u017eite zavolajte na toto telef\u00f3nne \u010d\u00edslo zdravotn\u00edckeho zariadenia.\u201c U pacientov s diabetom explicitne aktivujte \u201epravidl\u00e1 pre obdobie choroby\u201c (\u201esick day rules\u201c): ur\u010dte frekvenciu monitorovania glyk\u00e9mie (napr\u00edklad ka\u017ed\u00e9 \u0161tyri hodiny) a in\u0161truujte pacienta, aby bezodkladne kontaktoval svojho v\u0161eobecn\u00e9ho lek\u00e1ra alebo predpisuj\u00faceho lek\u00e1ra kv\u00f4li mo\u017en\u00e9mu do\u010dasn\u00e9mu vysadeniu niektor\u00fdch peror\u00e1lnych antidiabet\u00edk (napr\u00edklad inhib\u00edtorov SGLT2 z d\u00f4vodu prevencie euglykemickej ketoacid\u00f3zy). Zabezpe\u010dte, aby pacienti aj ich opatrovatelia vedeli pou\u017e\u00edva\u0165 potrebn\u00e9 dom\u00e1ce monitorovacie pom\u00f4cky.<\/span><\/p>\n

      \n
    1. Personalizujte hrozbu s cie\u013eom prekona\u0165 v\u00e1hanie\u00a0<\/b><\/li>\n<\/ol>\n

      Ak pacient v\u00e1ha s u\u017e\u00edvan\u00edm antivirot\u00edk, preto\u017ee jeho sympt\u00f3my p\u00f4sobia \u201emierne\u201c, prepojte riziko priamo s jeho konkr\u00e9tnou komorbiditou, aby bolo pre neho relevantnej\u0161ie a naliehavej\u0161ie.<\/span><\/p>\n

      Ako to aplikova\u0165: <\/i><\/b>Namiesto v\u0161eobecn\u00e9ho tvrdenia \u201eCOVID-19 je nebezpe\u010dn\u00fd\u201c povedzte napr\u00edklad: \u201ePreto\u017ee je v\u00e1\u0161 imunitn\u00fd syst\u00e9m oslaben\u00fd, tento v\u00edrus m\u00f4\u017ee vies\u0165 k vzniku z\u00e1va\u017en\u00e9ho bakteri\u00e1lneho z\u00e1palu p\u013e\u00fac, aj ke\u010f v\u00e1s moment\u00e1lne iba \u0161kriabe v hrdle. Tento liek pom\u00e1ha odstr\u00e1ni\u0165 v\u00edrus sk\u00f4r, ne\u017e bakt\u00e9rie sp\u00f4sobia v\u00e1\u017enej\u0161ie po\u0161kodenie.\u201c<\/span><\/p>\n

        \n
      1. Aktivujte syst\u00e9m soci\u00e1lnej podpory<\/b><\/li>\n<\/ol>\n

        Zranite\u013en\u00ed pacienti \u010dasto odkladaj\u00fa vyh\u013eadanie pomoci, preto\u017ee orient\u00e1cia v zdravotn\u00edckom syst\u00e9me po\u010das choroby je vy\u010derp\u00e1vaj\u00faca alebo preto, \u017ee ak\u00fatne kognit\u00edvne zhor\u0161enie im br\u00e1ni kona\u0165.<\/span><\/p>\n

        Ako to aplikova\u0165: <\/b>Po\u010das be\u017enej ambulantnej n\u00e1v\u0161tevy sa op\u00fdtajte: \u201eAk by ste zajtra mali pozit\u00edvny test, kto by v\u00e1s odviezol do lek\u00e1rne alebo do ambulancie?\u201c Identifikujte \u201ehlavn\u00fa podporn\u00fa osobu\u201c (rodinn\u00e9ho pr\u00edslu\u0161n\u00edka, suseda) a zapojte ju do ak\u010dn\u00e9ho pl\u00e1nu. Je to obzvl\u00e1\u0161\u0165 d\u00f4le\u017eit\u00e9 u star\u0161\u00edch dospel\u00fdch \u2013 ak ur\u010den\u00fd opatrovate\u013e pozn\u00e1 pr\u00edznaky del\u00edria, m\u00f4\u017ee v\u010das rozpozna\u0165 klinick\u00e9 zhor\u0161ovanie a zabezpe\u010di\u0165 r\u00fdchlu reakciu, \u010do pom\u00f4\u017ee pred\u00eds\u0165 neskorej reakcii.<\/span><\/p>\n

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

        Odborn\u00e1 korekt\u00fara: Alexandra Bra\u017einov\u00e1<\/b><\/p>\n","protected":false},"featured_media":5170,"template":"","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_uf_show_specific_survey":0,"_uf_disable_surveys":false},"class_list":["post-5017","module","type-module","status-publish","has-post-thumbnail","hentry"],"translation":{"provider":"WPGlobus","version":"3.0.2","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":false,"content":false,"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\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