{"id":2243,"date":"2021-07-14T14:02:35","date_gmt":"2021-07-14T14:02:35","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=2243"},"modified":"2025-11-04T14:10:04","modified_gmt":"2025-11-04T14:10:04","slug":"if-medicine-is-a-team-game-patients-should-play-too-a-psychological-perspective-on-patient-engagement","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/sk\/2021\/07\/if-medicine-is-a-team-game-patients-should-play-too-a-psychological-perspective-on-patient-engagement\/","title":{"rendered":"Ak je medic\u00edna t\u00edmov\u00e1 hra, mali by hra\u0165 aj pacienti: psychologick\u00fd poh\u013ead na zapojenie pacienta"},"content":{"rendered":"<p><strong> Graffigna, Universit\u00e0 Cattolica del Sacro Cuore, Taliansko<\/strong><\/p>\n<p>Zdravotn\u00edcki pracovn\u00edci na celej ceste starostlivosti musia spolupracova\u0165 a koordinova\u0165 svoje \u00fasilie o efekt\u00edvne fungovanie syst\u00e9mov zdravotnej starostlivosti. In\u00fdmi slovami, medic\u00edna si na to aby bola \u00faspe\u0161n\u00e1 vy\u017eaduje t\u00edmov\u00fa pr\u00e1cu. Ak sa na tomto princ\u00edpe zhodneme, potom &#8211; po prijat\u00ed \u0161portovej metafory &#8211; by sa aj pacient mal pova\u017eova\u0165 za hr\u00e1\u010da t\u00edmu!<\/p>\n<p>Koncept zapojenia pacienta si to uvedomuje a je d\u00f4le\u017eitou ingredienciou na zv\u00fd\u0161enie efekt\u00edvnosti a udr\u017eate\u013enosti zdravotnej starostlivosti.<\/p>\n<p><!--more--><\/p>\n<p><em>\u010co je zapojenie pacienta?<\/em><\/p>\n<p><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/252269\">Koncept zapojenia a anga\u017eovanosti pacientov<\/a> pova\u017euje \u013eud\u00ed nielen za \u201epr\u00edjemcov starostlivosti\u201c, ale za rozhoduj\u00facich akt\u00e9rov pri pl\u00e1novan\u00ed a poskytovan\u00ed slu\u017eieb zdravotnej starostlivosti. Je to proces, pri ktorom sa \u013eudia akt\u00edvne a skuto\u010dne zap\u00e1jaj\u00fa do definovania relevantn\u00fdch probl\u00e9mov v starostlivosti. To zah\u0155\u0148a rozhodovanie o faktoroch, ktor\u00e9 ovplyv\u0148uj\u00fa ich \u017eivot, navrhovanie a implement\u00e1ciu polit\u00edk, pl\u00e1novanie, v\u00fdvoj a poskytovanie slu\u017eieb a prij\u00edmanie opatren\u00ed na dosiahnutie zmien v spr\u00e1van\u00ed a \u017eivotnom \u0161t\u00fdle. Pre tento proces s\u00fa z\u00e1sadne d\u00f4le\u017eit\u00e9 psychologick\u00e9 postoje, motiv\u00e1cie, pocity a pripravenos\u0165 pacienta zapoji\u0165 sa do zdravotnej starostlivosti.<\/p>\n<p>V roku 2017 na\u0161a skupina navrhla a vedecky potvrdila psychosoci\u00e1lny r\u00e1mec na diagnostiku a podporu zapojenia pacientov: <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6056150\/\">Model zapojenia pacientov v oblasti zdravia<\/a>. T\u00e1to nov\u00e1 psychologick\u00e1 te\u00f3ria zalo\u017een\u00e1 na d\u00f4kazoch si kladie za cie\u013e vysvetli\u0165, ako sa vyv\u00edja zapojenie pacienta z poh\u013eadu pacientov. Model zapojenia pacientov v oblasti zdravia popisuje zapojenie pacientov ako dynamick\u00fd a vyv\u00edjaj\u00faci sa proces, v\u010faka ktor\u00e9mu m\u00f4\u017eu \u013eudia z\u00edska\u0165 sp\u00e4\u0165 svoje schopnosti v oblasti osobn\u00fdch pl\u00e1nov a zamerania na cie\u013e &#8211; aj ke\u010f \u017eij\u00fa s chorobou.<\/p>\n<p>Model zd\u00f4raz\u0148uje osobn\u00fa vo\u013ebu pacientov zmeni\u0165 svoj postoj k syst\u00e9mu zdravotnej starostlivosti, od pas\u00edvneho pr\u00edjemcu a\u017e po partnera a druh\u00e9ho pilota v oblasti zdravotnej starostlivosti. T\u00e1to zmena identity osobnej role je funkciou dynamick\u00e9ho v\u00fdvoja adapt\u00e1cie pacientov a odolnosti vo\u010di ich stavu. Pln\u00e1 anga\u017eovanos\u0165 pacienta je v\u00fdsledkom s\u00e9rie emocion\u00e1lnych a motiva\u010dn\u00fdch sn\u00e1h o preladenie jeho\/jej zdravotn\u00e9ho stavu ako aj jeho\/jej roly a identity ako pacienta. To je z\u00e1sadn\u00e9 pre udr\u017eanie adherencie pacientov k lie\u010dbe a samoriadeniu a pre \u00faspe\u0161n\u00e9 udr\u017eanie zmien v spr\u00e1van\u00ed a \u017eivotnom \u0161t\u00fdle.<\/p>\n<p>Model zapojenia pacientov v oblasti zdravia obsahuje \u0161tyri f\u00e1zy a zdravotn\u00edcki pracovn\u00edci m\u00f4\u017eu podporova\u0165 zapojenie pacientov v ka\u017edej z nasledovn\u00fdch f\u00e1z.<\/p>\n<ul>\n<li>F\u00e1za 1: Zatemnenie. V tejto f\u00e1ze maj\u00fa pacienti pocit psychologickej zranite\u013enosti spojen\u00fd s kritickou udalos\u0165ou, zvy\u010dajne s diagn\u00f3zou. Zdravotn\u00edcki pracovn\u00edci by mali poskytova\u0165 emocion\u00e1lnu podporu, aby pomohli pacientom prisp\u00f4sobi\u0165 sa svojmu nov\u00e9mu zdravotn\u00e9mu stavu. D\u00f4raz by sa mal kl\u00e1s\u0165 na pomoc pacientom pri rozv\u00edjan\u00ed nov\u00e9ho zmyslu pre kontrolu nad ich chorobou. In\u00fdmi slovami, pacienti by mali by\u0165 podporovan\u00ed, aby prec\u00edtili, \u017ee ich konanie m\u00f4\u017ee vies\u0165 k \u00fa\u010dinn\u00e9mu mana\u017ementu ich zdravotn\u00e9ho stavu.<\/li>\n<li>F\u00e1za 2: Nabudenie. V tejto f\u00e1ze maj\u00fa pacienti po\u010diato\u010dn\u00e9 povedomie o svojom zdravotnom stave, st\u00e1le v\u0161ak maj\u00fa iba povrchn\u00e9 vedomosti o tom, ako ho efekt\u00edvne mana\u017eova\u0165. V tejto f\u00e1ze je be\u017en\u00e9, \u017ee pacienti nedokon\u010dia proces starostlivosti. Na tomto mieste s\u00fa poskytovatelia zdravotnej starostlivosti rozhoduj\u00facimi referen\u010dn\u00fdmi bodmi pre pacientov. Musia tie\u017e podporova\u0165 pacientov pri zvl\u00e1dan\u00ed chor\u00f4b a vyrovn\u00e1van\u00ed sa s chorobami, a t\u00fdm predch\u00e1dza\u0165 pred\u010dasn\u00e9mu ukon\u010deniu starostlivosti.<\/li>\n<li>F\u00e1za 3: Adh\u00e9zia. V tejto f\u00e1ze si pacienti vyvinuli dobr\u00e9 prijatie svojej choroby a prekonali ve\u013ek\u00e9 psychologick\u00e9 \u0165a\u017ekosti spojen\u00e9 s n\u00e1stupom choroby. Zdravotn\u00edcki pracovn\u00edci m\u00f4\u017eu v tejto f\u00e1ze podporova\u0165 pacientov t\u00fdm, \u017ee im pom\u00f4\u017eu udr\u017eiava\u0165 adapt\u00edvne so zdrav\u00edm s\u00favisiace spr\u00e1vanie aj v stresov\u00fdch alebo atypick\u00fdch situ\u00e1ci\u00e1ch.<\/li>\n<li>F\u00e1za 4: Eudaimonick\u00fd projekt. V tejto z\u00e1vere\u010dnej f\u00e1ze si pacienti plne uvedomili svoje ochorenie a jeho d\u00f4sledky. Zmenili n\u00e1vyky \u017eivotn\u00e9ho \u0161t\u00fdlu v s\u00falade s terapeutick\u00fdmi po\u017eiadavkami a st\u00e1vaj\u00fa sa akt\u00edvnymi \u010dinite\u013emi pri dosahovan\u00ed pozit\u00edvnej a uspokojivej kvality \u017eivota napriek tomu, \u017ee maj\u00fa chronick\u00e9 \u0165a\u017ekosti. V tejto f\u00e1ze sa odborn\u00edci na zdravotn\u00fa starostlivos\u0165 pova\u017euj\u00fa za spo\u013eahliv\u00fdch spojencov a pacienti by mali ma\u0165 podporu v tom, aby sa pova\u017eovali za akt\u00edvnych \u010dlenov t\u00edmu starostlivosti.<\/li>\n<\/ul>\n<p>Prechod od pas\u00edvneho pr\u00edstupu k pravideln\u00e9mu a \u00fa\u010dinn\u00e9mu akt\u00edvnemu spr\u00e1vaniu v r\u00e1mci mana\u017eovania zdravia je zalo\u017een\u00fd na komplexnom procese vytv\u00e1rania zmyslu a vypracovania vlastnej identity. Subjekt\u00edvne a niekedy iracion\u00e1lne vn\u00edmanie, ktor\u00e9 jednotlivci maj\u00fa o sebe, a jedine\u010dn\u00e9 perspekt\u00edvy, prostredn\u00edctvom ktor\u00fdch jednotlivci hodnotia kvalitu svojho \u017eivota, s\u00fa pod\u013ea n\u00e1\u0161ho n\u00e1zoru z\u00e1sadn\u00e9 pre uskuto\u010dnenie procesu zapojenia. Zdravotn\u00edcki pracovn\u00edci tak m\u00f4\u017eu za\u010dleni\u0165 tieto poznatky do svojich vlastn\u00fdch modelov zapojenia sa do zdravia v re\u00e1lnom \u017eivote.<\/p>\n<p>Uk\u00e1zalo sa, \u017ee navrhovan\u00fd model zapojenia pacientov v oblasti zdravia <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5487073\/\">predpoved\u00e1<\/a> mieru dodr\u017eiavania lek\u00e1rskych odpor\u00fa\u010dan\u00ed uschopnenia pacientov v seba-mana\u017emente. Prijatie psycho-soci\u00e1lnej perspekt\u00edvy na definovanie a meranie zapojenia pacientov s\u013eubuje, \u017ee v\u00fdrazne roz\u0161\u00edri na\u0161e ch\u00e1panie toho, ako sa \u013eudia rozhodn\u00fa zmeni\u0165 svoju \u00falohu na ceste v zdravotnej starostlivosti v prospech lep\u0161ieho zapojenia do starostlivosti o svoje zdravie.<\/p>\n<p>Ak to zhrnieme, pocit emocion\u00e1lnej kontroly jednotlivcov nad ich chorobou a starostlivos\u0165ou hr\u00e1 z\u00e1sadn\u00fa \u00falohu v tom, ako dobre sa dok\u00e1\u017eu vyrovna\u0165 so svojou chorobou. \u010c\u00edm lep\u0161ie s\u00fa tieto em\u00f3cie a \u00falohy pochopen\u00e9, t\u00fdm lep\u0161ia je mo\u017enos\u0165 pacientov efekt\u00edvne sa zapoji\u0165 do starostlivosti o svoje zdravie. Zdravotn\u00edcki pracovn\u00edci musia hra\u0165 k\u013e\u00fa\u010dov\u00fa \u00falohu pri ka\u017edom prechode od diagn\u00f3zy k \u00fapln\u00e9mu informovan\u00e9mu a anga\u017eovan\u00e9mu jednotlivcovi, ktor\u00fd sa akt\u00edvne podie\u013ea na svojej vlastnej zdravotnej starostlivosti.<\/p>\n<p><strong>Praktick\u00e9 odpor\u00fa\u010dania <\/strong><\/p>\n<ul>\n<li><strong>Pos\u00fa\u010fte zapojenie pacienta:<\/strong> <a href=\"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2015.00274\/full\">\u0160k\u00e1la zapojenia pacientov v oblasti zdravia<\/a> m\u00f4\u017ee pom\u00f4c\u0165 pri systematickom meran\u00ed zapojenia v klinick\u00fdch podmienkach a \u010dasov\u00fdch r\u00e1mcoch s cie\u013eom orientova\u0165 personalizovan\u00e9 strat\u00e9gie a intervencie na jeho podporu.<\/li>\n<li><strong>Budujte d\u00f4veru:<\/strong> Pou\u017e\u00edvajte osobn\u00fa komunik\u00e1ciu (tj. komunik\u00e1ciu medzi pacientom a lek\u00e1rom, verejn\u00fa komunik\u00e1ciu, soci\u00e1lnu marketingov\u00fa komunik\u00e1ciu), ktor\u00e1 je v s\u00falade s nameranou \u00farov\u0148ou zapojenia pacienta.<\/li>\n<li><strong>Otvoren\u00e1 kult\u00fara zdravotnej starostlivosti:<\/strong> Zdravotn\u00edcke zariadenia a vzdel\u00e1vanie by sa mali usilova\u0165 o implement\u00e1ciu v\u00fdcvikov\u00fdch programov, ktor\u00e9 poskytn\u00fa zdravotn\u00edckym pracovn\u00edkom potrebn\u00e9 vedomosti a komunika\u010dn\u00e9 a vz\u0165ahov\u00e9 zru\u010dnosti na podporu zapojenia pacientov.<\/li>\n<li><strong>Podporujte nad\u0161enie pacientov:<\/strong> Pom\u00f4\u017ete pacientom pozera\u0165 sa na svetl\u00fa str\u00e1nku. Podpora optimistick\u00e9ho pr\u00edstupu, ktor\u00fd h\u013ead\u00e1 pozit\u00edva, m\u00f4\u017ee pom\u00f4c\u0165 \u013eu\u010fom odfiltrova\u0165 niektor\u00e9 zl\u00e9 alebo odr\u00e1dzaj\u00face spr\u00e1vy, ktor\u00e9 by mohli ma\u0165 vplyv na motiv\u00e1ciu zapoji\u0165 sa.<\/li>\n<\/ul>\n<p>Prelo\u017eila Zuzana Dankulincov\u00e1]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Healthcare professionals along the whole care journey must collaborate and coordinate their efforts for healthcare systems to function effectively. In other words, medicine requires teamwork to be successful. If we agree on this principle, then \u2013adopting a sports metaphor \u2013the patient too should be considered a player in the team!<\/p>\n","protected":false},"author":1,"featured_media":2268,"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":[43],"tags":[],"class_list":["post-2243","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-engagement"],"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","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":true},"id":{"title":true,"content":true,"excerpt":false},"my":{"title":true,"content":true,"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":false,"content":false,"excerpt":false},"he":{"title":true,"content":true,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"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":true,"content":true,"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":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":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/2243","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/comments?post=2243"}],"version-history":[{"count":36,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/2243\/revisions"}],"predecessor-version":[{"id":4573,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/2243\/revisions\/4573"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media\/2268"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media?parent=2243"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/categories?post=2243"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/tags?post=2243"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}