{"id":2360,"date":"2021-11-25T14:38:11","date_gmt":"2021-11-25T14:38:11","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=2360"},"modified":"2025-11-04T14:06:19","modified_gmt":"2025-11-04T14:06:19","slug":"helping-patients-manage-their-condition-illness-representations-matter","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/sk\/2021\/11\/helping-patients-manage-their-condition-illness-representations-matter\/","title":{"rendered":"Pomoc pacientom zvl\u00e1da\u0165 ich stav: Na reprezent\u00e1cii choroby z\u00e1le\u017e\u00ed"},"content":{"rendered":"

Yael Benyamini, Univerzita v Tel Avive, Izrael a Evangelos C. Karademas, Univerzita na Kr\u00e9te, Gr\u00e9cko<\/strong><\/p>\n

Anna a Mary s\u00fa zdrav\u00e9 45-ro\u010dn\u00e9 \u017eeny, \u017eij\u00face vo ve\u013ekom eur\u00f3pskom meste. Ka\u017ed\u00fd z nich pozn\u00e1 nieko\u013eko \u013eud\u00ed, ktor\u00ed sa nakazili COVID-19 a neust\u00e1le o \u0148om po\u010d\u00favaj\u00fa a \u010d\u00edtaj\u00fa. Anna je presved\u010den\u00e1, \u017ee ide o ve\u013emi v\u00e1\u017enu chorobu, a je ve\u013emi znepokojen\u00e1, \u017ee ak sa \u0148ou nakaz\u00ed, hoci sa vzh\u013eadom na svoj vek uzdrav\u00ed, pravdepodobne bude trpie\u0165 dlhodob\u00fdmi nepr\u00edjemn\u00fdmi pr\u00edznakmi. Pracuje z domu tak \u010dasto ako je to len mo\u017en\u00e9, nikdy nechod\u00ed vonku bez r\u00fa\u0161ka a \u010dak\u00e1 na \u010fal\u0161iu d\u00e1vku o\u010dkovania.<\/span><\/p>\n

<\/p>\n

Mary si mysl\u00ed, \u017ee COVID-19 je \u201echr\u00edpka s dobr\u00fdm PR\u201c. Vo svojom veku a bez ak\u00fdchko\u013evek zdravotn\u00fdch probl\u00e9mov ver\u00ed, \u017ee aj keby sa nakazila, s najv\u00e4\u010d\u0161ou pravdepodobnos\u0165ou sa nebude c\u00edti\u0165 ve\u013emi zle, alebo v najhor\u0161om pr\u00edpade str\u00e1vi nieko\u013eko dn\u00ed doma, ako ke\u010f m\u00e1 n\u00e1dchu. V pr\u00e1ci a na spolo\u010densk\u00fdch akci\u00e1ch sa stret\u00e1va s mnoh\u00fdmi \u013eu\u010fmi a r\u00fa\u0161ko nos\u00ed len tam, kde je to absol\u00fatne nevyhnutn\u00e9. Nevid\u00ed d\u00f4vod da\u0165 sa zao\u010dkova\u0165 a boj\u00ed sa jej ved\u013eaj\u0161\u00edch \u00fa\u010dinkov.<\/span><\/p>\n

Anna a Mary maj\u00fa spolo\u010dn\u00fa vlastnos\u0165. Hoci nevidia veci rovnak\u00fdm sp\u00f4sobom, obe sa sna\u017eia pochopi\u0165 rovnak\u00fa hroziv\u00fa situ\u00e1ciu. Ke\u010f sme konfrontovan\u00ed s ohrozen\u00edm zdravia, \u010di u\u017e je to COVID-19, kardiovaskul\u00e1rne ochorenie, boles\u0165 k\u013abov alebo ak\u00fdko\u013evek in\u00fd probl\u00e9m, v\u0161etci o \u0148om zhroma\u017e\u010fujeme inform\u00e1cie z vlastn\u00fdch telesn\u00fdch pocitov, z na\u0161ej osobnej hist\u00f3rie, od in\u00fdch \u013eud\u00ed okolo n\u00e1s a z m\u00e9di\u00ed. Na\u0161\u00edm cie\u013eom je vytvori\u0165 si s\u00favisl\u00fd pr\u00edbeh choroby. Aby sme tak urobili, sna\u017e\u00edme sa zisti\u0165 a skombinova\u0165 p\u00e4\u0165 hlavn\u00fdch komponentov vn\u00edmania choroby alebo reprezent\u00e1cie choroby: <\/span>jej identitu, pr\u00ed\u010diny, d\u00f4sledky, \u010dasov\u00fa os a schopnos\u0165 chorobu vylie\u010di\u0165 alebo kontrolova\u0165<\/span><\/a>.<\/span><\/p>\n

Z\u00e1le\u017e\u00ed na tom, \u010do si o chorobe mysl\u00edme? Aj ke\u010f na\u0161e reprezent\u00e1cie choroby nemusia by\u0165 medic\u00ednsky presn\u00e9, ur\u010dia, ako sa c\u00edtime a \u010do s t\u00fdm urob\u00edme: ako sa s chorobou vyrovn\u00e1me, \u010do urob\u00edme, aby sme predi\u0161li sympt\u00f3mom, ako ju kontrolova\u0165 alebo vylie\u010di\u0165, alebo ju integrova\u0165 do n\u00e1\u0161ho \u017eivota, ak je to mo\u017en\u00e9. \u0160t\u00fadie uk\u00e1zali, \u017ee negat\u00edvne reprezent\u00e1cie choroby (napr. vn\u00edmanie choroby ako ve\u013emi ohrozuj\u00facej, dlhotrvaj\u00facej alebo nekontrolovate\u013enej\/nelie\u010dite\u013enej) s\u00favisia so zvl\u00e1dan\u00edm a v\u00fdsledkami, ako je hor\u0161ia kvalita \u017eivota, pomal\u0161ie zotavovanie sa z choroby a hor\u0161\u00ed funk\u010dn\u00fd stav pri nieko\u013ek\u00fdch stavoch, ako je <\/span>rakovina<\/span><\/a> alebo <\/span>cukrovka<\/span><\/a>.<\/span><\/p>\n

Ako praktizuj\u00faci zdravotn\u00edcky pracovn\u00edci by sme sa mali pacientov bez odsudzovania p\u00fdta\u0165 na ich vn\u00edmanie s\u00fa\u010dasnej choroby alebo choroby, ktor\u00e1 im hroz\u00ed. Mohli by sme sa ich jednoducho op\u00fdta\u0165, \u010do si o svojom stave myslia vlastn\u00fdmi slovami; \u010do si myslia, \u017ee to sp\u00f4sobilo, alebo ak\u00e9 s\u00fa najviac znepokojuj\u00face sympt\u00f3my; \u010di ich lie\u010dba funguje alebo \u010do robia na zvl\u00e1dnutie choroby. Mohli by sme ich dokonca po\u017eiada\u0165, aby <\/span>nakreslili svoju chorobu,<\/span><\/a> preto\u017ee kresba m\u00f4\u017ee prezradi\u0165 ve\u013ea o tom, ako o nej uva\u017euj\u00fa a \u010do vo vz\u0165ahu k nej c\u00edtia. Pacienti neb\u00fdvaj\u00fa ve\u013emi \u010dasto dopytovan\u00ed na ich vlastn\u00fd n\u00e1zor, ale v\u00e4\u010d\u0161inou s\u00fa takejto diskusii otvoren\u00ed. P\u00fdtanie sa na vyjadrenia pacientov je d\u00f4le\u017eit\u00e9 aj pre <\/span>lek\u00e1rov<\/span><\/a> alebo in\u00fdch <\/span>poskytovate\u013eov zdravotnej starostlivosti<\/span><\/a>, preto\u017ee pochopenie a rie\u0161enie n\u00e1zorov pacientov na ich stav a ich prepojenie so spr\u00e1van\u00edm (napr. dodr\u017eiavanie r\u00e1d) m\u00f4\u017ee pacientom u\u013eah\u010di\u0165 adapt\u00e1ciu. Napr\u00edklad pomoc Mary uvedomi\u0165 si, \u017ee potenci\u00e1lne ved\u013eaj\u0161ie \u00fa\u010dinky vakc\u00edny nie s\u00fa porovnate\u013en\u00e9 so skuto\u010dn\u00fdm dopadom COVID-19, ak by sa n\u00edm nakazila, by jej tie\u017e mohlo pom\u00f4c\u0165 zmeni\u0165 jej p\u00f4vodn\u00e9 rozhodnutie o o\u010dkovan\u00ed. M\u00f4\u017ee to by\u0165 prv\u00fd krok k systematickej\u0161iemu individu\u00e1lnemu alebo skupinov\u00e9mu z\u00e1sahu prisp\u00f4soben\u00e9mu reprezent\u00e1ci\u00e1m pacientov, aby sa dosiahla maxim\u00e1lna \u00fa\u010dinnos\u0165.<\/span><\/p>\n

Povzbudzovanie pacientov, aby sa podelili o svoj n\u00e1zor na svoju chorobu, m\u00f4\u017ee tie\u017e pom\u00f4c\u0165 pri identifik\u00e1cii maladapt\u00edvnych vn\u00edman\u00ed. \u010clovek by si v\u0161ak mal d\u00e1va\u0165 pozor na rozhodnutie pok\u00fasi\u0165 sa zmeni\u0165 reprezent\u00e1ciu pacientovej choroby. Napr\u00edklad pacient m\u00f4\u017ee ma\u0165 nie ve\u013emi presn\u00e9 zn\u00e1zornenie identity choroby, ale to m\u00f4\u017ee by\u0165 u\u017eito\u010dn\u00e9 na zmiernenie jeho \u00fazkosti. Odborn\u00edk by mal ma\u0165 na pam\u00e4ti, \u017ee reprezent\u00e1cie choroby s\u00fa len \u010das\u0165ou \u0161ir\u0161ieho, dynamick\u00e9ho samoregula\u010dn\u00e9ho syst\u00e9mu, ktor\u00fd zah\u0155\u0148a aj spr\u00e1vanie zameran\u00e9 na zvl\u00e1danie a ak\u010dn\u00e9 pl\u00e1ny, hodnotenia v\u00fdsledkov. Poskytovate\u013e zdravotnej starostlivosti by mal zv\u00e1\u017ei\u0165 v\u0161etky tieto aspekty pacientovej sk\u00fasenosti a jeho stavu a v spolupr\u00e1ci s pacientom ur\u010di\u0165 ako a s oh\u013eadom na ktor\u00e9 reprezent\u00e1cie zasiahnu\u0165. S \u00faspechom mo\u017eno pou\u017ei\u0165 <\/span>strat\u00e9gie intervencie zhora nadol (t. j. abstraktn\u00e9\/kognit\u00edvne) aj zdola nahor (t. j. konkr\u00e9tne\/behavior\u00e1lne)<\/span><\/a>. \u010casto je rovnako d\u00f4le\u017eit\u00e9 sk\u00fama\u0165 a diskutova\u0165 o reprezent\u00e1ci\u00e1ch rodinn\u00fdch pr\u00edslu\u0161n\u00edkov \u2013 <\/span>rodi\u010dov<\/span><\/a>, <\/span>man\u017eelov<\/span><\/a> a in\u00fdch, preto\u017ee tieto m\u00f4\u017eu ovplyvni\u0165 vlastn\u00e9 reprezent\u00e1cie a spr\u00e1vanie pacientov.<\/span><\/p>\n

Praktick\u00e9 odpor\u00fa\u010dania <\/b>\u00a0\u00a0\u00a0\u00a0\u00a0<\/span><\/p>\n

    \n
  1. Pos\u00fa\u010fte reprezent\u00e1cie choroby<\/b> \u2013 pochopte ako pacient uva\u017euje o svojom stave. Nechajte ho rozpr\u00e1va\u0165 svoj pr\u00edbeh o zdravotnom probl\u00e9me vlastn\u00fdmi slovami, nie medic\u00ednskymi term\u00ednmi, a \u010falej sk\u00famajte nehodnotiacim sp\u00f4sobom pomocou otvoren\u00fdch ot\u00e1zok alebo kresby. M\u00f4\u017eete sa op\u00fdta\u0165 partnera alebo in\u00fdch rodinn\u00fdch pr\u00edslu\u0161n\u00edkov alebo opatrovate\u013eov na ich n\u00e1zory (ktor\u00e9 sa m\u00f4\u017eu l\u00ed\u0161i\u0165 od n\u00e1zorov pacienta a ovplyvni\u0165 tak podporu, ktor\u00fa mu poskytuj\u00fa).<\/span><\/li>\n
  2. Pos\u00fa\u010fte reprezent\u00e1cie lie\u010dby<\/b> \u2013 pacienti maj\u00fa svoj vlastn\u00fd n\u00e1zor na \u00fa\u010dinnos\u0165 lie\u010dby, pr\u00ednosy, rizik\u00e1 a d\u00f4sledky, ktor\u00e9 \u010dasto <\/span>ovplyv\u0148uj\u00fa dodr\u017eiavanie lek\u00e1rskych odpor\u00fa\u010dan\u00ed<\/span><\/a>.<\/span><\/li>\n
  3. Identifikujte nepresn\u00e9 alebo nefunk\u010dn\u00e9 reprezent\u00e1cie alebo \u201eiracion\u00e1lne\u201c presved\u010denia, ako aj ich v\u00e4zby na spr\u00e1vanie<\/b>. Pam\u00e4tajte, \u017ee sp\u00f4sob, ak\u00fdm pacient ch\u00e1pe svoj stav, je \u201epsychologicky spr\u00e1vny\u201c, t. j. d\u00e1va mu zmysel. Tak\u017ee zobrazenie sa m\u00f4\u017ee zda\u0165 \u201enepresn\u00e9\u201c v\u00e1m, ale nie pacientovi.<\/span><\/li>\n
  4. Pom\u00f4\u017ete pacientovi zmeni\u0165 poh\u013ead na chorobu<\/b> \u2013 ak reprezent\u00e1cie choroby s\u00favisia s dysfunk\u010dn\u00fdm spr\u00e1van\u00edm alebo dlhodobo ohrozuj\u00fa pohodu pacienta, m\u00f4\u017eete pom\u00f4c\u0165 pacientom zmeni\u0165 ich t\u00fdm, \u017ee (a) im poskytnete presn\u00e9 inform\u00e1cie, (b) pou\u017eijete pr\u00edklady in\u00fdch pacientov, ktor\u00ed maj\u00fa viac funk\u010dn\u00fdch reprezent\u00e1ci\u00ed (alebo umo\u017e\u0148uj\u00fa interakciu v\u00e1\u0161ho pacienta s nimi), (c) <\/span>pou\u017eijete \u0161pecifick\u00e9 interven\u010dn\u00e9 techniky<\/span><\/a>.\u00a0<\/span><\/li>\n
  5. Podporte pacienta pri vytv\u00e1ran\u00ed funk\u010dn\u00fdch ak\u010dn\u00fdch pl\u00e1nov s\u00favisiacich s chorobou<\/b>, ktor\u00e9 s\u00fa v s\u00falade s ich (rovnako funk\u010dn\u00fdmi) reprezent\u00e1ciami a s\u00fa relevantn\u00e9 pre jeho \u017eivot. Reprezent\u00e1cie choroby nie je \u013eahk\u00e9 zmeni\u0165, najm\u00e4 v neskor\u0161\u00edch \u0161t\u00e1di\u00e1ch choroby. Niekedy je teda lep\u0161ie zamera\u0165 sa na spr\u00e1vanie ako na reprezent\u00e1cie.<\/span><\/li>\n<\/ol>\n

    Prelo\u017eila [Zuzana Dankulincov\u00e1]<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

    By Yael Benyamini, Tel Aviv University, Israel and Evangelos C. Karademas, University of Crete, Greece Anna and Mary are both healthy 45-year-old women, living in a large European city. Each of them knows several people who have contracted COVID-19 and […]<\/p>\n","protected":false},"author":1,"featured_media":2376,"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":[32,28,45,35],"tags":[],"class_list":["post-2360","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-assessment","category-communication","category-illness-representation","category-stress-and-coping"],"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":false},"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":true,"content":true,"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\/2360","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=2360"}],"version-history":[{"count":22,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/2360\/revisions"}],"predecessor-version":[{"id":4569,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/2360\/revisions\/4569"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media\/2376"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media?parent=2360"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/categories?post=2360"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/tags?post=2360"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}