{"id":4954,"date":"2026-06-05T12:12:49","date_gmt":"2026-06-05T12:12:49","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=4954"},"modified":"2026-06-05T12:54:41","modified_gmt":"2026-06-05T12:54:41","slug":"helping-caregivers-when-patients-leave-hospital-practical-lessons-from-co-production","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/sk\/2026\/06\/helping-caregivers-when-patients-leave-hospital-practical-lessons-from-co-production\/","title":{"rendered":"Pomoc opatrovate\u013eom pri prep\u00fa\u0161\u0165an\u00ed pacientov z nemocnice: Praktick\u00e9 poznatky zo spolutvorby"},"content":{"rendered":"

Kathryn McEwan, Northumbria University, Spojen\u00e9 kr\u00e1\u013eovstvo<\/strong><\/p>\n

Sarah pom\u00e1hala svojmu otcovi zbali\u0165 si veci; \u00fa\u013eava sa mie\u0161ala s narastaj\u00facou \u00fazkos\u0165ou. Po piatich d\u0148och v nemocnici po mozgovej pr\u00edhode bol prepusten\u00fd domov. Sestra stru\u010dne spomenula zmeny v liekoch a kontroln\u00e9 vy\u0161etrenia, no Sarah (ktor\u00e1 sa mala o otca doma stara\u0165) nebola s\u00fa\u010das\u0165ou t\u00fdchto rozhovorov. Odch\u00e1dzala s prep\u00fa\u0161\u0165acou spr\u00e1vou, ktorej \u00faplne nerozumela, bez jasn\u00fdch inform\u00e1ci\u00ed o varovn\u00fdch pr\u00edznakoch, ktor\u00e9 si m\u00e1 v\u0161\u00edma\u0165, a bez predstavy, komu zavola\u0165, ak by nastali probl\u00e9my. Do 48 hod\u00edn bol jej otec op\u00e4\u0165 prijat\u00fd do nemocnice.<\/span><\/i><\/p>\n

<\/p>\n

Pre mnoh\u00fdch pacientov a opatrovate\u013eov predstavuje prepustenie z nemocnice za\u010diatok neist\u00e9ho a nedostato\u010dne podporen\u00e9ho prechodu, pri ktorom sa zodpovednos\u0165 za zvl\u00e1danie starostlivosti pres\u00fava do dom\u00e1ceho prostredia. Ak tento proces zlyh\u00e1 \u2013 v d\u00f4sledku un\u00e1hlen\u00fdch vysvetlen\u00ed, ch\u00fdbaj\u00facich inform\u00e1ci\u00ed alebo nedostato\u010dn\u00e9ho zapojenia opatrovate\u013ea \u2013 d\u00f4sledky m\u00f4\u017eu by\u0165 v\u00e1\u017ene: zbyto\u010dn\u00e9 op\u00e4tovn\u00e9 hospitaliz\u00e1cie, zhor\u0161enie zdravotn\u00e9ho stavu doma a obrovsk\u00fd stres pre osoby poskytuj\u00face starostlivos\u0165.<\/span><\/p>\n

Rozsah probl\u00e9mu<\/strong><\/p>\n

Rozsah probl\u00e9mu je zna\u010dn\u00fd. V Anglicku zost\u00e1va ka\u017ed\u00fd de\u0148 <\/span>pribli\u017ene 13 000 \u2013 14 000 pacientov v nemocnici<\/span><\/a> napriek tomu, \u017ee s\u00fa z medic\u00ednskeho h\u013eadiska pripraven\u00ed na prepustenie (\u00fadaje z okt\u00f3bra 2025). Oneskoren\u00e9 prep\u00fa\u0161\u0165anie prispieva k nedostatku l\u00f4\u017eok, dlh\u0161\u00edm \u010dakac\u00edm \u010dasom sanitiek a ru\u0161eniu pl\u00e1novan\u00fdch v\u00fdkonov. <\/span>Jedno zo siedmich nemocni\u010dn\u00fdch l\u00f4\u017eok je obsaden\u00e9 pacientom, ktor\u00fd u\u017e nepotrebuje ak\u00fatnu starostlivos\u0165<\/span><\/a>, pri\u010dom podobn\u00e9 tlaky mo\u017eno pozorova\u0165 <\/span>aj v in\u00fdch krajin\u00e1ch<\/span><\/a>.<\/span><\/p>\n

Viac ako polovica neplaten\u00fdch opatrovate\u013eov<\/span><\/a> (rodinn\u00fdch pr\u00edslu\u0161n\u00edkov, priate\u013eov alebo susedov poskytuj\u00facich podporu) uv\u00e1dza, \u017ee neboli zapojen\u00ed do rozhodovania o prepusten\u00ed. <\/span>T\u00edto opatrovatelia vykon\u00e1vaj\u00fa n\u00e1ro\u010dn\u00e9 \u00falohy<\/span><\/a> vr\u00e1tane spr\u00e1vy liekov, o\u0161etrovania r\u00e1n a pou\u017e\u00edvania zdravotn\u00edckych pom\u00f4cok. <\/span>V\u00fdskumy v\u0161ak ukazuj\u00fa, \u017ee mnoh\u00ed sa c\u00edtia nepripraven\u00ed<\/span><\/a>, dost\u00e1vaj\u00fa nedostato\u010dn\u00e9 usmernenia a s\u00fa zahlten\u00ed n\u00e1ro\u010dnos\u0165ou \u00faloh, ktor\u00e9 maj\u00fa po prepusten\u00ed zvl\u00e1da\u0165.<\/span><\/p>\n

\u010co mo\u017eno pri prep\u00fa\u0161\u0165an\u00ed z nemocnice robi\u0165 lep\u0161ie?<\/strong><\/p>\n

N\u00e1\u0161 ned\u00e1vny spolutvoren\u00fd v\u00fdskum realizovan\u00fd spolu s opatrovate\u013emi, odborn\u00edkmi v zdravotnej a soci\u00e1lnej starostlivosti a kolegami z neziskov\u00e9ho sektora tieto probl\u00e9my potvrdzuje a z\u00e1rove\u0148 pon\u00faka praktick\u00e9 rie\u0161enia. Zistili sme, \u017ee komunika\u010dn\u00e9 zlyhania nevypl\u00fdvaj\u00fa z individu\u00e1lnych pochyben\u00ed, ale zo syst\u00e9mov\u00fdch tlakov a \u0161truktur\u00e1lnych bari\u00e9r.<\/span><\/p>\n

Identifikovali sa tri behavior\u00e1lne podlo\u017een\u00e9 strat\u00e9gie, ktor\u00e9 m\u00f4\u017eu zdravotn\u00edcki pracovn\u00edci okam\u017eite uplatni\u0165:<\/span><\/p>\n

    \n
  1. Za\u010dnite rozhovory o prepusten\u00ed u\u017e pri prijat\u00ed<\/strong><\/li>\n<\/ol>\n

    Opatrovatelia opakovane opisovali, \u017ee boli zapojen\u00ed pr\u00edli\u0161 neskoro, a\u017e po prijat\u00ed k\u013e\u00fa\u010dov\u00fdch rozhodnut\u00ed. To zodpoved\u00e1 <\/span>medzin\u00e1rodn\u00e9mu v\u00fdskumu prechodovej starostlivosti<\/span><\/a>, ktor\u00fd ukazuje, \u017ee skor\u00e9 zapojenie opatrovate\u013eov zni\u017euje psychick\u00fa z\u00e1\u0165a\u017e, predch\u00e1dza nere\u00e1lnym o\u010dak\u00e1vaniam a vytv\u00e1ra priestor na rie\u0161enie ob\u00e1v sk\u00f4r, ne\u017e sa nahromadia. Pand\u00e9mia COVID-19 tieto postupy naru\u0161ila \u2013 zanikli poz\u00edcie soci\u00e1lnych pracovn\u00edkov priamo na oddeleniach aj kontakt s rodinou pri prijat\u00ed, \u010do ovplyv\u0148uje pl\u00e1novanie prepustenia dodnes.<\/span><\/p>\n

      \n
    1. Pou\u017e\u00edvajte jednoduch\u00fd a zrozumite\u013en\u00fd jazyk na nastavenie o\u010dak\u00e1van\u00ed<\/strong><\/li>\n<\/ol>\n

      Opatrovatelia opisovali probl\u00e9my s odborn\u00fdm \u017earg\u00f3nom, skratkami a r\u00fdchlymi vysvetleniami. Niektor\u00ed si medic\u00ednske term\u00edny vyh\u013ead\u00e1vali online priamo po\u010das rozhovorov, zatia\u013e \u010do emocion\u00e1lna z\u00e1\u0165a\u017e a nezn\u00e1me prostredie s\u0165a\u017eovali spracovanie inform\u00e1ci\u00ed. <\/span>T\u00e1to sk\u00fasenos\u0165 je dobre zdokumentovan\u00e1<\/span><\/a>: v\u00fdskumy pripravenosti opatrovate\u013eov a zdravotnej gramotnosti ozna\u010duj\u00fa nedostato\u010dn\u00fa komunik\u00e1ciu za prek\u00e1\u017eku bezpe\u010dn\u00e9ho prepustenia. <\/span>Systematick\u00e9 preh\u013eady ukazuj\u00fa<\/span><\/a>, \u017ee opatrovatelia \u010dasto prech\u00e1dzaj\u00fa z \u00faplnej z\u00e1vislosti od sestier v nemocnici k \u00faplnej samostatnosti doma, pri\u010dom s\u00fa zahlten\u00ed n\u00e1ro\u010dnos\u0165ou \u00faloh, ktor\u00e9 maj\u00fa vykon\u00e1va\u0165.<\/span><\/p>\n

      Jasn\u00fd a konkr\u00e9tny jazyk zni\u017euje po\u010det ch\u00fdb a buduje d\u00f4veru. Odborn\u00edci n\u00e1m povedali, \u017ee niekedy prece\u0148uj\u00fa, \u010do opatrovatelia dok\u00e1\u017eu doma realisticky zvl\u00e1dnu\u0165. To je v s\u00falade s <\/span>v\u00fdskumami poukazuj\u00facimi na mocensk\u00fa nerovnov\u00e1hu<\/span><\/a> medzi opatrovate\u013emi a odborn\u00edkmi \u2013 v\u00e4\u010d\u0161ia znalos\u0165 zdravotn\u00edckeho syst\u00e9mu zo strany person\u00e1lu m\u00f4\u017ee ne\u00famyselne vytl\u00e1\u010da\u0165 opatrovate\u013eov z d\u00f4le\u017eit\u00fdch rozhovorov. Transparentnos\u0165 v ot\u00e1zkach syst\u00e9mov\u00fdch tlakov, limitov starostlivosti a toho, \u010do je re\u00e1lne dosiahnute\u013en\u00e9, pom\u00e1ha predch\u00e1dza\u0165 neskor\u0161\u00edm nedorozumeniam a frustr\u00e1cii. Tak\u00e1to otvoren\u00e1 komunik\u00e1cia podporuje efekt\u00edvne pl\u00e1novanie namiesto neo\u010dak\u00e1van\u00fdch po\u017eiadaviek.<\/span><\/p>\n

        \n
      1. Poskytnite jeden jasn\u00fd kontaktn\u00fd bod po prepusten\u00ed<\/strong><\/li>\n<\/ol>\n

        Opatrovatelia opisovali v\u00fdrazn\u00fa neistotu v tom, komu zavola\u0165 pri ot\u00e1zkach o liekoch, oneskoren\u00ed pom\u00f4cok alebo pri zn\u00e1mkach zhor\u0161enia zdravotn\u00e9ho stavu. T\u00e1to nejasnos\u0165 zvy\u0161uje \u00fazkos\u0165 a m\u00f4\u017ee vies\u0165 k zbyto\u010dn\u00fdm rehospitaliz\u00e1ci\u00e1m alebo oneskoren\u00e9mu vyh\u013eadaniu pomoci. <\/span>D\u00f4kazy ukazuj\u00fa<\/span><\/a>, \u017ee poskytnutie jedn\u00e9ho konkr\u00e9tneho kontaktu \u2013 aj ke\u010f iba sprostredkuje \u010fal\u0161ie rie\u0161enie \u2013 v\u00fdrazne zni\u017euje stres opatrovate\u013eov a zvy\u0161uje bezpe\u010dnos\u0165. <\/span>V\u00fdskum kontinuity starostlivosti ukazuje<\/span><\/a>, \u017ee pocit, \u017ee ich slu\u017eby \u201epoznaj\u00fa\u201c, zni\u017euje strach a zlep\u0161uje rozhodovanie pacientov aj opatrovate\u013eov.<\/span><\/p>\n

        Uplatnenie t\u00fdchto princ\u00edpov v praxi<\/strong><\/p>\n

        Na podporu implement\u00e1cie sme spoluvytvorili <\/span>S\u00fabor n\u00e1strojov pre prep\u00fa\u0161\u0165anie<\/span><\/a> pre opatrovate\u013eov, ktor\u00fd obsahuje p\u00e4\u0165 flexibiln\u00fdch n\u00e1strojov: uv\u00edtac\u00ed list, sprievodcu pri prijat\u00ed, karti\u010dku s ot\u00e1zkou \u201eNa \u010dom v\u00e1m z\u00e1le\u017e\u00ed?\u201c, spolo\u010dn\u00fd kontroln\u00fd zoznam prepustenia a kontaktn\u00fa karti\u010dku po prepusten\u00ed. Tieto n\u00e1stroje boli navrhnut\u00e9 pre vy\u0165a\u017een\u00e9 oddelenia a zlep\u0161uj\u00fa vz\u0165ahov\u00e9 aspekty prepustenia, pri\u010dom zoh\u013ead\u0148uj\u00fa r\u00f4znorodos\u0165 opatrovate\u013esk\u00fdch rol\u00ed. Z\u00e1rove\u0148 ich mo\u017eno prisp\u00f4sobi\u0165 nemocni\u010dn\u00fdm t\u00edmom, komunitn\u00fdm slu\u017eb\u00e1m aj organiz\u00e1ci\u00e1m neziskov\u00e9ho sektora.<\/span><\/p>\n

        Posolstvo od opatrovate\u013eov a odborn\u00edkov<\/strong><\/p>\n

        Mal\u00e9, z\u00e1mern\u00e9 zmeny v komunik\u00e1cii m\u00f4\u017eu zmeni\u0165 prepustenie z un\u00e1hlen\u00e9ho ukon\u010denia hospitaliz\u00e1cie na podporovan\u00fd prechod. Ke\u010f sa opatrovatelia c\u00edtia uznan\u00ed, informovan\u00ed a pripraven\u00ed \u2013 <\/span>ke\u010f s\u00fa vn\u00edman\u00ed ako partneri<\/span><\/a> \u2013 v\u00fdsledky sa zlep\u0161uj\u00fa pre v\u0161etk\u00fdch.<\/span><\/p>\n

        Podpora opatrovate\u013eov nie je len prejavom empatie, ale nevyhnutnou podmienkou bezpe\u010dn\u00e9ho a efekt\u00edvneho prepustenia. N\u00e1\u0161 s\u00fabor n\u00e1strojov a <\/span>princ\u00edpy, na ktor\u00fdch je zalo\u017een\u00fd<\/span><\/a>, pon\u00fakaj\u00fa praktick\u00fd v\u00fdchodiskov\u00fd bod pre t\u00edmy, ktor\u00e9 chc\u00fa t\u00fato zmenu uskuto\u010dni\u0165.<\/span><\/p>\n

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

          \n
        1. Za\u010dnite s pl\u00e1novan\u00edm prepustenia u\u017e pri prijat\u00ed, nie pri prepusten\u00ed.<\/strong><\/li>\n<\/ol>\n

          V\u010dasn\u00e9 zapojenie zni\u017euje \u00fazkos\u0165, vyh\u00fdba sa nerealistick\u00fdm o\u010dak\u00e1vaniam a vytv\u00e1ra \u010das na vzdel\u00e1vanie a rie\u0161enie probl\u00e9mov. Pou\u017e\u00edvajte jednoduch\u00e9 ot\u00e1zky na dosiahnutie spolo\u010dn\u00e9ho porozumenia od za\u010diatku:<\/span><\/p>\n

          Kto v\u00e1s doma podporuje?<\/span><\/i><\/p>\n

          \u010co u\u017e funguje dobre vo va\u0161om dennom re\u017eime?<\/span><\/i><\/p>\n

          \u010co m\u00f4\u017ee by\u0165 \u0165a\u017ek\u00e9 po prepusten\u00ed?<\/span><\/i><\/p>\n

          Toto prehodnocuje prepustenie z n\u00e1hleho odovzdania na postupn\u00fd, podporovan\u00fd prechod, \u010do poskytuje \u010das na koordin\u00e1ciu slu\u017eieb po prepusten\u00ed a rie\u0161enie probl\u00e9mov sk\u00f4r, ako sa zhor\u0161ia.<\/span><\/p>\n

            \n
          1. Pou\u017e\u00edvajte jednoduch\u00fd, be\u017en\u00fd jazyk a overte si porozumenie<\/strong><\/li>\n<\/ol>\n

            Vyh\u00fdbajte sa \u017earg\u00f3nu. Nahra\u010fte \u201eprobl\u00e9my s mobilitou\u201c v\u00fdrazom \u201e\u0165a\u017ekosti s ch\u00f4dzou\u201c, \u201epozorovania\u201c v\u00fdrazom \u201ekontrola teploty a krvn\u00e9ho tlaku\u201c. Po vysvetlen\u00ed zmeny liekov alebo \u00faloh starostlivosti overte porozumenie, namiesto toho, aby ste ho predpokladali. Pou\u017e\u00edvajte otvoren\u00e9 podnety:<\/span><\/p>\n

            \u010co by v\u00e1m pomohlo c\u00edti\u0165 sa istej\u0161ie doma?<\/span><\/i><\/p>\n

            \u010co v\u00e1s najviac znepokojuje pri zvl\u00e1dan\u00ed dom\u00e1cich situ\u00e1ci\u00ed?<\/span><\/i><\/p>\n

            Tieto ot\u00e1zky vytv\u00e1raj\u00fa priestor na objavenie sa myln\u00fdch predst\u00e1v. Bu\u010fte transparentn\u00ed oh\u013eadom tlaku na syst\u00e9m a toho, \u010do je skuto\u010dne dosiahnute\u013en\u00e9, \u010do zni\u017euje frustr\u00e1ciu a podporuje realistick\u00e9 pl\u00e1novanie.<\/span><\/p>\n

              \n
            1. Zabezpe\u010dte jeden prieh\u013eadn\u00fd kontakt po prepusten\u00ed.<\/strong><\/li>\n<\/ol>\n

              Zabezpe\u010dte, aby boli existuj\u00face komunika\u010dn\u00e9 kan\u00e1ly jasn\u00e9 a predv\u00eddate\u013en\u00e9. Poskytnite meno, telef\u00f3nne \u010d\u00edslo a inform\u00e1ciu, kedy vola\u0165 (napr. \u201eKontaktujte Louise Jones, prep\u00fa\u0161\u0165aciu sestru, v pr\u00edpade ot\u00e1zok o liekoch alebo pom\u00f4ckach po\u010das pracovn\u00fdch dn\u00ed medzi 9:00 a 17:00\u201c). Aj ke\u010f t\u00e1to osoba ot\u00e1zky iba presmeruje \u010falej, vedomie, \u017ee existuje niekto, na koho sa mo\u017eno obr\u00e1ti\u0165, men\u00ed sk\u00fasenos\u0165 po prepusten\u00ed z pocitu opustenosti na podporovan\u00fa starostlivos\u0165.<\/span><\/p>\n

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

              By Kathryn McEwan, Northumbria University, UK Sarah helped her father pack his belongings; relief mixed with rising anxiety. After five days in hospital following his stroke, he was being discharged. A nurse had briefly mentioned medication changes and follow-up appointments, […]<\/p>\n","protected":false},"author":9,"featured_media":4956,"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":[28,13,43,20],"tags":[],"class_list":["post-4954","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-communication","category-interventions","category-patient-engagement","category-social-support"],"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","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":false,"content":false,"excerpt":false},"my":{"title":false,"content":false,"excerpt":false},"bg":{"title":true,"content":true,"excerpt":false},"zh":{"title":false,"content":false,"excerpt":false},"hr":{"title":true,"content":true,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":false,"content":false,"excerpt":false},"de":{"title":true,"content":true,"excerpt":false},"es":{"title":false,"content":false,"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":true,"content":true,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"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":false,"content":false,"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":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"sr":{"title":false,"content":false,"excerpt":false},"fi":{"title":false,"content":false,"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\/4954","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\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/comments?post=4954"}],"version-history":[{"count":17,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/4954\/revisions"}],"predecessor-version":[{"id":4986,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/4954\/revisions\/4986"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media\/4956"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media?parent=4954"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/categories?post=4954"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/tags?post=4954"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}