{"id":5067,"date":"2026-07-06T07:21:49","date_gmt":"2026-07-06T07:21:49","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=5067"},"modified":"2026-07-14T11:47:10","modified_gmt":"2026-07-14T11:47:10","slug":"the-integrative-model-of-adjustment-to-continuous-challenges-imacc-understanding-and-supporting-biopsychosocial-adjustment","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/sk\/2026\/07\/the-integrative-model-of-adjustment-to-continuous-challenges-imacc-understanding-and-supporting-biopsychosocial-adjustment\/","title":{"rendered":"Integrat\u00edvny model prisp\u00f4sobenia sa neust\u00e1lym v\u00fdzvam (IMACC): pochopenie a podpora biopsychosoci\u00e1lneho prisp\u00f4sobenia"},"content":{"rendered":"

Lis Dreijer Hammond, Aalborg University (DK), Christian Karlsen Hansen & Martin Lehmkuhl Kristensen, Rehabilitation Centre for Refugees, North Jutland Regional Health Services (DK) and Chalotte Glintborg, Aalborg University (DK)<\/strong><\/p>\n

Ke\u010f d\u00f4jde k chorobe alebo z\u00e1va\u017en\u00fdm negat\u00edvnym \u017eivotn\u00fdm udalostiam, \u017eivot sa \u010dasto nevr\u00e1ti do p\u00f4vodn\u00e9ho stavu. Pre \u013eud\u00ed \u017eij\u00facich s dlhodob\u00fdmi zdravotn\u00fdmi probl\u00e9mami nie je v\u00fdzvou len zvl\u00e1danie sympt\u00f3mov, ale <\/span>prisp\u00f4sobenie sa zmenen\u00e9mu \u017eivotu<\/span><\/a>. Ke\u010f je tento proces prisp\u00f4sobovania naru\u0161en\u00fd, m\u00f4\u017ee to prispie\u0165 k <\/span>\u00fazkosti, depresii, hor\u0161\u00edm v\u00fdsledkom v oblasti fyzick\u00e9ho zdravia<\/span><\/a> a <\/span>zv\u00fd\u0161en\u00e9mu vyu\u017e\u00edvaniu zdravotn\u00edckych slu\u017eieb<\/span><\/a>. Odhady toho, ako dobre sa \u013eudia prisp\u00f4sobuj\u00fa dlhodob\u00fdm zdravotn\u00fdm probl\u00e9mom, sa zna\u010dne l\u00ed\u0161ia v z\u00e1vislosti od toho, ako sa prisp\u00f4sobenie meria. Slab\u00e9 prisp\u00f4sobenie vykazuje odhady medzi <\/span>16,9<\/span><\/a> a <\/span>62%<\/span><\/a>. Odhad dobr\u00e9ho prisp\u00f4sobenia sa pohybuje od <\/span>13<\/span><\/a> do <\/span>36,3%<\/span><\/a>. Celosvetovo \u017eije <\/span>viac ako 1 miliarda \u013eud\u00ed s dlhodobou multimorbiditou<\/span><\/a>. Ak a\u017e dve tretiny z nich maj\u00fa \u0165a\u017ekosti s prisp\u00f4soben\u00edm, je naliehavo potrebn\u00e9 zlep\u0161i\u0165 podporu pri prisp\u00f4sobovan\u00ed sa dlhodob\u00fdm zdravotn\u00fdm probl\u00e9mom.<\/span><\/p>\n

<\/p>\n

Prisp\u00f4sobenie sa neobmedzuje len na dodr\u017eiavanie lek\u00e1rskych r\u00e1d, ani sa net\u00fdka len zdravotn\u00e9ho spr\u00e1vania. <\/span>Integrat\u00edvny model prisp\u00f4sobenia sa neust\u00e1lym v\u00fdzvam [predt\u00fdm \u201echronick\u00fdm stavom\u201c] (IMACC)<\/span><\/a> je te\u00f3ria biopsychosoci\u00e1lneho procesu prisp\u00f4sobenia, ako ho \u010dlovek pre\u017e\u00edva. IMACC bol vyvinut\u00fd prostredn\u00edctvom <\/span>\u0161t\u00fadie o cukrovke 2. typu<\/span><\/a> a nesk\u00f4r <\/span>overen\u00fd pre pou\u017eite\u013enos\u0165 pri epilepsii s n\u00e1stupom v dospelosti<\/span><\/a>. Spolo\u010dn\u00e9 pou\u017e\u00edvanie IMACC m\u00f4\u017ee poskytn\u00fa\u0165 priamy poh\u013ead do procesu adapt\u00e1cie osoby, ako je op\u00edsan\u00e9 ni\u017e\u0161ie.\u00a0<\/span><\/p>\n

Adapt\u00e1cia je norm\u00e1lny a celo\u017eivotn\u00fd proces<\/span><\/a>; ke\u010f sa \u017eivot zmen\u00ed, men\u00edme sa s n\u00edm. Prisp\u00f4sobenie sa v\u0161ak m\u00f4\u017ee by\u0165 \u0165a\u017ek\u00e9. IMACC stanovuje, \u017ee na to, aby ka\u017edodenn\u00fd \u017eivot fungoval \u010do najlep\u0161ie, m\u00f4\u017ee by\u0165 potrebn\u00e9 zmeni\u0165 my\u0161lienky a spr\u00e1vanie, ktor\u00e9 u\u017e v nov\u00fdch podmienkach nie s\u00fa u\u017eito\u010dn\u00e9. Tak\u00e9to zmeny sa naz\u00fdvaj\u00fa adapta\u010dn\u00e9 \u00falohy. \u00daspe\u0161n\u00e9 rie\u0161enie t\u00fdchto \u00faloh vedie k lep\u0161iemu prisp\u00f4sobeniu sa, funk\u010dnej\u0161iemu ka\u017edodenn\u00e9mu \u017eivotu a pozit\u00edvnej zmene identity. \u0164a\u017ekosti s adapt\u00e1ciou m\u00f4\u017eu by\u0165 sp\u00f4soben\u00e9 prek\u00e1\u017ekami, ktor\u00e9 br\u00e1nia zmene, \u010do m\u00f4\u017ee proces adapt\u00e1cie zastavi\u0165 a \u010dasom vies\u0165 k zlej adapt\u00e1cii, zhor\u0161eniu du\u0161evn\u00e9ho a fyzick\u00e9ho zdravia a negat\u00edvnym zmen\u00e1m identity.<\/span><\/p>\n

\u0160trukt\u00fara IMACC<\/strong><\/p>\n

IMACC pozost\u00e1va z troch vz\u00e1jomne p\u00f4sobiacich \u00farovn\u00ed:<\/span><\/p>\n

\u00darove\u0148 1: Zmeny osobnosti a \u017eivota<\/strong> sa t\u00fdkaj\u00fa minulej osobnosti, presved\u010den\u00ed a spr\u00e1vania. D\u00f4raz sa kladie na aspekty, ktor\u00e9 m\u00f4\u017eu ma\u0165 vplyv na proces adapt\u00e1cie, bu\u010f ako prek\u00e1\u017eky procesu, alebo ako siln\u00e9 str\u00e1nky, ktor\u00e9 m\u00f4\u017eu adapt\u00e1ciu podpori\u0165. Okrem toho, ur\u010dovanie sk\u00fasenost\u00ed, ktor\u00e9 sa vyskytuj\u00fa v s\u00favislosti s negat\u00edvnymi \u017eivotn\u00fdmi udalos\u0165ami, ktor\u00e9 sp\u00f4sobuj\u00fa potrebu adapt\u00e1cie, m\u00f4\u017ee tie\u017e ovplyvni\u0165 proces adapt\u00e1cie, a to negat\u00edvne (napr. incidenty v zdravotnej starostlivosti) aj pozit\u00edvne (napr. podpora).<\/span><\/p>\n

\u00darove\u0148 2: Cyklus prebiehaj\u00faceho adapt\u00e1cie<\/strong> pozost\u00e1va z piatich oblast\u00ed s \u00falohami adapt\u00e1cie. Ke\u010f \u010dlovek \u010del\u00ed dlhodob\u00e9mu zdravotn\u00e9mu probl\u00e9mu alebo postihnutiu, za\u010d\u00edna <\/span>invent\u00farou<\/b>. Spracov\u00e1va po\u010diato\u010dn\u00e9 emocion\u00e1lne reakcie, ako je \u0161ok alebo hnev, a z\u00e1rove\u0148 prem\u00fd\u0161\u013ea o tom, \u010do by sa mohlo musie\u0165 zmeni\u0165, aby \u017eivot op\u00e4\u0165 fungoval. To zah\u0155\u0148a rozvoj motiv\u00e1cie k adapt\u00e1cii.<\/span><\/p>\n

Osoba potom prech\u00e1dza k <\/span>u\u010deniu<\/b>, z\u00edskava vedomosti o stave a dostupn\u00fdch mo\u017enostiach, ako aj zru\u010dnosti pre sebariadenie a zvl\u00e1danie. To zvy\u010dajne zah\u0155\u0148a rozvoj nov\u00fdch postojov k \u017eivotu a ostatn\u00fdm. D\u00f4le\u017eit\u00fa \u00falohu zohr\u00e1va jeho <\/span>okolie<\/b>. Rodina, pr\u00e1ca, zdravotn\u00edcki pracovn\u00edci a \u0161ir\u0161ie prostredie ovplyv\u0148uj\u00fa adapt\u00e1ciu, rovnako ako vn\u00edmanie okolia a vlastn\u00fdch \u017eivotn\u00fdch rol\u00ed \u010dloveka.<\/span><\/p>\n

Ako adapt\u00e1cia postupuje, \u010dlovek sa mus\u00ed zapoji\u0165 do procesu <\/span>odp\u00fatania<\/b>, spracovania str\u00e1t s\u00favisiacich s minul\u00fdm fungovan\u00edm alebo bud\u00facimi snami a pl\u00e1nmi, ktor\u00e9 u\u017e nie s\u00fa realizovate\u013en\u00e9. Postoje alebo spr\u00e1vanie, ktor\u00e9 v novej situ\u00e1cii u\u017e nefunguj\u00fa, sa m\u00f4\u017ee musie\u0165 vzda\u0165. Postupom \u010dasu m\u00f4\u017ee \u010dlovek pri ka\u017edej zmene <\/span>prija\u0165 a integrova\u0165<\/b> nov\u00fd sp\u00f4sob \u017eivota integr\u00e1ciou a udr\u017eiavan\u00edm nov\u00fdch postojov a spr\u00e1vania vo svojom ka\u017edodennom \u017eivote. D\u00f4le\u017eit\u00e9 je, \u017ee pri ka\u017edom probl\u00e9me, ktor\u00fd si vy\u017eaduje zmenu, \u010dlovek prech\u00e1dza <\/span>cyklom prebiehaj\u00faceho prisp\u00f4sobovania<\/b>, \u010do znamen\u00e1, \u017ee nieko\u013eko oblast\u00ed m\u00f4\u017ee by\u0165 akt\u00edvnych s\u00fa\u010dasne.<\/span><\/p>\n

\u00darove\u0148 3: Cyklus udr\u017eiavania<\/strong> ukazuje, \u010do sa deje v n\u00e1ro\u010dn\u00fdch chv\u00ed\u013each. Je to klasick\u00fd kognit\u00edvno-behavior\u00e1lny cyklus udr\u017eiavania s jedn\u00fdm rozdielom: Kognit\u00edvy s\u00fa charakterizovan\u00e9 konfliktom medzi zhodnoten\u00edm alebo u\u010den\u00edm (v z\u00e1vislosti od toho, v ktorej \u010dasti procesu adapt\u00e1cie sa \u010dlovek zastavil), odp\u00fa\u0161\u0165an\u00edm a okol\u00edm. Pre ilustr\u00e1ciu, (stereotypick\u00fdm) pr\u00edkladom je \u017eena, ktor\u00e1 sa sna\u017e\u00ed nau\u010di\u0165 sa viac zameriava\u0165 na starostlivos\u0165 o seba, preto\u017ee sa nedok\u00e1\u017ee vzda\u0165 svojej \u00falohy varenia a upratovania zo strachu, \u017ee bude \u201ezlou matkou\u201c alebo \u201ezlou man\u017eelkou\u201c. Udr\u017eiavanie bl\u00edzkych vz\u0165ahov (soci\u00e1lneho prostredia) sa jej jav\u00ed ako d\u00f4le\u017eitej\u0161ie ako starostlivos\u0165 o seba (z\u00e1kladn\u00fd postoj).<\/span><\/p>\n

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

Stanovte si zmyslupln\u00fd cie\u013e:<\/strong> Podporte zamyslenie sa nad t\u00fdm, ktor\u00e9 zmeny v ka\u017edodennom \u017eivote osoby by mohli ma\u0165 pozit\u00edvny vplyv (napr. zmena zdravotn\u00fdch n\u00e1vykov). Diskutujte o tom, ako m\u00f4\u017eu t\u00fato zmenu integrova\u0165 do svojho denn\u00e9ho re\u017eimu. Konkr\u00e9tnos\u0165 v detailoch (\u010das, miesto at\u010f.) u\u013eah\u010duje za\u010diatok. Op\u00fdtajte sa, \u010do by pre nich znamenalo t\u00fato zmenu \u2013 a \u010do by to mohlo znamena\u0165, ak by sa NEZMENILI. Zmyslupln\u00e9 ciele pom\u00e1haj\u00fa motiv\u00e1cii.<\/span><\/p>\n

Prekonajte prek\u00e1\u017eky<\/strong>: <\/b>Prehodno\u0165te pokusy o implement\u00e1ciu zmeny a normalizujte v\u0161etky \u0165a\u017ekosti, ktor\u00e9 by mohli nasta\u0165. Diskutujte o ned\u00e1vnom pokuse o zmenu a venujte pozornos\u0165 z\u00e1kladn\u00fdm hodnot\u00e1m a postojom (napr. \u201eMus\u00edm najprv pom\u00f4c\u0165 druh\u00fdm\u201c alebo \u201eMus\u00edm dokon\u010di\u0165 \u00falohu predt\u00fdm, ako si odd\u00fdchnem\u201c).<\/span><\/p>\n

Zv\u00e1\u017ete \u00falohu ostatn\u00fdch<\/strong>: <\/b>Op\u00fdtajte sa osoby, ak\u00fd vplyv si mysl\u00ed, \u017ee zmena m\u00f4\u017ee ma\u0165 na bl\u00edzke vz\u0165ahy. Napr\u00edklad, ak potreba zlep\u0161i\u0165 starostlivos\u0165 o seba znamen\u00e1 robi\u0165 menej pre druh\u00fdch, ak\u00e9 si mysl\u00ed, \u017ee by to mohlo ma\u0165 d\u00f4sledky? \u010co by to znamenalo pre ich identitu (napr. zmena \u017eivotn\u00fdch rol\u00ed). \u010co si myslia, \u017ee by si ostatn\u00ed mohli myslie\u0165, hovori\u0165 alebo robi\u0165?<\/span><\/p>\n

Podpora pri vyjedn\u00e1van\u00ed zmien<\/strong>: <\/b>O \u010dom by sa dan\u00e1 osoba mohla potrebova\u0165 porozpr\u00e1va\u0165 s ostatn\u00fdmi? Mo\u017eno by sa mala p\u00fdta\u0165, \u010do to pre ostatn\u00fdch znamen\u00e1 (namiesto toho, aby sa spoliehala na vlastn\u00e9 predpoklady). Mo\u017eno by sa mala potrebova\u0165 dohodn\u00fa\u0165 na \u00faprav\u00e1ch denn\u00fdch rut\u00edn alebo zlep\u0161i\u0165 svoje zru\u010dnosti v komunik\u00e1cii svojich potrieb (napr. kol\u00edsav\u00e1 \u00farove\u0148 bolesti \u2013 \u010do m\u00f4\u017eu ostatn\u00ed o\u010dak\u00e1va\u0165, \u017ee dnes bud\u00fa schopn\u00ed urobi\u0165).<\/span><\/p>\n

Zlep\u0161enie<\/strong> z\u00e1kladn\u00e9ho telesn\u00e9ho uvedomenia<\/b><\/a>: <\/b>Podporte osobu, ktor\u00e1 sa u\u010d\u00ed rozumie\u0165 telesn\u00fdm sympt\u00f3mom a pocitom, \u010do znamenaj\u00fa a ako ich pou\u017e\u00edva\u0165 na usmernenie starostlivosti o seba. Pom\u00f4\u017ete jej zvl\u00e1da\u0165 stres spojen\u00fd so zmenou spr\u00e1vania a vplyv zmeny na bl\u00edzke vz\u0165ahy.<\/span><\/p>\n

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

By Lis Dreijer Hammond, Aalborg University (DK), Christian Karlsen Hansen & Martin Lehmkuhl Kristensen, Rehabilitation Centre for Refugees, North Jutland Regional Health Services (DK) and Chalotte Glintborg, Aalborg University (DK) When illness or major negative life events occur, life often […]<\/p>\n","protected":false},"author":9,"featured_media":5115,"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,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[22,13,36,24,35],"tags":[],"class_list":["post-5067","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-behavioural-theory","category-interventions","category-mental-health","category-self-regulation","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","sr","fi","et","sv","tr","uk","hi","sw","ta"],"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":false,"content":false,"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":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},"et":{"title":false,"content":false,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":false,"content":false,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false},"hi":{"title":false,"content":false,"excerpt":false},"sw":{"title":false,"content":false,"excerpt":false},"ta":{"title":false,"content":false,"excerpt":false}}},"aioseo_notices":[],"aioseo_head":"\n\t\t\n\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