{"id":761,"date":"2017-11-22T11:52:03","date_gmt":"2017-11-22T11:52:03","guid":{"rendered":"http:\/\/practicalhealthpsychology.com\/?p=761"},"modified":"2025-11-04T14:43:32","modified_gmt":"2025-11-04T14:43:32","slug":"very-brief-interventions","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/sk\/2017\/11\/very-brief-interventions\/","title":{"rendered":"Very Brief Interventions"},"content":{"rendered":"<p><strong>Stephen Sutton, University of Cambridge, England<\/strong><\/p>\n<p>Ve\u013ek\u00e9 probl\u00e9my vy\u017eaduj\u00fa rozsiahle rie\u0161enia. Rie\u0161enie probl\u00e9mov v\u00a0tzv. &#8220;ve\u013ekej 4&#8221; (nedostatok fyzickej aktivity, faj\u010denie, nadmern\u00e1 konzum\u00e1cia potrav\u00edn a alkoholu) si vy\u017eaduje \u0161k\u00e1lovate\u013en\u00e9 intervencie, ktor\u00e9 m\u00f4\u017eu zasiahnu\u0165 ve\u013ek\u00fd po\u010det \u013eud\u00ed na to, aby dosiahli v\u00fdznamn\u00fd vplyv na verejn\u00e9 zdravie. Jedn\u00fdm zo s\u013eubn\u00fdch pr\u00edstupov je pou\u017eitie kr\u00e1tkych intervenci\u00ed poskytovan\u00fdch lek\u00e1rskymi pracovn\u00edkmi v zdravotn\u00edckych zariadeniach. Napr\u00edklad v Spojenom kr\u00e1\u013eovstve N\u00e1rodn\u00fd in\u0161tit\u00fat pre excelentnos\u0165 v oblasti zdravia a starostlivosti odpor\u00fa\u010da, aby lek\u00e1ri poskytuj\u00faci prim\u00e1rnu starostlivos\u0165 pon\u00fakali neakt\u00edvnym dospel\u00fdm &#8220;kr\u00e1tke&#8221; poradenstvo v oblasti telesnej aktivity, a aby v tom pokra\u010dovali aj pri nasleduj\u00facich stretnutiach.<\/p>\n<p><!--more--><\/p>\n<p>Existuj\u00fa d\u00f4kazy o \u00fa\u010dinnosti kr\u00e1tkych intervenci\u00ed. Probl\u00e9m s interpret\u00e1ciou tejto literat\u00fary je v\u0161ak to, \u017ee existuj\u00fa r\u00f4zne defin\u00edcie &#8220;kr\u00e1tkeho poradenstva&#8221; alebo &#8220;kr\u00e1tkej intervencie&#8221;. Jeden z\u00a0preh\u013eadov literat\u00fary definoval kr\u00e1tke poradenstvo ako &#8220;trvaj\u00face krat\u0161ie ako 30 min\u00fat alebo poskytnut\u00e9 po\u010das jedn\u00e9ho stretnutia&#8221;. Mnoh\u00e9 tak\u00e9to &#8220;kr\u00e1tke&#8221; intervencie s\u00fa pr\u00edli\u0161 dlh\u00e9 na zahrnutie do rutinn\u00fdch konzult\u00e1ci\u00ed do prim\u00e1rnej lek\u00e1rskej starostlivosti. V na\u0161ej pr\u00e1ci sme sa preto s\u00fastredili na vypracovanie a hodnotenie &#8220;ve\u013emi kr\u00e1tkych&#8221; intervenci\u00ed, definovan\u00fdch ako jedin\u00e9 stretnutie trvaj\u00face maxim\u00e1lne p\u00e4\u0165 min\u00fat, ktor\u00e9 by rie\u0161ili nedostatok fyzickej aktivity. Tieto ve\u013emi kr\u00e1tke intervencie by mohli by\u0165 pou\u017eit\u00e9 v r\u00f4znych zdravotn\u00edckych zariadeniach, ale rozv\u00edjali sme ich v\u00a0r\u00e1mci prevent\u00edvnych prehliadok n\u00e1rodn\u00fdch zdravotn\u00edckych slu\u017eieb (NHS) v Anglicku. Tie vyz\u00fdvaj\u00fa dospel\u00fdch vo veku od 40 do 74 rokov, ktor\u00ed nie s\u00fa v registri chor\u00f4b, aby ka\u017ed\u00fdch p\u00e4\u0165 rokov absolvovali prevent\u00edvnu kontrolu. V\u00e4\u010d\u0161ina t\u00fdchto kontrol sa uskuto\u010d\u0148uje v prim\u00e1rnej lek\u00e1rskej starostlivosti a vykon\u00e1vaj\u00fa ich praktick\u00e9 sestry a asistenti zdravotnej starostlivosti. Ide o ide\u00e1lnu pr\u00edle\u017eitos\u0165 poskytn\u00fa\u0165 ve\u013emi kr\u00e1tku intervenciu na zmenu spr\u00e1vania potenci\u00e1lne mili\u00f3nom \u013eud\u00ed.<\/p>\n<p>Na rozv\u00edjanie z\u00e1sahov sme pou\u017eili itera\u010dn\u00fd pr\u00edstup, ktor\u00fd kombinoval d\u00f4kazy a odborn\u00e9 poznatky z viacer\u00fdch zdrojov, vr\u00e1tane systematick\u00fdch recenzi\u00ed, konzult\u00e1ci\u00ed so zainteresovan\u00fdmi stranami, kvalitat\u00edvnej \u0161t\u00fadie, odhadu n\u00e1kladov na zdroje a t\u00edmov\u00fdch diskusi\u00ed. \u0160pecifikovali sme obsah ve\u013emi kr\u00e1tkej intervencie z h\u013eadiska techn\u00edk zmeny spr\u00e1vania. Napr\u00edklad na\u0161a ve\u013emi kr\u00e1tka intervencia zalo\u017een\u00e1 na krokomeroch zah\u0155\u0148al dev\u00e4\u0165 r\u00f4znych techn\u00edk zmeny spr\u00e1vania, vr\u00e1tane nastavenia cie\u013ea (spr\u00e1vanie), pl\u00e1novania akci\u00ed a vlastn\u00e9ho monitorovania spr\u00e1vania. Tieto boli realizovan\u00e9 tak, \u017ee \u00fa\u010dastn\u00edkovi bol poskytnut\u00fd krokomer a tabu\u013eka krokov spolu so slovn\u00fdmi in\u0161trukciami, ako napr\u00edklad &#8220;Ka\u017ed\u00fd t\u00fd\u017ede\u0148 si m\u00f4\u017eete nastavi\u0165 po\u010det krokov, napr\u00edklad 6 000 krokov denne, a potom ka\u017ed\u00fd de\u0148 si m\u00f4\u017eete zap\u00edsa\u0165, ko\u013eko krokov ste pre\u0161li a \u010di ste dosiahli svoj cie\u013e &#8220;. Vyvinuli sme tie\u017e trojhodinov\u00fd tr\u00e9ning a manu\u00e1l pre praktizuj\u00facich lek\u00e1rov.<\/p>\n<p>Tak\u00e9to ve\u013emi kr\u00e1tke intervencie zalo\u017een\u00e9 na technike by sa mali odli\u0161ova\u0165 od jednoduch\u00fdch &#8220;odpor\u00fa\u010dan\u00ed&#8221;. Poradenstvo zvy\u010dajne zah\u0155\u0148a v\u00fdzvam na zmenu a inform\u00e1cie o\u00a0negat\u00edvnych dopadoch fyzickej ne\u010dinnosti alebo v\u00fdhod\u00e1ch akt\u00edvnej\u0161ej \u010dinnosti. M\u00f4\u017ee by\u0165 u\u017eito\u010dn\u00e9 zahrn\u00fa\u0165 aj techniky, ako je nastavenie cie\u013eov a vlastn\u00e9 monitorovanie, ktor\u00e9 maj\u00fa pom\u00f4c\u0165 \u013eu\u010fom zmeni\u0165 svoje spr\u00e1vanie.<\/p>\n<p>Uk\u00e1zali sme, \u017ee je mo\u017en\u00e9 zahrn\u00fa\u0165 ve\u013emi kr\u00e1tke intervencie do zdravotn\u00fdch prehliadok a \u017ee s\u00fa prijate\u013en\u00e9 pre praktizuj\u00facich lek\u00e1rov ako aj pacientov. Na\u0161e prv\u00e9 zistenia o ich \u00fa\u010dinnosti boli dos\u0165 s\u013eubn\u00e9. Na z\u00e1klade objekt\u00edvne meranej fyzickej aktivity pomocou akcelerometra mala ve\u013emi kr\u00e1tka intervencia za pomoci krokomerov 73% pravdepodobnos\u0165, \u017ee bude efekt\u00edvna (t.j. zv\u00fd\u0161enie fyzickej aktivity v porovnan\u00ed s\u00a0kontrolnou skupinou bez intervencie). Pri sk\u00fa\u0161an\u00ed tejto ve\u013emi kr\u00e1tkej intervencie v rozsiahlej\u0161ej \u0161t\u00fadii (po\u010det respondentov 1 007) mala v\u0161ak len mal\u00fd, nev\u00fdznamn\u00fd pozit\u00edvny \u00fa\u010dinok na objekt\u00edvne meran\u00fa fyzick\u00fa aktivitu po troch mesiacoch. Ekonomick\u00e9 hodnotenie v\u0161ak nazna\u010duje, \u017ee existuje 60% pravdepodobnos\u0165, \u017ee intervencia bude z dlhodob\u00e9ho h\u013eadiska n\u00e1kladovo efekt\u00edvna v porovnan\u00ed so samotnou prevent\u00edvnou prehliadkou bez ak\u00e9hoko\u013evek z\u00e1sahu. Poskytnutie ve\u013emi kr\u00e1tkej intervencie teda m\u00f4\u017ee by\u0165 lep\u0161ie ako ni\u010d nerobi\u0165.<\/p>\n<p>Je mo\u017en\u00e9 zv\u00fd\u0161i\u0165 \u00fa\u010dinnos\u0165 ve\u013emi kr\u00e1tkych intervenci\u00ed za\u010dlenen\u00edm \u010fal\u0161\u00edch dodato\u010dn\u00fdch prvkov. V\u00fdzvou je urobi\u0165 to bez v\u00fdrazn\u00e9ho zv\u00fd\u0161enia n\u00e1kladov. Jednou z\u00a0mo\u017enost\u00ed je kombinova\u0165 ve\u013emi kr\u00e1tku osobn\u00fa intervenciu poskytovan\u00fa praktick\u00fdm lek\u00e1rom s &#8220;digit\u00e1lnou&#8221; intervenciou, ktor\u00e1 poskytuje pacientovi trval\u00fa podporu zmeny spr\u00e1vania. Kombin\u00e1cia osobnej intervencie a digit\u00e1lnych prvkov m\u00f4\u017ee by\u0165 \u00fa\u010dinnej\u0161ia ako ka\u017ed\u00e1 z\u00a0t\u00fdchto mo\u017enost\u00ed oddelene. Tak\u00fato verziu interven\u010dn\u00e9ho modelu sme pou\u017eili v na\u0161ej pr\u00e1ci zameranej na zv\u00fd\u0161enie miery odvykania od faj\u010denia u faj\u010diarov v prim\u00e1rnej lek\u00e1rskej starostlivosti, v ktor\u00fdch digit\u00e1lna zlo\u017eka pozost\u00e1va z 90-d\u0148ov\u00e9ho programu prisp\u00f4soben\u00fdch textov\u00fdch spr\u00e1v posielan\u00fdch do mobiln\u00e9ho telef\u00f3nu faj\u010diara.<\/p>\n<p><strong>Odpor\u00fa\u010dania<\/strong><\/p>\n<ul>\n<li>Existuj\u00fa d\u00f4kazy o \u00fa\u010dinnosti <em>kr\u00e1tkych<\/em> intervenci\u00ed na zmenu spr\u00e1vania, ako je faj\u010denie a telesn\u00e1 aktivita. Mnoh\u00e9 z t\u00fdchto intervenci\u00ed s\u00fa v\u0161ak pr\u00edli\u0161 dlh\u00e9 na zahrnutie do rutinn\u00fdch konzult\u00e1ci\u00ed s pacientmi.<\/li>\n<li>Namiesto toho zv\u00e1\u017ete <em>ve\u013emi kr\u00e1tke<\/em> intervencie trvaj\u00face nie viac ako p\u00e4\u0165 min\u00fat. D\u00f4kazy o ich \u00fa\u010dinnosti s\u00fa s\u00edce slab\u0161ie ako pri kr\u00e1tkych intervenci\u00e1ch, ale poskytnutie ve\u013emi kr\u00e1tkej intervencie je pravdepodobne lep\u0161ie, ne\u017e nerobi\u0165 v\u00f4bec ni\u010d.<\/li>\n<li>Sk\u00f4r ako len &#8220;d\u00e1va\u0165 radu&#8221;, zamyslite sa nad ve\u013emi kr\u00e1tkymi intervenciami zahr\u0148uj\u00facimi jednu alebo viacero techn\u00edk ur\u010den\u00fdch na zmenu spr\u00e1vania. Napr\u00edklad m\u00f4\u017ee by\u0165 u\u017eito\u010dn\u00e9 po\u017eiada\u0165 pacienta, aby sledoval svoje spr\u00e1vanie alebo urobil konkr\u00e9tny ak\u010dn\u00fd pl\u00e1n t\u00fdm, \u017ee zap\u00ed\u0161e, kedy, kde a ako zv\u00fd\u0161i svoju fyzick\u00fa aktivitu alebo sa vyhne l\u00e1kav\u00e9mu ob\u010derstveniu.<\/li>\n<li>Upozornenie pacientov na u\u017eito\u010dn\u00e9 zdroje (napr\u00edklad aplik\u00e1cia pre smartf\u00f3ny) netrv\u00e1 dlho a m\u00f4\u017ee zv\u00fd\u0161i\u0165 vplyv intervencie. Zorganizovanie n\u00e1sledn\u00e9ho stretnutia m\u00f4\u017ee by\u0165 tie\u017e u\u017eito\u010dn\u00e9.<\/li>\n<\/ul>\n<p>Vyu\u017eite v\u0161etky stretnutia. Zaka\u017ed\u00fdm, ke\u010f uvid\u00edte pacienta, m\u00e1te potenci\u00e1lnu pr\u00edle\u017eitos\u0165 poveda\u0165 nie\u010do o zmene spr\u00e1vania. Dodato\u010dn\u00fd efekt lek\u00e1rov, ktor\u00ed pou\u017e\u00edvaj\u00fa ve\u013emi kr\u00e1tke intervencie so svojimi pacientmi, m\u00f4\u017ee ma\u0165 v\u00fdznamn\u00fd vplyv na verejn\u00e9 zdravie.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Stephen Sutton, University of Cambridge, England Large-scale problems require large-scale solutions. Tackling the \u2018Big 4\u2019 behaviours (physical inactivity, tobacco use, excessive consumption of food and alcohol) requires scalable interventions that can reach large numbers of people to achieve a [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":778,"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":[13],"tags":[],"class_list":["post-761","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-interventions"],"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":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":true,"content":true,"excerpt":false},"da":{"title":true,"content":true,"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":true,"content":true,"excerpt":false},"he":{"title":true,"content":true,"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":true,"content":true,"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":true,"content":true,"excerpt":false},"ro":{"title":true,"content":true,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":false,"content":true,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":false,"content":false,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/761","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=761"}],"version-history":[{"count":24,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/761\/revisions"}],"predecessor-version":[{"id":4638,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/761\/revisions\/4638"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media\/778"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media?parent=761"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/categories?post=761"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/tags?post=761"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}