{"id":975,"date":"2018-07-30T14:59:54","date_gmt":"2018-07-30T14:59:54","guid":{"rendered":"http:\/\/practicalhealthpsychology.com\/?p=975"},"modified":"2025-11-04T14:37:31","modified_gmt":"2025-11-04T14:37:31","slug":"self-regulation-from-theory-to-practice-supporting-your-patients-goals-for-change","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/sk\/2018\/07\/self-regulation-from-theory-to-practice-supporting-your-patients-goals-for-change\/","title":{"rendered":"Seba-regul\u00e1cia \u2013 pd te\u00f3rie k praxi: ako podporova\u0165 svojich pacientov pri dosahovan\u00ed ich cie\u013eov na ceste k zmene"},"content":{"rendered":"

Stan Maes & V\u00e9ronique De Gucht, Leiden University, Holandsko<\/strong><\/p>\n

V priebehu posledn\u00fdch desa\u0165ro\u010d\u00ed sa \u00faloha jednotlivcov v syst\u00e9me zdravotnej starostlivosti vyv\u00edjala od “dodr\u017eiavania lek\u00e1rskych re\u017eimov”, \u010do nazna\u010duje poslu\u0161nos\u0165; k “seba-mana\u017ementu”, \u010do ozna\u010duje zodpovednos\u0165 za kontrolu vlastn\u00e9ho zdravia alebo choroby. To ned\u00e1vno pokro\u010dilo e\u0161te \u010falej k my\u0161lienke “seba-regul\u00e1cie”, systematick\u00e9ho procesu, ktor\u00fd zah\u0155\u0148a stanovenie osobn\u00fdch cie\u013eov t\u00fdkaj\u00facich sa zdravia a riadenia spr\u00e1vania na dosiahnutie t\u00fdchto cie\u013eov. Na ilustr\u00e1ciu neust\u00e1leho procesu seba-regul\u00e1cie sme si vybrali starobyl\u00fd symbol “ouroboros” (t. j. had pojedaj\u00faci si vlastn\u00fd chvost), ktor\u00fd sprev\u00e1dza tento blogov\u00fd pr\u00edspevok.<\/p>\n

<\/p>\n

Seba-regul\u00e1cia prebieha v nieko\u013ek\u00fdch f\u00e1zach: (1) uvedomenie a stanovenie si cie\u013ea; (2) akt\u00edvne dosahovanie cie\u013ea a (3) dosiahnutie cie\u013ea, jeho udr\u017eiavanie \u010di vzdanie sa cie\u013ea. V nasleduj\u00facich odsekoch tieto f\u00e1zy vykresl\u00edme pomocou pr\u00edkladu Johna, ktor\u00fd utrpel srdcov\u00fd z\u00e1chvat.<\/p>\n

F\u00e1za 1<\/strong><\/p>\n

V prvej f\u00e1ze by si jednotlivci mali uvedomi\u0165 a stanovi\u0165 realistick\u00e9 a osobne d\u00f4le\u017eit\u00e9 ciele t\u00fdkaj\u00face sa (zmeny) zdravia. Niekto by sa napr\u00edklad mohol Johna op\u00fdta\u0165: “Ako by mohlo vyzera\u0165 Va\u0161e zotavovanie sa?”, na \u010do by mohol odpoveda\u0165, \u017ee s\u00fa pre neho d\u00f4le\u017eit\u00e9 prech\u00e1dzky v pr\u00edrode s jeho vn\u00fa\u010da\u0165om. Ako prv\u00fd krok by si teda mohol John stanovi\u0165 cie\u013e “za\u010da\u0165 kr\u00e1tke prech\u00e1dzky v mojom susedstve.” Je d\u00f4le\u017eit\u00e9, aby sa tak\u00e9to ciele pomerne \u013eahko v\u017eili a boli re\u00e1lne vzh\u013eadom na s\u00fa\u010dasn\u00e9 fungovanie. D\u00e1vaj\u00fa tak pocit vlastn\u00edctva a dosahuj\u00fa sa omnoho \u013eah\u0161ie ako ciele stanoven\u00e9 in\u00fdmi \u013eu\u010fmi. Techniky motiva\u010dn\u00e9ho rozhovoru m\u00f4\u017eu pom\u00f4c\u0165 pri vytv\u00e1ran\u00ed osobn\u00fdch cie\u013eov dokonca aj u \u013eud\u00ed bez motiv\u00e1cie.<\/p>\n

F\u00e1za 2<\/strong><\/p>\n

Druh\u00e1 f\u00e1za<\/em> sa vyzna\u010duje sledovan\u00edm cie\u013eov. V tejto f\u00e1ze je potrebn\u00e9 preklen\u00fa\u0165 be\u017en\u00fd bod zlomu medzi my\u0161lienkou (z\u00e1merom) a \u010dinnos\u0165ou. Na tento \u00fa\u010del je potrebn\u00fd konkr\u00e9tny “ak\u010dn\u00fd pl\u00e1n” zalo\u017een\u00fd na reflexii, v ktorom sa presne uv\u00e1dza, kedy, kde a ako kona\u0165. V na\u0161om pr\u00edklade to m\u00f4\u017ee by\u0165: “Od bud\u00faceho t\u00fd\u017ed\u0148a budem chodi\u0165 s man\u017eelkou do bl\u00edzkeho obchodu s potravinami, aby som si k\u00fapil jedlo v pondelok, stredu a piatok o 15:00”. Tak\u00e9to ak\u010dn\u00e9 pl\u00e1ny, ktor\u00e9 s\u00fa dostato\u010dne podrobn\u00e9, zd\u00e1 sa zvy\u0161uj\u00fa \u00faspe\u0161nos\u0165 pri dosahovan\u00ed cie\u013eov s\u00favisiacich s cvi\u010den\u00edm, zdrav\u00fdm stravovan\u00edm a in\u00fdm spr\u00e1van\u00edm, ktor\u00e9 s\u00favis\u00ed so zdrav\u00edm.<\/p>\n

Okrem toho zohr\u00e1vaj\u00fa d\u00f4le\u017eit\u00fa \u00falohy po\u010das dosahovania cie\u013ea tri regula\u010dn\u00e9 mechanizmy. Prv\u00fdm z nich je sp\u00e4tn\u00e1 v\u00e4zba<\/em>, ktor\u00e1 zah\u0155\u0148a monitorovanie a hodnotenie pokroku. V na\u0161om pr\u00edklade by mohol by mohol Johna niekto po\u017eiada\u0165, aby zaznamen\u00e1val svoju aktivitu, aby zistil, \u010di splnil svoj cie\u013e. V\u00fdsledky by si potom s Johnom pre\u0161iel bu\u010f na identifik\u00e1ciu \u00faspechov, alebo na identifik\u00e1ciu probl\u00e9mov, ktor\u00e9 by sa mali prekona\u0165 v bud\u00facnosti. Druh\u00fd mechanizmus zah\u0155\u0148a procesy anticip\u00e1cie a\u00a0kladnej sp\u00e4tnej v\u00e4zby<\/em>, ktor\u00e9 zah\u0155\u0148aj\u00fa o\u010dak\u00e1vania vo vz\u0165ahu k v\u00fdsledku (t.j. to, \u010do si \u010dlovek mysl\u00ed, \u017ee sa stane, ak bude kona\u0165) a vieru v svoju seba-\u00fa\u010dinnos\u0165 (t. j. \u010di \u010dlovek c\u00edti, \u017ee m\u00f4\u017ee kona\u0165 \u00faspe\u0161ne). O\u010dak\u00e1vania vo vz\u0165ahu k v\u00fdsledkom a\u00a0seba-\u00fa\u010dinnos\u0165 s\u00fa posil\u0148ovan\u00e9 pozorovan\u00edm \u00faspechov in\u00fdch, pokrokom v\u00a0dosahovan\u00ed cie\u013ea a povzbudzovan\u00edm. Lek\u00e1ri by preto mali pon\u00faknu\u0165 kontakt s in\u00fdmi \u013eu\u010fmi, ktor\u00ed porovnate\u013en\u00e9 ciele u\u017e \u00faspe\u0161ne dosiahli, aby tak zv\u00fd\u0161ili \u0161ance na dosiahnutie cie\u013ea a poskytli pr\u00edle\u017eitos\u0165 z\u00edska\u0165 podporu pre svoj cie\u013e. Posledn\u00fd tret\u00ed mechanizmus zah\u0155\u0148a aktiv\u00e1ciu kontroln\u00fdch procesov<\/em>, aby sa tak zabezpe\u010dilo pokra\u010duj\u00face \u00fasilie napriek konkuren\u010dn\u00fdm cie\u013eom alebo prek\u00e1\u017ekam. Rozpt\u00fdlenie sa od stanoven\u00e9ho cie\u013ea, napr\u00edklad neo\u010dak\u00e1van\u00fdmi udalos\u0165ami v ka\u017edodennom \u017eivote, m\u00f4\u017ee ma\u0165 negat\u00edvny vplyv na jeho dosahovanie. Nedostato\u010dn\u00fd pokrok smerom k cie\u013eu (t. j. zlyhanie) tie\u017e \u010dasto vedie k\u00a0negat\u00edvnym pocitom. Ak k tomu d\u00f4jde, mo\u017eno budete chcie\u0165 pon\u00faknu\u0165 Johnovi podporu pri rie\u0161en\u00ed t\u00fdchto em\u00f3ci\u00ed a pom\u00f4c\u0165 pri zvl\u00e1dan\u00ed zlyhania t\u00fdm, \u017ee ich zadefinujete ako pr\u00edle\u017eitosti na u\u010denie sa.<\/p>\n

F\u00e1za 3<\/strong><\/p>\n

Tretia f\u00e1za<\/em> sa t\u00fdka dosiahnutia cie\u013ea, jeho udr\u017eania \u010di vzdania sa cie\u013ea. Dosiahnutie cie\u013ea nie je koniec, ale sk\u00f4r nov\u00fd za\u010diatok. \u013dud\u00ed to m\u00f4\u017ee povzbudi\u0165, aby si stanovili nov\u00e9 ciele na udr\u017eanie pokroku aj v bud\u00facnosti. Ak sa v\u0161ak vlastn\u00fd, na zdravie zameran\u00fd cie\u013e uk\u00e1\u017ee ako nedosiahnute\u013en\u00fd, je \u010dasto m\u00fadrej\u0161ie vzda\u0165 sa ho a\u00a0zvoli\u0165 si lep\u0161ie zvl\u00e1dnute\u013en\u00fd cie\u013e. V na\u0161om pr\u00edklade by mohol John pokra\u010dova\u0165 v sledovan\u00ed svojho cie\u013ea zv\u00fd\u0161enej fyzickej aktivity, alebo by si mohol nastavi\u0165 nov\u00fd cie\u013e, ako napr\u00edklad chodi\u0165 na kr\u00e1tku denn\u00fa prech\u00e1dzku so psom. Seba-\u00fa\u010dinnos\u0165 a soci\u00e1lna opory s\u00fa aj tu k\u013e\u00fa\u010dov\u00fdmi prediktormi \u00faspechu.<\/p>\n

Ve\u013ea v\u00fdskumov podporilo \u00fa\u010dinnos\u0165 intervenci\u00ed zalo\u017een\u00fdch na seba-regul\u00e1cii v pr\u00edpade zmeny so zdrav\u00edm s\u00favisiaceho spr\u00e1vania u be\u017enej popul\u00e1cie ako aj u pacientov s chronick\u00fdmi ochoreniami, napr\u00edklad na zn\u00ed\u017eenie hmotnosti pri cukrovke 2. typu, na fyzick\u00fa aktivitu u \u013eud\u00ed s artrit\u00eddou, na zmene \u017eivotn\u00e9ho \u0161t\u00fdlu v r\u00e1mci rehabilit\u00e1cie po srdcovej pr\u00edhode, a na vyva\u017eovanie aktivity a odpo\u010dinku pri chronickom \u00fanavovom syndr\u00f3me.<\/p>\n

\"\"
Obr\u00e1zok: Cyklus seba-regul\u00e1cie.<\/figcaption><\/figure>\n

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

1) Podporujte jednotlivca pri formulovan\u00ed osobn\u00e9ho cie\u013ea zameran\u00e9ho na zmenu, ktor\u00fd by sa t\u00fdkal pr\u00edslu\u0161n\u00e9ho zdravotn\u00e9ho probl\u00e9mu (napr. ” Ako by mohlo vyzera\u0165 Va\u0161e zotavovanie sa?”). Tieto ciele by mali by\u0165 \u0161pecifick\u00e9, d\u00f4le\u017eit\u00e9 pre jednotlivca, nie pr\u00edli\u0161 jednoduch\u00e9 alebo pr\u00edli\u0161 \u0165a\u017ek\u00e9 a dosiahnute\u013en\u00e9 v obmedzenom \u010dasovom r\u00e1mci.<\/p>\n

2) Pom\u00f4\u017ete jednotlivcovi pri vytv\u00e1ran\u00ed ak\u010dn\u00e9ho pl\u00e1nu t\u00fdm, \u017ee sa sp\u00fdtate, kedy, kde, ako a ako dlho bude kona\u0165 vo vz\u0165ahu k stanoven\u00e9mu cie\u013eu.<\/p>\n

3) Po\u017eiadajte jednotlivca, aby vytvoril “cie\u013eov\u00fd rebr\u00edk”, ktor\u00fd definuje (hodnotite\u013en\u00e9) kroky smeruj\u00face k dosiahnutiu cie\u013ea.<\/p>\n

4) Zv\u00fd\u0161te seba-\u00fa\u010dinnos\u0165 jednotlivca t\u00fdm, \u017ee uk\u00e1\u017eete pr\u00edklady in\u00fdch, ktor\u00ed dosiahli porovnate\u013en\u00fd cie\u013e, povzbudzujte a chv\u00e1\u013ete ho pre dosiahnut\u00fd pokrok. U\u010dte jednotlivca, ako sa vyrovna\u0165 s prek\u00e1\u017ekami a recid\u00edvou.<\/p>\n

5) Podporujte udr\u017eiavanie cie\u013ea a pom\u00f4\u017ete jednotlivcovi pri preformulovan\u00ed dosahovania jeho cie\u013ea lep\u0161ie zvl\u00e1dnute\u013en\u00fdm sp\u00f4sobom, ak ho v s\u00fa\u010dasnej podobe pova\u017euj\u00fa za nedosiahnute\u013en\u00fd.<\/p>\n

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

By Stan Maes & V\u00e9ronique De Gucht, Leiden University, Netherlands Over the last decades, the role of individuals within the healthcare system has evolved from \u2018compliance with medical regimens\u2019, implying obedience; to \u2018self-management\u2019, denoting responsibility for the control of one\u2019s […]<\/p>\n","protected":false},"author":1,"featured_media":1029,"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":[24],"tags":[],"class_list":["post-975","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-self-regulation"],"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":true,"content":true,"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":true,"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\/975","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=975"}],"version-history":[{"count":31,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/975\/revisions"}],"predecessor-version":[{"id":4627,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/posts\/975\/revisions\/4627"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media\/1029"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/media?parent=975"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/categories?post=975"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/sk\/wp-json\/wp\/v2\/tags?post=975"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}