{"id":936,"date":"2013-12-02T21:29:03","date_gmt":"2013-12-02T19:29:03","guid":{"rendered":"http:\/\/slanedeti.sk\/cms\/subjektivne-prezivanie-kvality-zivota-u-pacientov-s-cystickou-fibrozou-1-cast-2\/201312"},"modified":"2013-12-31T17:25:16","modified_gmt":"2013-12-31T16:25:16","slug":"subjektivne-prezivanie-kvality-zivota-u-pacientov-s-cystickou-fibrozou-1-cast-2","status":"publish","type":"post","link":"https:\/\/slanedeti.sk\/cms\/subjektivne-prezivanie-kvality-zivota-u-pacientov-s-cystickou-fibrozou-1-cast-2\/936","title":{"rendered":"Subjekt\u00edvne pre\u017e\u00edvanie kvality \u017eivota u pacientov s cystickou fibr\u00f3zou – 1. \u010das\u0165"},"content":{"rendered":"

Chronick\u00e9 ochorenie neovplyv\u0148uje negat\u00edvne len fyzick\u00fa str\u00e1nku osobnosti, m\u00e1 tie\u017e vplyv na kvalitu \u017eivota. Term\u00edn kvalita \u017eivota sa v posledn\u00fdch dvoch desa\u0165ro\u010diach stal ve\u013emi popul\u00e1rnym. V\u00fdskum v tejto oblasti si z\u00edskava st\u00e1le v\u00e4\u010d\u0161iu d\u00f4le\u017eitos\u0165 i napriek tomu, \u017ee pojem kvality \u017eivota nie je jednozna\u010dne a jednotne definovan\u00fd. Je to \u0161irok\u00fd multidimenzion\u00e1lny koncept, ktor\u00fd zah\u0155\u0148a fyzick\u00fa, funk\u010dn\u00fa, psychologick\u00fa a soci\u00e1lnu dimenziu. Kvalitu \u017eivota m\u00f4\u017eeme ch\u00e1pa\u0165 aj ako viacfaktorov\u00fd kon\u0161trukt, ktor\u00fd opisuje jednotlivcovo vn\u00edmanie fyzick\u00e9ho, psychologick\u00e9ho a soci\u00e1lneho fungovania.<\/p>\n

Pre\u010do je vlastne d\u00f4le\u017eit\u00e9 zis\u0165ova\u0165 kvalitu \u017eivota u pacientov s chronick\u00fdm ochoren\u00edm? Jedn\u00fdm z d\u00f4vodov je, \u017ee kvalita \u017eivota reprezentuje funk\u010dn\u00fd efekt ochorenia a tie\u017e n\u00e1slednej terapie na pacienta. Subjekt\u00edvne hodnotenie kvality \u017eivota m\u00f4\u017ee by\u0165 pou\u017eit\u00e9 zdravotn\u00edckym person\u00e1lom ako skr\u00edningov\u00fd n\u00e1stroj pre identifik\u00e1ciu pacientov, u ktor\u00fdch je zv\u00fd\u0161en\u00e9 riziko nepriazniv\u00fdch zdravotn\u00fdch v\u00fdsledkov. M\u00f4\u017ee by\u0165 tie\u017e psychosoci\u00e1lnym ukazovate\u013eom, ktor\u00fd pom\u00e1ha pri h\u013eadan\u00ed individu\u00e1lne \u0161pecifickej fyzickej alebo psychologickej intervencie umo\u017e\u0148uj\u00facej zlep\u0161enie zdravotn\u00e9ho stavu a kvality \u017eivota u pacientov s chronick\u00fdmi ochoreniami. Meranie kvality \u017eivota je vhodn\u00e9 pou\u017ei\u0165 aj pri hodnoten\u00ed a porovnan\u00ed efektivity r\u00f4znych intervenci\u00ed.<\/p>\n

Cystick\u00e1 fibr\u00f3za sp\u00f4sobuje u pacientov zna\u010dn\u00fd emocion\u00e1lny stres a vy\u017eaduje intenz\u00edvnu, \u010dasovo n\u00e1ro\u010dn\u00fa denn\u00fa terapiu, \u010do spolo\u010dne m\u00f4\u017ee ma\u0165 ve\u013emi nepriazniv\u00fd vplyv na kvalitu \u017eivota. Kvalitu \u017eivota pacientov s CF a tie\u017e d\u013a\u017eku ich \u017eivota ovplyv\u0148uje viacero skuto\u010dnost\u00ed, ako s\u00fa multidisciplin\u00e1rna \u0161pecializovan\u00e1 zdravotn\u00edcka starostlivos\u0165, efektivita met\u00f3d lie\u010dby a vek diagnostikovania ochorenia. Kvalitu \u017eivota a pre\u017e\u00edvanie ovplyv\u0148uj\u00fa mnoh\u00e9 faktory. S\u00fa to napr\u00edklad faktory biologick\u00e9 a fyziologick\u00e9, ako pr\u00edtomnos\u0165 p\u013e\u00facnych infekci\u00ed \u010di pankreatick\u00e1 nedostato\u010dnos\u0165, socioekonomick\u00e9 faktory ako neadekv\u00e1tne alebo \u017eiadne zdravotn\u00e9 poistenie, ktor\u00e9 b\u00fdvaj\u00fa spojen\u00e9 so zn\u00ed\u017eenou kvalitou \u017eivota a pre\u017eitia. V\u00fdskumy preuk\u00e1zali, \u017ee \u010fal\u0161\u00edm faktorom ovplyv\u0148uj\u00facim kvalitu \u017eivota je pohlavie, ktor\u00e9 hr\u00e1 vo vn\u00edman\u00ed kvality \u017eivota podstatn\u00fa rolu.
\nMedzi prv\u00e9 v\u00fdskumy kvality \u017eivota CF pacientov patril v\u00fdskum Orensteina (1989), ktor\u00fd zistil signifikantn\u00fa pozit\u00edvnu korel\u00e1ciu medzi p\u013e\u00facnymi funkciami a funk\u010dnou aktivitou. Podobne Kaplan et al. (1989) v \u010fal\u0161om v\u00fdskume zistil pozit\u00edvnu korel\u00e1ciu medzi p\u013e\u00facnymi funkciami, rehabilit\u00e1ciou a v\u00fdsledkami v \u0161k\u00e1le meraj\u00facej kvalitu \u017eivota. Tieto \u0161t\u00fadie patrili k prv\u00fdm d\u00f4le\u017eit\u00fdm krokom vo v\u00fdskume kvality \u017eivota pacientov s CF. Sk\u00faman\u00e9 tie\u017e bolo, \u010di pacientmi poci\u0165ovan\u00e1 kvalita \u017eivota m\u00f4\u017ee predikova\u0165 d\u013a\u017eku ich pre\u017eitia. Zhroma\u017eden\u00fd bol s\u00fabor vy\u0161e 220 pacientov s CF a bola zis\u0165ovan\u00e1 kvalita ich \u017eivota a zdravotn\u00fd stav. Na z\u00e1klade meran\u00ed zopakovan\u00fdch po 10 rokoch sa dve dimenzie kvality \u017eivota, a to fyzick\u00e9 fungovanie a poci\u0165ovan\u00e1 boles\u0165 uk\u00e1zali ako v\u00fdznamn\u00fd prediktor d\u013a\u017eky pre\u017eitia. Tento v\u00fdsledok nazna\u010duje, \u017ee fyzick\u00e9 fungovanie a soci\u00e1lne fungovanie, spolu s poci\u0165ovanou boles\u0165ou s\u00fa relevantn\u00fdmi faktormi progn\u00f3zy pacientov s CF.<\/p>\n

V\u00fdskumy sa zamerali tie\u017e na porovnanie pacientov s chronick\u00fdmi ochoreniami a zdravej popul\u00e1cie. V\u00fdsledkom bola ni\u017e\u0161ia poci\u0165ovan\u00e1 kvalita \u017eivota pacientmi s astmou, diabetes a CF v porovnan\u00ed s kvalitou \u017eivota poci\u0165ovanou zdrav\u00fdmi rovesn\u00edkmi. Pacienti s chronick\u00fdm ochoren\u00edm, vr\u00e1tane CF, uv\u00e1dzali, \u017ee ochorenie im br\u00e1ni vo vykon\u00e1van\u00ed fyzick\u00fdch aktiv\u00edt, prek\u00e1\u017ea im pri plnen\u00ed si \u0161kolsk\u00fdch povinnost\u00ed a pri vo\u013eno-\u010dasov\u00fdch aktivit\u00e1ch s priate\u013emi \u010di rodinou.<\/p>\n

Vybran\u00e9 aspekty psychick\u00e9ho stavu pacientov s cystickou fibr\u00f3zou<\/strong><\/h4>\n

Cystick\u00e1 fibr\u00f3za je pova\u017eovan\u00e1 za stigmatizuj\u00face ochorenie, ktor\u00e9 v\u00fdrazne pozna\u010duje \u017eivoty t\u00fdch, ktor\u00ed s\u00fa n\u00edm postihnut\u00ed. Pr\u00ed\u010dinou stigmy u pacientov s CF s\u00fa telesn\u00e9 rozdiely, badate\u013en\u00e9 rozdiely vo fyzickej v\u00fddr\u017ei, neust\u00e1ly ka\u0161e\u013e a tie\u017e mo\u017en\u00fd dojem n\u00e1kazlivosti ochorenia. Vplyv stigmatiz\u00e1cie je najkritickej\u0161\u00ed v obdob\u00ed detstva a adolescencie, kedy s\u00fa formovan\u00e9 soci\u00e1lne vz\u0165ahy a identita jednotlivca. Stigmatiz\u00e1cia m\u00f4\u017ee ma\u0165 nepriazniv\u00fd vplyv na dodr\u017eiavanie lie\u010dby, socializ\u00e1ciu a vz\u0165ahy s rodinn\u00fdmi pr\u00edslu\u0161n\u00edkmi, \u010do m\u00e1 priamy dopad na kvalitu \u017eivota.<\/p>\n

\"kvalita_zivota_cf1\"<\/div>\n

Napriek tomu, \u017ee bolo uskuto\u010dnen\u00e9 mno\u017estvo v\u00fdskumov psychick\u00e9ho stavu pacientov s CF, n\u00e1zory na t\u00fato problematiku sa st\u00e1le r\u00f4znia. Je prekvapiv\u00e9, \u017ee pokia\u013e sa ochorenie nezhor\u0161\u00ed, psychick\u00e9 fungovanie pacientov s CF sa neodli\u0161uje od psychick\u00e9ho fungovania zdravej popul\u00e1cie. Dospel\u00ed pacienti s CF vo v\u0161eobecnosti vykazuj\u00fa relat\u00edvne zdrav\u00e9 psychick\u00e9 fungovanie, \u010di\u017ee sa d\u00e1 poveda\u0165, \u017ee nevykazuj\u00fa v\u00fdznamn\u00fa \u00farove\u0148 depresie, anxiety \u010di psychopatologick\u00fdch sympt\u00f3mov. Lep\u0161ie p\u013e\u00facne funkcie a siln\u00e1 soci\u00e1lna podpora s\u00fa prediktormi lep\u0161ieho psychick\u00e9ho stavu a tie\u017e ni\u017e\u0161ej anxiety.<\/p>\n

U pacientov trpiacich chronick\u00fdm ochoren\u00edm je zv\u00fd\u0161en\u00e9 riziko depresie s v\u00e1\u017enym priamym i nepriamym vplyvom na zdravotn\u00fd stav. V\u00fdskumy porovn\u00e1vaj\u00face skupiny mlad\u0161\u00edch a star\u0161\u00edch pacientov uv\u00e1dzaj\u00fa nieko\u013eko zisten\u00ed. Sympt\u00f3my por\u00fach pr\u00edjmu potravy sa viac vyskytuj\u00fa vo vekovej skupine 8 a\u017e 15 rokov a sympt\u00f3my depresie a anxiety s\u00fa zase \u010dastej\u0161ie v skupine star\u0161\u00edch pacientov, a to vo veku 16 a\u017e 40 rokov. Depres\u00edvne sympt\u00f3my s\u00fa roz\u0161\u00edrenej\u0161ie u star\u0161\u00edch pacientov, u ktor\u00fdch s\u00fa tie\u017e spojen\u00e9 so sympt\u00f3mami anxiety. Star\u0161\u00ed pacienti s\u00fa v porovnan\u00ed s mlad\u0161\u00edmi \u00fazkostlivej\u0161\u00ed, c\u00edtia sa nepr\u00edjemne v soci\u00e1lnych situ\u00e1ci\u00e1ch, viac o sebe pochybuj\u00fa a vykazuj\u00fa viac emocion\u00e1lnych konfliktov prostredn\u00edctvom fyzick\u00fdch sympt\u00f3mov. \u010co sa t\u00fdka genderov\u00fdch rozdielov, mu\u017esk\u00e9 pohlavie je prediktorom vy\u0161\u0161ej \u00farovne depresie a anxiety.<\/p>\n

\"kvalita_zivota_cf2\"<\/div>\n
<\/div>\n

Sympt\u00f3my anxiety a depresie s\u00fa rizikov\u00fdm faktorom pre zvl\u00e1danie ochorenia, maj\u00fa negat\u00edvny vplyv na dodr\u017eiavania lie\u010dby, sp\u00f4sobuj\u00fa zv\u00fd\u0161en\u00fa chorobnos\u0165 a celkov\u00e9 zhor\u0161enie zdravotn\u00e9ho stavu. Anxieta i depresia s\u00fa spojen\u00e9 s negat\u00edvnej\u0161\u00edm rodinn\u00fdm fungovan\u00edm, hor\u0161\u00edmi zdravotn\u00fdmi v\u00fdsledkami a taktie\u017e s hor\u0161ou kvalitou \u017eivota. Ni\u017e\u0161\u00ed stupe\u0148 dodr\u017eiavania lie\u010dby s\u00favis\u00ed \u0161peci\u00e1lne s depresiou. Pod\u013ea s\u00fa\u010dasn\u00fdch v\u00fdskumov s\u00fa sympt\u00f3my anxiety u pacientov s CF \u010dastej\u0161ie ako depresia. Depres\u00edvne sympt\u00f3my s\u00fa nepriamo \u00famern\u00e9 s p\u013e\u00facnymi funkciami, depres\u00edvne sympt\u00f3my sa teda zni\u017euj\u00fa so zvy\u0161uj\u00facimi sa p\u013e\u00facnymi funkciami na spirometrickom vy\u0161etren\u00ed. Vy\u0161\u0161ie depres\u00edvne sympt\u00f3my s\u00fa vo vz\u0165ahu s hor\u0161ou kvalitou \u017eivota. Na lie\u010denie depresie je dostupn\u00e1 psychologick\u00e1 i farmakologick\u00e1 intervencia, av\u0161ak pacientmi s CF e\u0161te nebola zhodnoten\u00e1.<\/p>\n","protected":false},"excerpt":{"rendered":"

Chronické ochorenie neovplyvňuje negatívne len fyzickú stránku osobnosti, má tiež vplyv na kvalitu života. Termín kvalita života sa v posledných dvoch desaťročiach stal veľmi populárnym. Výskum v tejto oblasti si získava stále väčšiu dôležitosť i napriek tomu, že pojem kvality … Continued<\/a><\/p>\n","protected":false},"author":10,"featured_media":951,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"kt_blocks_editor_width":"","footnotes":""},"categories":[253],"tags":[],"class_list":["post-936","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-o-cystickej-fibroze"],"yoast_head":"\nSubjekt\u00edvne pre\u017e\u00edvanie kvality \u017eivota u pacientov s cystickou fibr\u00f3zou - 1. \u010das\u0165 - Slan\u00e9 deti<\/title>\n<meta name=\"description\" content=\"Kvalitu \u017eivota pacientov s cystickou fibr\u00f3zou a tie\u017e d\u013a\u017eku ich \u017eivota ovplyv\u0148uje viacero skuto\u010dnost\u00ed. 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