{"id":22,"date":"2016-11-01T21:26:01","date_gmt":"2016-11-01T21:26:01","guid":{"rendered":"http:\/\/medfam.ro\/neculau\/?page_id=22"},"modified":"2017-10-21T20:21:44","modified_gmt":"2017-10-21T20:21:44","slug":"autoingrijirea-pacientilor-conceptul","status":"publish","type":"page","link":"https:\/\/medfam.ro\/neculau\/educatie\/autoingrijirea-pacientilor-conceptul\/","title":{"rendered":"Autoingrijirea pacientilor &#8211; conceptul"},"content":{"rendered":"<div style=\"padding-bottom:20px; padding-top:10px;\" class=\"hupso-share-buttons\"><!-- Hupso Share Buttons - https:\/\/www.hupso.com\/share\/ --><a class=\"hupso_counters\" href=\"https:\/\/www.hupso.com\/share\/\"><img decoding=\"async\" src=\"https:\/\/static.hupso.com\/share\/buttons\/share-small.png\" style=\"border:0px; padding-top:2px; float:left;\" alt=\"Share Button\"\/><\/a><script type=\"text\/javascript\">var hupso_services_c=new Array(\"facebook_like\",\"facebook_send\",\"google\",\"print\");var hupso_counters_lang = \"ro_RO\";var hupso_image_folder_url = \"\";var hupso_url_c=\"\";var hupso_title_c=\"Autoingrijirea%20pacientilor%20-%20conceptul\";<\/script><script type=\"text\/javascript\" src=\"https:\/\/static.hupso.com\/share\/js\/counters.js\"><\/script><!-- Hupso Share Buttons --><\/div><p style=\"text-align: justify;\">To\u021bi pacien\u021bii cu afec\u021biuni cronice iau decizii legate de managementul bolii lor. \u00cencep\u00e2nd de la felul \u00een care g\u0103tesc \u0219i termin\u00e2nd cu felul cum \u00ee\u0219i organizeaz\u0103 timpul liber, de la felul cum \u00ee\u0219i planific\u0103 vizitele la medic sau cum \u00ee\u0219i respect\u0103 schema terapeutic\u0103, ei aplic\u0103 decizii personale care influen\u021beaz\u0103 \u00een mod semnificativ felul cum va evolua afec\u021biunea respectiv\u0103.<\/p>\n<p style=\"text-align: justify;\">\u00cenc\u0103 din 1993, un studiu [1] a demonstrat c\u0103 automonitorizarea nivelului glicemiei la pacientul cu diabet zaharat reprezint\u0103 o modalitate de cre\u0219tere a complian\u021bei la tratament. Auto\u00eengrijirea este reprezentat\u0103, \u00een ultim\u0103 instan\u021b\u0103, de modul \u00een care pacientul \u00ee\u0219i asum\u0103 responsabilitatea privind boala sa. Ce facem noi profesioni\u0219tii ca s\u0103 \u00eei sprijinim, cum comunic\u0103m cu ei, ce suport le oferim pentru a-i putea avea ca parteneri este un demers care necesit\u0103 o preg\u0103tire specific\u0103 a echipei medicale. Este recunoscut faptul ca mul\u021bi dintre pacien\u021bi a\u0219teapt\u0103 ca \u00een mod pasiv s\u0103 fie instrui\u021bi \/\u00a0sfatui\u021bi de c\u0103tre personalul medical, adopt\u00e2nd o atitudine pasiv\u0103, de acumulare a informa\u021biei, pe care o prelucreaz\u0103 ulterior. Pornind de la asump\u021bia ca nivelul de cuno\u0219tin\u021be influen\u021beaz\u0103 comportamentele, informa\u021biile sunt furnizate de c\u0103tre personalul medical \u00een func\u021bie de ceea ce este teoretic necesar unui anume tip de pacient. \u00cen modelul descris (\u0219i practicat \u00een prezent de majoritatea profesioni\u0219tilor medicali) decizia apar\u021bine medicului, iar pacientului i se solicit\u0103 aderen\u021ba la planul terapeutic stabilit.<\/p>\n<p style=\"text-align: justify;\">Un studiu [2] din 2002 arat\u0103 c\u0103 din 1000 de vizite la medic \u00een mai pu\u021bin de 9% din cazuri pacientul a fost implicat \u00een procesul de decizie. De aceea, cercet\u0103torii au fost preocupa\u021bi de identificarea unui mod de comunicare cu pacientul care s\u0103 devin\u0103 premiza unui parteneriat. \u00cen aceast\u0103 formul\u0103, denumit\u0103 decizie clinic\u0103 \u00een colaborare, informa\u021bia \u0219i abilit\u0103\u021bile sunt transmise \u00een mod corelat cu dorin\u021bele \u0219i solicit\u0103rile pacien\u021bilor.<\/p>\n<p style=\"text-align: justify;\">Mecanismele schimb\u0103rii care stau la baza acestui model sunt \u00eencrederea \u00een puterea de schimbare (denumit\u0103 de cercet\u0103tori \u2013 autoeficien\u021b\u0103) &#8211; \u0219i cunoa\u0219terea. Suportul pentru auto\u00eengrijire este reprezentat de m\u0103surile de sprijin pe care echipa de asisten\u021b\u0103 medical\u0103 le ofer\u0103 pacien\u021bilor cu afec\u021biuni cronice \u00een scopul \u00eencuraj\u0103rii asum\u0103rii de decizii zilnice [4]. Scopul acestui demers este \u00eembun\u0103t\u0103\u021birea comportamentelor legate de s\u0103n\u0103tate \u0219i a prognosticului afec\u021biunii respective. Suportul pentru auto\u00eengrijire poate fi oferit de c\u0103tre profesioni\u0219ti din diferite domenii de activitate: medici, asistente medicale, psihologi, educatori pentru s\u0103n\u0103tate, farmaci\u0219ti. Ace\u0219tia parcurg un proces specific de formare care le confer\u0103 abilitatea de a interveni cu tehnici de modificare comportamental\u0103 Programele de auto\u00eengrijire sunt o parte a suportului pe care profesioni\u0219tii \u00eel pun la dispozi\u021bia pacien\u021bilor cu boli cronice. Ele constau \u00een cursuri, interven\u021bii online destinate \u00eembun\u0103t\u0103\u021birii abilit\u0103\u021bilor de decizie ale pacien\u021bilor. O metaanaliza a 22 de studii [5] a demonstrat c\u0103 aceste interven\u021bii produc rezultate pozitive legate de participarea la procesul de \u00eengrijire sau de aderen\u021b\u0103 la scheme de tratament specifice fiecarei boli (ex. corecta utilizare a medica\u021biei antiasmatice). Pentru a putea fi \u00eendeplinite obiectivele unui program de auto\u00eengrijire, pacien\u021bii au nevoie de:<\/p>\n<ul style=\"text-align: justify;\">\n<li>informa\u021bii medicale;<\/li>\n<li>\u00een\u021belegerea modelului \u0219i a modului \u00een care pot fi asista\u021bi \u00een construirea de abilit\u0103\u021bi;<\/li>\n<li>sprijin efectiv, continuu din partea echipei de profesioni\u0219ti, a familiei \u0219i a comunit\u0103\u021bii (Institute for Healthcare Improvement).<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Informa\u021biile medicale devin tot mai accesibile pacien\u021bilor prin diferite medii. Pliante, bro\u0219uri, reviste, articole \u00een ziare, resurse web &#8211; sunt doari c\u00e2teva exemple \u00een acest sens. Evolu\u021bia dinamic\u0103 a societ\u0103\u021bii arat\u0103 interesul crescut pentru resursele web. Un studiu american [3] din 2005 a ar\u0103tat c\u0103 aproximativ 46% din persoanele adulte din USA au consultat Internetul pentru probleme medicale. Aceste materiale ajut\u0103 pacien\u021bii s\u0103-\u0219i \u00eenteleag\u0103 diagnosticul, tratamentul \u0219i managementul general al afec\u021biunii.<\/p>\n<p style=\"text-align: justify;\"><strong>Bibliografie:<\/strong><\/p>\n<ol>\n<li>1. US Food and Drug Administration, Blood Glucose and Diabetes Management<\/li>\n<li>2. Norris, S. L., Nichols, P. J., Caspersen, C. J., Glasgow,R. E., Engelgau, M. M., Jack, L., et al. 2002. The Effectiveness of Disease and Case Management for People with Diabetes. A Systematic Review. American Journal of Preventive Medicine 22 (4 Supplement); 1538.<\/li>\n<li>3. Rainie, Lee, and Horrigan, John. 2005. A decade of Adoption: How the internet has Woven itself into American Life, Pew Research Center.January 2005)<\/li>\n<li>4. Bodenheimer T., MacGregor K. Sharifi C. Helping patients manage their chronic conditions. California Health care Foundation. June 2006<\/li>\n<li>5. Wantland, et al 2004. The Effectiveness of Web-based vs. Non- Web- Based Interventions. A metaanalisis of Behavioral Change Outcomes Journal of Medical Internet Research. October 11<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<div style=\"padding-bottom:20px; padding-top:10px;\" class=\"hupso-share-buttons\"><!-- Hupso Share Buttons - https:\/\/www.hupso.com\/share\/ --><a class=\"hupso_counters\" href=\"https:\/\/www.hupso.com\/share\/\"><img src=\"https:\/\/static.hupso.com\/share\/buttons\/share-small.png\" style=\"border:0px; padding-top:2px; float:left;\" alt=\"Share Button\"\/><\/a><script type=\"text\/javascript\">var hupso_services_c=new Array(\"facebook_like\",\"facebook_send\",\"google\",\"print\");var hupso_counters_lang = \"ro_RO\";var hupso_image_folder_url = \"\";var hupso_url_c=\"\";var hupso_title_c=\"Autoingrijirea%20pacientilor%20-%20conceptul\";<\/script><script type=\"text\/javascript\" src=\"https:\/\/static.hupso.com\/share\/js\/counters.js\"><\/script><!-- Hupso Share Buttons --><\/div><p>To\u021bi pacien\u021bii cu afec\u021biuni cronice iau decizii legate de managementul bolii lor. \u00cencep\u00e2nd de la felul \u00een care g\u0103tesc \u0219i termin\u00e2nd cu felul cum \u00ee\u0219i organizeaz\u0103 timpul liber, de la felul cum \u00ee\u0219i planific\u0103 vizitele la medic sau cum \u00ee\u0219i respect\u0103 schema terapeutic\u0103, ei aplic\u0103 decizii personale care influen\u021beaz\u0103 \u00een mod semnificativ felul cum va&hellip; <br \/> <a class=\"button small blue\" href=\"https:\/\/medfam.ro\/neculau\/educatie\/autoingrijirea-pacientilor-conceptul\/\">Cite\u0219te mai mult<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":16,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"class_list":["post-22","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/pages\/22","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/comments?post=22"}],"version-history":[{"count":15,"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/pages\/22\/revisions"}],"predecessor-version":[{"id":569,"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/pages\/22\/revisions\/569"}],"up":[{"embeddable":true,"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/pages\/16"}],"wp:attachment":[{"href":"https:\/\/medfam.ro\/neculau\/wp-json\/wp\/v2\/media?parent=22"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}