Ukwehliswa Kwezinkinga Zokudla: Kungokoqobo Noma Kuyinkohliso?

-Delile

• Ukuphazamiseka Kokudla Okufundwayo Okubalulekile
• Kungani Ukuphazamiseka Kwendlela Yokudla Kukhula Nge-COVID-19

I-comorbidity yisihloko esiyinkimbinkimbi, ngokomqondo nangokomtholampilo. Incazelo yokwehliswa komzimba ngokubuka komqondo ibhekisa esimweni lapho "ibhizinisi elihlukile lomtholampilo livela phakathi nesikhathi sesifo" - ngokwesibonelo lapho isiguli esinesifo sikashukela siqala isifo sikaParkinson. Kulokhu, kunezinto ezimbili ezihlukile zomtholampilo futhi kusetshenziswa umqondo wokuphila konke.

Incazelo ye-comorbidity kusuka endaweni yokubuka yomtholampilo ibhekisa, esikhundleni salokho, esimweni lapho "izinhlangano ezimbili noma ezingaphezulu ezihlukile zomtholampilo zihlala khona." Kulesi simo, ukwanda kwe-comorbidity kuncike encazelweni yokuphazamiseka (okungukuthi, uhlelo lokuhlukaniswa nemithetho yalo yokuxilonga).

Emkhakheni wezempilo yengqondo, lapho kungatholakali ama-biomarker athile kuze kube manje, kuyangabazeka ukuthi ngabe ukuphazamiseka kwengqondo okumbili yizinto "ezihlukile" zezinhlangano zokwelashwa, noma kumane kungumphumela wokuhlukaniswa kwamanje kokuphazamiseka kwengqondo okuthe, ngokususelwa kusibonakaliso esiveziwe, okukhuthazayo ukusetshenziswa kwezifo eziningi zengqondo esigulini esifanayo.

Izinkinga ezihlobene nencazelo ye-comorbidity zingaba nemiphumela ebalulekile yomtholampilo ethinta ukwelashwa. Isibonelo, izici zokudangala zivamile ezigulini ezinenkinga yokudla kepha zingaba ubufakazi bokuthi kukhona ukucindezeleka komtholampilo okukhona ('comorbidity true') noma umphumela oqondile wokukhuluphala ngokweqile ku-anorexia nervosa noma ukuzitika ngokudla ngokweqile e-bulimia nervosa ('inkohliso comorbidity ') (bona Umfanekiso 1). Esimweni sokuqala, ukucindezeleka komtholampilo kufanele kulashwe ngqo, kanti esimweni sesibili ukwelashwa kwesifo sokudla kufanele kuholele ekuxolelweni kwezici zokudangala.

Ukwehliswa kwezinkinga zokudla

Ukubuyekezwa okulandisayo kwezifundo zaseYurophu kuphethe ngokuthi abantu abangaphezu kwama-70% abanenkinga yokudla bathola ukuxilongwa kokugula kwengqondo. Izinkinga zengqondo ezivame kakhulu ezikhona ukubhekana nezinkinga zokukhathazeka (> 50%), ukuphazamiseka kwemizwelo (> 40%), ukuzilimaza (> 20%), nokuphazamiseka kokusebenzisa izidakamizwa (> 10%).

Kufanele kugcizelelwe ukuthi idatha evela ezifundweni ezenziwayo iveza ukwehluka okubanzi esilinganisweni se-psychiatric comorbidity ezinkingeni zokudla; ngokwesibonelo, ukwanda komlando wokuphila kwesifo sokukhathazeka kubikwe kwabambalwa njengama-25% kuya kwabangu-75% wamacala. Lolu hambo ngokungenakugwenywa lubeka ukungabaza okukhulu ekuthembekeni kwalokhu okubonwayo. Ngokunjalo, izifundo ezihlolisise ukwanda kokuphazamiseka kobuntu obukhona obukhona nezinkinga zokudla zibike ukwehluka okukhulu kakhulu, kusuka ku-27% kuya ku-93%!

Izinkinga zendlela

Izifundo ezihlolisise ukonakala kwezinkinga zokudla ziba nezinkinga ezinkulu zendlela. Isibonelo, umehluko bekungakahlali kwenziwa ukuthi ngabe i- "comorbid" disorder yenzeka ngaphambi noma ngemuva kokuphazamiseka kokudla; amasampula ahlolwe kaningi mancane futhi / noma afaka imikhakha yokuxilonga yokuphazamiseka kokudla ngezilinganiso ezehlukene; inombolo enkulu nexakile yezingxoxo zokuxilonga kanye nokuhlolwa okuzimele kusetshenziselwe ukuhlola ukungahambi kahle komzimba. Kodwa-ke, inkinga esemqoka ukuthi izifundo eziningi azizange zihlolisise ukuthi ngabe izici ze-comorbidity zazingaphansi kwesisindo esiphansi noma ukuphazamiseka ekudleni.

Ukuqothula noma amacala ayinkimbinkimbi?

Umbono wokuthi kune-subset kuphela "yamacala anzima" awunakusetshenziswa ezinkingeni zokudla Ngempela, cishe zonke iziguli ezinenkinga yokudla zingathathwa njengezimo eziyinkimbinkimbi. Iningi, njengoba kuchaziwe ngenhla, lihlangabezana nenqubo yokuhlonza isifo esisodwa noma eziningi zengqondo. Izinkinga zomzimba zivamile, kanti ezinye iziguli zikhona futhi zisebenzelana nezifo zezokwelapha. Ubunzima bokuxhumana nabantu bujwayelekile, futhi inkambo engapheli yesifo ingaba nomthelela omubi kakhulu ekukhuleni nasekusebenzeni komuntu. Konke lokhu kukhombisa ukuthi ezigulini ezinenkinga yokudla, ubunzima yinkambiso kunalokho okuhlukile.

Ukwahlukaniswa kokufakelwa kwezimo eziyinkimbinkimbi zomtholampilo zibe yizicucu ezincane zokuxilongwa kwengqondo kungaba nemiphumela emibi yokuvimbela indlela ephelele yokwelashwa nokukhuthaza ukusetshenziswa okungekho emthethweni kwezidakamizwa eziningana noma ukungenelela ukuphatha izingcezu ezilodwa zesithombe esibanzi futhi esiyinkimbinkimbi somtholampilo. Ngaphezu kwalokho, ukuhlolwa okunganembile nokuphathwa kwama-co-morbidities kungaba nomphumela ophikisayo wokugxilisa ukwelashwa ezintweni ezibalulekile ezigcina isifo sokugula kwengqondo se-psychopathology nokunikeza iziguli izindlela zokwelashwa ezingadingekile nezingaba yingozi.

Indlela e-pragmatic yamacala anzima

Ekwenzeni kwami ​​imitholampilo, ngisebenzisa indlela ebambekayo yokubhekana nokugula kwengqondo okuhambisana nokuphazamiseka kokudla. Ngiyabona futhi ekugcineni ngibhekane nokonakala kuphela uma kubalulekile futhi kunomthelela emtholampilo. Kuze kube manje, incwajana yokwelashwa kokuziphatha okuthuthukisiwe (CBT-E) yokuphazamiseka kokudla ihlukanisa ama-comorbidities abe ngamaqembu amathathu:

Ukuphazamiseka Kokudla Okufundwayo Okubalulekile

Kungani Ukuphazamiseka Kwendlela Yokudla Kukhula Nge-COVID-19