Ukudityaniswa kokuphazamiseka kwindlela yokutya: Ngaba iyinyani okanye ayisiyonyani?

Umxholo

• Ukuphazamiseka kwindlela yokutya kubalulekile ukuba kufundwe
• Kutheni le nto ukuphazamiseka kokutya kungaphaya kwe-COVID-19

IComorbidity sisihloko esintsonkothileyo, ngokwengqondo nangokwezonyango. Inkcazo yokudodobala ngokwembono yokujonga ibhekisa kwimeko apho "into ebonakalayo yeklinikhi ibonakala ngexesha lesifo" - umzekelo xa isigulana esinesifo seswekile siqala isifo sikaParkinson. Kule meko, kukho izinto ezimbini ezahlukileyo zeklinikhi kwaye kusetyenziswa umxholo wobomi bonke.

Inkcazo yokudodobala kwindawo yokubona yeklinikhi ibhekisa, endaweni yoko, kwimeko apho "izinto ezimbini okanye ezingaphezulu ezahlukileyo zeklinikhi zihlala khona." Kule meko, ubukho be-comorbidity buxhomekeke kwinkcazo yeziphazamiso (okt, inkqubo yokuhlelwa kunye nemigaqo yokuqonda isifo).

Kwicandelo lezempilo yengqondo, apho kungafunyanwanga zimpawu zikhoyo ukuza kuthi ga ngoku, kuyathandabuza ukuba ngaba ukuphazamiseka kwengqondo "kwahlukile" ngamayeza onyango, okanye sisiphumo soluhlu lwangoku lweengxaki zengqondo, ezisekwe kwimpawu ebonisiweyo, ekhuthazayo. ukusetyenziswa kwezifo ezininzi zengqondo kwisigulana esinye.

Iingxaki ezinxulumene nenkcazo ye-comorbidity zinokuba neziphumo ezibalulekileyo zekliniki ezichaphazela unyango. Umzekelo, iimpawu zoxinzelelo zixhaphakile kwizigulana ezinengxaki yokutya kodwa zinokuba bubungqina bokuba kukho uxinzelelo lweklinikhi olukhoyo ('comorbidity yokwenyani') okanye isiphumo esithe ngqo sokutyeba kakhulu kwi-anorexia amanosa okanye ukuzinkcinkca ngotywala kwi-bulimia nervosa ('ubuqhetseba comorbidity ') (jonga Umzobo 1). Kwimeko yokuqala, uxinzelelo lweklinikhi kufuneka lunyangwe ngokuthe ngqo, ngelixa kwimeko yesibini unyango lwesifo sokutya kufuneka lukhokelele kuxolelo kwiimpawu zokudakumba.

Ukomelela kwiingxaki zokutya

Ukuphononongwa ngokubalisayo kwezifundo zaseYurophu kugqitywe ukuba ngaphezulu kwama-70% abantu abanengxaki yokutya bafumana isifo se-psychiatric comorbidity. Ezona ngxaki zihlala zikho ngokubakho kwengqondo kukuphazamiseka koxinzelelo (> 50%), ukuphazamiseka kwemood (> 40%), ukuzenzakalisa (> 20%), kunye nokuphazamiseka kokusetyenziswa kweziyobisi (> 10%).

Kuya kugxininiswa ukuba idatha evela kwizifundo ezenziweyo ibonakalisa umahluko omkhulu kwinqanaba lokuphazamiseka kwengqondo kwizifo zokutya; umzekelo, ukuxhaphaka kwembali yobomi besifo esixhalabisayo kuye kwanikelwa ingxelo ngako njengambalwa njenge-25% ukuya kuthi ga kwi-75% yamatyala. Olu luhlu ngokuqinisekileyo lubeka amathandabuzo abalulekileyo ekuthembekeni kwezi zinto ziqwalaselweyo. Kwangokunjalo, izifundo ezivavanye ukuxhaphaka kokuphazamiseka kubuntu obukhoyo kunye neengxaki zokutya zichaze umahluko omkhulu ngakumbi, ukusuka kwi-27% ukuya kwi-93%!

Iingxaki zendlela

Izifundo ezivavanye ukonyuka kokuphazamiseka kwindlela yokutya zinengxaki yeendlela ezinzima. Umzekelo, umahluko bekungasoloko kusenziwa ukuba ngaba "comorbid" disorder yenzeka ngaphambi okanye emva kwengxaki yokutya; iisampulu ezivavanywa rhoqo zincinci kwaye / okanye zibandakanya iintlobo zokuqonda isifo sokuphazamiseka kumanqanaba ahlukeneyo; inani elikhulu kunye ne-heterogeneous inani lodliwanondlebe kunye novavanyo olwenziwe ngokwakho lusetyenziselwe ukuvavanya ukomelela. Nangona kunjalo, eyona ngxaki iphambili kukuba uninzi lwezifundo aluzange luvavanye ukuba ngaba iimpawu zekomorbidity zazisekondari kubunzima obuphantsi okanye ukuphazamiseka kukutya.

Comorbidity okanye iimeko ezinzima?

Uluvo lokuba kukho iseti kuphela "yamatyala antsonkothileyo" ayinakusetyenziswa kukuphazamiseka kwindlela yokutya Ngokwenene, phantse zonke izigulana ezinengxaki yokutya zinokuthathwa njengezona meko zinzima. Uninzi, njengoko kuchaziwe apha ngasentla, luhlangabezana neekhrayitheriya zokuchonga isifo esinye okanye nangaphezulu. Iingxaki zomzimba ziqhelekile, kwaye ezinye izigulana zikhona kunye nokusebenzisana ngezifo zonyango. Ubunzima ekuhlaleni buqhelekile, kwaye ikhosi engapheliyo yesifo inokuba nefuthe elibi kuphuhliso nasekusebenzeni komntu phakathi kwabantu. Konke oku kubonisa ukuba kwizigulana ezinengxaki yokutya, ubunzima ngumgaqo ngaphandle kokukhetha.

Ukwahlulahlulwa kweemeko ezintsonkothileyo zeklinikhi zibe ngamaqhekeza amancinci ovavanyo lwengqondo kunokuba neziphumo ezibi zokuthintela indlela ebanzi ngakumbi kunyango kunye nokukhuthaza ukusetyenziswa ngokungekho semthethweni kwamachiza aliqela okanye ungenelelo ukunyanga iziqwenga zomfanekiso weklinikhi obanzi kwaye unzima ngakumbi. Ngaphaya koko, uvavanyo oluchanekileyo kunye nolawulo lwee-co-morbidities lunokuba nefuthe lokuphikisa unyango kwizinto eziphambili ezigcina ukuphazamiseka kwengqondo ekutyeni nasekuhambiseni kwizigulana unyango olungafunekiyo nolunokuba yingozi.

Indlela ebambekayo yamatyala anzima

Kwindlela yam yezonyango, ndisebenzisa indlela ebambekayo yokujongana ne-psychiatric comorbidity enxulunyaniswa nokuphazamiseka kukutya. Ndiyayiqonda kwaye ekugqibeleni ndiyisombulule imeko yokuxinana kuphela xa ibalulekile kwaye ineziphumo zeklinikhi. Ukuza kuthi ga ngoku, incwadana yokuphucula indlela yokuziphatha kwengqondo (CBT-E) yokuphazamiseka kwindlela yokutya yahlulahlulahlulahlulahlulwe kwaba ngamaqela amathathu:

Ukuphazamiseka kwindlela yokutya kubalulekile ukuba kufundwe

Kutheni le nto ukuphazamiseka kokutya kungaphaya kwe-COVID-19