Kuongorora kunamata-utano hwehutano
Kubvira pakupera kwema1990, kwakave nekuputika kwehuwandu hwezvidzidzo zvakagadzirirwa kuongorora basa iro kunamata nechitendero kune zvehutano. Pakazosvika 2001 na2011, nhamba yezvidzidzo zvekutsvakurudza kuongorora hukama hwehutano hwehutano hwakapetwa kanopfuura kaviri, kubva pa1200 kusvika ku3000.
Kuvandudza mune pharmacology ndeimwe chikonzero chikuru chekuchinja.
Nemhaka yokuti tatova nemishonga yakawanda yakawanda yatinogona kuwana, kune chido chikuru pakuongorora basa rechitendero uye zvekunamata mune hutano.
Pasinei nokuwedzera kwechido, zvisinei, ukama huri pakati pechitendero / humweya uye hutano hunoramba husingarevi uye hunooma kuongorora. Manzwiro evanhu, maitiro, uye zvitendero hazvisi zvinyoro, zvakaoma, uye zvinogadzirisa. Nzira dzinotarisana nedzimwe nhamba, iyo ikozvino inoshandiswa kuongororwa uku kunamata-hutano hwehutano, haisi iyo mishonga yakanakisisa yekujekesa kunzwisisa kwenyaya iyi yakaoma.
Kunyange zvakadaro, mazana ezvidzidzo akaratidza kuwirirana kwakanaka pakati pechitendero / humweya uye hutano. Ngatinyatsoongororai zvimwe zvezvinetso zvakaoma zvakapoteredza iyi link.
Tsanangudzo
Tisati tatarisa shamwari, zvakakosha kutsanangura mazwi "chitendero" uye "kunamata."
Muchikamu chekuongorora zvegore ra2015 chinonzi "Chitendero, Zvokunamata, uye Utano: Kuongorora uye Kuvandudza," Koenig akatsanangura chitendero sezvinotevera:
Chitendero chinosanganisira zvitendero uye zviito zvakabatana neTranscendent. MuTsika dzeMadokero, Transcendent inogona kunzi Mwari, Allah, HaShem, kana Simba Rokudenga, uye mumitambo yeEastern, Transcendent inogona kunzi Vishnu, Ishe Krishnan, Buddha, kana Icho Chinhu Chaicho Chaicho. Zvitendero zvinowanzova nemitemo yekutungamirira maitiro panyika uye dzidziso pamusoro pehupenyu mushure mekufa. Chitendero chinowanzorongwa senharaunda asi chinogonawo kuva kunze kwechirongwa uye chinogona kuitwa chega kana chega.
Kwenguva refu, zvaifungidzirwa kuti kunamata kwaiva pamucheto wekunamata. Zvisinei, vanhu vazhinji avo vemuMweya havateereri kudzidziso dzechitendero. Nokudaro, zvinorehwa nekunamata zvakashanduka. Zvakare, maererano naKoenig:
Zvomudzimu, zvisinei, zvave zvichinyanya kupararira, kusanganisira kwete ivo chete avo vanonyanya kuda zvechitendero, asiwo avo vasina kunyanya kunamata neavo vasingatendi zvachose (kureva, vanhu vanoita zvekunamata). Kutaura zvazviri, ukama hwemweya hwave huri kunyanya kuzvitsanangura uye hunogona kureva chero chinhu chipi nechipi munhu anoda kuti chireve.
Nenzira, vanhu vepanyika vanofunga kuti hupenyu hwevanhu husina simba rakakwirira uye panzvimbo iyoyo vanoisa pfungwa pamanzwiro evanhu, munharaunda, uye nesayenzi.
Zvinonyanya kukosha, kutsvakurudza kwepamweya kunoratidza kuti, kune vakawanda, kunamata ndeye chikamu chekuve munhu uye kunosanganisira pfungwa yekubatana nevamwe. Inobatsira vanhu kuvanzwira tsitsi uye kutarisira kune avo vakavapoteredza. Munguva yechirwere, kunamata kunogona kubatsira nekudzikinura kuburikidza nekuita nekuzvidzivirira nekuita kuti kukura kudarika zvinokonzera kurwara.
MuChipical Setting
Vanachiremba vane maonero akasiyana ekunamata pane kuvarwere. Izvi zvingangodaro zvinokonzera kuoma kwakaitwa navanachiremba nekunamata mune zvekunamata.
Kunyange zvazvo vanachiremba nevarwere vachiratidza kunzwisisa kwakadaro kwezvinoreva zvekunamata, basa rekunamata mukudzoka kwehutano kunoonekwa zvakasiyana. Chimbofunga ndima inotevera kubva muna 2016 kudzidza yakabudiswa muBCC Psychiatry .
Vatengi [varwere] vaiwanzoona kubatana kune vamwe nechitendero sezvikonzero zvekuzadzika kwezvido zvavo zvemukati zve rudo, kutarisira, uye kugamuchirwa. Vamwe vavo vakazviona ivo sevashandi vanogona kushandisa zviitiko zvavo kubatsira vamwe. Vashandi [vashandi vezvehutano], kune rumwe rutivi, vakaona hukama huno sehunobata, zvakadai kuti vatengi vangawana rubatsiro rwevanhu kubva kune vamwe, izvo zvingagona kubatsira kugadzirisa pfungwa dzavo nezviratidzo.
Muzvirongwa zvekurapwa, izwi rokuti kunamata kunofanirwa kuve nekutenda nokuti murwere anokwanisa kurondedzera ukama hwemufananidzo mune fashoni inonzwisisa. Kunamata kunoshanda sekubata-zvose kune maonero akasiyana-siyana enyika. Zvisinei, mune zvidzidzo zvekliniki, kuwirirana kwehumwe hwemweya kwakaoma kuputsa; asi, pane zvakajeka zvikuru nezviratidzo zvechitendero. Mushure mezvose, zvinhu zvakadai sekunamatira, kupinda misangano yechitendero, nezvimwe zvinogona kuverengerwa.
Kana zviri nyore uye zvakajeka, munyaya ino, tichagashira izwi rakasiyana-siyana rakataurwa naKoenig: chitendero / zvekunamata.
Associating Associations
Mumabhuku ake akadzokorora, Koenig akapfupikisa kuti iye neboka rake vakaongorora sei zvidzidzo zve 3300 zvakabudiswa pamberi pegore ra2010 kusarudza kushamwaridzana pakati pehutano nechitendero / zvekunamata. Ongororo yeKoenig yaiva yakazara uye inosanganisira mupfungwa, hutsika, tsika, uye utano hwepanyama.
Itafura inotevera inosimbisa migumisiro kubva kuongororo yekuongorora iyo Koenig yaifunga kuti yakakwirira: zvidzidzo zvehutano nehutano hwekutsvakurudza, nzira, zviyero, kuongororwa kwenhamba, nekududzirwa.
| Mamiriro | Nhamba Yezvidzidzo NeZviitiko Zvakanaka |
|---|---|
| Kuvandudza Utano | 82% |
| Kuvandudza Chinangwa & Chinangwa | 100% |
| Kuwedzera kuzvikudza | 68% |
| Tariro Yakakura | 50% |
| Kuwedzera Kunaka | 73% |
| Kupera Kunetseka | 57% |
| Kupera Kuzviuraya | 80% |
| Kuderedza Kuora Mwoyo | 67% |
| Kuderedza Kunwa Doro Doro | 90% |
| Kuderedza Kudhakwa Kwezvinodhaka | 86% |
| Kuwedzera Kudzidzira | 76% |
| Kuvandudza Diet | 70% |
| Kupera kweCholesterol | 56% |
| Yakaderedza Cigarette Kusvuta | 90% |
| Kuvandudza muCoronary Disease | 69% |
| Kuwedzerwa Kufa | 66% |
| Kuvandudzwa Kwemwoyo Mushonga | 69% |
Mukuwedzera pakatarisa zvidzidzo zvakabudiswa pamberi pa2010, Koenig akatarisa masangano pakati pechitendero / zvekunamata uye hutano mune tsvakurudzo ichangopfuura.
Kuora mwoyo
Mune chidzidzo paKunivhesiti yeUnited University, masayendisiti epfungwa dzepfungwa anoshandisa maitiro ekugadzira MRI kuti aongorore vatori vechikamu vari pangozi yekutambudzika. Pakupedzisira, vatsvakurudzi vakaona kuti njodzi yokuderedza kuora mwoyo yaiva 90 muzana pasi kune vanhu vane chitendero / zvekunamata zvakakosha zvikuru. Ikoko vakawana kuti nzvimbo huru dze cortex (dzinofanirwa nehupamhi-huropi hunoita) huripo humwe humispheres dzaive dzakatapudzwa kune vatori vechikamu vari pangozi yekutambudzika. Zvisinei, vanhu vaive vechitendero / vekunamata vakaratidza kuderera kwakanyanya kwekortical.
Kunyangwe ichi chidzidzo chakanga chisingaratidzi kuti chitendero / humweya hwakakonzera kuderera kwekortical shoma, vatsvakurudzi vakafunga kuti chitendero / ukama hwakabatsira kudzivirira kudzivisa kuora mwoyo.
Kuzviuraya
Chimwe chidzidzo chakawana kuti pakati pevanhu 20 014 vakatevera kwemakore gumi nemashanu, dambudziko rekuzviuraya raive mazana makumi mapfumbamwe kubva muzana muvatori vechikamu vaipinda misangano yechitendero kanenge ka24 pagore kana vachienzanisa nevaya vakapinda maitiro akadaro kashoma. Vatsvakurudzi vanoratidza kuti kugara vachienda kune zvekunamata zvinogona kudzivirira kudzivisa kuzviuraya kwenguva refu.
Kufunganya
Kubva pakutsvakurudza kwe2010 Baylor Religion Survey, vatsvakurudzi vakaona kuti pakati pevane 1511 vakapindura, avo vane ruvimbo rwakachengeteka kuna Mwari avo vakapinda munamato vakawana zviratidzo zvishoma zvekuzvidya mwoyo. Mune avo vane chisungo chisingaverengeki kuna Mwari, munyengetero wakanga wakabatana nehuwandu hwekunyanya kunetseka zviratidzo. Izvi zvinowirirana neongororo dzakawanda dzakawanda.
Cystic Fibrosis
Muboka duku revana vemakore makumi mana nemakumi mana nemakore vari kuyaruka vane cystic fibrosis iyo yakateverwa kwemakore mashanu, vatsvakurudzi vakawana kuti maitiro makuru ekubatana kwechitendero, zvakadai semisangano yekunamatira nekuenda kumapoka evechidiki echechi, aibatanidza nekunonoka kuderera mune zvekudya, kunonoka kuderera mubasa remapapu, uye mazuva mashomanana akapedza muchipatara gore rose. Kunyanya, vanhu vane huwandu hwakawanda hwekutenda kwechitendero hwakanaka vakapedza mavhareji kwemazuva matatu pagore muchipatara vachienzaniswa nemazuva 125 pagore kune avo vane huwandu hwakanaka hwekutenda kwechitendero.
Sezviri pachena, kushushikana kwechitendero kwakanaka kwakashanda sekutsigirwa uye kudzivirirwa pakunetseka uye kunetseka. Uyezve, vachiri kuyaruka vakapinda mumabasa echitendero kana mune zvekunamata zvakadaro vaiwanzoita muhutano hwehutano hwakanaka uye kushandisa masangano ekurapa zvakakodzera.
HIV
Vatsvakurudzi vanobva kuYunivhesiti yeMiami vakatevera vanhu vane HIV vane makore maviri uye vakaongorora hutachiona hweHIV kuburikidza nekuyera hutachiona hwehutachiwana muropa. Vatsvakurudzi vakatarisa kuwedzera kwehutachiona hunotevera mushure mekufa kwewaidiwa (kureva, kufirwa) kana kurambana. Vakaona kuti kuwedzera kwechitendero / zvekunamata kwakagara kuchifananidzira kuwedzera kuduku kwehutachiona hwehutachiona kubva pachiyero chekutanga shure kwechiitiko chinotyisa. Nenzira, avo vanotsvakurudza vanoronga nezvemishonga inorwisa mabhakitiriya uye hutachiona hwehutachiona hunotangira.
Mune mamwe mazwi, mumamiriro ezvinhu apo zvimwe zvose zvaive zvakaenzana, vatori vechikamu vaHIV vainge vari vechitendero / vekunamata vakaona kuwedzera kwehutachiona hwehutachiwana-kuratidza huwandu hushoma hwekuita hutachiona hweHIV-mushure mekunyanya kushungurudzwa kwehupenyu kupfuura avo vakanga vasingatendi / vekunamata .
ICU Care
Tsvakurudzo dzinoverengeka dzechangobva kuongorora dzakaongorora zvinodiwa zvomudzimu zvevaya vanobata nehutano hwakakomba kana husingaperi. Kunyanya, mubhuku ra2014 rakabudiswa muCritical Care Medicine, Johnson nevamwe vaishanda navo vakawana kuti pakati pevanhu vemhuri 275, mabasa akawanda ekutarisira pakunamata uye nhamba yakawanda yekukurukurirana nevechikoro vakaguma nekuwedzera kugutsikana kwemhuri neCIU kuchengetedza uye kugutsikana kwemhuri nekugutsikana -kuita.
Pane imwe nhoroondo yakafanana, vatsvakurudzi veoncology kuDana-Farber Cancer Institute vakawana kuti vadzidzisi nevadzidzisi vehutano vakashaya kugadzirisa zvinodiwa zvomudzimu zvevarwere vekenza-kunyanya avo vane chirwere chekupedzisira. Kakawanda, kukwana kutarisirwa mune zvekunamata kwakabatana nekuwedzera kwehupenyu -kuwedzera kupindira mukati mevhiki yekupedzisira yehupenyu, izvo zvakazoguma zvichidhura kaviri kana katatu zvakapetwa kana zvichienzanisa nevarwere avo vane zvido zvekunamata zvavakawana.
Kutsvakurudza Kusingakwanisi
Iko mabhuku akajeka neakawana izvo zvinobatanidza chitendero / humweya kuti huve hutano hwakanaka. Zvisinei, isu tinofanira kukodzera izvi zvinogutsa zvakanaka nezvikwereti zvakajeka zvezvidzidzo zvakadaro. Izvozvi, kukonzera-kana kuti kudai chitendero / ukama hunoita zvakananga noutano huri nani-hazvibviri.
Somuenzaniso, zvidzidzo zvakawanda zvakaratidza kuti kuenda kune zvinyorwa zvechitendero kunobatanidzwa nehana yepamusoro yekuora mwoyo . Vamwe vanofunga kuti izvi zvinoreva kuti chitendero chinodzivirira kupera mwoyo. Zvisinei, zvinonyanya kuitika kuti vanhu vanozoora mwoyo vanomira kupinda misangano yechitendero zvachose. Ongororo dzakawanda dzinoita kuti sangano rive pakati pekuwedzera kupinda kune mamwe masangano echitendero uye kuderedza kuderedza kusagadzikana kwemashoko akareba uye zviyero zvine simba zvekushanda uye kushungurudzika kwekufamba kwekugadzirisa chero hupi hupi huripo hwehutano. Zvinonyanya kukosha, ruzivo rwemukati, kana data yakatorwa kubva pane imwe nguva nenguva, hazvibatsiri kutarisa chinetso.
Takeaways for Physicians
Saka tinoshandisa sei data iyi? Zvose zviri nguva isati yasvika uye zvisingarangariri kuti chiremba anopa varwere zano kune kukosha kwechitendero / zvekunamata mukurwara kwehutano. Kana murwere asingagamuchiri chitendero / zvekunamata, mazano panyaya iyi angave asingagamuchiri uye asina kukodzera. Chero kushandiswa kwechitendero / zvekunamata mukurapa kunofanirwa kuve pamusana pemurwere uye kuratidza hutano hunodiwa nekuwana kurapwa. Pane kudaro, kushamwaridzana pakati pechitendero / zvekunamata uye utano kunogona kushandira zviri nani kudzidzisa chipatara.
Heano dzimwe nzira dzinogona kuonekwa kuti vanachiremba vanokwanisa kuwedzera hutendero / humweya mune tsika yavo yekurapa.
- Vanachiremba vanogona kusanganisira kushandiswa kwechitendero uye chekuongorora zvemukati mumubvunzo wevarwere. Nhoroondo, zvigadzirwa zvakawanda zvekuongorora, zvakadai seSIMIR History, CHITENDO, HOPE, uye Royal College yePfungwa dzemapfungwa, dzakagadzirirwa nekuda kwechinangwa chakajeka. Paunotora nhoroondo yechitendero kana yezvokunamata, vanachiremba vanofanira kufungidzira mutauro wekutaurirana uye unogadzikana pamwe chete nemararamiro anongorwara.
- Imwe yakaziviswa nachiremba, nyaya dzekutambudzika kwakaoma mune zvemweya kana matambudziko echitendero zvinogona kutumirwa kune mutungamiri wezvitendero akakodzera, mutungamiri wemweya, munhu wefundisi, kana mutungamiriri wekutenda.
- Neavo vanogamuchira, pfungwa dzepfungwa dzinosanganisira chitendero / zvekunamata zvinogona kubatsira. Semuenzaniso, chiKristu chekuziva-maitiro ehutachiona akave akaratidzwa kuti akabudirira kupfuura kukanganisa kugadzirisa-hutano hwehutano kune avo varwere vanoita saizvozvo. Uyezve, chiSulumani-based psychotherapy yakaratidzwawo kuti inobatsira varwere vechiSulumani vane kutambura, kushushikana, nekuzvidya mwoyo. Kune varwere vomweya asi asiri vechitendero, kupindira kwepfungwa kunogona kubatsira.
- Vanachiremba vanogona kugamuchira zvakanyanya kuvarwere apo ava varwere vanoratidza kufarira muchitendero / mune zvehupenyu panguva yekurwara kwehutano. Nokuda kweizvi, varwere vane kukanganisa kwepfungwa vanogona kunge vane dambudziko rekukurukurirana zvinyorwa zvinyorwa. Kunyange zvakadaro, vatapi vezvehutano vanofanira kuedza kuratidza zvinodiwa nemurwere kunyange kana izvi zvingave zvisingave zvakanyanya kunyatsoziva.
- Vanachiremba vanofanira kutama kure nepfungwa yokuti chitendero / huMwari hunogona kushandiswa kugadzirisa zviratidzo uye kugadzirisa kusava nesimba. Pane kudaro, vanachiremba vanofanira kuziva kuti varwere avo vari mumweya / vechitendero vanowanzofarira kubatsira vamwe uye vanoda kuve vanopa. Somugumisiro, vanachiremba vanokwanisa kushandisa simba-uye mano-anotarisa maonero pavanorapa varwere. Mune mamwe mazwi, chiremba anogona kubatsira murwere kuona kuti chitendero / kunamata chingashandiswa sei kubatsira vamwe. Zvichida kubatsirwa kwechitendero / zvekunamata panyaya yehutano kwakawanda uye kunobva mukupa kweunhu. Uyezve, apo varwere vanotora nzira yezvipo yechitendero / zvekunamata, pfungwa yavo yekubatana nevamwe inowedzera.
> Sources:
> Ho, RTH, et al. Kunzwisiswa kwemweya uye basa rayo pakurwara kwehutano kune vanhu vane schizophrenia uye vadzidzisi vehutano hwepfungwa: unyanzvi hwokudzidza. BMC Psychiatry. 2016; 16: 86.
> Koenig, HG. Chitendero, Zvomudzimu, uye Utano: Kuongorora nekuvandudza. Kufambira Mberi Mupfungwa-Muviri Mushonga. 2015; 29: 19-26.
> VanderWeele, TJ, et al. Social Psychiatry uye Psychiatric Epidemiology. 2016; 51: 1457-1466.
> Weber Washington, Pargament, KI. Basa rechitendero uye zvekunamata mune utano hwepfungwa. Ikozvino Maonero mu Psychiatry. 2014; 27: 358-63.