Psychologie a její kontexty, Vol.10, No.1

DOI: 10.15452/PsyX.2019.10.0006

Potřeby pacientů v adolescenci a mladé dospělosti se spondylolistézou

The needs of adolescent and young adult patients with spondylolisthesis

Markéta Šťastná, Martin Kupka

Výzkum se zaměřuje na potřeby pacientů po stabilizaci páteře. Cílem je upozornit na onemocnění, která jsou méně závažná, přesto však velmi omezující. Respondenti popisují své zkušenosti z jednotlivých období onemocnění, kterými je zjištění diagnózy, zjištění nevyhnutelnosti operace, poslední týden před operací a návrat do běžného života po operaci. Výzkumný soubor se skládá ze čtyř respondentů, dvou žen a dvou mužů, kteří prodělali operaci spondylolistézy v období adolescence nebo mladé dospělosti. Data byla získána prostřednictvím polostrukturovaných rozhovorů. Výzkum byl proveden kvalitativně metodou IPA a hloubkově zpracován do případových studií. Zjistili jsme 4 základní potřeby, které se ve všech obdobích vyskytovaly nejčastěji. Byla to potřeba získání potřebných informací, potřeba pozornosti, péče a vhodného chování lékařů (pod čímž si můžeme představit jejich zájem, ochotu, empatii, citlivé zacházení a nebagatelizování problému), potřeba sociální opory a jistoty a potřeba vyrovnat se se situací a zaměřit se na sebe. V jednotlivých obdobích k těmto čtyřem potřebám potom přibývaly další.

Klíčová slova:
Potřeby, vztah lékaře s pacientem, komplexní přístup, onemocnění páteře, spondylolistéza

The main aim of this research is examining the needs of patients after the stabilization of their spines. The purpose is to point out the diseases that are less serious, however, still very limiting. We want to arouse interest among doctors, psychologists and relatives of patients and show them how to work with such patients. For this research we chose spondylolisthesis, which affects mainly lumbar and sacrum part of the spine. The problem is caused by the slide of one vertebra over the other. We used a qualitative method, the Interpretative phenomenological analysis. The data were gained by semi-structured interviews where patients responded retrospectively. Respondents describe their experience in four periods – finding out the diagnosis, finding out the necessity of the operation, the last week before the surgery, and returning to their normal life after the surgery. The research sample consists of four respondents, two women and two men who were operated in their adolescence or young adulthood. In the time of these interviews, they were not older than thirty five because we wanted them to have the exact memories from the time of the surgery. We focused on young people because vertebra diseases are more common in older age and that is why we think it is harder for young people to reconcile to it. Although we wanted to ensure homogeneity of our sample, there are big differences, concerning the time of the surgery of our respondents – one of them was just two months after the surgery but the other seventeen years. This fact could affect the whole experience. Unfortunately, this is the forfeit for our strict criteria. We found four basic needs, which were the same in all periods. It was the need to have the necessary information, appropriate behaviour, attention and the doctor care, social support and security, and the need to cope with the situation and focus on oneself. In each period there were more needs emerging than just these four. In the first period it was the need to be perceived and accepted by other people. In the second period the need of a miracle, belief in good end, the need of help from other people, the need to go back to normal life and the need to show emotions without shame. In the third period there were the need to show real emotions again and the need of having the surgery done. They wanted to do other things – to make waiting bearable and to solve practical questions of disease in this period. In the fourth period it was very important to see some progress, to learn how to move, to be careful and to let others help with casual daily activities. The results were quite often the same as the findings in some foreign articles. For example Snelgrove & Liossi (2009), Osborn & Smithe (1998), Middleton (2014) and Alqahtani (2015). We can see people with spine diseases feel the same in different parts of the Earth. We recommend focusing on this kind of a less serious disease and work with patients not just through their body but psychologically as well. For this case we create lists for doctors, psychologists and relatives which suggest how to communicate with patients.

Keywords:
Needs, doctor-patient relationship, holistic attitude, vertebrogenic diseases, spondylolisthesis