Haɗuwa a cikin Rashin Cutar: Haƙiƙa ne ko Mai Haɗari?

Wadatacce

• Ciwon Ciwon Muhimmancin Karatu
• Dalilin da yasa Cutar Cutar ta Cutar da COVID-19

Comorbidity abu ne mai rikitarwa, ra'ayi da na asibiti. Ma'anar ɓarna daga mahangar ra'ayi tana nufin yanayin da "wani yanki na asibiti ke bayyana yayin cutar" - misali lokacin da mai fama da ciwon sukari ya kamu da cutar Parkinson. A wannan yanayin, akwai ƙungiyoyin asibiti daban -daban guda biyu kuma ana amfani da manufar rayuwa.

Ma'anar haɗin kai daga ra'ayi na asibiti yana nufin, a maimakon haka, zuwa yanayin da "ƙungiyoyin asibiti biyu ko fiye ke zama tare." A wannan yanayin, yaduwar cutar ta dogara ne akan ma'anar rikice -rikice (watau tsarin rarrabuwa da ƙa'idodin bincike).

A fagen lafiyar kwakwalwa, inda ba a sami takamaiman masu nazarin halittu ba, yana da tambaya ko rashin lafiyar kwakwalwa guda biyu “rarrabe” ne na asibiti, ko kuma sakamakon sakamakon rarrabuwar kawunan kwakwalwa na yanzu wanda, dangane da alamar da aka gabatar, yana ƙarfafawa aikace -aikace na bincike masu tabin hankali da yawa a cikin marasa lafiya iri ɗaya.

Matsalolin da ke da alaƙa da ma'anar ɓarna na iya samun mahimmancin sakamako na asibiti wanda ya shafi magani. Misali, halayen ɓacin rai sun zama ruwan dare a cikin marasa lafiya da ke fama da matsalar rashin abinci amma yana iya zama shaidar ko dai akwai ɓacin rai na asibiti ('haƙiƙa ta gaskiya') ko sakamakon kai tsaye na rashin nauyi a cikin anorexia nervosa ko cin binge a cikin bulimia nervosa ('spurious comorbidity ') (duba Hoto 1). A cikin akwati na farko, dole ne a kula da ɓacin rai na asibiti kai tsaye, yayin da a cikin akwati na biyu maganin matsalar cin abinci yakamata ya haifar da gafara a cikin abubuwan ɓacin rai.

Haɗuwa a cikin matsalar cin abinci

Binciken labari na nazarin Turai ya ƙare cewa sama da 70% na mutanen da ke fama da matsalar cin abinci suna samun ganewar cutar tabin hankali. Yawancin rikice-rikicen tunani na yau da kullun sune rikicewar damuwa (> 50%), rikicewar yanayi (> 40%), cutar da kai (> 20%), da rikicewar amfani da kayan (> 10%).

Ya kamata a nanata cewa bayanai daga binciken da aka gudanar suna ba da babban canji a cikin adadin cutar tabin hankali a cikin matsalar cin abinci; alal misali, an ba da rahoton yawan tarihin rayuwar tashin hankali a cikin kaɗan daga 25% zuwa 75% na lokuta. Wannan zangon babu makawa yana haifar da babban shakku kan amincin waɗannan abubuwan lura. Hakanan, binciken da ya tantance yawan rikice-rikicen halayen da ke tare da rikicewar abinci sun ba da rahoton mafi girman canji, daga 27% zuwa 93%!

Matsalolin hanya

Nazarin da ya kimanta rashin daidaituwa a cikin matsalar cin abinci yana fama da manyan matsalolin hanyoyin. Misali, ba koyaushe ake rarrabewa ko cutar “comorbid” ta faru kafin ko bayan matsalar cin abinci; samfuran da aka kimanta sau da yawa ƙanana ne kuma/ko sun haɗa da nau'ikan bincike na rikicewar abinci a cikin daban -daban; an yi amfani da adadi mai yawa da na hirarrakin bincike da gwaje-gwajen sarrafa kai don tantance cutar. Koyaya, babbar matsalar ita ce yawancin karatun ba su tantance ko halayen cutarwa sun kasance na biyu ga ƙarancin nauyi ko tashin hankali a cikin abincin ba.

Haɗuwa ko lokuta masu rikitarwa?

Ba za a iya amfani da ra'ayin cewa akwai wani sashi na "hadaddun lamura" ba ga matsalar cin abinci Tabbas, kusan duk marasa lafiya da ke fama da matsalar cin abinci ana iya ɗaukar su hadaddun lamura. Yawancin, kamar yadda aka bayyana a sama, sun cika ƙa'idodin bincike don cutar guda ɗaya ko fiye. Rikicin jiki na kowa ne, kuma wasu marasa lafiya suna da haɗin gwiwa tare da hulɗa da cututtukan likitanci. Matsalolin da ke tsakanin mutane al'ada ce, kuma yanayin rashin lafiyar na yau da kullun na iya yin mummunan tasiri a kan ci gaba da aikin ɗan adam. Duk wannan yana nuna cewa a cikin marasa lafiya da ke fama da matsalar cin abinci, rikitarwa shine doka maimakon banda.

Rarraba wucin gadi na yanayin asibiti mai rikitarwa cikin ƙananan ƙwayoyin cuta na tabin hankali na iya samun mummunan sakamako na hana mafi cikakkiyar hanyar magani da haɓaka amfani mara kyau na magunguna da yawa ko tsoma bakin don magance guda ɗaya na mafi girman hoto mai rikitarwa. Haka kuma, rashin daidaiton kimantawa da gudanar da cututtukan cututtukan na iya haifar da sakamako mai ban tsoro don kawar da magani daga mahimman abubuwan da ke kula da ilimin rashin lafiyar abinci da isar da ga marasa lafiya marasa magani da cutarwa.

Hanyar da ta dace ga lamura masu rikitarwa

A cikin aikina na asibiti, na ɗauki madaidaicin hanyar magance matsalar tabin hankali da ke da alaƙa da matsalar cin abinci. Na gane kuma a ƙarshe na magance rikice -rikice kawai lokacin yana da mahimmanci kuma yana da tasirin asibiti. Don wannan, littafin ingantaccen ilimin halayyar halayyar hankali (CBT-E) don rikicewar cin abinci ya raba rikice-rikice zuwa ƙungiyoyi uku:

Ciwon Ciwon Muhimmancin Karatu

Dalilin da yasa Cutar Cutar ta Cutar da COVID-19