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Funda kabanzi apha

Isithuba sengqondo

By UBill W, MD

Hayi, andithethi ngemiqondiso kwizikhululo zikaloliwe eziphantsi komhlaba zaseLondon. “Isikhewu” esilapho sibhekisa kwisithuba esiphakathi kweqonga kunye nololiwe wokwenene. IiBrits zifuna ukuqiniseka ukuba unyathela phezu kwesi sithuba, okanye isikhewu, kwaye ungene ngokukhuselekileyo kuloliwe.

Kunoko, ndithetha ngomnye umsantsa. Oko kukuthi, umsantsa kwiinkonzo nabani na kuthi anokuba nazo eziphazamisana nendlela yokuzigcina sisempilweni.

Masixhase umzuzwana.

Ababoneleli bokhathalelo lokuqala abaxakekileyo bahlala beneenjongo ezininzi xa bebona isigulana. Bamamele naziphi na iinkxalabo ezisebenzayo okanye amaxhala kwicala lesigulana. Kwangaxeshanye, bajolise kuzo naziphi na iimeko ezingapheliyo abazaziyo kwaye baqinisekise ukuba naluphi na uhlengahlengiso kwiyeza okanye uvavanyo luyahoywa. Okokugqibela, uninzi lwababoneleli ngononophelo oluphambili baneenkqubo zokubakhumbuza malunga naluphi na uvavanyo lwesiqhelo, uvavanyo, okanye ugonyo olunokufuneka. Oogqirha abaninzi kunye noogqirha abakumgangatho ophakathi babhekisa koku “njengesikhewu.” Oku kuthetha ngokukodwa ukuba xa nabani na kuthi ebonwa, kukho iinkonzo ezicetyiswayo ngokusekelwe kwisini sethu, ubudala, okanye iimeko zonyango. Oku kuquka nogonyo olucetyiswayo. Bafuna ukuvala lo msantsa kangangoko. Isithuba sengqondo.1

Ukugcinwa kwempilo kuthi sonke kuxhomekeke kwindawo esikuyo kumjikelo wobomi. Iintsana, abantwana kunye nabafikisayo, ababhinqileyo abadala, kunye namadoda ngamnye uneentlobo ngeentlobo zemisebenzi ebonakaliswe yinzululwazi yehlisa umthwalo wezifo. Loluphi uhlobo lwemisebenzi enokubandakanya oku? Kubantwana nakwishumi elivisayo, umzekelo, ugqirha uhlala ejongana nesigulane kunye nomzali / umnakekeli kunye nokubuza malunga nesebe eliphuthumayo okanye ukhathalelo lwesibhedlele ukususela ekutyeleleni kokugqibela; indlela yokuphila (ukutya, umthambo, ixesha lesikrini, ukuchaswa komsi wecuba, iiyure zokulala ubusuku ngabunye, ukhathalelo lwamazinyo, imikhwa yokhuseleko); kunye nendlela esiqhuba ngayo isikolo. IAmerican Academy of Pediatrics icebisa ukuba kujongwe uxinzelelo lwegazi oluphezulu rhoqo ngonyaka, kujongwe yonke le minyaka mibini ukubona iingxaki zokuva, kunye nokujonga amanqanaba aphezulu e-cholesterol kanye phakathi kwe-9 kunye ne-11 leminyaka ubudala. Ukujongwa rhoqo kwemimiselo yentlalo yezinto ezinobungozi ezinxulumene nempilo nazo ziyacetyiswa. Ugonyo olulungele iminyaka yobudala kunye nogonyo lokufumana ugonyo kufuneka lunikezelwe. Kukho izindululo ezifanayo kodwa ezahlukileyo zeminyaka nganye kunye neqela lesini.2

Zivela phi ezi ngcebiso? Bahlala bevela kwimithombo ehlonelwayo efana ne-United States Preventive Services Taskforce (USPSTF) okanye imibutho ekhethekileyo ehlonitshwayo efana noMbutho woMhlaza waseMelika, iAkhademi yaseMelika yokuziqhelanisa noSapho, iAkhademi yaseMelika yePediatrics, kunye nabanye.3

Ukusebenzisa iirekhodi zempilo ye-elektroniki (EHRs) kuboniswe ukuphucula amazinga ophuhliso lokuhlola, ukuhlolwa komngcipheko, kunye nesikhokelo esilindelekileyo. Oku kunokuba ngenxa "yokudityaniswa kwezinto ezicwangcisiweyo zedatha, izixhobo zokuxhasa izigqibo, ukujonga ixesha elide kwedatha yesigulane, kunye nokufikelela okuphuculweyo kwebhubhoratri kunye nedatha yesishwankathelo sokhathalelo lwempilo." Amazinga ogonyo anokuphuculwa ngokusebenzisa iisistim zokukhumbuza okanye zokukhumbula, ezinokuthi zihanjiswe ngenkqubo yefowuni ezenzekelayo, iileta okanye amakhadi eposi, okanye buqu ngexesha lezinye iintlobo zokutyelela eklinikhi.4

Kungenxa yale "misebenzi" ukuba unikezelo lonyango oluphambili ludityaniswe neziphumo zempilo eziphuculweyo, kubandakanywa zonke izizathu, umhlaza, isifo senhliziyo, isifo, kunye nokufa komntwana; ubunzima bokuzala obuphantsi; izinto ozilindile emhlabane; kunye nempilo yokuzimela.5

Ngoko ke, idatha ibonakala iqinisekisa ukubaluleka kokuphuhlisa ubudlelwane kunye nonyango jikelele ukuze bafumane iinkonzo zokukhusela. Unokuqonda ngokukhawuleza ukuba kutheni ababoneleli bezononophelo abaphambili bexakeke kakhulu kwaye ixesha eliyimfuneko lothintelo linokuncipha emva kokuba ezinye iimfuno zihlangatyeziwe.

Enye into kufuneka ikhankanywe malunga nokuthintela. Kubekho intshukumo (Ukukhetha ngoBulumko) iminyaka eyi-10+ edlulileyo ukuchonga ezo nkonzo AKUKHO luncedo. Ngaphezulu kwama-70 abantu abakhethekileyo baye bafumanisa ukuba kukho iimvavanyo okanye iinkqubo ezisetyenziswa ngokugqithisileyo phakathi kwezinto zabo ezizodwa. Kukho ikhonkco elingezantsi elibonisa ukuba zeziphi iinkonzo i-American Academy of Practice yeNtsapho ezibone zingenakunceda, kwaye ngamanye amaxesha ziyingozi.6

Kwaye ewe, ngoku inxalenye yeenkonzo ezicetyiswayo zibandakanya umntwana omtsha kwibhloko. Ugonyo lwe-COVID-19. Abanye bacebise ukuba i-COVID-19 ngoku iyafana nomkhuhlane kuba kuya kubakho ugonyo olucetyiswayo, okunokwenzeka ubuncinci minyaka le, kwikamva elibonakalayo. Abanye baye bacebisa ukuba impembelelo yesitofu sokugonya i-Covid ifana nokucebisa umntu ukuba angatshayi. Ukutshaya kunxulumene ngokucacileyo ne-emphysema, i-bronchitis, umhlaza wemiphunga kunye nezinye izifo ezininzi. UKUNGAFUMANI isitofu sokugonya se-COVID-19 kunokuphikiswana njengokukhetha ukutshaya. Umalunga namaxesha angama-64 amathuba okuba ulaliswe esibhedlele nge-COVID-19 ukuba ukhetha ukungalufumani ugonyo.7

Ke, kwixesha elizayo xa ubona umboneleli wakho wokhathalelo oqhelekileyo, yazi ukuba ujonge kuwe ngokwembono yokubonelela ngeenkonzo ezinokugunyaziswa bubudala bakho, isini, kunye nemeko yonyango. Injongo kukuphucula impilo yakho, ngoko ukhululekile ukuba uphile ubomi bakho ngokupheleleyo.

 

Ucaphulo

  1. https://www.aafp.org/family-physician/patient-care/clinical-recommendations/clinical-practice-guidelines/clinical-practice-guidelines.html
  2. https://www.aafp.org/pubs/afp/issues/2019/0815/p213.html
  3. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations
  4. https://www.aafp.org/pubs/afp/issues/2011/0315/p659.html
  5. https://pubmed.ncbi.nlm.nih.gov/17436988/
  6. https://www.aafp.org/family-physician/patient-care/clinical-recommendations/choosing-wisely.html
  7. https://www.theatlantic.com/health/archive/2022/02/covid-anti-vaccine-smoking/622819/