“Ukuphila Nje,” Noma Ingabe Ngicindezelekile?
U-Okthoba yinyanga enhle. Ubusuku obupholile, amaqabunga aphendukayo, kanye nethanga elinongwe yonke into.
Kuphinde kube yinyanga ebekelwe ukucabanga ngempilo yethu engokomzwelo. Uma unjengami, ngisola ukuthi izinsuku ezimfushane nobusuku obude akuyona into oyikhethayo. Njengoba silindele ubusika obuzayo, ukucabanga ngendlela esibhekana ngayo nempilo yethu engokomzwelo kunengqondo. Lokhu okungase kusho ukuthi sizimisele ukuhlolelwa ukuthi impilo yethu yengqondo isebenza kanjani.
Ukubaluleka kokuhlolwa kwempilo yengqondo kusenesikhathi kwaziwa kahle. Cishe ingxenye eyodwa kwezimo zempilo yengqondo iqala ngeminyaka eyi-14 kanye nama-75% ngeminyaka engama-24, ngokweNhlangano Kazwelonke Yezempilo Yengqondo. Ukuhlola nokuhlonza izinkinga kusenesikhathi kusiza ukuthuthukisa imiphumela. Ngeshwa, kukhona ukulibaziseka okuphakathi kweminyaka eyi-11 phakathi kwezimpawu zokuqala nokungenela.
Ngokuhlangenwe nakho kwami, kungase kube nokuphikiswa okuningi kokuhlolelwa izinto ezinjengokucindezeleka. Abaningi bayesaba ukubizwa nokucwaswa. Abanye, njengesizukulwane somzali wami, babekholelwa ukuthi le mizwa noma izimpawu “ziwukuphila nje” nokusabela okuvamile ebunzimeni. Ngezinye izikhathi iziguli zikholelwa ukuthi ukucindezeleka akusona isifo “sangempela” kodwa empeleni uhlobo oluthile lwamaphutha omuntu siqu. Okokugcina, abaningi bayangabaza nje ngesidingo noma ukubaluleka kokwelashwa. Uma ucabanga ngakho, izimpawu eziningi zokucindezeleka, njengokuzizwa unecala, ukukhathala, nokungazethembi, zingaphazamisa ukufuna usizo.
Ukucindezeleka kwandile e-United States. Phakathi kuka-2009 no-2012, u-8% wabantu abaneminyaka engu-12 nangaphezulu babike ukuthi banengcindezi isikhathi esingaphezu kwamasonto amabili. Ukucindezeleka wukuxilongwa okuyinhloko kokuvakashelwa kwezigidi ezingu-8 emahhovisi odokotela, emitholampilo, namagumbi ezimo eziphuthumayo unyaka ngamunye. Ukucindezeleka kuthinta iziguli ngezindlela eziningi. Basengozini ephindwe kane yokuhlaselwa isifo senhliziyo kunalabo abangenawo ukucindezeleka.
Njengoba kubonakala, ukucindezeleka kuyisifo sengqondo esivame kakhulu emphakathini jikelele. Njengomhlinzeki wokunakekelwa oyinhloko amashumi eminyaka ambalwa, uthola ngokushesha ukuthi iziguli azivamile ukufika zithi, "Ngicindezelekile." Ngokunokwenzeka kakhulu, zivela nalokho esikubiza ngokuthi izimpawu ze-somatic. Lezi yizinto ezifana nekhanda elibuhlungu, izinkinga zeqolo, noma ubuhlungu obungapheli. Uma sihluleka ukuhlolela ukucindezeleka, kuhlonzwa kuphela u-50%.
Lapho ukucindezeleka kuhlala kungelashiwe, kungaholela ekwehleni kwezinga lempilo, imiphumela emibi kakhulu enezimo zezokwelapha ezingamahlalakhona njengesifo sikashukela noma isifo sezempilo, kanye nengozi eyengeziwe yokuzibulala. Futhi, umthelela wokucindezeleka udlulela ngalé kwesiguli ngasinye, kube nomthelela omubi kwabashade nabo, abaqashi, nezingane.
Zikhona izici eziyingozi ezaziwayo zokucindezeleka. Lokhu akusho ukuthi uzocindezeleka, kodwa ungase ube sengozini enkulu. Kuhlanganisa ukucindezeleka kwangaphambili, iminyaka encane, umlando womndeni, ukubeletha, ukuhlukumezeka kwasebuntwaneni, izehlakalo zakamuva ezicindezelayo, ukusekelwa okungalungile komphakathi, iholo elincane, ukusetshenziswa kwezidakamizwa, kanye nokuwohloka komqondo.
Ukucindezeleka akukhona nje ukuba “phansi.” Ngokuvamile kusho ukuthi unezimpawu cishe nsuku zonke amasonto amabili noma ngaphezulu. Kungabandakanya ukuzizwa uphansi, ukuphelelwa isithakazelo ezintweni ezivamile, inkinga yokulala, amandla aphansi, ukugxilisa ingqondo, ukuzizwa ungelutho, noma imicabango yokuzibulala.
Kuthiwani ngabantu abadala asebekhulile?
Bangaphezu kwama-80% abantu abaneminyaka engama-65 nangaphezulu okungenani banesimo sempilo esisodwa esingamahlalakhona. Amaphesenti angamashumi amabili nanhlanu anesine noma ngaphezulu. Lokho odokotela bengqondo abakubiza ngokuthi “ukucindezeleka okukhulu” ngokuvamile kwenzeka cishe ku-2% wabantu abadala asebekhulile. Ngeshwa, ezinye zalezi zimpawu zisolwa kwezinye izimo esikhundleni sokudabuka.
Kubantu abadala asebekhulile, izici ezisengozini yokucindezeleka zihlanganisa isizungu, ukulahlekelwa umsebenzi, ukuxilongwa okusha kwezokwelapha, ukungabi namandla ngenxa yokucwasa ngokobuhlanga noma ubudala, isifo senhliziyo, imithi, ubuhlungu obungapheli, nosizi ngenxa yokulahlekelwa.
Ukuhlola
Odokotela abaningi bakhetha ukwenza inqubo yokuhlola eyizinyathelo ezimbili ukusiza ukuhlonza lezo ziguli okungenzeka ukuthi zicindezelekile. Amathuluzi avame kakhulu i-PHQ-2 ne-PHQ-9. I-PHQ imele i-Paent Health Questionnaire. Kokubili i-PHQ-2 ne-PHQ-9 zingamasethi angaphansi ethuluzi elide lokuhlola i-PHQ.
Isibonelo, i-PHQ-2 iqukethe imibuzo emibili elandelayo:
- Kule nyanga edlule, ingabe uye wazizwa unesithakazelo esincane noma ukujabulela ukwenza izinto?
- Kule nyanga edlule, ingabe uke wazizwa udangele, ucindezelekile, noma ungenathemba?
Uma uphendule kahle kuyo yomibili imibuzo noma kuyo yomibili, akusho ukuthi nakanjani uhlushwa ukudangala, ukuthi nje kuzokhuthaza umnakekeli wakho ukuthi ahlole kabanzi ukuthi uqhuba kanjani.
Imicabango yokugcina
Izimpawu zokucindezeleka ziholela emthwalweni omkhulu wezifo kusuka kokubili ubude bempilo kanye nekhwalithi yokuphila. Umthelela wokucindezeleka esikhathini esiphelele sokuphila udlula imiphumela yesifo senhliziyo, isifo sikashukela, umfutho wegazi ophakeme, isifuba somoya, ukubhema, nokungawuvivinyi umzimba. Futhi, ukucindezeleka, kanye nanoma yiziphi zalezi zimo nezinye izimo zezokwelapha, ziba zimbi kakhulu imiphumela yezempilo.
Ngakho-ke, kulo Mfumfu, zenzele umusa (noma ukhuthaze othandekayo). Bheka ukuthi ukuphi ngokomzwelo, futhi uma kukhona umbuzo wokuthi kungenzeka yini ukuthi ubhekene nenkinga yezempilo yengqondo, njengokucindezeleka noma okunye, khuluma nomhlinzeki wakho wezempilo.
Lukhona usizo lwangempela.
Resources
nami.org/Advocacy/Policy-Priorities/Improving-Health/Mental-Health-Screening
pubmed.ncbi.nlm.nih.gov/18836095/
uptodate.com/contents/screening-for-depression-in-adults
aafp.org/pubs/afp/issues/2022/0900/lown-right-care-depression-older-adults.html
aafp.org/pubs/fpm/issues/2016/0300/p16.html
I-Psychiatry Epidemiol. 2015;50(6):939. I-Epub 2015 Feb 7