{"id":1403,"date":"2021-10-11T13:16:11","date_gmt":"2021-10-11T13:16:11","guid":{"rendered":"https:\/\/uzpruk.com\/?p=1403"},"modified":"2021-10-11T13:16:13","modified_gmt":"2021-10-11T13:16:13","slug":"73-de-ani-de-evolutie","status":"publish","type":"post","link":"https:\/\/uzpruk.com\/en\/73-de-ani-de-evolutie\/","title":{"rendered":"73 de ani de evolu\u021bie"},"content":{"rendered":"

I<\/em><\/strong>ntervi<\/em><\/strong>u<\/em><\/strong> cu <\/em><\/strong>P<\/em><\/strong>siholog<\/em><\/strong> Dr.<\/em><\/strong> Nistor Becia, <\/em><\/strong>s<\/em><\/strong>pecialist pe <\/em><\/strong>r<\/em><\/strong>ecuperare <\/em><\/strong>\u0219<\/em><\/strong>i <\/em><\/strong>r<\/em><\/strong>eabilitare de <\/em><\/strong>s\u0103<\/em><\/strong>n<\/em><\/strong>\u0103<\/em><\/strong>tate <\/em><\/strong>m<\/em><\/strong>int<\/em><\/strong>al\u0103 \u00ee<\/em><\/strong>n Marea Britanie<\/em><\/strong><\/p>\n\n\n\n

Contextul socio-economic generat de efectul pandemic ne-a pus \u00een fa\u021ba unor situa\u021bii neprev\u0103zute, pentru care nu am fost preg\u0103ti\u021bi s\u0103 ac\u021bion\u0103m. Izolarea, teama, distan\u021ba de ceilal\u021bi au dus la accentuarea unor comportamente latente care, ulterior au contribuit la instalarea unor boli psihice. \u0218i ce facem cu boala!?? O ducem la doctor!! Unde? La cine? C\u00e2nd \u0219i cum?<\/p>\n\n\n\n

Dintr-un \u0219ir lung de \u0219tiri, interviuri \u0219i articole menite la redeschiderea discu\u021biei despre necesitatea reform\u0103rii sistemului de sanatate mintala din Rom\u00e2nia, am decoperit un articol publicat de catre  Uniunea Ziari\u015ftilor Profesioni\u015fti din Rom\u00e2nia (UZP) in 2015 intitulat \u2018Na<\/em><\/strong>\u0219terea Sistemului Na<\/em><\/strong>\u021bional de S<\/em><\/strong>\u0103n<\/em><\/strong>\u0103t<\/em><\/strong>ate, cea mai pre<\/em><\/strong>\u021bioas<\/em><\/strong>\u0103 institu<\/em><\/strong>\u021bie <\/em><\/strong>\u00een Regatul Unit al Marii Britanii\u2019. <\/em><\/strong>Acest articol <\/em><\/strong>a fost publicat <\/strong>de c\u0103tre Nistor Becia, psiholog Clinician din Marea Britanie, de origine rom\u00e2n\u0103, cu care \u00een cei mai recen\u021bi ani am reu\u0219it s\u0103 dezvolt o colaborare \u00een domeniul psihologic. De\u0219i stabilit de mul\u021bi ani acolo, Nistor face eforturi deosebite de a-\u0219i ajuta \u021bara ori de c\u00e2te ori are ocazia.<\/p>\n\n\n\n

P\u00e2n\u0103 foarte recent, colegul nostru Nistor Becia a fost coordonatorul Departamentului Psihologic al Spitalului de Psihiatrie din Cardiff, Tara Galilor, iar pe func\u021bia sa curent\u0103 de specialist, are responsabilit\u0103\u021bi pe zone extinse \u00een domeniul recuper\u0103rii persoanelor externate din unit\u0103\u021bile psihiatrice, asistate \u00een comunitate. <\/p>\n\n\n\n

Din  amalgamul de articole din Rom\u00e2nia  ce scot la iveal\u0103 tot felul de idei \u0219i discu\u021bii despre ce ar putea fi \u0219i cum ar putea func\u021biona eficient sistemul de s\u0103n\u0103tate din Rom\u00e2nia, ceea ce m-a atras la articolul colegului nostru din Marea Britanie este c\u0103, pe l\u00e2ng\u0103 descrierea impresionant\u0103 a dezvolt\u0103rii sitemului de s\u0103n\u0103te din Marea Britanie, eviden\u021biaz\u0103 situa\u021bia curent\u0103extraordinar\u0103 a acestui sistem care trateaz\u0103 gratuit peste 1 milion de pacien\u021bi la fiecare 36 de ore. <\/p>\n\n\n\n

Acesta acoper\u0103 totul, de la screening-ul prenatal \u0219i proiec\u0163ii de rutin\u0103, la  serviciile psihologice \u0219i de s\u0103n\u0103tate mintal\u0103, tratamente pentru condi\u0163ii medicale de lung\u0103 durat\u0103, transplanturi, tratament de urgen\u021b\u0103 \u0219i fazele terminale.<\/p>\n\n\n\n

\u00cen 2014, Fondul Commonwealth a declarat c\u0103, \u00een compara\u0163ie cu sistemele de s\u0103n\u0103tate a altor 10 state (Australia, Canada, Fran\u0163a, Germania, \u0162arile de Jos, Noua Zeelanda, Suedia, Danemarca, Elve\u0163ia \u015fi USA), sistemul britanic a fost cel mai impresionant. Acesta a fost evaluat ca cel mai bun sistem \u00een ceea ce prive\u015fte eficien\u0163a, coordonarea, \u00eengrijirea centrat\u0103 pe pacient, condi\u0163ii de siguran\u0163\u0103 si probleme legate de costuri.<\/p>\n\n\n\n

Iar legat de aceste ultime aspecte, am \u021binut s\u0103 discut direct cu colegul nostru Nistor Becia care, pe func\u021bia sa \u00een Marea Britanie, este implicat \u00een politiciile de administrare \u0219i eficentizare a sistemului, adres\u00e2ndu-i urmatoarele intrebari:<\/p>\n\n\n\n

Camelia Bancila: <\/strong>Cum exact este structurat sistemul de s\u0103n\u0103tate britanic ( cu accent pe s\u0103n\u0103tatea mintal\u0103) ?<\/p>\n\n\n\n

Nistor Becia: <\/strong>Este \u00eemp\u0103rtit in doua mari componente, Sistemul Primar \u0219i Sistemul Secundar de s\u0103n\u0103tate.<\/p>\n\n\n\n

  1. Sistemul primar care include: Medici de familie, clinici de specialitate \u0219i echipe de asisten\u021b\u0103 \u00een comunitate. Pacien\u021bii cu grad redus de risc sunt diagnostica\u021bi \u0219i trata\u021bi \u00een comunitate de psihiatrii \u0219i psihologi specializa\u021bi \u00een domeniu care lucreaz\u0103 \u00een echipe de s\u0103n\u0103tate mintal\u0103.<\/li>
  2. Sistemul secundar format din spitale, penitenciare \u0219i clinici specializate cu regim de spital. Aceast\u0103 structur\u0103 se aplic\u0103\u0219i \u00een cazul sistemului de s\u0103n\u0103tate mintal\u0103. <\/li><\/ol>\n\n\n\n

    Camelia Bancila:<\/strong> \u00cen domniul s\u0103n\u0103t\u0103\u021bii mintale \u00een Marea Britanie domin\u0103 modelul  de asisten\u021b\u0103 spitalizat\u0103 (sistem secundar) sau accentul este pus pe sistemul primar de sanitate \u0219i asisten\u021b\u0103 \u00een comunitate?<\/p>\n\n\n\n

    Nistor Becia: <\/strong>La inceput accentul a fost pus  ca \u0219i \u00een Rom\u00e2nia, pe tratament \u0219i au existat multe centre \u0219i spitale mari  \u00eemp\u0103r\u021bite fiecare pe patologie cu pavilioane, saloane \u0219i dot\u0103ri specifice. \u00cen ultimii zece ani ,au fost coroborate cercetarea \u0219i eviden\u021bele acumulate din practica iar aceast\u0103 ideologie s-a schimbat.  Accentul si orientarea noastr\u0103 este acum pe prevenire \u0219i asisten\u021b\u0103 \u00een comunitate.  Chiar \u0219i din punct financiar s-a constatat c\u0103 eforturile \u0219i pre\u021bul de a men\u021bine aceste centre \u0219i institu\u021bii spitalicesti au fost mult mai mari comparativ cu investitia \u00een practicile de prevenire. Bine\u00eenteles, asta nu inseamn\u0103 c\u0103 noi nu mai avem spitale, doar c\u0103, modul \u00een care acestea opereaz\u0103 s-a schimbat o dat\u0103 ce numarul de pacien\u021bi \u0219i perioada de spitalizare s-a redus.  <\/p>\n\n\n\n

    Camelia Bancila: <\/strong>Exist\u0103 criterii bine stabilite \u0219i reguli care s\u0103  ghideze practicienii din domeniul s\u0103n\u0103ta\u021bii mintale la stabilirea cazurilor de tratare \u00een spital sau de asisten\u021b\u0103 \u00een comunitate?<\/p>\n\n\n\n

    Nistor Becia: <\/strong>Criterile \u0219i regulile dup\u0103 care noi lucr\u0103m sunt informate de evaluarea si managementul riscului realizate de echipe multidisciplinare. Acesta a devenit un domeniu de expertiz\u0103 pentru practicienii din Marea Britanie iar planurile de tratament, monitorizarea \u0219i orice activitate va lua \u00een considerare \u0219i calcul evaluarea \u0219i managemntul riscului. \u00cen ultimii ani s-au creat multe ghiduri \u0219i instrumente standardizate \u0219i specifice \u00een stabilirea gradul de risc pe care pacientul \u00eel prezint\u0103 pentru sine insusi sau pt ceilalti. De altfel, evaluarea \u0219i managementul riscului au devenit o parte din preg\u0103tirea noastr\u0103 la locul de munca, necesar\u0103 \u0219i obligatorie pentru fiecare membru al personalului.<\/p>\n\n\n\n

    Camelia Bancila:<\/strong> Exist\u0103 structuri intermediare, subsidiare care fac trecerea spre revenirea acestui pacient \u00een s\u00e2nul comunit\u0103\u021bii?<\/p>\n\n\n\n

    Nistor Becia:<\/strong> Nu exist\u0103 structuri separate care s\u0103 fac\u0103 aceast\u0103 tranzi\u021bie dar exist\u0103 programe \u0219i un plan bine stabilit care va fi adoptat de c\u0103tre echipa de asisten\u021b\u0103 \u00een comunitate. Acest plan este focusat pe unicitatea \u0219i nevoile fiec\u0103rui pacient \u0219i este conceput \u00eenc\u0103 de la stagiul c\u00e2nd pacientul este \u00een sistemul secundar, adic\u0103 \u00een spital. Acesta inseamn\u0103 c\u0103, chiar daca avem dou\u0103 sisteme diferite, acestea lucreaz\u0103 \u00eempreun\u0103 sub o bun\u0103 colaborare \u0219i comunicare \u00eentre cele dou\u0103. Aceast\u0103 comunicare este de altfel ajutat\u0103 \u0219i de o baz\u0103 de date comun\u0103, o platform\u0103 on-line a sistemului de s\u0103n\u0103tate unde orice practician din sistemul primar sau secundar are acces pentru a vedea istoricul. Eforturile de implementare a acestei platforme comune on-line a avut la baz\u0103 idea de a elimina confuzia \u00een ceea ce prive\u0219te planul de tratament \u0219i riscurile asociate, deci to\u021bi  care lucreaz\u0103 sau vin \u00een contact cu pacientul vor fi bine informati. Ca urmare, beneficiul este bilateral,  at\u00e2t al pacientului dar \u0219i al sistemului de s\u0103n\u0103tate. <\/p>\n\n\n\n

    Camelia Bancila: <\/strong>Ce se int\u00e2mpl\u0103 cu cei care sunt externa\u021bi si nu au un suport familial sau pe nimeni care s\u0103 vad\u0103 c\u0103-\u0219i urmeaz\u0103 tratamentul, sunt \u00eengriji\u021bi de echipa de asisten\u021b\u0103 \u00een comunitate? Aceast\u0103 asisten\u021b\u0103 \u00een comunitate reprezint\u0103 un concept nou pentru Rom\u00e2nia unde un pacient cu boal\u0103 psihic\u0103 merge la medic doar dac\u0103 dore\u0219te s\u0103 i se prelungeasc\u0103 medica\u021bia.<\/strong><\/p>\n\n\n\n

    Nistor Becia: <\/strong>La inceput aceasta a fost o problem\u0103 dar pentru a reduce costurile \u0219i presiunea pe sistemul de sanatate, guvernul  a facilitat construirea oragiza\u021biilor de caritate sau ONG-uri care lucreaz\u0103 \u00een colaborare cu sistemul de s\u0103n\u0103tate \u0219i care preiau asisten\u021ba acestor persoane f\u0103r\u0103 familie, au suport astfel \u00eenc\u00e2t  nimeni nu este l\u0103sat nesupraveghiat. \u00cen felul acesta, se va reduce \u0219i riscul de recidiv\u0103 \u0219i costurile asociate cu o nou\u0103 internare sau admitere \u00een spital. <\/p>\n\n\n\n

    Camelia Bancila: <\/strong>Ce crede\u021bi c\u0103 ar trebui s\u0103 se schimbe \u00een Romania pentru ca lucrurile s\u0103 evolueze intr-o direc\u021bie pozitiv\u0103?<\/p>\n\n\n\n

    Nistor Becia:<\/strong> Probabil orice sistem de s\u0103n\u0103tate care acum func\u021bioneaz\u0103 peste hotare a trecut la un moment  dat  printr-un stadiu de criz\u0103 care a fost necesar \u0219i determinant \u00een a se produce schimbarea. Cred c\u0103, evenimentele recente \u0219i din p\u0103cate tragice precum cel de la spitalul de psihiatrie S\u0103poca din Romania <\/strong>ar trebui folosite ca \u0219i o oportunitate pentru a \u00eenv\u0103\u021ba o lec\u021bie important\u0103 \u0219i pentru a invoca schimbarea c\u0103tre o direc\u021bie mult mai optimist\u0103.                                                                                                        \u00cen felul acesta, cel pu\u021bin via\u021ba acelor oameni care au decedat nu va fi irosit\u0103. Consider c\u0103,  sistemul din Rom\u00e2nia ar avea un avantaj, deoarece \u00een prezent exist\u0103 \u00een lume c\u00e2teva modele de succes \u00een domeniul s\u0103n\u0103t\u0103\u021bii mintale \u0219i al  s\u0103n\u0103t\u0103\u021bii \u00een general. La baza evolu\u021biei acestor sisteme a fost nevoie de mult\u0103 cercetare \u0219i investi\u021bie iar pe parcurs au fost multe lec\u021bii dure de invatat. Desigur, orice cultur\u0103 are specificul ei aparte dar lu\u00e2nd \u00een considerare elementele comune, sistemul de s\u0103n\u0103tate din Rom\u00e2nia are avantajul \u0219i posibilitatea de a \u00eenv\u0103\u021ba \u0219i de a lua tot ce este mai bun de la aceste sisteme \u00een a-\u0219i construi un sistem propriu func\u021bional.  Totul va depinde de c\u00e2t de repede sau de t\u00e2rziu se va accepta \u00een Romania c\u0103 nimic nu este nou iar  faptul de a inv\u0103\u021ba din lec\u021biile altora salveaz\u0103 mai multe vie\u021bi. <\/p>\n\n\n\n

    Not\u0103 editor:<\/strong> Un rol important \u00eel de\u021bin serviciile de interven\u021bie psihologic\u0103 din Rom\u00e2nia, servicii nedecontate de Casa de Asigur\u0103ri dec\u00e2t \u00een mic\u0103 parte la acest moment. Ace\u0219ti pacien\u021bi monitoriza\u021bi, \u00eenregistra\u021bi \u0219i trata\u021bi la timp nu vor mai genera costuri \u00een sistemul secundar, adic\u0103 \u00een spitale \u0219i vor prezenta un risc sc\u0103zut, controlabil pentru societate. \u00cen prezent, \u00een Rom\u00e2nia pacientul se re\u00eentoarce din sistemul secundar direct \u00een societate f\u0103r\u0103 a beneficia de consiliere psihologic\u0103, interven\u021bie \u0219i monitorizare \u00een sistemul primar , practic inexistent. Mai depare, pentru a nu comite acelea\u0219i gre\u0219eli este recomandat s\u0103 lucr\u0103m \u00een echipe multidisciplinare la schimbarea legii s\u0103n\u0103t\u0103\u021bii mintale \u0219i numai.<\/p>\n\n\n\n

    Interviul a fost scurtat \u0219i editat pentru claritate. <\/em><\/p>","protected":false},"excerpt":{"rendered":"

    Interviu cu Psiholog Dr. Nistor Becia, specialist pe recuperare \u0219i reabilitare de s\u0103n\u0103tate mintal\u0103 \u00een Marea Britanie Contextul socio-economic generat de efectul pandemic ne-a pus \u00een fa\u021ba unor situa\u021bii neprev\u0103zute, pentru care nu am fost preg\u0103ti\u021bi s\u0103 ac\u021bion\u0103m. Izolarea, teama, distan\u021ba de ceilal\u021bi au dus la accentuarea unor comportamente latente care, ulterior au contribuit la instalarea unor boli psihice. \u0218i ce facem cu boala!?? O […]<\/p>\n","protected":false},"author":1,"featured_media":1405,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","footnotes":""},"categories":[44],"tags":[71,72,73,76,74,77],"class_list":["post-1403","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-interviuri","tag-evolutie","tag-pandemie","tag-psihologie","tag-sanatate","tag-sanatate-mintala","tag-sistem-de-sanatate"],"yoast_head":"\n73 de ani de evolu\u021bie - Uniunea Ziari\u0219tilor Profesioni\u0219ti din Rom\u00e2nia (UZPR)<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/uzpruk.com\/en\/73-de-ani-de-evolutie\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"73 de ani de evolu\u021bie - Uniunea Ziari\u0219tilor Profesioni\u0219ti din Rom\u00e2nia (UZPR)\" \/>\n<meta property=\"og:description\" content=\"Interviu cu Psiholog Dr. Nistor Becia, specialist pe recuperare \u0219i reabilitare de s\u0103n\u0103tate mintal\u0103 \u00een Marea Britanie Contextul socio-economic generat de efectul pandemic ne-a pus \u00een fa\u021ba unor situa\u021bii neprev\u0103zute, pentru care nu am fost preg\u0103ti\u021bi s\u0103 ac\u021bion\u0103m. 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