101297069 by WN PWN

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1. 2(/76 ' (, %,/, 0-,ĸ" 7+ & 64&)&7 6'+ – Renata Wójcik .....................

ǖǽǖǽ /$ +&7 ' ,Š/,!(Ń4 !& "1,),$& 7+6 % ...................................................... ǖǽǖǽǖǽ /$ +&7 ' ,-&"(& + ! !,/,0ĸ6* %,/6* + 2(/76 Ė ..................... 1.1.2. /$ +&7 ' ,-&"(& !& "1,),$& 7+"' + ! !7&"þ*& & *ĸ,!7&"Ɠû %,/6*& + 2(/76 Ė ............................................................................ 1.2. Epidemiologia cukrzycy ................................................................................... ǖǽǘǽ ,!7& ĸ 2(/76 6Ǿ "1&,),$& & - 1,$"+"7 ......................................................... ǖǽǙǽ ,0716 0-,ĸ" 7+" )" 7"+& 2(/76 6 ................................................................ ǖǽǚǽ 0-Ńĸ-/ -&")Ė$+& /(& 4 7"0-,)" 1"/ -"216 7+6* ......................................

1 1 2 3 4 7 9

2. ,01Ė-,4 +&" 1"/ -"216 7+" 4 2(/76 6 .............................................................

Ǘǽǖǽ "1,!6 +&"# /* (,),$& 7+" ............................................................................. Ǘǽǖǽǖǽ !Ɠ64& +&" Ȕ / Ɠ6+ ,/7"+&"40( Ǿ +21 '"40( .................... ǗǽǖǽǗǽ 60&ĸ"( #&76 7+6 Ȕ Anna Stefanowicz-Bielska ...................................... ǗǽǗǽ "1,!6 # /* (,),$& 7+" .................................................................................. 2.2.1. Leczenie lekami doustnymi – 4 ,01/7"4 Ȓ ĸ, ( .................... ǗǽǗǽǗǽ " 7"+&" &+02)&+û Ȕ )& ' 7"4 76(Ǿ "+ 1 , 7 +Ǿ "+ 1 "/"!6+ .....................................................................................

13 13 46 51 51 69

3. -&"( -&")Ė$+& /0( + ! - '"+1"* 7 2(/76 û .................................................

3.1. Samokontrola w cukrzycy – "/"0 "+ "+"(Ȓ )2- Ǿ 4 /$,ĺ0( Ȓ &"(21,40( ............................................................................ ǘǽǖǽǖǽ ,+&1,/,4 +&" $)&("*&& ....................................................................... ǘǽǗǽ 01/" -,4&(ĸ +& 2(/76 6 Ȕ " 6)& )07 (Ǿ )Ɠ &"1 ,4& ( Ǿ ,/,1 "/ 21 .................................................................................................... 3.2.1. Hipoglikemia ........................................................................................ ǘǽǗǽǗǽ 1 +6 ,01/"$, +&"!, ,/2 &+02)&+6 Ȕ Š-&û 7(& %&-"/$)&("*& 7+" ......... ǘǽǘǽ /7"4)"(ĸ" -,4&(ĸ +& 2(/76 6 ...................................................................... 3.3.1. Retinopatia cukrzycowa – $+&"07( /Ń )"40( Ǿ )&+ 72/ ...... 3.3.2. Cukrzycowa choroba nerek – $+&"07( / 7"40( Ǿ /6016+ Š/Ń!"(Ǿ /,)&+ 2Š+&"/7 ..................................................... ǘǽǘǽǘǽ %,/, 6 + 76+&,4" *Ń7$2 4 -/7" &"$2 2(/76 6 Ȕ " 6)& )07 (Ǿ )Ɠ &"1 ,4& ( Ǿ ,/,1 "/ 21 ...........................................................

97 100 115 115 125 137 137 148 156

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3.3.4. Kardiomiopatia cukrzycowa – " 6)& )07 (Ǿ )Ɠ &"1 ,4& ( Ǿ ,/,1 "/ 21 ....................................................................................... ǘǽǘǽǚǽ *& +6 0(Ń/+" Ȕ ĸ$,/7 1 / '"40( .............................................. ǘǽǘǽǛǽ - )"+&" -/767Ė & 4 -/7" &"$2 2(/76 6 Ȕ )Ɠ &"1 ,Š &ĺ0( ....... ǘǽǙǽ "0-Ńĸ 01,-6 2(/76 ,4"' ................................................................................ 3.4.1. Zasady rozpoznawania – &/,0ĸ 4 ĸ6+ / 72( ................................ ǘǽǙǽǗǽ 6( 7 ! ĺ 01,0,4 +6 % 4 !& $+,016 " & *,+&1,/,4 +&2 7"0-,ĸ2 01,-6 2(/76 ,4"' Ȕ &/,0ĸ 4 ĸ6+ / 72( .......................... 3.4.3. Edukacja z zakresu profilaktyki stopy cukrzycowej – 2016+ -2Š &,( ................................................................................ ǘǽǚǽ -&"( -&")Ė$+& /0( + ! !7&"þ*& %,/6*& + 2(/76 Ė 4 Š/,!,4&0(2 nauczania i wychowania – )& ' 7"4 76( ...................................................... ǘǽǚǽǖǽ ! +& /,!7& !7&" ( 7 2(/76 û 4 07(,)" ...................................... ǘǽǚǽǗǽ 612 '" 07 7"$Ń)+" .............................................................................. ǘǽǚǽǘǽ 7(,)+6 (,!"(0 -/ 4 !7&" ( 7 2(/76 û ............................................ ǘǽǛǽ -&"( -&")Ė$+ 6'+,Ȓ-,ĸ,Ɠ+& 7 4 -/7" &"$2 &ûƓ6 Ȕ / Ɠ6+ û 7"(Ǿ 4")&+ ! * 76(Ȓ /,Ɠ6+ .............................................................................. ǘǽǛǽǖǽ 2(/76 -/7"! &ûƓ,4 Ȕ ,-&"( + ! (, &"1û 4 ,(/"0&" -/7"!(,+ "- 6'+6*Ǿ 4 7 0&" &ûƓ6Ǿ ,-&"( ,(,ĸ,-,/,!,4 & 4 7 0&" -,ĸ,$2 .................................................................................. ǘǽǛǽǗǽ -&"( + ! (, &"1û 4 &ûƓ6 %,/û + 2(/76 Ė &ûƓ,4û .................... ǘǽǜǽ -&"( ,(,ĸ,,-"/ 6'+ 2 %,/6 % + 2(/76 Ė Ȕ )Ɠ &"1 ,4& ( Ǿ " 6)& )07 (Ǿ ,/,1 "/ 21 ...........................................................................

159 164 172 174 174 186 194 205 206 208 214 214

215 222 231

4. !2( ' %,/6 % + 2(/76 Ė ................................................................................ 255 4.1. Wprowadzenie .................................................................................................. – )Ɠ &"1 ,Š &ĺ0( 4.2. Cele, funkcje i znaczenie edukacji terapeutycznej .......................................... – )Ɠ &"1 ,Š &ĺ0( 4.2.1. Edukacja formalna i nieformalna......................................................... ǙǽǗǽǗǽ "0-Ńĸ "!2( 6'+6 4" 40-Ńĸ 7"0+6* 0601"*&" , %/,+6 7!/,4& .... 4.2.3. Etapy edukacji terapeutycznej w cukrzycy .......................................... ǙǽǗǽǙǽ "1,!6 & #,/*6 -/, "02 2 7"+& 0&Ė ..................................................... ǙǽǗǽǚǽ 76++&(& !"1"/*&+2'û " "#"(164+,Šþ 2 7"+& 0&Ėȡ+ 2 7 +& ............ 4.2.6. Zakres edukacji ..................................................................................... Ǚǽǘǽ ,!")" "!2( '& 7!/,4,1+"' 4 2(/76 6 ......................................................... 4.3.1. Wprowadzenie – )Ɠ &"1 ,Š &ĺ0( .................................................... ǙǽǘǽǗǽ ,!") 2 !7&" & & *ĸ,!7&"Ɠ6 Ȕ )& ' 7"4 76( ...................................... Ǚǽǘǽǘǽ ,!") 2 ,0Ń !,/,0ĸ6 % Ȕ )Ɠ &"1 ,Š &ĺ0( ..................................... ǙǽǘǽǙǽ ,!") 2 0"+&,/Ń4 Ȕ )Ɠ &"1 ,Š &ĺ0( ............................................... Ǚǽǘǽǚǽ ,!") 2 ,0Ń 0ĸ ,4&!7û 6 % & +&"4&!,*6 % Ȕ ,/,1 "/ 21Ǿ " 6)& )07 (Ǿ )Ɠ &"1 ,4& ( .......................................................... ǙǽǘǽǛǽ ,!")" "!2( '& Ȕ -/76(ĸ !6 !, /6 % -/ (16( Ȕ Ewa Kobos .............. ǙǽǙǽ ,/ ! -&")Ė$+& /0( 2 ,0Ń 7 2(/76 û .......................................................... ǙǽǙǽǖǽ ,/ ! -&")Ė$+& /0( 4 !& "1,),$&& 4 * 2) 1,/6'+"' Opiece Specjalistycznej (AOS) – )& ' 7"4 76( .................................

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255 256 260 262 264 266 271 276 277 277 279 284 284 286 299 315 315

4.4.2. Porady edukacyjne realizowane w Podstawowej Opiece Zdrowotnej ț Ȝ 4 / * % Š4& ! 7"+& ,-&"(& (,,/!6+,4 +"' Ȕ /&,) &"1/7 (Ǿ )"(0 +!"/ &"0& ! Ǿ )& ' 7"4 76(Ǿ 4 , ,0Ǿ " 1 01/76 ( ..................................................................................... 320 5. $ !+&"+& -06 %,),$& 7+" 4 ,-&" " + ! - '"+1"* 7 2(/76 û – , ++ &"1/20&ĺ0( Ȓ 2+7& 1& ..................................................................................... 331 5.1. Psychologia chorego somatycznie .................................................................. ǚǽǗǽ -" 6#&( 2(/76 6 4 2'Ė &2 -06 %,),$& 7+6* ............................................... 5.2.1. Czynniki emocjonalne w przebiegu i leczeniu cukrzycy ..................... 5.2.2. Cukrzyca z perspektywy psychologicznej ........................................... ǚǽǘǽ 06 %,),$& 7+ 0612 ' ,0, 6 7 2(/76 û ..................................................... 5.3.1. Reakcja pacjenta na rozpoznanie cukrzycy ........................................ ǚǽǘǽǗǽ ,01Ė-,4 +&" 4 -&"/407"' # 7&" %,/, 6 ........................................... ǚǽǘǽǘǽ *, ',+ )+" /" ( '" + %,/, Ė ........................................................ ǚǽǘǽǙǽ 2/7"+& "*, ',+ )+" & 7 %,4 +& 1,4 /7607û " 2(/76 6 ........ ǚǽǙǽ 2(/76 16-2 ǖ 4 Ɠ6 &2 & /,74,'2 !7&" ( ...................................................... 5.4.1. Dynamika adaptacji rodziny do choroby ............................................ ǚǽǙǽǗǽ 2(/76 4 /ŃƓ+6 % ,(/"0 % Ɠ6 & !7&" ( ....................................... ǚǽǙǽǘǽ ,74Ń' !7&" & & *ĸ,!7&"Ɠ6 7 2(/76 û .................................................. ǚǽǙǽǙǽ ,!7&+ 4, " -/7"4)"(ĸ"' %,/, 6 !7&" ( ..................................... ǚǽǙǽǚǽ 6$+ ĸ6 "*, ',+ )+"' ! -1 '& !, 2(/76 6 2 !7&" & & *ĸ,!7&"Ɠ6 ... ǚǽǚǽ 0-Ńĸ-/ 7 - '"+1"* 4 ,-&" " !& "1,),$& 7+"' ...................................... 5.5.1. Zmiana paradygmatu w terapii cukrzycy: od przedmiotu do podmiotu leczenia .......................................................................... 5.5.2. Psychologiczne znaczenie wiedzy o chorobie .................................... ǚǽǚǽǘǽ ,*2+&( ' 7 - '"+1"* %,/6* + 2(/76 Ė ................................. 5.5.4. 06 %,),$& 7+" ĸĖ!6 4 -,01Ė-,4 +&2 4, " - '"+1 7 2(/76 û ............................................................................................. ǚǽǛǽ (,Šþ Ɠ6 & ,0Ń 7 2(/76 û ...........................................................................

331 332 332 332 335 335 335 336 337 338 339 339 340 341 342 343 343 344 346 346 347

6. Programy profilaktyczne i terapeutyczne w cukrzycy – 4 ,01/7"4 Ȓ ĸ, ( ............................................................................................ 353 6.1. Schemat programu zdrowotnego .................................................................... 354 7. ,!01 46 -&")Ė$+& /014 ,- /1"$, + !,4,! % + 2(,46 % 4 -/ (16 " -&")Ė$+& /(& !& "1,),$& 7+"' – Ewa Kobos ............................................................ 361 7.1. Praktyka oparta na dowodach naukowych (evidence-based practice) .......... 7.2. Pytanie kliniczne – kluczowy krok w EBP ........................................................ 7.2.1. Analiza sytuacji klinicznej, budowanie pytania klinicznego + -,1/7" 6 46072(&4 +& !,4,!Ń4 + 2(,46 % ............................. ǜǽǗǽǗǽ ,!7 '" 0 %"* 1Ń4 ! 4 76 % ....................................................... ǜǽǗǽǘǽ 6 Ń/ 7 0, Ń4 .................................................................................... ǜǽǗǽǙǽ 6072(&4 +&" 46+&(Ń4 ! ĺ 7 2Ɠ6 &"* 0ĸŃ4 ()2 7,46 % ..............

361 363 368 370 392 396

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ǜǽǘǽ /616 7+ , "+ 4& /6$,!+,Š & !,4,!Ń4 + 2(,46 % ................................. 405 7.4. Wykorzystanie danych naukowych .................................................................. 408 8. &")Ė$+& /014, 7 4 +0,4 +"' -/ (16(& – " 1 ,/+&( .................................... 411 8.1. ,!") 7 4 +0,4 +"' -/ (16(& -&")Ė$+& /0(&"' 4 !& "1,),$&& ..................... ǝǽǗǽ 601"* 2760(&4 +& 2-/ 4+&"ĺ ....................................................................... ǝǽǘǽ ,!")" 4 46 / +6 % (/ ' % ................................................................... ǝǽǙǽ "1,!6 , "+6 & *,+&1,/,4 +& ................................................................ ǝǽǚǽ ) 016 7+,Šþ *,!")2 ................................................................................ ǝǽǛǽ ,*-"1"+ '" -&")Ė$+& /(& ........................................................................ ǝǽǜǽ ,!") 7 4 +0,4 +"' -/ (16(& -&")Ė$+& /0(&"' 4 !& "1,),$&& ..................... ǝǽǜǽǖǽ "#&+& ' & 7 (/"0 !7& ĸ ĺ ...................................................................... ǝǽǜǽǗǽ &")Ė$+& /(& !& "1,),$& 7+" 4 7"0-,ĸ % interdyscyplinarnych ........................................................................... 8.8. Uzasadnienie dla rozwoju APN w diabetologii ................................................

411 413 414 418 418 419 419 419 421 422

9. 6/, 6 *"!6 7+" ,/!6+,4 +" -/7"7 -&")Ė$+& /(& - '"+1,* 7" 7!& $+,7,4 +û 2(/76 û – /&,) &"1/7 (Ǿ ,#& &"+(&"4& 7 ........................ 425 10. "7-&" 7"ĺ014, - '"+1 4 ,-&" " !& "1,),$& 7+"' – Józefa Czarnecka ......... 440 11. Towarzystwa naukowe i stowarzyszenia w diabetologii – )& ' 7"4 76( ........ 446 11.1. Towarzystwa naukowe i stowarzyszenia polskie ............................................ 446 11.2. Towarzystwa naukowe i stowarzyszenia zagraniczne .................................... 448 12. (16 -/ 4+" 74&û7 +" 7 ,-&"(û -&")Ė$+& /0(û – )& ' 7"4 76( ........................ 450 Skorowidz

XIV

............................................................................................................... 455

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