Pastirska briga i religiozna podrška kao deo lečenja religiozne bolesnice s teškim oblikom osteoartritisa
Sažetak
Uvod. Religiozne potrebe bolesnika stalno se zanemaruju u kliničkoj medicini. Pastirska briga je religiozna podrška koju religioznom bolesniku pružaju sveštenici, pastori, imami, rabini i ostali religiozni autoriteti. Religiozna podrška u smislu kliničke medicine, je duhovna podrška koju religioznom bolesniku pružaju religiozni i za to obučeni medicinski radnici. Cilj rada bio je da se prikažu efekti pastirske nege i religiozne podrške u sklopu bolničkog lečenja 73-godišnje bolesnice sa teškom formom osteoartritisa. Prikaz bolesnika. Veoma religozna bolesnica, stara 73 godine, sa teškom formom osteoartritisa, primljena je na lečenje u Kliniku za fizikalnu medicinu i rehabilitaciju Vojnomedicinske akademije u Beogradu, zbog više problema koji su ometali njen svakodnevni život. Bolesnica se kretala otežano uz pomoć štapa, trpela je bolove i bila je anksiozna i depresivna. U cilju objektivnog sagledavanja efekata pastirske nege i religiozne podrške u lečenju ove bolesnice, sproveli smo multiplo obrtno lečenje koje se sastojalo od primene bazičnog tretmana (bolnička nega, terapija lekovima i fizikalna terapija), označenog kao tretman A, koji se naizmenično menjao sa tretmanom sastavljenim od bazičnog tretmana uz dodatak religiozne podrške koju su obazbeđivali verujući fizijatar i fizioterapeut (tretman B), odnosno bazičnog tretmana uz dodatak pastirske nege koju je pružao vojni sveštenik (tretman C). Bazični tretman bio je primenjen tri puta, svaki put u trajanju od po dve nedelje, a kombinovani tretmani sa religioznom, odnosno pastirskom podrškom, primenjivni su jedanput, po tri nedelje svaki. Redosled primenjenih tretmana bio je sledeći: A→B→A→C→A. Glavna obeležja posmatranja i merne skale bili su: nivo depresije meren Hamiltonovom skalom depresije i Cungovom skalom depresije; nivo anksioznosti, Cungovom skalom anksioznosti, a funkcionalna sposobnost bolesnika merena je indeksom Bartel i Merom funkcionalne nezavisnosti. Merenja su vršena svaki dan. U statističkoj obradi podataka korišćene su dve neparametrijske metode za kvantitativnu obradu podataka: procenat tačaka koje se ne preklapaju – (percentage of non-overlapping data – PND) i procenat tačaka koje prelaze nivo medijane (percentage of data points exceeding the median – PEM). Vrednosti PND i PEM između 0,7 i 0,9 govore o zadovoljavajućem efektu lečenja. Vrednosti od 0,9 i više govore o značajnom efektu lečenja. Uvođenjem religiozne podrške u lečenje, smanjenje anksioznosti bilo je umereno do značajno tretman (B); ґ ± SD = 50,1 ± 10,89; varijabilnost = 4,598653; srednji pomak = 0.219626; PND = 0,6, PEM = 0,9). Depresija bolesnice značajno se smanjila samo nakon uvođenja pastirske brige i samo prema jednoj statistici (PEM = 0,9). Nasuprot ovome, nije došlo do poboljšanja funkcionalne sposobnosti bolesnice. Zaključak. Kod visoko religiozne bolesnice sa teškom formom osteoartritisa, pastirska nega i religiozna podrška, primenjeni u sklopu standardnog medicinskog lečenje tog stanja, ispoljili su određene povoljne efekte na anksioznost i depresivno raspoloženje, ali bez značajnijeg poboljšanja funkcionalne sposobnosti bolesnice.
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