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Mm.kikviZe , l.miqiaSvili , m.oniani , m.erisTavi , l.waqaZe Tbilisi, tfdec 2011, aprili

janmrTelobasTan dakavSirebuli cxovrebis xarisxi da misi gansazRvra rezistentuli tuberkuloziT daavadebul pacientebSi. Mm.kikviZe , l.miqiaSvili , m.oniani , m.erisTavi , l.waqaZe Tbilisi, tfdec 2011, aprili. gansazRvra.

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Mm.kikviZe , l.miqiaSvili , m.oniani , m.erisTavi , l.waqaZe Tbilisi, tfdec 2011, aprili

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  1. janmrTelobasTandakavSirebulicxovrebisxarisxidamisigansazRvrarezistentulituberkuloziTdaavadebulpacientebSijanmrTelobasTandakavSirebulicxovrebisxarisxidamisigansazRvrarezistentulituberkuloziTdaavadebulpacientebSi Mm.kikviZe, l.miqiaSvili, m.oniani, m.erisTavi, l.waqaZe Tbilisi, tfdec 2011, aprili

  2. gansazRvra “janmrTeloba – esadamianisfizikuri, fsiqologiuridasocialurisrulikeTildReobaadaaraubraloddaavadebisararseboba.” janmo “cxovrebisxarisxi– esfizikuri, fsiqologiuri, emociuridasocialurifunqcionirebisdaxasiaTebaa, dafuZnebulimissubieqtiuraRqmaze.” janmo

  3. socialurikeTildReoba FfsiqikurikeTildReoba FfizikurikeTildReoba

  4. “vmkurnalobTavadmyofs daaradaavadebas”

  5. istoriulieqskursi • aSSkolumbiisuniversitetisprofesormaD.A. Karnovsky 1947 w. gamoaqveynanaSromi – “qimioTerapiisklinikuriSefasebakibosdros” • 1980 w. eqimmaEngelSeqmnamedicinisbiofsiqologiurimodeli • 1995 wlidansafrangeTSifunqcionirebssaerTaSorisoarakomerciuliorganizacia, romeliccxovrebisxarisxsSeiswavlis, yovelwliuradsazogadoeba - International Society of Quality of Life Research–ISOQOL atarebskongresebs. • XXI s. dasawyisidantardebamravalricxovanisamecnierokvlevebicxovrebisxarisxisgansazRvrisaTvissxvadasxvadaavadebebisdros . dazustdamisisaxelwodeba - Health–related Quality of Life - HRQoL– janmrTelobasTandakavSirebulicxovrebisxarisxi. • QoLmecnierulSeswavlaSididiwvliliSeitanajanmom, romelmacSeimuSavamisiZiriTadikriteriumebi

  6. cxovrebisxarisxiskoncefciisganviTarebiswinapirobebi • teqnologiuriprogresizogierTidaavadebebisdiagnostikasadamkurnalobaSidamokrZalebuliwarmatebebisxvadaavadebebismkurnalobaSi • viwrospecializaciamedicinaSi • AadamianiskeTildReobismravalsafexurianistruqtura

  7. cxovrebisxarisxisZiriTadimaxasiaTeblebi • cxovrebisxarisxismravalgazomvianoba • droSicvalebadoba • avadmyofismonawileobaTavisimdgomareobisSefasebaSi

  8. medicinaSicxovrebisxarisxiskvlevismimarTulebebi • DdaavadebiszegavlenisSeswavlaavadmyofisfizikur, fsiqologiurdasocialurfunqcionirebaze • MmkurnalobiszegavlenisSeswavlaavadmyofiscxovrebisxarisxisparametrebze • samkurnalopreparatebisadamkurnalobismeTodebisefeqturobisSefaseba • cxovrebisxarisxisparametrebisprognozulimniSvneloba • cxovrebisxarisxirogorcremisiisadagankurnebiskriteriumi • cxovrebisxarisxisindividualurimonitoringi • socialur-samedicinopopulaciurikvlevebisCatareba • axalisamkurnalopreparatebiseqspertizisxarisxisamaRleba • mkurnalobismeTodebisekonomikuridasabuTebaiseTimaCveneblebisgaTvaliswinebiT, rogoricaa “fasi-xarisxi”, “Rirebuleba-efeqturoba” , QALY (Quality Adjusted Life Year) dasxvafarmako-ekonomikurikriteriumebi.

  9. cxovrebisxarisxisgansazRvra • cxovrebisxarisxis (cx) SeswavlisZiriTadiinstrumentia: profilebi (cxTiToeulikomponentisSefaseba) dakiTxvarebi (cxkompleqsuriSefasebisaTvis), • kiTxvarebiDSeiZlebaiyos – zogadi (janmrTelobisSefasebazogadad) daspecialuri(konkretulinozologiisSeswavlisaTvis). • zogadikiTxvarebia mag. Medical Outcomes Study 36-item Short Form Survey -36 (MOS SF-36). • specialurikiTxvaria mag."New York Heart Association Functional Classification Scale" (NYHA), romelicgamoiyenebafizikuriaqtivobisSezRudvisSesafasebladgulsisxlZarRvTadaavadebulpacientebSi, Quality of Life after Myocardial Infarction Questionnaire" (QLMI)

  10. cxovrebisxarisxisgansazRvrismeTodika SF-36 kiTxvarisstruqtura: kiTxvariSedgeba 11 nawilisagan, SedegebiwarmodgeniliaqulebissaxiT 8 SkalismixedviT. raodenobrivadfasdebaSemdegimonacemebi: • General Health (GH) • Physical Functioning (PF) • Role-Physical (RP) • Bodily Pain (BP) • Vitality (VT) • Social Functioning (SF) • Role-Emotional (RE) • Mental Health (MH)

  11. QoLkvlevisprotokoli • kvlevismizanidaamocanebi • avadmyofTaCarTviskriteriumebi • kvlevisdizaini • avadmyofisklinikurigamokvlevisbaraTi • kvlevisinstrumentisaRwera • sakvlevijgufismoculobisgansazRvra • randomizaciismeTodi • instruqciakvlevaSimonawilTaTvis • pacientisinformirebuliTanxmoba

  12. QoLkvlevisZiriTadietapebi • kvlevisprotokolisSemuSaveba • kvlevisinstrumentisSerCeva • monacemTaSegroveba • monacemTabazisformireba • kiTxvarismonacemTaSkalireba • monacemTastatistikuridamuSaveba • Sedegebisanalizidainterpretacia

  13. cxovrebisxarisxisgansazRvrarezistentulituberkuloziTdaavadebulpacientebSicxovrebisxarisxisgansazRvrarezistentulituberkuloziTdaavadebulpacientebSi kvlevisprotokoli mizani- rezistentulituberkuloziTdaavadebulpacientebSicxovrebisxarisxisSefaseba. MmasaladameTodebi– tfdecTerapiulganyofilebebSi 2010 wlisnoember – 2011 wlismartisTveebSiSemosuliavadmyofebi. Seswavliliqna 25 avadmyofi. CarTviskriteriumebi: • filtvistuberkulozi • multirezistentuli forma • axalidawarsulSinamkurnaleviSemTxvevebi Ggamoricxviskriteriumebi: • avadmyofebi18 wlamdeda 70 wliszemoT • TanmxlebidaavadebebidagarTulebebi • komunikaciuriproblemebi (qarTulienisarcodnadasxva)

  14. kvlevisprotokoli kvlevisaTvisgamoyenebuliqnakiTxvariMOS SF-36 . kiTxvarisSevsebis forma - mklevarisinterviuavadmyofTan. gakeTdaanalizikiTxvaris 8 ZiriTadiSkalismixedviTGH, PF daa.S. TiToeuliSkalafasdeboda 0 – 100.damatebiTiTvlebodaPCS – Physical Component Summary , MCS - Mental Component Summary. gamoTvlebisaTvisgamoyenebuliiyostandartulialgoriTmi. statistikurianalizi: aRwerilobiTistatistika (%, standartuligadaxris, saSualosadamedianisgamoTvla). intervius win yvelaavadmyofseZleodainformaciakvlevisSesaxeb, maTSorissurvilisamebrwerilobiTisaxiT – “pacientisinformaciulifurceli”. kvlevaSiCarTulmayvelaavadmyofmamoaweraxeliTanxmobisbaraTs – “pacientisinformirebuliTanxmoba”.

  15. KkvlevisSedegebisanalizidainterpretacia tab 1. kvlevaSiCarTuliavadmyofebisdaxasiaTeba

  16. KkvlevisSedegebisanalizidainterpretacia tab. 2 cxovrebisxarisxisparametrebi

  17. daskvna CatarebulmakvlevamaCvena: • filtvistuberkuloziTdaavadebulebSisicocxlisxarisxis, rogorcfizikuri, asevefsiqikurikomponentebisSemcireba, (metaddaqveiTebuliaPF, RP, RE); • msgavsiKkvlevisgafarToebisaucileblobadadamatebiTimaxasiaTeblebisgansazRvra (6MWT, spirometria) tuberkuloziTdaavadebulavadmyofebSi; • HRQoLcnebisada XXI saukunisaxalimeTodologiisdanergvissaWiroebafTiziatriulpraqtikaSi; • HRQoLparametrebisfarTodgamoyenebissaWiroebatuberkuloziTdaavadebulpacientebSiindividualurimkurnalobistaqtikisarCevisadaprognozulifaqtorisgansazRvrismizniT.

  18. gmadlobTyuradRebisaTvis

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