{"id":441,"date":"2020-09-04T09:48:33","date_gmt":"2020-09-04T07:48:33","guid":{"rendered":"https:\/\/hjerteforeningen.dk\/fagnet\/?p=5850"},"modified":"2024-03-21T13:30:08","modified_gmt":"2024-03-21T13:30:08","slug":"sundhedskompetence-et-praktisk-vaerktoej-i-hjerterehabilitering","status":"publish","type":"artikel","link":"https:\/\/hjerteforeningen.dk\/fagnet\/artikler\/alle-artikler\/sundhedskompetence-et-praktisk-vaerktoej-i-hjerterehabilitering\/","title":{"rendered":"Sundhedskompetence – et praktisk v\u00e6rkt\u00f8j i hjerterehabilitering"},"content":{"rendered":"\t\t
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Borgere som starter\u00a0<\/span><\/span>i<\/span><\/span>\u00a0hjerterehabiliteringsforl\u00f8b, kommer med forskellige kompetencer og foruds\u00e6tninger. Et fokus fra de sundhedsprofessionelle p\u00e5 s<\/span><\/span>undhedskompetence<\/span><\/span>\u00a0<\/span><\/span>kan bidrage til, at rehabiliteringstilbuddet kan rumme og ramme alle typer borgere.<\/span><\/span>\u00a0<\/span><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Som sundhedsprofessionelle giver vi hver dag information til patienter og borgere om<\/span>,<\/span>\u00a0hvordan de passer p\u00e5 deres helbred<\/span>,<\/span>\u00a0og hvad de skal g\u00f8re<\/span>,<\/span>\u00a0n\u00e5r de er syge.<\/span>\u00a0<\/span>Det kr\u00e6ver kompetencer hos<\/span>\u00a0borgeren<\/span>\u00a0at kunne forst\u00e5 og handle p\u00e5 den information<\/span>,<\/span>\u00a0de enten f\u00e5r serveret<\/span>,<\/span>\u00a0eller i nogle tilf\u00e6lde selv skal ops\u00f8ge.<\/span>\u00a0<\/span>Ikke alle besidder\u00a0<\/span>s\u00e5danne<\/span>\u00a0<\/span>kompetencer<\/span>\u00a0i lige h\u00f8j grad<\/span>, og det kan betyde, at nogle ikke f\u00e5r den behandling<\/span>,<\/span>\u00a0de har brug for.\u00a0<\/span>\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Individuelle kompetencer og samfundets krav<\/span><\/h3>

Sundhedskompetence, eller\u00a0<\/span>health<\/span>\u00a0<\/span>literacy<\/span>\u00a0som det ogs\u00e5 kaldes,\u00a0<\/span>vinder i h\u00f8jere og h\u00f8jere\u00a0<\/span>gr<\/span>ad indpas og er blevet et vigtigt emne ogs\u00e5 for Verdenssundhedsorganisationen WHO<\/span>.<\/span>\u00a0<\/span>Begrebet\u00a0<\/span>kan ved f\u00f8rste m\u00f8de\u00a0<\/span>synes\u00a0<\/span>relativt bredt<\/span>, da det<\/span>\u00a0d\u00e6kker over b\u00e5de individuelle og samfundsm\u00e6ssige aspekter<\/span>.\u00a0<\/span>\u00a0<\/span><\/p>

L\u00e6ge og ph.d.\u00a0<\/span>Anna Aaby<\/span>\u00a0har i sin forskning arbejdet med netop sundhedskompetence inden for hjerteomr\u00e5det<\/span>,<\/span>\u00a0og<\/span>\u00a0med<\/span>\u00a0hvordan det kan v\u00e6re et v\u00e6rkt\u00f8j til at sikre, at alle f\u00e5r mest muligt ud af<\/span>\u00a0et behandlingsforl\u00f8b<\/span>.<\/span>\u00a0<\/span><\/p>

– Lidt simplificeret s\u00e5 handler sundhedskompetence om vores individuelle evne<\/span>r<\/span>\u00a0til at kunne alt det<\/span>,<\/span>\u00a0som er n\u00f8dvendigt for at finde, forst\u00e5 og handle p\u00e5 sundhedsinformation. Det kan eksempelvis v\u00e6re at\u00a0<\/span>v<\/span>ide<\/span>,<\/span>\u00a0hvorn\u00e5r man skal\u00a0<\/span>s\u00f8ge<\/span>\u00a0l\u00e6ge,\u00a0<\/span>at kunne<\/span>\u00a0<\/span>have en dialog med sin\u00a0<\/span>behandler<\/span>\u00a0og<\/span>\u00a0at<\/span>\u00a0forst\u00e5 den vejledning man f\u00e5r<\/span>, forklarer<\/span>\u00a0Anna Aaby<\/span>.<\/span>\u00a0<\/span><\/p>

De individuelle kompetencer\u00a0<\/span>skal dog ses i\u00a0<\/span>relation<\/span>\u00a0til omverdenen<\/span>.\u00a0<\/span>K<\/span>ontekst<\/span>en<\/span>\u00a0og de krav samfundet stiller til befolkningen<\/span>,<\/span>\u00a0<\/span>har<\/span>\u00a0<\/span>ogs\u00e5\u00a0<\/span>betydning<\/span>.<\/span>\u00a0<\/span><\/p>

– Hvis\u00a0<\/span>der<\/span>\u00a0stille<\/span>s<\/span>\u00a0krav til<\/span>,<\/span>\u00a0<\/span>at\u00a0<\/span>borger<\/span>n<\/span>e<\/span>\u00a0for eksempel selv\u00a0<\/span>skal\u00a0<\/span>kende\u00a0<\/span>til\u00a0<\/span>og<\/span>\u00a0<\/span>reagere p\u00e5 sygdoms<\/span>symptomer<\/span>,<\/span>\u00a0<\/span>eller<\/span>\u00a0<\/span>selv\u00a0<\/span>skal\u00a0<\/span>kunne s\u00e6tte sig ind i<\/span>,<\/span>\u00a0hvordan\u00a0<\/span>de<\/span>\u00a0skal tage\u00a0<\/span>deres<\/span>\u00a0medicin, s\u00e5\u00a0<\/span>sl\u00e5<\/span>r<\/span>\u00a0<\/span>de<\/span>\u00a0<\/span>individuelle\u00a0<\/span>kompetence<\/span>r<\/span>\u00a0m\u00e5ske<\/span>\u00a0ikke til<\/span>,<\/span>\u00a0<\/span>siger<\/span>\u00a0Anna Aaby og forts\u00e6tter:<\/span>\u00a0<\/span><\/p>

–\u00a0<\/span>Desuden spiller det ind<\/span>,<\/span>\u00a0hvilken\u00a0<\/span>situation<\/span>\u00a0<\/span>borgern<\/span>e<\/span>\u00a0<\/span>st\u00e5r i<\/span>. Har man\u00a0<\/span>for eksempel\u00a0<\/span>lige haft en blodprop i hjertet<\/span>,\u00a0<\/span>er man\u00a0<\/span>sandsynligvis<\/span>\u00a0pr\u00e6get af\u00a0<\/span>ch<\/span>ok og kan have sv\u00e6rt ved at tage imod en masse information<\/span>, som man i andre situationer sagtens kunne rumme<\/span>.<\/span>\u00a0<\/span>P\u00e5 den m\u00e5de er\u00a0<\/span>sundhedskompetence et\u00a0<\/span>meget\u00a0<\/span>dynamisk begreb<\/span>, da\u00a0<\/span>kompetencer<\/span>ne<\/span>\u00a0\u00e6ndre<\/span>r<\/span>\u00a0sig gennem livet og best<\/span>e<\/span>m<\/span>te<\/span>\u00a0livssituatione<\/span>r<\/span>.<\/span>\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Et b<\/span>redt begreb<\/span>,<\/span>\u00a0men\u00a0<\/span>et\u00a0<\/span>praktisk<\/span>\u00a0redskab<\/span><\/h3>

Selvom s<\/span>undhedskompetence<\/span>\u00a0d\u00e6kker over mange<\/span>\u00a0dimension<\/span>er<\/span>,<\/span>\u00a0<\/span>er\u00a0<\/span>det<\/span>\u00a0if\u00f8lge Anna Aaby<\/span>\u00a0<\/span>et<\/span>\u00a0meget<\/span>\u00a0<\/span>praktisk\u00a0<\/span>og konkret\u00a0<\/span>redskab<\/span>\u00a0<\/span>til at<\/span>\u00a0<\/span>sikre<\/span>,<\/span>\u00a0at\u00a0<\/span>man kan favne alle typer borgere<\/span>.\u00a0<\/span>\u00a0<\/span><\/p>

I\u00a0<\/span>forbindelse med forskningsprojektet\u00a0<\/span>\u201dH\u00e5nden p\u00e5 hjertet<\/span>\u201d<\/span>\u00a0har Anna Aaby\u00a0<\/span>unders\u00f8gt, hvad sundhedskompetence betyder for<\/span>\u00a0<\/span>et\u00a0<\/span>hjerterehabilitering<\/span>sforl\u00f8b<\/span>, og hvordan man ved\u00a0<\/span>strukturelt og organisatorisk\u00a0<\/span>at fokusere p\u00e5\u00a0<\/span>begrebet<\/span>\u00a0kan hj\u00e6lpe<\/span>\u00a0<\/span>s\u00e5rbare\u00a0<\/span>borgere<\/span>\u00a0til at f\u00e5 mest muligt ud af\u00a0<\/span>deres genoptr\u00e6ning<\/span>.<\/span>\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Sundhedskompetence og hjerterehabilitering<\/span>\u00a0i Randers<\/span><\/h3>

Som en del af projektet har\u00a0<\/span>Anna Aaby<\/span>\u00a0i samarbejde med<\/span>\u00a0<\/span>ledelse<\/span>,\u00a0<\/span>medarbejder<\/span>e<\/span>\u00a0og\u00a0<\/span>borgere<\/span>\u00a0<\/span>ved<\/span>\u00a0<\/span>Randers Rehabiliteringsenheds udviklet og afpr\u00f8vet konkrete tiltag<\/span>,<\/span>\u00a0som\u00a0<\/span>tager udgangspunkt i t\u00e6nkningen omkring<\/span>\u00a0sundhedskompetence<\/span>.\u00a0<\/span>\u00a0<\/span><\/p>

Processen har blandt andet omfattet\u00a0<\/span>en<\/span>\u00a0<\/span>behovs<\/span>analyse\u00a0<\/span>hos\u00a0<\/span>borgere<\/span>\u00a0i rehabilitering<\/span>\u00a0<\/span>og en vurdering af selve organiseringen af rehabiliteringe<\/span>n<\/span>. P\u00e5 den baggrund og ved hj\u00e6lp af den internationale litteratur p\u00e5 omr\u00e5det, blev\u00a0<\/span>der\u00a0<\/span>i samarbejde\u00a0<\/span>genereret ideer til, hvordan man bedst\u00a0<\/span>sikre<\/span>r<\/span>\u00a0gode\u00a0<\/span>rehabiliteringsforl\u00f8b<\/span>\u00a0for alle typer borgere<\/span>. E<\/span>ksempelvis\u00a0<\/span>blev<\/span>\u00a0der udviklet<\/span>\u00a0<\/span>forskellige initiativer\u00a0<\/span>til<\/span>\u00a0at sikre, at de p\u00e5r\u00f8rende bliver inddraget i rehabiliteringen<\/span>, fort\u00e6ller Anna Aaby.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>

Derudover har medarbejderne brugt\u00a0<\/span>samtale<\/span>redskab<\/span>et CHAT (<\/span>Conversational<\/span>\u00a0Health\u00a0<\/span>Literacy<\/span>\u00a0<\/span>Assessment<\/span>\u00a0Tool)<\/span>\u00a0<\/span>\u00a0<\/span>til at implementer<\/span>e<\/span>\u00a0en\u00a0<\/span>struktureret<\/span>\u00a0dialog med nye\u00a0<\/span>borgere i rehabilitering<\/span>.\u00a0<\/span>CHAT<\/span> er et af flere sundhedskompetenceredskaber, som<\/span>\u00a0<\/span>hj\u00e6lper\u00a0<\/span>den sundhedsprofessionelle<\/span>\u00a0<\/span>til at vurdere\u00a0<\/span>borgerens<\/span>\u00a0sundhedskompetence og\u00a0<\/span>identificere<\/span>\u00a0de<\/span>,<\/span>\u00a0som er<\/span>\u00a0s\u00e5rbare og\u00a0<\/span>m\u00e5ske<\/span>\u00a0<\/span>har brug for ekstra st\u00f8tte.<\/span>\u00a0<\/span>D<\/span>e<\/span>n st\u00f8tte<\/span>\u00a0har de\u00a0<\/span>blandt andet f\u00e5et\u00a0<\/span>i form\u00a0<\/span>af\u00a0<\/span>en opf\u00f8lgende dialog med de<\/span>n<\/span>\u00a0<\/span>sundhedsprofessionelle<\/span>, hvor der er\u00a0<\/span>fokus p\u00e5\u00a0<\/span>en langt brede<\/span>re<\/span>\u00a0og dyb<\/span>d<\/span>eg\u00e5ende\u00a0<\/span>behovsafklaring og<\/span>\u00a0dermed en bedre<\/span>\u00a0tilpasning af genoptr\u00e6ningsforl\u00f8b<\/span>et til deres individuelle behov<\/span>.<\/span>\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Ansvar hos medarbejderne<\/span><\/h3>

Initiativet i Randers Rehabiliteringsenhed har prim\u00e6rt\u00a0<\/span>haft<\/span>\u00a0fokus p\u00e5\u00a0<\/span>samskabelse<\/span>sprocessen mellem medarbejdere, ledere og borgere<\/span>, og det er\u00a0<\/span>endnu\u00a0<\/span>ikke muligt at m\u00e5le p\u00e5 effekten<\/span>\u00a0af initiativerne<\/span>.\u00a0<\/span>\u00a0<\/span><\/p>

Noget af d<\/span>et<\/span>,<\/span>\u00a0<\/span>som<\/span>\u00a0<\/span>st\u00e5r frem\u00a0<\/span>fra forl\u00f8bet i<\/span>\u00a0Randers<\/span>,<\/span>\u00a0er<\/span>\u00a0dog<\/span>\u00a0if\u00f8lge Anna Aaby<\/span>, at processen\u00a0<\/span>med at s\u00e6tte fokus p\u00e5 sundhedskompetence\u00a0<\/span>og\u00a0<\/span>p\u00e5<\/span>,<\/span>\u00a0<\/span>hvordan<\/span>\u00a0man\u00a0<\/span>k<\/span>an\u00a0<\/span>im\u00f8dekomme<\/span>r<\/span>\u00a0<\/span>alle typer borgere<\/span>,<\/span>\u00a0uanset hvilke kompetencer de kommer med<\/span>,<\/span>\u00a0<\/span>har v\u00e6ret godt for alle\u00a0<\/span>involverede.\u00a0<\/span>\u00a0<\/span><\/p>

–<\/span>\u00a0<\/span>For\u00a0<\/span>nogle\u00a0<\/span>har det\u00a0<\/span>v\u00e6ret en<\/span>\u00a0<\/span>udfordr<\/span>ing<\/span>\u00a0at blive tvunget ud af\u00a0<\/span>deres<\/span>\u00a0komfortzone og se borgeren i et bredere perspektiv end\u00a0<\/span>det\u00a0<\/span>deres uddannelse som fysioterapeut eller sygeplejerske n\u00f8dvendigvis har kl\u00e6dt dem p\u00e5 til<\/span>, forklarer Anna Aaby<\/span>\u00a0og forts\u00e6tter<\/span>:<\/span>\u00a0<\/span><\/p>

–\u00a0<\/span>For\u00a0<\/span>andre\u00a0<\/span>har det v\u00e6ret sv\u00e6rt at tage\u00a0<\/span>en mere dybdeg\u00e5ende\u00a0<\/span>dialog<\/span>\u00a0med\u00a0<\/span>borgerne<\/span>\u00a0og i h\u00f8jere grad\u00a0<\/span>skulle\u00a0<\/span>tage ansvar og stole\u00a0<\/span>p\u00e5\u00a0<\/span>deres<\/span>\u00a0egen\u00a0<\/span>faglige\u00a0<\/span>vurdering, fremfor at f\u00f8lge en forudbestemt\u00a0<\/span>proce<\/span>dure<\/span>. Det kr\u00e6ver\u00a0<\/span>tilv\u00e6nning<\/span>. Til geng\u00e6ld\u00a0<\/span>er det<\/span>\u00a0min oplevelse<\/span>,<\/span>\u00a0at\u00a0<\/span>medarbejderne<\/span>\u00a0har v\u00e6ret glade for at\u00a0<\/span>tage<\/span>\u00a0<\/span>mere fagligt\u00a0<\/span>ansvar<\/span>\u00a0for at vurdere<\/span>,<\/span>\u00a0hvad borgern<\/span>e<\/span>\u00a0har brug for og tilrettel\u00e6gge<\/span>\u00a0<\/span>genoptr\u00e6ningsforl\u00f8bet herefter<\/span>.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Et redskab til at overkomme social ulighed i sundhed<\/span><\/h3>

Forskningsprojektet \u201dH\u00e5nden p\u00e5 hjertet\u201d har if\u00f8lge Anna Aaby understreget<\/span>, at sundhedskompetence er\u00a0<\/span>vigtig\u00a0<\/span>i relation til forebyggelse og\u00a0<\/span>hjerte<\/span>rehabilitering<\/span>.\u00a0<\/span>\u00a0<\/span><\/p>

–<\/span>\u00a0<\/span>Hvis det\u00a0<\/span>bruges rigtigt, kan det v\u00e6re et praktisk redskab til <\/span>at\u00a0<\/span>modg\u00e5 stigmatisering\u00a0<\/span>og kasset\u00e6nkning\u00a0<\/span>og i stedet fokusere p\u00e5\u00a0<\/span>borgeren<\/span>s konkrete evner og udfordringe<\/span>r og tilrettel\u00e6gge forl\u00f8bet derefter<\/span>, forklarer hun<\/span>.<\/span>\u00a0<\/span><\/p>

–<\/span>\u00a0<\/span>Desuden ber\u00f8rer s<\/span>undhedskompetence mange af de elementer<\/span>, som indg\u00e5r i temaer<\/span>ne<\/span>\u00a0<\/span>patientinddragelse og\u00a0<\/span>empowerment<\/span>, og som man i forvejen arbejder med mange steder inden for sundhedsv\u00e6snet. Sundhedskompetence<\/span>\u00a0kan\u00a0<\/span>dog\u00a0<\/span>v\u00e6re nemmere at h\u00e5ndtere og handle p\u00e5<\/span>, og derfor v\u00e6re et rigtig godt sted at starte,\u00a0<\/span>slutter Anna Aaby.\u00a0<\/span>\u00a0<\/span><\/p>

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