{"id":1138,"date":"2025-10-22T11:42:34","date_gmt":"2025-10-22T09:42:34","guid":{"rendered":"https:\/\/www.moodbites.eu\/lesson\/2-analyse-the-clients-needs-plan-intervention-actions-in-accordance-with-ebm-principles\/"},"modified":"2026-06-22T08:55:56","modified_gmt":"2026-06-22T06:55:56","slug":"2-analyse-the-clients-needs-plan-intervention-actions-in-accordance-with-ebm-principles","status":"publish","type":"lesson","link":"https:\/\/www.moodbites.eu\/cs\/lesson\/2-analyse-the-clients-needs-plan-intervention-actions-in-accordance-with-ebm-principles\/","title":{"rendered":"2. Analyzovat pot\u0159eby klienta, pl\u00e1novat interven\u010dn\u00ed opat\u0159en\u00ed v souladu s principy EBM"},"content":{"rendered":"\n

2.1.<\/strong> Definov\u00e1n\u00ed c\u00edle nutri\u010dn\u00ed intervence<\/strong> <\/p>\n\n\n\n

P\u0159esto\u017ee t\u00e9ma v\u00fd\u017eivy bylo v profesn\u00edm vzd\u011bl\u00e1v\u00e1n\u00ed soci\u00e1ln\u00edch pracovn\u00edk\u016f dlouho opom\u00edjeno, modern\u00ed p\u0159\u00edstupy k podpo\u0159e lid\u00ed v obt\u00ed\u017en\u00fdch \u017eivotn\u00edch situac\u00edch ukazuj\u00ed, \u017ee v\u00fd\u017eiva hraje kl\u00ed\u010dovou roli v oblasti du\u0161evn\u00edho zdrav\u00ed, soci\u00e1ln\u00edho fungov\u00e1n\u00ed a ka\u017edodenn\u00ed pohody klient\u016f. Kayla Harter (2017) ukazuje, \u017ee v\u00fd\u017eiva by m\u011bla b\u00fdt vn\u00edm\u00e1na jako ned\u00edln\u00e1 sou\u010d\u00e1st p\u0159\u00edstupu „\u010dlov\u011bk v prost\u0159ed\u00ed“ \u2013 holistick\u00e9 perspektivy, kter\u00e1 bere v \u00favahu klienta v jeho biologick\u00e9m, soci\u00e1ln\u00edm a emocion\u00e1ln\u00edm kontextu. <\/p>\n\n\n\n

<\/div><\/div>\n\n\n\n

<\/p>\n\n\n\n

Z v\u00fdzkumu Harterov\u00e9 vypl\u00fdv\u00e1, \u017ee a\u017e 68,2 % soci\u00e1ln\u00edch pracovn\u00edk\u016f se ve sv\u00e9 praxi zab\u00fdv\u00e1 v\u00fd\u017eivou, p\u0159esto\u017ee v\u011bt\u0161ina z nich (77 %) nikdy neabsolvovala \u017e\u00e1dn\u00fd v\u00fdcvik souvisej\u00edc\u00ed s v\u00fd\u017eivou a 89 % takov\u00e9 kurzy b\u011bhem magistersk\u00e9ho studia soci\u00e1ln\u00ed pr\u00e1ce neabsolvovalo (Harter, 2017). <\/p>\n\n\n\n

Z toho vypl\u00fdv\u00e1, \u017ee t\u00e9ma v\u00fd\u017eivy je d\u016fle\u017eit\u00e9 i pot\u0159ebn\u00e9 a \u017ee soci\u00e1ln\u00ed pracovn\u00edci \u010dasto jednaj\u00ed intuitivn\u011b nebo se spol\u00e9haj\u00ed na z\u00e1kladn\u00ed v\u0161eobecn\u00e9 l\u00e9ka\u0159sk\u00e9 poznatky. D\u011blaj\u00ed to proto, \u017ee si uv\u011bdomuj\u00ed souvislost mezi j\u00eddlem, n\u00e1ladou, zdrav\u00edm a ka\u017edodenn\u00edm fungov\u00e1n\u00edm klienta. <\/p>\n\n\n\n

P\u0159i pr\u00e1ci s lidmi s du\u0161evn\u00edm onemocn\u011bn\u00edm se t\u00e9ma v\u00fd\u017eivy \u010dasto objevuje jako vedlej\u0161\u00ed probl\u00e9m \u2013 „n\u011bkdo j\u00ed p\u0159\u00edli\u0161 mnoho“, „n\u011bkdo jin\u00fd t\u00e9m\u011b\u0159 nej\u00ed v\u016fbec“. Je snadn\u00e9 p\u0159edpokl\u00e1dat, \u017ee posta\u010d\u00ed n\u00e1vrh nebo let\u00e1k s informacemi. Pokud v\u0161ak skute\u010dn\u011b chceme, aby do\u0161lo ke zm\u011bn\u011b, pot\u0159ebujeme dob\u0159e promy\u0161len\u00fd ak\u010dn\u00ed pl\u00e1n \u2013 a jeho z\u00e1kladem je jasn\u00fd c\u00edl. <\/p>\n\n\n\n

Stanoven\u00ed c\u00edle intervence nen\u00ed jen formalita \u2013 je to proces, kter\u00fd pom\u00e1h\u00e1 organizovat akce, definovat sm\u011br spolupr\u00e1ce s klientem a posilovat jeho motivaci. S dob\u0159e definovan\u00fdm c\u00edlem klient vid\u00ed \u00fa\u010del zm\u011bny a c\u00edt\u00ed, \u017ee jej\u00edho dosa\u017een\u00ed je mo\u017en\u00e9 \u2013 krok za krokem. <\/p>\n\n\n\n

Pr\u00e1v\u011b proto se vyplat\u00ed pou\u017e\u00edvat metodu SMART \u2013 n\u00e1stroj, kter\u00fd pom\u00e1h\u00e1 formulovat c\u00edle tak, aby byly jasn\u00e9, re\u00e1ln\u00e9 a praktick\u00e9. <\/p>\n\n\n\n

<\/p>\n\n\n\n

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Metoda SMART \u2013 jak si stanovit c\u00edle, kter\u00e9 funguj\u00ed<\/strong>

SMART je zkratka, kter\u00e1 popisuje p\u011bt kl\u00ed\u010dov\u00fdch charakteristik dob\u0159e formulovan\u00e9ho c\u00edle. Ka\u017ed\u00fd prvek pom\u00e1h\u00e1 vyhnout se v\u00e1gn\u00edm tvrzen\u00edm a m\u011bn\u00ed c\u00edl ve strukturovanou ak\u010dn\u00ed strategii. <\/p>\n<\/div>\n\n\n\n

\n
Zkratka<\/strong> <\/td>V\u00fdznam <\/strong> <\/td>Co to znamen\u00e1 v praxi?<\/strong> <\/td><\/tr>
S<\/strong> <\/td>Specifick\u00fd (angl. Specific)<\/em> <\/td>C\u00edl by m\u011bl b\u00fdt jasn\u011b definovan\u00fd<\/strong> \u2013 bez v\u00e1gn\u00edch fr\u00e1z\u00ed jako „jezte zdrav\u011bji“. <\/td><\/tr>
M<\/strong> <\/td>M\u011b\u0159iteln\u00fd (angl. Measurable)<\/em> <\/td>M\u011blo by b\u00fdt mo\u017en\u00e9 ov\u011b\u0159it , zda bylo c\u00edle dosa\u017eeno.<\/strong> <\/td><\/tr>
A<\/strong> <\/td>Dosa\u017eiteln\u00fd (angl. Achievable)<\/em> <\/td>C\u00edl mus\u00ed b\u00fdt dosa\u017eiteln\u00fd<\/strong> pro danou osobu v jej\u00ed konkr\u00e9tn\u00ed situaci. <\/td><\/tr>
R<\/strong> <\/td>Relevantn\u00ed (angl. Relevant)<\/em> <\/td>C\u00edl by m\u011bl b\u00fdt d\u016fle\u017eit\u00fd a relevantn\u00ed<\/strong> k probl\u00e9m\u016fm klienta. <\/td><\/tr>
T<\/strong> <\/td>\u010casov\u011b ohrani\u010den\u00fd (angl. Time-bound)<\/em> <\/td>Je nutn\u00e9 ur\u010dit, kdy<\/strong> toho chceme dos\u00e1hnout. <\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div>\n<\/div><\/div>\n\n\n\n

<\/p>\n\n\n\n

Kdy\u017e soci\u00e1ln\u00ed pracovn\u00edk a klient formuluj\u00ed c\u00edl pomoc\u00ed tohoto modelu, je snaz\u0161\u00ed nejen pl\u00e1novat konkr\u00e9tn\u00ed kroky, ale tak\u00e9 hodnotit pokrok a reagovat, pokud n\u011bco nejde podle pl\u00e1nu. <\/p>\n\n\n\n

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P\u0159\u00edklad spr\u00e1vn\u00e9ho SMART c\u00edle v kontextu stravov\u00e1n\u00ed: <\/strong>
„Jan (\u017eij\u00edc\u00ed s dlouhodobou depres\u00ed, podv\u00fd\u017eivou, st\u011b\u017euj\u00edc\u00ed si na \u00fanavu a nedostatek energie) bude b\u011bhem n\u00e1sleduj\u00edc\u00edch dvou t\u00fddn\u016f j\u00edst alespo\u0148 jedno tepl\u00e9 j\u00eddlo denn\u011b obsahuj\u00edc\u00ed zeleninu, kter\u00e9 si nakoup\u00ed nebo p\u0159iprav\u00ed s pomoc\u00ed pracovn\u00edka.“

\u2022 S (Specifick\u00fd): p\u0159esn\u011b v\u00edme, co m\u00e1 klient ud\u011blat \u2013 sn\u00edst tepl\u00e9 j\u00eddlo se zeleninou.
\u2022 M (M\u011b\u0159iteln\u00fd): jedno j\u00eddlo denn\u011b \u2013 lze snadno sledovat.
\u2022 A (Dosa\u017eiteln\u00fd): pouze jedno j\u00eddlo, mo\u017en\u00e1 podpora ze strany pracovn\u00edka \u2013 realistick\u00e9.
\u2022 R (Relevantn\u00ed): c\u00edl \u0159e\u0161\u00ed konkr\u00e9tn\u00ed probl\u00e9m \u2013 podv\u00fd\u017eivu, nedostatek energie.
\u2022 T (\u010casov\u011b ohrani\u010den\u00fd): je stanoven jasn\u00fd \u010dasov\u00fd r\u00e1mec \u2013 dva t\u00fddny. <\/p>\n<\/div>\n\n\n\n

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\"Casual<\/figure><\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n

<\/p>\n\n\n\n

Abyste pochopili, pro\u010d je metoda SMART tak efektivn\u00ed, je u\u017eite\u010dn\u00e9 pod\u00edvat se na p\u0159\u00edklady, kter\u00e9 touto metodou nedodr\u017euj\u00ed: <\/p>\n\n\n\n

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Jan by se m\u011bl stravovat zdrav\u011b.\u201c<\/strong>
Tento c\u00edl zn\u00ed rozumn\u011b, ale je p\u0159\u00edli\u0161 v\u00e1gn\u00ed. Co znamen\u00e1 \u201ezdrav\u011b\u201c? Vztahuje se to na vyh\u00fdb\u00e1n\u00ed se cukru, konzumaci zeleniny, pravideln\u00e9 stravov\u00e1n\u00ed? Chyb\u00ed mu m\u011b\u0159itelnost, \u010dasov\u00fd r\u00e1mec a konkr\u00e9tn\u00ed akce. Takov\u00fd c\u00edl neposkytuje ani klientovi, ani pracovn\u00edkovi jasn\u00fd sm\u011br. <\/p>\n<\/div>\n\n\n\n

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\u201cJan will stop eating unhealthy things forever.\u201d<\/strong>
This goal is too ambitious, vague, and ultimately unrealistic. \u201cForever\u201d is an overwhelming demand \u2013 especially for someone with mental health difficulties. It lacks specifics, measurability, and timing. Nav\u00edc to m\u016f\u017ee vyvolat strach ze selh\u00e1n\u00ed a odradit klienta hned od za\u010d\u00e1tku. <\/p>\n<\/div>\n<\/div><\/div>\n\n\n\n

<\/p>\n\n\n\n

Z v\u00fdzkumu Kayly Harter (2017) vypl\u00fdv\u00e1, \u017ee a\u017e 68 % dot\u00e1zan\u00fdch soci\u00e1ln\u00edch pracovn\u00edk\u016f zahrnuje v\u00fd\u017eivu do sv\u00fdch rozhovor\u016f s klienty \u2013 nej\u010dast\u011bji jednoduch\u00fdm, ka\u017edodenn\u00edm zp\u016fsobem, p\u0159izp\u016fsoben\u00fdm situaci a mo\u017enostem klienta. Mluv\u00ed se p\u0159edev\u0161\u00edm o z\u00e1kladech zdrav\u00e9ho stravov\u00e1n\u00ed. Nejedn\u00e1 se o komplexn\u00ed znalosti o strav\u011b, ale o jednoduch\u00e9 pokyny, jako jsou: <\/p>\n\n\n\n

    \n
  1. „Zkuste jednou denn\u011b sn\u00edst n\u011bco tepl\u00e9ho.“ <\/li>\n<\/ol>\n\n\n\n
      \n
    1. „Bylo by dobr\u00e9 p\u0159idat k ob\u011bdu zeleninu.“ <\/li>\n<\/ol>\n\n\n\n
        \n
      1. „Voda m\u00edsto sladk\u00e9ho n\u00e1poje v\u00e1m m\u016f\u017ee pomoci c\u00edtit se l\u00e9pe.“ <\/li>\n<\/ol>\n\n\n\n

        Nejedn\u00e1 se o teorie \u2013 jsou to mal\u00e9 zm\u011bny, kter\u00e9 klient m\u016f\u017ee pochopit, zapamatovat si a implementovat, i kdy\u017e m\u00e1 pot\u00ed\u017ee s pam\u011bt\u00edm, motivac\u00ed nebo ka\u017edodenn\u00ed organizac\u00ed. <\/p>\n\n\n\n

        Dal\u0161\u00edm \u010dasto sklo\u0148ovan\u00fdm t\u00e9matem je omezen\u00ed „nezdrav\u00e9ho j\u00eddla“ \u2013 sladkost\u00ed, chips\u016f, rychl\u00e9ho ob\u010derstven\u00ed a sycen\u00fdch n\u00e1poj\u016f. Soci\u00e1ln\u00ed pracovn\u00edci ned\u00e1vaj\u00ed ultim\u00e1ta ani nevyn\u00e1\u0161ej\u00ed soudy \u2013 m\u00edsto toho kladou ot\u00e1zky jako: <\/p>\n\n\n\n

          \n
        1. „A co obvykle j\u00edte, kdy\u017e je v\u00e1m smutno?“ <\/li>\n<\/ol>\n\n\n\n
            \n
          1. „N\u011bkte\u0159\u00ed lid\u00e9 se c\u00edt\u00ed podr\u00e1\u017ed\u011bn\u011bj\u0161\u00ed po vypit\u00ed slazen\u00e9ho n\u00e1poje \u2013 jak to m\u00e1te vy?“ <\/li>\n<\/ol>\n\n\n\n

            Tyto rozhovory spojuj\u00ed emoce s j\u00eddlem a jejich c\u00edlem nen\u00ed z\u00e1kaz \u2013 ale reflexe, uv\u011bdom\u011bn\u00ed a drobn\u00e9 \u00fapravy. <\/p>\n\n\n\n

            D\u016fle\u017eit\u00fdm a velmi praktick\u00fdm t\u00e9matem je pl\u00e1nov\u00e1n\u00ed j\u00eddel s velmi omezen\u00fdm rozpo\u010dtem. Z tohoto d\u016fvodu m\u00e1 mnoho klient\u016f probl\u00e9m s pravideln\u00fdm p\u0159\u00edstupem k j\u00eddlu, a je\u0161t\u011b v\u00edce s va\u0159en\u00edm, pl\u00e1nov\u00e1n\u00edm n\u00e1kup\u016f nebo jednodu\u0161e s organizac\u00ed sv\u00e9ho dne kolem j\u00eddla. Zde m\u016f\u017ee soci\u00e1ln\u00ed pracovn\u00edk: <\/p>\n\n\n\n

              \n
            1. pomoci vytvo\u0159it n\u00e1kupn\u00ed seznam <\/li>\n<\/ol>\n\n\n\n
                \n
              1. uk\u00e1zat m\u00edstn\u00ed potravinovou banku <\/li>\n<\/ol>\n\n\n\n
                  \n
                1. napl\u00e1novat spole\u010dn\u011b jednoduch\u00fd a cenov\u011b dostupn\u00fd j\u00eddeln\u00ed\u010dek. <\/li>\n<\/ol>\n\n\n\n

                  To je \u010dasto d\u016fle\u017eitou sou\u010d\u00e1st\u00ed ka\u017edodenn\u00ed podpory \u2013 zejm\u00e9na p\u0159i pr\u00e1ci s lidmi bezdomova, \u017eij\u00edc\u00edm se zdravotn\u00edm posti\u017een\u00edm nebo s probl\u00e9my v oblasti du\u0161evn\u00edho zdrav\u00ed. <\/p>\n\n\n\n

                  N\u011bkte\u0159\u00ed soci\u00e1ln\u00ed pracovn\u00edci si tak\u00e9 v\u0161\u00edmaj\u00ed stravovac\u00edch n\u00e1vyk\u016f, kter\u00e9 mohou nazna\u010dovat poruchu p\u0159\u00edjmu potravy \u2013 nap\u0159\u00edklad obsedantn\u00ed vyh\u00fdb\u00e1n\u00ed se j\u00eddlu, epizody z\u00e1chvatovit\u00e9ho p\u0159ej\u00edd\u00e1n\u00ed nebo prohl\u00e1\u0161en\u00ed jako: „Nej\u00edm, proto\u017ee si to nezaslou\u017e\u00edm.“ <\/p>\n\n\n\n

                  Nestanovuj\u00ed diagn\u00f3zy, ale reaguj\u00ed empaticky a v\u011bd\u00ed, kdy klienta poslat ke specialistovi \u2013 dietologovi, nutri\u010dn\u00ed terapeutce, terapeutovi nebo psychiatrovi. Jejich \u00falohou je v\u0161imnout si prvn\u00edho n\u00e1znaku a pomoci klientovi naj\u00edt vhodnou podporu. <\/p>\n\n\n\n

                  Jak vid\u00edme, t\u00e9mata souvisej\u00edc\u00ed s v\u00fd\u017eivou, kter\u00fdmi se soci\u00e1ln\u00ed pracovn\u00edci zab\u00fdvaj\u00ed, nejsou n\u00e1hodn\u00e1 \u2013 vych\u00e1zej\u00ed z re\u00e1ln\u00fdch pot\u0159eb, rozhovor\u016f a pozorov\u00e1n\u00ed. Tato t\u00e9mata jsou \u010dasto mostem k budov\u00e1n\u00ed vztahu, prvn\u00edm krokem ke zm\u011bn\u011b a zp\u016fsobem, jak klientovi uk\u00e1zat, \u017ee n\u011bkdo vid\u00ed jeho ka\u017edodenn\u00ed tr\u00e1pen\u00ed. <\/p>\n\n\n\n

                  Je d\u016fle\u017eit\u00e9, aby si soci\u00e1ln\u00ed pracovn\u00edk pamatoval, \u017ee jeho role v nutri\u010dn\u00edch intervenc\u00edch m\u00e1 sv\u00e9 limity. Mohou klienta podpo\u0159it v ka\u017edodenn\u00edch \u010dinnostech, jako jsou: <\/p>\n\n\n\n

                    \n
                  • povzbuzov\u00e1n\u00ed k mal\u00fdm zm\u011bn\u00e1m, <\/li>\n<\/ul>\n\n\n\n
                      \n
                    • pomoc s pl\u00e1nov\u00e1n\u00edm n\u00e1kupu, <\/li>\n<\/ul>\n\n\n\n
                        \n
                      • podpora rozvoje jednoduch\u00fdch n\u00e1vyk\u016f. <\/li>\n<\/ul>\n\n\n\n

                        V mnoha p\u0159\u00edpadech, zejm\u00e9na kdy\u017e: <\/p>\n\n\n\n

                          \n
                        • jsou zde zn\u00e1mky poruch p\u0159\u00edjmu potravy (nap\u0159. anorexie, bulimie), <\/li>\n<\/ul>\n\n\n\n
                            \n
                          • klient m\u00e1 t\u011blesnou nemoc ovliv\u0148uj\u00edc\u00ed stravu (nap\u0159. cukrovka, podv\u00fd\u017eiva), <\/li>\n<\/ul>\n\n\n\n
                              \n
                            • nebo klient odm\u00edt\u00e1 j\u00edst a vznikaj\u00ed zdravotn\u00ed rizika, je nezbytn\u00e1 spolupr\u00e1ce s dal\u0161\u00edmi specialisty, jako je klinick\u00fd dietolog, l\u00e9ka\u0159 nebo psychoterapeut. <\/li>\n<\/ul>\n\n\n\n

                              Soci\u00e1ln\u00ed pracovn\u00edk by m\u011bl rozpoznat, kdy samostatn\u00e9 kroky nemus\u00ed sta\u010dit, a nab\u00eddnout klientovi extern\u00ed odbornou podporu. <\/p>\n\n\n\n

                              A\u0165 u\u017e pracujete na mal\u00e9 zm\u011bn\u011b n\u00e1vyk\u016f nebo podporujete klienta s v\u00e1\u017en\u00fdmi zdravotn\u00edmi probl\u00e9my, jeho blaho a bezpe\u010d\u00ed mus\u00ed b\u00fdt v\u017edy na prvn\u00edm m\u00edst\u011b.
                              Stanoven\u00ed realistick\u00fdch, spole\u010dn\u011b dohodnut\u00fdch c\u00edl\u016f nejen zvy\u0161uje efektivitu intervence, ale tak\u00e9 buduje d\u016fv\u011bru a d\u00e1v\u00e1 klientovi pocit kontroly \u2013 a to je kl\u00ed\u010dov\u00fd prvek ka\u017ed\u00e9 zm\u011bny, zejm\u00e9na v kontextu du\u0161evn\u00edho zdrav\u00ed. <\/p>\n\n\n\n

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                              INTERAKTIVN\u00cd AKTIVITA 46<\/strong><\/p>\n\n\n