Uma uhamba esitolo sokunethezeka semama-no-pop ngempelasonto, ungathola ukuthi isevisi ihamba kancane. Amaviki eviki yizinkathi zokuphumula ezomabhizinisi amaningi, futhi izitolo eziningi zithengiswa ngaphansi kwezinkathi ezisezingeni eliphansi njengezimpelasonto, ubusuku namaholide.
Kodwa-ke, ungase umangale uma ufunda ukuthi ukungena ngaphansi kwezinsizakalo kanye nokunciphisa ngesikhathi sokuncintisana nakho kunezibhedlela.
Lesi simo, esibizwa ngokuthi i-Weekend Effect, sihlobene nokufa kakhudlwana phakathi kweziguli ezivunyelwe esibhedlela. I-Weekend Effect nayo ihlotshaniswe nezinye izimpikiswano ezinkulu, ezifana nokuphuma kwegazi nokutheleleka.
Ngokusobala, isikhathi se-Weekend Effect sesiphakamiso sesiphakamiso sokulondoloza impilo, futhi ngeziboniso eziphuthumayo esimisweni sesibhedlela, umehluko wamaminithi ambalwa ungabalulekile. Lesi senzakalo singase siboshwe ekuhluphekeni kwezinsizakalo zokuphenya (ezitholakalayo) ezitholakalayo ngempelasonto kanye nokufinyelela okunciphise odokotela abakhethekile, abavame "ukushayela" futhi abangekho emitholampilo ngezimpelasonto.
Nakuba i-Weekend Effect iye yabhalwa kwamanye amazwe-ikakhulukazi e-United Kingdom lapho ikhulise ukukhathazeka okukhulu-isanda kubhalwa e-United States. Ngaphezu kwalokho, nakuba kunezifundo ezingaphumeleli ukusekela ukufaneleka kwayo, ubufakazi obuningi bokukhula obubonakalayo bubonakala bukhomba ngalesi simo.
Ake siqale sibone ezinye zezibonelo ze-Weekend Effect njengoba kuboniswe ezincwadini. Khona-ke, sizohlola ukubaluleka kwalesi senzakalo.
I-Weekend Effect kanye nesifo sohlangothi
Ngentuthuko ekunakekeleni, abantu abaningi abanobuchopho basinda. Noma kunjalo, esimweni esihle kakhulu se-2015 eshicilelwe ku-PLoS ONE, abacwaningi bathole ukuthi i-Weekend Effect iyaphila nase-United Kingdom.
Kulolu cwaningo oluphindaphindiwe, abacwaningi bahlola ukushona (okungukuthi, ukufa) phakathi kwabantu abangu-37 888 ababelethwe ngesifo esibhedlela phakathi kuka-2004 no-2012. Uma kuqhathaniswa ne-admission day ukubhekana nokushaywa yisifo, ukufa kwezinsuku eziyisikhombisa ngemuva kokungeniswa kwezimpelasonto kwaba amaphesenti angu-19 ephakeme-yize kwakunezingeniso ezingamaphesenti angu-21 ezamukelwayo! Ukuhlaziywa kwedatha kwahlelwa iminyaka yobudala, ubulili kanye nezimo ezihlukumezayo ezingu-11, noma ezinye izimo ezingapheliyo, kuhlanganise nezidakamizwa, ezinye izinkinga zesifo se-circulatory, isifo sikashukela , nesifo sengqondo somqondo .
Okuphawulayo, kulolu cwaningo, ukushona kwakuphansi kunazo zonke esibhedlela ngesigungu esiphethwe yi-stroke unit. Ngaphezu kwalokho, ukufa kwakungaphezu kwezibhamu ngenhloso engacacisiwe kunaleyo ye-cerebral infarction, lapho i-clot yegazi iphazamisa ukugeleza kwegazi kuya ebuchosheni.
Abacwaningi baphinde bahlola imiphumela yezinye izici ezintathu ngokufa kwesibalo: ukufakwa kwamanye amazwe phakathi nezinyanga zasebusika, ukuhanjelwa kwezibhedlela zomphakathi nezikhulu kanye nokude okuphakathi kokuhlala kwesineke kanye nesibhedlela ngokwayo (engaphezu kwamakhilomitha angaphezu kwangu-20). Nakuba ukutholakala kwabo kwakungabonakali ngokuphawulekayo mayelana nethonya lalezi ezinye izinto eziguquguqukayo ezilinganisweni zokufa, abacwaningi basikisela ukuthi lezi ezinye izici ezintathu zingase zenze indima ngandlela-thile inselelo yokuphila kwesiguli ngemva kokushaywa yisifo.
I-Weekend Effect nayo ibonwe ngokuphathelene nokufa kwesifo esiwu-stroke e-United States. Encwadini yocwaningo ebizwa ngokuthi "'Weekend Effect' noma 'Effect Saturday'? Ukuhlaziya Ukufa Kwezibhedlela Kweziguli Eziphethwe Isifo Sikasemikhali eNingizimu Carolina, "abacwaningi bahlola zonke izifo ezibhekene nesifo sochungechunge lwe-ischemic (izibalo ezingu-20 187) eSouth Carolina phakathi kuka-2012 no-2013. Abacwaningi bahlola ukuvama kokufa kweziguli ezivunyelwe ukushaywa ngokocansi ngokusho kosuku kokungeniswa, kanti lezi zinyathelo ezingenasici zokufa zishintshelwa ngokocansi lwesineke, iminyaka, ubuhlanga, unyaka wokungeniswa, inkathi yokungena, uhlobo lokukhokha, kanye neCharlson Comorbidity Index (isilinganiso esifaka ezinye izimo ezihlukahlukene ezingapheli).
Phakathi kwalesi siguli sabantu baseNingizimu Carolina, ukushona kwesifo sokushaya isisindo kwakuphakeme kakhulu ngoMgqibelo, ngaleyo ndlela kuphazamisa ukuphela kwezimpelasonto ngosuku oluthile.
Encwadini ehlobene, imiphumela evela kulolu cwaningo lwase-US lisikisela ukuthi ukuqina kwesisindo kwakukhulu kakhulu ngezimpelasonto ngaleyo ndlela kubonisa umkhawulo ophakeme wokungena; iziguli ezivunyelwe ukushaywa yizinhlungu phakathi nempelasonto zazivame ukugula kunezo ezivunyelwe phakathi nezinsuku zamasonto. Lokhu kutholakala kungahle kuphazamise imiphumela futhi kuchaze ezinye zezimiso zokufa. Ngamanye amazwi, ngoba iziguli ezine-stroke ezazivunyelwe ngezimpelasonto zazigula kakhulu, zingase zithole ingozi yokufa.
Ukuphela kweviki kanye nokuhlinzwa kwezingane
Esifundweni se-2014 eshicilelwe kuyi- Journal of Pediatrics , abacwaningi be-The Johns Hopkins University bafuna i-Weekend Effect phakathi kwama-439,457 e-US abahlinzeka ngokuhlinzwa kwabantwana phakathi kuka-1988 no-2010. Lezi zindlela zokuhlinza zazibandakanya ukugeleza kwe-abscess, appendectomy nge-fixation yangaphakathi (ORIF) , ukubekwa kokukhishwa okuhlinzekwayo, noma ukubuyekezwa kokukhishwa okuhlinzekwayo.
Abacwaningi bathola ukuthi ukufa kwabaphezulu phakathi kwezingane ezazihlinzekwa ngezimpelasonto kunokuba ziphakathi kwabantwana abahlinzekwa ngeviki. Ngaphezu kwalokho, izingane ezazitholwa ukuhlinzwa phakathi nempelasonto zazingengozini enkulu yokulahlekelwa igazi nokumpompela igazi, izifo ezilimazayo, ukuphuka kwesilonda (ukulimala kwesilonda) neminye imiphumela emibi. Njengazinye izifundo ezihlola i-Weekend Effect, lezi zithole zinikezwe ngokuzimela kwezinye izici zesiguli nesibhedlela.
Kumele kuqashelwe ukuthi ukufa kokubili kokuhlinzwa kwezingane akuvamile e-United States nakwamanye amazwe athuthukile. Kodwa-ke, imiphumela yalolu cwaningo inokubaluleka komtholampilo ngoba i-Weekend Effect isaxhumene nenani elincane lokufa, futhi ukufa okuvinjelweyo ngisho nengane eyodwa kuyindlala enkulu emndenini, kubangani nasemphakathini.
I-Weekend Effect noMnyango Wezimo Eziphuthumayo
Ngezimpelasonto kanye nezinye izikhathi zokuphumula, umnyango ophuthumayo yindawo lapho iziguli eziningi ezibhedlela zivunyelwe khona. Esifundweni sika-2013 esibizwa ngokuthi "Ungalali Ngempelasonto: Ukuhlolwa Kwempelasonto Yokufa Kwezimpilo Ezigulane Ezivakashela Ama-US ED," abacwaningi baseNyuvesi yaseMichigan bafuna ubufakazi be-Weekend Effect phakathi kweziguli ezivunyelwe esibhedlela nge umnyango ophuthumayo.
Kulolu cwaningo oluthatha isikhathi eside, amacala angu-4,225,973 abamele amaphesenti angu-20 e-admissions ephelele eyenzeka ngendlela yomnyango ophuthumayo ngo-2008 ahlaziywa. I-Weekend Effect ibonwe kulesisampula, futhi abantu abaningi abavunyelwe ngempelasonto bafa kunelabo abavunyelwe ngezimpelasonto. Lo mphumela wawugcinwa njalo ngaphandle kokuthola imali yesiguli, isimo somshuwalense, ubunikazi bembhedlela (umphakathi noma ngasese), isimo sokufundisa esibhedlela kanye nokubalwa kwabantu egumbini lokuphuthumayo. Ngaphezu kwalokho, i-Weekend Effect yayibonakaliswa njalo phakathi kwezifo eziyishumi eziphezulu kakhulu ezixilongwa, ezifana nokushaya isifo, ukuhlasela kwenhliziyo, ukulimala kwekhanda nokulimala kwekhanda, okubonisa ukuthi lesi senzakalo sasingacacile kunoma yikuphi ukutholakala.
Lokho Esingazi
Nakuba ukusebenza kweviki lokunciphisa kuncitshangwa kubhekwe incazelo ejwayelekile ye-Weekend Effect, asiqiniseki ukuthi yiziphi izimbangela zalesi senzakalo. Isibonelo, asazi ukuthi lezi zinkinga zokusebenza ziphathelene nabahlengikazi, ochwepheshe, odokotela noma inhlanganisela ethile. Asazi ukuthi ngabe ukukhulelwa kwezibhedlela kanye nokwedlulela ngokweqile ngempelasonto kudlala indima. Okubaluleke kakhulu, ushintsho lwezimpelasonto lokushintsha lapho ukunakekelwa lushintsha kungase kube negalelo kulokhu okwenzekayo.
Ekugcineni, izifundo ezihlola i-Weekend Effect njengamanje zilinganiselwe ngomklamo wabo wokubuyisa (hhayi ukulawulwa okungahleliwe), nokucwaninga okuqhubekayo kudinga ukwenziwa ukuphakamisa izixazululo eziningi zokukhonkolo. Phakathi naleso sikhathi, mhlawumbe umqondo omubi wokunquma noma ukuphika imali eyimali echaphazela abasebenzi kubhedlela.
Kwenzekani Konke Lokhu?
Ake sicabangele ukuthi ithini le-Weekend Effect lisho kubantu ngabanye. Kulezi zifundo ezikhulunywe ngazo, lesi senzakalo sasiqaphele phakathi kwabantu abavunyelwe esibhedlela ukuze bathulume ngokuzwakalayo. Ngenxa yokuthi lezi ziyizinkinga eziphuthumayo, iziguli zazingenakho ukulawula isikhathi senkomfa futhi azikwazanga ukukhetha ukuthi zingene esibhedlela yini ngesonto noma ngeviki.
Ngokufanayo, uma wena noma othandekayo uthola usizo oluphuthumayo lwezokwelapha, ukungena kuyadingeka ukuba kube ngesivinini kungakhathaliseki ukuthi usuku. Ngamanye amazwi, ukuhlaselwa kwenhliziyo okwenzeka ngoMgqibelo awukwazi ukulinda ukungena ngoMsombuluko. Ngaphezu kwalokho, sicela uqiniseke ukuthi naphezu kokukhathazeka mayelana ne-Weekend Effect, ukunakekelwa okuhlinzekwa yiziningi zezibhedlela zase-US kuhle futhi kulandela iziqondiso zomtholampilo eziqinile-ukufa okuvinjelwe akuvamile ngisho nangezimpelasonto.
Esikhundleni sokubhekelana nomuntu ngamunye, imiphumela yalezi zifundo ibonisa ukuthi kunenkinga enkulu ebhekene nabahlengikazi, abaqondisi, abagqugquzeli, nabakhiqizi: indlela yokunciphisa ukufa okungadingekile okuhlanganiswe nokungahambisani nokunakekelwa okuhlinzekwa ngezimpelasonto nezinye izinkomba zokuphumula. Ngezindleko zokunakekelwa kwempilo kwezempilo, kuningi lokukhuluma ngokusika imali. Kodwa-ke, kumelwe sishaye indiva le-rhetoric futhi gingerly sicabange ukusikeka okuthinta ukusebenza noma izinga lokunakekelwa kwezilungiselelo zezempilo.
Uma isibhedlela sisebenza ngezimpelasonto, izinsizakalo kumele zibe sezinhlanzi. Izibhedlela azikwazi ukushibhile uma kuziwa ezinsizeni nasekusebenzeni. Ngaphezu kwalokho, lapho ukushintshwa kwezinguquko nokunakekelwa kwesineke kudluliselwa, akufanele kube khona ukuphazamiseka ezinsizeni ezivela kulezi zinguquko. Ekugcineni, uma isibhedlela singakwazi ukuhlinzekela izinga elifanayo lokunakekelwa ngezimpelasonto kanye nesonto, kungabaza ukuthi ngabe kufanele yini ukuhlinzeka ukunakekelwa kweviki nhlobo. Ngokuqondile, ucwaningo luye lwaphakamisa ukuthi ukufinyelela kwama-24/7 ezindaweni ezikhethekile zokuhlaselwa, izinhlelo zokuhlukunyezwa, nezinyunithi zokunakekela izingane ezinamandla-izilungiselelo lapho ukutholakala nokutholakala kwabasebenzi kuhlale kuhambisana-konke kuboniswe ikhono lokuqeda i-Weekend Effect.
Ngesikhathi esilandelayo lapho uzwa osombusazwe ekhuluma ngokusikeka ekunakekelweni kwempilo, sicela ucabange ukuthi lezi zicucu zingashintsha emiphumeleni ethinta sonke, njenge-Weekend Effect. Isibhedlela asisona esitolo sokunethezeka samama-no-pop lapho ungalinda khona isikhathi eside sendebe yekhofi noma iphakethe lezinkukhu ngaphandle kokukhathazeka ngempilo yakho. Isibhedlela siyindawo lapho ukutholakala kwesikhathi nokutholakala kwemithombo kubalulekile futhi kubalwa imizuzu.
> Imithombo
> Goldstein SD et al. "Umphumela weviki 'ekuhlinzekeni kwezingane - ukwanda kwezingane ezibhekene nokuhlinzwa okuphuthumayo ngempelasonto." Journal of Surgery Pediatric. 2014; 49: 1087-1091.
> Roberts SE, et al. "Ukufa okulandela u-Stroke, i-Weekend Effect kanye Nezici Ezihlobene: Ukurekhoda I-Linkage Study." PLoS ONE . 2015.
> I-Sharp AL, u-Choi H no-Hayward RA. "Ungaguli ngempelasonto: ukuhlolwa kwesimpelasonto umphumela wokufa kweziguli ezihambela i-US ED." I- American Journal of Emergency Medicine . 2013; 31.
> Shi, L, et al. "'Ukuphela kweMpelasonto' noma 'uMgqibelo Wempumelelo'? Ukuhlaziywa Kwezokufa Kwezibhedlela Kwabagulayo abane-Stroke Isikemikhali eNingizimu Carolina. " Ukujikeleza . 2016; 134: 1510-1512.