Rahoton masu ruwa da tsaki a kan jama'a game da batun ICD-11 sun shafi lafiyar mutum da tunani (2019)

Bayanin YBOP: Takarda tana ƙunshe da sashe na tattaunawa game da sharhi game da sabon ganewar asali na "Tsarin halayen jima'i". A cikin ɓangaren ƙarfin hali marubutan suna kwatanta Nicole Prause wanda ya yi sharhi ba sau 14 ba amma sama da sau 20. Yawancin maganganunta sun haɗa da hare-hare na sirri, maganganun karya, ɓarnatar da binciken, zaɓen ceri da ɓata suna.

Rashin halin halayen jima'i mai karfin gaske ya karbi mafi yawan yawan maganganu na nakasa (N = 47), amma sau da yawa daga mutane guda (N = 14). An gabatar da gabatar da wannan sashin binciken a cikin muhawara3 da kuma sharhi game da bayanin ICD-11 ya sake yin amfani da polarization a cikin filin. Bayanan da aka gabatar sun haɗa da sharuddan maganganun da aka yi a tsakanin masu sharhi, irin su zargi da rikice-rikice ko rashin fahimta (48%; κ = 0.78) ko kuma iƙirarin cewa wasu kungiyoyi ko mutane zasu amfana daga hadawa ko cirewa a cikin ICD-11 (43%; κ = 0.82). Wata ƙungiya ta nuna goyon baya (20%; κ = 0.66) kuma sunyi la'akari da cewa akwai wadatattun shaidu (20%; κ = 0.76) don haɗawa, yayin da ɗayan ke adawa da haɗawa (28%; κ = 0.69), yana mai da hankali ga rashin fahimta mai kyau (33 %; κ = 0.61), shaidar da ba ta isa ba (28%; κ = 0.62), da sakamako masu illa (22%; κ = 0.86). Dukansu rukunin sun kawo hujjoji game da ilimin kimiya (35%; κ = 0.74) don tallafawa maganganunsu. Commentan masu sharhi sun ba da ainihin canje-canje ga ma'anar (4%; κ = 1). Madadin haka, bangarorin biyu sun tattauna tambayoyin ilimin kimiyya kamar fahimtar yanayin a matsayin impulsivity, compulsivity, jaraba da halayyar mutum ko kuma nuna halin al'ada (65%; κ = 0.62). WHO ta yi imanin cewa hada wannan sabon nau'in yana da mahimmanci ga yawan marasa lafiya marasa lafiya don karɓar sabis4. An damu da damuwa game da maganin maganin ƙwaƙwalwa a cikin CDDG, amma wannan jagora ba ya bayyana a cikin taƙaitaccen bayanin da ake bayarwa ga masu sharhin beta.

Idan kana so ka karanta bayanan jama'a game da sassan ICD-11 CSBD (ciki har da masu adawa da / gurɓatawa / gurɓatawa) amfani da wadannan hanyoyi:

• https://icd.who.int/dev11/f/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1630268048
• https://icd.who.int/dev11/proposals/f/en#/http://id.who.int/icd/entity/1630268048
• https://icd.who.int/dev11/proposals/f/en#/http://id.who.int/icd/entity/1630268048?readOnly=true&action=DeleteEntityProposal&stableProposalGroupId=854a2091-9461-43ad-b909-1321458192c0

Kuna buƙatar ƙirƙirar mai amfani don karanta bayanin.

Fuss, Johannes, Kyle Lemay, Dan J. Stein, Peer Briken, Robert Jakob, Geoffrey M. Reed, da Cary S. Kogan.

Duniya Mashahuri 18, a'a. 2 (2019): 233-235.

Wani muhimmin karfi na cigaban Cibiyar Kula da Lafiya ta Duniya (WHO) ta ICD-11 da ke tattare da cututtukan tunani, halayya da kuma ciwon kwakwalwa ne ya kasance mai aiki mai karfi daga mahalarta masu amfani da duniya.

Takardun sigin na ICD-11 don Labaran Ƙaddanci da Mutuwa (MMS), ciki har da ma'anar taƙaitaccen bayani, an samo su akan tsarin ICD-11 beta (https://icd.who.int/dev11/l‐m/en) don nazarin jama'a da kuma sharhi don shekarun da suka wuce1. An duba bita na WHO don bunkasa duka sakon MMS na ICD-11 da kuma sigar don amfani da asibiti ta hanyar likita na kiwon lafiya, da Bayanan Clinical da Jagororin Diagnostic (CDDG)1. A nan, muna taƙaita abubuwan da ke faruwa na kowa game da shigarwa ga kundin da ke samar da mafi girma.

An sake nazarin maganganun da bada shawarwari ga Kategorien a halin yanzu an rarraba su a cikin sura ta kan cututtukan tunani da na hali a cikin ICD-10, kodayake wasu daga cikin wadannan sun sake ganewa kuma suka koma sabon rubutun ICD-11 akan rashin barci da yanayin da suka shafi lafiyar jima'i.2.

Tsakanin Janairu 1, 2012 da Disamba 31, 2017, an gabatar da ra'ayoyi 402 da shawarwari 162 a kan rikice-rikice na hankali, halayya da ci gaban ci gaban jiki, rikicewar tashin bacci, da yanayin da ke da alaƙa da lafiyar jima'i. Mafi yawan maganganun da aka gabatar dangane da larurar hankali, halayya da rashin ci gaban jiki sun mai da hankali ne ga rikice-rikicen halayen jima'i (N = 47), rikitarwa bayan rikicewar rikice-rikice (N = 26), matsalar damuwa na jiki (N = 23), cutar rashin jituwa ta Autism ( N = 17), da matsalar caca (N = 11). Abubuwan da aka gabatar a kan yanayin da ke da alaƙa da lafiyar jima'i yawanci sun shafi rashin dacewar jinsi na samartaka da balaga (N = 151) da rashin dacewar jinsi na ƙuruciya (N = 39). Suban bayanan da aka gabatar suna da alaƙa da rikicewar bacci (N = 18).

Mun gudanar da bincike na ingantaccen abun ciki don gano manyan batutuwan gabatarwa masu alaƙa da rukunin waɗanda aƙalla akwai tsokaci 15. Don haka, an tsara 59% na duk tsokaci da kashi 29% na duk shawarwarin. Abubuwan da aka gabatar sun kasance masu kimantawa ta masu tantancewa biyu. Lambobin abun ciki da yawa na iya amfani da kowane ƙaddamarwa. An ƙididdige amincin Inter-rater ta amfani da kahen Cohen; codings kawai tare da kyakkyawan tsaka-tsakin abin dogara (-0.6) ana ɗaukarsu a nan (82.5%).

Rashin halin halayen jima'i mai karfin gaske ya karbi mafi yawan yawan maganganu na nakasa (N = 47), amma sau da yawa daga mutane guda (N = 14). An gabatar da gabatar da wannan sashin binciken a cikin muhawara3 da kuma tsokaci kan ma'anar ICD-11 ma'anar sake fasalin mai gudana a cikin filin. Abubuwan da aka gabatar sun haɗa da maganganun adawa tsakanin masu sharhi, kamar zargin rikice-rikice na sha'awa ko rashin iya aiki (48%; κ = 0.78) ko iƙirarin cewa wasu ƙungiyoyi ko mutane za su ci riba daga haɗawa ko cirewa a cikin ICD ‐ 11 (43%; κ = 0.82) . Wata ƙungiya ta nuna goyon baya (20%; κ = 0.66) kuma sunyi la'akari da cewa akwai wadatattun shaidu (20%; κ = 0.76) don haɗawa, yayin da ɗayan ke adawa da haɗawa (28%; κ = 0.69), yana mai da hankali ga rashin fahimta mai kyau (33 %; κ = 0.61), shaidar da ba ta isa ba (28%; κ = 0.62), da sakamako masu illa (22%; κ = 0.86). Dukansu rukunin sun kawo hujjoji game da ilimin kimiya (35%; κ = 0.74) don tallafawa maganganunsu. Commentan masu sharhi sun ba da ainihin canje-canje ga ma'anar (4%; κ = 1). Madadin haka, bangarorin biyu sun tattauna tambayoyin ilimin kimiyya kamar fahimtar yanayin a matsayin impulsivity, compulsivity, jaraba da halayyar mutum ko kuma nuna halin al'ada (65%; κ = 0.62). Hukumar ta WHO ta yi imanin cewa shigar da wannan sabon rukunin yana da mahimmanci ga halattaccen asibiti na asibiti don karɓar sabis4. An damu da damuwa game da maganin maganin ƙwaƙwalwa a cikin CDDG, amma wannan jagora ba ya bayyana a cikin taƙaitaccen bayanin da ake bayarwa ga masu sharhin beta.

Bayanan da aka bayar game da hadaddun ƙananan cututtuka na baya bayanan sun goyi bayan hadawa a cikin ICD-11 (16%; κ = 0.62), ba tare da yin gardama ba game da hada (k = 1). Duk da haka, da dama da dama da aka bayar sun nuna canje-canje ga fassarar (36%; κ = 1), sun gabatar da mahimmanci (24%; κ = 0.60) (misali, game da fahimta), ko kuma tattauna batun lalata (20%; κ = 1) . Yawancin maganganu (20%; κ = 0.71) ya jaddada cewa fahimtar wannan yanayin a matsayin rikici na hankali zai taimaka wajen bincike da kuma taimakawa ganewar asali da magani.

Mafi yawan abubuwan da aka bayar game da rashin lafiyar jiki sun zama mahimmanci, amma yawancin mutane (N = 8) sun yi sau da yawa. Kisanci yafi mayar da hankali ga fahimta (48%; κ = 0.64) da sunan cuta (43%; κ = 0.91). Amfani da lokacin bincike wanda yake da dangantaka da bambancin ciwo na jiki5 an gani kamar matsala. Ɗaya daga cikin zargi shi ne cewa ma'anar ya dogara sosai a kan shawarar ƙwararrakin ƙwararrakin cewa kula da marasa lafiyar da aka nuna game da bayyanar cututtukan jiki shine "wuce kima". Yawancin sharhi (17%; κ = 0.62) ya nuna damuwa cewa wannan zai haifar da marasa lafiya da aka lasafta su a matsayin kwakwalwar tunani kuma ya hana su daga karbar kulawa da daidaituwa ta hanyar rayuwa. Wasu masu bayar da gudummawa sun bada shawarwari don canje-canje ga fassarar (30%; κ = 0.89). Wasu sun yi tsayayya da hada gaba da wannan cuta (26%; κ = 0.88), yayin da rashin biyayya (k = 1) ya nuna goyon baya don hadawa. WHO ta yanke shawara ta ci gaba da rikitarwa ta jiki kamar yadda aka gano nau'i6 da kuma magance matsalolin da ake buƙata a cikin CDDG da kasancewar ƙarin siffofi, irin su rashin lahani na aiki.

Bayani game da yanayin da suka danganci lafiyar jima'i ya nuna goyon baya mai karfi don kaucewa zubar da halayen jima'i da jinsin jinsin daga mawuyacin lahani da kuma ƙirƙirar wani ɓangare na dabam (35%; κ = 0.88)7. Abubuwan da yawa (25%; κ = 0.97) sun yi amfani da sakon samfurin da Ƙungiyar Ƙungiyar Harkokin Jima'i ta bayar. Yawancin ra'ayoyin sun yi iƙirarin cewa ci gaba da jinsin jituwa a cikin cututtukan cututtuka zai cutar da shi kuma ya lalata mutane masu ɗaukar hoto (14%; κ = 0.80), ya ba da shawara ga bambancin ma'anar (18%; κ = 0.71) ko lakabi na daban (23%; κ = 0.62). WHO ta canza ma'anar a bangare bisa ga abin da aka karɓa7.

Abin sha'awa shine, babban rukuni na gabatarwa akan bayanin ICD-11 da aka gabatar don rashin daidaiton jinsi na ƙuruciya sun nuna adawa ga ƙa'idodin kulawa ta yanzu ta hanyar ƙin yarda da sauyin zamantakewar jama'a da tabbatar da jinsi treatment yara kanana (46%; κ = 0.72), batutuwan da , kodayake mahimmanci da rikice-rikice, suna da alaƙa da magani maimakon rarrabawa. An soki ko ƙaddamar da ma'anar da aka gabatar a cikin 31% na ƙaddamarwa (κ = 0.62), tare da wasu ta yin amfani da samfurin da Worldungiyar Duniya don Kiwon Lafiyar Jima'i ta bayar don roƙon sake dubawa bisa ga shawarwari daga jama'a (15%; κ = 0.93). Sauran sun yi adawa da cutar da ke nuna tsoron cutar da bambancin jinsi na yara (15%; κ = 0.93) da da'awar cewa ba dole ba ne saboda ba za a sami damuwa ba (11%; κ = 0.80) ko buƙatar jinsi ‐ tabbatar da kiwon lafiya (28% ; κ = 0.65) a cikin yara. Wasu kuma sunyi jayayya cewa ganewar asali ba lallai ba ne don dalilai na bincike, suna nuna cewa bincike akan liwadi ya bunkasa tun lokacin da aka cire shi daga ICD (9%; κ = 0.745). Yayinda yake yarda da rikice-rikicen da ke tattare da jiyya, WHO ta riƙe rukunin don taimakawa tabbatar da samun damar kula da asibiti mai dacewa yayin magance ɓarna ta hanyar sanya shi a cikin sabon babi na yanayin da ya shafi lafiyar jima'i da kuma ta ƙarin bayani a CDDG7.

A cikin fassarar waɗannan maganganun, ya bayyana a fili cewa an gabatar da dama daga cikin takardun da aka ba da shawara, sau da yawa akan mayar da hankali ga wani yanki. Yana da kyau ga masana kimiyya su sake nazarin shawarwarin su a cikin hasken haƙuri da amsawa. Hukumar ta WHO ta yi amfani da maganganun da shawarwari game da tsarin beta tare da wasu hanyoyin samar da bayanai, musamman nazarin nazari8, 9, a matsayin dalilin yin gyare-gyare a cikin MMS da CDDG.