„სარეზიდენტო პროგრამების დამტკიცების შესახებ“ საქართველოს შრომის, ჯანმრთელობისა და სოციალური დაცვის მინისტრის 2014 წლის 4 თებერვლის №01-6/ნ ბრძანებაში ცვლილების შეტანის თაობაზე

,,danarTi 32

sarezidento programa

`saojaxo medicina~

(xangrZlivoba 3 weli – 33 Tve)

Sinaarsi

Tavi I. zogadi debulebebi 2

muxli 1. programis mizani da amocanebi 2

muxli 2. specialobis aRweriloba 2

muxli 3. profesiuli mzadebis struqtura 28

muxli 4. sarezidento programis modulebad dayofa da modulebis ganxorcielebis organizacia, sarezidento programis etapebis modulebad dayofa 29

muxli 5. sarezidento programis etapebis zogadi daxasiaTeba da ganxorcielebis organizacia 30

muxli 6. sarezidento programis I etapis mizani da amocanebi 30

muxli 7. sarezidento programis II etapis mizani da amocanebi 33

muxli 8. sarezidento programis III etapis mizani da amocanebi 36

muxli 9. akademiuri personali, kvalifikacia da saganmanaTleblo resursebi 39

muxli 10. programis marTva da administrireba 40

muxli 11. programis xangrZlivoba 40

muxli 12. programis ganaxlebis perioduloba 41

muxli 13. programis Sesabamisoba saerTaSorisod aRiarebul standartebTan 41

Tavi II. programis I etapi 42

muxli 14. 42

muxli 15. 43

muxli 16. 51

muxli 17. 53

muxli 18. 56

Tavi III. programis II etapi 62

muxli 19. 62

muxli 20. 62

muxli 21. 64

muxli 22. 65

muxli 23. 66

muxli 24. 67

muxli 25. 69

muxli 26. 71

muxli 27. 73

muxli 28. 75

muxli 29. 78

Tavi IV. programis III etapi 79

muxli 30. 79

muxli 31. 80

muxli 32. 87

muxli 33. 90

Tavi I. zogadi debulebebi

muxli 1. programis mizani da amocanebi

1. specialobaSi `saojaxo medicina~ diplomis Semdgomi mzadebis umTavresi mizania Camoayalibos eqimi-specialisti, romlis Teoriuli codna da proaqtiური unar-Cvevebi Seesabameba ojaxis eqimis specialobis aRwerilobas, romelic, Tavis mxriv, maqsimalurad Seesabameba saerTaSorisod aRiarebul (upirveles yovlisa, evropul) standartebs saqarTvelos mosaxleobis janmrTelobis interesebsa da Taviseburebebs da iTvaliswinebs Sromis bazris moTxovnebs.

2. winamdebare sarezidento programa aRwers specialobaSi `saojaxo medicina~ rezidentebis swavlebis/mzadebis procesis yvela ZiriTad komponents. programis amocanaa Camoayalibos rezidenti rogorc specialisti `ojaxis eqimi~, am specialobis yvela ZiriTadi 12 maxasiaTeblis da 6 kompetencis mixedviT (ix. specialobis aRweriloba).

muxli 2. specialobis aRweriloba

1. specialobis (`saojaxo medicina~) gansazRvreba: saojaxo medicina – pirvelad jandacvaze orientirebuli akademiuri da mecnieruli disciplinaa sakuTari saganmanaTleblo SinaarsiT, kvleviTi, mtkicebebze dafuZnebuli da klinikuri saqmianobiT.

2. zogadi praqtikis/saojaxo medicinis evropis sazogadoebis (WONCA EUROPE) bolo ganmartebebis mixedviT (European Definition of Family Medicine, 2002) saojaxo medicinis, rogorc disciplinis, maxasiaTeblebia:

a) Cveulebriv, samedicino personalTan pirveli Sexebis wertilia jandacvis sistemaSi; uzrunvelyofs Ria da SeuzRudav xelmisawvdomobas momxmareblisaTvis da dakavebulia misi janmrTelobis problemebiT asakis, sqesis an raime pirovnuli maxasiaTeblis miuxedavad;

b) racionalurad iyenebs jandacvis resursebs pirvelad jandacvaSi samedicino daxmarebis koordinaciis, sxva profesionalebTan erToblivi saqmianobis gziT, agreTve, sxva specialobebTan urTierTobis marTviT da advokatirebiT im SemTxvevebSi, roca pacients es sWirdeba;

g) aviTarebs individze (pirovnebaze) orientirebul midgomas, orientirebuls Tavad individze, mis ojaxze da Temze;

d) aqvs unikaluri sakonsultacio procesi, romelic afuZnebs droiT SeuzRudav urTierTobebs eqimsa da pacients Soris efeqturi komunikaciis gziT;

e) pasuxismgebelia gamWoli, uwyveti daxmarebisaTvis pacientis saWiroebebis Sesabamisad;

v) sargeblobs specifikuri gadawyvetilebis miRebis procesiT, rac ganpirobebulia TemSi daavadebebis gavrcelebiTa da sixSiriT;

z) erTdroulad marTavs pacientis rogorc mwvave, ise qronikul problemebs;

T) marTavs daavadebebs romelnic warmodgenilni arian aradiferencirebuli formiT, Tavisi ganviTarebis adreul etapebze, rac SeiZleba Txoulobdes gadaudebel Carevas;

i) xels uwyobs janmrTelobas da keTildReobas saTanado da efeqturi CarevebiT;

k) specifikuri pasuxismgeblobis matarebelia Temis jandacvaze;

l) exmianeba janmrTelobis problemebs maTi fizikuri, socialuri, kulturuli da egzistencialuri ganzomilebebis gaTvaliswinebiT.

3. specialistis (`ojaxis eqimis~) gansazRvreba:

a) ojaxis eqimi aris eqimi specialisti, romelic saTanado ganswavlis gziT dauflebulia `saojaxo medicinis~, rogorc disciplinis principebs. is personaluri eqimia, romelic pasuxismgebelia yovlismomcveli da mudmivi zrunvisaTvis yovel pirze, romelsac esaWiroeba samedicino daxmareba, ganurCevlad misi asakis, sqesisa da daavadebisa;

b) ojaxis eqimi zrunavs pirovnebaze ojaxis, Temis, kulturis konteqstSi, yovelTvis pativs scems pacientis avtonomias. is iRebs pasuxismgeblobas Temis winaSec. pacientTan samoqmedo gegmis Sedgenisas ojaxis eqimi erToblivad ganixilavs biologiur, fsiqologiur, socialur da kulturul faqtorebs. amisaTvis iyenebs pacientTan ganmeorebiTi kontaqtebis safuZvelze SeZenil codnasa da mopovebul ndobas;

g) ojaxis eqimi Tavis profesiul rols asrulebs janmrTelobisaTvis xelSewyobis, daavadebaTa prevenciisa da mkurnalobis, movlisa da paliatiuri mzrunvelobis gziT;

d) yovelive aRniSnuls ojaxis eqimi an Tavad akeTebs, an koordinacias uwevs sxvebis mier gaweul momsaxurebas. ojaxis eqimi yovelTvis iTvaliswinebs janmrTelobis saWiroebebs da arsebul, xelmisawvdom resursebs; saWiroebis SemTxvevaSi exmareba pacients am resursebis Sesabamisi momsaxurebis miRebaSi.

4. specialistis profesiuli zogadi codna: ojaxis eqimis, rogorc specialistis zogadi kompetencia (codna, unar-Cvevebi, damokidebuleba) mTlianad disciplinis zemoxsenebuli maxasiaTeblebidan gamomdinareobs. ojaxis eqimis, rogorc specialistis, profesiuli zogadi kompetencia 6 mTavar komponents moicavs:

a) pirveladi samedicino daxmarebis marTva;

b) individze koncentrirebuli samedicino daxmareba;

g) specifikuri problemebis gadaWris unari;

d) yovlismomcveli midgoma;

e) orientacia Temze;

v) holisturi modelireba.

5. pirveladi samedicino daxmarebis marTva: aRniSnuli kompetencia moicavs Semdeg unarebs:

a) pacientTan pirveli kontaqtis marTva misi janmrTelobis nebismier problemasTan dakavSirebiT; amisaTvis aucilebelia:

a.a) pirvelad jandacvaSi arsebuli problemebis epidemiologiis codna;

a.b) pirvelad jandacvaSi xSirad arsebuli mdgomareobebis codna da marTva;

a.g) mwvave da qronikuli daavadebebis marTvis organizaciuli uzrunvelyofis unar-Cvevebi;

b) janmrTelobis problemebis sruli speqtris mocva; amisaTvis aucilebelia:

b.a) pirvelad jandacvaSi gamoyenebuli prevenciuli RonisZiebebis codna;

b.b) mwvave da qronikuli mdgomareobebis marTvis, prevenciuli RonisZiebebis, paliatiuri da gadaudebeli daxmarebis unar-Cvevebi;

b.g) pirvelad jandacvaSi xSirad arsebuli problemebis diagnostirebisaTvis aucilebeli anamnezuri monacemebis Sekrebis, fizikuri gasinjvis da damatebiTi gamokvlevebis gamoyenebis unar-Cvevebi;

b.d) aRniSnuli mdgomareobebis farmakologiuri da arafarmakologiuri mkurnalobis unar-Cvevebi;

b.e) problemebis prioritetulobis gansazRvra.

g) samedicino momsaxurebis koordinacia pirvelad jandacvaSi momuSave sxva personalTan da sxva specialobis eqimebTan; amisaTvis aucilebelia:

g.a) saqarTveloSi pirveladi janmrTelobis dacvis arsebuli sistemis codna;

g.b) pacientebTan da TanamSromlebTan efeqturi komunikaciis unar-Cvevebis flobis mniSvnelobis gaazreba;

g.g) efeqturi gunduri muSaobis unar-Cvevebi;

d) adekvaturi da efeqturi samedicino momsaxurebis gawevis da jandacvis servisebis utilizaciis unari; amisaTvis aucilebelia:

d.a) saqarTvelos janmrTelobis dacvis sistemisa da am sistemaSi pirveladi jandacvis funqciisa da rolis codna;

d.b) jandacvis sistemis sxvadasxva doneebze referalis ganxorcielebis wesebis codna;

d.g) pirveladi da meoreuli jandacvis doneebs Soris urTierTobis marTvis unar-Cvevebi, jandacvis sxva profesionalebTan komunikaciis unaris CaTvliT.;

e) pacientisaTvis aucilebeli servisebis xelmisawvdomobis uzrunvelyofa jandacvis sistemis farglebSi; amisaTvis aucilebelia:

e.a) komunikaciis unar-Cvevebi pacientis da misi ojaxis wevrebisaTvis konsultaciis gawevisas, maTi swavlebisTvis, pacientis mkurnalobisTvis;

e.b) organizaciuli unar-Cvevebi samedicino Canawerebis warmoebisTvis, informaciis marTvisTvis, gunduri muSaobisTvis, praqtikis marTvisa da samedicino momsaxurebis xarisxis auditisTvis;

v) pacientis advokatis rolis Sesruleba; amisaTvis aucilebelia:

v.a) pacientTan Tanaswori, Tanabari urTierTobis Camoyalibeba, rac gamoricxavs paternalistur damokidebulebas;

v.b) efeqturi liderobis, molaparakebebis da kompromisis miRwevis unaris floba.

6. individze koncentrirebuli samedicino daxmareba: aRniSnuli kompetencia moicavs Semdeg unarebs:

a) pacientTan urTierTobisas da misi problemebis marTvisas pirovnebaze orientirebuli midgomis gamoyeneba da pacientis Taviseburebebis gaTvaliswineba; amisaTvis aucilebelia:

a.a) fundamenturi, mecnieruli codna pirovnebis, misi cxovrebiseuli miznebis da molodinis Sesaxeb;

a.b) spეcifikuri midgomis gamomuSaveba pirovnebis damokidebulebis, faseulobebis da rwmenis Sesafaseblad da aRsaqmelad, am pirovnebis ojaxis, Temis, socialuri da kulturuli Taviseburebis gaTvaliswinebiT;

a.g) daavadebis (obieqturi; organos an organoTa sistemis struqturis an funqciis darRveva) da avadmyofobis (subieqturi; pacientiseuli gancda daavadebisa) koncefciebis gageba;

a.d) zemoxsenebulis praqtikaSi gamoyenebis unar-Cvevebi;

b) konsultaciis warmarTva eqimsa da pacients Soris ndobaze, Tanasworobaze dafuZnebuli urTierTobis Camosayalibeblad, pacientis avtonomiis pativiscemis gaTvaliswinebiT; amisaTvis aucilebelia:

b.a) pacientze orientirebuli konsultaciis modelis gamoyeneba, romlis mizania moZiebuli informaciis gasagebi eniT gadacema pacientisTvis, misTvis daxmarebis aRmoCena sakuTari Sexedulebebis, wuxilis da molodinis gansjaSi, maTi Sejereba ojaxis eqimis mier SeTavazebul gegmasTan saerTo, SeTanxmebuli gadawyvetilebis da samoqmedo gegmis Camoyalibeba;

b.b) gadawyvetilebis miRebisas pacientis avtonomiis pativiscema;

b.g) pacientTan urTierTobisas subieqturi faqtorebis gaTvaliswineba, saxeldobr, rogorc pacientis grZnobebis, faseulobebis, prioritetebis, ise sakuTari faseulobebis, grZnobebis da damokidebulebis gaazreba;

g) prioritetebis gansazRvra da partnioruli moqmedeba; amisaTvis aucilebelia:

g.a) janmrTelobis mravlobiTi problemebis arsebobisas maTi rangirebis unari;

g.b) partnioruli urTierTobis Camoyalibebis unari;

g.g) pacientTan emociur siaxlovesa da aucilebel distancias Soris balansis dacvis unari;

d) xangrZlivi, uwyveti da koordinirebuli (sxva specialistebTan erTad) momsaxurebis uzrunvelyofa pacientis saWiroebebis Sesabamisad; amisaTvis aucilebelia:

d.a) uwyvetobis sami aspeqtis gageba da maTi gamoyenebis unari: (1) uwyvetoba pirovnul doneze (erT pirTan xangrZlivi urTierToba), (2) informaciis uwyvetoba (pacientis janmrTelobis Sesaxeb informaciis mudmivi xelmisawvdomoba) da (3) samedicino momsaxurebis uwyvetoba (24 saaTi dReSi, 365 dRe weliwadSi);

d.b) pacientis daxmareba Sroma-cxovrebis adekvaturi balansis gaazrebasa da miRwevaSi;

d.g) samedicino Canawerebis, daavadebaTa registrebis da sxva instrumentebis efeqturi gamoyeneba qronikuli daavadebebis efeqturi marTvisaTvis, sxvadasxva samedicino personalis mier pacientisaTvis gaweuli momsaxurebis uwyvetobis uzrunvelyofisaTvis.

7. specifikuri problemis gadaWris unari: ojaxis eqimis saqmianobaSi ufro mniSvnelovania problemaze orientirebuli midgoma, vidre daavadebaze orientirebuli midgoma. gansxvaveba ojaxis eqimsa da saavadmyofoSi momuSave specialistebs Soris SeZleba ase aRiweros[1]: ojaxis eqims unda SeeZlos `gaurkvevlobis~ pirobebSi muSaoba (igulisxmeba daavadebis adreuli stadia, roca diagnozi naTeli ar aris), albaTobis gansja (igulisxmeba ama Tu im daavadebis arsebobis albaToba) da safrTxis gamoricxva (im mdgomareobebis droulad amocnoba, romlebic safrTxes uqmnis pacientis sicocxles); saavadmyofos eqimma unda Seamciros gaurkvevloba (igulisxmეba diagnozis dazusteba), gansajos albaToba da gamoricxos Secdoma. aRniSnuli kompetencia moicavs Semdeg unarebs:

a) gadawyvetilebis miRebisas TemSi daavadebis incidenturobis da prevalenturobis gaTvaliswineba; amisaTvis aucilebelia:

a.a) daavadebis prevalenturobis da incidenturobis codna;

a.b)samizne Temis kargad codna (demografiuli da qronikuli daavadebebis statistikuri monacemebi);

a.g) gadawyvetilebis miRebis teqnikis floba;

b) anamnezis Sekrebis, fizikuri gasinjvis, gamokvlevebis Catarebisas informaciis seleqciuri, miznobrivi Segroveba da interpretacia, misadageba samoqmedo gegmasTan pacientTan TanamSromlobis gziT; amisaTvis aucilebelia:

b.a) anamnezis Sekrebis da fizikuri gasinjvis unar-Cvevebi, monacemebis interpretaciis unari;

b.b) janmrTelobis konkretuli problemis Sesabamisi kiTxvebis dasmis (anamnezis Segrovebisas), saWiro fizikuri gasinjvis meTodebisa da paraklinikuri meTodebis SerCevis, miRebuli monacemebis interpretaciis unari;

b.g) pacientis Taviseburebebis gaTvaliswineba – ojaxi, socialuri da samuSaosTan dakavSirebuli faqtorebi;

b.d) arsebuli sadiagnozo da samkurnalo resursebis codna;

b.e) daavadebis marTvis gegmaSi pacientis CarTvis survili da unari.

g) specifikuri samuSao principebis gaTaviseba, rogoricaa, magaliTad, gamokvlevebis etapobrivi (martividan rTulisken) gamoyeneba, drois, rogorc iaraRis gamoyeneba, tolerantulobis gamomuSaveba gaurkvevlobis mimarT; amisaTvis aucilebelia:

g.a) interesis, gulmodginebis da yuradRebis unaris gamomuSaveba;

g.b) etapobrivi midgomis gamoyeneba gadawyvetilebis miRebisas, drois, rogorc iaraRis gamoyeneba diagnozisa da mkurnalobis optimaluri gzebis SerCevaSi;

g.g) gaazreba da Segueba im faqtTan, rom pirvelad jandacvaSi problemis gadaWrisas met-naklebi gaurkvevloba gardauvalia; ojaxis eqims unda hqondes aRniSnuli gaurkvevlobis pirobebSi muSaobisa da Sesabamisi strategiis gamomuSavebis unari;

d) gadaudebeli Careva saWiroebisas; amisaTvis aucilebelia:

d.a) gadawyvetilebis miRebis specifikuri unari gadaudebeli mdgomareobebis arsebobisas;

d.b) pirvelad jandacvaSi arsebuli gadaudebeli mdgomareobebis marTvisTvis aucilebeli manipulaciebis Catarebis unar-Cvevebi;

e) daavadebebis marTva maTi ganviTarebis adreul, aradiferencirebul stadiaze; amisaTvis aucilebelia:

e.a) codna imisa, Tu rodis SeiZleba mocda da dakvirveba da rodis aris aucilebeli damatebiTi sadiagnozo da samkurnalo RonisZiebebis gamoyeneba;

v) sadiagnozo da samkurnalo RonisZiebebis efeqturi da racionaluri gamoyeneba; amisaTvis aucilebelia:

v.a) codna da gaazreba imisa, rom simptomebis da niSnebis, agreTve damatebiTi gamokvlevis meTodebis prognozuli Rirebuleba farTo sazRvrebSi meryeobs;

v.b) sxvadasxva sadiagnozo meTodis xarjefeqturobis codna da gaazreba.

8. yovlismomcveli midgoma: aRniSnuli kompetencia moicavs Semdeg unarebs:

a) erTdoulad mravlobiTi Civilis da paTologiuri mdgomareobis (rogorc qronikuli, ise mwvave problemebis) marTva; amisaTvis aucilebelia:

a.a) komorbidulobis koncefciis codna da gageba;

a.b) erTdroulad arsebuli sxvadasxva janmrTelobis problemis marTva maTi amocnobis da gaanalizebis, agreTve pacientTan SeTanxmebis da prioritetebis gansazRvris gziT;

a.g) samedicino Canawerebis da sxva informaciis gamoyenebis unari;

a.d) mocemuli droisTvis arsebuli saukeTeso mtkicebulebebis moZiebis da gamoyenebis unari;

b) janmrTelobisaTvis xelSewyobis da daavadebaTa prevenciis strategiebis gamoyeneba; amisaTvis aucilebelia:

b.a) janmrTelobis koncefciis gageba;

b.b) janmrTelobisaTvis xelSewyoba individualurad, calkeuli konsultaciis farglebSi;

b.g) janmrTelobis mdgomareobis gaumjobeseba janmrTelobisaTvis xelSewyobis da daavadebaTa prevenciis programebis pirvelad jandacvaSi ganxorcielebis gziT;

b.d) ojaxis eqimis rolis gageba TemSi janmrTelobis xelSewyobisTvis;

b.e) individisa da Temis saWiroebebs Soris SesaZlo dapirispirebis gageba da am dapirispirebis mniSvnelobis gaazreba;

g) janmrTelobisaTvis xelSewyobis, prevenciis, mkurnalobis, movlis, reabilitaciis da paliatiuri mzrunvelobis koordinacia da marTva; amisaTvis aucilebelia:

g.a) zogad praqtikaSi janmrTelobis problemebis kompleqsuri bunebis gageba;

g.b) mrvlobiTi, gansxvavebuli midgomebis arsebobis SesaZleblobis gageba;

g.g) calkeuli pacientisaTvis gansxvavebuli midgomis gamoyeneba da misi Secvla, saWiroebisamebr;

g.d) gundis muSaobis koordinacia pirvelad jandacvaSi.

9. Temze orientacia: aRniSnuli kompetencia moicavs Semdeg unarebs:

a) calkeuli pacientisa da Temis janmrTelobis saWiroebebis SeTavseba-Sejereba da gaTvaliswineba arsebulი resursebis ganawilebisas; amisaTvis aucilebelia:

a.a) Temis janmrTelobis saWiroebebis gageba samizne mosaxleobis epidemiologiuri maxasiaTeblebis codnis safuZvelze;

a.b) janmrTelobasa da socialur garemos Soris urTierTkavSiris gageba;

a.g) samizne Temis janmrTelobaze siRaribis, eTnikurobis da adgilobrivi epidemiologiuri mdgomareobis gavlenis gageba;

a.d) samedicino momsaxurebaSi arsebuli uTanabrobis aRqma;

a.e) arsebuli jandacvis sistemis struqturisa da misi resursebis farglebis gageba;

a.v) Temis janmrTelobis sakiTxebSi CarTuli sxva profesionalebis rolis gageba;

a.z) gageba imisa, Tu rogor SeuZliaT pacients da eqims gamoiyenon jandacvis arsebuli sistema;

a.T) individis saWiroebebis Sejereba Temis saWiroebebTan;

a.i) ojaxis eqimis rolis gageba pacientisaTvis samedicino momsaxurebis organizebaSi.

10. holisturi midgoma: aRniSnuli kompetencia moicavs Semdeg unarebs:

a) biofsiqosocialuri midgomis gamoyeneba; amisaTvis aucilebelia:

a.a) holistikis koncefciis codna da misi mniSvnelobis gaazreba pacientisaTvis samedicino momsaxurebis gawevisaTvis;

a.b) pacientis, rogorc biofsiqosocialuri `erTobis~, aRqma;

a.g) holisturi gagebis praqtikul RonisZiebebSi ganxorcielebis unari;

a.d) pacientis kulturuli Taviseburebebis gaTvaliswineba, rasac SeiZleba mniSvneloba hqondes pacientis samedicino momsaxurebisaTvis;

a.e) pacientis gamocdilebis, gancdis, rwmenis, faseulobebis da molodinis gageba da aRqma, rasac mniSvneloba aqvs samedicino momsaxurebis gawevisTvis.

11. eqim-specialistis zogadi unar-Cvevebi:

a) ojaxiს eqims unda SeeZlos nebismieri pacientis, janmrTelobis nebismieri problemis pirveladi Sefaseba da adekvaturi gadawyvetilebis miReba, rac, upirveles yovlisa, moicavs gadaudebeli daxmarebis saWiroebis amocnobas da Sesabamis moqmedebas, kerZod:

a.a) gadaudebeli daxmarebis aRmoCenas eqimis samuSao adgilze an binaze sicocxlisaTvis saSiSi mdgomareobebis dros (ix. cxrili 1) da saswrafo samedicino daxmarebis gamoZaxebas an;

a.b) gadaudebel referals (sxva specialistTan mimarTva an hospitalizacia);

b) ojaxis eqimi daavadebis pirveladi Sefasebis Semdeg agrZelebs im daavadebebis marTvas, romelic mis kompetencias Seesabameba (ix. Tavi 4). aRniSnuli daavadebis marTvisas is TanamSromlobs, faqtobrivad, yvela specialobis eqimTan, romlebTanაც ojaxis eqimi saWiroebisas pacients periodulad konsultaciisTvis agzavnis;

g) im daavadebebis da mdgomareobebis dros, romelebic, erTi mxriv, ar saWiroeben gadaudebel daxmarebas, xolo, meore mxriv, ar Sedis ojaxis eqimis mier samarTav CamonaTvalSi eqvemdebareba referals Sesabamisi specialobis eqimTan pirveladi an meoreuli, an mesameuli donis dawesebulebaSi.

d) ojaxis eqimis kompetencia gadaudebeli daxmarebis gawevisas:

o mdgomareobis Sefaseba, saswrafo daxmarebis gamoZaxebis saWiroebis dadgena da saWiroebisas misi gamoZaxebis uzrunvelyofa, pirveladi daxmarebis dawyeba;

o ZiriTadi sasicocxlo funqciebis SenarCuneba da kardiopulmonuri reanimacia, Cvenebisas defibrilaciis Catarebis CaTvliT;

o periferiuli venis xelmisawvdomobis uzrunvelyofa wamlebisa da sainfuzio xsnarebisTvis (iv. kanulireba);

o

o zogadi simptomuri Terapia;

– Jangbadis miwodeba Cvenebis mixedviT;

– intravenurad xsnarebis infuziis dawyeba Cvenebis mixedviT;

– sxeulis temperaturis normalizeba da SenarCuneba (gaTboba an gagrileba);

– tkivilis marTvis dawyeba Cvenebis mixedviT;

o

o janmrTelobis problemis Sesabamisi (specifikuri) daxmarebis dawyeba saswrafo daxmarebis brigadis mosvlamde:

– Soki (hipovolemiuri, neirogenuli, kardiogenuri, anafilaqsiuri, septikuri);

– cnobierebis darRveva, koma;

– mwvave cerebrovaskuluri daavadebebi;

– cns-is mwvave infeqciuri da anTebiTi daavadebebi, meningitis CaTvliT;

– gulyra;

– epilefsiuri statusi;

– mwvave Tavis tkivili;

– xerxemlis malebis kompresia;

– mxedvelobis mwvave dakargva;

– Cvilis uecari sikvdilis sindromi;

– mwvave cnobierebis aSlis mdgomareoba;

– panikuri Seteva;

– isteria;

– TviTmkvlelobis mcdeloba;

– fsiqikuri daavadebiT SepyrobilTa gadaudebeli hospitalizaciis saWiroeba;

– aRkveTis sindromi (fsiqoaqtiur nivTierebaTa moxsnis sindromi);

– gulis gaCereba (cardiac arrest);

– sicocxlisTvis saSiSi ariTmia;

– mwvave koronaruli sindromi;

– gulmkerdisa da muclis aortis anevrizmis ganSreveba da gaskdoma;

– mwvave respiraciuli distresi;

– filtvis arteriis embolia;

– gamonaJoni plevris RruSi, empiema, pnevmoToraqsi;

– asTma, asTmuri statusi;

– sisxldena Sinagani organoebidan;

– eqtopiuri orsuloba;

– mosalodneli an spontanuri aborti;

– naadrevi mSobiaroba;

– preeklamfsia da eklamfsia;

– saTesle bagirakis mwvave Semogrexa;

– parafimozis da priapizmis gadaudebeli marTva;

– Sardis mwvave Sekaveba;

– Tirkmlis kolika;

– anafilaqsia;

– mwvave infeqciebiT gamowveuli mdgomareobebi, romlebic gadaudebel daxmarebas saWiroeben;

– mwvave intoqsikacia, miuxedavad gamomwvevisa (maT Soris, mwvave intoqsikacia – gamowveuli alkoholiT, opioidebiT, kanabinoidebiT da sxva fsiqoaqtiuri nivTierebebiT);

– travma, miuxedavad dazianebis adgilisa da meqanizmisa;

– damwvroba (qimiuri, Termuli, eleqtruli):

– sasikvdilo eleqtrotravma, mexis dacema;

– daxrCoba da CaZirva wyalSi;

– siTburi dakvra da mzis dakvra, siTburi sinkope, siTburi krunCxva;

– hipoTermia;

– moyinva;

– nakbeni, adamianisa da cxovelis;

– Zaladobis msxverpli;

– masobrivi, garemosTan dakavSirebuli/bunebrivi katastrofebis Tanmxlebi mdgomareobebi.

12. specialoba moicavs qvemoCamoTvlili daavadebebis, paTologiuri mdgomareobebis klinikas, diagnostikas, mkurnalobasa da profilaqtikas:

a) ojaxis eqimi mis kompetenciaSi Semaval janmrTelobis problemebs marTavs an damoukideblad an sxva specialobis eqimebTan TanamSromlobis gziT. yvela SemTxvevaSi ojaxis eqimi TanamSromlobs pirveladi jandacvis gundis wevrebTan;

b) erTi da igive daavadeba, misi mimdinareobis Taviseburebidan (stadia, garTulebebi) gamomdinare, ojaxis eqimma SeiZleba marTos TviTon (an damoukideblad, an sxva eqimTan TanamSromlobis safuZvelze), an mimarTos sxva specialobis eqimTan;

g) referalis saWiroebebis zogadi daxasiaTeba mocemulia TavSi 8 `im specialobaTa da Sesabamisi subspecialobebis (specializaciebis) CamonaTvali, romelTanac konkretul dargs SesaZlebelia hqondes saerTo/saziaro kompetenciebi da aRwerdes maT Soris kompetenciaTa gamijvnis SesaZleblobebs pirveladi jandacvis, zogadi profilis hospitaluri da maRalteqnologiuri servisebis specifikis gaTvaliswinebiT~;

d) qvemoT mocemulia ori magaliTi, romlis drosac ojaxis eqimi daavadebaს marTavs damoukideblad an mimarTavs sxva specialistTan:

d.a) esenciuri arteriuli hipertenzia ojaxis eqimma damoukideblad unda marTos. amasTan, rezistentuli hipertenziis SemTxvevebSi ojaxis eqimma SeiZleba gamoiyenos referali sxva specialobis eqimTan;

d.b) gastroezofaguri refluqs-daavadebis (gerd) marTva ojaxis eqimma damoukideblad unda SeZlos; Tumca, warumatebeli mkurnalobis SemTxvevaSi ojaxis eqimi pacients mimarTavs sxva specialobis eqimTan;

e) daavadebaTa prevencia ojaxis eqimis saqmianobis umniSvnelovanesi Semadgenelia. ojaxis eqimi eweva, faqtobrivad, yvela daavadebis pirvelad prevencias (profilaqtikas) da im daavadebaTa meoreul prevenecias, romelTa skriningis resursi ojaxis eqims aqvs (arteriuli hipertenzia, simsuqne, dislipidemia da a.S.). ojaxis eqimi icnobs daavadebaTa meoreuli prevenciis yvela SesaZleblobas. amasTan, skriningis im meTodebs, romlebic qveyanaSi ar aris danergili an ar aris misi gamoyenebis SesaZlebloba qveynis masStabiT, an skriningis programebisaTvis Seqmnilia damoukidebeli qseli (e.w. skriningis centrebi), ojaxis eqimi an ar iyenebs an skriningisTvis mimarTavs specializebul dawesebulebaSi. ojaxis eqimi axorcielebs, faqtobrivad, yvela qronikuli daavadebis mesameul prevencias an damoukideblad an Sesabamisi specialobis eqimTan TanamSromlobis safuZvelze;

v) qvemoT mocemulia im daavadebebis da janmrTelobis problemebis CamonaTvali, romelTa marTva ojaxis eqims unda SeeZlos damoukideblad an sxva specialobis eqimebTan TanamSromlobis safuZvelze;

z) janmrTel pirTa meTvalyureoba: janmrTelobisaTvis xelSewyoba da daavadebaTa prevencia:

z.a) pirveladi, meoreuli da mesamეuli prevenciis principebi;

z.b) prevenciuli RonisZiebebi bavSvebsa da xandazmulebisTvis ix. Sesabamisi CamonaTvali (`bavSvTa janmrTeloba~, `xandazmul pirTa janmrTeloba~);

z.g) 15-dan 65 wlamde asakis janmrTel pirTa meTvalyureoba: Tambaqos weva, alkoholis Warbi moxmareba, simsუqne, adinamia/hipodinamia, dislipidemia, skriningi hipertenziaze, gul-sisxlZarRvTa daavadebebis riskis Sefaseba, Saqriani diabeti, kibos prevencia (saSvilosnos yelis kibo, sarZeve jirkvlis kibo, winamdebare jirkvlis kibo, msxvili nawlavis kibo);

T) qalTa janmrTeloba:

T.a) simptomebis marTva:

T.a.a) mkerdis tkivili, simagre mkerdSi, gamonadeni dvrilidan;

T.a.b) vulvis qavili, gamonadeni saSodan;

T.a.g) disparunia, tkivili menjis areSi, endometriozi;

T.a.d) amenorea, menoragia, dismenorea, intermenstrualuri sisxldena, araregularuli sisxldena, postmenopauzuri sisxldena, premenstrualuri sindromi, menopauza da masTan dakavSirebuli problemebi;

T.a.e) uSviloba – pirveladi da meoreuli;

T.a.v) dizuria, Sardis Seukavebloba;

T.a.z) fekaluri Seukavebuloba;

T.a.T) emociuri problemebi, depresiis simptomebis CaTvliT;

T.b) gavrcelebuli mdgomareobebis marTva:

T.b.a) saSos yelis nacxi – gadaxra normidan;

T.b.b) saSos da saSvilosnos prolafsi;

T.b.g) fibromebi;

T.b.d) ginekologiuri infeqciebi, barTolinis abscesis da sqesobrivad gadamdebi daavadebebis CaTvliT;

T.b.e) ginekologiuri simsivneebi;

T.b.v) spontanuri aborti;

T.b.z) saSvilosnosgare orsuloba;

T.b.T) trofoblasturi daavadeba;

T.b.i) normaluri orsuloba, orsulobasTan dakavSirebuli problemebi – hiperemezisi, welis tkivili, boqvenis simfizis disfunqcia, orsuloba mravlobiTi nayofiT, zrdaSi CamorCena, preeklamfsia, mSobiarobis wina hemoragia, naadrevi mSobiaroba, polihidramniozi, placentis winmdebareoba, Rrma venebis Trombozi da pulmonuri embolia, dagvianebuli mSobiaroba, nayofis moZraobis daqveiTeba, intrauteruli infeqcia, intrauteruli sikvdili, nayofis anomalia;

T.b.k) orsulobis dros wamliT mkurnalobis Taviseburebebi;

T.b.l)seqsualuri darRvevebi, fsiqoseqsualuri mdgomareobebis CaTvliT;

T.b.m) fsiqikuri janmrTelobis problemebi, SfoTvis, depresiis, suicidis, kvebis

aSlilobis CaTvliT, am aSlilobebis kavSiri orsulobasa da menopauzasTan;

T.b.n) menopauzis marTva, CanacvlebiTi hormonuli Terapiis CaTvliT;

T.b.o) tkivilis da sxva simptomebis marTva, paliatiuri mzrunveloba qalebSi;

T.g) prevencia:

T.g.a) orsulobisaTvis mzadeba: kontraceptivebis Sewyveta, foliumis mJavis gamoyeneba, ojaxuri da genetikuri anamnezi, cxovrebis wesi da a.S.;

T.g.b) prevencia orsulobis dros: janmrTelobisaTvis xelSewyoba, socialuri da kulturuli faqtorebi, Tambaqos weva da alkoholis miReba, asakTan dakavSirebuli sakiTxebi, wina sameano anamnezi, diabeti da simsuqne, rezus-faqtori, antidepresantebis gamoyeneba, hipertenzia da sxva daavadebebi orsulobis dros, anemia, gastroezofaguri refluqsi, fexebis tkivili da qvemo kidurebis venebis varikozuli gaganiereba, hemoroiduli venebi, gamokvleva wiTuraze da imunizacia;

T.g.g) osteoporozis riskis Sefaseba, skriningi da marTva;

i) bavSvTa janmrTeloba:

i.a) simptomebis marTva;

i.b) Rebineba, cxeleba, Zilianoba, ganviTarebis Seferxeba, axalSobilTa kolika, zrdis darRvevebi, qcevis problemebi;

i.b.ა) gavrcelebuli mdgomareobebis marTva:

i.b.ბ) axalSobilTa problemebi: samSobiaro travmis Semdegomi periodi, kvebis problemebi, gulis Suilebi, gamonadeni Tvalidan, siyviTle;

i.b.გ) Sekruloba, mwvave da ganmeorebiTi muclis tkivili;

i.b.დ) cxeleba, febriluri gulyrebi;

i.b.ე) xvela, qoSini, mstvinavi xixini, respiratoruli infeqciebi, bronqioliti;

i.b.ვ) Sua yuris anTeba;

i.b.ზ) sensoruli deficiti, siyrue;

i.b.თ) gastroenteriti;

i.b.ი) virusuli egzanTema;

i.b.კ) saSarde gzebis infeqcia;

i.b.ლ) meningiti;

i.b.მ) epilefsia;

i.b.ნ) qronikuli daavadebebi: asTma, diabeti, arTriti, swavlis problemebi;

i.b.ო) Zaladoba bavSvze;

i.b.პ) fsiqikuri problemebi – yuradRebis deficitisa da hiperaqtivobis sindromi, depresia, kvebis aSliloba, mokidebuleba, TviTdazianeba, autizmi da masTan dakavSirebuli darRvevebi;

i.b.ჟ) fsiqologiuri problemebi: enurezi, enkoprezi, `daSineba~, problemebi skolaSi, qcevis problemebi `tantrumis~ CaTvliT;

i.g) prevenciuli RonisZiebebi:

i.g.a) prenataluri diagnozi;

i.g.b) ZuZuTi kveba, jansaRi kveba da fizikuri aqtiuroba;

i.g.g) socialuri da emociuri keTildReoba;

i.g.d) bavSvTa usafrTxoeba, bavSvis dacva da travmis prevencia;

i.g.e) imunizacia;

i.g.v) Tambaqos wevis, alkoholis miRebisa da wamaldamokidebulebis Tavidan acileba;

i.g.z) mozardebis dacva naadrevi sqesobrivi cxovrebis dawyebisgan da masTan dakavSirebuli problemebisgan;

k) mamakacTa janmrTeloba:

k.a) simptomebis marTva:

k.a.a) dizuria;

k.a.b) niqturia;

k.a.g) hematuria;

k.a.d) prostatizmi;

k.a.e) Sardis Sekaveba;

k.a.v) tkivili welis da hipogastriumis areSi;

k.a.z) saTesle jirkvlis Sesieba;

k.a.T) orqalgia;

k.a.i) asos tkivili, dawyluleba;

k.a.k) ereqciis darRveva;

k.b) gavrcelebuli mdgomareobebis marTva:

k.b.a) mamakacTaTvis damaxasiaTebeli onkologiuri daavadebebi – saTeslis da prostatis kibo;

k.b.b) prostatis keTilTvisebiani hipertrofia/hiperplazia da prostatiti;

k.b.g.) saTesleebis sxva daavadebebi: kriptorqizmi, varikocele, hematocele, hidrocele, epididimoorqiti da epididimiti;

k.b.d) seqsualuri darRvevebi, fsiqoseqsualuri darRvevebis CaTvliT;

k.b.e) mamakacis kontracefcia da uSviloba;

k.b.v) cirkumcizia;

k.b.z) fsiqikuri darRvevebi, depresiis, suicidisa da andropauzis CaTvliT;

k.b.T) sqesobrivad gadamdebi daavadebebi;

k.g) prevencia:

k.g.a) ganaTleba cxovrebis jansaRi wesis Sesaxeb: Tambaqo, alkoholi, wamaldamokidebuleba, seqsualuri janmrTeloba, fsiqikuri janmrTeloba;

l) xandazmul pirTa janmrTeloba;

l.a) Sefaseba:

l.a.a) xandazmuli pacientis mdgomareobis Sefaseba, janmrTelobis problemebis amocnoba, geriatriuli sindromebis amocnoba, samedicino momsaxurebis prioritetebis gansazRvra – mwvave da qronikuli daavadebebis marTva da prevenciuli RonisZiebebis dagegmva;

l.b) gavrcelebuli mdgomareobebis marTva:

l.b.a) qronikuli daavadebebis marTva (mag., art. hipertenzia, gulis ukmarisoba, cerebrovaskuluri daavadebebi, hipoTireozi, diabeti, neirodegeneraciuli daavadebebi da a.S.);

l.b.b) geriatriuli sindromebis marTva;

l.b.g) terminaluri mdgomareobaSi myofi xandazmulisaTvis Sesabamisi samedicino daxmarebis gaweva (ix. paliatiuri mzrunveloba);

l.გ) prevenciuli RonisZiebebi:

l.გ.a) pirveladi prevencia: riskfaqtorebis Sefaseba; fizikuri aqtiurobis rCeva da xelSewyoba; imunizaciis saWiroebis gansazRvra da organizeba (mag. gripis, pnevmoniis prevencia – vaqcinacia gripis virusis da pnevmokokuri infeqciis winaaRmdeg); dacemis da motexilobis prevencia; osteoporozis prevencia;

l.გ.b) meoreuli prevencia: kibos skriningis programebis SerCeva da ganxorcieleba asakis mixedviT; sxva skrininguli RonisZiebebi (hipertenzia, hiperqolesterinemia, diabeti, osteoporozi, deliriumi, wonიs deficiti);

l.გ.g) mesameuli prevencia: gavrcelebuli qronikuli daavadebebis mesameuli prevencia (diabeti, instulti da sxv.);

l.გ.d) geriatriuli sindromebis prevencia: cnobierebis darRveva-daqveiTeba; dacema; fizikuri aqtiurobis SezRudva; siarulis da balansis darRveva; Sardis Seukavebloba; sarkopenia da wonis dakargva; socialuri aqtiurobis daqveiTeba, depresia;

l.გ.e) iatrogenuli daavadebebis (mag., medikamentebiT gamowveuli, hospitalizaciasTan dakavSirebuli) prevencia xandazmulebSi;

m) gadaudebeli medicina da travma:

m.a) ix. gadaudebeli mdgomareobebis marTva: cxrili 1;

n) gul-sisxlZarRvTa sistemis daavadebebi:

n.a) simptomebis marTva:

n.a.a) tkivili gulmkerdis areSi: kardiovaskuluri paTologiiT gamowveuli mdgomareobebi (mag., gid, perikarditi, aortis ganSreveba) da maTi gamijnva arakardiovaskuluri paTologiisgan (ZvalkunTovani tkivili, respiratoruli, gastrointestinuri da fsiqologiuri problemebi);

n.a.b) qoSini (gulis ukmarisoba, respiratoruli problemebi, Tromboembolia, anemia, simsuqne, avTvisebiani simsivneebi);

n.a.g) koW-wvivis SeSupeba (gulis ukmarisoba, Tromboembolia, venuri Segubeba, venebis varikozi, Rrma venebis Trombozi, fexis wyluli, limfedema, anemia, simsuqne, avTvisebiani simsivne, hipoporteinemia);

n.a.d) periferiuli sisxlZarRvebis (arteriebi da venebi) dazianebiT gamowveuli simptomebi an niSnebi;

n.a.e) gulisfriali da asimptomuri ariTmia;

n.a.v) cerebrovaskuluri daavdebebis simptomebi da niSnebi;

n.a.z)kolafsi;

n.b) gavrcelebuli mdgomareobebis marTva:

n.b.a) arteriuli hipertenzia;

n.b.b) gulis iSemiuri (koronaruli) daavadeba (stenokardia, mwvave koronaruli sindromi, gulis gaCereba – `cardiac arrest~);

n.b.g) gulis ukmarisoba;

n.b.d) ariTmia (eqstrasistolia, winagulebis cimcimi da TrTolva, viwro da farTokompleqsovani taqikardiebi, bradiariTmiebi);

n.b.e) gulis sxva daavadebebi (sarqvlovani paTologia, miokardiumis da endokardiumis daavadebebi, Tandayolili anomaliebi);

n.b.v) periferiuli sisxlZarRvebis daavadebebi (arteriebis da venebis);

n.b.z) cerebrovaskuluri daavadebebi (insulti da gardamavali/tranzitoruli iSemiuri Seteva);

n.b.T) Tromboemboliuri daavadeba;

n.g) prevencia:

n.g.a) sisxlis arteriuli wneva, lipidebi, Tambaqos weva, fizikuri aqtiuroba, simsuqne, dieta, alkoholis Warbi moxmareba;

n.g.b) komorbidobis marTva (gansakuTrebiT diabeti);

n.g.g) riskis Sefaseba;

o) sunTqvis sistemis daavadebebi:

o.a) simptomebis marTva:

o.a.a) haeris ukmarisoba;

o.a.b) xvela;

o.a.g) naxvelis gamoyofa;

o.a.d) sisxliani xvela;

o.a.e) yelis tkivili;

o.a.v) tkivili gulmkerdis areSi;

o.a.z) xmauriani sunTqva;

o.b) gavrcelebuli mdgomareobebis marTva:

o.b.a) zeda sasunTqi gzebis infeqciebi: gacieba, faringiti, tonziliti, peritonziluri abscesi, epiglotiti, laringiti, traqeiti;

o.b.b) qveda sasunTi gzebis infeqciebi: bronqiti, pnevmonia;

o.b.g) mwvave arainfeqciuri respiratoruli problemebi (mxolod amocnoba da gadaudebeli marTva; ix. zemoT): alergia-anafilaqsia, filtvis arteriis Tromboembolia, pnevmoToraqsi, ucxo sxeulis aspiracia;

o.b.d) qronikuli arainfeqciuri respiratoruli problemebi: qronikuli xvela, filtvebis qronikuli obstruqciuli daavadeba, asTma, filtvebis tuberkulozi, mukoviscidozi, filtvebis qronikuli intersticiuli daavadeba;

o.b.e) filtvis kibo;

o.გ) prevencia:

o.გ.a) Tambaqos mitoveba;

o.გ.b) imunizacia;

o.გ.g) sunTqvis sistemis qr. daavadebebis mesameuli prevencia;

p) saWmlis momnelebeli sistemis daavadebebi:

p.a) simptomebis marTva:

p.a.a) dispefsia;

p.a.b) tkivili muclis areSi;

p.a.g) gulisreva-Rebineba;

p.a.d) umadoba da wonaSi kleba;

p.a.e) sisxliani Rebineba da melena;

p.a.v) reqtaluri sisxldena da tenezmebi;

p.a.z) siyviTle;

p.a.T) diarea;

p.a.i) yabzoba;

p.a.k) disfagia;

p.b) gavrcelebuli mdgomareobebis marTva:

p.b.a) gastroezofaguri refluqsdaavadeba (gerd);

p.b.b) peptiuri wyluli;

p.b.g) gastriti;

p.b.d) arawylulovani dispefsia;

p.b.e) gaRizianebuli nawlavis sindromi;

p.b.v) gastroenteriti;

p.b.z) yabzoba;

p.b.T) celiakia;

p.b.i) nawlavis anTebiTi daavadebebi;

p.b.k) kuWnawlavis traqtis kibo – saylapavis, kuWis, RviZlis, pankreasis, msxvili nawlavis;

p.b.l) divertikulozi;

p.b.m) mwvave muceli (mag., mwvave apendiciti, qolecistiti, pankreatiti);

p.b.n) perianaluri paTologia (mag., hemoroiduli venebis gaganiereba, perianaluri hematoma);

p.g)prevencia:

p.g.a) jansaRi kveba, maT Soris, xilis saTanado ulufebis miReba;

p.g.b) Tambaqos da alkoholis miRebis Semcireba kibos prevenciisTvis;

J) saSarde organoTa sistemis daavadebebi:

J.a) simptomebis da niSnebis amocnoba:

J.a.a) dizuria;

J.a.b) oliguria da anuria;

J.a.g) poliuria, niqturia;

J.a.d) hematuria;

J.a.e) Tirkmlis kolika;

J.a.v) Sardis Seukavebloba;

J.a.z) ureTraluri sindromi;

J.a.T) nefrozuli sindromi;

J.b) gavrcelebuli mdgomareobebis marTva:

J.b.a) qvemo saSarde gzebis infeqcia;

J.b.b) pielonefriti;

J.b.g) prostatiti;

J.b.d) SardkenWovani daavadeba;

J.b.e) glomerulonefriti;

J.b.v) fimozi, parafimozi;

J.b.z) kriptorqizmi;

J.b.T) Tirkmlis toqsikuri dazianeba;

J.b.i) Tirkmlisa da saSarde gzebis Tandayolili anomaliebi;

J.b.k) saSarde organoebis axalwarmonaqmnebi, kibo;

J.b.l) Sardis Seukavebloba, enurezi;

J.b.m) Tiრkmlebis qronikuli ukmarisoba;

J.b.n) Tirkmlisa da saSarde gzebis tuberkulozi;

J.b.o) saSarde sistemis gadaudebeli mdgomareobebis amocnoba, pirveli daxmareba da referali (Tirkmlebis mwvave ukmarisoba, Tirkmlis kolika da sxva);

r) sqesobrivi janmrTeloba:

r.a) simptomebis marTva:

r.a.a) gamonayari, dawyluleba sasqeso organoebis midamoebSi;

r.a.b) uCveulo suni sasqeso organoebidan;

r.a.g) gamonadeni asodan an uCveulo gamonadeni saSodan;

r.a.d) dizuria;

r.a.e) muclis qveda areSi tkivili qalebSi;

r.a.v) saTesle jirkvlis tkivili da Sesieba;

r.a.z) mtkivneuli koitusi;

r.a.T) intermenstrualuri sisxldena;

r.a.i) vaginaluri sisxldena koitusis Semdeg;

r.b) gavrcelebuli mdgomareobebis marTva:

r.b.a) qvemo saSarde gzebis infeqcia qalebSi;

r.b.b) baqteriuli vaginozi;

r.b.g) kandidozi;

r.b.d) qlamidiuri infeqciebi;

r.b.e) gonorea;

r.b.v) triqomoniazi;

r.b.z) anogenitaluri wylulebi: herpesi, sifilisi, aiv infeqcia;

r.b.T) anogenitaluri meWeWebi;

r.b.i) imunodepresiis arsebobaze mimaniSnebeli mdgomareobebi;

r.b.k) sifilisi;

r.b.l) reiteris sindromi;

r.b.m) aiv/Sidsis niSnebi da garTulebebi;

r.b.n) sqesobrivi darRvevebi;

r.g) prevencia:

r.g.a) sqesobrivi gziT gadamdebi daavadebebis prevencia;

r.g.b) skriningi: qlamidia, aiv, saSvilosnos yelis dazianebis;

r.g.g) imunizacia: hepatiti;

s) sisxlis da sisxlmbadi sistemis daavadebebi:

s.a) simptomebis da niSnebis amocnoba:

s.a.a.) sisxlnaklebobis niSnebi;

s.a.b) hemoragiuli diaTezi;

s.a.g) hematoma;

s.a.d) peteqia;

s.a.e) purpura;

s.a.v) limfadenopaTia;

s.b) gavrcelebuli mdgomareobebis marTva:

s.b.a) anemiebi;

s.b.b) hemoragiuli diaTezebi;

s.ბ.g) agranulocitozi;

s.ბ.d) mwvave da qronikuli leikozi;

s.ბ.e) eriTremia da eriTrocitozi;

s.ბ.v) limfadenopaTia;

s.ბ.z) limfogranulomatozi;

s.ბ.T) limfoma;

s.ბ.i) mielomuri daavadeba;

s.გ) prevencia:

s.გ.a) anemiis prevencia specifikur jgufebSi (orsulebSi xandazmulebi);

s.გ.b) travmis prevencia sisxldenis Tavidan asacileblad;

t) endokrinuli daavadebebi da metaboluri darRvevebi:

t.a) simptomebis marTva:

t.a.a) simptomebis amocnoba, romelic SeiZleba miuTiTebdes Semdegi daavadebebis arsebobaze: diabeti, hipoTireozi, hiperTireozi, hiperlihipedmia, hiperurikemia;

t.b) gavrcelebuli mdgomareobebis marTva:

t.b.a) simsuqne;

t.b.b) diabeti;

t.b.g) glukozisadmi tolerantulobis darRveva;

t.b.d) hipoTireozi;

t.b.e) hiperTireozi;

t.b.v) hiperlipidemia;

t.b.ზ) hiperurikemia;

t.b.თ) hipofizis, Tirkmelzeda jirkvlis da farsebraxlo jirkvlis dazianebebis drouli amocnoba da referali;

t.g) prevencia:

t.g.a) endokrinuli da metaboluri darRvevebis prevencia dietisa da fizikuri aqtiurobis gziT;

t.g.b) hiperurikemiis prevenciis saWiroebis dadgena;

t.g.g) mesameuli prevencia endokrinuli da metaboluri darRvevebis dros: diabeti, simsuqne;

u) SemaეrTebelqsovilovani da ZvalkunTovani sistemis daavadebebi;

u.a) simptomebis marTva:

u.a.a) saxsrebis, Zvlebisa da kunTebis anTebis niSnebi – tkivili, Sesiebა, siwiTle, temperaturis adgilobrivi mateba;

u.a.b) funqciis moSla – kunTovani sisuste, moZraobis farglebis SezRudva, deformacia;

u.a.g) saxsrebis, Zvlebisa da kunTebis travmuli dazianebis niSnebi;

u.a.d) sistemuri gamovlinebebi: daRla, nervis kompresia, gamonayari;

u.b) gavrcelebuli mdgomareobebis marTva:

u.b.a) kisris mwvave tkivili;

u.b.b) welis mwvave tkivili;

u.b.g) kisris qronikuli tkivili;

u.b.d) welis qronikuli tkivili;

u.b.e) mxris tkivili;

u.b.v) muxlis tkivili;

u.b.z) rbili qsovilebis dazianeba;

u.b.T) osteoarTriti;

u.b.i) osteoporozi;

U u.b.k) somatizacia, fibromialgia da msgavsi sindromebi;

u.b.l) mwvave arTropaTiebi;

u.b.m) qronikuli anTebiTi arTropaTiebi;

u.b.n) revmatuli polimialgia;

u.b.o) qronikuli daRliloba;

u.b.p) travmuli dazianeba;

u.g) prevencia:

u.g.a) varjiSi da misi formis da intensiurobis dadgena;

u.g.b) travmis prevencia;

f) alergologiuri da imunologiuri problemebi:

f.a) simptomebis marTva:

f.ა.ა) alergiis simptomebis da niSnebis drouli amocnoba – qavili, gamonayari, surdo, xvela, sunTqvis gaZneleba.

f.b) gavrcelebuli mdgomareobebis marTva:

f.b.a) urtikaria, angiodedema;

f.b.b) asTma;

f.b.g) alergiuli riniti;

f.b.d) wamlismieri alergia;

f.b.e) sakvebismieri alergia;

f.b.v) alergiuli dermatiti;

f.b.z) anafilaqsia;

f.გ) prevencia:

f.გ.a) alergiuli reaqciebis pirveladi prevencia (alergenTan Sexebis Tavidan acileba);

ქ)fsiqikuri janmrTelobis problemebi:

q.a) simptomebis marTva:

q.a.a) qronikuli daRliloba;

q.a.b) uZiloba;

q.a.g) SfoTva;

q.a.d) depresia;

q.a.e) mravlobiTi somaturi Civilebi;

q.a.v) Tavbruსxveva;

q.a.z) gulis friali;

q.a.T) paresTezia;

q.a.i) muclis tkivili bavSvebSi;

q.a.k) fsiqozis adreuli niSnebi;

q.b) gavrcelebuli mdgomareobebis marTva:

q.b.a) depresia;

q.b.b) kvebis darRvevebi;

q.b.g) SfoTviTi aSlilobebi;

q.b.d) posttravmuli stresuli aSliloba;

q.b.e) gadaudebeli fsiqiatriuli mdgomareobebis drouli amocnoba, pirveladi daxmareba da referali: suicidis mcdeloba, deliriumi, fsiqozi, panika, agresia;

q.g) prevencia:

q.g.a) fsiqikuri janmrTelobis xelSewyoba;

q.g.b) autizmis skriningi bavSvebSi, romlebic gvian iwyeben laparaks;

q.g.g) fsiqozis adreuli amocnoba;

R) narkologiuri problemebi:

R.a) simptomebi da niSnebi:

R.a.a) opiatebis mavne moxmarebis niSnebi;

R.a.b) stimulatorebis gamoyenebis niSnebi;

R.a.g) kanabisos gamoyenebis niSnebi;

R.a.d) alkoholis mavne moxmarebasTan asocirebuli niSnebi: fizikuri, fsiqologiuri, socialuri;

R.b) gavrcelebuli mdgomareobebis marTva:

R.b.a) ama Tu im saSualebis moxmarebasTan dakavSirebuli specifikuri garTulebebi (heroini, kokaini, alkoholi, kanabisi);

R.b.b) narkotikuli saSualebis miRebis gzebTan dakavSirebuli garTulebebi (intravenuri, inhalaciuri);

R.b.g) narkotikuli saSualebis gamoyenebasTan dakavSirebuli cxovrebis wesTan dakavSirebuli garTulebebi.

R.b.d) aiv infeqciis, virusuli hepatitebis niSnebis amocnoba, marTvis principebi;

R.b.e) alkoholis miRebiT gamowveuli gadaudebeli mdgomareobebis marTva – krunCxva, deliriumi, fsiqozi.

R.g)prevencia:

R.g.a) ama Tu im fsiqotropuli saSulebis moxmarebasTan

R.g.b) zianis prevenciis strategiebis codna da gamoyeneba;

y) nevrologiuri daavadebebi:

y.a) simptomebis marTva:

y.a.a) Tavis tkvili;

y.a.b) Tavbruxveva;

y.a.g) tremori;

y.a.d) neiropaTia;

y.a.e) kankali, qorea;

y.a.v) gulyra;

y.a.z) Zilianoba;

y.a.T) cnobierebis dakargva, koma;

y.b) gavrcelebuli mdgomareobebis marTva:

y.b.a) epilefsia;

y.b.b) Tavis tkivili;

y.b.g) vertigo;

y.b.d) neiropaTiuli tkivili;

y.b.e) mononeiropaTia;

y.b.v) parkinsonizmi;

y.b.z) gadaudebeli nevrologiuri mdgomareobebis amocnoba da drouli referali;

y.g) prevencia:

y.g.a) epilefsiis mqone pirebis ganaTleba da dazianebebis prevencia;

y.g.b) meningokokuri infeqciis pirveladi prevencia vaqcinaciis gziT;

y.g.g) Sakikis Setevebis prevencia;

y.g.d) nevrologiuri daavadebebis drouli amocnoba genetikuri winaswarganwyobis dros;

შ) yel-yur-cxviris daavadebebi:

S.a) simptomebis marTva:

S.a.a) smenis daqveiTeba;

Sa.b) yuris tkivili;

Sa.g) gamonadeni yuridan;

S.a.d) Tavbruxveva;

S.a.e) Suili yurebSi;

S.a.v) sisxldena cxviridan;

S.a.z) yelis tkivili;

S.a.T) xmis CaxleCa;

S.a.i) ylapvis moSla;

S.a.k) krupi;

S.a.l) simsivne/Sesieba kisris areSi, maT Soris, Ciyvi, limfuri jirkvlebis gadideba da sxva;

S.a.m) metyvelebis Seneleba;

S.a.n) ucxo sxeulebi;

S.b) gavrcelebuli mdgomareobebis marTva:

S.b.a) gare yuris anTeba;

S.b.b) Sua yuris anTeba;

S.b.g) dafis apkis perforacia;

S.b.d) qolesteatoma;

S.b.e) Tavbruxveva, menieris daavadeba;

S.b.v) temporomandibuluri tkivili; trigeminuri nevralgia;

S.b.z) faringiti, tonziliti, laringiti;

S.b.T) piris Rrus sokovani infeqcia da herpesi;

S.b.i) sanerwyve jirkvlebis/sadinaris qvebi;

S.b.k) infeqciuri da alergiuli riniti;

S.b.l) cxviris polipebi;

S.b.m) sinusiti;

S.b.n) cxviris motexiloba;

S.b.o) xvrinva da Zilis apnoe (obstruqciuli);

S.b.p) eWvi Tavkisris kibos arsebobaze;

S.b.J) smenis calmxrivi daqveiTeba gareTa yuris aSkara paTologiis arsebobis gareSe;

S.g) prevencia:

S.g.a) smenis daqveiTebis skriningi;

S.g.b) wamliT gamowveuli ototoqsikurobis prevencia;

ჩ) Tvalis daavadebebi:

C.a) gavrcelebuli mdgomareobebis marTva:

C.a.a) quTuTosa da sacremle sistemis daavadebebi;

C.a.b) skleris, rqovanas da uvealuri traqtis winა nawilis daavadebebi;

C.a.g) refraqciis darRvevebi;

C.a.d) glaukoma;

C.a.e) minisebri sxeulis da baduras daavadebebi;

C.a.v) mxedvelobis dvrilis daavadebebi;

C.a.z) Tvalis moZraobis da binokularuli mxedvelobis darRvevebi;

C.a.T) Tvalis dazianebis mwvave dazianebebi (romlebic swraf amocnobas, pirvel daxmarebas da/an referals saWiroebs);

C.b) prevencia:

C.b.a) Tvalis dazianebis prevencia diabetisa da hipertenziis dros;

C.b.b) Tvalis dazainebis genetikuri safuZvlebis dadgena;

c) kanis daavadebebi:

c.a) simptomebis marTva:

c.a.a) gamonayari;

c.a.b) Tmis cvena;

c.a.g) frCxilebis dazianeba;

c.a.d) qavili;

c.a.e) kanis pigmenturi laqebi;

c.a.v) kanis inficirebis niSnebi;

c.a.z) purpura;

c.a.T) kanis da kanqveSa simsivnuri warmonaqmnebi;

c.a.i) fotosensitiuroba da wiTeli saxe;

c.b) gavrcelebuli mdgomareobebis marTva:

c.b.a) eგzema;

c.b.b) fsoriazi;

c.b.g) generalizebuli qavili;

c.b.d) urtikaria da vaskuliti;

c.b.e) akne;

c.b.v) kanis infeqciebi;

c.b.z) muni;

c.b.T) Tmis da frCxilis dazianeba;

c.b.i) wamliT gamowveuli gamonayari;

c.g) prevencia:

c.g.a)kanis dazianebis prevencia mzis dasxivebis Semcirebis gziT;

c.g.b) kanis dazianebis prevencia genetikuri winaswarganwyobis dros;

c.g.g) kanis dazianebis prevencia profesiuli da sxva garemo faqtorebis arsebobisas;

Z) orTopediuli, travmatologiuri da qirurgiuli paTologia:

Z.a) gavrcelebuli mdgomareobebis marTva:

Z.a.a) terfmrudoba;

Z.a.b) displaziuri menj-barZayis saxsari;

Z.a.g) rotaciuli problemebi;

Z.a.d) skoliozi: idiopaTiuri da SeZenili;

Z.a.e) daWimva, amovardniloba da motexiloba;

Z.a.v) mcire, zedapiruli, arainficirebuli Wrilobebi;

Z.a.z) zedapiruli damwvroba;

Z.a.T) hemoroiduli kvanZebi (amocnoba, konservatiuli mkurnaloba);

Z.a.i) Tiaqari (Sefaseba, referali);

Z.a.k) postoperaciuli mdgomareobebis meTvalyureoba;

Z.a.l) orTopediaSi gadaudebeli mdgomareobebis gamovlena, stabilizacia, referali;

Z.a.m) mwvave qirurgiuli mdgomareobebis drouli amocnoba da referali; prevencia;

Z.a.n) travmuli dazianebebis pirveladi prevencia;

Z.a.o) orTopediuli paTologiis adreuli amocnoba (skriningi);

Z.a.p) postoperaciuli garTulebebis prevencia;

w) onkologiuri daavadebebi:

w.a) gavrcelebuli mdgomareobebis marTva: kibos simptomebis da niSnebis adreuli amocnoba da referali (agreTve skrininguli programebi; ix. qvemoT);

w.b) prevencia:

w.b.a) onkologiuri daavadebebis pirveladi prevencia;

w.b.b) onkologiuri daavadebebis skriningis programebi; skriningis erovnuli programebi (saSvilosnos yelis, mkerdis, msxvili nawlavis, winamdebare jirkvlis kibos skriningi);

w.b.g) onkologiuri daavadebebis garTulebebis prevencia;

W) paliatiuri mzrunveloba:

W.a) simptomebis marTva:

W.a.a) tkivili;

W.a.b) anoreqsia da kaxeqsia;

W.a.g) fsiqonevrologiuri da nevrologiuri simptomebi: asTenia, agzneba- SfoTva, depresia, cnobierebis dabindva, zurgis tvinis depresia;

W.a.d) gulisreva da Rebineba;

W.a.e) yabzoba;

W.a.v) diarea;

W.a.z) disfagia;

W.a.T) meteorizmi;

W.a.i) boyini;

W.a.k) xvela;

W.a.l) sunTqvis gaZneleba, qoSini;

W.a.m) slokini;

W.a.n) nawolebi (dekubituri wylulebi);

W.a.o) qavili;

W.a.p) Sardis Seukavebloba;

W.a.J) Sardis buStis spazmi;

W.a.r) Sardis Sekaveba;

W.a.s) hematuria;

W.a.t) hiperkalciemia (drouli amocnoba da referali).

W.b) prevencia:

W.b.a) sxvadasxva garTulebebis prevencia: nawolebis, kaxeqsiis, depresiis, yabzobis, hipovolemiis da sxva.

13. im laboratoriul-instrumentuli gamokvlevebis CamonaTvali, romelTa Sedegebis interpretacia da klinikuri Sefaseba unda SeeZlos eqimspecialists:

a) instrumentuli gamokvlevebi:

a.a) eleqtrokardiografia;

a.b) 24-saaTiani ekg monitorireba;

a.g) arteriuli wnevis ambulatoriuli monitorireba;

a.d) mimoxilviTi rentgenografia;

a.e) spirometria;

a.v) rentgenokontrastuli gamokvlevebi (specialistis daskvnis interpretacia);

a.z) ultrasonografia (specialistis daskvnis interpretacia);

a.T) doplerografia (specialistis daskvnis interpretacia);

a.i) kompiuteruli tomografia (specialistis daskvnis interpretacia);

a.k) magnitur-rezonansuli tomografia (specialistis daskvnis interpretacia);

a.l) endoskopia (specialistis daskvnis interpretacia);

a.m) kolposkopia (specialistis daskvnis interpretacia);

b) laboratoriuli gamokvlevebi:

b.a) sisxlis saerTo analizi;

b.b) Sardis saerTo analizi;

b.g) ganavlis saerTo analizi;

b.d) sisxlis bioqimiuri analizebi;

b.e) infeqciis dasadgeni testebi;

b.v) eleqtrolitebi;

b.z) serologiuri gamokvlevebi;

b.T) hormonuli gamokvlevebi;

b.i) koagulograma;

b.k) onkomarkerebi, prostatis specifikuri antigenis (PSA) kvleva;

b.l) baqteriologiuri da virusologiuri gamokvlevebi;

b.m) citologiuri da histomorfologiuri gamokvlevebi,-testi;

b.n) spermis analizi.

14. eqim-specialistis aucilebeli praqtikuli unar-Cvevebi -(diagnostikuri da samkurnalo manipulaciebi): ojaxis eqims unda SeeZlos Semdeg sadiagnozo da samkurnalo manipulaciebis damoukideblad Catareba, risTvisac aucilebelia Sesabamisi aRWurvilobiTa da masalebiT uzrunvelyofa da anazRaurebis adekvaturi sistemis Camoyalibeba:

a) fizikuri gasinjvis meTodebi yvela organoTa sistemis mixedviT (daTvaliereba, palpacia, perkusia, auskultacia), maT Soris, zogadi nevrologiuri gasinjva, reqtaluri gasinjva, vaginaluri gasinjva, axalSobilis fizikuri gasinjva, sisxlZarRvebis auskultacia da palpacia, diabeturi fexis gasinjva-Sefaseba;

b) ZiriTadi sasicocxlo funqciebis SenarCuneba da kardiopulmonuri reanimacia (mozrdilebSi, bavSvebSi, Cvilebsa da axalSobilebSi); maT Soris, ventilacia ambus parkiT, sasunTqi gzebis gaTavisufleba, haimlikis manevri, nemsiT Torakostomia, krikoTireoidotomia da defibrilacia;

g) Jangbadis miwodeba (niRbiT, kanuliT);

d) masobrivi katastrofebis dros daSavebulTa `triaJi~;

e) ekg-is gadaReba;

v) glukometria (portatuli aparatis gamoyenebiT);

z) orsulobis swrafi testis Catareba (e.w. `striptesti~);

T) Sardis aReba (`Sua ulufis~ aReba) da `stritestis~ Catareba;

i) ganavlis analizi farul sisxldenaze (swrafi testi);

k) kanis tuberkulinis alergiuli testis Catareba;

l) pikfloumetriis gamoyeneba da swavleba pacientisaTvis;

m) sxvadasxva tipis inhalatoris da nebulaizeris gamoyeneba da swavleba pacientisaTvis;

n) fataluri ariTmiebis marTva defibrilaciis CaTvliT;

o) axalSobilis pirveladi higienuri RonisZiebebis Catareba;

p) imunizacia;

J) mcireqirurgiuli manipulaciebi: Wrilobis pirveladi damuSaveba, Wrilobis sanacia, zedapirul Wrilobaze qirurgiuli nakerebis dadeba, nakerebis moxsna, infiltraciuli anesTezia (gamtareblobiTi da budobrivi), abscesebis, panariciumebis, flegmonebis gakveTa da drenireba, Cazrdili frCxilis mocileba, rbili qsovilebis zedapirul simsivneTa inokulacia, naxvevis dadeba da moxsna, drenaJis amoReba, kolostomis movla;

r) sisxldenis SeCereba;

s) damwvrobisa da inficirebuli Wrilobis damuSaveba;

t) zedapiruli ucxo sxeulebis mocileba;

u) inieqcebi: kanSida, kanqveSa, intramuskuluri;

f) intravenuri inieqca, venis kaTeterizacia da intravenuri infuzia;

q) mxedvelobis organis gasinjva: mxedvelobis simaxvilis, mxedvelobis velis da Tvalis mamoZravebeli funqciis gamokvleva;

R) ofTalmoskopia/fundoskopia,

y) Tvalis tonometria;

S) otoskopia, gogirdis sacobis gamoZeveba wylis WavliT;

C) smenis gamokvleva, kamertonis testebis gamoyeneba;

c) rinoskopia, faringoskopia, arapirdapiri laringoskopia;

Z) cxviris martivi kauterizacia;

w) cxviridan sisxldenis SeCereba, cxviris wina tamponada;

W) ucxo sxeulis amoReba cxviridan, xaxidan da gareTa sasmeni milidan;

x) nazogastraluri zondireba;

j) kanis, frCxilisa da Tmis sinjebis aReba gamokvlevisTvis;

h) sarZeve jirkvlebis gasinjva;

h1) menjis organoebis gasinjva, bimanualuri vaginaluri da reqtovaginaluri gamokvleva, gamokvleva sarkis daxmarebiT; saSvilosnos zomis, mdebareobisa da mobilurobis Sefaseba da menjis Rrus organoebis mdgomareobis normidan gadaxris amocnoba;

h2) garegani sameano gasinjva, nayofis guliscemis Sefaseba;

h3) placentis mdebareobis Sefaseba;

h4) orsulis mdgomareobis Sefaseba;

h5) fiziologiuri mSobiarobis marTva;

h6) vaginaluri da cervikaluri nacxis aReba citologiuri gamokvlevisaTvis;

h7) Sardis buStis kaTeterizacia;

h8) swori nawlavis gasinjva TiTiT;

h9) winamdebare jirkvlis gasinjva TiTiT;

h10) saTesleebis gasinjva;

h11) amovardnilobis koreqcia;

h12) satransporto imobilizacia kidurebis Zvlebisa da xerxemlis dazianebis SemTxvevaSi;

h13) nacxis aReba baqteriologiuri da citologiuri gamokvlevebisaTvis;

h14) paracentezi;

h15) plevris punqcia;

h16) daWimuli pnevmoToraqsis gadayvana Ria pnevmoToraqsSi.

15. eqim-specialistis pacientTa momsaxurebis populacia (asakobrivi jgufi), romelsac emsaxureba konkretuli specialobis eqimi – ojaxis eqimis samizne populacia ar Semoifargleba asakiT, sqesiT da janmrTelobis problemebis TaviseburebebiT. specialobis ganmartebidan gamomdinare, ojaxis eqimi zrunavs yovel pirze, romelsac esaWiroeba samedicino daxmareba, ganurCevlad misi asakis, sqesisa da daavadebisa.

16. sxva specialistebTan TanamSromloba da referali:

a) ojaxis eqims, rogorc pirveladi jandacvis eqims, romelic uzrunvelyofs samedicino momsaxurebis koordinacias da uwyvetobas, Sexeba aqvs faqtobrivad nebismieri specialobis eqimTan, romelic CarTulia pacientis janmrTelobis problemis mogvarebaSi;

b) specialobaTa did nawilTan saojaxo medicinas saziaro kompetenciebi gaaCnia;

g) ojaxis eqims saziaro kompetenciebi gaaCnia faqtobrivad yvela saeqimo specialobasTan:

g.a) Sinagani sneulebebi da misi momijnave specialobebi, garda homeopaTiisa;

g.b) pediatria da misi momijnave specialobebi;

g.g) meanoba-ginekologia da misi momijnave specialobebi;

g.d) fsiqiatria da misi momijnave specialobebi;

g.e) nevrologia da misi momijnave specialobebi;

g.v) ofTalmologia;

g.z) otorinolaringologia;

g.T) urologia;

g.i) zogadi qirurgia, bavSvTa qirurgia, proqtologia; saziaro kompetenciebs ganekuTvneba mcireqirurgiuli manipulaciebi, konservatiuli mkurnaloba (mag., hemoroiduli kvanZebis Trombozis konservatiuli mkurnaloba), postoperaciuli periodis ambulatoriuli marTva;

g.k) orTopedia-travmatologia;

g.l) onkologia;

g.m) gadaudebeli medicina;

g.n) fizikuri medicina, reabilitacia da kurortologia;

g.o) sportis medicina;

g.p) profesiuli sneulebebi;

d) ojaxis eqimma unda SeZlos nebismieri pacientis janmrTelobis nebismieri problemis pirveladi Sefaseba, ris Semdegac ojaxis eqimma SeiZleba problema mTlianad an sawyis etapze marTos TviTon (maT Soris, gauwios pacients gadaudebeli daxmareba), an gaagzavnos sxva specialistTan, an meoreuli donis samedicino dawesebulebaSi. saojaxo medicinasa da zemoT CamoTvlili specialobebisa da subspecialobebis specifikaciaSi CarTuli daavadebebis/mdgomareobebis marTvisas kopetenciebis `gadafarva/damTxveva” pirveladi jandacvis garduvali Tanamdevia. PaseT SemTxvevebSi aucilebelia ojaxis eqimis mier pacientis janmrTelobis problemis marTvaSi sxva specialistis CarTvis droulobis da xarisxis Sesaxeb adekvaturi gadawyvetilebis miReba;

e) zogadad sxva specialistTan referali da/ an meoreul Tu mesameul dawesebulebaSi pacientis gagzavnis safuZveli Semdegia:

e.a) pacientisaTvis gadaudebeli daxmarebis gawevis saWiroeba, rodesac:

e.a.a) ojaxis eqims ar SeuZlia pirveladi gadaudebeli daxmarebis gaweva (Sesabamisi pirobebis ararsebobis gamo an Sesabamisi kompetenciis arqonis gamo) an;

e.a.b) ojaxis eqimma ukve gauwia pacients pirveladi gadaudebeli daxmareba (ix. qveTavi 3 `eqim-specialistis zogadi unar-Cvevebi~) da pacienti saWiroebs hospitalizacias (mag., ojaxis eqimma pacients mwvave koronaruli sindromiT, romelmac ofisSi mimarTa mas, gadauRo ekg, misca aspirini antiTrombocituli doziT, nitroglicerini, beta-blokeri da gamoiZaxa saswrafo daxmarebis samsaxuri an mZRoliani manqaniT gaagzavna pacienti saavadmyofoSi);

v) rTuli sadiagnozo SemTxveva (daavadebis atipiuri mimdinareoba, eWvi iSviaTi daavadebis arsebobaze):

z) warumatebeli mkurnaloba (mkurnalobisadmi rezistentuli SemTxvevebi, mniSvnelovani gverdiTi efeqtebi mkurnalobisas);

T) janmrTelobis problema, romelic saWiroebs iseT sadiagnozo da samkurnalo manipulacias, romelsac ojaxis eqimi ar flobs; mag., qirurgiuli mkurnaloba (garda mcireqirurgiuli manipulaciebisa), endoskopia, ultrabgeriTi diagnostika, audiometria, sxivuri Terapia da a.S.;

i) janmrTelobis problema, romlis marTvisTvisac qveyanaSi Seqmnilia adviladxelmisawvdomi specialuri qseli; mag., tuberkulozi, fsiqiatriuli daavadebebi; amasTan, daavadebis pirveladi Sefaseba da referalis saWiroebis gansazRvra mainc ojaxis eqimis kompetenciaSi Sedis.

muxli 3. profesiuli mzadebis struqtura

1. diplomisSemdgomi samedicino ganaTlebis (rezidenturis) programa dayofilia 3 etapad (nawilad):

|etapi |dasaxeleba |xangrZlivoba: Tve |

|I |saojaxo medicinis Sesavali kursi |6 Tve |

|II |rotaciebi klinikebSi |15 Tve |

|III |saojaxo medicinis specializebuli kursi |12 Tve |

|Svebulebebi |Tve |

2. rezidenturis I etapis mizania gaacnos rezidents saojaxo medicinis principebi da strategiebi, rac sasargeblo iqneba misTvis mzadebis mTel periodSi.

3. mzadebis II etapis mizania rezidentisaTvis im codnisa da unar-Cvevebis SeZena-gamomuSaveba, rac aucilebelia pirvelad jandacvaSi arsebuli specifikuri problemebis marTvisaTvis, maT Soris gansakuTrebiT im problemebisa, romlebic umniSvnelovanesia saqarTvelosaTvis.

4. mzadebis III etapze rezidentma unda SeiZinos specifikuri codna, unar-Cvevebi da midgomebi, romlebic mas SesaZleblobas miscemen efeqturad marTos gavrcelebuli qronikuli da mwvave mdgomareobebi, romlebic tipuria saojaxo medicinisaTvis. dasaSvebia, rom am periodis ganmavlobaSi rezidents eqneba SesaZlebloba ganaxorcielos garkveuli kontingentisaTvis uwyveti samedicino daxmareba, eqneba damoukidebeli saqmianobis nebarTva, rogorc saojaxo medicinis specialists.

muxli 4. sarezidento programis modulebad dayofa da modulebis ganxorcielebis organizacia, sarezidento programis etapebis modulebad dayofa

1. sarezidento programis I etapi: sarezidento programis I etapi moicavs 4 moduls da grZeldeba 6 Tves. 6 Tvis ganmavlobaSi maZiebeli mzadebas gadis pirveladi jandacvis dawesebulebaSi:

|# |modulis dasaxeleba |xangrZlivoba (Tve) |

|I.1 |specialobisa da profesionalizmis safuZvlebi |2 |

|I.2 |jandacvis sistema da praqtikuli saqmianobis organizacia |1.5 |

|I.3 |მtkicebulebebze dafuZnebuli medicina da biosamedicino kvlevis safuZvlebi |1.5 |

|I.4 |praqtikuli unar-Cvevebi da tkivilis marTvis safuZvlebi |1 |

2. sarezidento programis II etapi: sarezidento programis II etapi moicavs Sesabamisi profilis saavadmyofoebSi an klinikebSi rotaciebis 9 ZiriTad (13 Tve) da 2 eleqtiur moduls (2 Tve), sul 11 moduls saerTo xangrZlivobiT 15 Tve:

|# |modulis dasaxeleba |xangrZlivoba |

|ZiriTadi modulebi – 13 Tve |

|II.1 |kardiologia |1 Tve |

|II.2 |filtvebis daavadebebi da tuberkulozi |1 Tve |

|II.3 |endokrinologia |1 Tve |

|II.4 |infeqciuri sneulebebi |1 Tve |

|II.5 |gadaudebeli medicina da travma |2 Tve |

|II.6 |bavSvTa janmrTeloba |3 Tve |

|II.7 |qalTa janmrTeloba |2 Tve |

|II.8 |fsiqikuri janmrTeloba |1 Tve |

|II.9 |narkologia |1 Tve |

|eleqtiuri modulebi – 2 Tve |

|II.11 |eleqtiuri moduli 1 |1 Tve |

|II.12 |eleqtiuri moduli 2 |1 Tve |

3. sarezidento programis III etapi: sarezidento programis III etapi moicavs 3 moduls, romelsac maZiebeli gadis pirveladi jandacvis dawesebulebaSi:

|modulis dsaxeleba |xangrZlivoba |

|moduli III.1. `daavadebaTa prevencia da marTva pirvelad jandacvaSi~ – 7 Tve |

|sakiTxi 1. |janmrTelobisaTvis xelSewyoba da prevenciuli programebi pirvelad jandacvaSi |1 Tve |

|sakiTxi 2. |qronikuli daavadebebis marTva |3 Tve |

|sakiTxi 3. |xandazmulebis samedicino momsaxureba |1 Tve |

|sakiTxi 4. |paliatiuri mzrunveloba |1 Tve |

|sakiTxi 5. |wamlis racionaluri gamowera |1 Tve |

|moduli III.2. `ojaxi da Temi ojaxis eqimis saqmianobaSi~ – 2 Tve |

|sakiTxi 1. |ojaxi, rogorc zrunvis/daxmarebis erTeuli |1 Tve |

|sakiTxi 2. |Temze orientirebuli pirveladi jandacva |1 Tve |

|moduli III.3. `xarisxis uzrunvelyofa da samecniero kvleva” – 3 Tve |

|sakiTxi 1. |xarisxis uzrunvelyofa |1 Tve |

|sakiTxi 2. |pacientis kmayofileba da auditi |1 Tve |

|sakiTxi 3. |samecniero kvleva |1 Tve |

4. sarezidento programis saerTo struqtura modulebis raodenobis miTiTebiT:

|etapi da dasaxeleba |modulebis raodenoba |xangrZlivoba (Tve) |

|etapi I. saojaxo medicinis Sesavali kursi |4 |6 |

|etapi II. rotaciebi klinikebSi |11 |15 |

|etapi III. saojaxo medicinis specializebuli kursi |3 |12 |

|sul |20 |33 |

muxli 5. sarezidento programis etapebis zogadi daxasiaTeba da ganxorcielebis organizacia

1. zogadi principebi:

a) sarezidento programis gavlisas aucilebelia mzadebis etapebis Tanmimdevrobis dacva (jer I, Semdeg II, dasasruls III);

b) dasaSvebia erTi an ramdenime gamotovebuli modulis mogvianebiT gavla (`aRdgena~) programis xelmZRvanelis rekomendaciis safuZvelze.

2. modulebis Tanmimdevroba: erTi etapis farglebSi SesaZlebelia modulebis gavla gansxvavebuli TanmimdevrobiT. Tanmimdevrobas adgenen programis xelmZRvaneli da koordinatori tutorebTan erTad.

muxli 6. sarezidento programis I etapis mizani da amocanebi

1. rezidenturis I etapis (pirveli 6 Tve) bolos rezidenti ukve icnobs saojaxo medicinis principebsa da strategiebs. mas SeuZlia msjeloba ojaxis eqimis ZiriTad kompetenciebsa da specialobis maxasiaTeblebze. flobs saeqimo konsultaciis Catarebis meTodologias da komunikaciis Cvevebs. SeuZlia msjeloba ojaxis eqimis praqtikis organizaciul aspeqtebze. icnobs mtkicebulebiTi medicinis safuZvlebsa da meTodebs. SeuZlia gaanalizos ama Tu im sadiagnozo meTodis validuroba da samkurnalo meTodis efeqturoba arsebuli literaturis Sefasebis safuZvelze. icnobs saqarTvelos kanonmdeblobas janmrTelobis dacvis sferoSi da eqimisa da pacientis urTierTobis samarTlebriv da eTikur aspeqtebs. SeuZlia kvlevis meTodebze msjeloba pirveladi jandacvis konteqstSi.

2. mzadebis es nawili tardeba ojaxis eqimis ofisSi (modulze pasuxismgebeli piris – `ojaxis eqimi-maswavleblis~ meTvalyureobiT) da garemoSi, sadac maZiebels xvdeba tutori.

3. erTi modulis farglebSi rezidenti/maZiebeli muSaobs erTi ojaxis eqimis zedamxedvelobis qveS.

4. tutori muSaobs 6-8 rezidentTan/maZiebelTan, rac moicavs sawyis da daskvniT Sexvedrebs calkeuli modulis farglebSi.

5. mocemuli etapis specifikuri amocanebi moicavs Semdegs:

a) pirveladi jandacvis marTva:

a.a) pirvelad jandacvaSi arsebuli problemebis (maT Soris, Civilebis) epidemiologiis codna;

a.b) pirveladi jandacvisaTvis tipuri simptomebisa da Civilebis codna, gansakuTrebiT daavadebaTa adreul stadiebze; maTi mniSvnelobis codna diagnozisa da mkurnalobisaTvis (bazisuri procedurebi saojaxo medicinis praqtikaSi);

a.g) organizaciuli midgomebis codna qronikuli mdgomareobebis marTvisaTvis (praqtikis organizacia da administrireba);

a.d) jandacvis sistemis struqturisa da misi komponentebis funqciis codna pirvelad jandacvasTan kavSirSi;

a.e) ZiriTadi skomunikacio unar-Cvevebi pacientisa da misi ojaxis wevrebis konsultirebisa da swavlebisaTvis, maTTan urTierTobisaTvis;

a.v) ZiriTadi saorganizacio unar-Cvevebi Canawerebis Senaxvis, sainformacio marTvis, gunduri muSaobis, praqtikis warmarTvisa da saqmianobis xarisxis auditisaTvis;

ბ) pirovnebaze koncentrirebuli daxmareba:

b.a) bazisuri mecnieruli codna pirovnebis, misi ganviTarebis, miznebisa da cxovrebiseuli molodinebis gagebisaTvis;

b.b) moZiebuli monacemebis pacientisaTvis misTvis misaRebi da gasagebi formiT Setyobinebis unari, rac, agreTve, gulisxmobs pacientisaTvis informaciis miwodebas misi mosazrebebis Taobaze da erTiani safuZvlis Camoyalibebas Semdgomi gadawyvetilebis misaRebad;

b.g) gadawyvetilebis miReba pacientis avtonomiis gaTvaliswinebiT;

g) specifikuri problemebis mogvarebis unar-Cvevebi:

g.a) bazisuri codna daavadebebisa da paTologiuri mdgomareobebis Sesaxeb pirvelad jandacvasa da zogadad, saqarTveloSi zemoxsenebulTa sixSirisa da gavrcelebis specifikurobis gaTvaliswinebiT;

g.b) anamnezis Segrovebisa da fizikuri gasinjvis, agreTve moZiebuli Sedegebis Sefasebis unar-Cveva;

d) yovlismomcveli midgoma:

d.a) ojaxis eqimis rolis gacnobiereba TemSi janmrTelobis xelSewyobisaTvis;

d.b) individisa da Temis moTxovnebs Soris arsebuli eTikuri winaaRmdegobebis mniSvnelobis gaTvaliswineba da Sesabamisad moqmedeba;

d.g) gundis wevrebis gansxvavebuli SesaZleblobebisa da gansxvavebuli wvlilis Setanis unaris gacnobiereba;

e) Temze orientacia:

e.a) janmrTelobis dacvasa da socialur dacvas Soris urTierTkavSiris gacnobiereba;

e.b) siRaribis, eTnikuri Taviseburebebisa da lokaluri epidemiologiuri monacemebis janmrTelobaze zegavlenis gacnobiereba;

e.g) jandacvis sferoSi arsebuli uTanabrobis gacnobiereba;

e.d) jandacvis sistemis struqturisa da misi ekonomikuri SesaZleblobebis SezRudulobis gacnobiereba;

e.e) gacnobiereba imisa, rogor SeiZleba iqnes gamoyenebuli jandacvis sistema pacientisa da eqimis mier (referaluri procedurebi, Tanagadaxda, saavadmyofo furceli, sakanonmdeblo sakiTxebi da a.S.) maTi problemebis konteqstSi;

v) holisturi midgoma:

v.a) holizmis koncefciis codna da misi gamoyeneba pacientebisaTvis daxmarebis aRmoCenisas; mzadebis am nawilis arsebiTi maxasiaTeblebi SeiZleba gaxdes:

v.ა.ა) konteqstualuri: adgilobrivi Temis, ekonomikuri faqtorebis, geografiuli da kulturuli faqtorebis gavlena samuSao adgilze da pacientisaTvis daxmarebis aRmoCenis procesze; ra saxis finansur da sakanonmdeblo garemoSi xorcieldeba janmrTelobis dacva praqtikul doneze;

v.ა.ბ) damokidebulebiTi: personaluri eTikis sakiTxebis gacnobiereba;

v.ა.გ) mecnieruli: samecniero kvlevis zogadi principebis, meTodebisa da koncefciis, agreTve statistikis safuZvlebis (sixSire, gavrceleba, progrnozuli mniSvneloba da sxv.) codna; samedicino literaturis moZiebis, kiTxvisa da kritikuli Sefasebis unari.

6. Catarebis adgili:

a) mzadebis es nawili unda Catardes ojaxis eqimis ofisSi, sasurvelia, rezidentis personaluri xelmZRvanelis meTvalyureobiT. mzadebis garkveuli nawili SeiZleba ganxorcieldes saojaxo medicinis centrSi an sxva adgilze (mag., saswavlo centrebSi);

b) drois ganrigi: mzadebis saerTo xangrZlivobaa 6 Tve. es periodi dayofilia modulebad (ix. zemoT `sarezidento programis etapebis modulebad dayofa~).

7. calkeuli modulis ganxorcielebis meTodi:

a) modulebi ganxorcieldeba struqturirebuli saswavlo sesiebis saxiT yoveli modulis dasawyisSi da dasasruls. sesiebs Soris drois monakveTi gamoyenebuli iqneba amocanis SesrulebisaTvis da, Tu SesaZlebelia, rezidentebTan regularuli yovelkvireuli SexvedrebisTvis, saswavlo programis miznebis miRwevis uzrunvelsayofad;

b) yoveli moduli iwyeba erTi an ramdenime dRiani Sesavali nawiliT da misi daniSnulebaa saswavlo kursis CatarebasTan dakavSirebuli saorganizacio sakiTxebis ganxilva da kursis miznis ganmarteba;

g) yoveli modulis damTavrebisas moewyoba daskvniTi saswavlo sesia, romlis mizania ganvlili samuSao Sefaseba da Sejameba.

8. swavlebis meTodebi: gamoyenebuli iqneba swavlebis sxvadasxva meTodebi. ZiriTadi meTodia saqmianoba xelmZRvanelTan da praqtikis warmoeba meTvalyureobiT, rasac Tan mohyveba rezidentis damoukidebeli konsultaciebi. auditoriaSi swavleba mimdinareobs sxvadasxva formiT:L leqcia, diskusia mcire jgufebSi, davalebebis Sesruleba da sxv.

9. Sefaseba: yoveli modulis Semdeg tardeba Sefaseba, romelic gansazRvravs dasaxuli miznis miRwevis xarisxs. Sefaseba tardeba daskvniTi sesiebis dros.

muxli 7. sarezidento programis II etapis mizani da amocanebi

1. profesiuli mzadebis II etapis mizaniა:

a) mzadebis II etapis bolosTvis rezidents gamomuSavebuli aqvs codna da unar-Cvevebi, rac aucilebelia pirvelad jandacvaSi arsebuli specifikuri problemebis marTvisaTvis, maT Soris, gansakuTrebiT im problemebisa, romlebic umniSvnelovanesia saqarTvelosaTvis;

b) SeuZlia gavrcelebuli qronikuli daavadebebis diagnostika da marTva; icnobs gadaudebeli medicinisa da travmis marTvis principebs, SeuZlia gavrcelebuli samedicino problemebis marTva bavSvebSi, icnobs qalTa janmrTelobis dacvis ZiriTad principebs da SeuZlia specifikuri problemebis marTva sqesobrivi gziT gadamdebi daavadebebis CaTvliT; SeuZlia pacientis fsiqikuri janmrTelobis ZiriTadi maxasiaTeblebis Sefaseba da gavrcelebuli aSlilobebis amocnoba an maT arsebobaze eWvis mitana; SeuZlia garcelebuli daavadebebis amocnoba da pirveladi marTva Semdegi sferoebidan: yel-yur-cxviris daavadebebi, dermatologia, ofTalmologia, nevrologia, orTopedia, onkologia, qirurgia.

2. profesiuli mzadebis II etapis amocanebi: mocemuli etapis specifikuri amocanebi moicavs Semdegs:

a) pirveladi jandacvis marTva:

a.a) pirveladi jandacvis sferoSi tipuri (uxSiresi) simptomebisa da Civilebis codna, gansakuTrebiT daavadebaTa adreul stadiebze; am ukanasknelTa niSnebisa da simptomebis mniSvnelobis codna sadiagnozo da samkurnalo RonisZiebebis SerCevisaTvis;

a.b) unar-Cvevebi mwvave, qronikuli, prevenciuli, paliatiuri da gadaudebeli daxmarebis aRmoCenisaTvis;

a.g) anamnezis Segrovebis, fizikuri gamokvlevisa da damatebiTi testebis gamoyenebis unar-Cvevebi im mdgomareobaTa sadiagnozod, romlebic aReniSnebaT pacientebs pirvelad jandacvaSi;

a.d) mkurnalobis unar-Cvevebi, maT Soris, rogorc medikamenturi, ise aramedikamenturi midgomebis gamoyenebiT im mdgomareobebis dros, romlebic xSiria pirvelad jandacvaSi (mag., kardiovaskuluri daavadebebi, cerebrovaskuluri daavadebebi, diabeti, filtvis daavadebebi da a.S.);

a.e) sxva specialistebTan efeqturi TanamSromlobis unari;

b) pirovnebaze koncentrirebuli daxmareba: bazisuri sakomunikacio unar-Cvevebi (gagrZeleba iqneba);

g) specifikuri problemebis gadaWris unar-Cvevebi:

g.a) specifikuri gadawyvetilebebis miRebis unar-Cveva, maT Soris, iseTi berketebis gamoyenebis unari, rogoricaa klinikuri msjeloba da gadawyvetilebis miRebis zogadi wesebi;

g.b) anamnezuri monacemebis moZiebisaTvis saWiro kiTxvebisa da mniSvnelovani fizikuri niSnebis codna da maTi misadageba arsebul problemasTan, yuradRebis gamaxvilebiT gadaudebeli daxmarebis saWiroebaze da piriqiT;

g.g) pacientTan dakavSirebuli garemoebebis, maT Soris ojaxisa da socialuri faqtorebis, moZiebis codna;

g.d) warmodgenili problemebis gadaWrisaTvis saWiro sadiagnozo da samkurnalo resursebis Sesaxeb informacis floba;

g.e) anamnezis Segrovebisa da fizikuri gamokvlevis unar-Cvevebi, moZiebuli monacemebis Sefasebis codna;

g.v) saqmianobisadmi midgomis iseTi maxasiaTeblebis gaTaviseba, rogoricaa codnis wyurvili, mondomeba da yuradRebianoba;

g.z) specifikuri gadawyvetilebebis miRebis unar-Cveva urgentul situaciebSi;

g.T) specifikuri unar-Cvevebis qona gadaudebeli daxmarebisaTvis saWiro procedurebis ganxorcielebisaTvis pirveladi jandacvisaTvis damaxasiaTebel situaciebSi;

g.i) codna imisa, rodis SeiZleba mocda/dayovneba da rodis aris saWiro damatebiTi sadiagnozo RonisZiebebi;

g.k) simptomebisa da niSnebis, damatebiTi gamokvlevebis monacemebis pozitiuri da negatiuri prediktuli mniSvnelobisa da `samizne~ daavadebebis dros maTi sixSiris codna;

g.l) sadiagnozo da samkurnalo RonisZiebebis xarjefeqturobisa da xarjsargeblianobis gacnobiereba.

d) yovlismomcveli midgoma:

d.a) polimorbidulobis (polinozologiurobis) koncefciisa da Sedegebis gacnobiereba;

d.b) pacientis janmrTelobis sxvadasxva problemebis erTdroulad marTvis unar-Cveva maTi amocnobis, Seswavlis, ganmartebis micemis, saubris warmarTvisa da prioritetebis gamoyofis gziT;

e) Temze orientacia: jandacvasTan dakavSirebul saTemo politikaSi CarTul sxva profesionalebTan muSaoba da maTi rolis gacnobiereba;

ვ) mecnieruli gamoyenebis maxasiaTeblebi iqneba: srulyofili codna paTologiis, simptomebisa da diagnozis, mkurnalobisa da prognozis, epidemiologiis, agreTve, gadawyvetilebis miRebis, hipoTezis Camoyalibebisa da problemis gadaWris Teoriebis formirebisa da prevenciuli samedicino daxmarebis mecnieruli safuZvlebis Sesaxeb.

3. II etapis eleqtiuri modulebis Sesaxeb:

a) mTlianad mzadeba II etapze mzadebis 2 Tve gamoyofilia eleqtiuri modulebisTvis. maZiebels/rezidents SeuZlia SearCios erT Tviani xangrZlivobis 2 eleqtiuri moduli qvemoT mocemuli nusxidan:

Aa.a) nevrologia (1 Tve);

Ba.b) onkologia (1 Tve);

a.g) ofTalmologia (1 Tve);

a.d) qirurgia (1 Tve);

a.e) orTopedia (1 Tve);

a.v) yel-yur-cxviris daavadebebi (1 Tve);

a.z) dermatologia (1 Tve);

b) yoveli rotaciis nawils (sasurvelia 50%) rezidenti gaatarebs ambulatoriul klinikaSi. specialuri/viwro sakiTxebisaTvis organizebuli iqneba moklevadiani saswavlo kursebi.

4. mzadebis II etapis daniSnuleba da mniSvneloba:

a) imisaTvis, rom II etapis rotaciebisas gaumjobesdes mzadebis xarisxi da Sesabamisoba, saojaxo medicinis maswavleblebma (`ojaxis eqimi-maswavlebeli~) yuradReba unda gaamaxvilon imaze, Tu ras elian msmenelebi/rezidentebi mzadebis procesis am komponentisagan da ra saSualebebi arsebobs am molodinis gasamarTleblad. saganmanaTleblo programis mzardi xarisxis molodinis gamarTleba damokidebulia specialisti maswavleblebis momzadebis donesa da maTTvis mxardaWeris uzrunvelyofaze. konsultant maswavleblebs unda hqondeT sakmarisi dro ara marto swavlebisTvis, aramed imisTvisac, rom SeiZinon da srulyon swavlebis unar-Cvevebi. iq, sadac mzadeba mimdinareobs pirveladi jandacvis klinikis gareT, maT Soris, saavadmyofoSi, unda arsebobdes sistema, romelic uzrunvelyofs swavlebaze pasuximgebeli dawesebulebisaTvis Sesabamisi informaciis miwodebas da saojaxo medicinis maswavleblebis mier xelmZRvanelobis SesaZleblobas;

b) saojaxo medicinis rezidentebis pirveladi jandacvis sistemis agreT, maT Soris saavadmyofoebSi, mzadebis periodSi „Cavardnebis” Tavidan asacileblad da saganmanaTleblo miznebis gansaxorcieleblad uzrunvelyofili unda iqnes balansi mzadebis saganmanaTleblo da samomsaxureo komponentebs Soris. yvela klinikasa da saavadmyofoSi unda iyos formaluri da araformaluri swavlebisTvis drois gamoyofis SesaZlebloba. unda arsebobdes konkretuli piri, romelic pasuxismgebeli iqneba mimdinare Sefasebaze, individualuri saswavlo gegmis Sefasebaze da meTvalyureobaze; A

g) klinikuri auditi – samedicino daxmarebis xarisxis sistematuri mimoxilva, Tanamedrove jandacvis sistemis mniSvnelovani komponentia. idealuria, Tu is saganmanaTleblo programis nawilia yvela klinikasa da saavadmyofoSi, romlebic SerCeulia saojaxo medicinis swavlebisTvis;

d) swavleba orientirebuli unda iyos momavali ojaxis eqimis saWiroebebze, saavadmyofoebSi mzadebis periodSi unda SenarCundes mudmivi kontaqti saojaxo medicinis dawesebulebasTan. saojaxo medicinis rezidentebis mzadebis programa saavadmyofosa da klinikebSi iseTive mniSvnelobis mqonea, rogorc sxva specialobis rezidentebisTvis specialur ganyofilebebSi mzadeba.

5. swavlebis/Sefasebis meTodebi mzadebis II etapze: mzadebis mocemul etapze swavlebis da Sefasebis meTodebi analogiuria da TiTqmis arafriT gansxvavdeba erTmaneTisagan da efuZneba klinikuri sagnebis swavlebas calkeul specialobebSi:

a) swavleba klinikuri praqtikis gareT: swavleba mcire jgufebSi, romlis mizania ZiriTadi informaciis miwodeba rezidentebisaTvis ama Tu im klinikuri sakiTxis Sesaxeb;

b) praqtikuli saqmianoba klinikasa da saavadmyofoSi:

b.a) dakvirveba samedicino personalis saqmianobaze, daswreba samedicino konsultaciebze;

b.b) praqtikuli klinikuri saqmianoba mocemul specialobaSi modulze pasuxismgebeli piris (e.w. `maswavlebeli spicalisti~) zedamxedvelobiT;

b.g) maswavleblis angariSebi da swavlebis procesis gaumjobesebis sakiTxebze msjeloba;

g) praqtikuli saqmianoba pirveladi jandacvis dawesebulebebSi (es komponenti etapobriv danergvas saWiroebs da SesaZlebelia dasaწyisSi, bazebis ukmarisobis gamo ar dainergos):

g.a) dakvirveba samedicino personalis saqmianobaze, daswreba samedicino konsultaciebze ojaxis eqimis ofisSi;

g.b) praqtikuli klinikuri saqmianoba ojaxis eqimis ofisSi: mocemuli specialobis farglebSi arsebuli janmrTelobis problemebis marTva modulze pasuxismgebeli piris (ojaxis eqimis) zedamxedvelobiT;

g.g) modulze pasuxismgebeli piris angariSi programis xelmZRvanelisadmi da swavlebis procesis gaumjobesebis sakiTxebze msjeloba;

d) swavlebis meTodebis CamonaTvali:

d.a) pirdapiri dakvirveba (viwro specialistisa da ojaxis eqimis saqmianobaze);

d.b) samedicino konsultacia simulirebuli pacientis daxmarebiT;

d.g) Cvevebis Seswavla mulaJis gamoyenebiT;

d.d) swavleba mcire jgufebSi;

d.e) interaqtiuri diskusia;

d.v) interaqtiuri prezentacia, leqcia TandarTuli saxelmZRvanelo masalebiT;

d.z) ukukavSiri/angariSebi praqtikis maswavleblebisgan da sxva personalisagan;

e) Sefasebis meTodebis CamonaTvali:

e.a) rezidentis mier warmoebuli klinikuri saqmianobis Sefaseba rezidentis Canawerebis safuZvelze;

e.b) pirdapiri dakvirveba rezidentis mier warmoebul saqmianobaze da dakvirvebis Sedegebis ganxilva rezidentTan;

e.g) rezidentis mier warmoebuli profesiuli saqmianobis gadaReba da misi ganxilva rezidentTan;

e.d) samedicino konsultacia simulirebuli pacientis daxmarebiT;

e.e) klinikuri Cvevebis demonstireba mulaJze/manekenze/simulatorze;

e.v) rolebis TamaSi;

e.z) klinikuri SemTxvevebis analizi (werilobiTi da zepiri);

e.T) pacientis mosazrebebi da Canawerebi;

v) mzadebis II etapze aucilebelia regularuli (yovelTviuri) `ukukavSiris~ sesiebi, romelsac atarebs tutori.

muxli 8. sarezidento programis III etapis mizani da amocanebi

1. profesiuli mzadebis III etapis mizani: specialobaSi `ojaxis eqimi~ rezidentebis mzadebis III etapis dasasrulisTvis rezidents aqvs specifikuri codna, flobs unar-Cvevebsa da midgomebs, romlebic mas SesaZleblobas miscemen efeqturad marTos gavrcelebuli qronikuli da mwvave mdgomareobebi, romlebic tipuria saojaxo medicinisaTvis. mocemuli droisTvis rezidents Seswevs unari ganaxorcielos damoukidebeli uwyveti samedicino daxmareba garkveuli kontingentisTvis.

2. profesiuli mzadebis III etapis amocanebi: mocemuli etapis specifikuri amocanebi moicavs Semdegs:

a) pirveladi jandacvis marTva:

a.a) im midgomebis codna, romelic uzrunvlyofs pacientisaTvis araseleqciuri problemebis mqone pacientisaTvis momsaxurebis advilad xelmisawvdomobas;

a.b) qronkuli mdgomareobebis marTvis organizaciuli midgomebis codna;

a.g) im prevenciuli RonisZiebebis codna, rac moeTxoveba praqtikas pirvelad jandacvaSi;

a.d) problemebis prioritetulobis gansazRvris unari;

a.e) pirveladi jandacvis dawesebulebis (klinikis) organizaciis codna;

a.v) gundis sxva wevrebTan efeqturi komunikaciis damyareba;

a.z) gunduri muSaobis Cveva;

a.T) sxva specialistebTan efeqturi TanamSromlobis unari;

a.i) konsultaciis, pacientisa da misi ojaxis wevrebis ganaTlebisaTvis saWiro sakomunikacio Cvevebi;

a.k) Canawerebis Senaxvis, sainformacio menejmentis, gunduri muSaobis, praqtikis warmmarTvisa da momsaxurebis xarisxis auditirebisaTvis saWiro saorganizacio Cvevebi;

a.l) pacientTan partnioruli kavSiris damyarebisaTvis saWiro urTierTobisa da komunikaciis unar-Cvevebis ganviTareba da SenarCuneba;

a.m) efeqturi liderobis, molaparakebisa da kompromisebis Cvevebi.

b) pirovnebaze koncentrirebuli daxmareba:

b.a) koncefciuri midgoma ojaxis da Temis faqtorebisadmi; pirovnebis damokidebulebis, faseulobebisa da rwmenis socialuri da kulturuli konteqstis gageba;

b.b) avadmyofi pacientisa da zogadad daavadebis koncefciis Camoyalibeba;

b.g) pacientze orientirebuli sakonsultacio modelis ganxorcielebis unari, pacientis Taviseburebebis/damokidebulebis gaazrebisa (magaliTad, yinulis galRoba, ideebi, interesi da molodinebi) da masTan maswavleblis damokidebulebis integrirebiT, saerTo safuZvlebis Camoyalibebisa da erTiani samomavlo gegmis formirebisaTvis;

b.d) eqimisa da pacientis urTierTobis subieqturi komponentis codna, rogorc pacientis (misi SegrZnebebi, Rirebulebebi da warmodgenebi), aseve rezidentis Tvalsawieridan (faseulobebis, midgomebisa da SegrZnebebis TviTanalizi);

b.e) pacientTan partnioruli urTierTobebis damyarebisaTvis saWiro unar-Cvevebi da midgomebi;

b.v) unar-Cvevebi da midgomebi pacientTan distancirebisa da axlo urTierTobebis dasabalanseblad;

b.z) uwyvetobis sami aspeqtis gageba/SeTviseba: pirovnuli urTierTobis uwyvetoba mTeli cxovrebis ganmavlobaSi (midgoma xangrZlivi urTierTobis Camosayalibeblad erT pirovnebasTan), informaciis miwodebis uwyvetoba – konkretuli pacientisaTvis saWiro samedicino informaciis xelmisawvdomobis uzrunvelyofa yovel saWiro momentSi (informaciis miwodeba personalurad da eleqtronuli sistemis saSualebiT), movlis uwyvetoba mTeli dRe-Ramis ganmavlobaSi (samuSao da arasamuSao saaTebSi).

3. specifikuri problemebis gadawyvetis unar-Cvevebi:

A a) marTvis gegmaSi pacientis CarTvis survili;

b) samedicino gadawyvetilebis nabij-nabij miRebis unari, drois, rogorc sadiagnozo da samkurnalo berketis gamoyenebiT;

g) pirvelad jandacvaSi problemebis gadawyvetis procesSi gaurkveveli, saeWvo situaciebis aRmocenebis garduvalobis gageba da mis mimarT tolerantobis gamomuSaveba.

4. yovlismomcveli midgoma:

a) polinozologiurobis koncefciisa da Sedegebis misadageba yoveli calkeuli pacientisaTvis;

b) pacientis janmrTelobasTan dakavSirebuli yvela problemis erTdroulad marTvis unar-Cveva maTi identificirebis, Seswavlis, cnobis, prioritetulobis gansazRvris gziT;

g) samedicino Canawerebisa da sxva informaciis saTanadod gamoyenebis unar-Cveva;

d) saukeTeso mtkicebulebebis moZiebisa da maTi praqtikaSi gamoyenebis unari;

e) janmrTelobis koncefciis gageba mTlianobaSi, misi mravalsaxovnebis gaTvaliswinebiT;

v) janmrTelobisaTvis xelSewyoba yoveli individis doneze, rogorc yoveldRiuri saqmianobis nawili;

z) janmrTelobisaTvis xelSewyobisa da prevenciis ganxorcieleba saTanado programebis meSveobiT;

T) sxvadasxva midgomebis gamoyenebis unari calkeuli pacientis mimarT;

i) praqtikis gundis saqmianobis koordinaciis unari;

k) Temis janmrTelobis saWiroebebis gageba populaciis epidemiologiuri maxasiaTeblebis mixedviT.

5. Temze orientacia:

a) Temis jandacvis politikasTan dakavSirebul sxva profesionalebTan erToblivi saqmianoba da maTi rolis gacnobiereba;

b) praqtikaze da Temze dafuZnebuli informaciis mniSvnelobis gacnobiereba praqtikis xarisxis uzrunvelyofisaTvis;

g) individebisa da Temis saWiroebebis SesabamisobaSi moyvana.

6. holisturi midgoma:

a) pacientis, rogorc biofsiqosocialuri mTlianobis gageba;

b) holisturi gagebis praqtikul ganzomilebebSi transformaciis unar-Cveva;

g) samedicino daxmarebasTan mimarTebaSi pacientis kulturuli da egzistencialuri safuZvlebis codna;

d) tolerantoba da pacientis gamocdilebis, rwmenis, faseulobebisa da molodinebis gageba, rasac SeuZlia gavlena moaxdinos momsaxurebis miwodebaze.

7. treningis am nawilis maxasiaTeblebi SeiZleba iqnes:

a) konteqstualuri:

a.a) codna imisa, Tu ra gavlenas axdens mTlianad samuSaos moculoba mis mier konkretuli pacientisTvis gaweul samedicino daxmarebis xarisxze;

a.b) gageba imisa, Tu ra gavlenas axdens eqimis sacxovrebeli da samuSao pirobebi mis mier gaweul samedicino momsaxurebis xarisxze;

b) midgomiTi:

b.a) codna imisa, ra SesaZleblobebi da faseulobebi gaaCnia eqims – eTikuri aspeqtebis identificireba klinikur praqtikaSi (prevencia/diagnozi/Terapia/cxovrebis stilze gavlenis momxdeni faqtorebi);

b.b) sakuTari Tavis Secnoba: imisi gacnobiereba, rom sakuTari midgomebi da SegrZnebebi praqtikis mniSvnelovani ganmsazRvreli faqtorebia;

b.g) piradi cxovrebasa da profesiul saqmianobas Soris kavSiris arsebobis gacnobiereba, maT Soris saTanado balansis damyareba.

8. swavlebis/Sefasebis meTodebi mzadebis III etapze

a) Catarebis adgili – programis es nawili agreTve ganxorcieldeba saojaxo praqtikaSi. TiToeuli rezidentisTvis SeiZleba gamoyenebul iqnes ori an sami saojaxo medicinis dawesebuleba araerTgvarovan pirobebSi samedicino momsaxurebis gansxvavebulobis sailustraciod (magaliTad, soflad, SedarebiT qalaqTan an dedaqalaqTan ახლოს). programis am nawilis mimdinareobisas SeiZleba daigegmos vizitebi sxva samedicino dawesebulebebSic (magaliTad, tubdispanseri, onkologiuri dispanseri, tkivilis klinika) an esa Tu is xanmokle kursebi;

b) drois ganrigi – etapis saerTo xangrZlivobaa 10 Tve, rac moicavs 10 1-Tvian moduls (ix. zemoT `sarezidento programis etapebis modulebad dayofa~).

g) swavlebis meTodebi – swavlebis ZiriTadi meTodia rezidentis mier Catarebul konsultaciaze zedamxedveloba. swavleba auditoriaSi sasurvelia moicavdes sxvadasxva meTodebs: leqciebs, mcire jgufebSi diskusias, davalebebis Sesrulebas da sxva meTodebs. vizitebi klinikebSi da sxva institucionalur dawesebulebebSi organizebuli unda iqnes rezidentebis saWiroebebis gaTvaliswinebiT, mas Semdeg, rac ganisazRvreba es saWiroebebi;

d) Sefaseba – saboloo Sefaseba unda ganxorcieldes gamocdis formiT, profesiuli mzadebis damTavrebis Semdeg. regularuli ukukavSiri ganxorcieldeba xelmZRvanelis mier rezidentis warmoebuli saqmianobis Sesabamisad.

muxli 9. akademiuri personali, kvalifikacia da saganmanaTleblo resursebi

1. rezidentebis mzadebis adekvaturi xarisxiT uzrunvelyofisaTvis aucilebelia Semdegi personalis SerCeva, mowveva da uwyvet profesiul ganaTlebaSi CarTva:

a) maswavlebeli – e.w. `tutori~, romelic zedamxedvelobs ramdenime rezidentis mzadebas;

b) ojaxis eqimi-maswavlebeli – modulze pasuxismgebeli piri pjd centrSi;

g) Sesabamis specialobaSi sertificirebuli eqimi-maswavlebeli – modulze pasuxismgebeli piri Sesabamisi profilis stacionarsa da klinikaSi;

2. saojaxo medicinaSi mzdebis udidesi nawili, kerZod, mzadebis I da III etapi xorcieldeba ojaxis eqimi-maswavleblis monawileobiT da/an maTi meTvalyureobiT.

3. mzadebis II etapze CarTuli arian Sesabamisi specialobis eqimebi. mzadeba saWiroebis mixedviT mimdinareobs rogorc ambulatoriulad ise stacionarSi.

4. tutorebi uzurnvelyofen I etapis Sesavali da daskvniTi sesiebis Catarebas, agreTve II da III etapis `ukukavSiris~ sesiebis organizebas.

5. ojaxis eqimi-maswavlebeli aris sertificirebuli eqimi specialobaSi `saojaxo medicina~, romelიc dauflebulia mozrdilTa swavlebis meTodebs. sasurvelia, rom mas gavlili hqondes ojaxis eqimTa maswavlebelTa formalizebuli kursi, romelic orientirebulia mozrdilTa swavlebis meTodebze.

6. maswavleblebis SerCevis dros gaTvaliსwinebuli unda iqnes:

a) maswavleblis profesiuli biografia;

b) misi, rogorc eqimis Sesaferisobis Sefaseba – profesiuli saqmianobis warmoebis xarisxis TvalTaxedviT da rogorc maswavleblis, sxvis ganaTlebaze pasuxismgebeli piris TvalTaxedviT;

g) gasaubrebis Sedegebi;

d) saswavlo dawesebulebis Sefaseba. dasawyisisTvis igi unda moicavdes praqtikis dawesebulebis vizits daTvalierebis mizniT. vizitis dros yuradReba unda mieqces klinikur saqmianobas, am ukanasknelis kulturas da swavlebisaTvis saWiro garemos arsebobas.

7. sasurvelia, rom yvela maZiebels hyavdes erTi (an ori) konkretuli `maswavlebeli~/zedamxedveli mzაdebis I da III etapze, romelic pasuxismgebelia saganmanaTleblo programis ganxorcielebisaTvis. zedamxedveli unda iyos ojaxis eqimi-maswavlebeli.

1. a) maswavlebeli II etapze aris Sesabamis specialobaSi sertificirebuli eqimi, romelic dauflebulia mozrdilTa swavlebis meTodebs, aqvs saTanado praqtika (pacientebis raodenoba, daavadebaTa speqtri) saavadmyofoSi da/an ambulatoriul klinikaSi da aqvs ojaxis eqimTa diplomis Semdegomi mzadebis progaramaSi moanwileobis survili da motivacia. modulze pasuxismgebeli piri pasuxismgebelia modulis gavlaze im klinikasa Tu hospitalSi, sadac is eweva praqtikul saqmianobas;

2. b) maswavlebeli – `tutori~: tutori aris akademiuri personali (rogorc arCeuli akademiuri personali, ise mowveuli pedagogi) specialobaSi `saojaxo medicina~, romlebic uzrunvelyofen zedamxedvelobas maZiebelTa erT jgufze, romelic SeiZleba warmodgenili iyos 6-8 maZiebliT. tutori uzruvnelyofs:

b.a) mzadebis I etapze Sesavali da daskvniTi sesiebis Catarebas;

b.b) mzadebis II etapze `ukukavSiris~ sesiebis uzruvnelyofas;

b.g) mzadebis III etapze `ukukavSiris~ sesiebis uzrunvelyofas.

muxli 10. programis marTva da administrireba

1. programas unda hyavdes: mmarTveli organo da sakonsultacio sabWo.

2. mmarTveli organo uSualod programis ganxorcielebaSia CarTuli da pasuxismgebelia programis ganxorcielebasa da mis xarisxze.

3. mmarTveli organo moicavs programis xelmZRvanels da programis koordinators an koordinatorebs. rezidentis raodenobis mixedviT programas SeiZleba hyavdes erTi an ramdenime koordinatori.

4. amasTan, e.w. `tutorebic~, faqtobrivad, CarTuli arian programis ganxorcielebaSi da misi xarisxis uzrunvelyofaSi, radgan maT aqvT regularuli Sexvedra maTTan mimagrebul 6-8 rezientTan/maZiebelTan.

5. sakonsultacio sabWo aucilebelia programis struqturis, misi miznebis da amocanebis, ganxorcielebis meTodebis, xarisxis, mzadebaSi CarTuli pirebis kompetenciis sakiTxebze mudmivi msjelobisTvis da programis mudmivi gaumjobesebisTvis. sabWoSi muSaoba ar aris anazRaurebadi.

muxli 11. programis xangrZlivoba

1. programis xangrZlivoba saSualebas unda iZleodes kompetenturi ojaxis eqimis mzadebisTvis. dRes evropis qveynebSi mzadebis xangrZlivobis minimaluri standarti specialobaSi `ojaxis eqimi~/`zogadi praqtikis eqimi~ 3 welia.

2. mzadebis 3 weli – 36 Tve Sedgeba Semdegi komponentebisagan:

a) 6 Tve – mzadebis I etapi;

b) 15 Tve – mxadebis II etapi;

g) 12 Tve – mzdebis III etapi;

d) 3 Tve – Svebuleba.

e) sul 36 Tve.

3. Svebulebis Tvis SerCeva damokidebulia mzadebis dawyebis TariRze da dawesebulebaze, sadac rezidenti/maZiebeli gadis mzadebas. uxSiresad es aris agvisto. Svebulebis Tve SeiZleba Seicvalos mzadebis klinikuri bazis saWiroebebis mixedviT. ar aris aucilebeli Svebulebebs Soris fiqsirebuli intervalebis (mag., zustad 11 Tvis dacva).

muxli 12. programis ganaxlebis perioduloba

1. sasurvelia programis perioduli ganaxleba. amasTanave, programa stabiluric unda iyos, raTa SesaZlebeli gaxdes misi danergva, programis ganxorcielebaSi CarTul pirTa gaTviTcnobiereba da koordinirebuli muSaobis uzrunvelyofa da programis efeqturobis Sefaseba.

2. zemoxsenebulidan gamomdinare, agreTve programis xangrZlivobis gaTvaliswinebiT (3 weli), sasurvelia programis pirveli Zireuli ganaxlebis sakiTxi ganxiluli iqnes arauadres 5 wlisa misi aRiarebidan. pirveli Zireuli ganaxlebis SemTxvevaSi dadgindeba Semdgomi ganaxlebis vadebi.

3. ganaxlebis Sesaxeb sakiTxis dasmis Semdeg unda Sefasdes, aris Tu ara Zireuli cvlilebis saWiroeba. aRniSnulis Semdeg miRebuli iqneba gadawyvetileba programis Zireuli ganaxlebis Sesaxeb.

4. amasTan, SesaZlebelia misi calkeuli nawilis Sinaarsoblivi cvlileba, rac ar exeba programis saerTo struqturas da principebs.

5. programis ganaxlebis Sesaxeb gadawyvetilebis miRebisas aucilebelia maZiebelTa gamocdilebisa da Sexedulebebis gaziareba, maTi molodinisa da miRebuli Sedegebis analizi, radgan saboloo mizani mainc maZieblis saWiroebebisadmi maqsimalurad misadagebuli programis Camoyalibebaa.

muxli 13. programis Sesabamisoba saerTaSorisod aRiarebul standartebTan

1. programas safuZvlad udevs Semdegi rekomendaciebi da programebi:

a) zogadi praqtikis/saojaxo medicinis evropuli organizaciis (WONCA) zogadi praqtikis/saojaxo medicinis evropuli ganmarteba (WONCA Europe [The European Society of General Practice/Family Medicine]: The European Definition of General Practice/Family Medicine; Barcelona: WONCA, 2002);

b) ojaxis eqimTa maswavleblebis evropuli akademiis (EURACT – European Academy of Teachers in General Practice) saganmanaTleblo programas Education Agenda; EURACT, Leuven 2005);

g) amerikis ojaxis eqimTa akademiis `rezidenturis programis ganmartebebi: warmatebis kriteriumebi”, me-8 gamocema, 2011 weli;

d) amerikis ojaxis eqimTa akademiis kurikulumis masalebi ojaxis eqimTa rezidenturaSi mzadebisaTvis (www.aafp.org ), 2011 weli;

e) kanadis ojaxis eqimTa kolegiis (CFPC) `kompetenciebze dafuZnebuli kurikulumi~ (Triple C Competency-based Curriculum (Triple C)), 2011 weli (marti);

v) kanadis ojaxis eqimTa kolegiis (CFPC) `kompetenciebis gansazRvra sasertifikacio gamocdisTvis kanadis ojaxis eqimTa kolegiis mier~, 2010 weli;

z) kanadis ojaxis eqimTa kolegiis (CFPC) `CanMEDS – saojaxo medicina~ (CanMEDS-Family Medicine) – kurikulumis Sefasebis samuSao jgufis angariSi, 2009 weli;

T) didi britaneTis zogadi praqtikis eqimTa samefo kolegiis (RCGP) `swavlebisa da swavlis saxelmZRvanelo~, romelic asaxavs RCGP ZiriTadi kurikulumis debulebaSi (RCGP core curriculum statement Being a General Practitioner) da RCGP mzadebis kurikulumSi (Part One: a statement on the eight PMETB standards for curricula, a submission to the Postgraduate Medical Education and Training Board; PMETB) asaxul principebs. 2007 weli.

Tavi II. programis I etapi

muxli 14

1. sarezidento programis I etapi moicavs 4 moduls (6 Tve):

|# |modulis dasaxeleba |xangrZlivoba (Tve) |

|I.1 |specialobisa da profesionalizmis safuZvlebi |2 |

|I.2 |jandacvis sistema da praqtikuli saqmianobis organizacia |1.5 |

|I.3 |mtkicebulebebze dafuZnebuli medicina da biosamedicino kvlevis safuZvlebi |1.5 |

|I.4 |praqtikuli unar-Cvevebi da tkivilis marTvis safuZvlebi |1 |

2. TiToeuli moduli moicavs qvesakiTxebs, romelsac iTvaliswinebs tutori samuSaos dagegmvisa da warmarTvisas:

|# |modulis dasaxeleba |sakiTxebi |

|1 |specialobisa da profesionalizmis safuZvlebi |saojaxo medicinis Sesavali kursi |

| | |komunikaciis unar-Cvevebi |

| | |samedicino eTika ojaxis eqimis saqmianobaSi |

|2 |jandacvis sistema da praqtikuli saqmianobis organizacia |saqarTvelos jandacvis sistema |

| | |ojaxis eqimis praqtikuli saqmianobis organizcia |

|3 |mtkicebulebebze dafuZnebuli medicina da biosamedicino |mtkicebulebze dafuZnebuli medicina |

| |kvlevis safuZvlebi | |

| | |biosamedicino kvlevis warmoeba saojaxo medicinis sferoSi – Sesavali |

| | |kursi |

|4 |praqtikuli unar-Cvevebi da tkivilis marTvis safuZvlebi |praqtikuli unar-Cvevebi ojaxis eqimis saqmianobaSi |

| | |tkivilis marTvis safuZvlebi |

3. pirveli etapis pirveli sami modulis sakiTxebis Seswavlis struqtura analogiuria – pirveli da bolo dRe tutorTan muSaoba da danarCeni dReebi ojaxis eqimTan muSaoba saojaxo medicinis klinikaSi.

4. TiToeuli sakiTxis pirvel dRes rezidenti/maZiebeli xvdeba Tavis tutors danarCen rezidentebTan/maZieblebTan erTad da tutori maT acnobs sakiTxis miznebs da amocanebs, aZlevs davalebas.

5. Semdeg rezidenti/maZiebeli mTels dros (garda bolo dRisa) atarebs saojaxo medicinis klinikaSi.

6. miuxedavad imisa, rom am etapze modulebis dasaxeleba da sakiTxebis Sinaarsi gansxvavdeba, praqtikuli muSaobis komponenti analogiuria da moicavs:

a) daswrebas konsultaciebze;

b) anamnezis SekrebaSi monawileobas;

g) samedicino Canawerebis warmoebaSi monawileobis miRebas;

d) referalis organizebaSi monawileobas;

e) sxvdasxva specialisebTan koordinacia-komunikacias;

v) pacientis ganaTlebaSi monawileobas;

z) ojaxis eqimis angariSebis momzadebaSi monawileobas;

T) klinikaSi organizebul klinikur garCevebze daswrebas;

i) moxsenebis gakeTebas xelmZRvanelis mier SerCeul Temaze, rac, upirveles yovlisa, moicavs moxsenebas klinikuri praqtikis gaidlainze da gaidlainis damtkicebis Semdeg dagrovil faqtebsa da axal midgomebze; amasTan, moxseneba SeiZleba exebodes ojaxis eqimis saqmianobis nebismeir aspeqts;

k) ojaxis eqimis saqmianobis sxva komponentebSi CarTulobas.

7. TiToeuli modulis miznebidan gamomdinare, rezidenti/maZiebeli agrovebs informacias tutoris mier micemuli davalebis Sesaxeb, rasac is axorcielebs ojaxis eqimTan erTad praqtikuli muSaobis procesSi.

muxli 15

1. moduli I.1. modulis dasaxeleba, xangrZlivoba – `specialobisa da profesionalizmis safuZvlebi~, 2 Tve.

2. modulis mizani – modulis mizania (a) rezidenti gaecnos specialobis safuZvlebs (saojaxo medicina, rogorc disciplina da specialoba), (b) gamoimuSaos pacientze orientirebuli samedicino konsultaciis Catarebis unar-Cvevebi da (g) gamoimuSaos saqarTvelos kanonmdeblobaSi gacxadebuli normebisa da biosamedicino eTikis principebis praqtikul saqmianobaSi gamoyenebis unari.

3. specifikuri amocanebi pacientze orientirebuli samedicino konsultaciis Catarebis unar-Cvevebis gamomuSavebisas:

a) pirveladi jandacvis marTva:

a.a) SeeZlos klinikur praqtikaSi profesiuli komunikaciis Cvevebis gamoyeneba (rogorc oraluri, ise weriTi) droisa da sxva resursebis efeqturi xarjvis fonze;

a.b) SeeZlos efeqturi/adekvaturi urTierTobis damyareba jandacvis profesionalebTan organizaciis SigniT da mis gareT;

a.g) gamoimuSaos komunikaciis Cvevebi saeqimo konsultaciis Casatareblad, swavlebisaTvis, pacientebTan da maTi ojaxis wevrebTan urTierTobis dasamyareblad;

a.d) gamoimuSaos partniorobaze, TanamSromlobaze dafuZnebuli urTierTobis stili pacientebTan muSaobisas;

b) pirovnebaze koncentrirebuli daxmareba:

b.a) SeeZlos pacientis janmrTelobis problemis mimoxilva da vizitis mizezebis gansazRvra;

b.b) SeeZlos Seafasos da mimoixilos pacientis gaTviTcnobierebuloba da damokidebuleba sakuTari janmrTelobis problemisadmi da misi marTvis sakiTxebisadmi;

b.g) SeeZlos Seafasos da adekvaturad upasuxos pacientis wuxils, dards misi janmrTelobis problemebisa da am problemebis marTvis sakiTxebTan dakavSirebiT;

b.d) SeeZlos miawodos pacients Sesaferisi ganmartebebi misi janmrTelobis problemebTan dakavSirebuli mosazrebebisa da kiTxvebis Sesaxeb;

b.e) SeeZlos gansazRvra imisa, Tu ramdenad gaigo da sworad aRiqva eqimis mier miwodebuli ganmartebebi da ramdenad moaxerxa eqimma pacientis wuxilsa da dardze adekvaturad reagireba.

g) specifikuri problemebis mogvarebis unar-Cvevebi:

g.a) gamoimuSaos efeqturi komunikaciis unari gansakuTrebul situaciebSi; kerZod, rezidents unda SeeZlos: `cudi ambebis~ (pacientisaTvis arasasiamovno ambis) Setyobineba; reagireba ukmayofilebze, gaRizianebasa da agresiaze; `rTuli~ pacientis marTva;

g.b) SeeZlos pacientis CarTva misi janmrTelobis problemebis marTvasTan dakavSirebuli gadawyvetilebis miRebis procesSi;

g.g) SeeZlos, warmarTos konsultacia im saxiTa da TanmimdevrobiT, rac Seesabameba pacientis saWiroebebs; amasTan, erTi mxriv, CarTos pacienti konsultaciis procesSi, xolo meore mxriv, efeqturad gamoiyenos dro;

d) yovlismomcveli midgoma:

d.a) gamoimuSaos unari, daarwmunos calkeuli pacienti janmrTelobisaTvis xelSewyobis aucileblobaSi TiToeuli samedicino problemis marTvisas;

d.b) SeeZlos komunikaciis sxvadasxva meTodisa da midgobis saWiroebisda mixedviT gamoyeneba, zogjer erTsa da imave pacientTan urTierTobisas;

e) Temze orientacia:

e.a) SeeZlos, xeli Seuwyos pacientisa da samedicino personalis mier janmrTelobis dacvis sistemaSi arsebuli resursebis gamoyenebas (pacientis gagzavna konsultaciaze – `referali~, Tanagaxdis sistemebi, avadmyofobis furceli, sxvadasxva samarTlebrivi sakiTxebi da sxv.);

e.b) axsnas, Tu rogor aris calkeuli individis saWiroeba gadajaWvuli Temis saWiroebebTan, sadac isini cxovroben;

v) holisturi midgoma:

v.a) SeeZlos pacientTan kargi urTierTobis damyareba da mis mimarT, rogorc pirovnebisadmi, pativiscemis gamoxatva;

v.b) iqonios pacientTan adekvaturi urTierToba pacientis faseulobebis, kulturuli Taviseburebebis, tradiciebis, gamocdilebis, rwmenisa da molodinis gaTvaliswinebiT, ramac SeiZleba gavlena iqonios samedicino momsaxurebis gawevaze.

4. zemoT moxseniebulTan erTad rezidenturis kursdamTavrebuls unda SeeZlos gamoimuSaos unar-Cvevebi Semdegi maxasiaTeblebis mixedviT:

a) konteqstualuri: gaiTvaliswinos pirovnebis, ojaxis, Temis Taviseburebebi da daamyaros efeqturi urTierToba pacientebTan gansxvavebuli pirovnuli da kulturuli maxasiaTeblebiT;

b) damokidebulebiTi: sakuTari SesaZleblobebis, faseulobebisa da eTikuri principebis gaTvaliswinebiT Seafasos da gaiazros, Tu rogoria misi SegrZnebebi da damokidebuleba gansxvavebul situaciebSi; gamoimuSaos saWiro informaciisa da mxardaWeris moZiebis unari; agreTve, gamoimuSaos Cvevebi, romelic mas daexmareba iseTi situaciebSi, sadac eqimi ganicdis Zlier emociur da fsiqologiur zewolas (mag., `rTuli pacienti~, samedicino Secdomebi);

g) mecnieruli: gamoimuSaos kritikuli da mecnierebaze dafuZnebuli midgoma profesiul saqmianobaSi.

5. specifikuri amocanebi samarTlebrivi da eTikuri normebisa da principebis praqtikul saqmianobaSi gamoyenebis unaris gamomuSavebisas: modulis gavlis Semdeg maZiebels unda hqondes:

a) profesiuli saqmianobisas konkretuli SemTxvevis samarTlebrivi da eTikuri mxareebis warmoCenis unari;

b) yoveldRiuri profesiuli saqmianobis Tanamedrove samedicino eTikis principebisa da arsebuli kanonmdeblobis Sesabamisad warmarTvis unari, maT Soris, profesiuli saqmianobis procesSi samarTlebrivi koliziebisa da eTikuri dilemebis gadawyvetis unari.

6. literaturis nusxa:

a) specialobis Sesaxeb:

a.a) The European Definition of General Practice/Family Medicine; Barcelona: WONCA, 2002;

a.b) The EURACT Educational Agenda of General Practice/Family Medicine; EURACT Leuven, 2005;

a.g) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007;

a.d) Havelock P., Hasler J., Flew R., McIntyre D., Schofield T., Toby J. (1995) Professional Education for General Practice. Oxford General Practice Series 31. Oxford University Press, Oxford, New York, Toronto;

a.e) Jones R (Ed). Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004;

a.v) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004;

a.z) Rakel RE. Textbook of Family Practice 6th edition London: W.B. Saunders, 2001;

a.T) Bordage G and Zacks R. The Structure of Medical Knowledge in the Memories of Medical Students and General Practitioners: Categories and Prototypes. Medical Education 1984; 18: 406–16;

a.i) Bordage G. Elaborated Knowledge: A Key to Successful Diagnostic Thinking Acad Med 1994; 69:883–5;

a.k) Little M., Midtling J.E. (1989) Becoming a Family Physician. Springer – Verlag New York;

b) komunikaciis Sesaxeb da konsultaciis meTodebis Taobaze:

b.a) Mead N, Bower P. „Patient-centredness: a conceptual framework and review of the empirical literature.” Social Science & Medicine 2000; 51: 1087–1110;

b.b) Stewart M, Brown, JB, Freeman, TR. Patient-Centered Medicine. Transforming the Clinical Method (2nd edn). Oxford: Radcliffe Medical Press, 2003;

b.g) Silverman J, Kurtz S, Draper J. Skills for communicating with patients (2nd edition). Oxford: Radcliffe Medical Press, 2004;

b.d) Kurtz S, Silverman J, Draper J. Teaching and learning communication skills in medicine (2nd edition). Oxford: Radcliffe Medical Press, 2004;

b.e) Maguire, Pitceathly C. „Key communication skills and how to acquire them.” BMJ 2002; 325: 697–700;

b.v) BMA. Communication skills and continuing professional development London, BMA, 1998;

b.z) Midland Faculty of the Royal College of General Practitioners Consulting: Communication skills for general practitioners Birmingham: Midland Faculty of the Royal College of General Practitioners 2005;

b.T) Kjeldmand D Balint training makes GPs thrive better in their job. Patient Education and Counselling 2004; 55: 2: 230-235;

b.i) Smith RC, Marshall-Dorsey AA, Osborn GG, Shebroe V, Lyles JS, Stoffelmayr BE, Van Egeren LF, Mettler J, Maduschke K, Stanley JM, Gardiner JC. Evidence-based guidelines for teaching patient-centered interviewing. Patient Educ Couns. 2000 Jan; 39(1):27-36;

b.k) Pendleton D, Hasler J. Doctor Patient Communication, 1983 London;

b.l) Buckman R. How to Break Bad News, Macmillan Press, 1992;

b.m) Ungar L, Alperin M, Amiel GE, Beharier Z, Reis S. Breaking bad news: structured training for family medicine residents. Patient Educ Couns. 2002 Sep; 48(1): 63-8;

b.n) Smith R.C. The patient's story: Integrated patient–doctor interviewing. Little, Brown and Company (now Lippincott, Williams and Wilkins), Boston (1996);

b.o) Beckman HB, Frankel RM. The effect of physician behaviour on collection of data. Ann Intern Med, 1984; 101:692-6;

b.p) Baile,W.F.; Buckman,R.; Lenzi,R.; Glober,G.; Beale,E.A.; Kudelka,A.P. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-311;

b.J) Newman,M.C. The emotional impact of mistakes on family physicians. Archives of Family Medicine, 1996; 5(2): 71-76;

b.r) Rubin S.B, Zoloth L. Margin of error. The ethics and mistakes in the practice of medicine. University Publishing group, Hagerstown, Maryland;

b.s) Rowland-Morin PA, Carroll JG. Verbal communication skills and patient satisfaction. A study of doctor-patient interviews. Eval Health Prof., 1990; 13(2):168-185;

g) eqimis saqmianobis samarTlebrivi da eTikuri sakiTxebis Sesaxeb:

g.a) `saqarTvelos kanonmdebloba janmrTelobis dacvis sferoSi (mokle qronologiuri mimoxilva, ZiriTadi etapebi)~; kiknaZe, javaSvili, barkalaia; jandacvis marTvis nacionaluri centris samecniero SromaTa krebuli, tomi I, 1998, 15-20;

g.b) pacientis uflebebi da maTi ganxorcielebis meqanizmebi: kiknaZe, javaSvili Tbilisi, 1999;

g.g) `pacientis ombudsmeni: ideidan realizaciamde~; javaSvili, kiknaZe saqarTvelos bioeTikis da jandacvis samarTlebrivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2001. ISBN 99928-908-1-9;

g.d) `adamianis uflebebi biomedicinis sferoSi~; javaSvili, kiknaZe, barkalaia; saqarTvelos bioeTikis da jandacvis samarTlebrivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2001. ISBN 99928-908-0-0;

g.e) `eqimis profesiuli saqmianobis samarTlebrivi safuZvlebi~; kiknaZe, javaSvili saqarTvelos bioeTikis da jandacvis samarTlebrivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2002. ISBN 99928-908-5-1;

g.v) `jandacvis ombudsmeni: pirveli nabijebi~; javaSvili, kiknaZe saqarTvelos bioeTikis da jandacvis samarTlebrivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2002. ISBN 99928-908-8-6;

g.z) `pacientis mkurnaloba da movla daavadebis terminalur stadiaze: saqarTvelos kanonmdeblobis mimoxilva~; javaSvili, kiknaZe; `Tanamedrove medicina~, tomi 1, #3;

g.T) `ieRovas mowmeTaTvis mkurnalobis mizniT sisxlis gadasxmis eTikuri da samarTlebrivi sakiTxebi~; kiknaZe, javaSvili, barkalaia; `Tanamedrove medicina~, tomi 1, #1, gv. 37-44;

g.i) „Encyclopedia of Bioethics”, Warren Thomas Reich (Ed.), Simon & Schuster Macmillan, New York, 1995 (5 Volumes);

g.k) „Principles of Biomedical Ethics” (4th Ed.), T.L. Beauchamp, J.F. Childress, Oxford University Press, 1994;

g.l) „Ethical Issues in Modern Medicine” (5th Ed.), John D. Arras, Mayfield Publishing Company, 1999;

g.m) „Principles of modern medical ethics and Health care professionals; Relation between health and education: from declaration to implementation (Georgian Experience)” Kiknadze, Javashvili;

g.n) „Patients' rights legislation in Georgia” Kiknadze, Javashvili, Barkalaia; „Journal of Health Sciences and Publlic Health”, Volume 1, Number 1, 2000, 17-26;

g.o) „Ethics committees in Georgia”; Javashvili, Kiknadze „Ethics Committees in Central and Eastern Europe”, 2000, Charis – IMEB Fdn. Bratislava, Slovakia 179-185 ISBN 80-88743-40-0;

g.p) „Georgian Legislation on Human Rights in the sphere of health care and biomedicine: Current trends and harmonisation with international developments”; Javashvili, Kiknadze; in „Europe and its impact on National Healthcare systems Yearbook 2001”, 2002, Erasmus University Press, Rotterdam, The Netherlands, 60-72, ISBN 90 807503 I X;

g.J) „Treatment and care at the end-of-life: Review of Georgian Legislation” Javashvili, Kiknadze; in „Ethical Eye”, 2003, Council of Europe Publishing, Strasbourg, France, In Press;

g.r) „A Clinician’s Commentary from a Post-Soviet Society on Organizational Issues of Care for Alzheimer’s Disease”; Javashvili; in „Book on Alzheimers's Disease”, 2003, Johns Hopkins University Press. in press.

7. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|pirveladi jandacva jandacvis arsi da |msjeloba pirveladi jandacvis rolsa | |Sesrulebuli samuSao dReebi; |

|mniSvneloba, misi miznebi; |da mniSvnelobaze; |klinikis gacnoba – 1; |Catarebuli konsultaciebi; |

|saojaxo medicinis ganmarteba, saojaxo|msjeloba saojaxo medicinaze rogorc |daswreba konsultaciebze – 50; |ese; |

|medicina, rogorc disciplina da |disciplinaze da specialobaze; |anamnezis SekrebaSi monawileoba – 10; |modulze pasuxismgebeli piris |

|specialobis ZiriTadi maxasiaTeblebi |ojaxis eqimis kompetenciebis da |vitaluri niSnebis Sefaseba (P, TA, R) – 10; |Sefaseba; |

|da kompetenciebi; |maxasiaTeblebis analizi, magaliTebis|samedicino Canawerebis warmoebaSi monawileoba|tutoris Sefaseba daskvniTi sesiis |

|saojaxo medicinis Camoyalibeba da |moyvana da TiToeulis mniSvnelobis |– 50; |dros. |

|ganviTareba evropasa da msoflios |dasabuTeba; |referalis organizebaSi monawileoba – 10; | |

|ganviTarebul qveynebSi; saojaxo |konsultaciis Catareba; |sxvdasxva specialistebTan | |

|medicina saqarTveloSi. |anamnezis Sekreba; |koordinacia-komunikacia – 5; | |

| |referalis organizeba. |pacientis ganaTlebaSi monawileoba – 10; | |

| | |ojaxis eqimis angariSebis momzadebaSi | |

| | |monawileoba – 5; | |

| | |klinikaSi organizebul klinikur garCevebze | |

| | |daswreba – 3-6; | |

| | |moxsenebis gakeTebas xelmZRvanelis mier | |

| | |SerCeul Temaze – 1. | |

| | |sxvadasxva. | |

cxrili #2

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

| pacientze orientirebuli |pacientze orientirebuli konsultaciis|daswreba konsultaciebze – 100; |Sesrulebuli samuSao dReebi; |

|konsultacia, konsultaciis miznebi |Catareba; |anamnezis SekrebaSi monawileoba – 30; |Catarebuli konsultaciebi; |

|da amocanebi, konsultaciis etapebi;|pacientisaTvis komfortis Seqmna, |fizikuri gasinjva – 20; |ese; |

|araverbaluri komunikacia samedicino|piraduli garemos uzrunvelyofa; |samedicino Canawerebis warmoebaSi |modulze pasuxismgebeli piris Sefaseba;|

|konsulaciis dros |araverbaluri komunikaciis unar |monawileoba – 100; |tutoris Sefaseba daskvniTi sesiis |

|kiTxvebis formulireba da pacientis |Cvevebi (pacientis miReba, |referalis organizebaSi monawileoba – 20;|dros; |

|mosmena; |moTavseba, distancia, eqimis poza, |sxvdasxva specialistebTan | |

|pacientis mosazrebebi, Sexedulebebi|TvaliT kontaqti da a.S.); |koordinacia-komunikacia – 5; | |

|da molodini samedicino |Ria da daxuruli kiTxvebis gamoyeneba|pacientis ganaTlebaSi monawileoba – 20; | |

|konsultaciasTan dakavSirebiT; |da aqtiuri mosmenis unari; |ojaxis eqimis angariSebis momzadebaSi | |

|axsna-ganmartebebis miwodeba, |pacientis vizitis mizezis gamovlena;|monawileoba – 5; | |

|informirebuli Tanxmobis miReba da |pacientis molodinis, Sexedulebebis |klinikaSi organizebul klinikur | |

|cxovrebis jansaRi wesis sakiTxebis |gamovlena; |garCevebze daswreba – 4-8; | |

|ganixlva; |konsultaciebis etapebis |moxsenebis gakeTebas xelmZRvanelis mier | |

|konsultaciis dro da urTierToba |Tanmimdevruli gavla; |SerCeul Temaze – 1; | |

|eqimsa da pacients Soris; |konsultaciis Sejameba; |sxvadasxva. | |

|`cudi ambebis~ (pacientisaTvis |pacientisaTvis mkafio ganmartebebis | | |

|arasasiamovno ambis) Setyobineba; |da rCevebis miwodeba; | | |

|reagireba ukmayofilebze, |kargi urTierTobis SenarCuneba | | |

|gaRizianebasa da agresiaze; |konsultaciis ganmavlobaSi dam is | | |

|`rTuli~ pacientis marTva; |Semdeg. | | |

|eqimis damokidebuleba samedicino | | | |

|Secdomebisadmi. | | | |

cxrili # 3

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|kanonisa da eTikis roli samedicino |konkretuli SemTxvevis |daswreba konsultaciebze – 75; |Sesrulebuli samuSao dReebi; |

|momsaxurebis gawevisas. |samarTlebrivi da eTikuri |anamnezis SekrebaSi monawileoba – 20; |Catarebuli konsultaciebi; |

|samedicino eTikis principebi: |mxareebis warmoCenis unari; |fizikuri gasinjva – 15; |ese; |

|pacientis individualuri uflebebi, |problemis analizis unari |samedicino Canawerebis warmoebaSi |modulze pasuxismgebeli piris |

|saqarTvelos kanonmdebloba; |Tanamedrove eTikis principebis |monawileoba – 75; |Sefaseba; |

|informirebuli Tanxmoba, pacientis |da kanonmdeblobis moTxovnis |referalis organizebaSi monawileoba – 15; |tutoris Sefaseba daskvniTi sesiis |

|qmedunarianoba da mis mier |safuZvelze; |sxvdasxva specialistebTan |dros; |

|gacnobierebuli gadawyvetilebis |samarTlebrivi koliziebisa da |koordinacia-komunikacia – 5; | |

|miRebis unari; |eTikuri dilemebis gadawyvetis |pacientis ganaTlebaSi monawileoba – 10; | |

|sikvdilisa da evTanaziis, |unari; |ojaxis eqimis angariSebis momzadebaSi | |

|mkurnalobaze uaris Tqmis |eTikuri da samrTlebrivi |monawileoba – 5; | |

|samarTlebrivi da eTikuri sakiTxebi;|problemis gadaWraSi |klinikaSi organizebul klinikur garCevebze| |

|sicocxlis SemanarCunebeli |organizaciuli resursebis |daswreba – 3-6; | |

|mkurnalobis Sewyvetis samarTlebrivi|gamoyenebis unari; |moxsenebis gakeTebas xelmZRvanelis mier | |

|da eTikuri sakiTxebi; |pacientis srulyofilad |SerCeul Temaze – 1; | |

|usargeblo samedicino |informirebis unari; |sxvadasxva. | |

|Careva/pacientis gaumarTlebeli |sarwmuno (ara fiqtiuri) | | |

|moTxovna; |informirebuli Tanxmobis miRebis| | |

|pediatriuli praqtikis samarTlebrivi|unari; | | |

|da eTikuri sakiTxebi; |konfidencia-lurobis dacvis | | |

|paliatiuri mzrunvelobis da tkivilis|unari, piradi pasuxismgeblobis | | |

|marTvis eTikuri sakiTxebi; |da garemo pirobebis | | |

|rTuli pacienti; |uzrunvelyofis xarjze; | | |

|arasakmarisi resursebi janmrTelobis|pacientis piradi cxovrebis | | |

|dacvis sistemaSi, organizaciuli |(piradulobis) dacvis unari; | | |

|eTika da marTvadi jandacvis |saqmianobis warmarTva | | |

|sistema; |Tanamedrove samedicino eTikis | | |

|pacientis uflebebis dacva |principebisa da arsebuli | | |

|samedicino dawesebulebaSi; |kanonmdeblobis Sesabamisad | | |

|eqimis fici, eqimis qcevis kodeqsi,| | | |

|eqimis qcevis wesebi; | | | |

|eqimis profesiuli pasuxismgebloba; | | | |

|specifikuri garemoebebi | | | |

|(pacientebi, meTodebi sxva | | | |

|garemoebani) | | | |

muxli 16

1. moduli I.2. modulis dasaxeleba, xangrZlivoba – `jandacvis sistema da praqtikuli saqmianobis organizacia~, 1.5 Tve.

2. modulis mizani – modulis mizania (a) saqarTvelos jandacvis sistemis, misi funqcionirebis, dagegmvisa da marTvis Taviseburebebis, saqarTvelos mosaxleobis janmrTelobis problemebis specifikurobisa da maTi gadaWris SesaZlo gzebis gacnoba rezidentisaTvis., (b) gamoumuSaos rezidents ojaxis eqimis praqtikis marTvis Cvevebi (maT Soris, gansxvavebul garemoSi; saxelmwifo da kerZo seqtorSi, qalaqad, urbanizebul raionebSi da soflad, jandacvis ganviTarebuli infrastruqturis mqone regionebSi da mwiri resursebis pirobebSi).

3. literaturis nusxa:

a) saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros debuleba da Semdegi dokumentebi:

a.a) jandacvis sistemis strategiuli ganviTarebis Sesaxeb;

a.b) pirveladi jandacvis da hospitaluri seqtoris ganviTarebis Sesaxeb;

a.g) specialobaTa nusxis Sesaxeb;

a.d) xarisxis marTvis, licenzirebisa da sertificirebis, uwyveti profesiuli ganviTarebis Sesaxeb;

a.e) statistikis, epidzedamxedvelobis da angariSgebis Sesaxeb;

b) `saqarTvelos jandacva~ – yovelwliuri angariSebi;

g) `saqarTvelos kanonmdebloba janmrTelobis dacvis sferoSi (mokle qr onologiuri mimoxilva, ZiriTadi etapebi)~; kiknaZe, javaSvili, barkalaia; jandacvis marTvis nacionaluri centris samecniero SromaTa krebuli, tomi I, 1998, 15-20;

d) pacientis uflebebi da maTi ganxorcielebis meqanizmebi – kiknaZe, javaSvili Tbilisi, 1999.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|saqarTvelos jandacvis sistemis |saqarTvelos jandacvis sistemis |daswreba konsultaciebze – 100; |Sesrulebuli samuSao dReebi; |

|Taviseburebebi da prioritetebi; |ZiriTad maxasiaTeblebze msjelobis |anamnezis SekrebaSi monawileoba – 30; |Catarebuli konsultaciebi; |

|pirveladi janadcva; |unari; |fizikuri gasinjva – 20; |ese; |

|hospitaluri seqtori; |informaciis moZiebis unari jandacvis |samedicino Canawerebis warmoebaSi |modulze pasuxismgebeli piris |

|jandacvis dafinanseba; |sistemis regulaciis sferoSi, maT |monawileoba – 100; |Sefaseba; |

|samedicino dazRvevis sistema; |Soris, Sesabamisi normatiuli aqtebis |referalis organizebaSi monawileoba – |tutoris Sefaseba daskvniTi |

|samedicino momsazurebis xarisxi; |moZiebis unari; |20; |sesiis dros; |

|jandacvis sferos regulireba; |qveyanaSi avadobisa da sikvdilianobis|sxvdasxva specialistebTan | |

|sistemis Sefaseba; |ZiriTad mizezebis Sesaxeb msjeloba da|koordinacia-komunikacia – 5; | |

|klinikuri praqtikis gaidlainebi; |Sesabamisi informaciis moZiebis |pacientis ganaTlebaSi monawileoba – 20;| |

|klasifikatorebi; |unari; |ojaxis eqimis angariSebis momzadebaSi | |

|wamlis politika; |klasifikatorebis moZiebis da |monawileoba – 5; | |

|sazogadoebrivi jandacva; |gamoyenebis unari. |klinikaSi organizebul klinikur | |

|Sromis, janmrTelobisa da socialuri | |garCevebze daswreba – 4-8; | |

|dacvis saministro: funqciebi, | |moxsenebis gakeTebas xelmZRvanelis mier| |

|struqturebi, marTvis meTodebi | |SerCeul Temaze – 1; | |

| | |sxvadasxva | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|profesiuli saqmianobis saxis, |piradi da profesiuli interesebis |daswreba konsultaciebze – 100; |Sesrulebuli samuSao dReebi; |

|adgilis, garemos Sefaseba; |balansireba; |anamnezis SekrebaSi monawileoba – 30; |Catarebuli konsultaciebi; |

|dawesebulebis tipebi, |praqtikis tipis SerCeva; |fizikuri gasinjva – 20; |ese; |

|Taviseburebebi; |molaparakebis warmoeba eTikuri |samedicino Canawerebis warmoebaSi |modulze pasuxismgebeli piris |

|ofisis organizacia (Sida |principebis gamoyenebiT; |monawileoba – 100; |Sefaseba; |

|komunikaciis jaWvi, ganrigi, |konsultantebisa da momwodeblebis |referalis organizebaSi monawileoba – 20; |tutoris Sefaseba daskvniTi |

|damxmare personalis raodenoba da |windaxeduli SerCeva da gamoyeneba; |sxvdasxva specialistebTan |sesiis dros. |

|tipi, kompiuteruli sistemebi, |kompiuteruli programebis praqtikis |koordinacia-komunikacia – 5; | |

|momarageba da inventaris movla) |marTvisTvis gamoyeneba; |pacientis ganaTlebaSi monawileoba – 20; | |

|dawesebulebis saqmianoba: |drois marTva; |ojaxis eqimis angariSebis momzadebaSi | |

|pacientebi, momwodebelebi, dazRveva|komunikaciis warmoeba individebTan da|monawileoba – 5; | |

|da a.S. |organizaciebTan (sityvieri, |klinikaSi organizebul klinikur garCevebze | |

|samedicino Canawerebis organizacia |werilobiTi) |daswreba – 4-8; | |

|konsultaciebis organizeba, |resursebis marTva. |moxsenebis gakeTebas xelmZRvanelis mier | |

|pacientebis ganaTlebis organizeba | |SerCeul Temaze – 1; | |

|daavadebebis gamovlenis sistemebi | |sxvadasxva | |

|da prevenciuli momsaxureba | | | |

|mimRebi rgolis funqciebi | | | |

|riskis marTva da sakanonmdeblo | | | |

|sakiTxebi | | | |

|kompiuteruli resursebis gamoyeneba;| | | |

|urTierTobebi personals Soris | | | |

|dafinansebis modelebi; | | | |

|gadaxdis sistemebi | | | |

M

muxli 17

1. moduli I.3. modulis dasaxeleba, xangrZlivoba – `mtkicebulebebze dafuZnebuli medicina da biosamedicino kvlevis safuZvlebi~, 1.5 Tve.

2. modulis mizani – modulis mizania (a) gaacnos rezidents mtkicebulebiTi medicinis safuZvlebi, gamoumuSaos mas unari gamoiyenos mtkicebulebiTi medicinis meTodebi da resursebi konkretuli samedicino problemis gadasaWrelad da (b) miawodos informacia rezidents pirveladi jandacvis sferoSi biosamedicino kvlevebis warmoebis Taviseburebebis Sesaxeb, kvlevis SesaZlo mimarTulebebis, Temebisa da midgomebis Taobaze; gamoumuSaos unari rezidents SearCios kvlevis sagani arsebuli problemebis analizis safuZvelze da miusadagos mis mier dasaxul mizans kvlevis Tanamedrove da adekavturi meTodebi.

3. literaturis nusxa:

a) mtkicebulebebze dafuZnebuli medicinis sakiTxebi:

a.a) Haynes RB, Sackett RB, Gray JMA, Cook DC, Guyatt GH. Transferring evidence from research into practice: 1. The role of clinical care research evidence in clinical decisions. ACP Journal Club. 1996 Nov-Dec;125:A-14-15;

a.b) Guyatt GH, Sackett DL, Cook DJ for the Evidence-based Medicine Working Group. Users' guides to the medical literature. II – How to use an article about therapy or prevention. Part B. What were the results and will they help me in caring for my patients. JAMA 1994:271:59-63;

a.g) Introduction to Research: Understanding and Applying Multiple Strategies, Elizabeth Depoy, Laura N. Gitlin, 2005, Elsevier Health Sciences;

a.d) Foundations of Clinical Research: Applications to Practice, Leslie Gross Portney, Mary P. Watkins, 1999, Pearson Education;

a.e) Interpreting the Medical Literature, Stephen H. Gehlbach 2002 McGraw-Hill Companies, The Studying a Study and Testing a Test: How to Read the Medical Evidence 5e, Richard K. Riegelman, 2004 Lippincott Williams & Wilkins;

a.v) Data Monitoring and Case Studies in Clinical Trials, David L. Demets (Editor), Lawrence Friedman (Editor), Curt D. Furberg (Editor), 2005, Springer-Verlag New York, LLC;

a.z) Basic and Clinical Biostatistics, Beth Dawson, Robert G. Trapp 2004, McGraw-Hill Companies;

a.T) Primer of Biostatistics Stanton A. Glantz 2005, McGraw-Hill Medical Publishing;

a.i) Biostatistics: A Foundation for Analysis in the Health Sciences, Wayne, W. Daniel, Noel A. C. Cressie (Editor), David J. Balding (Editor), Ian M. Johnstone (Editor) 2004, Wiley, John & Sons, Incorporated;

a.k) Evidence Based Medicine: How to Practice and Teach EBM Sharon E. Straus, R. Brian Haynes, W. Scott Richardson, Paul Glasziou 2005, Elsevier Health Sciences;

a.l) Users' Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice, Evidence-Based Medicine Working Group, Drummond Rennie, Preface by Gordon H. Guyatt 2002 American Medical Association;

a.m) Evidence-Based Medicine Guidelines, Staff of Duodecim Medical Publications, Duodecim Medical Publications Staff, Ilkka Kunnamo, 2005, Wiley, John & Sons, Incorporated;

a.n) mtkicebulebebze dafuZnebuli medicinis sferoSi gamoyenebul terminTa ganmartebani (Semdg. givi javaSvili): http://www.afdg.ge/index.php?act=page&id=6;

b) pmd-Si biosamedicino kvlevis warmoebis sakiTxebi:

b.a) Introduction to Research: Understanding and Applying Multiple Strategies, Elizabeth Depoy, Laura N. Gitlin, 2005, Elsevier Health Sciences;

b.b) Foundations of Clinical Research: Applications to Practice, Leslie Gross Portney, Mary P. Watkins, 1999, Pearson Education;

b.g) Interpreting the Medical Literature, Stephen H. Gehlbach 2002 McGraw-Hill Companies, The Studying a Study and Testing a Test: How to Read the Medical Evidence 5e, Richard K. Riegelman, 2004 Lippincott Williams & Wilkins;

b.d) Data Monitoring and Case Studies in Clinical Trials, David L. Demets (Editor), Lawrence Friedman (Editor), Curt D. Furberg (Editor), 2005, Springer-Verlag New York, LLC;

b.e) Basic and Clinical Biostatistics, Beth Dawson, Robert G. Trapp 2004, McGraw-Hill Companies;

b.v) Primer of Biostatistics Stanton A. Glantz 2005, McGraw-Hill Medical Publishing;

b.z) Biostatistics: A Foundation for Analysis in the Health Sciences, Wayne, W. Daniel, Noel A. C. Cressie (Editor), David J. Balding (Editor), Ian M. Johnstone (Editor) 2004, Wiley, John & Sons, Incorporated;

b.T) Evidence Based Medicine: How to Practice and Teach EBM Sharon E. Straus, R. Brian Haynes, W. Scott Richardson, Paul Glasziou 2005, Elsevier Health Sciences;

b.i) Users' Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice, Evidence-Based Medicine Working Group, Drummond Rennie, Preface by Gordon H. Guyatt 2002 American Medical Association.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|mtkicebulebebze dafuZnebuli |Zveli da mimdinare klinikuri |daswreba konsultaciebze – 100; |Sesrulebuli samuSao dReebi; |

|medicinis safuZvlebi; |praqtikis analizis unari da miRebuli |anamnezis SekrebaSi monawileoba – 30; |Catarebuli konsultaciebi; |

|klinikur praqtikaSi |gamocdilebiT momavali samedicino |fizikuri gasinjva – 20; |ese; |

|mtkicebulebebze dafuZnebuli |momsaxurebis gaumjobeseba; |samedicino Canawerebis warmoebaSi |modulze pasuxismgebeli piris |

|medicinis principebis gamoyeneba: |saTanado kiTxvis dasmis unari; |monawileoba – 100; |Sefaseba; |

|(a) proble-mis gansazRvra da kl. |literaturis Ziebis unari nabeWdi da |referalis organizebaSi monawileoba – |tutoris Sefaseba daskvniTi sesiis |

|kiTxvis formulireba; (b) |eleqtronuli resursebis gamoyenebiT |20; |dros |

|mtkicebulebis moZieba; (g) |literaturis gamoyenebis unari |sxvdasxva specialistebTan | |

|mtkicebu-lebebis Sefaseba; (d) |konkretuli pacientis klinikur |koordinacia-komunikacia – 5; | |

|gadawyvetilebis miReba; (e) |problemasTan dakavSirebiT. |pacientis ganaTlebaSi monawileoba – 20;| |

|moqmedebis Sedegis Sefaseba; | |ojaxis eqimis angariSebis momzadebaSi | |

|klinikuri praqtikis `gaidlainebis~| |monawileoba – 5; | |

|da `protokolebis~ arsi, | |klinikaSi organizebul klinikur | |

|mniSvneloba, SemuSavebisa da | |garCevebze daswreba – 4-8; | |

|gamoyenebis gzebi da sferoebi; | |moxsenebis gakeTebas xelmZRvanelis mier| |

|klinikuri literaturis kritiruli | |SerCeul Temaze – 1; | |

|Sefaseba | |sxvadasxva | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|biosamedicino kvlevis arsi; kvleva|kvlevis mniSvnelobaze msjeloba |daswreba konsultaciebze – 50; |Sesrulebuli samuSao dReebi; |

|da auditi; |pirvelad jandacvaSi; |anamnezis SekrebaSi monawileoba – 15; |Catarebuli konsultaciebi; |

|kvlevis elementebi; | |fizikuri gasinjva – 10; |ese; |

|kvlevis dizaini da misi formebi; |kvlevis prioritetebi pirvelad |samedicino Canawerebis warmoebaSi |modulze pasuxismgebeli piris |

|sakvlevis masala; |jandacvaSi; |monawileoba – 50; |Sefaseba; |

|Sedegebis damuSavebis da analizis | |referalis organizebaSi monawileoba – |tutoris Sefaseba daskvniTi sesiis|

|meTodebi; |kvlevis sakiTxis SerCeva; |10; |dros |

|kvlevis sakiTxis SerCeva | |sxvdasxva specialistebTan | |

| |literaturis moZieba da analizi; |koordinacia-komunikacia – 5; | |

| | |pacientis ganaTlebaSi monawileoba – 10;| |

| |msjeloba kvlevis dizanze |ojaxis eqimis angariSebis momzadebaSi | |

| | |monawileoba – 5; | |

| | |klinikaSi organizebul klinikur | |

| | |garCevebze daswreba – 2-4; | |

| | |moxsenebis gakeTebas xelmZRvanelis mier| |

| | |SerCeul Temaze – 1; | |

| | |sxvadasxva | |

muxli 18

1. moduli I.4. modulis dasaxeleba, xangrZlivoba – `praqtikuli unar-Cvevebi da tkivilis marTvis safuZvlebi~, 1 Tve.

2. modulis mizani – modulis mizania (a) ojaxis eqimis saqmianobisaTvis aucilebeli praqtikuli unar-Cvevebis gamomuSaveba da (b) tkivilis medicinis, rogorc saeqimo saqmianobis Semadgenelis, tkivilis diagnozisa da mkurnalobis safuZvlebis gacnoba.

3. literaturis nusxa:

a) praqtikuli unar-Cvevebi:

a.a) სამედიცინო მანიპულაციები; სახელმძღვ. სტუდ., რეზიდენტ. და ექიმებისათვის/ჰ. ჩენი, ჯ. სოლა, ქ. ლილემო; თარგმანის რედ.: გივი ჯავაშვილი. – თბ.: მთაწმინდელი, 2004;

a.b) Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004Jones R, Britten N, Culpepper L, Gass DA, Grol R, Mant D, Silagy C (eds);

a.g) Procedures for Primary Care, 3rd Ed, Pfenninger and Fowler, 2011.

b) tkivilis medicina:

b.a) AMDA Clinical Practice Guideline (CPG) for Pain Management (2007, For detailed information go to: www.amda.com;

b.b) Practical Pain Management 2009 (Michael H. Moskovith, Md, MPH);

b.g) Алгоритм терапии острого вертеброгенного болевого синдрома (кафедра неврологии и нейрохирургии Российского государственного медицинского университета, Москва 2009 г.).

4. Sesasrulebeli samuSaos moculoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis |Sefasebis meTodebi |

| | |raodenoba | |

|ZiriTadi sasicocxlo funqciebis |kardiopulmonuri reanimaciis teqnikis codna; |TiTo manipulacias rezidenti |unar-Cvevis demonstrireba |

|SenarCuneba da kardiopulmonuri |otoskopiis teqnikis Catarebis Cvenebebi da |atarebs manam, sanam ar |rezidentis mier mulaJze; |

|reanimacia; |ukuCvenebebis codna, Catareba, dafis apkisa da |gamoiricxeba Secdomebi, saSualod|Sefaseba kiTxvaris saSualebiT |

|specializebuli kard. daxmareis |gareTa sasmeni milis Sefasebis unari; |saWiroa TiToeuli manipulaciis, |(chek-list) |

|elementebi: eleqtro-kardiografia, |1ofTalmoskopiis teqnikis Catarebis Cvenebebisa |sul mcire, 5-jer Catareba. | |

|defibrilacia. |da ukuCvenebebis codna; „wiTeli refleqsis~ | | |

|otoskopia da gareTa sasmeni milis |danaxva; mxedvelobis nervis dvrilisa da | | |

|`gamorecxva~; |sisxlZarRvebis mdgomareobis Sefaseba. | | |

|Tvalis gamokvleva da oTalmoskopia;|Sardis buStis kaTeterizaciis Catarebis | | |

|Sardis buStis kaTeterizacia; |Cvenebebisa da ukuCvenebebis codna, | | |

|intravenuri, intramuskuluri da |procedurisaTvis saWiro aRWurvilobis sworad | | |

|kanqveSa inieqcebi; |gamoyeneba da septikisa da antiseptikis wesebis | | |

|periferiuli venebis kaTeterizacia;|dacva, proceduris Catarebis dros sirTuleebisa da| | |

|Wrilobis pirveladi Sefaseba, |maTi Tvidan acilebis gzebis codna, proceduris | | |

|damuSaveba, nakerebis dadeba da |SesaZlo garTulebebis codna. | | |

|moxsna; |venis kaTeterizaciis Cvenebebisa da ukuCvenebis | | |

|nazogastraluri zondis Cadgma; |codna, sainieqco venis SerCeva, manipulaciis | | |

|ginekologiuri saSosmxrivi |etapebis Tanmimdevrobis dacva. | | |

|gasijnva: sarkis Cadgma, |xalSobilis barZayis amovardnilobis gamovlenis | | |

|pap-testis aReba; |meTodebis codna, displaziis sirTulis Sefaseba da| | |

|barZayis displaciis gamovlena; |gamokvlevebis Tanmimdevrobis dasaxva, referalis | | |

|pikfloumetria da glukometria; |Cvenebebis codna. | | |

|sarqvlovani pnevmoToraqsis |nazogastraluri zondis Cadgmis Cvenebebi da | | |

|gadayvana Ria pnevmoToraqsSi |ukeCvenebebis codna, gamosayenebeli zondis | | |

| |momzadeba, misi sigrZis gansazRvra, proceduris | | |

| |SesaZlo garTulebebis codna. | | |

| |inieqcebis Catarebis teqnika; | | |

| |Wrilobis moculobisa da sirTulis Sefaseba, | | |

| |nakerebis dadebisa da moxsnis unar-Cvevebi, | | |

| |Wrilobis daxurvisas SesaZlo garTulebis da maTi | | |

| |Tavidan acilebis unari | | |

|Teoriuli kursis Sinaarsi, moculoba |Sefasebis meTodebi |

|tkivilis marTva – Pain Management – tkivilis marTvis taqtikis SemuSavebis ZiriTadi principebis gansazRvra. |zepiri Sefaseba |

|menejmentis riskfaqtorebi – Risk Management – samedicino sabWoebis federaciis (Federation of State Medical Boards) | |

|gaidlainebis ZiriTadi debulebebis gacnoba kontrolirebadi substanciebis gamoyenebis Sesaxeb. | |

|saerTaSoriso kvlevebi tkivilis Sesaxeb – Pain Research – 2000 – 2010 wlebi gamocxadebuli tkivilis kvlevis dekadis | |

|farglebSi Sesrulebuli kvlevevbis analizi. | |

|tkivilis sazogadoebebi – Pain Societies – amerikis tkivilis medicinis sabWos (American Board of Pain Medicine), evropis | |

|tkivilis sabWoebis saqmianobebis mimoxilva. | |

|uwyveti samedicino ganaTleba – Continuing Medical Education – amerikis tkivilis marTvis akademiis (American Academy of | |

|Pain Management) mier mowodebuli specializirebuli saswavlo kursebebis mimoxilva. | |

|tkivili, rogorc daavadeba – The Disease of Pain. tkivilis medicina – Pain Medicine. |zepiri Sefaseba |

|tkivili rogorc socialuri daavadeba – Pain as a Social Disease – tkivilis programebis da funqcionaluri aRdgenis | |

|programebis multidisciplinuri midgomis safuZvlebi. | |

|biofsiqosocialuri medicina – Biopsychosocial Model biologiuri, fsiqologiuri da socilauri aspeqtebis ganxilva qronikuli | |

|tkivilis CamoyalibebaSi. | |

|paliaturi mzrunveloba – End of LifeCare – ZiriTadi aspeqtebis ganxilva – cxovrebis xarisxis gaumjobeseba, tkivilis |zepiri Sefaseba |

|Semsubuqeba, movlaSi fsiqosocilauri da sulieri aspeqtebis CarTva. | |

|unarSezRuduloba – Disability – socialuri dazRveva unarSezRudulobis gamo, socialuri dazRvevis indeqsi, muSakTa droebiTi da| |

|mudmivi kompensacia da kerZo dazRveva. specialistebTan mimarTva – Specialy Referrals | |

|qronikuli tkivilis mqone pacientebis Sefaseba – Evalution of Chronic Pain Patients – pacientis struqturuli dazianebebis | |

|molekuluri aspeqtebis analizis saSulebiT mkurnalobis gegmis SemuSaveba | |

|tkivilis (periferiuli, centraluri) molekuluri safuZvlebi – Molecular Pain Processes – neirotransmiterebis stimulaciasa da|prezentacia |

|gamoyofis principebi – substancia, glutamati, dofamini, norepinefrini, serotonini, histamini, acetilqolini da nervis | |

|zrdis faqtori (Nerve Growth Factor). | |

|aramedikamentozuri meTodebi – Non Medication Modalites – funqcionaluri aRdgenis programebis (Functional Restoration |zepiri Sefaseba |

|Programs) mimoxilva. | |

|damxmare mkurnaloba – Complementary Treatment – masaJi, akupunqtura, homeopaTia, naturopaTia da moZraobiTi Terapia – | |

|gamoyenebis aspeqtebi. | |

|fsiqosocialuri meTodebi – Psychosocial Modalities -fsiqologiuri Sefasebis, kognitiuri funqciis da socialuri kavSirebis | |

|Seswavlis aspeqtebi. | |

|racionaluri farmakoTerapia – Rational Polypharmacology – qronikuli tkivilis mkurnalobisas gamoyenebuli racionaluri |prezentacia |

|farmakoTerapiis principebi – medikamentebis SerCeva, gverdiTi efeqtebis gaTvaliswinebiT. | |

|medikamentebis moqmedebis principebi – Medications -opioidebi, neiromodulatorebi, antidepresantebi, koqsibebi, alfa-2 | |

|agonistebi, NMDA receptorebis antagonistebi. | |

|invaziuri meTodebi – Invasive Modalities – diagnostikuri da Terapiuli blokadebis, nervebis ablaciis, implantaciis da | |

|qirurgiul Carevebis Cvenebebis ganxilva. | |

|tkivilis saxeebi: |zepiri Sefaseba |

|mwvave tkivilis – Acute Pain – samkurnalod gamoyenebuli safexurebrivi midgomis ganxilva. | |

|qronikuli tkivilis – Chronic Intratable Pain -klasifikaciis sxvadasxva modelebis gacnoba/ganxilva, mkurnalobis sxvadasxva| |

|meTodebis gamoyenebis gzebi. | |

|nociceptiuri tkivilis – Nociceptive Pain -centraluri meqanizmebis modelirebaSi medikamentozuri da aramedikamentozuri | |

|Carevebi. | |

|neiropaTiuri tkivili – Neuropathic Pain – simptomi, daavadeba, gamomwvevi mizezebi, eqtopia, centraluri sensitizacia. | |

|kompleqsuri mkurnalobis meqanizmebis gansazRvris meTodologia. | |

|centraluri tkivili – Central Pain – warmoqmnis meqanizmebi, melzekis (Melzak) Teoria (neiromatricis Sesaxeb). mkurnalobis| |

|taqtika. | |

|nervuli daZabulobiT gamowveuli tkivili – Wind-up Pain – daavadeba Tu simptomi. NMDA receptorebis aqtivaciis roli. | |

|tkivilis saxeebi: areklili tkivili – Referred Pain koncefcia, lokalizaciis wyaroebi. |zepiri Sefaseba |

|ganaxlebadi tkivili – Rebound Pain – warmoqmnis meqanizmebi. informacia samkurnalo preparatebis Terapiuli efeqtisa da | |

|dozis Sesaxeb. | |

|kompleqsuri regionaluri tkivilis sindromi – Complex Regional Pain Syndrome – tipebi 1 da 2, diagnostikur kriteriumebi. | |

|diskis degeneraciuli daavadeba – Degenerative Disc Disease – mwvave da qronikuli formebi, Tanmxlebi procesebi, | |

|mkurnalobis SerCevis diferencirebuli midgomebi. | |

|Sida diskis naxeTqi – Internal Disc Disruption – medikamentozuri da invaziuri procedurebi- mkurnalobis principebi. | |

|tkivilis saxeebi: pulpozuri birTvis Tiaqari – Herniated Nucleus Pulposis – intervertebraluri diskebis Tiaqaris |zepiri Sefaseba |

|konservatiul RonisZiebebis gacnoba. mcireinvaziuri Carevebi. | |

|saxsris arTropaTia – Facet Arthropathy – faceturi arTropaTiT gamowveuli miofasciuri tkivilis sindromi. | |

|spondilolistezi – Spondylolistehesis – etiologia, Tandayolili, yelis (isthmic, isthmian), degenraciuli, travmuli, | |

|paTologiuri da postqirurgiuli formebi. | |

|araqnoiditi – Arachnoiditis – aRwera, warmoqmnis mizezebi, mkurnalobis taqtika. | |

|postherpesuli nevralgia – Post Herpetic Neuralgia – periferiuli da centraluri gavrcelebis meqanizmebi. antivirusuli | |

|preparatebiT, gabapentiniT da opioiduri preparatebiT mkurnalobis meqanizmebi. | |

|tkivilis saxeebi: diabeturi neiropaTia – Diabetic Neuropathy – qvetipebis – Sereuli, simetriuli polineiropaTia, fokaluri/|zepiri Sefaseba |

|multifokaluri neiropaTiebis warmoqmnis meqanizmebi. simptomuri mkurnalobis taqtika. | |

|tkivili aiv infeqciis dros – HIV Pain – aiv infeqciis dros warmoqmnili nocicepturi, visceraluri da neiropaTiuri tkivilis | |

|saxeebis ganxilva. | |

|kancerogenuli tkivili – Cancer Releated Pain – intervenciebTan dakavSirebul mwvave da qronikul tkivilis formebi. tkivilis| |

|kontrolis meqanizmebi. | |

|tkivilis saxeebi: trigeminuli nevralgia – Trigeminal Neuralgia – samwvera nervis nevralgiis (Tic Douloureux) da atipuri |zepiri Sefaseba |

|saxis tkivilisagan (Atypical Facial Pain) ganmasxvavebeli niSnebi. mkurnalobis sqemebi. | |

|Sakiki – migrenozuli tkivili – Migraine Headaches -intrakranialuri an eqstrakranialuri mizeziT warmoqmnili Sakikis | |

|formebi. analgeziuri mkurnalobis taqtika. | |

|kisris an Tavis uecari moZraobiT gamowveuli travma – Whiplash – paTofiziologia, periferiuli nociceptiuri da neiropaTiuri | |

|procesebis ganxilva centralur sensitizaciasTan kombinaciaSi. mkurnalobis taqtika. | |

|tkivilis saxeebi: arTriti – Arthritis – anTebis sawinaaRmdego preparatebiT da opioidebiT mkurnalobis taqtika. |saboloo zepiri Sefaseba |

|fibromialgia – Fibromyallgia – Tanamedrove kvlevebis hipotezebis mimoxilva. | |

|miofascialuri tkivili – Myofascial Pain – botulinis toqsinis inieqcebis gamoyenebis SesaZlobebi. | |

Tavi III. programis II etapi

muxli 19

1. sarezidento programis II etapi moicavs klinikaSi rotaciebis 9 ZiriTad da 2 eleqtiur moduls, sul 11 moduls saerTo xangrZlivobiT 15 Tve:

|# |modulis dasaxeleba |xangrZlivoba |

|ZiriTadi modulebi – 15 Tve |

|1 |kardiologia |1 Tve |

|2 |filtvebis daavadebebi da tuberkulozi |1 Tve |

|3 |endokrinologia |1 Tve |

|4 |infeqciuri sneulebebi |1 Tve |

|5 |gadaudebeli medicina da travma |2 Tve |

|6 |bavSvTa janmrTeloba |3 Tve |

|7 |qalTa janmrTeloba |2 Tve |

|8 |fsiqikuri janmrTeloba |1 Tve |

|9 |narkologia |1 Tve |

|eleqtiuri modulebi – 2 Tve |

|10 |eleqtiuri moduli 1 |1 Tve |

|11 |eleqtiuri moduli 2 |1 Tve |

2. mzadebis II etapis ZiriTad nawils rezidentebi/maZieblebi Sesabamisi profilis saavadmyofoSi an klinikaSi atareben modulze pasuxismgebeli piris – Sesabamis specialobaSi sertificirebuli eqimi-maswavleblis zedamxedvelobiT. periodუlad, sul mcire, TveSi erTxel, rezidenti/maZiebeli xvdeba tutors.

muxli 20.

1. moduli II.1. modulis dasaxeleba, xangrZlivoba –,,kardiologia~, 1 Tve.

2. modulis mizani – kardiologiuri daavadebebis marTvis unar-Cvevebis gamomuSaveba pirvelad jandacvaSi.

3. literaturis nusxa:

a) klinikuri praqtikis erovnuli gaidlainebi Sinagani medicinis sferoSi (tkivili gulmkerdis areSi, stabiluri stenokardia, ST segmentis elevaciiT mimdinare infarqti, arastabiluri stenokardia, gulis ukmarisoba, supraventrikuluri ariTmiebis marTva, arteriuli hipertenzia;

b) diagnostikuri Zieba Sinagan sneulebaTa klinikaSi, giorgi qavTaraZe, 2009, `codna~, Tbilisi, saqarTvelo;

g) lipiduri cvlis darRvevebi Sinagan sneulebaTa klinikaSi, daviT kezeli, maia sulaqveliZe, 2010, Tbilisi;

d) HARRISON’S Manual of Medicine, 16th edition, 2005, The McGraw-Hill Companies, Inc. Medical Publishing Division;

e) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

v) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

z) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins;

T) Greenspan's Basic & Clinical Endocrinology, David G. Gardner et al. 8th edition, (Lange Endocrinology), 2007; The McGraw-Hill Companies, Inc.;

i) Williams Hematology. 7th edition, Marshall A. Lichtman et al. 2007; The McGraw-Hill Companies, Inc.;

k) Current Rheumatology, 2nd edition, John B. Imboden et al. 2007; The McGraw-Hill Companies, Inc.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis |Sefasebis meTodebi |

| | |raodenoba | |

|arteriuli hipertenzia; |detaluri anamnezis Segrovebis unar-Cveva |gatarebuli pacientebi |Sesrulebuli samuSao dReebi; |

|gulis iSemiuri (koronaruli) daavadeba (stenokardia,|gulsisxlZarRvTa sistemis paTologiis dros;|raodenoba – 10; |morigeobebi; |

|mwvave koronaruli sindromi, gulis gaCereba – |detaluri fizikuri gasinjvis unar-Cveva |morigeoba – 4; |gatarebuli pacientebi; |

|`cardiac arrest~); |gulsisxlZarRvTa sistemis paTologiis dros;|samedicino Canawerebi – 30; |modulze pasuxismgebeli piris |

|gulis ukmarisoba; |instr. kvlevis Sedegebis interpretacia: |ekg gadaReba da interpretacia |Sefaseba; |

|ariTmia (eqstrasistolia, winagulebis cimcimi da |ekg, 24-saaTiani ekg; arteriuli wnevis |– 30; |tutoris Sefaseba ukukavSiris sesiis|

|TrTolva, viwro da farTokompleqsovani taqikardiebi, |ambulatoriuli monitorireba; |iv punqcia da/an kaTeterizacia|dros |

|bradiariTmiebi); |mimoxilviTi rentgenografia; da sxv. |– 20; | |

|gulis sxva daavadebebi (sarqvlovani paTologia, |lab. kvlevis Sedegebis interpretacia |iv infuzia – 10 | |

|miokardiumis da endokardiumis daavadebebi, | | | |

|Tandayolili anomaliebi); | | | |

|periferiuli sisxlZarRvebis daavadebebi (arteriebis | | | |

|da venebis); | | | |

|cerebrovaskuluri daavadebebi (insulti da | | | |

|gardamavali/tranzitoruli iSemiuri Seteva); | | | |

|Tromboemboliuri daavadeba | | | |

muxli 21

1. moduli II.2. modulis dasaxeleba, xangrZlivoba – `filtvebis daavadebebi da tubekulozi~, 1 Tve.

2. modulis mizani – filtvebis gavrcelebuli daavadebebisa da tuberkulozis marTvis unar-Cvevebs gamomuSaveba.

3. literaturis nusxa:

a) Treatment of Tuberculosis: Guidelines, 4th edition; 2009; WHO;

b) Guidelines for Programmatic Management of drug-resistant Tuberculosis; 2008; WHO

g) rezistentuli tuberkulozis gaidlaini; 2007; saqarTvelo;

d) International Standarts for Tuberculosis Care; 2006; WHO;

e) „tuberkulozis marTvis saerTaSoriso standartebi”; 2008; Targmani;

v) „Management of Tuberculosis; A Guide to the Essentials of Good Practice" Sixth edition; 2010; UNION;

z) „tomanis tuberkulozi – SemTxvevaTa gamovlena, mkurnaloba, monitoringi; 2005; Targmani;

T) „tuberkulozi – saxelmZRvanelo pirveladi jandacvis muSakebisaTvis”, 2003;

i) „tuberkulozi – saxelmZRvanelo samedicino institutis studentebisaTvis’’;

k) diagnostikuri Zieba Sinagan sneulebaTa klinikaSi, giorgi qavTaraZe, 2009, `codna~, Tbilisi, saqarTvelo;

l) HARRISON’S Manual of Medicine, 16th edition, 2005, The McGraw-Hill Companies, Inc. Medical Publishing Division;

m) Current Medical Diagnosis & Treatment 2013, Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

n) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

o) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba|Sefasebis meTodebi |

|zeda da qveda sasunTqi gzebis |sunTqvis sistemis fizikuri fizikuri |sunTqvis sistemis fizikuri gasinjva |Sesrulebuli samuSao dReebi; |

|infeqciebi, |gamokvleva; |– 30; maT Soris, tuberkulozze saeWvo|morigeobebi; |

|mwvave arainfeqciuri respiratoruli |pikfloumetria; |niSnebis arsebobisas – 15; |gatarebuli pacientebi; |

|problemebi, |inhalatoris gamoyeneba da swavleba |samedicino Canawerebis warmoeba – |modulze pasuxismgebeli piris |

|qronikuli arainfeqciuri respiratoruli |sxvebisTvis; |30; |Sefaseba; |

|problemebi, |spirometris gamoyeneba da misi Sedegebis|naxvelis Segroveba – 10 |tutoris Sefaseba ukukavSiris |

|filtvis kibo. |interpretacia. | |sesiis dros |

|tuberkulozis epidemiologia |tuberkulozze saeWvo pacientis fizikuri | | |

|tuberkulozTan brolis Tanamedrove |gamokvleva; | | |

|strategiis principebi; |naxvelis Segrovebis procedurebi; | | |

|tuberkulozis gadacemis gzebi, |drouli referali tubsawinaaRmdego qselSi;| | |

|daavadebis risk-faqtorebi; |TanamSromloba zemoaRniSnl qselTan | | |

|tuberkulozze eWvmitanili pacientis | | | |

|amocnoba da drouli mimarTva | | | |

|tubsawinaaRmdego qselSi; | | | |

|diagnostikis Tanamedrove meTodebi; | | | |

|konsultaciaze mosul pacientebSi | | | |

|tuberkulozze saeWvo niSnebis amocnoba; | | | |

|filtvgareSe tuberkulozis diagnostikis | | | |

|meTodebi; | | | |

|tuberkulozis stacionaruli da | | | |

|ambulatoriuli mkurnalobis meTodebi. | | | |

muxli 22

1. moduli II.3. modulis dasaxeleba, xangrZlivoba – `endokrinologia~, 1 Tve.

2. modulis mizani – endokrinologiuri daavadebebis marTvis unar-Cvevebs gamomuSaveba pirvelad jandacvaSi;

3. literaturis nusxa:

a) klinikuri praqtikis erovnuli gaidlainebi endokrinuli paTologiis sakiTxebze: Saqriani diabeti, hipoTireozi, metaboluri sindromi, osteoporozi, simsuqne bavSvebSi, simsuqne mozrdilebSi, dislipidemia;

b) diagnostikuri Zieba Sinagan sneulebaTa klinikaSi, giorgi qavTaraZe, 2009, `codna~, Tbilisi, saqarTvelo;

g) lipiduri cvlis darRvevebi Sinagan sneulebaTa klinikaSi, daviT kezeli, maia sulaqveliZe, 2010, Tbilisi;

d) Greenspan's Basic & Clinical Endocrinology, David G. Gardner et al. 8th edition, (Lange Endocrinology), 2007; The McGraw-Hill Companies, Inc;

e) HARRISON’S Manual of Medicine, 16th edition, 2005, The McGraw-Hill Companies, Inc. Medical Publishing Division;

v) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc;

z) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

T) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis |Sefasebis meTodebi |

| | |raodenoba | |

|simsuqne; |detaluri anamnezis Segrovebis unar-Cveva |gatarebuli pacientebi |Sesrulebuli samuSao dReebi; |

|diabeti; |endokrinuli paTologiis dros; |raodenoba – 10; |morigeobebi; |

|glukozisadmi tolerantulobis darRveva; |detaluri fizikuri gasinjvis unar-Cveva endokrinuli|samedicino Canawerebi – 30; |gatarebuli pacientebi; |

|hipoTireozi; |paTologiis dros; |glukozis eqspres-testi – 20 |modulze pasuxismgebeli piris |

|hiperTireozi; |instr. kvlevis Sedegebis interpretacia: | |Sefaseba; |

|hiperlipidemia; |lab. kvlevis Sedegebis interpretacia | |tutoris Sefaseba ukukavSiris sesiis|

|hiperurikemia; | | |dros |

|hipofizis, Trikmelzeda jirkvlis da | | | |

|farsiebraxlo jirkvlis dazianebebis | | | |

|drouli amocnoba da referali | | | |

muxli 23

1. moduli II.4 modulis dasaxeleba, xangrZlivoba – `infeqciuri sneulebebi~, 1 Tve.

2. modulis mizani – infeqciuri daavadebebis marTvis unar-Cvevebis gamomuSaveba pirvelad jandacvaSi.

3. literaturis nusxa:

a) klinikuri praqtikis erovnuli gaidlainebi infeqciuri sneulebebis sakiTxebze;

b) diagnostikuri Zieba Sinagan sneulebaTa klinikaSi, giorgi qavTaraZe, 2009, `codna~, Tbilisi, saqarTvelo;

g) HARRISON’S Manual of Medicine, 16th edition, 2005, The McGraw-Hill Companies, Inc. Medical Publishing Division;

d) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

e) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

v) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis |Sefasebis meTodebi |

| | |raodenoba | |

|gastroenteriti; |detaluri anamnezis Segrovebis unar-Cveva |gatarebuli pacientebi raodenoba – |Sesrulebuli samuSao dReebi; |

|virusuli hepatitebi; |infeqciuri daavadebebis dros; |10; |morigeobebi; |

|aiv infeqcia/Sidsi; |detaluri fizikuri gasinjvis unar-Cveva |morigeoba – 4; |gatarebuli pacientebi; |

|cns-is infeqciuri da anTebiTi daavadebebi, |infeqciuri daavadebebis dros; |samedicino Canawerebi – 30; |modulze pasuxismgebeli piris |

|meningitis CaTvliT; |instr. kvlevis Sedegebis interpretacia: |iv punqcia da/an kaTeterizacia – |Sefaseba; |

|mwvave infeqciebiT gamowveuli |lab. kvlevis Sedegebis interpretacia |20; |tutoris Sefaseba ukukavSiris sesiis |

|mdgomareobebi, romlebic gadaudebl | |iv infuzia – 15 |dros |

|daxmarebas saWiroeben | | | |

M

muxli 24

1. moduli II.5. modulis dasaxeleba, xangrZlivoba – `gadaudebeli medicina~, 2 Tve.

2. modulis mizani – modulis mizania rezidentma/maZiebelma gamoimuSaos gadaudebeli mdgomareobebis, maT Soris travmis, amocnobis, Sefasebisa da marTvis Cvevebi prehospitalur etapze; agreTve, aiTvisos gadaudebeli mdgomareobebis prevenciis efeqturi meTodebi.

3. literaturis nusxa:

a) klinikuri praqtikis erovnuli gaidlainebi: gulmkerdSi tkivilis marTva zogad saeqimo praqtikaSi, gavrcelebuli gadaudebeli mdgomareobebis marTva zogad saeqimo praqtikaSi, miokardiumis infarqti ST elevaciiT, miokardiumis infarqti ST-segmentis elevaciis gareSe /arastabiluri stenokardia; axalSobilTa pirveladi reanimacia, gavrcelebuli gadaudebeli mdgomareobebis marTva zogadsaeqimo praqtikaSi da sxva klinikuri praqtikis gaidlainebi, romlebic moicaven gadaudebeli mdgomareobebis marTvas;

b) Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004Jones R, Britten N, Culpepper L, Gass DA, Grol R, Mant D, Silagy C (eds);

g) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc;

d) Washington Manual(TM) of Medical Therapeutics, The, 32nd Edition, Editors: Cooper, Daniel H.; Krainik, Andrew J.; Lubner, Sam J.; Reno, Hilary E. L.; 2007, Department of Medicine, Washington University School of Medicine. Published by Lippincott Williams & Wilkins.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

| | |gatarebuli pacientebi – 50; |Sesrulebuli samuSao dReebi; |

|sicocxlisaTvis saSiSi mdgomareobebi; |sicocxlisaTvis saSiSi mdgomareobebis |kardiopulmonuri reanimacia – 1-5; |morigeobebi; |

|kardiopulmonuri reanimaciis principebi; |amocnoba; |defibrilacia – 1-5; |gatarebuli pacientebi; |

|travmis marTva principebi; |ZiriTadi sasicocxlo funqciebis |tramvis mqone pacientis Sefaseba – 5; |modulze pasuxismgebeli piris |

|nevrologiuri gadaudebeli daxmareba |SenarCunebis da kardiopulmonuri |ekg – 15; |Sefaseba; |

|fsiqiatriuli gadaudebeli daxmareba |reanimaciis teqnika (1 da 2 piris |adgilobrivi anesTezia – 5; |tutoris Sefaseba ukukavSiris |

|garemos faqtorebTan dakavSirebuli |mier); |periferiuli venis kaTeterizacia – 20; |sesiis dros |

|darRvevebi |defibrilacia; |cxviridan sisxldenis SeCereba – 1-5; | |

|toqsikologiuri gadaudebeli daxmareba |travmis mqone pacientis Sefaseba: |nazogastraluri zondireba da lavaJi – | |

|sameano-ginekologiuri gadaudebeli daxmareba|pirveladi da meoreuli Sefaseba, |5; | |

|Zaladobis msxverpli |dazianebis meqnizmis gansazRvra: |Sardis buStis kaTeterizacia – 5-10; | |

|mwvave sicocxlisTvis saSiSi mdgomaareobis |sadiagnozo gamokvlevebi: ekg, |xerxemlis da Zvlebis pirveladi | |

|identificireba da menejmenti: mwvave |radiologiuri kvleva; |imobilizacia – 5-10 | |

|respiratoruli daavadebebi, gul-sisxlZarRvTa|adgilobrivi anesTezia; | | |

|mwvave daavadebebi, saswrafo toqsikologiuri|periferiuli venebis kaTeterizacia; | | |

|daxmareba, masobrivi katastrofa, metaboluri|centraluri venebis kaTeterizacia da | | |

|daavadebebi/ mJava-tutovani wonasworoba, |venaseqcia | | |

|Soki (hipovolemiuri, neirogenuli, |cxviridan sisxldenis SeCereba (wina da | | |

|kardiogenuri, septikuri), gadaudebeli |ukana tamponada) | | |

|daxmareba mwvave infeqciebis dros |nazogastraluri zondireba da lavaJi | | |

|sadiagnozo gamokvlevebi gadaudebeli |Sardis buStis kaTeterizacia | | |

|mdgomareobebis dros; |xerxemlis pirveladi imobilizacia | | |

|samrTlebrivi sakiTxebi; |motexi-lobis an amovardnilobis | | |

|urgentuli mdgomareobebis prevencia |pirveladi imobilizacia; | | |

| |infuziuri Terapia; | | |

| |masobrivi katastro-febis dros | | |

| |daSave-bulTa `triaJi~; erTdorulad | | |

| |ramdenime pacientis marTva; | | |

| |gardacvlili pacientis axlobelTan | | |

| |urTierToba kritikul incidentTan | | |

| |dakavSirebuli stresis marTva | | |

muxli 25

1. moduli II.6. modulis dasaxeleba, xangrZlivoba – `bavSvTa janmrTeloba~, 3 Tve.

2. modulis mizani – modulis mizania rezidentma gamoimuSaos bavSvTa janmrTelobis problemebis marTvis unari (ganviTarebis Sefaseba, daavadebaTa prevencia, janmrTelobis mwvave da qronikuli problemebis marTva), bavSvis ganviTarebis yvela etapze;

3. literaturis nusxa: klinikuri praqtikis erovnuli rekomendaciebi (gaidlainebi):

a) ZuZuTi kvebis marTva samSobiaro saxlSi adreul neonatalur periodSi, klinikuri praqtikis erovnuli rekomendacia;

b) simxuqnis marTva bavSvTa asakSi pirvelad jandacvaSi, klinikuri praqtikis erovnuli rekomendacia;

g) enurezis marTva pirvelad jandacvaSi, klinikuri praqtikis erovnuli rekomendacia;

d) adreuli asakis bavSvTa fizikuri ganviTareba, klinikuri praqtikis erovnuli rekomendacia;

e) mSoblis konsultireba bavSvis movlis sakiTxebze, klinikuri praqtikis erovnuli rekomendacia;

v) 2 wlamde asakis bavSvis kveba, klinikuri praqtikis nacionaluri rekomendacia;

z) bavSvis janmrTelobaze zedamxedvelobis ZiriTadi principebi, klinikuri praqtikis erovnuli rekomendacia;

T) raqitis diagnostika, marTva da prevencia, klinikuri praqtikis erovnuli rekomendacia;

i) saSarde gzebis infeqcia bavSvebSi, klinikuri praqtikis erovnuli rekomendacia;

k) axalSobilTa respiraciuli distres-sindromi, klinikuri prაqtikis erovnuli rekomendacia;

l) axalSobilTa hipoTermia, axalSobilTa hiperbilirubinemia, klinikuri preqtikis erovnuli rekomendacia;

m) hipokalcemiis diagnostika, marTva da prevencia, klinikuri praqtikis erovnuli rekomendacia;

n) Bannon M, Carter Y (Eds). Protecting Children from Abuse and Neglect in Primary Care Oxford: Oxford;

o) University Press, 2003;

p) British Medical Association, Royal Pharmaceutical Society of Great Britain, Royal College of Paediatrics;

J) and Child Health, The Neonatal and Paediatric Pharmacists Group BNF for Children London: BMA, 2005;

r) Chambers R Licence K, Looking after children in primary care Oxford: Radcliffe Medical Press, 2004;

s) Cohen BA Paediatric Dermatology London: Elsevier Mosby, 2005;

t) Donovan C, Suckling H Difficult Consultations with Adolescents Oxford: Radcliffe Medical Press, 2004;

u) Harndon A Sheikh A (Eds) Promoting Child Health in Primary Care London: RCGP, 2002;

f) Hall D, Elliman D. Health for All Children (4th Ed) Oxford: Oxford University Press, 2003;

q) Jones R, Britten N, Culpepper L, Gass DA, Grol R, Mant D, Silagy C (eds). Oxford Textbook of Primary;

R) Medical Care Oxford: Oxford University Press, 2004;

y) Keeley D Cot Death London: RCGP, 1995;

S) Lissauer T, Clayden G Illustrated Textbook of Paediatrics (2nd Ed) London: Mosby, 2001;

C) McPherson A, Donovan C, McFarlane A Healthcare of Young People: Promotion in Primary Care Oxford: Radcliffe Medical Press, 2002;

c) Valman HB ABC of the first year London: BMJ Books, 2001;

Z) Valman HB ABC of One to Seven London: BMJ Books, 2002;

w) Viner R (Ed) ABC of Adolescence London: BMJ Books, 2002.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis |Sefasebis meTodebi |

| | |raodenoba | |

|janmrTeli bavSvis ganviTarebis ZiriTadi |bavSvis globaluri ganviTarebis Sefaseba; |imunizacia; |Sesrulebuli samuSao dReebi; |

|aspeqtebi; |bavSvis jansaRi kvlebis Sesaxeb mSoblebis |konsulta-ciis Cvevebi; |morigeobebi; |

|imunizaciis nacionaluri kalendari; |konkultireba; |bavSvis ganviTarebis |gatarebuli pacientebi; |

|bavSvTa asakis gavrcelebuli daavadebebis|ZuZuTi kvlebis sirTuleebis SemTxvevaSi |Sefaseba-ganviTarebis testebis |modulze pasuxismgebeli piris |

|da problemebis marTvis strategia da |mSoblisTvis daxmarebis aRmoCena; |gamoyeneba |Sefaseba; |

|saSiSroebis niSnebi |saSiSroebis niSnebis Sefaseba, mSoblebisaTvis | |tutoris Sefaseba ukukavSiris sesiis |

| |ganviTarebis xelSemწyobi rCevebis micema; | |dros |

| |bavSvTa asakis gavrcelebuli daavadebebis | | |

| |marTva, saSiSroebis niSnebis amocnoba; | | |

| |imunizaciis nacionaluri kalendris mixedviT | | |

| |vaqcinaciis Catareba | | |

muxli 26

1. moduli II.7. modulis dasaxeleba, xangrZlivoba – `qalTa janmrTeloba~, 2 Tve.

2. modulis mizani – modulis mizania rezidentma/maZiebelma gamoimuSaos qalTa janmrTelobis problemebis marTvis unari, normaluri orsulobis warmarTvis da sqesobrivad gadamdebi daavadebebis amocnobisa da marTvis CaTvliT.

3. literaturis nusxa: klinikuri praqtikis erovnuli rekomendaciebi (gaidlainebi):

ა) antenataluri meTvalyureoba fiziologiurad mimdinare orsulobis dros;

ბ) fiziologiuri mSobiarobis marTva;

გ) antenataluri meTvalyureoba;

d) preeklamfsia/eklamfsiis marTva;

ე) naadrevi mSobiarobis prevencia da marTva;

v) saSvilosnosgare orsuloba;

ზ) ojaxis dagegmva;

T) saSvilosnos yelis paTologiaTa citologiuri diagnostika papanikolaus meTodiT;

i) PAP-testis safuZvelze dafuZnebuli saSvilosnos yelis kibos skriningi da diagnostika;

k) ZuZuTi kvebis marTva samSobiaro saxlSi adreulneonatalur periodSi;

l) venuri Tromboemboliis prevencia da mkurnaloba;

m) Tromboembolizmis prevencia antenatalurad da mSobiarobis Semdgom periodSi;

n) mSobiarobis Semdgomi cxelebis marTva;

o) sqesobrivi gziT gadamdebi daavadebebis marTva zogadsaeqimo praqtikaSi;

p) Chlamydia Trachomatis-iT gamowveuli ginekologiuri infeqciebis marTva pirvelad jandacvaSi.

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|fiziologiurad mimdinare orsulobis |orsulobis riskis Sefaseba, fiziologiurad |ginekologiuri gasinjva: sarkis Cadgma,|Sesrulebuli samuSao dReebi; |

|ZiriTadi aspeqtebi; |mimdinare orsulobis dros; |nacxis aReba – 30; |morigeobebi; |

|nayofis da dedis janmrTelobis |antenataluri meTvalyureobis ganxorcieleba;|mcire menjis bimanualuri palpacia – |gatarebuli pacientebi; |

|Sefasebis meTodebi; |orsuli qalis konsultireba cxovrebis |50; |modulze pasuxismgebeli piris |

|orsulobis, mSobiarobisa da |jansaRi wesis Sesaxeb; |konsultaciis |Sefaseba; |

|postnataluri periodis gavrcelebuli|informaciis miwodeba orsulobisa da |Cvevebi – 100; |tutoris Sefaseba ukukavSiris |

|problemebis marTvis gzebi; |mSobiarobis periodze; |sarZeve jirkvlebis gasinjva – 50; |sesiis dros |

|ojaxis dagegmvis meTodebi; |orsulobis dros rutinuli skrining testebis |pap-nacxis aReba – 30 | |

|klimaqteruli periodis marTva; |Catareba da interpretacia; | | |

|sarZeve jikvlis gavrcelebuli |qalis konsultireba ojaxis dagegmvis | | |

|problemebis Sefasebisa da marTvis |sakiTxebze; | | |

|meTodebi; |pacientisaTvis misaRebi kontraceptivis | | |

|prevenciis meTodebi, sqesobrivi |SerCeva, gavrcelebuli ginekologiuri | | |

|gziT gadamdebi daavadebebis |problemebis marTva da drouli referali | | |

|diagnostika da marTva; |saWiroebis SemTxvevaSi; | | |

|ginekologTan, onkologTan da |sqesobrivi gziT gadamdebi daavadebebis | | |

|qirurgTan referalis kriteriumebi. |diagnostika da analizebis interpretacia, | | |

|orsulobisa da ginekologiuri |infeqciis marTva da, saWiroebisas, drouli | | |

|problemebis dros sagangaSo |referali ganxorcieleba; | | |

|niSnebis codna da drouli |orsulobisa da ginekologiuri problemebis | | |

|reagirebis gzebi |dros sagangaSo niSnebis identificireba da | | |

| |drouli reagirebis ganxorcieleba. | | |

| |asakis mixedviT individualuri skrining | | |

| |gegmis miwodeba saSvilosnos yelis kibos da| | |

| |sarZeve jirkvlis kibos adreul etapze | | |

| |gamosavlenad; | | |

| |mamografiisa da pap-nacxis Sedegebis | | |

| |interpretacia | | |

muxli 27

1. moduli 2.8. modulis dasaxeleba, xangrZlivoba – `fsiqikuri janmrTeloba~, 1 Tve.

2. modulis mizani – modulis mizania rezidentma gamoimuSaos fsiqikuri janmrTelobis Sefasebis, fsiqikuri janmrTelobis sferoSi aRmocenebuli problemebis droulad amocnobis da pirveladi Sefasebis, drouli da adekvaturi mimarTvis da fsiqikuri daavadebebis xangrZlivi marTvis Cvevebi fsiqiatrTan mWidro TanamSromlobis gziT.

3. literaturis nusxa:

a) klinikuri praqtikis erovnuli gaidlaini obsesiur-kompulsiuri aSliloba;

b) klinikuri praqtikis erovnuli gaidlaini panikuri aSliloba;

g) klinikuri praqtikis erovnuli gaidlaini guneba-ganwyobis (afeqturi) aSliloba;

d) `fsiqikur daavadebaTa diagnostika~, T. silagaZe, l. menTeSaSvili, 2010w.;

e) `fsiqiatriis mokle kursi~, g.naneiSvili, 2006;

v) The treatment of common mental health problems in general practice, Family Practice 2006; 23: 53–59;

z) Journal: Mental Health in Family Medicine (WONCA).

4. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis |Sefasebis meTodebi |

| | |raodenoba | |

|normuli fsiqosocialuri ganviTareba cxovrebis ciklis |arafsiqiatriuli aSlilobis emociuri |stacionarSi myofi pacientebi –|Sesrulebuli samuSao dReebi; |

|ganmavlobaSi, misi variantebi da gadaxrebi; |aspeqtebis marTva; |20; |morigeobebi; |

|biologiuri, fsiqologiuri da socialuri faqtorebis |fsiqiatriu-li gadaudebeli daxmarebis|ambula-toriuli pacientebi – |gatare-buli pacientebi; |

|urTierTkavSiri; |pirveladi organizeba (suiciduri |40. |modulze pasuxismgebeli piris |

|mwvave da qronikuli daavadebebis gavlena pacientze da |pacienti, mwvave fsiqikuri aSlilobis| |Sefaseba; |

|mis ojaxze; |mqone pacienti); | |tutoris Sefaseba ukukavSiris |

|faqtorebi, romlebic zegavlenas axdenen mkurnalobis |fsiqofarma-kologiuri mkurnalobis | |sesiis dros |

|gegmis Sesrulebaze; |monitoringi, gverdiTi efeqtebi, | | |

|ojaxis funqiebi da zogadi interaqtiuli modeli stresTan |wamalTa urTierTqmedeba; | | |

|gamklavebisas; |ojaxTan TanamSromloba, ojaxis | | |

|piradi damokidebulebebisa da faseulobebis Secnoba, rac |Tanadgomis uzrunvelyofa; | | |

|zegavlenas axdens eqimis moqmedebis efeqturobaze da |sazogadoebrivi resursebis | | |

|eqimiT kmayofilebaze; |gamoyeneba; | | |

|eqimze zemoqmedi stresuli faqtorebi da maTi efeqtis |rCevis micema krizisis SemTxvevaSi; | | |

|Tavidan acilebis gzebi; |referalis saWiroebis gansazRvra da | | |

|eTikuri sakiTxebi samedicino praqtikaSi, informirebuli |referalis organizeba fsiqiatrTan, | | |

|Tanxmobis, pacientis avtonomiis, konfidencialurobisa da|TanamSromloba fsiqiatrTan pacientis | | |

|sicocxlis xarisxTan dakavSirebuli sakiTxebis CaTvliT. |qr. problemebis marTvaSi | | |

|pirvelad gamovlinebuli fsiqikuri aSliloba Cvilebs, | | | |

|bavSvebsa da mozardebs Soris; | | | |

|aSlilobebi, romelTa arsebobaze eWvis mitana, pirveladi | | | |

|Sefaseba, referalis organizeba da fsiqiatrTan erTad | | | |

|marTva unda SeeZlos ojaxis eqims: deliriumi, demencia, | | | |

|amnezia da cnobierebis sxva darRvevebi, Sizofrenia da | | | |

|sxva fsiqikuri aSlilobebi, guneba-ganwyobis aSla, | | | |

|SfoTva, somatoformuli aSlilobebi, disociaciuri | | | |

|aSliloba, seqsualuri da sqesobrivi identurobis | | | |

|aSliloba, impulsis kontrolis darRveva, garemosTan | | | |

|Seguebis aSliloba, personalurobis darRveva, Zaladobasa | | | |

|da gulgrilobasTan dakavSirebuli problemebi, kvebasTan | | | |

|dakavSirebuli aSlilobebi, Zilis darRveva | | | |

muxli 28

1. moduli II.9. modulis dasaxeleba, xangrZlivoba – `narkologia~, 1 Tve.

2. modulis mizani – modulis mizania gaacnos pirveladi jandacvis sferoSi momuSave eqimebs (ojaxis eqimebsa da Terapevtebs) narkologiis ZiriTadi aspeqtebi, fsiqoaqtiuri nivTierebebis mavned moxmarebisa da damokidebulebis diagnostirebis meTodebi (skriningi), wamaldamokidebulebis prevenciuli RonisZiebebi, mkurnalobisa da menejmentis mTavari principebi. moduli emsaxureba agreTve, TanamSromlobis gzebis dasaxvas pirveladi jandacvis sferos muSakebsa da narkologiur samsaxurebs Soris.

3. modulis gavlis Sedegad ojaxis eqimma unda icodes:

a) narkologiaSi xmarebuli ZiriTadi terminologiis ganmartebebi;

b) wamaldamokidebulebis skriningis meTodebi, romlebic gamoiyeneba pirveladi jandacvis sferoSi;

g) narkologiuri daavadebebis ZiriTadi Taviseburebebi;

d) fsiqoaqtiur nivTierebebze (alkoholi, Tambaqo, opioidebi, stimulatorebi da sxv.) damokidebulebis formireba da klinikuri mimdinareoba;

e) wamaldamokidebulebis menejmentis ZiriTadi aspeqtebi da kerZod, daavadebaTa marTvis Taviseburebebi ojaxis eqimis doneze.

4. modulis gavlis Sedegad ojaxis eqims unda SeeZlos:

a) fsiqoaqtiuri nivTierebebis arasworad moxmarebisa (saxifaTo moxmareba, mavned moxmareba) da nivTierebebze damokidebulebis diagnostireba;

b) wamaldamokidebulebis profilaqtika pirveladi jandacvis doneze;

g) alkoholizmisa da Tambaqoze damokidebulebis menejmenti pirveladi jandacvis doneze.

5. literaturis nusxa:

a) klinikuri praqtikis erovnuli rekomendacia (gaidlaini) `alkoholuri damokidebulebis marTva pirvelad jandacvaSi~. damtkicebulia saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros mier 2009 wlis 30 dekembers;

b) klinikuri praqtikis erovnuli rekomendacia (gaidlaini) `Tambaqos wevis mitoveba da prevencia~. damtkicebulia saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros mier 2009 wlis 30 dekembers;

g) `opioideuri damokidebulebis fsiqosocialur daxmarebasTan kombinirebuli farmakologiuri mkurnalobis saxelmZRvanelo~. jandacvis msoflio organizacia. saqarTvelos narkologiis s/k instituti. gamomcemloba „nekeri”. 2009 weli;

d) national clinical guideline; Scottish Intercollegiate Guidelines Network. The management of harmful drinking and alcohol dependence in primary care.; first published 2003; Update to printed guideline 7Dec 2004; http://www.sign.ac.uk/pdf/sign74.pdf;

e) Denise Ernst, William R. Miller, Stephen Rollnick. Treating substance abuse in primary care: a demonstration project. International Journal of Integrated Care – Vol. 7, 10 October 2007 – ISSN 1568-4156 – http://www.ijic.org/ Projects and Development;.

v) Berks J, McCormick R Screening for alcohol misuse in elderly primary care patients: a systematic literature review. Int Psychogeriatr 2008 Dec;20(6):1090-103. Epub 2008 Jun 9

z) Data collection and analysis. Effectiveness of brief alcohol interventions in primary care populations (Review) 1 Copyright © 2009 The Cochrane Collaboration;

T) Database of Abstracts of Reviews of Effects-DARE Produced by the Centre for Reviews and Dissemination-CRD. Anders Beich, Thorkil Thorsen, Stephen Rollnick Screening in brief intervention trials targeting excessive drinkers in general practice: systematic review and meta-analysis. Database entry date 9 August 2008. Copyright©2008 University of York;

i) Screening, diagnosis and referral for substance use disorders. © 1998-2008 National Guideline Clearinghouse Date Modified: 11/3/2008. BIBLIOGRAPHIC SOURCE(S): Michigan Quality Improvement Consortium. Screening, diagnosis and referral for substance use disorders. Southfield (MI): Michigan Quality Improvement Consortium; 2007 Aug. 1 p;

k) Adam O. Goldstein, Robert E. Gwyther, Carol E. Ripley-Moffit. 2007- Essentials of Family Medicine. Fifth Edition Psychiatric Problems and Substance Abuse Chapter 46. Addictions http://thepointeedition.lww.com/pt/re/9780781781886/bookContentPane_frame.01273257...

l) A View From the Front Lines. Motivating Patients (and Providers) – What Makes a Difference? Ken Saffier, MD Contra Costa Regional Medical Center. California Academy of Family Physicians. Primary Care and the Chemically Dependent Patient. April 14, 2005. PowerPoint Presentation;

m) Behavioral Counseling Interventions in Primary Care to Reduce Risky/Harmful Alcohol Use by Adults: A Summary of the Evidence for the U.S. Preventive Services Task Force. Evelyn P. Whitlock, MD, MPH; Michael R. Polen, MA; Carla A. Green, PhD, MPH; C. Tracy Orleans, PhD; Jonathan Klein, MD, MPH; Ann Intern Med. 2004;140:558–569;

n) Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar). http://images2.clinicaltools.com/images/pdf/ciwa-ar.pdf;

o) Current Medical Diagnosi&Treatment 2007-12-08 is the 46th annual volume. substance Use Disorders. From-SMTD-2007;

p) EFNS guideline on the diagnosis and management of alcohol-related seizures: report of an EFNS task force; European Journal of Neurology 2005, 12: 575-581; (http://www.efns.org);

J) Family Practice Exam&Board Review. Chapter 26. Substance Abuse. pp 833-854. www.samhsa.gov;

r) Guideline for Physicians Working in California Opioid Treatment Programs. Editor: Deborah K. Stephenson, MD, MPH for the CSAM Committee on Treatment of Opioid Dependence. © 2005 CSAM.Adopted April 4, 2005 by the Executive Council of the California Society of Addiction Medicine www.csam-asam.org;

s) Introduction to Addiction. Sean Koon, MD. California Academy of Family Physicians And California Society of Addiction Medicine. April 14, 2005. PowerPoint Presentation;

t) Kosten TR et al: Management of drug and alcohol withdrawal. N Engl J Med 2003;348:1786. [PMID:12724485];

u) Management of alcohol withdrawal delirium. An evidence-based practice guideline. Mayo-Smith MF- Arch Intern Med- 12-Jul-2004; 164(13):1405-12. The information was verified by the guideline developer on May 20, 2005;

f) PRACTICE GUIDELINE FOR THE Treatment of Patients With Substance Use Disorders. Second Edition. This practice guideline was approved in December 2005 and published in August 2006. AMERICAN PSYCHIATRIC ASSOCIATION STEERING COMMITTEE ON PRACTICE GUIDELINES. pp 276. http://www.psych.org/psych_pract/pg/reviewform.cfm;

q) Rigotti NA: Treatment of tobacco use and dependence. N Engl J Med 2002;346:506 [PMID: 12088292];

R) Substance Use Disorders.From Screening to Brief Intervention. Maureen Strohm, M.D. Director, USC/California Hospital Family Medicine Residency; PowerPoint Presentation;

y) The management of harmful drinking and alcohol dependence in primary care. Scottish Intercollegiate Guidelines Network, September 2003; (www.sign.ac.uk);

S) TREATING SUBSTANCE USE DISORDERS. A Quick Reference Guide. American Psychiatric Association. Steering Committee on Practice Guidelines. Based on Practice Guideline for the Treatment of Patients With Substance Use Disorders, Second Edition, originally published in August 2006.pp.48. www.psych.org;

C) Thomas F. Babor; John C. Higgins-Biddle; John B. Saunders; Maristela G. Monteiro. The Alcohol Use Disorders Identification Test. Guidelines for Use in Primary Care.S e c o n d E d i t i o n.pp. 41. © World Health Organization 2001.www.health.org;

c) 10. The Role of Biomarkers in the Treatment of Alcohol Use Disorders. Substance Abuse Treatmen ADVISORY. News for the Treatment Field. September 2006. Volume 5. Issue 4. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment. www.samhsa.gov;

Z) Treatment of Alcoholism and Addiction. Steven R. Ey, M.D. Medical Director Genesis Chemical Dependency Unit. South Coast Medical Center. Laguna Beach, CA. April 14, 2005. PowerPoint Presentation.

w) US Preventive Services task Force. Screening and Behavioral Counseling Interventions in Primary Care to Reduce alcohol misuse: recommendation statement. Ann Intern Med 2004; 140:554-7. www.ahrq.gov;

W) Guideline title: Treating tobacco use and dependence: 2008 update. http://www.guideline.gov/summary/summary.aspx?doc_id=12520 Status: current release;

x) Guideline title: Treating tobacco use and dependence: 2008 update. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service; 2008 May. 257p

j) Guideline title: Smoking cessation services in primary care, pharmacies, local authorities and workplaces, particularly for manual working groups, pregnant women and hard to reach communities. Status: current release. http://www.guideline.gov/summary/summary.aspx?doc_id=12286;

h) Guideline title: Brief interventions and referral for smoking cessation in primary care and other settings. Status: current release. http://www.guideline.gov/summary/summary.aspx?doc_id=9740

6. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba|Sefasebis meTodebi |

|wamaldamokidebulebis arsi, ZiriTadi terminebis |skriningis da diagnostikis |diskusia winaswar SerCeul sakiTxebze|Sesrulebuli samuSao dReebi; |

|ganmartebebi, narkotikebis klasifikacia. |meTodebi; |konkretuli SemTxvevebis garCeva |SeminarebSi monawileoba; |

|fsiqoaqtiuri nivTierebebis mavned moxmarebisa da |xanmokle intervenciebis Catareba;|roluri TamaSebi; |pacientebTan muSaoba; |

|damokidebulebis diagnostireba. |alkoholizmis menejmenti; |pirveladi anamnezis Segroveba; |koloqviumSi monawileoba; |

|narkologiuri daavadebebis ZiriTadi Taviseburebebi. |Tambaqoze damokidebulebis |meoradi anamnezis Sekreba; |saboloo testuri Sefaseba |

|wamaldamokidebulebis etiopaTogenezi. |menejmenti |mkurnalobis meTvalyureoba; | |

|standartuli daleva, saxifaTo moxmareba, mwvave alkoholuri | |medikamentebis administrirebis | |

|intoqsikacia, alkoholizmi. | |meTvalyureoba | |

|opioiduri narkomania. | | | |

|CanacvebiTi Terapiis ZiriTadi aspeqtebi, CanacvlebiTi | | | |

|Terapia saqarTveloSi. | | | |

|sedatiuri da hipnozuri saSualebebi. | | | |

|stimulatorebi da halucinogenebi. | | | |

|nikotinuri damokidebuleba da misi menejmenti. | | | |

|aqroladi gamxsnelebi. | | | |

|kanabinoidebi (anaSa). | | | |

|wamaldamokidebulebis mkurnalobisa da menejmentis ZiriTadi | | | |

|principebi. | | | |

|xanmokle intervenciebi | | | |

muxli 29

1. modulebi II.10 da II.11. eleqtiuri modulebi 2 1-Tviani moduli.

2. modulis dasaxeleba, xangrZlivoba – damokidebulia msmenelis mier SerCeul modulze (ix. qveTavi `II etapis eleqtiuri modulebis Sesaxeb~) 1 Tve.

3. modulis mizani – damokidebulia msmenelis mier SerCeul modulze.

Tavi IV. programis III etapi

muxli 30

1. sarezidento programis III etapi moicavs 3 moduls, romelsac maZiebeli gadis pirveladi jandacvis dawesebulebaSi:

|modulis dsaxeleba |xangrZlivoba |

|moduli III.1. `daavadebaTa prevencia da marTva pirvelad jandacvaSi~ – 7 Tve |

|sakiTxi 1. |janmrTelobisaTvis xelSewyoba da prevenciuli programebi pirvelad jandacvaSi |1 Tve |

|sakiTxi 2. |qronikuli daavadebebis marTva |3 Tve |

|sakiTxi 3. |xandazmulebis samedicino momsaxureba |1 Tve |

|sakiTxi 4. |paliatiuri mzrunveloba |1 Tve |

|sakiTxi 5. |wamlis racionaluri gamowera |1 Tve |

|moduli III.2. `ojaxi da Temi ojaxis eqimis saqmianobaSi~ – 2 Tve |

|sakiTxi 1. |ojaxi, rogorc zrunvis/daxmarebis erTeuli |1 Tve |

|sakiTxi 2. |Temze orientirebuli pirveladi jandacva |1 Tve |

|moduli III.3. `xarisxis uzrunvelyofa da samecniero kvleva” – 3 Tve |

|sakiTxi 1. |xarisxis uzrunvelyofa |1 Tve |

|sakiTxi 2. |pacientis kmayofileba da auditi |1 Tve |

|sakiTxi 3. |samecniero kvleva | Tve |

2. mesame daskvniTi etapis struqtura saerToa: muSaoba ojaxis eqimTan saojaxo medicinis klinikaSi da regularuli ukukavSiris sesiebi.

3. rezidenti/maZiebeli yoveldRe muSaobs ojaxis eqimis ofisSi `ojaxis eqimi-maswavleblis~ zedamxedvelobiT (modulze pasuxismgebeli piri saojaxo medicinis klinikaSi).

4. TveSi erTxel rezidenti/maZiebeli xvdeba tutors.

5. miuxedavad imisa, rom am etapze modulebis dasaxeleba gansxvavdeba, praqtikuli muSaobis komponenti analogiuria da moicavs ojaxis eqimTan erTad muSaobas Tavisuflebis gacilebiT meti xarisxiT, vidre es mzadebis I etapze iyo.

6. rezidenti/maZiebeli, faqtobrivad, eqimis samuSaos asrulebs, magram yvela gadawyvetilebas aTanxmebs modulze pasuxismgebeli pirTan – `ojaxis eqim – maswavlebelTan~.

7. amasTan, TiToeuli modulis Sinaarsis mixedviT, rezidenti/ maZiebeli muSaobs literaturaze, iRebs rCevebs modulze pasuxismgebeli pirisgan da TveSi erTxel xvdeba tutors.

8. ojaxis eqimis yoveldRiuri saqmianoba moicavs:

a) konsultaciebis Catarebas;

b) vizitebs binaze;

g) gadaudebeli miRebis konsultaciebs;

d) samedicino Canawerebis warmoebas, rasac amowmebs modulze pasuxismgebeli piri;

e) referalis organizebas;

v) sxvdasxva specialisტebTan koordinacia-komunikacias;

z) pacientis ganaTlebas;

T) ojaxis eqimis angariSebis momzadebas;

i) klinikaSi organizebul klinikur garCevebSi monawileobas;

k) moxsenebis gakeTebas xelmZRvanelis mier SerCeul Temaze, rac, upirveles yovlisa, moicavs uaxles informacias ojaxis eqimisaTvis mniSvnelovan Temebze;

l) ojaxis eqimis saqmianobis sxva komponentebis Sesrulebas.

muxli 31

1. moduli III.1. modulis dasaxeleba xangrZlivoba – `daavadebaTa prevencia da marTva pirvelad jandacvaSi~, 5 Tve.

2. moduli moicavs 5 ZiriTad Temas, romlis aTvisebas rezidenti andomebs TiTo Tves:

a) janmrTelobisaTvis xelSewyoba da prevenciuli programebi pirvelad jandacvaSi;

b) qronikuli daavadebebis marTva;

g) xandazmulebis samedicino momsaxureba;

d) paliatiuri mzrunveloba;

e) wamlis racionaluri gamowera.

3. modulis mizani – modulis mizania:

a) gamoumuSaos rezidents/maZiebels unari, CarTos mis yoveldRiur saqmianobaSi janmrTelobisaTvis xelSewyobisa da prevenciis RonisZiebebi, rogorc individebis, ise Temis doneze;

b) gamoumuSaos rezidents/maZiebels qronikuli daavadebebis marTvis unari;

g) gamoumuSaos rezidents/maZiebels xandazmuli pacientis janmrTelobis problemis Sefasebis da marTvis, agreTve, marTvaSi sxva resursebis (ojaxi, Temi, instituciebi) CarTvis unari;

d) gamoumuSaos rezidents/maZiebels mis samizne kontingentSi arsebuli pacientebisTvis paliatiuri mzrunvelobis organizebis unari;

e) gamoumuSaos rezidents/maZiebels racionaluri farmakoTerapiis unari.

4. literaturis nusxa:

a) janmrTelobisaTvis xelSewyoba da prevenciuli programebi pirvelad jandacvaSi:

a.a) klinikuri praqtikis erovnuli gaidlainebi: janmrTel pirTa (15-65) da axali pacientebis janmrTelobis mdgomareobis Semowmeba Tambaqos wevis mitoveba da prevencia, simsuqnis marTva pirvelad jandacvaSi, simsuqnis marTva bavSvTa asakSi pirvelad jandacvaSi, hiperoqloesterinemiis marTva pirvelad jandacvaSi, kvebis qceviTi darRvevebis marTva zogad saeqimo praqtikaSi, metaboluri sindromis gamovlena da marTva zogad saeqimo praqtikaSi, osteoporozis prevencia zogad saeqimo praqtikaSi;

a.b) profilaqtikuri acrebis erovnuli kalendari, Sromis, janmrTelobisa da socialuri dacvis saministro;

a.g) არაგადამდებ დაავადებათა პრევენციისა და კონტროლის მექანიზმების შეფასება პირველად ჯანდაცვაში, ბეჟან წინამძღვრიშვილი, და თანაავტ. 2009, თბ.: შპს "ჯისიაი";

a.d) S. Department of Health and Human Services. Healthy people 2010. 2nd ed. Vol. I: understanding and improving health objectives for improving health (part A); vol. II: objectives for improving health (part B); and appendices. Washington, DC: U.S. Government Printing Office, November 2000;

a.e) Yarnall KS, Pollak KI, Ostbye T, et al. Primary care: is there enough time for prevention? Am J Public Health 2003;93:635;

a.v) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011);

a.z) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

a.T) Case Files: Family Medicine, (second edition) by Eugene C. Toy, Donald Briscoe, Bruce Britton, Bal Reddy; 2010, The McGraw-Hill Companies, Inc.;

a.i) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

a.k) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins;

a.l) Oxford Textbook of Primary Medical Care, Jones R (Ed). Oxford: Oxford University Press, 2004;

a.m) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004;

a.n) Rakel RE. Textbook of Family Practice 6th edition London: W.B. Saunders, 2001;

b) qronikuli daavadebebis marTva:

b.a) klinikuri praqtikis erovnuli gaidlainebi: qronikuli daavadebebis marTvis Sesaxeb;

b.b) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011);

b.g) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

b.d) Case Files: Family Medicine, (second edition) by Eugene C. Toy, Donald Briscoe, Bruce Britton, Bal Reddy; 2010, The McGraw-Hill Companies, Inc;.

b.e) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

b.v) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

b.z) Ferri's Clinical Advisor 2009, 1st ed; 2009, Mosby, An Imprint of Elsevier;

b.T) Current Practice Guidelines in Primary Care, 2009; Ralph Gonzales, Jean S. Kutner; 2008, The McGraw-Hill Companies, Inc;

b.i) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

b.k) Blueprints: Family Medicine, second edition, 2006; Wolters Kluwer/Lippincott, Williams & Wilkins;

b.l) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins:

b.m) Jones R (Ed). Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004;

b.n) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004;

g) xandazmulebis samedicino momsaxureba:

g.a) Essentials of Clinical Geriatrics: Sixth Edition; Robert Kane et al. 2008, The McGraw-Hill Companies, Inc;

g.b) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011);

g.g) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

g.d) Case Files: Family Medicine, (second edition) by Eugene C. Toy, Donald Briscoe, Bruce Britton, Bal Reddy; 2010, The McGraw-Hill Companies, Inc.;

g.e) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

g.v) Ferri's Clinical Advisor 2009, 1st ed; 2009, Mosby, An Imprint of Elsevier;

g.z) Current Practice Guidelines in Primary Care, 2009; Ralph Gonzales, Jean S. Kutner; 2008, The McGraw-Hill Companies, Inc;

g.T) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

g.i) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins;

g.k) Jones R (Ed). Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004;

g.l) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004.

d) paliatiuri mzrunveloba:

d.a) paliatiuri mzrunveloba – samedicino da organizaciuli aspeqtebi; Tbilisi, 2003w 138gv. r. RvamiCavas redaqciiT;

d.b) paliatiuri mzrunveloba; Tbilisi, 2005; d. korZaias redaqciiT;

d.g) r. RvamiCava, m. Savdia „onkologia~; Tbilisi, 2010w, 674gv. (Tssu biblioTeka);

d.d) ბრძანება N 157/ნ – ქრონიკული ინკურაბელური დაავადებით შეპყრობილი პირების პალიატიური მზრუნველობით უზრუნველყოფის შესახებ ინსტრუქციის დამტკიცების თაობაზე (10.07.2008);

d.e) EPEC-O (Education in Palliative and End-of Life Care) – http://www.epec.net.;

d.v) Essentials of Clinical Geriatrics: Sixth Edition; Robert Kane et al. 2008, The McGraw-Hill Companies, Inc.;

d.z) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011);

d.T) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

d.i) Case Files: Family Medicine, (second edition) by Eugene C. Toy, Donald Briscoe, Bruce Britton, Bal Reddy; 2010, The McGraw-Hill Companies, Inc.;

d.k) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

d.l) Ferri's Clinical Advisor 2009, 1st ed; 2009, Mosby, An Imprint of Elsevier;

d.m) Current Practice Guidelines in Primary Care, 2009; Ralph Gonzales, Jean S. Kutner; 2008, The McGraw-Hill Companies, Inc;

d.n) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

d.o) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins

d.p) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004;

e) wamlis racionaluri gamowera:

e.a) Desk Reference of Clinical Pharmacology, 2nd Ed. Manuchair Ebadi, 2008; Taylor & Francis Group, LLC;

e.b) Basic & Clinical Pharmacology, 11th Edition, Bertram G. Katzung, Susan B. Masters, Anthony J. Trevor; 2009, The McGraw-Hill Companies, Inc.;

e.g) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011)

e.d) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

e.v) Case Files: Family Medicine, (second edition) by Eugene C. Toy, Donald Briscoe, Bruce Britton, Bal Reddy; 2010, The McGraw-Hill Companies, Inc.;

e.z) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc.;

e.T) Ferri's Clinical Advisor 2009, 1st ed; 2009, Mosby, An Imprint of Elsevier;

e.i) Current Practice Guidelines in Primary Care, 2009; Ralph Gonzales, Jean S. Kutner; 2008, The McGraw-Hill Companies, Inc;

e.k) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

e.l) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins;

e.m) Jones R (Ed). Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004;

e.n) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004.

5. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|cxovrebis wesis da garemos roli |prevenciuli RonisZiebebis CarTva |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|daavadebaTa ganviTarebaSi; |nebismieri tipis konsultaciaSi |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|daavadebaTa risk-faqtorebi; |(gadaudebeli mdgomareobebis |vizitebs binaze – 10; |modulze pasuxismgebeli piris Sefaseba; |

|prevenciis saxeebi; |gamoklebiT); |gadaudebeli miReba (pacienti) – 10; |tutoris Sefaseba ukukavSiris sesiis |

|pirveladi prevencia, imunizacia, |mavne Cvevebis da risk-faqtorebis |samedicino Canawerebis warmoeba – 100; |dros |

|risk-faqtorebis identifikacia da |identifikaciis unari; |referalis organizeba – 75; | |

|marTva; |pacientis konsultireba cxovrebis |sxvdasxva specialisebTan | |

|meoreuli prevencia, asimptomuri |jansaRi wesis da janmrTelobisaTvis |koordinacia-komunikacias – 50; | |

|daavadebebis skriningi; |xelSewyobis sakiTxebze; |pacientis ganaTleba – 50; | |

|mesameuli prevencia; |mavne Cvevebis mitovebaze |klinikaSi organizebul klinikur garCevebSi | |

|prevenciis erovnuli programebi; |orientirebuli konsultaciis Catareba; |monawileoba – 4-8; | |

|prevencia ojaxis eqimis yoveldRiur |xangrZlivi dakvireva cxovrebis wesis |moxsenebis gakeTeba xelmZRvanelis mier | |

|saqmianobaSi |modifikaciasTan dakavSirebiT |SerCeul Temaze – 1-2; | |

| | |ojaxis eqimis angariSebis momzadeba; | |

| | |ojaxis eqimis saqmianobis sxva | |

| | |komponentebis Sesruleba | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|qronikuli daavadebebis wili saerTo |konsultaciis Catareba qr. daavadebis |konsultaciebi ofisSi (asistireba, damoukidebeli) |Sesrulebuli samuSao dReebi; |

|avadobasa da sikvdilobaSi; |marTvis Sesaxeb; |– 150; |Catarebuli konsultaciebi; |

|gavrcelebuli qronikuli daavadebebi; |xangrZlivi dakvirveba da Sefaseba; |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|epidemiologiuri monacemebi |mkurnalobis koordinacia pjd gundis |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|saqarTveloSi; |wevrebTan; |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris |

|asakobrivi jgufebi; |ojaxis CarTva; |referalis organizeba – 75; |sesiis dros |

|qronikuli daavadebebis marTvis |anamnezi da fizikuri gasinjva; |sxvdasxva specialisebTan koordinacia-komunikacias| |

|principebi; |laboratoriul-instrumenteuli |– 50; | |

|gunduri muSaobis mniSvneloba qr. |gamokvlevebis racionaluri gamoyeneba; |pacientis ganaTleba – 50; | |

|daavadebebis marTvaSi; |medikamentur mkurnalobaze da wamlis |klinikaSi organizebul klinikur garCevebSi | |

|meTvalyureobis meTodebi, samedicino |gverdiT efeqtebze dakvirveba |monawileoba – 4-8; | |

|Canawerebi, Semaxseneblebi, registrebi | |moxsenebis gakeTeba xelmZRvanelis mier SerCeul | |

| | |Temaze – 1-2; | |

| | |ojaxis eqimis angariSebis momzadeba; | |

| | |ojaxis eqimis saqmianobis sxva komponentebis | |

| | |Sesruleba | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|xandazmuli pacientis janmrTelobis |xandazmulis janmrTelobis da |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|Taviseburebebi; |funqcionirebis Sefaseba: fizikuri |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|daberebis fiziologia; |funqcionirebis daqveiTebis, kognitiuri |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|janmrTelobis problemaTa speqtri |funqciis Sefaseba; |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|xadazmul asakSi; |davardnis da motexilobis prevencia; |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris |

|farmakologiuri mkurnalobis Tavisebureba|rekomendaciebi kvebis da fizikuri |referalis organizeba – 75; |sesiis dros |

|xandazmul asakSi; |aqtiurobis Sesaxeb |sxvdasxva specialisebTan | |

|mkurnalobis miznebi xandazmul asakSi; | |koordinacia-komunikacias – 50; | |

|gunduri muSaobis da ojaxis roli | |pacientis ganaTleba – 50; | |

|xandazmulTa janmrTelobaze zrunvaSi; | |klinikaSi organizebul klinikur garCevebSi | |

|movla binaze da dawesebulebaSi | |monawileoba – 4-8; | |

| | |moxsenebis gakeTeba xelmZRvanelis mier SerCeul | |

| | |Temaze – 1-2; | |

| | |ojaxis eqimis angariSebis momzadeba; | |

| | |ojaxis eqimis saqmianobis sxva komponentebis | |

| | |Sesruleba | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|ojaxis eqimis roli paliatiur mzrunvelobaSi;|efeqturi komunikacia pacientebTan, ojaxis |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|simptomTa marTva qronikul inkurabelur |wevrebTan da gundis wevrebTan; |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|pacientebSi; |qronikuli tkivilis Sefaseba da marTva; |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|tkivilis Sefaseba; |sxva mtanjveli simptomebis Sefaseba; |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|qronikuli tkivilis marTva; |cudi ambebis miwodeba; |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris |

|gunduri midgoma; |Jangbadis miwodeba (niRbiT, kanuliT); |referalis organizeba – 75; |sesiis dros |

|movla sicocxlis bolo dReebSi |intravenuri inieqca, venis kaTeterizacia da |sxvdasxva specialisebTan | |

| |intravenuri infuzia; |koordinacia-komunikacias – 50; | |

| |nazogastraluri zondireba; |pacientis ganaTleba – 50; | |

| |Sardis buStis kaTeterizacia; |klinikaSi organizebul klinikur | |

| |Wrilobebis, nawolebis movla |garCevebSi monawileoba – 4-8; | |

| | |moxsenebis gakeTeba xelmZRvanelis mier | |

| | |SerCeul Temaze – 1-2; | |

| | |ojaxis eqimis angariSebis momzadeba; | |

| | |ojaxis eqimis saqmianobis sxva | |

| | |komponentebis Sesruleba | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|farmakologiuri mkurnalobis principebi; |individuali-zebuli farmakologiuri |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|individze orientirebuli mkurnaloba, wamlis, |mkuranloba; |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|misi formis, dozis SerCeva da mkurnalobis |warmlebis arsenalis gansazRvra, romelTa |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|xangrZlivoba; |gamoyenebis unari aqvs |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|farmakoTerapiis efeqtze dakvirveba; |maZiebels/rezidents; |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris |

|gverdiT movlenebze dakvirveba; |sarwmuno informaciis moZieba wamalze, |referalis organizeba – 75; |sesiis dros |

|pacientis CarTva farmakoTerapiaze dakvirvebaSi;|misi Sefaseba da gamoyeneba; |sxvdasxva specialisebTan | |

|wamlebis urTierTqmedeba; |wamlis gverdiT efeqtebze dakvirveba; |koordinacia-komunikacias – 50; | |

|polipragmaziis Tavidan acileba; |mimdinare mkurnalobis koreqcia (wamali, |pacientis ganaTleba – 50; | |

|farmakoTerapiaze moqmedi faqtorebi; |doza, forma); |klinikaSi organizebul klinikur garCevebSi | |

|farmakoTerapiis xarjefeqturoba; |adekvaturi Canawerebis warmoeba |monawileoba – 4-8; | |

|farmakoTerapia da kanonmdebloba, wamlis |mimdinare farmakoTerapiis Sesaxeb |moxsenebis gakeTeba xelmZRvanelis mier | |

|gamowera, wamlis xelmisawvdomoba, specialur | |SerCeul Temaze – 1-2; | |

|controls daqvemdebarebuli wamlebi | |ojaxis eqimis angariSebis momzadeba; | |

| | |ojaxis eqimis saqmianobis sxva | |

| | |komponentebis Sesruleba | |

muxli 32.

1. moduli III.2. modulis dasaxeleba, xangrZlivoba – `ojaxi da Temi ojaxis eqimis saqmianobaSi~, 2 Tve.

2. moduli moicavs 2 ZiriTad Temas, romlis aTvisebas rezidenti andomebs TiTo Tves:

a) ojaxi, rogorc zrunvis/daxmarebis erTeuli;

b) Temze orientirebuli pirveladi jandacva.

3. modulis mizani:

a) gamoumuSavos rezidents/maZiebels ojaxis rolis Sefasebisa da pacientze zrunvaSi misi CarTvis unari; agreTve, ojaxis daxmarebis unari janmrTelobasTan dakavSirebuli problemebis marTvaSi;

b) gamoumuSavos rezidents/maZiebels pirvelad jandacvaSi TemTan muSaobis unar-Cvevebi.

4. literaturis nusxa:

a) ojaxi, rogorc zrunvis/daxmarebis erTeuli:

a.a) Family-Oriented Primary Care, Second Edition; Susan H. McDaniel et al. 2005, Springer Science+Business Media, Inc;

a.b) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011);

a.g) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

a.d) Case Files: Family Medicine, (second edition) by Eugene C. Toy, Donald Briscoe, Bruce Britton, Bal Reddy; 2010, The McGraw-Hill Companies, Inc;

a.e) Handbook of Signs & Symptoms, 4th Edition; 1010, Lippincott Williams & Wilkins;

a.v) Current Medical Diagnosis & Treatment 2010, Forty-Ninth Edition; Stephen J. McPhee, Maxine A. Papadakis, The McGraw-Hill Companies, Inc;

a.z) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

a.T) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins;

a.i) Jones R (Ed). Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004;

a.k) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004;

b) Temze orientirebuli pirveladi jandacva:

b.a) erovnuli moxsenebebi da erovnuli angariSebi, Sjsd saministro, daavadebaTa kontrolis da sazogadoebrivi jandacvis erovnuli centri (mimdinare);

b.b) Community-Based Health Interventions by Sally Guttmacher, Patricia J. Kelly and Yumary Ruiz-Janecko (Feb 2, 2010) – Kindle eBook;

b.g) Evaluating Public and Community Health Programs by Muriel J. Harris (Jan 28, 2010) – Kindle eBook;

b.d) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011);

b.e) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

b.v) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

b.z) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins;

b.T) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004.

5. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|ojaxis konteqstis roli pacientis |konsultaciis Catareba ojaxis |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|janmrTelobis problemis SefasebaSi; |konteqstis analizisTvis; |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|ojaxi rogorc resursi pacientis |ojaxSi arsebuli resursebis |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|problemis marTvaSi; |gamovlena da misi gamoyeneba |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|ojaxi rogorc zrunvis sagani; |pacientis problemebis |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris sesiis |

|ojaxis tipebi da ganviTarebis |marTvaSi; |referalis organizeba – 75; |dros |

|ciklebi; |ojaxis analizi; |sxvdasxva specialisebTan | |

|ojaxis problemebis marTva |ojaxis konsultaciis Catareba |koordinacia-komunikacias – 50; | |

| | |pacientis ganaTleba – 50; | |

| | |klinikaSi organizebul klinikur garCevebSi| |

| | |monawileoba – 4-8; | |

| | |moxsenebis gakeTeba xelmZRvanelis mier | |

| | |SerCeul Temaze – 1-2; | |

| | |ojaxis eqimis angariSebis momzadeba; | |

| | |ojaxis eqimis saqmianobis sxva | |

| | |komponentebis Sesruleba | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|Temi: gansazRvreba, maxasiaTeblebi, |Temis identifikaciis da |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|Tavisebureba (qveyana, regioni, |Sefasebis unari; |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|geografia), |TemTan muSaobis meTodebis |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|Temis janmrTeloba, determinantebi, |floba; |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|Sefaseba, marTva; |Temis resursebis gamoyenebis |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris sesiis |

|Temis roli Temis janmrTelobis |unari |referalis organizeba – 75; |dros |

|marTvaSi | |sxvdasxva specialisebTan | |

| | |koordinacia-komunikacias – 50; | |

| | |pacientis ganaTleba – 50; | |

| | |klinikaSi organizebul klinikur garCevebSi| |

| | |monawileoba – 4-8; | |

| | |moxsenebis gakeTeba xelmZRvanelis mier | |

| | |SerCeul Temaze – 1-2; | |

| | |ojaxis eqimis angariSebis momzadeba; | |

| | |ojaxis eqimis saqmianobis sxva | |

| | |komponentebis Sesruleba | |

muxli 33.

1. moduli III.3. modulis dasaxeleba, xangrZlivoba – `xarisxis uzrunvelyofa da samecniero kvleva~, 3 Tve.

2. moduli moicavs 3 ZiriTad Temas, romlis aTvisebas rezidenti/maZiebelი andomebs TiTo Tves:

a) xarisxis uzrunvelyofa;

b) pacientis kmayofileba da auditi;

g) samecniero kvleva.

3. modulis mizani:

a) gamoumuSavos rezidents/maZiebels pirvelad jandacvaSi ojaxis eqimis mier gaweuli momsaxurebis xarisxis uzrunvelyofisaTvis aucilebeli unar-Cvevebi;

b) gamoumuSaos rezidents/maZiebels pacientis kmayofilebis Sefasebis iaraRebis gamoyenebis, misi Sedegebis interpretaciisa da praqtikasTan misadagebis, auditis dagegmvis, Catarebis da misi Sedegebis safuZvelze xarisxis gaumjobesebis RonisZiebebis dagegmvis unarს;

g) gamoumuSaos reზidents/maZiebels kvlevis ZiriTadi kiTxvis Sesabamisi kvlevis dizainis gansazRvris, kvlevis gegmis Camoyalibebisa da misi ganxorcielebis unari.

4. literaturis nusxa:

a) xarisxis uzrunvelyofa;

b) pacientis kmayofileba da auditi;

b.a) daavadebaTa marTvis erovnuli saxelmZRvanelos (gaidlainis) SemuSavebis saxelmZRvanelo, 2010 w.;

b.b) klinikuri praqtikis erovnuli gaidlainebi: 2006 – 2011;

b.g) `klinikuri praqtikis gaidlainebis implementacia: saerTaSoriso da nacionaluri gamocdilebis mimoxilva~, g.javaSvili, g. kiknaZe, 2008, CoReform;

b.d) `rekomendaciebi saqarTveloSi klinikuri praqtikis erovnuli gaidlainebis implementaciisaTvis~, g.javaSvili, g. kiknaZe, 2008, CoReform;

b.e) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011);

b.v) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel; and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

b.z) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

b.T) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins;

b.i) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004

g) samecniero kvleva:

g.a) Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe, EGPRN (European General Practice Research Network), 2009, WONCA;

g.b) Epidemiology, biostatistics and preventive medicine, third edition, 2007, Saunders, Elsevier;

g.g) Introduction to Research: Understanding and Applying Multiple Strategies, Elizabeth Depoy, Laura N. Gitlin, 2005, Elsevier Health Sciences;

g.d) Foundations of Clinical Research: Applications to Practice, Leslie Gross Portney, Mary P. Watkins, 1999, Pearson Education;

g.e) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007 (six edition, 2011);

g.v) Family Medicine Ambulatory Care & Prevention, (fifth edition) Eds: Mark B. Mengel and L. Peter Schwiebert; 2009, The McGraw-Hill Companies, Inc ( A LANGE Clinical Manual);

g.z) Current Clinical Strategies: Family Medicine, 2008 Edition; Paul D. Chan, Christopher R. Winkle, Peter J. Winkle;

g.T) Principles of Ambulatory Medicine, 7th Edition; Eds: Fiebach, Nicholas H.; Kern, David E.; Thomas, Patricia A.; Ziegelstein, Roy C; 2007, Lippincott Williams & Wilkins;

g.i) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004.

5. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi;

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|pirvelad jandacvaSi ojaxis eqimis |ojaxis eqimis mier gaweuli |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|mier gaweuli momsaxurebis xarisxis|momsaxurebis auditis dagegmvis, |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|komponentebi; |Catarebis da rekomendaciebis |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|xarisxis Sefasebis meTodebi; |momzadebis unari; |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|pacientis usafrTxoeba; |pacientis kmayofilebis Seswavlis |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris |

|pacientis kmayofileba; |instrumentebis gamoyenebis unari; |referalis organizeba – 75; |sesiis dros |

|ojaxis eqimis saqmianobis auditi; |klinikuri praqtikis gaidlainebis |sxvdasxva specialisebTan | |

|klinikuri praqtikis gaidlainebi; |moZiebis da gamoyenebis unari; |koordinacia-komunikacias – 50; | |

|licenzireba da sertificireba; |mtkicebulebebis moZiebis da |pacientis ganaTleba – 50; | |

|higienuri normebi da standartebi |gamoyenebis unari; |klinikaSi organizebul klinikur | |

| |sakuTar profesiul kompetenciaze |garCevebSi monawileoba – 4-8; | |

| |zrunvis unari, upg programebis |moxsenebis gakeTeba xelmZRvanelis mier | |

| |SerCevisa da maTSi monawileobis |SerCeul Temaze – 1-2; | |

| |CaTvliT; |ojaxis eqimis angariSebis momzadeba; | |

| |praqtikaSi arsebuli problemebis |ojaxis eqimis saqmianobis sxva | |

| |warmoCenis, analizis da Sesabamisi|komponentebis Sesruleba | |

| |RoisZiebebis dagegmvis unari | | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|ojaxis eqimis saqmianobis auditi; |auditis saqmianobis |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|auditis mniSvneloba xarisxis |gansazRvra ojaxis eqimis |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|uzrunvelyofisTvis; |praqtikaSi; |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|auditis cikli; |auditis Temis SerCeva; |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|ojaxis eqimis saqmianobis auditisaTvis|auditis kriteriumebis |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris sesiis|

|saWiro resursebi |gansazRvra; |referalis organizeba – 75; |dros |

| |auditis kriteriumis |sxvdasxva specialisebTan | |

| |Sesabamisis standartis |koordinacia-komunikacias – 50; | |

| |gansazRvra; |pacientis ganaTleba – 50; | |

| |informaciis Segroveba |klinikaSi organizebul klinikur | |

| |auditisTvis; |garCevebSi monawileoba – 4-8; | |

| |auditis Sedegebis Sefameba da|moxsenebis gakeTeba xelmZRvanelis mier | |

| |interpretacia; |SerCeul Temaze – 1-2; | |

| |xarisxis gaumjobesebis |ojaxis eqimis angariSebis momzadeba; | |

| |RonisZiebebis dagegmva |ojaxis eqimis saqmianobis sxva | |

| | |komponentebis Sesruleba | |

|Teoriuli kursi |profesiuli unar-Cvevebi |Sesasrulebeli manipulaciis raodenoba |Sefasebis meTodebi |

|samecniero kvleva pirvelad |kvlevis saWiroebis Sefasebis |konsultaciebi ofisSi (asistireba, |Sesrulebuli samuSao dReebi; |

|jandacvaSi; |unari; |damoukidebeli) – 150; |Catarebuli konsultaciebi; |

|prioritetebi ojaxis eqimis |kvlevis sferos da sakiTxis |vizitebs binaze – 10; |modulze pasuxismgebeli piris |

|kompetenciebis gaTvaliswinebiT; |formulirebis unari; |gadaudebeli miReba (pacienti) – 10; |Sefaseba; |

|kvlevis meTodebi pirvelad |Sesabamisi samizne |samedicino Canawerebis warmoeba – 100; |tutoris Sefaseba ukukavSiris sesiis |

|jandacvaSi; |kontingentis gansazRvris |referalis organizeba – 75; |dros |

|sakiTxis SerCeva, literaturis |unari; |sxvdasxva specialisebTan | |

|moZieba, kvlevis dizainis SerCeva; |kvlevis dizainis SerCevi |koordinacia-komunikacias – 50; | |

|kvlevis protokoli |unari; |pacientis ganaTleba – 50; | |

| |kvlevis protokolis sqemis |klinikaSi organizebul klinikur garCevebSi| |

| |Sedgenis unari; |monawileoba – 4-8; | |

| |masalis moZiebis unar-Cvevebi |moxsenebis gakeTeba xelmZRvanelis mier | |

| | |SerCeul Temaze – 1-2; | |

| | |ojaxis eqimis angariSebis momzadeba; | |

| | |ojaxis eqimis saqmianobis sxva | |

| | |komponentebis Sesruleba | |

.“.

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[1] Marinker M and Peckham P J (eds). Clinical Futures London: BMJ Books, 1998.