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I mean, they complain about it all the time.
|
Mármint, állandóan erről panaszkodnak.
|
en-hu
|
We talk about it in terms of engagement, or non-compliance.
|
Mówi sie o tym w kontekście zobowiązan pacjenta lub nieprzestrzegania zaleceń,
|
en-pl
|
When people don't take their pills, when people don't follow doctors' orders -- these are behavior problems.
|
insanlar ilaçlarını almadıklarında ya da doktorun önerilerini dinlemediklerinde bu oluyor. Bunlar davranışssal problemler.
|
en-tr
|
But for as much as clinical medicine agonizes over behavior change, there's not a lot of work done in terms of trying to fix that problem.
|
Но колкото и много клиничната медицина да се оплаква от липсата на промяна на поведението, няма много направено по въпроса за разрешаването на този проблем.
|
en-bg
|
So the crux of it comes down to this notion of decision-making -- giving information to people in a form that doesn't just educate them or inform them, but actually leads them to make better decisions, better choices in their lives.
|
Vậy nên điểm then chốt của nó liên quan đến khái niệm về việc đưa ra quyết định - đưa thông tin cho mọi người theo cái cách không chỉ là chỉ dạy họ hay thông báo cho họ, mà còn là giúp họ đưa ra những quyết định sáng suốt hơn, những lựa chọn tốt hơn trong cuộc sống.
|
en-vi
|
One part of medicine, though, has faced the problem of behavior change pretty well, and that's dentistry.
|
واحد اقسام الطب الذي يظن انه واجه مشكلة تغير الطباع بصورة ناجحة هو قسم طب الاسنان
|
en-ar
|
Dentistry might seem -- and I think it is -- many dentists would have to acknowledge it's somewhat of a mundane backwater of medicine.
|
A fogászat, úgy tűnhet-- ahogy én is gondolom-- sok fogorvosnak ezt el kellene ismernie, valahogy hétköznapi, az orvoslás állóvize.
|
en-hu
|
Not a lot of cool, sexy stuff happening in dentistry.
|
Não estão acontecendo um monte de coisas legais e sexy na odontologia.
|
en-pt-br
|
But they have really taken this problem of behavior change and solved it.
|
Aber das Problem der Verhaltensänderung hat die Zahnmedizin gut angegangen und gelöst.
|
en-de
|
It's the one great preventive health success we have in our health care system.
|
É o maior sucesso da medicina preventiva que temos no nosso sistema de saúde.
|
en-pt
|
People brush and floss their teeth.
|
Ο κόσμος βουρτσίζει και περνά με νήμα τα δόντια του.
|
en-el
|
They don't do it as much as they should, but they do it.
|
No lo hacen tanto como deberían, pero lo hacen.
|
en-es
|
So I'm going to talk about one experiment that a few dentists in Connecticut cooked up about 30 years ago.
|
コネチカット州の歯科医の数人が 30年前に成功させた 1つの実験について話します。
|
en-ja
|
So this is an old experiment, but it's a really good one, because it was very simple, so it's an easy story to tell.
|
非常に古い実験だが、効率的で、 単純で 簡単に話せます。
|
en-ja
|
So these Connecticut dentists decided that they wanted to get people to brush their teeth and floss their teeth more often, and they were going to use one variable: they wanted to scare them.
|
Allora questi dentisti decisero che volevano convincere la gente a lavarsi i denti ed usare il filo più frequentemente. E avrebbero usato una variabile: volevano spaventarli.
|
en-it
|
They wanted to tell them how bad it would be if they didn't brush and floss their teeth.
|
Они хотели рассказать им, как плохо будет, если они не будут чистить зубы и использовать зубную нить.
|
en-ru
|
They had a big patient population.
|
Imali su veliku populaciju pacijenata.
|
en-hr
|
They divided them up into two groups.
|
הם חילקו אותם לשתי קבוצות.
|
en-he
|
They had a low-fear population, where they basically gave them a 13-minute presentation, all based in science, but told them that, if you didn't brush and floss your teeth, you could get gum disease. If you get gum disease, you will lose your teeth, but you'll get dentures, and it won't be that bad.
|
قسم سيعرضون عليه معلومات " ليست مرعبة كثيراً " وهو عبارة عن عرض مدته 13 دقيقة كله قائم على العلم واخبروهم انهم ان لم يقوموا بفرش اسنانهم والاعتناء بها سوف يصابون بامراض الفك ويمكنهم ان يفقدوا اسنانهم ولكن يمكنهم ان يستعيضوا عنها بطقم اسنان .. وهو امرٌ ليس سيءٌ للغاية
|
en-ar
|
So that was the low-fear group.
|
這就是低恐慌人群實驗。
|
en-zh-tw
|
The high-fear group, they laid it on really thick.
|
За "группу страха" они взялись по-настоящему.
|
en-ru
|
They showed bloody gums.
|
Mostravano loro gengive sanguinanti,
|
en-it
|
They showed puss oozing out from between their teeth.
|
Họ cho xem hình ảnh mủ chảy ra từ kẽ răng.
|
en-vi
|
They told them that their teeth were going to fall out.
|
elmondták, hogy a fogaik ki fognak hullani,
|
en-hu
|
They said that they could have infections that would spread from their jaws to other parts of their bodies, and ultimately, yes, they would lose their teeth.
|
Είπαν ότι θα μπορούσαν να πάθουν μολύνσεις που θα εξαπλώνονταν στις σιαγώνες και άλλα μέρη του σώματός τους, και τέλος, θα έχαναν τα δόντια τους.
|
en-el
|
They would get dentures, and if you got dentures, you weren't going to be able to eat corn-on-the-cob, you weren't going to be able to eat apples, you weren't going to be able to eat steak.
|
틀니를 할 수도 있겠지만, 그렇다 하더라도 옥수수도 먹을 수 없게 될거고, 사과를 베어 먹지도 못하게 될 것이고, 스테이크도 먹을 수 없고,
|
en-ko
|
You'll eat mush for the rest of your life.
|
že budou do konce života odkázáni na kaši.
|
en-cs
|
So go brush and floss your teeth.
|
歯磨きとフロスをして下さい。
|
en-ja
|
That was the message. That was the experiment.
|
Dat was de boodschap van dat experiment.
|
en-nl
|
Now they measured one other variable.
|
Eles mediram também outra variável.
|
en-pt
|
They wanted to capture one other variable, which was the patients' sense of efficacy.
|
Vroiau să captureze încă o variabilă, care era simțul de eficacitate al pacientului.
|
en-ro
|
This was the notion of whether the patients felt that they actually would go ahead and brush and floss their teeth.
|
Cílem bylo změřit, jestli to na pacienty zapůsobilo tak, že by nakonec opravdu šli a vyčistili si zuby a vytáhli zubní nit.
|
en-cs
|
So they asked them at the beginning, "Do you think you'll actually be able to stick with this program?"
|
אז הם שאלו אותם בהתחלה, "האם אתם חושבים שבאמת תצליחו לדבוק בתכנית הזאת?"
|
en-he
|
And the people who said, "Yeah, yeah. I'm pretty good about that," they were characterized as high efficacy, and the people who said, "Eh, I never get around to brushing and flossing as much as I should," they were characterized as low efficacy.
|
És azok az emberek, akik azt mondták: "Igen, igen. Ebben jó leszek." ... őket egy magas hatékonyság jellemezte, és azok az emberek, akik azt mondták, "Én sosem fogok annyiszor fogat mosni és selymezni, mint kellene," alacsony hatékonyságot mutattak.
|
en-hu
|
So the upshot was this.
|
Vậy kết quả là thế này.
|
en-vi
|
The upshot of this experiment was that fear was not really a primary driver of the behavior at all.
|
המסקנה מהניסוי הייתה שהפחד לא היה ממש מניע מרכזי להתנהגות בכלל.
|
en-he
|
The people who brushed and flossed their teeth were not necessarily the people who were really scared about what would happen -- it's the people who simply felt that they had the capacity to change their behavior.
|
Oamenii care s-au spălat pe dinți și au folosit ață dentară nu au fost neapărat oamenii care erau foarte speriați de ceea ce urma să se întâmple - erau oamenii care au simțit ca au capacitatea de a-și schimba comportamentul
|
en-ro
|
So fear showed up as not really the driver.
|
yani, korku ana itici güç değil,
|
en-tr
|
It was the sense of efficacy.
|
効力感が動機です。
|
en-ja
|
So I want to isolate this, because it was a great observation -- 30 years ago, right, 30 years ago -- and it's one that's laid fallow in research.
|
Tehát ezt akarom elkülöníteni, mert ez egy nagyszerű megfigyelés volt-- 30 évvel ezelőtt, igen, 30 éve és ez a kutatási eredmény parlagon hevert.
|
en-hu
|
It was a notion that really came out of Albert Bandura's work, who studied whether people could get a sense of empowerment.
|
Isto foi a noção que realmente surgiu do trabalho de Albert Bandura, que estudou se pessoas poderiam adquirir um senso de capacitação.
|
en-pt-br
|
The notion of efficacy basically boils down to one -- that if somebody believes that they have the capacity to change their behavior.
|
效能感的信念最终归结到一点: 一个人是否相信他有能力改变自己的行为。
|
en-zh-cn
|
In health care terms, you could characterize this as whether or not somebody feels that they see a path towards better health, that they can actually see their way towards getting better health, and that's a very important notion.
|
وفي المجال الصحي يمكننا سحب ذلك عليه سواء كان الشخص يظن انه قادر على ان يرى الطريق ويسير به نحو صحة افضل وانهم يمكنهم ان يروا انفسهم يتحسنون و تصبح صحتهم افضل وهذا مفهوم مهم جدا
|
en-ar
|
It's an amazing notion.
|
وهو مفهوم رائع
|
en-ar
|
We don't really know how to manipulate it, though, that well.
|
我們也不知道如何很好的運用這個觀點,
|
en-zh-tw
|
Except, maybe we do.
|
Tedy, možná víme.
|
en-cs
|
So fear doesn't work, right? Fear doesn't work.
|
Korku işe yaramıyor, korku işe yaramıyor.
|
en-tr
|
And this is a great example of how we haven't learned that lesson at all.
|
这里有一个很好的例子, 证明了我们有多么不知悔改。
|
en-zh-cn
|
This is a campaign from the American Diabetes Association.
|
Dies ist eine Kampagne der Amerikanischen Gesellschaft für Diabetes.
|
en-de
|
This is still the way we're communicating messages about health.
|
นี่ยังคงเป็นวิธีที่เราใช้ส่งสารเกี่ยวกับเรื่องสุขภาพ
|
en-th
|
I mean, I showed my three-year-old this slide last night, and he's like, "Papa, why is an ambulance in these people's homes?"
|
لقد جعلت ابني - 3 سنوات - يشاهد هذه اللوحة وقال لي " والدي .. لماذا تتواجد سيارة الاسعاف داخل منزل هؤلاء الاشخاص ؟ "
|
en-ar
|
And I had to explain, "They're trying to scare people."
|
". Tuve que explicar, "Están tratando de asustar a la gente."
|
en-es
|
And I don't know if it works.
|
ولا اعي ان كان الامر يفيد ام لا
|
en-ar
|
Now here's what does work: personalized information works.
|
Ето какво работи, обаче, персонализираната информация работи.
|
en-bg
|
Again, Bandura recognized this years ago, decades ago.
|
Une fois encore, Bandura était arrivé à cette conclusion il y a des années, il y a des dizaines d'années.
|
en-fr
|
When you give people specific information about their health, where they stand, and where they want to get to, where they might get to, that path, that notion of a path -- that tends to work for behavior change.
|
Cuando le das información específica a las personas acerca de su salud, donde se encuentran, y a donde quieren llegar, a donde podrían llegar, el camino, la idea de un camino, esto tiende a funcionar para cambiar comportamientos.
|
en-es
|
So let me just spool it out a little bit.
|
Laat me daar wat meer over uitweiden.
|
en-nl
|
So you start with personalized data, personalized information that comes from an individual, and then you need to connect it to their lives.
|
A więc zaczynamy od spersonalizowanych danych, spersonalizowanej informacji, które pochodzą od pewnej osoby i następnie musimy odnieść je do życia tej osoby.
|
en-pl
|
You need to connect it to their lives, hopefully not in a fear-based way, but one that they understand.
|
Você precisa conectá-la à vida deles, espera-se que não de maneira baseada no medo, mas de forma que eles entendam.
|
en-pt-br
|
Okay, I know where I sit. I know where I'm situated.
|
這樣一來,人們就可以知道自己所處的情況和所面臨的問題。
|
en-zh-tw
|
And that doesn't just work for me in terms of abstract numbers -- this overload of health information that we're inundated with.
|
และไม่ใช่แสดงให้เห็นในรูปตัวเลขเท่านั้น นั่นเป็นข้อมูลทางสุขภาพที่มากเกินไป มันมากเกินไป
|
en-th
|
But it actually hits home.
|
ovo doista pogađa u srž.
|
en-hr
|
It's not just hitting us in our heads; it's hitting us in our hearts.
|
Nu este vorba doar de a conștientiza obiectiv, ci de a lovi în suflet.
|
en-ro
|
There's an emotional connection to information because it's from us.
|
Có những sự kết nối về mặt cảm xúc đối với những thông tin bởi vì nó xuất phát từ chính chúng ta.
|
en-vi
|
That information then needs to be connected to choices, needs to be connected to a range of options, directions that we might go to -- trade-offs, benefits.
|
Acea informație trebuie apoi să fie conectată la alegeri, trebuie să fie conectată la o paletă de opțiuni, direcții pe care am putea să le urmăm -- compromisuri, beneficii.
|
en-ro
|
Finally, we need to be presented with a clear point of action.
|
最后,我们要清楚明了地告知人们他们应采取什么行动。
|
en-zh-cn
|
We need to connect the information always with the action, and then that action feeds back into different information, and it creates, of course, a feedback loop.
|
Trebuie să conectăm informația întotdeauna cu acțiunea, iar apoi acea acțiune să ne fie redistribuită în alt fel de informație, și asta crează, desigur, un ciclu de comunicare (feedback).
|
en-ro
|
Now this is a very well-observed and well-established notion for behavior change.
|
To wszystko zostało zaobserwowane i udowodnione w kontekście zmiany zachowań.
|
en-pl
|
But the problem is that things -- in the upper-right corner there -- personalized data, it's been pretty hard to come by.
|
Das Problem ist jedoch das hier oben rechts: Persönliche Daten sind ziemlich schwer zu bekommen.
|
en-de
|
It's a difficult and expensive commodity, until now.
|
É um bem difícil e dispendioso, até agora.
|
en-pt
|
So I'm going to give you an example, a very simple example of how this works.
|
Ora vi darò un esempio molto semplice di come funziona.
|
en-it
|
So we've all seen these. These are the "your speed limit" signs.
|
Svi smo ovo već vidjeli. Ovo su znakovi "ograničenja brzine".
|
en-hr
|
You've seen them all around, especially these days as radars are cheaper.
|
Láthatják körülöttünk, főleg napjainkban, amikor a sebességradar olcsóbb.
|
en-hu
|
And here's how they work in the feedback loop.
|
Να πώς λειτουργούν στον βρόχο ανάδρασης.
|
en-el
|
So you start with the personalized data where the speed limit on the road that you are at that point is 25, and, of course, you're going faster than that.
|
אז מתחילים במידע מותאם אישית כאשר המהירות המותרת בכביש עליו אתה נוסע היא 25, ואתה, כמובן, נוסע יותר מהר מזה.
|
en-he
|
We always are. We're always going above the speed limit.
|
Vždycky to děláme. Vždy jezdíme přes rychlostní limit.
|
en-cs
|
The choice in this case is pretty simple.
|
Izbor u ovome slučaju je prilično jednostavan.
|
en-hr
|
We either keep going fast, or we slow down.
|
או שאנחנו ממשיכים ליסוע מהר, או שאנחנו מאטים.
|
en-he
|
We should probably slow down, and that point of action is probably now.
|
Ar trebui, probabil, să încetinim iar momentul acelei acțiuni ar fi acum.
|
en-ro
|
We should take our foot off the pedal right now, and generally we do. These things are shown to be pretty effective in terms of getting people to slow down.
|
Ayağımızı gaz pedalından şimdi çekmeliyiz. Genelde de bunu yaparız; bu uyarıların insanların yavaşlamalarını sağlamada çok etkili oldukları görülmüş.
|
en-tr
|
They reduce speeds by about five to 10 percent.
|
Họ sẽ giảm tốc độ từ 5-10 %.
|
en-vi
|
They last for about five miles, in which case we put our foot back on the pedal.
|
הם משפיעים למשך כחמישה מיילים, ואז אנחנו מחזירים את הרגל לדוושה.
|
en-he
|
But it works, and it even has some health repercussions.
|
但這的確起作用了,甚至還帶來了一些健康的效應。
|
en-zh-tw
|
Your blood pressure might drop a little bit.
|
Кръвното ви може да падне малко.
|
en-bg
|
Maybe there's fewer accidents, so there's public health benefits.
|
Magari ci saranno meno incidenti, e dunque vantaggi per la sanità pubblica.
|
en-it
|
But by and large, this is a feedback loop that's so nifty and too rare.
|
Dar, în general, acesta este un ciclu de comunicare care este atât de strașnic și mult prea rar.
|
en-ro
|
Because in health care, most health care, the data is very removed from the action.
|
เพราะส่วนใหญ่ในทางการแพทย์แล้ว ข้อมูลมักจะถูกแยกออกจากการลงมือทำ
|
en-th
|
It's very difficult to line things up so neatly.
|
Így nagyon nehéz a dolgokat felsorakoztatni.
|
en-hu
|
But we have an opportunity.
|
しかし機会はあります。
|
en-ja
|
So I want to talk about, I want to shift now to think about how we deliver health information in this country, how we actually get information.
|
Şimdi konuşmak istediğim konu ise bu ülkede sağlık ile ilgili bilgileri nasıl sunduğumuz, bilgileri nasıl alıyoruz.
|
en-tr
|
This is a pharmaceutical ad.
|
Este é um anúncio farmacêutico.
|
en-pt
|
Actually, it's a spoof. It's not a real pharmaceutical ad.
|
Всъщност е шега, не е истинска реклама на лекарство.
|
en-bg
|
Nobody's had the brilliant idea of calling their drug Havidol quite yet.
|
Ainda ninguém teve a brilhante ideia de chamar o seu medicamento de Habidol.
|
en-pt
|
But it looks completely right.
|
Ali izgleda u redu, u potpunosti.
|
en-hr
|
So it's exactly the way we get health information and pharmaceutical information, and it just sounds perfect.
|
這也正是得到 我們的健康信息和藥物信息的方法, 而這看上去的確很好。
|
en-zh-tw
|
And then we turn the page of the magazine, and we see this -- now this is the page the FDA requires pharmaceutical companies to put into their ads, or to follow their ads, and to me, this is one of the most cynical exercises in medicine.
|
Και μετά γυρνάμε τη σελίδα του περιοδικού, και βλέπουμε αυτό -- είναι η σελίδα που απαιτεί ο ΕΟΦ από τις φαρμακευτικές εταιρίες να βάζουν στις διαφημίσεις τους, ή μετά απ' αυτές, και για μένα, αυτό είναι μία από τις πιο κυνικές πρακτικές στην ιατρική.
|
en-el
|
Because we know.
|
Защото ние знаем.
|
en-bg
|
Who among us would actually say that people read this?
|
Qui parmis nous affirmerait vraiment que les gens lisent cela?
|
en-fr
|
And who among us would actually say that people who do try to read this actually get anything out of it?
|
ומי מאיתנו באמת יאמר שאנשים שאכן קוראים את זה באמת יקבלו מזה משהו?
|
en-he
|
This is a bankrupt effort at communicating health information.
|
Это -- старания неудачника в предоставлении медицинской информации.
|
en-ru
|
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