No 76 (2019)

Articles
PECULIARITIES OF HOSPITAL TREATMENT OF PATIENTS WITH PARANOID SCHIZOPHRENIA
Rogozina M.A., Podvigin S.N., Azarova A.M., Nemyh L.S.
Abstract
There was conducted a continuous study of paranoid schizophreniainpatients in a psychiatric hospital.The drug therapy effectiveness was evaluated by medical patient’s histories. The reasons for preferences in choosing antipsychotic medications were clarified during the interviews with psychiatrists. It was determined that first-generation antipsychotics were predominantly used in treatment. In particular, therapy was carried out exclusively with first-generation antipsychotics; at the stabilizing stage, more than half of the patients received injections of prolonged preparations of the same group. Second-generation antipsychotics (clozapine or olanzapine) were prescribed to more than a third of patients with therapeutic resistance in combination with typical neuroleptics. On the one hand, the psychiatrists explained the preference in choosing the first-generation antipsychotics by the good therapeutic efficacy of these medications and, on the other hand, the insufficient supply of the second-generation antipsychotics to the hospital, due to which their choice was limited.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):3-7
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MODERN STRATEGIES OF SCHIZOPHRENIA THERAPIES (INFORMATION, ETHICAL, DIAGNOSTIC AND THERAPEUTIC ASPECTS)
Protopopova A.M., Grechko T.U.
Abstract
The article presents the main approaches to the formation of compliance (“adherence to therapy”) in the treatment of schizophrenia. Schizophrenia is one of the most common and most severe mental illnesses, which has a chronic course. Accompanied by the increase in negative symptoms, cognitive impairment, social maladjustment. In many cases, schizophrenia leads to disability and loss of self-care ability. However, with timely diagnosis and adequate therapy, in many cases it is possible to achieve persistent drug remissions and a significant improvement in the patient's quality of life. An important role in the treatment of schizophrenia during the entire period of the disease (manifestation, active course, defect) is played by the formation of a high level of compliance (“adherence to therapy”).The cooperation of the doctor and patient plays a very important role in effective treatment. The patient’s refusal to adhere to the medication regime for schizophrenia can lead to exacerbation of psychopathological symptoms. Compared with somatic and other mental diseases in the treatment of schizophrenia, the frequency of non-compliance is high. The article analyzes the factors that lead to low levels of compliance and modern strategies for improving compliance. The ethical aspects of the interaction between the doctor and the patient in the treatment of schizophrenia are considered. The article discusses the effect of comorbid disorders on compliance.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):8-13
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MODERN STRATEGIES OF SCHIZOPHRENIA THERAPIES (INFORMATION, ETHICAL, DIAGNOSTIC AND THERAPEUTIC ASPECTS)
Grechko T.U., Protopopova A.M., Chuprinina T.N.
Abstract
The article presents the main trends in the approach to the problem of treating patients with schizophrenia at the present stage. Schizophrenia is one of the most severe mental illnesses. It takes a long time and often leads to disability of patients due to a combination of negative symptoms, cognitive impairment, social maladjustment, pronounced decline in social functioning. The article discusses the main strategies of therapy (informational, ethical, diagnostic, psychopharmacological), which are proposed as an integrated approach. The treatment of schizophrenia is a complex process where several factors are integrated. One of these factors is timely diagnosis, which allows to develop a treatment plan. Ethical and informational factors play a very important role in the interaction of a psychiatrist with a patient.The article discusses the information aspects that need to be paid attention to the doctor for optimal interaction with the patient. Some ethical issues arising in the process of communication between a psychiatrist and a patient are discussed. The article analyzes the modern psychopharmacological options for therapy, their impact on the quality of life of patients, social functioning. The article discusses drugs of the III generation of antipsychotics (aripiprazole, cariprazine), their features and benefits of use.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):14-21
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ANALYSIS OF DISORDERS OF THE AFFECTIVE SPHERE OF PATIENTS WITH MALIGNANT NEOPLASMS
Panasenko P.I., Romanova M.M., Babkin A.P.
Abstract
Chronic noncommunicable diseases are a threat to the social and economic development of humanity in the twenty-first century. Among them, a special place is occupied by cancer and mental disorders. The problem of affective disorders in patients with oncological diseases exists and needs to be solved, as they have a significant impact on the course and outcomes of the underlying disease, reducing the patient's adherence to treatment, the effectiveness of antiblastoma therapy, social adaptation and quality of life up to suicide attempts and early death. The article is devoted to the results of research on the study and analysis of affective disorders in patients with malignant tumors, taking into account the age, location, stage, prescription of diagnosis. The work used clinical and psychopathological and experimental psychological methods of research. In the study of the age structure of the study group of cancer patients, it was found that the highest incidence of anxiety is observed at the age of 50 to 70 years, and depression is most evident in patients older than 70 years. Most commonly anxiety and depressive disorders were found in cancer but obrazovaniyakh genital organs and urinary tract. The greatest severity of anxiety disorders was observed in patients aged 50 to 70 years, depressive - in persons over 70 years. Based on the obtained results, we can note the high comorbidity of affective disorders and cancer, which remains a significant problem that requires further study in order to correct and optimize approaches to treatment, prevention and rehabilitation.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):22-27
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FEATURES OF CLINICAL PICTURE AND TUMOR SYMPTOMATICS OF THE CENTRAL NERVOUS SYSTEM IN CHILDREN AND TEENS OF THE VORONEZH REGION
Kutashov V.A., Ulyanova O.V.
Abstract
In Russia, 1.4 tumors per 100 thousand children under the age of 16 fall annually in the central nervous system (CNS), which is approximately 450 cases per year. CNS tumors occupy the second place in the structure of childhood and adolescent tumors, second only to acute leukemia. Constituting 20% of all malignant 33 childhood tumors, CNS tumors are more often represented by intra-oral tumors between the ages of 2 and 15 years and extracentorial tumors between the ages of one year and 15 years old. Interest in the incidence of CNS tumors is due to the high mortality and increasing opportunities to provide adequate medical care. The clinical picture is mainly characterized by symptoms of general intoxication, headache, and to a lesser extent, focal symptoms and convulsive syndrome. However, despite the modern methods of diagnosis and neuroimaging, the introduction of new technologies in medicine, often the period from the debut of the first symptoms to the final diagnosis of the CNS disease, is measured in months and sometimes even years.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):28-32
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STRUCTURE OF SCHIZOPHRENIA MORBIDITY IN VORONEZH
Shtankov S.I., Mytyga P.G., Golyshev V.Y., Maleva S.S.
Abstract
The question of the features of the structure of the distribution of suicides, Voronezh, the allocation of groups with the highest suicidal risk, highlighting the most important reasons for attempting suicide, the presence of background diseases or conditions of the neuropsychic sphere, which serve as the motivation to commit acts of self-harm, identification of potentially vulnerable categories of citizens who will need additional preventive psychological and psychiatric support in order to normalize their mental status, and reduce suicidal risk. It also covers the issues of preventing stigmatization of patients who have committed suicide, as well as their family members, leveling the likelihood of repeated suicidal attempts.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):33-38
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OBSTRUCTIVE APNEA COMORBID SYNDROME WITH CHRONIC BRAIN IHEMIA AND ARTERIAL HYPERTENSION
Ulyanova O.V., Kutashov V.A.
Abstract
Obstructive sleep apnea syndrome (OSA) is currently regarded as one of the significant risk factors for the development of neurovascular and cardiovascular diseases and their complications. Hypoxia and hypersimpicotonia, underlying their development, increase the risk of neurovascular and cardiovascular pathology several times. Mortality from cardiovascular and neurovascular diseases with sleep disorders over the last decade has increased 7 times. Currently, dissatisfaction with the quality of their sleep is found in 30-45% of the population, and the prevalence of OSA in the population is 10-12%. When identifying patients with OSA, you should clearly focus on 7 symptoms: respiratory arrest in a dream (according to relatives) and suffocation during sleep, frequent waking up; loud intermittent snoring and morning headaches, night sweats and dry mouth after waking up; increased daytime sleepiness, not bringing recuperation and a constant feeling of tiredness during the daytime with a violation of concentration and attention; frequent night urination and decreased potency; violation of night sleep for more than six months; overweight and / or obesity; arterial hypertension (AH) - especially night or morning rise in blood pressure (BP), and in children - paradoxical movements of the chest in a dream. At the same time, cognitive impairment is also possible: irritability and memory loss.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):39-43
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RISK ASSESSMENT OF DEVELOPMENT OF DEPRESSION IN THE PERSONS OF THE SENIOR AGE GROUP
Skrebneva A.V., Melikhova E.P., Vasilyeva M.V., Gubina O.I.
Abstract
The article “Assessing the risk of developing depression in the older age group” discusses the risk of development and the presence of depression in the elderly population. An assessment of the risk of developing depression was carried out using the “Geriatric Depression Scale” (GDS) questionnaire, which was developed specifically for the elderly. The study involved 104 people, whose average age was 71 ± 0.7 years. All participants were divided into two groups. The first group consisted of the elderly population aged from 60 to 74 years. The second group is represented by respondents 75 years and older. The authors of the article found that 32% of respondents are at risk of developing depression, and patients with depression are 11%. The paper also discusses the assessment of the increased risk of developing depressive disorders in patients with a history of arterial hypertension. In the conducted study of elderly people with arterial hypertension - 58%, according to the data of ambulatory cards. The conclusions are made about the need for further observation and study of the state of the respondents, in order to identify the causes of depression in the older age group.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):44-47
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THE IDENTIFICATION OF MENTAL DISORDERS, FOLLOWED BY ALCOHOLIC AND NARCOTIC EXCESS
Ekaterina S.A., Vladimir H.V.
Abstract
The article deals with analysis of alcohol and drug intoxication signs severity associated with destructive to health effect and presence of psychic disorders. In the statistic research that has been carried out we describe signs of alcohol and drugs intoxication accompanied by psychopathologic symptoms. Taking into consideration rise of mental and behavioral disorders resulting from psychoactive substances use by adults and youngsters, especially students, the issue of search for new methods and means of psychopathologic symptoms correction accompanied by clinical picture of alcohol and drug intoxication is of great importance.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):48-55
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RELATION TO ALCOHOL OF PATIENTS WITH PANCREONECROSIS
Sudakov D.V., Yakusheva N.V., Shevtsov A.N., Pospelova E.S.
Abstract
The article discusses the relationship of patients with pancreatic necrosis to alcohol. The features of the use of alcohol as the main cause of the disease are studied, depending on the experience of alcohol use. In the case of each patient, the type as well as the quality of alcohol consumed is studied. And separately considered a weak and strong alcohol. A separate place is allocated to clarify the patient's life history. It is important to determine the presence of diseases of the gastrointestinal tract and the attitude of the patient to this pathology, as well as the combination with alcohol intake. The data obtained as a result of the study may be important in building a prediction of the possible recurrence of this pathology in people who abuse alcohol.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):56-61
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MENTAL HEALTH OF ADOLESCENTS AND THE SCREENING METHOD
Gayvoronskaya E.B., Proskurina D.S., Romanenko L.N.
Abstract
In this article the urgency of the study of adolescents’ mental state is emphasized, since grew a quantity of teenage deviant behavior and suicides. In the investigation the need and the urgency of conducting screening among the adolescents for the revealing of aggression, anxiety and depressive symptoms is examined. An attempt at conducting the screening among the 9-11 classes’ pupils on the base of two Voronezh schools is undertaken. There were used: the anxiety scale of Kondash, the children's depression questionnaire of M. Kovach, and also Bass and Darky questionnaire. On the basis obtained results the frequency of the occurrence of aggression as well as anxiety and depressive symptoms in adolescents requiring the correction is determined. In the structure of depression the category “interpersonal problems” was highlighted. Conclusions about the importance of psychological screening among the adolescents are made, since adolescents are the most un-protected category in the sphere of mental health. For prevention of mental disorders and serious disturbance of behavior in adolescents the conducting of such screening is recommended as well as a further work with the adolescents who reveal the increased level of aggression and anxiety and depressive states. Preventive and individual consultations with the adolescents are also proposed.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):62-65
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RISK FACTORS AND POSSIBLE LONG-TERM CONSEQUENCES OF PERINATAL ENCEPHALOPATHY IN CHILDREN
Kaliyeva M.A., Palchikov M.A., Zuykov K.G.
Abstract
The article addresses the issue of the consequences of perinatal damage to the central nervous system. The analysis of risk factors and possible long-term effects in children with perinatal encephalopathy with varying degrees of hypoxic and ischemic brain damage. Clinical cases were analyzed, indicators of the course of pregnancy and childbirth, Apgar score, speech development delay, adaptation in school institutions, Wexler test, level of severity of anxiety disorders, hereditary burden were taken into account. Conclusions about the factors that have the greatest impact on the severity of perinatal encephalopathy were made. An assessment of the school performance of this group of patients. The relationship between pathologically flowing pregnancy and childbirth in the mother, followed by the severity of the perinatal lesion of the central nervous system of the newborn, was revealed. Revealed a high prevalence of concomitant behavioral disorders in this category of patients in the form of a high level of anxiety disorders.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):66-71
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ANALYTIC INVESTIGATION OF OVEREATING EPISODE, ANXIETY AND DEPRESSIVE SYMPTOMS IN OBESE CHILDREN AND THEIR PARENTS IN HOSPITAL
Korzhova S.O., Shiriaev O.Y., Makhortova I.S., Chubarov T.V.
Abstract
The study analyzed anxiety-depressive manifestations among children with endogenous-constitutional obesity and their parents. To assess anxiety and depression, Beck psychometric scales of anxiety and depression and the adapted anxiety scale of anxiety by A.M. Parishioners. This article presents the interim results of the analysis of the episode of overeating, which is considered as one of the possible factors that provoke and aggravate the clinical picture of obesity. To study the episode of overeating, a specially designed questionnaire was used, reflecting the dynamics of the episode of overeating. The questionnaire questions are open, which allows patients to independently describe the episode itself in relation to emotions, thoughts and relevant behavior. It has been found that in obese children, the frequency of episodes of overeating is several times a week and is associated with pronounced positive emotions during and after the episode, when triggers of the onset of overeating are pronounced negative emotions. In the group of parents, the emotional state after overeating is qualitatively different and is characterized by pronounced negative emotions at the end of the overeating episode and the presence of guilt. The results obtained are heterogeneous and require further study of the phenomenon of overeating among children with endocrine pathology.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):72-77
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STUDY OF THE BASIC PROPERTIES OF ATTENTION IN MEDICAL STUDENTS OF THE FIRST COURSE
Gladysheva O.V., Khabarova T.Y., Priputnevich D.N.
Abstract
The article deals with the problem of reducing the basic properties of attention in first-year students of a medical university. Students of medical educational organizations are at risk for the formation of stressful states, as adaptation to new conditions of activity, emotional, intellectual and informational burdens, difficulties in rational distribution of their time, lead to costs of psychological resources. The difficulties that first-year students face often lead to unrest and anxiety. A high level of excitement can have a negative effect on concentration, stability, switching attention, which are so necessary in the process of learning activities. The article presents the results of the study of the basic properties of attention in first-year medical students with the help of B. Bourdon's test. The study shows that unstable attention is characteristic of the majority of students, which is associated with anxiety and feelings during the answers, the fear of incorrectly expressing their thoughts. In addition, students with low levels of knowledge and a lack of incentive to learn, had scattered attention and emotional lethargy. Based on the study, recommendations were made aimed at improving the basic properties of attention among first-year medical students.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):78-83
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THE RELATIONSHIP BETWEEN PERFECTIONISM AND FEELINGS OF "HAPPINESS" AND "ENVY" AMONG STUDENTS
Larska M.V., Pashkevich A.A., Galichkina E.N., Dyakonov S.A.
Abstract
The high level of perfectionism is associated with such psychological and psychiatric problems as depression, anxiety, obsessive-compulsive disorder. The dependence between the level of perfectionism and such experiences as "happiness" and "envy" of students is considered. The relevance of the study is due to the fact that the period of study in high school coincides with significant stress loads, accompanied by the development of emotional disorders and maladjustment. Methods: multidimensional perfectionism scale of Hewitt - Flett, Oxford happiness questionnaire, the questionnaire "survey envy personality" (MISL) T. V. seafront Berkovoy. Participants: students (n = 30) of medical University. Three significant correlations between the studied parameters were revealed. The positive Association between perfectionism focused on yourself and level of happiness; a negative relationship between perfectionism, focused on themselves a parameter of "envy"; a positive correlation between the General level of perfectionism and a measure of "happiness". It is concluded that students with the growth of perfectionism increases the level of happiness and decreases the level of envy, ie, dominated by constructive perfectionism.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):84-89
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ASSESSMENT OF SOCIAL ANXIETY LEVEL OF OLDER YEARS STUDENTS OF THE MEDICAL UNIVERSITY
Afanasyev S.O., Gayvoronskaya E.B., Palchikov M.A.
Abstract
The article presents the analysis of data of literature on social anxiety, provides. figures of prevalence of anxiety, economic costs of treatment of this group of diseases. Within this research were used the scale of anxiety manifestation by Taylor (Manifest Anxiety Scale, MAS), Liebowitz's scale for assessment of symptoms of sociophobia (Liebowitz Social Anxiety Scale) and a Brief scale of Fear of negative assessment (BFNE). The research was conducted among students of the Voronezh State Medical University of older years, in total amount there were 250 people. The got points were analysed and ranged on degrees of manifestation of symptoms of sociophobia. Also there were made charts demonstrating the frequency of occurrence of various extents of social anxiety disorder among graduating students, were revealed risk groups, developed recommendations about control of risk factors of development of anxiety and a psychoemotional condition of students.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):90-96
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A STUDY OF THE BASIC PROCESSES OF MEMORY IN THE FIRST YEAR STUDENTS OF THE MEDICAL SCHOOL
Gladysheva O.V., Khabarova T.Y., Nemykh L.S.
Abstract
The article deals with the problem of memory loss in first-year students of a medical university. Most of them are hard to adapt to the study of a large amount of new and complex educational material, often experiencing difficulties in the rational distribution of their time. Difficulties faced by first-year students often lead to agitation and increased fatigue. Research shows that unstable attention and fatigue are common to most students. The article presents the results of the study of basic memory processes in first-year students of a medical college using the “Learning 10 words” method (A.R. Luria). Students with low levels of knowledge and lack of incentive to learn, were observed scattered attention and emotional lethargy. The average and greater amount of short-term and long-term memory was noted among students with an average and with a high level of knowledge. Students with low levels of knowledge had low memory levels. Based on the study, recommendations were given to students aimed at improving the memorization of educational material.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):97-102
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HARMFUL HABITS OF MEDICAL UNIVERSITY STUDENTS
Chernykh A.V., Sudakov D.V., Belov E.V., Pospelova E.S.
Abstract
The issue of the presence of “bad habits” among medical students is studied on the example of 3 and 5 year students of the medical faculty. Revealed that the most common among all bad habits is alcohol. A smaller number of students are exposed to smoking, and drug use is almost never encountered. The article draws parallels between the “bad habits” of the subjects and their families. Conclusions are drawn about the most common causes that "push" students to alcohol, smoking and drugs.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):103-108
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BURNOUT SYNDROME IN STOMATOLOGISTS
Pankova S.N., Azarova O.A., Kumirova O.A.
Abstract
The Burnout Syndrome (BS) is a body response arising from the con-tinuous exposure to various stressful situations during the professional activity. As the work of a stomatologist is one of the most stressful ones, the data on the BS research by different authors presented in this article is considered to be a very important issue of contemporary medical psychology and dentistry. According to different authors, the professional stress of various levels accounts for 53.7-60%. The methodology of the occupational burnout level diagnostic is described. Based on the data from literature, the types of the BS clinical displays in stomatologists and the development of the approaches to the BS prevention are presented. Most of the authors focus on the three major BS indicators: the first one is psychological exhaustion, the second one is feeling disconnected, the third one is reduction of self-esteem during the BS, which is usually followed by the decline in the quality of the services provided. According to the authors’ research, the early detection, treatment, prevention and the actions aimed at the identification of symptoms can repair the damage that the BS has on a person’s physical and mental health, which directly influences not only the treatment quality, but also the well-being of society in general.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):109-115
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PSYCHOLOGICAL ASSISTANCE BY MEANS OF INTERNET TO PERSONS WITH PRENOSOLOGICAL FORMS OF MENTAL DISORDERS
Ivanov V.G., Lazareva E.Y., Nikolaev E.L.
Abstract
The widespread use of Internet technologies inevitably leads to the need to solve problems related to the assessment of the effectiveness of online psychological intervention. The aim of the study is to assess the effectiveness of the provision of psychological assistance to persons with prenosological forms of mental disorders. The study involved 11 people who applied for psychological help online. The basis of psychological intervention is the method of corrective influence and the model of psychological well-being of the individual, taking into account the harmonious combination of material, social and spiritual values. The analysis of the features of the severity of psychopathological disorders, the self-attitude of the individual, life meaningful orientations and the use of adaptive coping strategies before and after the provision of psychological assistance was carried out. Analyzed are the results of the study, obtained before the psychological intervention and 1-2 months after its completion. On the basis of the results obtained, the examined showed a decrease in the severity of somatic symptoms, anxiety and discomfort in the process of interpersonal relationships. Formed more positive self-attitude in the studied patients is accompanied by a tendency of frequent use of protective forms of behavior and resistance to ongoing personality changes. Patients after the provision of psychological assistance revealed a great sense of purpose, emotional richness and meaningfulness of life. In the process of providing online psychological assistance to patients, there is an increase in adaptive and relatively adaptive and reduction of maladaptive forms of coping behavior.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):116-120
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EXPERIENCE IN THE USE OF MODERN METHODS OF PSYCHO-PHYSIOLOGICAL REHABILITATION SPECIALISTS OF EMERGENCY RESCUE TEAMS
Petrova A.V., Sklyarova T.P.
Abstract
The article deals with the experience of using psychophysiological methods in the rehabilitation of specialists who took part in the elimination of the consequences of emergency situations. Global climate change on the planet contributes to the occurrence of disasters and increase the damage from them. Specialists of emergency rescue units are exposed to various damaging factors of the emergency situation during its liquidation. Extreme conditions in their work determine the primacy of the tasks of saving people in the hierarchy of life values. Reactions to a traumatic event can be manifested by multiple violations of the functioning of physiological systems, which leads to a decrease in efficiency and a state of maladjustment in the professional and family spheres. The aim of the work was to identify post-traumatic stress disorders in specialists of emergency rescue units for the subsequent correction of these conditions by modern methods. According to the results of the survey and psychodiagnostic examination, the specialists of emergency rescue units showed signs of post-traumatic stress disorder of varying severity and somatic complaints. Restoration activities were carried out using modern psycho-physiological methods of rehabilitation on the apparatus "Alfaria" and "ASIR", which contributed to the improvement of the functional state.
Научно-медицинский вестник Центрального Черноземья. 2019;(76):122-128
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