Kradinova E A, Moshkova E D, Nazarova E V
V.I. Vernadsky Crimean Federal University, Simferopol, Republic of Crimea, Russia.
Vopr Kurortol Fizioter Lech Fiz Kult. 2019;96(3):16-24. doi: 10.17116/kurort20199603116.
Child disability, especially as a result of nervous system diseases, affects all aspects of family life, causing extreme emotional and physical exhaustion in parents. However, today there is not enough scientific evidence on the features of development of nonpsychotic mental disorders in parents raising children with cerebral palsy and on the possibilities of using modern physiotherapy methods to correct these conditions and comorbidities. Considering that sanatorium-resort rehabilitation in children with cerebral palsy is accompanied by their parents, it is urgent to optimize clinical and functional approaches to treating mothers with borderline mental disorders with the simultaneous rehabilitation of children in sanatorium-resort conditions.
To study the efficiency of sanatorium-resort treatment aimed at the psychological correction of mothers accompanying children with cerebral palsy to a sanatorium.
The study enrolled 151 mothers who had borderline mental disorders and raised children with cerebral palsy. A study group included 103 women aged 33.2±0.6 years; a comparison group consisted of 48 mothers aged 31.8±0.5 years. The examination was conducted before sanatorium-resort treatment and after a therapy cycle. The mothers underwent clinical and psychodiagnostic examinations via the standardized Minnesota Multiphasic Personality Inventory (a short form) MMPI-mini (adapted by L.N. Sobchik, 2000); emotional and motivational sphere study the WAM (well-being, activity, mood) questionnaire, the Spielberger-Khanin Inventory, and the Depression Rating Scale (adapted by T.I. Balashova). The patients of both groups received combination treatment: the comparison group (n=48) had a general sanatorium-resort therapeutic complex and group psychotherapy; the study group (n=103) additionally took valerian-bromine baths based on sodium chloride water with a mineralization of 20 g/dm), and a transcranial magnetic therapy cycle.
The general sanatorium-and-resort complex with psychotherapy predominantly affected the quality of night sleep (p<0.01) and reduced personality disorders according to the hypochondria scale (from 74.60±7.52 to 52.91±4.04 scores, p<0.01). The additional use of transcranial magnetic therapy and valerian-bromine baths based on sodium chloride water in the mothers had a psychocorrecting effect recorded according to basic (hysteria, psychopathy, psychasthenia) scales. Reduced depression was noted in 36.4% of the mothers (7% in the comparison group).
Transcranial magnetic therapy used in combination with valerian-bromine baths based on sodium chloride water and with psychotherapy in mothers with borderline mental disorders, by taking into account psychological dysregulation, contributed to increases in the body's clinical and functional reserves within 6-8 months and to the preservation of psychological adaptation in 54.7% of cases. Incorporation of a maternal psychocorrective complex into the sanatorium-resort treatment of a child with cerebral palsy is a promising method for improving the quality of treatment outcomes in a sanatorium.
儿童残疾，尤其是由神经系统疾病导致的残疾，会影响家庭生活的方方面面，使父母在情感和身体上极度疲惫。然而，目前关于抚养脑瘫患儿的父母中非精神病性精神障碍的发展特征，以及使用现代物理治疗方法纠正这些状况和合并症的可能性，尚无足够的科学证据。鉴于脑瘫患儿的疗养院康复治疗是由其父母陪同的，因此迫切需要优化针对患有边缘性精神障碍母亲的临床和功能治疗方法，同时在疗养院环境中对患儿进行康复治疗。
研究旨在对陪同脑瘫患儿到疗养院的母亲进行心理矫正的疗养院治疗效果。
该研究纳入了151名患有边缘性精神障碍且抚养脑瘫患儿的母亲。研究组包括103名年龄为33.2±0.6岁的女性；对照组由48名年龄为31.8±0.5岁的母亲组成。在疗养院治疗前和治疗周期结束后进行检查。母亲们通过标准化的明尼苏达多相人格问卷简版（MMPI-mini，由L.N. Sobchik于2000年改编）进行临床和心理诊断检查；通过WAM（幸福感、活动、情绪）问卷、斯皮尔伯格-卡宁量表和抑郁评定量表（由T.I. Balashova改编）研究情绪和动机领域。两组患者均接受综合治疗：对照组（n = 48）采用一般的疗养院综合治疗和团体心理治疗；研究组（n = 103）在此基础上还进行了基于矿化度为20 g/dm³的氯化钠水的缬草-溴浴，以及一个经颅磁治疗周期。
综合疗养院治疗和心理治疗主要影响了夜间睡眠质量（p < 0.01），并根据疑病量表降低了人格障碍（从74.60±7.52分降至52.91±4.04分，p < 0.01）。母亲们额外使用经颅磁治疗和基于氯化钠水的缬草-溴浴，根据基本量表（癔症、精神病态、精神衰弱）记录有心理矫正效果。36.4%的母亲抑郁程度减轻（对照组为7%）。
对于患有边缘性精神障碍的母亲，将经颅磁治疗与基于氯化钠水的缬草-溴浴以及心理治疗相结合，考虑到心理失调因素，有助于在6 - 8个月内提高身体的临床和功能储备，并在54.7%的病例中保持心理适应。将针对母亲的心理矫正综合措施纳入脑瘫患儿的疗养院治疗，是提高疗养院治疗效果质量的一种有前景的方法。
