KHARKIV MEDICAL ACADEMY OF POSTGRADUATE EDUCATION, KHARKIV, UKRAINE.
BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE.
Wiad Lek. 2022;75(2):444-450.
The aim of the study was on the basis of the study of clinical manifestations and mechanisms of the formation of disorders of psychological adaptation among the combatants, to develop the principles and program of their medical and psychological rehabilitation.
Materials and methods: The study was attended by 153 people at the sanatorium and resort stage of treatment, of which 98 people were combatants and 55 people were civilians. The study used a set of methods aimed at the study of emotional disorders (HDRS, BDI, Spielberger Scale, "Asthenic state scale"), individual psychological features (Multilevel personal questionnaire "Adaptability," Test questionnaire G. Shmishek, K. Leonhard), features of psychosocial functioning (Mississippian scale of PTSD-military version) and quality of life (WHOQOL-BREF).
Results: At the stage of sanatorium treatment of combatants is important readaptation to peaceful living conditions. A clinical and psychological analysis of combatants showed that the presence of experienced state of subjective distress and emotional disorder leads to a decrease in the productivity of adaptation to a stressful event. The stress factor disrupted the integrity of the micro-social network of combatants and their system of social support and social values, with the prevailing sense of inability to overcome problems and build plans. A detailed analysis of the nature of depressive and anxiety manifestations was carried out, which allowed to determine the predictors of the violation of adaptation in combatants. Thus, on the basis of the study of clinical manifestations and mechanisms of the formation of disorders of psychological adaptation among the participants of hostilities, the principles of their medical and psychological rehabilitation at the sanatorium and resort stage of treatment are developed.
Conclusions: The peculiarities of stress response in combatants as a component of personal potential play a role in the formation of predictors of psychological adaptation disorders among combatants. Psychological intervention at the tertiary stage of rehabilitation (sanatorium-resort) should be targeted, taking into account individual-psychological characteristics (preventors) and psychosocial factors (predictors).
本研究旨在通过研究战斗人员心理适应障碍形成的临床表现和机制,制定其医疗和心理康复的原则和方案。
研究对象为疗养和度假阶段治疗的 153 人,其中 98 人为战斗人员,55 人为平民。研究采用了一套方法,旨在研究情绪障碍(HDRS、BDI、斯皮尔伯格量表、“乏力状态量表”)、个体心理特征(多层次个人问卷“适应性”、G. Shmishek 测试问卷、K. Leonhard)、心理社会功能特征(密西西比 PTSD 军事版量表)和生活质量(WHOQOL-BREF)。
结果:在疗养阶段,战斗人员的重要任务是重新适应和平的生活条件。对战斗人员的临床和心理分析表明,经历的主观痛苦和情绪障碍状态会导致适应压力事件的效率降低。应激因素破坏了战斗人员微观社会网络及其社会支持和社会价值观体系的完整性,使他们普遍感到无法克服问题和制定计划。对抑郁和焦虑表现的性质进行了详细分析,从而确定了战斗人员适应障碍的预测因素。因此,在研究战斗人员参与敌对行动时心理适应障碍形成的临床表现和机制的基础上,制定了他们在疗养和度假阶段治疗的医疗和心理康复原则。
结论:战斗人员应激反应的特点作为个人潜力的一部分,在战斗人员心理适应障碍预测因素的形成中发挥作用。康复三级阶段(疗养-度假)的心理干预应具有针对性,同时考虑到个体心理特征(预防因素)和心理社会因素(预测因素)。