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Abstract
О. Dukhovskyy
The study involved a comprehensive survey of 137 families (mother and father) of children with severe somatic disease aimed at the development and evaluation of the system of medical and psychological support of families with a somatically challenged child. The main group comprised 97 families participating in the program of medical and psychological support, and the control group included 40 families who did not receive psychological support. According to our findings, a serious disease of the child became a psychotraumatic situation for all the parents, resulting in the development of anxiety-depressive reactions and conditions. Psychodiagnostic examination showed that the parents had mild, moderate depressive and anxious episodes on the Hamilton Rating Scale; high levels of situational and personal anxiety according to the C.D. Spielberger Inventory, a high level of neuropsychic stress on T.A. Nemchin Scale. The couples under investigation noted tensions in family relationships, family conflicts, related to the treatment of the child and escalation of pre-existing interpersonal and marital problems that led to distancing and a decrease in internal family resource. Based on these data, we have developed a system of medical and psychological support of the families with somatically challenged child, which consisted of four consecutive phases and included the use of individual cognitive-behavioral therapy (Beck AT, 2006), family therapy (Eidemiller E. G., 2003), rational therapy (classic Dubois P., 1912) and psychological educational programs. Case monitoring in the main group following the employment of the proposed system of medical and psychological support showed a stable positive pattern of psychological state with a statistically significant total reduction of anxiety-depressive states and the harmonization of the marital relationship.
Key words: Medical and psychological support, anxiety, depression, family interactions, infants with severe craniocerebral trauma.
СУЧАСНІ ПІДХОДИ ДО МЕДИКО-ПСИХОЛОГІЧНОГО СУПРОВОДУ СІМ’Ї ДИТИНИ ПЕРШОГО РОКУ ЖИТТЯ З ВАЖКОЮ ЧЕРЕПНО-МОЗКОВОЮ ТРАВМОЮ.
Духовський О.Є.
У ході роботи з метою розробки та апробації системи медико-психологічного супроводу сім’ї дитини першого року життя з важкою черепно-мозковою травмою проведено комплексне обстеження 137 родини (мати та батько) дітей першого року життя які отримали важку черепно-мозкову травму. Основну групу склали 97 родин, які прийняли участь у програмі медико-психологічного супроводу, контрольну групу 40 родин, які не отримували психологічну підтримку. Як показали результати дослідження черепно-мозкова травма дитини стала психотравмуючою ситуацією для усіх батьків, яка приводила до розвитку тривожно-депресивних реакцій та станів. За даними психодіагностичного обстеження у батьків відмічалися легкій помірний депресивний та тривожний епізоди за шкалою Гамільтона; високі рівні ситуативної й особистісної тривожності за методикою Ч.Д. Спілбергера, високій рівень виразності нервово-психічної напруги по шкалі Т.А. Немчина. Обстежені родини відзначали наявність напруженості в сімейних відносинах, сімейні конфлікти, як пов’язані з лікуванням дитини, так і ескалації існуючих раніше міжособистісних та подружніх проблем, що призводило до дистанціювання та зниження внутрішньосімейного ресурсу. Базуючись на отриманих даних нами розроблена система медико-психологічного супроводу сімʼї дитини першого року життя з важкою черепно-мозковою травмою, яка складалася із чотирьох послідовних етапів та включла використання індивідуальної когнітивно-поведінкової терапії (Бек A. T., 2006), сімейної терапії (Ейдміллер Е. Г., 2003), раціональної психотерапії (класичний варіант Дюбуа П., 1912) та псих освітніх програм. Як показали результати динамічного спостереження, на фоні застосування запропонованої системи медико-психологічного супроводу в основній групі відзначена стійка позитивна динаміка психологічного стану з повною редукцією тривожно-депресивних та гармонізацією подружніх відносин.
Ключові слова: Медико-психологічний супровід, тривога, депресія, родинна взаємодія, дитина з важкою черепно-мозковою травмою.
СОВРЕМЕННЫЕ ПОДХОДЫ К МЕДИКО-ПСИХОЛОГИЧЕСКОМУ СОПРОВОЖДЕНИЮ СЕМЬИ РЕБЕНКА ПЕРВОГО ГОДА ЖИЗНИ С ТЯЖЕЛОЙ ЧЕРЕПНО-МОЗГОВОЙ ТРАВМОЙ.
Духовской А.Э.
В ходе работы с целью разработки и апробации системы медико-психологического сопровождения семьи ребенка первого года жизни с тяжелой черепно-мозговой травмой проведено комплексное обследование 137 семей (мать и отец) детей первого года жизни получивших тяжелую черепно-мозговую травму. Основную группу составили 97 семей, принявших участие в программе медико-психологического сопровождения, контрольную группу 40 семей, не получавшие психологическую поддержку. Как показали результаты исследования, черепно-мозговая травма ребенка стала психотравмирующей ситуацией для всех родителей, которая приводила к развитию тревожно-депрессивных реакций и состояний. По данным психодиагностического обследования у родителей отмечались легкой умеренный депрессивный и тревожный эпизоды по шкале Гамильтона; высокие уровни ситуативной и личностной тревожности по методике Ч.Д. Спилбергера, высокий уровень выраженности нервно-психического напряжения по шкале Т.А. Немчина. Обследованные супруги отмечали наличие напряженности в семейных отношениях, семейные конфликты, как связанные с лечением ребенка, так и эскалацией существующих ранее межличностных и супружеских проблем, чт приводило к дистанцированию и снижению внутрисемейного ресурса. Основываясь на полученных данных нами разработана система медико-психологического сопровождения семьи ребенка первого года жизни с тяжелой черепно-мозговой травмой, которая состояла из четырех последовательных этапов и включала использование индивидуальной когнитивно-поведенческой терапии (Бек AT, 2006), семейной терапии (Ейдмиллер Е. Г., 2003), рациональной психотерапии (классический вариант Дюбуа П., 1912) и психобразовательных программ. Как показали результаты динамического наблюдения, на фоне применения предложенной системы медико-психологического сопровождения в основной группе отмечена устойчивая положительная динамика психологического состояния с полной редукцией тревожно-депрессивных состояний и гармонизацией супружеских отношений.
Ключевые слова: Медико-психологическое сопровождение, тревога, депрессия, семейное взаимодействие, ребенок с тяжелой черепно-мозговой травмой.
References
Back A. L., Arnold R. M., Baile W. F. et al.(2007). Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med., 167, 5, 453 – 460.
Salehpoor F., Bazzazi A. M., Estakhri R. et al. (2010). Correlation between catecholamine levels and outcome in patients with severe head trauma. Pak. J. Biol. Sci., 13, 15, 738—742.
Kobori N. Hu B., Dash P. K. (2011). Altered adrenergic receptor signaling following traumatic brain injury contributes to working memory dysfunction. Neuroscience, 172, 293—302.
Pearlin, L. I. (2012). The social contexts of stress. Handbook of stress. Theoretical and clinical aspects. Eds. L. Goldberger, S. Breznitz. N. Y.: The Free Press, 367—379.
Hung-Chen Wang, Tzu-Ming Yang, Yu-Jun Lin et al. (2014). Serial Serum Leukocyte Apoptosis Levels as Predictors of Outcome in Acute Traumatic Brain Injury. BioMed Research International, 11, Article ID 720870,
Polinder S., Haagsma J., Klaveren D. van. (2015). Health-related quality of life after TBI: a systematic review of study design, instruments, measurement properties, and outcome [Electronic Resource]. Population Health Metrics., 13(4), DOI: 10.1186 / s12963-015-0037-1.
Steinbuechel N. von, Covic A., Polinder S. (2016). Assessment of Health-Related Quality of Life after TBI: Comparison of a Disease-Specific (QOLIBRI) with a Generic (SF-36) Instrument [Electronic Resource]. Behavioral Neurol, 2016, DOI: 10.1155 / 2016/7928014
Valiullina S.A., Promyslova S.A. (2014).Children craniocerebral trauma: epidemiology and basic principles of the organization of medical care. Moscow, 24.
Kvasnitskiy M.V. (2013). Diagnostics and prescription of the first medical aid in cases of craniocerebral trauma. Medicine of Urgent Conditions, 2013, 3 (50), 34-38.
Kazakov V. Ye. (2014).Immune disorders as harbingers of the unfavorable course of craniocerebral trauma. Ukrainian Journal of Psychoneurology, 22, 1(78), 129-131.
Lin Hung-Chen Wang, Tzu-Ming Yang, Yu-Jun. (2014). Serial Serum Leukocyte Apoptosis Levels as Predictors of Outcome in Acute Traumatic Brain Injury. BioMed Research International, 2014, 720870, 11-13
Markova M.V., Piontkovskaya O. V. (2013). Functionality of the family system as a factor of the prevention of mental health disorders in parents of children with cancer pathology. International Neurological Journal, 4, 58, 49-53.
Piontkovskaya O. V. (2013). Behavioral Patterns to Overcome Stress in Parents of Oncologic Children. Journal of Psychiatry and Medical Psychology, 1, 32, 80 - 83.
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