DIRECTIONS OF PSYCHOLOGICAL ASSISTANCE TO PATIENTS WITH THE CONSEQUENCES OF A STROKE IN CONDITIONS OF REHABILITATION WITH THE PARTICIPATION OF A MULTIDISCIPLINARY TEAM OF A POLYCLINIC

Ermakova N.G.
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Abstract

The disabling consequences of a stroke, impaired motor and cognitive functions, the unpredictability of the prognosis of their recovery, affective reactions to the disease can make it difficult to form adherence to treatment and acceptance of the disease, and therefore psychological assistance to patients after a stroke in the rehabilitation process is relevant. The aim of the study was to identify the direction of psychological assistance to patients with the consequences of a stroke in the conditions of rehabilitation in a polyclinic with the participation of a multidisciplinary team (MDB). The study involved 115 patients after a stroke, 63 men, 52 women; aged 38 to 94 years, with self-service disorders of varying severity. Rehabilitation measures were carried out with patients (drug therapy, exercise therapy, occupational therapy, speech therapy and psychological assistance) in a polyclinic at home. The psychological assistance was aimed at correcting attitudes towards the disease and treatment, at forming a positive therapeutic and life perspective in the mind of the patient, and at forming adherence to treatment. Family counseling was aimed at improving the interaction between relatives and patients. After carrying out rehabilitation measures and a psychological assistance program, there is a positive trend in self-care indicators (Bartel scale), cognitive functions (MMSE scale), and a decrease in anxiety and depression (HADS scale). Our study in a district clinic showed the relevance and extreme importance of including a psychological assistance program in the work of a multidisciplinary team. Directions of psychological assistance in a polyclinic included work with patients and with the micro-society (with relatives of patients).
在综合医院多学科小组的参与下,在康复条件下为中风后遗症患者提供心理援助的方向
中风的致残性后果、运动和认知功能受损、康复预后的不可预测性、对疾病的情感反应会使患者难以坚持治疗和接受疾病,因此在康复过程中对中风后遗症患者提供心理援助具有重要意义。本研究的目的是在多学科小组(MDB)的参与下,确定在综合医院康复条件下为中风后遗症患者提供心理援助的方向。研究涉及 115 名中风后遗症患者,其中男性 63 人,女性 52 人;年龄在 38 至 94 岁之间,患有不同程度的自我服务紊乱。患者在家中的综合诊所进行康复治疗(药物治疗、运动治疗、职业治疗、语言治疗和心理辅导)。心理援助的目的是纠正患者对疾病和治疗的态度,在患者心中形成积极的治疗和生活观点,并坚持治疗。家庭咨询旨在改善亲属与患者之间的互动。在实施康复措施和心理援助计划后,患者的自理能力指标(巴特尔量表)、认知功能(MMSE 量表)和焦虑与抑郁程度(HADS 量表)均呈上升趋势。我们在一家地区诊所进行的研究表明,将心理援助计划纳入多学科团队的工作中具有现实意义和极端重要性。综合诊所的心理援助方向包括与患者和微型社会(患者亲属)的合作。
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