The article presents transformation of medical care for patients with mental disorders and the establishment of psychiatric care in Chernivtsi in the late 19th century. Since the proclamation of Bukovyna as the crown land of the Austro-Hungarian Empire, the provision of psychiatric care has changed. A psychiatric service appeared and helped to understand what a mental disorder really is. There was a transition to a scientific interpretation and a scientific approach to providing psychiatric care.The authors research and systematize information from various available sources, various articles, information messages, data from the state archives of Chernivtsi region, etc.It is known that the model of the regional psychiatric hospital in Chernivtsi was developed by the latest requirements for the construction of mental health facilities in Austria and other European countries of the time.At the beginning of the 20th century, the Bukovynian psychiatric hospital was extremely modern, equipped with all necessary equipment and the location of the wards in accordance with the standard of the time. Leading doctors were involved, as well as local ones, who had the opportunity to train at the University of Vienna and psychiatric hospitals. 15 hectares of land were allocated for the territory of the hospital, which was located outside the city on the territory of the former Strazagasse (Storozha) and Maisgasses (Kukurudziana) streets, now Mussorgsky Street.The opening of the regional psychiatric hospital in Bukovyna took place on May 1, 1902. The structure of the psychiatric hospital included 6 buildings, as well as the administration building and other technical facilities.The purpose of the article was to highlight the main historical moments of assisting persons with mental disorders in Chernivtsi in the late 19th and early 20th centuries. Describe the historical chronology from the first psychiatric ward at the city hospital to a separate regional psychiatric hospital in Bukovyna. The methodology of the article is a synthesis of the historical chronology of psychiatric care as part of health care in Chernivtsi.The history of the emergence of psychiatric services in Chernivtsi has experienced ups and downs that corresponded to challenging conditions of the time. The transformation of mental service changed from the worldview and level of development of contemporary science. We can observe changes from mystification to the formation of psychiatry, as real modern neuroscience with an evidence-based approach and humane treatment of patients. Through the ages, different countries and changes in the understanding of the aetiology and pathogenesis of mental disorders, Chernivtsi remains the centre of mental health in Bukovyna.
The origins of psychiatric care in Bukovina can be divided in two stages: the first stage - pre-scientific, the second stage - scientific or nosological. During the pre-scientific period of providing assistance to persons with mental disorders occurred in monasteries. They were regarded as possessed, that is, persons with demons. On the territory of modern Chernivtsi area there were several such monasteries where they could get help patients with mental disorders. Since the proclamation Bukovina is the crown land of the Austro-Hungarian Empire psychiatric care has changed. A psychiatric service was bornunderstanding what a mental disorder is. There was a transition to science interpretation and approach to psychiatric care. The purpose of the article was to cover the formation of the psychiatric service in Bukovina, the transformation of the approach to care for patients with mental disorders, from mysticism to the modern model. Scientific novelty is to analyze the history of psychiatry in Bukovina from the past to present and coverage of the main historical moments that gave impetus for the formation of true neuroscience. Methodological principles research: chronological and comparative-historical approach, systemic interdisciplinary analysis. Conclusions. History of origin psychiatric service in Bukovina experienced ups and downs that corresponded to the conditions of the time. The transformation of mental service has changed from the worldview and level of development of contemporary science. You can watch changes from mystification to the emergence of psychiatry as a real modern neuroscience with an evidence base and humane treatment of patients.
Introduction. Throughout life, everyone faces a variety of emotionally complex situations. Pregnancy is one of such situations for a woman. It’s a very strong level of experience and a specific set of sensations in life, the study of which has recently received close attention. Circumstances that have developed in Ukraine in connection with environmental disadvantages mainly determine the low health index of pregnant women, and create preconditions for the increasing frequency of premature pregnancies in future generations. This problem is of great medical and social importance. More than a third of babies born prematurely lag behind in physical and psychomotor development. Considering the above mentioned, it can be argued that the creation of a system of medical and psychological support for pregnant women with a risk of preterm birth in the last trimester of pregnancy is relevant, necessary and timely. The purpose of the study is to develop a set of measures for medical and psychological support of women at risk of preterm birth in the last trimester of pregnancy and after childbirth based on a systematic approach to the study of individual psychological, pathopsychological and psychosocial characteristics. Material and methods. During 2016-2019 the study was conducted based on Storozhynets Central District Hospital in the Chernivtsi region. 150 pregnant women in the third trimester of pregnancy (23-37 weeks) and their husbands were examined. The main group (MG) included 120 women with the risk of premature birth in the last trimester of pregnancy. The comparison group (CP) included 30 women with a physiological course of pregnancy. The main therapeutic group (MTG) consisted of 42 women with a risk of preterm birth in the last trimester of pregnancy with maladaptive (MTG1) and destructive (MTG2) types of interaction in the triad "mother-child-father", who agreed to participate in medical and psychological care. The correctional group (CG) included 12 women with a risk of preterm birth in the last trimester of pregnancy with maladaptive and destructive types of interaction in the triad "mother-child-father", who refused to participate in the proposed measures. Results. Analysis of the evaluation of the developed system of medical and psychological support of the family during pregnancy showed the following (p <0.001): a) improvement of psycho-emotional state, well-being and overcoming emotional stress demonstrated by MTG1 women (up to 43.7 ± 0.8 and 42.5 ± 1.5, respectively, and after 20.8 ± 1.5 and 22.1 ± 1.2, respectively), the level of depression and anxiety on the Hamilton scale (up to HDRS 11.4 ± 1.2 and HARS 12.5 ± 1.2 after HDRS 4.2 ± 0.4 and HARS 5.7 ± 0.4) and female MTG2 indicators of RA and PA on the Spielberger-Khanin scale (up to 51.7 ± 0.8 and 50.7 ± 1.5, respectively, and after 21.4 ± 1.8 and 23.1 ± 1.5, respectively), the level of depression and anxiety on the Hamilton scale (up to HDRS 16.3 ± 1.2 and HARS 18.3 ± 1.2 after HDRS 7.6 ± 0.7 and HARS 6.9 ± 0.6). Among CG women indicators RA and PA on the Spielberger-Khanin scale (up to 47.7 ± 0.8 and 46.6 ± 1.5, respectively; after 45.8 ± 1.5 and 42.1 ± 1.2, respectively), the level of depression and anxiety on the Hamilton scale (before HDRS 13.8 ± 1.2 and HARS 15.4 ± 1.2; after HDRS 12.2 ± 0.4 and HARS 14.7 ± 0.4) were higher. b) there was an increased level of social support on the last two scales - "support of colleagues" and "support of public organizations" among MTG1 and MTG2 women (up to 25.3%, after 55.2% / up to 14.8%, after 45, 2%, respectively) compared with CG women (up to 18.5%, after 24.5%). c) there was a complete reduction of the deformation of marital relations in the majority of MTG1 (83.3%) and MTG2 (75%) women in contrast to the examined CG. Conclusions. The implementation of the system of medical and psychological support for women with a risk of preterm birth in the last trimester of pregnancy and after childbirth allowed to optimize the choice of adequate behavioral strategies in a family, improve emotional state and well-being, optimize women's attitudes to pregnancy and harmonize family interaction (72.5%) ˂0.001), to harmonize the relationship in the triad "mother - child - father" in the postpartum period (66.4%) (p˂0.001).
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