BACKGROUND: There is a need to optimizethe continuity between the various organizations involved in the rehabilitation of the sick and disabled. The application of the International Classification of Functioning, Disabilities and Health will allow overcoming the existing barriers of interdepartmental interaction.
AIMS: to create a scoring system for persistent disorders of the blood and immune system as determinants of ICF in patients with HIV infection.
MATERIALS AND METHODS: A random sampling method was used to perform a retrospective analysis of 100 protocols for conducting a medical and social examination of citizens with HIV infection and AIDS. The average age of those surveyed was 39 years. Men predominated (64%). The first group of disability is set at 21%, the second ― 45%, the third group ― 25%.
RESULTS: The most significant persistent disorders of body functions in patients with HIV infection were identified in the immune system (p 0.01).
CONCLUSIONS: The relationship between the severity of persistent disorders of the immune system and the disability group was revealed: among the disabled of the first and second groups, severe and extremely severe problems were statistically significantly more common (p 0.01), which confirms the possibility and necessity of using the international classification of functioning in people with HIV infection/AIDS in the form of a scoring as a way to reflect the quantitative characteristics of persistent disorders of the blood and immune system, including in disabled people.
The article highlights the issues of using the International Classification of Functioning, Disability and Health in persons with HIV infection / AIDS in the form of a point assessment as a way of reflecting the severity of persistent disorders of the body's functions, in particular of the blood and the immune system, the possibility of using it for people with disabilities.
The data of our own research, a clinical example are presented.
To date in Russia continues the spread of HIV/AIDS. At the stage of secondary lesions in HIV infection, the patient has persistent violations of the functions of various organs and systems of the body, which reduce the quality of life, lead to a restriction of human life, which requires assistance from society and the state. The Russian Federation has established a system of economic, legal, and social measures to support disabled people, as well as all citizens with HIV infection. The establishment of a disability group, its causes, timing, time of onset, and the needs of a disabled person in various types of social assistance is assigned to federal institutions of medical and social expertise.
A retrospective analysis of 100 protocols of medical and social examination of citizens with HIV infection was carried out by random sampling/AIDS in federal state institutions of medical and social expertise of St. Petersburg and other regions of Russia in the period from 2017 to 2020. The purpose of our study was the possibility of including the provisions of the International Classification of Functioning, disability and Health in the assessment of categories of disability in people with HIV-AIDS. The frequency and severity of disability, designated in the form of domains of the international classification of functioning Activity and participation in the group of patients under consideration, were studied, while the most striking or generalizing domain was taken from each section, characterizing the restriction of each category of vital activity established in a disabled person with HIV infection (d599 unspecified Self-care; d450 Walking; d230 Daily routine; d350 Conversation; d710 Basic interpersonal interactions; d859 Work and Employment, other specified and unspecified).
According to the results obtained, the most common functional disorders lead to restrictions in daily activity (self-care and everyday life) and in the main areas of life (education, work and employment). Violations of physical and cognitive functions as the process progresses have a significant impact on the ability to work of AIDS patients, limiting their choice of occupations and leading to termination of employment.
The International Classification of Functioning, Disability and health is a convenient tool that reflects the level of functioning of an individual at various stages of the disease.
The article discusses the main points of the form 088/u «Referral for medical and social examination (MSE) by a medical organization: drawn up by specialists of medical organizations (MO), when sending citizens for medical and social examination, causing difficulties in filling out for specialists of the MO and containing the greatest informative for MSE.
When examining citizens in federal state medical and social examination institutions when recognizing a person as disabled, it is necessary to apply the criteria for determining disability set out in Order of the Ministry of Labor of Russia dated August 27, 2019 No. 585н. The conditions for recognizing a citizen as a disabled person are persistent violations of body functions, which lead to a limitation in various categories of life, the need for social support. A quantitative assessment of the severity of persistent dysfunctions of the human body is determined in percent. Certain clauses of the Order regulate the examination of citizens with diabetes. The article sets out the generally accepted criteria for assessing the severity of diabetes and its complications, the main research methods to determine the dysfunction of the target organs for a timely and reasonable referral for examination at the bureau of medical and social examination.
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