Anxieties, depression, fear, depressive disorders are symptoms, which may be the part of physiological feeling with incurable disease, especially when the diagnosis is informed. Sometimes, the assumption of difficult news, related to worsening of health and even risk to life can lead to fatal consequences. For family physicians and other professionals, who are involved in palliative care, it is important to be able to diagnose the worsening of patients’ psycho-emotional state in time, in order to provide professional psychological support. In this article, the results of research of level of difficulty of depressive disorders in palliative patients depending on different demographic and social data are presented, which can be modified with changing attitudes towards these patients (when ensuring correct communication and managing of the palliative patient by the family physician). The research has shown that socio-demographic indicators significantly affect the forming of state of depression in palliative patients, and require appropriate communication between the family physician and the patient, and the organization of additional measures for managing these patients. Special attention should be given to some results of research when providing palliative care, in particular: depression of different level of difficulty, based on the PHQ-9 scale was found in 81 % of palliative patients; it was set that 90 % of people, aged of 75–90 years had depression of different level of difficulty; it was determined that all patients with high income had depression, among them 16.7 % of light and 58.3 % of moderate level of difficulty, that can be considered as a neurotic reaction of incurable disease. Depression was found in all unmarried patients, among them 35 % of light and 35 % of moderate level of difficulty, and 30 % of patients with high level as well, that significantly predominate over the number of married people (4.1 %) and widows 14 %), that may indicate character traits, which complicate the adaptation of behavioral reactions on stress factors , including to the disease. Depression was found in all unmarried patients, among them 35 % of light and 35 % of moderate level of difficulty, and 30 % of patients with high level as well, that significantly predominate over the number of married people (4.1 %) and widows 14 %), that may indicate character traits, which complicate the adaptation of behavioral reactions on stress factors, including to the disease. Such patients need additional psychological support for reducing their suffering, in particular for preventing of mental genesis pains. According to the indicators of various socio-demographic parameters, the portrait of the most vulnerable palliative patients was determined: they are women of age group 75–89 years, living in the city, by civil state – single (additional depressive factor can be assumed – long-term loneliness), by social status – pensioners with Higher Education and high income, based on a scale of PHQ-9 >20 points, that corresponds to the diagnosis: depressive syndome of heavy level.
Current approaches to non-specialized help with stress are set out in this article and stress management tools are provided, which are developed by WHO in the stress management handbook “Doing What Matters in Times of Stress: An Illustrated Guide”. This knowledge is especially current in the giving of first aid in emergencies, and in giving psychosocial support to patients as well, by primary care physicians, who must have effective communication skills and mutual understanding, and have experience in supporting people in difficult situations too, as it is specified in numerous WHO recommendations on mental health, in such as : «mhGAP Intervention Guide for mental, neurological and substance use disorders in nonspecialized health settings», «IASC Guidelines for mental health and psychosocial support in emergency settings»,«mhGAP Humanitarian Intervention Guide (mhGAP-HIG): clinical management of mental, neurological and substance use conditions in humanitarian emergencies», «Support for Rehabilitation: Self-Management after COVID-19 Related Illness» and etc. Aim – to give the information for the distant self-learning of the primary care professionals to use the simple stress-management tools in difficult circumstances. Distance learning is built on the basis of the evidence based WHO documents and recommendations about low intensity psychological interventions. The WHO Guide has five sections, where five ideas and techniques for reducing stress are descibed, which are designed as the acquisition of five skills. The authors at the end of each section of the Guide developed algorithms of use the skills of such tools as: «Grounding», «Unhooking», «Acting according to own values», «Showing kindness», «Creating space». The psychosocial support provided by the primary care physician / facilitator / assistant lies in helping people to use guidance and apply strategies in their own lives, and it prevents the professional burnout of healthcare professionals as well. The short information about WHO guide and stress -management methods are described in sufficient details to enhance the awareness level of the primary care personnel about stress-management tools use. As the result of using the Guide will enhance the capacity of local helth care staff and non medical staff to provide the mental health services and psychosocial support during the current COVID-19 pandemic, and readiness for the future emergencies.
Резюме. Стаття присвячена оцінці структури нервово-психічного стану пацієнтів літнього та старечого віку з гіпертонічною хворобою (ГХ) ІІ та ІІІ стадії, ускладненою інфарктом міокарда. Проведено психодіагностичне дослідження невротичних станів та рівня ситуаційної та особистісної тривожності залежно від рівня стресу, стадії ГХ та вікової категорії. Виявлено зростання невротичних станів залежно від стадії ГХ і збільшення віку. Встановлено прогресування процесу виснаження психофізіологічних якостей психічних реакцій особистості залежно від перебігу ГХ та формування високого рівня неспокою, що заважає психосоціальній адаптації, комплайєнсу з лікарем, знижує ефективність лікування та якість життя пацієнтів літнього та старечого віку з ГХ ІІ–ІІІ стадії.
This article provide new recommendations and main tasks that is needed to general practitioners – family doctors and family medical nurses in order to care about the patients with depressive disorders.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.