Abstract

Nowadays the medical and social issues associated with hereditary and congenital pathologies, and first of all, congenital malformations and chromosomal diseases are very relevant. For a decade they have been assuming ever greater medical, social and economic importance. Long-term and complicated care of patients with congenital malformations, medical correction of the defects, pedagogical intervention as well as psychological support to social adaptation require a long time and much of finances, material and technical resources. Surgical pathologies in neonates and namely congenital malformations causing most perinatal and infant deaths are in the focus of current neonatology. The prevalence of congenital malformations of gastrointestinal tract and anterior abdominal wall ranges from 13 to 26, 4 cases per 10000 live-born neonates, and diaphragmatocele is registered in 2.5 – 5.0 cases per 10000 of livebirths. These pathologies account for 29.1% of the total congenial malformations ranking the 3 rd position. The most effective and reliable technique to spot congenital malformations of a fetus is ultrasound scanning. The optimal timing for detecting congenital malformations of gastrointestinal tract is 12 – 23 weeks of gestation. In addition to purely medical aspects of the diagnosis of birth defects which may be corrected surgically, there is another, but not less important psychological aspect. There is no doubt about the necessity of psychological support to parents and family members during the prenatal period (from diagnosis to birth), at all stages of surgical correction and postoperative care, regardless of their length. When any congenital complications have been detected the medical and psychological follow-up should be aimed to establish the most accurate diagnosis by experts, to provide detailed informing parents about the diagnosis and all up-to-date methods of treatment of this disease, to afford them ground for consulting with experts experienced in the treatment of certain pathologies. There are several behaviour types demonstrated by parents who become aware of their child’s diagnosis of congenital malformation: compensated families fully accepting a child and its defect (23%); families showing unacceptance of the child with birth defects, family with snail syndrome (26%), dysadvantaged families or families with low or unsatisfactory socio-cultural status (26%). Implementation of a certain type of behaviour by the family starts from the moment of diagnosis. Psychological correction in these families is multiple-aspect, complex and based on a number of principles, compliance with which ensures effective result of the influence: the principles of humane and empathic attitude, the unity of diagnosis and correction, harmonization of family relations, the encouragement of positive thinking towards the child, providing person-centred assistance, creating an inner positive plan for actions, the coordination in the activity of the medical staff, psychological groups and families. Psychological correction is performed in three main vectors (directions): a psychological study of the problem, psychological counselling, and providing psychological and educational support to family members. Prenatal diagnosis of congenital malformations shocks parents, causes psychological discomfort, in some cases mental and emotional stress with elements of emotional unacceptance of the child. The reaction of parents to the news that their child has birth defect is characterized by the staging that includes: phase of shock, phase of reactivity, adaptive phase, the phase of orientation. Since the baby has been born, the major stressful factor is staying in the atmosphere of uncertainty, expectations of surgical treatment and its results. Psychological supporter aimed to develop positive thinking, stipulates the following objectives: to correct unconstructive parental behaviour, to develop parents’ awareness of the problem of their child, to improve family relationship. Next, goals psychological rehabilitation of families where a child is brought up with the defect, the reconstruction of the hierarchy of values in life parents of a sick child, parents exercise personal growth in the process of interaction with your child. Further, the goals of psychological rehabilitation of families caring children with congenital malformation is the reconstruction of parents’ hierarchy of values in life, and the stimulation of personal growth in the process of interaction with the child.

Highlights

  • Surgical pathologies in neonates and namely congenital malformations causing most perinatal and infant deaths are in the focus of current neonatology

  • Якщо діагноз не був встановлений пренатально і батьки дізнаються про ваду у дитини після народження, першою реакцією є емоційний шок, перебування в атмосфері невизначеності, очікування хірургічного лікування та його результатів є основним психотравмуючим фактором

  • Который позволяет в период беременности установить пороки развития, является ультразвуковое исследование плода

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Summary

Introduction

Surgical pathologies in neonates and namely congenital malformations causing most perinatal and infant deaths are in the focus of current neonatology. При виявленні ускладнень медико-психологічний супровід має включати максимально точне встановлення діагнозу експертною комісією, детальне інформування батьків про діагноз та всі сучасні методи лікування цього захворювання, консультації з фахівцями, які мають досвід в лікуванні саме цієї вади.

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