Psycho-emotional State Research Articles

Clinical and radiological efficacy of a new conservative treatment for fibrocystic disease

Background. Long-lasting dyshormonal breast diseases in women represent a risk factor for breast cancer, especially in patients with atypia. Clinical manifestations of fibrocystic breast disease (FBD) and mastopathy, including high-intensity pain cause psychoemotional discomfort and reduce the quality of life of women. The search for effective management strategies for mastopathy with an antiproliferative effect is highly relevant.Aim. To assess clinical and radiological efficacy of a new conservative treatment for FBD, “Evening primrose oil” administered orally for 6 months in women with symptomatic FBD.Materials and methods. This randomized, blind, placebo-controlled trial included 144 patients with clinical FBD manifestations (pain and tension in the breast). Patients were randomly assigned to one of the two treatment groups. Women in group I received “Evening primrose oil”, whereas women in group II received placebo (ascorbic acid) for 6 months. We measured the dynamics of radiological findings (at mammography and ultrasound examination) in the breast before and after treatment, as well as pain intensity using the visual-analog scale.Results. Patients in group I with all types of FBD (diffuse mastopathy, nodular, and mixed forms) demonstrated positive dynamics and BI-RADS category downgrading within 6 months. In the placebo group, the examination after 6 months demonstrated no significant changes in the breast and no BI-RADS category downgrading among women with diffuse mastopathy. Some patients with nodular and mixed FBD receiving placebo had negative dynamics after 6 months (as demonstrated by mammography and ultrasound examination; BI-RADS category upgraded from II to III, p<0.01). Patients receiving “Evening primrose oil” also showed positive dynamics in their clinical manifestations, including decreased breast pain (from 7.8 to 1.8 on the visual analog scale). By contrast, patients receiving placebo had no changes in their breast pain intensity after 6 months (from 7.3 to 7.1 on the visual analog scale), which resulted in poorer psychoemotional state in 55.6 % of women.Conclusion. Our new treatment strategy for FBD patients with clinical and radiological manifestations in the breast demonstrated high efficiency and can be implemented into routine clinical practice.

Psychoemotional status and arterial hypertension in children: search for correlation and clinical application

Arterial hypertension is a common problem in pediatrics that requires close attention from pediatricians and pediatric cardiologists. Scientific discoveries describing molecular-genetic interactions in disease progression unfortunately do not always help practitioners and patients to achieve full control of the disease. The anatomo-physiologic features of childhood have forced researchers to search for new reference points that can help clinicians select effective therapies. In recent years, clinicians and psychologists have noted a steady increase in anxiety disorders in childhood and adolescence. Approximately 32% of adolescents have symptoms of anxiety that are mostly ignored and not corrected. In the future, such patients have a significantly increased risk of developing not only psychiatric abnormalities, but also cardiovascular diseases. Assessment of the patient's psychoemotional status may become an important factor in the selection of complex treatment, which will provide a personalized approach to the therapy of arterial hypertension in a child and prevent the development of its long-term consequences.

Comprehensive Geriatric Assessment of Older and Oldest-Old Patients in the Perioperative Period. Russian Gerontology Research and Clinical Centre Experience

With the aging population, the significance of preoperative diagnostics and optimizing the treatment of surgical patients with frailty syndrome is gaining momentum. For such patients a comprehensive geriatric assessment (CGA) is carried out to clarify the severity of frailty and the individual characteristics of the geriatric status [1]. The results of this assessment are used to stratify the risk in the postoperative period and to determine targeted interventions for the correction of geriatric syndromes [2]. The introduction of new geriatric technologies during hip and knee replacement in weakened older patients needs scientific justification and confirmation of effectiveness.Objective: to test the method of complex geriatric management of older and oldest-old patients before and after surgical interventions in the provision of planned inpatient orthopedic care (knee and hip arthroplasty).Materials and methods: the study involved two groups of older and oldest-old patients with frailty: 50 patients, average age 69.2 ± 6.0 years [60 to 87 years] with gonarthrosis and 50 patients, average age 67.6 ± 5.5 years [60 to 81 years] with coxarthrosis. At the prehospital stage, patients were diagnosed with frailty, in accordance with the clinical recommendations of «Senile asthenia» [3]. Upon admission to surgical treatment, a CGA was performed, including indicators of basic (Barthel Activities of daily living Index, Barthel scale [4]) and instrumental activity (The Instrumental Activities of Daily Living Scale, IADL scale [5]), nutrition assessment (Mini Nutritional assessment, MNA scale [6]), cognitive functions (The Montreal Cognitive Assessment, MOCA test [7]), depression (Geriatric Depression Scale, GDS-15 scale [8]), as well as quality of life (A Visual Analogue Scale, EQ-VAS scale [9]), multimorbidity and polypragmasia. An individual plan of perioperative management was drawn up.Results. A comparative analysis demonstrated statistically significant improvements in functional status (based on the Barthel scale), cognitive status (based on the MOCA test), nutritional status (based on the MNA scale) and quality of life (based on the EQ-VAS scale) 12 months after surgical intervention in groups of patients after knee and hip replacement. In the group of patients after hip replacement, there was also an improvement in the quality of life of patients 12 months after surgery. The assessment and dynamics of indicators in functional and cognitive status within the control group were not carried out, which makes it difficult to compare the results. However, there was a reduction in hospital stay for patients using geriatric approaches compared with previously used surgical care in the control group.Conclusion: the management of patients with frailty in the perioperative period with the use of CGA allows for preventive measures aimed at maintaining functional, psycho-emotional status. Individual characteristics of the state of psychoemotional and functional status in older and oldest-old patients may not be considered during the traditional preoperative risk stratification and increase the risks of adverse outcomes of surgical treatment, duration of hospital staying and repeated hospitalizations.

Predictors of the Effectiveness of Psychological Support in Addition to the Base Treatment in Pulmonary Tuberculosis

The aim of the study was to investigate the effect on the psycho-emotional state and adherence to treatment in patients with pulmonary tuberculosis of remaxol inclusion in the accompanying therapy regimens.Material and methods. The data from 326 patients (252 men and 74 women) with various forms of pulmonary tuberculosis treated at the Regional Clinical Tuberculosis Dispensary were analyzed; the average age of patients was 41.3±1.6 years. A low level of adherence to treatment, as well as clinical and laboratory signs of grade I hepatotoxicity were revealed in patients receiving a course of etiotropic therapy in the main group (N=72). In this regard, in addition to the psychological support for the main course of treatment, accompanying therapy was prescribed: remaxol 400 ml intravenous drip every other day (course No. 5), after-wards — 1 time a week (course No. 4). Patients in the comparison group (N=254) received standard treatment. In addition to the standard examination, the cytokine profile (the level of IL-1β, 4, 6), TNF-α and IFN-γ) was determined in dynamics according to the indications in patients. The level of adherence to the treatment was also determined in dynamics through testing according to the original methodology.Results. The study revealed that the inclusion of remaxol in the treatment regimens facilitated more pronounced positive dynamics in clinical and laboratory data compared with the standard regimen: a decrease in signs of hepatotoxicosis and a tendency towards improvement in cytokine profile parameters. This contributed to maintaining the etiotropic therapy regimen and improving the well-being of patients, which, in turn, increased the level of adherence and therefore the effectiveness of treatment in patients.Conclusions. The combination of positive effects of remaxol use in patients with pulmonary tuberculosis contributes to an increase in their psycho-emotional state and thereby increases adherence to treatment and its effectiveness.

Method and organization for expert evaluating of rehabilitation services for lower limb prosthetics: problems and solutions

Relevance. Prosthetics of the lower limb after amputation restores the patient's ability to move and self-care. Preparation and prosthetics in the early stages after amputation, in the absence of contraindications, improves the physical, psycho-emotional state of patients, reduces the risk of complications due to forced exercise and exacerbation of concomitant somatic pathology, as well as increases exercise tolerance, restores mobility, functioning after amputation.The aim of the work is to improve the quality of life of patients with mobility disabilities.Materials and methods. The information base of the study was the normative legal acts of the Russian Federation, standards, clinical recommendations defining the existing system of providing rehabilitation services for prosthetics of the lower limb.Conclusion. Unsatisfactory prosthetics of the limb after amputation negatively affects the quality of life of the patient. For this reason, the assessment of the rehabilitation service of prosthetics of the lower limb, including using the tools of the International Classification of Functioning, Disability and Health, is both relevant and necessary.

APPLICATION OF REFLEXOTHERAPY ACCORDING TO THE “HEXAGRAM BALANCING” METHOD IN THE COMBINED REHABILITATION OF DISEASES OF THE RESPIRATORY SYSTEM WITH PSYCHOEMOTIONAL DISORDERS

Abstract. The article is devoted to one of the most urgent problems of medicine – complex treatment of bronchial asthma. Often, various diseases, especially those that occur with aggravated under the influence of psycho-emotional stress, depression, asthenia and other adverse psychosocial factors, are accompanied by long-term symptoms. Medicinal methods of treatment are not fully effective, so non-medicinal technologies should be resorted to. Combined treatment of bronchial asthma using іn rehabilitation reflexotherapy methods has been used for a long time, it is especially effective when there are also psychosomatic problems. The article as well presents the main theoretical principles of the “balancing of hexagrams” method and its practical implementation. A clinical case is also presented: bronchial asthma in the patient with psychoemotional disorders. The methods of acupuncture diagnosis are presented, the acupuncture diagnosis is characterized in detail, the description of acupuncture correction is given, the methods of medical correction used in treatment, the features of the “favorable” hexagram are considered. Thus, patients with bronchial asthma with psychoemotional disorders are found in the practice of a reflexologist. In the complex of therapeutic measures for bronchial asthma with psychoemotional disorders, the use of the acupuncture method “balancing hexagrams” can be effective. Purpose. To consider the peculiarities of the use of reflexotherapy by the method of “balancing hexagrams” in the complex rehabilitation of patients with diseases of the respiratory system with psycho-emotional disorders. Scientific novelty. For the first time in our country, the technique of making acupuncture prescriptions and acupuncture using the method of “balancing hexagrams” was used in the complex rehabilitation of patients with diseases of the respiratory system with psycho-emotional disorders. Methods. We consider one clinical case of the use of reflexotherapy using the method of “balancing hexagrams” in the complex rehabilitation of diseases of the respiratory organs with psycho-emotional disorders. Results. As a result of treatment using the “balancing hexagrams” method, the patient's condition improved: his psychoemotional state normalized, he was able to completely give up alcohol, went on a diet; his respiratory conditions improved. Conclusions. 1. Bronchial asthma occurs in the practice of a reflexologist, and with this disease, reflexotherapy methods are effective primarily for psycho-emotional disorders. 2. The use of the acupuncture method “balancing hexagrams” can be effective in the complex of treatment measures for bronchial asthma.

Psychological conditions of the impact of social exclusion during the pandemic on the psychoemotional state of students

Relevance. The COVID-19 pandemic has had a profound impact on all spheres of life, as it was preceded by a series of sweeping changes. Therefore, the study of the factors and objects on which it affected is an extremely topical issue in modern scientific doctrine. The increased interest is also due to the fact that social exclusion is a fairly new phenomenon in every society, to which citizens were clearly not prepared and which in turn provoked not only technical and organizational difficulties, but also psychological.Purpose. The aim of this work is to study the psychological conditions affecting the psycho-emotional state of students, in the context of the fight against acute respiratory disease COVID-19.Methodology. Different methods of scientific research were used to realize this goal. Among them functional and dialectical approaches, as well as a method of psychological analysis, synthesis, comparison, qualitative analysis of psychical phenomena.Results. As a result of the study, solid conclusions were obtained on the issue under consideration. Accordingly, the article reveals the theoretical part, which consists in establishing the essence and properties of basic concepts, such as distance learning, psycho-emotional state. In addition, practical results were also identified by examining the main conditions and factors that have the greatest impact on students and their internal condition during the pandemic and, consequently, general social exclusion.Conclusions. Later work should explore ways to reduce the impact of the pandemic and isolation on school-age children, to maintain their normal psycho-emotional state. The practical value of the work lies in the fact that it can be used both by teachers during the educational process and by parents or directly by students who are studying remotely and are forced to be isolated from other social groups.

Динамика психоэмоционального и когнитивного статусов женщин репродуктивного возраста на фоне приема комбинированного орального контрацептива, содержащего эстетрол

Objective. To study the dynamics of change in psycho-emotional and cognitive indicators in reproductive-aged women receiving a combined oral contraceptive (COC) with estetrol/drospirenone. Patients and methods. A prospective open-label observational study included 64 patients aged 18 to 45 years who applied for contraception selection. According to the study protocol, all patients underwent general clinical examination at baseline, 3 and 6 months from the start of COC administration. The examination included calculation of body mass index (BMI) by Brey formula, measurement of blood pressure, transvaginal ultrasound, assessment of psycho-emotional state and cognitive function. Results. The data obtained in this study indicate a positive effect of COC containing estetrol/drospirenone on the psychoemotional state and cognitive function in patients, which is characterized by increased levels of physical activity regardless of age, decreased levels of anxiety and depression, greater satisfaction with sleep quantity and quality, improved cognitive function due to a positive effect mainly on mild cognitive disorders. Conclusion. Current data on the neuroprotective effect of estetrol in relation to the central nervous system require further study and comprehension. Key words: psycho-emotional state, cognitive disorders, combined oral contraceptive, estetrol, drospirenone

Dynamics of parameters of autonomic nervous system functioning and psychoemotional status as a criterion for the effectiveness of the physical therapy program for patients with bruxism

Dynamics of parameters of autonomic nervous system functioning and psychoemotional status as a criterion for the effectiveness of the physical therapy program for patients with bruxism

Anxiety-depressive disorders in patients before and in the long terms after aortic replacement

To study the structure and dynamics of anxiety-depressive disorders in patients with dissection/aneurysm of the ascending aorta and aortic arch before and in the long term after surgical treatment and to identify factors associated with disturbances in psycho-emotional status. We examined 124 patients with dissection/aneurysm of the ascending aorta and arch before and in the long-term period after aortic replacement, assessing anxiety and depression using the Generalized Anxiety Disorder (GAD-7) and Beck Depression Questionnaires. Multivariate regression analysis was used to identify factors associated with clinically significant anxiety and depressive disorders. Average scores on the GAD and the depression scale before surgery decreased from 6.5 (4.0-9.0) and 12.0 (8.0-16.0) to 3.0 (2.0-5.0) and 6.0 (3.0-10.0) (p<0.05) respectively, in the long-term postoperative period. There was no significant decrease in the proportion of patients with clinically significant levels of GAD and depression (p>0.05). Before surgery, clinically significant anxiety and depressive disorders are associated with older age, chronic cerebrovascular insufficiency (CCI) and atrial fibrillation (AF) in the hospital period. After surgery, clinically significant GAD was associated with older age, CCI, and a history of stroke. Depressive disorders were associated with older age and a history of stroke. In all patients with aortic disease, GAD and depression of varying severity are recorded; clinically significant GAD and depression are recorded in 19.2 and 23.2% of cases. In the long-term postoperative period, there is no significant decrease in the proportion of patients with clinically significant levels of GAD and depression, which amounted to 10.1 and 13.1%. Clinically significant anxiety and depressive disorders before and after surgery are associated with older age and the history of cerebrovascular disorders. In addition, the baseline clinically significant anxiety and depressive disorders showed an association with the subsequent development of AF in the early postoperative period.

Методы немедикаментозной терапии функциональных нарушений голосовой функции

The development of physical and rehabilitation medicine makes it possible to introduce nondrug methods of treatment more widely. Treatment of patients with hypofunctional dysphonia is aimed at improving the condition of the neuromuscular apparatus of the larynx. The number of such patients increased significantly during and after the Covid-19 pandemic. Neuromuscular electrophonopedic stimulation (NMEPS) is a modern method combining physiotherapeutic and voice therapy effects. Objectives. To study the effectiveness of various nondrug treatments methods for hypofunctional dysphonia. Materials and methods. 45 patients with hypofunctional dysphonia were examined. For the treatment of vocal function, 25 patients of the observation group used NMEPS of the larynx, and 20 patients of the comparison group used phonopedic correction. Each course consisted of 10 lessons. A point assessment of patient complaints, an analysis of videoendoscopic end videolaryngostroboscopic signs of hypofunctional dysphonia and the psychoemotional status of patients were performed. Results. Before treatment, there was no significant difference between the groups. After the course of treatment, the number of complaints from patients in the observation group decreased from 10.3±1.1 to 4.1±0.3 points, in the comparison group, from 10.5±0.8 to 6.8±0.4 points (p &lt; 0.05). When analyzing the videoendoscopic picture in the observation group, a significant improvement in most indicators was noted. Normal indicators of the videoendostroboscopic picture were diagnosed in 88% of patients in the observation group and 65% of patients in the comparison group (p &lt; 0.05). In both groups, an improvement in the psychoemotional status during treatment was revealed compared to the initial one. Conclusions. The data obtained confirm the effectiveness of the NMEРS in the treatment of patients with hypofunctional dysphonia.

ОЦЕНКА ЭФФЕКТИВНОСТИ «ПАНТОГЕМАТОГЕНА-С» В КОМПЛЕКСНОЙ МЕДИКО-ПСИХОЛОГИЧЕСКОЙ РЕАБИЛИТАЦИИ ВОЕННОСЛУЖАЩИХ С АСТЕНИЧЕСКИМ СИНДРОМОМ В УСЛОВИЯХ САНАТОРИЯ

Introduction. The utilization of the dietary supplement "Pantohematogen-C" within the medical and psychological rehabilitation program for military personnel with secondary asthenic syndrome in a sanatorium-resort setting has demonstrated its positive impact on normalizing key asthenia symptoms, including physical and mental exhaustion, vegetative disorders, and sleep disturbances. Aim. This study aimed to enhance the effectiveness of comprehensive medical and psychological sanatorium-resort rehabilitation for military personnel with asthenic syndrome using the dietary supplement "Pantohematogen-C". Materials and Methods. The study involved 39 male military personnel aged 24 to 59 years (average age 39.2±4.18 years), with 20 patients in the main group and 19 in the comparison group. The patients underwent a 21-day sanatorium rehabilitation program at the Military Sanatorium "Yeltsovka" of the Ministry of Defense of the Russian Federation. The rehabilitation program included various interventions such as diet therapy, gentle-training motor regime, physical therapy methods, daily dosed walking, exercise equipment, transcranial electrical stimulation (TES), iodine-bromine baths, and psychological correction. Additionally, the main group received the dietary supplement "Pantohematogen-C" three times a day, while the comparison group underwent only the procedures of the basic complex. The effectiveness of the rehabilitation measures was evaluated using several assessment tools. Results. Following the comprehensive sanatorium rehabilitation program, including "Pantohematogen-C", a significant decrease in physical and mental components of asthenia, an increase in activity on the MFI-20 scale, normalization of vegetative status, and improved sleep quality were observed. Patients also reported enhanced well-being, mood, and activity. Moreover, the program led to a statistically significant decrease in situational anxiety. Conclusions. The study has explored the potential and suitability of using Pantohematogen-C to enhance the effectiveness of the sanatorium-resort program for medical and psychological rehabilitation of military personnel with secondary asthenic syndrome. This intervention has shown promise in normalizing vegetative and psycho-emotional status, improving sleep quality, and increasing patient activity in sanatorium-resort organizations catering to these patient categories.

СРАВНИТЕЛЬНАЯ ЭФФЕКТИВНОСТЬ КОМПЛЕКСНОГО ВОССТАНОВИТЕЛЬНОГО ЛЕЧЕНИЯ ПАЦИЕНТОВ С АНДРОГЕННОЙ АЛОПЕЦИЕЙ ПРОДУКТАМИ ПАНТОВОГО МАРАЛОВОДСТВА И ФИЗИОТЕРАПЕВТИЧЕСКИМИ ТЕХНОЛОГИЯМИ

Objective. Comparative assessment of the results of complex restorative treatment of patients with androgenetic alopecia using pantohematogen and darsonvalization. Materials and methods. There were 93 patients under observation who underwent outpatient rehabilitation treatment for androgenic alopecia for 21 days. Two equivalent groups of patients and a group of 30 healthy people were formed. Subjects in the main group (31) were prescribed diet therapy, vitamin therapy, and scalp massage. Additionally, patients took pantohematogen inside and masks of pantohematogen on the scalp. 32 patients in the comparison group (32) received scalp darsonalization physiotherapy against the background of the basic program. Before, after rehabilitation treatment and after 3 months, the patients were examined. Results. The inclusion of pantohematogen in the comprehensive restorative treatment of patients with androgenic alopecia demonstrated statistically more significant effectiveness, which manifested in a decrease in the number of complaints, improvement of microcirculation in the scalp, psychoemotional status, an increase in hemoglobin levels in the blood, restoration of hair texture. The comparison group also showed significant positive dynamics, but less significant. In catamnesis, after 3 months in the main group, there was a decrease in hair loss and an improvement in their growth, and in the comparison group the results were statistically less significant. Conclusion. A comparative evaluation of complex rehabilitation treatment demonstrated statistically more significant effectiveness with the inclusion of pantotherapy in patients in the main group. In the comparison group, whose patients underwent darsonvalization procedures in addition to the basic complex, the results of restorative treatment were statistically less significant.

ЭФФЕКТИВНОСТЬ ФИЗИОТЕРАПИИ У РАБОТНИКОВ РЕЧНОГО ТРАНСПОРТА, ИМЕЮЩИХ ДОКЛИНИЧЕСКИЕ СТАДИИ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ, И ФАКТОРЫ РИСКА ИХ РАЗВИТИЯ

Aim. The primary objective of this study was to evaluate the effect of physical therapy on blood pressure, dyslipidemia, the level of somatic and mental health, and cardiovascular risk in river transport workers with preclinical stages of cardiovascular disease and risk factors for their development. Methods. Sixty-two employees of JSC "Tomsk Shipping Company" who were divided into 2 groups were studied. The first group consisted of riverboat workers with risk factors for cardiovascular disease, and the second group included workers with preclinical stages of cardiovascular disease and risk factors for their development. In the river transport crew, the correction of the main risk factors for cardiovascular disease was carried out following the DASH diet, moderate physical activity, application of physical factors, preventive talks, and biofeedback training. In preclinical forms of cardiovascular disease (AH of the 1st degree), complex hypotensive therapy was also applied. To study the effectiveness before and after physical therapy, BP was recorded, the level of somatic health and psychoemotional status was evaluated, the adaptation potential was calculated, the contents of total cholesterol and low density lipoprotein cholesterol, as well as absolute or relative cardiovascular risk were determined. Results. Therapeutic and prophylactic measures allow to increase adaptation and psychological capabilities of rivermen, to normalize blood pressure in all workers of the river transport crew under 40 years old, to reduce the degree of arterial hypertension in workers over 40 years old, to reach target values of total cholesterol and low density lipoprotein cholesterol in 18% of cases, to increase the level of somatic health in 1/3 of workers, and to reduce the level of cardiovascular risk in 38% of workers. Conclusion. The therapeutic and prophylactic measures carried out on the seafaring personnel had positive hypotensive, antispastic, antianginal, hemodynamic, lipid-correcting, and adaptogenic effects.

Pelotherapy and pelotherapy combined with intravenous laser blood irradiation at the sanatorium-resort stage of treatment of patients with psoriasis vulgaris

To carry out a comparative analysis of the impact of different variants of sanatorium-resort treatment (SRT) - pelotherapy and pelotherapy in combination with intravenous laser blood irradiation (ILBI) - on the level of IL-17 and TNF-a, dermatological status, psychoemotional state and quality of life (QL) assessment of patients with psoriasis vulgaris. A naturalistic comparative study included 120 patients with psoriasis vulgaris, who were undergoing SRT: 57 patients in the pelotherapy group and 63 in the group of pelotherapy in combination with ILBI. The SRT effectiveness was assessed using the PASI index, the HARS and HDRS scales and the DLQI questionnaire. The dynamics of IL-17 and TNF-a plasma levels in blood plasma was studied. The study duration was 6 months 14 days. After 14 days of SRT, a decrease in IL-17 and TNF-a levels in blood plasma was statistically significant both in the pelotherapy group and in the group of pelotherapy in combination with ILBI, no statistically significant differences between the groups were found. Furthermore, the comprehensive use of pelotherapy in combination with ILBI has contributed to a more pronounced statistically significant decrease in the PASI index, the HARS and HDRS scales' total scores and an increase in the level of QL. The number of patients with clinical remission was statistically higher in the group of pelotherapy combined with ILBI compared to the pelotherapy group (87.3% versus 42.1%) six months after SRT. The advantage of comprehensive application of pelotherapy and ILBI in comparison with pelotherapy in patients with psoriasis vulgaris in SRT has been shown. The comprehensive application of pelotherapy and ILBI reduces the level of inflammatory biomarkers, improves dermatological and psychoemotional status, improves QL and is well tolerated by patients.

Систематизація та обґрунтування рекреаційних механізмів сміху в системі особистості

B a c k g r o u n d . A theoretical and methodological analysis of approaches to recreational laughter mechanisms is presented. Laughter is regarded as an individual psycho-physiological reaction to a certain unexpected situation that is formed based on emotionally colored personal senses and value ideas, shown in various expressions of joy. M e t h o d s . Given the multilevel phenomenon, the mechanisms of its influence on the individual are analyzed in the context of philosophical, theological, cultural, pedagogical, psychophysiological, and psychological (social) approaches. Theoretical research methods were used: analysis of scientific sources on the research topic, system analysis, synthesis, generalization of scientific approaches, classification and specification of laughter mechanisms in the personality system. R e s u l t s . In the context of the restorative mechanisms of laughter, its connection with direct play and joy arising in the process and accompanied by release, relief, satisfaction, and relaxation, helping to go beyond the ordinary, is considered. It has been revealed that laughter is also one of the ways for the soul to realize and liberate itself through release from fears and mental tension. It has also been proven that laughter serves as a certain stimulator of brain activity, activates imagination and fantasy, that is, promotes creativity. It is substantiated that laughter is a necessary element of stress relief, has a restorative and regenerative effect on the physical and psycho-emotional state, acts on the physiological and hormonal levels, activates the frontal, motor lobes, brain stem and cortex, hippocampus, thalamus and limbic system. It is argued that during laughter a spastic effect is realized, it affects the regulation of breathing, unites the physical and mental principle. C o n c l u s i o n s . It was determined that laughter, as an important personal resource of interaction with other people, plays a special role in the prevention and correction of unwanted stress states of the individual. It has been found that it greatly helps a person to adapt to various unexpected situations, because laughter unites people, helps to free oneself from the influence of fears, anxieties and doubts and allows to manifest the true qualities laid down from birth, such as love, clarity of perception, compassion, joy, enthusiasm, gratitude and wisdom. Laughter can help you make good decisions and show kindness in your actions.

Evaluation of the effectiveness of the drug Cortexin in combination with the use of the application Aphasia.No (Afaziyam.Net) in the correction of speech disorders in patients with cerebral infarction

Assessing the effectiveness of using a complex that includes the use of the drug Cortexin and classes using the mobile application Aphasia.No (Afaziyam.Net) in working with speech disorders in patients with acute stroke. The study involved 71 patients aged from 40 to 85 years with diagnoses of the ONCM group (I63-I64), as well as complications aphasia, 50 of them consented to neuropsychological rehabilitation using the application Aphasia.No (Afaziyam.Net) and received the drug Cortexin as a peptide drug at a dose of 10 mg 2 times a day intramuscularly (IG). 21 patients made up the comparison group. To assess the effectiveness of the rehabilitation complex, the following psychodiagnostic methods were used: MoCA, MMSE, a set of tasks for the study of speech, writing, reading, and the HADS scale. The average score based on the results of a comprehensive study of speech, writing and reading in the group on day 2 in the hospital was: speech - 141.8±21.6 (normal - 262 points); writing - 20.5±4.23 (normal - 44 points); reading - 14.5±1.87 (normal - 29 points) points. An examination before discharge in IG showed the following results: speech - 214.3±15.9; writing - 31.5±4.5; reading - 24.4±4.7 points. The differences compared to the baseline and the 2nd group were statistically significant. The complex treatment used in the work can be recommended as an effective tool in working with speech disorders in patients with acute stroke. In addition, the program has a positive effect on the psycho-emotional state.

Особенности формирования синдрома эмоционального выгорания у медицинских работников в период пандемии коронавируса

Aim. Identification of the features of the psycho-emotional state of nurses of a multidisciplinary clinic, COVID hospital and outpatient clinic during an unfavorable epidemiological situation of coronavirus infection. Design. A prospective cohort study in parallel groups. Materials and methods. In 2020–2021, a study was conducted on the psychoemotional state of nursing staff working in medical institutions in Samara. All the subjects were divided into groups according to their place of work: the 1st group included nurses working in COVID hospitals (n = 39), the 2nd group represented nurses who worked in a multidisciplinary clinic (n = 41), the 3rd group consisted of nurses performing their professional duties in an outpatient clinic (n = 39), the 4th group (control) included people not related to medicine, mainly economic and technical specialties (n = 160). The analysis of the psycho-emotional state was carried out on the basis of the results of the Maslach Burnout questionnaire, designed to assess and identify the state and degree of formation of phases of emotional burnout. Results. The indicators of emotional burnout in nurses working in the COVID hospital and in the polyclinic were significantly higher than in the control group, as well as in the nurses group of the multidisciplinary clinic. An extremely high level of emotional burnout was observed only in nurses working in the “red zone”, and they also more often had a high level of emotional burnout than in other groups. In the conditions of a polyclinic, the degree of emotional burnout in nurses was also significantly higher than in a multidisciplinary hospital. Conclusion. Increased stress and the presence of signs of professional burnout are primarily noted when nursing staff work in a COVID hospital, to a somewhat lesser extent — in those working in an outpatient clinic, and nurses of a multidisciplinary clinic are even less susceptible to them. The data obtained confirm the expediency of continuing scientific research on the psychoemotional state of nursing staff during periods of unfavorable epidemiological conditions for timely preventive measures aimed at preserving the health of this category of medical workers. Keywords: stress, emotional burnout, medical staff, nurse, COVID-19.

Psychoemotional state and sexual function in women with chronic pelvic pain in genital endometriosis

The purpose of this review is to consider current ideas about psychophysiology of chronic pelvic pain (CPP) in external genital endometriosis (GE), as well as the impact of the psychoemotional state and sexual function in women with CPP on its development and maintenance. The review is based on the study of original Russian and English-language articles and our own extensive clinical experience. References are made to statistically reliable, randomized and placebo-controlled studies of the last 20 years, in some cases to small and open-ended studies indicating their low evidence. The analysis shows a variety of opinions on this issue united by an understanding of the promising role of a biopsychosocial approach to the diagnosis and treatment of CPP in GE. Further studies of the role of psychosocial factors in the development of CPP are needed, as well as an assessment of the effectiveness of a comprehensive multidisciplinary approach to the treatment of CPP and associated sexual dysfunctions.

Male Survivors’ Disclosure of Conflict‐Related Sexual Violence in Mental Health Care Settings: Results from a Phenomenological Study with Clinical Experts in Germany

Conflict‐related sexual violence (CRSV) can severely impair survivors’ mental health and prompt their need for mental health care. Male survivors face gender‐related barriers to disclosing experiences of sexual violence, yet the understanding of factors impeding or promoting disclosure is limited. This knowledge gap is even more pronounced regarding male disclosure in refugee settings. The high prevalence of CRSV experiences in male refugees in European host countries points to the urgency of understanding male disclosure processes along with its barriers and facilitators, in order to provide for adequate mental health care. 10 clinical experts working with male survivors of CRSV in Germany were interviewed adopting an explorative phenomenological approach and using the Problem‐Centered Interview. Qualitative content analysis yielded five themes describing male disclosure of CRSV: 1. Experiences of CRSV commonly remain nonverbalized, 2. Disclosure of CRSV is a dialogical and iterative process, 3. The process of (non‐)disclosure is a negotiation of agency, 4. Disclosure of CRSV affects the survivor’s psychoemotional state, and 5. Disclosure and recovery are interdependent processes. Additionally, seven categories describing barriers to and facilitators of male disclosure were extracted: 1. trauma characteristics, 2. survivor variables, 3. clinician variables, 4. interpreter variables, 5. interpersonal variables, 6. contextual variables, and 7. sociocultural variables. Clinical experts emphasize the effectivity of a gender‐specific communicative taboo for male refugee survivors that intersect with socio‐cultural norms. Variables characterizing survivors who are at risk of not disclosing CRSV are identified. A discussion of clinical approaches to address the taboo surrounding CRSV and to support male refugee survivors in agentic disclosure and recovery is provided.