Psychological Components Of Health Research Articles

EFFECTIVENESS OF A BIOLOGICAL PROSTHESIS IN THE TREATMENT OF TRAUMATIC FEMORAL ARTERY INJURIES

HighlightsThe prevalence of vascular injuries during military engagements can reach 20%. In the thigh, vascular injuries are the second most frequent type of injury. Vascular replacement using a graft is required in case of a femoral artery injury with length of more than 10 cm. If autologous blood vessels are not available for replacement, specialists resort to using a synthetic prosthesis. Selection of an appropriate prosthesis remains a priority for vascular surgeons. Aim. To evaluate the outcome of vascular replacement using a biological prosthesis derived from bovine internal thoracic arteries for the treatment of femoral artery injuries.Material and methods. The study involved 30 patients with femoral artery injuries. The analysis focused on the indicators of comprehensive examination and treatment of these patients, who were divided into 2 statistically homogeneous groups of 15 people each. In the first group, a biological prosthesis derived from bovine internal thoracic artery was used to replace the artery, and in the second group, a large subcutaneous vein was used. The results of treatment were evaluated by the number of postoperative complications, the durability of grafts and the quality of life of patients.Results. There were no fatal cases. In the first group, 6 (40%) patients suffered postoperative complications, and in the second group – in 5 (33.3%) patients. After 5 years, 12 (80%) grafts remained functioning in the first group, and 13 (86.7%) grafts in the second group. The physical component of the health of patients in the first group was equal to 60.6 ± 3.2, in the second group – 62.5 ± 3.4, and the psychological component of health 58.7 ± 2.8, and 59.5 ± 3.1, respectively. There was no statistical reliability between the indicators of the groups (p > 0.05).Conclusion. Biological prosthesis derived from bovine internal thoracic arteries for the treatment of femoral artery injuries is quite effective.

The effect of complex treatment including osteopathic correction on pain intensity and quality of life in patients with chronic tonsillitis

Introduction. The relevance of the problem of chronic tonsillitis is due to the wide spread of the disease and the occurrence of complications associated with it, which, in turn, contributes to the appearance of pain and a decrease in the quality of life. Available information about the role of the palatine tonsils as an important organ of the immune system makes conservative treatment methods more preferable. Conventional conservative treatment is reduced to episodic implementation of individual techniques and remains insufficiently effective. Obtaining in-depth knowledge about the mechanisms of development of chronic tonsillitis necessitates the search for an integrated approach to treatment including non-drug methods. Often, questions about the severity of pain in patients that affect the level of quality of life are not given due attention.The aim is to study the effect of complex treatment including osteopathic correction on the quality of life and intensity of pain in patients with chronic tonsillitis.Materials and methods. In a prospective controlled randomized study conducted at the Department of Osteopathy and the Department of Otorhinolaryngology of the North-Western State Medical University named after I. I. Mechnikov of the Ministry of Health of Russia in the period from 06.2022 to 06.2023, 60 patients with a diagnosis of chronic tonsillitis were included. All patients, depending on the treatment, were divided using the randomization envelope method into two groups — main (n=30) and control (n=30). Patients in both groupsreceived otorhinolaryngological treatment in the form of lavage of the palatine tonsils (five rinsing procedures using an antiseptic solution, the interval between procedures was 2 days). Patients in the main group additionally received osteopathic correction (three procedures with an interval of 14 days). In all patients, before and after completion of treatment, the intensity of pain was assessed using a visual analogue scale (VAS) and quality of life using the SF-36 questionnaire.Results. In patients of both the main and control groups, there was a statistically significant decrease in the intensity of sore throat (p<0,05) after treatment. The increase in the level of quality of life in terms of both physical and psychological components of health was statistically significant (p<0,001) in patients of the main group. The level of quality of life in patients in the control group increased only due to the psychological component (p<0,001) of health, and the indicators of the physical component did not change (p=0,092).Conclusion. The inclusion of osteopathic correction in the complex therapy of patients with chronic tonsillitis in the inter-relapse period helps to reduce the pain and improve the physical component of quality of life compared to traditional conservative treatment alone. The study should be continued with a larger sample.

ASSESSMENT OF THE LIFE QUALITY OF PERSONS WITH KNEE JOINT INJURIES AFTER SURGERY INTERVENTION

ASSESSMENT OF THE LIFE QUALITY OF PERSONS WITH KNEE JOINT INJURIES AFTER SURGERY INTERVENTION

Selection of surgery type for patients with inguinal hernias

The purpose of the study: to investigate the quality of life of patients with inguinal hernias after Lichtenstein’s surgery using the implants with a tissue-gripping system and conduct a comparative assessment of this technique and the results of classical laparoscopic surgery. The prospective controlled clinical study included the results of follow-up of 99 patients with inguinal hernias. The first group included the patients who underwent LHR surgery of the inguinal canal using a composite self-fixing polypropylene mesh. In the patients of the second group, LHR was performed using a composite polypropylene mesh, which was fixed with polypropylene suture material. The third group consisted of the patients operated on using the technique of laparoscopic transabdominal preperitoneal surgery. Indicators of physical and psychological health components were studied in the patients using the SF-36 questionnaire in the preoperative period and 3, 6, and 12 months after surgery. Results: The patients with inguinal hernias in the long-term postoperative period had different periods of restoration of quality of life, which were determined by the type of surgical intervention and the type of fixation of the synthetic implant. Three months after surgery, significant signs of normalization of indicators of the physical health component were recorded only in groups of the patients after LHR using self-fixing implants and TAPP. In the patients with suture fixation of implants during LHR, the first signs of restoration of the physical component of health, comparable to self-fixing meshes, were observed 6 months after surgery. Changes in indicators of the psychological health component in the patients of the LHR and TAPP groups did not differ at all study intervals. Conclusion: The use of implants with a tissue-gripping system when performing LHR leads to optimization and reduction of physical rehabilitation in patients with inguinal hernias, which makes it possible to recommend the use of self-fixing meshes for open repair in cases of relative and absolute contraindications to TAPP.

THE INFLUENCE OF REPRODUCTIVE HEALTH DISORDERS ON THE LIFE QUALITY OF MEN

The purpose of the publication is to conduct a medical and sociological study of changes in the quality of life components of men diagnosed with reproductive health disorders.
 Materials and Methods. The publication is based on the results of a medical and sociological study conducted among 810 men. The universal and standardized Medical Outcomes Study Short-Form 36 questionnaire was used to study changes in quality of life components. The results obtained reliably reflect the impact of the disease on changes in the components of quality of life.
 Results. Final calculations of the main components of life quality of men have found significant differences in the values of the "Psychological component of health" scales between the main group, which had a value of 12628.0 conventional units, and the control group, which had a value of 17542.0 conventional units. The control group had a higher value, which was 38.9% higher than the main group. Only 4.4% of differences were found in the components of "Physical Health" between the main (9747.4 conventional units) and control (10178.5 conventional units) groups. After calculating the data, it was discovered that there was a difference of 23.9% between the experimental group (22375.4 conventional units) and the control group (27720.5 conventional units).
 Discussion. Based on the abovementioned information, it is reasonable to conclude that men who experience reproductive health disorders frequently face negative impacts on their life quality, particularly on their psychological well-being. It can result in emotional disorders and a decrease in energy levels, leading to fatigue and exhaustion. The scientific evidence suggests few similar studies dedicated to gender-specific changes in the life quality of men with reproductive disorders. The obtained results on changes in the main components of the quality of life under the influence of reproductive health disorders become a valuable informational basis for the development of preventive measures against these disorders.
 Conclusions. According to the results of a medical and sociological study, changes in the components of life quality of men were identified in individuals diagnosed with reproductive health disorders. The study confirmed that the disorders negatively affect physical (4.4%) and psychological (38.9%) components of life quality. The overall calculations confirm the ability of reproductive health disorders to reduce the life quality of men by almost a quarter (23.9%).

THE IMPACT OF COVID-19 ON THE QUALITY OF LIFE OF PATIENTS IN DENTAL PRACTICE: AN ANALYSIS OF HEALTH AND PSYCHOSOCIAL WELL-BEING

Quality of life (QoL) is a composite measure that reflects the overall level of satisfaction and well-being that a person experiences in their daily life. Understanding QoL is key to providing care and rehabilitation to patients, and issues identified during a QoL self-assessment may indicate the need to modify and improve treatment. It is widely recognized that COVID-19 has a diverse symptomatic spectrum. For the above reasons, COVID-19 can lead to a deterioration in health-related quality of life in both the short and long terms. The direct impact of COVID-19 on quality of life indicators, as well as the impact of coronavirus disease on dental health in general, served as a prerequisite for writing this article.
 The purpose of our study is to analyse the impact of COVID-19 on the quality of life of patients in dental practice.
 Materials and methods: all patients were interviewed for self-assessment of quality of life using the 36item Short Form-36 questionnaire.
 Results and Discussion: the obtained results among patients in group 1 and group 2 indicated a significant deterioration in both physical and psychological health components. The physical functioning (PF) score indicated average physical activity. The results of the impact of physical condition on role functioning (RP) reflected limitations in performing daily activities, both at work and at home. The pain intensity score (BP) indicated moderate body discomfort. The result for general health (GH) indicated the possibility of problems with general health and self-esteem. The vitality score (VT) indicated an average level of energy. The result obtained for the social functioning (SF) score indicated severe limitations in the social and psychological aspects of life. The value of the impact of the emotional state on role functioning (RE) indicated a significant effect of emotional difficulties on the patients' ability to perform habitual activities. The indicator of selfassessment of mental health (MH) indicated emotional and mental difficulties.
 Conclusions: This research demonstrates the ability of COVID-19 to cause long-term problems that directly affect the quality of life of patients and, accordingly, the possibility of developing dental diseases and their favourable prognosis.

The influence of walking in an exoskeleton on rehabilitation of patients with spinal cord injury consequences

Objective: to substantiate the expediency of including training walking in an exoskeleton in the complex rehabilitation of patients with severe motor dysfunctions of the lower limbs due to spinal cord injury (SCI).Methods: 120 patients (84 men and 36 women, age 37.1 ± 8.40 years) with the consequences of SCI at the level of thoracic and lumbar spine who were in the hospital at the second stage of medical rehabilitation were examined. The duration of injury ranged from 1 year to 19 years (77.8 ± 4.05 months). All patients were divided into two groups (80 and 40 patients), comparable by sex, age, duration and severity of injury. Training walking in exoskeleton have been added in the group I rehabilitation program. ASIA, SCIM III scales and SF-36 quality of life questionnaire were used to evaluate the effectiveness of the rehabilitation measures.Results: there was an increase in the total score on SCIM III by 3.20 ± 0.50 (p = 0.05) in group I, which indicates an increase in the level of functioning and daily activity of patients. Positive dynamics was revealed when assessing the quality of life using SF-36 questionnaire: sum index reflecting the psychological component of health increased from 56,0 to 59,5 points (p = 0,05). Group II also showed positive dynamics of the analyzed indicators, but the changes by the end of the rehabilitation course were not statistically significant.Conclusion: the use of exoskeleton training walking at the second stage of medical rehabilitation increases the effectiveness of rehabilitation measures and improves the quality of life of patients with severe motor dysfunctions of the lower limbs due to spinal cord injury (SCI).

The effect of complex therapy on the quality of life in patients with arterial hypertension on the background of gout

Abstract. Gout remains the most common type of inflammatory arthritis worldwide. Hypertension (AH) prevails in the structure of comorbid diseases in gout. In patients with hypertension in combination with gout, the problem of choosing treatment tactics remains quite relevant. Aim. To assess the effectiveness of the combination of basic therapy drugs for the treatment of patients with hypertension in combination with gout on quality of life indicators at the primary level of medical care. Materials and methods. Two groups of patients were formed. The first group, 36 patients who received losartan, allopurinol, atorvastatin. The second group, 36 people who received ramipril, allopurinol, atorvastatin. Quality of life was assessed using the SF-36 standardized questionnaire. The patient's functional status was assessed using the HAQ-DI health status questionnaire. Statistical analysis was performed using Statistica 6.1. Results. In the studied groups of patients, the quality of life of patients before and after treatment was evaluated. It was established that before the appointment of treatment, no significant difference was found between the groups according to the SF-36, HAQ-DI questionnaires. In patients of both groups, the indicators of the physical component of health (PCH) and the psychological component of health (PsCH) on the SF-36 scale were reduced, and a greater proportion of patients with minimal and moderate impairment of vital activity according to the HAQ-DI was registered. According to the results of the analysis, it was established that the level of quality of life according to the PCH indicator increased by 21.7 % in the first group and by 20.4 % in the second group (p < 0.01), according to the PsCH indicator – by 18.4 % and 17.5 % (p < 0.01), respectively. A probable decrease in the HAQ-DI indicator was found only in patients who received ramipril compared to the initial data before treatment by 33.3 % (р < 0.05). In patients of the I group, the share of patients with minimal disorders is increasing, and the proportion of patients with moderate disorders is decreasing, and in the II group, the prevalence of minimal and moderate disorders is increasing, which indicates the effectiveness of the prescribed therapy. Conclusions. Complex therapy (losartan or ramipril, allopurinol, atorvastatin) for 6 months in patients with hypertension in combination with gout is accompanied by a significant improvement in the quality of life according to the indicators of PCH (25.1 %, p < 0.01) and PsCH (17.7 %, p < 0.01) and degree of vital activity (25.0 %, p < 0.01).

Dance and Psychological Health: Effect of Dance Participation on Social Development

Dance is listed among the most common physical activities that have been integrated into almost all cultures and societies worldwide. The art of dancing engages an individual’s cognitive, social, and physical facets, all of which are integral components of psychological health and wellbeing. The social element of dance has been integrated into the modern health sector and other social settings to influence the relationship between psychological health and wellbeing and social support-related challenges. The purpose of the present study was to evaluate whether engaging in dance has an impact on the social dimension of psychological health and well-being. The initial hypothesis of the study, which was based on a literature review, was that participating in dance positively influences the social dimension of psychological well-being. An online literature review search that was conducted on the Google Scholar database for research published between 2013 and 2023 yielded 169 results from which 20 most recent studies between 2019-2023 were selected for inclusion in the final analysis. Dance promotes social wellness regardless of the settings in which it is performed by influencing the cognitive and behavioral processes regulating social relations among humans. Thus, dance is an effective vehicle for social support and a vital network for healthy social connections. Recent dance-based trends and dance practice characteristics could potentially serve as the new modes of social connections to promote social welfare.

Health-related quality of life of the rural and urban population in Western Siberia: a descriptive study

Aim. To assess the health-related quality of life of the rural and urban population in Western Siberia.Materials and methods. The study was conducted by simple random sampling of 205 people (97 men and 108 women) from residents of rural areas of the Omsk region (n = 132) and the city of Omsk (n = 73). The method of active survey in the form of an interview was used. The MOS SF-36 health survey questionnaire was used in combination with a specially developed questionnaire for sociological studies of the health of rural populations.Results. The highest scores were found on the scales of physical (PF), role physical (RF), and social functioning (SF). For the majority of questionnaire scales, the values obtained for rural residents were lower than those for urban residents. These concerned the PF, General Health (GH), Vitality (VT), SF, and mental health (MH) scales. The values characterizing the physical and psychological components of health were also lower in rural residents. A similar pattern was established when comparing the indicators of rural and urban men on the VT, SF, and MH scales. When comparing the indicators of rural and urban women, significant differences were found on the PF, GH, VT, SF, and MH scales. On all these scales, indicators were also higher among urban women. The respondents’ answers to questions about physical well-being and mental state showed a greater severity of characteristics indicating the development of emotional exhaustion among rural residents.Conclusion. The established low levels of the health-related quality of life among the rural population of the region indicate the relevance of developing and implementing respective targeted preventive programs.

Quality of life in patients with autonomic nervous system disorder

The paper studied the quality of life (QOL) in individuals of an organized population of Petrozavodsk with autonomic nervous system disorder (ANSD) (n=104; mean age 37.64±5.8 years; gender index 1:1). The control group included healthy individuals (n=30; mean age 37.64±5.8 years; gender index 1:1; p=0.761). The Short Form-36 Quality of Life Scale was used, and a medical assessment of signs of autonomic nervous system disorders was carried out according to the method by A.M. Vein. It was found that patients with ANSD were characterized by a lower level of QOL compared to healthy individuals without gender differences (indicators in men/women: “Physical component of health (Physical health)” (PH) 44.7±5.41/40.72±6.28 (patients) and 58.37±1.8/57.25±1.96 points (control); “Psychological component of health (Mental health)” (MH) 36.69±5.56/35.48±6.94 (patients) and 56.53±2.67/54.78±1.98 points (control); p=0.001). The first ranking places in the decline of QOL were the decrease in “role physical functioning” (in the treatment of PH) and the reduction of “mental health” (in the treatment of MH). Moderate vegetative imbalance in men/women with ANSD (36.86±8.58/42.96±10.62 points according to the method by A.M. Vein, compared with the results of healthy individuals of 2±0.29/2.13±0.97 points; p=0.001) correlates with a decrease in PH (R = – 0.368) and MH (R = –0.572). The revealed patterns are aimed at optimizing the medical and psychological rehabilitation of patients with ANSD.

Understanding the interplay of light, color, and interior design in healthcare spaces

Healthcare facilities have evolved from strictly functional to therapeutic places, integrating spiritual and psychological components of health. Design issues must be given specific attention to establish a therapeutic atmosphere that promotes successful therapy and stress alleviation. Color and light have a tremendous influence on the human mind and body, according to extensive studies, making them critical aspects of healthcare facility design. This study’s approach is to contribute to the construction of more effective therapeutic settings by investigating the effects of color and light on human wellness and providing design alternatives. So, it tries to provide a complete design paradigm that combines the strategic use of color and light in healthcare facility interior design. Because healthcare institutions play an important role in improving general well-being, this approach can help to create more effective healing settings. To provide the theoretical framework and collect data, this study uses a combination of library studies and descriptive research. The research initially investigates the notion of color and light, then explains their impact on physical and mental health disorders, as well as their use in therapeutic settings. The study concludes with the creation of a conceptual model and recommended design solutions for healthcare facilities.

Self-Assessment of the Quality of Life and the Formation of a Healthy Lifestyle of Medical Students

The purpose of research is to analyze sample data on self-assessment of health and formation of healthy lifestyle attitudes of medical students. Methods. The sample structure is characterized by the distribution of respondents by gender, the course of study at a university and college, and the age of 15–18 years. Data collection was carried out by a questionnaire method using a direct survey of respondents. Anthropometry was performed with the subsequent calculation of the body mass index (BMI) of the respondents. The assessment of the quality of life was carried out using the SF-36 questionnaire on indicators of physical and mental components of health, general health, vital activity and mental health. Results. The respondents were divided into 4 groups: 1 – boys studying at a university, 2 – girls studying at a university, 3 – boys studying at a college and 4 – girls studying at a college. It was found that the surveyed girls have a lower self-assessment of health, more than 30 % of university and college students rate their health as mediocre and poor, and among young men this indicator was 25,0 % and 20,0 %, respectively. The physical component of health differed slightly in the groups. The psychological component of health in girls was: 32,98 ± 1.35 (in high school) and 38,98 ± 1,14 (in college) versus 41,10 ± 2,22 for boys in high school and 44,61 ± 2,12 in college. The indicator of the general state of health was 66,50 ± 4,01; 58,12 ± 2,86; 65,40 ± 4,48 and 63,85 ± 1,95 in representatives of the analyzed groups, respectively; mental health – 63,38 ± 3,83; 49,09 ± 2,63; 64,6 ± 4,48 and 60,34 ± 2,21. Conclusion. Analysis of the data obtained indicates that there are gender differences in self-assessment of health, represented by lower indicators in girls. Moreover, students at the university show this more clearly, which requires more in-depth study. It has been established that first-year students of KSMU have motivation to lead a healthy lifestyle and promote it among the population, and it can be traced more clearly among students of the university.

Markers of quality of life in patients with nosocomial pneumonia caused by SARS-CoV-2

Objective — to investigate and analyze total white blood cell count and leukogram in an order with community-acquired pneumonia caused by SARS-CoV-2 and to establish their relationship with subjective health assessment using the SF-36 tool 1 year after hospital discharge.
 Materials and methods. A retrospective study of the medical records of 208 patients who were hospitalized for community-acquired pneumonia with a negative smear test for the SARS-CoV-2 virus was conducted. The main group consisted of patients with SARS-CoV-2 nucleic acid identification and signs of pneumonia. According to the severity of pneumonia, patients were divided into three groups: II group —patients with pneumonia of category 2 of complexity (n = 124), group III — patients with pneumonia of category 3 of complexity (n = 68), group IV — patients with pneumonia of category 4 of complexity (n = 16). The comparison group consisted of patients with SARS-CoV-2 nucleic acid identification and the absence of pneumonia. Charlson’s comorbidity index (Charlson Comorbidity Index) for the general prognosis of mortality was calculated using a special computer program. The general questionnaire SF-36 was used to assess the quality of life. Statistical analysis of data was carried out using the Statistica 7.0 software.
 Results and discussion. Probably higher values ​​of the total number of leukocytes were established in the patients of the studied groups compared to the comparison group. At the same time, this indicator in patients of the IV group statistically significantly exceeded the similar data of the II and III groups. The increase in leukocytes as the complexity of pneumonia progressed was mainly due to segmented neutro­phils. In patients with acquired pneumonia of the 3rd and 4th severity category caused by SARS-CoV-2 1 year after discharge from the hospital, the indicators of physical and psychological components of health are likely to be lower, while increasing age is likely to be associated with a decrease in quality of life.
 Conclusions. In patients with community-acquired pneumonia caused by COVID-19, an increase in the content of leukocytes upon admission to the hospital is associated with a decrease in indicators of physical and psychological components of health 1 year after discharge from the hospital.

Аспекты качества жизни лиц трудоспособного возраста с хроническими неинфекционными заболеваниями органов дыхания

Chronic noncommunicable diseases (NCD) are widespread and affect people of different age groups in all countries. The fight against this group of diseases is one of the priorities of the modern health care. Non-infectious diseases of the respiratory system as well as other diseases, affect social, physical and mental components of well-being. The qualitative assessment of their influence helps to assess the study of the quality of life. P u r p o s e : to assess the quality of life of the working-age population of the Nizhny Novgorod region and to develop measures to reduce the risk factors for chronic non-infectious diseases of the respiratory system in these cohorts. M a t e r i a l s a n d m e t h o d s . A one-stage comparative study was carried out using the method of standardized interviewing using the SF‑36 questionnaire. The quality of life of people of various age-gender groups with chronic non-infectious diseases of the respiratory system was assessed. All respondents were stratified into groups by pathology and age. R e s u l t s . The scientific article reflects the results of the study of assessing the quality of life of working-age patients with the chronic respiratory system pathology. The analysis of the data revealed statistically significant differences in age, gender and groups of pathologies among the respondents. Differences in indicators reflecting emotional states were revealed among men and women of the working age. Age-related changes in indicators of physical and psychological components of health and on all scales of the quality of life were presented. The obtained values of patient indicators show the need to develop specific measures to reduce behavioral risk factors for chronic non-infectious respiratory diseases of the population of the Nizhny Novgorod region. Findings. The comparative analysis of the results of the scales of the quality of life and health components reflects the age-related changes in indicators. The people of the older age group of the working age demonstrate significantly low results. The indicators of physical functioning are statistically significantly different in different pathologies of the respiratory system. Chronic obstructive pulmonary disease (COPD) restricts the physical activity of patients more strongly than other pathologies. Low values of the quality of life reflect the need to develop the measures to reduce the risk factors for chronic non-infectious diseases for the population of the Nizhny Novgorod region.

“Blue flags” of pain such as an important factor, has been influenced in the chronification of the low back pain

BACKGROUND. Despite the widely discussed problem of pain chronification, the issues of assessing the relationship between emotional-affective disorders and the social status of patients with pain in the context of assessing the so-called blue flags of pain remain poorly understood.
 AIM. To determine the relationship between biopsychosocial factors, particularly socioeconomic status, and the quality of life of patients with back pain.
 MATERIAL AND METHODS. The study included 32 patients suffering with non-specific back pain of various localization. During of the study, the results of neuropsychological tests (HADS, SF-36, VAS) were analyzed to assess the mental state and social aspects of the patients lives. A specially designed questionnaire was used to assess the so-called blue flags of pain, which including the level of satisfaction with work and relationships in the workplace. The statistical processing of the data obtained was carried with using the programe Statistica 6.0 with the evaluation of Students criterion and Pearsons coefficient.
 RESULTS. Correlations were found between emotional-affective disorders and socio-economic aspects, namely: job satisfaction and relationships with colleagues. Emotional and affective disorders were found to have a significant impact on relationships at work. People with emotional-affective disorders and chronic pain syndrome are more likely to have an unsatisfactory self-assessment of their health. The relationship between emotional-affective disorders and the intensity of the pain syndrome and life impairment was also determined, and it was found that patients with psychological distress are more susceptible to life impairment due to back pain. In the process of determining the level of quality of life of the examined individuals, low values were found according to the SF-36 questionnaire due to a decrease in the psychological component of health in patients with chronic pain syndrome (r=0.64, p 0.05). Significant correlations were found between affective disorders and job satisfaction (r=0.46, p 0.05) and relationships with co-workers (r=0.44, p 0.05), as well as pain intensity according to VAS (r=0.37, p 0.05).
 CONCLUSION. Socio-economic factors, the so-called blue flags of pain, together with emotional and affective disorders, have a significant impact on the outcome of the pain syndrome and largely determine the chronification of pain, with a regression in the quality of life of patients with back pain.

Quality of life of patients with pre-dialysis chronic kidney disease, its relationship with oxidant stress and uromodulin excretion

Background. The purpose of this study was to assess the quality of life (QoL) in patients with pre-dialysis chronic kidney disease (CKD), to reveal the factors affecting the QoL in this category of patients and to investigate the effect of antioxidant therapy on the QoL of patients with CKD stages 1–5. Materials and methods. Patients with CKD (n = 61), whose average age was 44.51 ± 11.90 years, were included in the study. Twenty (32.79 %) men and 41 (67.21 %) women were divided into two groups representative in terms of age and gender composition: group 1 (n = 31) — patients with CKD who took glutathione 100 mg 2 times a day with meals for 3 months, group 2 (n = 30) — those with CKD who took ubiquinone 100 mg once daily with meals for 3 months. The QoL was assessed using the SF-36 questionnaire. Patient adherence to treatment was assessed with the Morisky-Green test. To assess the kidney function of patients, the level of urinary uromodulin excretion (uUMOD), urine albumin-to-creatinine ratio (ACR) were determined. The impact of antioxidant therapy on the QoL of these patients was evaluated and the factors affecting QoL were determined. Results. In the structure of CKD, urolithiasis was most common — 22 (36.1 %) patients, 5 (8.2 %) people had chronic pyelonephritis, 18 (29.5 %) — diabetic nephropathy, 4 (6.6 %) — polycystic kidney disease, 6 (9.8 %) — gouty nephropathy, 1 (1.6 %) — chronic glomerulonephritis and 5 (8.2 %) patients presented with hypertensive nephropathy. The duration of CKD in the first group was 5.42 ± 3.88 (1; 15) years, in the second one — 5.57 ± 3.79 (1; 16) years, no significant difference was found between the groups in terms of age and gender (U = 463m, p = 0.9827). In all patients, the indicators at the beginning were lower than those by the end of the study. The lowest indicator in the first group is general health, in the second — vitality. The psychological component of health (PsCH) was lower than the physical component of health (PhCH) in both groups. A significant positive relationship (p < 0.001) was observed, which was most pronounced for glomerular filtration rate (GFR), ACR, systolic blood pressure, hemoglobin. At the end of the study, 12 (19.67 %) patients had 4 points on the Morisky-Green test, which meant high adherence to therapy. There was a reliable strong positive relationship between the QoL and GFR, ACR, uUMOD. At the beginning of treatment, a significant average positive relationship was found between the QoL (PhCH) and uUMOD: r (59) = 0.372, p = 0.003; between the QoL (PhCH) and GFR, there is a significant positive relationship: r (59) = 0.707, p < 0.001. There is a very insignificant positive relationship between the QoL (PsCH) and patients’ adherence to treatment, r (59) = 0.0882, p = 0.499. Conclusions. Antioxidant therapy with glutathione and ubiquinone significantly improves the QoL of patients with CKD. Considering the safety and effectiveness of antioxidant therapy, we suggest including antioxidant therapy in treatment protocols for patients with CKD. Further research is recommended to determine a standard protocol.

Rehabilitation experience of a patient with severe form of COVID-19 at the pulmonological climatic resort of the Southern Coast of Crimea

Introduction. The increase in the number of patients with post-COVID syndrome determines the relevance of their rehabilitation in sanatorium and resort institutions, of both local and climate-therapeutic resorts.Aim. To identify the possibility for the rehabilitation of patients with severe forms of COVID-19 in the conditions of the climatic pulmonological resort of the South Coast of Crimea in the winter season.Materials and methods. Clinical-anamnestic, laboratory, functional and computed-tomographic results of the examination of the thorax of a patient who had a severe form of COVID-19. Rehabilitation was carried out 21 days complexly using climatotherapy, therapeutic exercise, respiratory, medication and physiotherapy. The effectiveness of treatment was assessed using a 6-minute step test, Borg scale, mMRC dyspnea scale, oxygen assessment chart, rating of health status, Hospital Anxiety and Depression Scale (HADS), Fatigue Assessment Scale (FAS), dyspnea assessment index (DDI/TDI), questionnaires of life quality EQ-5D and SF-36.Results. At the end of the rehabilitation course, general well-being improved, shortness of breath decreased, exercise tolerance increased, positive dynamics of spirographic parameters, Borg scale scores and a 6-minute step test were noted. The indicators of depression on the HADS scale normalized, positive dynamics was noted according to the SF-36 questionnaire of the psychological component of health. The severity of pain/discomfort and anxiety/depression according to the EQ-5D questionnaire decreased. The X-ray picture has improved. When determining the diffusion capacity of the lungs (DLCО), an increase of 30% from the initial value was revealed.Conclusion. Rehabilitation of a patient who had a severe form of COVID-19 with bilateral lung damage in the conditions of the climatic pulmonology resort of the South Coast of Crimea in the winter season is effective. To assess the lung function of patients who have undergone COVID-19, the most effective method can be considered the determination of lung diffusion capacity (DLCО). Spirogram indicators do not always objectively reflect the severity of the condition.

PSYCHO-EMOTIONAL HEALTH OF MEDICAL STUDENT AT THE STAGE OF CHOOSING THE FUTURE DIRECTION OF PROFESSIONAL ACTIVITY

Abstract. The current realities exacerbate the crisis of adaptation of the individual, especially the adolescent, who is acutely experiencing an intense sense of anxiety due to the ever-increasing impact of the emotional factors, such as fear for their own safety due to the current military realities of our country. This can cause a loss of authenticity and a sense of psychological well-being. Therefore, the article analyzes in detail the concepts of “mental health”, “psychological health”, “psycho-emotional health”, identifies common and distinctive characteristics. Attention is focused on the psycho-emotional health of a student of a higher medical institution when choosing a future profession under stressful conditions. The key factors influencing the psychoemotional health of a medical student are determined. It is established that emotions play a motivating and semantic role in the choice of future professional activity, because they generate and mobilize the perception, thinking and actions of a medical student. Taking into account a number of studies, it is stated that psycho-emotional health is a guarantor of active action of the future medical specialist, aimed at realizing the need and possibility of self-realization. In addition, it is stipulated that vitality and stress resistance are of great importance in the context of understanding the psychological health of the individual at the stage of his professional development. Generally speaking, it is about the protective and compensatory parameters of personality resources throughout life, which directly or indirectly affect the components of psychological health. It is noted that each component of psycho-emotional health in this complex structural formation performs a corresponding function. Instead, it is inappropriate to consider the independent and independent role of the components. The psycho-emotional health of a student determines his ability to self-regulate behavior, activate his own vital resources, comprehend his life position, choose a future profession and assert himself in society.

Assessment of the psycho-emotional state of patients after COVID-19-associated pneumonia in relationship with laboratory indicators

The aim. To study peculiarities and association of psychological and laboratory indicators in patients with cardiovascular diseases (CVD) who underwent COVID-19 to clarify the factors affecting the possibility of developing delayed psychological and cardiovascular adverse events.Methods. The study enrolled 350 patients with COVID-19. Group 1 consisted of 92 patients without CVD, Group 2 – of 258 patients with CVD. Indicators of laboratory and psychological parameters were assessed according to the data of psychological questionnaire using GAD-7 (General Anxiety Disorder-7), PHQ-9 (Patient Health Questionnaire-9), PSS (Perceived Stress Scale) screening scales and SF-36. Parameters of complete blood count and biochemical blood tests were measured during hospitalization and three months after discharge from the monohospital.Results. After three months, in the general group of patients, signs of anxiety and depression were detected in more than 30 % of the examined patients, signs of stress – in 10.4 %. In the group with CVD, psycho-emotional disorders were identified in 1/4 of the patients, and severe stress – in 8 % of those included in the study. In addition, it was registered that the indicators of erythrocyte sedimentation rate, fibrinogen, high-sensitivity C-reactive protein (CRP), homocysteine and IL-6 remained at a higher level in the second group.Correlation analysis showed that the psychological component of health is interconnected with the level of neutrophils (p = 0.044) and fibrinogen (p = 0.050); the physical component of health is correlated with the level of erythrocytes (p = 0.030), hemoglobin (p = 0.015), CRP (p = 0.002), creatine phosphokinase (p = 0.036) and glucose (p = 0.017). Regression analysis revealed that in patients with CVD three months after hospitalization, an increased glucose index contributes to deterioration, and increased hematocrit and mean hemoglobin concentration improve the quality of life of patients.Conclusion. Laboratory markers that maintain the duration of a prolonged vascular reaction, violation of the rheological and metabolic properties of blood, determine the nature of the development of both psychological and cardiovascular complications.