Dynamics of disorders of adaptive functions in doctors of military mobile hospital in the fulfillment of their professional duties during military conflict
Background. In conditions of local armed conflict, the requirements for the qualification of military medical personnel, the performance of their professional activities, and the quality of medical care they provide are maximally raised. It is possible on the condition of professional competence of the military doctor, his psychological and physical health, and, importantly, psychological resistance to the development of negative conditions due to the stressfulness of their roundtheclock work. The professional duties of military medical personnel are associated with a high degree of responsibility for the life and health of the wounded, injured and ill soldiers. They often require a military specialist for urgent decision making, selfdiscipline, ability to maintain high performance in extreme conditions, emotional feedback, and constant psychological and intellectual stress. All of this can lead to the exhaustion of psychological and physical resources and, consequently, to professional burnout and disease. At the same time, today there are virtually no effective clinical psychological and medical technologies aimed at preserving the health of a military doctor, preventing or reducing the risk of psychosomatic illness. Materials and methods. Based on informed consent, in line with the principles of medical bioethics and deontology, 30 officers and military doctors were interviewed: 26 men and 4 women serving in the military hospital (Pokrovsk, Donetsk region). The assessment of the subjective state was carried out using basic psychological questionnaires: BussDurkee (hostility, aggressiveness); SpielbergerKhanin (assessment of situational and personality anxiety); Zung selfrating depression scale; Malkova’s scale for the evaluation of asthenia. Results. As a result of the survey, it was found that the respondents do not have the expressed signs of hostility and there is a low level of aggressiveness. In women, this figure is greater, but does not exceed the limit of normal. Also, in the examined military doctors, according to Zung selfrating depression scale, depressive tendency at the level of subdepression was detected on the twelfth month of stay in the combat zone. It’s more about female doctors. The surveyed doctors also have clear asthenic manifestations. The average figures for the asthenic state scale are 75.2, which corresponds to moderate asthenia. The average rate for women was 76.4 (moderate asthenia), in men the mean score was 54.1 (slightly pronounced asthenia). Based on the findings of the SpilbergerKhanin scale, it can be concluded that all types of anxiety are progressive that increases with the duration of stay in the combat zone. If in men anxiety is regarded as average, then in women it is high. The average score on SpilbergerKhanin scale: situational anxiety — 45.8; personal anxiety — 45.5. In men, the average figures were: situational anxiety — 43.3, personal — 43.1; in women — 55.8 and 55.2. Conclusions. Adaptive disorders in military doctors are characterized by a combination of asthenic and anxietydepressive symptoms, which significantly progress with an increase in the length of stay in the combat zone. In the conditions of the need for constant interaction with colleagues and patients, there are deviations in the somatic and psychological state of doctors. Frequent psychosomatic manifestations of burnout are general malaise, dyspnea, nausea, dizziness, insomnia, increased sweating, tremor, unpleasant sensations in the heart, changes in blood pressure. The transition of reactions from the level of emotions to the level of psychosomatic disorders suggests that emotional protection does not cope with invariably high loads and inevitably manifests itself in physiological disorders at this stage. Analysis and solution of this problem will allow developing the concept of early diagnosis and comprehensive prevention of neurotic disorders, psychosomatic diseases or exacerbation of chronic somatic diseases. It will also help to preserve and strengthen the mental and physical health of doctors and, accordingly, improve the quality of medical care they provide to the wounded persons in the combat zone.
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САЙКО О. В.
ДИНАМІКА ПОРУШЕНЬ АДАПТИВНИХ ФУНКЦІЙ У ЛІКАРІВ ВІЙСЬКОВО- МОБІЛЬНОГО ГОСПІТАЛЮ ПРИ ВИКОНАННІ ПРОФЕСІЙНИХ ОБОВ’ЯЗКІВ В УМОВАХ ВІЙСЬКОВОГО КОНФЛІКТУ
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