METHOD FOR PSYCHOLOGICAL REHABILITATION IN PATIENTS WITH CHRONIC RENAL DISEASE BEING UPON HEMODIALYSIS-BASED THERAPY

摘要

FIELD: medicine, psychology, nephrology, medicinal psychology.;SUBSTANCE: the present innovation deals with combined application of medicinal and psychological impacts according to individual curative-rehabilitation program and group training on rehabilitation educational program that includes the cycle of studies in the course of which corresponding specialists inform the group of patients about the history of hemodialysis development, about the methods of substitution therapy, about introductory period into hemodialysis, about the ways for preventing the complications of hemodialysis therapy, about the peculiarities of dietotherapy in dialysis-patients, about the ways of preparing and chemical control for dialyzing solutions, about physical rehabilitation in hemodialysis-patients, about psychic adaptation and quality of life in such patients, about psychic health in hemodialysis-patients, about the methods of psychic self-regulation and studying the foundations of autogenous trainings. It is necessary to conduct group psychological training at applying the techniques of behavioral psychotherapy, form a suggestion to follow curative mode at applying the technique for motivation exchange, in the course of every lesson specialists answer the questions, conduct group discussion at participation of patients and specialists, form constructive methods to overcome all the difficulties by dramatizing different situations being very common for hemodialysis-patients during their therapy period and under domestic conditions, also, by carrying out a group discussion. According to the results of every lesson it is necessary to make correctives into patients' individual rehabilitation programs. Both before the onset and on finishing the course of studying it is important to evaluate the following parameters: a patient's knowledge level according to a questionnaire on knowledge level about chronic renal disease and ways of its treatment; the level of quality of life according to the questionnaire MOS SF-36, A patient's neurotization level by the scale for psychological express-diagnostics of neurotization level, the frequency of applying the ways to overcome all the difficulties according to the questionnaire "Ways of coping". One should compare the results obtained before and after studying and achieve positive dynamics by repeating the cycle of education and considering the fact that the more efficient psychological rehabilitation is, the higher the level of quality of life is, the lower the neurotization level is and the more constructive the applied ways for overcoming the difficulties are. The innovation enables to create a closer doctor-patient contact, a group support among patients with analogous disease, form more constructive ways for overcoming difficulties in case of group training of hemodyalysis-patients.;EFFECT: higher efficiency of rehabilitation.;3 ex, 2 tbl