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Vol 26, No 4 (2023)

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Original study articles

Implementation of an Interdepartmental Model of Complex Rehabilitation in the Perm Region in a Specialized Centre

Bronnikov V.A., Grigoreva M.I., Mavlikaeva Y.A., Plotnikova O.A., Sklyannaya K.A.

Abstract

BACKGROUND: Contemporary Russian system of complex rehabilitation and habilitation of disabled people is in the process of transformation. Application of the biopsychosocial approach through the use of the International Classification of Functioning, Disability and Health as a planning methodology Implementation and evaluation of rehabilitation measures make it possible to implement the key principles of rehabilitation: earlier, comprehensiveness, continuity, individual approach.

AIM: To substantiate the possibility of implementing a modern regional interdepartmental model of integrated rehabilitation in a specialized centre, taking into account the structure of disability and the formation of new target rehabilitation groups.

MATERIALS AND METHODS: Analysis of the dynamics of primary disability of the adult population, description of the structural and functional model of the creation and operation of a multidisciplinary rehabilitation center in conditions of interdepartmental cooperation.

RESULTS: The structure of primary and secondary disability in the Perm Region is characterized by the predominance of persons with disabilities of groups 1 and 2 (60%) of working age, whose disability is caused in 30% of cases by malignant neoplasms. This determines the content of individual rehabilitation and habilitation programs to be developed for persons with disabilities and should be reflected in the development of appropriate infrastructure in the region. Modernization of the whole system, involving the use of targeted rehabilitation groups, ensuring continuity of medical and social activities in the relevant organizations and creating conditions for their continuation in the place of residence, should contribute to the effectiveness of rehabilitation activities in general.

CONCLUSION: Recommendations on improvement of the system of complex rehabilitation in the conditions of a specialized center on the basis of interdepartmental cooperation have been proposed as a result of the research.

Medical and Social Expert Evaluation and Rehabilitation. 2023;26(4):185-196
pages 185-196 views

Analysis of the structure and dynamic of disability of uterine cancer patients in the Volgograd region

Zhavoronkova V.V., Grushina T.I., Suvorov V.A.

Abstract

BACKGROUND: Among oncogynecological pathology, uterine cancer occupies the first rank place. A significant number of patients are women of working age, which makes the analysis of their disability relevant.

AIM: Analysis of primary and repeated disability of uterine cancer patients in the Volgograd region.

MATERIALS AND METHODS: The object of the study were 1978 patients with uterine cancer, who were recognized as disabled for the first time and again. The study period included 2018–2022 with an annual analysis of the number of disabled people in three age groups: young (18–44 years), middle (45–54 years) and older (55 years and older) age. Research methods: analysis of statistical forms, statistical analysis.

RESULTS: Of the 1978 disabled: in 2018 there were 374 (18.9%), in 2019 — 346 (17.5%), in 2020 — 371 (18.8%), in 2021 — 429 (21.7%), in 2022 — 465 (23.5%) women. The total number of disabled has increased by 19.5% in 5 years (from 374 to 465). The age structure of the disabled: young patients accounted for 109 (5.5%), middle — 325 (16.5%) and older — 1544 (78%). Of all the patients, disability I gr. was established in 117 (5.9%), II gr. in 295 (14.9%) and III gr. in 1566 (79.2%). The structure of disability severity in three age groups remained stable for 5 years (p=0.35). In all age groups, there was increase in repeated disability, especially significant in older age group.

CONCLUSION: In the course of the analysis of the structure and dynamics of disability of patients with malignant neoplasms of the uterus in the Volgograd region for 5 years, multidirectional trends were established. Based on the data obtained, it is advisable to plan further work to prevent disability and restore the ability of patients to work.

Medical and Social Expert Evaluation and Rehabilitation. 2023;26(4):197-204
pages 197-204 views

Analysis of newly diagnosed disabilities dynamics among medical workers in the Irkutsk region from 2003 to 2021 period

Rybchenko N.V., Vladymyrova O.N.

Abstract

BACKGROUND: The specificity of the professional activities of medical workers is one of the main reasons for their high morbidity, including due to the influence of unfavorable factors in the working environment. The need to reduce labor losses in the industry necessitates the study and analysis of the disability status of doctors within the framework of long-term observation.

AIM: A study of the dynamics of primary disability indicators of doctors working in their specialty in the Irkutsk region at the time of examination, in comparison with the primary disability of the adult population of the Irkutsk region for 19 years from 2003 to 2021.

MATERIALS AND METHODS: An observational retrospective continuous study of primary disability indicators of working doctors in the Irkutsk region for 19 years (2003–2021) was conducted. Analytical, statistical, data copying, and expert assessment methods were used.

RESULTS: During the study period, 1,703 people working as doctors in the Irkutsk region were recognized as disabled for the first time. The average long-term intensive rate of primary disability of doctors for 19 years averaged 75.4 (±7.55) per 10 thousand working doctors, which is 17% lower than the same indicator for the adult population of the region. The following diseases took the first place among doctors during 2003–2011: diseases of the circulatory system, and over the past ten years since 2012 — malignant neoplasms.

CONCLUSIONS: The level of primary disability in physicians responds more quickly and sensitively to changes in social legislation, and is less affected by changes in the number of physicians in the region than the corresponding rates in the adult population of the region as a whole. The nosological structure of doctors disabled mainly coincides with the indicators of the adult population.

Medical and Social Expert Evaluation and Rehabilitation. 2023;26(4):205-214
pages 205-214 views

Rehabilitation of the disabled with osteoarthritis in a multidisciplinary rehabilitation center

Syrnikova B.A., Storozhenko D.V., Storozhenko E.E., Temirov R.A.

Abstract

BACKGROUND: Current demographic trends indicate an increase in the proportion of elderly and senile people in the general population structure. Osteoarthritis is one of the most important causes of pain and limited mobility in old age. The most effective methods of treating osteoarthritis are physical therapy and teaching.

AIM: To analyze the possibilities of inpatient rehabilitation departments of a multidisciplinary institution of social protection of the population in the rehabilitation of people with osteoarthritis.

MATERIALS AND METHODS: The study is continuous, single-stage, single-center, retrospective. 6578 persons with disabilities who received inpatient rehabilitation from 2021 to 2023 were examined. Demographic indicators and nosological structure have been studied. A group of disabled people with osteoarthritis has been identified and studied in depth. The composition and scope of measures for the medical rehabilitation of people with ostearthritis have been studied.

RESULTS: It was found that people with disabilities with osteoarthritis constitute the largest group among all people who received inpatient rehabilitation (37.9%). The vast majority of people with osteoarthritis with disabilities were female (88.8%). The basis of the inpatient rehabilitation program for patients with osteoarthritis was based on methods with proven effectiveness.

CONCLUSION: Rehabilitation social protection institutions make a significant contribution to meeting the needs of people with disabilities, as one of the most socially vulnerable categories of the population, in rehabilitation assistance.

Medical and Social Expert Evaluation and Rehabilitation. 2023;26(4):215-222
pages 215-222 views

Resilience of elderly patients with sarcopenic obesity and age-related visual impairment

Kopylov A.E., Neudakhin M.A., Popova N.V.

Abstract

BACKGROUND: The development of visual deficit due to glaucoma or cataracts significantly limits motor activity and reduces the independence of elderly patients from others in daily activities. However, resilience among older patients with primary open-angle glaucoma and cortical cataract remains largely unexplored.

AIM: To analysis of the resilience of elderly patients with primary open-angle glaucoma and cortical cataract

MATERIALS AND METHODS: For this study, two clinical groups were formed: patients aged 60–74 years with primary open-angle glaucoma without secondary cataracts in the amount of 135 people (64 men and 71 women) and patients with cortical cataracts without combination with glaucoma in the number of 128 people (59 men and 69 women). To study the viability of patients, the Connor-Davidson Resilience Scale-25, validated in the Russian Federation, was used.

RESULTS: To the greatest extent, representatives of both study groups differed in the subdomain “security in relationships” and “positivity of accepted changes” with a representative difference. The compared groups of patients also had statistically significant differences in such an important subdomain as individual perseverance (p <0.05) and competence in mean scores for each cohort. At the same time, there was a deterioration in age-related vitality according to the final parameter of patients on the Connor-Davidson Resilience Scale-25. At the same time, the decrease in the average value of the integral parameter according to the age-related vitality scale used in the study was 16.3 points with a statistically significant difference (p <0.05) in the group with cortical cataracts.

CONCLUSION: As a result of the study, it was found that cortical cataracts and primary open-angle glaucoma contributed to a decrease in the vitality of elderly patients, and this was more pronounced in patients with primary open-angle glaucoma, which should be taken into account when justifying medical and psychological support for such patients.

Medical and Social Expert Evaluation and Rehabilitation. 2023;26(4):223-229
pages 223-229 views


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