Clinical typology and mechanisms of psychogenesis of states of psychological maladaptation of internship doctors
PDF (Українська)

Keywords

internship doctors
adaptation
maladaptiven states
medical and psychological support
psychotherapy
psychoeducation
professional stress

How to Cite

Vyun, V. (2020). Clinical typology and mechanisms of psychogenesis of states of psychological maladaptation of internship doctors. Medicine Today and Tomorrow, 84(3), 55–60. https://doi.org/10.35339/msz.2019.84.03.09

Abstract

A comprehensive examination of 213 interns of both sexes was carried out. A system of psychotherapeutic correction of maladaptive states and psycho-preventive support of interns during the period of professional training has been developed. Levels of adaptation of internship doctors for professional activity were emphasized: high (14,1 %), average (20,2 %) and low level (65,7 %). It was described the asthenical (25,8 % of men and 22,5 % of women), hypersthenic (20,6 % of men and 23,2 % of women), anxiodepressive (11,3 % and 20,6 % respectively), psychosomatic (14,5 % of men and 18,1 % of women), asthenic-apathetical (12,3 % and 11,2 % respectively) and addictive (15,5 % of men and 4,4 % of women) variants of maladaptive reactions among the internship doctors. The developed model of the formation of disorders of adaptation of internship doctors is presented by a complex of pathogenic factors. It was established that the basis for the formation of maladaptive reactions among the internship doctors is the presence of somatic pathology, craniocerebral injury and neuroinfection in the anamnesis and the tendency to addictive behavior. Prognostically important factors in the formation of adaptation disorders are conflicts of family and professional relations, disturbing suspiciousness, low communicativeness, difficult working conditions, lack of positive emotions, awareness of inadequate level of competence, low level of motivation, and imperfectiveness of mechanisms of psychological protection. Triggers for the development of maladaptive states are the high level of professional stress, depletion of adaptation, prolonged mental stress, frustration of significant basic needs, and high rates of clinical scale of anxiety and depression HDRS. An individualized three-stage system of medical and psychological support during the professional training period, which involves the application of complex psychodiagnostic, psychotherapeutic, psychoeducational and psychoprophylactic influences, has been developed and tested.

https://doi.org/10.35339/msz.2019.84.03.09
PDF (Українська)

References

Pshuk N.H., Kaminska A.O. (2014). Deiaki indyvidualno-psykholohichni predyktory formuvannia profesiinoi dezadaptatsii likariv khirurhichnoho ta terapevtychnoho profiliu [Some individual psychological predictors of the formation of professional maladaptation of doctors of surgical and therapeutic profile]. Ukrainskyi visnyk psykhonevrolohii – Ukrainian Bulletin of Psychoneurology, vol. 22, № 1 (78), pp. 84–87 [in Ukrainian].

Vitenko I.S. (2011). Spetsyfika adaptatsiinykh reaktsii likaria zahalnoi praktyky – simeinoi medytsyny do profesiinoi diialnosti [The specifics of adaptive reactions of general practitioners – family medicine to professional activities]. Medychna psykholohiia – Medical Psychology, vol. 6, № 3 (23), pp. 10–13 [in Ukrainian].

Yurieva L.N. (2017). Krizisy professionalnoi deiatelnosti vracha i puti ikh preodoleniia [Crises of professional activity of a doctor and ways to overcome them]. Zdorovia Ukrainy – Health of Ukraine, № 2 (41), pp. 23–24 [in Russian].

Kozhyna H., Mykhaylov V., Vyun V. (2017). The phenomenon of psychological adaptation to the professional activities of doctors. European psychiatry. The Journal of the European psychiatric association, vol. 41, pp. 690–691.

Kokun O.M. (2005). Adaptatsiia ta adaptatsiini mozhlyvosti liudyny: prykladni aspekty [Adaptation and adaptive capabilities of man: applied aspects]. Aktualni problemy psykholohii. Psykhofiziolohiia. Medychna psykholohiia. Henetychna psykholohiia – Current Problems of Psychology. Psychophysiology. Medical Psychology. Genetic Psychology, vol. 5, № 4, pp. 77–85 [in Ukrainian].

Arshava I.F. (2006). Funktsionalni stany liudyny v protsesi adaptatsii do ekstremalnykh umov diialnosti (u paradyhmi «osobystist–stan») [Functional states of man in the process of adaptation to extreme conditions of activity (in the paradigm «personality–state»)]. Visnyk APN Ukrainy. Pedahohika i psykholohiia – Bulletin of the Academy of Pedagogical Sciences of Ukraine. Pedagogy and Psychology, № 4 (53), pp. 82–90 [in Ukrainian].

Lisovyi V.M., Kapustnyk V.A., Markovskyi V.D., Kozhyna H.M. (2011). Porushennia adaptatsii studentiv pershoho kursu do navchalnoi diialnosti u vyshchomu navchalnomu zakladi [Violation of adaptation of first-year students to educational activities in higher education]. Proceedings from Novi napriamky vprovadzhennia kredytno-modulnoi systemy orhanizatsii navchalnoho protsesu u vyshchykh medychnykh i farmatsevtychnomu navchalnykh zakladakh Ukrainy III–IV rivniv akredytatsii: Vseukrainska naukovo-navchalna ta metodychna konferentsiia – New directions of introduction of credit-modular system of organization of educational process in higher medical and pharmaceutical educational establishments of Ukraine of III–IV levels of accreditation: All-Ukrainian scientific-educational and methodical conference. Ternopil, pp. 399–400 [in Ukrainian].

Sokolova I.M. (2007). Psikhofiziolohicheskiie mekhanizmy adaptatsii studentov [Psychophysiological mechanisms of adaptation of students]. Kharkiv: KhHMU, 412 p. [in Russian].

Aimedov K.V., Buchok Yu.S., Venher O.P., Vyshnichenko S.I., Voloshyn P.V. (Team of authors) (2016). Sotsialno-stresovi rozlady (klinika, diahnostyka, profilaktyka) [Social stress disorders (clinic, diagnosis, prevention)]. Voloshyn P.V., Maruta N.O., Kozhyna H.M., Markova M.V. (Ed.). Kharkiv, 335 p. [in Ukrainian].

Herasymenko L.O. (2017). Terapiia, reabilitatsiia ta profilaktyka psykhosotsialnoi dezadaptatsii u zhinok iz rozladamy adaptatsii [Therapy, rehabilitation and prevention of psychosocial maladaptation in women with adaptation disorders]. Ukrainskyi visnyk psykhonevrolohii – Ukrainian Bulletin of Psychoneurology, vol. 25, № 2 (91), pp. 38–39 [in Ukrainian].

Markova M.V., Kozyra P.V. (2015). Poststresovi dezadaptyvni stany na tli sotsialnykh zmin: analiz problemy [Post-stress maladaptive states against the background of social change: a problem analysis]. Medychna psykholohiia – Medical Psychology, № 1 (37), pp. 8–13 [in Ukrainian].