Mental health is one of the necessary components of the social well-being of the individual, the level of his physical comfort and ability to work. Despite the huge efforts made to develop and improve the health care system, over the past century, the prevalence of mental disorders has increased many times in world countries.
Approaches to the definition of medical psychology
In this situation, the development of medical (clinical) psychology, a scientific field designed to solve the most complex problems of our time, is of particular relevance. The specificity of the status of a scientific direction lies in its interdisciplinary nature, position at the intersection of medical and psychological knowledge and practices. Acting as an independent scientific field, medical psychology does not lose its ties with either medicine or psychology.
Definition 1
At the present stage of its development, medical psychology is an independent section of medical knowledge, which includes psychological problems that arise in people at various stages of the development of diseases in various conditions of seeking medical help.
The focus of science is the psychology of the patient, the psychological state of the individual, which is crucial in the occurrence of the disease, determines the features of its course, determines the development and success of treatment.
Tasks of medical psychology
In the process of providing medical and psychological assistance, medical psychology is aimed at solving a number of urgent problems, including the psychological analysis of the nature of diseases, in particular neuropsychiatric ones, the study of mental illnesses; study of the whole range of harmful and beneficial influences on the personality.
Definition 2
The subject of the scientific field is the study of the diverse manifestations of the patient's psyche, their influence on illness and health, the provision of optimal conditions, psychologically healing influences.
Medical psychology is designed to optimize contacts between the patient and the doctor, to promote the fastest and complete recovery, and the prevention of diseases.
General and private medical psychology
Medical psychology can be conditionally divided into general and particular.
Definition 3
The focus of the general attention is on the main patterns of the mental states of the patient (development of criteria for a painful, partially altered and normal psyche), the psychology of a medical worker, the psychology of everyday interaction between the patient and the doctor, the psychology of the atmosphere of medical organizations.
Definition 4
Private clinical psychology explores the leading aspects of the professional activity of a medical worker in the process of his interaction with a specific patient with certain diseases.
Disease as a basic category of medical psychology
Any disease is a pathological condition not of individual organs, but of the whole organism as a whole, respectively, and the treatment should be complex.
In modern medicine, pathological conditions are conditionally divided into:
- internal (somatic), in which pathological transformations are carried out in the systems and organs of the human body;
- nervous diseases. Pathological conditions of this type are most often systemic;
- mental illness, the essence of which lies in the disorder of specifically subjective, ideal, rational forms of human activity. Pathologies of this type are reflected in changes in productivity, effectiveness of purposeful activity, changes in the sequence, completeness and adequacy of psychomotor, pantomimic expressiveness, inadequacy of assessments of others, etc.
Regardless of the nature of the disease, the pathological condition leads to changes in the psyche of the individual. The reduction of negative experiences, stressful conditions due to mental changes is one of the most urgent tasks of medical psychology.
Thus, clinical psychology is one of the promising scientific areas that allow optimizing the psychological state of a sick person, contributing to the fastest and complete recovery of the individual.
Home > LectureGoals and objectives of medical psychology.
Medical psychology studies the psychological characteristics of patients and medical staff in the treatment and diagnostic process. For psychology, it is important to be able to study a person in a state of crisis - illness, that is, to study the features of changes in the psyche in a pathological state of the body. The main position of medicine - the doctor should not treat the disease, but the patient - requires knowledge not only of the biological and physiological characteristics of a person, but also of the characteristics of his psyche. The participation of the individual in the suffering of the body associated with the disease carried has been known for a long time. The unity of clinical and psychological approaches in medical practice has always distinguished the great doctors of antiquity and modernity. M.Ya.Mudrov, S.P.Botkin, G.A.Zakharyin, V.M. Bekhterev, V.N. Myasishchev, Z. Freud and many other doctors - oriented their students to the need to understand the sick person and take into account its characteristics in the course of diagnosis and treatment. Definition 1: In domestic psychology, medical psychology is considered as a branch of psychological science aimed at solving theoretical and practical problems related to the psychoprophylaxis of diseases, the diagnosis of pathological conditions, psychocorrectional forms of influence on the process of recovery and adaptation to the disease, with the solution of expert issues, social and labor rehabilitation of sick people (Psychological Dictionary, ed. Zinchenko V.P. and Meshcheryakova B.G., 2004). Definition 2: Medical psychology is understood as a field of professional activity aimed at increasing the mental resources of a person and his adaptive capabilities, harmonizing mental development, protecting health, overcoming ailments and psychological rehabilitation. The content of MP, its place, volume are still differently defined by various specialists. What is common is that the MT is understood as a border area between psychology and medicine. At the same time, she studies problems of medicine in the psychological aspect and methods of psychology. The differences between the names "clinical" and "medical" refer to: - firstly, the differences between doctors and psychologists: doctors prefer to say "medical", and psychologists - "clinical", - secondly, in foreign scientific literature they often use the term "clinical", and in the domestic - "medical". Different psychological schools understand the subject and tasks of clinical psychology in different ways. Some believe that medical psychology should study mental disorders in various diseases. Others believe that medical psychologists should investigate personality traits and engage in psychological correction. Still others consider the task of medical psychology to develop programs for correcting the maladaptive picture of the disease and maladaptive behavior. According to the direction of psychological research (to identify general patterns or to the characteristics of a particular patient), one can distinguish GENERAL and PRIVATE MP. General Medical Psychology includes the following sections: - the main patterns of the psychology of a sick person, the psychology of a doctor, the psychology of communication between a patient and a doctor, the psychological atmosphere of a medical institution; - psychosomatic and somatopsychic influences; - medical deontology (issues of medical duty, secrecy, ethics); - psychohygiene (education, training of doctor-patient relationships, psychology of marriage, psychology of the family, crisis periods). Private Medical Psychology studies: - features of mental processes in mentally ill patients; - the psyche of patients at various stages of preparation, performance of operations, in the postoperative period; - features of the psyche of patients with various diseases (cardiac, infectious, oncological, skin, etc.); - features of the psyche of patients with defects in organs and systems (blindness, deafness, etc.); - features of the psyche of patients during the examination (military, labor, judicial); - mentality of patients with alcoholism and drug addiction. The main task of medical psychology as a science is the study of the objective patterns of functioning and manifestation of mental phenomena and processes of a person in a situation of illness and therapeutic interaction. The subject of medical psychology - features of the mental activity of the patient in their significance for the pathogenetic and differential diagnosis of the disease, optimization of treatment, as well as for the preservation and promotion of health. Tasks of medical psychology. The specific tasks of the MP were formulated as follows (Lebedinsky, Myasishchev, 1966, Kabanov, Karvasarsky, 1978):- Study of the influence of diseases on the human psyche and behavior; Analysis of the influence of psychological factors on the occurrence, development and treatment of diseases, as well as on prevention; The study of the role of the mental as a factor opposing the emergence and development of the disease; The study of developmental disorders of the psyche; Study of manifestations and dynamics of mental disorders in various diseases; Development of principles and methods of psychological research in the clinic; Study of the influence of the characteristics of the relationship of the patient with medical personnel and the microenvironment on the process of the course of the disease and recovery; Creation and study of psychological methods of influencing the human psyche for medicinal purposes.
Research methods in medical psychology.
Methods are divided into main and auxiliary. The main ones are observation and experiment, all the rest are auxiliary. Observation - the study of psychological phenomena without interfering with their course. Zhiteiskoe observation - limited to the registration of facts, has a random, unorganized character. Scientific observation - organized, has a plan, fixing the results in a special diary. Included observation - involves the participation of the researcher in the activity that he studies. Not included observation - does not involve the participation of the researcher. The method of observation is the most fundamental method of psychological research. It consists in professional registration all detected in the external behavior of the subject manifestations internal psychological structure. A variation of the observation method is the clinical-psychological method (professional psychological conversation with the patient). The role of the method of observation increases with suspicion of simulation and dissimulation, Experiment - a method that involves the active intervention of the researcher in the activities of the subject in order to create the best conditions for studying specific psychological phenomena. The experiment can be laboratory when it takes place in specially organized conditions, and the actions of the subject are determined by instructions, natural when the study is carried out in natural conditions, ascertaining when only certain psychological phenomena are studied, formative- in the process of which certain qualities are developed. Helper methods. Poll - a method that involves the answers of the subjects to specific questions of the researcher. The survey can be written (questionnaire), oral (conversation) and in the form of an interview. The interview involves establishing personal contact with the subject, has its own principles, stages and scheme of conduct. Testing - a method in which the subject performs certain actions on the instructions of the researcher. Many methods have been developed for testing. Difference between testing and survey:
The curriculum (Syllabus) of the discipline "_Medical__Psychology__" is compiled on the basis of the State Educational Standard in the specialty "Psychology", the model curriculum "Medical Psychology", the model curriculum _Medical Psychology and logical
Curriculum (Syllabus) Discipline: Medical psychology Specialty 050503 Psychology (2)
ProgramThe curriculum (Syllabus) of the discipline "_Medical__Psychology__" is compiled on the basis of the State Educational Standard in the specialty "Psychology", the model curriculum "Medical Psychology", the model curriculum "Medical Psychology" and the logical
Explanatory note Medical psychology
Explanatory noteO.A. Skugarevsky, Head of the Department of Psychiatry and Medical Psychology, Educational Institution "Belarusian State Medical University",
The subject and tasks of medical psychology Medical psychology is a branch of psychological science aimed at solving theoretical and practical problems related to the psychoprophylaxis of diseases, diagnosing diseases and pathological conditions, as well as solving issues related to psychocorrectional forms of influence on the recovery process, solving various expert issues , social and labor rehabilitation of sick people.
Medical psychology, as one of the branches of psychology, includes or is associated with the following sections: the psychology of the patient, the psychology of therapeutic interaction, the norm and pathology of mental activity, pathopsychology, the psychology of individual differences, developmental clinical psychology, family clinical psychology, the psychology of deviant behavior, psychological counseling, psychocorrection and psychotherapy, neurosology, psychosomatic medicine.
Medical psychology is closely related to related disciplines, primarily psychiatry and pathopsychology. The area of common scientific and practical interest of medical psychology and psychiatry is the diagnostic process. Recognition of psychopathological symptoms and syndromes is impossible without knowledge of their psychological antonyms - phenomena of everyday life that reflect the individual psychological characteristics of a person and are located within the normal variations of mental response.
In medical psychology, questions of psychology and the main tasks of medicine are closely intertwined. Like psychology and the major clinical disciplines, medical psychology is divided into general medical psychology and specific medical psychology.
General medical psychology studies the personality of the patient, doctor, middle and junior medical worker and their relationship.
Private medical psychology studies the same issues in relation to each specific medical discipline: surgery, therapy, pediatrics, sanitation, gerontology, neuropathology, psychiatry, etc.
The subject and tasks of medical psychology.
Medical psychology studies the influence of mental factors on the occurrence and course of diseases and on the process of people's recovery.
Modern medical psychology is divided into two main areas. The first is related to the use of psychology in the clinic of neuropsychiatric diseases, where the main problem is to study the effect on the patient's psyche of a change in the structure and functioning of the brain, caused by an in vivo acquired pathology or determined by congenital anomalies. Another area of medical psychology is associated with its application in the clinic of somatic diseases, where the main problem is the influence of mental states (factors) on somatic processes.
The first area of medical psychology received the greatest development, this was manifested in the emergence of such scientific disciplines as neuropsychology (A.R. Luria) and experimental pathopsychology (B.V. Zeigarnik).
The subject of study of medical psychology is: the personality of a sick person, the personality of a medical worker (including the future), as well as the relationship of a sick person and a medical worker in various conditions - when visiting a patient at home, in an outpatient clinic and clinic.
This circle of questions also includes the psychology of the relationship between medical workers of each link and all links among themselves in the process of professional activity and in everyday life, with specialization and improvement, in public life, etc.
Medical psychology studies: 1) the role of the psyche in promoting health and preventing diseases; 2) the place and role of mental processes in the occurrence and course of various diseases; 3) the state of the psyche during the treatment of the disease and, in particular, the reaction to various medications; 4) mental disorders arising from various diseases, and methods for their relief.
Important issues of medical psychology are psychoprophylaxis, psychotherapy and psychohygiene.
Methods of medical psychology.
The main methods of medical and psychological research are conversation, observation and experiment.
Methods for studying the mental characteristics of somatic patients are borrowed by medical psychology from psychodiagnostics and general psychology, and the assessment of the adequacy or deviance of human behavior from psychiatry, developmental psychology and developmental psychology. The psychosomatic section of clinical psychology is based on scientific ideas from such areas as psychotherapy, vegetology, and valueology.
In addition to the basic methods of talking with the patient and observing his behavior, testing is used in medical psychology.
For psychodiagnostic purposes, tests are widely used that make it possible to distinguish two main groups of mental properties: properties of the intellect and properties of the character of the personality.
For example. Wiene-Simon system. The tests are age appropriate. Mental development, or mental age is determined by the number of tasks solved as a percentage of the passport age. The points from the solution of each problem are added up, and the average age indicator is displayed as a percentage. An indicator below 70% means the presence of oligophrenia.
Wexler test system for children and adults. According to the researchers, this method gives an idea of the intelligence and personal qualities of the subject. The system includes 6 verbal tests and 5 practical tests. The first 6 are in the study of: 1) awareness, 2) general intelligence, 3) the ability to reproduce numbers, 4) solve arithmetic problems, 5) establish similarities, b) identify 42 words. The five action tests represent tasks for: 1) recognizing objects with missing parts; 2) establishing a sequence of pictures; 3) folding drawings from parts; 4) drawing up geometric figures from parts (from 9 to 16) according to the model; 5) encryption of numbers, according to the code, within 90 s.
Rorschach method. The essence of the method is to find meaning in ink colored and black spots peculiarly located on the card. Rorschach testing is used to check the level of mental development of the subject.
The Minnesota multifactorial personality questionnaire (MMP1) is widely used in our country in the modification of domestic authors.
Psychological methods (tests) are not the main ones in assessing the individual psychological characteristics of the subject, but only supplement the data of the patient's clinical examination, such as a thorough history taking, conversation, observation, data from clinical and laboratory studies.
Medical psychology as an applied science has the following tasks :
- - study of mental factors influencing the development of diseases, their prevention and treatment;
- - study of the influence of certain diseases on the psyche;
- - study of various manifestations of the psyche in their dynamics;
- - study of developmental disorders of the psyche;
- - study of the nature of the relationship of a sick person with medical personnel and the microenvironment surrounding him;
- - development of principles and methods of psychological research in the clinic;
- - creation and study of psychological methods of influencing the human psyche for therapeutic and prophylactic purposes.
In the medical field, the term "clinical psychology" is often used. Sometimes the terms "medical psychology" and "clinical psychology" are used interchangeably. This opinion was shared, for example, by M. S. Rogovin (1969), A. E. Lichko and N. Ya. Ivanov (1992), Yu. F. Polyakov (1996). However, the representation of other authors in Russian psychology (N.V. Ivanov, V.M. Bleikher, V.M. Banshchikov) is reduced to an understanding of clinical psychology as a field of medical psychology that has an applied character and is focused on the needs of a psychiatric, somatic and neurological clinic.
In foreign psychology, the field of psychology, which in domestic science refers to medical psychology, is most often called clinical psychology. At the same time, the subject of clinical psychology can be understood in different ways. Clinical psychologists study mental disorders in various diseases, study personality traits and psychological counseling, and develop ways to eliminate signs of maladaptive behavior.
Clinical psychology aims to solve the problems of clinical practice (psychiatric, neurological, somatic). The sections of clinical psychology include pathopsychology, neuropsychology, somatopsychology.
AT pathopsychology Painful changes in the psyche, patterns of disturbance of mental activity and personality traits in mental illness are studied. The value of pathopsychology in medical practice lies in the development and application of methods for diagnosing mental disorders in sick people. A pathopsychologist, according to the well-known Russian specialist in the field of medical psychology B.V. Zeigarnik, should be, first of all, a psychologist and at the same time be well aware of the theoretical foundations and practical needs of a psychiatric clinic. The applied value of pathopsychology is especially high in psychiatry. Pathopsychology is necessary to establish the degree and structure of an intellectual defect, to conduct an examination, and also to evaluate the effectiveness of treatment. In pathopsychology, disorders of consciousness and personality, perception, memory, and thinking are studied.
Pathopsychology as a field of scientific and practical psychological knowledge should not be confused with psychopathology. Psychopathology - this is the doctrine of the pathology of the psyche, its painful changes. Psychopathology is a branch of psychiatry (i.e. medicine) and deals with the clinical description of the signs of mental illness (using such medical concepts as etiology, pathogenesis, symptom, syndrome). She studies the patterns of development of mental illness.
The issue of delimiting the subject of pathopsychology and psychopathology remains debatable. Both spiders study mental disorders, but they use different methods to do so. Pathopsychology studies mental disorders using the methods of psychology (pathopsychological experiment, testing), and psychopathology mainly resorts to the clinical descriptive method. The most authoritative specialists in the field of pathopsychology in our country are B. V. Zeigarnik, S. Ya. Rubinshtein, V. M. Bleikher, I. V. Kruk.
V. M. Bleikher and I. V. Kruk (1986) identify the following tasks facing practical pathopsychology:
- 1) obtaining data for diagnostics;
- 2) study of the dynamics of mental disorders in connection with the ongoing therapy - an assessment of the effectiveness of the treatment process;
- 3) participation in expert work - military, medical and social, judicial, psychological, medical and pedagogical examinations;
- 4) participation in rehabilitation work;
- 5) study of insufficiently studied mental illnesses, as well as the structure of mental disorders in certain neurological and somatic diseases;
- 6) participation in psychotherapy.
Mental disorders of a person are often associated with impaired brain activity as a result of trauma. Therefore, as a branch of medical psychology is often called neuropsychology, which explores the dependence of mental phenomena on the physiological processes occurring in the brain. Neuropsychology studies the brain mechanisms of higher mental functions, changes in the psyche of patients with local lesions of the brain. In neuropsychology, disorders of perception (agnosia), voluntary purposeful movements and actions (apraxia), disorders of various forms of speech activity (aphasia), memory disorders (amnesia), attention, thinking, and emotions are studied. New techniques for early and accurate diagnosis of local brain lesions created in neuropsychology make it possible to develop and apply evidence-based methods for restoring mental functions. A. R. Luria was the founder of neuropsychology in Russia. In recent decades, E. D. Khomskaya and L. S. Tsvetkova have also been actively working in the field of neuropsychology.
The most important area of work of medical psychologists is work with somatic patients. The relationship between human mental functions and somatic diseases has long been known. The emergence of the term "psychosomatic" dates back to 1818, when the German physician Johann Heinroth first proposed it to refer to the connection between psychological conflicts and physical illness. In 1825, Jacobi used the related concept "somatopsychic". The origin of psychosomatic medicine is associated with the psychoanalytic works of 3. Freud.
At present, it has been proven that the mental factor plays an important role in the origin of such diseases as bronchial asthma, gastric ulcer, hypertension. It is known that strong emotional unrest, prolonged stressful experiences can adversely affect the body and cause somatic diseases. This connection of the mental factor with the emergence and development of somatic and neuropsychiatric diseases was expressed in the name "psychogenic diseases". On the other hand, some neuropsychiatric disorders, personal characteristics of a person arise in connection with somatic diseases. Such changes in the patient's psyche are commonly called somatogenies. So, with cardiovascular pathology, patients experience anxiety, fear, especially in the afternoon. With gastrointestinal diseases, patients are depressed, irritable, show hypochondria (increased fears for their health). Tuberculosis is characterized by frequent manifestations of euphoria (an unreasonable state of excessive cheerfulness, characterized by complacency, joy, carelessness, serenity). Therefore, a medical psychologist should pay attention to patients who are often and chronically ill. They are very vulnerable, they are distinguished by irritability, irascibility, touchiness, tearfulness.
Ministry of Health of the Russian Federation
Voronezh State Medical Academy. N. N. Burdenko
Faculty of Higher Nursing Education (correspondence department)
Department of Nursing
Head of the Department Associate Professor, Candidate of Medical Sciences Evstratova E.F.
Test
On Medical psychology on the topic:
Medical psychology - subject, tasks, methods. The value of learning for FVSO students. Psychological and nursing diagnoses.
Completed: student of group 301
Kretinina G.P.
Checked:
Voronezh
P L A N
1. Key concepts.
2. History of medical psychology.
3. Medical psychology - subject, tasks, methods.
4. Psychological and nursing diagnosis.
5. The relevance of the study of medical psychology by students of the FVSO.
6. Test control.
7. Solution of situational problems.
8. List of used literature.
KEY CONCEPTS
Psyche - this is a special property of highly organized matter, which consists in the subjective reflection of the objective world.
these are properties of the brain that provide humans and animals with the ability to reflect objects and phenomena of the outside world.
Psychology is a science that studies subjective sensations, images, ideas, phenomena of memory, thinking, speech, will, imagination, interests, motives, needs, emotions, feelings and much more, i.e. the human psyche.
medical psychology is a branch of psychology that uses psychological patterns in the diagnosis, treatment and prevention of diseases.
pathopsychology (from the Greek pbthos - suffering, illness) - a section of medical psychology that studies the patterns of disturbance of mental activity and personality traits in case of illness.
Analysis of pathological changes is carried out on the basis of comparison with the nature of the formation and course of mental processes, states and personality traits in the norm.
Pathopsychology studies mental disorders primarily by experimental psychological methods. The applied significance of pathopsychology in the practice of medicine is manifested in the use of data obtained in the experiment for the differential diagnosis of mental disorders, establishing the severity of a mental defect in the interests of expertise (judicial, labor, military, etc.), evaluating the effectiveness of treatment based on objective characteristics of the dynamics of the mental state patients, analysis of the possibilities of the patient's personality in terms of its intact aspects and prospects for compensating for lost properties in order to select optimal psychotherapeutic measures, and conduct individual mental rehabilitation.
Psychotherapy - a complex therapeutic verbal and non-verbal impact on emotions, judgments, self-awareness of a person in many mental, nervous and psychosomatic diseases.
Psychogeny - these are violations that occur in the body and in the psyche of the patient under the influence of various, usually severe for the personality of mental trauma.
Somatogeny - These are mental disorders caused by somatic diseases.
Psychosomatic relationships - the primary influence of the psyche on somatics, first of all, the personality traits, its psychological type, which create the prerequisites for the emergence of certain types of adaptation disorders, play a role.
Somatopsychic relationships - the primary influence of somatics on the psyche. Certain personality traits can develop as a result of the impact on the psyche of a chronic illness or stress.
Psychosomatic diseases - these are physical diseases or disorders, the cause of which is affective stress (conflicts, discontent, mental suffering, etc.). Psychosomatic reactions can occur not only in response to mental emotional influences, but also to the direct action of stimuli (for example, the sight of a lemon). Representations, imagination can also influence the somatic state of a person.
Internal picture of the disease - the subjective-psychological side of any disease, which is created by the patient himself on the basis of the totality of his sensations, ideas and experiences associated with the physical state.
Type of attitude towards the disease - experiences, feelings of the disease, prognosis, attitude to treatment, which the patient himself makes for himself.
Burnout Syndrome - represents an acquired stereotype of emotional, most often professional, behavior. "Burnout" is partly a functional stereotype, since it allows a person to dose and economically spend energy resources. At the same time, its dysfunctional consequences may arise, when "burnout" negatively affects the performance of professional activities and relationships with partners.
It includes the following characteristics: refusal of career growth, loss of interest in work and life, insomnia, headaches, excessive use of drugs.
The development of this syndrome was due to the need to work in a strictly normalized and monotonous - intense daily routine, with great emotional saturation of personal interaction with difficult patients, clients, etc.
Professional deformation of the personality of a medical worker - the process of expanding the ways of responding in a professional context to all large areas of life.
chronic fatigue syndrome
- a disease characterized by increased fatigue, decreased mood, sleep disturbances, joint pain, difficulty concentrating.
With CFS, there is inhibition of the hypothalamic-pituitary-adrenal system, which regulates the production of the hormone cortisol. Evidence of the important role of hormones in the occurrence of CFS is the positive effect that hydrocortisone has on patients with CFS. Improve the condition of patients with CFS and some methods of psychotherapy (cognitive-behavioral therapy). Psychotherapeutic influences not only improve the physical and psychological status of the patient, but also normalize the hormonal balance, which may indicate that hormonal disorders in patients with CFS may be of a secondary nature.
Transfer (transfer) - the tendency to see the past in the present, resort to the use of old ways of perception and response, excluding any new information;
this is a special kind of relationship between the patient and the doctor, which is based on a feeling not for the doctor, but for some person from the past; it is a liberation from the past, or rather an erroneous understanding of the present through the past.
Countertransference (countertransference) - a reciprocal feeling of hostility, irritation, etc .; intensifies during times of stressful events and unresolved conflicts. Countertransference can be seen as a reaction to an internal imbalance.
Conversion - factors of an emotional nature that affect physical well-being.
Stress - a set of physiological mechanisms in response to the action of unfavorable, superstrong, extreme stimuli; the body responds with a tension of adaptive protective forces.
Distress - the negative impact of stress on human activity, up to its complete destruction.
Personality - a concept denoting a set of stable psychological qualities of a person that make up his personality.
Temperament - a dynamic characteristic of mental processes and human behavior, manifested in their speed, variability, intensity and other characteristics.
Character - a set of personality traits that determine the typical ways of its response to life circumstances.
iatrogeny - this is a method of treatment, examination or preventive measures, as a result of which a health worker harms the patient's health.
Sorogenia - this is a method of treatment, examination or preventive measures, as a result of which the nurse harms the health of the patient.
Egogenia - the influence of the patient on himself in connection with an illness or a certain state of health, that is, the result of a positive or negative self-hypnosis of the patient.
Egrotogeny - mutual influence of patients on each other.
mental trauma is a life situation characterized by individual and relative insolubility and a retiring state of neuropsychic stress, which leads to mental health disorders. The main characteristic of psychic trauma is its pathogenicity for the individual, depending on the severity, duration, recurrence, unexpectedness of the psychic trauma, and on the vulnerability of the individual to a specific psychic trauma.
HISTORY OF MEDICAL PSYCHOLOGY
The history of medical psychology in our country is inextricably linked with the name of V.N. V.M. Bekhterev, in which he worked all his life. VN Myasishchev made a significant contribution to the development of domestic medical psychology, having determined, in fact, its scientific and practical significance for medicine in general and for psychotherapy in particular, his scientific school exists and develops. Largely due to the selfless scientific, pedagogical and organizational activities of V. N. Myasishchev, the Institute. V. M. Bekhterev became the leading scientific, practical and educational center of medical psychology and psychotherapy in our country.
It is known that in Russia the founder of Russian medical psychology, V. M. Bekhterev, following Wundt, who opened the first psychological laboratory in Leipzig in 1879, organized in 1885 in Kazan the second experimental psychological laboratory in Europe. Later, similar laboratories are created in St. Petersburg. Following V. M. Bekhterev, at the end of the 19th - beginning of the 20th century, V. F. Chizh, S. S. Korsakov and A. A. Tokarsky, N. N. Lange, G. I. Rossolimo, A. I. Sikorsky created in other cities of Russia, psychological laboratories where experimental approaches were developed and tested for solving the problems of clinical and psychological diagnostics, in particular in psychiatry.
It is impossible not to say about the role and significance of the problematic commission "Medical Psychology" created by V.N. Myasishchev at the USSR Academy of Medical Sciences in 1962. in medicine. The problematic commission headed by V.N. Myasishchev and M.S. Lebedinsky gathered like-minded people. Largely thanks to the recommendations of the commission, new directions became possible in official research plans, dissertations, in improving organizational forms and the content of teaching work, in particular at Leningrad University, where V. N. Myasishchev taught in those years. A little later, he first achieved the introduction of postgraduate studies in this then seemingly exotic discipline.
MEDICAL PSYCHOLOGY - SUBJECT, OBJECTIVES, METHODS
MEDICAL PSYCHOLOGY - a branch of psychology that studies the personality, individuality of a sick person; features of mental activity, its changes in diseases; the influence of the patient's personality on the processes of the onset of the disease and recovery, as well as the relationship between the patient and medical personnel during the treatment and rehabilitation process.
The subject of study of medical psychology
According to the direction of psychological research, one can distinguish general and particular medical psychology.
General medical psychology studies general issues and includes the following sections:
1. The main patterns of the psychology of a sick person, the psychology of a medical worker, the psychology of communication between a medical worker and a patient, the psychological climate of the department.
2. Psychosomatic and somatopsychic relationships, that is, psychological factors affecting the disease, changes in psychological processes and the psychological make-up of the personality under the influence of the disease, the influence of mental processes and personality traits on the onset and course of the disease.
3. Individual characteristics of a person and their changes in the process of life.
4. Medical deontology and bioethics.
5. Mental hygiene and psychoprophylaxis, that is, the role of the psyche in promoting health and preventing disease.
6. Psychology of the family, psychohygiene of persons during the crisis periods of their lives (pubertal, menopausal). Psychology of marriage and sexual life.
7. Psychohygienic education, psychotraining of the relationship between the doctor and the patient.
8. General psychotherapy.
Private medical psychology studies:
1. Features of the psychology of specific patients with certain forms of illness, in particular with borderline neuropsychiatric disorders, various somatic diseases, the presence of defects in organs and systems;
2. Psychology of patients during the preparation and conduct of surgery and in the postoperative period;
3. Medico-psychological aspects of labor, military and forensic examination;
4. The psyche of patients with defects in organs and systems (blindness, deafness, etc.);
5. The psyche of patients with alcoholism and drug addiction;
6. Private psychotherapy.
Tasks of medical psychology:
1. psychocorrectional work (psychotherapy)
2. mental hygiene
3. psychological expertise related to the social and labor rehabilitation of patients
· medical-diagnostic and medical-rehabilitation.
Medical and diagnostic unit includes pathopsychological, neuropsychological, somatopsychological, psychophysiological, socio-psychological diagnostics.
Treatment and rehabilitation unit includes psychotherapeutic, psychocorrective, psychoprophylactic and sociotherapeutic measures.
The main methods of research in medical psychology:
observation of the patient's behavior,
experiment: laboratory and in vivo,
Questionnaire - questionnaire survey
conversation with the patient (collection of facts about mental phenomena in the process of personal communication),
· interview,
study of the products of the patient's activity (letters, drawings, diaries, crafts, etc.)
clinical diagnostic tests.
Observation:
outside surveillance is a way of collecting data about the psychology and behavior of a person by direct observation of him from the side.
Internal Surveillance, or self-observation, is used when a psychologist-researcher sets himself the task of studying a phenomenon of interest to him in the form in which it is directly represented in his mind.
Free observation does not have a predetermined framework, program, procedure for its implementation.
Standardized Observation pre-determined and clearly limited in terms of what is observed, is conducted according to a pre-thought-out program and strictly follows it, regardless of what happens in the process of observation with the object or the observer himself.
Included Surveillance characterized by the direct participation of the observer in the process under study.
Third Party Surveillance does not imply the personal participation of the observer in the process that he is studying.
Poll is a method by which a person answers a series of questions asked of him.
oral questioning used in cases where it is desirable to observe the behavior and reactions of the person answering questions. This type of survey allows you to penetrate deeper into human psychology than a written one, but it requires special training, education and a lot of time spent on research.
Written survey allows you to reach more people. The most common form is the questionnaire. But its disadvantage is that, when using the questionnaire, it is impossible to take into account in advance the reactions of the respondent to the content of her questions and, based on this, change them.
Free Poll- a kind of oral or written survey, in which the list of questions and possible answers to them is not limited in advance to a certain framework. A survey of this type allows you to flexibly change the tactics of research, the content of the questions asked, and receive non-standard answers to them.
Standardized Poll- with it, the questions and the nature of the answers to them are usually limited to a narrow framework, it is more economical in time and in material costs than a free survey.
Tests are specialized methods of psychodiagnostic examination, using which you can get an accurate quantitative or qualitative characteristic of the phenomenon under study. The tests imply a clear procedure for collecting and processing primary data, as well as the originality of their subsequent interpretation.
Test questionnaire is based on a system of pre-thought out, carefully checked in terms of their validity and reliability questions, the answers to which can be used to judge the psychological qualities of the subjects.
Test task involves assessing the psychology and behavior of a person based on what he does. The subject is offered a series of special tasks, based on the results of which they judge the presence or absence and the degree of development of the quality being studied.
projective test- it is based on the projection mechanism, according to which a person tends to attribute unconscious personal qualities, especially shortcomings, to other people.
Most Common Personality Tests
Method for researching the level of claims. The technique is used to study the personal sphere of patients. The patient is offered a number of tasks, numbered according to the degree of complexity. The subject himself chooses a feasible task for himself. The experimenter artificially creates success-failure situations for the patient, while analyzing his reaction in these situations. To explore the levels of claims, you can use the cubes of Koos.
Dembo-Rubinstein method. Used to study self-esteem. The subject on vertical segments, symbolizing health, mind, character, happiness, notes how he evaluates himself according to these indicators. Then he answers questions that reveal his idea of the content of the concepts “mind”, “health”, etc.
Rosenzweig's frustration method. With the help of this method, reactions characteristic of the individual in stressful situations are studied, which allows us to draw a conclusion about the degree of social adaptation.
The method of incomplete sentences. The test belongs to the group of verbal projective methods. One version of this test includes 60 unfinished sentences that the subject must complete. These sentences can be divided into 15 groups; as a result, the relationship of the subject to parents, persons of the opposite sex, superiors, subordinates, etc. is examined.
Thematic Aperception Test (TAT) consists of 20 plot pictures. The subject must write a story for each picture. You can get data on perception, imagination, the ability to comprehend the content, the emotional sphere, the ability to verbalize, psychotrauma, etc.
Rorschach method. Consists of 10 cards featuring symmetrical monochrome and polychrome inkblots. The test is used to diagnose the mental properties of a person. The subject answers the question what it might be like. Formalization of answers is carried out in 4 categories: location or localization, determinants (shape, movement, color, semitones, diffuseness), content, popularity-originality.
Minnesota Multidisciplinary Personality Inventory (MMPI). Designed to study personality traits, character traits, physical and mental state of the subject. The subject must react positively or negatively to the content of the statements proposed in the test. As a result of a special procedure, a graph is constructed that shows the ratio of the studied personality traits (hypochondria - overcontrol, depression - tension, hysteria - lability, psychopathy - impulsivity, hypomania - activity and optimism, masculinity - femininity, paranoia - rigidity, psychasthenia - anxiety, schizophrenia - individualistic, social introversion).
Adolescent diagnostic questionnaire. It is used to diagnose psychopathy and character accentuations in adolescents.
Luscher test. Includes a set of eight cards - four with primary colors (blue, green, red, yellow) and four with secondary colors (purple, brown, black, gray). The choice of color in order of preference reflects the focus of the subject on a certain activity, his mood, functional state, as well as the most stable personality traits.
Experiment - with it, an artificial situation is purposefully and thoughtfully created in which the studied property is distinguished, manifested and evaluated in the best way. The experiment allows more reliable than all other methods to draw conclusions about the cause-and-effect relationships of the phenomenon under study with other phenomena, to scientifically explain the origin of the phenomenon and development.
natural experiment- is organized and carried out in ordinary life conditions, where the experimenter practically does not interfere in the course of ongoing events, fixing them in the form in which they unfold on their own.
Laboratory experiment- involves the creation of some artificial situation in which the property under study can be best studied.
Modeling - creation of an artificial model of the studied phenomenon, repeating its main parameters and expected properties. This model is used to study this phenomenon in detail and draw conclusions about its nature.
Mathematical modeling is an expression or formula that includes variables and relationships between them, reproducing elements and relationships in the phenomenon under study.
Logic Modeling based on the ideas and symbolism used in mathematical logic.
Technical Modeling involves the creation of a device or device, in its action reminiscent of what is being studied.
Cybernetic simulation is based on the use of concepts from the field of informatics and cybernetics as elements of the model.
PSYCHOLOGICAL AND NURSING DIAGNOSIS
Each stage of the nursing process can be correlated with the work carried out by the nurse with the patient. Since one of the goals of the nursing process is to promote the health of the patient by psychological methods.
Nursing process.
Nursing diagnosis is a clinical judgment by a nurse that describes a patient's actual or potential response to a disease and condition, with the desired indication of the reasons for such a response. In a number of recent studies, nursing diagnosis is replaced by the concept of a priority problem.
Psychological diagnosis - assessment of the psychological state of the patient, as a system of relationships and influences exerted on this system by the disease.
Psychological and nursing diagnoses have their own specifics and content, but their relationship is indisputable, which manifests itself in the common goal of helping the patient.
RELEVANCE OF THE STUDY
OF MEDICAL PSYCHOLOGY BY FVSO STUDENTS
The main causes of conflicts that arise in medical institutions are ignorance of medical psychology, the inability to understand the psychology of the patient and his relatives. A nurse needs to study and know the psychology of her patients, their attitude to their disease and treatment methods, the characteristics and character traits of their patients, emotions, and much more.
Modern medical psychology has a solid methodological and methodological apparatus that allows you to receive reliable practical recommendations necessary for the effective diagnosis and treatment of various diseases, as well as for the ethically and socially justified impact on people's thinking and behavior in order to adapt them to changing living conditions, normalize psychological climate in teams.
The growing importance of medical psychology has led to its spread in higher educational institutions, and especially in the FVSO.
The disease is always individual, it affects a specific person, and in order to find means for its cure, a physician must imagine not only the external, but also the internal picture of the disease, see the possible psychological prerequisites and consequences of pathological processes, and understand the patient's personality changed by the disease. Analysis of complaints and collection of anamnesis, somatic and psychiatric examinations, all types of examinations. Appointment and implementation of etiological and pathogenetic differentiated therapy, resolving issues of convalescents - all this requires a medical worker to penetrate into the personality of the patient.
In addition, a nurse performing the functions of an organizer (manager) must possess and put into practice the knowledge of psychology, planning the work of nurses who are subordinate to her, which will allow her to avoid conflicts on the one hand, and increase the efficiency of patient care.
Medicine belongs to the field of professions "man - man", therefore, it requires great mental costs and psychological health. Knowledge of medical psychology will allow the nurse to diagnose psychological problems in a timely manner, using self-regulation methods to correct her condition, which ultimately will help to avoid burnout syndrome or professional deformations.
TEST CONTROL
1. The first medical psychology laboratory was opened in Russia:
a. V.M. Bekhterev in Kazan;
b. S.S. Korsakov in Moscow;
in. A.F. Lazursky in St. Petersburg;
G. there are no correct answers;
2. Medical psychology studies:
a. individual psychological characteristics of the patient's personality;
b. internal mental processes;
in. the cause of the occurrence of psychopathological phenomena;
G. causes and ways to resolve conflicts;
3. The first medical psychology laboratory in Russia was opened in:
a. 1879;
b. 1885;
in. 1886;
G. 1890;
4. The methods of medical psychology are:
a. ways to study the characteristics of the patient's personality;
b. appeal to live communication with the subject;
in. observation of the behavior of the subjects in a natural situation;
G. all answers are correct;
5. A research method that provides scientific character and evidence in the study of a particular mental phenomenon:
a. observation;
b. poll;
in. experiment;
G. questionnaire;
6. Observation is a method that allows you to:
a. conduct selective selection of information about the studied mental property in conditions of direct and feedback connection between the researcher and the subject;
b. obtain extensive information about a person's biography;
in. identify internal unconscious desires and interests;
G. obtain a quantitative description of a mental phenomenon;
7. Highly formalized psychodiagnostic methods are:
a. tests;
b. questionnaires;
in. questionnaires;
G. all answers are correct;
8. Tests include methods that meet the conditions:
a. validity;
b. reliability;
in. standardization;
G. all answers are correct;
9. The testing method involves the use of the following methods:
a. tests;
b. questionnaires;
in. questionnaires;
G. projective techniques;
10. Psychodiagnostics is:
a. section of medical psychology;
b. a field of psychology that develops methods for identifying and studying the individual psychological characteristics of a person;
in. the field of applied psychology;
G. all answers are correct;
11. Psychological diagnosis is:
a. the end result of the psychologist's activity;
b. description and identification of the essence of individual psychological characteristics of a person;
G. identification and description of disorders of mental activity;
12. The purpose of the psychological history is:
a. obtaining information about the patient's complaints;
b. obtaining information about the onset of the disease;
in. identification of the patient's attitude to his disease;
G. identification of bad habits of the patient;
13. A psychological history, in contrast to a medical history, has the following properties:
a. designed to find out the internal picture of the disease;
b. is a questioning of the patient;
in. collects information about the life of the patient;
G. there are no correct answers;
ANSWERS: 1 -a; 2 -a; 3 -b; 4 -G; 5 -in; 6 -a; 7 -G; 8 -G; 9 -a; 10 -b; 11 -b; 12 -in; 13 -a.
SOLUTION OF SITUATIONAL PROBLEMS
Nursing diagnosis in a patient with stress
Physiological problems: insomnia, pain in various parts of the body, tachycardia, shortness of breath, gastrointestinal disorders (diarrhea, constipation, heartburn, hiccups), sexual disorders, changes in appetite, chronic fatigue, drowsiness.
Psychological problems: mood swings, fears, depression, aggressiveness, suicidal thoughts, nightmares.
Social problems: reduced responsibility, postponing things for tomorrow, unproductive activities, disruption of relationships with relatives, work colleagues.
Spiritual Issues: loss of faith, loss of interest in the world around you, in your appearance, thoughts of suicide.
Potential issues: risk of developing distress.
Nursing diagnosis in a patient with hypertension
Physiological problems: headache, dizziness, fatigue, palpitations, shortness of breath.
Psychological problems: concern about one's condition, anxiety, fear of a new hypertensive crisis, fear of death.
Social problems: inability to perform normal daily activities.
Spiritual Issues: sickness care.
Potential issues: risk of stroke, risk of injury due to dizziness.
Nursing diagnosis in a patient with gastric ulcer
Physiological problems: acute pain in the epigastric region, heartburn, nausea, belching.
Psychological problems: anxiety about their condition, anxiety, mostly depressed mood, irritability, fear of malignant degeneration of the ulcer.
Social problems: difficulties in combining daily life and the need to follow a special diet.
Potential issues: risk of ulcer perforation, gastric bleeding, ulcer malignancy.
Nursing diagnosis in a patient with coronary artery disease
Physiological problems: attacks of sudden pain behind the sternum, increased heart rate, shortness of breath.
Psychological problems: anxiety about their condition, anxiety, fear of myocardial infarction, fear of death.
Social problems: the inability to perform normal activities associated with physical activity.
Potential issues: the risk of developing complications.
Nursing diagnosis in a patient with neurodermatitis
Physiological problems: rash, lichenification of the skin, itching in the area of lesions.
Psychological problems: anxiety about their condition, depressed mood, irritability.
Social problems: violation of relationships with relatives, work colleagues.
Potential issues: the risk of exacerbations.
Features of psychological care in geriatric practice
When working with patients of elderly and senile age, the psychological dominant of age is characteristic - "the leaving life," the approach of death ". Feelings of sadness and loneliness. Increasing helplessness. Purely age-related changes: decreased hearing, vision, memory, narrowing of interests, increased resentment, vulnerability, reduced ability to self-service. Interpretation of the disease only through age, lack of motivation for treatment and recovery.
Features of psychological care for mental patients
When working with mentally ill patients, there are many difficulties due to the closeness of the department, the impossibility in some cases of normal communication and feedback with the patient, as well as the peculiarities of visiting patients with relatives, since relatives themselves can contribute to an increase in painful manifestations in patients.
LIST OF USED LITERATURE
1. Abramova G.S., Yudchits Yu. A. Psychology in medicine: Proc. allowance - M.: LPA "Department - M", 1998.
2. Avanesyants E.M., Rukavishnikova EE. Psychology and nursing process. - M., 2002.-49s.
3. Bleikher V.M. Clinical pathopsychology. - Tashkent: Medicine, 1976.
4. Burlachuk L.F., Korzhova E.Yu. Psychology of life situations. - M, 1998 - 263.
5. Galperin P.Ya. Introduction to psychology: Proc. allowance - M .: "Yurayt", 2000.
6. Karvasarsky B.D. Medical psychology. - L., 1982.
7. Karvasarsky B.D. Psychotherapeutic encyclopedia. - St. Petersburg: Peter Kom, 1998.
8. Karvasarsky B.D. Psychotherapy - M.: Medicine, 1985.
9. Clinical psychology. 2nd international edition / Ed. M. Pere, W. Bauman. - SPb., M., Kharkov, Minsk: "Peter", 2002.
10. Kondratenko V.T., Donskoy D.I., Igumnov S.A. General psychotherapy. - Minsk, 1999.-524p.
11. Kosenko V.G., Smolenko L.F., Cheburakova T.A. Medical psychology for nurses and paramedics. - Rostov n / D., 2002 - 416.
12. Lakosina N.D., Ushakov G.K. Medical psychology. - 2nd ed., revised. and additional - M .: Medicine, 1998.
13. Maklakov A.G. General psychology. - St. Petersburg: "Peter", 2001.
14. Myagkov I.F. Medical psychology. M., 2002.
15. Myagkov I.F., Bokov S.N. Medical psychology. Fundamentals of pathopsychology and psychopathology. -M, 1999.-232 p.
16. Polyantseva O.I. Psychology - Rostov n / D., 2002 - 416s.
17. Stolyarenko L.D. Psychology of business communication and management. - Rostov n / a, 2001 - 512s
