Mental Health: Global Challenges Journal
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Mental Health and Ethical Issues in Cultural and Organizational Change
Get PDFIntroduction. Human behavior and by extension and organizational behavior becomes intelligible, adaptable and with the possibility of optimization if analyzed from the perspective of development and bio-psychological evolution of the human individual. In his bio-psycho-social evolution, the human individual goes through stages with specific needs, being equipped with specific tools, necessary to satisfy those needs.
Purpose. The results of the researches in the field of neurosciences, interpreted in epigenetic and psychological key, offer necessary solutions in the optimization and efficiency of the organizational life. On the other hand, new perspectives open up in understanding interpersonal behavior and relationships, with potential for use in organizational dynamics
Methodology. Each stage of the development of the human brain implies the manifestations of behavior, specific to those stages. The creation of an explanatory model based on the interpretation of the functioning of the human brain and on the analogy between its dynamics and concrete, observable behavior's, deepens the knowledge of the individual on his way to becoming a human being
Results, Discussion and Conclusion. The concepts of Human Being 1.0, 2.0 and 3.0 are closely related to the organization and functioning of the human brain. They describe the type of needs specific to each component level of the brain, needs that determine and motivate human behavior, the rewards associated with their satisfaction, which strengthen behaviors, and the evolutionary hypostasis of human behavior in relation to values and moral principles.
The experimentation of soft skills takes place only by respecting certain conditions that meet the specific needs of employees but especially by ensuring the framework of manifestation of Human being 3.0 through self-control of intention, proactive attitude and building a moral architecture to guarantee its achievemen
Psychological, ethical and deontological needs of the patients
Get PDFIntroduction. We live in time of rapid technical development. And this in turn contributes to the formation of a technical approach to the doctor-patient relationship. The rapid and easily accessible flow of information, excessive awareness of patients sometimes complicates compliance - the cooperation of the doctor with the patient (Mandal, J., et.al., 2016 ). In world practice, compliance is considered excellent when the patient follows 75% of the doctor's instructions. In addition patient safety is a persistent issue in public health that has taken a new connotation in the contemporary sanitary context (Façanha, T. R.et.al., 2019). Purpose. The purpose of the paper is to investigate what qualities a doctor of the 21st century should have from the point of view of a modern patient in order to improve compliance, cooperation of the doctor with the patient.Methodology. The survey was completely anonymous and voluntary. If the answer is yes, the patient had to choose from the proposed options the one that would most fully reflect his needs. In order to exclude subjectivity and systematic errors, the survey was conducted in various medical institutions of Ivano-Frankivsk. We interviewed 120 patients: 75 (group I) were hospitalized, 45 (group II) - outpatient. The special questionnaire developed by us consists of 30 questions, which are grouped into groups, each of which reflects certain qualities: competence and personal experience of the doctor; review features; the ability to explain to the patient the essence of the disease; appearance.Some items of the questionnaire were: "Does age or gender of the doctor matter to you?"; "Did you have problems with" doctor's handwriting "? Did it in any way affect your cooperation with the doctor on the way to better health? ? ».Results and Discussion. The study found that among the main qualities of the doctor, 88% of patients of group I and 80% of group II distinguish competence and professionalism; 42.66% vs 46.5% - attention; 60.0% vs 53.2% - patience and kindness; 90.6% vs 80.0% - the ability to easily and informatively answer questions of concern to the patient. The distribution of the qualities of the doctor and the manifestation of the need for them among the studied patients are shown in Figure 1.Significantly fewer patients focused on the doctor's appearance or age. Significantly fewer patients focused on the doctor's appearance or age. However, there has been a trend: most respondents prefer middle-aged female doctors.Causal analysis of the problem of poor handwriting of doctors showed the following data: 42.6% of patients of group I and 53.2% of group II complained of poor handwriting of doctors. And 6.6% and 2.2%, respectively, consider it illegible. According to the patients, they had the experience of buying and even using drugs issued incorrectly in the pharmacy due to the "medical handwriting" of 5 patients of group I and 1 patient of group II. However in the conditions of inpatient treatment this problem was quickly solved thanks to good cooperation of the doctor-nurse. It is almost impossible to control the same problem in the conditions of outpatient reception. Practical value. The results of our study were successfully implemented in the educational and scientific process of the Department of Propaedeutics of Internal Medicine and the Department of Psychiatry, Narcology and Medical Psychology at Ivano-Frankivsk National Medical University and can be used in lectures and workshops on occupational therapy and rehabilitation, medical psychology, the psychology of creativity, general, pedagogical psychology, pedagogy, sociology, philosophy, etc. Conclusion. The results of the study are statistically processed and allow to develop a model of the relationship between doctor and patient. It is possible that this study will promote better collaboration between physicians and patients. And medical students to think about what qualities should be nurtured in themselves for successful wor
The ecosystem approach in health social work
Get PDFIntroduction
Health is the greatest value in our lives. Analyzing the current approaches of the WHO (2014), we consider this concept not only from the standpoint of physical health and the absence of disease, but understand this phenomenon as a holistic state of complete well-being, which includes, in addition to physical, emotional, mental, social, spiritual, sexual, environmental and many other aspects. This is the so-called holistic model of health (Orzhekhovska, 2013).
Our reasoning suggests (given various aspects of health) that this value does not depend only on an individual's choice to be or not to be healthy, and cannot be governed solely by personal actions. Here are some examples. The lack of geographically close medical services and / or free medical services causes the inability to receive emergency medical care and / or to systematically monitor health. Negative relationships in the family, the absence of a father or mother in the family can lead to emotional rejection of the child (psycho-emotional disorders), the acquisition of undesirable behavior (child addictive behavior or delinquent behavior), lack of self-care skills (this can cause various infectious diseases), getting into institutional care, which usually do not contribute to the full development of personality, etc. Inadequate social policies and an imperfect health care system in the country can cause outbreaks of socially dangerous diseases and provoke the spread of pandemics. Aggressive urbanization creates uncomfortable living conditions in cities due to traffic jams, pollution, noise, which causes other health risks from stress to cancer. As we can see, good health depends not only on the individual being healthy in the broad context of this word, but on the complex impact on us of a number of systems in which we are included. It is important to emphasize the role of social work in this context, the theory and practice of which aim, inter alia, to promote social development and well-being, as well as to improve the health care system and reduce social inequalities. Therefore, the task of social work in general and social workers together with other professionals in particular is to support the individual, family, community, society in the context of strengthening and maintaining the health of both individual and public. An ecosystem approach in social work helps us to understand the process of maintaining and strengthening health, which explains well the mutual influence of each element of the system.
Purpose
The aim of the article was to consider health social work according to ecosystem approach.
Methodology
The study used theoretical methods of research, in particular, analysis, comparison, synthesis and implementation of the results of the study of health social work based on the principles of integral ecology and ecosystem approach.
Results and Discussion
The ecosystem approach is used in various spheres of practical and scientific activity: public health, ecology, economy, legal and social spheres, church-religious sphere and even education (Forget, Lebel, 2001; Deinega, 2018; Veklych, 2017; Voronkin, 2017).
Kabanenko and T. Semigina (2004) write about the separation of the ecological approach in social work on the basis of systems theory (sociological group of social work theories). Within this approach, the authors consider the main models of work and tools that can be used by social workers in their practice: eco-maps, genograms, etc. Systems theory and environmental theory are mentioned in the manual "Introduction to Practical Social Work". In systems theory, "a whole is greater than the sum of its parts", so it is important to consider "the interaction of the client and the environment." Ecological theory considers a person in the context of his or her entourage, but not only the family, society, but also the environment (Klos, Mykytenko, 2005, 52-54). In contrast to the mentioned researchers, T. Syla (2012) explores the problem of violence in the context of the ecosystem approach, she notes that this approach originates from the socio-ecological theory of Bronfenbrenner in psychology. So, no matter what theories the ecosystem approach is based on, the idea behind this concept is a wide range of interconnections. Every smaller object, such as a person, is part of a large range of interactions of larger systems: family, community, society, environment, and so on. Each element of the system affects the other, so solving a problem situation in one area can be an impetus for positive change in another.
Chaikovska and O. Hlavatska talk about the need to train social workers with a "high level of environmental culture" (2019). In scientific works on social work we find the concepts "ecosystem approach" and "ecological approach", which are virtually identical in content. This perspective has formed over time one of the modern concepts of social work: "environmental social work", or "eco-social work", or "green social work". The latter in her current research is much covered by T. Semigina (2018). The researcher notes that "a healthy environment is seen as an inalienable human right, a component of human dignity and non-discrimination." However, today there is no research on health social work from the standpoint of an ecosystem approach.
The ecosystem approach resonates with another very important concept. It is an integrated ecology. This concept appeared in the church-religious sphere, and was covered in the Encyclical (papal document) "Laudato si" by the head of the Catholic Church Pope Francis (2015/2019). According to the vision of Francis, there can be no question of ensuring the common good, guaranteeing fundamental rights, social justice, if humanity understands nature as something separate and does not link environmental pollution with economic activity, behavior, etc.
Conclusion
Therefore, it is obvious that today, in the conditions of social transformations and globalization processes, the solution of any social problem should be considered from the standpoint of the ecosystem approach. Health issues in social work cannot be considered without taking into account changes in the environment. For such activities, it is necessary to train social workers in the context of the ecosystem approach, programs and projects should be developed to help overcome the problems of clients' health in a comprehensive way. Further research is needed to study existing and develop new forms and models of social work on the basis of strengthening and maintaining the health of clients, taking into account the ecosystem approach and the basics of integral ecolog
Symptom. Toxic story: case study
No full textIntroduction
Such symptoms as hard, complex, bodily or mental feelings, that turn our everyday life into a hell, at first, lead us to a doctor, and then - to a psychotherapist. A sick man is keen to get rid of a symptom. A doctor prescribes medication, that is ought to eliminate a symptom. A psychotherapist searches for a reason of the problem that needs to be removed.
There is such an idea that a neurotic symptom, in particular, an anxiety - is a pathological (spare or extra) response of a body. It is generally believed that such anxiety doesn’t have some real, objective reasons and that it is the result of a nervous system disorder, or some disruption of a cognitive sphere etc.
Meanwhile, it is known that in the majority of cases, medical examinations of anxious people show that they don’t have any organic damages, including nervous system. It often happens that patients even wish doctors have found at least any pathology and have begun its treatment. And yet - there is no pathology. All examinations indicate a high level of functionality of a body and great performance of the brain's work. Doctors throw their hands up, as they can't cure healthy people. One of my clients told me her story of such medical examinations (which I’ll tell you with her permission). She said that it was more than 10 years ago. So, when she told her doctor all of her symptoms - he seemed very interested in it. He placed a helmet with electrodes on her head and wore some special glasses, when, according to her words, he created some kind of stressful situation for her brain, as she was seeing some flashings of bright pictures in her eyes. She said that he had been bothered with her for quite a long time, and at the end of it he had told her that her brain had been performing the best results in all respects. He noted that he’d rarely got patients with such great health indicators. My client asked the doctor how rare that was. And he answered: “one client in two or three months.” At that moment my client didn’t know whether to be relieved, flattered or sad. But since then, when someone told her that anxiety was a certain sign of mental problems, or problems with the nervous system, or with a body in general, she answered that people who had anxiety usually had already got all the required medical examinations sufficiently, and gave them the advice to go through medical screening by themselves before saying something like that.
Therefore, we see a paradoxical situation, when some experts point to a neurotic anxiety as if it is a kind of pathology, in other words - some result of a nervous system disorder. Other specialists in the same situation talk about cognitive impairments. And some, after all the examinations, are ready to send such patients into space
Main text
I don’t agree with the statement that any neurotic anxiety that happens is excessive and unfounded. It often happens that there is objective, specific and real causes for appearance of anxiety conditions. And these causes require solutions. And it’s not about some organic damages of the brain or nervous system. The precondition that may give a rise to anxiety disorder is the development of such a life story that at some stage becomes too toxic - when, on the one hand, a person interacts with the outside world in a way that destroys his or her personality, and, on the other hand, this person uses repression and accepts such situation as common and normal. Repression - is an essential condition for the development of a neurotic symptom. Sigmund Freud was the first who pointed this out.
Repression is such a defense mechanism that helps people separate themselves from some unpleasant feelings of discomfort (pain) while having (external or internal) irritations. It is the situation when, despite the presence of irritations and painful feelings, a person, however, doesn't feel any of it and is not aware of them in his or her conscious mind. Repression creates the situation of so-called emotional anesthesia. As a result, a displacement takes place, so a body starts to signal about the existing toxic life situation via a symptom.
Anxiety disorder is usually an appropriate response (symptom) of a healthy body to an unhealthy life situation, which is seen by a person as normal. And it’s common when such a person is surrounded by others (close people), who tend to benefit from such situation, and so they actively maintain this state of affairs, whether it is conscious for them or not.
At the beginning of a psychotherapy almost all clients insist that everything is good in their lives, even great, as it is like in everyone else’s life. They say that they have only one problem, which is that goddamn symptom. So they focus all of their attention on that symptom. They are not interested in all the other aspects of their life, and they show their irritation when it comes to talking about it. People want to get rid of it, whatever it takes, but they often tend to keep their lives the way that it was. In such cases a psychotherapist is dealing with the resistance of clients, trying to turn their attention from a symptom to their everyday situation that includes their way of thinking, interactions with themselves and with others and with the external world in order to have the opportunity to see the real problem, to live it through, to rethink and to change the story of their lives.
For better understanding about how it works I want to tell you three allegorical tales.
The name of the first tale is “A frog in boiling water”.
There is one scientific anecdote and an assumption (however, it is noted that such experiments were held in 19 century), that if we put a frog in a pot with warm water and start to slowly heat the water, then this frog get used to the temperature rise and stays in a hot water, the frog doesn’t fight the situation, slowly begins to lose its energy and at the last moment it couldn’t find enough strength and energy to get out of that pot. But if we throw a frog abruptly in hot water - it jumps out very quickly.
It is likely that a frog, that is seating in boiling water, will have some responses of the body (symptoms). For example, the temperature of its body will rise, the same as the color of it, etc., that is an absolutely normal body response to the existing situation.
But let us keep fantasizing further. Imagine a cartoon where such a frog is the magical cartoon hero, that comes to some magical cartoon doctor, shows its skin, that has changed the color, to the doctor, and asks to change the situation by removing this unpleasant symptom. So the doctor prescribes some medication to return the natural green color of the frog’s skin back. The frog gets back in its hot water. For some period of time this medication helps. But then, after a while, the frog’s body gets over the situation, and the redness of the frog's skin gets back. And the magical cartoon doctor states that the resistance of the body to this medication has increased, and each time prescribes some more and more strong drugs.
In this example with the frog it is perfectly clear that the true solution of the problem requires the reduction of the water temperature in that pot. We could propose that magical cartoon frog to think and try to realize that: 1) the water in that pot is hot, and that is the reason why the skin is red; 2) the frog got used to this situation and that is why it is so unnoticeably for this frog; 3) if the temperature of the water in the pot still stay so hot, without any temperature drop, then all the medication works only temporarily; 4) if we lower the temperature in that pot - the redness disappears on its own, automatically and without any medication.
Also this cartoon frog, that will go after the doctor to some cartoon physiotherapist, will face the necessity to give itself some answers for such questions as: 1) What is going on? Who has put this frog in that pot? Who is raising the temperature progressively? Who needs it? And what is the purpose or benefit for this person in that? Who benefits? 2) Why did the frog get into the pot? What are the benefits in it for the frog? Or why did the frog agree to that? 3) What does the frog lose when it gets out of this pot? What are the consequences of it for the frog? What does the frog have to face? What are the possible difficulties on the way? Who would be against the changes? With whom the frog may confront? 4) Is the frog ready to take control over its own pot in its own hands and start to regulate the temperature of the water by itself, so to make this temperature comfortable for itself? Is this frog ready to influence by itself on its own living space, to take the responsibility for it to itself?
The example “A frog in boiling water” is often used as a metaphorical portrayal of the inability of people to respond (or fight back) to significant changes that slowly happen in their lives. Also this tale shows that a body, while trying to adjust to unfavorable living conditions, will react with a symptom. And it is very important to understand this symptom.
Symptom - is the response of a body, it’s a way a body adjusts to some unfriendly environment.
Symptom, on the one hand, informs about the existence of a problem, and from the other hand - tries to regulate this problem, at least in some way (like, to remove or reduce), at the level on which it can do it. The process is similar to those when, for example, in a body, while it suffers from some infectious disease, the temperature rises. Thus, on the one hand, the temperature informs about the existence of some infection. On the other hand, the temperature increase creates in a body the situation that is damaging for the infection. So, it would be good to think about in what way does an anxiety symptom help a body that is surrounded by some toxic life situation. And this is a good topic for another article.
Here I want to emphasize that all the attempts to remove a symptom without a removal of a problem, without changing the everyday life story, may lead to strengthening of the symptom in the body. Even though the removal of a symptom without elimination of its cause has shown success, it only means that the situation was changed into the condition of asymptomatic existence of a problem. And it is, in its essence, a worse situation. For example, it can cause an occurrence of cancer.
The tale “A frog in boiling water” is about the tendency of people to treat a symptom, instead of seeing their real problems, as its cause, and trying to solve it. People don’t want to see their problems, but it doesn’t mean that the problem doesn’t exist. The problem does exist and it continues to destroy a person, unnoticeably for him or her.
A person with panic disorder could show us anxiety that is out of control (fear, panic), which, by its essence, seems to exist without any logical reason. Meanwhile the body of such a person could be in such processes that are similar to those that occur in the conditions of some real dangers, when the instinct for self-preservation is triggered and an automatic response of a body to fight or flight implements for its full potential. We can see or feel signs of this response, for example, in cases when some person tries to avoid some real or imaginary danger via attempts to escape (the feeling of fear), or tries to handle the situation by some attempts to fight (the feeling of anger).
As I mentioned before, many doctors believe that such fear is pathological, as there is no real reason for such intense anxiety. They may see the cause of the problem in worrisome temper, so they try to remove specifically anxiety rather than help such patients to understand specific reason of their anxiety, they use special psychotherapeutic methods that are designed to help clients to develop logical thinking, so it must help them to realize the groundlessness of their anxiety.
In my point of view, such anxiety often has specific, real reasons, when this response of a body, fight or flight, is absolutely appropriate, but not excessive or pathological. Inadequacy, in fact, is in the unconsciousness, but not in the reactions of a body.
For a better understanding of the role of anxiety in some toxic environment, that isn’t realized, I want to tell you another allegorical tale called “The wolf and the hare”.
Let us imagine that two cages were brought together in one room. The wolf was inside one cage and the hare was in another. The cages were divided by some kind of curtain that makes it impossible for them to see each other. At this point a question arises whether the animals react to each other in some way in such a situation, or not? I think that yes, they will. Since there are a lot of other receptors that participate in the receiving and processing of the sensory information. As well as sight and hearing, we have of course a range of other senses. For example, animals have a strong sense of smell.
It is well known that people, along with verbal methods of communicating information, like language and speaking, also have other means of transmitting information - non-verbal, such as tone of voice, intonation, look, gestures, body language, facial expressions etc., that gives us the opportunity to receive additional information from each other. The lie detector works by using this principle: due to detecting non-verbal signals, it distinguishes the level of the accuracy of information that is transmitted.
It is assumed, that about 30% of information, that we receive from the environment, comes through words, vision, hearing, touches etc. This is the information that we are aware of in our consciousness, so we could consciously (logically) use it to be guided by. And approximately 70% of everyday information about the reality around us we receive non-verbally, and this information in the majority of cases could remain in us without any recognition. It is the situation when we’ve already known something, and we even have already started to respond to it via our body, but we still don’t know logically and consciously that we know it. We can observe the responses of our own body without understanding what are the reasons for such responses.
We can recognize this unconscious information through certain pictures, associations, dreams, or with the help of psychoanalysis. Psychoanalysis is a great tool that can help to recognize the information from the unconscious mind, so that it can be logically processed further on, in other words, a person then receives the opportunity to indicate the real problems and to make right decisions.
But let us return to the tale where the hare and the wolf stay in one room and don’t see each other, and, maybe, don’t hear, though - feel. These feelings (in other words - non-verbal information that the hare receives) activate a certain response in the hare’s body. And it reacts properly and adequately to the situation, for instance, the body starts to produce adrenaline and runs the response “fight or flight”. So the hare starts to behave accordingly and we could see the following symptoms: the hare is running around his cage, fussing, having some tremor and an increased heart rate, etc..
And now let us imagine this tale in some cartoon. The hare stays in its house, and the wolf wanders about this house. But the hare doesn’t see the wolf. Though the body of the hare gives some appropriate responses. And then that cartoon hare goes to a cartoon doctor and asks that doctor to give it some pill from its tremor and the increased heart rate. And in general asks to treat in some way this incomprehensible, confusing, totally unreasonable severe anxiety.
If we try to replace the situation from this fairy-tale to a life story, we could see that it fits well to the script of interdependent relationships, where there are a couple “a victim and an aggressor”, and where such common for our traditional families’ occurrences as a domestic family violence, psychological and physical abuse take place. Only in 2019 a law was passed that follows the European norms and gives a legislative definition of such concepts as psychological domestic abuse, sexual abuse, physical abuse, bullying, that criminalizes all of these occurrences, establishes the punishment and directly points to people that could be a potential abuser. Among them are: a husband towards his wife, parents towards their children, a wife towards her husband, a superior towards a subordinate, a teacher towards his or her students, children towards each other etc..
When it comes to recognition of something as unacceptable, it seems more easy to put to that category such occurrences as physical and sexual abuse, as we could see here some obvious events. For example, beating or sexual harassment. Our society is ready to respond to these incidents in more or less adequate way, and to recognize them as a crime. But it is harder to deal with the recognition of psychological abuse as an offence. Psychological abuse in our families is common. Psychological abuse occurs through such situations, when one person, while using different psychological manipulations, such as violation of psychological borders, imposition of feeling of guilty or shame, etc., force another person to give up his or her needs and desires, and so in such a way make this person live another’s life. Such actions have an extremely negative effect on the mental health of these people, just as much as physical abuse. It can destroy a person from the inside, ruin self-esteem and a feeling of self-worth, create the situation of absolute dependence such victim from an abuser, including financial dependence etc.. It often happens that psychological abuse takes place against the backdrop of demonstrations of care and love.
So you've got this story about the wolf and the hare, that are right next to each other, and the shield between two of them is a repression - a psychological defense mechanism, when a person turns a blind eye to such offences, that take place in his or her own life and towards him or her. And this person considers this as normal, doesn't realize, doesn't have a resource to realize, that it is a crime. Most importantly - doesn’t feel anything, as a repression takes place. But a body responds in a right way - from a certain point of the existence of such a toxic situation the response “fight or flight” is launched in a body at full, in other words - the fear and anxiety with the associated symptoms.
The third allegorical tale I called “Defective suit”, which I read in the book of Clarissa Pinkola Estés with the name “Running With the Wolves".
“Once one man came to a tailor and started to try on a suit. When he was standing in front of a mirror, he saw that the costume had uneven edges.
- Don’t worry, - said the tailor. - If you hold the short edge of the suit by your left hand - nobody notices it.
But then the man saw that a lapel of a jacket folded up a little bit.
- It's nothing. You only need to turn your head and to nail it by your chin.
The customer obeyed, but when he put on trousers, he saw that they were pulling.
- All right, so just hold your trousers like this by your right hand - and everything will be fine, - the tailor comforts him.
The client agreed with him and took the suit.
The next day he put on his new suit and went for a walk, while doing everything exactly in the way that the tailor told him to. He waddled in a park, while holding the lapel by his chin, and holding the short edge of the suit by his left hand, and holding his trousers by his right hand. Two old men, who were playing checkers, left the game and started to watch him.
- Oh, God! - said one of them. - Look at that poor cripple.
- Oh, yes - the limp - is a disaster. But I'm wondering, where did he get such a nice suit?”
Clarissa wrote: “The commentary of the second old man reflects the common response of the society to a woman, who built a great reputation for herself, but turned into a cripple, while trying to save it. “Yes, she is a cripple, but look how great her life is and how lovely she looks.” When the “skin” that we put on ourselves towards society is small, we become cripples, but try to hide it. While fading away, we try to waddle perky, so everyone could see that we are doing really well, everything is great, everything is fine”.
As for me, this tale is also about the process of forming a symptom in a situation when one person tries very hard to match to another one, whether it is a husband, a wife or parents. It’s about a situation when such a person always tries to support the other one, while giving up his or her own needs and causing oneself harm in such a way by feeling a tension every day, that becomes an inner normality. And so this person doesn’t give oneself a possibility to relax, to be herself (or himself), to be spontaneous, free. As a result, in this situation the person, who was supported, looks perfect from the outside, but those who tried to match, arises some visible defect, like a limp - a symptom. And so this person lives like a cripple, under everyday stress and tension, trying to handle it, while sacrificing herself (or himself) and trying to maintain this situation, so not to lose the general picture of a beautiful family and to avoid shame.
The tailor, who made this defective suit and tells how to wear the suit properly, in order to keep things going as they are going, often is a mother who raised a problematic child and then tells another person how to deal with her child in the right way. It is the situation when a mother-in-law tells her daughter-in-law how to treat her son properly. In other wo
The nature of the manifestation of procrastination, level of anxiety and depression in medical students in a period of altered psycho-emotional state during forced social distancing because of pandemic COVID-19 and its impact on academic performance
Get PDFIntroduction: The fact that learning is moving online is probably a disappointment to most medical students. This is especially true for middle and senior students, in whom most disciplines are clinical and focus on practical work with patients. During the period of forced social distancing and online learning in connection with the COVID-19 pandemic, such a common way of learning became impossible. All these changes obviously affect the mental health of medical students, who are already at risk for such phenomenon as procrastination and disorders as anxiety and depression.
Purpose: Investigate and evaluate the level of anxiety, depression, and the nature of the manifestation of procrastination in medical students Faculty of Medicine and the Faculty of Training Foreign Citizens (FTFC) of Ivano-Frankivsk National Medical University (IFNMU) in a period of altered psycho-emotional state during the period of forced social distancing and its impact on academic performance.
Methodology: 212 medical students were interviewed. The survey was voluntary and anonymous. We used two clinical test methods to identify emotional disturbances: the Hospital Anxiety and Depression Scale (HADS) and the Montgomery-Asberg Depression Rating Scale (MADRS) (Zigmond A.S. et.al.,1983; Svanborg P., 2001). In order to assess the propensity of students to procrastinate, we also used the "Questionnaire to study the propensity of the individual to procrastination" (Shivari ,O.A., 2015), which is a modification of the "General Procrastination Scale" (Lay, C., 1986) and consists of two scales: "Personally conditioned procrastination scale" (Scale I) and "Situationally conditioned procrastination scale" (Scale II). The statistical analysis of the results was performed using STATISTICA 7.0 software packages and the package of statistical functions of Microsoft Excel.
Results and Discussion: During the testing, students note that the most important problem for them is time management. The analysis of the results survey by "Personally conditioned procrastination scale" (Scale I) "showed that 15% of the students have a low, 47.5% - medium, 37.5% - high level of personal propensity to procrastination. The analysis of the results "Situationally conditioned procrastination scale" (Scale II) showed that 25% of students have a low level of situational procrastination, 37.5% - medium and 37.5% - high, respectively. The study of the relationship between the level of propensity to procrastination (Scale I) and academic performance in medical students showed that in the group with low procrastination the success rate is higher than in groups with medium and high procrastination (r = -0.58; p <0.05). We also established a direct correlation between the Scale II indicators and the average academic performance indicators. After the survey and analysis of the results on the HADS and MADRS scales, we found a clear relationship between increased learning during the period of altered psychoemotional state and the severity of anxiety-depressive symptoms in medical students, which manifested itself in an increase in the level of anxiety and mood disorders of varying degrees.
Conclusions: Thus, procrastination that occurs in the surveyed medical students in the period of altered psycho-emotional state during forced social distancing because of pandemic COVID-19 has had "situational" situational nature. Besides, the study confirmed that the pandemic of COVID-19, as a stressful moment of the external test of identity, caused the emergence of protective mechanisms in medical students in the form of emotional and behavioral changes and disorders. The results obtained indicate the presence of adjustment disorders in the period of the altered psychoemotional state during forced social distancing because of pandemic COVID-19 in all the studied groups. Medical students also need to be made aware that depression is not a cause for shame. Future doctors should be able to maintain their mental and emotional health, as well as know, how to deal with classmates who suffer from mental illnes
Types of parent-child relationship and indicators of neuropsychological development of preschool children
Get PDFIntroduction: During the last 20 years, in Russia and in many EU countries, there has been significant change in the global social and cultural situation. Individualistic tendencies rose sharply and there is a widespread destruction of the sense of belonging. In this regard, the type of parent-child relationship is changing, which is one of the key dimension of the neuropsychological development of children. There is a logical question for psychologists, teachers and parents, what types of parent-child relationships are constructive, that is, they favor normal neuropsychological development of children of preschool age (6-7 years).
Purpose: The purpose of the present work is to investigate correlation between types of parent-child relationships and indicators of neuropsychological development of children, as well as identifying constructive types of parent-child relationships for the normal neuropsychological development of children.
Methodology: The study was conducted within the framework of the basic screening program (pre-school stage). The Order of the Ministry of health of the Russian Federation of 03.07.2000 ? 241 On approval of the Medical card of the child for educational institutions (together with the Instruction on the procedure of an accounting form ? 026/u-2000 (The Medical card of the child for educational institutions of preschool, primary, basic, secondary (complete) general education, primary and secondary vocational education, orphanages and boarding schools). Determination of the correspondence of neuropsychological development to the child's age was carried out according to the following indicators: thinking and speech; attention and memory; positive emotions and social contacts; sensorimotor development. Types of parental relationship was studied using the methodology of the Questionnaire “Parental relationship” (QPR), A.Y. Varga, V.V. Stolin. The sample was formed from 94 respondents who were screened in the framework of the basic screening program (preschool stage) at the health Center of the MC “Gubernia” in Novosibirsk. The study of determination of the type of parent-child relationship of 47 respondents (mothers) was conducted and the neuropsychic development of 47 children of preschool age in the families (6-7 years) was evaluated.
Results and Discussion: The data obtained indicate that different types of parent-child relationship such as “Cooperation” and “Symbiosis” positively interrelated with different indicators (attention and memory; the development of positive emotions and the presence of significant experiences in children) of the child's neuropsychological development. Such types of parent-child relationship as “Infantilism” and “Acceptance-rejection” negatively interrelated with such indicators of child's neuropsychological development as attention and memory; thinking, speech and positive emotions and social contacts.
Conclusion: Children in groups with a more “constructive” parental relationship type have higher cognitive scores and fewer behavioral problems. The materials of the study can be used by child psychologists in the evaluation of neuropsychological development of the child. The Bank of diagnostic techniques that quickly allow diagnosing the state of neuropsychic development of the child in relation to the type of parental relations and thereby increasing the effectiveness of its correction through work with parents is of practical importanc
The Effectiveness of Cognitive Behavioral Therapy for Eating Disorders
Get PDFIntroduction: Considering the importance of studying young Kosovars, with a special focus on the mental disorders that are appearing every day in our society, we have researched the effectiveness of behavioral cognitive therapy in patients with eating disorders.
Purpose: To prove the effectiveness and impact that cognitive-behavioral therapy has on patients with eating disorders, compared to patients who use only medications.
Methodology: The research was conceptualized as a cause-and-effect experiment, lasted 8-12 weeks for 60 patients selected with eating disorders, in 30 patients CBT and medications were applied and in 30 patients only medications were used. In the same patients, it was measured by the level of anxiety and depression at the beginning in the middle and at the end of therapy.
Results: According to the results, there is a statistically significant difference in the level of anxiety in patients with bulimia nervosa who applied CBT compared with patients who used only medications. There is also a statistically significant difference in the level of depression in patients with anorexia nervosa who applied CBT compared with patients who used only medications. According to the data, the duration of the disease in patients with CBT lasts less than 6 months, while patients with medication last 8-12 months.
Conclusions: According to research facts, the application of behavioral cognitive therapy has shown high efficacy in the treatment of eating disorders, compared to patients who have used only medications. Applying cognitive behavioral therapy still remains a challenge for our societ
Implementation of the DIR Model and the DIR/Floortime Approach in the System of Palliative Care for Children
Get PDFIntroduction. One of the systems that can be used in the system of palliative care for children is the Developmental Individual Relationship (DIR)/Floortime concept, which can be flexibly adapted to individual features of a child, and at the same time it has intelligible and clearly-defined tools for work and interaction, that take into consideration not only individual peculiarities of a patient, but also their parents and specialists.
Purpose. The purpose of the paper was to review the possibilities and prospects of using DIR/Floortime model in the system of palliative care for children.
Methodology. The paper was prepared on the basis of input from Belarusian Children's Hospice and also took into account experience of implementation of the DIR/Floortime Model (report information of ICDL’ specialists).
Results and Discussion. In the course of the work the main tasks for providing palliative care to sick children were outlined and 6 points of introduction of the DIR /Floortime concept into this system were singled out.
Conclusions. The main postulates of the DIR concept fully coincide with the modern principles of palliative support. Using DIR/Floortime Model also can solve urgent tasks of the system of palliative care for children: build a team-based, positive, supportive and safe relationship around a child and family; help to prevent conflicts; improve the emotional background of the child in car
Stigma and mental health: The curious case of COVID-19
Get PDFIntroduction: This article considers the impact of COVID-19 on stigma and mental health across the life spectrum and the ways that people access services.
Purpose: To explore the ways that a pandemic (COVID-19) has changed/shifted the relationship between mental illness or mental ill health and stigma across the life spectrum and call to re-focus resources on sustainable healthy societies, building cultures of peace.
Methodology: A literature search was employed, combined with informal interviews and observation.
Results and Discussion: On the one hand, the pandemic has opened public discussion of mental health challenges such as anxiety and depression, reducing some of the stigma attached as the experience is more common amongst people who have not previously declared mental health challenges. On the other hand, people previously experiencing mental ill health have mostly had that health challenge exacerbated by the pandemic. With fewer resources available, and changes in service delivery to largely on-line resources, the reduction in stigma has not meant better mental health care and services, but rather further marginalized some of the population. Cultures of peace are inclusive and provide space for full growth of all citizens, in contrast to reactive approaches now more readily applied. Mental health services are a basic right for all people and should be considered as such in all planned health strategies.
Limitations: The article focuses on literature review, anecdotal and observation and is focused over a short term, in North America. It is a preliminary study.
Strengths: As a preliminary study, the article highlights an emergent and present dilemma. It also highlights the need for a much more holistic, global approach to mental health and wellbeing across the lifespan.
Conclusion: While there are calls for national strategies for mental health services and services for people with dementia, in particular, there is still a need to take a more holistic approach to mental health as part of a whole health strategy to support human dignity and inclusion across the lifespa
Peculiarities of interpersonal relationships of Ukrainian Antarctic expeditions participants
Get PDFIntroduction: Extreme conditions of the Antarctic environment is affected both on the psychophysiological state of peoples and interpersonal relationships in a small group of winterers.
Purpose: To determinate the peculiarities of interpersonal relations in an isolated small group of winterers of Ukrainian Antarctic expeditions
Methodology: The study was conducted by diagnostic Technique for interpersonal relationships T. Leary for self-assessment of behavior (Leary, 1957). The predominant type of relations in the group of winterers was revealed as a component of interpersonal interaction. Monitoring was carried out in the last three years in the dynamics of "before" and "after" the expedition.
Results and Discussion: The study identified the relationship of "dominance" prevails in 70% of winterers before the expedition and increases to 84% on the end of expedition. 73% of winterers to establish friendly relations and cooperation. However, we observe a transition from friendliness at the beginning of the expedition to a gradual increase in aggression in interpersonal relationships after returning from the expedition by 17%. During the expedition (in the dynamics) we observed a gradual decrease in the average indicators of "subordination" and "dependence" as factors of interpersonal relations "dominance" and "aggression". There significant inverse correlation between the level of adaptation to the extreme conditions of Antarctica and the dependent type of relationship (r = - 0.63 *; p = 0.04). According to the expert assessment, such people have problem with adaptation to the environment of Antarctica and could be complicated relations and interaction in an isolated group of winterers.
Conclusions: 1) The "friendliness" and "dominance" are the predominant type of relationship in a small group of winterers: 2) The authoritarianism, aggression, selfishness and dependence are the inadmissible and undesirable types of interpersonal relations in extreme conditions of relative isolation on the Antarctic statio