В отвечающей современным стандартам практике оказания медицинской помощи пациентам с онкологическими заболеваниями, основанной на биопсихосоциальном подходе, внимание уделяется психосоциальному функционированию как пациента, так и членов его семьи. Разработка эффективных моделей психосоциального сопровождения больных в процессе лечения и реабилитации предполагает научное обоснование критериев адаптации/дезадаптации, а также методов выявления и мониторинга семей, нуждающихся в различных видах психологической поддержки. Международные организации в своих руководствах по сопровождению пациентов с онкологическими заболеваниями для интегративной оценки психологического состояния предлагают применять регулярный скрининг эмоционального дистресса, определив дистресс как «шестой жизненный показатель» в дополнение к температуре тела, дыханию, артериальному давлению, пульсу и боли. В статье обобщены основные сведения о концепте «эмоциональный дистресс», проанализированы возможности и ограничения его использования в качестве критерия оценки дезадпатации в процессе лечения, показана целесообразность внедрения этого концепта и соответствующего измерительного метода в российскую практику психологического сопровождения педиатрических пациентов и их семей на разных этапах лечения. Обосновываются возможности использования данного критерия для быстрого и достоверного выявления необходимости оказания дополнительной (психологической/психиатрической) помощи по отношению к лечению основного заболевания ребенка; для отслеживания динамики эмоционального состояния пациентов и их родителей на каждом этапе лечения.

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Background. Children undergoing cancer treatment face a number of emotional, physical, and other problems leading to distress that need to be identified in a timely fashion. Regular assessment of patients' and their caregivers' psychosocial health care needs during the patients' hospital stays has become the standard of psychological care. Objective. This study was conducted to determine the validity of the Distress Rating Scale (DRS) on a Russian pediatric sample. The DRS appeared to be a reliable pediatric measure of patients' distress level. Design. One hundred fifty-nine (159) children of ages 7-17 with cancer and blood disorders, 153 caregivers, and 51 physicians were included in our study. Forty-five families were reassessed as a test-retest group after a four-week interval. The DRS was validated through the use of the Children's Depression Inventory (CDI) by M. Kovacs and by the Pediatric Quality of Life Inventory (PedsQL 4.0). Results. The convergent validity of the DRS's Russian version was shown by the reasonable agreement between the children's distress level and standardized measure scores. The criterion validity was demonstrated by significant correlations between the children's DRS self-reports, and those of their parents and physicians. The robustness and consistency of the results in the primary and repeated assessments between the DRS, the CDI, and the PedsQL, proved the reliability of the scale. Age-specific cutoff scores were determined. Conclusion. The Russian version of the DRS is a valid tool for rapid and reliable assessment of children's emotional distress in order to identify their needs for psychological assistance in a timely manner.

The results of the study of individual factors of psychological adaptation to the stressful situation of treatment by hematopoietic stem cells transplantation in adolescents and their mothers are presented. Measures were obtained from 28 adolescents aged 11—18 (M=14,25, 16m/12f) and their mothers aged 31—53 (M=41,1). The results show a significant positive correlation between levels of adjustment of adolescents and their mothers (r=0,643, p=0,001), between levels of adjustment to treatment and emotional distress of adolescents (r=0,544; p=0,007). The original hypothesis of significant associations between the levels of emotional distress, adjustment and individual factors such as appraisal of stressful event was confirmed: the lower level of adolescent’s adjustment was associated with their mothers’ appraisal of HSCT as a Threat (r=0,463, p=0,030) or Loss (r=0,450, p=0,035); high level of adolescent’s distress was associated with his/hers subjective appraisal of HSCT as a Threat (r=0,695, p=0,000) and Loss (r=0,659, p=0,000). Significant associations were also found between psychological adjustment of adolescents and coping behavior (of ad- olescents and parents), which confirms the importance of further research on both individual and family factors of psychological adjustment to HSCT.