The aim of the work was to study the psycho-vegetative state of students using standardized questionnaires. Materials and methods of research. The study involved students of 18–20 y/o, I–II course of the medical university. According to the results of screening of 448 students, we used a standardized questionnaire by OM Vein. There were 82 people with signs of autonomic dysfunction, which comprised the main study group. To assess the state of autonomic balance, we used cardiointervalography; to verify the hyperventilation syndrome, we used the Nijmegen questionnaire; to assess the psycho-emotional state and anxiety, we used the State-Trait Anxiety Inventory. Results of the research. Among 82 students with signs of autonomic dysfunction, the average score by the Vein scale was 36.12 ± 4.26 points (p ˂ 0.001) vs. 15 points denoting the norm. Subjective symptoms identified by the Vein scale closely correlated with the results of the Nijmegen questionnaire. A positive indicator of the latter – 36.24 ± 1.26 points – was observed in 71.95 % of people, which indicated the presence of hyperventilation syndrome in this group of students. The rest of the students in the main group had a negative result (less than 23 points), although according to the Vein scale, they had signs of autonomic dysfunction, which could indicate a certain premorbid condition. According to the State-Trait Anxiety Inventory, among the 82 people surveyed, students with signs of personal anxiety scored the most points, which were accompanied by emotional "explosions" (56.1 %), neurotic conflicts (35.37 %), feelings of insecurity (46.34 %) and anxiety (37.8 %), etc. We found an association between signs of anxiety and hyperventilation syndrome (r = 0.76). According to the results of the assessment, against the background of anxiety and neurotic symptoms and manifestations of hyperventilation syndrome, the results of the survey revealed signs of somatoform autonomic dysfunction in a significant proportion of students (71.95 %) of the main group, including complaints of respiratory, circulatory and gastrointestinal nature. The lack of isolated psychological markers specific to each psychosomatic disorder should also be noted. Thus, the identified signs of autonomic imbalance by the Vein questionnaire were significantly correlated with the manifestations of hyperventilation syndrome, increased anxiety, somatoform abnormalities, which is the evidence of statistical significance and informativeness of the results of the surveys. Conclusions. Screening surveys among students using standardized questionnaires, analysis of heart rate variability allows identifying a risk group with manifestations of psycho-vegetative dysfunction, maladaptation syndrome and recommending the use of certain health measures to improve quality of life, professional activity.

The signs of hyperventilation syndrome are detected among hypertensive patients, but are notnoticed by doctors that in some way can complicate the progression of the hypertension. It was established during the research that for the hypertensive syndrome and its extent of reveal verification, besides standardized Nijmegen questionnairespirometry or diaphragm amplitude can be used. It was established, that among group of hypertensive patients (n=43) with the signs of hyperventilation syndrome, the decrease of lung ventilation figures in accordance to proper magnitude was revealed. Specifically, such figures as vital capacity, forced expiratory volume in 1 sec, inspiratory and expiratory reserve volume, peak expiratory flowwere accurately lower. The reveled changes increased after conducting of the hyperventilation probe among all patients of the main group. At the same moment only among 28,57 % of patients from control group (n=14), without signs of hyperventilation syndrome, according to the survey, the violation of lung ventilation from slight (21,43 %) to moderate (7,14 %) was revealed under the hyperventilation probe. Besides that, among patients from the main group the limitation of diaphragm amplitude was noticed in comparison to results gained in the control group which became stronger under the forced breathing. The revealed changes among hypertensive patients require on time diagnostic and correction.

During the last years it has been observed the worldwide trend in regular creation, upgrading and implementation of emergency care protocols at the prehospital stage in the medical practice. The huge role is given to the methods of doctors` simulation preparedness in case of the emergency care at the scene. Modern doctors` preparedness requires practicing of the resuscitation in the simulation centers on the specific dummies or devices without the risk of making any harm to the patient, developing the ability to make quick and correct decision and conduct all necessary manipulations and interferences without any mistake. According to the professional literature, it is usually observed the lack of practical skills concerning the emergency care at the scene of an accident among therapeutic doctors`. Nowadays, one of the most important task undergraduate and postgraduate medical educations is the creation of simulation centers for quality training of highly qualified specialists, including emergency medical care. The aim of given investigation is the evaluation of the professional therapeutic doctors` competency in providing emergency medical care at the scene in accordance to the latest recommendations of the European Resuscitation Council (2021) and American Heart Association (2020). According to tests conducted in the 2017-2018s among therapeutic doctors about their abilities of the resuscitation conducting, it was revealed that only 52% were able to diagnose the state of clinical death; 63% - were able to perform chest compression; 15% were able to provide opening of airways; extremely low was the numbers of those who were able to use AED and ventilation – 5% and 9% correspondently. Therefore, one of the key tasks of the modern medical simulative education is to prepare therapeutic doctors to be able to perform emergency resuscitation at the scene. Key words. Simulative medicine, emergency medical care, the scene of an accident, therapeutic doctors.

The objective of the paper was the verification of psychosomatic disorders against the background of disadaptation among senior medical students. Materials and Methods. We used screening and psychometric diagnostic methods to examine 292 4th-year students, 181 (62 %) of whom showed signs of disorders relating to psychological and emotional adjustment to the stressful influence of external irritants against the background of somatic symptoms. We used the standardized Spielberger–Hanin, Zung, Cohen, and Nijmegen questionnaires and anamnestic data for the in-depth questionnaire in our research. Results. When assessing the overall results of the psychometric screening, we found that more than half of the 4th-year students surveyed (62 %) had some signs of adjustment disorders. According to the Spielberger questionnaire, 43.65 % of students in the main group (n = 181) showed signs of increased state anxiety. The majority of young people showed signs of trait anxiety, among whom 53.04 % had severe anxiety disorders and 41.99 % had moderate anxiety disorders. According to the Zung questionnaire, 17 people showed signs of depression. The Cophen scale assessment revealed a high number of young people with low stress tolerance among respondents. We found that among 181 students, 35.36 % had a satisfactory result (6.8 ± 1.43 units) and 50.28 % had a poor result (28.2 ± 1.18 units). The remaining 10 students in this group had a very poor result (36.5 ± 2.16 units). 48 students in the main group showed positive results according to the Nijmegen questionnaire. On the background of the detected changes, psychosomatic symptoms were established in most students, which can act as a marker of a non-adaptive type of autonomic reaction. Conclusions. Screening assessment of medical students with the use of standardized questionnaires makes it possible to detect manifestations of psychovegetative dysfunction, disadaptation syndrome against the background of psychosomatic symptoms.

Comorbid conditions in patients with hypertension on the background of occupational hazards create additional problems in the treatment of hypertension. An analysis of working conditions in 76 workers of the Ivano-Frankivsk armature factory who underwent regular medical check-ups regarding first-/second-degree hypertension (the main group) showed that they were exposed to occupational hazards of chemical (acrolein carbon, iron oxide, chromium, fluorine compounds, sulfuric acid) and physical (high temperature, noise, vibration, electromagnetic radiation, dust) nature for a long period of time (from 4 to 11 years). Comorbid conditions were most often observed among the patients of the main group as compared to the patients of the control group (n = 17), who were not exposed to occupational hazards - 82.06% and 73.34% of cases, respectively. In the patients of the main group, chronic bronchitis was detected in 26.56% of cases and coronary artery disease was diagnosed in 25.09% of cases as compared to 8.33% and 18.34% of cases in the control group. At the same time, 38.89% of hypertensive patients of the main group were diagnosed with chronic bronchitis and concomitant coronary artery disease, which were not observed in the patients of the control group. The patients of the main group were more likely to have dyslipidemia, left ventricular hypertrophy, aortic fibrosis, hypertensive retinopathy as compared to the patients of the control group. In the control group, patients with overweight and type 2 diabetes mellitus prevailed. Quality of life assessment using the 36-Item Short Form Health Survey among the patients of the main group revealed a significant decrease in the indicators of physical and vital activity, fulfillment of daily professional duties. In the control group, a worsening emotional state prevailed.