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A sharp increase in life expectancy over the past century has led to a significant increase in demand for long-term medical and social care. With aging, the reactivity of the body to the effects of the external environment changes, in particular, a decrease in resistance to pathogenic factors. Older people have chronic diseases (cardiovascular system, respiratory and digestive organs, central nervous system, joints, organs of vision and hearing, as well as diabetes, oncological diseases, etc.) that reduce physical and social activity. Vascular diseases of the brain remain one of the most acute medical and social problems that cause enormous damage to society. A special place among them is occupied by cerebral stroke due to the high mortality rate, significant disability and social maladaptation of elderly patients. According to modern data, at least 1/3 of stroke patients develop motor function disorders on average. These disorders significantly worsen the daily functioning of the quality of life. The aim of rehabilitation of elderly patients who have suffered a stroke is to return the patient to active social and household activities, create optimal conditions for his active participation in society and, ultimately, improve the quality of life of both the patient and his relatives. The task of psychological and physical recovery, social and labor adaptation of post-stroke patients is most successfully solved in the system of complex multidisciplinary rehabilitation. The lack of timely restorative treatment leads to irreversible anatomical and functional changes and a violation of the psychoemotional status of a person. Evidence has been provided that physical rehabilitation measures for elderly patients can significantly improve the indicators of physical, mental and social functioning without increasing the risk of undesirable effects. Successful and safe interventions have made it possible to achieve the goal of rehabilitation, increasing the functional status of elderly patients and independence in everyday life, as well as reducing the burden of the disease for both the individual and his family and society as a whole.
A sharp increase in life expectancy over the past century has led to a significant increase in demand for long-term medical and social care. With aging, the reactivity of the body to the effects of the external environment changes, in particular, a decrease in resistance to pathogenic factors. Older people have chronic diseases (cardiovascular system, respiratory and digestive organs, central nervous system, joints, organs of vision and hearing, as well as diabetes, oncological diseases, etc.) that reduce physical and social activity. Vascular diseases of the brain remain one of the most acute medical and social problems that cause enormous damage to society. A special place among them is occupied by cerebral stroke due to the high mortality rate, significant disability and social maladaptation of elderly patients. According to modern data, at least 1/3 of stroke patients develop motor function disorders on average. These disorders significantly worsen the daily functioning of the quality of life. The aim of rehabilitation of elderly patients who have suffered a stroke is to return the patient to active social and household activities, create optimal conditions for his active participation in society and, ultimately, improve the quality of life of both the patient and his relatives. The task of psychological and physical recovery, social and labor adaptation of post-stroke patients is most successfully solved in the system of complex multidisciplinary rehabilitation. The lack of timely restorative treatment leads to irreversible anatomical and functional changes and a violation of the psychoemotional status of a person. Evidence has been provided that physical rehabilitation measures for elderly patients can significantly improve the indicators of physical, mental and social functioning without increasing the risk of undesirable effects. Successful and safe interventions have made it possible to achieve the goal of rehabilitation, increasing the functional status of elderly patients and independence in everyday life, as well as reducing the burden of the disease for both the individual and his family and society as a whole.
The disabling consequences of a stroke, impaired motor and cognitive functions, the unpredictability of the prognosis of their recovery, affective reactions to the disease can make it difficult to form adherence to treatment and acceptance of the disease, and therefore psychological assistance to patients after a stroke in the rehabilitation process is relevant. The aim of the study was to identify the direction of psychological assistance to patients with the consequences of a stroke in the conditions of rehabilitation in a polyclinic with the participation of a multidisciplinary team (MDB). The study involved 115 patients after a stroke, 63 men, 52 women; aged 38 to 94 years, with self-service disorders of varying severity. Rehabilitation measures were carried out with patients (drug therapy, exercise therapy, occupational therapy, speech therapy and psychological assistance) in a polyclinic at home. The psychological assistance was aimed at correcting attitudes towards the disease and treatment, at forming a positive therapeutic and life perspective in the mind of the patient, and at forming adherence to treatment. Family counseling was aimed at improving the interaction between relatives and patients. After carrying out rehabilitation measures and a psychological assistance program, there is a positive trend in self-care indicators (Bartel scale), cognitive functions (MMSE scale), and a decrease in anxiety and depression (HADS scale). Our study in a district clinic showed the relevance and extreme importance of including a psychological assistance program in the work of a multidisciplinary team. Directions of psychological assistance in a polyclinic included work with patients and with the micro-society (with relatives of patients).
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