Viun V. Psychological maladaptation state of internship doctors (mechanisms of formation, the system of psychotherapeutic correction and psychoprophylactic support)

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0518U000587

Applicant for

Specialization

  • 19.00.04 - Медична психологія

29-05-2018

Specialized Academic Board

Д 64.609.03

Essay

The study was conducted on the basis of the Institute of Postgraduate Education of the Kharkiv National Medical University of the Ministry of Health of Ukraine during the period of 2014-2017. In the course of work, based on the development of the system of psychotherapeutic correction of maladaptation and psychoprophylactic support of internship doctors during the period of professional training, a comprehensive examination of 213 internship doctors of both genders was conducted. Levels of adaptation of internship doctors for professional activity were emphasized: high (14.1 %), average (20.2 %) and low level (65.7 %). It was described the asthenical (25.8 % of men and 22.5 % of women), hypersthenic (20.6 % of men and 23.2 % of women), anxiodepressive (11.3 % and 20.6 % respectively), psychosomatic (14.5 % of men and 18.1 % of women), asthenic-apathetical (12.3 % and 11.2 % respectively) and addictive (15.5 % of men and 4.4 % of women) variants of maladaptive reactions among the internship doctors. The developed model of the formation of disorders of adaptation of internship doctors is presented by a complex of pathogenic factors. It was established that the basis for the formation of maladaptive reactions among the internship doctors is the presence of somatic pathology, craniocerebral injury and neuroinfection in the anamnesis and the tendency to addictive behavior. Prognostically important factors in the formation of adaptation disorders are conflicts of family and professional relations, disturbing suspiciousness, low communicativeness, difficult working conditions, lack of positive emotions, awareness of inadequate level of competence, low level of motivation, and imperfectiveness of mechanisms of psychological protection. Triggers for the development of maladaptation states are the high level of professional stress, depletion of adaptation, prolonged mental stress, frustration of significant basic needs, and high rates of clinical scales of anxiety and depression HDRS. An individualized three-stage system of medical and psychological support during the professional training period, which involves the application of complex psychodiagnostic, psychotherapeutic, psychoeducational and psychoprophylactic influences, has been developed and tested.

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