Shapovalova H. Sanatorium-and-health resort rehabilitation of children at the stage of remission of oncologic diseases: substantiation of differentiated programs taking into account concomitant pathology

The thesis covers important scientific – practical problem of medical rehabilitation, balneology and physiotherapy, which is to improve the quality of life of children in different periods of remission of oncohematologic diseases (OHD) and some solid tumors (ST) (brain and kidney tumors) by developing a comprehensive sanatorium-resort rehabilitation taking into account the peculiarities of the disease and concomitant pathology. It was found that children in remission of OHD and ST of up to 5 years and more than 5 years retain varying degrees of polymorphism of clinical-functional and psychosomatic disorders, which allowed to identify common approaches to SRR taking into account the peculiarities of the somatic status, concomitant pathology and remission period. There were substantiated the basic principles of application of SRR complexes taking into consideration the course of the disease and the most common concomitant pathology (hepatobiliary, nervous and cardiovascular systems) in children in different periods of remission of OHD and ST. For the first time the efficacy of internal use of mineral waters of low mineralization is shown: hydrocarbonate-sodium chloride "Voznesenskaya" and "Aqua Libra", hydrocarbonate-magnesium-calcium "Truskavetskaya Aqua-Eco" with the increased content of organic substances "Maria" in complexes of rehabilitation of children taking into account the period of remission of OHD and ST in concomitant diseases. A differentiated approach to the psychological support of sick children was substantiated taking into consideration the manifestations of anxiety and types of aggression, which improved social adaptation, psycho-emotional status, relationships in the team, as well as the need for psychological assistance to mothers in remission of oncologic diseases, which was confirmed by reliable reduction of manifestations of personal and reactive anxiety. There has been established effectiveness of successive 3-4-fold courses as a complex stage process of restoration of the body dysfunctions of children in different periods of remission of OHD and ST. The principles of differentiated administration of rehabilitation programs for children were substantiated, taking into account the period of remission of OHD and ST, the most common comorbidities, aimed at improving the quality of life. The analysis of the need for sanatorium rehabilitation of patients after radical treatment of oncologic diseases was carried out.