ATTITUDE TO THE DISEASE AND ADHERENCE TO TREATMENT OF PATIENTS WITH CONSEQUENCES OF STROKE

Ermakova N.G., Zashchirinskaia O.V.
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Abstract

In patients with consequences of a stroke, disturbances in motor, cognitive, and sensory functions are observed; cardiovascular, endocrine and other body systems, impairment of self-care and independent walking. Physical dependence, the inability to self-care in fulfilling urgent biological needs leads to a feeling of helplessness and is accompanied by depressive, neurotic reactions to the disease. Restoration of impaired functions after a stroke has a long period and the success of recovery depends, on the one hand, on the volume and location of the brain lesion, the severity of motor and cognitive impairments, on the other hand, on the position of the patient himself, the attitude of the patient’s personality to the disease and adherence to treatment. A patient’s stay in a hospital is associated with the social expectations of the staff for certain behavior of the patient: fulfilling the instructions of the attending physician, partnership with staff (physical therapy methodologist, speech therapist, occupational therapist, etc.), the patient’s activity, the formation of healthy lifestyle attitudes (giving up smoking, alcohol, fatty food, etc.), which can be called psychological conditions for rehabilitation. However, not all patients are ready to fulfill these rehabilitation conditions, which are targets for psychological correction. The tasks of psychological assistance should be focused on developing adherence to treatment, forming cooperative relationships with staff, and healthy lifestyle attitudes, which can contribute to restorative treatment and the prevention of recurrent stroke. Psychological assistance during individual and group work should be focused on providing emotional support, setting realistic and understandable goals for the patient, adequate to the patient’s capabilities, both in a hospital and clinic, which can ensure his active inclusion in the treatment process.
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中风后遗症患者对疾病的态度和坚持治疗的情况
中风后遗症患者的运动、认知和感觉功能会出现障碍,心血管、内分泌和其他身体系统也会出现障碍,生活自理和独立行走能力也会受到影响。身体依赖性、无法自理以满足迫切的生理需求会导致无助感,并伴有抑郁、神经质的疾病反应。中风后受损功能的恢复需要较长的时间,恢复的成功与否一方面取决于脑损伤的体积和位置、运动和认知障碍的严重程度,另一方面取决于患者自身的状况、患者对疾病的个性态度以及对治疗的依从性。病人住院期间,医院工作人员会对病人的某些行为寄予社会期望:遵从主治医生的指示、与工作人员(物理治疗方法学家、言语治疗师、职业治疗师等)合作、病人的活动、形成健康的生活方式(戒烟、戒酒、戒油腻食物等),这些可以称为康复的心理条件。然而,并非所有患者都能满足这些康复条件,这些条件是心理矫正的目标。心理援助的任务应侧重于培养患者对治疗的依从性、与医护人员建立合作关系以及健康的生活方式,这有助于恢复性治疗和预防脑卒中复发。无论是在医院还是在诊所,个体和团体工作期间的心理援助都应侧重于提供情感支持,为患者设定现实且易于理解的目标,以满足患者的能力需求,从而确保其积极参与治疗过程。
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