关于医疗和预防机构是否准备好保护受军事行动影响的乌克兰人民的精神健康问题

V. Chorna
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The purpose of the work: on the basis of a retrospective analysis of the incidence rates of the Ukrainian population with mental disorders, to make a forecast of the readiness of domestic medical institutions’ (DMI) state to organize mass psychiatric and psychological assistance to the population that suffered as a result of hostilities. Methods: In the course of the analysis, statistical materials of the Ministry of Health of Ukraine for the period 2018-2020 were used regarding the incidence of mental and behavioral disorders and the provision of medical institutions with medical personnel, data from Form № 18 of the Ministry of Health of Ukraine «Report on the work on monitoring environmental factors affecting the health of the population» for the period 2014-2021. Results: It was found that men for the period 2018-2020 more sought help and were treated in psychiatric hospitals over the years from 67.2% to 65.3%, and were also treated in psychiatric day hospitals 57.3% to 59.4%. At the same time, women during the same period were treated on an outpatient basis from 78.9 to 81.0%, respectively, while less were treated in psychiatric hospitals - 32.8 to 34.7%. Non-compliance with the regulatory requirements of state sanitary rules № 173-96, state building norms V.2.5.-28: 2018 «Natural and artificial lighting» was determined, where the largest share was in 2017 - 11.8% and in 2019 - 10.7% , and the lowest non-compliance rates were noted in 2015 - 3.4% and in 2018 - 3.78%. The largest share of microclimate inconsistency in healthcare facilities was 11.3% in 2015 and 12.9% in 2016, and 3.2% in 2014, 4.4% in 2020, 2021 - 4.2%. The non-compliance with the regulatory requirements of state sanitary rules №. 173-96, state building norms V.2.5.-28:2018 \"Natural and artificial lighting\" was determined, where the largest share was in 2017 11.8%, in 2019 - 10, 7%, and the lowest non-compliance rates were noted in 2015 3.4%, in 2018 - 3.78%. 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引用次数: 0

摘要

目的:本文对乌克兰人口心理健康状况进行了预测性卫生评估,分析了2018-2020年战前时期精神障碍的发病率,确定了国内医疗机构保护乌克兰人口心理健康的准备水平,受敌对行动影响的人,以及提供医务人员。对战前时期固定房舍的病人住院条件和院内舒适状况进行了回顾性分析,并研究了欧洲国家在这一问题上的经验。这项工作的目的是:在对乌克兰精神疾病发病率进行回顾性分析的基础上,预测国内医疗机构(DMI)是否准备向遭受敌对行动影响的人口组织大规模精神和心理援助。方法:在分析过程中,使用乌克兰卫生部2018-2020年期间关于精神和行为障碍发生率以及医疗机构医务人员配备的统计资料,数据来自乌克兰卫生部2014-2021年期间“影响人口健康的环境因素监测工作报告”表格第18号。结果:2018-2020年期间,男性在精神病院寻求帮助和治疗的比例从67.2%上升到65.3%,在日间精神病院治疗的比例从57.3%上升到59.4%。与此同时,妇女在同一时期接受门诊治疗的比例分别为78.9 - 81.0%,而在精神病院接受治疗的比例较低,为32.8% - 34.7%。不符合国家卫生法规№173-96,国家建筑规范V.2.5的监管要求。-28: 2018确定了“自然和人工照明”,其中最大的份额是2017年的11.8%和2019年的10.7%,最低的不合规率是2015年的3.4%和2018年的3.78%。医疗机构中小气候不一致的最大比例分别为2015年11.3%和2016年12.9%,2014年3.2%,2020年4.4%,2021年4.2%。不符合国家卫生法规的监管要求。173-96,国家建筑规范V.2.5。-28:2018确定了“自然和人工照明”,其中2017年的最大份额为11.8%,2019年为10.7%,2015年最低的不合规率为3.4%,2018年为3.78%。医疗机构中小气候不一致的最大比例为2015年11.3%和2016年12.9%,2014年3.2%,2020年和2021年4.4% - 4.2%。结论:根据乌克兰卫生部的结论,考虑到俄罗斯联邦正在进行的大规模武装侵略和乌克兰实行戒严令,预计该国人口中精神疾病发病率将大规模增加,这将导致精神治疗和预防机构的负担增加,而这些机构仅部分准备好从质量上解决问题。为确保国内医疗机构做好保护乌克兰人民心理健康的准备,建议建立一个社会心理援助/咨询中心网络,由心理学家、社会工作者和开放的精神科、日间医院、综合医院门诊部组成。
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To the question of readiness of the medical and preventive institutions to protect the mental health of the population of Ukraine, which suffered as result of military operations
Objective: The article carried out a predictive hygienic assessment of the state of mental health of the Ukrainian population, analyzed the incidence of mental disorders in the pre-war period of 2018-2020, determined the level of readiness of domestic medical institutions to protect the mental health of the Ukrainian population, suffered as a result of hostilities, and provision of medical personnel. A retrospective analysis of the stay conditions of patients and the state of intrahospital comfort in stationary premises in the pre-war period was carried out and the experience of European countries on this issue was studied. The purpose of the work: on the basis of a retrospective analysis of the incidence rates of the Ukrainian population with mental disorders, to make a forecast of the readiness of domestic medical institutions’ (DMI) state to organize mass psychiatric and psychological assistance to the population that suffered as a result of hostilities. Methods: In the course of the analysis, statistical materials of the Ministry of Health of Ukraine for the period 2018-2020 were used regarding the incidence of mental and behavioral disorders and the provision of medical institutions with medical personnel, data from Form № 18 of the Ministry of Health of Ukraine «Report on the work on monitoring environmental factors affecting the health of the population» for the period 2014-2021. Results: It was found that men for the period 2018-2020 more sought help and were treated in psychiatric hospitals over the years from 67.2% to 65.3%, and were also treated in psychiatric day hospitals 57.3% to 59.4%. At the same time, women during the same period were treated on an outpatient basis from 78.9 to 81.0%, respectively, while less were treated in psychiatric hospitals - 32.8 to 34.7%. Non-compliance with the regulatory requirements of state sanitary rules № 173-96, state building norms V.2.5.-28: 2018 «Natural and artificial lighting» was determined, where the largest share was in 2017 - 11.8% and in 2019 - 10.7% , and the lowest non-compliance rates were noted in 2015 - 3.4% and in 2018 - 3.78%. The largest share of microclimate inconsistency in healthcare facilities was 11.3% in 2015 and 12.9% in 2016, and 3.2% in 2014, 4.4% in 2020, 2021 - 4.2%. The non-compliance with the regulatory requirements of state sanitary rules №. 173-96, state building norms V.2.5.-28:2018 "Natural and artificial lighting" was determined, where the largest share was in 2017 11.8%, in 2019 - 10, 7%, and the lowest non-compliance rates were noted in 2015 3.4%, in 2018 - 3.78%. The largest share of microclimate inconsistency in healthcare facilities was 11.3% in 2015 and 12.9% in 2016, and 3.2% in 2014, 4.4% in 2020 and 2021 - 4.2%. Conclusions: In connection with the ongoing large-scale armed aggression of the Russian Federation and the introduction of martial law in Ukraine, according to the conclusions of the Ministry of Health of Ukraine, a large-scale increase in the incidence of mental disorders among the country’s population can be expected, which will lead to an increase in the burden on psychiatric treatment and preventive institutions, which are only partially ready for a qualitative solution of problems. To ensure the readiness of domestic medical institutions to protect the mental health of the population of Ukraine, it is recommended to create a network of Centers for socio-psychological assistance / counseling, which will be staffed by psychologists, social workers and open psychiatric departments, day hospitals, outpatient clinics based on general hospitals.
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