PHYSICAL MEDICINE AND REHABILITATION IN UKRAINE: MAIN PRINCIPLES AND DIRECTIONS, WAYS OF REHABILITATION HELP IMPROVEMENTS

Teslenko Yu., Teslenko M., Katerenchuk I.

LITERATURE REVIEWS

Scentific article

Problems of including new specialization of physical medicine and rehabilitation doctor into Ukrainian structure of Health Care were investigated and updated. The main task of physical medicine and rehabilitation is organization and rehabilitation process control that includes medical and rehabilitation examination, setting of rehabilitation goals, defining of rehabilitation interventions needed for reaching those goals, recruitment of multidisciplinary rehabilitation team who are going to provide those inventions, realization of rehabilitation interventions, control of rehabilitation interventions efficiency according to established goals, further adjustment of individual rehabilitation program. Study of organization, main principles, ways and methods of physical medicine and rehabilitation will contribute implementation and methods development of physical medicine and rehabilitation into the structure of Healthcare that will lead to treatment process improvement and its higher efficiency. The article’s purpose is to investigate current condition of physical medicine and rehabilitation in Ukraine, its main ways, tasks and methods, and also ways of improvements on example of psychological rehabilitation methods implementations. Comprehensive rehabilitation of patients with a therapeutic pathology has to consist of medical, social and professional activities that are held by professional of different profiles. The direction of their work is under requirements control of maximal recovery and compensation of lost functions and integrative qualities of individual. The feasibility of psychological rehabilitation methods, development of individual questionnaires for evaluation of patient’s psychological status with physical diseases, elaboration and implementation of methods of comprehensive rehabilitation have to be noted. Physical medicine and rehabilitation are perspective and significant areas in healthcare structure. There are such specific and basic requirements of rehabilitation process. Phasing principle which is shown in a clear structuring of rehabilitation plan according to the disease stage (organization of rehabilitation process in stages: clinic or ambulatory stage). Pathogenetic conditionality. Learning and consideration of mechanisms of genesis and disease development, the usage of medicines in rehabilitation process. Continuity of rehabilitation process principle. Usage of complex and interdisciplinary approach in medical institutions (application of not only treatment measures but also measures of social and medical, professional and pedagogical and psychological ways in a rehabilitation process with involvement of rehabilitation specialists of different profiles into a rehabilitation process. Timely start and gradualism of rehabilitation measures. Individual approach in prescription of rehabilitation measures. Required usage of International Classification of Functioning Disability and Health in clinical practice is recommended. This will lead to the best results in rehabilitation process and will contribute the maximum development of patients adaptation opportunities. It is also needed to mention perspectives and expediency of psychological rehabilitation methods combined with main physical rehabilitation medicine methods as one of the most important ways of fully patients rehabilitation process. Perspectives of furthers researches in this field are more detailed investigation of physical medicine and rehabilitation specifics in Ukraine, comparison of the state of medical rehabilitation of EU countries and the USA, development and implementation of new complex ways of patients with therapeutic profile rehabilitation.

physical medicine and rehabilitation, medical rehabilitation, international classification of functioning, psychological rehabilitation.

1. Diachenko TV. Stan vyvchennia problemy pidhotovky fakhivtsiv-reabilitolohiv v osvitnomu prostori Ukrainy. Pedahohika, psykholohiia ta medyko-biolohichni problemy fizychnoho vykhovannia i sportu. 2007;10:38-41. [in Ukrainian].
2. Bielikova NO. Orhanizatsiia praktychnoi pidhotovky maibutnikh fakhivtsiv z fizychnoi reabilitatsii do zdoroviazberezhuvalnoi diialnosti. Osvitolohichnyi dyskurs. 2014;2:13-22. Dostupno: http://nbuv.gov.ua/UJRN/osdys_2014_2_4. [in Ukrainian].
3. Hertsyk AM. Fakhivets z fizychnoi reabilitatsii, chy fizychnyi terapevt: natsionalne ta mizhnarodne tlumachennia nazv profesii. Pedahohika, psykholohiia ta medyko-biolohichni problemy fizychnoho vykhovannia i sportu. 2010;10:21-4. [in Ukrainian].
4. Bielikova NO. Orhanizatsiia praktychnoi pidhotovky maibutnikh fakhivtsiv z fizychnoi reabilitatsii do zdoroviazberezhuvalnoi diialnosti. Osvitolohichnyi dyskurs. 2014;2:13-22. [in Ukrainian].
5. Horodynskyi SI. Bahatohrannist protsesu praktychnoi pidhotovky maibutnikh fakhivtsiv z fizychnoi reabilitatsii. Molodyi vchenyi. 2015;1(16):196-9. [in Ukrainian].
6. Krupa VV. Vyznachennia sutnosti ta zmistu formuvannia profesiinoi kompetentnosti maibutnikh fakhivtsiv fizychnoi reabilitatsii. Pedahohichni nauky. Zbirnyk naukovykh prats Natsionalnoi akademii derzhavnoi prykordonnoi sluzhby Ukrainy. Seriia: Pedahohichni ta psykholohichni nauky. 2014;4(73):176-87. [in Ukrainian].
7. Prymachok LL. Istoriya medycyny ta reabilitaciyi: navch. posib. Nizhyn : NDU im. M. Gogolya; 2014. 104 s. [in Ukrainian].
8. Novi posady i multydyscyplinarna komanda: MOZ Ukrayiny prodovzhuye vprovadzhuvaty pidhid dokazovoyi reabilitaciyi. Dostupno: http:// moz.gov.ua/article/news/novi-posadi-i-multidisciplinarna-komanda-moz-ukraini-prodovzhue-vprovadzhuvati-pidhid-dokazovoi-reabilitacii [in Ukrainian].
9. Berlinecz IA. Zarubizhnyj dosvid u sferi medychnoyi reabilitaciyi: perspektyvy vykorystannya v Ukrayini. Derzhavne upravlinnya: udoskonalennya ta rozvytok [serial online]. 2019;4:1–5. DOI: 10.32702/2307-2156-2019.4.100 [in Ukrainian].
10. Chepuryshkin IK. Voprosu o sushchnosti ponyatiya «abilitatsiya» kak pedagogicheskiy fenomen. Lichnost. semia i obshchestvo: voprosy pedagogiki i psikhologii: sb. st. po mater. I mezhdunar. nauch.-prakt. konf. № 1. Chast IV. Novosibirsk: SibAK; 2010. s. 135-8. [in Russian].
11. Zakon Ukrayiny «Pro reabilitaciyu osib z invalidnistyu v Ukrayini» vid 31.08.2018 № 2462-VIII [serial online]. Dostupno: http://zakon.rada.gov. ua/laws/show/2961-15 [in Ukrainian].
12. Pro vnesennya zmin do Dovidnyka kvalifikacijnyh harakterystyk profesij pracivnykiv. Vypusk 78 «Ohorona zdorovʼya». Dostupno: https:// zakon.rada.gov.ua/rada/show/v2331282-18 [in Ukrainian].
13. International Statistical Classification of Diseases and Related Health Problems 10th Revision. Available from: https://icd.who.int/ browse10/2016/en
14. Mezhdunarodnaya klassifikatsiya funktsionirovaniya. ogranicheniy zhiznedeyatelnosti i zdorovia. Zheneva: VOZ. 2001;342. Dostupno: https:// apps.who.int/iris/bitstream/handle/10665/85930/9241545445_rus.pdf;jsessionid=C4FF7599FC03D35AD081F1CE1121B85E?sequence=1 [in Russian].
15. Rogacheva TV, Shestakova EV. Teoreticheskie osnovaniya sotsialno-sredovoy reabilitatsii invalida. Meditsinskaya psihologiya v Rossii. [Internet]. 2018;10(3). Dostupno: http://www.mprj.ru/archiv_global/2018_3_50/nomer08.php doi: 10.24411/2219-8245-2018-13040. [in Russian].
16. Golik VA, Moroz EN, Pogorelova SA. Ispolzovanie Mezhdunarodnoy klassifikatsii funktsionirovaniya, ogranicheniy zhiznedeyatelnosti i zdorovya v ekspertnoy nevrologicheskoy praktike. Mezhdunarodniy nevrologicheskiy zhurnal. 2011;5(43):136-42. [in Russian].
17. Vasilchenko EM, Lyahovetskaya VV, Karapetyan KK, Filatov EV, Zoloev GK. Primenenie instrumentov Mezhdunarodnoy klassifikatsii funktsionirovaniya, ogranicheniy zhiznedeyatelnosti i zdorovya v reabilitatsionnoy praktike na modeli patsientov s travmaticheskoy boleznyu spinnogo mozga. Fizioterapiya, balneologiya i reabilitatsiya. 2017;16(5):234-43. [in Russian].
18. Korobov MV, Katyukhin VN, Shvartsman ZD, Pomnikov VG. Mezhdunarodnaya klassifikatsiya funktsionirovaniya. ogranicheniy zhiznedeyatelnosti i zdorovia v praktike mediko-sotsialnoy ekspertizy pri vnutrennikh boleznyakh. Terapevticheskiy arkhiv (arkhiv do 2018 g.). 2013;85(4):43-6. [in Russian].
19. Scobbie L, Dixon D, Wyke S. Goal setting and action planning in the rehabilitation setting: development of a theoretically informed practice framework. Clin Rehabil. 2011;25(5):468-82.
20. Kovyazina MS, Varako NA, Rasskazova NI. Psikhologicheskiye aspekty problemy reablitatsii. Voprosy psikhologii. 2017;3:40-50. [in Russian].
21. Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the health action process approach. Rehab. Psychol. 2011;56(3):161-70.
22. Smithson EF, Kennedy P. Organization and planning in person-centered hospital-based rehabilitation services. Oxford handbook of rehabilitation psychology. Oxford: Oxford Univ. Press; 2012. р. 128-42.
23. Rasskazova EI, Thostov ASh. Biopsihosocialnyj podhod k ponimaniyu zdorovya i bolezni. Obozrenie psihiatrii i medicinskoj psihologii imeni V.M. Bekhtereva. 2015;2:17-21. [in Russian].
24.  Tvorogovoj ND, redaktor. Klinicheskaya psihologiya: ehnciklopedicheskij slovar’. M.: Prakticheskaya medicina; 2016. 608 s. [in Russian].
25. Gillen G. Cognitive and perceptual rehabilitation: optimizing functioning. St Louis, MO: Mosby Elsevier; 2009.
26. Kennedy P. Rehabilitation psychology: Introduction, review, and background. Oxford handbook of rehabilitation psychology. Oxford: Oxford Univ. Press. 2012a. р. 3-9.
27. Kennedy P. Rehabilitation psychology: The continuing challenge. Oxford handbook of rehabilitation psychology. Oxford: Oxford Univ. Press; 2012b. р. 574-5.
28. Merbitz NH, Merbitz CT, Ripsch JP. Rehabilitation outcomes and assessment: toward a model of complex adaptive rehabilitation. Oxford handbook of rehabilitation psychology. Oxford: Oxford Univ. Press; 2012. р. 96-127.
29. Vasserman LI, Trifonova EA, Shchelkova OYu. Psihologicheskaya diagnostika i korrekciya v somaticheskoj klinike. Prakticheskoe rukovodstvo. SPb.: Rech’; 2011. 231 s. [in Russian].
30. Stiers W, Perry KN, Kennedy P, Scherer MJ. Rehabilitation psychology. IAAP handbook of applied psychology. Oxford: Wiley-Blackwell; 2011. р. 573-87.

«Bulletin of problems biology and medicine» Issue 2 Part 2 (151), 2019 year, 58-63 pages, index UDK 615.8+616-08-039.76](477)

10.29254/2077-4214-2019-2-2-151-58-63