Approaches to Correction of Adaptation Disorder in Women who Gave Birth to Premature Baby

Zavgorodnia N.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Introduction. It is known that birth of a premature baby is a cause-significant psycho traumatic situation, which can be a trigger of adaptation disorder, which, in turn, may manifest by borderline neuropsychic disorders. Correction of adaptation disorders carries out with the wide range of psychological, psychotherapeutic and psychopharmacological methods. The purpose of the work was to develop a short version of a method of psychotherapy, adapted to work with a woman in a somatic hospital and estimate the efficacy of psychotherapy developed variant based on the study of the dynamics of clinical-psychopathological and psychometric characteristics of women. Materials and Methods. With respect to the principles of bioethics and ethics we conducted a complex exami- nation of 150 women who gave a premature baby. The work was carried out at Kharkov Regional Clinical Perinatal Center, Kharkov City Perinatal Clinical Center, and Kharkov Regional Clinical Hospital № 1. Clinical psychopatho- logical method, history taking, psycho diagnostic method and methods of mathematical statistics were used. Results and Discussion. Most women participating in the survey, 77 (51 %), permanently resided in a city, 37 respondents resided in rural areas (25 %) and 36 in small towns (24 %). The main purpose of the psycho educational program was to fill the specific information (medical) knowledge deficit in patients and their families. Psycho educational program classes were held in closed groups of 7-8 women. Each session lasted an average of 45 minutes. The optimal frequency of meetings was conducting exercises 2-3 times a week (for the duration of stay of mother with a baby in the neonatal ward): average number of meetings was 10-12. The basis of creating of short-term therapy model the interpersonal psychotherapy paradigm of short-term treatment of depression were used. In the process, conventionally distinguished three main phases: initial phase of adaptation to the psychotherapeutic process, immediate correction phase and stage of preventive work. Practical implementation of psychotherapeutic strategies have been made within the tactical scheme, which consisted of 10-15 consistently lined up sessions that were conducted in parallel with studies on psycho educational modules. Based on a comprehensive evaluation of the efficiency of psycho correction: a decline of points of situational anxiety from 33,62 ± 0,9895 to 22,11 ± 0,7560; no signs of depressive disorder in the vast majority of women – 73 (49 %); only 40 women (27 %) hag the results of Perceived Guilt Index above 10 – it was determined that a designed comprehensive system has proven effective and can be recommended for further use and implemented in perinatal medicine. The methodological basis of the development of content of psychotherapeutic program is statistically confirmed the hypothesis about the primary role of the feeling of fault in forming of adaptation disorders, clinically manifested by depressive, anxiety and mixed variants. The developed psychological correction program has been carried out in several successive stages, aimed at destigmatization of parturient woman. The main issues that were discussed during the psychoeducational process were issues related to the peculiarities of the development of the child and elimination of shortage of essential medical information that has been offered in the most accessible and coherent form. On the ground of the complex evaluation of the efficiency of the chosen approach and methods of practical implementation of psychological correction of adaptation disorders, including the block of psychoeducational pro- gram and short-term psychotherapeutic group work, it has been determined that the developed system of complex psychocorrectional work with women, who gave birth to premature baby, proved its effectiveness and may be rec- ommended for further use and be implemented into practical link of providing assistance in the field of perinatal medicine.

women delivering a premature baby, psycho education, psycho correction

• Карвасарский Б. Д. Психотерапия / Б. Д. Карвасарский. – М. : Медицина, 1985. – 303 с.
• Когнитивная терапия депрессии / А. Бек, А. Раш, Б. Шо, Г. Эмери. – СПб. : Питер, 2003 – 304 с.
• Королева Е. Г. Психодинамические подходы в терапии депрессии / Е. Г. Королева // Актуальные вопросы диагностики, терапии и реабилитации психических и поведенческих расстройств : материалы междунар. конф, посвящ. 50-летию каф. психиатрии и наркологии, 14 мая 2012 г. – Гродно : ГрГМУ, 2012. – С. 145–148.
• Мазурова Н. В. Психолого-педагогическое сопровождение недоношенного ребенка и его семьи в структуре ком- плексной реабилитации / Н. В. Мазурова // Российский педиатрический журнал. – 2012. – № 5. – С. 13–17.
• Пезешкиан Н. Психосоматика и позитивная психотерапия / Н. Пезешкиан. – М. : Медицина, 1996. – 464 с.
• Прибытков А. А. К вопросу о нозологической структуре и факторах риска депрессивных расстройств невротиче- ского уровня в послеродовом периоде / А. А. Прибытков // Российский психиатрический журнал. – 2005. – № 1. – C. 16–18.
• Прибытков А. А. Психогенные послеродовые депрессии непсихотического уровня (клиническая картина и опыт тера- пии) / А. А. Прибытков // Социальная и клиническая психиатрия. – 2011. – Т . 21, № 1. – С. 9–13.
• Психологическая диагностика / Под ред. М. К. Акимовой, К. М. Гуревича. – СПб. : Питер, 2003. – 304 с.
• Старцева Н. В. Особенности адаптационных реакций при преждевременных родах женщин с патологическими ти- пами гестационной доминанты / Н. В. Старцева, Л. В. Юшкова, М. В. Швецов // Пермский медицинский журнал. – 2011. – Т. 28, № 4. – С. 98–103.
• Чернуха Е. А. Состояние психовегетативной сферы у женщин в послеродовом периоде / Е. А. Чернуха, Ю. Д. Соловье- ва, С. К. Кочиева // Акушерство и гинекология. – 2001. – № 5. – С. 28–32.

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