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The article is devoted to the issues of conceptual understanding of the assessment of the quality of life in the context of the development of the sociology of medicine. There are several theoretical and methodological approaches to the study of the quality of life. The objective approach involves the analysis of the quality of life using a combination of various normative and statistical characteristics, with the help of which one can objectively judge the degree of satisfaction of the needs and interests of people. A subjective approach to the study of the quality of life is associated with an assessment of the needs and interests of specific people, which are reflected in the subjective perceptions of individuals, their personal opinions and assessments. The study of quality of life problems in patients with diabetes mellitus should be based on the analysis of sustainable social practices, which are based on the interaction of attitudes and values. It is important not only to identify the place of health in the value system of patients, but also to study life strategies and real behavior. Diabetes mellitus, taking into account the complex regimen of control and treatment, as well as numerous somatic manifestations (acute and chronic complications), has a pronounced impact on the quality of life and the ability to implement a life strategy. At the same time, both the quality of life and the patient's personal life strategy, in turn, have a significant impact on the effectiveness of the treatment of the disease. The author's attention is focused on the interdependence and relationship between the quality of life and the effectiveness of the treatment strategy, the need for a comprehensive model of medical and social care, in which the patient's activity and the formation of attitudes of self-preserving behavior plays a key role, is substantiated.

diabetes

the quality of life

quality of life assessment

self-preserving behavior

1. Novik A.L., Ionova T.I. Guidelines for the study of quality of life in medicine. - M.: Mediagroup.-2007.-314 p.

2. Reshetnikov A.V., Shapovalova O.A. Health as a subject of study in the sociology of medicine. M., GEOTAR-Media, 2008.

3. Reshetnikov A.V. Sociology of Medicine - M, GEOTAR-Media, 2007.

4. Savchenko T.N., Golovina G.M. Subjective quality of life: approaches, assessment methods, applied research. - M.: Publishing House of the Institute of Psychology of the Russian Academy of Sciences. - 2006. - 168 p.

5. Saranskov V.E., Gruzina E.S. Quality of life: on the question of the essence and content of the concept // Improving the quality of life of the population is the most important problem Russian Federation: Collection of scientific articles based on the materials of the III International Forum "Quality of Life: Commonwealth of Science, Government, Business and Society" / Social Innovation Foundation in 2 parts. - M: Municipal world, 2005.

6. Abetz, L., Sutton, M., Brady, L., McNulty, P., Gagnon, D.D. The Diabetic Foot Ulcer Scale (DPS): a quality of life instrument for use in clinical trials // Pract. Diab. Int. - 2002. - No. 19. - P. 167-175.

7. Anderson, R.J., Freedland, K.E., Clouse, R.E., Lustman, P.J. The prevalence of comorbid depression in adults with diabetes: a meta-analysis // Diabetes Care. - 2001. - 24. - P. 1069-1078.

8. Bradley C. Importance of Differentiating Health Status from Quality of Life // The Lancet. - 2001. - No. 357. - P. 7-8.

9. Bradley, C., Todd, C., Gorton, T., Symonds, E., Martin, A., Plowright, R. The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: theADDQoL / /Qual Life Res. - 1999. - No. 8.-P. 79-91.

10. Garratt, A.M., Ruta, D.A., Abdalla, M.I., Buckingham, J.K., Russell, I.T. The SF36 health questionnaire survey: an outcome measure suitable for routine use within the NHS // British Medical Journal. - 1993. - No. 306. - P. 1440-1444.

11. Gill, T., Feinstein, A.R. A critical appraisal of the quality of quality-of-life-measurements // JAMA. - 1994. - No. 272. -P. 619-626.

12. Global status report on noncommunicable diseases 2010. Geneva, World Health Organization, 2011

13. Hart, N. The Sociology of Health and Medicine. Oxford. 1993.

14. International Diabetes Federation. Diabetes Atlas, 4th edition. - 2011.

15. Mathers, C.D., Loncar, D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med, 2006, 3(11):e442.

16. Rubin, R.R. Diabetes and Quality of Life//Diabetes Spectrum. 2000.-No. 13.-P. 21-23.

17. Snoek, F.J. Quality of Life: A Closer Look at Measuring Patients" Weil-Being // Diabetes Spectrum. - 2000. - No. 13.-P. 24-28.

Diabetes mellitus is one of the most common chronic diseases worldwide. According to the International Diabetes Federation, there are already more than 366 million diabetic patients in the world, and by 2030 their number will almost double and exceed 552 million people. The World Health Organization predicts that diabetes will become the seventh leading cause of death in 2030. More than 80% of diabetes deaths occur in low- and middle-income countries.

Medical statistics show that there is also a trend in the age structure of diabetes mellitus, the number of patients with type 1 diabetes mellitus, which is called "young diabetes", is growing by 3% per year. Diabetes mellitus is a serious medical, social and economic problem. modern world, there is a growing need to improve the quality of life of patients and the effectiveness of diabetic care based on comprehensive medical and sociological studies.

The problem of quality of life is the subject of research in various branches of scientific knowledge. At the initial stages of the study, the concept of "quality of life" was replaced by such categories as "lifestyle", "lifestyle", "standard of living". However, these categories generalize only certain qualitative and quantitative aspects of people's lives. Indeed, the category "way of life" fixed the forms of people's life activity typical of historically defined social relations. The category "lifestyle" specified the content of the way of life, revealed its features, expressed in communication and behavior. The category "standard of living" focused its attention on life support, fixing only the quantitative side of life, the degree of satisfaction of the material and cultural needs of people.

Conceptually, there are several theoretical and methodological approaches to the study of quality of life. The objective approach involves the analysis of the quality of life using a combination of various normative and statistical characteristics, with the help of which one can objectively judge the degree of satisfaction of the needs and interests of people (for example, the level of crime, unemployment, environmental pollution, population, the amount of national capital, the share of capital in agriculture, the amount of available natural resources.). Objective indicators are based on information obtained from outside and are not part of the life experience of a particular person. The main purpose of using objective indicators is to measure the standard of living of a society or an individual as accurately as possible on the basis of statistical information. This direction of studying the quality of life is now being most intensively developed in the sciences adjacent to psychology.

A subjective approach to the study of the quality of life is associated with an assessment of the needs and interests of specific people, which are reflected in the subjective perceptions of individuals, their personal opinions and assessments. The concepts of quality of life within the framework of this approach are based on the assertion that the true meaning of the quality of life is reflected in the subjective feelings of individuals, which are formed on the basis of the individual's life experience, his emotional state, and the level of intellectual development. This direction is connected with the study of general life satisfaction, feelings of happiness, the main factors and determinants that determine a person's life satisfaction in modern conditions; hierarchy of the structure of the components of the quality of life and the main indicators of this phenomenon; features of the spiritual and cultural life of people; socio-psychological factors of the life of the individual in the face of change; socio-psychological characteristics of a person, his value orientations, norms of behavior.

Historically, quality of life has been measured in two different ways: measuring the objective conditions of life and measuring subjective assessments life. One of the attempts to take into account the multidimensionality of the concept of quality and standard of living was the concept of "human development" (Human Development Project), widely used in cross-country comparisons. Social development is associated primarily with the accumulation and development of human capital. The level of human development is directly related to the possibility of realizing a person as an individual and as a member of a given society. This aspect of the standard of living includes two elements: the first is the quality of life of people, taking into account the demographic, medical, environmental and intellectual conditions of their existence and self-realization; the second is the integration of individuals into society: their influence on social processes (participation in governance, democratic procedures.), the presence or absence of discrimination against certain social groups.

At the present stage, an approach is being formed that is focused on the integration of subjective and objective indicators of the quality of life. R.R. Rubin considers the quality of life as a multidimensional construct, including personal subjective perception of physical, emotional and social well-being, as well as cognitive (satisfaction) and emotional (happiness) components. Studies have shown that quality of life is correlated with the widest range of individual human experience.

The problems of interdependence between the quality of life and human health are of increasing scientific interest. In the structure of the quality of life, the state of health is one of the components. The World Health Organization defines quality of life as the perception by individuals of their position in life in the context of the culture and value system of the environment in which they live, inextricably linked to their goals, expectations, standards and concerns. The following parameters are identified as fundamental criteria for the quality of life by the World Health Organization: physical (strength, energy, fatigue, pain, discomfort, sleep, rest); psychological (positive emotions, thinking, learning, concentration, self-esteem, experiences); level of independence (daily activity, performance, dependence on drugs and treatment); social life (personal relationships, social value of the subject, sexual activity); environment(life, well-being, safety, accessibility and quality of medical and social care, security, ecology, learning opportunities, accessibility of information); spirituality (religion, personal beliefs).

In addition, the World Health Organization notes that in the absence of a real threat to the patient's life, the quality of life should be considered as the main criterion for the effectiveness of treatment. But at the same time, the introduction of quality of life research into clinical practice is accompanied by difficulties, which are largely associated with both the lack of unified approaches to assessing quality of life parameters and the complexity of interpreting the data obtained. In this regard, some studies introduce the special term “health-related quality of life” (HRQL), which is associated with the assessment of the impact of health or disease on the quality of life. Within this approach, the assessment of quality of life is primarily associated with the study of the impact of illness and treatment on functioning, hopes and subjective well-being. International; and domestic experience in studying the quality of life of patients indicates significant prospects for the method. .

The effectiveness of diagnostic and treatment-and-prophylactic care for patients with diabetes is still not high, which is also confirmed by the negative dynamics of acute and chronic complications, increased disability and mortality associated with diabetes. Living conditions, features of upbringing and traditions play a very important, and sometimes decisive role in shaping human behavior, including in relation to one's own health. Of particular importance is the formation of motivational attitudes of patients in relation to a healthy lifestyle and self-preserving behavior.

The use of a sociological system of interpretations in the analysis of health and quality of life problems leads to a shift in the focus of attention to the intersubjective area of ​​individual existence - to the sphere of social and interpersonal relations of the subject. The sociological approach involves considering the problem of health in the light of the main problems of socialization and social interaction. Self-assessment of the quality of life and health status depends on many factors, which necessitates further comprehensive assessment of the degree of impact of certain socio-economic factors on the deterioration of the course of diabetes mellitus, in order to find the causes and conditions for improving the quality of its treatment and diagnosis, the problem of conceptual justification of the optimization model is updated medical and social assistance to patients with type 1 diabetes mellitus.

Improving the quality of life is inextricably linked with the consideration of the possibilities of implementing life strategies, the activity of the patient, and the expansion of the set of available social roles. When providing medical and social assistance to patients with diabetes, it is important to take into account not only biomedical, but social, behavioral and psycho-emotional indicators.

In the context of ensuring the quality of life of patients with diabetes mellitus, life self-determination, the problems of choosing and forming life strategies are among the social problems that cause constant research interest, but at the same time, the ongoing changes in the forms and methods of determining life prospects, factors and conditions that determine them require constant updating of theoretical and methodological approaches to a new level of conceptual understanding of dynamically changing social practices in the context of social transformations. The emphasis in sociological research on the formation of life strategies is associated with an increased variety of social channels, a change in the methods of social adaptation.

In the value world of every person, there are certain “cross-cutting” values ​​that are practically pivotal in any field of activity. These, in our opinion, include human health, attitude to one's own health, as a factor in achieving success in modern society, a healthy lifestyle, as a way to maintain and improve the health of the individual. The decline in the importance of these values ​​in a given period causes serious concern in a normal society. Hence, a new methodological strategy for combining the data of mass quantitative studies with the study of individual cases, individual typical life trajectories, appears in world practice. The problem of identifying special states of a personality that precedes its real behavior is present in many researchers.

The attitude to health and perception of the state of health, in fact, integrates such categories as knowledge about health, awareness and understanding of the role of health in the process of human life, its impact on social functions, emotional and behavioral reactions. Often, patients associate a change in their health status with the influence of certain external factors, they do not believe in their own ability to influence their disease. This perception is determined by the external, or external, locus of control. Internal (internal) locus of control implies the presence of conviction in one's ability to influence the circumstances of one's own life, including the state of health. The locus of control in illness is the psychological basis on which coping strategies are built; it also determines the extent to which patients comply with medical advice. Patients with different variants of the locus of control require special attention in determining the strategy and tactics of treatment.

In addition, over time, under the influence of the disease, many personality characteristics change, and the hierarchy of motives does not remain unchanged. As a result, the patient's behavior is formed, which is largely determined by the life strategy, the functional role position that the patient implements in communication with others. Currently, the assessment of the quality of life and the study of life strategies are becoming increasingly important in the overall system for assessing treatment and preventive care for patients, including those with type 1 diabetes.

Of fundamental importance in the context of increasing the effectiveness of treatment is the formation of active, conscious self-preservation behavior. At the cognitive level, the degree of awareness or competence of the patient on the problems of diabetes mellitus, knowledge of the main risk factors and complications, understanding of the role of one's own activity and self-preserving behavior in ensuring the effectiveness of life and the effectiveness of treatment are important. On emotional level it is important to establish a high level of trust in the doctor-patient relationship, reduce the level of anxiety, and the ability to control one's own emotional state. At the motivational-behavioral level, the key is the change in the importance of maintaining health in the individual hierarchy of values, the degree of formation of motivation for the preservation and promotion of health, the degree of compliance of the patient's actions and actions with the requirements and the doctor's recommendation; compliance with self-assessment of health status. Treatment strategies should be aimed not only at correcting the somatic state caused by the disease, but also at correcting the psycho-emotional state, social well-being associated with the degree of socialization and the possibilities of self-realization of patients.

The study of quality of life problems in patients with diabetes mellitus should be based on the analysis of sustainable social practices, which are based on the interaction of attitudes and values. It is important not only to identify the place of health in the value system of patients, but also to study life strategies and real behavior. Diabetes mellitus, taking into account the complex regimen of control and treatment, as well as numerous somatic manifestations (acute and chronic complications), has a pronounced impact on the quality of life and the ability to implement a life strategy. At the same time, both the quality of life and the patient's personal life strategy, in turn, have a significant impact on the effectiveness of the treatment of the disease.

The traditional natural-science orientation of medical thinking leads to the fact that in practice, attention in the process of therapy is paid mainly to clinical and metabolic indicators, leaving social and psychological aspects out of the scope of attention. At the same time, within the framework of the modern biopsychosocial model of health and illness, the center is the patient as a person with his own experiences and fears, aspirations and hopes. Health-related quality of life and satisfaction with treatment are important parameters in assessing the effectiveness of treatment. A significant research interest of the medical community in the subjective picture of the disease is associated with the interconnectedness and mutual influence of objective and subjective factors related to the disease and its treatment, as well as a wide range of variables and conditions that determine a full, rich life of an individual and the possibility of implementing a life strategy.

Currently, in the field of quality of life research in diabetes, there is no universal toolkit that would allow a comprehensive assessment of all its aspects. The choice of one or more instruments for assessing the quality of life depends on the objectives of a particular study. Common instruments include: Medical Outcomes Study 36-ltem Short Form Health Survey-SF-36, Nottingham Health Profile - NHP, EuroQoL, The World Health Organization special . At the same time, in order to obtain the most complete picture characterizing the behavioral attitudes of the behavior of those suffering from type 1 diabetes, the identification social factors and personal characteristics that predetermine the patient's activity in the treatment strategy and the implementation of self-preserving behavior, in our opinion, research tools should include scales based on a system of indicators that characterize the assessment of life prospects and social status, social well-being; perception of depriving factors; stereotypes, motivational and behavioral attitudes towards health.

Interpretation of the results of the study, in our opinion, will allow us to most fully substantiate the relationship and dependence between changes in the quality of life of the patient, the type of life strategy and the course of the disease in people suffering from type 1 diabetes; identify factors of social deprivation and features of the internal picture in the perception of the disease and one's own role in the effectiveness of treatment; highlight the features of the perception of life prospects and opportunities for self-realization of patients suffering from type 1 diabetes.

Reviewers:

Smirnova E.N., Doctor of Medical Sciences, Professor, Head of the Department of Endocrinology and Clinical Pharmacology, Perm State Medical Academy. Ak. E.A. Wagner, Perm;

Anikin L.S., Doctor of Social Sciences, Professor, Head of the Department of Sociology of Communications and Management, National Research University “Saratov State University named after I.I. N.G. Chernyshevsky, Saratov.

Bibliographic link

Taraskina T.A., Rodionova T.I. CONCEPTUAL MODELS FOR ASSESSING THE QUALITY OF LIFE OF PATIENTS WITH TYPE 1 DIABETES MELLITUS // Contemporary Issues science and education. - 2015. - No. 5.;
URL: http://site/ru/article/view?id=22177 (date of access: 02/01/2020).

We bring to your attention the journals published by the publishing house "Academy of Natural History"

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At the turn of the 20th and 21st centuries, mechanization and automation of production led to physical inactivity of a significant part of humanity, which, in turn, was caused by an imbalance in energy consumption, a change in the course of a number of biochemical processes and an increase in body weight among the population of economically developed countries. In general, this problem is becoming one of the global ones, affecting all countries. Therefore, the problem of obesity in our time is becoming increasingly relevant and begins to pose a social threat to people's lives. This problem is relevant regardless of social and professional affiliation, area of ​​residence, age and gender. The significance of the problem of obesity is determined by the threat of disability in young patients and a decrease in overall life expectancy due to the frequent development of severe comorbidities.

Social and technogenic factors of society have contributed in recent decades to an increase in the prevalence of overweight. But it should be noted that this problem is not only and not so much medical as social - both in terms of the genesis and factors of its development, and due to the coverage of a significant part of the population and due to the specifics of the social status of overweight people. Most of these individuals suffer from more than just illness and limited mobility; they have low self-esteem, depression, emotional distress and other psychological problems due to prejudice, discrimination and exclusion in society. Assessment of the quality of life of patients allows us to solve such problems as determining the effectiveness of known methods of treatment; stratification of patients into groups and determination of differentiated tactics of treatment and diagnosis, search for new methods of treatment and rehabilitation aimed at improving the course of the disease.

The social aspect of the problem lies in the fact that there are certain objective limitations in the life of such people, there are multiple factors of social deprivation of these people. Gaps in social opportunities between overweight and non-overweight people are steadily growing, which worsens the social well-being of overweight people. The solution of this issue is possible only through not so much highly specialized as a wide range of medical and social measures.

Purpose of the work: to study the quality of life of patients with overweight and obesity in the socio-economic conditions of a large industrial region in comparison with the control group.

Materials and methods. 674 people were interviewed, the respondents were divided into two groups - the control group (150 - with a normal BMI (18.5-25 kg/m2) and the main group (524 - BMI over 25 kg/m2).

The survey tools included a system of indicators that can be conditionally combined into the following content blocks: self-assessment of the quality of life and socio-economic status; factors affecting social well-being and health status, social well-being; value orientations and behavioral stereotypes in relation to health and orientation towards a culture of self-preserving behavior.

When processing and analyzing data, such approaches were used as highlighting meaningful results, generalizing indicators within blocks, establishing inter-block links to highlight the most significant of them. Relationships were described on the basis of one-dimensional, two-dimensional and correlation analyses. To identify internal relationships, more complex methods were used: multivariate and factor analyzes, which made it possible to identify hidden variables that are important for characterizing the quality of life and attitudes towards health, frustration factors.

Results. An analysis of the correlation dependences of the degree of obesity on key parameters of the quality of life was carried out. In the examined group of patients, a wide variability of total indicators of quality of life was observed at different values ​​of the body mass index.

The results of the study indicate differences in the perception of health-related problems, depending on gender and age, and the degree of obesity. The vast majority of respondents from the main group (64%) noted that being overweight strongly affects their health. With rather high assessments of feelings of happiness and cheerfulness, expressed by 26% of the respondents of the main group of agreement with the statement that they have excellent health, 21% noted that they were very nervous over the past 4 weeks, 14.1% noted severe depression, only 24% noted that most of the time they feel calm and peaceful. Excess weight, according to the overwhelming majority, primarily affects physical well-being, respondents quite often note pain and discomfort in the head (73.2%), loss of strength (71.7%), 59.1% - sleep disturbance.

A fairly significant part of the respondents noted the impact excess weight on the psycho-emotional state: 34.6% emphasize the loss of interest in usually pleasant activities, 48% - a feeling of depression in the morning, 27.7% - note that the future generally seems gloomy to them, and they do not expect anything good from it, 36.6 % focus on the fact that being overweight hinders professional fulfillment to a certain extent, so additional efforts are required to get started (36.6%).

It is necessary to focus on the fact that among women there are much higher those who believe that being overweight contributes to the formation of low self-esteem, those who experience a feeling of insecurity and fear of being rejected. 35.8% of men agreed with the statement that self-esteem due to weight is not what it could be, among women 74% agree with this statement. 44% of women feel insecure about their weight, among men this figure is much lower - 23.2%. More than half of women agree that they do not like themselves precisely because they are overweight.

Along with overweight, 62.2% of respondents noted that they suffer from hypertension, 20.5% - angina pectoris, 65.4% - osteochondrosis, 60.2% - joint diseases, 25.6% - diabetes mellitus, 2.4% noted hypothalamic syndrome. 85.5% believe that they are overweight and 7.9% noted that they are not overweight. 32.7% noted that they were overweight in childhood.

55% of obese patients noted a significant limitation when performing heavy loads, while among non-obese patients this was 26%. Moderate exercise was performed without restrictions by 80% in the non-obese group and only 60% in the obese group. At the same time, differences in responses in assessing difficulties in performing light loads (lifting and carrying a bag of groceries) did not differ significantly, although there was also a trend towards greater difficulties in the obese group. The same trend was observed when assessing the difficulty in climbing several flights of stairs. Significant restrictions were equally rare in both groups, but in the absence of obesity, almost 86% of patients did not report any restrictions, while the presence of obesity was associated with a moderate restriction in climbing one flight of stairs and the proportion of patients without restrictions was 65%.

Most of the respondents took measures to beat themselves from being overweight. Among the most popular means that were used for weight loss, diets are in the first place, fasting and fasting days are in the second position, loads and gymnastics are in the third position, nutritional supplements are in the fourth, 6.7% practiced separate meals. In terms of age, it should be noted that young respondents are more focused on using diets, fasting days and fasting for weight loss (35, 25 and 22%, respectively) and do not resort to medicines unlike the older generation.

Conclusions. The results obtained allow us to assume the existence of a relationship and the influence of overweight and obesity on indicators of the quality of life, since it is obesity that can be one of the factors responsible for the decrease in the quality of life compared with the control group and determining the processes of social adaptation and the possibility of social realization. At the same time, there is an effect on the quality of life of other factors that reduce the effects of obesity. Potential factors are age and duration of weight-related disease, which are inversely related to obesity rates and are determinants of quality of life.

The results of the study show that the majority of respondents consider health in the current socio-economic conditions as an enduring value, on which much depends in this life: material well-being, happy family life, career advancement. Satisfactory assessments prevail in self-assessments of health and prospects for improving the condition; in patients with obesity, assessments of the state of health are much more pessimistic and less satisfied with the state compared to the control group.

It is necessary to reorient public opinion in the direction of social recognition of obesity as a disease and the need for social support for obese people. It can be argued that overweight people constitute one of the most massive communities in the atypical social risk group, united by the unity of their lifestyle and lifestyle, life chances, their social problems and differs from other categories included in the risk group by greater latency. these problems, non-recognition on the part of society and the state of the very fact of deprivation of this category, as well as the specificity and diversity of possible ways to overcome social infringement.

Bibliographic link

Tepaeva A.I., Rodionova T.I. SOCIAL ASSESSMENT OF THE QUALITY OF LIFE OF PATIENTS SUFFERING OVERWEIGHT AND OBESITY IN THE CONDITIONS OF A LARGE INDUSTRIAL REGION // Successes of modern natural science. - 2013. - No. 5. - P. 53-55;
URL: http://natural-sciences.ru/ru/article/view?id=31667 (date of access: 02/01/2020). We bring to your attention the journals published by the publishing house "Academy of Natural History"

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Budgetary institution of health care of the Omsk region

"Clinical Medical and Surgical Center of the Ministry of the Omsk Region"

The role of a nurse in improving the quality of life of patients suffering from prostate diseases

Baranova Svetlana Alexandrovna

ward nurse

urology department

Introduction

Chapter 1. Quality of life and quality of nursing care

1.1 Psychological aspect of nursing

1.2 Health education in nursing

Conclusions for chapter 1

Chapter 2. Research methodology

2.1 Analysis of the incidence of prostate diseases in the urological department of the "Clinical Medical and Surgical Center"

2.2 Indicators of the quality of life of patients identified at the initial stage of the study

Conclusion on chapter 2

Chapter 3

3.1 Problems of patients suffering from prostate diseases

3.2 Evaluation of the implementation of the developed leaflets in the daily work of a nurse

Chapter 3 Conclusion

Conclusion

List of used literature

Applications

Introduction

nursing prostatic urological medical

The relevance of research. According to the literature and statistics, prostate diseases are widespread, tend to increase in incidence and occur in men at any age. The most common of these are prostatitis, benign prostatic hyperplasia (the old name is prostate adenoma) and prostate cancer.

“Prostatitis affects 30-75% of young and middle-aged men. At the same time, the highest proportion of morbidity is recorded in people of the most able-bodied and sexually active age - 20-40 years old.

“After 50 years, prostate adenoma affects every second, after 60 years - 75%, over 70 years - 80-90%. Pronounced clinical manifestations occur only in 30-40% of cases.

"Prostate cancer ranks first among all oncourological diseases in men over 50 years of age and ranks second in terms of mortality among all malignant tumors in Russia and the United States" .

Prostate diseases significantly reduce the quality of life of patients, make it very difficult, and sometimes even impossible. Symptoms such as urination disorders, disorders in the genital area cause patients a lot of anxiety, disrupt their usual way of life and ability to work. The chronic course of prostate diseases, the need for surgical treatment, long-term treatment - all this often leads the patient into a depressed state, he ceases to believe in recovery. Depressed mood significantly worsens the course of the disease.

Although the nurse does not treat patients on her own, her role in their treatment is very large. Being all the time near the patient, the nurse notices all the changes that occur in his condition, knows how to calm him down and alleviate his suffering. The work of a nurse, if it is carried out at a high professional level, increases the patient's confidence in a favorable outcome of treatment, teaches the patient to live with his illness more fully, thereby improving his quality of life. However, in the domestic literature, there are very few scientific publications with an analysis of the dynamics of the quality of life of patients suffering from prostate diseases in connection with the nursing care provided to them. It is necessary to identify patterns and relationships between improving the quality of life of patients suffering from prostate diseases and improving the quality of nursing care provided to them.

Object of study.

The object of the study is the problems of patients suffering from diseases of the prostate gland, which serve as an indicator of the deterioration in the quality of life of patients.

Subject of study.

The subject of the study is the formation of nurse's knowledge about the problems of patients suffering from prostate diseases, the creation on their basis of leaflets for patients aimed at improving the quality of nursing care provided to them.

Purpose of the study.

Identification of patterns and relationships between improving the quality of life of patients suffering from prostate diseases and improving the quality of nursing care provided to them.

Research objectives:

1. Identify and analyze the problems of patients suffering from prostate diseases.

2. Create, based on them, memos for patients and implement them in the daily work of a nurse.

3. To analyze the effectiveness of the introduction of the developed memos into the daily work of a nurse.

Hypothesis.

The quality of life of patients suffering from prostate diseases directly depends on the quality of nursing care provided to the full extent and in an accessible form for the patient, namely in the form of an individual conversation with the patient with handing memos on the main problems of patients.

Research stages:

1. To identify the problems of patients suffering from prostate diseases using the developed questionnaire.

2. Theoretical analysis of the problems of patients suffering from prostate diseases.

3. In the practical part, create and implement reminders for patients in the daily work of a nurse.

4. To analyze, using a previously developed questionnaire, the effectiveness of introducing reminders for patients into the daily work of a nurse.

Research methods:

1. Historical method.

2. Method of observation.

3. Sociological method.

4. Logical method.

theoretical significance.

The identification of patterns and relationships between improving the quality of life of patients suffering from prostate diseases and improving the quality of nursing care provided to them contributes to the development of further research in the field of improving the quality of nursing care provided to these patients and patients with other diseases in order to improve the quality of life of these patients.

Practical significance.

The knowledge gained in the course of this work about the problems of patients suffering from prostate diseases, the developed leaflets for patients, the developed questionnaires for determining the problems of these patients, can be used in the practical work of nurses of urological departments. They will help improve the quality of nursing care provided to patients suffering from prostate diseases, as well as improve the quality of life of patients with these diseases.

Chapter 1.Quality of life and quality of nursing care

Preserving the health of the population and improving the quality of life is a strategic task of the state policy of the government.

"Health is a complex concept defined by the World Health Organization as a state of complete physical, mental and social well-being". Appropriate indicators are used to assess the category "health": healthy life and quality of life.

Quality of life, according to the definition of the World Health Organization, "a person's complex perception of his position in life in the context of the culture and value system to which he belongs" . That is, the quality of life is an integral characteristic of the physical, psychological, emotional and social functioning of a person (healthy or sick), based on his subjective perception of the features and characteristics of the environment.

The medical concept of quality of life includes, first of all, those indicators that are associated with the state of human health. That is, the medical aspects of the quality of life should be understood as the impact of the manifestations of the disease itself and the limitation of the functional ability that occur as a result of the disease, as well as the impact of treatment on the daily activities of the patient. Thus, the patient's quality of life can serve as a criterion for the quality of medical care provided to him and can be measured using various questionnaires, scales, and indices.

"The quality of medical care is a set of characteristics that confirm the compliance of the provided medical care with the existing needs of the patient (population), his expectations, the current level of medical science and technology" .

The quality of nursing care is such properties of nursing care, due to which the patient is satisfied with its provision in general, as well as satisfied with its result and the process of its provision. And also, the quality of nursing care is the fulfillment by a nurse of functional duties in strict accordance with the legal documentation, that is, her professional competence.

To understand the importance of nursing care in the process of improving the effectiveness of medical care, the following “characteristics of nursing care are used:

1. professional competence;

2. availability;

3. effectiveness of nursing intervention;

4. interpersonal relationships;

5. efficiency;

6. continuity, that is, consistency and continuity in receiving nursing care;

7. safety - means ensuring a safe hospital environment;

8. convenience, which implies not only comfort and cleanliness, but also conditions that ensure the patient's maximum possible independence in the implementation of physiological needs.

The external component of the quality of nursing care is the correspondence between the need and perception of nursing care, which is characterized by the concept of "satisfaction". The organization, content and results of nursing care must meet the expectations and needs of patients and their relatives, as well as the nurses themselves.

“Improving the quality of nursing care is possible with the effective interaction of a professionally competent nurse and the patient (his relatives) in positive socio-psychological, logistical, organizational and economic conditions of a single legal space in the presence of a stable positive motivation of the patient (relatives) for recovery ( maintaining health).

1.1 The psychological aspect of nursing

The work of a nurse has its own characteristics. First of all, it involves the process of interaction with patients and their relatives, the purpose of which is to improve the quality of nursing care provided.

When communicating with a patient, a nurse should remember that any disease is a fairly strong factor that causes stress (a process that leads to tension in all functional systems of the body), and this inevitably affects his mental state. The nurse should be able to timely assess the patient's neuropsychic state and, if possible, have a fruitful and positive impact on the patient in the process of communicating with him.

In order for the process of the relationship between a nurse and a patient to be effective, it is necessary to study the psychological aspects of such a relationship.

Of particular importance for effective and conflict-free interaction is communicative competence, that is, the ability to establish and maintain the necessary contacts with people. At the same time, communicative competence implies not only the presence of certain psychological knowledge, but also the formation of some special skills: the ability to establish contact, listen, “read” non-verbal communication language, build a conversation, formulate questions. It is also important that the nurse owns her own emotions, knows how to maintain confidence, “control her reactions” and behavior in general. No less important are the qualities of a nurse, such as the desire to help and empathy, which are the necessary qualities of any medical worker.

Effective communication is impossible without trust. For the manifestation of the patient to the nurse, the first impression that the patient has when meeting with her matters. At the same time, the actual facial expressions of the nurse, her gestures, tone of voice, facial expression, as well as appearance nurse.

Throughout the illness, the patient needs psychological support and the maximum satisfaction of all his psychological needs. The nurse's knowledge of the laws of psychology, ethical and deontological principles, combined with professional skills, allows providing better care to patients, even in the most difficult situations.

1.2 Sanitary and educational work in nursingbnews

"Sanitary and educational work in a medical institution is a complex of differentiated, targeted sanitary and educational measures that provide for the hygienic education of various contingents of the population and are organically related to activities" . Health education is part of a complex of preventive and therapeutic measures carried out with patients and the professional duty of all medical workers.

The purpose of hygienic education in a medical institution is to increase the effectiveness of therapeutic and preventive measures by actively informing and educating patients. In accordance with the informative tasks, sanitary and educational work is carried out at all stages of the patient's stay in the hospital.

Since the nurse spends more time with the patient than other medical workers, most of the health education work falls on her. The main method in this case is a conversation between a nurse and a patient. During these conversations, the nurse should take into account the patient's attitude towards their disease and ensure that this attitude is adequate.

An adequate attitude to one's illness is distinguished by the awareness of one's illness and the recognition of the need to take measures to restore health. Such patients take an active part in carrying out diagnostic and therapeutic measures, consciously and clearly follow the recommendations of the doctor, which contributes to a speedy recovery and eliminates complications of the disease.

There are many variants of the patient's inadequate attitude to his disease - from denying the very fact of the disease to excessive attention to his health and exaggeration of the symptoms of the disease. Inadequate attitude to one's disease significantly complicates the communication of medical workers with such a patient, increases the risk of complications, increases the duration of treatment, and often leads to a chronic course of the disease.

Carrying out sanitary and educational work with the patient, the nurse is obliged to build her conversations in such a way as to solve the problems of a particular patient, ensure the completeness, accessibility and consolidation of oral material, with the help of memos, brochures, re-training and conversations. A competently conducted conversation with the patient contributes to a more adequate attitude of the patient to his disease, improves the quality of medical care and the quality of life of the patient.

Conclusions for chapter 1

Improving the quality of medical care is a priority for the modernization of healthcare. Nursing care plays an important role in the process of improving the effectiveness of medical care. The patient's quality of life is an indicator of the patient's health and an important criterion for the quality of medical care. Studying the quality of life of patients allows you to identify the advantages or disadvantages of the medical care provided to the patient.

Competent conduct of health education work by a nurse and the availability of knowledge and skills of effective communication by a nurse improves the quality of nursing care provided to the patient, which in turn improves the quality of medical care provided to him and the quality of life of patients.

Chapter 2. Research methodology

The study was carried out in stages on the basis of the urological department of the Clinical Medical and Surgical Center.

At the first stage, in accordance with the purpose and objectives of the undertaken study and by summarizing the data of the medical literature on this issue, analyzing medical records, personal observations of patients, a questionnaire (Appendix 2) was developed to assess the quality of life of patients suffering from prostate diseases. A survey was conducted in the control group of patients, in the amount of 50 patients undergoing treatment. The results of the survey made it possible to identify the main problems of patients suffering from prostate diseases and to assess the availability, completeness and quality of nursing care provided to them.

Based on the analysis of the results obtained during the survey, as well as the generalization of medical literature data on this issue, the analysis of medical records, personal observations of patients, leaflets for patients were developed (Appendices 3 - 10), and introduced into the daily work of the nurse of the urological department of the Clinical Medical -surgical center.

At the final stage of the study, among the patients of the experimental group, in the amount of 50 people, it was analyzed, using a previously developed questionnaire, the effectiveness of introducing the developed leaflets for patients into the daily work of nurses in the urological department.

2.1 Analysis of the incidence of prostate diseases in the urological department of the Clinical medical and surgical centerntra"

"Clinical Medical and Surgical Center" is a multidisciplinary hospital complex with a capacity of 820 beds, which has 48 specialized departments and 1,547 employees. The Clinical Medical and Surgical Center provides outpatient and inpatient care to employees of transport enterprises and their families, combatants and their families, residents of the Omsk District, the Omsk Region and the Central Administrative District.

The Urology Department was opened in 1984. The department is located on the fifth floor of the inpatient building of the hospital and has 30 beds in a round-the-clock hospital and 10 beds in a day stay. Hospitalization in the department is carried out in a planned manner in accordance with the plan of bed-days. The main direction in the work of the department is highly specialized care for patients with various diseases of the male reproductive system of any degree of complexity.

Analyzing the data on the incidence of prostate diseases, shown in Diagram 1 (Appendix 1), we can draw the following conclusions: the number of treated patients in 2010 increased compared to 2009: the number of prostatitis increased by 22 people, the number of prostate adenomas increased by 40 people, and the number of patients with prostate cancer increased by 5 people. These figures indicate an increase in the incidence of prostate diseases. Also, in diagram 1 (Appendix 1), it can be seen that the number of adenomectomy and TUR performed in the department in 2010 increased by 21 operations compared to 2009, which is also associated with an increase in the incidence of benign prostatic hyperplasia and an increase in the population aged over 60 years old.

The proportion of the incidence of prostate diseases in the urological department in 2010, according to diagram 2 (Appendix 1), was 37%: prostatitis accounted for 15.9%; the proportion of prostate adenomas was 18.6%: and the proportion of prostate cancer was 2.5%. Thus, the number of patients suffering from prostate diseases is more than a third of all patients treated in the department in 2010.

2.2 Showquality of life of patientsidentified at the initial stage of the studyOvaniya

The objectives of the survey were to identify the problems of patients in the control group and assess the availability, quality and completeness of nursing care provided to them. In accordance with these tasks and by summarizing the data of the medical literature on this issue, analyzing medical records, personal observations of patients, a questionnaire was developed to assess the quality of life of patients suffering from prostate diseases (Appendix 2).

The survey involved 50 patients of the control group who were treated in the urological department of the Clinical Medical and Surgical Center.

The survey data, as seen in Diagram 3 (Appendix 1), showed a satisfactory quality of life in 14% of patients, a poor quality of life in 36% of patients, and a terrible quality of life in 50% of patients.

At the same time, 86% of patients noted late referral to a specialist doctor; 68% of patients noted urination disorders that were very disturbing to them; 84% of patients noted a lack of information about their disease and 45% of patients noted difficulties in self-care during treatment and / or in the postoperative period; and also, 78% of patients had various psychological problems: a feeling of fear and anxiety about the outcome of the operation and treatment, a feeling of insecurity and anxiety about their health, a feeling of inconvenience and embarrassment due to the stoma and during medical procedures (diagram 4 in Appendix 1).

Also, the results of the survey reflect the level of patient satisfaction with the quality of nursing care. Diagram 5 (Appendix 1) shows that 50% of respondents rated the attitude of nursing staff towards patients as benevolent, 27% - as satisfactory, 18% of patients noted the indifference of nursing staff, and 5% of patients noted the rude attitude of nursing staff towards patients.

Nursing care, the indicators of which are shown in Diagram 6 (Appendix 1), was received in full by 38% of patients, 30% of patients rated nursing care as satisfactory, 27% of patients received nursing care not in full, and 5% of patients did not receive nursing care at all care.

Advisory nursing care was positively assessed by 45% of patients, 15% of patients rated it as satisfactory, 30% of patients needed additional information, 10% of patients received advisory nursing care in an inaccessible form (diagram 6 in Appendix 1).

The results obtained indicate that the majority of 86% of the examined patients in the control group have a low level of quality of life and 78% of patients have various psychological problems. Also, from the data obtained, it can be seen that a significant percentage of patients are not satisfied with the quality of nursing care.

Based on these data, it was concluded that it is necessary and extremely urgent to improve the quality of life of patients suffering from prostate diseases, as well as to improve the quality of nursing care provided to them. For this purpose, leaflets for patients suffering from prostate diseases were developed and introduced into the daily work of nurses of the urological department of the Clinical Medical and Surgical Center, developed on the basis of the problems of these patients identified during the study.

Conclusion on chapter 2

According to the analysis of the incidence of prostate diseases in the urological department of the "Clinical Medical and Surgical Center", we see that among all hospitalized patients in 2010, the percentage of patients suffering from prostate diseases was 37%, and we also see that the incidence rates for the period from 2009 to 2010 grew (chart 1 - 2 in Appendix 1). This confirms the relevance of the study.

The results of a survey of the control group of patients revealed a low level of quality of life of patients and a significant dissatisfaction of these patients with the quality of nursing care (diagram 3 - 6 in Appendix 1). Based on these data, it was concluded that it is necessary and extremely urgent to improve the quality of life of patients suffering from prostate diseases, as well as to improve the quality of nursing care provided to them. For this purpose, leaflets for patients suffering from prostate diseases were developed and introduced into the daily work of nurses of the urological department of the Clinical Medical and Surgical Center.

Headsa 3.The role of the nurse in patient caresuffering from prostate diseases

The social significance and relevance of improving the quality of life of patients suffering from prostate diseases is justified by a significant decrease in the quality of life of such patients. Symptoms such as urination disorders, disorders in the genital area cause patients a lot of anxiety, disrupt their usual way of life and ability to work. The chronic course of prostate diseases, the need for surgical treatment, long-term treatment - all this often leads the patient into a depressed state, he ceases to believe in recovery. Depressed mood significantly worsens the course of the disease.

The nurse is almost constantly in contact with the patient and takes an active part in the process of restoring his health, since it is she who continuously monitors him, fulfills all the doctor's instructions, and carries out medical procedures. Also, the direct and main duty of the nurse is the constant and comprehensive care of patients, which is aimed at alleviating the patient's suffering, speedy recovery and prevention of complications. Helping to restore the health of patients, the nurse, thereby improves their quality of life.

Fulfilling all the doctor's prescriptions and constantly monitoring patients, the nurse promptly reveals hidden symptoms or changes in the patient's condition, side effects of medicines or medical procedures. This, in turn, allows you to timely adjust the treatment of patients suffering from prostate diseases, and, if necessary, provide emergency medical care.

Carrying out sanitary and educational work with the patient, the nurse builds her conversations in such a way as to solve the problems of a particular patient, ensure the completeness, accessibility and consolidation of the oral material, with the help of memos, brochures, repeated classes and conversations. The nurse provides early and adequate activation of patients and the performance of breathing and therapeutic exercises after surgical interventions, diet, helps the patient in mastering the skills of self-care and care for the cystostomy, and, if necessary, teaches the patient's relatives how to care for him. A competently conducted conversation with the patient contributes to a more adequate attitude of the patient to his disease, improves the quality of medical care and the quality of life of the patient.

The psychological aspect in the work of a nurse is to create psychological comfort for patients suffering from prostate diseases. This requires the nurse to have the knowledge and skills of effective communication, the communicative competence of the nurse. The main methods used by the nurse are talking with patients and observing them. The nurse, talking with the patient, instills in the patient confidence in the correctness of the procedures performed, talks about his illness, about the treatment process, distracts from negative thoughts about his state of health, inspires him with vigor and faith in recovery. At the same time, the patient is provided with psychological support: he can discuss his problems, feel that he is not alone, that he is understood, the patient develops confidence and active assistance in the treatment process. It is the nurse who helps patients suffering from diseases of the prostate gland to adapt to the environmental conditions of the department and a rich program of therapeutic measures that require a certain emotional and physical stress from the patient. At the same time, the nurse shows friendly participation, care and patience, since the patient, as a rule, experiences fear, anxiety, depression due to forced dependence on others.

The nurse plays the same important role in restoring the health of patients and improving their quality of life as the attending physician. But the volume of activities performed by her is greater than that of a doctor, since the nurse not only provides nursing care and supervision, but is also the direct executor of the doctor's prescriptions, an intermediary between the patient, his relatives and the attending physician. The work of a nurse, if it is carried out at a high professional level, significantly improves the quality of life of the patient, increases the efficiency of medical care provided to the patient, reduces the risk of complications and accelerates the rehabilitation of patients.

3.1 Problems of patients suffering from diseasesAthyroid gland

In order to improve the quality of nursing services provided in the urology department, taking into account the nursing process, purposeful actions of the nurse are needed to address the violated needs of the patient. Each violated need is a problem for the patient, therefore, work was carried out to identify the problems of patients suffering from prostate diseases. Further, based on the analysis of the results obtained during the survey, as well as the generalization of medical literature data on this issue, the analysis of medical documentation and personal observations, an analysis of the identified problems was carried out.

In the analysis of problems, patients suffering from prostate diseases were divided into two groups:

A. Patients in need of examination and conservative treatment;

B. Patients requiring surgical treatment.

A. Problems of patients requiring examination and conservative treatment:

I.Priority issues:

1. Pain in the lower abdomen and in the perineum, constant and / or during urination;

2. fever;

3. sleep disorders associated with frequent urge to urinate;

4. acute urinary retention;

5. sexual disorders.

II.Real problems:

1. feeling of discomfort and embarrassment due to urination disorders;

2. anxiety about the upcoming examination due to a lack of knowledge about the upcoming examination and behavior during the examination;

3. a feeling of insecurity and anxiety about one's health, due to a lack of knowledge about one's disease;

4. feeling of fear and anxiety about the negative result of the examination due to anxiety for one's health;

5. feelings of anxiety due to the need to change lifestyle.

III.Potential problems:

1. the risk of developing complications of the disease.

2. state of depression, despair and hopelessness associated with the detection of cancer.

C. Problems of patients suffering from prostate diseases requiring surgical treatment:

I. priority issuesare potential problems in the postoperativeAndone period:

1. risk of shock due to the condition after surgery;

2. the risk of nausea, vomiting due to the condition after surgery;

3. pain in the area of ​​the postoperative wound,

4. hyperthermia due to the condition after surgery;

5. pain and cramps due to impaired patency of the irrigation system;

6. the risk of developing bedsores due to prolonged stay in a forced position;

7. risk of congestion in the lungs;

8. risk of postoperative complications: bleeding, suture divergence, infection;

9. the risk of developing thrombotic processes in the venous system due to the condition after surgery;

II. Real problems:

1. feeling of fear and anxiety about the upcoming surgery due to a lack of knowledge about behavior in connection with the upcoming surgery;

2. lack of self-care due to a decrease in motor activity due to surgery;

3. embarrassment and inconvenience due to an unpleasant odor in ostomy patients;

4. feeling of discomfort with the urethral catheter;

5. maceration of the skin in the presence of epicystostomy;

6. decrease in motor and physical activity associated with weakness after surgery;

7. violation of the diet due to the condition after the operation;

8. violation of the regimen of defecation due to bed rest;

9. a feeling of fear and anxiety for one's health due to a lack of knowledge about one's disease;

10. feelings of fear, anxiety and insecurity associated with hospitalization;

11. feelings of insecurity and confusion about discharge due to lack of knowledge about post-discharge behavior and the presence of an epicystostomy.

It should be noted that the majority of patients suffering from prostate diseases requiring surgical treatment undergo a thorough preliminary examination and receive a course of drug treatment. Therefore, such patients have problems in both the first (A) group and the second (B) group.

3. 2 Evaluation of the implementation of the developed memoriesyatokin everyday worknurse bot

The objectives of the survey were to identify the problems of patients in the experimental group and assess the availability, quality and completeness of nursing care provided to them. And the purpose of this survey: to identify the dynamics of the indicators assessed in the experimental group of patients compared with the indicators of the control group.

The survey involved 50 patients of the experimental group suffering from diseases of the prostate gland, who were treated in the urological department of the "Clinical Medical and Surgical Center", after the introduction of instructions for patients into the daily work of the nurse (Appendix 3 - 10).

The survey data, as we see in Diagram 7 (Appendix 1), showed a satisfactory quality of life in 53% of patients, a poor quality of life in 27% of patients, and a terrible quality of life in 20% of patients.

At the same time, as can be seen in Diagram 8 (Appendix 1), 83% of patients reported late visits to a specialist doctor; 57% of patients noted urination disorders that were very disturbing to them; 80% of patients noted the presence of pain in the postoperative period and 31% of patients noted difficulties in self-care in the postoperative period; and also, 56% of patients had various psychological problems: a feeling of fear and anxiety about the outcome of the operation and treatment, a feeling of uncertainty and anxiety about their health, a feeling of inconvenience and embarrassment due to the stoma and in the postoperative period.

The results of the survey also reflect the level of satisfaction of patients with benign prostatic hyperplasia with the quality of nursing care. The attitude of nursing staff to patients was rated by 70% of respondents as benevolent, 20% - as satisfactory, 8% of patients noted the indifference of nursing staff, and 2% of patients noted the rude attitude of nursing staff towards patients (diagram 9 in Appendix 1).

Nursing care, the indicators of which are shown in Diagram 10 (Appendix 1), was received in full by 70% of patients, nursing care was rated as satisfactory by 25% of patients, 5% of patients received nursing care not in full.

Advisory nursing care was positively assessed by 75% of patients, 15% of patients rated it as satisfactory, 10% of patients need additional information (diagram 10 in Appendix 1).

Chapter 3 Conclusion

The nurse plays the same important role in restoring the health of patients and improving their quality of life as the attending physician. The work of a nurse, if it is carried out at a high professional level, significantly improves the quality of life of the patient, increases the efficiency of medical care provided to the patient, reduces the risk of complications and accelerates the rehabilitation of patients.

Patients suffering from prostate diseases often need not only conservative treatment, but also surgical treatment. Therefore, these patients have many different problems that reduce their quality of life. Knowledge of these problems by a nurse should improve the quality of nursing care provided.

The data obtained during the survey of the experimental group indicate a significant positive dynamics in the estimated indicators of the quality of life of patients, compared with the indicators assessed earlier in the control group.

Indicators of satisfactory quality of life of patients in the experimental group increased by 39% compared with the indicators of the questionnaire conducted earlier in the control group (diagram 11 in Appendix 1).

As can be seen in Diagram 12 (Appendix 1), among the indicators of “patient problems”, special attention should be paid to the decrease in the indicators “psychological problems” and “difficulties in self-care” by 14% and 22%, respectively, as well as a significant decrease in the indicator “lack of information about their disease” by 25% in the experimental group compared with the indicators of the questionnaire conducted earlier in the control group.

There is a positive dynamics in the results of the indicator "attitude of nursing staff to patients" in the experimental group compared with the results in the control group: 20% more patients of the experimental group rated it as benevolent (diagram 13 in Appendix 1).

Significantly improved indicators of the "quality of nursing care" in the experimental group compared with the same indicators of the survey of the control group, which is reflected in diagrams 14 and 15 (Appendix 1). Full coverage was received by 32% more patients in the experimental group than in the control group (diagram 14 in Appendix 1). And advisory nursing care in full in the experimental group was received by 30% more patients than in the control group (diagram 15 in Appendix 1).

Conclusion

The positive dynamics of the indicators that determine the quality of life of patients suffering from prostate diseases and the quality of nursing care provided to them undoubtedly indicates a direct dependence of these indicators on the introduction of the developed leaflets for patients into the nurse's work, which in turn improved the quality of nursing care provided. Thus, the quality of life of patients suffering from prostate diseases directly depends on the quality of nursing care provided to the full extent and in an accessible form for the patient, namely in the form of an individual conversation with the patient with handing memos on the main problems of patients.

To further improve the quality of nursing care in the urology department and improve the quality of life of patients suffering from prostate diseases - we think it is necessaryOsmoke:

1. To organize in the department a “Health School for patients with epicystostomies and nephrostomies”.

2. Organize a postoperative ward in the department.

3. Organize a "Health Corner" focused on highlighting topical problems of prostate cancer in the department.

4. To develop and implement in the work of the nurse of the urological department a memo on various aspects of prostate diseases to increase the level of knowledge of patients about these diseases.

5. To develop and implement in the work of the nurse of the urological department the standards for conducting conversations with patients before and after surgical interventions.

List of used literature

1. Sadykov G.M. Chronic abacterial prostatitis. - J. Urology. - 2010, No. 6. - P.11.

2. Website: www.vitosan.ru. - Causes of diseases of the prostate gland.

3. Chudnovets I.Yu., Gatilov A.V., Borosenets N.V. The first experience of laparoscopic prostatectomy. / Innovative technologies in urology: VIII regional scientific-practical conference of Siberian urologists. - Omsk, GOU OMGMA MZOO. - 2009. - S. 195-196

4. Sopina Z.E., Fomushkina I.A. Quality management of nursing care: textbook. - M.: GEOTAR. Media. - 2009. - S. 176

5. Gensh N.A. Handbook of rehabilitation. - Rostov-on-Don: Phoenix. - 2008. - S. 348

6. Skuryagina E.A. Business etiquette in the work of a nurse. - J. Nursing. - 2007, No. 8. - S. 36-37

7. Tysenchuk O.N. Learning to prevent conflicts. - J. Nursing. - 2007, No. 8. - S. 46

8. Orlova T.A. Caring for stoma patients. - J. Nursing. - 2008, No. 6. - S. 38-40

9. Samoilenko V.N. Ethical principles of nursing. - J. Nursing. - 2009, No. 1. - pp. 14-16

10. Samoilenko V.N. Active triangle: nurse - patient - society. - J. Nursing. - 2009, No. 3. - S. 21-23

11. Maslova V.N., Makarova I.A. Organization of health schools. - J. Nursing. - 2010, No. 1. - S. 35-37

12. Gaboyan Ya.S., Logvinova O.V. Organization of the activities of nursing staff in the department of nursing care on the basis of the city clinical hospital No. 64. - M .: Zh. Nurse. - 2006, No. 6. - p.7-9

13. Stepanov V.V. On the state of scientific research on the organization of the work of nursing staff. - J. Head nurse. - 2006, No. 1. - pp. 87-92

14. Nursing. Professional disciplines: Textbook. / Ed. G.P. Kotelnikova. - Rostov-on-Don: Phoenix, ed. 2nd. - 2007. - S. 697

15. Turchina Zh.E., Myagkova E.G. Nursing in geriatrics: Textbook. - Rostov-on-Don: Phoenix. - 2006. - S. 215

16. Dmitrieva Z.V., Teplova A.I. Theoretical foundations of nursing in surgery. - M.: SpecLit. - 2010. - S. 319

17. Paleev N.R. Nursing: The Complete Nurse's Guide. - M.: Esmo. - 2009. - S. 544

18. Ivanyushkin A.Ya. Biomedical ethics. Textbook for medical schools, medical colleges, faculties of the VSO. - M.: Moscow. - 2010 - p. 112

19. Kuleshova L.I. Fundamentals of nursing: theory and practice. Part 2. - Rostov-on-Don: Phoenix. - 2008 - p. 411

20. Kozlova L.V. Fundamentals of Rehabilitation for Medical Colleges. - Rostov-on-Don: Phoenix. - 2011 - p. 475

21. Barykina N.V. Nursing in surgery: textbook. - Rostov-on-Don: Phoenix. - 2010. - S. 447

22. Barykina N.V. Nursing in surgery: workshop. - Rostov-on-Don: Phoenix. - 2009. - S. 460

23. Filatova S.A. Gerontology: textbook. - Rostov-on-Don: phoenix. - 2009. - S. 510

24. Tleptserishev R.A. Economics and health management: a textbook. - Rostov-on-Don: Phoenix. - 2009. - S. 623

25. Rudenko A.M. Psychology for medical specialties. - Rostov-on-Don: Phoenix. - 2009. - S. 634

26. Turkina N.V. General nursing: a textbook. - M.: Moscow. - 2007. - S. 550

27. Sprints A.M. Fundamentals of Nursing: A Handbook. - M.: SpecLit. - S. 463

28. Sprints L.M. Medical psychology with elements of general psychology. - M.: SpecLit. - 2009. - S. 447

29. Pugachev A.G. Urology: textbook. - M.: MIA. - 2008 - p. 248

30. Balabanova A.N. Features of nursing care for geriatric patients with diseases of the kidneys and urinary tract. - M.: GOU VUNMTs. - 2008 - p. 128

31. Rodoman V.E. Diseases of the prostate gland: A guide for physicians. - M.: MIA. - 2009. - S. 672

32. Alyaev Yu.G., Grigoryan V.A., Gadzhieva Z.K. Urinary disorders. - M.: Litera. - 2006. - S. 208

33. Shcheplev P.A. Prostatitis. - M.: Medpress. - 2007. - S. 224

34. Pushkar D.Yu. radical prostatectomy. - M.: Medpress-inform. - 2009. - S. 172

Annex 1

Diagram 1. Analysis of the incidence of prostate diseases in the urological department of the "Clinical Medical and Surgical Center".

Diagram 2. The proportion of the incidence of prostate diseases in the urological department of the "Clinical Medical and Surgical Center" in 2010.

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Posted on http://www.allbest.ru/

Diagram 3. Assessment of the quality of life of patients suffering from prostate diseases in the control group.

Diagram 4. Problems of patients suffering from prostate diseases in the control group.

Diagram 5. The ratio of nursing staff to patients in the control group.

Diagram 6. Evaluation of the quality of nursing care according to the assessment of patients in the control group

Diagram 7. Assessment of the quality of life of patients suffering from prostate diseases in the experimental group.

Diagram 8. Problems of patients suffering from prostate diseases in the experimental group.

Diagram 9. The ratio of nursing staff in the assessment of patients in the experimental group.

Diagram 10. Evaluation of the quality of nursing care by patients in the experimental group.

Diagram 11. Dynamics of quality of life indicators in patients suffering from prostate diseases.

Diagram 12. Dynamics of indicators of problems of patients suffering from diseases of the prostate gland.

Diagram 13. Dynamics of indicators of patients' assessment of the attitude of nursing staff to patients.

Diagram 14. Dynamics of indicators of patient assessment of care provision

Diagram 15. Dynamics of indicators of evaluation of consultative nursing care by patients.

Appendix 2

Questionnaireto assess the quality of lifepatients sufferingdiseases presentAthyroid gland

Dear patient, I ask you to answer a few of my questions in connection with my research work to assess the quality of life of patients suffering from prostate diseases.

I. Identification of patient problems:

	Question		score	points	points
	How long after the appearance of complaints did you contact a specialist doctor?		during a year	in a year	some years
	How often do you get out of bed at night to urinate?				5 or more times
	How much pain and/or discomfort do you experience while urinating?	disturbed	slightly	disturbed	bothered me a lot
	Do you know enough about your disease, its prevention?		yes, but still have questions	yes, but a lot is unclear
	Did you have any difficulty in self-care during treatment/after surgery?		There were minor problems		There were great difficulties
	Do you feel insecure and anxious about the outcome of your treatment and/or surgery?		slightly	worries	worries a lot
	Did you experience anxiety and anxiety before the examination/surgery?		slightly		very much
	Did you feel awkward and uncomfortable during treatment procedures and/or because of your stoma?		slightly		very much
	Are you worried about your future health after discharge from the hospital?		minor		severe anxiety

II. Patient satisfaction levelestvomnursing pomOcabbage soup:

№	question		score	points	points
	Did a nurse explain to you how to behave after a prostate biopsy/surgery/removal of stitches?		yes, but still have questions	yes, but a lot was unclear
	Did a nurse teach you breathing and exercise after surgery?		told but not shown	yes, but a lot was unclear
	Did the nurse help you after the operation in carrying out hygiene measures?		helped but you felt embarrassed	slightly
	What was the attitude of the nurse towards you?	benevolent	satisfactory	indifference
	Did your nurse teach you how to care for your stoma?		yes, but still have questions	yes, but a lot was unclear
	Did the nurse explain the goals of the treatment procedures/tests to you?		yes, but still have questions	yes, but a lot was unclear
	Did the nurse tell you how to eat with your illness?		yes, but still have questions	yes, but you don't remember much
	Did the nurse explain to you your questions regarding your illness?		yes, but still have questions	yes, but a lot was unclear
	Did the nurse explain to you how to behave before and during the examinations?		yes, but still have questions	yes, but a lot was unclear
	Did the nurse explain to you how to behave after being discharged from the hospital?		yes, but still have questions	yes, but a lot was unclear

III. Criteria for assessing the quality of life of patients suffering from diseasesAbody gland:

Thank you for your attention!

Annex 3

Memo 1

REMINDER FOR THE PATIENT

"HOW TO PREPARE

TOPROSTATE RESEARCH»

* How to prepare for an ultrasound of the bladder and prostate in men?

1. The examination is performed with a full bladder, so it is necessary not to urinate before the examination for 3-4 hours

2. Drink 1 liter of non-carbonated liquid 1 hour before the procedure.

3. Before a transrectal examination of the prostate (TRUS), it is necessary to make a cleansing enema.

* ABOUTWhat should you know when taking a PSA blood test?

1. The analysis is given in the morning, on an empty stomach. Do not take the test after eating!

2. Within 3-4 days prior to the analysis, it is necessary to refrain from sexual intercourse, cycling, and taking alcoholic beverages.

3. If the doctor performed a prostate massage, cystoscopy or bladder catheterization, then it is advisable to wait at least 2 weeks before taking the test

4. If you have had a prostate biopsy - at least a month.

5. When evaluating the results of the analysis by a doctor, you must inform about all the medications you take, as well as about previously discovered prostate diseases (prostatitis, adenoma)

6. Otherwise, the results may be misinterpreted.

What preparation is needed before a prostate biopsy?

If you are planning to have a prostate biopsy:

* Do not plan anything for this day and stay at home.

* It is necessary to pass urine in advance for a general analysis and for sowing.

* Stop taking aspirin at least 7 days before the biopsy.

* If you are taking indirect anticoagulants (Sinkumar, Thrombostop,

Pelentan, etc.), it is necessary to warn the doctor about this in advance and stop taking them 3-4 days before the biopsy, after which, on the eve of the biopsy, donate blood to determine the prothrombin time and prothrombin index.

* On the evening before the biopsy, as well as on the morning of the biopsy, you need to give yourself a cleansing enema. It is better to refrain from eating after 7 - 8 pm on the eve of the biopsy.

...

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ID: 2013-07-3928-A-2733

Original article (free structure)

Tepaeva Alisa Iskyandiarovna

Saratov State Medical University

Summary

The article deals with the problems of studying the quality of life, questions of the conceptual definition of parameters and conditions that determine the quality of life of patients suffering from overweight and obesity. The author presents the results of a sociological study that makes it possible to identify the key problems associated with ensuring the quality of life of patients and develop practical recommendations aimed at improving the effectiveness of corrective action and the formation of a culture of self-preserving behavior of patients.

Keywords

Quality of life, obesity, overweight

Article

Quality of life of overweight and obese patients: results of a sociological analysis

Tepaeva A.I.

Scientific adviser: Doctor of Medical Sciences, Professor Rodionova T.I.

State Budgetary Educational Institution of Higher Professional Education Saratov State Medical University im. IN AND. Razumovsky Ministry of Health of the Russian Federation

Department of Endocrinology

Obesity is one of the most common chronic diseases in the world. At the turn of the 20th and 21st centuries, mechanization and automation of production led to physical inactivity of a significant part of humanity, which, in turn, was caused by an imbalance in energy consumption, a change in the course of a number of biochemical processes and an increase in body weight among the population of economically developed countries. In general, this problem becomes one of global, affecting all countries. According to WHO, there are more than 1.7 billion people in the world who are overweight or obese. In most developed European countries, 15 to 25% of the adult population is obese. Recently, there has been an increase in the incidence of obesity in children and adolescents around the world: in developed countries, 25% of adolescents are overweight, and 15% are obese. Being overweight in childhood is a significant predictor of obesity in adulthood: 50% of children who were overweight at age 6 become obese in adulthood, and in adolescence this probability increases to 80%.

Therefore, the problem of obesity in our time is becoming increasingly relevant and begins to pose a social threat to people's lives. This problem is relevant regardless of social and professional affiliation, area of ​​residence, age and gender. The significance of the problem of obesity is determined by the threat of disability in young patients and a decrease in overall life expectancy due to the frequent development of severe comorbidities. These include: type 2 diabetes mellitus, arterial hypertension, dyslipidemia, atherosclerosis and related diseases, reproductive dysfunction, cholelithiasis, osteochondrosis. Obesity reduces resistance to colds and infectious diseases, in addition, dramatically increases the risk of complications in surgical interventions and trauma.

The problem of the quality of life of overweight and obese patients in modern society is quite relevant, massive and socially significant. Social and technogenic factors of society have contributed in recent decades to an increase in the prevalence of overweight. But it should be noted that this problem is not only and not so much medical as social - both in terms of the genesis and factors of its development, and due to the coverage of a significant part of the population and due to the specifics of the social status of overweight people.

Most of these individuals suffer from more than just illness and limited mobility; they have low self-esteem, depression, emotional distress and other psychological problems due to prejudice, discrimination and exclusion in society.

It is important to focus on the relationship and interdependence of the quality of life and health, recently this issue has become the object of specialized research, attempts are being made to identify the essential components of the quality of life that are influenced by the state of health, illness and treatment, with the exception of those aspects that depend on sociocultural, political, religious and other external reasons.

Currently, the relevance and social significance of studies on the quality of life of patients with obesity is constantly increasing due to the growing prevalence of obesity and understanding of its impact on life expectancy, the risk of developing other chronic diseases and conditions.

Currently, the study of the quality of life is becoming one of the most common and generally recognized methods for studying the course of diseases, especially chronic ones. According to the definition of the World Health Organization (WHO), quality of life is defined as "the perception by individuals of their position in life in the context of the culture and value system of the environment in which they live, inextricably linked with their goals, expectations, standards and concerns" . The same organization defines health as "the complete physical, psychological and social well-being of a person and not merely the absence of disease".

The World Health Organization defines the key criteria for the quality of life: physical (vital activity, energy, fatigue, pain, discomfort, sleep, rest); psychological (positive and negative emotions, cognitive functions, self-esteem, appearance, mobility); level of independence (working capacity, daily activities, dependence on drugs and treatment); public life (personal relationships, social value of the subject, sexual activity); environment (life, safety, well-being, accessibility and quality of medical and social care, security, information ecology); spirituality (religion, personal beliefs).

Health-related quality of life acts as an integral characteristic of the physical, mental and social functioning of a healthy and sick person, based on his subjective perception.

Assessment of the quality of life of patients allows us to solve such problems as determining the effectiveness of known methods of treatment; stratification of patients into groups and determination of differentiated tactics of treatment and diagnosis, search for new methods of treatment and rehabilitation aimed at improving the course of the disease.

The social aspect of the problem lies in the fact that there are certain objective limitations in the life of such people, there are multiple factors of social deprivation of these people. Gaps in social opportunities between overweight and non-overweight people are steadily growing, which worsens the social well-being of overweight people. The solution of this issue is possible only through not so much highly specialized as a wide range of medical and social measures.

At the same time, it should be noted that there is a problem in complex, especially medical and social studies of the social group of people who are overweight, as a rule, attention is paid to professional and medical aspects, social factors are not taken into account, which entail both a further increase in the incidence, a decrease in life expectancy, as well as social consequences in the form of a violation of the rights of this category of people, the creation of social barriers to their socialization, social adaptation and internalization to social conditions, their social well-being are insufficiently studied in a sociological way.

Goal of the work: study of the quality of life of patients with excess body weight and obesity in the socio-economic conditions of a large industrial region in comparison with the control group.

Materials and methods: The survey tools included a system of indicators that can be conditionally combined into the following content blocks: self-assessment of the quality of life and socio-economic status; factors affecting social well-being and health status, social well-being; value orientations and behavioral stereotypes in relation to health and orientation towards a culture of self-preserving behavior.

A total of 674 people were interviewed, the respondents were divided into two groups - the control group (150 with normal BMI (18.5-25 kg/m 2) and the main group (524 - BMI over 25 kg/m 2).

When processing and analyzing data, such approaches were used as highlighting meaningful results, generalizing indicators within blocks, establishing inter-block links to highlight the most significant of them. Relationships were described on the basis of one-dimensional, two-dimensional and correlation analyses. To identify internal relationships, more complex methods were used: multivariate and factor analyzes, which made it possible to identify hidden variables that are important for characterizing the quality of life and attitudes towards health, frustration factors.

Results: The quality of life, as a comprehensive assessment of people's life, is a system of indicators characterizing the level of realization of human needs, the degree of his satisfaction with the implementation of his life plans.

In the course of the study, attention was focused on such aspects as self-assessment of the quality of life, parameters that determine the quality of life of respondents, value orientations and behavioral stereotypes, and opportunities for self-realization.

Empirically fixed criteria for social assessment of the quality of life of respondents are:

at the cognitive level the degree of awareness or competence of a person in the field of self-preserving behavior, knowledge of social factors in ensuring the effectiveness of life;

on an emotional level- the optimal level of social anxiety, assessment of future prospects, anxiety about life prospects and health status;

at the motivational-behavioral level - the importance of health in the individual hierarchy of values, the degree of formation of motivation for the preservation and promotion of health, the degree of compliance of the respondents' actions with the requirements of a healthy lifestyle, as well as the normatively prescribed requirements of medicine, sanitation and hygiene, mental and social health.

We have carried out an analysis of the correlation dependences of the degree of obesity on key parameters of the quality of life. In the examined group of patients, a wide variability of total indicators of quality of life was observed at different values ​​of the body mass index.

The results obtained allow us to assume the existence of a relationship and the influence of overweight and obesity on indicators of the quality of life, since it is obesity that can be one of the factors responsible for the decrease in the quality of life compared with the control group and determining the processes of social adaptation and the possibility of social realization.

55% of obese patients noted a significant limitation when performing heavy loads, while among non-obese patients this was 26%. Moderate exercise was performed without restrictions by 80% in the non-obese group and only 60% in the obese group. At the same time, differences in responses in assessing difficulties in performing light loads (lifting and carrying a bag of groceries) did not differ significantly, although there was also a trend towards greater difficulties in the obese group.
The same trend was observed when assessing the difficulty in climbing several flights of stairs. Significant restrictions were equally rare in both groups, but in the absence of obesity, almost 86% of patients did not report any restrictions, while the presence of obesity was associated with a moderate restriction in climbing one flight of stairs and the proportion of patients without restrictions was 65%.

Overweight is a serious frustration factor and is associated with various types of social deprivation; overweight people suffer not only from illness, but are more prone to depression, they are characterized by low self-esteem. Excess weight leads to a number of serious psychological problems due to a distorted perception of people, a fairly high level of discrimination, social stereotypes in relation to obese patients.

The results of the study show that the majority of respondents consider health in the current socio-economic conditions to be an enduring value on which many things in this life depend: material well-being, a happy family life, career advancement. Satisfactory assessments prevail in self-assessments of health and prospects for improving the condition; in patients with obesity, assessments of the state of health are much more pessimistic and less satisfied with the state compared to the control group.

The results of the study indicate differences in the perception of health-related problems, depending on gender and age, and the degree of obesity. The vast majority of respondents from the main group (64%) noted that being overweight strongly affects their health. With rather high assessments of feelings of happiness and cheerfulness, expressed by 26% of the respondents of the main group of agreement with the statement that they have excellent health, 21% noted that they were very nervous over the past 4 weeks, 14.1% noted severe depression, only 24% noted that most of the time they feel calm and peaceful.

Excess weight, according to the vast majority, primarily affects physical well-being, respondents quite often note pain and discomfort in the head (73.2%), loss of strength (71.7%), 59.1% - sleep disturbance.

A fairly significant proportion of respondents note the impact of being overweight on their psycho-emotional state: 34.6% emphasize the loss of interest in usually pleasant activities, 48% - a feeling of depression in the morning, 27.7% - note that the future generally seems gloomy to them, and they do not expect nothing good from him, 36.6% focus on the fact that being overweight hinders professional fulfillment to a certain extent, so additional efforts are required to get started (36.6%).

In our opinion, it is necessary to focus on the fact that among women there are much higher those who believe that being overweight contributes to the formation of low self-esteem, those who experience a feeling of insecurity and fear of being rejected. 35.8% of men agreed with the statement that self-esteem due to weight is not what it could be, among women 74% agree with this statement. 44% of women feel insecure about their weight, among men this figure is much lower - 23.2%. More than half of women agree that they do not like themselves precisely because they are overweight.

According to the results of the study, overweight occupies a leading position in terms of the degree of influence. Along with being overweight, 62.2% of respondents noted that they suffer from hypertension, 20.5% - angina pectoris, 65.4% - osteochondrosis, 60.2% - joint diseases, 25.6% - diabetes mellitus, 2.4% noted hypothalamic syndrome. 85.5% believe that they are overweight and 7.9% noted that they are not overweight. 32.7% noted that they were overweight in childhood.

Most of the respondents took measures to beat themselves from being overweight. Among the most popular means that were used for weight loss, diets are in the first place, fasting and fasting days are in the second position, loads and gymnastics are in the third position, nutritional supplements are in the fourth, 6.7% practiced separate meals. In terms of age, it should be noted that young respondents are more focused on using diets, fasting days and fasting for weight loss (35%, 25% and 22%, respectively) and do not resort to drugs, unlike the older generation.

Conclusions: The results obtained indicate a difference in the quality of life in patients without obesity and the control group. At the same time, there is an effect on the quality of life of other factors that reduce the effects of obesity. Potential factors are age and duration of weight-related disease, which are inversely related to obesity rates and are determinants of quality of life. Therefore, we conducted an additional analysis of the impact of obesity on the quality of life to reduce the impact of these additional factors.

Analysis of the results of the study of the impact of obesity on the quality of life leads to the conclusion that among the most important for successful adaptation, the most important are the formation of personal dispositions, orientations both to overcome one's physical handicap and to social status sublimation, to replace dissatisfaction with one's physical appearance and capabilities. social achievements. Therefore, within the framework of individual programs, it is advisable to form in such patients “confident optimism”, the desire to resolve internal contradictions in themselves, thereby creating powerful prerequisites for reducing excess weight. In addition, it is necessary to reorient public opinion towards the recognition of obesity as a disease by society and the need for social support for obese people. It can be argued that overweight people constitute one of the most massive communities in the atypical social risk group, united by the unity of their lifestyle and lifestyle, life chances, their social problems and differs from other categories included in the risk group by greater latency. these problems, non-recognition on the part of society and the state of the very fact of deprivation of this category, as well as the specificity and diversity of possible ways to overcome social infringement.

Promising for research may be the issues of achieving the standards adopted in developed countries for the attitude of the state and society to overly full, mechanisms for overcoming the negative stereotypes of the population towards this group. To optimize the social well-being of this category, it is advisable, along with the organization of a systemic counteraction to overweight, to form a holistic program for the development of a culture of self-preserving behavior and a healthy lifestyle.

Literature

1. Ageev, F.T. Quality of life as a criterion for successful therapy of patients with chronic heart failure / F.T. Ageev, Ya.I. Code, R.A. Libis, V.Yu. Mareev // RMJ No. 2 1999

2. Novik A.A., Ionova T.I. Study of the quality of life in medicine. M., 2004. c. 125-129.

3. Mkrtumyan A.M., Doctor of Medical Sciences, Professor, Moscow State Medical University, Moscow Actual Problems of Conservative Treatment of Obesity 2011

4. Myasoedova, N.A. Assessment of the quality of life in various cardiovascular diseases. /ON THE. Myasoedova, E.B., Tkhostova, B. Belousov // Quality Clinical Practice No. 1 2002

5. Yashkov Yu.I. Stages of development of obesity surgery // Bulletin of Surgery. - 2003. - No. 3.

6. Lean M. E. J Clinical handbook of weight management. Martin Dunitz 1998, p. 113.

7. Moonseong, H. Obesity and Quality of Life: Mediating Effects of Pain and Comorbidities /H. Moonseong /7 Obesity Research 11:209-216 (2003)

8. Orley J., Saxena S., herrman h. quality of life and mental illness // the british J. of Psychiatry. 1998 Vol. 172. P. 291-293

9. Schutz Y. Macronutrients and energy balance in obecity // Metabolism. -1995, Sep. - V.44-No. 9 - P.7-11

10. Seidell J.S. The worldwide epidemic of obesity. In Progress in obesity research. 8th International congress on obesity. B. Guy-Grand, G. Ailhaud, eds. - London: John Liddey & Company Ltd. 1999. - R. 661-8.

11. The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties. // Soc. sci. Med. -1998. -N. 46(12). -p. 1569-1585.

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Relevance of the topic.

Despite the fact that many questions of diabetology regarding the tactics of treatment and prevention of complications of the disease have already been answered, diabetes remains a serious problem, including because it has a pronounced negative impact on the quality of life of patients. A decrease in the quality of life in diabetes is associated not only with a deterioration in health due to late complications, but also with various psychopathological conditions (for example, depression), changes in the nature of social contacts and habitual lifestyle.

Currently, the quality of life is considered as an important indicator of health, and its improvement is one of the key tasks of health care. The assessment of the quality of life and the emotional state closely related to it in diabetes mellitus is also important because the subjectively perceived reduced quality of life and emotional distress can significantly impair the patient's adherence to self-management of diabetes and thereby reduce the effectiveness of therapeutic measures.

Rehabilitation and preservation of the patient's health is impossible without taking into account the psycho-emotional characteristics of the individual, the degree of "satisfaction" with one's condition, the level of independence and social status, personal beliefs and other aspects that determine "the degree of comfort both within oneself and within one's society."

According to WHO recommendations, the fundamental criteria for the quality of human life of the late twentieth century were physical (strength, energy, fatigue, pain, rest, sleep), psychological (positive emotions, thinking, self-esteem, appearance, negative experiences), the level of independence (daily activity, working capacity, dependence on drugs and treatment), social life (personal relationships, social value, sexual activity), environment (well-being, safety, life, security, accessibility and quality of medical and social security, accessibility of information, leisure, ecology), spirituality (religion, personal beliefs).

Thus, quality of life issues are of fundamental importance, as they can become a determining factor in an individual's ability to manage their disease and ensure health and well-being in the future. Therefore, it seems promising to develop individual programs that include various aspects that take into account psychological characteristics, attitudes towards the disease and treatment of patients with diabetes mellitus. All this determined the relevance of studying psycho-emotional, socio-demographic aspects related to the quality of life of patients with diabetes mellitus.

In view of the foregoing, the choice of the topic “Quality of life in patients with diabetes mellitus” was made and a research program was developed.

The first stage is a theoretical analysis of the problem related to the study of the quality of life of patients with diabetes mellitus.

The second stage is a direct study, which was carried out on the basis of the endocrinology department of MBUZ GB No. 1.

Purpose of the study: studying the quality of life, the psychological characteristics of the patient, which allows for a personal approach and finding the best ways for a full-fledged medical, psychological and social rehabilitation of patients with diabetes.

Object of study: patients of the endocrinology department of MBUZ GB No. 1 aged from 18 to 82 years.

Subject of study: quality of life of patients with diabetes mellitus and its medical and social aspects.

Research objectives:

• 1. To study the methodology for studying the quality of life of patients with DM.
• 2. Study of the subjective picture of the disease, attitudes towards the disease and treatment in people with diabetes.
• 3. Study of the emotional state of patients with diabetes mellitus.
• 4. Study of the structural features of the personality and characteristics of the motivational-volitional sphere of patients with diabetes mellitus.
• 5. Study of stress coping behavior strategies in patients with diabetes mellitus.
• 6. Study of the level and structure of the quality of life of patients with diabetes mellitus.
• 7. Study of the relationship between quality of life and clinical and psychological characteristics of patients with diabetes mellitus.

Scientific novelty of the research: For the first time, a study of the quality of life of patients with diabetes mellitus is being conducted in the endocrinology department of the City Clinical Hospital No. 1.

Practical significance of the study: recommendations have been developed to improve the quality of life of patients with diabetes mellitus.

Research methods:

• 1. Scientific and theoretical analysis of medical literature on the quality of life of patients with diabetes mellitus.
• 2. Statistical method.
• 3. Sociological method (questionnaire).

Research base: endocrinology department of MBUZ "City Clinical Hospital No. 1".

The structure of the final qualifying work:

This work consists of an introduction, two chapters, a conclusion, a list of references and appendices.