Vol 19, No 3 (2016)


Aspects of rehabilitation of disabled elderly persons in the Russian Federation

Puzin S.N., Shurgaya M.A., Shkurko M.A., Krasnomyasova I.A., Khristophorov S.N., Memetov S.S.


The article presents the results of the study of recommendations both for the rehabilitation of citizens, recognized primary and re-examination as disabled patients in the Russian Federation (2014). A positive result of the implementation of individual rehabilitation program was achieved in 45.1% of persons with disabilities, with the most significant recovery rates being at the level of 51.7% (integration of disabled persons in the family and society) and 50.8% (achievement of a partial compensation of lost functions). Disturbed functions were partially restored in 28.6% ofpersons with disabilities. As a result of the analysis of questionnaires of the evaluation tool (308forms), performed in the Care Home of Labor Veterans number 17, the Department of Labor and Social Protection of Moscow, there was revealed the medical and social status of persons with disabilities staying in this institution. The gender structure ofpersons with disabilities is characterized by a slight predominance ofwomen (59.7%) versus 40.3% of men. Among of all persons with disabilities there are dominated people aged of 75-89 years (51.9%). In the implementation of the comprehensive rehabilitation of disabled patients the need in drug therapy accounts of 100%, in the physiotherapy treatment - 89.6%, and physical therapy methods are used in 99.4% ofpersons with disabilities. With bearing in mind medical indications there are applied methods of socio-environmental, social and domestic, socio-psychological, sociocultural (art therapy, library therapy and adaptive physical education). For the creation of a barrier-free environment patients with disabilities are provided with the technical means of Rehabilitation. At the end of 2014 16.0 thousand people stand on the waiting list for the admission in stationary social care institutions for adults in the Russian Federation. With taking into account of demographical situation of an aging of the population and the gain in the demand for stationary establishments [2] intended for living of the older generation of people who cannot take care of themselves independently and need constant assistance, the further development of the social service system is feasible and has an important medical health value.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):116-122
pages 116-122 views

Principles and criteria for detection of the persistence of disorders of functions of the organism in the practice of the medical and social expertise

Goncharenko A.G., Akimov E.I.


Actuality of the theme offered to the discussion in the real article is conditioned by the absence of legislative and normative documents through this question from one side and by a necessity every day to estimate the persistence of disorders offunctions of the organism in the execution of the medical and social examination, because it is a starting pointfor taking away of expert decision at detection of disability and establishment of the degree of loss ofprofessional ability to work due to industrial accidents and professional diseases. Authors offer the point of view on this issue in a hope on an active discussion with colleagues from a number practicing experts and holding positions which allow to go forward with legislative initiatives.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):123-124
pages 123-124 views

Innovative approach to the rehabilitation of patients undergone surgical treatment of herniated invertebrate discs

Kulikov A.G., Voronina D.D., Luppova I.V., Abramovich S.G.


One of the most remarkable manifestations of the spinal degeneration is the occurrence of herniation of the invertebrate disc and in more than in 80% of cases the disease is revealed in the lumbar spine. The surgical treatment is merely a phase in the treatment of a patient. The changes persisting in the postsurgical period necessitate the implementation of an early comprehensive rehabilitation program, including along with medication treatment, kinesitherapy, aquatic therapy and physical therapy. The aim of the study - the elevation of the efficacy of rehabilitation ofpatients after surgical treatment of herniated invertebrate discs in lumbar sacral spine by including into the complex of treatment procedures general magnetic therapy. There was performed an examination and observation of 52 patients divided into 2 groups matchedfor the gender, age and main clinical manifestations. All patients received basic therapy including medications, kinesitherapy, hydro kinesitherapy. Patients from the basic group additionally received the course of the general magnetic therapy. It has been found that procedures of the general magnetic therapy were revealed to favourably affect on the common symptoms of the disease, regeneration processes, as well as improves of the state local blood circulation in the area of surgical intervention.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):125-128
pages 125-128 views

Invalidization in patients with myasthenia, factors affecting disability

Konkova D.Y., Karnaukh V.N.


Myasthenia gravis, as a disease associated with impaired neuromuscular transmission and manifested by muscle weakness and fatigue, necessarily leads to the disability of patients. There were analyzed terms and the factors influencing upon disability in 52 patients with myasthenia, 67 per cent of whom had a disability group. The duration of the disease from the beginning to the referral to the examination in the Bureau of the Medical and Social Expertise was revealed to amount in average of 2.68 ± 0.44 years. Out of factors influencing upon more earlier disability there were noted primary or early generalization of the process, severe crisis course and pronounced severity according to MGFA, poor compensation on anticholinesterase drugs, inadequate therapy. There was noted the positive effect of thymectomy on the consequent course of the disease, only 2 out of the 18 operated patients showed its further progression.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):129-132
pages 129-132 views

A comparative analysis of the medico-social characteristics of primary disability of the population of Saint Petersburg in comparison of periods: 2007-2009 and 2013-2015

Karasaeva L.A., Kalichava A.S., Dubrovskaja N.V., Svetlichnaja I.V.


The article presents the medical and social characteristics ofprimary disability in the period from 2007 to 2009 and from 2013 to 2015. In the article there are presented medical-social characteristics of the primary disability over the periods from 2007 to 2009 and from 2013 till 2015. There were analyzed extensive and intensive indices of the primary disability which manifest as dynamics characteristics of the public health ofthe adult population of St. Petersburg. There were revealed clear cut downward trends in the number ofpersons for the first time recognized as disabled and the level of the primary disability in a major metropolis. There is established a consistent trend of the increase of specific weight of working-age persons for the first time recognized as disabled in the total number of the disabled adult population. In the compared periods there were revealed trends of increasing of the specific gravity of cases for the first time recognized as disabled at a young age. The use of indices obtained in the study can serve as the basis for the analysis and evaluation of the activities of the Bureau of the Socio-Medical Expertise in the modern conditions.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):133-136
pages 133-136 views

Social skills, social networks and psychological well-being of patiens with spinal cord injury

Boulyubash I.D., Bashta O.S.


The paper presents information concerning the relations between the subjective evaluation of social skills, parameters of the social network and the factors determining psychological well-being ofpatients with spinal cord injury sequellae (SCIS). Thus, one of the focuses of the diagnostic and therapeutic work of a clinical psychologist and psychotherapist in the rehabilitation hospital environment becomes as well a subjective assessment by SCIS patients of their own social skills, as the development of these skills, contributing to the expansion of the social network, which is a resource for the provision ofpsychological wellbeing ofpatients. This testifies not only to the need for correction of the emotional state ofpatients, but also the necessity of specific psychotherapeutic interventions. Such interventions should be aimed at the increasing in the level of communication skills which are useful for the formation of new social relationships and the development of the social network of patients (group forms of training, support groups, chat forums, etc.).
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):137-142
pages 137-142 views

Personality characteristics of patients with fibro-cavernous pulmonary tuberculosis

Gurova Y.V., Udalova T.Y., Mordyk A.V., Bagisheva N.V., Rudenko S.A., Fefelov I.D.


There is represented to be relevant to clarify what personal characteristics contribute to the formation of fibro-cavernous tuberculosis, to prevent its formation in the course of treatment. The aim is to identify the personal features ofpatients with fibro-cavernous pulmonary tuberculosis to develop psychological support in the subsequent treatment of newly diagnosed patients, preventing the formation of chronic specific process. Material and methods. 96 patients participated in a study: 48 cases with fibro-cavernous tuberculosis and 48 healthy volunteers. To study the personality characteristics there was used «Combined Personality Inventory (CPI)» based on the Raymond Cattell’s 16 Personality Factors (adaptation by G.A. Leevik). Results. In comparison with the control group patients with fibro-cavernous pulmonary tuberculosis had higher averages in scales A (reserved demeanor - openness), F (poverty - wealth of emotional reactions), Н (reservedness - activity in communication), L (credulity - suspicion), M (practical - dreamy style of thinking), N (easy - the sophistication of behavior), O (confidence - lack of confidence), Q1 (conservatism - the desire for new), Q2 (conformity - non-conforming), Q4 (relaxed - alertness), P (plasticity - rigidity) and Tr (anxiety). They have reduced the level of logical intelligence, they are both less balanced and easier to subjugate, not disciplined, have low self-control, low level of claims, a less favorable climate in the family, coupled with introversion. Conclusion. Thus, patients with fibro-cavernous tuberculosis are distinguished by reservedness in communications, reserved demeanor, suspicion, alertness, anxiety, lack of discipline, poor self-control. Creation of a special social and psychological support services for this group ofpatients can elevate the efficiency of the complex treatment and improve prognosis.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):143-148
pages 143-148 views

Professional education of students with impaired hearing development

Lotova I.P.


In the article there is presented the analysis of organization and technological assistance of the vocational education of students with impaired hearing development on the example of the Moscow State Technical University named after N. E. Bauman which has long term experience in this area. In particular, there is discovered the content of educational and rehabilitation technologies of educational of the mentioned category of students.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):149-152
pages 149-152 views

Professional rehabilitation as aspect integration of disabled people in society (on example of the Republic of Mari El)

Nizova L.M., Danilova M.I.


In the article there is reflected the complex of the most important andfundamental problems ofintegration ofpersons with disabilities into society in two ways: in the theoretical and methodological and analytical-sociological. There are considered institutional aspects of the vocational rehabilitation atfour levels: international, national, regional and local. The study of the views ofdomestic researchers in theoretical and methodological terms has shown problems of the employment ofpersons with disabilities at the regional level to be insufficiently studied up until now. In this connection there were investigated main directions of vocational rehabilitation and integration of disabled people into society thanks to efforts of the Government of the Mari El Republic, Main Bureau of Social and Medical and Expertise of the Republic of Mari El of the Ministry of Labor and Social Protection of the Russian Federation, Department of Labor and Employment ofpopulation of the Republic of Mari El. There is given an estimation of the management and vocational rehabilitation of persons with disabilities in the competitive mesoeconomic labour market. On the basis of monitoring and sociological research of two categories of respondents there were identified priorities, issues andfactors, determined the employment of the disabled persons as a specific population group. The dynamics of active forms of the employment and ranging opinions of respondents allowed to prove the positive role of vocational rehabilitation to expedite the integration processes of disabled persons in society: decline in the number of cases of disability among working age persons surveyedfirstly, reducing the percentage of the gain in the severity ofdisability, the increase in the proportion of the complete rehabilitation among the adult population, the decline in the proportion ofpersons with disabilities among the unemployed people owing to such forms as the organization of specialized job fairs, quotas and creation of work places, referral of disabled persons about self employment. Nevertheless, bearing in mind the persistence of revealed problems, there are proposed author measures on the improvement of the efficacy of the impact of vocational rehabilitation ofpersons with disabilities to accelerate their integration into society, taking into account vectorness, including governing bodies, employers and people with disabilities.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):153-158
pages 153-158 views

Features of the organization of public service of medical and social expertise at the present stage

Puzin S.N., Memetov S.S., Shurgaya M.A., Baleka L.Y.


In the modem society, the state acts as the guarantor ofsocial security of citizens with disabilities. In this direction as an important stage the ratification by the Russian Federation of the Convention on the Rights of Persons with Disabilities in 2012 has turned. Convention was directed to the assurance of the full participation of persons with disabilities in civil, political, economic, social and cultural life of the society. Ratification of the Convention required to insert amendments in the acting legislations of the Russian Federation, including those concerning Medical and Social Expertise (MSE). In particular, there was changed quantitative and qualitative body of specialists, members of the Bureau of the MSE, there was changed the classification and the criteria used for the implementation of medical and social examination of citizens by Federal State MSE institutions. There was the replacement of a paradigm in relation to persons with restrictions in the life activity. The role of health care organizations in terms of examinations and clinical diagnosis in citizens, sent to the medical and social expertise has increased significantly. In the article there is presented an analysis of the current regulatory - legal frameworkfor the implementation of medical and social examination of citizens by Federal State MSE institutions. There was emphasized the importance of quantitative evaluation system of the severity of persistent disorders of the human body functions, caused by diseases, consequences of injuries and defects.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):159-163
pages 159-163 views

Methods of assessing the health and social status of elderly disabled persons

Shurgaya M.A.


Execution of documentation is an essential component of the vocational work of experts engaged in the provision of medical and social assistance to the disabled, from the clinical diagnostic to rehabilitation. In the article there is presented the questionnaire of the assessment of health and social status of the elderly disabled person, which allows to reflect the existence of violations of the functions and limitations of life activity, the degree of their severity, needs in certain types of rehabilitation, including with the use of technical means of compensation of disturbedfunctions. This type of documentation allows to reduce (speed up) the time on the execution and to increase the level of the vocational competence of the professionals engaged in medical and social activities as well in health institutions as social protection institutions. With properfilling ofpreprinted forms (layout, template) it will be received medical and social portrait ofa disabled elderly person. Questionnaire can also be used in execution ofscientific research.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):164-167
pages 164-167 views

To the memory of professor Andrey Yur'evich Makarov

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Medical and Social Expert Evaluation and Rehabilitation. 2016;19(3):168-168
pages 168-168 views

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