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Introduction

1.The concept of medical psychology

2. Sections of medical psychology

Conclusion

Literature

Introduction

Medical psychology is relevant and one of the leading branches of modern psychology. Medical psychology is characterized by a close connection between its theoretical foundations and their practical use in solving a wide range of problems of protecting and promoting public health.

In modern conditions of worsening social problems in our country, deteriorating health indicators of the population, the objective need to solve interrelated problems of a medical and social nature at a qualitatively new level is increasing. Objectively, the need has become ripe for the active introduction of new forms and methods of social work into the practice of health care authorities.

In the 90s XX century A new direction of social work and type of professional activity - medical and social work - began to take shape and is actively being introduced into healthcare practice. The peculiarity of medical and social work is that it, as a type of professional activity, is formed at the junctions of two independent branches

- social protection of the population and healthcare. This nature of medical and social work requires special approaches to the training of social work specialists, aimed at developing the foundations of knowledge in the field of medicine and medical psychology.

The close connection between medical psychology and psychiatry is based on the commonality of the object of study, a common understanding of mental illness, manifested by disorders in the reflection of the real world and, as a consequence, disorganization of behavior or its changes.

In solving theoretical and practical problems, a medical psychologist relies on subject knowledge, consisting of two interconnected parts. On the one hand, these are the ideas accumulated to date about the nature, structure, brain mechanisms, basic patterns of individual development and manifestations of the human psyche, i.e. what is called general psychology, on the other hand, knowledge of one’s own subject, reflecting the psychological patterns of disorders and deviations in cognitive processes and a person’s personality, caused by a specific disease. In this case we are talking about medical psychology and, above all, about pathopsychology as one of its branches, formed within the framework of clinical psychology. But the basis of the approach to understanding pathology (anomalies, deviations in the psyche) is a system of views about the nature of mental reflection in a healthy normal person.

The problem of the structure and dynamic characteristics of the psyche is solved in different ways by different psychological schools and is interpreted differently by representatives of various directions within the framework of their own conceptual ideas about a person as a subject of reflection of the surrounding world. This is directly related to the solution of practical problems, since the psychological concept determines the methodology for studying a person, followed by a system of specific techniques for identifying the desired characteristics of the psyche in normal conditions and in pathology. In this sense, psychological methods are not neutral; they are created and implemented to identify and evaluate those components of the psyche that are adequate to the accepted psychological concept (or scientific paradigm). The choice of methodology is, first of all, a meaningful choice of a certain system of views on the essential components of the human psyche.

1. The concept of medical psychology

Medical psychology is a branch of psychology devoted to the study of the influence of mental factors on the occurrence and course of diseases, diagnosis of pathological conditions, psychoprophylaxis and psychocorrection of diseases. It is customary to distinguish two main areas of application of medical psychology: neuropsychic and somatic diseases. Based on the data obtained in medical psychology, productive hypotheses can be built about the process of normal mental development.

Medical psychology (from the Latin medicus - medical, therapeutic) is a branch of psychology that studies the psychological aspects of hygiene, prevention, diagnosis, treatment, examination and rehabilitation of patients. The field of study of Medical Psychology includes a wide range of psychological patterns associated with the occurrence and course of diseases, the influence of certain diseases on the human psyche, the provision of an optimal system of health-improving effects, and the nature of the relationship of a sick person with the macrosocial environment. The structure of Medical Psychology includes a number of sections focused on research in specific areas of medical science and practical healthcare. The most common of them is clinical psychology, including pathopsychology, neuropsychology and somatopsychology. Branches of Medical psychology related to psychocorrectional work - psychohygiene, psychopharmacology, psychotherapy, mental rehabilitation - are intensively developing. Kerbikov O. V., Izbr. works, M., 1971, p. 300--11: About psychohygienic work at school.

Among the most important problems of Medical Psychology are the interaction of mental and somatic (bodily, physiological) processes during the occurrence and development of diseases, the patterns of formation of the patient’s idea of his illness, the study of the dynamics of awareness of the disease, the formation of adequate personal attitudes associated with treatment, the use of compensatory and protective mechanisms individuals for therapeutic purposes, studying the psychological impact of therapeutic methods and means (medicines, procedures, clinical and instrumental studies, surgical interventions, etc.) in order to ensure their maximum positive impact on the physical and mental state of the patient. A significant place among the issues studied by Medical Psychology is occupied by the psychological aspects of the organization of the medical environment (hospital, sanatorium, polyclinics, etc.), the study of the relationships of patients with relatives, staff and with each other. In the complex of problems of organizing therapeutic measures, of particular importance is the study of the patterns of psychological influence of a doctor during his diagnostic, therapeutic, preventive work, the rational construction of relationships between participants in the treatment process, the prevention of iatrogenics Psychology Dictionary. / Under the general editorship. A.V. Petrovsky, M.G. Yaroshevsky. - 2nd ed. M., 1990

2. Sections of medical psychology

medical psychology disease psychocorrection

Medical psychology includes the following sections:

1.) Pathopsychology, a branch of psychology that studies the patterns of disorders of mental activity and personality traits based on comparison with the patterns of their formation and course in the norm.

The formation of pathopsychology is closely intertwined with the development of psychiatry. The first experimental psychological laboratories in psychoneurological institutions were created at the end of the 19th century. German psychologist W. Wundt, Russian psychoneurologists V. M. Bekhterev and S. S. Korsakov.

At the beginning of the 20th century. The first manuals on the use of experimental psychological methods for studying mentally ill patients began to be published. The ideas of L. S. Vygotsky played a major role in the development of pathopsychology in Russia.

Pathopsychological research is of great importance for a number of general methodological problems in psychology, for example, for resolving the issue of the relationship between the biological and the social in the development of the psyche. The data from these studies show that personality disorder does not mean the “release” of its biological instincts and needs, but is characterized, first of all, by a change in the human motives and needs themselves. It is also established that the patterns of the disintegration of the psyche do not repeat in reverse order the stages of its development.

Data from pathopsychological studies are used in psychiatry: as diagnostic criteria; when establishing the degree of intellectual decline; during examination (judicial, labor, military); when taking into account the effectiveness of treatment, especially when using psychopharmacological agents; when analyzing mental disorders in the case of harmful working conditions; when deciding on the restoration of lost performance.

Pathopsychology uses experimental research methods, the main principle of which is a qualitative analysis of mental disorders as an indirect and motivated activity. A pathopsychological experiment provides an opportunity to update not only mental operations, but also the motives of a sick person. The pathopsychology of childhood has received particular development, in which, based on Vygotsky’s position on the “zone of proximal development,” special methods have been developed, in particular the method of a teaching experiment.

The methods of medical psychology, while not differing in principle from the methods of general psychology, are specified depending on the nature of the disease. Medical psychology pays special attention to anamnesis - an analysis of the patient’s past experiences from infancy to the moment of illness.

2). Anamnesis (Greek anamnesis - memory), information about the patient’s living conditions that preceded this disease, as well as the entire history of the development of the disease.

Anamnesis is an integral part of every medical examination, often providing the necessary instructions for the diagnosis of a disease. There is a general history and anamnesis of the disease. The general history includes answers to the following groups of questions: diseases of parents and immediate relatives (hereditary diseases, malignant tumors, mental illnesses, tuberculosis, syphilis, etc.); previous diseases and operations, lifestyle (marital status, nutritional conditions), habits (drinking alcohol, smoking), sex life, working conditions, all living conditions.

The history of this disease concerns the onset of the disease, its course and treatment until the day of the study. The anamnesis is collected from the story of the patient himself or those around him.

In veterinary practice, anamnesis is collected by interviewing those caring for animals, studying documentary data (medical histories, etc.). The origin of the animal and the health status of its parents, the presence of diseases in the farm to which the animal belongs, conditions of care and maintenance (characteristics of feeding, watering place, premises for the animal, operating conditions) are established. They find out previous diseases, the time of occurrence of the disease, its symptoms, cases of a similar disease on the farm, information about the treatment used. Shklyar V.S., Diagnosis of internal diseases. K., 1960

3). The painful nature of the experience, the intractability of the pathogenic situation, the duration of the traumatic stress - all these factors can be understood and explained only taking into account the individual characteristics of the personality and character of the patient.

Stress (from the English stress - pressure, pressure, tension),

1) in technology - an external force applied to an object and causing its deformation.

2) in psychology, physiology and medicine - a state of mental stress that occurs in a person when operating in difficult conditions (both in everyday life and in specific circumstances, for example during space flight). The concept of stress was introduced by the Canadian physiologist G. Selye (1936) when describing the adaptation syndrome.

Stress can have both a positive and negative impact on activity, up to its complete disorganization, which poses the task of studying a person’s adaptation to difficult (so-called extreme) conditions, as well as predicting his behavior, especially in such conditions.. Levitov N D., On the mental states of a person, M., 1964: Emotional stress, trans. from English, L., 1970.

The further development of medical psychology leads to the identification of such branches as clinical psychophysiology (clinical psychosomatology) and clinical neuropsychology, psychological problems of defectology and pathopegogy. Medical psychology is the basis of psychotherapy and mental hygiene.

4) Neuropsychology, a branch of psychology that studies the cerebral basis of mental processes and their connection with individual brain systems; developed as a branch of neurology.

For centuries, idealistic psychology proceeded from the idea of the parallelism of brain (physiological) and conscious (mental) processes or from the idea of interaction between these two areas, which were considered independent.

Only in the 2nd half of the 19th century. In connection with the successes of studying the brain and the development of clinical neurology, the question was raised about the role of individual parts of the cerebral cortex in mental activity. Pointing out that when certain zones of the cortex of the left (leading) hemisphere are damaged in a person, certain mental processes (vision, hearing, speech, writing, reading, counting) are disrupted, neurologists have suggested that these zones of the cerebral cortex are the centers of the corresponding mental processes and that “mental functions” are localized in certain limited areas of the brain. This is how the doctrine of the localization of mental functions in the cortex was created. However, this teaching, which was of a “psychomorphological” nature, was simplified.

Modern neuropsychology proceeds from the position that complex forms of mental activity, formed in the process of social development and representing the highest forms of conscious reflection of reality, are not localized in narrowly limited areas (“centers”) of the cortex, but represent complex functional systems in the existence of which the complex takes part jointly working areas of the brain. Each region of the brain makes a specific contribution to the construction of this functional system. Thus, the brain stem and reticular formation provide the energy tone of the cortex and are involved in maintaining wakefulness. The temporal, parietal and occipital regions of the cerebral cortex are an apparatus that ensures the receipt, processing and storage of modality-specific (auditory, tactile, visual) information that enters the primary sections of each cortical zone and is processed in more complex “secondary” sections of these zones and is combined and synthesized in “tertiary” zones (or “overlap zones”), especially developed in humans. The frontal, premotor and motor areas of the cortex are an apparatus that ensures the formation of complex intentions, plans and programs of activity, implements them in the system of corresponding movements and makes it possible to exercise constant control over their course.

Thus, the entire brain is involved in the performance of complex forms of mental activity.

Neuropsychology is important for understanding the mechanisms of mental processes. At the same time, by analyzing mental disturbances that arise from local brain lesions, neuropsychology helps to clarify the diagnosis of local brain lesions (tumors, hemorrhages, injuries), and also serves as the basis for the psychological qualification of the resulting defect and for restorative training, which is used in neuropathology and neurosurgery .

In Russia, problems of neuropsychology are dealt with at the Department of Neuropsychology of the Faculty of Psychology of Moscow State University, in a number of laboratories and neurological clinics. Scientists from other countries made a great contribution to the development of neuropsychology: H. L. Teuber and K. Pribram (USA), B. Milner (Canada), O. Zangwill (Great Britain), A. Ekaen (France), E. Weigl (GDR ). Special journals “Neuropsychologia” (Oxf., since 1963) are devoted to the problems of neuropsychology. “Cortex” (Mil., since 1964), etc. There is an international society of neuropsychology. Introduction to clinical neuropsychology, L., 1973; A. R. Luria.

5) Psychotherapy (from psycho... and Greek therapeia - treatment), a system of mental influences aimed at treating the patient. The goal of psychotherapy is to eliminate painful deviations, change the patient’s attitude towards himself, his condition and the environment. The ability to influence the human psyche was noticed in ancient times. The formation of scientific research began in the 40s. 19th century (works of the English physician J. Brad, who explained the effectiveness of mental influence by the functional characteristics of the human nervous system). The theoretical justification and practical development of special methods of psychotherapy are associated with the activities of J. M. Charcot, V. M. Bekhterev and many others. The method of psychoanalysis had a certain influence on the development of psychotherapy, which increased attention to the world of internal human experiences and the role they play in the origin and development of diseases; however, Freudianism (and earlier - in the 1st half of the 19th century - the school of “psychics”, which considered mental illness as a result of the “oppression of sin”) is characterized by an irrational approach to understanding the nature of mental illness. Psychotherapy in the USSR is based on data from medical psychology and physiology of higher nervous activity, clinical and experimental research methods.

There are general and private, or special, psychotherapy. General psychotherapy is understood as a complex of psychological influences that strengthen the patient’s strength in the fight against the disease (the relationship between the doctor and the patient, the optimal psychological climate in the institution, excluding mental trauma and iatrogenic diseases, the prevention and timely elimination of secondary neurotic layers that can be caused by the underlying disease). General psychotherapy is a necessary component of the treatment process for all forms of diseases. Private psychotherapy is a method of treating patients with so-called borderline forms of neuropsychic disorders (neuroses, psychopathy, etc.), using special methods of psychotherapeutic influence: rational (explanatory) psychotherapy, suggestion while awake and in hypnosis, distractive psychotherapy, autogenic training , collective psychotherapy, etc. (in combination with medication and other treatment methods). Psychotherapy is impossible without positive emotional contact with the patient. Platonov K.I., The word as a physiological and healing factor, 3rd ed., M., 1962;

6) Psychohygiene, a branch of hygiene that studies measures and means of forming, maintaining and strengthening people’s mental health and preventing mental illness. Theoretical basis Psychohygiene - social and general psychology, psychotherapy, social psychiatry and physiology of higher nervous activity. The first special work, “Hygiene of the Passions, or Moral Hygiene,” belongs to Galen. The original idea for Psychohygiene of the dependence of people’s mental health on the conditions of their social life was put forward by J. J. Cabanis. The founder of Psychohygiene in Russia, I.P. Merzheevsky, saw the most important means of preserving mental health and increasing productivity in the high aspirations and interests of the individual. Psychohygiene in Russia is characterized by predominant attention to such social measures as improving working and living conditions, the consistent formation of active socially valuable attitudes in adolescents, vocational guidance that contributes to the implementation of these attitudes, as well as psychohygienic education and training in special methods for managing one’s own mental state and well-being. An important method of Psychohygiene is medical examination of persons with neuropsychic disorders. P.’s current tasks include the prevention of mental trauma in children and the development of ways to rationalize the learning process in secondary and higher schools (in order to prevent neuropsychic overload). In connection with the consequences of the scientific and technological revolution, the importance of managing the psychological climate in large and small social groups, as well as methods of increasing the mental resilience of workers in professions of increased complexity, is increasing. Sections of Psychohygiene: industrial (Occupational Psychohygiene), mental work, sexual life and family relationships, children and adolescents, the elderly.

Conclusion

Thus, in solving the practical problems of psychiatry, a branch of psychological science takes part, which is designated as medical psychology (Currently, the tendency to rename medical psychology into clinical psychology is clearly defined. This is caused by the need for terminological unity at the level of international professional cooperation. In Western countries, medical psychology refers to the whole the context of general psychological knowledge necessary for a doctor and constituting a significant part in the content of educational programs for training specialists in the field of medicine. In contrast, the sphere of scientific and practical activity of a psychologist in the healthcare system is designated abroad as clinical psychology. This situation of the transition period of changing names is characterized by the use in the domestic literature and regulatory documents of the concepts “medical” and “clinical” psychology as synonyms). Having its own subject and logic of development, it participates in solving problems of diagnosis, examination, and in the implementation of psychocorrectional, psychotherapeutic and rehabilitation measures aimed at adapting the patient to life in society. At the same time, psychological research contributes to the solution of theoretical problems of modern psychiatry.

Literature

Luria A. R. Fundamentals of neuropsychology, M., 1973;

Shklyar V.S. Diagnosis of internal diseases. K., 1960

Introduction to clinical neuropsychology, L., 1973;

Kerbikov O. V., Izbr. works, M., 1971, p. 300--11: About psychohygienic work at school.

Platonov K.I., The word as a physiological and healing factor, 3rd ed., M., 1962;

Psychology Dictionary. / Under the general editorship. A.V. Petrovsky, M.G. Yaroshevsky. - 2nd ed. M., 1990

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Ministry of Health of the Russian Federation

Voronezh State Medical Academy named after. N. N. Burdenko

Faculty of Higher Nursing Education (correspondence department)

Department of Nursing

Head of Department Associate Professor, Ph.D. Evstratova E.F.

Test

In Medical Psychology on the topic:

Medical psychology - subject, tasks, methods. The importance of studying for FVSO students. Psychological and nursing diagnoses.

Completed: student of group 301

Kretinina G.P.

Checked:

Voronezh

P L A N

1. Key concepts.

2. History of medical psychology.

3. Medical psychology – subject, tasks, methods.

4. Psychological and nursing diagnosis.

5. The relevance of studying medical psychology by students of the Faculty of Higher Education.

6. Test control.

7. Solving situational problems.

8. List of used literature.

KEY CONCEPTS

Psyche - this is a special property of highly organized matter, which consists in a subjective reflection of the objective world.

These are properties of the brain that provide humans and animals with the ability to reflect objects and phenomena of the outside world.

Psychology is a science that studies subjective sensations, images, ideas, phenomena of memory, thinking, speech, will, imagination, interests, motives, needs, emotions, feelings and much more, i.e. human psyche.

Medical psychology is a branch of psychology that uses psychological patterns in the diagnosis, treatment and prevention of diseases.

Pathopsychology (from the Greek pbthos - suffering, illness) - a section of medical psychology that studies the patterns of disturbances in mental activity and personality traits during illness.

The analysis of pathological changes is carried out on the basis of comparison with the nature of the formation and course of mental processes, states and personality traits in the norm.

Pathopsychology studies mental disorders primarily using experimental psychological methods. The applied significance of pathopsychology in the practice of medicine is manifested in the use of experimental data for the differential diagnosis of mental disorders, establishing the severity of a mental defect in the interests of examination (judicial, labor, military, etc.), assessing the effectiveness of treatment based on objective characteristics of the dynamics of the mental state patients, analysis of the capabilities of the patient’s personality from the point of view of its intact aspects and prospects for compensation of lost properties in order to select optimal psychotherapeutic measures, conduct individual mental rehabilitation.

Psychotherapy – complex therapeutic verbal and non-verbal impact on emotions, judgments, and self-awareness of a person in many mental, nervous and psychosomatic diseases.

Psychogenies – these are disorders that arise in the body and psyche of the patient under the influence of various, usually severe, mental traumas for the individual.

Somatogeny - These are mental disorders caused by somatic diseases.

Psychosomatic relationships – the primary influence of the psyche on somatics, primarily in this case, the role of personality traits and its psychological type play a role, creating the preconditions for the occurrence of certain types of adaptation disorders.

Somatopsychic relationships – the primary influence of somatics on the psyche. Certain personality traits can develop as a result of the influence of chronic illness or stress on the psyche.

Psychosomatic diseases – these are physical diseases or disorders, the cause of which is affective stress (conflicts, discontent, mental suffering, etc.). Psychosomatic reactions can occur not only in response to mental emotional influences, but also to the direct action of stimuli (for example, the sight of a lemon). Ideas and imagination can also influence a person’s somatic state.

Internal picture of the disease – the subjective psychological side of any disease, which is created by the patient himself based on the totality of his sensations, ideas and experiences associated with his physical condition.

Type of attitude towards illness – experiences, feelings of illness, prognosis, attitude towards treatment, which the patient himself makes for himself.

Burnout syndrome – is an acquired stereotype of emotional, most often professional, behavior. “Burnout” is partly a functional stereotype, since it allows a person to dose and use energy resources sparingly. At the same time, its dysfunctional consequences may arise when “burnout” negatively affects the performance of professional activities and relationships with partners.

Includes the following characteristics: refusal of career growth, loss of interest in work and life, insomnia, headaches, excessive use of medications.

The development of this syndrome was due to the need to work in a strictly standardized and monotonously stressful day, with great emotional intensity of personal interaction with difficult patients, clients, etc.

Professional deformation of the personality of a medical worker – the process of expanding the ways of responding in a professional context to increasingly larger areas of life.

Chronic fatigue syndrome – a disease characterized by increased fatigue, decreased mood, sleep disturbances, joint pain, and difficulty concentrating.
In CFS, there is a suppression of the hypothalamic-pituitary-adrenal system, which regulates the production of the hormone cortisol. Evidence of the important role of hormones in the occurrence of CFS is the positive effect that hydrocortisone has on patients with CFS. Some methods of psychotherapy (cognitive-behavioral therapy) also improve the condition of patients with CFS. Psychotherapeutic influences not only improve the patient’s physical and psychological status, but also normalize hormonal balance, which may indicate that hormonal disorders in patients with CFS may be secondary.

Transfer (transfer) - the tendency in the present to see the past, to resort to using old ways of perception and response, excluding any new information;

this is a special type of relationship between a patient and a doctor, which is based on a feeling not for the doctor, but for some person from the past; this is liberation from the past, or rather an erroneous understanding of the present through the past.

Countertransference (countertransference) – a reciprocal feeling of hostility, irritation, etc.; intensifies during times of stressful events and unresolved conflicts. Countertransference can be seen as a reaction to an internal imbalance.

Conversion – factors of an emotional nature that affect physical well-being.

Stress – a set of physiological mechanisms in response to the action of unfavorable, super-strong, extreme stimuli; the body responds by exerting adaptive defense forces.

Distress – the negative impact of stress on human activity, up to its complete destruction.

Personality – a concept denoting a set of stable psychological qualities of a person that make up his individuality.

Temperament – a dynamic characteristic of mental processes and human behavior, manifested in their speed, variability, intensity and other characteristics.

Character – a set of personality traits that determine typical ways of responding to life circumstances.

Iatrogenesis – this is a method of treatment, examination or preventive measures, as a result of which the health worker causes harm to the health of the patient.

Sorogeny – this is a method of treatment, examination or preventive measures, as a result of which the nurse causes harm to the patient’s health.

Egogenia – the patient’s influence on himself in connection with an illness or a certain health condition, that is, the result of the patient’s positive or negative self-hypnosis.

Egrotogeny – mutual influence of patients on each other.

Mental trauma is a life situation characterized by individual and relative insolubility and a resulting state of neuropsychic tension, which leads to mental health problems. The main characteristic of mental trauma is its pathogenicity for the individual, depending on the severity, duration, repetition, unexpectedness of mental trauma, and on the vulnerability of the individual to a specific mental trauma.

HISTORY OF MEDICAL PSYCHOLOGY

The history of medical psychology in our country is inextricably linked with the name of V.N. Myasishchev and the Institute. V.M. Bekhterev, where he worked all his life. V.N. Myasishchev made a significant contribution to the development of domestic medical psychology, defining, in fact, its scientific and practical significance for medicine in general and for psychotherapy in particular; his scientific school exists and is developing. Largely thanks to the selfless scientific, pedagogical and organizational activities of V. N. Myasishchev, the Institute named after. V. M. Bekhterev has become the leading scientific, practical and educational center of medical psychology and psychotherapy in our country.

It is known that in Russia, the founder of domestic medical psychology V.M. Bekhterev, following Wundt, who opened the first psychological laboratory in Leipzig in 1879, organized in 1885 in Kazan the second experimental psychological laboratory in Europe. Later, similar laboratories were created in St. Petersburg. Following V. M. Bekhterev at the end of the 19th - beginning of the 20th centuries, V. F. Chizh, S. S. Korsakov and A. A. Tokarsky, N. N. Lange, G. I. Rossolimo, A. I. Sikorsky create in other cities of Russia there were psychological laboratories in which experimental approaches were developed and tested to solve problems of clinical and psychological diagnostics, in particular in psychiatry.

It is impossible not to say about the role and significance of the problem commission “Medical Psychology” created by V.N. Myasishchev at the USSR Academy of Medical Sciences in 1962. This was the period of the “thaw”, and the situation required, among other things, the “legalization” of psychology, especially in medicine. The problem commission under the leadership of V.N. Myasishchev and M.S. Lebedinsky brought together like-minded people. Largely thanks to the recommendations of the commission, new directions in official research plans, dissertations, in improving organizational forms and content of teaching work became possible, in particular at Leningrad University, where V. N. Myasishchev taught in those years. Somewhat later, for the first time, he achieved the introduction of graduate school in this, then seemingly exotic, discipline.

MEDICAL PSYCHOLOGY – SUBJECT, OBJECTIVES, METHODS

MEDICAL PSYCHOLOGY – a branch of psychology that studies the personality and individuality of a sick person; features of mental activity, its changes in diseases; the influence of the patient’s personality on the processes of disease occurrence and recovery, as well as the relationship between the patient and medical personnel during the treatment and rehabilitation process.

Subject of study of medical psychology

According to the focus of psychological research, we can distinguish general and specific medical psychology.

General medical psychology studies general issues and includes the following sections:

3. Individual characteristics of a person and their changes in the process of life.

4. Medical deontology and bioethics.

5. Mental hygiene and psychoprophylaxis, that is, the role of the psyche in promoting health and preventing disease.

6. Family psychology, mental hygiene of individuals during crisis periods of their lives (puberty, menopause). Psychology of marriage and sexual life.

7. Psychohygienic training, psychotraining of the relationship between doctor and patient.

8. General psychotherapy.

Private medical psychology studies:

2. Psychology of patients during the preparation and conduct of surgical operations and in the postoperative period;

3. Medical and psychological aspects of labor, military and forensic examination;

4. The psyche of patients with defects of organs and systems (blindness, deafness, etc.);

5. The psyche of patients with alcoholism and drug addiction;

6. Private psychotherapy.

Tasks of medical psychology:

1. psychocorrectional work (psychotherapy)

2. mental hygiene

3. psychological examination related to social and labor rehabilitation of patients

· diagnostic and treatment and treatment and rehabilitation.

Treatment and diagnostic unit includes pathopsychological, neuropsychological, somatopsychological, psychophysiological, socio-psychological diagnostics.

Treatment and rehabilitation block includes psychotherapeutic, psychocorrective, psychoprophylactic and sociotherapeutic measures.

Basic research methods in medical psychology:

Observing the patient's behavior

· experiment: laboratory and in natural conditions,

· questionnaire - questionnaire survey

· conversation with the patient (collection of facts about mental phenomena in the process of personal communication),

· interview,

· study of the patient’s products (letters, drawings, diaries, crafts, etc.)

· clinical diagnostic tests.

Observation:

External surveillance is a way of collecting data about a person’s psychology and behavior through direct observation of him from the outside.

Free observation does not have a pre-established framework, program, or procedure for its implementation.

Participant observation characterized by the direct participation of the observer in the process under study.

Third party surveillance does not imply personal participation of the observer in the process he is studying.

Survey is a method in which a person answers a series of questions asked to him.

Standardized survey– with it, questions and the nature of the answers to them are usually limited within a narrow framework; it is more economical in time and material costs than a free survey.

Projective test– it is based on the mechanism of projection, according to which a person tends to attribute his unconscious qualities, especially shortcomings, to other people.

The most common personality tests

Rosenzweig's frustration method. Using this method, individual reactions in stressful situations are studied, which allows us to draw a conclusion about the degree of social adaptation.

Adolescent Diagnostic Questionnaire. Used to diagnose psychopathy and character accentuations in adolescents.

Laboratory experiment– involves the creation of some artificial situation in which the property being studied can best be studied.

Math modeling is an expression or formula that includes variables and relationships between them, reproducing elements and relationships in the phenomenon being studied.

Logic modeling based on ideas and symbolism used in mathematical logic.

Technical Modeling involves the creation of a device or device that in its action resembles what is being studied.

Cybernetic simulation is based on the use of concepts from the field of computer science and cybernetics as model elements.

PSYCHOLOGICAL AND NURSING DIAGNOSIS

Each stage of the nursing process can be correlated with the work carried out by the nurse with the patient. Since one of the goals of the nursing process is to promote the patient’s health using psychological methods.

Nursing process.

Nursing diagnosis - this is the clinical judgment of the nurse, which describes the patient's existing or potential reaction to the disease and his condition, with the desired indication of the reasons for such reaction. In a number of recent studies, nursing diagnosis is replaced by the concept of priority problem.

Psychological diagnosis - assessment of the patient’s psychological state as a system of relationships and influences exerted on this system by the disease.

Psychological and nursing diagnoses have their own specifics and content, but their relationship is undeniable, which manifests itself in the common goal of helping the patient.

RELEVANCE OF THE STUDY

MEDICAL PSYCHOLOGY BY FVSO STUDENTS

The main causes of conflicts that arise in medical institutions are ignorance of medical psychology, inability to understand the psychology of the patient and his relatives. A nurse needs to study and know the psychology of her patients, their attitude towards their disease and treatment methods, the characteristics and character traits of their patients, emotions and much more.

Modern medical psychology has a solid methodological and methodological apparatus that makes it possible to obtain reliable practical recommendations necessary for the effective diagnosis and treatment of various diseases, as well as for an ethically and socially justified impact on the thinking and behavior of people in order to adapt them to changing living conditions and normalize psychological climate in teams.

The growing importance of medical psychology has led to its spread in higher educational institutions, and especially in the Faculty of Higher Education.

The disease is always individual, it affects a specific person, and in order to find the means to heal it, the physician must imagine not only the external, but also the internal picture of the disease, see the possible psychological prerequisites and consequences of pathological processes, and understand the patient’s personality changed by the disease. Analysis of complaints and collection of anamnesis, somatic and psychiatric examinations, conducting all types of examinations. Prescribing and implementing etiological and pathogenetic differentiated therapy, resolving the issues of those recovering - all this requires the medical worker to penetrate into the personality of the patient.

In addition, a nurse performing the functions of an organizer (manager) must possess and apply in practice the knowledge of psychology, planning the work of the nurses under her command, which will allow her to avoid conflicts on the one hand, and increase the efficiency of caring for patients.

Medicine belongs to the field of “person-to-person” professions, and therefore requires great emotional investment and psychological health. Knowledge of medical psychology will allow the nurse to timely diagnose psychological problems, using self-regulation methods to correct their condition, which will ultimately avoid burnout syndrome or professional deformation.

TEST CONTROL

1. The first medical psychology laboratory was opened in Russia:

A. V.M. Bekhterev in Kazan;

b. S.S. Korsakov in Moscow;

V. A.F. Lazursky in St. Petersburg;

G. there are no correct answers;

2. Medical psychology studies:

A. individual psychological characteristics of the patient’s personality;

b. internal mental processes;

V. the cause of psychopathological phenomena;

G. causes and methods of resolving conflicts;

3. The first laboratory for medical psychology in Russia was opened in:

A. 1879;

b. 1885;

V. 1886;

G. 1890;

4. Methods of medical psychology are:

A. ways to study the patient’s personality characteristics;

b. turning to live communication with the subject;

V. observation of the behavior of subjects in a natural situation;

G. all answers are correct;

5. A research method that ensures scientificity and evidence in the study of a particular mental phenomenon:

A. observation;

b. survey;

V. experiment;

G. questionnaire;

6. Observation is a method that allows:

A. carry out selective selection of information about the mental property being studied in conditions of direct and feedback between the person being studied and the subject;

b. obtain extensive information about a person’s biography;

V. identify internal unconscious desires and interests;

G. obtain a quantitative characteristic of a mental phenomenon;

7. Highly formalized psychodiagnostic techniques are:

A. tests;

b. questionnaires;

V. questionnaires;

G. all answers are correct;

8. Tests include methods that meet the following conditions:

A. validity;

b. reliability;

V. standardization;

G. all answers are correct;

9. The testing method involves the use of the following techniques:

A. tests;

b. questionnaires;

V. questionnaires;

G. projective techniques;

10. Psychodiagnostics is:

A. section of medical psychology;

b. the field of psychology that develops methods for identifying and studying individual psychological characteristics of a person;

V. field of applied psychology;

G. all answers are correct;

11. Psychological diagnosis is:

A. the final result of the psychologist’s activity;

b. description and identification of the essence of individual psychological characteristics of a person;

G. identification and description of mental disorders;

12. The purpose of psychological history is:

A. obtaining information about the patient’s complaints;

b. obtaining information about the onset of the disease;

V. identifying the patient’s attitude towards his disease;

G. identifying the patient’s bad habits;

13. Psychological history, unlike medical history, has the following properties:

A. designed to clarify the internal picture of the disease;

b. is a questioning of the patient;

V. collects information about the patient’s life;

G. there are no correct answers;

ANSWERS: 1 -A; 2 -A; 3 -b; 4 -G; 5 -V; 6 -A; 7 -G; 8 -G; 9 -A; 10 -b; 11 -b; 12 -V; 13 -A.

SOLVING SITUATIONAL PROBLEMS

Nursing diagnosis in a patient with stress

Physiological problems: insomnia, pain in various parts of the body, tachycardia, shortness of breath, gastrointestinal disorders (diarrhea, constipation, heartburn, hiccups), sexual disorders, changes in appetite, chronic fatigue, drowsiness.

Psychological problems: mood swings, fears, depression, aggressiveness, thoughts of suicide, nightmares.

Social problems: decreased responsibility, putting things off until tomorrow, unproductive activities, disruption of relationships with relatives and work colleagues.

Spiritual problems: loss of faith, loss of interest in the world around us, in one’s appearance, thoughts of suicide.

Potential problems: risk of developing distress.

Nursing diagnosis in a patient with hypertension

Physiological problems: headache, dizziness, fatigue, palpitations, shortness of breath.

Psychological problems: concern about one’s condition, anxiety, fear of a new hypertensive crisis, fear of death.

Social problems: inability to carry out daily work normally.

Spiritual problems: going into illness.

Potential problems: risk of stroke, risk of injury due to dizziness.

Nursing diagnosis in a patient with gastric ulcer

Physiological problems: acute pain in the epigastric region, heartburn, nausea, belching.

Psychological problems: concern about one’s condition, anxiety, predominantly depressed mood, irritability, fear of malignant degeneration of an ulcer.

Social problems: Difficulty balancing daily life with the need to follow a special diet.

Potential problems: risk of ulcer perforation, gastric bleeding, ulcer malignancy.

Nursing diagnosis in a patient with ischemic heart disease

Physiological problems: attacks of sudden pain in the chest, increased heart rate, shortness of breath.

Psychological problems: concern about your condition, anxiety, fear of developing myocardial infarction, fear of death.

Social problems: inability to normally perform activities related to physical activity.

Potential problems: risk of complications.

Nursing diagnosis in a patient with neurodermatitis

Physiological problems: rash, lichenification of the skin, itching in the affected areas.

Psychological problems: anxiety about your condition, depressed mood, irritability.

Social problems: disruption of relationships with relatives and work colleagues.

Potential problems: risk of exacerbations.

Features of psychological care in geriatric practice

When working with elderly and senile patients, the psychological dominant of age is characteristic - “departing life, “approaching death.” Feelings of sadness and loneliness. Increasing helplessness. Purely age-related changes: decreased hearing, vision, memory, narrowing of interests, increased sensitivity, vulnerability, decreased ability to self-care. Interpretation of the disease only through age, lack of motivation for treatment and recovery.

Features of psychological care for mental patients

When working with mental patients, there are many difficulties due to the closed nature of the department, the impossibility in some cases of normal communication and feedback with the patient, as well as the peculiarities of visiting patients with relatives, since the relatives themselves can contribute to the intensification of painful manifestations in patients.

LIST OF REFERENCES USED

1. Abramova G.S., Yudchits Yu.A. Psychology in medicine: Textbook. manual - M.: LPA "Department - M", 1998.

2. Avanesyants E.M., Rukavishnikova E.E. Psychology and nursing process. - M., 2002.-49 p.

3. Bleikher V.M. Clinical pathopsychology. – Tashkent: Medicine, 1976.

4. Burlachuk L.F., Korzhova E.Y. Psychology of life situations. - M, 1998 - 263.

5. Galperin P.Ya. Introduction to psychology: Proc. manual – M.: “Yurait”, 2000.

6. Karvasarsky B.D. Medical psychology. – L., 1982.

7. Karvasarsky B.D. Psychotherapeutic encyclopedia. – St. Petersburg: Peter Kom, 1998.

8. Karvasarsky B.D. Psychotherapy - M.: Medicine, 1985.

9. Clinical psychology. 2nd international edition/Ed. M. Pere, U. Bauman. - St. Petersburg, M., Kharkov, Minsk: “Peter”, 2002.

10. Kondratenko V.T., Donskoy D.I., Igumnov S.A. General psychotherapy. - Minsk, 1999.-524 p.

11. Kosenko V.G., Smolenko L.F., Cheburakova T.A. Medical psychology for nurses and paramedics. - Rostov n/d., 2002-416.

12. Lakosina N.D., Ushakov G.K. Medical psychology. – 2nd ed., revised. and additional - M.: Medicine, 1998.

13. Maklakov A.G. General psychology. – St. Petersburg: “Peter”, 2001.

14. Myagkov I.F. Medical psychology. M., 2002.

15. Myagkov I.F., Bokov S.N. Medical psychology. Fundamentals of pathopsychology and psychopathology. -M, 1999.-232 p.

16. Polyantseva O.I. Psychology - Rostov n/d., 2002- 416 p.

17. Stolyarenko L.D. Psychology of business communication and management. - Rostov n/d, 2001 - 512s

As one of the areas of general psychology, medical psychology is a scientific field that examines the theoretical and practical medical aspects of psychological disorders in people.

The subject of study of this discipline is the psychology of individuals, which is associated with the identification of factors provoking pathology, prevention, treatment and prevention of diseases. Combining medical and psychological concepts, this area of science plays a special role in terms of preserving physical and strengthening psychological health among the population. What this term means and what niche medical psychology occupies in Russia, we will tell you in this article.

Independent direction of psychological activity

With the advent of the science of psychology, which studies the patterns of the appearance and manifestation of the psyche at different stages of its development, such areas as general and medical psychology arose. And while the general one examines in detail mental functions (their formation and implementation in practical conditions), the medical one studies the functioning against the background of diseases occurring in the human body.

Within the framework of this scientific knowledge, which is an independent field of psychology, work is being done to eliminate factors that cause psychological abnormalities in people, as well as treatment and psychocorrectional effects on the disease. Thus, medical psychology studies the patterns of “work” of the psyche of patients and the activities of medical staff carried out in relation to sick people.

This scientific direction occupies a certain place in medical practice. This is connected with the object of study itself, since medical psychology is aimed at studying changes in a person’s psychological state that arise against the background of pathological deviations.

As areas of scientific knowledge, medicine, general psychology and medical psychology have several points of contact within the framework of this teaching:

Psychological characteristics of the activities of a medical employee in identifying and treating a particular disease.
Corrective methods of influencing the patient’s psyche, used during his treatment.
Psychotherapeutic influence on a person.

This science has a direct connection with various disciplines that represent the basis of medicine (therapy and pediatrics, neurology, obstetrics, speech therapy, etc.). Therefore, it is of no small importance for the training of professional personnel and provides for specific methods of influence within the framework of their practical activities.

The main tasks of psychology in medicine include the following:

Monitoring of psychological individual characteristics of patients.
Assessment of changes in psychological health and functions that arise against the background of pathologies of various types.
Study of the mental sphere of adults and children, which changes with mental, somatic and neurological disorders.
Assessing the significance of impact factors during therapeutic activities, as well as in the diagnosis and prevention of diseases.
Analysis of behavioral activity and the use of professional skills by medical workers during the treatment of people with pathologies.
Assessing and studying the nature of the relationship that arises between the patient and the medical staff who are responsible for diagnosing and treating the patient.
Development of specific techniques and principles that represent the fundamentals of medical psychology and allow for clinical research, the use of correctional methods and psychotherapeutic influence, on which the success of treating patients in the clinic depends.

Within the framework of medical psychology, the main branches of medicine are studied in detail, which play an important role in therapeutic activities, namely:

Signs and symptoms of diseases that allow us to judge the appearance of abnormalities.
Causes and nature of the appearance of pathologies.
Therapy of patients and care for them during treatment.
Prevention and prevention of diseases.
Increasing the resistance of the human body to the effects of pathogenic factors.

In accordance with this, we can identify the main areas that are the subject of study of medical psychology:

1. Mental characteristics of diseases in dynamics.

2. The role and state of the patient’s mental health in the occurrence, course and prevention of disorders, as well as during the ongoing hygienic measures.

3. The significance of the influence of the disease on the psychological state of the patient.

4. The course of development of mental disorders.

5. Techniques, principles and methods of psychological experimental activity in the clinic.

At the same time, not all psychological schools unanimously accept the goals, subject and objectives of medical psychology. For example, some believe that it should cover in more detail the topic of mental disorders against the background of specific diseases.

According to others, the main task of medical psychologists should be to consider the characteristics of the psychological state of patients in order to apply appropriate correction techniques to them. There are also those who consider the task of this science to be the development of special correctional programs for maladaptive therapeutic patterns and maladaptive behavioral techniques.

What questions does scientific research address?

In fact, medical psychology (MP) is divided into two branches, which are engaged in different psychological research and therefore have different tasks. Thus, there are general and private medical psychology, which differ in the areas of scientific activity carried out.

At the same time, general medical care consists of several sections, the subject of study of which is the patterns of psychology of the patient and the doctor, the relationship between them, the characteristics of the medical institution and the nature of the influence of the disease on the patient’s condition. In addition, general medical psychology examines in detail the issues of deontology and hygiene within the framework of ongoing therapeutic activities.

At the same time, the tasks of private medical psychology include the study of the characteristics of the course of diseases and the nature of emerging mental processes, the patient’s conditions at different stages of therapy, and individual aspects of the psyche within the framework of specific deviations. Also, private medical practice examines the characteristics of the psychological background of people with developmental disabilities and defects (blind, mute, deaf), as well as patients suffering from alcoholism and drug addiction.

Thus, we can safely say that in general the subject of medical psychology identifies and studies the objective patterns of functioning of various psychological phenomena depending on the clinical picture of the disease and the treatment process. The MP pays special attention to the peculiarities of the patient’s activity and behavior in the clinic, which can help identify the cause of the disease and increase the success of treatment to preserve the person’s health and improve the body’s resistance to provoking factors in the future.

The development of theoretical and practical techniques and correctional programs for medical psychology was initially carried out by foreign qualified specialists, thanks to whom this scientific branch began to develop as an independent field. This concept became widespread in the West at the beginning of the 19th century, when medical psychologists began to become more actively involved in medical issues, the problems of patients with mental disorders and their interaction with doctors.

Thanks to the practical activities of Western specialists, medical psychology in Russia began to actively develop at the beginning of the 20th century. Currently, a scientific journal of the same name is regularly published, covering the activities of doctors in this field. Also, the textbook “Fundamentals of General and Medical Psychology”, authored by D.A., will help you become familiar with the chronology and stage-by-stage development of this scientific direction, the subject of its study and objectives. Shkurenko.

By studying materials on the development of this scientific area, one can understand that modern medical psychology is divided into two areas related to the use of psychology in clinics of different specializations. For example, one of the areas of MP is associated with the use of correctional techniques in medical institutions for patients with neurological and mental disorders.

And in this case, science considers changes in the patient’s condition against the background of disturbances in the structure or functioning of the brain that have arisen due to acquired or congenital pathologies. The second area of MP has a direct connection with the diagnosis and treatment of somatic diseases that arise due to the influence of mental factors on the somatic processes occurring in the human body.

What methods do industry experts use?

The methods of medical psychology, which are actively used in clinical practice today within the framework of this scientific direction, can be divided into basic ones, which include experimental research and observation, and auxiliary ones (obtaining additional information during questioning and testing of patients, analysis of received materials, etc.) .d.). The final stage of research in which MP methods are used is the writing of an expert opinion based on the results obtained.

For example, testing according to the Wiene-Simon system, aimed at different age categories. These tests help determine the degree of mental development by the number of tasks completed in accordance with the actual age of the person. The properties can be judged by the average percentage of solved problems. And if, as a result of the study, the patient demonstrates an insufficient level of intelligence (less than 70%), this may indicate that he has oligophrenia.

There is another test system (Wechsler), through which it is possible to assess the intelligence and individual characteristics/qualities of adult patients and children. This system consists of 11 points: 6 tests for oral questioning and 5 tests for practical activities (recognition of objects, comparison, systematization, folding of individual elements, etc.).

These are just some of the methods that are used within medical psychology. But it is worth noting that all of them are only an addition to the general clinical picture of the examination and treatment of patients, allowing us to give the most accurate assessment of the personal psychological qualities of the subjects. Author: Elena Suvorova

Subject of study of medical psychology are pathological mental states and processes, psychological factors influencing the occurrence and course of diseases, the personality of the patient in connection with his illness or health and social microenvironment, the personality of the medical worker and the system of relations in the medical institution, the role of the psyche in promoting health and preventing diseases.

Consequently, the main task of medical psychology is to study the patient’s psyche under various conditions.

General medical psychology studies:
1. Basic patterns of psychology of a sick person (criteria of normal, temporarily altered and painful psyche); psychology of a health worker, psychology of communication between a health worker and a patient, psychological climate of relationships.
2. Psychosomatic and somatopsychological relationships, i.e. psychological factors influencing the disease, changes in mental processes and psychological make-up of the individual under the influence of the disease, the influence of mental processes and personality characteristics on the occurrence and course of the disease.
3. Individual characteristics of a person (temperament, character, personality) and their changes in the process of life and illness.
4. Medical deontology (medical duty, medical ethics, medical confidentiality).
5. Mental hygiene and psychoprophylaxis, i.e. the role of the psyche in promoting health and preventing disease.

Private medical psychology studies:
1. Features of the psychology of specific patients with certain forms of disease.
2. Psychology of patients during preparation, carrying out diagnostic and surgical interventions.
3. Medical and psychological aspects of labor, pedagogical, military and forensic examination.

We can single out specific clinics where knowledge of the relevant sections of medical psychology is put into practical use: in a psychiatric clinic - pathopsychology; in neurology – neuropsychology; in somatic – psychosomatics.

Pathopsychology studies, as defined by B.V. Zeigarnik, the structure of mental disorders, the patterns of mental disintegration in comparison with the norm. At the same time, pathopsychology uses psychological methods and operates with the concepts of modern psychology. Pathopsychology can consider the tasks of both general medical psychology (when the patterns of mental disintegration and personality changes in mental patients are studied) and private psychology (when the mental disorders of a particular patient are studied to clarify the diagnosis, conduct a labor, forensic or military examination).

Close to pathopsychology is neuropsychology, the object of study of which is diseases of the central nervous system (central nervous system), mainly local focal lesions of the brain.

Psychosomatics studies the influence of the psyche on the occurrence of somatic manifestations.

Of the entire scope of medical psychology, this manual will focus on pathopsychology. Pathopsychology should be distinguished from psychopathology. The latter is part of psychiatry and studies the symptoms of mental illness using clinical methods, using medical concepts: diagnosis, etiology, pathogenesis, symptom, syndrome, etc. The main method of psychopathology is clinical descriptive.

Goals and objectives of medical psychology. Subject of medical psychology

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Introduction

Medical psychology is relevant and one of the leading branches of modern psychology. Medical psychology is characterized by a close connection between its theoretical foundations and their practical use in solving a wide range of problems of protecting and promoting public health.

- social protection of the population and healthcare. This nature of medical and social work requires special approaches to the training of social work specialists, aimed at developing the foundations of knowledge in the field of medicine and medical psychology.

The close connection between medical psychology and psychiatry is based on the commonality of the object of study, a common understanding of mental illness, manifested by disorders in the reflection of the real world and, as a consequence, disorganization of behavior or its changes.

1. The concept of medical psychology

Conclusion

Literature

Luria A. R. Fundamentals of neuropsychology, M., 1973;

Shklyar V.S. Diagnosis of internal diseases. K., 1960

Introduction to clinical neuropsychology, L., 1973;

Kerbikov O. V., Izbr. works, M., 1971, p. 300--11: About psychohygienic work at school.

Platonov K.I., The word as a physiological and healing factor, 3rd ed., M., 1962;

Psychology Dictionary. / Under the general editorship. A.V. Petrovsky, M.G. Yaroshevsky. - 2nd ed. M., 1990

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