Method for assessing occupational adaptation of mid-level health workers

FIELD: medicine.

SUBSTANCE: invention refers to medicine and medical psychology, more specifically to the occupational adaptation assessment of mid-level health workers. What is involved is psychological testing of professional burnout, family relationship, active calling strategies, and objective functional status. The derived values are used to calculate linear discriminant functions (LDF) as per two assessment rates: LDF1 shows the risk factors of the occupational deadaptation; LDP2 provides stating the high occupational adaptation; the mid-level health workers have been grouped considering the highest LDF with a sign character: LDF(=-604.151-4.550X1+1.021X2+1.270X3-0.203X4-0.142X5+3.136X6+346.786X7+11.566X8; LDF2=-637.127+4.957X1+1.305X2+1.131X3-0.230X4-0.149X5+3.237X6+360.126X7+11.904X8, wherein X1 is assessed by the Independence scale; X2 is assessed by the Family Relationship Establishment scale; X3 is assessed by the PCI Preventive Management scale; X4 is the MBI generalised estimate; X5 is the blood circulation efficiency factor; X6 is the birth-death ratio; X7 is the functional change index; X8 is the stroke volume.

EFFECT: method enables the occupational adaptation assessment ensured by including the objective functional status and mathematical expressions of the regression analysis.

2 ex

 

The invention relates to the field of medicine and medical psychology.

Under the professional adaptation (PA) medical personnel shall mean the process of awareness and mastery of the value orientations of the profession, making components of professional activity (task, object, methods, tools, results and conditions in the provision of medical services).

There is a method of assessment of professional suitability of personnel in the selection of personnel (U.S. Pat. 2245097 Grew. Federation. The way a professional evaluation staff for various activities / E.A. Melnikova - Publ. 27.01.2005 g), including the registration of psychophysiological indicators to detect rough and underlying organic brain lesions, contributing to the pathology of the Central nervous system. Way complement psychological testing, however, it is not presented in a concrete form to the user and to assess its effectiveness is not possible.

There is a method of assessing the level of psychological adaptation (U.S. Pat. 2240031 Grew. Federation. Method of assessment of mental status and level of psychological adaptation of personality / Miroshnik E.V., Chubarov M.M., starinets Û.F. - Publ. 20.11.2004, including the examination of psycho-physiological functions of humans, however, this method does not allow to evaluate the nature of social environments is occurring and active coping strategies, have a significant effect on the process of professional adaptation.

The closest analogue to the claimed method from the prior art is not revealed.

The technical result of the proposed invention is the accuracy and objectivity of the assessment of PA nursing staff who are at high risk of psycho-physiological maladjustment and development of professional burnout, this is achieved by the inclusion of objective indicators of the functional state of the organism and the mathematical expressions of the regression analysis.

The technical result is achieved in that the method of estimating PA nursing staff includes psychological testing personnel, followed by the generic assessment results, impose additional objective indicators of the functional state of the organism and on the basis of the received data calculated linear discriminant functions (LDF), corresponding to the two grades of severity PA: LDF1- there are risk factors disorders PA; LDF2- high level of PA, choose the LDF with the highest value (with regard to algebraic sign), which indicates the likely degree of impairment of the PA.

The proposed method is as follows.

It is established that the formation of PA promote individual is s, interpersonal and professional factors. Introduction to generalized assessment of PA indicators of the functional state of the organism and create conditions for the objectivity of the assessment and expand opportunities to investigate the risk factors of violations of the PA.

General evaluation test "Professional burnout MBI (Est MBI) was determined by the formula (Assessment of professional burnout among health care workers / Viewdemo, Iaeaoea, Aigulin, Weapon. Voronezh: SPb.: Polytechnic-service, 2009. 82 C.):

OC MBI=EI+D-RLD,

where EI - emotional exhaustion MBI test;

Dr. depersonalization test MBI;

RLD is the reduction of personal achievement test MBI.

Family relationships were studied using a questionnaire Scale family relations" (SSO)developed R.H.Moos and adapted Vcher and Sujopryntys. Estimated scale of "Independence" and "family relationships" (Evdokimov V.I. Quality of life and professional success of flight personnel. M., 2001. 104 C.).

Active coping strategies were studied using a questionnaire Proactive coulduse behavior" (PCI) in the modification Eszterhas. Evaluated the scale Preventive coping (Starchenkov Y.S. Concept of proactive coping behavior, " Vestn. S. St. Petersburg. Univ. Ser. 12: Psychology, sociology, pedagogy. 2009. Issue 3, part 1. S-204).

The condition of the body for paramedical p is rsonal was determined using the functional coefficients (Aulic .. Determination of physical performance in the clinic and in sports. M.: Medicine, 1990. 191 S.; Baevsky R.M., Berseneva A.P. Assessment of adaptive capacity and the risk of developing diseases. M.: Medicine, 1997. 231 S.):

- coefficient of efficiency of the circulatory system (CECS):

KAC=HR (HELLSyst.- ADdust.),

where HR is the heart rate at 1 min;

HELLSyst.- systolic blood pressure, mm RT. Art.;

HELLdust.- diastolic blood pressure, mm RT. Art.;

- life index (LM):

LM=M/MT,

where VC - vital capacity, ml;

MT - body weight, kg;

- index of functional changes (IFS):

IFS=0,CS+0,ADSyst.+0,ADdust.+0,W+0,MT-0,R is 0.27,

where HR is the heart rate at 1 min;

HELLSyst.- systolic blood pressure, mm RT. Art.;

HELLdust.- diastolic blood pressure, mm RT. Art.;

In age, years;

MT - body weight, kg;

P - growth, cm;

0,27 - free rate equations;

- stroke volume of the heart (PP):

UO=90,97+0,ADthe heartbeat.- 0,UDdust.- 0,V,

where the HELL isthe heartbeat.pulse, blood pressure, mm RT. Art.;

HELLdust.- diastolic blood pressure, mm RT. Art.;

In - age, - years.

Step-by-step selection discriminant analysis : open ofany two models of linear discriminant functions (LDF): LDF 1- there are risk factors disorders PA; LDF2- with a high level of PA. Reliable considered the inclusion in the model signs at 70%, or at p<0,3. The model was statistically significant (p<0.001) and classification capable of 83.6%.

Characteristic values of LDF identified in the survey, were substituted into the equations and summarized with regard to sign. Nurses attributed to the group for which data LDF was the greatest. The characteristics of the models and their coefficients are summarized in the formula:

(1) LDF1=-604,151-4,550X1+1,H2+1,H3-0,H4-0,H5+3,H6+346,H7+11,566X8;

(2) LDF2=-637,127+4,957X1+1,H2+1,H3-0,230 X4-0,H5+3,H6+360,H7+11,H8,

where X1- assessment of the scale of "Independence" SSO;

X2- assessment scale Organization of family relations" SSO;

X3- assessment scale Preventive overcoming test PCI;

X4- overall assessment test MBI;

X5- coefficient of efficiency of blood circulation.

X6- living index;

X7- the index of the functional changes;

X8- stroke volume of the heart.

The method allows to objectively identify the degree of impairment of PA, assess their severity and, thus, to more focused psycho-preventive work among cf is the last of the medical staff on the prevention of the development of their violations of professional adaptation, reduce the effectiveness and reliability of professional activity.

The presented method is illustrated by examples.

Example 1. Clinical laboratory S., age - 47 years experience - 26 years. Performance scales: X1- 3; X2- 5; X3- 23; X4- -5; X5- 3800; X6- 42; X7- 2,41; X8- 56,9 introduced in formulas (1) and (2) and the resulting LDF1=530, LDF2=526. Clinical laboratory technician assigned to the group LDF1- there are risk factors for violations of the PA. It is worth noting that according to expert estimates, this clinical assistant was assigned to the 1st group (average score adaptation -4,2). The distribution of the clinical laboratory in the LDF group1contributed to the functional state of the organism, which can be interpreted as a significant voltage physiological reserves.

Example 2. Nurse M, age - 30 years experience - 11 years. Performance scales: X1- 4; X2- 8; X3- 31; X4- -31; X5- 2340; X6- 62; X7- 1,88; X8- 56,5 introduced in formulas (1) and (2) and the resulting LDF1=535, LDF2=537. The nurse assigned to the group LDF2- high score PA. Expert assessment of occupational adaptation of the nurses was high and amounted to 5 points (5-point evaluation system). It was noted low scores psychological determinants professionalnogo the burnout, expressed active coping strategies and optimal functional reserves of the organism.

The method of evaluation of professional adaptation (PA) nursing staff, including psychological testing professional burnout, family relations, active coping strategies, objective indicators of the functional state of the organism and on the basis of the received data calculated linear discriminant functions (LDF), corresponding to the two levels of assessment: LDF1- there are risk factors disorders PA; LDF2- high level PAS, nurses attributed to the group for which data LDF with regard to algebraic sign was nebolsine:
LDF1=-604,151-4,550X1+1,H2+1,H3-0,H4-0,H5+3,H6+346,H7+11,H8;
LDF2=-637,127+4,957X1+1,H2+1,H3-0,230 X4-0,H5+3,H6+360,H7+11,H8,
where X1- assessment of the scale of "Independence" SSO; X2- assessment scale Organization of family relations" SSO; X3- assessment scale Preventive overcoming test PCI; X4- overall assessment test MBI; X5- coefficient of efficiency of blood circulation; X6- living index; X7- the index of the functional changes; X8- stroke volume of the heart.



 

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4 ex

FIELD: medicine.

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1 dwg, 2 ex

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3 ex

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1 tbl, 2 ex

FIELD: medicine.

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FIELD: medicine.

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8 dwg

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5 dwg, 4 tbl

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2 tbl, 1 ex

FIELD: medicine.

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2 tbl, 2 ex

FIELD: medicine.

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FIELD: medicine.

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FIELD: medicine, neurology.

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EFFECT: higher accuracy of diagnostics.

1 ex, 1 tbl

FIELD: medicine, pediatrics.

SUBSTANCE: the present method deals with predicting deviations in psychic disorders in small children to detect initial manifestations of psychic disorders in children aged 1 mo - 3 yr. A child undergoes diagnostic tests to study 5 spheres of psychic activity: sensorics including the studying of vision, hearing, reflector tactile sensitivity and individual tactile sensitivity; emotions; the sphere of gnosis including the studying of attention, expressive and impressive speech, peculiarities of one's thinking; in behavioral sphere one should evaluate biological behavior that includes alimentary behavior and one's skills to be neat, and, also, social behavior that includes the development of "mother-child" system and communication with alien people, moreover, for every age period there are 20 test questions and each task is evaluated by 5 points, then one should determine the coefficient of psychic development (CPD) by the following formula: CPD = Σ (+ n), where Σ (+ n) - the sum of points for all fulfilled age tasks and at CPD being equal to 90 - 110 points one should detect normal psychic development, at CPD being equal to 80 - 89 and 111 points and higher the risk for the development of nervous-psychic pathology is detected and at CPD being equal to 79 points and less one should state nervous-psychic development as affected.

EFFECT: higher quality of diagnostics.

4 ex

FIELD: medicine, medicinal psychology.

SUBSTANCE: one should test a patient by seven scales: frequency, duration, intensity, sensor perception of pain, emotional attitude towards pain, neurotization level, adaptation capacity level to evaluate the results obtained by the scales mentioned from 0 to 6 points. Moreover, the scales for sensor perception and emotional attitude, the levels of neurotization and adaptation capacity should be evaluated in accordance to the Tables given in description. Additionally, one should, compare the degree of psychogenic constituent of pain according to chromatic choice made by a patient depending upon, at least, three choices of pain intensity: "pain during testing", "no pain", "severe pain" in accordance to the Tables given in description. Then, according to the results of testing one should evaluate the degree of patient's pain feelings both quantitatively and qualitatively. Moreover, by the scale of frequency the appearance of pain should be evaluated from "pain appeared once during several days or rarely" to "constant pain". By the scale of duration pain should be evaluated from "momentary pain" to "constant pain". By the scale of intensity the pain should be evaluated from "very weak pain" to "unbearable pain". By the scale of neurotization level one should take into account basic behavioral factors, such as anxiety, emotional lability, aggression, depression, psychogenia, hypochondria. The present innovation enables to increase significance in evaluating pain achieved due to broadened verbal description of patient's pain feelings.

EFFECT: higher accuracy of evaluation.

5 cl, 4 dwg, 2 ex, 17 tbl

FIELD: medicine, psychotherapy.

SUBSTANCE: the method deals with correcting neurological and psychopathological disorders with anxiety-phobic symptomatics due to individual trainings. The method includes evaluation of body reaction to stimulating signals, seances of individual training performed due to the impact of two quasiantipodal stimulating signals of similar physical modality applied in time of sporadic character, and as a signal one should present biological feedback for the altered value of physiological parameter adequately reflecting body reaction to the impact of stimulating signal. At the first stage of training it is necessary to achieve body adaptation to the impact of quasiantipodal stimulating signals, at the second stage it is necessary to obtain conditional reflex for one out of stimulating signals, for this purpose one should accompany this stimulating signal with discomfort impact, during the third stage, finally, due to volitional efforts one should suppress body reaction to stimulating signal. The devise suggested contains successively connected a transformer of physiological parameter into electric signal and a bioamplifier, an analysis and control block with a connected block to present the signals of biological feedback, a block for presenting discomfort impact, an indication block and that of forming and presenting quasiantipodal stimulating signals. The innovation enables to have skills to control one's emotions, decrease sensitivity threshold to environmental impacts and learn to how behave during stress situations.

EFFECT: higher efficiency of training.

15 cl, 8 dwg

FIELD: medicine.

SUBSTANCE: method involves measuring patient weight, recording age and sex of the patient. The patient is positioned in front of computer display unit. The data are inputted into the computer comprising software containing a program for estimating organism organs and systems condition. The following organs are detected. Lung, spleen, heart, kidneys, liver are proved for having deviations from norm with negative sign towards hypofunction or with positive sign towards hyperfunction. The data are displayed with the program on the screen as a table with reference and current values being shown in relative units with plus or minus sign. Canal states are estimated from detected organs being under maximum stress on the basis of infogram: lung canal P, spleen - canal RP, heart - canal C, kidneys - canal R, liver - canal F. When estimating organ state with deviation having plus sign, that means hyperfunction, canal state is estimated as having energy excess. When organ state deviation has plus sign, that means hyperfunction, canal state is estimated as having lack of energy. Eye diseases are diagnosed from state of organs and canals of P, RP, C, R and F. Hyperfunction in organ and excess in canal being available, initial ophthalmic disease stage is diagnosed. Hypofunction in organ and deficit in canal being available, chronic ophthalmic disease stage is diagnosed.

EFFECT: wide range of functional applications.

3 cl, 7 tbl

FIELD: medicine.

SUBSTANCE: method involves carrying out situation, planning, self-control and correction analysis. Volitional effort is included into functional self-organization process structure components. Functional self-organization process structure components characterize the following individual human specific characteristics: 1) goal-setting as taking and retaining aims; 2) situation analysis as revealing and analyzing circumstances essential from the point of view of achieving the set goal; 3) planning as scheduling private activity; 4) volitional effort as changing private activity sense; 5) self-control as controlling and estimating private actions; 6) correction as adjusting private goals, situation analysis, plan of actions, private activity sense, estimation criteria and self-control forms. Human self-organization process structure diagnosis is set after relaxation training aimed at relieving emotional effort and overfatigue. The relaxation training is exercised in coachman position with calming musical accompaniment and comprises the following stages: 1) respiratory exercises (inspiration duration is equal to expiration one, breath is hold between the inspiration and expiration for a time twice as short as inspiration time) 4 min long; 2) relaxation exercises (invoking heaviness and warmth sensation) of head, arms, legs and body -8 min long; 3) rest in maximum relaxation state - 4 min long.

EFFECT: high accuracy of diagnosis.

3 cl, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves showing sequence of two luminous pulses of 10 ms duration separated by 150 ms long pause. The pulses are repeated in constant 1.5 s long interval. Pause duration between two luminous pulses is reduced at the first measurement stage at constant speed of 20ms/s until a testee fixes fusion of two luminous pulses into single one in subjective assessment mode. Pause duration between two luminous pulses is increased at the second measurement stage with given constant step of 0.4 ms until the testee identifies the moment of subjective perception of two luminous pulses separation. Pause duration is reduced in discrete mode with given constant 0.1 ms long step at the third measurement stage until the testee identifies the moment of subjective perception of two luminous pulses fusion into single one. Human vision system persistence time is determined to be equal to pause duration between two luminous pulses when subjective fusion into single pulse takes place at the third measurement stage.

EFFECT: high accuracy in determining human vision system persistence time.

3 dwg

FIELD: medicine.

SUBSTANCE: method involves asking patient to tell or write down 5-7 novels. Rhetorical structure representations of the novels are built. Rhetorical structure mean depth being greater than 8, branching index being greater than 88 and occurrence of relations like sequence and consequence being less than 8, cognitive source relation being greater than 5, opposition relation being greater than 2 per 100 discourse units, neurotic disorder is to be diagnosed.

EFFECT: high accuracy of the method.

2 dwg, 1 tbl

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