Method of medical-psychological adaptation of railway employees

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to preventive, rehabilitation, railway medicine, general medical (family) practice, neurology and psychotherapy, and can be used for prevention of stress and pre-stress states, as well as consequences of uncompensated stress response of railway transport employee's organism irrespective of character peculiarities of stressor or stressors. Employee's anthropometric parameters are measured: height, weight, chest circumference, index of cardiovascular system activity - pulse. Individual digital series (IDS) of RW transport employee is calculated on the basis of obtained data. Employee gets acquainted with method of IDS calculation and session of psychotherapy, during which employee in convenient position, relaxed state sits in front of computer screen and whispers IDS, is started, with IDS periodically displayed on screen, to finish the session employee makes quiet deep inhalation and exhalation.

EFFECT: method makes it possible to ensure medical-psychological adaptation of railway transport employees.

5 cl, 1 ex

The invention relates to medicine, namely to preventive, restorative, railway medicine, General medical (family) practice, neurology and psychotherapy, and can be used for the prevention of stress and prestressing States, and the consequences that result from uncompensated stress reaction of railway employees regardless of the characteristic features of the stressor or stressors.

The urgency of the problem of improving approaches to individual medical and psychological adaptation of railway workers caused by uncompensated stress reactions in the body, is great. At the present stage of development of railway transport in the conditions of new technologies and materials significantly increases the relevance of the problem of safety, improving individual health and psychological samonadymannuy and prevention of safety of railway workers, directly associated with stress and disease.

The main efforts of the railway medicine is aimed at an organization to provide professional security, the establishment of such medical and psychological conditions that meet the requirements of the preservation of life and health W is leznodorozhny employees in the course of their work. One of the main strategic directions is the ordering of all activity and the establishment of comprehensive programs on the basis of chemoprophylactic, government protection of their health, i.e. the creation of individual programs and systems safety, which would take into account and seamlessly integrate all aspects of protecting the health and lives of railway workers.

According to the world health organization, 45%-55% of all illnesses are due to stress, and some experts believe that in a stressful situation daily fall ⅔ of the population of the planet. The international labour organization (International Labor Organization) estimates the losses resulting from occupational stress in two hundred billion dollars annually. The study of the International Association of stress management (ISMA), conducted in the UK showed that occupational stress in the course of the year felt more than 64% of the respondents, however, only 14% of them were assisted, and 78% had not received any professional advice. According to world statistics, occupational stress (the stress associated with the performance of professional duties) was the cause of personality disorders (40%), nervousness (47%), endogenous psychosis (13%).

The genetic weakness and failure of the acquired skills of struggle and stress which causes the body of railway employees to the negative manifestations and reactions what is the reason for the development of stress diseases (Hypertension, Coronary heart disease, peptic Ulcer and 12 P.K., Bronchial asthma, skin diseases, allergic diseases, neuroses, psychoses, depression, fatigue syndrome and so on).

Future economic and geopolitical position of Russia is determined, including the number and professional competence of railway workers, willingness to self-realization and self-regulation of behavior. Thus, the public order of society, modern market economy with high demands for such professional and personal qualities as adaptive abilities of a professional railwayman and his stress levels.

The computer is an essential accessory of modern railroads. Computers have become faithful helpers in the work of managers of freight and passenger traffic, ticket cashiers, supervisors RZD different levels, etc. as in the conventional production conditions, and in a typical home environment. Each of them uses a computer at work and at home, experiencing daily several times a day exposure to all kinds of compensated and uncompensated stressors. To reduce or avoid negative impact on activities.it is the motion of the body as a physiological stressors, and psychological character, using the computer at the workplace or at home, this is a great opportunity for each railroad. Reducing the negative impact of stressors on your body, Manager, ticket cashier, etc. will be able to improve not only their quality of life and longevity, but the quality of his work, therefore, reduce their safety and the safety of passengers.

In General, however, questions the effectiveness of preventive and remedial medical interventions, psycho anti-stress methods using mathematical information-digital computer models based on individual anthropometric and physiological indicators of worker, studied insufficient or non-existent in the railway system of preventive medicine.

Closest to the proposed method the methodology currently exists as whether computer preventive program for dealing with stress or indirect psychotherapeutic method of increasing stress tolerance, they are all shared similar for all patients according to the method and type of impact and have nothing to do with the use of individual anthropometric parameters of the employee and his physiological is pokazateli.

Achievable with implementation of the proposed method the technical result is the provision of medico-psychological adaptation of railway workers. The effectiveness of the proposed method is based on the individual interest and responsibility of railway employees for preventive sessions, as well as by reducing the average frequency of stress reactions stress on psychological and physiological attacks, self-monitoring of the status of the level of stress and your health with increased personal and social stress safety.

The developed method is the individual preventive courses on the prevention of emotional breakdowns and self-control enhance stress tolerance and inclusion in the course mediated psychotherapy - training using a variety of methods, the emotional-volitional relaxation and breathing exercises.

Mediated psychotherapy includes: psychological impact, deliberately raising the self-esteem of railway employees, using play at least four types of physiological conditions associated with satisfaction the leading types of physiological and social need to the needs of (in security; freedom and independence; in goal achievement and self-realization; approval, recognition and love, family and others), and then dynamically and verbal fixation resulting psychophysiological States; indirect subliminal psychological impact of increasing the motivation of employees to improve stress resistance; psychological effects that enhance the skills of psychophysiological self-regulation and solving to stress the most disturbing employee problems.

Emotional stress is largely caused by violation of satisfying the current needs. To meet their key needs and reduce the impact of stressors employee of a railway transport it is important to change or extend its repertoire of methods focused cognitive and behavioral response that is possible only together with improve its self-esteem.

In order to help the employee of a railway transport to improve self-esteem, it is proposed to induce his memories of situations in which he, after a period of its activity meets any of the leading needs. During such memories is reproduced corresponding to this need comfortable psychophysiological state. His many who fold repeat in conjunction with adequate associated with individual digital phrase and gesture leads to the formation of the conditioned reflex. The repetition of individual digital phrase and gesture in the future in and of itself is associated and helps to reproduce the specified comfort and improve confidence of railway employees is that it can reach such a state, that is, his self-esteem. At the same time an employee of a railway transport learns to change the slightest sign of discomfort state in the corresponding comfortable condition in professional and everyday life in dealing with any small, seemingly everyday tasks that establishes a high level of self-esteem based on the acquisition of new experience.

Depending on the semantic orientation can be roughly divided into four types of leading medical and social needs: 1 - the need for security in isolation from the stress of the object that is implemented by suppressing its aggression and its invisible care or escape from obstacles; 2 - the need for freedom and independence from others and the environment, implemented by active-aggressive confrontation and getting rid of a stressor and release your own personal internal and external space; 3 - the need for self-realization and achievement of objectives, implemented through their own stress management object and its active-aggressive is the change; 4 - the need for approval, acceptance and love from family and others, implemented by suppressing aggression, expressing their benevolence and rapprochement with the social environment. Depending on what the needs of railway employees is leading and how the emotional-cognitive-behavioral response he prevail, there are four personality types.

The satisfaction of physiological and social needs is accompanied by the emergence of different psychophysiological States differing by its own characteristics vegetovisceral, neurohumoral, neuromuscular control. With this in mind self-esteem are encouraged to use play at least four types of physiological conditions associated with satisfaction the four basic types of medical and social needs. The employee of a railway transport associated stimulates memories of situations in which he felt a sense of one's own attractiveness, success, independence, and security. Dynamic (using the same type adopted a relaxing posture and calm breathing, sitting at the computer) and verbal (using monotonically mental repetition of individual d / the th row) conditioned reflex aggravation of confrontation between the effects of different stressors will contribute to the stabilization of positive self-esteem, that is, the assessment of their abilities to interact successfully with the environment, while also meeting the corresponding need for heightened stress safety.

Motivation to increase efficiency, improve attention, sleep, improve their own health is of particular importance for the railway workers, who usually don't believe in all these things and so do not expect it and do not make active efforts to achieve it. In addition to unbelief in his power passivity of railway workers also often contributes unconscious conditional inevitability of one disease or another. To increase the motivation to strengthen their health, improve sleep, and increase efficiency is to link the conscious and the subconscious of railway employees sensations, emotions and thoughts related to health status, sleep, attention and performance with other sensations, emotions, images and thoughts related to the satisfaction of any of its actual needs, i.e. to achieve a very important task. Such a connection can be set using informed regularly associated indirect suggestion. You must help a railwayman to form p is zestawienie about his state of health, that is, to consciously feel the feelings, emotions, thoughts, whom he defines it. Targeted self-training, self study and prevention of stress security helps to reduce severity production of emotional stress and in a broad sense is a skill psychophysiological self-regulation.

Especially important is the learning and training of railway workers skills of self-observation. Improving the skill of self-observation and observation of the world contributes to the improvement of the adequacy of responses, and learning purposeful perception is not only negative, but also positive signals from the external and internal environment of the body allows you to increase the weight of positive emotions in the psychological state, reducing the share is negative.

For the subconscious correction of cognitive style response possible learning positive thinking. Replacing negative thoughts and beliefs into positive also leads to a decrease in the intensity of negative emotions and reduced severity of emotional stress. The railwayman consciously aims to improve anti-stress safety: the ability to act effectively in extreme and challenging professional and domestic conditions is; the ability to relax and focus at the right moment; conserving strength and quick recovery; freedom and independence from circumstances. This goal allows an employee of a railway transport to enhance their abilities to realize their desired activities and to diversify the ways of its achievement. This independently produced and permanently fixed skill allows you to increase the efficiency of solution of many professional and life's problems and thereby reduce the level of emotional tension, as well as regularly resorting to rethink the events of his recent past (from one hour to several days), the employee of a railway transport reduces the adverse effects experienced emotional and psychological trauma.

The proposed method is as follows. Carry out the measurement of anthropometric indicators of employee RZD - height, weight, chest circumference; measure of the performance of the cardiovascular system - the heart rate. On the basis of the received data to calculate individual digital number (DDI) of the employee by the formula:

DDI=((β×(r+o+v)+γ×(r+o+v)):ρ/n):g,

where P is the individual rate of birth date in the form "xy", x - date of birth, and y is the month of birth of the employee,

γ - individual coefficient year of birth,presents a four-digit number, year of birth of the employee,

r - the patient's height (cm)

o - circumference of the chest of the patient (cm)

v - weight of patient (kg)

ρ - pulse (BPM) of a patient, measured in the morning after 5-7 manpole Wake,

n - step-down age factor: at the age of 30 years (n=1; 30-39 years n=2; 40-49 years n=3; 50-59 years n=4; 60 years and older n=5,

g - lowering professional factor for women g=2, for men g=3.

The employee is introduced to the calculation method of DDI. Then begin a psychotherapy session.

The main thing - to realize their choice, their freedom and responsibility. The introductory part. The railwayman sits in front of his computer at the workplace or at home. Posture should be comfortable, muscles relaxed. He must be configured: a sober assessment of the situation, the desire to contribute to the success of the medico-psychological adaptation of railway workers, relieve stress tension or to warn the upcoming stress that may occur during the execution of a particular work (a report from the chief, will perform heavy physical or mental work, computer work continues for at least an hour, you need to deliver passengers or cargo without incident and on time and so on).

The main part. The railwayman configures your breath and breathing evenly in a calm those who is. Worker speaks in a whisper their individual digital number, which is periodically displayed on the screen of his computer. The playback procedure must be repeated 2 times per day depending on the time he spends at the computer. The process is mediated relaxation of 1.5-3 min of Elementary exercises for indirect impacts their individual digital near consciously on my mind is monotonous, even at a leisurely pace repeating in a whisper within 1.5-3 min in a strict sequence of their individual digital number. To run hidden adaptive-compensatory capacity that is sufficient. Preferably the use of individual digital number for 1.5-2.0 hours before bedtime will help to improve sleep, attention and memory after 4-6 weeks after the start of the prevention program.

The final part. 1.5-3 min manages to repeat his individual digital series about 35-40 times (the number of repetitions to calculate optional). The employee makes a quiet deep breath and exits the program before their normal professional duties.

Instructions for use of individual digital number.

1. The railwayman got their own individual digital number, therefore, his consciousness can and is able to learn to control and manage their emotions and stress.

2. Developed methodology shall be used to prevent the development prestressing and stressful situations, to adapt the railway workers: with the upcoming implementation or performing heavy physical work; with the upcoming implementation or execution heavy mental work; when preparing for athletic or other competitions, contests, speeches, reports, responsible meetings, negotiations and so on; if the employee's increased emotional or physical tone, he is irritable and short-tempered, especially with family and friends; the worker is difficult to collect my thoughts, it all goes wrong, it is difficult to adjust themselves to implementation will likely not pleasant work, but it should be done; the worker a bad dream, he is irritable, he feels that he breaks down, he begins a depression, personal digital number is his chance. To improve memory, adaptive-compensatory abilities of the body it is necessary to use personal digital next. In developed conflict situation, it is necessary to concentrate and choose 1.5 to 3 min and take advantage of the individual digital next and then you will find the correct way out of this situation. Individual digital number will help to improve the physical condition is, to overcome frustration, fatigue, emotional and moral weight before the upcoming or already an accomplished event. Individual digital number will help the employees of the Railways to properly assess the surrounding world; to reduce the chance of becoming hypertensive, lady's finger, asthmatic, neurotic, psycho, etc.; get rid of complex fatigue.

3. The digital correction of a number of desirable once during the season (summer, autumn, winter, spring).

4. Use of personal digital near without correction for over three months is not desirable.

5. The method preferably the first 1.5-2 weeks to use every day, 2 times a day for 1.5-3 minutes (you can exclude Saturday and Sunday), and in the following only two times a week.

6. If weight, height, chest circumference worker remain constant, the individual digital number is adjusted only by changing the pulse, if you change the weight, you need to re-use the digital code to run the program and get all their anthropometric data in strict sequence, height, chest circumference, weight (new), pulse, and to obtain a new individual digital number.

7. Pulse is an indicator that changes constantly. To measure it in the morning after waking up, sitting up in bed. If the daily differences in heart rate (measurement of the case is conducted in the morning after waking up, sitting alone) differs 6-10 strokes per minute, the digital number can not be adjusted, if more than 10 beats is desirable to adjust, as shown in paragraph 5.

Detailed description of the results of the application of the method.

Validation and testing of the invention "Method of medico-psychological adaptation of railway workers" took place in the context of the Institution of the Russian Academy of medical Sciences Institute of medical-ecological problems of the North" (IMAPS RAMS) in Murmansk, which saw 100 patients of the employees of the Railways, which with the preventive purpose it was required to increase stress resistance. Testing and the test was conducted with the financial support of the Government of the Russian Federation "Fund of assistance to development of small forms of enterprises in the scientific-technical sphere", SC No. R/9021 from 28.12.2008, state registration of computer programs certificate No. 2010611504, registration number R & d 01200951860. Diagnosis associated with stress, was defined according to the International statistical classification of diseases, tenth revision (F40-F48) with regard to the diagnostic criteria of the International Association of stress management (ISMA). Along with clinical and neurological and standard laboratory and instrumental diagnostic survey was carried out psychodiagnostic examination. Conducted polysomatism research is s, representing a variety of kardiointervalografii with the subsequent mathematical analysis of the data in a special program.

Depending on the degree of change in heart rate (heart rate) in terms of behavioral temporal segments all subjects were divided into four groups. The first group were classified as subjects, in which the heart rate was slightly increased (p<0,05). Men in this group was 5, and women 15. The second group of men (10 people) and women (20 people) was presented to subjects in which the heart rate increased significantly (p<0,001), but not exceed 90 beats per minute. The third group presents subjects with fluctuations of heart rate in the range from 90 to 100 beats per minute (5 men and 15 women). In the fourth group of subjects heart rate exceeding 100 beats per minute, and it was represented only by men (30 people).

In accordance with the recommendation of the who expert Committee (2000) changes in heart rate and registered kardiogemodinamicheskuyu manifestations in the first and the second group was regarded as the norm, with the third as the "danger zone" and the fourth as changes characteristic of the stress response.

In the description of the results of the application of the method provides data concerning only the third and fourth groups, as in prognostic terms, they are of the greatest interest. In men with type of reaction, rate is audace as the "danger zone", kardiogemodinamicheskuyu changes occur already at the stage of "afferent synthesis and characterized by a significant increase in heart rate (p<0,05). At subsequent stages kardiogemodinamicheskuyu change continue to grow, reaching the greatest shifts in "socially significant" activity: heart rate increases by 30%. The data obtained indicate that, despite a significant reduction in heart rate, stress response in men continues to grow, reaching "dangerous" values.

In women with changes kardeogemodyinamiki characteristic of the "danger zone"on stage "afferent synthesis, increase in heart rate by 20% (p<0,05). The maximum deviation curves of the examined patients observed at the stage of "decision making" and "success" by 38%. Thus, the increase in heart rate to values characteristic of the "danger zone"that occurs in men amid the stress response. Men show notes and more appropriate behavior than women. However, the importance of heart rate in women is more pronounced than in men. This feature kardiogemodinamicheskuyu mechanism to ensure the heart rate to a certain extent, can be attributed to women with this type of reaction kardeogemodyinamiki to the group of "at risk" for complications that are the result of stress reactions of the organism.

In the study, only men (30 people) Rea is irout increase heart rate to values, typical stress response (100 beats per minute or more). In this case kardiogemodinamicheskuyu providing heart rate is characterized by stability. The greatest intensity changes kardeogemodyinamiki marked by "socially important" activities. Changes in heart rate remains significantly high and in the recovery period. Evidence suggests that men with increased heart rate to values characteristic of the stress response, kardiogemodinamicheskuyu the attitudinal time steps maximum mobilization of blood circulation apparatus. Therefore, men with these kardiogemodinamicheskuyu manifestations that occur in response to emotional stress, due to the "socially significant" activities should be considered "at risk" for complications that are the result of stress reactions of the organism.

All groups identified the types of adaptive responses at the time of the study, at 2-3 days (the period of formation of urgent adaptation), 5-7 days (the interim period) and a period of more than 11 days after receipt stress injury (formation of long-term adaptation).

The pattern of "decompensation" were classified as: stress medium, low and very low levels of reactivity, reaction activation very low level is her reactivity, reaction training very low levels of reactivity; the pattern "subcompensation": stress high levels of reactivity, reaction activation low levels of reactivity, reaction training medium and low levels of reactivity; the pattern of the "compensation": activation reactions of high and medium levels of reactivity, reaction training high levels of reactivity.

The analysis of reactions in the intermediate adaptation period (5-7 days) showed the important role to predict the outcome of extreme conditions. So stress response came back to normal and amounted to: in the development of reactions to the pattern of "decompensation" stress response - 66,8%, pattern "subcompensated" stress response - 88,4%, the pattern of "compensation" stress response - 100%. Therefore, the definition in the interim period of adaptation reactions I and II of the pattern is an adverse prognostic feature and requires additional comprehensive medical and preventive measures with the mandatory inclusion complex emotional stressthere.

When analyzing the duration of the stress response of railway workers noted that with the development of reactions to the pattern of "compensation" in the interim period of adaptation, the average recovery period is much smaller and made up 15.0±5,0 min "subcompensated" - 30,0±10,0, "decompos the tion" - 45,0±27,0 (p<0,001). The railway workers who use "Method medico-psychological adaptation of railway workers", set: reducing irritability, temper, fatigue; improved sleep, memory; increased efficiency; disappeared apathy, have confidence in their own abilities, etc.

To study the psychological characteristics of railway workers used an abbreviated multifactor questionnaire for personality research (TAR) in adaptation VP Zaitseva, vosmiruchevoj lüscher test. Level of depression was determined by the scale of Zhang. Test of Spilberger Hanina revealed the increase or decrease of reactive and personal anxiety. The said examination was performed before and after a three-week course of application of the developed methods.

When assessing the immediate results of increasing stress safety take into account the dynamics associated with stress, change of parameters of mathematical analysis pulsogram and results of psychodiagnostic testing.

The degree of normalization of relations between ergotamine and triotropium autonomic effects were determined on the basis of an integrated assessment of the dynamics of indicators of the provisional mathematical analysis of heart rate and was estimated cucumerina (1 point) or insignificant (0 points). Changes in the psychological state of the employee is assessed as a significant improvement (1 point) or marginal improvement (0 points) based on the results of clinical observations of a railwayman, and comparative analysis of the performance of the test RESINS and after a course of application of the developed methods.

General assessment of the effectiveness of stress resistance improvement by the end of the year of application of the developed technique was carried out based on the number of those of the listed parameters that have undergone significant improvement, and implemented on a 5 - point scale (0 points - no improvements, 4 points - a significant improvement).

When assessing differences in the indicators used student test t for related and unrelated samples, as well as nonparametric test Mann-Whitney (criterion of homogeneity T). Evaluating the significance of differences share (%) was produced according to the method of the angular transformation Fischer. To study the dependence between random variables was determined by Pearson correlation coefficient.

When analyzing the dynamics of indicators of the test RESINS workers found a significant decrease of the values of the first, second, third, sixth, and seventh basic scales after application of the developed technique. By reducing the "neurotic tilt" and slimming the Express lift to the sixth and seventh happened smoothing of the General configuration of the average personality profile, reflecting a tendency to decrease emotional stress, increase overall behavioral activity and improve health-psychological adaptation of the employees of the Railways for all groups. According to the integral evaluation of the results of all used psychodiagnostic methods, a significant improvement in psychological status after the course was noted in 85% of employees.

The results obtained indicate that the railway workers after preventive course there was a significant, increase physical endurance, improve the functional state of the autonomic system and the reduction of emotional stress, which testifies to the effectiveness of the proposed method "Method medico-psychological adaptation of railway workers".

One of the possible mechanisms of therapeutic effect may be caused by the use of mediated psychotherapy optimization of the functional state of regulatory systems of the brain. These data are consistent with the view according to which mediated psychotherapy load capable of modulating the level of excitability of the various parts of the brain, to change the nature of the neuroendocrine, vegetovisceral reactions, destabilizing Pato is logicheskie hyperactive neuronal systems, responsible for chronic stress exposure. Restoration of natural patterns of afferent flow and normalization of the functional state of the Central nervous system contributed to the special attention he was focused to improve the ability of the railway workers to understand their internal and external sensations and feelings. Typically, a specialist with weak stress is characterized by increased sensitivity to the negative (nociceptive) physiological and negative mental stimuli. It is possible that attract the attention of railway workers to positive incentives contributed to the balancing ergo - and trophotropic systems at the physiological level and improve their emotional sentiments on a psychological level.

Thus, the results obtained indicate that the application of the developed technique worker of the Russian Railways, leads them to reduce irritability, temper, fatigue; improves sleep, memory, and improves the workability and stress; apathy disappears, appears self-confidence, etc.

Clinical example of a specific use "method medico-psychological adaptation of railway workers".

Worker jelly is accessible transport I-n AI, 47 years old, a resident of the city, adviser to the General Director of the subsidiary of JSC "RZD", candidate of technical Sciences, used the method in terms of the Institutions of the Russian Academy of medical Sciences ' Institute of medical and ecological problems of the North" (IMAPS RAMS) Murmansk within three weeks.

Complaints on the overall health of the subject is not present. Given the specific professional, psychological factors, complex psycho-emotional overload associated with performance of professional duties, all to the end of the day led to the manifestation of the test: fatigue, irritability, emotional lability, poor sleep, weakening of memory. All the listed signs were attributed to the symptoms manifested by chronic stress, what subject did not agree and thought it was the regularity of performing complex professional duties. Preventive, curative and other recreational activities to strengthen their health subject is not conducted, drugs without doctor's prescription was not accepted.

From other diseases suffered from peptic Ulcer 12 duodenal ulcer. Recently the symptoms of this disease began to increase, and therefore A.I. suggested a surgical treatment which he refused.

The history of life. Born into an intact family, b is achiev and sisters did not. His mother worked as a teacher at the school, was a strict woman, loved order and constantly monitored the life of her son. Father was a railwayman, he often abused alcohol, But the character was a man of stern, but soft and pliable, his wife and son were not hurt.

A.I. was in school 4-5, graduated from the Institute of railway transport engineers. He worked as an engineer for railway transport, specialist in one of the departments of JSC "RZD", he defended his dissertation, passed by the Advisor to the General Director of the subsidiary of JSC "RZD".

Married for love in 26 years, has a daughter and a son. Relations with his wife in the last year has deteriorated. A.I. upset due to the fact that she was inattentive, indifferent to him. My daughter married, she lives alone and rarely visits the parents. The son of a first-year student of the same Institute, where he studied the subject.

The nature of A.I. always differed responsibility and diligence, but in recent times recalls how in the student's age got addicted to drugs, but successful treatment helped to get rid of this disease. Love all the procedure. The workplace contains almost perfect purity. At home and at work does a lot of cases and assignments, often not only for themselves but also others, not being able to refuse neighborhood is the missing requests. Different softness and pliability. These qualities, as well as visual appeal always attracted a lot of friends and acquaintances. Accustomed to restrain their negative emotions, afraid to offend the other person. Try never to lie. Childhood is characterized by a high level of anxiety, tendency to worry for any occasion. Recently became very tired by the end of the week notes increased irritability, anxiety, temper, worsening of mood. All this relates to family relationships and the fact that the total state after the next holiday is normalized.

When viewed In neurological status there was almost a slight tremor of the outstretched hands fingers, even the revival of the tendon reflexes of the hands and feet without their asymmetry. Motor, sensitive disorders and disorders of the cranial nerves were not identified.

Changes by the common blood and urine tests, carbohydrate, lipid and protein exchanges not found.

At the time the analysis pulsogram found increased compared with srednerazmernymi the values of the following parameters: amplitude fashion (55%); the index of autonomic balance (340.8 units); vegetative indicator rhythm (CDF) - 10.6 units, tension index (ti) up to 312 units. At the same time the detection is but a decline in these indicators, as the standard deviation of the dynamic range of the R-interval (RMS) to 0.03 s; variational scale (BP) pulsogram - up to 0.01 sec; the coefficient of variation (KB) - up to 4.0%. These results evidenced the background activation newsegments mechanisms of regulation of heart rhythm, increased tone of the sympathetic division of the ANS and a slight activation of the parasympathetic division of the ANS.

When psychodiagnostic study, the color range of preferences, according to Luscher test, amounted to the following sequence: brown, green, grey, purple, red, blue, black, yellow. The indicator "alarm" was equal to 9 points (when Sredneuralsk score 0-3 points). The level of depression on a scale of Zhang was equal to 62 points, indicating moderate depression is situational or neurotic origins. Test of Spilberger Hanina revealed a moderate increase of reactive anxiety (40 points) and a high degree of personal anxiety (70 points).

Personality profile test RESINS had a sawtoothed edge" character, situated between 75 and 95 T-scores, with peaks in the second and seventh scales, testified to the condition of moderate emotional tension with the prevalence of anxiety and depressive personality traits.

Started a course of medical and psychological adaptationand using software to normalize the personal mode of operation, rest and sleep included the use of mediated psychotherapy according to the proposed method.

After an introductory discussion of the subject was informed about the nature of chronic psycho-emotional stress, negative physiological consequences and adverse effects on overall health. Together with the test were analyzed most obvious reason is the available chronic psychoemotional stress and the most exciting of his problems. The subject realized that along with the depressing action of the state of his family life and is caused by limitations in activities of daily living stress impact and other professional factors. A.I. realized that worries in connection with the aggravation of Ulcer and 12 duodenal ulcer. He does not want to be operated, but surgeons insist. Believes that this will make him finally "inferior man". In his time at the same age such an operation was moved by his father, after which worsened his relationship with his wife, mother A.I. A.I. Now afraid that he will have the same fate, especially as feels cool from the side of his wife, became less attentive and caring. In addition, the state of chronic fatigue cause permanent overload at work and at home, wismann the e desire A.I. to keep everything under control, do yourself and the best way.

By the end of the three-week independent (daily during working hours A.I. paid twice for 7-8 minutes for the developed technique) medico-psychological adaptation course of railway workers. The intensity of emotional tension to the end of the day virtually disappeared.

The analysis of the dynamics of indicators WHALE showed a reduction compared to the baseline amplitude value fashion (AMO) - 40%, index of autonomic balance (IIA) - 158,0, vegetative indicator rhythm (CDF) of 5.5, tension index (ti) - 145 and at the same time increasing the values of the standard deviation of the dynamic range of the R-interval (RMS) - 0.05 s, the variation of the magnitude (VR) of 0.03 s, the coefficient of variation (KB) is 7.5%, which indicates a reduction of the initial excess sympathetic and increase initial lack of parasympathetic activity, and the reduction the degree of centralization of heart rhythm management. Heart rate spectrum was characterized by a compensatory increase in the contribution of the relative values of power LW - 12.5% and no change in the relative power values MB₁- 14% and MV₂to 12.5%. Minor dynamics of the index of centralization (CI) after a course of medical-psychological adaptation (to 305,27 and after 318,67)./p>

When re psychodiagnostic examination after completion of the course of medical-psychological adaptation of the detected source reduction-increased personal profile of the RESINS according to the scale F and all the basic scales, on average, 30-40 Tons of points. Received when you checked the profile was located within 40-50 Tons of points and was characterized by significantly smaller than in the primary study, the severity of the peaks in the second and seventh scales. The results evidenced a decrease in the intensity of emotional stress and improve psychological adaptation employee of the Railways.

1. The way the medical-psychological rehabilitation of the railway workers, including the measurement of anthropometric indicators of employee - height, weight, chest circumference; measure of the performance of the cardiovascular system - heart rate, on the basis of the received data to calculate individual digital number (DDI) of the employee by the formula:
DDI=((β×(r+o+v)+γ×(r+o+v)):ρ/n):g
where β is the individual rate of birth date in the form "xy", x - date of birth, and y is the month of birth of the employee, γ - individual coefficient year of birth, presents a four-digit number, year of birth of the worker, r is the growth of the employee (cm), o - chest circumference employee (cm), v is the weight of patient (kg), ρ is the pulse (beats/min) rabot the ka, measured in the morning after 5-7 minutes after waking up, n - lowering the age factor: at the age of 30 years (n=1; 30-39 years n=2; 40-49 years n=3; 50-59 years n=4; 60 years and older n=5, g - lowering professional factor for women g=2, for men g=3; the employee is introduced to the calculation method of DDI and begin a psychotherapy session, during which the employee is in a comfortable position, relaxed seated in front of a computer screen and speaks in a whisper HTTP while on the screen periodically displayed DDI, for termination, the employee makes a quiet deep breath and exhale.

2. The method according to claim 1, characterized in that the psychotherapy session is held twice a day.

3. The method according to claim 1, characterized in that the duration of a single session of psychotherapy is 1.5-3 minutes

4. The method according to claim 1, characterized in that therapy sessions are held five days in a row, two days break in a period of 4-6 weeks.

5. The method according to claim 1, characterized in that the value of DDI adjust once a season.