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15
Vestnik KazNMU №1-2019
Ж.Т.Надыров, 2Д.А.Оспанова, 3А.Н.Нурбакыт, 3Н.Ж. Дармен
ЩМУ «ЖКДСМ» 2К,азац Медициналыц Уздказ БШм Беру Университетi 3С.Ж. Асфендияров атындагы К,азац Улттыцмедицинауниверситетi
АСТАНА ЦАЛАСЫНДАГЫ ДЕНСАУЛЫК; САЦТАУ ИНФРАЦ¥РЫЛЫМЫНЬЩ ДАМУ ДИНАМИКАСЫ
ТYЙiн: Астана каласындагы денсаулык; са;тау инфракурылымын калыптастырудыц бастап;ы кезец колданыстагы инфракурылымдык; ресурстарды кайта курылымдау жэне олардыц денсаулык; са;тау ;bi3MeTTepi Yшiн ;арк;ынды всiп келе жат;ан кажеттшжтерше максималды бейiмделуiмен сипатталды. Кешннен бул «пассивтж YPдiс» жаца денсаулык; са;тау ортасын курып, медициналык; уйымдардыц колданыстагы желiсiн оцтайландыру мен кайта куруды, сондай-ак; жогары технологиялык; медициналык; квмектiц жедел дамуын талап ететш амбулаториялык-емханалык; денсаулык са;тау уйымдарыныц жаца куаттарыныц елеулi всуiмен ауысты.
TY^H4i свздер; денсаулык; са;таудыц дамуы, инфракурылым.
3K.T.Nadyrov, 2D.A.Ospanova, 3A.N.Nurbakyt, 3 N. Zh. Darmen
1KMU «Kazakhstan Graduate School of Public Health» 2Kazakh Medical University of Continuing Education 3Asfendiyarov Kazakh National medical university
DYNAMICS OF DEVELOPMENT OF THE HEALTH CARE INFRASTRUCTURE OF ASTANA
Resume: The initial period of the formation of the health infrastructure of the city of Astana was characterized by the restructuring of the existing infrastructure resources and their maximum adaptation to the rapidly growing needs for health services. Subsequently, this "passive trend" was replaced by a significant increase in new capacities of outpatient and hospital healthcare organizations, which created a new healthcare environment and necessitated the optimization and restructuring of the existing network of medical organizations, as well as the accelerated development of high-tech medical care. Keywords: health development, infrastructure
y^K 614.39:616-053.9-082
V. Chaikovska1,3 , B. Zhanturiyev2, T. Vialykh1, V. Tolstikh1, S. Moskalyuk1
1Dmitry Chebotarev Institute of Gerontology of the National Academy of Medical Sciences,
Kyiv, Ukraine,
2 National Center for Expertise of medicine, medical devices and medical equipment,
Almaty, Kazakhstan, 3Shupyk National Medical Academy of postgraduate education, Kyiv, Ukraine,
STRENGTHENING OF ELDERLY PEOPLE CARE POTENTIAL: METHODOLOGICAL OF EDUCATIONAL PROCESS
In the article, the techniques of the educational training for the preparation of the trainers (doctors, nurses, social workers) for the organization of medico-social care for senior people were shown. This educational process is based on peculiarities of physical and psychical health of the elderly, principals of the prevention of age-dependent diseases, rehabilitation, and palliative care. A very important role plays the provision with the illustrative materials on the actual aspects of gerontology and geriatrics for medical personnel, elderly people and members of their families, instructions for the organization of health schools and rehabilitation programs for elderly people.
Keywords: elderly people, education, training, medico-social care, palliative care, prevention, rehabilitation, gerontology, geriatrics
Intensive aging of the population, accumulation of elderly people, single persons, chronically ill ones, persons with a decreased and lost capability to self-care who need a constant support from the state, society and family are observed in Kazakhstan and Ukraine. Material losses of the majority of the pensioners, connected with a retirement on a pension, impossibility of employment, losses of the significant social contacts, role functions in the family and society, are accompanied with the destruction of the stereotypes formed during the life.
Objective of the educational training is a preparation of the trainers (lecturers) (doctors, nurses, social workers) in the issues of the organization of medico-social care to elderly people, peculiarities of physical and psychical health of the elderly, basics of the prevention of age-dependent diseases, rehabilitation and care, palliative care; provision with the illustrative materials on the actual aspects of gerontology and geriatrics for the holding of the training of medical personnel, elderly people and members of their families, instruction for the organization of the schools of health and rehabilitation programs for elderly people.
As a result of the training its participants have to know:
tendencies of the demographic changes in the country and world, strip charts for the realization of the Madrid international plan on aging and ways of its realization , rights of elderly people; features of the psychology of the people of elder age groups, principles of the communication with them and psychological support in crises;
age-dependent changes in the human organism at aging and age-dependent diseases of the organs and systems, principles of prophylaxis;
ways for the decrease of the effect of negative social, physical, and psychological factors on the capability of the human for independent life;
rules of the communication with elderly people with the disorders in the functions of different organs and systems; significance of the healthy life style as a basis of active longevity, including physical load and rational nutrition; principles of the prevention of the beginning of the syndrome of "professional burnout";
BecmHUK Kß^HJ^ №1-2019
main elements of the care at the beginning of age-dependent disorders, including the end of the life;
symptoms of urgent states among elderly people and principles of first aid.
As a result of the training its participants must:
be skilled in the educational habits and illustrative material and also disseminate their knowledge and habits among other students (cascade approach);
use the approaches for the improvement of the practical consulting and the habits in the work with the elderly; use the relative management habits in their everyday life; be skilled in obtained habits of the communication and exchange of the experience with elderly people and temporary displaced persons;
form the groups of self-care and mutual aid among elderly residents;
perform an explanatory work on the healthy life style at elderly age, features of nutrition, physical load, and prevention of the development of cognitive disorders;
interpret the results of general, functional, and basic instrumental methods of the research applied in geriatric practice;
formulate and substantiate a tactics for the care at acute urgent states in geriatrics;
apply rationally knowledge on the prevention of the professional burnout of the personnel who help the elderly people temporary displaced persons and palliative patients. Recommendations for Trainers.
The training program consists of 3 modules: each of them includes lecture blocks, pedagogical games and work in groups. Module themes 1:
Demographic aging: the elderly people in Kazakhstan, Ukraine and in the world. Gerontology: development of gerontology in Ukraine and in the world. Theory and practice of longevity. Life quality at elderly age. Organization of geriatric care in Kazakhstan , Ukraine and other countries. Health of the elderly and their needs in specific kinds of care. Individual medical actions. Features of the communications with elderly people . Module themes 2:
Age-dependent changes in the organism during aging. Decrease of cognitive functions in elderly people. Rehabilitation at elderly age. Conception of rehabilitation. Personal hygiene. First aid. Module themes 3:
Palliative care: features of palliative care to elderly people; prevention of the "professional burnout" syndrome, ageism. Right for pension and capacity for work.
Each modulus is held during three days and consists of introductory, main, and concluding parts. Every day the students have brakes for lunch - 60 minutes and two short breaks - 10 minutes. Total number of the academic hours for lecture blocks -52.0, total number of the academic hours for pedagogical games -2.4, total number of the academic hours for work in groups - 9.6. Final test is a result control of the students' knowledge after each modulus. After performance of training the students fill in the cards for the assessment of training quality. Contingent of the students: medical workers, social workers, instructors that work with the elderly, temporary displaced individuals, persons in a zone of military conflict and palliative patients.
20 minutes are devoted to the general introductory part at the beginning of the training and acquaintance with the participants of the training, 10 minutes - to the introductory parts for each modulus, 50 minutes - to the final parts for each modulus. For the provision of the optimality of the education each group consists of 15 students. Visual instruction is provided owing to the demonstration of prepared before materials (slides, video films) with the help multimedia projector.
For the provision of the efficiency of the education the leader of training should take into account professional, physical, and psychological peculiarities of the students. It is necessary: At the selection of the students to the groups to provide the homogeneity of their professional objectives;
At the performance of the lectures to provide the regular brakes in 10 minutes;
To perform the lectures in the language intelligible for the participants of the training;
At the demonstration of the materials to use the examples from the practice , including the examples from the experience of the students;
To encourage widely the students to active discussion of the materials in a course of its teaching;
To ensure a friendly relationships among the participants of the training.
At the beginning of the training it should be emphasized a necessity for each students participation in all three modules, test control of the obtained knowledge after every modulus, active participation in the discussion of the training themes, participation in the working groups and pedagogical games, assessment of lecture and illustrative materials at the end of training, presentation of the proposals for further improvement of the performance of the training. To meet with all the participants of the training.
Knowledge and skill, obtained at the training, help the students to master modern knowledge and habits in medical, social, and psychological care to elderly people and internally displaced people.
Work in groups:
LComponents of the Healthy Longevity oblast programs for elderly people. (All the participants are divided into 3 groups -representatives of different oblasts. A plan of the most effective and urgent measures (in the opinion of the participants) on the formation of the regional projects for the provision of healthy longevity of the population according to the MIAP and the UNO basic principles for the elderly people are developed in every group.)
2. Measures for the improvement of the organization of medico-social care to elderly people and internally displaced people at the regional level_(Work with the people in crises state effective and urgent measures (from point of view of the members of the group) on the formation of the ways for its overcoming the region in medical , social, and psychological care.)
3. Rehabilitation at the primary level. All participants are divided into 3 groups. The most important and efficient measures for medical, social, and psychological rehabilitation in practical activity of the participants are determined in every group.
4. Rights of elderly people. All participants are divided into 3 groups. The most important and efficient measures (from the point of view of the members of the group) for opposition of the violations of the rights of elderly and internally displayed people.). Presentations of the results of the work in groups (10 minutes for every groups). Discussion.
Assessment of the training by its participants. Quality of training (availability of teaching of theoretical material and presentations) is determined by means of assessment questionnaire filling in by every participants. Evaluation criteria of the results of training for every modulus.
At the final lecture of every modulus the control tests are proposed to the students and knowledge are evaluated by the results of the correct answers. The final attestation is performed by means of testing or in the form of oral test, knowledge of the students is evaluated according the ball system. Thus, the presented teaching method allows you to cover broad aspects of systematic and comprehensive training of specialists, family members of the elderly, and the elderly themselves in providing assistance to the elderly, including self-help and mutual assistance, taking into account their physical, mental and social status. This allows you to use this technique to prepare a wide range of specialists in the field of gerontology and geriatrics.
Vestnik KazNMU №1-2019
В. Чайковская13 , Б. Жантуриев2, Т. Вялых1, В. Толстых1, С. Москалюк1
1 "Украинадагы МГ¥А-ньщ Д.Ф.Чеботарев атындагы геронтология институты", мемлекеттiкмекеме, Киев, Украина, 2 Цазацстан Республикасы Денсаулыц сацтау министрлтнщ "ДэрШкзаттарды, медициналыцмацсаттагы буйымдарды жэне медицина техникасын сараптау ¥лттыц орталыгы" ШЖК, РМК, Алматы, Казахстан, 3 П.Л. Шупика атындагы жогары оцу орнынан кейiнгi бшм беру ¥лттыцмедицина академиясы, Киев, Украина
ЕГДЕ ЖАСТАГЫ АДАМДАРГА КУТ1М ЖАСАУДЬЩ ЭЛЕУЕТ1Н НЫГАЙТУ: Б1Л1М БЕРУ УДЕР1С1НЩ ЭД1СТЕМЕС1
ТYЙiн: Ма;алада егде жастагы адамдарга медициналык-элеуметтж кемек уйымдастыру бойынша нус;аушыларды (дэрiгерлер, медбикелер, элеуметтж кызметкерлер) дайындаудыц о;ыту эдiстемелiк эд^темеа керсетiлген. Бул бiлiм беру Yрдiсi егде жастагы адамдардыц физикалык; жэне психикалык; денсаулыгыныц ерекшелiктерiне, жас;а байланысты аурулардыц алдын алу принциптерiне жэне оцалту мен паллиативтi кемекке непзделген. Медициналык; кызметкерлерге, егде жастагы адамдарга жэне олардыц отбасыларына геронтология жэне гериатрияныц мацызды аспектiлерi, денсаулык; са;тау мектептерiн уйымдастыру женiндегi нус;аулар жэне карт адамдарга арналган оцалту багдарламаларын жасау бойынша визуалды деректер усыну ете мацызды рел ат;арады.
ТYЙiндi свздер: карт адамдар, бiлiм, тренингтер, медициналык; жэне элеуметтiк кемек, паллиативтж кемек, алдын алу, оцалту, геронтология, гериатрия
В. Чайковская13 , Б. Жантуриев2, Т. Вялых1, В. Толстых1, С. Москалюк1
1 Государственное учреждение "Институт геронтологии имени Д.Ф.Чеботарева НАМН Украины", Киев, Украина, 2 РГП на ПХВ «Национальный Центр экспертизы лекарственных средств, изделий медицинского назначения и медицинской техники» МЗ РК, Алматы, Казахстан, 3 Национальная медицинская академия последипломного образования имени П. Л. Шупика, Киев, Украина
УКРЕПЛЕНИЕ ПОТЕНЦИАЛА ПО УХОДУ ЗА ПОЖИЛЫМИ ЛЮДЬМИ: МЕТОДОЛОГИЯ ОБРАЗОВАТЕЛЬНОГО ПРОЦЕССА
Резюме: В статье показаны методики учебно-методической подготовки для подготовки инструкторов (врачей, медсестер, социальных работников) по организации медико-социальной помощи пожилым людям. Этот образовательный процесс основан на особенностях физического и психического здоровья пожилых людей, принципах профилактики возрастных заболеваний, реабилитации и паллиативной помощи. Очень важную роль играет предоставление наглядных материалов по актуальным аспектам геронтологии и гериатрии для медицинского персонала, пожилых людей и членов их семей, инструкций по организации школ здоровья и программ реабилитации для пожилых людей.
Ключевые слова: пожилые люди, образование, тренинги, медико-социальная помощь, паллиативный уход, профилактика, реабилитация, геронтология, гериатрия
УДК 616.083
А.М. Арингазина, Н.Е. Есенова, Д.С. Сейдуманов
Казахстанский медицинский университет «ВШОЗ»
ОРГАНИЗАЦИЯ МЕДИКО-СОЦИАЛЬНОЙ ПОМОЩИ ПОЖИЛЫМ БОЛЬНЫМ С КОГНИТИВНЫМИ РАССТРОЙСТВАМИ
Различные виды когнитивных расстройств у пожилых людей являются распространенным явлением и связаны с низким качеством жизни, повышенной заболеваемостью и ранней смертностью. Данная статья излагает обзорную характеристику проблемы с когнитивными расстройствами, раскрывая причины, факторы и оказание помощи пожилым больным. Произведен анализ потребностей пожилых людей в различных видах помощи и разработаны предложения по совершенствованию социальной адаптации.
Ключевые слова: когнитивные расстройства, деменция, пожилой пациент
Когнитивные нарушения (КН) являются важнейшей медико-социальной проблемой, как в Казахстане, так и во всем мире, что связано с высокой распространенностью их в популяции, обусловленной постарением населения. В настоящее время в мире прослеживается тенденция к увеличению роста когнитивных нарушений различной этиологии, что позволяет расценивать данную патологию как актуальную социально-медицинскую проблему [1]. Доля лиц, страдающих умеренной интеллектуально-мнестической дисфункцией, варьирует в среднем от 16 до 19% [2]. Это связано с увеличением средней продолжительности жизни людей в большинстве развитых стран, ростом промышленного производства и ухудшением экологической обстановки [3]. В течение года прогрессирование. рассматриваемых нарушений до степени деменции наблюдается приблизительно у 15% пациентов с умеренными когнитивными расстройствами, спустя три года уже 50% больных данной категории соответствуют
диагностическим критериям деменции, а через шесть лет количество таких пациентов может достигать 80% [4]. Социальное значение умеренных когнитивных нарушений заключается в том, что их прогрессирование в ряде случаев лишает пациентов дееспособности, приводит к дезадаптации, а также требует значительных усилий по уходу за больным от близких и общества в целом. Наличие интеллектуально-мнестических расстройств оказывает выраженное негативное влияние на качество жизни больных. Таким образом, умеренные когнитивные нарушения являются достаточно частой и социально значимой патологией, сопровождающейся субклиническими изменениями одной или нескольких когнитивных сфер, которые при отсутствии адекватного лечения закономерно прогрессируют, достигая степени деменции [5, 21]. По состоянию на начало 2019 года в населении Казахстана 7,4% составило число людей старше 64 лет, что в абсолютных числах 1 375 137 человек старше 64 лет: 470
