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4THE PSYCHOLOGICAL SIGNIFICANCE OF INTRODUCING PSYCHOLOGICAL SERVICES IN THE HEALTH CARE
SYSTEM
Shukurova Ugiloy Umarovna
Doctor of Psychology (PhD), associate professor Gulistan State University https://doi.org/10.5281/zenodo.7665942
Abstract. This article discusses the problems of organizing psychological services in health care organizations, the analysis of research and practical work in this area, as well as the introduction of the position of "medical psychologist" to provide convenient and quality medical and psychological care to the population, socio-psychological bases are covered.
Keywords: psychological services, psychological assistance, psychoprophylaxis, psycho correction, psychosomatics, psychotherapy, patient, doctor, psychologist, psychotherapist, socio-psychological survey, medical institution, psychodiagnostics.
In the world, health is recognized as one of the main factors that ensure human peace and security. The World Health Organization's "Global Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020" (2013), "European Action Plan for Strengthening Public Health System Capacity and Services" (2012), "Health Systems for Health and Well-Being" for" important documents such as the Tallinn Charter (2015) emphasize that it is necessary for the population to have the opportunity to use the achievements of medical and psychological sciences to achieve a high level of health. Today, improving the health of the population is considered an important need on a global scale, and solving these problems by organizing a psychological service in the health system remains urgent.
In the world, special attention is paid to scientific research on the theoretical, methodological and practical foundations of the organization of psychological services in the field of health care, as well as the development of a modern model. In the conducted studies, the patient's attitude to his illness, psychological characteristics, social environment in which he lives, interactions with other people are recognized as factors that determine the effectiveness of treatment. At the same time, firstly, the number of psychologists specializing in the field of medicine is small, secondly, the population does not have relevant information and the skills of applying for professional medical-psychological help are not formed.
Comprehensive measures are being implemented in our country to organize the healthcare system, especially in recent years, on the basis of modern requirements, raise the quality of medical service to a new level, and improve the protection of the population's health, including mental health. In the Action Strategy for the five priority areas of the development of the Republic of Uzbekistan in 2017-2021, it is stated that "to increase the convenience and quality of medical and socio-medical services to the population, to create a healthy lifestyle among the population, to strengthen the material and technical base of medical institutions, to improve the health sector, first of all, tasks such as "further reform of its initial link, rapid and emergency medical care system" are set. In the implementation of these tasks, the effectiveness of clinical psychological
research on psychological changes occurring in patients with chronic somatic diseases is of particular importance.
In recent years, the national system of health care in our country has been fundamentally changed and concern for public health, promotion of a healthy lifestyle, improvement of medical culture and literacy, prevention and prevention of diseases, as well as the field of diagnosis and important Decisions and documents on the introduction of international standards of treatment were adopted. As a result of the reforms carried out in the country, the average life expectancy has increased from 67 to 73.1 years for more than 25 years, the overall mortality rate has decreased from 6.1 to 4.8 per 1000 people, mothers and it has been shown that the child mortality rate has decreased significantly. On October 18, 2017, under the chairmanship of the President of the Republic of Uzbekistan Shavkat Mirziyoyev, dedicated to the analysis of reforms in the field of further improvement of the health care system, improvement of the quality and efficiency of medical services, strengthening of public health, provision of quality medicines as noted at the meeting, in recent years, about 30 decrees and decisions aimed at developing the medical field, increasing the scope and quality of medical services have been adopted. The program of measures to further improve the emergency medical service in the country was approved by the decision PQ-28-38 signed by the President on March 16, 2017.
Today, psychological service is organized in various sectors of the economy, in particular, in production, trade, financial organizations, organizations and institutions, personnel selection, work with employees, formation of corporate culture, and other areas. Psychological service is also well established in the field of social work, supporting people with special needs and the elderly. Meanwhile, the post of psychologist has been introduced in the system of the Ministry of Defence, Emergency Situations and Internal Affairs. The establishment of psychodiagnostic and psychological support services in prisons, the participation of psychologists in the criminal investigation system, the establishment of special psychological centers in military-medical commissions, and the fact that the field of psychological services has become an indispensable link in our daily life and its practical importance is recognized. means According to V.V. Rubsov, the national psychological services established in different countries solve similar tasks despite their different structures. In the 80s of the last century, scientists such as N.S. Safarov, R.A. Atakhanov, A.D. Alferov, S.I. Ravikovich, F.I. Ivashenkov emphasized that the main place in their practical psychological work is occupied by issues of psychological enlightenment, that is, psychological service promotes psychological knowledge who believed that it should be focused on doing. Among the researchers, V.V. Mironenko, N.F. Talizina, V.A. Ivannikov, U.V. Ulyenkova emphasized psychodiagnostics in psychological service, A.A. Verbitskaya, D.B. Bogoyavlenskaya emphasized that psychological service should be focused on educational correction, V.V. Stolin, Y.V. Ukke emphasized that psychological service consists of psychoprophylaxis and consultation.
The widespread field of psychological services is the educational system, and it is possible to make sure that the methodological basis and methodological support of the organization of psychological support in this field is much more advanced than in other fields, both through the analysis of research and the results of practical work. According to the Uzbek scientist Sh.R. Barotov (2006), when it comes to the theoretical and methodological foundations of psychological services, special attention should be paid to the studies that show the perspectives of the approach based on the system of attitudes towards the person who is considered the object and subject of
psychological services. fainting. After all, without analyzing the social level of a person's relationships with himself, others (interpersonal), activities, which are inevitably manifested and developed in the process of psychological service, from his unpleasant feelings, it is impossible to determine the scope of measures aimed at psychological protection from conflict situations related to establishing cooperation with others, failures in activity.
The analysis of the literature on the topic showed that the problem of organizing psychological services in health care organizations is insufficiently covered from a scientific point of view, and there are different, conflicting opinions and ideas in this regard. L. G. Matveyeva states that clinical psychology is the most widespread psychological specialty in the world today, and 41% of those working in various fields of psychological practice belong to the field of medical psychology. To become a full-fledged professional, a clinical psychologist must complete a 3,000hour training program that includes client work and supervision. Among other things, the author focuses on the problems of training clinical psychologists in Russia, paying special attention to its didactic, theoretical and practical aspects. I.N.Gurvich notes that in modern society there are groups in need of goal-oriented psychological help, and the socio-psychological problem of health is increasing. Psychological scientists G. M. Andreyeva, V. V. Boyko, Y. N. Yemelyanov, Y. S. Kuzmin, B. F. Lomov, A. G. Maklakov, T. A. Nemchin, L. A. Petrovskaya, K. K. Platonov, Y. D. Khomskaya; psychiatrists V.A. Abramov, Y.A. Aleksandrovsky, V.M. Yeleicher, L.I. Wasserman, I.Y. Gurovich, N.M. Zharikov, D.N. Isayev, V.Y. Kagan, B.D. Karvasarsky, O.V. Kerbikov, V.V. Kovalyov, D.Y. Melekhov, V.V. Nechiporenko, Y.L. Nuller, Y.Y. Rakhalsky, S.L. Rokhlin. Semichov, V.Y.Semke, P.I.Sidorov, F.I.Sluchevsky, V.A.Tashlikov, B.S.Frolov, L.K.Khokhlov, V.M.Shumakov's work shed light on the socio-psychological aspects of health and illness, but despite this, the countries of the former Soviet Union are far behind the Western countries in terms of practical psychological help. is recognized by many authors. After all, according to information provided in the medical literature, 49-57% of patients who turn to neuropathologists in polyclinics, and 34-47% of patients who are treated by therapists need psychotherapeutic treatment. World experience shows that psychologists should work in all clinical and treatment-preventive areas, and in each of them specific tasks should be performed.
According to V.V. Guldan, the establishment of networks of medical and psychological care offices in polyclinics and the introduction of the position of "medical psychologist" will ensure the provision of convenient and high-quality medical and psychological care to the population. The main task of psychologists working in these offices is to timely identify psychosomatic and somatopsychic pathology, borderline neuropsychological disorders, pre-morbid conditions and implement psychocorrective measures. Medical-psychological service also occupies an important place in the system of rehabilitation of patients with somatic, neurological and mental diseases. In this regard, the psychologist can help the patient by performing neuropsychological and pathopsychological diagnosis of disorders of mental and cerebral functions, carrying out secondary psychoprophylactic measures, correction of changes in the characteristics of the patient's personality, and, if necessary, psychotherapeutic procedures.
The main debates in this regard are where psychologists should be trained for the healthcare system - in medical institutes or universities, whether a medical psychologist should have a doctor's degree, or whether a psychologist who has graduated from a university can also work as a medical psychologist. Life experiences show that psychologists who graduated from the university are not ready for practical work in the clinic. On the other hand, the knowledge of the
psychology of the patient, the characteristics of th e i nfluence of the human psyche on the course of the disease and the effectiveness of the treatment is shown to be insufficient. Most doctors, focusing on the clinical appearance of the disease, the results of laboratory and instrumental research methods, do not consider the patient as a person with his own individual-typological characteristics, scope of treatment, character of interpersonal relations. As a result, despite consistent treatment of the disease with medical methods, the patient's treatment process is prolonged and the effectiveness of treatment measures is not visible. This causes dissatisfaction among patients, wrong conclusions about the level of medical service and doctor's qualifications.
The socio-psychological survey compiled by the author shows that the organization of psychological services in medical institutions does not meet the needs of the time and the population, even the majority of doctors do not know what psychological services should look like in clinical conditions and who a psychologist really is and what he does. showed that they do not have enough idea about. In our opinion, this situation reduces the possibility of timely registration of psychological problems hidden behind somatic diseases and implementation of preventive measures. It should be noted that from the results of interviews and questionnaires with a number of doctors, different answers were received to the question of who is a psychotherapist and what does he do. Our research has more clearly repeated the trend observed in modern world psychology, that is, the fact that the problem of what kind of educated specialist should work in the field of psychological services in medical institutions and what are his main functions in clinic and polyclinic conditions has not been solved to the end, confirmed that it is also observed in the conditions of our country. . This situation makes it necessary to establish a clear direction and create a program for establishing a psychological service in medical institutions.
The convenient and extremely important aspects of today's psychological service for personal development have been approved and appreciated by all. However, the special official order from above for the widespread promotion of psychological services and the extreme shortage of practicing psychologists hindered the implementation of the same psychological service in all schools. By the 1990s, in the conditions of Uzbekistan, where feelings of independence, freedom, and self-awareness prevailed, a unique ground was prepared for the wide spread of psychological services, as well as all social spheres aiming at the perfection of man and society. This made it inevitable to move to the next stage of training psychologists in the development of psychological services characteristic of Uzbekistan. Because, it would not be possible to successfully implement psychological services in Uzbekistan without training qualified practitioners-psychologists who can analyze the social and psychological climate in the school. In accordance with this, first in Tashkent, then in Bukhara, and later in Navoi, Andijan, Samarkand and other regions, retraining courses on the specialty of "practitioner-psychologists" were opened, and those who successfully completed these courses became psychological service supervisors in many schools of our republic. are doing effective work as promoters and researchers. It is known that psychological services are being implemented in all countries, even in different scientific and organizational forms. Because, only measures suitable for the socio-economic and political development of each country are used in this country and, if necessary, developed. Accordingly, taking into account the lack of qualified and mature specialists for the development of psychological services in Uzbekistan, the first step began with the initiative to train practicing psychologists from among the most advanced and talented teachers of the school. In this regard, a reasonable question arises: Why were only experienced teachers involved in the course of "practicing psychologists"? Indeed,
it is not for nothing that only highly qualified pedagogues are involved in the course. Because we think that in order to become a school psychologist, first of all, it is necessary to have the qualifications and experience to analyze the personality of the student, the educational process, and the criteria of education in depth and correctly. There are also social organizational aspects of the issue. For example, if people who do not have a certain experience working in a school are admitted to the course, they will not be able to acquire the skills to correctly and successfully analyze the pedagogical-psychological process in the school within a period of 4-5 months.
Based on the results of the conducted socio-psychological survey, it can be said that establishing psychologist services in medical institutions is one of the urgent problems. Taking into account the specific aspects of each treatment facility, the specific aspects of patients with various types of diseases, the use of specific and appropriate approaches to their diagnosis and correction will increase the effectiveness of the work of psychologists-specialists. it can be said that it helps. However, as we can see, the results of the questionnaire show that the organization of psychological services in medical institutions does not meet the needs of the time and the population, even the majority of doctors are concerned about what psychological services should look like in clinical settings and who a psychologist actually is and what he does. doesn't have enough imagination. This situation reduces the possibility of timely registration of psychological problems hidden behind somatic diseases and implementation of preventive measures. It should be noted that from the results of interviews and questionnaires with a number of doctors, different answers were received to the question of who is a psychotherapist and what does he do. There were answers that a psychotherapist is a doctor with higher medical education, specializing in psychiatry, but with knowledge of psychotherapy. Doctors have repeatedly emphasized that a psychologist with a university degree cannot be a psychotherapist. Our observations showed that the activities of psychoneurologists and the methods they use in the polyclinics of Tashkent are almost no different from those of psychologists. Among other things, psychiatrists among our test-takers considered it incompetence that psychologists with university education interfere in forensic psychological examination, and said that only psychiatrists with medical education should be involved in this work.
Our research has more clearly repeated the trend observed in modern world psychology, that is, the problem of what kind of educated specialist should work in the field of psychological services in medical institutions and what are his main functions in the clinic and polyclinic conditions has not been solved to the end. It was also confirmed in the conditions of our country. . This situation makes it necessary to establish a clear direction and create a program for establishing a psychological service in medical institutions. For this, we believe that first of all, with the help of clinical and psychological research, it is necessary to determine the psychological changes that occur in patients with chronic somatic diseases and justify the need for psychological services.
Based on the conducted research, we can make the following practical recommendations: it is advisable for a psychologist-specialist who performs psychological services in the healthcare system to undergo special training for working with patients. That is, a psychologist-specialist is required to have characteristics such as tolerance for patients, empathy, and communicative competence. This can be achieved by setting up training and retraining courses in medical educational institutions and universities training psychologists; In our opinion, the promotion of medical and psychological knowledge among the population is one of the components of
establishing a psychological service in the medical field. Patients suffering from this or that disease
have information about the characteristics of changes in the psychological state in the conditions
of the disease, which ensures that they turn to a psychologist-specialist in time.
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