Trauksmes, obsesīvi kompulsīvo traucējumu un ar stresu saistītu traucējumu (F41-F43) pacientu ārstēšanas iespējas psihiatriskajā dienas stacionārā.
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Trauksmes, obsesīvi kompulsīvi un ar stresu saistītie traucējumi ir izplatīti visā pasaulē, tie skar dažādu vecumu un abu dzimumu cilvēkus, un būtiski ietekmē personas dzīves kvalitāti. Pētījuma mērķis ir noskaidrot, kādi medikamenti un nemedikamentozās terapijas metodes tiek lietotas, ārstējot pacientus ar šiem traucējumiem psihiatriskā profila dienas stacionārā, izpēti veicot RPNC Ambulatorajā centrā “Pārdaugava”.
Lai atbildētu uz pētījuma jautājumiem un izpildītu darba uzdevumus, tika izstrādāts kvantitatīvs šķērsgriezuma tipa pētījums. Pētījuma populāciju veidoja visi pacienti, kas 2019. gadā vai 2020. gadā, ārstējās dienas stacionārā un kuru ambulatorajā kartē norādītais pamata diagnozes kods bija F41, F42 vai F43, vai to apakškods (pēc SSK-10). Dati, ievērojot konfidencialitātes un datu aizsardzības principus, šifrētā veidā tika apkopoti programmā Microsoft Excel 2016. Datu statistiskā analīze tika veikta, izmantojot programmu IBM SPSS 26.0.
Pētījuma populāciju veidoja 66 pacienti vecumā no 18 līdz 65 gadiem. Lielākā daļa pacientu (N=57; 86.4%) dienas stacionārā ārstējās pirmreizēji. Stacionārā medikamentozu terapiju nozīmēja 61 pacientam (92.4%). 43 pacienti (65.2%) saņēma kombinētu medikamentozo terapiju – divus vai vairāk medikamentus. Biežāk pielietotās medikamentu grupas, ārstējot pacientus ar neirotiskiem un ar stresu saistītiem traucējumiem, bija selektīvie serotonīna atpakaļsaistes inhibitori un citu grupu antidepresanti, atipiskie antipsihotiskie līdzekļi, garastāvokļa stabilizatori un benzodiazepīnu grupas medikamenti. Jebkura nemedikamentozā terapijas metode tika nozīmēta individuāli, lēmuma pieņemšanā aktīvi iesaistot pašu pacientu. Biežāk apmeklētās bija klīniskā psihologa vizītes un fizioterapijas nodarbības. No mākslu terapijām vispopulārākās bija mūzikas un vizuāli plastiskās mākslas terapija, savukārt, psihodrāma bija visretāk pielietotā terapijas metode. Kombinēta (medikamentoza un nemedikamentoza) terapija tika nozīmēta 61 no 66 pacientiem.
Apkopojot iegūtos rezultātus, var secināt, ka gan nozīmētā medikamentozā terapija, gan izvēlētās rehabilitācijas terapiju metodes tika pielāgotas individuāli katram pacientam, vadoties pēc prevalējošām sūdzībām un iepriekš pielietotās terapijas efektivitātes, kā arī ņemot vērā paša pacienta vēlmes. Jāatzīmē, ka rehabilitācijas speciālistu vadīto nodarbību piedāvājums vēl aizvien ir ierobežots, un ne vienmēr pacients var saņemt piemērotāko nemedikamentozo terapiju.
Anxiety, obsessive-compulsive disorder and stress related disorders are common worldwide and cause significant decrease in quality of life of patients. The aim of this study is to determine pharmacologic and non-pharmacologic methods employed in treatment of patients with neurotic and stress related disorders in psychiatric day care clinic – in ambulatory care clinic “Pārdaugava” of Riga Psychiatry and Narcology Centre. The author conducted a quantitative cross-sectional study. Study population consisted of all patients who were treated in ambulatory care clinic “Pārdaugava” in 2019 and 2020 with the main code of diagnosis F41, F42 or F43, or its subcode (according to ICD-10). The data were compiled using Microsoft Excel 2016. Statistical analysis was done using IBM SPSS 26.0. 66 patients aged 18 to 65 were included in the study. For most of the patients (N=57; 86.4%) this was the first treatment in a psychiatric day care clinic. Pharmacologic treatment was prescribed for 61 (92.4%) patients of them 43 (65.2%) patients received more than one medication. The most frequently used groups of medications were antidepressants, especially selective serotonin reuptake inhibitors, atypical antipsychotics, mood stabilizers and benzodiazepines. Any method of rehabilitative therapy was offered individually according to the patients’ motivation to participate in them. Patients most often attended clinical psychology sessions and physiotherapy practices. Music therapy and art therapy were the most popular arts therapy forms, however, drama therapy was less applied. For 61 out of 66 patients combined pharmacologic and non-pharmacologic therapy was used. The author concluded that both pharmacologic and non-pharmacologic treatment methods were customized individually for every patient according to main symptoms and complaints, the effectiveness of previously used therapy and considering the patients’ aspirations. However, the availability of rehabilitation specialists and therapies is often limited and patients cannot always receive the most appropriate non-pharmacologic care.
Anxiety, obsessive-compulsive disorder and stress related disorders are common worldwide and cause significant decrease in quality of life of patients. The aim of this study is to determine pharmacologic and non-pharmacologic methods employed in treatment of patients with neurotic and stress related disorders in psychiatric day care clinic – in ambulatory care clinic “Pārdaugava” of Riga Psychiatry and Narcology Centre. The author conducted a quantitative cross-sectional study. Study population consisted of all patients who were treated in ambulatory care clinic “Pārdaugava” in 2019 and 2020 with the main code of diagnosis F41, F42 or F43, or its subcode (according to ICD-10). The data were compiled using Microsoft Excel 2016. Statistical analysis was done using IBM SPSS 26.0. 66 patients aged 18 to 65 were included in the study. For most of the patients (N=57; 86.4%) this was the first treatment in a psychiatric day care clinic. Pharmacologic treatment was prescribed for 61 (92.4%) patients of them 43 (65.2%) patients received more than one medication. The most frequently used groups of medications were antidepressants, especially selective serotonin reuptake inhibitors, atypical antipsychotics, mood stabilizers and benzodiazepines. Any method of rehabilitative therapy was offered individually according to the patients’ motivation to participate in them. Patients most often attended clinical psychology sessions and physiotherapy practices. Music therapy and art therapy were the most popular arts therapy forms, however, drama therapy was less applied. For 61 out of 66 patients combined pharmacologic and non-pharmacologic therapy was used. The author concluded that both pharmacologic and non-pharmacologic treatment methods were customized individually for every patient according to main symptoms and complaints, the effectiveness of previously used therapy and considering the patients’ aspirations. However, the availability of rehabilitation specialists and therapies is often limited and patients cannot always receive the most appropriate non-pharmacologic care.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Psihiatriskā profila dienas stacionārs; trauksmes traucējumi; obsesīvi kompulsīvi traucējumi; ar stresu saistīti traucējumi, Psychiatric day hospital; anxiety disorder; obsessive-compulsive disorder; reaction to severe stress; adjustment disorder