METHOD DEVELOPMENT AND EFFECTIVENESS EVALUATION EXPERIENCE OF THE EDUCATION-BEHAVIORAL CORRECTION IN PATIENTS WITH CHRONIC DERMATOSES AT THE PRIMARY HEALTH CARE LEVEL

Abstract

The examination of 60 patients with chronic dermatoses (30 patients presented with psoriasis, 30 - with eczema) was carried out before and after the education-behavioral correction applying the method for differentiated self-estimation of general health state and anxiety scales according to Spielberger C. in Yu. L. Khanina modification. To evaluate the effectiveness of the education-behavioral correction applied, the dynamics of the most informative acceptor- indicators characteristic of the patients with chronic dermatoses was determined, namely, the indices of AI frequency (P m,%), its severity (S, points), number of patients with chronic dermatoses and diagnostically significant level of psychological traits (Dn , persons). The index AI (Sst , number of patients in unit fractions), AI index of clinical severity (Ics) and the entropy index of the corresponding acceptor-indicator (habc, bit) before and after the education-behavioral correction were calculated, as well as the integral index of the education-behavioral correction effectiveness (IEBC).The effectiveness of the education-behavioral correction was evaluated according to the informative acceptorindicator complex in 60 patients with chronic dermatoses (30 patients - with psoriasis, 30 - with eczema). The data obtained made it possible to determine that the primary health care level could provide the effectiveness achievement by 8.0?16.0% (according to the integral index). In patients with psoriasis, the education-behavioral correction effectiveness was manifested by the decrease (p <0.05) in the absolute number of persons with the diagnostically significant level of general health state declining (before the education-behavioral correction - (76.7 7.7)%, after - (53.3 9.1) %) and the decrease in severity of this AI from (3.9 0.1) points up to (3.5 0.2) points; the decrease in the number of persons with the low mood level (before the education-behavioral correction - (83.3 6.8)%, after - (60.0 8.9)%, p <0.01); the decrease in the number of patients with the low level of the everyday activity (before the education-behavioral correction - (63.3 8.8)%, after - (46.7 9.1)%, p <0.01). The education-behavioral correction effectiveness in patients with eczema was manifested by the decrease in the absolute number of people with reduced level of general health state (before the education-behavioral correction - (70.0 8.4)%, after - (56.7 9.0)%) with severity decrease in this AI from (3.7 0,1) points to (3.4 0.2) points; the decrease in the number of persons with the low level of mood (before the education-behavioral correction - (80.0 7.7)% and after - (53.3 9.1)%, p <0.01). The results of the education-behavioral correction effect on the reactive and personal anxiety indicators can be observed in their positive dynamics, both in case of psoriasis and eczema, concerning the severity reduction of these indicators of psychological state. Despite the absence of significant reduction in the number of persons with the high anxiety level (in psoriasis: from 70.0% to 60.0%, in case of eczema: from 63.3% to 56.7% of patients), the integral indicators of the education-behavioral correction effectiveness amounted to 14.3% and 6.4% for reactive anxiety and 3.4% and 3.8% - for personal anxiety, correspondingly. Generally, the effect of education-behavioral correction performed at the primary health care level is limited by the medical personnel competence areas, which requires the interdisciplinary cooperation of medical specialists of various specialties while dealing with such patients (the studied issue should involve medical psychologists and more patient-specific techniques for cognitive-behavioral correction).

Keywords

• general practice-family medicine
• chronic dermatoses
• education-behavioral correction
• effectiveness