RU2286715C2 - Method for detecting total human body state - Google Patents

Abstract

FIELD: medicine, psychology.

SUBSTANCE: the present innovation deals with quick test diagnostics of human body state. It is necessary to measure the values of arterial pressure at rest - systolic arterial pressure (SAP) and diastolic arterial pressure (DAP), psychophysiological values followed by the test of individual minute at counting (IM/c). Psychophysiological values should be evaluated through self concept of anxiety and depression levels according to hospital questionnaire of anxiety and depression (HQAD). Additionally, it is necessary to conduct the test of IM at no counting (IMn/c)followed by detecting the index of functional state of adaptation (IFSA) calculated by the following formula: IFSA=0.1xSAP-0.06xDAP+0.29XIM/c+0.28xIMn/c-0.4xT-0.42xD. At IFSA values ranged 26-45 the state should be considered to be as normal, in case of below 26 - as anxious, and at above 45 -as depressive. The innovation enables to obtain subjective evaluation of total state of human health.

EFFECT: higher accuracy of detection.

3 ex

Description

The invention relates to medicine, namely to psychology, and can be used for rapid assessment of the functional state of human health as an indicator of adaptation to one's state of health and the need for psychotherapeutic support.

Currently, a systematic, integrated approach is widely used to predict the state of health and functional states of a person, a search is being made for integral indicators characterizing the state of a person in various aspects: assessing the level of physical health, the state of adaptation systems, adaptive homeostatic, functional states, psychological and psychophysiological properties individual. It is urgent to identify the problem of a person’s adaptation to his health condition, especially to solve the question of the optimal choice of psychological and somatic rehabilitation paths, which is especially important at the sanatorium stage due to the short treatment time.

A known method for determining the overall state of human health (Klyuev A.V., Kachalkin A.N., "Methodology for self-monitoring the level of physical health (UFSZ) of patients who underwent treatment in a sanatorium", Bulletin of new medical technologies, 2002, No. 2 , 62-63 pp.), Allowing to evaluate the physical state of health by the interaction of two body systems: cardiovascular and respiratory, which ensure the physical activity of a person. 6 main indicators are measured: heart rate (HR), blood pressure (systolic and diastolic), respiratory rate (BH), an indicator of the body's resistance to oxygen debt (apnea 2 / apnea 1), an indicator of the ratio of body weight to normal. To measure these indicators, a minimum of devices (stopwatch, floor scales, tonometer and calculator) is used and, using further calculations according to the graphs and the formula, the UFSZ is self-monitored.

However, the disadvantage of this method is the complexity of measurements and calculations, while the psychological state of a person remains unaccounted for, and, as the authors themselves note, this aspect greatly affects the physical state of health.

The closest to the achieved positive result is a method for determining the general condition of the human body, (S.L. Melnikova, V.V. Melnikov "Indicators of individual perception of time as a characteristic of the general condition of the body", Bulletin of new medical technologies, 2002, No. 2, 21-23 p.), Which consists in determining indicators such as "individual minute" (MI) and "biological age" (BV), reflecting the state of the physiological functions of a person at any given time. In the concept of BV, the cumulative characteristic of the objective state of the cardiovascular, nervous, respiratory systems, weight and height index (GRP), as well as a subjective assessment of health, is embedded. The authors conducted more than 1000 observations over 3 years on 150 healthy students of both sexes of the same age group. At the same time of the day, they determined the duration of myocardial infarction (a uniform score for 60 seconds), heart rate, SBP and DBP after exercise, indicators of weight, height, physical condition index, vegetative Kerdo index, GRP, and working capacity. A general blood test was performed, the immune status was assessed, the level of anxiety and emotional stability was determined by the method of color choices Lusher, tested a subjective assessment of health. The authors identified three groups of examined depending on the duration of MI: an adequate estimate of the time, "slowdown" and "acceleration" of the course of MI. At the same time, indicators of other functions change, specifically for each group. It was found that at lower BV values, the acceleration of the individual flow of time is more pronounced; an increase in BV is associated in some cases with an increase in SBP, in others with a decrease in the time of holding the breath. In addition, there are cases when an increase in BV is associated with a poor subjective assessment of one's own state of health. The authors conclude that the MI and BV values can serve as a criterion for the general state of the human body and to some extent characterize the direction of adaptive shifts in the main body systems: cardiovascular, autonomic nervous, and immune.

The disadvantage of this method is the complexity and complexity of the application, in addition, obtaining results is impossible without special diagnostic methods and measurements, the psychological state of a person remains unaccounted for.

The authors offer a simple and affordable way, which consists in conducting psychological and psychophysiological measurements, the results of which judge the person’s adaptation to his state of health and the need for psychotherapeutic assistance.

A positive result of the claimed invention is the simplification of the method through the use of simple psychological and psychophysiological measurements that do not require special complex methods. A positive result is achieved by conducting an MI test with a score and a MI without a score, assessing a person’s psychological adaptation through self-assessment of anxiety and depression levels and determining the adaptation functional state index (IFAS), which is calculated by the formula, and judging by the obtained values state of human adaptation.

The method is as follows.

At the first stage of the reaction of the human body to stress, emotional experiences of anxiety appear, and the final stage, provided that the person can not cope with the stressful situation, are the depressive reactions leading to a decrease in immunity, and, consequently, to the disease. Assessment of levels of anxiety and depression is carried out on the hospital questionnaire of anxiety and depression (GOTD) (Zigmond A.S. Snaith R.P. The Hospital Anxiety and Depression scale // Acta Psychiatr. Scand. 1983 - Vol.67 - P.361-370). GOTD refers to subjective scales and actually determines the degree of emotional distress associated with the manifestation of somatic distress, identifying the psychological symptoms of anxiety and depression. A direct relationship between high values of anxiety and depression with a tendency to exaggerate the importance of somatic distress and with a low level of subjective control in relation to their somatic state was revealed. These conclusions determine the choice of rehabilitation paths towards the predominance of psychotherapeutic effects, rather than somatic treatment, and confirm the need for psychotherapeutic assistance to such patients.

Thus, stress is not represented as a life event itself, but as a subjective, psychological reaction of a person, his adaptation systems, to a specific life situation, including somatic disease, which affects the general condition of the body and is reflected in the person’s perception of time, causing a mismatch of biological rhythms.

The authors proposed a modification of the "Individual Minute" test: IM with an account and IM without an account. MI with a score characterizes a person’s conscious attitude to the passage of time, while MI without a score reflects a sense of time, an unconscious perception of time by a person, and in the case of maladaptation, their values may not coincide, reflecting the desynchronization of the mental and emotional processes of the human body.

Materials and methods. The study was conducted on the basis of the sanatorium of general therapeutic profile. The following psychophysiological indicators were measured in patients, men and women of working age (25-55 years) upon admission to treatment: heart rate, SBP and DBP before and after physical activity, indicators of weight, height, index of functional changes in adaptation systems, vegetative Kerdo index; and psychological: perception of time, levels of anxiety and depression, indicators of the Luscher color test (psycho-emotional stress, the presence of internal conflict, the coefficient of autonomic tone). The conducted factor regression analysis made it possible to identify a group of factors designated as the index of the functional state of adaptation (IFSA), the structure of which is determined by statistically significant correlations. Based on the analysis, the multiple regression equation was constructed to calculate IFAS, which is calculated by the formula:

IFSA = 0.1 × GAD-0.06 × DBP + 0.29 × IMS / s + 0.28 × IMB / s-0.4 × T-0.42 × D, where

SBP and DBP are indicators of resting arterial pressure;

IM s / s and IM b / s - individual minute test indicators with and without an account;

T and D are indicators of levels of anxiety and depression.

0.1; 0.06; 0.29; 0.28; 0.4; 0.42 - multiple regression coefficients.

As follows from the formula, the index of the functional state of adaptation (IFSA) is an indicator of the objective functional state of the human body, which reflects the person’s adaptation to his health condition and is formed under the influence of a person’s subjective assessment of his psychological state through levels of anxiety and depression. The diagnostic procedure takes 15-20 minutes in time and consists of 3 consecutive steps:

1. testing levels of anxiety and depression;

2. measurement of blood pressure (SBP and DBP) at rest;

3. performance of the test "Individual minute";

Testing levels of anxiety and depression.

Conducted according to the hospital questionnaire of anxiety and depression (GOTD) Scales are easy to use and process: filling out the scale does not require a long time and does not cause difficulties for the patient, which allows recommending it for use in somatic practice for the initial detection of anxiety and depression levels (screening). The scale has a high discriminant validity for two disorders: anxiety and depression.

Method of use: the scale form is issued for self-completion to the patient and is accompanied by instructions. The scale is composed of 14 statements serving 2 subscales: "anxiety" (odd points - 1, 3, 5, 7, 9, 11, 13) and "depression" (even points - 2, 4, 6, 8, 10, 12 , 14) (Appendix). Each statement corresponds to 4 response options, reflecting the gradation of the severity of the symptom and encoded by the increase in the severity of the symptom from 0 (absence) to 3 (maximum severity). After completing the test, the number of points is calculated and the degree of severity of the levels of anxiety and depression is evaluated in points.

Blood pressure measurement

Measure the pressure using a medical Korotkov tonometer, on the right hand in a sitting position at least two times. If the indicators of the second dimension coincide with the first, then they are used for calculation. If the indicators differ (which is possible with a strong emotional reaction of the patient to the check situation), the pressure is measured a third time and the average of the last two measurements is taken to calculate.

Individual minute test

Two parameters of the flow of an individual minute are studied with the registration of results by a stopwatch:

- Awareness of time by man - a uniform account for 60 seconds;

- a sense of time - guessing, "feeling" without counting a time interval of 1 minute (60 seconds).

Each indicator is measured twice and the average of two measurements is taken for calculation.

After measuring all indicators, IFAS is calculated according to the formula:

IFSA = 0.1 × GAD-0.06 × DBP + 0.29 × IMS / s + 0.28 × IMB / s-0.4 × T-0.42 × D, where

SBP and DBP are indicators of resting arterial pressure;

IM s / s and IM b / s - individual minute test indicators with and without an account;

T and D - indicators of levels of anxiety and depression;

0.1; 0.06; 0.29; 0.28; 0.4; 0.42 - multiple regression coefficients.

It was revealed that for IFSA values:

- from 26 to 45 points - the functional state of adaptation is normal: a person adequately responds to his state of health; there is self-regulation of psychological and physiological functions;

- less than 26 points - the functional state of adaptation is anxious: a functional state with psychological symptoms of anxiety, characterized by increased emotionality and a tendency to exaggerate its psychological and somatic distress, impaired self-regulation in the field of emotional management;

- more than 45 points - the functional state of adaptation is depressive: a functional state with psychological symptoms of depression, characterized by a decrease in vitality and ignoring its somatic state, impaired self-regulation due to rigidity of thinking processes;

- in the case of severe functional impairment, in order to conduct effective rehabilitation, the patient primarily needs psychotherapeutic help.

In the claimed method, the authors determine precisely the functional state of adaptation, and not the diagnosis of mental illness. A diagnosis of depression or anxiety-depressive disorder requires additional diagnosis.

Examples

1. A woman of 30 years old, with a diagnosis of vegetative-vascular dystonia of the hypotonic type. Complains of poor health, chronic fatigue, poor sleep, longing. Testing results: GARDEN - 102 mmHg, DBP - 69 mmHg, MI with a score of 72 seconds, MI without a score of -125 seconds, T - 8 points, D - 3 points. IFAS = 57, 48, i.e. the functional state of adaptation is regarded as depressive. In a further conversation, it turns out that at the age of 17, the girl's parents died, she was left alone with her younger brother in her arms. Unsuccessfully married, her husband beat her. Divorced, one raising a child and brother. The unreacted “acute grief”, a lot of distorted stereotypes and life ideas that interfere with normal family life and affect well-being are revealed.

2. A woman of 27 years old, with a diagnosis of Tachycardia of unknown etiology. Complains of heart palpitations, anxiety and homesickness. Married 4 years, a small child, but soon to go to work. Testing results: GARDEN - 98 mm Hg, DBP - 67 mm Hg, MI with a score of -34 seconds, IM without a score of 24 seconds, T - 12 points, D - 10 points. IFAS = 13.36, i.e. the functional state of adaptation is regarded as alarming. Further revealed increased emotionality and panic fear of physical activity.

3. A 43-year-old man with hypertension of the 2nd degree. Drug therapy for hypertension does not improve well-being. He occupies a leading position in work. Single, and never been married. Testing results: GARDEN - 148 mm Hg, DBP - 95 mm Hg, IM with a score of 63 seconds, IM without a score of 80 seconds, T - 6 points, D - 1 point. IFAS = 47.0, i.e. the functional state of adaptation is regarded as depressive, accompanied by psychoemotional stress and a tendency to angry emotional reactions.

The inventive method is simple to use, does not require expensive equipment, allows you to get a subjective assessment of the general state of health with the help of simple psychological and psychophysiological measurements, the results of which make conclusions about the adaptation of a person to his state of health. The findings allow us to quickly resolve the issue of the optimal choice of ways of psychological and somatic rehabilitation, which is especially important at the sanatorium stage in view of the short duration of treatment.

Claims (1)

The method for determining the general state of the human body, which consists in measuring resting blood pressure indicators - systolic blood pressure (SBP) and diastolic blood pressure (DBP), psychophysiological indicators, individual minute test with a score, characterized in that psychophysiological indicators are evaluated through self-assessment of levels anxiety and depression according to the hospital questionnaire of anxiety and depression (GOTD), additionally conduct an individual minute test without counting, then op edelyayut index functional adaptation state (IFSA), which is calculated by the formula: IFSA = 0.1 · CAD-0.06 · DBP + 0.29 · IMs / s + 0.28 · IMb / s-0.4 · T-0.42 · D, where SBP and DBP are indicators of resting arterial pressure; IM s / s and IM b / s - individual minute test indicators with and without an account; T and D - indicators of levels of anxiety and depression; 0.1; 0.06; 0.29; 0.28; 0.4; 0.42 - multiple regression coefficients, and if the IFAS indices are from 26-45, the state is regarded as normal, less than 26 as alarming, and more than 45 as depressive.