RU2472537C1 - Method for correction of psychosomatic disorders in pre-school children and their mothers - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to paediatrics, concerns a method for correction of psychosomatic disorders in pre-school children, and may be used in pre-school educational institutions, child health centres, rehabilitation convalescent hospitals, health resorts and other sanitary institutions. Psychosomatic disorders in pre-school children and their mothers are corrected by assessing a degree of neuropsychic disorders and an incidence of respiratory diseases in a child. If having detected a high degree of neuropsychic disorders and a high incidence of respiratory diseases causing by psychosomatic disorders, sequential family psychotherapy is conducted for 1.5-2 hours once a week for 2 weeks, individual psychotherapy for 30-40 minutes once a week for 5 weeks and group psychocorrection for 1-1.5 hours once a week for 5 weeks within the therapeutic course of 12 weeks. Additionally, the mothers whose children undergo psychocorrection are diagnosed for neuropsychic disorders of the neuropsychic state. There are used sequential family psychotherapy for 1.5-2 hours once a week for 2 weeks, individual psychotherapy for 1.5-2 hours once a week for 2 weeks and group psychocorrection for 1.5-2 hours once a week for 5 weeks within the therapeutic course of 9 weeks, with psychocorrection conducted in the children and the mothers conducted simultaneously on the same days of week.

EFFECT: method provides higher effectiveness of prevention of acute respiratory diseases in the pre-school children, providing a reduced level of incidence of acute respiratory diseases and a degree of neuropsychic disorders, recovering cell protection mechanisms of upper airway mucosa with no complications and side effects.

1 dwg, 6 tbl, 1 ex

Description

The invention relates to medicine, namely to pediatrics, and relates to a method for the correction of psychosomatic disorders (PSH) in children of preschool educational institutions and can be used in preschool educational institutions, children's clinics, rehabilitation centers, sanatoriums and other health institutions.

Numerous methods are known in the available literature aimed at reducing the high incidence of respiratory diseases (AML) in children in preschool educational institutions (DOEs). Health complexes for children with a high incidence of AML or acute respiratory infections (ARI) include numerous medications (antiviral and antibacterial agents, immunomodulators and biogenic stimulants, herbal remedies, vitamins, mineral preparations, etc.), antiviral vaccination, natural and preformed physical factors (hardening, sun and air baths, aerosol inhalation, low-intensity laser irradiation, microwave and ultrasound therapy, etc. p.), as well as the organization of a rational regime of a child’s day, good nutrition, rehabilitation of chronic foci of infection, stay in rehabilitation and health centers and sanatoriums and other events (Palagina M.V., Belyakova M.A., Itskovich A.I. Correction the state of local factors of protection of the upper respiratory tract in preschoolers in environmental conditions. // Pediatrics. - 2000. - No. 6. - P.9-11 .; Spirichev VB, Shatnyuk L.N., Poznyakovsky V.M. . Enrichment of foods with vitamins and minerals. - Novosibirsk, 2004 .-- 547 p .; Soroka N.D. Features of immunotherapy of prolonged and recurrent respiratory diseases in children. // Pediatric pharmacology. - 2008. - Volume 5. - No. 5. - S.88-92 .; Samsygina G.A., Koval G.S. Often sick children. Problems of diagnosis, pathogenesis and therapy. // Children's doctor. - 2008. - No. 6. - S.5-10 .; Baranov A.A., Kuchma V.R., Sukhareva L.M. Assessment of the health status of children. New approaches to preventive and health-improving work in educational institutions: a guide for doctors. - M .: GEOTAR - Media, 2008 .-- 432 p .; Lupan I.N., Samarin O.I., Taturevich et al. Innovative approach to immunotherapy of frequently ill children. // Questions of modern pediatrics. - 2009. - Volume 8. - No. 3. - S.104-107; Stennikova O.V. Boborykina A.E., Levchuk L.V. The role of iodine supply in the formation of the intellectual and somatic health of the child population. // Questions of modern pediatrics. - 2009. - Volume 8. - No. 3. - S. 48-53).

Psychocorrection, as well as other methods of healing and treatment, are widely used in medicine, in particular for the correction of psychosomatic disorders, disorders and diseases in children.

A known method of improving children’s health (application RU No. 97121618, class А61Н 7/00 А61Н 39/04, А61М 21/00, publ. 1999), which consists in initiating a state of meditation, in the massage of biologically active points of the head and auricle, a set of exercises aimed at improving the flexibility of the spine, the joints of the arms and legs, a set of exercises for the eyes and training the vestibular apparatus.

The method has the following disadvantages.

To initiate a state of meditation, only a specialist trained in this field is required, and a clinical psychologist or general psychotherapist does not always possess this technology, which limits the application of the method; difficulties in reproducibility of technical techniques by other persons in the required volume, since it is not generally accepted, which also limits the application of the method; preschool children (5-7 years old) are unlikely to be able to cause sensations of an increasing flow of heat or cold and other sensations due to the functional immaturity of the psyche in various areas of their body, such training will become possible only with a conscious attitude to the procedure in adults and adolescents ; the method involves only individual recovery of each child individually and excludes collective recovery of children, which requires significant time and material resources, does not take into account the influence of the family factor on the child’s mental health.

There is a method of psychotherapeutic effects on children (patent RU No. 2160607, class A61M 21/00, publ. 2000), which consists in the fact that psychotherapy is carried out with the mother and / or grandmother, convincing them that the child’s health depends on the psycho-emotional contact between him and his mother. During the child’s sleep period or 20-30 minutes after falling asleep, the mother sets herself up to achieve positive treatment results, focuses and, slightly touching the child, adjusts the rhythm of her breathing to the rhythm of his breathing, speaks first mentally, and then out loud the formulas of suggesting a treatment program with installation to convey to the child its meaning and content, which affirms the love for the child, the improvement of his physical and mental health and release from existing diseases. Sessions are held daily and the results are recorded in the diary. The method allows to achieve a positive effect in the treatment of many pathologies.

However, the method has disadvantages.

Carrying out a psychotherapeutic effect with the mother or grandmother of the child requires the need for high-quality training of performers in such a highly sensitive psychological effect, the method does not imply monitoring by a doctor or psychologist and does not guarantee the correct execution of the procedure by the mother and, especially, the grandmother; the method does not imply a collective effect on a group of children, which limits its use.

A known method of art therapy conducted with children (patent RU No. 2372108, class A61M 21/00, 2009, bull. No. 31), in which the therapist offers the child to draw an installation that he has implemented, since verbalization is difficult for many children. Positive changes are created with various forms of maladaptive and deviant behavior, including pathological addictions, with psychosomatic disorders of various nature, due to the disclosure of the role of underlying psychosomatic mechanisms in the pathogenesis of these diseases. The method is effective in the prevention and treatment of neurosis and psychosomatic disorders.

The disadvantages of this method

An overly complicated procedure requires a conscious and understanding attitude to its essence on the part of the child, therefore, due to the immaturity of consciousness of children - preschoolers (5-7 years old), the method cannot be accessible to them and can be recommended only for adult patients.

A known method for the correction of psychosomatic diseases (patent RU No. 23039774, class A61M 21/00, bull. No. 31, 2006), which is based on the choice of the patient's preferred color of the rainbow. Sessions of suggestive psychotherapy - "Rainbow" are conducted to calm music. The patient is advised to look at the picture of the colors of the rainbow for 5 minutes once a day daily for 3 months. The method allows to concentrate the patient on the preferred color, which he chose subconsciously, and to conduct a successful correction of psychosomatic diseases.

The method has several disadvantages.

The method involves only individual execution of the procedure without the participation of children's groups in recovery; does not take into account the family factor, possibly affecting negatively the neuropsychic state of the child; It takes a long period of three months of daily procedures and a significant investment of time; in essence, psychocorrection has only one-sided orientation, based on color perception without taking into account other mechanisms of psychosomatic disorders.

A known method of psychocorrection (patent RU No. 2133360, class A61M 21/00, publ. 1998), intended for the treatment of neurosis and borderline conditions. The harmonization of personality and interpersonal relationships. An image of a person is proposed in which his personality characteristics to be changed are revealed. Change facial features and other attributes on the image in accordance with a given direction. Repeatedly affect the received image on the person and the people around him, which causes a change in the attitude of people around him and adjust his personal characteristics in a given direction.

The disadvantage of this method is that it is intended for the treatment of neurosis and borderline conditions, preschool children (5-7 years old) cannot identify their personal characteristics, which limits its use, and can only be used to treat adult patients and, possibly, adolescents .

A known method of correction of psychosomatic dysfunctions (application RU No. 94032555, class A61M 21/00, publ. 1996). They compose a psychotherapeutic program taking into account a representative system of patient information perception. At the beginning of the session, deprivation of vision is carried out, the rhythm of respiration is established with the elongated expiratory phase of the respiratory cycle. The patient is introduced into a state of light trance, psychotherapeutic information is presented, the semantic emphasis of the suggestion formula is combined with the expiratory phase of the patient’s respiratory cycle. The method allows to increase the effectiveness of psychotherapeutic effects, to increase the period of remission and to form optimal forms of response.

However, the known method has disadvantages.

It is necessary to introduce the child into a trance state, which may not be possible in principle in preschool children (5-7 years old) due to functional lack of maturity and immaturity, primarily the state of consciousness; in addition, the method involves only individual work with the patient and is not aimed at the collective recovery of children.

Closest to the claimed invention is a "Method of healing frequently ill children" (patent RU No. 2391960, class A61H 7/00, A61H 33/02, A61H 33/04, A61M 15/00, A61K 35/08, A61P 43/00 , 2006, bull. No. 17), selected as a prototype. The method includes a training regimen, medical nutrition, therapeutic gymnastics, chest massage, inhalation of mineral water, application of tambucan silt-sulfide mud to the cervical-collar zone in appropriate modes for younger and older students. The method reduces the number of exacerbations of chronic foci of infection (chronic tonsillitis, pharyngitis, adenoiditis, sinusitis, etc.) in rehabilitation institutions.

However, the prototype has several disadvantages.

These include the absence of a significant and sustainable reduction in the incidence of AML or ARI over a long period of time; frequent and prolonged AML and ARI serve as a pathogenetic basis for changes in the immunological reactivity of the body; against the background of frequent AML and acute respiratory infections, diseases of the ENT organs, as well as pathology of the lower respiratory tract are quickly formed; excessive and unreasonable use of drugs for frequent AML and acute respiratory infections often leads to toxic complications and allergic reactions, to frequent and prolonged omissions in children visiting preschool institutions; the rehabilitation of children with pre-school education requires significant material costs and parents' time, they are often forced to receive temporary disability certificates and medical certificates, indicators of temporary disability and labor losses are growing; due to the high incidence of AML and acute respiratory infections, neuropsychic and physical development and the socialization of children are often delayed; somatic diseases often develop in this category of children of preschool educational institution with a high incidence of AML and acute respiratory infections, their relationships with neuropsychic disorders are formed, and all this leads to the occurrence of psychosomatic disorders. However, in the complex of recreational activities for children with frequent AML and acute respiratory infections, psychocorrection has not yet found its proper place. The prototype method assumes only individual psychocorrection and is not suitable for the children's team as a whole, and also does not imply psychocorrection of neuropsychiatric disorders (NI) in mothers. Psychocorrection and psychotherapy are carried out in the form of various methods and technologies aimed at the correction of psychosomatic disorders only in children. At the same time, it is known that deviations in the neuropsychic state of parents, especially mothers who have the greatest psycho-emotional contact with the child, play a major causal role in the occurrence of psychosomatic disorders. They create a traumatic situation in connection with frequent illnesses of the child, forced interruptions in labor activity, economic losses and significant costs of funds for treatment, cohabitation of diseases and many other factors.

The objective of the invention is to develop a method for the correction of psychosomatic disorders (PSN) in children and their mothers in a preschool (DO), which can reduce the acute incidence of AML, reduce or eliminate the degree of NAP and create favorable conditions for further neuropsychic development ( CPD) children.

The problem is solved by the implementation of the correction of PSN in children of preschool educational institutions, both with medication and physical factors, and with the methods of psychocorrection of PSN in children and NAP in their mothers at the same time, providing the effect of correction of somatic disorders and neuropsychiatric disorders.

The technical result is expressed in increasing the effectiveness of the prevention of acute AML in children with preschool education by obtaining a fundamentally new effect of psychocorrection through pathogenetically consistent sequential use of family, individual and group psychocorrection, simultaneously performed in children and their mothers, ensuring a decrease in the acute incidence of AML and the degree of NIP rapid restoration of cellular mechanisms of protection of the mucous membrane of the upper respiratory tract (VDP) in the absence of complications and side effects.

The proposed method is implemented as follows.

First, in children of preschool educational institutions, the incidence of AML is graded according to the number of cases of diseases per year by the method of sigmal deviations. A low level is determined within less than X-1S with fluctuations in cases of diseases from 0 to 1.5; the average level is within X ± 1S and the range of cases of diseases from 1.6 to 4.8 and the high incidence rate is in the range of more than X + 1S with fluctuations in cases of diseases from 4.9 and higher per year.

The revealed high level of morbidity serves as an indication for the psychodiagnostics of NIP, including the determination of the degree of anxiety, self-esteem disorders, social adaptation and emotional conflict in the family, and the appointment of PSN psychocorrection in children.

Methods of psychodiagnostics of children:

1. The test "Choose the right face" was developed by American psychologists R. Tamml, M. Dorki and V. Amen. It is a children's anxiety test and is designed to determine the level of personal anxiety, indicating a lack of emotional fitness, poor adaptation of the child to life situations of concern (Nemov RS Psychology. In 3 books. - Book 3. Psychodiagnosis. Introduction to the scientific psychological research with elements of mathematical statistics. - M .: VLADOS, 2007. - 631 p.).

2. The test "Choice in action" is a study and assessment of the relationship of the child with peers, the violation of which is a subtle indicator of deviations of mental development. The value of relationships with others is important (Nemov R. S. Psychology. In 3 books. - Book 3. Psychodiagnostics. Introduction to scientific psychological research with elements of mathematical statistics. - M .: VLADOS, 2007. - 631 p.). Due to the inability to organize communication, to be interesting to others, the child becomes wounded, rejected, timid, withdrawn, anxious (Klyueva N.V., Filippova Yu.V. Communication. Children 5-7 years old - 2nd edition, revised and add. - Yaroslavl: Development Academy: Holding Academy, 2001. - 160 p.).

3. The test "What Am I?" Is aimed at determining the self-esteem (opportunities and abilities) of a preschool child (Nemov RS Psychology. In 3 books. - Book 3. Psychodiagnostics. Introduction to scientific psychological research with elements of mathematical statistics. - M .: VLADOS, 2007 .-- 631 p.). Adequate self-esteem is an indicator of a successful mental development. Decreased self-esteem is observed in children with a psychologically depressive attitude, leading to internal self-depreciation. Overstated self-esteem testifies to the position of superiority, which leads to the child’s self-separation from others, his isolation (Klyueva N.V., Filippova Yu.V. Communication. Children 5-7 years old - 2nd edition, revised and additional - Yaroslavl: Development Academy: Holding Academy, 2001. - 160 p.).

4. The test “Family drawing” is a procedure that reflects the child’s perception of his place and the level of emotional conflict in the family (Igumnov SA Psychotherapy and psychocorrection of children and adolescents. - M .: Publishing house of the Institute of Psychotherapy, 2000. - 112 p. .).

Psychodiagnostics of each child is carried out sequentially in four tests. Interpretation of test results is expressed in points for each test. Then, the total number of points for four tests is calculated and the result is evaluated as follows:

0-11 points - low level of neuropsychiatric disorders,

12-26 points - the average level of neuropsychiatric disorders,

27-43 points - a high level of neuropsychic disorders.

As a result of psychodiagnostics, all children can be divided into three groups: with a low degree of NI, with an average degree of NI, with a high degree of NI. Then, mothers whose children have a high degree of NIP and a high incidence of AML, causing PSN, assess the neuropsychic state (NPS) by the level of anxiety, the nature of emotional contact with the child and the type of parental relationship. When assessing anxiety, high, medium and low degrees are distinguished. By the nature of emotional contact, excessive emotional distance is established with the child, optimal emotional contact and excessive concentration on the child. As a result of the diagnosis of the types of parental attitude towards the child, a socially desirable type of attitude towards the child is determined (“Cooperation” and socially undesirable types of attitude towards the child (“Rejection”, “Symbiosis”, “Control”, “Little Loser”). judged mainly on the basis of a high degree of anxiety, the presence of excessive distance and excessive concentration on the child, the predominance of socially undesirable types of attitudes towards the child. they have psychocorrection.

The methods of psycho-diagnosis of their parents (mothers) include:

1. John Taylor’s Anxiety Scale test is designed to measure the manifestations of anxiety in adults (Shapar VB, Timchenko AV, Shvydchenko VN Practical Psychology. Instrumentation. - Rostov-on-Don: Publishing House Phoenix , 2002 .-- 688 p.).

2. The Parental Attitude Research Instrument (PARI) test is designed to study the attitude of parents (primarily mothers) to family life and, above all, to children. The test examines two aspects - the aspect of attitude to the family role and the aspect of attitude to the child. In this study, the aspect of parent-child relationships is of interest, namely, the nature of the emotional contact of the mother and the child (optimal, excessive emotional distance, excessive concentration on the child). The authors of the test are American psychologists E.S. Schaefer and R.K. Bell. In Russia, the methodology was adapted by T.V. Nescheret (Shapar V. B., Timchenko A. V., Shvydchenko V. N. Practical psychology. Toolkit. - Rostov-on-Don: Phoenix Publishing House, 2002. - 688 p.).

3. The test “Parental Relationship Questionnaire” (ORO) is a psychodiagnostic tool focused on identifying the parent’s rational, emotional and behavioral attitude towards the child. The questionnaire of parental relations was developed by Russian psychologists A.Ya. Varga, V.V. Stolin (Nemov R.S. Psychology. In 3 books. - Book 3. Psychodiagnostics. Introduction to scientific psychological research with elements of mathematical statistics. - M .: VLADOS , 2007 .-- 631 p.).

The test contains questions that make up 5 scales:

1. The scale "Adoption-rejection of the child" reflects the overall emotionally positive (acceptance) or emotionally negative (rejection) attitude towards the child.

2. The scale "Cooperation" expresses the desire of adults to cooperate with the child. The manifestation of their sincere interest and participation in his affairs.

3. The scale "Symbiosis" reveals the interpersonal distance in communication with the child.

4. The scale "Control" reveals the form and direction of control over the behavior of the child, democracy and authoritarianism in relation to him.

5. The scale "Attitude to the failures of the child" reflects the attitude of the parent to the abilities of the child, to his strengths and weaknesses, successes and failures.

After determining the indications in children and their mothers proceed to psychocorrection.

In the structure of the proposed correction method, there are generally accepted methods for preventing AML and improving children, as well as methods for psychocorrection of children and their mothers (Figure 1). Conventional methods for preventing AML and improving the health of children in preschool education include organizing the correct daily regimen; good nutrition, balanced by ingredients and enriched with natural vitamins; rehabilitation of chronic foci of infections (ENT organs, oral cavity and teeth, etc.); regular tempering procedures with exposure to natural factors (air, sun, water); morning hygienic gymnastics; breathing exercises in the air at different times of the year; complexes of special breathing exercises; organization of a rational summer vacation; massage of biologically active points (BAP) for 1 month 2 times a year; a course of vitamin therapy for 30-40 days 2 times a year; phytoprophylaxis using multivitamin, biostimulating, anti-inflammatory, anti-allergic, antiseptic, expectorant and other groups of herbal remedies, for 2-4 weeks 2 times a year; pharmacosanation by adaptogens (eleutherococcus, etc.) for 1 month 2 times a year; local sanitation of the nasopharynx with mineral water and decoctions of herbal remedies for 1 month 2 times a year; prophylactic total ultraviolet radiation in groups of 12-14 procedures 2 times a year specific antiviral prophylaxis with drugs according to epidemic indications for two weeks in an epidemiologically unfavorable period for ARI 1-2 times a year. Conventional methods for preventing AML and improving children’s health were used in 48.1-92.5% of children in the main group and in 46.2-96.2% of children in the comparison group. No significant differences in the number of children who used methods of prophylaxis of AML were found, which indicates the identity of the studied groups (table 1.).

Table 1 AML PREVENTION METHODS FOR CHILDREN ATTENDING DOW (Abs.h., P ± m p,%) AML Prevention Methods Groups of children examined The main group (n = 27) Comparison Group (n = 26) Significance of Differences Abs. P ± m p Abs. P ± m p p ₁ -p ₂ one 2 3 four 5 6 Organization the correct daily routine 24 88.9 ± 6.0 24 92.3 ± 5.2 > 0.5 Nutrition 25 92.5 ± 5.1 24 92.3 ± 5.2 > 0.5 Reorganization chronic foci of infection 19 70.4 ± 8.8 eighteen 69.2 ± 9.1 > 0.5 Hardening 21 77.8 ± 8.0 23 88.5 ± 6.3 > 0.2 Morning hygienic gymnastics 24 88.9 ± 6.0 25 96.2 ± 3.7 > 0.2 Breathing outdoor gymnastics twenty 74.1 ± 8.4 21 80.8 ± 7.7 > 0.5 Special breathing exercises eighteen 66.7 ± 9.1 16 61.5 ± 9.5 > 0.5 Organization rational summer vacation fifteen 55.6 ± 9.6 17 65.4 ± 9.3 > 0.2 Massage biologically active points (BAP) fourteen 51.9 ± 9.6 13 50.0 ± 9.8 > 0.5 Vitamin Therapy Course 24 88.9 ± 6.0 25 96.2 ± 3.7 > 0.2 The course of biostimulants eighteen 66.7 ± 9.1 16 61.5 ± 9.5 > 0.5 Pharmacosanation adaptogens (eleutherococcus) 22 81.5 ± 7.5 twenty 76.9 ± 8.3 > 0.5 Local rehabilitation of the nasopharynx fifteen 55.6 ± 9.6 12 46.2 ± 9.8 > 0.2 Preventive General UV 13 48.1 ± 9.6 12 46.2 ± 9.8 > 0.5 Antiviral specific prophylaxis 23 85.2 ± 6.8 21 80.8 ± 7.7 > 0.5 Note: p ₁ -p ₂ - significance of differences between the indicators in the main group and the comparison group

Psycho-correction of PSN for children of the main group provides for consistent family, individual and group psychocorrection. The total duration of psychocorrectional methods is 12 weeks. Maternal psychocorrection also includes family, individual and group correction. The total duration of psycho-corrective measures for mothers is 9 weeks. Moreover, psychocorrection in children and their mothers is carried out simultaneously on the same days of the week (table 2).

Methods of psychocorrection of children:

1. The method of family psychocorrection

The purpose of family psychocorrection is to eliminate the consequences of the negative upbringing of the child in the family.

The main procedure for family psychocorrection is a psychological conversation (consultation) with the child and mother.

Means of support: a separate room for consultation, results of psycho-diagnostics of children and their mothers, results registration cards.

The duration and frequency of meetings involves 2 meetings lasting 1.5-2 hours at the beginning of the correction.

2. The method of individual psychocorrection

The purpose of this method is to reduce emotional stress in children and to actualize the possibilities of their development.

The main procedure of this method is the individual game of the child in the presence of a doctor or psychologist and with his participation.

Means of support: a game room, a variety of game materials: toys, plasticine, clay, paints, pencils, felt-tip pens, designers, children's mosaics, etc.

Number and duration of classes: 5 lessons of 30-40 minutes 1 time per week for five weeks.

3. The method of group psychocorrection

The purpose of this method is to normalize interpersonal relationships between children, their peers and parents, mastering communication skills and social adaptation.

table 2 PSYCHO CORRECTION OF PSYCHOMATIC DISORDERS IN CHILDREN OF DOW AND THEIR MOTHERS Psychocorrection Methods Characteristics of psychocorrection Psychocorrection of children Maternal Psychocorrection Correction duration Correction Frequency Number of weeks Correction duration Correction Frequency Number of weeks Family psychocorrection 1.5-2 hours Once a week 2 1.5-2 hours Once a week 2 Individual psychocorrection 30-40 minutes Once a week 5 1.5-2 hours Once a week 2 Group psychocorrection 1-1.5 hours Once a week 5 1.5-2 hours Once a week 5 Total: 12 9

The main procedure of this method consists in role-playing role-playing game situations (playing “family”, “holiday”, “store”, etc.) in which children, their peers and parents interact. During one meeting, one game is held at the choice of participants, in which all children and adults participate.

The number of children in the group reaches 6-8. The number of adults involved is equal to the number of children.

Means of support: games room, toys by age, household items (household, construction, bedding, clothing, dishes, etc.)

The number and duration of classes is 5 lessons of 1-1.5 hours 1 time per week for five weeks.

Therefore, the proposed method of psychocorrection of children consistently includes three consecutive methods (family, individual and group psychocorrection) and generally lasts for 12 weeks (Zakharov A.I. Neuroses in children and psychotherapy. - St. Petersburg: Soyuz Publishing House, Lenizdat . - 2000. - 336 p .; AI Zakharov. Game as a way to overcome neurosis in children. - St. Petersburg: KARO, 2006. - 416 p.).

Methods of psychocorrection of mothers:

1. The method of family psychocorrection

The purpose of family psychocorrection is to prevent the consequences of negative parenting in the family.

The main procedure for family psychocorrection is a psychological conversation (consultation) with the mother and child.

Means of support: a separate room for consultation, results of psycho-diagnostics of children and their mothers, results registration cards.

The duration and frequency of meetings involves 1 meeting lasting 1.5-2 hours at the beginning of the correction.

2. The method of individual psychocorrection

The purpose of individual psychocorrection is to disclose the main features of the neuropsychic state of mothers (according to the results of psychodiagnostics), their influence on the process of raising children, and the possibilities of prevention and correction of neuropsychiatric disorders.

The basis of the individual psychocorrection procedure is a psychological conversation (consultation) with the mother.

Means of support: a separate room for a consultation, results of psycho-diagnostics of mothers, paper, writing materials, a card for recording results.

Duration and frequency of meetings: 2 meetings lasting 1.5-2 hours for the entire correction period

3. The method of group psychocorrection

The purpose of this method is to normalize interpersonal relationships between mothers and children, master the communication skills with children and gain a deeper understanding of their psychology and behavior.

The main procedure of this method is to role-play conditional game situations in which mothers interact with their children and their peers.

Means of support: a games room, toys for children, household items (household, construction, bedding, items of clothing, dishes, etc.).

The number of mothers in the group is 6-8 people and corresponds to the number of children.

Number and duration of classes: 5 lessons of 1-1.5 hours 1 time per week for five weeks.

Therefore, the proposed method of psycho-correction of mothers includes three sequentially conducted methods (family, individual and group psycho-correction), lasting for 8 weeks. Moreover, psychocorrection of mothers and children is carried out simultaneously (Zakharov A.I. Neurosis in children and psychotherapy. - St. Petersburg: "Soyuz Publishing House", "Lenizdat." - 2000. - 336 p .; A. Zakharov. Game as a way to overcome neurosis in children .-- SPb: KARO, 2006. - 416 p.).

The proposed method of psychocorrection was used in 27 (50.9 ± 6.9%) children of the main group, and generally accepted methods of prevention and recovery of children (without psychocorrection) were used in 26 (49.1 ± 6.9%) children of the comparison group.

The effectiveness criteria of the compared methods of the main group and the comparison group were the incidence of AML, the immuno-cytological parameters of the mucous membrane of the upper respiratory tract, the frequency and degree of NAP in children and their mothers.

Studies on the level of AML incidence against the background of PSN correction in children of the main group allow it to be considered more effective. In the main group of children, the incidence of airborne diseases significantly decreased by 1.9 times, NDP - by 3.8 times and, accordingly, the overall incidence rate - by 2.1 times. In children of the comparison group, the incidence of airborne diseases significantly decreased by 1.2 times, NDP - 1.7 times, and the overall incidence of 1.3 times (table 3.).

Table 3

)COMPARATIVE CHARACTERISTIC OF ACUTE INCIDENCE OF BOD DEPENDING ON THE METHODS OF CORRECTION OF PSN IN CHILDREN OF DOW (Abs.ch.

) Diseases (cases of illness per 1 child per year) Groups of children examined The main group (n = 27) Comparison Group (n = 26) Significance of Differences Before correction After correction Before correction After correction p ₁ -p ₃ p ₁ -p ₂ p ₃ -p ₄ p ₂ -p ₄ Abs.

Abs.

Abs h

Abs.

Diseases upper respiratory tract 121 4.48 ± 0.19 62 2,30 ± 0,19 130 5.00 ± 0.20 105 4.04 ± 0.20 > 0.05 0.001 0.01 0.001 Diseases lower respiratory tract 27 1.00 ± 0.10 7 0.26 ± 0.10 25 0.96 ± 0.10 fifteen 0.58 ± 0.10 > 0.5 0.001 0.02 0.05 Total number cases of illness 148 5.48 ± 0.19 69 2.55 ± 0.24 155 5.96 ± 0.30 120 4.62 ± 0.30 > 0.1 0.001 0.01 0.001 Note: p ₁ -p ₃ - the significance of differences between the indicators of the main group and the comparison group before correction, p ₁ -p ₂ - the significance of differences between the indicators of the main group before and after correction, p ₃ -p ₄ - the significance of differences between the indicators of the comparison group before and after correction, p ₂ -p ₄ - the significance of differences between the indicators of the main group and the comparison group after correction.

A comparative analysis of immuno-cytological parameters obtained after correction in the main group and the comparison group, indicates the advantages of the proposed method. The total cytogram of nasal secretion in children of the main group is distinguished by 1.1 times higher values of ciliary epithelial cells (CE) (p <0.001) and 1.1 times lower goblet cells (CD) (p <0.02), a large decrease the number of migrating epithelial cells (E), neutrophils (H), lymphocytes (Lf) 1.2-1.4 times (p <0.001, p <0.001, p <0.001) and, accordingly, more significant values of EC / Lc in 1 6 times (<0.001). Partial cytograms of CE of the main group are characterized by lower values of the cytopathological index of destruction of the ciliary epithelium (IDCE), the average index of destruction of the ciliary epithelium (SPEC), the vacuolization index of the ciliary epithelium (IVCE) 1.1-1.4 times (p <0.05, p <0.01, p <0.01) and large values of the cytophysiological index of regeneration of the ciliary epithelium (IRCE) 1.3 times (p <0.001). In partial H cytograms, the indicators of the neutrophil destruction index (IDN), the average neutrophil destruction index (SPD), and the neutrophil cytolysis index (ICN) were 1.1 - 1.4 times (p <0.01, p <0.01, p <0.01) (table 4).

Evaluation of the results of the diagnosis of neuropsychiatric disorders in children of preschool educational institutions before and after correction in the main group and in the comparison group allows us to identify a number of their features and establish the interdependence of the degree of NAP on the method for correcting PSN.

The integrative psychodiagnostics of PSN allows us to confirm the revealed pattern of a 4.5-fold increase in the frequency of a low degree of CAP and a 5.0-fold decrease in a high degree of CAP in the main group. In contrast, in children in the comparison group there were no regular changes in the frequency of occurrence of low, medium and high degrees of NI (table 5).

Table 4

)COMPARATIVE CHARACTERISTICS OF IMMUNO-CYTOLOGICAL INDICATORS OF VDP, DEPENDING ON THE METHODS OF CORRECTION OF PSN IN CHILDREN (

) Indicators Groups of children examined The main group (n = 27) Comparison Group (n = 26) Significance of Differences Before correction After correction Before correction After correction p ₁ -p ₃ p ₁ -p ₂ p ₃ -p ₄ p ₂ -p ₄ one 2 3 four 5 6 7 8 9 Total cytogram: - CE,% 62.80 ± 0.94 74.20 ± 1.76 60.80 ± 0.55 67.28 ± 0.61 > 0.5 <0.001 <0.001 <0.001 - BC,% 3.65 ± 0.10 2.92 ± 0.10 3.95 ± 0.16 3.30 ± 0.10 > 0.5 <0.001 <0.01 <0.02 - E,% 3,50 ± 0,12 2.15 ± 0.02 3.30 ± 0.10 2.85 ± 0.18 > 0.1 <0.001 <0.001 <0.001 - N,% 26.00 ± 0.67 19.20 ± 0.28 27.30 ± 0.79 23.30 ± 0.41 > 0.1 <0.001 <0.001 <0.001 - Lf,% 2,50 ± 0,13 1.40 ± 0.03 2.70 ± 0.11 1.90 ± 0.14 > 0.2 <0.001 <0.001 <0.01 - ETs / Lts 1.34 ± 0.06 3.00 ± 0.11 1.54 ± 0.10 1.88 ± 0.12 > 0.5 <0.001 > 0.05 <0.001 Cytogram of the ciliary epithelium: - IDCE 0.54 ± 0.02 0.40 ± 0.02 0.56 ± 0.02 0.47 ± 0.02 > 0.5 <0.01 <0.01 <0.05 - SPDCE 1.80 ± 0.04 1.22 ± 0.03 1.84 ± 0.04 1.39 ± 0.04 > 0.2 <0.001 <0.001 <0.01 - ICCE 0.14 ± 0.01 0.09 ± 0.01 0.15 ± 0.01 0.10 ± 0.01 > 0.2 0.01 <0.01 > 0.2 - IRCE 0.130 ± 0.02 0.54 ± 0.02 0.28 ± 0.01 0.41 ± 0.01 > 0.5 <0.001 <0.001 <0.001 - IMCE 0.15 ± 0.01 0.08 ± 0.01 0.16 ± 0.01 0.10 ± 0.01 > 0.5 <0.001 <0.001 > 0.1 - IVCE 0.31 ± 0.02 0.12 ± 0.01 0.32 ± 0.02 0.17 ± 0.01 > 0.5 <0.001 <0.001 0.01 - IMCN 0.42 ± 0.02 0.25 ± 0.01 0.46 ± 0.02 0.29 ± 0.02 > 0.2 <0.001 <0.001 > 0.2 Cytogram of neutrophils: - IDN 0.81 ± 0.03 0.58 ± 0.02 0.83 ± 0.03 0.69 ± 0.03 > 0.5 <0.001 <0.01 0.01 - SPDN 1.75 ± 0.04 1.28 ± 0.03 1.78 ± 0.04 1.44 ± 0.04 > 0.5 <0.001 0.001 0.01 - CPI 0.22 ± 0.01 0.12 ± 0.01 0.25 ± 0.02 0.17 ± 0.01 > 0.2 <0.001 0.01 0.01 - IVN 0.24 ± 0.01 0.14 ± 0.01 0.24 ± 0.01 0.16 ± 0.01 > 0.5 <0.001 0.01 > 0.1 - IFN 0.22 ± 0.01 0.10 ± 0.01 0.23 ± 0.01 0.12 ± 0.01 > 0.5 <0.001 0.001 > 0.1 Note: p ₁ -p ₃ - the degree of significance of differences between the indicators of the main group and the comparison group before correction, p ₁ -p ₂ - the degree of significance of differences between the indicators of the main group before and after correction, p ₃ -p ₄ - the degree of significance of differences between the indicators of the comparison group before and after correction, p ₂ -p ₄ - the degree of significance of differences between the indicators of the main group and the comparison group after correction.

Table 5 COMPARATIVE CHARACTERISTICS OF FREQUENCY OF MEETINGS OF THE DEGREES OF INTEGRATIVE PSYCHODIAGNOSIS DEPENDING ON THE METHOD OF CORRECTION IN CHILDREN OF DOW (Abs.h., P ± m p,%) Degrees of integrative psychodiagnostics (performance criteria) Groups of children examined The main group (n = 27) Comparison Group (n = 26) Significance of Differences Before correction After correction Before correction After correction p ₁ -p ₃ p ₁ -p ₂ p ₃ -p ₄ p ₂ -p ₄ Abs. % Abs. % Abs. % Abs. % I. Low degree of NPN (0-11 points) 2 7.4 ± 5.0 9 33.3 ± 9.1 one 3.8 ± 3.7 2 7.7 ± 5.2 > 0.5 <0.02 > 0.5 <0.02 II. The average degree of NIP (12-26 points) 10 37.0 ± 9.3 fifteen 55.6 ± 9.6 7 26.9 ± 8.7 10 38.5 ± 9.5 > 0.5 > 0.1 > 0.2 > 0.1 III. High degree of NIP (27-43 points) fifteen 55.6 ± 9.6 3 11.1 ± 6.0 eighteen 69.3 ± 9.0 fourteen 53.8 ± 9.8 > 0.2 <0.001 > 0.2 <0.001 Note: p ₁ -p ₃ - the degree of significance of differences between the indicators of the main group and the comparison group before correction, p ₁ -p ₂ - the degree of significance of differences between the indicators of the main group before and after correction, p ₃ -p ₄ - the degree of significance of differences between the indicators of the comparison group before and after correction, p ₂ -p ₄ - the degree of significance of differences between the indicators of the main group and the comparison group after correction.

Indicators of integrative psychodiagnostics (performance criteria) Group of children examined Main group Comparison group Significance of Differences Before correction After correction Before correction After correction p ₁ -p ₃ p ₁ -p ₂ p ₃ -p ₄ p ₂ -p ₄ Abs.h % Abs. % Abs. % Abs. % 1. Low degree of NPN (0-11 points) 2. The average degree of NIP (12-26 points 3. High degree of NIP (27-43 points)

Mothers of children from the main group also found positive dynamics of indicators of neuropsychiatric disorders after correction 3.0-6.7 times. Psychocorrection had an impact on reducing anxiety of mothers, establishing optimal contact with children and changing the type of parental attitude towards his social desirability. The results of the study showed different effectiveness of correction methods. The inclusion of psychocorrection in the generally accepted complex of children's health has a positive effect on their neuropsychic state (table 6).

Table 6 EFFECTIVENESS OF PSYCHO CORRECTION IN THE FREQUENCY OF THE MEETING OF NERVOUS-MENTAL DISORDERS BEFORE AND AFTER PSYCHO CORRECTION OF MOTHERS (Abs.h., P ± m p,%) Mothers with Neuropsychiatric Disorders Performance criteria Before After Credibility corrections (n = 27) corrections (n = 27) differences Abs. P ± m p Abs. P ± m p R The degree of anxiety: - low 2 7.4 ± 5.0 12 44.5 ± 9.6 <0.01 - average 9 33.3 ± 9.1 10 37.0 ± 9.3 > 0.5 - high 16 59.3 ± 9.5 5 18.5 ± 7.5 <0.01 Character emotional contact: - excessive distance 13 48.2 ± 9.6 3 11.1 ± 6.0 0.01 - optimal contact 3 11.1 ± 6.0 twenty 74.1 ± 8.4 0.01 excessive concentration eleven 40.7 ± 9.5 four 14.8 ± 6.8 0.05 on a child Parent Relationship Type: - socially desirable 3 11.1 ± 6.0 3 70.4 ± 8.8 0.001 - socially undesirable 24 88.9 ± 6.0 24 29.6 ± 8.8 0.001 Note: p - significance of differences between indicators before and after correction.

The alleged invention is illustrated by an example:

Danil 3., 5 years 7 months., A pupil of the municipal DOU №157 of Vladivostok suffers from frequent AML. When assessing the incidence of disease, it was found that over the past year he suffered 4 times of acute respiratory infections and 3 times acute bronchitis, i.e. suffered an acute pathology of the upper respiratory tract (UR and NDP) up to 7 times and this corresponds to a high incidence of AML (from 4.9 diseases per year and above).

Studies of local cellular defense of the mucosa of the VDF have shown significant changes. In the total cytogram, the number of CE cells was 64.6% (decreased), CD - 3.55% (increased), E - 3.5% (increased), N - 24, 0% (increased), Lf - 2.3 % (normal), EC / Lts (decreased). The partial cytogram of the ciliary epithelium was characterized by increased IDCE (0.55), SPDCE (1.26), IVEC (90.30) and reduced IREC (0.16), the partial cytogram of neutrophils (H) was characterized by an increase in IDN values (0.52) , SPDN (1.70), ICN (0.21). Consequently, the obtained cytogram data indicate the presence of pronounced defects in the local cellular defense of airborne diseases, facilitating the penetration of pathogens and contributing to the development of AML.

As a result of the study of the child’s neuropsychic state, a high degree of anxiety, an average degree of impaired self-esteem, a high degree of impaired adaptation and a high degree of emotional conflict in the presence of a high integrative degree of NPN were established.

Psychological testing of the mother showed a high degree of anxiety, the presence of excessive emotional distance with the child and the type of parental attitude “Rejection” of social undesirability.

Consequently, a high incidence of acute AML and a predominantly high degree of NIP in a child in whose family the mother also suffers from NIP, allow us to consider the psychosomatic nature of his respiratory pathology, which was an indication for the psycho-correction of PSN in the complex rehabilitation of the child.

Among the methods of preventing AML, the child’s health plan included: organizing the correct regimen of the day, hardening, breathing exercises in the air, rational summer vacations, massage of biologically active points (BAP), a course of vitamin therapy, pharmacosanation with Eleutherococcus, local sanitation of the nasopharynx, specific antiviral prophylaxis in season epidemic distress.

At the end of the general course of psychocorrection, an assessment was made of its effectiveness in the comprehensive rehabilitation of the child according to the incidence of AML, immuno-cytological indicators, the degree of NAP in the child, and the dynamics of NIP in his mother.

The number of cases of DTP diseases in a boy decreased from 4 to 2 diseases per year or 2.0 times, the number of cases of NDP diseases - from 3 to 1 per year or 3.0 times. The overall incidence rate has changed from a high level to an average level. The total number of cases of AML in the boy decreased from 7 to 3 cases of diseases per year, or 2.3 times. Consequently, the incidence rate of AML Danila Z. from high (from 4.9 diseases per year and above) decreased to an average level (from 1.6 to 4.8 diseases per year).

After the correction by the proposed method, the total cytogram of the nasal secret in the boy was distinguished by an increase in the values of ciliary epithelial cells (CE) from 64.6 to 75.4% or 1.2 times and a decrease in the values of goblet cells (CD) from 3.5 to 2, 9% ± 0.10 or 1.2 times, a decrease in the number of migrating epithelial cells (E) from 3.5 to 2.1% or 1.7 times, neutrophils (H) from 24.0 to 18.3% or 1.3 times, lymphocytes (Lf) from 2.3 to 1.3% or 1.9 times and, accordingly, an increase in the EC / Lc values (from 1.3 to 3.0% or 2.3 times ) The partial cytogram of CE was characterized by a decrease in the values of cytopathological IDCE from 0.55 to 0.38% or 1.4 times, SPDCE from 1.80 to 1.26% or 1.4 times, IVEC from 0.30 to 0.11 % or 2.7 times and an increase in the values of cytophysiological IREC from 0.16 to 0.49% or 3.1 times. In the partial cytogram H, the values of IDN indices decreased from 0.78 to 0.52% or 1.5 times, SPDN from 1.70 to 1.28% or 1.3 times, ICN from 0.21 to 0.10 % or 2.1 times.

In the neuropsychic status, there was a decrease in the degree of anxiety from high to medium, the degree of disturbances in self-esteem changed from medium to low, the disturbances in social adaptation decreased from high to low, and emotional conflict in the family decreased from high to medium. Integrative psychodiagnostics of PSN allowed to confirm the revealed pattern and revealed a decrease in the degree of NIP from high to medium.

The mother of the child also found a positive trend in the indicators of neuropsychiatric disorders after correction. Psychocorrection had an impact on reducing anxiety from high to low, changing the excessive emotional distance to optimal contact with the child, and changing the type of parental relationship from the type of “Rejection” to the type of “Cooperation” towards its social desirability.

Thus, the psychocorrection of psychosomatic disorders in the child in its comprehensive recovery and the psychocorrection of neuropsychic disorders of his mother had a positive impact on the health status of the pupil of the preschool educational institution and his mother.

The advantages and positive effects of the proposed method are that the inventive method is characterized by the simplicity of technical implementation and the wide availability of application in DOW and medical facilities of any type. Allows you to increase the effectiveness of the correction of psychosomatic disorders in children with a high incidence of AML and the degree of neuropsychiatric disorders in the conditions of preschool education. As a result of the application of the method, the incidence rate of the upper respiratory tract (UDP) significantly decreased by 1.9 times, the lower respiratory tract (NDP) - by 3.8 times, respectively, the overall incidence rate - by 2.1 times. Against the background of the correction method, positive changes in the immuno-cytological parameters of the VDP were noted. In the general cytogram of nasal secretion, there was an increase in CE cells by 1.1 times and a decrease in the number of CDs by 1.1 times, a decrease in the number of migrating E, H, Lf by 1.2-1.4 times and an increase in ETs / Lts by 1, 6 times. Partial cytograms of CE are characterized by lower values of cytopathological IDCE, SPDCE, IVCE 1.1-1.4 times and higher values of cytophysiological IREC 1.3 times. In partial cytograms of H, cytopathological IDN, SPDN, ICN turned out to be lower 1.1-1.4 times. Due to the mechanisms of cellular protection, defects in the mucous membrane of the VDP are eliminated, preventing the possible development of AML. The method of psychocorrection has a positive effect on the neuropsychic state of children and their mothers. In children, the frequency of occurrence of a low degree of anxiety, self-esteem disorders, social adaptation and emotional conflict in the family increased 2.4-4.5 times, and the frequency of a high degree of neuropsychiatric disorders decreased 2.7-8.0 times. Their mothers showed a positive dynamics in the indicators of NIP by 3.0-6.7 times.

The method makes it possible to conduct screening diagnostics and correction of NIP in children and their mothers simultaneously in organized teams of the preschool educational institution.

As a result of the correction of psychosomatic disorders, psychosomatic and somatopsychic mutual influences were partially or completely interrupted (rupture of the “vicious circle”).

Claims (1)

A method for the correction of psychosomatic disorders in preschool children and their mothers, characterized in that they assess the degree of neuropsychic disorders and the incidence rate of respiratory diseases in a child, with a high degree of neuropsychic disorders and a high incidence of respiratory diseases causing psychosomatic disorders carry out consistent family psychocorrection 1.5-2 hours 1 time per week for 2 weeks, individual - 30-40 minutes 1 time per week for 5 weeks group prsihokorrektsiyu 1-1.5 h 1 time per week for 5 weeks general course of 12 weeks; additionally, mothers whose children are subject to psychocorrection are diagnosed with neuropsychiatric disorders of the neuropsychic state and sequentially carry out family psychocorrection 1.5-2 hours once a week for 2 weeks, individual - 1.5-2 hours 1 once a week for 2 weeks and group psychocorrection for 1.5-2 hours 1 time per week for 5 weeks with a general course of 9 weeks, conducting psychocorrection in children and their mothers simultaneously on the same days of the week.

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