Official Journal of the International Academy of Integrative Anthropology
DOI: 10.31393
ISSN 2719-5996
eISSN 2616-6208
Biomedical and Biosocial
Аnthropology
№ 38, 2020
Scientific peer-reviewed journal in the fields of medicine, biology, anthropology, ecology,
health care organizations, medical economics
Published since 2003
Periodicity: 4 times a year
Aleksandrów Łódzki 2020
ORIGINAL ARTICLES
ORIGINAL ARTICLES
Biomedical and Biosocial Anthropology
Founders: Public organization "International Academy of Integrative Anthropology", Polish
representation of the Public Organization "International Academy of Integrative Anthropology" and
National Pirogov Memorial Medical University, Vinnytsya
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Janiszewski Mirosław (Poland); Juenemann Anselm (Germany); Graeb Christian (Germany); Gulmen
Mete Korkut (Turkey); Rejdak Robert (Poland); Rogozińska-Mitrut Joanna (Poland); Maievskyi
Oleksandr, (Ukraine); Sarafinyuk Larisa (Ukraine); Serheta Igor (Ukraine)
Editorial council:
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Mishalov V.D. (Ukraine); Mostoviy Yu.M. (Ukraine); Pogoriliy V.V. (Ukraine); Prokopenko S.V. (Ukraine);
Puchlik B.M. (Israel); Shepitko V.I. (Ukraine); Shkolnikov V.S. (Ukraine); Shutz Yu. (Germany); Vasylenko
D.A. (Ukraine); Włodzimierz Ziółkowski (Poland); Yoltukhivskyy M.V. (Ukraine)
Approved by the editorial board of the journal "Biomedical and Biosocial Anthropology", protocol
№1 from 29.09.2020
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CONTENT
4
Chorna V. V., Makhniuk V. M., Khliestova S. S., Gumeniuk N. I. Assessment of the quality of medical
services to relatives of the mentally ill who are in inpatient treatment ................................................................. 5
Kaskova L. F., Yanko N. V., Kulai O. O., Chupryna L. F., Artemyev A. V. Features of the dental status
of the Nogais who lived on the territory of Ukraine in the 15th century .............................................................. 12
Kostiuk O. H., Hodovan N. L., Taran I. V., Mashevska O. V., Grebeniuk D. I. Development of a
method for serial intravesical administration of drugs in experiment.................................................................. 17
Serheta I. V., Bratkova O. V., Drezhenkova I. L., Cherkasova L. А., Dzevulska І. V. Features of
social-psychological adaptation of girls and boys 15-17 years during the study period in senior classes
of the modern school ........................................................................................................................................ 24
Selskyy P. R., Veresiuk T. O. Structural changes in skeletal muscles of the hind limbs of rats in acute
ischemia-reperfusion and its correction by carbacetam, detected by polarization microscopy ......................... 30
Sobo
ń J. S., Cherkasova O. V., Gunas V. I., Babych L. V., Kotsyura O. O. Correlations of linear sizes
of molars with cephalometric indicators of practically healthy men of the southern region of Ukraine ............... 36
Redka I. V., Danуlenko H. M., Sotnikova-Meleshkina Zh. V., Mikhalchuk O. Ya. Prenosological
screening of autonomic regulatory systems tension in secondary school students .......................................... 47
Antoniuk Ya. O., Gumeniuk A. F., Sakovych O. O., Zhebel V. M. The role of the brain natriuretic
peptide gene polymorphism in the diagnostic use of the biomarker in myocardial dysfunction in men,
residents of Podillya with comorbid essential hypertension and type 2 diabetes mellitus ................................. 54
Kryvoviaz Yu. O. General clinical and anthropometric parameters in patients with type 1 diabetes
mellitus depending on the level of albumin in the urine ..................................................................................... 61
Maryenko N. I., Stepanenko O. Yu. Fractal dimension of the cortex and white matter of human
cerebellum (magnetic resonance imaging study) .............................................................................................. 69
Assessment of the quality of medical services to relatives of the
mentally ill who are in inpatient treatment
Chorna V. V.
1
, Makhniuk V. M.
2
, Khliestova S. S.
1
, Gumeniuk N. I.
1
1
National Pirogov Memorial Medical University, Vinnytsya, Ukraine
2
SU "Institute of Public Health O. M. Marzeeva National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine
The mental state of the mentally ill is one of the most important factors in the treatment
of the patient by a medical professional. But aggression, high-pitched communication,
indifference of a doctor or health care worker can negatively affect the outcome of
treatment and recovery of a patient with mental and behavioral disorders. The problem
of modern medical deontology in Ukraine is the stigmatization of health workers to
patients with mental disorders, which lead to self-stigmatization of both patients and
their families. The purpose of the study is to enable the relatives of mentally ill people
undergoing long-term inpatient treatment, to determine the quality of medical services
in a psychoneurological hospital, to identify ethical and deontological shortcomings in
the doctor's relationship with relatives of mentally ill person, to determine the level of
self-stigmatization in relatives of the patient by medical staff. The analysis of domestic
and foreign scientific sources, bibliosemantic, analytical and statistical research
methods were used in the work. A questionnaire was conducted (using a specially
designed questionnaire) with elements of interviews of 92 respondents (relatives of
mentally ill patients who were treated at a psychoneurological hospital in Vinnytsia).
The results were processed using the licensed standardized package "Statistica 6.1".
The need to comply with state building codes for health care facilities in accordance
with European requirements has been proven. This will eliminate the feeling of
hopelessness during hospitalization in public psychoneurological hospitals, which
are a great trauma for relatives of patients. It has been shown that in order to prevent
stigmatization of relatives of patients in psychoneurological hospitals, it is necessary
to conduct trainings and interviews after training, which will determine the degree of
stigmatization and subsequent preventive measures. It is shown that for relatives of
mentally ill on the basis of psychoneurological hospitals it is necessary to equip rooms
for psychodiagnostics and further psychocorrection. Development of affordable
correctional programs for relatives of patients will reduce maladaptation and improve
life satisfaction.
Keywords: families of the mentally ill, questionnaires with elements of interviews, the
attitude of doctors to the relatives of the mentally ill, preventive measures for the
families of patients with mental and behavioral disorders.
ARTICLE INFO
Received: 04 August, 2020
Accepted: 02 September, 2020
UDC: 614.2:005.336.3:616
CORRESPONDING AUTHOR
e-mail: valentina.chorna65@gmail.com
Chorna V. V.
©
2020 Medical centre "Gebrand", Poland
5
DOI: 10.31393/bba38-2020-01
Biomedical and Biosocial Anthropology, №38, Pages 5-11
ISSN 2719-5996 eISSN 2616-6208
Introduction
The rapid development of modern technologies in the
medical field significantly increases the effectiveness of
diagnosis and treatment of patients in European countries.
Unfortunately, in Ukraine, the constant, total underfunding
of the health care sector has led to the neglected material
and technical and sanitary and hygienic condition in public
health care facilities, namely: extortion of patients; obsolete
equipment, furniture and beds; bed linen from home;
personal hygiene products and medicines for patients'
money; insufficient disinfectants, etc. The premises of the
health care facilities are in a terrible state of emergency
and need major repairs. There is a growing trend of non-
transparent procurement and use of medicines. Work on
any preventive measures with the mentally ill has been
suspended and, worst of all, the violation of the rules of
professional ethics and the basics of deontological culture
of medical staff in communication with the mentally ill,
relatives of patients, attitude (stigmatization) of medical
BIOMEDICAL AND BIOSOCIAL ANTHROPOLOGY
Official Journal of the International Academy
of Integrative Anthropology
journal homepage: http://bba-journal.com
6
ISSN2719-5996 eISSN 2616-6208 Biomedical and Biosocial Anthropology
Assessment of the quality of medical services to relatives of the mentally ill who are in inpatient treatment
workers to patients, ie non-compliance Oaths of the doctor
of Ukraine, the text of which was approved by the Decree of
the President of Ukraine dated 15.06.1992 349, and
which consists of all graduates of medical institutions of
higher education of Ukraine [16].
The main international instruments governing patients'
rights in the field of medicine are the WIA Lisbon Declaration
on Patients' Rights (World International Association, 1981);
Declaration on Patient Rights Policy in Europe, 1994;
Council of Europe "Convention on Human Rights and
Biomedicine", 1996; The EU Charter of Fundamental
Rights, which in Article 6 declares the human right to safety
and access to health care and medical assistance in order
to achieve a high level of health care; WHO Patient Safety
Program (World Alliance for Patient Safety, 2004); The WHO
program for 2008-2009, which identified priority areas in
the fight for safe health care [11].
However, ethical and deontological issues, namely the
concept of "deontological culture", are ignored and do not
find a place in the hearts of medical staff who work with the
mentally ill and constantly communicate with their relatives
or guardians. Every medical professional should have a
basic understanding of the origins of medical deontology
in order not to indulge in immoral things with patients, and
especially with the mentally ill. Deontology is a science
that studies the rules and norms of the duty of a specialist
in the field of his professional activity. The term "deontology"
was introduced into scientific circulation at the beginning
of the nineteenth century by the English philosopher and
jurist Jeremiah Bentham (1748-1832), to define the science
of the professional duty of man [2, 10].
Summarizing the retrospective approaches and
scientific statements of prominent scientists on the study
of medical ethics and deontology, we recommend
considering "deontological culture" as one of the most
important components of professional culture and
characterize it as a set of spiritual, intellectual and
intellectual, which will help determine the significance and
specificity of their professional activities [21].
Thus, the reflection of deontological requirements,
professional norms in the mind of a medical professional
will allow him to more fully and adequately perceive
professional reality, navigate in it, develop strategy and
tactics, goals and specific plans of professional activity,
and recognition and acceptance of these norms as basic
principles. professional duty will help him to form a proper
attitude to the chosen profession and professional activity
in general.
Under no circumstances should not patients' rights to
emergency, highly qualified medical care be fully violated
to all those who need it, regardless of age, social status,
religion or race; humane treatment of the patient, and
especially to patients with severe, incurable diseases or
mental disorders; observance of confidentiality and medical
secrecy as specified in the International Code of Medical
Ethics "Geneva Declaration" adopted in 1949 [23].
Another problem of modern medical deontology in
Ukraine is the stigmatization of health workers to HIV-
infected patients, tuberculosis patients, currently COVID-
19 patients, and especially to patients with mental disorders
and any mental health problems, which lead to self-
stigmatization of both patients and their families, who are
left alone in solving this problem.
In the EU countries, various measures have been
introduced to stigmatize health workers in relation to
patients, and measures are constantly taken to prevent
and prevent such phenomena in society. The main
principles in treatment in the EU are "restoration of human
life", spiritual recovery of patients, reintegration into society
and a full life. Forms for overcoming the stigma of health
care workers in European countries are different, for
example: training, coaching, psychological consultations
with health care workers and relatives who care for relatives;
persons caring for patients (for money or free of charge),
etc. [12].
The Law of the Republic of Poland "On the Protection of
Mental Health" ("Ustawa o ochronie zdrowia
psychicznego"), which has been in force for 26 years
(adopted on 19.08.1994) defines the term "mental health
is the main personal good of a person, and protection the
rights of persons with mental disorders are the duty of the
state". This law regulates the rights of a psychiatric hospital
patient who has the right to appoint an ombudsman, whose
responsibilities include protecting the rights of patients with
mental disorders in matters related to admission,
treatment, conditions of stay and discharge from hospital,
as well as access to medical care. documentation with the
consent of the patient, guardian. Consultation, treatment
of such patients is free, comprehensive (medical, social,
legal) which is a great support for Polish citizens with
mental disorders and the prospect of their socialization.
The purpose of the study is to enable the relatives of
mentally ill people undergoing long-term inpatient
treatment, to determine the quality of medical services in a
psychoneurological hospital, to identify ethical and
deontological shortcomings in the doctor's relationship with
relatives of mentally ill, determine the level of self-
stigmatization in relatives of the patient by medical staff.
Materials and methods
The analysis of domestic and foreign scientific sources,
bibliosemantic, analytical and statistical research methods
were used in the work.
92 respondents, relatives of the mentally ill, took part in
the survey with elements of the interview. Patients with
mental disorders were treated at the Vinnytsia Regional
Clinical Psychoneurological Hospital named after
Academician O. I. Yushchenko of the Vinnytsia Regional
Council, of which men - 29.3 % and women - 70.7 %, (under
the age of 20 - 3.3 %, from 21 to 30 years - 9.8 %, from 31
to 40 years - 17.4 %, from 41 to 50 years - 33.7 % and over
50 years - 35.9 %). Respondents with basic secondary
№38, Page 5-11
Chorna V. V., Makhniuk V. M., Khliestova S. S., Gumeniuk N. I.
7
education - 10.9 %, specialized secondary education -
23.9 %, vocational education - 30.4 %, higher education -
34.8 % took part in the survey with elements of interviews.
The survey was conducted using a specially designed
questionnaire: "Method of determining the quality of medical
care by relatives of a patient in a psychiatric hospital and
the relationship "doctor-relative"", recognized as an
innovation from 16.01.2020 and registered in the journal of
innovation proposals National Pirogov Memorial Medical
University, Vinnytsya for 2 and "Method of determining
the personal opinion of the patient's relatives about the
payment of medical care in a psychiatric hospital" from
16.01.2020 and registered in the register of innovation
proposals of National Pirogov Memorial Medical University,
Vinnytsya for 3.
The results of the questionnaire were processed using
the licensed standardized package "Statistica 6.1".
Results
Conditions of patients' stay in psychiatric hospitals of
Ukraine encourage patients and their relatives to seek
medical help in psychiatric hospitals only in case of
exacerbated diseases (crisis conditions): deterioration of
health of the total number of respondents- 68.5 %; re-
registration of disability group for mental disorders -
21.7 %; the psychogenic load of family and household
nature - 8.7 % (Table 1).
According to the survey of relatives of inpatients, 32.6 %
of the total number of respondents applied to a psychiatric
hospital without a referral (37.0 % of them were male
relatives and 30.8 % were female relatives); according to
the direction of the psychoneurologist of the polyclinic -
27.2 % (29.2 % of them are female relatives and 22.2 %
are male relatives); in the referral of a family doctor - 22.8 %
(of which 23.1 % - female relatives and 22.2 % - male
relatives); 10.0 % of the total number of respondents (of
whom 11.1 % were male relatives and 10.8 % were female
relatives) were referred by a psychoneurological
dispensary; an ambulance crew took 6.0 % of patients to a
psychoneurological hospital on call of relatives (7.4 % of
them were male relatives and 6.2 % were female relatives)
(Fig. 1).
In the questionnaire to the question "How often do you
meet with your relative's doctor?", the following answers
were received from relatives of patients: every day when
visiting their sick relative they talked to a doctor - 8.7 % of
the total number of respondents (of which 7.4 % - male
relatives and 9.2 % - female relatives); twice a week talked
to a doctor - 32.6 % (of which 18.5 % - male relatives and
38.5 % - female relatives); once a week - 42.4 % (of which
55.6 % were male relatives and 36.9 % were female
relatives), talked to the doctor twice a month - 9.8 % (of
which 3.7 % - male relatives and 12.3 % - female relatives)
and only 6.5 % of the total number of respondents (of whom
14.8 % - male relatives and 3.1 % - female relatives) -
communicated once a month due to the fact that they visited
their sick relatives rarely because they get to hospital them
more than three hours (Fig. 2).
In the questionnaire "How often do you visit your sick
relative?", the following answers were received from
relatives of patients: every day they visited their sick relative
- 28.3 % of the total number of respondents (of which
29.6 % - male relatives and 27.7 % - relatives-women);
twice a week - 33.7 % (of which 29.6 % were male relatives
and 35.4 % were female relatives); once a week - 25.0 %
Relatives of
patients
Reasons for treatment
health
worsening
re-registration
of the
disability
group for
mental
disorders
due to the
psychogenic
burden of
family and
domestic
nature
the
reason
is not
specified
Male
relatives
74.1 18.5 3.7 3.7
Female
relatives
66.2 23.1 10.7 0
Total of all
respondents
68.5 21.7 8.7 1.1
Table 1. The results of a survey of relatives of patients on the
reasons for seeking psychiatric care for hospitalization in a
psychoneurological hospital (%).
Fig. 1. The results of a survey of relatives of patients with mental
disorders to the question "Who sent your relative for treatment in
a psychiatric hospital?" (%).
Fig. 2. The results of a survey of relatives of patients on the
frequency of meetings with the attending physician (%).
(of which 25.9 % are male relatives and 24.6 % are female
relatives), visited their sick relatives twice a month - 6.5 %
(of which 3.7 % - male relatives and 7.7 % - female relatives)
and 6.5 % of the total number of respondents (of whom
11.2 % - male relatives and 4.6 % - female relatives) -
visited sick relatives once a month due to the fact that they
get to the hospital more than three hours (Fig. 3).
According to the results of our research, we established
the time spent by relatives waiting for a doctor to
communicate about a relative. Of the total number of
respondents - 68.5 % of relatives of patients waited up to
30 minutes; 29.3 % - from 30 minutes to one hour; 2.2 % -
from one hour to two hours, while the doctors of the
psychoneurological hospital are not urgent, emergency
doctors. But the generally accepted ethical principles in
the daily activities of a doctor are: trust, openness, the desire
to be useful to the patient, to be able to put himself in the
place of the patient, to look at the world through his eyes. All
the variety of approaches to the cooperation of the doctor
and the relative of the mentally ill should be manifested in
emotional support, understanding, respect and
compassion.
The doctor's respect for the patient's relative should be
manifested in his recognition as an individual. It is
necessary not only to write a long list of drugs, but also to
listen to the person, the main thing - to show that his words
are important to him, to recognize the significance of events
that bother the patient's relative because he has no one to
share with the "burden" he carries all life. Therefore, we
also investigated how much time the doctor spent talking
to a relative of the patient: up to 10 minutes the doctor
talked about the patient from the total number of
respondents - 52.2 %; from 10 to 20 minutes - 42.4 % and
only - 5.4 % of doctors talked from 20 to 30 minutes, from
30 minutes and more - there were no such doctors.
According to the results of the survey, female relatives talked
to doctors for the longest time, from 10 to 20 minutes - 43.1
%, and among male relatives - 40.7 %; only female relatives
communicated from 20 to 30 minutes - 7.7 %.
In analyzing the questionnaires, we found that 54.3 %
of the total number of respondents agreed that they had
enough time to resolve all issues with the attending
physician about their relative, and 45.7 % of relatives did
not have enough time. Therefore, 32.6 % of relatives out of
the total number of respondents thought that the doctor did
not fully understand the patient's problem. Doctors must
honestly perform their professional duties and remember
the words of the Oath of the Doctor of Ukraine: "I do not cure
a disease, but a living person".
Research on the structure of difficulties that arise in
families with mental disorders and faced by the family - is
the financial cost of treatment in a psychoneurological
hospital for the purchase of products - 96.0 %, for drugs -
85.3 %, for personal care hygiene - 81.3 % and on the way
to the hospital - 68.0 % of the total number of respondents.
Relatives who took part in any programs on psycho-
correctional and psycho-educational measures accounted
for only 3.3 % of the total number of respondents, and the
remaining 96.7 % did not take or did not know about such
measures. We proposed a list of programs in which they
would like to participate and get the following results
(Table 2).
According to the survey, it was found that 85.2 % of men
who care for their sick wives need communication, support,
participation in psycho-educational programs; 81.5 % of
men want to participate in programs for the prevention of
chronic fatigue syndrome; 66.7 % of men want to take part
in programs for communication and understanding with a
sick woman. Female relatives also most often choose such
programs (see Table 2). In addition, in contrast to men,
female relatives quite often (27.7 %) choose trainings on
prevention of self-stigmatization (see Table 2).
Discussion
According to the results of the monitoring of the
Ukrainian Helsinki Union in three regional
psychoneurological hospitals (Mykolaiv, Poltava, Kherson)
and according to its analytical report on human rights in
2015, the lack of material and technical and sanitary
conditions of psychiatric facilities in Ukraine is practically
repeated: patient privacy - we are talking about non-
compliance with the area per patient (6 m2), but after the
second stage of medical reform from April 1, 2020 in the
field of psychiatry, after reducing inpatient care for patients
Fig. 3. Results of the survey relatives of patients on the frequency
of visits patients in hospital (%).
Table 2. The results of a survey of relatives of patients in a
psychoneurological hospital to participate in rehabilitation programs,
provided that they were offered (%).
Names of rehabilitation programs for relatives of
the mentally ill
Male
relatives
Female
relatives
Educational program for relatives 85.2 76.9
Trainings on prevention of chronic fatigue
syndrome
81.5 56.9
Trainings on development of skills of
communication with sick relatives
66.7 50.7
Trainings on prevention of self-stigmatization 7.4 27.7
Trainings on development of skills of
communication with the doctor
7.4 3.1
8
ISSN2719-5996 eISSN 2616-6208 Biomedical and Biosocial Anthropology
Assessment of the quality of medical services to relatives of the mentally ill who are in inpatient treatment