Health Status and Features of Medical Rehabilitation of Adolescents Whose Parents Suffer from Alcoholism

The dissertation is devoted to the study of the health status and features of medical rehabilitation of adolescents whose parents suffer from alcoholism. The relevance of the research is due to the fact that children raised in socially disadvantaged families with parental alcoholism represent a risk group for the development of somatic and mental diseases, while issues concerning their health are insufficiently addressed in the available literature. Adolescence (10–18 years of age) is considered a critical period in which neurohumoral lability increases the likelihood of pronounced changes in vital organs and systems.

In the work, a comprehensive social and hygienic study of adolescent children from families of social disadvantage has been conducted, and a complex of medical rehabilitation has been developed and piloted in the conditions of a day hospital of a secondary educational institution. Criteria for evaluating the effectiveness of rehabilitation measures have been proposed, and metabolite drugs and a device for audiovisual stimulation with biofeedback have been recommended. The research results can be used in the practice of district pediatricians and family physicians, and for the training of medical and social workers.

Relevance of the Problem. Changes in the lifestyle of the population of the Russian Federation under the influence of socio-economic, ecological, and psychological factors have caused a significant deterioration in many indicators characterizing public health. The decline in birth rates and the persistence of a sharply negative natural population growth, the rise in morbidity and disability, especially among children, give rise to an acute need for the development of new strategies in healthcare development oriented toward a socially significant final result [66].

During the transition of the country to market relations, the establishment of a legal state, and democratic transformations of all structures and spheres of life, social protection of the family must be the focus of attention of society as a whole. At the same time, the dynamism of social development at the current stage, the crisis in the economy and other spheres of public life inevitably lead to an increase in social pathology (drunkenness, alcoholism, prostitution, drug addiction, crime, etc.). It has been proven that children born in such socially disadvantaged families may be a risk group for the development of many somatic and mental diseases.

However, the available literature does not sufficiently address issues regarding the health status of children raised in families with high social risk, and the features of the development of somatic pathology in them have not been determined. Despite the widespread prevalence of chronic diseases among such children, the processes of their formation have not been thoroughly and comprehensively studied. Only a few works are devoted to the study of these problems in childhood and adolescence. At the same time, many questions remained unresolved or had contradictory interpretations.

Adolescence (10–18 years of age) can be classified as a critical period of life, since neurohumoral lability during the pubertal period determines the possibility of pronounced changes in vital organs and systems. This condition can be regarded as a natural functional stress test. However, the obvious priority of care for newborns, infants, and young children until recently led to the neglect of a range of problems of older children and adolescents in children's outpatient and polyclinic institutions [87, 88, 89].

In light of the above, the significance of rehabilitation of adolescents from socially disadvantaged families as a form of prevention and an essential component of the system of measures for preserving the health of the entire population is particularly heightened. At the same time, improving the health status of persons in need of rehabilitation measures is impossible without the adoption of new approaches to solving the relevant tasks facing medical and preventive institutions providing medical and social assistance [3].

Thus, at present, one of the most urgent tasks in the field of protection and strengthening of children's health is an in-depth study and identification of the features of the health status, as well as the substantiation of the system of medical rehabilitation of children whose parents suffer from alcoholism.

Aim of the work: on the basis of a comprehensive study of the health status of adolescent children whose parents suffer from alcoholism, to substantiate and implement a methodology for medical rehabilitation in the conditions of a secondary educational institution.

Research objectives:

1. To assess the health status of adolescent children whose parents suffer from alcoholism.

2. To study the key indicators of medical and social activity, including the conditions and lifestyle of this contingent of adolescents, and to identify factors leading to the deterioration of their health status.

3. To substantiate a complex of rehabilitation measures among adolescents from families of social disadvantage.

Scientific novelty.

For the first time, a comprehensive social and hygienic study of adolescent children from socially disadvantaged families has been conducted, which made it possible to identify the features of the health status of children from families in which parents suffer from alcoholism, and to provide a medical and social characterization of the conditions and lifestyle of the said contingent of adolescents.

For the first time, a complex of medical rehabilitation for adolescents from families of social disadvantage has been developed, substantiated, and piloted, along with a system for evaluating the effectiveness of these measures (inventor's proposals No. 2523 and No. 2524 dated September 9, 2002).

Practical significance.

The results of the study of the health status and lifestyle of children from socially disadvantaged families indicate the advisability of establishing a medical and social service in urban children's polyclinics. Data on the features of conditions and lifestyle, and the health status of children whose parents suffer from alcoholism, made it possible to optimize the medical and social rehabilitation of this contingent of children. The obtained research results can be used in the work of district pediatricians and family physicians, as well as for the training of medical and social workers.

For children whose parents suffer from alcoholism, a complex of health-promoting measures has been substantiated, piloted, and implemented, whose medical effectiveness has been statistically confirmed.

The device for audiovisual stimulation with biofeedback, piloted by the authors, demonstrates high effectiveness in the rehabilitation of adolescents whose parents suffer from alcoholism. The complex of rehabilitation measures recommends the inclusion of metabolite drugs: "Glycine," "Biotredin," and a plant-origin drug "Dolytsar."

The developed methods of diagnosis, treatment, and prevention of adolescents whose parents suffer from alcoholism are, on the whole, easily implementable and are recommended for adoption in day hospitals of secondary educational institutions and rehabilitation centers of children's urban polyclinics. The dissertation materials are recommended for inclusion in the teaching of pediatrics, hygiene of children and adolescents, social medicine, and healthcare organization in educational courses for students of pediatric departments of medical universities and cadets of postgraduate education institutes.

Testing of the work. The dissertation work was tested at an inter-departmental meeting of the departments of hospital pediatrics, faculty pediatrics with a propedeutics course, and pediatrics of the postgraduate education institute, jointly with the problem commission of Bashkir State Medical University "Age-related features of the child organism in normal and pathological conditions," and physicians of children's polyclinic No. 2 of the city of Ufa.

Publications. Seven works have been published on the topic of the dissertation.

Implementation in practice. The dissertation materials are used in the work of physicians of children's polyclinic No. 2 of the city of Ufa, in the educational process of advanced training of physicians at the postgraduate education institute, in the training of students, resident physicians, and in the preparation of clinical residents and postgraduates of Bashkir State Medical University.

The main provisions of the dissertation have been discussed at plenary and section meetings of the Bashkir Republican Branch of the Union of Pediatricians of Russia (1999–2002); at urban, republican, and interregional scientific and practical conferences (2000–2003).