You are using an outdated browser. For a faster, safer browsing experience, upgrade for free today.

Peculiarities of chronic fatigue formation in combatants with long stays in the zone of combats treated in a mobile hospital. Message 3. Dynamics of transformation of chronic fatigue

Peculiarities of chronic fatigue formation in combatants with long stays in the zone of combats treated in a mobile hospital. Message 3. Dynamics of transformation of chronic fatigue

ISSN 2223-6775 Ukrainian journal of occupational health Vol.17, No 1, 2021

Peculiarities of chronic fatigue formation in combatants with long stays in the zone of combats treated in a mobile hospital. Message 3. Dynamics of transformation of chronic fatigue

Kalnysh V. V.1, 2, Skochko T. V.1

https://doi.org/10.33573/ujoh2021.01.015

1 Ukrainian Military Medical Academy, Kyiv

2 State Institution «Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine», Kyiv

Full article (PDF)

Introduction. It is stated that the number of publications on various aspects of burnout in different professions is quite large, but the development of burnout in people with different predisposition to its formation is given little attention, which makes the study of this problem relevant. Another important reason is the heterogeneity of dangerous situations in which a person is for a long time, and especially in the period when he is no longer affected by the harmful factor. These problems can be solved by studying combatants who are treated immediately after an injury or illness in a mobile hospital.

The purpose of the study is to identify the features of changes in the level of emotional burnout in servicemen with different severity.

Methods and scope of research. To perform this work, 98 male servicemen aged 21 to 57 were examined after injuries or illnesses due to their stay in the environmental protection zone. Treatment of combatants was carried out on the basis of a mobile hospital. In determining the trends in the development of chronic fatigue on the parameters of emotional burnout used the method "Diagnosis of emotional burnout of the individual" VV Boyko. In addition, the level of "individual minute" was assessed by the combatants according to F. Halberg. The level of depression was determined by a special PHQ-9 questionnaire. The level of anxiety disorder was assessed using the GAD-7 questionnaire. The degree of satisfaction with the service was stated. Statistical analysis of data was performed by methods of nonparametric statistics and cluster analysis.

Research results. The formulated problem was solved in two ways. First, correlation analysis revealed the relationships between the studied indicators of different subgroups. The data obtained on these connections suggested possible mechanisms for the process of adaptation to a long stay in the war zone. Secondly, with the help of cluster analysis, the studied subgroups were divided into two sets of individuals with different terms of influence of the factors of the combat environment. This technique made it possible to determine the changes in psychological indicators that occur in combatants with different levels of emotional burnout in these individuals and to obtain information on changes in the symptoms of emotional burnout with increasing duration of extreme environmental factors.

Conclusions. It is established that each phase of burnout in combatants who have been in the war zone for a long time indicates the specificity of the relevant mechanisms of formation of this condition in persons with different levels of its manifestation: for subgroup 1 - the mechanism of gradual and steady "immersion" in burnout; subgroup 2 - the mechanism of maintenance of imbalance of a condition, and for subgroup 3 - the mechanism of stabilization of emotional reactions of an organism. It is shown that the number of symptoms that significantly transform over time tend to increase from subgroup 1 to subgroup 3. However, the direction of the observed changes in different subgroups has a different direction. If the representatives of subgroup 1 increase the length of stay in the environmental protection leads to the degradation of their condition, then in subgroup 2 - there are multidirectional changes aimed at stabilizing the deterioration of combatants, and in subgroup 3 there are positive changes in their emotional state. The invented emotional burnout shifts require the appropriate psychophysiological service to periodically monitor the emotional state of combatants due to its constant transformation over time. Particular attention should be paid to representatives of the risk group - servicemen of subgroup 1.

Key words: emotional burnout, combatants, extreme factors, combat environment, chronic fatigue.

References

  1. Boyko V. V. (1996), Sindrom emotsional'nogo vygoraniya d professonalnom obschenii [Burnout syndrome in professional communication], Moscow, Russia.
  2. Boyko V. V. (2008), Sindrom emotsional'nogo vygoraniya: diagnostika i profilaktika [Burnout syndrome: diagnosis and prevention], Piter, SPb, Russia.
  3. Bulygina V. G., Shport S. V., Dubinskii A. A., Pronicheva M. M. (2017), "The influence of extreme factors of performance on the mental health of specialists in hazardous professions (a review of foreign studies). Biomedical and socio-psychological problems of safety in emergency situations", Mediko-biologicheskiye i sotsial'no-psikhologicheskiye problemy bezopasnosti v chrezvychaynykh situatsiyakh. 2. 93-100. https://doi.org/10.25016/2541-7487-2017-0-3-93-100
  4. Izard K. E. (2000), Psihologiya emotsii , Piter, SPb, Russia.
  5. Il'in E. P. (2005), Psihofiziologiya sostoyanii cheloveka [Psychophysiology of human states], Piter, SPb, Russia.
  6. Lutsenko O. L. (2017), «Measurement of an individual minute as a way of express assessment of human adaptation», in: The current state of development of extreme and crisis psychology, Materials of the IV International scientific-practical conference, Kharkiv, 165-167.
  7. Molchanova L. N., (2011), "The state of mental burnout of representatives of extreme professions in the context of personal experience of participation in hostilities, Vestnik KGU im. Nekrasova. 2. 228-232.
  8. Moskaleva T.V. (2018, "The professional «outburning» syndrome", Vestnik MITU-MASI. 4. 63-68.
  9. Orel V. E. (2001), "The phenomenon of "burnout" in foreign psychology: empirical research and prospects", Psikhologicheskiy zhurnal, 22 (1), 90-101.
  10. Plummer F., Manea L., Trepel D., McMillan D. (2016), "Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis", Gen Hosp Psychiatry. 39. 24-31. https://doi.org/10.1016/j.genhosppsych.2015.11.005
  11. Ronginskaya T. I. (2002), «Burnout syndrome in social professions», Psikhologicheskiy zhurnal, 23 (3), 85-95.
  12. Sivash O. N. (2012), "Emotional burnout of military pilots of different categories. Psychological research", Institut Psihologii RAN. 6/ 119-133.
  13. Soshkin P. A. (2020), "Protective overcoming behavior in naval professionals with signs of occupational burnout", Morskaya meditsina. 6 (2). 74-79. https://doi.org/10.22328/2413-5747-2020-6-2-74-79
  14. Spitzer R. L. (2006), "A brief measure for assessing generalized anxiety disorder: the GAD-7", Arch Intern Med. 22;166(10):1092-7. https://doi.org/10.1001/archinte.166.10.1092
  15. Juravlev E. A., Cargienko M. (2011), "Stress, burnout, coping in the modern context", Institut Psihologii RAN.
  16. Formaniuk T. V. (1994), "The syndrome of "emotional burnout" as an indicator of professional maladjustment of a teacher", Voprosy psihologii. 6. 54-67.
  17. Khazhuev I.S. (2017), "Emotional and professional combustion in the context of experiencing the stres of high intensity", Izvestiya chechenskogo gosudarstvennogo pedagogicheskogo universiteta. 2 (18). 197-204.
  18. Khaustova O., Bushinska O., Prokhorova O., Sahno S. (2014), "Patient health questionnaire (phq) is a standardart diagnostic method to elisit psychopathological disorders in patients with chronic noninfectious diseases in primary health care", Social psychiatry. 2 (77). 22-26.
  19. Halberg F., Cornellissen G., Kotinas G. Feedsidewards Intermodulation strictly among Time Structures, Cronomes, around Us and Cosmo-Vasculo-Neuroimmunity. Neuroimmunomodulation. Perspectives at the new millennium. N.Y. Acad. Sci. 2000. V. 917. P. 348-375. https://doi.org/10.1111/j.1749-6632.2000.tb05401.x
  20. Kroenke K., Spitzer R.L., Williams J.B., Monahan P.O., Löwe B. Anxiety Disorders in Primary Care: Prevalence, Impairment, Comorbidity, and Detection. Annals of Internal Medicine 2007. 146(5):317-25 https://doi.org/10.7326/0003-4819-146-5-200703060-00004
  21. Kroenke K., Spitzer R.L., Williams J.B. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001. No 16(9). P. 606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  22. Spitzer R.L., Kroenke K., Williams J.B. Patient Health Questionnaire Study Group. Validity and utility of a self-report version of PRIME-MD: the PHQ Primary Care Study. JAMA. 1999. V. 282. P. 1737-1744. https://doi.org/10.1001/jama.282.18.1737