ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2018, 3(3): 188–192
https://doi.org/10.26693/jmbs03.03.188
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Determining Signs of Disability in the Practice of Family Doctor: Functional State of Cardiovascular System

Borisova I.
Abstract

The article explains the need to use in clinical practice specific criteria characterizing the patient’s life impairment. Criteria of life impairment and degree of their expressiveness are used as signs of disability and characteristics of rehabilitation treatment in the practice of medical and social expertise. Identifying the signs of disability in patients or people with disabilities is very important in practice of a family doctor. In addition, it has some features because of "social" criteria. In patients with diseases of the cardiovascular system the following criteria of life are impairment: ability to walk, ability to work, ability to self-service and ability to study (in the context of the need for a new profession or re-training). In Ukraine, according to statistics, the number of people with disabilities does not exceed 6% in recent years. There are 2709982 people with disabilities, among them are 310 494 persons of Group I, 1078 721 persons of Group II, 1155 646 people of Group III, and 165 121 children with disabilities. According to the results of the work of state medical and social commissions, the first ranked place among the adult population is occupied by cardiovascular system diseases, which accounts for 22.5%. To determine the degree of life impairment criteria in patients with cardiovascular system diseases, it is necessary to use additional methods of research. First, the functional state of the cardiovascular system should be studied using functional load tests and additional studies characterizing the functional capacity of the blood flow, for example, echocardiography, 24 hour blood pressure monitoring, electrocardiography. The study brought us to the following conclusions. Issues of medical and social expertise on the identifying signs of disability in daily practice of a family doctor are quite important and have certain features due to the use of "social" criteria. The leading pathology in the practice of a family doctor today is the disease of the cardiovascular system: CHD, GC, CH. To determine the violations of the criteria for viability in patients with cardiovascular diseases, a thorough investigation of the functional state of the cardiovascular system through functional loading tests and additional studies characterizing the functional capacity of the circulatory system, in particular, echocardiographic studies and daily studies of pressure and electrocardiographic activity of the myocardium.

Keywords: cardiovascular system, functional state, disability, medical and social expertise, criteria of life impairment

Full text: PDF (Ukr) 215K

References
  1. Vsemyrnyi doklad ob ynvalydnosty, 2011. Available from: http://apps.who.int/iris/bitstream/10665/70670/7/WHO_NMH_VIP_11.04_rus.pdf?ua=1. [Russian]
  2. Osnovy medyko-sotsialnoi ekspertyzy i reabilitatsiyi khvorykh ta invalidiv: navchalno-metodychnyi posibnyk. Za red prof LYu Naumenka. D, 2017. 336 s. [Ukrainian]
  3. Ipatov AV, Moroz OM, ta in. Osnovni pokaznyky invalidnosti ta diyalnosti medyko-sotsialnykh ekspertnykh komisiy Ukrainy za 2015 rik: Analityko-informatsiynyi dovidnyk. Za red Nachalnyka viddilu orhanizatsiyi sotsialnoi dopomohy okremym katehoriyam hromadyan, a takozh pytan MSEK MOZ Ukrainy SI Chernyaka. Dnipropetrovsk: Aktsent PP, 2016. 162 s. [Ukrainian]
  4. Postanova KM № 10 vid 21 sichnya 2015. «Pro zatverdzhennya pereliku anatomichnykh defektiv, inshykh neoborotnykh porushen funktsiy orhaniv i system orhanizmu, staniv ta zakhvoryuvan, za yakykh vidpovidna hrupa invalidnosti vstanovlyuyetsya bez zaznachennya stroku povtornoho ohlyadu». [Ukrainian]
  5. Postanova KM № 1317 vid 3 hrudnya 2009. «Pytannya medyko-sotsialnoi ekspertyzy (iz zminamy, vnesenymy zhidno z Postanovamy KM № 752 vid 18.08.2010 № 762 vid 20.07.2011; № 485 vid 31.05.2012; № 482 vid 26.06.2015; № 874 vid 21.10.2015; № 569 vid 31.08.2016). [Ukrainian]
  6. Proekt Prohramy rozvytku OON «Pidtrymka reformy sotsialnoho sektoru v Ukraini». Metodychni rekomendatsiyi z vyznachennya katehoriy otrymuvachiv sotsialnykh posluh ta normy chasu nadannya sotsialnoi posluhy vidpovidno do katehoriyi. Kyiv, 2013. 55 s. [Ukrainian]
  7. Nakaz MOZ Ukrainy № 248 vid 08.04.2014. Pro zatverdzhennya Derzhavnykh sanitarnykh norm ta pravyl «Hihiyenichna klasyfikatsiya pratsi za pokaznykamy shkidlyvosti ta nebezpechnosti faktoriv vyrobnychoho seredovyshcha, vazhkosti ta napruzhenosti trudovoho protsesu»: zareyestrovano v Ministerstvi yustytsiyi Ukrainy 6 travnya 2014 r. za № 472/25249. [Ukrainian]
  8. Standartnye pravyla obespechenyya ravnykh vozmozhnostey dlya ynvalydov (United Nations Standard Rules on the Equalization of Opportunities for Persons with Disabilities), 1993. Available from: http://apps.who.int/iris/bitstream/10665/70670/7/WHO_NMH_VIP_11.04_rus.pdf?ua=1. [Russian]
  9. Mezhdunarodnaya nomenklatura narushenyi, ohranychenyi zhyznedeyatelnosty y sotsyalnoy nedostatochnosty: Rukovodstvo po klassyfykatsyi bolezney y prychyn ynvalydnosty. M, 1994. 106 s. [Russian]
  10. Nakaz MOZ Ukrainy № 561 vid 05.09.2011. «Pro zatverdzhennya Instruktsiyi pro vstanovlennya hrup invalidnosti». [Ukrainian]