Features of clinical and psychological counseling of women taking into account their psycho-emotional state at the birth of a child with a disease in the neonatal period

Features of clinical and psychological counseling of women taking into account their psycho-emotional state at the birth of a child with a disease in the neonatal period

 

Authors

 

I.A. Zolotova

Federal State Budgetary Educational Institution of Higher Education “Yaroslavl State Medical University” of the Ministry of Health of the Russian Federation, Yaroslavl, Russian Federation

 

https://doi.org/10.26617/1810-3111-2024-3(124)-71-78

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2024; 3 (124):  71-78.

 

Abstract

The relevance is dictated by the need to improve the organization of medical and socio-psychological care for women in the early postpartum period when giving birth to a child with a disease. Knowledge of the characteristics of the attitude towards the newborn and the level of severity of neurotic states allows achieving the maximum effect in the therapy process. Objective: to establish the level of personal involvement of a woman and her understanding of the situation associated with the disease of a newborn, to assess the level of neurotic states, to describe the correlations obtained during the study with the psychological component of the gestational dominant in the “mother-child” relationship system. Material and Methods. A 4-year study was conducted in the departments of pathology of newborns at various medical organizations in the Central region of Russia. The study involved women (n=326) who had children with the disease in the neonatal period. Two groups were formed: the main group (n=190, 58%) ‒ with a history of perinatal loss, the control group (n=136, 42%) ‒ with no history of perinatal loss. Psychodiagnostic questionnaires were used: Semantic Differential of Life Situation (Aleksandrova O.V., Dermanova I.B., 2018), an adapted version of the Pregnant Woman's Relationship Test (Dobryakov I.V., 2010), and the Clinical Questionnaire of Neurotic States (Yakhin K.K., Mendelevich D.M., 1978). Results. In women of the main group with a history of perinatal loss, a depressive attitude towards the newborn correlated with high scores on the asthenia scale (r=0.39, p<0.05), and a euphoric attitude correlated with neurotic manifestations on the obsessive-phobic disorders scale (r=0.41, p<0.05). In the control group of women, positive correlations were established between the scale of positive expectations from the situation and 3 scales of the questionnaire for assessing neurotic states: hysterical type of response (r=0.48, p<0.01), neurotic depression (r=0.51, p<0.001), asthenia (r=0.53, p<0.001), as well as between the scale of personal involvement with a hypogestognostic attitude towards loved ones (r=0.44, p<0.01) and an anxious attitude towards strangers (r=0.40, p<0.01). Conclusion. Based on the results of the study, psychological portraits of women were compiled: 1) with a history of perinatal losses: an anxious type of the psychological component of the gestational dominant in relation to the newborn, a euphoric attitude towards oneself, average and low levels of involvement in the situation, high levels of anxiety, hysterical type of reaction and obsessive-phobic disorders, an average level of manifestation of vegetative disorders, 2) without experience of perinatal losses in the anamnesis: a euphoric type of the psychological component of the gestational dominant in relation to the newborn, an average level of personal involvement, high levels of hysterical type of reaction and neurotic depression, sometimes symptoms of asthenia, a euphoric attitude towards breastfeeding. Identification of diagnostically significant features of women's experience of a traumatic situation associated with a newborn's illness allowed compiling the individual program of medical and psychological support in the early post-partum period with an emphasis on accepting the prospect of the child's illness.

 

Keywords: clinical and psychological counseling, psychotherapeutic compliance, attitude towards the newborn, asthenia, vegetative disturbances, neurotic depression, birth of a child with an illness.

 

Article (pdf)

 

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Materials  

For citation: Zolotova I.A. Features of clinical and psychological counseling of women taking into account their psycho-emotional state at the birth of a child with a disease in the neonatal period. Siberian Herald of Psychiatry and Addiction Psychiatry.2024; 3 (124): 71-78. https://doi.org/10.26617/1810-3111-2024-3(124)-71-78

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