HEALTH-SAVING OF THE WORLD WAR II VETERANS LIVING IN THE SOUTH OF THE TYUMEN REGION
Янтимирова Р. А.1 , Наймушина А. Г.2
1Кандидат медицинских наук, докторант кафедры анатомии и физиологии человека и животных, Тюменский государственный университет
2Доктор медицинских наук, профессор кафедры физического воспитания, Тюменский государственный нефтегазовый университет
СОСТОЯНИЕ ЗДОРОВЬЯ ВЕТЕРАНОВ ВЕЛИКОЙ ОТЕЧЕСТВЕННОЙ ВОЙНЫ, ПРОЖИВАЮЩИХ НА ЮГЕ ТЮМЕНСКОЙ ОБЛАСТИ
Аннотация
Проведена комплексная оценка состояния здоровья и организации медико-социальной поддержки ветеранам Великой Отечественной войны и членам их семей (вдов) в период с 2010 по 2013 годы. Первое место в структуре заболеваний и ранговой значимости в структуре общей смертности у ветеранов ВОВ занимают болезни системы кровообращения. Сахарный диабет II типа является ведущей эндокринологической патологией у данной категории пациентов. Коммуникативные функции ограничены в силу естественных инволюционных процессов – развития вторичной тугоухости и снижения зрения. На основании метода прямого респондентов установили, что основная проблема сохранения здоровья кроется не в организации медицинской помощи, а в формальном отношении со стороны общественных организаций и близкого окружения пожилого человека.
Ключевые слова: Здоровье, ветераны Великой Отечественной войны, медицинская помощь.
Yantimirova R. A.1, Naymushina A. G.2
1PhD, Head of Department of Anatomy and Physiology Humans and Animals,Tyumen State University
2Dr. Med. Sci. Department of Physical Education, Tyumen State Oil and Gas University
HEALTH-SAVING OF THE WORLD WAR II VETERANS LIVING IN THE SOUTH OF THE TYUMEN REGION
Abstract
The complex assessment of a health state and the organization of medico-social support of the World War II veterans and to members of their families (widows) during the period from 2010 to 2013 is carried out. The first place in the structure of diseases and the grade importance in the structure of the general death rate from the Second World War veterans is occupied by blood circulatory system diseases. Diabetes of the II type is the leading endocrinological pathology at this category of patients. Communicative functions are limited owing to natural involution processes – developments of secondary deafness and the depletion sense of sight. On the basis of a direct poll method respondents established that the main problem of health preservation is covered not only in the organization of medical care, and in a conventional attitude from public organizations but in the inner circle of the elderly person.
Keywords. Health, the World War II veterans, medical care.
Veterans and participants of the World War II (WWII) became that symbol of the civic consciousness and patriotism the care about which is expressed in the realization of state programs on health preservation and quality improvement of special category citizens life, whose social status "the veteran of the Second World War" is defined only in the late sixties of the XX century [3, 6, 8]. The main measures of social support of veterans are stated in the Federal law of January 12, 1995 to No. 5-FL "About veterans", Federal Law "About Bases of Public Health Protection in the Russian Federation" No. 323-FL of November 21, 2011, the National Health project. Within the interdepartmental program for quality improvement of elderly people life in the Tyumen region for 2011-2013 "The senior generation", Resolutions of the Tyumen region government on December 24, 2012. No. 560-p "About the territorial program of the state guarantees of free medical care rendering to citizens in the Tyumen region in 2013 and planning period 2014 and 2015", regional State program of the Tyumen region "The main directions of health care development " in 2014-2016 in the Tyumen region a complex of the treatment-and-prophylactic actions directed on a health-saving of veterans and participants of the Second World War is realized [1,2,4,5,7,9].
Simultaneously, the special climatic and geographic, social and demographic, culturological and medicobiological terms of accommodation in the south of the Tyumen region dictate the necessity of complex research of a health state among elderly people and veterans of the Second World War in each administrative region.
Research objective: to estimate a health state and the level of the medico-social help rendering to veterans of the Second World War and to members of their families in the Nizhnetavdinsky area.
Materials and methods of research. The method of a direct poll is directed on the identification of main problems of social support rendering to elderly inhabitants of the Nizhnetavdinsky area. The profound clinicodiagnostic inspection included: the examination of the cardiologist, endocrinologist, pulmonologist, gastroenterologist, rheumatologist, the developed biochemical blood test, an electrocardiography and Holter monitoring, echocardiogram, X-ray examination according to clinical indications. The assessment of empirical data is carried out with the observance of norms and rules of ethical examination accepted for biomedical researches.
Results of research. From 2012 till 2013 586 people were examined, 17 persons were senior than 75 years. In 2012 by order of No. 181 of the Health Care Department of the Tyumen region in 16.04.2012 "About an order of carrying out of the profound dispensary inspection of the World War II participants in the Tyumen region in 2012 " 77 people were examined. The organization of medical care to the veterans of the Second World War and their widows living in the territory of the Nizhnetavdisky area includes:
1) the rendering the ambulatory help in polyclinic of GBIH TR "Regional hospital No. 15", in polyclinics of Velizhansky local hospital, Bukhtalsky local hospital, Chugunayevsky medical ambulance, Antipinsky ambulance, No. 31 FAPE;
2) the hospital help is carried out on the basis of the round-the-clock hospital placed in the village Nizhnaya Tavda in Velizhansky local hospital, in Bukhtalsky local hospital;
3) the implementation of the available specialized medical care rendering program is carried out due to work of mobile teams, in particular: endocrinology clinic of Tyumen Regional oncologic centre, Center of health of GBIH TR "Regional hospital No. 19".
In the hospital for veterans of the Second World War in Tyumen 32 persons, among them 7 participants of the Second World War were treated. Specialized medical care was provided to 6 disabled people and participants of the Second World War in "The Tyumen cardiocenter".
During the planning and the realization of treatment-and-prophylactic measures it is necessary to consider the following medico-biological features of this category of patients:
1) the multimorbid character of pathological states;
2) the limited list of rehabilitation measures (mainly pharmaceutical treatment);
3) the necessity of carrying out of diagnostic and treatment manipulations in the conditions of the round-the-clock hospital supervision, because of high probability of the expected case fatality rate of this patient category.
The structure of the diseases revealed among 77 participants of the Second World War and members of their families according to the results of medical examination is presented: The diseases of the blood circulatory system – 40,2%; Diseases of an ear and mastoid shoot – 17,6%; Diseases of an eye – 15,8%; Diseases of musculoskeletal system – 8,3%; Diseases of endocrine system – 7,3%; Diseases of a gastro-intestinal tract – 6,2%; Others – 4,6%.
In the disease structure among veterans of the Second World War the blood circulatory system diseases occupy the first place. It should be also noted that blood circulatory system diseases on the grade importance among disabled people and participants of the Second World War also occupy the first place in the structure of the total death rate. The main method of the necessary functional condition maintenance of the elderly person organism a pharmacologic correction of main disease symptoms and syndromes: the achievement of the target level of arterial tension, the reduction of anginose attacks and the reduction of pain syndrome intensity. The second place – an ear and a mastoidal shoot diseases among which the post primary deafness is in the leading position.
The guaranteeing of veterans with earphones is carried out free of charge according to the program of rehabilitation in working hours of the MSEK exit bureau No. 5. Eye diseases were at the third place. Involution changes of touch systems – the decrease in sight and post primary deafness significantly limit the communicative abilities of elderly people. Diabetes of the II type is the leading endocrine pathology at this category of patients.
Nowadays the preventive measures program the "School of the elderly person" considering major factors of environment and the organization feature of health care delivery to the population of the Nizhnetavdinsky area is developed:
1) hypocomfortable climatic conditions and the high risk zone of agriculture in the South of the Tyumen region;
2) the low density of the population living in the territory of the Nizhnetavdinsky area (3,5 persons on 1 km.2);
3) service radius when rendering an emergency medical service – 100 km.;
4) delivering time by public transport from the most remote settlements to GBIH TR "Regional hospital No. 15" – 1, 2 hours.
For preservation of the necessary health level among veterans and participants of the Second World War in the Nizhnetavdinsky area the complex of the interconnected treatment-and-prophylactic, social and psychological and educational measures is realized. Annually, on the eve of the Victory Day celebration meetings with veterans, exhibitions and concerts of amateur performances are held. But, as veterans consider, such measures have the "single" character. According to the results of a direct poll 94 respondents answered that the main problem of social support rendering to elderly people is the conventional attitude from an inner circle of the elderly person and the lack of regularity in the social and psychological support organization of veterans from public organizations.
Conclusion. According to the international criteria, the population of the Nizhnetavdinsky area, having the proportion of persons in age structure more than 30% are senior than working-age and is considered "demographically old". The treatment-and-prophylactic help to veterans and participants of the Second World War living in the territory of the Nizhnetavdinsky area is organized at the necessary level. The social and psychological support of veterans has to include not only cultural events, but also the organization of the individual and personal help for each person.
The old age, weak physical health, psychological vulnerability and the high emotional sensitivity become the major factors defining an incidence and high probability of the expected death rate of this citizen’s category. The foundation of the "School of the elderly person" has to promote a health-saving of the Second World War veterans.
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