• Features of the psychological aspect of the work of initial contact physicians in providing palliative care to the patient and their family

Features of the psychological aspect of the work of initial contact physicians in providing palliative care to the patient and their family


Matiukha L. F., Medvedovska N. V., Matviiets L. H.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

In article the analysis of difficulties of rendering palliative care in practice of medical personnel which provide primary medical care on the principles of the general medical practice in Ukraine is carried out. In foreign sources of information when rendering palliative care much attention is paid to psychological aspect therefore in article it is also reflected this aspect in Ukraine. Determination of difficulties and features of psychological aspect of work of physicians of primary contact when rendering palliative care to the patient and his family became the purpose of our research.
Materials and methods. Results of scientific research of the last years of problems of the organization of rendering palliative care in which solutions of such problems in practical the robot of doctors of the general practice – family medicine and family nurses are described became materials for writing of work. Results of a research and their discussion. In daily practice of the doctor of the general practice – the family doctor and junior staff with medical education important is knowledge of components of quality of life of the patient with an incurable disease, influencing components of which it would be possible to improve efficiency of the applied medical interventions. Making qualities of life there are physical and psychological health, social and spiritual wellbeing. High-quality palliative treatment of the patient which obligations of the organization lie on the doctor of the general practice – the family doctor is directed to the solution of the questions connected with quality of life. It is necessary to consider psychological aspect, namely uneasiness, subjective sense of danger which often arises without a certain reason at the patient. Important at the same time is assessment of existence and force of a pain syndrome, specification of existence of behavioral incentives. It is important to be able to listen to the patient, without changing a topic of conversation, without hurrying, promoting that the patient has shared with you the reminiscence, and emotions interrelations. For expansion of opportunities of palliative treatment the doctor we delegate the most part of powers to the nurse who visits family of the patient with an incurable disease more often, promotes cross-disciplinary approach to conducting observation of him. It is necessary to remember that at communication of the physician with the patient important are features of behavior, style of communication of the health worker, existence or lack of the personal experience connected with death or dying, fear of ignorance of answers, lack of mutual understanding with the patient’s relatives, language and intellectual barriers.
Conclusions. Treatment and observation of the patient with an incurable disease has such difficulties: difficulties in the solution of the questions connected with quality of life of the palliative patient; limitation of the integrated brigade approach of social workers, psychologists and health workers in rendering palliative care that considerably lowers her quality and efficiency; the lack of additional psychological training of physicians for robots with incurably sick also reduces its efficiency. Features of psychological aspect robots of physicians of primary contact when rendering palliative care to the patient and his family remain: carrying out adaptation of the incurable patient to the disease, to the changes in life caused by a disease and to current vital events in the period of a disease; belief of the patient to formation of adequate assessment of vital values and priorities during her concrete period; ability, keeping psychologically, to spend the patient through five stages of perception of a disease described by Elisabeth Kyubler-Ross and as soon as possible to reach a reconciliation stage; ability to help the patient to find sense in all that occurs, and in particular, in this difficult period of life limited to a disease; LZP-SL is important to own technicians of decrease in mental pain. Possession of knowledge and skills of communication with such patient are important in prevention of professional burning out of physicians who provide first aid on the principles of the general practice – family medicine.
Key words: palliative care, psychological aspect, medical personnel of primary contact, the doctor of the general practice – the family doctor.


1. Andriyishin L-OI. (2015). Peculiarities of work of a psychologist in institutions of palliative care. Rehabilitation and Palliative Medicine. 2:39-42. doi 10.15574/IJRPM.2015.2.39

2. Huzii OV. (2017). Patsiientoriientovana statystyka ta paliatyvna dopomoha v Ukraini. Ukrainskyi medychnyi chasopys. VII/VIII; 4(120). http://www.umj.com.ua/article/112712/patsiyentoriyentovana-statistika-ta-paliativnadopomoga-v-ukrayini

3. Karpenko MM. (2014). Svitovyi dosvid planuvannia pidhotovky spetsialistiv vidpovidno do prohnozovanykh potreb suspilstva. Stratehichni priorytety. 1(30): 129-134.

4. Kontseptsiia rozvytku okhorony zdorovia naselennia Ukrainy. Ukaz Prezydenta Ukrainy vid 07.12 2000 r. №1313/2000. http://www.moz.gov.ua.

5. My tut usi trokhy pryrecheni – patsiientka khospisu. https://www.radiosvoboda.org/a/27649255.html

6. Paliatyvna dopomoha. Posibnyk dlia chleniv rodyny paliatyvnoho patsiienta. Savytskyi A, Chernets O. (pereklad). Pankov K. (zah. red.) (2014). Kyiv: Vydavnychyi dim «Kalyta»: 52.

7. Poniattia pro paliatyvnu dopomohu, istoriia rozvytku kontseptsii. Filosofski, psykholohichni, sotsialni ta etychni aspekty paliatyvnoi medytsyny. http://intranet.tdmu.edu.ua/data/kafedra/internal/magistr/lectures_stud 01.01.2018.

8. Pro zatverdzhennia Derzhavnoho standartu paliatyvnoho dohliadu: nakaz Ministerstva sotsialnoi polityky Ukrainy vid 29.01.2016 #58. http://www.zakon.rada.gov.ua.

9. Pro orhanizatsiiu paliatyvnoi dopomohy v Ukraini: nakaz MOZ Ukrainy vid 21.01.2013 r. №41. http://www.moz.gov.ua.

10. Rol upravlinnia kadrovymy resursamy u pokrashchenni rezultativ diialnosti systemy okhorony zdorov‘ia Ukrainy. Posibnyk pidhotovleno v ramkakh proektu Yevropeiskoho Soiuzu «Spryiannia reformi vtorynnoi medychnoi dopomohy v Ukraini». (2009). Kyiv: 72.

11. Rukovodstvo po razrabotke strategii obespecheniya kachestva i bezopasnosti s pozitsii sistem zdravoohraneniya. Evropeyskoe regionalnoe byuro Vsemirnoy organizatsii zdravoohraneniya (2008): 86.

12. Slabkyi HO. Kadrova polityka. http://www.uiph.kiev.ua/index.asp.p=information&s=2.

13. Unifikovanyi klinichnyi protokol paliatyvnoi medychnoi dopomohy pry khronichnomu bolovomu syndromi. Nakaz MOZ Ukrainy vid 25.04.2012 r. № 311. http://www.moz.gov.ua.

14. Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy «Depresiia». Nakaz MOZ Ukrainy vid 25.12.2014 #1003. http://www.moz.gov.ua.