[PSYCHOLOGICAL CARE FOR SCHOOL-AGE PATIENTS WITH CORONAVIRUS INFECTION IN THE HOSPITAL].

For the first time in pediatric practice, the psychological state of 100 children (7-17 years old) with COVID-19 in the state of hospitalization was studied on the basis of the Scientific Medical Research Center of Children's Health of the Russian Ministry of Health Care and the directions of psychological and pedagogical assistance were determined. Analysis of medical and psychological-pedagogical documentation, conversation, observation, screening diagnostics were conducted. It was established that according to the totality of physical and psychological factors (the main psychological difficulty) patients can be grouped into the following groups: children in a severe physical state, with unstable manifestations of mental activity (n = 4; 4%); children in a predominantly moderately severe state with significant distress related to the disease (n = 48; 48%); children in a satisfactory physical state, with mild and mostly situational difficulties in adapting to the situation of hospitalization (n = 46; 46%); children in a satisfactory physical state, in a relatively stable positive psychological state (n = 2; 2%). Consideration of the severity of their physical and psychological condition and their basic psychological difficulties allows differentiated psychological aid to be rendered to children and teenagers in special conditions of the «red zone¼.

PSYCHOLOGICAL AID FOR CHILDREN INFECTED WITH COVID-19 IN “RED ZONE” IN THE CONTEXT OF ILLNESS OF CLOSE ADULTS

The article defines the first-ever directions of psychological aid for children infected with COVID-19 in “red zone” in the context of illness of close adult people. The goal of the research is psychological state of children infected with COVID-19 in “red zone” in the context of illness of close adults and determination of the required psychological aid. Methods and sample. Analysis of 36 clinical cases of 7-17 years old children in the context of illness of close adults, who were in critical condition in intensive care department (first group - 28 children) or in satisfactory condition being treated at home (second group - 8 children). The research included the following: observation of medical records;screening diagnostics, which included the ‘Three Wishes” technique, an adapted method of “Unfinished sentences” (for adolescents), a drawing (any topic);10-questions questionnaire focused on child’s physical well-being, its wishes for organization of everyday life and leisure activities in hospital ward, etc. Results. The majority of patients appeared to be in unfavorable psychological state (close to acute stress or unstable state), which manifested itself in three different ways: severe anxiety;over-excitement, impaired mood. These symptoms were constant and illustrative for children whose relatives were in critical condition in the intensive care department. Children, whose relatives were in satisfactory condition and were treated at home were observed during periods when they were influenced by additional stressors. Conclusions. Taking into account psychological differences and other factors (such as age, level of psychological maturity, severity of physical condition) provides an opportunity to give children and adolescents in “red zone” differentiated psychological aid. В статье впервые определены направления психологической помощи детям с COVID-19 в «красной зоне» в ситуации болезни близких взрослых. Цель: изучение психологического состояния детей с COVID-19 в «красной зоне» в ситуации болезни близких взрослых и определение направлений психологической помощи. Методики и выборка: анализ 36 клинических случаев детей 7-17 лет в ситуации болезни близких взрослых, которые находились в тяжелом состоянии в реанимации (первая группа, 28 детей), либо в удовлетворительном состоянии и получали лечение на дому (вторая группа, 8 детей). Проведено: изучение медицинской документации;скрининг-диагностика, включавшая методику «Три желания», адаптированную методику «Незаконченные предложения» (для подростков), рисунок на свободную тему;анкета из 10 воп росов, направленных на выяснение физического самочувствия ребенка, его пожеланий к организации быта и досуговой деятельности в палате и т.п. результаты исследования. У большинства пациентов выявилось неблагоприятное психологическое состояние (близкое к состоянию острого стресса либо нестабильное), которое проявлялось в трех различных вариантах: выраженная тревога;повышенное возбуждение;сниженный фон настроения. Эти проявления были постоянны и ярко выражены у детей, чьи близкие находились в тяжелом состоянии в отделении реанимации;у детей, чьи близкие имели удовлетворительное состояние и лечились на дому, они наблюдались эпизодически при воздействии дополнительных стрессоров. Выводы . Учет психологических различий, как и ряда других факторов (возраста, уровня психологической зрелости, тяжести физического состояния), позволяет оказать детям и подросткам дифференцированную психологическую помощь в особых условиях «красной зоны».

Possibility of breastfeeding support during the COVID-19 pandemic: A review of world and Russian protocols

The review analyses the available literature on the main principles of breastfeeding support in cases of confirmed/suspected novel coronavirus infection in breastfeeding mothers. Various approaches to management of mother and baby in the conditions of the COVID-19 pandemic have been studied that found reflection in the protocols of the World Health Organization, Chinese, American and European medical communities. The evolution of Russian recommendations is analysed. A rationale is offered for the current guidelines on temporary mother-child separation in the healthcare settings when maternal COVID-19 is suspected/confirmed and on the organization of infant feeding with expressed maternal milk. The literature on the nutritional and biological value and the safety of expressed breast milk stored in various conditions is reviewed. Practical advice is given on organization of an individual breast milk bank at home. © 2020, Dynasty Publishing House. All rights reserved.