Ppt about something

1. LECTURE 3. SOCIOPSYCHOLOGICAL CHARACTERISTICS OF
PEOPLE WITH DISABILITIES (PWD).
THE ETHICAL FOUNDATIONS FOR INTERACTION BETWEEN
DOCTOR AND PWD.

2. CONTENT
1. The changes of self-concept through the disease
2. The internal image of the disease
3. The sociopsychological features of the PwD’s
character
4. Disease survival: psychological defense mechanisms.
5. Ethics in interaction with PwD with different nosology.

3. SELF-CONCEPT
It is an abstract term that encompasses all
notions that one holds about themselves.
• It constitutes of everything
ranging from their strengths to
their weaknesses. In
psychology, self-concept can be
understood as patterns of
thoughts one holds about the
self. It could be positive or
negative.
• In 1999, Baumeister defined the
self-concept as “The individual’s
belief about himself or herself,
including the person’s attributes
and who and what the self is.”
The concept was proposed by Carl Rogers in 1959 as an
attempt to establish a new personality theory and is now
largely used by psychologists practicing under the
framework of the client-centered approach.

5. AN AFFECTED AREA OF PWD’S LIFE
• Psychological
discomfort associated
with the defect.
•Difficulties in exercising their rights,
low income, difficulties in family and
personal life. Problems with
understanding one's social role in
society
• Impairment or defect
affecting normal
functioning
•Difficulties in realizing one's
"mission" or "destiny", violation
of the internal subjective idea of
being.
spiritual
physiological
Psychological /
Emotional
Social

6. SUBJECTIVELY PERCEIVED CHANGE OF
SELF-CONCEPT
 changes in the temperament and character performance
 difficulties in the automated use of intellectual experience and the acquisition of new
knowledge
 an emotional surge, reactivity and sensitivity
 difficulty in a spontaneous manifestation of an individual’s character traits and their
de-automatization.
 excessive "soul-searching" and reflection
 a pessimistic assessment of one's qualities, shyness and resentment surge
 one makes great efforts to maintain their former social status
 "passive compensation reaction“
 use of pathological forms of compensation - excessive sports, unusual hobbies, drug
addiction or alcoholism

7. OBJECTIVELY DEFINED CHANGES
the loss of pre-morbid
individual properties of
temperament and character
arises and signs of social
maladaptation appear.
in these cases, PwD is not
aware of their changes, but
others see it.

8. TYPES OF OBJECTIVELY DEFINED CHANGES
personality disharmony, including schizopathy
(formal preservation of abilities, but the loss of their social significance, a change in the nature of the individual,
their needs and motives for activity)
energy potential decrease (reduction of mental activity, productivity, need for
communication, etc.)
personality decline (the interests of individual are limited by the needs for pleasure)
personality regression (different kinds of the complete collapse of the individual’s
structure of personality)
mental insanity is the complete disintegration of mental
activity with the loss of the possibility of contact with
others, the complete disappearance of interests and
motives.
(often combined with signs of general destruction of the body - physical exhaustion, trophic disorders
such as bedsores, dystrophy of internal organs, etc.).

9. THE DEVELOPMENT OF A SOMATIC DISEASE AND THE
RESPONSE OF INDIVIDUAL TO THE DISEASE.
THE CONCEPT OF THE INTERNAL IMAGE OF THE DISEASE.
Goldscheider (1926) R.A. Luria (1935)
Autoplastic image of the disease means
sensations, experiences and ideas a sick person
about his illness
Internal picture of the disease (IPD) – a complex of the
patient's experiences associated with the disease: general
well-being, sensations, perceptions, emotions, thoughts
about the disease

10. HISTORY
The external picture of the disease
(objective data that the doctor receives using special
research methods)
The internal picture of the disease
(experiences of the patient about the disease)

11. AUTOPLASTIC IMAGE OF THE DISEASE
(ACCORDING TO GOLDSCHEIDER-LURIA)
1. "SENSITIVE" LEVEL OF ILLNESS
based on the patient's feelings
2 . "INTELLECTUAL" ILLNESS LEVEL
the result of the patient's reflections on their physical condition

12. LEVELS OF IPD
• (motivational level) is
associated with a
certain attitude of the
patient to his disease
•(rational-informational level) is associated
with the patient's ideas and knowledge
about his disease, reflections on its
causes and consequences
• associated with various types
of emotional response to
individual symptoms, the
disease as a whole and its
consequences
• (level of sensations, sensory
level) - localization of pain
and other unpleasant
sensations, their intensity,
etc.
A painful
aspect of
the
disease
The
emotional
aspect of
the disease
Volitional
aspect of
the
disease
The
Intellectual
aspect of
the disease

13. DISEASE MODEL
It IS A CONCEPT OF THE ETIOPATOGENESIS,
CLINIC, TREATMENT AND PROGNOSIS OF
THE DISEASE, WHICH DETERMINES THE
“SCOPE OF EXPERIENCES” AND THE
BEHAVIOR OF PATIENT IN GENERAL.
A REAL STATUS OF HEALTH
DISEASE MODELS

14. THE SCALE OF THE EXPERIENCE OF THE
DISEASE
Normonosognosia (adequate type of response) patients
correctly evaluate their condition and prospects, their
assessment coincides with the doctor's assessment.
Hypernosognosia - the tendency to overestimate the
significance of symptoms and / or the disease in general
Hyponosognosia - the tendency to underestimate the
significance of symptoms and / or the disease in general
Dysnognosia - distortion of perception and denial of the
presence of the disease and its symptoms for the purpose
of dissimulation or due to fear of its consequences
Anisognosia - a complete denial of the disease as such, is
typical for patients with alcoholism and cancer.

15. TYPES OF DISEASE REACTION
(ACCORDING TO THE CRITERION OF POSITION IN RELATION TO THE DISEASE)
Sthenic reaction– characterized by an active life
position of patient to treatment and examination
Asthenic reaction - characterized by a patient's
tendency to pessimism and suspiciousness
Rational reaction – characterized by a real
assessment of the situation and a rational escape
from frustration

16. TYPES OF PERSONAL RESPONSE TO A DISEASE
(ACCORDING TO THE CRITERION OF DOCTOR-PATIENT
RELATIONSHIP) (YAKUBOV B.A., 1982)
Friendly reaction.
It is typical for people with a developed intellect. They seem to become "assistant" of the
doctor, demonstrating compliance with the prescriptions, punctuality, attention, goodwill.
Calm reaction.
It is typical for people with stable emotional and volitional processes. They respond
adequately to all doctor's instructions, accurately perform medical and recreational activities,
and easily come into contact with medical personnel.
Unconscious reaction.
The reaction, having a pathological basis, in some cases plays the role of psychological
protection, and this form of protection should not always be eliminated, especially in severe
diseases with an unfavorable outcome.
Trace reaction.
Typical for people with low intelligence, they have expressive emotional reactions. Even if the
disease has a favorable outcome, they usually wait for a relapse of the disease. After the
illness, they are depressed and have hypochondria, they consider themselves incurable
patients.

17. TYPES OF PERSONAL RESPONSE TO A DISEASE
(ACCORDING TO THE CRITERION OF DOCTOR-PATIENT RELATIONSHIP)
Negative reaction.
Patients are in the power of prejudice. They are aggressive and distrustful, hardly
come into contact with the attending physician, do not attach serious importance to
his instructions and advice. They often have conflict with medical staff.
Panic reaction.
Patients are in the power of fear, easily suggestible, often inconsistent, treated at
the same time in different medical institutions, as if testing one doctor by another
doctor. Often they are treated by healers or use the Internet. Their actions are
inadequate, they are characterized by affective instability.
Destructive reaction
Patients ignoring all instructions of the attending physician. they do not want to
change their usual way of life, professional workload. This is accompanied by a
refusal to take medication, from treatment in a hospital.

18. CLASSIFICATION OF TYPES OF PERSONALITY
RESPONSE TO ILLNESS (A. LICHKO)
The classification has 12 psychotypes of potential patients and covers almost the entire spectrum
of possible reactions to the disease.
1. Harmonious psychotype (realistic, balanced). rational
2. Ergopathic (sthenic). "Escape from illness to work.“ social
3. Anosognosic (euphoric). "Denial disease». adaptation
are not broken
4. Anxiety-depressive and phobic type. the patient fantasizes about his illness.
5. hypochondriacal type. "Ouch! It's very painful!" adaptation
6. Neurasthenic. "Leave me! I feel bad!" is broken
7. Melancholic type. "Life is over!" "I don't want / cannot live".
8. Apathetic type. "I don't care!".
9. Sensitive type. Intense pain, shy, fussing all the time.
10. Egocentric (hysterical) type. "Everyone should do everything for me, I know how to treat me."
11. Paranoid type. “I know you doctors! You will always make a mistake!«
12. Aggressive type. An angry and gloomy silent man.

19. DISEASE RESPONSE STAGES
(ELIZABETH KUBLER-ROSS IN «ABOUT DEATH AND DYING».)
Shock
Rage
Bargain
Depression
Adoption

20. STAGES OF EXPERIENCING THE
DISEASE IN TIME
Pre-medical phase
Breaking the life stereotype
Adaptation to illness
The “surrender” phase
The phase of formation of compensatory
mechanisms of adaptation to life

21. DEFENSE MECHANISMS AGAINST STRESS DURING
DISABILITY AND ILLNESS
intellectual emotional Поведенческие.
 study of information
related to the disease
 communication with
doctors
 learning the stories of
others
 emotional release
 outburst of negative
emotions
 optimism
 trust in the doctor with
the transfer of
responsibility for his
own destiny
 keeping one's
composure
 escape to work
volunteering
 making dreams come
true
 meditation
 communicating with
friends who will
always listen and
understand
 various activities and
hobbies.

22. The result of successful
protection
stop impulses causing anxiety
weakening intrapersonal conflict
regulation of behavior
increasing adaptive capacity
it is a system of
personality stabilization
aimed at protecting
consciousness from
unpleasant, traumatic
experiences
PSYCHOLOGICAL
PROTECTION
The criterion for the effectiveness of
protective mechanisms is eliminating
anxiety and getting rid of fear

23. CONSEQUENCES OF USING
PSYCHOLOGICAL PROTECTIONS
Positive consequences:
Protection mechanisms protect
the psyche from injury
Protection maintain the stability
of the personality against the
background of destabilizing
experiences
The beneficial (adaptive) effect
of psychological protection is
more pronounced when the
scale of the conflict that
threatens the integrity of the
individual is relatively small.
Negative consequences
Protection do not allow a
person to realize his
delusions about their own
character traits and motives
of behavior.
Protection does not allow a
person to actively influence
the situation and eliminate
the source of experiences.

24. MAIN MECHANISMS OF PSYCHOLOGICAL
PROTECTION
First group
protective mechanisms
that are united by the
lack of processing of
the content of
experience
crowding out
suppression
blocking
denial

25. MAIN MECHANISMS OF PSYCHOLOGICAL
PROTECTION
The second group
psychological defense
is associated with
transformation
(distortion) of the
content of thoughts,
feelings, behaviour,
etc.
rationalization
projection
alienation
substitution
compensation

26. MAIN MECHANISMS OF PSYCHOLOGICAL
PROTECTION
The third group
ways of psychological
protection that helps to
discharge negative
emotional stress.
SUBLIMATION
it is a way of
avoiding a different
path of discharge
tension

27. MAIN MECHANISMS OF PSYCHOLOGICAL
PROTECTION
The fourth group
are the mechanisms of
psychological
manipulative type
protection
Regression to
earlier behavior
Suspiciousness,
helplessness,
infantilism

28. MAIN MECHANISMS OF PSYCHOLOGICAL
PROTECTION
The fifth group
are the mechanisms of
psychological protection
associated with such a
change in values, which
leads to a weakening of
the influence of the
traumatic factor
insight
catharsis

29. Ethics in interaction with PwD with
reduce mobility
• if the offer of help is accepted, you must ask what needs to be done and
follow the instructions clearly
• always ask if help is needed before giving it. Need to offer help if you need
to open a heavy door
• remember that a wheelchair is an inviolable space of a person. It is not
allowed to lean on it, push it, put your feet on it without permission, start
moving the stroller without the consent of the disabled person
• if permission has been obtained to move the wheelchair, it must first be
rolled slowly. The stroller picks up speed quickly, and an unexpected push can
cause you to lose balance.

30. Правила этикета при общении с инвалидами,
испытывающими трудности при передвижении
•you must personally verify the availability and availability of places in the room.
Consider what problems or barriers might arise and how they can be addressed
• do not slap a person in a wheelchair on the back or shoulder
•if possible, it is necessary to be located so that the faces are at the same level.
You should avoid a position in which the interlocutor needs to throw back his
head
• if there are architectural barriers, they should be warned about them so that the
person has the opportunity to make decisions in advance
• it must be remembered that, as a rule, people with mobility difficulties do not
have problems with vision, hearing and understanding
Ethics in interaction with PwD with
reduce mobility

31. Правила этикета при общении с инвалидами,
испытывающими трудности при передвижении
Ethics in interaction with PwD with
visual impairment
Rule 1
The blind person must hold the accompanying person by the arm and walk half a
step behind. This helps the maintainer to respond more quickly to emerging
obstacles.
Rule 2
When moving up the stairs and when crossing the threshold, if it stands out in height,
the blind person should first be warned about the obstacle with a word or gesture, as
well as at the end of the descent or ascent of the stairs - indicating the last step.
Rule 3
Hazards include ajar doors, columns, glass doors and partitions, as well as
advertising installations located on the ground or floor and objects hanging from
above, as well as anything that makes sudden sharp or loud sounds. A blind
person should be warned about this.
Rule 4
The escort brings the blind person to an armchair or chair, puts the hand of the
blind person on the back of the chair or armrest. Then the visually impaired
person performs the necessary manipulations.

32. Правила этикета при общении с инвалидами,
испытывающими трудности при передвижении
Ethics in interaction with PwD with
hearing impairment
Rule 1
To get the attention of a person who is hard of hearing, wave or touch them. Look him straight
in the eyes and speak clearly, with good articulation. If the conversation does not work out, you
can offer to type text or write by hand
Rule 2
Do not obscure your face or block it with your hands, hair, or other objects
Rule 3
Very often deaf people use sign language. If you communicate through an interpreter, do not
forget that you need to contact the interlocutor directly, and not the interpreter
Rule 4
Not all people who are hard of hearing can read lips. It is best for you to ask about this at the
first meeting. You need to look into the face of the interlocutor and speak clearly and slowly,
use simple phrases and avoid irrelevant words.
Rule 5
There are several types and degrees of deafness. Accordingly, there are many ways to
communicate with people who are hard of hearing. If you don't know which one to prefer, ask
them