JUSTIFICATION OF APPROACHES TO THE ORGANIZATION OF REHABILITATION OF PATIENTS WITH UROLITHIASIS

Author:

Diachuk Myhajlo D.ORCID

Abstract

Introduction. Rehabilitation makes it possible to improve the results of treatment and the quality of a person's life, as well as to reduce health care costs. Evidence-based domestic technologies for the rehabilitation of patients with a surgical profile have not been developed, in particular, for patients with urolithiasis. Aim. To investigate traditional clinical practice for the rehabilitation of a patient with urolithiasis in a multidisciplinary healthcare facility and to justify and develop a typical patient clinical pathway incorporating rehabilitation technologies. Materials and methods. European clinical guidelines for the treatment of urolithiasis, systematic reviews and scientific sources from the PUBMED and NICE databases, administrative data for the years 2019-2023 and 236 medical records of inpatients operated on for urolithiasis were selected as research materials; methods: bibliosemantic, systematic approach and analysis, medical-statistical, descriptive and graphic modeling. Results. It was found that traditional rehabilitation measures on the clinical path of a patient with urolithiasis are fragmentary and limited in content and scope. At the same time, manageable risk factors have been identified that can be targeted for rehabilitation: high levels of chronic non-infectious diseases – circulatory system and endocrine system (respectively, 8,826.7 and 4,809.1 per 10,000 population). In general, there were 1.6 manageable risk factors (irrational diet, overweight, low physical activity, smoking) common to chronic non-communicable diseases per person. The specific weight of urolithiasis in the structure of urological pathology (12.7%) remained stable during the study, and the specific weight of patients with the need for surgical treatment was equal to 90.7%-93.2%. A typical clinical route of a patient with urolithiasis has been substantiated and developed. A feature of the route is the use of a short-term rehabilitation program during conservative treatment, perioperative rehabilitation - in the case of operative treatment, long-term rehabilitation – at the ambulatory stage after conservative and/or operative treatment of urolithiasis. The programs are aimed at reducing the impact of risk factors on the development and/or recurrence of urolithiasis and other most common chronic non-infectious diseases. The programs are carried out by multidisciplinary teams of specialist doctors. The interaction of doctors is ensured by the local medical information system. Conclusions. A typical clinical pathway for a patient with urolithiasis includes short-term, perioperative and long-term rehabilitation programs. They have the potential to affect not only the health of an individual, but also the entire contingent of the population being served.

Publisher

State Institution of Science Research and Practical Center

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