Moscow Institute of Medico-Social Rehabilitation, Russia

Modern medicine is on the way to getting rid of the consequences of diseases, and the causes of diseases in modern medicine are often not detected. Selection of techniques, procedures, drug support is based on the diagnosis, without taking into account the individual properties of a person, the state of his psyche and consciousness. A special role in modern medicine belongs to rehabilitation because of its focus – helping people with diseases, especially the consequences of infectious diseases (for example, tuberculosis or poliomyelitis).

If we consider the early stages of the development of rehabilitation care, then at this stage it was passive. The increase in the number of chronic diseases caused by genetic defects and accidents reoriented rehabilitation from passive to active in the broad sense of the word.
The definition of the concept of medical rehabilitation cannot be identified with restorative treatment, as a section of clinical medicine.
In modern medical literature, the content of the notion of medical rehabilitation is understood as a set of methods of recovery and treatment known in medicine: exercise therapy, electrotherapy, kinesiotherapy, massage, manual and reflexotherapy, etc. Simultaneously with this interpretation, the thesis of its “limitation” is advanced, which makes further the existence of social events The
state social policy of Russia needs a revision of strategic directions.
The existing mechanisms for its implementation are ineffective, since they do not reduce the number of socially unprotected layers of the population, the demographic indicators of the state of the country’s population are dramatically worsening, there is a general health crisis, and the environmental situation in the country is deteriorating. At present, it is obvious that the factors influencing the health of people and the degree of their impact are as follows: the conditions and lifestyle of people – 50-55%, the state of the environment -20-25%, genetic factors-1 5-20% activity of health care institutions up to 10-15%.
The result of the systemic crisis of social policy was a sharp deterioration in the health of the population and unprecedented in peacetime – a decrease in the population. In recent years, mortality in all age groups has significantly increased (14.3 per 1000 inhabitants). The number of deaths exceeds the number of births by 1.7 times. In the total number of deaths, the third part consists of persons of working age. High
indicators show infant mortality. The average life expectancy in Russia fell to 64 years (in men – up to 58 years). People began to die younger, not surviving until retirement. Mortality of 20-30-year-olds grew by 61%. Progressive growth of disability of the population, including young people, is noted. Currently, 8 million people with disabilities live in Russia (of whom 1 million are disabled children) and this group is expected to grow further.
The above data indicate insufficient effectiveness of social policy, which is connected not only with insufficient attention of the state to providing medical and social assistance to the population, but also because the focus of social policy of the state (region, city, district) is not a specific person in its environment, but only a mechanical list of social services is taken into account.
Currently, medical and social sections of rehabilitation exist by themselves in different dimensions – social requirements do not have an impact on the goals of therapeutic effects, and medicine does not control the implementation of social activities in any way. There is no interpenetration between them. The reconciliation between the medical and social sections of rehabilitation can not be carried out automatically. On the one hand, social tasks should determine the goals and methods of medical rehabilitation, and on the other hand, the sequence of restoration of socially significant functions should not come into conflict with restorative medicine. Only in this case the concept of medical and social rehabilitation will acquire real content.
Rehabilitation is a new synthesis science. The subject of its study is the system “Man – Habitat” ie. the unit of observation in this systemic science is the person in the habitat. Only when multidimensional influences of both external and internal factors are taken into account, it is possible to develop individual rehabilitation approaches that give the maximum effect.
To implement a social strategy to improve the quality of life, specialists of the synthesis system of knowledge are needed. All this knowledge should be based on the social law of different age-sex and social groups of the population. In other words, training specialists who represent synthetical rehabilitation requires them to master theory and practice that go far beyond the training of doctors of any medical specialty.
If we focus on the existing healthcare system in Russia and take into account the possible organizational forms of the service of rehabilitation treatment and rehabilitation (rehabilitation hospitals, rehabilitation centers, rehabilitation departments of medical and preventive institutions, a sanatorium and resort complex, etc.) that can be integrated into the country’s current system health care, it is obvious that such a specialist as a rehabilitator doctor is needed. He does not replace doctors – specialists in a particular clinical specialty, he does not work in place of a physiotherapist or physician of physical therapy. He, together with them, makes up an individual program for the rehabilitation of a patient or an invalid. He clearly represents the possibilities and expected results of his appointments taking into account the patient’s condition and competently evaluates the course, dynamics of rehabilitation and rehabilitation. The rehabilitation physician should have a minimum of legal knowledge in the interests of the patient and disabled person, cooperate with the bodies of social development. Such personnel should own new technologies, methods, a new system of knowledge about the person in the environment.

After graduating from the university, a psychologist will receive the qualification “Psychologist, Teacher, Clinical Psychologist” corresponding to the state educational standard of 5-year education (full-time) and 5.5 years (evening form).
The state educational standard in the field of clinical psychology was prepared by the Department of Psychology of the Educational and Methodological Association of Universities of Russia and approved by the Ministry of General and Professional Education in 1 999.
In accordance with their fundamental and special training, graduates will be able to successfully solve many problems not only in health care, but also in other areas – pedagogy, social work, business, production, private life, law enforcement structures, etc.

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