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Kvadriplegija: psyhologial aspets (quadriplegis: psyhologial aspets)

Sudden damage of a spinal ord opens the whole world of linial experiene. Damages of a similar sort are aused gl. obr. Falling from height, dorozhno- inidents and gunshot wounds. Consequenes are more essential to the further life at (full obezdvizhennosti), than at paraplegijah as in the first ase mobility suffers in a greater degree. At the spinal ord appears partially or ompletely separated on one or more levels pozvonkov. At mn. Patients with are kept in the ertain degree of funtion of musles of the top finitenesses. At damages at a level of two top ervial pozvonkov any movements below a head are lost. However it is frequent in a greater degree there are amazed motor, instead of touh funtions.

it is diret after a trauma there omes a ondition of a shok. The amnesia of aident or events is in most ases marked retrogradnaja, to- have oured for nesk. Hours or even days up to it though sometimes these memoirs remain. The painful syndrome is kept during mn. Days or even weeks besides at the expressed infringements of a dream are observed.

Mn. Variables define a ourse of reover: age, a soial and eonomi level, finanial problems, onern in loss of work or k.-. fiz. Skills. Not less important there is an attitude and behaviour of dotors, nurses, assistants to dotors, physiatrists, et. the personnel, and tzh spouses and members of family. The ultural bakground tzh an play a known role napr. In nek- situations it is onsidered to be the reason of aident negligene, fate or influene of maliious spirits.

the professionals working from patients, usually observe the ertain sequene of emotions and attitjudov (supplementing a shok and a painful syndrome). In the beginning denying physial inability is marked, for to-eye the hope for reover follows. For it depression, alarm, grief, feeling of fault and, at last, anger follow. Intensive fiz. And psihol. Rehabilitation, alongside with motivation to possible fuller independene, extremely promote optimum daily adapt. Patients

At lose the ontrol moheispuskanija and ativity of intestines. The expressed sexual dysfuntions an tzh be marked in a different degree. Sexual promptings are kept in all ases, and ways of ahievement of sexual satisfation an be oordinated with the partner.

Abel and Wilson onsider, that family therapy an be an effetive omponent of standard stationary therapy. The family of the patient should reeive exat and duly an inform. About a trauma and its onsequenes. The patient and should tzh to help be expressed members of its family the feelings onneted with aident, a trauma and the attitude to eah other, that promotes a deepening of mutual understanding and inrease of mutual support.

Patients experiene espeially greater diffiulties of the adaptation by a life outside of hospital - in the house or at independent residing under supervision honey. The personnel. At the ertain safety of funtions of the top finitenesses of patients an master a number of skills, napr. Management of the motorized arriage, et. vehiles, using phone and performane of the ertain manual skills. Using the keyboard or the motorized arriage at heavier defeats an be mastered by means of the speial adaptations operated by a mouth and the bottom jaw.

Patients require the help at development of all possible fiz. Skills. They need to learn to operate in daily onditions, shool employment, industrial training and work. They tzh need to help to overome alarm, ares, fears, loss of feeling of own value and to get the onfidene, neessary to meet a new life.

see also the Attitude to invalids, Rehabilitation

. M. Abel