ASSESSMENT OF THE IMPACT OF WAR ON THE PSYCHOLOGICAL STATE OF INTERN DOCTORS IN THE SOUTHERN REGION OF UKRAINE

Abstract

Abstract. The Russian Federation launched a full-scale war on the territory of Ukraine on February 24, 2022. The war led to changes in the life of every Ukrainian, both every day and educational. Currently, hundreds of young doctors of Ukraine were forced to move to other cities of Ukraine or abroad and acquired the status of temporarily displaced persons. However, many intern doctors remained at their place of work or residence in cities and towns where active hostilities continue or in temporarily occupied territories. As of June, in the Southern region of Ukraine, these are the territories of the Mykolaiv and Kherson regions. Intern doctors, like other sections of the population of Ukraine, are in the conditions of martial law and are prone to the occurrence of generalized anxiety disorder (GAD). Since medical higher education institutions (HEIs) did not stop training during the wartime period, it is within the framework of classes that young doctors can receive psychological support and distract themselves from all the troubles that may be set them in everyday life. It was for this purpose that a study of the impact of war on the psychological state of medical interns in the Southern region of Ukraine was conducted. According to the design, the study was conducted on the basis of the Department of Family Medicine and Polyclinic Therapy of Odesa National Medical University. Traditionally, at the beginning of the internship, our doctors are tested for the presence of GAD using the Generalized Anxiety Disorder Questionnaire (GAD-7). We repeat this test several times during the training period so that interns who have been diagnosed with GAD can receive psychological help. In this article, we will present the data of the survey on the available GADs of intern doctors of the 2nd year of training. In our opinion, the presentation of these data is more expedient, because in a few months these doctors will start working independently, and helping them overcome psychological problems is an important component. In addition, at the beginning of the war, 1st-year intern doctors were sent to the place where the correspondence internship was held, and it was difficult to establish permanent contact with them. in 2022, most of the graduates of interns at our department were 53, namely 53. In 2022, 40 medical interns graduated from the specialty of VH. In March, interns were reluctant to join online classes and lacked sufficient motivation for learning. During the oral survey, 21.50% (n=20) interns of the total number had motivation for further education. However, with the passage of time, more and more medical interns became motivated for further education and even expressed the opinion that the education, which did not stop, helps them feel that life continues and gives them at least some stability. Two intern doctors were in the zone of active hostilities, namely in Bashtanka and Snigurivka. It should be noted that these doctors were not just in the zone of active hostilities, but also worked in the hospitals of these settlements. All interns, regardless of region, had GAD to one degree or another. In this diagram, all interns, both PGMS and VC, are presented, as they did not have a statistically significant difference between the obtained results. In March, interns who did not change their place of residence had the greatest manifestations of GAD, namely 13.02±0.46 points – Mykolaiv branch, 12.25±0.31 points for interns at Odesa branch and 9.54±0.96 points of the Kherson branch. That is, as it is not paradoxical, the interns of Kherson and the region had more positive dynamics regarding GAD compared to other cities (p±0.05). As for the temporarily displaced medical interns, during the 3 months of the war, the GAD began to gain momentum. This can be explained by the «refugee syndrome» and concern for relatives who remained at home. Among such a cohort of intern doctors, the doctors of Odesa and Kherson branches had the highest scores (10.04±1.53 and 10.43±1.47, respectively). When communicating with intern doctors in these regions, it became clear that residents of Odesa and the region already regretted leaving, because life in Odesa began to improve, while in Kherson, on the contrary, they began to worry more and more about their relatives and loved ones due to the long occupation and a possible increase in hostilities in Kherson. The interns of the Mykolaiv branch, who were in different places, did not have a significant difference in the results of the questionnaire, and the average score was 9.37±0.73 points. At the end of the training, the vast majority of interns were grateful that the training did not stop, and noted in 84.94% of cases (n=79) that the training helped them fight against panic and gave them strength and motivation to move on. At the beginning of the war, interns of Odesa and Mykolaiv branches had the greatest manifestations of GAD (13.02±0.46 and 12.25±0.31 points, respectively). In June, the number of medical interns who experienced GAD symptoms increased in Kherson and the region from 9.54±0.96 to 13.14±0.43 points, while in Odesa and the region, on the contrary, it decreased from 12.25±0, 31 to 7.75±0.36 points (р±0.05; p±0.05).