Студенческий проект "Синдром хронической усталости"
проект

Государственное бюджетное профессиональное образовательное учреждение

Департамента здравоохранения города Москвы

 «Медицинский колледж № 7»

 (ГБПОУ ДЗМ «МК № 7»)

УЧЕБНО – ИССЛЕДОВАТЕЛЬСКИЙ ПРОЕКТ

«Синдром хронической усталости»

Chronic Fatigue Syndrome

СПЕЦИАЛЬНОСТЬ 31.02.01 ЛЕЧЕБНОЕ ДЕЛО

        Москва, 2022 год

Рассмотрено и одобрено

на заседании ПЦК № ___                                                  

Протокол № ___                                                              

от «____»__________2022г.                                          

Председатель ПЦК № __

______________

Координаторы и руководители проекта:

         Сухова Л.С. – методист, преподаватель высшей квалификационной категории ГБПОУ ДЗМ «МК № 7»

Булавина Е.В.  - преподаватель первой квалификационной категории ГБПОУ ДЗМ «МК № 7»

Участник проекта: студенты группы Н-23Л специальности «Лечебное дело»

           СОДЕРЖАНИЕ:

1.Введение

2.Паспорт проекта

3. Цели и задачи проекта

4.Обоснование актуальности проекта

5.Этапы работы над проектом

6.Ресурсное обеспечение

7.Список используемой литературы
8. Приложения

КРАТКАЯ АННОТАЦИЯ ПРОЕКТА

Исследовательский проект «Синдром хронической усталости» направлен на изучение данной проблемы и выявление у студентов этого заболевания.

Синдром хронической усталости - это заболевание, характеризующееся необъяснимым чувством выраженной слабости, длящейся более 6 месяцев. Слабость не проходит даже после длительного отдыха и усиливается после физических или умственных нагрузок. Более 3000 научных исследований доказали, что синдром хронической усталости – не форма депрессии или ипохондрии, а реальное соматическое заболевание, приводящее к  профессиональной, социальной и индивидуальной дезадаптации людей.  

ПАСПОРТ ПРОЕКТА

Наименование проекта: «Синдром хронической усталости»

Тип проекта: индивидуальный студенческий проект

Специальность: 31.02.01 Лечебное дело

Профессиональный модуль: ПМ.02

Курс, группа: Н-23Л

Количество участников проекта: 1

Цель проекта – подготовить анкету для опроса студентов и проанализировать полученные результаты. «Синдром хронической усталости»

Задачи проекта:

1. Ознакомиться с инструкцией по составлению анкеты для опроса.
2. Изучить и проанализировать литературу и интернет источники по теме «Синдром хронической усталости».

Подготовить анкету для опроса студентов по теме «Синдром хронической усталости»

3. Защитить проект по теме «Синдром хронической усталости».

В результате подготовки и участия в творческом проекте формируются общие компетенции:

•        ОК 1. Понимать сущность и социальную значимость своей будущей профессии, проявлять к ней устойчивый интерес.

•        ОК 2. Организовывать собственную деятельность, выбирать типовые методы и способы выполнения профессиональных задач, оценивать их выполнение и качество.

•        ОК 4. Осуществлять поиск и использование информации, необходимой для эффективного выполнения профессиональных задач, профессионального и личностного развития.

•        ОК 5. Использовать информационно-коммуникационные технологии в профессиональной деятельности.

Профессиональные компетенции:

ПК 4.6. Проводить мероприятия по сохранению и укреплению здоровья различных возрастных групп населения.

ПК 5.2. Проводить психосоциальную реабилитацию.

Руководитель проекта: Булавина Е.В.

Объект исследования – анализ данных анкетирования студентов о заболевании СХУ. Исследования выступает синдром хронической усталости как состояние утомления в современном обществе. 

Предмет исследования – определены изучение распространенности и способов профилактики СХУ.

Цели проекта:

• Познакомить с понятием «Синдром хронической усталости», влиянием стресса и дистресса на организм и психику человека;
• Показать пути выработки адаптивной стратегии поведения в стрессовых ситуациях;
• Изучить распространенность синдрома хронической усталости у студентов медицинского колледжа.

Задачи:

• Изучить специальную литературу по предмету исследования;
• Выявить причины и условия возникновения, распространения, а также способы профилактики и снятия СХУ;
• Выявить наличие и степень выраженности СХУ у студентов в ходе анкетирования;
• Сформулировать выводы и предложить рекомендации.

Обоснование актуальности проекта

        Данная проблема актуальна на сегодняшний день так как синдром хронической усталости (далее - СХУ) очень часто маскируется под различные заболевания, и поэтому остается нераспознанным из-за низкой информированности врачей (фельдшеров) о его существовании. Нередко больные на протяжении многих лет интенсивно обследуются у различных специалистов, в том числе эндокринологов, и получают разнообразное медикаментозное лечение без какого-либо клинического эффекта. Распространенность СХУ в популяции, по разным оценкам, может достигать 2% (сколько на самом деле людей в мире страдают СХУ, имеют высокую степень риска развития его, не знает никто). 

        Продукт проектной деятельности – проведение защиты проекта.

        Форма представления продукта проектной деятельности – анализ анкетирования, презентация проекта.

Этапы работы над проектом

Необходимое оборудование и ресурсы

ТСО: компьютер, мультимедийный проектор

Методическое: методическая разработка, мультимедийные презентации

PowerPoint

Материальное: экран, микрофон

                                                ПЛАН

реализации проекта

1. Предварительное анкетирование студентов (опрос по подготовленной анкете)

2. Анализ анкетирования

3. Проведение презентационной части проекта

СПИСОК ИСПОЛЬЗУЕМОЙ ЛИТЕРАТУРЫ

• Библиографические источники:

1. Комаров, С. Г   Синдром хронической усталости (распространенность и организация медицинской помощи) : автореф.дис. ...канд.мед.наук 
2. Мороз И.Н., Подколзин А.А. // Журнал «Профилактика и старение», Выпуск 1, 1998. 

• Электронные ресурсы

1. https://www.rmj.ru/articles/nevrologiya/SINDROM_HRONIChESKOY_USTALOSTI/
2. http://victorvorobyov.blogspot.com/2014/07/blog-post.html
3. https://apteka.ru/info/articles/bolezni-i-lechenie/sindrom-khronicheskoy-ustalosti/

ПРИЛОЖЕНИЯ

Приложение 1

Анализ анкетирования

Синдром хронической усталости (СХУ) одна из самых распространенных патологий нашего времени, главным признаком которой является немотивированная выраженная общая слабость, на длительное время ограничивающая повседневную жизнь человека. Заболевание, как правило, сопровождается и другими характерными симптомами, такими как снижение памяти и концентрации, нарушение сна (бессонница, реже повышенная сонливость), боли в мышцах и суставах, головные боли, уплотнение шейных и подмышечных лимфатических узлов, частые рецидивы болей в горле.

В ходе анкетирования было выявлено, что примерно 43% из 100 человек не испытывают усталости после 8-часового сна. Остальные просыпаются утром с чувством усталости. 35% студентов определяют физическую нагрузку как причину усталости, остальная же часть студентов ответили, что физическая активность помогает набраться сил и концентрации. Половина 50% не способна уснуть в течение рабочего дня. 30% опрошенных сказали, что не употребляют алкоголь. 10% употребляют алкоголь от случая к случаю. 15% 2-3 раза в неделю. 48% 2 раза в месяц. Все студенты замечали за собой чрезмерную раздражительность за последнее время. Почти половина студентов выполняют физическую зарядку по утрам. Остальные редко или никогда. 41% студентов питаются правильно. 56% выделили причиной неуспеваемости в учебе собственную лень. 17% -социальные проблемы. 10% - неорганизованность. 7% - здоровье. 5% - когнитивные способности. Вывод: по итогам установлено, в группе риска СХУ находятся 28%. А 19 % убеждены, что ведут вполне здоровый образ жизни. А меж тем, это не совсем так.

Chronic fatigue syndrome (CFS) is one of the most common pathologies of our time, the main sign of which is an unmotivated pronounced general weakness that limits a person's daily life for a long time. The disease, as a rule, is accompanied by other characteristic symptoms, such as a decrease in memory and concentration, sleep disturbance (insomnia, less often increased drowsiness), muscle and joint pain, headaches, compaction of the cervical and axillary lymph nodes, frequent relapses of sore throat.

During the survey, it was found that approximately 43% of 100 people do not experience fatigue after 8 hours of sleep. The rest wake up in the morning feeling tired. 35% of students identify physical activity as the cause of fatigue, while the rest of the students answered that physical activity helps to gain strength and concentration. Half of 50% are unable to fall asleep during the working day. 30% of respondents said that they do not drink alcohol. 10% drink alcohol from time to time. 15% 2-3 times a week. 48% 2 times a month. All students have noticed excessive irritability in recent years. Almost half of the students perform physical exercises in the morning. The rest are rare or never. 41% of students eat properly. 56% singled out the reason for the failure to succeed in studying their own laziness. 17% - social problems. 10% - disorganization. 7% - health. 5% - cognitive abilities. Conclusion: according to the results, it was established that 28% are at risk of CFS. And 19% are convinced that they lead a completely healthy lifestyle.

Приложение 2

АНКЕТА

                             Тест на синдром хронической усталости

1. По утрам при пробуждении вам необходимо дольше обычного «раскачиваться», делая над собой усилие, чтобы включиться в привычную (в том числе и трудовую) жизнь?

Да                                                         Нет

 2. В разгар работы вы начинаете чувствовать падение ее продуктивности, необходимость напрягаться, прилагать дополнительные усилия для ее качественного выполнения?

Да                                                          Нет

 3. Вам нужны какие-то «допинги» (кофе, крепкий чай…), чтобы хотя бы в рабочее время чувствовать себя в тонусе?

Да                                                          Нет

4. Вы стали плохо реагировать на перемены погоды, которые вызывают у вас боли в спине, суставах, головные боли, слабость?

Да                                                            Нет

 5. У вас то повышается, то понижается аппетит?

Да                                                            Нет

 6. У вас начали возникать неприятные, порой болевые ощущения в области сердца?

Да                                                           Нет

7. У вас стала появляться зябкость кистей рук, стоп?

Да                                                 Нет

8. Вас стали беспокоить какие-то дисфункции, какие-то нарушения деятельности желудочно-кишечного тракта?

Да                                                Нет

9. У вас стали нарастать раздражительность, вспыльчивость, бывают эпизоды беспричинного снижения настроения?

Да                                                Нет

10. У вас стали возникать или участились аллергические реакции?

Да                                                Нет

11. У вас снижается половое влечение?

Да                                                Нет

12. Ваш сон стал прерывистым, беспокойным, поверхностным или у вас нарушилось засыпание?

Да                                              Нет

Chronic Fatigue Syndrome Test

1. In the morning, when you wake up, do you need to "swing" longer than usual, making an effort on yourself to get involved in the usual (including working) life?

Yes No

 2. In the midst of work, do you begin to feel a drop in its productivity, the need to strain, to make additional efforts for its qualitative implementation?

Yes No

 3. Do you need any "doping" (coffee, strong tea ...) to feel in good shape at least during working hours?

Yes No

4. Have you started to react poorly to weather changes that cause you back pain, joint pain, headaches, weakness?

Yes No

 5. Does your appetite go up and down?

Yes No

 6. Have you begun to have unpleasant, sometimes painful sensations in the region of the heart?

Yes No

7. Do you begin to have chilliness of the hands, feet?

Yes No

8. Did you begin to worry about any dysfunctions, any violations of the gastrointestinal tract?

Yes No

9. Do you begin to increase irritability, short temper, there are episodes of unreasonable decrease in mood?

Yes No

10. Have you experienced or become more frequent allergic reactions?

Yes No

11. Do you have a decreased sex drive?

Yes No

12. Has your sleep become intermittent, restless, superficial or have you fallen asleep?

Yes No

Приложение 3

Risk factors

Fatigue is a common experience. It is one of the top ten symptoms that people mention when they visit the doctor. Some people, however, are at higher risk for

developing fatigue. For example, the risk for women is about 1.5 times the risk for men, and the risk for people who don’t exercise is twice that of active people. Some researchers question whether women really are at higher risk, since they are more likely than men to go to the doctor with health problems; also, men are less likely to admit they feel fatigued. Other risk factors include obesity; smoking; use of alcohol; high stress levels; depression; anxiety; and low blood pressure. Having low blood pressure is usually considered desirable in the United States, but is regarded as a treatable condition in other countries. Low blood pressure or postural hypotension (sudden lowering of blood pressure caused by standing up) may cause fatigue, dizziness, or fainting.

Major sources of chronic fatigue

Disease

There are many diseases and disorders in which fatigue is a major symptom— for example, cancer, cardiovascular disease, emphysema, multiple sclerosis, rheumatic arthritis, systemic lupus erythematosus, HIV/AIDS, infectious mononucleosis, chronic fatigue syndrome, and fibromyalgia. The reasons for the fatigue, however, vary according to the organ system or body function affected by the disease. Physical reasons for fatigue include:

• Circulatory and respiratory impairment. When the patient’s breathing and blood circulation are impaired, or when the patient has anemia (low levels of red blood

cells), body tissues do not receive as much oxygen and energy. Hence, the patient experiences a general sense of fatigue. Fatigue is also an important warning sign of

heart trouble because it precedes 30%–55% of myocardial infarctions (heart attacks) and sudden cardiac deaths.

• Infection. Microorganisms that disturb body metabolism and produce toxic wastes cause disease and lead to fatigue. Fatigue is an early primary symptom of chronic, nonlocalized infections found in such diseases as acquired immune deficiency syndrome (AIDS), Lyme disease, and tuberculosis.

• Nutritional disorders or imbalances. Malnutrition is a disorder that promotes disease. It is caused by insufficient intake of important nutrients, vitamins, and minerals; by problems with absorption of food through the digestive system; or by inadequate calorie consumption. Protein-energy malnutrition (PEM) occurs when people do not consume enough protein or calories; this condition leads to wasting of muscles and commonly occurs in developing countries. In particular, young children who are starving are at risk of PEM, as are people recovering from major illness. In general, malnutrition damages the body’s immune function and thereby encourages disease and fatigue. Taking in too many calories for the body’s needs, on the other hand, results in obesity, which is a predictor of many diseases related to fatigue.

• Dehydration. Dehydration results from water and sodium imbalances in body tissues. The loss of total body water and sodium may be caused by diarrhea, vomiting, bed rest, exposure to heat, or exercise. Dehydration contributes to muscle weakness and mental confusion; it is a common and overlooked source of fatigue. Once fatigued, people are less likely to consume enough fluids and nutrients, which makes the fatigue and confusion worse.

• Deconditioning. This term refers to generalized organ system deterioration resulting from bed rest and lack of exercise. In the 1950s and 1970s, the National

Aeronautics and Space Administration (NASA) studied the effects of bed rest on healthy athletes. The researchers found that deconditioning set in quite rapidly

(within 24 hours) and led to depression and weakness. Even mild exercise can counteract deconditioning, however, and has become an important means of

minimizing depression and fatigue resulting from disease and hospitalization.

• Pain. When pain is severe enough, it may disrupt sleep and lead to the development of such sleep disorders as insomnia or hypersomnia. Insomnia is the term for having difficulty falling and/or staying asleep. Hypersomnia refers to excessive sleeping. In general, disrupted sleep is not restorative; people wake up feeling tired, and as a result their pain is worsened and they may become depressed. Furthermore, pain may interfere with movement or lead to too much bed rest, which results in deconditioning. Sometimes pain leads to social isolation because the person cannot cope with the physical effort involved in maintaining social relationships, or because family members are unsympathetic or resentful of the ill or injured person’s reduced capacity for work or participation in family life. All of these factors worsen pain, contributing to further sleep disruption, fatigue, and depression.

• Stress. When someone experiences ongoing pain and stress, organ systems and functional processes eventually break down. These include cardiovascular, digestive, and respiratory systems, as well as the efficient elimination of body wastes. According to the American Psychiatric Association, various chronic diseases are related to stress, including regional enteritis (intestinal inflammation); ulcerative colitis (a disease of the colon); gastric ulcers; rheumatoid arthritis; cardiac angina, and dysmenorrhea (painful menstruation). These diseases deplete the body’s levels of serotonin (a neurotransmitter important in the regulation of sleep and wakefulness, as well as depression), and endorphins (opiate-like substances that moderate pain). Depletion of these body chemicals leads to insomnia and chronic fatigue.

• Sleep disorders. There are a variety of sleep disorders that cause fatigue, including insomnia, hypersomnia, sleep apnea, and restless legs syndrome. For example, hypersomnia may be the result of brain abnormalities caused by viral infections. Researchers studying the aftermath of infectious mononucleosis proposed that exposure to viral infections might change brain function with the effect of minimizing restorative sleep; hence, some people developed hypersomnia. Another common disorder is sleep apnea, in which the patient’s breathing stops for at least ten seconds, usually more than 20 times per hour. Snoring is common. People may experience choking and then wake up gasping for air; they may develop daytime hypersomnia (daytime sleepiness) to compensate. Sleep apnea is associated with aging, weight gain, and depression. It is also a risk factor for stroke and myocardial infarctions. Restless legs syndrome is a condition in which very uncomfortable sensations in the patient’s legs cause them to move and wake up from sleep, or keep them from falling asleep. All of these disorders reduce the quality of a person’s sleep and are associated with fatigue.

Fibromyalgia and chronic fatigue syndrome

Fibromyalgia (also known as myofascial syndrome or fibrositis) is characterized by pain and achiness in muscles, tendons, and ligaments. There are 18 locations on the body where patients typically feel sore. These locations include areas on the lower back and along the spine, neck, and thighs. Adiagnostic criterion for fibromyalgia (FM) is that at least 11 of the 18 sites are painful. In addition to pain, people with FM may experience sleep disorders, fatigue, anxiety, and irritable bowel syndrome. Some researchers maintain, however, that when fatigue is

severe, chronic, and persistent, FM is indistinguishable from chronic fatigue syndrome (CFS). The care that patients receive for FM or CFS depends in large measure on whether they were referred to a rheumatologist (a doctor who specializes in treating diseases of the joints and muscles), neurologist, or psychiatrist.

Some doctors do not accept CFS (also known as myalgic encephalomyelitis in Great Britain) as a legitimate medical problem. This refusal is stigmatizing and

distressing to the person who must cope with disabling pain and fatigue. It is not uncommon for people with CFS to see a number of different physicians before finding one who is willing to diagnose CFS. Nevertheless, major health agencies, such as the Centers for Disease Control (CDC) in the United States, have studied the syndrome. As a result, a revised CDC case definition for CFS was published in 1994 that lists major and minor criteria for diagnosis. The major criteria of CFS include the presence of chronic and persistent fatigue for at least six months; fatigue that does not improve with rest; and fatigue that causes significant interference with the patient’s daily activities. Minor criteria include such flulike

symptoms as fever; sore throat; swollen lymph nodes; myalgia (muscle pain); difficulty with a level of physical exercise that the patient had performed easily

before the illness; sleep disturbances; and headaches. Additionally, people often have difficulty concentrating and remembering information; they experience extreme frustration and depression as a result of the limitations imposed by CFS. The prognosis for recovery from CFS is poor, although the symptoms are manageable.

Psychological disorders

While fatigue may be caused by many organic diseases and medical conditions, it is a chief complaint for several mental disorders, including generalized anxiety

disorder and clinical depression. Moreover, mental disorders may coexist with physical disease. When there is considerable symptom overlap, the differential diagnosis of fatigue is especially difficult.

GENERALIZED ANXIETY DISORDER. People are diagnosed as having generalized anxiety disorder (GAD) if they suffer from overwhelming worry or apprehension that persists, usually daily, for at least six months; and if they also experience some of the following symptoms unusual tiredness, restlessness and irritability, problems with concentration, muscle tension, and disrupted sleep. Such stressful life events as divorce, unemployment, illness, or being the victim of a violent crime are associated with GAD, as is a history of psychiatric

problems. Some evidence suggests that women who have been exposed to danger are at risk of developing GAD; women who suffer loss are at risk of developing

depression, and women who experience danger and loss are at risk of developing a mix of both GAD and depression.

While the symptoms of CFS and GAD overlap, the disorders have different primary complaints. Patients with CFS complain primarily of tiredness, whereas

people with GAD describe being excessively worried. In general, some researchers believe that anxiety contributes to fatigue by disrupting rest and restorative

sleep.

DEPRESSION. In the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSMIV), the presence of depressed mood or sadness, or loss of pleasure in life, is an important diagnostic criterion for depression. Daily fatigue, lack of energy, insomnia and hypersomnia are indicators of a depressed mood.

The symptoms of depression overlap with those of CFS; for example, some researchers report that 89% of people with depression are fatigued, as compared to 86%–100% of people with CFS. The experience of fatigue, however, seems to be more disabling with CFS than with depression. Another difference between CFS and depression concerns the onset of the disorder. Most patients with CFS experience a sudden or acute onset, whereas depression may develop over a period of weeks or months. Also, while both types of patients experience sleep disorders, CFS patients tend to have difficulty falling asleep, whereas depressed patients tend to wake early in the morning. Some researchers believe that there is a link between

depression, fatigue, and exposure to too much REM sleep. There are five distinct phases in human sleep. The first two are characterized by light sleep; the second two by a deep restorative sleep called slow-wave sleep; and the last by rapid eye movement or REM sleep. Most dreams occur during REM sleep. Throughout the night, the intervals of REM sleep increase and usually peak around 8:30 A.M. A sleep deprivation treatment for depression involves reducing the patient’s amount of REM sleep by waking him or her around 6:00 A.M. Researchers think that some fatigue associated with disease may be a form of mild depression and that reducing

the amount of REM sleep will reduce fatigue by moderating depression.

Managing fatigue

The management of fatigue depends in large measure on its causes and the person’s experience of it. For example, if fatigue is acute and normal, the person will recover from feeling tired after exertion by resting. In cases of fatigue associated with influenza or other infectious illnesses, the person will feel energy return as they recover from the illness. When fatigue is chronic and abnormal, however, the doctor will tailor a treatment program to the patient’s needs. There are a variety of approaches that include:

• Aerobic exercise. Physical activity increases fitness and counteracts depression.

• Hydration (adding water). Water improves muscle turgor or tension and helps to carry electrolytes.

• Improving sleep patterns. The patient’s sleep may be more restful when its timing and duration are controlled.

• Pharmacotherapy (treatment with medications). The patient may be given various medications to treat physical diseases or mental disorders; to control pain; or to

manage sleeping patterns.

• Psychotherapy. There are several different treatment approaches that help patients manage stress; understand the motives that govern their behavior; or change maladaptive ideas and negative thinking patterns.

• Physical therapy. This form of treatment helps patients improve or manage functional impairments or disabilities. In addition to seeking professional help, people can understand and manage fatigue by joining appropriate self-help groups; reading informative books; seeking information from clearinghouses on the Internet; and visiting web sites maintained by national organizations for

various diseases.

See also Brain; Breathing-related sleep disorder;

Caffeine and related sleep disorders; Circadian rhythm sleep disorder; Pain disorder; Self-help groups; Somatization and somatoform disorders

KEY TERMS

Biological marker—An indicator or characteristic trait of a disease that facilitates differential diagnosis (the process of distinguishing one disorder from other, similar disorders).

Deconditioning—Loss of physical strength or stamina resulting from bed rest or lack of exercise.

Electrolytes—Substances or elements that dissociate into electrically charged particles (ions) when dissolved in the blood. The electrolytes in human blood include potassium, magnesium, and chloride.

Metabolism—The group of biochemical processes within the body that release energy in support of life.

Stress—A physical and psychological response that results from being exposed to a demand or pressure.

Syndrome—A group of symptoms that together characterize a disease or disorder.