Medical and psychological care provided to combat veterans of current armed conflicts at the stage of inpatient rehabilitation

Introduction. For most of the military, inpatient treatment and rehabilitation is associated with psychological adaptation challenges which can impede the treatment, leading to manifest combat stress, i. e. Enduring personality change after catastrophic experience (F62.0 in ICD-10). Prevention includes early medical and psychological assistance at the acute and subacute trauma stages, as well as comprehensive rehabilitation throughout follow-up. So far, military medical organizations are facing problems due to inability to provide comprehensive treatment and psychological assistance to the veterans suffering combat stress and the undergoing inpatient rehabilitation. Further advancement requires good governance, research and practical investigations. The objective is to develop a framework of medical and psychological assistance for combat veterans receiving inpatient treatment and rehabilitation; therefore, the paper summarizes the last 3 years’ experience gained by medical psychologists working at surgical and general medicine hospitals of the Kirov Military Medical Academy (MMA). Methods. The paper relies on current laws and regulations regarding inpatient medical and psychological treatment and rehabilitation. In addition, reports presented over the last three years by medical psychologists and chief freelance experts working at surgical and general medicine MMA hospitals were analyzed and summarized. Results and analysis. The existing standards adopted by the Russian Ministry of Defense regarding the medical and psychological care of the veterans of local armed conflicts were initially developed for rehabilitation resorts, rather than inpatient rehabilitation, and therefore fail to consider specific aspects of combat trauma treatment. A study of laws and regulations demonstrated that since internal guidelines were missing, military hospitals provided combat veterans with inpatient medical and psychological treatment and rehabilitation in accordance with national laws and regulations. By summarizing the experience gained by the MMA medical psychologists, the key principles of medical and psychological care were formulated regarding disorder-specific psychodiagnostics, short-term multimodal corrective therapy, and social support. Medical psychologists should be well aware of the social guarantees provided to armed conflict combats and have relevant practical skills. A special focus is made on the most common reasons for veterans to seek psychological help, as well as the most effective corrective therapies for private sessions. Both private and group social and behavioral corrective sessions are recommended for combat veterans with maladaptive disorders. To ensure an informed approach and motivation, medical psychologists should provide a favorable ethical and psychological environment during daily ward check-ups. Conclusion. Disorder-specific psychodiagnostics, short-term multimodal psychological treatment, and social support must be recognized as the backbone of inpatient medical and psychological care provided to the injured combat veterans.