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THEORETICAL ASPECTS OF QUALITY OF LIFE IN
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consider the issue of efficiency and quality of medical care taking into account three main criteria: adequacy, economy, scientific and technical level. At the same time, the adequacy of medical care is understood as the need to achieve an acceptable "quality of life" for the patient [25].
That is why the criterion "quality of life" is used to determine the effectiveness of treatment in medical programs, to determine the advantages of a treatment method with equivalent effects of both medicinal therapeutic actions and other medical care.
The problem of "quality of life" is researched and discussed by specialists in various scientific fields. Research in this field generally aims at the development of an individual, the state, the world community, etc. In medicine, special attention is paid to physical health, in economics - to the level of well-being and security, in ecology - to the state of the environment. Psychology, for its part, examines the needs of the individual, a person's search for the meaning of life, his desire for happiness, etc.
The study of the problems of "quality of life" began in the mid-1960s, when the highly developed countries of the West began to transition to the post-industrial stage of the development of society, which caused humanity's interest in the humanitarian content of economic progress. The concept of "quality of life" is introduced on the basis of "social indicators" as a sociological category that expresses the degree of satisfaction of various population groups with the conditions of their life activities, self-realization in professional activities, the use of innovative approaches.
Initially, the term "quality of life" was used by American economists S.N.Ordway and N.F. Osborn as an indicator of ecological danger of economic development. In the 1960s, John Helbert used this term in connection with an attempt to model the trajectory of industrial dynamics, describing the transition of Western society to the post-industrial stage of development. At the same time, sociologists of the Chekaz school, R.Park, E.Burgess, worked on this problem, studying the influence of such factors as environmental pollution, noise, population density on social activity, where this term began to be used [15; 17; 18].
Researcher D.L.Scott emphasizes that - "the quality of life is an individual correlation of a person's goals in society, his plans and opportunities with the individual's position in the life of society in the context of the culture and value systems of this society" [21].
The founder of the science of quality of life in medicine is considered to be the professor of Columbia University, USA, D.A. Karnovsky, who published the work
"The clinical evaluation of chemotherapeutic agents in cancer". It comprehensively examines a patient suffering from a serious illness. Since then, the interest in researching the problem of quality of life in medicine has been steadily growing [11].
In particular, in 1980, G.L. Engel proposed a biopsychosocial model of medicine, the essence of which is accounting for the psychosocial aspects of the disease [7].
In studies of the quality of life, the works of A. McSweeny, who proposed its evaluation based on four aspects (emotional state, social functioning, daily activity and leisure activities), were of great importance. In turn, N. Wenger singled out three main parameters of this concept: functional ability, perception, symptoms and nine sub-parameters (everyday mode, social and intellectual activity, perception of general
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health, symptoms of the main and accompanying diseases, economic status, well-being, life satisfaction).
At the beginning of the 80s of the last century, the study of this topic entered a qualitatively different phase. Thus, in 1982, researchers R. M. Kaplan and J. Brazier proposed to introduce the term "health-related quality of life" ("HRQOL"), on the basis of which in 1984 the WHOQOL Group formulated a fundamentally new definition of health as "a state of physical, mental, and social well-being, not just the absence of disease." In this context, "quality of life" is already defined as an indicator of the patient's adaptation to the presence of the disease, the ability to perform normal functions related to the patient's socio-economic position at work and in everyday life.
Such approaches make it possible to make a deep and multi-component analysis of the physical, physiological, psychological, emotional and social problems of a sick person [24].
The analysis of scientific literature conducted by P. Kosmidis and E. Yelin shows that since the beginning of the 1990s, the number of publications devoted to "quality of life" issues worldwide has increased annually by almost a third. This problem is most often mentioned in studies devoted to patients with pathologies of the circulatory system, cancer patients and patients with diseases of the respiratory system [12 ].
During this period, the process of identifying the relationship between dental diseases and the problem of quality of life takes place. In particular, the conceptual framework for measuring the status of dental health was described by Locker D. It is based on the classification of possible violations, disabilities, and disabilities related to dental health. According to this model, the disease leads to an anatomical defect. An anatomical defect causes functional limitations, physical and psychological discomfort, which can lead to a decrease in social capacity [12].
During this period, the process of identifying the relationship between dental diseases and the problem of quality of life takes place. In particular, the conceptual framework for measuring the status of dental health was described by Locker D. It is based on the classification of possible violations, disabilities, and disabilities related to dental health. According to this model, the disease leads to an anatomical defect. An anatomical defect causes functional limitations, physical and psychological discomfort, which can lead to a decrease in social capacity [13].
Quality of life related to dental health and assessment of factors associated with it have been studied in many foreign studies. In them, special emphasis was placed on self-assessment of dental health, subjective symptoms of temporomandibular joint diseases, etc. [9]
The use of the above quality of life criteria in dentistry allows to assess the degree of loss of dental health, their psychosocial and financial and economic consequences, and even the results of dental treatment in dynamics. For example, J.G. Steele's research emphasized the importance of a person's perception of dental problems in the context of cultural identity. Research results have outlined an important relationship between age and the quality of life of dental patients [22].
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The results of a study conducted by F.Mack using the SF-12 questionnaire among 1,406 patients aged 60 to 79 years showed that reducing the number of dentition without replacing missing teeth with removable or fixed prostheses reduces the physical component of quality of life to the same extent as and cancer or kidney disease and significantly affects other aspects of patients' lives [14].
M.V. Saintrain et al. conducted a survey of fully edentulous patients aged 60 to 72 years, of whom 81.9% reported a deterioration in the quality of life associated with tooth loss. In this study, the most significant aspects affecting the quality of life were masticator dysfunction and social deprivation associated with the aesthetic component of the problem [20].
At the same time, in a clinical review, D.G. Haag, K.G.Peres, et al.. stated that 10 of 16 studies reported a negative impact of tooth loss on quality of life. In 4 out of 7 studies, it was about the deterioration of its quality in connection with periodontal diseases, which was fully correlated with the data obtained by the HRQOL Group [8].
Thus, the analysis of foreign studies on the impact of diseases on the quality of life shows that a huge number of works are devoted to this problem. It is worth emphasizing that "quality of life" in modern concepts abroad is understood as a complex characteristic of socio-economic, political, cultural-ideological, environmental factors and conditions of existence of an individual, a person's position in society. The quality category becomes a symbol of progress and survival of civilization.
On the other hand, studies of the relationship between dental diseases and quality of life in Ukraine are multi-vector and depend on the influence of many heterogeneous factors. They are multidisciplinary in nature, which contribute to the search for new approaches in the study of the specified problem.
Thus, scientists Ya.Yu. Vodoriz, A.V. Lemeshko, and others. in their research found that patients with a low quality of life were associated with dental problems, were most concerned about their own appearance, the aesthetics of their teeth during communication at work and at home [8].
Researchers N.V. Yanko, Kaskova and others. evaluated parameters of oral health and related quality of life among 19-26-year-old students of the 3rd-4th year of the Faculty of Dentistry of the UMSA. Analysis of the results of the study revealed that problems with teeth, oral cavity and prostheses in 15.46% of students led to irritation during communication with other people. Respondents were dissatisfied with their dental health, teeth and oral cavity [6].
Authors Kolenko Y.G., Volovik I.A, K.O. Myalkivskyi K.O., in his work investigated the impact of periodontal tissue diseases on the quality of life of patients, as a result of the analysis, it was confirmed that the use of Tantum Verde in generalized periodontitis of the initial - I degree of the chronic course provides a significant improvement in the quality of life, which takes place against the background of a reduction in the number exacerbations and increased duration of remission [3].
Maiborodina D.D., Velyka N.V., Antonenko M.Yu. in their research on the assessment of the quality of life during the situational analysis of risk factors for generalized periodontal lesions in young people with obesity came to the conclusion that eating disorders in patients with generalized periodontal lesions with obesity
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occurred in 90.6% of cases, and in 63.6% a mixed type was detected. Most patients have anxiety-depressive disorders and reduced quality of life indicators. [4].
Summarizing what has been said, it should be noted that in medicine the concept of "quality of life" refers primarily to the state of health, therefore, in our opinion, it is appropriate to use the concept of "health-related quality of life" ("health-related quality" in the English-language literature of life"). Among the majority of domestic and foreign scientists, it is believed that it reflects the level of well-being and satisfaction with those aspects of life that are affected by the disease or its treatment or accidents. Although this term more accurately reflects the essence of the issue, the general term "quality of life" is still more common in medical literature.
The analysis of the works of foreign and domestic authors shows that the problem of the patient's quality of life in dental practice continues to be very relevant, since dental morbidity both in our country and in the world in general is one of the most common. However, he points out that the quality of life of patients with diseases of the oral cavity (periodontal disease, adentia, etc.), although studied with the help of various questionnaires, and their results reflect functional, social and psychological problems that arise against the background of dental diseases is not sufficiently reflected and needs further research.
Prospects for further research. Based on the lack of sufficiently researched scientific aspects in the study of this topic, we consider it promising to further develop and justify the latest scientific-theoretical and methodological approaches to the study of the impact of dental diseases on the quality of life of women and men, as well as the study of generalized periodontal diseases in patients with manifestations of anxiety.
References:
1. Vodoriz Y.Yu., Lemeshko A.V., Marchenko I.Ya., Shundryk M.A., Tkachenko I.M., Kovalenko V.V. Evaluation of the quality of life of patients with a need for treatment of the teeth of the frontal group.// Herald of problems of biology and medicine. 2019; No. 4 (1): 296-300.
2. Voytenko V.P. The health of the healthy. //V.P. Voytenko. Kyiv: Zdorovya, 1991. – p. 248.
3. Kolenko Y.G., Volovik I.A., K.O. Myalkivskyi K.O.// Impact of periodontal tissue diseases on patients' quality of life// Modern stomatology. – No. 2. –.2021. P.36 – 42. DOI: 10.33295/1992-576X-2021-2-36
4. Maiborodina D.D., Velyka N.V., Antonenko M.Yu. Evaluation of the quality of life during the situational analysis of risk factors of generalized periodontal lesions in young people with obesity// Modern dentistry. - No. 3. - 2019. P.32-35. DOI:
10.33295/1992-576X-2019-3-32
5. Polivyana M.Yu. Assessment of the quality of life of mentally ill patients/ M.
Yu. Polyvyana // Archives of psychiatry. — 2002. — No. 2. — P. 5-9.
6. Yanko N.V., Kaskova et al.. L.F., Pavlenkova O.S., Soloshenko Yu.I., Amosova L.I. Assessment of the impact of oral health parameters on the related quality of life in future dentists.// Ukrainian Dental Almanac. 2020. No. 2. P. 47-.52.
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MODERN EDUCATION USING THE LATEST TECHNOLOGIES
7. Engel G. E. The clinical application of the biopsychosocial model /G. E. Engel // Am. J. Psychiatry. – 1980. – Vol. 137. – P. 535–543. http://www.medicina–
online.ru/articles/42756/
8. Haag D.G., Peres K.G., Balasubramanian M., Brennan D.S. Oral Conditions and Health-Related Quality of Life: A Systematic Review // J Dent Res. 2017. Vol. 96, N 8. P. 864–874. doi: 10.1177/0022034517709737
9. Improvement and factors associated with improvement in quality of life during 10 years after coronary artery ypass grafting / J. Herlitz, G. Brandrup-Wognsen, K. Caidahl et al. // Coron. Artery Dis. –2003. – V.14 (7). – P. 509–517.
10. Karimi M. Health, health-related quality of life, and quality of life: What is the difference? / M. Karimi, J. Brazier // Pharmacoeconomics. – 2016. – Vol. 34 (7). – P. 645–649. DOI: 10.1007/s40273-016-0389-9.
11. Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM (ed.) Evaluation of chemotherapeutic agents. New York: Columbia University Press, 1949, pp. 191–205.
12. Kosmidis, P. Quality of life as a new end point / P. Kosmidis // Chest. – 1996.
– Vol. 109 (Suppl. 5). – P. 110–121
13. Locker, D. Oral health: a conceptual framework / D. Locker // Community Dental Health. - 1988. - Vol. 5. - P. 3-18;
14. Mack F., Schwahn C., Feine J.S., et al. The impact of tooth loss on general health related to quality of life among elderly Pomeranians: results from the study of health in Pomerania (SHIP-O) // Int J Prosthodont. 2005. Vol. 18, N 5. P. 414–419.
15. Ordway S.N. Resources and the American dream: including a theory of the limit of growe. New York: Ronald Press/ 1953.
16. Orley J. Quality of life and mental illness / J. Orley, S.Saxena, H. Herrman //
The British J.of Psychiatry. – 1998. – Vol. 172. – P. 291–293.
17. Osborn N.F. The limits of the Earth/ Boston:Little Brown and Co. 1954..
18. Park, R. E., Burgess, E. W., & McKenzie, R. D. . The city. Chicago, Illinois:
The University of Chicago Press. 1925.- 142 р.
19. Reid K. Health related quality of life questionnires : are they fit for purpose?
/ K. Reid, D. Farrel, C. Dealey // Intech. Europ. – 2012. – 389 p.
20. Saintrain M.V., de Souza E.H. Impact of tooth loss on the quality of life //
Gerodontology. 2012. Vol. 29, N 2. P. e632–636. doi: 10.1111/j.1741-2358.2011.00535.x
21. Scott D.L. Quality of life measures: use and abuse / D.L. Scott, T. Garrood //
Pract. Res. Clin. Rheumatol. 2000. — Vol. 14, № 4. — P. 663—687.
22. Steele J.G., Sanders A.E., Slade G.D., et al. How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples //
Community Dent Oral Epidemiol. 2004. Vol. 32, N 2. P. 107–114. doi: 10.1111/j.0301-5661.2004.00131.x
23. The association of multiple visual im–pairments with self–reported visual disability: SEE project / G. S. Rubin, K. Bandeen Roche, G. H. Huang [et al.] // Invest.
Ophthalmol. Vis. Sci. – 2001. – Vol. 42 (1). – P. 64–72.
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24. WHOQOL Croup. Whoch Quality of life? // World Health Forum. - 1996. - Vol. 17 (4). - P. 354-336.
25. World Health Organization. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization // Soc.
Sci. Med. – 1995. – Vol. 41 (10). – P.1403–1409.
26. Yelin, E. Measuring Functional Capacity of Persons with Disabilities in Light of Emerging Demands in the Workplace // NAP. – 1999. – Р.100–161.
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