PSYCHOSOCIAL CARE IN ONCOHEMATOLOGY IN RUSSIA

General. Department of Psychiatry and Neurology in Hematology (DPNH (Chief Vybornykh D.E. MD, DMSc) and its Clinical Psychology Division (Director Khrushchev S.O. M.Sc)) conduct a wide range of psychosocial care, research and educational activities at the largest hematology hospital in Russian Federation (National Research Center for Hematology, Moscow). DPNH deliver psychosocial care for patients with wide range of hematological disorders (including leukemia, lymphoma and multiple myeloma) at all stages of disease course and treatment. In accordance with well-established standards, interdisciplinary team (physicians, psychiatrist, neurologist, clinical psychologist) conduct in thorough diagnosis and care of all relevant conditions and symptoms for patients and their relatives with special emphasis on individual rehabilitation plan development. During this process we analyze strengths and weaknesses of patient overall adaptation (somatic and psychiatric status, symptoms intensity and manifestations, psychosocial buffers and triggers etc.) to understand underlying causes and prescribe suitable therapy or/and interventions.

Research. DPNH research interests cover a wide range of practical and theoretical issues. DPNH research program core methodology is qualitative and quantitative analysis of specific and general factors affecting patients and their relatives during disease course and treatment. Currently DPNH focuses on: psychosocial factors, mediators and moderators of rehabilitation process (in the biopsychosocial model), psychosocial interventions effectiveness (in RCT studies), cognitive impairments after chemotherapy and bone marrow transplantation (neurological, neurophysiological and neuropsychological aspects), psychological aspects of stigmatization process. DPNH also take part in development of the national standards of psychosocial care, psychosocial screening projects and design e-health systems. Several research projects are funded by federal grants (The Russian Foundation for Basic Research).

Principles. In order to improve quality of care and generate new knowledge DPNH collaborate with Lomonosov Moscow State University, Mental Health Research Center and oncology-hematology hospitals in Moscow, St.Petersburg and other Russian regions. Development and implementation of up-to date standards of psychosocial care and rehabilitation require intensive bilateral cooperation of highly specialized organizations (hospitals, healthcare policy and psychosocial institutions, universities etc.) with well-established program and outlined areas of responsibility. Continuous exchanges of experience and local thought-leaders who share core values provide fertile soil for growth of new quality of care standards. Seminars, lectures, printed and online materials play major role in informational and educational policy. Such measures help to explain physicians and patients how situation and circumstances can be changed for better quality of life and treatment. High level of awareness allows for dissemination of both general standards and projects of specific needs.

Congress. In order to support and catalyze process of implementation of psychosomatic and psychosocial care principles, DPNH organized psycho-hematology/psycho-oncology section at Russian International Hematological Congress (2018). Leading researchers and healthcare professionals were invited to make oral presentations and share best practices. Specialists in psychiatry, neurology, clinical psychology, oncology and hematology from top medical and educational organizations (Lomonosov Moscow State University, National Institute of Mental Health, National Research Center for Oncology etc.) shared their experience with hundreds of medical and healthcare professionals from many Russian regions and other countries. Thanks to congress our psychosomatic and psychosocial community discussed and designed some collaborative projects with other regional clinics and medical centers.

Future directions. National standards for psychosocial care, in general, entail networking and coordination of federal and regional hospitals to the adoption of up-to date care and educational practices and a common healthcare policy. National Society for Psychosomatics and Health Care Management could serve as a central organization to create administrative and institutional resources for development of up to date high standards of psychosocial care.