Psycho-emotional conditions in primary care physicians who serve in a direct vicinity to the frontline

Abstract

Introduction. Armed conflicts, wars, social/economic/political/national/racial conflicts and rebellions have been accompanying all periods of the historical development of the mankind. Within the framework of the above-mentioned crises from the point of view of existentialism and the development of the community of events, each person was assigned a certain unique role that was associated with equally unique physical and psycho-emotional consequences. However, even in the XXI century, history, philosophy, medical and political sciences, potentially try to equate the psycho-emotional spectrum of experience that combatants, medical workers, and representatives of the civilian population take on. The Russian Federation's full-scale war against Ukraine shook the continent and became, undoubtedly, an unprecedented trigger for revising the above concept. Thus, based on the fundamental philosophical theory of utilitarianism, as the clue of formation of the palette of human actions, compared with the vision of leading scientists about the specifics of post-demobilization and reintegration processes, as well as those that ensure the social inclusion of ex-combatants, the civilian population and, in particular, medical specialists, who work directly on the front line and, ultimately, completing with the actual scientific and practical experience of a global cohort of medical scientists, who since 2019 have emphasized the relevance of highlighting the different spectrum and specifics of the development of psycho-emotional conditions specifically in front-line medical workers in the framework of a critical existential situation; all this leads to the need to separate representatives of the health care sector into an independent category of active persons within the ongoing wartime, not only from the point of view of the role they play at the front, but also from the point of view of unique psycho-emotional conditions experienced by them under the prism of the profession/role they perform.

Materials and methods. Unsystematic observation, deduction, induction, synthesis, analysis, factor analysis, statistics, survey.

Results. Within the frame of our research, we highlighted the uniqueness of the psycho-emotional conditions that are being developed among primary care physicians in wartime conditions. In addition, we analyzed the relationship between the development of psycho-emotional disorders in the aforementioned professional group and the degree of impairment of their reintegration and social inclusion in the post-war/post-demobilization period. Concepts, visions and recommendations were created to optimize both the psycho-emotional well-being of first-line medical specialists and their more optimized social inclusion into civilian post-war professional and social life. This scientific work includes a detailed description of the psycho-emotional conditions that are inherent in first-line doctors who serve and/or served in  a close vicinity to the front lines of a full-scale war. Postwar reintegration into civilian life, however, alongside with the additional triggers that can possibly affect the deterioration and/or exacerbation of the development process of the above-mentioned primary conditions, will be considered by us in separate scientific works.

Discussion. This study revealed and analyzed the uniqueness of the psycho-emotional conditions that are being faced by primary care physicians under the prism of war, namely within the framework of service on the line of direct vicinity to the frontline. Thanks to an in-depth analysis of available literary sources, as well as our own practically applied research, we have proven the uniqueness and specificity of the above-mentioned conditions, including the principles of their development, as well as psycho-emotional and socio-cultural triggers that deepen the crisis level of these states. Thanks to the comprehensive analysis that was carried out as part of our research, and which will be described in the further part of the work, there is a prospect of creating a scientific and practical basis for effective prevention,  diagnosis, optimization and treatment of specific psycho-emotional conditions in primary care physicians serving on the frontline, which will allow not only the domestic, but also the global society to prevent the repetition of the negative phenomenon of the "lost generation", to change the socio-cultural vision of the role and position of the doctor in the conditions of hostilities, as well as to create mechanisms for the successful implementation of effective strategies for the reintegration and social inclusion of first-line doctors to the normalized peaceful civilian life in the post-war/post-demobilization period in order to prevent a crisis of social adaptation inherent in this stage of interaction with the surrounding society.