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4 . 2021

Scientific substantiation of the cognitive-behavioral strategy for the prevention of iron deficiency in women of reproductive age

Abstract

The aim is to develop evidence-based preventive measures to manage the risks of iron deficiency in women of reproductive age.

Material and methods. Social, hygienic and psychological research in women of reproductive age was aimed at developing algorithmic prevention tools for outpatient-polyclinic doctors. The research included two blocks: a survey and training seminars. The questionnaire included questions on lifestyle in google-forms and such tests as "Express diagnostics of iron deficiency conditions" (E.V. Kochneva, M.V. Kralevska, 2017) and "Identification of personal and situational anxiety according to Charles Spielberger" (adapted into Russian by Yu. Khanin).

Training seminars were held in 2021 in Kazan in a group of women (n=54) with laboratory-confirmed iron deficiency in frames of "Steps to Health" Nutritional Support Course (D.R. Kuznetsova, 2021).

The seminar program includes information block with the recent evidence on epidemiology of iron deficiency states, diagnostic and prevention algorithms. Work in a small group was expanded with empathic cognition techniques, which contributes to value-mediated perception of information and effective assimilation of the material.

Considering that the problem of iron deficiency in women is often associated with lifestyle and psychological status, a training module on "Elements of cognitive behavior therapy in the practice of a general practitioner" has been added to the program.

Results. It was found out that 26% of the women surveyed have laboratory confirmed iron deficiency (Hb <120 g/l), 35% of the respondents have a low level of tissue iron stores (serum ferritin <40 ng/ml). Among the latter, 89% of women have serum ferritin values <20 ng/ml. 18.5% of the questionnaires had laboratory data attached that testified to latent iron deficiency (serum ferritin <40 ng/ml with Hb ≥120 g/l).

When asked if the doctor of your polyclinic ever talked to you about the prevention of iron deficiency, 87% ticked the box "no", 92% reported that they rate the interaction with their doctor as "insufficient".

Short "before-after training" questionnaire was used to assess the dynamics of female awareness of the problem of iron deficiency. It showed that the basic Level of women's knowledge averaged to 4.6 points, while after they participated in seminars it equaled to 8.8 points (p<0.05).

Conclusion. During the training, women received algorithmized information about iron deficiency conditions risk factors and self-control tactics for primary prevention. There was a positive feedback on the "Latent iron deficiency: from diagnosis to causes" block (86% of the participants highlighted this part of the program as especially valuable).

Thus, evidence obtained during the pilot study shows that women of reproductive age need to get high-quality reliable information on the prevention of iron deficiency conditions. However, to successfully implement such an approach at the population level, we should take measures to develop preventive thinking in clinicians: to introduce a program in frames of training cycles for general practitioners and "Hygiene" course for students of medical and pediatric departments.

Keywords:железодефицитная анемия, женщины репродуктивного возраста, профилактическое консультирование, рациональный образ жизни, эмпатия

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Shulaev A.V., Chernobrovkina G.I., Kuznetsova D.R. Scientific substantiation of the cognitive-behavioral strategy for the prevention of iron deficiency in women of reproductive age. ORGZDRAV: novosti, mneniya, obu-chenie. Vestnik VSHOUZ [HEALTHCARE MANAGEMENT: News, Views, Education. Bulletin of VSHOUZ]. 2021; 7 (4): 32-9. DOI: https://doi.org/10.33029/2411-8621-2021-7-4-32-39 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Guzel E. Ulumbekova
MD, MBA from Harvard University (Boston, USA), Head of the Graduate School of Healthcare Organization and Management (VSHOUZ)

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