Functional state of a person: concept, types, research. Mental and physical condition

The functional state of a person is nothing more than a whole complex of properties indicating the level of his vitality. It is the basis for characterizing the activity of the body in certain conditions, directions, with the available reserve of strength and energy.

In addition, the functional state serves as the main criterion for characterizing a person’s capabilities and behavior.

Components of health level

The general functional state of the human body consists of certain changes. They occur in all its physiological systems, namely in:

- central nervous; — motor; - endocrine; - respiratory; - cardiovascular, etc.

In addition, the functional state of a person is significantly influenced by changes that are possible during the course of mental processes, such as sensation and perception, thinking and memory, attention and imagination. Your health also depends on subjective experiences.

Classification of human conditions

There are a huge number of factors influencing human behavior and health. That is why the functional state of the body in each specific situation is unique. Nevertheless, from a huge number of special cases, scientists have identified the most basic ones. They are grouped into certain classes. This state:

- normal life activity; - pathological; - borderline.

It is possible to assign a functional state to one class or another only if certain evaluation criteria are used, namely, reliability and cost of activity. The first of them characterizes a person’s ability to work with a given level of accuracy, reliability and timeliness. The indicator of the cost of activity serves to characterize the functional state from the point of view of depletion of the vital forces of the body, which ultimately has a direct impact on the level of its health.

Based on these criteria, the functional state is differentiated into acceptable and unacceptable. This classification is used in studies of the possibility of working.

Which class the patient’s functional state belongs to is decided by doctors specifically depending on a particular case. For example, a state of fatigue. It leads to a decrease in performance indicators, but it is incorrect to consider it unacceptable. However, if the degree of fatigue exceeds the lower limits of a certain norm, then in this case the functional state is prohibited. This assessment is not given by chance.

Excessive strain on a person’s psychological and physical resources worsens his physical condition. In the future, this kind of fatigue is a potential source of various ailments. On this basis, normal and pathological functional health states are distinguished. The last of these two classes is the subject of medical research. For example, after prolonged experiences or stress, diseases of the blood vessels and heart, the digestive system, as well as neuroses often occur.

There is another classification of human functional states. It is built using criteria for the adequacy of responses to the requirements of work activity. According to this classification, functional states are related to adequate mobilization and dynamic mismatch.

The first of these two types is characterized by a correspondence between the degree of intensity of a person’s capabilities and the requirements that are placed on him in specific conditions. This condition can be disrupted by increased stress, duration and excessive activity. In this case, fatigue accumulates in the body and a condition related to dynamic mismatch arises. In this case, in order to achieve the desired result, a person will be forced to make efforts that exceed what is necessary.

Basic approaches to FS analysis

As of 2015, four main groups of approaches to the study of FS can be distinguished.

Energy approach

FS is considered as a characteristic of the course of life support processes at the level of both individual physiological systems and the entire organism as a whole, in terms of the intensity and efficiency of energy expenditure on the part of physiological systems involved in solving behavioral problems. Research focuses on the analysis of the basic physiological mechanisms that ensure the occurrence of metabolic, neurohumoral, cerebral, autonomic and other processes in different conditions and modes of activity. The main goal of these studies was to find physiological correlates that would allow different types of psychophysiological states to be differentiated according to specific “activation patterns”, i.e. according to stable configurations of physiological reactions characteristic of different situations.

Phenomenological approach

FS is considered as a characteristic of the experience experienced by a person, including in an affectively colored form (feelings, emotions, experiences, etc.), presented in observations or introspection. In studies carried out within the framework of the phenomenological approach, the multidimensional nature of the manifestations of a mental state is substantiated and productive attempts are made to identify structural and functional connections between reflexive assessments of the state and the “launch” of behavioral programs corresponding to the characteristics of the subjective attitude or “vision of oneself” in a particular situation.

Behavioral approach

FS is considered as a characteristic of the results and methods of performing activities / solving problems at the level of externally presented behavior. An important direction within the framework of this approach is research into the qualitative side of the implementation of behavioral acts, changes in which lead to shifts in performance. The development of the behavioral approach also stimulated the emergence of more advanced behavioral and psychometric methods for assessing FS - test tests simulating the solution of certain fragments of behavioral tasks.

A complex approach

FS is considered as a holistic multicomponent characteristic of the manifestations of the studied mental phenomena, including states. Based on numerous studies conducted within the framework of an integrated approach, new theoretical constructs and methodological tools were developed, which prepared the basis for the implementation of the principles of system analysis of FS. However, in general, the integrated approach serves primarily as a strategy for collecting data on the multilevel manifestations of FS, but does not provide a sound conceptual framework for analyzing, integrating, and meaningfully interpreting these multidimensional data. The solution of practical problems related to the full diagnostics and optimization of the PS as a complex system object was justified in the development of a structural-integrative approach to the analysis of the PS.

Systems approach

FS is considered as a relatively stable (for a certain period of time) structure of internal means actualized by the subject, which characterizes the mechanisms of activity regulation that have developed in a particular situation and determines the effectiveness of solving behavioral problems. It is important to emphasize that in this case, FS is considered as the result of a person’s inclusion in the process of active and purposeful activity, the leading role in which is played by the employee’s motivational attitudes and the internal resources available to him in a specific period of time to complete the tasks being solved.

Basic concepts of the systems approach

• A system is a set of interacting elementary structures/processes, united into a whole by solving a common task that cannot be performed by any of its components separately.
• The system-forming factor is the main factor that integrates the work of different-quality elements into a single whole and determines its dynamics over time.

Primary examination by a doctor

When contacting medical institutions, a specialist assesses the patient’s functional state based on examination, survey, laboratory and other studies. Sometimes similar events are carried out in relation to patients who are undergoing surgery. In this case, comprehensive studies are carried out to identify the level of a person’s functional state.

At the same time, the patient’s complaints and his anatomical data are considered, and the results of a clinical examination are evaluated, containing information about:

- blood pressure; - heart rate; — decrease or increase in body weight; - presence of edema, etc.

Condition of the vascular system and heart

Where does the study of the functional state of the body begin? From an assessment of the functioning of his heart and blood vessels. And this is not surprising. The normal functional state of the cardiovascular system allows the delivery of oxygen to every cell of the human body. This allows the whole body to work as usual. In addition, assessment of the condition of blood vessels and the heart is in the first place due to the fact that in modern man they are extremely vulnerable.

What are the main indicators of the functional state of such an important system for us? This is the pulse, indicating the heart rate, as well as analyzing its changes.

This indicator for men at rest should be from 55 to 70 beats per minute, and for women - from 60 to 75. At higher values, the pulse is considered rapid, which is a sign of tachycardia. A heart rate below normal indicates a disease such as bradycardia.

Also, your health directly depends on your blood pressure. Its normal value is in the range of 100-129/60-79 mm. Hg Art. High blood pressure indicates hypertension, and low blood pressure indicates hypotension.

It is impossible to assess the functional state of the cardiovascular system without studying the characteristics of changes in its functioning after intense physical activity. The duration of the body’s recovery is also taken into account. Similar studies are carried out using a variety of functional tests.

NECPAL rating scale

Might a patient need palliative care if the “yes” answers are less than three? The NECPAL scale says it can.

NECPAL, short for Necesidades Paliativas, means “palliative needs” in Spanish. This is a technique for identifying patients who require any form of palliative care as part of a general medical examination. The scale was developed by the Catalan Institute of Oncology in Spain, the Catalan Department of Health and with the participation of WHO.

The NECPAL scale also begins with a question about “surprise.” And the second question is: Has the patient or primary caregiver explicitly or implicitly expressed a request to receive palliative or symptomatic treatment only? Did he suggest limiting other therapy or avoiding specialized treatment?

This approach gives the patient the right to choose. Accordingly, if the doctor answered the question “about surprise”: “No, I will not be surprised,” and answered “Yes” to the second question, then we can say that the patient has indications for palliative care.

Respiratory system condition

To ensure the vital functions of the body, a constant process of oxygen intake and removal of water vapor and carbon dioxide is necessary. The respiratory organs are responsible for this.

Three parameters are included in assessing the indicators of the functional state of this system. These are the depth, frequency and type of breathing.

One of the most important indicators is the respiratory rate. This is the breathing rate that is necessary for the normal supply of oxygen to all body systems. The values ​​of this indicator depend on a number of reasons. This may be body or environmental temperature, as well as the period before or after eating. The breathing rate varies depending on the position of the body. Its smaller values ​​are observed in a lying position, and its larger values ​​are observed in a standing position. Men breathe 2-4 breaths per minute less frequently than women. On average, the normal RR value ranges from 14 to 16.

How to determine the functional state of the respiratory system? This is possible by analyzing:

1. The ratio of heart rate and respiratory rate. At rest and during physical activity, these values ​​range from 4:1 to 5:1. An increase in these indicators due to heart rate will indicate a decrease in the thermodynamics of the heart. A decrease in values ​​due to an increase in RR will indicate less economical lung function.

2. Holding your breath. To do this, a Stange test is performed. If a person was able to hold his breath for more than 80 seconds, we can talk about the excellent condition of his lungs, 70-80 - good, 65-70 - average, less than 65 - weak.

PPI scale

This is the simplest tool for assessing a patient's life prognosis. Initially, the PPI scale was created for oncology patients, but we also use it in somatic patients.

Five parameters are assessed:

• functional status (the same percentage on the PPS scale),
• oral food intake,
• swelling,
• shortness of breath at rest
• psychomotor agitation (delirium).

If the PPI is more than six, then the patient's life expectancy is less than three weeks.

This method helps to resolve the issue of the advisability of continuing specialized treatment by oncologists, the advisability of applying a gastrostomy, as well as the need for palliative surgery or registration of the patient in a social institution, registration of the IPRA disability group for him.

The scale is the answer to the most common and painful question from relatives: “How long will my loved one live?” The data obtained on the scale makes it possible to prepare for the departure of a loved one.

You can download the PPI scale from this link.

Important Identifying the need for palliative care does not mean that specialized treatment should be stopped or treatment procedures should be limited if they improve the patient's quality of life. Palliative and curative care can be combined.

Condition of the central nervous system

The performance of all organs is assessed during the examination and based on the results of a whole range of biochemical tests. However, as for the nervous system, here specialists face a number of difficulties associated with the limitations of instrumental research.

A person’s physical condition directly depends on the performance of his central nervous system. Moreover, the strength of the nervous processes occurring in our body is quite great. This can be evidenced by the fact that our emotional sphere also depends on the functioning of the nervous system. These are stability of mood and the ability to restrain yourself, perseverance and courage, as well as many other criteria.

In order to determine the functional state of the central nervous system, it is important for a specialist to find out the patient’s sleep characteristics. The fact is that night rest has two phases. This is slow and fast sleep. During the night, these phases change places, repeating from 3 to 5 times. If this alternation is disrupted, a sleep disorder is diagnosed, which indicates mental and neurotic disorders in the body.

An important indicator of the functional state of the central nervous system is coordination of movements. To determine this indicator, special samples are used. With their help, the static and dynamic coordination of the patient’s movements is revealed.

A disorder of this function indicates overwork of the body or the presence of pathological changes that have arisen in certain areas of the nervous system.

Also, to clarify the functional state of the central nervous system, the following are used:

— EEG, or electroencephalogram, which records the electrical activity of brain tissue; - REG, or rheoencephalogram, examining the cerebral blood flow of the brain vessels; - EMG, or electromyography, which records the electrical activity of skeletal muscles; — chronaximetry, which studies the excitability of nervous tissue depending on the period of action of the stimulus; - Romberg test, which detects imbalance when a person is in a standing position; - Yarotsky test, which determines the sensitivity threshold of the vestibular analyzer; — finger-nose test, for which the patient must reach the tip of the nose with his index finger (failure to reach the tip may indicate neurosis, brain injury, fatigue and other functional impairments).

Studies of the nervous system can reveal some of its pathologies. These are neuroses or neurosis-like conditions, neurasthenia, etc.

Fatigue

The functional mental state of the body, as a rule, examines the dynamics of a person’s performance. In this case, one of the main indicators is the body’s fatigue, that is, its natural reaction that occurs when tension increases during prolonged work.

From a physiological point of view, the fatigue that occurs in a person indicates the depletion of his internal reserves. At the same time, all body systems transfer their functional activity to other modes. For example, due to an increase in the number of heart contractions, the minute volume of blood flow decreases. This process, like many others, slows down the pace of work, disrupts the accuracy, coordination and rhythm of movements.

As fatigue increases, the emotional sphere also suffers. Changes affecting mental processes slow down the functioning of the senses, transferring them to an inertial mode. Also, when tired, the reaction rate decreases, which indicates an increase in the sensorimotor reaction time.

It becomes difficult for a tired person to perform complex movements. In addition, in this state there is a narrowing of the scope of attention with a decrease in the functions of its distribution and switching. As a result, the conscious control that a person must exercise over the performance of his activities is significantly deteriorated. The deterioration of the functional state of the body during fatigue leads to difficulty in retrieving information contained in long-term memory. The short-term storage system is also disrupted.

As fatigue increases, a person’s motives for activity are transformed. Thus, in the early stages of the work process, a businesslike mood takes place. However, due to the accumulation of fatigue, motives for avoiding activities become predominant.

Diagnosis of FS

Types of the most common applied diagnostic tasks for assessing FS:

1. Assessment of the reliability of human activity directly in the process of work (diagnosis of the current FS).
2. Assessment of a specialist’s readiness to perform activities in a specific situation (short-term forecast of FS development).
3. Assessment of a person’s potential to reliably/successfully cope with professional tasks (long-term forecast in terms of professional suitability).
4. Assessment of threatening factors for the health/well-being of workers employed in certain professional positions (long-term prognosis in terms of professional longevity, preservation of working capacity).
5. Examination of “difficult situations”, accidents, accidents (assessment of the role of the “human factor” in the occurrence of various incidents).

FS assessment methods (data collection):

• Physiological Biochemical
• Assessment of vegetative changes
• Electrophysiological

Performance stages

During the work process, the human body goes through four stages. They include the stages:

— working in; — optimal performance; — fatigue; - the final impulse.

After completion of the last stage, a mismatch of work activity occurs. How to restore optimal performance? To do this, you need to stop activities in order to actively or passively rest.

Sometimes a person experiences cumulation, or accumulation of fatigue. This happens in cases where the fullness or duration of rest periods is insufficient for him. In such cases, chronic fatigue occurs, which is expressed in a feeling of constant fatigue, drowsiness, etc. Objective signs of this functional state in its initial stages are little expressed. But their appearance can always be indicated by a change in the ratio of periods such as the run-in stage, as well as optimal performance.

Tension

This is one of the indicators of the functional state of a working person’s body. The degree of intensity of activity can be determined based on the structure of the labor process. This takes into account the content of the workload, as well as its saturation and intensity.

There are two classes of states of tension. The first of them is specific. It determines the intensity and dynamics of psychophysical processes that underlie the performance of labor skills. The second class of tension is nonspecific. It reveals the psychophysical resources of the employee.

Maintaining the normal functional state of the body

The limit of a person’s performance depends on his:

— health; — age; - nutrition; — the magnitude of the body’s reserve capabilities; — motivation; — experience and professional preparedness; — sanitary and hygienic working conditions; - personality orientation.

In order to maintain a normal level of functional state of the body, it is necessary to comply with conditions that prevent fatigue. To do this, it is important to correctly alternate between work and rest.

However, not all problems associated with fatigue can be solved by taking breaks from work. An important role in this case will be the organization of the place of personnel and their work. In this case, the following conditions must be met:

— ensuring sufficient work space; — availability of artificial and natural lighting; — permissible level of vibration, noise and other production factors; — presence of warning signs and necessary instructions; — cost-effectiveness and trouble-free maintenance of working equipment, etc.

Properties of PS as a systemic reaction

1. FS is the result of a restructuring in the work of functional systems that ensure the implementation of purposeful activities:

• FS cannot be considered outside the context of solving a specific problem, situation and conditions for the implementation of activities;
• The FS is not the background against which activities are carried out.

2. FS reflects changes in the structure of the “involved” functional system for supporting activities:

• Reconstruction of the main components in the functional system for supporting activities is required (highlighting professionally important functions and qualities);
• It is necessary to assess the manifestations (symptoms) of FS at all levels of the functional system for supporting activity (energetic, perceptual-cognitive, reflexive and behavioral).

3. FS is a systemic reaction formed under the influence of a complex of factors in the working environment:

• “Physical environment” (sanitary, hygienic and environmental conditions): microclimate;
• illumination;
• noise, vibration;
• Atmosphere pressure;
• radiation; harmful substances;
• infections and biological agents.