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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">natszdrav</journal-id><journal-title-group><journal-title xml:lang="ru">Национальное здравоохранение</journal-title><trans-title-group xml:lang="en"><trans-title>National Health Care (Russia)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2713-069X</issn><issn pub-type="epub">2713-0703</issn><publisher><publisher-name>Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47093/2713-069X.2025.6.1.50-62</article-id><article-id custom-type="elpub" pub-id-type="custom">natszdrav-365</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>МЕДИЦИНСКИЕ КАДРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PERSONNEL</subject></subj-group></article-categories><title-group><article-title>Социально-демографические и клинико-психологические предикторы курения и злоупотребления алкоголем у медицинских работников</article-title><trans-title-group xml:lang="en"><trans-title>Socio-demographic and clinical-psychological predictors of smoking and alcohol abuse in health workers</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5411-9611</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фадеева</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Fadeeva</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Фадеева Евгения Владимировна – канд. психол. наук, заведующая отделом организации профилактической помощи в наркологии; младший научный сотрудник отделения терапии стационарных больных с аддиктивными расстройствами; доцент кафедры клинической и судебной психологии факультета юридической психологии </p><p>Малый Могильцевский пер., д. 3, г. Москва, 119034;ул. Бехтерева, д. 3, г. Санкт-Петербург, 192019;ул. Сретенка, д. 29, г. Москва, 127051</p></bio><bio xml:lang="en"><p>Eugenia V. Fadeeva – Cand. of Sci. (Psychology), Head of the Department of Organization of Preventive Care in Narcology; Junior Researcher, Department of Therapy of Inpatients with Addictive Disorders; Associate Professor, Department of Clinical and Forensic Psychology, Faculty of Legal Psychology </p><p>Maly Mogiltsevskiy Lane, 3, Moscow, 119034;Bekhtereva str., 3, St. Petersburg, 192019;Sretenka str., 29, Moscow, 127051</p></bio><email xlink:type="simple">nscnfadeeva@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4080-7103</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цветкова</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsvetkova</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Цветкова Лариса Александровна – д-р психол. наук, профессор, академик РАО, ведущий научный сотрудник института психологии; заместитель директора по научной деятельности; вице-президент </p><p>наб. реки Мойки, д. 48, г. Санкт-Петербург, 191186;ул. Союза Печатников, д. 16, г. Санкт-Петербург, 190008;ул. Погодинская, д. 8, г. Москва, 119121</p></bio><bio xml:lang="en"><p>Larisa A. Tsvetkova – Dr. of Sci. (Psychology), Professor, Academician of the Russian Academy of Education, Leading Researcher, Institute of Psychology; Deputy Director for Research; Vice President</p><p>Moika River Embankment, 48, St. Petersburg, 191186;Soyuza Pechatnikov str., 16, St. Petersburg, 190008;Pogodinskaya str., 8, Moscow, 119121</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4255-7953</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лановая</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Lanovaya</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лановая Алеся Михайловна – научный сотрудник отдела организации профилактической помощи в наркологии </p><p>Малый Могильцевский пер., д. 3, г. Москва, 119034;</p></bio><bio xml:lang="en"><p>Alesya M. Lanovaya – Researcher, Department of Organization of Preventive Care in Narcology </p><p>Maly Mogiltsevskiy Lane, 3, Moscow, 119034</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ННЦ наркологии – филиал ФГБУ «Национальный медицинский исследовательский центр психиатрии и наркологии имени В.П. Сербского» Министерства здравоохранения Российской Федерации;&#13;
ФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева» Министерства здравоохранения Российской Федерации;&#13;
ФГБОУ ВО «Московский государственный психолого-педагогический университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Research Center on Addictions – branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology;&#13;
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology;&#13;
Moscow State University of Psychology and Education</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Российский государственный педагогический университет имени А.И. Герцена»;&#13;
НИУ «Высшая школа экономики» (Санкт-Петербургский филиал);&#13;
ФГБУ «Российская академия образования»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Herzen State Pedagogical University of Russia;&#13;
National Research University Higher School of Economics (St. Petersburg branch);&#13;
Russian Academy of Education</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ННЦ наркологии – филиал ФГБУ «Национальный медицинский исследовательский центр психиатрии и наркологии имени В.П. Сербского» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Research Center on Addictions – branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>20</day><month>05</month><year>2025</year></pub-date><volume>6</volume><issue>1</issue><fpage>50</fpage><lpage>62</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Фадеева Е.В., Цветкова Л.А., Лановая А.М., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Фадеева Е.В., Цветкова Л.А., Лановая А.М.</copyright-holder><copyright-holder xml:lang="en">Fadeeva E.V., Tsvetkova L.A., Lanovaya A.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.natszdrav.ru/jour/article/view/365">https://www.natszdrav.ru/jour/article/view/365</self-uri><abstract><p>Значительный вклад в злоупотребление психоактивными веществами (ПАВ) медицинскими работниками вносят психоэмоциональные нарушения, обусловленные профессиональными нагрузками, что требует изучения специфических предикторов формирования зависимого поведения и разработки таргетированных программ профилактики. Цель. Изучение социально-демографических и клинико-психологических предикторов курения и злоупотребления алкоголем среди медицинских работников при помощи метода факторного анализа и с учетом гендерных различий. Материалы и методы. Выборку составили 575 медицинских работников (86,3% женщин), средний возраст 42,7 ± 10,2 года. В структуру факторного анализа вошли социально-демографические данные, параметры клинико-психологических факторов риска зависимого поведения (тест ASSIST), показатели психоэмоционального состояния (шкалы K10 и IES-R). Результаты. Факторные модели были разработаны с учетом гендера и уровня риска употребления ПАВ. Были выделены 2 группы риска по употреблению никотиносодержащей продукции (отсутствие и низкий риск; умеренный риск) и 2 группы риска по употреблению алкоголя (отсутствие и низкий риск; умеренный и высокий риск). Наибольший вклад в увеличение риска злоупотребления никотиносодержащей продукцией и алкоголем для всех групп вносил фактор посттравматического стрессового расстройства и психологического дистресса, кроме группы медицинских работников мужского пола, употреблявших алкоголь с умеренным или высоким риском. В группах медицинских работников, употреблявших алкоголь с умеренным или высоким риском, вне зависимости от гендера наблюдались признаки анозогнозии в отношении вредного потребления алкоголя. Заключение. Полученные результаты подчеркивают важность комплексной психологической и психотерапевтической работы с медицинскими работниками, имеющими специфичные социально-демографические, клинико-психологические и психоэмоциональные предикторы злоупотребления психоактивными веществами.</p></abstract><trans-abstract xml:lang="en"><p>Psychoemotional disorders caused by professional stress make a significant contribution to substance abuse by health workers, which requires studying specific predictors of the formation of addictive behavior and developing targeted prevention programs. Aim. To study the socio-demographic and clinical-psychological predictors of smoking and alcohol abuse among health workers using the factor analysis method and taking into account gender differences. Materials and methods. The sample consisted of 575 health workers (86.3% women), the average age was 42.7 ± 10.2 year. The structure of the factor analysis included socio-demographic data, parameters of clinical and psychological risk factors for addictive behavior (ASSIST test), indicators of the psychoemotional state (K10 and IES-R scales). Results. Factor models were developed taking into account gender and the level of risk of substance use. Two risk groups for the use of nicotine-containing products (absence and low risk; moderate risk) and two risk groups for alcohol use (absence and low risk; moderate and high risk) were identified. The greatest contribution to the increase in the risk of abuse of nicotinecontaining products and alcohol for all groups was made by the factor of post-traumatic stress disorder and psychological distress, except for the group of male health workers who consumed alcohol with moderate or high risk. In the groups of health workers who consumed alcohol with moderate or high risk, regardless of gender, signs of anosognosia in relation to harmful alcohol consumption were observed. Conclusion. The obtained results emphasize the importance of complex psychological and psychotherapeutic work with health workers who have specific socio-demographic, clinicalpsychological and psychoemotional predictors of substance abuse.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>медицинские работники</kwd><kwd>факторы риска</kwd><kwd>предикторы</kwd><kwd>курение</kwd><kwd>злоупотребление алкоголем</kwd><kwd>факторный анализ</kwd></kwd-group><kwd-group xml:lang="en"><kwd>health workers</kwd><kwd>risk factors</kwd><kwd>predictors</kwd><kwd>smoking</kwd><kwd>alcohol abuse</kwd><kwd>factor analysis</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование проводилось при финансовой поддержке РФФИ в рамках научного проекта № 20-04-60222</funding-statement><funding-statement xml:lang="en">The study was conducted with financial support from the Russian Foundation for Basic Research within the framework of scientific project No. 20-04-60222.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Wilson J., Tanuseputro P., Myran D.T., et al. 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