Introduction More often, cardiac surgery patients (CSP) receive systematic psychological aid after surgery. However, their need for psychosocial interventions in the perioperative period is underestimated. Objectives The goal is to determine the stages of psychosocial interventions for CSP that could cover the whole period of their treatment and rehabilitation. Methods Analysis of scientific papers and practical experience gained in cardiologic clinic allowed dividing the system of psychosocial interventions for cardiac surgery patients into periods in accordance with actual stages of medical aid for CSPs. Results According to the principles of personalized approach, we determined six consecutive semantically different stages of psychosocial interventions: out-of-hospital pre-surgery, in-hospital pre-surgery, early post-surgery, in-hospital post-surgery, post-surgery rehabilitation, and out-of-hospital rehabilitation. They have different duration and cover the whole period of treatment and rehabilitation of CSPs beginning with the moment of indication to surgery up to the complete rehabilitation and full adaptation to their post-surgery somatic condition. Each stage has its own goals, main objectives and expectations. Duration of the stages is conditional and can change depending on the nature of every clinical situation. Conclusions Determination of clinical stages in the process of psychosocial interventions for CSPs gives ground for selecting optimal psychological methods and techniques for each stage and sets exact goals, achievement of which becomes possible only through a properly organised work of an interdisciplinary team of specialists. Disclosure No significant relationships.
Introduction Differentiation of targets for psychotherapy allows determining certain ways and priorities in psychological treatment of a patient. Objectives To work out a multi-level system of psychotherapeutic targets for clinical groups of cardiac surgery patients (CSPs). Methods Clinical and psychological analysis of 152 CSPs who were to undergo different types of cardiac surgery treatment. Results We have established four levels of psychotherapeutic targets: a patient’s response to surgery, psychopathologic manifestations, personality’s dysfunctional characteristics, and social interaction specificities. Towards CSPs with open-heart coronary artery bypass grafting, the targets appeared to be as follows: low expectations from surgery, low hopes for recovery, low level of satisfaction with life, depressive disorders with somatic manifestations, cognitive abnormalities, anxiety manifestations, manifestation of hostility, rejection of the past, inclination for fatality, reduced vitality, reduced social activity, expectation of help from closest people.Towards CSPs indicated to open-heart aortic valve repair surgery, psychotherapeutic targets were as follows: high expectations from surgery; moderate fear of death; not feeling well; low spirits; depressive disorders with somatic and cognitive-and-affective manifestations; cognitive abnormalities; anxiety manifestations; manifestation of hostility; rejection of the past; reduced hedonism; expectation of help from closest people; reduced social activity. Towards CSPs indicated to minimally invasive surgery, we set such targets as: moderate expectations from surgery; apparent fear of death; depressive disorders with somatic manifestations; anxiety manifestations; cognitive abnormalities; rejection of the past; expectation of help from closest people; reduced social activity. Conclusions Psychotherapy of CSPs that includes the established targets can contribute to personalized approach in a patient’s treatment. Disclosure No significant relationships.
Introduction Cardiac surgery patients (CSP) are cardiovascular patients who undergo surgery to treat their disease. Are their psychological characteristics different from those of other cardiac patients? Objectives The goal is to establish peculiarities of the clinical-and-psychological status of CSPs in different clinical groups. Methods According to clinical parameters, 152 CSPs were divided into three groups. The first group comprised patients with CHD indicated to an open-heart coronary artery bypass grafting, the second one included patients with heart failure who were to undergo aortic valve surgery, and the third group included CHD patients and those with heart rhythm abnormalities indicated to minimally invasive surgery. Results CSPs had a number of cardiologic complaints, mental disturbance manifestations and concomitant somatic diseases. They showed difference in the duration of the disease, previous occurrence of heart surgery or myocardial infarction, and in the degree of heart failure manifestations. Self-assessment of pre-surgery CSPs corresponded to the severity of their clinical condition, while indications of hope for recovery were at the maximum level. The second group showed a moderate level of depression, while the third one – slight depression. All the groups revealed a disharmonic profile of time perspective. Group 1 CSPs showed some manifestations of hostility. We saw different manifestations of CSPs’ personal adaptation resources. While hardiness had insufficient showings at the level of most components, social support was excessive in all groups. Conclusions CSPs as other cardiac patients revealed depressive disorders and hostility. At the same time, they have more social support, which testifies availability of good interpersonal resources. Disclosure No significant relationships.
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