Background: Coronary heart disease (CHD) is one of the most common diseases and the most common cause of death worldwide. It is known that psychosocial factors have a definite effect on the development and course of CHD. In this regard, the study of the psychoemotional characteristics of patients with CHD and their psychological features seems to be extremely important for the development and improvement of preventive measures, as well as psychotherapeutic work with this group of patients. Aim: The article aims to analyze modern foreign studies for considering the psychoemotional factors and psychological characteristics inherent in patients with coronary artery disease, as well as their impact on the development, course, and outcome of the disease. Conclusion: The present work studies and summarizes the digest of scientific literature on the features of the psychoemotional sphere of patients with coronary heart disease (CHD). The information about the link between psychoemotional factors and CHD is presented. In particular, a review of the role of anxiety and depression in CHD is presented. It is noted that describing the psychoemotional characteristics of patients with CHD requires taking into account not only the likely symptoms of anxiety and depressive disorders but such manifestations as hostility, fatigue, and stress. The present study shows that the role of traditional psychological factors in CHD is disputable and ambiguous. According to the results of the review, a comprehensive study of psychoemotional and personal characteristics in patients with cardiovascular pathology is essential to improve means for correcting psychological risk factors of CHD and its consequences, as well as for reducing their negative impact.
The authors have attempted to design and verify by means of mathematical modelling methods a model of comprehensive (medical, social and psychological) prognosis in cardiovascular disease, which would cover different aspects of patients’ disease, treatment and life functioning and would be relevant to the objectives of the treatment and rehabilitation process. A multidisciplinary set of methods was used to accomplish the aim: clinical and psychological. The study included 437 patients with coronary heart disease and/or chronic heart failure undergoing surgical treatment.Part I of the article presents the results of the first 4 stages of the study.1) A theoretical prediction model based on existing data was developed and empirically tested on different patient populations at various stages of surgical treatment. 2) An overall information database was compiled on the basis of our own research. A total of 245 indicators were taken into account; they were expertly divided into five groups: clinical, socio-behavioural, personality characteristics, emotional state indicators, and cognitive functioning indicators.3) The missing cells in the sampling matrix were filled in by means of mathematical modelling and neural networks. 4) An exploratory factor analysis of all characteristics in the allocated groups was performed, resulting in 24 factors: 3 in the group of clinical characteristics (“Coronary heart disease”, “Transplantation”, “Patient’s age and duration of heart failure”), 6 in the group of socio-behavioural (“Social and occupational orientation”, “Keeping a habitual lifestyle in spite of illness”, “Occupational strain”, “Lifestyle”, “Non-adherent behaviour”, “Occupational stress”), 5 in the group of personality characteristics (“Attitude towards illness”, “Motivational orientation”, “Decreased resilience”, “Irrational beliefs”, “Coping strategies and coping resources”), 4 in the group of emotional state characteristics (“Dominant emotional state and feelings”, “Quality of life and mood”, “Absence of anxiety at the moment of the study”, “Functioning in conditions of illness”), 6 in the group of characteristics of cognitive functioning (“Neuropsychological characteristics”, “Spatial–constructive thinking and pace of mental activity”, “Visual memory”, “Attention and verbal–logical thinking”, “Verbal memory”, “No significant decrease in IQ”).
Aim. The article presents the results of psychological investigations of patients in the terminal stage of chronic heart failure (n = 105, average age 51.9 ± 0.9 years, males – 86.7 %) undergoing medical treatment at the Almazov National Medical Research Centre (St. Petersburg). The investigations were carried out before the medical commission for inclusion of patients into the waiting list for heart transplantation (HTWL). Materials and methods. After 6 months of treatment in a cardiology hospital, the patients were divided into 2 groups – the patients included in and retained their positions in the HTWL (n = 55) and the patients not included in or excluded from the HTWL (n = 55). That was done in order to identify the prognostically significant psychosocial characteristics of patients. Clinical, psychological and psychometric methods were used such as a structured interview, expert questionnaire for doctors, the Alcohol Use Disorders Identification Test (AUDIT), the Short Form-36 (SF-36). Results. Comparative analysis reveals a wide range of psychological characteristics, among which the indicators of adherence for treatment and willingness to change lifestyle have the greatest importance. Emotional support and relationships outside the family, an adequate understanding of the disease, an optimistic assessment of the outcome of surgery treatment, etc., as well as the presence of one's own family and minor children are essential in the structure of the psychosocial potential of patients during preparation for HT. Conclusion. Using the obtained results will improve the methodology and procedure for a comprehensive clinical assessment of patients with chronic heart failure before inclusion into the waiting list for heart transplantation, which is extremely important for advanced surgical technologies.
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