The objective of the research was to analyze the effectiveness of using suggestive therapy in the patients with acute coronary syndrome by assessing the dynamics of the clinical condition and indicators of anxiety. Materials and Methods. There were examined 135 patients with non-ST-segment elevation myocardial infarction, 60 patients with the use of the conservative treatment and 75 patients who underwent percutaneous coronary intervention. The dynamics of objective indices, adaptation changes and anxiety indices in the groups of patients with traditional treatment and in the groups of patients with suggestive therapy in addition to the traditional rehabilitation measures, were analyzed. Results. Analyzing the dynamics of adaptive indices, it was determined that in the group of patients with non-ST-segment elevation myocardial infarction, who were performed conservative therapy, the dynamics was less significant, which is related to the general desadaptative syndrome. Changes in the group of patients undergoing percutaneous coronary intervention and suggestive therapy, with a decrease of blood pressure, heart rate, and a decrease in the index of functional changes from 3.78±0.15 points before the intervention up to 2.92±0.13 points after suggestive therapy (p<0.01) were more significant. In all groups of patients, high levels of reactive anxiety were observed at the beginning of treatment. As a result of treatment, a decrease in anxiety was noted, but more pronounced changes were seen in the group with the use of suggestive therapy (p<0.05). Conclusions. The use of suggestive therapy methods when treating the patients with acute coronary syndrome is an important intervention, that provides a comprehensive approach considering all the components, enhances the patients’ adaptive abilities in the rehabilitation phase, improves the quality and effectiveness of restorative treatment. The use of suggestive therapy at the rehabilitation stage improves the clinical course, reduces anginal manifestations, stabilizes blood pressure and increases exercise tolerance.
Background: Rehabilitation of patients following myocardial revascularization remains major problem in today’s world. Through psychological support and training, it is possible to develop a positive attitude to health and illness, optimize an individual’s inner health perception, and improve a person’s self-image as healthy and their knowledge of how to maintain that health. Aim of the study: To examine new rehabilitation interventions for patients following myocardial revascularization. Material and methods: 60 patients were reviewed following myocardial revascularization, using clinicalanamnestic, instrumental methods, assessment of quality of life, cognitive therapy and physical rehabilitation. Rehabilitation of the patients was performed using the author’s program “Psychological rehabilitation of patients with ischemic heart disease and myocardial infarction by optimization of the inner picture of health”. Results: Training by optimization of the patients’ inner picture of health leads to a reduction in the manifestations of anxiety and depression, improves subjective and objective indicators, quality of life, and changes the patient’s attitude to illness. At the beginning of the observation period, there were subclinical signs of anxiety in the majority of patients, with an average score of 11.23±0.70. During the course of treatment, there was a decrease in the mean score of anxiety in the group receiving suggestive therapy of 7.58±0.69 (22.6%), and in the group using of optimization of IPH there was a decrease of 7.69±0.63 (30.8%). A reduction in manifestations of depression was found, from 8.89±0.64 at the beginning of treatment to 7.65±0.51 after 1 month of the treatment. For patients participating in the optimization of IPH program, the average score was 8.85±0.65 and 6.85±0.49, respectively. In terms of indices of quality of life, after 6 months an increase in most scales was noted. The use of suggestive therapy contributed to a gradual decrease in volumetric indices of LV EDV, from 135.61±10.66 cm3 at the beginning of the observation to 108.90±5.98. During the same period of observation, there was a decrease in the values of EDD and ESD and a significant increase in EF from 49.65±1.93% to 55.29±1.88. Conclusions: In order to maximize the benefits of rehabilitation, it is important to develop strategies for the optimization of the inner picture of health. A change in attitude to disease leads to an improved perception of the patient to health, motivation for treatment, and the need for active participation in rehabilitation interventions.
Àêòóàëüí³ñòü òåìè äîñë³äaeåííÿ. Ó ñó÷àñíîìó ñâ³ò³ ³øåì³÷íà õâîðîáà ñåðöÿ º îäí³ºþ ç íàéïîøèðåí³øèõ çàõâîðþâàíü ñåðöåâî-ñó-äèííî¿ ñèñòåìè.  öåíòð³ óâàãè íàóêîâö³â çàëèøàþòüñÿ ïðîáëåìè ðîçðîáêè ïðèéîì³â ÿê³ äàþòü çìîãó ï³äâèùèòè ÿê³ñòü ðåàá³ë³òàö³¿ õâîðèõ íà ³øåì³÷íó õâîðîáó ñåðöÿ [4; 5; 7; 11; 14]. Îñîáëèâå ì³ñöå çàéìàþòü ì³aeäèñöïë³-íàðí³ äîñë³äaeåííÿ, äå, îêð³ì òðàäèö³éíèõ ë³êóâàëüíèõ ìåòîä³â, âèêîðèñòîâóþòü ïñèõîëî-ã³÷íó ðåàá³ë³òàö³þ [10; 11; 16; 19]. Ó êàðä³îëîã³÷íèõ õâîðèõ åìîö³îãåíí³ ÷èííèêè "çàïóñêó" õâîðîáè º íåçàïåðå÷íèìè, àäaeå ñàìå åìîö³¿ ïîñòàþòü ò³ñíèìè ñóïóòíèêàìè âèíèêíåííÿ òà ïðîÿâó ñåðöåâî-ñóäèííèõ çàõâîðþâàíü [14; 15; 17; 19], à åôåêòèâí³ñòü ðåàá³ë³òàö³¿ ÷àñòî çàëåaeèòü â³ä åìîö³éíîãî íàëàøòóâàííÿ õâîðîãî [4; 11]. Ðåçîííî ïðèïóñòèòè, ùî çäàòí³ñòü ïîñòóãîâóâàòèñÿ åìîö³ÿìè, äîñÿãàòè ñòàíó êîìôîðòíî¿ ðåëàêñàö³¿ òà óñâ³äîìëåííÿ ìîaeëèâîñò³ ñàìîìó êåðóâàòè õî÷à á îêðåìèìè ïðîöåñàìè ìîaeå ñòàòè âàaeëèâèì ÷èííèêîì ïîêðàùåííÿ ÿêîñò³ ðåà-á³ë³òàö³¿ êàðä³îëîã³÷íèõ õâîðèõ. Îäíèì ç îñîáëèâèõ ìåòîä³â, ÿê³ ìîaeóòü áóòè çàñòîñîâàíèìè äëÿ ï³äâèùåííÿ ÿêîñò³ ðåàá³ë³òàö³¿ êàðä³îëîã³÷íèõ õâîðèõ ó êë³í³÷íèõ äîñë³äaeåííÿõ, º ñóãåñòèâíà òåðàï³ÿ àáî ìåòîä âåðáàëüíèõ ñóãåñò³é, ñóòü ÿêîãî çâîäèòüñÿ äî äîñÿãíåííÿ ê볺íòîì çà äîïîìîãîþ ïñèõîëîãà ñòàíó êîìôîðòíî¿ ðåëàêñàö³¿ ³ ñïðèéíÿòòÿ ñåáå
Досліджено динаміку змін якості життя пацієнтів з ішемічною хворобою серця (ІХС) з гострим коронарним синдромом (ГКС) без елевації сегмента ST, з консервативною чи інвазивною тактикою лікування у процесі реабілітації за традиційними підходами та у ході реабілітації за «Програмою психологічної реабілітації кардіологічних хворих шляхом оптимізації внутрішньої картини здоров'я». Доведено, що показники якості життя пацієнта можуть виступати критерієм ефективності реабілітації кардіологічного хворого.
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