Psychological aspects as compared to the technological part of direct myocardial revascularization and its consequences for cognitive functioning, which in turn affect the compliance and quality of life of patients, have not been enough studied yet. In this regard, the purpose of the study was to analyze the clinical and psychosocial characteristics of patients with coronary heart disease (CHD) with different dynamics of cognitive functions in the process of rehabilitation after coronary artery bypass grafting (CABG). A new method for the mathematical determination of cognitive dynamics, namely, the assessment of the improvement and deterioration of cognitive functioning after open-heart surgery was proposed. A total of 118 patients with coronary artery disease were examined. Among them there were 80.5% of men and 19.5% of women; mean age 59.86 ± 7.31 years. The study was conducted using the clinical-psychological method and the developed complex of patho- and neuropsychological methods for assessing various spheres of cognitive functioning. It was shown that patients with worse cognitive dynamics after CABG at the preoperative stage tend to have more frequent atherosclerosis of the brachiocephalic arteries, a complication of the early postoperative period in the form of postpericardiotomy syndrome, as well as burdened heredity of cardiovascular diseases. At the same time, a shorter aortic clamping time and the duration of use of cardiopulmonary bypass was recorded during the surgery in patients with cognitive impairment. A comparative analysis of the psychosocial characteristics of patients indicates significant differences in understanding the causes of the development of the underlying cardiovascular disease and the consequences of CABG in patients of both groups studied: patients with impaired cognitive functioning have a lower treatment adherence (compliance), and they tend to evaluate the upcoming operation as a negative life event.
European Organization of Research and Treatment of Cancer (EORTC) Bone Metastases (BM22), developed by the Quality of Life Assessment Group, is a specialized module of the quality of life questionnaire EORTC QLQ-C30, assessing the quality of life in patients with bone tumors. The aim of the study is to develop its Russian version. The study included a sample of 139 patients with bone tumors — inpatients of N.N. Blokhin Cancer Research Center. The scale has a good convergent validity and internal consistency (0,871), factor analysis confirmed the structure of the scale and its compliance with the original model. The results revealed significant decrease in quality of life due to patients’ focus on pain and its severity. We conclude by drawing out the main directions of psychological aid to patients with bone tumors.
Summary. The current biopsychosocial paradigm in medicine and medical psychology ensures the development of the theory and methodology of medical psychodiagnostics as a comprehensive study of psychological and psychosocial factors underlying mental adaptation. The diagnostic of prenosological and initial manifestations of borderline spectrum disorders designated as adjustment disorders in ICD-10 (F43.2), requires the criteria qualification of real or potential stressogenic social functioning conditions, thus, an arsenal of adequate methods of clinical and medical-psychosocial psychodiagnostics is required. The questionnaire «Social Frustration Level» represents one of such methods. The study of social frustration phenomenon as a predictor of emotional tension and stress resistance allows to characterize personality traits in relation to environmental influence and assess the specificity and pathogenic significance of socially frustrating factors. The article substantiates theoretical and methodological foundations of the questionnaire, its attributive characteristics — the phenomena of external and internal social frustration identified in medical psychodiagnostics for the first time. Socio-diagnostic criteria are illustrated by examples of the practical use in medical psychodiagnostics of social frustration in teachers of mass schools, the military and in patients with focal epilepsy. The specified research contingent is united by the problem of stress resistance in crisis situations (including a disease situation and the attitude to the disease). The questionnaire «Social Frustration Level» can be considered as a necessary form of psychosocial diagnostics of stress genesis, a source of information in screening psychoprophylactic studies, as well as in the forming of indications for psycho- and sociotherapy.
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