Results of Audiovisual Stimulation and Psychotherapy in Psychological Correction of Emotional Disorders in Patients in the Late Recovery Period after an Ischaemic Stroke: a Prospective Randomized Study

O. Odarushchenko, A. Kuzyukova, Margarita B. Nuvakhova, O. V. Yurova, M. Yakovlev
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Abstract

INTRODUCTION. Emotional and personality disorders that occur in patients after a stroke have a negative impact on the rehabilitation process, reducing its effectiveness, disrupting the motivation for treatment and quality of life. Today, comprehensive rehabilitation programs for patients in the late recovery period after acute cerebrovascular accident, aimed at psychological correction of emotional disorders, are becoming relevant. AIM. To study the effectiveness of audiovisual stimulation and techniques of rational-emotive and body-oriented psychotherapy on the emotional state of patients in the late recovery period after an ischaemic stroke. MATERIALS AND METHODS. The study included 40 patients after an acute cerebrovascular accident (ACVA) in the late recovery period (from 6 months to 2 years after ACVA) aged between 45 and 75 years, average age 61.6 [53.95; 68.1]. The patients were randomized into two groups. The main group included patients (n = 20 people, of which 7 men, 13 women, age — 62.09 [53.5; 68.6] years), who underwent a complex basic rehabilitation program, including audiovisual stimulation and psychotherapy techniques; the control group included patients (n = 20, including 6 men, 14 women, age — 61.1 [54.4; 67.5] years) who underwent a basic rehabilitation program. For psychological diagnostics, the Hospital Anxiety and Depression Scale (HADS) and the author’s computer program were used to study the current emotional state. The statistical significance of differences before and after the treatment was determined using the nonparametric Wilcoxon test. To assess the statistical comparability of the two groups, the Mann-Whitney test was used (p 0.05). RESULTS. The use of audiovisual stimulation and techniques of rational-emotive and body-oriented psychotherapy in the psychological correction of emotional disorders in patients in the late recovery period after an ischemic stroke allows us to achieve a statistically significant effect in reducing state and trait anxiety, the level of chronic fatigue, as well as increasing the subjective comfort and quality of life (p 0.05). DISCUSSION. The study showed that patients in the late recovery period after a stroke before treatment experienced high levels of anxiety and depression and experienced a severe psycho-emotional stress. As a result of audiovisual stimulation and psychotherapy techniques, indicators of the negative emotional state of patients in the late recovery period after an ischemic stroke significantly decreased, mood improved, activity and tolerance to psychological stress increased. CONCLUSION. A comprehensive rehabilitation of patients in the late recovery period after a stroke, aimed at psychological correction of emotional disorders, significantly improved the emotional background, increased tolerance to psychological stress, and also contributed to increased motivation for restorative treatment and rehabilitation.
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视听刺激和心理疗法对缺血性脑卒中晚期恢复患者情绪障碍的心理矫正效果:一项前瞻性随机研究
引言。中风后患者出现的情绪和人格障碍会对康复过程产生负面影响,降低康复效果,破坏治疗动机和生活质量。如今,针对急性脑血管意外后晚期康复期患者的综合康复计划,旨在对情感障碍进行心理矫正,正变得越来越重要。目的研究视听刺激以及理性-情感和躯体导向心理治疗技术对缺血性脑卒中后期恢复期患者情绪状态的影响。研究对象包括 40 名处于恢复后期(急性脑血管意外后 6 个月至 2 年)的急性脑血管意外(ACVA)患者,年龄在 45 岁至 75 岁之间,平均年龄为 61.6 [53.95; 68.1]。患者被随机分为两组。主组包括患者(n = 20 人,其中男性 7 人,女性 13 人,年龄 - 62.09 [53.5; 68.6] 岁),他们接受了复杂的基础康复计划,包括视听刺激和心理治疗技术;对照组包括患者(n = 20 人,其中男性 6 人,女性 14 人,年龄 - 61.1 [54.4; 67.5] 岁),他们接受了基础康复计划。在心理诊断方面,采用了医院焦虑抑郁量表(HADS)和作者的计算机程序来研究患者当前的情绪状态。治疗前后差异的统计学意义采用非参数 Wilcoxon 检验。为了评估两组的统计可比性,采用了曼-惠特尼检验(P 0.05)。结果在缺血性脑卒中后期恢复期患者情绪障碍的心理矫治中使用视听刺激和理性动机与身体导向心理治疗技术,在降低状态和特质焦虑、慢性疲劳水平以及提高主观舒适度和生活质量方面取得了统计学意义上的显著效果(P 0.05)。讨论。研究表明,中风患者在治疗前的恢复后期会出现高度焦虑和抑郁,并承受严重的心理情感压力。通过视听刺激和心理治疗技术,缺血性脑卒中后期恢复期患者的负性情绪指标明显下降,情绪得到改善,活动能力和对心理压力的耐受力增强。结论对脑卒中后期恢复期患者进行综合康复治疗,旨在对情绪障碍进行心理矫正,能明显改善患者的情绪背景,提高对心理压力的耐受力,同时也有助于提高恢复性治疗和康复的积极性。
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