稳定性缺血性心脏病与冠状动脉搭桥术患者心理状态参数的动态变化

A. Solodukhin, O. Trubnikova, O. Barbarash
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引用次数: 0

摘要

的目标。冠心病患者行冠状动脉搭桥术(CABG)的心理状态参数评价与分析材料与方法。对58例40 ~ 74岁男性冠心病稳定患者在冠脉搭桥手术前后的心理状态参数,特别是对疾病的态度、应对策略和终身取向进行了研究。这些参数由临床心理学家在患者入院后2-3天和CABG后7-8天进行评估。临床和心理诊断使用以下问卷进行:TOBOL (L.I. Wasserman等人),“生活目标取向”(d.a ontiev),“应对行为策略”(r.l azarus,改编自T.A. Kryukova)。采用计算机Statistica 10.0软件进行统计分析。结果。冠状动脉疾病患者冠脉搭桥后,基于TOBOL问卷的疾病内部图景焦虑变体、基于压力应对行为评估的“积极再评估”应对策略、基于“生活目的”测试的神经化水平评估的“目标”量表水平均显著降低。结论。研究结果表明,冠状动脉疾病患者在冠状动脉搭桥后,由于行为障碍和难以制定进一步的康复目标,对疾病的适应水平降低。为提高术后适应能力,心理矫正措施可“针对性地”针对冠脉搭桥术后阶段的“积极再评价”应对策略,并协助设定目标。
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Dynamics of parameters of psychological status of patients with stable ischemic heart disease and coronary artery bypass surgery
Aim. Assessment and analysis of parameters of psychological status of patients with coronary heart disease (CHD) referred for coronary artery bypass surgery (CABG). Materials and Methods . A study of parameters of psychological status, in particular, of the attitude to illness, coping strategies, and lifelong orientations was conducted in 58 male patients aged 40 to 74 years with a stable form of CHD before and after CABG surgery. The parameters were evaluated by a clinical psychologist in 2-3 days after admission of the patient to the hospital and in 7-8 days after CABG. Clinical and psychological diagnostics was carried out using the following questionnaires: TOBOL (L.I. Wasserman, et al.), «Life-Purpose Orientations» (D.A. Leontiev), «Coping Behavior Strategies» (R. Lazarus, adapted version of T.A. Kryukova). Statistical analysis was performed with use of computer Statistica 10.0 software program. Results . After CABG patients with coronary artery disease show a significant reduction of the parameters of the anxious variant of the internal picture of the disease on the basis of TOBOL questionnaire, of the «positive re-evaluation» coping strategy on the basis of evaluation of stress-coping behavior and of the level of «Aim» scale on the basis of evaluation of the level of neurotization using the «Life-Purpose» test. Conclusion . The results of the study indicate reduction of the level of adaptation to the disease in patients with coronary artery disease after CABG in result of behavioral disorders and difficulties in setting further aims for recovery. To increase postoperative adaptation, the psychocorrection measures may be «targeted» to the coping strategy for «positive re-evaluation» and assistance in setting aims in the postoperative stage of CABG.
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