Background. Coronary heart disease (CHD) is a leading cause of disabilities and death. CHD is known to be a multifactorial disease and in the process of complex research, it is important to take into account the role of psychological factors. The presence of gender specificities in the formation and course of cardiovascular diseases determines the need to study the psychological characteristics of men and women with CHD in order to plan and develop prevention and rehabilitation programs.
Objective. The present research is aimed at studying the psychological features in men and women with CHD before coronary artery bypass grafting (CABG) at the stage of preoperative care: 1) the study of asthenic condition in patients with CHD (men and women) during inpatient treatment before CABG; 2) the study of the severity and structure of anxiety in patients with CHD (men and women) before CABG; 3) the study of psychopathological symptoms including depressive manifestations in patients (men and women) before CABG; 4) the study of personality peculiarities in patients with CHD before CABG.
Design. In the course of the present study 60 patients with CHD before CABG were surveyed with a gender distribution of 30 women and 30 men. The study was carried out on the basis of Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation (St. Petersburg, Russia). The average age of patients was 60.9 ± 7.6. The study included the clinical interview and the following methods of psychological testing were used: Asthenic State Scale, Integrative Test of Anxiety (ITT), Symptom Check List-90-Revised, and The Big Five Personality Test.
Results. In women with CHD before CABG, the higher level of asthenia and anxiety (both state and trait) was found as compared with men. Also in women in comparison with male patients higher rates of such manifestations in the structure of their psychological features as “somatization”, “interpersonal sensitivity”, “depression”, “phobic anxiety” were noted. According to the results of the study of personality peculiarities, it was found that among men with CHD the indicator of emotional stability is higher than in women.
Conclusion. It is necessary to take into account the possible variants of a sensitive emotional response which may be more common in women at the stage of impatient treatment before CABG (including such manifestations as anxiety, low mood, emotional sensitivity, asthenia). In accordance with this, during psychocorrectional work, it is important to apply techniques aimed at working with those emotional-negative experiences that may worsen noticeably in connection with the upcoming surgical intervention.
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Keywords: coronary heart disease; coronary artery bypass surgery; anxiety; fatigue; depression; personality traits; psychopathological symptoms;
Available Online 31.12.2019
Table 1. Results of the Integrative Test of Anxiety methodology, stanine
|
Integrative Test of Anxiety Subscale |
Mean Total |
Mean females |
Mean males |
|
Situational anxiety (scale of Situational Anxiety, SA)* |
6.33±2.41 |
7.25±1.65 |
5.4±2.72 |
|
Emotional discomfort (SA) |
6.13±2.56 |
6.55±2.52 |
5.7±2.6 |
|
Asthenic component (SA)* |
6.1±2.4 |
7.5±1 |
4.65±2.56 |
|
Phobic component (SA) |
5.1±2.9 |
5.65±3.27 |
4.5±2.48 |
|
Anxious Perspective Assessment (SA) |
6.13±2.46 |
6.55±2.37 |
5.7±2.54 |
|
Social Protection Reactions (SA)* |
5.58±2.57 |
6.55±2.56 |
4.6±2.23 |
|
Personal Anxiety (scale of Personal Anxiety. PA)* |
6.55±1.77 |
7.55±1.32 |
5.55±1.61 |
|
Emotional discomfort (PA)* |
6.73±1.98 |
7.75±1.41 |
5.7±1.95 |
|
Asthenic component (PA)* |
6.28±2.23 |
7.05±2.14 |
5.5±2.09 |
|
Phobic component (PA) |
5.25±2.08 |
5.85±2.35 |
4.65±1.63 |
|
Anxious Perspective Assessment (PA)* |
6.53±1.89 |
7.4±1.70 |
5.65±1.69 |
|
Social Protection Reactions (PA)* |
5.48±2.25 |
6.6±2.06 |
4.35±1.87 |
* – (р<0.01)
Table 2. Results of Symptom Check List-90-Revised, points
|
Symptom Check List-90-Revised) Subscale |
Mean Total |
Mean females |
Mean males |
|
Somatization (SOM)* |
0.97±0.7 |
1.35±0.66 |
0.6±0.52 |
|
Obsessive-Compulsive (O–C) |
0.94±0.6 |
1.11±0.61 |
0.78±0.56 |
|
Interpersonal Sensitivity (INT)* |
0.85±0.72 |
1.16±0.69 |
0.54±0.61 |
|
Depression (DEP)* |
0.93±0.6 |
1.2±0.6 |
0.66±0.48 |
|
Anxiety (ANX)* |
0.96±0.79 |
1.35±0.78 |
0.57±0.6 |
|
Hostility (HOS) |
0.5±0.49 |
0.36±0.42 |
0.64±0.52 |
|
Phobic Anxiety (PHOB)* |
0.51±0.62 |
0.8±0.73 |
0.21±0.28 |
|
Paranoid Ideation (PAR) |
0.34±0.33 |
0.4±0.39 |
0.28±0.25 |
|
Psychoticism (PSY) |
0.23±0.21 |
0.24±0.2 |
0.22±0.22 |
|
Global Severity Index (GSI)* |
0.68±0.43 |
0.86±0.42 |
0.5±0.37 |
|
Positive Symptom Distress Index (PSDI) |
1.33±0.65 |
1.53±0.61 |
1.13±0.65 |
|
Positive Symptom Total (PST)* |
37.3±14.1 |
43.65±12.93 |
30.95±12.5 |
* – (р<0.01)
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