Relationship of psychological characteristics of the perception of illness and the coping strategies of patients with coronary artery disease with the indicators of their purpose-in-life orientation

Aim. To study the relationship of the perception of illness and coping strategies in patients with ischemic heart disease before coronary artery bypass grafting with purpose in life orientation. Methods. The study included 108 males aged 45 to 73 years with a diagnosis of ischemic heart disease. Clinical and psychological diagnostics included the study of the patient's perception of illness using the Personal Questionnaire of the Bekhterev Institute, the coping strategies were assessed with the Ways of Coping scale developed by Lazarus and Folkman. To study the purpose in life orientation (formation of goals in life, the level of self-realization of a person, meaningfulness and saturation of life in the past and present, plans for the future), the «Purpose-in-Life Test» by D.A. Leont'ev was used. Results. The study showed the predominance of adaptive variants of the perception of illness and moderate use of both productive and unproductive coping strategies in the studied group, as well as the preservation of aims and guidelines for the future in the situation of preparing for coronary bypass surgery. A positive relationship was found between the indicators of general meaningfulness of life, dedication, satisfaction with the process of activity and achievement of results with the indicators of adaptive variants of the perception of illness and productive coping behavior. Low levels of overall meaningfulness of life, inability to set goals and achieve them, as well as lack of satisfaction from past events, are associated with high rates of maladaptive variants of the perception of illness and the choice of unproductive coping strategies. Conclusion. A high level of purpose in life orientation in patients with ischemic heart disease can lead to the formation of adaptive variants of the perception of illness variants and productive coping strategies, whereas a low level of purpose in life orientation probably leads to the risks of the formation of maladaptive perception of illness variants and coping strategies

ПОВЕДЕНЧЕСКИЕ ОСОБЕННОСТИ ПАЦИЕНТОВ, ПЛАНИРУЕМЫХ НА КОРОНАРНОЕ ШУНТИРОВАНИЕ

Aim. To assess attitude of patients to coronary arthe in-hospital settings and determining coping stratetery disease (CAD) for evaluating their adaptation to gies used to overcome surgery-related stress.Materials and methods. 132 male patients (the mean age 61 years) with stable coronary artery disease were included in the study. All patients underwent the assessmentof psychological status performed by clinical psychologists in the preoperative period. The subjective assessment of patients’ psychological state and attitude to the disease was evaluated using the A.E. Lichko questionnaire. The Lazarus “Ways of Coping” questionnaire was used to determine behavioral strategies for coping with stress. Patients’ responsibility for their somatic symptoms was assessed using the health scale “Level of Subjective Control”. Psychological testing was performed on days 5-7 before CABG.Results. Harmonious, ergopathicand anosognostic types of attitude to the diseaseprevailed in the study group. 114 (80%) patients had a combination of two or more types of attitude to the disease. Harmonious and ergopathic types of attitude were commonly com bined with other types of attitude to the disease (n=96, 73%). The assessment of the subjective level of control reported that internal locus of control was found in 36 patients (27%) and externallocus of control in96 patients (73%). The assessment of coping-strategies showed that 79 (60%) patientsrarely used stress-coping strategies. Moreover, 6 patients (5%) did not use any coping strategies.Conclusion. Harmonious, ergopathic and anosognostic types of attitude to the disease prevailed in patients with coronary artery disease in the preoperative period. Moreover, external locus of control and the rare use of stress-coping strategies in these patients suggested the need for comprehensive medical and psychological support that should be intriduced in the in-hospital setting.Цель. Изучение типа отношения к болезни у па-циентов с ишемической болезнью сердца (ИБС) для определения особенностей адаптации к стационарным условиям и выявления способов преодоления такой стрессовой ситуации, как предстоящее оперативное вмешательство.Материалы и методы. В исследование включены 132 пациента-мужчин со стабильной формой ИБС, (средний возраст 61 год).Оценка психологического статуса пациентов осуществлялась клиническим психологом на предварительном этапе подготовки к КШ. Для диагностики субъективной оценки пациентом своего психологического состояния и отношения к заболеванию использовался опросник «Тип отношения к болезни по А.Е. Личко», для определения стратегий поведения в стрессовых ситуациях и способов их преодоления опросник «Способы совладающего поведения» Лазаруса, для определения ответственности пациента за свое соматическое состояние использовалась шкала здоровья теста «Уровень субъективного контроля». Психологическое тестирование проводилось за 5-7 дней до предстоящей операции.Результаты. В исследуемой группе пациентов было выявлено преобладание гармоничного, эргопатического и анозогностического типов отношения к болезни. Преобладающее количество пациентов имели сочетание двух и более типов отношения к болезни, что наблюдается у 114 (80%) пациентов. Больше всего комбинаций наблюдается у гармоничного и эргопатического типа с другими типами отношения к болезни 96 (73%). При исследовании уровня субъ-ективного контроля в отношении здоровья интернальный локус контроля наблюдался у 36 пациентов (27 %) и экстернальный локус контроля наблюдался у 96 пациентов (73%). Исследование копинг-стратегий выявило, что 79 (60%) пациентов относились к группе с редким использованием стратегий преодоления стрессовых ситуаций. Редкое использование всех копинг-стратегий наблюдалось у 6 пациентов (5%).Заключение. Поведенческие особенности пациентов с ИБС на этапе подготовки к КШ характеризуются гармоничным, эргопатическим и анозогнозическим типами отношения к болезни, преимущественно экстернальным локусом контроля и преобладанием редкого использования копинг-стратегий, что требует комплексного медико-психологического сопровождения

Features of professional and personal orientation of the teacher

In the modern Russian society, which is in the process of reforming education, more than ever the professional activity and personal maturity of the teacher is claimed. In connection with this problem a great debate about professional and personal features of the teacher takes place, that provide the efficiency of its operations and development. The main objective of the article consists in theoretical substantiation of the phenomenon of professional-personal orientation and empirical study of the peculiarities of the professionalpersonal orientation of the teacher. In the process of the research the following method were used: theoretical (analysis and synthesis of philosophical, psychology and pedagogical of methodological researches on orientation; phenomenological analysis); empirical methods (tests, questionnaires) and methods of interpretation of the results. The Individually-typological features of professional and personal orientation of the teacher are identified. The effective types are defined which corresponding to the functional level of a professional and personal orientation (generative, self-actualization, subjective), and the types needing in the optimization (manipulative and dependent, compensatory, formal and productive, communicative, egocentric, administrative) which belong to pre-functional and dysfunctional levels of the professional and personal orientation. The materials presented in this present article can be used in support of professional development of teachers, in the course of implementation of programs of the higher professional and postgraduate education, and also at professional development and professional retraining of teachers. © 2018 Transilvanian Association for the Literarure and Culture of Romanian People (ASTRA)

Features of professional and personal orientation of the teacher

In the modern Russian society, which is in the process of reforming education, more than ever the professional activity and personal maturity of the teacher is claimed. In connection with this problem a great debate about professional and personal features of the teacher takes place, that provide the efficiency of its operations and development. The main objective of the article consists in theoretical substantiation of the phenomenon of professional-personal orientation and empirical study of the peculiarities of the professionalpersonal orientation of the teacher. In the process of the research the following method were used: theoretical (analysis and synthesis of philosophical, psychology and pedagogical of methodological researches on orientation; phenomenological analysis); empirical methods (tests, questionnaires) and methods of interpretation of the results. The Individually-typological features of professional and personal orientation of the teacher are identified. The effective types are defined which corresponding to the functional level of a professional and personal orientation (generative, self-actualization, subjective), and the types needing in the optimization (manipulative and dependent, compensatory, formal and productive, communicative, egocentric, administrative) which belong to pre-functional and dysfunctional levels of the professional and personal orientation. The materials presented in this present article can be used in support of professional development of teachers, in the course of implementation of programs of the higher professional and postgraduate education, and also at professional development and professional retraining of teachers. © 2018 Transilvanian Association for the Literarure and Culture of Romanian People (ASTRA)

Worries and Fears in the System of Attitudes to Personal Security of Patients with Cardiovascular Diseases

This paper presents the results of studying the psychological aspects of attitudes to personal security of patients with coronary artery disease (CAD) and heart defects. The research involved 40 patients aged 45 to 81 years (47.5 % male, 52.5 % female): 20 patients with ischemic heart disease with stable angina and 20 patients with acquired heart defects. In the course of the research conducted with the help of the techniques based on subjective scaling, the attitudes to personal security, including the sources of threats, the consequences of the realization of threats and the assessment of efforts on the counteraction to these threats, posing in the author’s theoretical model as the components of the system of the attitudes to personal security, have been studied. The results show that in the patients with heart diseases, the assessments for a variety of threats, the consequences of their realization and the efforts on the counteraction to them are significantly higher, than in the patients with CAD. In general, the estimates for all the parameters in the group of the patients with CAD were closer to the estimates of healthy people, obtained in the previous studies. In the patients with heart defects, characterized by a greater duration and disease severity, the results of the indicators of the attitudes to personal security, in general, are higher and less differentiated. The conclusion is made that the attitudes to personal security as a part of the system of the psychological attitudes in general, can act as a diagnostic criterion and the indicator of the efficiency of the adaptation in cardiovascular diseases and also can be an independent target of the correctional work in a psychological consultation and psychotherapy of the patients with cardiovascular diseases. In the conclusion the recommendations for the experts who are engaged in the psychological help to the patients with cardiovascular diseases in diagnostic and correctional work with the attitudes to personal security are formulated

THE RELATIONSHIP BETWEEN PSYCHOLOGICAL CHARACTERISTICS OF THE ATTITUDE TO THE DISEASE, COPING BEHAVIOR OF PATIENTS WITH ISCHEMIC HEART DISEASE, AND THEIR COGNITIVE STATUS

The paper presents the study of the relationship between the attitude to the disease, coping behavior of patients with coronary heart disease prior to coronary bypass grafting (CABG), and indicators of cognitive status. Bekhterev Institute Personality Questionnaire, Ways of Coping Behavior test by R. Lazarus, Mini-Mental State Examination scale, Frontal Dysfunction Battery test, and Clock- Drawing test were used in the study. The sample included 132 patients. The results of study show that in patients with coronary artery disease prior to CABG the most frequently observed type of attitude to the disease is either the harmonious type or a combination of harmonious and ergopathic types. Confrontation, Distancing, and Problem Solution Planning were identified as the preferred coping strategies. Correlation analysis revealed positive associations between cognitive status and harmonious, ergopathic, and hypochondriac types of attitude to the disease, and negative associations between cognitive status and anosognostic and sensitive types of attitude to the disease. Furthermore, positive correlations between cognitive status and Confrontation, Self-control, Responsibility taking, Problem Solution Planning, Positive revaluation coping strategies and negative correlations between cognitive status and Distancing and Escape-avoidance coping strategies were found. The results of this study will help to improve the level of diagnostic and rehabilitation psychological care of patients with coronary artery disease in preparation for CABG

ОПЫТ ПРИМЕНЕНИЯ ЭВАКУАЦИОННО-СПАСАТЕЛЬНОГО КОНТЕЙНЕРА В ХОДЕ УЧЕНИЙ КОРАБЛЕЙ БАЛТИЙСКОГО ФЛОТА

A large number of people need medical care at sea, not only in war but also in peacetime. In terms of peaceful navigation, despite the improved reliability of vessels and the advancement of navigation techniques, shipwrecks and damage of the equipment occur which lead to the need for marine medical specialists to be provided with medical assistance and evacuated to the places of medical assistance. One of the factors of the success of medical care is the speedy transfer of the wounded and sick from the ship to the means of medical evacuation. However, the open sea dictates its difcult conditions in which it is necessary to transfer the injured. Aggravating factors, such as severe weather conditions, sea waves, design features of ships, can significantly affect the timeliness of medical care. The experience gained during the actual and training rescue operations strongly shows that rescue of people at sea is an extremely difcult and demanding task, the success of which requires constant readiness of the forces and means of the search and rescue service, as well as personnel involved in rescue operations. The aim of the study was to assess the possibility of using an evacuation rescue container for the transfer of wounded, sick, injured, cargo from ship to ship in the open sea. The article presents the result of the use of the container evacuation and rescue in the open sea. Rules for the use of evacuation and transport container and typical difculties that may arise in the transfer of the wounded (patient) with the use of this container are described.В медицинской помощи на море нуждается значительное число людей не только в военное, но и в мирное время. В условиях мирного судоходства, несмотря на повышение надежности судов и совершенствование техники мореплавания, происходят кораблекрушения, аварии кораблей и поломки материальной части, которые приводят к необходимости оказания морским специалистам медицинской помощи и эвакуации пострадавших к местам оказания медицинской помощи. Одним из факторов успешности оказания медицинской помощи является скорейшая передача раненых и больных с корабля на средства медицинской эвакуации. Однако открытое море диктует свои сложные условия, в которых приходится осуществлять передачу пострадавших. Отягчающие факторы, такие как тяжелые погодные условия, волнение моря, конструктивные особенности кораблей, могут значительно повлиять на своевременность оказания медицинской помощи. Опыт, накопленный при проведении фактических и тренировочных спасательных работ, убедительно свидетельствует, что спасение людей на море является чрезвычайно сложной и ответственной задачей, для успешного выполнения которой требуется постоянная готовность сил и средств поисково-спасательной службы, а также личного состава привлекаемого к выполнению спасательных работ. Целью исследования была оценка возможности использования эвакуационного спасательного контейнера для передачи раненых, больных, пораженных, грузов с корабля на корабль в условиях открытого моря. В статье представлен результат применения эвакуационноспасательного контейнера в условиях открытого моря. Описаны правила использования и типовые трудности, которые могут возникнуть при передаче раненого (больного) с использованием эвакуационно-транспортного контейнера.</p