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

К проблеме выбора коррекционных компьютерных программ для восстановления когнитивных функций у пациентов кардиологического профиля

Introduction. The present review aims to examine computer programs used in psycho-correctional practice for cognitive rehabilitation of cardiac patients. Currently, there is a high prevalence of cognitive disorders among the elderly population in Russia. The disease has an impact on cognitive functioning of cardiac patients, which leads to difficulties in social adjustment and reduces their quality of life. In this regard, assessing the performance of existing computer programs for cognitive rehabilitation of cardiac patients is important. Theoretical Basis. This paper presents an overview of the main criteria for choosing cognitive rehabilitation programs for patients suffering from cardiac diseases, as well as characteristics of cognitive rehabilitation. The analysis of previous studies enabled the authors to develop a number of recommendations and restrictions for using cognitive rehabilitation programs. Results and Discussion. The authors (a) provide a description of the structure of cognitive impairment in cardiac patients, (b) describe specific patterns of cognitive impairment in cardiac patients, and (c) concentrate on impairments of frontal lobe functions, including goal choice, concentration, and attention switching. The following platforms are currently used for cognitive rehabilitation: Constant Therapy, Cognifit, Brain +, My Aphasia Coach, Lingraphica, Prologue2go, Tactus therapy, Soch Genie, Lumosity, Neuro Nation, Memorado, Wikium, Brain Apps, and B-trainika. When choosing a correctional computer program, it is important to take into account the presence of a flexible system of settings and modular architecture, as well as the possibility of changing the complexity of tasks in accordance with the degree of cognitive impairment in patients. Conclusion. This paper may be of interest to physicians, medical psychologists, defectologists, and programmers when choosing or developing the programs for cognitive rehabilitation of cardiac patients.Введение. Целью обзорной статьи стало изучение используемых в психокоррекционной практике компьютерных программ, направленных на восстановление когнитивных функций у пациентов кардиологического профиля. В настоящее время наблюдается высокая распространенность нарушений когнитивной сферы среди лиц пожилого возраста в российской популяции. В том числе снижение когнитивного функционирования в силу влияния заболевания возникает у пациентов кардиологического профиля, что приводит к проблемам социальной адаптации и снижает их качество жизни. В связи с этим требуется изучение существующих компьютерных программ когнитивной реабилитации для пациентов кардиологического профиля. Теоретическое обоснование. По результатам теоретического обзора представлены основные критерии выбора программ когнитивной реабилитации при работе с пациентами, страдающими кардиологическими заболеваниями, а также особенности восстановления когнитивных функций. На основании анализа российских и зарубежных исследований обозначен ряд рекомендаций и ограничений по применению программ когнитивной реабилитации. Результаты и их обсуждение. По результатам анализа ряда исследований дано описание структуры нарушений когнитивной сферы у пациентов кардиологического профиля. Выделены параметры нарушений когнитивной сферы при кардиологических заболеваниях. Представлено описание нарушений управляющих (лобных) функций: выбора цели, устойчивости внимания, переключаемости. Среди актуальных в настоящее время платформ, используемых для восстановления когнитивных функций, были выделены следующие: Constant Therapy, Cognifit, Brain+, My Aphasia Coach, Lingraphica, Prologue2go, Tactus therapy, Soch Genie, Lumosity, Neuro Nation, Memorado, Wikium, Brain Apps, B-trainika. По результатам исследования указано, что при выборе коррекционной компьютерной программы необходимо учитывать наличие гибкой системы настроек и модульной архитектуры, а также возможности изменения настроек сложности под степень когнитивных нарушений пациента. Заключение. Данная информация может быть полезна врачам, медицинским психологам, дефектологам, программистам при выборе или разработке программ по восстановлению нарушенных когнитивных функций у пациентов кардиологического профиля

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