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Attitude to the disease in the early postoperative period in elderly patients with open heart surgery

Authors: Kurilovich A.N., Smagina S.S., Dzhitava T.G., Filaretova O.V., Filatova A.G., Pachuashvili N.V., Shamsiev G.A.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2024-18-4-483-493

For citation: Kurilovich A.N., Smagina S.S., Dzhitava T.G., Filaretova O.V., Filatova A.G., Pachuashvili N.V., Shamsi- ev G.A. Attitude to the disease in the early postoperative period in elderly patients with open heart surgery. Creative Cardiology. 2024; 18 (4): 483–493 (in Russ.). DOI: 10.24022/1997-3187-2024-18-4-483-493

Received / Accepted:  10.10.2024 / 04.12.2024

Keywords: cardiac rehabilitation attitude towards the disease internal picture of the disease elderly patients components of the perception of the disease experiencing the threat of the disease

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Abstract

The purpose of the study – to study the attitude towards the disease in elderly patients (over 60 years old) who underwent cardiac surgery under artificial circulation in the early postoperative period.

Material and methods. We examined 60 elderly patients (60–84 years old) with diagnoses of atherosclerotic heart disease, coronary heart disease, aortic stenosis with insufficiency, coronary artery disease angina, mitral valve insufficiency, aortic stenosis with insufficiency, aortic valve disease, rheumatic mitral valve insufficiency.

A review of empirical data from the main areas of medical and psychological research in patients with CVD at various stages of cardiac rehabilitation was conducted and the individual specificity of subjective ideas about the disease was identified in elderly patients with various CVD who underwent open cardiac surgery in the early postoperative period.

Results. In the structure of cognitive ideas about illness, the leading constructs are “Experience of the threat of illness,” “Identification of illness,” and “Perception of the controllability of illness”. Confidence in the controllability of the disease by medical staff is combined with an awareness of the limited possibilities of personal control of the disease – universal subjective ideas of patients about somatic, behavioral, emotional, situational features as possible causes that meaningfully correspond to premorbid psychological risk factors in patients with cardiovascular diseases; the presentation of the disease is inconsistent; the image of the doctor is uncritically positive; attitude towards treatment is associated with an assessment of missed opportunities, the forced duration of treatment and an assessment of varying degrees of satisfaction with treatment; the predominance of an optimistic perception of the future (ranging from “optimal-realistic” to “rosy-unrealistic”); high adherence to treatment and readiness to take any action to overcome the disease; preference for passive stress-overcoming coping (type of coping “passive cooperation”).

Conclusion. At the initial stage of inpatient cardiac rehabilitation, the cognitive concepts of the disease in elderly patients are based on the experience of threat, comprehension of bodily symptoms and awareness of the causes, consequences, duration of the disease; at the same time, the belief in medical control of the disease is combined with awareness of the limited possibilities of personal control of the disease. The revealed high adherence to medical recommendations and the authority of doctors are favorable signs in the prognosis of recovery in elderly patients at an early stage of cardiac rehabilitation.

References

  1. Boсkeria O.L., ShvartsV.A., Sokol’skaya M.A., SatyukovaA.S.The factors influencingthe satisfaction with thetreatmentofcardiosurgicalpatients. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2019; 20 (6): 484–490 (in Russ.). DOI: 10.24022/1810-0694-2019-20-6-484-490
  2. Tkhostov A.Sh. Cultural-historical pathopsychology. Moscow; 2020. (in Russ.).
  3. Pelekh D.M., Nikitina T.G., Gulyan K.S., Filippkina T.Yu., Golukhova E.Z. Assesment of quality of life in the medium-long terms after the correction of valvular heart disease in old-aged patients. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2023; 24 (2): 117–126 (in Russ.). DOI: 10.24022/1810-0694-2023-24-2-117-126
  4. Mobini S., Allahbakhshian A., Shabanloei R., Sarbakhsh P. Illness perception, self-efficacy, and medication adherence in patients with coronary artery disease: a path analysis of conceptual model. SAGE Open Nurs. 2023; 9:23779608231171772. DOI: 10.1177/23779608231171772
  5. Dugunchi F., Mudgal S.K., Marznaki Z.H., Shirafkan H., Abrotan S., Jafarian F., Pourkia R. Levels of adherence to treatment, illness perception and acceptance of illness in patients with coronary artery disease – descriptive and correlational study. BMC Cardiovasc Disord. 2024; 24 (1): 171. DOI: 10.1186/s12872-024-03827-w
  6. Mosleh S.M., Almalik M.M. Illness perception and adherence to healthy behaviour in Jordanian coronary heart disease patients. Eur. J. Cardiovasc. Nurs. 2016; 15(4): 223–230. DOI: 10.1177/1474515114563885
  7. Demchenko T.V., Isaeva E.R. Gerontological aspects of somatic diseases: modern research. Personality in a changing world: health, adaptation, development. 2020; 8 (4): 379–388 (in Russ.). DOI:10.23888/humJ20204379-388
  8. Dubinina E.A. Psychological aspects of rehabilitation of patients who have suffered myocardial infarction. Medical Psychology in Russia. 2018; 10 (2): 1–12 (in Russ.). DOI: 10.24411/2219-8245-2018-12030
  9. Trifonova E.A., Chernoraj A.V., Chumakova I.O. The role of the attitude towards the disease of cardiac patients experiencing a vital threat in shaping the prognosis of their mental adaptation in the post-hospital period. Psychological Science and Education. 2014; 6 (4): 157–168 (in Russ.). DOI: 10.17759/psyedu.2014060414
  10. Esenkova N.Yu. Internal picture of the disease and features of the viability of patients with coronary heart disease who have undergone cardiac surgery. Living Psychology. 2018; 5 (2): 173–180 (in Russ.). DOI: 10.18334/lp.5.2.39226
  11. Chernoraj A.V. Attitude to the disease and treatment of patients with exacerbation of cardiovascular disease at the rehabilitation stage. Izvestia: Herzen Journal of Humanityes and Sciences. 2012; 153:237–242 (in Russ.).
  12. Shtrakhova A.V., Semiryazhko A.V. Features of intraception and internal picture of the disease in patients with painful and painless forms of ischemic heart disease. Bulletin of SUSU. 2015; 8 (2): 43 – 58 (in Russ.).
  13. Thomson P., Rushworth G.F., Andreis F., Angus N.J., Mohan A.R., Leslie S.J.. Longitudinal study of the relationship between patients’ medication adherence and quality of life outcomes and illness perceptions and beliefs about cardiac rehabilitation. BMC Cardiovasc. Disord. 2020; 20(1): 71. DOI: 10.1186/s12872-020-01378-4
  14. Golukhova E.Z. Report on the scientific and clinical activity of Bakoulev National Medical Research Center for Cardiovascular Surgery for 2022 and development prospects. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2024; 25 (Special Issue) (in Russ.). DOI: 10.24022/1810-0694-2024-25S
  15. Pelekh D.M., Nikitina T.G., Filippkina T.Yu., Golukhova E.Z. Predictor of the results of surgical treatment of heart valve defects in elderly and old patients based on their psychofunctional status (state of the issue for 2022). Russian Journal of Thoracic and Cardiovascular Surgery. 2022; 64 (5): 440–451 (in Russ.). DOI: 10.24022/0236-2791-2022-64-5-440-451

About Authors

  • Antonina N. Kurilovich, Cand. Med. Sci.; ORCID
  • Svetlana S. Smagina, Cand. Psychol. Sci., Associate Professor; ORCID
  • Tamara G. Dzhitava, Cand. Med. Sci., Head of Department; ORCID
  • Olga V. Filaretova, Dr. Med. Sci., Researcher; ORCID
  • Angelina G. Filatova, Cardiologist; ORCID
  • Nona V. Pachuashvili, Cand. Med. Sci., Cardiologist; ORCID
  • Gufron A. Shamsiev, Dr. Med. Sci., Cardiac Surgeon; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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