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• W83619796 abstract "IntroductionRecent studies provide clear andconvincing evidence that such psychological factors as depression, anxiety,personality factors, social isolation, and chronic life stress contribute greatlyto the pathogenesis and expression of coronary artery disease (CAD) (Rosancki,Blumenthal, Kaplan, 1999, Sokolova, Nikolaeva, 1995). The pathophysiologicalmechanism by which these factors promote CAD includes 1) behavioral and 2)direct pathophysiological effects (Rosancki, Blumenthal, Kaplan, 1999). Sincethere is plenty of information on this part of the problem, we will turn ourattention straight to the situation of open heart surgery.By and large, there are severaltreatment choices to consider in a patient with significant CAD disease:medication, bypass surgery, angioplasty, or combination of these (Laurence,2002). If the treatment were simple and without potentially adverse effects,the decision on treatment would be simple. But the reality is more complicated.Bypass surgery is by far the most traumatic, as it involves surgery andanesthesia, a long recovery period, and potential complications (Bokeria, 2010,Laurence, 2002). It can fail, prove ineffective, or even result in death. Uncertaintyis the hardest part of experiencing illness.Although the cardiologist decides onthe best treatment in every situation, the patient takes his share ofresponsibility in agreeing to the surgery. Even when the best treatment choiceis obvious for the physician, it can be unacceptable to the patient, who fearshospitalization, pain, or has a friend whose outcome from similar treatment waspoor. In such a situation, the biopsychosocial view of illness and the role ofthe psychologist who can help identify the problem is very important.The situation of open heart surgeryconsists of a patient's subjective perception of what medics do and say, aprognosis of the surgery outcome, and many other factors which take on asecondary psychosemantic meaning. Inadequate implicit concepts of forthcomingsurgery can produce respective somatic sensations and, on the contrary, realsomatic sensations can be wrongly identified by the patient (Thostov, 2002).Models of negative surgery outcomes can cause a negative placebo affect (noceboeffect). A nocebo effect is an ill effect caused by the suggestion or beliefthat something is harmful.When a patient faces the necessity ofopen heart surgery (coronary artery by- pass for CAD patients) he finds himselfin a terrifying situation with an unknown outcome. The threat for his bodyimage, life risk, pain, and helplessness stir up many feelings.Recent studies show that depressionand anxiety symptoms common for CAD patients worsen the outcomes of cardiacsurgery (Allen, Becker, 1990; Appels, Mulder, 1988; Atrinian, 1991; Berron,1986; Blumental, 1988, 2003; Connerney, 2010; Contrada, 2008; Cserep, 2010,Gallagher, 2007; Hoyer, 2008; Pigney-Demaria, 2003; Rozancki, 1999;Rymaszewska, 2003; Viars, 2009, Zaitsev, 1997). In such a situation,psychological support is very necessary.Patients stay in hospital for only afew days before the surgery, so there is not much time for deep psychologicalintervention. This means that identifying the main targets for psychologicalhelp is very important.We suggest that the negative attitudeof patients towards forthcoming open heart surgery is associated with theadverse postsurgical period. The type of attitude towards forthcoming openheart surgery determines illness behavior, compliance, and coping strategies.Assistance in modeling adequate expectations from surgical treatment should beone of the targets of psychological maintenance in the perioperative period.Method120 patients (44% female) with CAD,scheduled for open heart surgery, volunteered for the study (the study group).The mean age was 48±13. NYHA class -- II-III.The control group consisted of 35people (45% females) without somatic and mental disorders.Patients from the study group wereinterviewed and asked to fill in questionnaires the day before heart surgery,and one week afterwards. …" @default.
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• W83619796 date "2013-01-01" @default.
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• W83619796 title "Psychological factors and outcomes of coronary surgery" @default.
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• W83619796 doi "https://doi.org/10.11621/pir.2013.0414" @default.
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