Email this article 
Dynamics of psychoemotional characteristics in patients with coronary heart disease after coronary artery bypass graft surgery: Russian sampling specifics
- Authors: Velikanov A.A.1, Stoljarova A.A.1, Protasov E.A.1, Zelenskaya I.A.1, Lubinskaya E.I.1
-
Affiliations:
- Almazov National Medical Research Centre
- Issue: Vol 17, No 2 (2020): PERSONALITY AND CHALLENGES OF MODERN SOCIETY
- Pages: 310-329
- Section: CLINICAL PSYCHOLOGY IN CULTURAL DIMENSION
- URL: https://journals.rudn.ru/psychology-pedagogics/article/view/24110
- DOI: https://doi.org/10.22363/2313-1683-2020-17-2-310-329
Cite item
Full Text
Abstract
Coronary artery bypass graft (CABG) is known to be one of the most important surgical methods for treating coronary heart disease (CHD) which significantly reduces mortality and improves the quality of life of patients. In most cases, surgical intervention is a serious lifethreatening event and also a strong stress factor that affects the patient’s mental state. For this reason, there is an urgent need for psychological support for patients with CHD who are preparing for CABG. Therefore, when developing rehabilitation programmes and optimising psychodiagnostic and psychocorrectional measures, it is very important to study the psychoemotional characteristics of patients with CHD prior to CABG surgery. The objective of the present research was to study the dynamics of psychoemotional characteristics (including manifestations of asthenia, anxiety and psychopathological symptoms) in the patients with CHD during their stay in the cardiology hospital prior to CABG surgery. The study used a clinical-psychological method and an experimentalpsychological method, including the “Scale of Asthenic State” (SAS), “Integrative Anxiety Test” (IAT), “Symptom Check List-90-Revised” (SCL-90-R), and the “Big Five Personality Test”. A comparative study of the asthenic state in the patients with CHD before and after myocardial revascularisation during inpatient treatment revealed the presence of a more pronounced asthenic component in the postoperative period as compared with the results obtained at the preoperative stage. The patients with CHD prior to CABG during inpatient treatment had a higher level of anxiety as compared with the postoperative stage, especially regarding the general level of state anxiety, including emotional discomfort and social defence reactions. In the postoperative period, a higher rate of the asthenic component was observed in the structure of state anxiety. A comparative study of the severity of psychopathological symptoms in the patients with CHD prior to CABG surgery and during the postoperative period recorded more intense manifestations of anxiety, obsessiveness and compulsiveness as well as paranoid tendencies before the operation. In the structure of personal characteristics of the patients with CHD during their stay in the cardiology hospital prior to CABG surgery, the lowest indicators, on average, were “Agreeableness” and “Conscientiousness”. The results obtained are crucial for planning psychological intervention for patients with CHD.
About the authors
Arseniy A. Velikanov
Almazov National Medical Research Centre
Author for correspondence.
Email: arsen.velikanov@gmail.com
Ph.D. in Psychology, is Associate Professor, Associate Professor of Human Sciences Department
2 Akkuratova St, Saint Petersburg, 197341, Russian FederationAnna A. Stoljarova
Almazov National Medical Research Centre
Email: anna.stoljarova@gmail.com
psychologist, volunteer
2 Akkuratova St, Saint Petersburg, 197341, Russian FederationEvgeniy A. Protasov
Almazov National Medical Research Centre
Email: akkuratova2@gmail.com
physiotherapist
2 Akkuratova St, Saint Petersburg, 197341, Russian FederationIrina A. Zelenskaya
Almazov National Medical Research Centre
Email: angel_wife@inbox.ru
clinical psychologist
2 Akkuratova St, Saint Petersburg, 197341, Russian FederationEkaterina I. Lubinskaya
Almazov National Medical Research Centre
Email: lubinskaya1@bk.ru
Ph.D. in Medicine, is cardiologist, senior researcher of the Research Laboratory of Rehabilitation
2 Akkuratova St, Saint Petersburg, 197341, Russian FederationReferences
- AbuRuz, M.E. (2019). Pre-operative depression predicted longer hospital length of stay among patients undergoing coronary artery bypass graft surgery. Risk management and healthcare policy, 12, 75–83. https://doi.org/10.2147/RMHP.S190511
- Açıkel, M. (2019). Evaluation of Depression and Anxiety in Coronary Artery Bypass Surgery Patients: A Prospective Clinical Study. Brazilian Journal of Cardiovascular Surgery, 34(4), 389–395. https://doi.org/10.21470/1678-9741-2018-0426
- Ajtahed, S.S., Rezapour, T., Etemadi, S., Moradi, H., Habibi Asgarabad, M., & Ekhtiari, H. (2019). Efficacy of neurocognitive rehabilitation after coronary artery bypass graft surgery in improving quality of life: An interventional trial. Frontiers in psychology, 10, 1759. https://doi.org/10.3389/fpsyg.2019.01759
- Alekseevich, G.Yu., Rodikov, M.V., Marchenko, A.V., Myalyuk, P.A., & Alekseevich, G.V. (2017). An analysis of postoperative cognitive dysfunction in different methods of coronary artery bypass. S.S. Korsakov Journal of Neurology and Psychiatry, 117(7), 16–20. https://doi.org/10.17116/jnevro20171177116-20 (In Russ.)
- Amiri, M.J., Sadeghi, T., & Negahban Bonabi, T. (2017). The effect of natural sounds on the anxiety of patients undergoing coronary artery bypass graft surgery. Perioperative Medicine (London, England), 6(1). https://doi.org/10.1186/s13741-017-0074-3
- Bagheri Nesami, M., Shorofi, S.A., Jafari, A., Khalilian, A.R., & Ziabakhsh Tabari, S. (2016). The Relationship between stressors and anxiety levels after CABG in Sari, Iran. Iranian Red Crescent Medical Journal, 18(5), e25407. https://doi.org/10.5812/ircmj.25407
- Belyalov, F.I. (2017). Depression, anxiety and stress in patients with coronary heart disease. Therapeutic Archive, 89(8), 104–109. https://doi.org/10.17116/terarkh2017898104-109 (In Russ.)
- Benjamin, E.J., Muntner, P., Alonso, A., Bittencourt, M.S., Callaway, C.W., Carson, A.P., Chamberlain, A.M., et al. (2019). Heart Disease and Stroke Statistics – 2019 At-aGlance: On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2019 update: a report from the American Heart Association. Circulation, 139(10), e56–e528. https://doi.org/10.1161/CIR.0000000000000659
- Bizyuk, A.P., Wasserman, L.I., & Iovlev, B.V. (2005). Primenenie integrativnogo testa trevozhnosti (ITT) [The Application of the Integrative Test of Anxiety]: Methodic Recommendations. Saint Peterburg: V.M. Bekhterev SPb NIPNI Publ. (In Russ.)
- Blumenthal, J.A., Feger, B.J., Smith, P.J., Watkins, L.L., Jiang, W., Davidson, J., Hoffman, B.M., Ashworth, M., Mabe, S.K., Babyak, M.A., Kraus, W.E., Hinderliter, A., & Sherwood, A. (2016). Treatment of anxiety in patients with coronary heart disease: Rationale and design of the understanding the benefits of exercise and escitalopram in anxious patients with coronary heart disease (UNWIND) randomized clinical trial. American Heart Journal, 176, 53–62. https://doi.org/10.1016/j.ahj.2016.03.003
- Botzet, K., Dalyanoglu, H., Schäfer, R., Lichtenberg, A., Schipke, J.D., & Korbmacher, B. (2018). Anxiety and depression in patients undergoing mitral valve surgery: A prospective clinical study. The Thoracic and Cardiovascular Surgeon, 66(07), 530–536. https://doi.org/10.1055/s-0037-1604461
- Celano, C.M., Daunis, D.J., Lokko, H.N., Campbell, K.A., & Huffman, J.C. (2016). Anxiety disorders and cardiovascular disease. Current Psychiatry Reports, 18(11), 101. https://doi.org/10.1007/s11920-016-0739-5
- Chauvet-Gelinier, J.C., & Bonin, B. (2017). Stress, anxiety and depression in heart disease patients: A major challenge for cardiac rehabilitation. Annals of Physical and Rehabilitation Medicine, 60(1), 6–12. https://doi.org/10.1016/j.rehab.2016.09.002
- Correa-Rodríguez, M., Abu Ejheisheh, M., Suleiman-Martos, N., Membrive-Jiménez, M.J., Velando-Soriano, A., Schmidt-RioValle, J., & Gómez-Urquiza, J.L. (2020). Prevalence of depression in coronary artery bypass surgery: A systematic review and meta-analysis. Journal of Clinical Medicine, 9(4), pii: E909. https://doi.org/10.3390/jcm9040909
- Derogatis, L.R. (1992). SCL-90-R: Administration, Scoring of Procedures Manual – II for the Revised Version and Other Instruments of the Psychopathology Rating Scale Series. Towson, MD: Clinical Psychometric Research Incorporated.
- Goldstein, C.M., Gathright, E.C., & Garcia, S. (2017). Relationship between depression and medication adherence in cardiovascular disease: The perfect challenge for the integrated care team. Patient Preference and Adherence, 11, 547–559. https://doi.org/10.2147/PPA.S127277
- Hernández-Palazón, J., Fuentes-García, D., Falcón-Araña, L., Roca-Calvo, M.J., BurguillosLópez, S., Doménech-Asensi, P., & Jara-Rubio, R. (2018). Assessment of Preoperative Anxiety in Cardiac Surgery Patients Lacking a History of Anxiety: Contributing Factors and Postoperative Morbidity. Journal of Cardiothoracic and Vascular Anesthesia, 32(1), 236–244. https://doi.org/10.1053/j.jvca.2017.04.044
- Kidd, T., Poole, L., Ronaldson, A., Leigh, E., Jahangiri, M., & Steptoe, A. (2016). Attachment anxiety predicts depression and anxiety symptoms following coronary artery bypass graft surgery. British Journal of Health Psychology, 21(4), 796–811. https://doi.org/10.1111/bjhp.12191
- Neumann, F., Sousa-Uva, M., Ahlsson, A., Alfonso, F., Banning, A.P., Benedetto, U., Byrne, R.A., Collet, J., Falk, V., Head, S.J., Jüni, P., Kastrati, A., Koller, A., Kristensen, S.D., Niebauer, J., Richter, D.J., Seferović, P.M., Sibbing, D., Stefanini, G.G., Windecker, S., Yadav, R., & Zembala, M.O. (2019). ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal, 40(2), 87–165. https://doi.org/10.1093/eurheartj/ehy394
- Nikolaev, E.L., & Lazareva, E.Yu. (2015). Psychotherapy and psychological intervention for patients with cardiovascular diseases. The Bulletin of Chuvash Psychiatry and Psychology, 11(1), 57–76. (In Russ.)
- Pervin, L., & John, O. (2001). Personality: Theory and Research. Мoscow: Aspect-Press. (In Russ.) Piepoli, M.F., Hoes, A.W., Agewall, S., Albus, C., Brotons, C., Catapano, A.L., et al. (2016).
- European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European Heart Journal, 37(29), 2315–2381. https://doi.org/10.1093/eurheartj/ehw106
- Poole, L., Ronaldson, A., Kidd, T., Leigh, E., Jahangiri, M., & Steptoe, A. (2017). Pre-surgical depression and anxiety and recovery following coronary artery bypass graft surgery. Journal of Behavioral Medicine, 40(2), 249–258. https://doi.org/10.1007/s10865-0169775-1
- Prado-Olivares, J., & Chover-Sierra, E. (2019). Preoperatory anxiety in patients undergoing cardiac surgery. Diseases, 7(2), 46. https://doi.org/10.3390/diseases7020046
- Prokhorov, A.O. (2004). Methods of diagnosis and measurement of individual mental states. Moscow: PER SE Publ. (In Russ.)
- Ramesh, C., Nayaka, B.S., Paib, V.B., Georgea, A., Georgea, L.S., & Devi, E.S. (2017). Preoperative anxiety in patients undergoing coronary artery bypassgraft surgery – A crosssectional study. International Journal of Africa Nursing Sciences, 7, 31–36. https://doi.org/10.1016/j.ijans.2017.06.003
- Ravven, S., Bader, C., Azar, A., & Rudolph, J.L. (2013). Depressive symptoms after CABG surgery: a meta-analysis. Harvard Review of Psychiatry, 21(2), 59–69. https://doi.org/10.1097/HRP.0b013e31828a3612
- Sadeghi, M., Hashemi, M., Sararoudi, R.B., Merasi, M.R., Molaeinezhad, M., & Shamsolketabi, H. (2017). Demographic and psychological predictors of recovery from coronary artery bypass graft. Journal of Education and Health Promotion, 6, 92. https://doi.org/10.4103/jehp.jehp_154_16
- Shamsaei, F., Safi Arian, R., Cheraghi, F., & Ahmadpanah, M. (2015). A comparison of psychological status of patients pre and post coronary artery bypass graft surgery. Russian Journal of Cardiology, (4S), 9–14. https://doi.org/10.15829/1560-4071-2015-04-9-14
- Stenman, M., Holzmann, M.J., & Sartipy, U. (2016). Association between preoperative depression and long-term survival following coronary artery bypass surgery – A systematic review and meta-analysis. International Journal of Cardiology, 222, 462–466. https://doi.org/10.1016/j.ijcard.2016.07.216
- Tsai, M.F., Tsay, S.L., Moser, D., Huang, T.Y., & Tsai, F.C. (2019). Examining symptom trajectories that predict worse outcomes in post-CABG patients. European Journal of Cardiovascular Nursing, 18(3), 204–214. https://doi.org/10.1177/1474515118809906
- Vaccarino, V., Badimon, L., Bremner, J.D., Edina, C., Cubedo, J., Dorobantu, M., Duncker, D.J., Koller, A., Manfrini, O., Milicic, D., Padro, T., Pries, A.R., Quyyumi, A.A., Tousoulis, D., Trifunovic, D., Vasiljevic, Z., de Wit, C., & Bugiardini, R. (2020). ESC Scientific Document Group Reviewers. Depression and coronary heart disease: 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation. European Heart Journal, 41(17), 1687–1696. https://doi.org/10.1093/eurheartj/ehy913
- Wells, A., & Faija, C. (2018). Metacognitive Therapy for anxiety and depression in cardiac rehabilitation: Commentary on the UK National Institute of Health Research funded PATHWAY programme. Journal of Cardiology and Cardiovascular Sciences, 2(3), 10–14. https://doi.org/10.29245/2578-3025/2018/3.1131
- Wilkins, E., Wilson, L., Wickramasinghe, K., Bhatnagar, P., Leal, J., Luengo-Fernandez, R., Burns, R., Rayner, M., & Townsend, N. (2017). European Cardiovascular Disease Statistics 2017. European Heart Network, Brussels.
- Yanichev, D.P. (2006). Cognitive aspects of self-perception of personality traits in patients with neurotic and neurosis symptoms: Ph.D. in Psychology Thesis. Saint Petersburg: Saint Petersburg State University. (In Russ.)
