The paper presents the results of the study focusing on coping strategies and personal resources of patients with chronic heart failure (CHF) during the waiting period for heart transplantation (HT). The sample included 105 patients directed to the commission for inclusion in the waiting list of HT (WLHT) in the Almazov National Medical Research Centre. After 6 months of hospitalization, the patients were divided into two groups: those included in WLHT initially who kept their positions (n=55; Group 1), and those who were excluded or not included initially (n=50; Group 2). Methods: The Ways of Coping Questionnaire and Purpose in Life Test. It was found out that the most endorsed coping strategies were confrontation, positive reappraisal and self-control for Group 1, and distancing and escape/avoidance for Group 2. The significant increase in the life purposefulness general score, and subscale scores reflecting goals, time perspective and internal locus of control was observed in Group 1. We conclude that the obtained data can be used in planning psychological work with patients with CHF during the period of waiting for HT.

The authors have attempted to design and verify by means of mathematical modelling methods a model of comprehensive (medical, social and psychological) prognosis in cardiovascular disease, which would cover different aspects of patients’ disease, treatment and life functioning and would be relevant to the objectives of the treatment and rehabilitation process. A multidisciplinary set of methods was used to accomplish the aim: clinical and psychological. The study included 437 patients with coronary heart disease and/or chronic heart failure undergoing surgical treatment.Part I of the article presents the results of the first 4 stages of the study.1) A theoretical prediction model based on existing data was developed and empirically tested on different patient populations at various stages of surgical treatment. 2) An overall information database was compiled on the basis of our own research. A total of 245 indicators were taken into account; they were expertly divided into five groups: clinical, socio-behavioural, personality  characteristics,  emotional  state  indicators,  and  cognitive  functioning  indicators.3) The missing cells in the sampling matrix were filled in by means of mathematical modelling and neural networks. 4) An exploratory factor analysis of all characteristics in the allocated groups  was  performed,  resulting  in  24 factors:  3 in  the  group  of  clinical  characteristics (“Coronary heart disease”, “Transplantation”, “Patient’s age and duration of heart failure”), 6 in the group of socio-behavioural (“Social and occupational orientation”, “Keeping a habitual lifestyle in spite of illness”, “Occupational strain”, “Lifestyle”, “Non-adherent behaviour”, “Occupational stress”), 5 in the group of personality characteristics (“Attitude towards illness”, “Motivational orientation”, “Decreased resilience”, “Irrational beliefs”, “Coping strategies and coping resources”), 4 in the group of emotional state characteristics (“Dominant emotional state and feelings”, “Quality of life and mood”, “Absence of anxiety at the moment of the study”, “Functioning in conditions of illness”), 6 in the group of characteristics of cognitive functioning (“Neuropsychological characteristics”, “Spatial–constructive thinking and pace of mental activity”, “Visual memory”, “Attention and verbal–logical thinking”, “Verbal memory”, “No significant decrease in IQ”).

A pilot study of psychosocial status of 80 patients (85% males) with terminal chronic heart failure (CHF), during the preparation for heart transplantation (HT) has been carried out in the Almazov National Medical Research Centre. The correlation of psychological, medical, biological and socio-demographic characteristics of patients as well as the dynamics of patients’ emotional state (anxiety and depression) during a long cardiology hospital stay (4 measurements over half a year) has been studied. The authors’ structured interview and a set of psychodiagnostic methods (“Index of General Well-being”, “Brief neuropsychological examination of cognitive sphere”, depression scale (SDS), scale of anxiety (STAI), personality questionnaire BIG-V) have been used in the study. For mathematical and statistical data processing the following methods included in the software package SPSS v. 20.0 have been used: the Pearson’s chi-squared test (χ2), the Mann - Whitney U test, the Spearman and Pearson correlations, and ANOVA. The results revealed the absence of clinically significant signs of depression, cognitive impairment, personality and system of significant relationships in the majority of patients at the first stage of the study (upon admission into hospital). The exception was the increased level of situational anxiety (M ± m = 43.2 ± 7.1). The study of the dynamics of the emotional state of patients reflected a systematic increase in the average group indices of the depression scale (upon admission M ± m = 46.9 ± 6.7; after 2 months M ± m = 48.9 ± 7.4; after 4 months M ± m = 51.1 ± 7.6; after 6 months M ± m = = 52.6 ± 7.5), as well as a decrease in the level of situational anxiety at the second stage of the study compared with the first and a further increase starting from the second period: after 2, 4, 6 months of the stay in hospital, respectively: M ± m = 41.3 ± 5.2; M ± m = 46.7 ± 6.8; M ± m = 50.8 ± 7.9). It was revealed that the level of situational anxiety at the second (F = 6.18; p < 0.05) and the third (F = 4.11; p < 0.05) stages of treatment is significantly higher in the patients after myocardial infarction(s). Also, the level of situational anxiety is higher at the first (F = 4.00; p < 0.05) and third (F = 3.68; p < 0.05) stages of hospitalization of the patients who have rare meetings with relatives as compared to the patients who are often visited by their relatives. The results reflect the psychosocial potential of patients waiting for HT, and may have a prognostic significance in relation to adherence to treatment in the postoperative period, which, in turn, largely determines the survival of patients.

Aim. The article presents the results of psychological investigations of patients in the terminal stage of chronic heart failure (n = 105, average age 51.9 ± 0.9 years, males – 86.7 %) undergoing medical treatment at the Almazov National Medical Research Centre (St. Petersburg). The investigations were carried out before the medical commission for inclusion of patients into the waiting list for heart transplantation (HTWL). Materials and methods. After 6 months of treatment in a cardiology hospital, the patients were divided into 2 groups – the patients included in and retained their positions in the HTWL (n = 55) and the patients not included in or excluded from the HTWL (n = 55). That was done in order to identify the prognostically significant psychosocial characteristics of patients. Clinical, psychological and psychometric methods were used such as a structured interview, expert questionnaire for doctors, the Alcohol Use Disorders Identification Test (AUDIT), the Short Form-36 (SF-36). Results. Comparative analysis reveals a wide range of psychological characteristics, among which the indicators of adherence for treatment and willingness to change lifestyle have the greatest importance. Emotional support and relationships outside the family, an adequate understanding of the disease, an optimistic assessment of the outcome of surgery treatment, etc., as well as the presence of one's own family and minor children are essential in the structure of the psychosocial potential of patients during preparation for HT. Conclusion. Using the obtained results will improve the methodology and procedure for a comprehensive clinical assessment of patients with chronic heart failure before inclusion into the waiting list for heart transplantation, which is extremely important for advanced surgical technologies.