Comparative analysis of clinical and psychosocial characteristics of patients with different dynamics of cognitive functioning after coronary artery bypass grafting

Abstract

Psychological aspects as compared to the technological part of direct myocardial revascularization and its consequences for cognitive functioning, which in turn affect the compliance and quality of life of patients, have not been enough studied yet. In this regard, the purpose of the study was to analyze the clinical and psychosocial characteristics of patients with coronary heart disease (CHD) with different dynamics of cognitive functions in the process of rehabilitation after coronary artery bypass grafting (CABG). A new method for the mathematical determination of cognitive dynamics, namely, the assessment of the improvement and deterioration of cognitive functioning after open-heart surgery was proposed. A total of 118 patients with coronary artery disease were examined. Among them there were 80.5% of men and 19.5% of women; mean age 59.86 ± 7.31 years. The study was conducted using the clinical-psychological method and the developed complex of patho- and neuropsychological methods for assessing various spheres of cognitive functioning. It was shown that patients with worse cognitive dynamics after CABG at the preoperative stage tend to have more frequent atherosclerosis of the brachiocephalic arteries, a complication of the early postoperative period in the form of postpericardiotomy syndrome, as well as burdened heredity of cardiovascular diseases. At the same time, a shorter aortic clamping time and the duration of use of cardiopulmonary bypass was recorded during the surgery in patients with cognitive impairment. A comparative analysis of the psychosocial characteristics of patients indicates significant differences in understanding the causes of the development of the underlying cardiovascular disease and the consequences of CABG in patients of both groups studied: patients with impaired cognitive functioning have a lower treatment adherence (compliance), and they tend to evaluate the upcoming operation as a negative life event.

Physiology and Technology of Clinical Gollin Test

“…Elderly subjects showed an increase in the recognition threshold for incomplete images. The Gollin test was successfully used in diagnosing cognitive dysfunctions of patients with ischemic heart disease who had coronary artery bypass surgery during the rehabilitation period [81,82]. A distinctive feature of the Gollin test for visual recognition is its length in time.…”

Natural Disasters and Life-threatening Diseases: Psychological Consequences

“…Опасное для жизни заболевание может рассматриваться человеком в контексте анализа причинно-следственных связей [4], соотносится с чувством вины, нарушением принципов здоровьесберегающего поведения, с интернальным локусом контроля. Различия в понимании причин заболевания и его последствий часто отражаются на приверженности лечению и оценке успешности реабилитации [2].…”

“…В разработке классификации травматических событий принимала участие сотрудник Института психологии РАН Н.Н. Казымова 2. Указывались убийство, самоубийство, насильственная смерть родственника, близкого человека или даже незнакомого.…”