Life-purpose orientations as the target of cognitive-behavioral therapy among patients with coronary artery disease preparing for the coronary bypass surgery

This article reflects the study of the influence of methods of cognitive-behavioral psychotherapy on mental status and life-purpose orientations among patients with stable ischemic heart disease (IHD) in preparation for coronary artery bypass grafting. For this purpose a clinical and psychological examination of 74 male patients from 44 to 73 years of age with stable ischemic heart disease was performed. Patients before the surgery were comparable in the duration of the history of IHD, the presence and duration of an anamnesis of arterial hypertension, the fraction of the ejection of the left ventricle and the presence of stenoses of the carotid arteries. Psychological studies were conducted during 3-6 sessions, of which 3 sessions at the preoperative stage and 3 sessions for two weeks after the coronary bypass surgery. The duration of the session was set within 4"-6" minutes. At the 1st session the diagnosis of the perception of the disease and life-purpose orientations among patients with ischemic heart disease was carried out. Psychological work consisted of applying methods of cognitive-behavioral psychotherapy: maintaining a diary of rehabilitation; cognitive restructuring; rehearsal of adaptive behavior; systematic desensitization; using the method of mental self-regulation - muscle relaxation according to E. Jacobson. Measurement of the parameters of life-purpose orientations before conducting psychological studies showed high values of the indices both in the main and the control groups. Patients demonstrated high faith in their ability to control their own lives, their conviction for freedom of choice, and the need to plan for a future. In the analysis of the dynamics of the parameters of life-purpose orientations in the psychological support group, a significant increase in the indicators was recorded: "Control locus - Life" (p = "Ю2) and General meaning of life (p = "Ю5). In the group without psychological support, there was a statistically significant decrease in the "Life Purpose" (p = "."4) and "Life Outcome" indicators (p = "Ш). A comparative analysis of the parameters of life-purpose orientations in 7-Ю days after the coronary bypass surgery showed a greater value of the indicators "Life Outcome" (p = 0.04), "Control locus - Life" (p = 0.01) and General meaning of life (p = 0.02) in the group with psychological support. The obtained results of the study allow us to conclude that the psychotherapeutic work with patients suffering from ischemic heart disease helps to form a more meaningful attitude to one's own health and life as a whole. Thus, special measures are needed to develop life-purpose orientations among patients with IHD in preparation for coronary bypass through psychological interventions within the framework of cognitive-behavioral psychotherapy.

Keywords

Authors

References