Personal Characteristics and Adaptation Mechanisms of Patients with Arterial Hypertension and Chronic Heart Failure

Adaptation processes in chronic diseases, including arterial hypertension (AH) and chronic heart failure (CHF), depend both on the personality of the patient and on comorbidity. Objective: to study the characteristics of adaptation and mental functioning of patients with hypertension and heart failu...

Full description

Saved in:
Bibliographic Details
Main Authors: E. V. Efremova, A. M. Shutov, E. V. Petrova
Format: Article
Language:Russian
Published: SINAPS LLC 2021-01-01
Series:Архивъ внутренней медицины
Subjects:
Online Access:https://www.medarhive.ru/jour/article/view/1118
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1839572767266045952
author E. V. Efremova
A. M. Shutov
E. V. Petrova
author_facet E. V. Efremova
A. M. Shutov
E. V. Petrova
author_sort E. V. Efremova
collection DOAJ
description Adaptation processes in chronic diseases, including arterial hypertension (AH) and chronic heart failure (CHF), depend both on the personality of the patient and on comorbidity. Objective: to study the characteristics of adaptation and mental functioning of patients with hypertension and heart failure with comorbidity (the patient has concomitant diseases). Design and methods. 122 patients (49 women and 73 men, average age 62.9 ± 9.4 years) with hypertension and heart failure were examined. AH was diagnosed and evaluated according to guidelines for the treatment of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology (2013). CHF was diagnosed in accordance with the guidelines for the diagnosis and treatment of chronic heart failure of the Society of Heart Failure Specialists, Russian Cardiology Society (2016). Charlson Comorbidity Index (IC) was used to evaluate comorbidity; comorbidity was regarded as high at IC ≥ 6 points (60 patients). To assess personal characteristics and mental status, a projective methodology was used — Sondi’s test, a Mini-mult questionnaire (shortened version of MMPI). To assess the adaptive psychological mechanisms were used «Life Style Index» and «Copy Test». Cognitive functions and quality of life were evaluated. Results. IC was 5.3 (IQR:4-7) points. The group of patients with hypertension, heart failure and high comorbidity differed in the severity of the depressive-hypochondriacal profile compared with patients with low comorbidity. Similar data were obtained in a projective methodology: in the group with high comorbidity, the most pronounced factor is D− (depression) (1.7 (IQR: 1-2) and 0.9 (IQR: 0-1), points respectively, p = 0.009) and factor P− (paranoid) (1.8 (IQR: 1-2.5) and 1.3 (IQR: 1-2) points respectively, p= 0.01). Relationships have been identified that make it possible to talk about common adaptation processes in patients with AH and CHF depending on comorbidity: in patients with high comorbidity, non-constructive coping strategies («confrontational», «flight-avoidance») correlated with psychological defense mechanisms of the regression type (r=0.41, p=0.003) and replacement (r=0.39, p=0,001). Conclusions. Comorbidity has a negative impact on the cognitive and adaptive capabilities of patients with hypertension and heart failure, contributes to the emergence of depressive-hypochondriacal conditions, accompanied by a decrease in motivation and adherence to treatment, which must be taken into account with an interdisciplinary approach to this category of patients.
format Article
id doaj-art-3e1a0b4966154d25aff1f4e20f09a1b3
institution Matheson Library
issn 2226-6704
2411-6564
language Russian
publishDate 2021-01-01
publisher SINAPS LLC
record_format Article
series Архивъ внутренней медицины
spelling doaj-art-3e1a0b4966154d25aff1f4e20f09a1b32025-08-04T14:09:47ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642021-01-01111344210.20514/2226-6704-2021-11-1-34-42824Personal Characteristics and Adaptation Mechanisms of Patients with Arterial Hypertension and Chronic Heart FailureE. V. Efremova0A. M. Shutov1E. V. Petrova2Ulyanovsk State UniversityUlyanovsk State UniversityPenza State UniversityAdaptation processes in chronic diseases, including arterial hypertension (AH) and chronic heart failure (CHF), depend both on the personality of the patient and on comorbidity. Objective: to study the characteristics of adaptation and mental functioning of patients with hypertension and heart failure with comorbidity (the patient has concomitant diseases). Design and methods. 122 patients (49 women and 73 men, average age 62.9 ± 9.4 years) with hypertension and heart failure were examined. AH was diagnosed and evaluated according to guidelines for the treatment of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology (2013). CHF was diagnosed in accordance with the guidelines for the diagnosis and treatment of chronic heart failure of the Society of Heart Failure Specialists, Russian Cardiology Society (2016). Charlson Comorbidity Index (IC) was used to evaluate comorbidity; comorbidity was regarded as high at IC ≥ 6 points (60 patients). To assess personal characteristics and mental status, a projective methodology was used — Sondi’s test, a Mini-mult questionnaire (shortened version of MMPI). To assess the adaptive psychological mechanisms were used «Life Style Index» and «Copy Test». Cognitive functions and quality of life were evaluated. Results. IC was 5.3 (IQR:4-7) points. The group of patients with hypertension, heart failure and high comorbidity differed in the severity of the depressive-hypochondriacal profile compared with patients with low comorbidity. Similar data were obtained in a projective methodology: in the group with high comorbidity, the most pronounced factor is D− (depression) (1.7 (IQR: 1-2) and 0.9 (IQR: 0-1), points respectively, p = 0.009) and factor P− (paranoid) (1.8 (IQR: 1-2.5) and 1.3 (IQR: 1-2) points respectively, p= 0.01). Relationships have been identified that make it possible to talk about common adaptation processes in patients with AH and CHF depending on comorbidity: in patients with high comorbidity, non-constructive coping strategies («confrontational», «flight-avoidance») correlated with psychological defense mechanisms of the regression type (r=0.41, p=0.003) and replacement (r=0.39, p=0,001). Conclusions. Comorbidity has a negative impact on the cognitive and adaptive capabilities of patients with hypertension and heart failure, contributes to the emergence of depressive-hypochondriacal conditions, accompanied by a decrease in motivation and adherence to treatment, which must be taken into account with an interdisciplinary approach to this category of patients.https://www.medarhive.ru/jour/article/view/1118arterial hypertensionchronic heart failurepsychological characteristicsadaptation mechanism
spellingShingle E. V. Efremova
A. M. Shutov
E. V. Petrova
Personal Characteristics and Adaptation Mechanisms of Patients with Arterial Hypertension and Chronic Heart Failure
Архивъ внутренней медицины
arterial hypertension
chronic heart failure
psychological characteristics
adaptation mechanism
title Personal Characteristics and Adaptation Mechanisms of Patients with Arterial Hypertension and Chronic Heart Failure
title_full Personal Characteristics and Adaptation Mechanisms of Patients with Arterial Hypertension and Chronic Heart Failure
title_fullStr Personal Characteristics and Adaptation Mechanisms of Patients with Arterial Hypertension and Chronic Heart Failure
title_full_unstemmed Personal Characteristics and Adaptation Mechanisms of Patients with Arterial Hypertension and Chronic Heart Failure
title_short Personal Characteristics and Adaptation Mechanisms of Patients with Arterial Hypertension and Chronic Heart Failure
title_sort personal characteristics and adaptation mechanisms of patients with arterial hypertension and chronic heart failure
topic arterial hypertension
chronic heart failure
psychological characteristics
adaptation mechanism
url https://www.medarhive.ru/jour/article/view/1118
work_keys_str_mv AT evefremova personalcharacteristicsandadaptationmechanismsofpatientswitharterialhypertensionandchronicheartfailure
AT amshutov personalcharacteristicsandadaptationmechanismsofpatientswitharterialhypertensionandchronicheartfailure
AT evpetrova personalcharacteristicsandadaptationmechanismsofpatientswitharterialhypertensionandchronicheartfailure