Effects of psychological characteristics of patients with hypertension on their adherence to treatment. Analysis of clinical cases

Abstract

Objective — to acquaint cardiologists and family medicine doctors with modern treatment approaches that take into account the psychological characteristics of patients. The professional activity of therapeutic doctors is to a large extent (especially in comparison with surgical and anesthesiology specialties) related to the need to develop communication skills, since patients differ not only in clinical features, but also in psychological traits that are revealed in the process of diagnosis and treatment. The authors performed the analysis of four clinical cases with a detailed description of socio‑demographic and behavioral characteristics of patients who ask for a cardiologist’s consultation for the purpose of correcting drug treatment. In addition to the analysis of complaints, anamnesis and data from laboratory and instrumental examinations, typical problems of communication with «difficult» patients have been described and practical recommendations were provided. Four variants of the possible behavior of patients are presented, determined by their psychological characteristics and manifested during communication with doctors of a therapeutic profile. The following psychotypes were chosen as «classical»: «expressive», «directive», «analytical» and «friendly». For the first two, a characteristic feature is the presence of a high level of authority in the process of communicating with interlocutors, and for the last two — a low level. Also, «analytical» and «directive» personalities are marked by a significantly higher degree of self‑control compared to «expressive» and «friendly». Doctors mostly come into contact with patients who combine the features of two psychotypes with the dominance of one of them. Physicians’ understanding of the therapeutic profile of patients’ psychological characteristics will allow understanding their expectations and improving adherence to pharmacotherapy.