Abstract
Ischemic heart disease remains an actual problem of modern clinical and rehabilitation medicine. One of the forms of ischemic heart disease (IHD) is an acute coronary syndrome (ACS) in patients presenting without persistent ST-segment, the treatment of which involves the use of conservative treatment and reperfusion techniques. An integral part of the management of patients after acute coronary syndrome is rehabilitation and restoration with the search for methods of changing the attitude of the patient to his health. To improve the rehabilitation of patients it is important to assess the internal picture of health with the formation of the correct attitude of the patient to his health. Aim. To study the peculiarities of the components of the internal picture of health in patients with acute coronary syndrome in patients presenting without persistent ST-segment in the process of treatment and rehabilitation. Materials and methods. There were examined 135 patients with ACS presenting without persistent ST-segment, who were divided into the groups depending on the treatment performed; 60 patients with conservative treatment tactics and 75 patients with the performed PCI. The analysis of the internal picture of health was carried out with the help of methods: hospital scale for the detection of anxiety and depression (HADS); patient health questionnaire (PHQ-9); scale for measuring the level of reactive (situational) and personality anxiety of Spielberg-Hanin; SF-36; indicators of the Seattle Quality of Life Questionnaire for Patients with Angine Pectoris (Seattle Angina Questionnaire - SAQ). Results. The study of the internal picture of health in patients with ACS presenting without persistent ST-segment showed low levels of emotional, sensory, cognitive, value-motivational, behavioral components on the appropriate scales, which also depend on the method of treatment used. The revealed peculiarities of patients with ACS presenting without persistent ST-segment need to increase the knowledge of the patient about the disease and the importance of rehabilitation measures. Conclusions. In assessment of the internal picture of health in patients with ACS presenting without persistent ST-segment after transcutaneous coronary intervention and in the process of rehabilitation, it has been determined that the course of ischemic heart disease in patients with ACS presenting without persistent ST-segment, both during conservative treatment and in the course of PCI at the stages of rehabilitation, is accompanied by significant changes of the internal picture of health (IPH); the most significant changes in patients with ACS presenting without persistent ST-segment is the value-motivational and behavioral components of the internal picture of health. In order to increase the effectiveness of rehabilitation after ACS, it is advisable to apply programs that will significantly affect the positive changes in the rehabilitation of patients with ACS.
Highlights
Ischemic heart disease remains an actual problem of modern clinical and rehabilitation medicine
In the analysis of indicators of reactive anxiety levels in patients with acute coronary syndrome (ACS) presenting without persistent ST-segment were observed high levels in the group who had conservative treatment and who were performed percutaneous coronary intervention (PCI) (Table 1)
The score according to the scale “Role Emotional” in patients with ACS presenting without persistent ST-segment with conservative treatment was (42.5±5.0) points, in the group of patients with ACS presenting without persistent ST-segment, who were performed PCI, respectively (45.7±4.8) points and are those indicating the absence of desire and motivation to perform work in patients of both groups
Summary
Ischemic heart disease remains an actual problem of modern clinical and rehabilitation medicine. One of the forms of IHD is ACS presenting without persistent ST-segment, which has a mortality rate similar to the ACS with elevation of ST segment in the distant terms, which causes attention to the data of patients in the acute phase, and in the long-term period of observation and rehabilitation [1, 2]. An integral part of the management of patients after acute coronary syndrome is rehabilitation and restoration. The effectiveness of cardiological rehabilitation in the reduction of the mortality rate in patients with acute coronary syndrome and after coronary artery bypass surgery is determined, but there is a necessity to find ways to improve it in patients with various manifestations of IHD [6, 7]
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