Abstract
The basic way to prevent cerebral stroke in symptomatic 70–99% stenosis of internal carotid artery (ICA) is an open or endovascular surgical procedure. Psychological research done so far among ICA stenosis patients focused on cognitive functioning changes. The objective was to assess attitude to surgery in relation to self-efficacy, life quality perception, and health locus of control in ICA stenosis patients. Materials and Methods: The study involved 53 asymptomatic ICA stenosis patients, aged from 53 to 81. Four scales were applied: Generalized Self-Efficacy Scale (GSES); Satisfaction With Life Scale (SWLS); Multidimensional Health Locus of Control Scale (MHLC); and a simple scale to examine the attitude to surgery, where “−10” stands for the maximally negative attitude, “0”—neutral, and “+10”—maximally positive. The obtained results were put to statistical analysis. Results: It was found that women and men assessed their attitude to the surgery as positive (M = 7.92; SD = 3.094), though the men estimated it slightly higher (M = 8.03; SD = 3.02) than the women (M = 7.67; SD = 3.37). The mean value of self-efficacy was high (M = 32.53; SD = 6.231), and slightly higher for the men (M = 32.79; SD = 5.576) compared to the women (M = 31.87; SD = 7.836). The patients generally tended to manifest the external personal health locus of control (M = 28.62; SD = 3.17). The runner-up was internal health locus of control (M = 26.02; SD = 3.775), and the next one—external impersonal aspect (chance/luck) (M = 23.57; SD = 4.457). The mean assessment of the patients’ own life quality proved to be above average (M = 23.60) but varied (SD = 5.95). The women perceived the quality of their lives as better (M = 24.33; SD = 6.422) than the men (M = 23.32; SD = 5.818). Very strong positive correlations were found between self-efficacy and life quality assessment (p < 0.001) and between the internal and external personal aspects of health locus of control (p < 0.007) in the women, and positive correlations were found between the attitude to surgery and internal health locus of control (p < 0.021) in the men. Conclusions: When breaking the news of a need to have a surgical intervention due to ICA stenosis, the physician should strongly refer to the value of human life and health. The message should arise from external (in the case of women) or internal (in the case of men) motivation to undergo surgery, and enhance the patient’s conviction that the disease should be considered a challenge which must be taken to reverse their unfavorable situation and improve life quality.
Highlights
Internal carotid artery stenosis (ICAS) is a recognized risk factor for cerebral stroke
Consent was granted by the Research Ethics Committee; 53 asymptomatic internal carotid artery (ICA) stenosis patients were recruited in a period of 6 months
The study results prove that in the case of internal carotid artery stenosis (ICAS) patients who suddenly, during out-patient consultation, face the news of the disease and are required to make a tough and risky decision on surgery, it is necessary to pay particular attention to their personal resources— with regard to their mental dispositions showing a correlation with positive attitude to surgery, as an optimistic attitude has a positive influence on the treatment and recovery process [25,26,27], and in the case of this disease, on taking a decision to undergo surgery [28]
Summary
Internal carotid artery stenosis (ICAS) is a recognized risk factor for cerebral stroke. Apart from pharmacological treatment, the basic way to prevent cerebral stroke is an open or endovascular surgical procedure [1]. A standard procedure in symptomatic internal carotid artery stenosis is open endarterectomy, there are still pending discussions about whether interventions are advisable in asymptomatic internal carotid artery stenosis and what kind of intervention to choose [2]. Despite the documented beneficial effects of surgical treatment for the patients’ population, the individual risk in elective surgery is still high and, according to different sources of data, the cumulative risk of cerebral stroke, cardiac infarction and death may reach 1.5–6% regardless of the method applied: endarterectomy (CEA) or stenting (CAS) [5,6]. Qualifying an ICAS patient for surgical treatment requires the physician to understand the nature of the condition and the surgical treatment benefits for the patient, and to know how the patient may react to the news of the need for surgery in the case of an asymptomatic condition
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