Title Strategije prilagodbe kao posrednici u cjelovitom oporavku srčanih bolesnika : doktorska disertacija
Author Jasna Grković
Mentor Ljiljana Moro (mentor)
Committee member Tanja Frančišković (predsjednik povjerenstva)
Committee member Ognjen Šimić (član povjerenstva)
Committee member Rudolf Gregurek (član povjerenstva)
Committee member Ljiljana Moro (član povjerenstva)
Granter University of Rijeka Faculty of Medicine Rijeka
Defense date and country 2006-01-01, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Psychiatry
Universal decimal classification (UDC ) 616 - Pathology. Clinical medicine
Abstract Poučavanje promjena stanja bolesnika koji su sa ozbiljnom ili terapijskim zahvatom približava psihijatriju somatskoj medicini i zanimanje za ova dodirna
buja i u praksi i u znanstvenim istraživanjima. Svjetska epidemija srčanih bolesti posljednjih desetljeća stavlja bolesnike u samo središte zanimanja.
Cilj ovoga rada je ustanoviti utjecaj strategije suočavanja, koje koriste srčani bolesnici, na njihov oporavak i psihičko stanje.
Trebalo je istražiti kako se bolesnici nose s novonastalom situacijom koja je za njih akutna i iznenadna ( pretrpljen udar) ili očekivana ( izveden kardiokirurški operativni zahvat).
Cilj ovog rada činilo je i osmišljavanje modela za konzultacijsko-suradni psihijatrijski rad sa bolesnicima, na temelju proučenih stilova suočavanja sa njihovom situacijom nakon preboljelog infarkta miokarda, odnosno nakon što su imali operaciju na srcu.
Ispitana su 147 bolesnika, 74 kardiološka bolesnika i 73 kardiokirurška bolesnika. Mjerenja za ovo prospektivno, longitudinalno istraživanje su prikupljana tijekom 1999-2005. godine. Prvo psihometrijsko mjerenje dobiveno je tjedan dana od pretrpljenog infarkta miokarda odnosno iza operativnog zahvata na otvorenom srcu; upitnici za drugo mjerenje (nakon šest mjeseci) i
mjerenje ( nakon dvanaest mjeseci ) bolesnicima su odaslani poštom, a istraživanje je kompletiralo 41% bolesnika ( šezdeset bolesnika). Primijenjen je sljedeći instrumentarij: konstruirana ljestvica intenziteta stresa, STAI - ljestvica za mjerenje anksioznosti, BDI- upitnik za depresivnost i COPE-upitnik suočavanja sa stresom.
Dobiveni rezultati ukazali su da se u obje grupe bolesnika oporavak može pratiti kroz smanjivanje procjene stresnosti i smanjivanje depresivnosti kroz razdoblje od godinu dana.
Anksioznost se ne mijenja u tom razdoblju niti u jednoj ispitivanoj grupi. Dvije ispitivane grupe ne razlikuju se u upotrijebljenim strategijama nego u tjelesnim
značajkama depresivnosti koje su više izražene kod kardiokirurških bolesnika. Procjena stresnosti ima odloženi efekt na tjelesno i psihičko stanje bolesnika, što se vidi kroz pozitivnu korelaciju s tjelesnim značajkama depresivnosti. Jedina strategija suočavanja koja ima prediktivnu važnost je
problemu usmjereno suočavanje koje smanjuje anksioznost bolesnika. Na osnovi rezultata istraživanja mogu se odrediti područja psihološkog suočavanja bolesnika tijekom oporavka koja bi suradni psihijatar trebao zahvatiti u pristupu srčanim bolesnicima i cjelokupnom timu koji skrbi
o pacijentima.
Abstract (english) Studies of psychic changes in patients confronted with serious illness or therapeutic procedure bring together psychiatry and somatic medicine, resulting in escalating interest for those intertwining fields in both clinical practice and scientific research.
The aim ofthis paper isto establish the influence of coping strategies that cardiac patients use, on their recovery and psychic status. lt was also supposed to be explored how patients cope with a novel situation, such as an acute, unexpected heart attack or an expected procedure of open
heart surgery. The goal ofthis paper was also to propose a model of implementation of consultation-liaison psychiatric service strategies for cardiac patients, based on established coping styles of cardiac patients confronted with their life situation after myocardial infarction or open heart surgery.
147 patients were examined; 74 cardiac and 73 cardiosurgery patients. Measurements for this prospective, longitudinal study were obtained in 1999-2005 period oftime. First psychometric measurement was carried out during the first week after myocardial infarction or open heart nsurgery; the same psychometric inventories for second ( six months after) and third ( twelve months after) were mailed to patients; 41 % of patients completed the study with ali three measurements. The following instruments were used: constructed perception of stress scale; State Trait Anxiety Inventory; Beck Depression Inventory and COPE Questionnaire.
The results obtained showed that in both groups recovery process is marked with reduction in perceived level of stress and reduction of depression. There is no change in anxiety level in both groups throughout the one year period.There is no 'difference in coping strategies between the groups, but they differ in somatic components of depression - cardiosurgery patients are significantly more depressed when somatic component is in center. Perception of stress has long-term effects on somatic components of depression. Only problem oriented coping has predictive effect on recovery process in cardiac patients, it lessens the anxiety. The results obtained can pinpoint the areas of interst in psychological coping strategies that liaison psychiatrist should address while approaching the cardiac patient and the whole team that is dealing with those patients.
Keywords
suradna psihijatrija
stres
suočavanje
bolesnik
srčani
Keywords (english)
keyword1
Language croatian
URN:NBN urn:nbn:hr:188:561502
Promotion 2006-04-10
Study programme Title: Biomedicine Postgraduate (doctoral) study programme Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Catalog URL http://www.svkri.uniri.hr/DUFOVI_files/DUF-625.pdf
Type of resource Text
Extent 134 str; 30 cm
File origin Reformatted digital
Access conditions Open access
Terms of use
Created on 2017-01-19 19:37:08