Differentiation of targets for psychotherapy allows determining certain ways and priorities in psychological treatment of a patient.

To work out a multi-level system of psychotherapeutic targets for clinical groups of cardiac surgery patients (CSPs).

Clinical and psychological analysis of 152 CSPs who were to undergo different types of cardiac surgery treatment.

We have established four levels of psychotherapeutic targets: a patient’s response to surgery, psychopathologic manifestations, personality’s dysfunctional characteristics, and social interaction specificities. Towards CSPs with open-heart coronary artery bypass grafting, the targets appeared to be as follows: low expectations from surgery, low hopes for recovery, low level of satisfaction with life, depressive disorders with somatic manifestations, cognitive abnormalities, anxiety manifestations, manifestation of hostility, rejection of the past, inclination for fatality, reduced vitality, reduced social activity, expectation of help from closest people.Towards CSPs indicated to open-heart aortic valve repair surgery, psychotherapeutic targets were as follows: high expectations from surgery; moderate fear of death; not feeling well; low spirits; depressive disorders with somatic and cognitive-and-affective manifestations; cognitive abnormalities; anxiety manifestations; manifestation of hostility; rejection of the past; reduced hedonism; expectation of help from closest people; reduced social activity. Towards CSPs indicated to minimally invasive surgery, we set such targets as: moderate expectations from surgery; apparent fear of death; depressive disorders with somatic manifestations; anxiety manifestations; cognitive abnormalities; rejection of the past; expectation of help from closest people; reduced social activity.

Psychotherapy of CSPs that includes the established targets can contribute to personalized approach in a patient’s treatment.

No significant relationships.

More often, cardiac surgery patients (CSP) receive systematic psychological aid after surgery. However, their need for psychosocial interventions in the perioperative period is underestimated.

The goal is to determine the stages of psychosocial interventions for CSP that could cover the whole period of their treatment and rehabilitation.

Analysis of scientific papers and practical experience gained in cardiologic clinic allowed dividing the system of psychosocial interventions for cardiac surgery patients into periods in accordance with actual stages of medical aid for CSPs.

According to the principles of personalized approach, we determined six consecutive semantically different stages of psychosocial interventions: out-of-hospital pre-surgery, in-hospital pre-surgery, early post-surgery, in-hospital post-surgery, post-surgery rehabilitation, and out-of-hospital rehabilitation. They have different duration and cover the whole period of treatment and rehabilitation of CSPs beginning with the moment of indication to surgery up to the complete rehabilitation and full adaptation to their post-surgery somatic condition. Each stage has its own goals, main objectives and expectations. Duration of the stages is conditional and can change depending on the nature of every clinical situation.

Determination of clinical stages in the process of psychosocial interventions for CSPs gives ground for selecting optimal psychological methods and techniques for each stage and sets exact goals, achievement of which becomes possible only through a properly organised work of an interdisciplinary team of specialists.

No significant relationships.

Cardiac surgery patients (CSP) are cardiovascular patients who undergo surgery to treat their disease. Are their psychological characteristics different from those of other cardiac patients?

The goal is to establish peculiarities of the clinical-and-psychological status of CSPs in different clinical groups.

According to clinical parameters, 152 CSPs were divided into three groups. The first group comprised patients with CHD indicated to an open-heart coronary artery bypass grafting, the second one included patients with heart failure who were to undergo aortic valve surgery, and the third group included CHD patients and those with heart rhythm abnormalities indicated to minimally invasive surgery.

CSPs had a number of cardiologic complaints, mental disturbance manifestations and concomitant somatic diseases. They showed difference in the duration of the disease, previous occurrence of heart surgery or myocardial infarction, and in the degree of heart failure manifestations. Self-assessment of pre-surgery CSPs corresponded to the severity of their clinical condition, while indications of hope for recovery were at the maximum level. The second group showed a moderate level of depression, while the third one – slight depression. All the groups revealed a disharmonic profile of time perspective. Group 1 CSPs showed some manifestations of hostility. We saw different manifestations of CSPs’ personal adaptation resources. While hardiness had insufficient showings at the level of most components, social support was excessive in all groups.

CSPs as other cardiac patients revealed depressive disorders and hostility. At the same time, they have more social support, which testifies availability of good interpersonal resources.

No significant relationships.

Depressive disorders are common for cardiac patients; however, a surgical intervention enhances their distress. How typical is suicidal ideation for cardiac surgery patients and with what clinical and psychological signs does it correlate?

To estimate the frequency of suicidal ideation and correlations between suicidal ideation, clinical and psychological manifestations in cardiac surgery patients.

We examined 60 cardiac surgery patients, aged 25 – 65, prior to their operation. The Pierson correlation between manifestation of suicidal ideation, clinical and psychological signs was calculated with p<0.05.

We revealed suicidal ideation in 3.33% of cardiac surgery patients. Its intensity credibly correlated with the frequency of taking alcohol (r=.32), as well as with manifestation of dysorexia (r=.59), dissatisfaction with life (r=.53), general level of depression (r=.49), sleeping disorders (r=.44), sense of guilt (r=.43), asthenia (r=.31), self-abhorrence (r=.29), and irritability(r=.29). A higher level of suicidal ideation correlated with a lower index of Positive-Past in their personal time perspective (r=-.27), which revealed itself in a patient having lack of positive impressions and recollections of their past life, which reduced a person’s adaptability in the present.

The frequency of suicidal ideation in preoperative cardiac surgery patients is not high. Nevertheless, we should bear in mind that high suicidal risk is characteristic for patients with not only depression, but also alcohol problems, as well as for those who have manifestations of negative attitude to their past.

No significant relationships.

During the pandemic, many surveys studied people’s attitude to COVID-19. However, less information is available about the peculiarities of such attitude of the most vulnerable groups including chronic somatic patients who are in need of operative treatment.

To identify the specificity of preoperative cardiac surgery patients’ attitudes toward COVID-19 as compared to that of healthy people.

We used the Attitudes towards COVID-19 questionnaire (Nikolaev E.) to survey 60 preoperative cardiac patients and 327 healthy university students. Difference validity was assessed with significance level of p<0.05.

Cardiac patients are more likely to trust the government measures to fight COVID-19 (t=3.131; p=.002), and their COVID-19-related fears for their life are higher (t=2.793; p=.005). As compared to healthy people, patients are less likely to think that pandemic broke their customary way of life (t=-2.793; p=.005) and plans for the future (t=-3.337; p=.000). Credibly more often than healthy people, cardiac surgery patients consider that it is useless to wear a mask and limit contacts, as any person will eventually catch the virus (t=2.401; p=.017). We did not reveal any more evidently expressed COVID-19-related anxiety in preoperative cardiac surgery patients.

Attitudes of cardiac surgery patients toward COVID-19 manifest in an adequate assessment of threat to their personal health, trust in the government measures, and readiness to change their daily plans. It is latent fatalistic ideas about ultimate uselessness of restrictive measures that pose threat to people’s own health and the health of the people around them, which health professionals should remember in their preventive actions.

No significant relationships.

Depression is one of common comorbid states that accompany cardiovascular diseases. Risk of co-morbidity can rise when patients have to undergo heart surgery, which is an additional stress-factor.

To specify psychological correlations between depressive manifestations in cardiac surgery patients based on the analysis of their time perspective profile.

Using the Zimbardo Time Perspective Inventory, we examined 60 cardiac surgery inpatients (80% male, mean age 58.25±10.55). We calculated the statistical estimation of the received data based on the comparison with the norm and the correlation analysis.

The research revealed that cardiac surgery patients’ indices significantly exceeded the norm on three out of five scales – Negative-Past (t=4.405; p=.000), Positive-Past (t=3.536; p=.000), and Future (t=5.008; p=.000). We also identified essential correlations between the level of depression and the indices of Negative-Past (r=.390; p=.002) and Positive-Past (r=-.270; p=.037). We distinguished a positive correlation of the negative attitude to the past with cognitive-affective (r=.369; p=.004) and somatic (r=.338; p=.008) manifestations of depression, and a negative correlation with the level of education (r=-.292; p=.024).

The personal time perspective profile in cardiac surgery patients is unbalanced due to a high level of their negative attitude to the past with an optimal level in other time perspectives. The degree of the Negative-Past attitude correlates in the patients with a low level of education and a high risk of depression in all its manifestations. The given correlations should be taken into account when conducting preventive psychological interventions.

No significant relationships.