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Резюме Резюме Summary Рецензент: д.мед.н., проф. Я.А. Соцька УДК 616.33-002.44:616.61-002.3 Харківська медична академія післядиполомної освіти МОЗ України Харьковская медицинская академия последипломного образования Kharkov medical academy of Postgraduate Education serg_shklyar@ukr.net The purpose of the research consisted in determination of the most meaningful medical psychological indicators for the further estimation of efficiency of behavioural-cognitive correction among persons of the young age with hCVR. Materials and research methods. The results of complex clinical anamnestic examination of 450 patients of the young age that were previously stratified after the level of CVR diagnosed after the methodology "SCORE" became a primary informative base for implementation of research [1, 4, 9].125 patients (nMR =125) were refered to the group of minimum (low) CVR and 102 patients (nHR =102) were refered to the group of high CVR. Results and their discussion. With the purpose of determination of hCVR influence on the level of anxiety as property of psyche and psychological state of patients it was applied the scale of personal and reactive anxiety after Spielberger C. in modification of Yu.L.Khanin. It is found out at the analysis of levels of personal anxiety that in general patients of both clinical groups are characterized by excessive (on the average on 35,5% higher than reference values) anxiety the level of that depends (р<0,05) on the presence of CVR. Among patients with mCVR is a part of persons with moderately (within the limits of 31-45points) increased level of personal anxiety - (60,8±4,4)% while at presence of hCVR most of the patients have had high (over 45 points) level of personal anxiety, it is diagnosed for (50,8±3,6)%. The analysis of indexes of reactive anxiety revealed that on the average its level on 25,8% exceeded reference values and within the limits of these values - only (5,6±1,3) patients, while the moderate level (31÷45 points) of reactive anxiety in the groups accordingly presented (70,4±4,3)% and (55,6±3,6)% of examined patients; more than third of persons of the young age regardless of CVR presence had high level of reactive anxiety - (33,2±2,7)%. The analysis of characterological features of patients of the examined groups, in particular indexes of extra- / introversion and level of neuroticism revealed that on the whole (14,6±2,0)% of patients had expressive and (12,4±1,9)% high level of neuroticism; depending on the level of CVR were revealed reliable (р<0,05) differences in the level of neuroticism. In the case of heightened CVR frequency of high levels of neuroticism for certain (р<0,01) is higher (practically in three times), and its level is higher (in 1,5-1,6 times (р<0,01)); frequency of high levels of introversion is higher (in 1,8-1,9 times), while frequency of the diagnosed levels of extraversion is identical (р>0,05) at for certain higher levels of its expressiveness (р<0,05). At presence of heightened CVR frequency of disharmonious persons for certain (р<0,01) is higher (practically in three times) and its expressiveness is higher (in 1,3-1,4 times (р<0,01)); frequency of high levels of anxiety is higher in 4 times at its for certain greater expressiveness, while frequency of the diagnosed levels of hypochondria is for certain higher (р<0,05) at higher levels of its expressiveness (р<0,01). It should be noted that level of neurasthenia of the examined patients of both clinical groups differed and reaching on the average (36,0±2,7)% for certain was less among patients with mCRV than at hCRV (accordingly, (27,2±4,0)% and (41,8±3,6)% р<0,05). At presence of hCRV frequency of apathetical persons does not differ for certain, however the increase of expressiveness of apathy (р<0,05) ) takes place ; frequency of neurasthenia evidence is in 1,5-1,7 times higher at its for certain greater expressiveness (р<0,01) while frequency of the diagnosed levels of obsessiveness is for certain higher (р<0,01) at higher levels of its expressiveness (р<0,01). Conclusions. 1. After the results of comparative analysis of frequency and expressiveness of separate personal psychological factors in the groups of patients with low and high cardiovascular risk it is determined those of them that are most informing. 2. It is made rank distribution of informing personal psychological factors, formulated a concept "acceptor-indicator" as an index after that in future is estimated the efficiency of behavioural-cognitive correction. 3. It is proved clinical heterogeneity of risk metric groups from the point of view of individualization of behavioural-cognitive correction of cardiovascular risk. Trends of further researches are related to stratification of persons with heightened CVR on the groups of differentiated cognitive-behavioural therapy (correction) with taking into account present unpsychotic abnormalities of psychical sphere. Літератрура 1. Горбась І.М. Шкала SCORE у клінічній практиці: переваги й обмеження / І.М. Горбась // Здоров’я України. - 2008. - № 11(1). – С. 40-41. | |
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