Determining disease response patterns in patients with coronary heart disease

Background. Attitude towards one's own illness significantly affects the course of the disease, the effectiveness of treatment and the possibility of rehabilitation. The formation of certain types of response to the disease determines adherence to treatment.

Aim. To study the types of attitude to the disease in patients with coronary heart disease, depending on the severity of coronary atherosclerosis and the planned treatment tactics.

Material and methods. To study the type of patient's response to the disease, a personal questionnaire of the Bekhterev Institute was used. The study included 240 patients with coronary heart disease (150 men and 90 women): the first group — 26 people without coronary artery disease; the second group — 41 people who were subject to conservative treatment, with hemodynamically unexpressed atherosclerosis of the coronary arteries; the third group — 84 patients with severe atherosclerotic lesions of the coronary arteries, who were candidates for surgical revascularization methods; the fourth group — 38 people hospitalized for coronary artery stenting; the fifth group — 51 people hospitalized for coronary artery bypass grafting. The sixth group was represented by healthy volunteers (40 people). To assess the statistical significance of the differences between the two groups in terms of any parameters with the non-normal distribution of features the Mann–Whitney test was used. To assess the relationship between two features, the Spearman rank correlation coefficient with an assessment of its significance was used. Differences were considered significant at p <0.05.

Results. Patients with ischemic heart disease chose statements characteristic of ergopathic and harmonious (p <0.05) types of attitude to the illness. In 56% (p <0.05) of the representatives of the control group, the anosognosic type prevailed. A higher frequency of the euphoric type of attitude towards the disease was found in patients of the second group in comparison with the third one (p=0.009). The fifth group was dominated by sensitive (42.5%) and paranoid (32.5%) types of response; less common were anxious (27.5%) and neurasthenic (30%) ones. A direct correlation was demonstrated between the age of patients and the detectability of hypochondriacal (p=0.027, r=0.15), apathetic (p=0.005, r=0.2) and paranoid (p=0.011, r=0.17) types of attitude towards illness.

Conclusion. Patients with coronary heart disease have predominantly ergopathic and harmonious types of response, which determine whether they have a sober assessment of their state of health, as well as the significance of work activity for the individual.