Yanovska S. Cognitive disability factors and their psychological correction in patients with ischemic stroke in the setting of hypertension

Українська версія

Thesis for the degree of Candidate of Sciences (CSc)

State registration number

0418U005203

Applicant for

Specialization

  • 19.00.04 - Медична психологія

27-11-2018

Specialized Academic Board

Д 64.609.03

The Kharkiv Medical Academy of Postgraduate Education, Ministry of Health of Ukraine

Essay

In the course of the research, 141 patients suffering from post-stroke hypertension of stage II and stage III were taken to study and assess their psychological peculiarities and cognitive functions, which limit their vital activity. Based on the findings obtained, a new solution to a crucial task in medical psychology – to improve diagnostics efficiency and to restore cognitive functions as disability factors in patients with AH and post stroke effekts by developing diagnostic procedure and psychological correction programmes. An informational solution to psychological correction of cognitive impairments in AH patients with ischemic stroke was developed for the first time. This solution includes the models of cognitive functions assessment and their role in patients’ disability, as well as psychological correction of cognitive impairments providing psychological and rehabilitative potential and prognosis. The model of cognitive functions assessment and their role in disability in AH patients with ischemic stroke requires studying individual specifics of patients (individual and character traits, internal picture of the disease) and their cognitive functions (concentration, memory, thinking, intellect); their activity and participation in social life (disability in dominating spheres of life, mobility, learning and knowledge application, daily living activities, communication); their interrelation and psychological rehabilitation potential. Psychological and cognitive factors which enhanced forming the restrictions of the life-sustaining activity of the patients suffering from arterial hypertension with ischemic stroke were defined, namely the deconditioning attitude to the disease (apathetic and egocentric type of attitude to disease (TAD), C-emotional instability); memory and attention (memorization, short-term, long-term and visual memory, short-term memory capacity and efficiency of work); personality features (D-depression, Pa-paranoia, Sc-schizoid); memory and thinking (B-limited thinking, content memory, general mental abilities, level and productivity of thinking, understanding of logical connections); the desire to show oneself "in a favourable light" (demonstrative accentuation); adequate response to the disease (harmonic, euphoric and anosognosiс TDA); features of character (O-anxiety-calm, Q2-autonomy-inducibility); emotional intelligence (understanding and managing emotions of others, understanding their emotions, control of expression, interpersonal and internally personal emotional intelligence, understanding and management of all emotions, general level of emotional intelligence). The model of psychological correction of cognitive impairments in AH patients with ischemic stroke is expected to detect mild, moderate and severe cognitive impairments and extent of disability in patients and to develop a system, principles and methods of psychological correction of cognitive impairments to reduce disability. It is shown in the research that the improved diagnostics algorithm and psychological correction programmes contribute to higher efficiency of diagnostics and cognitive functions restoration as disability factors in AH patients with ischemic stroke.

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