IMPACT OF PREDISPOSITION TO PSYCHOLOGICAL DISTRESS ON THE DYNAMICS OF QUALITY OF LIFE ONE YEAR AFTER CORONARY ARTERY BYPASS GRAFTING SURGERY
Objective. To study impact of predisposition to psychological distress on the dynamics of quality of life (QL) of patients one year after coronary artery bypass grafting (CABG) surgery. Material and methods. Assessment of psychological status (type D personality, extent of depression, anxiety, quality of life) before and one year after CABG were focused on 408 patients (58 ± 3 years old, 327 male patients and 81 female patients). Two groups were formed: group I presenting type D personality ( n =93), group II non-presenting type D personality ( n =315). The questionnaire SF-36 was used for evaluation of QL. Two integral determinants were assessed i. e. physical and psychological components of quality of life. Impact of different factors on the dynamics of physical and psychological components of QL one year after surgical intervention were studied with the help of the model of logistic regression. Results. «Distressed» type of personality was observed in 22.8 % of patients before CABG and in 22.3 % of patients one year after the operation. The presence of type D personality was accompanied by the greater level of depression and anxiety. Physical component of QL – Me (Q) – was lower in group of patients presenting with type D personality in comparison with control for both before (46.9 (22.8) and 67.3 (16.8) points; p <0.001) and after CABG (67.8 (17.4) and 72.1 (15.1) points; p < 0.001). As for psychological component the difference was alike, i. e. 37.9 (20.7) and 64.6 (15.2) points ( p < 0.002) before the operation and 45.6 (16.2) and 68.2 (15.8) points ( p < 0.002) one year after CABG. One year after CABG the positive increase of determinants of QL was reported in both groups. Plural logistic regression analysis has reported that type D personality (odds ratio 1.55; 95 % confidence interval 1.00–2.51; p < 0.05) and risk of operation according to EuroSCORE have made the independent influence on improvement of physical component of QL after CABG operation as well as type D personality (odds ratio 1.08; 95 % confidence interval 1.03–1.15; p =0.01) and carotid endarterectomy in the anamnesis has made the independent influence on improvement of psychological component. Conclusion. Presence of type D personality has been accompanied by low determinants of quality of life both before and one year after CABG operation. Most growth of both physical and psychological components of quality of life has been observed in group of patients presenting with type D personality. Evaluation of the personality type and purposeful behavioral influence might facilitate improvement of QL in the long-term period after CABG.