PERSON-CENTERED INTERVIEW AS A TOOL FOR CLINICAL WORK IN MYOCARDIAL INFARCTION SETTING

The issue of non-communcable diseases risk factors is one of the main in global targets of healthcare.  However the key point in this direction is still a  patient-clinician  communication  that  demands   high  level  of understanding and  empathy.  A  useful tool for clinical work might be person-centered interview.

Aim. To evaluate epistemological role of person-centered interview and to define its place in cardiological care for acute  myocardial infarction patients (MI).

Material and methods. The study is done in qualitative methodology: in-depth semistructured interview. Totally, 216 consequent MI patients screened. After inclusion  criteria  assessment  (economically  active males  with first MI, none  severe  comorbidities  and  no anamnesis  of coronary heart disease)  and study procedures, 14 interviews included into analysis  by phenomenological  descriptive  with the  elements  of interpretation, method.

Results. A range of non-expressed experiences  revealed of the living through of the disease state in this group of patients: serious life change, borderline of life “before” and “after”; anxiety and fear of sudden death and repeat  of the event; discourage  and confusion; puzzlement; disorientation in symptoms,  misunderstanding;  loss of perspective  for better  in life; stigmatization; self-image  changes; feelings of guilt and resentment;  somatic markers; specifics of social stress.

Conclusion.  Person-centered  interview as  a  method  of  dialogue, implemented  to  the  work of clinician, makes  it to  reveal  the  nonexpressed  but  very important  sides  of  the  disease   course.   In the experiencing of males with first MI, economically active, there is a range of issues  requiring specific  work. Addressing  to the  phenomenal  of patients  might be  a  higher  level position  in the  work with life style determined non-communicable diseases.

1. Health 2020: the European Policy for Health and Wellbeing. URL: http://www. euro.who.int/en/health-topics/health-policy/health-2020-the-european-policy-forhealth-and-well-being

2. People-Centred Healthcare: a Policy Framework. URL: http://www.wpro. who.int/health_services/people_at_the_centre_of_care/documents/ENGPCIPolicyFramework.pdf

3. Piepoli M, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J, 2016; 37(29): 2315-81. URL: https://academic.oup.com/eurheartj/article/37/29/2315/1748952/2016European-Guidelines-on-cardiovascular-disease

4. Shaffer J, Falzon L, Cheung K, et al. N-of-1 randomized trials for psychological and health behavior outcomes: a systematic review protocol. Systematic Reviews 2015; 4: 87-94.

5. Sheeran P. The Intention-Behavior Gap. Soc and Pers Psych Compass, 2016; 10(9): 503-18.

6. Nikolaev EL, Lazareva EYu. Personality adaptation and cardiovascular diseases. Bulletin of Psychiatry and Psychology of Chuvashia 2015; 11(2): 82-96. Russian (Николаев Е. Л., Лазарева Е. Ю. Адаптация личности и сердечно-сосудистые заболевания. Вестник психиатрии и психологии Чувашии 2015; 11(2): 82-96).

7. Healthcare in Russia. Statistical Bulletin 2015. Federal Service for State Statistics, Moscow, 2015. Russian (Здравоохранение в России. Статистический сборник 2015. Федеральная служба государственной статистики, Москва 2015; 174 с).

8. Orlov AB, Orlova NA. The Psychological Status of a Psychotherapist. J of Higher School of Economics 2014; 11(2): 136-49. Russian (Орлов А. Б., Орлова Н. А. Психологический статус психотерапевта. Журнал Высшей Школы Экономики 2014; 11(2): 136-49).

9. Heesook S, Friedmann E, Sue TA, et al. Biopsychosocial predictors of coping strategies of patients postmyocardial infarction. Int J of Nursing Practice 2016; 22(5): 493-502.

10. Kolpachnikov VV. Psychotechinal system of client-centered psychotherapy. Counsel Psychol and Psychother, 2014; 3: 80-92. Russian (Колпачников ВВ. Психотехническая система клиентоцентрированной психотерапии. Консульт Психология и Психотер 2014; 3: 80-92).

11. Cho J, Trent A. Evaluating Qualitative Research. The Oxford Handbook of Qualitative Research Leavy P. (ed.). Oxford University Press 2014; 677-95.

12. Thorne SE. Applied interpretive approaches. The Oxford Handbook of Qualitative Research Leavy P. (ed.). Oxford University Press 2014; 99-115.

13. Taratukhin E. Patient’s personality: an interdisciplinary approach to cardiovascular pathology. Russ J Cardiol 2014; 9(113): 22-5. Russian (Личность больного: междисциплинарный подход в работе с кардиологической патологией. Российский кардиологический журнал 2014; 9: 22-5).