Psychological Counseling in Heart Diseases and Cardiovascular Surgery
“Every emotion of the mind that gives pain or pleasure, hope or fear reaches the heart”
Prof. Dr. Sedat ÖZKAN
Although a person does not make a certain effort not to get sick during his life, he does not want to get sick at all. The most interesting thing is that after being sick, he wants to recover very quickly. He makes a great effort to return to normal life as soon as possible. Prolonging this process negatively affects recovery.
This is what our patients should know after heart surgery:
“Time is the best medicine”. As a result of our one-year experience, it has been proven that Liaison Psychiatry is the biggest helper of the surgeon and the patient in the use of this drug. One night's perfect sleep or the personal confidence he regains when he returns home to work contributes greatly to his rapid reintegration into society and family.
Prof. Dr. Bingür SÖNMEZ
Our physical and mental health are an inseparable whole. Physical diseases affect our mental health, and our mental state affects our physical functions.
Liaison psychiatry is a specialized psychiatric discipline that provides services for the investigation, diagnosis, treatment, monitoring and prevention of mental crises and diseases seen in patients with physical diseases or undergoing surgical intervention. . It integrates medical treatment and care with psychiatric-psychosocial care. Every physical illness and treatment attempt leads to a crisis. It causes various conflicts, from boredom to loss reaction, future anxiety, feeling of inadequacy, and disability anxiety. The disease affects emotions, thoughts, and relationships as well as the body. Various concerns and reactions are observed that vary depending on the disease, the affected organ, the characteristics of the disease, and the environment the patient is in (grief, panic, denial, guilt, etc.).
Developing in physical diseases and surgeries Psychological reactions sometimes affect our daily functions, interpersonal relationships, sleep and sleep. It can negatively affect our bodily functions such as appetite. These reactions can range from simple adaptation difficulties to psychiatric conditions requiring urgent intervention (such as thoughts of death, mental confusion, etc.). Temporary biological changes in the nervous system, the patient's personality structure, mood and environmental factors play a role in the development of these psychiatric reactions. Behavioral and psychological problems that develop in physical diseases and surgeries negatively affect compliance with treatment, quality of life, treatment and care process, course of the disease, recovery, and response to treatment. Psychological-behavioral reactions that negatively affect the course of the disease, adaptation to the disease and recovery can be prevented or corrected with appropriate psychological approach, early cooperation and timely treatment. Consultation-liaison psychiatry is the psychiatry of physical diseases and surgical interventions, and is a higher specialty than general and traditional psychiatry.
Liaison psychiatry in psychocardiology deals with the diagnosis and treatment of psychological conditions that occur in heart diseases and cardiac surgical interventions. It is a sub-discipline within the field of science service.
We all know the effects of excitement and mental strain on the heart. In daily life, we see the effects and reflections of sadness, anger, excitement and tension on the cardiovascular system (palpitations, shortness of breath, blood pressure). elevation, fever, etc.), we all experience it.
Psychological and behavioral factors directly affect the heart through the sympathoadrenal system. In addition to familial predisposition, smoking, hypertension, and high cholesterol, type A behavior characteristics, which are increasingly common in people today, are among the risk factors for the development of heart disease. Personality traits such as being ambitious, competing with time, having a high drive for success, and having difficulty coping with anger and rage constitute the basis of this behavioral pattern.
The main characteristics seen in a spectrum ranging from coronary artery disease to heart infarction and coronary by-pass surgery. The main psychological crises and situations that require help and treatment are as follows:
- Anxiety and panic states
- Depression
- Difficulties in adapting to the disease and treatment (denial) , refusal of treatment, sleep and appetite disorders �)
- Neuropsychological disorders (disorders of consciousness and orientation)
- Personality changes
- Psychosexual problems
- Continuation of risky behaviors (smoking, non-compliance with diet)
Psychological preparation of the patient for surgery, providing post-operative psychological care and psychological support and follow-up after discharge; It is an integral part of holistic care and treatment. Preparation of the heart, brain and psychological state for the new life together complement each other. Medical, surgical and psychological services form a whole.
Signs and Symptoms Requiring Psychological Counseling and Support
- Distress, Depression and Mental Confusion
- Insomnia, nightmares and frequent awakenings at night
- Feelings and thoughts of hopelessness, helplessness, guilt
- Difficulty in adaptation
- Complaints continue despite appropriate treatment
- Difficulties in coping with the disease and treatment process
- Social withdrawal and panic states
- Reluctance and Lack of Enthusiasm
- Memory disorder
- Narrowing of interests
- Personality changes
- Denial, rejection of treatment
- Grief reactions
- Disappearance of life ideals and loss of professional functions withdrawal
- Decrease in pleasure, desire, interest and activities
- Thought and attention disorders
- Continuous anxiety, pessimism
- Continuation of risky behavior
- Inability to plan for the future
Appropriate treatment of emerging psychological crises, adaptation difficulties and correction of negative habits (diet, smoking, alcohol use) In addition to drug treatments, there are often medical psychotherapeutic, behavioral (relaxation exercises) and psychosocial treatment and support programs.
In these psychological support and treatment programs, in addition to the administration of drugs that regulate the nervous system; The person is helped to express his/her feelings and concerns, to develop strategies to cope with stress, to improve family relationships, to improve adaptation to changing roles, and to adapt to the new situation. Development of new areas of interest, endeavor, expectation, emotional investment and creativity is supported. It stutters. Ensuring physical-spiritual-environmental harmony from illness to life with consciousness, emotion and hope will ensure health and happiness. A more experienced, equipped, hopeful, happy (new) life will begin.
Psychological treatment, support and counseling, while receiving treatment in the hospital, before and after surgery. and following discharge, with medical treatment and care; It is carried out in cooperation with the team through cooperation and coordination.
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