PSYCHO-EMOTIONAL STATUS AND COPING STRATEGIES IN PATIENTS WITH LONG-TERM CONSEQUENCES OF TRAUMATIC DISEASE OF SPINAL CORD

Abstract

Subject and purpose of the study. Personal resources of patients with traumatic disease of spinal cord (TDSC), individual abilities of psychological adaptation to changed conditions of life and motivation for recovery have significant influence on their full-value rehabilitation throughout the entire restorative period. The purpose of the present study is to evaluate psycho- emotional status and styles of coping with the disease in patients with TDSC. Participants of the study and methods. 49 patients were selected (average age 32.4 +/- 2.2 years, among them -63.3% males) with TDSC with duration of the disease over 3-4 months; with the type of spinal cord damage B, C by ASIA scale. With all patients the following techniques were applied: 1) Self-evaluation of depression according to A. Back; 2) Evaluation of trait and state anxiety according to Spielberg-Hanin test; 3) study of coping-behaviour by E. Haim. For evaluation of the results we calculated the arithmetical mean (M) and its error (+/- m), correlation coefficient r-Pearson with evaluation according to Cheldok scale. Results. In the examined group all patient were diagnosed with clinically evident disorders of conductivity of the spinal cord leading to functional limitations: 81.6% of the patients were referred to groups B and C according to ASIA scale with severe incomplete spinal cord injury. The injury was often located at cervical and thoracic level, which caused severe neurological disorders and disability of the patients. We evaluated psycho-emotional condition of patients in interim and late periods of traumatic disease of the spinal cord and observed high trait anxiety in 42.8% of cases, while state anxiety was observed only in 4% of patients. Significant depression was diagnosed only in 4% of patients. Neither level of state anxiety, nor level of depression depended on severity of neurological disorders. Prevailing variants of cognitive coping strategies are: "Exercising self-control" (22.4%), "Humility" (14.2%) and "Religiosity" (22.4%), emotional coping "Optimism" (61.2%) and "Suppression of emotions" (18.3%), behavioural coping "Distraction" (38.7%) and adaptive "Collaboration" (20.4%). A lot of factors contribute to formation of depression, including various variants of coping- behaviour: cognitive, emotional, behavioural. Predominance of adaptive coping-strategies forms positive psychological status of patients. Negative psycho-emotional background is observed in presence of non-adaptive and relatively adaptive behavioural and cognitive coping strategies. In our opinion, absence of severe depression and psychogenic changes is explained by the work of coping mechanisms and coping strategies, which are directed at overcoming difficulties, rueful emotions, reduction of stress and help the person to adapt to difficult life situation associated with the spinal trauma.