Bożena Grochmal-Bach

Bożena Grochmal-Bach – Psychiatric rehabilitation of a patient after myocardial infarct. Fizjoterapia Polska 2001; 1(2); 161-166

Abstract
Background. The purpose of this article is to describe the psychiatric rehabilitation of patient RK, who in the course of cardiological rehabilitation subsequent to a myocardial infarct experienced psychopathological symptoms provoked by the crisis situation resulting from his heart attack. A specially developed program of psychiatric rehabilitation was implemented, using goal management techniques. Research methods. The instruments used to evaluate the effects of rehabilitation included clinical interviews oriented towards psychopathological symptoms, an abbreviated version of the Beck Depression inventory, the Claparede Memory Test, the Wechsler Memory Scale – Revised (Polish version), and an authorial Clinical Self-Evaluating Test of Cognitive, Emotional, Vegetative, and Neurobehavioral Disturbances, which includes measurements of anxiety, mood, sleep disturbances, psychomotor arousal, self-esteem, and fatigue. Results. When retested after 6 months of rehabilitation the patient proved to have higher level self-esteem, while symptoms of anxiety, depression, restlessness, and aggression had diminished. Despite the very small doses of antidepressive, antianxiety, and sedative drugs, the patient’s condition improved due various other of the therapy program. Conclusion. The patient described in this article was characterized prior to his heart attack by superficial politeness severing to conceal anxiety and the resultant aggression, which was directly related to the development of cardiomyopathy. The interdisciplinary treatment program involved an entire team, including especially cooperation between the psychiatrist and the physiotherapist. It was directed especially towards improving the patient’s ability to relax and cope with stress constructively, which made it possible to improve the patient’s physical condition in daily functioning, reduce physical and mental tension, ameliorate emotional disturbances, and rebuild disturbed cognitive functions, improvement was obtained not only in the patient’s overall condition, but also in his of life.

Key words:
cardiological rehabilitation, psychoterapy, psychotonic training

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