Academic Scientific JournalsPsychological determinants of the attitude towards vascular interventions in patients with lower limb ischaemia
Keywords:
critical limb ischaemia, personal resources, vascular surgeryAbstract
Background:
Critical lower limb ischaemia is associated with a 20% annual risk of amputation and death. It is necessary to activate pa-tients’ personal resources which comprise mental dispositions needed to effectively cope with the disease. The objective of the study was to evaluate the correlation between the attitude toward the vascular reconstruction and self-efficacy (SE), health locus of control (HLoC) and own life quality (QOL) assessment in patients with critical lower limb ischaemia.
Participants and procedure:
The study involved 64 patients with critical lower limb ischaemia (Rutherford 4 and 5), 26 women and 38 men. Four scales were applied during primary admission: the Generalized Self-Efficacy Scale; the Satisfaction with Life Scale; the Multidimensional Health Locus of Control Scale; and the visual scale revealing attitude to vascular reconstruction.
Results:
The attitude to the vascular reconstruction was positive (M = 8.50). The lowest grades were given by those hospitalised several times during follow-up (M = 8.30); women expressed low grades (M = 7.71). An overall positive correlation was found between the positive attitude to the surgery and self-efficacy (p = .012), internal HLoC (p = .041) and external locus (p = .026). In the patients who died within six months from baseline assessment, no correlations were found. In subjects with no readmission, a correlation was found between positive attitude to surgery and the external personal HLoC (p = .023). In patients with subsequent readmissions, a correlation was found between the originally positive attitude to the surgery and poor self-efficacy (p = .009).
Conclusions:
Patients with weak mental dispositions cannot cope with difficult situations and show a tendency to experience strong emotions, concentrating on their deficiencies, resulting in decreased motivation and feeble engagement in treatment. Poor mental disposition influences the final outcome of the vascular reconstruction.
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References
Adam, D. J., Beard, J. D., Cleveland, T., Bell, J., Bradbury, A. W., Forbes, J. F., Fowkes, F. G., Gillepsie, I., Ruckley, C. V., Raab, G., Storkey, H., & BASIL trial participants (2005). Bypass versus angioplasty in severe ischaemia of the leg (BASIL): Multicentre, randomised controlled trial. Lancet, 366, 1925–1934. https://doi.org/10.1016/S0140-6736(05)67704-5.
Antonovsky, A. (1984). The sense of coherence as a determinant of health. In: J. D. Matarazzo & N. E. Miller (Eds.), Behavioral health (pp. 114– 129). John Wiley.
Armstrong, D. G., & Lavery, L. A. (1998). Diabetic foot ulcers: Prevention, diagnosis and classification. American Family Physician, 57, 1325–1338.
Aronow, W. S., & Ahn, C. (1994). Prevalence of coexistence of coronary artery disease, peripheral arterial disease, and atherothrombotic brain infarction in men and women > or = 62 years of age. The American Journal of Cardiology, 74, 64–65. https:// doi.org/10.1016/0002-9149(94)90493-6.
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, 122–147. https:// doi.org/10.1037/0003-066X.37.2.122.
Bandura, A. (1977). Social learning theory. Prentice Hall Inc.
Baum, S. K., & Stewart, R. B., Jr (1990). Sources of meaning through the lifespan. Psychological Reports, 67, 3–14. https://doi.org/10.2466/pr0.1990.67.1.3.
Criqui, M. H., Langer, R. D., Fronek, A., Feigelson, H. S., Klauber, M. R., McCann, T. J., & Browner, D. (1992). Mortality over a period of 10 years in patients with peripheral arterial disease. The New England Journal of Medicine, 326, 381–386. https://doi.org/10.1056/ NEJM199202063260605.
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49, 71–75. https://doi.org/ 10.1207/s15327752jpa4901_13.
Farber, A., & Eberhardt, R. T. (2016). The current state of critical limb ischemia: a systematic review. JAMA Surgery, 151, 1070–1077. https://doi.org/10.1001/jamasurg.2016.2018.
Heszen, I., & Sęk, H. (2007). Psychologia zdrowia [Psychology of health]. Wydawnictwo Naukowe PWN.
Hirsch, A. T., Criqui, M. H., Treat-Jacobson, D., Regensteiner, J. G., Creager, M. A., Olin, J. W., Krook, S. H., Hunninghake, D. B., Comerota, A. J., Walsh, M. E., McDermott, M. M., & Hiatt, W. R. (2001). Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA, 286, 1317–1324. https://doi.org/10.1001/jama.286.11.1317.
Juczyński, Z. (2001). Narzędzia pomiaru w promocji i psychologii zdrowia [Measurement tools in health promotion and health psychology]. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego.
Kościelak, R. (2010). Poczucie umiejscowienia kontroli i przekonania o własnej skuteczności w zdrowiu i chorobie [Health locus of control and selfefficacy in health and illness]. Impuls.
Matsumura, J. S., Yamanouchi, D., Goldstein, J. A., Pollock, C. W., Bosiers, M., Schultz, G. A., Scheinert, D., & Rocha-Singh, K. J. (2013). The United States study for evaluating endovascular treatments of lesions in the superficial femoral artery and proximal popliteal by using the Protégé EverFlex nitinol stent system II (Durability II). Journal of Vascular Surgery, 58, 73–83.e1. https://doi. org/10.1016/j.jvs.2012.12.066.
Moulik, P. K., Mtonga, R., & Gill, G. V. (2003). Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Diabetes Care, 26, 491–494. https://doi.org/10.2337/diacare.26.2.491.
Norgren, L., Hiatt, W. R., Dormandy, J. A., Nehler, M. R., Harris, K. A., Fowkes, F. G., & TASC II Working Group (2007). Inter-society consensus for the management of peripheral arterial disease (TASC II). Journal of Vascular Surgery, 45, S5–S67. https://doi. org/10.1016/j.jvs.2006.12.037.
Pavot, W., & Diener, E. (2008). The Satisfaction with Life Scale and the emerging construct of life satisfaction. The Journal of Positive Psychology, 3, 137– 152. https://doi.org/10.1080/17439760701756946.
Peterman, A. H., & Cella, D. (2000). Quality of life. In A. I. Kazdin (Ed.), Encyclopedia of Psychology (pp. 491–495). American Psychological Association.
Peters, C., de Vries, J., Steunenberg, S. L., Ho, G. H., Lodder, P., & van der Laan, L. (2019). Is there an important role for anxiety and depression in the elderly patients with critical limb ischemia, especially after major amputation? Annals of Vascular Surgery, 58, 142–150. https://doi.org/10.1016/j. avsg.2018.10.045.
Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs: General and Applied, 80, 1–28. https://doi.org/10.1037/h0092976.
Ruffin, R., Ironson, G., Fletcher, M. A., Balbin, E., & Schneiderman, N. (2012). Health locus of control beliefs and healthy survival with AIDS. International Journal of Behavioral Medicine, 19, 512–517. https://doi.org/10.1007/s12529-011-9185-2.
Stanisić, M., & Rzepa, T. (2012). Attitude towards one’s illness vs. attitude towards a surgical operation, displayed by patients diagnosed with asymptomatic abdominal aortic aneurysm and asymptomatic internal carotid artery stenosis. International Angiology, 31, 376–385.
Schillinger, M., Exner, M., Mlekusch, W., Rumpold, H., Ahmadi, R., Sabeti, S., Haumer, M., Wagner, O., & Minar, E. (2002). Vascular inflammation and percutaneous transluminal angioplasty of the femoropopliteal artery: association with restenosis. Radiology, 225, 21–26. https://doi.org/10.1148/ radiol.2251011809.
Schwarzer, R., & Jerusalem, M. (1995). Generalized Self-Efficacy Scale. In J. Weinman, S. Wright, & M. Johnston (Eds.), Measures in health psychology: a user’s portfolio. Causal and control beliefs (pp. 35–37). NFER-Nelson.
Steunenberg, S. L., Raats, J. W., Te Slaa, A., de Vries, J., & van der Laan, L. (2016). Quality of life in patients suffering from critical limb ischemia. Annals of Vascular Surgery, 36, 310–319. https://doi.org/10.1016/j. avsg.2016.05.087.
Tunis, S. R., Bass, E. B., & Steinberg, E. P. (1991). The use of angioplasty, bypass surgery, and amputation in the management of peripheral vascular disease. The New England Journal of Medicine, 325, 556–562. https://doi.org/10.1056/NEJM199108223250806.
van Dijk, T. K., Dijkshoorn, H., van Dijk, A., Cremer, S., & Agyemang, C. (2013). Multidimensional health locus of control and depressive symptoms in the multi-ethnic population of the Netherlands. Social Psychiatry and Psychiatric Epidemiology, 48, 1931– 1939. https://doi.org/10.1007/s00127-013-0678-y.
Wallston, K. A., Stein, M. J., & Smith, C. A. (1994). Form C of the MHLC scales: a condition-specific measure of locus of control. Journal of Personality Assessment, 63, 534–553. https://doi.org/10.1207/ s15327752jpa6303_10.
Wallston, K. A., & Wallston, B. S. (1982). Who is responsible for your health? The construct of health locus of control. In G. S. Sanders & J. Suls (Eds.), Social psychology of health and illness (pp. 65–95). Erlbaum.
Wallston, K. A., Wallston, B. S., & DeVellis, R. (1978). Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Education Monographs, 6, 160–170. https://doi.org/ 10.1177/109019817800600107.
Xu, D., Chu, X., Wang, K., Wei, L., Xu, Y., Huang, X., Li, J., Xu, L., Yin, L., Liu, H., Liu, X., Leng, H., Xue, Q., Peng, M., Jia, L., & Wang, H. (2021). Potential factors for psychological symptoms at three months in patients with young ischemic stroke. BioMed Research International, 2021, 5545078. https://doi. org/10.1155/2021/5545078.
Zotti, A. M., Balestroni, G., Cerutti, P., Ferrario, S. R., Angelino, E., & Miglioretti, M. (2007). Application of the General Perceived Self-Efficacy Scale in cardiovascular rehabilitation. Monaldi Archives for Chest Disease, 68, 178–183. https://doi.org/10.4081/ monaldi.2007.451.
