Features of purpose-in-life orientations in hypertensive patients and their use in outpatient psychological support

Zhakupova Y.; Shumakova O.; Shaposhnik I.

doi:10.14529/jpps260103

Y. T. Zhakupova South Ural State Medical University (64 Vorovskiy str., 454092, Chelyabinsk, Russia) https://orcid.org/0000-0002-2699-7430 ps-gold@yandex.ru
O. A. Shumakova South Ural State Medical University (64 Vorovskiy str., 454092, Chelyabinsk, Russia) https://orcid.org/0000-0001-9928-0548 olgash37@yandex.ru
I. I. Shaposhnik South Ural State Medical University (64 Vorovskiy str., 454092, Chelyabinsk, Russia) https://orcid.org/0000-0002-7731-7730 shaposhnik@yandex.ru

DOI: https://doi.org/10.14529/jpps260103

Keywords: purpose-in-life orientations, coping resources, life satisfaction, hypertension, adherence to treatment, psychotherapeutic targets, psychological correction

Abstract

Introduction: Hypertension (HTN) is one of the most common diseases and has significant social implications. The psychological experience of illness status in patients can worsen the course of the disease and reduce the effectiveness of treatment. Patients often experience a deep intrapersonal crisis accompanied by multiple psychological changes, among which significant alterations in the meaning of life and a restructuring of personal value orientations are particularly prominent. At the same time, patient’s purpose-in-life (PIL) orientations contribute to an adequate psychological response to their illness, facilitating the choice of appropriate behaviors during rehabilitation and adaptation to life as a chronic patient. Studies on PIL in hypertensive patients are scarce, yet they highlight the need to shift focus toward non-pharmacological approaches to hypertension management. In particular, there is a recognized need for the development and implementation of specialized psychological programs aimed at supporting patients and ensuring treatment adherence during the outpatient phase. Aims: this paper aims to identify features of PIL orientations in hypertensive patients to inform the development of psychological rehabilitation programs for outpatient settings. Materials and methods: The study was conducted at State Clinical Hospital No. 1 (Chelyabinsk, Russia). The sample consisted of 60 individuals, including 30 patients from the inpatient cardiology unit. This study employed the following psychological and clinical diagnostic methods: a clinical interview, the Russian adaptation of the Purpose-in-Life Test, the Satisfaction with Life questionnaire, and the Ways of Coping Behavior Questionnaire. Results: The study demonstrated that the existential components of PIL orientations in hypertensive patients were higher than those of the comparison group. Scores on the “Goals in Life” and “Result of Life” subscales significantly exceeded the normative sample, as did scores on “Process of Life” and “Locus of Control – Self”. Regarding life satisfaction in hypertensive patients, scores on the “Life Fatigue” and “Future Anxiety” subscales, as well as on “Life Engagement” and “Disappointment in Life”, differed significantly from the normative sample. Among hypertensive patients, the dominant coping strategies were the constructive ones “Accepting Responsibility” and “Planful Problem Solving”. The greatest number of correlations with PIL variables was found for the “Escape–Avoidance” coping strategy. Conclusion: Our findings enabled us to identify the key areas of psychological support for hypertensive patients in outpatient settings. These include psychoeducational interviews, motivation for adherence to a healthy lifestyle, and training in effective self-management of stressful situations.

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Author Biographies

Y. T. Zhakupova , South Ural State Medical University (64 Vorovskiy str., 454092, Chelyabinsk, Russia)

Candidate of Psychological Sciences, Associate Professor, Associate Professor of the Department of Psychology

O. A. Shumakova , South Ural State Medical University (64 Vorovskiy str., 454092, Chelyabinsk, Russia)

Doctor of Psychology, Professor, Head of the Department of Psychology

I. I. Shaposhnik , South Ural State Medical University (64 Vorovskiy str., 454092, Chelyabinsk, Russia)

Doctor of Medical Sciences, Professor, Head of the Department of Propaedeutics of Internal Diseases

References

1. Viktorova I.A., Lisnyak M.V., Trukhan D.I. Optimized management of hypertensive patients with anxiety: focus on nonpharmacological approaches. Mezhdunarodnyi zhurnal serdtsa i sosudistykh zabolevanii = International Heart and Vascular Disease Journal. 2016;12:44–51. (in Russ.).
2. Melekhov A.V., Emelina E.I., Andreeva O.Yu. et al. The effect of educational programs on effectiveness of treatment of arterial hypertension at out-patient stage of medical care rendering. Rossiiskii meditsinskii zhurnal = Medical Journal of the Russian Federation. 2016;22(4):207–212. (in Russ.). DOI: 10.18821/0869-2106-2016-22-4-207-212
3. Shishkova V.N. Correction of psychoemotional disorders in patients with arterial hypertension. Farmakologiya i Farmakoterapiya = Pharmacology and Pharmacotherapy. 2022;5:63–67. (in Russ.).
4. Primachenko A.S., Sarsenbaeva L.O. Clinical and psychological features in patients with hypertension. Biologiya i integrativnaya meditsina = Biology and integrative medicine. 2025;2(74):76–89. (in Russ.). DOI: 10.24412/cl-34438-2025-76-89
5. Semenova E.A. Medical and psychological support of patients with arterial hypertension. Zdorove i obrazovanie v XXI veke = Health and education in the XXI century. 2011;13(10):495–496. (in Russ.).
6. Kovalenko T.G., Trofimova I.M. Medical and psychological aspects of the treatment of patients with hypertension. Zdorove i obrazovanie v XXI veke = Health and education in the XXI century. 2011;13(10):345–346. (in Russ.).
7. Semenova E.A., Vishnevsky V.I. The work of the school of hypertension. Zdorove i obrazovanie v XXI veke = Health and education in the XXI century. 2010;12(10):506–507. (in Russ.).
8. Dyusenova L.B., Pivina L.M., Belikhina T.I. et al. Evaluation of the impact of medical and psychological counselling on patient adherence to antihypertensive treatment. Nauka i zdravookhranenie = Science and Healthcare. 2018;20(4):34–49. (in Russ.).
9. Dyusenova L.B., Pivina L.M., Ostroumova E. et al. The influence of psychological factors on adherence of patients with arterial hypertension to treatment. A literature review. Nauka i zdravookhranenie = Science and Healthcare. 2018;20(3):127–138. (in Russ.).
10. Ergasheva Z.A., Usmanova M.B., Abdurahimov A.H. Features of psychotherapy in the treatment of hypertension. Rehealth journal. 2019;1:16–20. (in Russ.).
11. Larionov P.M. Psychosomatic relationships in patients with hypertension. Rossiiskii kardiologicheskii zhurnal = Russian Journal of Cardiology. 2020;25(3):3683. (in Russ.). DOI: 10.15829/1560-4071-2020-3-3683
12. Kostina L.A., Kubekova A.S. Psikhologicheskii status bolnykh gipertonicheskoi boleznyu [The psychological status of patients with hypertension]. Moscow. Mir nauki Publ. 2021:103. (in Russ.).
13. Sidorova Yu.I., Biletskaya M.P. Psychological features of patients with GB II stage. Pediatr = Pediatrician. 2013;4(1):86–88. (in Russ.).
14. Meredova B.A., Toylyeva K.P., Meredova L.R. Psychological changes in hypertension in humans. Vestnik nauki = Bulletin of Science. 2023;5(10):540–544. (in Russ.).
15. Sidorov P.I., Sovershaeva E.P. Synergetic biopsychosociospiritual conception of arterial hypertension. Ekologiya cheloveka = Human ecology. 2015;1:49–60. (in Russ.).
16. Baksanskiy O.E., Skorobogatova A.V. Philosophical and psychological aspects of studying intellectual life orientations of a person in domestic and foreign literature. Kollektsiya gumanitarnykh issledovanii = The Collection of Humanitarian Researches. 2019;4(19):10–21. (in Russ.).
17. Leontev D.A. Psikhologiya smysla: priroda, stroenie i dinamika smyslovoi realnosti [Psychology of meaning: the nature, structure and dynamics of semantic reality]. Moscow. Smysl Publ. 2003:487. (in Russ.).
18. Ataev K., Ataeva S.A. The role of psychology in health care. Vestnik nauki = Bulletin of Science. 2023;3(1):264–267. (in Russ.).
19. Ayvazyan T.A. Basic principles of psychocorrection in hypertension. Atmosfera. Novosti kardiologii = Atmosphere. Cardiology news. 2002;1:5–7. (in Russ.).
20. Kagramanyan I.N. The role of compliance in improving quality of medical care. Remedium. 2015;5:25–29. (in Russ.).
21. Viktorova I.A., Lisnyak M.V., Akhmedzhanov N.V., Nebieridze D.V. Non-adherent behavior in patients with anxiety and hypertension: focus on non-pharmacological treatment as a method to increase compliance. Ratsionalnaya farmakoterapiya v kardiologii = Rational Pharma-cotherapy in Cardiology. 2016;12(6):661–668. (in Russ.). DOI: 10.20996/1819-6446-2016-12-6-661-668
22. Coleman C.I., Limone B., Sobieraj D.M. et al. Dosing frequency and medication adherence in chronic disease. Journal of Managed Care and Specialty Pharmacy. 2012;18(7):527–539. DOI: 10.18553/jmcp.2012.18.7.527.
23. Pan Y., Cai W., Cheng Q. et al. Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies. Neuropsychiatric Disease and Treatment. 2015;11:1121–1130. DOI: 10.2147/NDT.S77710
24. Moiseyeva M.V., Viktorova I.A., Trukhan D.I., Bagisheva N.V. The prognosis of low ad-herence to therapy of patients with arterial hypertension in the primary healthcare stage. Trudnyi patsient = A difficult patient. 2018;16(3):16–19. (in Russ.).
25. Irvin M.R., Shimbo D., Mann D.M. et al. Prevalence and correlates of low medication adherence in apparent treatment-resistant hypertension. Journal of clinical hypertension. 2012;14(10):694–700. DOI: 10.1111/j.1751-7176.2012.00690.x.
26. Forte G., Favieri F., Pazzaglia M., Casagrande M. Mental and Body Health: The Association between Psychological Factors, Overweight, and Blood Pressure in Young Adults. Clinical Medicine. 2022;11(7):1999. DOI: 10.3390/jcm11071999.
27. Alekhin A.N., Dubinina E.A. Psychological interventions in hypertension: rationale and efficiency. Arterialnaya Gipertenziya = Arterial Hypertension. 2018;24(2):132–144. (in Russ.). DOI: 10.18705/1607-419X-2018-24-2-132-144

References on translit

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