Psychological care for persons after functional loss

Loginova I.; Kononenko I.

doi:10.14529/jpps220106

I. O. Loginova 1) Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University (1, Partizan Zheleznyak str., Krasnoyarsk, 660022, Russia); 2) Federal State-Financed Institution Federal Center for Cardiovascular Surgery (Karaulnaya str., 45, Krasnoyarsk, Krasnoyarsk Territory, 660020) https://orcid.org/0000-0002-9551-1457 loginova70_70@mail.ru
I. O. Kononenko Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University (1, Partizan Zheleznyak str., Krasnoyarsk, 660022, Russia) https://orcid.org/0000-0002-9416-3040 kio62@mail.ru

DOI: https://doi.org/10.14529/jpps220106

Keywords: psychological care, traumatic loss, functional loss, human life-world stability

Abstract

Introduction. The importance of psychological care for persons with functional loss is based on a number of reasons. Functional loss is considered as traumatic stress and can lead to serious changes in ordinary life and psychological well-being. Moreover, the ability to perform various activities may be questioned or become impossible as a result of functional loss. An adequate perception of functional loss depends on the characteristics of world perception formed before amputation. Aim. The paper aims to identify the specifics of psychological care with respect to the features of functional loss perception in persons with different world perception. Materials and methods. This article is based on case studies of three patients experiencing functional loss from 2018 to 2021. The following methods were used for the purpose of the study: analytical (analysis of the situation of experiencing functional loss), clinical and psychological methods (observation, structured clinical interview, psychodiagnostic testing with the I.O. Loginova “Human life-world stability” test). Results. According to the results of the study, regular manifestations of functional loss were identified: patients were dissatisfied with their emotional state and had no resource to cope with the problem; significantly reduced levels of physical activity, role functioning, pain-related and emotional components, vital activity, which indicated worsening in the quality of life. Variable experiences were manifested depending on the stage of experiencing functional loss. These results allowed to develop individual targets of psychological intervention, change patients’ life perception in new circumstances (favorable or unfavorable), adequately assess these circumstances and include them in future life events. Conclusion. A different dynamics of self-identity changes after amputation was recorded with respect to world perception, which facilitated adaptation to the disease and possible disease-related problems. The results obtained indicate that patients perceive their body as more perfect before amputation, however, they discover new psychological resources to compensate their functional loss.

Downloads

Download data is not yet available.

Author Biographies

I. O. Loginova , 1) Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University (1, Partizan Zheleznyak str., Krasnoyarsk, 660022, Russia); 2) Federal State-Financed Institution Federal Center for Cardiovascular Surgery (Karaulnaya str., 45, Krasnoyarsk, Krasnoyarsk Territory, 660020)

1) Prof., Grand PhD in (Psychological) Sciences, Head of the Department of Clinical Psychology and Psychotherapy with postgraduate course; 2) Consultant in Psychology

I. O. Kononenko , Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University (1, Partizan Zheleznyak str., Krasnoyarsk, 660022, Russia)

PhD in (Pedagogical) Sciences, Associate Professor, Associate Professor of the Department of Clinical Psychology and Psychotherapy with postgraduate course

References

1. Abyshov N.S., Zakirdzhaev E.D. Immediate results of “large” amputations in patients with occlusive diseases of the lower limb arteries. Khirurgiya = Surgery. 2005;11:15–19. (in Russ.).
2. Vasilchenko E.M. Dynamics of the frequency of lower limb amputations in the city of Novokuznetsk. Retrospective study. Meditsina v Kuzbase = Medicine in Kuzbass. 2018;17(4):5–10. (in Russ.).
3. Wrobei J.S., Mayfield J.A., Reiber G.E. Geographic variation of lower extremity major amputation in individuals with and without diabetes in the medicare population. Diabetes Care. 2005;24(5):860–864.
4. Eskelinen E., Luther M., Eskelinen A. Infrapopliteal bypass reduces amputation incidence in elderly patients: a population-based study. European Journal of Vascular and Endovascular Surgery. 2003;26(1):65–68.
5. Eskelinen E., Lepantalo M., Hietala E.M. Lower limb amputation in Southern Finland in 2000 and Trends up to 2001. European Journal of Vascular and Endovascular Surgery. 2004;27(2):193–200.
6. Benoit E., ODonnell T.F.Jr., Kitsios G.D. et al. Improved amputation-free survival in unreconstructable criticallimb ischemia and its implications for clinical trial design and quality meas-urement. Journal of Vascular Surgery. 2012;55(3):781–789.
7. Savelev B.C., Koshkin V.M., Karalkin A.V. Patogenez i konservativnoe lechenie tyazhelykh stadii obliteriruyushchego ateroskleroza arterii nizhnikh konechnostei [Pathogenesis and conservative treatment of severe stages of obliterating atherosclerosis of the arteries of the lower extremities]. Moscow. MIA. 2010:214 (In Russ.).
8. Kalbaugh C.A., Strassle P.D., Paul N.J. et al. Trends in Surgical Indications for Major Lower Limb Amputation in the USA from 2000 to 2016. European Journal of Vascular and Endovascular Surgery. 2020;6(60). DOI: https://doi.org/10.1016/j.ejvs.2020.03.018
9. Desmond D.M., Coffey L., Gallagher P. et al. Limb amputation. Ed. P. Kennedy. The Oxford handbook of rehabilitation psychology. Oxford University Press. 2012:351–367. DOI: https://doi.org/10.1093/oxfordhb/9780199733989.013.0020
10. Marini I., Stebnicki M.A. (Eds.). The psychological and social impact of illness and disability (6th ed.). Springer Publishing Company. 2012.
11. Meffen A., Pepper C.J., Sayers R.D., Gray L.J. Epidemiology of major lower limb amputation using routinely collected electronic health data in the UK: a systematic review protocol. Epidemiology Protocol. 2020;6. DOI: https://doi.org/10.1136/bmjopen-2020-037053
12. Panyi L.K., Lábadi B. Pszichológiai alkalmazkodás alsóvégtag-amputációt követően. Orvosi Hetilap. 2015;156(39):1563–1568. DOI: https://doi.org/10.1556/650.2015.30257
13. Parkes C.M. Components of the reaction to loss of a lamb, spouse or home. Journal of Psychosomatic Research. 1972;16(5):343–349. DOI: https://doi.org/10.1016/0022-3999(72)90087-6.
14. Sahu A., Sagar R., Sarkar S., Sagar S. Psychological effects of amputation: A review of studies from India. Industrial Psychiatry Journal. 2016;25(1):4–10. DOI: https://doi.org/10.4103/0972-6748.196041
15. Horgan О., MacLachlan М. Psychosocial adjustment to lowerlimb amputation: a review. Disability and Rehabilitation. 2004;26:837–850. DOI: https://doi.org/10.1080/09638280410001708869
16. Pedras S., Vilhena E., Carvalho R., Pereira M.G. Psychosocial adjustment to a lower limb amputation ten months after surgery. Rehabilitation Psychology. 2018;63(3):418–430. DOI: https://doi.org/10.1037/rep0000189
17. Szkody E., McKinney C. Appraisal and social support as moderators between stress and physical and psychological quality of life. Stress and Health. 2020;36(5):586–595.
18. Cox P.St.L., Williams S.K.P., Weaver S.R. Life after lower extremity amputation in diabetics. West Indian Medical Journal. 2011;60(5):536–540.
19. Durović А., Ilić D., Brdareski Z., Plavsić А., Durdević S. Pain, functional status, social function and conditions of habitation in elderly unilateraly lower limb amputees. Vojnosanitetski pregled. 2007;64(12):837–843. DOI: https://doi.org/10.2298/vsp0712837d.
20. Kekelidze Z.I., Trushchelev S.A. The format for presenting a clinical case in a scientific journal. Guidelines. Rossiiskii psikhiatricheskii zhurnal = Russian Psychiatric Journal. 2017;2:54–58.
(in Russ.).
21. Loginova I.O. Research of stability of the mans lifeworld: the method and psychometric characteristics . Psikhologicheskaya nauka i obrazovanie = Psychological Science and Education. 2012;17(3):18–28. (in Russ.).
22. Popenko N.V., Loginova I.O., Cherdantsev D.V. Investigation of factors that determine life-changing processes in patients with critical ischemia of the lower extremities. Sibirskoe meditsinskoe obozrenie = Siberian Medical Review. 2012;4:72–75. (in Russ.).

References on translit

-