Methodology for the development of the system model of prognosis for cardiovascular diseases

Abstract

The article presents the necessity and timeliness of development of the system prognostic model, which in its unity will display the three main terms of therapeutic dynamics in cardiovascular diseases (CVD) — medical, psychological and social. The main attention is paid to the prognostic factors of the effectiveness of rehabilitation of patients with coronary heart disease during rehabilitation and in long-term periods after coronary artery bypass grafting (CABG), as well as to psychosocial assessment in the period of preparation for heart transplantation in the terminal stage of chronic heart failure. Based on the analysis of modern literature, the need for a comprehensive study of the psychological factors of prognosis is shown; among them a special position is held by the dynamics of patients’ cognitive functioning, closely related to the hemodynamics of the brain in CVD, as well as patients’ adherence to treatment during rehabilitation after CABG and during preparation for heart transplantation. The program of empirical research is presented, including the study of the relationship between patients’ biological, clinical, psychological and social characteristics and the CVD prognosis. The results of the first stage of the study of 111 CHD patients, aimed at identifying the most informative psychological factors in terms of labor prognosis after cardiac operations, are also presented in the article proving the special socio-economic importance of the problem of patients’ nonreturn to work after successful myocardial revascularization. It is planned to carry out a metaanalysis of prognostic studies presented in the scientific literature, and to design a systematic (biopsychosocial) prediction model for CVD upon completion of a study of 400 CVD patients using mathematical modeling methods. The next step in studying the factors of the prognosis will be an empirical verification of the developed model which will allow substantiating the main ways of psychological intervention in life-threatening heart diseases with the aim of increasing the effectiveness of treatment and optimizing the quality of patients’ life.