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Skumin syndrome

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Skumin syndrome
Classification and external resources

Victor A.Skumin, 1978
ICD-10 F48.8
ICD-9 300.8

Skumin syndrome is a specific mental disorder, which a quarter of the patients develop after the prostheses of the valve heart device [1] and manifests with persistent doubts about the reliability of the implant, fear of its breakdown, fixed negative attitude to physical and psychoemotional load, specific sleep disorder, feeling of anxiety, mental confusion and depression.[2] [3]

Contents

History

This disease was described in 1978 by Victor Skumin and called "cardioprosthetic psychopathological syndrome".[4] V. Skumin for the first time studied the etiology, pathogenesis and the disease pattern, worked out methods of its diagnostics, treatment, prophylaxis, effective system of rehabilitation measures, programme of culture of health basics fostering to that cohort of people. The stated above was based on the research lead in the Nikolai Amosov Institute[5] According to N. Amosov and Ya. Bendet (1990) this psychological syndrome was observed for 27.5% of patients".[6]

Etiology and pathogenesis

[unbalanced opinion]

Etiopathogenetic mechanisms, which cause its origin, are as follows:

  • Presence of functioning foreign matter (prosthesis) into the heart, work of which is accompanied by specific sound matters. As a result there appears unnatural feedback: heart-central nervous system which supplies the sensation of the prosthesis vibrations and the existence of auditory analyzer.
  • The surgical traumatization of nerve-muscular heart apparatus, big vessels, cerebral-cordial links violation.
  • Peculiarities of mental and somatic condition of the patients with valvular heart disease.

The state into which hospitalized patients get after a long conservative therapy is notable for characteristic features:

  • They offer patients a more complicated surgical procedure in the heart - the organ which has special psychological significance.
  • A person imagines a heart not as a mere pump that transfers blood, but as Ivan Pavlov stated, "a sensitive organ of sense", which possesses a life’s destiny.

Signs and symptoms

Skumin syndrome has a typical disease pattern[7] Thinking and behaviour of patients differ specifically. The attention is concentrated on the prosthesis functioning. There appear unusual sensations from a heart when a person fears possible break-down of artificial valves, ball splitting and tearing off a prosthesis. A person is depressed, miserable, alarmed, with a special kind of dismay (how to live with "a piece of iron in the heart", with a prosthesis in the "motor of life"). Patients tend to keep themselves away from petty physical or psycho-emotional tenseness, introducing inadequate self-restrictions in the routine. They avoid walks, medical physical training and other adequate work, supposing this can prevent early wear of artificial valves. Sleep disorder is typical of 76.6% of the patients.[8] At night they cannot fall asleep because they listen to a heart beat, count the number of extrasystoles, note petty changes in the heart rhythm and melody of the implanted prosthesis. On the contrary, in the daytime, when it is noisy they can have sound sleep. Neurologically a patient has vegetative faults – painfulness in the zones of solar plexus and carotid artery, arterial hypotension. The research registered faults in mental activity of the patients with a prosthesis. It considerably hampers the realization of rehabilitation programmes. Systematic use of special psychotherapeutic and prophylactic measures is required for the correction and prevention of these faults.[9]

Psychotherapy

There is the system of psychotherapy and psychoprophylaxis in rehabilitation of the patients with heart valve prosthesis.[citation needed]

Preparatory stage:

  • mental state study,
  • establishment of psychotherapeutic contact,
  • psychological preparation for the process of equipping with a prosthesis of valve heart device. Aspects of psychoprophylaxis are as follows: teaching patients to adjust to conditions of life, preventing psychotraumatic and stressful influence, supporting positive emotional tone, regulating industrial and appliance load, maintaining favourable sanitary conditions, wise use of one’s knowledge and experience.

Sedative-mobilizing stage:

  • calming down of the operated on,
  • forming adequate attitude to the postoperational period,
  • working out active personal positions.

Psychotraining according to V. Skumin is one of the effective psychotherapeutic methods and it includes five exercises:

Special attention is paid to relaxation of hands, back, face, excessive tenseness of which is especially expressed in this cohort of people.

  • «Warmness» – is generated in legs, arms, solar plexus, neck and head.

Patients with artificial heart valves and Skumin syndrome suffer from the cold in peripheral area. Elimination of unpleasant feelings, besides its positive effect, leads to a person’s encouragement in the fight against the disease.

  • «Soaring, zero gravity» – special formulas are used, which generate the feeling of soaring, "zero gravity" and "dissolvation" of the body.

Having mastered this exercise one feels reduced pain, less heavy weight, which is characteristic of such patients; their mood and health improve.

  • «Target autosuggestion» – its formulas are defined by definite medical tasks.

They are targeted on developing adequate attitude to the work of implants, normalization of sleep, correction of character deviations, overcome of fears and uneasiness, mobilization of personal resources.

  • «Activation» – is carried out through formulas and concepts, which contribute to the exit from the state of immersion.

It is stressed that a body is charged with energy, force, and it heads to health restoration and further health improvement. The five exercises according to V. Skumin are the most optimal and highly effective means of mental selfregulation, which lead to quick stabilization of mental condition and have a positive influence on self-esteem and medical state. By the whole, inclusion of mental rehabilitation into medical-management programmes eliminates and predicts the progress of psychological adaptation.

Leading role psychotherapies in the treatment Skumin syndrome and does not exclude the application of psycho-pharmacological preparations, although one should remember about the cardiotoxic action of some of them.[10]

See also

References

  1. ^ "About artificial heart". Heart For Your Soul. http://heartforyoursoul.com/. 
  2. ^ Skumin syndrome
  3. ^ Syndrome de Skumin
  4. ^ Bendet, IaA; Morozov, SM; Skumin, VA (1980). "Психологические аспекты реабилитации больных после хирургического лечения пороков сердца [Psychological aspects of the rehabilitation of patients after the surgical treatment of heart defects]" (in Russian). Kardiologiia 20 (6): 45–51. PMID 7392405. 
  5. ^ Amosov Institute.
  6. ^ Amosov, NM; Bendet, IaA (1990) (in Russian). Терапевтические аспекты кардиохирургии. Киев: Здоровья [Therapeutic aspects of cardiac surgery]. p. 265. 
  7. ^ Bobina LA. The Skumin syndrome as a nosological form.
  8. ^ Skumin syndrome
  9. ^ Skumin, VA (1982). "Непсихотические нарушения психики у больных с приобретёнными пороками сердца до и после операции (обзор). [Nonpsychotic mental disorders in patients with acquired heart defects before and after surgery (review)]" (in Russian). Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova 82 (11): 130–5. PMID 6758444. 
  10. ^ Skumin syndrome

Further reading

  • Skumin, VA (1979). "Nurse's role in medico-psychological rehabilitation of patients with artificial heart valves". Meditsinskaia sestra 38 (9): 44–5. PMID 259874. 
  • Skumin VA. “Psychotherapy and psychoprophylaxis in the system of rehabilitation of the patients with heart valve prosthesis. Methodical recommendations MofPH UkSSR. Kiev, 1980. – 16 p.[verification needed]

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