Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации6363UnclassifiedTHE LEVEL OF ANXIETY AND PSYCHOLOGICAL CHARACTERISTICS OF THE ATTITUDE TO THE DISEASE OF PATIENTS WITH A NEW CORONAVIRUS INFECTIONKhmyzInnainnakhmyz2012@yandex.ruhttps://orcid.org/0000-0003-1119-4798SemikolenovaValeriiavaleria-semikolenova@rmbler.ruhttps://orcid.org/0000-0002-7342-22181405202110S15405451102202111022021Copyright © 2021, Молодежный инновационный вестник2021<p>Relevance. The problem of mental assessment of patients with different levels of anxiety is very relevant, because in many cases, the effectiveness of treatment depends on the mental mood of the person. Therefore, the determination of the level of anxiety plays an incomparable role in the management of patients [1].<br />Goal. To conduct a comparative analysis of the level of situational and personal anxiety in patients with a new coronavirus infection complicated by pneumonia with the volume of lung lesions CT1 and CT2.<br />Methods. A survey of 50 patients with coronavirus infection complicated by pneumonia with lung lesions CT1 and CT2 was conducted using the Spielberger-Hanin questionnaire.<br />Results. Differences in the level of anxiety, and, accordingly, in the attitude to their disease, were revealed in patients with different degrees of lung damage to CT1 and CT2.<br />Conclusion. Regularities of formation of the picture of the disease, and various types of psychological response on disease combined in the clinic with the specific features of the mental state of patients, the nature of the response to it, the success of treatment and, as a result, the outcome.</p>Coronavirus infection, pneumonia, anxiety, rehabilitation.Коронавирусная инфекция, пневмония, тревожность, реабилитация.<p>Relevance. At the end of 2019, there was an outbreak of a new coronavirus infection in China. February 11, 2020 WHO has determined the official name of COVID-19, and on March 11, 2020, the COVID-19 pandemic was announced [2]. The virus affects various organs and tissues. The disease is accompanied by a variety of clinical manifestations. Every patient in one way or another experiences anxiety and fear due to an uncertain future, the fear of death or the fact that a person will not be able to lead a full life. It is known that the perception of the disease, as well as the formation of an internal picture of the disease, eventually leads to a disorder of adaptation and the formation of new behavioral reactions, on which the effectiveness of treatment and rehabilitation depends[3].The purpose of the study. To conduct a comparative analysis of reactive and personal anxiety on the Spielberger-Hanin scale in patients with coronavirus infection (established), moderate form, depending on the volume of lung damage. Materials and methods. The study was conducted on the basis of the participation of 50 patients with the diagnosis: coronavirus infection COVID-19 (established), moderate form. Bilateral polysegmental pneumonia with the volume of lung lesions CT1 and CT2 in patients who were treated on an outpatient basis by a pulmonologist at the Broad Hearts Medical Center. The study was conducted using a questionnaire for assessing reactive and personal anxiety on the Spielberger scale, adapted by Yu. L. Khanin. The questionnaire includes 40 judgment questions, 20 of which are designed to assess the level of reactive anxiety and 20 for the level of personal anxiety.</p>
<p>The results of the study.In the course of the study, 50 respondents were interviewed, who were further divided into 2 groups: Group I - 25 (50%) people with a diagnosis of: COVID-19 coronavirus infection (established), moderate form. Bilateral polysegmental pneumonia, mild severity (CT1). Group II - 25 (50%) patients with the diagnosis: COVID-19 coronavirus infection (established), moderate form. Bilateral polysegmental pneumonia, moderate severity (CT2). When assessing situational anxiety in the first group, the question "I am calm" was answered "never" -3 (12%), "almost never" - 8 (32%), "often" - 13 (52%), "almost always" - 1 (4%). In the comparison group, the same question was answered "never" - 6 (24%), "almost never" - 10 (40%), "often" - 9 (36%), "almost always" - 0 (0%). The second question "I am not in danger" in group I was answered "never" - 5 (20%), "almost never" - 8 (32%), "often" - 11 (44%), "almost always" - 1 (4%). The comparison group answered "never" -3 (12%), "almost never" - 6 (24%), "often" - 16 (64%), "almost always" - 0 (0%). The third question "I am under stress" in the main group was answered "never" -8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" -3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The fourth question "I am internally constrained" in the main group was answered "never" - 2 (8%), "almost never" - 3 (25%), "often" - 13 (52%), "almost always" - 7 (28%). The comparison group answered "never" -2 (8%), "almost never" - 3 (25%), "often" - 11 (44%), "almost always" - 9 (36%). The fifth question "I feel free" in the main group was answered "never" -7 (28%), "almost never" - 6 (24%), "often" - 10 (40%), "almost always" - 2 (8%). In the comparison group, the answer was "never" -9 (36%), "almost never" - 8 (32%), "often" - 5 (20%), "almost always" - 3 (12%). The sixth question "I am upset" in the main group was answered "never" -3 (12%), "almost never" - 8 (32%), "often" - 13 (52%), "almost always" - 1 (4%). The comparison group answered "never" -1 (4%), "almost never" - 2 (8%), "often" - 13 (52%), "almost always" - 9 (36%). The seventh question "I care about possible failures" in the main group was answered "never" -8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" -3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The eighth question "I feel peace of mind" in the main group was answered "never" - 7 (28%), "almost never" - 10 (40%), "often" - 5 (20%), "almost always" - 3 (12%). In the comparison group, the answer was "never" - 8 (32%), "almost never" - 12 (48%), "often" - 5 (20%), "almost always" - 0 (0%). The ninth question "I'm worried" in the main group was answered "never" - 2 (8%), "almost never" - 3 (25%), "often" - 13 (52%), "almost always" - 7 (28%). The comparison group answered "never" -2 (8%), "almost never" - 3 (25%), "often" - 11 (44%), "almost always" - 9 (36%). The tenth question "I feel a sense of inner satisfaction" in the main group was answered in the main group: "never" - 6 (24 %), "almost never" - 7 (28%), "often" - 9 (36%), "almost always" - 3 (12%). In the comparison group, the answer was "never" -8 (32%), "almost never" - 8 (32%), "often" - 8 (32%), "almost always" - 1 (4%). The eleventh question "I am confident" in the main group was answered in the main group: "never" - 6 (24 %), "almost never" - 7 (28%), "often" - 9 (36%), "almost always" - 3 (12%). In the comparison group, the answer was "never" -8 (32%), "almost never" - 8 (32%), "often" - 8 (32%), "almost always" - 1 (4%). The twelfth question "I'm nervous" in the main group was answered "never" -8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" -3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The thirteenth question "I don't find a place for myself" in the main group was answered "never" -8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, they answered "never" -3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The fourteenth question "I'm stressed" in the main group was answered "never" - 8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" -3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The fifteenth question "I do not feel constrained, tense" in the main group was answered "never" -3 (12%), "almost never" - 8 (32%), "often" - 13 (52%), "almost always" - 1 (4%). The comparison group answered "never" -1 (4%), "almost never" - 11 (44%), "often" - 13 (52%), "almost always" - 0 (0%). The sixteenth question "I am satisfied" in the main group was answered "never" -8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" -3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The seventeenth question "I am concerned" in the main group was answered "never" -8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" -3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). On the eighteenth question "I am very excited and I feel uncomfortable" in the main group, they answered "never" - 5 (20%), "almost never" - 5 (20%), "often" - 7 (28%), "almost always" - 8 (32%). The comparison group answered "never" -2 (8%), "almost never" - 3 (25%), "often" - 11 (44%), "almost always" - 9 (36%). The nineteenth question "I am happy" in the main group was answered in the main group: "never" - 6 (24%), "almost never" - 7 (28%), "often" - 9 (36%), "almost always" - 3 (12%). In the comparison group, the answer was "never" -8 (32%), "almost never" - 8 (32%), "often" - 8 (32%), "almost always" - 1 (4%). The twentieth question "I am pleased" in the main group was answered "never" - 6 (24 %), "almost never" - 7 (28%), "often" - 9 (36%), "almost always" - 3 (12%). In the comparison group, the answer was "never" -8 (32%), "almost never" - 8 (32%), "often" - 8 (32%), "almost always" - 1 (4%).When assessing personal anxiety, the question "I have a high mood" in the first group was answered "never" - 5 (20%), "almost never" - 8 (32%), "often" - 11 (44%), "almost always" - 1 (4%). In the comparison group, the answer was "never" - 7 (28%), "almost never" - 7 (28%), "often" - 11 (44%), "almost always" - 0 (0%). The second question "I am irritable" in group I was answered "never" - 1 (4%), "almost never" - 8 (32%), "often" - 11 (44%), "almost always" - 5 (20%). In the comparison group, the answer was "never" - 1 (4%), "almost never" - 6 (24%), "often" - 16 (64%), "almost always" - 2 (8%). The third question "I can easily get upset" in the main group was answered "never" - 4 (16%), "almost never" - 5 (20%), "often" - 8 (32%), "almost always" - 8 (32%). In the comparison group, the answer was "never" - 2 (8%), "almost never" - 4 (16%), "often" - 9 (36%), "almost always" - 10 (16%). The fourth question "I would like to be as lucky as others" in the main group was answered "never" - 2 (8%), "almost never" - 3 (25%), "often" - 13 (52%), "almost always" - 7 (28%). In the comparison group, the answer was "never" - 3 (12%), "almost never" - 2 (8%), "often" - 11 (44%), "almost always" - 9 (36%). The fifth question "I am very worried about trouble and can't forget about it for a long time" was answered in the main group "never" - 3 (12%), "almost never" - 6 (24%), "often" - 10 (40%), "almost always" - 6 (24%). In the comparison group, the answer was "never" - 2 (8%), "almost never" - 5 (20%), "often" - 5 (20%), "almost always" - 13 (52%). The sixth question "I feel a surge of energy, a desire to work" in the main group was answered "never" - 3 (12%), "almost never" - 3 (12%), "often" - 13 (52%), "almost always" - 6 (24%). In the comparison group, the answer was "never" - 4 (16%), "almost never" - 5 (20%), "often" - 10 (40%), "almost always" - 6 (24%). The seventh question "I am calm, cool and collected" in the main group was answered "never" - 8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" - 3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The eighth question "I am concerned about possible difficulties" in the main group was answered "never" - 2 (8%), "almost never" - 4 (16%), "often" - 12 (48%), "almost always" - 7 (28%). In the comparison group, the answer was "never" - 2 (8%), "almost never" - 5 (20%), "often" - 12 (48%), "almost always" - 6 (24%). The ninth question "I worry too much about nothing" in the main group was answered "never" - 2 (8%), "almost never" - 3 (25%), "often" - 13 (52%), "almost always" - 7 (28%). In the comparison group, the answer was "never" - 2 (8%), "almost never" - 3 (25%), "often" - 11 (44%), "almost always" - 9 (36%). The tenth question "I am quite happy" in the main group was answered in the main group: "never" - 6 (24 %), "almost never" - 7 (28%), "often" - 9 (36%), "almost always" - 3 (12%). In the comparison group, the answer was "never" - 8 (32%), "almost never" - 8 (32%), "often" - 8 (32%), "almost always" - 1 (4%). The eleventh question "I take everything to heart" in the main group was answered in the main group: "never" - 4 (16 %), "almost never" - 7 (28%), "often" - 11 (44%), "almost always" - 3 (12%). In the comparison group, the answer was "never" - 8 (32%), "almost never" - 3 (12%), "often" - 8 (32%), "almost always" - 6 (24%). The twelfth question "I lack self-confidence" in the main group was answered "never" - 8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" - 3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The thirteenth question "I feel defenseless" in the main group was answered "never" - 8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, they answered "never" - 3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The fourteenth question "I try to avoid critical situations" in the main group was answered "never" - 4 (16%), "almost never" - 5 (20%), "often" - 8 (32%), "almost always" - 8 (32%). In the comparison group, the answer was "never" - 6 (24%), "almost never" - 6 (24%), "often" - 4 (16%), "almost always" - 9 (36%). The fifteenth question "I have a melancholy" in the main group was answered "never" - 3 (12%), "almost never" - 8 (32%), "often" - 13 (52%), "almost always" - 1 (4%). In the comparison group, the answer was "never" - 1 (4%), "almost never" - 11 (44%), "often" - 13 (52%), "almost always" - 0 (0%). The sixteenth question "I am happy" in the main group was answered "never" - 8 (32%), "almost never" - 5 (20%), "often" - 4 (16%), "almost always" - 8 (32%). In the comparison group, the answer was "never" - 3 (12%), "almost never" - 4 (16%), "often" - 14 (56%), "almost always" - 4 (16%). The seventeenth question "All sorts of trifles distract and excite me" in the main group was answered "never" - 5 (20%), "almost never" - 5 (20%), "often" - 7 (28%), "almost always" - 8 (32%). In the comparison group, the answer was "never" - 2 (8%), "almost never" - 3 (25%), "often" - 11 (44%), "almost always" - 9 (36%). The eighteenth question "Sometimes I feel like a failure" in the main group was answered "never" - 5 (20%), "almost never" - 5 (20%), "often" - 7 (28%), "almost always" - 8 (32%). In the comparison group, the answer was "never" - 2 (8%), "almost never" - 3 (25%), "often" - 11 (44%), "almost always" - 9 (36%). The nineteenth question "I am a balanced person" in the main group was answered in the main group: "never" - 1 (4 %), "almost never" - 2 (8%), "often" - 19 (76%), "almost always" - 3 (12%). In the comparison group, the answer was "never" - 2 (8%), "almost never" - 2 (8%), "often" - 8 (32%), "almost always" - 13 (52%). The twentieth question, "I get restless when I think about my affairs and concerns," was answered in the main group by "never" - 2 (8 %), "almost never" - 3 (12%), "often" - 9 (36%), "almost always" - 11 (44%). In the comparison group, the answer was "never" - 2 (8%), "almost never" - 2 (8%), "often" - 10 (40%), "almost always" - 11 (44%).In group I (patients with the degree of lung damage CT1), when assessing situational (reactive) anxiety, 2 people scored 27 points, 6 people 28 points, 1 person 32 points, 3 people 35 points, 7 people 40 points, 2 people 43 points, 4 people 44 points. When assessing personal anxiety, 2 people scored 26 points, 4 people 30 points, 2 people 33 points, 1 person 34 points, 2 people 38 points, 1 person 42 points, 5 people 43 points, 3 people-44 points, 1 person 45 points, 2 people 47 points, 2 people 49 points.</p>
<p>In group II (patients with the degree of CT2 lung damage), when assessing situational (reactive) anxiety, 3 people scored 27 points, 4 people 28 points, 2 people 32 points, 1 person 40 points, 3 people 44 points, 5 people 48 points, 2 people 51 points, 1 person 54 points, 2 people 55 points, 1 person 59 points, 1 person 62 points. When assessing personal anxiety, 2 people scored 27 points, 2 people 30 points, 1 person 32 points, 2 people 33 points, 4 people 39 points, 2 people 44 points, 1 person 45 points, 2 people 48 points, 4 people 50 points, 1 person 51 points, 1 person 53 points, 2 people 57 points, 1 person 50 points.Discussion. When interpreting the results showed that the level of anxiety is moderate in 68% of patients in group I and 24% of patients in the comparison group, high level of anxiety was only 48% of patients of group II. A moderate level of personal anxiety was found in 76% of patients in the main group and in 48% of patients in the comparison group, a high level of personal anxiety was found in 16% of patients in group I and 44% of patients in group II.After analyzing the questionnaires, we identified differences in the groups ' attitudes to their health and mental state, assessing anxiety as a state and as a personal property. These patients should be assisted in developing a sense of confidence in the successful treatment and outcome. It is the comparison of the results on two indicators (situational and personal anxiety) in the Spielberger-Hanin method that makes it possible to assess the individual significance of the stressful situation for the test patients with the diagnosis: COVID-19 coronavirus infection (established), moderate form. Bilateral polysegmental pneumonia, moderate severity (CT2)), moderate and high levels of anxiety prevail.Conclusion. In patients with a diagnosis of: coronavirus infection COVID-19 (established), moderate form. Bilateral polysegmental pneumonia, moderate severity (CT2)) is dominated by a moderate and high level of situational and personal anxiety, which must be taken into account when conducting differentiated psychocorrection to form an internal picture of the disease that contributes to effective treatment and rehabilitation. The results of the study show that in patients with coronavirus infection COVID-19 (established), the moderate form. Bilateral polysegmental pneumonia, moderate severity (CT2), the level of situational and personal anxiety is more pronounced.</p>
<p></p>[1. Лазебник А.И. Динамика показателей распространенности суицидов в г. Ижевске и Удмуртской республике на разных этапах переходного периода / XVI Съезд психиатров России. Всероссийская научно- практическая конференция с международным участием «Психиатрия на этапах реформ: проблемы и перспективы», 23-26 сентября 2015 года, г. Казань. СПб.: Издательский отдел ООО «Альта Астраю». С.898.][2. Ениколопов С.Н., Бойко О.М., Медведева Т.И., Воронцова О.Ю., Казьмина О.Ю. Динамика психологических реакций на начальном этапе пандемии COVID-19 // Психологическая газета. 28.04.2020 г. URL: https://psy.su/feed/8182/ (дата обращения 25.05.2020).][3. Любов Е.Б., Зотов П.Б, Положий Б.С. Пандемии и суицид: идеальный шторм и момент истины // Суицидология. 2020. Т. 11. № 1(38). С. 3-38.][4. Молчанова Е.В. Психологические особенности молодежи в условиях мирового экономического кризиса: обзор зарубежных исследований // Мир образования – образование в мире. 2018. № 2(70). С. 37-45.][Федосенко Е.В. Жизнь после карантина: психология смыслов и коронавирус COVID-19 // Психологическая газета. 14.05.2020 г. URL: https://psy.su/feed/8248/ (дата обращения 25.05.2020).][5. Петунова С.А. Психосоциальные особенности отношения к заболеванию у больных туберкулёзом легочной локализации // Вестник психиатрии и психологии Чувашии. 2015. Т. 11, № 4. С. 60-61.]