EFFICACY OF MEDICAL-PSYCHOLOGICAL CARE OF ADOLESCENTS WITH ESSENTIAL HYPERTENSION

Abstract

Relevance: in our time, the problem of treating essential hypertension (EH) remains relevant, since high blood pressure (BP) is a factor in the development of new cases of cardiovascular diseases, including coronary heart disease, myocardial infarction, brain stroke, and independent predictor of mortality. In Europe, EH occurs in 2.2-13 % of children, and among adolescents with overweight in 22 %. Objective of this work was to evaluate the effectiveness of the algorithm of medical and psychological support of adolescents with EH. Materials and methods. In the Kiev city center for the diagnosis and correction of autonomic dysfunctions in children of Children's Clinical Hospital No. 6, a comprehensive clinical and psychological study was conducted in 20 adolescents (7 girls, 13 boys) aged 11-17 years (average 14.40±1.63 years),who were hospitalized for EH, the effectiveness of the algorithm of medical and psychological care was evaluated. Result. Considering the peculiarities of body weight, manifestations of type D personality, the high values according to the “Computer addiction” questionnaire of patients were divided into 2 groups of 3 subgroups each. The first group included adolescents, in whom the EH combined with overweight, to the second – with normal body weight. Subgroups 1a and 2a included patients with type D personality, to 1b and 2b – with a high rate of the “Computer addiction” test, to subgroup 1c and 2c – the rest of the patients. Psychocorrection was differentiated – the focus on psycho-education was made for patients of the first group. Attention was paid to increasing adherence to treatment, especially in patients with type D personality. As the main method of psychocorrection for adolescents with subgroups 1a, 1b, 2a, 2b, cognitive-behavioral therapy was used. A positive treatment outcome was achieved in 17 (85 %) patients, on average, treatment adherence increased more than twice and role functioning, viability, mental health, general health and emotional functioning significantly increased. Conclusion. The use of the algorithm of medical and psychological care of adolescents with EH in 85 % of patients was associated with an increase in the effectiveness of treatment (in the comparison group, treatment was effective only in 35.3 % of adolescents), adherence to treatment, quality of life.

Keywords

• primary arterial hypertension, adolescents, medical and psychological support