THE FACTORS OF THE QUALITY OF LIFE IN CARDIAC PATIENTS

Kardiologija predstavlja granu interne medicine koja se bavi liječenjem bolesti srca i krvnih žila. Tzv. kardiovaskularne bolesti (KVB) su vodeći uzrok mortaliteta u razvijenim zemljama svijeta, dok su u manje razvijenim zemljama u stalnom porastu. Od posljedica ovih bolesti godišnje umire 17,3 milijuna ljudi. Kvaliteta života podrazumijeva način na koji doživljavamo i vrednujemo svoj vlastiti život. Kao posljedica shvaćanja da je zdravlje vrlo važan uvjet dobrog kvalitetnog života, nastao je pojam kvalitete života povezanog sa zdravljem pri čemu obuhvaća bolesnikovu procjenu njegovih sposobnosti u četiri oblasti: fizička i profesionalna sposobnost, psihičko stanje, društvene aktivnosti i interakcije i somatske senzacije. Postoje brojni instrumenti kojima se mjeri kvaliteta života u odnosu na zdravlje. Neki od njih obuhvaćaju više, a neki pojedinačna područja kvalitete života, dok su drugi vezani za određene bolesti. Kod mjerenja kvalitete života kardioloških bolesnika koriste se različiti upitnici, a jedan od najpouzdanijih je tzv. Short-form 36. Budući da KVB i psihijatrijski poremećaji spadaju u vodeće uzroke mortaliteta, smanjene životne i radne sposobnosti, a samim time i smanjene kvalitete života, važno je istaknuti da liječenje psihijatrijskih poremećaja smanjuje rizik od razvoja KVB te utječe na poboljšanje kvalitete života oboljelih od istih. Dokazano je da određene psihološke crte i stanja predstavljaju rizične čimbenike kod kardioloških bolesnika. U radu sam prikazala utjecaj određenih tipova ličnosti, utjecaj depresije, anksioznosti, hostilnosti, super-ega i stresa. Također, prikazala sam i utjecaj zdravstvenog ponašanja na kvalitetu života kardioloških bolesnika, prije svega čimbenike rizičnog ponašanja u koje ubrajamo: pušenje, hipertenziju, povišenu razinu masti u krvi, pretilost, nedovoljnu tjelesnu aktivnost i šećernu bolest. Osim ovih čimbenika, na kvalitetu života utječu također i razni sociokulturalni i međuljudski čimbenici, od kojih se posebno ističu obiteljski problemi, manjak podrške i socijalna izolacija. Medicinska sestra ima važnu ulogu u zbrinjavanju hospitaliziranih kardioloških bolesnika. Ona je ta koja prva može uočiti i prepoznati patološke promjene, kako u fizičkim, tako i u psihičkim reakcijama oboljelog od KVB. Medicinska sestra promatra znakove i simptome bolesnika, te na temelju njihovih specifičnih, utvrđuje bolesnikov problem, planira i provodi odgovarajuće intervencije s ciljem njegovog rješavanja. Prevencija KVB obuhvaća rad patronažnih sestara kroz provođenje zdravstvenog odgoja, edukaciju rizičnih osoba i cijelog pučanstva. Cilj edukacije je djelovati na pogrešno naučeno ponašanje bolesnika i promijeniti loše životne navike koje dovode do razvoja bolesti, pomoći mu da što uspješnije svlada nastale teškoće i prevenira komplikacije te tako utječe na očuvanje zadovoljavajuće kvalitete života.Cardiology is a branch of internal medicine that deals with the treatment of heart and blood vessels diseases. So-called cardiovascular diseases (CVD) are the leading causes of mortality in developed countries of the world, while in less developed countries are steadily growing. Every year there are 17.3 million people that die of the consequences of these diseases. Quality of life implies the way we experience and appreciate our own life. As a result of understanding that health is a very important condition of good quality of life, the concept of health-related quality of life was found and it includes a patient's assessment of his or her abilities in four domains: physical and professional ability, mental state, social activity and interaction and somatic sensations. There are numerous instruments that measure health-related quality of life. Some of them include more domains of quality of life, while some of them include only individual domains of quality of life and others are related to certain diseases. Different questionnaires are used for measuring the quality of life in cardiac patients but one of the most reliable is the one that is called Short-form 36. Since CVD and psychiatric disorders are the leading causes of mortality, reduced life and work abilities, the same as reduced quality of life, it is important to emphasize that the treatment of psychiatric disorders reduces the risk of CVD development and it has an impact on improving the quality of life of these patients. It has been proved that certain psychological traits and conditions represent risk factors for cardiac patients. In this work, I have shown the influence of certain types of personality, the influence of depression, anxiety, hostility, super-ega and stress. Also, I have shown the impact of health behavior on the quality of life in cardiac patients, but first of all, the risk factors like: smoking, hypertension, increased blood fat levels, obesity, insufficient physical activity and diabetes mellitus. In addition to these factors, there are various sociocultural and interpersonal factors which have an impact on quality of life. Especially, there are: family problems, lack of support and social isolation. The nurse has an important role in the care of hospitalized cardiac patients. She is the first person who can recognize pathological disorders, in the physical and the psychological reactions affected by cardiac patients. The nurse notices the signs and symptoms of the patient and based on their specific, she recognizes patient's problem, plans and performs appropriate interventions with the aim of solving it. The prevention of CVD is the work of patron nurses where they educate people at risk and the whole population. The aim of education is to influence on the wrong behavior of the patient, to change his bad habits that lead to the development of these diseases and help him to successfully overcome the difficulties and prevent complications