The Effectiveness of Progressive Counting Method on Post-Traumatic Stress Symptoms in Patients with Coronary Artery Bypass Surgery

Document Type : Research Paper

Authors

Department of Psychology, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran

Abstract

The aim of the study was to investigate the effectiveness of the progressive counting method on PTSD symptoms (including avoidance, intrusion, and hyperarousal) that occur in CABG patients according to research literature. It was an applied research conducted in a quasi-experimental design (pretest-posttest with a control group and follow-up). The statistical population was the patients referred to the rehabilitation clinic of Tehran Heart Center in 2021-four to six weeks after coronary artery bypass graft surgery. Twenty-four patients (10 women and 14 men) were randomly selected from those who scored 24 or higher on the Impact of Event Scale-Revised (IES-R). The Impact of Event Scale-Revised (IES-R) was used for measurement. Mixed two-way analysis of variance in SPSS-26 was used to examine the effectiveness of the intervention. The progressive counting method statistically significantly reduced the magnitude of avoidance symptoms in the intervention group. This method made no significant difference in the amount of intrusion and hyperarousal (α=0.05). The progressive counting method is effective in reducing avoidance symptoms in CABG patients and this intervention is recommended. The level of hyperarousal and intrusion in the follow-up phase is largely determined by these levels in the pretest phase. As a result, screening of patients in this regard is recommended.

Keywords

References

اصفهانی، ا. (1395). طرح آزمایش‌های کاربردی با SPSS. چاپ دوم. جلد اول. تهران: مؤسسۀ فرهنگی-هنری دیباگران تهران.
پناغی، ل.، حکیم شوشتری، م.، و عطاری‌مقدم، ج. (1385). اعتباریابی نسخۀ فارسی مقیاس تجدیدنظریافتۀ تأثیر حوادث. مجلۀ دانشکدۀ پزشکی. 64(3)، 60-52.
دلاور، ع. (1375). روش تحقیق در روان‌شناسی و علوم تربیتی. چاپ سوم. تهران: نشر ویرایش.
راوند، م.، عطارباشی‌مقدم، ب.، مرآثی، م.، راوند، م.، و رضائیان، ز. (1392). تعیین پایایی و روایی ترجمۀ فارسی پرسشنامۀ آنژین سیاتل (SAQ) در بیماران سکتۀ قلبی. پژوهش در علوم توان‌بخشی. 9(5)، 817-805.
رحیمی، ا.، تقی پور، ح.، عبادی، ع.، و پورابراهیمی، م. (1397). بررسی عملکرد جنسی بیماران مرد قبل و بعد از عمل جراحی پیوند عروق کرونر. نشریۀ پژوهش توان‌بخشی در پرستاری. 5(2)، 46-42.
رضائیان، م. (1396). معرفی آزمون‌های آماری برای مقایسۀ یک پیامد در بین دو گروه. مجلۀ دانشگاه علوم پزشکی رفسنجان. 16(5)، 394-393.
سادوک، ب. ج.، سادوک، و. آ.، و روئیز، پ. (1398). خلاصۀ روان‌پزشکی. چاپ یازدهم. جلد اول. ترجمۀ فرزین رضاعی. تهران: ارجمند.
سرمد، ز. (1391). آمار استنباطی، گزیده‌ای از تحلیل‌های آماری تک‌متغیری. تهران: سمت.
Barron, I., & Tracey, J. K. (2017). Quasi-qualitative evaluation of progressive counting in secure accommodation in Scotland: An exploratory cluster case study. Journal of Child & Adolescent Trauma, 11(3), 305-315.
Becker, J., Greenwald, R., & Mitchell, C. (2011). Trauma-informed treatment for disenfranchised urban children and youth: An open trial. Child & Adolescent Social Work Journal, 28(4), 257-272.
Christianson, S., & Marren, J. (2012). The Impact of event scale - revised (IES-R). Medsurg Nursing, 21(5), 321-322.
Dao, T. K., Chu, D., Springer, J., Gopaldas, R. R., Menefee, D. S., Anderson, T., & Nguyen, Q. (2010). Clinical depression, posttraumatic stress disorder, and comorbid depression and posttraumatic stress disorder as risk factors for in-hospital mortality after coronary artery bypass grafting surgery. Thoracic and Cardiovascular Surgery, 140(3), 606-610.
Deng, L. X., Khan, A. M., Drajpuch, D., Fuller, S., Ludmir, J., Mascio, C. E., & Kim, Y. Y. (2016). Prevalence and correlates of post-traumatic stress disorder in adults with congenital heart disease. The American Journal of Cardiology, 117(5), 853-857.
Elliott, D. E., Bjelajac, P., Fallot, R. D., Markoff, L. S., & Reed, B. G. (2005). Trauma-informed or trauma-denied: Principles and implementation of trauma-informed services for women. Journal of Community Psychology, 33(4), 461–477.
Greenwald, R. (2008). Progressive counting: A new trauma resolution method. Journal of Child & Adolescent Trauma, 1(3), 249-262.
Greenwald, R. (2012). Progressive counting: Asking recipients what makes it work. Traumatology, 8(3), 59-63.
Heydari, M. (2021). Prevalence of anxiety, depression and PTSD in open heart surgery patients of Fatemeh Zahra Hospital in Sari in 5-year follow-up. PhD Dissertation. Faculty of Nursing and Midwifery. Mazandaran University of Medical Sciences. Iran.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41(3), 209-218.
Jacquet-Smailovic, M., Tarquinio, C., Alla, F., Denis, I., Kirche, A., Tarquinio, C., & Brennstuhl, M. J. (2020). Posttraumatic stress disorder following myocardial infarction: A systematic review. Traumatic Stress, 34(1), 190-199.
Jarecki, K., & Greenwald, R. (2016). Progressive counting with therapy clients with post‐traumatic stress disorder: Three cases. Counselling & Psychotherapy Research, 16(1), 64–71
 Johnson, D., Lubin, H., & Ochberg, F. (2007). The counting method manual. New Haven, Connecticut: Post Traumatic Stress Center.
Kanel, R. V., Meister-Langraf, R. E., Barth, J., Schnyder, U., Pazhenkott, A. P., Ledermann, K., & Princi, M. (2021). Course, moderators, and predictors of acute coronary syndrome-induced post-traumatic stress: A secondary analysis from the myocardial infarction-stress prevention intervention randomized controlled trial. Front Psychiatry, 12, 621284.
Kovacs, A. H. (2019). Neuropsychological outcomes and posttraumatic stress disorder in adults with congenital heart disease. Cham: Springer.
Kuruppu, S., Ghani, M., Pritchard, M., Harris, M., Weerakkody, R., Stewart, R., & Gayan, P. (2021). A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London. European Psychiatry, 64(1), 1-10.
Narisawa, T., Nishi, D., Okubo, R., Noguchi, H., Hamazaki, K., & Yamashita, A. (2021). Impact of peritraumatic distress on posttraumatic stress disorder symptoms at 6 months after acute coronary syndrome: A prospective cohort study. European Journal of Psychotraumatology, 12(1), 1-9.
Porhomayon, J., Kolesnikov, S., & Nader, N. D. (2014). The impact of stress hormones on post-traumatic stress disorders symptoms and memory in cardiac surgery patients. Journal of Cardiovascular and Thoracic Research, 6(2), 79-84.
Rosson, S., Monaco, F., Miola, A., Cascino, G., Stubbs, B., Correll, C., & Perrotti, A. (2021). Longitudinal course of depressive, anxiety, and posttraumatic stress disorder symptoms after heart surgery: A meta-analysis of 94 studies. Psychosomatic Medicine, 83(1), 85-93.
Sveen, J., Low, A., Dyster-Aas, J., Ekselius, L., Willebrand, M., & Gerdin, B. (2010). Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns. Journal of Anxiety Disorders, 24(6), 618–622. 
Sommer, J. (2019). Mental health sequelae in the perioperative period: An examination of perioperative dissociation, postoperative delirium, and posttraumatic stress. MA Thesis. Department of Psychology, University of Manitoba, Canada.
Thomson, P., Niven, C. A., Peck, D. F., & Eaves, J. (2013). Patients’ and partners’ health-related quality of life before and 4 months after coronary artery bypass grafting surgery. BMC Nursing, 12(1), 1-15.
Vilchinsky, N., Ginzburg, K., Fait, K., & Edna, F. B. (2017). Cardiac-disease-induced PTSD (CDI-PTSD): A systematic review. Clinical Psychology Review, 55, 92-106.
Weiss, D. S., Marmar, C. R., Wilson, J. P., & Keane, T. M. (1997). Assessing psychological trauma and PTSD. 399-411. New York: Guilford Press Wilson JP.
Weiss, D. S. (2004). The impact of event scale-revised. In J. P. Wilson, & T. M. Keane, assessing psychological trauma and PTSD (2nd Ed.). 168-189. New York, London: The Guilfor
Journal of Applied Psychological Research
Volume 13, Issue 3
December 2022
Pages 39-52

Files

Share

How to cite

Statistics