Análisis neuropsicológico del proceso del pensamiento en pacientes portadores de enfermedad cardiovascular con hipoperfusión cerebral
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Fecha
2010-07-25
Autores
Delgado Suárez, Yiana María
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Editor
Universidad Central “Marta Abreu” de Las Villas
Resumen
La elevada incidencia de las enfermedades cardiovasculares con hipoperfusión cerebral y el aumento de las secuelas provocadas por éstas constituyen un área sensible de investigación. Cómo rehabilitar desde una perspectiva multidisciplinaria y desarrolladora a los pacientes portadores de estas enfermedades representa una cuestión aún irresuelta. Los estudios neuropsicológicos realizados en esta dirección aportan una visión renovadora para comprender los mecanismos cerebrales y psicológicos implicados aunque todavía es imprescindible conocer qué peculiaridades neuropsicológicas posee el pensamiento de los pacientes con enfermedad cardiovascular con hipoperfusión cerebral de manera que puedan determinarse sus principales características. Así, el objetivo de esta investigación se enfoca en caracterizar neuropsicológicamente el proceso del pensamiento en pacientes con enfermedad cardiovascular con hipoperfusión cerebral del Hospital Universitario “Dr. Gustavo Aldereguía Lima” en la provincia de Cienfuegos.
La muestra estuvo conformada por 15 pacientes portadores de una enfermedad
cardiovascular con hipoperfusión cerebral hospitalizados en dicho centro a los cuales se les aplicó: una entrevista psicológica semiestructurada inicial, la técnica de exclusión de objetos, la prueba de interpretación de refranes, la técnica de resolución de problemas, el While-Bear Supresión Inventory (WBSI) y el inventario de pensamiento constructivo (CTI) complementándose con la observación participante. Además, se obtuvo información del análisis de la historia clínica y de las entrevistas semiestructuradas dirigidas al médico y al familiar respectivamente.
El análisis de los datos obtenidos permitió perfilar como los componentes del pensamiento más afectados: la verificación de la acción, la orientación investigativa, la flexibilidad y la generalización; encontrándose además que las ECV que más afectaban el proceso del pensamiento eran: el IAM IV, el bloqueo A-V y el paro cardio-respiratorio. A su vez, se hallaron alteraciones en el tercer sistema funcional regulado esencialmente por las áreas pre-frontales de la corteza cerebral; en la región temporal izquierda y una elevación de los niveles del tono cortical.
Estos resultados plantean la necesidad de una reconceptualización del proceso de
rehabilitación favoreciendo la consecución de investigaciones posteriores relacionadas con el tema.
The high incidence of cardiovascular diseases with cerebral hypoperfusion and the subsequent aftermath are a sensitive area of research. How to rehabilitate the patients with these diseases from a multidisciplinary and developing perspective is an unresolved issue. The previous neuropsychological studies focused in this direction have provided an innovative vision to understand the psychological and brain mechanisms involved; however, knowing neuropsychological characteristics of patients with cardiovascular diseases with cerebral hypoperfusion is still essential in order to determine their main characteristics. Thus, this research focuses on characterizing neuropsychologically the thinking process in patients with cardiovascular diseases with cerebral hypoperfusion at the Hospital "Dr. Aldereguía Gustavo Lima" in the province of Cienfuegos. The sample consisted of 15 hospitalized patients with cardiovascular diseases with cerebral hypoperfusion to whom were applied the following techniques: initially, a semistructured psychological interview, the exclusion of objects technique, the interpretation of sayings test, the resolving problems technique, the While-Bear Suppression Inventory (WBSI) and the Constructive Thinking Inventory (CTI), all these techniques complemented with participating observation. In addition, information came from the analysis of medical records and semistructured interviews realized to the doctor and the family respectively. As result of the analysis the most affected components of thinking were: verification of the action, investigative orientation, flexibility and generalization. Also was found that the main CVD affecting the thinking process were: IAM IV, blocking AV and cardio-respiratory arrest. At the same time, there were alterations in the third functional system regulated primarily by the pre-frontal areas of the cerebral cortex, in the left temporal region and an elevated level of cortical tone. These findings suggest the necessity to reconceptualize the rehabilitation process and encourage subsequent researches related to this topic.
The high incidence of cardiovascular diseases with cerebral hypoperfusion and the subsequent aftermath are a sensitive area of research. How to rehabilitate the patients with these diseases from a multidisciplinary and developing perspective is an unresolved issue. The previous neuropsychological studies focused in this direction have provided an innovative vision to understand the psychological and brain mechanisms involved; however, knowing neuropsychological characteristics of patients with cardiovascular diseases with cerebral hypoperfusion is still essential in order to determine their main characteristics. Thus, this research focuses on characterizing neuropsychologically the thinking process in patients with cardiovascular diseases with cerebral hypoperfusion at the Hospital "Dr. Aldereguía Gustavo Lima" in the province of Cienfuegos. The sample consisted of 15 hospitalized patients with cardiovascular diseases with cerebral hypoperfusion to whom were applied the following techniques: initially, a semistructured psychological interview, the exclusion of objects technique, the interpretation of sayings test, the resolving problems technique, the While-Bear Suppression Inventory (WBSI) and the Constructive Thinking Inventory (CTI), all these techniques complemented with participating observation. In addition, information came from the analysis of medical records and semistructured interviews realized to the doctor and the family respectively. As result of the analysis the most affected components of thinking were: verification of the action, investigative orientation, flexibility and generalization. Also was found that the main CVD affecting the thinking process were: IAM IV, blocking AV and cardio-respiratory arrest. At the same time, there were alterations in the third functional system regulated primarily by the pre-frontal areas of the cerebral cortex, in the left temporal region and an elevated level of cortical tone. These findings suggest the necessity to reconceptualize the rehabilitation process and encourage subsequent researches related to this topic.
Descripción
Palabras clave
Pensamiento, Neuropsicología, Enfermedades Cardiovasculares, Thinking, Neuropsychology, Cardiovascular Diseases