Attitude towards one's illness vs. attitude towards a surgical operation, displayed by patients diagnosed with asymptomatic abdominal aortic aneurysm and asymptomatic internal carotid artery stenosis.
OBJECTIVE
Two most frequent asymptomatic diseases qualifying for vascular surgery are abdominal aortic aneurysm (AAA) and internal carotid artery stenosis (ICAS). Emotions experienced by the patient activate processes of dealing with the cognitive dissonance of asymptomatic disease. The aim of this paper was to compare the reasons involved in decision making on surgery in two asymptomatic vascular pathologies.


METHODS
Fifty patients were divided into two groups: the ICAS group-27 (CAS or CEA) and the AAA group-23 (EVAR or open surgical operation (OSR). Specific questionnaire regarding: 1) self-image; 2) attitude to one's illness; 3) reasons for decision on surgery was applied for the study. The χ² test was used to for the analysis.


RESULTS
The AAA patients reacted emotionally (88.2%) comparing to ICAS patients reacting "rationally" (59.3%) (α=0.05). In AAA patients attitude towards themselves had worsened (α=0.001) AAA patients were less likely to seek support in decision on surgery (α=0.01). ICAS patients are internally motivated (78.7%), whereas AAA patients are externally motivated (63.9%) (α=0.001). Reasons underlying the decision on surgery, were predominantly rational (55.8%).


CONCLUSIONS
In the process of decision-making on surgery by asymptomatic patients, evolutionary transformation takes place - the emotional attitude to one's illness leads to rationally evaluated decision. Regardless of the causes the process of making a decision on surgical operation tended to run more smoothly in ICAS patients. The ICAS patients tended to display a rational attitude to their illness. AAA patients displayed a distinctly emotional attitude towards their illness.
Department of General and Vascular Surgery, Poznań University of Medical Sciences, Poznań, Poland.
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Rzepa
D000223:Adaptation, Psychological; D000368:Aged; D017130:Angioplasty / Q000295:instrumentation / Q000523:psychology; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D058070:Asymptomatic Diseases; D019917:Blood Vessel Prosthesis Implantation / Q000523:psychology; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D016009:Chi-Square Distribution; D002755:Choice Behavior; D004644:Emotions; D016894:Endarterectomy, Carotid / Q000523:psychology; D057510:Endovascular Procedures / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009042:Motivation; D010342:Patient Acceptance of Health Care; D010361:Patients / Q000523:psychology*; D011044:Poland; D011908:Rationalization; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D011795:Surveys and Questionnaires; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000523:psychology*