FRI0621-HPR CHANGES IN LOCUS OF CONTROL LEVEL IN PATIENTS WITH RHEUMATOID ARTHRITIS AFTER THE COURSE OF BIOFEEDBACK TRAINING
Authors: R. Grekhoff
Journal: Annals of the Rheumatic Diseases (2020)

Background: Objectives: Our aim was to study the effect of biofeedback (BFB) training on the locus of control in patients suffering from rheumatoid arthritis (RA), and to justify the use of this method in the complex treatment of the disease. Methods: 40 RA patients hospitalized in the rheumatology department were examined. The average age of patients was 48. 6 years ± 7.73 years (from 30 to 70 years), women accounted for the majority = 26 (86%), the average duration of the disease was 12 years ± 3.44 years. We use J. Rotter’s Locus of Control Scale in E.F.Bazhin adaptation. RA patients were divided into two groups: the main (20 patients) and control (20 patients). Patients of the main group received complex therapy with 12 sessions of BFB training, mainly based on the parameters of the brain’s electrical activity — EEG relaxation using the Reakor™ psychophysiological rehabilitation complex manufactured by Medicom MTD (Taganrog). Results: We revealed externality in RA patients in the general field (3.03 ± 0.3), as well as in the field of relation to the disease (3.86 ± 0.23) and in the field of production relations (3.43 ± 0, 25). After BFB trainings, an increase in internality was observed on the scales of the general sphere (p &lt;0.05) and attitude to the disease (p &lt;0.01) in patients of the main group. In the group of patients receiving conventional treatment, the dynamics of the results was unreliable. Conclusion: It should be noted that the locus of control (or subjective control) is a quality that characterizes a person’s tendency to attribute responsibility for the results of his activity to external forces, or to his own abilities and efforts. Externality is manifested when people prefer to shift responsibility for important events of their life to external circumstances, and external forces (bosses, colleagues, etc.). In the field of attitude to the disease, externality is manifested when patient behaves passively, and believes that he cannot influence the course of the disease in any way, shifting all responsibility for the treatment results to medical staff, which can lead to non-compliance with the treatment regimen and an increase in the level of anxiety and depression, decreased self-esteem. The onset of the disease and its associated social consequences (disability, loss of social roles, etc.) can cause a negative mental state of learned helplessness. Learned helplessness is defined as a condition that occurs as a result of uncontrolled, mainly negative events, which manifests itself in violations of emotional, motivational and cognitive processes. In other words, RA patient suffering from this condition expects treatment failures and reduces control over compliance with the treatment regimen. BFB therapy can be used in order to correct and prevent the state of learned helplessness by increasing the level of internality. It is assumed that increasing internality in the BFB process is associated with teaching the patient the skills of self-regulation of physiological processes. The mechanisms of BFB therapeutic effect are not only changes in physiological parameters (improvement of cerebral and peripheral blood flow, muscle relaxation, and improvement of sleep) but also in a shift in the locus of control from external to internal, which can increase compliance, reduce neurotic complaints, mobilize volitional potential and improve patient self-esteem. As a result of BFB course, an increase in the internality was noted in patients on the scales of the general sphere and the sphere of attitude to the disease. It is advisable to use the BFB to increase the compliance and effectiveness of complex treatment of RA patients. Disclosure of Interests: None declared