Heart & Lung最新文献

Background: To perform self-care, individuals with a chronic illness must be able to perceive bodily changes (ie., interoception) so they can respond to symptoms when they arise. Interoception is regulated by the insular cortex of the brain. Symptom perception is poor in various physical diseases, which may be associated with impairments in the insular cortex.

Objective: The purpose of this study was to explore whether patterns of insular impairment exist among adults with chronic physical diseases and to analyze the relationship with disease-related symptoms.

Methods: We identified studies that assessed the structure and/or activity of the insula through MRI and/or (f)MRI in adults with chronic physical diseases (vs. healthy controls) by searching five databases. Results are reported as a narrative synthesis.

Results: Fifty studies were conducted to investigate the structure or activity of the insula among adults with diabetes, cancer, heart failure, or chronic pulmonary disease. In 19 studies investigators found that patients with a chronic disease had lower/damaged insular volume/density/thickness than healthy controls or reduced insular blood flow. When insular activity was explored in 22 studies, most investigators reported higher insular activity and lower neural connectivity. Five studies explored the association between insular volume/activity and symptom severity: four reported a positive trend.

Conclusion: People with chronic physical diseases have lower insular grey matter volume/density/thickness and abnormal insular activity when compared to healthy people. Insular activity may be related to symptom severity. These results suggest that insular structure and/or activity may explain poor symptom perception.

Background: Social media is a common source of health-related information. However, more clarity regarding ACS symptom information posted on social media is needed.

Objectives: The objective was to describe ACS symptom information on social media platforms, including Twitter (now named X), Instagram, and TikTok.

Methods: A cross-sectional, qualitative descriptive design was used. The three social media platforms were searched in 2022 for posts containing ACS symptom information. A random sample of posts meeting inclusion was drawn. Posts were analyzed using a qualitative coding process, and network analysis was used to triangulate data.

Results: Posts (N = 342) included in the final analysis were most often published by healthcare organizations (46.2 %), lay persons (20.8 %), or healthcare professionals (13.7 %). Five key themes were identified: 1) a focus on gendered symptom experiences, 2) diverse types of symptom messages (educational, emphasis on getting help, personal testimony, advertising, diagnostic help, research findings), 3) variety of specific symptoms mentioned, 4) different dimensions of symptoms included, and 5) varying levels of information quality and accuracy. Chest pain was the most common ACS symptom highlighted in posts, and symptom differences between men and women were often emphasized.

Conclusions: Of particular concern was incorrect or misleading ACS symptom information on social media that could create misconceptions and contribute to delays in seeking care for ACS. The findings from this study provide more insight into the ACS symptom information shared on social media platforms and provide preliminary information that can influence practice and future research.

Background: Current literature suggests that immersive virtual reality (IVR) could be an efficacious therapeutic approach for patients with cardiovascular diseases (CVD) undergoing cardiac rehabilitation program (CRP). However, this has only been affirmed in individual studies and is yet to be confirmed by a systematic review.

Objectives: To determine the efficacy of IVR interventions on depression, anxiety, and stress symptoms in patients with CVD.

Methods: A meta-analysis was performed in line with PRISMA guidelines following a literature search between inception and June 2024 in PubMed, SCOPUS, WOS, CINAHL and PEDro for retrieving randomized controlled trials (RCTs) that compared the efficacy of IVR versus conventional CRPs on depression, anxiety and stress in patients with CVD. The PEDro scale was used to evaluate the methodological quality of the studies. Pooled effects were calculated using the Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI), or mean difference (MD) if studies used the same measure.

Results: Eight RCTs, providing data from 510 patients with CVD (63.8±5.4 years, 60% men), were included. The methodological quality was moderate (M=5.1±1 points). A large rehabilitative effect of IVR was found for reducing depression (SMD=-0.54; 95% CI -0.77 to -0.31; p<0.001), anxiety (SMD=-0.43; 95% CI -0.74 to -0.12; p=0.006) and stress (MD=-14.96; 95% CI -20.1 to -9.8; p<0.001). The findings suggest that combine IVR and CRP is the most appropriate approach for reducing depression, anxiety and stress.

Conclusion: IVR, especially when combined with a traditional CRP, reduces depression, anxiety and stress in patients with CVD.

Background: Patients in the Surgical Intensive Care Unit (SICU) often experience psychological stress.

Objectives: To evaluate the feasibility, acceptability, and potential outcomes of virtual reality (VR) interventions for enhancing patient experience during SICU stay.

Methods: This mixed-method study employed a pre-post-test design complemented by a sequential explanatory approach, conducted from January to December 2023 in the SICU of a hospital in China. Quantitative data (n = 32) were collected using a Visual Analog Scale to assess pain, fatigue, depression, anxiety, and comfort. Physiological parameters, including blood pressure (BP), heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO²) were obtained from a bedside patient monitor. Additionally, self-designed questionnaires were used to evaluate VR acceptance, while the Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ) was used to assess discomfort related to VR interventions. Qualitative data from experimental patients (n = 10) were analyzed through in-depth interviews.

Results: Post-intervention, patients showed significant reductions in pain, fatigue, depression, and anxiety, along with increased comfort levels (P < 0.05). There were no significant differences in pre- and post-intervention BP, HR, RR, or SpO². The mean VR acceptance score was 3.90±0.62, with minimal discomfort reported. Qualitative analysis revealed four themes: positive patient attitude toward VR, benefits of VR for well-being, multiple influences on VR implementation, and implementation of VR with safety assurance.

Conclusion: VR interventions significantly reduced psychological stress and improved comfort in SICU patients, with high acceptance and minimal side effects. Further research is needed to optimize VR use in this setting.