Improving Attention and Mood in Heart Failure: Natural Restorative Environment Intervention.

heart failure;chronic;psychological: attention;intervention studies;neuropsychological tests;Nursing;Health Sciences;Nursing

Jung, MiyeonBerman, Marc Glenn ;

University of Michigan

关键词: heart failure;    chronic;    psychological: attention;    intervention studies;    neuropsychological tests;    Nursing;    Health Sciences;    Nursing;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/116681/miyeon_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Impaired attention has been found in approximately 1 out of 4 patients with heart failure (HF). Mechanisms of attention impairment are lowered cerebral oxygen supply due to cardiac dysfunction and increased mental effort from dealing with the fatal disease, HF.Although there is evidence that attention impairment is common in these patients and can affect their HF self-care activities, no interventions to date have directly targeted attention in HF patients. To improve attention, natural restorative environment (NRE) interventions have been conducted and found to be efficacious in diverse populations. NRE interventions are based on Attention Restoration Theory, which asserts that when directed attention is rested, it can be restored. Whether NRE intervention is efficacious for HF patients is not known. Thus, the primary aim of this study was to examine the efficacy of a NRE intervention for patients with HF on attention.The secondary aim was to examine its efficacy on mood.A randomized crossover design was used in 20 HF patients and 20 age- and education-matched healthy adults. The NRE intervention involved viewing 50 photographs of nature on a computer and the control condition involved viewing 50 photographs of urban environments.Pre and post intervention, attention was measured by four neuropsychological tests: the Multi-source Interference Task, Trail Making Test, Stroop Test, and Digit Span Test.Mood was measured by the Positive and Negative Affect Schedule.Intervention order was randomly assigned and delivered one week apart. At baseline, poorer attention was found correlated with lower oxygen saturation and greater mental effort in HF patients compared to healthy adults.Linear mixed models in a pooled sample (n = 40) showed that NRE intervention was efficacious in improving attention, specifically sustained attention compared to the control condition. Attention switching, however, was preserved only in healthy participants after the control condition, but decreased in HF patients. Mood did not differ after interventions. The NRE intervention is safe and has the potential to be widely disseminated. Future studies are needed on a larger sample with different intervention doses and a longer period of observations, providing knowledge about optimal quality of the intervention.