Somatic Perception Research Articles

Treating Anxiety-Based Cognitive Distortions Pertaining to Somatic Perception for Better Chronic Pain Outcomes: A Recommendation for Better Practice in the Present Day and the Cyber Age of Medicine.

Anxiety-based cognitive distortions pertaining to somatic perception (ABCD-SPs)-primarily catastrophizing, fear avoidance, and kinesiophobia-have been repeatedly linked to worsening chronic, non-cancer pain (CNCP) outcomes of increased disability, amplified pain, ineffective opioid use, and opioid misuse. Several studies have suggested that treating ABCD-SPs can improve pain outcomes, yet identification and targeting of ABCD-SPs are not part of the standard medical pain assessment and treatment plan. Utilizing a narrative review of proposed mechanisms, published patient perspectives, and study correlations connecting these cognitive distortions with CNCP outcomes, an approach for better practice in the delivery of standard medical CNCP care can be deduced and formulated into a Belief and Behavior Action Plan (BBAP) for medical clinicians treating CNCP to implement into initial and maintenance care planning. These recommendations require relatively few resources to implement and have the potential to disseminate more effective CNCP treatment on a large scale now and in the future with the new frontier of cognitive computing in medicine.

Do indicators for DSM-5 sexual dysfunction and somatic symptom disorder overlap? Evidence from the Hamburg City Health Study population-based sample.

Symptoms of sexual dysfunction and somatic symptom disorder may resemble each other in their presentation as lasting and distressing alterations of expected bodily "functioning"; their co-occurrence has not yet been studied in nonclinical settings or by DSM-5 criteria (Diagnostic and Statistical Manual of Mental Disorders, fifth edition). To investigate (1) the association of indicators consistent with DSM-5 sexual dysfunction and somatic symptom disorder diagnoses, (2) whether individuals with different sexual dysfunction diagnoses differ in somatic symptoms and their perception, and (3) whether distress from sexual difficulties is related to somatic symptoms and symptom perception. We examined links among sexual dysfunctions/distress from sexual difficulties (Brief Questionnaire on Sexuality), somatic symptom severity (Patient Health Questionnaire-15 [PHQ-15]), and symptom perception (Somatic Symptom Disorder-B Criteria Scale) in 9333 participants of the Hamburg City Health Study aged 45 to 74 years. For a sensitivity analysis, we repeated all analyses after excluding an item on sexual difficulties from the PHQ-15 score. Outcomes included scores on the Brief Questionnaire on Sexuality indicating sexual difficulties and dysfunction according to DSM-5, PHQ-15 for somatic symptom severity, and Somatic Symptom Disorder-B Criteria Scale for symptom perception. Indicators consistent with DSM-5 sexual dysfunction and somatic symptom disorder diagnoses were linked (P = .24) before the sensitivity analysis but not after. Individuals with different sexual dysfunction diagnoses did not differ in their somatic symptom severity or their symptom perception. Distress from sexual difficulties was weakly correlated with somatic symptom severity (after sensitivity analysis: ρ = .19, P = .01) and symptom perception (ρ = .21, P = .01). Both correlations were stronger for men than for women. Our results convey that it is worth exploring sexual difficulties and somatic symptom disorder in patients presenting with either complaint but also that sexual difficulties should still be regarded as an independent phenomenon. Our sample consisted of participants from one metropolitan region who were >45years of age and thus does not demographically represent the general population. Assessing via self-report questionnaires may have influenced the reporting of symptoms, as may have prevailing shame around experiencing sexual dysfunction. The final sample size was reduced by missing values from some questionnaires. Despite these limitations, sample sizes for all analyses were large and offer meaningful new observations on the subject. Our data suggest that indicators for sexual dysfunction and somatic symptom disorder somewhat overlap but still represent distinct phenomena and should be treated accordingly in research and clinical practice.

Behavioural stochastic resonance across the lifespan.

Stochastic resonance (SR) is the phenomenon wherein the introduction of a suitable level of noise enhances the detection of subthreshold signalsin non linear systems. It manifests across various physical and biological systems, including the human brain. Psychophysical experiments have confirmed the behavioural impact of stochastic resonance on auditory, somatic, and visual perception. Aging renders the brain more susceptible to noise, possibly causing differences in the SR phenomenon between young and elderly individuals. This study investigates the impact of noise on motion detection accuracy throughout the lifespan, with 214 participants ranging in age from 18 to 82. Our objective was to determine the optimal noise level to induce an SR-like response in both young and old populations. Consistent with existing literature, our findings reveal a diminishing advantage with age, indicating that the efficacy of noise addition progressively diminishes. Additionally, as individuals age, peak performance is achieved with lower levels of noise. This study provides the first insight into how SR changes across the lifespan of healthy adults and establishes a foundation for understanding the pathological alterations in perceptual processes associated with aging.

An afferent nerve-like electronic device with somatic mechanical perception and sensation management

Tactile and pain perception are essential for biological skin to interact with the external environment. This complex interplay of sensations allows for the detection of potential threats and appropriate responses to stimuli. However, the challenge is to enable flexible electronics to respond to mechanical stimuli such as biological skin, and researchers have not clearly reported the successful integration of somatic mechanical perception and sensation management functions into neuro-like electronics. In this work, an afferent nerve-like device with a pressure sensor and a perception management module is proposed. The pressure sensor comprises two conductive fabric layers and an ionic hydrogel, forming a capacitor structure that emulates the swift transition from tactile to pain perception under mechanical stimulation. Drawing inspiration from the neuronal “gate control” mechanism, the sensation management module adjusts signals in response to rubbing, accelerating the discharge process and reducing the perception duration, thereby replicating the inhibitory effect of biological neurons on pain following tactile interference. This integrated device, encompassing somatic mechanical perception and sensation management, holds promise for applications in soft robotics, prosthetics, and human-machine interaction.

Symptom perception, health-related quality of life and predicted survival in heart failure patients

BackgroundHeart failure (HF) is a chronic and progressive condition that significantly impacts patients’ lives, necessitating a comprehensive understanding of the factors influencing their health outcomes. Among these factors, symptom perception, health-related quality of life (HRQoL), and predicted survival are paramount. This study aimed to assess symptom perception, HRQoL and predictive survival among HF patients. MethodsA baseline analysis was carried out in a randomized controlled trial involving patients with HF. Heart Failure Somatic Perception Scale to assess symptom perception, Kansas City Cardiomyopathy Questionnaire-12 to assess HRQoL and Seattle Heart Failure Model to assess predicted survival were used. ResultsAmong the 160 patients, 62.5 % were between 36 and 59 years of age and were married (88 %). Hypertension and diabetes were reported in 104 and 94 participants respectively, and among them, 65 participants had both hypertension and diabetes. The mean left ventricular ejection fraction was 33(%), and 56.5 % of the participants were in New York Heart Association functional class III and IV. The average symptom perception score was 27.4 ± 18.3, while the mean HRQoL score was 37.2 ± 14.2. The predicted one-year survival score was 80 ± 11.5, and the predicted five-year survival score was 38.5 ± 21.3. HRQoL showed a significant negative correlation with symptom perception (r = −0.75; p = 0.001) and a positive correlation with one-year survival (r = 0.53; p = 0.001), and five-year survival (r = 0.56; p = 0.001). ConclusionPatients with HF experience persistent symptoms and poor HRQoL. Symptom severity decreases HRQoL. Understanding HRQoL and symptom perception is crucial for developing effective self-care interventions, which are vital for improving patient outcomes and managing HF effectively.

Psychometric Analysis of the Heart Failure Somatic Perception Scale in Japanese Patients With Heart Failure.

Patients with heart failure (HF) experience a wide variety of symptoms. Appropriate recognition of symptoms is important in HF care. The Heart Failure Somatic Perception Scale (HFSPS) measures the presence of HF symptoms and the degree to which physical symptoms are bothersome. The aim of this study was to assess the validity and reliability of the Japanese version of the HFSPS. Confirmatory factor analysis was used to assess structural validity. Construct validity was assessed using Spearman's rank correlation coefficient to evaluate the association between HFSPS total and subscale scores and global physical health on the Patient-Reported Outcomes Measurement Information System. Internal consistency was assessed using the model-based internal consistency for the HFSPS as a whole and Cronbach α for the subscales. Participants were 315 Japanese outpatients (72.1% male), with a mean age of 72.9 ± 12.9 years. The result of confirmatory factor analysis was an adequate model fit by adding error correlations. Construct validity was significant for the correlation with global physical health of the Patient-Reported Outcomes Measurement Information System. The model-based internal consistency was 0.95. Cronbach αs for each subscale were 0.88 for dyspnea, 0.60 for chest discomfort, 0.77 for early and subtle symptoms, and 0.77 for edema. The findings support the use of the HFSPS in a more diverse population, suggesting that it is a reliable and valid instrument in Japanese patients with HF. The HFSPS may provide an accurate assessment of the symptoms experienced by patients with HF in daily life in future educational intervention studies to improve symptom perception and coping behaviors.

The Association Between Mental Disorders and Postoperative Outcomes of Scoliosis Surgery: A Systematic Review and Meta-analysis.

Mental disorders may adversely impact postoperative recovery in scoliosis surgery. However, study findings have been inconsistent and a systematic synthesis is lacking. We searched PubMed, Embase, PsycINFO, and Cochrane Library for studies examining associations between preoperative mental disorders, assessed by various scales, such as the Patient Health Questionnaire (PHQ), the Modified Somatic Perception Questionnaire (MSPQ), and the State-Trait Anxiety Inventory (STAI), and postoperative outcomes, such as pain, disability, quality of life, and satisfaction, in scoliosis surgery. Random-effects meta-analyses pooled standardized mean differences (SMDs) in postoperative outcomes between patients with and without mental disorders. Twelve observational studies were included for the systematic review, and 5 studies were included in the meta-analysis. The meta-analysis demonstrated significantly worse postoperative outcomes in patients with mental disorders compared to those without (SMD -1.96, 95% confidence interval [CI] -3.08 to -0.84, P < 0.001). Significant heterogeneity was present (I2 = 76%). Review of included studies found mental disorders linked to higher preoperative pain/disability and lower quality of life/satisfaction, as well as worse postoperative scores on these outcomes. Moderating factors identified included mental disorder severity, treatment specifics, and patient demographics. Preoperative mental disorders, especially depression and anxiety, are associated with significantly worse postoperative pain, disability, quality of life, and satisfaction in scoliosis surgery. This association may be mediated by psychological factors, such as catastrophizing, self-criticism, and kinesiophobia, and biological factors, such as inflammation, neuroendocrine changes, and central sensitization. Routine psychological screening and interventions for high-risk patients may improve postoperative outcomes but not necessarily surgical effectiveness. Further research is warranted to confirm these findings and elucidate optimal treatment approaches.

The effects of psychological distress after surgery in patients undergoing lumbar spinal fusion

BackgroundThe aim of this study was to evaluate the psychological distress pre-operatively, at 3, 6, and 12 months in patients who underwent lumbar spine fusion surgery.MethodsA total of 440 patients received instrumented lumbar spine fusion were enrolled. Psychological distress was evaluated using the Modified Somatic Perception Questionnaire (MSPQ) and the Modified Zung Depressive Index (ZDI). The results of lumbar fusion surgery were evaluated using the Oswestry Disability Index (ODI), the Japanese Orthopedic Association (JOA-29), and the visual analog scale (VAS).ResultsPsychological distress was reported among 23% of patients and 7, 5.5, and 4.0% of the patients preoperatively, at 3, 6, and 12 months after lumbar surgery, respectively. The mean MSPQ score decreased from 8.78 (before surgery) to 4.30, 3.52, and 3.43 at 3, 6 and 12 months in after surgery, respectively, in patients with psychological distress patients (p < 0.001). The mean ZDI score decreased from 17.78 to 12.48, 10.35, and 9.61 (p < 0.001). The mean ODI score decreased from 22.91 to 11.78, 10.13, and 9.96 (P < 0.001). The mean JOA score increased from 13.65 to 22.30, 23.43, and 23.61 (P < 0.001). The mean low back pain (LBP) VAS score decreased from 4.48 to 1.96, 1.52, and 1.51 (P < 0.001); moreover, the mean leg pain (LP) VAS score decreased from 5.30 to 1.30, 1.04, and 1.03 (P < 0.001).ConclusionsPatients with psychological distress may experience surgical intervention benefits equal to those of ordinary patients. Moreover, reduced pain and disability after surgical intervention may also alleviate psychological distress. Hence, we highly recommend that patients with psychological distress undergo surgical intervention as normal patients do, but appropriate screening measures and interventions are necessary.

Illustrating the pathway from affect to somatic symptom: the Affective Picture Paradigm*

ABSTRACT High levels of somatic symptom distress represent a core component of both mental and physical illness. The exact aetiology and pathogenesis of this transdiagnostic phenomenon remain largely unknown. The Affective Picture Paradigm (APP) represents an innovative experimental paradigm to study somatic symptom distress. Based on the HiTOP framework and a population-based sampling approach, associations between facets of somatic symptom distress and symptoms induced by the APP were explored in two studies (N 1 = 201; N 2 = 254) using structural equation bi-factor models. Results showed that the APP effect was significantly positively correlated with general somatic symptom distress (PHQ-15, HiTOP), cardio-respiratory symptoms (PHQ-15), as well as difficulties identifying feelings. In conclusion, negative affective cues in the APP can elicit somatic symptoms, particularly in people with higher levels of somatic symptom distress. Difficulties identifying feelings might contribute to this phenomenon. Results are compatible with a predictive processing account of somatic symptom perception.

Psychometric Evaluation of the Heart Failure Somatic Perception Scale in a Middle Eastern Heart Failure Population.

The Heart Failure Somatic Perception Scale (HFSPS) is an 18-item instrument used to assess how bothersome are common signs and symptoms of heart failure (HF). To date, the psychometric properties of the HFSPS have been tested in American, Italian, and Japanese samples. The aim of this study was to evaluate the validity and reliability of the HFSPS in a population of Lebanese patients living with HF. A rigorous translation and back-translation process was performed. Cultural appropriateness ratings were assessed by an expert panel. Exploratory factor analysis was conducted to confirm construct validity, whereas an independent t test using the Minnesota Living With HF Questionnaire's scores was conducted to confirm convergent validity. Pearson correlation was performed to confirm discriminant validity using the Self-Care in HF Index Management subscale, whereas predictive validity was evaluated using the Control Attitudes Scale-Revised. Internal consistency reliability was evaluated using Cronbach α. A total of 109 patients (mean age, 63.66 ± 10.55 years; 69.7% male) were included. A series of exploratory factor analyses was conducted and resulted in a 4-factor model. Cronbach α was 0.869. Convergent (high correlation with total Minnesota Living With HF Questionnaire; r = 0.762, P < .0001), discriminant (no correlation with self-care management; r = 0.180, P = .078), and predictive (significant correlation with the Control Attitudes Scale-Revised; r = -0.523, P < .0001) validity was supported. The reliability and validity of the HFSPS were supportive in this Middle Eastern sample. The HFSPS can be used to assess how bothersome HF symptoms are to improve their management.

Sympathetic dysfunction is associated with worse fatigue and early and subtle symptoms in heart failure: an exploratory sex-stratified analysis.

Physical symptoms impact patients with heart failure (HF) despite treatment advancements; however, our understanding of the pathogenic mechanisms underlying HF symptoms remains limited, including sex differences therein. The objective of this study was to quantify associations between sympathetic markers [norepinephrine (NE) and 3,4-dihydroxyphenylglycol (DHPG)] and physical symptoms in patients with HF and to explore sex differences in these associations. We performed a secondary analysis of combined data from two studies: outpatients with HF (n = 111), and patients prior to left ventricular assist device implantation (n = 38). Physical symptoms were measured with the Heart Failure Somatic Perception Scale (HFSPS) dyspnoea and early/subtle symptom subscales and the Functional Assessment in Chronic Illness Therapy Fatigue Scale (FACIT-F) to capture dyspnoea, early symptoms of decompensation, and fatigue. Norepinephrine and DHPG were measured with high-performance liquid chromatography with electrochemical detection. Multivariate linear regression was used to quantify associations between symptoms and sympathetic markers. The sample (n = 149) was 60.8 ± 15.7 years, 41% women, and 71% non-ischaemic aetiology. Increased plasma NE and NE:DHPG ratio were associated with worse FACIT-F scores (P = 0.043 and P = 0.013, respectively). Increased plasma NE:DHPG ratio was associated with worse HFSPS early/subtle symptoms (P = 0.025). In sex-stratified analyses, increased NE:DHPG ratio was associated with worse FACIT-F scores (P = 0.011) and HFSPS early/subtle scores (P = 0.022) among women but not men. In patients with HF, sympathetic dysfunction is associated with worse fatigue and early/subtle physical symptoms with associations stronger in women than men.

Visual and acoustic exploratory behaviors toward novel stimuli in Antillean manatees (Trichechus manatus manatus) under human care.

Exploratory behaviors describe the actions performed by an animal to obtain information on an object, environment, or individual by using its different senses. Exploration is described in some marine mammals, but not yet in manatees. Our study investigated behavioral and acoustic responses of two groups of Antillean manatees (N = 12 and N = 4) housed in zoological parks toward various stimuli involving three sensory modalities: visual, tactile, and auditory. Simultaneous audio and video recordings were collected during three periods of time (i.e., before, during, and after the presentation of all stimuli). Behaviors related to interest, social behaviors, the number and type of calls produced, and their frequency and duration were recorded and analyzed. Manatees reacted more to submerged stimuli than to out-of-water and sound stimuli, with an increase in approach, social contacts, and number of vocalizations. The proportion of squeaks and squeals call types also varied according to stimuli, and call entropy and F0 range varied according to periods. Our results suggest that manatees display sensory preferences when exploring stimuli, with more interest in manipulable stimuli, supporting the importance of their somatic perception. We highlight the need for particular enrichment programs (i.e., involving submerged objects) in zoological facilities. By displaying social contacts and by producing vocalizations, manatees communicate information such as their motivational state. The increase in call rate, harsh calls, and entropy values could be valid indicators of heightened arousal. We encourage further studies to associate acoustic recordings with ethological data collection to increase the understanding of manatees' behaviors andperception. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Spanish version of the Heart Failure Somatic Perception Scale (HFSPS v.3) - psychometric properties.

The Heart Failure Somatic Perception Scale (HFSPS) is an instrument that examine the existence and gravity of physical signs and symptoms in patients with heart failure, as well as early and subtle symptoms of HF that have clinical value, we aimed to translate and adapt the HFSPS from English to Spanish and evaluate the psychometric properties. HFSPS translation and back translation were carried out according to the method established by of Beaton et al. A confirmatory factor analysis (CFA) was performed to test the factor structures. To assess criterion-related validity, HFSPS factor scores were correlated with Kansas City Cardiomyopathy Questionnaire (KCCQ) scores using the Spearman correlation method. The reliability of the internal consistency of the HFSPS was determined by calculating the Cronbach's alpha coefficient and the factor score determination coefficient. Data from 173 patients with a mean age of 80.7 years (SD 9.1), women (51.1%), were analyzed. The majority (74.7%) were NYHA class II/III. The confirmatory factor analysis of four factors after eliminating one item showed fit indices close to the recommended indices: χ2 = 169.237, p < 0.001, CFI = 0.920, TLI = 0.901, RMSEA = 0.057 and SRMR = 0.061. Regarding the validity related to the criterion, all the scores of the HFSPS dimensions were correlated with all the scores of the KCCQ dimensions and were statistically significant. The reliability of the HFSPS factors of the coefficient of determination obtained scores of 0.73 for the dyspnea factor and early and subtle and lower for edema and chest discomfort with fewer items. Cronbach's alpha was acceptable for three of the scales >0.71 and poor 0.52 for chest discomfort with two items. The internal consistency index based on the model was 0.850. The Spanish version of the HFSPS is a valid and reliable instrument that that would be feasible to use in clinical and research setting to evaluate in the perception of symptoms in patients with heart failure.

Abstract 12479: Cardiovascular Stroke Nursing Best Abstract Award: Sex Differences in Relationships Between Inflammation and Symptoms in Persons With Heart Failure

Background: Heart failure (HF) is a complex syndrome involving interplay of pathologic processes, such as inflammation and myocardial remodeling. Sex differences in cardiac remodeling and function are linked to differences in inflammation. Female hearts show a pro-inflammatory shift and increased cytokine expression with aging not seen in male hearts. Yet, sex is not often considered in HF interventions. Previous studies suggest sex may moderate the relationship between inflammation and symptoms in cardiometabolic disease, but the relationship in HF is unknown. Purpose: To examine sex differences in inflammation and symptoms in Black adults living with HF. Methods: Black adults living with HF (N=41) were enrolled in this pilot study. Physical symptoms were measured with PROMIS Dyspnea, Heart Failure Somatic Perception Scale (HFSPS), and Multidimensional Fatigue Inventory (MFI). Mood symptoms were measured with Center for Epidemiological Studies Depression Scale (CESD), State-Trait Anxiety Inventory (STAI), and Perceived Stress Scale (PSS). Inflammatory biomarkers were measured via multiplex immunoassay. Xanthine oxidase (XO) activity, an indicator of oxidative stress, was measured via ELISA. Pearson correlations were stratified by sex. Results: The mean age was 57 ± 11 years, and 66% were female. Dyspnea was positively associated with XO activity in both groups. Among females, dyspnea was positively associated with matrix metalloproteinase (MMP)-12 (r=.519, p=.033), interleukin (IL)-6 (p=.564, p=.018), [C-C motif chemokine ligand(CCL)-3, (r=.509, p=.037), and CCL-11 (r=.520, p=.032). HFSPS was positively associated with XO activity among females only (r=.445, p=.014). CCL-11 was positively associated with MFI (r=.616, p=.008), PSS (p=.0537, r=.032), STAI (r=.714, p=.001), and CESD (r=.635, p=.008) symptoms among females but not males. Conclusions: While physical symptoms were associated with similar inflammatory pathways, fatigue and mood symptoms were associated with inflammation among females only. Women may be more vulnerable to inflammation-induced mood changes and fatigue. Further work is needed to better understand how sex modulates the relationship between inflammation and symptoms in persons with HF.

Abstract 16404: Symptom Perception Predicts Short-Term Prognosis in Patients With Heart Failure

Background: The type and severity of symptoms perceived by heart failure (HF) patients may be a useful prognostic predictor, but the impact of symptom perception on clinical events among HF patients has not been fully tested. Aim: To assess the symptoms perceived by HF patients using the Heart Failure Somatic Perception Scale (HFSPS) and to test whether symptom perception predicts short-term prognosis in HF patients. Methods: Using the prospective observational design, we collected data from 315 outpatients with HF (mean age 73 ± 13 years, 72% male). Data included sample characteristics, BMI, BNP, comorbidities, ADL, depressive symptoms, symptom perception assessed by HFSPS at baseline, and clinical composite outcomes (readmission, all-cause death, and emergency department visits) at three months. HFSPS is a scale that assesses the degree to which 18 physical symptoms perceived by HF patients are bothersome in daily life. The study subjects were classified into low, medium, and high HFSPS total score groups. The impact of HFSPS on clinical composite outcomes was analyzed using the Cox proportional hazard model, considering the influence of covariates. Results: The mean overall HFSPS score was 11.7 ± 12.3 points, with 87 patients (28%) in the low HFSPS group, 151 (48%) in the medium group, and 77 (24%) in the high group. Symptoms reported were nocturia (74.6%), shortness of breath (58.4%), fatigue (54.6%), malaise (44.5%), and cough (42.9%). Three-month composite event rate was 25.7%, with statistically significant differences between the HFSPS groups (16.1% in the low group, 23.2% in the medium group, and 41.6% in the high group (p=0.001). The results of analysis using the Cox proportional Hazard model using age, gender, BMI, BNP, comorbidities, depression, and ADL as covariates, the high HFSPS group had a significantly higher incidence of clinical composite. The incidence of clinical composite outcomes at three months was significantly higher in the high HFSPS group than in the other groups (HR=2.090 (95% CI=1.067-4.096), p=0.032). Conclusions: Symptom perception, which can be regarded as a patient-reported outcome, is a promising predictor of short-term prognosis in HF patients.

Abstract 15239: Patient Self-Care Mediates the Relationship Between Caregiver Contributions and Symptom Burden in Heart Failure

Introduction: Patients with heart failure (HF) experience high symptom burden that can be mitigated with adequate self-care. The situation-specific theory of caregiver contribution to HF self-care suggests that caregivers have a key role in improving patient symptom burden. Hypothesis: a) caregiver contribution to self-care influences patient self-care; b) patient self-care influences symptom burden; c) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden. Methods: Secondary analysis of baseline and three-months data from the MOTIVATE-HF trial, which enrolled 510 HF patient-caregiver dyads in Italy. Data were collected using the Self-Care of HF Index v.6.2, the Caregiver Contribution to Self-Care of HF Index, and the HF Somatic Perception Scale. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test study hypotheses. Results: On average, caregivers were 54 ± 15.46 years and mainly female (74.5%), while patients were 72.4 ± 12.28 years and mainly male (68%). Better caregiver contribution to self-care maintenance was associated with better patient self-care maintenance (β=0.280, p&lt;0.001), which, in turn, was associated with lower symptom burden (β=-0.280, p&lt;0.001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (β=-0.079, 95% BC bootstrapped CI: -0.130, -0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (β=0.238, p=0.006). The model accounted for 37% of the variance in symptom burden (p&lt;0.001). Conclusions: Targeting caregivers to increase their contribution to self-care can increase patient self-care and, consequently, lower patients’ HF symptom burden.

Psychometric evaluation of the heart failure somatic perception scale in Iranian heart failure patients: a cross-sectional study.

This study aimed to evaluate the psychometric evaluation of heart failure somatic perception scale (HFSPS) in Iranian heart failure patients. A total of 220 heart failure (HF) patients were enroled in the study. Data gathering was conducted via consecutive sampling from August 2022 to April 2023. Face validity, content validity, construct validity, and internal consistency were used to evaluate the validity and reliability of the Persian version of the HFSPS. Construct validity was done through confirmatory factor analysis and convergent validity. Convergent validity between HFSPS and symptom status questionnaire-heart failure was measured using Pearson's correlation coefficient. Cronbach's alpha and Macdonald's omega coefficient were used to evaluate the reliability of instruments. A total of 220 HF patients participated in this study. Their mean age was 66.46 (SD=11.40). Among the participants, 70% were men. The results of the confirmatory factor analysis evaluation showed the goodness of fit indices of the final HFSPS model after modification was within an acceptable range (χ2=306.18 P<0.001, Minimum Discrepancy Function Divided by Degrees of Freedom=2.47, Comparative of Fit Index=0.91, Tucker-Lewis index=0.90, Adjusted goodness of fit index=0.81, Parsimonious norm fit index=0.70, root mean square error of approximation=0.082). Convergent validity between HFSPS and symptom status questionnaire-heart failure indicated a positive and significant correlation. Cronbach's alpha coefficient in the HFSPS was 0.868, and McDonald's omega coefficient in the HFSPS was 0.832. Overall, the Persian version of the HFSPS was determined to be a reliable and valid scale among Iranians with HF.

Are Physical and Depressive Symptoms Different Between Women and Men With Heart Failure?: An Exploration Using Two Analytic Techniques.

Adults with heart failure (HF) experience a constellation of symptoms; however, understanding of gender differences in HF symptoms remain elusive. The aim of this study was to determine whether there are gender differences in physical and depressive symptoms and symptom patterns in HF using 2 different analytic techniques. We performed a secondary analysis of combined data from 6 studies of adults with HF. Physical symptoms were measured with the HF Somatic Perception Scale, and depressive symptoms were measured with the Patient Health Questionnaire-9. First, we performed propensity matching with the nearest neighbor to examine the average treatment effect for HF Somatic Perception Scale and Patient Health Questionnaire-9 in the matched sample of women and men. Next, we used the entire data set in a latent class mixture model to determine patterns of symptoms. Finally, we calculated predictors of class membership with multinomial logistic regression. The sample (n = 524, 86.5% systolic HF) was 37% women with a mean age of 58.3 ± 13.9 years and mean number of years with HF of 6.9 ± 6.9. Three hundred sixty-six participants were matched on propensity scores; there were no significant gender differences in symptom scores between matched women (n = 183) and men (n = 183). Among all 524 participants, 4 distinct latent classes of symptom patterns indicate that many patients with HF are fatigued, some have more depressive symptoms, and others have significantly more edema or cough. Gender did not predict membership to any symptom pattern. There were significant gender differences in sociodemographics, health behaviors, and clinical characteristics, but not HF symptoms or symptom patterns, using either analytic technique.

Factors associated with somatic symptoms perception in patients living with heart failure

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): University Review Board of the American University of Beirut Background Heart Failure [HF] affects 64.3 million individuals globally and despite its decreasing global burden it remains dramatically high in countries of the Eastern Mediterranean Region. Self-care is highly recommended to improve HF patient outcomes and an integral aspect for effective HF self-care is symptom perception. This involves body listening, symptom recognition and monitoring, and interpreting and labeling the meaning of these symptoms. Purpose To identify factors related to HF symptom burden as perceived by patients living with HF and using the Heart Failure Somatic Perception [HFSP] scale. Methods This was a secondary analysis of a cross-sectional correlational study that recruited dyads living with HF. Patients were assessed for symptom burden measured by the HFSP scale, depression measured using the Patient Health Questionnaire [PHQ-9], perceived control measured using the Control Attitudes Scale [CAS], and quality of life measured using the Minnesota Living with HF [MLWHF] questionnaire. Independent t-Test and Pearson correlation were used for analysis. Results A total of 109 HF patients [mean age 63.24 ± 10.77 years, 69.7% males] were included. The mean score of HFSP scale was 27.96 ± 19.43. Symptomatic HF patients [New York Functional Class (NYHA) I and II] had significantly higher HFSP than asymptomatic patients [NYHA III and IV] indicating higher symptom burden [32.90 ± 19.65 versus 23.16 ± 17.79; p = 0.11]. Likely, higher symptom burden was associated with lower total quality of life [higher MLWHF score; r = .802; p &amp;lt;.001], lower physical quality of life [r = .802; p &amp;lt;.001], lower emotional quality of life [r = .384; p &amp;lt;.001], more depression [higher PHQ-9 score; r = .464; p &amp;lt;.001], and lower perceived control over symptoms and disease process [lower CAS score; r = -.506; p &amp;lt;.001]. Predictors were retained in the regression model if they contributed significantly to the model or were conceptually relevant and did not negatively affect the variance. Worse quality of life and lower perceived control explained about 60% of the variance in symptom burden [F = 49.189; p = 0.001]. Conclusion Results of this secondary analysis suggest that patients’ somatic perception of their illness has an independent and substantial relationship to their functionality, quality of life, and perceived control over illness. Illness perceptions are amenable to change, and healthcare providers are tasked with developing and testing targeted interventions aimed to modify these as this may be helpful for improving quality of life and control over disease process.

Association of heart failure symptoms burden with physical well-being: exploring the roles of self-care and sleep quality using a moderated-mediation analysis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients with heart failure (HF) commonly experience symptom burden. Symptoms such as breathlessness, fatigue, and fluid retention can have an important impact on the patient's daily activities and overall health. Given the evidence of symptoms' negative impact on the quality of life in patients with HF, self-care maintenance is critical. However, there is a paucity of knowledge regards the role played by self-care and the quality of sleep in this population. Purpose To explore the association between HF symptoms burden and quality of life (i.e., physical well-being) and how the association was moderated by levels of self-care maintenance and mediated by sleep quality. Methods This was a secondary analysis of a single-center cross-sectional study conducted in Spain, between February and December 2017. Symptom burden was measured using the Heart Failure Somatic Perception Scale (HFSPS), and quality of life was assessed using the physical well-being subscale of the 12-Item Short Form Survey (SF-12). Self-care was assessed using the self-care maintenance subscale of the Self-Care Heart Failure Index (SCHFI) (version 6.2), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A moderated-mediation analysis was conducted to explore the role of self-care as a moderator and sleep quality as a mediator in the association using SPSS PROCESS macro with 5000 bootstrap samples, adjusted for age, sex, Body Mass Index (BMI) and NYHA covariates. Results A total of 178 patients completed the questionnaires. The patients were older (mean age 80, SD ±8,9) with a mean BMI of 29 (SD ± 5,5). About of patients were males (50.6%) and NYHA class 1 or 2 (58.4%). Symptom burden was negatively associated with sleep quality (B = -.104, t(1, 176) = -7.7675, p = &amp;lt;,001), which was positively associated with physical well-being (B = .5664, t(1, 176) = 2.9810, p = .003). The association between symptom burden and physical well-being was moderated by self-care maintenance (interaction value= -.0038, t(1, 176) = -2.0022, p = .047). In the moderated mediation analysis (Figure 1), we found that the direct effect strength of burden symptom on physical well-being was different by the level of self-care maintenance (Johnson-Neyman value= 32.3560, low = 15.1685 high = 84.8315). There was also a significant indirect effect of symptom burden on physical well-being through sleep quality adjusted (B = -.0589, 95% CI [ -.1001, -.0230]). Conclusion Self-care maintenance moderates the association symptom burden and physical well-being, while sleep quality acts as a mediator in the association. Improving quality of life, while empowering self-care, should also consider an evaluation and improving stretegies of sleep quality as it impacts physical quality of life.Moderated-mediation analysis