Perceived dyspnea and experience of hospitalized patients with acute decompensated heart failure undergoing an early MObilization protocol with immersive Virtual rEality: MOVE study protocol for a parallel superiority randomized clinical trial.

BACKGROUND: Immersive virtual reality (VR) is an innovative strategy for inpatient rehabilitation programs. Using immersive VR in early mobilization protocols has not yet been investigated in the setting of hospitalized patients with acute decompensated heart failure (ADHF), especially to improve perceived dyspnea, a common symptom of heart failure (HF). METHODS: This is a single-center parallel superiority randomized clinical trial. The study will be conducted at a public teaching hospital in Brazil from January 2023 to January 2024. The sample will include adult patients with ADHF hospitalized for at least 24 h, randomly assigned in a 1:1 ratio to the control (standard early mobilization protocol conducted in the intensive care unit (ICU)) or intervention group (the same standard early mobilization protocol but associated with immersive VR). The primary outcome will be assessing perceived dyspnea, and the secondary outcome will be assessing patient experience. DISCUSSION: Using immersive VR in early mobilization protocols in the ICU is expected to improve perceived dyspnea in patients with ADHF as well as patient experience regarding care. This study has the potential to increase patient adherence to early mobilization protocols in the setting of ADHF as well as to promote a positive patient experience. Filling this gap could promote the rational incorporation of technologies in health care. TRIAL REGISTRATION: This study protocol is in its first version. CLINICALTRIALS: gov NCT05596292. Registered on 1 December 2022.

Influência da cicatrização e amplitude de movimento na qualidade de vida de pacientes queimados em acompanhamento ambulatorial / Influence of wound healing and range of motion in the quality of life of burned patients in ambulatory follow up / Influencia de la cicatrización y amplitud de movimiento en la calidad de vida de pacientes quemados en acompañamiento ambulatorial

Objetivo: Avaliar a influência da cicatrização e amplitude de movimento na qualidade de vida de pacientes queimados em acompanhamento ambulatorial. Método: Estudo transversal realizado no Hospital de Pronto Socorro-Porto Alegre. Instrumentos avaliativos: escala de cicatrização de Vancouver, goniometria ativa e questionário Burn Specific Health Scale Revised. Resultados: Amostra composta por 15 participantes, sendo 53,3% homens, e a média de idade foi 46,47±14,02 anos. Em relação à cicatriz, houve prevalência de cicatrizes hiperpigmentadas (n=11), maleáveis (n=6), deformadas (n=5) e firmes (n=5), com prevalência de hiperpigmentação nos fototipos cutâneos II (n=4) e III (n=4). Na variável amplitude de movimento articular, 93,3% apresentou limitação. A articulação mais acometida foi o punho (33,30%) e 86,70% das queimaduras eram bilaterais, com prevalência de limitação para movimentos de flexão e extensão (66,70%) das articulações testadas. No questionário, o subgrupo "afeto e imagem corporal" apresentou pior escore. "Afeto e imagem corporal" teve associação significativa com os subgrupos "tratamento" e "relações interpessoais" (p<0,05), e "sensibilidade da pele" teve associação significativa com o subgrupo "trabalho" (p<0,01). Conclusões: Alterações cicatriciais/estéticas e prejuízo funcional p equeno foram encontrados, podendo ser associados à redução da qualidade de vida, prejudicada principalmente nos aspectos de autoimagem e sensibilidade da pele, advindos da cicatrização. A associação destes fatores traz dificuldade no retorno ao trabalho e atividades de vida diária, gerando custos e isolamento social.

Objective: To assess the influence of healing and range of motion on the quality of life of burned patients in outpatient care. Methods: Cross-sectional study carried out at Hospital de Pronto Socorro-Porto Alegre. evaluation instruments: Vancouver Scar Scale, active goniometer and questionnaire Burn Specific Health Scale Revised. Results: Sample composed of 15 participants, 53.3% men and the mean age 46.47±14.02 years. Regarding the scar, there was a prevalence of hyperpigmented scars (n=11), flexible (n=6) deformed (n=5) and firm (n=5), with a prevalence of hyperpigmentation in skin phototypes II (n=4) and III (n=4). In the variable range of motion, 93.3% had limitation. The most affected joint was the handle (33.30%) and 86.70% of the burns were bilateral, with a prevalence for limiting flexion and extension movements (66.70%) of the tested joints. Considering the questionnaire, subgroup "affection and body image" had a worse score. "Affect and body image" was significantly associated with subgroups "treatment" and "Interpersonal Relations" (p<0.05), and "sensitive skin" was significantly associated with the subgroup "work" (p<0.01). Conclusions: Scar/aesthetic changes and small functional impairment have been found, and may be associated to a reduction in the quality of life, which is mainly impaired in the autoimaging and sensitivity aspects of the skin, resulting from scarring. The association of these factors brings difficulty in returning to work and activities of daily living, generating costs and social isolation.

Objetivo: Evaluar la influencia de la cicatrización y amplitud de movimiento en la calidad de vida de pacientes quemados en seguimiento ambulatorial. Método: Estudio transverso cumplido en el Hospital de Pronto Socorro-Porto Alegre. Instrumentos de evaluación: Escala de Cicatrización de Vancouver, goniómetro activa y el cuestionario Burn Specific Health Scale Revised. Resultados: Muestra compuesta de 15 participantes, 53,3% eran hombres y la edad media de 46.47±14.02 años. En cuanto a la cicatriz era prevalencia de cicatrices hiperpigmentadas (n=11), flexible (n=6) deformada (n=5) y firme (n=5), Con una prevalencia de hiperpigmentación en la piel fototipos II (n=4) y III (n=4). En el rango variable de movimiento, 93,3% tenían limitación. La articulación más afectado fue el mango (33,30%) y 86,70% de las quemaduras fueron bilaterales, con una prevalencia para limitar de flexión y extensión movimientos (66,70%) de las articulaciones ensayadas. En el cuestionario, subgrupo "afecto y la imagen corporal" tuvo una puntuación peor. "Afecto y la imagen corporal" se asoció significativamente con subgrupos "tratamiento" y "Relaciones interpersonales" (p<0,05), y "piel sensible" se asoció significativamente con el subgrupo "trabajo" (p<0,01). Conclusiones: Se han encontrado alteraciones cicatrices/estéticas y pérdida funcional pequeña, pudiéndose asociar a la reducción de la calidad de vida, perjudicada principalmente en los aspectos de autoimagen y sensibilidad de la piel, provenientes de la cicatrización. La asociación de estos factores trae dificultad en el retorno al trabajo y actividades de vida diaria, generando costos y aislamiento social.