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1.
J Cogn ; 7(1): 33, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38638460

RESUMO

Extensive literature elucidated the mechanisms underlying the ability to memorize the positions of objects in space. However, less is known about the impact that objects' features have on spatial memory. The present study aims to investigate differences in egocentric and allocentric object-location memory between hand stimuli depicted in a first-person perspective (1PP) or in a third-person one (3PP). Fifty-two adults encoded spatial positions within a virtual museum environment featuring four square buildings. Each of these buildings featured eight paintings positioned along the walls, with two pictures displayed on each of the four walls. Thirty-two stimuli were employed, which represented pictures of the right hand performing various types of gestures. Half of the stimuli depicted the hand in the 1PP, while the other half depicted the hand in the 3PP. Both free and guided explorations served as encoding conditions. Immediately after that, participants underwent a two-step object-location memory task. Participants were provided with a map of the museum and asked to identify the correct building where the image was located (allocentric memory). Then, they were presented with a schematic representation of the exhibition room divided into four sections and instructed to select the section where they thought the picture was located (egocentric memory). Our findings indicate a memory performance boost associated with egocentric recall, regardless of the perspective of the bodily stimuli. The results are discussed considering the emerging literature on the mnemonic properties of body-related stimuli for spatial memory.

2.
J Pers Med ; 14(2)2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38392625

RESUMO

Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer's disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-ε4) has been associated with both sporadic and familial late-onset AD, and patients with mild cognitive impairment (MCI) due to AD are more likely to progressively deteriorate. Spatial navigation performance will be examined on a sample of 76 community-dwelling senior citizens (25 healthy controls; 25 individuals with subjective cognitive decline (SCD); and 26 patients with MCI due to AD) via a virtual computer-based task (i.e., the AppleGame) and a naturalistic task (i.e., the Detour Navigation Test-modified version) for which a wearable device with sensors will be used for recording gait data and revealing physiological parameters that may be associated with spatial disorientation. We expect that patients with MCI due to AD and APOE-ε4 carriers will show altered SN performances compared to individuals with SCD and healthy controls in the experimental tasks, and that VR testing may predict ecological performance. Impaired SN performances in people at increased risk of developing AD may inform future cognitive rehabilitation protocols for counteracting spatial disorientation that may occur during elders' traveling to unfamiliar locations. The research protocol has been approved by the Ethics Committee of the Istituto Auxologico Italiano. Findings will be published in peer-reviewed medical journals and discussed in national and international congresses.

3.
Cyberpsychol Behav Soc Netw ; 27(1): 28-36, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38197837

RESUMO

Immersive virtual reality (IVR) technology provides several educational affordances that make it a valuable tool for learning, especially from a constructivist learning perspective. Combined with the increasing availability of Metaverse social platforms, such as ENGAGE and AltSpace VR, where students and teachers can meet and work together, IVR may transform how students learn and interact with educational content. However, little is known about students' attitudes toward IVR in education. To address this gap, we surveyed 329 undergraduate students from different universities in Italy. We used the Unified Theory of Acceptance and Use of Technology (UTAUT) to predict students' intention to adopt IVR for learning. We further explored the role that different individual factors, including students' learning styles, affordances perceptions, and personal innovativeness, have on their attitudes toward IVR. A hierarchical multiple regression analysis revealed that the four constructs of the UTAUT, namely performance expectancy, effort expectancy, social influence, and facilitating conditions were the strongest predictors of students' intention to use IVR in education and that individual factors only had little impact on it. Based on these results, this study provides helpful indications for researchers and educators who wish to introduce IVR effectively in educational contexts. Given the new possibilities provided by Metaverse applications based on IVR technology for learning, it is indeed crucial to fully understand the attitudes different stakeholders in education have toward adopting this technology in educational contexts.


Assuntos
Aprendizagem , Realidade Virtual , Humanos , Universidades , Estudantes , Intenção
4.
5.
J Cogn ; 6(1): 61, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37841669

RESUMO

According to embodied theories (including embodied, embedded, extended, enacted, situated, and grounded approaches to cognition), language representation is intrinsically linked to our interactions with the world around us, which is reflected in specific brain signatures during language processing and learning. Moving on from the original rivalry of embodied vs. amodal theories, this consensus paper addresses a series of carefully selected questions that aim at determining when and how rather than whether motor and perceptual processes are involved in language processes. We cover a wide range of research areas, from the neurophysiological signatures of embodied semantics, e.g., event-related potentials and fields as well as neural oscillations, to semantic processing and semantic priming effects on concrete and abstract words, to first and second language learning and, finally, the use of virtual reality for examining embodied semantics. Our common aim is to better understand the role of motor and perceptual processes in language representation as indexed by language comprehension and learning. We come to the consensus that, based on seminal research conducted in the field, future directions now call for enhancing the external validity of findings by acknowledging the multimodality, multidimensionality, flexibility and idiosyncrasy of embodied and situated language and semantic processes.

6.
Psychol Res ; 87(8): 2499-2510, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37204615

RESUMO

Space can be used as a metaphor to describe semantic and perceptual similarity. Research has shown that similarity and spatial information can influence each other. On the one hand, similarity entails spatial closeness; on the other hand, proximity leads to similarity judgment. This spatial information can be stored in declarative memory and measured later on. However, it is unknown if phonological similarity/dissimilarity between words is represented as spatial closeness/distance in declarative memory. In this study, 61 young adults were tested on a remember-know (RK) spatial distance task. Participants learned noun pairs on the PC screen that were manipulated concerning their phonological similarity (similar vs. dissimilar) and reciprocal spatial distance (near vs. far). In the recognition phase, old-new, RK, and spatial distance judgments were asked. We found that for hit responses in both R and K judgments, phonologically similar word pairs were remembered closer compared to phonologically dissimilar pairs. This was also true for false alarms after K judgments. Lastly, the actual spatial distance at encoding was only retained for hit R responses. Results suggest that phonological similarity/dissimilarity is represented respectively with spatial closeness/distance and that this information is stored in the neurocognitive system of declarative memory.


Assuntos
Aprendizagem , Reconhecimento Psicológico , Adulto Jovem , Humanos , Reconhecimento Psicológico/fisiologia , Rememoração Mental , Semântica , Idioma
7.
Mem Cognit ; 51(8): 1870-1880, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37204674

RESUMO

Growing evidence has revealed the crucial role of motor simulation and spatial perspective-taking in action language. However, there is still a lack of understanding of how motor and spatial processes interact when there are multiple actors involved, and if embodied processes are consistent across different cultures. To address this gap, we examined the interaction between motor simulation and spatial perspective-taking in action-sentences comprehension, along with the consistency of embodied processes across cultures. We collected data from Italian and US English speakers using an online sentence-picture verification task. The participants completed four conditions: two congruent (i.e., the participant is the agent in the sentence and the photo; the agent is someone else interacting with the participant in both the sentence and the picture) and two incongruent (i.e., the agents of the sentence and the picture do not match). The results show that when the perspective of the picture matched that described in the sentence-processing reaction times (RTs) were faster than in the incongruent conditions. In the congruent conditions where the agent is someone else, RTs were slower compared to the condition where the participant is the agent. This has been interpreted as claiming that motor simulation and perspective-taking are independent processes interacting during sentence comprehension (e.g., motor simulation is always run in the role of the agent, but we can adopt multiple perspectives depending on the pronouns and the contextual cues). Furthermore, Bayesian analysis provided evidence that embodied processing of action language entwines a common mechanism, suggesting cross-cultural consistency of embodied processes.


Assuntos
Compreensão , Comparação Transcultural , Humanos , Teorema de Bayes , Idioma , Tempo de Reação
8.
J Neural Eng ; 20(2)2023 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-37019103

RESUMO

Objective.Syntax involves complex neurobiological mechanisms, which are difficult to disentangle for multiple reasons. Using a protocol able to separate syntactic information from sound information we investigated the neural causal connections evoked by the processing of homophonous phrases, i.e. with the same acoustic information but with different syntactic content. These could be either verb phrases (VP) or noun phrases.Approach. We used event-related causality from stereo-electroencephalographic recordings in ten epileptic patients in multiple cortical and subcortical areas, including language areas and their homologous in the non-dominant hemisphere. The recordings were made while the subjects were listening to the homophonous phrases.Main results.We identified the different networks involved in the processing of these syntactic operations (faster in the dominant hemisphere) showing that VPs engage a wider cortical and subcortical network. We also present a proof-of-concept for the decoding of the syntactic category of a perceived phrase based on causality measures.Significance. Our findings help unravel the neural correlates of syntactic elaboration and show how a decoding based on multiple cortical and subcortical areas could contribute to the development of speech prostheses for speech impairment mitigation.


Assuntos
Idioma , Semântica , Humanos , Eletroencefalografia , Fala , Percepção Auditiva
9.
EXCLI J ; 22: 191-206, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36998712

RESUMO

The body is a very special object, as it corresponds to the physical component of the self and it is the medium through which we interact with the world. Our body awareness includes the mental representation of the body that happens to be our own, and traditionally has been defined in terms of body schema and body image. Starting from the distinction between these two types of representations, the present paper tries to reconcile the literature around body representations under the common framework of body memory. The body memory develops ontogenetically from birth and across all the life span and is directly linked to the development of the self. Therefore, our sense of self and identity is fundamentally based on multisensory knowledge accumulated in body memory, so that the sensations collected by our body, stored as implicit memory, can unfold in the future, under suitable circumstances. Indeed, these sets of bodily information had been proposed as possible key factors underpinning several mental health illnesses. Following this perspective, the Embodied Medicine approach put forward the use of advanced technologies to alter the dysfunctional body memory to enhance people's well-being. In the last sections, recent experimental pieces of evidence will be illustrated that targeted specifically bodily information for increasing health and wellbeing, by means of two strategies: interoceptive feedback and bodily illusions. See also Figure 1(Fig. 1).

10.
Behav Res Methods ; 55(8): 4035-4047, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-36307624

RESUMO

Neuroscience research has provided evidence that semantic information is stored in a distributed brain network involved in sensorimotor and linguistic processing. More specifically, according to the embodied cognition accounts, the representation of concepts is deemed as grounded in our bodily states. For these reasons, normative measures of words should provide relevant information about the extent to which each word embeds perceptual and action properties. In the present study, we collected ratings for 959 Italian nouns and verbs from 398 volunteers, recruited via an online platform. The words were mostly taken from the Italian adaptation of the Affective Norms for English Words (ANEW). A pool of 145 verbs was added to the original set. All the words were rated on 11 sensorimotor dimensions: six perceptual modalities (vision, audition, taste, smell, touch, and interoception) and five effectors (hand-arm, foot-leg, torso, mouth, head). The new verbs were also rated on the ANEW dimensions. Results showed good reliability and consistency with previous studies. Relations between perceptual and motor dimensions are described and interpreted, along with relations between the sensorimotor and the affective dimensions. The currently developed dataset represents an important novelty, as it includes different word classes, i.e., both nouns and verbs, and integrates ratings of both sensorimotor and affective dimensions, along with other psycholinguistic parameters; all features only partially accomplished in previous studies.


Assuntos
Idioma , Semântica , Humanos , Reprodutibilidade dos Testes , Psicolinguística , Percepção Auditiva
11.
J Clin Med ; 11(21)2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36362551

RESUMO

Post-stroke, in addition to sensorimotor signs and symptoms, could lead to cognitive deficits. Theories of embodiment stress the role of sensorimotor system and multisensory integration in sustaining high-order cognitive domains. Despite conventional post-stroke cognitive rehabilitation being effective, innovative technologies could overcome some limitations of standard interventions and exploit bodily information during cognitive rehabilitation. This systematic review aims to investigate whether 'multisensory technologies' compared to usual care treatment can be a viable alternative for cognitive rehabilitation. By applying PRISMA guidelines, we extracted data and assessed the bias of 10 studies that met the required criteria. We found that multisensory technologies were at least comparable to standard treatment but particularly effective for attention, spatial cognition, global cognition, and memory. Multisensory technologies consisted principally of virtual reality alone or combined with a motion tracking system. Multisensory technologies without motion tracking were more effective than standard procedures, whereas those with motion tracking showed balanced results for the two treatments. Limitations of the included studies regarded the population (e.g., no study on acute stroke), assessment (e.g., lack of multimodal/multisensory pre-post evaluation), and methodology (e.g., sample size, blinding bias). Recent advancements in technological development and metaverse open new opportunities to design embodied rehabilitative programs.

12.
Brain Sci ; 11(8)2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34439686

RESUMO

Along with deficits in spatial cognition, a decline in body-related information is observed in aging and is thought to contribute to impairments in navigation, memory, and space perception. According to the embodied cognition theories, bodily and environmental information play a crucial role in defining cognitive representations. Thanks to the possibility to involve body-related information, manipulate environmental stimuli, and add multisensory cues, virtual reality is one of the best candidates for spatial memory rehabilitation in aging for its embodied potential. However, current virtual neurorehabilitation solutions for aging and neurodegenerative diseases are in their infancy. Here, we discuss three concepts that could be used to improve embodied representations of the space with virtual reality. The virtual bodily representation is the combination of idiothetic information involved during virtual navigation thanks to input/output devices; the spatial affordances are environmental or symbolic elements used by the individual to act in the virtual environment; finally, the virtual enactment effect is the enhancement on spatial memory provided by actively (cognitively and/or bodily) interacting with the virtual space and its elements. Theoretical and empirical findings will be presented to propose innovative rehabilitative solutions in aging for spatial memory and navigation.

14.
Sci Rep ; 11(1): 17278, 2021 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446772

RESUMO

According to theories of Embodied Cognition, memory for words is related to sensorimotor experiences collected during learning. At a neural level, words encoded with self-performed gestures are represented in distributed sensorimotor networks that resonate during word recognition. Here, we ask whether muscles involved in gesture execution also resonate during word recognition. Native German speakers encoded words by reading them (baseline condition) or by reading them in tandem with picture observation, gesture observation, or gesture observation and execution. Surface electromyogram (EMG) activity from both arms was recorded during the word recognition task and responses were detected using eye-tracking. The recognition of words encoded with self-performed gestures coincided with an increase in arm muscle EMG activity compared to the recognition of words learned under other conditions. This finding suggests that sensorimotor networks resonate into the periphery and provides new evidence for a strongly embodied view of recognition memory.


Assuntos
Retroalimentação Sensorial/fisiologia , Antebraço/fisiologia , Gestos , Aprendizagem/fisiologia , Músculo Esquelético/fisiologia , Reconhecimento Psicológico/fisiologia , Vocabulário , Adulto , Eletromiografia/métodos , Feminino , Humanos , Masculino , Memória/fisiologia , Estimulação Luminosa/métodos , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologia , Adulto Jovem
15.
J Alzheimers Dis ; 79(1): 95-116, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33216034

RESUMO

BACKGROUND: Spatial navigation is the ability to estimate one's position on the basis of environmental and self-motion cues. Spatial memory is the cognitive substrate underlying navigation and relies on two different reference frames: egocentric and allocentric. These spatial frames are prone to decline with aging and impairment is even more pronounced in Alzheimer's disease (AD) or in mild cognitive impairment (MCI). OBJECTIVE: To conduct a systematic review of experimental studies investigating which MCI population and tasks are used to evaluate spatial memory and how allocentric and egocentric deficits are impaired in MCI after navigation. METHODS: PRISMA and PICO guidelines were applied to carry out the systematic search. Down and Black checklist was used to assess methodological quality. RESULTS: Our results showed that amnestic MCI and AD pathology are the most investigated typologies; both egocentric and allocentric memory are impaired in MCI individuals, and MCI due to AD biomarkers has specific encoding and retrieval impairments; secondly, spatial navigation is principally investigated with the hidden goal task (virtual and real-world version), and among studies involving virtual reality, the privileged setting consists of non-immersive technology; thirdly, despite subtle differences, real-world and virtual versions showed good overlap for the assessment of MCI spatial memory. CONCLUSION: Considering that MCI is a subclinical entity with potential risk for conversion to dementia, investigating spatial memory deficits with navigation tasks might be crucial to make accurate diagnosis and rehabilitation.


Assuntos
Doença de Alzheimer/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Memória Espacial , Navegação Espacial , Doença de Alzheimer/psicologia , Disfunção Cognitiva/psicologia , Humanos
16.
Front Psychiatry ; 11: 563319, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33173511

RESUMO

BACKGROUND: Living in the time of the COVID-19 means experiencing not only a global health emergency but also extreme psychological stress with potential emotional side effects such as sadness, grief, irritability, and mood swings. Crucially, lockdown and confinement measures isolate people who become the first and the only ones in charge of their own mental health: people are left alone facing a novel and potentially lethal situation, and, at the same time, they need to develop adaptive strategies to face it, at home. In this view, easy-to-use, inexpensive, and scientifically validated self-help solutions aiming to reduce the psychological burden of coronavirus are extremely necessary. AIMS: This pragmatic trial aims to provide the evidence that a weekly self-help virtual reality (VR) protocol can help overcome the psychological burden of the Coronavirus by relieving anxiety, improving well-being, and reinforcing social connectedness. The protocol will be based on the "Secret Garden" 360 VR video online (www.covidfeelgood.com) which simulates a natural environment aiming to promote relaxation and self-reflection. Three hundred sixty-degree or spherical videos allow the user to control the viewing direction. In this way, the user can explore the content from any angle like a panorama and experience presence and immersion. The "Secret Garden" video is combined with daily exercises that are designed to be experienced with another person (not necessarily physically together), to facilitate a process of critical examination and eventual revision of core assumptions and beliefs related to personal identity, relationships, and goals. METHODS: This is a multicentric, pragmatic pilot randomized controlled trial involving individuals who experienced the COVID-19 pandemic and underwent a lockdown and quarantine procedures. The trial is approved by the Ethics Committee of the Istituto Auxologico Italiano. Each research group in all the countries joining the pragmatic trial, aims at enrolling at least 30 individuals in the experimental group experiencing the self-help protocol, and 30 in the control group, over a period of 3 months to verify the feasibility of the intervention. CONCLUSION: The goal of this protocol is for VR to become the "surgical mask" of mental health treatment. Although surgical masks do not provide the wearer with a reliable level of protection against the coronavirus compared with FFP2 or FFP3 masks, surgical masks are very effective in protecting others from the wearer's respiratory emissions. The goal of the VR protocol is the same: not necessarily to solve complex mental health problems but rather to improve well-being and preserve social connectedness through the beneficial social effects generated by positive emotions.

17.
Healthcare (Basel) ; 8(2)2020 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-32316370

RESUMO

Stress is an inescapable element of the modern age. Instances of untreated stress may lead to a reduction in the individual's health, well-being and socio-economic situation. Stress management application development for wearable smart devices is a growing market. The use of wearable smart devices and biofeedback for individualized real-life stress reduction interventions has received less attention. By using our unobtrusive automatic stress detection system for use with consumer-grade smart bands, we first detected stress levels. When a high stress level is detected, our system suggests the most appropriate relaxation method by analyzing the physical activity-based contextual information. In more restricted contexts, physical activity is lower and mobile relaxation methods might be more appropriate, whereas in free contexts traditional methods might be useful. We further compared traditional and mobile relaxation methods by using our stress level detection system during an eight day EU project training event involving 15 early stage researchers (mean age 28; gender 9 Male, 6 Female). Participants' daily stress levels were monitored and a range of traditional and mobile stress management techniques was applied. On day eight, participants were exposed to a 'stressful' event by being required to give an oral presentation. Insights about the success of both traditional and mobile relaxation methods by using the physiological signals and collected self-reports were provided.

18.
Front Neurosci ; 13: 198, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30914915

RESUMO

Spatial cognition is an umbrella term used to refer to the complex set of abilities necessary to encode, categorize, and use spatial information from the surrounding environment to move effectively and orient within it. Experimental studies indicate that the cerebellum belongs to the neural network involved in spatial cognition, although its exact role in this function remains unclear. Our aim was to investigate in a pilot study using a virtual reality navigation task in healthy subjects whether cerebellar transcranial direct current stimulation (tDCS), a non-invasive technique, influences spatial navigation. Forty healthy volunteers (24 women; age range = 20-42 years; years of education range 13-18) were recruited. The virtual reality spatial navigation task comprised two phases: encoding, in which participants actively navigated the environment and learned the spatial locations for one object, and retrieval, in which they retrieved the position of the object they had discovered and memorized in the previous encoding phase, starting from another starting point. Participants received tDCS stimulation (anodal or sham according to the experimental condition they were assigned to) for 20 min before beginning the retrieval phase. Our results showed that cerebellar tDCS left the accuracy of the three indexes used to measure effective navigational abilities unchanged. Hence, cerebellar tDCS had no influence on the retrieval phase for the spatial maps stored. Further studies, enrolling a larger sample and testing a different stimulation protocol, may give a greater insight into the role of the cerebellum in spatial navigation.

19.
Front Psychol ; 10: 33, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30761033

RESUMO

Word learning is basic to foreign language acquisition, however time consuming and not always successful. Empirical studies have shown that traditional (visual) word learning can be enhanced by gestures. The gesture benefit has been attributed to depth of encoding. Gestures can lead to depth of encoding because they trigger semantic processing and sensorimotor enrichment of the novel word. However, the neural underpinning of depth of encoding is still unclear. Here, we combined an fMRI and a behavioral study to investigate word encoding online. In the scanner, participants encoded 30 novel words of an artificial language created for experimental purposes and their translation into the subjects' native language. Participants encoded the words three times: visually, audiovisually, and by additionally observing semantically related gestures performed by an actress. Hemodynamic activity during word encoding revealed the recruitment of cortical areas involved in stimulus processing. In this study, depth of encoding can be spelt out in terms of sensorimotor brain networks that grow larger the more sensory modalities are linked to the novel word. Word retention outside the scanner documented a positive effect of gestures in a free recall test in the short term.

20.
Front Psychol ; 9: 2279, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30538650

RESUMO

Breast cancer is the most common cancer in women worldwide, with increases in diagnoses at all ages. Due to several age-related factors, older breast cancer patients show particular difficulties in adjusting to breast cancer and its related treatments. One consistent indicator of vulnerability to long-term complications is emotional distress occurring within 3 months of diagnosis. Thus, it is critical to develop early interventions specifically aimed at mitigating distress and promoting emotional wellbeing in older breast cancer patients. By taking advantage of the opportunities of online interventions, the present study aimed to test the efficacy of a 2 weeks e-health stress inoculation training (SIT) intervention on emotion regulation and cancer-related well-being, compared with a control group without such intervention. Twenty-nine women with a diagnosis of breast cancer, who had received radical surgery and who were suitable candidates for adjuvant chemotherapy with anthracyclines and taxanes (mean age = 62.76; SD = 6.19) voluntarily took part in the current study after giving written informed consent. To test intervention efficacy, self-report questionnaires were administered to all participants at baseline, at the end of the 2 weeks intervention, and 3 months after the end of the intervention. Results showed that after 2 weeks of ehealth intervention, patients did not achieve significant change, however, they significantly reduced emotional suppression and increased cancer-related emotional well-being 3 months after the end of the intervention. Furthermore, by monitoring at a distance the emotional experience during the online intervention, we found an increase in relaxation and a reduction of anxiety. Finally, patients in the experimental group reported a good level of acceptance of the ehealth intervention. To conclude, designing and developing eHealth interventions as part of the regular care path for breast cancer patients of all ages represents both a challenge and an opportunity; in particular, online interventions can be an important step in universal psychosocial care within a tiered model of care.

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