RESUMO
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients' risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties. AIM: To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff. METHODS: We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented. RESULTS: Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories. CONCLUSION: As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.
RESUMO
The existence of neural correlates of spatial attention is not limited to the reactive stage of stimulus processing: neural activities subtending spatial attention are deployed well ahead of stimulus onset. ERP evidence supporting this proactive (top-down) attentional control is based on trial-by-trial S1-S2 paradigms, where the onset of a directional cue (S1) indicates on which side attention must be directed to respond to an upcoming target stimulus (S2). Crucially, S1 onset trigger both attention and motor preparation, therefore, these paradigms are not ideal to demonstrate the effect of attention at preparatory stage of processing. To isolate top-down anticipatory attention, the present study used a sustained attention paradigm based on a steady cue that indicates the attended side constantly throughout an entire block of trials, without any onset of an attentional cue. The main result consists in the description of the attention effect on the visual negativity (vN) component, a growing neural activity starting before stimulus presentation in extrastriate visual areas. The vN was consistently lateralized in the hemisphere contralateral to the attended side, regardless of the hand to be used. At the opposite, the lateralized motor activity emerged long after, confirming that the hand-selection process followed the spatial attention orientation process. The present study confirms the anticipatory nature of the vN component and corroborate its role in terms of preparatory visuospatial attention.
