Attention deficits in Brazilian health care workers with chronic pain

Abstract

The impact of COVID-19 on chronic pain (CP) in non-infected vulnerable South American subjects is unknown. Healthcare workers (HCWs) are at increased risk for CP. During the pandemic, many HCWs with CP kept working. Knowing how cognition is affected by CP in these subjects is an important subject for work safety. The attention domain has a pivotal role in cognition. Previously, the Continuous Visual Attention Test (CVAT) was applied to detect specific attention deficits in fibromyalgia patients. The present investigation described CP prevalence in non-infected Brazilian HCWs during the pandemic and assessed HCWs’ attentional performance with the aid of the CVAT. This study was carried out at a reference University Hospital in Rio de Janeiro, Brazil. HCWs of both sexes, aged 20 or older, were interviewed from August to December 2020. A 90-second version of the CVAT was performed. The average reaction time to correct responses and the respective intraindividual reaction time variability for correct responses to target (VRT) was determined. Omission and commission errors were also calculated. Then, for each participant we calculated the Z-scores of the CVAT variables based on the distribution of CVAT performance of 211 healthy subjects (reference-comparison group). HCWs with Z-scores > 1.64 were classified as significantly impaired. From the 154 selected HCWs, 72 reported CP during the pandemic (prevalence = 47%). Post hoc ANCOVAs showed that the average correct VRT was significantly higher in the CP group than in the non-CP group (F = 4.99, df = 1/150, p = 0.027, η2 = 0.032). The percentage of participants with impaired VRT performance was 30% (n = 21) in the CP group and 16% (n = 13) in the non-CP group. The difference between these two propositions reached significance (χ2 = 3.96, df = 1, p = 0.047). As VRT is associated with the sustained-attention subdomain, our data suggest that this subdomain is disrupted in the CP group.

Comparing online and face-to-face administration of a neuropsychological computerized attention test: Assessment modality does not influence performance

“…ICC for VRT reached significance. VRT is considered the best predictor of attention deficits in Alzheimer’s disease ( Munro Cullum et al, 2014 ; Schmidt et al, 2020 ), ADHD ( Schmidt et al, 2019 ), Mild Cognitive Impairment ( Schmidt et al, 2020 ), Chronic Pain ( Schmidt et al, 2022 ), and post-COVID patients who presented early gastrointestinal symptoms ( Schmidt et al, 2023 ). Therefore, our result shows that we can reliably measure the VRT variable independent of the way the test is administered.…”

Attention Deficits in Healthcare Workers with Non-Clinical Burnout: An Exploratory Investigation

“…Then, we applied the following exclusion criteria: use of antipsychotic or antiepileptic medications that might interfere with performance on the CVAT, a history of head trauma with loss of consciousness, current use of alcohol or illicit substances, pre-existing neurological or psychiatric conditions, shift workers, and a past medical record of COVID-19. The exclusion of participants who had COVID-19 was necessary because the infection itself can cause attention impairment [39][40][41]. All workers were tested at the beginning of their work shifts to exclude fatigue.…”

“…The basic paradigm of the CVAT task is characterized by a serial presentation of target and non-target stimuli, and the subject's task is to respond to target stimuli and control inadequate responses [37][38][39][40][41]. Inhibition is the ability to control inadequate responses, measured by the number of CEs.…”

“…Focused attention reflects the ability to respond to correct targets, and sustained attention is frequently described as the ability to concentrate over time to detect correct events [31]. Attention subdomains can be reliably measured by Continuous Performance Tests, such as the Continuous Visual Attention test (CVAT) [37][38][39][40][41].…”