Nardelli M, Del Piccolo L, Danzi Op, Perlini C, Tedeschi F, Greco A, Scilingo Ep, Valenza G
Annu Int Conf IEEE Eng Med Biol Soc. 2017 Jul;2017:3473-3476. doi: 10.1109/EMBC.2017.8037604.
Emphatic doctor-patient communication has been associated with an improved psycho-physiological well-being involving cardiovascular and neuroendocrine responses. Nevertheless, a comprehensive assessment of heartbeat linear and nonlinear/complex dynamics throughout the communication of a life-threatening disease has not been performed yet. To this extent, we here study heart rate variability (HRV) series gathered from 17 subjects while watching a video where an oncologist discloses the diagnosis of a cancer metastasis to a patient. Further 17 subjects watched the same video including additional affective emphatic contents. For the assessment of the two groups, linear heartbeat dynamics was quantified through measures defined in the time and frequency domains, whereas nonlinear/complex dynamics referred to measures of entropy, and combined Lagged Poincare Plots (LPP) and symbolic analyses. Considering differences between the beginning and the end of the video, results from non-parametric statistical tests demonstrated that the group watching emphatic contents showed HRV changes in the LF/HF ratio exclusively. Conversely, the group watching the purely informative video showed changes in vagal activity (i.e., HF power), LF/HF ratio, as well as LPP measures. Additionally, a Support Vector Machine algorithm including HRV nonlinear/complex information was able to automatically discern between groups with an accuracy of 76.47%. We therefore propose the use of heartbeat nonlinear/complex dynamics to objectively assess the empathy level of healthy women.
强调医患沟通与改善心理生理健康有关，涉及心血管和神经内分泌反应。然而，尚未对危及生命疾病沟通全过程中的心跳线性和非线性/复杂动力学进行全面评估。在此，我们研究了17名受试者在观看肿瘤学家向患者披露癌症转移诊断的视频时收集的心率变异性（HRV）系列。另外17名受试者观看了包含额外情感强调内容的同一视频。为了评估这两组，通过在时域和频域中定义的测量方法对心跳线性动力学进行量化，而非线性/复杂动力学则涉及熵测量以及组合滞后庞加莱图（LPP）和符号分析。考虑到视频开始和结束之间的差异，非参数统计测试结果表明，观看强调内容的组仅在低频/高频比值上显示出HRV变化。相反，观看纯信息性视频的组在迷走神经活动（即高频功率）、低频/高频比值以及LPP测量方面均有变化。此外，包含HRV非线性/复杂信息的支持向量机算法能够以76.47%的准确率自动区分两组。因此，我们建议使用心跳非线性/复杂动力学来客观评估健康女性的共情水平。
