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The article offers information on the complexities of Intimate Partner Violence (IPV) and the importance of tailored care for victims. Topics include the mechanisms by which women prioritize their children's health even in IPV situations, the role of healthcare providers within national anti-violence networks, and the biases healthcare providers may have when approaching IPV victims.

Aim: To report an analysis of the concept of fundamental care in the literature. Design: An evolutionary concept analysis. Data sources PubMed and CINAHL Complete databases were consulted using the key terms: fundamental care, fundamentals of care, essential care, basic nursing care and basic care revised. Articles published from 2008 to 2022, in English and Italian, in scholarly/peer‐reviewed nursing journals were included. Methods: Rodgers's Evolutionary Method of concept analysis was used. Our thematic analysis yielded common themes related to the concept, antecedents, attributes and consequences of fundamental care. Results: A total of 50 articles were analysed. Thirty‐eight attributes were identified, such as integration of care, patient and family centred care and trusting relationship; eight antecedents including nursing care, nursing practice and care context; and 17 consequences including the safety, quality and consistency of care. Conclusion: This review of literature reveals that there is no consistent definition of the concept of 'fundamental care'. Findings from this exploration of the literature emphasized the importance of communication, the contextual environment, leadership influence and nurse–patient relationship in providing effective and high‐quality fundamental care. Our definition of this concept may help nurse leaders in practice, research, education, management and policy to promote and enhance the application of fundamental care. Impact: What problem did the study address? While numerous studies examine fundamental nursing care, various terms are used with no consensus on definitions emerging. Given the relevance of this topic, reaching a clear and agreed definition of fundamental care is essential. What were the main findings? Fundamental care encompasses the importance of communication, the contextual environment, leadership influence and nurse‐patient relationship in providing effective and high‐quality care. Where and on whom will the research have an impact? This definition of fundamental care will assist nurse leaders and researchers to promote and enhance the examination and application of fundamental care in clinical practice to ensure better care outcomes across all healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Emergency departments are the services with the highest risk of violence for nurses. Reports of violence in health care have increased exponentially in the last decade. Front line hospital services are more at risk, and worldwide there are attempts to quantify, manage and prevent episodes of violence, but no consistent solutions have yet been identified. Aims: To stimulate reflection on causal factors of violence against nurses in emergency departments and discuss potential solutions and strategies for aspects that largely remain unresolved. Design: A position paper underpinned by experiences and evidence reported in the literature. Methods: A search of Scopus and CINAHL using the term 'violence' provided information concerning the prevalence of the term 'violence' in contemporary literature and enabled to capture a general overview of contributing factors of violence and current approaches to its management and prevention. Conclusions: However, while risk factors have been identified, there is a tendency to over accentuate the extent of their contribution. The main risk factors present conditions related to or accompanied by mental illness and the impact of overcrowding and long waiting times. Relevance to Clinical Practice: More is needed in terms of implementation of more far‐reaching, holistic, practical and effective management solutions to promote nurses' safety and adequately support vulnerable patients. [ABSTRACT FROM AUTHOR]

The article presents the discussion on impact of declining response rates by nurses in nursing research projects. Topics include collecting data from practitioners showuing low response rates to survey type research projects by nurses; and describe staffing levels, work environment, aspects of well-being, and correlating the findings with specific patient outcomes.

An editorial is presented on the implications of nursing work organization in Italian hospitals on job satisfaction, nurse well-being, and patient safety. Topics include the nurse-to-patient ratio, the impact of functional nursing care delivery models, missed nursing care and efforts to improve working conditions and patients' outcomes through person-centered care models and nursing-sensitive outcomes.

Aims and objectives: To understand the experiences and support needs of informal caregivers of patients with chronic obstructive pulmonary diseases chronic obstructive pulmonary disease who return home following an acute exacerbation. Background: The presence of an informal caregiver is important to provide practical and emotional support after an episode of acute exacerbation of chronic obstructive pulmonary disease. However, caregiving in such circumstances can be challenging and stressful. Design: Phenomenology. Methods: This is a phenomenological study based on semi‐structured interviews with sixteen primary caregivers of chronic obstructive pulmonary disease patients. Interview data were analysed using Colaizzi's descriptive analysis framework, to identify significant themes and sub‐themes. Data were collected between April‐December 2017 in a Teaching Hospital in Italy. The study was designed and reported following the COREQ guidelines and checklist. Results: Analysis elicited five themes embracing various aspects of the caregivers' lived experiences: (a) a home disrupted, (b) living with constant vigilance and anxiety, (c) feeling the need to escape (d) self‐justifications for caregiving role/duty, and (e) feeling abandoned by professionals. Conclusions: Our results show that carers experience a range of difficulties when caring for their relative at home with chronic obstructive pulmonary disease. Some of these are linked to the physical disruption of their home but many are linked to feelings of inability to cope and the psycho‐social impact of the caring role. The study also shows how participants felt unsupported by professionals. Focused support for carers is required to enable them to meet these challenges. Relevance to clinical practice: Healthcare professionals should be trained to provide technical and psychological support to caregivers especially during the phases of disease that may involve episodes of exacerbation. Home care and continuity of care can work if there is excellent communication and collaboration between healthcare professionals and caregivers. Developing appropriate support for family caregivers is essential to address the problems they can face. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To conduct a systematic review and meta‐synthesis of findings from qualitative research about sexuality and intimate relationship among patients with dermatological diseases. Background: Over the last few decades, there has been an increase in clinical research investigating aspects related to sex and sexuality in patients living with dermatological diseases. In fact, studies recognise a negative impact on various aspects of intimacy, such as sexual function, self‐esteem and romantic relationships. The body of qualitative literature about sexuality in the context of dermatological diseases is emerging but consists mainly of small studies that would benefit from aggregation, synthesis and interpretation to highlight and summarise the overarching dimensions to this clinical issue. Design: A systematic review and meta‐synthesis of qualitative studies. Methods: BioMed Central, Cochrane Library, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, ERIC, Scopus, and Web of Science were searched between June–November 2017 with no publication date limits. Screening and selection of studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines (PRISMA). After retrieval, the qualitative data were subject to meta‐synthesis to identify overarching themes. Results: Ten qualitative studies were found. We identified four themes: (a) Embarrassment and shame; (b) Impaired sense of attractiveness and sexual avoidance; (c) Relationship issues; and (d) Lack of professional support. The patients in these studies adopted negative coping styles, such as avoidance and hiding their bodies. Conclusion: When assessing and evaluating patient care in dermatology, it is important that sexuality and the impact the disease could have on relationships is included. Relevance to clinical practice: An important part of nursing care is ensuring that patients are helped to develop positive coping strategies rather than negative ones. Patients with dermatological conditions also need advice and treatment to address any physically related sexual problems. Nurses need to be the initiators of these sensitive conversations to put patients at ease and work together to implement positive measures to reduce the sexuality‐related issues patients face. [ABSTRACT FROM AUTHOR]

Aim: To explore Italian paediatric nurses' reported burnout and its relationship to their perceptions of safety and adverse events. Design: A cross-sectional study using the RN4CAST@IT-Ped database with a webbased survey design. Methods: The RN4CAST@IT-Ped questionnaire was used to collect data in 2017. This comprised three main components: three dimensions (22 items) of the Maslach Burnout Inventory including emotional exhaustion, depersonalization and personal accomplishment. Participants also scored an overall grade of patient safety and estimated the occurrence of adverse clinical events. Results: Nurses (N = 2,243) r eported h igh l evels of b urnout. M ost r ated c linical safety as high. The risk of adverse events ranged from 1.3-12.4%. The degree of burnout appeared to influence the perception of safety and adverse events. Conclusion: The association between nurses' burnout and perceptions of higher rates of adverse events and reduced safety in clinical practice is an important finding. However, it is unclear whether this was influenced by a negative state of mind, and whether reduced safety and increased adverse events negatively influenced nurses' well-being, thus leading to burnout. Regardless, the association between nurses' burnout and these quality concepts needs further exploration to examine the effect, if any, on burnout and safety, and identify supportive mechanisms for nurses. Impact: The association between reported burnout and perception of safety and risk of adverse events in Italian paediatric nurses has been reported for the first time. Nurses reporting burnout are at greater risk of intensely negative perceptions of clinical safety and adverse events. This is an important finding as perceptions can influence practice and behaviours. Quality measures in children's clinical environments need to go beyond obvious indicators to examine nurses' well-being as this also influences quality and safety. [ABSTRACT FROM AUTHOR]

Aims and objectives: To synthesise and review literature related to instruments that measure psychosocial aspects of fundamental care in acute hospital care settings. Background: Psychosocial aspects of care often receive less priority in terms of care provision in acute care environments. At the same time, if these elements are overlooked, there may be consequences. Despite the availability of many instruments designed to measure specific aspects of care, these concepts are often not studied within the broader context of fundamentals of care, but rather coexist as isolated explorations of specific subelements. Design: A scoping review was conducted, based on Arksey & O'Malley's (2005) methodological framework and following the PRISMA checklist. Methods: Using the five recommended steps—identifying the research question; identifying relevant studies; study selection; charting the data; and summarising and reporting the results—three databases were searched: MEDLINE/PubMed, CINAHL and EMBASE, in February 2019. Results: Following independent screening by two of the authors, 48 papers were included. From these 48 papers, 33 instruments were identified. Only five of these tools thoroughly assessed psychosocial aspects elements of care (dignity, respect, privacy and patients' choice) through dedicated items. Conclusions: This review provides nurses with a synthesis of 33 instruments that assess the psychosocial aspects of care. This provides an important resource to guide measurement of dignity, respect, privacy and patients' choice. The findings also provide guidance to future research in this field. Relevance to clinical practice: This paper reviews and synthesises these instruments to provide a resource to nurses to inform their decisions and practice around measurement and evaluation of these key aspects of care. This provides a useful guide to measure and monitor the improvement of fundamental care delivery in practice and points to strengths and weaknesses of the instruments concerned. [ABSTRACT FROM AUTHOR]

Aims and objectives: To review and synthesise research studies on surgical and medical inpatients' perceptions on unmet nursing care needs. Background: Missed nursing care is a growing phenomenon that has been shown to adversely affect care outcomes—mainly in adult medical and surgical care settings. However, to date the aggregated and synthesised evidence of missed care comes from research that measures perceptions on missed care in surgical and medical settings from nurses, but not from the patients. Design: Scoping review. Methods: In September 2018, three databases were searched: MEDLINE/PubMed, CINAHL and SCOPUS and papers were selected using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Inclusion criteria were as follows: primary studies; published in peer‐reviewed journals; in English or Italian; and regarding routine care provided to adult inpatients. Quality appraisal and a thematic analysis were conducted. Results: Of the 1541 abstracts initially identified, 44 papers were included. Five themes emerged: "communication," "self‐management, autonomy and education," "personal sphere," "essential physical care" and "emotional and psychological care." The majority of the unmet needs were related to the "personal sphere" and "emotional and psychological care." These unmet needs were not identified in previous literature on nurses' perspectives of missed care. Also, physical care deficits like oral hygiene were identified. Conclusion: It is important to take into account patients' perspectives. The themes focusing on patients' personal sphere, and emotional and psychological care, underline how patients need nurses to pay more attention to their cultural background, consider the person as a whole and for nursing care to be holistic and respectful of patients' dignity. Relevance to Clinical Practice: This study intends to raise awareness amongst nurses and policymakers about the importance of addressing missed nursing care and unmet patients' needs in adult medical or surgical inpatient settings to ensure high‐quality care and patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Developing nursing research skills, awareness and research utilisation are important for improving healthcare outcomes and are key to ensuring the full understanding and knowledge base necessary for optimal delivery of care. Nevertheless, little is known about research awareness in children's nurses. Aims and objectives: To address this issue, an integrative literature review was conducted for studies published between January 2007 and January 2017 to obtain up‐to‐date evidence about the extent of research awareness and utilisation among children's nurses. Methods: Using PubMed, Cochrane Library, ILISI and CINAHL databases, 21 studies related to children's nurses' research awareness were included in the final review, which was later developed and structured in keeping with PRISMA checklist and guidelines. Conclusions: The studies isolated show that nurses' knowledge about and utilisation of research vary and that there are many existent barriers to and facilitators of evidence‐based practice in the paediatric setting. Some studies report that introducing a cultural and/or change in clinical practice change to improve research utilisation can have positive impacts on healthcare outcomes and the quality of nursing care of children. It is recommended that structured approaches to improving research utilisation be considered and additional research is needed to explore the benefits of these approaches. Relevance to clinical practice: Despite more than three decades of the evidence‐based practice movement within nursing, barriers still exist among children's nurses in the use of research in practice. If the use of research to improve the delivery of children's nursing care is to become a reality, then nurses' research awareness needs to improve to underpin care delivery with optimal evidence in a cohesive informed manner. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article offers information on lack of suitable personal protective equipment (PPE) in Italy amid COVID-19 pandemic. Topics discussed include online courses for health professionals to help to keeping safe against Covid-19 by Italian National Institute of Health; fear of introducing the virus in nurses; and need to ensure provide appropriate logistic and financial support to help medical personnel with course of action.

Aims and objectives: To explore the experience of patients affected by chronic obstructive pulmonary disease following hospitalisation due to an acute exacerbation event. Background: Chronic obstructive pulmonary disease is a progressively debilitating disease, often with very burdensome symptoms such as acute and chronic breathlessness and fatigue. Acute exacerbation often creates a life‐threatening event. Exacerbation can also have substantial psychological effects including anxiety and depression although this aspect is less well researched—especially amongst people with chronic obstructive pulmonary disease recovering from an acute event and facing a return home. Design: A descriptive phenomenological study. Methods: In‐depth interviews were conducted with 12 chronic obstructive pulmonary disease patients recently recovering from an acute exacerbation of their chronic obstructive pulmonary disease. Data were analysed using Colaizzi's phenomenological framework. Results: Four themes were identified from the data: a sense of loss and frustration, hopelessness, uncertainty about the future and fear of becoming a burden. Participants expressed quite negative views including a loss of hope, uncertainty about their future care and the burden they may become on their families. They appeared stressed and anxious as a result of the acute event they had experienced. Conclusions: This study shows that an acute episode of illness can generate a sense of hopelessness and uncertainty about their future care in people with chronic obstructive pulmonary disease. This occurs as they recover physically and think about the future, often in quite negative terms. Relevance to clinical practice: For healthcare professionals, it is important to take into account the potential feelings of loss, hopelessness and uncertainty that people can experience following an acute exacerbation of their chronic obstructive pulmonary disease and ensure that psychological care is available as physical recovery takes place. Such care to include good discharge planning, giving patients time to express concerns and referral to counselling services if appropriate. [ABSTRACT FROM AUTHOR]

Aims and objectives To assess the effects of a texture-modified food program for dysphagia on the nutritional, biochemical and functional profile in a cohort of institutionalised older people in Italy. Background Dysphagic institutionalised older people, often also affected by dementia, are frequently exposed to malnutrition. Malnutrition in older people has negative effects on mortality, days of hospitalisation, infection, wound healing and risk of pressure injuries. Therefore, it is very important to prevent malnutrition in this frail population. Design A pre-post study without a control group. Methods The study included 479 dysphagic institutionalised older people from 20 nursing homes. Anthropometrical, biochemical, nutritional and functional parameters were collected retrospectively, 6 months before the study intervention, at time zero and, prospectively for 6 months after implementing the NUTRICARE food programme, for a total of nine evaluations. The NUTRICARE programme includes meals without nutritional supplementation, and personalised levels of density, viscosity, texture and particle size. Results The total mean body mass index of our sample passed from 17.88-19.00; body weight averagely improved by 7.19%, as well as their nutritional and biochemical profiles. There was a progressive improvement of total protein and serum albumin values. Nutritional parameters (serum transferrin and lymphocytes) displayed similar changes. Plasma lymphocytes reached normal levels in 98.23% of the sample. Plasma creatinine levels remained steady throughout the study and within the normal range. No side effects were reported. Conclusion The NUTRICARE food programme with a adequate proteins, calories, balanced nutritional and bromatological properties, and appropriate texture and palatability significantly improved the nutritional, biochemical and functional profile in a cohort of institutionalised dysphagic older people. Relevance to clinical practice The introduction of a balanced nutritional programme, using high-quality natural ingredients, appropriate texture and palatability can significantly improve health and quality of life in dysphagic older people. [ABSTRACT FROM AUTHOR]

Aims and objectives To review the use of mixed-methods research in nursing with a particular focus on the extent to which current practice informs nurse researchers. It also aimed to highlight gaps in current knowledge, understanding and reporting of this type of research. Background Mixed-methods research is becoming increasingly popular among nurses and healthcare professionals. Emergent findings from this type of research are very useful for nurses in practice. The combination of both quantitative and qualitative methods provides a scientific base for practice but also richness from the qualitative enquiry. However, at the same time mixed-methods research is underdeveloped. Methods This study identified mixed-methods research papers and critically evaluated their usefulness for research practice. To support the analysis, we performed a two-stage search using CINAHL to find papers with titles that included the key term 'mixed method'. Conclusion An analysis of studies that used mixed-methods research revealed some inconsistencies in application and reporting. Attempts to use two distinct research methods in these studies often meant that one or both aspects had limitations. Overall methods were applied in a less rigorous way. This has implications for providing somewhat limited direction for novice researchers. There is also potential for application of evidence in healthcare practice that limited validity. Relevance to clinical practice This study highlights current gaps in knowledge, understanding and reporting of mixed-methods research. While these methods are useful to gain insight into clinical problems nurses lack guidance with this type of research. This study revealed that the guidance provided by current mixed-methods research is inconsistent and incomplete and this compounds the lack of available direction. There is an urgent need to develop robust guidelines for using mixed-methods research so that findings may be critically implemented in practice. [ABSTRACT FROM AUTHOR]

Aim To identify items for a new instrument that measures emotional behaviour abilities of meaningful learning, according to Fink's Taxonomy. Background Meaningful learning is an active process that promotes a wider and deeper understanding of concepts. It is the result of an interaction between new and previous knowledge and produces a long-term change of knowledge and skills. To measure meaningful learning capability, it is very important in the education of health professionals to identify problems or special learning needs. For this reason, it is necessary to create valid instruments. Design A Delphi Study technique was implemented in four phases by means of e-mail. Methods The study was conducted from April-September 2015. An expert panel consisting of ten researchers with experience in Fink's Taxonomy was established to identify the items of the instrument. Data were analysed for conceptual description and item characteristics and attributes were rated. Expert consensus was sought in each of these phases. An 87·5% consensus cut-off was established. Results After four rounds, consensus was obtained for validation of the content of the instrument 'Assessment of Meaningful learning Behavioural and Emotional Abilities'. This instrument consists of 56 items evaluated on a 6-point Likert-type scale. Foundational Knowledge, Application, Integration, Human Dimension, Caring and Learning How to Learn were the six major categories explored. Conclusions This content validated tool can help educators (teachers, trainers and tutors) to identify and improve the strategies to support students' learning capability, which could increase their awareness of and/or responsibility in the learning process. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe the knowledge, attitudes and beliefs of nurses and midwives who have attended to women who suffered violence. This study further analyses the possible changes of attitude that have occurred over the past five years. Background Gender violence or violence against women is the largest problem with regard to public health and violated human rights all over the world. In Italy, it is estimated that 31·5% of women suffer physical or sexual violence during their life. Healthcare operators play a crucial role in recognising the signs of the violence suffered when taking care of victims. Design A cross-sectional study was conducted. Methods A questionnaire was administered; this was used in a previous survey of a convenience sample of 51 nurses and midwives who work in an emergency room or in an obstetrics emergency room and gynaecological ward. Results Of the respondents, 51 (80·4%) have taken care of women who suffered violence, and 25 (49%) believe they can detect violence. The relational/communicative approach presents the most difficulty, and all the operators believe they need more knowledge. The number of operators who suggest women be observed in an emergency room and file a complaint or who primarily consider listening to women has decreased. A tendency to 'blame' women, although decreasing, persists; it is higher among male nurses and, in general, among male operators. Conclusion Knowledge of this issue has not been completely recognised among operators despite training and the emergence of the phenomenon in the mass media. Difficulties in receiving and in relational procedures continue to exist, in addition to 'blaming' the woman. Relevance to clinical practice Awareness paths and cultural changes regarding the phenomenon of violence need to be developed, as does a specific training programme on the approach to and assessment of the abused woman. [ABSTRACT FROM AUTHOR]

The article discusses the necessity of strictly implementing food and mealtimes rules in hospitals and its contribution to public health service. Topics addressed include the hospital patient nutrition and malnutrition in Great Britain, the negative impact of malnutrition in health and quality of life, and the nutritional screening of the Republic of Ireland (ROI). The role of nurses and health care staff in raising the nutrition level of hospitalized patient is mentioned.

Aims To identify patient safety competencies, and determine the clinical learning environments that facilitate the development of patient safety competencies in nursing students. Background Patient safety in nursing education is of key importance for health professional environments, settings and care systems. To be effective, safe nursing practice requires a good integration between increasing knowledge and the different clinical practice settings. Nurse educators have the responsibility to develop effective learning processes and ensure patient safety. Design Rapid Evidence Assessment. Data Sources MEDLINE, CINAHL, SCOPUS and ERIC were searched, yielding 500 citations published between 1 January 2004-30 September 2014. Review methods Following the Rapid Evidence Assessment process, 17 studies were included in this review. Hawker's (2002) quality assessment tool was used to assess the quality of the selected studies. Results Undergraduate nursing students need to develop competencies to ensure patient safety. The quality of the pedagogical atmosphere in the clinical setting has an important impact on the students' overall level of competence. Active student engagement in clinical processes stimulates their critical reasoning, improves interpersonal communication and facilitates adequate supervision and feedback. Conclusion Few studies describe the nursing students' patient safety competencies and exactly what they need to learn. In addition, studies describe only briefly which clinical learning environments facilitate the development of patient safety competencies in nursing students. Further research is needed to identify additional pedagogical strategies and the specific characteristics of the clinical learning environments that encourage the development of nursing students' patient safety competencies. [ABSTRACT FROM AUTHOR]

The article discusses concerns regarding missed care, which is defined as unfinished care or implicitly rationalized care, in children's nursing. It explains that missed care is an error of omission in the care process that has three major influencing factors including labour resources, material resources, and communication, which influence the nurses' internal processes such as team norms, priority decision making, internal values, and beliefs determining whether or not care is missed.

The authors discuss a work being performed in Italy on nurse forecasting showing that nurses will make judicious choices about the work to leave undone, which is referred at as missed care or omitted care. Missed care is said to be a consequence of austerity measures due to world recession. Community nursing has been observed as a particular omission in the work on missed care to date. There has been little focus on missed care in older populations.

Aim To test if the Barrows Cards method improves adherence to immunosuppressive therapy self-management following hematopoietic stem-cell transplantation in adolescents affected by blood cancer and reduce costs. Background Chronically ill adolescents need to be helped to improve self-management, make sure they can confidently and safely manage therapy at home and reduce readmissions and costs. We identified the Barrows Cards method, originally used to test decision-making skills and critical thinking in medical students. In this pilot study, we tested the efficacy of the Barrows Cards Method in improving adhesion to immunosuppressive therapy in a group of adolescents following hematopoietic stem-cell transplantation and analysed its cost-effectiveness. Design A mixed-method study. Methods The Barrows Cards method is an educational intervention based on the theory of problem-based learning that uses at least 15 cards specially designed to teach participants how to manage a specific problem. We piloted the Barrows cards method in terms of adherence to immunosuppressive therapy and self-management in a group of 17 adolescents affected by blood cancer before being discharged. Participants were enrolled between 2013-2015. Activity Based Costing was used to analyse the cost-effectiveness. Results The Barrows Cards method significantly improved adherence to immunosuppressive therapy in blood cancer adolescents and reduced readmissions. We also showed how this method could significantly reduce healthcare costs. Conclusions Further research is required, but the Barrows Cards method could be effectively used by nurses to improve self-management in chronic patients and reduce health costs. [ABSTRACT FROM AUTHOR]

Aims To describe the utility of artificial neural networks in predicting communication risks. Background In health care, effective communication reduces the risk of error. Therefore, it is important to identify the predictive factors of effective communication. Non-technical skills are needed to achieve effective communication. This study explores how artificial neural networks can be applied to predict the risk of communication failures in emergency departments. Design A multicentre observational study. Methods Data were collected between March-May 2011 by observing the communication interactions of 840 nurses with their patients during their routine activities in emergency departments. The tools used for our observation were a questionnaire to collect personal and descriptive data, level of training and experience and Guilbert's observation grid, applying the Situation-Background-Assessment-Recommendation technique to communication in emergency departments. Results A total of 840 observations were made on the nurses working in the emergency departments. Based on Guilbert's observation grid, the output variables is likely to influence the risk of communication failure were 'terminology'; 'listening'; 'attention' and 'clarity', whereas nurses' personal characteristics were used as input variables in the artificial neural network model. A model based on the multilayer perceptron topology was developed and trained. The receiver operator characteristic analysis confirmed that the artificial neural network model correctly predicted the performance of more than 80% of the communication failures. Conclusion The application of the artificial neural network model could offer a valid tool to forecast and prevent harmful communication errors in the emergency department. [ABSTRACT FROM AUTHOR]

The article reports on exposing hospitalized patients to death risks associated with understaffing. England-based Care Quality Commission has included staffing levels as one of the auditing quality standards when inspecting hospitals and health centres. The Royal College of Nursing (RCN) defined which nurse staffing levels should be adopted by policy makers to ensure the provision of safe care.

Aim To establish the psychometric properties of instruments to measure learning outcomes in healthcare students. Background Meaningful learning is an active process that promotes a wider and deeper understanding of concepts. It is the result of an interaction between new and previous knowledge. Meaningful learning produces a long-term change in knowledge and skills, which is underpinned by willingness to learn and experience and it is exclusively built by the learner. Design Systematic psychometric review protocol developed from Cochrane Effective Practice and Organization of Care guidance. Method Searches of MEDLINE, CINAHL, SCOPUS, ERIC, Psyc INFO, Cochrane Library, Psychology & Behavioral Sciences Collection Database between 1990-2013. Selected studies will be evaluated with the Consensus-based Standards for the selection of health status Measurement INstruments ( COSMIN) checklist. Funding for the review was confirmed on January 2011 by the Centre of Excellence for Nursing Scholarship in Rome. Results The systematic review will produce a synthesis of the data related to the instruments that measure learning outcomes. These data will help us decide which tools to use and identify the state of knowledge in this field. Conclusions Measuring learning outcomes is very important for the large amount of human and financial resources employed in educating and training health professionals and this requires reliable and valid instruments. [ABSTRACT FROM AUTHOR]

The article presents the study which examines the impact of adequate nurse-patient ratios and work environment on patient safety and the quality of nursing care in Italy. It highlights the finding of the study which shows a certain percentage of patient care activities that are left undone and the tendency of nurses in the country to leave undone relational, communication, educational and planning activities.

Aim To describe a protocol for a quantitative systematic review, to identify critique and summarize factors that influence self-management education. Background Self-management education enables patients to manage their condition successfully and it is associated with better self-care, good control over lifestyle and leading the best possible quality of life, notwithstanding the presence of a chronic disease. Type II Diabetes is a chronic disease that requires lifestyle adjustments and disease management to keep glycaemia and long-term complications under control. Education has to be customized and based on an assessment that includes factors influencing self-management, such as personal characteristics that can optimize the educational intervention. Design The protocol for the systematic review was conducted according to the guidelines of the Centre for Reviews and Dissemination, York ( UK). Method The review question was defined in terms of population, interventions, comparators, outcomes and study designs. The protocol included decisions about the review question, inclusion criteria, search strategy, study selection, data extraction, quality assessment, data synthesis and plans for dissemination. Funding for the review was confirmed on January 2011 by the Centre of Excellence for Nursing Scholarship in Rome. Discussion An initial summary will be made by tabulating the data; the review will be reported in a narrative style and be developed according to the PRISMA guidelines. The protocol for the systematic review will allow us to identify, among the factors influencing self-management in people with Type II diabetes, the personal characteristics most relevant to the factors of motivation and empowerment. In addition, the systematic review will also identify an appropriate self-management model. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe what puerperal women know about postpartum contraception and to identify their related needs and expectations. Background Puerperal women face the problem of beginning or resuming contraception, the choice of the right method of contraception and the right time to start it. This choice becomes particularly important in case they breastfeed since the contraceptive method should not interfere with breastfeeding. Different factors, such as the level of knowledge women have about various contraceptive methods, their individual preferences or their desire to have a baby, can strongly influence this choice. Design A cross-sectional study had been carried out within the period of six months, from November 2011-February 2012. Methods Three hundred puerperal women were interviewed before their discharge from a Maternity Home. The women were asked for their personal characteristics, their maternity history, the information they had received, their knowledge and expectations about postpartum contraception and their intention to use contraception. Results During pregnancy and postpartum, 45·5% of the women reported that they had received adequate information about contraception. Of these ones, 64·3% reported their intention to use contraception either to avoid pregnancy or to space out future births, even if they did not always have appropriate knowledge about fertility and the use of contraceptive methods during postpartum. During this study, we also discovered that women's intention to use contraception was proportional to their level of education. Conclusion Women need more and appropriate information about postpartum contraception, to make a conscious choice in relation to their needs and without putting their health at risk. Relevance to clinical practice To promote awareness of the choices related to postpartum contraception, it is important to understand the personal characteristics that influence or hinder this choice. Midwives can play a very important role in informing women and in developing educational interventions to support a safe contraceptive choice. [ABSTRACT FROM AUTHOR]

To understand what level of awareness health professionals working in a hospital of Northern Italy had of the patient safety culture by using the Italian version of the Hospital Survey on Patient Safety Culture questionnaire and also validate its use in this setting. The Hospital Survey on Patient Safety Culture questionnaire was developed by the Agency for Health Research and Quality in 2008 and validated by several studies. Therefore, we decided to test the Italian version of this tool to see if it could be used effectively to measure and appraise patient safety culture also in Italy. Survey. To check the validity of the questionnaire, we applied the continued comparison and the global data treatment methods. Of the 1008 questionnaires we administered, 724 (71%) were returned. The majority of the questions were answered (mean 98, SD 3·4%). From a Chi-square test on the consistency of the answers, we found that six of the 12 perspectives we explored had a high level of significance, whereas in the other six, the differences in the answers were just casual. The Italian version of the Hospital Survey on Patient Safety Culture questionnaire allowed us to assess health professionals' awareness of patient safety culture and thus validate the effectiveness of this tool. The findings of our survey could be useful to design an objective tool that would allow the five health professional groups involved in the study (directors/coordinators, physicians, nurses/midwives, physiotherapists and technicians) gain a better knowledge of the patient safety culture and thus improve the quality of clinical practice. [ABSTRACT FROM AUTHOR]

The article offers the author's insights on the noisy behavior of domestic staff of hospital wards. Topics discussed include the noise reduction initiatives in several hospitals, its impact on patients and the patient's family, and the need for raising awareness among nursing staff on the effect of noise on hospital environment.

The author reflects on the importance of RN4CAST project in health care industry in Italy. He discusses the foundation of the project which started in January 2009 under the 7th European Framework Program; the first phase of the study which was conducted for nurse, patient, and hospital organization surveys; and second phase was conducted appropriate healthcare service and quality of work environment.

The article presents a study which aims to investigate the lifestyle and eating habits of obese children. Analysis of the data reveals that just 38% of children regularly eat breakfast, 63% of children eat both main and first course for both lunch and dinner, and just one of three children eats vegetables or fruits at meals. It shows that 62% of children spend two and four hours average watching television (TV) during leisure time, while 16% between five and eight hours.

Aim Design Data Sources Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To identify, synthesize, and interpret the scientific literature on the experience, perspectives, and feelings of transgender people during hospitalization.A qualitative metasynthesis.PubMed, CINAHL and PSYCHINFO were consulted in March 2024.A literature review was conducted following Sandelowski and Barroso's four‐step metasynthesis methodology. The article selection process was conducted using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines. Studies were selected based on the objectives of the review, pre‐established criteria and quality appraisal. A thematic analysis was conducted after extracting relevant quotations and a metasynthesis table was created to compare quotations and analyse overarching themes.Twenty‐two studies were included after screening titles and abstracts, full texts, and references. Three themes were identified: ‘Perception of self‐identity’; ‘Misgendering’ and ‘Lack of staff training and awareness’.Transgender people's healthcare experiences during hospitalization were mainly negative, delayed or uncomfortable. Misgendering and lack of awareness of transgender issues among healthcare workers generated anxiety and frustration. Key aspects of care for transgender people need to be included in all training programs for health professionals.There is a need to increase education and awareness among healthcare professionals towards transgender people's needs during hospitalization ensure high quality care. This study addressed the negative experience, perspectives and feelings of transgender people during hospitalization. Misgendering and unawareness of transgender peoples' issues create anxiety and frustration among nurses. Elements to improve care for transgender people need to be integrated into all nursing curricula and training programs. The authors adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines and the Critical Appraisal Skills Programme (CASP).Since this was a metasynthesis, no patient or public contribution was required. [ABSTRACT FROM AUTHOR]

An editorial is presented which argues that qualitative research can enhance the quality, rigor, and depth of an randomized controlled trial (RCT.) Topics discussed include information of RCT which involve standard approach to testing the efficacy of medicines; importance of qualitative research with patients which helps to identify several health issues; and information for RCT designs by analysis of risks to trial concordance and the way participants feel about the process of the trial.

Aim Design Methods Results Conclusions Implication for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To explore the attitudes of healthcare workers towards COVID‐19 vaccines.A qualitative descriptive design was used.Five focus groups were conducted between October and November 2021, with a total of 30 nurses from different contexts in Northern Italy. Thematic analysis was used to analyse the transcripts.Three main themes were identified: ‘favourable’, ‘unsure’ and ‘contrary to’ COVID‐19 vaccines. The favourable position was underpinned by trust in science, research and vaccination; protection for themselves, their families, patients and the population; duty as professionals; necessity to set an example for others. Participants who were unsure had doubts about the composition, safety and efficacy of the vaccine and were sometimes afraid that media provided incomplete information. The main reason why nurses were against was the feeling that being forced to vaccinate perceived as blackmail. Favourable or unsure nurses struggled to deal with those who were against and developed a series of emotions that ranged from respect and attempt to rationalize, to frustration and defeat.Identifying the areas of hesitation is essential to understand what affects the choices of acceptance, delay or refusal of vaccination. The issues that emerged regarding proper communication within the vaccination campaign highlights the key importance of adequate vaccination strategies.Understanding attitudes towards vaccine and related motivations among healthcare workers could help develop more specific and targeted vaccination campaigns that can ensure proper vaccination coverage rates and avoid hesitancy or refusal. Healthcare workers experiences of COVID‐19 vaccines, their views and know how they feel during COVID‐19 vaccinations. Healthcare workers had three different positions in COVID‐19 vaccination. This research will guide and target future vaccination campaigns. The study is reported using the Standards for Reporting Qualitative Research (SRQR).No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Patient or Public Contribution To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors.An online cross‐sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES‐NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines.A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards.Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence‐free policies for hospitals. Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID‐19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job. The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses. Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high‐quality care in a totally safe environment. No patient or public contribution. [ABSTRACT FROM AUTHOR]

The author discusses clinical competence in the field of nursing in relevance with patient care. Other topics addressed include nurse-sensitive outcome issue, bachelor educated nurses, and study and teaching of nurses. Particular focus is given to the meaning and importance of competence in nursing.

The author discusses the article, "Data collection and sampling in qualitative research: does size matter?" published in the "Journal of Advanced Nursing." Topics discussed include the importance of the patients' perspectives in qualitative research in health care for a deeper understanding of issues and in humanizing care, gain a concrete understanding of patient and family adherence to treatment and identifies Grounded Theory as the most appropriate for studying healthcare systems.

The author reflects on the difficulties of finding a funding agency to back researches using theoretical sampling in grounded theory strategies. He discussed purposive or purposeful sampling in which sampling is defined before the beginning of data collection. He recalls using the strategy in a study in Northern Italy on the validation and application of standards in the involvement of children and their families in the healthcare process.

The article discusses the use of research-based evidence by nurses as a reason for the gap in nursing between evidence and practice in Europe. The authors confirm a study which showed the association between the decrease in the use of research-based evidence and the increase in nurses' working seniority. They identify several factors and possible areas for actions suggested by the Commission of the European Communities, including ensuring better working conditions for health workers.

The author reflects on the guest editorial by D. R. Thompson and R. Watson titled "H-Indices and the Performance of Professors of Nursing in the UK," published in a 2010 issue of the "Journal of Clinical Nursing." She claims that the decision to set an exceedingly high Hirsch (h)-index for Italian nursing academics has no rational foundation. She adds that the h-index cannot be the sold measurement to rate nurses' academic excellence.