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Background One of the scales most used to measure quickly and easily eHealth Literacy is the eHealth LiteracyScale (eHEALS); however, there was no validation of this scale in Italian. Therefore, the aim of this study was to adapt and validate the eHealth Literacy Scale (eHEALS) to the italian context. Methods:Italian translation of eHEALS was administered along unit to another two scale for measure lifestyle habits self-esteem and life satisfaction). A sample of 650 university students aged between 18 and 45 years was selected. An exploratory factor analysis, confirmatory factor analysis, analysis of invariance, reliability, stability and bivariate correlations were performed. Results:Exploratory factor analysis revealed a monofactorial structure that explained 67% of variance,. Reliability of 0.87 and test-retest correlation of 0.78 was obtained. The questionnaire was invariant by gender. Regarding the criterion validity, a statistically significant and positive correlations between 0.05 and 0.15 with three indicators was obtained (self-esteem, lifestyle habits and life satisfaction). The italian version of the eHEALS tested in this work has shown to be a valid and reliable scale to measure eHealth competence in university students. [ABSTRACT FROM AUTHOR]

Every day there is a data explosion on the web. In 2013, 5 exabytes of content were created each day. Every hour internet networks carries a quantity of texts equivalent to twenty billion books. For idea Iit is a huge mass of information on the linguistic behavior of people and society that was unthinkable until a few years ago. It is an opportunity for valuable analysis for understanding social phenomena, also in nursing and health care sector.This poster shows the the steps of an idealy strategy for textual statistical analysis and the process of extracting useful information about health care, referring expecially nursing care from journal and web information. We show the potential of web tools of Text Mining applications (DTM, Wordle, Voyant Tools, Taltac 2.10, Treecloud and other web 2.0 app) analyzing text data and information extraction about sentiment, perception, scientific activites and visibility of nursing. This specific analysis is conduct analyzing "Repubblica", first newspaper in Italy (years of analisys: 2012- 14) and one italian scientific nursing journal (years: 2012-14). [ABSTRACT FROM AUTHOR]

This survey provides an update on the experience of Myasthenia Gravis (MG) patients in Australia. Items were drawn from the 2011 Australian Survey and a 2019 US survey allowing for comparative discussion of survey findings. Patients were recruited through the Myasthenia Alliance Australia. Following consent, patients completed an online survey using REDCap software. Questions included demographics, clinical features, treatment side-effects and quality of life (QOL) scales. Samples for completion of survey sections ranged from N = 242-280 representing a power level of over 80%. Female and seronegative patients reported a significantly greater symptom load, earlier disease onset, longer time to diagnosis, more MG exacerbations, treatment side-effects, and poorer QOL. For exacerbation management there was a higher rate of oral corticosteroid use (66%), a lower use of Intravenous Immunoglobulin (IVIg, 47%) and particularly, Therapeutic Plasma Exchange (TPE, 4.5%) within this sample. Although steroid induced side-effects were rarer (9-34%), a comparatively high use of corticosteroids was reported for current and overall treatments including those for MG crises (52-83%). Common treatment side-effects reported by 57-85% of patients, included fatigue, weight gain, a decrease in the ability to fight infections, gastrointestinal symptoms, and muscle weakness. The impact of MG on daily activities and QOL was considerable, but those who had a thymectomy reported better QOL. The survey identified areas for potential practice improvement in MG treatments (corticosteroids, IVIg, TPE), particularly for exacerbation management, and review is recommended. Further research on gender and antibody status differentials regarding clinical features is required., Competing Interests: Declaration of Competing Interest Terumo BCT Australia Pty. Ltd. contributed to the funding for the study for those authors then employed by or as an affiliate of, the Biological Data Science Insitute at the Australian National University and later as affiliates of the Health Outcomes Collaboration. A representative of Terumo BCT, Yvonne Lee PhD, participated in the project group until June 2022 but was not involved in manuscript preparation. Professor Steve Vucic has reported no interests to declare. Ms Susan White, the patient representative, is affiliated with the Myasthenia Alliance Australia and the Myasthenia Gravis Association of Queensland. The material reflects the views of all authors and does not reflect the views of the funding body or other groups., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Clinical quality registries (CQRs) monitor compliance against optimal practice and provide feedback to the clinical community and wider stakeholder groups. Despite a number of CQRs having incorporated the patient perspective to support the evaluation of healthcare delivery, no recommendations for inclusion of patient-reported outcome measures (PROMs) in CQRs exist. The aim of this study was to develop a core set of recommendations for PROMs inclusion of in CQRs., Method: An online two-round Delphi survey was performed among CQR data custodians, quality of life researchers, biostatisticians and clinicians largely recruited in Australia. A list of statements for the recommendations was identified from a literature and survey of the Australian registries conducted in 2019. The statements were grouped into the following domains: rationale, setting, ethics, instrument, administration, data management, statistical methods, and feedback and reporting. Eighteen experts were invited to participate, 11 agreed to undertake the first online survey (round 1). Of these, nine experts completed the online survey for round 2., Results: From 117 statements presented to the Delphi panel in round 1, a total of 72 recommendations (55 from round 1 and 17 from round 2) with median importance (MI) ≥ 7 and disagreement index (DI) < 1 were proposed for inclusion into the final draft set and were reviewed by the project team. Recommendations were refined for clarity and to read as stand-alone statements. Ten overlapped conceptually and, therefore, were merged to reduce repetition. The final 62 recommendations were sent for review to the panel members for their feedback, which was incorporated into the final set., Conclusion: This is the first study to develop preliminary recommendations for PROMs inclusion in CQRs. Recommendations for PROMs implementation are critically important for registries to assure meaningful PROMs data capture, use, interpretation, and reporting to improve health outcomes and healthcare value., (© 2022. The Author(s).)

Summary: Object. The following study was carried out in order to evaluate through guidelines the best evidence in occupational therapy for daily activities and quality of life of patients with hip prostheses. Methods. Recommendations were generated following the grading method of the National Program for Guidelines/National System Guidelines (PNLG-SNLG), a system for developing guidelines for recommendations in clinical practice. The Appraisal of Guidelines Research and Evaluation in Europe (AGREE) tool was also applied. Results. A total of seven studies were included in this research: one randomized controlled trial, two systematic reviews, two outcomes research studies, and two observational studies. We found that, for the three clinical questions we proposed, more research on the effectiveness of treatments is required. Conclusions. The evidence resulting from this study is not sufficient to determine whether the rehabilitation techniques under consideration are effective., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by GIMLE.)

Study Design: Cross-sectional study., Objective: To develop an Italian version of the Levels of Cognitive Functioning Assessment Scale (LOCFAS) and examine its reliability and validity., Subject: Patients with acquired brain injury in an early post-coma state., Methods: The original scale was translated from English to Italian using the guidelines set forth in the Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice. Intra-rater reliability was examined using the intraclass correlation coefficient (ICC). Concurrent validity was evaluated using Pearson's correlation coefficients with some of the functional and disability components of the International Classification of Functioning, Disability and Health (ICF), excluding environmental factors., Setting: The highly specialized neurorehabilitation department of "San Raffaele" Hospital, Cassino., Results: The Italian version of the LOCFAS (LOCFAS-I) was administered to 38 subjects from May 9, 2017 to August 31, 2017. The mean ± SD of the LOCFAS-I score was 3.05 ± 1.88. All LOCFAS-I items were either identical or similar in meaning to the original version's items. Test-retest reliability (ICC) was 0.996 (p<0.01). The Pearson correlation coefficient of the LOCFAS-I scores with some of the functional and disability components of the ICF was > 0.536 (p<0.01)., Conclusions: The LOCFAS-I was found to be reliable and a valid measurement tool for the assessment of cognitive functioning post-coma in the Italian population.

Objectives: To measure psychometric properties of the Italian version of the Pediatric Evaluation of Disability Inventory (PEDI-I) in a population with Autism Spectrum Disorder (ASD)., Methods: The PEDI-I was administered to different children with ASD. The internal consistency was examined by using Cronbach's Alpha, while the intraclass correlation coefficient (ICC) was used to investigate both inter-observer and intra-observer reproducibility. Its concurrent validity was evaluated with the Italian version of the Barthel Index., Results: The PEDI-I was administered to 60 children with a diagnosis of ASD. Cronbach's Alpha showed statistically significant values (.885-.965). Inter-observer and intra-observer investigations confirm the reproducibility of the scale with a range of high and very high parameters. The Pearson Correlation Coefficient with the Barthel Index showed significant data for all PEDI-I subscales with a p<0.01., Conclusions: The PEDI-I showed good psychometric properties and it is possible to confirm its validity and reliability in ASD population. However, for better understanding of how PEDI-I works in clinical practice, further researches are recommended.

This systematic review of randomized controlled trials (RCTs) aims at evaluating the efficacy of Occupational therapy (OT) interventions in Asperger's syndrome (AS) pediatric patients. We conducted a systematic review according to PRISMA guidelines. The screening of the literature was carried out on PUBMED, SCOPUS, WEB OF SCIENCE and OT SEEKER databases, TO December 2018. We selected three RCTs having the common objective to evaluate whether children with AS can improve their social skills thanks to OT treatments. The interventions targeted by the three selected studies were: LEGO therapy, Social Use of Language Programme, Let's Face It! software and Parent Training combined with the administration of risperidone. All the studies showed that the intervention groups improved their overall social ability.This review shows that OT interventions can help concretely AS children in overcoming their social issues. Nevertheless, more RCTs are needed to better understand the OT's benefits and limitations in AS patients.

In Italy, chronic pain affects more than a quarter of the population, whereas the average European prevalence is 21%. This high prevalence might be due to the high percentage of Italian people who do not receive treatment, even after the passing of law 38/2010 (the right to access pain management in Italy), which created a regional network for the diagnosis and treatment of noncancer chronic pain. Italian epidemiologic studies on chronic pain are scanty, and this observational, multicenter, cross-sectional study is the first to investigate the clinical characteristics of patients who attended the pain management clinics in the Latium Region, Italy, for the management of their noncancer chronic pain. A total of 1,606 patients (mean age 56.8 years, standard deviation ± 11.4), 67% women, were analyzed. Severe pain was present in 54% of the sample. Women experienced pain and had it in two or more sites more often than men (57% vs. 50%, p = .02; and 55.2% vs. 45.9%, p < .001, respectively). Chronic pain was musculoskeletal (45%), mixed (34%), and neuropathic (21%). In more than 60% of the cases, chronic pain was continuous, and in 20% it had lasted for more than 48 months; long-lasting pain was often neuropathic. Low back (33.4%) and lower limbs (28.2%) were the main locations. Severe intensity of pain was statistically significantly associated with female gender (odds ratio [OR] 1.39; 95% confidence interval [CI] 1.06-1.84); with International Classification of Diseases, Ninth Revision, codes for chronic pain syndrome (OR 2.14; 95% CI 1.55-2.95); and with continuous pain (OR 2.02; 95% CI 1.54-2.66). Neuropathic pain and mixed pain were significantly associated with number of sites, and a trend seemed to be present (OR 2.11 and 3.02 for 2 and 3 + sites; 95% CI 1.59-2.79 and 2.00-4.55, respectively)., (Copyright © 2019 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

Objective: To provide clinicians and researchers information regarding (1) the existing outcome measures to assess the loss of functionality in the activities of daily living (ADLs) of patients with stroke and (2) the presence of these assessment tools in the Italian context., Study Design and Setting: For this Systematic Review Medline, CINAHL, and PsycINFO were searched for articles published up to 4 July 2017. Two authors independently identified eligible studies on the basis of predefined inclusion criteria and extracted data. Study quality and risk of bias were assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies., Results: Of 370 publications identified and screened, 46 studies fell within the inclusion criteria and were critically reviewed. The most commonly used tools were: the Frenchay Activities Index and the Functional Independence Measure., Conclusion: This review has emphasized the need for agreement among researchers as to which tool must be studied in depth or adapted to other national contexts in order to develop universal norms and standards.

Motor impairments of the upper extremities affect approximately 60% of stroke patients. Rehabilitation is extremely important and can make it possible to identify which manual function is causing difficulty for the patient and hindering daily activities. The Wolf Motor Function Test (WMFT) was recently highly recommended as one of several outcome measures that assess limitations of activities with a high level of psychometrics and clinical utility. The objective of this study was to translate and culturally adapt the WMFT for the Italian population (WMFT-IT) and examine its reliability and validity in Italian post-stroke adults with chronic hemiplegia or hemiparesis. The original scale was translated into Italian and culturally adapted in accordance with international guidelines. Its internal consistency and stability were examined using the Cronbach's alpha (α) coefficient and the intra-class correlation coefficient (ICC), respectively. Its concurrent validity was evaluated using the Pearson's correlation coefficient to compare the instrument with the Italian version of the Jebsen-Taylor Hand Function Test and the Disabilities of the Arm, Shoulder and Hand outcome measure. All WMFT-IT items were either identical or similar in meaning to the items in the original version. The WMFT-IT was administered to 24 subjects. Cronbach's α was 0.91 and 0.98 for the time and performance subscales respectively, and the ICC for test-retest reliability was 0.99. Pearson's correlation coefficients of the time subscale and the performance subscale both showed significant positive correlations (p <0.01). The WMFT-IT was found to be reliable and a valid outcome measure for assessing function and quality of movement of the upper extremities in post-stroke adults in the Italian population.

Objective: The aim of the study was to translate and culturally adapt the Physical Activity Scale for the Elderly into Italian (PASE-I) and to evaluate its psychometric properties in the Italian older adults healthy population., Methods: For translation and cultural adaptation, the "Translation and Cultural Adaptation of Patient-Reported Outcomes Measures" guidelines have been followed. Participants included healthy individuals between 55 and 75 years old. The reliability and validity were assessed following the "Consensus-Based Standards for the Selection of Health Status Measurement Instruments" checklist. To evaluate internal consistency and test-retest reliability, Cronbach's α and Intraclass Correlation Coefficient (ICC) were, respectively, calculated. The Berg Balance Score (BBS) and the PASE-I were administered together, and Pearson's correlation coefficient was calculated for validity., Results: All the PASE-I items were identical or similar to the original version. The scale was administered twice within a week to 94 Italian healthy older people. The mean PASE-I score in this study was 159±77.88. Cronbach's α was 0.815 (p < 0.01) and ICC was 0.977 (p < 0.01). The correlation with the BBS was 0.817 (p < 0.01)., Conclusions: The PASE-I showed positive results for reliability and validity. This scale will be of great use to clinicians and researchers in evaluating and managing physical activities in the Italian older adults population.

Introduction: The Geriatric Depression Scale (GDS) is commonly used to assess depressive symptoms, but its psychometric properties have never been examined in Italian people with Parkinson's disease (PD). The aim of this study was to study the reliability and validity of the Italian version of the GDS in a sample of PD patients., Methods: The GDS was administered to 74 patients with PD in order to study its internal consistency, test-retest reliability, construct, and discriminant validity., Results: The internal consistency of GDS was excellent ( α  = 0.903), as well as the test-retest reliability (ICC = 0.941 [95% CI: 0.886-0.970]). GDS showed a strong correlation with instruments related to the depression ( ρ  = 0.880) in PD ( ρ  = 0.712) and a weak correlation with generic measurement instruments (-0.320 <  ρ  <-0.217). An area under the curve of 0.892 (95% CI 0.809-0.975) indicated a moderate capability to discriminate depressed patients to nondepressed patient, with a cutoff value between 15 and 16 points that predicts depression (sensitivity = 87%; specificity = 82%)., Conclusion: The GDS is a reliable and valid tool in a sample of Italian PD subjects; this scale can be used in clinical and research contexts.

Objective: The Geriatric Depression Scale (GDS) is an evaluation tool to diagnose older adult's depression. This questionnaire was defined by Yesavage and Brink in 1982; it was designed expressly for the older person and defines his/her degree of satisfaction, quality of life, and feelings. The objective of this study is to evaluate the psychometric properties of the Italian translation of the Geriatric Depression Scale (GDS-IT)., Methods: The Italian version of the Geriatric Depression Scale was administered to 119 people (79 people with a depression diagnosis and 40 healthy ones). We examined the following psychometric characteristics: internal consistency reliability, test-retest reliability, concurrent validity, and construct validity (factor structure)., Results: Cronbach's Alpha for the GDS-IT administered to the depressed sample was 0.84. Test-retest reliability was 0.91 and the concurrent validity was 0.83. The factorial analysis showed a structure of 5 factors, and the scale cut-off is between 10 and 11., Conclusion: The GDS-IT proved to be a reliable and valid questionnaire for the evaluation of depression in an Italian population. In the present study, the GDS-IT showed good psychometric properties. Health professionals now have an assessment tool for the evaluation of depression symptoms in the Italian population.

Purpose: The purpose of this study was to develop prioritised indicators to measure cancer patient experience and thus guide quality improvement in the delivery of patient care., Methods: A Delphi study, consisting of two surveys and three workshops, was employed to gather expert opinions on the most important indicators to measure. Survey participants were 149 health professionals, academics/technical experts and consumers. The first survey was based on a literature review which identified 105 elements of care within 14 domains of patient experience. These were rated on a 7-point Likert scale, with '1' representing high importance. Elements with mean ratings between 1.0 and 2.0 were retained for the second survey. The 43 least-important elements were omitted, four elements were revised and nine new elements added. Consensus was defined as at least 70% of participants rating an element '1' or '2'. Multivariate and cluster analyses were used to develop 20 draft indicators, which were presented to 51 experts to refine and prioritise at the three workshops., Results: All elements in the second survey were rated '1' or '2' by 81% of participants. Workshop participants agreed strongly on the four most important indicators: coordinated care, access to care, timeliness of the first treatment, and communication. Other indicators considered highly important were follow-up care for survivors; timeliness of diagnosis; information relating to side effects, pain and medication; comprehensibility of information provided to patients; and needs assessment., Conclusions: Experts identified priorities with a high level of consensus, providing a rigorous foundation for developing prioritised indicators of quality in cancer patient experience.

This literature review focused on the experience, care, and service requirements of people with younger onset dementia. Systematic searches of 10 relevant bibliographic databases and a rigorous examination of the literature from nonacademic sources were undertaken. Searches identified 304 articles assessed for relevance and level of evidence, of which 74% were academic literature. The review identified the need for (1) more timely and accurate diagnosis and increased support immediately following diagnosis; (2) more individually tailored services addressing life cycle issues; (3) examination of the service needs of those living alone; (4) more systematic evaluation of services and programs; (5) further examination of service utilization, costs of illness, and cost effectiveness; and (6) current Australian clinical surveys to estimate prevalence, incidence, and survival rates. Although previous research has identified important service issues, there is a need for further studies with stronger research designs and consideration of the control of potentially confounding factors.

Background: Numerous international policy drivers espouse the need to improve healthcare. The application of Improvement Science has the potential to restore the balance of healthcare and transform it to a more person-centred and quality improvement focussed system. However there is currently no accredited Improvement Science education offered routinely to healthcare students. This means that there are a huge number of healthcare professionals who do not have the conceptual or experiential skills to apply Improvement Science in everyday practise., Methods: This article describes how seven European Higher Education Institutions (HEIs) worked together to develop four evidence informed accredited inter-professional Improvement Science modules for under and postgraduate healthcare students. It outlines the way in which a Policy Delphi, a narrative literature review, a review of the competency and capability requirements for healthcare professionals to practise Improvement Science, and a mapping of current Improvement Science education informed the content of the modules., Results: A contemporary consensus definition of Healthcare Improvement Science was developed. The four Improvement Science modules that have been designed are outlined. A framework to evaluate the impact modules have in practise has been developed and piloted., Conclusion: The authors argue that there is a clear need to advance healthcare Improvement Science education through incorporating evidence based accredited modules into healthcare professional education. They suggest that if Improvement Science education, that incorporates work based learning, becomes a staple part of the curricula in inter-professional education then it has real promise to improve the delivery, quality and design of healthcare., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Every day there is a data explosion on the web. In 2013, 5 exabytes of content were created each day. Every hour internet networks carries a quantity of texts equivalent to twenty billion books. For idea Iit is a huge mass of information on the linguistic behavior of people and society that was unthinkable until a few years ago. It is an opportunity for valuable analysis for understanding social phenomena, also in nursing and health care sector.This poster shows the the steps of an idealy strategy for textual statistical analysis and the process of extracting useful information about health care, referring expecially nursing care from journal and web information. We show the potential of web tools of Text Mining applications (DTM, Wordle, Voyant Tools, Taltac 2.10, Treecloud and other web 2.0 app) analyzing text data and information extraction about sentiment, perception, scientific activites and visibility of nursing. This specific analysis is conduct analyzing "Repubblica", first newspaper in Italy (years of analisys: 2012-14) and one italian scientific nursing journal (years: 2012-14).

Background: One of the scales most used to measure quickly and easily eHealth Literacy is the eHealth LiteracyScale (eHEALS); however, there was no validation of this scale in Italian. Therefore, the aim of this study was to adapt and validate the eHealth Literacy Scale (eHEALS) to the italian context., Methods: Italian translation of eHEALS was administered along unit to another two scale for measure lifestyle habits self-esteem and life satisfaction). A sample of 650 university students aged between 18 and 45 years was selected. An exploratory factor analysis, confirmatory factor analysis, analysis of invariance, reliability, stability and bivariate correlations were performed., Results: Exploratory factor analysis revealed a monofactorial structure that explained 67% of variance. Reliability of 0.87 and test-retest correlation of 0.78 was obtained. The questionnaire was invariant by gender. Regarding the criterion validity, a statistically significant and positive correlations between 0.05 and 0.15 with three indicators was obtained (self-esteem, lifestyle habits and life satisfaction). The italian version of the eHEALS tested in this work has shown to be a valid and reliable scale to measure eHealth competence in university students.

Pain is multidimensional, and, as such, the chief reason patients seek urgent healthcare services. If inadequately assessed and untreated, pain may negatively impact on the quality of life of the patient. Treating pain is an important step in regaining control over quality of life. The objective of the present study is to examine the level of knowledge and types of approach among Italian nurses who deal with pain assessment and management. The Ferrell and McCaffery's Knowledge and Attitudes Survey Regarding Pain (KASRP) was distributed to 286 nurses employed in one of the biggest specialized hospitals in Rome, Italy. The interviewed staff work at three different settings, according to the healthcare assistance they are required to provide: intensive care unit (ICU), subintensive care unit (SICU), and ordinary ward (OW). Descriptive statistics, including frequencies and means, as well as analysis of chi-square (p < .05), were used to compare differences in scores by demographic characteristics of the participants and different settings. A logistic regression model was performed to evaluate the factors that may influence the attitude to pain and the level of knowledge of care providers. Results have shown that the odds of developing positive attitudes towards pain management were 1.62 times higher (95% CI: .92 to 2.85) in nurses employed in SICUs than in those working in OWs, while the odds of possessing a satisfactory level of knowledge was 1.76 times higher (95% CI: .93 to 3.31) among nurses in ICUs than those in OWs. A "good assessment" was better for SICU (OR = 2.17, p < .05) and ICU (OR = 3.20, p < .05) nurses. Our survey has highlighted an overall limited level of knowledge in the assessment and management of pain among the nursing staff. It is therefore a priority to implement specific training to healthcare providers from different fields, who may respond differently to patients with pain. On the other hand, further investigations are required on a greater sample of Italian nurses to better understand how to overcome the most problematic barriers to achieving good pain assessment and control., (Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

Introduction: Individuals and population's health is influenced by environmental, social economical and cultural aspects which in turn connect individuals to society. In order to decide autonomously, independently and consciously individuals should have several competences. The aim of this study is to identify, analyse and emphasise health literacy concept relevance per se,its relationship with nursing through a narrative revision focused on: Health literacy definition recognition and analysis; evaluation of connection between nursing and health literacy., Methods: A narrative review was carried out through PUBMED and CINHAL, using 'health literacy' and nursing related terms, in English or Italian between 2010 and 2015., Results: Results show that 'health literacy' is fully appraised, while attention paid by nurses on the topic is poor due both to a lack of awareness of its relevance on individuals' health and of appraisal. Twenty-height definition emerged from the revision; concepts expressed by scholars are mainly focused on very few individuals' abilities and competences applied to the health context (reading, writing, calculation, comprehension, listening and so on)., Conclusions: According to the results it is difficult to define health literacy due to its multidimensional nature. Notwithstanding the above an attempt to develop a unique new definition of health literacy has been carried out although its multidimensional nature and its strong connection to several variables constantly under development. Nevertheless it is imperative that educational modules would be developed and stably integrated in health care education, at the same time a strong effort is due from professional and policy makers to provide population of the necessary tools in order to improve their health.

ICNP is a standardized nursing terminology included within acknowledged terminologies by WHO, it is a relevant aspect of ICN programs and strategies. This paper aims to describe structure and characteristics of ICNP terminology as well as to highlight how this tool can be useful both in practice and in terms of nursing professional development. This version looks like a pyramid with seven axes describing different areas of nursing and related interventions, enriched by two special axes related to pre-coordinated Diagnosis / Outcomes (DC) and Operations (IC) which facilitate daily use in practice. In order to clarify how this tool can be actually be used in daily nursing practice some examples are provided, clarifying how adopting the current version of ICNP terminology (2015 release) Diagnosis/Outcomes and Interventions can be built. The ICNP Italian Centre is committed to introduce it to Italian nurses as a tool for sharing and disseminating terminology in our Country, having as main final aim to achieve even in Italy, professional visibility objectives promoted in different ways by the International Council of Nurses.

Introduction: Distraction is a non-pharmacological intervention aimed to reduce procedural pain in children. Venipuncture is one of the most widely used diagnostic and therapeutic procedure in pediatric patients. Analgesia during venipuncture may be efficiently achieved with distracting techniques., Objective: To describe active and passive distraction techniques to reduce distress in children undergoing venipuncture., Method: Data from CINHAL, PubMed, ILISI and Cochrane's databases were used to review existing literature and primary and secondary studies published between 2003 and 2014 were included. Queries were obtained with keywords such as distraction, complementary therapies, pain, pediatric, the Boolean operators AND and OR were used., Result: Twenty eligible articles out of the one hundred and forty-three retrieved (20/143) were selected; among these there were 3 systematic and 5 narrative reviews, 11 experimental and quasi-experimental studies and 1 observational study. Active and passive distraction techniques seemed extremely effective to reduce distress and pain in children undergoing venipuncture. Modest evidence of efficacy and absent side effects support this approach., Conclusion: Further RCTs are needed to compare the different types of existing active and passive distraction techniques. The presence of parents and the location where painful procedures are administered should be included in the assessment of this approach.

Purpose: To detect what is written in literature with respect to the access of non-urgent patients in Emergency Department, highlighting associated nursing roles during the period 2003-2013., Method: A literature review on international literature was carried out using PubMed database, where 41 significant articles were selected., Results: The articles analyzed are focused on the organization of the E.D., the response patterns (Fast Track-See and Treat etc.) in some countries and the evaluation of the nursing roles and competences. In literature, the model and the roles studied have proved to be effective in reducing waiting times in E.D. and increasing users' satisfaction without reducing the quality of provided care., Conclusions: The literature shows that the implementation of Fast Track must be developed with a nursing staff with advanced skills on emergency. The introduction of these roles assumes that health systems should address the problem of inter-professional work.

The Great War had a huge impact on Italian society. The organisation of the armed forces health service faced extreme difficulties due to the extensive loss of life of an almost exclusively terrestrial war. In this context, the role of the medical staff and nursing staff was essential, as the example of the volunteer Red Cross nurses testifies. However, this conflict revealed the need to improve the training of the nursing staff, as was the case in Anglo-Saxon countries.

Objectives: Reviews of patient satisfaction suggest seven dimensions, each of which should be assessed. This study reports development of a short generic patient satisfaction measure for use in routine clinical practice., Study Design and Settings: Participants were randomly recruited from two Australian incontinence clinics. Participants completed a follow-up questionnaire including patient satisfaction items. Iterative Mokken and Rasch analyses derived the Short Assessment of Patient Satisfaction (SAPS) scale from the item bank., Results: The SAPS psychometric properties illustrated the following features, namely its descriptive system covers all seven patient satisfaction dimensions, there were no misfitting items, and the scale exceeded the Loevinger H criteria for a strong unidimensional scale. The reliability of the SAPS was Cronbach α=0.86. When discriminatory function was examined, the SAPS scale was more sensitive than two other generic patient satisfaction instruments., Conclusion: The SAPS scale is based on a firm theoretical model of patient satisfaction and its descriptive system covers the known dimensions contributing to patient satisfaction. Its internal psychometric properties exceeded standard psychometric standards, and it discriminated at least as well as other longer patient satisfaction measures. Although it needs further validation, the study results suggest that it may be useful for assessing patient satisfaction with health care., (Copyright © 2011 SAPS is held and will continue to be held in perpetuity by the authors with a license to the Commonwealth of Australia. Researchers are welcome to use the SAPS subject to acknowledgement/citation of the authors' rights in the usual way. Published by Elsevier Inc. All rights reserved.)

Introduction: The increasing use of digital technologies and e-learning in nursing education and the health professions was also reflected in the time to many studies and reviews. The aim of this overview was to analyze education through e-learning technologies for nursing and health professional students., Method: A comprehensive search of literature was conducted using database PubMed/MEDLINE, Ebsco/CINAHL, 2003-2013., Result: The search strategy resulted in the inclusion, in first instance, of 9732 items. After the reduction of duplicates, applying limits and other parameters of inclusion/exclusion and, at the end, evaluation of quality through AMSTARD check list, we included in this overview, 22 reviews. The analized reviews were allowed to spread in different topic areas: study population (students and faculty), e-learning methods (blended learning Game/3D/situated learning) and evaluation (information technology, learning satisfaction comparison of e-learning with the traditional teaching methods), Conclusion: This overview demonstrates that e-learning in nursing academic education is a valid alternative to traditional learning. If e-learning activities are well structured and modulated, some advantages and economies are clear possible. Regard effects of e-learning on the improvement of ability, data are at the momenti limited when compared to traditional learning. Often e-learning appear as an adjunct respect traditional learning, but is necessary consider e-learning and digital tecnology as priority for the future of education of nursing students.

The aim of this study is to investigate the experience of primary caregivers (men and women) of Alzheimer Disease dementia, in order to tailor program and project to avoid care giving burden. A qualitative phenomenological method was used and the sample was defined by data saturation. Interviews were carried out and recorded in a day care Centre, transcribed verbatim. The analysis was conducted coding common themes and phrases. Six main themes emerged. Our results are similar to those existing in literature, showing care givers as individual in great danger physically and mentally. In the light of the study it is possible to tailor a nursing model in order to improve quality of life and decrease the burden of caregivers, this model should be implemented and analyzed.

The chronic nonmalignant pain is an underestimated epidemiologic health problem. It is a disease in its own right. It is one of the major reasons because patients use health service. The magnitude of chronic pain is in terms of human suffering and costs to society. The aim of this review is to identify the diagnosis and the prevalence of nonmalignant chronic pain in the adults. We have done a review of the literature from 1998 to 2012 using the virtual newspaper libraries starting from data bases (Pub-Med, CINAHL, Cochrane). We have made a narrative review of the articles obtained. Excluding topics of headache, pain for pediatric and geriatric groups, cancer pain and disease-specific items. Studies were classified for year, author sample, methods, age groups and definition of pain. We have obtained 7 articles. These epidemiological studies conducted in different part of the world, reported prevalence rates of chronic pain ranging from 16-53%. They shows a high heterogeneity of results concerning diagnosis and methods. Although limited the number of articles, show the high complexity of the phenomenon.

This study investigated whether problem-based learning (PBL) was an effective strategy for nursing students learning anatomy and physiology. Anatomy and physiology are subject areas that have posed long standing difficulty for nursing students. Since anatomy and physiology underpin clinical decision making it is important that nursing students are able to understand and retain this knowledge and apply it to practice. Problem-based learning offers potential advantages for teaching anatomy and physiology as clinical cases can provide the impetus for student problem solving. This project trialled a simple PBL scenario and investigated students' response to the task of problem solving in a laboratory setting adapted to simulate a hospital ward. The study found students learn better, retain the knowledge and merge theory with simulated practice when a PBL teaching mode is used. While PBL was effective, blended, web based and hybrid PBL models warrant investigation.

Background: Informal caring or caregiving is very common in our postindustrial society. Caregiving burden grows with the worsening of cognitive impairment of the patient and is one of the factors influencing institutionalization. Alzheimer's disease (AD) is a type of dementia that is chronic and deteriorative. The symptoms of this neuropsychiatric disorder generally begin to manifest after the age of sixty and currently 8.9 million family caregivers provide assistance to someone with AD or a related dementia. As the patient's condition worsens, it increases the burden on the caregivers, due to the physical, psychological, and emotional stresses that result from caring for the patient., Methods: A search of the literature was conducted on electronic database: PubMed, Google Scholar, Science direct, CINAHL in a exploratory way. Inclusion criteria were: articles in English and Italian published between 1999-2011 which mentioned Alzheimer's caregivers, burden, stressors, and institutionalization. The exclusion criterion was failure to mention the word "caregivers". About 100 titles were found and 30 articles abstracts with key words in the title were reviewed. Of the 30 articles selected for further review based on the relevance to the study purpose, 17 articles were finally selected for inclusion in this literature review., Results: Results display that caregiver burden is influenced by patient behavioral and cognitive status, hours involved in care, stress, social isolation, gender, relationship to the patient, availability of support resources, and caregiver characteristics. Assessment tools available to assess and recognize risk factors and burden in caregivers are useful both in terms of caregivers health and decision on istitutionalization., Conclusion: Literature suggests to provide information for health care providers to reduce burden and support caregiver health and well-being. Assessment tools available to assess and recognize risk factors and burden in caregivers should be used more often to contribute to reducing caregiver stress and the impact of institutionalization.

Background: The patient perspective on fecal incontinence can only be captured through the use of participant-reported measures. There are few psychometric evaluations of such measures, and these evaluations have reported some problems with existing measures., Objective: This study clinically evaluated the new Revised Faecal Incontinence Scale which was developed to provide a short, psychometrically sound measure for epidemiological and evaluative research., Design: A sample of consecutive patients was recruited and administered a questionnaire pre and posttreatment (Continence Advising, Physiotherapy and Surgery)., Settings: The study was conducted at 6 incontinence clinics across Australia., Patients: : The sample included 61 people with fecal incontinence at baseline and 38 at follow-up., Main Outcome Measures: Measures included the Revised Faecal Incontinence Scale, the Wexner Continence Scale, and the St Mark's Incontinence Score. Additionally, patient and clinician ratings of severity and improvement were collected., Results: The internal reliability of the Revised Faecal Incontinence Scale had a Cronbach's α = 0.78 compared with 0.65 for both the Wexner and St Mark's scales. Test-retest reliabilities were 0.80, 0.74, and 0.68. All 3 instruments were similarly responsive to change at follow-up. Correlations with other fecal incontinence measures were high and significant., Limitations: The small sample size, particularly at posttreatment, provides limitations concerning generalizability and subanalyses that could be undertaken., Conclusions: The Revised Faecal Incontinence Scale possessed evaluative discrimination between different levels of incontinence severity. In this sample it had superior internal consistency and test-retest reliability to the Wexner and St Mark's Incontinence Scales. It was at least as responsive as the Wexner and St Mark's in detecting change in incontinence status following treatment. Although ongoing clinical validation is required, these findings suggest it is a short, reliable, and valid scale that could be considered for use by researchers, epidemiologists, and clinicians.

This study investigates  the number of  articles published by Italian nursing journals by analyzing five Italian journals between 2003 and 2009. This is the third part of a study started  in 1978,  two articles were already published in 2005. The work is aimed at monitoring the number of nursing articles published. The articles were cataloged according to predefined criteria with the main aim to verify the status of the progress of research and theoretical development among Italian nurses. Results show that, although there is an increase in publications which apply research methods, these are still below the international trend and that, at national level, nurses prefer  topics such as care plans, regulations and organization of work rather than research or scientific evidence. On the one hand there is a raise on Italian nurses of interest in wider topic in order to be closer to the international debate, on the other hand there is a lack of adequate tools to improve knowledge and specific investments in research. As result of this there is a strong limitation in the knowledge growth of Italian nurses together with a lack of participation among and for different generations of nurses. In addition to the above it has been enucleated a scarcity within the literature analyzed of development of theoretical models, theories and concepts. Conversely theoretical models, theories and concepts are important pillars of scientific knowledge and they have a strong role in professional development, moreover these are necessary in order to set and improve nursing and nurses image nowadays far from the exclusive applied science.

Purpose: Although there has been an increase in the use of CT (Complementary Therapy) in Europe, little is known about CT available in Italian hospices. The present study is aimed at assessing the diffusion and typologies of CT used to treat chronic pain in Italian hospices. METHODS. An online survey was e-mailed to a regional sample of 16 hospices, which included questions on common CT used to treat malignant or nonmalignant chronic pain, and the barriers to their utilization., Results: The response rate was 81%. Only 5 hospices (38%) offered CT with conventional treatment. Massage therapy was the most common type of CT used, followed by naturopathy, nurturing touch, hypnotherapy, guided imagery, and aromatherapy. Barriers to the delivery of CT included insufficient knowledge of CT by staff, limited knowledge, and lack of funding., Conclusions: Although limited to Lazio hospices, this survey shows a partial use of CT for the treatment of chronic pain, caused by economic and cultural barriers.

Human rights have undergone constant evolution. Recently, however, new generations of rights are developing: from political and civil rights to social and economic rights, so much so that this period may be defined as the age of human rights. Many differences exist between moral rules and judicial law. While moral rights are not necessarily recorded in statutory law, some judicial laws, which are capable of being imposed and/or appealed within a true territorial government, originate from moral rules. Common sense has reservations about whether human rights can be labelled as laws in a rudimentary way; instead, society places human rights in the category of moral rights. These moral rights, in fact, are not the fruit of compromise, but are absolute and essential to the inner self. Throughout this article, the evolution of end of life rights is discussed, with particular regard to how those rights are directly correlated to organ transplantation.

This article describes the experience of patients (8) who have come out of coma , using a method combining qualitative evaluation and semi-structured interview. The experience of the family members who acted as care-givers is also taken into consideration. Given the context, data saturation was not observed, and 8 interviews were obtained. The principle caregivers were also asked to describe their experience. The interviews were transcribed verbatim and read through carefully so that the significant aspects could be divided into groups using a model for the evaluation of outcome which requires further validation.

Aim: This paper reports a study examining the hand hygiene knowledge, beliefs and practices of Italian nursing and medical students with the aim of informing undergraduate curricula., Background: In comparison with registered nurses, physician status is a risk factor for non-compliance with hand hygiene guidelines. Little research has been conducted to determine if differences between the professions in relation to hand hygiene are apparent at the undergraduate level. Cross-disciplinary studies that may provide an insight into this topic are lacking., Methods: A questionnaire was administered to a convenience sample of 117 nursing and 119 medical students in a large university in Rome, Italy, to determine their hand hygiene knowledge, beliefs and practices. The data were collected in 2007-2008., Results: Nursing students' hand hygiene knowledge (F = 9·03(1,230); P = 0·003), percentage compliance (Z = 6·197; P < 0·001) and self-reported hand hygiene practices (F = 34·54(1,230); P < 0·001) were significantly higher than that of medical students. There were no statistically significant differences between hand hygiene beliefs. Mean scores on the knowledge questions were low for both groups, reflecting primarily a knowledge deficit in relation to the use of alcohol-based hand rubs to decontaminate hands in the healthcare setting., Conclusion: Statistically significant disciplinary differences in hand hygiene knowledge and self-reported practices were apparent among undergraduate Italian healthcare students. Further research is needed to determine the causative factors. The overall low scores on the knowledge items indicate that these students require further education on hand hygiene, particularly in relation to the use of alcohol-based hand rubs., (© 2011 Blackwell Publishing Ltd.)

The study investigates and describes post-traumatic stress testing for the Italian validation of the abbreviated form of the Scale for the Symptoms of Post Traumatic Stress Disorder (PTSS-10). It's a scale comprising 10 items and the article takes into consideration the German version, derived from the original Norwegian. The scale is based on the concept of multidirectional stress supported by Lazarus. Its validation and testing was conducted on a group of 60 ARES 118 volunteers of Latina. The study reports the internal reliability of the translated instrument, calculated using Cronbach's alpha and compared to German study. 'Factor Analysis is calculated and the results are discussed. Some remarks, also, are made by relating scores indicating a suspected PTSD with socio-demographic variables. The results demonstrate the reliability of the instrument, but for a generalization, it should be tested on a larger sample and apply the test -retest.

The main objective of the study is assessing knowledge, opinions and compliance with the procedures of health professionals (physician, nurses, medical and nursing students) about Hand Hygiene (HH). There is a number of research which indicates that physicians respect less than nurses Hand Hygiene, there are a smaller number which investigates the differences in the attitude of the aforementioned subjects during their studies. A questionnaire was administered to a sample of 756 participants (252 doctors, 268 nurses, 117 nursing students and 119 students of medicine) at a large University Hospital in Rome, to determine their knowledge, compliance and procedures with Hand Hygiene. Knowledge of medical students is lower than that of nursing students, as well as they have lower values in adherence to practice. In both HH Beliefs Scale (HBS) and HH Practices Inventory (HHPI) questionnaires, nursing students have higher scores than nurses, doctors and medical students. The questions on the use of alcohol-based cleaners have been those where there was the lowest number of correct responses, across all professions. Physicians compared to nurses have a lower adherence to Hand Hygiene. Future research should clarify what the differences are in the construction of the study on the practice of washing hands, what are the barriers to health professionals and best methods for teaching habits, namely the effectiveness of hand washing. Professionals should be more involved in the fight against Healthcare-associated infections.

Chronic or intermittent headache affects the patients' quality of life, and has direct and indirect social costs. Several chronic illnesses are already treated through telephone counseling, however there is poor evidence in literature about headache treatment via telenursing, and it is not clear which role could the nurse play in this specific field. The study was carried out at the headache centre of "G. D'Annunzio" University - Chieti, and involved 62 patients, half of them were assigned to receive specialized telenursing in addiction to the standard care bean. During the 13 weeks of follow up the headache characteristics were regularly assessed (frequency and intensity). Pain assessment was performed using the VAS, and quality of life was assessed at baseline and at the end of the follow up using the SF-12 standard V1 questionnaire. The differences between the two groups are statistically significant during the last 5 week of follow up, (8th -12th; 0.002

Objective: The study reviewed all the published instruments used for the assessment, diagnosis, screening, and outcomes monitoring/evaluation of behavioral disturbances associated with dementia (BDAD) to recommend a set of psychometrically valid measures for clinicians and researchers to use, across a range of different practice settings., Methods: The study involved a broad scoping search, followed by a series of in-depth literature reviews on 29 instruments using scientific literature databases (MEDLINE, PsycINFO, CINAHL, and the Cochrane Library) and various national, international government, and government agency websites and professional organization websites. External consultations from measurement, clinical and research experts in dementia care, consumer representatives, and policy/decision makers, were sought in selecting the best instruments and in making the final recommendations., Findings: Key attributes and psychometric properties of a short list of five instruments were measured against prespecified criteria. The Neuropsychiatry Inventory (NPI) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) were rated as the best measures for assessment of behavioral disturbances, followed by the Consortium to Establish a Registry for Alzheimer's Disease-Behavior Rating Scale for Dementia (CERAD-BRSD), the Dementia Behavior Disturbance Scale, and the Neurobehavioral Rating Scale., Conclusion: The use of valid and standardized outcome measures for the assessment of BDAD is critical for epidemiological studies, prevention, early intervention and treatment of dementia conditions, and funding for relevant healthcare services. The review recommends the NPI and BEHAVE-AD as the most appropriate measures for both clinical and research, whereas the CERAD-BRSD is suited better for research. The review was designed for the Australian context; however, the findings are applicable in other developed countries.

The aging population is increasing worldwide. According to Italian authors, Italy is one of the leading and increasing aging populations in the world. Placing more numbers on the elderly increases the number of people who will live with dementia in the future and in our case of study, in an increase of people with Alzheimer's disease. Researchers have demonstrated that Alzheimer's disease comes with aging and it eventually affects the person's cognitive, emotional, and physical well being. Those who become diagnosed with Alzheimer's will eventually need assistance in their daily living, especially when it begins to progress to a higher stage. Daily assistance can come from staff at a hospital or from family members at home, but whether it is the patient's spouse or offspring, the person caring for the patient forms a burden of responsibility on themselves over time. The objective of this paper is to discuss and compare the effects of the burden placed on the Alzheimer's caregiver: sleep, anxiety and depression, stress, and use or nonuse of support services. The focus of this literature review is to submit what on the research of caregiver strain at home.

Not unfrequently stress in nurses is related to work organization. The literature shows that the nursing profession has a high risk of psychological stress. Stress is one of the factors that contributes to inefficiency, increasing staff turnover and sick leave, and reduces the quality and quantity of care , affecting health costs and diminishing work satisfaction. This article presents the results of a study performed to evaluate 34 variables, constituting the Nursing Stress Scale (NSS) , and their level in the nursing staff of a Rome specialistic hospital. Of the 80 nurses who received the questionaire , 49 responded, a sufficient number to make the results of the study significant. The authors illustrate the methods used together with some socio-demographic considerations and how some of these can be correlated to the 7 factors adopted for multi-variate analysis. The results obtained were concordant with those described in the literature, confirming that poor organization and conflictual or ambiguous work roles negatively affect well-being and that nursing directors should bear this in mind when aiming to create a harmonious work environment.

The procedures necessary to ensure hand hygiene are simple and non-expensive but are extremely important for the patient and the quality of care he receives. It is therefore fundamental that health workers are aware of these procedures and how they should be performed to reduce the risks of care-related infections. The authors selected 195 articles from a review of the abundance of published reports in international journals, which deal with the awareness and respect of guidelines regarding hand hygiene on which to base their discussion.

This study presents the results of a retrospective study evaluating the contribution of Italian nurses to the public debate on the Englaro case, analysing the articles published by two major daily newspapers during a precise period. The data collected testify to the intensity of the debate that involved the whole nation in which many diverse social and professional categories took part. The nursing category was principally represented by the Sisters of Mercy who, at the insistence of the media, gave their own opinion although their role in this context was more as personal assistants to Eluana Englaro rather than representatives of a professional category expressing a bioethical opinion.

Unlabelled: The article describes the results of a study comparing job satisfacion in nurses working in public and private health structures in the same city, in the light of a wider study at national level., Background: Job satisfaction in nurses also affects patients, improving care and preventing stress that may cause burnout, increased turnover or even professional abandonment. Methods and instruments: a quantatitive-descriptive study was performed using a socio-demographical questionnaire composed of 44 items (Index of Work Satisfacion di Stamps, 1972) related to autonomy, professional status, tasks involved , retribution, interaction and organizational policy., Results: the outcome of the study confirmed previous findings and corresponded to national and international averages. The satisfaction/insatisfaction index was 12.75 (range 0.9-37.1) for the public sector and 13.08 (range 0.9-37.1)for the private one, indicating a low to medium job satisfaction rate.

This qualitative study is related to leaving experience of mothers of a preborn child. The sample got saturation after eight women interviews. Verbatim transcriptions have been conducted and categories of meanings formed. Parse theories has been used to give meaning to categories to enhance feelings, hope and dreams of interviewed woman.. Results could be beneficial to orient nursing for a global vision of person's health, in the present case, of a specific group of people. Nurse is viewed as a facilitator supporter with a unique role during human experience.