76 results on '"Gavaruzzi T"'
Search Results
2. Conspiracy mentality and health-related behaviour during the COVID-19 pandemic: a multiwave survey in Italy
- Author
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Candini, V, Brescianini, S, Chiarotti, F, Zarbo, C, Zamparini, M, Caserotti, M, Gavaruzzi, T, Girardi, P, Lotto, L, Tasso, A, Starace, F, Calamandrei, G, de Girolamo, G, Candini V., Brescianini S., Chiarotti F., Zarbo C., Zamparini M., Caserotti M., Gavaruzzi T., Girardi P., Lotto L., Tasso A., Starace F., Calamandrei G., de Girolamo G., Candini, V, Brescianini, S, Chiarotti, F, Zarbo, C, Zamparini, M, Caserotti, M, Gavaruzzi, T, Girardi, P, Lotto, L, Tasso, A, Starace, F, Calamandrei, G, de Girolamo, G, Candini V., Brescianini S., Chiarotti F., Zarbo C., Zamparini M., Caserotti M., Gavaruzzi T., Girardi P., Lotto L., Tasso A., Starace F., Calamandrei G., and de Girolamo G.
- Abstract
Objectives: This study aimed to (1) explore the changes in conspiracy mentality across the four waves of the COVID-19 pandemic; (2) assess the relationship between conspirative mentality and psychological/behavioural variables; (3) identify the predictors of conspirative mentality; and (4) explore the effect of conspirative mentality on COVID-19 protective behaviour. Study design: This was a multiwave survey. Methods: A total of 10,013 Italian individuals, aged 18–70 years, were assessed across the four waves (from January to May 2021) through online survey. We collected information about the sociodemographic characteristics of participants, personal experiences of COVID-19 infection, trust, COVID-19 protective behaviours, COVID-19 risk perception, arousal, auto-efficacy, resilience and well-being. Conspiracy mentality was assessed with the Conspiracy Mentality Questionnaire. The statistical analyses included exploratory factorial analyses, Pearson correlations and multiple linear regressions. Results: The conspiracy mentality score during the COVID-19 pandemic was medium–high (mean 59.0 on a 0–100 scale) and slightly increased from 58.2 to 59.9 across months, in parallel with a slight decrease in trust in health institutions and scientific informational sources. Individuals aged >35 years, poorly educated and particularly scared about their financial situation were at risk of showing higher levels of conspirative mentality. Higher levels of conspirative mentality were risk factors for low levels of COVID-19 protective behaviours. Conclusions: Clear and effective communication may improve trust in health institutions and informational sources, decrease conspirative theories and increase compliance with protective behaviour.
- Published
- 2023
3. Sleep disturbance in Inflammatory Bowel Disease: prevalence and risk factors – A cross-sectional study
- Author
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Marinelli, C., Savarino, E. V., Marsilio, I., Lorenzon, G., Gavaruzzi, T., D’Incà, R., and Zingone, F.
- Published
- 2020
- Full Text
- View/download PDF
4. Who is likely to vacillate in their COVID-19 vaccination decision? Free-riding intention and post-positive reluctance
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Caserotti, M, Gavaruzzi, T, Girardi, P, Tasso, A, Buizza, C, Candini, V, Zarbo, C, Chiarotti, F, Brescianini, S, Calamandrei, G, Starace, F, de Girolamo, G, Lotto, L, Caserotti M, Gavaruzzi T, Girardi P, Tasso A, Buizza C, Candini V, Zarbo C, Chiarotti F, Brescianini S, Calamandrei G, Starace F, de Girolamo G, Lotto L, Caserotti, M, Gavaruzzi, T, Girardi, P, Tasso, A, Buizza, C, Candini, V, Zarbo, C, Chiarotti, F, Brescianini, S, Calamandrei, G, Starace, F, de Girolamo, G, Lotto, L, Caserotti M, Gavaruzzi T, Girardi P, Tasso A, Buizza C, Candini V, Zarbo C, Chiarotti F, Brescianini S, Calamandrei G, Starace F, de Girolamo G, and Lotto L
- Abstract
Despite the actual availability of COVID-19 vaccines to combat the pandemic, many people are still vacillating in their decision to vaccinate. In this study, we considered the effect of two relevant contextual issues on vaccination intention: the number of people infected with COVID-19 is increasing, and the pace of vaccination is gaining speed. Specifically, we hypothesized that having already contracted SARS-CoV-2 (post-positive reluctance) could lead people to underestimate the importance of vaccination. Moreover, as the number of vaccinated people increases, more hesitant people could fall into the free-riding intention category, benefitting from the immunity provided by others' vaccinations. Vaccine hesitancy becomes more critical as the vaccination campaign proceeds: at one point, it will be inevitable to deal with hesitant people. This study is part of a WHO Regional Office for Europe project and involved a representative sample of 5006 Italians interviewed in January–February 2021. In case of post-positive reluctance, both young age and female gender increase vaccine hesitancy, while a high level of education reduces free-riding intention. Considering post-positive reluctance and free riding, a protective effect on hesitancy is associated with negative affective states, adherence to protective behaviors, trust in health information sources, and resilience. In contrast, increased vaccine hesitancy is associated with a high level of conspiracy-mindedness and trust in media information sources. Recognizing and studying the post-positive reluctance and the phenomenon of free-riding people can help us to become more efficient in combatting the virus.
- Published
- 2022
5. COVID-19 Vaccine Hesitancy in Italy: Predictors of Acceptance, Fence Sitting and Refusal of the COVID-19 Vaccination
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Zarbo, C, Candini, V, Ferrari, C, D'Addazio, M, Calamandrei, G, Starace, F, Caserotti, M, Gavaruzzi, T, Lotto, L, Tasso, A, Zamparini, M, de Girolamo, G, Zarbo C., Candini V., Ferrari C., d'Addazio M., Calamandrei G., Starace F., Caserotti M., Gavaruzzi T., Lotto L., Tasso A., Zamparini M., de Girolamo G., Zarbo, C, Candini, V, Ferrari, C, D'Addazio, M, Calamandrei, G, Starace, F, Caserotti, M, Gavaruzzi, T, Lotto, L, Tasso, A, Zamparini, M, de Girolamo, G, Zarbo C., Candini V., Ferrari C., d'Addazio M., Calamandrei G., Starace F., Caserotti M., Gavaruzzi T., Lotto L., Tasso A., Zamparini M., and de Girolamo G.
- Abstract
BackgroundThe hesitancy in taking the COVID-19 vaccine is a global challenge. The need to identify predictors of COVID-19 vaccine reluctance is critical. Our objectives were to evaluate sociodemographic, psychological, and behavioral factors, as well as attitudes and beliefs that influence COVID-19 vaccination hesitancy in the general population of Italy. MethodsA total of 2,015 people were assessed in two waves (March, April and May, 2021). Participants were divided into three groups: (1) individuals who accepted the vaccination ("accepters"); (2) individuals who refused the vaccination ("rejecters"); and (3) individuals who were uncertain about their attitudes toward the vaccination ("fence sitters"). Group comparisons were performed using ANOVA, the Kruskal-Wallis test and chi-square tests. The strength of the association between the groups and the participants' characteristics was analyzed using a series of multinomial logistic regression models with bootstrap internal validation (one for each factor). ResultsThe "fence sitters" group, when compared to the others, included individuals of younger age, lower educational level, and worsening economic situation in the previous 3 months. After controlling for sociodemographic factors, the following features emerged as the main risk factors for being "fence sitters" (compared with vaccine "accepters"): reporting lower levels of protective behaviors, trust in institutions and informational sources, frequency of use of informational sources, agreement with restrictions and higher conspirative mentality. Higher levels of COVID-19 perceived risk, trust in institutions and informational sources, frequency of use of informational sources, agreement with restrictions and protective behaviors were associated with a higher likelihood of becoming "fence sitters" rather than vaccine "rejecters." ConclusionsThe "fence sitters" profile revealed by this study is intriguing and should be the focus of public programmes aimed at impro
- Published
- 2022
6. Psychological well-being during the COVID-19 pandemic in Italy assessed in a four-waves survey
- Author
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de Girolamo, G, Ferrari, C, Candini, V, Buizza, C, Calamandrei, G, Caserotti, M, Gavaruzzi, T, Girardi, P, Habersaat, K, Lotto, L, Scherzer, M, Starace, F, Tasso, A, Zamparini, M, Zarbo, C, de Girolamo G, Ferrari C, Candini V, Buizza C, Calamandrei G, Caserotti M, Gavaruzzi T, Girardi P, Habersaat KB, Lotto L, Scherzer M, Starace F, Tasso A, Zamparini M, Zarbo C, de Girolamo, G, Ferrari, C, Candini, V, Buizza, C, Calamandrei, G, Caserotti, M, Gavaruzzi, T, Girardi, P, Habersaat, K, Lotto, L, Scherzer, M, Starace, F, Tasso, A, Zamparini, M, Zarbo, C, de Girolamo G, Ferrari C, Candini V, Buizza C, Calamandrei G, Caserotti M, Gavaruzzi T, Girardi P, Habersaat KB, Lotto L, Scherzer M, Starace F, Tasso A, Zamparini M, and Zarbo C
- Abstract
COVID-19 pandemic had a negative impact on the mental health and well-being (WB) of citizens. This cross-sectional study included 4 waves of data collection aimed at identifying profiles of individuals with different levels of WB. The study included a representative stratified sample of 10,013 respondents in Italy. The WHO 5-item well-being scale (WHO-5) was used for the assessment of WB. Different supervised machine learning approaches (multinomial logistic regression, partial least-square discriminant analysis—PLS-DA—, classification tree—CT—) were applied to identify individual characteristics with different WB scores, first in waves 1–2 and, subsequently, in waves 3 and 4. Forty-one percent of participants reported “Good WB”, 30% “Poor WB”, and 28% “Depression”. Findings carried out using multinomial logistic regression show that Resilience was the most important variable able for discriminating the WB across all waves. Through the PLS-DA, Increased Unhealthy Behaviours proved to be the more important feature in the first two waves, while Financial Situation gained most relevance in the last two. COVID-19 Perceived Risk was relevant, but less than the other variables, across all waves. Interestingly, using the CT we were able to establish a cut-off for Resilience (equal to 4.5) that discriminated good WB with a probability of 65% in wave 4. Concluding, we found that COVID-19 had negative implications for WB. Governments should support evidence-based strategies considering factors that influence WB (i.e., Resilience, Perceived Risk, Healthy Behaviours, and Financial Situation).
- Published
- 2022
7. Conspiracy Mentality and Health-Related Behaviour During the Covid-19 Pandemic: An Italian Multi-Wave Survey
- Author
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Candini, V., Brescianini, S., Chiarotti, F., Zarbo, C., Zamparini, M., Caserotti, M., Gavaruzzi, T., Girardi, P., Lotto, L., Tasso, A., Starace, F., Calamandrei, G., Girolamo, De, and G
- Subjects
ConspiracyCOVID-19TrustBeliefsHealth behaviour - Published
- 2023
8. Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer
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Pucciarelli, S., Giandomenico, F., De Paoli, A., Gavaruzzi, T., Lotto, L., Mantello, G., Barba, C., Zotti, P., Flora, S., and Del Bianco, P.
- Published
- 2017
- Full Text
- View/download PDF
9. Psychological Well-Being During the Covid-19 Pandemic in Italy: Results from a Four-Wave Survey
- Author
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Girolamo, De, Ferrari, G., Candini, V., Buizza, C., Calamandrei, G., Caserotti, M., Gavaruzzi, T., Girardi, P., Habersaat, K. B., Lotto, L., Scherzer, M., Starace, F., Tasso, A., Zamparini, M., and Zarbo, C.
- Published
- 2022
10. The COVID-19 Vaccine Communication Handbook. A practical guide for improving vaccine communication and fighting misinformation
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Lewandowsky, S., Cook, J., Schmid, P., Holford, D., Finn, A., Leask, J., Thomson, A., Lombardi, D., Al-Rawi, A., Amazeen, M., Anderson, E., Armaos, K., Betsch, C., Bruns, H., Ecker, U., Gavaruzzi, T., Hahn, U., Herzog, S., Juanchich, M., Kendeou, P., Newman, E., Pennycook, G., Rapp, D., Sah, S., Sinatra, G., Tapper, K., and Vraga, E.
- Published
- 2021
11. Interventions to Help People Understand Community Protection: A Systematic Review
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Hakim, H., Provencher, T., Chambers, CHRISTOPHER DAVID IAIN, Chipendadansokho, S., Driedger, M., Dube, E., Gavaruzzi, T., Giguere, A., Ivers, N., Leask, JULIE-ANNE, Macdonald, S., Paquette, J., Wilson, GRAHAM KEITH, Zikmund-Fisher, B., Reinharz, D., and Witteman, H. O.
- Published
- 2019
12. Analysis of morbidity and mortality, quality of life and bowel function after total colectomy with ileorectal anastomosis compared to right and left hemicolectomy cases: a study to optimize treatment of Lynch Syndrome
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Urso, E. D., Celotto, Francesco, Giandomenico, F., Gavaruzzi, T., Del Bianco, P., Bao, R. Q., Pucciarelli, S., and Nitti, D.
- Published
- 2017
13. f you were a BRCA mutation carrier what would you do? Factors predicting the choice of prophylactic ovariectomy in a sample of Italian women
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Gavaruzzi, T., Tasso, A., Franiuk, M., Varesco, L., and Lotto, L.
- Published
- 2016
14. What’s in a name: Drug names convey implicit information about their riskiness and efficacy
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Tasso, Alessandra, Lotto, L., and Gavaruzzi, T.
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drug names ,judgment ,perceived risk ,perceived efficacy - Published
- 2014
15. Subjective and physiological emotional responses while reading patients’ narratives about colorectal cancer screening
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Gavaruzzi, T., Sarlo, M., Giandomenico, F., Polato, F., De Lazzari, F., Rumiati, R., and Lotto, L.
- Published
- 2014
16. Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer
- Author
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Pucciarelli, S, primary, Giandomenico, F, additional, De Paoli, A, additional, Gavaruzzi, T, additional, Lotto, L, additional, Mantello, G, additional, Barba, C, additional, Zotti, P, additional, Flora, S, additional, and Del Bianco, P, additional
- Published
- 2016
- Full Text
- View/download PDF
17. Using emotions conveyed by patient narratives: Comparing reassurance- and regret-based stories in colorectal cancer screening
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Gavaruzzi, T., Sarlo, M., Giandomenico, F., Polato, F., De Lazzari, F., Rumiati, R., and Lotto, L.
- Published
- 2013
18. 'Patient dies due to hernia: Doctors in trouble' A study on the effect of framing and numerical information format on liability judgments
- Author
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Gavaruzzi, T., Alessandra TASSO, and Lotto, L.
- Published
- 2010
19. PG 5.2 Quality of life after surgery for rectal cancer
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Pucciarelli, S., primary, Giandomenico, F., additional, Lotto, L., additional, Perin, A., additional, and Gavaruzzi, T., additional
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- 2014
- Full Text
- View/download PDF
20. PO.15 PREVENTION AND EARLY DIAGNOSIS OF COLORECTAL CANCER WITH ENDOSCOPY: WHAT IS USEFUL?
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Polato, F., primary, Lobello, S., additional, Meggiato, T., additional, Gavaruzzi, T., additional, Lotto, L., additional, and De Lazzari, F., additional
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- 2008
- Full Text
- View/download PDF
21. how framing and numerical information affect people's judgments when reading a newspaper story
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Alessandra TASSO, Lotto, L., Gavaruzzi, T., Carnaghi, A., and Rumiati, R.
22. Drugs: Are perceived risk and effectiveness in the name?
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Gavaruzzi, T., Alessandra TASSO, Rostellato, M., and Lotto, L.
23. COVID-19 Vaccine Hesitancy in Italy: Predictors of Acceptance, Fence Sitting and Refusal of the COVID-19 Vaccination
- Author
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Cristina Zarbo, Valentina Candini, Clarissa Ferrari, Miriam d'Addazio, Gemma Calamandrei, Fabrizio Starace, Marta Caserotti, Teresa Gavaruzzi, Lorella Lotto, Alessandra Tasso, Manuel Zamparini, Giovanni de Girolamo, Zarbo C., Candini V., Ferrari C., d'Addazio M., Calamandrei G., Starace F., Caserotti M., Gavaruzzi T., Lotto L., Tasso A., Zamparini M., de Girolamo G., Zarbo, C, Candini, V, Ferrari, C, D'Addazio, M, Calamandrei, G, Starace, F, Caserotti, M, Gavaruzzi, T, Lotto, L, Tasso, A, Zamparini, M, and de Girolamo, G
- Subjects
Cross-Sectional Studie ,conspiracy ,COVID-19 Vaccines ,SARS-CoV-2 ,COVID-19 Vaccine ,Public Health, Environmental and Occupational Health ,COVID-19 ,restriction ,trust ,protective behaviors ,SH4_4 ,vaccination ,perceived risk ,NO ,restrictions ,Cross-Sectional Studies ,protective behavior ,Humans ,Vaccination Hesitancy ,Human - Abstract
BackgroundThe hesitancy in taking the COVID-19 vaccine is a global challenge. The need to identify predictors of COVID-19 vaccine reluctance is critical. Our objectives were to evaluate sociodemographic, psychological, and behavioral factors, as well as attitudes and beliefs that influence COVID-19 vaccination hesitancy in the general population of Italy.MethodsA total of 2,015 people were assessed in two waves (March, April and May, 2021). Participants were divided into three groups: (1) individuals who accepted the vaccination (“accepters”); (2) individuals who refused the vaccination (“rejecters”); and (3) individuals who were uncertain about their attitudes toward the vaccination (“fence sitters”). Group comparisons were performed using ANOVA, the Kruskal-Wallis test and chi-square tests. The strength of the association between the groups and the participants' characteristics was analyzed using a series of multinomial logistic regression models with bootstrap internal validation (one for each factor).ResultsThe “fence sitters” group, when compared to the others, included individuals of younger age, lower educational level, and worsening economic situation in the previous 3 months. After controlling for sociodemographic factors, the following features emerged as the main risk factors for being “fence sitters” (compared with vaccine “accepters”): reporting lower levels of protective behaviors, trust in institutions and informational sources, frequency of use of informational sources, agreement with restrictions and higher conspirative mentality. Higher levels of COVID-19 perceived risk, trust in institutions and informational sources, frequency of use of informational sources, agreement with restrictions and protective behaviors were associated with a higher likelihood of becoming “fence sitters” rather than vaccine “rejecters.”ConclusionsThe “fence sitters” profile revealed by this study is intriguing and should be the focus of public programmes aimed at improving adherence to the COVID-19 vaccination campaign.
- Published
- 2022
24. Psychological well-being during the COVID-19 pandemic in Italy assessed in a four-waves survey
- Author
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Giovanni de Girolamo, Clarissa Ferrari, Valentina Candini, Chiara Buizza, Gemma Calamandrei, Marta Caserotti, Teresa Gavaruzzi, Paolo Girardi, Katrine Bach Habersaat, Lorella Lotto, Martha Scherzer, Fabrizio Starace, Alessandra Tasso, Manuel Zamparini, Cristina Zarbo, de Girolamo, G, Ferrari, C, Candini, V, Buizza, C, Calamandrei, G, Caserotti, M, Gavaruzzi, T, Girardi, P, Habersaat, K, Lotto, L, Scherzer, M, Starace, F, Tasso, A, Zamparini, M, Zarbo, C, de Girolamo G., Ferrari C., Candini V., Buizza C., Calamandrei G., Caserotti M., Gavaruzzi T., Girardi P., Habersaat K.B., Lotto L., Scherzer M., Starace F., Tasso A., Zamparini M., and Zarbo C.
- Subjects
Cross-Sectional Studie ,Cross-Sectional Studies ,Multidisciplinary ,Mental Health ,Italy ,Pandemic ,Surveys and Questionnaires ,Humans ,Surveys and Questionnaire ,COVID-19 ,Pandemics ,Human - Abstract
COVID-19 pandemic had a negative impact on the mental health and well-being (WB) of citizens. This cross-sectional study included 4 waves of data collection aimed at identifying profiles of individuals with different levels of WB. The study included a representative stratified sample of 10,013 respondents in Italy. The WHO 5-item well-being scale (WHO-5) was used for the assessment of WB. Different supervised machine learning approaches (multinomial logistic regression, partial least-square discriminant analysis—PLS-DA—, classification tree—CT—) were applied to identify individual characteristics with different WB scores, first in waves 1–2 and, subsequently, in waves 3 and 4. Forty-one percent of participants reported “Good WB”, 30% “Poor WB”, and 28% “Depression”. Findings carried out using multinomial logistic regression show that Resilience was the most important variable able for discriminating the WB across all waves. Through the PLS-DA, Increased Unhealthy Behaviours proved to be the more important feature in the first two waves, while Financial Situation gained most relevance in the last two. COVID-19 Perceived Risk was relevant, but less than the other variables, across all waves. Interestingly, using the CT we were able to establish a cut-off for Resilience (equal to 4.5) that discriminated good WB with a probability of 65% in wave 4. Concluding, we found that COVID-19 had negative implications for WB. Governments should support evidence-based strategies considering factors that influence WB (i.e., Resilience, Perceived Risk, Healthy Behaviours, and Financial Situation).
- Published
- 2022
25. Clarifying Values: An Updated and Expanded Systematic Review and Meta-Analysis
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Celia E. Wills, Marieke Geertruida Maria Weernink, Teresa Gavaruzzi, Douglas B. White, Sandrine Comeau, Dean A. Regier, Angela Fagerlin, Selma Chipenda Dansokho, Praveen Thokala, Arwen H. Pieterse, Holly O. Witteman, Ruth Ndjaboue, Charles Racine, Bob Arnold, Melina Marcoux, Thierry Provencher, Charlotte Rochefort-Brihay, John F.P. Bridges, Jesse Jansen, Gratianne Vaisson, Michael Pignone, Witteman H.O., Ndjaboue R., Vaisson G., Dansokho S.C., Arnold B., Bridges J.F.P., Comeau S., Fagerlin A., Gavaruzzi T., Marcoux M., Pieterse A., Pignone M., Provencher T., Racine C., Regier D., Rochefort-Brihay C., Thokala P., Weernink M., White D.B., Wills C.E., and Jansen J.
- Subjects
PATIENTS PREFERENCES ,CONJOINT-ANALYSIS ,Applied psychology ,shared decision making ,Reviews ,DESIGN-FEATURES ,Decisional conflict ,CINAHL ,Cochrane Library ,PATIENT ,decision making ,Decision Support Techniques ,law.invention ,Decision Support Technique ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Decision aids ,Humans ,PROSTATE ,Preference elicitation ,030212 general & internal medicine ,preference elicitation ,Health Policy ,030503 health policy & services ,Absolute risk reduction ,RANDOMIZED CONTROLLED-TRIAL ,CARE ,Data science ,Conjoint analysis ,INFORMED DECISION-MAKING ,AIDS ,Values clarification ,Research Design ,Strictly standardized mean difference ,Meta-analysis ,values clarification ,Patient Participation ,CLARIFICATION METHODS ,0305 other medical science ,Psychology ,Human - Abstract
Background Patient decision aids should help people make evidence-informed decisions aligned with their values. There is limited guidance about how to achieve such alignment. Purpose To describe the range of values clarification methods available to patient decision aid developers, synthesize evidence regarding their relative merits, and foster collection of evidence by offering researchers a proposed set of outcomes to report when evaluating the effects of values clarification methods. Data Sources MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, and CINAHL. Study Selection We included articles that described randomized trials of 1 or more explicit values clarification methods. From 30,648 records screened, we identified 33 articles describing trials of 43 values clarification methods. Data Extraction Two independent reviewers extracted details about each values clarification method and its evaluation. Data Synthesis Compared to control conditions or to implicit values clarification methods, explicit values clarification methods decreased the frequency of values-incongruent choices (risk difference, –0.04; 95% confidence interval [CI], –0.06 to –0.02; P < 0.001) and decisional conflict (standardized mean difference, –0.20; 95% CI, –0.29 to –0.11; P < 0.001). Multicriteria decision analysis led to more values-congruent decisions than other values clarification methods (χ2 = 9.25, P = 0.01). There were no differences between different values clarification methods regarding decisional conflict (χ2 = 6.08, P = 0.05). Limitations Some meta-analyses had high heterogeneity. We grouped values clarification methods into broad categories. Conclusions Current evidence suggests patient decision aids should include an explicit values clarification method. Developers may wish to specifically consider multicriteria decision analysis. Future evaluations of values clarification methods should report their effects on decisional conflict, decisions made, values congruence, and decisional regret.
- Published
- 2021
26. Conspiracy mentality and health-related behaviour during the COVID-19 pandemic: a multiwave survey in Italy
- Author
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V. Candini, S. Brescianini, F. Chiarotti, C. Zarbo, M. Zamparini, M. Caserotti, T. Gavaruzzi, P. Girardi, L. Lotto, A. Tasso, F. Starace, G. Calamandrei, G. de Girolamo, Candini, V, Brescianini, S, Chiarotti, F, Zarbo, C, Zamparini, M, Caserotti, M, Gavaruzzi, T, Girardi, P, Lotto, L, Tasso, A, Starace, F, Calamandrei, G, and de Girolamo, G
- Subjects
Settore M-PSI/01 - Psicologia Generale ,Conspiracy ,Belief ,Beliefs ,Settore M-PSI/03 - Psicometria ,Public Health, Environmental and Occupational Health ,COVID-19 ,Health behaviour ,General Medicine ,Trust ,Settore MED/01 - Statistica Medica - Abstract
Objectives: This study aimed to (1) explore the changes in conspiracy mentality across the four waves of the COVID-19 pandemic; (2) assess the relationship between conspirative mentality and psychological/behavioural variables; (3) identify the predictors of conspirative mentality; and (4) explore the effect of conspirative mentality on COVID-19 protective behaviour. Study design: This was a multiwave survey. Methods: A total of 10,013 Italian individuals, aged 18–70 years, were assessed across the four waves (from January to May 2021) through online survey. We collected information about the sociodemographic characteristics of participants, personal experiences of COVID-19 infection, trust, COVID-19 protective behaviours, COVID-19 risk perception, arousal, auto-efficacy, resilience and well-being. Conspiracy mentality was assessed with the Conspiracy Mentality Questionnaire. The statistical analyses included exploratory factorial analyses, Pearson correlations and multiple linear regressions. Results: The conspiracy mentality score during the COVID-19 pandemic was medium–high (mean 59.0 on a 0–100 scale) and slightly increased from 58.2 to 59.9 across months, in parallel with a slight decrease in trust in health institutions and scientific informational sources. Individuals aged >35 years, poorly educated and particularly scared about their financial situation were at risk of showing higher levels of conspirative mentality. Higher levels of conspirative mentality were risk factors for low levels of COVID-19 protective behaviours. Conclusions: Clear and effective communication may improve trust in health institutions and informational sources, decrease conspirative theories and increase compliance with protective behaviour.
- Published
- 2022
27. Joint analysis of the intention to vaccinate and to use contact tracing app during the COVID-19 pandemic
- Author
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Marta Caserotti, Paolo Girardi, Alessandra Tasso, Enrico Rubaltelli, Lorella Lotto, Teresa Gavaruzzi, Caserotti M., Girardi P., Tasso A., Rubaltelli E., Lotto L., and Gavaruzzi T.
- Subjects
Settore M-PSI/01 - Psicologia Generale ,COVID-19 Vaccines ,Science ,COVID-19 Vaccine ,Mobile Application ,Diseases ,Intention ,Article ,NO ,Medical research ,Surveys and Questionnaires ,Psychology ,Humans ,Surveys and Questionnaire ,Settore SECS-S/05 - Statistica Sociale ,Pandemics ,Multidisciplinary ,Pandemic ,Vaccination ,COVID-19 ,Mobile Applications ,Italy ,Medicine ,Contact Tracing ,Settore SECS-S/01 - Statistica ,Human - Abstract
Pharmacological and non-pharmacological measures will overlap for a period after the onset of the pandemic, playing a strong role in virus containment. We explored which factors influence the likelihood to adopt two different preventive measures against the COVID-19 pandemic. An online snowball sampling (May–June 2020) collected a total of 448 questionnaires in Italy. A Bayesian bivariate Gaussian regression model jointly investigated the willingness to get vaccinated against COVID-19 and to download the national contact tracing app. A mixed-effects cumulative logistic model explored which factors affected the motivation to adopt one of the two preventive measures. Despite both COVID-19 vaccines and tracing apps being indispensable tools to contain the spread of SARS-CoV-2, our results suggest that adherence to the vaccine or to the national contact tracing app is not predicted by the same factors. Therefore, public communication on these measures needs to take in consideration not only the perceived risk associated with COVID-19, but also the trust people place in politics and science, their concerns and doubts about vaccinations, and their employment status. Further, the results suggest that the motivation to comply with these measurements was predominantly to protect others rather than self-protection.
- Published
- 2022
28. Who is likely to vacillate in their COVID-19 vaccination decision? Free-riding intention and post-positive reluctance
- Author
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Giovanni de Girolamo, Cristina Zarbo, Valentina Candini, Paolo Girardi, Fabrizio Starace, Sonia Brescianini, Marta Caserotti, Lorella Lotto, Gemma Calamandrei, Alessandra Tasso, Teresa Gavaruzzi, Flavia Chiarotti, Chiara Buizza, Caserotti, M, Gavaruzzi, T, Girardi, P, Tasso, A, Buizza, C, Candini, V, Zarbo, C, Chiarotti, F, Brescianini, S, Calamandrei, G, Starace, F, de Girolamo, G, and Lotto, L
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Settore M-PSI/01 - Psicologia Generale ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,media_common.quotation_subject ,COVID-19, COronaVirus DIsease of 2019 ,VH, Vaccine hesitancy ,Intention ,World Health Organization ,Article ,NO ,COVID-19 ,Free-riding intention ,Post-positive reluctance ,Vaccination hesitancy ,Vaccination intention ,Female ,Humans ,SARS-CoV-2 ,Vaccination ,Vaccination Hesitancy ,Pandemic ,Medicine ,Pace ,media_common ,business.industry ,Magnetic reluctance ,Public Health, Environmental and Occupational Health ,SARS-CoV-2, Severe acute respiratory syndrome CoronaVirus-2 ,EFA, Explorative factorial analysis ,Free riding ,COVID-19 Vaccination intention Vaccination hesitancy Post-positive reluctance Free-riding intention ,Psychological resilience ,business ,Settore SECS-S/01 - Statistica ,Social psychology - Abstract
Despite the actual availability of COVID-19 vaccines to combat the pandemic, many people are still vacillating in their decision to vaccinate. In this study, we considered the effect of two relevant contextual issues on vaccination intention: the number of people infected with COVID-19 is increasing, and the pace of vaccination is gaining speed. Specifically, we hypothesized that having already contracted SARS-CoV-2 (post-positive reluctance) could lead people to underestimate the importance of vaccination. Moreover, as the number of vaccinated people increases, more hesitant people could fall into the free-riding intention category, benefitting from the immunity provided by others' vaccinations. Vaccine hesitancy becomes more critical as the vaccination campaign proceeds: at one point, it will be inevitable to deal with hesitant people. This study is part of a WHO Regional Office for Europe project and involved a representative sample of 5006 Italians interviewed in January-February 2021. In case of post-positive reluctance, both young age and female gender increase vaccine hesitancy, while a high level of education reduces free-riding intention. Considering post-positive reluctance and free riding, a protective effect on hesitancy is associated with negative affective states, adherence to protective behaviors, trust in health information sources, and resilience. In contrast, increased vaccine hesitancy is associated with a high level of conspiracy-mindedness and trust in media information sources. Recognizing and studying the post-positive reluctance and the phenomenon of free-riding people can help us to become more efficient in combatting the virus.
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- 2021
29. The Role of Emotional Competences in Parents’ Vaccine Hesitancy
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Anna Sannino, Alessandra Tasso, A Ferro, Lorella Lotto, Teresa Gavaruzzi, Enrico Rubaltelli, Irene Leo, Marta Caserotti, Elena Fretti, Leonardo Speri, Gavaruzzi T., Caserotti M., Leo I., Tasso A., Speri L., Ferro A., Fretti E., Sannino A., Rubaltelli E., and Lotto L.
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Vaccine safety ,Mediational analysis ,Immunology ,lcsh:Medicine ,emotions ,Article ,decision making ,Developmental psychology ,Emotional competence ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Intervention (counseling) ,Drug Discovery ,Pharmacology (medical) ,030212 general & internal medicine ,Valence (psychology) ,Emotion ,Pharmacology ,lcsh:R ,parents ,vaccines ,Infectious Diseases ,Parent ,attitude ,Vaccine refusal ,Psychology ,Attitude ,Decision making ,Emotions ,Parents ,Vaccines ,Mental image ,Intrapersonal communication - Abstract
The role of parents’ emotional competencies on vaccine hesitancy and decision making has been seldom examined. Two studies investigated the relationship between parents’ attitudes towards childhood vaccines and self-reported behavior (Study 1) and between parents’ emotional competence and attitudes towards vaccines (Study 2). In Study 1, predictors of temporal, partial, or complete vaccine refusal (having voluntarily postponed/forgone some/all vaccines) were examined in 2778 parents. In Study 2, psychological predictors of the attitude towards vaccines were examined in 593 parents, using the Profile of Emotional Competence and the valence of mental images spontaneously associated with the term “vaccine”. In Study 1, attitudes were aggregated in three independent factors (concerns about vaccine safety, diseases prevented by vaccines, and naturalistic views) that independently predicted vaccine refusal. In Study 2, a significant mediational analysis showed a positive indirect effect of intrapersonal emotional competences on attitudes towards vaccines, through mental images associated with the word “vaccine”. Parents’ intrapersonal emotional competences affected all dimensions of attitudes towards vaccines, suggesting that being able to manage, identify, and recognize one’s own emotions is central to vaccine acceptance. These findings suggest that intervention strategies, rather than stressing the pro-social benefits of vaccinating, should focus on aspects related to one’s own emotions.
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- 2021
30. A Web Application About Herd Immunity Using Personalized Avatars: Development Study
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Martin Tremblay-Breault, Beate Sander, Éric Kavanagh, Julie A. Bettinger, Holly O. Witteman, Christine T. Chambers, Anik Giguère, Jacynthe Roberge, S. Michelle Driedger, Hina Hakim, Kumanan Wilson, Jean-Sébastien Paquette, Shannon E. MacDonald, Julie Leask, Daniel Reinharz, Eve Dubé, Elizabeth Parent, Aaron M. Scherer, Teresa Gavaruzzi, Rita Orji, Hakim H., Bettinger J.A., Chambers C.T., Michelle Driedger S., Dube E., Gavaruzzi T., Giguere A.M.C., Kavanagh E., Leask J., MacDonald S.E., Orji R., Parent E., Paquette J.-S., Roberge J., Sander B., Scherer A.M., Tremblay-Breault M., Wilson K., Reinharz D., and Witteman H.O.
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Adult ,Immunity, Herd ,Male ,Population ,Applied psychology ,Health Informatics ,Population health ,lcsh:Computer applications to medicine. Medical informatics ,Avatar ,Community immunity ,Herd immunity ,Vaccination ,Vaccine hesitancy ,Web application ,Female ,Health Communication ,Humans ,Internet ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,herd immunity ,030212 general & internal medicine ,education ,Health communication ,education.field_of_study ,Original Paper ,business.industry ,lcsh:Public aspects of medicine ,Immunity ,avatar ,lcsh:RA1-1270 ,Cognition ,community immunity ,web application ,Herd ,Visualization ,Risk perception ,Community health ,lcsh:R858-859.7 ,vaccine hesitancy ,Psychology ,business - Abstract
Background Herd immunity or community immunity refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving the understanding of community immunity may increase intentions to get vaccinated. Objective This study aims to design a web application about community immunity and optimize it based on users’ cognitive and emotional responses. Methods Our multidisciplinary team developed a web application about community immunity to communicate epidemiological evidence in a personalized way. In our application, people build their own community by creating an avatar representing themselves and 8 other avatars representing people around them, for example, their family or coworkers. The application integrates these avatars in a 2-min visualization showing how different parameters (eg, vaccine coverage, and contact within communities) influence community immunity. We predefined communication goals, created prototype visualizations, and tested four iterative versions of our visualization in a university-based human-computer interaction laboratory and community-based settings (a cafeteria, two shopping malls, and a public library). Data included psychophysiological measures (eye tracking, galvanic skin response, facial emotion recognition, and electroencephalogram) to assess participants’ cognitive and affective responses to the visualization and verbal feedback to assess their interpretations of the visualization’s content and messaging. Results Among 110 participants across all four cycles, 68 (61.8%) were women and 38 (34.5%) were men (4/110, 3.6%; not reported), with a mean age of 38 (SD 17) years. More than half (65/110, 59.0%) of participants reported having a university-level education. Iterative changes across the cycles included adding the ability for users to create their own avatars, specific signals about who was represented by the different avatars, using color and movement to indicate protection or lack of protection from infectious disease, and changes to terminology to ensure clarity for people with varying educational backgrounds. Overall, we observed 3 generalizable findings. First, visualization does indeed appear to be a promising medium for conveying what community immunity is and how it works. Second, by involving multiple users in an iterative design process, it is possible to create a short and simple visualization that clearly conveys a complex topic. Finally, evaluating users’ emotional responses during the design process, in addition to their cognitive responses, offers insights that help inform the final design of an intervention. Conclusions Visualization with personalized avatars may help people understand their individual roles in population health. Our app showed promise as a method of communicating the relationship between individual behavior and community health. The next steps will include assessing the effects of the application on risk perception, knowledge, and vaccination intentions in a randomized controlled trial. This study offers a potential road map for designing health communication materials for complex topics such as community immunity.
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- 2020
31. Sleep disturbance in Inflammatory Bowel Disease: prevalence and risk factors – A cross-sectional study
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Renata D'Incà, Edoardo Savarino, Ilaria Marsilio, Fabiana Zingone, Carla Marinelli, Greta Lorenzon, Teresa Gavaruzzi, Marinelli C., Savarino E.V., Marsilio I., Lorenzon G., Gavaruzzi T., D'Inca R., and Zingone F.
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Adult ,Male ,Sleep Wake Disorders ,medicine.medical_specialty ,Cross-sectional study ,lcsh:Medicine ,Hospital Anxiety and Depression Scale ,Article ,Inflammatory bowel disease ,Pittsburgh Sleep Quality Index ,Young Adult ,03 medical and health sciences ,Medical research ,0302 clinical medicine ,Quality of life ,Internal medicine ,Prevalence ,medicine ,Humans ,Prospective Studies ,lcsh:Science ,Prospective cohort study ,Depression (differential diagnoses) ,Aged ,Aged, 80 and over ,Sleep disorder ,Multidisciplinary ,business.industry ,lcsh:R ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,digestive system diseases ,Cross-Sectional Studies ,Logistic Models ,N/A ,030220 oncology & carcinogenesis ,Quality of Life ,Anxiety ,lcsh:Q ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Inflammatory bowel diseases (IBD) are chronic relapsing disorders that have a negative impact on quality of life. They can be highly disabling and have been associated with sleep disturbance. The aim of our study was to evaluate the sleep quality of a large cohort of IBD patients to identify possible associated cofactors. We prospectively recruited consecutive patients attending the IBD Unit of “Azienda Ospedaliera” of Padua from November 2018 to May 2019 and collected demographics and clinical characteristics. The patients completed the Pittsburgh Sleep Quality Index (PSQI), the IBD questionnaire (IBDQ), the IBD-Disability Index (IBD-DI) questionnaire, and the Hospital Anxiety and Depression Scale (9-HADS). A multivariate regression model was applied to assess independent risk factors of sleep disturbance among IBD-related variables, disability, quality of life, anxiety, and depression. We investigated the sleep quality of 166 patients with IBD, finding 67.5% of them suffering from sleep disturbance. In particular, low quality of life, presence of disability and extraintestinal manifestations were identified as independent risk factors of sleep disturbance. We discovered that all depressed patients were also affected by sleep disturbance, while we found no difference in sleep disturbance between patients with or without anxiety state. However, a positive correlation was reported between both anxiety and depression scores and PSQI score (Spearman correlation: r = 0.31 and r = 0.38 respectively). Our study showed that sleep quality is not directly associated with an active or inactive IBD state or with the ongoing treatment, but it is mostly correlated with the patients’ mood state, disability, and quality of life. Gastroenterologists and psychologists should join forces during clinical outpatients’ visits to evaluate emotional states for a better IBD management.
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- 2020
32. Colonic J-pouch or straight colorectal reconstruction after low anterior resection for rectal cancer: Impact on quality of life and bowel function: A multicenter prospective randomized study
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Daniela Rega, Silvia De Franciscis, Giuseppe La Torre, C. R. Asteria, Dajana Cuicchi, Salvatore Pucciarelli, Francesco Marchegiani, Emilio Morpurgo, Ugo Pace, Paola Del Bianco, Elio Jovine, Paolo Delrio, Gianluca Pellino, Luigi Boccia, Luigi Zorcolo, Lorella Lotto, Francesca Giandomenico, A. Amato, Gian Luca De Salvo, Angelo Restivo, Teresa Gavaruzzi, Gaya Spolverato, Antonio Chiappa, Diego Coletta, Francesco Selvaggi, Francesco Bianco, Gavaruzzi, T., Pace, U., Giandomenico, F., Pucciarelli, S., Bianco, F., Selvaggi, F., Restivo, A., Asteria, C. R., Morpurgo, E., Cuicchi, D., Jovine, E., Coletta, D., La Torre, G., Amato, A., Chiappa, A., Marchegiani, F., Rega, D., De Franciscis, S., Pellino, G., Zorcolo, L., Lotto, L., Boccia, L., Spolverato, G., De Salvo, G. L., Delrio, P., and Del Bianco, P.
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Quality of life ,Male ,Reconstructive surgery ,medicine.medical_specialty ,Colonic Pouche ,Constipation ,Low anterior resection ,Patient Reported Outcome Measure ,Colorectal cancer ,Colon ,Colonic Pouches ,Anastomosis ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,Reconstructive Surgical Procedure ,Patient Reported Outcome Measures ,Bowel function ,Rectal cancer ,Patient-reported outcome ,Gynecology ,Patient-reported outcomes ,Proctectomy ,business.industry ,Rectal Neoplasms ,Anastomosis, Surgical ,Gastroenterology ,Postoperative complication ,General Medicine ,J-pouch reconstruction ,Plastic Surgery Procedures ,Middle Aged ,medicine.disease ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Postoperative Complication ,medicine.symptom ,Pouch ,business ,Colorectal Surgery ,Human - Abstract
BACKGROUND Patient-reported outcomes associated with different bowel reconstruction techniques following anterior resection for rectal cancer are still a matter of debate. OBJECTIVE This study aimed to assess quality of life and bowel function in patients who underwent colonic J-pouch or straight colorectal anastomosis reconstruction after low anterior resection. DESIGN Bowel function and quality of life were assessed within a multicenter randomized trial. Questionnaires were administered before the surgery (baseline) and at 6, 12, and 24 months after surgery. SETTINGS Patients were enrolled by 19 centers. The enrollment started in October 2009 and was stopped in February 2016. The study was registered at www.clinicaltrials.gov (Identifier: NCT01110798). PATIENTS Patients who underwent low anterior resection for primary mid-low rectal cancer and who were randomly assigned in a 1:1 ratio to receive either stapled colonic J-pouch or straight colorectal anastomosis were selected. MAIN OUTCOME MEASURES The primary outcomes measured were quality of life and bowel function. RESULTS Of the 379 patients who were evaluable, 312 (82.3%) completed the baseline, 259 (68.3%) the 6-month, 242 (63.9%) the 12-month, and 199 (52.5%) the 24-month assessment. Bowel functioning and quality of life did not significantly differ between arms for almost all domains. The total bowel function score, the urgency, and the stool fractionation scores significantly worsened after surgery and remained impaired over time in both arms (p < 0.0032), whereas constipation improved after surgery but recovered to baseline levels from 1 year onward (p < 0.0036). All patients showed a significant and continuous improvement in emotional functioning (p < 0.0013) and future perspective (p < 0.0001) from baseline to the end of the study. LIMITATIONS Limitations of the study include missing data, which increased over time; the possibility that some treatments have slightly changed since the study was conducted; and investigators not blind to treatment allocation. CONCLUSION The findings of this study do not support the routine use of colonic J-pouch reconstruction in patients with rectal cancer who undergo a low anterior resection. See Video Abstract at http://links.lww.com/DCR/B328. BOLSA J COLONICA O RECONSTRUCCION COLORRECTAL RECTA DESPUES DE RESECCION ANTERIOR BAJA PARA CANCER RECTAL: IMPACTO EN LA CALIDAD DE VIDA Y LA FUNCION INTESTINAL: UN ESTUDIO ALEATORIZADO PROSPECTIVO MULTICENTRICO: Los resultados informados por el paciente asociados con diferentes tecnicas de reconstruccion intestinal despues de la reseccion anterior para el cancer de recto aun son tema de debate.Evaluar la calidad de vida y la funcion intestinal en pacientes que se sometieron a una bolsa en J colonica o reconstruccion de anastomosis colorrectal recta despues de una reseccion anterior baja.La funcion intestinal y la calidad de vida se evaluaron en un ensayo aleatorizado multicentrico. Los cuestionarios se administraron antes de la cirugia (basal) y a los 6, 12 y 24 meses despues de la cirugia.Los pacientes fueron incluidos en 19 centros. La inscripcion comenzo en Octubre de 2009 y se detuvo en Febrero de 2016. El estudio se registro en www.clinicaltrials.gov (Identificador: NCT01110798).Pacientes que se sometieron a reseccion anterior baja por cancer rectal primario medio-bajo y que fueron aleatorizados en una proporcion de 1: 1 para recibir bolsa J colonica con grapas o anastomosis colorrectal recta.calidad de vida y funcion intestinal.De los 379 pacientes que fueron evaluables, 312 (82.3%) completaron la evaluacion inicial, 259 (68.3%) a los 6 meses, 242 (63.9%) a los 12 meses y 199 (52.5%) a los 24 meses. . El funcionamiento intestinal y la calidad de vida no difirieron significativamente entre los dos grupos en casi todos los dominios. La puntuacion total de la funcion intestinal, la urgencia y las puntuaciones de fraccionamiento de las heces empeoraron significativamente despues de la cirugia y continuaron con el tiempo extra en ambos grupos (p
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- 2020
33. To vaccinate or not to vaccinate? The interplay between pro- and against- vaccination reasons.
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Caserotti M, Girardi P, Sellaro R, Rubaltelli E, Tasso A, Lotto L, and Gavaruzzi T
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- Adult, Humans, Vaccination, Communication, Educational Status, COVID-19 Vaccines, COVID-19 epidemiology, COVID-19 prevention & control
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Background: By mid 2023, European countries reached 75% of vaccine coverage for COVID-19 and although vaccination rates are quite high, many people are still hesitant. A plethora of studies have investigated factors associated with COVID-19 vaccine hesitancy, however, insufficient attention has been paid to the reasons why people get vaccinated against COVID-19. Our work aims to investigate the role of reasons in the decision to get vaccinated against COVID-19 in a representative sample of 1,689 adult Italians (March-April 2021) balanced in terms of age, gender, educational level and area of residence., Methods: Through an online questionnaire, we asked participants to freely report up to three reasons for and against COVID-19 vaccination, and the weight each had in the decision to get vaccinated. We first investigated the role of emotional competence and COVID-19 risk perception in the generation of both reasons using regression models. Next, we studied the role that the different reasons had in the vaccination decision, considering both the intention to vaccinate (using a beta regression model) and the decision made by the participants who already had the opportunity to get vaccinated (using a logistic regression model). Finally, two different classification tree analyses were carried out to characterize profiles with a low or high willingness to get vaccinated or with a low or high probability to accept/book the vaccine., Results: High emotional competence positively influences the generation of both reasons (ORs > 1.5), whereas high risk perception increases the generation of positive reasons (ORs > 1.4) while decreasing reasons against vaccination (OR = 0.64). As pro-reasons increase, vaccination acceptance increases, while the opposite happens as against-reasons increase (all p < 0.001). One strong reason in favor of vaccines is enough to unbalance the decision toward acceptance of vaccination, even when reasons against it are also present (p < 0.001). Protection and absence of distrust are the reasons that mostly drive willingness to be vaccinated and acceptance of an offered vaccine., Conclusions: Knowing the reasons that drive people's decision about such an important choice can suggest new communication insights to reduce possible negative reactions toward vaccination and people's hesitancy. Results are discussed considering results of other national and international studies., (© 2023. The Author(s).)
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- 2023
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34. Decision aids to assist patients and professionals in choosing the right treatment for kidney failure.
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Bekker HL, Winterbottom AE, Gavaruzzi T, Finderup J, and Mooney A
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Background: Kidney services vary in the way they involve people with kidney failure (PwKF) in treatment decisions as management needs change. We discuss how decision-science applications support proactively PwKF to make informed decisions between treatment options with kidney professionals., Methods: A conceptual review of findings about decision making and use of decision aids in kidney services, synthesized with reference to: the Making Informed Decisions-Individually and Together (MIND-IT) multiple stakeholder decision makers framework; and the Medical Research Council-Complex Intervention Development and Evaluation research framework., Results: This schema represents the different types of decision aids that support PwKF and professional reasoning as they manage kidney disease individually and together; adjustments at micro, meso and macro levels supports integration in practice., Conclusion: Innovating services to meet clinical guidelines on enhancing shared decision making processes means enabling all stakeholders to use decision aids to meet their goals within kidney pathways at individual, service and organizational levels., Competing Interests: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.)
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- 2023
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35. Communication and shared decision-making after stillbirth: Results of the ShaDeS study.
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Ravaldi C, Mercuro C, Mosconi L, Roper F, Lotto L, Vannacci A, and Gavaruzzi T
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- Pregnancy, Humans, Female, Cross-Sectional Studies, Patient Participation, Communication, Decision Making, Stillbirth
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Background: Shared decision-making (SDM) is included in guidelines for bereavement care after a stillbirth, as it can improve women's long-term health and wellbeing. SDM within the stillbirth context is still not common, and Italy does not yet have standardised guidelines., Aim: The ShaDeS (Shared Decision-Making in Stillbirth) study aims to investigate how Italian women with a stillbirth perceive their own centrality in decision-making processes around bereavement care and how this might impact satisfaction of care., Methods: The ShaDeS study is a cross-sectional study based on a web survey consisted of four sections: sociodemographic information and medical history, communication of bad news and bereavement care, decisions about childbirth (SDM-Q-9, SHARED, and DCS), and decisions and communication about autopsy (CPS)., Findings: 187 women answered the survey. For the 41.1% of women that did not have an emergency childbirth, the SDM-Q-9 median score was 66.6 (0-100 range), and the SHARED median score was 3.5 (1-5 range). 29.4% of participants reached the proposed cutoff of 37.5 in the DCS (0-100 range) suggesting a difficulty in reaching decisions. Satisfaction scores were lower for those with such difficulties (p < 0.0001). Of the 64.5% of women that discussed autopsy, 28.3% were involved in an SDM approach, despite this being associated with higher levels of satisfaction of care (p < 0.05)., Conclusion: An SDM approach is only moderately widespread amongst our participants, despite it being significantly related to higher levels of satisfaction. Further studies should investigate the tools that both patients and healthcare professionals need for an SDM approach., Competing Interests: Conflict of interest None to declare., (Copyright © 2023 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)
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- 2023
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36. The Interplay of Perceived Risks and Benefits in Deciding to Become Vaccinated against COVID-19 While Pregnant or Breastfeeding: A Cross-Sectional Study in Italy.
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Gavaruzzi T, Caserotti M, Bonaiuti R, Bonanni P, Crescioli G, Di Tommaso M, Lombardi N, Lotto L, Ravaldi C, Rubaltelli E, Tasso A, Vannacci A, and Girardi P
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The present study examined the role of the perception of risks and benefits for the mother and her babies in deciding about the COVID-19 vaccination. In this cross-sectional study, five hypotheses were tested using data from a convenience sample of Italian pregnant and/or breastfeeding women (N = 1104, July-September 2021). A logistic regression model estimated the influence of the predictors on the reported behavior, and a beta regression model was used to evaluate which factors influenced the willingness to become vaccinated among unvaccinated women. The COVID-19 vaccination overall risks/benefits tradeoff was highly predictive of both behavior and intention. Ceteris paribus, an increase in the perception of risks for the baby weighed more against vaccination than a similar increase in the perception of risks for the mother. Additionally, pregnant women resulted in being less likely (or willing) to be vaccinated in their status than breastfeeding women, but they were equally accepting of vaccination if they were not pregnant. COVID-19 risk perception predicted intention to become vaccinated, but not behavior. In conclusion, the overall risks/benefits tradeoff is key in predicting vaccination behavior and intention, but the concerns for the baby weigh more than those for the mother in the decision, shedding light on this previously neglected aspect.
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- 2023
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37. People's perspectives about COVID-19 vaccination certificate: Findings from a representative Italian sample.
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Caserotti M, Gavaruzzi T, Girardi P, Sellaro R, Rubaltelli E, Tasso A, and Lotto L
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- Humans, Vaccination, Vaccination Coverage, Italy epidemiology, COVID-19 Vaccines, COVID-19 epidemiology, COVID-19 prevention & control
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In Italy, like in other countries, issues still exist regarding how to reach high vaccine coverage and several countries have considered policies to increase vaccine uptake. In the present study, we focused on people who have a favorable attitude towards vaccination. In March-April 2021, we asked a representative sample of Italian participants (N = 1,530) to assess to what extent they would support the adoption of a COVID-19 vaccination certificate, excluding unvaccinated people from participating in public and cultural events. Furthermore, as the vaccination coverage increases, severe forms of COVID-19 requiring hospitalization more likely involve unvaccinated individuals, who might be perceived as those who don't contribute to ending the pandemic and who constitute a significant health cost for society. We then asked participants to assess to what extent they would favor the idea of requiring people who refuse the vaccine to pay for their own medical expenses in case of hospitalization. We hypothesized that support for the adoption of the vaccination certificate would be predicted by the COVID-19 vaccination status (received, booked, high-, medium-, low-willingness to be vaccinated, or refused) and by the same factors that are known to affect the willingness to get vaccinated. These factors were also tested in a model aimed at investigating if a vaccinated person would favor a measure requiring the unvaccinated individuals to pay for medical expenses. Results confirmed that the support towards the vaccination certificate policy was strongly predicted by the vaccination status and by factors known to affect the willingness to get vaccinated. Interestingly (and surprisingly), a similar pattern was observed for the support of the policy about medical expenses. In conclusion, support for a COVID-19 vaccination certificate was high among the Italian population in the early phases of the vaccination rollout. The findings are discussed considering potential policies to tackle the pandemic., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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38. Psychological well-being during the COVID-19 pandemic in Italy assessed in a four-waves survey.
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de Girolamo G, Ferrari C, Candini V, Buizza C, Calamandrei G, Caserotti M, Gavaruzzi T, Girardi P, Habersaat KB, Lotto L, Scherzer M, Starace F, Tasso A, Zamparini M, and Zarbo C
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- Humans, Pandemics, Cross-Sectional Studies, Surveys and Questionnaires, Mental Health, Italy epidemiology, COVID-19 epidemiology
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COVID-19 pandemic had a negative impact on the mental health and well-being (WB) of citizens. This cross-sectional study included 4 waves of data collection aimed at identifying profiles of individuals with different levels of WB. The study included a representative stratified sample of 10,013 respondents in Italy. The WHO 5-item well-being scale (WHO-5) was used for the assessment of WB. Different supervised machine learning approaches (multinomial logistic regression, partial least-square discriminant analysis-PLS-DA-, classification tree-CT-) were applied to identify individual characteristics with different WB scores, first in waves 1-2 and, subsequently, in waves 3 and 4. Forty-one percent of participants reported "Good WB", 30% "Poor WB", and 28% "Depression". Findings carried out using multinomial logistic regression show that Resilience was the most important variable able for discriminating the WB across all waves. Through the PLS-DA, Increased Unhealthy Behaviours proved to be the more important feature in the first two waves, while Financial Situation gained most relevance in the last two. COVID-19 Perceived Risk was relevant, but less than the other variables, across all waves. Interestingly, using the CT we were able to establish a cut-off for Resilience (equal to 4.5) that discriminated good WB with a probability of 65% in wave 4. Concluding, we found that COVID-19 had negative implications for WB. Governments should support evidence-based strategies considering factors that influence WB (i.e., Resilience, Perceived Risk, Healthy Behaviours, and Financial Situation)., (© 2022. The Author(s).)
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- 2022
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39. Where are we in shared decision-making in Italy? A brief updated review.
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Gavaruzzi T
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- Germany, Humans, Italy, Patient Participation, Decision Making, Decision Making, Shared
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The aim of this paper is to provide an overview of the current state of the art concerning patient-centred care (PCC), shared decision-making (SDM), and patient involvement in health care in Italy, by updating the previous versions of the review. In the past 5 years some progress has been made towards a higher involvement of patients in their health care and patient-centredness into the national health care system. The updated scoping literature search focused on articles reporting primary data collected in Italy and showed a great increase in the number of publications. Nonetheless, the research efforts are still relatively sporadic compared to other countries especially as for evaluations of interventions and, most notably, they are not driven by a consistent effort to promote SDM and PCC in clinical practice., (Copyright © 2022. Published by Elsevier GmbH.)
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- 2022
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40. COVID-19 Vaccine Hesitancy in Italy: Predictors of Acceptance, Fence Sitting and Refusal of the COVID-19 Vaccination.
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Zarbo C, Candini V, Ferrari C, d'Addazio M, Calamandrei G, Starace F, Caserotti M, Gavaruzzi T, Lotto L, Tasso A, Zamparini M, and de Girolamo G
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- Cross-Sectional Studies, Humans, SARS-CoV-2, Vaccination psychology, COVID-19 epidemiology, COVID-19 prevention & control, COVID-19 Vaccines, Vaccination Hesitancy
- Abstract
Background: The hesitancy in taking the COVID-19 vaccine is a global challenge. The need to identify predictors of COVID-19 vaccine reluctance is critical. Our objectives were to evaluate sociodemographic, psychological, and behavioral factors, as well as attitudes and beliefs that influence COVID-19 vaccination hesitancy in the general population of Italy., Methods: A total of 2,015 people were assessed in two waves (March, April and May, 2021). Participants were divided into three groups: (1) individuals who accepted the vaccination ("accepters"); (2) individuals who refused the vaccination ("rejecters"); and (3) individuals who were uncertain about their attitudes toward the vaccination ("fence sitters"). Group comparisons were performed using ANOVA, the Kruskal-Wallis test and chi-square tests. The strength of the association between the groups and the participants' characteristics was analyzed using a series of multinomial logistic regression models with bootstrap internal validation (one for each factor)., Results: The "fence sitters" group, when compared to the others, included individuals of younger age, lower educational level, and worsening economic situation in the previous 3 months. After controlling for sociodemographic factors, the following features emerged as the main risk factors for being "fence sitters" (compared with vaccine "accepters"): reporting lower levels of protective behaviors, trust in institutions and informational sources, frequency of use of informational sources, agreement with restrictions and higher conspirative mentality. Higher levels of COVID-19 perceived risk, trust in institutions and informational sources, frequency of use of informational sources, agreement with restrictions and protective behaviors were associated with a higher likelihood of becoming "fence sitters" rather than vaccine "rejecters.", Conclusions: The "fence sitters" profile revealed by this study is intriguing and should be the focus of public programmes aimed at improving adherence to the COVID-19 vaccination campaign., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zarbo, Candini, Ferrari, d'Addazio, Calamandrei, Starace, Caserotti, Gavaruzzi, Lotto, Tasso, Zamparini and de Girolamo.)
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- 2022
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41. Joint analysis of the intention to vaccinate and to use contact tracing app during the COVID-19 pandemic.
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Caserotti M, Girardi P, Tasso A, Rubaltelli E, Lotto L, and Gavaruzzi T
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- Humans, Intention, Italy epidemiology, Surveys and Questionnaires, Vaccination, COVID-19 prevention & control, COVID-19 Vaccines administration & dosage, Contact Tracing methods, Mobile Applications statistics & numerical data, Pandemics prevention & control
- Abstract
Pharmacological and non-pharmacological measures will overlap for a period after the onset of the pandemic, playing a strong role in virus containment. We explored which factors influence the likelihood to adopt two different preventive measures against the COVID-19 pandemic. An online snowball sampling (May-June 2020) collected a total of 448 questionnaires in Italy. A Bayesian bivariate Gaussian regression model jointly investigated the willingness to get vaccinated against COVID-19 and to download the national contact tracing app. A mixed-effects cumulative logistic model explored which factors affected the motivation to adopt one of the two preventive measures. Despite both COVID-19 vaccines and tracing apps being indispensable tools to contain the spread of SARS-CoV-2, our results suggest that adherence to the vaccine or to the national contact tracing app is not predicted by the same factors. Therefore, public communication on these measures needs to take in consideration not only the perceived risk associated with COVID-19, but also the trust people place in politics and science, their concerns and doubts about vaccinations, and their employment status. Further, the results suggest that the motivation to comply with these measurements was predominantly to protect others rather than self-protection., (© 2022. The Author(s).)
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- 2022
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42. Who is likely to vacillate in their COVID-19 vaccination decision? Free-riding intention and post-positive reluctance.
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Caserotti M, Gavaruzzi T, Girardi P, Tasso A, Buizza C, Candini V, Zarbo C, Chiarotti F, Brescianini S, Calamandrei G, Starace F, de Girolamo G, and Lotto L
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- Female, Humans, Intention, SARS-CoV-2, Vaccination, Vaccination Hesitancy, World Health Organization, COVID-19, COVID-19 Vaccines
- Abstract
Despite the actual availability of COVID-19 vaccines to combat the pandemic, many people are still vacillating in their decision to vaccinate. In this study, we considered the effect of two relevant contextual issues on vaccination intention: the number of people infected with COVID-19 is increasing, and the pace of vaccination is gaining speed. Specifically, we hypothesized that having already contracted SARS-CoV-2 (post-positive reluctance) could lead people to underestimate the importance of vaccination. Moreover, as the number of vaccinated people increases, more hesitant people could fall into the free-riding intention category, benefitting from the immunity provided by others' vaccinations. Vaccine hesitancy becomes more critical as the vaccination campaign proceeds: at one point, it will be inevitable to deal with hesitant people. This study is part of a WHO Regional Office for Europe project and involved a representative sample of 5006 Italians interviewed in January-February 2021. In case of post-positive reluctance, both young age and female gender increase vaccine hesitancy, while a high level of education reduces free-riding intention. Considering post-positive reluctance and free riding, a protective effect on hesitancy is associated with negative affective states, adherence to protective behaviors, trust in health information sources, and resilience. In contrast, increased vaccine hesitancy is associated with a high level of conspiracy-mindedness and trust in media information sources. Recognizing and studying the post-positive reluctance and the phenomenon of free-riding people can help us to become more efficient in combatting the virus., (Copyright © 2021 Elsevier Inc. All rights reserved.)
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- 2022
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43. Clarifying Values: An Updated and Expanded Systematic Review and Meta-Analysis.
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Witteman HO, Ndjaboue R, Vaisson G, Dansokho SC, Arnold B, Bridges JFP, Comeau S, Fagerlin A, Gavaruzzi T, Marcoux M, Pieterse A, Pignone M, Provencher T, Racine C, Regier D, Rochefort-Brihay C, Thokala P, Weernink M, White DB, Wills CE, and Jansen J
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- Humans, Research Design, Decision Support Techniques, Patient Participation
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Background: Patient decision aids should help people make evidence-informed decisions aligned with their values. There is limited guidance about how to achieve such alignment., Purpose: To describe the range of values clarification methods available to patient decision aid developers, synthesize evidence regarding their relative merits, and foster collection of evidence by offering researchers a proposed set of outcomes to report when evaluating the effects of values clarification methods., Data Sources: MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, and CINAHL., Study Selection: We included articles that described randomized trials of 1 or more explicit values clarification methods. From 30,648 records screened, we identified 33 articles describing trials of 43 values clarification methods., Data Extraction: Two independent reviewers extracted details about each values clarification method and its evaluation., Data Synthesis: Compared to control conditions or to implicit values clarification methods, explicit values clarification methods decreased the frequency of values-incongruent choices (risk difference, -0.04; 95% confidence interval [CI], -0.06 to -0.02; P < 0.001) and decisional conflict (standardized mean difference, -0.20; 95% CI, -0.29 to -0.11; P < 0.001). Multicriteria decision analysis led to more values-congruent decisions than other values clarification methods (χ
2 = 9.25, P = 0.01). There were no differences between different values clarification methods regarding decisional conflict (χ2 = 6.08, P = 0.05)., Limitations: Some meta-analyses had high heterogeneity. We grouped values clarification methods into broad categories., Conclusions: Current evidence suggests patient decision aids should include an explicit values clarification method. Developers may wish to specifically consider multicriteria decision analysis. Future evaluations of values clarification methods should report their effects on decisional conflict, decisions made, values congruence, and decisional regret.- Published
- 2021
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44. Do Personal Stories Make Patient Decision Aids More Effective? An Update from the International Patient Decision Aids Standards.
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Shaffer VA, Brodney S, Gavaruzzi T, Zisman-Ilani Y, Munro S, Smith SK, Thomas E, Valentine KD, and Bekker HL
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- Decision Making, Humans, Narration, Decision Support Techniques, Patient Participation
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Background: This article evaluates the evidence for the inclusion of patient narratives in patient decision aids (PtDAs). We define patient narratives as stories, testimonials, or anecdotes that provide illustrative examples of the experiences of others that are relevant to the decision at hand., Method: To evaluate the evidence for the effectiveness of narratives in PtDAs, we conducted a narrative scoping review of the literature from January 2013 through June 2019 to identify relevant literature published since the last International Patient Decision Aid Standards (IPDAS) update in 2013. We considered research articles that examined the impact of narratives on relevant outcomes or described relevant theoretical mechanisms., Results: The majority of the empirical work on narratives did not measure concepts that are typically found in the PtDA literature (e.g., decisional conflict). Yet, a few themes emerged from our review that can be applied to the PtDA context, including the impact of narratives on relevant outcomes (knowledge, behavior change, and psychological constructs), as well as several theoretical mechanisms about how and why narratives work that can be applied to the PtDA context., Conclusion: Based on this evidence update, we suggest that there may be situations when narratives could enhance the effectiveness of PtDAs. The recent theoretical work on narratives has underscored the fact that narratives are a multifaceted construct and should no longer be considered a binary option (include narratives or not). However, the bottom line is that the evidence does not support a recommendation for narratives to be a necessary component of PtDAs.
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- 2021
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45. The Authors Reply.
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Gavaruzzi T, Pucciarelli S, Lotto L, Spolverato G, and Del Bianco P
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- 2021
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46. The Role of Emotional Competences in Parents' Vaccine Hesitancy.
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Gavaruzzi T, Caserotti M, Leo I, Tasso A, Speri L, Ferro A, Fretti E, Sannino A, Rubaltelli E, and Lotto L
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The role of parents' emotional competencies on vaccine hesitancy and decision making has been seldom examined. Two studies investigated the relationship between parents' attitudes towards childhood vaccines and self-reported behavior (Study 1) and between parents' emotional competence and attitudes towards vaccines (Study 2). In Study 1, predictors of temporal, partial, or complete vaccine refusal (having voluntarily postponed/forgone some/all vaccines) were examined in 2778 parents. In Study 2, psychological predictors of the attitude towards vaccines were examined in 593 parents, using the Profile of Emotional Competence and the valence of mental images spontaneously associated with the term "vaccine". In Study 1, attitudes were aggregated in three independent factors (concerns about vaccine safety; diseases prevented by vaccines; and naturalistic views) that independently predicted vaccine refusal. In Study 2, a significant mediational analysis showed a positive indirect effect of intrapersonal emotional competences on attitudes towards vaccines, through mental images associated with the word "vaccine". Parents' intrapersonal emotional competences affected all dimensions of attitudes towards vaccines, suggesting that being able to manage, identify, and recognize one's own emotions is central to vaccine acceptance. These findings suggest that intervention strategies, rather than stressing the pro-social benefits of vaccinating, should focus on aspects related to one's own emotions.
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- 2021
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47. Associations of COVID-19 risk perception with vaccine hesitancy over time for Italian residents.
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Caserotti M, Girardi P, Rubaltelli E, Tasso A, Lotto L, and Gavaruzzi T
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- Adult, Aged, Communicable Disease Control, Cross-Sectional Studies, Female, Humans, Influenza Vaccines administration & dosage, Italy, Male, Middle Aged, COVID-19 prevention & control, COVID-19 Vaccines administration & dosage, Risk Assessment, Vaccination psychology
- Abstract
Rationale: Many countries were and are still struggling with the COVID-19 emergency. Despite efforts to limit the viral transmission, the vaccine is the only solution to ending the pandemic. However, vaccine hesitancy could reduce coverage and hinder herd immunity., Objective: People's intention to get vaccinated can be shaped by several factors, including risk perception which, in turn, is influenced by affect. The present work aimed at investigating how risk perception and some factors associated with the decision to comply with vaccination modulated vaccine acceptance for COVID-19 as compared to seasonal influenza, and how these have varied during the lockdown phases., Method: The study followed the main phases of the emergency in Italy, investigating the intention to get vaccinated against flu and against SARS-CoV-2 (if a vaccine was available) before, during and after the first national lockdown, covering the period from the end of February to the end of June 2020. We investigated the effect of risk perception and other predictors on the decision of getting vaccinated., Results: Compared to the pre-lockdown phase, during the lockdown more people were willing to get vaccinated for COVID-19, regardless of their beliefs about vaccines, and as risk perception increased, so did the intention to accept the vaccine. The acceptance of the flu vaccine increased after the re-opening phase. In addition, the intention to get vaccinated against COVID-19 and against flu increased if there was previous flu vaccination behavior but decreased with increasing doubts about the vaccines in general., Conclusions: The observation of vaccination intentions across the three main phases of the emergency allows important considerations regarding psychological, affect, and demographic determinants useful to tailor public health communication to improve public response to future epidemics., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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48. Colonic J-Pouch or Straight Colorectal Reconstruction After Low Anterior Resection For Rectal Cancer: Impact on Quality of Life and Bowel Function: A Multicenter Prospective Randomized Study.
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Gavaruzzi T, Pace U, Giandomenico F, Pucciarelli S, Bianco F, Selvaggi F, Restivo A, Asteria CR, Morpurgo E, Cuicchi D, Jovine E, Coletta D, La Torre G, Amato A, Chiappa A, Marchegiani F, Rega D, De Franciscis S, Pellino G, Zorcolo L, Lotto L, Boccia L, Spolverato G, De Salvo GL, Delrio P, and Del Bianco P
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- Colorectal Surgery methods, Female, Humans, Male, Middle Aged, Patient Reported Outcome Measures, Anastomosis, Surgical adverse effects, Anastomosis, Surgical methods, Colon physiopathology, Colonic Pouches adverse effects, Postoperative Complications etiology, Postoperative Complications physiopathology, Postoperative Complications psychology, Proctectomy adverse effects, Proctectomy methods, Plastic Surgery Procedures adverse effects, Plastic Surgery Procedures methods, Rectal Neoplasms pathology, Rectal Neoplasms psychology, Rectal Neoplasms surgery
- Abstract
Background: Patient-reported outcomes associated with different bowel reconstruction techniques following anterior resection for rectal cancer are still a matter of debate., Objective: This study aimed to assess quality of life and bowel function in patients who underwent colonic J-pouch or straight colorectal anastomosis reconstruction after low anterior resection., Design: Bowel function and quality of life were assessed within a multicenter randomized trial. Questionnaires were administered before the surgery (baseline) and at 6, 12, and 24 months after surgery., Settings: Patients were enrolled by 19 centers. The enrollment started in October 2009 and was stopped in February 2016. The study was registered at www.clinicaltrials.gov (Identifier: NCT01110798)., Patients: Patients who underwent low anterior resection for primary mid-low rectal cancer and who were randomly assigned in a 1:1 ratio to receive either stapled colonic J-pouch or straight colorectal anastomosis were selected., Main Outcome Measures: The primary outcomes measured were quality of life and bowel function., Results: Of the 379 patients who were evaluable, 312 (82.3%) completed the baseline, 259 (68.3%) the 6-month, 242 (63.9%) the 12-month, and 199 (52.5%) the 24-month assessment. Bowel functioning and quality of life did not significantly differ between arms for almost all domains. The total bowel function score, the urgency, and the stool fractionation scores significantly worsened after surgery and remained impaired over time in both arms (p < 0.0032), whereas constipation improved after surgery but recovered to baseline levels from 1 year onward (p < 0.0036). All patients showed a significant and continuous improvement in emotional functioning (p < 0.0013) and future perspective (p < 0.0001) from baseline to the end of the study., Limitations: Limitations of the study include missing data, which increased over time; the possibility that some treatments have slightly changed since the study was conducted; and investigators not blind to treatment allocation., Conclusion: The findings of this study do not support the routine use of colonic J-pouch reconstruction in patients with rectal cancer who undergo a low anterior resection. See Video Abstract at http://links.lww.com/DCR/B328. BOLSA J COLÓNICA O RECONSTRUCCIÓN COLORRECTAL RECTA DESPUÉS DE RESECCIÓN ANTERIOR BAJA PARA CÁNCER RECTAL: IMPACTO EN LA CALIDAD DE VIDA Y LA FUNCIÓN INTESTINAL: UN ESTUDIO ALEATORIZADO PROSPECTIVO MULTICÉNTRICO: Los resultados informados por el paciente asociados con diferentes técnicas de reconstrucción intestinal después de la resección anterior para el cáncer de recto aún son tema de debate.Evaluar la calidad de vida y la función intestinal en pacientes que se sometieron a una bolsa en J colónica o reconstrucción de anastomosis colorrectal recta después de una resección anterior baja.La función intestinal y la calidad de vida se evaluaron en un ensayo aleatorizado multicéntrico. Los cuestionarios se administraron antes de la cirugía (basal) y a los 6, 12 y 24 meses después de la cirugía.Los pacientes fueron incluidos en 19 centros. La inscripción comenzó en Octubre de 2009 y se detuvo en Febrero de 2016. El estudio se registró en www.clinicaltrials.gov (Identificador: NCT01110798).Pacientes que se sometieron a resección anterior baja por cáncer rectal primario medio-bajo y que fueron aleatorizados en una proporción de 1: 1 para recibir bolsa J colónica con grapas o anastomosis colorrectal recta.calidad de vida y función intestinal.De los 379 pacientes que fueron evaluables, 312 (82.3%) completaron la evaluación inicial, 259 (68.3%) a los 6 meses, 242 (63.9%) a los 12 meses y 199 (52.5%) a los 24 meses. . El funcionamiento intestinal y la calidad de vida no difirieron significativamente entre los dos grupos en casi todos los dominios. La puntuación total de la función intestinal, la urgencia y las puntuaciones de fraccionamiento de las heces empeoraron significativamente después de la cirugía y continuaron con el tiempo extra en ambos grupos (p <0.0032), mientras que el estreñimiento mejoró después de la cirugía pero se recuperó a los niveles basales a partir de 1 año en adelante (p <0.0036). Todos los pacientes mostraron una mejora significativa y continua en el funcionamiento emocional (p <0.0013) y la perspectiva futura (<0.0001) desde el inicio hasta el final del estudio.Datos faltantes, que aumentaron con el tiempo; la posibilidad de que algunos tratamientos hayan cambiado ligeramente desde que se realizó el estudio; investigadores no cegados a la asignación del tratamiento.Los hallazgos de este estudio no respaldan el uso rutinario de la reconstrucción de la bolsa J colónica en pacientes con cáncer rectal que se someten a una resección anterior baja. Consulte Video Resumen en http://links.lww.com/DCR/B328. (Traducción-Dr. Yesenia Rojas-Khalil).
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- 2020
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49. A Web Application About Herd Immunity Using Personalized Avatars: Development Study.
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Hakim H, Bettinger JA, Chambers CT, Driedger SM, Dubé E, Gavaruzzi T, Giguere AMC, Kavanagh É, Leask J, MacDonald SE, Orji R, Parent E, Paquette JS, Roberge J, Sander B, Scherer AM, Tremblay-Breault M, Wilson K, Reinharz D, and Witteman HO
- Subjects
- Adult, Female, Humans, Internet, Male, Health Communication methods, Immunity, Herd physiology, Vaccination methods
- Abstract
Background: Herd immunity or community immunity refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving the understanding of community immunity may increase intentions to get vaccinated., Objective: This study aims to design a web application about community immunity and optimize it based on users' cognitive and emotional responses., Methods: Our multidisciplinary team developed a web application about community immunity to communicate epidemiological evidence in a personalized way. In our application, people build their own community by creating an avatar representing themselves and 8 other avatars representing people around them, for example, their family or coworkers. The application integrates these avatars in a 2-min visualization showing how different parameters (eg, vaccine coverage, and contact within communities) influence community immunity. We predefined communication goals, created prototype visualizations, and tested four iterative versions of our visualization in a university-based human-computer interaction laboratory and community-based settings (a cafeteria, two shopping malls, and a public library). Data included psychophysiological measures (eye tracking, galvanic skin response, facial emotion recognition, and electroencephalogram) to assess participants' cognitive and affective responses to the visualization and verbal feedback to assess their interpretations of the visualization's content and messaging., Results: Among 110 participants across all four cycles, 68 (61.8%) were women and 38 (34.5%) were men (4/110, 3.6%; not reported), with a mean age of 38 (SD 17) years. More than half (65/110, 59.0%) of participants reported having a university-level education. Iterative changes across the cycles included adding the ability for users to create their own avatars, specific signals about who was represented by the different avatars, using color and movement to indicate protection or lack of protection from infectious disease, and changes to terminology to ensure clarity for people with varying educational backgrounds. Overall, we observed 3 generalizable findings. First, visualization does indeed appear to be a promising medium for conveying what community immunity is and how it works. Second, by involving multiple users in an iterative design process, it is possible to create a short and simple visualization that clearly conveys a complex topic. Finally, evaluating users' emotional responses during the design process, in addition to their cognitive responses, offers insights that help inform the final design of an intervention., Conclusions: Visualization with personalized avatars may help people understand their individual roles in population health. Our app showed promise as a method of communicating the relationship between individual behavior and community health. The next steps will include assessing the effects of the application on risk perception, knowledge, and vaccination intentions in a randomized controlled trial. This study offers a potential road map for designing health communication materials for complex topics such as community immunity., (©Hina Hakim, Julie A Bettinger, Christine T Chambers, S Michelle Driedger, Eve Dubé, Teresa Gavaruzzi, Anik M C Giguere, Éric Kavanagh, Julie Leask, Shannon E MacDonald, Rita Orji, Elizabeth Parent, Jean-Sébastien Paquette, Jacynthe Roberge, Beate Sander, Aaron M Scherer, Martin Tremblay-Breault, Kumanan Wilson, Daniel Reinharz, Holly O Witteman. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.10.2020.)
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- 2020
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50. Analysis of morbidity and mortality, quality of life and bowel function after total colectomy with ileorectal anastomosis versus right and left hemicolectomy: A study to optimise the treatment of lynch syndrome and attenuated polyposis coli.
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Urso EDL, Celotto F, Giandomenico F, Gavaruzzi T, Del Bianco P, Lotto L, Spolverato G, Pucciarelli S, and Bao QR
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- Adenomatous Polyposis Coli pathology, Adult, Aged, Aged, 80 and over, Blood Loss, Surgical, Colorectal Neoplasms, Hereditary Nonpolyposis pathology, Female, Humans, Ileum surgery, Length of Stay, Male, Middle Aged, Mortality, Operative Time, Rectum surgery, Surgical Wound Infection epidemiology, Adenomatous Polyposis Coli surgery, Anastomosis, Surgical methods, Colectomy methods, Colorectal Neoplasms, Hereditary Nonpolyposis surgery, Postoperative Complications epidemiology, Quality of Life
- Abstract
Background: The optimal surgical treatment for colonic colorectal carcinoma (CRC) in Lynch Syndrome (LS) and attenuated polyposis coli (A-FAP phenotype) patients is still debated, since there is a high risk of metachronous colonic adenomas and carcinoma after primary surgery. The aim of this study was to compare surgical outcome, functional data, and Quality of Life (QoL) after total colectomy with ileorectal anastomosis (TC-IRA) compared to right (RH) or left hemicolectomy/sigmoidectomy (LH/SI)., Methods: Patients who underwent TC-IRA (ileorectal anastomosis from 8 to 15 cm from the anal verge) for CRC and/or polyposis at our Surgical Department between 2001 and 2017 were included in the study group, and were matched one-to-one by baseline and clinical characteristics with a control group of RH and LH/SI. Morbidity and mortality data were collected (Clavien-Dindo classification). International validated questionnaires were used to investigate QoL and bowel function., Results: Fifty-five patients were enrolled in each group. No differences were found on length of hospital stay, Clavien-Dindo grade III-IV complications and mortality (p > 0.05). TC-IRA showed a longer operative time than RH and LH/SI (p < 0.0001) and a major blood loss than RH (p < 0.0001). Worse bowel function and worse QoL, only for the bowel-related items, were recorded in TC-IRA group. The general QoL was similar among the groups., Conclusions: TC-IRA and segmental resection have similar morbidity and mortality. The worse bowel function in TC-IRA group does not impact on the general QoL. These data can be useful in the setting of risk-reducing surgery decision in LS and A-FAP patients., Competing Interests: Declaration of Competing interest All the authors have indicated they have no conflicts of interest to declare., (Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
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- 2020
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