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Children with medical complexity (CMC) are a high priority population with chronic illnesses dependent on the use of health services, on technological systems to support their vital functions and characterized by multiple health needs. One of the main challenges linked to chronic conditions is finding solutions to monitor CMC at home, avoiding re-hospitalization and the onset of complications. Telemedicine enables to remotely follow up patients and families. An integrative review was performed to assess whether telemedicine improves health outcomes for CMC. Medline/PubMed, CINAHL, Cochrane Library, Web of Science, and Scopus were searched to identify studies describing the effect of using telemedicine systems on health outcomes for CMC. The PRISMA guidelines were used to select the papers. The methodological quality of the studies was evaluated through the Johanna Briggs Institute critical appraisal tools and the Cochrane Collaboration ROB 2.0. A total of 17 papers met the quality criteria and were included. Specialized telemedicine systems (tele-visits), telehealth, and tele-monitoring have been reported to reduce unplanned hospitalizations and visits, decrease total costs for healthcare services and families, and increase satisfaction for family members. No effect was found on the quality of life in children and their families. Conclusion: Available evidence supporting the use of telemedicine in CMC is favorable but limited. High-quality methodological studies including other unexplored health outcomes such as mental health, hospital readmissions, mortality, caregiver competences, and self-efficacy are needed to confirm the effectiveness of telemedicine systems in improving health outcomes for CMC. What is Known:• CMC are an extremely fragile patient population with frequent access to healthcare services compared with other chronic conditions.• There is conflicting evidence of the effectiveness of telemedicine clinical outcomes, healthcare utilization, and costs in pediatrics.What is New:• There is some evidence that for CMC, telemedicine reduces unplanned hospitalizations, healthcare service costs, and financial burden for families, while increasing caregivers’ satisfaction with care.• Further research is needed to confirm the effectiveness of telemedicine systems in improving health for CMC. Supplementary information The online version contains supplementary material available at 10.1007/s00431-021-04164-2.

Aim This concept analysis aims to clarify the concept of diabetic education in nursing to provide guidance for the further conceptualization and clarification of diabetic education in nursing. Background Patient education is a fundamental component of diabetes care. Nurses have taken up a major role in educating people with diabetes to manage their conditions. However, the exact meaning of diabetic education in nursing remains challenging. Design Rodgers' evolutionary method of concept analysis was performed to explore the concept of diabetic education in nursing. Data source We conducted a literature search on Cumulative Index to Nursing and Allied Health Literature (CINAHL), MedLine, and PsycInfo for works published until October 2020 using "patient education," "diabetes," and "nursing" as key terms. Results The concept analysis revealed that key attributes of diabetic education in nursing include patient-centered and interactive approaches, planning, and problem solving. Antecedents related to individuals with diabetes are their backgrounds, needs, and motivations, while the antecedents related to nurses are experience and attitude. Finally, three different consequences of the concept emerged: an increase in knowledge and skills, a behavioral change, and the improvement of clinical outcomes.

Aims To identify the main diagnostic features of SARS-CoV-2-positive patients at the time of hospitalisation and their prevalence. Background Since the COVID-19 outbreak in China in December of 2019, several studies attempted to identify the epidemiological, viral and clinical characteristics of SARS-CoV-2. Given the rapid widespread transmission of the COVID-19 disease worldwide, a more comprehensive and up-to-date understanding of its features is needed to better inform nurses, clinicians and public health policy makers. Methods A rapid review and meta-analysis were carried out to identify the main diagnostic features of SARS-CoV-2-positive patients at the time of hospitalisation. All case series, cross-sectional, case-control and cohort studies published from 01/01/2020 till 30/06/2020 in English and Chinese that stated all or at least two of the outcomes of interest (clinical features, laboratory and radiological findings) were included. We performed a random-effects model meta-analysis to calculate pooled prevalence and 95% confidence intervals. Conduction of the review adheres to the PRISMA checklist. Results 21 studies involving 8837 patients were included in the quantitative synthesis. Fever, cough and fatigue were the most common clinical features, while the most relevant laboratory abnormalities at the time of hospitalisation were lymphopenia, elevated C-reactive protein and lactate dehydrogenase. CT images showed a bilateral lung involvement, with ground glass infiltrates and patchy shadows on most patients. Conclusion This review provides an up-to-date synthesis of main diagnostic features of SARS-CoV-2-positive patients at the time of hospitalisation. Relevance to clinical practice Our findings could provide guidance for nurses and clinicians to early identification of positive patients at the time of the hospitalisation through a complete definition of main clinical features, laboratory and CT findings.

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Stroke is the second cause of death worldwide and the third cause of death in industrialized countries. To investigate the effectiveness of the nurse's role the management for people affected by stroke after discharge from hospital to home.A systematic review was performed. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was carried out. MEDLINE, CINAHL, Web of Science and Scopus were searched for studies on the effectiveness of the nurse's role in managing the stroke rehabilitation process after discharge from the home hospital from 2000 to June 2018 in English. The methodological quality was assessed by the Cochrane Collaboration's tool for assessing Risk of Bias (RoB). The GRADE system was used for evaluating evidence quality of each outcome.7,025 studies were identified, 12 met the inclusion criteria. The outcomes in the literature are quality of life related to the degree of independence and depression, to the perception and health management and to the adaptation and stress tolerance. No primary outcome is reported in the literature with a high degree of confidence.The nurse's role the management for people affected by stroke after discharge from hospital to home represent an effective strategy for an improvement in the functional outcome, quality of life and reduction of costs.L'ictus è la seconda causa di morte in tutto il mondo e la terza causa di morte nei paesi industrializzati. Scopo di questo lavoro è fornire una sintesi della letteratura sull'efficacia del ruolo dell'infermiere nella gestione del processo di riabilitazione delle persone colpite da ictus dopo la dimissione dall'ospedale a casa.Revisione sistematica della letteratura di tipo quantitativo effettuata seguendo il metodo PRISMA. La ricerca è stata condotta su: Cinhal-EBSCO, Medline-PUBMED, Web of Science e Scopus. Sono stati ricercati studi sulla efficacia del ruolo dell’infermiere nella gestione del processo di riabilitazione del paziente colpito da ictus dopo la dimissione dall’ospedale a domicilio in lingua inglese dal 2000 al 2018. La selezione è stata effettuate utilizzando criteri di inclusione ed esclusione. La qualità degli articoli è stata valutata con il Risk of Bias (RoB) della Cochrane Collaboration. Il sistema GRADE è stato utilizzato per valutare la qualità delle prove di ciascun risultato.Sono stati identificati 7.025 studi, di questi 12 hanno soddisfatto i criteri di inclusione. I risultati in letteratura sono la qualità della vita correlata al grado di indipendenza e depressione, alla gestione della percezione e della salute, all’adattamento e alla tolleranza allo stress. Nessun risultato primario è riportato in letteratura con un alto grado di sicurezza.Il ruolo dell'infermiere nella gestione delle persone colpite da ictus dopo dimissione dall'ospedale a casa rappresenta una strategia efficace per un miglioramento del risultato funzionale, della qualità della vita e della riduzione dei costi.

Objective To identify and meta-synthesize results of qualitative studies on the needs of women cared for by midwives during childbirth in hospitals. Data Sources MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and the Cochrane Library. Study Selection We restricted the bibliographic search to articles published in English to July 31, 2020. The initial search yielded 6,407 articles, and after 2,504 duplicates were removed, we screened the titles and abstracts of 3,903 articles. We conducted a full-text review of 89 articles and included 13 qualitative studies about the needs of women who were hospitalized during childbirth and had midwives as their primary maternity care providers. Data Extraction We extracted data (e.g., authors, publication date, type of study, sample size, results, and quotes) from the full text of each article into a standardized table. Two authors reviewed all articles using the Critical Appraisal Skills Programme tool to assess study quality and to independently score each study. Data Synthesis We analyzed the findings of each study and synthesized them to develop themes. We found 14 major themes that reflected the needs of women during hospitalization for childbirth: Nutrition, Hygiene, Privacy, Information, Bodily Respect, Respect for Social Role, Family Intimacy, Shelter, Pain Management, Partnership, Movement, Reassurance, Support, and Empowerment. We categorized these themes in Maslow’s hierarchy of needs to better understand the phenomenon. Conclusion We identified 14 needs that midwives and nurses can meet when they care for women in hospitals during childbirth. Standardized methods to assess these needs and to link them to specific interventions can be used by midwives and nurses, which will likely affect women’s satisfaction with their experience and overall quality of care.

Despite the many advances obtained thanks to vaccination, in recent years it has been a marked drop in vaccination coverage. In fact, data show the failure in reaching the 95% of coverage, equal to the safety threshold for almost all vaccinations. This is due to the phenomenon of vaccine hesitancy. Aim of this study is to describe knowledge, attitudes and perceptions respect to childhood vaccinations in a sample of parents of patients of a Free Choice Pediatrician (PLS) in the territory of Salerno Local Healthcare Service, (ASL) to assess what might be the educational needs of parents to decrease the hesitation.A quantitative observational descriptive and phenomenological study was conducted, recruiting parents belonging to a PLS in ASL Salerno, through a questionnaire constructed ad hoc.Parents are not always favorable to vaccination and for some vaccine they fear a bond with a pharmaceutical business. All have vaccinated their children but not for all available vaccinations. DISCUSSION AND CONCLUSIONS . Through the educational means of the PLS doubts about vaccinations are minor and the sample of children is vaccinated, although parents appear not totally supportive and considers vaccinations as a warranty by the ASL. The sample has shown a discrepancy between the health workers about the need to vaccinate or not. Hence the need to train the health care professional before and make him responsible and then inform, through a dedicated path, who should receive the vaccine.OBIETTIVO. Nonostante i numerosi progressi ottenuti grazie alle vaccinazioni, negli ultimi anni si è registrato un netto calo di copertura vaccinale, infatti, nessuna vaccinazione raggiunge la soglia di sicurezza del 95%. Tutto questo è dovuto al fenomeno dell’esitazione vaccinale. Lo scopo dello studio è quello di descrivere conoscenze, attitudini e percezioni dei genitori rispetto alle vaccinazioni in una Azienda Sanitaria Locale (ASL) di Salerno per individuare l’entità di esitazione vaccinale e gli elementi che la determinano. METODI. È stato condotto uno studio quali-quantitativo basato sull’approccio di tipo osservazionale descrittivo e fenomenologico, reclutando genitori afferenti ad una Pediatra di Libera Scelta (PLS) nella ASL di Salerno, attraverso un questionario costruito ad hoc e validato. RISULTATI. Sono stati intervistati 93 genitori. La totalità del campione ha vaccinato i propri figli. Di questi il 75% ha effettuato tutte le vaccinazioni previste dal calendario vaccinale, il restante 25% solo alcune di quelle proposte. Le opinioni emerse dall’intervista qualitativa sono state: senso di protezione per i propri figli, evitare sensi di colpa, business farmaceutico, obbligo da parte delle ASL, necessità di una maggiore informazione, di una figura e servizio di riferimento e di professionisti sanitari motivati e preparati. DISCUSSIONE E CONCLUSIONI . Tutti hanno vaccinato i loro figli ma non per tutte le malattie prevenibili da vaccino in età pediatrica. Attraverso l’intervento educativo della PLS, molti dubbi sulle vaccinazioni sono stati dissolti. I risultati di questa indagine hanno evidenziato come l’opinione non favorevole dei sanitari dedicati alle vaccinazioni e la non accuratezza delle informazioni a riguardo sia un determinante dell’esitazione vaccinale. Da qui l’esigenza di una maggiore cura nella formazione e nella scelta dei professionisti ai quali affidare l’informazione, l’educazione e la somministrazione dei vaccini ai fini di mantenere il livello di copertura vaccinale al disopra della soglia di sicurezza.

Introduction Heart Failure (HF) is a pandemic chronic disease with a prevalence up to 3% in the general population, representing the main cause of hospitalization for people over 65. Self-care plays a central role in the management of patients with HF, showing evidence of effectiveness in reducing re-hospitalization rates and mortality. Methods We carried out a systematic review and meta-analysis to assess the efficacy of nurse-led educational interventions Vs usual care in improving self-care skills of patients with chronic HF. The main biomedical databases were searched for Randomized Control Trials (RCTs) of nurse-led educational interventions performed on adults with a previous diagnosis of HF. Improvement of HF self-management skills (self-care level) was summarized by calculating the standardized mean difference (SMD) and 95% confidence intervals (CI) stratified for the length of the follow-up. Results Globally, 14 RCTs were included involving 2078 participants. Ten studies showed the efficacy of the interventions at 3 months (short term) with a SMD of 0.78 (95% CI 0.38-1.18) in favor of the self-care education interventions. Five studies reported on self-care abilities at 6-9 months (medium term), not showing statistically significant results (SMD 0.35, 95%CI 0.11-0.81). The long-term effect of the educational interventions showed no statistically significant improvement in self-care behaviors (three studies, SMD 0.05, 95CI% 0.12 - 0.22). Conclusions These results show that nursing educational interventions improve self-care behaviors in HF, but mainly in the short term. Intensive educational interventions led by nurses, associated with appropriate continuity and transition of care, can determine the best outcomes for patients with HF, strengthening self-care behaviors over time. This approach could have a major impact not only on individual level, but on the general reduction of complications, hospitalization, medical costs and ultimately mortality. Key messages Nurse-led educational programs have a short-term efficacy in enhancing self-care behaviors among heart failure patients. Post-discharge repeated educational interventions, along with timely and shared plans ruling the transition between the hospital and the other providers, are strongly needed.

Background Few studies report educational interventions for pediatric patients with asthma or diabetes type 1 as a fundamental instrument to engage them and improve their health. The aim of this systematic review and meta-analysis was to synthesize evidence about behavioral changes in life style, disease management and clinical outcome in pediatric patients after a structured educational intervention delivered by nurses. Methods A systematic review of the literature was carried out in MEDLINE, Scopus and CINHAL including only RCTs. Methodological quality of the studies was assessed using Cochrane tool. Meta-analyses on HbA1c reduction for diabetes and hospitalization, emergency department (ED) visits and medication for asthma were carried-out. Results Of the 3559 papers initially retrieved, 5 regarding diabetes and 19 asthma met the inclusion criteria for the systematic review and 14 for the meta-analyses. Included studies were highly heterogeneous in terms of type of intervention and follow-up duration. Almost all the studies showed an improvement but only few were statistically significant. All studies regarding diabetes showed a low risk of bias (only one RCTs had a high risk of bias in one domain), while almost all RCTs on asthma showed a high risk of bias. The pooled mean differences in favor of the experimental groups were: HBA1c -0.02 (IC95%: -0.26 - 0.22), Hospitalization 0.58 (IC95%: 0.19 - 1.78), Medication -0.10 (IC95%: -0.43 - 0.23), ED Visits 0.82 (IC95%: 0.44 - 1.54). Conclusions There is a general agreement about the central role of educational intervention delivered by nurses to pediatric patients and the assessment of the behavioral changes after educational interventions is strongly recommended in pediatric population. However, more efforts are requested in designing studies on patients with asthma and to program more appropriate follow-up and periodic recall in order to engage pediatric patients in the management of their own chronic disease. Key messages educational intervention delivered by nurses to pediatric patients with asthma or diabetes type 1 as a fundamental instrument to engage them. more efforts are requested in designing studies on patients with asthma and to program more appropriate follow-up and periodic recall in order to engage pediatric patients.

Adherence has a key role in treating patients as influences the effectiveness of therapeutic treatment for improving overall survival, life expectancy, quality of life and reducing healthcare costs. There are gaps in identifying indicators to be used to evaluate adherence and ways in which these indicators should be adopted. The aim of this paper is to identify adherence's indicators in literature.Systematic review was carried out in, Cinhal-EBSCO, Medline-PUBMED and Scopus including studies of measure patient's adherence in English and published from 2010 to 2016. Inclusion and exclusion criteria were used. The quality of the articles was assessed with the NewCastle Ottawa Scale for observational studies and the Cochrane Collaboration Risk of Bias for experimental studies.Of the 7,368 papers initially retrieved, 15 met the inclusion criteria (11 observational studies, 4 RCTs), for a total of 1,396 patients. The indicators found are: self-report tools, pill counts, drug recharge rate, continuous measures, metabolic dosage. A patient is considered adherent to the treatment if he or she assumes a percentage of drugs ≥ 80% of the prescribed medications.A better adherence rating is obtained by using multiple instruments at the same time. The objective indicators derive from the direct measurement methods of adherence, the subjective ones from the indirect.INTRODUZIONE. L’indice di aderenza ha un ruolo fondamentale nel trattamento dei pazienti poichè influenza notevolmente l’efficacia di un trattamento terapeutico in termini di miglioramento della sopravvivenza globale, della speranza di vita, della qualità della stessa e di riduzione dei costi sanitari. Esistono lacune nell’individuazione degli indicatori da utilizzare per valutare l’aderenza e le modalità attraverso cui tali indicatori debbano essere adottati. L’obiettivo di questo lavoro è quello di individuare in letteratura gli indicatori di aderenza. METODO. Revisione sistematica della letteratura di tipo quantitativo effettuata seguendo il metodo PRISMA. La ricerca è stata condotta su: Cinhal-EBSCO, Medline-PUBMED e Scopus. Sono stati ricercati studi che misurassero l’aderenza dei pazienti al trattamento in lingua inglese e pubblicati dal 2010 al 2016. La selezione è stata effettuate utilizzando criteri di inclusione ed esclusione. La qualità degli articoli è stata valutata con la NewCastle Ottawa Scale per gli studi osservazionali e con la Cochrane Collaboration Risk of Bias per gli studi sperimentali. RISULTATI. Sono stati ritrovati in totale 7,368 articoli e di questi selezionati 15 (11 studi osservazionali, 4 RCT), per un totale di 1,396 pazienti. Gli indicatori individuati sono: strumenti self-report, conta pillola, tasso di ricarica del farmaco, misure continue, dosaggio dei metaboliti. Un paziente oncologico è considerato aderente al trattamento se assume una percentuale di farmaci superiore all'80% rispetto ai farmaci prescritti. DISCUSSIONE. Si ottiene una valutazione migliore di aderenza mediante l’utilizzo di più strumenti contemporaneamente. Gli indicatori oggettivi derivano dall’utilizzo dei metodi di misurazione diretta dell’aderenza, quelli soggettivi da quella indiretta. PAROLE CHIAVE: self-management support, oral chemioterapy, measure adherence, measure compliance.

Aim To examine the current state of empowerment of nurses in Italy. Background Empowerment is a broad concept that is also relevant to the field of nursing practice. Its comprehension and use are important because empowerment allows nurses to take control of their own practice. A clear understanding of empowerment is necessary for nurses to take advantage of this important tool. Design Focus groups were conducted. Methods A literature review was performed, and two focus groups were selected between January and February 2014. Results Sixteen nurses participated in the research. Empowerment is seen as being strongly connected to autonomy and is not associated with power, as the word itself suggests. Italian nurses define empowerment as the creation of conditions that help to establish the possibility for people to develop and express their value and potential. Conclusions Empowerment is defined as a condition in which the individual nurse takes control of his/her own practice and thereby provides awareness and confidence to a group. Implications for nursing management Italian nurses need to feel appreciated and supported by their own organisations. If warranted, empowerment would allow them to contribute to enhance care, which is the core of the nursing profession.

The expansion of primary care and community-based service delivery systems is intended to meet emerging needs, reduce the costs of hospital-based ambulatory care and prevent avoidable hospital use by the provision of more appropriate care. Great emphasis has been placed on the role of self-management in the complex process of care of patient with long-term conditions. Several studies have determined that nurses, among the health professionals, are more recommended to promote health and deliver preventive programs within the primary care context. The aim of this systematic review and meta-analysis is to assess the efficacy of the nurse-led self-management support versus usual care evaluating patient outcomes in chronic care community programs. Systematic review was carried out in MEDLINE, CINAHL, Scopus and Web of Science including RCTs of nurse-led self-management support interventions performed to improve observer reported outcomes (OROs) and patients reported outcomes (PROs), with any method of communication exchange or education in a community setting on patients >18 years of age with a diagnosis of chronic diseases or multi-morbidity. Of the 7,279 papers initially retrieved, 29 met the inclusion criteria. Meta-analyses on systolic (SBP) and diastolic (DBP) blood pressure reduction (10 studies-3,881 patients) and HbA1c reduction (7 studies-2,669 patients) were carried-out. The pooled MD were: SBP -3.04 (95% CI -5.01--1.06), DBP -1.42 (95% CI -1.42--0.49) and HbA1c -0.15 (95% CI -0.32-0.01) in favor of the experimental groups. Meta-analyses of subgroups showed, among others, a statistically significant effect if the interventions were delivered to patients with diabetes (SBP) or CVD (DBP), if the nurses were specifically trained, if the studies had a sample size higher than 200 patients and if the allocation concealment was not clearly defined. Effects on other OROs and PROs as well as quality of life remain inconclusive.

Background Nursing as clinical practice, management and research are based on nursing philosophy and theory. Thus, the philosophical and theoretical content is required to be incorporated in academic education in order to enable nurses' skills for reflection, analysis, and thinking about the profession. Objective The aim of this review was to describe what is known of the philosophical and theoretical content of the nursing discipline within academic education. Design A critical interpretive synthesis (CIS). Methods Electronic searches were performed across four databases, CINAHL, Scopus, Medline, and Web of Science, for papers published in English from 1980 to 2016. The selection of original articles was based on stages, and inclusion and exclusion criteria were used. Quality of the selected papers were evaluated by method sensitive appraisal criteria. The five phases of CIS were used to combine the selected data. Results The searches resulted 9148 titles, whereas 13 were selected. Nurses need philosophical and theoretical education in order to be aware of human health and explain the complexity of the human experience of illness. The philosophy of science, the philosophy of care, and theory development were highlighted as the key contents in nursing academic education as these subjects are central to the discipline that ensures that nurses acquire advanced skills. A model was developed that linked disciplinary issues the progression nursing science through the influence of advanced skills. Conclusions Based on the findings in this study the philosophical and theoretical content of nursing discipline crates a basis for the academic education and enables a professional and exclusive vision for nurses. It provides an overall understanding of people's lives and support nurses to achieve deeper awareness of the meaning of illness and health in a person lifespan what is needed on the evidence-based decision making., final draft, peerReviewed

In literature, the structural empowerment and the job satisfaction have been studied in many different work settings but more need to be done in the setting of Head Nurses.The goal of the study is to evaluate the structural empowerment level of head nurses and if it impacts on the job satisfaction.A cross sectional design study was used. We enrolled 125 head nurses from three different hospitals of Rome. To collect the data we used a questionnaire that included both a part of the collection of sociopersonal data and the two scales (job satisfaction and structural empowerment). We used the SPSS19.0 statistical Software for data analysis to detect significant results.Head Nurse declared to be not enough satisfied at work (mean=3.43) and their structural empowerment level resulted moderate (mean=3.16). The structural empowerment of head nurses impacts their job satisfaction especially concerning opportunities for social and professional interactions, praises, awards, audit and responsibilities.Results underline structural empowerment relevance in head nurses job satisfaction. Healthcare organizations need to address job satisfaction to improve quality of care and more specifically that of head nurses since they directly impact on nurses job satisfaction.In letteratura, l’empowerment strutturale e la soddisfazione sul lavoro sono stati ampiamente studiati in diversi setting lavorativi. Poco conosciuta è la loro rilevanza negli infermieri con funzioni di coordinamento. Obiettivo. Lo studio ha lo scopo di valutare il livello di empowerment strutturale degli infermieri coordinatori e se questo influenza la loro soddisfazione sul lavoro.È stato utilizzato un disegno di studio analitico di tipo cross sectional. Sono stati arruolati 125 coordinatori in tre strutture ospedaliere romane. Per la rilevazione dei dati è stato utilizzato un questionario che comprendeva sia una parte per la raccolta dei dati socio-anagrafici che le due scale (soddisfazione sul lavoro ed empowerment strutturale). L’analisi dei dati è stata effettuata con il Software statistico SPSS 19.0.Gli infermieri coordinatori hanno dichiarato di essere poco soddisfatti sul lavoro (Media=3.43), mentre moderato (Media=3.16) è risultato il loro livello di empowerment strutturale. L’empowerment strutturale degli infermieri coordinatori influenza la loro soddisfazione sul lavoro specialmente in alcune dimensioni della scala come le opportunità di interazione sociale e quelle professionali, gli elogi e riconoscimenti e il controllo/responsabilità.I risultati di questo studio sottolineano l’influenza dell’empowerment strutturale nella soddisfazione sul lavoro degli infermieri coordinatori. Le organizzazioni sanitarie in un’ottica di qualità del servizio erogato devono puntare sulla soddisfazione lavorativa del personale e maggiormente su quella dei coordinatori per le implicazioni che questi hanno sulla soddisfazione degli infermieri.

Our society requires health professionals of increasingly competence, able to modulate their skills according to the needs and the requirements of the context. This survey (cross - sectional) has as primary aim to collect information on employment status of individuals who have a Master degree in Nursing and Midwifery, and as secondary objective to describe if and how the post graduation education has affected the quality and the outcomes of nursing work. A questionnaire devised for the purpose has been used. The survey was conducted from May to August 2011 on all individuals who have a Master in Nursing and Midwifery at the UCSC (from 2004-2005 to 2009-2010). Results show that in 44 cases out of 111 (= 40%) there was a change of employment status after obtaining the Master's Degree and of these 68% (30 out of 44) state that the change is definitely linked to the Post graduation education. All respondents state that the University curriculum has certainly helped to modify some professional behaviors: research utilization (93%), skills in problem solving at work (68%); greater ease to communicate the reasons underlying their organizational choices or decision making (70%); self-training abilities (63%). Within the Italian context, however it seems that those individuals are involved in a managerial progression of their career rather than in the core nursing activities despite the fact that educational programs have important subjects for Advanced Nursing Practice and Nursing Science.La società oggi richiede ed esige professionisti della salute di sempre più ampia ed elevata taratura tali da riuscire a modulare le proprie competenze in base ai bisogni e alle necessità del contesto. L’indagine di tipo trasversale (cross sectional) ha come obiettivo primario rilevare informazioni sullo stato occupazionale dei laureati specialisti, e come obiettivo secondario descrivere se e in che modo il percorso di studi ha influito, secondo le autovalutazioni degli intervistati, sulla qualità e sui risultati del loro lavoro. Lo strumento adottato per la raccolta dei dati è un questionario costruito ad hoc. L’indagine è stata condotta da maggio ad agosto 2011 su tutti coloro che hanno conseguito la Laurea specialistica in Scienze infermieristiche e ostetriche presso l’UCSC (dall’a.a. 2004-05 al 2009-10). I risultati evidenziano che in 44 casi sui 111 considerati (40%) è avvenuto un cambiamento di posizione lavorativa dopo il conseguimento della Laurea specialistica e di questi il 68% (30/44) dichiara che il cambiamento è sicuramente legato al conseguimento del titolo accademico. Tutti gli intervistati dichiarano che il percorso di studi ha sicuramente contribuito a modificare alcuni comportamenti professionali: utilizzo di studi di ricerca (93%); risoluzione di problematiche lavorative (68%); maggiore facilità a comunicare le ragioni che stanno alla base delle proprie scelte organizzative/assistenziali (70%); attenzione all’autoformazione (63%). Tuttavia, da un punto di vista di spendibilità del titolo accademico, questi professionisti vengono quasi esclusivamente chiamati a esplicare ruoli dirigenziali, nonostante la forte connotazione disciplinare del percorso formativo attualmente posto in essere e che permetterebbe una crescita professionale anche nella Pratica Infermieristica Avanzata (APN).

The aim of the present study is to define the state of the art in nursing management training in Italy and to assess the effectiveness of training in a working context. The first phase of the IN.FOR.MA project consisted of creating a data collection tool, a questionnaire, based on paradigmatic pedagogic methodology. This was followed by a pilot study to test its effectiveness. Reliability was tested using the Cronbach's alpha test and the values obtained were between 0.79 and 0.82 for the overall scale and between 0.71 and 0.90 for the subscales. The maximum expression of the competencies perceived using the Likert scale was 4 (Fair), with a maximum value of 5 obtained in 53,06% of the total sample in the "Management" area and a minimum value between 3 (discreet) and 4 (fair) in 33.6% of the total in the area "Training and Research". Perception of the working value of the training experience reached 5 (very) , with an average value of 54,08% of the overall sample. The IN.FOR.MA questionnaire made it possible to assess the training course by focusing on the perception of the competencies acquired, with medium to high levels according to the Likert scale. The level of usefulness of these competencies in daily activities was highest in "Management" followed by "Programming and organization" and "Integration".

Molto è stato detto e scritto sul ruolo del corpo nella pratica infermieristica: il corpo del paziente non è un semplice “oggetto” sul quale mettere in atto pratiche assistenziali, terapeutiche e riabilitative, ma un “soggetto incarnato”, carico di esperienze, idee, vissuti e aspettative. Nella relazione di cura, il professionista infermiere entrando in contatto con il corpo dell’altro, che è un corpo vissuto, denso di significati “attiva” anche il “proprio corpo” che è altrettanto “vivo”, carico di emozioni, affettività, intimità, sessualità. Dall’incontro tra “corporeità” emergono le dimensioni più profonde e latenti del proprio essere donne e uomini. Nella riflessione concettuale sull’assistenza infermieristica grande rilievo ha assunto il tema del prendersi cura e il considerare la persona assistita nella sua multidimensionalità bio-psico-sociale, ma nella realtà lavorativa si fa fatica a vedere professionisti sanitari che concretamente mettano in atto quanto sistematizzato a livello teorico. La motivazione prevalente nel presentare questo lavoro risiede nell’interesse di fornire una chiave di lettura che sia di stimolo sia per l’operare quotidiano sia per la riflessione epistemologica sui principi fondanti l’infermieristica. Il richiamo al corpo, infatti, non è solo al corpo della persona assistita ma anche al proprio corpo e sollecita tutti a revocare la propria esperienza in senso nuovo, più ampio e profondo. ---------- A lot is been said about the role of the human body in the nursing practice: the patient’s body isn’t simply an object to apply care practices, therapeutic and rehabilitation, but it should be seen as an “embodied subject”, full of experiences, ideas and expectations. Throughout the care procedure, the nursing professional comes into contact with the body of the patient, a living person full of emotions creating an interaction between patient and care worker. Reflecting upon the theoretical concept of nursing care, much significance is placed on to the theme of the cure for the patient considering their bio-psycho-social multidimensionality, but in the reality of the working environment it is difficult to witness the systematically application of these theories. The primary motive for presenting this work resides in the interest of providing a key to stimulate, review daily operations and epistemological reflection on the founding principles of nursing. In fact, the concept of the body, not being an object, is equally applicable to that of the nurse and evokes their experience in a new sense, more broad and deep.

Aim: Chronic disorders of the musculoskeletal system, particularly low back pain (LBP), are increasing and represent a social and economic problem of growing importance, especially if correlated with working conditions. Health care workers are at higher risk of developing LBP during work shifts in the hospital. The aim of this study was to assess the prevalence of LBP among operating room nurses and to investigate the risk factors for musculoskeletal injuries in the operating room. Methods: We carried out a cross-sectional study that included operating room nurses from nine hospitals. Information on sociodemographic characteristics, lifestyle habits, working activity and psychological attitude of nurses was collected using an anonymous self-administered structured questionnaire. We evaluated the association of frequency, localization and intensity of LBP (FLI) with qualitative variables, making use of univariate analysis, chi-square test and Fisher's exact test. Multiple logistic regression analysis was performed to identify the variables that affected the FLI. The covariates included in the model were the variables that had a p 35 years vs. age

The aim of this study was to measure Quality of Life (QOL) before a pacemaker (PM) implantation and 1, 6 and 12 months later. Using a descriptive, comparative and correlative design a sample of 157 patients was studied who were divided in four groups: the group A (43 patients) who had to implant the PM; the group B (38 patients) who had the PM implanted 1 month before; the group C (29 patients) who had the PM implanted 6 months before, and the group C (44 patients) who the PM implanted 12 months before. The SF-36 scale was used. Groups B, C and D had QOL levels significantly higher than group A. In group A QOL was higher in people who were male, older, more educated, with higher income, more cohabitants and children. In group B QOL was higher in patients with ventricular pacing, male, younger, without job and illnesses. In group C QOL was higher in patients with non rate responsive PM, younger, without job and illnesses. In group D QOL was higher in younger and in those without job and illnesses. The present study gives and overview of QOL before and after a PM implantation and highlights the importance to modify nursing care from the preoperative to the immediate and later postoperative period.

Hope, long considered an essential element for life, has been shown to be important among cancer patients in coping, perceived control over the illness, and psychologic adjustment to the illness. The purpose of this study was (a) to describe the level of hope in Italian cancer patients; (b) to compare the levels of hope during and after hospitalization; (c) to determine whether hope was correlated with quality of life and several symptoms; and (d) to determine whether the variables from the international literature also pertain to Italian cancer patients. A descriptive correlational design using repeated measures was chosen to study 80 Italian cancer patients during hospitalization and then at home. The following instruments were used: a Sociodemographic Questionnaire, the Hope Related Variable Questionnaire, the Nowotny Hope Scale, the Rotterdam Symptom Checklist, and the Hospital Anxiety and Depression Scale. Overall, patients were moderately hopeful and the level of hopefulness was similar in the hospital and at home. Hope was positively correlated with quality of life, self-esteem, coping, adjustment to the illness, well-being, comfort in the hospital, satisfaction with information received, relationship with, and support from family, healthcare professional, and friends. Hope was negatively correlated with anxiety, depression, and boredom during hospitalization. Time since diagnosis, illness stage, and knowing or not knowing the diagnosis and treatment were not correlated with hope. Similarities and differences with the international literature are discussed, and implications for caring for Italian cancer patients are drawn.

Nursing research is a systematic and very important enquiry for improving clients' quality of life and effective and efficient nursing care. National and international literature state that all nurses should have knowledge and responsibilities in research which are different in relation to their educational level. The aim of the present study was to collect opinions of the new professors in nursing about objectives, contents and methods for teaching nursing research at Bachelor and Master Degree. The sample was made of nine participants who were interviewed by twenty questions sent by e-mail. The interviews were analysed using quantitative-descriptive and qualitative-phenomenological methods (triangulation). Interviews revealed that Bachelor students should be educated to retrieve and criticise scientific literature, to apply research finding in practice and to collaborate in research studies; Master students should improve knowledge of Bachelor degree and be able to design and conduct research studies. Participants emphasised the importance of using active methodologies for teaching and to involve students in research. By analysing the literature and the results of the present study educational objectives for teaching nursing research at Bachelor and Master degree are defined.