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

Cross-sectional study.To develop an Italian version of the Levels of Cognitive Functioning Assessment Scale (LOCFAS) and examine its reliability and validity.Patients with acquired brain injury in an early post-coma state.The original scale was translated from English to Italian using the guidelines set forth in the Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice. Intra-rater reliability was examined using the intraclass correlation coefficient (ICC). Concurrent validity was evaluated using Pearson's correlation coefficients with some of the functional and disability components of the International Classification of Functioning, Disability and Health (ICF), excluding environmental factors.The highly specialized neurorehabilitation department of "San Raffaele" Hospital, Cassino.The Italian version of the LOCFAS (LOCFAS-I) was administered to 38 subjects from May 9, 2017 to August 31, 2017. The mean ± SD of the LOCFAS-I score was 3.05 ± 1.88. All LOCFAS-I items were either identical or similar in meaning to the original version's items. Test-retest reliability (ICC) was 0.996 (p0.01). The Pearson correlation coefficient of the LOCFAS-I scores with some of the functional and disability components of the ICF was0.536 (p0.01).The LOCFAS-I was found to be reliable and a valid measurement tool for the assessment of cognitive functioning post-coma in the Italian population.

Motor impairments of the upper extremities affect approximately 60% of stroke patients. Rehabilitation is extremely important and can make it possible to identify which manual function is causing difficulty for the patient and hindering daily activities. The Wolf Motor Function Test (WMFT) was recently highly recommended as one of several outcome measures that assess limitations of activities with a high level of psychometrics and clinical utility. The objective of this study was to translate and culturally adapt the WMFT for the Italian population (WMFT-IT) and examine its reliability and validity in Italian post-stroke adults with chronic hemiplegia or hemiparesis. The original scale was translated into Italian and culturally adapted in accordance with international guidelines. Its internal consistency and stability were examined using the Cronbach's alpha (α) coefficient and the intra-class correlation coefficient (ICC), respectively. Its concurrent validity was evaluated using the Pearson's correlation coefficient to compare the instrument with the Italian version of the Jebsen-Taylor Hand Function Test and the Disabilities of the Arm, Shoulder and Hand outcome measure. All WMFT-IT items were either identical or similar in meaning to the items in the original version. The WMFT-IT was administered to 24 subjects. Cronbach's α was 0.91 and 0.98 for the time and performance subscales respectively, and the ICC for test-retest reliability was 0.99. Pearson's correlation coefficients of the time subscale and the performance subscale both showed significant positive correlations (p0.01). The WMFT-IT was found to be reliable and a valid outcome measure for assessing function and quality of movement of the upper extremities in post-stroke adults in the Italian population.

The objectives of this work were to fill the gap in the scientific literature and to evaluate the results of physical therapy treatments in individuals affected by chronic fatigue syndrome, considering only studies that employed a randomized controlled trial.A systematic review was carried out according to PRISMA guidelines. Three bibliographic databases were searched: MEDLINE, Cochrane Library, and PEDro. The minimum prerequisites for papers to be included in the systematic review were that they had to (a) employ a randomized controlled trial; (b) be published in English; and (c) be published during the last ten years (2007-2017). The studies were evaluated according to Jadad score.Four studies were included. This systematic review suggests that a treatment that is more effective than all the others cannot be defined. This conclusion is related to the low number of investigated studies; therefore, the collected results cannot be generalized.Chronic fatigue syndrome is not yet a well-understood pathology, and the physical mechanisms that influence the outcomes still need more study. Rehabilitation programs that promote physiotherapy techniques such as exercise, mobilization, and body awareness (e.g., MRT and GET) are the most effective in reducing medium and long-term fatigue severity in CFS patients.

The Bologna Process and the Directives of the European Union have had a profound impact on nursing education in Europe. The aim of this study was to identify the similarities and differences within nursing education framework at entry level in 2014 in European countries.A questionnaire was devised by the researchers and distributed via e-mail to the nursing associations/nursing regulatory bodies of 30 European countries. Data were collected from January to May 2014.Responses were received from 21 European Countries. Results indicated that while a completion of 12 years of general education was a requirement to access nursing education in almost all respondent countries, other admission requirements differed between countries. Nursing courses were offered mostly by Faculties of Nursing and Faculties of Health Sciences (in higher education Institutions) and lecturers and management staff were mainly nurses. The results indicated significant different educational requirements for nurse educators. A foreign language was mandatory in half of the respondent countries. Nursing profession was represented at government level in just over half of the respondent countries, often with a Directorate position.The Bologna Process has helped harmonise initial nursing education in Europe but clear standards for nursing education need to be set up. Therefore, the research about the influence of the Bologna process on the development of the nursing profession should be further encouraged.

Introduzione: Le migliori evidenze sulla gestione del dolore raccomandano l’uso di programmi multidisciplinari al fine di ottenere significativi risultati terapeutici. Questi possono essere garantiti dai Centri di Terapia del Dolore (CPM), in cui team multidisciplinari sono in grado di fornire attività assistenziali avanzate e specializzate per la valutazione, la diagnosi e il trattamento del dolore cronico benigno. Ad oggi, le informazioni relative alla rete sanitaria e la struttura organizzativa di questi centri in Italia sono esigue. Lo scopo di questo studio è quello di descrivere l’offerta sanitaria e organizzativa dei CPM in una regione italiana (Lazio).Metodi:. Studio descrittivo che ha coinvolto tutti i 37 CPM esistenti nella regione Lazio nel 2011, e che ha focalizzato l’attenzione sui 28 CPM che hanno partecipato all’indagine. Risultati: I CPM sono generalmente situati in policlinici universitarie e in strutture ospedaliere pubbliche o private. La loro struttura organizzativa prevede la presenza di ambulatori, Day Surgery, Day Hospital e posti letto. I CPM sono gestiti da medici anestesisti che, nella maggior parte dei casi, non lavorano in team multidisciplinari. Infatti, il numero di altri operatori sanitari, quali infermieri, psicologi e fisioterapisti è esiguo. I centri forniscono principalmente trattamenti di natura farmacologica, seguiti da terapie complementari (CAM ) e trattamenti interventistici invasivi di diversa complessità. Il tempo di attesa mediano per una visita ambulatoriale è di circa 30 giorni. I centri non sono omogeneamente distribuiti sul territorio regionale, e sono maggiormente concentrati nella città di Roma (56%), seguiti da quelli presenti nelle altre province della regione Lazio (26%) e infine nella provincia di Roma (18%). Chiaramente, Roma è la città offre la più ampia gamma di servizi ambulatoriali per il trattamento del dolore cronico benigno e il più alto numero di prestazioni di consulenze ambulatoriali ai pazienti, con differenze significative tra le tre diverse aree (χ2 = 19,6 p

The aim of the work presented was to assess job satisfaction of a number of nurses from different departments working in public hospitals in Italy. The assessment was carried out through the combined use of questionnaires, which measured different aspects of job satisfaction, such as coping abilities, stress level and optimism/pessimism. The literature supports the fact that nurses' job dissatisfaction is closely connected with high levels of stress, burnout and physical and mental exhaustion, together with high workload levels and the complexity of care. The growing interest in measuring the levels of nurses' job satisfaction is attributable to a number of problems that have been raised worldwide, two of which are becoming ever so important: turnover and shortage of nurses. The research question is: Which are the main motivating factors of Italian nurses' job satisfaction/dissatisfaction?The study used a convenience (non probability) sample of 1,304 nurses from 15 different wards working in Italian public hospitals from a number of cities in northern, central and southern Italy. The survey instrument was a questionnaire consisting of 205 items which included 5 different questionnaires combined together.The results show a low level of job satisfaction (IWS= 11.5, JSS=126.4). However, the participants were overall happy about their job and considered autonomy and salary important factors for job satisfaction.Research has shown that the nurses' level of satisfaction in Italian hospitals is low. The results revealed dissatisfaction with task requirements, organizational policies and advance in career. Nurses interviewed did not feel stressed and showed to be optimistic overall. New research on the subject should be conducted by focusing on ward differences, North and South of Italy and on gender differences.

Introduzione: Il dolore cronico non oncologico rappresenta un problema sanitario sottostimato dal punto di vista epidemiologico ed in termini di salute pubblica. Esso è una malattia in senso stretto, e rappresenta una delle maggiori motivazioni per cui i soggetti si rivolgono ai servizi sanitari. La grandezza del fenomeno si esprime in termini di sofferenza umana e di costi sociali. L’obiettivo di questa revisione è quello di identificare le cause e la prevalenza del dolore cronico non oncologico nei soggetti adulti. Metodi: E’ stata realizzata una revisione della letteratura dal 1998 al 2012 utilizzando le emeroteche virtuali partendo dalle banche dati (Pub-Med, CINHAL). È stata effettuata una revisione narrativa degli articoli ottenuti. Sono stati esclusi articoli riguardanti cefalee, fasce di età pediatriche e geriatriche, oncologici e articoli specifici per patologia. Risultati: Sono stati selezionati 7 articoli e classificati per anno, autore campione, metodi, fasce di età e definizione di dolore. Emerge una elevata eterogeneità di risultati relativi alle diagnosi e metodi. Conclusioni: Seppure limitato il numero degli articoli, emerge una elevata complessità del fenomeno. Introduction: The chronic nonmalignant pain is an underestimated epidemiologic health problem. It is a disease in its own right. It is one of the major reasons because patients use health service. The magnitude of chronic pain is in terms of human suffering and costs to society. The aim of this review is to identify the diagnosis and the prevalence of nonmalignant chronic pain in the adults. Methods: We have done a review of the literature from 1998 to 2012 using the virtual newspaper libraries starting from data bases (Pub-Med, CINAHL). We have made a narrative review of the articles obtained. Excluding topics of headache, pain for pediatric and geriatric groups, cancer pain and disease-specific items. Results: We have obtained 7 articles, classified their for year, author sample, methods, age groups and definition of pain. They shows a high heterogeneity of results concerning diagnosis and methods. Conclusions: Although limited the number of articles, show the high complexity of the phenomenon.

Objective: The study reviewed all the published instruments used for the assessment, diagnosis, screening, and outcomes monitoring/evaluation of behavioral disturbances associated with dementia (BDAD) to recommend a set of psychometrically valid measures for clinicians and researchers to use, across a range of different practice settings. Methods: The study involved a broad scoping search, followed by a series of in-depth literature reviews on 29 instruments using scientific literature databases (MEDLINE, PsycINFO, CINAHL, and the Cochrane Library) and various national, international government, and government agency websites and professional organization websites. External consultations from measurement, clinical and research experts in dementia care, consumer representatives, and policy/decision makers, were sought in selecting the best instruments and in making the final recommendations. Findings: Key attributes and psychometric properties of a short list of five instruments were measured against prespecified criteria. The Neuropsychiatry Inventory (NPI) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) were rated as the best measures for assessment of behavioral disturbances, followed by the Consortium to Establish a Registry for Alzheimer's Disease-Behavior Rating Scale for Dementia (CERAD-BRSD), the Dementia Behavior Disturbance Scale, and the Neurobehavioral Rating Scale. Conclusion: The use of valid and standardized outcome measures for the assessment of BDAD is critical for epidemiological studies, prevention, early intervention and treatment of dementia conditions, and funding for relevant healthcare services. The review recommends the NPI and BEHAVE-AD as the most appropriate measures for both clinical and research, whereas the CERAD-BRSD is suited better for research. The review was designed for the Australian context; however, the findings are applicable in other developed countries. © 2011 American Association for Geriatric Psychiatry.

The purpose of this project is to develop a set of recommended measures/tools for routine use in the assessment, diagnosis, screening and outcomes monitoring of dementia conditions and the evaluation of treatments that are applicable for the Australian health care context. By developing a set of recommended measures it is hoped to standardise the assessment and evaluation procedures used in this field to enhance comparability of findings across research and practice settings. Put simply, we a trying to create a tool-kit of measures for clinicians and researchers to use with people with dementia, in order to assist with communication across the field. A related aim is to make recommendations concerning the clarification and standardization of the clinical terminology applicable in this field. To enhance comparisons between studies it is important that standardized approaches to diagnosis and patient classification be undertaken.

Scopo: Sebbene ci sia un incremento dell’utilizzo delle Terapie Complemntari (CT) in Europa, ancora è poco noto l’utilizzo di esse negli hospice italiani per il trattamento del dolore cronico. Questa indagine ha lo scopo di descrivere la diffusione delle CT e le loro diverse tipologie impiegate per il trattamento del dolore cronico nel setting assistenziale delle Cure Palliative. Metodi. È stata realizzata una indagine on-line su tutto il campione dei 16 hospices presenti nel territorio della Regione Lazio, utilizzando un questionario adattato e validato per descriverne utilizzo e barriere dell’uso delle CT per il trattamento del dolore cronico oncologico e benigno. Risultati: Il tasso di risposta è stato dell’ 81%. Solo 5 hospices (38%) offrono CT abbinati a trattamenti convenzionali. Il Massaggio è il più comune trattamento usato, seguito dalla Naturopatia, dal Nurturing Touch, l’Ipnosi, l’Immanginario guidato, e l’Aroma Terapia. Le barriere rilevate all’utilizzo delle CT includono insufficienti conoscenze sulle CT da parte del team assistenziale, e limitati fondi destinati all’implementazione di tali trattamenti.. Conclusioni: Anche se si strata di un campione esiguo di tutti gli hospices della Regione Lazio, questo studio rileva il parziale uso di CT per il trattamento del dolore cronico, dovuto per lo più a barriere culturali ed economiche. Parole Chiave: Terapie Complementarie, Cure Palliative, Hospice, Dolore Cronico, CAM, Non Farrmacologico Purpose: Although there has been an increase in the use of CT (Complementary Therapy) in Europe, little is known about CT available in Italian hospices. The present study is aimed at assessing the diffusion and typologies of CT used to treat chronic pain in Italian hospices. METHODS. An online survey was e-mailed to a regional sample of 16 hospices, which included questions on common CT used to treat malignant or nonmalignant chronic pain, and the barriers to their utilization. Results: The response rate was 81%. Only 5 hospices (38%) offered CT with conventional treatment. Massage therapy was the most common type of CT used, followed by naturopathy, nurturing touch, hypnotherapy, guided imagery, and aromatherapy. Barriers to the delivery of CT included insufficient knowledge of CT by staff, limited knowledge, and lack of funding. Conclusions: Although limited to Lazio hospices, this survey shows a partial use of CT for the treatment of chronic pain, caused by economic and cultural barriers.

In the caring professions it is important to be able to assess not only knowledge and competencies but also the behavior of future professionals in the different sectors of health care. The aim of this work is to define and describe the core values of the health professions and shed light on the essential values which act as the basis for future behavior. Many international documents (League of Nursing, American Board of International Medicine), define the Core Values of specific professions as the bases on which teaching and training curricula are founded. The authors intend to find out whether it is possible to improve behavioral learning of professional values. For example, in the USA the Medical Association has proposed a model for this purpose. Before receiving professional abilitation, suitable professional behavior should be practically tested.A questionnaire was issued to University course Coordinators in Nursing and Obstetrics in Italy, asking them to express their opinion on an existing model of "Core Values" and the need for their assessment.It was generally agreed that behavior should be assessed in the light of the essential values of the profession. The description of "Core Values" thus becomes a tool for identifying which behavior should be assessed. Coordinators did not express a precise opinion regarding the assessment tool proposed.There was a general consensus regarding the need to assess the values at the basis of behavior in health care students, as well as the "Core Value" proposed. Doubt remained regarding the assessment modalities owing to the fact that the practical test actually used does not always focus on behavioral values.