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Analysis of quality palliative care in a specialized medicine setting: an observational study. 专业医学环境中姑息治疗质量分析:一项观察性研究。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744270a

Francesca Napolitano, Mattia Francesco Bussa, Donatella Cristilli

{"title":"Analysis of quality palliative care in a specialized medicine setting: an observational study.","authors":"Francesca Napolitano, Mattia Francesco Bussa, Donatella Cristilli","doi":"10.7429/pi.2021.744270a","DOIUrl":"https://doi.org/10.7429/pi.2021.744270a","url":null,"abstract":"BACKGROUND Recently health economic expenditure has increased considerably determining an increased awareness of excessive use of \"low-value care\" treatments, especially for chronic-degenerative diseases. AIM Describing Quality of life (QoL) of patients and palliative care's skills of nurses in internal medicine unit. METHODS Observational study conducted in an internal medicine unit that admit patients with chronic critical illness. Patients' QoL was measured with the integrated Palliative Care Outcome Scale (IPOS), and nursing staff skills regarding palliative care with the Questionnaire of Professional Skills Nurses in Palliative Care (QVPICP). IPOS was administered at admission and one week later. RESULTS All the patients (n=13) accepted to participate to the study (mean age 80 years; SD 15). Eight (61%) were female. All the nurses invited (n=17) completed the QCPICP. Most of them was female (70%). The mean age was 40 years SD 14. Nurses perceived they have skills, knowledge, and abilities to approach patient's palliative care path (mean QVPICP: 7). IPOS means scores were worse in the following variables: pain (before: 3; after: 4); lack of mobility (before: 3; after: 4); sleepiness (before: 3; after: 4); depression (before: 3; after: 4). CONCLUSION Patient's QoL showed a worsening in the after assessment. Although nurses perceived themselves skilled in taking care of patients with palliative care needs, organizations may not allow nurses to perform their role to the best of their competencies. NURSING IMPLICATION Team briefing and debriefings in internal medicine unit may promote a holistic approach aimed at improving patients' QoL.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71304502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nurses' perception of the oncology patient's death: a qualitative study. 护士对肿瘤患者死亡认知的质性研究。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744248

F. Gambalunga, E. Taraborelli, R. De Domenico, M. Di Muzio, I. Notarnicola, R. Latina, L. Iacorossi

{"title":"Nurses' perception of the oncology patient's death: a qualitative study.","authors":"F. Gambalunga, E. Taraborelli, R. De Domenico, M. Di Muzio, I. Notarnicola, R. Latina, L. Iacorossi","doi":"10.7429/pi.2021.744248","DOIUrl":"https://doi.org/10.7429/pi.2021.744248","url":null,"abstract":"BACKGROUND Death is one of the basic theme with which nurses are faced, and for which it is hard for them to prepare deeply and sincerely. The difficulties in handling the emotional burden can cause them to develop negative feelings towards life and clinical practice, so that it affects their caregiving capacity and the quality of care provided. AIM To explore nurses' perceptions facing the death of a hospitalized oncology patient. METHODS Qualitative phenomenological study. The sample of nurses was recruited at IRCCS (Scientific Institute for Research and Healthcare) in Rome, a hospice in Latina and a hospice in Rieti. The data were collected by means of focus groups. The semi-structured interviews featuring three guiding questions constructed for this purpose, were audio-recorded, transcribed, and then analyzed using the analysis framework approach. RESULTS In total 7 focus groups were conducted with a total participation of 39 nurses. Four themes emerged from the qualitative analysis: \"The different meanings of death\", \"The rupture of death\", \"The perceptual variables of death\", and \"Requests for help\". CONCLUSION The study highlighted the need to provide nurses with substantial psychological and emotional support, and give consideration to organizational and environmental factors for better management of the event of death in oncology.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71303682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Educating the cancer patient about the immunotherapy toxicity: a descriptive observational study. 教育癌症患者免疫治疗毒性:一项描述性观察研究。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744262b

Maila Congiu, Tania Buttiron Webber

{"title":"Educating the cancer patient about the immunotherapy toxicity: a descriptive observational study.","authors":"Maila Congiu, Tania Buttiron Webber","doi":"10.7429/pi.2021.744262b","DOIUrl":"https://doi.org/10.7429/pi.2021.744262b","url":null,"abstract":"BACKGROUND Immunotherapy can cause immune-related adverse events. Recognizing and communicating these symptoms is important for the patient to allow nurses to manage them promptly, avoiding complications or interruptions in therapy. AIM We conducted an observational study with the objective of creating a readable tool to be shared with patients to provide information on immune-related adverse events and provide clinical guidance to prevent and manage symptoms. Secondary objective was to determine the acceptability of the tool through a questionnaire developed ad hoc. METHODS For each patient, data were collected such as: sex, age, educational qualification, marital status, area of residence, diagnosis, comorbidities, therapy, performance status. The information tool and a questionnaire were administered with the aim of evaluating its acceptability and feasibility. RESULTS 35 patients were enrolled (mean age 65 years, standard deviation 10.7). The drugs used are: Pembrolizumab, Nivolumab, Atezolizumab, Durvalumab. A preliminary analysis of the data revealed a poor knowledge of immune-related adverse events (skin rash, thyroid disorders, pneumonia, gastrointestinal disorders, fatigue). All patients find the educational tool useful and easy to understand for recognizing and managing symptoms of therapy. The format of the tool was also appreciated. CONCLUSIONS Patient education is of fundamental importance to ensure early identification of immune-related adverse events, to avoid severe grades of toxicity and therapy interruptions, also causing a poor patient quality of life. NURSING IMPLICATIONS The nurse has a fundamental role in educating the patient about possible immune related adverse events and training courses are also needed in collaboration with oncologists.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71303994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Innovation in organizational model of the Health Professions Research Unit in an hospital. 某医院卫生专业研究室组织模式的创新。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744260b

T. Bolgeo, R. Di Matteo, D. Gatti, M. Gardalini, M. Bertolotti, M. Betti, A. Roveta, A. Maconi

{"title":"Innovation in organizational model of the Health Professions Research Unit in an hospital.","authors":"T. Bolgeo, R. Di Matteo, D. Gatti, M. Gardalini, M. Bertolotti, M. Betti, A. Roveta, A. Maconi","doi":"10.7429/pi.2021.744260b","DOIUrl":"https://doi.org/10.7429/pi.2021.744260b","url":null,"abstract":"BACKGROUND The organizational model of the Health Professions Research Unit is unique in Italy. It is a centralized sector within of the Intercompany Department of Integrated Activities Research Innovation, afferent to the Complex Infrastructure Research Training Innovation of the SS Antonio e Biagio e Cesare Arrigo Hospital of Alessandria. It emerges from a need to promote, structure and broaden research in the clinical-healthcare field with the primary aim of improving patient care. Its internal organization is represented by a Coordinator Director (PhD) with a function assignment and three research nurses. AIM Increase scientific production, promote partnerships with scientific communities, encourage the development of professional healthcare networks. METHODS The definition of specific result indicators on which to estimate the trend of annual activities. The institution of a company network of Department and Structure and the establishment of collaborations with Institutions and Universities. RESULTS From 2019 to 2021, 11 departmental and 67 Structure referents have been identified; 13 collaborations with National and 3 International Institutions have been activated (42% Increase), 23 clinical trials have been activated (92% increase), 7 articles on impacted journals have been published (100% increase) and 7 are under publication, 27 grey literature papers have been produced (47% increase)and have participated to 5 sponsored calls (100% increase) CONCLUSIONS: The new organizational model established has achieved the objectives set, proving reproducibility in other national and international realities. NURSING IMPLICATIONS The model could increase at national and international level the scientific production related to the Healthcare professions with important benefits on the clinical outcomes of patients.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71304049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Past, present and future]. [过去，现在和将来]。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.741001

Walter De Caro

引用次数: 0

Nursing education in Albania: Evolution and future prospects of health policy. 阿尔巴尼亚护理教育:卫生政策的演变和未来前景。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744265b

Blerina Duka, A. Stievano, Alta Arapi, Emanuela Prendi, G. Rocco, I. Notarnicola

{"title":"Nursing education in Albania: Evolution and future prospects of health policy.","authors":"Blerina Duka, A. Stievano, Alta Arapi, Emanuela Prendi, G. Rocco, I. Notarnicola","doi":"10.7429/pi.2021.744265b","DOIUrl":"https://doi.org/10.7429/pi.2021.744265b","url":null,"abstract":"BACKGROUND Nursing in Albania has grown rapidly over the past decade in response to government initiatives to strengthen primary care. There is limited data on how this expansion has impacted the role of the nurse leadership, the scope of practice, and the characteristics of the workforce. AIM The purpose of this study is to try to describe the current demographic and occupational characteristics of Albanian nurses. METHOD A national survey was undertaken to describe the demographics, clinical roles, and skills of nurses. This retrospective study will attempt to describe the situation of nurses from 2009-2021 and the analysis in the processed dataset was carried out to explore changes in the workforce over time. RESULTS This study presents a retrospective analysis of Albanian nursing regarding the evolution of nursing. It also provides some information on the preparations for vocational training. In this study it is highlighted that there has been a reformulation of the theme of nursing professional qualification, and the need to improve the quality of educational processes and a wide offer of continuing education for Albanian nurses. CONCLUSION This study identified that some of the structural barriers to nursing in Albanian general care have been addressed over time. However, it also identifies ongoing barriers that impact the development of the nurse s role. Understanding and addressing these issues is critical to optimizing both the effectiveness of the nursing workforce and undergraduate education. NURSING IMPLICATIONS There is a clear indication of increased intellectual and conceptual accumulation in the decades when professional nursing education at the technical level has been part of the public policy agenda. This knowledge serves as a reference for the formulation of new actions aimed at other professionals who provide direct assistance to the population.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71303710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nurses' experiences of the effects of mindfulness training: a qualitative systematic review and meta-synthesis. 护士对正念训练效果的体验:一项定性的系统回顾和元综合。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744256a

M. Hayter

{"title":"Nurses' experiences of the effects of mindfulness training: a qualitative systematic review and meta-synthesis.","authors":"M. Hayter","doi":"10.7429/pi.2021.744256a","DOIUrl":"https://doi.org/10.7429/pi.2021.744256a","url":null,"abstract":"INTRODUCTION Mindfulness training is often offered to health care staff to help them manage stress and burnout in relation to their job. However, there is a need to amalgamate and synthesise the qualitative evidence on how nurses experience this training. AIM To explore nurses' experiences of the effects of undertaking mindfulness training. METHODS Qualitative meta-synthesis. Qualitative literature from seven scientific databases: Pubmed, Cochran Library, Science Direct, EBSCO, Web of Science, Scopus and PsycINFO were searched. The PRISMA flow diagram was used to report the phases of the literature search. The Critical Appraisal Skills Program (CASP) qualitative research checklist, and the Mixed-Methods Appraisal Tool MMAT for mixed method studies were used as appraisal framework. Data synthesis was conducted using Thematic synthesis. RESULTS Four qualitative studies and 3 mixed-methods studies were included in the review. Five interpretive themes were generated to show how nurses experience of the effects of mindfulness training: 1) Stress conceptualisation and management; 2) Nurses' valued aspects of mindfulness training strategies; 3) Self-care awareness and strategies; 4) Challenges of mindfulness training; 5) Feasibility and acceptance of mindfulness training. CONCLUSION Conducting mindfulness-based interventions among nursing professionals helps to reduce work-related stress and has positive effects on work and life.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71303746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Essential elements in determining patient's complexity of nursing care. 决定病人护理复杂性的基本要素。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744268b

D. Ivziku, F. M. Ferramosca, L. Filomeno, Raffaella Gualandi, Manuel Iacuitto, L. Vollero, D. Tartaglini

{"title":"Essential elements in determining patient's complexity of nursing care.","authors":"D. Ivziku, F. M. Ferramosca, L. Filomeno, Raffaella Gualandi, Manuel Iacuitto, L. Vollero, D. Tartaglini","doi":"10.7429/pi.2021.744268b","DOIUrl":"https://doi.org/10.7429/pi.2021.744268b","url":null,"abstract":"BACKGROUND Nurses dedicate majority of working time to satisfy patients' needs, which are oftentimes complex. Although the concept of patient's complexity of care (PCC) has been extensively studied, it remains undefined in its essential characteristics. Various tools for assessing PCC have been developed, yet, there is no gold standard of reference. AIM This study intends to explore the elements that determine PCC focusing on the patient's needs. METHODS The bed management team of a University Hospital developed in 2010 a PCC measurement instrument, similar to a triage system, to classify rapidly patients into macro-levels of care complexity (low, medium, high, intensive). Descriptive analysis of prospectively collected data registered in nursing records during 2016-2017 are presented in this study. The incidence of individual metrics on the value assigned to the overall PCC level was calculated. RESULTS 26593 patients' records were analyzed. The final level of PCC was equal to patient's level of autonomy in 92,2% of cases, to clinical stability in 74,4% and to cognitive status in 58,4%. CONCLUSIONS Our finding indicate that essential elements to determine PCC are patient's autonomy and clinical stability. Therefore, nurses can use these metrics to classify quickly PCC in their work settings. NURSING IMPLICATIONS Identifying and measuring PCC is very important for nurses. It can facilitate and support nurse decision-making in design, implementation and evaluation of activities aimed at improving patient care. Moreover, it can help in the distribution of care loads in the shift, and from an organizational point of view, it can allow defining staffing assets.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71303871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Music before undergoing cardiac catheterisation between preference and reality. A pilot study. 接受心导管插入术前的音乐偏好与现实之间。一项初步研究。

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744272a

A. Pesce

{"title":"Music before undergoing cardiac catheterisation between preference and reality. A pilot study.","authors":"A. Pesce","doi":"10.7429/pi.2021.744272a","DOIUrl":"https://doi.org/10.7429/pi.2021.744272a","url":null,"abstract":"BACKGROUND Previous studies have reported beneficial effects of music in the context of health care: anxiolytic, distracting, pain reliever, promoting nutrition, socialization and comfortable environment. AIM In this pilot study, the patient's point of view before undergoing cardiac catheterization procedure was described. Attitudes to music, including habitual listening by genre and broadcasting were compared with its useful in hospital and in the specific pre-procedural condition. METHOD In this cross-sectional study, the interview was conducted through a semi-structured paper questionnaire, subjected to face validity. The sample consisted of patients waiting for the procedure (N=45) included by randomized sampling. A Spearman coefficient was conducted to observe statistically significant correlations. Data were analysed using 24.0 SPSS software. RESULTS 80% of respondents prefer Italian pop music during procedural waiting, played by loudspeakers (71%). they think music can help them engage the wait (55.6%) and alleviate unpleasant feelings (33.3%). Favorable attitude to music in hospital (91.1%) is significantly correlated to its useful in hospital (p=0.01) but only 8.9% actually use it. CONCLUSIONS Music Preferences support pre-recorded Italian pop music played with loudspeakers, recognized by the patient as the most desired activity while waiting for the procedure. NURSING IMPLICATIONS The patient's choice to attribute to music the ability to alleviate unpleasant sensations before the procedure is due to the need for emotional support, to which it can effectively respond. Studies are needed to explore preferences before, during and after music listening and also educate stakeholders in the use of guidelines for music based interventions.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71304394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[How do Advanced Practice Nurses participate in building health policy projects?] 高级执业护士如何参与卫生政策项目的建设?］

Professioni infermieristiche Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.741003

Romina Barca, Vincenzo Cacio, Alessandro Leone, Verdiana Silano, Sara Levati, Vincenzo D'Angelo, Monica Bianchi, Cesarina Prandi

{"title":"[How do Advanced Practice Nurses participate in building health policy projects?]","authors":"Romina Barca, Vincenzo Cacio, Alessandro Leone, Verdiana Silano, Sara Levati, Vincenzo D'Angelo, Monica Bianchi, Cesarina Prandi","doi":"10.7429/pi.2021.741003","DOIUrl":"https://doi.org/10.7429/pi.2021.741003","url":null,"abstract":"Introduction: Patients' needs and the change of health professionals' roles have led researchers to reflect about the involvement of nurses in care processes development, as well as health policies. Studies confirm how advanced nursing training promotes quality of care and reduces the costs of healthcare. The introduction of the Advanced Practice Nurses (APNs) could potentially be an added value also in the Swiss healthcare context, where this figure is positioning. The study aims to investigate how APNs can participate in building health policy projects.Method: This is a qualitative study. Four focus groups were conducted on nurses with managerial and clinical roles. A content analysis approach with three review phases was applied.Results: The identified macro-themes are: APN: Advanced training provides the skills needed to exercise the role. However, it emerges that the recognition of nurses in the field of health policies originates from a cultural change. Interprofessional collaboration: Multidisciplinary work allows overall patient care. However, requests for advice from the APN is still marginal. Health policy: The emerged needs are: defining a target population, educating the population and encouraging organizations to obtain quality certifications. Proposals for improvement: adequate training and the involvement of specialized figures are required for suitable care.Conclusions: APNs have potential impact upon health policy discussions. The authors recommend investing on education and cultural change, in order to maximize the active involvement in discussions supporting progress in nursing practice.","PeriodicalId":34911,"journal":{"name":"Professioni infermieristiche","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39063823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0