Evaluating a nurse-led narrative interview intervention with cancer patients with a first diagnosis: A feasibility study.

Narrative Medicine and Nursing are clinical-supporting intervention methodologies that aim to enhance professionals' communication skills and place patients at the heart of their therapeutic path. A narrative interview (NI) is a communication tool between practitioner and patient. The role of NI is debated extensively in the literature, but no studies focus on its use by nurses responsible for first-diagnosed cancer patients. This study aimed to evaluate the feasibility and utility of NI, carried out by Nurses, in managing people recently diagnosed with cancer. A pilot mixed-methods study with before-and-after-intervention evaluation, qualitative longitudinal data analysis, and concurrent data triangulation was conducted. The Mini-Mental Adjustment to Cancer assessed disease adaptation, while the Psychological Distress Inventory investigated psychological distress. The qualitative analysis of the narrative interviews assessed the usefulness of this intervention. 13 out of 14 eligible patients took voluntary part in the study. Of those, 9 (69 %) completed T1 and T2 questionnaires and NI. The following five themes emerged from thematic analysis: reaction to the disease, feelings related to the new condition of life, changes, importance of relationships and perception of care. Patients reported being highly stressed and recognized the importance of a supporting social network for better coping with the condition. The adoption of an NI approach at the time of cancer diagnosis is feasible. Due to the limited sample size, it is unclear if NI may positively impact psychological distress in this patient population. Further studies would benefit from the integration of an additional investigation tool aiming to clarify whether NI promotes disease awareness in cancer patients. Furthermore, the recruitment of a larger sample is equally recommended.

Strategies implemented by informal caregivers to facilitate self-care in patients with chronic obstructive pulmonary disease (COPD): a scoping review protocol.

BACKGROUND AND AIM: Chronic obstructive pulmonary disease (COPD) is a disease characterized by persistent respiratory symptoms and airflow limitation. COPD is a significant social and economic burden, and hospital admissions contribute to increased costs. Informal caregivers play a crucial role in supporting COPD patients in their self-care efforts. Therefore, understanding informal caregiver interventions to improve self-care may be helpful in reducing hospitalizations. This is the protocol for a scoping review that aims to map the literature on informal caregiver interventions to facilitate self-care in COPD patients. RESEARCH QUESTION: What are the strategies implemented by informal caregivers to facilitate self-care for patients with COPD? METHODS: The review will adhere to the methodology outlined by the JBI. A comprehensive search strategy will be executed in PubMed, CINAHL, Embase, Web of Science, Scopus, Cochrane, and PsycINFO. Additionally, grey literature and relevant unpublished documents will be searched to minimize publication bias. Studies describing strategies/actions implemented by informal caregivers to promote self-care in COPD patients from all countries will be included. We will exclude abstracts, editorials, articles on paid caregivers and social and healthcare workers. Two independent reviewers will screen titles, abstracts, and full-text articles based on inclusion criteria. Key data from the selected studies will be extracted using a predefined data extraction table. The results will be aggregated into themes and described qualitatively, figures and graphs may also be presented. The results will be presented according to the PRISMA-ScR. REVIEW REGISTRATION: Open Science Framework https://doi.org/10.17605/OSF.IO/4TWRM.

Experiences of newly hired nurses during the Covid-19 emergency: descriptive qualitative research.

BACKGROUND AND AIM OF THE WORK: The Covid-19 pandemic led to an increased demand for healthcare professionals, particularly nurses. The Piacenza Local Health Service, Northern Italy, issued several calls for tenders in order to recruit nurses and the University anticipated graduation sessions, so several new graduates nurses found themselves facing their first work experience in the middle of the pandemic emergency. It is well known that being a first-time employee causes stress, but there are few studies yet investigating the perception of newly employed nurses during the pandemic. The aim of this research is therefore to describe the experience of these nurses. METHODS: A descriptive qualitative study was conducted through interviews. The research was approved by the 'Area Vasta Emilia Nord Ethics Committee. RESULTS: 14 nurses were interviewed and nine themes were found. Emotions, awareness, job opportunities, professional liability, organisational aspects and relationship with the other. CONCLUSIONS: Our study shows how stress, anxiety and feelings of inadequacy characterise new nurses' entry into the workplace. Emotional support strategies, such as counselling and emergency preparedness training, could help early career professionals to cope with complex and emotionally charged clinical care situations with greater resilience. STUDY REGISTRATION: ClinicalTrials.gov Identifier: NCT05110859.

Role and challenges to digital technologies in community health promotion programs in Italy during the COVID-19 pandemic: a multiple embedded case study protocol.

BACKGROUND AND AIM: Due to the COVID-19 pandemics, The Italian League Against Cancer (LILT), a national federation of local associations promoting cancer prevention, had to face the challenge to find new ways and technologies to promote health in their territories. This study aims to explore how LILT associations led their health promotion interventions during the COVID-19 pandemic and to understand which interventions had a greater impact, for which population group, and why. METHODS: In this descriptive multiple embedded case study, each case will focus on the activities of a local LILT association and their collaborators on the perception and experience of the use of digital technology for health promotion and prevention, through interviews, observations, and a study of products and artifacts. A general overview of each case study will be provided, along with an introduction of the unit(s) of more in-depth analysis. The logical models that emerge from the analysis of each case will be described by using realist analysis, producing a list of possible CMO configurations (Context; Mechanisms; Outcomes). The final report will consist of a cross-case analysis (a comparison between the different case studies). DISCUSSION: This multiple case study will help generate a first "theory of the use of digital technology in health promotion in local LILT communities. The observation of what local LILT associations in Italy have done during COVID-19 will help identify new and useful health promotion strategies based on these technologies.

COVID-19 in Pregnancy: Knowledge about the Vaccine and the Effect of the Virus. Reliability and Results of the MAMA-19 Questionnaire.

BACKGROUND: Fear or mistrust of the vaccine and concern for the well-being of their unborn infants are the main reasons for COVID-19 vaccine hesitancy in pregnant women. The aim of this work was to validate a questionnaire on knowledge about COVID-19 vaccination during pregnancy and to examine the sources of information in a group of new mothers, as well as their effectiveness and intelligibility. METHODS: A literature review was carried out to develop a questionnaire of forty-five questions, divided into six sections, called MAMA-19. The assessment of agreement and the interrater reliability was carried out using Cronbach's analysis and Cohen's kappa statistic. Data obtained from the questionnaire were analysed using descriptive and univariate statistics. RESULTS: The total alpha values in the two sections about knowledge of vaccination during pregnancy and about the effects of disease and possible post-COVID-19 consequences for the unvaccinated showed sufficient consistency, at 0.860 and 0.725, respectively. Non-vaccinated women thought that receiving the COVID-19 vaccine during pregnancy can lead to malformations in the newborn (60% vs. 40%, p = 0.002) and to an increased risk of foetal growth restriction (61.9% vs. 38.1%, p < 0.001). The percentage of vaccinated women was significantly higher than non-vaccinated when more than one professional was consulted and consistent information was received from them (74.2% vs. 25.8%, p = 0.008). CONCLUSION: The MAMA-19 questionnaire shows results in line with the literature and valid in the two main sections. It is quick to use for measuring communication effectiveness by healthcare professionals and institutions in the context of the COVID-19 vaccination campaign in the pregnant population. The results evidence that a physician's recommendation to get vaccinated is the most important factor in maternal decision making, regardless of geographic, social or educational context.

Impact of chorioamnionitis on maternal and fetal levels of proinflammatory S100A12.

Histologic chorioamnionitis (HCA) may lead to the fetal inflammatory response syndrome (FIRS). The aim of this pilot study was to evaluate S100A12, a marker of innate immune activation, in mothers with or without HCA and in their infants. Concentrations of S100A12, interleukin 6 (IL-6), and C-reactive protein (CRP) were evaluated in maternal, cord, and neonatal blood of very preterm infants. Histologic examinations of the placenta and umbilical cords were performed. The 48 mother-neonate pairs enrolled were subdivided into two groups: HCA group (N = 15) and control group without HCA (N = 33). Maternal S100A12 levels were similar between HCA and control group. Similarly, S100A12 concentrations in cord and neonatal blood did not differ between the groups. However, high S100A12 concentrations were detected in cord and neonatal blood of two out of three neonates exposed to HCA associated with advanced funisitis. Concentrations of IL-6 and CRP were higher in maternal blood of the HCA group compared with controls (p < 0.05, p < 0.001; respectively), but no differences in cord or neonatal blood was found.Conclusion:S100A12 did neither identify mothers with HCA nor very preterm infants exposed to HCA. It is currently unknown if S100A12 may identify neonates with FIRS. What is known: • Histologic chorioamnionitis (HCA) may lead to the fetal inflammatory response syndrome (FIRS). • S100A12 represents an early, sensitive, and specific diagnostic marker of inflammatory processes. What is new: • S100A12 did neither identify mothers with HCA nor very preterm infants exposed to HCA. • It is currently still unclear if S100A12 has a potential in identifying preterm infants with FIRS.

Delivery room interventions to improve the stabilization of extremely-low-birth-weight infants.

OBJECTIVE: To retrospectively verify whether the positioning of the umbilical venous catheter (UVC) in the delivery room (DR) and the early start of the preheated infusion of 10% glucose solution conditioned temperature and glycemia values of ELBW neonates in the first hours of life. METHODS: Neonates (N = 137) were divided into two groups on the basis of timing of positioning of the UVC. In Group I the UVC was placed in DR, while in Group II after Neonatal Intensive Care Unit (NICU) admission. Data were assessed in different times: body temperature at neonatal admission to NICU (T1); after 2 hours (T2); then, every 2 hours until normothermia; glycemia value at NICU admission, every 1-2 hours in the first 12 hours, every 4 hours from 12 to 24 hours, and every 6-12 hours until normalization. Time slot childbirth was also detected since only in the morning shift there was a dedicated resuscitation team always present in DR, while during the afternoon and night it was available on-call. Preventive measures to limit heat dispersion were adopted in both Groups. RESULTS: In Group I respect to Group II, both at T1 and T2: (a) the rate of normothermic neonates was higher and (b) the rate of neonates with moderate hypothermia was lower. The hourly temperature increase was similar between the groups and the time needed to reach normothermia was significantly lower in Group I than in Group II. Glycemic values at T1 were lower in Group II. In Group II, after UVC positioning and glucose solution administration, the 42.2% of infants immediately brought glycemia back to normal, while the 57.8% needed specific treatment. The majority of newborns of Group I was born during the morning shift. CONCLUSIONS: The early UVC placement by a dedicated interdisciplinary team is a relevant intervention to carry out during the "Golden minutes" to improve the ELBW stabilization soon after birth.