Determinants of the Financial Contribution to the NHS: The Case of the COVID-19 Emergency in Italy.

The COVID-19 pandemic has quickly become an unprecedented challenge for many countries at a global level, requiring a significant amount of financial resources to support the National Healthcare System (NHS). In Italy, most of these resources came from the general public through tax payments and monetary donations. The present work aims to investigate the antecedents of citizens' willingness to financially support the NHS in a situation of public emergency such as the one related to the COVID-19 outbreak. It also aims to distinguish between the willingness to support the system through two different forms of financial contribution, tax payment and charitable giving. An empirical study was performed in the midst of the Italian public health emergency, while the country was reaching its contagion peak. Results showed that participants were more willing to give a financial contribution when it was framed as a one-off donation rather than as a one-off tax payment. Moreover, it was found that trust in money management was the most important factor in predicting the intention to make a financial contribution to the NHS, either through a tax payment or through charitable giving. The perceived risks with regard to the pandemic, in contrast, had no impact.

The Caregiving Health Engagement Scale (CHE-s): development and initial validation of a new questionnaire for measuring family caregiver engagement in healthcare.

BACKGROUND: This study was aimed to preliminary validate a cross-disease psychometric measure to assess the psycho-social experience of family caregiver engagement in healthcare (Caregiving Health Engagement Scale, CHE-s), which refers to the caregiver's psychological attitude to be an active, skilled and motivated player in the care process of their loved ones. METHOD: The study consisted of a mixed methods, multi-stage research. First, a preliminary qualitative stage was aimed at investigating - in the caregivers' perspective - the engagement process in providing care to a ill relative (stage 1). The second stage of the research was aimed at developing a psychometric scale to assess this concept (i.e. the Caregiving Health Engagement Scale - CHE-s) and to preliminary test its psychometric properties (stage 2). RESULTS: Overall, 230 caregivers (32 in stage 1, and 198 in stage 2) participated to the study. The first qualitative stage, conducted by qualitative interviews on 32 family caregivers, highlighted four main experiential positions of caregiver engagement (namely, denial, hyper-activation, drawing, and balance), showing that "full engagement" occurs when caregivers become able to reach balance between their caring tasks and their broad life goals. In the second quantitative stage, we used the qualitative evidences emerged from stage one as a basis for developing the items of the Caregiving Health Engagement scale (CHE-s). We preliminary tested its psychometric properties through a cross-sectional study on 198 caregivers, which demonstrated CHE-s to be a reliable measure to capture the dynamic nature of caregiver engagement. The CATPCA results, together with the ordinal alpha of 0.88, suggests a mono-dimensional latent structure and a very good internal consistency and CFA showed adequate goodness of fit indices. (CFI = 0.96, RMR = 0.03, RMSEA = 0.05). CONCLUSIONS: Health care systems that prioritize person-led care may benefit from using the Caregiving Health Engagement Model and the CHE scale (CHE-s) to assess the engagement level of family caregivers in order to better tailor the supportive and educational intervention addressing them.

Social frame and tax compliance modulate electrophysiological and autonomic responses following tax-related decisions.

Given the intrinsic complexity of cognitive and affective processes affecting how people reason about taxes and their decisions to be compliant with such social duty, we aimed at exploring those latent processes by combining the analysis of their central and peripheral physiological correlates. We asked participants to make realistic economic decisions concerning tax-payment and manipulated the social vs. individual decisional frame. In addition, we took into account the potential role of tax-compliance trait. Thirty self-employed professionals took part in the study and completed a public good game while their autonomic (skin conductance - SC - and heart rate - HR) and neural brain (electroencephalography - EEG) activities were recorded. The analysis of physiological responses during the feedback phase - where participants could be presented or not with a fiscal audit - highlighted: (i) increased tonic SC levels and theta activity in the social condition than in the individual one; (ii) increased HR values when a fiscal audit did not take place, especially in participants who presented an enforced tax-compliance trait. Present findings support the idea that classic economic theories of tax behaviour developed under the assumption that taxpayers act as rational and individualist agents do not provide a comprehensive account for the decision-making process. They add to available evidence highlighting the contribution of psychological and social-affective variables to individuals' decision-making processes to pay or evade taxes and to their appraisal of the consequences of such choice, as suggested by the 'slippery slope' framework.