The psychometric evaluation of the Italian version of the Surgical Fear Questionnaire in adult patients waiting for major cardiac surgery.

Background and aim: Preoperative surgical fear is an emotional reaction that can be observed in many patients who are waiting to undergo a surgical procedure. The Surgical Fear Questionnaire was originally developed to determine the level of fear in patients who are expected to undergo elective surgery. This study aims to test the validity and reliability of this Italian version in a population of patients waiting for major cardiac surgery. Study design: Methodological research model. Methods: The population of this methodological study included the patients who presented to Lecco Hospital in Italy between January 2022 and October 2023 and were scheduled to undergo valve surgery, aortic surgery or coronary surgery; the sample involved 416 patients who met the inclusion criteria. Results: Results of the analyses showed that the Surgical Fear Questionnaire can be used with two subscales; the "Surgical Fear Questionnaire-S", which shows the fear of the short-term consequences of cardiac-surgery, and the "Surgical Fear Questionnaire-L", which shows the fear of the long-term consequences of cardiac-surgery. The mean score of the patients was 26.32+9.23 on the former, 27.62+11.89 on the latter, and 53.94 +19.16 for the entire questionnaire. The Cronbach's α coefficient was 0.952 for the "Surgical Fear Questionnaire-S", 0.920 for the "Surgical Fear Questionnaire-L", and 0.914 for the entire questionnaire. Conclusion: Based on the validity and reliability tests, we consider the questionnaire adaptable to the Italian reality, specifically to the population waiting for major cardiac surgery.

Co-infections in critically ill adults with severe acute respiratory syndrome coronavirus 2 infection: an Italian multi-center prospective study.

BACKGROUND: To date, few studies have described Hospital-acquired infections (HAIs) during COVID-19 outbreak. To examine the incidence of HAIs in critically ill adult patients with SARS-CoV-2 infection and to observe risk factors, and the impact on outcome of HAI. METHODS: A prospective multicenter study was conducted that included adult patients with SARS-CoV-2 infection admitted to 18 Italian Intensive Care Units from September 2020 to November 2021. RESULTS: A total of 589 patients were included. A total of 233 patients were diagnosed with at least one HAI (39.6%). The co-infection/co-colonization rate >48 hours after admission was 31.0 per 1000 person-days (95% CI 18.8-34.8). Age, length of ICU stay >7 days, obesity, type 2 diabetes mellitus, cardiovascular disease, inserted central venous catheter, intubation, APACHE II score >25, mechanical ventilation (MV) >48 hours, obesity and inserted urinary catheter are associated outcomes for infection acquisition. The overall mortality rate of patients was found to be significantly higher in patients who had acquired a HAI (RR=4.37; 95% CI 3.30-5.78; P<0.001). CONCLUSIONS: Associated factors for HAI acquisition and mortality in ICU patients were identified and cause for revision of existing infection control policies.

Impact of COVID-19 outbreak on ICU nurses' mental health. An Italian multicenter study. / Impatto dell'epidemia di COVID-19 sulla salute mentale degli infermieri di Terapia Intensiva. Uno studio multicentrico Italiano.

AIM: AIM: The aim of this study was to evaluate variations in ICU nurses ' mental health status over the COVID-19 outbreak by quantifying the extent of symptoms of depression, anxiety and PTSD over time. METHODS: METHODS: This study was an Italian multicenter prospective cohort study assessing caseness of anxiety, depression and PTSD at 6 and 12 months from the beginning of the COVID-19 outbreak in Italy. RESULTS: RESULTS: A total of 359 nurses, 233 (64.9%) were males and 126 (35.1%) were females were enrolled. At 6 months the caseness prevalence for anxiety, depression and PTSD were 31.3%, 32.1% and 18.7% respectively. At 12 months the caseness prevalence for anxiety, depression and PTSD were 34.8%, 36.4% and 24.1 % respectively. No statistically significant increase between 6 and 12 months was recorded for the caseness prevalence anxiety (p= .29) and depression (p= .19). However, an increase for the caseness prevalence PTSD at 12 months was observed (p= .049). The significant risk factors for the 221 patients with at least one disorders were age 31-40 (RR= 1.44, IC= 1.25-1.89; p < .001), female gender (RR= 1.31, IC= 1.02-1.51; p=. 042) and had 0-5 years of professional experience (RR= 1.36, IC= 1.02-1.63; p = .031). CONCLUSION: The results of our study may provide support for the implementation of some interventions for well-being in COVID-19 outbreak condition.

Long-term consequences in survivors of critical illness. Analysis of incidence and risk factors.

AIM: This study investigates the incidence of long-term consequences in survivors of critical illness 6 months after ICU care. A retrospective analysis of the risk factors was also completed. METHODS: A mixed-method design was used. A qualitative design was used in the questionnaire study (phase 1), and a quantitative design was used for the retrospective study (phase 2). RESULTS: 116 patients were interviewed. Forty-eight patients (41.4%) reported at least one long-term consequence 6 months after ICU discharge. The most frequent consequences were anxiety (n = 33, 28.4%), depression (n = 32, 27.6%) and chronic pain (n = 24, 20.7%). The interview showed the concurrent caseness of PTSD, anxiety and depression in 14 (12.1%) patients. Observed risk factors were age > 60 years (OR = 2.65, IC = 1.23-5.69; p = 0.0119), trauma diagnosis (OR = 5.3, IC = 1.60-17.76; p = 0.0033), length of mechanical ventilation > 7 days (OR = 2.18, IC = 1-4.74; p = 0.0471) length of ICU stay > 10 days (OR = 2.47, IC = 1.16-5.26; p = 0.0185) and clinical conditions at the ICU admission. The quality of life score was lower if the respondent had long-term consequences. DISCUSSION: A high incidence of long-term consequences is found in survivors of critical illness. In future, studies that investigate interventions to prevent these issues after ICU care are need.

[Burnout syndrome among Italian nursing staff during the COVID 19 emergency. Multicentric survey study]. / Sindrome di Burnout tra il personale infermieristico italiano durante l'emergenza COVID 19. Indagine conoscitiva multicentrica.

AIM: To analyze the prevalence of Burnout defined by the MBI-GS among Italian nursing staff during the COVID-19 emergency. INTRODUCTION: The recent health emergency which in the first half of 2020 has seen Italy involved in the management of patients with COVID-19 (COronaVIrus Disease 19), has led to further stress for hospitals both in terms of beds and in terms of workload for healthcare workers. METHOD: A multicenter study was conducted. A convenience sample of 208 nurses participated in the study. Between March 20 and July 20, 2020, the Maslach Burnout Inventory-General Survey (MBI-GS) questionnaire was made available online by using the Google Forms platform in order to detect and measure the severity of Burnout Syndrome (BOS). RESULTS: BOS-related symptoms (medium or high score) for individual MBI-GS domains were identified in at least 68% of nurses. One hundred and sixty-one nurses (77.4%) had a risk of emotional exhaustion, 143 (68.7%) of depersonalization, and 162 (77.9%) of reduced professional accomplishment. High risk was observed among nurses who managed COVID patients at their own operating unit (RR = 1.27, p = 0.016). Severe BOS risk was observed in 146 nurses analyzed (70.2%) with an increased risk among Intensive Care nurses. CONCLUSIONS: Our results suggest that the nurses during the coronavirus pandemic, had high levels of work-related suffering and were at risk of physical and emotional exhaustion. Further research should be undertaken to establish causal relationships between BOS and personal and environmental risk factors among healthcare professionals in relation to the COVID-19.