The Italian Validation of the Healthcare Professional Humanization Scale for Nursing.

Purpose: The Healthcare Professional Humanization Scale (HUMAS) is a measure of the evaluation of the humanization of care in nursing professions. Despite being validated for the Spanish language, there still needed validation in Italian, which seems essential considering the cultural differences. Aim: We aimed to test the validity and reliability of the HUMAS with an Italian sample of registered nurses. Methods: The present study used cross-sectional data from 300 nurses that completed the survey. The study's main phases were (a) construction of the Italian version; (b) testing and analyzing the psychometric properties of the scale. The exploratory factor analysis and the Content Validity Index (CVI) were performed. Cronbach's alpha and test-retest were used to determine the reliability. Findings: The final Italian version of HUMAS (HUMAS-I) comprised 19 items grouped into five correlated latent factors, accounting for 68.4% of the variance. Additionally, it exhibited a satisfactory Cronbach's alpha for each latent component and an average CVI for the entire scale of 0.68. Conclusions: The HUMAS-I shows acceptable psychometric proprieties as the original Spanish version. Therefore, it could be an advantageous instrument for use in nursing practice and research.

Predictors of nurses' attitudes and knowledge towards pain management in Italy. A cross-sectional study in the hospital settings.

INTRODUCTION: Pain is multidimensional, and as such it is the chief reason patients require urgent health care services. If inadequately assessed and untreated, pain may negatively impact on the quality of life of the patient. Pain management is an essential part of Nursing. The aim to this study is to examine the level of knowledge and attitudes with regard to pain among Italian nurses who work in clinical settings. METHODS: The Ferrell and McCaffery's Knowledge and Attitudes Survey Regarding Pain was distributed to 266 nurses employed in one specialized hospital in Rome, Italy. The staff in the survey work in three different settings: the intensive care unit, the sub-intensive care unit, and an ordinary ward. Descriptive statistics were employed and a logistic regression model was performed to evaluate the factors that may influence the attitude and knowledge of care providers. RESULTS: 49.6% of the sample correctly answered items about attitudes, 47.4% about knowledge, and 36.5% about assessment. The results show that the odds ratio of developing positive attitudes towards pain was 1.76 times higher in nurses employed in the sub-intensive care unit than in other settings. There are no statistically significant associations of knowledge between setting, sex or education. CONCLUSIONS: Our survey revealed a limited overall level of knowledge and attitudes with regards to pain management among nurses. Implementing specific training for health professionals, starting with academic education, is therefore a priority. Further research is needed on a larger sample of Italian nurses.

Violence against women: An observational study in an Italian emergency department.

Violence against women is a pervasive phenomenon affecting one in three women aged ≥15 in the world that are more likely to visit an emergency department (ED) for the serious physical and psychological consequences of the abuse. The aim of this observational single-centre study is to describe the socio-demographic and clinical variables associated with violence against women. We enrolled 425 female patients who attended an Italian ED for trauma on 2019 and the patients' information was collected and analyzed with descriptive statistics. The average age of the patients was 41.5 (standard deviation = 14.2) years. 74.6% of the women were Italians, and 86.6% were of metropolitan origin. The reasons for the ED visit included aggression (67.5%), accidental trauma (29.0%) and unknown reasons (3.5%). Multivariate analysis confirmed that three factors were independently associated with violence: nationality (odds ratio [OR] = 0.27; 95% confidence interval [CI], 0.09-0.77), head/face/neck injuries (OR = 7.32; 95% CI, 3.76-14.27) and multiple injuries (OR = 8.52; 95% CI, 1.03-70.47). Age over 25 was a protective factor. The study confirmed that being a foreigner and having head/face/neck injuries or multiple injuries are associated with violence against women.

[Impact of job satisfaction on nursing turnover: a mixed method study]. / Impatto della job satisfaction sul turnover infermieristico: uno studio mixed-method.

AIM: To describe job satisfaction and to explore the rationale for the nurse turnover request. METHOD: A mix-method was carried out. The study was conducted in Hub Hospital in Rome, using a convenience sampling to all nursing staff on duty in the following areas: medical area, surgical and urgency/emergency areas. RESULTS: The sample of 133 nurses was found to have good job satisfaction (60.9%). 21% feel dissatisfied and 18% are uncertain about the degree of satisfaction. Nurses belonging to the urgent-emergency area showed the highest satisfaction (43.7%), while the most dissatisfied were nurses of the surgical area (53.3%). The age group between 45-50 years is useful for immediate turnover, compared to the over 50 who prefer to remain in the reality where it operates. The qualitative analysis revealed 7 macro-areas. CONCLUSIONS: Nurses have good job satisfaction, but many of them believe a turnover is necessary. The findings have important implications for nurses by helping to improve work environments, thus reducing turnover intention.

Prevalence and risk factors of delirium in the intensive care unit: An observational study.

BACKGROUND: Several risk factors, such as age, alcohol abuse, dementia, and severe illness, can contribute to the development of delirium. However, limited information is available in the literature regarding the risk of delirium among surgical, trauma, neurological, and medical intensive care patients. AIM: To describe the prevalence of risk factors associated with delirium in intensive care units. DESIGN: This study used an observational design. METHODS: We enrolled 165 patients hospitalized in two intensive care units in Italy. Patients were first evaluated using the Prediction of Delirium model and were subsequently evaluated using the Intensive Care Delirium Screening Checklist; evaluation lasted a maximum of 5 days for each admitted patient after sedation. A logistic regression model was used to identify the prevalence and risk factors of delirium. RESULTS: The average age of the patients was 57.6 (SD = 18.3) years, and the patients were predominantly male (65.0%). The majority of patients had been subjected to trauma (38.8%); 37.6% had undergone general surgical interventions, and 23.6% had undergone medical interventions. Delirium occurred in 55.8% of the 165 patients. The risk of delirium was independently associated with coma (odds ratio = 10.6; 95% confidence interval, 3.08-39.9) and the Acute Physiology and Chronic Health Evaluation II score (odds ratio = 4.27; 95% confidence interval, 1.58-11.53). CONCLUSIONS: This study confirmed that coma and the Acute Physiology and Chronic Health Evaluation II score were non-modifiable risk factors for delirium. Further studies could categorize the different types of coma. Proper delirium management could limit the impact on the recovery of these patients, their autonomy, and their reintegration into the social and professional world. RELEVANCE TO CLINICAL PRACTICE: Delirium increases intensive care unit and hospital length of stay. Early identification and risk factor assessment by critical care nurses are considered the key factors in the treatment of delirium.

[Health information in the era of social network: a nursing analysis]. / Le informazioni sanitarie nell'era dei Social network: una analisi infermieristica.

INTRODUCTION: Web and social networks play a crucial role in health information seeking and health literacy levels. In the last ten years people are able to access a wide range of health information from a plethora of sources. People who live in the city experience an increased stimulus level related to the density of people and the overload of information inputs. METHODS: We undertook a census analysis of groups on a social network to identify the importance of health information for the all population and with the aim to evaluate the intersection between digital health information seeking, social networks, and social capital. RESULTS: This study shows that there is a relevant growing number of groups health-related, especially connected to chronic disease and another aspect relevant to the daily health of the population. The study identifies two aspect in all groups: one aspect is connected to share information about treatment and medication and other aspect connected to the relationship in terms of sharing experiences and emotional support. CONCLUSION: Social networks have a relevant impact on health and allow millions of users fast, easy, and concise access to the most important and useful medical information. More research should be conducted to enhance the understanding of the correct pathway to follow to align and measures outcomes of understanding health information and health literacy, use of social networks and the key role of the environment, infrastructure, algorithms and construction in building social capital of individuals and society. It's necessary avoid to think that people live in many separate islands, instead in the same interconnected arena with health professionals that have to work for a better understanding of digital and social networks.

The prevalence of musculoskeletal disorders and low back pain among Italian nurses: An observational study.

BACKGROUND AND AIM OF THE WORK: Musculoskeletal disorders and low back pain have negative impact amongst Italian nurses who work in hospital. Nursing staff are known to be at risk of developing back disorders, where low back pain has a prevalence from 16% to 60% in the world. This study aims to determine the prevalence of musculoskeletal disorders and low back pain among nurses who working in a Roman hospital. METHODS: Cross sectional study was carried out in an Italian hospital and the Nordic Musculoskeletal Questionnaire-IRSST was administered to 256 registered nurses. Logistic regression analyses were performed to understand risk factors associated with pain. RESULTS: Nurses reported different locations of pain related to musculoskeletal disorders. The prevalence of low back pain was 90.2% during life, 80% during the last year and 44.5% during the last week. Female sex increases the risk of being affected by low back pain (OR = 2.07, 95% CI= 1.00-4.32). CONCLUSIONS: Musculoskeletal disorders and low back pain are reported by the majority of nurses interviewed, and a higher prevalence is observed in women. Pain does not depend on the amount of years of work, nor on age or body mass index. In order to assess the prevalence of low back pain carefully, it is recommended to study a greater number of Italian nurses in different hospitals.

[A cross-sectional study on the prevalence and incidence of pressure ulcers in an Italian University Hospital-Umbria Region]. / Prevalenza e incidenza delle ulcere da pressione in Italia: studio trasversale in un'Azienda Ospedaliera-Universitaria dell'Umbria.

OBJECTIVE: The aim of the present study was to assess the prevalence and incidence of pressure ulcers (PUs) in patients hospitalized in a University Hospital in central Italy. METHODS: We carried out a prevalence and incidence study on PUs and an additional prevalence estimate of PUs was also produced ten days after the first assessment. All data were explored by descriptive statistics, the Chi-square test and a multivariate analysis. RESULTS: The prevalence of pressure ulcers was of 6,5%, while it increased to 9,9% at the second assessment ten days after the first measurement. Prevalence was statistically significant and increased with the age of inpatients (p=0,004) and was correlated to the origin of the patients (p=0,002). The incidence of PUs ten days after hospital admittance was of 3,6%. Ulcers are more frequently observed in the general medicine rather than in the surgery and intensive care units. Results showed that there exists a meaningful relationship between increased risk (Braden 16) and the presence of PUs, with an OR of 1,40 (95% CI 1,03-1,62) in high risk patients (Braden -12) and with an OR of 1,61 (95% CI 1,06-2,42) in very high or prohibitive risk patients (Braden 13-16). The most affected areas are the sacrum, the heels and the ankles. Mobilization plans were scarcely available, or do not described. CONCLUSIONS: The obtained data confirmed the difficulty to measure whether PU prevention practices are being carried out in compliance with the set guidelines presently in use in all the University Hospital Units. There is still a very limited use of available risk assessment tools for predicting PU risk and mobilization plans are still poorly documented. A monitoring and follow-up strategy should be implemented to better understand prevalence and incidence rates.

Correlation between Work Engagement and Burnout among Registered Nurses: an Italian hospital survey.

AIM: To investigate the correlation between work engagement and burnout among Italian nurses. INTRODUCTION: Work engagement is a protective factor against burnout. Both of them may be affected by the cultural and organizational features of the investigated population, which means that results cannot be generalized. In Italy studies to measure how they correlate have never been performed. METHODS: Monocentric and quantitative observational study. The Maslach Burnout Inventory and the Utrecht Work Engagement Scale were used on a convenience sample of 318 nurses from an Italian hospital to assess the burnout and work engagement levels and to measure the existing correlation between the two conditions. RESULTS: Work engagement assessment highlighted average values of vigor (57.2%) and absorption (48%), while data referring to burnout demonstrated high levels of emotional exhaustion (55%) and depersonalization (41,5%). The three burnout dimensions and the three work engagement dimensions showed a close and meaningful correlation (p ≤0,01). A correlation between work engagement and burnout has been found. CONCLUSIONS: The correlation between Work Engagement and Burnout highlighted in Italian nurses should encourage the implementation of strategies which may enhance work engagement levels to limit burnout, improving the well-being of healthcare workers and significantly influencing the quality of the care process.

[Improving operating room efficiency: an observational and multidimensional approach in the San Camillo-Forlanini Hospital, Rome]. / Miglioramento dell'efficienza nel blocco operatorio: uno studio osservazionale e multidimensionale nell'Azienda Ospedaliera San Camillo-Forlanini di Roma.

AIM: The management of operating rooms (ORs) is a complex process which requires an effective organizational scheme. In order to amore convinient allocation of resources a rigorous monitoring plan is needed to ensure operating rooms performances. All the necessary actions should be taken to improve the quality of the planning and scheduling procedure. METHODS: Between April-December, 2016 an organizational analysis has been carried out on the performances of the A.O. S. Camillo-Forlanini Hospital Operating Block applying the "process management" approach to the ORs efficiency. The project involved two different surgical areas of the same operating block the multi-specialist and elective surgery and cardio-vascular surgery . The analyses of the processes was made through the product, patient and safety approach and from different points of view: the "asis", process and stakeholder perspectives. Descriptive statistics was used to process raw data and Student's t-distribution was used to assess the difference between the two means (significant p value ˂0,05). The Coefficient of Variation (CV) was used to describe the variabilityamong data. RESULTS: The asis approach allowed us to describe the ORs inbound activities. For both operating block the most demanding weekly commitments in terms of time turned out to be the inventory management procedures of controlling and stocking medicines, general medical supplies and instruments (130[DS=±14] for BOE and 30[DS=±18] for CCH. The average time spent on preparing the operating room, separately calculated starting from the first surgical case, was of 27 minutes (SD=± 17) while for the following surgical procedures preparation time decreased to 15 minutes (SD= ± 10), which highlighted a meaningful difference of 12 minutes. A great variability was registered in CCH due to the unpredictability of these operations (CV 82%). The stakeholders' perspective revealed a reasonable level of satisfaction among nurses and surgeons (2.9 vs 2.3, respectively) and in anesthesiologist (2.8-BOE vs 2.4 CCH).Being brought to the surgical suite from an "external Unit" seems to have negatively influenced the patient's perception: preparation time turned out to be significantly lower for CCH patients rather than BOE ones (p˂0,001).The results of the safety procedure approach highlighted a moderate criticality in terms of cleaning up time and delay in the starting time of the first surgical case. CONCLUSION: More effort should be made to avoid any slowdown during the whole process. It is advisable to implement a lean system that may improve efficiency and quality of the service to reduce wastes and unproductive times. This would inevitably generate a more positive outcomes.

Attitude and Knowledge of Pain Management Among Italian Nurses in Hospital Settings.

Pain is multidimensional, and, as such, the chief reason patients seek urgent healthcare services. If inadequately assessed and untreated, pain may negatively impact on the quality of life of the patient. Treating pain is an important step in regaining control over quality of life. The objective of the present study is to examine the level of knowledge and types of approach among Italian nurses who deal with pain assessment and management. The Ferrell and McCaffery's Knowledge and Attitudes Survey Regarding Pain (KASRP) was distributed to 286 nurses employed in one of the biggest specialized hospitals in Rome, Italy. The interviewed staff work at three different settings, according to the healthcare assistance they are required to provide: intensive care unit (ICU), subintensive care unit (SICU), and ordinary ward (OW). Descriptive statistics, including frequencies and means, as well as analysis of chi-square (p < .05), were used to compare differences in scores by demographic characteristics of the participants and different settings. A logistic regression model was performed to evaluate the factors that may influence the attitude to pain and the level of knowledge of care providers. Results have shown that the odds of developing positive attitudes towards pain management were 1.62 times higher (95% CI: .92 to 2.85) in nurses employed in SICUs than in those working in OWs, while the odds of possessing a satisfactory level of knowledge was 1.76 times higher (95% CI: .93 to 3.31) among nurses in ICUs than those in OWs. A "good assessment" was better for SICU (OR = 2.17, p < .05) and ICU (OR = 3.20, p < .05) nurses. Our survey has highlighted an overall limited level of knowledge in the assessment and management of pain among the nursing staff. It is therefore a priority to implement specific training to healthcare providers from different fields, who may respond differently to patients with pain. On the other hand, further investigations are required on a greater sample of Italian nurses to better understand how to overcome the most problematic barriers to achieving good pain assessment and control.

[Mission woman: a survey on the perception of the "Service of Welcome and Listening" offered in the Emergency Department at the San Camillo Hospital in Rome by women victims of violence]. / Mission woman: indagine sulla percezione del "Servizio di Accoglienza e Ascolto" nel Pronto Soccorso dell'Az. Osp. S.Camillo-Forlanini di Roma da parte delle donne vittime di violenza.

INTRODUCTION: The project Mission Woman was set up to describe how the service offered by the Emergency Department of the Hospital San Camillo-Forlanini in Rome was perceived by women victims ( or supposed to be) of violence. The objective of this investigation is to frame clients' perception about the service offered by staff in terms of sensitivity, recognition and management of the issue. The access to the Emergency Room is the first contact of the client with a helping relationship which goes beyond the simple provision of medical care. METHODS: A questionnaire devised for the purpose was filled in by women who have asked for help to the Service "Door Woman" . The Service "Door Woman", set up in 2009, aimed to welcome and listen women victims of violence with the collaboration of different operators in the emergency department: nurses, doctors, psychologists and social workers. The project developed within the Hospital S. Camillo-Forlanini is managed by both professionals of the Emergency Department together with the Charity "Be Free". The service is open 24/7, all year, the clients could be women or children and could receive assistance or medical, nursing, psychosocial and legal counselling. The triage nurses are those who through their expertise could first identify the victims of violence and to introduce them in the path. CONCLUSION: Despite the level of injuries, who access to the Emergency Room for single or repeated events of violence, may have decided to claim in court and not hide seeking.. The research aims to understand what are the theoretical and practical deficiencies of staff in the management of a issue which is not only medical but also social and legal, as well as structural and organizational weaknesses of the service.

[From admission team to hospital bed management]. / Dal team accoglienza al bed management ospedaliero.

Reduction on number of hospital beds i.e. on patients' admission among hospitals in Lazio has lead to a reformulation of health service framework within Lazio indentifying hospital as the only place to go to treat acute and urgent diseases. San Camillo-Forlanini, the largest hospital in Rome, according to the regional health plan, the recovery plan and the redevelopment of network hospital has had a significant reduction of hospital beds leading, as consequence, to the need of an internal reorganization. In order to correctly address this issue, the management of the Hospital started in February 2008 a project, setting up a group made up by nursing coordinators which had as a main aim to manage the number of hospital beds needed for emergencies. This group has been called "Admission Team" and nurses within the group are familiar with hospital policies and organization. The team collaborates daily with physicians and nurses in  emergency room, in order to decide the most appropriate health care protocol for each patient. The project follows a specific methodology i.e. Systemic Analysis. Over the years this project has contributed to the improvement to a number of indicators and more generally to the health care within the hospital together with the enhancement of education of new managerial roles among health professional. In 2009, the Regional Council of Lazio has recognized this project as strategic within private and public hospitals.

Right to life, right to end of life: some considerations.

Human rights have undergone constant evolution. Recently, however, new generations of rights are developing: from political and civil rights to social and economic rights, so much so that this period may be defined as the age of human rights. Many differences exist between moral rules and judicial law. While moral rights are not necessarily recorded in statutory law, some judicial laws, which are capable of being imposed and/or appealed within a true territorial government, originate from moral rules. Common sense has reservations about whether human rights can be labelled as laws in a rudimentary way; instead, society places human rights in the category of moral rights. These moral rights, in fact, are not the fruit of compromise, but are absolute and essential to the inner self. Throughout this article, the evolution of end of life rights is discussed, with particular regard to how those rights are directly correlated to organ transplantation.

[Retrospective study regarding the contribution of Italian nurses to the debate on the Englaro case: between paradigms of catholic and non-religious bioethics]. / Il dibattito sul caso Englaro tra i paradigmi italiani della bioetica laica e della bioetica cattolica e il contributo degli Infermieri italiani. Analisi di un caso e risultati di una ricerca retrospettiva.

This study presents the results of a retrospective study evaluating the contribution of Italian nurses to the public debate on the Englaro case, analysing the articles published by two major daily newspapers during a precise period. The data collected testify to the intensity of the debate that involved the whole nation in which many diverse social and professional categories took part. The nursing category was principally represented by the Sisters of Mercy who, at the insistence of the media, gave their own opinion although their role in this context was more as personal assistants to Eluana Englaro rather than representatives of a professional category expressing a bioethical opinion.

[The experience to be mother of a preterm infant]. / L'esperienza di essere madre di un bambino pretermine.

This qualitative study is related to leaving experience of mothers of a preborn child. The sample got saturation after eight women interviews. Verbatim transcriptions have been conducted and categories of meanings formed. Parse theories has been used to give meaning to categories to enhance feelings, hope and dreams of interviewed woman.. Results could be beneficial to orient nursing for a global vision of person's health, in the present case, of a specific group of people. Nurse is viewed as a facilitator supporter with a unique role during human experience.

[Early treatment directives: some considerations]. / Le direttive anticipate di trattamento: qualche riflessione.

In a traditional social setting, the entire family was involved when one of its members died; nowadays, this event has been transformed into a private affair. Medicine has alienated us at a time of family intimacy and death has become institutionalized in either a hospital or hospice environment. In a society whose values are changing , is it possible to restore respect and dignity to the final moments of life?. Sometimes life can be shortened or prolonged depending on the opinion of the medical staff, the equipment available in the hospital, the economic status of the family and their country of residence. How far should cure be taken when cure means forcing life to continue regardless of its quality : who chooses how and when to die?. Death is an inevitable aspect of human life and the medical community must accept this as part of their mission. Although intensive care is a precious tool, it may lead to paradoxal situations in which it is difficult to identify the exact moment when a human being becomes a corpse . When death is inevitable , it is no longer possibile to choose between life and death: the only choice left is how the patient chooses to die. The biological testament will be able to answer some of these questions and provide information making it possible to agree to or refuse further medical treatment.In the second part of this paper, that will be published later, the opinions of young people on this topic are will be reported together with those of the nurses whose institutional role is to divulge the necessary information.

[EU-Project "healthPROelderly" - evidence-based guidelines on health promotion for older people: social determinants, inequality and sustainability]. / Prof.ssa Med 45, Area Infermieristica, Dipartimento Scienze di Sanità Pubblica, Sapienza Università di Roma.

In this phase of rapid demographic change and low birth rate , coupled with an increasing life expectancy , the challenge for the future consists of being able to age in good health . European policies should therefore be aimed at promoting healthiness in the elderly and, although some CEE countries have introduced various projects and schemes, the majority are of a national or local nature and do not take into account the European context. The healthPROelderly project, on the other hand , is aimed at collecting information in the countries who participate in the project to pinpoint the best schemes for promoting healthiness in the elderly. This study focuses on the models that have a sustainable approach as far as socio-economical, environmental and lifestyle aspects are concerned. The specific aim of the project is to identify the criteria that have the highest impact on health schemes for the elderly and to establish relative guidelines at local, national and European level.

[Therapeutical rehabilitation project and burnout: a experience of quali-quantitative research in a psychiatric department]. / Progetto terapeutico riabilitativo e burnout a confronto: una ricerca quali-quantitativa su un'esperienza del servizio psichiatrico di diagnodi e cura.

Burnout is a syndrome which takes to long-term exhaustion and diminished interest, depersonalisation, usually in the work context. Burnout appears specially in help professions- Considering all aspects which characterize the syndrome of burnout, at the department S.P.D.C. of Civitavecchia were made some observances, starting with a quality research to analyze the research problem context. After this it was made a quantity research through help of Maslach Burnout Inventory. The aim of our research is to prove that a change in the organization of the Nursing Department can improve the employees' burnout level, to direct towards an independent management of rehabilitation therapies aimed to relationships. Changes in the organization verified through the project named ATRI consist in four different therapeutical-rehabilitation activities: cooking-, reading-, psicomotion-, music-therapy. The results of research shows how these changes of organization can affect employees' burnout.