Nurses' attitudes towards COVID-19 vaccines: A qualitative study (PROACTIVE-study).

AIM: To explore the attitudes of healthcare workers towards COVID-19 vaccines. DESIGN: A qualitative descriptive design was used. METHODS: Five focus groups were conducted between October and November 2021, with a total of 30 nurses from different contexts in Northern Italy. Thematic analysis was used to analyse the transcripts. RESULTS: Three main themes were identified: 'favourable', 'unsure' and 'contrary to' COVID-19 vaccines. The favourable position was underpinned by trust in science, research and vaccination; protection for themselves, their families, patients and the population; duty as professionals; necessity to set an example for others. Participants who were unsure had doubts about the composition, safety and efficacy of the vaccine and were sometimes afraid that media provided incomplete information. The main reason why nurses were against was the feeling that being forced to vaccinate perceived as blackmail. Favourable or unsure nurses struggled to deal with those who were against and developed a series of emotions that ranged from respect and attempt to rationalize, to frustration and defeat. CONCLUSIONS: Identifying the areas of hesitation is essential to understand what affects the choices of acceptance, delay or refusal of vaccination. The issues that emerged regarding proper communication within the vaccination campaign highlights the key importance of adequate vaccination strategies. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE: Understanding attitudes towards vaccine and related motivations among healthcare workers could help develop more specific and targeted vaccination campaigns that can ensure proper vaccination coverage rates and avoid hesitancy or refusal. IMPACT: Healthcare workers experiences of COVID-19 vaccines, their views and know how they feel during COVID-19 vaccinations. Healthcare workers had three different positions in COVID-19 vaccination. This research will guide and target future vaccination campaigns. REPORTING METHOD: The study is reported using the Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Protective and risk factors of workplace violence against nurses: A cross-sectional study.

AIMS: To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors. METHODS: An online cross-sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES-NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines. RESULTS: A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards. CONCLUSION: Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence-free policies for hospitals. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Impact Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID-19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job. The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses. Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high-quality care in a totally safe environment. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The effectiveness of continuing professional development for the residential long-term care workforce: A systematic review.

OBJECTIVES: To investigate the effectiveness of continuing professional development in residential long-term care. DESIGN: Systematic review. DATA SOURCES: PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), and Web of Science. REVIEW METHODS: Empirical studies published between 2003 and 2023 describing the effectiveness of continuing professional development in long-term care were selected according to PRISMA guidelines. The type, topic, and effectiveness of continuing professional development activities in long-term care were analysed, in addition to facilitators and barriers. The protocol of this review is registered in PROSPERO. RESULTS: A total of 155 studies were selected, including over 17,000 participants the majority of whom were nurses. The most common topics were 'dementia care' (n = 22; 14.2 %), and restraint use (n = 14; 9 %). The impact of continuing professional development was mainly evaluated in terms of 'participant satisfaction with continuing professional development' (n = 5; 3 %), 'staff knowledge' (n = 57; 37 %), 'staff competencies and skills' (n = 35; 23 %), 'resident outcomes' (n = 45; 29 %), and 'staff wellbeing' (n = 12; 8 %). A total of 64 (41 %) studies evaluated if impact of continuing professional development was sustained over time. 'Good organisation', 'a supportive learning environment', 'expressing personal preferences', and 'management support' were described as facilitators of continuing professional development. CONCLUSIONS: Increasing numbers of long-term care residents with complex health conditions require nurses with advanced skills, such as dementia care. To improve the effectiveness of continuing professional development, support from managers, who adopt relational leadership styles, is instrumental to integrate new knowledge and skills into practice. This needs to be linked to career progression, and consequently increase the attractiveness of working in the long-term care sector. This could meet the dual goal of improving outcomes for residents and nurses' job satisfaction.

The effectiveness of learning strategies for the development of Emotional Intelligence in undergraduate nursing students: A systematic review protocol.

AIM: This protocol proposes a systematic review to identify and disclose learning strategies and evaluation tools to improve Emotion Intelligence (EI) in undergraduate nursing students. BACKGROUND: EI improves the ability to manage emotions and their consequences. Management of emotions is fundamental in nursing both at inter- and intra-professional levels, and with the patients and their family carers. DESIGN: Systematic review protocol of effectiveness based on the Joanna Briggs Institute (JBI) guidelines. REVIEW METHODS: All articles based on educational programmes and/or activities to develop EI in nursing curricula will be included in the review. It will analyse the principle EI attributes and outcomes such as burnout, intention to leave and problem-solving skills. Based on the review question, seven databases will be searched: MEDLINE, The Cochrane Library, SCOPUS, CINAHL, EMBASE, PsycINFO and ERIC. Also, grey literature (Google Scholar and Open Gray) will be searched. Since no similar systematic reviews are present in the literature, no time limits will be set. To establish the quality of studies JBI tools will be used. When appropriate, we will meta-analyse prevalence and incidence estimates or we will meta-synthesize themes and findings. EXPECTED RESULTS: This systematic review is expected to provide an overview of educational and training methods, pedagogical strategies and evaluation tools to address EI in nursing and provide high-quality care to patients and their families. Results of the review will support nursing educators and leaders in implementing teaching and learning strategies to improve the Emotional Intelligence of undergraduate nursing students. CONCLUSIONS: Mastering emotions is fundamental for nurses. Implementing education courses based on EI according to the best training methods and pedagogical strategies could become key for nursing curricula. Moreover, after the review, it will be possible to identify the best training methods and pedagogical strategies for implementing continuing professional development (CPD) courses in EI in the courses of following graduation.

The experience and attitudes of long-term care workers with teaching and learning modalities for the delivery of continuing professional development activities: a mixed-methods study.

AIM: to develop a better understanding of the attitudes and experiences of healthcare workers and managers with face-to-face, online asynchronous (pre-recorded), and online synchronous (live) modalities for Continuing Professional Development (CPD) working in the Long-Term Care (LTC) sector. BACKGROUND: The recent global pandemic significantly interrupted the delivery and organisation of education and training for healthcare professionals internationally. As a result of the restrictions, healthcare professionals' access to CPD was limited, consequentially education and training activities were mostly delivered online. Research into the experiences of healthcare workers with the various teaching and learning modalities in the LTC setting is limited. DESIGN: An explanatory mixed methods study using an exploratory sequential design. METHODS: A two-phase study conducted from January 2022 to September 2022, in the Republic of Ireland. In phase one, researchers conducted four focus groups and in phase two 168 participants completed a survey to explore the results of phase one. RESULTS: From the focus groups interviews five themes emerged regarding participants' experiences, attitudes and preferences with the three modalities of CPD education and training in the field of LTC: 1) Flexibility, 2) Networking, 3) Resources and Support, 4) Engaging and meaningful learning, and 5) Balancing online and face-to-face learning through Blended Learning. Results from the survey found the preferred modality was face to face (n = 54, 32.1%), followed very closely by blended learning (n = 51, 30.4%). Most of the respondents reported that synchronous online CPD education was convenient, flexible, offers the opportunity to interact with peers, and that its quality depends on educators' skills. The majority of respondents (n = 155, 92.3%) declared that they would require support in the workplace to implement their new knowledge and skills. CONCLUSIONS: This study revealed the significance participants place on 'engagement' when taking part in education and training. Engagement was described as a key factor to improve the delivery of CPD in the LTC setting. In addition, regardless of the mode of delivery, participants reported that they need to be supported in the workplace to implement their new knowledge and skills. This requires the support and endorsement of employers and managers, who could ensure more protected time for learning, technical support and championing facilitators and mentors in the workplace to enhance the translation of new knowledge into clinical practice. TWEETABLE ABSTRACT: In LTC settings, face-to-face CPD is the preferred mode of delivery. Although synchronous online CPD is very convenient, educators must be able to engage learners. LTC workers need support by managers to implement their new knowledge and skills in their workplace.

Teaching and learning modalities for continuing professional development in the long-term care: A rapid synthesis review.

AIM: To describe the various teaching and learning modalities for the delivery of Continuing Professional Development activities for health care professionals in the long-term care sector. BACKGROUND: Continuing Professional Development is a key activity that organisations undertake to achieve effective workforce planning, recruitment, retention and upskilling strategies in long-term care settings. During the Covid-19 pandemic there was a rapid move to online modalities of Continuous Professional Development, but there is a paucity of evidence in relation to their effectiveness compared with face-to-face, or in-class learning. DESIGN: A rapid synthesis review. METHODS: MEDLINE, CINAHL and HEALTH BUSINESS ELITE databases were used to identify relevant articles that were published between 2016 and 2022. Original studies of any design investigating Continuing Professional Development activities, with or without a comparison between interventions or activities were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. The Kirkpatrick model was adopted as a globally recognised method for evaluating training programmes. RESULTS: After a full text analysis, 34 papers were included in the review. Face to face was the most common method of delivery followed by online, while blended (a mix of face-to-face and online delivery) was the least common method used. The teaching modalities were not associated with specific learning contents, but were used for a range of content. Most studies obtained positive outcomes following implementation of the educational interventions. Kirkpatrick Level 4 (results) was the most commonly measured outcome. CONCLUSIONS: While blended learning was the least common method of delivery, it was found to be more beneficial for learners than face-to-face or online exclusively. There are now new spaces to learn and new technologies that allow us to 'reimagine' where, when and how we teach. This requires Continuing Professional Development providers to design and tailor their courses according to health professionals' learning needs and the clinical contexts where they work. We recommend that Continuing Professional Development providers involve employers when designing teaching and learning activities for Long Term Care workers, to decide which modalities enable effective knowledge translation.

Communication experiences of tracheostomy patients with nurses in the ICU: A scoping review.

INTRODUCTION: The quality of care for tracheostomy and mechanically ventilated patients in intensive care units (ICUs) has improved considerably. However, the communication barrier attributable to these procedures generates many problems for patients, as they are unable to communicate effectively with family members and ICU healthcare professionals, especially nurses. AIMS: To describe (1) tracheostomy patients' needs, emotions and difficulties when communicating with ICU nurses and (2) which strategies nurses and patients have adopted to improve their communication. METHODS: A scoping review was completed using the Joanna Briggs Institute method and following the PRISMA-ScR Checklist. The research question was developed using the Population, Concept and Context framework. Five databases were searched. After screening, two researchers independently analysed the 75 papers, and finally, 19 studies were included in this review. RESULTS: All studies used a qualitative design. Seven adopted a phenomenological and two a hermeneutic approach, involving a total of 265 patients. Two main themes and four subthemes were identified: (1) the tracheostomy patients' needs, emotions and difficulties communicating with ICU nurses (patients' emotions, communication needs, and their content and difficulties) and (2) strategies that nurses and patients adopted to improve communication (communication strategies). CONCLUSIONS: It is essential to develop effective communication with tracheostomy patients to ensure they feel relieved, safe and considered. Communication content should focus on information relating to the person's personal condition and active involvement in care. RELEVANCE TO CLINICAL PRACTICE: It is important to prioritise the communication process in tracheostomised patients and create the organisational conditions that foster effective communication processes. Developing training programmes for new or practising nurses is essential to instil greater awareness about this crucial fundamental need.

Reorganization of Intensive Care Units for the COVID-19 pandemic: effects on nursing sensitive outcomes.

Background: Since the first months of 2020 COVID-19 patients who were seriously ill due to the development of ARDS, required admission to the intensive care unit to ensure potentially life-saving mechanical ventilation and support for vital functions. To cope with this emergency, an extremely rapid reorganization of premises, services and staff, to dedicate an entire intensive care unit exclusively to SARS-CoV-2 patients and increasing the number of beds was essential. The aim of the study was to evaluate the effects of reorganization of the COVID-19 intensive care unit in terms of nursing sensitive outcomes. Methods: a retrospective observational study was conducted to compare nursing sensitive outcomes between pre-COVID period and COVID period. Results: Falls (0.0 and 0.4%, respectively), physical restraint (1.8 and 1.1%, respectively), and pressure ulcers (8.0 and 3.0%, respectively) were similar in the COVID and in the pre-COVID group. After adjusting for gender, age, BMI, and number of comorbidities, the incidence of bloodstream infections was significantly higher in the COVID group than in the pre-COVID group. There were no statistically significant differences in the incidence between the two groups regarding other evaluated outcomes. Conclusion: The selected nursing sensitive outcomes maintained similar values in the pre-COVID and COVID patient groups. Healthcare-related infections rate must be considered an important alarm signal of quality of nursing care especially in conditions of excessive workload, stress and the presence of less experienced staff increase.

Predictors of events of violence or aggression against nurses in the workplace: A scoping review.

AIM: To identify predictors and consequences of violence or aggression events against nurses and nursing students in different work contexts. BACKGROUND: Workplace violence against nurses and nursing students is a very common and widespread phenomenon. Actions to manage or prevent violent events could be implemented knowing the risk factors and consequences. However, there is a lack of systematic reviews that summarize knowledge on the predictors and consequences of workplace violence. EVALUATION: A scoping review was conducted using electronic databases including APA PsycInfo, CINAHL, Cochrane, Ovid Medline, PubMed and Scopus. KEY ISSUES: After full text analysis, 87 papers were included in the current scoping review. Risk factors of horizontal violence were grouped into 'personal' and 'Environmental and organizational', and for violence perpetrated by patients into 'personal', 'Environmental and organizational' and 'Characteristics of the perpetrators'. CONCLUSIONS: The results of this scoping review uncover problems that often remain unaddressed, especially where these episodes are very frequent. Workplace violence prevention and management programmes are essential to counter it. IMPLICATIONS FOR NURSING MANAGEMENT: The predictors and the consequents identified constitute the body of knowledge necessary for nurse managers to develop and implement policy and system actions to effectively manage or prevent violent events.

Nursing management of fatigue in cancer patients and suggestions for clinical practice: a mixed methods study.

BACKGROUND: Fatigue is a complex and frequent symptom in cancer patients, influencing their quality of life, but it is still underestimated and undertreated in clinical practice. The aims of this study were to detect the presence of fatigue in cancer patients, describe how patients and nurses perceived it and how nurses managed fatigue. METHODS: This is a mixed methods study. Data were collected in two oncological wards using the Brief Fatigue Inventory (BFI), an ad hoc questionnaire, patient interviews, focus groups with nurses and the review of nursing records. Interviews and focus groups were analysed through thematic analysis. We used SPSS 22.0 for quantitative data and Nvivo 10 for qualitative data analysis. RESULTS: A total of 71 questionnaires were analysed (39 males, mean age 65.7 years). Fatigue was reported 5 times (7%) in nursing records, while in 17 cases (23.9%) problems associated to it were reported. Twelve patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses' gestures, and being informed. Three themes were identified through the focus groups: objectivity and subjectivity in the assessment of fatigue, nurses' contribution to the multidisciplinary management of fatigue, and difficulty in evaluating outcomes. CONCLUSIONS: The approach to the management of fatigue was unstructured. Patients were satisfied with the care they received but needed more information and specific interventions. Useful aspects were identified that could be used to change health professionals' approach towards the management of fatigue.

[The conceptualization of nursing in the Italian literature: an integrative analysis to inform theory development]. / La concettualizzazione dell'assistenza infermieristica nella letteratura italiana: un'analisi integrativa a supporto dello sviluppo di una teoria.

INTRODUCTION: Nursing theories are essential for orienting nursing practice. To date, three models for nursing practice have been developed in Italy. In addition, significant epistemological reflections have been published, sparking a rich professional debate regarding the theoretical foundations of nursing in Italy. However, conceptual models from other countries are often still used, despite many difficulties associated with applying them in practice. In order to investigate and redress this 'theoretical gap' and related implications for intervention, three scoping reviews of the Italian nursing literature were conducted to examine three categories of nursing knowledge: (a) nursing practice in Italy; (b) the basic nursing concepts of person, health, environment and nursing; and (c) regulatory/normative statements regarding what nursing practice should be in Italy. AIM: The purpose of this investigation was to identify how nursing is conceptualized in the Italian literature through an integrative narrative analysis of three scoping reviews. METHODS: The Scoping Review according to the recommendations published by Arksey and O'Malley and subsequently implemented by Levac et al. has been selected as the optimal methodology for mapping nursing knowledge. At the end of the reviews carried out to answer the three research questions, the researchers integrated the results by conducting a coding of the results. RESULTS: The narrative synthesis highlighted a systemic conception of persons in their social context, 'incorporated' within relational systems. Persons are imagined as active agents with self-determination toward promoting their own health. Health, derived from levels of equilibrium between multiple systemic components and based on the person's holistic view, is a fundamental right and a collective social interest. Maintaining or promoting a person's health requires careful consideration of all these constitutive and integral elements. The nursing process is implemented through technical acts as well as relational and caring skills. Professional autonomy, influenced by clinical and organizational contexts, is expressed in collaboration with other professionals who contribute to the healthcare process. The results of this integrative narrative analysis suggest the need for a holistic vision of persons, with an active role in their health management, indissociable from the system of relationships in which this is contextualized, within which nurses are embedded. CONCLUSION: In light of the results of our investigation, the promotion of a conceptualization of nursing based on the centrality of the person-social relational system and on the active role of persons that nurses work with, this could guide approaches used in nursing education and administration. This could help enhance care provided by nurses and persons' participation in decisions regarding their own health.

The effects of the reorganisation of an intensive care unit due to COVID-19 on nurses' wellbeing: An observational cross-sectional study.

OBJECTIVES: To evaluate the effects of the reorganisation of an intensive care unit for COVID-19 patients in the context of the SARS-CoV-2 pandemic on wellbeing perceived by nurses. METHODS: An observational cross-sectional study was conducted to evaluate wellbeing perceived by nurses who during the study were on duty in the COVID-19 intensive care unit. The "Covid-19-Nurse Well-being at Work (NWB) scale" questionnaire consisting of 72 items divided into 13 sections, was validated and used to collect data. RESULTS: The level of wellbeing perceived by the nurses was very good (4.77; SD 0.83). Differences in the of level of perceived wellbeing were found for "years of experience" and the various levels of competence. We found a positive correlation between "female gender" and "nurses' togetherness and collaboration", a negative correlation between "male gender" and "satisfactory practical organisation of work, and a negative correlation between "work experience" and the overall "level of wellbeing at work. CONCLUSIONS: The reorganisation had positive effects in terms of wellbeing perceived by the nurses. The factors that contributed mostly to the perception of wellbeing were in the area of "support", "communication, and "socializing with colleagues". It is appropriate to consider "gender differences", "work experience" and "levels of competence" when implementing this type of reorganisation to respond to a pandemic or a health emergency.

Reducing Pain During Emergency Arterial Sampling Using Three Anesthetic Methods: A Randomized Controlled Clinical Trial.

BACKGROUND: Taking a sample of arterial blood is widely reported as a cause of significant pain. OBJECTIVES: To compare three anesthetic methods with standard practice (no anesthesia) to establish which was the most effective in reducing pain caused by radial artery puncture in patients requiring an arterial blood gas test in the emergency department (ED). METHODS: A randomized controlled trial was conducted to compare the effectiveness between anesthetic cream, cryoanalgesia, and subcutaneous mepivacaine in reducing pain caused by radial artery puncture in ED patients. RESULTS: After comparing perceived pain during arterial puncture, the lowest median score was obtained in the mepivacaine group (1 interquartile range 0.6-1.3) and the highest median score in the control group (5 interquartile range 4.0-7.0). When comparing the control group with the three intervention groups, the Kruskal-Wallis test showed that mepivacaine (p = 0.023) and cryoanalgesia (p = 0.012) were associated with significantly lower pain scores. The anesthetic cream (p = 0.861) intervention group did not produce a statistically significant median difference compared with the control group. CONCLUSIONS: The results of this study encourage the use of anesthetic methods like cryoanalgesia or mepivacaine for their proven effectiveness in reducing or eliminating pain during arterial puncture.

[Patients and caregivers experience on Nursing in Italy: scoping review]. / L'infermieristica in Italia attraverso l'esperienza di pazienti e caregivers: scoping review.

INTRODUCTION: Comparison of the state of nursing in Italy with other countries has shown that theory development in Italian nursing remains quite undeveloped. Theory development in Italian nursing will need to consider local cultural and professional aspects, specific to the Italian practice context, by drawing on known health needs, experiences and nursing approa- ches. The aim of this investigation was to map current knowledge related to nursing in Italy, based on the experiences of patients, families and communities, to provide a basis on which nursing theories could be developed. METHODS: Scoping Review was selected as the best method for this knowledge mapping. Fawcett's nursing metaparadigm was chosen as a broad guide and means by which the litera- ture analysis could be structured. RESULTS: Twenty-two studies were retained and examined in this analysis, including contexts relating to acute care, chronic conditions, as well as emergency and home care services. We defined themes in line with the nursing metaparadigm. Although these definitions are partial, referring only to certain contexts specific to some aspects of nursing care, the original contributions of this investigation provides an important starting point for theory development in Italian nursing, based on the Italian context. CONCLUSION: Strong and credible theory development, that can be readily adapted to practice, requires a rigorous analysis of the points of view of all actors involved in the nursing care process.

Promoting nighttime sleep in the intensive care unit: Alternative strategies in nursing.

AIM: To identify if complementary interventions impacted on conscious intensive care patients' perception of stress factors and quality of sleep. RESEARCH METHODOLOGY: A non-controlled clinical study was undertaken on conscious patients in an intensive care unit in central Italy. Patients perception of stress factors and quality of sleep during the first night with usual medical and nursing treatments was measured using two questionnaires: the Stress Factors in Intensive Care Unit Questionnaire and the Modified Richards-Campbell Sleep Questionnaire. During the second night two specific treatments were administered: (1) receptive musical sounds and (2) a massage using sweet lavender/lemon-scented almond oil. The same variables were measured on the third day using the same questionnaires. RESULTS: The data of 74 patients were analysed. The patients' main concerns were "hearing unusual noises" (n = 46, 62.2%), "having people continuously working around the bed" (n = 53, 71.6%), "being worried" (n = 60, 81.1%) and "being unable to sleep" (n = 47, 63.5%). Fifty-three patients (71.6%) reported waking up in the middle of the night and 21 (28.3%) of them were unable to fall asleep again. Receptive musical sounds and massage using aromatherapy improved the quality of patients' sleep (t = 2.01, p = 0.047). CONCLUSION: Complementary interventions may reduce patients' perception of stress and improve their sleep. Further research is now needed.

The communication experience of tracheostomy patients with nurses in the intensive care unit: A phenomenological study.

OBJECTIVES: To describe the experience and sources of comfort and discomfort in tracheostomy patients, when they communicate with nurses in the Intensive Care Unit. RESEARCH METHODOLOGY/DESIGN: Benner's interpretive phenomenology. Data were collected through: a) semi-structured interviews conducted with the patients after leaving the intensive care unit; b) participant observation; c) situated interviews with intensive care nurses. SETTING: The intensive care unit of a hospital in Northern Italy. FINDINGS: Eight patients and seven nurses were included in this study. Two main themes were identified 1) feeling powerless and frustrated due to the impossibility to use voice to communicate; 2) facing continual misunderstanding, resignation, and anger during moments of difficulty and/or communication misunderstandings. The main communication discomfort factors were: struggling with not knowing what was happening, feeling like others had given up on me, living in isolation and feeling invisible. The main comfort factors were: being with family members, feeling reassured by having a call bell nearby and nurses' presence. CONCLUSIONS: This study highlights the important role of communication in tracheostomy patients in intensive care and how closely it is linked to all the aspects of a person's life, which cannot be underestimated as just not being able to use one's voice.

Health Care Professionals Attitudes Towards Mental Illness: Observational Study Performed at a Public Health Facility in Northern Italy.

The United Nations Convention on the Rights of Persons with Disabilities Defines stigma as the process of social oppression barring persons with mental illness from enjoying social interaction through discrimination, exclusion and denial of human and social rights. Modern stereotypes still portray the mentally ill as guilty, unpredictable and violent. Observational studies report how healthcare professionals, including nurses, are often part of the stigma. Such phenomenon belittles the needs of people seeking mental care. The aim of this study is to describe attitudes held by psychiatric nurses and mental care professionals from different care settings of an Italian Healthcare Facility, towards the mentally ill and to identify any associated factors. Mental health care professionals were recruited for this observational study from 10 Italian different psychiatric care units. The Italian version of the Community Attitudes Mentally Ill inventory (CAMI-I) was validated and used for this study. 120 completed questionnaires were deemed valid. Optimal internal consistency (α=0.856) was measured by calculating Cronbach's Alpha for the CAMI-I. Demographic variables were correlated to items grouped into three factors of the CAMI-I (authoritarian attitudes, benevolence, social restrictiveness). Parametric test (ANOVA) highlight significant differences between CAMI-I results for different demographic variables. Significant data were obtained by comparing responses for each factor of the CAMI-i per professional profile. All healthcare professionals studied show sensitivity and positive attitude towards mental illness. Positive approaches to mental illness contribute towards easing therapeutic care and recovery in patient-centred care. CAMI-I will be a useful tool to identifying discriminatory approaches and sensitize health professionals in Italy.