Enhancing empowerment in young adults during the COVID-19 era in Italy through the Photovoice technique.

The spread of COVID-19 has led to increasingly stringent containment measures. After the first period of lockdown, there has been an easing of measures worldwide. However, this choice has helped bring about a second wave to be faced by many states. The present research was conducting during the period in which it was necessary for the population to find strategies for living with COVID-19. The proposed action research envisaged the use of Photovoice and, due to social distancing, was carried out online. A total of 250 young adults were involved with the aim of bringing out individual and community solutions for effective coexistence with COVID-19. The data, collected through a triangulation process, were analysed on the basis of grounded theory and the support of NVivo 12. The results highlight how online Photovoice is an effective tool for implementing individual and community empowerment and for identifying solutions to live with COVID-19.

A qualitative study on decision-making about BRCA1/2 testing in Italian women.

OBJECTIVE: In the era of cancer panel testing, new models of genetic counselling providing effective decision-making support are needed. As little is known about Southern European patients' and families' needs and experiences in this regard, we explored Italian women's experiences of clinical BRCA1/2 counselling and testing. METHODS: We interviewed 19 Italian women with a strong family history but no personal history of cancer who had had clinical BRCA1/2 testing. Interviews were recorded and transcribed, and qualitative data were organised into themes. RESULTS: Most respondents had decided to pursue testing before pre-test counselling. Although half the sample reported having reached the decision without thinking through its implications, most participants qualified their choice as unequivocally "the right one." CONCLUSION: A subset of Italian women may arrive at their first cancer genetic consultation having already made a firm decision about testing. To empower women's decision-making, new models of cancer genetic counselling could usefully take into account differences in how they approach the testing process. This includes understanding decision-making from different cultural perspectives. In familistic countries like Italy, for example, decisional support may involve exploring widely shared assumptions regarding responsibilities towards family members and the prioritisation of family over self.

Academic climate, well-being and academic performance in a university degree course.

BACKGROUND: The psychological climate within organisations affects not only the behaviour and the attitude of group members, but also the performance of the group itself. According to the ecological model, this research examines how learning in different classroom contexts of the same nursing degree programme can affect academic performance, well-being, self-esteem and perceived climate. METHODS: Four scales were used to assess students' perceptions by collecting primary data while academic performance was measured by obtaining students' academic records. A questionnaire completed by 391 first-year nursing students was administered. RESULTS: Differences were observed in the perceptions of climate and academic performance in different classroom contexts with trends, which did not always overlap; however, strong correlations were observed among self-esteem, well-being and climate, and schoolmate relationships. CONCLUSIONS: Universities should not merely train competent professionals but also build learning communities that support the well-being of relationships and the development of well-being contexts. IMPLICATIONS FOR NURSING MANAGEMENT: The findings support the need for an educational intervention for improving the quality of life and well-being of the community and individual students. This type of intervention requires a 'compliant' organisational environment that puts studetns, teachers and professionals in the condition to practice their professional skills.

Living with migraine: A meta-synthesis of qualitative studies.

Introduction: Migraine is one of the top ten causes of disability worldwide. However, migraine is still underrated in society, and the quality of care for this disease is scant. Qualitative research allows for giving voice to people and understanding the impact of their disease through their experience of it. This study aims at synthesising the state of the art of qualitative studies focused on how people with migraine experience their life and pathology. Methods: MEDLINE via PubMed, EMBASE, CINAHL, PsycINFO, and Cochrane Library were consulted up to November 2021 for qualitative studies. Studies to be eligible had to focus on adults (age > 18 years) with a diagnosis of primary episodic or chronic migraine following the International Classification of Headache. The quality of the study was analysed using the CASP (Critical Appraisal Skills Programme) tool. The synthesis was done through a thematic analysis. CERQual (Confidence in Evidence from Reviews of Qualitative research) approach was used to assess the confidence in retrieved evidence. Results: Ten studies were included, counting 262 people with migraine. Our synthesis produced four main themes. (1) "Negative impact of migraine symptoms on overall life" as migraine negatively impacts people's whole life. (2) "Impact of migraine on family, work and social relationship" as migraine reduces the possibility to focus at work and interact with people. (3) "Impact of migraine on emotional health" as people with migraine experience psychological distress. (4) "Coping strategies to deal with migraine" such as keep on living one's own life, no matter the symptoms. Conclusions: Migraine negatively impacts people's whole life, from private to social and work sphere. People with migraine feel stigmatised as others struggle with understanding their condition. Hence, it is necessary to improve awareness among society of this disabling condition, and the quality of care of these people, tackling this disease from a social and health-policy point of view.

The Fear of Contagion and the Attitude Toward the Restrictive Measures Imposed to Face COVID-19 in Italy: The Psychological Consequences Caused by the Pandemic One Year After It Began.

The pandemic nature of COVID-19 has caused major changes in health, economy, and society globally. Albeit to a lesser extent, contingent access to shops and places to socialize the imposition of social distancing and the use of indoor masks is measures still in force today (more than a year after the start of the pandemic), with repercussions on economic, social, and psychological levels. The fear of contagion, in fact, has led us to be increasingly suspicious and to isolate ourselves from the remainder of the community. This has had repercussions on the perception of loneliness, with significant psychological consequences, such as the development of stress, anxiety, and, in extreme cases, depressive symptoms. Starting from these assumptions, this research was developed with the aim of deepening the perceptions that the participants have of their own mental health, loneliness, fear linked to contagion, and attitudes toward imposed social distancing. In particular, we wanted to analyze whether there is a relationship between perceived fear and the perceived level of mental health, loneliness, and attitude toward social distancing. Finally, we wanted to analyze whether there are differences related to gender, age, marital status, current working mode, and educational qualifications. The research, performed after the diffusion of the vaccination in Italy, lasted 14 days. The participants were 500 Italians who voluntarily joined the study and were recruited with random cascade sampling. The research followed a quantitative approach. The analyzed data, from participants residing throughout the national territory, allow us to return the picture of the perceptions that Italians have of the fear of contagion, of their level of mental health, of loneliness and of their attitude toward social distancing. In particular, the data show that fear of COVID-19 is an emotional state experienced by the entire population and that young people have suffered more from loneliness and have been less inclined to accept the imposed social distancing. The data that emerged should make policymakers reflect on the need to find functional strategies to combat COVID-19 or other health emergency crises whose effects do not affect the psychological wellbeing of the population.

Living with COVID-19: emotions and health during the pandemic.

BACKGROUND: COVID-19 has led and still leads all nations to adopt virus containment plans, considering possible strategies that help to live with the virus. The present study aimed to investigate the practical, psychological and emotional aspects of living with COVID-19. PARTICIPANTS AND PROCEDURE: A total of 250 young adults (86% female), who lived in north-western Italy, took part in an online photovoice study, in respect of social distancing. They participated in a group discussion following the method SHOWeD. The researchers analyzed the photographs along with comments and transcripts from the SHOWeD group discussions using the triangulation process of visual and textual data. The collected data were analyzed on the basis of grounded theory, with the support of the NVivo 12 software. RESULTS: From the analysis of the emotions concerning the psychological health of participants, 4 categories were identified. The results reveal benefits and emotional aspects that have stimulated the increase of individual and community empowerment. COVID-19 has led and still leads all nations to adopt virus containment plans, considering possible strategies that help to live with the virus. CONCLUSIONS: From the analysis of the results it emerged how the online photovoice was a tool that allowed on the one hand the sharing of experiences and emotions related to living with COVID-19 and on the other hand to maintain social ties despite physical distance.

Attitudes and Beliefs of the Italian Population towards COVID-19 Vaccinations.

BACKGROUND: Despite the numerous campaigns to encourage vaccination against COVID-19, the public debate and often conflicting information have left many individuals uncertain about the decision to make on whether or not to vaccinate. METHODS: This research aims to analyze the attitudes and beliefs of the Italian population towards COVID-19 and other vaccinations through a quantitative methodology. In all, 500 adults (Age M = 39.52) participated in this exploratory study with an online questionnaire conducted in April 2021. RESULTS: most participants believe vaccination is necessary to defeat COVID-19; there is an age-related difference in getting vaccinations, and women were more afraid of unexpected future effects than men; older participants have expressed a greater willingness to pay to be vaccinated against COVID-19 (4). CONCLUSION: In light of these results, it is necessary to pay greater attention to the perplexity and fears expressed by the population, especially women and youth, in relation to vaccinations; in fact, it would help to achieve a wider adherence to the tools designed to contain the spread of viruses at the base of severe health crises.

Unaccompanied migrant minors in Europe and U.S.: A review of psychological perspective and care challenges.

Unaccompanied migrant minors are youth under the age of 18 who migrate alone, traveling separately from both parents. These youth may be asylum seekers, recognized refugees, or other externally displaced persons. Unaccompanied migrant minors have become an increasingly prevalent global issue. However, this phenomenon might be better understood considering the peculiarities of their contexts, since there are differences related to specific conditions and reception systems. The present study reviewed and compared visually previously reported psychological perspective of unaccompanied migrant minor receiving services from select European countries and the U.S. Unaccompanied migrant minors create a challenge on a nation's care system because these minors are the most vulnerable group in the context of migration. Our explorative assessment suggested underlining similarities and differences between contexts, reflecting the unique needs of the unaccompanied migrants and proposed services and intervention models.

Psychological Impact of the Lockdown in Italy Due to the COVID-19 Outbreak: Are There Gender Differences?

The COVID-19 emergency has hit the whole world, finding all countries unprepared to face it. The first studies focused on the medical aspects, neglecting the psychological dimension of the populations that were forced to face changes in everyday life and in some cases to stay forcedly at home in order to reduce contagion. The present research was carried out in Italy, one of the countries hardest hit by the pandemic. The aim was to analyze the perception of happiness, mental health, and the sense of loneliness experienced by adults during the lockdown due to the COVID pandemic. Specifically, the variables will be examined in relation to gender difference, living alone, with partner, or with partner and children. The research followed a quantitative approach using an online questionnaire. The project involved 1100 subjects from whom 721 participants (75.5% women) were extrapolated. Of them, 17.3% claimed to live alone, 39.5% with their partner, and 43.1% with their partner and children. The results show that people in general experienced a lower level of happiness and mental health and higher levels of loneliness compared to normative sample. The lockdown and pandemic condition due to COVID-19 seems to have canceled the gender differences in the perception of happiness and mental health, while it seems to have increased the perception of loneliness experienced by males compared to the pre-pandemic condition. In addition, those who lived alone perceived a greater level of loneliness than those who lived with their partner or partner and children. Unexpectedly, no significant differences emerged regarding the level of happiness and mental health between those who had direct contact with the virus and those who did not. These data should make political decision-makers reflect on the need to pay more attention to the implications that such drastic measures as a lockdown can have on people's psychological well-being.

Spiritual Well-Being and Mental Health During the COVID-19 Pandemic in Italy.

During the COVID-19 pandemic in Italy, people and families experienced a new and sudden situation that forced them to stay in their homes for a long period (February 25- May 26). In this context, many people found themselves in great difficulty, not only because of the fear of contagion or the economic problems deriving from the closure of production activities but also because the virus profoundly changed the way of life in society. The "Social distancing" concept became central in all personal relationships, including close family relationships. In this situation, our paper seeks to understand the role of spirituality and religiosity in reacting to this difficult situation and in particular on the physical and psychological health of the people involved. The data we present here are part of a multidisciplinary research with a quantitative theoretical framework. As the data was collected during the first Italian lockdown, a total of 1,250 adults from all over Italy participated in the on-line questionnaire. Among the main results it emerged that the participants perceived lower levels of spiritual well-being and mental health than the pre-pandemic situation with a significant gender difference; in fact, women perceived lower mental health than men. At the same time, it is evident that spirituality and religious practices are a protective factor connected not only with psychological and mental but also physical health. Finally, it appears evident that the family is a protective factor with respect to mental health, even in a period so full of stress factors, those who did not live alone and especially those who had to take care of small children reported higher perceived mental health and a greater ability to activate coping resources.

Women Face to Fear and Safety Devices During the COVID-19 Pandemic in Italy: Impact of Physical Distancing on Individual Responsibility, Intimate, and Social Relationship.

The COVID-19 pandemic of 2020 in Italy had its first epidemic manifestations on January 31, 2020. The socio-sanitary rules imposed by the government concerned the social distance and management of intimate relationships, the sense of individual responsibility toward public health. Physical distancing and housing isolation have produced new representations of intrafamily, generational, neighborhood, community responsibility, bringing out a new "medicalized dimension" of society. In light of this contextual framework, the research aims are to analyze how: the perception of individual responsibility for public and familial health and physical distancing has redrawn the relation between subjects-family-community; the State's technical-health intervention has reformulated the idea of social closeness, but also how the pandemic fear and social confinement has re-evaluated a desire for community, neighborhood, proximity; during the lockdown families, friends, neighbors have reconstructed feelings of closeness and forms of belonging. The methodology used is quanti-qualitative and involved 300 women through an online questionnaire. The data collected highlight how the house during the lockdown is perceived as a safe place and how women implement both the recommendations and the behaviors aimed at preventing contagion, but also ways that allow coping with the situation from a perspective of well-being. Furthermore, the data show how the dimension of distancing has loosened the relational dimension outside the family unit, with a greater distancing compared to pre-pandemic data. However, the majority of women report that they have joined solidarity initiatives, demonstrating that they want to maintain ties and participate actively in community life.

Reflective Practices to Study Group Dynamics: Implement Empowerment and Understand the Functioning of Groups.

Introduction: Individual and group reflection practices are qualitative methods useful in a group context to develop group skills and more awareness of the dynamics that take place within the group to which one belongs. Aim: The aim of this work is to highlight how individual reflective practices and group reflections contribute to the development of group skills. More specifically, the effectiveness of relevant group dynamics is investigated, with the aim of creating a space for reflection, and activation for individual and group empowerment. Participants: The participants were 130 university students (86% female), resided in northwestern Italy, and had a mean age of 27.5 years (SD = 7.52). They were randomly divided into 23 groups (ranged from four to nine members). Method: The participants engaged in several online training activities and at the end of every activity they completed individual reflection practice in which they presented both positive and negative aspects related to the group experiences. Then they participated in online group reflections that allowed them to reflect on the group dynamics, particular attention given to factors such as climate, participation and roles played by each participant in a variety of training activities. This study analyzes 130 individual reflective practices and 23 group reflections. The data collected through individual reflective practices and the transcripts of the group reflections were analyzed using grounded theory. Two independent judges analyzed and categorized the data and then identified the main common categories that emerged by the support of Nvivo software. Results: From the analysis of the content, it is determined that the participants, based on the construction of the individual and group reflections, paid greater attention to the dynamics that occurred within the group during the various activities in which they participated, thus allowing them to be more aware of the various factors that affected the importance attributed to the different roles, the climate, and their active participation. Conclusion: Combined, these factors allowed participants to strengthen their relationships with each other and enhance the cohesion of the group.

Gender matters and the challenge for improving community health and well-being.

The present paper introduces present issue focused on community gender perspective and health in an Italian context. After a brief analysis of the disparity and inequity that persist in Europe and Italy, we present six papers from different Italian regions that demonstrate different elements of the complex gender matters and challenges of well-being and health in the community. Considering the differences in social vulnerability and risk between men and women, the unequal power relationships between the sexes could improve the efficacy of intervention and preventative actions. Through this series of papers, we aim to contribute to the debate about how gender perspective can shape studies and interventions that promote both individual and community health and well-being. Gender, one of the key determinants of health, is revealed in many ways; it is necessary to better understand and plan health service interventions to improve the health of women and men. Furthermore, more attention and reflection are needed to promote policy interventions for health and to consider the contribution of women to the health of the community.

Psychological well-being and healthy communities: Women as makers of relational well-being by social street strategies.

This paper presents a Social Street experience born of the perception of a lack of solidarity among neighbors and the desire to create a new neighborhood model. The goal was to explore the Social Street phenomenon through the relationship between individuals and their community. Furthermore, the goals include promoting the awareness of the critical issues of the territory to activate empowerment and change, analyzing the effectiveness of Social Street through the study of social networks, and investigating differences in social participation and in social cohesion. The most relevant result is that gender emerges as a context variable because Social Street members are mostly women. In fact, the role of women is relevant in structuring relational contexts and improving community networks and relationships.

Giving voice to my childbirth experiences and making peace with the birth event: the effects of the first childbirth on the second pregnancy and childbirth.

This autoethnographic study describes the author's waterbirthing experience to evidence the relationship between fear of childbirth and communication with, and support from, healthcare professionals and the medical process during labour and delivery. The study provides a rereading of the author's experience, which demonstrates how the traumatic consequences of a first childbirth influenced the experience of a second pregnancy and childbirth. This account indicates how lack of training and inadequate communication by medical staff can lead to traumatic childbirth experience. The study enhances understanding of womens' transition to motherhood with implications for practice, education and research of midwives and other medical providers.

The Caregiving Experiences of Fathers and Mothers of Children With Rare Diseases in Italy: Challenges and Social Support Perceptions.

Family caregiving is a growing phenomenon with the increased prevalence of chronic illness and shorter hospitalizations. Rare diseases pose significant challenges not only to patients living with these kinds of pathologies but also to those who care for these patients. The caregiving role has specific characteristics. The present work aims to increase knowledge of the challenges that are common or specific to fathers and mothers of children diagnosed with a rare disease. Moreover, the paper analyses the kinds of social support they experience according to gender. A descriptive study was conducted using grounded theory methodology. A semi-structured interview with open-ended questions was conducted with 15 parents of children with a rare disease. The interview was organized into three main areas: personal experiences in caring for a child with a rare disease, family changes and perceived social support. The transcriptions were analyzed using NVivo 11 software. From data analysis, themes emerged regarding the challenges shared by fathers and mothers, but some aspects also emerged that were gender-specific. The analyses of differences between mothers' and fathers' narratives showed that there is a specific experience of the impact that caregiving has on parents' relationships with their jobs and on their worries. Self-help group is the main source of social support for all respondents. We discuss these findings in relation to possible appropriate specific interventions and support for family caregiving.

How Could Self-Determination Theory Be Useful for Facing Health Innovation Challenges?

This paper offers a presentation of the characteristics of self-determination theory (SDT) in the health context as well as attempts to identify how this theory could be useful for facing health innovation challenges. Health innovation is based on scientific advances that have more complex relationships with health. This paper encourages the use of the SDT approach to face health innovation, both for physiological and pathological processes. In particular, the focus is on the changes and lifestyle choices related to physiological pregnancy and birth and to oncological genetic tests in the Italian context. The health innovation paradigm focuses on patients taking responsibility for making important health-related choices, and we think that SDT can offer new stimuli in light of the changes implemented from innovations in the field of health. The aim is that this manuscript will stimulate researchers to test the potential of this theory in the field of changing health-related processes. Practitioners are called upon to revise their orientation toward patients and, according to SDT, they should support autonomy rather than control the promotion of health-related change.

Family Acculturation in Host and Immigrant Couples: Dyadic Research in an Italian Context.

The purpose of this research is to study acculturation strategies and attitudes in central and peripheral domains of host and immigrant couples in an Italian context. The participants were 60 dyads (30 host couples and 30 immigrant couples) who completed a questionnaire based on the Relative Acculturation Extended Model (RAEM). Based on the analysis, we found that the general acculturation attitude preferred by immigrant couples is integration, and Italian couples prefer that immigrants adopt it. Furthermore, Italian partners show moderate internal agreement, whereas immigrant couples show a high degree of agreement. In both groups, the level of agreement between dyadic members is only partially determined by their membership within a social group. The socio-cultural context has a significant role in the internal similarity of Italian couples. In contrast, there is dyadic agreement within immigrant couples.

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study.

Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014-2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one's own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources.