ALLiance for sEcondary PREvention after an acute coronary syndrome. The ALLEPRE trial: A multicenter fully nurse-coordinated intensive intervention program.

The main objective of cardiovascular disease prevention is to reduce morbidity and mortality by promoting a healthy lifestyle, reducing risk factors, and improving adherence to medications. Secondary prevention after an acute coronary syndrome has proved to be effective in reducing new cardiovascular events, but its limited use in everyday clinical practice suggests that there is considerable room for improvement. The short-term results of evidence-based studies of nurse-coordinated secondary prevention programs have been positive, but there is a lack of long-term outcome data. The Alliance for the Secondary Prevention of Cardiovascular Disease in the Emilia-Romagna region (ALLEPRE) is a multicenter, randomized, controlled trial designed to compare the effects of a structured nurse-coordinated intensive intervention on long-term outcomes and risk profiles after an acute coronary syndrome with those of the standard of care. All of the patients randomized to the intervention group take part in 9 one-to-one sessions with an experienced nurse from the participating centers with the aim at promoting healthy lifestyles, reducing risk factors, and increasing adherence to medication over a mean period of 5 years. The primary clinical end point is the reduction in the risk of the 5-year occurrence of major adverse events (a composite of cardiovascular mortality, nonfatal reinfarction, and nonfatal stroke). The primary surrogate end point is the achievement of prespecified targets relating to classical risk factors, lifestyle modifications, and adherence to pharmacological therapy after 2 years of follow-up. Coronary heart disease is a chronic degenerative disease, and patients who recover from an acute coronary syndrome (ACS) are at high risk of developing recurrent events.1 Although secondary prevention measures have proved to be effective and are strongly recommended by all of the international guidelines,2., 3. the 4 EUROASPIRE surveys4., 5., 6., 7., 8. showed that there was still a high prevalence of conventional risk factors, that secondary prevention measures were inadequately implemented, and that their main goals were often not reached. In addition, there were considerable discrepancy in secondary prevention practices between centers and countries, and a widespread underuse of cardiac prevention and rehabilitation programs despite their demonstrated effectiveness in reducing cardiovascular risk over time.9., 10. Over the last 10 years, nurses have been increasingly involved in successful cardiovascular risk management,11., 12., 13. but although this has improved levels of cardiovascular risk, no clear reduction in hard end points such as major cardiovascular adverse events and mortality has been demonstrated.10 The aim of the ALLEPRE trial is to evaluate the benefit of a homogeneous, structured, secondary prevention intervention program, fully coordinated by nurses from in- and outpatient clinics, in terms of cardiovascular risk profiles and major clinical events in ACS patients living in the large Emilia-Romagna region of Italy.

Therapeutic adherence and health outcomes in acute coronary syndrome (SCA) patient: the role of nursing.

BACKGROUND AND AIM: The literature on cardiovascular disease has highlighted that therapeutic adherence is often inadequate. What are the reasons for this poor adherence to medication? The goal has been to measure the different factors related to therapeutic adherence,  differentiating the SCA patients on three levels of self-referred therapeutic adherence and delving the relations between self-reported therapeutic adherence and socio-demographic, clinical, emotive, cognitive and socio-relational variables. METHOD: A total of 84 Italian patients (66.7% males) with (SCA) took part in the study and completed a semi-structured questionnaire investigating the variables described above. RESULTS: RESULTS indicate the influence of clinical variables, showing that patients suffer more of dyspnea and angina symptoms than those that state to follow prescriptions. But the emotive aspects seem able to interfere more with the adherence: the subjects scarcely adherent have felt more threatened by their illness, and experimented more symptoms of anxiety and sadness than highly adherent patients. At a cognitive level the adherent patients have chosen coping strategies not centred on emotions, but headed to the solution of the problem. At socio-relational level is confirmed the importance of the social support in favouring the adherence. CONCLUSIONS: Among the different factors here considered, are those psychological and relational that tend to be associated to level of adherence for prescriptions. The outcomes have shown that the demo-graphical and clinical variables result are not tightly associated to the adherence, confirning instead the importance of psycho-social factors, as already notable in the literature in heart studies. The implications have been discussed.

Meeting the needs of cancer patients: identifying patients', relatives' and professionals' representations.

BACKGROUND AND AIM: The literature on cancer patients agrees that most of the cancer patients' needs often remain unmet. How are these different needs perceived by patients, relatives and professionals? The present research has tried to make a contribution by analysing evidences of the needs, especially unmet, that different actors attribute to a cancer patient. METHOD: A total of 42 Italian participants (76.2% women) took part in the study. Patients, relatives, physicians, nurses, social care assistants and volunteers participated separately in six focus groups. Three face-to-face interviews were conducted with psychologist, general practitioner and social worker. All focus groups/interviews were processed through an analysis of thematic content. RESULTS: The results showed a priority given to the need for information, and also the importance of psychological and social support needs, confirming that they remain unmet. Differences between participants are visible by looking at the needs cited more frequently. For example, the oncologists are more sensitive to information needs related to the illness and its treatment, while the social worker cited the need for social, economic and legal assistance more frequently. The nurses highlighted the need for continuity of care, and the psychologists underlined the importance of psychological support, while the relatives cited the need of support both from and for families. CONCLUSIONS: RESULTS suggested that a comprehensive approach that addresses medical and psychosocial factors is needed. Cancer patients must be provided with a multidisciplinary survivorship care plan that addresses information related to their long-term care and identifies available psychological and social services.

Evaluating a nurse-led narrative interview intervention with cancer patients with a first diagnosis: A feasibility study.

Narrative Medicine and Nursing are clinical-supporting intervention methodologies that aim to enhance professionals' communication skills and place patients at the heart of their therapeutic path. A narrative interview (NI) is a communication tool between practitioner and patient. The role of NI is debated extensively in the literature, but no studies focus on its use by nurses responsible for first-diagnosed cancer patients. This study aimed to evaluate the feasibility and utility of NI, carried out by Nurses, in managing people recently diagnosed with cancer. A pilot mixed-methods study with before-and-after-intervention evaluation, qualitative longitudinal data analysis, and concurrent data triangulation was conducted. The Mini-Mental Adjustment to Cancer assessed disease adaptation, while the Psychological Distress Inventory investigated psychological distress. The qualitative analysis of the narrative interviews assessed the usefulness of this intervention. 13 out of 14 eligible patients took voluntary part in the study. Of those, 9 (69 %) completed T1 and T2 questionnaires and NI. The following five themes emerged from thematic analysis: reaction to the disease, feelings related to the new condition of life, changes, importance of relationships and perception of care. Patients reported being highly stressed and recognized the importance of a supporting social network for better coping with the condition. The adoption of an NI approach at the time of cancer diagnosis is feasible. Due to the limited sample size, it is unclear if NI may positively impact psychological distress in this patient population. Further studies would benefit from the integration of an additional investigation tool aiming to clarify whether NI promotes disease awareness in cancer patients. Furthermore, the recruitment of a larger sample is equally recommended.

Measuring the psychosocial impact of COVID-19 by means of the "international student well-being study questionnaire": Evidence on Italian university students.

Background: The COVID-19 pandemic appeared as an unpredictable disruption of daily activities. This situation produced a unique mental health impact for the general population, youth, and vulnerable groups. A documented consequence has been alcohol abuse and impaired mental health. To our knowledge, no published study has yet evaluated the rates of depressive symptoms, academic frustration, and substance abuse in the Italian student population in the COVID era linking them to sociodemographic variables. Aims: To investigate the incidence of depressive symptoms, academic frustration, and substance abuse students developed in one university in Northern Italy during the first COVID-19 outbreak, using a student wellbeing framework borrowed from Allardt's and Bronfenbrenner's theories. Methods: Descriptive statistics, correlations, Wilcoxon test and factorial ANOVA were performed on data gathered through an online questionnaire sent to a convenience sample of university students. Data collection occurred between 18 May and June 21, 2020. Results: According to the framework used, Being was the dimension of sociodemographic variables, Having was economic support and Loving was social support. Students experienced academic frustration and related depressive symptoms. Male gender seemed to be less affected by the depressive syndrome. With regard to economic support and related repercussions on depressive symptoms, students who reported that they could not obtain a loan showed significantly higher depressive symptoms. Students benefiting from greater financial support showed less academic frustration. Age appeared to be a predictor of academic frustration since young students proved to be the most frustrated. The examined students' population showed a significant decrease in alcohol and cigarettes consumption. Conclusions: Having and Being dimensions influenced depression and academic frustration. Having and Loving dimensions were related with use of substances. The study findings support the implementation of interventions to help students, at a psychological, social, financial level aiming at fostering the quality of students' educational life.

Which factors may affect the willingness to take the HIV test? A research on Italian adults' sample.

Background and aim. Why people do not take the HIV test? The literature on the health-related behaviors associated with HIV infection has highlighted the role played by socio-demographical, behavioral, and cognitive variables. Less often has been studies the impact of psychosocial and normative factors that can affect willingness to test HIV. The aim of this study was to investigate which were the main psycho-social factors that promote/inhibit the intention to take the HIV test. Method. A questionnaire was submitted to a sample of 775 Italian adults (50. 7% female; mean age = 37.24; SD = 10.94; range 17 - 66 years). Results. Logistic Regression Analysis shown that age, risk behaviors, and personal concern are significantly predictors of the intention even if a positive attitude towards HIV test is the strongest predictor. Results showed also that the normative component of attitude (perception of social disapproval) and emotional component (shame and embarrassment) discouraged people from taking the test, while the cognitive-rational component did not. Conclusions. Are the perception of social disapproval by "significant others" and the social emotions of shame and embarrassment that discourage people from taking the test. Implications will be discussed.

The impact of the alterations in caring for COVID-19 patients on Compassion Satisfaction and Compassion Fatigue in Italian nurses: a multi method study.

BACKGROUND AND AIM OF THE WORK: During COVID-19 first wave,  healthcare professionals were exposed to a major psychological pressure related to uncertainty, a lack of therapies or a vaccine and shortages of healthcare resources. They developed higher levels of Burnout and  Compassion Fatigue, and similar levels of Compassion Satisfaction. Aim is evaluating in Italian nurses Compassion Satisfaction and Compassion Fatigue and impacting individual and relational variables. METHODS: A multi-methods approach was used. Qualitative data were collected through 2 focus group. Quantitative data were collected through a web survey composed by an ad hoc questionnaire developed from the focus group results, the Professional Quality of Life Scale-5 and the Resilience Scale (RS-14). RESULTS: In the qualitative phase 6 categories emerged. From the quantitative analysis the sample reported a moderate level of Compassion Satisfaction, a low level of Burnout  and a moderate level of Secondary Traumatic Stress. Compassion Satisfaction had as predictors resilience (ß = .501), followed by feeling part of the team (ß = .406) and collaboration with colleagues (ß = .386). Secondary Traumatic Stress had as predictors the impact of PPE (ß = .269), and feeling Covid-related individual sufferance (ß = .212). The only predictor of Burnout was resilience (ß = -2195). Conclusions: During COVID-19 first wave Italian nurses were exposed to a higher risk of Secondary Traumatic Stress, mainly impacted by frustration, loss of control, loss of possibility to properly care for patients, and personal threat. Relational and team support had a crucial role in sustaining Compassion Satisfaction.

The unmet needs of women with breast cancer: a qualitative research.

BACKGROUND AND AIM OF THE WORK: Breast cancer (CM) is the most commonly diagnosed form of cancer in Italy and the most common malignancy in women (25%) with 53,000 new cases. This disease affects all age groups (1 in 40 women <49 years, 1 in 20 between 50 and 69 years, 1 in 25 between 70 and 84 years). The percentage of patients diagnosed with cancer within 5 years of diagnosis is higher than for other cancers, and this conviction rate in these cancer patients has increased, leading to an ever-improving level of attention. The research aims to understand the main needs of women with breast cancer, compare them with those reported in the literature and in particular to identify which of these are still unsatisfied. Method The study is based on the use of the narrative interview conducted by the Case Manager, in the Breast Unit of Melegnano (Milan), selected with a sampling of convenience.The participants who joined the research project were 12 women with breast cancer, aged between 40 and 60, who are in the active treatment phase of the disease. RESULTS: As highlighted by literature, various unmet needs have emerged, afferent to well-defined areas: emotional health, continuity of care, information, adverse effects, educational strategies, economics, information and social support. The study showed that, the needs that are most unsatisfied relate to the information area and the psychological area. CONCLUSION: The interviews conducted underlined the importance of the role of the Case Care Manager as a facilitator of the disease path that patients are experiencing both in terms of the clinical and psychological aspects but also as a support in managing daily life. future research should investigate the role of the Case Vare manager in meeting these needs.

[The degree of coincidence between the needs of cancer patients and the answers in the statutes of associations and dedicated health services]. / I bisogni del paziente con patologia oncologica e le risposte negli statuti di servizi sanitari dedicati e associazioni.

AIMS: The research took place in the northern area of Emilia Romagna, and aimed at investigating the needs expressed by cancer patients and those included in the goals of health services and associations dedicated to cancer disease. METHOD: The study involved 22 cancer patients (12 females and 10 males, mean age 55.36 +/- 10.7) through a semi-structured interview. Twenty-five Organizational Regulations and 17 Health Card Services of institutions dedicated to cancer disease were also analyzed. RESULTS: The basic needs of cancer patients are rarely economic, legal, material and more often medical and psychological (e.g. psychological support, medical care and equal treatment, continuity of care in hospital and at home and information about diagnosis and treatment). The health services focus on the fulfillment of the needs of self-determination, dignity and respect for people, information on diagnosis and treatments, and of psychological support. The associations provide help through activities geared towards ensuring socialization opportunities (need for aggregation and company), support patients and their family and aim to be a connection in the continuity of care between hospital and home. CONCLUSIONS: While the aims of health services and associations are oriented to respond to many basic needs, some remain still unmet and others are not adequately considered (eg. need to return to daily lives). The offer, aimed to fulfill these need, could be enhanced through a network of synergistic partnerships between health services, citizenship and associations.

The influence of media representations on citizens' perceptions towards nurses: a comparison between before and after the COVID-19 pandemic.

BACKGROUND AND AIM OF THE WORK: In December 2019 in Wuhan, China, an outbreak related to a new Coronavirus (Covid-19) rapidly spread to other countries, including Italy, emerged. On 11 March 2020, the WHO declared a state of pandemic. During the ensuing health crisis, the media exposure of Italian nurses increased. The aim of this research was to investigate whether and how, during the pandemic, citizens' perceptions of nurses have changed, and if this change were related to the public image of health professionals provided by the mass media.  Method: A multi-centric quantitative exploratory study has been conducted. 2114 online questionnaires were analysed for residents of Italy, including health working but excluding the nurses themselves. The results obtained were compared with the results of the scientific literature. RESULTS: Positive perceptions on the part of the citizens towards the nurses are evident, coming to define them "heroes", while discriminatory attitudes are rare. According to the participants, the mass media have conveyed a positive image of the nurses and in relation to this, a percentage of respondents have changed their opinion favourably regarding nurses.  Conclusions: The Covid19-related health emergency has helped raise awareness of the nursing role among both citizens and other health workers, even if a lack of knowledge has been highlighted in the training and care role of nurses. The opportunity should be taken by nurses to make well-know their role, promoting public communication, in order to make their image clearer and more truthful.

A protocol for Italian validation of DEMQoL-Proxy Scale: assessing the Quality of Life of people with moderate or mild dementia.

In this paper, we propose an adaptation of a protocol for a tool's validation. We have utilized this phases-theory to validate in Italian language an instrument to assess Quality of Life for people with moderate or mild dementia. We will explain the example of our Italian validation of DEMQoL-Proxy considering each De Vellis's phase. We will explain our application of De Vellis's model to Italian example described. For the first three phases, we reproduced the original validating study in which authors (Smith et al., 2005) defined what to measure, how generate a set of items and the structure of the scale. Indeed, for the last five phases we explained the adaptation of De Vellis's model to Italian validation. We hope that this model could be effective to validating goals, for researchers and in particular for all professionals who deal with caregivers and patients with moderate and mild dementia. Furthermore, the measurement of the Quality of Life makes the scale widely useful within the various professional specialties and setting. Finally, thanks to the methodological assumptions adopted following the De Vellis's eight-phase model, we can affirm that this first Italian pre-validation of the DEMQoL-Proxy seems to be an excellent forerunner for its effective validation in the Italian context.

The Patient's Narrative Agenda as an assessment tool: the story of Robert, suffering from osteosarcoma.

BACKGROUND AND AIM OF THE WORK: To activate the participation of the person in his/her care path, the literature highlight the impact of the professional's ability to show a genuine interest in the problems brought by the patient and to recognize him/her as 'competent'. In these sense the narrative patient's agenda could be a useful relational tool, because is focused on the perception of patient experiences of his/her illness. Thus this study aims to analyze the usefulness of patient's narrative agenda during the assessment phase. METHOD: A semi-structured interview has been adopted to explore the agenda of Robert, 21 years old, suffering from osteosarcoma. A first level analysis identified the four functional areas of the agenda: ideas and beliefs; expectations and desires and context in which he lives and interacts. A second level analysis assessed the main Robert's problems. RESULTS: The narrative agenda has highlighted many central problems of Robert (e.g. therapeutic adherence, quality of life, mood, body image, existential problems related to experiences, hopes and expectations). Of course these results could be integrated with other tools: qualitative, to understanding difficulties and to formulate hypotheses, and quantitative, to measure the level of severity of problems reported. DISCUSSION AND CONCLUSION: The narrative agenda has not only proved to be a valid instrument of assessment, allowing an adequate insight on the patient's problems, as we exemplified, but it can be also used for monitoring the dynamic situation of the person's history, lending itself to the re-exploration of its functional areas over time.

The impact of a "narrative interview" intervention in oncology. A study protocol for a feasibility study.

BACKGROUND AND AIM OF THE WORK: Oncological diagnosis determines a biographical breakdown and requires the person to adapt to the disease. If patients, after diagnosis, ask professionals for 'compassionate care', research on these issues is still underdeveloped. There are currently no studies that use the narrative interview as an intervention tool. The objectives of the study are to evaluate: (1) the feasibility of the narrative interview intervention on cancer patients in the first diagnosis; (2) the impact of the narrative medicine intervention on the patient's self-perception, his psychological distress and adaptation to the disease. METHODS: It is a mixed-method study, with an intervention (narrative interview) and quantitative evaluation before/after intervention and qualitative evaluation post-intervention (reflective writing). The analysis will use the Psychological Distress Inventory scale for the assessment of psychological distress and the Mini-Mental Adjustment to Cancer Scale for the assessment of disease adaptation. Adult patients, with oncological pathology will be recruited one month after the communication of the diagnosis, regardless of the type of tumor. The Wilcoxon test for paired data will be used to verify pre-post-intervention differences. The 'reflective writings' will be subjected to thematic analysis. DISCUSSION AND CONCLUSION: The study evaluates the feasibility of the narrative interview intervention as a primary outcome. Secondly, the impact of the intervention is assessed in relation to: a) identification of risk or protective factors on psychological distress and adaptation to the disease; b) re-elaboration of the patient's experiences and experiences related to his/her own illness.

Evaluation of midwifery students' satisfaction with regards to clinical internship.

BACKGROUND AND AIM OF THE WORK: The clinical internship is fundamental for the training of the future socio-health professional. Through the practical activity, the student develops professional skills, critical thinking and decision-making ability, internalizing the complexity of the professional role. While in the nursing field there are several tools for assessing the clinical experience of students, in the obstetric field there is a lack of validated tools. Therefore, the purpose of this work was to investigate the perception of the students of the Degree Course in Midwifery regarding the internship experience. METHOD: The study was conducted at the obstetric clinical internship where students carry out practical activities and involved all the students of the Degree Course in Midwifery at the University of Modena and Reggio Emilia. The data were collected through an anonymous online questionnaire (Google Model), which was inspired by the nursing CLES + T, simplified and adapted to the obstetric field. RESULTS: In total, 54 students took part in the research (81.8% of all students enrolled in the degree program examined). They were mainly of Italian nationality (98.1%), women (94.4%), aged between 18-22 years (85.2%). In general, the third-year students were more satisfied with the internship experience than the second- and first-year students, most likely for having achieved a degree of autonomy of care, awareness and greater professional motivation.  Conclusions. The results indicate the need to periodically investigate the quality and satisfaction of the clinical internships to ensure increasingly effective obstetric training.

Job satisfaction, work engagement and stress/burnout of elderly care staff: a qualitative research.

BACKGROUND AND AIM OF THE WORK: Faced with the widespread use of services and facilities for the care and assistance of the elderly, the aim of this study was to explore the factors that can affect job satisfaction, work engagement and stress / burnout of the professionals who work there. METHOD: 32 semi-structured interviews were administered to a not probabilistic sample of the different professional roles (coordinators, nurses, healthcare assistants, physiotherapists, community animators) of a Human Services Company in Reggio Emilia (Italy). This includes day-care and residential care facilities for the elderly. RESULTS: The thematic content analysis showed that inter-professional collaboration and positive relationships with superiors, colleagues and elderly people favour the job satisfaction, while workload, high responsibilities, reduction of rest periods and contributory inequity create dissatisfaction. The work engagement is favoured by professional autonomy, a sense of belonging, professional growth, specific training, while it is disadvantaged by scarce career opportunities, job insecurity and low recognition of one's contribution. Finally, inadequate pay, work load, high turnover and strong emotional experiences related to elderly people increase work-related stress/burnout, while working autonomy, psychological support and good relationships with the elderly reduce it. Some specificities were found according to the different professional roles and the type of services offered. DISCUSSION AND CONCLUSIONS: The results suggest organizational improvement strategies that take these factors into account. Among the improvement proposals we highlight, for example, the promotion of training events, a greater involvement of personnel in corporate decisions and an adequate psychological support for professionals.

Self-efficacy in breastfeeding support: a research on Italian midwifery students.

BACKGROUND AND AIM OF THE STUDY: Maternal breastmilk represents the best nourishment for the newborn baby during its first six months, as it offers several benefits for the health and well-being of babies and mothers. In order to promote, protect and support effectively mother and child during breastfeeding, it is essential for midwives to be properly educated and to acquire highly professionalizing skills. This study aimed to evaluate the level of self-efficacy of the students attending the Degree Course of Midwifery, regarding the support of mother and child in breastfeeding. METHOD: A questionnaire of 37 items (Blackmanet al, 2015) validated in Italian by Mazzeo Melchionda (2019), was sent on-line to students of ten different Midwifery Degree Courses to assess their level of self-efficacy regarding the management of breastfeeding. Statistical analysis was carried out using statistic software R3.4.3 (The Foundation for Statistical Computing). RESULTS: 158 questionnaires were collected from ten Italian Midwifery Degree Courses. The areas in which students showed a high level of self-efficacy in managing breastfeeding include: the benefits of breastfeeding; the child's tendency to take the breast within an hour from childbirth and the relevance of skin to skin contact and rooming-in. Low levels of self-efficacy concerned the comfortably breastfeeding in public places and avoiding giving formula to the baby in its first six weeks of life. CONCLUSIONS: Generally the students attending Midwifery Degree Courses show a high level of self-efficacy in assisting mothers during breastfeeding and they prove to have a good knowledge of the benefits of breastfeeding to improve the health of mothers and their children. (www.actabiomedica.it).

Italian Validation of the Chiba Interprofessional Competency Scale (CICS29).

BACKGROUND AND AIM OF THE WORK: The Chiba Inter-professional Competency Scale (CICS29) validated in several languages, it is a self-report instrument that investigates the degree of interprofessional collaboration in six areas: attitudes and beliefs of the professional; ability to manage a work group; actions to achieve goals; providing assistance that respects the patient; attitudes and behaviours that improve the cohesion of the working group; fulfilling or performing the own professional role. In addition to being recent, the scale investigates collaboration among all health professionals, and is not limited to specific professionals. The aim of the study was to validate the Italian version of CICS29. METHOD: A questionnaire-based study was conducted with an Italian sample consisting of 530 health professionals (419 women¸ mean age = 40 years, SD = 10.7; range 23- 58 years). The internal validity was measured using factor analysis. To verify the convergent validity, the Italian Version of Interprofessional Collaborative Competency Attainment Survey (ICCAS) was correlated with the CICS29; Results: The reliability and the internal validity of the CICS29 revealed 6 factors corresponding to the original subscales. The analysis presents an excellent sample adequacy measure (KMO = .933) with the scores ranging from 0.62 to 0.78 for the interclass correlation coefficients of the 6 domains. A significant level of correlation was found between the subscales of the CICS29 and the ICCAS. CONCLUSIONS: In conclusion, the Italian version of CICS29 has a satisfactory level of reliability and validity and it is recommended for measuring interprofessional collaboration of the health professionals. (www.actabiomedica.it).

Editorial.

This editorial focuses on qualitative research, often mistakenly considered less scientific than quantitative research, in that it is "research without statistics". [...].

Editorial: a focus on Post-Graduate specializations.

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The narrative interview for the assessment of the assisted person: structure, method and data analysis.

BACKGROUND AND AIM: If it is true that the impact of the symptoms of the disease is differently perceived by each person and that there is an incommunicability of the experiences of suffering, it is equally true that the narration provides an understandable representation, which derives from the network of representations that are part of a personal history.  The aim of this study was to offer an in-depth analysis of the "narrative interview" collected during the assessment of a 74 years old diabetic woman. METHODS: A case study was conducted by a nurse with advanced expertise in conducting narrative interview. Content analysis and Meaning analysis were performed using a Grounded theory approach and according with Gee's Poetic Method. RESULTS: The patient after the diagnosis felt disbelief, anger and confusion. The illness forces her to change her life, habits and social role, with high suffering. However she adjusted to this new condition and thanks to her strong and positive attitude and the social support she received, she has succeeded in activating her "post traumatic growth". CONCLUSIONS: A good narrative interview starts long before the interview itself and it requires: a specific training in the use of the instrument; the strengthening of specific skills (e.g. the active listening); the choice of optimal setting and timing for the patient; the ability to offer encouragement in the expression of the subjective experience and to conduct an analysis of the patient's words with a subjective lens, reflecting the uniqueness of each illness experience.