Exploring the Landscape of Breast Cancer Prevention among Chinese Residents in Italy: An In-Depth Analysis of Screening Adherence, Breast Self-Examination (BSE) Practices, the Role of Technological Tools, and Misconceptions Surrounding Risk Factors and Symptoms.

BACKGROUND: Breast cancer remains a significant health concern among women globally. Despite advancements in awareness and diagnostic techniques, it persists as a leading cause of death, with profound impacts on affected individuals' quality of life. Primary and secondary prevention, including regular screenings and practices like breast self-examination (BSE), are pivotal in ensuring early diagnosis. The national health system (NHS) in Italy offers screenings for women aged 50-69 every two years, managed by the local health authority. However, the participation rates, especially among the Chinese female population residing in Italy, are not well understood. METHODS: Using a snowball method, we electronically disseminated a survey to investigate how Chinese women living in Italy engage with available NHS screening programs. The survey also explores their practice of BSE and the use and impact of technological tools on prevention. Furthermore, the study aims to understand the subjects' depth of knowledge and misconceptions about breast cancer. RESULTS: The data reveal a significant gap in breast cancer screening adherence and knowledge among Chinese women in Italy, with a notable discrepancy between the general population and those who have previously encountered cancer. CONCLUSIONS: The results highlight the urgent need for interventions that are culturally sensitive, stressing that these actions are not only desirable but essential.

Statistical analysis and generative Artificial Intelligence (AI) for assessing pain experience, pain-induced disability, and quality of life in Parkinson's disease patients.

The Parkinson's Disease (PD) is a chronic neurodegenerative condition characterized by motor symptoms such as tremors, rigidity, and bradykinesia, which can significantly impact various aspects of daily life. Among these aspects, pain is a prominent element. Despite the widespread use of therapies aimed at improving symptoms and quality of life, effective pain management is essential to enhance the quality of life of individuals affected by this disease. However, a detailed understanding of the factors associated with pain in PD is still evolving. In this study, we examined the disability caused by pain and the pain experienced by PD patients using two validated questionnaires, namely the Parkinson's Disease Questionnaire (PDQ) and the King's Parkinson's Disease Pain Questionnaire (KPPQ). Customized questions were also included to further explore the pain experience and management strategies adopted by PD patients. Through statistical analysis, we explored the relationships between questionnaire scores, socio-demographic data, and other relevant variables. Additionally, generative Artificial Intelligence (AI) was employed to gain a deeper understanding of patient responses. The results indicate the extent and impact of pain in PD and provide valuable insights for more targeted and personalized management. This study lays the foundation for future research and the development of interventions aimed at improving the quality of life for individuals affected by this condition.

The role of the nursing coordinator and the leadership style in the Italian healthcare organizations.

BACKGROUND AND AIM: The leadership of the Nursing Coordinator is essential to ensure quality care and to empower the nursing staff. To identify the leadership style used by the coordinator as nurses and the support staff perceive the leadership behaviors of the coordinator. METHODS: Data were collected through an online questionnaire including the Empowering Leadership Questionnaire. RESULTS: Positive associations were recorded between participants' satisfaction levels and high standards of job performance (p<0.001), being a good example for the whole group (p=0.004) and to encourage sharing ideas and suggestions (p=0.003), hearing ideas and suggestions (p=0.013), giving the opportunity to express their opinions (p=0.046); in the "Coaching" dimension, according to attitudes to help the group to become aware (p<0.001), among all group members (p=0.044); by focusing on their goals (p<0.001); in the "Informing" dimension according to levels and attitudes to explain decisions (p<0.017) and rules and expectations (p=0.046); in the "Showing Concern/Interacting with the Team" dimension according to attitude in personal problems (p<0.028); to discuss concerns (p=0.033); to show interest (p<0.040) and to chat with members (p=0.003). Negative association was registered between the ability to make decisions based solely on the coordinator's ideas (p=0.010), ability to pay attention to the group's efforts (p<0.015). CONCLUSIONS: The role of the Nursing Coordinator within the work setting is very fundamental. The latter must be able to guarantee, through good leadership, a serene work environment so that professionals can provide optimal care to patients and safeguard their profession.

The Social and Professional Image of the Nurse: Results of an Online Snowball Sampling Survey among the General Population in the Post-Pandemic Period.

Background. The COVID-19 pandemic has transformed people's lifestyles by imposing social, economic, and labor changes. Health professionals have been in the spotlight, occasionally even elevated to the status of "heroes", as they have been at the forefront of the health emergency. Media exposure has undoubtedly played a pivotal role in the evolution and perception of the public's image of nurses, especially within the Italian context. Currently, there is only one study conducted in Italy during the pandemic period. For this reason, we have opted to delve further into this subject during the post-pandemic period, with the ultimate goal of identifying this perceptual evolution. Methods. An online snowball sampling survey was conducted among the Italian population using social networks between August 2022 and January 2023. The survey utilized the Nursing Attitude Questionnaire (NAQ) to collect data. Results. The sample consisted of 564 individuals. Among the respondents, 63.8% (n = 360) were familiar with the nursing pathway, and the level of agreement regarding the training of nurses was 81.5% (n = 260). In terms of recognizing the professional role of nurses, variations emerged in certain domains of the NAQ. Specifically, professional values of nurses were more pronounced in northern and central Italy (M = 26.27). Moreover, stereotypes were more prevalent in the north (23.73 ± 3.538) and the center (23.13 ± 4.104) (p = 0.001). Conclusions. The sample acknowledged a unique competence inherent to nurses that cannot be replaced by other professionals. The study population perceives the nursing profession as pivotal within the IHS (Integrated Health System). However, the attractiveness of the profession remains exceedingly low. This study was not registered on a publicly available registry.

Work-family conflict in a cohort of Italian nurses. An observational, multicenter, cross-sectional study.

BACKGROUND AND AIM OF THE WORK: Work-family and family-work conflict can be defined as the degree to which participation in one role, in this case as a worker, interferes with the ability to cope with the responsibilities of another role, namely that of a member of a household. The aim of the study is to investigate the presence of indicators of work- family and/or family-work conflict in a cohort of Italian nurses and possible correlations with social and work variables. RESEARCH DESIGN AND METHODS: An observational, quantitative, multicenter survey was conducted for the study through the computerized administration of a validated questionnaire (Work-Family and Family-Work Conflict, CLF), with the implementation of sociographic variables. The cooperation of 15 Orders of Nursing Professions throughout the country was sought for sample collection. Data collection was bimonthly. RESULTS: Among the participating nurses, there is a statistically significant predominance of conflict in the family-work direction. In particular, the phenomenon seems to be related to age and the presence of children and/or elderly at home to care for. Some work variables seem to positively affect the prevention of potential work-life conflict, such as rostering and work articulation. CONCLUSIONS: These findings place emphasis on the need for healthcare organizations to address the work-family balance of their employees.

Breast Cancer Prevention: The Key Role of Population Screening, Breast Self-Examination (BSE) and Technological Tools. Survey of Italian Women.

Breast cancer is the most common tumor among women worldwide and still remains the leading cause of death in women in Italy. Although survival from this pathology has increased, this disease and its treatment can have lasting or delayed effects that can greatly affect a woman's quality of life. Primary and secondary prevention are currently the best strategies to combat this cancer: improved lifestyle, early adherence to screening, Breast Self-Examination (BSE), and even now the use of technology, have become among the most important tools to ensure increasingly early diagnosis of this disease, which is a major cause of suffering and premature mortality in women. Indeed, early diagnosis of the disease can lead to a good prognosis and a high survival rate. This study investigates the attitude of Italian women to perform clinical checkups aimed at cancer prevention, particularly adherence to free screening programs offered by the National Health Service (NHS) for women in the 50-69 age group. The knowledge, use and emotional approach toward BSE as a screening tool and the use of dedicated apps for this purpose are also investigated. Low adherence to screening programs, lack of BSE practice, and nonuse of dedicated apps are just some of the results observed in this study. Therefore, it becomes essential to spread the culture of prevention, cancer awareness and the importance of screening throughout life.

Clinical Features of Takotsubo Syndrome and Its Differential Diagnostic Criteria in Clinical Nursing Practice: A Review of the Literature.

PURPOSE OF REVIEW: Takotsubo cardiomyopathy (TCM) is a heart disease that mimics the symptoms of a myocardial infarction (MI). The exact cause of TCM is unknown, but the main theory is that the syndrome is triggered by an excessive release of catecholamines, a consequence of factors related to stress or severe emotional distress. The aim of this review is to summarize the various scientific journal articles on the nursing differential diagnosis of TCM, on the specific nurse training (particularly the role of the Advanced Practice Nurse, APN), and on the nursing educational support for the patient after hospital discharge. RECENT FINDINGS: A literature review was conducted on Medline (via PubMed), Web of Science (WoS), Scopus, and Google Scholar databases. Relevant indexed articles that investigated the elements characterizing TCM in nursing differential diagnosis and the role of the APN were identified. RESULTS: Sixteen studies were included in the review; they highlighted the role of the nurse in identifying and educating patients with TCM. Nurses must have a thorough understanding of the syndrome, the onset symptoms, the unusual characteristics, and the probable etiology of TCM in order to recognize and promptly treat patients affected by this syndrome and have the opportunity to educate them after hospital discharge to reduce the possibility of recurrence.

Estimation of the optimal time needed for weaning of Intensive Care Unit tracheostomized patients on mechanical ventilation. A prospective observational study.

BACKGROUND AND AIM: Determining the time that is required for weaning, as well as the factors that influence it can be used for the appropriate planning of patient's medical and nursing care. The aim of this study is to estimate the optimal time an Intensive Care Unit (ICU) patient with tracheostomy needs to wean from mechanical ventilation. METHODS: This prospective observational study was conducted on 162 patients from two general hospitals in Athens, Greece.  A specially designed recording form was created to conduct the study. The Statistical Package for the Social Sciences (SPSS) v.25 for Windows was used to record and analyze the data. The level of statistical significance was set at α=5%. RESULTS: Results were found after comparing and associating the demographic and clinical characteristics and medical history of patients with the duration of weaning, the length of post-tracheostomy ICU stay and the time from intubation to tracheostomy. CONCLUSIONS: According to the results of our study, there are various factors that affect success and duration of weaning. More specifically, there seems to be an association between duration of weaning and age, number of closure attempts, success of closure, time from intubation to tracheostomy, length of the patient's post-tracheostomy ICU stay and diagnosis upon admission. The shorter the duration of weaning, the greater the benefits for the patients themselves, such us avoiding respiratory damage, reduction of mortality and morbidity and preventing of length of patient's ICU stay.

Nursing students' attitudes on caring for people living with HIV/AIDS. A European Multicentre Study.

BACKGROUND AND AIM: Caring for people with HIV/AIDS is a challenging issue for nursing students, involving sometimes misconceptions due to different cultural, political and religious views. The aim of this project was to investigate nursing students' attitudes on caring for people with HIV/AIDS. METHODS: A convenient sample of undergraduate nursing students enrolled in four European universities was recruited. Data were collected by administering the AIDS Attitude Scale (AAS). Statistical analysis included the ANOVA test, the t-test for independent variables, and the Kruskal-Wallis test with a confidence level P <0.05. RESULTS: The sample consisted of 594 students of which 162 (27.3%) were English, 246 (41.4%) Italian and 186 (31.3%) Greek. Study findings demonstrated that students' attitudes toward HIV/AIDS patients were relatively positive, although the majority of them indicated fear of contracting HIV through clinical practice. Nursing students' positive feelings for HIV/AIDS patients were also correlated with the strong willingness to take care of them. CONCLUSIONS: Despite being exposed to different teaching and learning experiences, a significant part of the participants believe that HIV/AIDS make nursing a high-risk profession. Furthermore, students' misconceptions are not limited to clinical practice areas as they expressed concerns in sending their children in a class along with a child affected by AIDS and/or in dining in a restaurant where a chef affected by AIDS works. Students are in general well-disposed towards this patients' population but there is still stigma associated with this condition. A new teaching and learning approach may help redefining students' attitudes and in limiting the negative impact of misconceptions on the quality of nursing care. Further investigation in this area would help in shading light on the reasons why students are still biased in approaching AIDS/HIV patients. The use of a qualitative approach based on semi-structured interviews and/or focus group would be recommended.

Early versus Late Tracheostomy Promotes Weaning in Intensive Care Unit Patients: a retrospective observational study.

BACKGROUND AND AIM: The time interval between the patients' intubation and the performance of a tracheostomy has been considered as critical for the disease prognosis and outcome. The aim of the present study was to compare and contrast the outcomes of early vs late tracheostomy with regard to ICU patients' weaning from respiratory support. METHODS: This retrospective observational study, involved patients who were hospitalized in two general and one Covid-19 ICUs of two tertiary hospitals in Athens and were subjected to tracheostomy. Data were collected from the patients' medical records in order to estimate the duration of patient weaning and the number of days from the patients' intubation until the time of tracheostomy. In the present study the term earlytracheostomy denotes tracheostomy performed within 14 days from patient intubation and late tracheostomydefines the tracheostomy carried out after 14 days. For Covid-19 patients, guidelines suggested that tracheostomies should be performed 21 days following intubation, due to the high risk of virus transmission. RESULTS: One hundred and thirty-one patients who underwent tracheostomy participated in the study. Most tracheostomies were performed using the percutaneous technique. The group of patients tracheostomized within 14 days after their admission in ICU weaned faster from respiratory support compared to ones who were tracheostomized after 14 days. CONCLUSIONS: The most common distinction between early and late tracheostomy is 14 days, with early tracheostomy being more beneficial in terms of patients' outcomes, and specifically ICU patients' weaning.

Nurse's knowledge and perceptions on communicative hypnosis: an observational study.

Background Much evidence shows that hypnotic communication can have a pain-relieving effect and reduce complications such as anxiety, insomnia and depression. Whenever this technique was applied, the use of pharmaceuticals was reduced, there were less side effects, shorter hospitalization timesframes and lower treatment costs. Aim of the study Evaluate the knowledge and perceptions of nurses about hypnotic communication and the causes for which this technique is not frequently used. A secondary objective pointed to measuring the effectiveness of an educational event on hypnosis. Method The evaluation was done by administering an anonymous and voluntary survey, in a pre-test and post-test modality to nurses subscribed to a formative event on hypnotic communication organized by the Nursing Order, Province of Ravenna. Results 78 nurses participated in the study. The analysis of the pre-test results show a gap of knowledge regarding hypnotic communication. The main causes were found regarding the lack of use for hypnotic communication: stereotypes and prejudices related to this technique and insufficient university education. Conclusions The implementation of this technique, effective and efficient under various aspects, requires a preliminary creation of culture regarding this theme, capable of surpassing the stereotypes and resistances brought by a lack of theoretical elements.

Nursing student attitudes toward dying patient care: A European multicenter cross-sectional study.

Background and aim of the work Nursing education plays a key role in preparing future nurses to deal with dying patients, which represents one of the most emotionally involving aspect of nursing. The aims of the study were to explore nursing students' attitudes towards care of dying patients in three different European contexts and to analyze the variables that can influence them. Methods We conducted an international multicenter cross-sectional study. We administered the Frommelt Attitude Toward Care of the Dying Scale form B (FATCOD-B) and a demographic form to 569 students, enrolled in the Nursing Programmes in three different countries (Italy, Spain and the United Kingdom), who accepted to participate in the study. The data were analyzed using SPSS software version 26.0. Results Median total FATCOD-B scores indicated intermediate levels of students' attitudes towards care for dying patients, with a statistically significant difference among the three student groups. The median total FATCOD-B scores did not statistically significantly change in students with different age, gender, year of study, religious believes, nursing education on palliative care, previous experiences of dying patient care and personal grieving. Conclusions In our study, nursing students feel partially prepared in caring for dying patients and their attitudes do not change as the course of study progresses. No selected variables had an impact on students' attitudes towards palliative care. Since nurses play a vital role in ensuring the quality of care, education on end-of-life care should be offered as a core part of undergraduate nursing programs.

Emotional impact of clinical practice in Burns Unit among nursing students: a qualitative study.

BACKGROUND AND AIM OF THE WORK: In Burns Units, the long professional relationship with patients suffering from intense physical pain and psychological distress, which cannot be completely resolved or minimized, exposes nurses to very intense emotions and stressful experiences. Learning to care for patients with such medical conditions can arouse many emotions also in nursing students, that can be both positive and negative. The goal of this study was to describe the emotional impact experienced by nursing students in a Italian Burns Unit. METHODS: A qualitative research was implemented among 16 undergraduate nursing students, before and after clinical practice in a Burns Unit, through a semi-structured interview. RESULTS: Strong and conflicting emotions from nursing students were reported in the preliminary stage of the internship. Their enthusiasm and curiosity for a new opportunity countered their fear and anxiety of not feeling able to deal with the clinical situation. The internship experience ranged from emotions of joy at the healing of patients to impotence and frustration at not being able to alleviate intense and lasting suffering. All students reported that the internship was experienced as an important opportunity for personal and professional growth. CONCLUSIONS: In light of the results, we highlight that nurse trainers should support students to take full advantage of this training, helping them to express their emotions and, in the same time, to learn to manage them profitably.

Validation of the Italian version of Behavioral Pain Scale in sedated, intubated, and mechanically ventilated pediatric patients.

BACKGROUND AND AIM: Pain assessment in pediatric intensive care unit (PICU) is a demanding challenge. The COMFORT-B scale is recognized as the gold standard in such patients. However, the use of this instrument in PICU setting is disputed. The Behavioral Pain Scale (BPS), instead, is considered to be the gold standard for pain assessment in deeply sedated, mechanically ventilated adult patients. The BPS has been validated in Italian, requires a short observation time compared to the COMFORT-B and does not increase workloads. A first evaluation of BPS was made in PICU with good results regarding face validity and content validity, however suggesting further studies given the small sample on which it was tested. The aim of this study was the validation of the BPS in sedated, intubated, and mechanically ventilated pediatric patients. METHODS: A descriptive, comparative design was used. A convenience sample of 84 non-verbal, sedated and mechanically ventilated critical care pediatric patients was included. Patient pain was assessed concurrently with three observational scales (BPS, COMFORT-B, NRS) before, during and after routine procedures that are considered painful and non-painful. RESULTS: Internal consistency was α = .86. Correlations between BPS and the other instruments were high, demonstrating a good concurrent validity of the BPS. T test and assessment of ROC curves demonstrated a good discriminant validity of the BPS. CONCLUSIONS: The BPS proved to be valid and reliable for the assessment of pain also in the use with pediatric patients.

The skill of nursing students trained in the evaluation of electrocardiographic trace: a comparison with emergency nurses.

BACKGROUND AND AIM OF THE WORK: Cardiovascular diseases represent the main cause of death in Italy. Early recognition of pathological electrocardiographic (ECG) trace is an important skill for nurses. The theoretical knowledge and the practical skills on the recognition of pathological ECG trace of trained nursing students were compared with those of emergency nurses. METHODS: The study involved 35 nursing students and 41 nurses from the emergency room, emergency medicine and ambulance service. Students were previously trained through a theoretical and practical ECG course. The data were collected using  two questionnaires aimed at evaluating in the two groups the ability to recognize electrocardiographic signs. The tools were uploaded to an online platform and remotely administered. RESULTS: Both the students and the nurses showed a satisfactory theoretical knowledge of the ECG trace, with a statistically significant difference in favor of the nurses. Regarding practical skills, both groups showed difficulty in recognizing pathological electrocardiographic signs, particularly blockages and acute coronary syndromes. CONCLUSIONS: Nursing students' knowledge of ECG did not differ much from that of nurses. Training through simulation probably played a key role in improving the skill of ECG evaluation among students. More theoretical and practical courses on ECG should be recommended in Nursing Programme.

Healthcare personnel exposure to COVID - 19: an observational study on quarantined positive workers.

BACKGROUND AND AIM OF THE STUDY: COVID-19 is characterized by super spread events occurring in communities, e.g., hospitals. To limit virus diffusion among healthcare workers the use of personal protective equipment and screening tests are highly advised; also, isolation of virus positive professionals while monitoring their health condition is recommended. This study aims to assess, in a cohort of COVID-19 positive quarantined healthcare workers, the perceived source of infection and exposure risk as well as the clinical evolution of the disease through a surveillance interview. METHODS: A retrospective observational study accounting 896 observations on 93 healthcare professionals tested positive for COVID-19. Data were collected from the Nursing and Technical Directorate of Romagna, Ravenna, Local Health Company, Italy. RESULTS: 99.5% of the positive workers accepted phone interviews with management staff. 2.6% of workers were positive with increasing records in the specialist medical area. Nurses and social health professionals were mostly affected.  Patient exposure at a distance <1 m and a contact time > 2 hours was the first cause of positivity. In COVID-19 and territorial emergency departments, the first cause was the contact with colleagues. At the time of the infection, most of the staff wore a surgical mask. Cough, asthenia, fever, anosmia, dysgeusia, and rhinitis were common symptoms. Asymptomatic percentage was about 10%. The self-perceived physical condition was high (>7) and improved during the observation period. CONCLUSIONS: The diffusion rate of COVID-19 among healthcare workers is relatively low, probably due to the use of personal protective equipment. The distancing, also among colleagues, is a fundamental measure to reduce the possibility of infection. Symptoms are mild and can be controlled by surveillance measures. Constant contact with the organization is an essential strategy for promoting recovering of workers and reducing the spread of the virus within the healthcare organization.

Effectiveness of a video lesson for the correct use in an emergency of the automated external defibrillator (AED).

BACKGROUND AND AIM OF THE WORK: Every year around 275 thousand people in Europe and 420 thousand in the United States are affected by sudden cardiac arrest. Early electrical defibrillation before the arrival of emergency services can improve survival. Training the population to use the AED is essential. The training method currently in use is the BLSD course, which limits training to a population cohort and may not be enough to meet the requirements of the proposed Law no. 1839/2019. This study aims to verify the effectiveness of an online course that illustrates the practical use of the AED to a population of laypeople. METHODS: An observational study was conducted to compare a lay population undergoing the view of a video spot and a cohort of people who had participated in BLSD Category A courses. The performances of the two groups were measured immediately after the course and 6 months later. RESULTS: Overall, the video lesson reported positive results. Six months later the skills were partially retained. The cohort that followed the video lesson showed significant deterioration in the ability to correctly position the pads and in safety. CONCLUSIONS: Although improved through significant reinforcements, the video spot represents a valid alternative training method for spreading defibrillation with public access and could facilitate the culture of defibrillation as required by the new Italian law proposal.

Violence Against Nurses in the Triage Area: A Mixed-Methods Study.

INTRODUCTION: Workplace violence is a serious occupational problem among nurses in emergency departments. The aim of this study was to better understand workplace violence experienced by triage nurses. METHODS: A mixed-methods study was carried out with 27 Italian nurses involved in the triage area of an emergency department. Quantitative data were collected using the Violent Incident Form and qualitative data were obtained from 3 focus groups. RESULTS: Ninety-six percent of triage nurses had suffered an episode of violence during the previous year. Participants reported that perpetrators of violence were primarily patients' relatives or friends (62%), usually male and in a lucid state of consciousness. The aggressor was a male patient in 31% of violent episodes. Male nurses reported only verbal abuse, unlike female nurses who suffered both physical and verbal episodes. Females received assistance from other staff during the aggression event more frequently than males, and females more frequently suffered from physical injury. Only physical and verbal aggressions were associated with physical injury. Four main themes emerged from the focus groups. DISCUSSION: Nurses reported that high exposure to workplace violence in triaging had significant consequences on their psychological well-being and on their behavior at work and at home. Violence, perceived as a personal and/or professional injury owing to insufficient organizational support, led professionals to experience feelings of resignation and to believe that abuse was an inevitable part of the job. Nevertheless, in our study, the precipitating factors were investigated, suggesting several possible solutions to limit this phenomenon.

Peer-support: a coping strategy for nurses working at the Emergency Ambulance Service.

BACKGROUND AND AIM OF THE STUDY: Working in the emergency medical service often exposes nurses to highly stressful situations and can impact their quality of life. Among the strategies aimed at mitigating the effects of this phenomenon, peer-supporting represents an emerging model used in the emergency medical service setting. The aim of the study is to explore the experiences, the opinions and feelings of emergency medical service nursing staff in relation to the use of the peer supporting model. METHODS: A semi-structured interview was carried out. Participants were recruited on a voluntary basis from an emergency medical service in the north of Italy. Interviews were audio-recorded and the data extracted were anonymised. RESULTS: 14 nurses participated in the study. The totality of the participants recognized that their daily clinical practice, especially when involving paediatric patients, can have a profound emotional impact on their life in general. Furthermore, interviewees admitted that their personal copying mechanisms did not seem to be entirely effective when processing their painful experiences.  The majority of the participants were in favour of introducing a peer-supporter in the ambulance service. CONCLUSIONS: This study emphasises the need to implement emotional support tools for non-hospital emergency nurses in daily clinical practice, in order to facilitate emotional decompression secondary to particularly stressful interventions as soon as possible. The peer-supporting strategy could represent, in this direction, a valid and shared model.

The use of wearable devices in preventing hospital readmission and in improving the quality of life of chronic patients in the homecare Setting: A Narrative Literature Review.

INTRODUCTION: According to the World Health Organisation chronic diseases are the leading cause of mortality in the world, representing 60% of all deaths. Strategies employed to tackle chronic diseases aim to act on risk factors through adopting a healthy lifestyle. These strategies can be greatly implemented from the adoption of wearable devices, which allow a thorough and mini- mally invasive monitoring of patients' clinical data. This article aims to clarify whether wearable devices can help in preventing hospital readmission and improve quality of life in chronic patients. METHOD: A literature search of electronic databases was performed in January 2017. The following databases were searched: The Cochrane Database of Systematic Reviews, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Pub Med, EMBASE and MEDLINE. RESULTS: 33 articles met the inclusion criteria and were included in the literature review. DISCUSSION: Various wearable devices are currently available to monitor and keep records of diffe- rent clinical information. Some of them are proved to prevent hospital re-admissions and to treat effectively life-threatening situations in certain categories of chronic patients. Higher level of acceptability and usability are achieved when users are involved in the testing stage prior to the release of the device and/or the features and terms of use are clearly described to patients and carers. Wearable devices are also proved to be more accurate than clinical assessment only in estimating the risk of falls in chronic patients, thus improving safety in the home care setting. Regardless of their features, wearable devices are yet to be used by both healthcare professionals and patients on a large scale.