Quality of life in patients with scalp psoriasis.

AIM: The aims of this study were to describe the quality of life (QoL) in patients suffering of scalp psoriasis and to assess the impact of the socio-demographic and clinical features of this condition on patients' health-related QoL, using general and specific QoL scales. METHODS: This research is a cross-sectional study. The study involved 55 patients attending their first examination at the Dermatology Clinic of Padua University over the course of one year (April 2010-March 2011). The outcome was quality of life analyzed by means Scalpdex and SF-36 questionnaire. RESULTS: The sample's mean Scalpdex score was 43.60±17.52, while the mean SF-36 score was 68.28±20.32. The SF-36 identified statistically significant differences between the psoriasis patients and the Italian general population in two domains, i.e. general health (P=0.0075) and emotional role (P=0.0048). The severity of patients' scalp lesions emerged as a factor associated with a reduced QoL in these patients, irrespective of the severity of their disease as a whole. Sex, age, schooling and other socio-demographic factors also characterized patients' perceived QoL. CONCLUSION: Patients with scalp psoriasis suffered from a lower QoL relating to the highly visible site of their psoriatic lesions. Specific supportive measures should be dedicated to these patients by health care workers.

A comparison of student motivation in selecting bachelors of nursing or paediatric nursing at an Italian university.

AIM: To investigate students' reasons for choosing general or paediatric nursing, and to compare motivation factors and personal characteristics between the two professions. BACKGROUND: In Italy, nursing students can choose between two distinct career paths: general and paediatric nursing. However, it is unclear what factors motivate a student to choose between these two pathways. METHODS: A cross-sectional approach was used to compare a sample of general and paediatric nursing students enrolled in a university in northeast Italy. We administered a questionnaire that covered socio-demographic characteristics and included an instrument of motivation developed by Zysberg & Berry to 224 students enrolled in the 3-year classes. RESULTS: We analysed 215 questionnaires (96%). Paediatric nurses were generally younger, had attended a college preparatory high school and had previously failed another university programme. Many students, in both groups, had a relative who was a nurse, or had cared for a sick friend or family member. Students did not vary significantly in how they evaluated items included in the questionnaire. CONCLUSION: A career in nursing should be advised for students who are motivated to help other people. Paediatric nursing was identified as an acceptable career choice by students of college preparatory high schools or by students who had initially enrolled in a different university programme. General nursing was a satisfactory choice by students with previous work experience.

Undergraduate nursing students' attitudes towards organ donation: a survey in an Italian university.

AIMS: To examine undergraduate nursing students' attitudes towards organ donation and to determine whether or not attitudes were related to the students' education and training. BACKGROUND: Nurses' knowledge and personal opinion can influence patient's willingness to donate organs or to hold an organ donor card. It is unclear how Italy's future nurses view organ donation. METHODS: The study's source population consisted of third-year undergraduate nursing students enrolled in seven nursing schools from an Italian university during 2008. Respondents completed self-administered quantitative questionnaire with 61 questions, including the Organ Donation Attitude Scale. FINDINGS: Of the 378 students contacted, 183 (48%) completed all survey questions; 140 were females (76.5%) and the mean age of students was 25. The median score of students' attitude scores towards organ donation was 151 (the attitude is positive when the score is higher than 161). No significant correlations were found to exist between organ-donation attitude and sex, age, clinical practice in hospitals with a transplant unit, nursing care to patients waiting for a transplant or dialysis patients. Only 16% of the students had previously signed a donor card consenting to their own organ donation. The study revealed that doubts about transplantable organs still exist within the student body. CONCLUSIONS: This study highlighted that students' awareness of organ donation was not adequate and that attitude levels were lower than in other countries. If these future workers would receive adequate training, they could promote organ donation to the general public and to other hospital personnel.

Thirst distress and interdialytic weight gain: a study on a sample of haemodialysis patients.

Severe thirst distress is frequent in haemodialysis (HD) patients, and some studies have noted a positive relationship between thirst and an increased interdialytic weight gain (IDWG). The goal of this explorative study was to describe the perception of thirst and correlated symptoms in HD patients, and verify the correlation between thirst intensity and the IDWG. The study was performed on an opportunistic sample of patients treated in the dialysis unit of a city hospital in the North-East of Italy. Data were collected using a questionnaire containing a demographic and a clinical part, the Thirst Distress Scale, and a Visual Analogue Scale (VAS) 0-10 about thirst intensity. The sample of 107 patients was composed of 71 males (66%). The average age was 68 years (SD 12, median 70 years). Fluid restriction causes severe physical discomfort and xerostomy. 66% of the respondents declared a thirst level of more than 7 on the VAS scale. The average IDWG was 2.47 kg. The chi2 test did not show a significant difference when correlated with thirst intensity (p = 0.88).

Comparison of renal care practice in Europe: centre and patient characteristics.

The European Practice Database (EPD) contains data from 8 countries including 276 centres and 21,861 dialysis patients. Comparing patients and centre characteristics, remarkable similarities and pronounced differences in renal practice between different European countries and between centres within each country were found.

Development of indicators to measure European variation of nursing activities.

This paper describes a study to capture the key roles and activities of nephrology nurses across different countries in Europe. The concept of the study and the need to clarify the activities of the nephrology nurse arose as part of a larger study to develop the European Practice Database (EPD) (1). The Research Board (EDTNA/ERCA) needed to identify key questions that would detect significant differences in the role and responsibilities of nephrology nurses in different countries and monitor the evolution over time of nephrology nursing practice in Europe. It was therefore appropriate to devise a separate small study to generate evidence based questions for the EPD and confirm the reliability and usefulness of the information captured.

European practice in haemodialysis: results of the EPD.

The European Practice Database (EPD) project, developed by the EDTNA/ERCA Research Board, collects data on renal practice at centre level in different European countries. Results presented in this paper focus on the European Practice in Haemodialysis centres from 8 European countries or regions following data collection from 2002 to 2004. These results will enable international comparison in practice and will stimulate further research and the development of new practice recommendations.

The Research Board of EDTNA/ERCA: research activities and deliverables.

The Research Board (RB) of EDTNA/ERCA was formed ten years ago to provide opportunities for our members to participate in collaborative research projects at a European level. It provides educational support in research methodology via workshops at conference and in articles published in the Journal. The group has completed a total of seven collaborative research projects in diverse areas of renal care and has recently developed an ambitious new project, the European Practice Database (EPD). The EPD project aims to capture the current practice of renal care professionals in European centres on a three-year repeating cycle. The results of projects are presented at conference and at international scientific meetings by invitation and abstract submission. Recommendations, guidelines or educational material are produced collaboratively with the renal multi-disciplinary community.

European study on epidemiology and management of hepatitis C virus (HCV) infection in the haemodialysis population. Part 3: prevalence and incidence.

An analysis of the literature showed a high prevalence of HCV in the European dialysis population in the nineties. The prevalence was similar in most countries in northern Europe, but infection was more common in France, Italy, Spain, Portugal and Greece (1) and in Eastern European countries (2). The reported prevalence of anti-HCV-positive patients in the EDTA registry was 21% in 1992 and 18% in 1993 (3) ranging from 1% in Finland to 42% in Egypt (4). The incidence of HCV, in new patients starting renal replacement therapy, ranged from 3% to 7% (5,6) and reported seroconversion rates during dialysis treatment varied between 1% (7) and 16% (8) per year.

Transplant practice in Europe: selection of patients.

This paper reports the findings from the European Practice Database project (1) providing an overview of transplant practice in Europe and patient selection. From the 276 centres surveyed 25 recorded performing patient transplants across eight different countries. The overall figures indicate that the waiting list for transplants is made up of 38% women and 9% of patients above the age of 65 years. All countries offered pre-transplant counselling and screening and post-transplant follow-up, but the extent to which these activities occurred varied. The waiting/transplant ratio ranged from one in Norway to eight in Slovakia. Differences still exist as a result of country specific policies and legislation regarding transplantation.

Sero-conversion of HCV negative patients: a European study on the epidemiology and management of HCV haemodialysis patients.

This paper reports part of the findings from a larger study reported earlier, the European study on epidemiology and the management of HCV in the haemodialysis population (1). Centres recruited to the larger study were monitored for a further one year observation period to measure and generate a deeper understanding of HCV sero-conversion. From 4724 patients who were studied at the baseline, in 68 centres, only 13 patients were found to have sero-converted. These sero-conversions occurred in 7 hospitals within 5 different countries. Possible routes of transmission and risk factors are described with respect to the individual centres and good practice recommendations based on current evidence presented.

Infection control practice across Europe: results of the EPD.

The European Practice Database (EPD) project, developed by the EDTNA/ERCA Research Board, collects data on renal practice at centre level in different European countries. Results presented in this paper focus on infection control practice in haemodialysis centres from 8 different European countries or regions following data collection from 2002 up to 2004. The prevalence of hepatitis B (HBV), hepatitis C (HCV), human immune deficiency (HIV) and methicillin-resistant staphylococcus Aureus (MRSA) was studied as well as the use of screening and preventive actions. These results will enable international comparison in practice and will stimulate further research and the development of new practice recommendations.

The organisation of paediatric renal care in different European countries: results of the PAC project.

The Paediatric Access Care (PAC) project, organised by the Research Board of EDTNA/ERCA, aimed to study the organisation of paediatric renal care in Europe and to investigate the practice of access care for both haemodialysis (HD) and peritoneal dialysis (PD) paediatric patients. This paper reports on the organisation of paediatric renal care. The majority of paediatric renal care units were located in specific paediatric units of university hospitals. Most of the centres had offered HD, PD and transplantation (Tx) for more than 20 years. Half of nursing staff had qualifications in paediatric and renal nursing. Most of the centres offered an extended multidisciplinary team approach with the family actively involved in the care of the patient. PD and HD were equally used. Automatic Peritoneal Dialysis (APD) was offered as the standard PD treatment in 2 out of 3 centres. The HD schedule mostly utilised was 3 x 4 hours a week. Half of the patients were on the Tx waiting list and one third of registered patients were transplanted in 2004.

Paediatric access care in Europe: results of the Paediatric Access Care (PAC) project.

Part two of the Paediatric Access Care (PAC) project, a research project of EDTNA/ERCA, investigated PAC in HD and PD patients including the policy for the creation and maintenance of access, and the registration of access related complications that occurred during the registration year of 2004. Data were collected from 39 centres of 13 European countries and included 379 paediatric patients. Fatal complications, resulting in terminating the use of the access, were noted in 59 HD and 22 PD patients. Paediatric access care varied considerably between European centres and in many areas consensus or best practice evidence is still lacking. There is a need for recommendations for the paediatric renal nurse, handling access care in the paediatric renal population.

The European practice database (EPD): results of the study in thte North-East of Italy.

The survey, realized in 2002-03 in the North-East of Italy, describes renal care in dialysis services. A questionnaire, structured at European level, was sent to all dialysis centres by mail. The questionnaire was returned from 21 centres (61.8%) and related satellite units. Results show nonhomogeneity in renal care. Some important results were: low use of peritoneal dialysis (18%), compared to the rest of Europe, elevated presence of older people on haemodialysis, reduced percentage of patients on transplantation waiting list, diffused use of isolation for HCV positive patients, high use of AV fistulae (84%), low employment of renal technicians, absence of renal dieticians and social workers and nurses performing prevalently direct care. Data can be used for different goals: benchmarking activities, selection of deeper research topics and development of more oriented continuous education activities.

[Does the evaluation of the pressure ulcer risk increase better prevention?]. / Valutare il rischio di lesioni da decubito determina una maggiore prevenzione?

The aim of the study was to indagate if pressure sore risk group patients in a 500 beds' hospital received more preventive care of a no risk control sample. Data have been collected on all patients (minimum stay of three days) from admission to discharge using an assessment dedicated tool. Results of a modified Norton Scale show that a 20% of pressure sores' risk patients receive more preventive care. A positive correlation was demonstrated particularly with: patient's position, bed side at 30 degrees inclination, pillows use, preventive local medications. However, in both groups, the general preventive intervention was definite as low. While an encrease of pressure sores (12%) has been demonstrated in the risk group, no alteration has been reported in the control group.

[Postoperative pain in an urology department: evaluation by patients and by nurses]. / Indagine sul dolore postoperatorio in un reparto di urologia: la valutazione dei pazienti e degli infermieri.

A survey conducted in an urological ward of an Italian hospital, has studied the frequency of pain and altered vital signs connected with pain, in the first 36 postoperative hours. Aim of the study was to locate possible differences between pain assessment performed by patients and nurses. 30 patients operated of urological major surgery have been studied. More altered vital sings are pulse and blood pressure, instead respiration is more altered during the night. Pain is most important in the first 24 hours, particularly at 6 a.m. in the first day after surgery. For patients the most painful operation is radical prostatectomy. Nurses had generally substimated pain; only in the 22% of cases there was agreement with the patients, but with they were agreed that the most painful surgical operation is radical prostatectomy. Vital signs alterations are connected with pain peak only in the 25.36% of cases.

[Nurses, woman, breast cancer: integration in a surgical unit. Study of the needs of patients and possible solutions]. / L'infermiera/e, la donna, il cancro della mammella: l'integrazione in una unità operativa di chirurgia. Indagine conoscitiva dei bisogni delle pazienti e possibili proposte operative.

The authors report the results of an investigation performed in a surgical teaching department of the University of Padua. A form was given to all women admitted for breast cancer. Questions were related to the most important concerns during the hospital stay. The targets of this investigation were: To evaluate the feelings during the diagnostic work-up and the related procedures, to evaluate the role and the reaction of the patient's family, to define kind and quality of the informations given to the patients from the nurses staff, to report concern about the future, to define quality of nursing associate, ght to detect the most difficult moments of the disease. On the basis of this investigation the authors suggest the options to approach the problems and possible solutions.