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1.
BMC Med Educ ; 23(1): 452, 2023 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-37337231

RESUMEN

BACKGROUND: During the CoronaVIrus-19 (COVID-19) pandemic, nursing education has been dramatically transformed and shaped according to the restrictions imposed by national rules. Restoring educational activities as delivered in the pre-pandemic era without making a critical evaluation of the transformations implemented, may sacrifice the extraordinary learning opportunity that this event has offered. The aim of this study was to identify a set of recommendations that can guide the Italian nursing education to move forward in the post-pandemic era. METHODS: A qualitative descriptive design was undertaken in 2022-2023 and reported here according to the COnsolidated criteria for REporting Qualitative research guidelines. A network was established of nine Italian universities offering a bachelor's degree in nursing for a total of 6135 students. A purposeful sample of 37 Faculty Members, 28 Clinical Nurse Educators and 65 Students/new graduates were involved. A data collection was conducted with a form including open-ended questions concerning which transformations in nursing education had been implemented during the pandemic, which of these should be maintained and valued, and what recommendations should address the transition of nursing education in the post-pandemic era. RESULTS: Nine main recommendations embodying 18 specific recommendations have emerged, all transversally influenced by the role of the digital transformation, as a complementary and strengthening strategy for face-to-face teaching. The findings also suggest the need to rethink clinical rotations and their supervision models, to refocus the clinical learning aims, to pay attention towards the student community and its social needs, and to define a pandemic educational plan to be ready for unexpected, but possible, future events. CONCLUSIONS: A multidimensional set of recommendations emerged, shaping a strategic map of action, where the main message is the need to rethink the whole nursing education, where digitalization is embodied. Preparing and moving nursing education forward by following the emerged recommendations may promote common standards of education and create the basis on for how to deal with future pandemic/catastrophic events by making ready and prepared the educational systems.


Asunto(s)
COVID-19 , Bachillerato en Enfermería , Educación en Enfermería , Estudiantes de Enfermería , Humanos , Pandemias , COVID-19/epidemiología , Aprendizaje , Investigación Cualitativa , Bachillerato en Enfermería/métodos
2.
BMC Nurs ; 22(1): 269, 2023 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-37580681

RESUMEN

BACKGROUND: Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs' job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs' job satisfaction. METHODS: A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression. RESULTS: Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs' satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation. CONCLUSIONS: Nursing education plays a significant role in NGNs' job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs' job satisfaction and ultimately the high-quality care of the patients.

3.
BMC Nurs ; 21(1): 101, 2022 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-35505402

RESUMEN

BACKGROUND: Nursing education has been disrupted by the onset of the COronaVIrus Disease 19 (COVID-19) pandemic, potentially impacting learning experiences and perceived competencies at the time of graduation. However, the learning experiences of students since the onset of COVID-19, their perceived competences achieved and the employment status one month after graduation, have not been traced to date. METHODS: A cross sectional online survey measured the individual profile, the learning experience in the last academic year and the perceived competences of the first COVID-19 new nursing graduates in two Italian universities. Details relating to employment status and place of employment (Covid-19 versus non-COVID-19 units) one month after graduation were also collected and the data compared with those reported by a similar cohort of new graduates pre-pandemic in 2018-2019. All those who graduated in November 2020 and attended their third year after the onset of the COVID-19 pandemic were eligible. The online survey included individual, nursing programme and first working experience variables alongside the Nurse Competence Scale (NCS). Descriptive and inferential statistical analyses were performed. RESULTS: A total of 323 new graduates participated. In their last academic year, they experienced a single, long clinical placement in non-COVID-19 units. One month after graduation, 54.5% (n = 176) were working in COVID-19 units, 22.9% (n = 74) in non-COVID-19 units and 22.6 (n = 73) were unemployed. There was no statistical difference among groups regarding individual variables and the competences perceived. Fewer new graduates working in COVID-19 units experienced a transition programme compared to those working in non-COVID-19 units (p = 0.053). At the NCS, the first COVID-19 new graduate generation perceived significantly lower competences than the pre-COVID-19 generation in the 'Helping role' factor and a significant higher in 'Ensuring quality' and 'Therapeutic interventions' factors. CONCLUSIONS: The majority of the first COVID-19 new graduate generation had been employed in COVID-19 units without clinical experience and transition programmes, imposing an ethical debate regarding (a) the role of education in graduating nurses in challenging times with limited clinical placements; and (b) that of nurse managers and directors in ensuring safe transitions for new graduates. Despite the profound clinical placement revision, the first COVID-19 new graduate generation reported competences similar to those of the pre-COVID-19 generation, suggesting that the pandemic may have helped them to optimise the clinical learning process.

4.
Nurs Ethics ; 26(6): 1665-1679, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29783904

RESUMEN

BACKGROUND: Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. RESEARCH AIMS: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. RESEARCH DESIGN: An Italian national cross-sectional study design was performed in 2015-2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 - 'never' to 3 - 'very much'). PARTICIPANTS AND RESEARCH CONTEXT: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions. ETHICAL CONSIDERATIONS: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee. FINDINGS: Overall, 4707 (49%) perceived to have discussed ethical issues 'much' or 'very much'; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, 'enough' or 'never' ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues. CONCLUSION: Nursing faculties should assess the clinical environment prerequisites of the settings as a context of student experience before deciding on their accreditation. Moreover, the nursing faculty and nurse managers should also enhance competence with regard to discussing ethical issues with students among clinical nurses by identifying factors that hinder this learning opportunity in daily practice.


Asunto(s)
Ética en Enfermería/educación , Preceptoría/métodos , Estudiantes de Enfermería/psicología , Adolescente , Adulto , Análisis de Varianza , Estudios Transversales , Bachillerato en Enfermería/métodos , Bachillerato en Enfermería/normas , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Preceptoría/tendencias , Estudiantes de Enfermería/estadística & datos numéricos , Encuestas y Cuestionarios
5.
Med Educ ; 52(11): 1156-1166, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30345687

RESUMEN

CONTEXT: Error reporting is considered one of the most important mediating factors for patient safety (PS). However, reporting errors can be challenging for health care students. OBJECTIVES: The aims of the study were: (i) to describe nursing students' opportunity to report errors, near misses or PS issues that emerged during their clinical learning experience; and (ii) to explore associated factors of the process of reporting itself. METHODS: A national survey was conducted on 9607 (91.7%) undergraduate nursing students. The endpoint was to have reported PS issues in the last clinical learning experience (from 0 'never' to 3 'always'). Explanatory variables were set individual, nursing programme and regional levels. RESULTS: A total of 4004 (41.7%) nursing students reported PS issues from 'never/rarely' to 'sometimes'. In the multi-level analysis, factors increasing the likelihood of reporting events affecting PS have been mainly at the nursing programme level: specifically, higher learning opportunities (odds ratio [OR] = 3.040; 95% confidence interval [CI], 2.667-3.466), self-directed learning opportunities (OR = 1.491; 95% CI, 1.364-1.630), safety and nursing care quality (OR = 1.411; 95% CI, 1.250-1.594) and quality of tutorial strategies OR = 1.251; 95% CI, 1.113-1.406). By contrast, being supervised by a nurse teacher (OR = 0.523; 95% CI, 0.359-0.761) prevented the disclosure of PS issues compared with being supervised by a clinical nurse. Students attending their nursing programmes in some Italian regions showed a higher likelihood (OR from 1.346 to 2.938) of reporting PS issues compared with those undertaking their education in other regions. CONCLUSIONS: Nursing students continue to be reticent to report PS issues. Given that they represent the largest generation of future health care workers, their education regarding PS should be continuously monitored and improved; moreover, strategies aimed at developing a non-blaming culture should be designed and implemented both at the clinical learning setting and regional levels.


Asunto(s)
Revelación/estadística & datos numéricos , Errores Médicos/psicología , Errores Médicos/estadística & datos numéricos , Seguridad del Paciente/estadística & datos numéricos , Estudiantes de Enfermería/psicología , Adulto , Femenino , Humanos , Italia , Masculino , Investigación Cualitativa , Adulto Joven
6.
Worldviews Evid Based Nurs ; 15(6): 480-490, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30328676

RESUMEN

BACKGROUND: Easy-to-access tools have been demonstrated to improve evidence-based practice (EBP) competences among nursing students. However, students' perception of access to EBP tools (e.g., clinical practice guidelines [CPGs], protocols) is unknown. AIMS: To explore: (1) nursing students' opportunity to access EBP tools during their education, and (2) associated factors. METHODS: A national cross-sectional study including all Italian nursing programs. Nursing students were deemed eligible according to the following inclusion criteria: Those who (1) were attending or just ended their practical rotation lasting at least 2 weeks at the time of the survey, and (2) expressed through written informed consent their willingness to take part in the study. Participants were asked about their perceived opportunity to access EBP tools during their most recent clinical learning experience (from 0 - not at all to 3 - always). A set of explanatory variables was collected at the individual, nursing program, and regional levels by using a questionnaire. RESULTS: Nine thousand six hundred and seven (91.6%) out of 10,480 nursing students took part in the study. Overall, 4,376 (45.6%) students perceived not at all or only a small opportunity to access EBP tools during their most recent clinical rotation. In the multilevel analysis, factors promoting access were mainly set at the clinical learning environment level (high safety and nursing care quality, high self-directed learning opportunities, high quality of the learning environment, and being supervised by a clinical nurse). In contrast, male gender and lower academic class were associated with a lower perception of accessibility to EBP tools. A consistent variability in the perceived opportunity to access EBP tools emerged across regions. LINKING EVIDENCE TO ACTION: Evidence-based decision-making is increasingly expected from nurses. Therefore, nursing faculties should safeguard and continuously improve students' competence regarding EBP, by implementing strategies mainly at the nursing program and regional levels.


Asunto(s)
Curriculum/normas , Percepción , Estudiantes de Enfermería/psicología , Adulto , Estudios Transversales , Bachillerato en Enfermería/métodos , Bachillerato en Enfermería/normas , Práctica Clínica Basada en la Evidencia , Femenino , Humanos , Italia , Masculino , Encuestas y Cuestionarios
7.
Nurse Educ Pract ; 78: 104019, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38851041

RESUMEN

AIMS: To explore the differences, if any, in the competences perceived by newly graduated nurses who attended their education before and during the COrona VIrus Disease 19 (COVID-19) restrictions. BACKGROUND: Nursing education has undergone significant changes because of the COVID-19 restrictions. However, to date the perceived competences at the point of graduation have not been investigated over the restrictions years compared with the pre-restrictions era. DESIGN: A repeated cross-sectional study followed by a pseudo-panel analysis. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. Data on individual, nursing programme and perceived competences with Nurse Competence Scale (NCS) were collected and analysed by also using a pseudo-panel approach. METHODS: Two universities were involved. Those eligible were nursing students who graduated: (1) in 2020 (=323) as the first post-COVID-19 group, who were studying in the 3rd year at the onset of the restrictions; (2) in 2021 (=250) as the second post-COVID-19 graduated group, who were in the 2nd year at the restrictions onset; and (3) in 2022 (=247) as the third post-COVID-19 group, attending the 1st year of nursing education at the onset of the restrictions. Data were compared with those who graduated in 2019 (=336, pre-COVID-19 group). RESULTS: The overall NCS score was higher in the pre-COVID-19 group (68 out of 100, 95 % Confidence of Interval [IC] 66.4-69.5), lower in the first post-COVID-19 graduates (62.9, 95 % CI 60-65.8), higher in the second (66.6, 95 % CI 63.6-69.4) and lower again in the third post-COVID-19 group (63.8, 95 % CI 60.9-66.5). A sinusoidal pattern also emerged for the frequency of use of the competences from the pre-COVID-19 (2.3 out of 3) and the first group (2.1) and increased between the second and the third group (from 2.1 to 2.3) (p< 0.001). These sinusoidal trends are also evident in the pseudo-panel analysis. CONCLUSIONS: A different degree of perceived competences at the point of graduation emerged, with higher competences in the pre-restrictions group, lower in the first post-COVID-19 generation, higher again in the second and third group. However, all scores were over 60 points out of 100, thus indicating sufficient competences. The frequency of use of such competences slightly changed over the years with limited practical relevance. The findings may inform reflections regarding innovations in the clinical placements pathways as well as in the strategies supporting newly graduates nurses in their transition from education to health-care settings.

8.
BMJ Open ; 13(12): e077417, 2023 12 09.
Artículo en Inglés | MEDLINE | ID: mdl-38070911

RESUMEN

INTRODUCTION: Non-invasive ventilation (NIV) treatment combined with pronation in patients with COVID-19 respiratory failure has been shown to be effective in improving respiratory function and better patient outcomes. These patients may experience discomfort or anxiety that may reduce adherence to treatment. OBJECTIVE: The aim of this study was to explore and describe the subjective experiences of patients undergoing helmet NIV and pronation during hospitalisation for COVID-19 respiratory failure, with a focus on the elements of care and strategies adopted by patients that enabled good adaptation to treatments. METHOD: A qualitative descriptive study, using face-to-face interviews, was carried out with a purposeful sample of 20 participants discharged from a pulmonary intensive care unit who underwent helmet continuous positive airway pressure and pronation during hospitalisation for COVID-19. RESULTS: Content analysis of the transcripts revealed feelings and experiences related to illness and treatments, strategies for managing one's own negative thoughts, and practical strategies of one's own and healthcare workers to facilitate adaptation to pronation and helmet. Experience was reflected in five major topics related to specific time points and settings: feelings and experiences, helmet and pronation: heavy but beneficial, positive thinking strategies, patients' practical strategies, support of healthcare professionals (HCPs). CONCLUSIONS: This study may be useful to HCPs to improve the quality and appropriateness of care they provide.


Asunto(s)
COVID-19 , Ventilación no Invasiva , Insuficiencia Respiratoria , Humanos , COVID-19/terapia , Pronación , Insuficiencia Respiratoria/terapia , Cumplimiento y Adherencia al Tratamiento , Evaluación del Resultado de la Atención al Paciente
9.
Assist Inferm Ric ; 42(4): 218-234, 2023.
Artículo en Italiano | MEDLINE | ID: mdl-38230556

RESUMEN

. The education of specialized nurses' aides: current scenario and future perspectives. INTRODUCTION: The complementary training in health care of the nurse aides (NAs), launched in Italy in 2003, has little impact on health care organisations. OBJECTIVE: To analyse, through the regional provisions issued in the last three years, the current state of complementary training in health care and propose some recommendations for the nursing profession with respect to the inclusion of this figure in care teams. METHODS: A documentary content analysis was conducted with respect to six main topics: recipients and admission to the courses, organisation and characteristics of the courses, learning evaluation, responsibilities of the new NAs, expected competences and skills. RESULTS: There is a clear need to update and standardise the contents of the courses, with a focus on current social and health problems and future scenarios, and to render more homogeneous the structure of the courses, to guarantee high standards at national level. The need of increasing the skills of the NAs is associated with the implementation of innovative care and organisational models that require the ability to care for populations whose needs have changed profoundly over the last twenty years. CONCLUSIONS: Health care teams with professionals with different skill-mix guarantee safe, appropriate, effective and efficient care: the organization should enable nurses to free up time to act out their competences in care planning, health promotion, therapeutic education, transition management and specialist functions.


Asunto(s)
Enfermeras y Enfermeros , Asistentes de Enfermería , Humanos , Atención a la Salud , Aprendizaje , Italia , Competencia Clínica
10.
Antibiotics (Basel) ; 12(2)2023 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-36830285

RESUMEN

BACKGROUND: A correct approach to recurrent urinary tract infections (rUTIs) is an important pillar of antimicrobial stewardship. We aim to define an Artificial Neural Network (ANN) for predicting the clinical efficacy of the empiric antimicrobial treatment in women with rUTIs. METHODS: We extracted clinical and microbiological data from 1043 women. We trained an ANN on 725 patients and validated it on 318. RESULTS: The ANN showed a sensitivity of 87.8% and specificity of 97.3% in predicting the clinical efficacy of empirical therapy. The previous use of fluoroquinolones (HR = 4.23; p = 0.008) and cephalosporins (HR = 2.81; p = 0.003) as well as the presence of Escherichia coli with resistance against cotrimoxazole (HR = 3.54; p = 0.001) have been identified as the most important variables affecting the ANN output decision predicting the fluoroquinolones-based therapy failure. A previous isolation of Escherichia coli with resistance against fosfomycin (HR = 2.67; p = 0.001) and amoxicillin-clavulanic acid (HR = 1.94; p = 0.001) seems to be the most influential variable affecting the output decision predicting the cephalosporins- and cotrimoxazole-based therapy failure. The previously mentioned Escherichia coli with resistance against cotrimoxazole (HR = 2.35; p < 0.001) and amoxicillin-clavulanic acid (HR = 3.41; p = 0.007) seems to be the most influential variable affecting the output decision predicting the fosfomycin-based therapy failure. CONCLUSIONS: ANNs seem to be an interesting tool to guide the antimicrobial choice in the management of rUTIs at the point of care.

11.
Assist Inferm Ric ; 42(1): 4-11, 2023.
Artículo en Italiano | MEDLINE | ID: mdl-37283134

RESUMEN

. Transitioning Italian nursing education in the post-pandemic period: priorities in the light of lessons learnt. INTRODUCTION: Once back to normalcy, many nursing education activities have been restored without an in-depth analysis of which transformations enacted in the pandemic period should be maintained and valued. AIM: To identify priorities to effectively transitioning nursing education in the post-pandemic period. METHOD: Descriptive qualitative design. A network of nine universities involved 37 faculty members, 28 clinical nurse educators and 65 students/new graduates. Data were collected through semi-structured interviews; the main priorities reported in each university were combined to gain a global view. RESULTS: Nine priorities emerged, including the need to: 1. reflect on distance learning to promote its complementary role to face-to-face teaching; 2. rethinking the rotations of clinical practical training by refocusing their aims, duration, and preferred settings; 3. understanding how to integrate the virtual and the in-presence learning spaces into the educational pathway; 4. continuing with inclusive and sustainable strategies. Considering that nursing education is essential, it is a priority to develop a pandemic education plan capable of guaranteeing its continuity in all circumstances. CONCLUSIONS: Nine priorities have emerged all considering the importance of digitalization; the lessons learnt, however, indicate the need to enact an intermediate phase capable of guiding towards the complete transition of the education in the post-pandemic era.


Asunto(s)
Educación en Enfermería , Pandemias , Humanos , Aprendizaje , Docentes de Enfermería , Competencia Clínica
12.
Assist Inferm Ric ; 31(4): 191-9, 2012.
Artículo en Italiano | MEDLINE | ID: mdl-23334639

RESUMEN

BACKGROUND: In the public sector the selection of the health personnel is based on qualifications and exams with a written, an oral and practical test, on contents selected by the committee. The level of complexity and contents of the tests is very variable across committees. AIM: To analyze the tests for the selection of nurses, the level of complexity and contents assessed. METHODS: A sample of tests was analysed and for each item, the cognitive level tested, according to Bloom's taxonomy, areas and health problems investigated. RESULTS: One-hundred-twenty-eight selection tests of 14 hospitals and districts were analysed. Open questions are used in the majority of tests to assess mainly knowledge and not complex cognitive functions or problem solving skills. The contents vary widely and are not focused on priority health problems. Questions on prevention, health education and symptoms monitoring are missing. CONCLUSIONS: Written, oral and practical tests focus on the same contents and test mainly knowledge.


Asunto(s)
Evaluación Educacional/métodos , Evaluación Educacional/estadística & datos numéricos , Personal de Enfermería en Hospital , Selección de Personal , Competencia Clínica/estadística & datos numéricos , Cognición , Conocimientos, Actitudes y Práctica en Salud , Humanos , Italia/epidemiología , Solicitud de Empleo , Conocimiento , Licencia en Enfermería , Enfermeras y Enfermeros , Personal de Enfermería en Hospital/estadística & datos numéricos , Selección de Personal/estadística & datos numéricos
13.
Assist Inferm Ric ; 31(3): 145-50, 2012.
Artículo en Italiano | MEDLINE | ID: mdl-23164967

RESUMEN

Hydration with hypodermoclysis in elderly patients. Hypodermoclysis is a technique which consists in the administration of fluids into the subcutaneous tissue for the treatment of mild to moderate dehydration. The article starts from the case of a 74 year old man that, after a stroke, was unable to eat or drink, and was then hydrated with continuous hypodermoclysis for 45 days, obtaining a recovery of the clinical and psychological conditions. An update of the available knowledge on hypodermoclisis, together with some comments on the clinical case are presented.


Asunto(s)
Deshidratación/enfermería , Electrólitos/administración & dosificación , Hipodermoclisis/enfermería , Anciano , Deshidratación/terapia , Humanos , Hipodermoclisis/métodos , Masculino , Resultado del Tratamiento
14.
Assist Inferm Ric ; 41(1): 37-41, 2022.
Artículo en Italiano | MEDLINE | ID: mdl-35411882

RESUMEN

. The management of sexual problems in cancer patients. Sexual dysfunction is one of the most common and distressing consequences of cancer treatment. Many survivors face long-term effects such as treatment-induced menopause, altered gonadal function, and significant surgical disfigurement but some treatment-related sexual adverse effects are short-term. Many survivors do not feel prepared for potential sexual changes and often do not receive adequate support to manage sexual dysfunction. A concise review of the most common sexual problems experienced by cancer ptients is presented together with the main evidence based interventions to suggest to address sexual dysfunction.


Asunto(s)
Neoplasias , Disfunciones Sexuales Fisiológicas , Femenino , Humanos , Neoplasias/complicaciones , Neoplasias/terapia , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Fisiológicas/terapia , Sobrevivientes
15.
Assist Inferm Ric ; 41(4): 161-169, 2022.
Artículo en Italiano | MEDLINE | ID: mdl-37283168

RESUMEN

. Open ICU in pandemic phase Sars-CoV-2: the partial reopening of family visits in an ICU in Northern Italy. INTRODUCTION: During the Covid-19 pandemic, policies restricting family visits to health care facilities were commonly adopted, negatively impacting on patients, families and on the care team. AIM: To describe the reorganisation of a 23-bed Intensive Care Unit in Northern Italy for partial reopening to visits during the pandemic. METHODS: The reorganisation involved several phases: I) feasibility analysis, II) thawing out resistances; III) identifying behavioural, IV) organisational and structural indications for family access in the Covid area; V) fostering communication to guarantee information and emotional support for family members and VI) assessing, through an anonymous questionnaire, the degree of agreement on the impact of the presence of family members on health care team, patient and perception of safety. RESULTS: The majority of the relatives felt that the visit at the patient's bedside had a beneficial effect and reduced their anxiety. Almost all family members felt protected from the Covid-19 infectious risk. Healthcare staff also felt that the presence of family members contributed positively to the relationship with the patient. No family members contracted the Covid-19 infection during the evaluation period. CONCLUSIONS: Reopening access to family members during the Covid-19 period is possible, sustainable and beneficial. The use of flexible and motivational management principles by the coordinator were crucial in ensuring a family-centred approach during the pandemic.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiología , Pandemias , Unidades de Cuidados Intensivos , Italia/epidemiología
16.
Healthcare (Basel) ; 10(5)2022 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-35627891

RESUMEN

New nurses are needed in healthcare. To meet the role expectations of a registered nurse, nursing students must feel empowered at graduation. However, there are only a few studies focusing on nursing students' empowerment. This study aims to describe and analyze graduating nursing students' level of empowerment in six European countries and potential related factors. A comparative and cross-sectional study was performed in the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain with graduating nursing students (n = 1746) using the Essential Elements of Nurse Empowerment scale. Potentially related factors included age, gender, a previous degree in health care, work experience in health care, graduation to first-choice profession, intention to leave the nursing profession, level of study achievements, satisfaction with the current nursing programme, clinical practicums, theoretical education, and generic competence measured with the Nurse Competence Scale. The data were analysed statistically. Graduating nursing students' self-assessed level of empowerment was moderate, with statistical differences between countries. Those with high empowerment had no intention to leave the nursing profession, had a higher level of study achievements, and a higher self-assessed generic competence level. The results suggest that empowerment needs to be enhanced during nursing education. Further research is needed to understand the development of empowerment during the early years of a nursing career.

17.
Eur Urol Focus ; 8(5): 1476-1482, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35135727

RESUMEN

BACKGROUND: Management of recurrent urinary tract infection (rUTI) is still challenging. A better understanding of the natural history of rUTI could help us reduce antibiotic use and improve antibiotic stewardship. OBJECTIVE: To describe the effect of risk identification, stratification, and counseling on the natural course of the disease in women with rUTI. DESIGN, SETTING, AND PARTICIPANTS: A total of 373 women affected by recurrent cystitis were enrolled in this longitudinal cohort study between December 2014 and December 2019. A systematic and standardized identification of risk factors was performed. INTERVENTION: As intervention, risk factors were treated or removed where possible. Patients with nonremovable risk factors were included in the control group. All patients were scheduled for follow-up visits every 6 mo. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The main outcome measures were the rate of symptomatic recurrences and improvement in questionnaire results from baseline to the end of the follow-up period. Reduction of antibiotic usage was regarded as a secondary outcome measure. RESULTS AND LIMITATIONS: Finally, 353 women were analyzed: 196 in the study group and 157 in the control group. At the end of the follow-up period, a statistically significant reduction in the symptomatic recurrence rate was found between the two groups (0.9 ± 0.2 and 2.6 ± 0.5; p < 0.001), as well as in quality of life and anxiety according to mean questionnaire results: quality of life (0.88 ± 0.06 and 0.63 ± 0.09; p < 0.001) and Spielberger State-Trait Anxiety Inventory-Form Y (32.7 ± 9.3 and 47.5 ± 14.3; p < 0.001). The use of antibiotics was significantly lower in the study group: 4410 versus 9821 (p < 0.001). A limitation to consider is the lack of a randomized design for the active approach in the high-risk group. CONCLUSIONS: Identification, counseling, and removal of risk factors, where possible, are able to change the natural history of rUTI, by reducing the number of symptomatic episodes and antibiotic use and improving quality of life. PATIENT SUMMARY: In this report, we analyzed a large cohort of women affected by recurrent urinary tract infections and followed for a long time period. We found that risk factor identification and counseling may change the natural history of recurrent urinary tract infections, concluding that this approach is able to reduce the number of symptomatic episodes, reduce antibiotic usage, and improve patients' quality of life.


Asunto(s)
Cistitis , Infecciones Urinarias , Humanos , Femenino , Calidad de Vida , Estudios Longitudinales , Recurrencia , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Cistitis/tratamiento farmacológico , Antibacterianos/uso terapéutico , Factores de Riesgo
18.
Nurs Open ; 9(3): 1688-1699, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35156324

RESUMEN

AIM: To describe nursing students' level of self-directed learning abilities and identify possible factors related to it at graduation in six European countries. DESIGN: A cross-sectional comparative design across the countries. METHODS: The study was conducted from February 2018 to September 2019. Nursing students (N = 4,135) from the Czech Republic, Finland, Italy, Portugal, Slovakia and Spain were invited to respond to the research instruments (the Self-Rating Scale of Self-Directed Learning and the Nurse Competence Scale) at graduation. The data were analysed using the chi-square test, Pearson correlation coefficient and the linear model. RESULTS: The nursing students' (N = 1,746) overall self-directed learning abilities were at high level in all countries. Statistically significant differences occurred between countries. Spanish nursing students reported the highest level of self-directed learning abilities while students from the Czech Republic reported the lowest. Higher level of self-directed learning abilities was related to several factors, particularly with the self-assessed level of competence and country.


Asunto(s)
Estudiantes de Enfermería , Estudios Transversales , Europa (Continente) , Humanos , Inteligencia , Aprendizaje
19.
Int J Nurs Stud ; 127: 104172, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35124474

RESUMEN

BACKGROUND: There is need for improvement in effective pressure ulcers preventive strategies. OBJECTIVE: To study whether a multi-layer silicone-adhesive polyurethane foam dressing shaped for the sacrum prevents PUs development in addition to standard PU preventive care for at-risk hospitalized patients. DESIGN: Open-label, parallel group, multi-center randomized controlled trial. PARTICIPANTS AND SETTING: 709 in-hospital patients at risk for pressure ulcers from 25 medical, surgical, and intensive care units of 12 Italian hospitals. METHODS: A multi-layer silicone-adhesive polyurethane foam was applied to the sacrum in addition to standard PUs preventive care in the intervention group. In the control group, standard preventive care alone, including systematic pressure ulcer risk assessment, skin assessment three times per day, routine positioning every 4 h, use of active support surface as appropriate, and incontinence skin care, was guaranteed. Primary outcome was incidence of sacral pressure ulcers of any stage at seven days from hospital admission. Secondary outcomes were incidence of sacral pressure ulcers ≥ II stage, number of days needed to PU development, number of skin adverse events due to the foam dressing, number of dressings used for each patient, number of withdrawing patients due to discomfort caused by the foam dressing. Participants were evaluated at baseline and at seven days. RESULTS: In patients admitted to medical units, 15/113 controls and 4/118 in the intervention group developed sacral pressure ulcers (p = 0.010; absolute reduction 9.2%; NNT for benefit 11, 95% CI 6 to 44). In patients admitted to surgical units, 21/144 controls and 8/142 in the intervention group developed sacral pressure ulcers (p = 0.010; absolute reduction 8.9%; NNT for benefit 11 95% CI 6 to 49). Pressure ulcers incidence was not significantly different between the randomization arms (5.2% experimental vs 10.4% control, p = 0.141) in patients admitted to intensive care units. Overall, 46/358 (12.8%) controls and 17/351 (4.8%) in the intervention group developed sacral pressure ulcers (p<0.001; absolute reduction 8%; number needed to treat (NNT) for benefit 12, 95% CI 8 to 26). Incidence of sacral pressure ulcers ≥ II stage did not differ significantly between the two groups. No adverse skin reactions and discomfort attributable to the foam application were reported. CONCLUSION: A sacral multi-layer silicone-adhesive polyurethane foam in addition to standard preventive care is effective for pressure ulcers prevention in at-risk hospitalized patients admitted to medical and surgical units. TRIAL REGISTRATION: ClinicalTrials.gov NCT03900455. The registration (April 1st, 2019) occurred before the first patient was enrolled (October 21st, 2019).


Asunto(s)
Úlcera por Presión , Adhesivos , Vendajes/efectos adversos , Humanos , Poliuretanos , Úlcera por Presión/epidemiología , Siliconas
20.
J Adv Nurs ; 67(8): 1800-10, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21449985

RESUMEN

AIMS: This article is a report of a study of participants' responses to a reflective practice exercise about a mentoring programme. BACKGROUND: Participants' opinions on mentoring programmes are considered a fundamental component of their evaluation. These opinions are commonly gathered through questionnaires, interviews and focus groups. METHOD: An 18-month, multi-professional, mentoring programme was started in 2000. About thirty participants (60% nurses) were involved each time in three consecutive classes. Participants' learning achievements were assessed by short essays. Participants' perception of themselves was evaluated during the last course (ended in 2008) by a reflective writing exercise: 'write a letter to yourself'. A phenomenological-hermeneutic analysis was conducted on the 27 returned letters. The letters were inductively analysed, the resulting core concepts were labelled and then grouped into categories to identify the main themes. FINDINGS: Six themes were identified: (1) the mentoring programme can be a strategy for career advancement and professional development, but (2) it was also a challenging experience that put participants to the test; (3) the mentoring programme taught not only how to mentor students, but also how to be a mentor; (4) mentoring is an 'in progress' experience; (5) the mentoring programme was very positive for group processes and it created a web of professionals and (6) after the mentoring programme, many participants felt profoundly changed both professionally and personally. CONCLUSIONS: Mentoring is a profound relationship that can deeply change the mentee, and training to mentorship can affect the identity of the future mentor, as well.


Asunto(s)
Actitud del Personal de Salud , Correspondencia como Asunto , Educación en Enfermería/métodos , Mentores/educación , Autoimagen , Adulto , Femenino , Humanos , Relaciones Interprofesionales , Aprendizaje , Masculino , Mentores/psicología , Persona de Mediana Edad , Investigación en Evaluación de Enfermería , Preceptoría , Competencia Profesional , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Desarrollo de Personal/métodos
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