The community nurse's role on the promotion of papillomavirus vaccination among young students: A study protocol.

Vaccination is the principal strategy for primary prevention of infection by Human Papilloma Virus (HPV), which causes different pathological conditions, up to cancer, in both males and females. However, to date, knowledge among adolescents and their parents about the HPV vaccine is still low. The aim of this quasi-experimental, multicenter study is to assess the effectiveness of a digital educational intervention, conducted by a multidisciplinary health-care team including a Community Nurse, to increase adolescents' HPV vaccination uptake, their knowledge, self-efficacy, feelings and involvement in HPV vaccine decision-making, and parents' vaccination hesitancy. The study will be carried out among a population of students (and their parents), aged between 11 and 13, at secondary schools in Italy. Validated questionnaires will be administered to both students and parents at baseline (T0) and 3 months after a digital educational intervention (T1). The findings may be useful in evaluating and deepening a methodology for designing and implementing educational interventions, embedded in the school setting, that could promote the achievement of outcomes within the broader process of youth's health promotion.

Immersive and Non-Immersive Virtual Reality for Pain and Anxiety Management in Pediatric Patients with Hematological or Solid Cancer: A Systematic Review.

Invasive and painful procedures, which often induce feelings of anxiety, are necessary components of pediatric cancer treatment, and adequate pain and anxiety management during these treatments is of pivotal importance. In this context, it is widely recognized that a holistic approach, including pharmacological and non-pharmacological modalities, such as distraction techniques, should be the standard of care. Recent evidence suggested the use of virtual reality (VR) as an effective non-pharmacological intervention in pediatrics. Therefore, this systematic review aims to analyze previously published studies on the effectiveness of VR for the management of pain and/or anxiety in children and adolescents with hematological or solid cancer. Medline, SCOPUS, Web of Science, ProQuest, CINAHL, and The Cochrane Central Register of Controlled Trials were used to search for relevant studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Randomized controlled trial, crossover trial, cluster randomized trial, and quasi-experimental studies were included. Thirteen studies, published between 1999 and 2022, that fulfilled the inclusion criteria were included. Regarding the primary outcomes measured, pain was considered in five studies, anxiety in three studies, and the remaining five studies analyzed the effectiveness of VR for both pain and anxiety reduction. Our findings suggested a beneficial effect of VR during painful vascular access procedures. Limited data are available on the reduction of anxiety in children with cancer.

Effectiveness of virtual reality in the management of paediatric anxiety during the peri­operative period: A systematic review and meta-analysis.

BACKGROUND: Children undergoing surgery generally experience anxiety during the perioperative period, which could impact the surgical outcome, cause long-term psychological consequences and result in later healthcare avoidance. Preoperative anxiety in children is managed using both pharmacological and non-pharmacological therapies. The latter include distraction, a tour of the operating room and parental presence until the induction of anaesthesia. A novel and effective non-pharmacological therapies is the use of virtual reality to reduce anxiety and pain in children scheduled for medical procedures. However, the effectiveness of virtual reality in paediatric surgery has yet to be evaluated in a systematic review. OBJECTIVE: To evaluate the effectiveness of virtual reality in the management of anxiety in paediatric patients during the perioperative period. DESIGN: Both a systematic review and a meta-analysis of randomised controlled trials were performed according to the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and in accordance with the Cochrane Effective Practice and Organisation of Care. The results are reported as prescribed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. DATA SOURCES: A systematic search of randomised controlled trials was conducted using Medline, SCOPUS, Web of Science, Ovid MEDLINE and CINAHL. REVIEW METHODS: Two researchers screened potentially eligible articles and then assessed the quality of the reported studies using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and according to Cochrane Effective Practice and Organisation of Care. The data were synthesised using the random-effects models to incorporate the estimated heterogeneity in the weighting. Heterogeneity was tested using the Q and I2 statistics. The τ2 statistic, an estimate of the amount of variation between the included studies, was also determined. Studies whose heterogeneity with respect to primary outcome measurements hindered pooling of the results for meta-analysis were summarised narratively. RESULTS: Seven studies were eligible for inclusion in this systematic review. An effect size for anxiety could be determined in six. The results support the effectiveness of virtual reality in reducing anxiety in paediatric patients undergoing elective surgery. The overall effect was supported by a confidence interval < 0 (PL = -0.341, 95% confidence interval: -0.620 to -0.107) and by heterogenity indexes that were non significant (Q = 9.49, p = 0.091) or not important (I2 = 38.64%). CONCLUSIONS: Paediatric patients undergoing elective surgery may benefit from virtual reality as a distraction method that can reduce anxiety. PROSPERO register, number: (blinded for Referee).

Trust in Nurses Scale: validation of the core elements.

BACKGROUND: The Trust in Nurses Scale (TNS) was developed and psychometrically assessed so that patients' trust could be accurately and reliably measured. The TNS has been translated, assessed and administered to patients in Europe, Asia and North America. AIM: This descriptive, cross-sectional, correlational study aimed to assess the psychometric characteristics of the Italian version of the Trust in Nurses Scale. METHODS: An Italian version of the TNS was developed. We used a forward-backward translation methodology to establish semantic and conceptual equivalence within the Italian context. The scale was then administered to a convenience sample of 200 hospitalised patients in medical, surgical or oncology units. Internal consistency and construct validity were assessed performing Cronbach's alpha and confirmatory factor analysis (CFA). Both a 4-item and a 5-item TNS were assessed. RESULTS: The 4-item TNS demonstrated better construct validity than the 5-item version. Similarly, the internal consistency reliability was better with 4 items than 5 (0.83 and 0.79, respectively). CONCLUSION: The Italian version of the scale has acceptable reliability and validity and may be used to assess this aspect of the nurse-patient relationship. Being tested in different settings, it may be used with all patients admitted to hospital. Trust in nurses is critically important to patient outcomes; however, it is rarely measured quantitatively on a wide scale. The use of the Italian validated scale could be useful to increase evidences on this important topic, as it represents a core component of nursing care.

Self-reported medication adherence and beliefs among elderly in multi-treatment: a cross-sectional study.

AIM: To evaluate the association between adherence to treatment and beliefs about medications in multi-treated elderly patients. BACKGROUND: A large body of evidence documented the importance of adherence to therapy in predicting clinical outcomes, and the association between adherence and medication beliefs in patients of various ages and with different health conditions. However, so far only a few studies have specifically investigated the associations between medication beliefs and adherence among elderly in polypharmacy. METHODS: In this multicenter cross-sectional study we used the MMAS-8 and BMQ Scales to assess medication adherence and beliefs about medications, respectively. RESULTS: The final sample consisted of 567 patients. Patients reporting higher levels of necessity or concerns about their medicines showed higher adherence (OR: 1.61, and 2.02, respectively; both p<.001). Accepting patients (high necessity and low concerns) were less likely (OR: 0.24; p<.001) to report adherence than ambivalent ones (high necessity and concerns). CONCLUSIONS: Medication adherence is related to high necessity and concern about treatment. In nursing practice it is important to understand the specific barriers to adherence and to engage patients in the implementation of strategies to improve adherence.

[Index of Caring Complexity as a management tool in a surgical setting: an observational study]. / L'Indice di Complessità Assistenziale come strumento organizzativo in un contesto chirurgico: uno studio osservazionale.

INTRODUCTION: Among different methods of nursing classification, the Index of Caring Complexity (ICC) is a management tool to evaluate appropriateness of nursing procedures, integrate health-care support workers and to monitor the need of nursing staff. The objective of this observational study was to apply the ICC method in a surgical ward of the Marche Region (Italy), to determine the nursing staff level. METHODS: From 1 January to 30 April 2010, all data of patients admitted for more than 48 hours were collected. The determination of nursing staff level derived from the five patient classification on the basis of the complexity/gravity "scores" of data flow obtained during the caring process. RESULTS: The ICC method showed a staffing of 11 nurses: a staff shortage of three nurse, if compared to the actual staff. The ICC method also demonstrate its strength as a useful tool to reorganize care. The ICA showed that the most frequent nursing activities :"Apply postures to facilitate breathing "(83%),"Prepare/provide appropriate foods in temperature/texture/quantity "(100%); "Providing aids for elimination needs" (80.7%); "Help in dressing" (82.7%); "Transfer from stretcher to bed" (83.4%); "Remaking bed/unit sick" (100%); "Monitoring of vital signs" (100%); "Health Education" (100%); "Nursing Assessment" (100%); "Management and treatment of intravascular devices" (100%); "Performing instrumental exams". CONCLUSIONS: Assess the most frequent nursing activities, allows: to better distribute activities among professionals, identify nurses' competencies and activities to be prescribed to health-care support workers.