Patient perspective in perceived comparative genetic mutation risk: An exploratory review.

The genetic risk of chronic diseases represents a complex medical setting in which individuals need to adapt to health conditions that manage daily living towards to healthy behaviours. This exploratory review focused on psychological counselling for genetic risk diagnosis. This study aimed to address the psychological management of the impact of genetic risk on chronic diseases. We performed a systematic search of MEDLINE via PubMed, Embase, Web of Science, PsycINFO and Scopus for articles from May 2012 to August 2023. A descriptive analysis of the characteristics of the included studies was conducted. Based on the exclusion/inclusion criteria, the literature search yielded 250 studies. Seventeen full texts were assessed for eligibility and 207 articles were excluded. Observational (n = 15) and randomised clinical trials (n = 2) were examined. Most studies have been conducted on oncological diagnoses; the emotional dimensions examined have been worry, depression, anxiety and stress in most diseases. Psychological measures are based on self-reports and questionnaires; few studies have investigated the connections between quality of life, psychological traits and emotional dimensions. The complexity of clinics and from daily diagnostic and treatment practices to the everyday experience of those living with the risk of disease might be addressed in counselling settings to improve quality of life in genetic risk, increasing mental adaptation to tailored chronic conditions. Thus, the empowerment of communication of genetic risk information should be part of the general trend towards personalised medicine.

Cardiovascular risk and biopsychosocial interplay: Association among hypertension, anxiety, and emotional dysregulation-observational study in primary care setting for efficient self-care.

BACKGROUND: Aim of the study was to explore the relationship between emotional dimensions of hypertensive patients and the self-care skills; we tried to draw the psychological aspects could impact the health management in hypertension analyzing the effect of emotional regulation on self-care skills: our scope was to highlight the psychological dynamics into behavioral medicine approach. METHODS: In an observational study design, patients were collected. Patients with diagnosis of hypertension were recruited in primary care setting. Inclusion criteria included patients older than 18 years, with known and medically treated primary hypertension undergoing antihypertensive medication. RESULTS: Statistical analysis was carried out based on the data of 28 primary hypertensive patients (seven females, 21 males, mean age ± SD: 49.8 ± 7.8 years mean; clinic blood pressure: mean systolic blood pressure: 137.2 ± 13.1 mmHg, mean diastolic blood pressure: 82.1 ± 9.9 mmHg). Mean duration of hypertension in the sample was 13.1 years (±8.2 years). Correlations among the main variables of interest showed a positive and significant relationship between emotional dysregulation indexes, psychological distress, and self-care domains: awareness resulted negatively and significantly correlated to self-efficacy; nonacceptance, goals and impulse indexes seemed positively and significantly correlated to anxiety and depression; finally, stress was correlated positively and significantly to awareness and impulse. CONCLUSIONS: Evidencing the role of emotion dysregulation on self-care skills and psychological outcomes, and specifically highlighting the impact of emotion dysregulation on self-care, our findings could inform the development and implementation of psychological interventions aimed at promoting psychological well-being and healthy behavior by focusing on the promotion of emotion regulation strategies, to reduce the risk for co-morbidity and/or severe cardiovascular diseases.

Early career researchers and mental health: Observational study of challenge and wellbeing.

Background: Early career researchers (ECRs) are a strategic sector in the academic community because they represent a scientific incubator for future academic scholars. Recently, growing evidence suggests that relevant doctoral researchers work under elevated levels of stress and frustration and that this has a significant impact on their personal health and research output and their future career development. This study aimed to analyse the well-being and mental health within ECR, focusing on coping strategies for stress, and to contribute and exploit a conceptual framework tailored to the academic context considering the specifics and challenges of academia. Methods: Participants were 134 young early career academics (mean age = 30.6; SD = 4.38; range = 25-40 years) enrolled via institutional email. A 94-item questionnaire was created using Survey Monkey and distributed between October and December 2022. The survey assessment was based on three parts: (1) sociodemographic data, (2) psychological assessment, and (3) research skills design. Results: Our findings highlighted a general trend toward negative psychological dimensions in ECRs: PhD students and research contracts appeared to be stressed, anxious, and depressed. Moreover, they had segmented ECRs: PhD students showed higher levels of depression, anxiety, and stress than research contracts, highlighting reduced positive outcomes in psychological dimensions, as well as lower ability to manage emotional experiences and then to be perseverant for long-term goals and motivation. Our findings highlight that mental health in ECRs is a challenge that needs to be addressed in academia. Conclusions: New and innovative ways of encouraging help-seeking must be developed and implemented to address policy changes, communication activities, training, and health-promotion activities through the circulation of experience, sharing actions, and strategies to foster healthy academics by raising awareness, implementing interventions, or engaging professionals concerning mental health in academia.

Psychological Distress and Negative Emotions in Post-COVID Infection: A Comparative Study of the COVID and NO-COVID Young Patients.

According to the literature, mental health assumed urgent relevance, and several scholars are debating on the enduring of the neurological and psychiatric symptoms in post COVID patients. Our study aimed to investigate the emotional dimensions in young population to the COVID exposition: primary endpoint was to detect the psychological distress up to 3 months in post-COVID-19. A comparative study was conducted among young adults in Italy. We also assessed dysphoria, depression, anxiety, stress symptoms, pessimism, and positive personality traits. The participants were 140 Italian young aged 18-30 years (mean = 22.1, SD ± 2.65; 65.0% female). The sample was distinguished in two groups: COVID and NO-COVID groups. The results revealed that young who have been exposed to COVID-19 infection evidenced emotional vulnerability by higher psychological distress (depression, anxiety, stress), dysphoria signs (irritability, discontent, interpersonal resentment, and feelings of renunciation/surrender) then No COVID-19 infection young. Furthermore, COVID patients showed higher negative emotions about the expected life, uncertain for future, and loss of motivation (characterized no desires) than NO-COVID infection. In conclusion, the vulnerability of young exposed to COVID infection even in mild severity should be considered as emerging unmet need of mental health recovering: urgent health policy actions to boost the psychological, biological and social strategic pillar for young generation.

Digital affinitiy and cognitive reserve: Salience for resilient aging in pandemic.

Objective: The study aimed to analyze the impact of technology in the older adults after acute pandemic regarding to the development of digital confidence. Method: A sample of n. 56 healthy older adults (N = 22 female, N = 34 male) aged 64 to 86 years (M = 73.7, SD = 6.40) participated in observational study. The sample was distributed in two groups: (a) pre-COVID and (b) post-COVID. Psychological battery was applied: Mini-Mental State Examination, Cognitive Reserve Index Questionnaire, Beck Depression Inventory-II, Affinity for Technology Interaction Scale, and then Digital Mastery Questionnaire. Descriptive and (M)ANOVA statistical analyses have been applied. Results: Our results confirmed the increase in technology usage among elders, the higher use of smart devices and then more confident digital daily living; then, the improving of digital affinity for technology and higher adherence in seniors than older. In sex effect, men seemed developing higher digital confidence for digital experience, for access and use of financial online services than women. In the process of improvement by massive digital experience in daily living the cognitive reserve had relevant influence: elders with high level of cognitive reserve appeared to enhance own competence in digital mastery and affinity for technology. Conclusions: Our study highlighted the higher cognitive reserve being protective in older adults favoring the efficacy to the changing in daily living as well the develop of adaptive behaviors in order to achieve high Quality of Life.

Naturalizing digital and quality of life in chronic diseases: Systematic review to research perspective into technological advancing and personalized medicine.

The increasing of chronic diseases and related health management are the main clinical and public health challenges. The long-term nature and the need for continuous monitoring in chronic disease management gave rise to early technological innovations (mobile Health) to improve care management plans, therapeutic adherence, and psychological support to the patient. This review aimed to map the literature on the impact of the use of wearable device on quality of life in patients with chronic diseases. We performed a systematic search of MEDLINE through PubMed, Web of Science, and Scopus of all scientific literature published until January 2022. Based on inclusion and exclusion criteria, a total of 10 papers were included. This review pointed out the relevant focus on the use of wearable device in chronic disease patients highlighting the wearable device impact on several domains including quality of life, Self-Efficacy, Self-Management, and feelings on patients with chronic diseases. The available scientific literature related to the impact of the use of wearable device on quality of life and psychological features in patients with chronic diseases, general underline a need to develop professional healthcare guidelines and tailored intervention on patients with a chronic condition, using mobile Health solutions and trying to fill the lack of knowledge about the topic.

Chronic non-communicable diseases and health awareness of patients: An observational study analysing the health adaptive behaviours through self-care skills.

The incidence of chronic non-communicable diseases (CNCDs) increases with age, thus placing a burden on individuals and healthcare systems; furthermore, CNCDs are associated with lower quality of life (QoL) in the elderly. This study aimed to evaluate the behavioural management of CNCDs by comparing different diseases under its ambit exhibiting various side effects, as well as vascular, gastrointestinal, and other chronic diseases, simultaneously analysing self-care efficacy and emotional dimensions (i.e. anxiety, stress, and depression). A total of 122 outpatients aged >18 years (mean age, 50.0 years; standard deviation, ±13.8) participated in the study, and 59% of the participants were women. The psychological battery was composed of three standardised self-assessments measuring the relevant emotional dimensions, QoL, and self-care indices. Analysis of the emotional dimensions of depression, anxiety, and stress indices resulted in significant differences. Furthermore, post-hoc analyses (Tukey test) showed that patients with gastrointestinal disease (GD) experienced depression more than patients with vascular disease (VD) (p = 0.002). In addition, there were no differences between the VD and Oth and between the GD and Oth groups; however, the Oth group appeared to experience more anxiety than the VD group (p = 0.04); there were no differences between the GD and VD groups, as well the Oth group. The ANCOVA test compared the chronic disease groups, the disease stage (early and long-term), self-care indices, and sex. They were covariated by age, showing a significant effect on the management index only in chronic disease groups (p = 0.007). Our study suggests that the following specific factors need to be considered in health decision-making processes to enhance the compliance of patients to the clinically expected results: (1) tailored clinical therapies; (2) side effects of disease; (3) comorbidity; (4) mental health. The harmonisation of these internal and external factors could offer a powered perspective for personalized medicine.

Cardiovascular disease, self-care and emotional regulation processes in adult patients: balancing unmet needs and quality of life.

BACKGROUND: Cardiovascular disease is a chronic non-communicable illness that causes more than half of all deaths across Europe. Unhealthy lifestyle, inadequate adherence to medical prescriptions, themselves associated with psycho-emotional disorders are considered risk factors for reduced quality of life as well physical condition. OBJECTIVE: Aim of our study was to understand predictive factors for disease management by evaluating psychological aspects, self-care processes and emotional regilati0on in CVD outpatients. METHODS: An observational study was conducted. Sixty-one patients, age 18-75 years (M 56.4 ± sd 12.0), diagnosed with CVD participated in the study. The psychological battery was administered during clinical follow-up oriented to detect emotional and psychological dimensions as well adaptive behavioral and quality of life by standardized questionnaire/scales. RESULTS: Finding showed that emotional dysregulation might influence QoL, particularly significant effect of awareness (ß= 0.022; SE = 1.826; p < 0.002), goals (ß = - 0.54; SE = 1.48; p < 0.001) and clarity (ß = - 0.211; SE = 2.087; p < 0.003). The results also suggest that the mediated effect accounted for awareness index was 18.7% (R2 = 0.187) of the variance; goals index 62.8% (R2 = 0.628) of the variance and, then significant mediated effect of clarity was 58.8% (R2 = 0.588) of the variance. This evidence suggests that the relationship between triggers and QoL is mediated by emotional dysregulation indexes. CONCLUSION: In clinical practice psychological screening can be an effective tool for detecting predictive factors in the management of the CVD patient's health and adherence to medical treatment: the screening of predictive psychological factors for allowing a good clinical condition management and a self-care empowerment aimed at increasing psychological well-being and the Quality of Life by planning adequate integrated and multidisciplinary support.

Early Diagnosis of Melanoma and Breast Cancer in Women: Influence of Body Image Perception.

The diagnosis of melanoma and breast cancer may impact many aspects of life with significant reductions in emotional functioning and quality of life. The aim of the study was to analyze the emotional traits of female patients with oncological in early-stage diagnosis, investigating predictors for psychological distress and analyzing body image perception. An observational study was conducted, A sample of 84 female cancer patients (age range 30-55 years) with melanoma (n = 42) and breast cancer diagnosis (n = 42). The examined emotional variables were psychological distress; depression, stress, and anxiety; metacognitions; and body self-perception. Findings showed higher psychological distress in breast cancer than in melanoma patients (p = 0.00), which was related to lower positive self-perception of body image (p = 0.03). Furthermore, psychological distress was negatively correlated with consequences of clinical treatment on body image, and low well-being affected the social interaction and well-being with own body. There was no significant difference between cancer staging and timing from diagnosis. Prevention and therapeutic psychological protocols might be adapted and tailored to the unmet needs of the patients in medical treatments to promote and enhance the Quality of Life in survivorship.

Allostatic Load as an Insight into the Psychological Burden after Primary Treatment in Women with Breast Cancer: Influence of Physical Side Effects and Pain Perception.

Breast cancer (BC) diagnosis and treatment have become a cumulative long-standing chronic disease impairment, causing stress and turning into an allostatic load (AL) framework. This study aimed to investigate the relationship between physical issues and mental health in patients with BC after medical treatment. We conducted an observational study of 61 female patients with BC, and clinical and psychological markers have been detected. We conducted descriptive statistics, ANOVA analyses, correlations, and mediation analyses to verify the effect of the comorbidity index on psychological dimensions. The findings showed high levels of distress and moderate pain, and 32.8% of the patients showed moderate physical impairment. Significant effects of "age" and "physical issues" were found. The adult group reported a higher incidence of physical issues, and the group of patients reporting moderate physical impairment seemed more depressed than patients with mild physical issues. Finally, the comorbidity condition mediated the presence of signs of depression. Patients with BC seemed to experience negative emotions related to comorbidities associated with compromised activities of daily living. Our findings highlighted allostatic overload as a predictive framework to better understand the mental health of women with BC diagnoses to tailor effective psychological treatments for enhanced recovery.

Chronic Kidney Disease and Its Relationship with Mental Health: Allostatic Load Perspective for Integrated Care.

BACKGROUND: Chronic renal failure is a chronic medical condition characterized by a progressive and irreversible loss of kidney function. Up to 50% of patients undergoing dialysis experience symptoms of depression and anxiety: what is the impact of individual factors and medical conditions on the mental health issue? The present study was carried out to investigate the individual factors (biomarkers and psychological dimensions) of end-stage renal disease patients dealing with dialysis, analyzing their predictor values for developing negative disease adaptations by an allostatic paradigm. METHODS: We conducted an observational study on 35 patients affected by end-stage renal disease; biological and psychological markers have been detected. We conducted descriptive statistical analyses (t-tests) and performed a hierarchical regression analysis to investigate the relationship between pathological medical conditions and psychological dimensions. RESULTS: The findings showed a positive correlation between creatinine levels and psychological distress as well as stress index. No significant effect of "time of dialysis", "time from diagnosis", "age" and "personality traits" was found. CONCLUSION: Our findings showed that personality traits did not represent a protective factor by moderating positive emotional adaptations; conversely, creatinine levels appeared predictive for negative emotional adaptations. High levels of creatinine were found to be positively associated with high stress levels as well psychological distress. According to the allostatic paradigm, end-stage renal disease patients could experience an allostatic load and more overload towards poor health outcomes; integrated biological and psychological measurements could prevent increased negative mental health through a patient-centered approach.

Mediator Effect of Affinity for E-Learning on Mental Health: Buffering Strategy for the Resilience of University Students.

The pandemic affected the quality of life and wellness of the population, changing living habits through restriction measures. This study aimed to analyze the psychological impact of the fear of the COVID-19 pandemic and the adoption of e-learning for university students. The study was articulated in two research applications: the first application was a rapid review on the psychological effects of the pandemic on the emotional dimension of undergraduate students; the second application was an observational study on the effect of e-learning adoption in the pandemic emergency. In the first step, we performed a systematic search of MEDLINE through PubMed and the Web of Science [Science Citation Index Expanded (SCI-EXPANDED); Social Sciences Citation Index (SSCI); Emerging Sources Citation Index (ESCI)] of all scientific literature published from May 2020 to February 2021. The reviewed articles suggest the impact of the pandemic and lockdown measures on university students due to several mental symptoms, including anxiety, stress, depression, event-specific distress, and a decrease in psychological well-being. Psychological symptoms were related to the experience of several stressors, such as the risk for a reduction of academic perspectives, massive e-learning adoption, economic issues, social restrictions, and implications for daily life related to the COVID-19 outbreak. The second scientific application was conducted to evaluate the affinity for e-learning on a sample composed of Italian undergraduates exposed to massive e-learning adoption. The results evidence the positive influence of e-learning in academic programs for the wellbeing of undergraduates. The mediator effect of the affinity of youth for e-learning can be considered to have had a buffering effect for professional advancement and for the mental health of university students in a public health emergency.

Psychosomatic interactions in kidney transplantation: role of personality dimensions in mental health-related quality of life.

BACKGROUND AND AIMS: The increase in innovative and personalized medicine solutions in kidney surgery can improve patients' chances of survival; however, during the transplantation process, patients are exposed to many psychological challenges. This study aimed to evaluate the role and impact of personality dimensions on the behaviour of waiting-list patients towards the post-surgery adaptation process. METHOD: The participants were 113 out-patients aged 18-70 years (mean age 54.7 years, SD ± 9.9) who had received a kidney transplant at least 3 years prior to the study. RESULTS: The results of the study revealed that personality dimensions can predict mental health-related quality of life after kidney transplantation; in particular, the dimensions play an important role in patients' behavioural ability to manage their quality of life both during end-stage renal disease and after kidney transplantation. Psychological distress and anxiety were associated with a low level of the conscientiousness dimension, while a high level of the openness dimension was associated with a high level of psychological distress and stress. In addition, body self-perception was associated with personality dimensions. CONCLUSION: Personality dimensions were found to predict behavioural reactions when emotional traits and body self-perception for each patient were combined; clinical psychologists could apply personalized intervention by modeling the treatments step by step and mitigating the negative effects of the whole kidney transplantation disease, thus helping the individual to adapt to a new life.

Digital Innovation in Oncological Primary Treatment for Well-Being of Patients: Psychological Caring as Prompt for Enhancing Quality of Life.

One side-effect of oncological treatment is chemotherapy-induced alopecia (CIA), a temporary form of hair loss that could influence patients' mental health. Digitised scalp cooling systems are assuming an important role in the clinical setting during adjuvant treatment, promising hair loss prevention and allowing an efficient procedure to reinforce patients' mental health during chemotherapy by avoiding CIA. The present study was carried out through two research protocols: in Research Protocol 1, we conducted a randomised clinical study to evaluate the emotional impact of using scalp cooling technology in women with BC compared with a traditional chemotherapy setting; in Research Protocol 2, we conducted an observational pre-post study involving women with BC diagnosis being under adjuvant chemotherapy in two experimental conditions: no scalp cooling application and scalp cooling application. Seventy-four women undergoing chemotherapy, aged 30-55 years, were enrolled in both research protocols. We investigated oncological patients' psychological dimensions including body image, body appreciation, expectations, and satisfaction with the scalp cooling treatment, with reference to chemotherapy treatment applying the scalp cooling solution. Our data evidenced the need to implement a supportive clinical approach via brief, tailored psychological intervention addressing patients' progressive adaptation to chemotherapy adverse events and their concerns regarding induced alopecia and the value of the scalp cooling system. Patients receiving the innovative chemotherapy probably coped with it by neglecting its physical impact, instead focusing on avoiding alopecia by using the technological solution and neglecting the emotional impact of chemotherapy as a severe pharmacological treatment.

[Metacognitions and quality of life in survivorship after breast cancer diagnosis]. / Metacognizione e qualità della vita nella survivorship delle donne con diagnosi di cancro al seno.

AIM: Aim of the study was to measure the belief and metacognition strategies trend in the survivorship of fertile women with breast cancer. We wanted to observe the metacognitive performance of young women went out primary treatment getting survivors; we wanted to assess the impact of metacognitive strategies in coping with survivorship in cancer patients who have been diagnosed at an early age. METHODS: Seventy two women in age range 30-55 year olds (mean 48; sd= ±6) with breast cancer diagnosis participated in the study. Depression and anxiety, psychological distress and metacognitions thinking have been measured. RESULTS: Results evidenced age as vulnerable variable in emotions dealing with oncological post-treatment living (higher anxiety in young patients), but with some features: in our study, patients appeared resilient to the psychological distress and depression. DISCUSSION AND CONCLUSIONS: Our finding showed that early diagnosis in early age and early stage of disease might be related to emotional trend starting from fragility in early post-treatment and then in survivorship it tends to get positively by resilient dynamics.

Examining the Post-operative Well-Being of Women Who Underwent Mammoplasty: A Cross-Sectional Study.

Background: Mammoplasty is the most common surgery used for breast augmentation (aesthetic plastic) and breast reconstruction (disease-related plastic) in women who have been diagnosed with and surgically treated for regional breast cancer with modified radical mastectomy. This study aims to examine the long-term effects of mammoplasty on the psychological well-being of women. Methods: Participants were 44 women aged 30-50 years (mean = 40.4 ± 5.9). They were divided into two groups based on the purpose of the breast surgery they underwent [augmentation surgery (AS) vs. reconstruction surgery (RS)] and the time that had elapsed since their surgery (≤3 vs. >3 years). Results: Our findings suggest that women who underwent AS reported a decline in their psychological well-being over time. The women who had undergone AS ≤3 and >3 years did not show any differences in emotional functioning, with the exception of the BREAST-Q scores on the satisfaction with breasts subscale. We examined the impact of mammoplasty on the satisfaction levels and well-being of women who had undergone RS (after MRM). They were less satisfied with their breasts than those who belonged to the AS group, confirming our hypothesis. However, this was true only among those who had undergone surgery ≤3 years earlier. Conclusions: In conclusion, our findings underscore the need to provide psychological support to those who have undergone breast AS and RS. Additionally, this study implies the need for personalized psychological interventions to improve the emotional adaptation process and enhance women's mental well-being.

Prolonged COVID 19 Outbreak and Psychological Response of Nurses in Italian Healthcare System: Cross-Sectional Study.

Aim of the study was to analyze the posttraumatic stress disorder risk nurses, detecting the relationship between distress experience and personality dimensions in Italian COVID-19 outbreak. A cross-sectional study was conducted based on 2 data detection (March 2020 and September 2020). Mental evaluation was carried out in Laboratory of Clinical Psychology on n.69 nurses in range age 22-64 years old (mean age 37.3; sd ± 10.3; 55% working in nursing care with confirmed COVID-19 patients (named frontline; secondline nurses have been identified by nursing care working with infectious patients but no confirmed COVID-19). Measurement was focused on symptoms anxiety, personality traits, peritraumatic dissociation and post-traumatic stress for all participants. No online screening was applied. Comparisons (ANOVA test) within the various demographic characteristics demonstrated few significant differences between groups on DASS-21, PDEQ, and ISE-R scores. Correlation analysis (Spearman test) was performed among PDEQ, DASS-21, BFI-10 and IES-R and confirmed between anxiety (DASS-21) and peritraumatic dissociation and post-traumatic stress; then anxiety is positively correlated to agreeableness variable of BFI-10 test. The emotional distress was protracted overtime (after 6 months) but in long-term personality traits resulted mediator facing subjective stress. Our finding drew details for protective and predictive risk factors as well as mental health issues of nurses dealing with pandemic: healthcare workers faced the protracted challenge caring COVID-19 patients over and over again: in short time the impact was relevant, and the prolonged exposition to the stressor was tackled by personal resources such as personality traits.

Cognitive Reserve and Digital Confidence among Older Adults as New Paradigm for Resilient Aging.

OBJECTIVE: The purpose of this study was to examine the digital confidence of elder adults and identify behavioral patterns for technology that are related to cognitive abilities among elders. METHOD: An observational study was conducted using a sample of 94 elders, aged 53 to 86 years. Neuropsychological and emotional measures were used, and technology use was assessed. RESULTS: Finding showed elders by resilient neuropsychological aspects can have a good affinity for technology. We examined the role of not only cognitive reserve levels but also demographic characteristics (i.e., age, educational level) and found that elderly were more adherent to digital resources. Technology can be a beneficial resource to those with medium levels of cognitive reserve and make them feel "like they are leading an active lifestyle." CONCLUSIONS: The focal point of our findings is the relevance of cognitive reserve during older adulthood as a key factor that should be examined in investigations on successful aging; it would be more interesting to examine these factors within the context of analyses on the impact of technology on aging and digital living.

Predictive risk factors for post-traumatic stress symptoms among nurses during the Italian acute COVID-19 outbreak.

BACKGROUND: The aim of the study was to investigate the posttraumatic stress disorder risk in nurses, detecting the relationship between distress experience and personality dimensions in the Italian acute COVID-19 outbreak. The study is an observational study conducted in March 2020. PARTICIPANTS AND PROCEDURE: Mental screening was carried out in the Laboratory of Clinical Psychology on N = 36 nurses in the age range 22-64 years (M = 37.30, SD = 12.60). 76.3% were working in nursing care with confirmed COVID-19 patients; 47.4% of nurses worked in a high COVID-19 rate environment, whereas 52.6% worked in a low COVID-19 rate environment. RESULTS: The results confirm relation between anxiety and peritraumatic dissociation and posttraumatic stress; also anxiety is positively correlated with the agreeableness variable. Our finding was obtained in an acute Italian COVID-19 outbreak and measured and quantified the psychological response of nurses in terms of anxiety as an early reaction for emotional distress and high risk for posttraumatic stress disorders; the personality dimensions did not mediate the emotional distress or the probable risk for post-traumatic stress disorder. Nurses appeared to be exposed to mental distress and needed help. CONCLUSIONS: The results evidenced the need to carry out a mental health program for health workers (especially nursing professionals).

An Integrated Approach for a New Pattern in Pediatric Primary Care: Interaction Mediation for Active and Efficient Medical Consultations.

Introduction: This study analyzed the impact of an innovative integrated approach in pediatric care on children's behavior and cooperation during care. Methods: The participants included 75 children aged 3-8 years (30 girls and 45 boys) recruited from a pediatric surgery department. The sample was categorized into three groups according to experimental condition: the Control, Playing, and Interaction groups. Results: A one-way ANOVA revealed significant differences in cooperation between the three groups [F (2,1) = 5.52; p = 0.006]. A post-hoc analysis showed better performance in the Interaction group (p = 0.002) compared to the Control group during clinical care. The Control group also showed less cooperation compared to the Playing group (p = 0.009). Conclusions: The findings indicate that distraction before medical care can positively influence children's behavior, increasing their cooperation in medical settings. Future studies could objectively analyze physiological changes in children during medical care to better relieve anxiety and provide them with more efficient care.