Levels of Cognitive Functioning Assessment Scale: Italian cross-cultural adaptation and validation.

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To develop an Italian version of the Levels of Cognitive Functioning Assessment Scale (LOCFAS) and examine its reliability and validity. SUBJECT: Patients with acquired brain injury in an early post-coma state. METHODS: The original scale was translated from English to Italian using the guidelines set forth in the Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice. Intra-rater reliability was examined using the intraclass correlation coefficient (ICC). Concurrent validity was evaluated using Pearson's correlation coefficients with some of the functional and disability components of the International Classification of Functioning, Disability and Health (ICF), excluding environmental factors. SETTING: The highly specialized neurorehabilitation department of "San Raffaele" Hospital, Cassino. RESULTS: The Italian version of the LOCFAS (LOCFAS-I) was administered to 38 subjects from May 9, 2017 to August 31, 2017. The mean ± SD of the LOCFAS-I score was 3.05 ± 1.88. All LOCFAS-I items were either identical or similar in meaning to the original version's items. Test-retest reliability (ICC) was 0.996 (p<0.01). The Pearson correlation coefficient of the LOCFAS-I scores with some of the functional and disability components of the ICF was > 0.536 (p<0.01). CONCLUSIONS: The LOCFAS-I was found to be reliable and a valid measurement tool for the assessment of cognitive functioning post-coma in the Italian population.

Validation of the Pediatric Evaluation of Disability Inventory in an Italian Population with Autism Spectrum Disorder: a Cross-Sectional Study.

OBJECTIVES: To measure psychometric properties of the Italian version of the Pediatric Evaluation of Disability Inventory (PEDI-I) in a population with Autism Spectrum Disorder (ASD). METHODS: The PEDI-I was administered to different children with ASD. The internal consistency was examined by using Cronbach's Alpha, while the intraclass correlation coefficient (ICC) was used to investigate both inter-observer and intra-observer reproducibility. Its concurrent validity was evaluated with the Italian version of the Barthel Index. RESULTS: The PEDI-I was administered to 60 children with a diagnosis of ASD. Cronbach's Alpha showed statistically significant values (.885-.965). Inter-observer and intra-observer investigations confirm the reproducibility of the scale with a range of high and very high parameters. The Pearson Correlation Coefficient with the Barthel Index showed significant data for all PEDI-I subscales with a p<0.01. CONCLUSIONS: The PEDI-I showed good psychometric properties and it is possible to confirm its validity and reliability in ASD population. However, for better understanding of how PEDI-I works in clinical practice, further researches are recommended.

Occupational Therapy's efficacy in children with Asperger's syndrome: a systematic review of randomized controlled trials.

This systematic review of randomized controlled trials (RCTs) aims at evaluating the efficacy of Occupational therapy (OT) interventions in Asperger's syndrome (AS) pediatric patients. We conducted a systematic review according to PRISMA guidelines. The screening of the literature was carried out on PUBMED, SCOPUS, WEB OF SCIENCE and OT SEEKER databases, TO December 2018. We selected three RCTs having the common objective to evaluate whether children with AS can improve their social skills thanks to OT treatments. The interventions targeted by the three selected studies were: LEGO therapy, Social Use of Language Programme, Let's Face It! software and Parent Training combined with the administration of risperidone. All the studies showed that the intervention groups improved their overall social ability.This review shows that OT interventions can help concretely AS children in overcoming their social issues. Nevertheless, more RCTs are needed to better understand the OT's benefits and limitations in AS patients.

The effect of physiotherapy on fatigue and physical functioning in chronic fatigue syndrome patients: A systematic review.

OBJECTIVE: The objectives of this work were to fill the gap in the scientific literature and to evaluate the results of physical therapy treatments in individuals affected by chronic fatigue syndrome, considering only studies that employed a randomized controlled trial. METHODS: A systematic review was carried out according to PRISMA guidelines. Three bibliographic databases were searched: MEDLINE, Cochrane Library, and PEDro. The minimum prerequisites for papers to be included in the systematic review were that they had to (a) employ a randomized controlled trial; (b) be published in English; and (c) be published during the last ten years (2007-2017). The studies were evaluated according to Jadad score. RESULTS: Four studies were included. This systematic review suggests that a treatment that is more effective than all the others cannot be defined. This conclusion is related to the low number of investigated studies; therefore, the collected results cannot be generalized. CONCLUSION: Chronic fatigue syndrome is not yet a well-understood pathology, and the physical mechanisms that influence the outcomes still need more study. Rehabilitation programs that promote physiotherapy techniques such as exercise, mobilization, and body awareness (e.g., MRT and GET) are the most effective in reducing medium and long-term fatigue severity in CFS patients.

Cross-cultural adaptation and validation in the Italian population of the wolf motor function test in patients with stroke.

Motor impairments of the upper extremities affect approximately 60% of stroke patients. Rehabilitation is extremely important and can make it possible to identify which manual function is causing difficulty for the patient and hindering daily activities. The Wolf Motor Function Test (WMFT) was recently highly recommended as one of several outcome measures that assess limitations of activities with a high level of psychometrics and clinical utility. The objective of this study was to translate and culturally adapt the WMFT for the Italian population (WMFT-IT) and examine its reliability and validity in Italian post-stroke adults with chronic hemiplegia or hemiparesis. The original scale was translated into Italian and culturally adapted in accordance with international guidelines. Its internal consistency and stability were examined using the Cronbach's alpha (α) coefficient and the intra-class correlation coefficient (ICC), respectively. Its concurrent validity was evaluated using the Pearson's correlation coefficient to compare the instrument with the Italian version of the Jebsen-Taylor Hand Function Test and the Disabilities of the Arm, Shoulder and Hand outcome measure. All WMFT-IT items were either identical or similar in meaning to the items in the original version. The WMFT-IT was administered to 24 subjects. Cronbach's α was 0.91 and 0.98 for the time and performance subscales respectively, and the ICC for test-retest reliability was 0.99. Pearson's correlation coefficients of the time subscale and the performance subscale both showed significant positive correlations (p <0.01). The WMFT-IT was found to be reliable and a valid outcome measure for assessing function and quality of movement of the upper extremities in post-stroke adults in the Italian population.

Bologna Process and Basic Nursing Education in 21 European Countries.

BACKGROUND: The Bologna Process and the Directives of the European Union have had a profound impact on nursing education in Europe. The aim of this study was to identify the similarities and differences within nursing education framework at entry level in 2014 in European countries. METHODS: A questionnaire was devised by the researchers and distributed via e-mail to the nursing associations/nursing regulatory bodies of 30 European countries. Data were collected from January to May 2014. RESULTS: Responses were received from 21 European Countries. Results indicated that while a completion of 12 years of general education was a requirement to access nursing education in almost all respondent countries, other admission requirements differed between countries. Nursing courses were offered mostly by Faculties of Nursing and Faculties of Health Sciences (in higher education Institutions) and lecturers and management staff were mainly nurses. The results indicated significant different educational requirements for nurse educators. A foreign language was mandatory in half of the respondent countries. Nursing profession was represented at government level in just over half of the respondent countries, often with a Directorate position. CONCLUSIONS: The Bologna Process has helped harmonise initial nursing education in Europe but clear standards for nursing education need to be set up. Therefore, the research about the influence of the Bologna process on the development of the nursing profession should be further encouraged.

Textual Analysis and Data Mining: An Interpreting Research on Nursing.

Every day there is a data explosion on the web. In 2013, 5 exabytes of content were created each day. Every hour internet networks carries a quantity of texts equivalent to twenty billion books. For idea Iit is a huge mass of information on the linguistic behavior of people and society that was unthinkable until a few years ago. It is an opportunity for valuable analysis for understanding social phenomena, also in nursing and health care sector.This poster shows the the steps of an idealy strategy for textual statistical analysis and the process of extracting useful information about health care, referring expecially nursing care from journal and web information. We show the potential of web tools of Text Mining applications (DTM, Wordle, Voyant Tools, Taltac 2.10, Treecloud and other web 2.0 app) analyzing text data and information extraction about sentiment, perception, scientific activites and visibility of nursing. This specific analysis is conduct analyzing "Repubblica", first newspaper in Italy (years of analisys: 2012-14) and one italian scientific nursing journal (years: 2012-14).

eHealth Literacy Scale: An Nursing Analisys and Italian Validation.

BACKGROUND: One of the scales most used to measure quickly and easily eHealth Literacy is the eHealth LiteracyScale (eHEALS); however, there was no validation of this scale in Italian. Therefore, the aim of this study was to adapt and validate the eHealth Literacy Scale (eHEALS) to the italian context. METHODS: Italian translation of eHEALS was administered along unit to another two scale for measure lifestyle habits self-esteem and life satisfaction). A sample of 650 university students aged between 18 and 45 years was selected. An exploratory factor analysis, confirmatory factor analysis, analysis of invariance, reliability, stability and bivariate correlations were performed. RESULTS: Exploratory factor analysis revealed a monofactorial structure that explained 67% of variance. Reliability of 0.87 and test-retest correlation of 0.78 was obtained. The questionnaire was invariant by gender. Regarding the criterion validity, a statistically significant and positive correlations between 0.05 and 0.15 with three indicators was obtained (self-esteem, lifestyle habits and life satisfaction). The italian version of the eHEALS tested in this work has shown to be a valid and reliable scale to measure eHealth competence in university students.

Nurses' Job satisfaction: an Italian study.

BACKGROUND: The aim of the work presented was to assess job satisfaction of a number of nurses from different departments working in public hospitals in Italy. The assessment was carried out through the combined use of questionnaires, which measured different aspects of job satisfaction, such as coping abilities, stress level and optimism/pessimism. The literature supports the fact that nurses' job dissatisfaction is closely connected with high levels of stress, burnout and physical and mental exhaustion, together with high workload levels and the complexity of care. The growing interest in measuring the levels of nurses' job satisfaction is attributable to a number of problems that have been raised worldwide, two of which are becoming ever so important: turnover and shortage of nurses. The research question is: Which are the main motivating factors of Italian nurses' job satisfaction/dissatisfaction? METHODS: The study used a convenience (non probability) sample of 1,304 nurses from 15 different wards working in Italian public hospitals from a number of cities in northern, central and southern Italy. The survey instrument was a questionnaire consisting of 205 items which included 5 different questionnaires combined together. RESULTS: The results show a low level of job satisfaction (IWS= 11.5, JSS=126.4). However, the participants were overall happy about their job and considered autonomy and salary important factors for job satisfaction. CONCLUSION: Research has shown that the nurses' level of satisfaction in Italian hospitals is low. The results revealed dissatisfaction with task requirements, organizational policies and advance in career. Nurses interviewed did not feel stressed and showed to be optimistic overall. New research on the subject should be conducted by focusing on ward differences, North and South of Italy and on gender differences.

Features and organization of Pain Centers in the Lazio Region, Italy, in 2011.

BACKGROUND: Evidence on pain management highlights the importance of a multidisciplinary approach in order to achieve optimal therapeutic results. Such programs can be guaranteed by the Centers for Pain Management (CPMs), in which multidisciplinary teams are able to provide advanced and specialized activities for the assessment, diagnosis and treatment of chronic benign pain. To date, information related to healthcare supply and the organizational structure of these centers in Italy is incomplete. The aim of this paper was to provide an overview of the healthcare network of the CPMs in the Lazio region. METHODS: A descriptive survey was conducted in all the 37 CPMs existing in the Lazio region in 2011 of which 28 participated. RESULTS: CPMs were located either in Universities or in public or private hospital facilities. They included a clinic, a Day Hospital service, Day surgery and day-beds. CPMs were managed by anaesthesiologists who, in most instances, did not work in a multidisciplinary team. The number of other health professionals available, such as nurses, psychologists and physiotherapists, was limited. CPMs mainly provided drug therapy, Complementary Alternative Medicine (CAM) and complex interventional treatments. The median waiting time was 30 days. The clinics were not homogeneously distributed in the region with a higher concentration in Rome (56%), followed by other provinces of the Lazio region (26%) and the province of Rome (18%). Clearly, Rome was the city which offered the greatest range of healthcare services and the highest number of consultations with patients, which significantly differed from those of the other areas (χ²=19.6 p<0.01). CONCLUSIONS: In 2011, the availability of CPMs was not equally distributed throughout the territory, and there was an over-utilization of the facilities in Rome and an under-utilization in the provincial areas. Moreover, this study showed a lack of a multi-professional approach to chronic pain management.

Caregivers of Alzheimer's patients and factors influencing institutionalization of loved ones: some considerations on existing literature.

BACKGROUND: Informal caring or caregiving is very common in our postindustrial society. Caregiving burden grows with the worsening of cognitive impairment of the patient and is one of the factors influencing institutionalization. Alzheimer's disease (AD) is a type of dementia that is chronic and deteriorative. The symptoms of this neuropsychiatric disorder generally begin to manifest after the age of sixty and currently 8.9 million family caregivers provide assistance to someone with AD or a related dementia. As the patient's condition worsens, it increases the burden on the caregivers, due to the physical, psychological, and emotional stresses that result from caring for the patient. METHODS: A search of the literature was conducted on electronic database: PubMed, Google Scholar, Science direct, CINAHL in a exploratory way. Inclusion criteria were: articles in English and Italian published between 1999-2011 which mentioned Alzheimer's caregivers, burden, stressors, and institutionalization. The exclusion criterion was failure to mention the word "caregivers". About 100 titles were found and 30 articles abstracts with key words in the title were reviewed. Of the 30 articles selected for further review based on the relevance to the study purpose, 17 articles were finally selected for inclusion in this literature review. RESULTS: Results display that caregiver burden is influenced by patient behavioral and cognitive status, hours involved in care, stress, social isolation, gender, relationship to the patient, availability of support resources, and caregiver characteristics. Assessment tools available to assess and recognize risk factors and burden in caregivers are useful both in terms of caregivers health and decision on istitutionalization. CONCLUSION: Literature suggests to provide information for health care providers to reduce burden and support caregiver health and well-being. Assessment tools available to assess and recognize risk factors and burden in caregivers should be used more often to contribute to reducing caregiver stress and the impact of institutionalization.

Immersion research education: students as catalysts in international collaboration research.

BACKGROUND: This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research. AIM: To narrow the healthcare gap for disadvantaged families in the USA and partner countries. METHODS: Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the MHIRT program complete two introductory courses followed by a 3-month research practicum in a partner country guided by faculty mentors abroad. The overall program development, student study abroad preparation, research project activities, cultural learning, and student and faculty team outcomes are explored. RESULTS: Cross-fertilization of research, cultural awareness and ideas about improving family health occur through education, international exchange and research immersion. Faculty research and international team collaboration provide opportunities for learning about research, health disparities, cultural influences and healthcare systems. The students are catalysts in the research effort, the dissemination of research findings and other educational endeavours. Five steps of the collaborative activities lead to programmatic success. CONCLUSIONS: MHIRT scholars bring creativity, enthusiasm, and gain a genuine desire to conduct health research about families with chronic illness. Their cultural learning stimulates career plans that include international research and attention to vulnerable populations.

More than terminology: using ICNP to enhance nursing's visibility in Italy.

BACKGROUND: The International Council of Nurses (ICN) has elaborated an international terminology for nursing practice [International Classification of Nursing Practice (ICNP)] that can be useful to catalogue the problems of a nursing nature in diagnosis and also find a system for the classification of nursing activities. ICNP is also the reason why the Italian association Consociazione, representing Italian Nurses at ICN, through the School of Advanced Nursing of the University 'La Sapienza' of Rome, has set up a working group for the translation and experimentation of the ICNP version Beta 2. CONTENT: In this article the ICNP beta translation and validation into Italian is considered with some scenarios of how benefit could be derived by its utilization for nursing's visibility. The visibility of nursing care can be measured not only through patient outcomes but also by studying the existing data of patient care documentation. To have a common language and terminology in nursing is important for a universal understanding. RESULTS: Some philosophical reasoning on the genesis and development of ICNP is discussed along with arguments for and against nursing classification systems. Some findings on Italian experimentation for nursing documentation as well as economical analysis are reported along with a vision for future development and utilization.

[Italian translation and validation of the ICNP Beta (International Classification for Nursing Practice]. / Traduzione e validazione italiana della Classificazione Internazionale per la Pratica infermieristica (ICNP Beta).

The visibility of nursing care can be measured through the results on the patient and studying the existing data on patient care. An important area is tied up for a common language and terminology because it is important to have a universal understanding. For this reason the International Council of Nurses (ICN) has elaborated an international terminology for Nursing Practice that can be useful to pick up and to catalogue the problems of nursing nature in diagnosis also finding a system of classification of the activities The Consociazione Association, as representative of the ICN in Italy, through the School of Advanced Nursing of the University "La Sapienza" of Rome, has set up a Working group for the translation of the document ICNP version Beta. The present article explains the difficulties related to the Italian translation, the working group, the procedure, the validation and the met problems along with a vision for the future development and utilization.

[Stress, anxiety, and depression among caregivers of patients with Alzheimer's disease]. / Stress, ansia e depressione delle caregivers di pazienti affetti da malattia d'Alzheimer.

The aim of this study was to evaluate the levels of stress, anxiety and depression in women caregivers of Alzheimer's disease patients. A convenience sample of 37 women caregivers living with the patients was studied using a descriptive-correlational design. A sociodemographic questionnaire with scales measuring the variables taken into consideration were utilized. Caregivers were 60 years old, devoted to the patients 17 hours of caring per day and had only 1 hour for their personal needs. The 54, 21 and 29% of the sample had high levels respectively at the stress, anxiety and depression scale. Stress, anxiety and depression were positively correlated with caring hours, sleep problems in caregivers and behavioural disturbances of the patients; and were negatively correlated with free time and time spent out of the home. Implications for nursing care resulting from this study consists in giving more support to caregivers in order to avoid their excessive involvement in caring and in guaranteeing educational interventions to help caregivers to manage the behavioural disturbances of the patients.

[Parent's grief for the loss of a preterm child]. / Il lutto nei genitori per la perdita di un bambino nato pretermine.

The study takes into consideration the loss of a preborn child and the consequent grief of parents. The Italian nursing literature is quite poor on the subject while international literature show a variability of some phenomena particularly in the first three-five years from the loss. The present research, by a quantitative design and the Hogan bereavement conceptual framework, has considered parents since three years loss. A general socio demographic questionnaire, the Hogan Grief Reactions Checklist (HGRC), and the Beck Depression Inventory (BDI-II) have been utilized to collect data. The first instrument has been ad hoc formulated to enrich data, the second explores, by 61 items, 6 factors of reaction to the loss and the third, that consists of 21 groups of statements, measures the presence and the range of the depression. The HGRC has been validated for the Italian utilisation while the BDI-II has been validated in previous studies. Results, in accordance with the international literature, show a variability of different behaviours of explored phenomena for both questionnaires (Hogan's factors and depression). in the first three years of the grief. Parents suffer for the loss of a preborn child and their feelings of despair, disorganization, guilt, detachment, panic and personal growth change by the time from the loss.

[Strategy and priority of nursing research in Italy]. / Strategie e Priorità per la Ricerca Infermieristica in Italia.

This is a summary of a seminar held in Rome by the Advanced Nursing School of the University "La Sapienza" in collaboration with a Fulbright research fellow to explore the possibility to set up a strategy and to define priority of Nursing research in Italy. The seminar has been a consequence of the report of the Council of Europe on Nursing research. The Italo-American seminar has been honored by the participation to the works by the WHO (World Health Organization) Regional Adviser. The main international and national documents on the topic have been considered along with a national analysis through epidemiological data of the health of Italians, Considerations on actual nursing education have been done. The final document, produced by a peer review of participants to the seminar, will be ready shortly and spread out nationally and internationally.

[Problem-based learning in nursing training: liberation or confinement?]. / Il problem based learning (P.B.L) nella formazione infermieristica: liberazione o confinamento?

In this article some considerations are introduced on the method of the Problem Based Learning (PBL) for Nursing education. The method is criticized in its application. From the idea that it can be an active method, not conservative and that can be useful to develop the critical thinking, if it is not correctly used, it can result instead in a method that confines the education, negatively standardizes it and limits the critical thought. Some reflection points are underlined to promote a debate on the topic.