[BRCA mutations and decision regret: a comprehensive analysis of existing research through a scoping review and reflections from a nursing perspective.] / Mutazioni BRCA e rimpianto decisionale: un'analisi approfondita della ricerca esistente tramite scoping review e riflessioni da una prospettiva infermieristica.

INTRODUCTION: Given the significance of healthcare decisions in women with BRCA1 and BRCA2 mutations and their impact on patients' lives, this study aims to map the existing literature on decision regret in women with BRCA1 and BRCA2 mutations. METHODS: A scoping review was conducted in the following databases: PubMed, Embase, Scopus, CINAHL, Cochrane, and Google Scholar. Inclusion criteria focused on decision regret in the female population with BRCA1 and/or BRCA2 mutations, with no restrictions on the methodologies of the included studies, but only in the English language. The selection process led to the inclusion of 13 studies. RESULTS: The analysis revealed a significant trend toward decision regret among patients facing complex medical choices. The quality of healthcare communication, decision support, and genetic counselling emerged as key factors influencing patients' perceptions and experiences, with direct implications for their quality of life and psychological well-being. The results suggest that these decisions considerably impact patients, both in terms of clinical outcomes and emotional experiences. DISCUSSION: The investigation highlights the vital importance of a personalized care approach, emphasizing the critical role of managing patients' emotional and psychological complexity. Managing decision regret requires acute attention to individual needs and effective communication to mitigate emotional impact and improve patient outcomes. CONCLUSIONS: Insights from a nursing perspective in the analysis of results indicate the need for informed, empathetic, and integrated care that considers the emotional complexity of women with BRCA1 and/or BRCA2 mutations in their lives and health choices.

The efficacy of high-fidelity simulation on knowledge and performance in undergraduate nursing students: An umbrella review of systematic reviews and meta-analysis.

OBJECTIVES: This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students. DESIGN: Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results. DATA SOURCES: Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies. REVIEW METHODS: The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). Random-effect meta-analyses of meta-analyses were performed to estimate the pooled effects of high-fidelity simulation on knowledge and performance. Further random-effect meta-analyses of primary studies were conducted, with overlapping studies excluded (12 %). Subgroup analyses were performed to provide a more comprehensive analysis of the findings. Trim-and-fill analyses were conducted to adjust for potential publication bias. RESULTS: Six systematic reviews were included and encompassed 133 primary studies (2767 and 3231 participants concerning performance and knowledge, respectively). The adjusted pooled effects for knowledge (SMD = 0.877, 95 % CI: 0.182 to 1.572) and performance (SMD = 0.738, 95 % CI: 0.466 to 1.010) closely aligned with those obtained from meta-analyzing the primary studies for knowledge (SMD = 0.980) and performance (SMD = 0.540), both showing high statistical heterogeneity. Traditional lectures represented the more common comparison. The subgroup analysis revealed significant differences in effect sizes across geographic locations, topics, types of control, and how interventions were reported. CONCLUSIONS: The results provide robust evidence supporting the integration of high-fidelity simulation into undergraduate nursing programs to enhance students' knowledge and performance. The high reported heterogeneity may be attributed to variations in study contexts or methodologies. Future research should explore the optimal use of high-fidelity simulation in different educational and cultural contexts.

Microbiome-Modifiers for Cancer-Related Fatigue Management: A Systematic Review.

OBJECTIVES: This study systematically investigates the evidence regarding the use of probiotics in managing cancer-related fatigue (CRF). STUDY DESIGN: We conducted a systematic review of randomized controlled trials. DATA SOURCES: The systematic search encompassed six databases: PubMed, CINHAL, Cochrane Database of Systematic Reviews, Web of Science, Scopus, and EMBASE, covering the period from inception to December 2023. The assessment of risk of bias employed the Cochrane risk of bias tool (RoB 2). A narrative synthesis and an exploratory meta-analysis were conducted to summarize the evidence. RESULTS: Among 460 records, three studies met the eligibility criteria and were included in the review. These studies involved a total of 284 participants with colorectal and breast cancer. One study demonstrated a marginal improvement in CRF postchemotherapy in colorectal cancer patients using probiotics. Another study, also using probiotics, reported a significant reduction in CRF among colorectal cancer patients undergoing chemotherapy. Additionally, a study employing synbiotics showed a substantial decrease in CRF severity in breast cancer patients receiving chemotherapy. CONCLUSION: The study presents initial but varied evidence suggesting the potential of probiotics and synbiotics as adjunctive therapies in managing CRF alongside anticancer treatments. IMPLICATIONS FOR NURSING PRACTICE: In nursing practice, large-scale clinical trials are urgently needed to evaluate the effectiveness of probiotics in treating cancer-related fatigue during cancer therapy. Insights from this review could guide nurses in selecting appropriate probiotic strains and integrating microbiome modifiers into comprehensive care plans, potentially enhancing the quality of life for cancer patients.

Synbiotics in Oncology: A Scoping Review Protocol on Their Impact and Outcomes in Cancer Care.

Symptom management remains challenging in cancer care. Emerging from nutritional science, nutritional metabolomics has seen exponential growth over recent years, aiming to discern the relationship between dietary habits and health consequences. This protocol aims to present the rationale and methodology for conducting a scoping review to summarize the extent of evidence on synbiotics utilization in cancer symptom management among adults. The scoping review will be undertaken in accordance with the Joanna Briggs Institute (JBI) principles and the research process guided by the PRISMA 2020 scoping reviews extension. The following electronic databases will be searched from the inception: PubMed, Cinahl, Web of Science and Scopus. The authors expect to map the literature regarding the clinical outcomes, including patient-report measures and patient-experience measures, on which the effects of probiotics were tested, and identify potential gaps. This protocol presents a rigorous methodological approach to map the literature on the clinical outcomes that the utilization of synbiotics might improve. This analysis will shape future researchers to examine the efficacy of probiotics on specific clinical outcomes in oncology care. Nurses are uniquely positioned to influence cancer symptom management through the selection and use of appropriate interventions in the field of nutritional supplements, along with nutritional counseling.

Development of a Core Outcome Set for Family and Community Nursing: Protocol for a Delphi Study.

BACKGROUND: Family and community nurses (FCNs) play a crucial role in delivering primary care to patients within their homes and communities. A key aspect of their role involves various health interventions, which are influenced by their unique competencies, such as health promotion, advanced clinical knowledge, and strong interpersonal skills. However, it is essential to understand which specific health outcomes these interventions impact to better understand the relationship between FCNs' skills and the health results. OBJECTIVE: This study aims to outline the steps we will take to develop a set of core outcomes. These outcomes will be particularly sensitive to the health interventions carried out by FCNs, providing a clearer picture of their practice's impact. METHODS: A Delphi survey will be used for this research, conducted from January to December 2024. The process will involve 5 steps and input from 3 stakeholder categories. These stakeholders will help identify a preliminary list of outcomes that will form the basis of our core outcome set (COS). RESULTS: This guideline will be beneficial for a wide range of stakeholders involved in COS development, including COS developers, trialists, systematic reviewers, journal editors, policy makers, and patient groups. As of January 2024, we have successfully completed the first stage of the study, with the stakeholder group approving the reported outcomes and assigning participant lists for each stakeholder group. CONCLUSIONS: This study will provide a roadmap for identifying the key health outcomes influenced by the interventions of FCNs. The multistakeholder, multiphase approach will ensure a comprehensive and inclusive process. Ultimately, the findings will enhance our understanding of FCNs' impact on health outcomes, leading to more effective primary care strategies and policies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51084.

[Mobile Health Applications (mHealth apps) for breastfeeding: a qualitative review using the Mobile Application Rating Scale.] / Mobile Health app (mHealth app) per l'allattamento al seno: una revisione qualitativa mediante la Mobile Application Rating Scale.

INTRODUCTION: mHealth apps are the most commonly used applications by women for seeking information and support for breastfeeding. The primary goal of this study is to provide a quality assessment of Italian-language mHealth apps for breastfeeding using the Italian version of the Mobile App Rating Scale (I-MARS). METHODS: A systematic search was conducted on the Apple App Store, Google Play Store, and Windows Store. Inclusion criteria were: mHealth apps available in Italian, free of charge, and focused on the theme of breastfeeding. The quality assessment of the eligible mHealth apps was carried out on the latest available version using the I-MARS, by two authors independently. RESULTS: A total of 381 mHealth apps were identified, of which 38 mHealth apps were included and evaluated (n=9 on Google Play Store, n=29 on Apple App Store). The average total score of the objective dimension of I-MARS was found to be adequate, equal to 3,07±0,75, with a Cohen's Kappa score of 65,8%. The subjective dimension of the I-MARS, however, achieved a low average total score of 2,44±1,03, with a Cohen's Kappa score of 60,5%. In this regard, the subjective dimension of the I-MARS shows lower values compared to the subjective evaluation of the users (3,28±1,95). DISCUSSION: The informational quality dimension of mHealth apps was found to be lacking and/or inadequate in 80% of cases. 53% of the selected mHealth apps presented average quality scores that were adequate. The results of this study thus lay the groundwork for future recommendations for the development and proper use of mHealth apps for the protection, promotion, and support of breastfeeding.

A stepwise methodological approach to develop and validate the digital and technological self-efficacy scale for healthcare workers among nurses and nursing students.

AIMS: To develop and validate the Digital and Technological Self-Efficacy Scale (Digitech-S) for healthcare workers among nurses and nursing students. BACKGROUND: Digital and technological solutions (DTS) significantly impact working life in healthcare and educational settings. DTS-related self-efficacy might be defined the individual's confidence in proficiently performing digital and technological tasks, even when faced with challenges. Its assessment might guide educators in orienting focused interventions to enhance the self-efficacy of nurses and nursing students. Thus far, the assessment of DTS-related self-efficacy is currently undermined by the lack of valid and reliable measurements. DESIGN: A stepwise methodological approach was employed in two main phases. Phase one focused on tasks guided by literature for generating items reflecting DTS. Phase two encompassed three steps: A content validity step, a first cross-sectional data collection for Mokken scaling analysis (MSA) performed to reduce the number of items toward a unidimensional structure and with a hierarchical approach, and a confirmatory factor analysis including the group (nurses vs. nursing students) as a covariate (MIMIC) to cross-validate the unidimensional structure and assess the measurement invariance using a second cross-sectional data collection round. A Multi-Group Confirmatory Factor Analysis (MG-CFA) was also conducted to test for configural, metric, scalar, and strict invariance across the two groups. RESULTS: Phase one resulted in 36 items derived from a literature review, which was reduced to 33 after the content validity process. 660 responders (nurses = 388; nursing students = 272) were included in the sample analyzed with MSA, and 13 items were hierarchically selected for the subsequent data collection (Rho reliability = 0.95; Hs = 0.67; Hi ranging from 0.55 to 0.72). MIMIC models were performed on 421 responders (nurses = 268; nursing students = 153), and three items that caused non-invariance between nurses and nursing students were identified and removed from the final version (Cronbach's alpha = 0.928). The MG-CFA demonstrated configural and metric invariance, suggesting a consistent factor structure and factor loadings across both groups, but scalar and strict invariance were not fully achieved. CONCLUSIONS: The Digitech-S is a 10-item scale showing a unidimensional and stable structure, which could be used for educational and research purposes.

Cyclic AMP induces reversible EPAC1 condensates that regulate histone transcription.

The second messenger cyclic AMP regulates many nuclear processes including transcription, pre-mRNA splicing and mitosis. While most functions are attributed to protein kinase A, accumulating evidence suggests that not all nuclear cyclic AMP-dependent effects are mediated by this kinase, implying that other effectors may be involved. Here we explore the nuclear roles of Exchange Protein Activated by cyclic AMP 1. We find that it enters the nucleus where forms reversible biomolecular condensates in response to cyclic AMP. This phenomenon depends on intrinsically disordered regions present at its amino-terminus and is independent of protein kinase A. Finally, we demonstrate that nuclear Exchange Protein Activated by cyclic AMP 1 condensates assemble at genomic loci on chromosome 6 in the proximity of Histone Locus Bodies and promote the transcription of a histone gene cluster. Collectively, our data reveal an unexpected mechanism through which cyclic AMP contributes to nuclear spatial compartmentalization and promotes the transcription of specific genes.

Cross-Cultural Adaptation and Validation of the Revised Brief Diabetes Knowledge Test (DKT2) in Individuals With Type 2 Diabetes Mellitus and Their Caregivers.

PURPOSE: The purpose of the study was to develop an Italian version of the Revised Brief Diabetes Knowledge Test (DKT2), providing a cultural and linguistic validation supported by psychometrics and hypotheses testing. METHODS: This multimethods study was divided into 4 phases: (a) cultural-linguistic validation, with a translation and back-translation process; (b) confirmatory factor analysis (CFA) considering the original scale's structure (knowledge and insulin-specific knowledge); (c) criterion validity via hypotheses testing; and (d) cross-group measurement invariance. The internal consistency reliability was assessed by the Kuder-Richardson Formula 20 (KR-20) of the overall scale. RESULTS: A total of 251 patients and 251 caregivers were enrolled. The CFA showed good goodness of fit for both patients and caregivers. The tested hypotheses supported criterion validity in both groups. Reliability was adequate: All KR-20 values in both groups and domains were higher than 0.60. The mean percentage of knowledge score on DKT2 was lower for patients than caregivers. CONCLUSION: The DKT2 is a valid and reliable scale to assess overall knowledge of diabetes, considering its role in promoting appropriate self-care behaviors in patients with type 2 diabetes mellitus. The Italian version of DKT2 demonstrated reliability and validity, and it can be used by researchers and diabetes care and education specialists to assess a patient's or population's overall knowledge of diabetes.

Breastfeeding Self-Efficacy: A Systematic Review of Psychometric Properties Using COSMIN.

BACKGROUND: Breastfeeding self-efficacy has been proven to play a predictive role in enhancing breastfeeding initiation and continuation. Breastfeeding self-efficacy measurement tools have facilitated healthcare professionals' early identification and support of women at higher risk of early discontinuation of breastfeeding. RESEARCH AIM: The aim of this study was to assess the psychometric properties of breastfeeding self-efficacy measurement tools. METHOD: A systematic review was carried out in three phases. Phase One comprised a systematic literature review performed in PubMed, SCOPUS, Web of Science, and Cochrane Database of Systematic Reviews from February 2021 to January 2023, including 36 studies for final analysis. Phase Two provided a quality appraisal of the psychometric properties of each of the seven breastfeeding self-efficacy measurement tools, according to COnsensus-based Standards for the selection of health Measurement Instrument checklist (COSMIN) guidelines. Phase Three summarized and graded the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) modified approach. RESULT: The included articles comprised 9,225 participants and seven breastfeeding self-efficacy measurement tools. The Breastfeeding Self-Efficacy Scale, Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF), and Prenatal Breastfeeding Self-Efficacy Scale were supported by Grade A evidence sustaining their validity and reliability to assess breastfeeding self-efficacy in the continuum of maternity care. The BSES-SF is the most feasible tool in clinical practice and the most utilized internationally, available in 15 languages. CONCLUSION: This systematic review provided a Grade A recommendation on breastfeeding measurement tools that will be helpful both for clinical and research purposes.Registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021238450).

Embracing digital and technological solutions in nursing: A scoping review and conceptual framework.

INTRODUCTION: Digital and technological solutions (DTS) are emerging as promising avenues to improve the quality and efficiency of healthcare. This scoping review aimed to map the literature on embracing DTS in nursing, from primary to tertiary care settings. METHODS: The Joanna Briggs Institute guidance for scoping reviews was used. The authors searched MEDLINE, Embase, CINAHL, Scopus, Web of Science, Cochrane Library, and PROSPERO databases for published articles and relevant peer-reviewed research protocols. Screening and data abstraction were conducted by two reviewers independently, with a third reviewer resolving discrepancies. Frequency and thematic analyses were conducted. RESULTS: The study highlights the crucial role nurses play in introducing, implementing, and using DTS. The summarized literature emphasizes that cultivating positive attitudes, possessing sufficient knowledge, competencies, self-efficacy, and displaying appropriate behaviors toward such technologies are vital in ensuring their effective incorporation into nursing practice. DISCUSSION AND CONCLUSIONS: The findings of this scoping review provide a foundation for future research on DTS adoption in nursing and support the development of evidence-based strategies to improve nursing practice through DTS implementation. Therefore, the article proposes the Digital and Technological Framework (Digitech-F) for healthcare professionals as a comprehensive conceptual framework that addresses skills, knowledge, attitude, and competence to ensure the effective adoption of DTS in nursing.

Mapping the literature on decision regret in patients with non-communicable diseases (NCDs): a scoping review protocol.

INTRODUCTION: Decision regret refers to feelings of remorse or dissatisfaction with a decision made regarding the treatment. Mapping the meaningful aspects of decision regret in patients with non-communicable diseases (NCDs) is necessary to provide a comprehensive understanding of the phenomenon and inform the development of effective interventions to address it. For this reason, this protocol aimed to describe the methodological aspects of a scoping review focused on mapping all the meaningful aspects of decision regret in patients with NCDs and provide a conceptual and comprehensive framework of the phenomenon. METHODS AND ANALYSIS: The study described in this protocol will be performed following the Joanna Briggs Institute (JBI) methodology for scoping reviews. The anticipated starting time is July/August 2023 and the anticipated end of the review is June 2024. This scoping review will include quantitative, qualitative, primary and secondary literature, as well as grey literature on decision regret in patients with NCDs. The systematic search will be performed by consulting PubMed, Embase, Scopus, CINAHL, the Cochrane Library and Google Scholar. English-language articles from any context will be eligible for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers and extracting data. Disagreements among reviewers will be solved through consensus meetings. Results will be presented in relation to the review question by employing tables, figures and narrative summaries. ETHICS AND DISSEMINATION: This scoping review did not require ethical approval since it involves a literature review and does not include new data collection from human participants. The results of the review will provide a summary of the available literature on decision regret experienced by patients with NCDs, which is crucial for developing preventive educational interventions in situations where multiple therapeutic options are available.

Nursing Profession Self-Efficacy Scale-Version 2: A Stepwise Validation with Three Cross-Sectional Data Collections.

BACKGROUND: The nursing professional self-efficacy scale (NPSES) is one of the most used self-reporting tools for assessing nursing self-efficacy. Its psychometric structure was described differently in several national contexts. This study aimed to develop and validate version 2 of the NPSES (NPSES2), which is a brief version of the original scale selecting items that contribute to stably detecting attributes of care delivery and professionalism as descriptors of salient aspects of the nursing profession. METHODS: Three different and subsequent cross-sectional data collections were employed to reduce the number of items to generate the NPSES2 and validate its new emerging dimensionality. The first (June 2019-January 2020) involved 550 nurses and was used to reduce the number of the original scale items by using a Mokken scale analysis (MSA) to ensure the selection of items consistently with the invariant item ordering properties. The subsequent data collection was performed to conduct an exploratory factor analysis (EFA) involving 309 nurses (September 2020-January 2021), and the last data collection (n = 249) was performed to cross-validate with a confirmatory factor analysis (CFA), the most plausible dimensionality derived from the EFA (June 2021-February 2022). RESULTS: The MSA led to the removal of twelve items and retention of seven items (Hs = 0.407, standard error = 0.023), which showed adequate reliability (rho reliability = 0.817). The EFA showed a two-factor solution as the most plausible structure (factors loading ranged from 0.673 to 0.903; explained variance = 38.2%), which was cross-validated by the CFA that showed adequate fit indices: χ2 (13, N = 249) = 44.521, p < 0.001; CFI = 0.946; TLI = 0.912; RMSEA = 0.069 (90% CI = 0.048-0.084); SRMR = 0.041. The factors were labeled as care delivery (four items) and professionalism (three items). CONCLUSIONS: NPSES2 is recommended to allow researchers and educators to assess nursing self-efficacy and inform interventions and policies.

A Single-Center, Randomized Controlled Trial to Test the Efficacy of Nurse-Led Motivational Interviewing for Enhancing Self-Care in Adults with Heart Failure.

BACKGROUND: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance (primary endpoint), self-care management, and self-care confidence after three months from enrollment in adults with HF compared to usual care, and assessed changes in self-care over follow-up times (3, 6, 9, and 12 months). METHODS: A single-center, randomized, controlled, parallel-group, superiority study with two experimental arms and a control group was performed. Allocation was in a 1:1:1 ratio between intervention groups and control. RESULTS: MI was effective in improving self-care maintenance after three months when it was performed only for patients (arm 1) and for the patients-caregivers dyad (arm 2) (respectively, Cohen's d = 0.92, p-value < 0.001; Cohen's d = 0.68, p-value < 0.001). These effects were stable over the one-year follow-up. No effects were observed concerning self-care management, while MI moderately influenced self-care confidence. CONCLUSIONS: This study supported the adoption of nurse-led MI in the clinical management of adults with HF.

Developmental Strategy and Validation of the Midwifery Interventions Classification (MIC): A Delphi Study Protocol and Results from the Developmental Phase.

This study protocol aims to describe the rationale and developmental strategy of the first study in the Italian context which aimed to define a Midwifery Interventions Classification, an evidence-based, standardized taxonomy and classification of midwifery interventions. Midwifery interventions require a specific definition, developed through a consensus-building process by stakeholders to develop the Italian taxonomy of the Midwifery Interventions Classification with the potential for international transferability, implementation, and scaling up. A multi-round Delphi study was designed between June and September 2022, and data collection is planned between February 2023 and February 2024. The developmental phase of the study is based on a literature review to select meaningful midwifery interventions from the international literature, aiming to identify an evidence-based list of midwifery interventions. This phase led to including 16 articles derived from a systematic search performed on PubMed, CINAHL, and Scopus; 164 midwifery interventions were selected from the data extraction performed on the 16 included articles. Healthcare professionals, researchers, and service users will be eligible panelists for the Delphi surveys. The protocol designed a dynamic number of consultation rounds based on the ratings and interim analysis. A nine-point Likert scoring system is designed to evaluate midwifery interventions. Attrition and attrition bias will be evaluated. The results from the study designed in this protocol will inform the development of the Italian taxonomy of the Midwifery Interventions Classification. A shared classification of midwifery interventions will support audit and quality improvement, education, and comparable data collections for research, sustaining public recognition of midwifery interventions to promote optimal maternal and newborn health.

Motivational Interviewing for Enhancing Self-care in Patients With Heart Failure: Protocol for a Randomized Controlled Trial.

BACKGROUND: Heart failure (HF) is characterized by an increasing prevalence, representing a public health problem and a significant cause of morbidity and mortality. Self-care is a cornerstone approach for optimizing therapy for patients with HF. Patients play a crucial role in managing their condition, given that several adverse health outcomes might be avoided with adequate self-care. In this regard, the literature describes motivational interviewing (MI) as highly favorable for treating chronic diseases, with promising results supporting its efficacy in enhancing self-care. Moreover, caregivers' availability constitutes a fundamental supporting factor among the strategies to improve self-care behaviors in people with HF. OBJECTIVE: The primary study aim is to test the efficacy of a structured program, including scheduled MI interventions, in improving self-care maintenance in the 3-month follow-up from the enrollment. Secondary aims comprehend the assessment of the effectiveness of the above intervention on secondary outcomes (eg, self-care monitoring, quality of life, sleep disturbance) and the corroboration of the superiority of caregivers' participation to the intervention over the program administrated only to individual patients in enhancing self-care behaviors and other outcomes at 3, 6, 9, and 12 months from the enrollment. METHODS: This study protocol designed a prospective, parallel-arm, open-label, 3-arm, controlled trial. The MI intervention will be administered by nurses trained in HF self-care and MI; the education program will be provided to nurses by an expert psychologist. Analyses will be performed within the framework of intention-to-treat analysis. Comparisons between groups will be based on an alpha of 5% and 2-tailed null hypotheses. In the case of missingness, analyzing the extent of the missingness and identifying underlying mechanisms and patterns will guide imputation methods. RESULTS: The data collection was started in May 2017. We completed the data collection with the last follow-up in May 2021. We plan to perform data analysis by December 2022. We plan to publish the study results within March 2023. CONCLUSIONS: MI enhances potential self-care practices in patients with HF and their caregivers. Although MI is effectively largely employed either alone or combined with other treatments and is administered in different settings and ways, face-to-face interventions seem to be more effective. Dyads with higher shared HF knowledge are more efficient in promoting self-care adherence behaviors. Moreover, patients and caregivers may perceive proximity with health care professionals, resulting in a better ability to follow the received health professionals' directions. The scheduled in-person meetings with patients and caregivers will be exploited to administer MI, respecting all the safety regulations for infection containment. The conduction of this study may support changes in clinical practice to include MI to improve self-care for patients with HF. TRIAL REGISTRATION: ClinicalTrials.gov NCT05595655; https://clinicaltrials.gov/ct2/show/NCT05595655. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44629.

Non-pharmacologic interventions for improving cancer-related fatigue (CRF): A systematic review of systematic reviews and pooled meta-analysis.

INTRODUCTION: Literature encloses numerous systematic reviews (SRs) on nonpharmacologic interventions for improving cancer-related fatigue (CRF). The effect of these interventions remains controversial, and the available SRs have not been synthesized yet. We conducted a systematic synthesis of SRs and meta-analysis to determine the effect of nonpharmacologic interventions on CRF in adults. MATERIAL AND METHODS: We systematically searched 4 databases. The effect sizes (standard mean difference) were quantitatively pooled using a random-effects model. Chi-squared (Q) and I-square statistics (I²) tested the heterogeneity. RESULTS: We selected 28 SRs, including 35 eligible meta-analyses. The pooled effect size (standard mean difference, 95% CI) was -0.67 (-1.16, -0.18). The subgroup analysis by types of interventions showed a significant effect in all the investigated approaches (complementary integrative medicine, physical exercise, self-management/e-health interventions). CONCLUSIONS: There is evidence that nonpharmacologic interventions are associated with CRF reduction. Future research should focus on testing these interventions on specific population clusters and trajectories. PROSPERO REGISTRATION: CRD42020194258.

Individual-Level Variables Associated with Self-Efficacy in Nutritional Care for Older People among Italian Nurses: A Multicenter Cross-Sectional Study.

Malnutrition in older people is still an unsolved issue. Clinical nurses have a key role in malnutrition prevention. This study aims to describe the individual-level variables associated with self-efficacy in nutrition care for older adults among nurses. A cross-sectional descriptive observational study was performed involving nurses from four northern Italy hospitals. The self-efficacy scale for nursing nutrition care (SE-NNC) and Multiple linear regression (MLR) models were used, enrolling 305 nurses. The mean SE-NNC total score was 53.3 ± 19.7. Considering the three dimensions of the SE-NNC, mean scores were 45.9 ± 21.7 for boosting knowledge, 55.4 ± SD = 20.3 for assessment and evidence utilization, and 57.7 ± 21.1 for care delivery. To be a younger nurse, working in a chronic care setting, and being male were associated with a higher level of self-efficacy, both considering the SE-NNC total score and its dimensions. Working in acute care settings and being an older nurse was associated with lower nursing self-efficacy in nutrition care for older adults.

Development and validation of the parents' healthcare needs scale for adolescents with congenital heart disease.

PURPOSE: The healthcare needs of parents of adolescents with congenital heart disease (CHD) have been under-investigated as no valid and reliable tools have been developed for assessing their needs. Therefore, this study aims to develop and validate the Parents' Healthcare Needs Scale for adolescents with CHD (PHNS-CHD). DESIGN AND METHODS: A multi-method approach and multi-phase design were employed. Phase one referred to generating scale items based on emerging themes in the literature, and phase two showed the validation process, divided into three steps. Step one tested the content and face validity of the first version of the PHNS-CHD. After that, step two described the initial psychometric validation process of scale using an exploratory factorial analysis (EFA). Then, step three confirmed the PHNS-CHD factorial structure and assessed its internal consistency. RESULTS: The PHNS-CHD showed evidence of face and content validity, adequate construct, and internal consistency and stability. Specifically, it had 22 items grouped into five domains, labeled as follows: Healthcare education to the child; to be supported as a parent, clinical support to the child, the continuum of care to the child; emotional support to the child. CONCLUSIONS: The PHNS-CHD is a psychometrically robust measure for assessing the healthcare needs of parents of adolescents with CHD. PRACTICE IMPLICATIONS: The PHNS-CHD might help clinicians, especially pediatric nurses, assess the healthcare needs of parents of adolescents with CHD and design adequate care plans for the whole family.

Development and Psychometric Validation of the Nursing Self-Efficacy Scale for Managing Cancer Treatment-Induced Cardiotoxicity: An Exploratory Mixed-Method Study.

OBJECTIVE: Assessing nursing self-efficacy could be strategic to sustain nursing competence. This study aimed to develop and validate the nursing self-efficacy scale for managing cancer treatment-induced cardiotoxicity (NSS-CTC). DATA SOURCES: An exploratory mixed-method study was performed by including two main phases. The first comprised the developmental tasks to generate the initial pool of items, including a literature review and a consensus meeting based on a nominal group technique. The second phase initially involved an external panel of experts in assessing the content validity of the novel scale, followed by a cross-sectional data collection to perform exploratory factor analysis by employing a multicenter and convenience sampling approach. The most plausible psychometric structure derived from the exploratory factor analysis was tested with a confirmatory factor analysis using a second data collection round on another sample enrolled with a multicenter and convenience sampling approach. Internal consistency was assessed using Cronbach's alfa. CONCLUSION: The NSS-CTS is a novel 15-item self-report measure for assessing nurse self-efficacy in dealing with cancer treatment-related cardiotoxicity. Its two plausible domains were labeled knowledge-related self-efficacy (Cronbach's α = 0.924) and practice-related self-efficacy (Cronbach's α = 0.937); the factor analyses in both samples showed adequate fit to sample statistics. Future studies are necessary to corroborate its construct validity and assess its measurement invariance across various country contexts. IMPLICATIONS FOR NURSING PRACTICE: Assessing nursing self-efficacy for managing cancer treatment-induced cardiotoxicity is a promising approach for identifying educational gaps and promoting nursing competency in this particular area of cancer care.