Parents' Participation in Care during Neonatal Intensive Care Unit Stay in COVID-19 Era: An Observational Study.

BACKGROUND: Parents play a crucial role in the care of infants during their stay in the neonatal intensive care unit (NICU). Recent studies have reported a decrease in parental participation due to the coronavirus disease (COVID-19) pandemic, which has led to restricted access policies in hospitals. The aim of this study was to describe the barriers to good parental participation during their stay in the neonatal intensive care unit in the COVID-19 era. METHODS: This was a quantitative, observational study. RESULTS: A total of 270 parents participated in this study. Mothers' participation in care was higher than that of fathers (p = 0.017). Parents who lived at the birth of their first child reported a better level of participation in care compared to those who lived at the birth of their second-born (p = 0.005). Parents of extremely preterm neonates reported a lower interaction with their infants than parents of term newborns (p < 0.001). CONCLUSIONS: Some disadvantaged categories reported lower scores for cultural and linguistic minorities, parents of multiple children, and fathers. The COVID-19 pandemic has made several family-centred care activities impossible, with a higher impact on those who benefited most of these facilities. This study was prospectively approved by the IRB-CRRM of the University "G. d'Annunzio" Chieti-Pescara on 23 January 2024 (approval number CRRM: 2023_12_07_01).

Quality of Life of Pediatric Nurses During the COVID-19 Pandemic: A Cross-sectional Study.

BACKGROUND: In a public health emergency, the psychological stress of nursing staff should be assessed, and nurses who cared for coronavirus disease 2019 (COVID-19) patients were constantly under pressure. Currently, frontline health care workers are experiencing mental health issues. The personal quality of life is directly related to the working environment, especially at this moment, when nursing could be a highly stressful and emotionally draining job. OBJECTIVES: During the COVID-19 pandemic, the primary objectives of the study were to describe the quality of life, posttraumatic stress disorder, and self-efficacy and to identify any associated factors of pediatric critical care nurses. This study is a multicenter cross-sectional study. METHODS: Data were collected between February and May 2021 from pediatric critical care nurses. The following instruments were used: the Nursing Quality of Life Scale, the Nursing Profession Self-Efficacy Scale, and the Impact of Event Scale. RESULTS: One hundred twelve nurses participated in this study with a 40% of response rate. Data suggest a better global perception of quality of life by male subjects (F = 6.65, P = .011). The nurses who cared for COVID-19 patients reported a lower quality of social life (F = 4.09, P = .045); furthermore, the nurses who had clinically vulnerable people in their families reported a worse quality of physical life (F = 4.37, P = .045). Approximately 50% of nurses reported sleep disturbances, and 37% reported symptoms of posttraumatic stress disorder, especially female nurses (F = 8.55, P = .04). CONCLUSION: According to this study, female nurses were more likely to experience posttraumatic stress disorder symptoms during the COVID-19 pandemic. Furthermore, findings also highlighted a lower quality of social life for those with clinically vulnerable relatives may be due to a self-limitation of interactions with other people. Finally, sleep disturbances were prevalent, potentially affecting nurses' mental health and performance.

Regional Citrate Anticoagulation and Systemic Anticoagulation during Pediatric Continuous Renal Replacement Therapy: A Systematic Literature Review.

BACKGROUND: Clotting is a major drawback of continuous renal replacement therapy (CRRT) performed on critically ill pediatric patients. Although anticoagulation is recommended to prevent clotting, limited results are available on the effect of each pharmacological strategy in reducing filter clotting in pediatric CRRT. This study defines which anticoagulation strategy, between regional citrate anticoagulation (RCA) and systemic anticoagulation with heparin, is safer and more efficient in reducing clotting, patient mortality, and treatment complications during pediatric CRRT. METHODS: A systematic literature review was run considering papers published in English until December 2021 and describing patients' and treatments' complications in CRRT performed with heparin and RCA on patients aged less than 18 years. RESULTS: Eleven studies were considered, cumulatively comprising 1.706 CRRT sessions (62% with systemic anticoagulation and 38% with RCA). Studies have consistently identified RCA's superiority over systemic anticoagulation with heparin in prolonging circuit life. The pooled estimate (95% CI) of filter clotting risk showed that RCA is a protective factor for clotting risk (RR = 0.204). CONCLUSIONS: RCA has a potential role in prolonging circuit life and seems superior to systemic anticoagulation with heparin in decreasing the risk of circuit clotting during CRRT performed in critically ill pediatric patients.

Presenteeism levels among Italian nurses. A multicentric survey.

BACKGROUND: Presenteeism represents the need to "get to work although we feel sick"; thus, affecting the quality of work, leading to errors or omissions, reducing productivity and increasing costs. Nurses are among the job categories with the highest degree of Presenteeism, which may negatively affect work quality. AIMS AND OBJECTIVES: To assess the prevalence of Presenteeism among Italian nurses. METHODS: A cross-sectional, multicentric study was carried out from January to December 2015 in a sample of Italian nurses. A total of 652 nurses completed the questionnaire. The mean Stanford Presenteeism Scale (SPS-6) total score was 21.6 (±4.0). Nurses showed high Presenteeism levels when considering the "Avoiding distractions" and "Completing work" sections of the Scale. RESULTS: Male nurses showed a lower degree of Presenteeism than women, which also tended to be less severe with increasing age. The presence of ≥1 self-reported health problem was associated with an increase in the score. CONCLUSIONS: In line with previous studies performed outside Italy, Presenteeism appear to be a widespread condition also among Italian nurses, requiring appropriate treatment and recognition by healthcare providers. The results of this survey might be used as a minimum, most likely underestimated basis for targeted public health policies.

Italian Nurses' Attitudes Towards Neonatal Palliative Care: A Cross-Sectional Survey.

PURPOSE: Neonatal palliative care becomes an option for critically ill neonates when death is inevitable. Assessing nurses' attitudes towards, barriers to, and facilitators of neonatal palliative care is essential to delivering effective nursing care. METHODS: This study was conducted from January to September 2015 and involved Italian nurses employed in Level III neonatal intensive care units in 14 hospitals in northern, central, and southern Italy. A modified version of the Neonatal Palliative Care Attitudes Scale (NiPCAS) was adopted to assess nurses' attitudes. FINDINGS: A total of 347 neonatal nurses filled out the questionnaire. The majority were female (87.6%), with a mean age of 40.38 (±8.3) years. The mean score in the "organization" factor was 2.71 (±0.96). The "resources" factor had a mean score of 2.44 (±1.00), while the "clinician" factor had a mean score of 3.36 (±0.90), indicating the main barriers to and facilitators of implementing palliative nursing care. CONCLUSIONS: Italian neonatal nurses may face different obstacles to delivering neonatal palliative care and to improve their attitudes in this field. In the Italian context, no facilitators of, only barriers to, palliative care delivery were identified. CLINICAL RELEVANCE: Nurses' attitudes towards neonatal palliative care are essential to supporting nurses, who are constantly exposed to the emotional and moral distress connected with this field of end-of-life nursing care.

Self-Reported Cultural Competence of Nurses Providing Nursing Care in Slovakia.

PURPOSE: The goals of this study were to determine and evaluate the perception of cultural competence of nurses in the Slovak healthcare system, identify factors that influence their perception, and ascertain opportunities to improve nurses' cultural competence. DESIGN: Cross-sectional nonexperimental study. METHODS: Nurses from Slovakia were surveyed in this cross-sectional study using the standardized Cultural Competency Assessment (CCA) questionnaire. Statistical analysis was conducted using SPSS version 22 (IBM Corp., Armonk, NY, USA). RESULTS: In total, 267 nurses responded. Only 28% perceived themselves as very culturally competent to care for people from other cultures. Over 68% received no diversity training. Age (p < .011) and prior diversity training (p < .006) were significantly associated with culturally competent behavior (CCB). A significant relationship (r = 0.17; p < .015) was also confirmed between the self-reported CCA and CCB. CONCLUSIONS: Culturally competent care is a professional imperative. The ability to deliver high-quality, culturally congruent care may be enhanced by cultural diversity education and training. Further research is needed to identify other influences on cultural competency and the impact on patient care and outcomes. CLINICAL RELEVANCE: There is a need for nurses to enhance their knowledge and skills related to cultural competency, awareness, sensitivity, and behaviors. Education and training contribute to nurses' ability to provide high-quality, culturally competent nursing care to patients from different cultures, and may possibly contribute to decreased health disparities.

Attitudes Towards and Knowledge About Lesbian, Gay, Bisexual, and Transgender Patients Among Italian Nurses: An Observational Study.

PURPOSE: To assess Italian nurses' knowledge and attitudes towards gay and lesbian sexual orientation and lesbian, gay, bisexual, and transgender (LGBT) patients, as there is currently no literature exploring the attitudes of nurses in Italy. METHODS: A multicenter, cross-sectional study was conducted between May 2015 to January 2016, using a data collection tool composed of three validated questionnaires and a sociodemographic form. FINDINGS: Eight hundred twenty-four nurses filled out the questionnaire. Despite their awareness of homosexuality as a "natural expression of one's sexuality," Italian nurses showed only moderately positive attitudes towards lesbian and gay patients. A more positive attitude was displayed by women when compared with men (p < .001). Greater knowledge of homosexuality was associated with female gender (p = .042), moderate-wing political affiliation (p = .014), and more affirmative behaviors (p = .008). Men were found to have greater awareness of being prepared to care for LGBT people (p = .022). CONCLUSIONS: Although Italian nurses displayed moderately positive attitudes and affirmative behaviors, there is the need to increase their cultural competencies regarding sexual minorities. CLINICAL RELEVANCE: LGBT patients feel some discomfort in approaching physicians or nurses. It is important to know nurses' attitudes in caring for LGBT patients in order to modify inappropriate and discriminatory behaviors.

Pathological Gambling among Italian Nursing Students.

PURPOSE: To investigate the role of psychiatric dimensions, behavioral or substance addictions and demographical variables as determinants of pathological gambling among nursing students. DESIGN: Multicenter cross-sectional study. METHODS: From June to October 2015 a survey was carried out among Italian Nursing students. Data were collected using a six-section tool. FINDINGS: Nursing students who completed the survey numbered 1083, 902 (83.3%) had some problems with gambling and 29 (2.7%) showed pathological gambling. Percentage of pathological gambling was significantly associate with illicit drug/alcohol use (65.5%; p=0.001) and with male gender (58.6%) comparing to student nurse with non-pathological gambling (20%) and those with some problem (24.2%). Significant main effect was observed for IAT score (Beta=0.119, t=3.28, p=0.001): higher IAT scores were associated with higher SOGS scores. CONCLUSIONS: Italian nursing students have some problems with gambling and pathological gambling problem, and males are those who have more problems. Results might be useful for faculties of health professionals to identify students at risk in an early stage, to direct prevention tailored interventions. CLINICAL RELEVANCE: Nursing faculties should be aware of the prevalence of Gambling among students. Prevention interventions should be planned to minimize the risk of gambling behavior in the future nurses' health care workers.

Health literacy among caregivers of patients with heart failure: A multicentre cross-sectional survey.

AIMS AND OBJECTIVES: To assess the levels of health literacy of Italian caregivers of patients with heart failure. BACKGROUND: Health literacy is related to patients' health outcomes. Low health literacy has been found in older people with heart failure, and less is known on the health literacy of caregivers whose patients are suffering from heart failure. DESIGN: Observational, multicentre, cross-sectional study. METHODS: From July 2015-May 2016, caregivers were recruited in five hospitals from Central and Southern Italy. To assess health literacy, the Italian version of the Short Test of Functional Health Literacy tool was used. RESULTS: A total of 173 caregivers participated in the research, the majority being females (60.1%), aged between 46-60 years (52.6%) and 96 (55.5%) were from Central Italy. 33.5% of caregivers were patients' children, and 16.2% were paid caregivers of foreign origins. The average level of health literacy was adequate; however, lower levels were found among patients' spouses and those of older age. CONCLUSION: Our results, in contrast with previous studies, showed adequate health literacy levels of caregivers. However, caregivers older in age and with a low education level showed the lowest health literacy, emphasising the need for healthcare workers, to check caregivers' health literacy, before entrusting them with the care of patients. RELEVANCE TO CLINICAL PRACTICE: As this research gives, for the first time, an overview on Italian caregivers' levels of health literacy, its results may be used to improve Italian healthcare professionals' knowledge of caregivers' health literacy, before entrusting them with the care of patients.

The Experience of Family Caregivers of Patients With a Left Ventricular Assist Device: An Integrative Review.

OBJECTIVE: The purpose of this review is to understand the experience of caregivers of patients with left ventricular assist device (LVAD) and to evaluate how health professionals can support them properly. BACKGROUND: Left ventricular assist device can improve quality of life, enhance functional status, and prolong survival in patients with advanced heart failure. Nonetheless, LVAD can adversely influence quality of life for their family caregivers. METHODS: An integrative literature review was conducted using scientific databases between January to March 2015. RESULTS: A total of 15 studies are included in the final review. Three major themes emerged "emotional distress," "responsibility," and "coping strategies" that characterize family caregivers' experiences with care of patients with LVAD. CONCLUSION: Health care providers should understand the pivotal role of caregivers in promoting and maintaining patients' well-being and be able to help the caregiver to moderate the impact being overloaded. Research should be addressed to create interventions that motivate the caregivers to engage in activities that promote their health.

Validation of the Italian version of the Stanford Presenteeism Scale in nurses.

AIMS: To ascertain the validity and reliability of the Italian version of the Stanford Presenteeism Scale (SPS-6). BACKGROUND: Presenteeism has been associated with a work productivity reduction, a lower quality of work and an increased risk of developing health disorders. It is particularly high among nurses and needs valid tools to be assessed. METHODS: A validation study was carried out from July to September 2014. A three-section tool, made of a demographic form, the Stanford Presenteeism Scale (SPS-6) and the Perceived Stress Scale (PSS-10) was administered to a sample of nurses, enrolled in three Italian hospitals. RESULTS: Cronbach's α for the entire sample (229 nurses) was found to be 0.72. A significant negative correlation between SPS and perceived stress scores evidenced the external validity. The factor analysis showed a two-component solution, accounting for 71.2% of the variance. The confirmatory factor analysis showed an adequate fit. CONCLUSION: The Italian SPS-6 is a valid and reliable tool for workplace surveys. IMPLICATIONS FOR NURSING MANAGEMENT: Since the validity and reliability of SPS-6 has been confirmed for the Italian version, we have now a valid tool that can measure the levels of presenteeism among Italian nurses.

Cultural Competence Among Italian Nurses: A Multicentric Survey.

PURPOSE: To assess Italian nurses' cultural competence, as they are increasingly called upon to care for people of foreign origins. DESIGN: A cross-sectional, multicentric study. METHODS: From September 2013 to May 2014, a survey was carried out among Italian nurses. Cultural competence was assessed by the Cultural Competence Assessment tool, translated and adapted to the Italian context. FINDINGS: Nurses who completed the survey numbered 1,432; 70.6% were female; 42.6% ranged in age from 41 to 50 years; and 50.0% were bachelor's prepared. More than 50% had participated in some kind of cultural diversity training. Overall, cultural competence was moderate, showing a moderately high level of cultural awareness and sensitivity (mean = 5.41; SD = 0.66) and a moderate level of culturally competent behaviors (mean = 4.33; SD = 1.10). CONCLUSIONS: Although Italian nurses' cultural competence was acceptable, given the growing diversity of the patient population, nurses should be better prepared to face the changing health requests. CLINICAL RELEVANCE: Providing culturally competent care has been associated with improved provider-client communication, higher satisfaction with care, and health status improvement, as full comprehension of health status, adherence to medications and lifestyle recommendations, and appropriate utilization of the health system. Healthcare providers need to be adequately trained to provide culturally competent care. This research provides, for the first time, a report on Italian nurses' levels of cultural competence, and strengthens the current literature underlining the need for continuous education to enhance cultural competence among nurses.