Life experiences and coping strategies in adults with congenital heart disease.

Many adults with congenital heart disease (ACHD) have to face considerable psychosocial difficulties. The aim of this study was to explore the life experiences of ACHD patients, from when they become aware of having a condition, till after the open heart surgery they underwent. The study was conducted with the use of unstructured, in-depth interviews, performed on 11 patients (age ranging: 20 - 56 y) after they recovered from open heart surgery and a focus group, which included 16 participants (age ranging: 22 - 46 y). Both the interviews and the focus group were recorded, transcribed and analyzed according to Grounded Theory procedures. Our findings show that the condition of diversity is the core of the emotional experiences connected to ACHD. Feeling different and being perceived as being different are clearly interlinked and coping strategies adopted resulted as being influenced by this perception. This study also clearly outlines the importance of having an adequate perception of one's condition and the link between maladaptive coping strategies and an incorrect perception of one's heart condition. Results are discussed in order to promote psychosocial interventions within and outside of the hospital setting in order to improve the patients' emotional wellbeing.

[Art therapy for hospitalised congenital heart disease patients: a method of psychological intervention at the IRCCS Policlinico San Donato Milanese Hospital]. / L'arteterapia per i pazienti con cardiopatia congenita: metodologia di intervento psicologico presso il Reparto di cardiologia, cardiochirurgia pediatrica e cardiopatie conge- nite dell'adulto, IRCCS Policlinico San Donato.

The current work is the presentation of a new project at the IRCSS San Donato Milanese University hospital, in the sphere of Psychocardiology. Hospitalised children and adolescents often face psychosocial difficulties and the psychological condition of their parents frequently has an impact on their wellbeing. A strong need to take care, beyond the mere cure, is necessary in the hospital settings - that is a need to pay attention also to psychological aspects apart from the medical ones. Art therapy could be an answer for this need: the literature has outlined its efficacy in hospital, also due to the higher inclination of children and adolescents toward creativity. By providing and analysing the drawings of 10 young patients with congenital heart disease (CHD), this study outlines how the art therapy program gives these patients the opportunity to freely and directly express fears and anxieties about medical procedures and their disease. Moreover, through the creation of a tangible product, psychologists can better evaluate the psychological troubles of young patients and provide them and their parents with more focused and personalized support. This study also focuses on the perception of the utility that parents have of this new therapeutic intervention, offered at the Department of Paediatric Cardiac Surgery, confirming that art therapy is perceived as being effective and is definitely a good instrument in helping to "take care" of children and adolescents suffering from CHD.

[Nurse's role in the processes of hospital humanization and procedural pain relief in children]. / L'umanizzazione dell'ospedale: il ruolo dell'infermiere nella riduzione della paura e dello stress nel bambino, con particolare riferimento alla procedura del prelievo venoso periferico.

In childhood, hospital admission is frequently seen as something unexplanable and close to a "punishment". Involving parents/caretakers in the process of care is critical for the child to cope with the distress arising from hospital contacts and medical procedures. However, some grey zone remains for common procedures as venipuncture in hospital and ambulatory settings. We have conducted a literature review, searching for articles focused on procedural distress reduction/control in children. Several studies show that communication play a critical role and that children as young as 5 are able to "read" the way nurses and doctors interact with them and their approach is very important in reducing procedural distress. However, children attitude toward communication of health information may not be so linear, because they tend to continuously shift from a position of "passive bystander" to a "active participant" one, and viceversa. Nurse's role is crucial for the reduction of procedural distress because of her/his frequent contact with the young patients, but often she/he does not have the skills to help children to cope with procedural distress. Several approaches to this issue are discussed.

[Psychosocial difficulties and hospitalisation experiences in adults with congenital heart disease. The utility of psychological interventions]. / Difficoltà psicosociali ed esperienze ospedaliere dei pazienti cardiopatici congeniti adulti utilità dell'intervento psicologico.

Adults with congenital heart disease, especially the ones who require constant medical care, encounter many psychosocial difficulties. These difficulties also occur in the interventional departments of cardiology and cardiac surgery, where they often have to make important decisions, undergo cardiology interventions and cardiac surgeries, and more rarely they also have to deal with unexpected complications that can lengthen their hospitalisation duration considerably. The literature has also outline predictive factors when it comes to the psychological difficulties encountered in this population. For these reasons, the inclusion of the psychologist in this context is essential.

Immunization by aerosol with La Sota strain of Newcastle disease virus.

The respiratory symptoms observed after aerosol vaccination with the La Sota strain of Newcastle disease virus were eliminated by mixing the anti-inflammatory compound benzydamine with the vaccine prior to aerosol administration. Benzydamine had no effect on the vaccine virus or on the development of haemagglutination-inhibiting antibodies.