Scale of Assessment of Caregiver Care Burden of People With Dementia: A Systematic Review of Literature.

Cases of dementia have increased significantly in recent years. The family represents the main cornerstone of assistance to the elderly suffering from dementia, in particular the caregiver. Family members who take on the role of caregiver are subjected to physical, psychological, emotional, social and financial stress, which can be conceptualised with the term "burden". The aim of this study was to investigate which tools are best suited to measure the type of burden based on the type of dementia for each caregiver. A literature search was undertaken in MEDLINE, CINHAL and The Cochrane Database in September 2022, including articles from the last 20 years and using a combination of keywords and defined inclusion criteria. This literature review has been performed according to the PRISMA statement. From a total of 116 articles regarding the use of burden rating scales for caregivers, 18 scales were selected. The review provides a useful overview of burden assessment scales, classified into three categories, one-dimensional, multidimensional, or distinct concept with a subjective and objective component, in order to adopt appropriate strategies to assess caregiver burden and improve the quality of their health, both in the community and in hospitals. Indeed, the domestic context is the most studied as there is a greater risk of developing the burden of the caregiver: for this reason, some scales include the assessment of both the caregiver and the patient receiving treatment.

Fall Risk Assessment Scales: A Systematic Literature Review.

BACKGROUND: Falls are recognized globally as a major public health problem. Although the elderly are the most affected population, it should be noted that the pediatric population is also very susceptible to the risk of falling. The fall risk approach is the assessment tool. There are different types of tools used in both clinical and territorial settings. MATERIAL AND METHODS: In the month of January 2021, a literature search was undertaken of MEDLINE, CINHAL and The Cochrane Database, adopting as limits: last 10 years, abstract available, and English and Italian language. The search terms used were "Accidental Falls" AND "Risk Assessment" and "Fall Risk Assessment Tool" or "Fall Risk Assessment Tools". RESULTS: From the 115 selected articles, 38 different fall risk assessment tools were identified, divided into two groups: the first with the main tools present in the literature, and the second represented by tools of some specific areas, of lesser use and with less supporting literature. Most of these articles are prospective cohort or cross-sectional studies. All articles focus on presenting, creating or validating fall risk assessment tools. CONCLUSION: Due to the multidimensional nature of falling risk, there is no "ideal" tool that can be used in any context or that performs a perfect risk assessment. For this reason, a simultaneous application of multiple tools is recommended, and a direct and in-depth analysis by the healthcare professional is essential.

The Role of the Nurse in Informed Consent to Treatments: An Observational-Descriptive Study in the Padua Hospital.

BACKGROUND: The process to obtain valid informed consent in healthcare reflects many aspects. Healthcare professionals that take care of the patient must provide him all the necessary information and verify his understanding, considering individual characteristics. Nurses are one of the main participants in this process. OBJECTIVE: This study assesses nurses' perceptions of their role in the informed consent process. MATERIAL AND METHODS: An observational study involving 300 nurses operating in 13 wards of the Padua Hospital, through the submitting of a questionnaire in the period November-December 2018. RESULTS: The final sample is made up of 206 nurses-27 males (13.11%) and 179 females (86.89%). Work experience, on average 15 years, is significant in determining the answers to questions about opinions and experiences. Age is significant in determining how often nurses provide information to the patient's family members about the actions to be taken after discharge. The ward was decisive in the responses related to information provided to patients on the nursing care level and the actions to be taken after discharge, and the definition of the nurse's duties. CONCLUSIONS: The data collected show the need for interventions to reduce the causes of difficult that the nurse has in informing patients.

The perceptions and experience of the diabetic person with an insulin pump: a review of the literature.

BACKGROUND: diabetes mellitus is a chronic disease of the endocrine system, characterized by an increase in the concentration of glucose in the blood. For patients with diabetes, it is possible to cover the need for insulin through the use of an insulin pump, a subcutaneous implantable device, which aims to simulate the action of the Langherans islets. Therapy with an insulin pump allows patients who use it to have a greater flexibility in the long-term management of diabetes. OBJECTIVE: to investigate in the literature the perceptions and experiences of patients subjected to the use of the insulin pump. METHODS: this review was carried out using the international databases Pubmed, CINAHL and COCHRANE. The mesh terms "Insulin infusion system, attitude to health, experiences, emotions, perceptions, activities of daily living" were used combined with the Boolean operator AND. Age limits  and language were set and literature was investigated from 2008 to 2018, respecting specific inclusion and exclusion criteria. RESULTS: 260 articles from the Pubmed database were analyzed, 26 articles from Cinhal, no articles by COCHRANE; of these 188 excluded based on the reading of the abstract and because they were duplicate articles, 7 because they did not meet the inclusion criteria. 15 articles were included in the review. DISCUSSION: four main themes emerged regarding the personal experience of patients with insulin pumps: perceptions deriving from the use of the insulin pump, behaviour deriving from therapy, obstacles to adequate glycemic control and discrepancy between education received and reality. CONCLUSIONS: different moods and behaviors have been reported in people who use the insulin pump: one above all the fear of hypoglycemia. There are different expectations from patients and nurses. In addition to adequate training with respect to direct patient care, training is also required for nursing staff in emotional support and in technological development.

Barthel Index: creation and validation of two cut-offs using the BRASS Index.

BACKGROUND AND AIM: Hospital discharge should be planned during the first days of stay to avoid an inappropriate length of stay and an early rehospitalization. Blaylock Risk Assessment Screening Score Index (BRASS index) evaluates the risk of difficult discharge, Barthel Index the level of autonomy in "activities of daily living" (ADL). This is a prospective observational study, performed in Padua's Hospital (Italy), with the purpose of validating two cut-offs in the Barthel Index using the BRASS Index, in order to find three bands for difficult discharges: low, medium and high risk. METHODS: Two studies have been conducted: a pilot study in 2017 with 153 patients and a validation study in 2018 with 253 patients, in order to validate data emerged from the pilot study. Using a statistical method, two cut-offs have been identified in the Barthel Index. RESULTS: Both of study showed that the grade of autonomy is correlated with the risk of difficult discharge. A Barthel score between 0 and 35 corresponds to a high risk, between 35 and 70 to a medium and over 75 to a low. DISCUSSION: This study suggests that, by the use of only Barthel Index, it may be possible to identify patients who may have difficulty in early discharge. This result suggests that the degree of functional dependence is predictive of the risk of difficult discharge. Further studies are needed to confirm the correlation between these data also in other realities (e.g. outside hospital departments). CONCLUSION: Nurses could use a single instrument to evaluate the autonomy and the risk of difficult discharge in order to identify early patients that need a discharge plan. (www.actabiomedica.it).

[Assessment instruments for frail elders: a literature review.] / Scale di valutazione della fragilità nell'anziano:una revisione della letteratura.

. Assessment instruments for frail elders: a literature review. INTRODUCTION: The frail patient is a usually elderly person, chronically affected by multiple illnesses, with an unstable and frequently disabled state of health, whose care needs are determined by factors linked to clinical conditions, socio-family status, environment, accessibility to care. The evaluation of frailty, allows the development of care plans aimed at the real needs of the patient. AIMS: Identify the tools for assessing frailty in the elderly based on information collected by nurses. METHODS: Use of the databases Pubmed, CINAHL and COCHRANE, with the mesh terms "frailty, weights and measures, scale". Age limits (65+ years) and language (English and Italian) were set and the references of the selected articles were analyzed. The items of each tool were classified by domain (cognitive, psychological, physical and social). The main characteristics of each instrument were studied, assessing their potential use in nursing care, both of the original scale and of any modified versions. RESULTS: From the 115 selected articles, 13 frailty assessment tools were identified. The tools were classified as one and multidimensional. The one-dimensional instruments are oriented to the physical domain of functioning and biological / physiological state, while multidimensional evaluations are based on the analysis of the interactions of the physical, psychological and social domains of human functioning. CONCLUSION: There is no standard and internationally agreed on measure for assessing frailty; some measurements are more adequate for screening frailty at the community level, others for a hospital context.