Health coaching for undergraduate nursing students: a pilot study for an action research.

BACKGROUND AND AIM: The Nursing undergraduate degree educational program represents an intensive and complex course, and includes a number of professionalizing practical internships, and for these reasons it requires an action to support and improve. Coaching is based on the premise that people have personal strengths and abilities which, through a interview, can be directed to solving their problems. Several studies demonstrate the efficacy of Health Coaching in different University, but never have been measured benefits regard skills improving. The objective of the study is to assess the impact of a health coaching program on the nursing students. METHOD: A pre-post quasi-experimental study was conducted, involving the activation of a Health Coaching Program for 25 nursing students selected through convenience sampling, based on their fulfillment of the inclusion criteria. The Health Coaching Program was administered by the Health Coaching Academy. RESULT: This study also evaluated parameters such as: level of concentration in study, motivation, problem solving and reorganization skills, study organization skills, psycho-physical-emotional state comprehension, decision-making skills and self-esteem, noting a statistically significant increase post-HC program. A statistically significant improvement was also found in the students' perception of their own stress management skills after the course. CONCLUSION: This study strengthens the hypothesis that HC programs contribute to improving performance of nursing students. Those conclusions need to be corroborated by future studies on the topic to further support the hypothesis that programs of HC within the learning nursing contexts can lead to a tangible benefit for students of the health professions.

Missed care and support figures: Preliminary investigation in some surgical ward.

INTRODUCTION: Missed Nursing care (MNC) is defined as planned care in the patients care process that is omitted or delayed. Despite their importance in Italy, there are just few studies that measure MNC's prevalence and causes. We are not aware of studies published in literature that have related MNC with the presence or absence of support staff. OBJECTIVES: This study's objective, was to measure nurse's perception and reasons for missed care in surgical wards with or without Health Care Assistants (HCA), and, to assess whether there is a significant difference between the two groups of nurses. METHODOLOGY: A Cross-sectional observational study was conducted through the administration of the "Missed Nursing Care Survey" in the Italian Version to nurses of the wards surveyed. RESULTS: Results have confirmed that the most frequent MNC are hygiene and mobilisation activities as reported in other Italian and foreign studies, with higher frequency in wards without HCAs. Also, the study confirmed other Italian and foreign study results recognising the most significant motivation for MNC's as the lack of staff and unexpected events. CONCLUSIONS: Without wishing to attribute a cause/effect relation, it is interesting to assess the results, which seem to show that the presence of HCAs contributes to reduce the prevalence of missed activities. The lack of staff has revealed higher average of MNC for both groups, which seems to direct our attention not only towards the presence of HCAs but in regards to their inclusion in care activities. It may be necessary to reflect on the priority that nurses give to certain activities.

The expert vascular access nurse: a pilot study of competencies.

Background and aim In health care, competencies evolving with clinical and professional practice increasingly need to be defined. Identifying professional competencies in a general sense is no longer enough; it is necessary to define what competencies the professional must possess to ensure the appropriateness and effectiveness of their work. This pilot study aims to outline an initial competency framework specifically for vascular access nurses Methods: A cross-sectional observational study was conducted through structured interviews with professionals of a competency framework (108) to assess content validity and ensure relevance, comprehensibility, and completeness Results: The research involved 14 expert professionals who reported no significant language barriers or comprehensibility difficulties. The expert review showed that the content was valid for all proposed items (CVR .571 to 1.0). Conclusions: The framework identified could be a good starting point for a more in-depth assessment of expert nursing skills in venous access (www.actabiomedica.it).

Short report: social identification, quality of professional life and emotional maladjustment in healthcare providers during the first wave of the COVID-19 emergency.

This research analyzed the effect of professional, organizational and care-unit identifications on both healthcare professionals' quality of professional life and mental health. This research was done in a local hospital in a region of northern Italy which was one of the first regions to be impacted by the first wave of the pandemic. Using a cross-sectional research, a web-based questionnaire was sent to the healthcare professionals. Professional quality of life, professional identifications as well as emotional maladjustment in terms of stress, anxiety and depression were measured. Results indicated that professional and care unit identification were positively linked to increased compassion satisfaction and reduced burnout. Professional identification was negatively associated with secondary traumatic stress as well, while care unit identification was positively associated with vicarious trauma. The negative dimension of the professional quality of life had positive relations with emotional maladjustment. Professional and care unit identifications appeared to have an indirect effect via professional quality of life on maladjustment.

Pain Management in a Prehospital Emergency Setting: A Retrospective Observational Study.

Purpose: Acute pain is a prevalent symptomatology in prehospital emergency care. Although inadequate assessment and treatment of acute pain are associated with various complications, about 43% of adults suffering from pain are undertreated. This phenomenon is poorly studied, and limited data are available in the literature. The objective was to investigate the pain management in a prehospital emergency health-care setting, verifying pain assessment, pharmacological treatment adherence and the effectiveness of pain relief therapy. Patients and Methods: A retrospective observational study was conducted in a sample including all adults treated by the professionals of nurse-staffed ambulances and medical cars in an Italian Emergency Medical Services (EMS) from 1 January 2019 to 31 May 2019. We collected both demographic information and Numeric Rating Scale scores, which evaluated presence and intensity of pain, from the EMS paper forms. All analyses were performed using SPSS, version 27. Results: The study sample was composed of 629 people: 310 males (49%) and 319 females (51%), with an average age of 64.2±22 years (range 18-108). Pain information was collected in 75.5% (n = 475) of our sample; among them 222 patients (46.7%) suffered from pain. We recorded that 79.7% (n = 177) of the subjects with pain received no pharmacological treatment, and in almost all of the treated cases they did not adhere to the analgesia algorithm in use. Among those who were pharmacologically treated, pain statistically significantly decreased in intensity, from before to after, in both emergency vehicles (nurse-staffed ambulances pre m = 8.36±0.9 vs post m = 4.18±2.2, p<0.001; medical cars pre m = 7.25±1.7 vs post m = 3.50±2.6, p<0.001). Subsequently, pain was only re-ascertained in 24.3% of subjects. Conclusion: Our findings confirm that pain is a prevalent symptom in prehospital patients, especially in the younger age range, but that it remains an underrecognized, underestimated, and undertreated symptom with the risk of causing worse health outcomes.

Perceptions of Safety and Stress Among Health Professionals: The Role of Care Unit Identification as a Protective Factor During the COVID-19 Pandemic.

The present study aimed to investigate the role of motivational process and coping resources in health professionals during the COVID-19 emergency examining the role of Care Unit Identification and safety climate perception as resources that can help nurses to cope with stressors. A cross-sectional research design was used and 218 nurses completed a self-report questionnaire measuring: Perception of safety, Care Unit identification, Work Engagement, Psychological Distress, and Burnout. Results revealed that Work Engagement was significantly related with Burnout (b = -0.209, 95%CI [-0.309; -0.109]) and Distress (b = -0.355, 95%CI [-0.529; -0.18]) especially when the Care Unit identification is high (b = -0.303, 95%CI [-0.448; -0.157] and b = -0.523, 95%CI [-0.772; -0.275], respectively). The safety perception was positively related to Work Engagement (b = 0.315, 95%CI [0.198; 0.433]) and had an indirect effect on psychological Distress (b = -0.112, 95%CI [-0.181; -0.042]) and Burnout (b = -0.066, 95%CI [-0.105; -0.027]). High levels of both Care Unit identification and perception of safety, along with personal work engagement, appear to protect nurses from burnout and psychological distress. Findings suggest that the effort to improve teamwork identification and ensures an adequate degree of perceived safety for healthcare professionals need to be maintained and reinforced as they positively impact nurses' wellbeing.

A study on COVID-19-related stigmatization, quality of professional life and professional identity in a sample of HCWs in Italy.

BACKGROUND AND AIM: Perceived COVID-19-related stigmatizations have a strong impact on healthcare workers' wellbeing and quality of professional life, decreasing satisfaction and increasing fatigue. This work aims to investigate the role of professional identification in moderating the impact of COVID-19-related stigma on quality of professional life in a sample of healthcare professionals working in hospital. METHODS: A cross-sectional design in which a web-based questionnaire was sent to professionals was used to collect answers from 174 participants, most of whom women and nurses. RESULTS: Perceived stigma was negatively related with compassion satisfaction and positively related with an increase in both burnout and secondary traumatic stress. Professional identification had a positive correlation with satisfaction and a negative correlation with burnout, but this was not directly related with secondary traumatic stress. Importantly, stigma and identification interacted so that stigma decreased compassion satisfaction only when identification was low, and increased secondary traumatic stress only when identification was high. No interaction effect appeared with respect to burnout. CONCLUSIONS: Experience of stigmatization has the potential to decrease the quality of professional life of healthcare professionals. Professional identification seems to help professional to maintain higher level of compassion satisfaction and reduced burnout. However, professional identification seems also be associated with vicarious trauma experienced following stigma. (www.actabiomedica.it).

Effect of animal assistant therapy on quality of life in older adults: A meta-analysis.

This meta-analysis was conducted to determine the effect of animal-assistant therapy on the quality of life of older adults. This research systematically searched electronic databases (CINAHL, Cochrane Central, Medline/PubMed, Web of Science, Science Direct, and the National Thesis Centre and ULAKBIM of the Council of Higher Education) for studies published between April - June 2021. Seven studies with experimental design were used, three were quasi-experimental and four were randomly controlled studies. The total sample size in the meta-analysis was 375 (experimental group: 177 and control group: 198). The mean duration of animal-assistant therapy was 38.5 ± 12.4 min. Animal-assistant therapy had a significant effect on the quality of life of older adults (mean difference: -4.59 p: 0.03, Z:2.23). Therefore, animal assistant therapy is an effective method to improve older adults' quality of life.

The safety of care focused on patient identity: an observational study.

BACKGROUND AND AIM: Healthcare organizations, in order to reduce errors and extend the number of safe practices, are looking for possible solutions to enhance the clients' health quality care and trying to spread the culture of safety healthcare. Although in the literature the field of research "patient safety" is very debated, there are few empirical studies that investigate about the strategies undertaken by nursing students for the patients identification process during their care pathway. The aim of this study is to investigate the knowledge of the Ministerial Recommendation No. 3/2008 among nursing students, a specific Italian directive that aims to guarantee the safety of cares. METHODS: A four-weeks single-center observational study was conducted, involving a convenient sample of 112 students of the 2nd and 3rd  year of the Nursing Course Degree of the University of Parma. The survey was conducted using an ad-hoc questionnaire. RESULTS: The use of the identification wristband is considered one of the most important strategy to make sure the patient identification; unfortunately it is in practice used just in few occasions and only when performed specific procedures; it is furthermore noted that patients are not enough informed about the use and finalities of the identification wristband. CONCLUSIONS: Considering the importance of the patient identification process to guarantee the  safety of cares, the results produced, suggest that this investigation field deserves further insights in order to collect more substantial data and expand knowledge on the specific subject, so as to fill  knowledge gaps and sensitize nursing students to the correct use of the identification wristband.

The nurses' uniform in pediatrics, the opinion of children and nurses.

BACKGROUND AND AIM: The nursing uniform represents a non-verbal mean of communication which in the case of children can arouse positive or negative emotions. The first study conducted on a sample of 107 children, aimed to define their preferences on different models of decorated nursing uniforms; the second one conducted on 101 nurses to understand the preferences, the meanings attributed to the uniform and their availability to adapt it according to the preferences expressed by the children. METHODS: We conducted an observational study with a qualitative approach. For the first objective with the children, a visual stimulus was used, showing 6 models of uniform: the traditional plus 5 models of different colors and themes (cartoons characters and videogames). For the second objective with the nurses, in addition to reproducing the same visual stimulus, a semi-structured questionnaire was used. RESULTS: Children and nurses seem to be in perfect accord, because in both groups, color models were the most chosen. Nurses defined their uniform with terms of particular moral, intellectual and professional value and declared themselves available to align with the preferences of the children. CONCLUSIONS: This study leaves little doubt about preferences; it also represents the true originality of the study because almost never in the literature have been compared the point of views of children and professionals, generally favoring the comparison between children and care givers. Our findings could represent a further landmark for guiding the choices of health organizations on currencies to be adopted in the pediatric field. (www.actabiomedica.it).

Hope for the future, ingroup threat and perceived legitimacy in three healthcare professional groups.

Background and aims of the work: All societies are organised as hierarchies based on prestige or status. Similarly, healthcare organizations (as well as many other types of organization) are composed by professional hierarchies in which some professional groups are powerful and higher in status  and other groups are powerless and lower in status. This research investigated the effects of social status and hope for future group advancement on perceptions of social identity threat and legitimacy of social stratification. Physicians (the dominant professional group), nurses and healthcare operators (the dominated professional groups) were led to believe that professional stratification would change in the future, but that the nature of the change was unforeseeable. METHOD: A quantitative study was conducted, proposing to the participants an instrument consisting of a series of validated questionnaires for the measurement of: group status, Ingroup threat, hope for future ingroup improvement, legitimacy of the professional hierarchy and  Check for status differences. RESULTS: The results indicate that in the context of social instability, the dominant group perceived greater ingroup threat than the dominated groups. Hope for future advancement was negatively associated with perception of ingroup threat, regardless of group membership. Perception of ingroup threat was negatively associated with the perceived legitimacy of social stratification. Finally, perceived threat mediated the relationship between group status and perceived legitimacy. These results support social identity theory's contention that the legitimacy of social stratification is linked to social identity needs such as avoidance of ingroup threat.

Does the readiness for interprofessional education reflect students' dominance orientation and professional commitment? Evidence from a sample of nursing students.

BACKGROUND: Interprofessional education is an important factor in facilitating subsequent interprofessional collaboration. Therefore, implementing this teaching strategy is important to increase the chances that future professionals will work effectively together. Group membership, status and the power differential among professional groups are factors that can hinder both interprofessional education and collaboration. From a psychosocial point of view, interprofessional education may be described as an intergroup context in which members of different status groups interact. It involves at least two main psychosocial processes: commitment to the profession and acceptance or challenge of interprofessional hierarchy. OBJECTIVES: The purpose of this research was to analyse the effects of professional commitment and social dominance orientation on attitudes toward interprofessional education. DESIGN: A cross-sectional design was conducted. PARTICIPANTS: A total of 137 nursing science students from an Italian university were enrolled in this research. METHODS: Participants were surveyed using a questionnaire measuring attitudes toward interprofessional education, professional commitment and social dominance orientation. RESULTS: The more that students showed social dominance orientation, the less they were willing to engage in interprofessional education. This effect was qualified by an interaction with professional commitment. When professional commitment was higher, social dominance orientation was weakly related to attitude toward interprofessional learning. CONCLUSIONS: These results suggest that there is a belief that professional hierarchy is deserved and that this may decrease a nursing student's engagement in interprofessional education; however, this may be contrasted by an increased professional commitment.

"Could I return to my life?" Integrated Narrative Nursing Model in Education (INNE).

BACKGROUND AND AIM: The Integrated Narrative Nursing Model (INNM) is an approach that integrates the qualitative methodology typical of the human sciences, with the quantitative methodology more often associated with the natural sciences. This complex model, which combines a focus on narrative with quantitative measures, has recently been effectively applied to the assessment of chronic patients. In this study, the model is applied to the planning phase of education (Integrated Narrative Nursing Education, INNE), and proves to be a valid instrument for the promotion of the current educational paradigm that is centered on the engagement of both the patient and the caregiver in their own path of care. The aim of this study is therefore to describe the nurse's strategy in the planning of an educational intervention by using the INNE model. METHODS: The case of a 70-year-old woman with pulmonary neoplasm is described at her first admission to Hospice. Each step conducted by the reference nurse, who uses INNE to record the nurse-patient narrative and collect subsequent questionnaires in order to create a shared educational plan, is also described. RESULTS: The information collected was submitted, starting from a grounded methodology to the following four levels of analysis: I. Needs Assessment, II. Narrative Diagnosis, III. Quantitative Outcome, IV. Integrated Outcome. Step IV, which is derived from the integration of all levels of analysis, allows a nurse to define, even graphically, the conceptual map of a patient's needs, resources and perspectives, in a completely tailored manner. CONCLUSION: The INNE model offers a valid methodological support for the professional who intends to educate the patient through an inter-subjective and engaged pathway, between the professional, their patient and the socio-relational context. It is a matter of adopting a complex vision that combines processes and methods that require a steady scientific basis and advanced methodological expertise with active listening and empathy - skills which require emotional intelligence.

Integrated narrative assessment exemplification: a leukaemia case history.

BACKGROUND AND AIM: In the Integrated Narrative Nursing Assessment (INNA), the Evidence-Based Nursing Model is integrated with the Narrative-Based Nursing Model. The INNA makes use of quantitative instruments, arising from the natural sciences as well as of qualitative ones, arising from the human achieving results of standardization and reproducibility, as well as of customization and uniqueness. Accordingly, the purpose of this work is to exemplify the thinking process of and the method adopted by a nurse adopting an integrated narrative assessment in the evaluation of a patient. METHOD: The patient suffered from acute myeloid leukaemia, treated with chemotherapy. Her nurse worked in a haematology ward in a North Italy Hospital. The nurse had previous experience in conducting the assessment according to INNA. Based on patient's characteristics, the nurse chose to use the narration (to explore needs from their subjective perception) and the scales (to measure them objectively) among the various assessment instruments provided by the INNA. RESULTS: The resultant integrated outcomes helped the nurse to have a comprehensive overview of the person's health-care needs and their connections. These outcomes derive from the integration of narrative information with those obtained from the scales, which in this paper have shown consistent results. CONCLUSION: It is very difficult to reach this complexity by considering qualitative and quantitative assessment strategies as mutually foreclosing, given that both emerged as being very useful in identifying, understanding and measuring the needs of the assisted person. Then they both could be used to design a customized intervention, encouraging new connections between disease, illness, sickness and everyday life.

Healthcare associated infection: good practices, knowledge and the locus of control in heatlhcare professionals.

BACKGROUND AND AIM: The incidence of Healthcare Associated Infections (HAI) is an important indicator of the quality of care. The behaviors associated with the prevention of infections are not only supported by rational knowledge or motivation, but are mediated by social, emotional and often stereotyped behaviors. The awarness of the good practices related to HAI, may be a factor. Other studies, identify how the perception of the problem in healthcare professionals is often influenced by a tendency towards an external Locus of Control: the patient, the family, the other wards, other care settings. The aim of this study is to investigate the perception of healthcare professionals. In particular they have been measured their  awarness of the good practices, perceptions of the potential contamination level of some commonly used objects, knowledge about the management of invasive devices, Locus of Control. METHOD: A cross-sectional correlational design was utilized.  An ad hoc questionnaire was interviewed by 222 health professionals nurses and physicians in a northern hospital of Italy. RESULTS: The percentage of professionals who have attended training courses over the last 5 years was quite high, both for upgrades on HAI (78.7%) and Vascular Catheters (78.8%), while the percentage of professionals who updated on bladder catheterization (59.46%) was lower. The mean  score of good practice awareness towards HAI (5.06), is high. The perception of the potential level of contamination of some devices had a  mean ranging from 4.62 (for the drip) to 5.26 (for the door handle). The average value of the Locus of Control (43.54) indicates that participants demonstrated a value that is midway between External and Internal. The correlation test analysis revealed no significant relationships among professionals'age, knowledge about HAI, or infection related venus catheter. Also, results revealed that there were statistically significant positive relationships between professionals' Good Practices awareness about HAI , Knowledge, and Locus of Control. CONCLUSION: The study findings demonstrated that good practice awareness towards HAI among nurse and physician was good but not completely optimal. Findings revealed that knowledge toward HAI prevention and HAI related device prevention were not completely adequate. The educational courses, according to our correlational findings, should definitely take into account the psycho-social aspects of this phenomenon.

Pet therapy: an effective strategy to care for the elderly? An experimental study in a nursing home.

BACKGROUND AND AIM: There has recently been a growing interest towards patients' affective and emotional needs, especially in relational therapies, which are considered vital as to increase the understanding of those needs and patients' well-being. In particular, we paid attention to those patients who are forced to spend the last phase of their existence in residential facilities, namely elderly people in nursing homes, who often feel marginalized, useless, depressed, unstimulated or unable to communicate. The aim of this study is to verify the effectiveness of pet therapy in improving well-being in the elderly living in a nursing home. METHODS: This is a longitudinal study with before and after intervention variables measurement in two groups of patients of a nursing home for elderly people. One group followed an AAI intervention (experimental group) the other one did not (control group). As to perform an assessment of well-being we measured the following dimensions in patients: anxiety (HAM-A), depression (GDS), apathy (AES), loneliness (UCLA), and quality of life (QUALID). Both groups filled the questionnaires as to measure the target variables (time 0). Once finished the scheduled meetings (time 1), all the participants, including the control group, filled the same questionnaires. RESULTS: In accordance with scientific evidence the results confirmed a significant reduction of the measured variables. Especially for the quality of life, which showed a greater reduction than the other. CONCLUSIONS: The implementation and success of the Pet Therapy could have a great emotional and social impact, bringing relief to patients and their family members, but also to health professionals.

Perceived legitimacy follows in-group interests: Evidence from intermediate-status groups.

In two experiments, the effect of (in)stability of status differences on the perception of perspective legitimacy and in-group threat among intermediate-status group members (i.e., nurses students or nurses) was analysed. Both studies indicated that in downwardly unstable condition, legitimacy was lower and in-group threat was higher than in stable condition. In upwardly unstable condition, perceived legitimacy was higher and in-group threat was lower than in stable condition. The indirect effects of (in)stability via in-group threat on perceived legitimacy were significant.

The role of professional and team commitments in nurse-physician collaboration.

AIM: To analyse the effect of both professional and care unit commitments on attitudes towards interprofessional collaboration between nurses and physicians. BACKGROUND: The effects of both professional and care unit commitment on inter-professional collaboration have not been taken into account together, and previous research has analysed only one profession at a time, neglecting the nurse-physician comparison. METHOD: A cross-sectional survey of 138 physicians and 359 nurses was used. RESULTS: For physicians, professional commitment decreased attitudes towards interprofessional collaboration whereas care unit commitment had a positive influence. Conversely, for nurses, the professional commitment had a significant positive effect on attitudes towards interprofessional collaboration whereas care unit commitment had no significant effect. CONCLUSION: Intergroup relations affect the extent to which nurses and physicians are inclined to engage in interprofessional collaboration. Professional and care unit commitments had different effects on attitude toward the inter-professional collaboration of nurses and physicians. IMPLICATION FOR NURSING MANAGEMENT: Inter-professional collaboration is affected by the relationship between physicians and nurse at the professional group level. Managers who want to change and improve inter-professional collaboration should pay close attention to the interplay between changes they are introducing and well-established identities and practices between professionals.

Tutorship process in health care professions: a survey investigation in Emilia Romagna.

The areas that we wanted to investigate include: tasks performed, tools used, formalization of the assignment, workload, empowerment and satisfaction of the function performed, and training. The results clearly show that the processes of tutoring are different for physicians and non-physician healthcare professionals. The first interesting difference is the method of assignment of mentoring. While among medical professions the function is assigned by others, tutors are often non-medical volunteers. This evidence leads to two unanswered questions: what are the criteria by which they are chosen as tutors? Do volunteers really possess the skills and ability to carry out this role? Future research should be directed towards clearly defining the profile of the "tutor" among both doctors and non-medical professionals. Another difference is the way the work of the mentor is formalized. If they are doctors, the task is assigned to them; this is not the case for non-medical professions. Despite this difference, a high percentage of both medical professionals and doctors said they did not feel valued for their role of tutor. However, differences emerge: physicians see their role as a paid tutor and / or recognized in their curriculum vitae. For non-medical professions, however, the only reward is a recognition of ECM (Educazione Continua in Medicina)credits. A common feature among professionals is that for both physicians and non-physician healthcare tutors, a system of evaluation is rarely reported. Another common feature is the skills that professionals would like to see improved. Both groups of professionals, in fact, would like to see improved teaching methods, communication strategies and reporting and evaluation systems. Finally, non-physician tutors report the same level of satisfaction, although the non-physician professionals are more satisfied in their relationship with colleagues. The degree of empowerment reveals perceived differences and similarities among the professionals. In fact, both professional groups reported the same levels of competence and impact, but differ in meaning and self-determination. More specifically, the non-medical professionals show high scores, while doctors get a higher score for self-determination. These results suggest that for increased attention to the system of evaluation and enhancement of the function tutorial we need not only to increase the satisfaction of those who act as tutors, but also to improve the tutorial process itself. Furthermore, the results suggest the carrying out of training projects for teaching and assessment methods that represent the issues that are most in demand by tutors. The training should include the use of tools for the governance process that project tutorial and apprenticeships. The responses indicate that these tools are already in use, although not as widespread and continuous.

Strategies for pain management: a review.

UNLABELLED: PROBLEM/BACKGROUND: Pain management is a major worldwide health problem. It manifests itself in a variety of forms involving in turn a multiplicity of responses and therapeutic strategies. Following from this, the training of health personnel must deal with this situation and must not only offer technical assistance, but must also deal with the psychological and social aspects of the problem. In recent years various guidelines and protocols have become popular for pain management. The aim of this paper is to present a literature review of the major international databases. Type of research: Systematic review. OBJECTIVE: To identify relevant studies in the literature on pain management and identify the guidelines recognized by the scientific community. MATERIALS AND METHODS: A literature search was conducted using the keywords "pain management" and "nurse" published since 2000 in English and Italian in the following databases: PubMed, CINAHL, Med Line. Excluding items which did not meet the inclusion criteria, 49 articles were included in the review. RESULTS: Despite a growing availability of evidence-based guidelines, drugs for pain control and the enactment of legislation to promote the use of opioid analgesics in pain therapy, a substantial proportion of the European population continues to have pain. Estimates of the prevalence of pain symptoms in the literature show that between 40% and 63% of hospitalized patients reported pain, peaking at 82.3% in cancer patients in advanced stages of the disease or terminally ill (in hospital or at home). Several studies published in recent years have agreed on a definition of some key points in the management of pain. Studies agree that pain should be recognized as the 5th vital sign, hence the need for validated scales whether single or multi-dimensional, quantitative or qualitative. The approach to the management of pain must be multi-professional, and the use of pharmacology must be in accordance with the WHO three-step approach. Several studies have demonstrated that communication and training of operators, associated with accurate information to patients, are effective elements to improve health care delivered to patients. These studies have led to the publication of guidelines by various scientific societies, indicating timely strategies for effective pain management both in hospital and in the territory. A possible development of this research could be to conduct a retrospective study in accordance with the AUDIT methodology so that we can check the implementation of guidelines and propose corrective actions to meet the defined standards.