The perception of dignity in the hospitalized patient: Findings from a meta-synthesis.

Dignity is a value inherent to all human beings, guaranteed to every individual from birth, and influenced by culture and society. It is protected by various laws and declarations, and represents one of the fundamental human rights. Preserving human dignity is an essential aspect of nursing practice and a central element of care. Dignity is a highly subjective and personal concept; there may be variations in the way that patients perceive it and in the ways that nurses can guarantee it. A systematic review of the qualitative literature was conducted to obtain a comprehensive understanding of adult patients' perceptions of dignity in a hospital setting. This review adhered to the PRISMA Statement for reporting systematic reviews, and the results were reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Major databases (PubMed, CINAHL, Scopus, and PsycINFO) were consulted and resulted in the inclusion of 21 studies. Methodological quality was assessed using the Critical Appraisal Skills Program (CASP) Checklist for Qualitative Studies. Six main themes emerged from the data analysis: (1) The concept of dignity and its various dimensions; (2) The significance of maintaining one's own privacy and confidentiality; (3) The hospital environment's influence on patients' dignity; (4) Healthcare professionals' characteristics and behaviours that affect dignity; (5) The role of communication and the relationship with healthcare providers; and (6) The patient's ability to make choices and be involved actively in their care. These findings underscore the importance of understanding caregivers' perspectives on dignity to ensure that they provide respectful and dignified care and treatment that prioritizes the patient's mental and physical needs.

Outcomes of patient education in adult oncologic patients receiving oral anticancer agents: a systematic review protocol.

BACKGROUND: A large variety of oral anticancer agents have become available and while at first glance these therapies appear to provide only benefits, patients have expressed their need for educational interventions and raised safety issues. Although both patients and providers have recognized patient education's importance, and an interplay with safety has been acknowledged, no systematic reviews of the literature that summarize all of the current evidence related to patient education's outcomes for patients who receive oral anticancer agents have been performed to date. Accordingly, this systematic review will attempt to fill the gap in the literature as well as to map (1) contents, (2) methodologies, (3) settings, (4) timing/duration, and (5) healthcare professionals involved. METHODS: This protocol is being reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic review will be performed. Studies that targeted eligible adult patients (≥ 18 years old) in hospital, outpatient, and home settings, and reported patient education's outcomes for those taking oral anticancer agents will be included. Searches will be conducted in PubMed/MEDLINE, CINAHL, Embase, and Scopus, and gray literature will be also sought. Two researchers will screen the search results independently and blindly in two phases: (1) title/abstract screening and (2) full-text screening using the Rayyan AI platform. An electronic data extraction form will be implemented and piloted, and then, two trained data extractors will extract the data cooperatively. Thereafter, a quality appraisal will be conducted using the Critical Appraisal Tools from The Joanna Briggs Institute. The results will be analyzed, grouped, clustered into categories, and discussed until a consensus is reached. Emerging evidence will be synthesized narratively and reported in accordance with the synthesis without meta-analysis guidelines. DISCUSSION: The systematic review's results will be relevant to (1) policymakers and management at an institutional level, and (2) for clinical practice, in an evidence-based paradigm, potentially leading to a quality improvement with respect to safety and patient satisfaction. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022341797.

Communication experiences of tracheostomy patients with nurses in the ICU: A scoping review.

INTRODUCTION: The quality of care for tracheostomy and mechanically ventilated patients in intensive care units (ICUs) has improved considerably. However, the communication barrier attributable to these procedures generates many problems for patients, as they are unable to communicate effectively with family members and ICU healthcare professionals, especially nurses. AIMS: To describe (1) tracheostomy patients' needs, emotions and difficulties when communicating with ICU nurses and (2) which strategies nurses and patients have adopted to improve their communication. METHODS: A scoping review was completed using the Joanna Briggs Institute method and following the PRISMA-ScR Checklist. The research question was developed using the Population, Concept and Context framework. Five databases were searched. After screening, two researchers independently analysed the 75 papers, and finally, 19 studies were included in this review. RESULTS: All studies used a qualitative design. Seven adopted a phenomenological and two a hermeneutic approach, involving a total of 265 patients. Two main themes and four subthemes were identified: (1) the tracheostomy patients' needs, emotions and difficulties communicating with ICU nurses (patients' emotions, communication needs, and their content and difficulties) and (2) strategies that nurses and patients adopted to improve communication (communication strategies). CONCLUSIONS: It is essential to develop effective communication with tracheostomy patients to ensure they feel relieved, safe and considered. Communication content should focus on information relating to the person's personal condition and active involvement in care. RELEVANCE TO CLINICAL PRACTICE: It is important to prioritise the communication process in tracheostomised patients and create the organisational conditions that foster effective communication processes. Developing training programmes for new or practising nurses is essential to instil greater awareness about this crucial fundamental need.

The differences between learned and practiced competences among nurses: An international pilot study.

AIM: The primary aim was to describe differences, if any, between learned and practiced competences among a convenience sample of Italian and Slovenian nursing staff; the secondary aim was to validate an instrument capable of measuring internationally such competences. BACKGROUND: The distance between competences learned and those practiced as a source of under- or over-education has not been investigated to date at the international level. DESIGN: A explorative observational investigation was performed in 2019 by involving 426 Italian and Slovenian members of the nursing staff working in medical and surgical departments. The study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS: Members of the nursing staff (health care assistants, general nurses, specialist nurses and advanced nurses) were invited to complete the Nursing Competence Instrument based on the European Federation of Nursing Association's four categories of the nursing care continuum, from health care assistants to advanced practice nurses. RESULTS: The construct validity of the Nursing Competence Instrument indicated the presence of four identifiable dimensions (internal consistency ranging from 0.82 to 0.93). On average, the scores of the competences practiced were interestingly slightly higher than those learned among general care nurses. In contrast, health care assistants, specialist nurses and advanced practice nurses, reported to have learned importantly slightly lower as that practiced. CONCLUSIONS: At the overall levels, nurses tend to apply what they had been thought; additionally, all profiles seem to rate at low ranges both the competences practiced and those learned, suggesting the need to maximise nursing competences, both in the classroom and in the daily practice. Mapping the degree of competences acquired in education, as applied in the clinical practice, might assist clinical nurses, nurse educators and health care managers to identify areas at need of improvement. Moreover, mapping differences (if any) across countries might have research, managerial and educational implications.

Perceived Barriers and Enablers of Nursing Research in the Italian Context: Findings from a Systematic Review.

Introduction: The research capacity of nurses has been reported to be still constrained in several countries, and not fully implemented in its potentiality due to a large number of factors. Despite its relevance both for clinical and public health purposes, no summary has been compiled to date regarding factors influencing the research capacity in the Italian context. Therefore, the primary aim of this review was to identify the barriers and enablers of conducting research as perceived by Italian nurses. Methods: We conducted a systematic review. The following databases have been searched: ILISI ® (Indice della Letteratura Italiana di Scienze Infermieristiche) MEDLINE-via PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Ovid, Open Grey, Google Scopus, and Web of Science. Eight studies met the inclusion criteria. Results: The studies were mainly descriptive, with two quasi-experimental. A total of seven barriers and four facilitators of conducting research among Italian nurses were identified. The constraints were poor English knowledge, technology and library availability and accessibility, understaffing and lack of time, nursing culture characteristics, lack of nursing leadership support, scarce funding availability, and the bureaucratic ethical committee process. The facilitators were nursing journal reading, expert research team support, university and hospital partnerships, and international cooperation. Conclusions: Given the small number and the high heterogeneity of the emerged studies, this systematic review provides an initial framework for the constraints that prevent, and the strategies that promote, Italian nurses' participation/conducting of research projects that could inform policies in this field.

Nursing students' self-directed learning abilities and related factors at graduation: A multi-country cross-sectional study.

AIM: To describe nursing students' level of self-directed learning abilities and identify possible factors related to it at graduation in six European countries. DESIGN: A cross-sectional comparative design across the countries. METHODS: The study was conducted from February 2018 to September 2019. Nursing students (N = 4,135) from the Czech Republic, Finland, Italy, Portugal, Slovakia and Spain were invited to respond to the research instruments (the Self-Rating Scale of Self-Directed Learning and the Nurse Competence Scale) at graduation. The data were analysed using the chi-square test, Pearson correlation coefficient and the linear model. RESULTS: The nursing students' (N = 1,746) overall self-directed learning abilities were at high level in all countries. Statistically significant differences occurred between countries. Spanish nursing students reported the highest level of self-directed learning abilities while students from the Czech Republic reported the lowest. Higher level of self-directed learning abilities was related to several factors, particularly with the self-assessed level of competence and country.

[The conceptualization of nursing in the Italian literature: an integrative analysis to inform theory development]. / La concettualizzazione dell'assistenza infermieristica nella letteratura italiana: un'analisi integrativa a supporto dello sviluppo di una teoria.

INTRODUCTION: Nursing theories are essential for orienting nursing practice. To date, three models for nursing practice have been developed in Italy. In addition, significant epistemological reflections have been published, sparking a rich professional debate regarding the theoretical foundations of nursing in Italy. However, conceptual models from other countries are often still used, despite many difficulties associated with applying them in practice. In order to investigate and redress this 'theoretical gap' and related implications for intervention, three scoping reviews of the Italian nursing literature were conducted to examine three categories of nursing knowledge: (a) nursing practice in Italy; (b) the basic nursing concepts of person, health, environment and nursing; and (c) regulatory/normative statements regarding what nursing practice should be in Italy. AIM: The purpose of this investigation was to identify how nursing is conceptualized in the Italian literature through an integrative narrative analysis of three scoping reviews. METHODS: The Scoping Review according to the recommendations published by Arksey and O'Malley and subsequently implemented by Levac et al. has been selected as the optimal methodology for mapping nursing knowledge. At the end of the reviews carried out to answer the three research questions, the researchers integrated the results by conducting a coding of the results. RESULTS: The narrative synthesis highlighted a systemic conception of persons in their social context, 'incorporated' within relational systems. Persons are imagined as active agents with self-determination toward promoting their own health. Health, derived from levels of equilibrium between multiple systemic components and based on the person's holistic view, is a fundamental right and a collective social interest. Maintaining or promoting a person's health requires careful consideration of all these constitutive and integral elements. The nursing process is implemented through technical acts as well as relational and caring skills. Professional autonomy, influenced by clinical and organizational contexts, is expressed in collaboration with other professionals who contribute to the healthcare process. The results of this integrative narrative analysis suggest the need for a holistic vision of persons, with an active role in their health management, indissociable from the system of relationships in which this is contextualized, within which nurses are embedded. CONCLUSION: In light of the results of our investigation, the promotion of a conceptualization of nursing based on the centrality of the person-social relational system and on the active role of persons that nurses work with, this could guide approaches used in nursing education and administration. This could help enhance care provided by nurses and persons' participation in decisions regarding their own health.

Nursing Students' Knowledge of Patient Safety and Development of Competences Over their Academic Years: Findings from a Longitudinal Study.

INTRODUCTION: Future nurses should possess the knowledge and competences necessary to ensure patient safety. However, little evidence is available on the way in which students learn patient safety-related principles over time. This study explored the progress of a cohort of Italian undergraduate nursing students as they acquired patient safety knowledge and competences from time of enrolment to graduation. METHODS: A longitudinal study carried out between 2015 and 2018 enrolled a cohort of 90 nursing students from two Italian Bachelor of Nursing Science Degree Courses at the Udine University, Italy. The students were followed-up on an annual basis and data collection was performed three times: at the end of the 1st, 2nd and 3rd years. The validated Italian version of the Professional Education in Patient Safety Survey tool was used to collect data. RESULTS: At the end of the 1st year, students reported an average 4.19 out of 5 patient safety knowledge acquired in classrooms (CI 95%, 4.11-4.28), which was stable at the end of the 2nd (4.16; CI 95%, 4.06-4.26) and 3rd years (4.26; CI 95%, 4.16-4.32) and no statistical differences emerged over the years. With regard to the competences acquired in clinical settings, at the end of the 1st year the students reported an average 4.28 out of 5 (CI 95%, 4.20-4.37), which decreased significantly at the end of the 2nd year (4.15; CI 95%, 4.07-4.23; p=0.02) and increased at the end of the 3rd year (4.37; CI 95%, 4.27-4.47; p<0.01). CONCLUSIONS: Nursing students' competences in patient safety issues increases over time, while their knowledge remains stable. Students are more vulnerable at the end of the 1st year, when they seem to be overconfident about patient-safety issues.

The power of informal cancer caregivers' writings: results from a thematic and narrative analysis.

BACKGROUND: Cancer is a disease that disrupts not only the patient's life, but that of the entire family as well, from a care, organizational, and emotional perspective. Patients share their experience of illness frequently with their informal caregiver (IC), a partner, son/daughter, friend, volunteer, or any other person in the family or social network who offers to support them during their clinical journey. The purpose of this study was to investigate ICs' still unknown cancer experiences through the stories of IC participants in a Literary Artistic Competition the Centro di Riferimento Oncologico di Aviano (CRO) IRCSS organized, and understand the themes that emerged from their texts and hence, the power of expressive writing. MATERIALS AND METHODS: A qualitative study was carried out on literary texts using Mishler's three levels of narrative analysis: thematic (to detect themes and subthemes); structural (to support the thematic level), and performative (to understand the narratives' meaning). In addition, the narratives were classified based on Kleinman and Frank's models. A particular focus was placed on the language of the narratives to identify figures of speech, e.g., metaphors related to cancer. RESULTS: Seven main themes emerged from the 40 stories' thematic analysis: perceptions of the disease; biographical breakdown; relationships; transformation of the sick body; IC's role; encounter with death; and strength of memory. The ICs' stories also highlighted the strengths and weaknesses of the patient's clinical pathway. ICs are a resource not only for the patient, who, thanks to them, is assured of continuous assistance but also for the healthcare organization, above all because they serve a relational role as a "bridge" between patients and healthcare workers. ICs have important messages to offer to healthcare organizations. If involved adequately, they can provide a strategic strength in supporting patients and healthcare workers themselves. The in-depth analysis of the themes and subthemes in this study led the authors to hypothesize that expressive writing benefit ICs with respect to the possibility of sharing their experiences with others and giving evidence of their role. Their stories are a testimony that can help those who face a similar experience.

Rehabilitation strategies for low anterior resection syndrome. A systematic review.

OBJECTIVE: To summarize the evidence in the literature about rehabilitative treatments that reduce low anterior resection syndrome (LARS) symptoms in patients who underwent surgery for colorectal cancer. METHODS: We have search in PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health and Scopus databases. Studies selected were limited to those including only patient undergone low rectal resection with sphincter preservation and with pre-post assessment with a LARS score. Five articles fit the criteria. RESULTS: The percutaneous tibial nerve stimulation demonstrated moderate results and sacral nerve stimulation was found to be the best treatment with greater symptom improvement. Only one study considered sexual and urinary problems in the outcomes assessment. CONCLUSIONS: In clinical practice patients should evaluate with the LARS and other score for evaluation of urinary and sexual problems. Future research must be implemented with higher quality studies to identify the least invasive and most effective treatment/s.

Priorities for Cancer Research From the Viewpoints of Cancer Nurses and Cancer Patients: A Mixed-Method Systematic Review.

BACKGROUND: Setting priorities in oncology is a useful way to produce a robust set of research questions that researchers can address. OBJECTIVE: The aim of this review was to describe cancer nurses and patients' main research priorities and describe their development over time. METHODS: A mixed-method systematic review was conducted for the period from 2000 to 2018 through a search of multiple databases. The methodological quality of the studies included was assessed using the Mixed-Methods Appraisal Tool, and the process of setting the health research priorities was assessed using Viergever's tool. Each study's top research priorities were extracted and summarized in categories. RESULTS: Fifteen studies were included: 13 addressed nurses' research priorities, and 2 focused on those of patients. The majority were Delphi and quantitative studies that were conducted in the United States and United Kingdom. The quality criteria score and the quality of the process were considered sufficiently good. The most important research priorities were categorized as disease control and management, patient-related issues, and professional dimensions and issues. Management of symptoms and pain, education, information, and communication were research priorities always present in the articles during the study period. CONCLUSION: Priorities change over time and depend on several factors; however, some have remained consistent for the last 18 years. Although there is increasing emphasis on including patients in establishing research priorities that inform cancer care, this involvement is still lacking. IMPLICATIONS FOR PRACTICE: Future studies should describe the primary cancer research priorities of nurses in collaboration with patients.

Providing care to a family member affected by head and neck cancer: a phenomenological study.

BACKGROUND: Cancer is recognized as a family illness as many head and neck cancer (HNC) patients after treatment require assistance from a family caregiver throughout the rest of their life. The purpose of this study was to explore the lived experience of primary family caregivers of HNC patients dealing with laryngectomy regarding their complex supportive role. METHODS: Phenomenological study based on individual interviews of twelve primary caregivers of HNC patients, recruited by purposeful sampling. Interview contents were analyzed in depth, in accordance with Colaizzi's descriptive analysis framework, to explore and identify significant themes and subthemes. RESULTS: Analysis evidenced three main topics and subthemes embracing various aspects of the caregiver's lived experiences: (1) experiencing disease and the pathway of care, (2) handling changes to everyday life, and (3) support received by others. CONCLUSION: Given the essential role the caregiver has in the patient's post-treatment recovery, future planning of HNC patient care must consider the caregivers' needs. In order to guarantee an appropriate and effective health professional care, it is important to consider caregivers' issues and needs as part of HNC patient care planning from the diagnosis to the follow-up.

Correction to: providing care to a family member affected by head and neck cancer: a phenomenological study.

The name of Luca Ghirotto was incorrectly captured in the original manuscript.

The awareness of contextual factors, placebo and nocebo effects among nursing students: Findings from a cross-sectional study.

Contextual Factors (CFs) have been documented to influence nursing interventions and patients' outcomes triggering placebo/nocebo effects. However, given that no studies to date have explored the beliefs and the use of CFs among nursing students, a cross-sectional study was undertaken. Two Italian nursing programmes were involved and a self-administered survey tool was used. A total of 510 students participated. The majority (266; 52.2%) defined CFs as an intervention without a specific effect on the condition being treated, but with a possible nonspecific effect. They reported a substantial level of confidence in CFs and in using them more than twice/week in addition to nursing interventions to optimise clinical outcomes. Physiological and psychological therapeutic effects were mostly reported by participants in treating insomnia (n = 351; 68.8%) and chronic pain (n = 310; 60.8%). The use of CF was considered ethically acceptable when it exerted beneficial psychological effects (n = 188; 36.8%). Participants communicated to patients that a CF is a treatment that can help and will not hurt (n = 128; 25.1%). Students are aware of the value of CFs. Increasing their emphasis in nursing programmes can promote nursing students' consideration with regards to their use, their underlying mechanisms, their potential effects, as well as their ethical and comunicative implications.

Evaluating self-directed learning abilities as a prerequisite of health literacy among older people: Findings from a validation and a cross-sectional study.

AIMS AND OBJECTIVES: To validate a tool measuring self-directed learning (SDL) abilities and to determine these abilities among older individuals attending the University of the Third Age. BACKGROUND: Health literacy (HL) and SDL abilities have been documented as being closely linked to each other and as prerequisites in enhancing self-management competences required by older people to protect their health and to manage health issues. Furthermore, individuals with SDL abilities have been documented to have a full understanding of their health treatment prescriptions, to be able to demonstrate increased compliance and to further develop self-care competences. DESIGN: A validation and a cross-sectional study design. METHODS: A consecutive sample of 313 older people (68.7% female) who attended lessons in two Italian Universities of the Third Age and who were willing to participate in the study were enrolled. The Self-Rating Scale of Self-Directed Learning (SRSSDL) validated previously in the healthcare context, was used. RESULTS: At the exploratory and confirmatory factor analysis, the SRSSDL in Older people (SRSSDLO) has demonstrated good psychometric properties: the tool is composed by four factors ("Awareness," "Attitudes," "Availability" and "Motivation") and 13 items. According to the findings, the average SDL score was 54.27 ± 6.69 out of 65, and women achieved significantly higher scores compared with men (54.81 ± 6.69 vs. 53.08 ± 6.54, p = .033), while participants with a university degree (55.95 ± 6.56) or secondary education (54.75 ± 6.13) had higher scores than those with lower secondary education (50.37 ± 7.34, p = .002). CONCLUSIONS: Participants were responsible for their learning processes and were capable of identifying learning needs and goals. They were also internally motivated to develop learning methods and to organise learning activities. However, they were less able to keep up to date with the learning resources available. IMPLICATIONS FOR PRACTICE: The SRSSDLO can help nurses identify healthy older people that lack SDL abilities and design tailored educational interventions to prevent health conditions and/or promote self-care management in chronic conditions.

[The development of nursing research ten years after the establishment of PhD Schools of Nursing in Italy]. / Lo sviluppo della ricerca infermieristica in Italia a dieci anni dall'istituzione delle scuole dottorali.

INTRODUCTION: In Italy, the nursing doctoral programs were established in 2006, and after ten years we though it would be important to understand how nursing research in Italy has developed thanks to its four doctoral schools of nursing. Our research question was: How have the Italian doctoral schools of nursing contributed to the development of nursing research in the last ten years? METHODS: A national descriptive observational was conducted to collect all the publications made by the four nursing doctoral schools in Florence, Genoa, L'Aquila, and Rome between 2006 and 2015. For the enrolment of the participants, an online survey was sent to the e-mail address of each student provided by the reference University. The publications collected through the CVs of the current and former doctoral students were then checked against Web Science. The publication trends were analysed considering the type of journal, the Impact Factor (IF), and the topics. RESULTS: A total of 478 papers published between 2006-2015 were retrieved, of which 226 (47.59%) were published in Italian journals and 250 (52,41%) on international journals. The great majority of the papers (59,21%) were published in 30 journals, of which 15 had an Impact Factor (range 0.236 - 3.755). The main topics were clinical care, research methods, education, management, ethics, and policies. CONCLUSIONS: Between 2006 and 2015, Italy has produced nursing knowledge and scientific data that can be used to improve the quality of care and facilitate discussions with health policy decision-makers in order to better address the incumbent heath challenges of the near future.

[Research in Italian nursing practice: an extensive review of literature]. / La ricerca nella pratica infermieristica italiana: una revisione estensiva della letteratura.

PURPOSE: To identify orientations in Italian nursing research regarding nursing practice, highlighting strengths, needs for improvement, as well as suggestions and recommendations for promoting the future development of nursing knowledge. METHOD: An extensive review of the literature was conducted (scoping review) by consulting the following databases: PubMed, CINAHL, PsycINFO, Biosis and Scopus, for the time interval between January 2006 and July 2016. RESULTS: Out of a total of 5635 publications, 35 were identified as relevant to the research question. These highlighted the changes implemented by nurses in Italy through their professional actions according to the best available evidence, especially since 2011/2012. Many publications relate to the implementation of new technical procedures or educational systems for patients, but there is a lack of studies that examine the effectiveness of nursing care and its effects on patients. Many studies do not belong within a program of research or larger projects, and virtually none involve participation in international research teams. With regard to the clinical environments in which the studies were conducted, the majority involved hospitals and the focus was mainly on patients in an acute phase of an illness. Few studies have investigated persons with chronic illnesses, the elderly or have been conducted in long-term care settings such as nursing homes. Another finding identified in this review is the prevalence of quantitative studies, with descriptive study designs, the use of questionnaires that were often created ad hoc, and the recruitment of samples from 'convenience' populations. These findings highlight the need to further review orientations in the Italian nursing research literature, focusing attention on emerging clinical priorities. This should be done through a process that balances the needs of nurses and with those the patients. CONCLUSIONS: Italian nursing researchers tend to focus their investigations on technical and educational topics. Theoretical or philosophical frameworks are almost completely missing in the literature, highlighting the need for more work in this area. In most cases, Italian researchers do not seem to follow research tracks based on research priorities, highlighting the need to review practice settings to identify areas that need to be developed, explored or consolidated. For Italian nurses, research is an area that is still under development and consolidation, but with strong potential for the future.

The contribution of nursing doctoral schools to the development of evidence 10 years after their establishment in Italy: An exploratory descriptive survey of former and current doctoral students' publications.

AIM: To analyse through an exploratory descriptive survey how former and current doctoral students' publications have contributed to the development of evidence between the establishment of the doctoral schools of nursing in 2006-2015. DESIGN: An exploratory descriptive survey. METHODS: We analysed the papers published in peer-reviewed journals by the four Italian PhD Schools of Nursing between 2006-2015. Additional missing information was retrieved from Web of Science. RESULTS: We identified 478 scientific papers. The papers increased from 12 in 2006-110 in 2015. Most are published in 29 journals, of which 15 had an impact factor ranging between 0.236-3.755. These results show the increasingly significant contribution of nursing doctoral programmes to the production of evidence, which can be used to improve the quality of nursing and inform health policies. Nursing doctoral schools deserve a greater recognition, especially by Italian funding agencies and political institutions.