[Patient isolation during Sars-CoV-2 pandemic: the caregivers' experience in a neuro-rehabilitation unit]. / L'isolamento degli assistiti durante la pandemia da Sars-CoV-2: il vissuto dei familiari in un reparto di riabilitazione.

. Patient isolation during Sars-CoV-2 pandemic: the caregivers' experience in a neuro-rehabilitation unit. INTRODUCTION: During the Covid-19 pandemic, caregiver visits were suspended in many health care facilities and, even today, limitations remain. These restrictions have impacted not only the patients but also caregivers. AIM: To explore the life experience of caregivers of hospitalized patients, during the pandemic and the impact of visit limitations in a rehabilitation unit. METHOD: An exploratory qualitative study was conducted, following the COREQ guidelines. Caregivers of inpatients were purposefully sampled and interviewed, until data saturation. A qualitative thematic analysis with an inductive approach was performed. RESULTS: Fifteen caregivers were interviewed. The themes emerged were: 1. perception of the illness as a sudden change; 2. concerns for their loved one (i.e. the loneliness or the suffering); 3. critical (difficult to organize and perceived too short) and positive aspects of the visits; 4. barriers to communication (for example, masks when in presence; or the difficult use of technologies by elders); 5. patient's protection and support (thinking that the relative's presence may improve the rehabilitation); 6. emotions (from discouragement when visits were not allowed, to joy when meeting their loved one). CONCLUSIONS: Caregivers experienced uncertainty, worry, anxiety, fear, and lack of understanding of their loved one's clinical situation. Alternatives to the visits or the visits with physical barriers were helpful but not always effective.

Italian nurses' experiences of the COVID-19 pandemic through social media: A longitudinal mixed methods study of Internet posts.

Objective: To examine the experience of Italian nurses posted on social media and discover changes, if any, over the waves. Methods: A mixed methods study reported according to the Good Reporting of a Mixed Methods Study criteria. All narratives (texts, letters and interviews) posted by Italian nurses from February 2020 to May 2020 (first wave) and from October 2020 to May 2021 (second/third wave) on the five most famous Italian professional social media platforms. The data were analysed qualitatively (first wave) and then quantitatively (second/third wave). Results: A total of 380 narratives (202,626 words, 2510 quotes) were posted in the first wave, and 161 (68,388 words, 835 quotes) in the second/third wave. In the first wave, the following five themes emerged: (a) 'sharing what is happening within myself' (891; 35.5%); (b) 'experiencing unprecedented working conditions' (749; 29.8%); (c) 'failing to rehabilitate the image of nurses in society' (376; 15%); (d) 'experiencing a deep change' (253; 10.1%) and (e) 'do not abandon us' (241; 9.6%). The same themes and subthemes also emerged in the second/third wave with some significant differences, indicating changes in the lived experience of nurses. Moreover, in the second/third wave, a new theme emerged: 'experiencing the mixed emotions towards jabs'. Conclusions: By analysing their posts, Italian nurses continue to face challenges during the COVID-19 pandemic, with changes in their lived experiences across the waves. Governments, nursing associations and health care organizations should consider these changes to design policies to prevent the further loss of nurses.

The lived experience of healthcare workers in quarantine: Findings of a systematic review, meta-synthesis and meta-summary.

AIMS: In pandemics, infection exposure and quarantine represent critical occupational risks for healthcare workers (HCWs). However, while the psychological consequences of HCWs' quarantine have been reviewed, other potential implications of quarantine on HCWs, such as those that are work-, professional-, social- and private-related, have not been summarised to date. Summarising quarantined HCWs' experiences in the current and past pandemics, as investigated with qualitative studies, might improve awareness of their needs, concerns, and the consequences of quarantine on their personal lives. Therefore, the lived experience of quarantined HCWs was reviewed and subjected to meta-synthesis and -summary. METHODS: A systematic review of qualitative studies followed by a meta-synthesis and -summary allowing an interpretative integration of the findings of qualitative studies, was performed. PubMed, CINHAL and Scopus databases were explored up to 31 January, 2021, without any limitation in time. The methodological quality of the studies was assessed using the Critical Appraisal Skills Programme. Methods and findings are reported according to the Enhancing transparency in reporting the synthesis of qualitative research statement. RESULTS: A total of 635 records were retrieved and five studies were included. Overall, five themes summarised the lived experience of quarantined HCWs: 1) Being emotionally challenged; 2) Living the quarantine limitations; 3) Losing freedom; 4) Accepting the quarantine; and 5) Staying away from me. The most frequent categories across studies were 'Feeling stressed' and 'Being constrained' (both 100%). The least frequent were 'Feeling sad' (20%), 'Enjoying my family' (20%) and 'Being refused as a family member' (20%). CONCLUSIONS: The lived experience of HCWs is multidimensional, the implications of which also affect private spheres of life: the immediate family and wider relatives. Understanding and learning from HCWs' lived experiences might support policymakers, public health authorities and managers with the goal of maintaining the highest physical and mental health of staff during outbreaks. Timely services supporting HCWs, both during and after episode(s) of quarantine, are suggested to prevent additional burdens on frontline professionals.

[Why we need twitter]. / Perché ci serve Twitter.

. Why we need twitter. Assistenza infermieristica e ricerca will shortly be available also on twitter. Twitter is a valuable science communication and marketing tool for academic journals to increase web-based visibility, promote research, and translate science to lay and scientific audiences. Medical journals use Twitter to engage and disseminate their research articles and implement a range of strategies to maximize reach and impact. The first benefit of using Twitter derives very simply from the ability to follow the flow of information originated from credible sources. First and foremost, from the the major magazines in one's field of interest. The use of Twitter may help to delve into areas close though not strictly related to nursing, thus broadening one's perspective. Some advice and warn on for use are proposed.

Implications of quarantine among healthcare professionals: findings from a scoping review.

Although quarantine has been largely used in the recent period of novel coronavirus disease (COVID-19), there has to date been no summary of the available literature regarding its implications among health care workers (HCWs). A scoping review was performed, following The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review and the Joanna Briggs Institute Critical Appraisal Checklist. The CINAHL, PubMed, and SCOPUS databases were queried up to 31 January 2021. Nine studies ranging from low to high methodological quality, were included. These were conducted in diverse countries, predominantly regarding the Severe Acute Respiratory Syndrome and using cross-sectional designs. Quarantine was found to have multifaceted negative consequences that affected HCWs psychologically, professionally, personally, socially and economically. These findings could be useful as a framework for researchers while designing future study protocols, and for policy-makers or managers while establishing multidimensional effective strategies increasing HCWs' resilience and wellness.

Framing the time while designing and conducting reviews: A Focused Mapping Review and Synthesis.

AIMS AND OBJECTIVES: To identify the profile of time restrictions and their justifications as reported on a set of published reviews. BACKGROUND: There is a body of methodological knowledge addressing how to design and perform reviews in their different designs. However, how the time restrictions should be set and the justifications that should be provided have received limited attention to date. DESIGN: A Focused Mapping Review and Synthesis following three steps (Focus, Mapping and Synthesis) was performed on 2021. The ENTREQ checklist was followed to report methods and findings. METHODS: All Journal of Clinical Nursing reviews published in online or printed version on 2020 (n = 85). Time limits imposed in the literature search, and justifications provided were mapped and synthetised with quantitative and a qualitative analysis. RESULTS: Time restrictions in reviews are not always reported and, when available, reflect three different profiles: (a) including all studies, to provide a comprehensive review; (b) selecting a period, to provide reviews for a contemporary practice; and (b) including only recent studies for reviews reflecting current practice. Reasons justifying time restrictions are not always reported; when documented, justifications regard changes in the practice, in the research or in the theory occurred over time, recent or ongoing. CONCLUSIONS: In exploring the date restrictions applied in reviews published over the course of a year, it emerged that the time of access to the sources and the justifications are not always indicated. The attributes of the emerging concepts of "comprehensive reviews," "contemporary practice reviews" and "current practice reviews" might be further developed to support researchers in selecting an appropriate time frame. RELEVANCE TO CLINICAL PRACTICE: Reviews require improvements regarding the time restrictions and their justifications. Methodological efforts to standardise the approach ensuring transparency in review protocols and in the following review publication are recommended.

Italian Nurses' experiences during the COVID-19 pandemic: a qualitative analysis of internet posts.

AIM: To investigate the experience of Italian nurses during the first wave of the COVID-19 outbreak by analysing professional social media posts. BACKGROUND: The COVID-19 outbreak has overwhelmed health care institutions; as a consequence, nurses' lives and psycho-physical health have been affected. INTRODUCTION: The COVID-19 pandemic forced nurses to work in physically and psychologically stressful conditions impacting on their life. METHODS: A qualitative descriptive study. All narratives (texts and videos) posted by nurses from the 23rd of February 2020 to the 3rd of May (from the start of the outbreak to the end of the first lockdown) were analysed and published on the five most popular Italian professional social media platforms. The Consolidated Criteria for Reporting Qualitative research guidelines were followed. RESULTS: Five themes emerged from the 380 narratives explored: 'Sharing what is happening within myself'; 'Experiencing unprecedented working conditions'; 'Experiencing a deep change'; 'Failing to rehabilitate the image of nurses in society'; and 'Do not abandon us'. Even though nurses appreciated the recognition of their communities, they still felt devalued and not recognized as professionals. DISCUSSION: Several psychological, physical, social and professional implications emerged from nurses working during the COVID-19 pandemic. Despite being highly praised, nurses perceived they had failed in rehabilitating the image of nurses in society. CONCLUSION: The experience of working during the COVID-19 pandemic represented a traumatic event for nurses but it offered them personal and professional growth opportunities. IMPLICATIONS FOR NURSING PRACTICE, NURSING POLICY AND HEALTH POLICY: Supporting nurses' mental health is highly recommended, together with a cultural investment on nurses' role recognition, and a zero-tolerance policy towards violence and aggression towards nurses.

Missed nursing education: Findings from a qualitative study.

AIM: To understand what nursing education activities are missed in the daily life of nursing programmes, by also identifying antecedents and consequences of missed educational activities. DESIGN: A descriptive qualitative study according to the COnsolidated criteria for REporting Qualitative research guidelines. METHODS: A purposeful sample of 32 participants with different roles (nurse educators, clinical nurses, students, and administrative personnel) and working in different settings (university, administrative, healthcare service levels) were involved in three focus groups and nine face-to-face interviews from 2019-2020. Both focus groups and face-to-face interviews were audio-recorded and transcribed verbatim. The data that emerged were thematically categorized by induction. FINDINGS: Missed Nursing Education reflects those educational activities needed in the process of nursing education that are missed or delayed. Direct educational activities missed include clinical rotations, classroom teaching and students' overall learning experience. Indirect missed educational activities concern continuing professional development of nursing faculty members, nursing discipline development and the organizational processes of the nursing programme. As antecedents, missed nursing education is triggered by factors at the organizational, nursing faculty, and student levels. Consequences have been reported for students, nursing faculty, clinical nurses, and patients. CONCLUSIONS: Missed Nursing Education can be considered a multifaceted, multicausal phenomenon, with multitargeted consequences. IMPACT: To date, missed nursing care has only been investigated in clinical practice. However, care also permeates the relationship between nurse educators and students. Thus, at the point of 'educational care' delivery, aspects can also be omitted. Educational activities at risk of being missed or delayed affect the quality of nursing education and, in the short- and in the long- terms, also the quality of patient care. Some Missed Nursing Education antecedents can be modified by appropriate strategies that should be addressed by policy, health care and academic institutions.

Depicting clinical nurses' priority perspectives leading to unfinished nursing care: A pilot Q methodology study.

AIMS: To highlight (a) trends common to all nurses on priorities attributed to interventions, and (b) whether there are profiles of nurses working in the same context who prioritize interventions in a similar way. BACKGROUND: The underlying prioritization of interventions leading to unfinished nursing care has been minimally investigated. METHODS: A 2017 pilot Q methodology study. Full-time nurses, with at least 6 months of experience in a surgical unit, were involved. Eleven nurses rated the priority given in daily practice (from -3 as the lowest to +3 as the highest) to 35 Q-sample statements representing nursing care, non-nursing and organisational interventions. RESULTS: Overall, the intervention receiving the lowest priority was 'Providing patient hygiene', while the highest was 'Answering phone calls'. In the by-person factor analysis (total variance = 60.79%), three profiles of nurses emerged, (a) 'Patient safety-oriented' (variance = 31.66%); (b) 'Nursing task-oriented' (=16.32%); and (c) 'Team process-oriented' (=12.81%). CONCLUSIONS: Three profiles of nurses emerged in the same setting with significant differences both in the statistical order of priorities and in their practical implications. IMPLICATIONS FOR NURSING MANAGEMENT: Understanding levels of prioritization, which are not only affected by the unit but also by sub-groups of nurses who rank priorities in a similar way, can support nurse managers in their role.

Negative prompts aimed at maintaining eating independence.

BACKGROUND: Psychological abuse of older people is difficult to recognise; specifically, nursing home residents have been documented to be at higher risk of psychological abuse during daily care, such as during feeding. Healthcare professionals adopt positive and negative verbal prompts to maintain residents' eating independence; however, negative prompts' purposes and implications have never been discussed to date. RESEARCH AIMS: To critically analyse negative verbal prompts given during mealtimes as forms of abuse of older individuals and violation of ethical principles. RESEARCH DESIGN: This is a secondary analysis of three cases of negative prompts that emerged in a large descriptive study based upon focus group methodology and involving 13 nursing homes and 54 healthcare professionals. PARTICIPANTS AND RESEARCH CONTEXT: This study included 3 out of 13 nursing homes caring for residents with moderate/severe functional dependence in self-feeding mainly due to dementia; in these nursing homes, we conducted three focus groups and 13 healthcare professionals participated. ETHICAL CONSIDERATIONS: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after being approved by the Review Board of the Trust. FINDINGS: With the intent of maintaining self-feeding independence, negative verbal prompts have been reported as being used by nursing home teams. By critically analysing these negative prompts, it turned out they could trigger intimidation, depression and anxiety and thus could be considered as forms of abuse; moreover, negative prompts can threaten the ethical principles of (1) autonomy using a paternalist approach, (2) beneficence and non-maleficence as with the intent to act in the best interests of residents (to maintain self-feeding independence) they are harmed in their dignity and (3) justice, given that residents who received negative prompts are treated differently from those who received positive prompts. DISCUSSION: Eating should be a pleasant experience with a positive impact on physiological, psychological and social well-being. However, negative prompting can lead to abuse and violation of basic ethical principles, destroying the healthcare professional resident and relative relationships strongly dependent on trust. CONCLUSION: Negative verbal prompting must be avoided.