Social media for psychological support of patients with chronic non-infectious diseases: a systematic review.

Psychological complications of chronic diseases are often underestimated because they may be interpreted as normal consequences of the underlying illness. Additionally, chronic patients may find several obstacles to healthcare access, including physical, socioeconomic, geographical and psychological barriers. Social media may be potential tools to provide psychological care extending the possibility of treatment where the offer is limited. This review aimed to explore the use of social media in administering psychological interventions to patients with chronic noncommunicable diseases. Following the PRISMA guidelines, a systematic review was conducted by searching PubMed, Embase and PsycInfo (from 2004 to 2021). Randomized controlled trials outlining the social media use in administering psychological assistance to patients with chronic noncommunicable diseases were considered eligible. Out of 9838 records identified, 75 papers were included. Peer-to-peer interaction was the most used (n = 22), mainly via chat rooms and forums. Interventions were mostly administered to patients with psychiatric (n = 41) or oncologic disorders (n = 12). This work highlighted a lack of tailored interventions based on disease, age or gender, and a use of a limited range of relatively old platforms such as emails, blogs and forums. To administer efficient interventions, it would be advisable to continuously analyze the evolving use of these tools.

Psychological symptoms are common among patients with chronic non-infectious diseases. Seldom treated properly, they are a major reason for a low quality of life. Chronic patients, like those who suffer from oncologic, psychiatric or heart diseases, could have difficulties in finding the right psychological support. One way to potentially reach anyone is using social media, which are often used by chronic patients for educational purposes about their diseases, or for finding psychological support from others with similar conditions. We wanted to study whether social media have been used in clinical research for administering psychological support to patients with chronic diseases. We studied the existing scientific literature doing a systematic review, finding that often social media were not used at their full potential. Peer-to-peer interactions were the most common interactions, chats rooms and forums the most common social media platforms. Participants were most commonly psychiatric and oncological patients. It is very important not to overlook powerful instruments like social media: they could be easily used by patients to empower themselves in managing their conditions. Social media could be an efficient way to easily provide chronic patients with psychological support either administered by health professionals, like psychotherapists, or by peers.

Exploring the Relationship between COVID-19 Vaccine Refusal and Belief in Fake News and Conspiracy Theories: A Nationwide Cross-Sectional Study in Italy.

The COVID-19 pandemic has been accompanied by an infodemic, which includes fake news (FNs) and conspiracy theories (CTs), and which may worsen vaccine refusal (VR), thus hindering the control of the transmission. This study primarily aimed to assess COVID-19 VR in Italy and its relationship with belief in FNs/CTs. Secondarily, it explored the conviction in FNs and CTs and associated variables. An online cross-sectional study was conducted in Italy (2021). The primary outcome was VR and secondary outcomes were FN misclassification score (0% to 100%: higher score means higher misclassification) and CT belief score (1 to 5: higher score means higher agreement). There were 1517 participants; 12.3% showed VR. The median FN and CT scores were: 46.7% (IQR = 40-56.7%) and 2.8 (IQR = 2.2-3.4). Age, education, FN, and CT scores had significant associations with VR. Education, economic situation, health and e-health literacy showed significant relationships with secondary outcomes. Study/work background had a significant association only with the FN score. FN and CT scores were associated. This work estimated a VR lower than before the first COVID-19 vaccine approval. The relationship between VR and FN/CT belief represents a new scenario, suggesting the need for planning effective strategies to tackle FNs and CTs to implement successful vaccination campaigns.

Trajectories and determinants of emergency department use among nursing home residents: a time series analysis (2012-2019).

BACKGROUND: Emergency department (ED) use among nursing home (NH) residents is an internationally-shared issue that is understudied in Italy. The long term care in Italy is part of the health system. This study aimed to assess trajectories of ED use among NH residents and determinants between demographic, health supply, clinical/functional factors. METHODS: A pooled, cross-sectional, time series analysis was performed in an Italian region in 2012/2019. The analysis measured the trend of ED user percentages associated with chronic conditions identified at NH admission. A GLM multivariate model was used to evaluate determinants of ED use. The variables collected were sex, age, assistance intensity, destination after discharge from NH, chronic conditions at NH admission, need for daily life assistance, degree of mobility, cognitive impairments, behavioural disturbances and were taken from two databases of the official Italian National Information System (FAR and C2 registries) that were combined to create a unique and anonymous code for each patient. RESULTS: A total of 37,311 residents were enrolled; 55.75% (20,800 residents) had at least one ED visit. The majority of the residents had cardiovascular (25.99%) or mental diseases (24.37%). In all pathologies, the percentage of ED users decreased and the decrease accelerated over time. These results were confirmed in the fixed effects regression model (coefficient for linear term (b = - 3.6177, p = 0, 95% CI = [- 5.124, - 2.1114]); coefficient for quadratic term = - 0.7691, p = 0.0046, 95% CI = [- 1.2953, - 0.2429]). Analysis showed an increased odds of ED visits involving males (OR = 1.27, 95% CI 1.24;1.30) and patients affected by urogenital diseases (OR = 1.16, 95% CI [1.031-1.314]). The lowest odds of ED visits were observed among subjects aged > 90 years (OR = 0.64, 95% CI [0.60-0.67]), who required assistance for their daily life activities (OR = 0.86; 95% CI = [0.82, 0.91]), or with serious cognitive disturbances (OR = 0.86; 95% CI = [0.84, 0.89]), immobile (OR = 0.93; 95% CI = [0.89, 0.96]), or without behavioural disturbances (OR = 0.92; 95% CI = [0.90, 0.94]). CONCLUSIONS: The percentage of ED users has decreased, through support from the Italian disciplinary long-term care system. The demographic, clinical/functional variables associated with ED visits in this study will be helpful to develop targeted and tailored interventions to avoid unnecessary ED use.