Alternative Means of Informed Consent in Cardiology: Strategies and Effectiveness in a Group of Italian Patients.

Informed consent practices in healthcare represent a fundamental element of patient-centred care; however, the traditional use of a written, paper-based description of the medical procedure to obtain informed consent presents many limitations. This research aimed to evaluate the effects of an alternative modality of obtaining informed consent using a brief informative video for patients waiting to undergo a coronary angiography procedure in Italy. The study involved 40 participants-28 males and 12 females (mean age: 68.55, SD = 13.03)-divided equally into two groups: one group received the video-based informed consent and the other received a traditional paper-based form. Each group was asked to fill in two questionnaires; one was created by the researchers to measure the patient's level of understanding of the given information and the perception of usefulness of the informed consent, and the other was the Depression Anxiety Stress Scales-21 (DASS-21), which evaluates levels of anxiety, depression and stress. A comparison of the results of the two groups showed that video-based informed consent allowed participants to better understand the given information, to feel more confident concerning their subjective comprehension of it and to perceive the video-based informed consent as more useful than the traditional one. The video-based informed consent did not lead to higher levels of anxiety, depression or stress among the participants. It can be hypothesized that video-based formats may represent a more useful, understandable and safe alternative to traditional paper-based informed consent in healthcare.

Spirituality and Children's Coping with Representation of Death During the COVID-19 Pandemic: Qualitative Research with Parents.

The coronavirus disease 2019 (COVID-19) pandemic and the related lockdown measures have had intense negative impacts on the psychological well-being of both adults and children. Among such impacts is a significant increase in mortality salience and changes in how people deal with grief and losses. This qualitative research used semi-structured interviews with 23 Italian parents to draw insights on the impact of the pandemic on children aged 5-15 years with regard to their representation of death and the eventual role that family spirituality/ religiosity played in helping them understand both the concept of dying and possibly the pandemic itself. From the data analysis, four main thematic areas emerged: "Lockdown experience," "Fears and worries related to COVID-19," "Emergence of thoughts on the process of dying," and "Representation of death and the impact of religious beliefs." The participants highlighted how stressful the lockdown measures have been for their children and the anxiety that their children have experienced because of fears related to the pandemic. The interviews also surfaced how living in a religious family has contributed significantly to shaping children's representation and understanding of death and sometimes even helped both the parents and their children to face difficult moments such as those caused by the pandemic.

Facing Muscular Dystrophy During Covid-19 Pandemic: The Role of Support Associations and Spirituality.

Several researches in scientific literature analyze the theme of Muscular Dystrophy (MD), As well as many others focus on the theme of the Covid-19 pandemic; however, there is a rather limited number of studies that analyse how the pandemic has affected the life of people suffering from MD, especially during the time of the first lockdown in the spring of 2020. The present study has applied a qualitative research design with the aim to investigate how patients with MD have lived the social restrictions imposed for the contagion containment and whether the assistance of associations for their support has contributed to make the participants feel closer or more distant from the spiritual dimension. The analysis involved 12 participants, and they were presented with a semi-structured interview. The data obtained from the interviews have been analysed through a thematic analysis from which 4 thematic areas have emerged: (1) the impact of the pandemic on an emotional level; (2) the illness management and the role of family; (3) the role of the associations; (4) aspects related to spirituality. The crucial role that the closeness of family and the activities promoted remotely by the associations for patients' support has emerged, since they have allowed the participants to feel united by something beyond, to discover new aspects of themselves, to give more value to Life and to move closer to their spiritual dimension.

Catharsis Through Cinema: An Italian Qualitative Study on Watching Tragedies to Mitigate the Fear of COVID-19.

Background: Among different ways of coping with the unsettling situation of the COVID-19 pandemic, a very peculiar one has been identified: a more frequent request, by the general population, of movies or TV series related to the very theme of viruses, contagions, and epidemics. Objectives: The aim of the present study was to explore this peculiar phenomenon, in order to identify people's emotions and cognitions during and after the process, and to better understand the possible psychological function cinema can have during moments of intense and generalized crisis like the present COVID-19 pandemic. Participants: Fifteen Italian adults took part in the study - eight women and seven men (average age = 30 years, SD = 10.54). Participants were recruited through social media via a specific announcement, and subsequently, through a "snowball sampling." Method: For the present study a qualitative approach was adopted, and more specifically, the principles of Interpretative Phenomenological Analysis (IPA) have been followed. Semi-structured interviews were conducted by telephone or through online meeting platforms (Zoom or Skype). The written texts obtained from the transcription of each interview were analyzed using thematic analysis with the support of the software Atlas.ti, in order to highlight their fundamental contents. Results: From the data analysis, four main areas of thematic prevalence emerged, which reflected the participants' condition during the pandemic that actually led them to watch epidemic-themed movies or TV series: the need to document themselves concerning the theme of epidemics, the need to exorcize contagion anxiety, the desire to find a character with which they could identify, and the casual condition of finding a peculiar movie related to the theme of pandemics and being interested in it because of the striking resemblance with real life. Conclusions: The findings suggest that cinema could indeed represent a powerful tool to help people face the intense uncertainty of the new COVID-19 epidemic, since it allows spectators to both obtain more insight into the current situation, and to project their fears and uncertainties into the movie or TV series, thus reaching a sort of cathartic liberation that offers them hope toward the future.

Psychology Students' Perceptions of COVID-19 in a Death Education Course.

The systematic removal of death from social life in the West has exposed people living in areas affected by COVID-19 to the risk of being unable to adequately manage the anxiety caused by mortality salience. Death education is a type of intervention that helps people manage their fear of death by offering them effective strategies to deal with loss and anxiety. To that end, a path of death education has been carried out with University students of psychology. The main purpose of the research is to understand how students who participated in the death education course perceive the lockdown experience in light of course teachings. The research was carried out at a University in northern Italy in an area severely affected by COVID-19, during the first year of the pandemic. The group of participants included 38 students, 30 women and 8 men, with an average age of 25.45 years (SD = 7). At the end of the course, the students could respond on an optional basis to the request to comment on the training experience according to what they experienced during the pandemic. A thematic analysis was subsequently carried out on the texts, which made it possible to identify the most relevant thematic areas for the students. The qualitative analyses permitted recognition of three main forms of discovery: the removal of death in contemporary culture; the importance of community, ritual and funeral, and spirituality; and the significance of death education for future health professionals. The texts have highlighted how the removal of these issues exposes people to the risk of being unable to handle extremely painful events such as those related to dying. The results show the positivity of death education pathways conducted at the University level to help students reflect on these issues and manage the related anguish.

A Challenge for Palliative Psychology: Freedom of Choice at the End of Life among the Attitudes of Physicians and Nurses.

This article considers a particular aspect of palliative psychology that is inherent to the needs in the area of attitudes concerning Advance Healthcare Directives (AHDs) among Italian physicians and nurses after the promulgation of Law No. 219/2017 on AHDs and informed consent in 2018. The study utilized a mixed-method approach. The group of participants was composed of 102 healthcare professionals (63 females and 39 males). The quantitative part utilized the following scales: Attitudes toward Euthanasia, the Religious Orientation Scale, the Balanced Inventory of Desirable Responding, and the Testoni Death Representation Scale. The results were mostly in line with the current literature, especially concerning a positive correlation between religiosity and the participants' rejection of the idea of euthanasia. However, the qualitative results showed both positive and negative attitudes towards AHDs, with four main thematic areas: "Positive aspects of the new law and of AHDs", "Negative aspects of the new law and of AHDs", "Changes that occurred in the professional context and critical incidents", and "Attitudes towards euthanasia requests." It emerged that there is not any polarization between Catholics or religious people and secularists: Their positions are substantially similar with respect to all aspects, including with regard to euthanasia. The general result is that the law is not sufficiently understood, and so a quarter of the participants associate AHDs with euthanasia. Discussions on the opportunity for palliative psychologists to help health professionals to better manage these issues through death education courses are presented.

The Hospice as a Learning Environment: A Follow-Up Study with a Palliative Care Team.

In Western society, the topic of death has been removed from everyday life and replaced with medical language. Such censorship does not reduce individuals' fear of death, but rather limits their ability to elaborate their experiences of death, thus generating negative effects. The objective of this follow-up qualitative study was to detect how and if death education can help to improve individuals' relationship with death and enhance care environments like hospices. Semi-structured interviews were conducted with palliative care professionals and teachers who had taken part in a death education initiative three years earlier. The results confirmed the initiative's positive effect on both palliative care professionals and teachers. The participants reported that the education initiative helped them to positively modify their perspective on death, end-of-life care, and their own relationship to life, as well as their perception of community attitudes towards the hospice, which seemed to become less discriminatory. This study confirmed that school education initiatives can usefully create continuity between hospices and local communities. This project provided an educational space wherein it was possible for participants to elaborate their experiences in relation to death and to re-evaluate and appreciate hospices.

Neither God nor others: a qualitative study of strategies for avoiding suicide among homeless people.

Introduction Drug addiction and alcoholism characterize the existential condition of most homeless people, while the risk of suicide runs in parallel. Objectives Following the Provisional Model (PM), this study aimed to explore the relationships between addiction, suicidal ideation, and religiosity among 13 homeless people, and the roles of bonding ties (within the group) and bridging ties (intergroup). Method The study is rooted in the field of qualitative psychology research. A survey was conducted, analyzing the personal accounts of participants and applying the PM psychological interpretation integrated with theory from literature on drug addiction, religiosity, and suicidal ideation in the field of homelessness. Results Outcomes show that suicidal ideation appears in the first phase of homelessness and is opposed by alcoholism and drug addiction. Religiosity does not help to counteract suicidal ideation or to create bonding relationships. Conversely, drugs and alcohol seem to be more useful for preventing suicide, but also do not help in bonding relationships. Conclusion Our survey only partially confirmed the PM, because the main result was the importance of relationships between suicidal ideation and alcohol/drug abuse during the initial phase of becoming homeless, while the importance of bonding ties deriving from addiction behavior did not emerge.

Can Desire and Wellbeing Be Promoted in Adolescents and Young Adults Affected by Cancer? PhotoTherapy as a Mirror That Increases Resilience.

PhotoTherapy represents a recent psychotherapeutic intervention which, through the medium of photography, has the objective of helping a patient reach a higher self-knowledge and explore thoughts, desires, and intimate perceptions that would otherwise remain hidden. Because of this, it may help people overcome their cognitive and emotional boundaries and bring out their interiority, even when exploring some of the most distressing themes. The objective of the present research was to demonstrate that the elaboration and expression of inner desires, fears and needs of wellbeing among adolescents and young adults, who were either sick or had been cured of cancer, could be facilitated through the use of PhotoTherapy. Their responses were also compared with those of healthy young adults, in order to be able to explore the kind of impact such a pathology can have on those who are affected by it and highlight eventual differences in the kind of desires and needs expressed instead by those who never had a diagnosis of cancer. A qualitative research design was adopted. 45 people took part in the study, aged between 12 and 25 (mean age 19). The participants were divided into three groups: those currently being treated for cancer, those with a history of cancer and those who had no experience of cancer (third group). From the data analysis, different preferences and attitudes toward the presented pictures and themes emerged among the participants, depending on the specific group they belonged to. The article discusses these preferences and considers how PhotoTherapy can help treat psychological distress caused by cancer.

Neither God nor others: a qualitative study of strategies for avoiding suicide among homeless people

Abstract Introduction Drug addiction and alcoholism characterize the existential condition of most homeless people, while the risk of suicide runs in parallel. Objectives Following the Provisional Model (PM), this study aimed to explore the relationships between addiction, suicidal ideation, and religiosity among 13 homeless people, and the roles of bonding ties (within the group) and bridging ties (intergroup). Method The study is rooted in the field of qualitative psychology research. A survey was conducted, analyzing the personal accounts of participants and applying the PM psychological interpretation integrated with theory from literature on drug addiction, religiosity, and suicidal ideation in the field of homelessness. Results Outcomes show that suicidal ideation appears in the first phase of homelessness and is opposed by alcoholism and drug addiction. Religiosity does not help to counteract suicidal ideation or to create bonding relationships. Conversely, drugs and alcohol seem to be more useful for preventing suicide, but also do not help in bonding relationships. Conclusion Our survey only partially confirmed the PM, because the main result was the importance of relationships between suicidal ideation and alcohol/drug abuse during the initial phase of becoming homeless, while the importance of bonding ties deriving from addiction behavior did not emerge.

Lack of Truth-Telling in Palliative Care and Its Effects among Nurses and Nursing Students.

Unclear communication of inauspicious prognoses may disorientate both patients and their relatives, drastically jeopardizing the planning of palliative care. This paper considers the issue of truth-telling in the communicative problems of nurses and students of nursing with terminally ill patients. The fundamental objective is the analysis of the difficulties related to the lack of truth-telling and how it might impact their professional and personal lives. A qualitative study was realized, involving 47 participants, both nurses (25) and nursing students (22), working in palliative care units or in associations of volunteers for the assistance of oncological patients. The exploration was focused on the way they relate to patients who are not aware of their real health conditions and their consequences. Particular attention was paid to their opinions concerning what could be done in order to manage such problematic situations in the near future.