The impact of the alterations in caring for COVID-19 patients on Compassion Satisfaction and Compassion Fatigue in Italian nurses: a multi method study.

BACKGROUND AND AIM OF THE WORK: During COVID-19 first wave,  healthcare professionals were exposed to a major psychological pressure related to uncertainty, a lack of therapies or a vaccine and shortages of healthcare resources. They developed higher levels of Burnout and  Compassion Fatigue, and similar levels of Compassion Satisfaction. Aim is evaluating in Italian nurses Compassion Satisfaction and Compassion Fatigue and impacting individual and relational variables. METHODS: A multi-methods approach was used. Qualitative data were collected through 2 focus group. Quantitative data were collected through a web survey composed by an ad hoc questionnaire developed from the focus group results, the Professional Quality of Life Scale-5 and the Resilience Scale (RS-14). RESULTS: In the qualitative phase 6 categories emerged. From the quantitative analysis the sample reported a moderate level of Compassion Satisfaction, a low level of Burnout  and a moderate level of Secondary Traumatic Stress. Compassion Satisfaction had as predictors resilience (ß = .501), followed by feeling part of the team (ß = .406) and collaboration with colleagues (ß = .386). Secondary Traumatic Stress had as predictors the impact of PPE (ß = .269), and feeling Covid-related individual sufferance (ß = .212). The only predictor of Burnout was resilience (ß = -2195). Conclusions: During COVID-19 first wave Italian nurses were exposed to a higher risk of Secondary Traumatic Stress, mainly impacted by frustration, loss of control, loss of possibility to properly care for patients, and personal threat. Relational and team support had a crucial role in sustaining Compassion Satisfaction.

Health professionals' perception of appropriateness of care: a qualitative study in Italian pediatric hospices.

BACKGROUND: Appropriateness is particularly relevant in palliative care, an area in which it is essential to question the real need for treatments. Few studies explored the perception of appropriateness by professionals in pediatric palliative care, revealing the conflict sometimes faced when confronted with the uncertainty of prognosis and end-of-life decisions. AIMS: The objective of this study is firstly to investigate the perception that doctors, nurses and psychologists, operating in Italian pediatric hospices, have of the appropriateness of the care they provide. Secondly, to understand what repercussions the perception of non-appropriateness has at individual and team level. METHODS: A qualitative study was conducted between 2019 and 2020 through semi-structured interviews with a convenience sample of 17 professionals working it Italian pediatric hospices. RESULTS: The interviewees do not refer to a common concept of appropriateness, but compare the latter to: the quality of life, the global care of the assisted person, the proportionality of care, the early recognition of the need for palliative care. The discussion within the team emerges as a privileged place to manage the discomfort of individual professionals in the face of treatment choices in conflict with their own values. CONCLUSION: the non-referring to a univocal conception of appropriateness deprives professionals of an objective criterion to resolve the most difficult decisions. However, it allows them to establish what from time to time seems to be the most appropriate care pathway for a given patient, at a given time and context, preserving the goal of personalized care.

Myanmar health professionals' educational needs: a pilot study.

BACKGROUND AND AIM OF THE WORK: The main factor hindering the development of the Myanmar health system lies in the scarcity of financial and human resources attributed to the health system. This paper presents the preliminary results of a pilot study on the educational needs of Myanmar health professionals, addressing the empowerment of human resources as a strategic pillar for delivering the essential packages of health services. METHODS: An explorative study following a qualitative approach has been conducted through semi-structured interviews to a convenience sample of 15 persons, selected as authoritative key-informants. RESULTS: In addition to the lack of infrastructures, medicines, ambulances and health instruments, and the health disparities between the urban and rural areas, some widespread problems are reported as requiring health professionals' training empowerment: traumas due to road accidents, management of childbirth, non-communicable diseases' management and poor health education of the population. DISCUSSION: Some areas can be evidenced for an improvement of professionals, training: ​​maternal, neonatal and child health; communication between professionals and laypeople; Myanmar population's health education; inter-professional training between doctors and nurses, but also between health personnel and non-health personnel. CONCLUSIONS: The educational needs of Myanmar health professionals emerge as closely related to the social and health needs of the Myanmar population, to the available resources and missing resources of the country's health system and to the role of professionals within professionals/patients' relationship. (www.actabiomedica.it).

The use of blended learning to improve health professionals' communication skills: a literature review.

BACKGROUND AND AIM OF THE WORK: In recent years, health professionals' education has moved towards the increasing use of blended learning. One of the most widespread blended formulas is the mix of face-to-face and online learning, which combines the advantages of distance learning, both in training provision and in training fruition, with the maintenance of socialization goals and application to practice activities. This literature review aims to find out whether blended-learning is employed for improving health professionals' communication skills and which are its outcomes. METHODS: Literature review of publications released from January 2000 to January 2019 was conducted across the academic databases Cinahl (EBSCO), Cochrane and Pubmed using relevant keywords. RESULTS: Research has shown that blended learning is used in the education of different health professionals (students, nurses, physicians, etc.) at various stages of the educational path. The enhancement of communication skills appears to be a secondary learning objective in many studies, but it is shown to be nevertheless central to the proper acquisition and application of more clinical skills addressed by the blended courses. The blended modules here examined achieved their goals. However, the evaluation of the learning outcomes is still based on self-assessment, and thus needs to be implemented. CONCLUSIONS: Blended learning providers would need to pay more attention in the design and implementation phases of blended modules, assessing participants' needs and offering more tailored and targeted programs, and should provide a more rigorous evaluation of learning outcomes.