Psychological Support to the Community During the COVID-19 Pandemic: Field Experience in Reggio Emilia, Northern Italy.

We report the field experience of the psychological staff of Azienda USL-IRCCS di Reggio Emilia, a local health system conglomerate serving half a million inhabitants within a catchment area of the Emilia Romagna Region of Italy, during the coronavirus (COVID-19) pandemic. We provided free telephone-based psychological support for the community, with the specific aim of reducing stress caused by the COVID-19 pandemic and its consequences, such as quarantine and lock-down. We describe how the community used this opportunity of psychological support in terms of problems reported and interventions provided. Our field experience suggests that a service of phone psychological support is feasible and quickly implementable in the case of sudden emergencies that affect, to different extents, the whole community.

Application of palliative care in demented patients: the caregivers' point of view.

BACKGROUND: The 38/2010 law has widened the supply of palliative care for patients with chronic and degenerative illness. Dementia is a chronic and debilitating illness and it requires specific, complex and constant assistance, involving the health professionals' community and family, and should also benefit from palliative care. But what do the caregivers of these patients think about it? AIM: To explore the point of view of caregivers accompanying dementia patients regarding palliative care and the accompaniment of the medical team. METHOD: A qualitative method with phenomenological approach: 29 semi-structured interviews have been submitted to caregivers of patients suffering from dementia. The interviews were submitted to analysis of thematic content. RESULT: In the majority of cases the caregiver is a member of the family and holds this position because of the affective relationship he/she shares with the patient. They too live the illness of the relative as if it were theirs. The caregiver doesn't know about palliative care or has only heard of it, but is resistant to the application of this care, especially when its correct meaning and use are explained. At the same time, the health professionals'' role is important when it comes to taking decisions: caregivers rely completely on the team's competence and on their judgement. CONCLUSION: A correct sharing of knowledge is fundamental. The healthcare professionals must be trained in palliative care in order to correctly inform caregivers and to avoid false beliefs about or resistance to the application of these useful pathways.

The palliative care in dementia context: health professionals point of view about advantages and resistances.

BACKGROUND AND AIM: The 38/2010 law has expanded the provision of palliative care to patients with chronic-degenerative diseases. The ISTAT data show that 60% of the dying population is suffering from these diseases and could, according to the literature review, benefit particularly from such treatments. This study investigates the point of view of healthcare professionals, working in the context of dementia, regarding the knowledge and application of palliative care in the field of dementia. The focus is on the analysis of the resistance that may prevent the spread of palliative care, slowing the application of such care in different settings of terminality. METHODS: The method is a qualitative phenomenological approach. A grid of semi-structured interviews was created and was proposed to 33 health workers (18 women) who work in Health Centres or in the Alzheimer Nucleus of Northern Italy. RESULTS: Most operators think they understand palliative care, they believe it to be useful and necessary, but often only connect it with terminal illness. Others have a broader vision based on a more abstract and theoretical level than on real practical knowledge. A majority of respondents think that the spread of palliative care is slow and difficult because of the prevalence of the biomedical model that holistically and prejudicially hinders the introduction of new models. CONCLUSION: Appropriate training is the fundamental key to overcoming resistance. The professionals interviewed showed that they were aware of their lack of knowledge and declared that they had little competence in managing the complexity of long-term pathologies.