The Social and Professional Image of the Nurse: Results of an Online Snowball Sampling Survey among the General Population in the Post-Pandemic Period.

Background. The COVID-19 pandemic has transformed people's lifestyles by imposing social, economic, and labor changes. Health professionals have been in the spotlight, occasionally even elevated to the status of "heroes", as they have been at the forefront of the health emergency. Media exposure has undoubtedly played a pivotal role in the evolution and perception of the public's image of nurses, especially within the Italian context. Currently, there is only one study conducted in Italy during the pandemic period. For this reason, we have opted to delve further into this subject during the post-pandemic period, with the ultimate goal of identifying this perceptual evolution. Methods. An online snowball sampling survey was conducted among the Italian population using social networks between August 2022 and January 2023. The survey utilized the Nursing Attitude Questionnaire (NAQ) to collect data. Results. The sample consisted of 564 individuals. Among the respondents, 63.8% (n = 360) were familiar with the nursing pathway, and the level of agreement regarding the training of nurses was 81.5% (n = 260). In terms of recognizing the professional role of nurses, variations emerged in certain domains of the NAQ. Specifically, professional values of nurses were more pronounced in northern and central Italy (M = 26.27). Moreover, stereotypes were more prevalent in the north (23.73 ± 3.538) and the center (23.13 ± 4.104) (p = 0.001). Conclusions. The sample acknowledged a unique competence inherent to nurses that cannot be replaced by other professionals. The study population perceives the nursing profession as pivotal within the IHS (Integrated Health System). However, the attractiveness of the profession remains exceedingly low. This study was not registered on a publicly available registry.

How knowledge time influenced anxiety, depression, stress and quality of life levels in patients suffering from Crohn disease: a cross-sectional multicenter study.

BACKGROUND AND AIM OF THE WORK: The diagnosis of Crohn Disease (CD) represents a turning point in the life of patients, which inevitably marks them. The present study represents a direct "feed-back" from patients suffering from Crohn disease, in order to reveal how the diagnosis of CD changed lifestyles and psychological conditions in their patients. METHODS: An observational, cross sectional, online, snowball sampling study was conducted through participants suffered from CD and belonged to social networks and Facebook groups. For each participant, sampling characteristics, a series of lifestyle habits Before to After the diagnosis of CD and anxiety, depression, and stress conditions were investigated. RESULTS: A total of 785 participants agreed to participate. As Participants underwent significant challenges in their lifestyles after the CD diagnosis (p<0.001), specifically their reduced their smoking habits, alcohol and drugs intakes and also their diets both in high sugar and fatty compositions. Anxiety and stress levels were not statistical different among participants according to years of the knowledge of their CDs. Meanwhile, as regards depression condition, significantly higher levels were recorded among participants who knew their CD until 5 and 25 years, respectively (p=0.031). CONCLUSIONS: From the study emerges several aspects of quality of life compromised, a fact supported by the analysis of psychophysical sequelae, which allowed to lay the groundwork for further studies, studying the comorbidity of this disease with other factors. Future randomized controlled trials should deepen the correlation between eating disorders and CD, a link little explored in the literature.

The satisfaction level perceived by Italians during the first phase of the Covid-19 pandemic phase.

Aim of the work.  To survey the degree of satisfaction of the Italian population in reference to the health care provided throughout the national territory in the period of emergency COVID-19. METHODS: Observational, cross sectional, multicenter study conducted during the first phase of the pandemic (May-June 2020) involving the national population (n=889) subjects, through an online survey. RESULTS: 889 people participated in the study. Among the perceptions regarding the level of satisfaction with the care received during the first pandemic wave, significant differences were found in the level of satisfaction with the health care received in general (p=.049), the degree of satisfaction toward the health care to people admitted to the hospital (p=. 046), to the treatment received for the COVID-19 test (p=.002), to the difficulty of contacting the general practitioner (.032), to the treatment received by their own health care company (p=.006), to the treatment received by the toll-free number (p<.001) and the 1500 number (p<.001) and the treatment received for one's own relative (p<.001). The greatest difficulty for all detected was finding surgical masks to protect themselves from infection. CONCLUSIONS: The COVID-19 pandemic seems not to have created new problems, rather it has shown - in a violent way - many of the challenges that have been looming for some time in the health services (and not only the Italian one) and, for these reasons, it is necessary to start from what has been learned in the last few months and draw new guidelines for the future.

The psychological impact of the Coronavirus emergency on physicians and nurses: an Italian observational study.

BACKGROUND: The Coronavirus has put a strain on the response capacity of health systems and there are various psychological effects on health workers. AIM OF THE STUDY: To investigate the psychological impact of the coronavirus emergency on physicians and nurses. MATERIALS AND METHODS: A study was conducted on a sample of nurses and physicians (n=770), who were asked to fill in a questionnaire investigating physical and psychological problems. It also included the IES (Impact Event Scale), STAI (State Trait Anxiety Inventory) scale and BDI (Beck Depression Inventory). RESULTS: 87.7% of the sample was represented by nurses (n=675), 12.3% (n=95) by physicians. 52.3% (n=403) of the participants believed that they had not received good training on the correct use of Personal Protective Equipment. 18.2% (n=140) declared that they had experienced a moment in which they had had to choose among the patients whom to treat for an essential therapy. Among the psychological symptoms, stress (76.2%; n=587), anxiety (59.4%; n=457) and depression (11.8%) prevailed and only 3.9% of the healthcare personnel sought help from a psychologist. The total score of the IES-R scale was 3.47. A significant association emerged between exposure and the risk of contagion (p-value = 0.003), stress was more present among nurses than among physicians (77.5% vs. 67.4%; p = 0.003). Among physical symptoms, headache (52.2%; n=402) and pressure injuries (24.8% n= 191) prevailed. CONCLUSIONS: The results of the study show that mental health monitoring of health workers, who are at risk of developing major psychological disorders, is a priority.

The quality of patient-nurse communication perceived before and during the COVID-19 pandemic: an Italian pilot study.

BACKGROUND AND AIM OF THE WORK: Therapeutic communication is essential for assessing the quality of care of patients. The present study aimed how the forced use of the mask influenced the communication before and during the Covid-19 pandemic. METHODS: An online questionnaire was administered including two socio-demographic items, such as sex, as male and female, and role, as nurse or patient, and the Quality of Communication Questionnaire (QOC) for twice, referring to the period before during the pandemic. RESULTS: 178 subjects participated in the study, of which 60 (33.7%) were patients and 118 (66.3%) were nurses. During the pandemic, patients reported no significant differences in the perception of the quality of nurse-patient communication. While nurses recorded a lower perception of communication quality during the pandemic period than before. CONCLUSIONS: It emerged an urgent need to support the nursing activity from an organizational point of view, with less work overload, and psychological, with forms of help so that nurses could feel supported in the work fatigue, trying to give the best of himself.

Work environment and related burnout levels: survey among healthcare workers in two hospitals of Southern Italy.

BACKGROUND AND AIM OF THE WORK: Safety in hospitals is a structural variable on which depends not only on health, but also on physical safety of patients and employees, whom are increasingly exposed to risks as a result of which they may suffer from occupational diseases and/or develop important psycho-physical consequences. The study aimed to evaluate the association between work environment and perceived burnout levels in two hospitals of Southern Italy. METHOD: From March to August 2019 an observational study was carried out through a survey consisting of four sections: sociodemographic data; the Post Occupancy Evaluation (POE) questionnaire; the perception of the environment and possible causes of stress; the burnout levels perceived through the Maslach Burnout Inventory (MBI). A convenience sample of 169 healthcare workers participated in the study. All nurses (including nursing coordinators), clinicians, support staff of the "Vito Fazzi" Hospital of Lecce (Le) and "San Giuseppe da Copertino" Hospital of Copertino (Le) with at least one year of work experience and who signed the informed consent were recruited. RESULTS: The healthcare workers involved in the survey declared limits in handling and usability of the equipment, both for the patient n=77 (45.6%) and for the healthcare worker n=75 (44.4%), a lack of visual privacy n=89 (52.6%) and acoustic n=128 (75.7%).  The analysis also shows higher scores on the 'depersonalization' scale among the health care workers of San Giuseppe da Copertino" Hospital (LE) (M= 9.36; DS= 9.439) and higher levels on the 'emotional exhaustion' scale in the surgical areas (M= 22.0; DS= 11.86) and in the female gender (M= 23.10; DS=. 12.01).  Conclusions. The study reveals a poor condition of environmental comfort and safety, which generate high levels of stress and burnout in healthcare workers. Such a study can encourage further multicenter studies.

Healthcare workers perceptions in the difficult moment of the end of life and coping strategies adopted during the COVID-19 pandemic: an Italian pilot study.

BACKGROUND AND AIM OF THE WORK: In a society that tries so hard to forget and make people forget that death exists, death has never been so close to man in his daily life as during this pandemic. Health care professionals have therefore all too often had to  deal with the death of the people they care for and with related issues such as, for example, the dignity of death, the humanization of death and care for the dying. The aim of the study is to highlight the perceptions of physicians, nurses and health and social workers in the difficult moment of the end of life, also analyzing which coping strategies were implemented by them. METHODS: All Italian healthcare workers were enrolled in this survey. The questionnaire was administered in an online version. Physicians, nurses and support staff (social and health workers) were contacted through social networks. RESULTS: A total of 512 healthcare workers were enrolled in this survey. No statistical significant differences were recorded among the COPE-NVI- 25 sub dimensions according to sex, profession and to different wards. Additionally, by considering the COPE-NVI-25 sub dimensions according to years of work experience, a statistical significant difference was reported in the Transcendent Orientation sub dimension (p=.047), as healthcare workers with 11-20 years of work experience recorded higher levels than the other two groups. By considering differences in the COPE-NVI-25 sub dimensions according to religion, significant differences were recorded in the transcendent orientation (p=.032), in the positive attitude (p=.030), in the social support (p=.035). CONCLUSIONS: From the evidence in the literature, the quality of end-of-life care performance has a positive correlation with awareness of a good death and attitudes towards end-of-life care.

Effects of Influenza Vaccination on the Response to BNT162b2 Messenger RNA COVID-19 Vaccine in Healthcare Workers.

BACKGROUND: Vaccine-induced immunity is at present the main strategy to stop the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent evidences suggested a protective effect of influenza vaccination against coronavirus disease 2019 (COVID-19) severity, while impact on the immune response to BNT162b2 messenger RNA (mRNA) vaccine is under investigation. METHODS: We aimed to evaluate this aspect in a cohort of 297 healthcare workers (108 males, 189 females) after seasonal influenza vaccination compared to no-flu-vaccination. VAX+ (165 individuals; 63 males and 102 females) had tetravalent influenza vaccine, and VAX- (132 individuals; 45 males and 87 females) had no flu vaccination. Anti-spike-receptor binding domain (RBD) level was tested 15 - 70 days after BNT162b2 second inoculum. RESULTS: Increased antibody response was observed in total VAX+ compared to VAX- (2,047.4 vs. 1,494.2 binding antibody unit (BAU)/mL, P = 0.0039), independently from gender and body mass index (BMI). Younger total individuals (< 35 years) showed significant increase of the level of binding antibodies (2,184.8 vs. 1,590.9 BAU/mL, P = 0.0038) compared to ≥ 35 years; young/old difference was lost restricting to VAX+ subgroup. Flu vaccinations appear associated to better antibody response in older individuals (P = 0.027, ≥ 35 years VAX+ vs. VAX-). A decreasing trend during time was observed for both VAX+ and VAX-, except for < 35 years VAX- individuals. Early response was higher in VAX+ compared to VAX-; however a more rapid waning was observed in VAX+ subjects. CONCLUSIONS: Our data showed better antibody response to SARS-CoV-2 vaccine in subjects already vaccinated against seasonal influenza; this may represent one of the mechanisms underlying the cross-protective effects of influenza vaccination against heterologous infections reported in recent epidemiological studies.

The use of an automatic defibrillator by non-sanitary personnel in sport areas: an Observational Study.

INTRODUCTION: In industrialized countries, sudden cardiac death is a serious public health problem that accounts for about 15% to 20% of all deaths, with an incidence of 0.5 to 3 deaths per 100,000 athletes. In recent years, although both first aid prevention programs and the availability of External Automatic Defibrillator (AED) in public places have increased, few data are available with respect to real knowledge about the use of such devices. The aim of this study is to detect the level of knowledge and skills in the use of automatic external defibrillators among sports and management staff in sports facilities. MATERIALS AND METHODS: A cross-sectional, multicentre study conducted in 16 sports facilities in the Province of Lecce, Italy, and targeted to all the athletic and managerial staff of these sports facilities. Information was obtained through a validated questionnaire consisting of 27 items. RESULTS: 339 participants of which 59.3% male (n=201) (average=33.6; SD=13.1). 51.6% (n=175) were informed about the presence of the defibrillator, only 38.1% (n=129) declared to know where it was placed and 43.7% (n=96) considered it to be quite or very accessible. The majority of them (78.8%; n=267) were never involved in a training course and declared limited knowledge about the use of this device. CONCLUSIONS: Respondents stated that they have poor knowledge and skills in the use of the defibrillator, its operation and maintenance, which could reduce the positive outcomes of early treatment. Further studies should be conducted, although it may be appropriate to implement specific training courses for personnel working in sports centres.