Applying the Participatory Slow Design Approach to a mHealth Application for Family Caregivers in Pediatric Ear, Nose, and Throat Surgery.

Pediatric ear, nose, and throat (ENT) surgery is very common, and its outcomes may improve with family education. In this regard, mobile health (mHealth) applications (apps), which are on the rise due to digital transformation, can be beneficial in healthcare. This study outlines the user-centered design and development of a mHealth app (version 5.15.0) to support family caregivers during the perioperative process of pediatric ENT surgery. Conducted over two years in an Italian maternal and child health hospital (January 2020-May 2022), the study employed a participatory design method based on the Information System Research (ISR) framework and guided by the principles of Slow Medicine. Utilizing the Relevance, Rigor, and Design cycles of the ISR framework, the mHealth app's content, functionalities, and technical features were defined and developed. A committee of fifteen experts guided the process with input from 25 family caregivers and 24 healthcare providers enrolled in the study. The mHealth app content was structured around five crucial educational moments characterizing the ENT perioperative period, providing evidence-based information on surgical procedures, strategies for preparing children for hospitalization and surgery, pain management, and post-discharge care. The mHealth app featured a function that sends customized notifications to guide caregivers at specific perioperative stages. The development of mHealth apps by implementing a rigorous, participatory, and Slow design process can foster accessible and family-centered information and care in the field of maternal and child health and beyond.

Telehealth care and remote monitoring strategies in heart failure patients: A systematic review and meta-analysis.

BACKGROUND: Heart failure (HF) is a cardiac clinical syndrome that involves complex pathological aetiologies. It represents a growing public health issue and affects a significant number of people worldwide. OBJECTIVES: To synthesize evidence related to the impact of telemonitoring strategies on mortality and hospital readmissions of heart failure patients. METHODS: A systematic literature review was conducted using PubMed, Scopus, CINAHL, IEEE Xplore Digital Library, Engineering Source, and INSPEC. To be included, studies had to be in English or Italian and involve heart failure patients of any NYHA class, receiving care through any telecare, remote monitoring, telemonitoring, or telehealth programmes. Articles had to contain data on both mortality and number of patients who underwent rehospitalizations during follow-ups. To explore the effectiveness of telemonitoring strategies in reducing both one-year all-cause mortality and one-year rehospitalizations, studies were synthesized through meta-analyses, while those excluded from meta-analyses were summarized narratively. RESULTS: Sixty-one studies were included in the review. Narrative synthesis of data suggests a trend towards a reduction in deaths among monitored patients, but the number of rehospitalized patients was higher in this group. Meta-analysis of studies reporting one-year all-cause mortality outlined the protective power of care models based on telemonitoring in reducing one-year all-cause mortality. Meta-analysis of studies reporting the number of rehospitalized patients in one-year outlined that telemonitoring is effective in reducing the number of rehospitalized patients when compared with usual care strategies. CONCLUSION: Evidence from this review confirms the benefits of telemonitoring in reducing mortality and rehospitalizations of HF patients. Further research is needed to reduce the heterogeneity of the studies.

Nursing Diagnosis Accuracy in Nursing Education: Clinical Decision Support System Compared With Paper-Based Documentation-A Before and After Study.

Computer-based technologies have been widely used in nursing education, although the best educational modality to improve documentation and nursing diagnostic accuracy using electronic health records is still under investigation. It is important to address this gap and seek an effective way to address increased accuracy around nursing diagnoses identification. Nursing diagnoses are judgments that represent a synthesis of data collected by the nurse and used to guide interventions and to achieve desirable patients' outcomes. This current investigation is aimed at comparing the nursing diagnostic accuracy, satisfaction, and usability of a computerized system versus a traditional paper-based approach. A total of 66 nursing students solved three validated clinical scenarios using the NANDA-International terminologies traditional paper-based approach and then the computer-based Clinical Decision Support System. Study findings indicated a significantly higher nursing diagnostic accuracy ( P < .001) in solving cancer and stroke clinical scenarios, whereas there was no significant difference in acute myocardial infarction scenario. The use of the electronic system increased the number of correct diagnostic indicators ( P < .05); however, the level of students' satisfaction was similar. The usability scores highlighted the need to make the electronic documentation systems more user-friendly.

Impact of standardized nursing terminologies on patient and organizational outcomes: A systematic review and meta-analysis.

AIMS: To explore the impact of 12 American Nurses Association recognized standardized nursing terminologies (SNTs) on patient and organizational outcomes. BACKGROUND: Previous studies reported an effect of SNTs on outcomes, but no previous frameworks nor meta-analyses were found. DESIGN: Systematic review and meta-analyses. REVIEW METHODS: PubMed, Scopus, CINAHL, and OpenGrey databases were last consulted in July 2021. All abstracts and full texts were screened independently by two researchers. The review included primary quantitative studies that reported an association between recognized SNTs and outcomes. Two reviewers independently assessed the risk of bias and certainty of evidence for each meta-analyzed outcome using the "Grading of Recommendations, Assessment, Development and Evaluation" (GRADE) approach. RESULTS: Fifty-three reports were included. NANDA-NIC-NOC and Omaha System were the most frequently reported SNTs used in the studies. Risk of bias in randomized controlled trials and not-randomized controlled trials ranged from high to unclear, this risk was low in cross-sectional studies. The number of nursing diagnoses NANDA-I moderately correlated with the intensive care unit length of stay (r = 0.38; 95% CI = 0.31-0.44). Using the Omaha System nurse-led transitional care program showed a large increase in both knowledge (d = 1.21; 95% CI = 0.97-1.44) and self-efficacy (d = 1.23; 95% CI = 0.97-1.48), while a reduction on the readmission rate (OR = 0.46; 95% CI = 0.09-0.83). Nursing diagnoses were found to be useful predictors for organizational (length of stay) and patients' outcomes (mortality, quality of life). The GRADE indicated that the certainty of evidence was rated from very low to low. CONCLUSIONS: Studies using SNTs demonstrated significant improvement and prediction power in several patients' and organizational outcomes. Further high-quality research is required to increase the certainty of evidence of these relationships. CLINICAL RELEVANCE: SNTs should be considered by healthcare policymakers to improve nursing care and as essential reporting data about patient's nursing complexity to guide reimbursement criteria.

The Implementation of the WHO's Surgical Safety Checklist by Italian Operating Teams: A Descriptive Study.

AIM: The study aimed at reporting the extent to which nurses in operating teams comply with the WHO's surgical safety checklist at the national level. METHOD: A total of 621 nurses who attended the conferences held by the Association of Italian Nurses in Operating Teams (AICO) in 2019 were selected as the sample group for this descriptive study. They filled a paper-based questionnaire of items, which were according to WHO's recommendations for surgical safety. Descriptive analyses were used to illustrate participants' characteristics and responses to the questionnaire. The chi-square test was used to outline the relation between participants' socio-cultural features and the information on the extent to which participants implemented the surgical safety checklist. RESULTS: According to the data collected, a majority of the participants (95.2%) claimed to comply with the checklist in perioperative procedures. Moreover, most participants (63.2%) revealed that they revise the checklist according to specific circumstances affecting their workflow and/or operational team. Additionally, almost a third of participants (31.9%) stated that they undertake an oral completion of the steps in the checklist to ensure its effective implementation. CONCLUSION: In this study, it emerged that the implementation of measures ensuring safety standards is largely inconsistent with the guidelines provided by WHO. Notably, major discrepancies occur when it comes to team members' coordination, the revision of the checklist according to specific circumstances, the oral completion of the checklist's steps during the workflow, and the active contribution of all team members in the implementation of the surgical safety checklist.

Dose-Response Relationship between High-Fidelity Simulation and Intensive Care Nursing Students' Learning Outcomes: An Italian Multimethod Study.

Background: The best application modality of high-fidelity simulation in graduate critical care nursing courses is still rarely investigated in nursing research. This is an important issue since advanced nursing skills are necessary to effectively respond to critically ill patients' care needs. The aim of the study was to examine the influence of a modified teaching model based on multiple exposures to high-fidelity simulations on both the learning outcomes and the perceptions of graduate students enrolled in a critical care nursing course. Methods: A multimethod study involving a sample of graduate critical care nursing students was conducted. A theoretical teaching model focused on multiple exposures to high-fidelity simulations is currently applied as a teaching method in an Italian critical care nursing course. According to the Kirkpatrick model for evaluating training programs, the performance, self-efficacy, and self-confidence in managing critically ill patients were considered learning outcomes, while satisfaction with learning and students' lived experiences during the experimental phases were considered students' perceptions. Results: Multiple exposures to high-fidelity simulations significantly improved performance, self-efficacy, and self-confidence in managing virtual critically ill patients' care needs. The satisfaction level was high, while lived experiences of participants were positive and allowed for better explanation of quantitative results of this study. Conclusions: Multiple exposures to high-fidelity simulations can be considered a valuable teaching method that can improve the learning outcomes of graduate nurses enrolled in an intensive care course.

The lived experiences of intensive care nursing students exposed to a new model of high-fidelity simulation training: a phenomenological study.

BACKGROUND: In postgraduate intensive care nursing courses, high-fidelity simulation is useful to prepare students to guarantee safe and quality care of critically ill patients. Surprisingly, this issue has not attracted sufficient attention in the literature, and it is not clear whether the linear application of the traditional high-fidelity simulation method based on prebriefing, the simulation session and debriefing, can serve as empirical reference in postgraduate students' education. The aim of this study was to investigate the lived experiences of postgraduate students receiving multiple exposures to an innovative high-fidelity simulation design based on Kolb's Experiential Learning Theory. METHODS: A phenomenological study was conducted at an Italian University involving a purposive sample of 15 nursing students attending the postgraduate intensive care course. Audio-recorded face-to-face in-depth interviews were held by a researcher in a dedicated room complemented with non-verbal communication outlined in the field notes. Thematic analysis was used to analyse the transcribed data. RESULTS: Three themes and ten categories were derived from the data analysis. The themes included pragmatic learning experience, the emotional path, and confidence. CONCLUSIONS: Multiple exposure to high-fidelity simulation was lived as a pragmatic learning experience enhancing the students' ability to apply theory into practice. This novel approach also contributed to the transition from negative to positive feelings and improved students' confidence about technical and non-technical skills when caring for a critically ill patient.

Detailed data about a forty-year systematic review and meta-analysis on nursing student academic outcomes.

Data were extracted from observational studies describing undergraduate nursing students' academic outcomes that were included in a systematic review and meta-analysis conducted in 2019 and updated in 2020 [1]. Data were extracted by two researchers independently through a previously tested electronic spreadsheet; any disagreement about data extraction was discussed with a third author. Extracted data were studies' general information, characteristics (i.e., country, study design, involved centers, number of cohort of students involved, duration (years) and denomination of the program attended, sample (N), sociodemographic characteristics of the sample, and methods utilized for data collection), and data related to the research question(s) of the review, i.e., nursing students' academic outcomes occurrence and associated factors. Raw data for each included study are reported, along with meta-analyses that were performed using ProMeta free software utilizing Odds Ratio (OR) and Cohen's d as principal effect sizes. The random-effect model was used for all studies, while the level of heterogeneity was explored and quantified through the Cochran's Q-test and I2 , respectively. Substantial or considerable heterogeneity (i.e., I2 ≥ 50%) was explored through a subgroup analysis based on the study design, when feasible [2]. A sensitivity analysis was also performed to detect the possible influence of single studies on meta-analyses results [2]. Publication bias was assessed through funnel plots and the testsf for their asymmetry, i.e., Begg and Mazumdar's rank correlation and Egger's linear regression method [2]. These data provide for an updated state of the art about nursing students' outcomes and associated factors. Therefore, they could ease future literature summaries about the topic, other than allow a comparison of the literature with future research results.

Evaluating the interchangeability of infrared and digital devices with the traditional mercury thermometer in hospitalized pediatric patients: an observational study.

Gradual replacement of the mercury thermometers with alternative devices is ongoing around the world in a bid to protect human health and the environment from the adverse effects of mercury. However, to reduce the risks of misdiagnosis, unnecessary treatments, and omission of care in pediatric populations, more evidence on the reliability of alternative thermometers is needed. The aim of this comparative observational study was to detect any differences in temperature measurements between the use of the axillary mercury thermometer and the alternative techniques. Temperature values in degree Celsius (°C) were measured in a group of Albanian children aged up to 14 years using mercury and digital axillary thermometers, as well as forehead and tympanic infrared thermometers. The digital axillary device, compared with the mercury one, showed no clinically significant difference in the mean values (- 0.04 ± 0.29 °C) and the narrowest 95% level of agreement (+ 0.53 °C to - 0.62 °C) in the paired comparisons. For cut-off point of 37.5 °C, the digital axillary thermometer showed the highest levels of sensitivity (72.5%) and specificity (99.1%) in detecting fever. This study indicates that the digital axillary thermometer may be the better option since it adequately balances accuracy, safety, and children's comfort.

Distance education during COVID 19: an Italian survey on the university teachers' perspectives and their emotional conditions.

BACKGROUND: Following the COVID-19 pandemic, distance education (DE) replaced traditional "face-to-face" teaching and has become the main method of teaching. The aim of this study was to 1) evaluate the impact of DE by teachers in our department during the second semester of the 2019-20 academic year following the March-May 2020 Italian national lockdown and 2) evaluate the relationship between DE and the emotional well-being of teachers during the period of home confinement. METHODS: Ninety-seven university teachers (51.5% women; most represented age group 60-69 years range, 40.2%) responded to an anonymous online cross-sectional survey between July 15 - September 30, 2020, on the advantages and disadvantages of DE, developed by one online teacher focus group. The emotional conditions were assessed by a short version of the Beck Depression Inventory-II (BDI-II). The internal consistency reliability survey and the 10-item BDI-II were measured by Cronbach's alpha. A correlation analysis (r-Pearson) was conducted between the overall evaluation of the experience of DE and the variables included in the study. RESULTS: Teachers reported difficulties in technical aspects, and in psychological factors, as the discomfort of "speaking in the void" (64.7%). The absence of "face-to-face" eye contact with the students was complained by 81% of teachers. Significant impairments in sleep patterns and loss of energy were reported, with female teachers having greater difficulty concentrating than their male colleagues. A quarter of teachers showed depressive symptoms of varying severity. The most satisfied teachers were those most stimulated by DE (r = 0.752, p < 0.000), who showed a lower impact of depressive symptoms (r = - 0.289, p = 0.005). The teaching load in hours influenced the perception of disadvantages (r = 0.214, p = 0.035) and contributed to a lower appreciation of the challenges of DE. The more significant the manifestation of depressive symptoms during the lockdown was, the greater the subjective recovery of a good emotional condition once the domestic confinement was over (r = 0.344, p = 0.001), despite maintaining DE. CONCLUSIONS: Our study highlights the impact of technical, didactic, and psychological difficulties of DE, reported by our teachers. The appreciation of their new learning promoted by DE seemed related to better emotional well-being of university teachers accepting this "challenge" in their important role in the high-education system, influencing good learning and promoting students' professional success.

Graduate Student Outcomes Following Critical Care Simulation: An Italian Pilot Study.

ABSTRACT: High-fidelity simulation provides nursing students with the opportunity to learn and achieve competence in a safe context. The aim of the study was to assess learning outcomes following multiple exposures to high-fidelity simulation sessions. The sample consisted of 18 graduate students enrolled in a critical care nursing course. A four-hour high-fidelity simulation experience was conducted, with a four-hour retraining one month after. Group performance, self-efficacy, self-confidence, and satisfaction improved after multiple exposures to high-fidelity simulation. High-fidelity simulation is a valid adjunct to nursing education in the short term and may improve learning when offered at multiple time points.

Examining nursing student academic outcomes: A forty-year systematic review and meta-analysis.

OBJECTIVES: To synthesize the definitions of nursing students' academic outcomes and provide a quantitative synthesis of their associated and predictive factors. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Four scientific databases were searched until January 2020. REVIEW METHODS: Observational studies describing undergraduate nursing students' academic outcomes were included. Studies were analytically synthesized and meta-analyses were performed utilizing the Odds Ratio or Cohen's d as effect sizes. RESULTS: Eighteen studies, published from 1979 to 2018, were included in the review, nine were meta-analyzed. Studies involved 10,024 undergraduate nursing students and were mostly retrospective cohort (55.6%). Students were mostly female (75.4%) with a mean age ranging from 21.3 to 27.0 years. Meta-analysis revealed that being female (OR = 1.65, 95% CI = 1.26 to 2.12), having attended a Classical, Scientific or Academic high school (OR = 1.30, 95% IC = 1.16 to 1.46), and having reported higher final grades at the upper-secondary high school (Cohen's d = 0.42, 95% CI = 0.18 to 0.65) was significantly associated with student's ability to graduate within the regular duration of the program. Sensitivity analyses confirmed meta-analytic results and meta-analyses heterogeneity depended on study design. Contrasting and limited evidence were found for other investigated factors, and for academic outcomes different from graduation within the regular duration of the program. CONCLUSIONS: Despite meta-analytic results, gender and upper-secondary school would be unethical students' entry selection criteria. Final upper-secondary school grades should be considered for this scope and purpose. Conflicting and limited evidence found for other factors, such as students' background, suggested the influence of local contexts on the phenomenon and its investigation. Investigating the role of modifiable individual variables, such as empathy and critical thinking, could contribute to the open debate about students' entry selection strategies. An improvement in methodological quality of future studies is recommended and expected.

Effects of high-fidelity simulation based on life-threatening clinical condition scenarios on learning outcomes of undergraduate and postgraduate nursing students: a systematic review and meta-analysis.

OBJECTIVE: The purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students' learning outcomes. DESIGN: A systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. DATA SOURCES: PubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references. STUDY SELECTION: To be included, available full-texts had to be published in English, French, Spanish or Italian and (a) involved undergraduate or postgraduate nursing students performing HFPS based on life-threatening clinical condition scenarios, (b) contained control groups not tested on the HFPS before the intervention, (c) contained data measuring learning outcomes such as performance, knowledge, self-confidence, self-efficacy or satisfaction measured just after the simulation session and (d) reported data for meta-analytic synthesis. REVIEW METHOD: Three independent raters screened the retrieved studies using a coding protocol to extract data in accordance with inclusion criteria. SYNTHESIS METHOD: For each study, outcome data were synthesised using meta-analytic procedures based on random-effect model and computing effect sizes by Cohen's d with a 95% CI. RESULTS: Thirty-three studies were included. HFPS sessions showed significantly larger effects sizes for knowledge (d=0.49, 95% CI [0.17 to 0.81]) and performance (d=0.50, 95% CI [0.19 to 0.81]) when compared with any other teaching method. Significant heterogeneity among studies was detected. CONCLUSIONS: Compared with other teaching methods, HFPS revealed higher effects sizes on nursing students' knowledge and performance. Further studies are required to explore its effectiveness in improving nursing students' competence and patient outcomes.

Need for ethics support in clinical practice and suggestion for an Ethics Consultation Service: views of Nurses and Physicians working in Italian Healthcare Institutions.

INTRODUCTION: Ethics Consultation Services (ECS) and Ethical Committees manage several aspects of clinical ethical issues. In Italy there are only Ethical Committees, and, although they should also perform ethical consultations, their activity is limited to approving clinical trial protocols. AIM: To analyse the opinions of a sample of Nurses and Physicians about their motivations to ask for an ethical consultation. METHODS: A cross-sectional study was conducted on a sample of Italian Nurses and Physicians. RESULTS: Respondents would request ethical consultations mainly for end-of-life issues and, secondarily, for conflicts with patients' families. Respondents identified the provision of suggestions for hospital policy, the development of ethical guidelines, and the counselling for individual cases requested by clinicians, patients or families as the most important functions of ECS. CONCLUSIONS: ECS activities should focus on counselling and support to decisions in complex ethical situations according to institutional policies and guidelines self-developed.

Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study.

AIM: The aim of this study was to investigate any possible relationship between sleep disorders, burnout and job performance in a shift-work population of nurses. BACKGROUND: Sleep disorders and burnout can affect the job performance of nurses in terms of efficiency, productivity, task execution speed and supervision, which can be compromised when work shifts are organized on a 24-hour schedule and when the shift itself is irregular. DESIGN: A cross-sectional observational study was conducted from August 2014 - January 2015 on a sample of 315 shift-work nurses across 39 wards in seven central Italian hospitals. METHODS: The Pittsburgh Sleep Quality Index was used to detect the presence of sleep disorders, the Copenhagen Burnout Inventory was used to detect the presence of any possible type of burnout and the Job Performance Scale was used to measure job performance. Data analysis was mainly based on a multivariate logistic regression to identify variables significantly associated with investigated outcomes. RESULTS: On shift-work nurses' sleep quality and burnout correlated positively. The female gender and personal burnout were significantly associated with impaired sleep quality, while working in the psychiatric setting, working a long cycle shift pattern and experiencing daytime dysfunction were significantly associated with burnout. A significant negative association between patient-related burnout and job performance was observed. CONCLUSION: Specific characteristics of shift-work nurses can directly affect sleep quality and burnout and indirectly job performance. This evidence offers healthcare administrators opportunities to intervene with measures to promote nurse's health, well-being and safety.

Digital Axillary and Non-Contact Infrared Thermometers for Children.

Axillary digital thermometers (ADTs) and non-contact (infrared) forehead thermometers (NCIFTs) are commonly used in pediatric settings, where an incorrect body temperature measurement may delay treatments or lead to incorrect diagnoses and therapies. Several studies comparing ADT or NCIFT with other methods have found conflicting results. To investigate whether ADT and NCIFT can be used interchangeably, a comparative observational study was conducted involving 205 children aged 0 to 14 years who were consecutively admitted to the pediatric emergency department. The Bland-Altman plot illustrated agreement between the two methods. A total of 217 pairs of measurements were compared; axillary measurements showed average values significantly higher than forehead measurements (37.52°C and 37.12°C; t = 7.42, p = .000), with a mean difference of 0.41°C between the two methods (range = -1.80 and +2.40). In this setting and population, ADT and NCIFT cannot be used interchangeably.

Ethical difficulties in healthcare: A comparison between physicians and nurses.

BACKGROUND:: Advances in biomedical sciences, technologies and care practices have resulted in an increase in ethical problems and a resulting growth of difficulties encountered by health workers in their professional activity. OBJECTIVE:: The main objective of this study was to analyse knowledge in the ethical field and experience with and the propensity for using ethics consultations by nurses and physicians. METHODS:: Between March and June 2014, a cross-sectional observational study was conducted on a sample of 351 nurses and 128 physicians in four central Italian hospitals. For data collection, a semi-structured questionnaire was used, consisting of 21 items divided into four sections exploring (1) demographic and occupational characteristics, (2) knowledge in the ethics field, (3) experience with ethical issues and (4) the propensity to use ethics consultation. ETHICAL CONSIDERATIONS:: Research ethics approval was obtained from the Italian Nurses Professional Board. RESULTS:: The results show that both nurses and physicians are faced with ethically sensitive situations. Nurses were found to have better judgement concerning their own knowledge than physicians, but more physicians were found to have a deeper level of specific training in ethics issues. The propensity to ask for ethics consultations to address ethical issues was found to be significantly associated with the degree to which ethical issues have deepened (and the level of experience acquired in this field). CONCLUSION:: The presence of a consulting service that can lead to shared choices may represent, together with basic and continuing education, a valid support for professional growth in the ethical field for both physicians and nurses.

Continuous ECG Monitoring in Patients With Acute Coronary Syndrome or Heart Failure: EASI Versus Gold Standard.

The purpose of the study was to compare the EASI system with the standard 12-lead surface electrocardiogram (ECG) for the accuracy in detecting the main electrocardiographic parameters (J point, PR, QT, and QRS) commonly monitored in patients with acute coronary syndromes or heart failure. In this observational comparative study, 253 patients who were consecutively admitted to the coronary care unit with acute coronary syndrome or heart failure were evaluated. In all patients, two complete 12-lead ECGs were acquired simultaneously. A total of 6,072 electrocardiographic leads were compared (3,036 standard and 3,036 EASI). No significant differences were found between the investigate parameters of the two measurement methods, either in patients with acute coronary syndrome or in those with heart failure. This study confirmed the accuracy of the EASI system in monitoring the main ECG parameters in patients admitted to the coronary care unit with acute coronary syndrome or heart failure.

The public perception of nurses. An Italian cross-sectional study.

BACKGROUND AND AIM: The public opinion about the nursing profession can influence health service users, the work performance of nurses, health policies, and the choice to become a nurse. The aim of this study was to investigate the perception of nursing in modern society. METHODS: A cross-sectional study was conducted with a sample of 398 participants belonging to four population groups: Very Important Persons (VIPs), general population, upper-school students, and nursing students. This phenomenon was assessed through the Nursing Attitude Questionnaire (NAQ) and several additional items. RESULTS: The results highlighted that general population and nursing students showed a significantly better image of nurses than did VIPs and upper-school students. CONCLUSIONS: Overall, the sample acknowledged nurses fundamental connotations and functions, although secondary school students poorly recognized nurses' professional autonomy, and VIPs' judgements seemed to be more sensitive to the image of nurses given by mass media.

Primary Care Program in Prison: A Review of the Literature.

Nurses take on the role of primary caregiver in the prison setting, as they are usually the first to approach the prisoner, and they govern access to all aspects of the health care system. The aim of this review was to assess the effects of the use of the primary care model in a correctional setting. Major literature databases relevant to the specified areas were searched for studies published from 2004 to 2013. Three studies reported some implications for prisoners, nursing practice, and the correctional facility, as generated by using the primary care model in the prison setting. The primary care model can improve relevant outcomes for health management in the prison setting.