Protective and risk factors of workplace violence against nurses: A cross-sectional study.

AIMS: To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors. METHODS: An online cross-sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES-NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines. RESULTS: A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards. CONCLUSION: Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence-free policies for hospitals. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Impact Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID-19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job. The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses. Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high-quality care in a totally safe environment. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Development and psychometric testing of the care dependence perception questionnaire.

OBJECTIVE: This multicentre study aimed to develop a measure of the perception of care dependence in patients diagnosed with cancer and to test its psychometric properties. METHODS: The questionnaire was developed based on findings emerged from a meta-synthesis and from qualitative studies conducted in three hospitals in Italy. The draft questionnaire was tested for face and content validity and pilot-tested with patients. The questionnaire was completed by care-dependent patients with cancer. Test-retest was conducted to verify stability. Exploratory factor analysis (EFA) was performed using a Maximum Likelihood robust estimator. RESULTS AND CONCLUSION: The Scale-Content Validity Index was 0.92. The final 15-item questionnaire was completed by 208 patients admitted to two hospitals. The EFA yielded a two-factor model including a positive and a negative perception of care dependence. Factor score determinacy coefficients, Cronbach's alpha coefficients, composite reliability coefficients and Intraclass Correlations Coefficients yielded satisfactory results confirming internal consistency and stability. The hedonic balance score is also available as a single indicator of subjective well-being. The study provides initial validation of the Care DEeP Questionnaire that can be used by cancer nurses to assess positive and negative patient experiences with care dependence and to personalise and improve their care.

Core Evidence-Based Practice Competencies and Learning Outcomes for European Nurses: Consensus Statements.

BACKGROUND: Consensus on evidence-based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context. AIMS: To establish a set of core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries. METHODS: A multi-phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two-round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated. RESULTS: In Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two-round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others. LINKING EVIDENCE TO ACTION: The set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students' and nurses' perception of competencies required for EBP processes.

[Descriptive analytical study on patient mobilization of the Internal Medicine Department of the USL - IRCCS of Reggio Emilia (MOBINT)]. / Studio analitico descrittivo sulla mobilizzazione dei pazienti del Dipartimento Internistico dell'Azienda USL ­ IRCCS di Reggio Emilia (MOBINT).

INTRODUCTION: Hospitalisation represents a significant risk factor for the decline in the general conditions of the elderly. Loss of autonomy in elderly inpatients, together with immobilisation, has been defined as 'Hospital-Acquired Disability' and affects 65% of this class of patients. Less than half of them will regain independent mobilisation. Included among the negative effects are: falls, increased percentage of admission to nursing homes, longer hospital admissions, increased mortality and morbitity. Despite these facts, elderly patients remain in bed for 83-95% of their hospital stay; they rarely walk or are mobilised. Only on an international level has this issue been analysed OBJECTIVES: To analyse active mobilisation in inpatients. METHODS: Prospective analytical and descriptive study performed from December 2018 - May 2019 in the Clinical Medicine department of the AUSL of Reggio Emilia. Descriptive analysis of the data has been performed. RESULTS: A total of 1725 patients were screened for the study. After applying the inclusion criteria, 295 patients were enrolled in the study, 9 of which were then excluded for failure to be mobilised. 66.4% of these patients were mobilized the morning during hygiene-rounds. According to the nurse, they appeared in a stable state, alert and oriented (88.1%) and used a variety of aids (from 1 to 3) (57.3%). The frequency of mobilisations were: 44.4% once a day, 31.2% twice, 24.4% three times or more. DISCUSSION: This study highlighted that mobilisation is strictly correlated to first assistance, frequently relying on health care assistants, and is mostly applied to oriented patients who only need one assistant. Further studies are required to investigate connections between patient's features and mobilisation.

Finding meaning in life: an exploration on the experiences with dependence on care of patients with advanced cancer and nurses caring for them.

PURPOSE: Patients with advanced cancer are likely to face increasing levels of care dependence. Adult patients who become care dependent on others can experience this condition as one of suffering and humiliation. The nurse-patient relationship plays a key role in the experience of dependence. Understanding patients' and nurses' perceptions of care dependence is crucial to addressing the impact it has on the lives of both. The aim of this study is to explore the experiences of patients with cancer and nurses caring for them. METHODS: A multicentre qualitative study was conducted in Italy using semi-structured interviews with patients with advanced cancer admitted to 3 hospitals, and 9 focus groups with nurses working in oncology wards of 2 hospitals. Data were analysed with inductive content analysis. RESULTS: Thirty-two patients and 44 nurses participated in the study. Three common themes were identified: within dependence, the relationship is a lifeline; dependence is influenced by internal and external factors and dependence generates changes. Dependence impacts on patients' and nurses' lives and implies a process of personal maturing for both. Patients learn the humility to ask for help by exposing their vulnerability. Nurses become aware that a trusting relationship helps patients to accept dependence, and they learn to self-transcend in order to build it. CONCLUSIONS: Striving to build positive relationships implies a change in nurses' and patients' lives. In this way, they come to understand important aspects of life and find meaning in difficult situations. Further studies should explore also homecare settings and patients' families.

Linguistic-cultural validation of the oral health assessment tool (OHAT) for the Italian context.

BACKGROUND: The increase in the ageing population and the consequent establishment of a network of adequate structures to respond effectively to the welfare needs of institutionalized elderly people have stimulated the discussion by healthcare professionals on the subject of oral hygiene.Literature data show that the same attention has not been paid to oral health care compared to other health needs. Many studies have demonstrated that oral health has a significant impact on the quality of life, especially for older people. Poor oral health also has a considerable role on the physical condition of the elderly because it affects their ability to eat, feed themselves, forcing them to have unbalanced diets. The consequence of this condition is dehydration, malnutrition and impairment of communication skills. The essential nursing activity for oral care is the assessment of the state of oral health, an activity that should be conducted by means of valid tools. To date there are no tools for assessing the health of the oral cavity validated for the Italian linguistic-cultural context. The aim of this study is to conduct a linguistic-cultural validation for the Italian context, of the original Australian version of the Oral Health Assessment Tool (OHAT) scale. METHODS: Study design: Linguistic-cultural validation and adaptation of a tool for the assessment of oral health. The Beaton and Sousa & Rojjanasrirat (2011) models were used to conduct the linguistic-cultural validation and adaptation process. This validation involved 368 inmates/patients aged over 65 years with cognitive deficit. RESULTS: The face validity was confirmed by a score for each item related to clarity equal to or greater than 80%. The content validity was confirmed by an content validity index for items (I-CVI) score equal to or greater than 0.8 for each item and an content validity index for scales (S-CVI) of 0.93 for the entire tool. For the reliability of the internal consistency the Cronbach alpha was calculated, which was found to be 0.82. The test-retest was calculated by means of the Pearson coefficient correlation which turned out to be 0.5. CONCLUSIONS: The Italian version of the OHAT is a tool that can help to consider oral health at the same level as other health needs aimed at increasing the quality of nursing care provided. This tool can be used by nurses to assess the health of the oral cavity in elderly subjects also with cognitive deficit.

Is early integration of palliative care feasible and acceptable for advanced respiratory and gastrointestinal cancer patients? A phase 2 mixed-methods study.

BACKGROUND: There is evidence that early integration of palliative care improves quality of life, lowers spending and helps clarify preferences and goals for advanced cancer patients. Little is known about the feasibility and acceptability of early integration. AIM: Assessing feasibility of early integration of palliative care, and exploring concerns perceived and problems encountered by patients, relatives and oncologists. DESIGN: A phase 2 mixed-methods study ( ClinicalTrials.Gov :NCT02078700). METHODS: Oncologists of two outpatient clinics offered a specialised palliative care intervention integrated with standard oncological care to all consecutive newly diagnosed metastatic respiratory/gastrointestinal cancer patients. We interviewed samples of patients, relatives and oncologists to explore strengths and weaknesses of the intervention. RESULTS: The intervention was proposed to 44/54 eligible patients (81.5%), 40 (90.1%) accepted, 38 (95.0%) attended the first palliative care visit. The intervention was completed for 32 patients (80.0%). It did not start for three (7.5%) and was interrupted for three patients who refused (7.5%). The Palliative Care Unit performed 274 visits in 38 patients (median per patient 4.5), and 24 family meetings with relatives of 16 patients. All patients and most relatives referred to the usefulness of the intervention, specifically for symptoms management, information and support to strategies for coping. Oncologists highlighted their difficulties in informing patients on palliative intervention, sharing information and coordinating patient's care with the palliative care team. CONCLUSION: Early integration of palliative care in oncological setting seems feasible and well accepted by patients, relatives and, to a lesser extent, oncologists. Some difficulties emerged concerning patient information and inter-professional communication.

[Multicenter validation of an evaluation tool for clinical training activities (SVAT) of the nursing students]. / Validazione multicentrica di uno strumento di valutazione delle attivita' di tirocinio (SVAT) degli studenti infermieri.

OBJECTIVE: To evaluate the psychometric characteristics of the Scheda di Valutazione delle Attività di Tirocinio (SVAT). METHOD: The degree courses in Nursing of the University of Modena and Reggio Emilia, site of Reggio Emilia, the University of Bologna Formative Section BO1, Imola and training center of Cesena, the University of Ferrara training centers of Ferrara and Codigoro were all enrolled in the research. For the content validation the reactive Delphi method was chosen. The panel of experts expressed a qualitative-intuitive judgment on the adequacy of language and on the stimulus material (SVAT). For internal consistency Cronbach's alpha was calculated the. The test-retest method was used for the reliability of stability. RESULTS: all indicators of the SVAT have achieved a degree of consensus not less than 80% demonstrating its content validity. The face validity is demonstrated by an average score equal to or greater than 7 obtained by all indicators. The reliability of internal consistency of the SVAT was appraised by Cronbach's alpha that was 0.987 for the entire instrument. The reliability of the stability has been calculated through the correlation's coefficient expressed by Pearson's r that was 0.983 (p = 1.3E-198). DISCUSSION: in Italy there is no a "gold standard" tool to evaluate the clinical performance of nursing students during and at the end of their clinical training. The SVAT proves to be a valuable and reliable tool it furthermore could stimulate the discussion and the debate among educators and nurses, so that also in our country, it may be possible develop and refine tools that support the evaluation of clinical skills of nursing students.

The Italian validation of the Salford-Scott Nursing Values Questionnaire.

BACKGROUND: To properly direct nursing training and to improve the professional practice to become more effective, it is important to understand students' values. Literature review has shown that there have been changes in students' values in the last 20 years. In contemporary students, a general decrease in altruism has been observed, but also a larger appreciation for honesty toward patients has been declared. The analyzed literature did not find validated tools available in Italian that explore personal and professional values of nursing students. DESIGN OF THE STUDY: This study was an Italian linguistic and cultural adaptation of a research tool. PURPOSE: The authors aimed to validate, for the Italian context, the Salford-Scott Nursing Values Questionnaire, enhanced by Johnson to explore the nursing profession's values. METHODS: The Beaton Model was used as well as Valmi's. These models require five phases, with the goal of producing a pre-final version of the instrument for it to then be administered to a sample of the target and expert population. ETHICAL CONSIDERATIONS: The study was approved by the Council of the Nursing Degree University course of the Modena and Reggio Emilia University, Reggio Emilia site, and the identity of the subjects was protected at every moment of the testing. RESULTS: Face validation was achieved since the clarity percentile for each item was 100%. Content validity was also reached, measured from the content validity index and the scale validity index. The study has confirmed the reliability of the instrument's internal consistence with a value of Cronbach's alpha on 0.95 of total of items. The reliability of the test-retest confirms the stability of the instrument in time (r = 0.908; p = 0.01). CONCLUSION: The study concludes that the instrument is ready to be administered to the target population, a sample group of nursing students.

[Wastes in nursing practice: findings from a phenomenological study]. / Gli sprechi nella pratica clinica infermieristica: risultati di uno studio fenomenologico.

BACKGROUND: the International economic crisis has challenged the sustainability of health care systems imposing reforms aimed to reduce costs and increase production efficiency. At the international level, waste reduction is considered to be the basis to ensure the heath care systems sustainability. To reduce waste and increase production efficiency is required to document the types, the extent and the level were they occur. The purpose of this paper is to document the experience of waste in nurses clinical practice. METHODS: a descriptive phenomenological study was conducted. Clinical nursing operating in different care settings of the National Heath Care Service were recruited adopting a maximum variation purposeful sampling. Data saturation was considered as the finish line for the participants recruitment. RESULTS: thirty nurses participated in the study. They were mainly female (n = 28, 93.3%) and with an average age of 41.4 ± 7.3 years. For nurses waste means inadequate allocation of resources. Wastes are caused by individual and organizational choices determining improper, inefficient or ineffective use of material, human or virtual heath care resources and time as well as the incorrect application of clinical pathways, the inadequate use of electricity, food, and the improper disposal of the hospital waste. Wastes generates negative emotional impact on nurses such as frustration, anger and sense of impotence. Avoidable wastes were identified. They were mainly related to the expiration date, the use and the type of drugs and materials. Also unavoidable wastes were identified and they were related to established practices to ensure patients safety and changes in treatment choices due to the clinical instability of the patients. CONCLUSION: within the limits of the qualitative approach, in this study have been identified different types of waste present in clinical practice as perceived by nurses. National Health Service policies could focus on this evidences to improve production efficiency. To involve health care professionals in the choices and their awareness to the conscious and responsible use of public resources available, would avoid linear cuts and enhancing such operators.

[Assessment and choice of the device for vascular access]. / Accertamento e scelta dei dispositivi ad accesso venoso.

The accurate vascular monitoring by nurses both at the beginning and during infusion treatment, in addition to the selection of the best device for each patient, can increase patient satisfaction, reduce complications, preserve peripheral veins, reduce or eliminate time used to find unlikely vein access, reduce hospital stay length and reduce the costs associated with infusion treatment. Aims of study are to ascertain the presence of a procedure for choosing the most suitable venous device for each patient, to identify nurses' criteria to make a vascular assessment, and to describe when nurses make a vascular assessment. A descriptive study with convenience sample of 290 nurses. The data collection instrument is an anonymous questionnaire. The questionnaires administered, returned, and considered valid were 227. 14% of the sample states that within their ward there is a a procedure to evaluate the most suitable device, while 70% states the opposite and 16% of the sample states that "they do not know". The results show fairly clearly that in the wards considered there is no procedure currently in use in order to choose the most suitable device for each patient, that nurses do not have clear criteria to make a vascular assessment, that they carry out vascular assessment at different times of the infusion's process.

[Nursing practice based on theoretical models: a qualitative study of nurses' perception]. / La pratica infermieristica basata sui modelli teorici: uno studio qualitativo sulla percezione degli Infermieri.

Many faculty argue that theory and theorizing are closely related to the clinical practice, that the disciplinary knowledge grows, more relevantly, from the specific care context in which it takes place and, moreover, that knowledge does not proceed only by the application of general principles of the grand theories to specific cases. Every nurse, in fact, have  a mental model, of what may or may not be aware, that motivate and substantiate every action and choice of career. The study describes what the nursing theoretical model is; the mental model and the tacit  knowledge underlying it. It identifies the explicit theoretical model of the professional group that rapresents nursing partecipants, aspects of continuity with the theoretical model proposed by this degree course in Nursing.. Methods Four focus groups were made which were attended by a total of 22 nurses, rapresentatives of almost every Unit of Reggio Emilia Hospital's. We argue that the theoretical nursing model of each professional group is the result of tacit knowledge, which help to define the personal mental model, and the theoretical model, which explicitly underlying theoretical content learned applied consciously and reverted to / from nursing practice. Reasoning on the use of theory in practice has allowed us to give visibility to a theoretical model explicitly nursing authentically oriented to the needs of the person, in all its complexity in specific contexts.

Educating to sexuality care: the nurse educator's experience in a multicenter study.

Background: Sexuality is an issue inherent in the lives of all human beings. Education for Sexuality takes place informally, through relationships with the environment, with the family as a model, and formally, as a pedagogical practice in Teaching. Education for sexuality is recognized as an instrument of social transformation that leads to changes in behaviors and norms related to sexuality. Objectives: Knowing the perception of nursing professors about sexuality education in professional training, recognizing attitudes of these professors in relation to sexual education and identifying barriers in education for sexuality. Methods: Exploratory and descriptive study, using qualitative methodology. Data collection was carried out from semi-structured interviews and thematic analysis. Results: The interviewees consider sexuality education to be very important, being taught in the nursing course, addressing different themes. In general, they reported feeling comfortable teaching these topics. The identified barriers to the level of education students are in, students' knowledge and reactions to the topic, religious and cultural issues, and the time available to talk about the topic and professional aspects. Conclusion: Sexuality is a fundamental theme in nursing education and needs to be further explored to overcome the barriers associated with its approach.

A Multicentric Pilot Study of Student Nurse Attitudes and Beliefs toward Sexual Healthcare.

Nurse educators are tasked with the education of students to become providers of holistic care, and part of that care includes sexuality. Students carry attitudes and beliefs that influence their behavior; therefore, students who carry negative attitudes about sexual healthcare are less likely to provide that care. This is an international, multicenter study of nursing students' attitudes and beliefs about the provision of sexual healthcare. The Sexuality Attitudes and Beliefs Survey, which measures attitudes toward the provision of sexual healthcare and has a range of scores from 12 to 72, was given to 129 students across Spain, Portugal, Italy and the United States and revealed negative attitudes about sexuality, with a mean SABS score of 39.95. Higher scores on the SABS reveal more negative attitudes and reduced likelihood of provision of sexual healthcare. Statistically significant differences were found when comparing queer and heterosexual students (41.69 vs. 38.06), and students in their final year of school held more negative attitudes toward the provision of sexual healthcare (41.4 vs. 39.5 and 39.2). This study shows that nurse educators continue to need to focus on the attitudes student nurses carry about sexuality. There is a critical shortage of education strategies to meet the needs of student nurses so that they will be comfortable and confident in providing sexual healthcare.

Education on Vaccination Competence: an Intensive Course for Skillful Health Science Students.

Background: Vaccination is one of the most successful and cost-effective interventions for public health. Studies have shown that health professionals who have good knowledge and positive attitudes towards vaccination are more likely to provide effective vaccination protection to people, including themselves. Therefore, health science students must acquire evidence-based knowledge during their education to meet the challenges of healthcare. Objective: The aim of this study was to investigate the knowledge, attitudes and feedback of health science students who participated in the Educating Vaccination Competence (EDUVAC) Intensive Course. Methods: A five-day Intensive Course was implemented for health science students, which included a pre-assignment. The EDUVAC Intensive Course used different teaching methods (lectures, workshops, interactive games, discussions), group work, study visits, and cultural programs to encourage students' motivation. For the purpose of the study, students filled out an online questionnaire after giving informed consent. Results: Sample consisted of 31 health science students from five European Higher Institutions. They had very good knowledge on most knowledge questions. In the post measurement it was significantly greater and equal to 81%, p<0.001. Almost all students (93.5%) totally agreed that "It is important for adults to receive all recommended vaccines according to national guidelines". The statement "I have had an active attitude and participation in the Intensive Course" received 80.6% total agreement. Over 90.3% rated the Intensive Course as "excellent" or "above average". Conclusions: After completing the EDUVAC Intensive Course, students felt confident in their vaccination knowledge and skills, which benefited their professional development.

Attitudes and Beliefs of Portuguese and American Nursing Students about Patients' Sexuality.

Nursing school graduates must be prepared to interact comfortably and effectively with patients about their sexual health. This study analyses the attitudes and beliefs about patient sexuality held by Portuguese and American nursing students. OBJECTIVE: In Portuguese and American nursing students, (1) we analyzed students' attitudes and beliefs towards sexuality using the Sexuality Attitudes and Beliefs Survey (SABS); (2) we identified nationality, socio-demographic information, and affective-sexual beliefs and attitudes. METHOD: Quantitative, cross-sectional study; convenience sample of 296 students (63.2% Portuguese; 36.8% American); mean age: 21.9 years (SD = 3.12); two-way ANOVA and multiple correspondence analyses were performed. RESULTS: Attitudes and beliefs toward sexuality: Portuguese women are more liberal than men, contrary to American students. Among both nationalities, participants with multiple sexual partners held more conservative attitudes. Sexual orientation: bisexual American students and homosexual Portuguese students are conservative. Multiple correspondence analysis revealed two profiles: (1) Portuguese students: liberal-tolerant in attitudes towards patient sexuality, live with family/roommate, 18 to 21 years old, no or one sexual partner; (2) US students: traditionalist attitudes towards patient sexuality, share house, 22 and 23 years old, multiple partners. CONCLUSION: Human sexuality must be addressed in nursing education curricula.

Adaptation and Validation of the Sexuality Attitudes and Beliefs Scale for the Italian Context.

BACKGROUND: Nurses dealing with a patient's sexuality must start from an awareness of their own experience, specific attitudes, and possible limits. What emerges from the literature is a conservative tendency in nurses, which underlines the difficulty in this awareness, but even a difficulty in improving the necessary knowledge/skills. It is, therefore, essential to create tools that can raise awareness of these limits. OBJECTIVE: the present study aims to explore the psychometric properties of the Attitudes and Beliefs about Sexuality Scale, adapted and validated for the Italian context. METHOD: This is an instrumental, cross-sectional piece of research, whose SABS validation process applies the steps of Beaton and Valmi. The convenience sample collected data from 223 participants in the first approach. This was followed by a retest involving 44 students randomly selected from those who responded in the first phase. Ethical principles were respected. RESULTS: The SABS questionnaire demonstrated good test-retest reliability, good internal consistency, and adequate construct validity. CONCLUSIONS: The Italian version of the SABS is valid and reliable for use with nursing students. This is the fourth language in which the SABS is available for research.

Lifestyle changes during the first and second waves of the COVID-19 pandemic in medical college students: are there gender-related differences?

BACKGROUND AND AIMS: The COVID-19 pandemic has seriously affected young people. The present study aims to explore the effects of COVID-19 on lifestyle in 500 undergraduate students both during the acute phase of the pandemic (so-called "first wave") and during the second spread of infections (so-called "second wave"). Gender differences were also explored.  Methods and results. During the first wave we found weight gain in 48.6% of subjects, a switch to an unhealthy diet (43%), and an increase in the amount of food introduced (35%). Interestingly, women showed higher intake of food in order to cope, while men privileged higher wine consumption as a coping mechanism. We observed a sharp reduction in physical activity, increased sedentary behaviours and deterioration in sleep quality. Stress correlates with eating to cope (r=0.86; p<0.001); drinking to cope (r=0.83; p<0.001). Contrary to expectations, the second wave led to a situation similar to the first. We have detected a further deterioration in quality of sleep (67% vs 77%; p<0.01) and also a reduction in sleeping time (68.6% vs 77.7; p<0.01). CONCLUSIONS: The long pandemic has led to unhealthy lifestyle changes in the student population of our municipality in Northern Italy. There are gender differences in lifestyle modifications developed during the pandemic that suggest a different response to stress. Moreover, the persistence of pandemic-related stress due to the "second wave" has severely affected the lifestyle habits of undergraduate student.

Assessment of COVID-19 Fear in Five European Countries before Mass Vaccination and Key Predictors among Nurses and Nursing Students.

BACKGROUND: Levels of fear have increased since the COVID-19 pandemic outbreak. The absence of a safe and effective vaccine for mass-vaccination deteriorates this situation, which has a significant impact on mental health. This study aimed to assess the feelings of fear among nurses and nursing students in five European countries. METHODS: A multicenter cross-sectional study was conducted in five European countries (Greece, Albania, Cyprus, Spain, and Kosovo) before the start of mass vaccination in Europe. Data collection was conducted in December 2020-January 2021 using an online questionnaire for nursing students and professional nurses. Fear of COVID-19 Scale (FCV-19S) was used for measuring levels of fear. IBM SPSS version 21.0 was used for statistical analysis. RESULTS: The study population included 1135 nurses and 1920 nursing students from Kosovo (n = 1085), Spain (n = 663), Greece (n = 534), Albania (n = 529), and Cyprus (n = 244). According to multivariable analysis, females (OR = 2.53, 95% CI = 1.89-3.15), married (OR = 0.86, 95% CI = 0.24-1.48), nurses (OR = 0.87, 95% CI = 0.28-1.45) and those with a chronic disease (OR = 0.86, 95% CI = 0.11-1.62) were more fearful of COVID-19. CONCLUSIONS: It is important to decrease fear in the population of nurses who are at the frontlines of the pandemic. The provision of appropriate education and training activities for nurses and students to manage their stress levels is of high importance. Future studies should focus on levels of fear after the administration of several safe and effective vaccines worldwide.

[Perioperative nursing education and client satisfaction: an observational study]. / L'educazione infermieristica perioperatoria e la soddisfazione dell'utente: uno studio osservazionale.

Nowadays, an important goal has been reached in recognizing that the client plays a central role in the caring process. The educational relationship that is created between nurses and patients makes it possible to make the patient aware of his health problems and to understand and actively participate in the caring process. The main aim of this study was to assess the effectiveness of the teaching process undertaken by nurses , before discharging surgical patients , for rendering patients autonomous once they returned home and their level of "satisfaction" regarding the information they received. For this purpose they were asked to fill in a questionnaire when they returned for their first outpatient control. Results showed that, on the whole, patients were satisfied with the information they received during hospitalization, particularly in terms of postoperative pain, prevention of infections, medical therapy, mobilization and a return to normal eating and drinking. Some aspects still need to be improved regarding a post-discharge phone contact and better hospital-territorial integration.