PROMUOVERE LA COMUNICAZIONE SANITARIA IN UN’OTTICA IAP- CENTRED

The steady promotion of participatory healthcare, from Empowerment policies for cancer patients to Patient-Reported Outcomes (PROs), is acknowledging the patient- citizen’s status as an Individual Active Participant (IAP), thus establishing a new patient-centred era based on the healing power of words. Given the impact of health communication notably in oncology units, this Participatory Action Research project detected and gave expression to both clinical and social needs in favour of female IAPs treated with radiotherapy. The project consisted of group discussions and support initiatives aimed at: (1) spurring self-awareness; (2) fostering health communication; (3) building a community of female IAPs regionwide.La progressiva promozione di prassi sanitarie partecipative, dal Patto per l’Empowerment del paziente oncologico alla diffusione dei Patient-Reported Outcomes, sta riconoscendo al/la paziente-cittadino/a il suo status di Individuo Attivo e Partecipe (IAP), e sancendo l’ingresso della comunità medica e scientifica in una nuova fase patient- centred: quella delle “parole che curano”. Dato l’impatto della comunicazione sanitaria nei reparti oncologici, il presente progetto di Ricerca-Azione Partecipata ha posto al servizio di donne-IAP trattate con radioterapia l’analisi dei loro bisogni clinici e sociali attraverso gruppi di supporto e discussione tesi a: (1) incentivare autoconsapevolezza; (2) promuovere la comunicazione sanitaria; (3) istituire una comunità di donne-IAP nel territorio pugliese

The indirect effect of cognitive reserve on the relationship between age and cognition in pathological ageing: A cross-sectional retrospective study in an unselected and consecutively enrolled sample

Cognitive reserve (CR) allows individuals to maintain cognitive functionality even in the presence of pathologies. The compensation hypothesis suggests that CR plays an indirect role between age and cognitive decline, contrasting the negative effect of ageing on cognition. We test this hypothesis in an unselected and consecutively enrolled sample of memory clinic attendees (n = 134) who completed the CR Index questionnaire and three neuropsychological tests assessing global cognition (MMSE, FAB, CDT). Participants were divided into two groups based on standard diagnostic criteria (DSM-5): those who were cognitively impaired (n = 92) and those who were preserved (n = 42). A principal component analysis was used to extract a composite measure of global cognitive functioning from the three neuropsychological tests, and mediation analysis was used to examine the relationship between CR, age and global cognitive functioning in the two groups. Results revealed that: (i) age had a significant direct negative effect on the global cognitive score in both groups; (ii) the three socio-behavioural proxies of CR together suppress the direct negative relationship between age and global cognitive score in cognitively impaired patients but not in cognitively preserved participants. This study confirms the association between CR, age and cognition and allows us to validate its role in a population with cognitive impairment and extend findings to a low-to-middle educated population. These results hold important implications for public health and wellness promotion, emphasising the beneficial role of maintaining healthy and active physical, cognitive and social lifestyles

The influence of body image on psychological symptomatology in breast cancer women undergoing intervention: a pre-post study

IntroductionBody image concerns related to breast cancer surgery may challenge patients’ quality of life and their treatment outcomes, thus representing a key aspect to be assessed in the psycho-oncological settings. The present longitudinal study is aimed to (1) investigate the association between preoperative body image and postoperative psychological symptoms in breast cancer patients; (2) explore the impact of pre−/post-surgery variation in body image on psychological symptomatology.MethodsN = 72 women undergoing breast cancer surgery were preoperatively screened (T1) using the Body Uneasiness Test (BUT) and were assessed postoperatively (T2) using the Symptom Checklist-90 Revised (SCL-90-R) and re-administered the BUT. Spearman’s correlation was used to investigate the relationship between age, preoperative body image and postoperative psychological symptoms, and variation in body image. To predict post-surgical psychological symptomatology, two separated multiple regression models were used to evaluate preoperative body image and its variation after surgery controlling for covariates (i.e., education; intervention type). P significance was set as 0.05 for all analyses and adjusted for multiple comparisons.ResultsAt T1, anxiety in relation to body image scores emerged as the most frequently experienced psychological symptomatology after surgery (all adjusted p < 0.05). Significant correlations were observed between all SCL-90-R scores at T2 and avoidance behaviors and depersonalization scores at T1. The associations were most significantly strong for somatization, depression, anxiety, and hostility (all adjusted p < 0.05). However, change in body image between pre- and post-intervention was not associated with psychological symptomatology at T2 (all adjusted p > 0.05). Pre-surgery body avoidance was significantly associated with post-intervention psychological symptoms (SOMβ = 0.453, p = 0.0001; DEPβ = 0.507, p = 0.0001; AXβ = 0.459, p = 0.0001; HOSβ = 0.410, p=. 0001). However, increased weight phobia between pre- and post-surgery was statistically associated with increased somatization, anxiety, depression and hostility at T2 (βSOM = 0.439, p = 0.0001; βDEP = 0.454, p = 0.0001; βANX = 0.471, p = 0.0001).DiscussionOverall, pre−/post-intervention body concerns were significantly associated with primary psychological symptoms in breast cancer patients undergoing surgery. Higher levels of body avoidance and weight phobia were significantly associated with the primary psychological dimensions assessed. As body concerns might act as quality-of-life predictors, their evaluation is crucial in fostering patients’ well-being and treatment adherence

The Picture of Sexual Health: A Multimodal Approach to Digital Health Platforms

Spurred on by the social need for public health knowledge and sexual empowerment, this chapter addresses the new media challenges, narratives and social representations conveyed by open-access resources for sexual and reproductive health. In doing so, this work provides a multimodal discourse analysis of both expert-based and community-based digital platforms

Combining Corpus Linguistics and Discourse Analysis to examine Q&As on sexual and reproductive health

Recent advances in ICT have given rise to new opportunities and challenges in patient-centered practices (e.g. telehealth providers). Q&A expert services represent an effective paradigm of computer-mediated discourse of healthcare, affording a participatory virtual environment in which laypeople can seek and receive expert advice (Maglie, 2015). With reference to these platforms, asynchronicity and dissociative anonymity of questions (Q-posts) contribute to the online disinhibition effect (Suler, 2004), while correspondence of answers (A-posts) may indicate interpersonal connection and democratization of expertise among e-patients (Plastina, 2015; Tessuto, 2015). Further factors involved in e-health delivery have been extensively examined by interdisciplinary studies, from human sciences to corpus linguistics (Baker & McEnery, 2015; Brookes, Harvey & Mullany, 2018). The present work aims to investigate both corpus and discourse of sexual and reproductive health and appraise how “healthy communication” can affect attitudes among young people asking e-healthcare providers for advice and information. To this purpose, we selected as a dataset the complete sample of Q&A posts of a sexuality information service specifically designed by IU Bloomington. We used a third-generation tool to run a mixed- method analysis of collected data (238,020 running words). The combined approach provides the double advantage of detecting quantitative occurrence of qualitative discursive patterns and clusters, and exploring their context of occurrence. In view of these methodological premises, our poster presents quantitative and qualitative evidence and provides a broader outlo ok on linguistic and narrative elements characterizing patient-doctor virtual scenario to prevent high-risk sexual behaviour. Indeed, corpus-based findings show that Q-posts focus on sexual activity (>4,39%) and body issues (>1,25%), while A-posts include delayed feedbacks about sex (>2,98%) and relationships (>2,78%) in which the frequent use of personal pronouns and mixed register vocabulary acknowledge a patient-oriented perspective. Discourse-based findings suggest the following final remarks: (1) the “ask an expert” format is particularly successful at eliciting intimate self- disclosure from young users; (2) concerns and doubts among seekers can also result from misinformation; (3) confidential advice effectively encourage consensual safe sex, body acceptance and critical reflection on STIs and unwanted pregnancies; (4) multimodal and/or critical discourse analyses could further investigate involvement in communication exchanges

CMC per l'empowerment: uno studio delle piattaforme Q&A per il benessere del/la paziente nei contesti virtuali di cura

Com’è noto agli esperti ed agli operatori del settore, l’analisi della domanda è una metodologia clinica che prende ad esame la relazione fra psicologo e committenza. Sono infatti molteplici le dinamiche intrapsichiche, interpersonali e sociali che influenzano la relazione di aiuto pazienteprofessionista della salute e che possono orientare la presa in carico, la valutazione ed il trattamento del paziente. Aspetti salienti di questo scambio interattivo si rendono particolarmente espliciti nei processi comunicativi veicolati dai media digitali. La corrispondenza linguistica ed emotiva (rispecchiamento empatico) fra paziente e professionista diventa una risorsa imprescindibile per promuovere l’apertura e la spontaneità (“disinibizione”) del richiedente aiuto, favorire atteggiamenti positivi verso l’utilizzo di metodologie blended e produrre risposte che abbiano un “effetto normalizzante” verso la sua stessa percezione di malattia. Ricerche recenti suggeriscono il ricorso sempre maggiore ad approcci integrati e mutidisciplinari per analizzare le risorse narrativo-affettive del paziente e dell’esperto in una cornice virtuale di promozione del benessere. Oggetto della nostra presentazione sarà quindi un’analisi linguistica sull’impiego delle tecnologie dell’informazione nei contesti di cura, con particolare riferimento alle modalità asincrone di comunicazione mediata dal computer o CMC (blog, forum, social media, piattaforme online). Introdurremo lo studio di caso di due siti Q&A, Kinsey Confidential e Go! Ask Alice, in un’ottica dialogica ed altamente partecipativa che valorizzi la prospettiva dell’utenza (Insider’s perspective) nella richiesta di aiuto

Dolore e riparazione in un contesto socio-sanitario: riflessioni ed esperienze di una psicoterapeuta sistemica

Il processo di sintonizzazione affettiva nella relazione primaria tra la madre e il bambino con i suoi effetti sulla salute dell’individuo nel corso della sua crescita e l’isomorfismo con la sintonizzazione affettiva nella relazione terapeutica costituiscono il filo rosso che unisce tutti i capitoli di questo libro. Con il supporto degli studi nei campi della neurobiologia, neuroscienze, psicologia dello sviluppo e biologia naturale, l’autore sostiene la possibilità e la necessità di un dialogo in tutti i contesti di vita quotidiana per un mondo migliore. Nello stesso tempo, intende proporre un modello di psicoterapia aperto a una visione unitaria. Il libro si rivolge alle famiglie, docenti e operatori della scuola, del mondo della sanità, della giustizia minorile, del lavoro, della politica, in modo particolare, a chi aspira all’esercizio di una professione di aiuto, in ambito psicoterapeutico e non, o già la svolge. Gli studenti del corso di laurea in psicologia, gli specializzandi in neuropsichiatria infantile, in psichiatria e in psicoterapia, potranno trovarvi riflessioni e indicazioni utili per orientarsi nella loro formazione e pratica professionale

Knowledge dissemination for social change. A Multimodal Discourse Analysis of an online health information service

The study focuses on Kinsey Confidential™, a weekly newspaper column that adds an image to each answer it provides to the question received from a young reader. Based on corpus building criteria, the work collected all the web pages containing the image, the question, and the corresponding answer in the time span between February, 2015 to May, 2018. Tools of analysis found in Kress and van Leeuwen (2006), Machin and Mayr (2012), Ledin and Machin (2018), and in the pack of utilities of WordSmith 7.0 (Scott 2016) were used to identify a series of salient recurring discursive strategies through which the website depicts sexuality and promotes sexual health. These strategies help to represent a new multimedia mode of scientific knowledge dissemination and a multimodal channel of safe sex promotion for social change in the contemporary sociocultural context of adolescents’ sexual knowledge and behaviour. The data from previous studies, based exclusively on linguistic analysis of young people’s questions submitted online, showed the presence of misinformed socially-derived beliefs and understanding of sex, gender and reproduction (Harvey 2013; Maglie 2015, 2017). In addition, this study addresses the way knowledge dissemination on sexuality is communicated by the website, not just through popularised scientific language, but also through visual language. Thus, the combination of the linguistic and semiotic resources found in Kinsey Confidential™ helps to introduce different levels of signification of discourses, all aiming at fostering appropriate knowledge of sexual and reproductive health among the younger generation

The COVID-19 stress perceived on social distance and gender-based implications

Consistent with recent literature that holds a psychosocial approach to the COVID-19 pandemic, our paper investigates the extent to which having contracted the disease may lead to changes in mood and perceived distress, and how these changes may be reflected in the perception of interpersonal distance (IPD). Our work also focuses on gender differences in depression, distress, and IPD as women are expected to be more vulnerable than men while dealing with the emotional burden entailed by the COVID-19. The study relied on the combined use of direct (self-report) and indirect (visual-analogic) measures for data collection

Promuovere la comunicazione sanitaria in un’ottica IAP-centered. Un progetto di Ricerca-Azione Partecipata

Come sancito dalla World Health Organization, la salute è un “diritto umano fondamentale” ed un “valore” che i cittadini e l’intera collettività sono chiamati a tutelare e difendere (WHO, 1948). La pubblicazione del Patto per l’Empowerment del paziente oncologico (CPE, 2017) e la promozione di politiche di cittadinanza attiva e di servizi come i Patient-Reported Outcomes (PROs) in ambito ospedaliero ed ambulatoriale testimoniano l’attenzione istituzionale verso una sanità equa, plurale ed inclusiva, basata sulla persona. Diversi contesti di cura stanno riconoscendo al paziente lo status di “Individuo Attivo e Partecipe” (Individual Active Participant [IAP]) (Topol, 2015) a cui spettano le principali decisioni sanitarie. L’accresciuto controllo di tutti gli attori sociali può essere predittivo di una migliore aderenza al trattamento da parte dei pazienti (Náfrádi, Nakamoto & Schulz, 2017), e la comunicazione sanitaria svolge un ruolo cruciale in questo processo di consapevole partecipazione (Immacolato et al., 2010). Recenti studi (Chou et al., 2017) ipotizzano inoltre un’associazione fra qualità della comunicazione medico-paziente ed andamento pronostico in pazienti con diagnosi di tumore. In accordo con i principi della Ricerca-Azione Partecipata (RAP), il presente lavoro intende facilitare l’accesso e la partecipazione dei pazienti/IAP dell’Ospedale di Brindisi Di Summa-Perrino alle decisioni di cura radioterapica. Lo studio si articola nelle seguenti fasi: 1) conduzione di 6 sessioni di Focus Group Discussion (FGD) al fine di identificare i bisogni reali di ciascun paziente; 2) svolgimento di analisi linguistiche quantitative (Corpus Linguistics) e qualitative (analisi del discorso) sui dati raccolti dalle FGD con l’obiettivo di ottenere una mappatura dei pattern comunicativi dei pazienti; 3) restituzione ed implementazione dei dati nella pratica clinica, attraverso la co-costruzione di spazi di confronto e comunicazione fra pazienti, caregiver e personale sanitario. Scopo principale del progetto è offrire ai pazienti la duplice opportunità di “dar voce” e “dare un nome” ai propri bisogni, acquisendo un maggior controllo in tutte le fasi della terapia. Attraverso l’adozione di un approccio bottom-up multidisciplinare e multimetodo, lo studio rende possibile una collaborazione fra le diverse figure coinvolte nella realtà ospedaliera locale, volta a promuovere la comunicazione come un’essenziale prestazione sanitaria