Antonovsky’s Sense of Coherence Scale: Cultural Validation of Soc Questionnaire and Socio-Demographic Patterns in an Italian Population

BACKGROUND: The theory of salutogenesis entails that the ability to use resources for one's wellbeing is more important than the resources themselves. This ability is referred to as the Sense of Coherence (SOC). This paper present the cross-culturally adapted version of the Italian questionnaire (13 items), and the psychometric and statistical testing of the SOC properties. It offers for the first time a view of the distribution of SOC in an Italian sample, and uses a multivariate method to clarify the effects of socio-demographic determinants on SOC. METHODS: The cross-cultural adaptation of the English SOC questionnaire was carried out according to the guidelines reported in literature. To evaluate the psychometric and statistical properties we assessed reliability, validity and frequency distribution of the collected data. A Generalised Linear Model was used to analyse the effects of socio demographic variables on SOC. RESULTS: The Italian SOC scale demonstrates a good internal consistency (α = 0.825). The model obtained with factorial analysis is not related to the traditional dimensions of SOC represented in more than one factor. The multivariate analysis highlights the joint influence of gender, age and education on SOC. CONCLUSION: The validated Italian questionnaire is now available. Socio-demographic variables should be taken into account as confounders when SOC values among different populations are compared. Presenting data on SOC of the Italian population makes a control population available for comparisons with specific subgroups, such as patient populations. Now, the Italian challenge is to integrate the salutogenic approach into Public Health police

Dietary habits and growth: an urban/rural comparison in the Andean region of Apurimac, Peru

INTRODUCTION: The efficacy of interventions against children malnutrition crucially depends on a myriad of factors other than the simple food intake, that must be carefully studied in order to plan a balanced policy. The relation between dietary patterns and growth is at the very heart of the problem, especially in consideration of the fact that dietary pattern involves dimension other than pure caloric intake in its definition. In this work we investigated the relations between dietary pattern and growth comparing children from a rural and a urban area in Andean Peru, in terms of food habits and anthropometric variables to develop a model usable in context interventions against malnutrition. MATERIAL AND METHODS: A sample of 159 children (80 from urban, 79 from rural area), aged from 4 to 120 months (72.7 ± 37.5 SD) was collected. The data were investigated by a multidimensional (principal component analysis followed by inferential approach) analysis to correlate the different hidden dimensions of both anthropometric and dietary observables. The correlation between these dimensions (in the form of principal components) were computed and contrasted with the effects of age and urban/rural environments. RESULTS: Caloric intake and growth were not linearly correlated in our data set. Moreover urban and rural environment were demonstrated to show very different patterns of both dietary and anthropometric variables pointing to the marked effect of dietary habits and demographic composition of the analyzed populations. The relation between malnutrition and overweight was at the same time demonstrated to follow a strict area dependent distribution. DISCUSSION AND CONCLUSION: We gave a proof-of-concept of the non-linear character of the relation between malnutrition (in terms of caloric intake) and growth, pointing to the need to calibrate interventions on food pattern and not only quantity to contrast malnutrition effects on growth. The education toward a balanced diet must go hand-inhand with the intervention on caloric intake in order to prevent effects on health

Skin-to-skin contact: an easily implemented intervention to reduce perinatal complications and pain perception in a rural African community

To determine the effect of early Skin-to-Skin Contact (STSC) in a low-resource setting and to promote a correct educational training on STSC methodology among the hospital members. The research was performed at the Maternity ward of Ambrosoli Memorial Hospital of Kalongo, Infants were randomized immediately after birth either to receive early STSC or conventional care. During the 90 minutes\u2019 observation we evaluated neonatal infant pain scale score during the vitamin K injection; infant breastfeeding assessment tool at the first breastfeeding; axillary temperature at 15, 30, 45, 60, 75, 90 minutes; heart rate and respiratory rate; newborn and mother\u2019s blood glucose; time of placental delivery. Moreover the hospital staff were invited to complete an anonymous self-reported questionnaire to explore midwives and mothers\u2019 perceptions of the benefits of this procedure and to understand the acceptance and barriers to STSC in an African community setting. The main results indicate that STSC has a positive effect on infant blood glucose and temperature stability, first breastfeeding, newborns\u2019 pain, placental delivery and can reduce the stress associated with birth. The pilot study found that our adaptation of STSC for community-based implementation was quickly adopted and that it might be used immediately after birth as a beneficial clinical intervention to improve newborns health and survival

The influence of doctor-patient and midwife-patient relationship in quality care perception of Italian pregnant women: An exploratory study

BACKGROUND: The study focuses on the perceived nature / technique opposition in pregnancy and delivery emerging from gynaecologist/ midwife/ pregnant woman relationships. We developed a cross-sectional survey to identify, by means of a multidimensional data-driven approach, the main latent concepts structuring the between items correlation correspondent to the different general opinions present in the data set. The obtained results can set the basis to improve patient satisfaction while decreasing healthcare costs. METHODS: The sample is made of 90 pregnant women within 24-48 hours after natural or operative birth, from three maternity units in Italy. Women filled in a questionnaire about their relationship with gynaecologist and midwife during pregnancy and hospital stay for delivery. RESULTS: Participation rate approached 100%. The emerging factorial structure gave a proof-of-concept of the hypothesis of 'nature vs. technique' as the main dimension shaping women opinions. The results highlighted the role of midwife as the 'link' between the natural and technical dimension of birth. The quality of welcome and the establishing of an empathic relation between mother and healthcare professional was shown to decrease further request of care in the post-partum period. CONCLUSIONS: The "fault plane" between nature and technique is a very critical zone for litigation. Women are particularly sensitive to the consideration and attention they receive at their admission in the hospital, as well as to the quality of human relationship with midwife. The perceived quality of welcome scaled with a decreased need of additional care and, more in general, with a more faithful attitude towards health professionals. We hypothesize that increasing the quality of welcome can exert an effect on both welfare costs and litigation. This opens the way (through an extension of this pilot study to wider populations) to relevant ameliorative actions on quality of care at practically null cos

Pearson correlations between OP and EVAL components (bolded values correspond to statistically significant correlations at p < 0.05).

<p>Pearson correlations between OP and EVAL components (bolded values correspond to statistically significant correlations at p < 0.05).</p

Loading pattern for Evaluation variables (bolded values point to variables relevant for component meaning, Italics to borderline items).

<p><b>Variables codes</b>: <b>AVAL</b> = ‘Did your physician ever answered to phone calls?’; <b>BVAL</b>: ‘During pregnancy did you feel the need of more visits/exams?’; <b>CVAL</b> = ‘Did you receive all the necessary information during pregnancy/birth/post-birth periods?’; <b>DVAL</b> = ‘Was ever it possible to express your opinion during visits?’; <b>FVAL</b> = ‘Which is your evaluation of the technical skills of gynecologist?’; <b>GVAL</b> = ‘Which is your opinion of the patience demonstrated by your gynecologist?’; <b>HVAL</b>: ‘Which is your opinion about the clarity of the information given by gynecologist?’; <b>IVAL</b>: ‘Which is your opinion about the tact demonstrated by gynecologist in the relationships?’; <b>JVAL</b> ‘Which is your opinion about the professional ethics of your gynecologist?’; <b>KVAL</b>: ‘During your relationships with doctors did you ever felt considered/understood?’; <b>LVAL</b>: ‘Did the physician ever made all that it was possible to meet your needs?’; <b>MVAL</b> ‘Give a global score to your relationship with gynecologist’; <b>NVAL</b> ‘Did the physician made you to participate in the different choices?’; <b>OVAL</b>: ‘‘At the end of the birth, post-birth period how much your expectations were met?’; <b>PVAL, QVAL, RVAL</b>, are the possible answers to the question ‘Which of the virtues of your gynecologist did you appreciate most?’ correspondent to technical skills, patience, cheerfulness respectively; <b>SVAL</b>: ‘Did the midwife ever made all that it was possible to meet your needs?’; <b>TVAL</b> ‘Did you feel sometimes inappropriate in your questions and/or judged for your choices? (physician)’; <b>UVAL</b> ‘When arrived at the hospital had you to wait a long (<i>low values</i>) or short (<i>high values</i>) time?’; <b>VVAL</b>: ‘Did you think healthcare professionals put effort into establishing a positive human relationship with you?’; <b>WVAL</b>: ‘The relational environment you found among healthcare professionals did make you to feel safe?; <b>XVAL</b> ‘At admittance time did you feel yourself embraced?’; <b>YVAL</b>: ‘During your relationships with midwife did you ever felt considered/understood as well as supported in your decisions?’; <b>ZVAL:</b> ‘‘Did you feel sometimes inappropriate in your questions and/or judged for your choices? (midwife)’; <b>A2VAL</b> ‘Did you feel the need of more assistance during the first hours after delivery?’; <b>B2VAL</b>: ‘Did you judge as sufficient the information and the received assistance after you went back home?’; <b>C2VAL</b> ‘Did you receive a psychological support from health care professionals?.</p><p>Loading pattern for Evaluation variables (bolded values point to variables relevant for component meaning, Italics to borderline items).</p

Loading pattern for Opinion variables (bolded values point to variables relevant for component meaning, Italics to borderline items).

<p><b>Variable codes</b>: <b>AOP</b> = How much did you need physician during pregnancy?; <b>BOP</b> = How much did you need midwife during pregnancy?; <b>COP</b> = How much did you think the physician gender is important?; <b>DOP</b> = Did you prefer a male or female doctor? (1 = Male, 0 = Female); <b>NOP</b> = ‘How should be the perfect doctor/patient relationships? (High values: Mostly based on human relationships; Low Values: Mostly based on technical proficiency; Intermediate Values: Balance between human and technical); <b>LOP</b> = ‘How should be the perfect midwife/patient relationships? (High values: Mostly based on human relationships; Low Values: Mostly based on technical proficiency; Intermediate Values: Balance between human and technical); <b>FOP</b> = Are you used to verify the doctor or midwife suggestions on Internet?; <b>HOP</b> = Do you think midwife alone is sufficient for care?; <b>IOP</b> = How much dialogue is important in the patient/doctor(midwife) relation?; <b>GOP</b> = How much privacy is important in the relation with healthcare professionals?; <b>MOP</b>: How much consideration is important in the relationships with healthcare professionals?; <b>POP</b>: How much human virtues of the physician are important?; <b>QOP</b>: How much human virtues of the patient are important?.</p><p>Loading pattern for Opinion variables (bolded values point to variables relevant for component meaning, Italics to borderline items).</p