Il coraggio degli infermieri ai tempi del COVID-19

La diffusione del SARS-COV-2 è stata annunciata a partire dal 9 gennaio 2020, quando l'Organizzazione Mondiale della Sanità (OMS) ha dichiarato che le autorità sanitarie cinesi avevano individuato un nuovo ceppo di coronavirus mai prima identificato nel genere umano. Il virus è stato chiamato dapprima 2019-nCoV, per poi essere ufficialmente e definitivamente classificato con il nome di SARS-CoV-2. La sua diffusione è stata associata a un focolaio di polmoniti segnalato il 31 dicembre 2019 in Cina, nella sua parte centrale, nella città di Wuhan. La malattia respiratoria causata dal nuovo coronavirus ha preso il nome di COVID-19 con dichiarazione dell'OMS del seguente 11 febbraio. I primi due casi presenti in Italia sono stati confermati dall'Istituto Superiore di Sanità (ISS) in data 30 gennaio, successivamente il 21 febbraio è stato individuato un nuovo caso, identificato come il primo caso autoctono su territorio nazionale1. In seguito alla velocità e alla dimensione del contagio da parte del nuovo virus, l’OMS, in data 11 marzo 2020 ha dichiarato che l’infezione internazionale poteva essere considerata una pandemia. Dall’inizio della diffusione del virus, la pandemia ha creato danni enormi in tutti i Paesi del globo, con milioni di persone che hanno perso la vita. Gli infermieri e gli operatori dei sistemi sanitari nazionali di tutti i Paesi colpiti hanno visto stravolgere le proprie vite e i propri setting lavorativi in maniera repentina per far fronte con coraggio a questa pandemia, spesso non senza conseguenze. Infatti, basti considerare che in Italia il 72,2% dei contagi sul lavoro avvengono nel settore sanitario e di questi l’83% è rappresentato dagli infermieri, e in totale si contano una percentuale che ha superato, in alcune fasi della pandemia, anche il 15% di tutti i casi di COVID19 su territorio nazionale.La diffusione del SARS-COV-2 è stata annunciata a partire dal 9 gennaio 2020, quando l'Organizzazione Mondiale della Sanità (OMS) ha dichiarato che le autorità sanitarie cinesi avevano individuato un nuovo ceppo di coronavirus mai prima identificato nel genere umano. Il virus è stato chiamato dapprima 2019-nCoV, per poi essere ufficialmente e definitivamente classificato con il nome di SARS-CoV-2. La sua diffusione è stata associata a un focolaio di polmoniti segnalato il 31 dicembre 2019 in Cina, nella sua parte centrale, nella città di Wuhan. La malattia respiratoria causata dal nuovo coronavirus ha preso il nome di COVID-19 con dichiarazione dell'OMS del seguente 11 febbraio. I primi due casi presenti in Italia sono stati confermati dall'Istituto Superiore di Sanità (ISS) in data 30 gennaio, successivamente il 21 febbraio è stato individuato un nuovo caso, identificato come il primo caso autoctono su territorio nazionale1. In seguito alla velocità e alla dimensione del contagio da parte del nuovo virus, l’OMS, in data 11 marzo 2020 ha dichiarato che l’infezione internazionale poteva essere considerata una pandemia. Dall’inizio della diffusione del virus, la pandemia ha creato danni enormi in tutti i Paesi del globo, con milioni di persone che hanno perso la vita. Gli infermieri e gli operatori dei sistemi sanitari nazionali di tutti i Paesi colpiti hanno visto stravolgere le proprie vite e i propri setting lavorativi in maniera repentina per far fronte con coraggio a questa pandemia, spesso non senza conseguenze. Infatti, basti considerare che in Italia il 72,2% dei contagi sul lavoro avvengono nel settore sanitario e di questi l’83% è rappresentato dagli infermieri, e in totale si contano una percentuale che ha superato, in alcune fasi della pandemia, anche il 15% di tutti i casi di COVID19 su territorio nazionale

Governance nell'innovazione: Sanità Digitale, Mobile Health, Big Data, Virtual Reality

The introduction of modern Information and Communication Technologies (ICT) was one of the most remarkable innovations of recent decades. ICT brings with it a remarkable technological background that conveys all kinds of information and multimedia content with a significant change in human-technology interaction and significant implications also in the health sector. The constant process of digitization is increasingly affecting national health systems (SSN) and they turn out to be influenced by the process itself, where the literature shows itself in favor of the use of technologies in health, improving their effectiveness and efficiency. These include eHealth, Telemedicine, Electronic Health File, Big Data, Virtual Reality, Augmented Reality, ePrescription. The technologies allow, even remotely, to have an always active and direct contact, between the various professionals, and between professionals and users, and are also useful for the training of both healthcare professionals and users themselves. The use of technology in the healthcare sector should therefore be encouraged as it allows direct contacts between users and healthcare personnel, speed and correlation of data analysis, tracking, time and cost savings, reduction of errors and a positive environmental impact with a reduction in the use of printed paper. For all the points listed, the technological revolution in hospital and territorial care can no longer be postponed

Valutazione Del Benessere Psico-Fisico Nell'aderenza Terapeutica Nelle Donne Con Malattia Renale Policistica Autosomica Dominante: Uno Studio Osservazionale

Evaluation Of The Psychophysical Well-Being In The Compliance Of Women With Autosomal Dominant Policystic Kidney Disease: An Observational Study BACKGROUND: Autosomal dominant polycystic kidney disease is the most common inherited renal disease and affects less than 1 every 400-1,000 people. There are many effective treatments, including blood pressure management, physical activity, low sodium diet and hydration. Therapeutic education is part of a patient's care and treatment. This approach is an essential strategy in order to face the current healthcare scenario, in which the number of people affected by chronic diseases is progressively increasing. OBJECTIVES: This article aims to analyze the effect of therapeutic education in patients with ADPKD, the level of adherence to pharmacological therapy and their compliance to dietetic and lifestyle recommendations as part of a nursing-led education. METHODS: This is a prospective, longitudinal, observational pilot study. The following measurements were used: Kidney Disease Quality of life - Short Form, Hospital Anxiety and Depression Scale, Body Uneasiness Test. At the T0 visit, a nurse selected patients and carried out a personalized educational intervention with the aims of adhering to drug therapies, monitoring blood pressure and dietary behavior (physical activity and water intake). At the T1 visit, patients performed psychological tests. At the T2 visit, the following evaluations were performed: a psychological interview together with the delivery and evaluation of the tests performed, an interview with the nurse to evaluate the adherence to the prescriptions, and a control of parameters such as physical activity, diet, water intake, drug therapy, and blood pressure. RESULTS: Therapeutic education can have a positive impact on patients' health by improving adherence to the pharmacological therapy, diet and lifestyle. CONCLUSIONS: Therapeutic education improve the patient's knowledge, treatments and correct behaviors as well as promotes an independent management of the disease. Through an educational intervention, the patient acquires the ability and the awareness to modify the wrong behaviors and to guarantee a balance between his needs and the pathology, thus improving the quality of life

L'eredità di Florence Nightingale nel 2020, Anno Internazionale dell'infermiere: una revisione narrativa

Background: Nurses guarantee assistance using different nursing theories, which present different conceptual frameworks, but which have a common vision in the whole of the human being, his holistic needs and the connection with the environment. Florence Nightingale was the first to introduce aspects of the scientific method, structuring a theory focused on the connection between the management of the physical environment and the actions of nurses. Methods: The aim is the evaluation of Nightingale's theory in reference to its contemporary integration, through a narrative review of the literature. Results: The action of nurses on the environment according to Nightingale's theory in care settings and hand hygiene are identified as fundamental in the fight against the spread of infections and in the implementation of the holistic vision. Discussion: Nightingale's theory shows elements of applicability and modernity, such as the acquisition of a greater awareness of healthcare professionals in relation to the care of environments and hand hygiene. Conclusions: Florence Nightingale's theory presents aspects of validity, but further studies are needed to contribute to the evolution of her model, especially in its contemporary contextualization

Effectiveness of Rhythmic Auditory Stimulation on Gait in Parkinson Disease: A Systematic Review and Meta-analysis

Parkinson disease is a neurodegenerative disease present in approximately 2% of the population older than 65 years. Rhythmic auditory stimulation in the early 1990s aimed to improve individual mobility in terms of gait speed, stride length, and cadence. Our systematic review and meta-analysis aimed to summarize and evaluate the evidence of the effects of rhythmic auditory stimulation on gait speed, stride length, and cadence in patients with Parkinson disease. A systematic review and meta-analysis of randomized controlled trials was conducted to determine the efficacy of rhythmic auditory stimulation in patients with Parkinson disease. Five studies were included in the review (209 patients). Rhythmic auditory stimulation resulted, on average, a gait speed improvement of 0.53 standard deviation (SD) units (95% CI, 0.23 to 0.83; P = .0005), a stride length improvement of 0.51 SD units (95% CI, 0.18 to 0.84; P = .003) greater than that in the control group. All trials contained a risk of bias due to a lack of blinding. The quality of evidence was low. No adverse events were identified. Rhythmic auditory stimulation may have a beneficial effect on gait speed and stride length in patients with Parkinson disease. Future studies should consider a power analysis to recruit an adequate number of subjects and minimize the risk of sample bias. Further research should provide the additional results required for an acceptable estimate of the effects of rhythmic auditory stimulation on gait in patients with Parkinson disease

The impact of listening to music on orthopedic patients: a randomized controlled trial|Effetti dell'ascolto della musica in pazienti ortopedici: uno studio randomizzato controllato]

BACKGROUND. Music listening represents a gold standard in the evidence-based holistic nursing practice. However, music listening is seldom involved in orthopedic postoperative settings, and only a few related studies can be retrieved in literature. Purpose. The aim was to assess the effects of music during the orthopedic postoperative period, when patients frequently report pain and anxiety. METHODS. A randomized controlled trial on 56 patients, equally divided in an experimental group treated with music and a control group in standard care, was conducted during their first-day of recovery from orthopedic surgery. The primary outcome was the pain level assessed with the VAS scale and the Short Form-McGill Pain Questionnaire. Secondary outcomes assessed were anxiety level, blood pressure, heart and respiratory rates and oxygen saturation. Following surgery, when clinically stabilized and soon after their return to their ward room, patients listened to music from a personal programmed playlist using their smartphones for 30 minutes. RESULTS . In music group, the Short Form-McGill Pain Questionnaire score significantly improved in the sensorial dimension (p=0.006) and in the affective dimension (p=0.02). Patients showed a pleasant experience in listening to music (90%), found it useful in coping with pain (64%) and improving mood (86%). CONCLUSIONS. Music in the orthopedic post-surgical period induced significant improvement in pain relief, representing a useful complementary intervention to drug treatment. Music listening could be a safe treatment, inexpensive and simple to manage by nurses in orthopedic postoperative settings

Effetti dell'ascolto della musica in pazienti ortopedici: uno studio randomizzato controllato

Background. Music listening represents a gold standard in the evidence-based holistic nursing practice. However, music listening is seldom involved in orthopedic postoperative settings, and only a few related studies can be retrieved in literature. Purpose. The aim was to assess the effects of music during the orthopedic postoperative period, when patients frequently report pain and anxiety. Methods. A randomized controlled trial on 56 patients, equally divided in an experimental group treated with music and a control group in standard care, was conducted during their first-day of recovery from orthopedic surgery. The primary outcome was the pain level assessed with the VAS scale and the Short Form-McGill Pain Questionnaire. Secondary outcomes assessed were anxiety level, blood pressure, heart and respiratory rates and oxygen saturation. Following surgery, when clinically stabilized and soon after their return to their ward room, patients listened to music from a personal programmed playlist using their smartphones for 30 minutes. Results . In music group, the Short Form-McGill Pain Questionnaire score significantly improved in the sensorial dimension (p=0.006) and in the affective dimension (p=0.02). Patients showed a pleasant experience in listening to music (90%), found it useful in coping with pain (64%) and improving mood (86%). Conclusions. Music in the orthopedic post-surgical period induced significant improvement in pain relief, representing a useful complementary intervention to drug treatment. Music listening could be a safe treatment, inexpensive and simple to manage by nurses in orthopedic postoperative settings. Introduzione. L'ascolto della musica rappresenta un punto di riferimento nella pratica infermieristica olistica basata sull'evidenza. Tuttavia l'ascolto di musica a scopi terapeutici è raramente utilizzato nei settings assistenziali postoperatori ortopedici. Scopo. Valutare gli effetti della musica durante il periodo post-operatorio ortopedico, fase in cui i pazienti manifestano frequentemente dolore e ansia. Metodi. Studio randomizzato controllato, su 56 pazienti durante il il primo giorno post operatorio, allocati in maniera bilanciata in un gruppo sperimentale trattato con la musica e un gruppo di controllo in assistenza standard. L'outcome primario era il livello di dolore valutato con la scala VAS e il Short Form-McGill Pain Questionnaire. Gli outcomes secondari sono stati il livello di ansia, pressione arteriosa, frequenza cardiaca, frequenza respiratoria e la saturazione dell'ossigeno. Al rientro nella camera di degenza dopo l'intervento chirurgico in condizioni cliniche stabilizzate, i pazienti hanno ascoltato musica da una playlist personalizzata usando il proprio smartphone per 30 minuti. Risultati. Nel gruppo musica, il punteggio dello Short Form-McGill Pain Questionnaire è significativamente migliorato nella dimensione sensoriale (p = 0,006) e nella dimensione affettiva (p = 0,02). I pazienti hanno riportato una piacevole esperienza nell'ascolto della musica (90%), trovandola utile per la gestione del dolore (64%) e nel migliorare l'umore (86%). Conclusioni. La musica nel periodo post-chirurgico ortopedico ha mostrato un significativo miglioramento nel livello del dolore, rappresentando un'utile intervento complementare al trattamento farmacologico. L'ascolto della musica potrebbe essere un trattamento sicuro, economico e semplice da gestire da parte degli infermieri in ambito postoperatorio ortopedico

Virtual reality in dialysis: a new perspective on care

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