Quali sono i bisogni dei caregiver di persone che vivono una condizione di cronicità: ricerca qualitativa

Background: The population ageing generates new challenges related to the treatment of chronic diseases. The course of the disease makes patients and caregivers (CGs) vulnerable and their ability to self-care is threatened. CGs can be supported by the Advanced Practice Nurse (APN). Objective: The aim is to deepen the CGs’ needs of people with chronic conditions in Insubrica region. Method: It’s a qualitative descriptive survey, conducted between September 2019 and February 2020. The CGs’ convenience sample of people with chronic illness was differentiated by age, gender, profession, chronic diseases and included 20 participants. Data were collected through short motivational interviews and the compilation of a socio-family genogram. The thematic analysis of the interviews’ Verbatim transcription was carried out by 4 researchers. Results: The thematic analysis has shown 26 themes collected in 6 macrothemes and in addition highlighted that the chronic condition and vulnerability are linked together; therapeutic adherence and self-care depend on disease awareness, and CGs make little use of the social support network; Conclusion: Based on the results, it can be said that the APN can meet the GCs' needs through the skills gained in training (CanMEDS and Hamric model); encourage inter-professional and integrated care, and promote the formal and informal network.Introduzione: L’invecchiamento della popolazione genera nuove sfide nella cura delle malattie croniche. Alcuni eventi nel corso della malattia rendono pazienti e caregiver (CG) vulnerabili quando viene minacciata la loro capacità di self-care. Il CG può essere sostenuto dall’infermiere di pratica clinica avanzata (APN). Obiettivo: Approfondire i bisogni dei CG di persone in condizioni croniche nella regione insubrica. Metodo: Indagine descrittiva qualitativa, condotta fra settembre 2019 e febbraio 2020. Il campione di convenienza di CG di malati cronici differenziato per: età, sesso, professione, malattie croniche ha incluso 20 partecipanti. La raccolta dati è avvenuta tramite interviste motivazionali brevi e la compilazione di un genogramma socio-familiare. L’analisi tematica della trascrizione Verbatim delle interviste è stata svolta da 4 ricercatori. Risultati: L’analisi tematica ha fatto emergere 26 temi raggruppati in 6 macrotemi oltre ad evidenziare che le condizione di cronicità e vulnerabilità sono legate fra loro; l’aderenza terapeutica e il self-care dipendono dalla consapevolezza della malattia; i CG utilizzano scarsamente la rete di sostegno sociale; il malato e il CG, attraverso la sofferenza e le difficoltà, mettono in discussione molti aspetti della vita. Conclusioni: Sulla base dei risultati emersi è possibile affermare che l’APN può essere utile a soddisfare i bisogni dei CG grazie alle competenze acquisite nella formazione (basata su modello CanMEDS e Hamric), favorire una presa a carico interprofessionale e integrata e promuovere la rete formale e informale

Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry

The pandemic represented a challenge for hospital managers at different levels, required to reorganise services without compromising care. This study aimed to analyse the experiences of hospital managers during the COVID-19 pandemic. A narrative inquiry was conducted in a multisite acute hospital. Data were collected through narratives and open-ended questions. Direct and non-direct-care managers were invited to participate. Data were analyzed considering Clandinin & Connelly’s (2000) framework and Braun & Clarke, (2006). Thirty-six narratives and open-ended question responses were analysed. Participants were nurses (n = 20), doctors, technicians, administrative and hospitality service managers. Themes were grouped into three narrative dimensions: (1) personal—“the emergency engulfed us”, (2) practical/professional—“managing the pandemic”, (3) social—“the strength of the team and people”. Different narrative threads were identified between direct-care and non direct-care managers. Problems faced, factors helpful for management and suggestions for improvement were also reported. The pandemic had an important impact on managers and their roles, in terms of the need for clear concise information, staff support, and adequate professional and technical resources. A sense of unity and belonging facilitated management