La percezione degli infermieri della morte del paziente oncologico: uno studio qualitativo

Background: Il tema della morte è uno dei fondamentali problemi con cui gli infermieri si possono confrontare nell’agire professionale ed al quale difficilmente si è profondamente e sinceramente preparati. Le difficoltà nel gestire il carico emotivo possono indurlo a sviluppare sentimenti negativi nei confronti della vita e, nella pratica clinica tali da influenzare le capacità di caregiving e la qualità delle cure fornite.  OBIETTIVO: esplorare le percezioni dell’infermiere di fronte alla morte del paziente degente nei reparti di oncologia.  METODO: Studio qualitativo fenomenologico. Il campione di infermieri è stato reclutato presso un I.R.C.C.S. di Roma, un Hospice di Latina ed uno di Rieti. I dati sono stati raccolti mediante mediante focus group. Le interviste semi-strutturate caratterizzate da tre domande costruite ad hoc, audio-registrate, sono state poi trascritte ed analizzate utilizzando il framework analysis approach.  RISULTATI: sono stati condotti in totale 7 focus group con una partecipazione in totale di 39 infemieri. Dall’analisi qualitativa sono emersi quattro temi: “I diversi significati della morte”, “Lo strappo della morte”, “Le variabili percettive della morte”, “Le richieste di aiuto”.  CONCLUSIONI: Lo studio ha evidenziato la necessità di fornire al personale infermieristico un importante supporto psicologico ed emotivo, e di porre attenzione agli elementi organizzativi-ambientali per una migliore gestione dell’evento morte in oncologia.  PAROLE CHIAVE: Infermiere, fine vita, morte,paziente oncologico, studio qualitativo, cure palliative, psiconcologia BACKGROUND: Death is one of the basic theme with which nurses are faced, and for which it is hard for them to prepare deeply and sincerely.  The difficulties in handling the emotional burden can cause them to develop negative feelings towards life and clinical practice, so that it affects their caregiving capacity and the quality of care provided.  AIM: To explore nurses’ perceptions facing the death of a hospitalized oncology patient.  METHODS: Qualitative phenomenological study. The sample of nurses was recruited at IRCCS (Scientific Institute for Research and Healthcare) in Rome, a hospice in Latina and a hospice in Rieti. The data were collected by means of focus groups. The semi-structured interviews featuring three guiding questions constructed for this purpose, were audio-recorded, transcribed, and then analyzed using the analysis framework approach.  RESULTS: In total 7 focus groups were conducted with a total participation of 39 nurses. Four themes emerged from the qualitative analysis: “The different meanings of death”, “The rupture of death”, “The perceptual variables of death”, and “Requests for help”.  CONCLUSION: The study highlighted the need to provide nurses with substantial psychological and emotional support, and give consideration to organizational and environmental factors for better management of the event of death in oncology.  KEY WORDS: Nurse, end of life, nurses perception, death, oncology patient, qualitative study, palliative care, psycho-oncology&nbsp

Management of the patient with urostomy: Caregiver needs during the three months after discharge. A qualitative study

Objective: To examine caregivers' experiences and training needs after radical cystectomy with urinary diversion for the first three months following the patient's discharge. Methods: This study applied a phenomenological design approach through open-ended interviews and descriptive analysis. Phenomenology applied to empirical research requires researchers to explore the empirical facts narrated by partici-pants. This study followed the Consolidated Criteria for Reporting Qualitative Research guidelines, a 32 – item checklist for inter-views and focus groups. The study population included caregivers of bladder cancer patients, admitted to three Italian hospitals. Data were collected between March 2020 and March 2022. Results: Fifty-two caregivers of patients who underwent cystecto-my with urinary diversion from three Italian hospitals (41 males and 11 females) participated to the study. The data analysis con-verged in the identification of three themes – with sub-themes –that included various aspects of the caregiver's lived experiences: 1) living with the burden of being indispensable, for the family member, 2) feeling abandoned by institutions, 3) tiredness and less willingness to look after the relative due to work burden. Conclusions: Our study demonstrates that the caregiver of a patient with bladder cancer and urostomy in the first three months of hospital discharge is very worried and stressed. Despite the training program received in hospital, the caregiver does not recognize the newly acquired skills and has difficulty applying them. Further study would be required

Adherence to hormone therapy in women with breast cancer: a quantitative study

Introduction: The majority of patients with hormone receptor-positive breast cancer are treated with oral endocrine therapies, which are administered in periods ranging from 5 to 10 years. Adherence, ie the degree a subject's behavior corresponds to the agreed recommendations, then becomes a significant problem, which can also affect distress levels. The aim of this study is to evaluate the level of adherence to endocrine therapy and distress in a sample of Italian women.Methods: The study is a descriptive cross sectional survey. Adherence was measured with the Morisky Medication Adherence 8-item Scale and distress was measured by the Distress Thermometer. Socio-demographic and clinical data were also collected and then processed.Results: Adherence measured with MMAS-8 items scored 6.18 corresponding to an average level of adherence in the 151 patients examined. The only factors affecting adherence significantly were: level of education, marital status and, among the side effects of therapy, poor concentration and memory. The data analysis obtained from the Distress Thermometer showed a degree of discomfort equal to 4.71,For example, in younger patients' levels of distress are greater in relationships, whereas in married/defacto women and workers distress levels are greater in practical areas.Conclusions: Results from this study can be useful to identify patients at risk for non-adherence and distress, and consequently to help, the oncology team. Despite this, the study of adherence and related-factors needs further investigation. Keywords: Breastcancer, Endocrine Therapy, Adherence, Distress"ƒAderenza alla terapia ormonale nelle donne con carcinoma mammario: uno studio quantitativo Introduzione: La quasi totalití  delle pazienti con carcinoma mammario positivo ai recettori ormonali, viene trattata con terapie endocrine orali, da assumere per periodi che variano dai 5 ai 10 anni. L'aderenza, ossia il grado con il quale il comportamento di un soggetto corrisponde a quanto concordato con il medico, diviene quindi un problema rilevante, sul quale può incidere anche il Distress. L'obiettivo di questo studio è quello di valutare l'aderenza alla terapia endocrina ed il distress, in un campione di donne italiane.Metodi: Nell'indagine quantitativa descrittiva, per la raccolta dati è stato utilizzato il questionario per l'aderenza MMAS-8-item, una scheda di raccolta dati socio-demografici-clinici ed il DistressThermometer. I dati sono stati elaborati mediante il programma SPSS.Risultati: L'analisi dell'aderenza ha riportato, per le 151 pazienti prese in esame, un indice medio pari a 6.18. E' inoltre emerso che il livello d'istruzione, lo stato civile e la difficoltí  di concentrazione/memoria, incidono sull'aderenza. L'analisi dei dati ottenuti dal DistressThermometer ha evidenziato un grado di disagio pari a 4.71 che, per esempio,nelle pazienti più giovani è maggiore nell'area relazionale, mentre nelle donne coniugate/conviventi e in quelle lavoratrici è maggiore nell'area pratica.Conclusioni: Lo studio mette in evidenza come il campione risulti mediamente aderente e con un livello di distress medio-basso. Queste informazioni possono essere utili per identificare le pazienti a rischio di non-aderenza e di distress,ed aiutare, di riflesso, il team di oncologia. Nonostante questo, lo studio sull'aderenza e sui fattori ad essa correlati necessita di ulteriori indagini. Parole Chiave: Carcinoma Mammario, Terapia Endocrina, Aderenza, Distres

Nurses' perception of the oncology patient's death: a qualitative study

Background: Death is one of the basic theme with which nurses are faced, and for which it is hard for them to prepare deeply and sincerely. The difficulties in handling the emotional burden can cause them to develop negative feelings towards life and clinical practice, so that it affects their caregiving capacity and the quality of care provided. Aim: To explore nurses' perceptions facing the death of a hospitalized oncology patient. Methods: Qualitative phenomenological study. The sample of nurses was recruited at IRCCS (Scientific Institute for Research and Healthcare) in Rome, a hospice in Latina and a hospice in Rieti. The data were collected by means of focus groups. The semi-structured interviews featuring three guiding questions constructed for this purpose, were audio-recorded, transcribed, and then analyzed using the analysis framework approach. Results: In total 7 focus groups were conducted with a total participation of 39 nurses. Four themes emerged from the qualitative analysis: "The different meanings of death", "The rupture of death", "The perceptual variables of death", and "Requests for help". Conclusion: The study highlighted the need to provide nurses with substantial psychological and emotional support, and give consideration to organizational and environmental factors for better management of the event of death in oncology

Covid-19 and Personal Protective Equipment: the experience of nurses engaged in care of Sars-Cov-2 patients: a phenomenological study

To explore experiences of nurses who have worked in Covid-19 wards providing care for Covid-19 patients

Validazione Linguistica e Adattamento Culturale della Scala Infermieristica sul Ragionamento Clinico

 Introduzione: Il ragionamento clinico è un processo nel corso del quale gli infermieri raccolgono spunti, elaborano le informazioni arrivano a comprendere il problema o la situazione del paziente pianificando e attuando gli interventi, valutando i risultati. Disegno dello studio: Obiettivo di questo studio è effettuare la validazione linguistica e culturale per il contesto Italiano della Nurse Clinical Reasoning Scale (NCRS).Metodi: L'adattamento transculturale per sviluppare la versione italiana del questionario è stato effettuato seguendo le linee guida proposte da Beaton e collaboratori nel 2000.Risultati: I risultati hanno evidenziato che la versione italiana dello strumento risulta affidabile sia dimostrando una buona coerenza interna (Alpha di Cronbach = 0.90), che una buona stabilití  (ICC= 0.90; CI = 0.87-0.92; p= <0.001) e può essere proposta come un interessante mezzo di valutazione degli studenti infermieri nel corso dei tirocini clinici ed infermieri nella loro pratica clinica quotidiana.Conclusioni: Avere a disposizione strumenti in lingua italiana favorisce la realizzazione di nuovi progetti di ricerca in vari ambiti, come quello sanitario, al fine di garantire la centralití  del paziente nel processo assistenziale. Parole chiave: ragionamento clinico, competenze, validazione linguistica, infermieristica, studenti infermieri Linguistic validation and cultural adaptation of the Nurse Clinical Reasoning ScaleIntroduction: The clinical reasoning is a process in which nurses collect ideas, process information, they come to understand the problem or the patient's situation by planning and implementing interventions, evaluating the results. Study design: The aim of this study is to perform linguistic and cultural validation for the Italian context of the Nurse Clinical Reasoning Scale (NCRS). Methods: Transcultural adaptation to develop the Italian version of the questionnaire was carried out following the guidelines proposed by Beaton and collaborators in 2000. Results: The results showed that the Italian version of the instrument is reliable both showing a good internal consistency (Cronbach's Alpha = 0.90), and a good stability (ICC = 0.90; CI = 0.87-0.92; p = <0.001) and can be proposed as an interesting means of evaluating nursing students in the course of clinical placements and nurses in their daily clinical practice. Conclusions: Having tools available in Italian promotes the implementation of new research projects in various areas, such as health, in order to ensure the centrality of the patient in the care process. Key words: clinical reasoning, skills, linguistic validation, nursing, nursing student

Psychometric Properties of the Italian Version of the Leader Member Exchange Scale (LMX-7): A Validation Study

: For decades, scholars have studied leader-member exchange (LMX) relationships to understand and explain the effects of leadership on follower attitudes and performance outcomes within work settings. One available instrument to measure these aspects is the LMX-7 scale. This measurement has been widely used in empirical studies, but its psychometric properties have been poorly explored. The aim of this study was to test the psychometric characteristics (content, structural and construct validity, and reliability) of the Italian version of the LMX-7 scale and to support its cultural adaptation. We used a cross-sectional multi-center design. The forward-backward translation process was used to develop the Italian version of the scale. The scale was administered through an online survey to 837 nurses and nurse managers working in different settings. The factorial structure was tested using both exploratory and confirmatory factor analyses (EFA and CFA), and reliability was evaluated using Cronbach's alpha. For the construct validity, we used hypothesis testing and differentiation by known groups. The Italian version of the LMX-7 scale presented one dimension. All the psychometric tests performed confirmed its validity and suggested its usefulness for future research