Mappatura della letteratura sulle soluzioni digitali e tecnologiche nell'assistenza infermieristica: un protocollo di scoping review

   INTRODUCTION: Digital and technological solutions (DTS) might have an impact on people’s personal and professional lives. These types of solutions, according to studies, have the potential to revolutionize and improve the quality and long-term sustainability of healthcare activities, with nurses playing a significant role. Although DTS appears to be intimately linked to the future of nursing, technology must be utilized as an active rather than passive tool. Nonetheless, understanding DTS appears to be difficult, and a scoping study can provide a thorough overview of such a complicated topic. As a result, the scoping study on this topic will map all of the important aspects of DTS and synthesize studies on the nursing workforce, as well as analyze and clarify knowledge gaps and aid future research and development. This article presents the study protocol.  METHODS: The Joanna Briggs Institute (JBI) scoping review methodology will be used for the proposed scoping review. It will include both quantitative and qualitative scientific research as well as grey literature on DTS in nursing. Only English-language works will be considered for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers, and extracting data. Disagreements among reviewers will be resolved through debate until a consensus is reached or through consultation with the study team if necessary. Results will be presented using descriptive statistics, diagrammatic or tabular displayed information, and narrative summaries, as specified in the JBI guidelines.  DISCUSSION: This scoping review protocol explained why it is important to describe the literature on embracing DTS in the nursing field, how to approach the research process, and what the study's key implications will be. The protocol itself may be helpful to increase transparency in the research process, attract interested researchers to work with the group that developed the protocol and offer a practical methodological benchmark for researchers interested in performing scoping reviews by serving as an example of a scoping review protocol.  KEYWORDS: Digital solutions; Technological solutions; Nursing; Scoping review; Study protocol; Framework    INTRODUZIONE: Le soluzioni digitali e tecnologiche potrebbero avere un impatto sulla vita personale e professionale della popolazione. Questi tipi di soluzioni, secondo gli studi, hanno il potenziale per rivoluzionare e migliorare la qualità e la sostenibilità a lungo termine delle attività di salute, deve gli infermieri svolgono un ruolo significativo di innovatori, facilitatori e gestori dei processi. Sebbene le soluzioni digitali e tecnologiche sembrino essere intimamente legate al futuro dell’assistenza infermieristica, la tecnologia deve essere utilizzata come strumento attivo, piuttosto che passivo. Tuttavia, la comprensione del fenomeno sembra essere difficile e una scoping review può fornire una panoramica completa di un argomento di tale complessità. Di conseguenza, la presente scoping review mapperà tutti gli aspetti salienti legati alle soluzioni digitali e tecnologiche e sintetizzerà gli studi sul coinvolgimento della professione infermieristica, nonché analizzerà e chiarirà le lacune di conoscenza presenti e aiuterà la ricerca e i progetti futuri. Questo articolo presenta il protocollo di studio di scoping review per raggiungere l’obiettivo di mappatura della letteratura.  METODI: Il protocollo utilizza la metodologia di scoping review del Joanna Briggs Institute (JBI). Comprenderà sia la ricerca scientifica quantitativa che qualitativa, nonché la letteratura grigia sulle soluzioni digitali e tecnologiche nell’assistenza infermieristica. Solo i lavori in lingua inglese saranno presi in considerazione per l’inclusione. Due revisori indipendenti prenderanno parte a un processo iterativo di valutazione della letteratura, scelta dei documenti ed estrazione dei dati. I disaccordi tra i revisori saranno risolti attraverso il dibattito fino al raggiungimento di un consenso o attraverso la consultazione con il gruppo di studio, ove necessario. I risultati saranno presentati utilizzando statistiche descrittive, le informazioni presentate in forma grafica, tabulare o a mezzo narrativo, come specificato nelle linee guida JBI.  DISCUSSIONE: Questo protocollo di scoping review intende definire perché è importante descrivere la letteratura sull’adozione delle soluzioni digitali e tecnologiche in ambito infermieristico, come affrontare il processo di ricerca sottostante alla revisione e quali saranno le implicazioni chiave dello studio. Il protocollo stesso può essere utile per aumentare la trasparenza nel processo di ricerca, ingaggiare i ricercatori interessati a lavorare con il gruppo che ha sviluppato il protocollo (research engagement) e offrire un punto di riferimento metodologico e pratico per i ricercatori interessati a svolgere revisioni nel medesimo ambito.  PAROLE CHIAVE: Soluzioni digitali; Soluzioni tecnologiche; Infermieristica; Revisione della letteratura; Protocollo di studi

A Single-Center, Randomized Controlled Trial to Test the Efficacy of Nurse-Led Motivational Interviewing for Enhancing Self-Care in Adults with Heart Failure

Background: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance (primary endpoint), self-care management, and self-care confidence after three months from enrollment in adults with HF compared to usual care, and assessed changes in self-care over follow-up times (3, 6, 9, and 12 months). Methods: A single-center, randomized, controlled, parallel-group, superiority study with two experimental arms and a control group was performed. Allocation was in a 1:1:1 ratio between intervention groups and control. Results: MI was effective in improving self-care maintenance after three months when it was performed only for patients (arm 1) and for the patients-caregivers dyad (arm 2) (respectively, Cohen's d = 0.92, p-value < 0.001; Cohen's d = 0.68, p-value < 0.001). These effects were stable over the one-year follow-up. No effects were observed concerning self-care management, while MI moderately influenced self-care confidence. Conclusions: This study supported the adoption of nurse-led MI in the clinical management of adults with HF

Burnout precursors in oncology nurses: A preliminary cross-sectional study with a systemic organizational analysis

Burnout negatively affects nurses' health and performance. Healthcare managers have an ethical duty to create healthy organizations that reduce burnout, especially within critical settings such as oncology. The aim of this study was twofold: (1) to measure the presence of nurses' burnout to formulate organizational strategies to prevent the syndrome onset, and (2) to evaluate the effect of recent organizational changes on the burnout phenomenon. A descriptive, cross-sectional design supported by a systemic organizational analysis was conducted in a Swiss Oncology Institute in 2013. Of 103 nurses working in the Institute, 52 (51.4%) completed the Burnout Potential Inventory (BPI) questionnaire. Data were analyzed using descriptive statistics and Mann-Whitney and Kruskal-Wallis tests. Burnout risk levels were low to moderate. Only 2 nurses out of the 52 showed moderate burnout risk levels. Inpatient nurses showed a higher risk of burnout than outpatient nurses, particularly due to ambiguity and feelings of powerlessness. Nurses with post-basic education showed a higher risk when considering poor teamwork values and ambiguity in the workplace. Poor middle-management was found to negatively influence worker wellbeing. The working environment set by management resulted in low burnout risk levels. Managers must carefully select middle-management because inappropriate leadership might promote the onset of burnout

Is the equimolar mixture of oxygen and nitrous oxide (EMONO) associated with audiovisuals effective in reducing pain and side effects during peripheral venous access placement in children? Protocol for a single-centre randomised controlled trial from Italy

Introduction Nurses frequently place a peripheral venous catheter during children’s hospitalisation. Many studies suggest treatment of venipuncture-related pain. The administration of an equimolar mixture of oxygen and nitrous oxide (EMONO) is employed for pain control; however, no studies have analysed the association between EMONO and audiovisuals.The purpose of the study is to evaluate the effect of EMONO administration when combined with audiovisuals (EMONO+Audiovisual) versus EMONO alone on perceived pain, side effects and level of cooperation during peripheral venous access placement in children aged 2–5 years.Methods and analysis The first 120 eligible children admitted to the paediatric ward of the Lodi Hospital and presenting the indication for peripheral venous access will be enrolled. Sixty children will be randomly assigned to the experimental group (EMONO+Audiovisual) and 60 to the control group (EMONO alone).The Face, Legs, Activity, Cry, Consolability scale will be used to assess pain in the children aged 2-years old; pain in the children aged 3–5 years will be assessed using the Wong-Baker scale. The cooperation throughout the procedure will be measured using the Groningen Distress Rating Scale.Ethics and dissemination The Milan Area 1 Ethics Committee approved the study protocol (Experiment Registry No. 2020/ST/295). The trial results will be presented at conferences and published in peer-reviewed journals.Trial registration number NCT05435118

Technology-delivered motivational interviewing to improve health outcomes in patients with chronic conditions: a systematic review of the literature

Aims Provide an overview of remote motivational interviewing (MI) interventions for chronically ill patients, and understand their degree of effectiveness on different health outcomes. Methods and results A systematic review with meta-analysis was conducted using the following databases: PubMed, CINAHL, PsychInfo, and Web of Science. Eligibility criteria included studies that administered remote MI alone or in combination with other remote approaches. A narrative synthesis and two meta-analyses were performed. Fifteen studies met the inclusion criteria. MI administration almost exclusively occurred by telephone and individual sessions. Eight studies reported treatment fidelity aspects, and four declared adopting a theoretical framework. Most targeted outcomes were therapeutic adherence, physical activity, depression, quality of life, and mortality. Risk of bias varied markedly, with the largest source resulting from selection process and intervention performance. The two meta-analyses indicated a significant effect of MI on depression [standardized mean difference = -0.20, 95% confidence interval (CI): -0.34, -0.05, Z = 2.73, P = 0.006, I-2 = 0%], and no effect of MI on glycosylated haemoglobin (mean difference = -0.02, 95% CI: -0.48, 0.45, P = 0.94, I-2 = 84%). Conclusion Remote MI can be a promising approach for improving depression in chronic disease patients. However, studies are inconclusive due to risks of bias, heterogeneity, and lack of reporting of interventionist's training, treatment fidelity, and theoretical frameworks' use. More studies with solid designs are needed to inform clinical decision-making and research. Registration PROSPERO: CRD42021241516

Remote motivational interviewing to improve patient self-care and caregiver contribution to self-care in heart failure (REMOTIVATE-HF): Rationale, design, and methodology for a multicentre randomized controlled trial

In patients with heart failure (HF), self-care, and caregiver contribution to self-care (i.e., the daily management of the disease by patients and caregivers) are essential for improving patient outcomes. However, patients and caregivers are often inadequate in their self-care and contribution to self-care, respectively, and struggle to perform related tasks. Face-to-face motivational interviewing (MI) effectively improves self-care and caregiver contribution to self-care, but the evidence on remote MI is scarce and inconclusive. The aims of this randomized controlled trial will be to evaluate whether remote MI performed via video call in patients with HF: (1) is effective at improving self-care maintenance in patients (primary outcome); (2) is effective for the following secondary outcomes: (a) for patients: self-care management, self-care monitoring, and self-efficacy; HF symptoms; generic and disease-specific quality of life; anxiety and depression; use of healthcare services; and mortality; and (b) for caregivers: contribution to self-care, self-efficacy, and preparedness. We will conduct a two-arm randomized controlled trial. We will enroll and randomize 432 dyads (patients and their informal caregivers) in Arm 1, in which patients and caregivers will receive MI or, in Arm 2, standard care. MI will be delivered seven times over 12 months. Outcomes will be assessed at baseline and 3 (primary outcome), 6, 9, and 12 months from enrollment. This trial will demonstrate whether an inexpensive and easily deliverable intervention can improve important HF outcomes. With the restrictions on in-person healthcare professional interventions imposed by the COVID-19 pandemic, it is essential to evaluate whether MI is also effective remotely