Nurses as seen by patients: a phenomenological study

Objective: during the various periods of the history of the nursing profession, many differing representations of nurses have emerged in the collective imagination. The main purpose of this study, based on a qualitative approach, has been to discover the images of the nurse that patients retain in their minds when receiving care. Method: 6 sound-recorded focus groups were created, made up of patients and caregivers. These persons were members of 6 associations. The recordings and observations made were then analysed by adopting a hermeneutic phenomenological approach. Results: 6 themes characterising nurses emerged: Training; Between flexibility and personalisation; Organisation and nursing; Continuity in caregiving; Professional maturity; and Relations. While these themes do not provide a uniform definition for the figure of the nurse they do present the profiles that had the greatest impact on persons receiving care. Conclusions: From the experiences collected among the participants in the focus groups, no pre-defined "image" of nurses emerged, and the stereotypes and prejudices described in the literature were also not to be found. Important indications did, in any case, emerge as to the type of nurse these people want, and concerning areas which must be worked on. These indications provide valuable information that, if acted upon, might contribute to the profession's growth and improvement. In brief, there are various planes of activity upon which nurses should concentrate their efforts: training (greater specialisation), organisation (greater flexibility), and the profession (consideration of professional identity in the light of the task of meeting patients' needs).Keywords: Image, perception, stereotypes, portrayal, role of nurses, patientGli infermieri visti attraverso gli occhi dei pazienti: uno studio fenomenologicoObiettivo: Nel corso della storia professionale, gli infermieri hanno suscitato diverse e spesso distanti rappresentazioni di loro stessi nell'immaginario delle persone. Lo scopo principale di questa indagine, strutturata con approccio qualitativo, è stato quello di comprendere quale immagine d'infermiere si era impressa nella mente delle persone assistite durante un percorso di malattia. Metodo: Sono stati realizzati 6 focus group audio registrati, che hanno interessato sia pazienti che care giver, facenti parte di 6 associazioni diverse. Successivamente, le registrazioni e le osservazioni evidenziate sono state analizzate utilizzando un approccio fenomenologico ermeneutico. Risultati: Sono stati identificati 6 temi caratterizzanti gli infermieri: Formazione; Tra flessibilití  e personalizzazione; L'organizzazione e l'infermieristica; La continuití  assistenziale; La maturití  professionale; La relazione. Questi temi non definiscono una figura di infermiere uniforme, ma ne raffigurano i profili che hanno avuto particolare impatto sulle persone assistite. Conclusioni: Dalle esperienze raccolte dai partecipanti ai focus group non emerge una "immagine" predefinita d'infermiere, né si riscontra la presenza degli stereotipi e dei pregiudizi descritti in letteratura, ma emergono importanti indicazioni su quale tipo d'infermiere queste persone desiderano e su quali ambiti sia necessario lavorare, fornendo preziose informazione che, se accolte, consentirebbero di orientare la crescita e il miglioramento della professione. Essenzialmente, gli infermieri dovrebbero concentrarsi sui piani: formativo (maggiore specializzazione), organizzativo (più flessibilití ), professionale (riflessione sull'identití  professionale in funzione del soddisfacimento dei bisogni dei pazienti). Parole Chiave: Immagine, percezione, stereotipi, ritratto, ruolo dell'infermieri, pazient

Molecular classifications of gastric cancers: Novel insights and possible future applications

Despite some notable advances in the systemic management of gastric cancer (GC), the prognosis of patients with advanced disease remains overall poor and their chance of cure is anecdotic. In a molecularly selected population, a median overall survival of 13.8 mo has been reached with the use of human epidermal growth factor 2 (HER2) inhibitors in combination with chemotherapy, which has soon after become the standard of care for patients with HER2-overexpressing GC. Moreover, oncologists have recognized the clinical utility of conceiving cancers as a collection of different molecularly-driven entities rather than a single disease. Several molecular drivers have been identified as having crucial roles in other tumors and new molecular classifications have been recently proposed for gastric cancer as well. Not only these classifications allow the identification of different tumor subtypes with unique features, but also they serve as springboard for the development of different therapeutic strategies. Hopefully, the application of standard systemic chemotherapy, specific targeted agents, immunotherapy or even surgery in specific cancer subgroups will help maximizing treatment outcomes and will avoid treating patients with minimal chance to respond, therefore diluting the average benefit. In this review, we aim at elucidating the aspects of GC molecular subtypes, and the possible future applications of such molecular analyses