Nurse-physician collaboration: a meta-analytical investigation of survey scores.

This meta-analysis investigated differences between nurses and physicians in interprofessional collaboration (IPC) ratings. Fifty-one surveys, representing a total of 18 782 professionals and students (13 132 nurses and nursing students, and 5650 physicians and medical students), were meta-analyzed, considering several moderating variables. Overall, nurses scored higher on IPC than physicians. Sensitivity analysis revealed that while physicians perceived more existing collaboration than nurses, nurses had a more positive attitude toward collaboration than physicians. Moreover, IPC ratings of nursing and medical students did not differ from those of practitioners. Finally, it appeared that interprofessional education interventions were able to reduce the difference in IPC between nurses and physicians

Myanmar: the ties between health and democracy

In this viewpoint, we examined the ongoing crisis of the Myanmar health system following the military takeover of 1 February 2021, the health challenges faced by the population, and the tragic conditions in which the health professionals find themselves. We describe the efforts undertaken by representatives of the democratic health and university institutions to create the conditions for a resumption of the call for peace throughout the country and strengthen the resilience of the health system. In particular, we present the interim health service strategy devised by the Myanmar Ministry of Health (MOH), as appointed by the democratic government. The MOH's plan represents the entry point to use health as a bridge for peace and restoration of democracy and human rights, showing that the health sector of a country can be reshaped and revitalized in times of great adversity

The Master in International Health of Parma University: a possible model of sanitary cooperation with developing Countries

The Master in “International Health and Medicine for Cooperation with Developing Countries” was established by CUCI, based on the evaluation that many health facilities and hospitals in the low-middle income Countries are not properly equipped to face daily emergencies. The objective of the Master’s program is to train doctors with multi-sector skills, necessary to operate in healthcare ambulatories, hospitals and medical districts, characterized by poor infrastructures and management systems, that are typical in areas of high-poverty, facing cases of emergencies of various entities. The Italian Ministry of Foreign Affairs and International Cooperation is funding a number of scholarships for the best candidates classified in the final selection rating and residing in African Countries. The Course is also open to Italians who wish to extend their professional skills in order to work in resource-constrained settings. The Master course lasts one year and includes lectures, seminars, videoconferencing and internships both at the University Hospital of Parma and in other Structures / Laboratories. The final work includes a scientific section and a project work for future collaboration with the Countries from which the doctors come from. Besides the various fields of medicine, other important themes are addressed in the course, like guidelines for hospital managements, health cooperation, development, prevention strategies. Why this Master could be a model of sanitary cooperation? The WHO and the Geneva Foundation for Medical Education and Research provide scientific support and they are involved in the teaching programme; the physicians formed in the course, once back in their Countries, are expected to facilitate training of the local staff (physicians, nurses and auxiliary personnel) and to continue collaboration; the project allows strengthening of partnerships with other Universities, Ministries, local and international Associations, NGO. The feedback of the participants who have attended the previous editions will also be discussed

Opening the horizons of clinical reasoning to qualitative research

Clinical Reasoning (CR) is an important aspect of health professional education and effective prac-tice. It is a complex series of factors and cognitive functions, involving higher-level thinking to define prob-lems, examine the evidence and then making decisions and choices to improve the patient\u2019s physiological and psycho-social state.CR consists of 3 interconnected and interdependent sub-processes: clinical experience and clinical context and Evidence-Based Practice. This essay focuses on the opportunities that Qualitative Research offers during the CR process when the doctor finds the evidence to address a patient\u2019s health problem. Clini-cians are often faced with questions that randomized clinical trials or systematic reviews of efficacy studies can-not answer. For this reason, we considered it necessary to offer an expanded view of the process of interpretation of the scientific literature used in daily clinical practice through the complex process of Clinical Reasoning, through the use of studies conducted with qualitative methods, which are able to respond to a different range of clinical questions, and to support studies based on the effectiveness of treatments

Validation of the Italian version of Behavioral Pain Scale in sedated, intubated, and mechanically ventilated pediatric patients

Background and aim: Pain assessment in pediatric intensive care unit (PICU) is a demanding challenge. The COMFORT-B scale is recognized as the gold standard in such patients. However, the use of this instrument in PICU setting is disputed. The Behavioral Pain Scale (BPS), instead, is considered to be the gold standard for pain assessment in deeply sedated, mechanically ventilated adult patients. The BPS has been validated in Italian, requires a short observation time compared to the COMFORT-B and does not increase workloads. A first evaluation of BPS was made in PICU with good results regarding face validity and content validity, however suggesting further studies given the small sample on which it was tested. The aim of this study was the validation of the BPS in sedated, intubated, and mechanically ventilated pediatric patients. Methods: A descriptive, comparative design was used. A convenience sample of 84 non-verbal, sedated and mechanically ventilated critical care pediatric patients was included. Patient pain was assessed concurrently with three observational scales (BPS, COMFORT-B, NRS) before, during and after routine procedures that are considered painful and non-painful. Results: Internal consistency was α = .86. Correlations between BPS and the other instruments were high, demonstrating a good concurrent validity of the BPS. T test and assessment of ROC curves demonstrated a good discriminant validity of the BPS. Conclusions: The BPS proved to be valid and reliable for the assessment of pain also in the use with pediatric patients

The impact of the alterations in caring for COVID-19 patients on Compassion Satisfaction and Compassion Fatigue in Italian nurses: a multi method study

During COVID-19 first wave, healthcare professionals were exposed to a major psychological pressure related to uncertainty, a lack of therapies or a vaccine and shortages of healthcare resources. They developed higher levels of Burnout and Compassion Fatigue, and similar levels of Compassion Satisfaction. Aim is evaluating in Italian nurses Compassion Satisfaction and Compassion Fatigue and impacting individual and relational variables. A multi-methods approach was used. Qualitative data were collected through 2 focus group. Quantitative data were collected through a web survey composed by an ad hoc questionnaire developed from the focus group results, the Professional Quality of Life Scale-5 and the Resilience Scale (RS-14). In the qualitative phase 6 categories emerged. From the quantitative analysis the sample reported a moderate level of Compassion Satisfaction, a low level of Burnout and a moderate level of Secondary Traumatic Stress. Compassion Satisfaction had as predictors resilience (β = .501), followed by feeling part of the team (β = .406) and collaboration with colleagues (β = .386). Secondary Traumatic Stress had as predictors the impact of PPE (β = .269), and feeling Covid-related individual sufferance (β = .212). The only predictor of Burnout was resilience (β = -2195). Conclusions: During COVID-19 first wave Italian nurses were exposed to a higher risk of Secondary Traumatic Stress, mainly impacted by frustration, loss of control, loss of possibility to properly care for patients, and personal threat. Relational and team support had a crucial role in sustaining Compassion Satisfaction

Cholesterol Microlithiasis: Bacteriology, Gallbladder Bile and Stone Composition

It is not known whether microcalculi possess structural differences compared with larger stones or whether they represent simply an earlier stage in stone disease

Evaluation of fatigue in patients with pancreatic cancer receiving chemotherapy treatment: a cross-sectional observational study

Background and aim of the work: Cancer-related fatigue (CRF) is one of the most common symptoms experienced by cancer patients (CPs) and negatively affects quality of life. Although CRF is frequently experienced, it is often underreported, underdiagnosed and undertreated. The objectives of this study were to evaluate the level of fatigue in patients with pancreatic cancer undergoing chemotherapy and to analyse its correlation with patients\u2019 demographic and clinical variables. Methods: A cross-sectional observational study was implemented in the Oncology Day Hospital of a Northern Italian hospital. A sample of 48 patients receiving chemotherapy were evaluated through the Brief Fatigue Inventory Italian version (BFI-I) between 1 May and 12 October 2016. Data were statistically analysed. Results: Most of our patients (94%) experienced fatigue. Women as well as patients with an age 6565 years reported more fatigue. Anemia, pain and a weight loss of over 16 kg in the last 6 months were significantly related to the perception of fatigue. Regarding life habits, smoking was related to high global score of BFI-I. Conclusions: In accordance with literature, our study suggests that fatigue is a frequent symptom influenced by many constitutional, clinical and environmental factors. Our results highlight the need for an early and regular evaluation of fatigue among cancer patients, in order to implement all those pharmacological and non-pharmacological interventions with proven efficacy in attenuating this symptom

Take a picture! The role of visual methods in understanding psychiatric patient's everyday life

Understanding the patient's experience of mental illness can foster better support for this population and greater partnership with healthcare professionals. This study aims to explore the application of visual methods in the psychiatric field and, in particular, the experience of people suffering from psychotic disorders because it is still an open question that has not been only partially empirically examined