A Systematic Review and Integration of Concept Analyses of Self-Care and Related Concepts

Purpose This systematic review identified, synthesized, and integrated concept analyses on self‐care and related concepts. Design The guidelines for systematic literature reviews of the Joanna Briggs Institute were followed. Methods The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, and EMBASE databases were searched for concept analyses published in the past 20 years. Findings A total of 26 concept analyses were identified that had been published on self‐care, self‐care agency, self‐monitoring, self‐management, self‐management support, symptom management, and self‐efficacy. Differences and commonalities in the examined literature were identified, and a model was delineated, explaining the relations among the various concepts from the nursing perspective. Conclusions The healthcare literature has broadly described self‐care and related concepts; however, consensus on the definitions remains beyond our reach and should not be expected, due to the different perspectives and paradigms from which the concepts are interpreted. From a nursing perspective, self‐care can be considered a broad concept encompassing the other concepts, which describe more specific individual levels of activities and processes. Clinical Relevance Nurses are actively involved in disease management and self‐management support as well as in promoting self‐care in healthy and sick people. Referring to a model on self‐care and related concepts could avoid misinterpretations in nursing practice, research, and policy

L'evoluzione del concetto di cura di sé nell'assistenza sanitaria: una revisione narrativa della letteratura

Scopo: Descrivere ed analizzare le definizioni del concetto di self-care in ambito sanitario nella loro evoluzione temporale ed individuare i protagonisti della cura di sé. Metodo: E' stata condotta una revisione narrativa della letteratura consultando le banche dati CINAHL, PubMed, ed ILISI, senza limiti temporali. Inoltre è stata eseguita un'analisi secondaria della bibliografia degli articoli selezionati per individuare ulteriori fonti. Le definizioni di self-care reperite sono state raggruppate per decadi sulla base della loro data di pubblicazione ed esaminate nella loro evoluzione nel tempo. Risultati: Anche se le prime definizioni di self-care compaiono in letteratura negli anni settanta, è solo a partire dagli anni ottanta che il self-care viene considerato a tutti gli effetti una risorsa fondamentale per i sistemi sanitari. Negli anni novanta attivití  di cura considerate in passato di pertinenza esclusiva delle professioni sanitarie vengono ricomprese in questo concetto. Negli anni duemila viene formalizzato il ruolo dei professionisti della salute nel processo di self-care, e le attivití  di self-care si estendono alla sfera psicologica, sociale e spirituale. I comportamenti di self-care possono essere attuati direttamente dalla persona su di sé, delegati ad altri, oppure svolti su altri. Conclusioni: La revisione ha mostrato l'ampia letteratura pubblicata sul self-care in vari ambiti disciplinari e culturali, che ha portato al proliferare di definizioni ed interpretazioni. L'Italia risulta aver partecipato in maniera marginale al dibattito internazionale. Sarebbe, pertanto, utile che anche gli infermieri italiani avviassero progetti di ricerca per comprendere il fenomeno del self-care nell'ambito culturale e sanitario italiano.Parole chiave: cura di sé, salute, malattie croniche, assistenza infermieristicaThe evolution of the concept of self-care in the healthcare system: a narrative literature reviewABSTRACTPurpose: To identify and analyze the definitions of self-care in the healthcare system in the evolution over time as well as to identify the key actors of self-care. Method: We conducted a narrative review of the literature on the definition of self-care in the CINAHL, PubMed and ILISI databases. The searches ranged from the first year included in each database until May 2013. In addition, a secondary analysis was performed on the references of articles selected to identify additional data sources. The self-care definitions were grouped according to decades and examined in their evolution. Results: The first self-care definitions date back to the seventies, but only in the eighties self-care has been seen as a key resource for healthcare systems. In the nineties, care activities previously considered the exclusive domain of the health professions were included in this concept; and finally over the 2000s the role of health professionals in self-care is highlighted, extending the self-care activities to the psychological, social and spiritual dimensions. Self-care activities can be carried out directly by the person upon himself, delegated to others, or performed on others. Conclusions: The review has showed the large body of literature published in different disciplinary and cultural fields, which has led to the proliferation of definitions and interpretations of self-care. Italy has taken part in a marginal way to the international debate. It would be useful that also Italian nurses did research to describe and understand.Key words: self-care, health, chronic diseases, nursing Key words: self-care, health, chronic diseases, nursin

Nursing outcomes in wound care management: A mixed method study

Abstract Aim The aim of the study was to analyse the management of chronic wound outcomes and the experience of patients with chronic ulcers. Design Explanatory mixed method. Methods This study consisted in a sequential explanatory mixed method with a quantitative and a qualitative phase. In the first phase, quantitative data were collected during a longitudinal study, in a convenience sample of 44 patients presenting at a nursing outpatients' clinic. Linear regression was conducted to evaluate the associations between variables. In phase two, 14 patients from the initial sample were interviewed, and the data were analysed using Giorgi's descriptive phenomenological method. Results The participants, mostly males, in conditions of comorbidity and polypharmacotherapy, were mainly affected by venous leg ulcers. An association between the quality of life of patients (both physical and mental) and some socio‐demographic and clinical factors has been confirmed. I Variance analysis showed a significant wound improvement across all the measurement times. The themes identified through the qualitative analysis were: “Cared by self,” “Cared by Healthcare Providers” and “Quality of life”

Continuing Education through the Campus Game: A Sustainable Gamification Project to Improve Doctors’ and Nurses’ Knowledge of Quality and Clinical Risk Management

The COVID-19 disease has dramatically changed lives worldwide, including education. This is a challenge for traditional learning. In fact, the European Higher Education Area poses the challenge of boosting the quality of teaching through active methodologies supported by digital pedagogy. Gamification is one of these tools and it has considerable attention in the healthcare literature. We aimed to create a game in the Campus Bio-Medico University Hospital Foundation in order to offer continuing education on Quality and Clinical Risk procedures to our staff. The 2021 “Campus Game” (178 players) introduced the “Badge Challenge” (Team Building, Procedures, and Security) and 73 questions. The leaderboard of every single match was posted in some of the hospital’s strategic areas and also published online on the company intranet to ensure engagement and competitiveness. Gamification has spontaneously promoted teamworking and a virtuous process of multiprofessional education. We found that, during the Campus Game, there was a 4.9% increase in access to the intranet page containing information on Quality and Patient Safety and an 8% increase in access to the Hospital Policies and Procedures. In the near future, we wish to expand this game, involving hospitals with similar types of activity and levels of attention to quality and safety issues, and also to enhance the network of partners and the principles of Q&S management itself

Effectiveness of dyadic interventions to improve stroke patient–caregiver dyads’ outcomes after discharge: A systematic review and meta-analysis study

Background: Because of the importance of a dyadic approach, it is necessary to conduct a systematic review to identify which dyadic intervention could be implemented for stroke survivor–caregiver dyads after discharge from the rehabilitation hospital to improve outcomes. Aims: The aims were to systematically review the evidence to identify which dyadic interventions have been implemented in stroke survivor–caregiver dyads to improve stroke survivor–caregiver dyads’ outcomes and to analyse, through a meta-analysis, which intervention was found to be the most effective. Methods: A systematic review and meta-analysis were conducted using the following electronic databases: PubMed, CINAHL and PsycInfo. Randomized controlled trials (RCTs) and quasi-RCT studies published within the last 10 years were included. Quantitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI. Pooled effects were analysed between the experimental and control groups for each outcome. Results: Sixteen studies involving 2997 stroke survivors (male gender=58%) and 2187 caregivers (male gender=25%) were included in this review. In 16 studies, which were subdivided into three quasi-RCTs and 13 RCTs, the application of dyadic interventions for stroke survivors and caregivers was systematically reviewed, but only a few of these identified a significant improvement in the stroke survivors’ and caregivers’ outcomes of its intervention group. Dyadic interventions showed a significant effect on stroke survivors’ physical functioning (p=0.05), memory (p<0.01) and quality of life (p=0.01) and on caregivers’ depression (p=0.05). Conclusions: This study provides moderate support for the use of a dyadic intervention to improve stroke survivors’ physical functioning, memory and quality of life and caregiver depression

Outcomes of wound care nurses’ practice in patients with pressure ulcers : An integrative review

Background Wound care nurses are recognised as a key element for improving health outcomes. However, there is still fragmented knowledge of the outcomes associated with their practice in individuals with pressure ulcers. Aims and objectives To identify, summarise and map all available evidence related to the outcomes of wound care nurses’ practice in individuals with pressure ulcers. Design Integrative literature review. Review method To report the review, we followed the modified version of Cooper's five-step methodology, and the PRISMA guidelines. Methods The search was carried out on CINAHL, PubMed, the Cochrane Library and Scopus, with a time frame ranging from each database inception to December 21, 2019. We included observational or experimental studies of adult individuals affected by (or at risk of) developing pressure ulcers who were also cared for by wound care nurses. Results Of the 439 peer-reviewed publications, 13 studies met the inclusion criteria. The most frequent outcomes were pressure ulcer incidence, healing rate and time taken for complete healing. Less frequent outcomes were changes in pressure ulcers’ stage, number of completely healed wounds, treatment costs and physical discomfort. No patient-reported outcomes were assessed. Conclusion This review indicates that clinical-related outcomes were by far the most reported. Future studies should broaden the spectrum of outcomes to include more subjective parameters (e.g. pain, quality of life, stress, etc.), in order to gain a better understanding of the global impact of wound care practice on patients with pressure ulcers. Relevance to clinical practice There is promising evidence of a positive impact of wound care nurses’ practice on health and economic outcomes. Nonetheless, more robust and rigorous research is needed to provide stronger evidence in the field and support investment in these practitioners

Conoscenze e atteggiamenti nell’igiene delle mani del personale sanitario durante la pandemia Covid-19: uno studio osservazionale

INTRODUCTION: the infections correlated to the assistance represent the most common adverse events and sets up a world public sanity problem. Preventative behaviour, such as proper hand hygiene, are based on the knowledge and attitudes of care staff. Valuing health workers' knowledge and attitudes becomes fundamental for the individuation of any cognitive gaps.&nbsp; METHODS: a cross sectional study has been conducted in a healthcare authority, during the first lockdown of Covid-19 pandemic. The knowledge’s' data have been collected using the World Health Organization's Hand Hygiene Knowledge Questionnaire in its italian version and, for exploring attitudes, questions have been created on the basis of scientific literature.&nbsp; RESULTS: a sample of 363 healthcare workers was enrolled in this study. The 60% of respondent showed a sufficient level and 26.3% were at a good level of knowledge and all the personnel present good attitudes. There has been found an association between knowledge, gender and work area and between attitude, work area and presence of the alcoholic product in the structure.&nbsp; KEYWORDS: hands hygiene, healthcare workers, knowledge, attitudes, WHO questionnaire.&nbsp;INTRODUZIONE: le infezioni correlate all’assistenza rappresentano gli eventi avversi più comuni e costituiscono un problema di sanità pubblica mondiale. Alla base dei comportamenti atti a prevenirle, come la corretta igiene delle mani, vi sono le conoscenze acquisite e gli atteggiamenti del personale di assistenza. Valutare conoscenze e atteggiamenti degli operatori sanitari diventa fondamentale per individuare eventuali gap conoscitivi.&nbsp; METODI: uno studio trasversale è stato condotto in un’Azienda Sanitaria di Roma, durante il primo lockdown della pandemia Covid-19. I dati sulle conoscenze sono stati raccolti usando la versione italiana dell’Hand Hygiene Knowledge Questionnaire della World Health Organization e, per esplorare gli atteggiamenti, sono state create delle domande ad hoc sulla base della letteratura.&nbsp; RISULTATI: 363 operatori sanitari sono stati arruolati per questo studio. Il 60% del campione mostrava un sufficiente livello di conoscenze e il 26,3% un buon livello, mentre in tutto il personale erano presenti atteggiamenti positivi motivanti all’igiene delle mani. È stata trovata un’associazione tra le conoscenze, genere ed area lavorativa e tra atteggiamenti nell’igiene delle mani, area lavorativa e presenza del prodotto alcolico in struttura.&nbsp; CONCLUSIONI: i professionisti sanitari hanno dimostrato un livello di conoscenze da sufficiente a buono, e atteggiamenti positivi verso l’igiene delle mani. Permangono alcuni gap conoscitivi che andrebbero colmati con percorsi formativi aziendali al fine di prevenire le infezioni secondo i principi del programma di sicurezza dei pazienti “Clinic Care in Safer Care” della World Health Organization.&nbsp; PAROLE CHIAVE: igiene delle mani, personale sanitario, conoscenze, atteggiamenti, WHO questionario&nbsp

Nurses’ Organization of Work and Its Relation to Workload in Medical Surgical Units: A Cross-Sectional Observational Multi-Center Study

Introduction: Work contexts can affect nurses’ work and work outcomes. Work context factors of nurses, patients, or workflow can modulate nurses’ organization of work and determine increased workloads. Aim: The aim of this research was to analyze relationships between factors regarding the patient, the nurse, workflow, and nurses’ work organization, to investigate whether work organization is related to physical, mental, and emotional workloads, and to explore whether one dimension of workload influences the other dimensions. Methods: We used a cross-sectional design based on the Job Demand-Resources theory. We asked registered nurses, working in nine medical-surgical wards across three hospitals in Italy, to self-report on work organization and workloads regarding randomized shifts over three consecutive weeks. Four scales from the QEEW 2.0 questionnaire were used on an online survey for data collection. multivariable linear regressions with structural equation modelling were tested. The study was approved by the three local Ethics Committees. Results: We received 334 questionnaires regarding 125 shifts worked. Patient complexity (β = 0.347), patient specialties (β = 0.127), adequacy of staffing (β = −0.204), collaboration with colleagues (β = −0.155), unscheduled activities (β = 0.213), supply search (β = 0.141), and documentation (β = 0.221) significantly influenced nurses’ work organization. Nurses’ work organization was significantly related to physical, mental, and emotional nursing workloads. Conclusions: the patient, the nurse, and workflow aspects influence nurses’ work organization and workloads. Healthcare organizations, managers, and nurses should explore work settings to identify work turbulences early and implement strategies to improve nursing work conditions and workloads

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

Assessment of the Psychometric Characteristics of the Italian Version of the Nurse Manager Actions Scale

Nurse managers play a vital role in healthcare organizations, wielding the ability to substantially enhance work environments, foster nurses’ autonomy, and bolster retention within workplaces. In this context, this study focuses on the Nurse Manager Actions scale, aiming to evaluate its items’ scalability as well as the scale’s validity and reliability among nurses and nurse managers operating within the Italian healthcare context. The study protocol was not registered. To ensure linguistic and cultural alignment, an iterative and collaborative translation process was undertaken. Subsequently, a multi-center cross-sectional design was adopted. Using a web-survey approach, data were collected among 683 nurses and 188 nurse managers between August 2022 and January 2023. The Nurse Manager Actions scale was found to be a valid and reliable instrument in Italian after a Mokken Scale Analysis. For nurses (HT= 0.630, Molenaar–Sijtsma rho = 0.890), the scale included 6 items, while 11 items were confirmed for nurse managers (HT= 0.620, Molenaar–Sijtsma rho = 0.830). Nurse Manager Actions scale scores were correlated with increased satisfaction and decreased intention to leave for both nurses and nurse managers. The employed validation process enhanced the scale validity for use in Italy and provided a model for other researchers to follow when assessing similar measures in different populations. Measuring and empowering nurse manager actions in work contexts is essential to improve the general well-being and retention of nurses, especially in the current nursing shortage