The essentiality of nursing in modern health systems

Abstract not available

Policies for international transmission investment: Unlocking North Africa's renewable energy portfolio - for local use and international exchange. Final report

The study aims to identify suitable regulatory frameworks and business models for transmission investment to enable international exchange and local use of renewable energy across the EU and MENA regions. The analysis explores how policy frameworks can support the realization of individual transmission lines and their use to support renewable project investment and energy transport in the short-term, e.g. next ten years. The current ten year network development plan of ENTSO-e envisages such lines between Italy and Tunisia and between Italy and Algeria with a total capacity of 1.5 GW. An interconnection of similar scale already exists between Spain and Morocco. Grid and renewable projects could facilitate closer cooperation between the EU and MENA regions to support their economic development, job prospects and reducing reliance on domestic subsidized gas purchases. For the longer-term, large scale transmission between EU and MENA can lead to large cost savings, as it can enable an arbitrage in the daily and seasonal profiles of wind and solar plants and demand in the EU and MENA countries, and can allow to access some of the better resource potentials (DII, 2012). Such large scale energy cooperation requires early projects to develop trust, experience on institutional and technology sides and continuous dialog among all stakeholders involved. Therefore policy frameworks to support individual projects also need to be assessed with regard to their ability to contribute towards such a longer-term perspective

Developing a stoma acceptance questionnaire to improve motivation to adhere to enterostoma self-care

IntroductionIn stoma care, patient education is often weak in terms of improving patientsâ level of acceptance of living with a stoma. Self-care educational interventions in enterostomal patients, which according to Oremâs Theory should take into account these patientsâ specific needs, require instruments that measure patientsâ stoma acceptance to improve motivation based on the resumption of activities they used to carry out before having a stoma.MethodsThe aim was to develop an instrument that measures the level of stoma acceptance to improve motivation to adhere to enterostoma self-care.Aspects that improve stoma acceptance and consequently motivation to adhere to enterostoma self-care were identified through 10 focus groups. In the focus groups, the motivation indicators were grouped, categorised and results entered into a Stoma Acceptance Questionnaire (SAQ). The SAQ was then piloted with 104 enterostomal patients from three general hospitals. The SAQ latent structure was explored using nonparametric item response theory.ResultsA three-factor structure was demonstrated for the 16 items of the SAQ: Autonomy and normality; Self-determination and normality; and Trust and burden. Mokken Scaling identified the âresumption of enterostomal patientsâ normal activitiesâ as a measure of stoma acceptance.DiscussionThe SAQ could enable nurses to adopt a standardized approach to the assessment of enterostomal patientsâ motivation to resume their normal activities and identify needs linked to this. The SAQ could also be used to measure the effectiveness of psychosocial and educational interventions aimed at improving stoma acceptance

Preliminary testing using Mokken scaling of an Italian translation of the Edinburgh Feeding Evaluation in Dementia (EdFED-I) scale

© 2015 Elsevier Inc. Purpose: To study the psychometric properties of an Italian version of the Edinburgh Feeding Evaluation in Dementia (EdFED-I) Scale. Background: The EdFED Scale is the only validated instrument that measures difficulty with feeding in older people with dementia. The original English version of the EdFED had three factors measuring: behavioral aspects of feeding difficulty (obstinacy/passivity); indicators of feeding difficulty; and nursing interventions. Methods: Participants affected by dementia and living in nursing homes (n = 210) were selected. Data collectors were trained to observe the residents' eating problems and their food intake. The data were analyzed using Mokken scaling and Pearson's correlation. Results: The Italian version of the EdFED Scale formed a Mokken scale which correlated in the expected direction with measures of residents' weight, Body Mass Index, time taken to eat, Mini Mental State Examination score and Barthel Index according to the unmet needs model of Cohen-Mansfield. Conclusions: The EdFED-I shows reasonable psychometric properties and can be used for the assessment of feeding difficulty in Italian samples of older people with dementia. However, further work with larger samples is required to test the utility of the whole range of items and the necessity of their inclusion in the EdFED-I

Correctional nursing in Liguria, Italy: Examining the ethical challenges

IntroductionCorrectional nursing can involve significant ethical difficulties. This study examined ethical challenges encountered by correctional nurses in the Italian region of Liguria. Empirical data were analyzed in relation to relevant ethical standards. The former involved a study of 75 nurses and managers in the Ligurian correctional system, while the latter involved an analysis of the Italian Code of Ethics for Nurses and related standards for correctional practice. MethodsQuantitative and qualitative methods were used for the empirical study. Questionnaires were administered to collect data on participants’ characteristics and care settings. The Measure of Job Satisfaction (MJS) was also administered. Five focus groups were conducted. ResultsQuantitative Data: Respondents identified factors that mostly impacted on recruitment and retention. Unfavourable factors included: structural, organizational, and relational factors. Favourable factors included: nursing consultation, continuing education activities, and peer support. MJS results were equal to ‘unsatisfied’.Qualitative Data: Five themes were identified through thematic analysis of focus group data: Health needs of incarcerated persons; Negotiation of the boundaries between care and custody; Job satisfaction related to nursing in a correctional setting; Barriers to providing good care; and Security needs. Ten categories of norms were identified in the Code as areas of ethical standards relevant for the empirical data. ConclusionsOur empirical findings demonstrate that these nursing standards can be systematically compromised in correctional settings. Nurses feel compelled to provide ethically-problematic nursing services, with situations of moral distress. This research informs the development of needed policy, educational, and practice changes for nurses in correctional settings

Assistenza di base: tutto tranne che di base

Premessa della prof.ssa Loredana SassoIn Italia, oggi, è attivo un dibattito sul significato dell'assistenza infermieristica "di base" in relazione al ruolo dell'infermiere.Data la possibilití , nell'ambito della Scuola di Dottorato in Nursing, di confronto continuo con colleghi a livello internazionale, abbiamo voluto chiedere un contributo a questo dibattito ad un collega, il Prof. Roger Watson. Roger è portatore di una visione ampia sullo scenario internazionale dell'infermieristica, per i numerosi ruoli internazionali che ricopre; è Honorary Professor e Visiting Professor in molte Universití  Europee e extra Europee, è Editor in Chief del Journal of Advanced Nursing e Editor di Nursing Open. Il contributo si sostanzia in questa lettera che abbiamo voluto rendere disponibile per una riflessione comune

Spiritual Assessment within Clinical Interventions Focused on Quality of Life Assessment in Palliative Care: A Secondary Analysis of a Systematic Review

One of the most crucial palliative care challenges is in determining how patients' needs are defined and assessed. Although physical and psychological needs are commonly documented in patient's charts, spiritual needs are less frequently reported. The aim of this review was to determine which explicit, longitudinal documentation of spiritual concerns would sufficiently affect clinical care to alleviate spiritual distress or promote spiritual wellbeing. A secondary analysis of a systematic review originally aimed at appraising the effectiveness of complex interventions focused on quality of life in palliative care was conducted. Five databases were searched for articles reporting interventions focused on QoL including at least two or more QoL dimensions. A narrative synthesis was performed to synthesize findings. In total, 10 studies were included. Only three studies included spiritual wellbeing assessment. Spirituality tools used to assess spiritual wellbeing were different between studies: Hospital QoL Index 14; Spiritual Needs Inventory; Missoula-Vitas QoL Index; and the Needs Assessment Tool: Progressive Disease-Cancer. Only one study reported a healthcare professional's session training in the use of the QoL tool. Two out of three studies showed in participants an improvement in spiritual wellbeing, but changes in spiritual wellbeing scores were not significant. Overall patients receiving interventions focused on QoL assessment experienced both improvements in their QoL and in their spiritual needs. Although spiritual changes were not significant, the results provide evidence that a spiritual need exists and that spiritual care should be appropriately planned and delivered. Spiritual needs assessment precedes spiritual caring. It is essential that interventions focused on QoL assessment in palliative care include training on how to conduct a spiritual assessment and appropriate interventions to be offered to patients to address their spiritual needs

Holistic Nursing of Forensic Patients: A Focus on Spiritual Care

Prisons are a unique context where nurses are required to have specific skills to ensure that prisoners receive the same type of holistic care as anyone else out of prison, including spiritual care. This discussion paper focuses on understanding how nurses deliver spiritual care in Italian prisons where there are often limited resources and where organizational priorities hinder the provision of holistic nursing. This paper draws from a previous qualitative research study that we had conducted. In this study, we observed that prison nurses reported that they experienced many difficulties related to the provision of holistic care to prisoners. This was particularly true for spiritual care in vulnerable forensic patients, such as older individuals, and physically and mentally frail prisoners. Prison officers did not allow nurses to just "listen and talk" to their patients in prison, because they considered it a waste of time. The conflict between prison organizational constraints and nursing goals, along with limited resources placed barriers to the development of therapeutic relationships between nurses and prisoners, whose holistic and spiritual care needs remained totally unattended. Therefore, prison organizational needs prevailed over prisoners' needs for spiritual care, which, while fundamental, are nevertheless often underestimated and left unattended. Educational interventions are needed to reaffirm nurses' role as providers of spiritual care