The influencing factors of nurses’ well-being in critical care during pandemic era: a systematic review protocol

ABSTRACT Purpose: To review, identify and disclose predictive and protective factors of critical care nurse well-being in the COVID-19 era. Design: Systematic review protocol based on the Joanna Briggs Institute (JBI) guidelines. Review Methods: All quantitative primary studies focused on factors influencing the well-being of critical care nurses and the relationships among these factors will be included. Based on the review question, six databases will be searched: MEDLINE, The Cochrane Library, SCOPUS, CINAHL, Web on Science, PsycINFO. Time limits will be set according to the COVID-19 pandemic era. To establish the quality of studies JBI tools will be used. Where possible, data will be summarised quantitatively through meta-analysis. Expected Results:  We anticipate that this systematic review will provide an overview of the factors that impacted the professional well-being of critical care nurses during the pandemic period from Covid-19. Conclusions: This study will be the first to reveal which are the factors that play an important role in impacting intensive care nurses in covid-19 pandemic era. Furthermore, it will provide updated and valid evidence of which factors should be considered protective of intensive care nurses' well-being and which are to be considered hindering.  Implication for the profession: Enhancing the professional well-being of nurses is crucial in addressing the growing trend of their intention to leave the profession. Understanding the factors that positively or negatively impact the well-being of critical care nurses during the pandemic is key to developing effective retention strategies within the nursing field. The results of the review will support managers and leaders in direct health policies toward the implementation of interventions to promote the well-being of healthcare workers and to contrast the intention to leave.   KEYWORDS:  intensive care nurses, well-being, systematic review protocol, nursin

Advancing nursing in Italy through the development and evaluation of an innovative postgraduate programme in Family and Community Nursing - A pilot study

Introduction Due to the impact on the public health systems of the ageing and the increasing frailty of the population, the European Union and the World Health Organisation have emphasised how family and community nurses (FCNs) could play an important in supporting the ageing process through prevention, promotion, and protection in the territory. Methods This study describes the first experience in Italy of a one-year postgraduate course divided into 5 modules for FCNs piloted as part of the EuropeaN curriculum for fAmily aNd Community nursE (ENhANCE) 2018-2020 project, funded by the European Commission. Participants included a total of 45 students and 23 lecturers and a team of clinical tutors. Results The Italian pilot course for the FCNs proved to be a successful example of innovative teaching methods using blended didactic methods, which enabled participants to achieve high-standard learning outcomes and competencies in the field of family and community nursing. Conclusions The pilot course described in this paper is well suited to preparing highly skilled family and community nurses to meet the growing healthcare needs of the population. Therefore, we have planned to replicate this course to increase the workforce of family and community nurses, who through their healthcare services aimed at prevention, promotion and protection, will be able to ensure high quality services to the public and consequently relieve the burden on acute hospitals

The Impact of Emotional Intelligence on Nurses' Professional Quality of Life in Pre‐Hospital Emergency Settings: A Multicentre Mixed‐Method Study

Background: Pre‐hospital emergency nurses, frequently exposed to high‐stress situations, are at risk for burnout and stress‐related issues, affecting their overall well‐being. The Professional Quality of Life (ProQoL) scale, widely used among hospital nurses, remains untested in pre‐hospital emergency settings. Aim: To adapt and validate the ProQoL scale for pre‐hospital emergency contexts and explore the protective role of emotional intelligence in professional well‐being. Methods: A mixed‐method study was conducted. The qualitative approach involved semi‐structured interviews to inform the modification of items for adapting the ProQoL to the pre‐hospital emergency setting. A quantitative method was applied to assess the relationship between emotional intelligence and professional well‐being through content and face validity measures. Results: Qualitative interviews suggested refining the ProQoL for pre‐hospital emergency settings, emphasising factors such as job satisfaction and professional conduct. The revised 21‐item Pre‐Hospital Emergency‐Professional Quality of Life (PHE‐ProQoL) scale demonstrated strong content validity (I‐CVI: 0.86‐1, S‐CVI: 0.9) and face validity. Significant correlations were observed between emotional intelligence and professional well‐being, with negative correlations between emotional intelligence and both burnout (Pearson's r = −0.859) and post‐traumatic stress (Pearson's r = −0.792), and a positive correlation with compassion satisfaction (Pearson's r = +0.917). Pre‐hospital nurses displayed moderate levels of compassion satisfaction (27.3 ± 9.81), high emotional intelligence (28.0 ± 9.58), especially in empathy, and substantial levels of burnout (22.5 ± 6.09) and stress (21.2 ± 4.3). Discussion: The study found that pre‐hospital emergency nurses exhibit moderate compassion satisfaction and above‐average emotional intelligence, particularly in perceiving and managing others' emotions. However, they also experience significant levels of burnout and post‐traumatic stress. Conclusions: Burnout and post‐traumatic stress significantly affect pre‐hospital emergency nurses. Enhancing emotional intelligence is crucial for their well‐being. Nursing managers now have access to a validated and reliable tool to assess this

Benessere professionale e staffing sicuro in area critica: studio osservazionale multicentrico nazionale. Professional well-being and safe staffing in the critical care setting: a national multicentre observational study.

Professional well-being and safe staffing in the critical care area: a national multicenter observational study. Background: The 2008 financial crisis and COVID-19 worsened healthcare work environments, especially for critical care healthcare workers, leading to high stress, burnout, job dissatisfaction, and poorer patient outcomes, highlighting the need for improved work conditions and professional well-being. Aim: To evaluate professional well-being and related factors among Italian critical care nurses and physicians. Methods: This multicenter cross-sectional observational study towards online surveys investigates stress and burnout levels, job satisfaction, work environment, mental health, sleep quality, general health, work environment quality, and patient safety perception. Results: The study involved 697 nurses and 63 physicians employed in critical care settings of 26 Italian hospitals. Key findings include high-stress levels (50.7% of nurses, 62.1% of physicians) and burnout symptoms (14.6% of nurses, 34.4% of physicians). Job dissatisfaction was reported by over half of the physicians and a third of the nurses. Poor mental health indicators were significant, with 19.9% of nurses and 23.3% of physicians at risk for generalized anxiety disorder, and 18.6% of nurses and 28.3% of physicians showing depressive symptoms. Sleep quality was poor among 44.1% of nurses and 45% of physicians. The work environment was rated as excellent by only 4.2% of nurses and 3.4% of physicians, with 19.2% of nurses and 18.9% of physicians perceiving patient safety as poor or absent. A critical care nurse works 37.3 hours per week; a physician performs 3.16 night guards per month. The care most frequently missed are health information and education to patients and family members (51.5%), developing or updating nursing care plans/pathways of care (49.2%), and frequent mobilization of the bedridden patient (49.2%). The nurse-to-patient ratio in critical care is 1:3.4, while in emergency rooms it is 1:6.5 per nurse. Burnout is associated with intention to leave, anxiety, perceived quality of work environment and workload (p< .001) as well as measured quality of work environment is related to job satisfaction and perceived quality of work environment (p< .001). The quality of care and the patient’s safety are related to job satisfaction and perceived quality of the work environment (p< .001). Discussion: The study underscores the detrimental effects of reduced healthcare funding and understaffing on work conditions, particularly in critical care. It highlights the profound impacts of burnout on staff well-being and patient care, advocating for effective leadership, supportive environments, and comprehensive policies to boost healthcare professionals' well-being and ensure high-quality patient care. Conclusions: The research findings underline the urgent need for comprehensive approaches and targeted health policies to improve staff well-being, which is crucial for patient safety and quality of care in high-intensity health care settings, as well as to counter the ever-increasing phenomenon of the intention to leave, which affects physicians and nurses and puts the Health System in serious crisis

Fundamental care: An evolutionary concept analysis

Aim: To report an analysis of the concept of fundamental care in the literature. Design: An evolutionary concept analysis. Data sources: PubMed and CINAHL Complete databases were consulted using the key terms: fundamental care, fundamentals of care, essential care, basic nursing care and basic care revised. Articles published from 2008 to 2022, in English and Italian, in scholarly/peer-reviewed nursing journals were included. Methods: Rodgers's Evolutionary Method of concept analysis was used. Our thematic analysis yielded common themes related to the concept, antecedents, attributes and consequences of fundamental care. Results: A total of 50 articles were analysed. Thirty-eight attributes were identified, such as integration of care, patient and family centred care and trusting relationship; eight antecedents including nursing care, nursing practice and care context; and 17 consequences including the safety, quality and consistency of care. Conclusion: This review of literature reveals that there is no consistent definition of the concept of 'fundamental care'. Findings from this exploration of the literature emphasized the importance of communication, the contextual environment, leadership influence and nurse-patient relationship in providing effective and high-quality fundamental care. Our definition of this concept may help nurse leaders in practice, research, education, management and policy to promote and enhance the application of fundamental care. Impact: What problem did the study address? While numerous studies examine fundamental nursing care, various terms are used with no consensus on definitions emerging. Given the relevance of this topic, reaching a clear and agreed definition of fundamental care is essential. What were the main findings? Fundamental care encompasses the importance of communication, the contextual environment, leadership influence and nurse-patient relationship in providing effective and high-quality care. Where and on whom will the research have an impact? This definition of fundamental care will assist nurse leaders and researchers to promote and enhance the examination and application of fundamental care in clinical practice to ensure better care outcomes across all healthcare settings

The structure of the Italian version of the Practice Environment Scale of the Nursing Work Index

To investigate the factor structure of an Italian translation of the Practice Environment Scale of the Nursing Work Index (PES-NWI)

The Impact of Continuous Education on Healthcare Workers' Attitudes Toward Old people Nutrition: A Cross-sectional Study in Italian Nursing Homes

Abstract: Background: Malnutrition is a widespread issue among the old people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. This study examines the influence of continuing education on healthcare workers' attitudes and practices toward old people nutrition.Aim: The study assesses healthcare workers' attitudes toward old people nutrition using the validated Italian version of the SANN-G questionnaire, focusing on staff in nursing homes in Northern Italy.Methods: A cross-sectional study was conducted with 1,789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software.Results: Most respondents were female (68.59%) and aged 41–50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most displaying neutral or negative attitudes. Education on malnutrition significantly improved attitudes, particularly in assessment, intervention, and individualization. Younger respondents and nurses were more likely to have positive attitudes after educational interventions, while older respondents and physicians tended to show neutral or negative attitudes.Conclusion: Continuing education on malnutrition is crucial for fostering positive attitudes among healthcare workers. Specialized education leads to more proactive approaches, highlighting the need for targeted educational programs to improve old people nutritional care

Healthcare Workers’ Attitudes Toward Older Adults’ Nutrition: A Descriptive Cross-Sectional Study in Italian Nursing Homes

Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers’ attitudes toward older people’s nutrition using the validated Italian version of the Staff Attitudes to Nutritional Nursing Geriatric care scale (SANN-G), focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software (R-4.4.2 for Windows). Results: Most healthcare workers were female (68.59%) and aged 41–50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most exhibiting neutral or negative attitudes. Healthcare workers who attended a malnutrition course were more likely to exhibit positive attitudes toward nutrition, particularly in the dimension of norms, assessment, intervention, and individualization. Younger healthcare workers, with the role of nurses and who attended a course on malnutrition, were more likely to have positive attitudes, while older healthcare workers and with the role of physicians tended to show neutral or negative attitudes. Conclusions: Education on malnutrition improves healthcare workers’ attitudes toward older adults’ nutrition, especially among younger nurses. The low percentage of positive attitudes (23.48%) underscores the need for broader education programs to enhance nutritional care quality

Influencing Factors of Nurses’ Well‐Being in Critical Care During Pandemic Era: A Systematic Review

Aim: To identify factors protecting and hindering the well-being of critical care nurses during the COVID-19 pandemic. Background: The unique work challenges of critical care nurses can undermine their professional and mental well-being; as evidenced by the prevailing literature on burnout, compassion fatigue, and moral distress. The COVID-19 pandemic has seen these professionals on the front lines and has raised many questions about professional well-being. Identifying the factors that protect and hinder the well-being of critical care nurses would help to develop the strategies necessary to reduce worrying phenomena associated with professional malaise. Evaluation: A systematic review was conducted using electronic databases including PubMed, CINAHL, Scopus, Cochrane, PsycINFO, and Web on Science. Key issues: After full text analysis, 25 papers were included in the current systematic review. Factors influencing the well-being of critical care nurses have been grouped into “Protective” and “Hindering.”. Conclusions: This review shows that critical care nurses’ well-being is influenced by factors like personal resilience and supportive work environments, which enhance their experience. Challenges include sociodemographic issues and the COVID-19 pandemic's impact. Addressing these factors is crucial for their well-being and the effectiveness of healthcare systems. Implications for clinical practice: The well-being of nurses is intricately linked to the quality and security of patient care, ultimately influencing clinical outcomes. This review delves deeply into the multifaceted factors that affect the professional well-being of critical care nurses during the COVID-19 pandemic. Recognizing these elements is critical for directing health policy toward the development of initiatives that bolster healthcare workers’ welfare. Prioritizing the professional well-being of nurses is imperative, as it is fundamental in mitigating the increasing inclination towards job turnover, a challenge that is profoundly impacting the healthcare sector

Quality of Life and non-motor symptoms Improvement in Parkinson's Disease through Nutritional Intervention: A Case Study : Weancare Parkinson

Summary of the paper: The text discusses the significant impact of non-motor symptoms on the quality of life (QoL) of patients with Parkinson’s disease (PD), emphasizing the role of nutritional status. The Non-Motor Symptoms Scale (NNMS) evaluates QoL across various domains, including nutrition, which is crucial due to common issues like dysphagia leading to malnutrition and sarcopenia. These nutritional problems exacerbate motor deficits by reducing muscle mass and energy levels. Addressing dysphagia through targeted nutritional programs is essential for improving clinical outcomes and patients' QoL. A case study involving an 84-year-old PD patient with dysphagia and the Tower of Pisa Syndrome demonstrated the effectiveness of the 'Weancare' program. Initial assessments indicated poor nutritional status. Post-intervention, the program showed significant improvement in the patient’s non-motor symptoms and overall QoL, highlighting a better mealtime experience and clinical healt