Mappatura della letteratura sulle soluzioni digitali e tecnologiche nell'assistenza infermieristica: un protocollo di scoping review

   INTRODUCTION: Digital and technological solutions (DTS) might have an impact on people’s personal and professional lives. These types of solutions, according to studies, have the potential to revolutionize and improve the quality and long-term sustainability of healthcare activities, with nurses playing a significant role. Although DTS appears to be intimately linked to the future of nursing, technology must be utilized as an active rather than passive tool. Nonetheless, understanding DTS appears to be difficult, and a scoping study can provide a thorough overview of such a complicated topic. As a result, the scoping study on this topic will map all of the important aspects of DTS and synthesize studies on the nursing workforce, as well as analyze and clarify knowledge gaps and aid future research and development. This article presents the study protocol.  METHODS: The Joanna Briggs Institute (JBI) scoping review methodology will be used for the proposed scoping review. It will include both quantitative and qualitative scientific research as well as grey literature on DTS in nursing. Only English-language works will be considered for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers, and extracting data. Disagreements among reviewers will be resolved through debate until a consensus is reached or through consultation with the study team if necessary. Results will be presented using descriptive statistics, diagrammatic or tabular displayed information, and narrative summaries, as specified in the JBI guidelines.  DISCUSSION: This scoping review protocol explained why it is important to describe the literature on embracing DTS in the nursing field, how to approach the research process, and what the study's key implications will be. The protocol itself may be helpful to increase transparency in the research process, attract interested researchers to work with the group that developed the protocol and offer a practical methodological benchmark for researchers interested in performing scoping reviews by serving as an example of a scoping review protocol.  KEYWORDS: Digital solutions; Technological solutions; Nursing; Scoping review; Study protocol; Framework    INTRODUZIONE: Le soluzioni digitali e tecnologiche potrebbero avere un impatto sulla vita personale e professionale della popolazione. Questi tipi di soluzioni, secondo gli studi, hanno il potenziale per rivoluzionare e migliorare la qualità e la sostenibilità a lungo termine delle attività di salute, deve gli infermieri svolgono un ruolo significativo di innovatori, facilitatori e gestori dei processi. Sebbene le soluzioni digitali e tecnologiche sembrino essere intimamente legate al futuro dell’assistenza infermieristica, la tecnologia deve essere utilizzata come strumento attivo, piuttosto che passivo. Tuttavia, la comprensione del fenomeno sembra essere difficile e una scoping review può fornire una panoramica completa di un argomento di tale complessità. Di conseguenza, la presente scoping review mapperà tutti gli aspetti salienti legati alle soluzioni digitali e tecnologiche e sintetizzerà gli studi sul coinvolgimento della professione infermieristica, nonché analizzerà e chiarirà le lacune di conoscenza presenti e aiuterà la ricerca e i progetti futuri. Questo articolo presenta il protocollo di studio di scoping review per raggiungere l’obiettivo di mappatura della letteratura.  METODI: Il protocollo utilizza la metodologia di scoping review del Joanna Briggs Institute (JBI). Comprenderà sia la ricerca scientifica quantitativa che qualitativa, nonché la letteratura grigia sulle soluzioni digitali e tecnologiche nell’assistenza infermieristica. Solo i lavori in lingua inglese saranno presi in considerazione per l’inclusione. Due revisori indipendenti prenderanno parte a un processo iterativo di valutazione della letteratura, scelta dei documenti ed estrazione dei dati. I disaccordi tra i revisori saranno risolti attraverso il dibattito fino al raggiungimento di un consenso o attraverso la consultazione con il gruppo di studio, ove necessario. I risultati saranno presentati utilizzando statistiche descrittive, le informazioni presentate in forma grafica, tabulare o a mezzo narrativo, come specificato nelle linee guida JBI.  DISCUSSIONE: Questo protocollo di scoping review intende definire perché è importante descrivere la letteratura sull’adozione delle soluzioni digitali e tecnologiche in ambito infermieristico, come affrontare il processo di ricerca sottostante alla revisione e quali saranno le implicazioni chiave dello studio. Il protocollo stesso può essere utile per aumentare la trasparenza nel processo di ricerca, ingaggiare i ricercatori interessati a lavorare con il gruppo che ha sviluppato il protocollo (research engagement) e offrire un punto di riferimento metodologico e pratico per i ricercatori interessati a svolgere revisioni nel medesimo ambito.  PAROLE CHIAVE: Soluzioni digitali; Soluzioni tecnologiche; Infermieristica; Revisione della letteratura; Protocollo di studi

A Single-Center, Randomized Controlled Trial to Test the Efficacy of Nurse-Led Motivational Interviewing for Enhancing Self-Care in Adults with Heart Failure

Background: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance (primary endpoint), self-care management, and self-care confidence after three months from enrollment in adults with HF compared to usual care, and assessed changes in self-care over follow-up times (3, 6, 9, and 12 months). Methods: A single-center, randomized, controlled, parallel-group, superiority study with two experimental arms and a control group was performed. Allocation was in a 1:1:1 ratio between intervention groups and control. Results: MI was effective in improving self-care maintenance after three months when it was performed only for patients (arm 1) and for the patients-caregivers dyad (arm 2) (respectively, Cohen's d = 0.92, p-value < 0.001; Cohen's d = 0.68, p-value < 0.001). These effects were stable over the one-year follow-up. No effects were observed concerning self-care management, while MI moderately influenced self-care confidence. Conclusions: This study supported the adoption of nurse-led MI in the clinical management of adults with HF

Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Conundrum of “Where to Start”

Transforming nursing practice and leadership is an ongoing effort in the nursing profession, and it involves several key components, such as research, education, workforce, and regulation [...

Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Conundrum of “Where to Start”

Transforming nursing practice and leadership is an ongoing effort in the nursing profession, and it involves several key components, such as research, education, workforce, and regulation [...

Serum levels of hydroperoxides and multimorbidity among older patients with mild cognitive impairment or late-onset Alzheimer’s disease

Background Oxidative stress (OxS) might be involved in the pathogenesis of late-onset Alzheimer disease (LOAD); noteworthy, the presence of multimorbidity is regarded as a common denominator of OxS and dementia. Aim To evaluate the contribution of multimorbidity to OxS in LOAD and mild cognitive impairment (MCI). Results Serum hydroperoxides and multimorbidity (CIRS-CI scale) were evaluated in 46 Controls, 104 MCI and 75 LOAD. Results A trend toward an increase of hydroperoxides from Controls to MCI to LOAD was observed (LOAD vs Controls p = 0.01). This OxS marker was positively and significantly correlated with CIRS-CI in Controls (p = 0.002) and patients with MCI (p = 0.005) but not in those with LOAD (p = 0.104). Conclusions Multimorbidity is associated with systemic OxS but only in elderly people with either no or mild cognitive impairment. Although OxS is elevated in LOAD patients, its association with multimorbidity seems to be negligible, confirming the existence of strong disease-specific pro-oxidant mechanisms

The effect of health literacy on vaccine hesitancy among Italian anticoagulated population during COVID-19 pandemic: the moderating role of health engagement

Assessing vaccine hesitancy and its determinants is pivotal to optimize vaccine acceptance in anticoagulated patients, given that this population has been described to have a higher risk of severe COVID-19-related complications. This study assessed the moderator role of patients’ health engagement on the relationship between health literacy and vaccine hesitancy. A web-based survey was performed in Italy during the first wave (June–August 2020) and the second wave (October 2020–March 2021) of the COVID-19 pandemic, enrolling 288 patients. The rates of vaccine hesitancy reported during the first pandemic wave were 38.4% and 30.8% during the second wave (when a vaccine was available) (p = .164). A moderation analysis was performed to assess the role of health engagement in influencing the relationship from health literacy to vaccine hesitancy. Patients’ health engagement enhanced the effects of health literacy on decreasing vaccine hesitancy (p < .001), suggesting that co-construction strategies for communicative action are pivotal

Systemic oxidative stress in older patients with mild cognitive impairment or late onset Alzheimer's disease

A large body of evidences obtained in human and animal brain tissue suggest a role of oxidative stress (OxS) in the pathogenesis of late onset Alzheimer's disease (LOAD); on the contrary, data on peripheral markers of OxS in LOAD are still controversial. We evaluated the serum levels of products of lipid peroxidation, hydroperoxides, advanced oxidation protein products, total and residual antioxidant power, thiols, and uric acid in a sample of 334 older individuals: 101 LOAD patients, 134 patients with mild cognitive impairment (MCI), and 99 controls. At univariate analysis, serum hydroperoxides were higher while residual antioxidant power was lower in MCI and LOAD compared with in controls. By multivariate logistic regression analysis we found that, compared with controls, high levels (over median value) of serum hydroperoxides were independently associated with an increase in the likehood of having MCI (Odd Ratio: 2.59, 95% Confidence Interval: 1.08-6.21) or LOAD (OR: 4.09, 95%CI: 1.36-11.81). Furthermore, low levels of residual antioxidant power (below the median value) were associated with increased risk of having MCI (OR: 3.97, 95% CI: 1.62-9.72), but not dementia (OR: 2.31, 95%CI: 0.83-6.63). Our study suggests that a systemic redox-imbalance leading to OxS might be associated not only with LOAD but also with MCI

Health literacy in type 2 diabetes patients: a systematic review of systematic reviews

Aim To summarize, critically review, and interpret the evidence related to the systematic reviews on health literacy (HL) amongst type 2 diabetes mellitus (T2DM). Methods The methodology for this study consisted of a systematic review of systematic reviews, using the PRISMA statement and flowchart to select studies, and searching on PubMed, CINAHL, Scopus, and Cochrane. The search covered the period between January 2006 and June 2016. Results From the 115 identified record by the queries, only six systematic reviews were included, following a quality evaluation using AMSTAR. The included systematic reviews content was analyzed by the independent work of two authors, using a narrative synthesis approach. The findings of this study (i.e., main themes) are areas of consensus and gaps in knowledge. Areas of consensus are HL definition, HL measurement tools, and the relationship between T2DM patient knowledge (or literacy) and his/her HL. The gaps in knowledge were the assessment of the relations between HL and health outcomes and self-efficacy, the gender differences, the effectiveness of interventions to improve HL, the cost-effectiveness study of interventions to improve HL, and the understanding of the influence of organizational environment on HL. Conclusion This review provides a current state of knowledge to address clinical practice and research proposals. HL could be useful to personalize patients' follow-up and it should be routinely assessed in its three dimensions (i.e. functional, interactive and critical) to enhance patients' ability to cope with clinical recommendations. Future research should be mainly aimed to test the effectiveness of evidence-based interventions to improve HL amongst T2DM patients

Systemic oxidative stress might be in the path from normal cognitive function to dementia: data from cross-sectional and longitudinal study

Growing evidence from in vitro and animal model experiments suggest a role of oxidative stress (OxS) in the pathogenesis of late Alzheimer’s disease (LOAD) and vascular dementia (VAD). However, the definitive appreciation of the involvement of OxS in these two most common forms of dementia-related diseases need a confirmation in a population-based study on a large sample. The aim of our study was to investigate the possible relationship between OxS and the onset and clinical progression of LOAD and VAD. To achieve this purpose a sample of 431 older individuals: 101 LOAD, 43 VAD, 188 mild cognitive impairment (MCI, pre-dementia condition) and 99 healthy controls were enrolled and assessed for serum levels of hydroperoxides (HY; i.e., by products of lipid peroxidation), total amount of non-enzymatic antioxidants (RAP), uric acid (UA), thiols (TH) and advanced oxidation protein products (AOPP). In addition, a subgroup (n=126) of MCI patients were followed-up for averagely 2 years to evaluate if baseline levels of OxS markers were either related or not to the conversion to LOAD or VAD. Multivariate analysis (covariates: age, gender, smoking and comorbidities) of our cross-sectional data showed a significant (p<0.01 for all) decrease of RAP levels compared to controls in MCI (-24.5%), LOAD (-24.2%) and VAD (-29%) patients. On the other hand, HY emerged as significantly higher (p<0.05) in LOAD patients (+30.6 %), (but not in MCI and VAD) with respect to healthy. Multivariate logistic regression highlighted the presence of a similar unfavourable oxidative balance (high HY and low RAP) in MCI (O.R.: 4.87; 95%CI: 1.02-23.55) and LOAD (O.R.: 6.99; 95%CI, 1.87-25.21). Noteworthy, no differences were found in OxS markers between MCI patients who converted to LOAD (n=29) or to VAD (n=15) and those that remained stable (n=82) after follow-up time. Overall, our results suggest that systemic redox imbalance might be a significant feature of early stage of dementia. Moreover, the similar (deranged) oxidative profile in MCI and LOAD, could account for the observed inability of OxS markers to predict the conversion from prodromal phase to dementia