Empathy Levels in Albanian Health Professional Students: An Explorative Analysis Using the Jefferson Scale of Empathy:

The study aims were to define the psychometric properties of the Albanian Jefferson Scale of Empathy–Health Professional Students' version, compare empathy levels among Albanian Health Professional students, and explore any relationship among students' characteristics and their empathy levels. To achieve these aims, a comparative cross-sectional study was conducted. A preliminary exploratory factor analysis was conducted to determine the factor structure of the scale, while group comparisons of empathy scores were examined using t-test and ANOVA F-test. A total of 1,240 students were enrolled in the study. Psychometric properties of the scale were confirmed. Midwifery, physiotherapy, and female students showed higher levels of empathy than other groups. Similarly, third-year students showed higher empathy than first- and second-year students. Monitoring empathy levels is fundamental to the adoption of useful educational strategies by faculties to improve empathy skills in Health Professional students and guarantee better care of patients, especially those in need of psychological support

Need for ethics support in clinical practice and suggestion for an Ethics Consultation Service: views of Nurses and Physicians working in Italian Healthcare Institutions

Introduction. Ethics Consultation Services (ECS) and Ethical Committees manage several aspects of clinical ethical issues. In Italy there are only Ethical Committees, and, although they should also perform ethical consultations, their activity is limited to approving clinical trial protocols. Aim. To analyse the opinions of a sample of Nurses and Physicians about their motivations to ask for an ethical consultation. Methods. A cross-sectional study was conducted on a sample of Italian Nurses and Physicians. Results. Respondents would request ethical consultations mainly for end-of-life issues and, secondarily, for conflicts with patients’ families. Respondents identified the provision of suggestions for hospital policy, the development of ethical guidelines, and the counselling for individual cases requested by clinicians, patients or families as the most important functions of ECS. Conclusions. ECS activities should focus on counselling and support to decisions in complex ethical situations according to institutional policies and guidelines self-developed.

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys