Not only a problem of fatigue and sleepiness: Changes in psychomotor performance in Italian nurses across 8-h rapidly rotating shifts

Although many studies have detailed the consequences of shift work in nurses concerning health, fatigue, sleepiness, or medical errors, no study has been carried out trying to disentangle the contribution of sleepiness and fatigue associated to shift work from the attentional performance. The aim of this pilot study is (A) to investigate the effects of an 8-h rapidly rotating shift on fatigue and sleepiness among staff nurses and (B) how these factors affect their psychomotor performance. Fourteen nurses were selected for a within-subject cross-sectional study according to this sequence of shifts: morning–afternoon–night, which were compared as function of tiredness, sleepiness, and performance at the Psychomotor Vigilance Task (PVT). Subsequently, a within-subject Analysis of Covariance (ANCOVA) evaluated if the observed differences between shifts persist when the contribution of sleepiness is controlled. Our results clearly indicate that night shifts are associated with significant greater sleepiness and tiredness, and worsened performance at the PVT. As hypothesized, ANCOVA showed that these differences disappear when the contribution of sleepiness is controlled. Results point to a lower psychomotor performance in night compared to day shifts that depends on sleepiness. Hence, interventions to minimize the consequences of the night shift should consider a reduction of sleepiness

Usporedbeno istraživanje metoda prikupljanja podataka u procesu sestrinske njege: otkrivanje nuspojava kemoterapije pomoću upitnika za samoprocjenu

Toxicity of chemotherapy is a factor that most negatively affects the quality of life of cancer patients. Monitoring of side effects and adverse effects may be subject to errors due to various factors such as the lack of privacy during data collection, shame on the part of the patient to talk about some issues, lack of recognition of symptoms and/or unawareness of side effects of treatments, and/or inappropriate reference model of data collection. In order to assist caregivers in proper data collection, a ‘self-reporting questionnaire’ was designed. The questionnaire was developed using validated scales such as the Common Terminology Criteria for Adverse Event, Edmonton Symptom Assessment Scale and Douleur Neuropathique en 4 Questions. The survey involved the population of patients scheduled for chemotherapy in Day Hospital at the Campus Bio-Medico University Hospital, Rome, between June and July 2015. During the period of observation, 367 patients were admitted to Day Hospital, 57.5% of women and 38.4% of men, average age 64 years, for a total of 622 accesses; of these, only 173 were interviewed by the nursing staff in relation to side effects and toxicity. During the trial, 381 patients were involved, of which 60.1% of women (p=0.8) and 38.3% of men (p=0.9), average age 63 years (p=0.9), for a total of 611 accesses and 498 self-reporting questionnaires administered. At the end of the trial period, in order to evaluate usability, an evaluation questionnaire was given to medical personnel, including five doctors and six nurses, to consider possible amendments to the instrument and its perceived effectiveness. Comparative analysis of data collected during the observation period and the trial showed how the use of the self-reporting questionnaire allowed for detection of side effects of chemotherapy earlier and in a more detailed way than relying only on medical examination and unstructured interview by nursing staff. It also enabled reaching a larger number of users. In conclusion, the use of self-reporting systems, together with the work and clinical judgment of the expert, can contribute to improvement in the patient quality of life, corroborating nurse interviews through a precise and systematic data collection process that reduces the amount of interpretation of symptoms by the patient and the caregiver, while providing them with precise instructions on what to report and how to report it. The significant and rapid spread of computers, tablets and smartphones allows for speculating on further use and implementation of this system through its computerized application.Toksičnost kemoterapije je čimbenik koji ima najteži učinak na kvalitetu života u bolesnka s karcinomom. Praćenje nuspojava i štetnih učinaka može biti podložno greškama zbog raznih čimbenika kao što je nedostatna zaštita povjerljivosti ­tijekom prikupljanja podataka, nevoljkosti bolesnika da govori o nekim problemima, neprepoznavanje simptoma i/ili ­nepoznavanje nuspojava liječenja i/ili neodgovarajući referentni model prikupljanja podataka. Zato smo izradili upitnik za samoprocjenu kako bismo pomogli u ispravnom prikupljanju podataka onima koji pružaju skrb ovim bolesnicima. Upitnik je izrađen uz pomoć provjerenih ljestvica kao što su Common Terminology Criteria for Adverse Event, Edmonton Symptom ­Assessment Scale i Douleur Neuropathique en 4 Questions. Istraživanje je obuhvatilo bolesnike naručene za kemoterapiju u Dnevnoj bolnici Sveučilišne bolnice Campus Bio-Medico u Rimu u lipnju i srpnju 2015. godine. U tom razdoblju u Dnevnu bolnicu je primljeno 367 bolesnika, 57,5% žena i 38,4% muškaraca prosječne dobi od 64 godine, za ukupno 622 pristupa. Od svih tih bolesnika sestrinsko osoblje je samo njih 173 ispitalo o nuspojavama i toksičnosti. Za vrijeme istraživanja bio je uključen 381 bolesnik, od toga 60,1% žena (p=0,8) i 38,3% muškaraca (p=0,9) prosječne dobi od 63 godine (p=0,9), za ­ukupno 611 pristupa i 498 izdanih upitnika za samoprocjenu. Kako bismo procijenili primjenjivost ovoga upitnika, na kraju istraživanja upitnik za njegovu procjenu je podijeljen medicinskom osoblju uključujući pet liječnika i šest medicinskih sestara kako bi razmotrili moguće potrebne dopune ovoga instrumenta te njegovu učinkovitost. Usporedbena analiza podataka prikupljenih tijekom istraživanja pokazala je da je primjena upitnika za samoprocjenu omogućila otkrivanje nuspojava kemoterapije ranije i podrobnije nego kad se to oslanjalo samo na medicinski pregled i nestrukturirani razgovor sestrinskog osoblja s bolesnicima. Uz to, ovom metodom je obuhvaćen veći broj korisnika. U zaključku, primjena sustava za samoprocjenu zajedno sa stručnim radom i kliničkom prosudbom može doprinijeti poboljšanju bolesnikove kvalitete života, pružiti potporu razgovoru sestrinskog osoblja s bolesnikom kroz proces preciznog i sustavnog prikupljanja podataka, čime se znatno smanjuje tumačenje simptoma od strane bolesnika i osoba koje ih njeguju, ali im pruža točne upute o čemu trebaju izvijestiti i kako. Zahvaljujući značajnom i brzom širenju računala, tableta i ‘pametnih telefona’ može se promišljati o daljnjoj primjeni ovoga sustava kroz njegovu računalnu aplikaciju

A Phenomenological Approach to Medication Adherence in Elderly Patients: A Qualitative Study

Background: Patient adherence to drug treatment is crucial to the success of any prescribed therapy, especially in chronic conditions. The present phenomenological qualitative study aims to explore the elderly experience in managing their medication therapy and their perception of medication adherence. Methods: Based on Husserl's perspective, a qualitative descriptive study was conducted utilizing the phenomenological approach, specifically Interpretative Phenomenological Analysis (IPA). The data analysis followed Giorgi's phenomenological approach and the inductive content analysis method. Approval for the study was obtained from the relevant Ethics Committee. Results: Themes emerged when participants described experiences about their own adherence to therapy. The following general theme emerged from the interviews and the phenomenological analysis: Generating awareness: taking therapy saves your life. It was followed by three other themes: (1) Drug therapy awareness; (2) Drug therapy in daily life; and (3) Drug therapy as a life partner. Conclusions: Elderly patients undergoing polypharmacological treatment emphasize the key factors for improving medication adherence, highlighting the influence of individual, motivational, and relational aspects. They express a strong desire for information and value the support of family doctors and nurses in managing therapy. Patient interviews indicate general support among elderly patients for using mobile health in pharmacological treatment, recognizing its potential and limitations

La metafisica del dolore

Il dolore pone le sue radici nella notte dei tempi. Da sempre è stato oggetto d’interesse per il genere umano, suscitando timore e superstizione nell’antichità, studio e analisi nei tempi successivi. Ricerche accurate effettuate nei secoli sull’argomento hanno consentito solo oggi di poterlo comprendere e controllare nel migliore dei modi. Per anni, la difficoltà maggiore è stata quella di voler descrivere, in poche parole, una condizione che aveva risvolti psicologici, fisiopatologici, emotivi ed affettivi. C'è una disciplina che studia l'essere in quanto essere e le proprietà che gli sono inerenti per la sua stessa natura e non si identifica con nessuna delle cosiddette scienze particolari, giacché nessuna delle altre ha come suo oggetto d'indagine universale l'essere in quanto essere. Ciascuna di esse, infatti, ritaglia per proprio conto una qualche parte dell'essere e ne studia gli attributi, come fanno, ad esempio, le scienze matematiche. Solo la metafisica può farlo, visto che si tratta di una branca della Filosofia. La maggior parte di coloro che per primi filosofarono, pensarono che principi di tutte le cose fossero solo quelli materiali. Non a caso, essi affermano che ciò di cui tutti gli esseri sono costituiti (ciò da cui derivano originariamente e in cui si risolvono da ultimo) è elemento ed è principio degli esseri, in quanto è una realtà che permane identica pur nel trasmutarsi delle sue affezioni

Nursing students’ experience of risk assessment, prevention and management: a systematic review

Introduction:  As a fundamental dimension of quality, the patient safety and healthcare workers safety in the healthcare environment depend on the ability of each healthcare workers (whether administrators or technicians) to reduce the probability of error. This review focused on nursing students. The aim was to assess level and determinants of knowledge about risk assessment, risk prevention and risk management of nursing students. Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Two reviewers searched the bibliographic databases Pubmed, Scopus and Cinahl to collect all the available articles in English and Italian issued between 2015 and August 2019. To obtain an exhaustive string search, the following keywords were combined through Boolean operators AND and OR: Clinical Risk Assessment, Nursing Education, Nursing Student*, Patient Safety. The authors assessed the quality of the evidence by using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method.  Results: Twelve papers are included. Although the literature on the nursing student's error is limited, their frequencies are worrying. Some authors have created a model of prevention of clinical error based on three level. However, the majority of nursing students don’t felt confident with a patient safety. Many authors shown that patient safety education was delivery by lecture, laboratory or simulation sessions. Conclusions: This review underlines the need to revise the nursing curriculum on patient safety and the need to think what educational methodology is the better for the student to create a safe care. &nbsp

Reliability and use of Copenhagen Burnout Inventory in italian sample of university professors

Academics often have to face with burnout syndrome at work. This cross-sectional study evaluates the reliability of the Italian version of the Copenhagen Burnout Inventory (CBI) in a sample of Academics of Sapienza University of Faculty of Medicine and Pharmacy, through an online questionnaire composed of the CBI, SF12 Health Survey, and Positivity Scale. Univariate, bivariate, multivariate analyses, and Cronbach α coefficients of CBI were performed. Ninety-five participants completed the questionnaire (response rate 85%). Cronbach’s α of the three domains were high (0.892, 0.868, and 0.836). Women, younger and part time professors reported higher score in personal (p = 0.025; 0.060) and work burnout. In multivariate analysis decreasing age (β = −0.263; p = 0.001); being a professor in environmental technicians (β = −0.120; p = 0.098); and low mental (β = −0.263; p = 0.020), physical (β = −0.319; p ≤ 0.001) and positivity scores (β = −0.237; p = 0.031) predict significantly higher personal burnout. Low physical (β = −0.346; p < 0.001) and mental (β = − 0.249; p = 0.013) positivity (β = −0.345; p = 0.001) scores; fewer years of work (β = −0.269; p ≤ 0.001); and being a medical or nursing professor (β = 0.169; p = 0.016) predicts high work burnout. Low MCS predicts a high level of student burnout. Results suggest that the Italian version of the CBI is a reliable instrument. Further research should focus on the prevalence of burnout in academics

Morphology of planktonic zoeal stages of Palicus caronii (Decapoda, Brachyura), identified by DNA barcoding, provides novelties to Palicoidea larval systematics

The zoeal development of the brachyuran crab, Palicus caronii, comprises two zoeal stages and the morphology is described and illustrated in detail. The zoeae were collected in plankton samples from the Southern Ligurian Sea (Western Mediterranean). Although the morphology of the larval stages of this species was unknown, a combination of characters allowed the zoeae to initially be assigned to the Palicidae, based on the previous unique known first zoeal description of one species of this family. Later, the identification of the larvae as Palicus caronii was confirmed through molecular analysis. The morphological features of the zoeae that characterize the Palicidae and separate them from the Crossotonotidae are confirmed. Also, the larval development comprising only two zoeal stages observed in Palicus caronii, the peculiar and uncommon carapace surface setation, and the presence of anterodorsal and posterodorsal sensory dorsal organs suggest that these characters could be common to the Palicoidea.The collection of the larval stages used in the present work was performed in the context of a project carried out with the financial support of the Italian Ministero della Salute (Research Project IZSPLV 14/14 RC). COI sequence of adult crab of Palicus caronii was obtained within the framework of the MEGALOPADN project (CGL2009-11225) funded by the “Ministerio de Economía y Competividad (MINECO)” Spanish Plan R + D + I and FEDER. Authors would like to thank Prof. Simona Bonelli, Department of Life Sciences and Systems Biology (UNITO), for her support, and the entomology laboratory of Department of Agriculture, Forestry and Food Sciences (UNITO) for loaning the camera lucida, with a special thanks to Enrico Busato for his availability. The study was funded by the Italian Ministero della Salute (Research Project IZSPLV 14/14 RC)

Are knowledge and skills acquired during the Master Degree in Nursing actually put into practice? A pilot study in Italy

Background. Literature on the evaluation of the Master’s Degree in Nursing is scarce. The objective of this pilot study was to test a questionnaire aimed at monitoring the activities of nurses after receiving the Master’s degree. Methods. An electronic questionnaire was administered to 36 graduates who obtained the Master’s degree during the academic year 2010/2011. Results. Almost 80% of the participants judged their level of improvement in knowledge and skills during the course to have been satisfactory, but the level of implementation of these competencies at work was quite low. Conclusion. Competencies acquired during the Master’s degree course are not always put into practice