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Aims and Objectives: To explore the association between patient and caregiver depression and patient self‐care and caregiver contribution to self‐care in the context of ostomy care. Background: Self‐care is essential for ostomy patients and their caregivers. The ostomy self‐care process can be considered a dyadic phenomenon in which the patient and the caregiver interact together and work as a team. The presence of depressive symptoms may limit the patient's ability to perform self‐care and caregivers' abilities to engage in caregiving tasks. Research into the dyadic influence of depression on self‐care behaviours from the perspective of ostomates and their caregivers is still in its infancy. Design: Secondary analysis of a multicentre, cross‐sectional study. The STROBE checklist was used to report the present study. Methods: Patient–caregiver dyads were recruited from eight ostomy outpatient clinics from February 2017 to May 2018. Depression was assessed with the nine‐item Patient Health Questionnaire in both patients and caregivers. Patient self‐care was evaluated with the Ostomy Self‐Care Index, and caregiver contribution to self‐care was assessed with the Caregiver Contribution to Ostomy Self‐Care Index. Both instruments measure the dimensions of maintenance, monitoring and management. The actor–partner interdependence model was performed for the dyadic analysis. Results: In total, 252 patient–caregiver dyads (patients: 69.8% male, mean age 70.05; caregivers: 80.6% female, mean age 58.7) were enrolled. Patient depression was positively associated with caregiver contribution to self‐care maintenance. Caregiver depression was negatively associated with self‐care management. Relevance to Clinical Practice: These findings add a better understanding of the reciprocal influence of dyadic depression on patient and caregiver contributions to self‐care in ostomy contexts was found. Patient and caregiver depression influence patient self‐care and caregiver contribution to self‐care. Therefore, clinicians should assess and treat depression in both members of the dyad to improve self‐care. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe caregiver contribution (CC) to ostomy self‐care and identify its associated variables among caregivers of ostomy patients. Background: Self‐care is essential for ostomy patients, but it can be difficult to perform. In these cases, caregivers play a key role in promoting self‐care behaviours. So far, the CC to ostomy self‐care has not been investigated thoroughly. Design: This is a cross‐sectional and multicentre study conducted at seven outpatient clinics of two Italian regions. Methods: We recruited 252 caregivers between February 2017–May 2018. The Caregiver Contribution to Ostomy Self‐Care Index (CC‐OSCI) was used to measure CC to ostomy self‐care. Three multivariable linear regression models were fitted to identify variables associated with CC dimensions (maintenance, monitoring and management). The STROBE checklist was used to report the present study. Results: The sample (mean age = 58.73, SD = 13.98) was mostly female (80.60%), unemployed (58.70%) and resided with the patient (81.00%). Caregivers being employed and those declaring more hours of contribution per week were associated with a significantly lower contribution to self‐care maintenance. Caregivers with lower levels of education and those residing with the patient were less likely to contribute to CC to self‐care monitoring. Spousal caregivers and those with higher preparedness contributed significantly lower to CC to self‐care management. Conclusions: We found a variety of sociodemographic factors associated with CC to ostomy self‐care. Relevance to clinical practice: Sociodemographic variables associated with CC to ostomy self‐care can help clinicians develop more tailored educational interventions for caregivers who find their contribution challenging. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the sociodemographic and academic characteristics of nursing students who report academic failure and to identify the determinants of academic failure (no degree on time) in a population of nursing students. Background: Although prior studies have shown that academic failure is influenced by multiple factors, the studies mentioned have mostly focused on specific single variables associated with academic failure, and they have reported inconsistent results. Design: A prospective follow‐up study design was used in an Italian Baccalaureate Nursing Degree program. A total sample of 2,040 at baseline and a random subsample of 753 students were considered for academic failure determinants. The study followed the recommendations of STROBE (Strengthening the Reporting of Observational studies in Epidemiology). Methods: We included in the model academic background, self‐efficacy, sociodemographic variables and self‐efficacy in psychomotor skills and motivation. We used the Academic Nurse Self‐Efficacy Scale (ANSEs), the Nursing Self‐Efficacy in Psychomotor Skill Scale (NSE‐PS) and the Motivation Nursing Students' Scale (MNSS) which have been validated on nursing students. For the assessment of predictors of academic failure, a two‐stage hierarchical logistic regression analysis was performed. Results: Students who had academic failure were 69.4% of the sample. Predictors of academic failure were the secondary school certification grade, the university pre‐admission test score; the academic self‐efficacy, self‐efficacy in psychomotor skills and clinical training examination grades were additional predictors. Conclusions: The secondary school certification grade, the University pre‐admission test score, low academic self‐efficacy, low self‐efficacy in psychomotor skills and low clinical training examination grades were predictors of academic failure in nursing students. Relevance to clinical practice: Our findings suggest that the universities could consider a cut‐off in the pre‐admission test score as a critical value for identifying students who are likely to fail. In addition, nursing faculty staff should consider strategies for developing self‐efficacy and motivation. [ABSTRACT FROM AUTHOR]

Aim and objectives: To assess the prevalence of anxiety, sleep disorders and self‐efficacy and their predicting factors among nurses facing COVID‐19. Background: The spread of COVID‐19 throughout the world determined a series of modifications of several National Health Service organisations, with a potential series of psychological consequences among nurses, who were particularly afflicted by this situation of changes and precariousness. Design: A cross‐sectional study was carried out from February–April 2020. Methods: A total of 1,005 nurses employed in different Italian hospital wards, during the COVID‐19 pandemic, were recruited. Analyses were based on descriptive statistics and multivariate logistic regression. The STROBE checklist for cross‐sectional studies was used in this study. Results: The prevalence of sleep disturbances, moderate anxiety and low self‐efficacy was 71.4%, 33.23% and 50.65%, respectively. We found a positive correlation between anxiety and sleep quality (0.408; p <.0001) and negative correlations between self‐efficacy and anxiety (−0.217; p <.0001) and sleep quality and self‐efficacy (−0.134; p <.0001). The factor independently associated with all variables was gender. Females were more prone to sleep disturbances, anxiety and low levels of self‐efficacy than males (p <.05). Conclusions: The prevalence of anxiety, sleep disorders and low self‐efficacy among Italian nurses during the COVID‐19 pandemic was high. Healthcare managers should recognise and consider these results to reduce the risk of the onset of major mental problems that could result in post‐traumatic stress disorder. Relevance to clinical practice: Nurses facing major incidents as COVID‐19 pandemic are among healthcare personnel exposed to a high risk to develop psychological disturbance that should be assessed and recognised, in order to find helpful coping strategies to inform support services and avoid to hesitate in post‐traumatic stress disorders. [ABSTRACT FROM AUTHOR]

Background: Wound care nurses are recognised as a key element for improving health outcomes. However, there is still fragmented knowledge of the outcomes associated with their practice in individuals with pressure ulcers. Aims and objectives: To identify, summarise and map all available evidence related to the outcomes of wound care nurses' practice in individuals with pressure ulcers. Design: Integrative literature review. Review method: To report the review, we followed the modified version of Cooper's five‐step methodology, and the PRISMA guidelines. Methods: The search was carried out on CINAHL, PubMed, the Cochrane Library and Scopus, with a time frame ranging from each database inception to December 21, 2019. We included observational or experimental studies of adult individuals affected by (or at risk of) developing pressure ulcers who were also cared for by wound care nurses. Results: Of the 439 peer‐reviewed publications, 13 studies met the inclusion criteria. The most frequent outcomes were pressure ulcer incidence, healing rate and time taken for complete healing. Less frequent outcomes were changes in pressure ulcers' stage, number of completely healed wounds, treatment costs and physical discomfort. No patient‐reported outcomes were assessed. Conclusion: This review indicates that clinical‐related outcomes were by far the most reported. Future studies should broaden the spectrum of outcomes to include more subjective parameters (e.g. pain, quality of life, stress, etc.), in order to gain a better understanding of the global impact of wound care practice on patients with pressure ulcers. Relevance to clinical practice: There is promising evidence of a positive impact of wound care nurses' practice on health and economic outcomes. Nonetheless, more robust and rigorous research is needed to provide stronger evidence in the field and support investment in these practitioners. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the care provided to patients admitted into a community Nursing‐Led inpatient unit and to identify factors predicting a length of stay exceeding an established threshold. Background: Few studies have been conducted to describe the care provided in a Nursing‐Led unit. No studies have investigated factors affecting length of stay in these services. Design: Retrospective cohort study. Methods: Consecutive patients admitted to a community Nursing‐Led unit between 2009–2015 were enrolled. Sociodemographic, medical and nursing care (diagnoses and activities) variables were collected from electronic health records. Descriptive analysis and a backward stepwise logistic regression model were applied. The study followed the STROBE guidelines. Results: The study enrolled 904 patients (mean age: 77.7 years). The most frequent nursing diagnoses were bathing self‐care deficit and impaired physical mobility. The nursing activities most provided were enteral medication administration and vital signs measurement. Approximately 37% of the patients had a length of stay longer than the established threshold. Nine covariates, including being discharged to home, having an impaired memory nursing diagnosis or being treated for advanced wound care, were found to be independent predictors of prolonged length of stay. Variables related to medical conditions did not affect the length‐of‐stay threshold. Conclusions: The length of stay in the community Nursing‐Led unit was mainly predicted by conditions related to sociodemographic factors, nursing complexity and functional status. This result confirms that the medical and nursing needs of a community Nursing‐Led unit population substantively differ from those of hospitalised acute patients. Relevance to clinical practice: The nursing complexity and related nursing care to be provided may be adopted as a criterion to establish the appropriate length of stay in the community Nursing‐Led unit for each individual patient. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine nursing students' health habits. More specifically, the objectives were to determine whether there were any changes in their health habits during their course of study, and to understand whether the students' perceptions about good health conditions cohered with their health‐related behaviour. Background: The transition from high school to university has an undesirable effect on students' health habits, and nursing students' unhealthy behaviours may prevent them from helping patients improve their poor health habits. Design: A longitudinal design was used. The study followed the recommendations of STROBE (Strengthening the Reporting of Observational studies in Epidemiology). Methods: All students were recruited from a nursing science degree course in an Italian university. The sample consisted of 351 nursing students. Data were collected at the baseline during their entrance into the university (T0) and at the end of their third year of coursework (T3). We developed the Nursing Student Health Habits Scale, which was administered by a trained researcher. The McNemar test and the Wilcoxon signed‐rank test to evaluate the differences in health habits between T0 and T3, and a logistics model to assess the factors influencing students' good health perceptions were used. Results: From T0 to T3, there were decreases in the number of students who requested physician consultations (p =.01) and increases in those who exercised daily (p =.003). There was also a change in the nutrition model (p =.018). In the multivariate model, physician consultations for medical problems and performing physical exercise were factors influencing good health perceptions. Conclusions: Future research is needed to illuminate other aspects of students' health habits. Relevance to clinical practice: Universities are advised to address these problems by reflecting on undergraduate and postgraduate curriculum content concerning health management and disease prevention. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the impact of nursing diagnoses on patient and organisational outcomes in any field of health care where nurses are involved. Background In healthcare systems, descriptions of patient complexity and outcomes and payment criteria are primarily based on medical diagnoses and procedures. Other aspects of patient care are rarely considered. Nursing diagnoses are believed to be related to healthcare outcomes, but comprehensive evidence for this association is missing. Design Systematic literature review. Methods The search was conducted in PubMed, CINAHL and Scopus databases without year or language limitations. The studies were categorised according to their methodological quality (low, good or high) and classified based on their levels of evidence on a scale of 1 (strongest evidence) to 5 (weakest evidence). Results Seventeen of 3426 potentially relevant studies met the eligibility criteria. Eleven studies were classified as low, five as good and one as high quality. The levels of evidence were rated as 2 for one study, three for two studies, four for nine studies and five for five studies. Nursing diagnoses were found to predict patient (quality of life, mortality) and organisational (length of hospital stay, hospital charges, amount of nursing care, discharge dispositions) outcomes. Patient care plans based on nursing diagnoses improved sleep quality, quality of life and glycaemic control. When added to information from disease-based classification systems (e.g. diagnosis-related groups), nursing diagnoses improved the predictions of the above outcomes. Conclusions Nursing diagnoses have a great potential to predict patient and organisational outcomes. High-quality research is required to better investigate the existence and strength of these relationships. Relevance to clinical practice The systematic use of nursing diagnoses in clinical practice, as well as the sharing of high-quality nursing data in large databases, may provide a considerable boost to the contribution of nursing to healthcare outcomes. [ABSTRACT FROM AUTHOR]

Aims and Objectives To explore the lived experiences of patients with haematological malignancies who had been in protective isolation during their hospital stay for autologous haematopoietic stem cell transplantation. Background Although protective isolation aims to benefit patients' health by preventing infection, it could also imply harmful psycho-social implications for patients, such as loneliness. Design A descriptive phenomenological study was conducted in an Italian university hospital. Methods Nine patients with haematological malignancies who had been in protective isolation for autologous haematopoietic stem cell transplantation were enrolled. They were interviewed during their weekly ambulatory visits, which are usually carried out up to 100 days post-transplant, and asked about their stay in isolation. Giorgi's method of analysis was used to describe the experience of protective isolation from the patient' perspective. Results Eight themes emerged: isolation is a defence, threats from which patients have to defend themselves, rules for defence, the burden of the defence, external strategies for defence, inner strengths for defence, defending loved ones and outcomes of the defence. The general structure was expressed as a defence from suffering. Conclusions While fighting a hard battle against cancer, informants largely accepted the strict isolation measure and represented it as a shield for an effective defence. Relevance to clinical practice Nurses should provide emotional and social support to help patients feel like active fighters and strengthen their strategies for an effective defence from suffering. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the effectiveness of a follow-up telephone call to reduce the number of issues after hospital discharge. Background The postdischarge period is often a time of uncertainty and risk. The decreasing length of hospital stays has increased the need for specific instructions about the postdischarge period. A telephone follow-up could be a valuable tool to fill this information gap. Design Double-blind, randomised controlled trial. Methods The participants included medium or low-intensity orthopaedic patients. We implemented a structured telephone follow-up call conducted by a senior orthopaedic nurse to provide educational support to the intervention group ( n = 110), while the control group ( n = 109) received routine care after being discharged. Data were collected between September 2011-January 2012. Statistical differences between the two groups were tested using chi-square test or Wilcoxon rank sum test, as appropriate. A linear regression model was performed to investigate factors involved into postdischarge outcomes. Results The intervention group had a statistically significant reduction in all postdischarge problems except for pain and mobilisation; the group also had a lower chance of experiencing frequent or severe problems. The educational intervention and prior poor health had a strong correlation with problems after discharge. Patients who received a telephone follow-up call believed the information provided was valuable. Conclusion This nurse-led follow-up intervention significantly contributed to solving or reducing postdischarge health problems and contributed to reduce unnecessary burden on the community health system. Relevance to clinical practice A nurse-led telephone follow-up is a simple, feasible and low-cost tool to improve patients' outcomes after discharge. [ABSTRACT FROM AUTHOR]

Aims. The aim of this study is to evaluate the consistency between the care given to patients and that documented, by comparing care observations with nursing records and describing which interventions were reported and which were omitted. Background. Assumptions have been made about the relationship between documentation and care actually delivered, but there is insufficient evidence on the relationship between the actual care given and its recording. Design. Observational study of the care given, completed by interviews and retrospective survey of records. Methods. Structured observation during day shifts in the first six days of admission of pre and postsurgical care provided to 21 consecutive patients undergoing major abdominal surgery and audit of their nursing records. Each observation was completed by short interviews to nurses to ensure observations validity. Results. Only 40% of nursing activities observed were included in the nursing records (37% of the assessments and 45% of the interventions). This indicated that nurses carry out more activities than they report. Consistency between performed and recorded care decreased significantly during the days when a higher number of activities were performed. Consistency between recording and observation of assessment activities was 38% for physical needs and 0% for educational needs. Consistency was higher for the assessments of physical signs/symptoms and risk factors for complications compared to the assessment of basic needs and pain. Consistency was 47% for technical interventions and 3% for educational activities. Conclusions. Nursing records were not found to be an adequate tool for quality care evaluation, because they did not include all the caring activities that the nurses had carried out. Relevance to clinical practice. This study supports the need to identify documentation systems that are easy to complete. Moreover, nursing education should pay more attention to the competences in the field of holistic care and patient education. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Patient or Public Contribution To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors.An online cross‐sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES‐NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines.A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards.Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence‐free policies for hospitals. Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID‐19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job. The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses. Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high‐quality care in a totally safe environment. No patient or public contribution. [ABSTRACT FROM AUTHOR]