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BACKGROUND: To predict delirium in intensive care unit (ICU) patients, the Prediction of Delirium in ICU Patients (PRE-DELIRIC) score may be used. This model may help nurses to predict delirium in high-risk ICU patients. OBJECTIVES: The aims of this study were to externally validate the PRE-DELIRIC model and to identify predictive factors and outcomes for ICU delirium. METHOD: All patients underwent delirium risk assessment by the PRE-DELIRIC model at admission. We used the Intensive Care Delirium Screening Check List to identify patients with delirium. The receiver operating characteristic curve measured discrimination capacity among patients with or without ICU delirium. Calibration ability was determined by slope and intercept. RESULTS: The prevalence of ICU delirium was 55.8%. Discrimination capacity (Intensive Care Delirium Screening Check List score ≥4) expressed by the area under the receiver operating characteristic curve was 0.81 (95% confidence interval, 0.75-0.88), whereas sensitivity was 91.3% and specificity was 64.4%. The best cut-off was 27%, obtained by the max Youden index. Calibration of the model was adequate, with a slope of 1.03 and intercept of 8.14. The onset of ICU delirium was associated with an increase in ICU length of stay (P < .0001), higher ICU mortality (P = .008), increased duration of mechanical ventilation (P < .0001), and more prolonged respiratory weaning (P < .0001) compared with patients without delirium. DISCUSSION: The PRE-DELIRIC score is a sensitive measure that may be useful in early detection of patients at high risk for developing delirium. The baseline PRE-DELIRIC score could be useful to trigger use of standardized protocols, including nonpharmacologic interventions.

Background: The Trust Me Scale is a widely used instrument to measure trust in healthcare providers. However, no Italian version of the scale exists yet, limiting its use in Italian-speaking populations. The aim of this study is to translate and validate the Trust Me Scale for use in Italian-speaking populations in nurses and nurse managers. Methods: The translation process involved methodological steps of collaborative and iterative translation with cultural adaptation. The validation process included a cross-sectional study enrolling a convenience sample of 683 nurses and 188 nurse managers who completed the Italian version of the Trust Me Scale and measures of intention to leave, satisfaction, and organizational commitment. Results: Item 5 was removed for poor factor loading, and items 11 and 13 were removed following an a priori strategy focused on deleting items with correlations between residual variables different than expected based on theoretical expectations derived from previous research. The final model fit well to sample statistics with a three-factor structure (harmony, reliability, and concern) and 13 items. A multiple-indicator multiple-cause model showed a measurement invariance between nurses and nurse coordinators. Construct validity was also supported by the evidence that the measured domains of trust align with the theoretical expectations and are related to the intention to leave, job satisfaction, and organizational commitment. Each dimension showed adequate scale reliability. Conclusions: The Italian version of the Trust Me Scale is a valid and reliable instrument to measure trust in nurses and nurse managers in Italian-speaking contexts. It can be used for research in nursing and leadership and evaluation of interventions aimed at improving trust in healthcare contexts.

Background: Nursing education consists of theory and practice, and student nurses’ perception of the learning environment, both educational and clinical, is one of the elements that determines the success or failure of their university study path. This study aimed to identify the currently available tools for measuring the clinical and educational learning environments of student nurses and to evaluate their measurement properties in order to provide solid evidence for researchers, educators, and clinical tutors to use in the selection of tools. Methods: We conducted a systematic review to evaluate the psychometric properties of self-reported learning environment tools in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Guidelines of 2018. The research was conducted on the following databases: PubMed, CINAHL, APA PsycInfo, and ERIC. Results: In the literature, 14 instruments were found that evaluate both the traditional and simulated clinical learning environments and the educational learning environments of student nurses. These tools can be ideally divided into first-generation tools developed from different learning theories and second-generation tools developed by mixing, reviewing, and integrating different already-validated tools. Conclusion: Not all the relevant psychometric properties of the instruments were evaluated, and the methodological approaches used were often doubtful or inadequate, thus threatening the instruments’ external validity. Further research is needed to complete the validation processes undertaken for both new and already developed instruments, using higher-quality methods and evaluating all psychometric properties

In this article the affiliation details for Authors Laura Iacorossi and Irene Terrenato were incorrectly given as ‘‘Department of Nursing & Health Professions, IRRCS Regina Elena, National Cancer Institute, Rome, Italy’’ and ‘‘Biostatistics and Bioinformatic Unit, IRRCS.

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.

Introduction In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. Objective(s) The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. Methods A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. Results The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. Conclusion NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes.

Migration has always been a part of human history [...]

ObjectiveThe evaluation of post-traumatic stress disorder (PTSD), depression, anxiety and insomnia in patients with Marfan syndrome (MFS) during the third wave of the COVID-19 pandemic in a region of northern Italy (Lombardy) and the investigation of which mental health, sociodemographic and clinical factors were associated with PTSD.DesignDescriptive observational design with cross-sectional data collection procedure.SettingA single Italian MFS-specific specialised and reference centre in Lombardy (Italy) between February and April 2021.Participants112 adults with MFS. The majority of participants were female (n=64; 57.1%), with a high school diploma (n=52; 46.4%) and active workers (n=66; 58.9%). The mean age was 41.89 years (SD=14.00), and the mean time from diagnosis was 15.18 years (SD=11.91).Primary and secondary outcomesDescriptive statistics described PTSD, which was the primary outcome, as well as depression, anxiety and insomnia, which were the secondary outcomes. Four linear regression models described the predictors of PTSD total score and its three domains: avoidance, intrusion and hyperarousal.ResultsOne out of 10 patients with MFS had mild psychological symptoms regarding depression, anxiety and insomnia, and scores of PTSD that indicated clinical worries about the mental health status. The presence of PTSD was mainly predicted by anxiety (β=0.647; pConclusionDepression, anxiety and insomnia should be monitored in patients with MFS in order to minimise PTSD insurgence. Specific psychosocial interventions should be developed and tested for this population and adopted in clinical practice, given the relevance of mental health outcomes during the pandemic.

The aim was to explore nurses’ experiences of caring for and accompanying patients dying without the presence of family during the COVID-19 pandemic.A qualitative descriptive design was used.A purposive sample of registered nurses, caring for dying patients in Italian health-care settings during the COVID-19 pandemic, were selected. To capture a broad range of experiences, a maximum variety of participants about workplace, age, gender and work experience were included. A total of 31 nurses agreed to participate in the study; 28 participants were female; participants were aged 41 on average (range 25-63 years) and worked in hospitals and nursing homes in the Northern and Central Italian regions. Six focus groups were conducted from August to December 2020 through Microsoft Teams, reaching data saturation. The transcripts were analysed through inductive content analysis. The COREQ checklist was followed for study reporting.Four main categories emerged describing nurses’ experiences: hugely increased deaths in time of COVID-19; ensuring physical, emotional, interpersonal and spiritual care for dying patients and supporting their families despite difficulties; ensuring care procedures of patients’ bodies after death and psychological consequences of caring for dying people during the pandemic.Registered nurses provided physical, spiritual and emotional care to dying patients during the pandemic, despite limited resources and knowledge, standing in for relatives who were not allowed to visit them; the experiences of caring for dying patients in the absence of the family caused emotional distress in nurses.Health-care systems should develop guidelines aiming to meet the psychological needs of dying people in case of restrictions on patients’ family visits. Health-care administrators should offer services to support the grieving process of relatives who cannot accompany dying patients and to reduce emotional distress in nurses caring for dying patients.

Purpose. To develop an Italian tool that measures the therapy adherence of women with breast cancer undergoing treatment with oral endocrine therapy. Methods A two-phase study was conducted, which followed the guidelines of the European Statistical System for the development and validation of a questionnaire. In the first phase, the questionnaire was developed; in the second phase, a preliminary validation was carried out on patients with breast cancer undergoing treatment with oral hormonal therapies. Results In its final version, the questionnaire presents 6 main items which aim to investigate the level of adherence, the degree of awareness of the nature of the drug taken and the reasons that may influence nonadherence. 82 patients were recruited in the validation study, with an average age of 56.4 years, while for the re-test 40 were selected with an average age of 57.3 years. Content validity reported excellent results. Cronbach's alpha of each item showed a strong degree of correlation. Conclusions. The creation of a tool for measuring adherence to endocrine therapy in breast cancer patients can be a valuable support for healthcare professionals involved in their care. Future studies should be aimed at using A-BET (Adherence – Breast Endocrine Therapy) on larger cohorts of patients in order to verify its validity / reliability more accurately and to be able to generalize the results.

Living with people diagnosed with a mental disorder is known to increase the risk of developing high levels of so-called "caregiver burden" in informal caregivers. In-depth analysis of this phenomenon and specific assessment tools for caregivers of patients diagnosed with Eating Disorders (EDs) are lacking. In this study, we aimed to evaluate the psychometric properties of the Caregiver Burden Inventory in EDs and employ this adapted tool in this category of caregivers.A cross-sectional study was conducted in the Eating Disorders outpatient unit of an Italian University hospital. Face and content validity were investigated by calculating standard Content Validity Indices (CVI-I and CVI-S) after administering the Inventory to 6 expert nurses with at least 5 years of experience in mental health services assisting people diagnosed with Eating Disorders. Internal consistency was evaluated with Cronbach's α coefficient for the overall scale and subscales. An exploratory factor analysis (EFA) was performed to explore latent constructs. The adapted CBI was then administered to 62 informal caregivers of ED patients.The EFA yielded a 5-factor structure. The CVI-S was 97.2%; the Cronbach α coefficient was 0,90 ( 0.74 in each subscale). The median burden level in the experimental population was 40.0 [range = 21 to 54], in a theoretical range from 0 (no burden) to 96 (highest level of burden).The Caregiver Burden Inventory appears to be a valid and reliable instrument to assess caregiver burden in individuals diagnosed with Eating Disorders. Further research is needed to evaluate this tool's efficiency in improving individually tailored interventions on families.Eating disorders (EDs) are characterized by the development of abnormal eating habits, dysregulation of body weight and/or body image distortion. The pervasiveness of EDs may significantly affect the life of patients’ caregivers in terms of emotional load, termed Caregiver Burden (CB). This may impact the quality of life of the entire family and promote conflicts which may in turn exacerbate ED behaviours. Among several international assessment tools to measure CB, the Caregiver Burden Inventory (CBI) is perhaps the most widely employed. However, this tool has never been specifically tested in caregivers of ED patients. Here we show that CBI can adequately quantify burden in this category of caregivers. Systematic use of this instrument can support healthcare workers who aim to address the carer's discomfort and promote a focused monitoring of subjects with increased risk, in order to adequately plan targeted intervention programs.

Self-care is essential to achieve positive clinical outcomes in patients with chronic diseases; however, self-care behaviors of people living with HIV (PLWH) have not been extensively studied due to the lack of validated measurements. We performed preliminary psychometric analyses of the structural validity and internal consistency of the Self-Care of Chronic Illness Inventory among 108 PLWH living in Italy and assessed self-care levels. Our findings largely replicate the instrument's original factor structure and indicated high internal consistency and reliability. Additionally, we found that PLWH performed self-care behaviors at suboptimal levels. Recommendations for clinical care and future investigations are advanced.

Spirituality is a common theme in the field of healthcare research. This study aimed to examine nurses’ perceptions of spirituality in the context of the religious diversity of patients in pluri-religious settings. We performed a scoping review following the methodology on studies conducted between 2010 and 2020. We searched the following databases: CINAHL Plus, PubMed, and PsycINFO. For the identification of grey literature, the OpenGrey database was used. In total, 789 articles were reviewed. Of these, 16 met predetermined inclusion criteria. Two main overarching themes emerged from our inductive analysis: (a) the intertwining of spirituality and spiritual care in diverse religious landscapes and (b) obstacles impeding the inclusion of spiritual care in pluri-religious settings. According to our results, nurses consider that spirituality is interconnected with spiritual care for individuals from different religious backgrounds. Interpretations of spirituality in nursing practice vary widely, with spirituality and religiosity often shaped and influenced by culture and the experience of the professionals. Nurses attribute various meanings to spiritual care, most of which center on respecting personal, interpersonal, and relational aspects of religious and cultural beliefs and practices. Lack of education and specific skills, insufficient time, role ambiguity, and different religious beliefs were identified as hurdles to spiritual care. A poor work environment, a lack of patient privacy, including personal space, and a lack of compassion were also reported as deterrents to spiritual healing. More knowledge and training on different religions and spirituality are required to meet patients’ spiritual needs to better overcome these hurdles.

Background: Constipation is a common condition. Although numerous articles emphasise the importance of conservative interventions, none have set out a complete educational programme. Aims: To describe the results of an evidence-based, nurse-led educational intervention for functional constipation in adults. Methods: A retrospective study of patient records with an analysis of Wexner constipation scores and Bristol stool charts was carried out before and after a nurse-led educational programme on nutrition and bowel habits. Findings: Twenty-nine patients were enrolled (19 women and 10 men), with a median age of 61 (53–71) years, a mean BMI of 24.4±3.88 kg/m2 and comparable baseline Wexner and Bristol scores. A statistically significant improvement in Wexner scores (PConclusion: The results suggest this investigation should be repeated on a larger scale. An educational intervention could be included in all consultations on any issue that could affect bowel activity.

Objectives Non-technical skills (NTS) are fundamental to the nursing profession to ensure safe, quality care. Purpose: The aim of this study was to develop a new instrument to assess NTS among nursing students: the Non-Technical Skills Student Evaluation (NTS-SE) tool. Methods A cross-sectional study was conducted to test the psychometric properties of the tool. A number of 1,087 nursing students were enrolled from five Bachelor Schools of Nursing. Results Exploratory and confirmatory factor analysis suggested the suitability of a two-factor model. The final version of the NTS-SE consisted of 23 items distributed in two domains: cognitive skills and interpersonal skills. For each domain, Cronbach’s alpha coefficients were above 0.94. There were significant differences in scores between second- and third-year students (p Conclusions The NTS-SE can be useful when assessing the effect of educational strategies and/or clinical traineeship experiences on the acquisition of NTS.

Despite universities in the UK, USA and Australia having developed tools and strategies to enhance academic engagement, there is a paucity of information from universities and research hospitals where conceptual and theoretical research still appears more heterogeneous. In Italy, there is a growing recognition that more needs to be done to define strategies to improve research engagement. Italian research hospitals are represented by the Scientific Institute for Research, Hospitalization and Healthcare (named IRCCS from the Italian acronym of these organisations), representing the best of Italian research and the National Health Service System. This article provided a pilot description of research engagement in a representative Italian IRCCS hospital for the first time. A pilot study was developed, and a brief questionnaire was validated to explore research engagement. The identified clusters of researchers’ engagement were provided to describe an initial theory-grounded framework. Based on the perspective of research administrators and the Ministry of Health during round tables, the developed questionnaire identified two clusters of researchers’ engagement and measured “Project-oriented” and “Organisation-oriented” engagement. Among the responders, IRCCS senior researchers tended to have higher project-oriented engagement, while young researchers had slightly higher organisation-oriented engagement. The contribution of this article is a hypothesised two-level theory-grounded framework to study and improve research engagement activities and strategies in a research hospital, with the potential for an overlap with other European research institutions.

To translate and validate the Italian version of the Spirituality and Spiritual Care Rating Scale (SSCRS-ita).A single-center cross-sectional study was performed from October 15 to November 15, 2019 in a public hospital in Milan, Italy. The scale was drafted using the back-translation method. Prior to administration, the Italian version of the scale was assessed for content validity and retest stability by calculating the content validity index. Internal consistency was investigated by calculating Cronbach's alpha coefficient, test-retest stability by Spearman's rho coefficient.A total n = 337 nurses participated in the survey by correctly completing the scale. The Kaiser-Meyer-Olkin test (0.81) and Bartlett's test of sphericity (p 0.001) confirmed the adequacy of the sample to conduct exploratory factor analysis (EFA). The factorial model of EFA without rotation and then with nonorthogonal Promax rotation confirmed the presence of the four constructs identified by the original author.SSCRS-ita showed promising psychometric properties in terms of validity and reliability. The results of this study, together with the lack of in-depth studies in the Italian health and educational panorama, suggest the need to develop an educational pathway which, starting from the curricula of basic training and continuing with the updating of nursing staff, is dedicated to the detection of the spiritual needs of the patient.The SSCRS-ita is the first validated Italian tool concerning the consideration of the needs of spirituality and spiritual care in healthcare contexts; the possibility to use this tool is the first step towards a better integration of the mentioned dimensions of care in a nursing care qualitative perspective in Italy.Tradurre e validare la versione italiana della Spirituality and Spiritual Care Rating Scale (SSCRS-ita).È stato effettuato uno studio trasversale monocentrico dal 15 ottobre al 15 novembre 2019 in un ospedale pubblico di Milano, in Italia. La scala è stata redatta utilizzando il metodo della back-translation. Prima della somministrazione, sono state valutate la validità di contenuto e la stabilità di retest della versione italiana della scala calcolando il Content Validity Index. La consistenza interna è stata studiata calcolando il coefficiente alfa di Cronbach, la stabilità test-retest con il coefficiente rho di Spearman.Un totale di n. = 337 infermieri ha partecipato all'indagine completando correttamente lo strumento. Il test Kaiser-Meyer-Olkin (0,81) e il test di sfericità di Bartlett (p 0,001) hanno confermato l'adeguatezza del campione per condurre l'analisi fattoriale esplorativa (EFA). Il modello fattoriale di EFA senza rotazione e poi con rotazione Promax non ortogonale ha confermato la presenza dei 4 costrutti identificati dall'autore originale.La SSCRS-ita ha mostrato proprietà psicometriche promettenti in termini di validità e affidabilità. I risultati di questo studio, insieme alla mancanza di studi approfonditi nel panorama sanitario ed educativo italiano, suggeriscono la necessità di sviluppare un percorso educativo che, partendo dai curricula della formazione di base e proseguendo con l'aggiornamento del personale infermieristico, sia dedicato alla rilevazione dei bisogni spirituali del paziente.La SSCRS-ita è il primo strumento italiano validato riguardante la considerazione dei bisogni di spiritualità e assistenza spirituale nei contesti di assistenza sanitaria; la possibilità di utilizzare questo strumento è il primo passo verso una migliore integrazione delle dimensioni di assistenza menzionate in una prospettiva qualitativa dell'assistenza infermieristica qualitativa.

Introduction Health literacy (HL) can be defined as the individual's ability to understand and process health information. A low level of HL can be viewed as a stronger predictor of a person's health status than age, education level, and race. Although HL is an important determinant of health, it is often underestimated. This systematic review investigates the evidence on HL assessment in hospital settings. Methods PubMed Medline, CINAHL, Scopus, Web of Science and Educational Resources Information Centre databases were searched, with the date last searched being 16 March 2020. The PRISMA guidelines were applied, and the protocol of the study was registered with PROSPERO (CRD42021236029). The quality of the included studies was appraised using the STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. Results Five studies reported HL assessments in hospital patients’ clinical records. Four main strategies were used to implement HL routine assessment in hospitals: multidisciplinary teams, stakeholders, training, and monitoring. Different performance measures were used to monitor the feasibility of incorporating HL assessment into electronic health records (EHRs). Conclusion This review examined how inpatients’ HL is recorded in hospital settings. HL is poorly measured in a hospital setting. These results guide hospital leadership in involving nurses in HL assessment implementation in hospitals and support nurses in creating a specific performance measure dashboard to monitor effective HL assessments in hospitals.

Objective The present systematic review aimed to identify, critically assess and summarize which risk factors might determine the onset of ostomy complications, describing a pooled incidence and stratified incidences by each identified risk factor. Methods A systematic literature review with a meta-analysis of observational studies was performed by following the PRISMA statement and flow chart. The quality assessment of the included articles was performed through the Newcastle-Ottawa Scale (NOS). Results Sixteen articles published between 1990 and 2018 focused on the risk factors related to intestinal stomal complications, and the performed analysis led to identifying influenceable and non-influenceable risk factors. The median of the NOS evaluation was 6 (IQR = 5.75-6). Among 10,520 included patients, the pooled incidence of stomal complications was 35%, ranging from 9% to 63%, regardless of the nature of the complications. Analysis of the sub-groups highlighted obesity and ostomy surgery performed via laparoscopy or emergency conditions have significant incidences, respectively, of 66% and 68%. Conclusions The pooled incidence of stomal complications requires greater attention for its relevant epidemiology. From the clinical point of view, patients with obesity and chronic conditions require more attention to prevent complications, possibly employing accurate educational interventions to enhance proper stoma management.

Background. Major trauma describes serious injuries requiring lifesaving interventions or resulting in long-term disability; it represents about 8% of all deaths worldwide. Specific guidelines can help reduce deaths and disabilities, provided they adhere to high quality and trustworthiness standards. This article aims at introducing the development process of the Istituto Superiore di Sanità, ISS (Italian National Institute of Health) guideline for major trauma integrated management. Methods. We applied the ISS methodological standards including the GRADE-ADOLOPMENT approach for adoption, adaptation, and de novo development of trustworthy guidelines. Results. The scope was formulated by the multidisciplinary panel with stakeholders’ involvement; two guidelines were identified as appropriate sources for adolopment. Forty questions from the two source guidelines were prioritised and five new ones formulated. New systematic reviews or updates were conducted for each clinical question, Evidence to Decision frameworks developed or re-assessed and the recommendations formulated after public consultations and external review. The policy on conflicts of interest was applied throughout the process. Conclusions. Through a broad expertise representation, the early and wide stakeholders’ participation, a continual process for disclosure and management of conflict of interests and the transparency of the process, ISS standards are proving to be an efficient model for developing trustworthy clinical guidance.

Background During the COVID-19 outbreak, patients with left ventricular assist device (LVAD) faced several changes in their daily life. However, the effects of these changes on the patients’ lived experiences are not still investigated. Aims The current study explored the lived experience of people with left ventricular assist device (LVAD) during the COVID-19 pandemic. During the COVID-19 outbreak, people with LVADs faced several changes in their daily life. However, the effects of these changes on the patients’ lived experiences are not still investigated. Methods and results Qualitative data analysis was conducted employing the interpretative phenomenological analysis approach. We followed the Standards for Reporting Qualitative Research guidelines. Eight male participants with LVAD aged from 65 to 82 were interviewed. Overall, two main themes (‘Worsening of psychological distress’ and ‘Moving forward’) and eight sub-themes emerged from the qualitative analysis. Conclusions People with LVADs experienced feelings of worry and solitude related to the risk of being infected or not receiving adequate treatment due to changes in the healthcare system during the pandemic; however, they managed to move forward with their lives using different strategies for dealing with the difficult situation.

Background One of the most effective smoking cessation strategies involves care and advice from nurses due to their role in the front line of treatment. Lack of education on smoking cessation counselling may be detrimental, and adequate smoking cessation training during healthcare studies is needed. Objectives The study aimed to examine nurses’ attitudes, belief, and knowledge of smoking cessation counselling; knowledge of the health risks associated with smoking was also assessed. Design A cross-sectional survey on 77 nurses from the nursing staff of Cardiology, Cardiac Intensive Care and Surgical Oncology Units of two tertiary hospitals. Methods Cronbach’s alpha was calculated to assess the questionnaire’s internal consistency, and three composite indicators were computed to assess the three dimensions of the questionnaire (knowledge, attitude, belief). Furthermore, a stepwise linear regression model was used to predict the attitude to be engaged in smoking cessation counselling, related to demographic and behavioural variables, as well as knowledge and belief indicators. The analysis was stratified by Unit. Results Nurses from three Units had a significantly different attitude score (2.55 ± 0.93 for Cardiology, 2.49 ± 0.72 for Cardiac Intensive Care and 2.09 ± 0.59 for Surgical Oncology Unit) (P-value = 0.0493). Analogously, knowledge of smoking cessation counselling was reported to be higher for Cardiac Intensive Care Unit nurses (3.19 ± 0.70) compared to Surgical Oncology nurses (2.73 ± 0.74) (P-value = 0.021). At the multivariable analysis, attitude towards smoking cessation counselling was significantly related to the nurse’s belief about counselling, for Cardiology staff (coeff = 0.74, 95% CI [0.32–1.16], P-value = 0.002) and for Surgical Oncology staff (coeff = 0.37, 95% CI [0.01–0.72], P-value = 0.042). Conclusions Incorporation of smoking cessation interventions in nurses’ and nursing managers’ education could improve the nursing staff’s attitude, belief, and knowledge regarding smoking cessation counselling, which would lead to the inclusion of tobacco prevention and cessation as an integral part of patient care.

Background Psoriatic Arthritis (PsA) is a chronic inflammatory form of Arthritis associated with enthesitis, dactylitis, nail dystrophy, uveitis, and osteitis. PsA is strongly associated with comorbidities such as obesity, metabolic syndrome, and cardiovascular disease. As usual PsA patients are assessed either by rheumatologist or dermatologist but a multiprofessional assessment for those subjects is important to improve their disease control and their quality-of-life. The multidimensional assessment is a new model of care for PsA patients in which a multiprofessional team (rheumatologist, dermatologist, internal medicine physician, nutritionist and a phycologist) with a nurse as case manager, assess patients in the main domains of PsA from the admission to the follow-up. Different validated tools are used by the team to assess different patients’ dimension as patient-reported-outcomes. This study aimed to evaluate the association between and among clinical variables and Patient-Reported Outcomes in a realworld sample of PsA patients evaluated according the Multidimensional Assessment. Methods A cross-sectional study was conducted. Patients with PsA who signed the informed consent were enrolled at the PsA clinic at the ARNAS Civico in Palermo (Italy) from March 2018 to October 2020. Clinical, pharmacological, anthropometric, laboratory variables, and patientreported outcomes were evaluated, including: • Health Assessment Questionnaire (HAQ); • Facit-Fatigue (FACIT-F); • Psoriatic Arthritis Impact of Disease Questionnaire (PsAID); • Patient Health Questionnaire-9 (PHQ-9); • Disease Activity in PSoriatic Arthritis score (Dapsa); • Patient global assessment (PGA) STATA 14.1 was used to perform logistic analysis. Results According to CASPAR Criteria, 158 patients aged 55.2 (53.3 – 57.1) affected by Psoriatic Arthritis were included in the study. All the collected variables were evaluated ad a strong association was observed between functional disability measured by HAQ >2 and central obesity [OR (95% CI) 16.94 (2.22 - 129.48); p < 0.004]. Moreover, data analysis showed an association between high impact of disease on life (PsAID >4) and central obesity [OR (95% CI) 3.33 (1.56 - 7.13); p

Death is one of the basic theme with which nurses are faced, and for which it is hard for them to prepare deeply and sincerely. The difficulties in handling the emotional burden can cause them to develop negative feelings towards life and clinical practice, so that it affects their caregiving capacity and the quality of care provided.To explore nurses' perceptions facing the death of a hospitalized oncology patient.Qualitative phenomenological study. The sample of nurses was recruited at IRCCS (Scientific Institute for Research and Healthcare) in Rome, a hospice in Latina and a hospice in Rieti. The data were collected by means of focus groups. The semi-structured interviews featuring three guiding questions constructed for this purpose, were audio-recorded, transcribed, and then analyzed using the analysis framework approach.In total 7 focus groups were conducted with a total participation of 39 nurses. Four themes emerged from the qualitative analysis: "The different meanings of death", "The rupture of death", "The perceptual variables of death", and "Requests for help".The study highlighted the need to provide nurses with substantial psychological and emotional support, and give consideration to organizational and environmental factors for better management of the event of death in oncology.Il tema della morte uno dei fondamentali problemi con cui gli infermieri si possono confrontare nell’agire professionale ed al quale difficilmente si profondamente e sinceramente preparati. Le difficolt nel gestire il carico emotivo possono indurlo a sviluppare sentimenti negativi nei confronti della vita e, nella pratica clinica tali da influenzare le capacit di caregiving e la qualit delle cure fornite. OBIETTIVO: esplorare le percezioni dell’infermiere di fronte alla morte del paziente degente nei reparti di oncologia.Studio qualitativo fenomenologico. Il campione di infermieri stato reclutato presso un I.R.C.C.S. di Roma, un Hospice di Latina ed uno di Rieti. I dati sono stati raccolti mediante mediante focus group. Le interviste semi-strutturate caratterizzate da tre domande costruite ad hoc, audio-registrate, sono state poi trascritte ed analizzate utilizzando il framework analysis approach. RISULTATI: sono stati condotti in totale 7 focus group con una partecipazione in totale di 39 infemieri. Dall’analisi qualitativa sono emersi quattro temi: “I diversi significati della morte”, “Lo strappo della morte”, “Le variabili percettive della morte”, “Le richieste di aiuto”.Lo studio ha evidenziato la necessit di fornire al personale infermieristico un importante supporto psicologico ed emotivo, e di porre attenzione agli elementi organizzativi-ambientali per una migliore gestione dell’evento morte in oncologia.

Background and aim of the work. Veterans are military with health problems due to military conditions. The improved body armor and operational conditions has reduced the number of deaths, but increased the number of veterans with severe injuries, affected by musculoskeletal pain and associated syndromes, such as post-traumatic stress disorder. Multimodal approaches are considered in USA the gold standard for the treatment of these problems, while in Europe and Italy the data are unknown. The aim of this review was to describe and summarize multimodal therapeutic approaches that apply to the veteran population for chronic musculoskeletal pain and relate syndromes management. Methods. A comprehensive systematic review of the literature on Cochrane Library, PubMed, CINAHL e PsycINFO databases was conducted, from 2001 to 2020. Results. 228 papers have been found, 134 were selected after the first screening. 24 quantitative studies were included in the review, all from USA. Different multimodal interventions with different kind of treatment types emerged. The analyzed studies’ sample size was 11 million (mean age = 57.67 years; SD=±11.94). The multimodal approaches showed a significant improvement in all outcomes (pain reduction and control, opioid therapy reduction, psychosocial outcomes) compared to traditional therapy. Conclusions. Multimodal therapeutic approaches seem to guarantee a good management chronic musculoskeletal pain and related mental disorders, and the reduction and control to opioid use. Military nurses emerged as professionals who have a central role in this approach. European and Italian authorities should consider veterans, in order to assess their expected increase in the future. (www.actabiomedica.it)

Violence against women is a pervasive phenomenon affecting one in three women aged ≥15 in the world that are more likely to visit an emergency department (ED) for the serious physical and psychological consequences of the abuse. The aim of this observational single-centre study is to describe the socio-demographic and clinical variables associated with violence against women. We enrolled 425 female patients who attended an Italian ED for trauma on 2019 and the patients' information was collected and analyzed with descriptive statistics. The average age of the patients was 41.5 (standard deviation = 14.2) years. 74.6% of the women were Italians, and 86.6% were of metropolitan origin. The reasons for the ED visit included aggression (67.5%), accidental trauma (29.0%) and unknown reasons (3.5%). Multivariate analysis confirmed that three factors were independently associated with violence: nationality (odds ratio [OR] = 0.27; 95% confidence interval [CI], 0.09–0.77), head/face/neck injuries (OR = 7.32; 95% CI, 3.76–14.27) and multiple injuries (OR = 8.52; 95% CI, 1.03–70.47). Age over 25 was a protective factor. The study confirmed that being a foreigner and having head/face/neck injuries or multiple injuries are associated with violence against women.

Aims To identify the main diagnostic features of SARS-CoV-2-positive patients at the time of hospitalisation and their prevalence. Background Since the COVID-19 outbreak in China in December of 2019, several studies attempted to identify the epidemiological, viral and clinical characteristics of SARS-CoV-2. Given the rapid widespread transmission of the COVID-19 disease worldwide, a more comprehensive and up-to-date understanding of its features is needed to better inform nurses, clinicians and public health policy makers. Methods A rapid review and meta-analysis were carried out to identify the main diagnostic features of SARS-CoV-2-positive patients at the time of hospitalisation. All case series, cross-sectional, case-control and cohort studies published from 01/01/2020 till 30/06/2020 in English and Chinese that stated all or at least two of the outcomes of interest (clinical features, laboratory and radiological findings) were included. We performed a random-effects model meta-analysis to calculate pooled prevalence and 95% confidence intervals. Conduction of the review adheres to the PRISMA checklist. Results 21 studies involving 8837 patients were included in the quantitative synthesis. Fever, cough and fatigue were the most common clinical features, while the most relevant laboratory abnormalities at the time of hospitalisation were lymphopenia, elevated C-reactive protein and lactate dehydrogenase. CT images showed a bilateral lung involvement, with ground glass infiltrates and patchy shadows on most patients. Conclusion This review provides an up-to-date synthesis of main diagnostic features of SARS-CoV-2-positive patients at the time of hospitalisation. Relevance to clinical practice Our findings could provide guidance for nurses and clinicians to early identification of positive patients at the time of the hospitalisation through a complete definition of main clinical features, laboratory and CT findings.

Highlights • Epidemiological conditions should be monitored and enforced. • COVID-19 must be under control below thresholds of safeguards. • Testing, contact tracing, and isolation strategies are essential components to ease the lockdown. • The maintenance of social distancing measures is an overarching mitigation strategy. • The benefit gained from the implementation of social distancing was evident., In an attempt to curb the COVID-19 pandemic, several countries have implemented various social restrictions, such as closing schools and asking people to work from home. Nevertheless, after months of strict quarantine, a reopening of society is required. Many countries are planning exit strategies to progressively lift the lockdown without leading to an increase in the number of COVID-19 cases. Identifying exit strategies for a safe reopening of schools and places of work is critical in informing decision-makers on the management of the COVID-19 health crisis. This scoping review describes multiple population-wide strategies, including social distancing, testing, and contact tracing. It highlights how each strategy needs to be based on both the epidemiological situation and contextualize at local circumstances to anticipate the possibility of COVID-19 resurgence. However, the retrieved evidence lacks operational solutions and are mainly based on mathematical models and derived from grey literature. There is a need to report the impact of the implementation of country-tailored strategies and assess their effectiveness through high-quality experimental studies.

Background We conducted a systematic review to evaluate and compare the accuracy of pre-hospital triage tools for major trauma in the context of the development of the Italian National Institute of Health guidelines on major trauma integrated management. Methods PubMed, Embase, and CENTRAL were searched up to November 2019 for studies investigating pre-hospital triage tools. The ROC (receiver operating characteristics) curve and net clinical benefit for all selected triage tools were performed. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies–2. Certainty of the evidence was judged with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results We found 15 observational studies of 13 triage tools for adults and 11 for children. In adults, according to the ROC curve and the net clinical benefit, the most reliable tool was the Northern French Alps Trauma System (TRENAU), adopting injury severity score (ISS) > 15 as reference (sensitivity (Sn), 0.92; specificity (Sp), 0.41; 1 study; sample size, 2572; high certainty of the evidence). When mortality as reference was considered, the pre-hospital triage tool with the best net clinical benefit trajectory was the New Trauma Score (NTS) < 18 (Sn, 0.82; Sp, 0.86; 1 study; sample size, 1001; moderate certainty of the evidence). In children, high variability among all triage tools for sensitivity and specificity was found. Conclusion Sensitivity and specificity varied across all available pre-hospital trauma triage tools. TRENAU and NTS are the best accurate triage tools for adults, whereas in the pediatric area a large variability prevents any firm conclusion.

Background and aim of the work:Triage during the Covid-19 pandemic can impose difficult allocation deci-sions when demand for mechanical ventilation or intensive care beds greatly exceeds available resources. Tri-age criteria should be objective, ethical, transparent, applied equitably and publically disclosed. The aim of this review is to describe the triage tools and process for critical care resources in a pandemic health emergency. Methods:A narrative review was conducted of the literature on five electronic databases, namely PubMed, CINHAL, Web of Science, Cochrane and Embase, searching for studies published from 2006 to June 2020. Results:The results describe different triage tools. A gold standard of triage does not exist for the adult or paediatric population. Using probability of short-term survival as the sole allocation principle is problematic. In general, each triage protocol should be applied with a specific ethical justification, including transparency, duty to care, duty to steward resources, duty to plan, and distributive justice. Conclusions:Clinical triage deci-sions based on clinical judgment alone are prone to inconsistent application by triage officers in a pandemic. An ethical framework can inform decision-making and improve accountability. It remains difficult to connect clinical criteria and ethical criteria, because of the models on offer for health services.

BackgroundEvidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission.MethodsSystematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach.FindingsOur search identified 35 studies, including 3 randomised controlled trials (RCTs) (4017 patients), 10 comparative studies (18984 patients), 13 predictive models, 9 laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favour of wearing face masks versus no mask, but not at statistically significant levels (adjusted OR 0.90, 95%CI 0.78-1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45-97%). One laboratory study suggested a viral load reduction of 0.25 (95%CI 0.09-0.67) in favour of mask versus no mask.InterpretationThe findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomised trials on face mask effectiveness are needed to inform evidence-based policies.Fundingnone.PROSPERO registrationCRD42020184963.Contribution to the fieldGuidelines by various organizations provide conflicting evidence about the effectiveness of face mask use in the community. We performed a systematic review of the available evidence, including 35 studies, across 41 countries and six continents. Previous systematic reviews on the effectiveness of face mask use mainly focused on healthcare and household setting including only randomized controlled trials and observational studies with most of them of low quality. In our review, we included randomized controlled trials, observational studies, laboratory experimental studies as well as mathematical modelling studies in order to answer different questions and provide quantitative estimates for planning pandemic response efforts.Our review supports the use of surgical masks in the community for providing protection during the COVID-19 pandemic. However, the infection rate, mortality, spread of transmission (R0), filtering capacity of masks and viral load reduction are highly dependent on the type of face mask worn and on the adherence of the population wearing masks. Policy makers should promote face mask use in the community.

Background: Several risk factors, such as age, alcohol abuse, dementia, and severe illness, can contribute to the development of delirium. However, limited information is available in the literature regarding the risk of delirium among surgical, trauma, neurological, and medical intensive care patients. Aims and objectives: To describe the prevalence of risk factors associated with delirium in intensive care units. Design: This study used an observational design. Methods: We enrolled 165 patients hospitalized in two intensive care units in Italy. Patients were first evaluated using the Prediction of Delirium model and were subsequently evaluated using the Intensive Care Delirium Screening Checklist; evaluation lasted a maximum of 5 days for each admitted patient after sedation. A logistic regression model was used to identify the prevalence and risk factors of delirium. Results: The average age of the patients was 57.6 (SD = 18.3) years, and the patients were predominantly male (65.0%). The majority of patients had been subjected to trauma (38.8%); 37.6% had undergone general surgical interventions, and 23.6% had undergone medical interventions. Delirium occurred in 55.8% of the 165 patients. The risk of delirium was independently associated with coma (odds ratio = 10.6; 95% confidence interval, 3.08-39.9) and the Acute Physiology and Chronic Health Evaluation II score (odds ratio = 4.27; 95% confidence interval, 1.58-11.53). Conclusions: This study confirmed that coma and the Acute Physiology and Chronic Health Evaluation II score were non-modifiable risk factors for delirium. Further studies could categorize the different types of coma. Proper delirium management could limit the impact on the recovery of these patients, their autonomy, and their reintegration into the social and professional world. Relevance to clinical practice: Delirium increases intensive care unit and hospital length of stay. Early identification and risk factor assessment by critical care nurses are considered the key factors in the treatment of delirium.

Tra tutte le fasi dell’intervento chirurgico, la fase preoperatoria è generalmente vissuta dal paziente con maggiore ansia. Studi in merito dimostrano che una maggiore percezione dell’ansia o paura nella fase preoperatoria sia scientificamente correlata a un decorso postoperatorio prolungato. Il dolore è annoverato tra le principali cause che recano ansia al paziente. L’obiettivo della presente revisione della letteratura è quello di esaminare la letteratura in merito alla gestione del dolore preoperatorio nei pazienti candidati alla chirurgia addominale, confrontando gli outcome clinici dei pazienti sottoposti a metodologia ERAS® con quelli ottenuti con una gestione perioperatoria tradizionale. Gli studi hanno dimostrato che l’analgesia perioperatoria è più efficace con il protocollo ERAS® rispetto ai trattamenti tradizionali. L’elemento chiave del protocollo ERAS® è la minimizzazione dello stress psicofisico legato all’intervento chirurgico, attraverso un approccio multimodale e multidisciplinare. Greater fear or distress prior to surgery is associated with a slower and more complicated postoperative recovery. The main objective of this study is to examine the best evidence of the perioperative pain management in patients candidated for abdominal surgery comparing the clinical outcomes achieved with the ERAS® protocol to those achieved with traditional perioperative management. The studies showed that perioperative analgesia was more effective with ERAS® protocol than with traditional treatments. The key element of the ERAS® protocol is to minimize the psychophysical stress related to the surgical intervention, through a multimodal and multidisciplinary approach.

Stroke is the second cause of death worldwide and the third cause of death in industrialized countries. To investigate the effectiveness of the nurse's role the management for people affected by stroke after discharge from hospital to home.A systematic review was performed. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was carried out. MEDLINE, CINAHL, Web of Science and Scopus were searched for studies on the effectiveness of the nurse's role in managing the stroke rehabilitation process after discharge from the home hospital from 2000 to June 2018 in English. The methodological quality was assessed by the Cochrane Collaboration's tool for assessing Risk of Bias (RoB). The GRADE system was used for evaluating evidence quality of each outcome.7,025 studies were identified, 12 met the inclusion criteria. The outcomes in the literature are quality of life related to the degree of independence and depression, to the perception and health management and to the adaptation and stress tolerance. No primary outcome is reported in the literature with a high degree of confidence.The nurse's role the management for people affected by stroke after discharge from hospital to home represent an effective strategy for an improvement in the functional outcome, quality of life and reduction of costs.L'ictus è la seconda causa di morte in tutto il mondo e la terza causa di morte nei paesi industrializzati. Scopo di questo lavoro è fornire una sintesi della letteratura sull'efficacia del ruolo dell'infermiere nella gestione del processo di riabilitazione delle persone colpite da ictus dopo la dimissione dall'ospedale a casa.Revisione sistematica della letteratura di tipo quantitativo effettuata seguendo il metodo PRISMA. La ricerca è stata condotta su: Cinhal-EBSCO, Medline-PUBMED, Web of Science e Scopus. Sono stati ricercati studi sulla efficacia del ruolo dell’infermiere nella gestione del processo di riabilitazione del paziente colpito da ictus dopo la dimissione dall’ospedale a domicilio in lingua inglese dal 2000 al 2018. La selezione è stata effettuate utilizzando criteri di inclusione ed esclusione. La qualità degli articoli è stata valutata con il Risk of Bias (RoB) della Cochrane Collaboration. Il sistema GRADE è stato utilizzato per valutare la qualità delle prove di ciascun risultato.Sono stati identificati 7.025 studi, di questi 12 hanno soddisfatto i criteri di inclusione. I risultati in letteratura sono la qualità della vita correlata al grado di indipendenza e depressione, alla gestione della percezione e della salute, all’adattamento e alla tolleranza allo stress. Nessun risultato primario è riportato in letteratura con un alto grado di sicurezza.Il ruolo dell'infermiere nella gestione delle persone colpite da ictus dopo dimissione dall'ospedale a casa rappresenta una strategia efficace per un miglioramento del risultato funzionale, della qualità della vita e della riduzione dei costi.

BACKGROUND: After discharge from a rehabilitation hospital, stroke survivors and their families may face considerable stroke-related direct costs. The total amount could be ascribed to the costs of formal and informal care and to the equipment or materials needed for care. OBJECTIVES: This study aims to describe the direct costs incurred after a stroke by survivors during their first poststroke year and to analyze the basic predictors of these costs. METHODS: Stroke survivors (N = 415) were enrolled for this study during discharge from rehabilitation hospitals (baseline) and interviewed at 3, 6, 9, and 12 months after discharge for a longitudinal study. The trend of the direct costs incurred during the follow-up (from T1 to T4; n = 239) was evaluated using a linear mixed-effects model. The mixed-effects model was used to identify the baseline predictors of the incurred direct costs from the stroke survivors. RESULTS: During the first year after discharge, stroke survivors spent approximately $3700 on stroke-related direct (ie, medical and nonmedical) costs. The highest direct costs occurred during the first 6 months, although there was not a significant change over time. The higher direct costs incurred were predicted by the linear effect of time, by the educational level (higher vs low), and by the lower Barthel Index score, whereas a higher perceived cost was predicted only by the linear effect of time and by the lower Barthel Index score. CONCLUSION: In the first poststroke year, direct costs have remained stable over time and can be predicted by the level of education and physical functioning. The identification of specific direct cost predictors would be helpful for developing more socially and economically tailored interventions for stroke survivors in their first year after their stroke

Rationale Patients who have multiple chronic conditions (MCCs) and their informal caregivers experience poorer health-related quality of life (HRQOL). Perceived social support has been shown to influence HRQOL. Objectives This study aimed at identifying the differences between patients' and caregivers' physical and mental HRQOL; and determining the association between their perception of social support from different sources, and their own and their dyad partner's HRQOL. Method Patients with MCCs and their caregivers (345 dyads) were enrolled in a multicenter cross-sectional study conducted in Italy. The Multidimensional Scale of Perceived Social Support measured perceived social support from family, friends, and significant others, and the 12-Item Short-Form Health Survey measured the physical and mental component of HRQOL in dyads. The dyadic analysis was conducted using the Actor-Partner Interdependence Model through structural equation modelling. Results Family support perceived by each member of the dyad was associated positively with their own mental HRQOL, and that family support perceived by caregivers was also associated positively with patients’ mental HRQOL. Greater family support perceived by caregivers was also associated with better physical HRQOL in both caregivers and patients. Moreover, greater friend-support perceived by each member of the dyad was positively associated with own physical HRQOL. Conclusions The study suggests the reciprocal influence of perceived social support from family and friends on physical and mental HRQOL in MCC dyads. Healthcare professionals should identify those people who are the main sources of support for each member of the dyad, and develop care plans that promote the maintenance and enhancing of this support.

New technologies are becoming relevant for nursing practice in the home care field. Specifically, Mobile Applications can be useful tools for nurses to care for patients efficiently and to ensure optimal data protection with the help of electronic folders (HER) and with utilities that can be used as aids for work analysis in care planning.

Background and aim of the work: Musculoskeletal disorders and low back pain have negative impact amongst Italian nurses who work in hospital. Nursing staff are known to be at risk of developing back disorders, where low back pain has a prevalence from 16% to 60% in the world. This study aims to determine the prevalence of musculoskeletal disorders and low back pain among nurses who working in a Roman hospital. Methods: Cross sectional study was carried out in an Italian hospital and the Nordic Musculoskeletal Questionnaire-IRSST was administered to 256 registered nurses. Logistic regression analyses were performed to understand risk factors associated with pain. Results: Nurses reported different locations of pain related to musculoskeletal disorders. The prevalence of low back pain was 90.2% during life, 80% during the last year and 44.5% during the last week. Female sex increases the risk of being affected by low back pain (OR = 2.07, 95% CI= 1.00-4.32). Conclusions: Musculoskeletal disorders and low back pain are reported by the majority of nurses interviewed, and a higher prevalence is observed in women. Pain does not depend on the amount of years of work, nor on age or body mass index. In order to assess the prevalence of low back pain carefully, it is recommended to study a greater number of Italian nurses in different hospitals. (www.actabiomedica.it)