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Background–The pandemic of COVID-19 in Italy represents a unique threat in terms of psychological distress, especially among healthcare professionals. This study represents a first attempt to investigate both the psychological states and coping strategies of Italian healthcare professionals during the COVID-19 outbreak. Importantly, we assessed psychological distress and coping strategies regarding two phases, pre-COVID (asking participants to retrospectively recall their state in December 2019) and during the time of survey, which was in the midst of the COVID emergency outbreak (March-April 2020). Methods–Self-administered questionnaires were distributed online to healthcare professionals of different Italian regions from March 26 to April 9, 2020. The questionnaire included three main sections measuring changes in psychological states, coping strategies and demographic variables. Two linear regression models were run to analyze variations in both general health and infection-risk perception depending on changes in psychological states, coping strategies, personality trait, and demographic variables. Results– Altogether, the direct exposure to the virus and a negative impact of the COVID-19 emergency outbreak on contextual psychological functioning contribute to the deterioration of physical and mental health, which may lead to severe future consequences for Italian healthcare workers, if not provided immediately with an effective support program. Conclusions– Both immediate and long-term monitoring psychological assistance services for healthcare workers should be implemented by local and national institutions to reestablish psychological well-being and enhance self-confidence and resilience of Italian hospital personnel. These intervention programs should especially target women, and professionals at their first steps into the hospital job.

Low back pain (LBP) is a common reason for adults to seek medical care and is associated with important functional limitation and patient burden. Yet, heterogeneity in the causes and presentation of LBP and a lack of standardization in its management impede effective prevention and treatment. We conducted a modified Delphi study to generate consensus statements for the diagnosis, management, and prognosis of LBP. A panel of five experts proposed 19 statements that were subsequently evaluated by physicians who treat LBP in their everyday clinical practice. Physicians were asked to validate statements in the form of a web survey assessing level of agreement on a five-point Likert-like scale. Consensus (≥ 70% agreement) was obtained for all 19 statements. Strength of agreement and physician comments highlighted the importance of pain management, but also strategies to ameliorate functional limitation and prevent future LBP episodes. Respondents favored multidisciplinary approaches and multimodal management for LBP, although there was some ambiguity as to how multidisciplinary strategies could be feasibly incorporated into daily practice. Finally, the results indicated some conflict regarding the use of imaging for the diagnosis of LBP and how to classify LBP for targeted treatment. The results of this study provide a summary of favored clinical practice for the management of chronic LBP. While the consensus statements were generally agreeable to survey respondents, some areas of ambiguity, including how to increase the feasibility of multidisciplinary strategies, when and how to use diagnostic imaging in LBP, and LBP classification, necessitate clarification in future studies and guidelines.