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Introduction: The aging of the population requires an appropriate knowledge of the type of care that needs to be provided to inform healthcare policies. In Italy, neither home care nursing, nor the patient experiences have ever been described. Objectives: To describe the characteristics of nurses and care recipients involved in home care. Methods: A descriptive cross‐sectional study conducted in 18 Italian Regions. Between April and October 2023, data from nurses and patients involved in home care were collected through two surveys. Psychosocial conditions in workplaces, missed care, and care experiences were assessed using validated tools. Descriptive statistics and Pearson's correlations were performed. Results: A total of 46 local healthcare units were included in this study, with a total of 2549 nurses and 4709 care recipients. Nurses (mean age 46.60; 79.48% female; 44.68% regional nursing diploma as the highest qualification) reported good working conditions (42.37; SD = 12.25; range = 0–100) and a high mean number of missed care activities (5.11; SD = 3.19; range 0–9). Most nurses (83.41%) reported high levels of job satisfaction, while 20.28% intended to leave their job. Patients (mean age 75.18; 57.57% female; 36.95% primary school), on the other hand, rated positively the care they had received (8.23; range = 0–10). Conclusions: Despite the perception of critical issues at work and some missed care, satisfaction in nurses and patients was high. These data constitute a preliminary snapshot of the studied phenomena, which will be investigated through more in‐depth analyses. [ABSTRACT FROM AUTHOR]

The knowledge of variables associated with quality of life in women with nonvertebral fractures is poor. The aim of this study was to examine the independent associations between sociodemographic and clinical factors, self-care, and quality of life in this specific population. We undertook a 3-year multicenter longitudinal study on a cohort of Italian postmenopausal osteoporotic women with three follow-ups at 1, 3, and 6 months. Nurses asked women to complete questionnaires on quality of life and self-care. The sample (n = 532) had a mean age of 74.78 years. The results showed that women taking more than two medications per day (p = .026) and those with nine or more years of education (p = .036) were more likely to exhibit better quality of life levels (p < .001) than their counterparts. Both self-care and quality of life scores improved over time in all participants. This study shows positive independent associations between quality of life and polypharmacy, education, and self-care behaviors, which were improved by educational interventions to attain a better quality of life in our participants. [ABSTRACT FROM AUTHOR]

Background: Patients with heart failure experience high symptom burden, which can be mitigated with adequate selfcare. Caregiver contribution to self-care has been theorized to improve patient symptom burden. The mediating role of patient self-care in this relationship has not been tested yet. Objectives: The aim of this study was to test whether (a) caregiver contribution to self-care influences patient self-care, (b) patient self-care influences symptom burden, and (c) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden. Methods: In this study, the authors conducted a secondary analysis of the baseline and 3-month data from theMOTIVATE-HF trial, which enrolled 510 dyads (patient with heart failure and caregiver) in Italy. Multigroup confirmatory factor analysis was used to test measurement invariance. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test our hypotheses. Results: On average, caregivers were 54 years old andmainly female, whereas patientswere 72.4 years old and mainly male. Better caregiver contribution to self-care maintenance was associated with better patient self-caremaintenance (γ = 0.280, P < .001), which, in turn, was associated with lower symptomburden (γ = -0.280, P < .001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (γ = -0.079; 95% bias-corrected bootstrapped confidence interval, -0.130 to -0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (γ = 0.238, P = .006). The model significantly accounted for 37% of the total variance in symptom burden scores (P < .001). Conclusions: This study expands the situation-specific theory of caregiver contribution to heart failure self-care and provides new evidence on the role of caregiver contribution to self-care and patient self-care on symptom burden in heart failure. [ABSTRACT FROM AUTHOR]

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]

In recent years, the increase in textual data production has meant that researchers require faster text analysis techniques and software to reliably produce knowledge for the scientific–nursing community. Automatic text data analysis opens the frontiers to a new research area combining the depth of analysis typical of qualitative research and the stability of measurements required for quantitative studies. Thanks to the statistical–computational approach, it proposes to study more or less extensive written texts produced in natural language to reveal lexical and linguistic worlds and extract useful and meaningful information for researchers. This article aims to provide an overview of this methodology, which has been rarely used in the nursing community to date. [ABSTRACT FROM AUTHOR]

Background: In this updated Self-Care of Coronary Heart Disease Inventory (SC-CHDI) v3.0, items were added to better reflect the theory of self-care of chronic illness and revised based on recent research. The expanded SC-CHDI now reflects the theoretical concepts of self-care maintenance, monitoring, and management. Objective: The aim of this study was to evaluate the psychometric properties of the SC-CHDI v3.0. Methods: In a sample of adults with coronary heart disease, we tested the SC-CHDI v3.0 validity with confirmatory factor analysis. Reliability was calculated using Cronbach α , factor score determinacy coefficient, and global reliability index for multidimensional scales, with values > 0.70 considered adequate. Results: The sample (n = 205) was predominantly male (79%) with a mean age of 65.3 ± 11.1 years. The self-care maintenance scale encompassed 2 distinct behaviors, namely, "illness related behaviors" and "health promoting behaviors," which reflect consulting and autonomous dimensions, respectively. The goodness-of-fit indices were adequate: χ2(25, N = 205) =31.86, P =.16, comparative fit index = 0.97, Tucker-Lewis Index = 0.95, root mean square error of approximation = 0.04 (90% confidence interval, 0.00–0.07), P =.705, and standardized root mean square residual = 0.045. Analysis of the new self-care monitoring scale yielded a single factor; goodness-of-fit indices were excellent: χ2(12, N = 205) =11.56, P =.48, comparative fit index = 1.00, Tucker-Lewis Index = 1.00, root mean square error of approximation < 0.001 (90% confidence interval, 0.000–0.07), P =.86, and standardized root mean square residual = 0.02. The self-care management scale had 2 dimensions of autonomous and consulting behavior with strong goodness-of-fit indices: χ2(7, N = 205) =6.57, P =.47, comparative fit index = 1.00, Tucker-Lewis Index = 1.00, root mean square error of approximation ≤ 0.001 (90% confidence interval, 0.00–0.08), P =.76, and standardized root mean square residual = 0.02. Reliability estimates were ≥0.80 for all scales. Conclusions: Our testing suggests that the SC-CHDI v3.0 is a sound measure of the essential elements of self-care for adults with coronary heart disease. [ABSTRACT FROM AUTHOR]

Aims Provide an overview of remote motivational interviewing (MI) interventions for chronically ill patients, and understand their degree of effectiveness on different health outcomes. Methods and results A systematic review with meta-analysis was conducted using the following databases: PubMed, CINAHL, PsychInfo, and Web of Science. Eligibility criteria included studies that administered remote MI alone or in combination with other remote approaches. A narrative synthesis and two meta-analyses were performed. Fifteen studies met the inclusion criteria. MI administration almost exclusively occurred by telephone and individual sessions. Eight studies reported treatment fidelity aspects, and four declared adopting a theoretical framework. Most targeted outcomes were therapeutic adherence, physical activity, depression, quality of life, and mortality. Risk of bias varied markedly, with the largest source resulting from selection process and intervention performance. The two meta-analyses indicated a significant effect of MI on depression [standardized mean difference = –0.20, 95% confidence interval (CI): –0.34, –0.05, Z = 2.73, P = 0.006, I 2 = 0%], and no effect of MI on glycosylated haemoglobin (mean difference = –0.02, 95% CI: –0.48, 0.45, P = 0.94, I 2 = 84%). Conclusion Remote MI can be a promising approach for improving depression in chronic disease patients. However, studies are inconclusive due to risks of bias, heterogeneity, and lack of reporting of interventionist's training, treatment fidelity, and theoretical frameworks' use. More studies with solid designs are needed to inform clinical decision-making and research. Registration PROSPERO: CRD42021241516. [ABSTRACT FROM AUTHOR]

Qualitative research is fundamental to understanding the nature and complexity of human phenomena. While cultural and psychometric validations exist for quantitative tools, the same cannot be said of qualitative ones. There are other many challenges when conducting a multinational qualitative study, which includes different cultural and linguistic 'biases'. This paper presents some key issues that researchers may encounter when designing and developing multinational and multicultural qualitative studies, and also provides some strategies to overcome difficulties and ensure rigour. [ABSTRACT FROM AUTHOR]

Aims Caregiver characteristics and behaviours are associated with patients' and caregivers' outcomes. However, there is scarce evidence on interventions aimed at improving caregiver contribution (CC) to patient self-care, caregiver self-efficacy, and caregiver preparedness in heart failure (HF). This study aims to evaluate the effect of Motivational Interviewing (MI) on CC to patient self-care, caregiver self-efficacy, and caregiver preparedness in HF. Methods and results This is a secondary outcome analysis of MOTIVATE-HF randomized controlled trial. Caregivers of patients with HF were randomized into three arms: Arm 1 (MI for patients), Arm 2 (MI for patients and caregivers), and Arm 3 (standard care). The intervention consisted of one MI session plus three telephone contacts. Data were collected at baseline and after 3, 6, 9, and 12 months. A total of 510 patient and caregiver (median age 54 years, 76% females) dyads were enrolled, 235 caregivers and 238 patients completed the study until 12 months. Caregiver contribution to self-care maintenance and management and caregiver preparedness significantly improved over time, but without significant differences among the three arms. At 9 months, caregiver self-efficacy improved more in Arm 2 than Arm 3 [difference: 8.36, 95% confidence interval (CI) (3.13; 13.59), P = 0.001]. This improvement remained significant also at linear mixed model [ β ^ = 1.39, 95% CI (0.02; 2.75), P = 0.046]. Conclusion Motivational Interviewing did not improve CC to patient self-care and caregiver preparedness. However, it increased caregiver self-efficacy, which is known to be a powerful mediator of CC to self-care. Registration Clinicaltrials.gov: NCT02894502. [ABSTRACT FROM AUTHOR]

Aim: To test the mediating role of burnout in the relationship between self‐efficacy and academic success in nursing students. Design: This was a cross‐sectional secondary analysis of longitudinal research aimed at exploring the academic success of nursing students. Methods: We enrolled a convenience sample of nursing students attending 21 Italian baccalaureate nursing degree programmes. Data were collected from 2014 to the 2018–2019 academic year. We analysed the wave of data collected during the third year of the programme. The measurements were the Academic Nurse Self‐Efficacy scale (ANSEs) and the Scale of Work Burnout (SWEBO). A mediation analysis with a counterfactual approach was performed. Results: The participants (n = 556) had a median age of 20 years (IQR 19–22) and the majority was female [70.5% (392/556)]. Academic success was reached by 51.97% (289/556) of the students. The findings reveal a significant direct effect of self‐efficacy on academic success and also a significant indirect effect of this relationship via burnout. Conclusion: The mechanism by which self‐efficacy influences academic performance in nursing students is more complex than a simple direct relationship. Universities should consider screening students for variables affecting academic success to decrease academic costs and increase ranking systems classification. Impact Nurses' professors should be engaged in strategies to promote self‐efficacy. The area of intervention should be structured both during classes and internships, in tandem with the mentor and the clinical nurse. [ABSTRACT FROM AUTHOR]

Background: Although several authors have analyzed the effects of spirituality on stroke survivors' physical functioning and on their own caregiver's outcomes, such as quality of life, only few authors have explored the interaction between spirituality and anxiety and depression using a dyadic approach. Objectives: The aim of this study was to analyze the influence of spirituality in the stroke survivor–caregiver dyad and specifically on anxiety and depression in both parties. Methods: A total of 217 stroke survivor–caregiver dyads were enrolled at discharge from several rehabilitation hospitals in central and southern Italy. The actor-partner interdependence model was used to analyze the dyadic data. To verify the differences in the effects between survivors and caregivers, comparisons were made between the χ2 values of the model in which actor and partner effects were constrained to be equal. Results: The average age of stroke survivors and their caregivers at baseline was 71.2 and 52.7 years, respectively. Among the stroke survivors, there were slightly more men than women, whereas 65% of the caregivers were women. Most stroke survivors had had an ischemic stroke. Four statistically significant actor effects were identified. Higher survivors' and caregivers' spirituality was associated with higher survivor and caregiver anxiety. The only significant partner effect that was identified was the association between stroke survivor spirituality and caregiver depression. Conclusions: This study highlights the importance of studying spirituality in the population with stroke. Spirituality seems to play an important protective role in both stroke survivors' and caregivers' depression but not in anxiety. [ABSTRACT FROM AUTHOR]

Background: Higher education students, especially nursing students, have drawn more attention as a group that is vulnerable to the risk of developing burnout syndrome. Purpose: To test the psychometric properties of the Oldenburg Burnout Inventory in Nursing (OLBI-N). Methods: The OLBI-N validity and reliability was tested in a sample of 476 nursing students. The validity was assessed with explorative and confirmative factor analyses. For hypothesis testing, we evaluated the correlation between burnout and academic self-efficacy. Results: Two factors (exhaustion and disengagement) were identified, and the confirmative factor analysis of the OLBI-N yielded a good fit. The OLBI-N was significantly correlated with academic self-efficacy (r = −0.37, 0.29, p < 0.01). Conclusions: The OLBI-N is a valid, reliable questionnaire for measuring burnout among nursing students. [ABSTRACT FROM AUTHOR]

Aims Mutuality, a positive quality of the relationship between patients and their informal caregivers characterized by love and affection, shared pleasurable activities, shared values, and reciprocity, influences several patient–caregiver outcomes in chronic-condition cases, but it remains unknown whether it influences the heart failure (HF) patient–caregiver dyad quality of life (QOL). The aim of this study was to evaluate the influence of mutuality and its four dimensions (love and affection, shared pleasurable activities, shared values, and reciprocity) on QOL in HF patient–caregiver dyads Methods and results Cross-sectional study: Using the actor–partner interdependence model, we examined how an individual's mutuality influenced his/her own QOL (actor effect) and his/her partner's QOL (partner effect). Mutuality and physical and mental QOL were measured with the Mutuality Scale and Short Form 12, respectively. A total of 494 HF patient–caregiver dyads were enrolled in the study. Mutuality showed strong evidence of caregiver partner effects on the HF patients' physical QOL (total score B = 2.503, P = 0.001; shared pleasurable activities B = 2.265, P < 0.001; shared values B = 1.174, P = 0.420 and reciprocity B = 1.888, P = 0.001). For the mental QOL, mutuality and its four subscales had actor effects only on the patients' mental health (total mutuality B = 2.646, P = 0.003; love and affection B = 1.599, P = 0.360; shared pleasurable activities B = 2.599, P = 0.001; shared values B = 1.564, P = 0.001 and reciprocity B = 1.739, P = 0.020). In caregivers, mutuality had an actor effects on mental QOL (total score B = 1.548, P = 0.041 and reciprocity B = 1.526, P = 0.009). Conclusion Our results confirm the important role of mutuality in determining the physical and mental QOL in HF patient–caregiver dyads. Interventions aimed at improving the relationships within HF patient–caregiver dyads may have an impact on HF patients' and caregivers' QOL. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of a wound healing protocol for stage III and IV pressure ulcers (PUs), and to determine the predictive power of specific sociodemographic and clinical characteristics on wound healing and infection. Method: This longitudinal study included participants with stage III and IV PUs who were recruited from 10 acute care settings of an Italian university hospital, and who were managed with a protocol inspired by the TIMECare model. Data were collected between October 2018 and March 2019. The National Pressure Ulcer Advisory Panel Staging System was used to stage the PUs. Wound healing was assessed with the Pressure Ulcer Scale for Healing (PUSH). Nutritional status was assessed with the Mini Nutritional Assessment Index. Data collection took place at admission and every seven days thereafter—a total of six times before discharge. The outcome and predictors of wound healing were assessed with Student's paired t-tests and multiple linear regressions, respectively. Results: Patients (n=126) were almost equally split between male and female, with a mean age of 78.17 years and who were all retired. Stage III and IV PUs were most prevalent at the sacrum (65.5% and 73.2%, respectively). PUSH wound healing scores improved significantly after six weeks in both stage III and IV PUs (p<0.001). Nutritional status was predictive of wound healing (R2=0.12). Conclusion: Our results showed that a good nutritional status and a protocol inspired by the TIMECare model were associated with wound healing improvements in stage III and IV PUs. We recommend this protocol in older patients with stage III and IV PUs. [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: Because of the importance of a dyadic approach, it is necessary to conduct a systematic review to identify which dyadic intervention could be implemented for stroke survivor–caregiver dyads after discharge from the rehabilitation hospital to improve outcomes. Aims: The aims were to systematically review the evidence to identify which dyadic interventions have been implemented in stroke survivor–caregiver dyads to improve stroke survivor–caregiver dyads' outcomes and to analyse, through a meta-analysis, which intervention was found to be the most effective. Methods: A systematic review and meta-analysis were conducted using the following electronic databases: PubMed, CINAHL and PsycInfo. Randomized controlled trials (RCTs) and quasi-RCT studies published within the last 10 years were included. Quantitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI. Pooled effects were analysed between the experimental and control groups for each outcome. Results: Sixteen studies involving 2997 stroke survivors (male gender=58%) and 2187 caregivers (male gender=25%) were included in this review. In 16 studies, which were subdivided into three quasi-RCTs and 13 RCTs, the application of dyadic interventions for stroke survivors and caregivers was systematically reviewed, but only a few of these identified a significant improvement in the stroke survivors' and caregivers' outcomes of its intervention group. Dyadic interventions showed a significant effect on stroke survivors' physical functioning (p =0.05), memory (p <0.01) and quality of life (p =0.01) and on caregivers' depression (p =0.05). Conclusions: This study provides moderate support for the use of a dyadic intervention to improve stroke survivors' physical functioning, memory and quality of life and caregiver depression. [ABSTRACT FROM AUTHOR]

To develop a self-report scale to measure academic motivation among nursing students and to test its psychometric properties. a cross-sectional validation study with a convenience sample of nursing students (n=1,635) was performed. The Motivation Nursing Students Scale was developed; content, face, construct validity, hypothesis testing and reliability were evaluated. The validity structure revealed a four-factor solution and the model reached a satisfactory fit (χ2=622.835 df=160, p<0.01, CFI=0.90, TLT=0.83, RMSEA=0.060 (90% [CI] 0.055–0.064, p=0.001, SRMR=0.067). The hypothesis testing was confirmed with a positive correlation of the academic self-efficacy with Introjected, Intrinsic motivation and a negative correlation with Amotivation. We verified a link between academic self-efficacy and motivation. Both motivation and self-efficacy may increase academic achievement and the possibility for HEIs to degrees a number of students in line with demands. [ABSTRACT FROM AUTHOR]

The aim of this study was developing and testing a new tool for measuring quality of life (QoL) in patients with osteoporosis who had experienced nonvertebral fractures (NVFXs). Two main phases were carried out. First, the tool was developed based on expert opinion through three focus groups. Second, the tool was tested with exploratory factor analysis and confirmatory factor analysis in a sample of 458 postmenopausal women. The reliability of the developed Quality of Life Osteoporosis Scale—Nonvertebral Fractures (QoLOS-NVFX) was measured using Cronbach's α, maximal reliability (MR), composite reliability (CR), and average variance extracted (AVE). The QoLOS-NVFX resulted in a unidimensional scale with 23 items and showed good reliability, with a Cronbach's α of 0.94, an MR of 0.96, a CR of 0.96, and an AVE of 0.70. The QoLOS-NVFX shows good psychometric properties and can be used to assess the impact of NVFX on QoL in osteoporotic women. Furthermore, it can be easily used in clinical practice and research. [ABSTRACT FROM AUTHOR]

Background: An increasing number of patients worldwide are living with an ostomy. Among them, self-care management skills and stoma self-care abilities are associated with better quality of life. Aims: To identify the sociodemographic and clinical characteristics of Italian ostomy patients and investigate their knowledge of stoma management. Methods: A questionnaire was used to gather the sociodemographic and clinical data of 433 adult patients. Participants responded to a nine-item survey assessing their knowledge of stoma management. Findings: Respondents reported having received extensive or adequate information in 64.4% of cases, and the remaining 35.6% reported receiving little or no information at any time. The health professional who imparted at least adequate information was a stoma nurse specialist in 32.1% of cases, usually during admission (24.0%) or before and during admission (19.6%). Conclusion: This study demonstrated that most patients received adequate information regarding the ostomy. [ABSTRACT FROM AUTHOR]

Clinicians and researchers need valid and reliable instruments to evaluate heart failure (HF) self‐care. The Self‐Care of Heart Failure Index (SCHFI) is a theoretically driven instrument developed for this purpose. The SCHFI measures self‐care with three scales: self‐care maintenance, measuring behaviors to maintain HF stability; symptom perception, measuring monitoring behaviors; and self‐care management, assessing the response to symptoms. After the theory underpinning the SCHFI was updated, the instrument was updated to version 7.2 but it was only tested in the United States. In this study we tested the psychometric characteristics (structural and construct validity, internal consistency, and test–retest reliability) of the SCHFI v.7.2 in an Italian population of HF patients. We used a cross‐sectional design to study 280 HF patients with additional data collected after 2 weeks for test–retest reliability. Adults with HF (mean age 75.6 (±10.8); 70.8% in New York Heart Association [NYHA] classes II and III) were enrolled from six centers across Italy. Confirmatory factor analysis showed supportive structural validity in the three SCHFI v.7.2 scales (CFI from 0.94 to 0.95; RMSEA from 0.05 to 0.07). Internal consistency reliability estimated with Cronbach's α and composite reliability ranged between.73 and.88; test–retest reliability ranged between 0.73 and 0.92. Construct validity was supported with significant correlations between the SCHFI v.7.2 scale scores and quality of life, brain natriuretic peptide levels and NYHA class. This study further supports the psychometric characteristics of the SCHFI v.7.2, illustrating that it can be used in clinical practice and research also in an Italian population. [ABSTRACT FROM AUTHOR]

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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]

Background and Purpose: Perceptions toward nursing diagnosis (ND) may represent core drivers of its adoption within clinical practice. Few studies have investigated perceptions toward ND within nursing academic contexts. The study was conducted to validate the Italian version of the Minnesota Nurses' Perceptions of Nursing Diagnoses (MNPND) scale on a sample of Italian nursing students and explore the psychometric structure of perceptions in a sample drawn from this population. Methods: A cross-sectional survey with an online self-administered questionnaire was used. The study used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: A three-factorstructure was obtained from parallel analysis and EFA. This was confirmed using CFA; fit statistics: MLRχ² (132) = 230.150, p <. 001; CFI = 0.94; TLI = 0.93; RMSEA = 0.05 [90% CI = 0.041–0.064]; SRMR = 0.056). Conclusions: The MNPND scale is a useful instrument to measure nursing students' perceptions of ND [ABSTRACT FROM AUTHOR]

Background: Lay caregivers are important in contributing to self-care of patients with heart failure (HF). The Caregiver Contributions to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions, but after developing the Situation-Specific Theory of Caregiver Contributions to Heart Failure Self-Care, the CC-SCHFI needed updating to reflect the theory. Objective: The aim of this study was to test the psychometric characteristics of the CC-SCHFI 2 that measures caregiver contributions (CC) to HF self-care with 3 scales: CC to self-care maintenance, CC to symptom perception, and CC to self-caremanagement. Methods: This is a cross-sectional study. We tested the CC-SCHFI 2 with confirmatory factor analysis, internal consistency, item-total correlations, and test-retest reliability.With the CC-SCHFI 2, we also administered the Self-Care of Heart Failure Index v.7.2 to patients and the Caregiver Contribution to Heart Failure Self-Care Scale to caregivers to assess concurrent validity. Results: A sample of 277 caregivers was enrolled (mean [SD] age, 52.7 [14.9] years; 70.4%female). In confirmatory factor analysis, each CC-SCHFI 2 scale had supportive fit indices: comparative fit index ranged between 0.94 and 0.95, and root mean square error of approximation ranged between 0.05 and 0.07. Internal consistency of the 3 scales was evident with a Cronbach α between .81 and .83 and a global reliability index between 0.79 and 0.86. Item-total correlations were all greater than 0.30. In concurrent validity testing, there were significant correlations between the CC-SCHFI 2 and the Self-Care of Heart Failure Index v.7.2 and the Caregiver Contribution to Heart Failure Self-Care Scale. Test-retest reliability showed intraclass correlation coefficients between 0.72 and 0.91. Conclusions: Testing of the CC-SCHFI 2 supported validity and reliability, indicating that the instrument can be used in clinical practice and research to evaluate CC to the self-care of patients with HF. [ABSTRACT FROM AUTHOR]

Background: Caregiver contributions (CC) to heart failure (HF) self-care maintenance (ie, CC to maintaining HF stability) and management (ie, CC to dealing with HF signs and symptoms) improve patient outcomes, but it is unknown whether caregiver preparedness influences CC to self-care and whether caregiver confidence mediates this process. Objectives: We evaluated the influence of caregiver preparedness on CC to HF self-care maintenance and management and the mediating role of caregiver confidence. Methods: This is a secondary analysis of theMOTIVATE-HF study. Patients were 18 years or older, with a diagnosis of HF in New York Heart Association classes II to IV, who had insufficient self-care and did not have severe cognitive impairment. Patients' informal caregivers were those people inside or outside the family who gave most of the informal care to the patients. We used the Caregiver Preparedness Scale and the Caregiver Contribution to Self-Care of HF Index. We tested a path analysis model and the indirect effects. Results: Caregivers (n = 323)were 55 (SD, 15) years old on average and predominantly female (77%). The path analysis showed that higher scores in caregiver preparedness were associated with higher scores in caregiver confidence. In turn, higher caregiver confidence was associated with higher CC to self-care maintenance and management. Caregiver confidence mediated the association between caregiver preparedness and CC to self-care maintenance and management. Conclusions: Caregiver confidence may play a role in CC to self-care. Interventions to improve CC to HF self-care should not only be focused on improving caregiver preparedness but also should consider the role of caregiver confidence. [ABSTRACT FROM AUTHOR]

Background: Self‐employment represents a new work opportunity for new nursing graduates; however, little is known about nursing students' Intention to meet this new demand from the labour market. Aims: To develop a theory‐driven questionnaire to assess students' Intentions for self‐employment and psychometrically test this scale. Method: A cross‐sectional study was conducted investigating 344 nursing students in their final year in an Italian university. The content, face, construct, convergent and discriminant validity, and reliability were evaluated. We also tested the theory of planned behaviour. Results: The Planned Self‐Employment Scale demonstrated satisfactory validity and good reliability. A moderate Intention to be self‐employed emerged among nurses (3.6 ± 1.5 out of 7). This level of Intention was predicted by the Attitudes and Perceived Behaviour Control dimensions. Conclusion: The Planned Self‐Employment Scale exhibited good validity and reliability and can thus be used with nursing students. Implications for Nursing Management: Educators need to design a curriculum to improve students' decision‐making and autonomy. At the central level, there is a need to produce guidelines that offer guidance to both nurses and patients, as well as the system as a whole with regard to this new form of nursing service. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate if nursing diagnoses, interventions, and outcomes, as recorded by nurses in Italian hospitals, were semantically equivalent to the NANDA‐I, NIC, and NOC (NNN) terminology. METHODS: A cross‐mapping study using a multicenter design. Terms indicating nursing diagnoses, interventions, and outcomes were collected using the D‐Catch instrument. Cross‐mapping of these terms with NNN terminology was performed. FINDINGS: A sample of 137 nursing documentations was included. Over 80% of nursing diagnostic terms, interventions, and outcomes were cross‐mapped into NNN terminology. CONCLUSIONS: The study showed that most of the natural terms used by nurses were semantically equivalent to the standardized terms of NNN terminology. IMPLICATIONS FOR NURSING PRACTICE: In Italy, the use of NNN terminology is recommended; however, further development of this terminology is needed. [ABSTRACT FROM AUTHOR]

Background: The burden is high in caregivers of heart failure patients, but the literature on patient and caregiver predictors of caregiver burden is inconsistent. Also, it is unknown if caregiver contribution to heart failure self-care maintenance (i.e. helping patients to maintain heart failure stable) and self-care management (i.e. helping patients to act in case of heart failure worsening) increases caregiver burden. Aims: To identify caregiver and patient predictors of caregiver burden in heart failure; and to evaluate if caregiver contribution to heart failure self-care maintenance and management increases caregiver burden. Methods: A cross-sectional study with the enrolment of 505 caregivers of heart failure patients. We used the caregiver burden inventory and the caregiver contribution to self-care of heart failure index. We analysed the data using hierarchical regression. Results: Heart failure caregivers, mostly women (52.5%), with a mean age 56.5 (±14.9) years, cared for heart failure patients, mostly men (55.2%), with a mean age of 75.9 (±10.4) years. Caregiver predictors of higher caregiver burden were older age, female gender, fewer caregiving hours and poor social support. Patient predictors of higher caregiver burden were older age, better education, taking fewer medications and higher quality of life. Caregiver contribution to self-care maintenance and management were not significant predictors of caregiver burden. Conclusions: Our results could help providers to identify heart failure caregivers who are more exposed to burden. As caregiver contribution to heart failure self-care improves patient outcomes and seems not burdensome for caregivers, providers may consider educating caregivers about self-care as a viable option for improving patient outcomes without increasing caregiver burden. [ABSTRACT FROM AUTHOR]

Background: Heart failure (HF) patient-caregiver dyads experience severe psychological problems, such as anxiety and depression. A variable that has been found to be associated with anxiety and depression in patients and caregivers in severe chronic conditions is mutuality. However, this association has not been explored in HF patient-caregiver dyads to date. Objective: The aim of this study was to evaluate the associations among mutuality, anxiety, and depression in HF patient-caregiver dyads. Methods: This was a cross-sectional study. Mutuality, anxiety, and depression in HF patient-caregiver dyads were assessed using the Mutuality Scale (MS) total and 4 dimension scores and the Hospital Anxiety and Depression Scale, respectively. Data were analyzed using the actor-partner interdependence model to examine how mutuality of patients and caregivers was associated with both the patients' own (actor effect) and their partners' anxiety and depression (partner effect). Results: A sample of 366 dyads of patients with HF (mean age, 72 years; 56% male) and caregivers (mean age, 54 years; 73.3% female) was enrolled. Regarding patient anxiety, we observed only an actor effect between the MS dimension scores of "love and affection" and "reciprocity" and anxiety in patients (B = -1.108, P = .004 and B = -0.826, P = .029, respectively). No actor and partner effects were observed concerning caregiver anxiety. Regarding depression, we observed that only the MS dimension of "love and affection" in patients had both an actor (patient: B = -0.717, P = .032) and a partner (caregiver: B = 0.710, P = .040) effect on depression. Conclusions: The assessment of MS in HF patient-caregiver dyads is important to formulate interventions aimed at improving anxiety and depression in patients and caregivers. [ABSTRACT FROM AUTHOR]

Background: The Heart Failure Somatic Perception Scale (HFSPS) is a four-factor instrument used to assess how bothersome are 18 physical signs and symptoms of heart failure. To date, construct validity and reliability of the HFSPS have been evaluated in only one American study and never in a European population. Aim: To evaluate psychometric properties (validity and reliability) of the HFSPS in a European heart failure population. Methods: This was an Italian multicentre study in which the HFSPS factorial structure was assessed using confirmatory factor analysis. Criterion related validity of the HFSPS was evaluated by correlating its factor scores with the Kansas City Cardiomyopathy Questionnaire (KCCQ) scores using Pearson's r. The HFSPS internal consistency reliability was evaluated using the factor score determinacy coefficient, Cronbach's α and model-based internal consistency index. Results: Most of the participants (n =321) were male (56.6%), with a mean age of 71.48 years (SD, 12.75) and in New York Heart Association class II (61.8%). The confirmatory factor analysis, testing the original HFSPS four-factor structure (dyspnoea, chest discomfort, early and subtle, and oedema), resulted in the following supportive fit indices: χ2 (126, N =321)=337.612, p <0.001, comparative fit index =0.920, Tucker–Lewis index =0.903, root mean square error of approximation =0.072 and standardized root mean square residual =0.045. With regard to the criterion related validity, all the correlations with the KCCQ were statistically significant. The HFSPS reliability resulted in factor score determinacy coefficients ⩾ 0.87 and Cronbach's α ⩾ 0.75, with the exception of the two-item chest discomfort subscale; the model-based reliability coefficient was 0.914. Conclusion: The validity and reliability of the HFSPS were supportive in this European sample. The HFSPS can be used to assess how bothersome heart failure signs and symptoms are in order to improve their management. [ABSTRACT FROM AUTHOR]

Background: Caregiver contribution to heart failure (HF) self-care maintenance and management is important in HF care. Literature remains unclear regarding which practices caregivers perform to contribute to self-care for patients with HF, especially in Southern Europe. Objective: The objective of this study was to describe caregiver contributions to HF self-care maintenance (ie, treatment adherence and symptom monitoring) and management (ie, managing HF symptoms when they occur). Methods: Forty HF caregivers were enrolled from 3 outpatient clinics in Italy for a qualitative descriptive study. Data were collected with a semistructured interview and analyzed using content analysis. Results: Caregivers were 53.6 years old on average and mostly female (63.5%). Caregiver contributions to self-care maintenance included practices related to (1) monitoring medication adherence, (2) educating patients about HF symptom monitoring, (3) motivating patients to perform physical activity, and (4) reinforcing dietary restrictions. However, some of these practices were incorrect (eg, weighing the patient only once a week). Caregiver contributions to self-care management included practices related to (1) symptom recognition and (2) treatment implementation. Caregivers were able to recognize symptoms of HF exacerbation (eg, breathlessness) but lacked confidence regarding treatment implementation (eg, administering an extra diuretic). Conclusions: Although caregivers described contributing to patients' HF self-care maintenance and management, some of their practices were incorrect. Because the caregiver contributions to HF self-care can improve patient outcomes, clinicians should routinely assess caregiver HF self-care practices and provide education and reinforcement regarding evidence-based practices. [ABSTRACT FROM AUTHOR]

Mutuality in patient–caregiver dyad may improve heart failure (HF) patient self-care and caregiver contribution to self-care, but literature is scarce. We evaluated the influence of mutuality and its dimensions on patient–caregiver dyad self-care. A sample of 366 HF patient–caregiver dyads was enrolled. The Actor–Partner Interdependence Model was used to identify the influence of individual patient and caregiver mutuality on their own self-care (actor effect) and on partner self-care (partner effect). The total mutuality score had an actor effect on patient self-care maintenance (i.e., behaviors aimed at maintaining HF stability) and on patient and caregiver self-care confidence. Total score of patient mutuality also had a partner effect on caregiver self-care management (i.e., responses to symptoms of HF exacerbation). Specific mutuality dimensions had different actor and partner effects on patient and caregiver self-care. Interventions to improve mutuality in HF patient–caregiver dyads may influence patient self-care and caregiver contribution to self-care. [ABSTRACT FROM AUTHOR]

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Abstract: Aims: To identify clusters of nurses in relation to their beliefs about nursing diagnosis among two populations (Italian and Spanish); to investigate differences among clusters of nurses in each population considering the nurses' socio‐demographic data, attitudes towards nursing diagnosis, intentions to make nursing diagnosis and actual behaviours in making nursing diagnosis. Background: Nurses' beliefs concerning nursing diagnosis can influence its use in practice but this is still unclear. Design: A cross‐sectional design. Methods: A convenience sample of nurses in Italy and Spain was enrolled. Data were collected between 2014‐2015 using tools, that is, a socio‐demographic questionnaire and behavioural, normative and control beliefs, attitudes, intentions and behaviours scales. Results: The sample included 499 nurses (272 Italians & 227 Spanish). Of these, 66.5% of the Italian and 90.7% of the Spanish sample were female. The mean age was 36.5 and 45.2 years old in the Italian and Spanish sample respectively. Six clusters of nurses were identified in Spain and four in Italy. Three clusters were similar among the two populations. Similar significant associations between age, years of work, attitudes towards nursing diagnosis, intentions to make nursing diagnosis and behaviours in making nursing diagnosis and cluster membership in each population were identified. Conclusion: Belief profiles identified unique subsets of nurses that have distinct characteristics. Categorizing nurses by belief patterns may help administrators and educators to tailor interventions aimed at improving nursing diagnosis use in practice. [ABSTRACT FROM AUTHOR]

Background: Preventing hospitalization and improving event-free survival are primary goals of heart failure (HF) treatment according to current European Society of Cardiology guidelines; however, substantial uncertainty remains in our ability to predict risk and improve outcomes. Although caregivers often assist patients to manage their HF, little is known about their influence on clinical outcomes. Aims: To quantify the influence of patient and caregiver characteristics on patient clinical event risk in HF. Methods: This was a secondary analysis of data using a sample of Italian adults with HF and their informal caregivers (n = 183 patient–caregiver dyads). HF patients were followed over 12 months for the following clinical events: hospitalization for HF, emergency room visit for HF or all-cause mortality. Influence of baseline caregiver- and patient-level factors (patient and caregiver age; dyad relationship type; patient New York Heart Association (NYHA) Class, cognition, and comorbidities; and caregiver strain, mental health status, and contributions to HF self-care) on patient risk of death or hospitalization/emergency room use was quantified using Cox proportional hazards regression. Results: Over the course of follow up, 32.8% of patients died, 19.7% were hospitalized for HF and 10.4% visited the emergency room. Higher caregiver strain, better caregiver mental health status and greater caregiver contributions to HF self-care maintenance were associated with significantly better event-free survival. Worse patient functional class and greater caregiver contributions to patient self-care management were associated with significantly worse patient event-free survival. Conclusion: Considering caregiving factors together with patient factors significantly increases our understanding of patient clinical event risk in HF. [ABSTRACT FROM AUTHOR]

Aims To describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyse the relationship of nursing diagnoses to patient characteristics and hospital outcomes. Background Nursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking. Design Prospective observational study. Methods Data were collected for 6 months in 2014 in four inpatient units of an Italian hospital using a nursing information system and the hospital discharge register. Nursing diagnoses with prevalence higher or equal to 20% were considered as 'high frequency.' Nursing diagnoses with statistically significant relationships with either higher mortality or length of stay were considered as 'high risk.' The high-frequency/high-risk category of nursing diagnoses was identified. Results The sample included 2283 patients. A mean of 4·5 nursing diagnoses per patient was identified; this number showed a statistically significant difference among inpatient units and medical diagnoses. Six nursing diagnoses were classified as high frequency/high risk. Nursing diagnoses were not correlated with patient gender and age. A statistically significant perfect linear association (Spearman's correlation coefficient) was observed between the number of nursing diagnoses and both the length of stay and the mortality rate. Conclusion Nursing complexity, as described by nursing diagnoses, was shown to be associated with length of stay and mortality. These results should be confirmed after considering other variables through multivariate analyses. The concept of high-frequency/high-risk nursing diagnoses should be expanded in further studies. [ABSTRACT FROM AUTHOR]

Background: A better understanding of caregiver burden and its determinants is essential to support caregivers. Many instruments have been developed to measure caregiver burden in various illness contexts, but few have been psychometrically tested for caregivers of heart failure patients. Aims: The aim of this study was to test the validity (factorial and concurrent validity) and reliability (internal consistency) of the caregiver burden inventory (CBI) in a cohort of caregivers of heart failure patients. Methods: This was a secondary analysis from a cross-sectional study on heart failure patients and their caregivers enrolled from various Italian outpatient centres. The factorial validity of the CBI was tested with confirmatory factor analysis, and concurrent validity was tested correlating CBI scores with the short form-12 health survey scores. The internal consistency reliability was assessed with Cronbach’s alpha. Results: In total, 505 caregivers of heart failure patients (52.2% women, mean age 56.59±14.9 years) were enrolled. Confirmatory factor analyses confirmed the original five-factor model: time-dependence, developmental, physical, social and emotional burden. This model fits the data better than the single-factor model, and the dimensions showed high internal consistency reliability (Cronbach’s alpha 0.91 for time-dependence burden, 0.92 for developmental burden, 0.88 for physical burden, 0.89 for social burden and 0.93 for emotional burden; 0.96 for the total score of burden). Conclusion: The CBI proved to be a good multidimensional instrument for evaluating the burden in caregivers of heart failure patients and can be used in clinical practice and research. This tool can be considered to tailor interventions aimed at improving caregiver outcomes. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the psychometric properties of the D-Catch instrument. Methods A cross-sectional methodological study. Validity and reliability were estimated with confirmatory factor analysis ( CFA) and internal consistency and inter-rater reliability, respectively. Findings A sample of 250 nursing documentations was selected. CFA showed the adequacy of a 1-factor model (chronologically descriptive accuracy) with an outlier item (nursing diagnosis accuracy). Internal consistency and inter-rater reliability were adequate. Conclusions The D-Catch is a valid and reliable instrument for measuring the accuracy of nursing documentation. Caution is needed when measuring diagnostic accuracy since only one item measures this dimension. Implications for Nursing Practice The D-Catch can be used as an indicator of the accuracy of nursing documentation and the quality of nursing care. [ABSTRACT FROM AUTHOR]

Aim To test an explanatory model of nurses' intention to report adverse drug reactions in hospital settings, based on the theory of planned behaviour. Background Under-reporting of adverse drug reactions is an important problem among nurses. Methods A cross-sectional design was used. Data were collected with the adverse drug reporting nurses' questionnaire. Confirmatory factor analysis was performed to test the factor validity of the adverse drug reporting nurses' questionnaire, and structural equation modelling was used to test the explanatory model. Results The convenience sample comprised 500 Italian hospital nurses (mean age = 43.52). Confirmatory factor analysis supported the factor validity of the adverse drug reporting nurses' questionnaire. The structural equation modelling showed a good fit with the data. Nurses' intention to report adverse drug reactions was significantly predicted by attitudes, subjective norms and perceived behavioural control ( R² = 0.16). Conclusions The theory of planned behaviour effectively explained the mechanisms behind nurses' intention to report adverse drug reactions, showing how several factors come into play. Implications for nursing management In a scenario of organisational empowerment towards adverse drug reaction reporting, the major predictors of the intention to report are support for the decision to report adverse drug reactions from other health care practitioners, perceptions about the value of adverse drug reaction reporting and nurses' favourable self-assessment of their adverse drug reaction reporting skills. [ABSTRACT FROM AUTHOR]

Aim To describe a research protocol designed to formulate a conceptual framework of informal caregiver resilience in palliative care. Background Resilience is the ability to adapt or to improve one's own conditions following experiences of adversity. The end-of-life care provided by informal caregivers is a form of adversity because it entails objective difficulties, emotional involvement and deep levels of introspection that have been stimulated by the death event. Resilience has not yet been addressed in association with end-of-life care. Design This is a multicentre cross-sectional study. Methods We will administer a questionnaire to a sample of informal end-of-life caregivers to collect data about the main psychological, behavioural and healthcare factors that impact resilience. Data analysis will include descriptive and correlational statistical techniques, multiple linear regressions and structural equation modelling. Data will be collected in multiple palliative care centres and statistical analysis will be carried out using software: SPSS version 19.0 and MPlus version 7.3. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship in Italy (Research Grant number 2.13.10) that was awarded in March 2013. Discussion The study seeks to identify the predictive, mediating and moderating roles of select variables: caregivers' self-efficacy, burdens of caregiving, depression and resilience. The results of this analysis will impact the theoretical study of resilience in palliative care and will have practical implications for interventions aimed at supporting caregivers through healthcare teams. [ABSTRACT FROM AUTHOR]

Background: Caregivers play an important role in contributing to heart failure (HF) patients’ self-care but no prior studies have examined the caregivers’ contributions to HF patients’ self-care and no prior studies have examined potential determinants of the caregivers’ contribution to HF patients’ self-care. Aims: The purpose of this study was to describe the caregivers’ contribution to HF patients’ self-care and identify its determinants. Methods: The study design involved a secondary analysis of cross-sectional data. Caregivers’ contributions were measured with the Caregiver’s Contribution to Self-care of HF Index (CC-SCHFI) which measures the caregiver’s contribution to self-care maintenance and management and caregiver confidence in contributing to HF patient’s self-care. Potential determinants were measured using a socio-demographic questionnaire completed by caregivers and patients, and patient clinical data was obtained from the medical record. Results: Data from 515 caregiver/patient dyads were analyzed. Most (55.5%) patients were male (mean age 75.6 years) and most (52.4%) caregivers were female (mean age, 56.6 years). The caregivers’ contribution to patients’ self-care maintenance was low in weight monitoring and physical activity but higher in checking ankles, advising on low-salt foods and taking medicines. The caregivers’ contribution to patients’ self-care management was low in symptom recognition. When symptoms were recognized, caregivers advised patients to reduce fluids and salt and call the provider but rarely advised to take an extra diuretic. Caregiver confidence in the ability to contribute to patient self-care explained a significant amount of variance in the caregiver’s contribution. Conclusion: These findings suggest that caregivers in this sample did not contribute meaningfully to HF self-care. Providers should educate both HF patients and caregivers. Interventions that improve caregiver confidence have the potential to successfully increase the caregivers’ contribution to patients’ self-care. [ABSTRACT FROM AUTHOR]

Disease self-management is a critical component of maintaining clinical stability for patients with chronic illness. This is particularly evident in the context of heart failure (HF), which is the leading cause of hospitalization for older adults. HF self-management, commonly known as HF self-care, is often performed with the support of informal caregivers. However, little is known about how a HF dyad manages the patient's care together. The purpose of this study was to identify determinants of patient and caregiver contributions to HF self-care maintenance (daily adherence and symptom monitoring) and management (appropriate recognition and response to symptoms), utilizing an approach that controls for dyadic interdependence. This was a secondary analysis of cross-sectional data from 364 dyads of Italian HF patients and caregivers. Multilevel modeling was used to identify determinants of HF self-care within patient-caregiver dyads. Patients averaged 76.2 ( SD = 10.7) years old, and a slight majority (56.9%) was male, whereas caregivers averaged 57.4 ( SD = 14.6) years old, and about half (48.1%) were male. Most caregivers were adult children (48.4%) or spouses (32.7%) of patients. Both patients and caregivers reported low levels of HF maintenance and management behaviors. Significant individual and dyadic determinants of self-care maintenance and self-care management included gender, quality of life, comorbid burden, impaired ADLs, cognition, hospitalizations, HF duration, relationship type, relationship quality, and social support. These comprehensive dyadic models assist in elucidating the complex nature of patient-caregiver relationships and their influence on HF self-care, leading to more effective ways to intervene and optimize outcomes. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective: To test the suitability of the theory of planned behavior (TPB) for explaining Italian women's role in prostatic cancer screening promotion. Design/Methods: A descriptive, cross-sectional, online self-report survey was conducted with a convenience sample of 235 Italian women. Variables included attitudes women's role, perceived behavioral control, subjective norm, behavioral intention, and prostate cancer screening promotion behavior. A survey composed of the Eastland Prostate Cancer Survey subscales that were consistent with the TPB was distributed via e-mail to potential participants. The survey was live for 12 weeks (March 2013 to May 2013). Responses were collated with eSurv.org. Data were analyzed using latent path analysis and structural equation modeling. Results: Behavioral intentions in promoting prostate cancer screening significantly predicted the likelihood of the Italian women to adopt self-reported prostate cancer screening promotion behaviors. In addition, the exclusive direct impact of the intentions explained 39% of the variance in self-reported behaviors. Conclusions: The TPB could represent a good framework to explain the role of Italian women in prevention behaviors related to the prostatic screening domain. Consistent with literature findings in social and nursing sciences, the intention to promote prostate cancer screening was a powerful "predictor" of the behavior itself. [ABSTRACT FROM AUTHOR]

Background: The Stroke Impact Scale 3.0 (SIS 3.0) is widely used to measure quality of life in stroke survivors; however, previous studies have not tested the original 8-factor structure of the scale. In addition, previous studies have shown floor and ceiling effect and weak reliability within the scale. Objective: The aim of this study was to evaluate the psychometric characteristics of the SIS 3.0, including its construct validity (factorial structure, concurrent and contrasting group validity), floor and ceiling effect, and reliability. Method: A cross-sectional design was used to study 392 stroke survivors enrolled in 16 rehabilitation facilities across Italy. Factorial structure of the SIS 3.0 was tested with confirmatory factor analysis. Concurrent and contrasting group validities were evaluated with other scales measuring functional capacities, neurological functions, cognition, anxiety, depression, and generic quality of life. Floor and ceiling effects were evaluated by determining the percentages of patients with the minimum and the maximum score at SIS 3.0. Reliability was determined by Cronbach's a and test-retest. Results: Participants were 71 years old on average (SD, 11 years); 55% were men. Confirmatory factor analysis revealed a new 4-factor structure that fitted the data better than the original 8-factor structure did. Concurrent and contrasting group validity of the new 4-factor structure was supportive and no floor and ceiling effects were found. Internal consistency and test-retest reliability ranged between 0.79 and 0.98. Conclusion: The new factorial structure of the SIS 3.0 with 4 factors showed better psychometric properties than the original 8-factor structure did. This evidence supports further use of the SIS 3.0 in clinical practice and research. [ABSTRACT FROM AUTHOR]

Objectives: To identify which factors can influence the patients' perception of protective isolation following Haematopoietic Stem Cell Transplantation (HSCT). Methods: This is a prospective study conducted in 10 Italian centres, members of the Italian Group of stem cell transplant (GITMO). Patients' perception of protective isolation was assessed using the ISOLA scale between 7 and 9 days post‐transplant. Statistical linear regression analysis was performed. Results: The participants were 182 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. Male sex (β = .152), education level (β = −.245), double room (β = .186), satisfaction with visiting hours (β = −.174) and emotional support from nurses (β = −.169) were independently associated with isolation‐related suffering. Significant predictors of the relationship with oneself included body temperature (β = −.179), fatigue (β = −.192) and emotional support from nurses (β = −.292). Factors independently associated with the relationship with others were education (β = −.230), chemotherapy cycles (β = −.218), pain (β = .150) and satisfaction with visiting hours (β = −.162). Conclusion: Healthcare providers should pay greater attention in caring for those patients who are at risk for a negative isolation experience. Nurses should provide emotional support. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop and psychometrically test a questionnaire assessing patients' perception of protective isolation following haematopoietic stem cell transplantation (HSCT). The conceptual framework for developing the questionnaire was a three‐dimensional model that emerged from a metasynthesis: isolation‐related suffering, relationship with oneself and relationship with others. Item selection was performed through a focus group, comparison with the findings of two phenomenological studies, and content validity with 22 experts. Cognitive interviews with five patients were used to verify face validity. A validation study was conducted in 10 Italian centres, all members of the Italian Group of stem cell transplant (GITMO). Patients completed the questionnaires between 7 and 9 days post‐transplant. Dimensionality was tested through exploratory factor analysis (EFA). A total of 17 items yielded a content validity index (CVI) of 0.88. Participants included 186 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. The EFA yielded a three‐factor solution, explaining 55% of the variance. The scale showed adequate psychometric properties, with the exception of three items, which were eliminated. Future studies should test the psychometric properties of the questionnaire through confirmatory factor analysis and verify its transcultural validity. [ABSTRACT FROM AUTHOR]