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Background and Purpose: Clinical reasoning for nurses is considered a valuable component of clinical nursing competencies, but there are few tools to ascertain this. This study tested the Italian Nurses Clinical Reasoning Scale (I-NCRS) psychometric properties based on Levett-Jones' theoretical clinical reasoning model. Methods: Content, face, and construct characteristics were ascertained for their validity. The study had a two-phase design: (a) content and face validity and (b) construct validity. Results: Three factors emerged from the factorial analysis of our reference sample: nursing problems of health, nursing information of health, and nursing assessment of health. Conclusions: The scale represents a valuable tool for the self-assessment of the clinical reasoning skills of nurses. I-NCRS showed evidence of validity and reliability, being also useful for assessing clinical reasoning for educational and research purposes among Italian nurses. [ABSTRACT FROM AUTHOR]

Nurse managers play a vital role in healthcare organizations, wielding the ability to substantially enhance work environments, foster nurses' autonomy, and bolster retention within workplaces. In this context, this study focuses on the Nurse Manager Actions scale, aiming to evaluate its items' scalability as well as the scale's validity and reliability among nurses and nurse managers operating within the Italian healthcare context. The study protocol was not registered. To ensure linguistic and cultural alignment, an iterative and collaborative translation process was undertaken. Subsequently, a multi-center cross-sectional design was adopted. Using a web-survey approach, data were collected among 683 nurses and 188 nurse managers between August 2022 and January 2023. The Nurse Manager Actions scale was found to be a valid and reliable instrument in Italian after a Mokken Scale Analysis. For nurses (HT= 0.630, Molenaar–Sijtsma rho = 0.890), the scale included 6 items, while 11 items were confirmed for nurse managers (HT= 0.620, Molenaar–Sijtsma rho = 0.830). Nurse Manager Actions scale scores were correlated with increased satisfaction and decreased intention to leave for both nurses and nurse managers. The employed validation process enhanced the scale validity for use in Italy and provided a model for other researchers to follow when assessing similar measures in different populations. Measuring and empowering nurse manager actions in work contexts is essential to improve the general well-being and retention of nurses, especially in the current nursing shortage. [ABSTRACT FROM AUTHOR]

For decades, scholars have studied leader–member exchange (LMX) relationships to understand and explain the effects of leadership on follower attitudes and performance outcomes within work settings. One available instrument to measure these aspects is the LMX-7 scale. This measurement has been widely used in empirical studies, but its psychometric properties have been poorly explored. The aim of this study was to test the psychometric characteristics (content, structural and construct validity, and reliability) of the Italian version of the LMX-7 scale and to support its cultural adaptation. We used a cross-sectional multi-center design. The forward–backward translation process was used to develop the Italian version of the scale. The scale was administered through an online survey to 837 nurses and nurse managers working in different settings. The factorial structure was tested using both exploratory and confirmatory factor analyses (EFA and CFA), and reliability was evaluated using Cronbach's alpha. For the construct validity, we used hypothesis testing and differentiation by known groups. The Italian version of the LMX-7 scale presented one dimension. All the psychometric tests performed confirmed its validity and suggested its usefulness for future research. [ABSTRACT FROM AUTHOR]

(1) Background: In response to the impact of religious intervention on health outcomes and the importance of documenting how nurses experience the spiritual need of 392 hospitalized patients, it is vital to provide the nursing profession with instruments to evaluate these spiritual aspects. This study describes the development and validation of the Nursing Care and Religious Diversity Scale (NCRDS); (2) Methods: A two-step design was used for NCRDS translation and psychometric validation. The tool design was developed in the first step, while the psychometric characteristics were tested in the second step. An inductive study was conducted to test the validity and reliability of the NCRDS tool. The overall sample consisted of 317 nurses; (3) Results: The final instrument comprised 25 items in five dimensions. The construct validity indicated five dimensions. The face and content validity were adequate. Test-retest reliability displayed good stability, and internal consistency (Cronbach's α) was acceptable (0.83); (4) Conclusions: Initial testing of the NCRDS suggested that it is a valid and reliable instrument to evaluate individuals in religious diversity, with five dimensions for evaluating the meaning of spirituality and individual belief, the religious healthcare environment, educational adequacy, spiritual and religious needs, and religious plurality. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Copyright of L'Infermiere is the property of IPASVI - Italian Nursing Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Literature on the prevention of medication errors is growing, highlighting that knowledge, attitude and behavior with regard to medication errors are strategic to planning of educational activities and evaluating their impact on professional practice. In this context, the present pilot study aims to translate and validate nursing professionals' knowledge, attitudes and behavior (KAB theory) concerning medication administration errors in ICU from English into Persian. Furthermore, two main objectives of the project were: performing a pilot study among Iranian nurses using the translated questionnaire and carrying out a cultural measurement of the KAB theory concerning medication administration errors in an ICU questionnaire across two groups of Italian and Iranian populations. Methods: A cross-cultural adaptation of an instrument, according to the Checklist for reporting of survey studies (CROSS), was performed. The convenience sample was made up of 529 Iranian and Italian registered nurses working in ICU. An exploratory factor analysis was performed and reliability was assessed. A multi-group confirmatory factor analysis was conducted to test the measurement invariance. Ethical approval was obtained. Results: There was an excellent internal consistency for the 19-item scale. Results regarding factorial invariance showed that the nursing population from Italy and Iran used the same cognitive framework to conceptualize the prevention of medication errors. Conclusions: Findings from this preliminary translation and cross-cultural validation confirm that the questionnaire is a reliable and valid instrument within Persian healthcare settings. Moreover, these findings suggest that Italian and Persian nurses used an identical cognitive framework or mental model when thinking about medication errors prevention. The paper not only provides, for the first time, a validated instrument to evaluate the KAB theory in Iran, but it should promote other researchers in extending this kind of research, supporting those countries where attention to medical error is still increasing. [ABSTRACT FROM AUTHOR]

Interprofessional education requires that two or more professionals learn from and with each other to allow effective collaboration and improve health outcomes. Thus far, the interprofessional collaboration of healthcare students might be assessed using the Readiness for Interprofessional Learning Scale (RIPLS), which is currently not available in its Italian version. This study aimed to provide the intercultural adaptation of the RIPLS in Italian (I-RIPLS) and assess its validity and reliability. A two-phase validation study was performed in 2020, using a single-centre approach in students enrolled in the medical degree, physiotherapy, nursing, and dentistry courses at an Italian-speaking university in Albania. The first phase of the study determined the cross-cultural adaptation of the items by involving two translators who followed a forward and backward translation process. In the second phase, a sample of 414 students was enrolled. The preliminary corrected item-total correlations showed that five items did not show significant item-to-total correlations. Even if their deletion was not mandatory for generating a suitable correlation matrix for factor analysis, the advantages of keeping only items contributing to a more stable measurement with a shorter scale represented the rationale for removing items with non-significant item-to-total correlation from the correlation matrix before testing the dimensionality of the I-RIPLS with factor analysis. The answers from the first 50% of responders (n = 207) were used to determine the most plausible dimensionality of the I-RIPLS by employing an exploratory factor analysis (EFA), and the second 50% were used to cross-validate the most plausible dimensionality derived from EFA by employing confirmatory factor analysis (CFA) models. The most plausible dimensionality from EFA, by acknowledging the interpretation of the scree plot, the eigenvalues greater than 1, a parallel analysis, and the previous theoretical dimensions of the tool had two factors with adequate internal consistency. The CFA confirmed the two-factor solutions and the internal consistency for each domain. The I-RIPLS has 14 items with adequate evidence of validity and reliability. Future research should revise the tool for pursuing cross-cultural multigroup measurement invariance. [ABSTRACT FROM AUTHOR]

Family Centered Care (FCC) in Neonatal Intensive Care Units (NICUs) included family involvement in the care process of newborns and infants. Staff perceptions of FCC may influence clinical practice and management strategies in NICUs, with an impact on quality and humanization of the care. The Family-Centred Care Questionnaire-Revised (FCCQ-R) was adapted for the NICU setting, therefore the FCCQ-R@it-NICU was developed and used for the present study in 32 Italian NICUs. We calculated internal consistency using Cronbach's alpha correlation between Current and Necessary dimensions of the scale using the Pearson correlation coefficient. Furthermore, we investigated which characteristics could influence staff perceptions of FCC in NICUs. 921 NICU professionals participated in the study. The FCCQ-R@it-NICU revealed good internal consistency (0.96) and good correlation between dimensions (p < 0.05). Statistical and significant differences in Current and Necessary dimensions were found and some demographic characteristics were found predictable on FCC practice. The FCCQ-R@it-NICU is a valid tool to investigate staff perceptions about FCC in NICU settings. Profession, education level and work experience seem to positively influence the perception of what is required for FCC practice within NICUs. [ABSTRACT FROM AUTHOR]

Background: Dignity is a central human value supported by nurses' professional ethics. In previous studies, nurses in clinical practice have experienced that dignity increased their work well-being and pride of work. Dignity is also strictly interweaved to professional identity in the different nursing' roles, but little is known about dignity among public health nurses and primary care settings. Purpose: This study aimed to describe the perceptions of nursing's professional dignity of public health nurses in primary care in Finland. Research design: An inductive qualitative descriptive approach with semi-structured focus group interviews was utilised. Participants and research context: Twenty-seven Finnish public health nurses were interviewed via eight semi-structured focus group interviews in primary health care settings. Ethical considerations: Before data collection, research permissions were obtained from participating health care centres. This type of research in Finland, with competent adult participants, does not require ethical pre-assessment but written and oral informed consent obtained before the interviews. Findings: Based on our findings, public health nurses perceived that professional dignity was (1) part of their self-respect, an observed daily value based on their acknowledged competence. Besides, they perceived that (2) service users' trust in public health nurses was a strong expression of professional dignity, and it could be uncovered when recipients of care utilised their services. In addition, public health nurses experienced that (3) professional dignity was an expression of different intertwined interprofessional and social factors. Discussion and conclusion: Professional dignity is simultaneously an essential prerequisite and an outcome of public health nurses' work. In future, more information would be needed to implement strategies in primary health care to foster nurses' professional dignity also in international public health arenas. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand the experiences and support needs of informal caregivers of patients with chronic obstructive pulmonary diseases chronic obstructive pulmonary disease who return home following an acute exacerbation. Background: The presence of an informal caregiver is important to provide practical and emotional support after an episode of acute exacerbation of chronic obstructive pulmonary disease. However, caregiving in such circumstances can be challenging and stressful. Design: Phenomenology. Methods: This is a phenomenological study based on semi‐structured interviews with sixteen primary caregivers of chronic obstructive pulmonary disease patients. Interview data were analysed using Colaizzi's descriptive analysis framework, to identify significant themes and sub‐themes. Data were collected between April‐December 2017 in a Teaching Hospital in Italy. The study was designed and reported following the COREQ guidelines and checklist. Results: Analysis elicited five themes embracing various aspects of the caregivers' lived experiences: (a) a home disrupted, (b) living with constant vigilance and anxiety, (c) feeling the need to escape (d) self‐justifications for caregiving role/duty, and (e) feeling abandoned by professionals. Conclusions: Our results show that carers experience a range of difficulties when caring for their relative at home with chronic obstructive pulmonary disease. Some of these are linked to the physical disruption of their home but many are linked to feelings of inability to cope and the psycho‐social impact of the caring role. The study also shows how participants felt unsupported by professionals. Focused support for carers is required to enable them to meet these challenges. Relevance to clinical practice: Healthcare professionals should be trained to provide technical and psychological support to caregivers especially during the phases of disease that may involve episodes of exacerbation. Home care and continuity of care can work if there is excellent communication and collaboration between healthcare professionals and caregivers. Developing appropriate support for family caregivers is essential to address the problems they can face. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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 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]

Aims and objectives: To determine the relevance of nursing's professional dignity in palliative care. Background: Dignity is a valued concept in the ethical discourse of health disciplines. Nursing's professional dignity, a concept related to professional identity, is not clearly defined nor have its characteristics been delineated for its clinical relevance in palliative care. Design: A qualitative methodological approach. Methods: Focus groups elicited dialogues of nursing's professional dignity among 69 nurses working in hospices and home‐care in Italy. Data were content‐analysed via an inductive process. The COREQ checklist for qualitative studies was used for reporting this research. Results: A central theme related to (a) "Intrinsic dignity of persons" was embedded in the essence of palliative care. Several corollary themes underscored this central theme: (b) Professional (intra‐ and inter) relationships and teamwork; (c) Nursing professionalism; (d) Ethical dilemmas; and (e) Relationships with patients and their significant persons. Conclusions: Nurses valued the essence of respect as persons and the essence of respect for their work as coherent with intrinsic dignity and work dignity in palliative care. Nurses perceived their psycho‐social relationships with patients and their families as rewarding incentives amidst disputatious interactions with peers and/or other healthcare professionals. They experienced ethical dilemmas, which they perceived as inherent in palliative care. Relevance to clinical practice: Study findings corroborate the literature regarding the concept of nursing's professional dignity which is intrinsic in respect of the human person. The intrinsic dignity in palliative care manifests as nurses are working in juxtaposition of a demanding yet rewarding care ambience. [ABSTRACT FROM AUTHOR]

Background: There is growing awareness that patient care suffers when nurses are not respected. Therefore, to improve outcomes for patients, it is crucial that nurses operate in a moral work environment that involves both recognition respect, a form of respect that ought to be accorded to every single person, and appraisal respect, a recognition of the relative and contingent value of respect modulated by the relationships of the healthcare professionals in a determined context. Research question/aim: The purpose of this study was to develop better understandings of perceptions of nursing's professional respect in community and hospital settings in England. Research design: The research design was qualitative. Focus groups were chosen as the most appropriate method for eliciting discussion about nursing's professional respect. Participants and research context: A total of 62 nurses who had been qualified for at least a year and were working in two localities in England participated in this study. Methods: Data were collected using 11 focus group sessions. The data were analysed by means of an inductive content analysis, extracting meaning units from the information retrieved and classifying the arising phenomena into conceptually meaningful categories and themes. Ethical considerations: To conduct the research, permission was obtained from the selected universities. Results: Recognition respect of human beings was perceived as ingrained in the innermost part of nurses. Regarding appraisal respect, a great importance was placed on: the interactions among healthcare professionals, the time to build trust in these relationships, the influences of the workplace characteristics and nurses' professional autonomy and decision-making. Conclusion: Recognition respect of persons was embedded in the inmost part of nurses as individuals. Concerning appraisal respect, it was thought to be deeply enshrined in the inter- and intra-healthcare professional interactions. The forging of trusting relationships over time was deemed to be strongly associated with good quality interactions with other healthcare professionals. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the experience of patients affected by chronic obstructive pulmonary disease following hospitalisation due to an acute exacerbation event. Background: Chronic obstructive pulmonary disease is a progressively debilitating disease, often with very burdensome symptoms such as acute and chronic breathlessness and fatigue. Acute exacerbation often creates a life‐threatening event. Exacerbation can also have substantial psychological effects including anxiety and depression although this aspect is less well researched—especially amongst people with chronic obstructive pulmonary disease recovering from an acute event and facing a return home. Design: A descriptive phenomenological study. Methods: In‐depth interviews were conducted with 12 chronic obstructive pulmonary disease patients recently recovering from an acute exacerbation of their chronic obstructive pulmonary disease. Data were analysed using Colaizzi's phenomenological framework. Results: Four themes were identified from the data: a sense of loss and frustration, hopelessness, uncertainty about the future and fear of becoming a burden. Participants expressed quite negative views including a loss of hope, uncertainty about their future care and the burden they may become on their families. They appeared stressed and anxious as a result of the acute event they had experienced. Conclusions: This study shows that an acute episode of illness can generate a sense of hopelessness and uncertainty about their future care in people with chronic obstructive pulmonary disease. This occurs as they recover physically and think about the future, often in quite negative terms. Relevance to clinical practice: For healthcare professionals, it is important to take into account the potential feelings of loss, hopelessness and uncertainty that people can experience following an acute exacerbation of their chronic obstructive pulmonary disease and ensure that psychological care is available as physical recovery takes place. Such care to include good discharge planning, giving patients time to express concerns and referral to counselling services if appropriate. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the lived subjective experiences of immigrant Indian nurses in Italy and specifically their professional and social integration. Background To study the worldwide, nursing flux is a health priority in the globalised world. The growth in migration trends among nurses, not only from Philippines or India, has proliferated in recent years. The research on nurses' mobility for Southern European countries is underexplored, and in Italy, the out-migration flows of Indian nurses were never analysed. Design Qualitative methodological approach. Methods Semi-structured interviews ( n = 20) were completed with Indian clinical nurses working in Italy for more than one year mainly in private organisations. A purposive sampling technique was used for recruitment. The data were then content-analysed using an inductive method. Results The findings were categorised into four themes: (1) aspects of professional integration and working experience, (2) intra- and interprofessional relationships and perceptions of the IPASVI Regulatory Nursing Board, (3) initial nursing education and continuous professional development and (4) perceptions of social integration. Conclusion The results show that for Indian nurses in Italy emigration is important to gain opportunities to expand economic and social privileges as well as escape from historical assumptions of stigma associated with nursing work, especially for women. However, these conclusions have to be seen in wider socio-cultural complexities that are at the basis of transnational fluxes (Prescott & Nichter ). Relevance to clinical practice The research offers an insight into the complicated reasons for Indian nurses out-migration to Italy. Without comprehending the interwoven textures of the political and social relations that are continually constructed and re-constructed among different nations, it is difficult to understand nurses out-migration and consequently have a better and safer collaborative teamwork in the host countries. [ABSTRACT FROM AUTHOR]

Background: The concept of dignity can be divided into two main attributes: absolute dignity that calls for recognition of an inner worth of persons and social dignity that can be changeable and can be lost as a result of different social factors and moral behaviours. In this light, the nursing profession has a professional dignity that is to be continually constructed and re-constructed and involves both main attributes of dignity. Objectives: The purpose of this study was to determine how nurses described nursing’s professional dignity in internal medicine and surgery departments in hospital settings. Research design: The research design was qualitative. Ethical considerations: This study was approved by the ethics committees of the healthcare organizations involved. All the participants were provided with information about the purpose and the nature of the study. Participants: A total of 124 nurses participated in this study. Method: The data were collected using 20 focus group sessions in different parts of Italy. The data were analysed by means of a conventional inductive content analysis starting from the information retrieved in order to extract meaning units and sorting the arising phenomena into conceptually meaningful categories and themes. Results: Nursing’s professional dignity was deeply embedded in the innermost part of individuals. Regarding the social part of dignity, a great importance was put on the values that compose nursing’s professional identity, the socio-historical background and the evolution of nursing in the area considered. The social part of dignity was also linked to collaboration with physicians and with healthcare assistants who were thought to have a central role in easing work strain. Equally important, though, was the relationship with peers and senior nurses. Conclusion: The organizational environments under scrutiny with their low staffing levels, overload of work and hierarchical interactions did not promote respect for the dignity of nurses. To understand these professional values, it is pivotal to comprehend the role of different health professions in their cultural milieu and the evolution of the nursing profession in diverse countries. [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]

The article presents information on a study conducted to describe self-care in Italian adults suffering from heart failure, and to identify determinants of self-care. In the study, self-care of heart failure patients was measured by using the Self-Care of Heart Failure Index, which measures self-care maintenance and confidence. The study concluded that self-care is poor in Italian heart failure patients, and male gender and poor cognition are associated with poor self-care.

Aim To establish the psychometric properties of instruments to measure learning outcomes in healthcare students. Background Meaningful learning is an active process that promotes a wider and deeper understanding of concepts. It is the result of an interaction between new and previous knowledge. Meaningful learning produces a long-term change in knowledge and skills, which is underpinned by willingness to learn and experience and it is exclusively built by the learner. Design Systematic psychometric review protocol developed from Cochrane Effective Practice and Organization of Care guidance. Method Searches of MEDLINE, CINAHL, SCOPUS, ERIC, Psyc INFO, Cochrane Library, Psychology & Behavioral Sciences Collection Database between 1990-2013. Selected studies will be evaluated with the Consensus-based Standards for the selection of health status Measurement INstruments ( COSMIN) checklist. Funding for the review was confirmed on January 2011 by the Centre of Excellence for Nursing Scholarship in Rome. Results The systematic review will produce a synthesis of the data related to the instruments that measure learning outcomes. These data will help us decide which tools to use and identify the state of knowledge in this field. Conclusions Measuring learning outcomes is very important for the large amount of human and financial resources employed in educating and training health professionals and this requires reliable and valid instruments. [ABSTRACT FROM AUTHOR]