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Objectives To measure the association between patient activation and hospitalization or emergency department (ED) visits among adults with chronic diseases. Study design Systematic review and meta-analysis. Methods A systematic review of English articles was performed using the following databases: PubMed, Cochrane Library, Web of Science, PsycINFO, and Embase. Articles were searched from 2005 until July 2021. Observational studies that measured the association between patient activation, measured by the Patient Activation Measure (PAM), and hospitalization or ED visits among adults with chronic or multichronic diseases were included. Pairs of reviewers independently screened the studies and extracted data for qualitative and quantitative synthesis. The methodological quality was assessed using the Quality in Prognostic Studies (QUIPS) tool. Results A total of nine observational studies (153,121 participants) were included in the qualitative synthesis, whereas six were pooled in the quantitative synthesis (151,359 participants). High levels of patient activation were significantly associated with a reduced risk for both hospitalizations (RR [95% CI] = 0.69 [0.61; 0.77], I2 = 78%) and ED visits (RR [95% CI] = 0.76 [0.70; 0.84], I2 = 72%). Conclusions Our findings suggest the existence of an inverse association between patient activation and healthcare resources utilization. Further observational studies are needed to fully comprehend the magnitude of this association.

Work-related stress is a significant risk for healthcare workers (HCWs). This study aims aevaluating the effectiveness of an individual psychological support programme for hospital workersIn all, 35 workers participated (n). A control group of 245 workers (7n) was set. Occupationadistress was measured by the General Health Questionnaire, (GHQ-12), the quality of life by the Short Form-36 health survey, (SF-36), and sickness absence was recorded. Costs and benefits of the service were evaluated and the return on investment (ROI) was calculated. The level of distress was significantly reduced in the treated group at the end of the follow-up (p < 0.001). Quality of life had significantly improved (p < 0.003). A 60% reduction of sickness absence days (SADs) following the intervention was recorded. After the treatment, absenteeism in cases was significantly lower than in controls (p < 0.02). The individual improvement of mental health and quality of life was significantly correlated with the number of meetings with the psychologist (p < 0.01 and p < 0.03, respectively)The recovery of direct costs due to reduced sick leave absence was significantly higher than the costs of the programme; ROI was 2.73. The results must be examined with caution, given the very limited number of workers treated; this first study, however, encouraged us to continue the experience.

Aim: This concept analysis aims to clarify the concept of diabetic education in nursing to provide guidance for the further conceptualization and clarification of diabetic education in nursing. Background: Patient education is a fundamental component of diabetes care. Nurses have taken up a major role in educating people with diabetes to manage their conditions. However, the exact meaning of diabetic education in nursing remains challenging. Design: Rodgers' evolutionary method of concept analysis was performed to explore the concept of diabetic education in nursing. Data Source: We conducted a literature search on Cumulative Index to Nursing and Allied Health Literature (CINAHL), MedLine, and PsycInfo for works published until October 2020 using “patient education,” “diabetes,” and “nursing” as key terms. Results: The concept analysis revealed that key attributes of diabetic education in nursing include patient-centered and interactive approaches, planning, and problem solving. Antecedents related to individuals with diabetes are their backgrounds, needs, and motivations, while the antecedents related to nurses are experience and attitude. Finally, three different consequences of the concept emerged: an increase in knowledge and skills, a behavioral change, and the improvement of clinical outcomes.

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

The introduction of robotic neurorehabilitation among the most recent technologies in pediatrics represents a new opportunity to treat pediatric patients. This study aims at evaluating the response of physiotherapists, patients and their parents to this new technology. The study considered the outcomes of technological innovation in physiotherapists (perception of the workload, satisfaction), as well as that in patients and their parents (quality of life, expectations, satisfaction) by comparing the answers to subjective questionnaires of those who made use of the new technology with those who used the traditional therapy. A total of 12 workers, 46 patients and 47 parents were enrolled in the study. Significant differences were recorded in the total workload score of physiotherapists who use the robotic technology compared with the traditional therapy (p < 0.001). Patients reported a higher quality of life and satisfaction after the use of the robotic neurorehabilitation therapy. The parents of patients undergoing the robotic therapy have moderately higher expectations and satisfaction than those undergoing the traditional therapy. In this pilot study, the robotic neurorehabilitation technique involved a significant increase in the patients' and parents' expectations. As it frequently happens in the introduction of new technologies, physiotherapists perceived a greater workload. Further studies are needed to verify the results achieved.

Introduzione I sintomi comportamentali e psicologici (SCP) rappresentano uno degli aspetti cruciali nella gestione delle persone con demenza e uno dei principali fattori di rischio per la loro istituzionalizzazione. Diverse tipologie di intervento, complesse ed eterogenee fra loro, rivolte ai caregiver delle persone con demenza, hanno dimostrato di ridurre la frequenza o la severità dei SCP. L’obiettivo della revisione sistematica consiste nel valutare l’efficacia di interventi educativi, nei quali sia prevista la presenza di un infermiere, nell’incrementare la competenza dei caregiver nella gestione dei SCP, nel miglioramento degli stessi o nel ridurre l’istituzionalizzazione della persona con demenza. Metodi Una revisione sistematica della letteratura è stata condotta utilizzando MEDLINE. Sono stati inclusi RCT che, attraverso l’uso di scale validate, misurano l’efficacia di interventi educativi, psicoeducativi o multicomponent, in cui la componente educativa sia preponderante, rivolti ai caregiver o alla diade caregiver-persona con demenza, rispetto a un gruppo controllo non sottoposto a nessun intervento educativo strutturato. La qualità metodologica degli studi è stata valutata utilizzando il Cochrane Risk of Bias Tool per gli RCT. Risultati Dei 4.652 articoli screenati, 13 hanno soddisfatto i criteri di inclusione e sono stati inseriti nella revisione sistematica. Due studi hanno un basso rischio di bias. 10 studi rivolgono l’intervento solo ai caregiver mentre tre alla diade caregiver-paziente. Gli interventi hanno una durata variabile da una settimana a un anno e includono pazienti con demenza in diverso stadio di avanzamento. Sebbene condividano alcuni punti in comune, come fornire informazioni sulla demenza e nuove strategie di coping, gli interventi sono eterogenei tra loro, includendo in alcuni casi componenti non educative e basandosi su framework teorici differenti. Sei studi misurano un cambiamento nelle competenze del caregiver, mostrando sempre

Materials and methods A systematic review of the literature was carried out in MEDLINE, Scopus, Web of Science and CINHAL including RCTs, before-after and quasi-experimental studies. We used PICO strategy and PRISMA statement. Methodological quality of the studies was assessed using Cochrane tools. Results Of the 7,730 papers initially retrieved, 14 met the inclusion criteria. Studies were mainly conducted in Australia (5), USA (4), Asia (3) and Europe (2). The chronic conditions studied were cardiovascular diseases (CVD) (6), COPD (3), diabetes (DM) (3) or unspecified chronic conditions (2). Studied separately in the disease groups, the studies were quite homogeneous in terms of type of intervention and follow-up duration, and only four studies carried out an evaluation post-intervention. Globally, 21 tools have been used to assess behavioral changes, the greatest part of which were disease-specific. The interventions were effective in the CVD group, partially effective in DM patients, and completely ineffective in COPD and multichronic patients. Almost all the studies showed a high risk of bias (only two RCTs were at low risk of bias). Conclusions There is a general agreement about the central role of the nurses in educational intervention of chronic patients at primary care level. The assessment of the behavioral changes with appropriate tools after educational interventions is strongly recommended. Patient education seems to work, as demonstrated among CV conditions and, in part, in patients with diabetes. However, more efforts are needed in designing studies with a good methodological quality and an appropriate follow-up.

INTRODUZIONE. La politica, ovvero la scienza e l’arte di amministrare la cosa pubblica, è un ambito di grande importanza e occuparsi di politica professionale significa dedicarsi al bene della professione. Le politiche professionali sono parte integrante del prendersi cura e la famiglia professionale ha bisogno di punti chiari di riferimento: formazione, tutela, promozione, rappresentanza istituzionale. OBIETTIVO. Esplorare percezioni, idealità, immaginario condiviso e desideri circa le politiche professionali di infermieri/ostetriche e studenti della laurea magistrale per riuscire ad avere una rappresentazione della realtà e avviare una riflessione critica sul tema. METODO. È stato effettuato uno studio qualitativo su un campione propositivo di 22 professionisti infermieri/ostetriche quali testimoni qualificati della situazione nazionale. I dati sono stati raccolti attraverso un questionario costruito ad hoc. RISULTATI. Dall’analisi delle risposte sono emersi 10 temi principali, tra i quali spiccano: per la formazione l’importanza delle nuove conoscenze ma anche la scarsa differenziazione dei ruoli; per l’ambito lavorativo l’assenza di meritocrazia e di nuove opportunità; per la ricerca il divario tra teoria e pratica. In sintesi, i risultati evidenziano come la partecipazione ai processi di formazione delle politiche sia saltuaria e di poca intensità e come pochi infermieri/ostetriche siano coinvolti attivamente per la promozione e sviluppo di progetti nel settore delle politiche per i sistemi sanitari e per la salute. CONCLUSIONI. L’indagine rileva che vi è una coscienza forte delle problematicità esistenti, ma questa coscienza non sembra relazionarsi adeguatamente ai contesti lavorativi, istituzionali e culturali. Di conseguenza non si verifica quella necessaria crescita delle politiche professionali, la sola capace di generare percorsi politici atti a risolvere le questioni di fondo., INTRODUCTION: Politics, the science and the art of administering public affairs, is a very important field. Dealing with professional policy means to dedicate ourselves to the good of the profession. Professional policies are an integral part of taking care; the professional family needs clear reference points: training, tutoring, promotion and institutional representation. AIM: Exploring perceptions, ideals, shared imagination and desires about the professional policies of nurses/midwives and of master's students in order to be able to have a representation of the reality and to start a critical reflection on the subject. METHOD: A qualitative study was conducted on a proactive sample of 22 nurses / midwives as qualified witnesses of the national situation. The data was collected through a questionnaire built ad hoc. RESULTS: From the analysis of the answers given to the questionnaire, we identified 10 main themes. In the training sector two of the themes that were selected are the importance of the new knowledges and inadequate differentiation of the positions; Regarding the working sector two of the themes that came out are the lack of meritocracy and of new opportunities; meanwhile, in the research field one of the main theme identified is the gap between the theory and the practice. CONCLUSION: The present study finds out that participation in policy-making processes is occasional and of little intensity: just few nurses/midwives are actively involved in the promotion and development of projects in the health sector and of healthcare policies.