Search

The first wave of the COVID-19 pandemic led to high patient loads in many hospitals. However, paediatric emergency departments (EDs) saw a dramatic decrease in admissions, mainly due to the fear of contracting COVID-19 in hospitals. Moreover, paediatric EDs were required to reorganise their services rapidly to deal with the pandemic. We aimed to describe the experiences of healthcare professionals (HPs) working in a paediatric ED in Italy during the first wave of the COVID-19 pandemic through reflective practice. Twenty-six HPs (16 attending paediatricians, 5 residents, 5 paediatric registered nurses) wrote a single, comprehensive text, in which they reflected on their experiences of care during the first wave of the pandemic. The study was framed within narrative medicine as a means for reflective practice. We identified six main themes: the enemy is about to burst in and to sweep us away, raised fences against the enemy, the meaning of time, getting caught in the storm, being and staying in spaces, and the work unrecognisably transformed. Our findings reflect how profoundly HPs' lives changed, inside and outside the hospital, during the first wave of the pandemic. Narration was useful in helping HPs deal with personal issues brought on by the pandemic. [ABSTRACT FROM AUTHOR]

Copyright of Napolisana Campania is the property of Ordine delle Professioni Infermieristiche di Napoli 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.)

ABSTRACT: Implantable cardioverter defibrillators (ICDs) can reduce unexpected cardiac mortality, but they also have a dramatic impact on a patient's quality of life. We aimed to explore ICD recipients’ experiences in order to foster improvements in the quality of care. Analyses were done using a descriptive phenomenological method, based on qualitative interview data from a purposive sample of 20 ICD recipients. Four main themes emerged: living with fear; relying on technology; knowing about the ICD and how to live with it; and coping with the effects of the ICD on daily life. ICD recipients lived in a constant state of fear due to the presence of the device and the uncertainty related to the potential electrical shocks it could deliver. This fear was compounded by changes that severely affected the quality of their daily life. ICD recipients felt they were always on the brink of death, and that although they received sufficient technical information they did not feel they received meaningful information to help them accept, live with, and cope with the device. Emotional information and support, rather than technical information, must be provided to ICD recipients to give them the ability to cope with the everyday threats they perceive because of the device. Qualitative evidence may help professionals tackle known threats to patients’ quality of life and increase the quality of care. [ABSTRACT FROM AUTHOR]

Background: Cancer-related pain continues to be a major healthcare issue worldwide. Despite the availability of effective analgesic drugs, published guidelines and educational programs for Health Care Professionals (HCPs) the symptom is still under-diagnosed and its treatment is not appropriate in many patients. The objective of the study is to evaluate the efficacy of the Pac-IFicO programme in improving the quality of pain management in hospitalised cancer patients. Methods/design: This is a before-after cluster phase II study. After the before assessment, the experimental Intervention--the Pac-IFicO programme--will be implemented in ten medicine, oncology and respiratory disease hospital wards. The same assessment will be repeated after the completion of the intervention. The Pac-IFicO programme is a complex intervention with multiple components. It includes focus group with ward professionals for identifying possible local obstacles to optimal pain control, informative material for the patients, an educational program performed through guides from the wards, and an organisational intervention to the ward. The primary end-point of the study is the proportion of cancer patients with severe pain. Secondary end-points include opioids administered in the wards, knowledge in pain management, and quality of pain management. We plan to recruit about 500 cancer patients. This sample size should be sufficient, after appropriate statistical adjustments for clustering, to detect an absolute decrease in the primary end-point from 20% to 9%. Discussion: This trial is aimed at exploring with an experimental approach the efficacy of a new quality improvement educational intervention. [ABSTRACT FROM AUTHOR]

The behavior of clinical instructors, as observed by students, deeply influences their professional development. When instructors behave unprofessionally, they risk undermining the professional growth students gain from their clinical placement experience. Clinical instructors need to be aware of how their behavior can affect the students' learning process and the contributions they make to clinical nursing education. A qualitative study was performed to describe the nursing profession as perceived by students who observed their clinical instructors' behaviors during the clinical experience. In-depth interviews of nursing students were conducted until data saturation was attained. Sixteen interviews were analyzed using an inductive content analysis methodology. The nursing profession was described by the participants through five themes as follows: the helping relationship, technical role, professional growth, working group, and contradictions and conflicts. Several examples of unprofessional behaviors on the part of the clinical instructors were reported by the respondents. The nursing profession, as perceived by nursing students, does not always reflect their expectations and their ideas related to professionalism. Universities and schools of nursing should ascertain that clinical instructors are prepared to educate students. Faculty should clearly state to students what they can expect from the clinical experience, namely, preparing students to face real working environments that do not always reflect educational philosophies., (© 2019 Wiley Periodicals, Inc.)

Purpose: Pain is a common symptom in cancer patients and often the most tangible sign of disease they and their families perceive. Despite currently available treatments, cancer pain frequently remains underrated and undertreated because of lack of adherence to the prescribed drug regimen. With this study we sought to identify elements that could facilitate pain management by exploring through narrative interviews the lived experiences of patients with severe chronic cancer pain in relation to their adherence to pain therapy., Method: A purposive sample of 18 cancer patients, treated at the Centre for Oncology and Haematology (COES), City Hospital for Health and Science, Turin, were interviewed. The interview contents were analysed using a qualitative phenomenological methodology as described by Giorgi., Results: Three themes emerged from analysis of the interview transcripts: the significance of pain in subjective experience; the experience of being a patient pursuing a care pathway and the importance attributed to pain therapy. Factors facilitating adherence included the perception of the physical and psychological benefits of having and following a pain medications plan, subjective self-efficacy in pain control, and trust in the healthcare team. Barriers to adherence were negative attitudes toward opioid analgesic therapy, debilitating drug side effects, and denial of pain as a tangible sign of disease., Conclusion: Probing into the significance of the pain experience and its treatment through these narrative interviews revealed several core constituents of adherence. Healthcare providers can use this better understanding to build a trusting relationship with patients and foster adherence to treatment throughout the care pathway., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Introduction: Therapeutic patient' education is a complex process requiring a proper level of communication between the patient and the healthcare professional. Nurses play a key role in providing the patients and their families with educational activities., Objective: This paper is the report of a study which investigates the experiences of some Italian nurses with regards to their role in therapeutic education to cancer patients., Methods: Qualitative research. Semi-structured interviews were carried out with 52 nurses working in different Local Health Service Units of two northern Italy regions: Piedmont and Valle d'Aosta. To identify categories and items arising from the data, the researchers used a qualitative content analysis., Results: The interview format was classified into six main categories: a) Patient education as daily care activity; b) Relevance of communication and dialogue for educational purposes; c) Relative usefulness of written information; d) Therapeutic education recording; e) Patients' feedbacks as a tool for assessing therapeutic education; and f) Difficult communication., Conclusions: The experience of nurses in terms of their professional role in therapeutic education for cancer patients shows the steady presence of educational activities carried out in a non-planned way. This research confirms the need to launch educational interventions for nurses., Implications for Practice: It is essential to implement an action plan to promote opportunities of professional training in the field since among the most frequent reasons for project failure in therapeutic education is the lack of expert human resources.

Introdution: Immigration is growing and immigrants' presence is important also in the health care system, thereby services reorientation and a multicultural approach are needed., Objective: To explore health care professionals' training needs of Turin Azienda Città della Salute e della Scienza in taking care of foreign users., Methods: An ad hoc 4-sections questionnaire was built: (1) Knowledge, attitudes and perceptions; (2) Lived and Training; (3) Improvement in cultural competence; (4) Socio-demographic data. Questions were dichotomous (yes/no), closed and short open. Doctors, nurses, speech therapists and support staff of the "Head and Neck" Department were involved., Results: One hundred seventy-six operators answered (75%). Less than 20% (n=34) knew the normative concerning immigrants' health services use; tubercolosis, venereal diseases and AIDS were believed to be the most frequent diseases in foreign users. Female sex (p=0.008) and allied health care profile (trend p=0051) were significantly associated to consider clients' values important, while a previous training was associated to the need of improving their knowledge (p=0.0002). The most important training needs were: meaning of illness and care, perception of prevention, hygiene and self-care practices and perception of care. Among the most effective strategies: lecture and discussion, group work and filmography., Conclusion: The analysis shows the main needing education areas and the training strategies which operators considered more effective.

Introduction: The Service of Health Professions of this facility (TO2 of Turin) aimed during the 2010 to devise/develop a new evaluation tool for the new employees , trying to fit them with the profiles set up the previous year., Methods: The conceptual model of reference for the construction of working drafts of the grids was inspired by the special insert edition of "L'infermiere" in 2007, a literature review was carried out and a number of internal meeting within 6 of the Service of health Professions were set up. A working group were set up - 93 people - as well as indicators were developed to monitor and implementation of the instruments. Once the drafts of the standard tools were made, working groups started to improve the tools provided under the supervision of a tutor. Finally half way through an evaluation was carried out using a questionnaire., Conclusion: The new template leads a number of problems which were later sorted out also with the support of tutors.

Purpose of the Research: Announcing the death of a patient to another in hospices and nursing homes (NH) requires special skills, especially when the recipient is another resident. The aim of this study is to describe how hospice and NH staff deal with the communication regarding a patient's death, if this communication is perceived as a problem, and strategies implemented., Methods and Sample: The 55 health care workers (HCWs, 26 nurses and 29 auxiliary nurses) of two NHs and two hospices in Turin (Italy) were interviewed with a semi-structured interview exploring the residents' perception of need to receiving information on another patient's death, the experiences of having given this information in the last 6 months, and the strategies implemented. The interviews were analyzed using Colaizzi's method and researchers looked for the main themes and related subthemes., Key Results: Six themes were identified and grouped into 2 main themes: a. the choice to tell the truth or not, which may be influenced by: the patients' request for confirmation of the fate of the other resident, by patients' fear of death ("I will be next"), the relationships among the guests, and personal and group experiences; b. the need to share own feelings and the burden of deciding whether or not to inform the other residents and how to go about this., Conclusions: If a structured discussion of experiences and reflection on cases is not implemented, HCWs may limit communication to bare information, lies, and adopt behaviors of avoidance and concealment., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

In modern health-care , nursing managers play a strategic role in improving the quality of care and the skills of carers, since management and leadership strategies are known to be decisive in the deployment of resources and professional development. The aim of this study is to present the opinions and expectations of nursing coordinators regarding their managerial role. During the creation of a nursing service unifying the management of 3 local health authorities in Northern Italy, with different organizational and professional features, nursing coordinators were asked to fill in a questionnaire. Results showed that a priority aspect of the managerial role is to assess the appropriateness of care and the use of resources Their answers showed that they hoped for a style of management founded on aspects related to clinical government. For the style of leadership, they emphasized dedication to work, participation of staff in decision-making, group information and providing support in areas needing improvement. Although the study was territorial , it confirmed international guide-lines regarding the policies which give value to investments in the quality of organization and can be considered a point of reference for planning and creating future nursing services.

The core of nursing in western countries is interaction with the patient and with his/her body in particular. As all nursing practices revolve around caring for the patient's body, nurses need to understand the frailty of the body, the intimacy surrounding it, the story it tells, as well as the discomfort and difficulties both illness and close contact can generate in the nurse-patient relationship. With this study, we wanted to explore the ward experiences of a small group of nurses in their day-to-day interaction with patients and their bodies, to highlight their perceptions and possible difficulties in providing care. We collected qualitative data from in-depth interviews with 14 nurses working in departments of general internal medicine, neurology, and geriatrics. The interviews were conducted between April and June 2006 and interpreted using an interpretive phenomenological approach. Analysis of the interview transcripts revealed that while the nurses recognize the centrality of the body in nursing, they also expressed a certain ambiguity toward it: being able to improve a patient's well-being through attentive care to the body is a major source of job satisfaction, but various coping and defense strategies are deployed to overcome care-giving situations that elicit avoidance or refusal reactions to the patient's body.