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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, I2 = 0%], and no effect of MI on glycosylated haemoglobin (mean difference = –0.02, 95% CI: –0.48, 0.45, P = 0.94, I2 = 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.

COVID-19 patient experiences in the intensive care unit (ICU) are marked by family separation. Families understand the importance of isolation and hospital visiting policies, but they consider it necessary to visit their loved ones and use personal protective equipment.To describe the lived experiences of family members in their first contact with a relative in a COVID-ICU.A phenomenological study was conducted using Cohen's method. The subjects were interviewed using an open-question format to allow them full freedom of expression. Twelve family members were recruited between February and March 2021.Analysis of the qualitative data resulted in five major themes: (1) fear of contagion related to donning/doffing procedures, (2) positive emotions related to first contact with the hospitalized relative, (3) concern for the emotional state of the hospitalized relative, (4) impact of the COVID-ICU and comparisons between imagination and reality regarding the severity of the disease, and (5) recognition of and gratitude toward healthcare professionals.It has been confirmed that visits to the ICU reduce anxiety among family members. Our findings constitute an internationally relevant contribution to understanding of the needs of relatives who meet loved ones for the first time while wearing personal protective equipment.

Continuous progress in cancer care has led to its increased use in oral anticancer agents that are easily managed by patients at home with fewer costs and hospitalizations. However, correct self-care behaviors are needed for the safe use of these medications. This review aimed to synthesize studies on self-care behaviors in patients treated with oral anticancer agents.This systematic review used a convergent qualitative synthesis design for mixed studies. Studies on adult patients with cancer using any kind of oral anticancer agent and describing self-care maintenance, self-care monitoring, and/or self-care management behaviors were searched on PubMed, EMBASE, and CINAHL. After data extraction, the findings were retained for qualitative synthesis.Of 3419 records, 19 studies were included in this review. From the qualitative synthesis, all the retrieved behaviors were synthesized in the three self-care dimensions. Five themes and 18 subthemes were identified. Self-care maintenance included "adherence to the medications" and "prevention." Self-care monitoring consisted of "health surveillance and recognition of illness changes." Self-care management included "seeking help" and "autonomous management of side effects." Overall, most of the behaviors described focused only on adherence.The findings of this systematic review could guide future studies on self-care and drive future interventions aimed at improving self-care in this vulnerable population. Nurses and other healthcare professionals should provide self-care support to patients taking oral anticancer agents. In particular, they should promote behaviors aimed at improving well-being, preserving health, or managing side effects.

Home care workers (HCWs) are a highly heterogeneous population in Italy in terms of their professional qualifications. HCWs play an important role in helping patients affected by chronic diseases and their families. Although many investigators have studied the lived experiences of family caregivers, few have been conducted "to give a voice" to HCWs and even fewer have examined the experiences of HCWs during the present COVID-19 pandemic. We investigated the lived experiences of HCWs during the first wave of the pandemic in Italy. Cohen's phenomenological research approach was used to conduct this study. In our study, we enrolled and interviewed 19 HCWs who were female, and most were married, with an average age of 52 years. The participants were enrolled from September 2020 to November 2020, after the first COVID-19 wave in Italy. Four main themes emerged from the analysis of the data: (1) "I found myself alone"; (2) from invisibility to visibility; (3) a fear of getting sick and infecting others; and (4) "Health or work? That is the question." Understanding HCWs' lived experiences, especially those related to the COVID-19 pandemic, is a first step in giving a voice to this important but vulnerable population in the healthcare workforce.

Introduction: A stroke survivor’s Quality of life (QOL) could be associated with the caregiver’s anxiety, depression and burden. The identification of specific trajectories in stroke survivors and their associations with caregivers’ outcomes, would be helpful for developing more tailored interventions for survivors and caregivers within the first year after the stroke onset. The aims of this study were to: identify the distinct trajectories of the stroke specific QOLs of stroke survivors discharged from rehabilitation hospitals; examine the associations between the stroke survivors’ QOL trajectories and the caregivers’ anxiety, depression and burden over time; and identify the predictors of the survivors’ QOL trajectories. Methods: This is a longitudinal, multicentre prospective study. Were recruited 415 stroke survivors and their caregivers, after the patients’ discharge from one of 20 rehabilitation hospitals located in central and southern Italy and were followed up every 3 months for 1 year. Results: Stroke survivors had similar trajectories in the physical dimensions of QOL, unlike psychological dimensions, where emerge two distinct trajectories of change in the QOL stroke survivor. The first trajectory (86%) included those who started with greater levels of QOL and improved slightly to markedly in all psychological domains, with this improvement decelerating over time. The second trajectory (14%) comprised those who started with lower overall levels of psychological QOL and experienced a linear worsening in Memory and Communication and no changes in Emotion and Participation. The impact of the distinct stroke survivors’ QOL trajectories on caregiver variables, such as burden, anxiety, and depression were examined. Caregivers experienced linear decreases in anxiety ( p < .001)during the first year post-stroke, while burden ( p = .086)and depression ( p = .057)did not significantly change over time. Conclusion: Preventing the risk factors of a stroke survivor from causing a deterioration in QOL is a fundamental role in public health. Adopting precautionary strategies, for those who present certain risk factors for survivors’ discharged from rehabilitation hospitals, could lead to an improvement in the burden and depression of the caregiver.

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.

Introduction: Given that emergency procedures must be performed immediately and without the possibility of sufficiently informing and preparing a patient, the lived experiences of patients who undergo emergency procedures and those who undergo elective procedures may well differ. Elucidating the lived experiences of patients who underwent percutaneous coronary intervention (PCI) with stent implantation in an emergency situation is crucial because such knowledge might prove helpful in tailoring post-procedure interventions intended to improve the lives of PCI patients. Aim: To describe the experiences of patients 1 month after they underwent emergency PCI with coronary stent implantation. Methods: Cohen's phenomenology was applied in this study. This method combines the characteristics of descriptive (Husserlian) phenomenology with those of interpretative (Gadmerian) phenomenology, and it is by nature an inductive approach. The participants were enrolled 1 month after undergoing PCI with coronary stent implantation. They were interviewed using open-ended questions to provide them full freedom of expression. They were asked to describe their experiences of the PCI and stent implementation they have gone through. This study followed the recommendations of the Standard for Reporting Qualitative Research. Results: Our sample consisted of 15 participants. Data analysis revealed three main themes: (1) catheter lab and pain, (2) anxiety and feeling uncertain about the future, and (3) lifestyle changes. The anxiety theme encompassed two subthemes: (a) anxiety related to the procedure and (b) anxiety related to the continuation of life. Conclusion: Our study is one of the first works to explicitly investigate the lived experiences of patients who underwent emergency PCI. Understanding the experiences of these patients is key in understanding their realistic needs and concerns. Relevance to clinical practice: Knowledge of the lived experiences of patients who underwent emergency PCI with coronary stent implantation is fundamental in identifying aspects that warrant tailored interventions.

Background and purpose Stakeholder engagement is the basis of an emerging and innovative educational model called competency-based education. However, although several studies have analysed the stakeholders' perspective in nursing, few studies have analysed the stakeholders' perspective in competence-based curriculum design. Thus, the aim of this study was to analyse the opinions and perspectives of stakeholders about the development of a competency-based baccalaureate nursing curriculum with stakeholder engagement. Methods A phenomenological study was conducted. This method combines descriptive features (Husserlian) and interpretive phenomenology (Gadamerian). The interviews were ended when data saturation was achieved, specifically the redundancy of themes. Results The content analysis identified three main categories: (1) a “bridge” that merges education and the work context, (2) stakeholder engagement – a contentious issue; and (3) stakeholder engagement – structuring a methodology. Conclusions Through the stakeholder engagement, university could have a constant interaction between the didactics and professional practice and could improve professional identity and job satisfaction among nurses.

The Cardiac Children's Hospital Early Warning Score (C-CHEWS) is an early warning scale used to identify paediatric patients experiencing clinical deterioration which may warrant a transfer to an ICU. However, no studies have tested the C-CHEWS in an Italian paediatric cardiac population. The aims of this study were to translate/back-translate and validate the Italian version of the C-CHEWS and its algorithm.Retrospective study. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value were used to evaluate the performance of C-CHEWS. In additions the Cohen's kappa statistic was calculated to evaluate the agreement between patient's status described by C-CHEWS score (≥5) and actual ICU transfer.High discrimination was observed for sensitivity (81.5%), specificity (99.6%), accuracy (99.7%), positive predictive value (86.7%), and negative predictive value (99.8%). The Cohen's kappa score was observed to be equal to 0.837 (p-value0.001) indicating there was excellent significant agreement between a C-CHEWS score ≥ 5 and effective evaluation for patients transfer to an ICU.The Italian version of the C-CHEWS proved to be a sensitive, specific and reliable tool in the early detection of a physical deterioration of hospitalized paediatric cardiac surgical patients.This tool may help doctors, nurses and all healthcare professionals to promptly recognize and treat clinical deterioration and facilitate urgent transfers to the PICU.

The progressive and constant aging of the global population together with the economy crises and the social variations within family contexts increasingly leads to the use of external resources (Home Care Workers, HCWs) for health care within one's own family of origin. Purpose of the study is to describe Italian Home Care Workers' (HCWs) living and working conditions and understand the interactions with outcomes of the patients and informal caregiver.Observational study with cross sectional design to evaluate the interaction of HCWs without specific training on patients and informal caregivers' outcomes.understand Italian HCWs' condition and interaction between these conditions and outcomes of patients and informal caregiver.understanding how HCWs' conditions can affect outcome about patient and informal caregivers, represents a fundamental step in order to increase QoL of these families.

The COVID-19 pandemic is putting strain on every country in the world and their health systems. Healthcare professionals struggle on the frontline and they can experience stigma, which can create difficulties in controlling epidemic diseases, influencing the mental health of healthcare professionals, caregivers, families, communities, and the provided quality of care. The aim of this study is to explore the lived experience of Italian nurses about perceived stigma during COVID-19 pandemic with the phenomenological Cohen method. The principal themes that emerged from data analysis were “stigma in the working environment” and “stigma in everyday life”. Each of these themes had subthemes: “looks like gun sights”, “avoiding closeness to others”, “nobody wants to touch you”, and “the fault of being your family members”. Public health emergencies, such as the COVID-19 pandemic, are stressful events for individuals and communities. Stigma can be more dangerous than the disease, and a major obstacle to appropriate medical and mental health interventions. Understanding how healthcare professionals experience stigma is essential to design and implement specific educational, psychological, and organisational programmes.

To describe and develop a conceptual framework for the process of mutuality between nurse and patient.This was a qualitative study with a grounded theory (GT) design following the constructivist approach of Charmaz (SAGE handbook of research, 2014).A sample of 33 patients with one or more chronic diseases and 35 nurses were interviewed between July and October 2020. Comparative and simultaneous data analyses were conducted. Theoretical sampling and saturation of categories were used to define the sample size.A conceptual framework for mutuality between nurse (mean age 42 SD ±7 years, 89% female) and patient (mean age 63 SD ±8 years, 42% female) was developed, including the mutuality process, potential influencing factors for both nurses and patients, and outcomes. The mutuality process was characterised by three dimensions: developing and going beyond, being a reference, and deciding and sharing care. Influencing factors for nurses were personal characteristics and professional organisation, while for patients these were age and past experiences. Nurse outcomes were satisfaction and quality of life; patient outcomes were improved self-care and reduction of hospitalisation and emergency admissions.This study described a new conceptual framework for mutuality between nurse and patient, which could improve our understanding of the relationship between nurses and patients, thus enhancing both nurse and patient outcomes.

In this study, we analysed the lived experiences of frontline nurses and physicians who were affected by COVID-19 through a phenomenological study, using a Cohen's phenomenological methodology. The participants were enrolled in the study in May 2020 during the COVID-19 pandemic in Italy. The inclusion criteria were as follows: (1) was a nurse or physician employed full time caring for COVID-19 patients before falling ill; (2) contracting SARS-CoV-2 during the period from February 2020 to May 2020; and (3) had recovered before enrolment in the study. Sixteen participants (60% nurses) with an average age of 45 years were included in this study. The following main themes were extrapolated from our data analysis: "fear of diagnosis", "loneliness (as isolation)", "touch of nurses" and "feeling guilty of abandonment". From our study several aspects emerge that highlight how strong the emotional impact of COVID was on nurses and physicians infected during their activities, such as, on the one hand, feelings of fear, loneliness, and, on the other hand, the impotence of not being able to help.

Aims To examine the moderating role of caregiver preparedness on the association between stroke survivors’ depression and stroke-specific quality of life dimensions. Methods and results We used a multilevel modelling approach to analyse trajectories of change in the eight Stroke Impact Scale 3.0 subscales [i.e. strength, communication, mobility, activities of daily living (ADL)/instrumental activities of daily living (IADL), memory, emotion, hand function, participation] using Hierarchical Linear Modeling. Caregiver preparedness significantly moderated the association between survivor depressive symptoms and survivor communication (B = −0.95, P < 0.01), mobility (B = −0.60, P < 0.05), and ADL/IADL (B = −0.73, P < 0.01) at baseline; linear change for strength (B = 0.83, P < 0.05) and communication (B = 0.66, P < 0.05); and quadratic change for strength (B = −0.19, P < 0.01). Although caregiver preparedness did not significantly moderate the association between survivor depressive symptoms and strength at baseline, there was a significant moderating effect for change over time. Higher levels of caregiver preparedness were significantly associated with higher survivor scores of emotion, hand function, and participation at baseline. Conclusions Including immediate caregivers in the care process, through a psycho-educational training, would mean having better-prepared caregivers and consequently more-healthy stroke survivors. Given that preparedness includes coping with stress, responding and managing emergencies, assessing help and information may require tailored interventions aimed at improving the caregivers’ skills and knowledge about stroke survivors’ management.

Purpose Studies have shown that spirituality plays an important role in enhancing the quality of life of stroke survivors and their caregivers. Spirituality has been associated with positive patient and caregiver outcomes, so a valid, reliable measure of spirituality is important. It has not been tested with stroke survivors and their caregivers, so the aim of this study was to evaluate the validity and reliability of the World Health Organization Quality of Life Spiritual Religious and Personal Belief (WHOQOL-SRPB) scale for stroke survivors and their caregivers. Methods In this cross-sectional study, 414 stroke survivors at 10 rehabilitation hospitals and 244 caregivers completed the WHOQOL-SRPB. The WHOQOL-SRPB’s factorial structure was assessed with confirmatory factor analysis (CFA), criterion-related validity was evaluated with the WHOQOL-BREF, and internal consistency reliability was assessed with Cronbach’s α and ordinal α. Results The CFA results supported the hypothesized eight-factor structure. The stroke survivor and the caregiver versions of the model both had excellent fit indices. The factor loadings for the final models were strong: 0.78–0.98 for stroke survivors and caregivers (p < 0.001). The criterion-related validity for the WHOQOL-SRPB showed weak to moderate correlations with all the WHOQOL-BREF dimensions. Both ordinal α and Cronbach’s α had values more than 0.70. Conclusions The WHOQOL-SRPB scale is a valid, reliable instrument for measuring spirituality in stroke survivors and caregivers. Given the importance of spirituality for stroke survivors and caregivers, the WHOQOL-SRPB scale is recommended as an important tool for clinical practice and research.

Introduction: Cardiovascular diseases (CVD) are a major source of burden worldwide. COVID-19 pandemic has renewed the importance of remote psychoeducational interventions to improve outcomes in these patients. Technology-delivered motivational interviewing (TD-MI) has proven to be effective in chronic disease populations, yet there has been no attempt to summarize TD-MI characteristics and effectiveness in CVD populations. Methods: We searched PubMed, CINHAL, PsychInfo and Web of Science (from inception to May 1, 2021) for randomized controlled trials that enrolled adults with CVD. Record screening, data extraction and risk of bias assessment were performed in duplicate. This review is registered in PROSPERO, CRD42021241516. Results: Of the 2,742 records identified, 7 studies were eligible for qualitative synthesis. Participants (n=12,053, mean age = 62.25, 37.5% females) enrolled from community settings and prevalently affected by coronary artery disease (n. studies=5), hypertension (n=3) and heart failure (n=3), received an average of 11 phone (n=6) or video calls (n=1) over an average of 7 months. Interventionists were mostly nurses (n=4), followed by psychologists (n=2) and a social worker (n=1). Treatment fidelity was assessed in 5 trials; 2 trials reported the intervention to be based on a theoretical framework, and 2 studies specified if the interventionist underwent some training before TD-MI administration. Caregivers were never involved. Most targeted outcomes were medication adherence (n=5), quality of life (n=4), disease-related parameters (n=4), and depression (n=3). Risk of bias varied markedly, with the largest source resulting from lack of blinding of participants and assessors (performance bias). The only feasible meta-analysis showed no significant effects of TD-MI on depression (n=3; Z=1.18, p=0.24; I 2 =42%). Conclusions: The number of trials involving TD-MI interventions across CVD populations is scarce and their effectiveness is inconclusive. There was lack of reporting of interventionists’ training, description of treatment fidelity, and blinding procedures. More trials with stronger designs and better reporting are needed in the CVD field to inform clinical decision making and research.

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.

To describe the type and the amount of formal and informal care received during the first year after home discharge and to identify the baseline predictors of the formal and informal care needs of stroke survivors.Longitudinal study. Data were collected between June 2013-May 2016.Survivors (N = 415) were enrolled during discharge from rehabilitation hospitals and interviewed at 3 (T1), 6 (T2), 9 (T3), and 12 (T4) months. The linear mixed effects model with random intercept and random slopes was used to trend for the amount of formal and informal care received by survivors during the four observation times.Regarding formal care, only physiotherapy and speech therapy decreased significantly over time. Stroke survivors received a mean of 17 hr of paid informal care per week at T1 and these hours did not significantly decrease after one year from discharge, while unpaid informal care decreased significantly over time. Higher numbers of paid informal caregiving were predicted by older age, higher education levels, lower physical functioning, and living without unpaid informal caregivers while higher numbers of unpaid informal care were predicted by lower physical functioning and living with unpaid informal caregivers.Stroke has a great effect on survivors' lives. During the first few months after rehabilitation hospital discharge, survivors need further care because they are often discharged before achieving independent functioning.The results of this study could be important to guide future interventions aimed at imporving stroke survivors' conditions after post rehabilitation hospital discharge.目的: 在于描述出院后第一年接受正式和非正式护理的类型和数量,并确定中风幸存者正式和非正式护理需求的基线预测指标。 设计: 纵向分析。2013年6月至2016年5月期间,收集了相关数据。 方法: 幸存者(415名)在康复医院出院时登记,并在3个月(T1)、6个月(T2)、9个月(T3)和12个月(T4)接受访谈。使用了具备随机截距和随机斜率的线性混合效应模型来预测幸存者在四次观察期间接受的正式和非正式护理数量。 结果: 关于正式护理,随着时间的推移,只有物理疗法和语言疗法在显著减少。中风幸存者在T1时每周平均接受17小时的有偿非正式护理,出院一年后这些时间没有显著减少,而无偿非正式护理却随着时间的推移显著减少。年龄越大、受教育水平越高、身体机能越差以及没有无酬非正式护理人员的生活预示着有酬非正式护理的人数会越来越多,而身体机能越差和与无酬非正式护理人员的生活预示着无酬非正式护理的人数会越来越多。 结论: 中风对幸存者的生活有很大影响。在康复医院出院后的头几个月里,幸存者需要进一步的护理,原因在于他们通常在能独立活动之前就出院了。 影响: 这项研究的结果对于指导旨在改善康复出院后中风幸存者状况的未来干预措施非常重要。.

Introduction The family members of a patient admitted to a COVID Intensive Care Unit (COVID-ICU) could not communicate with and stay close to their loved one, which resulted in them becoming dependent on hospital staff for remote updates. Objective To describe the lived experiences of families with a member admitted to a COVID-ICU. Methods A phenomenological study was conducted. The subjects were interviewed with open-ended questions to allow them full freedom of expression. The researchers involved in the analysis immersed themselves in the data, independently reading and rereading the transcripts to gain a sense of the entire dataset. Results Fourteen first-degree family members were recruited. Five main themes emerged: fear, detachment, life on standby, family-related loneliness in the COVID-ICU, and an unexpected event. Conclusions Knowing the experience of families who have a relative in the COVID-ICU is essential for recognizing and reducing the risk of developing symptoms of post-intensive care syndrome.

Nurses are at greater risk of violence during their working hours. About 31% of all aggressions towards nurses occur in hospital or in care settings. The problem of aggressions on healthcare workers is difficult to classify, as the number of aggressions is often underestimated. For this reason, the aim of this study is to analyze physical, verbal and sexual aggressions on nursing staff and identify their predictors.A cross sectional study was performed. A sample of convenience was recruited consisting of nurses practicing in the Italian territory. The research team recruited subjects from various hospital, outpatient or territorial settings. The criteria for participation in the study were: (1) being registered nurses; (2) not being in an idle state (e.g. retirement). Multiple linear regression was used to identify the predictive variables of physical, verbal and sexual aggression.The sample consisting of 518 nurses had an average age of 37.5 years.The sample consisted prevalently of female subjects, with medium-high educational attendance. About 90% of the sample claims to have suffered physical, verbal and / or sexual aggressions during their working hours. People with a lower educational level, belonging to the southern regions are more at risk of physical and verbal aggression, while the female gender is a predictor of sexual assaults.The results of this study highlight how physical, verbal and sexual violence in nursing staff are non-isolated but highly frequent issues, being part of the daily working life of many health professionals.Introduzione: il personale sanitario risulta essere maggiormente a rischio di violenza durante l’orario lavorativo. Tuttavia, il problema è difficilmente inquadrabile, in quanto il numero di aggressioni viene spesso sottostimato. Per tale motivo l’obiettivo di questo studio è stato quello di analizzare le aggressioni fisiche, verbali e sessuali nel personale infermieristico ed identificarne i predittori. Metodi: Il disegno dello studio è stato di tipo cross sectional, cui campione era costituito da infermieri che esercitano nel territorio nazionale. Il gruppo di ricerca ha reclutato soggetti provenienti da vari setting ospedalieri, ambulatoriali o territoriali. I criteri per la partecipazione allo studio erano: (1) essere infermieri abilitati; (2) non essere in uno stato di inattività (es. pensionamento). La regressione lineare multipla è stata utilizzata per identificare le variabili predittive dell’aggressione fisica, verbale e sessuale. Risultati: Il campione composto da 518 infermieri aveva un’età media di 37.5 anni. Prevalentemente il campione era costituito da soggetti di sesso femminile, con una scolarità media-alta. Circa il 90% del campione afferma di aver subito durante il proprio orario di servizio un’aggressione fisica, verbale e/o sessuale. Le persone con un livello di istruzione più basso, appartenenti alle regioni del sud sono soggetti più a rischio di un’aggressione fisica e verbale, mentre il sesso femminile è un predittore delle aggressioni a carattere sessuale. Conclusioni: I risultati di questo studio evidenziano come la violenza fisica, verbale e sessuale nel personale infermieristico sia una problematica non isolata ma altamente frequente, facendo parte della vita lavorativa quotidiana di molti operatori sanitari.

Introduction: Research on the trajectory of survivors’ quality of life over time has generally focused on the first six months post-stroke, and results are inconsistent. Indeed, while some studies found an improvement of the stroke survivors’ quality of life from one to six months post-stroke, other studies showed an improvement during inpatient rehabilitation but a worsening at six months after discharge. Aim: To investigate the longitudinal growth trajectories of disease-specific quality of life dimensions and their predictors over one year. Methods: A multicentric longitudinal design were used for this study. Four hundred and fifteen stroke survivors (mean age 70.6 + 12.2 years; 81% ischemic stroke) were recruited after discharge from rehabilitation hospitals and were followed up every three months for one year. Changes in stroke impact scale dimension scores were evaluated using hierarchical linear models and linear, logarithmic, quadratic, and cubic time slope. Results: We observed a significant linear and quadratic increase in most stroke impact scale dimensions from the baseline to 12-month follow-up. The communication dimension was stable over time, while the memory dimension increased only linearly. Higher physical dimensions scores were predicted by lower age, hypercholesterolemia, and better physical functioning at baseline, while higher communication was predicted by lower age, better physical functioning, and a diagnosis of peripheral vascular disease. Better memory was predicted by lower age, married status, better physical functioning, and left-hemisphere stroke. Better participation was predicted by lower age and better physical functioning. No predictors were observed for emotion. Conclusions: Disease-specific quality of life significant increase from the baseline to 12-month follow-up, especially in physical dimensions. Lower age, hypercholesterolemia, better physical functioning and diagnosis of peripheral vascular disease seem to be predictors or better quality of life. Through the analyses of predictors, we identified stroke survivors who are more at risk and who need more tailored interventions to improve quality of life.

BACKGROUND: Advances in medicine have caused a notable increase in the survival rates of children born with congenital heart disease, even in the most complicated cases, almost mitigating the disease’s pathology from lethal to chronic. The quality of life perceived by such children is influenced by the perceptions of their parents. However, the international literature has rarely considered the entire family nucleus. AIMS: This study aims to study the temporal trend of quality of life of families with children with congenital heart disease, particularly with respect to parents following a child’s hospitalization for an invasive procedure. DESIGN: A longitudinal study. METHOD: A sample of families (that is, those including a child with congenital heart disease and their parents) will be enrolled following the patient’s discharge from the hospital and examined every 3 months for 1 year. The study’s adopted hypothesis is that there is an interdependence between the subjects of the study that is capable of influencing individual perceptions of quality of life. RESULTS: This study will attempt to identify variables (and their temporal trend) that can be attributed to the family unit and—together with physical and clinical variables—that may influence the quality of life of children with congenital heart disease. CONCLUSION: Examining family quality of life with the longitudinal method will allow us to identify the predictors and interdependence of this factor with respect to children and their parents. This will help to correct and elaborate upon care guidelines, providing better assistance to patients and their caregivers.

Objectives: To explore and understand the lived experiences of women with endometriosis. Design: Qualitative study using Cohen phenomenology. Setting:The study was conducted in the general setting of a university hospital in southern Italy. Participants:A total of twenty five adult women with endometriosis. Results:The data analysis identified four main themes and two sub-themes.The main themes are: delay in diagnosis, which includes the sub-theme of the misunderstanding of one's state; worsening of one's life, which includes the sub-theme of a painful life; disastrous intimate life with one's partner; and uncertainty about being able to have one’s own children. Conclusions: The themes that emerged represent the starting point for further research and for the implementation of specific educational and support strategies that improve self-care, commitment and quality of life for women with endometriosis.

Purpose: Redo operations and preoperative antiplatelet/anticoagulant therapy can significantly increase surgical risk in congenital heart surgery. This is a retrospective study on the impact of preoperative aspirin therapy on the outcome of Tetralogy of Redo Fallot patients undergoing right ventricle outflow tract (RVOT) conduit implantation. Methods: Ten-years retrospective analysis of medical records was carried out. A total of 72 patients were divided into two groups: &ldquo, Daily-on-ASA&rdquo, group on daily therapy with aspirin (ASA) until 5 days from surgery and &ldquo, No-Home-ASA&rdquo, without it. Propensity match analysis was done in order to standardize the populations. Intraoperative and postoperative lengths were compared as well as the need for inotropic support. In addition, differences in blood transfusions and need for Fresh frozen plasma (FFP)/platelets (PLT) were analysed. Findings: Intraoperative lengths were similar between the groups. Not statistically significative differences about postoperative time to extubation (p = 0.34), ICU Stay (p = 0.31) or in-hospital stay (p = 0.36) were found. Drain loss was higher in the &ldquo, group (407.9 &plusmn, 96.7 mL vs. 349.5 &plusmn, 84.3 mL, p = 0.03) as well as blood transfusions (372.7 &plusmn, 255.1 mL vs. 220.1 &plusmn, 130.3 mL, p = 0.02) and PLT/FFP need (217.7 &plusmn, 132.1 mL vs. 118.7 &plusmn, 147.1 mL, p = 0.01). No differences were found in postoperative complications or re-explorations for bleeding. Implications: We found no advantages in surgical times and hospital stay comparing redo patients who stopped aspirin versus those that didn&rsquo, t take it in the last 6 months. However, our results suggest that redo patients undergoing RVOT conduit implantation who take daily aspirin are at higher risk of bleeding even if it is stopped 5 days before surgery.

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.

To investigate the longitudinal growth trajectories of disease-specific quality of life (QoL) dimensions and their associations over 1 year.A longitudinal design. Data were collected between February 2015-May 2017.Four hundred and fifteen stroke survivors (mean age 70.6 years; 81% ischaemic stroke) were recruited after discharge from rehabilitation hospitals and were followed up every 3 months for 1 year. Changes in Stroke Impact Scale (SIS) dimension scores were evaluated using hierarchical linear models (HLMs) and linear, logarithmic, quadratic, and cubic time slope.We observed a significant linear and quadratic increase in most SIS dimensions from the baseline to 12-month follow-up, especially in physical dimensions. The communication dimension was stable over time, while the memory dimension increased only linearly. Higher physical dimension scores were significantly associated with lower age, hypercholesterolaemia, and better physical functioning at baseline, while higher communication was associated with lower age, better physical functioning, and a diagnosis of peripheral vascular disease. Better memory was associated with lower age, married status, better physical functioning, and left-hemisphere stroke. Better participation was associated with lower age and better physical functioning. No significant associations were observed for emotion.This study provides important information about the trajectories of stroke survivors' specific QoL and their associated variables.Stroke has a great impact on stroke survivors' QoL. Disease-specific QoL significantly increases from the baseline to 12-month follow-up, especially in physical dimensions. Lower age, hypercholesterolaemia, better physical functioning, and diagnosis of peripheral vascular disease seem to be associated with better QoL. Through the analyses of associated variables, we identified stroke survivors who are more at risk and who need more tailored interventions to improve their physical, psychological, emotional, and social dimensions.目的: 研究疾病特异性生活质量 (QoL) 各维度在1年内的纵向增长轨迹及其关联性。 设计: 一项纵向设计。在2015年2月至2017年5月之间收集数据。 方法: 招募了415名从康复医院出院的脑卒中幸存者 (平均年龄70.6岁; 81%为缺血性脑卒中) , 在1年内每隔3个月进行一次随访。使用多层线性模型 (HLMs) 和线性、对数、二次方和三次方时间斜率评估脑卒中影响量表 (SIS) 维度评分的变化。 结果: 据观察, 从基线检查到12个月的随访, 大多数脑卒中影响量表维度都呈显著的线性二次方增加趋势, 尤其是身体维度。沟通维度随着时间的推移保持稳定, 而记忆维度仅呈线性增加趋势。较高的身体维度评分与基线时较低的年龄、高胆固醇血症和较好的身体机能显著相关, 而较高的沟通维度评分与较低的年龄、较好的身体机能和周围血管疾病的诊断相关。较高的记忆维度评分与较低的年龄、已婚状态、较好的身体机能和左侧半脑中风相关。较高的参与维度评分与较低的年龄和较好的身体机能有关。情绪方面没有观察到显著的关联。 结论: 本研究提供了有关脑卒中幸存者的特定生活质量及其相关变量的重要轨迹信息。 影响: 脑卒中对脑卒中幸存者的生活质量影响很大。从基线检查到12个月的随访, 疾病特异性生活质量显著提高, 尤其是身体方面。较低的年龄、高胆固醇血症、较好的身体机能和周围血管疾病的诊断似乎与较高的生活质量相关。通过对相关变量的分析, 我们发现脑卒中幸存者的风险更高, 需要对脑卒中幸存者采取更具针对性的干预措施, 以改善脑卒中幸存者的生理、心理、情感和社会维度。.

Background Authors of previous research have not yet analyzed the role of potential moderators in the relationship between depressive symptoms and quality of life (QOL). Aims The aim of this study was to examine the moderating effect of mutuality between depressive symptoms and QOL in stroke survivor and caregiver dyads. Methods This study used a longitudinal design with 222 stroke survivor–caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed for 12 months. We examined survivor and caregiver QOL dimensions (physical, psychological, social, and environmental), depression, and mutuality at baseline and every 3 months. Hierarchical linear modeling was used to test 4 longitudinal dyadic moderation models (1 for each QOL domain). Results Survivors (50% male) and caregivers (65% female) were 70.8 (SD, 11.9) and 52.5 (SD, 13.1) years old, respectively. We observed no significant moderating effects of mutuality for survivors across the 4 dimensions of QOL over time. However, higher survivor mutuality was significantly associated with higher survivor psychological and social QOL at baseline. Regarding caregivers, caregiver mutuality significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.63, P < .05), psychological (B = 0.63, P < .01), and social (B = 0.95, P < .001) QOL at baseline, but not in environmental QOL. Higher caregiver mutuality was significantly associated with less improvement in caregiver physical QOL over time. Conclusions Mutuality is a positive variable on the association between depression and QOL for both members of the dyad at discharge but may lead to declines in physical health for caregivers over time. Further work is needed to understand the role of mutuality on long-term outcomes and associations with increased care strain.

Introduction: The quality of life of subjects who survived to acute myocardial infarction (AMI) is evaluated through the perception of their sexual life too. Contrary to recommendation write in international guidelines, this aspect is often overlooked, in fact patients who had suffered a AMI and their healthcare professionals do not appear to give proper attention to this aspect. After a heart attack resume to a normal sexual activity reduces anxiety, stress, depression and can improve quality of life. The doubts and fears that arise in patients after a myocardial infarction prevent proper recovery of sexual activity; often, these fears are unfounded and quickly disappear, but their presence puts the patient and partner’s relationship and also their quality of life at risk. Aim: The aim of the study was to understand the experience of the sexual health of Italian women one year after acute myocardial infarction. Methods: Phenomenology by Cohen. Results: ‘‘Fear of recurrence of infarction’’, ‘‘stress’’ and ‘‘the need to receive spontaneous information’’ are the main themes emerged from our analysis of interviews. Conclusions: Sexuality for myocardial infarction’s survivors is an important aspect of one’s health and quality of life. Understanding the lived experience about it in the health of women must stimulate careful consideration in all health workers and encourage rehabilitation programs that do not neglect this aspect.

Introduction: Although several studies have been conducted on stroke survivors during the post-rehabilitation discharge period, very few studies have focused on the formal and informal care received by stroke survivors during the first year after home discharge.Aims: To describe the type and the amount of formal and informal care received by stroke survivors during the first year after home discharge and to identify the baseline predictors. Methods: A 12-months longitudinal study was adopted. The linear mixed effects model was also used to identify the baseline predictors of formal and informal caregiving needs. Results: A sample of 415 stroke survivors was enrolled. Survivors were 70.6 years old and predominantly male at 52.7%. Regarding formal care, physiotherapy and speech therapy decreased significantly over time, but nursing care and occupational therapy remained stable. Regards paid informal care, stroke survivors received a mean of 17 h of paid informal care per week and these hours did not significantly decrease after one year from discharge. Higher numbers of paid informal caregiving hours per week were predicted by older age, higher education levels, lower BI scores and living without unpaid informal caregivers. Indeed, higher numbers of unpaid informal care hours per week were predicted by lower BI scores and living with unpaid informal caregivers. Conclusions: Especially during the first few months after rehabilitation hospital discharge, survivors need further care, both nursing and physiotherapy, because they are often discharged before achieving independent functioning

Aims and objectives To observe the extent to which a nursing discharge plan is effective in promoting therapeutic adherence and improving patient satisfaction with their treatment based on information interventions provided by nursing staff, direct hospital medication distribution and follow-up telephone calls. Background Patient adherence is a fundamental requirement for the treatment of chronic diseases. Among psychiatric patients, adherence to the prescribed course of treatment allows patients to keep the symptoms of their disease under control, allowing for improvements in the management of their condition, minimising the risks of relapse and reducing the number of hospitalisations. Design This study uses a prospective correlational design. Methods The Morisky Medication Adherence Scale, the Satisfaction with Information about Medicine Scale and the General Satisfaction Questionnaire were used. Results Of the 135 patients enrolled in the study, 57% of the sample was female, and, on average, patients were aged 33 years. About 72.9% were unmarried, and 88.1% were educated at less than high school level. This study showed that patients who received more information on their health status and on what would be done for them after their hospitalisation had a higher adherence to treatment. In addition, patients who were more satisfied with the nursing care provided had a higher rate of adherence to their treatment plan. Conclusions The interpersonal and educational nursing intervention improves adherence to a treatment plan by allowing patients to express themselves not only as individuals who rely on health care but also as protagonists able to effectively manage their disease and to empower themselves by acquiring disease management skills. Relevance to clinical practice A patient–nurse communication programme could help to analyse the individual patient circumstances that might become barriers to adherence and to apply nursing interventions that promote better patient adherence.

Introduction: In-service continuing education offers a unique opportunity to improve knowledge, skills, attitudes, and practices regarding breastfeeding. It has been shown that an online approach t...

Background: Although several studies have clearly shown that depressive symptoms in stroke survivors and caregivers decreases their quality of life (QOL), previous research has not yet analyzed the role of potential moderators in the relationship between the above two variables. Aims: To examine the moderating effect of caregiver preparedness between depressive symptoms and QOL in stroke survivor and caregiver dyads. Methods: Longitudinal design with 222 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivor and caregiver QOL dimensions (physical, psychological, social and environmental), depression and preparedness. Hierarchical Linear Modeling was used to test four longitudinal dyadic moderation models (one for each QOL domain). Results: Survivors (50% males) and caregivers (65% females) were 70.8 (SD=11.9) and 52.5 (SD=13.1) years old, respectively. Controlling for baseline covariates, caregiver preparedness significantly moderated the association between survivor depressive symptoms and survivor psychological (B = 0.56, p < .01) and environmental (B = 0.58, p < .01) QOL at baseline and social QOL over time (B = 0.24, p < .05). In each case, higher levels of caregiver preparedness were protective and buffered the influence of survivor depressive symptoms on survivor QOL. Similarly, caregiver preparedness significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.25, p < .01) and environmental (B = 0.18, p < .05) QOL over time. Conclusions: Caregiver preparedness is a positive variable for both members of the dyad and the paper highlights the importance of implementing tailored intervention which could improve caregivers’ preparedness already during the rehabilitation period.

Background: Little is known about the protective effect of spirituality on the association between known risk factors such as depression and quality of life (QOL) in stroke survivor-care partner dyads. Therefore, the aim of this study was to evaluate the moderating role of spirituality on the association between depressive symptomatology and QOL in stroke survivor–care partner dyads. Methods and Results: Longitudinal design with 223 stroke survivor–care partner dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivors’ and care partners’ depression, quality of life, and spirituality. Examining the moderating role of spirituality on the association between depressive symptoms and QOL within survivor-care partner dyads, we used a traditional Actor-Partner-Interdependence Model and a basic Actor-Partner-Interdependence Model moderation model for a mixed variable. Survivors (51% male) and care partners (66% female) were 70.7 and 52.3 years old, respectively. The survivor’s spirituality significantly moderated the association between care partner depressive symptomatology and survivor psychological QOL (B=0.03, P P P P Conclusions: The findings from this study have broad implications for the role of spirituality in relation to QOL in medical-health contexts and the importance of examining such concepts within a dyadic framework. Greater awareness of the importance of spirituality among clinicians and nurses may improve cultural competence in healthcare services.

BACKGROUND: After discharge from a rehabilitation hospital, stroke survivors and their families may face considerable stroke-related direct costs. The total amount could be ascribed to the costs of formal and informal care and to the equipment or materials needed for care. OBJECTIVES: This study aims to describe the direct costs incurred after a stroke by survivors during their first poststroke year and to analyze the basic predictors of these costs. METHODS: Stroke survivors (N = 415) were enrolled for this study during discharge from rehabilitation hospitals (baseline) and interviewed at 3, 6, 9, and 12 months after discharge for a longitudinal study. The trend of the direct costs incurred during the follow-up (from T1 to T4; n = 239) was evaluated using a linear mixed-effects model. The mixed-effects model was used to identify the baseline predictors of the incurred direct costs from the stroke survivors. RESULTS: During the first year after discharge, stroke survivors spent approximately $3700 on stroke-related direct (ie, medical and nonmedical) costs. The highest direct costs occurred during the first 6 months, although there was not a significant change over time. The higher direct costs incurred were predicted by the linear effect of time, by the educational level (higher vs low), and by the lower Barthel Index score, whereas a higher perceived cost was predicted only by the linear effect of time and by the lower Barthel Index score. CONCLUSION: In the first poststroke year, direct costs have remained stable over time and can be predicted by the level of education and physical functioning. The identification of specific direct cost predictors would be helpful for developing more socially and economically tailored interventions for stroke survivors in their first year after their stroke

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.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-care management.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.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.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.

Paediatric delirium is associated with a longer duration of hospitalization in paediatric intensive care units, the emergence of post-traumatic symptoms and possible neurocognitive dysfunction after discharge. In preschool children, the diagnosis of delirium appears rather challenging: their pre-verbal status and the presence of cognitive skills still in development make accurate diagnosis difficult. Recently, a pediatric delirium screening tool suitable for critical preschool children has also been developed and identified in international literature, with excellent results also in critical infants under 2 years of age: the Cornell Assessment of Pediatric Delirium (CAPD). The CAPD, using a Likert scale, bases the assessment of paediatric delirium within the context of child development. This scale follows the development of the infant by comparing the detection of specific items on the scale as the anchor points that characterize the development of infants by age groups.Culturally and linguistically validation in Italian language and prior testing of the Cornell Assessment of Pediatric Delirium.Translation and Cultural Validation of the Cornell Assessment of Pediatric Delirium (CAPD) for the Evaluation/Diagnosis of Pediatric Delirium within Pediatric Intensive Care. The translation and adaptation of this instrument followed the phases of the model proposed by the World Health Organization. Prior testings, such as item descriptive analysis, item-total correlation and Cronbach's alpha, were conducted.All phases of the cultural-linguistic validation process were carried out in a satisfactory manner. For the prior testing, the scale was administered to a sample of 42 children, with age ranged 0-5 years old (66.6%), with a higher prevalence of the male gender. All items were normally distributed and there was no excessive Skeweness and Kurtosis. Each item contributed to the scale fairly well and all coefficients of item total correlation (rjx) were higher than the recommended level of 0.30. The composite reliability index was 0.94 and Cronbach's alpha was 0.96.The process has meticulously followed the recommendations in international literature. The final version was approved by the authors of the original instrument.Il delirium pediatrico è associato ad una maggior durata di degenza all’interno delle terapie intensive pediatriche ed alla comparsa di sintomi post-traumatici. Nei bambini molto piccoli, in età prescolare, la diagnosi del delirium appare piuttosto impegnativa. Recentemente è stato sviluppato ed individuato anche dalla letteratura internazionale uno strumento di screening del delirium pediatrico adatto ai bambini critici ricoverati in età prescolare, con ottimi risultati anche nei neonati critici al di sotto dei 2 anni di età: la Cornell Assessment of Pediatric Delirium (CAPD). La CAPD fonda la valutazione del delirium pediatrico nel contesto dello sviluppo del bambino. Tale scala segue lo sviluppo del neonato rapportando la rilevazione degli item specifici della scala a punti di ancoraggio che caratterizzano lo sviluppo dei piccoli pazienti suddivisi per fasce di età. OBIETTIVO: eseguire una validazione linguistico culturale in lingua Italiana e test preliminari della Cornell Assessment of Pediatric Delirium per la valutazione/diagnosi del delirium pediatrico all’interno delle terapie intensive pediatriche.Studio di traduzione e validazione culturale. La traduzione e l’adattamento culturale di tale strumento ha seguito le fasi del modello proposto dalla World Health Organization. Test preliminari, come item descriptive analysis, item-total correlation e alfa di Cronbach, sono stati effettuati.Tutte le fasi del processo di validazione linguistico culturale sono state realizzate in modo soddisfacente. Per le analisi preliminari, la scala è stata somministrata ad un campione di 42 bambini, con età compresa da 0-5 anni (66.6%), con una maggiore prevalenza del sesso maschile. I test preliminari hanno mostrato una buona distribuzione di tutti gli item. Tutti i coefficienti dell’Item-total correlation avevano valori superiori rispetto il valore raccomandato di 0.30. Inoltre l’alfa di Cronbach ha mostrato valori superiori allo 0.90.Il processo ha minuziosamente seguito le raccomandazioni presenti nella letteratura internazionale. La versione finale è stata approvata dagli autori dello strumento originale.