Federica Dellafiore

Physical activity, dietary habits and cognitive decline in over 65 years Italian outpatients with type 2 diabetes: a cross-sectional pilot study

Abstract This pilot study aims to assess the relations between lifestyle and cognitive decline (CD) and to describe the prevalence of CD in outpatients over 65 years with type 2 diabetes mellitus (T2DM), examining the feasibility of a future research endeavor. This was a single-center pilot study, using a cross-sectional data collection. Lifestyles, including dietary habits and physical activities, were examined. To measure lifestyles, we used a self-report questionnaire aimed to explore seven domains: weekly consumption of bread, pasta, red meat, fish, alcohol, daily consumption of coffee, and weekly physical activities. To measure CD, the mini mental state examination was used. For the role of lifestyles in explaining cognitive functions, a multivariate regression model was used, where the physical activities and the diet treatment were the only significant predictors of cognitive efficiency. The model explained the 24% of the cognitive functions variance, showing a residuals normal distribution and no collinearity. This pilot study has some important limitations related to the study design. Nevertheless, it provides preliminary information to assess the feasibility of a future research endeavor, confirming the importance of lifestyles to prevent the CD in subjects with T2DM and giving cues for future investigation.

Anticoagulation Knowledge Tool (AKT): Further evidence of validity in the Italian population

Introduction Oral Anticoagulation therapy (OAC) is highly effective in the management of thromboembolic disorders. An adequate level of knowledge is important for self-management and optimizing clinical outcomes. The Anticoagulation Knowledge Tool (AKT) was developed to assess OAC knowledge and caters for both patients prescribed direct oral anticoagulants or vitamin K antagonist (VKA). However, evidence regarding its psychometric proprieties, validity and reliability are unavailable in non-English speaking settings. For this reason, the aim of this study is to provide further evidence of validity for AKT and also developing an Italian AKT version (I-AKT) supported by evidence of validity and reliability. Methods A multiphase study was conducted which included the following: cultural and linguistic validity; i.e. content validity; construct validity; reliability assessment. The Construct validity was performed using the contrasted group approach using three groups comprised of health care providers, patients and the general public. Furthermore, Exploratory Structural Equation Modelling (ESEM) was performed to confirm the mono-dimensional structure of the items in the AKT. Results In construct validity phase 334 participants were enrolled. One-way ANOVA and post hoc analysis test demonstrated significant differences between the means knowledge scores of the three groups: 30.42±3.04 vs 23.45± 4.57 vs14.32±6.07 (Statistic F = 266.83; p < .001). ESEM analysis demonstrates the I-AKT mono-dimensionally structure with an explained variance of 56.42%. The scale also showed both good internal consistency reliability (Cronbach’s α = 0.896) and test-retest reliability (r = 0.855). Conclusion This study developed and validated I-AKT with supporting evidence for validity and reliability. The study also confirms the mono-dimensional of the items in the AKT. This suggest that the instrument can be useful in non-English setting for knowledge assessment and in potentially developing patient education materials.

Italian version of the Assessment of Interprofessional Team Collaboration Scale II (I-AITCS II): a multiphase study of validity and reliability amongst healthcare providers

OBJECTIVE To develop and validate an Italian version of the Assessment of Interprofessional Team Collaboration Scale II (I-AITCS II). METHODS A multiphase validation study was conducted. The first phase was the AITCS-II translation from English into Italian to develop the first version of I-AITCS II for practitioners. The second phase was the study of I-AITCS II face and content validity, and the third phase was a cross-sectional data collection to provide evidence of construct validity using the psychometrics testing and the reliability assessment through the internal consistency study. RESULTS The agreement for the forward-translation among researchers was high. The face and content validity were satisfactory. The underlying constructs of I-AITCS II were partnership, cooperation and coordination. Internal consistency was good for both scale and domains level. There were significant differences related to partnership in the comparison between settings. CONCLUSIONS I-AITCS II showed evidence of validity and reliability. It will be useful to gather data to address programs aimed to enhance interprofessional team collaboration within the Italian healthcare contexts, and it could be used for cross-national researches.

Paradox of self-care gender differences among Italian patients with chronic heart failure: findings from a real-world cross-sectional study

Aim The aim of this study was to critically analyse and describe gender differences related to self-care among patients with chronic heart failure (HF). Methods and results A monocentric real-world cohort of 346 patients with chronic HF in follow-up was used for this cross-sectional study. We report data related to the cohort’s demographic and clinical characteristics. Self-care was assessed using the Self-Care of Heart Failure Index before patients’ discharge. After bivariate analysis, logistical regression models were used to describe the relationship between gender, self-care behaviours and self-care confidence. While men were found to have more than quadruple the risk of poor self-care than women (OR 4.596; 95% CI 1.075 to 19.650), men were also found to be approximately 60% more likely to have adequate self-care confidence than women (OR 0.412; 95% CI 0.104 to 0.962). Considering that self-care confidence is described as a positive predictor of behaviours, our results suggest a paradox. It is possible that the patient–caregiver relationship mediates the effect of confidence on behaviours. Overall, adequate levels of self-care behaviours are a current issue, ranging 7.6%–18.0%. Conclusion This study sets the stage for future research where elements of the patient–caregiver relationship ought to be considered to inform the planning of appropriate educational interventions. We recommend routinely measuring patients’ self-care behaviours to guide their follow-up and as a basis for any changes in their daily life behaviours.

Towards the Standardization of Transition Care Models for Adolescents with Congenital Heart Disease (CHD): A Perspective

This perspective paper is aimed to describe an Italian experience related to the empirical implementation of Congenital Heart Disease (CHD) transition care models, highlighting the most significant author’s perspectives. The CHD transition care models implementation strategy adopted at Policlinico San Donato (Italy) is closely linked to the clinical practice and to the research activity at national and international level. This strategy could be an efficient start-up to boost the understanding of the adolescent patients’ needs, also giving more evidence to the effectiveness of the transition care models.

Italian version of Dyspnoea-12: cultural-linguistic validation, quantitative and qualitative content validity study

Background: Dyspnoea-12 is a valid and reliable scale to assess dyspneic symptom, considering its severity, physical and emotional components. However, it is not available in Italian version due to it was not yet translated and validated. For this reason, the aim of this study was to develop an Italian version Dyspnoea-12, providing a cultural and linguistic validation, supported by the quantitative and qualitative content validity. Methods: This was a methodological study, divided into two phases: phase one is related to the cultural and linguistic validation, phase two is related to test the quantitative and qualitative content validity. Linguistic validation followed a standardized translation process. Quantitative content validity was assessed computing content validity ratio (CVR) and index (I-CVIs and S-CVI) from expert panellists response. Qualitative content validity was assessed by the narrative analysis on the answers of three open-ended questions to the expert panellists, aimed to investigate the clarity and the pertinence of the Italian items. Results: The translation process found a good agreement in considering clear the items in both the six involved bilingual expert translators and among the ten voluntary involved patients. CVR, I-CVIs and S-CVI were satisfactory for all the translated items. Conclusions: This study has represented a pivotal step to use Dyspnoea-12 amongst Italian patients. Future researches are needed to deeply investigate the Italian version of Dyspnoea-12 construct validity and its reliability, and to describe how dyspnoea components (i.e. physical and emotional) impact the life of patients with cardiorespiratory diseases. (www.actabiomedica.it)