Julita Sansoni

Immersion research education: students as catalysts in international collaboration research.

ANDERSON K.H., FRIEDEMANN M.L., BŰSCHER A., SANSONI J. & HODNICKI D. (2012) Immersion research education: students as catalysts in international collaboration research. International Nursing Review Background:  This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research. Aim:  To narrow the healthcare gap for disadvantaged families in the USA and partner countries. Methods:  Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the MHIRT program complete two introductory courses followed by a 3-month research practicum in a partner country guided by faculty mentors abroad. The overall program development, student study abroad preparation, research project activities, cultural learning, and student and faculty team outcomes are explored. Results:  Cross-fertilization of research, cultural awareness and ideas about improving family health occur through education, international exchange and research immersion. Faculty research and international team collaboration provide opportunities for learning about research, health disparities, cultural influences and healthcare systems. The students are catalysts in the research effort, the dissemination of research findings and other educational endeavours. Five steps of the collaborative activities lead to programmatic success. Conclusions:  MHIRT scholars bring creativity, enthusiasm, and gain a genuine desire to conduct health research about families with chronic illness. Their cultural learning stimulates career plans that include international research and attention to vulnerable populations.BACKGROUND This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research. AIM To narrow the healthcare gap for disadvantaged families in the USA and partner countries. METHODS Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the MHIRT program complete two introductory courses followed by a 3-month research practicum in a partner country guided by faculty mentors abroad. The overall program development, student study abroad preparation, research project activities, cultural learning, and student and faculty team outcomes are explored. RESULTS Cross-fertilization of research, cultural awareness and ideas about improving family health occur through education, international exchange and research immersion. Faculty research and international team collaboration provide opportunities for learning about research, health disparities, cultural influences and healthcare systems. The students are catalysts in the research effort, the dissemination of research findings and other educational endeavours. Five steps of the collaborative activities lead to programmatic success. CONCLUSIONS MHIRT scholars bring creativity, enthusiasm, and gain a genuine desire to conduct health research about families with chronic illness. Their cultural learning stimulates career plans that include international research and attention to vulnerable populations.

A Psychometric Properties Evaluation of the Italian Version of the Geriatric Depression Scale

Objective The Geriatric Depression Scale (GDS) is an evaluation tool to diagnose older adults depression. This questionnaire was defined by Yesavage and Brink in 1982; it was designed expressly for the older person and defines his/her degree of satisfaction, quality of life, and feelings. The objective of this study is to evaluate the psychometric properties of the Italian translation of the Geriatric Depression Scale (GDS-IT). Methods The Italian version of the Geriatric Depression Scale was administered to 119 people (79 people with a depression diagnosis and 40 healthy ones). We examined the following psychometric characteristics: internal consistency reliability, test-retest reliability, concurrent validity, and construct validity (factor structure). Results Cronbachs Alpha for the GDS-IT administered to the depressed sample was 0.84. Test-retest reliability was 0.91 and the concurrent validity was 0.83. The factorial analysis showed a structure of 5 factors, and the scale cut-off is between 10 and 11. Conclusion The GDS-IT proved to be a reliable and valid questionnaire for the evaluation of depression in an Italian population. In the present study, the GDS-IT showed good psychometric properties. Health professionals now have an assessment tool for the evaluation of depression symptoms in the Italian population.

[ICNP- International Classification of Nursing Practice: origin, structure and development].

ICNP is a standardized nursing terminology included within acknowledged terminologies by WHO, it is a relevant aspect of ICN programs and strategies. This paper aims to describe structure and characteristics of ICNP terminology as well as to highlight how this tool can be useful both in practice and in terms of nursing professional development. This version looks like a pyramid with seven axes describing different areas of nursing and related interventions, enriched by two special axes related to pre-coordinated Diagnosis / Outcomes (DC) and Operations (IC) which facilitate daily use in practice. In order to clarify how this tool can be actually be used in daily nursing practice some examples are provided, clarifying how adopting the current version of ICNP terminology (2015 release) Diagnosis/Outcomes and Interventions can be built. The ICNP Italian Centre is committed to introduce it to Italian nurses as a tool for sharing and disseminating terminology in our Country, having as main final aim to achieve even in Italy, professional visibility objectives promoted in different ways by the International Council of Nurses.

Reliability and Validity of the Geriatric Depression Scale in Italian Subjects with Parkinson’s Disease

Introduction The Geriatric Depression Scale (GDS) is commonly used to assess depressive symptoms, but its psychometric properties have never been examined in Italian people with Parkinsons disease (PD). The aim of this study was to study the reliability and validity of the Italian version of the GDS in a sample of PD patients. Methods The GDS was administered to 74 patients with PD in order to study its internal consistency, test-retest reliability, construct, and discriminant validity. Results The internal consistency of GDS was excellent (α = 0.903), as well as the test-retest reliability (ICC = 0.941 [95% CI: 0.886–0.970]). GDS showed a strong correlation with instruments related to the depression (ρ = 0.880) in PD (ρ = 0.712) and a weak correlation with generic measurement instruments (−0.320 < ρ <−0.217). An area under the curve of 0.892 (95% CI 0.809–0.975) indicated a moderate capability to discriminate depressed patients to nondepressed patient, with a cutoff value between 15 and 16 points that predicts depression (sensitivity = 87%; specificity = 82%). Conclusion The GDS is a reliable and valid tool in a sample of Italian PD subjects; this scale can be used in clinical and research contexts.

Physical Activity Scale for the Elderly: Translation, Cultural Adaptation, and Validation of the Italian Version

Objective The aim of the study was to translate and culturally adapt the Physical Activity Scale for the Elderly into Italian (PASE-I) and to evaluate its psychometric properties in the Italian older adults healthy population. Methods For translation and cultural adaptation, the “Translation and Cultural Adaptation of Patient-Reported Outcomes Measures” guidelines have been followed. Participants included healthy individuals between 55 and 75 years old. The reliability and validity were assessed following the “Consensus-Based Standards for the Selection of Health Status Measurement Instruments” checklist. To evaluate internal consistency and test-retest reliability, Cronbachs α and Intraclass Correlation Coefficient (ICC) were, respectively, calculated. The Berg Balance Score (BBS) and the PASE-I were administered together, and Pearsons correlation coefficient was calculated for validity. Results All the PASE-I items were identical or similar to the original version. The scale was administered twice within a week to 94 Italian healthy older people. The mean PASE-I score in this study was 159±77.88. Cronbachs α was 0.815 (p < 0.01) and ICC was 0.977 (p < 0.01). The correlation with the BBS was 0.817 (p < 0.01). Conclusions The PASE-I showed positive results for reliability and validity. This scale will be of great use to clinicians and researchers in evaluating and managing physical activities in the Italian older adults population.

Making it easy to do the right thing in healthcare: Advancing improvement science education through accredited pan European higher education modules

BACKGROUND Numerous international policy drivers espouse the need to improve healthcare. The application of Improvement Science has the potential to restore the balance of healthcare and transform it to a more person-centred and quality improvement focussed system. However there is currently no accredited Improvement Science education offered routinely to healthcare students. This means that there are a huge number of healthcare professionals who do not have the conceptual or experiential skills to apply Improvement Science in everyday practise. METHODS This article describes how seven European Higher Education Institutions (HEIs) worked together to develop four evidence informed accredited inter-professional Improvement Science modules for under and postgraduate healthcare students. It outlines the way in which a Policy Delphi, a narrative literature review, a review of the competency and capability requirements for healthcare professionals to practise Improvement Science, and a mapping of current Improvement Science education informed the content of the modules. RESULTS A contemporary consensus definition of Healthcare Improvement Science was developed. The four Improvement Science modules that have been designed are outlined. A framework to evaluate the impact modules have in practise has been developed and piloted. CONCLUSION The authors argue that there is a clear need to advance healthcare Improvement Science education through incorporating evidence based accredited modules into healthcare professional education. They suggest that if Improvement Science education, that incorporates work based learning, becomes a staple part of the curricula in inter-professional education then it has real promise to improve the delivery, quality and design of healthcare.

The Use of a Dedicated Platform to Evaluate Health-Professions University Courses

The aim of the current study is to discuss a national platform for evaluating nursing education in Italy by means of a progress test and to compare digital versus paper administration of the test. In 2016, the agency updated the research design, including the domains, the methodological approach, and the tests for both Transversal Competencies (TECO-T) and Disciplinary Competencies (TECO-D). The TECO project aims to construct indicators that reflect the skills developed from the first through the third year of the university degree. For the digital study, 8516 students at 19 Italian university universities were recruited; 5975 students of degree courses in nursing took the electronic TECO, and 4326 used the paper format. Asked to evaluate their satisfaction in completing the TECO, the students found it simple, clear, and understandable, but reported difficulty in answering questions due to a lack of practicality in the paper test. The project encourages the development of shared core disciplinary contents and their compatibility with the Dublin Descriptors; allows the development of disciplinary tests (TECO-D) whose results can be used for self-assessment and inter- and intra-university comparisons; and ensures centralized management of the collection of data.

Case Study in Nursing

Nursing complexity requires comprehensive tools for evidence appraisal and synthesis, able of taking into account several factors driving outcomes, resource use, and patient well-being. Umbrella reviews, overviews of reviews, and meta-epidemiologic studies offer a unique opportunity to capture and navigate such complexity, without disregarding the multiple evidence sources informing on nursing. In this chapter, a set of key umbrella reviews is presented on nursing which offer a poignant case study on the pros and cons of this kind of research design in this clinical and research discipline.

L'esperienza dei caregiver primari che assistono a domicilio le persone affette dalla Malattia di Alzheimer Alzheimer's disease and caregivers experience in home care

The aim of this study is to investigate the experience of primary caregivers (men and women) of Alzheimer Disease dementia, in order to tailor program and project to avoid care giving burden. A qualitative phenomenological method was used and the sample was defined by data saturation. Interviews were carried out and recorded in a day care Centre, transcribed verbatim. The analysis was conducted coding common themes and phrases. Six main themes emerged. Our results are similar to those existing in literature, showing care givers as individual in great danger physically and mentally. In the light of the study it is possible to tailor a nursing model in order to improve quality of life and decrease the burden of caregivers, this model should be implemented and analyzed.

Features and organization of Pain Centers in the Lazio Region, Italy, in 2011

BACKGROUND Evidence on pain management highlights the importance of a multidisciplinary approach in order to achieve optimal therapeutic results. Such programs can be guaranteed by the Centers for Pain Management (CPMs), in which multidisciplinary teams are able to provide advanced and specialized activities for the assessment, diagnosis and treatment of chronic benign pain. To date, information related to healthcare supply and the organizational structure of these centers in Italy is incomplete. The aim of this paper was to provide an overview of the healthcare network of the CPMs in the Lazio region. METHODS A descriptive survey was conducted in all the 37 CPMs existing in the Lazio region in 2011 of which 28 participated. RESULTS CPMs were located either in Universities or in public or private hospital facilities. They included a clinic, a Day Hospital service, Day surgery and day-beds. CPMs were managed by anaesthesiologists who, in most instances, did not work in a multidisciplinary team. The number of other health professionals available, such as nurses, psychologists and physiotherapists, was limited. CPMs mainly provided drug therapy, Complementary Alternative Medicine (CAM) and complex interventional treatments. The median waiting time was 30 days. The clinics were not homogeneously distributed in the region with a higher concentration in Rome (56%), followed by other provinces of the Lazio region (26%) and the province of Rome (18%). Clearly, Rome was the city which offered the greatest range of healthcare services and the highest number of consultations with patients, which significantly differed from those of the other areas (χ²=19.6 p<0.01). CONCLUSIONS In 2011, the availability of CPMs was not equally distributed throughout the territory, and there was an over-utilization of the facilities in Rome and an under-utilization in the provincial areas. Moreover, this study showed a lack of a multi-professional approach to chronic pain management.