Rosaria Alvaro

The Evolution of Professional Nursing Culture in Italy: Metaphors and Paradoxes

We explored the perceptions of Italian nurses regarding their developing culture as a health profession. We sought to understand the ongoing evolution of the nursing profession and the changes that were central to it becoming an intellectual discipline on par with the other health professions in Italy. In 2010, the Regulatory Board of Nursing established a center of excellence to build evidence-based practice, advocate for interdisciplinary health care, and champion health profession reforms for nursing. In this study, focus groups—involving 66 nurse participants from various educational, clinical, and administrative backgrounds—were utilized to better ascertain how the profession has changed. Six themes, three of them metaphors—“vortex,” “leopard spots,” and “deductive jungle”—explain nurses’ experiences of professional change in Italy between 2001 and 2011 and the multiple dimensions that characterize their professional identity and autonomy.

Mental and physical well-being in oncology-hematology–unit personnel

ABSTRACT Health care workers (HCWs) in university hematology units (UHUs) face high job demand that can have adverse health effects. This cross-sectional study investigated the relationship between some job stressors and health-related quality of life among HCWs of 3 UHUs in Rome. Work-related stress was measured with the Demand–Control Questionnaire; health-related functioning with the mental component score (MCS) and physical component score (PCS) of the Short Form 12 Survey; positivity with the Positivity Scale. Data of 201 respondents were analyzed. Job demand was inversely associated with MCS (p = .05) and PCS (p = .049); job control was directly associated with PCS (p < .001) and MCS (p = .024). A high positivity scale score and high decision latitude score predicted high MCS and PCS. High job demand score predicted low MCS and PCS scores. Reduced job stressors and enhanced positive attitudes can improve HCWs’ health-related quality of life.

Neonatal intensive care parent satisfaction: a multicenter study translating and validating the Italian EMPATHIC-N questionnaire

BackgroundIn Neonatal Intensive Care Units (NICUs), parent satisfaction and their experiences are fundamental to assess clinical practice and improve the quality of care delivered to infants and parents. Recently, a specific instrument, the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPATHIC-N), has been developed in the Netherlands. This instrument investigated different domains of care in NICUs from a family-centered care perspective. In Italy, no rigorous instruments are available to evaluate parent satisfaction and experiences in NICU with family-centered care. The aim of this study was to translate and validate the EMPATHIC-N instrument into Italian language measuring parent satisfaction.MethodsA psychometric study was conducted in nine Italian NICUs. The hospitals were allocated across Italy: four in the North, four in Central region, one in the South. Parents whose infants were discharged from the Units were enrolled. Parents whose infants died were excluded.ResultsBack-forward translation was conducted. Twelve parents reviewed the instrument to assess the cultural adaptation; none of the items fell below the cut-off of 80% agreement. A total of 186 parents of infants who were discharged from nine NICUs were invited to participate and 162 parents responded and returned the questionnaire (87%). The mean scores of the individual items varied between 4.3 and 5.9. Confirmatory factor analysis was performed and all factor loadings were statistically significant with the exception of item ‘Our cultural background was taken into account’. The items related to overall satisfaction showed a higher trend with mean values of 5.8 and 5.9. The Cronbach’s alpha’s (at domain level 0.73-0.92) and corrected item-total scale correlations revealed high reliability estimates.ConclusionsThe Italian EMPATHIC-N showed to be a valid and reliable instrument measuring parent satisfaction in NICUs from a family-centered care perspective. Indeed, it had good psychometric properties, validity, and reliability. Furthermore, this instrument is fundamental for further research and internationally benchmarking.

The current practice of family-centred care in Italian neonatal intensive care units: A multicentre descriptive study

OBJECTIVESnTo explore family-centred care practices in Italian neonatal intensive care units and describe areas for improvement.nnnMETHODSnA cross-sectional, multicentre, survey was conducted using the Italian language version of Advancing family-centred new-born intensive care: a self-assessment inventory. The instrument is divided into 10 sections rating the status of family-centred care (1u202f=u202fnot at all, 5u202f=u202fvery well) and ranking the perceived priority for change/improvement (1u202f=u202flow, 3u202f=u202fhigh). A representative group of staff and parent for each unit were invited to complete the survey. Data was collected between January and June 2015. Correlations among unit characteristics and sections within the survey were explored.nnnSETTINGSnAll Italian neonatal intensive care units (nu202f=u202f105) were invited.nnnRESULTSnForty-six (43.8%) units returned the survey. The Leadership section scored highest in status of family-centred care (meanu202f=u202f3.45; SD 0.78) and scored highest in priority for change (meanu202f=u202f2.44; SD 0.49). Section Families as Advisors and Leaders scored lowest both in status (meanu202f=u202f1.66; SD 0.67) and in priority for change (meanu202f=u202f2.09; SD 0.59). The number of discharged infants was positively correlated with many sections in priority for change (r 0.402-0.421; pu202f<u202f.01).nnnCONCLUSIONnThis study showed a variability in the organisation of family-centred care practices in Italian neonatal intensive care units and the need to involve parents as partners in the care team. Although family-centred care is considered important by Italian neonatology healthcare professionals, much remains to be done to improve family-centred care practices in neonatal intensive care units in Italy.

Self-care in heart failure patients: major results of a 7-year research program in Italy

Self-care improves patients’ outcomes in heart failure (HF). In this article we report the main results of a 7-year research program conducted in Italy. First, we established validity and reliability of the Self-Care of HF Index v.6.2 and the Caregiver Contribution to Self-Care of HF Index in the Italian population. Second, we tested the situation-specific theory of HF self-care that showed adequate fit to the data. Third, we showed in a sample of 1.192 HF patients that only about the 20% of them performs adequate self-care. Forth, we described caregiver contribution to self-care in a sample of 515 HF caregivers and we showed a low level of caregiver contribution to HF self-care. Fifth, we showed that patients and caregivers influence each other self-care. Six, we found that self-care confidence mediates between cognition and self-care, and comorbidity moderates between self-care confidence and self-care. Intervention studies are needed to improve self-care in Italian HF patients.