Background
According to the literature, patients requesting bariatric surgery have a higher prevalence of psychiatric comorbidities compared to severely obese patients who do not seek the surgical ...procedure for their desired weight loss. This study was designed with the aim of analyzing the relationship between the components of psychological distress and the presence of functional and adaptive resources of resilience in a sample of patients candidates for bariatric surgery.
Methods
All patients were enrolled from September 2019 to January 2020, carried out a clinical psychological assessment aimed at identifying any psychological contraindications to candidates to bariatric surgery. This study involves the administration of questionnaires for the evaluation of psychological functioning, emotional and behavioral self-regulation mechanisms, and resilience qualities.
Results
Depressive symptoms resulted in 26% of the sample, and 23% had clinically significant symptoms of anxiety. Additionally, 46% of the subjects also demonstrated difficulty in self-regulation of emotional states, with impulsive traits in 10%. Binge eating disorder was identified in 38% of the subjects. The most important outcomes of this study are as follows: (1) Global component of resiliency was differentially distributed in extreme idoneity classes. (2) Clinical judgement of eligibility can be mimicked by a psychometric profiling of patients.
Conclusions
We defined the parameters of resilience as a sort of psycho-marker that, for the same as discomfort indices, can orientate the clinicians to allow them to properly assess the patient’s psychological suitability for the surgery.
Level of evidence:Not gradable.
This study aimed to translate and test the psychometric properties of the Chase Nurse Manager Competency Instrument (CNMCI) among Italian nurse managers and to provide further support for the scale’s ...validity testing.
An instrument translation and cross-sectional validation study was conducted. The English version was translated into Italian using the translation method, which included pre-translation (establishing equivalence), initial translation, pretesting, review, and administration. From August 2022 to June 2023, 349 nurse managers were recruited through a web survey from 31 public and private healthcare organizations in North, Central, and Southern Italy. Validity assessments included content and structural validity. Reliability was evaluated using Cronbach’s α coefficient and test-retest reliability.
The content validity confirmed all the items of the CNMCI in the Italian version, including the two measurement sections, “knowledge and understanding” and “ability to implement and/or use.” The instrument’s item-content validity index (I-CVI) ranged from 0.83 to 1.00, while the scale-level content validity index (S-CVI) for both instrument sections was 0.97. The confirmatory factor analysis showed an acceptable fit. In the “knowledge and understand” section, Cronbach’s α coefficient was 0.978, and in the “ability to implement and use” section, Cronbach’s α coefficient was 0.976. The correlation coefficient between each dimension was 0.494–0.908. The test-retest reliability score was 0.82, suggesting good instrument consistency.
Overall, the Italian CNMCI demonstrates good reliability and validity for measuring nurse managers’ core competencies and supports the construct’s multi-dimensionality. Also, our findings support the hierarchical nature of the factors, further supporting the validity of the instrument.
Aim
To explore factors that influence intensive care nurses' experiences of being compliant with standard precautions (SP) during emergencies.
Intensive care nurses can be exposed to a greater risk ...of biohazardous exposure during an emergency. The primary strategy to address the complex variety of biological hazards in clinical practice is represented by the implementation of SP guidelines. Previous research has indicated that nurses' compliance rates with SPs are suboptimal, but no study has focused on the factors influencing compliance during an emergency.
A descriptive qualitative study was conducted in an Italian university hospital with 19 intensive care nurses who had at least two years of work experience in critical care. The nurses were interviewed in four focus groups and were asked about their experiences of being compliant with SPs during an emergency. Data were analyzed using conventional content analysis.
Three themes emerged: conflict, competencies, and context. Conflict was reported regarding the need to save the patient and the need for self-protection through the use of SPs. In particular, nurses had to manage the pressure of limited time. Competencies were identified by nurses' knowledge, attitude, skills, training, and experience. Context was related to the work and organizational conditions during the emergency, including overcrowding.
To support intensive care nurses' compliance with SPs during emergencies, conflict, competencies, and context should be audited regularly in clinical practice. The findings of this study could inform infection control programs and training that targets intensive care nurses.
•ICU nurses' compliance with SP can reduce exposure to biohazards during an emergency.•Conflict, competencies, and context, can affect compliance for ICU nurses.•Conflict was noted when deciding to save the patient or prioritize the nurse's self-protection.•Infection control programs and training for ICU nurses should address these aspects.
Top managers and policy makers measure nursing workload (NW) based on nurse-to-patient ratios or on nursing hours per patient a day, as a standard. To offer patients care of quality and to prevent ...negative outcomes on staff, leaders should consider specific workflow aspects when determining staffing assets.
The aim of this study was to identify some of NW deter-minants, particularly those linked to adequacy of staffing resources.
This was a cross-sectional prospective pilot study. Data were gathered in five medical-surgical wards of a University Hospital, through an online survey, asking nurses at the end of every shift, for three consecutive weeks, to describe the workload perceived.
We collected 205 surveys. A multivariate regression model was tested. Adequacy of staffing resources was signifi-cantly related to NW ( =0.372), whether nurse-to-patient ratio was not.
Our findings, although arising from a pilot study, are very important for organizations. These results put in discussion what was up to now used to take decisions on staffing resources, i.e., Nurse-to-Patient Ratios or Nursing Hours Per Patient a Day indicators. Further research is needed to confirm our results.
Our findings can be useful to hospitals middle and top management for definition of staffing assets. Adequacy of staffing includes not only the number of nurses and nurse assistants present in the shift, but also their expertise and ability to organize the work of these resources. Therefore, staffing adequacy rather than nurse-to-patient ratio should be considered when planning staffing assets. Interventions to improve nurses and nurse assistants' expertise are essential.
Nurses dedicate majority of working time to satisfy patients' needs, which are oftentimes complex. Although the concept of patient's complexity of care (PCC) has been extensively studied, it remains ...undefined in its essential characteristics. Various tools for assessing PCC have been developed, yet, there is no gold standard of reference.
This study intends to explore the elements that determine PCC focusing on the patient's needs.
The bed management team of a University Hospital developed in 2010 a PCC measurement instrument, similar to a triage system, to classify rapidly patients into macro-levels of care complexity (low, medium, high, intensive). Descriptive analysis of prospectively collected data registered in nursing records during 2016-2017 are presented in this study. The incidence of individual metrics on the value assigned to the overall PCC level was calculated.
26593 patients' records were analyzed. The final level of PCC was equal to patient's level of autonomy in 92,2% of cases, to clinical stability in 74,4% and to cognitive status in 58,4%.
Our finding indicate that essential elements to determine PCC are patient's autonomy and clinical stability. Therefore, nurses can use these metrics to classify quickly PCC in their work settings.
Identifying and measuring PCC is very important for nurses. It can facilitate and support nurse decision-making in design, implementation and evaluation of activities aimed at improving patient care. Moreover, it can help in the distribution of care loads in the shift, and from an organizational point of view, it can allow defining staffing assets.
The Role of the Leader on the nurses perception of work well-being Ferramosca, Federica Maria Pia; Filomeno, Lucia; Gualandi, Raffaella ...
Professioni infermieristiche (Consociazione Nazionale Associazioni Infermiere),
2021 Oct-Dec, Letnik:
74, Številka:
4
Journal Article
Recenzirano
Work well-being can affect performance and quality of care. Previous literature described the influence of leadership styles on nurse turnover, job satisfaction, attitudes and behaviours. There is a ...need to explore more nurses' perception of their leaders and related effects in the work environment.
The aim of this study was to explore relationships between nurses' inspiration by the leader and nurses perceptions of work pleasure, work problems, and teamwork satisfaction.
This was a cross-sectional pilot study based on the theory of social exchange (Gouldner, 1960). We administered some of QEEW instrument scales to nurses working in five medical-surgical wards of a hospital. Simple linear regression analysis were performed.
We received 81 completed questionnaires. The inspiration by the leader showed to be an antecedent of work pleasure (R2=26%), work problems (R2=30%), and teamwork satisfaction (R2=28%).
An inspiring leadership was associated with nurse perceptions of reduced work problems, and increased teamwork satisfaction and work pleasure. The role of the leader and the use of an appropriate leadership style is therefore essential to increase levels of well-being in nurses. Future studies with a larger sample are needed to confirm our findings.
Our results suggest that leadership style has a prediction effect on perceived nurse well-being. Moreover, leadership style has an impact on work climate and interdisciplinary teamwork. Therefore, chief executives should invest energies in leadership training and continuing education in order to develop among ward manager's effective leadership competencies.
BRASS score and complex discharge: a pilot study Cammilletti, Valentina; Forino, Fortunata; Palombi, Marina ...
Acta bio-medica de l'Ateneo Parmense,
01/2018, Letnik:
88, Številka:
4
Journal Article
Recenzirano
Odprti dostop
A highly functional continuity of patient care, which is linked to the reduction of the risk of long-term hospitalization, above all for 'at-risk' patients. Research into an objective, reliable ...instrument for redirecting individual results to organizational aims to extend the entire country, is a fundamental step to move from a reactive assistance approach to a pro-active one.
An observational and descriptive retrospective study was carried out July - November 2014 in two Italian state hospitals, completing the BRASS Index within 48/72 hours of admission.
The study group consisted of 122 inpatients. A correlation presented itself, albeit low (ñ=0.05191), between age and the number of 'revolving door' admissions; a medium correlation (ñ=0.485131) between age and risk band (according to BRASS).
The BRASS Index is straightforward and swift, and can prove a valuable tool in directing nurses' attention to those patients most at risk of prolonged hospitalization.
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