1,720,992 research outputs found
A nurse-led multidisciplinary service for Nipple-Areola complex tattooing after breast cancer: reporting on a complex intervention with TIDieR analysis
Full text linkBackground: The Nipple-Areola Complex (NAC) tattooing can restore physical and mental integrity after breast cancer, but it is not always easily accessible for women. This paper aims to report on the development of a multidisciplinary nurse-led service for NAC tattooing for women who underwent breast cancer surgery with NAC removal to allow its thorough review and replication. Methods: The Medical Research Council’s framework for developing complex healthcare interventions was followed. According to the results of a literature review, and the context analysis, an initial intervention was planned. The Template for Intervention Description and Replication checklist was chosen to ensure the quality and completeness of the intervention description. Results: The Breast Unit and the Research departments were engaged; three nurse-tattooists were selected; the informative material was created and shared with patients, families and local associations, involving them actively. Finally, the setting and the materials were defined. A monthly schedule of activities was set: patients with the indication for NAC tattooing were contacted by the nurse case manager. Each treatment involves 3–4 sessions, 30–40 days apart, in an ambulatory setting. It consists of NAC shaping and tattooing with a dermographer and sterile needles. Conclusion: Implementing freely and equally multidisciplinary nurse-led clinics might provide this treatment ensuring the patient’s quality of life and nurse competence. The NAC tattooing is a complex intervention that represents the final part of the breast cancer surgical care pathway
Covid-19: il sapere dall'esperienza
No full textNel tempo della pandemia abbiamo subito la violenza della realtà sul mondo umano. Si tratta di una violenza che ha annientato molte vite e ha interrotto la continuità della vita ordinaria. Di fronte a questo accadere i servizi sanitari hanno dovuto affrontare in uno stato di emergenza un significativo riassetto organizzativo, sostenere un impegno di lavoro considerevole, ideare nuovi modi di pensare la cura. La fatica, fisica e mentale, degli operatori è stata molta. Per affrontare la pandemia sono stati inventati nuovi saperi e nuovi dispositivi di cura, è stato sperimentato il valore e i limiti delle politiche che erano in atto e hanno preso forma nuovi saperi esperienziali. Una parte di questi saperi resta, o perché si è materializzato in dispositivi tecnologici o perché ha trovato forma in linee guida, ma una parte di quello che è stato elaborato rischia di non essere conservato. Questa ricerca nasce con l'intenzione di raccogliere i pensieri di coloro che hanno sostenuto questa grande fatica e cercare parole che consentano di conservare ciò di cui è stata fatta esperienza
Models of Care in Providing Comprehensive Healthcare on Cancer Survivors: A Scoping Review with a TIDieR Checklist Analysis
Full text linkBackground: The study's aim is to identify the models of care used to provide survivorship care plans (SCPs) to cancer survivors in healthcare services, describing what kind of professionals are involved, in which settings and timings, and their feasibility. Methods: The Joanna Briggs Institute methodology for scoping reviews is followed. Studies that considered the SCPs applying different models of care, in any healthcare setting on any adult cancer survivors who completed oncological treatments, have been included. Pubmed, Embase, Cochrane Library, Scopus, and Cinahal were searched from 2013 to 2023 with these keywords: "Survivorship Care Plan", "Oncology", and "Program". The study selection process was reported with the PRISMA-ScR. A total of 325 records were identified, 42 were screened, and, ultimately, 23 articles were included. Results: The models of care include: SCP standardization in hospitals; self-support oriented; consultation-based; primary or specialist direct referral; shared care; a multimodal approach. Multidisciplinary teams were involved in the SCP models of care. The settings were private clinics or cancer centers. One-hour SCP interventions were most frequently delivered through in-person visits, by telephone, or online. Conclusions: Implementing SCPs is feasible in healthcare contexts, but with challenges, like time and resource management. Patient-centered programs promoting coordinated care are promising models of care
Dealing with Central Vascular Access Devices: A Qualitative Study on Cancer Patients' Experiences
No full textThe role of professional and team commitment in nurse-physician collaboration: A dual identity model perspective
No full textNurse-physician collaboration involves healthcare operators from different professions working together. The dual identity model predicts that nurse-physician interprofessional collaboration could improve if these operators feel they belong to both their professional category and care unit. This study tested this prediction by analyzing the effect of professional and team commitments on interprofessional collaboration between nurses and physicians in a hospital based in Northern Italy. A cross-section questionnaire survey was administered to 270 nurses and 95 physicians. Results indicate that interprofessional collaboration is positively affected by team commitment, while professional commitment had no effect. In accordance with the dual identity model, results indicate that interprofessional collaboration is higher when: (i) both professional and team commitment is high, and (ii) when team commitment is high and professional commitment is low. These results support dual identity model predictions and suggest that interprofessional collaboration can be increased by bolstering both team and professional commitment of nurses and physicians
Evaluation of the impact of support for nursing research on scientific productivity in seven Italian hospitals: A multiple interrupted time series study
No full textBackground: Nursing research is notwell-developed in Italy, and knowledge of the methodologies for conducting
research is lacking. In several hospitals, including those inwhich this study was conducted, a research center has
been established to support and educate nurses on how to conduct clinical research.
Aims and Objectives: In this observational study, we sought to assess whether establishing a support center for
nursing research has resulted in an increase in scientific production in terms of the numbers of protocols approved
(primary outcome), articles published and nurse authors involved in the publications (secondary outcomes).
Design: Multiple interrupted time series.
Methods: Data from 2002 to 2012 were collected in seven hospitals. Research centers have been established at
various times in only four of these hospitals.
Results: A statistically significant increase in the primary outcome (the number of protocols approved by the Research
Ethics Committee inwhich the principal investigatorwas a nurse)was observed in two hospitals approximately
2 years after establishing a research center.
The number of nursing research articles published in scientific journals with an impact factor increased but was
not statistically significant. Finally, the number of nurse authors increased significantly in two hospitalswith support
units. Definitive conclusions could not be reached for the other two experimental hospitals because notably
few post-intervention data were available. In the control hospitals, the scientific production outcomes did not
change.
Conclusions: This study shows that establishing a support center for nursing research inside hospitals can facilitate
the production of research
Patterns and determinants of patient sharing in end-of-life health services: Empirical evidence from the Italian National Health Service
Full text linkEnd-of-life (EoL) care is critical for cancer patients, who tend to have high service needs that are dispersed across organizations and different levels of care. Although EOL has been widely studied, little is known about the patterns of coordination among EoL health care providers and how they contribute to the care of cancer patients. This study adopts a network perspective to examine the complex patterns of patient sharing among health care providers involved in EoL care, using data on the use of EoL health care services by 266 cancer patients in a large Local Health Authority in Italy. We conducted a social network analysis of the structural properties of the emerging network and used logistic regression-quadratic assignment procedures (LR-QAP) to explore how characteristics of health care providers, their collaborative network, and their distances predict the likelihood of observing patient sharing relationships. Our results show that complementarities in terms of medical specialization and co-location of services positively predict the likelihood of cancer patient sharing. This probability is also positively related to the difference in terms of eigenvector centrality as well as the degree of network transitivity. We discuss the policy implications of our findings
The Role of Nursing Diagnoses in Enhancing Prognostic Accuracy in Home-Based Cancer Care: Insights From a Retrospective Cohort Study
Full text linkAims: To (1) describe the characteristics of patients with advanced cancer receiving home-based care, (2) identify the nursing diagnoses associated with 6-month mortality and (3) explore the predictive power of nursing diagnoses on 6-month mortality for patients with an advanced cancer diagnosis. Background: Nursing diagnoses have been shown to capture the complexity of patients' experiences and the specific nursing care related to patients' responses to illness, including increased mortality risk. However, there is a lack of studies investigating the relationship between nursing diagnoses and mortality among cancer patients receiving home-based care. Design: Retrospective cohort study. Methods: Between July 2021 and June 2023, patients with advanced cancer were consecutively admitted to a home-based care service. Medical data, prognostic indexes and nursing assessment data, including nursing diagnoses from NANDA International, assigned during the first home visit, were extracted from patient health records. Survival analysis was performed over the first 6 months using the Kaplan-Meier method and Cox proportional hazards model. Results: Among 344 enrolled patients, the most frequent nursing diagnoses were chronic pain and constipation. The 45.9% of patients died at home within 6 months after discharge. Multivariate Cox regression identified a Palliative Prognostic Index ≥ 5, palliative status, terminal phase of illness and two nursing diagnoses-imbalanced nutrition: less than body requirements and death anxiety-as significant predictors of 6-month mortality. Conclusions: Survival in advanced cancer patients receiving home care was primarily predicted by the terminal phase of illness, Palliative Prognostic Index, palliative status and two specific nursing diagnoses: imbalanced nutrition: less than body requirements and death anxiety. Reporting method: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study. Patient or public contribution: No Patient or Public Contribution
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
- …
