1,720,967 research outputs found
Psychological impact of COVID-19 on healthcare leaders in Friuli-Venezia Giulia, Italy
No full textIntroduction: The current pandemic scenario may cause psychological distress among healthcare workers (HCWs). Although several studies highlighted this issue as particularly affecting frontline HCWs, no data are available regarding professionals dealing with the governance of healthcare organizations. This study aims to assess the psychological impact of COVID-19 on healthcare leaders (HeLs).
Methods: A cross-sectional study was carried out between October and November 2020, among HeLs working within Friuli-Venezia Giulia healthcare system (Italy). HeLs included: heads of surgical or medical department, deans of hospital, heads of doctors and nurses working at regional level or in hospital/community settings. We collected demographic data and assessed the presence of depressive (DS) and anxiety symptoms (AS), perceived stress (PS) and insomnia using internationally validated tools. Relationship between mental health outcomes and professional role was analysed using nonparametric tests.
Results: A total of 48 HeLs participated; their mean age was 53.4±7.9, women were 56.3%. Most (45.8%) were heads of department, 16.7% deans of hospital, 8.3% heads of doctors, 29.2% heads of nurses. The majority (60.4%) worked in hospital setting, 22.9% in the community and 16.7% at regional level. The prevalence of DS and AS was 14.6% and 12.5%, respectively. Moderate insomnia was found in 12.5% of HeLs, while severe
insomnia in 6.3% of them. The 45.8% of HeLs showed moderate level of stress, whereas 4.2% high level. PS was significantly higher among deans of hospital. Moreover, lower PS correlated with lower DS, AS and insomnia (p < 0.05).
Conclusions: The high level of perceived stress, insomnia, depressive and anxious symptoms experienced by HeLs shows another issue of the COVID-19 pandemic psychological impact. Considered the key role of HeLs in leading healthcare organizations over the current crisis, mental health of these professionals is a major issue that needs higher attention.
Key messages: Psychological impact of COVID19 not only affects frontline HCWs, but also the professionals who are leading healthcare organization through the crisis. Promotion of mental well-being among HCWs should be improved at all levels of healthcare organizations, ensuring a healthier workplace for all professionals working for public health
Psychological impact of COVID-19 on healthcare leaders: a cross-sectional survey in Friuli-Venezia Giulia, Italy
No full textIntroduction Although several studies highlighted the psychological burden of 2019 coronavirus disease (COVID-19) pandemic, no data are available regarding professionals leading healthcare organisations. This study aims to assess the psychological impact of COVID-19 on healthcare leaders (HeLs), along with the leadership skills and coping strategies needed for successful leadership. Methods A cross-sectional survey was conducted in Friuli-Venezia Giulia (Italy) between October and November 2020. We assessed the presence of depressive symptoms (DS), anxiety symptoms (AS), perceived stress (PS) and insomnia using internationally validated tools. Coping strategies and skills needed to overcome the crisis were examined, along with the most challenging phases. Results A total of 48 HeLs participated. The prevalence of DS and AS was 14.6% and 12.5%, respectively. Moderate and severe insomnia was found in 12.5% and 6.3% of them, respectively. Leaders showed moderate (45.8%) and high 4,2%) level of PS. The two most challenging phases were recognised in early recognition (45.2%) and peak phase (31.0%). Concerning healthcare leaders' skills required to manage with pandemic, the most reported were communication (35.1%) and decision-making (25.5%). Conclusion The high level of PS, insomnia, DS and AS experienced by healthcare leaders shows the COVID-19 pandemic's psychological impact. The two most challenging phases identified enhances the importance of public health surveillance and monitoring systems, and communication appeared a critical success skill for healthcare leaders. Given the key role these professional play in addressing the current crisis in healthcare organisations, their mental health and well-being deserve greater attention
The most challenging COVID19 phases and the skills healthcare leaders need to face the pandemic
No full textIntroduction: Coronavirus disease 2019 (COVID19) pandemic is the most significant public health threat of the century, a crisis that have been challenging healthcare systems around the world. Assessment of leadership skills is needed in order to identify attributes of successful leadership during public health emergencies. This study aims to highlight the critical role played by healthcare leaders during this pandemic, assessing
the most challenging and demanding phases of the health crisis and the characteristics required for a healthcare leader.
Methods: A cross-sectional survey was carried out between October and November 2020, using online questionnaires, involving medical and nursing leaders working in the healthcare organizations of the Friuli-Venezia Giulia Region (Northeast of Italy). Professionals from hospital, community setting and regional level were asked about the two most challenging phases of the current pandemic among: crisis early recognition, peak of the emergency phase, declining epidemic, long tail. The most important healthcare leaders’ skills were investigated among competence, awareness, communication,
decision-making, inspiring trust and data interpretation.
Results: A total of 48 healthcare leaders participated. Women were 56.3%. Mean age was 53.4 7.9. According to the leaders interviewed, the two most challenging phases of such crisis were crisis early recognition (45%) and the peak phase (31%). Lesser important phases were recognized in the declining epidemic (15%) and the long tail phases (8%). Concerning healthcare leaders’ skills required to manage with pandemic, the most reported were communication (35%) and decisionmaking (26%); while lower importance was identified in inspiring confidence (5%).
Conclusions: The two most challenging phases identified by this study suggested the importance of public health surveillance and monitoring systems. Communication appeared a critical success factor for leaders in public health emergencies.
Key messages: Early recognition of the crisis and the emergency peak management are considered the most challenging phases of the COVID19 pandemic by healthcare leaders. Ability to communicate and decision-making emerged as the two most important crisis skills, and should be included
among public health leaders core competencies
Nutrient values and sustainability of omnivorous, vegetarian and vegan choices in a hospital canteen
No full textBackground: A plant-based diet has a lower environmental impact than an omnivorous diet and, when balanced, may reduce the risk of certain non-communicable diseases. The aim of our work is to evaluate the nutritional profile and sustainability of omnivorous, vegan and vegetarian choices in an Italian hospital canteen.
Methods: We photographed the midday meals of users in the hospital canteen of Palmanova (Italy) for 5 consecutive days in September 2022. We examined the recipes provided by the canteen and divided the meal trays in omnivorous, vegan and vegetarian. For each tray we estimated the carbon and water footprint using the SU-EATABLE LIFE database and the energy and nutrient content using the Italian Food Composition Database for Epidemiological Studies.
Results: We analysed 228 trays (167 omnivorous, 7 vegan, 54 vegetarian). Median energy content was higher (p < 0.05) in the omnivorous trays (942 kcal/tray) than the plant-based trays (813 kcal/tray). The omnivorous trays contained more fats (42 %E) and less carbohydrates (36 %E) than the plant-based trays (fats: 35 %E; carbohydrates: 44 %E) (p < 0.05). The carbon and water footprint were higher (p < 0.05) for the omnivorous meals (1202 gCO2eq/tray, and 1370 LH2O/tray) than for the plant-based meals, which had a median value of 687 gCO2eq/tray and 907 LH2O/tray.
Conclusions: Vegan and vegetarian meals were more in line with the Italian dietary reference values and more sustainable than omnivorous
meals. Nutrition education is needed to improve the sustainability and quality of workers’ lunches and to ensure an adequate choice of plant-based meals.
Key messages: Even if plant-based meals were more sustainable and nutrionally balanced than the omnivorous ones, they were less chosen. Improving food choices can help achieve the Sustainable Development Goals
Second Victim Symptoms and Desired Support Strategies among Italian Health Care Workers in Friuli-Venezia Giulia: Cross-Sectional Survey and Latent Profile Analysis
No full textBackground and Objective The second victim (SV) phenomenon concerns health care workers (HCWs) whose involvement in a medical error, as well as non-error patient safety events, has affected their well-being. Its prevalence ranges from 10% to 75% and can predispose HCWs to burnout, increasing the probability of committing errors. The primary aim of our study was to determine the prevalence of HCWs involved in an adverse patient safety event in Friuli Venezia Giulia Region (Italy). The secondary aims were to use latent profile analysis to identify profiles of SVs and factors influencing profile membership, and to evaluate the relationship between the severity of symptoms and desired support options. Methods A cross-sectional survey through the Italian version of the Second Victim Experience and Support Tool tool was conducted in 5 local health authorities. Descriptive statistics were conducted for all variables. Associations and correlations were assessed with statistical tests, as appropriate. Latent profile analysis was based on the scores of dimensions measuring SVs' symptoms. Factors affecting profile membership were assessed through multinomial logistic regression. Results A total of 733 HCWs participated. Of them, 305 (41.6%) experienced at least 1 adverse event. Among dimensions measuring SVs' symptoms, psychological distress had the highest percentage of agreement (30.2%). Three latent profiles were identified: mild (58.7%), moderate (24.3%), and severe (17.0%) symptoms. Severe symptoms profile was positively associated with the agreement for extraoccupational support and negatively associated with the agreement for organizational support. A respected colleague with whom to discuss the details of the incident (78.7%) and free counseling outside of work (71.2%) were the support options most desired by HCWs. The severity of symptoms was directly associated with the desire for support strategies. Conclusions The prevalence of HCWs involved in adverse events is consistent with the literature. Three latent profiles have been identified according to SV symptoms, and the higher the severity of symptoms, the greater the reliance on extraoccupational support
Are adverse events related to the completeness of clinical records? Results from a retrospective records review using the Global Trigger Tool
No full textClinical record (CR) is a tool for recording details about the patient and the most commonly used source of information for detecting adverse events (AEs). Its completeness is an indicator of the quality of care provided and may provide clues for improving professional practice. The primary aim of this study was to estimate the prevalence of AEs. The secondary aims were to determine the completeness of CRs and to examine the relationship between the two variables. We retrospectively reviewed randomly selected CRs of patients discharged from the Academic Hospital of Udine (Italy) in the departments of general surgery, internal medicine, and obstetrics between July and September 2020. Evaluation was performed using the Global Trigger Tool and a checklist to evaluate the completeness of CRs. The relationship between the occurrence of AEs and the completeness of CRs was analyzed using nonparametric tests. A binomial logistic regression analysis was also performed. We reviewed 291 CRs and identified 368 triggers and 56 AEs. Among them, 16.2% of hospitalizations were affected by at least one AE, with a higher percentage in general surgery. The most common AEs were surgical injuries (42.6%; 24) and care related (26.8%; 15). A significant positive correlation was found between the length of hospital stay and the number of AEs. The average completeness of CRs was 72.9% and was lower in general surgery. The decrease in CR completeness correlated with the increase in the total number of AEs (R = -0.14; P = .017), although this was not confirmed by regression analysis by individual departments. Our results seem to suggest that completeness of CRs may benefit patient safety, so ongoing education and involvement of health professionals are needed to maintain professional adherence to CRs
How to assure the quality of clinical records? A 7-year experience in a large academic hospital
No full textIntroduction Clinical record (CR) is the primary tool used by healthcare workers (HCWs) to record clinical information and its completeness can help achieve safer practices. CR is the most appropriate source in order to measure and evaluate the quality of care. In order to achieve a safety climate is fundamental to involve a responsive healthcare workforce thorough peer-review and feedbacks. This study aims to develop a peer-review tool for clinical records quality assurance, presenting the seven-year experience in the evolution of it; secondary aims are to describe the CR completeness and HCWs' diligence toward recording information in it. Methods To assess the completeness of CRs a peer-review tool was developed in a large Academic Hospital of Northern Italy. This tool included measurable items that examined different themes, moments and levels of the clinical process. Data were collected every three months between 2010 and 2016 by appointed and trained HCWs from 42 Units; the hospital Quality Unit was responsible for of processing and validating them. Variations in the proportion of CR completeness were assessed using Cochran-Armitage test for trends. Results A total of 9,408 CRs were evaluated. Overall CR completeness improved significantly from 79.6% in 2010 to 86.5% in 2016 (p<0.001). Doctors' attitude showed a trend similar to the overall completeness, while nurses improved more consistently (p<0.001). Most items exploring themes, moments and levels registered a significant improvement in the early years, then flattened in last years. Results of the validation process were always above the cut-off of 75%. Conclusions This peer-review tool enabled the Quality Unit and hospital leadership to obtain a reliable picture of CRs completeness, while involving the HCWs in the quality evaluation. The completeness of CR showed an overall positive and significant trend during these seven years
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
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
- …
