Conectar
To translate, culturally adapt and validate the Italian version of Fundamentals of Care Framework and the Fundamentals of Care Practice Process.
Qualitative tool validation study.
The study followed internationally recommended procedures, including forward–backward translation, expert committee review, content validation through cognitive interviews and face validity testing with nurses and nursing students. Data were collected between January and October 2023.
Key terms were culturally and linguistically adapted to enhance clarity and contextual relevance, with changes informed by expert feedback. Content validation confirmed conceptual equivalence, and face validity testing demonstrated that Italian versions were perceived as clear, appropriate and applicable across clinical and educational settings.
Cultural adaptation of theoretical frameworks is essential for ensuring their relevance and usability in local contexts. The Italian versions of the Fundamentals of Care Framework and the Fundamentals of Care Practice Process will provide a robust, evidence-based foundation for person-centred care across education, research and clinical practice.
By making these tools accessible in Italian, this study supports the integration of fundamentals of care into national nursing education and practice, promoting international consistency in person-centred care. It lays the groundwork for curriculum reform, clinical implementation and global collaboration in nursing.
Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
This study did not involve any patient or public contribution.
ClinicalTrials.gov identifier: NCT05177627
To evaluate the effect of mutuality on self-care in people with CHD and the contribution of their caregivers, and whether such relationships can be mediated by self-efficacy.
Secondary analysis of baseline data from a multi-centre longitudinal study.
Patients at the onset of coronary artery disease who underwent angioplasty, along with their caregivers, were included in the sample. Data from 136 patients and 136 caregivers were used for the analysis. Mutuality between patients and caregivers was measured using the Mutuality Scale. Self-care was measured using the Self-Care of Coronary Heart Disease Index and the Caregiver Contribution to Self-Care of Coronary Heart Disease Index. The actor–partner interdependence mediation models were used to assess the mediating role of self-efficacy for self-care between perceived mutuality and self-care behaviours.
An actor indirect effect was found between patient mutuality and their self-care maintenance, self-care monitoring, and self-care management, through the mediation of their self-efficacy. Caregiver mutuality had a positive indirect effect on their contribution to self-care maintenance, self-care monitoring, and self-care management, through the mediation of their self-efficacy. Caregiver mutuality had a positive indirect effect on patient self-care maintenance and on patient self-care monitoring, through the mediation of patient self-efficacy. All models demonstrated satisfactory fit to the data.
Mutuality between patients and caregivers enhances self-care behaviours in patients with coronary heart disease, and self-efficacy is a crucial mediator in this relationship. Interventions targeting both mutuality and self-efficacy within patient–caregiver dyads may improve self-care outcomes.
We adhered to STROBE guidelines.
Patients and members of the public were not involved in the design, conduct, reporting, or dissemination plans of this research.
Early screening for autism spectrum disorder (ASD) can enhance educational and health outcomes for affected children. This narrative systematic review explores school-based screening tools used around the world to identify children with ASD and explore the differences across socio-demographic groups.
Systematic review of electronic databases (EMBASE, MEDLINE, PsycINFO, Cochrane and Scopus) in October 2024 of papers published between 2011 and 2024.
Mainstream school-based settings globally.
Children aged 4–16 years old attending mainstream school.
School-based screening tools for ASD, including all types of informant and format of tools reported in eligible studies.
Primary outcomes included prevalence of screen positives, sensitivity and specificity of the screening tools. Secondary outcomes included participants’ sex, socioeconomic status and ethnicity, and the relation of this to the primary outcomes.
Of 7765 eligible articles, 14 studies were included in this review. We identified eight different school-based ASD screening tools. Study populations ranged from 103 to 16 556 children, with sensitivity and specificity varying by screening tool used, age group, setting and ASD prevalence. The percentage of children screening positive for ASD ranged from 0.7% to 8.5%. Studies were conducted in Europe (n=6), Western Pacific (n=4), the Americas (n=3) and Eastern Mediterranean (n=1) regions. No studies explicitly explored accuracy or validity outcomes based on ethnicity or socioeconomic status. Half of the 14 studies (n=7) reported the sensitivity and specificity of the screening tools; sensitivity ranged from 58% to 94% and specificity from 61% to 100%. There was insufficient evidence to recommend any single ASD screening tool.
ASD screening tools vary widely across the globe, with limited standardisation. Evidence is lacking on how ethnicity and socioeconomic status affect their effectiveness in schools. Given the dearth of scientific evidence in this field, collaboration among educators, researchers and policymakers is needed to establish the evidence base for universal screening, identify optimal tools, coordinate their use and ensure their validation for specific populations.
To examine the association between nurse–patient mutuality (i.e., a good quality of the relationship between the nurse and the patient) and nurse professional quality of life.
A cross-sectional, multi-centre study was conducted across four tertiary hospitals in Italy.
Data collection took place from November 2023 to June 2024, enrolling 517 nurses. Both medical and surgical departments, as well as inpatients and outpatients departments were included. Data were collected on nurses caring for patients with chronic illness. Mutuality was measured with the Nurse–Patient Mutuality in Chronic Illness scale, which includes three dimensions: Developing and Going Beyond, Being a Point of Reference, Deciding and Sharing Care; Professional Quality of Life was measured with the Professional Quality of Life version 5, which includes three dimensions: Compassion Satisfaction, Secondary Traumatic Stress, Burnout. A Bayesian path analysis was employed to evaluate the contribution of mutuality dimensions to the dimensions of professional quality of life.
Nurses' sample consisted of 517 participants. The three dimensions of mutuality showed different associations with the three dimensions of professional quality of life. Specifically, Being a Point of Reference, along with Deciding and Sharing Care, was significantly associated with Compassion Satisfaction. The dimensions Developing and Going Beyond and Deciding and Sharing Care were significantly and negatively associated with Secondary Traumatic Stress. Additionally, Deciding and Sharing Care was significantly and negatively associated with Burnout.
As all the dimensions of mutuality were significantly associated with different aspects of professional quality of life, future interventions to improve nurses' professional quality of life may also consider nurse–patient mutuality.
Nurse–patient mutuality may be a novel area of research to enhance nurses' professional quality of life, with implications for clinical practice and organisational development.
Nurse–patient mutuality is a key indicator of a high-quality relationship, enabling shared goals and shared decision-making. Nurses' professional quality of life is one of the most important factors that influence their intention to leave. Little is known about the association between nurse–patient mutuality and nurses' professional quality of life. Mutuality influences nurses' and patients' outcomes. Understanding mutuality could enhance the professional quality of life for nurses, improving their compassion satisfaction and reducing their burnout.
We adhered to STROBE guidelines.
Patients were not included in the sample. Health workers were involved in the study.
To estimate the sociodemographic and geographical variation in prescribing selective serotonin reuptake inhibitors (SSRIs) and medications for attention-deficit/hyperactivity disorder (ADHD) to children and young people (CYP) in North West London, UK.
Cross-sectional population-based study.
General practices in North West London, UK, with data for the period 2020–2022 obtained from the Discover Now platform, which covers approximately 95% of the local population.
762 390 CYP aged 5–24 years in the year 2022.
Primary outcome: Prescription rates of SSRIs and ADHD medications. Secondary outcomes: Associations between prescription rates and sociodemographic factors, including age, gender, geographical area (local authority), ethnicity and socioeconomic deprivation (measured using the Index of Multiple Deprivation).
The total sample comprised 762 390 CYP. 2.20% of the sample were prescribed an SSRI (95% CI 2.17% to 2.24%) and 0.50% an ADHD medication (95% CI 0.49% to 0.52%) in years 2020–2022. High deprivation was associated with the highest rates of an SSRI prescription (2.5%). In contrast, low deprivation was associated with the highest rates of an ADHD medication prescription (0.70%). This divergent pattern was evident in some London boroughs and not in others. The relationship between level of area deprivation and prescription rates also differed by borough. Overall, the sociodemographic factors could not explain most of the variation in prescription rates (Pseudo R2 0.18 for SSRI and 0.06 for an ADHD medication).
Prescriptions for common mental disorders and ADHD for CYP from North West London varied by sociodemographic characteristics and London borough of residence, potentially exacerbating mental health inequalities. To monitor and address these inequalities, more extensive use of linked electronic health records should be undertaken; for example, data on mental health diagnosis and service utilisation are needed to investigate the relationship between diagnosis and treatment over time.
Racial disparities in critical illness outcomes are well-described, with social determinants of health as likely contributors. We sought to identify inequalities in readmissions and mortality between black and white patients among survivors of critical illness with sepsis and assess whether these disparities were explained by neighbourhood characteristics, health insurance and hospital quality.
Retrospective cohort study examining 90-day and 9-month readmissions and survival as coprimary outcomes. Models included age, sex, race and area deprivation index (ADI), Medicaid status or hospital Centers for Medicare & Medicaid Star rating. Accelerated failure time and Cox proportional hazards models with subgroup analyses by age and surgical status were employed.
14 community and tertiary hospitals in Western Pennsylvania.
48 027 survivors of sepsis with critical illness; 20 952 (50.4%) male; 6489 (13.5%) identified as black.
Black patients were younger (mean age 59.0 years vs 65.8 years), more likely to have higher ADI, Medicaid insurance and receive care at lower-quality hospitals. Black patients had higher readmission risk: (90-day subdistribution HR (SDHR) 1.13 (95% CI 1.04 to 1.23); p=0.003); 9-month SDHR: 1.11 (95% CI 1.03 to 1.20); p=0.005). Adjusting for age and sex, we found no difference in 90-day and 9-month mortality (90-day acceleration factor (AF): 1.04 (95% CI 0.91 to 1.19); p=0.556; 9-month: 1.08 (95% CI 0.96 to 1.22); p=0.196), which remained consistent when including ADI, Medicaid status or hospital quality. Mortality among black patients was increased relative to white patients among patients ≥60 years (9-month AF 1.23 (95% CI 1.07 to 1.42; p=0.004)) and among surgical patients (90-day AF: 1.23 (95% CI 1.01 to 1.50; p=0.04); 9-month AF: 1.28 (95% CI 1.07 to 1.53; p=0.006)). Medicaid status, but not ADI or hospital quality, attenuated racial differences in subgroup mortality.
In a retrospective analysis of intensive care unit (ICU) survivors with sepsis, black patients had higher readmission rates but comparable mortality to white patients, except among older and surgical subgroups. Medicaid status influenced racial inequalities in mortality, highlighting a need for targeted post-ICU interventions.
FreshRSS 