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To explore the topics and themes covered in published research studies in nursing about neurodegenerative disease, synthesise the available evidence, and discuss future directions.
Scoping review following the Joanna Briggs Institute guidelines.
A multi-step search strategy was applied across different databases to identify studies published in English or Italian up to September 2023. Data were analysed using a Nursing Data Matrix based on the nursing meta-paradigm and the Child Health and Nutrition Research Initiative (CHNRI) 4D-framework. Screening and data extraction were performed independently by pairs of reviewers; data were extracted and thematically analysed to identify existing research questions and potential priorities.
Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Embase databases were searched for studies published from 2013 to 2023.
A total of 351 studies met inclusion criteria. The majority of studies originated from the United States (35%). Parkinson's disease and Alzheimer's disease were the most studied conditions, while rare diseases were scarcely represented. Most studies focused on nursing care (39%), with limited attention to rehabilitation (0.8%) and cost-effectiveness (1%). Although 70% of articles included at least one nurse author, 22% lacked any nursing authorship despite addressing nursing-related topics. Thematic and matrix analyses revealed an uneven distribution of research, with a predominance of descriptive studies and limited work in discovery-oriented research.
This review provides a comprehensive overview of nursing research in neurodegenerative diseases, highlighting key themes and gaps. The findings informed the preliminary identification of new nursing research priorities in neurodegenerative diseases to guide future studies and enhance evidence-based nursing care.
The study highlights key trends and gaps in nursing research on neurodegenerative diseases, calling for a more inclusive, equitable, and comprehensive research agenda.
PRISMA-ScR guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
Review registration was done on Open Science Framework, and can be viewed at https://osf.io/tn5v9 (https://doi.org/10.17605/OSF.IO/TN5V9)
To synthesise current evidence on physiotherapists’ use of electronic health records (EHRs), with a focus on the determinants of adoption, implementation processes and associated implementation outcomes.
A systematic review employing a narrative synthesis approach.
PubMed, Cochrane, Scopus and Web of Science, covering all records from the inception of each database to 10 May 2024.
Studies conducted in physiotherapy clinical settings and using the International Classification of Functioning, Disability and Health (ICF).
Two authors independently screened articles and assessed methodological quality. Risk of bias was assessed using the Critical Appraisal Skills Programme tool for qualitative and for cohort studies, the Mixed Methods Appraisal Tool for mixed-methods studies and the JBI Critical Appraisal Checklist for analytical cross-sectional studies.
From 3820 records screened, 9 observational studies met inclusion criteria. Key factors influencing EHR adoption included organisational readiness, perceived usefulness, managerial support and training availability. Implementation patterns clustered into three domains: recorded content, ICF framework integration and record quality. Reported outcomes focused on care quality metrics and evidence of clinical effectiveness.
Persistent challenges in physiotherapy EHR use were identified, notably in data quality, completeness and alignment with the ICF framework. Improving EHR practices is crucial to improve clinical assessment and support digital health integration. However, limited evidence and methodological heterogeneity remain key limitations.
CRD42023420267.
Introducción: El cáncer es una enfermedad compleja y desafiante que afecta no solo la salud física, sino también las dimensiones emocionales, sociales y espirituales de los individuos. Objetivo: Describir las experiencias de un grupo de personas sobrevivientes al cáncer. Método: Se llevó a cabo un estudio cualitativo de tipo etnográfico. La saturación teórica se alcanzó con la participación de 15 personas sobrevivientes de cáncer seleccionadas mediante muestreo en bola de nieve. La recolección de datos se realizó mediante entrevistas semiestructuradas, previo consentimiento informado de los participantes, utilizando la guía propuesta por Leininger para el análisis de datos cualitativos. Resultados: La experiencia de los participantes al haber superado el cáncer se describió en cuatro categorías: el cáncer como sinónimo de muerte, el apoyo familiar, la resiliencia como recurso psicológico crucial y la importancia de la fe en Dios como un bálsamo de vida. Conclusiones: La experiencia de recuperación ante un cáncer comienza con incertidumbre y miedo, asociando inicialmente el diagnóstico con la muerte; pero, con el tiempo, los sobrevivientes logran enfrentar la enfermedad desarrollando una actitud resiliente.
To describe the prevalence and determinants of workplace violence against nurses in the Italian home care setting.
Secondary cross-sectional analysis of data from the multicentre study AIDOMUS-IT.
Nurses employed in home care services provided by Italian Local Health Authorities were interviewed using a variety of instruments. A multivariable binary logistic regression model was performed to model the risk of workplace violence against nurses in the last 12 months. Variables related to violence were selected among sociodemographic characteristics (such as age and gender), work-related factors (including years of experience, team composition, overtime working, previous experience in mental health care, burnout) and organisational elements (including leadership and support, workload, staffing and resources adequacy, and time to reach the patients' homes). Adjusted odds ratios (aOR) were used to present the results.
A total of 3949 nurses participated in the study and 20.49% of them reported to have experienced an episode of violence in the last 12 months. Determinants of higher risk of violence episodes were younger age (aOR = 1.02, p = 0.002), higher workload (aOR = 1.01, p = 0.002), working in a multiprofessional team (aOR = 1.24, p = 0.018), perception of inadequate managerial leadership and support (aOR = 1.38, p = 0.003), and higher burnout levels (aOR = 1.01, p < 0.001).
The prevalence of workplace violence against Italian home care nurses is high. Several modifiable determinants were found to be associated with a higher risk of violence, which can potentially be mitigated with tailored interventions.
Effective preventive strategies must be developed to lessen workplace violence against nurses in the home care setting. These strategies should focus on strengthening nursing managers' leadership and support skills, enhancing team-building strategies, avoiding inadequate workload, monitoring nurses' burnout, estimating optimum staffing levels, and assigning advanced-career nurses to home care services. These measures are imperative to guarantee the quality and safety of home care organisations and to attain favourable outcomes in the provision of care.
This study aimed to explore the prevalence and determinants of workplace violence against nurses in the Italian home care settings. We found that out of the 3949 nurses surveyed, 20% of the sample reported one episode of violence during the last 12 months. Determinants of this violence included younger age, higher workload and burnout, being in a multiprofessional team, and perception of lack of leadership and support by the nurse manager. The results of this study can be used to tailor interventions aimed at mitigating the risk factors of violence, particularly those that can be modified (e.g., workload, burnout, and leadership).
The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
No patient or public contribution.
Evidence-based practice (EBP) is essential for clinical decision-making, integrating the best available evidence, clinical expertise, and stakeholder values. In Italy, interest in EBP is growing, and a key step in its promotion is adopting tools to assess nurses' beliefs and behaviors toward EBP. While the EBP Beliefs Scale has been translated and validated in multiple languages, it has yet to be adapted for the Italian context.
This study aims to adapt EBP measurement tools for the Italian context and evaluate their psychometric properties.
This study used an observational cross-sectional design. The process of cross-cultural translation, adaptation, and validation was adopted. A panel of experts culturally adapted the Beliefs Scales (long and short version) through the item and scale content validity (I-CVI, S-CVI). To test the psychometric properties, 409 nurses were asked to complete the two scales. Confirmatory factor analysis was conducted to validate the factor structure within the Italian context. Convergent validity between the long and short versions of the scale was assessed using the correlation coefficient (r), and the reliability was assessed by computing Cronbach's alpha.
The I-CVI and S-CVI for the long and short version ranged from 0.75 to 1.00. The CFA model performed for the long and short version reported a good fit without the need for further refinements. The Cronbach's alpha was higher than 0.80 for both scales. The correlation of 0.615 (p < 0.01) indicated a moderate to strong positive relationship supporting the convergent validity of the short version in relation to the long version.
In time-constrained settings, the short scale should be utilized for efficient assessments and longitudinal tracking of changes. The long version serves as a complementary tool for in-depth analysis, facilitating a deeper understanding of underlying factors and informing targeted interventions to address specific barriers.
Uterine serous carcinoma (USC) accounts for 40% of endometrial cancer-related deaths. The standard of care for stages III and IV USC yields a 20%–30% survival at 2 years and a 10%–20% survival at 3–5 years. Recent advances in the second-line treatment of advanced or recurrent USC are rapidly evolving. Targeted therapeutic approaches with the use of lenvatinib plus pembrolizumab, as well as the use of trastuzumab deruxtecan, offer new hope for successful second-line therapies for patients. However, further investigation into novel targeted therapeutic approaches is warranted, given the high burden of disease associated with this aggressive histological subtype. USC shares clinical and genomic similarities with epithelial ovarian cancer, suggesting a correlation with ‘BRCAness’. Niraparib, a potent PARP1 and PARP2 inhibitor, was shown to have a positive impact on platinum-sensitive recurrent ovarian cancer, regardless of the presence or absence of BRCA status. Our hypothesis is that patients with stage III, stage IV and platinum-sensitive recurrent USC receiving niraparib maintenance in addition to standard therapy for USC may have an improved progression-free survival.
Participating sites include the primary site, Northwell Health Zucker Cancer Centre, and secondary site, Rutgers Cancer Institute of NJ. Females over the age of 18 with stage III, stage IV or platinum-sensitive recurrent USC will be recruited and enrolled based on inclusion/exclusion criteria. 24 subjects will be enrolled during phase 1 and 21 subjects will be enrolled during phase 2, over a total of 3 years. Patients will receive an individualised dose of niraparib daily every 28 days per cycle for 1 year or until progression of disease. Follow-up of disease status will continue for 5 years poststudy treatment. This phase II clinical trial will employ a Simon two-stage minimax design to test the null hypothesis that the 1 year response rate is
Ethical approval was granted by Northwell Health Cancer Institute institutional review board (reference number: 19–0380) and PRMS. Alongside journal publications, results will be available publicly on completion of the study as approved by the sponsor investigator.
NCTN04080284
The primary aim of this study was to evaluate the impact of the polyhexamethylene biguanide (PHMB) care bundle on the occurrence rates of surgical site infections (SSIs) in paediatric and neonatal cardiac surgery, addressing a critical gap in paediatric-specific infection prevention protocols. A retrospective cohort study included patients under 18 years old who underwent cardiac surgery at IRCCS Policlinico San Donato. Cohort A (n = 117) received the PHMB care bundle from April to December 2023, while Cohort B (n = 801) received conventional care from September 2020 to March 2023. The 1:1 propensity score matching was used to balance covariates between cohorts, resulting in two comparable cohorts (Cohort A = 114 patients and Cohort B = 112). The study found a significant reduction in SSIs among patients receiving the PHMB care bundle compared with those receiving conventional care (1.8% vs. 7.1%, p = 0.048). The comprehensive nature of the PHMB care bundle, including educational programs, preoperative and postoperative antimicrobial treatments, and consistent application of best practices, was instrumental in achieving these outcomes. Implementing antimicrobial care bundles could significantly reduce SSIs in paediatric cardiac surgery. Future research is needed to refine the tested bundle with prospective approaches.
Nurses' job satisfaction in hospitals is fundamental for the quality of care and the safety of patients. However, sociodemographic trends require moving care to patients' homes, and the predictors of job satisfaction for nurses working in the home care settings remain largely unknown. Therefore, the aim of this study was to investigate job satisfaction of nurses working in Italian home care settings and its determinants.
Multicenter observational cross-sectional study.
This study was conducted in the districts of 70 local health authorities in Italy. Data on the characteristics of the organization and nurses were collected. Nursing job satisfaction was evaluated on a four-point scale ranging from “very satisfied” to “very dissatisfied.” Additionally, the following variables were assessed: workload, quality of leadership, work–private life conflict, burnout symptoms, possibility for development, staffing and resource adequacy, nurse manager ability, safety climate, and teamwork climate. A logistic regression analysis was conducted to identify factors influencing job satisfaction.
Only organizational variables had a predictive value for nurses' job satisfaction. Workload (OR = 1.01; p = 0.033), work–private life conflict (OR = 1.02; p < 0.001), burnout (OR = 1.02; p < 0.001), and staffing inadequacy (OR = 1.44; p = 0.003) predicted higher levels of nurse dissatisfaction. Instead, high-quality leadership (OR = 0.981; p < 0.001), possibility for development (OR = 0.973; p < 0.001), and good teamwork climate (OR = 0.994; p = 0.003) were predictors of better levels of satisfaction.
This study suggested that home care nurses are generally satisfied with their jobs. To enhance job satisfaction, it is essential to improve nurses' work environment, the leadership quality and ensure professional development.
Our results are globally relevant as they contribute to the limited evidence available on this topic in home care settings. This study emphasizes the need of measuring nurses' job satisfaction and implementing interventions to promote healthy work environments.
Introducción: En la atención del parto es primordial brindar cuidado humanizado a la madre, garantizando de esta forma el respeto a su dignidad, bienestar y cultura. Objetivo: Describir la atención y cuidados que brinda el personal de enfermería durante el parto a mujeres hablantes de lengua náhuatl y comparla con la percepción de las y los enfermeros. Materiales y método: Investigación cualitativa, con ocho mujeres hablantes de la lengua náhuatl de Uxtuapan, a quienes se les realizó una entrevista semiestructurada mediante grupo focal y una segunda entrevista individualizada en domicilio. También se entrevistaron a 11 profesionales de enfermería con grabadora de voz. Se transcribieron las entrevistas, se identificaron unidades de significado, se recategorizó y se describieron los resultados a través de la conformación de categorías: Cuidado, Entorno, Cultura, Relación ayuda-confianza. Se respetó la confidencialidad de los datos. Resultados: La falta de comunicación, tiempo e interacción en la relación enfermera-paciente favorece una percepción errónea de las pacientes ante su cuidado, denotando maltrato, soledad, falta de empatía. Conclusión: Para asegurar el cuidado humanizado en la atención del parto, se requiere mantener una conexión con las mujeres y cuidadores, donde se respeta su cultura y se favorece la seguridad de la vida humana.
Durante la Segunda República en España, la elevada mortalidad infantil llevó al gobierno a implementar políticas sanitarias centradas en la prevención y promoción de la salud. Se creó la Escuela Nacional de Puericultura, destacando la importancia de la formación especializada para abordar la salud infantil. La institución, a pesar de ser fundada en 1923, consolidó su actividad y estatutos en 1935. La formación de Visitadoras Puericultoras en la escuela era crucial para actuar como enlace entre médicos y familias, promoviendo la educación sanitaria. Durante el periodo previo a la guerra civil, se intensificaron las actividades formativas y la Escuela se convirtió en esencial para la ejecución de políticas preventivas. Con el estallido de la guerra civil en 1936, la situación cambió drásticamente. A pesar de la adaptación a las nuevas circunstancias, con la convocatoria de cursos abreviados, se mantuvo el compromiso de formar profesionales especializados. Las convocatorias, como la de 1937 en Valencia, reflejan la necesidad de personal capacitado en medio de la guerra. Este estudio revela la importancia de las políticas sanitarias en contextos de crisis y la adaptación de la formación a las circunstancias cambiantes, subrayando la relevancia de mantener la atención a la infancia incluso en tiempos de emergencia.
To identify the current presence of stereotypes about the nursing profession in Italy and to understand how gendered processes and modalities are regulated and expressed in the physician-nurse dyad, and the implications for professional identity and autonomy.
Qualitative multimethod design.
Forty-five interviews were conducted with nurses and physicians. The collected qualitative data underwent automatic textual data analysis using a multidimensional exploratory approach and a gender framework analysis.
In Italy, nurses' roles are still associated with gender stereotypes stemming from the predominant male culture, which affects sexual and gender identity, the division of labor, and access to career paths. This leads to disadvantages in the nursing profession, which is heavily dominated by women.
Biological differences between sexes generate an unconscious yet shared symbolic gender order composed of negative stereotypes that influence nurses' professional roles and activities. They follow behaviors that enter the work routine and institutionalize organizational processes. These effects are also seen in the asymmetric, limited, and reciprocal interprofessional relationships between male physicians and female nurses, where the former hinders the latter's professional autonomy and access to top positions.
This survey raises awareness of gender issues and stimulates reflection. It also enables health and nursing organizations to take action to raise gender awareness and education by countering the image of a non-autonomous profession. The analysis of gender processes allows us to identify interventions that can counteract forms of oppression in the work environment that lead to the emergence of nursing as a non-autonomous profession.
To describe how workplace violence (WPV) is experienced by nurses in hospitals and community services and identify protective and risk factors.
An online cross-sectional national study was conducted from January to April 2021 in Italy. Hospitals and community services were involved in the study. The survey combined the adapted and validated Italian version of the Violence in Emergency Nursing and Triage (VENT) questionnaire, which explores the episodes of WPV experienced during the previous 12 months, the Practice Environment Scale of the Nursing Work Index (PES-NWI) and some additional questions about staffing levels extracted from a previous RN4CAST study. Nurses working in all clinical settings and community services were invited to participate in the survey. Descriptive and inferential statistics were used for data analysis. We adhered to the STROBE reporting guidelines.
A total of 6079 nurses completed the survey, 32.4% (n = 1969) had experienced WPV in the previous 12 months, and 46% (n = 920) reported WPV only in the previous week. The most significant protective factors were nurses' age, patients' use of illegal substances, attitude of individual nurses and considering effective the organization's procedures for preventing and managing episodes of violence. The most significant risk factors included workload, recognizing violence as an inevitable part of the job, patients' cultural aspects and patients' agitated behaviour. The frequency of WPV was significantly higher in certain areas, such as the emergency department and in mental health wards.
Workplace violence (WPV) against nurses is a very frequent and concerning issue, especially in hospitals and community services. Based on our findings, integrated and multimodal programmes for prevention and management of WPV are recommended. More attention and resources need to be allocated to reduce WPV by improving the quality of nurses' workplace environment and implementing violence-free policies for hospitals.
Workplace verbal and physical violence is a widespread phenomenon, both in hospital and community settings, and even during COVID-19 pandemic. This problem is exacerbated by the lack of effective reporting systems, fear of retaliation and the tendency to consider violence as an inevitable part of the job. The characteristics of professionals, patients, work environment and organizational factors are involved in the spread of workplace violence, determining its multifactorial nature. Integrated and multimodal programmes to prevent and manage of workplace violence are probably the only way to effectively counteract workplace violence against nurses. Healthcare policymakers, managers of hospital and community services need to proactively prevent and effectively manage and monitor episodes of violence. Nurses need to feel protected and safeguarded against any form of verbal or physical violence, to provide high-quality care in a totally safe environment.
No patient or public contribution.
Se presenta el caso clínico de una recién nacida de 3 días de vida que acude a la consulta enfermera de pediatría de Atención Primaria para realizar la primera visita, incluida en el Programa de Salud del Niño Sano. En ella, la madre describe que, durante su ingreso en la maternidad, tras el parto, manifestó su deseo de no lactar, por tanto, se prescribió Cabergolina como fármaco inhibidor. Sin embargo, actualmente, desearía reiniciar la lactancia materna. Tras realizar la valoración enfermera por patrones funcionales de Marjory Gordon, se detectaron dos patrones alterados y se estableció un plan de cuidados individualizado, utilizando la taxonomina NANDA-NOC-NIC.
Objetivo principal: Identificar la evidencia disponible en la literatura sobre el efecto de la musicoterapia en el dolor de pacientes adultos durante el postoperatorio. Metodología: Revisión integradora de literatura realizada en las bases de datos CUIDEN, CINAHL, PubMed, LILACS, SCIELO, EBSCO, SCOPUS, Web of Science y Google Scholar considerando artículos desde 2019, al 2022, utilizando los descriptores “musicoterapia”, “dolor postoperatorio” y “adulto”. Los datos se presentan de forma descriptiva. Resultados principales: Se encontraron 314 artículos, una vez filtrados se analizaron 18. Todos los pacientes presentaron algún nivel de dolor durante su periodo postoperatorio, algunos además, experimentaron depresión, temor y ansiedad y la musicoterapia demostró disminuir todos estos síntomas, ningún estudio reportó la presencia de alguna complicación durante su implementación. Conclusión principal: La música bien utilizada produce efectos positivos en los pacientes con cáncer, dolor, depresión, estrés, temor durante el periodo postoperatorio y en pacientes sometidos a procesos invasivos, es una intervención económica, inocua. Se puede utilizar por los enfermeros como parte del cuidado holístico y como tratamiento complementario de la farmacología analgésica.
Objetivo principal: Conocer los conocimientos y percepciones de los profesionales sanitarios sobre el método madre canguro (MMC) en las unidades neonatales españolas. Metodología: Estudio transversal, observacional y descriptivo, mediante encuesta online. Resultados principales: 331 profesionales respondieron la encuesta. 83,7% estaban formados en MMC. Respecto a las percepciones y barreras, no hubo diferencias significativas entre profesionales según su formación en MMC. La limitación con mayor porcentaje fue la inestabilidad hemodinámica con un 82,8%. Un 55,3% afirmó haber puesto limitaciones al MMC debido a la pandemia por SARS-CoV-2 y un 96,4% estableció que sería útil disponer de una guía de consenso sobre MMC a nivel nacional. Conclusión principal: Los profesionales sanitarios de las unidades neonatales españolas están formados en el cuidado MMC, conociendo bien cuáles son sus beneficios, pero todavía afloran algunas percepciones que pueden interferir en la implantación eficaz del MMC.
Actualmente, la salud digital permite incorporar la tecnología de la información y comunicación para mejorar la asistencia sanitaria, incrementando su efectividad y eficiencia. El desarrollo de herramientas digitales relacionadas con la lactancia materna facilita que los profesionales de la salud puedan mantenerse actualizados, buscar información o resolver dudas relacionadas con la lactancia, así como permite mejorar la atención y proporcionar un apoyo más eficaz a las madres que desean lactar o están lactando. Este artículo trata de describir una serie de recursos e intervenciones digitales relacionadas con la lactancia materna.
El paciente con Covid-19 en UCI presenta una alta carga de trabajo de enfermería, sumado al aumento de personal no formado, surge la necesidad de estandarizar un PAE. El objetivo es la presentación de un PAE de un paciente con Covid-19 en la UCI para aportar el conocimiento necesario para ofrecer una atención óptima y holística. En estos pacientes hay que valorar el requerimiento de sedoanalgesia y relajación, la tolerancia a la nutrición enteral, las hiperglucemias por estrés y corticoterapia, así como la vigilancia de la monitorización y ventilación mecánica. Debido a la posición prona, estos pacientes tienen riesgo de úlceras por presión. Los principales diagnósticos de enfermería están relacionados con el sistema respiratorio: limpieza ineficaz de las vías aéreas y deterioro del intercambio de gases. Por la sedoanalgesia existe un alto riesgo de síndrome de desuso, de lesión corneal, de úlceras por presión...en lo que se debe prestar aten-ción.
Objetivo principal: Analizar si una intervención de enfermería de información sobre la cirugía y el circuito quirúrgico, tendría como efecto la disminución del nivel de ansiedad en el familiar del paciente quirúrgico programado. Metodología: Ensayo clínico controlado no aleatorizado. Se efectúa la comparación del nivel de ansiedad entre los familiares pertenecientes al grupo control (con intervención estándar preexistente) respecto a los del grupo intervención (sometidos a la nueva intervención de enfermería). Se utiliza un instrumento validado como el inventario de ansiedad estado-rasgo (STAI) para medir el nivel de ansiedad. Resultados principales: Participaron en el estudio 76 familiares, 37 en el grupo control y 39 en el grupo intervención. Ambos grupos eran comparables respecto a sus características basales. Se observa una disminución estadísticamente significativa en la ansiedad situacional durante el postoperatorio en el grupo intervención respecto al grupo control. Conclusión principal: Una intervención de enfermería de información sobre la cirugía y el circuito quirúrgico reduce la ansiedad situacional del familiar del paciente quirúrgico programado.
La experiencia de someterse a un procedimiento quirúrgico operativo es una de las más estresantes para el ser humano, debido a que obliga a hacer adaptaciones psicológicas y fisiológicas importantes en el organismo lo que aumenta el riesgo de presentar complicaciones durante el mismo; para disminuir este riesgo se proporciona cuidados de enfermería integrales-holísticos a través de la musicoterapia, la cual es una intervención que disminuye los factores estresores, modifica el entorno y reduce el nivel de estrés fisiológico y psicológico. Este artículo propone especificaciones para la implementación de musicoterapia durante el procedimiento quirúrgico, aun que la Nursing Interventions Clasificación (NIC) ya la incluye, en México aún no se implementa en los quirófanos. Al hacer efectiva la implementación de esta intervención se mejora la calidad de vida de la persona a través de una atención de enfermería de excelencia.
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