The experience of the emergency psychologist during the Covid-19 pandemic

BACKGROUND AND AIM OF THE WORK

the new coronavirus pandemic COVID-19 has had a strong psy- chological impact on the world population. Volunteer psychologists, and psychologists that work in the emer- gencies have also been exposed to the consequences of the impact of the pandemic. The purpose of this study was to explore the experiences of the psychologist during the Covid-19 emergency intervention.

METHODS

an exploratory study, following a qualitative design using Focus Group method was adopted. A total of 24 psychologists was recruited from volunteers of the "Pronto Pșy - Covid-19" service, organized by the Ital- ian Society of Emergency Psychology Social Support, Emilia Romagna. Focus Group Discussions (FGDs) was held about: their experiences during the online psychological support; needs detected by users; training needs that emerged during the intervention and professional skills applied.

RESULTS

five themes were identi- fied: psychological distress of rescuers; online emergency setting; support of colleagues and gratitude as stress management strategies; need of skill and tools in pandemic emergency intervention; integrated psychological intervention.

DISCUSSION

the stress reaction of the emergency psychologists was due in particular to the type of emergency and lack of standardized approach. The group meetings represented an important resource to face traumatic stress.

CONCLUSIONS

this study showed the role the need for specific tools for pandemic intervention to protect the well-being of the professional from impact of stress. Further research is needed. (www.actabiomedica.it).

Intraosseus access vs ecoguided peripherical venous access in emergency and urgency: a systematic review

BACKGROUND AND AIM OF THE WORK

Ensuring vascular access in emergency conditions is critical. Peripheral venous catheters (CVP) are the most used devices in clinical practice, even though their positioning can result difficult, causing delay in life-support treatments with possible critical results. Ultrasounds allow you to view blood vessel in real time, for this reason they could result helpful during use. Another option for the vascular access can be intraosseous access (I.O.), by introducing a needle directly in the bone marrow cavity. This review aim is to examine what typology of vascular access is best for the drug delivery in emergency/urgency in international and national literature.

METHODS

Bibliographical research was conducted by consulting the main biomedical databases through keywords and MESH terminology. In this review 21 articles published in the last 7 years have been included. They were published in English, Italian and French.

RESULTS

Contraindications and complications of I.O and of ultrasound-guided CVP positioning are limited. I.O access finding attempts are as fast as CVP positioning attempts but with a higher chance of success. Furthermore, ultrasound-guided CVP insertion is more comfortable for patients, it minimizes delays in medical treatment and it guarantees a better healthcare, with high percentage of right venous catheter placement.

CONCLUSIONS

Intraosseous access is recommended for severely compromised patients; the ultrasound guide is a very useful tool when peripheral vascular areas are difficult to detect with only the palpation, it would be more appropriate in situations of urgency than that of emergency.

Interprofessional collaboration between different health care professions in Emilia Romagna

BACKGROUND

Interprofessional collaboration in the healthcare sector contributes to the delivery of high quality and safe services to patients across different subdivisions of the healthcare system which is faced with constant challenges. The international literature offers a plethora of tools for assessing the collaboration between health workers, but only a few of these have been validated in the Italian language. One that has undergone such validation is the interprofessional collaboration (IPC) scale, which measures the perception of collaboration among health professionals. An advantage of this scale is that is addresses all workers within the system, and is not limited to specific professions. The aim of the present study was to apply the validated Italian version of the IPC scale, to a context different to the one used for its validation, to measure the level of collaboration between different health care workers.

METHOD

A questionnaire-based study was conducted on a sample consisting of 329 health professionals working at Azienda USL-IRCCS in Reggio Emilia. The categorical and continuous variables were analysed using descriptive statistics (frequencies, percentages and SD).

RESULTS

The IPC scale showed physicians to express the highest level of collaboration with other professionals, in line with the results of other studies in the literature. The values calculated for the factors "accommodation" and "communication" were higher than for "isolation", depicting a good level collaboration. The only case in which the isolation factor, which describes an absence of collaboration, was equal to the other two factors was in relation to the evaluation of midwives by nursing aides/orderlies.

CONCLUSIONS

In conclusion, the Italian version of the IPC scale provides a useful instrument for measuring interprofessional collaboration between workers in the healthcare sector. In the present study, it revealed a satisfactory level of collaboration between health professionals in an organization located in Emilia Romagna, Italy.

"Growing through relationship" - the Engagement of the Health Professional Students in the Internship Experience: a Grounded Theory Research

BACKGROUND AND AIM

Little is known about the students' engagement in the training experience and how it is lived by the health professional students. We aim at building a theoretical model of the engagement process starting from their lived experiences with Grounded Theory approach.

METHODS

In-depth qualitative interviews are conducted with 12 students from the Master Degree Courses in Nursing, Physiotherapy and Prevention Techniques in the environment and in the workplace, who had carried out and/or were doing internships in the same territory (2nd and 3rd year). Results The health professions' student engagement in the training program is developed in three main phases: initial phase, central phase and final phase, where emotions, behaviours, awareness contribute to the development of the entire engagement process with different relevance. The intertwining of these different components that develop along the stages of the experience gives life to the core category: growing through relationship, which expressed the crucial role of the relational network built during the internship experience in shaping students' engagement.

CONCLUSIONS

The results of this study underline the crucial role of students' engagement in the internship experience in favouring both better learning outcomes and perspective professional success and wellbeing. (www.actabiomedica.it).

The safety of care focused on patient identity: an observational study

Background and aim:

Healthcare organizations, to reduce errors and extend the number of safe practices, are looking for possible solutions to enhance the clients’ health quality care and trying to spread the culture of safety healthcare. Although in the literature the field of research “patient safety” is very debated, there are few empirical studies that investigate about the strategies undertaken by nursing students for the patients’ identification process during their care pathway. The aim of this study is to investigate the knowledge of the Ministerial Recommendation No. 3/2008 among nursing students, a specific Italian directive that aims to guarantee the safety of cares.

Methods:

A four-weeks single-centered observational study was conducted, involving a convenient sample of 112 students of the 2^nd and 3^rd year of the Nursing Course Degree of the University of Parma. The survey was conducted using an ad-hoc questionnaire.

Results:

The use of the identification wristband is considered one of the most important strategy to make sure the patient identification; unfortunately, it is in practice used just on few occasions and only when performed specific procedures; it is furthermore noted that patients are not enough informed about the use and finalities of the identification wristband.

Conclusions:

Considering the importance of the patient identification process to guarantee the safety of cares, the results produced, suggest that this investigation field deserves further insights in order to collect more substantial data and expand knowledge on the specific subject, so as to fill knowledge gaps and sensitize nursing students to the correct use of the identification wristband.

A protocol for Italian validation of DEMQoL-Proxy Scale: assessing the Quality of Life of people with moderate or mild dementia

In this paper, we propose an adaptation of a protocol for a tool's validation. We have utilized this phases-theory to validate in Italian language an instrument to assess Quality of Life for people with moderate or mild dementia. We will explain the example of our Italian validation of DEMQoL-Proxy considering each De Vellis's phase. We will explain our application of De Vellis's model to Italian example described. For the first three phases, we reproduced the original validating study in which authors (Smith et al., 2005) defined what to measure, how generate a set of items and the structure of the scale. Indeed, for the last five phases we explained the adaptation of De Vellis's model to Italian validation. We hope that this model could be effective to validating goals, for researchers and in particular for all professionals who deal with caregivers and patients with moderate and mild dementia. Furthermore, the measurement of the Quality of Life makes the scale widely useful within the various professional specialties and setting. Finally, thanks to the methodological assumptions adopted following the De Vellis's eight-phase model, we can affirm that this first Italian pre-validation of the DEMQoL-Proxy seems to be an excellent forerunner for its effective validation in the Italian context.

Nurse's identity role during Covid-19

Background and aim of the work:

The main purpose of this study is to investigate on the experience of nurses working in the Covid-19 area focusing on their role’s perception. In particular, we explored the nurses’ perception of job satisfaction in relation to the images sent back by public opinion through the mass media and social communication channels. During the first wave of Covid-19 nurses have acquired media visibility, but their feeling is represented more by the discomfort of finding themselves suddenly glorified in the face of a lack of professional, social, and economic recognition.

Materials and methods:

A Mix-Method methodology and convenience sampling was adopted, on the population of professionals and students in post-graduate specializations, belonging to the Department of Medicine and Surgery of the University of Parma, and by nurses from the ASST-Bergamo Est, Lombardia Italy, who worked in the Covid emergency during the first

wave

of the pandemic, from February 2020 to May 2020. In the quantitative phase Stamm’s Professional Quality of Life Scale - ProQOL was administered to 89 respondents through a Google Form, In the qualitative phase, 3 Focus Groups were conducted on a total of 17 students.

Results:

At the ProQOL questionnaire, a moderate score was found in the Compassion Satisfaction scale (CF = 38.28) and in the Secondary Traumatic Stress subscale (STS-24.33), while low values emerged in the Burnout subscale (BO = 16.02). Five specific topics emerged from the focus groups: Professional collaboration, Job satisfaction, Nurse’s personal skills, Failure to protect the public image and the nursing profession.

Conclusions:

The professional collaboration, union with the work team, sense of solidarity, job satisfaction, professional growth, and awareness of one’s role seem to have worked favorably on Compassion Satisfaction, while keeping Compassion Fatigue levels under control.

Nomophobia in healthcare: an observational study between nurses and students

BACKGROUND AND AIM

The abuse of technical devices can be considered a form of addiction that is defined in current literature as Nomophobia. The phenomenon appears to be quite widespread among nurses and nursing students, and nomophobic behaviours of professionals can lead to a reduction in the quality of the care provided. The aim of this study is to investigate the situation in a University and in a hospital in northern Italy and evaluate the levels of nomophobia among nurses and students.

METHODS

An observational study was conducted with a questionnaire using a sample of nursing students and nurses.  Both of the studies had the common goal of investigating the levels of nomophobia and   evaluate the comparison between the two groups.

RESULTS

In general, neither nurses nor students seem to demonstrate nomophobia's critical levels. The comparison of the daily use of the smartphone between nurses and students shows that the frequent use of students is balanced by the nurses' daily trend line that progressively decreases. Both nurses and students affirm to use their smartphones at work with a certain frequency although, especially among the students, it is usually for appropriate and justified reasons.

CONCLUSIONS

It is necessary to consider the development of an educational project that regulates the use of smartphones, explaining the meaning of nomophobia, right from the first year of the University experience so as to correctly address the students'  (and future professionals') behaviours  to make them aware of the misuse of mobile phones, especially in the clinical setting that can easily cause distractions and consequently irreversible  errors.

The global health community must stand for health and democracy in Myanmar

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The qualitative method for a humanisation of research

Huge progress in scientific research, added to vast investments, have allowed to develop vaccines against the virus responsible for Sars-Cov-2 in times unimaginable, until recently (1). The use of these vaccines has documented their high efficacy and very low risk of adverse events. Undergoing vaccination campaigns around the world are changing the history of the COVID-19 pandemic. Never before has scientific research been a topic of widespread interest as in this period. [...].

Taking care. Nursing towards Covid-19 patients during the pandemic emergency in Italy: a qualitative study

BACKGROUND AND AIM OF THE STUDY

The Covid-19 pandemic has clearly impacted the Italian healthcare system. The growing number of patients in critical conditions has required a reorganization of the hospitals wards and of other healthcare structures, by changing the working routines of health professionals. The aim of the study is to explore if and how the nursing care towards Covid-19 positive patients have changed during the pandemic.

METHOD

Qualitative study with a phenomenological approach conducted through semi-structured interviews. Interviews have been carried out during the months of October and November 2020. Our research involved 21 nursing professionals attending post-graduate courses at the Department of Medicine and Surgery of the University of Parma (academic year 2019/2020) and who have worked during the pandemic period in health services structures and organizations.

RESULTS

The interviews showed how, during the period of the pandemic emergency, the care relationship between nurses and patients has changed because of the priority given to clinical and technical practices, in some cases, "life-saving". This happened due to different factors such as the nurses' fear of being infected by the virus and the lack of a sufficient time to ensure an holistic and integrated approach towards an increasing number of patients in highly complex conditions. Thus, the dimension of caring has been consciously overshadowed.

CONCLUSIONS

The health emergency that has hit Italy since the first months of 2020 has shown structural limits and gaps of public health policies, hospital settings and national health services organization that already existed in the pre-pandemic period. It also highlighted how, even before Covid-19, nursing was already in part denoted by a loss of caring, a missed nursing care.

Take a picture! The role of visual methods in understanding psychiatric patient's everyday life

Background and aim:

Understanding the patient’s experience of mental illness can foster better support for this population and greater partnership with healthcare professionals. This study aims to explore the application of visual methods in the psychiatric field and, in particular, the experience of people suffering from psychotic disorders, because it is still an open question that has not been only partially empirically examined.

Methods:

This qualitative study was conducted using two visual methods (auto-photography and photo-elicitation) associated with the narrative that emerged from an unstructured interview, in a clinical setting of adult Mental Health in Italy, between October 2019 and February 2020. A total of 5 patients and 5 corresponding referring healthcare professionals were identified and enrolled. Patients were asked to produce photographs following 4 thematic areas: “Fun”, “Time”, “Something indispensable”, “Place where I feel good”.

Results:

A total of 85 photographs were produced. Visual methods have proved to be a useful technique in qualitative research in the area of adult psychiatry. From the interviews it emerged that visual methods have allowed psychotic patients to use a new language to be able to communicate their emotions.

Conclusions:

The healthcare professionals involved also confirm the potential of this tool which, when combined with the traditional interview, is able to deepen the patient’s knowledge by overcoming the verbal barriers that often make it difficult to reconstruct the individual experience of illness.

The intervention of the emergency psychologist: the SIPEM SoS Emilia Romagna during the first lockdown from COVID-19

Background and purpose of this work: WHO 11 March 2020 declares that Sars-Cov-2 infection is not only a health emergency but must be considered a pandemic. Covid-19 required the urgency of a new psychological intervention model to better address the crisis and ensure a direct support response to the people involved in the pandemic. The present study aimed to detect the symptoms and reactions of the population with respect to the event. The survey was carried out by describing the clinical symptoms that emerged from the triage card used by SIPEM SoS Emilia Romagna (Italy), connoting the criteria of emergency psychology.

METHODS

A retrospective quantitative study was conducted on 288 psychological triage cards.

RESULTS

only 11% of users who ask for support say they are positive while 85% report not having contracted the virus. Of the total, 40.9% call for psychological support in the management of anxiety symptoms, a need also reported by 55% of the subsample who declared previous psychological problems. In reaction to the pandemic event, 51.1% of the total refers to coping resources and availability for help.

DISCUSSIONS

the need for support of the population to manage symptoms highlights the need for early interventions, also to facilitate that slice of the population that does not have effective individual coping strategies and resources available to help.

CONCLUSIONS

it can be deduced that interventions during these types of emergencies must be timely and aimed not only at those affected but also at the general population.

Effectiveness of Expressive Writing protocol in Palliative Care Healthworkers: a quantitative study

BACKGROUND AND AIM OF THE WORK

Palliative Care professionals are exposed to intense emotional environment. This puts them at risk for Compassion Fatigue and Burnout. The protective factors that can counter their onset are Compassion Satisfaction, Organizational Commitment and Resilience. Expressive Writing is a valid tool for adapting to traumatic events and enhancing psychological well-being. Aim of this study is to evaluate the effect of the Expressive Writing in Palliative Care professionals on Compassion Satisfaction, Organizational Commitment, Resilience, Compassion Fatigue and perceived distress.

METHODS

Prospective experimental study with experimental/control groups and pre/post measurements. 50 Palliative Care professionals were recruited in Northern and Central Italy. Participants filled: Organizational Commitment Questionnaire; ProQol - revision III; Resilience Scale for Adults; Impact of Event-Scale Revised; Emotion Thermometer; ad hoc questionnaire for the evaluation of protocol usefulness.

RESULTS

Wilcoxon test demonstrated change in Continuative Commitment (Z = -3.357, p = .001), anger (Z = -2.214, p = .027), sleep (Z = -2.268, p = .023), help (Z = -2.184, p = .029), intrusiveness (Z = -2.469, p = .014), hyperarousal (Z = -2.717, p = .007), and total IES (Z = -2.456 , p =, 014). Mann Whitney test showed a significantly lower score on post-test Intrusiveness in the experimental group (U = 202, p = .038).

CONCLUSIONS

The Expressive Writing intervention was effective in improving organizational and emotional variables. Expressive Writing supports healthcare professionals in relieving the burden of traumatic episodes, ordering associated thoughts and emotions, and implementing a process of deep comprehension.

First Italian validation of the "Satisfaction with simulation experience" scale (SSE) for the evaluation of the learning experience through simulation

BACKGROUND AND AIM OF THE WORK

Training in simulation through "mannequins" is increasingly widespread among nursing students. In the Italian context, however, there are no tools that measure the degree of student satisfaction after clinical training through simulation. The aim of the study is to provide a first validation in Italian of the Satisfaction with simulation experience" (SSE) scale, a tool already validated in several languages.

METHODS

After obtaining the author's consent, the SSE was subjected to forward and backward translation. The content validity was assessed by 5 training experts by calculating the Content Validity Index by Item and by Scale (I-CVI and S-CVI); the face validity was tested on 4 nursing students who had participated in a simulation experience. Subsequently, the SSE was administered to 10 nursing students with test-retest after 7 days in order to evaluate the reliability by calculating the reliability coefficient (r) and Cronbach's α.

RESULTS

The author approved the final version of the SSE translated into Italian: I-CVI values>0.80 and S-CVI was 0.94. r is 0.88 and the α of the scale is 0.713.

CONCLUSIONS

The detected values of I-CVI and S-CVI are satisfactory, demonstrating the validity of the content of the SSE-ITA. The test-retest showed "optimal" reliability and the α was considered acceptable given the little deviation from the original (0.776). Although the results demonstrate satisfactory values, this is a first validation and other studies with larger samples are needed.

Nursing spiritual assessment instruments in adult patients: a narrative literature review

Background and aim of the work:

Spiritual care in nursing is a critical part of providing holistic care. Whilst patients might desire spiritual care and value the opportunities that nurses take to engage with them to meet their spiritual needs, research suggests that nurses do not consistently engage in spiritual care with their patients. To identify instruments available to nurses to assess spirituality in different patient groups and highlight the characteristics and psychometric properties of these instruments.

Method:

A narrative literature review of the relevant literature published after 2008 was carried out in CINAHL, PsycINFO, MEDLINE and Google scholar databases in October 2020. Narrative review synthesized key findings and grouped instruments into macro areas by content.

Results:

After the screening, based on inclusion criteria, 31 articles were identified. 17 instruments were identified and divided into 4 macro areas: wellbeing (N = 4), attitude (N = 5) needs (N =6) and multiple domains (N = 2).

Conclusions:

This review enables an increased awareness of the variety of instruments available to aid spiritual care and therefore increase their use within nurse clinical practice. The widening of the patient group to be considered (i.e., non-oncological) may have a significant impact on the practice, causing professionals to reflect on the necessity to investigate spiritual needs even at an early stage of a disease process. Future studies should aim to test reliability and validity of existing instruments rather than develop further ones. (www.actabiomedica.it)

Health professionals' perception of appropriateness of care: a qualitative study in Italian pediatric hospices

Background:

Appropriateness is particularly relevant in palliative care, an area in which it is essential to question the real need for treatments. Few studies explored the perception of appropriateness by professionals in pediatric palliative care, revealing the conflict sometimes faced when confronted with the uncertainty of prognosis and end-of-life decisions.

Aims:

The objective of this study is firstly to investigate the perception that doctors, nurses and psychologists, operating in Italian pediatric hospices, have of the appropriateness of the care they provide. Secondly, to understand what repercussions the perception of non-appropriateness has at individual and team level.

Methods:

A qualitative study was conducted between 2019 and 2020 through semi-structured interviews with a convenience sample of 17 professionals working it Italian pediatric hospices.

Results:

The interviewees do not refer to a common concept of appropriateness, but compare the latter to: the quality of life, the global care of the assisted person, the proportionality of care, the early recognition of the need for palliative care. The discussion within the team emerges as a privileged place to manage the discomfort of individual professionals in the face of treatment choices in conflict with their own values.

Conclusion:

the non-referring to a univocal conception of appropriateness deprives professionals of an objective criterion to resolve the most difficult decisions. However, it allows them to establish what from time to time seems to be the most appropriate care pathway for a given patient, at a given time and context, preserving the goal of personalized care. (www.actabiomedica.it)

Psychosocial precursors of the correct sanitation and sanitization of the patient unit in the hospital setting

BACKGROUND AND AIM OF THE WORK

Worrying data indicate the urgency of strongly limiting Healthcare-Associated Infections (HAI). Therefore, according to the Theory of Planned Behavior, the psychosocial precursors of correct sanitation and sanitization were assessed.

METHODS

An Italian sample of hospital health workers (nurses, healthcare assistants, cleaners; N=250), replied to a validated questionnaire measuring: a) knowledge of HAI; b) favorable attitude towards the correct sanitation and sanitization procedure; c) perception that the management and colleagues give importance to the government of infectious risk; d) perception of being able to implement risk management behaviors; e) perception of having received proper training for the prevention of HAI.

RESULTS

The results show many mistakes about knowledge, the perception of insufficient specific training, and not always favorable attitude towards sanitation and sanitization practices. Workers also perceive that they can act the required behaviors and that the management of infectious risk represents a value in the group they belong to, but they believe that the management does not offer sufficient support.

CONCLUSIONS

The improvement of the factors considered (knowledge, personal attitudes, actions of management and colleagues, perception of being able to implement the required behaviors) is affected by proper training. This is one of the aspects on which management should invest more.

Job satisfaction, work engagement and stress/burnout of elderly care staff: a qualitative research

BACKGROUND AND AIM OF THE WORK

Faced with the widespread use of services and facilities for the care and assistance of the elderly, the aim of this study was to explore the factors that can affect job satisfaction, work engagement and stress / burnout of the professionals who work there.

METHOD

32 semi-structured interviews were administered to a not probabilistic sample of the different professional roles (coordinators, nurses, healthcare assistants, physiotherapists, community animators) of a Human Services Company in Reggio Emilia (Italy). This includes day-care and residential care facilities for the elderly.

RESULTS

The thematic content analysis showed that inter-professional collaboration and positive relationships with superiors, colleagues and elderly people favour the job satisfaction, while workload, high responsibilities, reduction of rest periods and contributory inequity create dissatisfaction. The work engagement is favoured by professional autonomy, a sense of belonging, professional growth, specific training, while it is disadvantaged by scarce career opportunities, job insecurity and low recognition of one's contribution. Finally, inadequate pay, work load, high turnover and strong emotional experiences related to elderly people increase work-related stress/burnout, while working autonomy, psychological support and good relationships with the elderly reduce it. Some specificities were found according to the different professional roles and the type of services offered.

DISCUSSION AND CONCLUSIONS

The results suggest organizational improvement strategies that take these factors into account. Among the improvement proposals we highlight, for example, the promotion of training events, a greater involvement of personnel in corporate decisions and an adequate psychological support for professionals.

The Pandemic from COVID 19: a Lesson that we must not forget

This issue of the Acta Biomedica for Health Professions magazine was prepared during the lockdown, imposed by the Italian government, for the contain- ment of COVID 19. This acute syndrome was initially thought to concern only the respiratory system and for this reason it has been defined as SARS CoV-2. To date, however, we know that COVID 19 affects numerous areas of the body (1,2). In Italy, the first western country where the infection manifested itself in the form of an epidemic, we listened to health bulletins that resembled war bulletins, which reported on thousands of people affected by the virus and hundreds of dead people. [...].

The VaRP Project: qualitative evaluation of the training effectiveness of Post Graduate Specializations for health professionals

INTRODUCTION

The healthcare professionals' specialized training has a positive impact on professional values, patient's outcome, and promotion of evidence-based practices. To raise the educational standard, the University of Parma has created Post Graduate Specializations which, in addition to learning sector-specific techniques and skills, include the acquisition of soft skills. Aim of the study is investigating the perception of the tutors dedicated to the organization, management, and teaching of the Post Graduate Specializations on the skills gained and the changes achieved in clinical practice, training, and research.

MATERIALS AND METHODS

Qualitative research was carried out through a semi-structured interview to 11 tutors who have been coordinating the Post Graduate Specializations.

RESULTS

The Qualitative analysis developed "thick" descriptions characterized by analytical density and interpretative richness. The emerging thematic nuclei were: General/unpredicted aspects, Professional empowerment, Satisfaction, Professional outcomes, Limits of the Post Graduate Specializations, and Development areas.

CONCLUSIONS

We identified the most effective areas of the Post Graduate Specializations that emerged consistently from the interviews. We hypothesized that the values and mission the Scientific Board, are effectively lived and championed in the everyday activities of the Post Graduate Specializations. Some domains still need to be furtherly developed, as the professional record, the absence of a "follow up" relationship with former students, and the effective management of workload both for students and tutors. The rise of these limits, can be particularly fruitful, as it gives the chance to identify the development trajectory the post-graduate trainings should pursue to raise the standard of excellence.

The impact of a "narrative interview" intervention in oncology. A study protocol for a feasibility study

BACKGROUND AND AIM OF THE WORK

Oncological diagnosis determines a biographical breakdown and requires the person to adapt to the disease. If patients, after diagnosis, ask professionals for 'compassionate care', research on these issues is still underdeveloped. There are currently no studies that use the narrative interview as an intervention tool. The objectives of the study are to evaluate: (1) the feasibility of the narrative interview intervention on cancer patients in the first diagnosis; (2) the impact of the narrative medicine intervention on the patient's self-perception, his psychological distress and adaptation to the disease.

METHODS

It is a mixed-method study, with an intervention (narrative interview) and quantitative evaluation before/after intervention and qualitative evaluation post-intervention (reflective writing). The analysis will use the Psychological Distress Inventory scale for the assessment of psychological distress and the Mini-Mental Adjustment to Cancer Scale for the assessment of disease adaptation. Adult patients, with oncological pathology will be recruited one month after the communication of the diagnosis, regardless of the type of tumor. The Wilcoxon test for paired data will be used to verify pre-post-intervention differences. The 'reflective writings' will be subjected to thematic analysis.

DISCUSSION AND CONCLUSION

The study evaluates the feasibility of the narrative interview intervention as a primary outcome. Secondly, the impact of the intervention is assessed in relation to: a) identification of risk or protective factors on psychological distress and adaptation to the disease; b) re-elaboration of the patient's experiences and experiences related to his/her own illness.