Functional Assessment of Cancer Therapy Questionnaire for Breast Cancer (FACT-B+4): Italian version validation

BACKGROUND

Improvements in breast cancer diagnosis and treatment led to an increased incidence of survivors' rate. The healthcare system has to face new problems related not only to the treatment of the disease, but also to the management of the quality of life after the diagnosis. The aim of this study was to validate the Italian version of the Functional Assessment of Cancer Therapy - Breast (FACT-B+4) questionnaire and to evaluate its reliability.

METHODS

The questionnaire was administered twice, with an interval of three days between each administration, to a cohort of women of the Breast Surgical Unit, PoliclincoUmberto I. Cronbach's alpha was used as a measure of the internal consistency of the Italian version.

RESULTS

The Italian version of the tool was administered to 55 subjects. The Cronbach's alpha for most scores registered values >0.7, both at baseline and at the follow-up analysis, therefore the subscale showed good internal consistency.

CONCLUSIONS

The Italian version of FACT-B+4 demonstrated acceptable reliability properties in the Breast Unit patients. The use of this questionnaire seemed to be effective and in line with the results derived from the English and Spanishversions. Internal consistency and validity had similar performance results.

Shift work, overweight and obesity in health professionals: a systematic review and meta-analysis

Shift work may have significant repercussions on the health of the worker, and has been linked to unhealthy lifestyles. The aim was to conduct a systematic review of the literature and to assess the relationship between night shift and overweight and obesity among health professionals. A literature search was performed using PubMed and Scopus. The keywords used included: "shift work", "night work", "obesity", "overweight", "nurses" "doctors" "physicians". The whole process of revision followed the PRISMA Statement. Two researchers independently, reviewed the search results, assessed the quality and extracted data. Six transversal and a cohort studies were found for the population of nurses. The meta-analysis did not produce significant results on the prevalence of obesity in the population of nurses (OR: 1.00; 95% CI 0.66-1.50). More high-quality studies and including a larger number of participants should be conducted, in order to assess whether there is real cause-effect relationship between the exposure to night shifts and weight gain as well as of obesity.

Errors in Medicine: perception of healthcare professionals in the Lazio Region

INTRODUCTION

The error in medicine is always the subject of debate in the scientific debates. The purpose of this study is to evaluate the degree knowledge, attitudes and behaviors of health workers towards the error in the health sector.

METHODS

A survey was carried out involving 435 health profes- sionals working in health facilities of the Lazio region, of which 312 females (71%) and 123 males (28%) with an age between 21 and 68 years. A structured questionnaire was administered for investigating the experiences and opinions about the errors found in medical prac- tice, the causes underlying them and the mistakes that should never be committed. Data were collected, stratified by sex, age, marital status, year of graduation, years of service and the workplace (medical or surgical). The statistical significance was set at p≤0.05.

RESULTS

The 5 errors found more frequently in the clinical prac- tice by health professionals were as follows: errors related to the request for examination (60.9%); errors in the collection of samples (37.5%); errors relating to the delivery of the reports (35.2%); errors due to reporting of examinations (31.7%); errors of history (29.2%). The five cases considered to be the most frequently responsible for such errors were: disorganization (52%); fast (46.4%); tiredness due to excessive workloads, stress (44.6%); negligence and carelessness (41.6%); inattention (41.1). With regard to the errors that you should never commit they were more frequently: exchange of patient or misidentification of the patient (49.2%); administration errors of therapies or medications (47.6%); errors related to surgery (41.6%); errors of prescription therapies or medications (39.3); errors in the reporting of exams (33.6%).

CONCLUSIONS

The results of this study shows the importance of a culture of error in medicine among healthcare professionals, those who have already gained practical experience in health care and therefore better able to perform a critical analysis and evaluation of the errors that occur every day. The continuous training of health professionals is fundamental for promoting patient safety and quality in the healthcare sector.

Does focal mechanical stimulation of the lower limb muscles improve postural control and sit to stand movement in elderly?

BACKGROUNDS

Imbalance in elderly is a common problem strictly related to fall.

AIMS

This study investigates the possibility that a new protocol based on the focal mechanical muscle vibration may improve balance and stability in elderly.

METHODS

Pre-post non-randomized clinical trial has been used. Patients referring postural disequilibrium with negative vestibular bed-side examinations have been treated with focal muscle vibration applied to quadriceps muscles and evaluated before and immediately after therapy and after 1 week and after 1 month with postural stabilometric examination and with an inertial measurement units during the time up and go test.

RESULTS

Stabilometric analysis showed statistically significant differences in both the area (p = 0.01) and sway (p < 0.01) of the center of pressure during the close eyes tests. Moreover, the global time of the time up and go test was reduced (p < 0.05) and the rotation velocity was increased (p < 0.01).

CONCLUSIONS

The findings confirm the beneficial role of focal muscle vibration in elderly patients improve postural stability and mobility.

Improving knowledge and behaviors on diet and physical activity in children: results of a pilot randomized field trial

BACKGROUND

The aim of this study was to increase the knowledge of healthy eating, to encourage change in nutritional behavior in accordance with the Mediterranean diet and to promote physical activity in children aged 7 to 9 years and their parents in a school setting through the use of cards and board games of the project Giochiamo (Let us play).

METHODS

This experimental randomized field trial enrolled children in a school setting. The trial consisted of two phases. The first phase, including both intervention and control groups, encompassed a informative session about the food pyramid and physical activity (PA) by experts of public health and preventive medicine. The second phase, including only the experimental groups, involved games focusing on the main concepts of the food pyramid and PA. A questionnaire was administered before the intervention and after one month in order to assess changing in knowledge and behavior scores.

RESULTS

Eighty-nine children were randomly allocated in the intervention (22 children of the fourth year, 22 children of the second year) and the control group (23 children of the fourth year, 22 children of the second year). The univariate analyses showed significant differences (p = 0,004) between intervention and control groups for behavior score after the intervention. In particular, in a stratified analysis classes of the second year showed significant differences for knowledge score (p = 0,005) and for behavior score (p = 0,002), resulting higher among the intervention group. No significant differences resulted in classes of the fourth year for both scores.

CONCLUSIONS

The results of the Giochiamo project clearly demonstrate that the lecture and the games were effective to improve knowledge and behavior habits on the Mediterranean diet and PA. Second year students showed significant differences for knowledge and behavior score in comparison to fourth year students suggesting that, the earlier the intervention occurs, the better are the results in terms of improvement of knowledge and eating habits and PA behaviors.

Counseling intervention to improve quality of life in patients with pre-existing acute myocardial infarction (AMI) or chronic obstructive pulmonary disease (COPD): a pilot study

BACKGROUND

In the light of diagnostic and therapeutic advances, patients with a previous myocardial infarction or with a diagnosis of chronic obstructive pulmonary disease are vulnerable and need continuous monitoring over time. These pathological frameworks have a strong impact on the economy and on the status of the population and require effective and low-cost solutions.

AIMS

The objective of this clinical trial is to evaluate the efficacy in the short term of a telephone counseling intervention to modify the lifestyles of these two patient populations.

METHODS

In May 2015, all the patients included in the study underwent a questionnaire to evaluate their eating and smoking habits and their quality of life. After randomization in two groups, the intervention group received telephone counseling related to the correct lifestyles. The control group did not undergo any intervention. In September-October 2015, the same initial questionnaire was administered to evaluate changes in patients' behavior.

RESULTS

64 patients were included in the study: 34 were assigned to the intervention group and 30 to the control group. The outcomes evaluated were: quality of life, assessment of eating habits and smoking status. After the telephone counseling, the intervention group (34 persons) showed a significant improvement in the score of adherence to the Mediterranean diet (p = 0.01) and a significant reduction in the percentage of smokers (p = 0.01) compared to the population that did not receive any intervention (30 persons). On the other hand, the changes related to the quality of life questionnaire were not significant.

CONCLUSIONS

A single telephone counseling intervention is effective in modifying the lifestyles of patients with a previous myocardial infarction or diagnosed with chronic obstructive pulmonary disease in the short term, reducing their risk profile.

How are the undocumented migrants in Rome? Assessment of quality of life and its determinants among migrant population

Aim

The aim of this study is to evaluate the level of Health-Related Quality of Life (HRQoL) and its determinants among migrants in irregular situations in Italy.

Methods

This cross-sectional study was held in Rome in 2014. HRQoL was assessed through SF-12 questionnaire and physical (PCS) and mental component scores (MCS) were calculated; socio-demographic information and medical conditions were collected. Bivariate and multivariate analyses were performed to assess the impact of demographic and pathological variables on the HRQoL.

Results

The median PCS among the 200 migrants enrolled was 46.5 and the median MCS was 37.9, some points below the Italian average. The multivariate analysis revealed a negative association between PCS and age (P < 0.01), respiratory (P: 0.03) and Poverty-Related Diseases (PRDs) (P < 0.01). MCS, on the other hand, resulted negatively associated with neuropsychiatric diseases (P: < 0.01) and PRDs (P < 0.01).

Conclusion

Although multivariate analyses revealed that gender acts as an effect modifier the negative association between PRDs and the two dimensions of HRQoL is confirmed in both genders. This suggests a great impact of socio-economic status on the HRQoL. Public health could contribute to improve the HRQoL of migrants only taking into account social aspects of diseases and tailoring intervention on the specific needs of migrants.

The synergistic effect between Positivity, socio-demographic factors and smoking cessation: results of a cohort study

OBJECTIVE

To examine the extent to which a effect does exist between Positivity (POS), smoking and socio-demographic factors in determining quitting smoking in subjects participating in a Group Counselling Program (GCP) for smoking cessation.

METHODS

481 subjects were contacted through a telephone call. A logistic regression analysis was carried out. Possible interaction between sociodemographic variables and POS level was tested using the Synergism Index (SI).

RESULTS

For individuals with a POS level over or equal to 3.4 the odds of being smoker was significantly higher among females (OR = 1.55), who smoked at home (OR = 2.16) and lower if there had children at home (OR = 0.53). For individuals with a POS level under 3.4, the only significant variable associated with smoking was beinga female (OR = 2.58). As far concerns the synergistic effect between the variables considered does exist between POS levels and having children at home (SI=1.13) and female gender (SI = 2.8).

CONCLUSIONS

The synergistic effect between POS and sociodemographic factors adds evidence on the use of POS as possible determinants of individual happiness.

Neuromuscular taping enhances hand function in patients with systemic sclerosis: a pilot study

Hand functioning is often impaired in patients with Systemic sclerosis. Neuromuscular Taping is a novel application of tape able to improve functioning. The aim of this study was to evaluate the possible role of this application in the hand functionality of patients with Systemic sclerosis. Women with a diagnosis of SSc has been recruited and evaluated using different scales before and immediately after NMT application and after one, three and six months. Fifty-three women has been evaluated and Cochin Hand Functional Disability scale, Hand Mobility in Sclerodermia, Modified Rodnan Skin Score and Dreiser Algo - Functional Index scores showed statistical significant differences during all the period; moreover a reduction of pain and Raynaud Phenomenon's and an improvement of finger flexion has been observed. Application of NMT in patients with Systemic sclerosis have showed beneficial effect and future studies are needed to confirm these results.

Ambulatory blood pressure monitoring-derived short-term blood pressure variability in primary hyperparathyroidism

INTRODUCTION

Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk.

PURPOSE

The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls.

METHODS

Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h "weighted" Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements.

RESULTS

Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P < 0.01) and average real variability (P < 0.05) of systolic blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P < 0.001). A positive correlation of serum calcium and parathyroid hormone with 24-h-average real variability of systolic BP was observed in the entire primary hyperparathyroidism patients group (P = 0.04, P  = 0.02; respectively).

CONCLUSION

Systolic blood pressure variability is increased in normotensive patients with primary hyperparathyroidism and is reduced by parathyroidectomy, and may potentially represent an additional cardiovascular risk factor in this disease.

Quality of life measurements for patients with chronic suppurative otitis media: Italian adaptation of "Chronic Ear Survey"

The chronic ear survey (CES) is a sensitive and disease specific quality of life (QoL) measurement tool in patients with chronic suppurative otitis media (CSOM). It is a 13-item survey that evaluates the frequency, duration and severity of problems associated with this disease. It is composed of three subscales that describe activity restrictions, symptoms and medical resource utilisation. Based on patient's answers, it is possible to obtain a score resulting in a scale ranging from 0 to 100; the highest indicates the best health, while the lowest denotes poor health. The questionnaire was originally created in English. The aim of this study is to validate the CES questionnaire in Italian (CES-I). Translation was made following international guidelines. The application follows the stages of translation from English to Italian and linguistic adaptation, and grammatical and idiomatic equivalence review. The CES-I and the Short Form Health Survey 36 (SF-36) questionnaires were administered to 54 patients with CSOM. A cross-sectional design was used to examine the internal consistency (Cronbach's alpha) and concurrent validity (Pearson's product moment correlation). To confirm the external validity of CES-I, Pearson correlation coefficient, considering the total score and single subscales of CES and the 8 scales of the SF-36, was calculated. Cronbach's alpha coefficient for internal consistency was 0.737. The intraclass correlation coefficient, measured through mixed effects, was 0.737 (95% CI: 0.600–0.835, p < 0.001) for average measures and 0.412 (95%CI: 0.273–0.559, p < 0.001) for individual measures. According to our results, CES-I is a reliable tool for evaluation of QoL in patients with CSOM among the Italian-speaking population.

Protocol for the evaluation of a chronic care model experience in Rome

INTRODUCTION

Chronic diseases are the leading cause of death and disability in almost all over the world; in Europe causing over 9 million deaths per year according to WHO estimates. A promising health organization model for chronic disease management is represented by the Chronic Care Model (CCM). In the 12th district of the ASL Roma 2 since 4 years was implemented a CCM for the management of patients affected by diabetes and/or at high cardiovascular risk.

OBJECTIVE

Aim of this study is to evaluate the effectiveness of the Chronic Care Model (CCM) for the management of chronic disease in terms of mortality reduction, avoidable hospitalizations reduction and improvement of clinical parameters.

MATERIALS AND METHODS

A retrospective cohort study will involve patients of 12th district of the ASL Roma 2 affected by diabetes and at high cardiovascular risk assisted through the CCM. Their health outcomes will be compared with those of patients in the same clinical conditions, residents in the same district but not assisted with CCM. The sample will be composed by adults (> 18 years) with a diagnosis of diabetes mellitus type 2 (DM2) or metabolic syndrome and / or arterial hypertension (IT) and two or more risk factors. Outcomes will be mortality from all causes and from causes related to DM and IT, preventable hospitalizations as defined in the Prevention Quality Indicators (PQI) by the Agency for Healthcare Research and Quality, and 10 clinical parameters. The data sources will be the records of causes of death (RENCAM), the hospital discharge records (SDO) and information systems for primary healthcare.

CONCLUSION

Data from the experience of CCM in Tuscany seem promising especially in the evaluation of patient satisfaction and clinical outcomes particularly on cardiovascular and neurological complications and long-term mortality.

Disinvestment in healthcare: an overview of HTA agencies and organizations activities at European level

Background

In an era of a growing economic pressure for all health systems, the interest for “disinvestment” in healthcare increased. In this context, evidence based approaches such as Health Technology Assessment (HTA) are needed both to invest and to disinvest in health technologies. In order to investigate the extent of application of HTA in this field, methodological projects/frameworks, case studies, dissemination initiatives on disinvestment released by HTA agencies and organizations located in Europe were searched.

Methods

In July 2015, the websites of HTA agencies and organizations belonging to the European network for HTA (EUnetHTA) and the International Network of Agencies for HTA (INAHTA) were accessed and searched through the use of the term “disinvestment”. Retrieved deliverables were considered eligible if they reported methodological projects/frameworks, case studies and dissemination initiatives focused on disinvestment in healthcare.

Results

62 HTA agencies/organizations were accessed and eight methodological projects/frameworks, one case study and one dissemination initiative were found starting from 2007. With respect to methodological projects/frameworks, two were delivered in Austria, one in Italy, two in Spain and three in U.K. As for the case study and the dissemination initiative, both came from U.K. The majority of deliverables were aimed at making an overview of existing disinvestment approaches and at identifying challenges in their introduction.

Conclusions

Today, in a healthcare context characterized by resource scarcity and increasing service demand, “disinvestment” from low-value services and reinvestment in high-value ones is a key strategy that may be supported by HTA. The lack of evaluation of technologies in use, in particular at the end of their lifecycle, may be due to the scant availability of frameworks and guidelines for identification and assessment of obsolete technologies that was shown by our work. Although several projects were carried out in different countries, most remain constrained to the field of research. Disinvestment is a relatively new concept in HTA that could pose challenges also from a methodological point of view. To tackle these challenges, it is necessary to construct experiences at international level with the aim to develop new methodological approaches to produce and grow evidence on disinvestment policies and practices.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-2941-0) contains supplementary material, which is available to authorized users.

Validation of a questionnaire for ICU nurses to assess knowledge, attitudes and behaviours towards medication errors

AIM

Medication errors are dangerous for the patients in an intensive care unit (ICU). Little is known about knowledge, attitudes and professional behaviour of nurses towards prevention of errors and clinical risk management can reduce errors during the preparation and administration phases of intravenous drugs. In this study we have evaluated the reliability and validity of the questionnaire to examine knowledge, attitudes and professional behaviour of ICU nurses.

METHODS

Reliability analysis was tested and content validity evaluated using Cronbach's alpha to check internal consistency with the intention to obtain no misunderstanding with the results. The questionnaire composed of seven sections for a total of 36 items, was administrated among ICU nurses working in a university hospital in Rome, Italy. Data were collected in October 2015. Statistical analysis was performed with the statistical software for Windows SPSS, version 22.0.

RESULTS

The questionnaire was administered to 30 ICU nurses' in anonymous, voluntary and self-administered form with close-ended type of questions, except for the socio-demographic characteristics. The highest value of Cronbach's alpha resulted on 19 items (alpha= 0,776) meaning that the questionnaire has a satisfactory internal validity. The study highlights that nurses (80%) are aware that appropriate knowledge on the calculation of medication's dose is essential to reduce medication errors during the phase of drugs'preparation.

CONCLUSION

This study demonstrated that a short version of the questionnaire has very good reliability properties in the study and this needs to be taken into account for future studies.

[Workplace Violence in the health sector: validation of the Italian version of the WHO questionnaire]

BACKGROUND

The phenomenon of violence and aggression in the workplace is frequent and constantly increasing. Healthcare professionals are most exposed to this phenomenon, especially those who work in urgent and psychiatric emergency departments.

OBJECTIVE

To validate the Italian version of the questionnaire "Workplace Violence in the Health Sector Case Study Research Instruments Survey Questionnaire", conducted by WHO.

OUTCOMES

55 randomly selected workers took part in the validation of the questionnaire among physicians, nurses and nursing trainees. The internal consistency analysis of the demand of 5 dichotomous variables on binary values ​​for violence levels suggests that Cronbach's alpha is 0.61, and Cronbach's alpha calculated on standardized elements is 0.69, which means that Reliability shows sufficient levels.

CONCLUSIONS

The Italian translation carried out in this WHO questionnaire study shows good internal reliability and consistency and could be considered a useful tool in assessing and preventing aggression and violence against health professionals.