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Magi CE, Rasero L, Mannucci E, Bonaccorsi G, Ranaldi F, Pazzagli L, Faraoni P, Mulinacci N, Bambi S, Longobucco Y, Dicembrini I, Iovino P. Use of ancient grains for the management of diabetes mellitus: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2024; 34:1110-1128. [PMID: 38553358 DOI: 10.1016/j.numecd.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 04/09/2024]
Abstract
AIMS A systematic review and meta-analysis of published randomized controlled trials was conducted to collate evidence from studies implementing ancient grains and investigate the impact of ancient grain consumption on health outcomes of patients with Diabetes Mellitus (DM). DATA SYNTHESIS Twenty-nine randomized controlled trials were included, and 13 were meta-analyzed. Interventions ranged from 1 day to 24 weeks; most samples were affected by DM type 2 (n = 28 studies) and the ancient grains used were oats (n = 10 studies), brown rice (n = 6 studies), buckwheat (n = 4 studies), chia (n = 3 studies), Job's Tears (n = 2 studies), and barley, Khorasan and millet (n = 1 study). Thirteen studies that used oats, brown rice, and chia provided data for a quantitative synthesis. Four studies using oats showed a small to moderate beneficial effect on health outcomes including LDL-c (n = 717, MD: 0.30 mmol/l, 95% CI: 0.42 to -0.17, Z = 4.61, p < 0.05, I2 = 0%), and TC (n = 717, MD: 0.44 mmol/l, 95% CI: 0.63 to -0.24, Z = 4.40, p < 0.05, I2 = 0%). Pooled analyses of studies using chia and millet did not show significant effects on selected outcomes. CONCLUSIONS For adults affected by DM type 2, the use of oats may improve lipidic profile. Further experimental designs are needed in interventional research to better understand the effects of ancient grains on diabetes health outcomes. PROSPERO REGISTRATION CRD42023422386.
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Affiliation(s)
| | - Laura Rasero
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Edoardo Mannucci
- Diabetology and Metabolic Diseases, Careggi Teaching Hospital, Florence, Italy; Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | | | - Francesco Ranaldi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Luigia Pazzagli
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Paola Faraoni
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Nadia Mulinacci
- Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Ilaria Dicembrini
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, Florence, Italy
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Locatelli G, Iovino P, Pasta A, Jurgens CY, Vellone E, Riegel B. Cluster analysis of heart failure patients based on their psychological and physical symptoms and predictive analysis of cluster membership. J Adv Nurs 2024; 80:1380-1392. [PMID: 37788062 DOI: 10.1111/jan.15890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
AIM Patients with heart failure experience multiple co-occurring symptoms that lower their quality of life and increase hospitalization and mortality rates. So far, no heart failure symptom cluster study recruited patients from community settings or focused on symptoms predicting most clinical outcomes. Considering physical and psychological symptoms together allows understanding how they burden patients in different combinations. Moreover, studies predicting symptom cluster membership using variables other than symptoms are lacking. We aimed to (a) cluster heart failure patients based on physical and psychological symptoms and (b) predict symptom cluster membership using sociodemographic/clinical variables. DESIGN Secondary analysis of MOTIVATE-HF trial, which recruited 510 heart failure patients from a hospital, an outpatient and a community setting in Italy. METHODS Cluster analysis was performed based on the two scores of the Hospital Anxiety-Depression scale and two scores of the Heart-Failure Somatic Perception Scale predicting most clinical outcomes. ANOVA and chi-square test were used to compare patients' characteristics among clusters. For the predictive analysis, we split the data into a training set and a test set and trained three classification models on the former to predict patients' symptom cluster membership based on 11 clinical/sociodemographic variables. Permutation analysis investigated which variables best predicted cluster membership. RESULTS Four clusters were identified based on the intensity and combination of psychological and physical symptoms: mixed distress (high psychological, low physical symptoms), high distress, low distress and moderate distress. Clinical and sociodemographic differences were found among clusters. NYHA-class (New York Heart Association) and sleep quality were the most important variables in predicting symptom cluster membership. CONCLUSIONS These results can support the development of tailored symptom management intervention and the investigation of symptom clusters' effect on patient outcomes. The promising results of the predictive analysis suggest that such benefits may be obtained even when direct access to symptoms-related data is absent. IMPLICATIONS These results may be particularly useful to clinicians, patients and researchers because they highlight the importance of addressing clusters of symptoms, instead of individual symptoms, to facilitate symptom detection and management. Knowing which variables best predict symptom cluster membership can allow to obtain such benefits even when direct access to symptoms-data is absent. IMPACT Four clusters of heart failure patients characterized by different intensity and combination of psychological and physical symptoms were identified. NYHA class and sleep quality appeared important variables in predicting symptom cluster membership. REPORTING METHOD The authors have adhered to the EQUATOR guidelines STROBE to report observational cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION Patients were included only for collecting their data.
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Affiliation(s)
- Giulia Locatelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, New South Wales, Sydney, Australia
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | - Alessandro Pasta
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Corrine Y Jurgens
- Connell School of Nursing, Boston College, Massachusetts, Boston, USA
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
| | - Barbara Riegel
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, New South Wales, Sydney, Australia
- School of Nursing, University of Pennsylvania, Pennsylvania, Philadelphia, USA
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Magi CE, Bambi S, Rasero L, Longobucco Y, El Aoufy K, Amato C, Vellone E, Bonaccorsi G, Lorini C, Iovino P. Health Literacy and Self-Care in Patients with Chronic Illness: A Systematic Review and Meta-Analysis Protocol. Healthcare (Basel) 2024; 12:762. [PMID: 38610184 PMCID: PMC11011384 DOI: 10.3390/healthcare12070762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Self-care plays a critical role in symptom recognition, management, and risk factor modification for patients with chronic illnesses. Despite its significance, self-care levels in this population are generally poor. Health literacy (HL) is pivotal for promoting effective self-care, yet the association across specific chronic illnesses remains fragmented and conflicting. Therefore, a systematic review and meta-analysis will be conducted. Inclusion criteria encompass quantitative studies involving adult patients with at least one chronic illness reporting on the association between a measure of HL and one or more elements of self-care behaviors as outcomes. Databases to be searched include PubMed, CINAHL, APA PsycINFO, Embase, Web of Science, and Cochrane Central Register of Controlled Trials. The studies will undergo risk of bias and certainty of evidence assessment using ROBINS-E and GRADE. Extracted data will include authors, publication date, aim(s), study location, design, sample characteristics, chronic illness type, study length, HL, and self-care measures. Understanding the link between HL and self-care can aid healthcare providers in implementing strategies to enhance health-promoting behaviors, contributing valuable insights to the scientific community and fostering nuanced discussions. This protocol ensures methodological transparency, stimulates discourse, and paves the way for informed interventions to improve overall health outcomes.
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Affiliation(s)
- Camilla Elena Magi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Khadija El Aoufy
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Carla Amato
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Ercole Vellone
- Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
- Department of Nursing and Obstetrics, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (S.B.); (L.R.); (Y.L.); (K.E.A.); (C.A.); (G.B.); (C.L.); (P.I.)
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Caggianelli G, Alivernini F, Chirico A, Iovino P, Lucidi F, Uchmanowicz I, Rasero L, Alvaro R, Vellone E. The relationship between caregiver contribution to self-care and patient quality of life in heart failure: A longitudinal mediation analysis. PLoS One 2024; 19:e0300101. [PMID: 38470867 DOI: 10.1371/journal.pone.0300101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Patients with heart failure may experience poor quality of life due to a variety of physical and psychological symptoms. Quality of life can improve if patients adhere to consistent self-care behaviors. Patient outcomes (i.e., quality of life) are thought to improve as a result of caregiver contribution to self-care. However, uncertainty exists on whether these outcomes improve as a direct result of caregiver contribution to self-care or whether this improvement occurs indirectly through the improvement of patient heart failure self-care behaviors. AIMS To investigate the influence of caregiver contribution to self-care on quality of life of heart failure people and explore whether patient self-care behaviors mediate such a relationship. METHODS This is a secondary analysis of the MOTIVATE-HF randomized controlled trial (Clinicaltrials.gov registration number: NCT02894502). Data were collected at baseline and 3 months. An autoregressive longitudinal path analysis model was conducted to test our hypotheses. RESULTS We enrolled a sample of 510 caregivers [mean age = 54 (±15.44), 24% males)] and 510 patients [mean age = 72.4 (±12.28), 58% males)]. Patient self-care had a significant and direct effect on quality of life at three months (β = 0.20, p < .01). Caregiver contribution to self-care showed a significant direct effect on patient self-care (β = 0.32, p < .01), and an indirect effect on patient quality of life through the mediation of patient self-care (β = 0.07, p < .001). CONCLUSION Patient quality of life is influenced by self-care both directly and indirectly, through the mediation of caregiver contribution to self-care. These findings improve our understanding on how caregiver contribution to self-care improves patient outcomes.
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Affiliation(s)
| | - Fabio Alivernini
- Department of Psychology of Development and Socialization processes, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization processes, "Sapienza" University of Rome, Rome, Italy
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | - Fabio Lucidi
- Department of Psychology of Development and Socialization processes, "Sapienza" University of Rome, Rome, Italy
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Laura Rasero
- Health Sciences Department, University of Florence, Florence, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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Giovannoni L, Longobucco Y, Iovino P, Barbetti C, Becattini S, Bonanni D, Cordelli F, Cosci M, Del Perugia C, Flego R, Giannuzzi D, Guasti B, Iannone SR, Latini R, Macchitella C, Piccardi F, Prisco E, Pucci T, Tricca M, Rasero L. Complementing Braden scale for pressure ulcer risk with clinical and demographic-related factors in a large cohort of hospitalized Italian patients. J Tissue Viability 2024:S0965-206X(24)00030-5. [PMID: 38458956 DOI: 10.1016/j.jtv.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 01/23/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024]
Abstract
AIMS To determine the prevalence, risk, and determinants of pressure ulcer risk in a large cohort of hospitalized patients. DESIGN A prospective cross-sectional study with data collection in January 2023. METHODS Registered nurses collected data from 798 patients admitted to 27 health care units of an Italian hospital. The pressure ulcer risk was assessed using the Braden scale. The presence of comorbidities was collected from clinical reports. Obesity was assessed according to international indicators (Body Mass Index). The receiver operating characteristic (ROC) curve was used to estimate the sensitivity and specificity of different Braden scores for identifying participants with pressure ulcers. RESULTS The prevalence of pressure ulcers was 9.5%, and 57.4% of the sample were at risk of developing pressure ulcers. The area under the ROC curve was 0.88. The best sensitivity and specificity were found for a Braden cutoff score of 15.5 (sensibility = 0.76; specificity = 0.85). The determinants of lower Braden scores were older age (p < 0.001), comorbidities (p < 0.001), wounds of other nature (p = 0.001), urinary incontinence (p < 0.001), fecal incontinence (p < 0.001), and urinary catheterization (p < 0.001). CONCLUSION Several demographic factors and specific clinical indicators have been identified as determinants of the risk of developing pressure ulcers, which are easily ascertainable by healthcare providers; thus, they may routinely complement the Braden Scale in the assessment of pressure ulcer risk in order to reinforce and accelerate clinical judgment.
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Affiliation(s)
- Lorenzo Giovannoni
- Research and Development of Clinical Practice Unit, Careggi University Hospital, Florence, Italy; Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Yari Longobucco
- Research and Development of Clinical Practice Unit, Careggi University Hospital, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, Florence, Italy.
| | - Chiara Barbetti
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Silvia Becattini
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Daniela Bonanni
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Francesco Cordelli
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Matteo Cosci
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | | | - Rachele Flego
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Domenica Giannuzzi
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Barbara Guasti
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | | | - Riccardo Latini
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | | | - Francesca Piccardi
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Elia Prisco
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Tiziana Pucci
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Manola Tricca
- Nursing and Midwifery Department, Careggi University Hospital, Florence, Italy
| | - Laura Rasero
- Research and Development of Clinical Practice Unit, Careggi University Hospital, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
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Micheluzzi V, Casu G, Sanna GD, Canu A, Iovino P, Caggianelli G, Vellone E. Improving adherence to rehabilitation for heart failure patients through immersive virtual reality (VIRTUAL-HF): A protocol for a randomized controlled trial. Contemp Clin Trials 2024; 138:107463. [PMID: 38302011 DOI: 10.1016/j.cct.2024.107463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/02/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND To improve symptoms and reduce poor outcomes related to heart failure (HF), international guidelines recommend cardiac rehabilitation (CR), particularly for those with a reduced ejection fraction. Unfortunately, patient adherence to rehabilitation programs remains suboptimal, with dropouts ranging from 15.4 to 63.3%. An innovative and promising intervention that could improve adherence to rehabilitation is virtual reality (VR). This study aims to evaluate the effects of VR in patients with HF who undergo CR using this technology in terms of adherence (primary outcome), functional capacity, perceived exertion, angina, quality of life, heart rate, oxygen saturation, blood pressure, maximum oxygen uptake, minute ventilation/carbon dioxide production slope, oxygen pulse, blood values of NT-proBNP and HF related rehospitalization rates (secondary outcomes). METHODS A randomized controlled trial will be conducted in a sample of 80 patients referred to CR. Participants will be enrolled in a cardiological rehabilitation unit of a large university hospital in Italy and randomized (1:1) to the experimental intervention consisting of CR performed with high-quality immersive VR with PICO 4® Head Mounted Display headset and TREADMILL XR® software (Arm 1) or standard CR (Arm 2). Patients, according to guidelines, will perform 30-min of CR sessions with moderate intensity, twice a week for one month. RESULTS Significant improvements in primary and secondary outcomes are expected in patients in the intervention group. CONCLUSIONS If proven to be effective, VR could be an innovative, safe, and easy digital health intervention to improve adherence to CR in patients with HF, as well as important clinical outcomes.
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Affiliation(s)
- Valentina Micheluzzi
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Gavino Casu
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy; Department of Medicine, and Pharmacy, University of Sassari, Sassari, Italy
| | | | - Antonella Canu
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland
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Iovino P, Lavorgna M, Orlo E, Russo C, De Felice B, Campolattano N, Muscariello L, Fenti A, Chianese S, Isidori M, Musmarra D. An integrated approach for the assessment of the electrochemical oxidation of diclofenac: By-product identification, microbiological and eco-genotoxicological evaluation. Sci Total Environ 2024; 909:168511. [PMID: 37977373 DOI: 10.1016/j.scitotenv.2023.168511] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
Diclofenac (DCF), a contaminant of emerging concern, is a non-steroidal anti-inflammatory drug widely detected in water bodies, which demonstrated harmful acute and chronic toxicity toward algae, zooplankton and aquatic invertebrates, therefore its removal from impacted water is necessary. DCF is recalcitrant toward traditional treatment technologies, thus, innovative approaches are required. Among them, electrochemical oxidation (EO) has shown promising results. In this research, an innovative multidisciplinary approach is proposed to assess the electrochemical oxidation (EO) of diclofenac from wastewater by integrating the investigations on the removal efficiency and by-product identification with the disinfection capacity and the assessment of the effect on environmental geno-toxicity of by-products generated through the oxidation. The electrochemical treatment successfully degraded DCF by achieving >98 % removal efficiency, operating with NaCl 0.02 M at 50 A m-2. By-product identification analyses showed the formation of five DCF parental compounds generated by decarboxylic and CN cleavage reactions. The disinfection capacity of the EO technique was evaluated by carrying out microbiological tests on pathogens generally found in aquatic environments, including two rod-shaped Gram-negative bacteria (Pseudomonas aeruginosa and Escherichia coli), one rod-shaped Gram-positive bacterium (Bacillus atrophaeus), and one Gram-positive coccus (Enterococcus hirae). Eco-toxicity was evaluated in freshwater organisms (algae, rotifers and crustaceans) belonging to two trophic levels through acute and chronic tests. Genotoxicity tests were carried out by Comet assay, and relative expression levels of catalase, manganese and copper superoxide dismutase genes in crustaceans. Results highlight the effectiveness of EO for the degradation of diclofenac and the inactivation of pathogens; however, the downstream mixture results in being harmful to the aquatic ecosystem.
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Affiliation(s)
- P Iovino
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, Caserta 81100, Italy
| | - M Lavorgna
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, Caserta 81100, Italy
| | - E Orlo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, Caserta 81100, Italy
| | - C Russo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, Caserta 81100, Italy.
| | - B De Felice
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, Caserta 81100, Italy
| | - N Campolattano
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, Caserta 81100, Italy
| | - L Muscariello
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, Caserta 81100, Italy
| | - A Fenti
- Department of Engineering, University of Campania "Luigi Vanvitelli", Via Roma 29, Aversa 81031, Italy.
| | - S Chianese
- Department of Engineering, University of Campania "Luigi Vanvitelli", Via Roma 29, Aversa 81031, Italy
| | - M Isidori
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Via Vivaldi 43, Caserta 81100, Italy
| | - D Musmarra
- Department of Engineering, University of Campania "Luigi Vanvitelli", Via Roma 29, Aversa 81031, Italy
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Locatelli G, Iovino P. Exploring the role of motivational interviewing in cardiovascular diseases. Eur J Cardiovasc Nurs 2024:zvad130. [PMID: 38211947 DOI: 10.1093/eurjcn/zvad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Giulia Locatelli
- Department of Medicine and Surgery, University of Milan-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, Florence, Italy
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Amato C, Iovino P, Longobucco Y, Salvadori E, Diaz RG, Castiglione S, Guadagno MG, Vellone E, Rasero L. Reciprocal associations between beliefs about medicines, health locus of control and adherence to immunosuppressive medication in allogeneic hematopoietic cell transplant patients: Findings from the ADE-TRAM study. Eur J Oncol Nurs 2023; 67:102410. [PMID: 37804755 DOI: 10.1016/j.ejon.2023.102410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/22/2023] [Accepted: 09/07/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT) are required to strictly adhere to immunosuppressive medications to avoid rejection and infective complications. Since medication adherence is among the most important modifiable behaviors to achieve better outcomes, the aims of this study were to measure the baseline and longitudinal trends of medication adherence and investigate the psychological factors associated with medication adherence in allo-HSCT patients. METHODS This was a single-center, longitudinal study of patients who underwent allo-HSCT to treat hematological malignancies at the University hospital of Florence (Italy). Adherence was measured with the Immunosuppressive Medication Self-Management Scale; psychological factors (i.e., beliefs about medicines and health locus of control) were measured with the Beliefs About Medicines Questionnaire and Multidimensional Health locus of Control Scale. Data were collected 1, 3, 6 and 12 months after discharge. A mixed effects model was performed after adjusting for demographic characteristics. RESULTS 50 adult patients were included in this study. Adherence to immunosuppressant was optimal and increased significantly 3 months after bone marrow transplantation (B = 0.23, p = 0.041). Patients with lower concerns about immunosuppressive medications were more likely to be adherent (B = 0.02, p = 0.040), while those having beliefs that their disease was due to external factors were less likely to be adherent (B = -0.02, p = 0.026) than their counterparts. CONCLUSIONS These results underline the importance of psychological factors in affecting adherence to immunosuppressants of allo-HSCT patients. Healthcare providers and researchers should target medication beliefs and reorient locus of control with appropriate interventions, in order to improve adherence.
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Affiliation(s)
- Carla Amato
- Health Sciences Department, University of Florence, Florence, Italy.
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy.
| | - Yari Longobucco
- Health Sciences Department, University of Florence, Florence, Italy.
| | | | | | - Sabrina Castiglione
- Bone Marrow Transplantation Unit, Careggi University Hospital, Florence, Italy.
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention University of Rome Tor Vergata, Rome, Italy; Department of Nursing and Obstetrics, Wroclaw Medical University, Poland.
| | - Laura Rasero
- Health Sciences Department, University of Florence, Florence, Italy.
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10
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Baldassini Rodriguez S, Bardacci Y, El Aoufy K, Bazzini M, Caruso C, Giusti GD, Mezzetti A, Lucchini A, Iozzo P, Guazzini A, Magi CE, Iovino P, Longobucco Y, Rasero L, Bambi S. Sleep Quality and Its Relationship to Anxiety and Hardiness in a Cohort of Frontline Italian Nurses during the First Wave of the COVID-19 Pandemic. Nurs Rep 2023; 13:1203-1215. [PMID: 37755346 PMCID: PMC10538004 DOI: 10.3390/nursrep13030103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances. MATERIALS AND METHODS A descriptive-exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State-Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI). RESULTS a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = -0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score. DISCUSSION AND CONCLUSION Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses.
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Affiliation(s)
- Samuele Baldassini Rodriguez
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, 50134 Florence, Italy; (S.B.R.); (Y.B.); (M.B.)
| | - Yari Bardacci
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, 50134 Florence, Italy; (S.B.R.); (Y.B.); (M.B.)
| | - Khadija El Aoufy
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Marco Bazzini
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, 50134 Florence, Italy; (S.B.R.); (Y.B.); (M.B.)
| | - Christian Caruso
- Emergency Medical System—AUSL Toscana Centro, 50122 Florence, Italy; (C.C.); (A.M.)
| | - Gian Domenico Giusti
- Medicine and Surgery Department, University of Perugia, 06100 Perugia, Italy;
- Teaching and Quality Department, Perugia University Hospital, 06100 Perugia, Italy
| | - Andrea Mezzetti
- Emergency Medical System—AUSL Toscana Centro, 50122 Florence, Italy; (C.C.); (A.M.)
| | - Alberto Lucchini
- UOS Terapia Intensiva Generale e UOSD Emergenza Intraospedaliera e Trauma Team, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Pasquale Iozzo
- Emergency Department, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, 90100 Palermo, Italy;
| | - Andrea Guazzini
- Department of Education, Languages, Intercultural Studies, Literatures and Psychology, University of Florence, 50135 Florence, Italy;
- Center for the Study of Complex Dynamics (CSDC), University of Florence, 50134 Florence, Italy
| | - Camilla Elena Magi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (C.E.M.); (P.I.); (Y.L.); (L.R.); (S.B.)
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11
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Iovino P, De Maria M, Corvese F, Giordano V, Alvaro R, Vellone E, Villa G. The influence of patient and caregiver depression on patient self-care and caregiver contribution to self-care in ostomy: A dyadic analysis. J Clin Nurs 2023; 32:6441-6449. [PMID: 36880219 DOI: 10.1111/jocn.16676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/16/2022] [Accepted: 02/20/2023] [Indexed: 03/08/2023]
Abstract
AIMS AND OBJECTIVES To explore the association between patient and caregiver depression and patient self-care and caregiver contribution to self-care in the context of ostomy care. BACKGROUND Self-care is essential for ostomy patients and their caregivers. The ostomy self-care process can be considered a dyadic phenomenon in which the patient and the caregiver interact together and work as a team. The presence of depressive symptoms may limit the patient's ability to perform self-care and caregivers' abilities to engage in caregiving tasks. Research into the dyadic influence of depression on self-care behaviours from the perspective of ostomates and their caregivers is still in its infancy. DESIGN Secondary analysis of a multicentre, cross-sectional study. The STROBE checklist was used to report the present study. METHODS Patient-caregiver dyads were recruited from eight ostomy outpatient clinics from February 2017 to May 2018. Depression was assessed with the nine-item Patient Health Questionnaire in both patients and caregivers. Patient self-care was evaluated with the Ostomy Self-Care Index, and caregiver contribution to self-care was assessed with the Caregiver Contribution to Ostomy Self-Care Index. Both instruments measure the dimensions of maintenance, monitoring and management. The actor-partner interdependence model was performed for the dyadic analysis. RESULTS In total, 252 patient-caregiver dyads (patients: 69.8% male, mean age 70.05; caregivers: 80.6% female, mean age 58.7) were enrolled. Patient depression was positively associated with caregiver contribution to self-care maintenance. Caregiver depression was negatively associated with self-care management. RELEVANCE TO CLINICAL PRACTICE These findings add a better understanding of the reciprocal influence of dyadic depression on patient and caregiver contributions to self-care in ostomy contexts was found. Patient and caregiver depression influence patient self-care and caregiver contribution to self-care. Therefore, clinicians should assess and treat depression in both members of the dyad to improve self-care.
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Affiliation(s)
- Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Corvese
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Vittoria Giordano
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
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12
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Locatelli G, Iovino P, Jurgens CY, Alvaro R, Uchmanowicz I, Rasero L, Riegel B, Vellone E. The Influence of Caregiver Contribution to Self-care on Symptom Burden in Patients With Heart Failure and the Mediating Role of Patient Self-care: A Longitudinal Mediation Analysis. J Cardiovasc Nurs 2023:00005082-990000000-00115. [PMID: 37550831 DOI: 10.1097/jcn.0000000000001024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
BACKGROUND Patients with heart failure experience high symptom burden, which can be mitigated with adequate self-care. Caregiver contribution to self-care has been theorized to improve patient symptom burden. The mediating role of patient self-care in this relationship has not been tested yet. OBJECTIVES The aim of this study was to test whether (a) caregiver contribution to self-care influences patient self-care, (b) patient self-care influences symptom burden, and (c) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden. METHODS In this study, the authors conducted a secondary analysis of the baseline and 3-month data from the MOTIVATE-HF trial, which enrolled 510 dyads (patient with heart failure and caregiver) in Italy. Multigroup confirmatory factor analysis was used to test measurement invariance. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test our hypotheses. RESULTS On average, caregivers were 54 years old and mainly female, whereas patients were 72.4 years old and mainly male. Better caregiver contribution to self-care maintenance was associated with better patient self-care maintenance (β = 0.280, P < .001), which, in turn, was associated with lower symptom burden (β = -0.280, P < .001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (β = -0.079; 95% bias-corrected bootstrapped confidence interval, -0.130 to -0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (β = 0.238, P = .006). The model significantly accounted for 37% of the total variance in symptom burden scores (P < .001). CONCLUSIONS This study expands the situation-specific theory of caregiver contribution to heart failure self-care and provides new evidence on the role of caregiver contribution to self-care and patient self-care on symptom burden in heart failure.
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13
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Magi CE, Bambi S, Iovino P, El Aoufy K, Amato C, Balestri C, Rasero L, Longobucco Y. Virtual Reality and Augmented Reality Training in Disaster Medicine Courses for Students in Nursing: A Scoping Review of Adoptable Tools. Behav Sci (Basel) 2023; 13:616. [PMID: 37504063 PMCID: PMC10376463 DOI: 10.3390/bs13070616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023] Open
Abstract
Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including virtual reality (VR) and augmented reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR and AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full texts were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR and AR and immersive simulation generally show promising evidence in enhancing practical skills and knowledge in MCI management. VR and AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experiential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.
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Affiliation(s)
- Camilla Elena Magi
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Khadija El Aoufy
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy
| | - Carla Amato
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Chiara Balestri
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, 50121 Firenze, Italy
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14
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Bolgeo T, Di Matteo R, Simonelli N, Molin AD, Lusignani M, Bassola B, Vellone E, Maconi A, Iovino P. Psychometric properties and measurement invariance of the 7-item General Anxiety Disorder scale (GAD-7) in an Italian coronary heart disease population. J Affect Disord 2023; 334:213-219. [PMID: 37149049 DOI: 10.1016/j.jad.2023.04.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Generalized Anxiety Disorder is predominant in coronary heart disease (CHD) patients. 7-item Generalized Anxiety Disorder (GAD-7) scale psychometric properties have never been tested in CHD populations. This study aims to verify the GAD-7 psychometric properties and measurement invariance in an Italian CHD sample. METHOD A baseline data secondary analysis from HEARTS-IN-DYADS study. Several healthcare facilities enrolled an adult inpatient sample. Anxiety and depression data were collected using GAD-7 and Patient Health Questionnaire 9 (PHQ-9). Factorial validity was assessed with confirmatory factor analysis; construct validity was tested by correlating GAD-7 scores with PHQ-9 scores and other sociodemographic characteristics; internal consistency reliability was assessed using Cronbach's alpha and the composite reliability index, while confirmatory multigroup factor analysis was employed to investigate measurement invariance across gender and age (65 vs. 65). RESULTS We enrolled 398 patients (mean age 64.7 years; 78.9 % male; 66.8 % married). Factor structure was confirmed as unidimensional. Construct validity was confirmed with significant associations between GAD-7 and PHQ-9 scores, female gender, having a caregiver, and being employed. Cronbach's alpha and composite reliability index were 0.89 and 0.90, respectively. Measurement invariance across gender and age was confirmed at the scalar level. LIMITATIONS A convenience sample in one European country, a small female sample, validity testing against a single criterion. CONCLUSION Study results demonstrate adequate validity and reliability of the GAD-7 in an Italian CHD sample. It showed satisfactory invariance properties; GAD-7 is suitable for measuring anxiety in CHD while making significant comparisons of scores among stratified gender and age groups.
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Affiliation(s)
- Tatiana Bolgeo
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberta Di Matteo
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
| | - Niccolò Simonelli
- SC Cardiology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Health Professions' Direction, Maggiore della Carità Hospital, Novara, Italy
| | - Maura Lusignani
- Department of Biomedical Science for Health, University of Milan, Milan, Italy; School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Barbara Bassola
- School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, (Italy)
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15
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Vellone E, Rebora P, Iovino P, Ghizzardi G, Baricchi M, Alvaro R, Sili A, Barello S, Ausili D, Trenta AM, Pedroni C, Dellafiore F, Arrigoni C, Riegel B, Caruso R. Remote motivational interviewing to improve patient self-care and caregiver contribution to self-care in heart failure (REMOTIVATE-HF): Rationale, design, and methodology for a multicentre randomized controlled trial. Res Nurs Health 2023; 46:190-202. [PMID: 36566360 DOI: 10.1002/nur.22289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/26/2022]
Abstract
In patients with heart failure (HF), self-care, and caregiver contribution to self-care (i.e., the daily management of the disease by patients and caregivers) are essential for improving patient outcomes. However, patients and caregivers are often inadequate in their self-care and contribution to self-care, respectively, and struggle to perform related tasks. Face-to-face motivational interviewing (MI) effectively improves self-care and caregiver contribution to self-care, but the evidence on remote MI is scarce and inconclusive. The aims of this randomized controlled trial will be to evaluate whether remote MI performed via video call in patients with HF: (1) is effective at improving self-care maintenance in patients (primary outcome); (2) is effective for the following secondary outcomes: (a) for patients: self-care management, self-care monitoring, and self-efficacy; HF symptoms; generic and disease-specific quality of life; anxiety and depression; use of healthcare services; and mortality; and (b) for caregivers: contribution to self-care, self-efficacy, and preparedness. We will conduct a two-arm randomized controlled trial. We will enroll and randomize 432 dyads (patients and their informal caregivers) in Arm 1, in which patients and caregivers will receive MI or, in Arm 2, standard care. MI will be delivered seven times over 12 months. Outcomes will be assessed at baseline and 3 (primary outcome), 6, 9, and 12 months from enrollment. This trial will demonstrate whether an inexpensive and easily deliverable intervention can improve important HF outcomes. With the restrictions on in-person healthcare professional interventions imposed by the COVID-19 pandemic, it is essential to evaluate whether MI is also effective remotely.
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Affiliation(s)
- Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland
| | - Paola Rebora
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | | | - Marina Baricchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Serena Barello
- Department of Psychology, EngageMinds Hub-Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alessia M Trenta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Cardiology Center Monzino IRCCS, University of Milan-Bicocca, Milan, Italy
| | | | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, North Sydney, Australia
- International Center for Self-Care Research
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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16
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Iovino P, Vellone E, Cedrone N, Riegel B. A Middle-Range Theory of Social Isolation in Chronic Illness. Int J Environ Res Public Health 2023; 20:4940. [PMID: 36981849 PMCID: PMC10049704 DOI: 10.3390/ijerph20064940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Chronic illnesses and social isolation are major public phenomena that drive health and social policy worldwide. This article describes a middle-range theory of social isolation as experienced by chronically ill individuals. Key concepts include social disconnectedness, loneliness, and chronic illness. Antecedents of social isolation include predisposing factors (e.g., ageism and immigration) and precipitating factors (e.g., stigma and grief). Outcomes of social isolation include psychosocial responses (e.g., depression and quality of life), health-related behaviors (i.e., self-care), and clinical responses (e.g., cognitive function and health service use). Possible patterns of social isolation in chronic illness are described.
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Affiliation(s)
- Paolo Iovino
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Nadia Cedrone
- Unità di Medicina Interna, Ospedale S. Pertini, 00157 Rome, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, VIC 3065, Australia
- Center for Home Care Policy & Research, VNS Health, New York, NY 10017, USA
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17
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Simonelli N, Bolgeo T, Iovino P, Di Matteo R, Maconi A, Vellone E. Self-care in coronary heart disease patient and caregiver dyads (HEARTS-IN-DYADS)-Protocol of a multicenter longitudinal study. Res Nurs Health 2023; 46:37-47. [PMID: 36538334 DOI: 10.1002/nur.22286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 11/18/2022] [Accepted: 11/26/2022] [Indexed: 12/24/2022]
Abstract
Self-care performed by patients and the caregiver contribution to this self-care are essential for improving cardiovascular outcomes; however, so far, no studies have sufficiently investigated this field in Italy. This paper describes a research protocol of a multi-center longitudinal study designed to investigate the self-care of patients affected by coronary heart disease (CHD), the caregiver's contribution to this self-care, the predictors of patient and caregiver self-care, the mediating role of self-efficacy, and the self-care outcomes. Data collection will be performed across seven Italian inpatient settings at baseline and 3 and 6 months from enrollment. Multilevel modeling and actor partner interdependence models will be implemented on a sample of 330 patient-caregiver dyads to adjust for the interdependence of measurements. The study received approval from an ethics committee in Italy and was financed in January 2021 by a grant from the Solidal Foundation in Alessandria. This research will advance the knowledge about the self-care process in CHD. The results will guide research and clinical practice by identifying variables sensitive to educational interventions.
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Affiliation(s)
- Niccolò Simonelli
- SC Cardiology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Tatiana Bolgeo
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing Midwifery and Paramedicin Australian Catholic University, Melbourne, Victoria, Australia
| | - Roberta Di Matteo
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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18
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Minozzi S, Gonzalez-Lorenzo M, Cinquini M, Berardinelli D, Cagnazzo C, Ciardullo S, De Nardi P, Gammone M, Iovino P, Lando A, Rissone M, Simeone G, Stracuzzi M, Venezia G, Moja L, Costantino G. Adherence of systematic reviews to Cochrane RoB2 guidance was frequently poor: a meta epidemiological study. J Clin Epidemiol 2022; 152:47-55. [PMID: 36156301 DOI: 10.1016/j.jclinepi.2022.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/23/2022] [Accepted: 09/06/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To assess whether the use of the revised Cochrane risk of bias tool for randomized trials (RoB2) in systematic reviews (SRs) adheres to RoB2 guidance. METHODS We searched MEDLINE, Embase, Cochrane Library from 2019 to May 2021 to identify SRs using RoB2. We analyzed methods and results sections to see whether risk of bias was assessed at outcome measure level and applied to primary outcomes of the SR as per RoB2 guidance. The relation between SR characteristics and adequacy of RoB2 use was examined by logistic regression analysis. RESULTS Two hundred-eight SRs were included. We could assess adherence in 137 SRs as 12 declared using RoB2 but actually used RoB1 and 59 did not report the number of primary outcomes. The tool usage was adherent in 69.3% SRs. Considering SRs with multiple primary outcomes, adherence dropped to 28.8%. We found a positive association between RoB2 guidance adherence and the methodological quality of the reviews assessed by AMSTAR2 (p-for-trend 0.007). Multivariable regression analysis suggested journal impact factor [first quartile vs. other quartiles] was associated with RoB2 adherence (OR 0.34; 95% CI: 0.16-0.72). CONCLUSIONS Many SRs did not adhere to RoB2 guidance as they applied the tool at the study level rather than at the outcome measure level. Lack of adherence was more likely among low and very low quality reviews.
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Affiliation(s)
- Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Marien Gonzalez-Lorenzo
- Laboratorio di Metodologia delle revisioni sistematiche e produzione di Linee Guida, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - Michela Cinquini
- Laboratorio di Metodologia delle revisioni sistematiche e produzione di Linee Guida, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Daniela Berardinelli
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Turin, Italy
| | - Celeste Cagnazzo
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy; Division of Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Stefano Ciardullo
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Paola De Nardi
- Gastrointestinal Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Paolo Iovino
- Department of Biomedicine and Prevention University of Rome Tor Vergata, Rome, Italy; School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Alex Lando
- Laboratory of Rehabilitation Technologies, IRCCS San Camillo Hospital, Venice, Italy
| | - Marco Rissone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Giovanni Simeone
- Local Health Unit of Brindisi, Pediatric Department, Brindisi, Italy
| | - Marta Stracuzzi
- Pediatric Infectious Disease Unit, Department of Pediatrics, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | | | - Lorenzo Moja
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giorgio Costantino
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Dickson VV, Iovino P, De Maria M, Vellone E, Alvaro R, Di Matteo R, Dal Molin A, Lusignani M, Bassola B, Maconi A, Bolgeo T, Riegel B. Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory Version 3.0. J Cardiovasc Nurs 2022; 38:00005082-990000000-00047. [PMID: 36288481 DOI: 10.1097/jcn.0000000000000952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND In this updated Self-Care of Coronary Heart Disease Inventory (SC-CHDI) v3.0, items were added to better reflect the theory of self-care of chronic illness and revised based on recent research. The expanded SC-CHDI now reflects the theoretical concepts of self-care maintenance, monitoring, and management. OBJECTIVE The aim of this study was to evaluate the psychometric properties of the SC-CHDI v3.0. METHODS In a sample of adults with coronary heart disease, we tested the SC-CHDI v3.0 validity with confirmatory factor analysis. Reliability was calculated using Cronbach α, factor score determinacy coefficient, and global reliability index for multidimensional scales, with values > 0.70 considered adequate. RESULTS The sample (n = 205) was predominantly male (79%) with a mean age of 65.3 ± 11.1 years. The self-care maintenance scale encompassed 2 distinct behaviors, namely, "illness related behaviors" and "health promoting behaviors," which reflect consulting and autonomous dimensions, respectively. The goodness-of-fit indices were adequate: χ2(25, N = 205) =31.86, P = .16, comparative fit index = 0.97, Tucker-Lewis Index = 0.95, root mean square error of approximation = 0.04 (90% confidence interval, 0.00-0.07), P = .705, and standardized root mean square residual = 0.045. Analysis of the new self-care monitoring scale yielded a single factor; goodness-of-fit indices were excellent: χ2(12, N = 205) =11.56, P = .48, comparative fit index = 1.00, Tucker-Lewis Index = 1.00, root mean square error of approximation < 0.001 (90% confidence interval, 0.000-0.07), P = .86, and standardized root mean square residual = 0.02. The self-care management scale had 2 dimensions of autonomous and consulting behavior with strong goodness-of-fit indices: χ2(7, N = 205) =6.57, P = .47, comparative fit index = 1.00, Tucker-Lewis Index = 1.00, root mean square error of approximation ≤ 0.001 (90% confidence interval, 0.00-0.08), P = .76, and standardized root mean square residual = 0.02. Reliability estimates were ≥0.80 for all scales. CONCLUSIONS Our testing suggests that the SC-CHDI v3.0 is a sound measure of the essential elements of self-care for adults with coronary heart disease.
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Caggianelli G, Iovino P, Rebora P, Ausili D, Alvaro R, Riegel B, Vellone E. Suggestions to Improve Research on Motivational Interviewing for Heart Failure Self-care: Insights From Study Experiences. J Cardiovasc Nurs 2022; 37:437-438. [PMID: 35200197 DOI: 10.1097/jcn.0000000000000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Baricchi M, Vellone E, Caruso R, Arrigoni C, Dellafiore F, Ghizzardi G, Pedroni C, Pucciarelli G, Alvaro R, Iovino P. Technology-Delivered Motivational Interviewing to Improve Health Outcomes in Patients with Chronic Conditions. A Systematic Review of the Literature. Eur J Cardiovasc Nurs 2022; 22:227-235. [PMID: 35943381 DOI: 10.1093/eurjcn/zvac071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/15/2022]
Abstract
AIM Provide an overview of remote Motivational Interviewing (MI) interventions for chronically-ill patients, and understand their degree of effectiveness on different health outcomes. METHODS AND RESULTS A systematic review with meta-analysis was conducted using the following databases: PubMed, CINAHL, PsychInfo, and Web of Science. Eligibility criteria included studies that administered remote MI alone or in combination with other remote approaches. A narrative synthesis and two meta-analyses were performed. Fifteen studies met the inclusion criteria. MI administration almost exclusively occurred by telephone and individual sessions. Eight studies reported treatment fidelity aspects, and four declared adopting a theoretical framework. Most targeted outcomes were therapeutic adherence, physical activity, depression, quality of life, and mortality. Risk of bias varied markedly, with the largest source resulting from selection process and intervention performance. The two meta-analyses indicated a significant effect of MI on depression (Standardized Mean Difference = -0.20, 95%CI: -0.34, -0.05, Z = 2.73, p = 0.006, I2 = 0%), and no effect of MI on glycosylated hemoglobin (Mean Difference = -0.02, 95%CI: -0.48, 0.45), p = 0.94, I2 = 84%). CONCLUSION Remote MI can be a promising approach for improving depression in chronic disease patients. However, studies are inconclusive due to risks of bias, heterogeneity, and lack of reporting of interventionist's training, treatment fidelity, and theoretical frameworks' use. More studies with solid designs are needed to inform clinical decision-making and research.
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Iovino P, Daniela D'angelo DD, Ercole Vellone EV, Matteo Ruggeri MR. The cost-effectiveness of nurse-led self-care interventions in patients with heart failure. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Nurse-led self-care interventions (NLSCI) in heart failure (HF), defined as the nurse education delivered to improve the daily patient self-management, are not widely adopted by the health-care systems, even though they are effective to improve outcomes (e.g., mortality, readmission). Moreover, few studies have evaluated whether NLSCI are also cost-effective.
Purpose
To determine the cost-effectiveness of NLSCI in the context of HF care compared with standard care (care delivered by general practitioner and/or cardiologist).
Methods
We performed a cost-effectiveness analysis, with a 20-year time horizon, from the perspective of the Italian National Health Service. We developed a Markov model to simulate the progression of a cohort of 1,000 HF patients aged 70 years, who were assumed to alternatively receive a NLSCI after hospital discharge, or usual care. Effectiveness on mortality and on hospitalizations of NLSCI and usual care were extrapolated from a review of randomized control trials. Health-care costs were derived from literature and national formularies. The differences in costs and the differences in Quality Adjusted Life Years (QALY) between the NLSCI and usual care were estimated to present an incremental cost-effectiveness ratio (ICER). A willingness to pay (WTP) threshold of €40,000 per QALY was considered. Probabilistic sensitivity analyses were conducted to test the robustness of results and to estimate a cost-effectiveness acceptability curve.
Results
Over the 20-year time horizon, NLSCI implied an extra cost of € 1.3 million and a gain of 247 QALYs compared to usual care. This resulted in an ICER of € 5,490/QALY, which is far below the €40,000/QALY WTP threshold. Sensitivity analysis showed that the ICER remains below the WTP threshold in 100% of simulations. Moreover, the cost-effectiveness acceptability curve showed a probability of 80% of being under € 7,500/QALY.
Conclusions
This study demonstrated that NLSCI represent an affordable solution to support patients with HF as the related extra costs of € 1.3 million is justified by the reduction in mortality and improvement in quality of life. This finding supports the promotion of NLSCI as part of routine care, in order to pursue an optimal allocation of public health expenditures.
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Affiliation(s)
- P Iovino
- University of Rome Tor Vergata, Rome, Italy. , Rome , Italy
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Iovino P, Giulia Locatelli LG, Giulia Locatelli LG, Alvaro Rosaria RA, Alvaro Rosaria RA, Barbara Riegel BR, Barbara Riegel BR, Corinne Jurgens CJ, Corinne Jurgens CJ, Ercole Vellone EV, Ercole Vellone EV. A cluster analysis of psychological and physical symptoms in patients with heart failure. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): CECRI (Center of Excellence for Nursing Scholarship) Rome
Background
The experience of psychological and physical symptoms of heart failure can be burdensome for patients. Identification of profiles of symptom burden may lead to greater understanding of the mechanism underlying this experience and improve symptom-centered care.
Purpose
The aim of this analysis was to identify profiles of psychological and physical symptoms in heart failure patients and compare the sociodemographic and clinical characteristics of patients in each cluster.
Methods
This was a secondary analysis of baseline data from the MOTIVATE-HF trial, that enrolled 510 patients across Italy. Cluster analysis was used to identify profiles of patients based on the two scores of the Hospital Anxiety and Depression scale and the total score of the Heart Failure Somatic Perception Scale. Each profile was described in terms of sociodemographic characteristics (e.g., age, gender, severity of disease), self-care maintenance and management behaviors, and self-efficacy (Self-care of Heart Failure Index), generic quality of life (12-item Short Form Survey), health-related quality of life (Kansas City Cardiomyopathy Questionnaire), and cognitive status (Montreal Cognitive Assessment Scale). Comparisons between the characteristics of each profile were performed by analysis of variance (ANOVA) and chi square test.
Results
Patients (n = 510) were 72.37 years old on average (SD = 12.28), with a slightly higher prevalence of men (58%). Sixty per cent of the sample were symptomatic: New York Heart Association (NYHA) class 2, 31.4% in NYHA class III, and 6.5% in NYHA class IV. Three profiles were identified: (1) low distress, characterized by the youngest patients (69.76, SD = 12.17), mostly in NYHA class II, and with the highest score on self-care self-efficacy and self-care maintenance behaviors; (2) average distress, characterized by the oldest patients (74.45, SD = 11.99), who were mostly retired, with the highest level of education, and poorest (physical) health-related quality of life and low self-care behaviors; (3) high distress, characterized by an average age of 73.08 (SD = 12.29), with the lowest hemoglobin level, the worst cognitive status, and the worst generic and health-related quality of life.
Conclusions
The profiles identified in this study and their characteristics provide new insights into the burden of psychological and physical symptoms experienced by heart failure patients. This represents the first step in promoting symptom-centered care in the future.
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Affiliation(s)
- P Iovino
- University of Rome Tor Vergata, Rome, Italy. , Rome , Italy
| | | | | | | | | | | | | | - C J Corinne Jurgens
- Boston College - William F. Connell School of Nursing , Boston , United States of America
| | - C J Corinne Jurgens
- Boston College - William F. Connell School of Nursing , Boston , United States of America
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Lee CS, Westland H, Faulkner KM, Iovino P, Thompson JH, Sexton J, Farry E, Jaarsma T, Riegel B. The effectiveness of self-care interventions in chronic illness: a meta-analysis of randomized controlled trials. Int J Nurs Stud 2022; 134:104322. [DOI: 10.1016/j.ijnurstu.2022.104322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
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Iovino P, Nolan A, De Maria M, Ausili D, Matarese M, Vellone E, Riegel B. The influence of social support on self-care is mediated by self-efficacy and depression in chronic illness: key findings from the 'SODALITY' observational study. Aging Ment Health 2022; 27:820-828. [PMID: 35416091 DOI: 10.1080/13607863.2022.2056877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objectives: Family is a major source of support for older chronically-ill patients and known to be associated with better self-care. Depression and self-care self-efficacy are associated with healthy behaviors and thus may serve as mechanisms by which family support influences self-care.We explored depression and self-care self-efficacy as mediators of the relationship between perceived family support and self-care.Methods: Five hundred forty-one older adults with multiple chronic illnesses were recruited from outpatients and community settings. Three structural equation models (SEM) were fit on cross-sectional data. We measured perceived family support (subscale of the Multidimensional Scale of Perceived Social Support, scores range 1-7), depression (Patient Health Questionnaire, scores range 0-27), selfcare self-efficacy (Self-Care Self Efficacy Scale, standardized scores range 0-100), and self-care maintenance, monitoring, and management (Self-care of Chronic Illness Inventory, standardized scores range 0-100).Results: Participants (mean age = 76.6±7.3 yrs) were predominantly females (55.6%). In the full sample, depression and self-care self-efficacy mediated the relationship between perceived family support and self-care; in the gender-stratified SEM, men's depression was no longer a significant mediator. Depression and self-care self-efficacy were significant mediators of the relation between perceived family support and self-care.Conclusion: In older chronically-ill patients, interventions addressing perceived family support may facilitate a rapid improvement in self-care self-efficacy and a decrease in depressive symptoms, particularly among women.
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Affiliation(s)
- Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Amy Nolan
- University of Pennsylvania, Philadelphia, PA, USA
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Monaco D, Zaghini F, Fiorini J, Venturini G, Iovino P, Vellone E, Alvaro R, Sili A. Effect of a wound healing protocol on patients with stage III and IV pressure ulcers: a preliminary observational study. J Wound Care 2022; 31:322-328. [DOI: 10.12968/jowc.2022.31.4.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: To evaluate the influence of a wound healing protocol for stage III and IV pressure ulcers (PUs), and to determine the predictive power of specific sociodemographic and clinical characteristics on wound healing and infection. Method: This longitudinal study included participants with stage III and IV PUs who were recruited from 10 acute care settings of an Italian university hospital, and who were managed with a protocol inspired by the TIMECare model. Data were collected between October 2018 and March 2019. The National Pressure Ulcer Advisory Panel Staging System was used to stage the PUs. Wound healing was assessed with the Pressure Ulcer Scale for Healing (PUSH). Nutritional status was assessed with the Mini Nutritional Assessment Index. Data collection took place at admission and every seven days thereafter—a total of six times before discharge. The outcome and predictors of wound healing were assessed with Student's paired t-tests and multiple linear regressions, respectively. Results: Patients (n=126) were almost equally split between male and female, with a mean age of 78.17 years and who were all retired. Stage III and IV PUs were most prevalent at the sacrum (65.5% and 73.2%, respectively). PUSH wound healing scores improved significantly after six weeks in both stage III and IV PUs (p<0.001). Nutritional status was predictive of wound healing (R2=0.12). Conclusion: Our results showed that a good nutritional status and a protocol inspired by the TIMECare model were associated with wound healing improvements in stage III and IV PUs. We recommend this protocol in older patients with stage III and IV PUs.
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Affiliation(s)
- Dario Monaco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Jacopo Fiorini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Australian Catholic University, Melbourne, Australia
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Sili
- Nursing Department, Tor Vergata University Hospital, Rome, Italy
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Bulfone G, Iovino P, Mazzotta R, Sebastian M, Macale L, Sili A, Vellone E, Alvaro R. Self-efficacy, burnout and academic success in nursing students: A counterfactual mediation analysis. J Adv Nurs 2022; 78:3217-3224. [PMID: 35307859 DOI: 10.1111/jan.15231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/20/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
AIM To test the mediating role of burnout in the relationship between self-efficacy and academic success in nursing students. DESIGN This was a cross-sectional secondary analysis of longitudinal research aimed at exploring the academic success of nursing students. METHODS We enrolled a convenience sample of nursing students attending 21 Italian baccalaureate nursing degree programmes. Data were collected from 2014 to the 2018-2019 academic year. We analysed the wave of data collected during the third year of the programme. The measurements were the Academic Nurse Self-Efficacy scale (ANSEs) and the Scale of Work Burnout (SWEBO). A mediation analysis with a counterfactual approach was performed. RESULTS The participants (n = 556) had a median age of 20 years (IQR 19-22) and the majority was female [70.5% (392/556)]. Academic success was reached by 51.97% (289/556) of the students. The findings reveal a significant direct effect of self-efficacy on academic success and also a significant indirect effect of this relationship via burnout. CONCLUSION The mechanism by which self-efficacy influences academic performance in nursing students is more complex than a simple direct relationship. Universities should consider screening students for variables affecting academic success to decrease academic costs and increase ranking systems classification. IMPACT Nurses' professors should be engaged in strategies to promote self-efficacy. The area of intervention should be structured both during classes and internships, in tandem with the mentor and the clinical nurse.
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Affiliation(s)
- Giampiera Bulfone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Australian Catholic University Melbourne
| | - Rocco Mazzotta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Loreana Macale
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Caggianelli G, Iovino P, Rebora P, Occhino G, Zeffiro V, Locatelli G, Ausili D, Alvaro R, Riegel B, Vellone E. A Motivational Interviewing Intervention Improves Physical Symptoms in Patients with Heart Failure: A Secondary Outcome Analysis of the Motivate-HF Randomized Controlled Trial. J Pain Symptom Manage 2022; 63:221-229.e1. [PMID: 34571194 DOI: 10.1016/j.jpainsymman.2021.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 12/28/2022]
Abstract
CONTEXT Heart failure (HF) patients experience high burden of physical symptoms during their disease trajectory. OBJECTIVE To evaluate the effects of Motivational Interviewing (MI) on the burden of physical symptoms in HF patients. METHODS We performed a secondary analysis of data from the MOTIVATE-HF randomized controlled trial. A sample of 510 patients (median 74 years, 58% male) and their caregivers (median 55 years, 75.5% female) was randomly allocated to Arm 1 (MI only for patients), Arm 2 (MI for patients and caregivers), and Arm 3 (standard of care). The MI intervention consisted of one face-to-face session plus three telephone calls conducted within two months from enrollment. Symptoms' burden was assessed with the Heart Failure Somatic Perception Scale (HFSPS) with the dimensions of Chest Discomfort, Dyspnea, Early and subtle and Edema. Data were collected at baseline and at 3, 6, 9, and 12 months after enrollment. RESULTS At 12 months, Chest Discomfort improved in Arms 1 and 2 vs Arm 3 (Δ: -8.13, 95% CI: -14.61; -1.65). Dyspnea improved in Arms 1 and 2 vs Arm 3 both at 9 and 12 months (Δ: -7, 95% CI: -13.18; -0.82 and -6.78, 95% CI: -13.19; -0.38); HFSPS total score improved in Arm 1 and Arm 2 vs Arm 3 at 9 months (Δ: -4.55, 95% CI: -9.05; -0.05). Over 1 year, Chest Discomfort and HFSPS total score in Arm 2 improved compared to Arm 3 (β= -2.61, 95% CI: -4.21; -1.00, P = 0.0015 and β=-1.35, 95% CI: -2.50; -0.21, P = 0.02). CONCLUSION MI reduces the burden of physical HF symptoms, particularly when caregivers are involved in the intervention.
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Affiliation(s)
- Gabriele Caggianelli
- Department of Biomedicine and Prevention (G.C., P.I., V.Z., G.L., R.A., E.V.), University of Rome Tor Vergata, Rome, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention (G.C., P.I., V.Z., G.L., R.A., E.V.), University of Rome Tor Vergata, Rome, Italy; School of Nursing, Midwifery and Paramedicine Faculty of Health Science (P.I., G.L.), Australian Catholic University, Melbourne, Australia.
| | - Paola Rebora
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre - B4 School of Medicine and Surgery (P.R., G.O.), University of Milan-Bicocca, Monza, Italy
| | - Giuseppe Occhino
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre - B4 School of Medicine and Surgery (P.R., G.O.), University of Milan-Bicocca, Monza, Italy
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention (G.C., P.I., V.Z., G.L., R.A., E.V.), University of Rome Tor Vergata, Rome, Italy
| | - Giulia Locatelli
- Department of Biomedicine and Prevention (G.C., P.I., V.Z., G.L., R.A., E.V.), University of Rome Tor Vergata, Rome, Italy; School of Nursing, Midwifery and Paramedicine Faculty of Health Science (P.I., G.L.), Australian Catholic University, Melbourne, Australia
| | - Davide Ausili
- Department of Medicine and Surgery (D.A.), University of Milan-Bicocca, Monza, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention (G.C., P.I., V.Z., G.L., R.A., E.V.), University of Rome Tor Vergata, Rome, Italy
| | - Barbara Riegel
- School of Nursing (B.R.), University of Pennsylvania, Philadelphia, PA, USA; Mary McKillop Institute of Health Research (B.R.), Australian Catholic University, Melbourne, Australia
| | - Ercole Vellone
- Department of Biomedicine and Prevention (G.C., P.I., V.Z., G.L., R.A., E.V.), University of Rome Tor Vergata, Rome, Italy
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De Maria M, Iovino P, Lorini S, Ausili D, Matarese M, Vellone E. Development and Psychometric Testing of the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale. Value Health 2021; 24:1407-1415. [PMID: 34593163 DOI: 10.1016/j.jval.2021.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Caregiver self-efficacy-a caregiver's belief in his/her ability to contribute to patient self-care-is associated with better patient and caregiver outcomes in single chronic conditions. It is, however, unknown if caregiver self-efficacy improves patient and caregiver outcomes in multiple chronic conditions (MCCs) because there is no instrument to measure this variable. We developed the 10-item Caregiver Self-Efficacy in Contributing to patient Self-Care (CSE-CSC) scale for that purpose, and we tested its psychometric characteristics in caregivers of patients with MCCs. METHODS In this cross-sectional multisite study, we tested the structural validity of the CSE-CSC scale with exploratory and confirmatory factor analysis, and we tested construct validity by correlating CSE-CSC scores with those of the Caregiver Contributions to Self-Care of Chronic Illness Inventory. We also tested reliability, and precision of the CSE-CSC scale. RESULTS The 358 enrolled caregivers (mean age 54.6 years; 71.5% female) cared for patients with an average of 3.2 chronic conditions. Structural validity was good, and it showed 2 factors within the scale. Construct validity showed significant correlations between scores of the CSE-CSC scale and the Caregiver Contributions to Self-Care of Chronic Illness Inventory. Reliability coefficients were between 0.90 and 0.97. Measurement error yielded satisfactory results. CONCLUSIONS The CSE-CSC scale is valid, reliable, and precise in measuring caregiver self-efficacy in contributing to patient self-care in MCCs. Because caregiver self-efficacy is a modifiable variable, the CSE-CSC scale can be used in clinical practice and research to improve patient and caregiver outcomes.
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Affiliation(s)
- Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Lorini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Maria Matarese
- Research Unit of Nursing Science, Campus Bio-medico University of Rome, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Caggianelli G, Iovino P, Rebora P, Occhino G, Zeffiro V, Locatelli G, Ausili D, Alvaro R, Riegel B, Vellone E. A motivational interviewing intervention improves the burden of physical symptoms in patients with heart failure: A secondary outcome analysis of a randomized clinical trial. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Center of Excellence for Nursing Scholarship, Rome, Italy
Background. Patients with heart failure (HF) experience a variety of physical symptoms. Symptoms are perceived by patients as burdensome and, as such, negatively affect quality of life. Besides, physical symptoms are among the first reasons for seeking emergency care and hospitalization. Findings from the MOTIVATE-HF trial show that motivational interviewing (MI) leads to better self-care. However, whether MI also reduces the burden of physical symptoms is not yet known.
Purpose. To evaluate the effectiveness of MI on the burden of physical symptoms in patients with HF.
Methods. Secondary outcome analysis of the MOTIVATE-HF trial. The study was a three-arm, multicenter randomized controlled trial with a 12-month follow-up. Patients with HF and their informal caregivers were enrolled and randomly divided into three arms: MI performed only with patients (Arm 1); MI performed both with patients and caregivers (Arm 2); usual care (Arm 3). Patients with a diagnosis of HF in NYHA functional class II-IV were recruited in three Italian centers. Participants underwent one face-to-face MI session, followed by three phone calls within two months from enrollment. Physical symptoms were measured with the Heart Failure Somatic Perception Scale (HFSPS) with the dimensions of dyspnea, chest discomfort, early and subtle, and edema. Higher scores at the HFSPS and its dimensions indicate worse physical symptom. Data were collected at baseline, and 3 (T1), 6 (T2), 9 (T3) and 12 (T4) months after enrollment. T-test was used to compare differences in HFSPS scores in Arms 1 and 2 versus Arm 3 at each follow-up. Changes over time were analyzed with mixed linear longitudinal models.
Results. A sample of 510 patients (median 74 years, 58% male) and their caregivers (median 55 years, 75.5% female) were randomized to Arm 1 (n = 155), Arm 2 (n = 177) and Arm 3 (n = 178). Chest discomfort improved in Arms 1 and 2 versus Arm 3 at T4 (mean difference(Δ): -8.13, P = .014). Dyspnea also improved in Arms 1 and 2 than Arm 3 both at T3 and T4 (Δ: -7, P = .027 and Δ: -6.78, P = .038, respectively). HFSPS total score improved in Arms 1 and 2 versus Arm 3 at T3 (Δ: -4.55, P = .048). Over the year of observation, the mixed linear longitudinal models showed a significant improvement in Chest discomfort and total HFSPS score in Arm 2 versus Arm 3 (β = -2.61, P = .002 and, β = -1.35, P = .02).
Conclusions. The results of this secondary analysis indicate that MI may be effective in decreasing the burden of physical symptoms in HF patients, especially if also caregivers are involved in the intervention. Since symptom burden is among the first reasons for seeking emergency care and hospitalization in HF, MI might be a viable option to improve symptom burden via self-care.
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Affiliation(s)
- G Caggianelli
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy
| | - P Iovino
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy
| | - P Rebora
- University of Milan-Bicocca, Department of Medicine and Surgery, Monza, Italy
| | - G Occhino
- University of Milan-Bicocca, Biostatistics and Bioimaging Centre, Monza, Italy
| | - V Zeffiro
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy
| | - G Locatelli
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy
| | - D Ausili
- University of Milan-Bicocca, Department of Medicine and Surgery, Monza, Italy
| | - R Alvaro
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy
| | - B Riegel
- University of Pennsylvania, School of Nursing, Philadelphia, United States of America
| | - E Vellone
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Rome, Italy
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Giordano V, Iovino P, Corvese F, Vellone E, Alvaro R, Villa G. Caregiver contribution to self-care and its associated variables among caregivers of ostomy patients: Results of a cross-sectional study. J Clin Nurs 2021; 31:99-110. [PMID: 34121255 DOI: 10.1111/jocn.15851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/02/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe caregiver contribution (CC) to ostomy self-care and identify its associated variables among caregivers of ostomy patients. BACKGROUND Self-care is essential for ostomy patients, but it can be difficult to perform. In these cases, caregivers play a key role in promoting self-care behaviours. So far, the CC to ostomy self-care has not been investigated thoroughly. DESIGN This is a cross-sectional and multicentre study conducted at seven outpatient clinics of two Italian regions. METHODS We recruited 252 caregivers between February 2017-May 2018. The Caregiver Contribution to Ostomy Self-Care Index (CC-OSCI) was used to measure CC to ostomy self-care. Three multivariable linear regression models were fitted to identify variables associated with CC dimensions (maintenance, monitoring and management). The STROBE checklist was used to report the present study. RESULTS The sample (mean age = 58.73, SD = 13.98) was mostly female (80.60%), unemployed (58.70%) and resided with the patient (81.00%). Caregivers being employed and those declaring more hours of contribution per week were associated with a significantly lower contribution to self-care maintenance. Caregivers with lower levels of education and those residing with the patient were less likely to contribute to CC to self-care monitoring. Spousal caregivers and those with higher preparedness contributed significantly lower to CC to self-care management. CONCLUSIONS We found a variety of sociodemographic factors associated with CC to ostomy self-care. RELEVANCE TO CLINICAL PRACTICE Sociodemographic variables associated with CC to ostomy self-care can help clinicians develop more tailored educational interventions for caregivers who find their contribution challenging.
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Affiliation(s)
- Vittoria Giordano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Francesco Corvese
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
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Iovino P, Rebora P, Occhino G, Zeffiro V, Caggianelli G, Ausili D, Alvaro R, Riegel B, Vellone E. Effectiveness of motivational interviewing on health-service use and mortality: a secondary outcome analysis of the MOTIVATE-HF trial. ESC Heart Fail 2021; 8:2920-2927. [PMID: 34085763 PMCID: PMC8318502 DOI: 10.1002/ehf2.13373] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/25/2021] [Accepted: 04/01/2021] [Indexed: 01/10/2023] Open
Abstract
Aims Intense health‐care service use and high mortality are common in heart failure (HF) patients. This secondary analysis of the MOTIVATE‐HF trial investigates the effectiveness of motivational interviewing (MI) in reducing health‐care service use (e.g. emergency service use and hospitalizations) and all‐cause mortality. Methods and results This study used a randomized controlled trial. Patients and caregivers were randomized to Arm 1 (MI for patients), Arm 2 (MI for patients and caregivers), or Arm 3 (control group). Data were collected at baseline and at 3, 6, 9, and 12 months. Face‐to‐face MI plus three telephone calls were performed in Arms 1 and 2. The sample consisted of 510 patient (median age 74 years, 58% male patients) and caregiver dyads (median age 55 years, 75% female patients). At 12 months, 16.1%, 17%, and 11.2% of patients used health‐care services at least once in Arms 1, 2, and 3, respectively, without significant difference. At 3 months, 1.9%, 0.6%, and 5.1% of patients died in Arms 1, 2, and 3, respectively. Mortality was lower in Arm 2 vs. Arm 3 at 3 months [hazard ratio (HR) = 0.112, 95% CI: 0.014–0.882, P = 0.04]; no difference was found at subsequent follow‐ups. Mortality was lower in Arm 1 vs. Arm 3 at 3 months but did not reach statistical significance (HR = 0.38, 95% CI: 0.104–1.414, P = 0.15). Conclusion This study suggests that MI reduces mortality in patients with HF if caregivers are included in the intervention. Further studies with a stronger intervention and longer follow‐up are needed to clarify the benefits of MI on health‐care service use and mortality.
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Affiliation(s)
- Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Paola Rebora
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre - B4 School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Giuseppe Occhino
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre - B4 School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gabriele Caggianelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Eileen O'Connor Institute of Nursing Research, Australian Catholic University
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Affiliation(s)
- P Iovino
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - M Bellini
- Gastrointestinal Unit-Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Monaco D, Iovino P, Lommi M, Marano G, Zaghini F, Vellone E, Alvaro R, Sili A. Outcomes of wound care nurses' practice in patients with pressure ulcers: An integrative review. J Clin Nurs 2020; 30:372-384. [PMID: 33270322 DOI: 10.1111/jocn.15583] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/27/2020] [Accepted: 11/13/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Wound care nurses are recognised as a key element for improving health outcomes. However, there is still fragmented knowledge of the outcomes associated with their practice in individuals with pressure ulcers. AIMS AND OBJECTIVES To identify, summarise and map all available evidence related to the outcomes of wound care nurses' practice in individuals with pressure ulcers. DESIGN Integrative literature review. REVIEW METHOD To report the review, we followed the modified version of Cooper's five-step methodology, and the PRISMA guidelines. METHODS The search was carried out on CINAHL, PubMed, the Cochrane Library and Scopus, with a time frame ranging from each database inception to December 21, 2019. We included observational or experimental studies of adult individuals affected by (or at risk of) developing pressure ulcers who were also cared for by wound care nurses. RESULTS Of the 439 peer-reviewed publications, 13 studies met the inclusion criteria. The most frequent outcomes were pressure ulcer incidence, healing rate and time taken for complete healing. Less frequent outcomes were changes in pressure ulcers' stage, number of completely healed wounds, treatment costs and physical discomfort. No patient-reported outcomes were assessed. CONCLUSION This review indicates that clinical-related outcomes were by far the most reported. Future studies should broaden the spectrum of outcomes to include more subjective parameters (e.g. pain, quality of life, stress, etc.), in order to gain a better understanding of the global impact of wound care practice on patients with pressure ulcers. RELEVANCE TO CLINICAL PRACTICE There is promising evidence of a positive impact of wound care nurses' practice on health and economic outcomes. Nonetheless, more robust and rigorous research is needed to provide stronger evidence in the field and support investment in these practitioners.
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Affiliation(s)
- Dario Monaco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing Midwifery and Paramedicin Australian Catholic University, Melbourne, Australia
| | | | | | - Francesco Zaghini
- Nursing Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Sili
- Nursing Department, Tor Vergata University Hospital, Rome, Italy
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Vellone E, De Maria M, Iovino P, Barbaranelli C, Zeffiro V, Pucciarelli G, Durante A, Alvaro R, Riegel B. The Self-Care of Heart Failure Index version 7.2: Further psychometric testing. Res Nurs Health 2020; 43:640-650. [PMID: 33141495 DOI: 10.1002/nur.22083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/25/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022]
Abstract
Clinicians and researchers need valid and reliable instruments to evaluate heart failure (HF) self-care. The Self-Care of Heart Failure Index (SCHFI) is a theoretically driven instrument developed for this purpose. The SCHFI measures self-care with three scales: self-care maintenance, measuring behaviors to maintain HF stability; symptom perception, measuring monitoring behaviors; and self-care management, assessing the response to symptoms. After the theory underpinning the SCHFI was updated, the instrument was updated to version 7.2 but it was only tested in the United States. In this study we tested the psychometric characteristics (structural and construct validity, internal consistency, and test-retest reliability) of the SCHFI v.7.2 in an Italian population of HF patients. We used a cross-sectional design to study 280 HF patients with additional data collected after 2 weeks for test-retest reliability. Adults with HF (mean age 75.6 (±10.8); 70.8% in New York Heart Association [NYHA] classes II and III) were enrolled from six centers across Italy. Confirmatory factor analysis showed supportive structural validity in the three SCHFI v.7.2 scales (CFI from 0.94 to 0.95; RMSEA from 0.05 to 0.07). Internal consistency reliability estimated with Cronbach's α and composite reliability ranged between .73 and .88; test-retest reliability ranged between 0.73 and 0.92. Construct validity was supported with significant correlations between the SCHFI v.7.2 scale scores and quality of life, brain natriuretic peptide levels and NYHA class. This study further supports the psychometric characteristics of the SCHFI v.7.2, illustrating that it can be used in clinical practice and research also in an Italian population.
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Affiliation(s)
- Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing, Australian Catholic University, Melbourne, Australia
| | | | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angela Durante
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Westland H, Jaarsma T, Riegel B, Iovino P, Henry Osokpo O, Stawnychy M, Tarbi E. Self-care interventions in patients with coronary artery disease: room for improvement. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
After a coronary artery event it is vital that patients perform self-care Self-care can be defined broadly as a process of maintaining health through treatment adherence and health-promoting practices (self-care maintenance), behavior and condition monitoring (self-care monitoring), and managing signs and symptoms when they occur (self-care management). For patients with coronary artery disease (CAD) essential self-care activities include adherence to medication, risk-factor management, symptom monitoring and preventive behavior. To advance the field of self-care in CAD patients, it is important to understand which self-care elements are currently addressed in interventions studies. The purpose of this study was to describe which behaviors are emphasized in self-care interventions for patients with CAD.
Methods
We conducted a systematic review of self-care interventions in chronic diseases. Four databases were search for randomized controlled trials with allocation to an intervention or to usual care or another intervention in adults with nine major symptomatic chronic conditions, one of which was coronary artery disease. Between 2008 and 2019 there were 9309 potential articles addressing self-care in chronic disease. After duplicates were removed and titles and abstracts were reviewed, 166 full-text articles on CAD studies evaluating a self-care intervention were assessed for eligibility and 15 studies remained after further assessment.
Results
Almost all studies (80%) in CAD patients included all three components of self-care (self-care maintenance, monitoring and management) in their interventions. Self-care maintenance behaviors addressed in these studies were mainly related to physical activity (73%) diet (60%) and medication management (33%) Another 40% included a psychosocial component, but only 4 studies (26%) were specially targeted at smoking behavior. With regard to self-care monitoring, most (60%) included monitoring of their physical activity level and 26% monitoring of symptoms. Self-care management behaviours were addressed rarely, but when addressed, focused on adapting activity level (60%), adapting diet (27%), medication changes (20%) and stress reduction (20%). Goal setting (60%), problem solving (40%) and feedback (33%) were the behavioural change techniques that were used most often to promote self-care. Only 1 study mentioned the use of social support. One study used reminders.
Conclusions
Most interventions that are tested to improve outcomes in patients with CAD address self-care maintenance, monitoring, management. The behavioural change techniques used are limited. There is a large variation in which behaviours are emphasized in research studies and the focus is primarily on changing traditional lifestyle factors, but not all life-style factors are addressed adequately in the interventions.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Australian Catholic University
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Affiliation(s)
- H Westland
- University Medical Center Utrecht, Julius Center, Utrecht, Netherlands (The)
| | - T Jaarsma
- Linkoping University, Linkoping, Sweden
| | - B Riegel
- Australian Catholic University, Melbourne, Australia
| | - P Iovino
- University of Rome Tor Vergata, Rome, Italy
| | - O Henry Osokpo
- University of Pennsylvania, School of Nursing, Philadelphia, United States of America
| | - M Stawnychy
- University of Pennsylvania, School of Nursing, Philadelphia, United States of America
| | - E Tarbi
- University of Pennsylvania, School of Nursing, Philadelphia, United States of America
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Iovino P, De Maria M, Matarese M, Vellone E, Ausili D, Riegel B. Depression and self-care in older adults with multiple chronic conditions: A multivariate analysis. J Adv Nurs 2020; 76:1668-1678. [PMID: 32281683 DOI: 10.1111/jan.14385] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 11/25/2022]
Abstract
AIMS To investigate the relationship between depression and self-care behaviours in older individuals with multimorbidity. DESIGN Cross-sectional study. Data were collected between April 2017 - June 2019. METHODS Patients were enrolled from community and outpatient settings and included if they were ≥65 years, affected by heart failure, diabetes mellitus or chronic obstructive pulmonary disease and at least another chronic condition. They were excluded if they had dementia and/or cancer. Patient Health Questionnaire-9 was used to measure depression and Self-Care of Chronic Illness Inventory was used to measure self-care maintenance, monitoring, and management. The relationship between depression and self-care was evaluated by performing two sets of univariate analyses, followed by multivariate and step-down analyses. The second set was performed to control for the number of chronic conditions, age, and cognitive function. RESULTS The sample (N = 366) was mostly female (54.2%), with a mean age of 76.4 years. Most participants (65.6%) had mild to very severe depressive symptoms. Preliminary analysis indicated a significant negative association between depression and self-care maintenance and monitoring and a significant negative association between depression and multivariate self-care. Step-down analysis showed that self-care maintenance was the only dimension negatively associated with depression, even after controlling for the number of chronic conditions, age, and cognitive function. CONCLUSION In multimorbid populations, depression is more likely to be associated with self-care maintenance than the other self-care dimensions. Therefore, self-care maintenance behaviours (e.g., physical activity and medication adherence) should be prioritized in assessment and focused on when developing interventions targeting depressed older adults with multimorbidity. IMPACT The results of this study may help guide clinical practice. In patients with depressive symptoms, self-care maintenance behaviours should be assessed first, as a potential first indicator of poor self-care.
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Affiliation(s)
- Paolo Iovino
- University of Rome Tor Vergata, Rome, Italy.,Australian Catholic University, Melbourne, Australia
| | | | | | | | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
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Iovino P, Lyons KS, De Maria M, Vellone E, Ausili D, Lee CS, Riegel B, Matarese M. Patient and caregiver contributions to self-care in multiple chronic conditions: A multilevel modelling analysis. Int J Nurs Stud 2020; 116:103574. [PMID: 32276720 DOI: 10.1016/j.ijnurstu.2020.103574] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/22/2020] [Accepted: 03/07/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Multiple chronic conditions (MCC) are highly prevalent worldwide, especially among older populations. Patient self-care and care partner (or caregiver) contributions to self-care are recommended to reduce the impact of MCC and improve patients' outcomes. OBJECTIVES To describe patient self-care and care partner contributions to self-care and to identify determinants of patient self-care and care partner contributions to self-care at the patient and care partner level. DESIGN Multicentre cross-sectional study. SETTING Outpatient and community settings in Italy. PARTICIPANTS A sample of 340 patients with MCC and care partner dyads was recruited between 2017 and 2018. METHODS We measured patient's self-care and care partner contributions to self-care in dyads using the Self-care of Chronic Illness Inventory and the Caregiver Contribution to Self-care of Chronic Illness Inventory. To control for dyadic interdependence, we performed a multilevel modelling analysis. RESULTS Patients' and care partners' mean ages were 76.65 (± 7.27) and 54.32 (± 15.25), respectively. Most care partners were female and adult children or grandchildren. The most prevalent chronic conditions in patients were diabetes (74%) and heart failure (34%). Patients and care partners reported higher levels of self-care monitoring than self-care maintenance and management behaviours. Important patient clinical determinants of self-care included cognitive status, number of medications and type of chronic condition. Care partner determinants of self-care contributions included age, gender, education, perceived income, care partner burden, caregiving hours per week and the presence of a secondary care partner. CONCLUSIONS Our findings support the importance of taking a dyadic approach when focusing on patients with MCC and their care partners. More dyadic longitudinal research is recommended to reveal the modifiable determinants of self-care and the complex relationships between patients and care partners in the context of MCC.
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Affiliation(s)
- Paolo Iovino
- University of Rome "Tor Vergata", Rome, Italy; Australian Catholic University, Melbourne, Australia.
| | | | | | | | | | | | - Barbara Riegel
- University of Pennsylvania, Philadelphia, United States.
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Iovino P, Scudeller L, Ferretti VV, Arcaini L, Dellafiore F. ICA-EMA: A Tool for Assessing Nursing Complexity of Patients With Oncohematologic Disease in an Italian Center. Creat Nurs 2019; 25:157-168. [PMID: 31085671 DOI: 10.1891/1078-4535.25.2.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Inpatients with hematologic cancer (HC), particularly in an aging population, often require levels of nursing care that feel very demanding. Therefore, it is important to assess nursing complexity in this care environment. The purpose of this study is to assess nursing complexity of inpatients with HC. A prospective observational study was carried out on 131 patients admitted to an adult hematologic center in northern Italy. The following variables were analyzed by means of the Index of Caring Complexity (ICA): age, sex, diagnostic category, purpose of admission, presence of transplant, Charlson Comorbidity Index, and length of stay. A total sample of 131 patients were enrolled. Patients older than 65 years, with a history of transplant, admitted for complications, and with a diagnosis of myeloma or myelodysplasia had higher ICA scores. Therefore, patients in these groups are more likely to exhibit a higher nursing complexity than other patients. The study results can help health-care professionals identify, at an early stage, patients who need higher levels of nursing care; promote a more efficient allocation of nursing staff to the patient needs based on their group; and qualify the need for higher levels of nursing care in order to improve nursing care quality and achieve higher standards of care in Italian hematologic centers.
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Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, Buchwald H, Scopinaro N. IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg 2018; 28:3783-3794. [PMID: 30121858 DOI: 10.1007/s11695-018-3450-2] [Citation(s) in RCA: 598] [Impact Index Per Article: 99.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIM The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), being a Federation of 62 national societies, is the ideal network to monitor the number and type of procedures at a global level. The IFSO survey, enriched with a special section on revisional procedures, aims to report the number and types of bariatric procedures performed worldwide in 2016 and analyzes the surgical trends from 2008 to 2016. METHODS The 2016 IFSO Survey form was emailed to all IFSO societies. Each Society was requested to indicate the number and type of bariatric procedures performed in the country. Trend analyses from 2008 to 2016 were also performed. RESULTS The total number of bariatric/metabolic procedures performed in 2016 was 685,874; 634,897 (92.6%) of which were primary and 50,977 were revisional (7.4%). Among the primary interventions, 609,897 (96%) were surgical and 25,359 (4%) were endoluminal. The most performed primary surgical bariatric/metabolic procedure was sleeve gastrectomy (SG) (N = 340,550; 53.6%), followed by Roux-en-Y gastric bypass (N = 191,326; 30.1%), and one-anastomosis gastric bypass (N = 30,563; 4.8%). CONCLUSIONS In 2016, there was an increase in the total number both of surgical and endoluminal bariatric/metabolic procedures. Revisional procedures represent about 7% of the total bariatric interventions. SG remains the most performed surgical procedure in the world.
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Affiliation(s)
- Luigi Angrisani
- General and Endoscopic Surgery Unit, "S. Giovanni Bosco" Hospital, Via Filippo Maria Briganti, 255, Naples, Italy.
| | - A Santonicola
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - P Iovino
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - A Vitiello
- General and Endoscopic Surgery Unit, "S. Giovanni Bosco" Hospital, Via Filippo Maria Briganti, 255, Naples, Italy
| | - K Higa
- Advanced Laparoscopy Surgery Associates, Fresno Heart and Surgical Hospital, Fresno, CA, USA
- Fresno Medical Education Program, University of California, San Francisco, San Francisco, CA, USA
| | - J Himpens
- Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - H Buchwald
- Departments of Surgery and Biomedical Engineering, University of Minnesota, Minneapolis, MN, 55455, USA
| | - N Scopinaro
- Department of Surgery, University of Genoa, School of Medicine, Genoa, Italy
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Angrisani L, Santonicola A, Vitiello A, Ferraro L, Iovino P. Reply to Letter to the Editor "Left Gastric Artery Embolization for Weight Loss-a Dead-End Procedure". Obes Surg 2018; 28:3627-3628. [PMID: 30128644 DOI: 10.1007/s11695-018-3464-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Luigi Angrisani
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Via Filippo Maria Briganti, 255, Naples, Italy.
| | - A Santonicola
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - A Vitiello
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Via Filippo Maria Briganti, 255, Naples, Italy
| | - L Ferraro
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Via Filippo Maria Briganti, 255, Naples, Italy
| | - P Iovino
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Angrisani L, Santonicola A, Vitiello A, Ferraro L, Iovino P. Reply to Letter to the Editor in Response to "Elipse Balloon: the Pitfalls of Excessive Simplicity". Obes Surg 2018; 28:3633. [PMID: 30121856 DOI: 10.1007/s11695-018-3461-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Luigi Angrisani
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Via Filippo Maria Briganti, 255, Naples, Italy.
| | - A Santonicola
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - A Vitiello
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Via Filippo Maria Briganti, 255, Naples, Italy
| | - L Ferraro
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Via Filippo Maria Briganti, 255, Naples, Italy
| | - P Iovino
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Bucci C, Amato M, Zingone F, Caggiano M, Iovino P, Ciacci C. Prevalence of Sleep Bruxism in IBD Patients and Its Correlation to Other Dental Disorders and Quality of Life. Gastroenterol Res Pract 2018; 2018:7274318. [PMID: 29721012 PMCID: PMC5867589 DOI: 10.1155/2018/7274318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/21/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Patients with inflammatory bowel diseases could experience mouth and teeth disorders and alterations in psychological mood. Vice versa, the psychological status may influence the presence of oral diseases. AIM To evaluate in inflammatory bowel disease patients the prevalence of sleep bruxism and its correlation with the presence of oral diseases, quality of sleep, and psychological disturbances. METHODS Patients were consecutively recruited in our clinic and examined for temporomandibular disorders, dental enamel disorders, sleep bruxism, and recurrent aphthous stomatitis by two dentists. Patients also underwent Pittsburgh Sleep Quality Index and Beck Depression Inventory Scale questionnaires. RESULTS 47 patients and 46 controls were included. Sleep bruxism and enamel wear disorders were more frequent in Crohn's disease patients when compared with ulcerative colitis patients and controls (p = 0.03 and p = 0.02, resp.). Among groups, no differences were noted for enamel hypoplasia, temporomandibular disorders, recurrent aphthous stomatitis, depression, and quality of sleep. We found a positive correlation between bruxism and temporomandibular disorders (Spearman 0.6, p < 0.001) and between bruxism and pathological sleep (Pittsburgh Sleep Quality Index > 5) (Spearman 0.3, p < 0.005). CONCLUSION Bruxism and enamel wear disorders should be routinely searched in Crohn's disease patients. Moreover, the attention of healthcare givers to sleep disturbances should be addressed to all inflammatory bowel disease patients.
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Affiliation(s)
- C Bucci
- Gastroenterology Unit, Department of Medicine and Surgery, AOU San Giovanni di Dio e Ruggi D'Aragona, University of Salerno, Salerno, Italy
| | - M Amato
- Department of Stomatology, AOU San Giovanni di Dio e Ruggi D'Aragona, University of Salerno, Salerno, Italy
| | - F Zingone
- Gastroenterology Unit, Department of Medicine and Surgery, AOU San Giovanni di Dio e Ruggi D'Aragona, University of Salerno, Salerno, Italy
| | - M Caggiano
- Department of Stomatology, AOU San Giovanni di Dio e Ruggi D'Aragona, University of Salerno, Salerno, Italy
| | - P Iovino
- Gastroenterology Unit, Department of Medicine and Surgery, AOU San Giovanni di Dio e Ruggi D'Aragona, University of Salerno, Salerno, Italy
| | - C Ciacci
- Gastroenterology Unit, Department of Medicine and Surgery, AOU San Giovanni di Dio e Ruggi D'Aragona, University of Salerno, Salerno, Italy
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Angrisani L, Santonicola A, Vitiello A, Iovino P. Reply to Letter to the Editor: Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg 2018; 28:251-252. [PMID: 29147939 DOI: 10.1007/s11695-017-2958-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- L Angrisani
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy.
| | - A Santonicola
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - A Vitiello
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - P Iovino
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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Vanore P, Coppola E, Iovino P, Leone V, Salvestrini S, Capasso S. Sorption thermodynamics of organic pollutants onto zeolitic tuff: Isosteric and standard enthalpy. J WATER CHEM TECHNO+ 2017. [DOI: 10.3103/s1063455x17040087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Angrisani L, Santonicola A, Iovino P, Vitiello A, Zundel N, Buchwald H, Scopinaro N. Erratum to: Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg 2017; 27:2290-2292. [PMID: 28681258 PMCID: PMC6829693 DOI: 10.1007/s11695-017-2773-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- L. Angrisani
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - A. Santonicola
- 0000 0004 1937 0335grid.11780.3fGastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende, Baronissi, Salerno, Italy
| | - P. Iovino
- 0000 0004 1937 0335grid.11780.3fGastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende, Baronissi, Salerno, Italy
| | - A. Vitiello
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - N. Zundel
- Minimally Invasive and Bariatric Surgery, FSFB, Bogota, Colombia
| | - H. Buchwald
- 0000000419368657grid.17635.36Department of Surgery, University of Minnesota, Minneapolis, MN 55455 USA
- 0000000419368657grid.17635.36Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455 USA
| | - N. Scopinaro
- 0000 0001 2151 3065grid.5606.5Department of Surgery, School of Medicine, University of Genoa, Genoa, Italy
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Abstract
BACKGROUND AND AIM Several bariatric surgery worldwide surveys have been previously published to illustrate the evolution of bariatric surgery in the last decades. The aim of this survey is to report an updated overview of all bariatric procedures performed in 2014.For the first time, a special section on endoluminal techniques was added. METHODS The 2014 International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) survey form evaluating the number and the type of surgical and endoluminal bariatric procedures was emailed to all IFSO societies. Trend analyses from 2011 to 2014 were also performed. RESULTS There were 56/60 (93.3%) responders. The total number of bariatric/metabolic procedures performed in 2014 consisted of 579,517 (97.6%) surgical operations and 14,725 (2.4%) endoluminal procedures. The most commonly performed procedure in the world was sleeve gastrectomy (SG) that reached 45.9%, followed by Roux-en-Y gastric bypass (RYGB) (39.6%), and adjustable gastric banding (AGB) (7.4%). The annual percentage changes from 2013 revealed the increase of SG and decrease of RYGB in all the IFSO regions (USA/Canada, Europe, and Asia/Pacific) with the exception of Latin/South America, where SG decreased and RYGB represented the most frequent procedure. CONCLUSIONS There was a further increase in the total number of bariatric/metabolic procedures in 2014 and SG is currently the most frequent surgical procedure in the world. This is the first survey that describes the endoluminal procedures, but the accuracy of provided data should be hopefully improved in the next future. We encourage the creation of further national registries and their continuous updates taking into account all new bariatric procedures including the endoscopic procedures that will obtain increasing importance in the near future.
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Affiliation(s)
- L. Angrisani
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - A. Santonicola
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende. Baronissi-, Salerno, Italy
| | - P. Iovino
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende. Baronissi-, Salerno, Italy
| | - A. Vitiello
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - N. Zundel
- Minimally Invasive and Bariatric Surgery, FSFB, Bogata, Colombia
| | - H. Buchwald
- Departments of Surgery and Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455 USA
| | - N. Scopinaro
- Department of Surgery, School of Medicine, University of Genoa, Genoa, Italy
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Angrisani L, Santonicola A, Iovino P, Vitiello A, Zundel N, Buchwald H, Scopinaro N. Erratum to: Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg 2017. [PMID: 28681258 DOI: 10.1007/s11695-017-2773-8.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Affiliation(s)
- L Angrisani
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - A Santonicola
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende, Baronissi, Salerno, Italy.
| | - P Iovino
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende, Baronissi, Salerno, Italy
| | - A Vitiello
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - N Zundel
- Minimally Invasive and Bariatric Surgery, FSFB, Bogota, Colombia
| | - H Buchwald
- Department of Surgery, University of Minnesota, Minneapolis, MN, 55455, USA.,Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, 55455, USA
| | - N Scopinaro
- Department of Surgery, School of Medicine, University of Genoa, Genoa, Italy
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Abstract
BACKGROUND The aim of the present study was to investigate the prevalence of urinary tract infection (UTI) and the risk of lower urinary tract symptoms (LUTS) in women with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhea, and mixed) compared to women in the general population. METHODS Between January 2014 and December 2015, consecutive adult female patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy women with regular bowel habits were enrolled in the study. At baseline, we checked for UTI with a dipstick test and questioned patients about the presence of LUTS in the previous 24 h. RESULTS We enrolled 141 IBS patients and 91 healthy controls in the study. There was no difference in the prevalence of UTI between IBS patients and healthy controls (4.9 vs 3.3%, p = 0.5). When we excluded patients with UTI, we found a 2.79 higher risk of increased urinary frequency [odds ratio (OR) 2.79, 95% confidence interval (CI) 1.37-5.68], a 2.68 higher risk of urinary urgency (OR 2.68, 95% CI 1.04-6.91), and more than three times the risk of having dysuria (OR 3.25, 95% CI 1.06-9.97) in IBS women compared to healthy controls. The risk of having at least one urinary symptom was independent of IBS subtype and IBS severity. CONCLUSIONS Our study shows that IBS women have a similar risk of UTI compared to healthy women even if they complain more of LUTS, independently of IBS subtype and severity.
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Affiliation(s)
- F Zingone
- AOU San Giovanni di Dio e Ruggi di Aragona, Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
- Gastrointestinal Unit, University of Salerno, Via San Leonardo 1, Salerno, Italy.
| | - P Iovino
- AOU San Giovanni di Dio e Ruggi di Aragona, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - A Santonicola
- AOU San Giovanni di Dio e Ruggi di Aragona, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - S Gallotta
- AOU San Giovanni di Dio e Ruggi di Aragona, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - C Ciacci
- AOU San Giovanni di Dio e Ruggi di Aragona, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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50
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Angrisani L, Santonicola A, Iovino P, Vitiello A, Zundel N, Buchwald H, Scopinaro N. Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg 2017. [PMID: 28405878 DOI: 10.1007/s11695-017-2666-x.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Several bariatric surgery worldwide surveys have been previously published to illustrate the evolution of bariatric surgery in the last decades. The aim of this survey is to report an updated overview of all bariatric procedures performed in 2014.For the first time, a special section on endoluminal techniques was added. METHODS The 2014 International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) survey form evaluating the number and the type of surgical and endoluminal bariatric procedures was emailed to all IFSO societies. Trend analyses from 2011 to 2014 were also performed. RESULTS There were 56/60 (93.3%) responders. The total number of bariatric/metabolic procedures performed in 2014 consisted of 579,517 (97.6%) surgical operations and 14,725 (2.4%) endoluminal procedures. The most commonly performed procedure in the world was sleeve gastrectomy (SG) that reached 45.9%, followed by Roux-en-Y gastric bypass (RYGB) (39.6%), and adjustable gastric banding (AGB) (7.4%). The annual percentage changes from 2013 revealed the increase of SG and decrease of RYGB in all the IFSO regions (USA/Canada, Europe, and Asia/Pacific) with the exception of Latin/South America, where SG decreased and RYGB represented the most frequent procedure. CONCLUSIONS There was a further increase in the total number of bariatric/metabolic procedures in 2014 and SG is currently the most frequent surgical procedure in the world. This is the first survey that describes the endoluminal procedures, but the accuracy of provided data should be hopefully improved in the next future. We encourage the creation of further national registries and their continuous updates taking into account all new bariatric procedures including the endoscopic procedures that will obtain increasing importance in the near future.
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Affiliation(s)
- L Angrisani
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - A Santonicola
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende. Baronissi-, Salerno, Italy.
| | - P Iovino
- Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S. Allende. Baronissi-, Salerno, Italy
| | - A Vitiello
- General and Endoscopic Surgery Unit, S. Giovanni Bosco Hospital, Naples, Italy
| | - N Zundel
- Minimally Invasive and Bariatric Surgery, FSFB, Bogata, Colombia
| | - H Buchwald
- Departments of Surgery and Biomedical Engineering, University of Minnesota, Minneapolis, MN, 55455, USA
| | - N Scopinaro
- Department of Surgery, School of Medicine, University of Genoa, Genoa, Italy
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