"Jumping into the COVID-19 arena": The professional transition into clinical practice of new graduate nurses in Italy at time of COVID-19.

AIMS AND OBJECTIVES: To evaluate the impact of the professional transition of new graduate nurses during the COVID-19 pandemic. BACKGROUND: The transition from the role of student to the professional role can be challenging for new graduate nurses for the acquisition of higher autonomy and responsibility. The COVID-19 pandemic impacted the quality of the professional transition. DESIGN: This was a cross-sectional observational study following the Strengthening and Reporting of Observational Studies in Epidemiology checklist. METHODS: One hundred and two nurses who graduated in three consecutive sessions (November 2019-pre-pandemic, March 2020-pandemic outbreak, and November 2020-2nd wave) in a north Italian university located in the most affected Italian region by the COVID-19 pandemic, completed an online survey assessing well-being, risk of burnout, resilience, perceived stigma, strengths and limitations and quality of the professional transition. The study was performed between March and May 2021. RESULTS: 81.4% of participants described the professional transition as worse than expected, and new graduate nurses who worked in COVID-19 settings reported a more difficult transition to professional life. No differences emerged in burnout, mental well-being and perceived stigma between new graduate nurses who worked in COVID-19 settings and those who did not. Similarly, no differences emerged amongst the three graduated cohort sessions. The most commonly mentioned challenges faced during the transition were organisational aspects, suddenly acquired autonomy and lack of suitable coaching. CONCLUSION: New graduate nurses reported a challenging academic-professional transition, in particular, those who worked in COVID-19 settings. The mid- and long-term impact of experiencing an academic-professional transition in COVID-19 settings should be assessed and monitored. RELEVANCE TO CLINICAL PRACTICE: The professional transition of new graduate students should be adequately planned and monitored, new graduates should be assisted to develop realistic expectations about the transition, and an adequate coaching period should be guaranteed all the more during health emergencies.

Is COVID-19 All That Glitters?

Over the last three years, the Coronavirus-19 disease has been a global health emergency, playing a primary role in the international scientific community. Clinical activity and scientific research have concentrated their efforts on facing the pandemic, allowing the description of novel pathologies correlated to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), such as the Multisystemic Inflammatory Syndrome in Children and Adults (MIS-C, MIS-A). Conversely, this shift of attention to COVID-19 disease and its complications could, in some cases, have delayed and underestimated the diagnosis of diseases not associated with SARS-CoV-2, including rare diseases. Here we describe the diagnostic process that led to the definition of a rare vasculitis in a young woman with a recent clinical history of SARS-CoV-2.

Self-Care of Adults with Type 2 Diabetes During the COVID-19 Pandemic: A Qualitative Interpretive Description Study.

Due to coronavirus disease 2019 (COVID-19), diabetes services have been disrupted, causing difficulties for people with type 2 diabetes mellitus (T2DM), and understanding their experience could help improve diabetes care. Therefore, we used a qualitative interpretive description to explore the experience of self-care of adults with T2DM during the COVID-19 pandemic. Data were collected using semi-structured interviews and analyzed theoretically. The sample (N = 30) was composed of 7 females and 23 males, with a mean age of 69.9 years (60-77) and 19.4 mean years (3-40) of people living with T2DM. Our findings show reduced physical activity and increased smoking and alcohol consumption affected that self-care. Increased food consumption and stress eating, with greater stress and anxiety, caused worsening of glycemic values. Participants were able to contact healthcare professionals via eHealth or telephone. Others, even those with complications, were not able to receive care or advice. These results suggest that easier contact with health providers, continuous engagement, eHealth solutions, and formal peer support could help self-care in T2DM. Advanced nursing roles and services could solve many issues reported in this study during and after the pandemic.

Association between coping strategies and professional quality of life in nurses and physicians during COVID-19: A cross-sectional study.

AIM: To explore the associations between coping strategies (social support, avoidance strategies, positive attitude, problem orientation, and transcendent orientation) and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress) of nurses and physicians during COVID-19. BACKGROUND: Little is known about the association between the way health care workers cope with stress and their professional quality of life during the unusual circumstances that the COVID-19 pandemic imposed. METHODS: A single-centre cross-sectional observational study was conducted with health care professionals (n = 143). The Professional Quality of Life scale Version 5 and the Italian Version of the Coping Orientations to the Problems Experienced measured the professional quality of life and coping strategies, respectively. RESULTS: Avoidance, problem orientation and social support coping worsened professional quality of life, whereas a positive attitude improved it. CONCLUSIONS: This study on the relationship between coping strategies and the professional quality of life during health emergencies like the COVID-19 pandemic can inform interventions aiming to foster functional coping strategies in health care personnel to sustain their professional quality of life. IMPLICATIONS FOR NURSING MANAGEMENT: Identifying people at greater risk of burnout and secondary traumatic stress can guide tailored interventions to improve health care workers' wellbeing. Increased professional quality of life might turn in improved quality of care and reduced absenteeism and intention to leave.

Direct and Indirect Effects of SARS-CoV-2 Pandemic in Subjects with Familial Hypercholesterolemia: A Single Lipid-Center Real-World Evaluation.

We evaluated the impact of direct and indirect effects of SARS-CoV-2 infection in subjects with familial hypercholesterolemia (FH). In this observational, retrospective study, 260 FH subjects participated in a telephone survey concerning lipid profile values, lipidologist and cardiologist consultations and vascular imaging evaluation during the 12 months before and after the Italian lockdown. The direct effect was defined as SARS-CoV-2 infection; the indirect effect was defined as the difference in one of the parameters evaluated by the telephone survey before and after lockdown. Among FH subjects, the percentage of the lipid profile evaluation was lower after lockdown than before lockdown (56.5% vs. 100.0%, p < 0.01), HDL-C was significantly reduced (47.78 ± 10.12 vs. 53.2 ± 10.38 mg/dL, p < 0.05) and a significant increase in non-HDL-C was found (117.24 ± 18.83 vs. 133.09 ± 19.01 mg/dL, p < 0.05). The proportions of lipidologist and/or cardiologist consultations and/or vascular imaging were lower after lockdown than before lockdown (for lipidologist consultation 33.5% vs. 100.0%, p < 0.001; for cardiologist consultation 22.3% vs. 60.8%, p < 0.01; for vascular imaging 19.6% vs. 100.0%, p < 0.001); the main cause of missed lipid profile analysis and/or healthcare consultation was the fear of SARS-CoV-2 contagion. The percentage of FH subjects affected by SARS-CoV-2 was 7.3%. In conclusion, a lower percentage of FH subjects underwent a lipid profile analysis, lipidologist and cardiologist consultations and vascular imaging evaluation after SARS-CoV-2 Italian lockdown.

Attitudes towards COVID-19 vaccine and reasons for adherence or not among nursing students.

BACKGROUND: The COVID-19 pandemic has spread widely among healthcare workers. Recently, new effective vaccines against COVID-19 have begun to be administered to healthcare workers in several countries, including Italy. PURPOSE: Our aim was to evaluate the intentions to be vaccinated against COVID-19 in a population of nursing students, identifying factors associated with the intentions. METHOD: We conducted an anonymous online survey among 728 nursing students. The questionnaire collected data on demographic and academic characteristics, health status, vaccine attitudes, and specific reasons regarding the intention to get or not get the COVID-19 vaccination. RESULTS: A total of 422 nursing students completed the survey. Almost 81% of participants wanted to take the vaccine against coronavirus. The intention to adhere to the vaccination program was associated with male gender, a previous flu vaccine uptake, and high school education. The main reason in favor of taking the vaccine was to protect family and friends. The main reason for opposition was the fear of adverse events. CONCLUSION: It is fundamental to consider vaccine hesitancy in healthcare students and face it properly, since these are the healthcare workers of the future who will have to provide recommendations to patients and promote adherence to vaccination programs.

Development and Psychometric Testing of the Self-Care in COVID-19 (SCOVID) Scale, an Instrument for Measuring Self-Care in the COVID-19 Pandemic.

AIM: To develop the Self-Care in COVID-19 (SCOVID) scale and to test its psychometric characteristics in the general population. METHODS: We tested SCOVID scale content validity with 19 experts. For factorial and construct validity, reliability, and measurement error, we administered the 20-item SCOVID scale to a sample of 461 Italians in May/June 2020 (mean age: 48.8, SD ± 15.8). RESULTS: SCOVID scale item content validity ranged between 0.85-1.00, and the total scale content validity was 0.94. Confirmatory factor analysis supported SCOVID scale factorial validity (comparative fit index = 0.91; root mean square error of approximation = 0.05). Construct validity was supported by significant correlations with other instrument scores measuring self-efficacy, positivity, quality of life, anxiety, and depression. Reliability estimates were good with factor score determinacy, composite reliability, global reliability index, Cronbach's alpha, and test-retest reliability ranging between 0.71-0.91. The standard error of measurement was adequate. CONCLUSIONS: The SCOVID scale is a new instrument measuring self-care in the COVID-19 pandemic with adequate validity and reliability. The SCOVID scale can be used in practice and research for assessing self-care in the COVID-19 pandemic to preventing COVID-19 infection and maintaining wellbeing in the general population.