ABSTRACT
BACKGROUND: The present study aims to monitor how the Italian psychiatric services changed their organizations by adapting to the COVID-19 pandemic and considering the different incidence rates of the SARS-CoV-2 infection spread in the different Regions of Italy. METHOD(S): An on line "ad hoc" questionnaire was created and administered to all Italian Mental Health Departments. The questionnaire included various typologies of mental health setting such as Mental Health Service (MHS), the psychiatric therapeutic community (TC) and the psychiatric hospital ward (PH);the Region of Italy belonging to each participants is considered in accordance to the incidence of new cases per 100.000 inhabitants, as published by the Higher Institute of Health in the bulletin of 20 April 2020. Moreover, 9 questions were administered to investigate any challenges in several aspects influenced by the pandemic. RESULT(S): One hundred seventeen questionnaires were received, complete in their answers, 66 of which belonged to MHSs, 27 to TCs and 24 to PHs. The answers collected according to psychiatric settings were all statistically significant (P<0.05), except for item no.8 concerning the periodic checks of healthcare workers in the search for SARS-CoV-2 infection (p=0.432). Considering the answers received according to the incidence rate of new cases of COVID-19 per 100.000 inhabitants, as reported in the Higher Institute of Health on 20 April 2020, there was no significant statistical difference among the answers for all the items of the questionnaire, with the exception of item no.5 regarding patient care procedures (P=0.004) as at least partially - if not totally - all the psychiatric settings considered changed their procedures for patient care according to the incidence rate of the pandemic. CONCLUSION(S): The pandemic required providing greater assistance to both psychiatric patients already in treatment and to the new ones, the new accesses. On the other hand, however, the pandemic condition had strongly affected the provision of assistance mainly by reducing the provision of services, especially on the community and thus giving priority to the management of the COVID-19 pandemic.Copyright © 2021 EDIZIONI MINERVA MEDICA.
ABSTRACT
Background Since December 2019, the new coronavirus disease (COVID-19) or severe acute respiratory syndrome SARS-CoV-2 has spread rapidly around the world and has reached pandemic proportions that have affected all continents. Methods Thanks to the PICO research strategy (population, intervention, comparison, results), a specific search string was used. To include relevant literature on the topic, several search terms belonging to each PICO section were combined. 339 studies published in English in the last 3 years (2020-2022) were identified, available on: EMBASE and MEDLINE. Results The studies included in this narrative review included 14 observational studies. Summarize the article's main findings. Conclusions Cultural, social and economic differences significantly influenced the mental health condition of all healthcare workers involved. Copyright © 2022 by Pacini Editore Srl.
ABSTRACT
The aim of the present study was to analyze any relations existed between sampling characteristics and the onset of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection, also by considering the number of times that it occurred in a cohort of Italian nurses interviewed. Additionally, by considering the nutritional supplemental taking, this research wanted to assess any differences both in the onset and in the number of times in which the infection occurred among participants. An observational cohort study was carried out thorough all Italian nurses by advertising the questionnaire through some professional Internet pages. Work typology (P=0.021), coronavirus disease 2019 (COVID-19) ward (P=0.002) and regular meal assumption (P=0.019) significantly associated to the onset of the SARS-CoV-2 infection. Most of nurses who contracted the SARS-CoV-2 infection worked during the night shift (53.7%), 44.3% worked in a no-COVID-19 ward and 53% declared to have a regular meals' assumption. Ward typology significantly associated to the times of the SARSCoV-2 onset (P=0.003), as most of nurses who contracted almost one time the SARS-CoV-2 infection were employed in a no-COVID-19 ward (55.5%) and 54.1% of them declared to have a regular meals' assumption. The onset of the SARS-CoV-2 infection seemed to be more present in the most part of the sample collects. The present study could be considered as pilot in this sense and also more studies will be performed in order to better relate the function of supplemental food intakes with a better functioning of the immune system.Copyright © the Author(s), 2022 Licensee PAGEPress, Italy.
ABSTRACT
Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2022
ABSTRACT
Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2022
ABSTRACT
Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets. Copyright © 2022
ABSTRACT
Background: COVID-19 is an infectious illness, featured by an increased risk of thromboembolism. However, no standard antithrombotic therapy is currently recommended for COVID-19 hospitalized patients. Aim of this study was to evaluate safety and efficacy of additional therapy with aspirin over prophylactic anticoagulation (PAC) in COVID-19 hospitalized patients and its impact on survival. Methods: 8168 patients hospitalized with COVID-19 were enrolled in a multicenter-international prospective registry (HOPE COVID-19). Clinical data and in-hospital complications, including mortality, were recorded. 344 patients with incomplete data were excluded. Study population included patients treated with PAC or with PAC and aspirin. A comparison of clinical outcomes between patients treated with PAC and PAC and aspirin was performed using an adjusted analysis with propensity score matching. Results: Of 7824 patients, 360 (4.6%) received PAC and aspirin and 2949 (37.6%) PAC. Propensity-score matching yielded 298 patients from each group. Mean age was 73±11 years, 67% were male, prevalence of hypertension and diabetes was 79 and 33% respectively and 7.5% underwent invasive ventilation.In the propensity score-matched population, cumulative incidence of in-hospital mortality was lower in patients treated with PAC and aspirin vs PAC (15% vs 21%, Log Rank p=0.01, Figure 1). At multivariable analysis in propensity matched population of COVID-19 patients, including age, sex, hypertension, diabetes, kidney failure and invasive ventilation, aspirin treatment was associated with lower risk of in-hospital mortality (HR 0.62, CI 95% 0.42–0.92, p=0.018). Conclusions: Additional therapy with aspirin over PAC in COVID-19 hospitalized patients was associated with lower mortality risk in a propensity score matched population. Funding Acknowledgement: Type of funding sources: None.Figure 1. Survival curves according to therapy
ABSTRACT
Summary. Aim. To investigate nomophobia levels in young Italian nurses and any differences based on socio-demo-graphic variables, such as: gender, age, years of work experience and shifwork. Methods. A cohort observational study was conducted from August to September 2021. Nurses were recruited through Facebook and Instagram nursing pages. Data focused on: gender, age, years of work experi-ence, shifts and nomophobia condition and its relating sub-dimensions, according to the “Nomophobia questionnaire”. Results. A total of 156 Italian nurses were enrolled. Nobody among the participants reported the absence of nomopho-bia;49.40% reported mild levels, 41.70% moderate levels and 9.00% severe levels. Additionally, these findings detailed a more specific image of the nomophobic nurse as: female, aged less than 25 and worked less 1 year, regardless of the shift. Conclusions. There is an urgent need for the nursing community and educational bodies to introduce a more judicious use of smartphones by professionals. © 2022, Il Pensiero Scientifico Editore s.r.l.. All rights reserved.
ABSTRACT
SUMMARY: Background and Aim. Starting from March 9, 2020, the Italian government has proclaimed a state of health emergency due to the epidemic, which later became a SARSCoV- 2 infection pandemic. The present study aimed to perform differences and any potential risk factors in anxious and depressive symptoms in Italian nurses during the Covid-19 pandemic according to selected sociodemographic variables. Methods. In November 2020 an "ad hoc" questionnaire was administered online to all Italian nurses. In the first part, a whole series of socio-demographic variables relating to the reference sample were collected, as: gender, the department to which participants belonged, if the respondent suffered from pulmonary or cardiovascular diseases, if the nurse lived alone or with other cohabitants and whether during the pandemic the participant contracted the SARS-CoV-2 infection or not. In the second part of the questionnaire, the Hospital Anxiety and Depression Scale was administered to quickly and easily assess the anxiety and depression levels among the Italian nurses during the Covid-19 pandemic. Results . 732 nurses agreed to participate to this survey. Among participants, 479 (65.3%) recorded an anxious symptomatology and 267 (6.4%) a depressive one. According to anxious symptoms, a significant difference was recorded between females and males (p min 0.001), as females recorded higher mild (24.04%), moderate (23.09%) and severe (13.39%) anxious symptom levels than males (Mild:1.50%;Moderate: 2.46%;Severe: 0.96%). By considering depressive symptoms according to socio demographic variables, only nurses without cardiovascular diseases recorded higher frequencies in mild (21.58%), moderate (8.47%) and severe (2.46%) depressive symptoms than nurses who suffered from a cardiovascular disease (Mild:2.05%;Moderate: 1.64%;Severe: 0.27%). Potential risk factors identified for anxious symptoms were: gender, both for mild (p min 0.001), moderate (p=.008) and severe (p=.003) anxious symptoms, and pulmonary diseases for severe anxious disorders (p=.014). Potential risk factors identified for the onset of depressive symptoms were: gender (p=.026), pulmonary diseases (p=.021), domestic partnership (p=.035), for mild symptoms;the presence of cardiac diseases (p=.006) for moderate symptoms. Conclusions . It urged to begin to further implement all forms of psychological support for nurses and further implementation of university nursing training programs that aim at both the technical and psychological management of the future professional to cope with maxi emergencies.
ABSTRACT
Aims: Standard therapy for Corona-virus-19 disease (COVID-19) is mainly developed for critical ill patients. Autopsy studies showed high prevalence of platelet-fibrin rich micro-thrombi in several organs. Aim of the study was to evaluate safety and efficacy of antiplatelet therapy (APT) in COVID-19 hospitalized patients and its impact on survival. Methods and results: 7824 consecutive patients with COVID-19 were enrolled in a multicentre-international prospective registry (HOPE-COVID-19). Clinical data and inhospital complications were recorded. Antiplatelet (AP) regimen, including aspirin and other antiplatelet drugs, was obtained for each patient. During hospitalization 730 (9%) patients received AP drugs with single (93%, n=680) or dual APT (7%, n=50). Patients treated with APT were older (74±12 vs. 63±17 years, P<0.01), more frequently male (68% vs. 57%, P<0.01) and had higher prevalence of diabetes (39% vs. 16%, P<0.01). Patients treated with APT compared with no APT showed no differences in terms of in-hospital mortality (18% vs. 19%, P=0.64, Log Rank P=0.23), need of invasive ventilation (8.7% vs. 8.5%, P=0.88), embolic events (2.9% vs. 2.5% P=0.34) and bleeding (2.1% vs. 2.4%, P=0.43) but shorter duration of mechanical ventilation (8±5 vs. 11±7 days, P=0.01);however, when comparing patients with APT vs. no APT and no anticoagulation therapy, APT was associated with lower mortality rates (Log Rank P<0.01, relative risk 0.79, 95% CI: 0.70-0.94). At multivariable analysis in-hospital APT was associated with a lower mortality risk (relative risk 0.39, 95% CI: 0.32-0.48, P<0.01). Conclusions: APT during hospitalization for COVID-19 could be associated with lower mortality risk and shorter duration of mechanical ventilation, without increased risk of bleeding.
ABSTRACT
Background: No standard therapy is currently recommended for Coronavirus-19 disease (COVID-19). Autopsy studies showed high prevalence of platelet-fibrin rich micro-thrombi in several organs. Aim of the study was to evaluate safety and efficacy of antiplatelet therapy (APT) in COVID-19 hospitalized patients and its impact on survival. Methods: 7824 consecutive patients with COVID-19 were enrolled in a multicenter-international prospective registry (HOPE-COVID19). Clinical data and in-hospital complications were recorded. AP regimen, including aspirin and other antiplatelet drugs, was obtained for each patient. Results: During hospitalization 730 (9.3%) patients received AP drugs with single (93%, n=680) or dual APT (7%, n=50). Patients treated with APT were older (73±12 vs 62±17 years, p<0.01), more frequently male (70% vs 64%, p<0.01) and had higher prevalence of diabetes (39.5% vs 17%, p<0.01). Patients treated with APT showed no differences in terms of in-hospital mortality (18% vs 19%, p=0.64, Log Rank p=0.23), need of invasive ventilation (8.7% vs 8.5%, p=0.88) and bleeding (2.1% vs 2.4%, p=0.43);However, after excluding patients treated only with anticoagulation, APT was associated with lower mortality rates (Log Rank p<0.01, relative risk 0.79, 95% CI 0.70-0.94) (Figure 1). At multivariable analysis including age, gender, diabetes, hypertension, respiratory failure, pre-hospital therapy with antiplatelet drugs, in-hospital APT, and anticoagulation therapy, in-hospital APT was associated with a lower mortality risk (relative risk 0.29, 95% CI 0.22-0.38, p<0.001). Conclusions: APT during hospitalization for COVID-19 could be associated with lower mortality risk without increased risk of bleeding. Randomized trials are needed to confirm these preliminary data.
ABSTRACT
This study identified and quantified the Mindfulness skills "Before" and "During" the Covid-19 pandemic. Data were in agreement to the current literature: The implementation of techniques aimed at increasing Mindfulness skills in clinical nursing practice has an effective a cost-benefit ratio all to the advantage of health company than professionals.
ABSTRACT
Background The COVID-19 pandemic strongly influenced the habits of the puerperal in the usual management of the birth event. The present study aimed to evaluate how post-traumatic stress in puerperia varied during the COVID-19 pandemic. Specifically, it assessed any differences in the distress perception by considering some socio-demographic variables related to the birth event, as: the weeks of gestation of the birth, the partum typology and the breastfeeding typology. Methods An online questionnaire was administered to women who complete their pregnancies during the pandemic. The questionnaire included items relating to the characteristics of childbirth and the Impact of Event Scale-Revised. Results 156 puerperal women were recruited, 36.54% of the participants registered a posttraumatic stress disorder (PTSD), 8.97% outlined a probable diagnosis of PTSD, 28.85% highlighted the presence of some symptoms related to PTSD and 25.64% were fine. Conclusions PTSD among puerperal women was intensely evident in the avoidance dimension, especially in participants who have given a pre-term birth, though the caesarean surgery and who had artificially breastfed their own unborn child in the puerperium.
ABSTRACT
Introduction. Nursing management aimed to prevent viral infection in order to promote care plans that reduce the SARS-CoV-2 infection as much as possible. Evidence acquisition. There were different studies focusing on small case series on Covid-19 pregnant women and on logistic management in order to reduce the risk of contagion. Evidence synthesis. A review of the primary and the secondary literature was carried out in the Clinical Key and the PubMed databases. The bibliographic research was focused on the critical reading of the studies from 1 February 2020 to 30 June 2020. A total of eight articles analyzed special measures necessary to prevent Covid-19 in the pregnant women by implementing algorithms to be shared in a multidisciplinary context, also on challenges in the nursing care and in proposals for future studies. Conclusions. Since there were few data available on the Covid-19 positive pregnant women, further developments of studies and more appropriate protocols were needed on this particular topic. © 2021, EDRA S.p.A. All rights reserved.
ABSTRACT
Objectives To perform if the knowledge on the COVID-19 pandemic and the nursing role could influence anxiety and depression levels in nursing and general population participants. Methods A descriptive correlational study was conducted. Participants were divided into nursing and general population groups, respectively. General knowledge on the COVID-19 pandemic was assessed and then, thanks to the Hospital Anxiety and Depression Scale (HADS), anxiety and depression levels were also performed. Results 400 subjects were enrolled in this study. Nurses and general population recorded the similar trend in anxiety levels (p =.265). Nurses recorded higher frequency in normal depressive score than general population (p =.006). Significant correlations were reported between: anxiety and depression levels (p <.001), anxiety levels and the pandemic knowledge (p =.024), anxiety levels and the nursing role (p =.005), depression levels and the nursing role (p <.001). Conclusions The pandemic knowledge and the nursing role might be protective factors both in anxiety and depressive disorders.
ABSTRACT
BACKGROUND: Women tend to report greater symptoms of anxiety and depression during outbreaks than men, especially in the pregnancy condition. The present study aimed to compare the level of anxiety and depression in postpartum women who gave birth before and during the period of the COVID-19 pandemic. METHODS: Women were divided into two groups: The case group, which included Italian women who delivered during the pandemic period (from December 2019) and the control group, which included Italian women who delivered before the pandemic period (until November 2019). An ad-hoc questionnaire was created and administered online. Depressive disorder was evaluated with the Edinburgh Postnatal Depression Scale and anxiety disorders were assessed with the Generalized Anxiety Disorder, version 7. The values obtained were then differentiated based on socio-demographic variables and the characteristics of childbirth and breastfeeding between the two groups and univariate regression analysis were performed to assess which factors influenced anxiety and depression disorders among the two groups considered. RESULTS: Atotal of 266 women participated in the study. Of these, 110 belonged to the control group and 156 women belonged to the case group. No statistically significant differences were recorded between the two groups as considering socio-demographic characteristics and characteristics of delivery. GAD values statistically differed considering the age groups (P0.001), the level of education (P=0.024), the type of birth (P=0.021). All factors related to the EPDTscores were not significantly influencing both in the case group and in the control group, except in the control group as the type of breastfeeding (P=0.037). Significantly influencing factors in the evaluation of generalized anxiety disorder were the age (P=0.045) and the number of weeks of gestation in the control group (P=0.021). CONCLUSIONS: Further investigations are desirable to understand which factors most influence the depressive and anxious state of women to better address all the numerous psychological support initiatives that may be the most appropriate, timely and effective, even in emergency situations.
ABSTRACT
BACKGROUND: The aim of this study was to evaluate the burnout syndrome among nurses who are engaged in the care of patients with Coronavirus disease (COVID-19). A cohort observational-survey study was carried among Italian nurses who work in the Italian Intensive Care Unit (ICU) during the pandemic COVID-19 period. METHODS: The questionnaire was published online on Google form, modules section, from March 25, 2020 to April 26, 2020. The questionnaire contained a first part of demographic data, as: gender, years of experience, if the nurse interviewed at the time of the pandemic COVID-19 event was already working in an ICU or if, due to the urgency of the context, he/she was transferred to an ICU that was set up during this period. Then, the Maslach Burnout Inventory (MBI) questionnaire was administered to evaluate the burnout level among nurses who are in direct contact with critically ill patients with COVID-19. RESULTS : 291 nurses answered the survey. With the MBI threshold values in mind, it can be seen that the clinical condition of burnout can be configured for all three dimensions, both for women and men. As regards the dimension of emotional exhaustion, female nurses are more exposed to the phenomenon than men (P<0.001). However, for the other two dimensions there are no statistically different differences between the two sexes (depersonalization: P=0.809;personal accomplishment: P=0.268). CONCLUSIONS : Burnout levels are high among nurses. Surely the situation since COVID-19 has accentuated the result, regardless of the years of experience or if the nurses have always worked in opposed intensive care units have been transferred due to the health emergency. Also interesting is the aspect of the trend of burnout levels between female nurses who are they are more affected by emotional exhaustion than male nurses.
ABSTRACT
OBJECTIVE: The aim of this review paper was to discuss the gut microbiota-related aspects of COVID-19 patients. We presented the faecal-oral transmission of SARS-CoV-2, gut microbiota imbalance, and fecal microbiota transplantation as a hidden source of this virus. MATERIALS AND METHODS: We analyzed the available literature (PubMed, Embase, Google Scholar databases) regarding COVID-19 and gut microbiota related aspects. RESULTS: The gastrointestinal symptoms, such as nausea, vomiting, diarrhea, abdominal discomfort/pain, may occur in these patients. Notably, these symptoms may contribute to the severity of COVID-19. Recent several studies have revealed a new SARS-CoV-2 transmission possibility, opening a fresh view on COVID-19. It is observed the possibility of SARS-CoV-2 transmission via faecal-oral route. Fecal microbiota transplantation may be a hidden source of SARS-CoV-2. Additionally, the pharmacological treatment of COVID-19 and other factors may significantly alter the composition of gut microbiota. Among others, loss of bacterial diversity, the decrease of commensal microbes as well as the increase of opportunistic pathogens are observed. CONCLUSIONS: The alterations of gut microbiota in COVID-19 patients consequently may lead to the development of gut dysbiosis-related diseases even after recovery from COVID-19. Therefore, it is recommended to screen stool samples taken from recovered patients at least 35 days after clearance of virus from respiratory tract. Before 35 days period, SARS-CoV-2 may still be detected in feces. It is also recommended to screen the composition as well as the activity of gut microbiota to assess its balance. In the case of gut dysbiosis, there should be introduced an appropriate method of its modulation. Additionally, all the fecal samples which are prepared for fecal microbiota transplantation should be tested for SARS-CoV-2 to provide protection for its recipients.