The narrative interview in therapeutic education. The diabetic patients' point of view.

INTRODUCTION: Due to the rise of the average age, chronic-degenerative diseases, including diabetes, are in constant increase, resulting in high complications, in terms of social-economical costs and of the quality of life of the people affected by it. For these reasons, adherence to therapeutic prescriptions becomes essential. Through the implementation of motivation, clear information and follow-up, health professionals can help patients with diabetes to increase therapeutic adherence and maintain healthy lifestyles. AIMS: The aims of this study were to explore the diabetic patient's adherence and their illness perceptions and the role of the Case-Care Manager in improving the empowerment of patients. METHOD: For this purpose, a semi-structured interview was used, and submitted by 30 patients (19 males; age range: 20-65; mean age: 49.9) belonging to two diabetological centres of Emilia-Romagna (Italy). RESULTS: In the both contexts, knowledge of diabetes is limited and 2/3 of patients found out about diabetes almost by chance. As for the correct lifestyle (diet and physical activity), patients have initially started to change but the behaviour was not maintained and not perceived as an important part of the disease management. It emerged that a health specialist could help them keep a healthy lifestyle. CONCLUSIONS AND DISCUSSION: The CCM, in particular, can effectively intervene on the poor knowledge of the disease, on difficulty in getting used to the new lifestyle and on the lack of motivation. In fact, The CCM deals specifically with information and education of the patient, promoting self-care and monitoring the patients' paths and outcomes.

Mapping the nursing competences in neonatology: a qualitative research.

BACKGROUND AND AIM: There are several studies that support the importance of advanced expertise and specialization of the neonatal pediatric nurse. However, proceeding with a analysis of the scientific literature regarding the nursing advanced competence in neonatology, very few studies specify and define these competences. The aim of the study is investigate and analyze skills, tasks and responsibilities of the neonatal pediatric nurse, to map a "neonatal nurse competence profile", offered from the points of view of the Neonatology Units professionals. METHODS: 32 professionals (nurses, physicians, psychologists, healthcare assistants) operating in the Neonatal Intensive Care Unit of two Italian Hospitals were interviewed. The semi-structured interviews have been performed, transcribed and analyzed following the Levati's model (based on Activity, Expectations and Evaluation system). RESULTS: About the nurses activities, the participants underlined the newborn care, the care of the caregiver and the "bureaucratic" activities. About the system of expectations, the participants marked on specific skills but those are described only comprehensively. About the evaluation system there are different perceptions among the professionals, but the nurses themselves feel that they have to answer for their actions primarily to infants and families, indicating a sense of responsibility towards the patients. CONCLUSIONS: On the basis of the interviews a profile of a neonatal nurse competences has been drawn up. This consists of 42 competences that future studies can further specify, integrate and expand.

Advanced competencies mapping of critical care nursing: a qualitative research in two Intensive Care Units.

BACKGROUND AND AIM: Nowadays, in Italy, the nursing profession has suffered important changes in response to the needs of citizens' health and to improve the quality of the health service in the country.  At the basis of this development there is an increase of the nurses' knowledge, competencies and responsibilities. Currently, the presence of nurses who have followed post-basic training paths, and the subsequent acquisition of advanced clinical knowledge and specializations, has made it essential for the presence of competencies mappings for each specialty, also to differentiate them from general care nurses. The objective is to get a mapping of nurse's individual competencies working in critical care, to analyze the context of the Parma Hospital and comparing it with the Lebanon Heart Hospital in Lebanon. METHOD: The survey has been done through a series of interviews involving some of the hospital staff, in order to collect opinions about the ICU nurses' competencies. RESULTS: What emerged from the data allowed us to get a list of important abilities, competencies, character traits and  intensive care nurse activities. Italians and Lebanese nurses appear to be prepared from a technical point of view, with a desire for improvement through specializations, masters and enabling courses in advanced health maneuvers. By respondents nurses can seize a strong desire for professional improvement. CONCLUSIONS: At the end of our research we were able to draw a list of different individual competencies, behavioral and moral characteristics. The nurse figure has a high potential and large professional improvement prospects, if more taken into account by the health system.

The mapping competences of the nurse Case/Care Manager in the context of Intensive Care.

BACKGROUND AND AIMS: Since the recent introduction of the Case/Care Manager's professional figure, it is quite difficult to identify properly his/her own particular features, which could be mainly be found revising mainly in American studies. Therefore, the present study intended to identify the Case/Care Manager's skills and professional profile in an Intensive Care Unit experience, taking into consideration the staff's activities, perception and expectations towards the Case/Care Manager. In particular, it has been compared the experience of an Intensive Care Units where the Case/Care Manager's profile is operational to a different Unit where a Case/Care Manager is not yet in force. METHOD: a Levati's model was used to map the Case/Care Manager's skills, involving each unit whole working staff, executives and caregivers through semi-structured interviews. It has been taken into consideration the Anaesthesia Unit and Emergency Unit of Cesena's healthcare organisation (AUSL of Romagna) and a Cardiology Intensive Care Unit of Piacenza's healthcare organisation, where the Case/Care Manager's profile has not been experimented yet. Firstly, it a data collection in each healthcare organization has been organised. Subsequently, semi-structured interviews to doctors, unit nurses, caregivers, nurses' coordinators and medical staff have been used to compare each healthcare system. The interviewees' described their expectations in relation to the Case/Care Manager working in a critical area. Then, every data collected during interviews has been organised to map a Case/Care Manager's essential professional profile to work in a critical area together with medical staff. RESULTS: Piacenza's O.U. critical area experience reported a major demand for patients' and patient's families' assistance. On the other hand, the very same aspects seem to have been better achieved in Cesena's O.U., where a Case/Care Manager's recent introduction has actually helped to overcome the void in organising systems. CONCLUSIONS: a Case/Care Manager's profile has been drafted on the basis of the comparative analysis conducted. It has been noted how the Case/Care Manager's professional profile can really improve relationships and communications between medical staff and patients, promoting a major unity among the working team. According to the present research, the Case/Care Manager's profile has been proved helpful in positively influencing the team activity and to elicit major satisfaction both in patients and their family.

Online access and motivation of tutors of health professions higher education.

The case study of PUNTOZERO as an open web lab for activities, research and support to 5 Master's courses for the health professions is described. A virtual learning environment integrated in a much wider network including social networks and open resources was experimented on for five Master's Courses for the health professions at the University of Parma. A social learning approach might be applied by the engagement of motivated and skilled tutors. This is not only needed for the improvement and integration of the digital and collaborative dimension in higher education, but it aims to introduce issues and biases of emerging e-health and online networking dimensions for future healthcare professionals. Elements of e-readiness to train tutors and improve their digital skills and e-moderation approaches are evident. This emerged during an online and asynchronous interview with two tutors out of the four that were involved, by the use of a wiki where interviewer and informants could both read and add contents and comments.