Barriers and facilitators to health technology adoption by older adults with chronic diseases: an integrative systematic review.

BACKGROUND: In recent years, healthcare systems have progressively adopted several technologies enhancing access to healthcare for older adults and support the delivery of efficient and effective care for this specific population. These technologies include both assistive technologies designed to maintain or improve the independence, social participation and functionality of older people at home, as well as health information technology developed to manage long-term conditions. Examples of such technologies include telehealth, wearable devices and mobile health. However, despite the great promise that health technology holds for promoting independent living among older people, its actual implementation remains challenging. METHODS: This study aimed to conduct an integrative systematic review of the research evidence on the factors that facilitate or hinder the adoption of different types of technology by older individuals with chronic diseases. For this purpose, four electronic databases (PsycArticles, Scopus, Web of Science and PubMed) were queried to search for indexed published studies. The methodological quality of the selected papers has been assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Twenty-nine articles were selected, including 6.213 adults aged 60 or older. The studies have been synthesised considering the types of technological interventions and chronic diseases, as well as the main barriers and facilitators in technology acceptance. The results revealed that the majority of the selected articles focused on comorbid conditions and the utilisation of telemedicine tools. With regard to hindering and facilitating factors, five main domains were identified: demographic and socioeconomic, health-related, dispositional, technology-related and social factors. CONCLUSION: The study results have practical implications not only for technology developers but also for all the social actors involved in the design and implementation of healthcare technologies, including formal and informal caregivers and policy stakeholders. These actors could use this work to enhance their understanding of the utilisation of technology by the ageing population. This review emphasises the factors that facilitate technology adoption and identifies barriers that impede it, with the ultimate goal of promoting health and independent living.

Psychometric properties of a new instrument for the measurement of the perceived quality of distance learning during the coronavirus disease 2019 (COVID-19) pandemic.

Introduction: The lockdown restrictions due to the COVID-19 pandemic forced many students to use distance learning. Few studies have examined the psychological effects of distance learning during the pandemic on university or on non-university students using a specific psychometric tool. The principal aim of this study was the construction and validation of a new psychometric tool, the Perceived Quality of Distance Learning (PQDL), to measure students' appreciation and reaction to distance learning. The connection between anxiety, depression, perceived self-efficacy, and students' perception of distance learning was analyzed to assess the nomological validity of the new scale. Method: The sample consists of 429 students who attended university or training courses. The factor structure of the new instrument was analyzed through Exploratory and Confirmatory Factor Analyses and its nomological validity was analyzed through regression analysis. Conclusion: The results showed that PQDL consists of two subscales: Distance Learning Organization and Cognitive-Emotive Reaction to Distance Learning. Higher student's ability to organize and plan distance learning and higher student's positive cognitive-emotive reaction to distance learning, higher student's perceived quality of distance learning. Anxiety and depression scores were negatively correlated with students' perceived quality of distance learning. Furthermore, students' perceived emotional self-efficacy of negative emotions and perceived scholastic self-efficacy were positively correlated with students' perceived quality of distance learning. These data indicate that PQDL is a reliable questionnaire to assess student's perceived quality of distance learning.

Health Risk Communication During COVID-19 Emergency in Italy: The Impact of Medical Experts' Debate on Twitter.

The COVID-19 emergency underlined the importance of an effective public health communication to limit the spread of the outbreak. Physicians as "public experts" can play a crucial part in health risk communication, even if their role is challenged by transformations into the information system. Therefore, the major objective of this study was to investigate public perception of medical experts' opinions regarding the COVID-19 emergency. The Italian public debate involving medical experts in the Twitter sphere during the SARS-CoV-2 pandemic has particularly been examined. A content analysis was performed on 2,040 randomly selected tweets. The results of content analysis show that the medical experts who tend to mitigate the risk received a higher number of tweets supporting their positions when compared to the experts whose statements were aimed at intensifying the risk. Since a public expert is a communicator, but also an advisor who can affect how laypersons perceive and react to risk events, this study can provide more knowledge about the public perception of different communication strategies incorporated by medical experts.

Italian validation of the situational Brief Cope Scale (I-Brief Cope).

The Brief COPE (Coping Orientation to Problems Experienced) inventory is 14 faced scales used to assess coping strategies. It has been administered on different population samples and translated into several languages. Nonetheless, the Italian validation of its situational format is missing, and the present study aimed to fill this gap. To this end, the original English version of the scale was translated into Italian and administered to a sample of 682 Italian healthcare workers (HCWs), during the first wave of COVID-19. The Exploratory and Confirmatory Factor Analysis (EFA and CFA) were performed and led to the validation of the Italian Brief COPE (I-Brief COPE) scale, consisting of 21 items, loading properly on 6 factors, which range from activation (F1) to deactivation (F2), via social support (F3), humorous reframing (F4), religious/spiritual reliance (F5), substances use (F6). The six factors identified represent, according to our analyses, the relevant dimensions of coping in a stressful situation such as COVID-19. The results of this study reveal that the I-Brief Cope can be considered as a valid tool for measuring coping strategies in facing stressful, unpredictable, and damaging events.

The Italian epistemic marker mi sa [to me it knows] compared to so [I know], non so [I don't know], non so se [I don't know whether], credo [I believe], penso [I think].

The two studies presented in this paper concern the Italian epistemic marker mi sa [lit. to me it knows], which seems to have no equivalent in other European languages and has received very little attention in the literature. No analysis of the occurrences of mi sa in contemporary spoken corpora can be found (first gap) as well as no investigation on the epistemic relationship between mi sa and (1) the other modal expressions that use the verb sapere [to know] in the first person singular of the simple present, i.e., so [I know], non so [I do not know], non so se [I do not know whether] as well as (2) its supposed synonyms credo [I believe] and penso [I think] (second gap). The two studies are closely intertwined, the first being an exploratory, qualitative pilot study for the second. Study 1 aims to fill the first gap through the analysis of the contemporary Italian spoken corpus KIParla. The quantitative and qualitative analyses revealed five types of occurrences (theoretically reducible to two main ones), the most numerous of which are 'mi sa che + proposition'. Study 2 aims to fill the second gap through a questionnaire administered online. The quantitative and statistical results showed the epistemic relationships between the six markers: for the majority of the participants, in the epistemic continuum that goes from unknowledge to uncertainty and then to knowledge, (1) non so refers to unknowledge; non so se, mi sa, credo and penso refer to uncertainty; so refers to knowledge; (2) mi sa, credo, penso confirm to be synonyms; (3) non so se is evaluated as much more uncertain than mi sa, credo, penso. These four epistemic markers seem to occupy a different position along the uncertainty continuum ranging between two poles: doubt (high uncertainty) and belief (low uncertainty).

The Robust Italian Validation of the Coping Humor Scale (RI-CHS) for Adult Health Care Workers.

The Coping Humor Scale (CHS) is a seven-item tool widely used to assess the use of humor in coping with stressful situations. The beneficial effect of humor in buffering the impact of negative experiences has been investigated in several contexts and populations; for this reason, the CHS has been used in many languages, but its solid validation in Italian is still missing. Our study aimed at building a robust instrument to measure coping humor strategies among Italian health care workers, a category which has been particularly exposed to stressful situations in the last two years. The CHS translated into Italian was administered to a sample of 735 health care workers during the first wave of the COVID-19 pandemic in Italy. Confirmatory factor analysis and Rasch analysis were performed. As a result, a six-item Robust Italian Coping Humor Scale (RI-CHS) was validated and ready to use for future studies on Italian health care workers' samples. This study gives evidence that our six-item solution works as a ruler (i.e., an instrument that meets the conditions of fundamental measurement in the context of the human sciences) to measure the degree to which Italian health care workers rely on humor to cope with stress.

Associations between Personality Traits, Intolerance of Uncertainty, Coping Strategies, and Stress in Italian Frontline and Non-Frontline HCWs during the COVID-19 Pandemic-A Multi-Group Path-Analysis.

The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs concerning (a) personality traits, intolerance of uncertainty, coping strategies and perceived stress, and (b) the models of their associations. A total of 682 Italian HCWs completed a self-report questionnaire: 280 employed in COVID-19 wards and 402 in other wards. The analysis of variance omnibus test revealed significant differences between the two groups only for perceived stress, which was higher among the frontline. The multi-group path analysis revealed significant differences in the structure of the associations between the two groups of HCWs, specifically concerning the relations between: personality traits and intolerance of uncertainty; intolerance of uncertainty and coping strategies. Regarding the relation between coping strategies and stress no difference was identified between the two groups. In both of them, emotionally focused coping was negatively related with perceived stress, whereas dysfunctional coping was positively related with stress. These results could be useful in planning actions aiming to reduce stress and improve the effectiveness of HCWs' interventions. Training programs aimed to provide HCWs with a skillset to tackle uncertain and stressful circumstances could represent an appropriate support to develop a preventive approach during outbreaks.

Italian onco-haematological patients' preferences in bad news communication: a preliminary investigation.

BACKGROUND: The manner in which bad news is communicated in oncological contexts can affect patients' engagement, their coping strategies and therapeutic compliance. Although this topic has been broadly investigated since the nineties, to the best of our knowledge, little has been written about Italian patients' experiences and preferences concerning what the oncologists should disclose and how they should intimate patients about their health conditions in different stages of oncological disease. METHODS: In an attempt to fill this gap, an online self-report questionnaire was administered to a sample of Italian onco-haematological patients. Data were analysed both qualitatively (by a content analysis) and quantitatively (by descriptive analysis and Generalized Linear Mixed Model). RESULTS: While the majority of patients elected to know the truth during their clinical course, a polarisation between those arguing that the truth be fully disclosed and those claiming that the truth be communicated in a personalised way was observed at the attitude level. Among demographic variables accounted for, age seems to most affect patients' preferences. Indeed, younger Italian patients decidedly reject concealment of the truth, even when justified by the beneficence principle. This result could be a reaction to some protective and paternalistic behaviours, but it could even reflect a relation according to which the more the age increases the more the fear of knowing rises, or an intergenerational change due to different ways of accessing the information. The qualitative analysis of the final open-ended question revealed three main sources of problems in doctor-patient encounters: scarcity of time, absence of empathy and use of not-understandable language that makes it difficult for patients to assume a more active role. CONCLUSIONS: The results of the present study, which represents a preliminary step in the subject investigation, will be deployed for the construction and validation of a more sophisticated questionnaire. Better awareness of the Italian onco-haematological patients' preferences concerning bad news communication and truth-telling could be useful in adopting more suitable medical practices and improving doctor-patient relationships.

"Old Wine in a New Bottle". Depression and Romantic Relationships in Italian Emerging Adulthood: The Moderating Effect of Gender.

Intimate partner violence is an important social issue all over the world, and human sciences, in particular, are working to reduce it. Despite this, the topic is a little recognized phenomenon. Understanding the origins and the variables that have an impact on manic-style romantic relationships, as defined by John Alan Lee, is of primary importance, in particular in Italy where the data reveal alarming statistics. Most studies have not controlled for earlier depressive symptoms as a cause of successive depression or as an antecedent of romantic styles. In our study, we investigate the association between depression and romantic style, trying to test the moderating role of the gender variable in 283 Italian emerging adults (139 women and 144 men). In order to achieve this aim, we performed a multigroup structural equation model analysis. The hypothesis that gender moderates the relationship between depression and romantic styles is still yet to be confirmed. Men with high levels of depression do not seem to be able to establish relationships based on commitment, as required by the eros style. Women with high levels of depression are more frequently involved in possessive and demanding relationships or in pragmatic ones, confirming their need for dependence.

Coronavirus Disease Stress Among Italian Healthcare Workers: The Role of Coping Humor.

The study aimed to understand how coping strategies in general and humor-based coping strategies in particular modulate the perception of pandemic-related stress in a sample of Italian healthcare workers during the coronavirus disease (COVID-19) outbreak in Italy. A total of 625 healthcare workers anonymously and voluntarily completed a 10-min questionnaire, which included psychometrically valid measurements preceded by a set of questions aimed at determining workers' exposure to COVID-19. The Perceived Stress Scale was used to measure healthcare workers' stress levels, and the Brief COPE Scale and Coping Humor Scale were used to assess participants' avoidant or approach coping style and verify the degree to which they relied on humor to cope with stress. The results show that (1) levels of perceived stress were higher in healthcare workers who were more exposed to COVID-19 (i.e., who came into contact with COVID-19 patients or worked in wards dedicated to COVID-19) in comparison to less-exposed workers; (2) participants who reported a higher use of avoidant coping strategies perceived the situation as more stressful than those who used them less; and (3) healthcare workers who reported higher use of humor-based coping strategies perceived the situation as less stressful in comparison with those who reported less use of coping humor. Such findings expanded other research studies by including coping humor as a potential factor to mitigate the perceived stress related to COVID-19. The paper concludes with a discussion of implications for future research and limitations of the study.

Writers' uncertainty in scientific and popular biomedical articles. A comparative analysis of the British Medical Journal and Discover Magazine.

Distinguishing certain and uncertain information is of crucial importance both in the scientific field in the strict sense and in the popular scientific domain. In this paper, by adopting an epistemic stance perspective on certainty and uncertainty, and a mixed procedure of analysis, which combines a bottom-up and a top-down approach, we perform a comparative study (both qualitative and quantitative) of the uncertainty linguistic markers (verbs, non-verbs, modal verbs, conditional clauses, uncertain questions, epistemic future) and their scope in three different corpora: a historical corpus of 80 biomedical articles from the British Medical Journal (BMJ) 1840-2007; a corpus of 12 biomedical articles from BMJ 2013, and a contemporary corpus of 12 scientific popular articles from Discover 2013. The variables under observation are time, structure (IMRaD vs no-IMRaD) and genre (scientific vs popular articles). We apply the Generalized Linear Models analysis in order to test whether there are statistically significant differences (1) in the amount of uncertainty among the different corpora, and (2) in the categories of uncertainty markers used by writers. The results of our analysis reveal that (1) in all corpora, the percentages of uncertainty are always much lower than that of certainty; (2) uncertainty progressively diminishes over time in biomedical articles (in conjunction with their structural changes-IMRaD-and to the increase of the BMJ Impact Factor); and (3) uncertainty is slightly higher in scientific popular articles (Discover 2013) as compared to the contemporary corpus of scientific articles (BMJ 2013). Nevertheless, in all corpora, modal verbs are the most used uncertainty markers. These results suggest that not only do scientific writers prefer to communicate their uncertainty with markers of possibility rather than those of subjectivity but also that science journalists prefer using a third-person subject followed by modal verbs rather than a first-person subject followed by mental verbs such as think or believe.