Evaluating Measurement Properties of the Adapted Interprofessional Collaboration Scale through Rasch Analysis.

This study aimed to evaluate the validity and reliability of the German and Italian versions of the Interprofessional Collaboration Scale (IPC scale) by applying a Rasch analysis. Data were gathered from 1182 nurses participating in a cross-sectional study in northern Italy. The scale demonstrated good reliability (Cronbach's alpha = 0.92). Item polarity of all 13 items was positive, indicating good construct validity. However, revising one item would further improve the validity of the scale. Item stability was confirmed for work experience, workplace, age range, the language version, and gender. The analysis, applying a non-classical test theory, confirmed that the IPC scale is a valid and reliable instrument to measure interprofessional collaboration between nurses and physicians.

[The implementation of family nursing in a municipality of the Provence of Bolzano]. / L'esperienza dell'introduzione dell'infermiere di famigliain un comune della Provincia di Bolzano.

. The implementation of Family Nursing in a municipality of the Provence of Bolzano. In the Province of Bolzano, 45 Family and Community Nurses have been trained to date with a 1250-hour course of which 400 hours of practical training. The working model adopted is the Calgary Assessment model, based on ithe relationship with families. The experience of the District of Bassa Atesina, which includes ten municipalities and about 40,000 inhabitants, is described, and in particular the assignment of three family nurses to a mountain municipality with a population of 1700 inhabitants, located with a considerable territorial dispersion. The FCNs cared for 48 families with tailored care plans. The model will be extended to other Districts.

Application of an adapted relationship scale for assessing the occurrence of six different relationships as perceived by seven health care professions in Northern Italy.

Interprofessional working relationships can influence the quality of collaborative practices, with consequences for patient safety outcomes. This article reports findings of an adapted relationship scale comprising six different relationship types, ranging from hostile to collegial, between seven health-care professions: physicians, nurses, dieticians, occupational therapists, physiotherapists, speech therapists, and psychologists. Survey data were gathered within amixed-method study aiming to explore the current status quo of interprofessional collaboration in aHealth Trust, located in Northern Italy. An online questionnaire was completed by 2,238 health professionals achieving aresponse rate of 44%. The working relationship element was answered by 1,897 respondents. The results of the survey are used as abasis for recommending strategies for advancing interprofessional collaboration in the Trust. Descriptive statistics were used to examine relationship-types, with frequency of occurrence considered. The non-parametric Mann Whitney and Kruskal Wallis tests were used to explore relationship differences among groups defined by sociodemographic variables. Participants reported overall positive relationships with other health professions. We noted variability in the occurrence of different relationship-types amongst the health professions. In particular, the six professions viewed their relationships with doctors more negatively than physicians who reported amore positive perception of their relationships with the six professions.

Perceptions of collaborative relationships between seven different health care professions in Northern Italy.

This article presents quantitative findings from a mixed method study that aimed to explore the status quo of interprofessional collaboration (IPC) in a Health Trust, located in a trilingual region in Northern Italy. The survey targeted seven health professions (physicians, nurses, dieticians, occupational therapists, physiotherapists, speech therapists, and psychologists). The survey was distributed online to more than 5,000 health professionals and completed by 2,238. This paper presents results on the frequency of collaboration as well as data from a multiple-group measurement scale for assessing IPC. Descriptive statistics were calculated for continuous variables while categorical data were analysed as counts and percentages. Pearson's Chi-square test and Fisher's exact test were calculated while Mann Whitney and Kruskal Wallis tests were applied to analyse statistical differences in IPC between groups according to sociodemographic variables. In general, our survey data showed that participants, perceived IPC in a positive way, even if the analysis indicated heterogeneity in the level of collaboration expressed. We also found that not all professions had an opportunity to collaborate with others. In addition, we found evidence to suggest that the way health care is organised impacted on perceptions of collaboration between the health professionals in this study. This study provides an initial insight into the perceived levels of IPC within a North Italian context. As such, it offers an account of the strengths and weaknesses of IPC from seven different professional groups based in this region of Europe.

A multiple-group measurement scale for interprofessional collaboration: Adaptation and validation into Italian and German languages.

This article presents a study that aimed to validate a translation of a multiple-group measurement scale for interprofessional collaboration (IPC). We used survey data gathered over a three month period as part of a mixed methods study that explored the nature of IPC in Northern Italy. Following a translation from English into Italian and German the survey was distributed online to over 5,000 health professionals (dieticians, nurses, occupational therapists, physicians, physiotherapists, speech therapists and psychologists) based in one regional health trust. In total, 2,238 different health professions completed the survey. Based on the original scale, three principal components were extracted and confirmed as relevant factors for IPC (communication, accommodation and isolation). A confirmatory analysis (3-factor model) was applied to the data of physicians and nurses by language group. In conclusion, the validation of the German and Italian IPC scale has provided an instrument of acceptable reliability and validity for the assessment of IPC involving physicians and nurses.

[An overview of clinical practice education models for nursing students: a literature review]. / Una panoramica sui modelli di insegnamento e tutorato clinico degli studenti infermieri in tirocinio: revisione della letteratura.

. An overview of education models for nursing students clinical practice: a literature review. INTRODUCTION: In the past decade the nursing education research developed and tested a number of clinical educational models. AIM: To describe the most used clinical educational models and to analyze their strengths and weaknesses in fostering the learning processes of nursing students. METHODS: A literature review of studies on clinical education models for undergraduate nursing student, published in English, was performed. Electronic database Pubmed and Cinhal were searched until November 2016. RESULTS: Nineteen studies were included in the review and five clinical education model identified: 1) the university tutor supervises a group of students and selects learning opportunities; 2) a clinical expert/tutor nurse works side by side with one student; 3) the student is responsible of his/her learning process with the supervision of the ward staff; 4) a clinical tutor of the ward is dedicated to the students' supervision; 5) the student is not assigned to a ward but clinical learning opportunities matched with his/her needs are selected by the university. CONCLUSIONS: All the clinical education models shared the focus on students' learning needs. Their specific characteristics better suit them for different stages of students' education and to different clinical settings.

The state of interprofessional collaboration in Northern Italy: a mixed methods study.

Health care systems are facing continual reorganizations in response to scientific and technological innovations as well as financial constraints. Simultaneously the rising prevalence of chronic diseases call for a kind of health care organization in which interprofessional collaboration (IPC) functions on a high level. This article describes a research project that aims to generate an empirical account of the current state of IPC in the South Tyrolean Health Trust, located in a bilingual region in northern Italy. The study will employ a sequential mixed methods' design. A survey will be followed by individual and focus group interviews. An innovative aspect of the study is that it will include participants from six different health professions (dieticians, nurses, occupational therapists, physicians, physiotherapists, and speech therapists). Qualitative data analysis will draw on the negotiated order/structural ordering approach and on the social world/arena perspective. The results are expected to generate specific recommendations to improve IPC in the South Tyrolean Health Trust and inform further research.

[The GRADE system]. / Il sistema GRADE.

The Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE Working Group) has developed a system for grading the quality of evidence. Over 20 organizations including the World Health Organization (WHO) have adopted it. The quality of a body of evidence involves consideration of within-study risk of bias (methodological quality), directness of evidence, heterogeneity, precision of effect estimates and risk of publication bias, and the system considers the assessment of the quality of a body of evidence for each individual outcome. The GRADE approach specifies four levels of quality. Randomized trials, usually the highest grade of evidence, can be downgraded depending on the presence of the methodological problems. A brief overview of the grade system is presented.

[The local adaptation of clinical practice guidelines]. / L'adattamento locale.

The ADAPTE process is a systematic approach to adapting guidelines produced in one setting for use in a different cultural and organizational context. It ensures that the guideline addresses specific health questions relevant to the context, accounting for the needs, priorities, legislation, policies, and resources in the targeted setting. The ADAPTE process was developed to meet the needs of different user groups, including guideline developers, health care providers, and policy makers at the local, national, and international level. The process is flexible; the transparent and explicit reporting enhances the quality and validity of the adapted guideline. The ADAPTE process is briefly described.

[Qualitative research: an overlook of the literature]. / La ricerca qualitativa: uno sguardo alla letteratura.

Qualitative research: an overlook of the literature. Qualitative studies published in 2012-2013 were analysed. Over 4616 studies published (3 in Italian language), 295 use the grounded theory, 218 a phenomenological approach, 86 ethnography, 14 narrative enquiry and 15 are case studies. A few studies and the methasmtheses were selected to present examples of areas of interest.

Becoming a caregiver: new family carers' experience during the transition from hospital to home.

AIMS AND OBJECTIVES: To explore and understand the experience of new informal caregivers in Italy during the transition from hospital to home. BACKGROUND: Frequent patient discharge into the home environment has lead to a significant increase in postdischarge care being provided by family caregivers. The transition period in particular is seen as a period of great significance, as caregivers may be unprepared and concerned as to the amount of care required by the recipient. DESIGN: A qualitative phenomenological approach was used to gain a deeper understanding of caregivers' lived experiences. METHODS: Data were collected at two points in time using different methodologies: in-depth interviews were conducted to explore the caregivers' perspective of the predischarge period; focus groups obtained data after the patients' re-entry into the home environment and aimed to validate interview findings. RESULTS: Family caregivers reflected on three main themes during the transition period: (1) their newly acquired role; (2) the recipient's condition; and (3) the support they required. The core concept of 'being responsible for everything' seemed to be a recurring theme running through these three subject matters. Fulfilling numerous commitments and different social roles besides the caring activity itself seemed to weigh heavily on caregivers. Carers were referring particularly to their need for hope, confidence and safety during the transition from hospital to home. CONCLUSIONS: It cannot be assumed a priori that families can cope with the demands of care-giving. Therefore, healthcare professionals should come to recognise caregivers as persons in need of emotional and practical support. RELEVANCE TO CLINICAL PRACTICE: The findings of this study can stimulate healthcare professionals to acquire effective communication skills and display an empathic attitude when assessing caregivers' needs in the particularly challenging phase of transition from hospital to home.

[The innovation and change processes: an update on background theories]. / I processi di cambiamento ed innovazione: uno sguardo alle teorie di riferimento.

UNLABELLED: The innovation and change processes: an update on background theories. INTRODUCTION: The change process was widely studied to improve its understanding and management. AIM: To synthesize the theoretical debate on organizational change, on the reactions of those involved and on the strategies suggested to manage it. RESULTS: The drive to change may come from factors internal or external to the organization. The aim of the change can be oriented to the adaptation or to a radical change; the worries of those involved span from its personal to professional impact. CONCLUSIONS: The guarantee of a support during the change process is especially important when several wards are involved and when a reallocation or transfer of resources has been planned.

[The worries and anxieties of nurses involved in the reorganization of a department]. / Le preoccupazioni degli infermieri coinvolti in un progetto di riorganizzazione dipartimentale.

INTRODUCTION: The change process generally elicits reactions not always positive, although expected. AIM: To describe the reactions to change before and after one year from implementation. METHODS: A questionnaire was administered to a group of nurses before and after their wards was moved to a new surgical department with a totally different organization. RESULTS: The nurses remained moderately worried before and after the change. Worries for the impact of the change on the patients and themselves significantly increased. Nurses with 4-14 years of experience expressed higher levels of concern. CONCLUSIONS: The worries are a normal reaction but their better understanding may give indications on support strategies.