Healthcare professionals' digital health competence and its core factors; development and psychometric testing of two instruments.

BACKGROUND: Healthcare professionals' digital health competence is an important phenomenon to study as healthcare practices are changing globally. Recent research aimed to define this complex phenomenon and identify the current state of healthcare professionals' competence in digitalisation but did not include an overarching outlook when measuring digital health competence of healthcare professionals. OBJECTIVES: The purpose of this study was to develop and psychometrically validate two self-assessed instruments measuring digital health competence and factors associating with it. METHODS: The study followed three phases of instrument development and validation: 1) conceptualisation and item pool generation; 2) content validity testing and pilot study; and 3) construct validity and reliability testing. The conceptual background of the instruments was based on individual interviews conducted with healthcare professionals (n = 20) and previous systematic reviews. A total of 17 experts assessed the instrument's content validity. Face validity was evaluated by a group of healthcare professionals (n = 20). Data collection from 817 professionals took place in spring-summer 2022 in nine organisations. Construct validity was confirmed with exploratory factor analysis. Cronbach's alpha was used to assess the internal consistency of the instruments. RESULTS: The instrument development and validation process resulted in two instruments: DigiHealthCom and DigiComInf. DigiHealthCom included 42 items in 5 factors related to digital health competence, and DigiComInf included 15 items in 3 factors related to educational and organisational factors associated with digital health competence. The DigiHealthCom instrument explained 68.9 % of the total variance and the factors' Cronbach alpha values varied between 0.91 and 0.97. The DigiComInf instrument explained 59.6 % of the total variance and the factors' Cronbach alpha values varied between 0.76 and 0.88. CONCLUSIONS: The two instruments gave valid and reliable results in psychometric testing. The instruments could be used to evaluate healthcare professionals' digital health competence and associated factors.

Attitudes toward COVID-19 vaccination in the nursing profession: validation of the Italian version of the VAX scale and descriptive study.

Foreward: Nurses' attitudes towards COVID-19 vaccination is a relevant issue, for the protection of the vulnerable people they care for, and the key role they play in promoting health behaviors that encourage trust and adherence to vaccination among population. This study aimed to validate the Italian version of the Vaccination Attitudes Examination (VAX) scale and to describe nurses' attitudes towards COVID-19 vaccination. Design: A cross-sectional study was carried out from May to June 2021. Descriptive statistics, Explorative and Confirmatory Factor Analyses have been performed. Methods: An online survey was carried out in Italy. The VAX scale referring to the COVID-19 vaccine was used. Findings: 430 nurses participated in the study, mainly female (73.2%). Mean age was 40.2 years. VAX scale revealed an optimal reliability; Exploratory Factor Analysis and Confirmatory Analysis supported a 4-factors model. VAX scale mean scores showed low mistrust about vaccine's benefit (2.03±1.07), concerns about commercial profiteering (2.33±1.39) and preference for natural immunity (2.90±1.37). More worries concerning unexpected future effects were found (4.46±1.36). Gender, taking care of a frail person in family, having children or working in a COVID-19 setting are no significantly related to vaccination attitude. Participants from northern Italy expressed greater confidence in vaccine's benefits, the younger had significant lower scores about commercial profiteering. Conclusions: The Italian version of the VAX scale resulted a reliable tool to assess the nurses' attitudes towards COVID-19 vaccination. An overall positive nurses' attitude towards the COVID-19 vaccination was highlighted. The concern about unforeseen future effects suggested the need to increase the information on this issue. Clinical relevance: The results provided a valid and reliable tool to measure vaccination attitudes in the Italian context. This study could strengthen the health policies with educational interventions of healthcare workers through specific vaccination pathways. The healthcare professionals' vaccination attitudes play the key role also in promoting vaccination uptake in the population.

Dental agenesis and evaluation of body composition through bioelectrical impedance analysis. Observational study on a sample of paediatric subjects.

AIM: The aim of the present study was to evaluate the anthropometric parameters and the body composition through bioelectrical impedance analysis on paediatric subjects with dental agenesis. MATERIALS AND METHODS: The study was conducted on 144 subjects (58.3% females and 41.7% males), aged 7-14 years (average age 10.22±2.53 years). Each patient underwent a dental check-up at the Paediatric Dentistry Unit, University of Rome Tor Vergata (Italy) and a nutritional evaluation, aimed at analysing the anthropometric characteristics and evaluating the indices of body composition through bioelectrical impedance analysis (BIA) at the Human Nutrition Unit, University of Rome Tor Vergata. The sample was divided into three groups: a group with single agenesis (Group 1), a group with multiple agenesis (Group 2) and a control group (Group A). Using the predictive equations, the following values were evaluated: resistance (R), reactance (Xc), phase angle (PHA), body cell mass index (BCMI), body cell mass (BCM), total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass (FM), fat free mass (FFM). STATISTICS: The Excel environment and the SAS System, version 9.3, were used for statistical analysis, providing a descriptive and parametric analysis of the sample. The values of the anthropometric parameters were expressed as mean ± standard deviation. For the statistical analysis of anthropometric parameters and body composition, analysis of variance (1-way ANOVA) was used, which allowed us to find differences and the Student's t-test to compare Groups 1, 2, and A. RESULTS: There is a significant difference in the resistance R value between the case group with single agenesis (Group 1) and the control group (Group A) (R, 710.28±72.46 vs 667.4±104.16, p=0.028), and the phase angle PHA between the case group with multiple agenesis (Group 2) and the control group (Group A) (PHA, 5.18±0.48 vs 5.85±1.05, p=0.028). The BCM% value shows a significant difference between both Group 1 and Group A (BCM%, 50.53 ± 3.29 vs 52.68 ± 4.74, p=0.016) and between Group 2 and Group A (BCM%, 49.25± 2.86 vs 52.68 ± 4.74, p=0.035). The TBW, ICW, ECW, FM, FFM values showed no significant differences between the various groups analysed. CONCLUSION: Body composition in subjects with dental agenesis presents a higher R, a consequently lower PHA and a lower BCM% compared to the control group. For the first time, the results highlighted the possible relationship between dental agenesis and body composition, measured through BIA.

[Reluctances in organized breast cancer screenig in Yvelines]. / Réticences au dépistage organisé du cancer du sein dans les Yvelines.

OBJECTIVES: Women's participation in organized screening of breast cancer was 52% in France and 40% in the Île de France in 2010. We wanted to investigate the reasons for non-participation in the screening program and the reluctance of women to it at the level of a department in Île de France. MATERIALS AND METHODS: An anonymous questionnaire was sent to non-respondents in organized screening for breast cancer in the Yvelines department in September 2011 on the occasion of the event "Octobre Rose", month of national mobilization for mass screening for breast cancer. The analysis of these questionnaires was used to determine the causes of non-adherence to organized screening and reluctance to it. We compared the questionnaire responses in the characteristics of patients attending an individual screening with those of patients without any screening. RESULTS: Two thousand nine hundred and ninety-two questionnaires were sent and 3026 responses received (10%). Two thousand six hundred and fifteen women (86%) reported regular screening and make mammograms every two years while 411 (14%) reported occasional or no screening. About the reluctance to conduct the review, the lack of time, the bad memories of a previous mammogram and the fear of pain were the predominant brakes. Nearly 50% of women do not participate in screening because they did not consider themselves at risk for various reasons (lack of symptoms, healthy lifestyle and no family history) and 22% of women surveyed had an attitude of denial cope with the disease. The typical profile of women performing individual or organized screening of breast cancer was that young, single, working, of low socio-professional category and rarely attending their general practitioner or gynaecologist. Health-care professionals seem most likely to cause adherence to screening for breast cancer. DISCUSSION AND CONCLUSION: Focusing on the poor communication and promote organized screening instead of individual screening by health-care professionals themselves could increase adherence to organized screening in the Yvelines.

The cost of the objective structured clinical examination on an Italian nursing bachelor's degree course.

The OSCE (Objective Structured Clinical Examination) is considered the most valid and reliable method for assessing the clinical skills of students training for health professions, but its use is limited by the related high costs. We analyzed the cost retrospectively of using an OSCE designed for second-year students (2009) in our degree course, adopting the Reznick et al. guidelines (1993), which recommend assessing both high-end costs and low-end costs. The high-end costs adopting the OSCE amounted to € 145.23 per student, while the low-end costs were € 31.51 per student. Considering the economic crisis and the cost-containment measures applied also in nursing education, strategies for further reducing costs are discussed.

[Italian validation of the Patient Satisfaction Scale]. / Misurare la soddisfazione del paziente: validazione della versione italiana della Patient Satisfaction Scale.

Patient's satisfaction is a major outcome of the health care services and it is mainly determined by patients' perception of the nursing care received. Many instruments measuring patients' satisfaction are described in the literature. In this study the validation of the Patient Satisfaction Scale in the Italian context is documented. Content validity of the scale has been reached with forward-backward translation, achieving semantic equivalence with the original scale. The scale has been completed by 220 (response rate 91%) surgical patients during their hospitalization and has showed a good response variability and a high reliability (Cronbach alpha = 0.93). The Italian version of the PSS is considered valid and reliable; moreover the high response rate obtained indicates a good level of acceptability of the scale in clinical settings.

[Assessing quality in clinical educational setting: Italian validation of the clinical learning environment and supervision (CLES) scale]. / La valutazione dellA qualità degli ambienti di apprendimento clinico: studio di validazione del Clinical Learning Environment and Supervision (CLES) nel contesto Italiano.

The clinical learning in the wards is one of the most important moment in nursing education: Instruments assessing the quality of the clinical settings as perceived by students may inform and support the best didactic and tutorial choices. In the last 10 years, three clinical learning environment assessment tools for Bachelor Nursing students has been validated. The aim of this study was to validate in the Italian context the Clinical Learning Environment and Supervision scale (CLES) developed in Finland and considered the gold standard within the instruments available. CLES's face and content validity has been evaluated with forward and backward translation and involving a selected group of experts in the field. 117 Bachelor Nursing Students from Udine and Verona University have been enrolled in the study. 28 out of 117 students have filed the instrument twice in order to measure test-retest reliability. The internal consistency has been evaluated with Cronbach alpha. Kurtosis and skewness was measured in order to verify the answers variability distribution. The CLES Cronbach' alpha was 0.96 and the test-retest reliability was r = -0.89. The validity and reliability of the scale has been confirmed. Further research is needed to define a cut-off in order to recognize positive clinical learning environments. The CLES practical use could support in the process of the teaching hospital accreditation and in the evaluation of the effectiveness of the tutorial strategies activated in the wards.