Duilio Manara

Vita-Salute San Raffaele University | UniSR · Center for Nursing Research and Innovation, Faculty of Medicine and Surgery

Background. Previous research has shown that patients with ostomy frequently exhibit a low health-related quality of life (HRQoL). Self-care is a key element that influences their HRQoL. However, the evidence regarding the relationship between these two constructs in patients with ostomy is still not clear. Materials and Methods. This was a seconda...

Engagement with mobile health (mHealth) technologies among patients with hypertension is linked to reduced blood pressure and improved patient understanding of the condition. This study aimed to evaluate the psychometric properties (validity and reliability) of the TWente Engagement with Ehealth Technologies Scale (TWEETS) in an Italian cohort with...

(1) Background: Pain is a common symptom in patients with Amyotrophic Lateral Sclerosis (ALS). There are no evidence-based pharmacological treatments for pain in ALS; recommendations are based on guidelines for chronic non-oncological pain and clinical experience. The aim is to map the literature on how people with ALS experience pain, and how this...

Despite the importance of social support in ostomy care, the Multidimensional Scale of Perceived Social Support (MSPSS) does not appear to be validated in the context of ostomy care. This study evaluated the psychometric characteristics of MSPSS in ostomy patients and their informal caregivers. The MSPSS was tested in a sample of 775 participants w...

Objective To develop and validate a questionnaire to evaluate missed nursing care (MNC) in a home care setting. Design A new instrument was developed and tested performing a preliminary analysis of a multicenter cross‐sectional study in Italy. Reporting was performed according to COnsensus‐based Standards for the selection of health status Measure...

The aim of this study was to adapt the National Aeronautics and Space Administration Task Load Index (NASA‐TLX) to the home care setting and translate and validate it in Italian. An online questionnaire containing the Italian version of the NASA‐TLX adapted to the home care setting was administered to home care nurses to measure workload. Content V...

Background To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored. Introduction Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational mod...

Introduction Postoperative patients with ostomies experience significant changes in their lives as a result of the device implantation. Self-care is important to improve their health outcomes. Telehealth provides an opportunity to expand access to self-care education. Aim This is a multicenter, non-inferiority randomized, open-label, controlled tr...

Widespread use of smartphone applications has opened new perspectives for home Blood Pressure monitoring based on mobile health (mHealth) technologies. Patient engagement has been dubbed ‘the silver bullet of the century’. The aim was to identify the impact of engagement in patients with blood pressure using mHealth. This scoping review was conduct...

Introduction: New educational approaches are emerging to assist healthcare professionals in better personalizing patient's educational pathways. Specifically, "gamification" - the incorporation of game elements into non-game contexts - appears to be a novel and affordable approach. This scoping review aims to explore and map the literature that ev...

Introduction The aging of the population requires an appropriate knowledge of the type of care that needs to be provided to inform healthcare policies. In Italy, neither home care nursing, nor the patient experiences have ever been described. Objectives To describe the characteristics of nurses and care recipients involved in home care. Methods A...

While for a long-time emotional reaction and moral distress, have been primarily investigated for the possible outcomes of the nursing decision-making process rather than in terms of their role as antecedents of the final decision taken. The primary study's aim is to explore how inpatient nurses' decision-making takes place in different care settin...

Background: Urinary incontinence (UI) has been identified as a World Health Organization health priority. In particular, urge UI (UUI) refers to urine leakage associated with a sudden and compelling desire to void urine. It affects quality of life more than other kinds of UI, but it is not always treated adequately. For these reasons, this study ai...

Background: Education plays a pivotal role in the care of oncological patients, reducing health costs, hospital readmission, and disease relapses. Education can be supportive in achieving multiple outcomes, improving symptom control and quality of life. A new approach is emerging in patient education: gamification. Gamification was defined as the “...

Objectives: Preventing postpartum depression (PPD) is a public health goal. The scientific literature has demonstrated the short-term efficacy of Mindfulness-Based Interventions (MBIs) delivered during pregnancy on PPD. Nevertheless, the long-term outcomes of MBIs are still unclear. Design: Systematic review and meta-analysis of randomized controll...

RIASSUNTO Introduzione: Le cure domiciliari in Italia sono un'opzione di assistenza sanitaria mirata a fornire cure a lungo termine direttamente a casa dei pazienti. Tuttavia, essendo di competenza regionale, possono variare da una regione all'altra. Obiettivi: Descrivere l'organizzazione dell'assistenza infermieristica sul territorio italiano, i...

The health profile of foreigners in Italy is affected by multiple factors and events, including environmental, microbiological, cultural, and behavioral. To explore nurses’ basic cross-cultural knowledge, and their perceptions of problems that arise in encounters with clients from outside the country, and to suggest solution strategies, we enrolled...

Introduction Considering the increasing complexity of care and workload for home care nurses due to the ageing of the population, it is crucial to describe the work environment and the community care setting. The aim of this study protocol is to map the characteristics and identify gaps of home care in the community to design future interventions a...

Background: Self-care is associated with clinical outcomes of adults with T1DM. Some evidence highlighted significant sex-related differences in self-care behaviors in this population. However, the literature on this topic has not been synthesized before. This study aimed to summarize, critically review, and interpret evidence regarding sex-relate...

Ethical challenges are traditionally described in a negative light, even though moral conflict can express the individual ability to perceive when something is not working and promote change. The true question, therefore, is not to how to silence moral conflict but how to educate it. Although the need for ethical support of health- and social-care...

Background: Research shows that the longer nurses care for terminally ill patients, the greater they experience moral distress. The same applies to nursing students. This study aims to analyze episodes of moral distress experienced by nursing students during end-of-life care of onco-hematologic patients in hospital settings. Methods: This study...

Introduction The development of this study protocol occurred in conjunction with the new Regulation defining models and standards for the development of community care in the National Health Service (Ministerial Decree n. 77-2022) with the redefinition of care in the community. Considered the increase in the elderly population, in the complexity of...

Background: The COVID-19 pandemic has imposed great pressure on healthcare facilities, exposing healthcare professionals to various challenges that may result in the onset of moral distress, a condition of psychological distress caused by the inability to act as it would be most morally appropriate. The purpose of this research was to investigate...

(1) Background: The globally promoted vaccination campaign has been shown to be the solution for the COVID-19 pandemic, reducing transmission, hospitalisation and the need for intensive care. Although several studies have examined the experiences of healthcare workers during the pandemic, few studies have investigated healthcare student experiences...

Background: No systematic review in the literature has analyzed the intensity and frequency of moral distress among ICU nurses. No study seems to have mapped the leading personal and professional characteristics associated with high levels of moral distress. This systematic review aimed to describe the intensity and frequency of moral distress exp...

What is the state of knowledge on the use of phytotherapy in the following urological benign diseases: prostatic hyperplasia, erectile dysfunction, male infertility, urolithiasis and low-urinary tract symptoms? Supplements derived from natural products are used in medicine alone or in combination with drugs. In urology, there are many products used...

Background. Chronic renal failure is an epidemic in elderly patients. Older population have an increased prevalence of frailty and sarcopenia, associated with a wide range of adverse health outcomes such as falls, hospitalization, disability. Aim. Describe the sociodemographic and clinical variables of an elderly Lombard population and identify pre...

Objective: The present systematic review aimed to identify, critically assess and summarize which risk factors might determine the onset of ostomy complications, describing a pooled incidence and stratified incidences by each identified risk factor. Methods: A systematic literature review with a meta-analysis of observational studies was perform...

Objective: To describe predictors of adjustment to living with an ostomy among Italian adults with an enterostomy or a colostomy. Methods: A multicenter, cross-sectional design was performed, sampling 403 patients with an ostomy in three different outpatient clinics of northern Italy between April 2018 and December 2020. Data were collected by s...

Introduction: The discontinuity between the high ideals of nursing education and real-world practice is a major cause of frustration, moral distress and burnout among the youngest, and pushes up to half nurses to change career within two years. These conditions are accentuated in the care of elderly patients with multiple chronic needs. Methods:...

This study aimed to identify the risk factors for the onset of postpartum urinary retention (PUR), to locate the most effective prevention, treatment interventions, and how to improve its management. The research questions were the following: ‘In postpartum women, what are the risk factors for PUR? In postpartum women, what are the interventions ai...

The phenomenon of Moral Distress in nursing practice is described as a situation of suffering that arises when the nurse recognizes the ethically appropriate action to be taken and yet institutional impediments make it impossible for him to follow the right course of action. Dialysis patients often have a complex disease trajectory that sometimes i...

The recent COVID-19 pandemic has had a significant impact on the population worldwide. Patients with chronic kidney disease treated with kidney replacement therapy were no exception because they were considered highly vulnerable due to multiple comorbidities. The consequences of the physical, biological, and ecological system on the environment as...

Background: ClinicalTrials.gov is the oldest and largest of these registries. Through this, the researchers can explore and monitor the clinical research landscape. In the last decades, the number of Medline-indexed publications on adverse events and medication errors have increased exponentially. The aims were to define the prevalence of clinical...

Moral distress is a concern for all healthcare professionals working in all care settings. Based on our knowledge, no studies explore the differences in levels of moral distress in hospital and community settings. This study aims to examine the level of moral distress among healthcare professional working in community or hospital settings and compa...

Background Despite various studies reporting a high prevalence, reaching 71%, the sensation of thirst in intensive care unit (ICU) patients, its prevention, detection, and management, is not well known nor considered. Limited research has examined the causes of thirst in ICU patients, while it has been examined in other patient populations.AimTo de...

Background and aim of the work .The fluctuation from day to day within a working week of moral distress, coping, and general health of frontline healthcare workers (HCWs) in facing the challenges of the COVID-19 pandemic has been poorly studied. This study described the weekly fluctuation from day to day of moral distress, coping, and general healt...

Background and aim of the work: The delivery of care to patients with COVID-19 enhanced many psychological issues among healthcare workers (HCWs), exacerbating the risk of burnout and compromising the efficacy and quality of services provided to patients. In this context, the peculiarities regarding professional roles in delivering care to patient...

Background: Moral distress has frequently been investigated in single healthcare settings and concerning a single type of professional. This study aimed to describe the experience of moral distress in all the types of professionals providing daily care to elderly patients and residents. Methods: The Grounded Theory approach, developed by Corbin and...

Prostate, kidney, and bladder cancer are the three most frequently diagnosed urological cancers. Educational programs could teach patients to become experts in disease management. The aim of this scoping review was to explore the literature to identify the educational requirements and strategies for improving and implementing educational processes...

Background: Since 1997, nursing ethics research has focused on solving ethical dilemmas, enhancing decision-making strategies, and introducing professional education. Few studies describe the triggers of ethical dilemmas among primary care nurses. The aim of this study was to explore the moral distress and ethical dilemmas among primary care nurse...

Hemodialysis is the most common treatment in patients with end-stage chronic kidney disease and the wide accessibility of this therapy has prolonged the patients' lifespan. However, it involves alterations in their emotional sphere and, often, a reduction in therapeutic compliance as the chronicity of kidney disease requires lifestyle changes diffi...

Aim To describe the facilitators and barriers perceived by healthcare teams after the implementation of the Awakening, Breathing, Coordination, Delirium monitoring/management and Early mobility bundle in an intensive care unit in Italy. This multicomponent intervention strategy has been associated with lower probabilities of delirium, improved func...

Background: The literature emphasizes the importance of the Intensive Care Unit (ICU) diary to fill the gaps and recover the delusional memories of patients admitted to ICU in order to build the history of their illness. The ICU diary is a measure originally intended to support the severely ill patient, but it would also seem to be useful for famil...

Background and aim of work: Despite national descriptions of awareness, knowledge, and perceptions about the exposure to the biological risk among nurses employed in renal-dialysis care are pivotal to increase work safety, there is a paucity of data on these descriptions in the Italian context. This study aimed at describing Italian nurses' awaren...

Novel coronavirus disease-2019 (COVID-19) is a new respiratory disease that has spread widely throughout the world. On February 20, 2020, the first Italian case of COVID-19 was reported. The infection rapidly spread across the country, and by August 11, 2020, a total of 250 566 official cases with 32 205 deaths (12.8%) were reported in Italy, count...

Background Moral distress is a neglected issue in most palliative education programmes, and research has largely focused on this phenomenon as an occupational problem for nursing staff. Research question The primary outcome of this study was to explore the causes of morally distressing events, feelings experienced by nurses and coping strategies u...

Le competenze infermieristiche esprimono una complessa integrazione di conoscenze che includono giudizio clinico professionale, valori e attitudini. L’European Federation of Nurses Association (EFN) ha confrontato la direttiva 2013/55/EU con il Competency Framework, un importante documento sulle linee guida scritto da un gruppo di esperti sul ri...

Nursing requires a complex set of skills encompassing professional clinical judgment, values and attitudes. In order to outline the future career path of the specialist nurse, the European Federation of Nurses Association compared the EU Directive 2013/55/EU with the Competency Framework, an important document on guidelines written by a group of ex...

Background An increasing number of professionals is challenged by the evolution of modern healthcare and society, often characterized by more expectations with reduced resources. Moral distress is among the psychophysical conditions now most under investigation in order to improve the wellbeing of professionals, the sustainability of organizations...

Background Delirium is a serious and common condition that needs an upgrade of the scientific and clinical attention.AimTo assess the delirium prevalence in an Italian university hospital.Methods The monocentric 1-day observational study cohort has been conducted on March 15, 2018; the population was composed of adult hospitalized patients. All the...

What is the degree of knowledge and awareness regarding testicular cancer and what interventions may improve information about testicular cancer in the male population? Testicular cancer incidence rates are increasing among young men, who typically demonstrate poor awareness and a lack of knowledge about this disease. Although testicular self‐exami...

Pandemic infection by COVID‐19 could be changing the public image of the nursing profession in Italy. Recently, as in any western country, we were being registered with an increase in the number of violence against healthcare professionals. Nevertheless, due to pandemic in the social media, the nursing profession is remembered for competence, deter...

Background: Literature has paid little attention in describing the specific contribution of each modifiable and non-modifiable characteristics on health-related quality of life (HRQoL) in physician-managed anticoagulated patients using vitamin K antagonists (VKAs). To describe how patients' treatment-specific knowledge, health literacy, treatment...

Self‐care is a key concept for ostomy patients as much as for chronically ill patients. Many studies describe how reaching a good self‐care level permits patient to perceive a higher quality of life, to adjust faster to the new condition, to grow empowerment feelings and to reduce readmissions and negative outcomes. There are many studies that stat...

Stoma patients and their caregivers need to be autonomous in stoma care, but there are few instruments for measuring the level of self‐care. This study aims to develop and test the psychometric properties of the Ostomy Self‐Care Index (OSCI) and the Caregiver Contribution to Self‐Care in Ostomy Patient Index (CC‐OSCI), from a clinical, operative an...

What are the dietary, fluid intake and lifestyle indications for the disease management and recurrences prevention in patients with urolithiasis? Despite the progress in urolithiasis diagnosis and treatment, its incidence has increased in the last decades and a high rate of recurrence is still a real problem. Dietary and lifestyle modifications rep...

Mi è stato chiesto di parlare attorno al rapporto tra politica professionale ed epistemologia infermieristica. Paroloni. Ma questo è un argomento molto difficile da affrontare. Se questo rapporto c'è, e c'è sicuramente, che tipo di rapporto è? A che punto siamo rispetto al nostro passato? Che cosa ci aspetta nel futuro? Suor Odilia, mi fa veramente...

Aim To explore the experiences of self-care of patients with urostomy and to identify the influencing factors of self-care. Background The creation of a urostomy results in the loss of an important bodily function and an alteration of the body image and causes physical, psychological, and social changes in the lifestyle through the adjustment and...

Nutritional status is considered a significant factor determining the post-operative outcomes after RC. The aim of this literature review is to describe the impact of early oral nutrition on functional outcomes in patients underwent cystectomy. Usually, these patients are not fed orally until the return of gastrointestinal function, because early o...

Does the postoperative use of chewing gum in patients undergoing radical cystectomy (RC) facilitate intestinal motility recovery, reduce intestinal recanalization times and decrease length of stay? Postoperative ileus is a temporary impairment of intestinal motility and a frequent complication after RC. It is characterized by abdominal distention a...

Background Endotracheal suctioning is a common procedure performed by intensive care nurses in order to establish and maintain gas exchange, adequate oxygenation and alveolar ventilation in critically ill patients under mechanical ventilation. As this procedure is associated with several complications and risks nurses should have an adequate knowle...

The nurse's moral competences in the management of situations which present ethical implications are less investigated in literature than other ethical problems related to clinical nursing. Phenomenology affirms that emotional warmth is the first fundamental attitude as well as the premise of any ethical reasoning. Nevertheless, it is not clear how...

Today's society is highly impacted by immigration, as well as healthcare system. It is becoming increasingly common and frequent to establish relationships with patients with different cultural backgrounds. The aim of this study is analyzing Italian nurses' perception of the relational dynamics with foreign patients, to determine its evolution, and...

The aim of this study was to translate into Italian , with semantic validation, the Individualized Care Scale and to provide some indications for using it in an Italian cultural and professional context , to improve its effectiveness as an indicator of the level of nursing care in Italy. This was done using a double forward blind parallel translati...

Despite the fact that Italian nurses have only recently gained autonomy when making health-care decisions, there is little evidence available regarding the decisions actually taken in clinical practice. Exploring the patterns that guide the nurses' decision-making process in weaning and extubating the patient after cardiac surgery. We have adopted...