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The identification of underlying profiles of nurses exhibiting different patterns of job demands (JD) and job resources (JR) is critical for developing targeted interventions that promote healthy work practices and enhance overall well-being within the nursing working population. This study aimed to adopt a person-centered approach to investigate patterns of JD and JR and their association with job burnout, work engagement, and general well-being among Korean nurses. Secondary data analysis was conducted using data from the Sixth Korean Working Conditions Survey. In total, 449 nurses were included in the analysis. Preliminary measurement models were assessed, and latent profile analysis was used to extract job profiles. Finally, we investigated the association between the profiles and work-related well-being. Five latent profiles best represented JD/JR configurations: low demanding job (9.7%), poor job (6.6%), balanced job (42.7%), demanding job (21.4%), and severely demanding job (19.5%). In addition, the highest levels of perceived well-being were reported in relation to low demanding and poor job profiles, whereas poor and severely demanding job profiles were associated with a higher risk of low work engagement and high physical and emotional exhaustion. In this study, the findings showed that nurses in demanding or severely demanding work profiles experienced more emotional and physical exhaustion than those in low demanding or poor work profiles. Work engagement was lowest in severely demanding profiles, whereas perceived well-being was highest among nurses in the low demanding work environments. The study findings can be used to support nurse managers and administrators in developing strategies to reduce JD while maintaining an average level of JR support.

The Job Demand-Control-Support (JDCS) model postulates that patterns of job demand, job control, and social support lead to eight job types that are associated with well-being and health. This study employed latent profile analysis (LPA) to identify JDCS profiles among Italian hospital workers (n = 1464) and examined the predictive roles of role clarity and negative relationships at work on profile membership. Furthermore, adopting a network perspective, this study explored the interrelationships among JDCS factors within each identified profile. The LPA results revealed four profiles: isolated prisoner, moderate strain, low strain, and participatory leader. In addition, role clarity increased the likelihood of being included in the low-strain, moderate-strain, and participatory leader profiles. In contrast, negative relationships at work increased the risk of being included in the isolated prisoner profile. Finally, the results of network analysis revealed that networks differed across profiles in terms of density (interconnections between nodes) and edge strength (magnitude of relationships between nodes). Our study extends previous JDCS research by highlighting that researchers should consider empirically identified profiles rather than theoretically defined subgroups. The implications for stress theory, future research, and practice are also discussed.

Objectives: The present cross-sectional web-based survey study aimed to examine the impact of gender and frontline/non-frontline condition on psychological health (depression and peritraumatic distress) of a sample of Italian healthcare workers, and to explore the mediating effects of emotional processing in these relationships. Methods: Emotional processing styles and depressive and peritraumatic distress symptoms were assessed between March and December 2021, a period which in Italy corresponds to the third and the start of the fourth wave of COVID-19, along with gender, frontline versus non-frontline role in the pandemic emergency, and other sociodemographic and background variables. Results: Results showed that emotional processing mediated the relationship between gender and frontline/non-frontline role with depressive and peritraumatic distress symptomatology. Being a woman, working on the frontlines, and having a maladaptive emotional processing style increased the negative effects of stress during the pandemic. Conclusions: The obtained results strengthen the importance of providing useful psychological support for health professionals to facilitate the expression and management of emotions as well as the learning of healthy and functional styles of emotional processing.

Background/Objective: Part of the workload of ambulance service involves patients with low-acuity health events that do not require the specific resources provided by ambulance services or emergency departments (EDs). The problem of inappropriateness is also present in Italy. However, research is limited to the perspective of triage nurses only, excluding patients and emergency medical service (EMS) staff. This study aims to identify the presence of inappropriate ambulance use in the study context by comparing patients’ perception of emergency with appropriateness perspectives of both triage nurses and emergency service staff. Methods: A cross-sectional study involving 109 patients transported by ambulance was performed between January and March 2020. Questionnaires were distributed to patients, EMS staff, and triage nurses operating in the chief town and hinterland of a region of Italy. Results: Non-penetrating trauma was the most frequent cause for calling an ambulance. Patients referred that activation of the service was necessary, while triage nurses and EMS technicians were in line in believing the non-urgency of the call due to non-emergent health conditions. Conclusions: Although we cannot conclude that citizens use the emergency system inappropriately, the results of this study make us think about the need to implement educational interventions that increase citizens’ knowledge of how the service works and the territorial services available.

Background The COVID-19 outbreak played a significant psychological impact on nurses, as they coped with intense emotional and cognitive demands, in a context in which the Health System was not prepared to face the emergency. Literature showed that pandemics influenced the nurses' stress and psychosocial health due to poor rest, high work overloads, a lack of control over the patient flows, and a frequent isolation from family. Under these circumstances, nurses experienced severe psychological and mental stressors that generated mental health problems. Recent literature showed that coping strategies, especially those that were positive, promoted mental health in workers and helped them to face stressors. Objective The study aimed to investigate the relationship between vicarious traumas and the impact of traumatic events on nurses' mental health. In addition, we analyzed the role of coping strategies in moderating the effect of vicarious traumas on mental health. Methods The study was performed in November 2020, during the first wave of the COVID-19 pandemic. A self-reported structured questionnaire was administered via an online method to reduce face-to-face contact. Logistic regressions were conducted to analyze the relationship between both vicarious traumas and the impact of traumatic events impact and mental health. An interaction analysis with the PROCESS macro was performed to analyze the role of coping strategies in moderating the relationship between vicarious traumas and mental health. Results A total of 183 nurses answered to the questionnaire. A moderation analysis showed that positive coping strategies such as physical activity, reading/music, and yoga/meditation showed to be protective in reducing the effect of vicarious traumas on the nurses' mental health problems. Conversely, negative coping strategies strengthened that relationship and may compromise their quality of working life. Conclusion These findings provide further support for considering positive coping strategies as an important resource to alleviate psychological distress, thus helping the professional to reduce the negative effects of stress.

Background In Italy, telecare has experienced significant growth in recent years, especially following the COVID-19 pandemic. This modality helps overcome geographic and time barriers, proving to be a valuable tool for ensuring access to care and improving the quality of life for patients. However, implementing telecare requires several challenges for nurses such as difficulty to adapt to a remote relationship, lack of training and adequate technological resources, and concerns about data security and privacy. The aim of the study is to explore nurses’ experience with telecare and their perceptions about its positive and negative implications for caring and the profession. Methods A qualitative study with semi-structured interviews was carried out by involving ten nurses working with telecare service from the Local Health Authority of a city in a central-Italy region. Results Four main themes emerged: (1) the benefits of telecare, (2) the disadvantages of telecare, (3) opportunities for professional growth, and (4) challenges in telecare. Conclusions The results of this study suggest that effective implementation of telecare should take into account not only its potential benefits for patients and nurses but also the challenges related to the nurse-patient relationship and technological barriers. To improve healthcare it is important to invest in training, develop accessible technologies, share patient data and integrate telecare into traditional care models, in order to foster an holistic and individualized approach. Clinical trial number Not applicable.

ObjectivesThe main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students.Design, setting and participantsA cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study.Outcome measuresWe measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10).ResultsResults showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from −0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range.ConclusionFinally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S.

ObjectiveTo examine the relationship between sense of coherence (SOC) and physical health–related quality of life in patients with chronic illnesses by focusing on the mediating role of the mental component of quality of life.DesignCross-sectional survey design.SettingSecondary care; three departments of an Italian university hospital.MethodsThe participants (n=209) in the study were adult (≥18 years) outpatients with a chronic pathology (eg, diabetes, thyroid disorders or cancer) at any phase in the care trajectory (eg, pre-treatment, undergoing treatment, follow-up care). They agreed to participate in the study after providing their informed consent. Data were collected using a structured self-reporting questionnaire. Data analysis was carried out using SPSS, and mediation analysis was performed via PROCESS macro.ResultsThe SOC score of the study sample was equivalent to that of the general population (mean difference=−2.50, 95% CI −4.57 to 0.00). Correlation analysis showed that SOC was mainly correlated to the mental component (MCS) (r=0.51, p<0.01) of quality of life and then to the physical component (PCS) (r=0.35, p<0.01). Mediation analysis showed that SOC was directly related to MCS (p<0.001, 95% CI 0.62 to 0.99) but not to PCS (p=0.42, 95% CI −0.27 to 0.12). In turn, MCS was directly related to PCS (p<0.001, 95% CI 0.76 to 1.01). The indirect effect of SOC on PCS through MCS was significant (0.71, p<0.001, bootstrap 95% CI 0.54 to 0.91), thus supporting the mediating role of the mental component of quality of life.ConclusionThe indirect effect suggests that SOC is a marker of quality of life, especially of the mental component. The findings show that SOC is a psychological process that impacts patients’ mental health status, which in turn affects physical health. Better knowledge of a person’s SOC and how it affects his/her quality of life may help to plan tailoring interventions to strengthen SOC and improve health-related quality of life.

Aim The study aim is to explore the experiences of patients who were admitted to intensive care units due to severe SARS‐CoV2 infection and their perceptions regarding the health care they received. This is important to provide appropriate support to the patients and prepare organisations for future pandemics. Design Qualitative investigation with phenomenological approach. Methods A semi‐structured interview with 27 patients discharged from intensive care units was performed. The research was carried out from May to December 2021 in Italy. Participation was voluntary, and informed verbal consent was obtained from all participants after a full explanation of the study objectives. Results Thematic analysis of participants' interviews revealed five core themes related to their ICU hospitalisation experiences and perceptions of care: (1) Quality of received care, (2) Critical care issues, (3) Personal protective equipment and patient–healthcare professional interaction, (4) Relationship with nurses and (5) Strategies to ensure communication. The results show that despite barriers due to safety devices, patients with COVID‐19 felt supported and cared for by healthcare professionals in several aspects during hospitalisation. However, post‐discharge care programs are needed to reduce the long‐term effects of the disease and provide more patient‐centered care in the intensive care units and during future outbreaks. The study results offer interesting insights for improving practice in intensive care units and patient care in the event of future pandemics.

Background Hospice workers are required to regularly use emotional regulation strategies in an attempt to encourage and sustain terminally ill patients and families. Daily emotional regulation in reaction to constantly watching suffering patients may be intensified among those hospice professionals who have high levels of compassion fatigue. The main object of this study was to examine the relationship between daily exposition to seeing patient suffering and daily emotional work, and to assess whether compassion fatigue (secondary traumatic stress and burnout) buffers this relationship. Methods We used a diary research design for collecting daily fluctuations in seeing patients suffering and emotional work display. Participants filled in a general survey and daily survey over a period of eight consecutive workdays. A total of 39 hospice professionals from two Italian hospices participated in the study. Results Multilevel analyses demonstrated that daily fluctuations in seeing patients suffering was positively related to daily emotional work display after controlling for daily death of patients. Moreover, considering previous levels of compassion fatigue, a buffering effect of high burnout on seeing patients suffering - daily emotional work display relationship was found. Conclusions A central finding of our study is that fluctuations in daily witness of patients suffering are positively related to daily use of positive emotional regulations. Further, our results show that burnout buffers this relationship such that hospice professionals with high burnout use more emotional display in days where they recurrently witness patients suffering.