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AIM: To translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Active Empathic Listening Scale (AELS-It) for first year students on a Bachelor degree in nursing. BACKGROUND: Active and empathic listening is characterised by the active and emotional involvement of the listener and is particularly important for nurses to understand and address patients' needs. When nurses demonstrate to patients that they are active and empathic listeners, it leads to deeper engagement and trust, strengthens the nurse-patient relationship and enhances the quality of care. Consequently, it is essential to incorporate active and empathic listening into nursing education, as it equips future nurses to communicate and respond to patients' needs effectively. AELS is a tool that measures active and empathic listening styles. To the best of our knowledge, no study has validated and psychometrically tested AELS among nursing students and no studies have examined the application of the AELS scale within the Italian context. DESIGN: A three-phase validation study. METHODS: The tool was first translated and adapted into Italian. A panel of 12 experts in nursing education evaluated the face and content validity. The psychometric properties of the Italian AELS (AELS-It) were assessed in a sample of nursing students. The dimensionality and construct validity of the tool were tested through exploratory and confirmatory factor analyses. Reliability was estimated using both traditional and composite methods. RESULTS: A total of 207 students were included. The overall content validity index was 0.9. The exploratory factor analysis confirmed a three factor structure. Confirmatory factor analysis showed a second-order factor structure with adequate fit indices. The reliability of the second-order factor analysis for the scale was adequate, with Cronbach's α (0.877) and Composite-ω (0.875). CONCLUSIONS: The Italian version of AELS-It proved to be a reliable tool to test active empathic listening in Italian nursing students and it could be a useful instrument in nursing education.

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BACKGROUND: Undergraduate nursing students may experience several ethical challenges during their clinical learning placement that can lead to moral distress and intention to leave the profession. Ethical challenges are complex phenomena and ethical frameworks may help improve their understanding and provide actionable recommendations to enhance students' readiness for practice. AIM: To explore undergraduate nursing students' ethical challenges experienced during their clinical learning and their suggestions for better ethics education; to illuminate students' experience against a foundational ethical framework. RESEARCH DESIGN: Qualitative study based on interpretative phenomenology. Semi-structured, in-person or at distance, one-to-one interviews were performed, audio-recorded, and transcribed verbatim. The 'Dignity-enhancing care framework' was employed to frame the study findings. PARTICIPANTS AND RESEARCH CONTEXT: Nineteen nursing graduands attending seven sites of one Northwestern Italian University were interviewed. ETHICAL CONSIDERATION: The study protocol was approved by the Ethics Committee of the University of Torino (number 0187646/2023). All participants provided written informed consent. FINDINGS: Students experienced several ethical challenges concerning daily practice such as pain control or the decision to restrain patients, and reported deficient professional ethics with healthcare professionals who demonstrated poor caring attitudes and teamwork. Moreover, they perceived professionals poorly committed to their role of educators and complained of poor support in the learning process. When a supportive, dialogical, and relational context lacked, students experienced negative feelings about the profession and the healthcare system and reported the intention to leave the profession. Dialogue with peers, family members or significant others, nursing educators, and clinical nurse supervisors, as well as self-learning activities and discussion-based teaching methods grounded on real scenarios helped to overcome challenging situations. CONCLUSION: While complying with normative standards, nursing education policies should encourage the adoption of dynamic teaching methods and sustain a regular, dialogical approach within and between the clinical and academic contexts to improve readiness for practice.

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. Are falls a nursing sensitive outcome? Falls have historically been regarded as nursing-sensitive outcomes, i.e., problems that nurses can intervene in, to prevent their occurrence. However, falls are not a uniform phenomenon, as they can vary significantly and occur despite good nursing care. Furthermore, their predictability and preventability in the care of patients should be carefully considered. Since patient care involves multiple professionals, it is important to reflect on whether and to what extent a fall can be considered a sensitive outcome of nursing care or care in general. This contribution proposes some reflections on falls as a sensitive outcome and indicator of quality of care.

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. Investing in healthcare professionals. The motivation for enrollment in bachelor nursing courses: results from a pilot study. INTRODUCTION: Understanding the reasons for enrolling in a Bachelor of Science in Nursing (BSc Nursing) is crucial for devising strategies to stimulate enrollment and counteract the current decline in applications. A multi-center longitudinal study was initiated to explore motivations for enrollment and dropout rates. The results of the pilot study focusing on enrollment motives are presented. OBJECTIVE: To identify the reasons for enrolling in BSc Nursing programs at five Italian universities. METHODS: First-year BSc Nursing students enrolled in the academic year 2022-2023 completed an online questionnaire exploring socio-demographic and personal information, priority criteria for their choice, information sources, and the following reasons for enrolling (Likert scale 1-5): altruistic motivations, personal interests, preferences, past experiences, job security, advice, fallback options, and the social image of nursing. RESULTS: 759 questionnaires were analyzed (78% of those involved). 64.7% of the students indicated nursing as their first choice, while one-third enrolled as a fallback option, by chance, or because they were uncertain. Altruism was the primary motivation for enrollment (91.8%), but 74.2% of students enrolled to secure a good job or to pursue a career (52.3%), or due to curriculum counseling sessions (13.7%). Some differences were observed between geographical areas. CONCLUSIONS: Students primarily enroll in BSc Nursing programs due to altruism, personal experience, and job prospect. These findings may be valuable for guiding and tailoring information campaigns, and for enhancing the appeal of nursing courses.

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. Patient and public involvement in research. Patient and public involvement (PPI) entails research being carried out 'with' members of the public, rather than 'to', 'about' or 'for' them. The word public can refer to patients, potential patients, carers and people who use health and social care services, people from organisations that represent people who use services as well as members of the public. People with lived experience of a particular service or health condition may add value to the research and even influence the research question. The involvement may occurr in any stage of the research process, but preferably since the very start, when the study is designed. To obtain a real involvement and participation some practical tips are suggested. In this paper advantages but also difficulties related to PPI are presented, based both on the literature but also from the authors' experience.

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. The consequences of visiting restrictions in long term care facilities: a narrative review of the literature. INTRODUCTION: To prevent the spread of Covid-19, residential health care facilities banned access to informal caregivers. AIM: To describe the consequences of visiting restrictions in residential facilities during the pandemic and to identify the strategies adopted to lessen their effects. METHODS: A narrative review of the literature was carried out by searching PubMed and CINAHL database between October 2022 and March 2023. The research included primary, qualitative and quantitative studies written in English/Italian language, and in which data collection was performed after 2020. RESULTS: Twenty-eight studies were included: 14 qualitative, 7 mixed-method and 7 quantitative. Residents and family members experienced anxiety, sadness, loneliness, apathy, anger and frustration. Technology tried to ensure contact, but with limitations due to residents' cognitive-sensory impairments, technological expertise, and staff's available time. Attempts to allow visitors again were welcomed with gratitude, but access was not always granted, causing discontent. Health care professionals experienced the restrictions with ambivalence, torn between the need to prevent contagion and concerns for residents' quali-ty of life. CONCLUSIONS: Visiting restrictions had negative consequences for residents, family members and health care professionals. The sense of abandonment experienced pointed out the lack of strategies able to balance safety and quality of life.

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. The need for palliative care in home care patients. Prospective observational study with the implementation of two algorithms. INTRODUCTION: The early identification of patients with palliative care needs is crucial for defining appropriate care settings and interventions. OBJECTIVE: To detect the need for palliative care in home care patients and to compare two instruments: the SPICT™ and the I-CURPAL-029. METHODS: All new patients taken on in home care in the South-West and North-West Districts of the ASL Città di Torino between 27/12/2021 and 19/02/2022 were included and assessed with the two systems at intake, at two and six weeks. Data collected on patients: demographic characteristics, diagnosis, reason and duration of admission, reason for discharge, degree of autonomy and mobility, presence of cognitive and behavioural disorders, social support. RESULTS: 170 patients were included. At admission, 99 (58.2%) patients with SPICT™ and 84 (49.4%) with I-CURPAL-029 were assessed as needing palliative care; 78 (45.9%) by both instruments. Of the 13 with a need for specialist palliation, 8 were transferred to specialist palliative care. Changes in patients' conditions between controls were detected by both instruments and only affected 12.4% of the sample. SPICT™ and I-CURPAL-029 were sensitive in detecting the need for palliation. SPICT™ was suitable for the home context due to the presence of indicators on caregiving. CONCLUSIONS: Many patients in home care need palliative care. To support decisions for specialistic care, patients classified as palliative by SPICT™ could be assessed with I-CURPAL-029 to identify the need for specialist palliative care.

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Sexually transmitted infections (STIs) are frequently underdiagnosed, representing a serious public health concern, especially during adolescence and in more vulnerable communities. AIM: to describe the last ten years of emergency department (ED) visits for STIs among adolescents. METHODS: a retrospective cross-sectional observation was carried out in the Piedmont region in Italy. Data were retrieved through the Italian National Information System database. ED visits related to specific ICD-9-CM codes carried out on 11 to 19-year-old youths between 2011 and 2020 were investigated. Age-specific, crude, and standardized rates and admission ratios, with 95% confidence intervals (CIs), were calculated to estimate the STI trend. RESULTS: from a total of 1,219,075 ED visits, 339 were related to STIs, representing an increasing ratio of 28 per 100,000 visits, primarily in females. Most infections occurred in girls (83.5%) and among 17 to 19-year-olds (71.5%). A drop in both ED visits and STI cases was observed in 2020. Genital Herpes and Genital Warts were more frequent in girls while Gonorrhea was more frequent in boys. CONCLUSIONS: the increasing trend of ED visits for STIs, particularly in girls, represents an emerging relevant public health issue that needs to be urgently tackled.

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. Experiences implemented during the Covid period in the Novara, Vercelli, Vallemaggia and Locarno areas. INTRODUCTION: The Covid-19 pandemic promoted the organization of several initiatives for the elderly. AIM: To map the local district initiatives for citizens >65 years active during the Covid pandemic in 3 districts of Piedmont and Ticino Canton. METHODS: The data were collected through interviews, contacting local Institutions, volunteer organisations and associations and through free research on the web and on institutional websites. RESULTS: The 26 interviews were conducted between August and September 2022: 16 in the Novara area, 4 in Vercelli and 6 in Canton Ticino. Forty-six initiatives were collected, mainly addressing social-healthcare needs, of which seven were already active in the pre-covid period; overall eight are still ongoing. The initiatives consisted of listening windows, home support (meals, shopping, face-masks, delivery of clean clothes to hospitalized patients). 31 were activated by public services with the collaboration of voluntary services. CONCLUSIONS: The mapping of the initiatives showed their heterogeneity and the fundamental role of volunteering in guaranteeing the continuity of supporting services. These experiences should be consolidated over time by institutions and the public health service, enhancing the contribution of volunteers.

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BACKGROUND: The paper aims to describe the 3-year incidence (2015/17) of aggressive acts against all healthcare workers to identify risk factors associated to violence among a variety of demographic and professional determinants of assaulted, and risk factors related to the circumstances surrounding these events. METHODS: A retrospective observational study of all 10,970 health workers in a large-sized Italian university hospital was performed. The data, obtained from the "Aggression Reporting Form", which must be completed by assaulted workers within 72 h of aggression, were collected for the following domains: worker assaulted (sex, age class, years worked); profession (nurses, medical doctors, non-medical support staff, administrative staff, midwives); aggressive acts (activity type during aggressive acts, season, time and location of aggressive acts); and type of aggressive acts (verbal, non-verbal, consequences, aggressors). RESULTS: Three hundred sixty-four (3.3%) workers experienced almost one aggression. The majority of the assaulted workers were female (77.5%), had worked for 6/15 years and were Nurses (64.3%). The majority of aggressive acts occurred during assistance and patient care (38.2%), in the spring and during the afternoon/morning shifts and took place in locations where patients were present (47.3%). The most prevalent aggression type was verbal (76.9%). The patient was the most common aggressor (46.7%). 56% of those assaulted experienced interruptions in their work. Being female, being < 50 years of age, having worked for 6-15 years were significant risk factors for aggression. Midwives suffered the highest risk of experiencing aggression (RR = 12.95). The risk analysis showed that non-verbally aggressive acts were related to assistance and patient care with respect to activity type, to the presence of patients and during the spring and afternoon/evening. CONCLUSIONS: The findings suggest the parallel use of future qualitative studies to clarify the motivation behind aggression. These suggestions are needed for the implementation of additional adequate prevention strategies on either an organizational or a personal level.

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