Carlo Alberto Camuccio

Background: The Fundamentals of Care (FoC) framework provides a structured model to support the delivery of person‐centered nursing care by integrating physical, psychosocial, and relational dimensions. Although the framework has been widely applied in acute care, little is known about its relevance in long‐term neurorehabilitation settings, where patients often face complex, prolonged, and multidimensional care needs. Objective: To explore how individuals with neurological disorders perceive their fundamental care needs during inpatient rehabilitation. Design: A qualitative secondary analysis. Setting: A rehabilitation hospital in Italy with a total capacity of 109 beds. Participants: We recruited individuals aged 18 years and older with a diagnosis of stroke, multiple sclerosis, or Parkinson disease, or who had undergone neurosurgical intervention for oncological conditions. Methods: A deductive content analysis was performed, using the FoC framework to guide coding and thematic development. Findings: The analysis identified care experiences across the three FoC dimensions. In the physical dimension, patients valued hygiene, toileting, mobility, and comfort not only as technical tasks but also as meaningful acts that contributed to dignity and recovery. The psychosocial dimension emphasized the importance of respectful communication, emotional support, privacy, and being informed, factors that fostered agency and trust. In the relational dimension, patients highlighted empathy, continuity, and presence as central to feeling emotionally safe and supported. Health care assistants emerged as key figures in delivering comfort‐focused and relational care. Across all dimensions, fundamental care was perceived as deeply interconnected and resistant to rigid, task‐based models. Conclusions: This study underscores the value of the FoC framework in capturing the multidimensional nature of care as experienced by neurorehabilitation patients. The findings reinforce the need for nurses and assistants to provide care that extends beyond physical tasks to include relational presence and person‐centered responsiveness.

Background and Aim: Hospitalization is increasingly seen as a key factor in rehabilitation outcomes, shaped by patient satisfaction, motivation, and relationships with staff. The lived experience of neurorehabilitation across neurological conditions, such as stroke, multiple sclerosis, Parkinson’s disease, and post-oncological care, remains largely unknown. This study explores the care and hospitalization experience of individuals admitted to neurorehabilitation units with diagnoses of stroke, multiple sclerosis, Parkinson’s disease, and post-neurosurgical recovery following oncological procedures. Methods: Thirty-seven patients with neurological conditions were enrolled and interviewed. A descriptive phenomenological design was employed, using semi-structured interviews. Data were analyzed following Colaizzi’s method, supported by Atlas.ti 25. Phenomenological analysis was used to identify themes emerging from patient narratives, with rigor ensured through independent coding, triangulation, and saturation-based sampling. Results: Five themes emerged: (1) the therapeutic bond with healthcare professionals; (2) the slow time of hospitalization, marked by waiting and boredom; (3) care is rehabilitation; (4) illness narratives; and (5) stories of closeness among inpatients and family members. Conclusions: The results of this study highlight neurorehabilitation as a relational process. These findings reinforce the importance of considering patients’ experiences as an integral component of neurorehabilitation hospitalization. Future research should further explore how these dimensions may contribute to the development of more person-centered approaches to neurorehabilitation.

Introduction. Depression, anxiety, fatigue, and pain are four pathological conditions and symptoms very common in stroke patients that often occur simultaneously, affecting each other. This mutual influence seems little studied, as literature tends to study them separately. Method. This study aims to analyze the literature on the co-presence and mutual influence of anxiety, depression, fatigue, and pain in stroke patients during neurorehabilitative hospitalization. Scopus, Pubmed, Embase, and Cinahl databases were searched from 01/2017 to 12/2023. Results. Out of the 24 included studies, 11 investigated fatigue and depression, 10 depression and pain, 6 fatigue and anxiety, and 3 anxiety and pain. In the anxiety and fatigue domains, the observational studies reported a direct association between the two variables, while the intervention studies showed the covariation over time. In anxiety and pain, all the studies reported a direct correlation. In the depression and fatigue, the observational studies showed a positive correlation of variable degree, while the RCTs didn't indicate correlations. No clear association emerged between depression and pain. Discussion. In conclusion, post-stroke pain and anxiety are less frequently assessed and addressed than fatigue and depression. Current assessment tools appear limited in their adequacy for stroke patients, highlighting important methodological gaps. Further research is needed to develop more appropriate instruments and improve psychological support and pain management in this population.

Background/Objectives: The placement of central venous access devices, including peripherally inserted central catheters (PICCs) and PICC-PORTs, is a routine procedure in oncology care. Usually associated with limited physical pain, these procedures may nevertheless generate significant anxiety and negatively influence the overall procedural experience. Virtual reality (VR) has emerged as a non-pharmacological intervention capable of modulating attentional and emotional responses during medical procedures; however, evidence in adult oncology patients undergoing vascular access placement remains scarce. The aim of this study is to evaluate the effect of VR on an oncological patient’s overall procedural experience. Methods: This manuscript outlines the design and methodology of a prospective, single-centre randomised controlled trial. Adult oncology patients scheduled for PICC/PICC-PORT placement are randomised to receive standard care alone or standard care combined with an immersive VR intervention delivered via a head-mounted display during the procedure under pragmatic, real-world clinical conditions. The primary outcome is a composite patient-reported procedural experience endpoint, assessed through a non-aggregated framework encompassing procedural anxiety, comfort, satisfaction and procedural tolerability. Procedural anxiety constitutes the main quantitative driver; the remaining domains are analysed as individual component dimensions and interpreted jointly to contextualise the overall experience. Secondary outcomes include procedural pain, physiological parameters and procedural characteristics. A mixed-methods approach integrates quantitative assessment with qualitative phenomenological analysis. Results: The study is expected to provide methodological and clinical insight into the role of immersive VR in improving procedural experience and support future multicentre trials. Conclusions: This trial will contribute to the expanding field of digital and immersive health technologies by evaluating VR as a patient-centred adjunct intervention in oncological procedural care using a predefined patient-reported experience-based primary endpoint. The protocol has been submitted to ClinicalTrials.gov with the registration number NCT07384741.

Background/Objectives: Oral mucositis (OM) is a common complication in onco-hematological patients undergoing chemotherapy and hematopoietic stem cell transplantation, negatively affecting comfort, nutrition, and quality of life. Despite existing assessment tools and recommendations, OM management—particularly non-pharmacological approaches—remains inconsistent, and evidence on nurses’ perspectives and contextual factors is limited. This study explored nurses’ perceptions and experiences regarding non-pharmacological treatments for OM, including educational needs and barriers and facilitators to implementation in clinical practice. Methods: A qualitative descriptive study using inductive content analysis was conducted. Semi-structured interviews were carried out with nurses working in onco-hematological settings in Italy. Data were analysed according to the Elo and Kyngäs framework. Results: Twelve nurses with extensive experience in onco-hematology and transplant care participated in the study. Five main themes emerged: (1) education and training pathways; (2) approaches to mucositis management; (3) nursing competence in OM care; (4) interprofessional collaboration; and (5) governance of practice, including protocols and guidelines. Findings highlighted strong experiential competence, high levels of nursing autonomy in assessment and patient education, and effective interprofessional collaboration, particularly in specialised settings. However, training pathways were predominantly informal, and the availability and use of protocols varied widely across clinical contexts. Conclusions: Non-pharmacological management of OM appears to be sustained primarily by advanced nursing competence and a specialised clinical culture rather than by structured education and standardised governance. Addressing educational gaps and promoting shared protocols may enhance the consistency, quality, and equity of supportive care while ensuring that the findings are clearly reflective of nurses’ experiences.

The treatment of individuals with psychiatric disorders who visit the Emergency Department (ED) remains a significant issue within healthcare organisations. Over the past decades, various organisational solutions have been proposed, ranging from dedicated Emergency Departments to liaison mechanisms involving mental health nurses within EDs or direct access to acute units. On one hand, there are clinical and organisational needs pushing towards the creation of dedicated pathways; on the other hand, there are concerns that such solutions may be counterproductive and dangerous in terms of health and social inclusion. The aim of this study is to assess the opinions of Mental Health and Emergency professionals on the advantages and disadvantages of clinical and organisational pathways dedicated to patients with psychiatric disorders who visit the general ED. The study was conducted using a qualitative research approach: semi‐structured interviews were carried out through purposeful sampling composed of two cohorts: Emergency and Mental Health professionals. The data were analysed using content analysis with the software Atlas.ti. Forty‐five interviews were collected, and six main themes/families were identified. A certain distance in opinions between the two cohorts emerged, especially regarding the adoption of dedicated pathways. In both cohorts, but particularly in the mental health cohort, there is a fear of stigmatisation and violation of patients' rights in dedicated pathways. Both groups believe that there is a need for more specific training and greater multidisciplinarity. This study adheres to the COREQ checklist for qualitative studies.

The ward climate or atmosphere refers to its material, emotional and social conditions. A good ward climate in psychiatric settings can influence the mood, behaviour and self‐concept of patients and staff members and improve patient outcomes. Many studies have examined the relationship between ward climate and aggression, but only a few have investigated the effect of a ward’s environment, rules and activities. This multicentric observational study aimed to assess the relationship between the rules/activities and the climate of four acute psychiatric units of Northern Italy. The Essen Climate Evaluation Scheme (EssenCES) questionnaire, which was administered to patients and staff, was used to evaluate the different dimensions of ward atmosphere. There was a good response rate (79%) in patients and staff members who completed the questionnaire (114 patients and 109 staff). Safety perception appeared to be quite different in patients and staff. The patients who were authorized to have more visiting hours and more time to use their mobile phone had higher scores on Experienced Safety subscale. A negative correlation between the Therapeutic Hold and Experienced Safety subscales was found in the staff members, and this was due to their negative perception. The ward climate seemed to be affected by the unit’s rules, especially with respect to visits and the smartphones use. Nurses need to be aware of the importance of ward climate and how their own perception may differ from and that of patients: this gap could lead to decisions detached from the patients’ needs.