Alberto Olivero

Fibromyalgia (FM) is characterized by chronic pain, fatigue, and sleep disturbances, which often coexist with psychiatric symptoms, complicating its clinical profile. This study aims to investigate the relationships between FM components and psychopathological correlates, focusing on the central role of depression within the FM symptom network. A cross-sectional study was conducted on 50 outpatients diagnosed with FM according to the American College of Rheumatology 2016 criteria. Participants completed a comprehensive battery of validated assessment tools measuring FM components (pain, fatigue, and sleep disturbances), psychopathology (depression and anxiety), and stress-related dimensions. Structural equation modeling (SEM) and network analysis were used to explore the interplay between FM-related and psychological factors. The findings revealed a complex relationship between depression and pain in FM, with depression emerging as a central and highly connected factor within the symptom network, associated with both emotional and physical dysfunction. Fatigue was identified as a significant mediator between depression and pain, while stress, though not central, contributed to the overall symptom burden. These interactions underscore the multifaceted nature of FM, where psychological and physical symptoms are intricately interconnected through shared mechanisms. Systematic assessment of depressive symptoms may represent a clinically relevant target and a potential leverage point for integrated care pathways in chronic pain services.

The manuscript addresses a highly relevant issue in contemporary medicine: the necessity of maintaining a holistic approach in patient care within an increasingly secularized and transcultural context. The figure of Hanna Chrzanowska is effectively u...

Background: Patient-centered care is becoming a paradigm in medicine. The Patient-Practitioner Orientation Scale (PPOS) is the only tool that measures the patient-centered attitude of healthcare students and professionals. Despite its spread, PPOS has had a poor process of scale modelling and validation and previous studies raised concerns about its psychometric robustness. Objective: This study aims to investigate the PPOS psychometric properties, factor structure, and construct validity on a large sample of undergraduate medical students. Methods: Participants of this cross-sectional single-center study are 1543 first-year medical students. PPOS item validity (internal consistency, test–retest reliability), factor structure (explorative principal axis factoring), and construct validity (convergent-discriminant validity, between-groups invariance) have been investigated. Results: A three-factor not clearly defined solution explaining 34.4% of the variance and containing 14 items out of 18 was retained. Internal consistency was questionable for factor 1 (a = 0.657), poor for factor 2 (a = 0.566), and unacceptable for factor 3 (a = 0.399). Item-total correlations for factor 1 and factor 2 were > 0.3, except for item 6 (ITC = 0.218) and item 12 (ITC = 0.283). Item total-correlations for factor 3 were all < 0.3. Test–retest reliability was acceptable for factor 1 (ICC = 0.704) and factor 2 (ICC = 0.789) and questionable for factor 3 (ICC = 0.661). Construct validity and measurement invariance across groups were satisfactory. Conclusion: Findings in this study corroborate previous evidences about PPOS psychometric limitations and provide new evidence about the multidimensionality of patient-centeredness construct.

The growing amount of evidence about the role of supportive care in enhancing cancer patients’ outcomes has made healthcare providers more sensitive to the need for support that they experience during cancer’s trajectory. However, the lack of a consensus in the definition of supportive care and lack of uniformity in the theoretical paradigm and measurement tools for unmet needs does not allow for defined guidelines for evidence-based best practices that are universally accepted. Contemporary cancer literature confirms that patients continue to report high levels of unmet supportive care needs and documents the low effectiveness of most of the interventions proposed to date. The aim of this critical review is to consolidate the conceptual understanding of the need for supportive care, providing definitions, areas of expertise and a careful overview of the measurement tools and intervention proposals developed to date. The possible reasons why the currently developed interventions do not seem to be able to meet the needs, and the issues for future research were discussed.