Francesco Fanari

ASST Fatebenefratelli Sacco

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Anna Maria Parini

ASST Fatebenefratelli Sacco

Antonio Villa

Universidad Nacional Autónoma de México

Silvia Poveda‐Moral

Hospital Terrassa

Monica Petralito

ASST Fatebenefratelli Sacco

Elena Viola

Universitat de Barcelona

Fiammetta Cicala

ASST Fatebenefratelli Sacco

Sara Gonzalez‐Del Hoyo

Bellvitge University Hospital

Anna Falcó‐Pegueroles

Universitat de Barcelona

Stefano Terzoni

University of Milan

Loris Bonetti

Ente Ospedaliero Cantonale

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ASST Fatebenefratelli Sacco

Universitat de Barcelona

University of Milan

Bellvitge University Hospital

Universidad Nacional Autónoma de México

Mylan (Switzerland)

Universitat Autònoma de Barcelona

Ajuntament de L’Hospitalet

Government of Catalonia

Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo

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COVID‐19 pandemic experiences, ethical conflict and decision‐making process in critical care professionals (Quali‐Ethics‐COVID‐19 research part 1): An international qualitative study

Journal of Clinical Nursing (2023)

Anna Falcó‐Pegueroles A. Bosch-Alcaraz Stefano Terzoni Francesco Fanari Elena Viola

The aim of this study was to explore the sources of ethical conflict and the decision-making processes of ICU nurses and physicians during the first and subsequent waves of the COVID-19 pandemic.Depside several studies exploring ethical conflicts during COVID-19 pandemic, few studies have explored in depth the perceptions and experiences of critical care professionals regarding these conflicts, the decision-making process or which have analysed the complexity of actually implementing the recommendations of scientific societies and professional/healthcare institutions in interdisciplinary samples.A descriptive phenomenological study.Thirty-eight in-depth interviews were conducted with critical care nurses and physicians from five hospitals in Spain and Italy between December 2020 and May 2021. A thematic content analysis of the interview transcripts was conducted by two researchers. Consolidated criteria for reporting qualitative research (COREQ) were employed to ensure the quality and transparency of this study.Two main themes emerged as sources of ethical conflict: the approach to end of life in exceptional circumstances and the lack of humanisation and care resources. The former comprised two subthemes: end-of-life care and withholding and withdrawal of life-sustaining treatment; the latter comprised three subthemes: the impossibility of guaranteeing the same opportunities to all, fear of contagion as a barrier to taking decisions and the need to humanise care.Professionals sought to take their decisions in line with professional ethics and bioethical principles, but, nevertheless, they experienced moral dilemmas and moral distress when not being able to care for, or to treat, their patients as they believed fit.Further education and training are recommended on the provision of end-of-life and post-mortem care, effective communication techniques via video calls, disclosure of bad news and bioethical models for decision-making in highly demanding situations of uncertainty, such as those experienced during the COVID-19 pandemic.

Bioethics

Thematic Analysis

Pandemic

Ethical decision

10.1111/jocn.16633

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Citations (10)

L'esperienza vissuta dagli operatori sanitari rispetto alla presenza dei familiari durante le manovre rianimatorie: uno studio osservazionale

Dissertation Nursing (2023)

Eleonora Pollini Anna Maria Parini Antonio Villa Francesco Fanari

BACKGROUND: La possibilità per i familiari di assistere durante la rianimazione cardiopolmonare (RCP) suscita controversie tra i professionisti sanitari. Nonostante esistano evidenze a supporto, tale presenza nei dipartimenti di emergenza-urgenza è poco praticata. OBIETTIVI: Misurare la percezione di medici e infermieri rispetto alla presenza dei familiari nelle UO di Pronto Soccorso (PS), Rianimazione (RIA), Unità coronarica (UTIC) e 118 di una ASST milanese. METODI: È stato somministrato un questionario agli operatori sanitari con quesiti relativi alla possibilità di far assistere i parenti, agli effetti di tale decisione e all’opinione degli operatori rispetto a questi temi. Si sono confrontate le risposte in base alla professione (medici, infermieri), all’UO di appartenenza (118, PS, RIA, UTIC) e all’anzianità professionale (≤ 5 anni, 6-14 anni, ≥ 15 anni). RISULTATI: Il campione analizzato è costituito da 200 schede (79% infermieri, 21% medici; 52.5% operatori di PS, 27% di RIA, 15.5% di UTIC e 5% di 118; 18,5% sanitari con ≤ 5 anni di esperienza, 31,5% 6-14 anni e 50% ≥ 15 anni). Prevale l’opinione che non sia possibile far assistere i parenti a manovre rianimatorie. I medici sono meno contrari degli infermieri, mentre si evidenziano differenze tra gli operatori di RIA e quelli di UTIC. Gli operatori con meno esperienza considerano maggiormente i famigliari di intralcio e temono ripercussioni legali. CONCLUSIONI: Nasce l’esigenza di delineare protocolli per supportare i professionisti sanitari su come comportarsi con la richiesta dei parenti di poter assistere a manovre rianimatorie sui propri cari.

10.54103/dn/19844

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[The Educational Programs in Home Hemodialysis: Scoping Review].

PubMed (2024)

Fiammetta Cicala Francesco Fanari Monica Petralito

Home hemodialysis is an effective therapeutic option for patients with chronic kidney disease. As highlighted in the literature, its management requires good self-care abilities from the patient and adequate support for self-care from the caregiver. Therefore, the development of educational programs plays a fundamental role in patient care.

Home hemodialysis

10.69097/41-05-2024-09

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