Psychological distress imposed by the SARS-CoV-2 outbreak particularly affects patients with pre-existing medical conditions, and the progression of their diseases. Patients who fail to keep scheduled medical appointments experience a negative impact on care. The aim of this study is to investigate the psychosocial factors contributing to the cancellation of medical appointments during the pandemic by patients with pre-existing health conditions. Data were collected in eleven Italian hospitals during the last week of lockdown, and one month later. In order to assess the emotional impact of the SARS-CoV-2 outbreak and the subject’s degree of psychological flexibility, we developed an ad hoc questionnaire (ImpACT), referring to the Acceptance and Commitment Therapy (ACT) model. The Impact of Event Scale-Revised (IES-R), the Depression, Anxiety and Stress Scale (DASS) and the Cognitive Fusion Questionnaire (CFQ) were also used. Pervasive dysfunctional use of experiential avoidance behaviours (used with the function to avoid thought, emotions, sensations), feelings of loneliness and high post-traumatic stress scores were found to correlate with the fear of COVID-19, increasing the likelihood of cancelling medical appointments. Responding promptly to the information and psychological needs of patients who cancel medical appointments can have positive effects in terms of psychological and physical health.

This explorative cross-sectional study aims at exploring emotional distress, psychological profiles, and the attitude towards receiving psychological support in eighty-seven patients with chronic migraine (CM) undergoing OnabotulinumtoxinA prophylactic treatment (OBT-A, n = 40) or withdrawal treatment (WT, n = 47). The outcomes were explored through a specific battery of questionnaires. 25% of patients undergoing OBT-A and almost half of the patients undergoing WT reported psychological distress of at least moderate-severe level, respectively. Coping strategies, self-efficacy, and perceived social support were similar in the two groups. Patients undergoing OBT-A presented lower psychological inflexibility than patients undergoing WT. Predictors of higher psychological distress were low perceived social support by friends, low self-efficacy, and higher avoidance strategies. In both groups, most of the patients evaluated receiving psychological support to be useful (79%). The potential beneficial effects of OBT-A on the severity of symptoms and psychological distress might further support its role in the multidisciplinary management of patients with CM. Identifying patients with psychological vulnerabilities who may benefit from psychological support is relevant in patients with CM.

The Caregiver Inventory (CGI), a measure of self-efficacy for caregiving that takes into account aspects of caregiving that are neglected by current measures of caregiving, was translated into Italian and validated. Ninety-one caregivers from a variety of locations in Italy completed the CGI-Italian (CGI-I) as well as the Hospital Anxiety and Depression Scale (HADS) and the Family Strain Questionnaire - Short Form (FSQ-SF). A confirmatory factor analysis based on the original CGI factor structure resulted in an adequate fit of the CGI-I using standard fit indices. Thus, the original factor structure was validated in the CGI-I: Managing Medical Information (α = 0.87), Caring for Care Recipient (α = 0.68), Caring for Oneself (α = 0.78), and Managing Difficult Interactions/Emotions (α = 0.55). The CGI-I total score was inversely related to anxiety (HADS, r = − 0.35, p = <.05), and depression (HADS, r = − 0.45, p = <.05). In addition, the CGI-I was inversely related to caregiver stress (FSQ-SF, r = − 0.39, p = <.05). Care of Oneself and Managing Difficult Interactions/Emotions emerged as the strongest and most robust negative relationships with anxiety, depression, and caregiver stress, which replicated, with similar constructs, findings from the original CGI. The results of this study established the CGI-I as a reliable and valid measure of self-efficacy for caregiving. This study also confirms the importance of self-care and managing difficult communication in the process of successfully navigating the demands of caregiving and in constructing interventions for caregivers who need support.

Positive dimension, reflecting "the pleasure you derive from being able to do your work well. For example, you may feel like it is a pleasure to help others through your work. You may feel positively about your colleagues or your ability to contribute to the work setting or even the greater good of society". Compassion Fatigue (CF) represents the negative dimension of professional quality of life. It, in turn, includes two subdomains: Burnout (BO) and Secondary Traumatic Stress (STS). Burnout is characterized by chronic emotional and physical exhaustion, frustration, and a sense of inefficacy, often resulting from prolonged exposure to demanding work environments. It typically develops gradually and is associated with feelings of hopelessness, decreased job performance, and the perception that one's efforts are futile. Contributing factors may include excessive workload, lack of support, and organizational stressors. Secondary Traumatic Stress, on the other hand, refers to the emotional distress that arises from indirect exposure to traumatic experiences through one's work with affected individuals. STS symptoms may include intrusive thoughts, sleep disturbances, hypervigilance, and avoidance behaviors related to the trauma encountered by those being helped (Stamm, 2005)." Using the Professional Quality of Life (ProQOL), Su and colleagues (2021) conducted a large-scale study into hospital staff in Taiwan, and found moderate levels of burnout (mean: 24.9), low levels of compassion fatigue (CF) (mean score: 20.9) but moderate levels of compassion satisfaction (CS) (mean score: 32). Perhaps, as some authors have proposed, a sense of purpose and of undertaking a shared mission could increase CS and possibly protect HCWs from lasting distress (Dwyer et al., 2021). Therefore compassion satisfaction could represent a protective factor in reducing stress and depression, as confirmed in other findings (Ruiz-Fernandez et al.,

L’interesse crescente per un percorso decisionale condiviso tra medico e paziente è finalizzato ad un miglioramento degli esiti clinici. La presente rassegna riporta i risultati di una revisione della letteratura sull’argomento nel contesto italiano, descrivendone gli ambiti di applicazione, gli obiettivi, gli strumenti utilizzati ed i principali risultati.