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Prof. Guendalina Graffigna
Università Cattolica del Sacro Cuore, Italy

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0 Behavioural Change
0 Health Psychology
0 Patient Communications
0 Patient engagement
0 Health & Communication

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Patient engagement
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vaccine hesitancy

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Review
Published: 14 August 2021 in Journal of Personalized Medicine
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The present review aims to map the current literature on educational interventions to promote food literacy in type 2 diabetes, with a particular focus on the concept of patient engagement. The systematic review was implemented on five databases with no restrictions on the publication year. The studies selected for the review were focused on patients with type 2 diabetes, ranging from 2003 to 2021 and published in 13 countries (44% USA). Thirty-three articles were analyzed. Twenty-seven articles targeted singular patients; fifteen articles conceptualized patient engagement as self-management. In seven articles, the provider is a multidisciplinary team. Twenty articles did not report a theoretical framework in the intervention development, and eleven did not use an intervention material. Twenty-six articles did not use a technology proxy. Outcome categories were narratively mapped into four areas: clinical, psychological, behavioral, and literacy. To date, most of the interventions are heterogeneous in the adopted methodology, measures, and outcomes considered. More attention should be given to the psychosocial characterization of patient engagement as well as the technological support. High-quality, randomized controlled trials and longitudinal studies are lacking and need to be conducted to verify the efficacy of these insights.

ACS Style

M. Savarese; M. Sapienza; G. M. Acquati; M. C. Nurchis; M. T. Riccardi; V. Mastrilli; R. D’Elia; E. A. Graps; G. Graffigna; G. Damiani. Educational Interventions for Promoting Food Literacy and Patient Engagement in Preventing Complications of Type 2 Diabetes: A Systematic Review. Journal of Personalized Medicine 2021, 11, 795 .

AMA Style

M. Savarese, M. Sapienza, G. M. Acquati, M. C. Nurchis, M. T. Riccardi, V. Mastrilli, R. D’Elia, E. A. Graps, G. Graffigna, G. Damiani. Educational Interventions for Promoting Food Literacy and Patient Engagement in Preventing Complications of Type 2 Diabetes: A Systematic Review. Journal of Personalized Medicine. 2021; 11 (8):795.

Chicago/Turabian Style

M. Savarese; M. Sapienza; G. M. Acquati; M. C. Nurchis; M. T. Riccardi; V. Mastrilli; R. D’Elia; E. A. Graps; G. Graffigna; G. Damiani. 2021. "Educational Interventions for Promoting Food Literacy and Patient Engagement in Preventing Complications of Type 2 Diabetes: A Systematic Review." Journal of Personalized Medicine 11, no. 8: 795.

Journal article
Published: 06 August 2021 in BMC Psychology
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Patients with inflammatory bowel disease (IBD) may be particularly vulnerable to the effects of the novel coronavirus (Covid-19) on disease management and psychological status. This study explored psychological reactions to the Covid-19 emergency and IBD disease management in a sample of Italian patients. An online questionnaire was designed to assess general concerns, psychological reaction, disease management, socio-demographics, and clinical information with validated scales and ad hoc items. A non-probabilistic purposive sample was selected, comprised patients with IBD who belonged to the Italian Association for patients with IBD (AMICI Onlus) completed the questionnaire in April 2020. Data obtained were analyzed using descriptive statistics, student’s T-test for independent groups, and one-way ANOVA (Analysis of Variance). One thousand fourteen eligible questionnaires were analyzed. Italian patients with IBD appeared to be very worried about the Covid-19 emergency (60.7%) and concerned about the risks of infection (59%). Half of the sample reported medium to high-perceived stress, and 74% had low-medium coping self-efficacy levels. One third was in a state of psychological arousal. Twenty-nine percent of patients had canceled hospital appointments for fear of contracting the virus. The majority of responders believed that belonging to the Italian Association for Patients with IBD - AMICI Onlus - is useful. The results revealed that this sample of Italian patients with IBD lived with medium level of stress and with inadequate coping self-efficacy regarding disease management. Accordingly, Covid-19 may affect self-management behaviors. Therefore, national and regional associations for patients with IBD, should largely support these patients in this emergency. The online version contains supplementary material available at 10.1186/s40359-021-00622-6.

ACS Style

Mariarosaria Savarese; Greta Castellini; Salvatore Leone; Enrica Previtali; Alessandro Armuzzi; Guendalina Graffigna. Psychological reaction to Covid-19 of Italian patients with IBD. BMC Psychology 2021, 9, 1 .

AMA Style

Mariarosaria Savarese, Greta Castellini, Salvatore Leone, Enrica Previtali, Alessandro Armuzzi, Guendalina Graffigna. Psychological reaction to Covid-19 of Italian patients with IBD. BMC Psychology. 2021; 9 ():1.

Chicago/Turabian Style

Mariarosaria Savarese; Greta Castellini; Salvatore Leone; Enrica Previtali; Alessandro Armuzzi; Guendalina Graffigna. 2021. "Psychological reaction to Covid-19 of Italian patients with IBD." BMC Psychology 9, no. : 1.

Journal article
Published: 16 July 2021 in Journal of Personalized Medicine
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Ensuring multiple sclerosis (MS) patients’ adherence to therapy is often challenging, but it is crucial to their survival and health-related quality of life (HRQoL). The aim of the present study was to outline connections between adherence, physical and mental HRQoL, levels of psychological readiness to engage in a treatment, levels of social support, anthropometric, socio-demographic and clinical factors in patients suffering from MS. This cross-sectional study involved a sample of 237 Italian MS patients. A survey was conducted with a structured self-administered online questionnaire using validated measures of quality of life, adherence to therapy and anthropometric, socio-demographic, psychological and clinical variables. A path analysis was used to test the overall structure of the associations between the variables. The pathway indicates a positive association between mental health index and a stronger degree of engagement and being or having been in a long-term relationship. Physical health index was positively associated with age, having an occupation, and having a specific form of MS. Having had relapses in the previous year raised the odds of better adherence to therapy, while an increase in Body Mass Index (BMI) reduced them. Our findings could help in the management of MS patients, promoting behavioral interventions that take the psychological and socio-demographic peculiarities of each patient into account with a view to improving their adherence to therapy.

ACS Style

Alessandra Buja; Guendalina Graffigna; Simona Mafrici; Tatjana Baldovin; Carlo Pinato; Umberto Bolzonella; Serena Barello; Alessia Tognetto; Gianfranco Damiani. Adherence to Therapy, Physical and Mental Quality of Life in Patients with Multiple Sclerosis. Journal of Personalized Medicine 2021, 11, 672 .

AMA Style

Alessandra Buja, Guendalina Graffigna, Simona Mafrici, Tatjana Baldovin, Carlo Pinato, Umberto Bolzonella, Serena Barello, Alessia Tognetto, Gianfranco Damiani. Adherence to Therapy, Physical and Mental Quality of Life in Patients with Multiple Sclerosis. Journal of Personalized Medicine. 2021; 11 (7):672.

Chicago/Turabian Style

Alessandra Buja; Guendalina Graffigna; Simona Mafrici; Tatjana Baldovin; Carlo Pinato; Umberto Bolzonella; Serena Barello; Alessia Tognetto; Gianfranco Damiani. 2021. "Adherence to Therapy, Physical and Mental Quality of Life in Patients with Multiple Sclerosis." Journal of Personalized Medicine 11, no. 7: 672.

Journal article
Published: 12 March 2021 in International Journal of Environmental Research and Public Health
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In the Italian context, the diffusion of online fake news about food is becoming increasingly fast-paced and widespread, making it more difficult for the public to recognize reliable information. Moreover, this phenomenon is deteriorating the relation with public institutions and industries. The purpose of this article is to provide a more advanced understanding of the individual psychological factors and the social influence that contributes to the belief in food-related online fake news and the aspects that can increase or mitigate this risk. Data were collected with a self-report questionnaire between February and March 2019. We obtained 1004 valid questionnaires filled out by a representative sample of Italian population, extracted by stratified sampling. We used structural equation modelling and the multi-group analyses to test our hypothesis. The results show that self-evaluation negatively affects the social-influence, which in turn positively affects the belief in online fake news. Moreover, this latter relationship is moderated by the readiness to change. Our results suggest that individual psychological characteristics and social influence are important in explaining the belief in online fake news in the food sector; however, a pivotal role is played by the motivation of lifestyle change. This should be considered to engage people in clear and effective communication.

ACS Style

Greta Castellini; Mariarosaria Savarese; Guendalina Graffigna. Online Fake News about Food: Self-Evaluation, Social Influence, and the Stages of Change Moderation. International Journal of Environmental Research and Public Health 2021, 18, 2934 .

AMA Style

Greta Castellini, Mariarosaria Savarese, Guendalina Graffigna. Online Fake News about Food: Self-Evaluation, Social Influence, and the Stages of Change Moderation. International Journal of Environmental Research and Public Health. 2021; 18 (6):2934.

Chicago/Turabian Style

Greta Castellini; Mariarosaria Savarese; Guendalina Graffigna. 2021. "Online Fake News about Food: Self-Evaluation, Social Influence, and the Stages of Change Moderation." International Journal of Environmental Research and Public Health 18, no. 6: 2934.

Letter
Published: 08 March 2021 in Psychological Medicine
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ACS Style

S. Barello; L. Palamenghi; G. Graffigna. Looking inside the ‘black box’ of vaccine hesitancy: unlocking the effect of psychological attitudes and beliefs on COVID-19 vaccine acceptance and implications for public health communication. Psychological Medicine 2021, 1 -2.

AMA Style

S. Barello, L. Palamenghi, G. Graffigna. Looking inside the ‘black box’ of vaccine hesitancy: unlocking the effect of psychological attitudes and beliefs on COVID-19 vaccine acceptance and implications for public health communication. Psychological Medicine. 2021; ():1-2.

Chicago/Turabian Style

S. Barello; L. Palamenghi; G. Graffigna. 2021. "Looking inside the ‘black box’ of vaccine hesitancy: unlocking the effect of psychological attitudes and beliefs on COVID-19 vaccine acceptance and implications for public health communication." Psychological Medicine , no. : 1-2.

Preprint
Published: 17 February 2021
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In the Italian context, the diffusion of online fake news about food is becoming increasingly fast-paced and widespread, making it more difficult for the public to recognize reliable information. Moreover, this phenomenon is deteriorating the relation with public institutions and industries. The purpose of this article is to provide a more advanced understanding of the individual psychological factors and the social influence contribute to the belief in food-related online fake news and the aspects that can increase or mitigate this risk. Data were collected with a self-report questionnaire between February and March 2019. We obtained 1004 valid questionnaires filled out by a representative sample of Italian population, extracted by stratified sampling. We used structural equation modelling (SEM) and the multi-group analyses to test our hypothesis. The results show that self-evaluation negatively affects the social-influence, which in turn positively affects the belief in online fake news. Moreover, this latter relationship is moderated by the readiness to change. Our results suggest that individual psychological characteristics and social influence are important to explain the belief in online fake news in the food sector; however, a pivotal role is played by the motivation of change lifestyle. This should be considered to engage people in clear and effective communication.

ACS Style

Greta Castellini; Mariarosaria Savarese; Guendalina Graffigna. Online Fake News About Food: Self-Evaluation, Social Influence And The Stages Of Change Moderation. 2021, 1 .

AMA Style

Greta Castellini, Mariarosaria Savarese, Guendalina Graffigna. Online Fake News About Food: Self-Evaluation, Social Influence And The Stages Of Change Moderation. . 2021; ():1.

Chicago/Turabian Style

Greta Castellini; Mariarosaria Savarese; Guendalina Graffigna. 2021. "Online Fake News About Food: Self-Evaluation, Social Influence And The Stages Of Change Moderation." , no. : 1.

Brief report
Published: 20 January 2021 in Vaccines
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Flu vaccination for the general population, and specifically for vulnerable subgroups, brings the potential to reduce the impact of the COVID-19 pandemic in terms of mobility, mortality, and hospitalizations. In Italy, flu vaccination is recommended to all ≥6 months of age, even if it is only free of charge for specific categories. We investigated the intentions towards flu and COVID-19 vaccinations from a sample of 436 Italian university students. Results of a web-based survey show that 77.52% of them were willing to get the flu vaccine and 94.73% were willing to be vaccinated against COVID-19 when available. We identified positive predictive factors to undertake flu vaccination as being a medical student, having undertaken a previous vaccination against flu, and having a high level of concern and perceived vulnerability to the COVID-19 pandemic. Reinforced public health activities might consider engaging university students a as possible “positive influencer” towards flu and COVID-19 vaccination programs.

ACS Style

Roberta Pastorino; Leonardo Villani; Marco Mariani; Walter Ricciardi; Guendalina Graffigna; Stefania Boccia. Impact of COVID-19 Pandemic on Flu and COVID-19 Vaccination Intentions among University Students. Vaccines 2021, 9, 70 .

AMA Style

Roberta Pastorino, Leonardo Villani, Marco Mariani, Walter Ricciardi, Guendalina Graffigna, Stefania Boccia. Impact of COVID-19 Pandemic on Flu and COVID-19 Vaccination Intentions among University Students. Vaccines. 2021; 9 (2):70.

Chicago/Turabian Style

Roberta Pastorino; Leonardo Villani; Marco Mariani; Walter Ricciardi; Guendalina Graffigna; Stefania Boccia. 2021. "Impact of COVID-19 Pandemic on Flu and COVID-19 Vaccination Intentions among University Students." Vaccines 9, no. 2: 70.

Journal article
Published: 01 October 2020 in Vaccines
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The actual effectiveness of the still-to-come vaccination against the coronavirus SARS-CoV-2 might be challenged by vaccine hesitancy, a rather common and known phenomenon whose psychological predictors are, nevertheless, still largely debated. Our study aims at understanding how adult citizens’ health engagement, perceived COVID-19 susceptibility and severity, and general vaccine-related attitudes affect the willingness to vaccinate against COVID-19. To that end, on a sample of Italian citizens, we implemented a path model to test the impact of health engagement on the willingness to vaccinate against SARS-CoV-2, and whether this relationship is direct or mediated by the general attitude towards vaccines and the risk perception. Moreover, we tested the configural and weak invariance of the model across gender and three age groups. Results show that health engagement is positively related to the intention to vaccinate and that this relationship is partially mediated by the general attitude towards vaccines. The model appears invariant across genders and partially invariant across age groups, showing some differences in the role of perceived susceptibility. These findings vouch for the implementation of educational campaigns aimed at sustaining future vaccination programs that also include health engagement promotion.

ACS Style

Guendalina Graffigna; Lorenzo Palamenghi; Stefania Boccia; Serena Barello. Relationship between Citizens’ Health Engagement and Intention to Take the COVID-19 Vaccine in Italy: A Mediation Analysis. Vaccines 2020, 8, 576 .

AMA Style

Guendalina Graffigna, Lorenzo Palamenghi, Stefania Boccia, Serena Barello. Relationship between Citizens’ Health Engagement and Intention to Take the COVID-19 Vaccine in Italy: A Mediation Analysis. Vaccines. 2020; 8 (4):576.

Chicago/Turabian Style

Guendalina Graffigna; Lorenzo Palamenghi; Stefania Boccia; Serena Barello. 2020. "Relationship between Citizens’ Health Engagement and Intention to Take the COVID-19 Vaccine in Italy: A Mediation Analysis." Vaccines 8, no. 4: 576.

Literature review
Published: 25 September 2020 in International Nursing Review
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Aim To systematically and critically summarize the state of the evidence about the Synergy Model and its utilization in nursing practice. Background The Synergy Model emphasizes the importance of alignment between patient needs and nurse competencies in achieving adequate patient‐ and nurse‐related outcomes. It is a relatively new patient‐centred care model developed at the end of the 1990s. Introduction Despite the Synergy Model’s potential to support patient‐centred care, its practical application is still mainly limited. Thus far, literature about the Synergy Model has not yet been synthesized, undermining its broader utilization globally. Methods A systematic search was performed on the following databases: PubMed, CINAHL and Scopus. The authors used the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) statement and checklist to guide the systematic search; 26 papers were included in this study. A critical interpretative synthesis was adopted to summarize the data extracted from the included papers. Results Five interpretative themes emerged: conceptualization, experiences from the field, nursing education, patient‐related outcomes and system‐related outcomes. Synergy Model shows a precise theoretical definition, and it was implemented in multiple clinical settings, mainly in critical care contexts. It seems to have a positive influence on patient‐related, nurse‐related and system‐related outcomes. Discussion Synergy Model seems to be positively associated with specific susceptible outcomes, such as patient satisfaction, reduction of patient’s complications, staff satisfaction, empowerment, and engagement of patients and healthcare providers. However, the level of evidence is still limited. Conclusion Future international research should demonstrate the feasibility of implementing the Synergy Model at an international level. More empirical research is needed to demonstrate the effectiveness of the model on susceptible outcomes. Implications for nursing and health policy This systematic review could support further development of international programmes based on the Synergy Model. The Synergy Model's implementation has the potential to optimize nursing competencies, patient‐ and nurse‐related outcomes.

ACS Style

T. Nania; S. Barello; R. Caruso; G. Graffigna; A. Stievano; F. Pittella; F. Dellafiore. The state of the evidence about the Synergy Model for patient care. International Nursing Review 2020, 68, 78 -89.

AMA Style

T. Nania, S. Barello, R. Caruso, G. Graffigna, A. Stievano, F. Pittella, F. Dellafiore. The state of the evidence about the Synergy Model for patient care. International Nursing Review. 2020; 68 (1):78-89.

Chicago/Turabian Style

T. Nania; S. Barello; R. Caruso; G. Graffigna; A. Stievano; F. Pittella; F. Dellafiore. 2020. "The state of the evidence about the Synergy Model for patient care." International Nursing Review 68, no. 1: 78-89.

Research article
Published: 11 September 2020 in PLoS ONE
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In January 2020, the coronavirus disease 2019 (COVID-19) started to spread in Italy. The Italian government adopted urgent measures to slow its spread. Enforcing compliance with such measures is crucial in order to enhance their effectiveness. Engaging citizens in the COVID-19 preventive process is urgent today both in Italy and around the world. However, to the best of our knowledge, no previous studies have investigated the role of health engagement in predicting citizens’ compliance with health emergency containment measures. An online survey was administered between February 28 and March 4, 2020 on a representative sample of 1000 Italians. The questionnaire included a measure of health engagement (Patient Health Engagement Scale), a 5-item Likert scale ranging from 1 to 7, resulting in 4 positions that describe the psychological readiness to be active in one’s own health management, and a series of ad hoc items intended to measure citizens’ perceived susceptibility and severity of the disease, orientation towards health management, trust in institutional bodies, health habits and food consumption. To investigate the relationship between health engagement and these variables, ANOVA analysis, logistic regression and contingency tables with Pearson’s chi-squared analysis have been carried out. Less engaged people show higher levels of perceived susceptibility to the virus and severity of the disease; they are less trustful of scientific and healthcare authorities, they feel less self-effective in managing their own health—both in normal conditions and under stress—and are less prone to cooperate with healthcare professionals. Low levels of health engagement also are associated with a change in the usual purchase behavior. The Patient Health Engagement model (PHE) provides a useful framework for understanding how people will respond to health threats such as pandemics. Therefore, intervention studies should focus on raising their levels of engagement to increase the effectiveness of educational initiatives intended to promote preventive behaviors.

ACS Style

Guendalina Graffigna; Serena Barello; Mariarosaria Savarese; Lorenzo Palamenghi; Greta Castellini; Andrea Bonanomi; Edoardo Lozza. Measuring Italian citizens’ engagement in the first wave of the COVID-19 pandemic containment measures: A cross-sectional study. PLoS ONE 2020, 15, e0238613 .

AMA Style

Guendalina Graffigna, Serena Barello, Mariarosaria Savarese, Lorenzo Palamenghi, Greta Castellini, Andrea Bonanomi, Edoardo Lozza. Measuring Italian citizens’ engagement in the first wave of the COVID-19 pandemic containment measures: A cross-sectional study. PLoS ONE. 2020; 15 (9):e0238613.

Chicago/Turabian Style

Guendalina Graffigna; Serena Barello; Mariarosaria Savarese; Lorenzo Palamenghi; Greta Castellini; Andrea Bonanomi; Edoardo Lozza. 2020. "Measuring Italian citizens’ engagement in the first wave of the COVID-19 pandemic containment measures: A cross-sectional study." PLoS ONE 15, no. 9: e0238613.

Review
Published: 04 September 2020 in International Journal of Public Health
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Objectives During a pandemic, healthcare workers (HCWs) are essential to the health system response. Based on our knowledge, little information is available regarding the psychosocial impact on HCWs or interventions for supporting them during pandemics. Therefore, the study aimed to assess available literature on perceived stress and psychological responses to influenza pandemics in HCWs and identify implications for healthcare practice and future research. Methods This is a rapid review of the literature. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis. Results Across all the studies—both qualitative and quantitative—HCWs working during the epidemic reported frequent concerns regarding their own health and the fear of infecting their families, friends and colleagues. Moreover, social isolation, uncertainty, fears of stigmatization and reluctance to work or considering absenteeism were frequently reported. Moreover, many studies highlighted a high prevalence of high levels of stress, anxiety and depression symptoms, which could have long-term psychological implications in HCWs. Conclusions This rapid review offers an overview of the major concerns regarding HCWs’ psychosocial well-being and possible preventive strategies, which could be useful for the current COVID-19 outbreak and similar future pandemics. Studies suggested to invest on preventive psychological, social, family and physical support and to guaranteeing reasonable work conditions and others in order to protect HCWs from the long-lasting psychological effect of the COVID-19 pandemic.

ACS Style

Serena Barello; Anna Falcó-Pegueroles; Debora Rosa; Angela Tolotti; Guendalina Graffigna; Loris Bonetti. The psychosocial impact of flu influenza pandemics on healthcare workers and lessons learnt for the COVID-19 emergency: a rapid review. International Journal of Public Health 2020, 65, 1205 -1216.

AMA Style

Serena Barello, Anna Falcó-Pegueroles, Debora Rosa, Angela Tolotti, Guendalina Graffigna, Loris Bonetti. The psychosocial impact of flu influenza pandemics on healthcare workers and lessons learnt for the COVID-19 emergency: a rapid review. International Journal of Public Health. 2020; 65 (7):1205-1216.

Chicago/Turabian Style

Serena Barello; Anna Falcó-Pegueroles; Debora Rosa; Angela Tolotti; Guendalina Graffigna; Loris Bonetti. 2020. "The psychosocial impact of flu influenza pandemics on healthcare workers and lessons learnt for the COVID-19 emergency: a rapid review." International Journal of Public Health 65, no. 7: 1205-1216.

Journal article
Published: 01 September 2020 in European Journal of Public Health
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Background At the end of February 2020 a new case was diagnosed with COVID-19 in north Italy, suddenly followed by new cases. Italian health authorities decided to enforce restrictive measures. Northern areas of Italy were identified as “red areas” to slow down the epidemic and its impact on the healthcare system. From this perspective, the COVID-19 epidemic in Italy constitutes a testing ground for the assessment of the ability of consumers to cope with this health risk. Methods A cross-sectional study on a representative sample of 1000 Italian citizens was conducted over the period 27 February- 5 March exploring the following hypotheses: 1) less engaged individuals are more concerned for the health emergency and feel more vulnerable; 2) less engaged have higher probability to develop negative attitudes and dysfunctional behaviors. Results only the 16% the interviewees presented a high level of engagement. Lower levels of engagement were measured in the southern parts of Italy (not yet touched by the epidemics at the time of data collection). People with lowers levels of engagement reported higher fears for the contagion and sense of vulnerability. Furthermore, they showed the lower levels of trust in the Public Health Authorities, in medical research and in vaccines. Finally, they appeared more dismissive in their preventive behaviors and more disorganized in the fruition of the healthcare services. Conclusions A psychological analysis of processes of attitudinal and role change in the direction of becoming more engaged in health prevention is worthy in order to forecast potential dysfunctional reactions to restrictive health prevention measures and to orient personalized education initiatives to consumers with different level of engagement. Key messages Profiling based on the levels of health engagement is important in order to plan more effective healthcare measures during epidemics. Targeted educational initiatives should take into account citizens' engagement profiles.

ACS Style

G Graffigna; S Barello; L Palamenghi; M Savarese; G Castellini. Patient health engagement model: explaining citizens noncompliance and maladaptive behaviors. European Journal of Public Health 2020, 30, 1 .

AMA Style

G Graffigna, S Barello, L Palamenghi, M Savarese, G Castellini. Patient health engagement model: explaining citizens noncompliance and maladaptive behaviors. European Journal of Public Health. 2020; 30 (Supplement):1.

Chicago/Turabian Style

G Graffigna; S Barello; L Palamenghi; M Savarese; G Castellini. 2020. "Patient health engagement model: explaining citizens noncompliance and maladaptive behaviors." European Journal of Public Health 30, no. Supplement: 1.

Vaccine hesitancy
Published: 17 August 2020 in European Journal of Epidemiology
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Researchers have been working quickly and collaboratively for the development of vaccines against the COVID-19 virus. The effort of the scientific community in searching a vaccine for COVID-19 may be hampered by a diffused vaccine hesitancy. Two waves of data collection on representative samples of the Italian population (during the “first” and “second” phase of the Italian Covid-19 mitigation strategy) were conducted to understand citizens’ perceptions and behaviors about preventive behaviors willingness to vaccine for COVID-19. Our study shows that willingness to COVID-19 vaccine is correlated to trust in research and in vaccines, which decreased between phase 1 and phase 2 of the Italian pandemic. According to the results of our study, the proportion of citizens that seem to be intentioned to get the Covid-19 vaccine is probably too small to effectively stop the spreading of the disease. This requires to foster a climate of respectful mutual trust between science and society, where scientific knowledge is not only preached but also cultivated and sustained thanks to the emphatic understanding of citizens worries, needs of reassurance and health expectations.

ACS Style

Lorenzo Palamenghi; Serena Barello; Stefania Boccia; Guendalina Graffigna. Mistrust in biomedical research and vaccine hesitancy: the forefront challenge in the battle against COVID-19 in Italy. European Journal of Epidemiology 2020, 35, 785 -788.

AMA Style

Lorenzo Palamenghi, Serena Barello, Stefania Boccia, Guendalina Graffigna. Mistrust in biomedical research and vaccine hesitancy: the forefront challenge in the battle against COVID-19 in Italy. European Journal of Epidemiology. 2020; 35 (8):785-788.

Chicago/Turabian Style

Lorenzo Palamenghi; Serena Barello; Stefania Boccia; Guendalina Graffigna. 2020. "Mistrust in biomedical research and vaccine hesitancy: the forefront challenge in the battle against COVID-19 in Italy." European Journal of Epidemiology 35, no. 8: 785-788.

Original research article
Published: 03 July 2020 in Frontiers in Medicine
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Background: Engaging patients in raising their voices to advocate for their priorities being taken into account is today acknowledged as essential to improve research and decision-making in healthcare. However, literature is scarce regarding an evaluation framework to monitor the extent to which this approach is successful, in particular in mental health, where the application of patient-reported outcome measures (PROMs) is particularly difficult. In this study, we describe the process of development and first implementation of a new assessment framework—“Co-production Compass” (COCO) framework—for monitoring patient preference collection in co-production of healthcare services within the scope of a national-based project (namely, Recovery.Net) in the mental health field. Method: We conducted (1) a narrative scan of relevant scientific literature on patient engagement in service co-production and (2) qualitative analysis of five subsequent workshops involving—in total−144 expert stakeholders (i.e., expert patients, doctors, nurses, psychologists, healthcare managers…). Data analysis involved three phases: identifying the themes, developing a framework, and confirming the framework. We coded and organized the data and abstracted, illustrated, described, and explored the emergent themes using thematic analysis. At the same time, content analysis was conducted to retrieve concepts and insights from relevant literature about health services co-production to integrate and extend the emergent conceptual framework. The framework was finally reviewed by the research partners belonging to the study project and preliminarily implemented. Results: According to the results of both the literature scan and the participatory workshops, the COCO evaluation framework for monitoring patient preference collection when coproducing medical pathways was drafted. The framework comprised of three organizing themes, corresponding to the three code clusters, which emerged from both the stakeholders' workshop data and relevant scientific literature: “the need for shared and practice-oriented evaluation standards”; “the quest for a multi-dominion approach”; “the need for a multi-stakeholder evaluation”. These themes were interconnected and formed a conceptual framework to measure the phenomenon of meaningful patient involvement in healthcare co-production. This framework was endorsed by the research partners of the project and preliminarily applied in a mental health setting. Conclusion: The COCO framework provides guidance on aspects of co-production in healthcare to address for meaningful patient involvement in giving their inputs for more effective service and drug development processes. It could be particularly useful when monitoring patient–researcher partnership initiatives.

ACS Style

Guendalina Graffigna; Serena Barello; Lorenzo Palamenghi; Fabio Lucchi. “Co-production Compass” (COCO): An Analytical Framework for Monitoring Patient Preferences in Co-production of Healthcare Services in Mental Health Settings. Frontiers in Medicine 2020, 7, 279 .

AMA Style

Guendalina Graffigna, Serena Barello, Lorenzo Palamenghi, Fabio Lucchi. “Co-production Compass” (COCO): An Analytical Framework for Monitoring Patient Preferences in Co-production of Healthcare Services in Mental Health Settings. Frontiers in Medicine. 2020; 7 ():279.

Chicago/Turabian Style

Guendalina Graffigna; Serena Barello; Lorenzo Palamenghi; Fabio Lucchi. 2020. "“Co-production Compass” (COCO): An Analytical Framework for Monitoring Patient Preferences in Co-production of Healthcare Services in Mental Health Settings." Frontiers in Medicine 7, no. : 279.

Journal article
Published: 02 July 2020 in Sustainability
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Nowadays, the problems that afflict our planet (climate change, loss of biodiversity, etc.) are leading to the implementation of a more sustainable type of consumption. Increasing the consumption of organic products is a way to face and try to solve these problems. In order to reach this aim, it is important to understand how consumers’ subjective relevance of these products impacts on their consumption. The recent literature, in fact, highlighted how food consumption is salient for the individual to express their identity and life orientations, even more in the case of organic food consumption. Nonetheless, little is known about how subjective relevance of food affects organic food consumption. The present research aims to measure the role of subjective relevance in organic food consumption. Data were collected with a self-report questionnaire that was filled out by a sample of 964 Italians, representative of the population. We used structural equation modelling (SEM) and the bootstrap technique to test the hypothesis. The results show that subjective food relevance is a mediator between the motivations of organic food consumption and the frequency of consumption of it. This research points out the necessity to study consumers in a wider way, using communication that emphasizes the role that these products have in satisfying the psychological needs of consumers.

ACS Style

Greta Castellini; Mariarosaria Savarese; Cinzia Castiglioni; Guendalina Graffigna. Organic Food Consumption in Italy: The Role of Subjective Relevance of Food as Mediator between Organic Food Choice Motivation and Frequency of Organic Food Consumption. Sustainability 2020, 12, 5367 .

AMA Style

Greta Castellini, Mariarosaria Savarese, Cinzia Castiglioni, Guendalina Graffigna. Organic Food Consumption in Italy: The Role of Subjective Relevance of Food as Mediator between Organic Food Choice Motivation and Frequency of Organic Food Consumption. Sustainability. 2020; 12 (13):5367.

Chicago/Turabian Style

Greta Castellini; Mariarosaria Savarese; Cinzia Castiglioni; Guendalina Graffigna. 2020. "Organic Food Consumption in Italy: The Role of Subjective Relevance of Food as Mediator between Organic Food Choice Motivation and Frequency of Organic Food Consumption." Sustainability 12, no. 13: 5367.

Correspondence
Published: 24 June 2020 in Patient Education and Counseling
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ACS Style

Serena Barello; Lorenzo Palamenghi; Guendalina Graffigna. Empathic communication as a “Risky strength” for health during the COVID-19 pandemic: The case of frontline Italian healthcare workers. Patient Education and Counseling 2020, 103, 2200 -2202.

AMA Style

Serena Barello, Lorenzo Palamenghi, Guendalina Graffigna. Empathic communication as a “Risky strength” for health during the COVID-19 pandemic: The case of frontline Italian healthcare workers. Patient Education and Counseling. 2020; 103 (10):2200-2202.

Chicago/Turabian Style

Serena Barello; Lorenzo Palamenghi; Guendalina Graffigna. 2020. "Empathic communication as a “Risky strength” for health during the COVID-19 pandemic: The case of frontline Italian healthcare workers." Patient Education and Counseling 103, no. 10: 2200-2202.

Journal article
Published: 20 June 2020
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Due to the ageing of cancer patients, new approaches that require a more active participation in the self-management of cancer treatment at home are needed. Nurses are strategic in improving the patient’s engagement capability in this regard. Knowing which interventions are more effective for the promotion of patient engagement could be useful to improve the effectiveness of the care provided. Therefore, this study aims to systematically review nursing interventions or programs that promote patient engagement in oncological nursing care and summarizing the main evidence related to their impact on relevant clinical and psychosocial outcomes. This is a systematic review and meta-analysis protocol based on Cochrane Handbook for the systematic review of interventions. We will search the most important electronic databases (PUBMED, CINAHL, EMBASE, SCOPUS, ISI Web of Science, Cochrane library) to find out which patient engagement interventions (active adult patient involvement) are implemented in oncological settings and understand what is the effectiveness of these interventions on the outcomes reported in the literature. The GRADE methodology will be used to synthetize the evidence. If possible, also a meta-analysis will be performed. We registered the study protocol on the PROSPERO database (N° CRD42020146189). To our knowledge, this is the first systematic review to address this clinical question in the field of oncology. This review will offer health professionals indications on the most frequently adopted patient engagement interventions and verify their clinical effectiveness. Furthermore, any gaps in the scientific literature will be highlighted. (www.actabiomedica.it)

ACS Style

Loris Bonetti; Angela Tolotti; Dario Valcarenghi; Guendalina Graffigna; Tiziana Nania; Davide Sari; Paola Ferri; Serena Barello. Nurses’ interventions to promote cancer patient engagement and related outcomes: a systematic review and meta-analysis protocol. 2020, 91, 65 -70.

AMA Style

Loris Bonetti, Angela Tolotti, Dario Valcarenghi, Guendalina Graffigna, Tiziana Nania, Davide Sari, Paola Ferri, Serena Barello. Nurses’ interventions to promote cancer patient engagement and related outcomes: a systematic review and meta-analysis protocol. . 2020; 91 (Suppl 6):65-70.

Chicago/Turabian Style

Loris Bonetti; Angela Tolotti; Dario Valcarenghi; Guendalina Graffigna; Tiziana Nania; Davide Sari; Paola Ferri; Serena Barello. 2020. "Nurses’ interventions to promote cancer patient engagement and related outcomes: a systematic review and meta-analysis protocol." 91, no. Suppl 6: 65-70.

Journal article
Published: 11 June 2020 in International Journal of Environmental Research and Public Health
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Patient engagement has been recognized as a key priority in chronic care. However, scholars agree that guidelines are needed to ensure effective patient engagement strategies. To this end, a Consensus Conference process was promoted with the following methodological steps: (1) extensive literature review about patient engagement initiatives in chronic care; (2) a stakeholders survey to collect best practices and (3) workshops with experts. On the basis of the information collected, a consensus statement was drafted, revised, and finalized by a panel of select renowned experts. These experts agreed in defining engagement as an eco-systemic concept involving multiple actors all of which contribute to influence patients’ willingness and ability to engage in chronic care. Moreover, experts recommended, whenever possible, to adopt standardized instruments to assess engagement levels and related unmet needs. Then, experts strongly advised appropriate trainings for healthcare professionals about patient engagement strategies. Furthermore, the importance of promoting healthcare professionals’ wellbeing has been advocated. Family caregivers, as well as patients’ organizations - should be trained and engaged to increase the effectiveness of interventions dedicated to patients. Finally, experts agreed that digital technologies should be considered as a crucial enhancer for patient engagement in chronic care.

ACS Style

Guendalina Graffigna; Serena Barello; Giuseppe Riva; Massimo Corbo; Gianfranco Damiani; Primiano Iannone; Albino Claudio Bosio; Walter Ricciardi. Italian Consensus Statement on Patient Engagement in Chronic Care: Process and Outcomes. International Journal of Environmental Research and Public Health 2020, 17, 4167 .

AMA Style

Guendalina Graffigna, Serena Barello, Giuseppe Riva, Massimo Corbo, Gianfranco Damiani, Primiano Iannone, Albino Claudio Bosio, Walter Ricciardi. Italian Consensus Statement on Patient Engagement in Chronic Care: Process and Outcomes. International Journal of Environmental Research and Public Health. 2020; 17 (11):4167.

Chicago/Turabian Style

Guendalina Graffigna; Serena Barello; Giuseppe Riva; Massimo Corbo; Gianfranco Damiani; Primiano Iannone; Albino Claudio Bosio; Walter Ricciardi. 2020. "Italian Consensus Statement on Patient Engagement in Chronic Care: Process and Outcomes." International Journal of Environmental Research and Public Health 17, no. 11: 4167.

Research article
Published: 22 May 2020 in Journal of Diabetes Research
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Background. Diabetes mellitus is a widely diffused chronic condition which impacts on several aspects of patients’ lives. In the current clinical practice, the implementation in the clinical routine of monitoring systems of patients’ outcomes has led to an increased generation and use of several measures for the assessment of patients’ quality of life (QOL). Nevertheless, this construct appears to be particularly complex, and its operationalization is variable across different measures. The purpose of this paper is to offer an updated review of the diabetes-specific QOL measures present in scientific literature with a specific focus on the broad domains assessed. Methods. A scoping review was carried out with the purpose of identifying the existing measures in literature and describing their implicit representation of QOL in diabetes care. Five different databases (Scopus; Web of Science Core Collection; Medline; PsycInfo; and Cochrane Central Register of Controlled Trials) were searched with a string including validation studies of adult-only, diabetes-specific QOL measures. Each measure was then qualified according to its structure, a qualitative assessment of the broad domains of QOL it comprises, and finally an overview of the psychometric properties of its first validation. Results. 30 scales were identified and assessed. Theme analysis shows that QOL is operationalized with multidimensional surveys comprising of both mental, physical, and social health components. Some scales also consider the impact of societal attitudes, public policies, and context on QOL. Conclusion. Several self-report measures of QOL specifically developed for diabetic patients exist in scientific literature. The present scoping review reports scales structure, broad domains of QOL, and development purpose. This may help in understanding the concept of QOL in diabetic patients and may also serve the purpose of guiding the reader in the choice of the most appropriate instrument or in the development of a new one.

ACS Style

Lorenzo Palamenghi; Milvia Marta Carlucci; Guendalina Graffigna. Measuring the Quality of Life in Diabetic Patients: A Scoping Review. Journal of Diabetes Research 2020, 2020, 1 -19.

AMA Style

Lorenzo Palamenghi, Milvia Marta Carlucci, Guendalina Graffigna. Measuring the Quality of Life in Diabetic Patients: A Scoping Review. Journal of Diabetes Research. 2020; 2020 ():1-19.

Chicago/Turabian Style

Lorenzo Palamenghi; Milvia Marta Carlucci; Guendalina Graffigna. 2020. "Measuring the Quality of Life in Diabetic Patients: A Scoping Review." Journal of Diabetes Research 2020, no. : 1-19.

Other
Published: 25 April 2020
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Background: In January 2020, the coronavirus disease 2019 (COVID-19) started to spread in Italy. The Italian government adopted urgent measures to hold its spread. Enforcing compliance to such measures is crucial in order to enhance their effectiveness. Engaging citizens′ in the COVID-19 preventive process is today urgent in Italy and around the world. However, to the best of our knowledge, no previous studies have investigated the role of health engagement in predicting citizens compliance to health emergency containment measures. Method: An online survey was administered between February 28th and March 4th 2020 on a representative sample of 1000 Italians. The questionnaire included a measure of Health Engagement (PHE-S) and a series of ad hoc items intended to measure both affective and behavioral responses of the citizens to the emergency in terms of perceived susceptibility to and severity of the disease, orientation towards health management, change in habits and in purchases. To investigate the relationship between Health Engagement and these variables, a series of ANOVAs, Logistic regressions and crosstabs have been carried out. Results: Less engaged people show higher levels of perceived susceptibility to the virus and of severity of the disease; they trust less scientific and healthcare authorities, they feel less self-effective in managing their own health - both in normal conditions and under stress - and are less prone to cooperate with healthcare professionals. Low levels of Health Engagement are also associated with a change in the usual purchase behavior. Conclusions: The Patient Health Engagement Model (PHE) provides a useful framework for understanding how people will respond to health threats such as pandemics. Therefore, intervention studies should focus on particular groups and on raising their levels of engagement to increase the effectiveness of educational initiatives devoted to promote preventive behaviors.

ACS Style

Guendalina Graffigna; Serena Barello; Mariarosaria Savarese; Lorenzo Palamenghi; Greta Castellini; Andrea Bonanomi; Edoardo Lozza. Measuring Italian Citizens′ Engagement in the First Wave of the COVID-19 Pandemic Containment Measures A Cross-sectional Study. 2020, 1 .

AMA Style

Guendalina Graffigna, Serena Barello, Mariarosaria Savarese, Lorenzo Palamenghi, Greta Castellini, Andrea Bonanomi, Edoardo Lozza. Measuring Italian Citizens′ Engagement in the First Wave of the COVID-19 Pandemic Containment Measures A Cross-sectional Study. . 2020; ():1.

Chicago/Turabian Style

Guendalina Graffigna; Serena Barello; Mariarosaria Savarese; Lorenzo Palamenghi; Greta Castellini; Andrea Bonanomi; Edoardo Lozza. 2020. "Measuring Italian Citizens′ Engagement in the First Wave of the COVID-19 Pandemic Containment Measures A Cross-sectional Study." , no. : 1.