RISULTATI RICERCA

The article addresses the topic of the contribution provided by third sector entities in the provision of healthcare services. This is a theme present in scientific literature, yet little attention has been paid to the role these entities play in meeting the healthcare needs of individuals in mar-ginalized, impoverished, and generally socioeconomically and relationally disadvantaged con-ditions. After analyzing the role of the third sector in different healthcare systems, the article focuses on the Italian case, first estimating the contribution of these entities within the National Health Service, and then concentrating on civil society actors specialized in the provision of socio-healthcare and healthcare services with a specific focus on hardship.

The paper analyses the consequences of the reorganisation of oncological care in Emilia-Romagna due to COVID-19 on patients’ illness trajectories. The paper shows how these or-ganisational changes led to an increase in two of the essential aspects of care work identified by Strauss and colleagues (1985) in the management of an illness trajectory: safety work, to control the new risks that emerged in the course of the pandemic, and sentimental work, to compensate for the absence of family members in hospital facilities. Both aspects required an increased commitment in terms of time and resources by healthcare personnel. However, while the increase of safety work was a direct consequence of the anti-infection directives and the need to translate them into everyday hospital practice, the increase in sentimental work emerged spontaneously as a response to the “care vacuum” caused by the emergency situation and the resulting restrictions. The results show an attention to the patient in the entirety of their medical, psychological and relational needs.

This article focuses on the reproductive experiences of women with physical disabilities. Through the analysis of some of the material collected for research on the relationship between psycho-emotional disablism and the embodied experience of motherhood, the authors intend to reflect on the ways in which women with disabilities negotiate their reproductive desires with social and medical expectations. Some stories of mothers with visible and invisible physical disabilities (multiple sclerosis, infantile cerebral palsy, spinal muscular atrophy) collected through semi-structured interviews are explored. The results highlight the ways in which med-ical discourse acts on their reproductive decision as a barrier to being that can guide their re-productive choices, actions and desires.

Within the framework of advancing the competencies of healthcare professionals via educa-tional initiatives that incorporate innovative methodologies, this paper presents an exploration of utilizing comic strips in a professional master’s program as a conduit for introspection on interprofessional dynamics and the enhancement of certain communicative competencies. This study engaged fourteen nurses, whose ages ranged from 35 to 55 years and who were em-ployed in hospital environments in Northern Italy, through their participation in the creation of comic strips and a concluding interview. The research was conducted over the period from November 2022 to May 2023. The examination of the findings, which included graphic repre-sentations and interview data, uncovered a daily professional existence marked by discord and paradoxes, yet unified under a shared professional designation.

The organisational, socio-technical and cultural changes that are affecting the health sector nat-urally also involve the occupational world and the health professions. Among the various changes in the socio-health ecosystem, there are also experiences from a relational point of view, placing the world of the health professions in the so-called affective turn (Leys, 2011). The role of emotions is therefore increasingly decisive, both when they are expressed and when they are latent, to interrogate and analyse the work of health professionals. At the same time, this (positive) emotional turn and the so-called feeling rules could also lead workers (dif-ferentially) to experience a kind of burnout or in other cases forms of cynicism and detach-ment that can be detrimental to both professional identity and patients. The article aims to ana-lyse these aspects through a qualitative investigation conducted within three complex facilities belonging to the Rizzoli Orthopaedic Institute.

Medical care is changing, driven both by necessity as well as innovation. The European healthcare sector’s digital transformation involves the rapid adoption of advanced technologies such as AI, robotics, autonomous systems, and Big Data. The study “Perception and acceptability of social robots in healthcare: ethnographic research based on a qualitative case study” investigates interaction with and acceptability of social robots in a pilot project based in Maribor Hospital, as a part of the European HosmartAI project. These robots functioned largely to assist patients and as “administrative support” for the nurses and doctors. This study focuses on the interactions of healthcare personnel with robots, including any emotions or fears and barriers that arose. The goal was to understand robot acceptance and challenges from a human-centric and individual perspective, focussing on key stakeholders that both use and develop these robots. All stakeholders are part of HosmartAI Living Labs, which works through collaboration to design and deliver advanced technologies.

The development of Essential Levels (LEPS) opens up new avenues for transforming profes-sionalism within territorial social services. On the one hand, a process of fortifying profes-sional social services has solidified, establishing a benchmark that all territorial areas should aspire to achieve. On the other hand, introducing a “supervisory LEPS” has brought to the forefront the issue of supporting the professional identity of social workers. This article, start-ing with examining Tuscany's social health system, explores the changes in the past three years and critically reflects on the potential implications at the regional and national levels.

The paper proposes to take into account the whole spectrum of care occupations: a set of inter-dependent activities essential for the maintenance and development of life and a fundamental support for social organisation. It also attempts to draw attention to a vicious circle that has been taking place in Italy for some time: structural disinvestment in care work, the conse-quences of which affect the quality of working conditions (as well as the quality of services offered to citizens), triggering processes of abandonment in the individual search for better working and living conditions, with a further deterioration in the conditions of remaining and a more general increase in inequalities between workers and the impoverishment of the sector as a whole.

Nurse-to-patient ratios (N/P) are designed to ensure acceptable levels of patient load as well as enough nurses to properly care for patients. Representatives of the nursing profession and unions have been urging government to implement regulation to ensure the respect of mini-mum established N/P ratios at all times in Quebec healthcare organizations. This paper aims to examine N/P ratios, in the context of demands of many organizations for a law enforcing mandatory staffing ratios in Quebec healthcare organizations. A qualitative exploration was conducted using 42 semi-directive interviews with unionized nurses throughout the province of Quebec. A thematic analysis was carried out using NVivo. Using the Nursing job de-mands-resource model, which gives importance to the broader organizational climate, we assessed nurses’ perceptions of their working environment. Four main themes emerged: 1) intensifying workload, 2) inadequate skill mix, 3) cost-effective management, 4) adverse outcomes. Our findings suggest that reducing the number of patients per nurse will not neces-sarily result in better working conditions if other lean strategies are adopted to compensate for the higher staffing costs, nor will it make the work environment fundamentally more attractive. While higher staffing levels are needed, seriously caution should be paid to the ways in which ratios are implemented. Alternative models of healthcare institutions, such as Magnet hospitals or other models, should be examined.

Access to primary healthcare is an important challenge in many countries, posing significant problems for population health and health equity. While family physicians’ (FPs) dedication is considered essential to increase access to primary care, several indications of a certain demobi-lization, even a deeper disengagement, among FPs has emerged. Using a specific case, that of FPs in the province of Quebec (Canada), this article aims to capture the processes that lead these professionals to redefine their work engagement by exploring various tensions that permeate their practice and impact meaning at work. The findings presented in this article are based on the analysis of 35 individual semi-directed interviews with FPs from three labor market integration cohorts (early-, mid- and late-career) working in various care settings. Our findings suggest that the tensions experienced related to the representation of family medicine, career expectations and personal aspirations lead many FPs to redefine their work engagement over the course of their professional journey. While physicians consistently demonstrate strong commitment to their patients, many disengage from work environments that impose practices contrary to their professional values and how they define high-quality family medi-cine, as well as conditions that hinder their involvement in family life.