1. Title Valentina Biagioli Tutors
PhD in Nursing -XXIX
Department of Biomedicine and Prevention
DEVELOPMENT OF A SCALE
TO ASSESS THE PERCEPTION
OF PROTECTIVE ISOLATION
IN PATIENTS HOSPITALISED FOR STEM CELL TRANSPLANTATION
Title
PhD student - 3° year:
Valentina Biagioli
Michela Piredda, PhD, RN, Assistant Professor
Rosaria Alvaro, MSN, RN, Associate Professor
Maria Grazia De Marinis, MSN, MEd, RN, Professor
Tutors

2. Background
Valentina Biagioli
Patients who undergo haematopoietic stem cell transplantation (HSCT) develop therapy-induced neutropenia and are at high risk for severe infections T R A N S P L
BONE MARROW C H E M O T R A P Y
STEM CELLS
AUTOLOGOUS
IMMUNOSOPRESSION
1° CAUSE %
CONCURREN %
ALLOGENEIC
INFECTION
MORTALITY
sibling unrelated
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3. Background PROTECTIVE ISOLATION
Valentina Biagioli
PROTECTIVE
ISOLATION
Protective isolation is used as a precautionary measure in several hospitals in Europe
Yokoe, D., Casper, C., Dubberke, E., Lee, G., Munoz, P., Palmore, T., et al. (2009).
Infection prevention and control in health-care facilities in which hematopoietic cell transplant recipients are treated. Bone Marrow Transplantation, 44(8),
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4. Background PROTECTIVE ISOLATION
Valentina Biagioli
PROTECTIVE
ISOLATION
«A state in which an individual experiences a reduction in the level of normal sensory and social input with possible involuntary limitations on physical space or movement»

5. Rationale
Valentina Biagioli +
Hospitalisation +
Loneliness
Cancer +
The psycho-social implications of protective isolation needs to be investigated further
PROTECTIVE
ISOLATION
Biagioli, V., Piredda, M., Alvaro, R., & De Marinis, M. (2016). The experiences of protective isolation in patients undergoing bone marrow or haematopoietic stem cell transplantation: Systematic review and metasynthesis. European Journal of Cancer Care.  
doi: /ecc
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6. Aim of the Study
Valentina Biagioli
To develop a self-report scale to assess patient’s perception of protective isolation during hospital stay for SCT.

7. To explore the experience of being isolated in the Italian patients
Overview of Methods
Valentina Biagioli
AIM
CONTEXT
METHOD
in literature
Metasynthesis
To explore the experience of being isolated
QUAL
in the Italian patients
Phenomenology
We conducted 1 meta-synthesis and 2 phenomenological studies about the lived experiences of patients in protective isolation
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8. through a questionnaire
Overview of Methods
Valentina Biagioli
and …
We are conducting a multicenter study to validate the self-report questionnaire that we have developed
AIM
CONTEXT
METHOD
through a questionnaire
Scale Development
To measure loneliness
QUANT
in Italian
and UK patients
Validation Study
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9. We developed a conceptual model including 3 dimensions:
Overview of Methods
Valentina Biagioli
We developed a conceptual model including 3 dimensions:
suffering
relating with oneself
relating with others
We chose the items of the scale based on this model

10. Overview of Methods
Valentina Biagioli
The European Guidelines of the Statistical System were used
Furr, M. (2011). Scale construction and psychometrics for social and personality psychology. London: SAGE.

11. SCALE ABOUT THE PERCEPTION OF PROTECTIVE ISOLATION
Results
SCALE ABOUT THE PERCEPTION OF PROTECTIVE ISOLATION
To verify face validity:
a focus-group with 10 experts
To verify content validity:
22 Experts (11 Italian; 11 English) rated CV for each item
17 items yielded adequate CVI
S-CVI was .88
Pre-test in 5 patients
I-CVI ≥ S-CVI ≥ .80
Polit, D. F., & Beck, C. T. (2006). The content validity index: are you sure you know what's being reported? Critique and recommendations. 
Research in nursing & health, 29(5),

12. SCALE ABOUT THE PERCEPTION OF PROTECTIVE ISOLATION
Results
SCALE ABOUT THE PERCEPTION OF PROTECTIVE ISOLATION

13. SUFFERING was expressed with items
Results
SUFFERING was expressed with items
about
boredom
enhanced fears
feelings of being imprisoned
movement limitations
isolation burden

14. was expressed with items
Results
RELATING WITH ONESELF
was expressed with items
about
ability to find meaning
safety
assuming a new perspective
finding the inner strength

15. was expressed with items
Results
RELATING WITH OTHERS
was expressed with items
about
missing someone to talk with
feeling cut off from the world
communication
being closed to loved ones

16. Conclusion
A new scale was developed for use in isolated patients undergoing HSCT in hospital
The scale yielded a good content validity both in Italian and in English

17. Practical Implications
Nurses should support HSCT patients to find a positive meaning to isolation

18. Practical Implications
Nurses should help patients to search effective defensive strategies in order to perceive themselves as active fighters against cancer and the effects of treatments

19. Academic Implications
A multicentre study is needed:
to test the psychometric properties of the scale
to compare the level of perceived isolation in relation to the protective measures implemented
to identify targeted supportive strategies for isolated patients
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20. Thank you very much for your attention
Biagioli Valentina
Piredda Michela
Rosaria Alvaro
Maria Grazia De Marinis
Development of a scale to assess the perception of protective isolation in patients hospitalised for stem cell transplantation