=Paper=
{{Paper
|id=Vol-2730/paper21
|storemode=property
|title=Supporting rehabilitation patients with COVID-19 during the pandemic: experiences from a technology-based psychological approach
|pdfUrl=https://ceur-ws.org/Vol-2730/paper21.pdf
|volume=Vol-2730
|authors=Anna Panzeri,Silvia Rossi Ferrario
|dblpUrl=https://dblp.org/rec/conf/psychobit/PanzeriF20
}}
==Supporting rehabilitation patients with COVID-19 during the pandemic: experiences from a technology-based psychological approach==
https://ceur-ws.org/Vol-2730/paper21.pdf
Supporting rehabilitation patients with COVID-19
during the pandemic: experiences from a technology-
based psychological approach
Anna Panzeri1[0000-0001-5999-858X] and Silvia Rossi Ferrario1[0000-0001-9498-0166]
1 Unit of Psychology-Neuropsychology, IRCCS ICS Maugeri, Institute of Veruno, Veruno,
Italy
panzeri.anna@outlook.it
Abstract. Patients with COVID-19 experienced severe physical conditions as
well as psychological difficulties. Moreover, the COVID-19 outbreak has dis-
rupted rehabilitation programs for patients isolating them from their family and
friends – that were not allowed to access hospital facilities to visit their beloved
ones. Patients underwent a psychological intervention aimed at reducing dis-
tress symptoms and at favoring communication with caregivers. In particular,
patients participated in videocalls via digital tablets to keep in contact with their
family and friends.
Through the (novel) use of technologic devices, this descriptive study aimed at
reporting the most common psychological issues displayed by patients with
COVID-19 during the recent pandemic in a rehabilitation Institute.
Results show that symptoms of psychological distress (e.g., acute stress, de-
pressive, anxious) were common among patients with COVID-19 in rehabilita-
tion and were equally distributed across sex. The technology-based approach
was feasible and easily integrated into the rehabilitation program.
In conclusion, in this situation of emergency and isolation, technologic devices
had a key role in re-establishing communication between patients and caregiv-
ers allowing to provide the so important social support resource that was lack-
ing. Technologic devices represent useful tools that can be integrated into psy-
chological interventions in rehabilitation contexts to promote the psychophysi-
cal health of patients and caregivers as well.
Keywords: Clinical psychology, Technologic-devices, Rehabilitation, COVID-
19.
1 Introduction
Recently, the COVID-19 pandemic disrupted the lives and routines of an outstanding
number of individuals. The COVID-19 disease represents a severe threat for both
physical [1] and psychological health across all ages [2, 3], and the risks of dangerous
complications are greater for patients with preexisting health issues and aged [4]. In
Italy, hospitals and rehabilitation Institutes had to reconvert whole wards to assist
Copyright © 2020 for this paper by its authors. Use permitted under Creative Commons Li-
cense Attribution 4.0 International (CC BY 4.0).
2
patients with COVID-19. In order to contain the contagion, caregivers were not al-
lowed to meet and visit their hospitalized beloved ones.
Thus, beyond the ‘usual’ hospitalization challenges, patients with COVID-19 and
their caregivers had to face further difficulties related to the viral emergency, as the
forced physical-isolation that resulted in a lack of reciprocal emotional support [5].
Despite these difficulties, digital technologies offer a considerable resource allow-
ing them to maintain social contacts with family and friends through technologic de-
vices such as smartphones and tablets [6]. In the last two decades, these tools have
become popular, but people of the currently aged generations do not always own them
or are not always confident in their use [7]. Moreover, most of the patients in rehabili-
tation are aged and/or fragile due to physical and/or cognitive issues, thus they fre-
quently show difficulties – or inability – in properly using technology devices to
communicate with their family and friends. Without communication, patients’ and
caregivers lacked the social support resource and were continuously worried about
each other health [8, 9].
As a result, the COVID-19 emergency exacerbated the stress of patients in reha-
bilitation and their caregivers at home. Consequently, the psychological intervention
for rehabilitation patients and caregivers forced to physical distancing targeted the
issues related to the COVID-19 emergency and aimed at re-connecting patients with
their beloved ones by providing new digital communication modalities [10].
This study aimed at describing the most common psychological issues displayed
by patients in rehabilitation who received a technology-based intervention during the
COVID-19 emergency. Moreover, the role of digital devices for COVID-19 patients
is discussed as well as its integration in routine clinical practice.
2 Methods
This study was conducted at the Maugeri Clinical and Scientific Research Rehabilita-
tion Institute of Veruno (NO), in northern Italy.
Inclusion criteria were (a) being admitted to the rehabilitation hospital from 2nd March
to 12th May 2020, (b) resulting positive to the COVID-19, and (c) participating to
digital video calls with caregivers. All patients provided written informed consent.
The psychological intervention was conducted by two psychologists with a special-
ization in psychotherapy. As a clinical routine practice, after the physician or patient
request for psychological assistance, the psychological assessment was conducted
through the clinical interview – allowing the patient to express thoughts and emotions.
Simultaneously, psychologists assessed a wide range of areas while providing imme-
diate feedback, reassurance, and support. The most relevant psychological issues of
patients were identified and an individual psychological intervention was started if
needed. The intervention aimed at reducing the psychological distress of patients and
caregivers and favoring communication with each other by using digital technologies.
The intervention was specifically tailored to each individual needs with both face-to-
face and technology-based modalities.
3
The novelty of the procedure consisted of introducing technology-based devices (i.e.,
tablets) to favor contact with caregivers through conducting routine video calls with
patients. The video calls among patients and caregivers were conducted via a digital
tablet or with the patients’ smartphones (if suitable). All patients with good cognitive
and physical resources were educated to use technologic devices on their own. If re-
quired, also caregivers could have individual psychological support by phone.
The following variables were registered:
─ Demographics: age and biological sex;
─ Medical diagnosis: COVID-19 vs. COVID-19 plus other medical conditions;
─ Barthel index at admission: it measures the extent to which a person is independent
and has mobility in activities of daily living, it ranges from totally dependent (=0)
to totally independent (=100);
─ CIRS ICS: it is an index of the severity of medical complications, higher values
express higher global severity;
─ Psychological issues: psychologists registered the most relevant psychological
issues for each patient.
Descriptive analyses were performed to explore the most relevant psychological is-
sues registered during the psychological sessions. The t-test and chi-square statistics
were respectively used to compare the patients’ age and psychological issues across
males and females. The Cohen’s d was used as effect-size. The R software was used.
3 Results
The overall sample included 63 patients, (females = 35; 55.6%), their age ranged from
48 to 95 years (mean = 76.95, SD = 10.35). A statistically significant difference was
found between females (mean age = 80.83, SD = 7.87) and males (mean = 72.11, SD
= 11.14): t = 3.64, p < 0.001, d = 0.90.
All patients had a COVID-19 diagnosis, some of them also showed additional preex-
istent health issues (N tot = 16, 25.4%) such as neurological (N = 6), cardiovascular
(N = 4), physiatric (N = 4), or other (N = 2).
Regarding physical conditions, the Barthel values did not differ between females
(mean = 33.27, SD = 27.89) and males (mean = 38.25, SD = 34.42): t = .542, p <
0.590, d = 0.15. Differently, the CIRS ICS showed worst values for females (mean =
2.10, SD = 0.38) than males (mean = 1.86, SD = 0.29) with a significant difference (t
= 2.28, p < 0.028, d = 0.71).
All patients conducted video calls to contact and see their relatives that were preferred
to friends. Also, some patients required specific CBT intervention due to various psy-
chological issues: depressive symptoms (15, 23.8%); acute stress symptoms (12,
19%); difficult grief elaboration (N= 7, 11.1%); anxious symptoms (6, 9.5%); and
cognitive impairment 16 (25.4%). Only a minority of patients (N = 7, 11.1%) did not
report any relevant psychological issue and only did videocalls.
The chi-square statistic showed no differences across sex regarding depressive, anx-
ious, stress symptoms, grief, and cognitive impairment (Table 1).
4
Females Males Statistic p-value
Yes 3 3
Anxiety χ2 = 0.083 p = 0.773
No 32 25
Yes 6 (%) 9 (%)
Depression χ2 = 1.929 p = 0.165
No 29 (%) 19 (%)
Yes 5 (%) 7 (%)
Acute stress χ2 = 1.158 p = 0.282
No 30 (%) 21 (%)
Yes 5 (%) 2 (%)
Grief χ2 = 0.804 p = 0.370
No 30 (%) 26 (%)
Yes 12 (%) 4 (%)
Cognitive impairment χ2 = 3.284 p = 0.70
No 23 (%) 24 (%)
Table 1. Distribution of neuro-psychological issues
Beyond participating in video calls regularly, all the principal caregivers were con-
tacted by telephone to reassure them about the patients’ conditions and to assess the
need for structured CBT psychological intervention that was provided at distance to 8
of them (12.7%).
At the end of data collection, 9 patients died (14.3%), 6 still had COVID-19 (9.5%),
21 were dismissed home (33.3%), and 27 resulted negative for COVID-19 (42.9%),
but still needed to continue rehabilitation in non-COVID-19 departments due to
COVID-19 complications (N = 9) or preexisting health-issues (N= 18).
4 Discussions and conclusions
This study aimed at summarizing the psychological issues that emerged among pa-
tients with COVID-19 in a rehabilitation Institute during the recent pandemic. Psy-
chological intervention enhanced with technology-devices was provided. Moreover, is
highlighted the role played by technologic devices, such as tablets, smartphones, and
telephones, in promoting communication, social support, and psychological health.
During the COVID-19 breakout, the rehabilitation challenges were exacerbated by
this novel life-threatening disease that caused severe distress among rehabilitation
patients with and without the COVID-19 virus. Also, caregivers were continuously
worried about the patients’ health conditions, most of them saw each other for the last
time in an emergency room or an ambulance.
As results show, symptoms of acute stress, depression, anxiety, and grief were com-
mon. According to results, the χ2 statistic did not reveal any significant difference in
the distribution of psychological issues among males and females that both displayed
5
symptoms of psychological distress – even despite women’s physical conditions were
frailer compared to men.
Literature showed that psychological intervention is a fundamental element of re-
habilitative care to support both patients (and caregivers) given its effectiveness in
enhancing adherence to medical treatments as well as psychophysical health [11, 12].
During this pandemic, the use of technology-based devices helped communication
between patients and caregivers thus contributing to psychological support that has a
key role in helping them in managing assistance-related stressors and maintaining
good functioning [13, 14].
In a context where lockdown and sanitary restrictions did not allow visiting hospi-
talized patients, the use of technologic devices and at-distance communication repre-
sented a turning-point for psychological intervention [15].
Regarding technologic devices for patients, technology-based video calls with tab-
lets and smartphones were crucial to re-establish the communication and connection
between patients and their families who were separated due to the COVID-19 emer-
gency. Indeed, in rehabilitation patients are usually surrounded by the social support
of family and friends, almost daily visiting them. Although, particular situations – as
the recent COVID-19 pandemic – may require adopting different online modalities to
keep social contacts. According to the results, despite most of the patients were not
used to technologic devices, all the patients willingly accepted to participate in the
online video calls via tablet in order to communicate with relatives, showing a good
and quick adaptation to the online modality that resulted to be feasible and well-
accepted.
Beyond the exceptional COVID-19 situation, technology-based devices are useful to
connect hospitalized patients with relatives living too far from the patient hospital or
unable to visit them. For some patients, learning new technological skills may become
part of the cognitive and practical rehabilitation activities.
Regarding psychological intervention for caregivers, it is usually delivered with
face-to-face sessions at the hospital, but the adoption of telepsychology approaches
(e.g., telephone, Skype, Zoom) represents a resource to extend both the number poten-
tial recipients and also the continuity of treatment over time, regardless of distance
and time limitations.
Moreover, given that it is recommended to continue psychological support also after
discharge to favor the adaptation to ‘daily’ life [12, 16–19], telepsychology approach-
es can allow delivering at distance monitoring and intervention with leaner modalities
that both patients and caregivers can easily integrate into their busy lives, reducing the
obstacles related to time and mobility constraints [20]. Indeed, it is important to moni-
tor and provide long-term psychological support [21] after discharge from rehabilita-
tion because some individuals may not be able to seek and require psychological help
[22], both due to illness denial [16] and because of the widespread stigma toward
psychological and mental issues [23–26].
This study is not free of limitations. This is a descriptive report so it not possible to
evaluate the effectiveness of the intervention. Moreover, the psychological assessment
was conducted with the clinical interview and no other formalized assessment meth-
odology was used due to the large gap between personnel-resources and the number
6
of patients. Also, hygiene rules for COVID-19 did not allow patients to leave their
room to reach the dedicated assessment rooms, nor to bring materials in and out of
patients’ rooms.
Future research should provide pre-post studies with formalized assessment meth-
odologies. Furthermore, future studies should focus on specific categories at-risk for
severe psychophysical health-outcomes, such patients with preexistent diseases (e.g.
cardiovascular, obesity) [27–34], the frail categories from the general population,
such as young adults [35–40], families going through challenging times [41–43], and
elderlies [44–47].
In conclusion, psychological intervention is crucial in rehabilitation and in particu-
lar in challenging times as the COVID-19 outbreak. Psychological intervention can be
enhanced by technologic devices and supports in order to favor communication, cop-
ing, adaptation, and the psychological health of patients and caregivers.
References
1. Williamson, E.J., Walker, A.J., Bhaskaran, K., Bacon, S., Bates, C., Morton, C.E.,
Curtis, H.J., Mehrkar, A., Evans, D., Inglesby, P., Cockburn, J., McDonald, H.I.,
MacKenna, B., Tomlinson, L., Douglas, I.J., Rentsch, C.T., Mathur, R., Wong, A.Y.S.,
Grieve, R., Harrison, D., Forbes, H., Schultze, A., Croker, R., Parry, J., Hester, F.,
Harper, S., Perera, R., Evans, S.J.W., Smeeth, L., Goldacre, B.: OpenSAFELY: factors
associated with COVID-19 death in 17 million patients. Nature 1–7 (2020).
2. Rossi, A., Panzeri, A., Pietrabissa, G., Manzoni, G.M., Castelnuovo, G., Mannarini, S.:
The Anxiety-Buffer Hypothesis in the Time of Covid-19: when self-esteem protects
from loneliness and fear to anxiety and depression. Frontiers in Psychology (2020).
3. Parola, A., Rossi, A., Tessitore, F., Troisi, G., Mannarini, S.: Mental health through
the COVID-19 quarantine: a growth curve analysis on Italian young adults. Frontiers
in Psychology (2020).
4. Baud, D., Qi, X., Nielsen-Saines, K., Musso, D., Pomar, L., Favre, G.: Real estimates
of mortality following COVID-19 infection, The Lancet Infectious Diseases (2020).
5. Simpson, R., Robinson, L.: Rehabilitation after critical illness in people with COVID-
19 infection, American Journal of Physical Medicine and Rehabilitation (2020).
6. Negro, A., Mucci, M., Beccaria, P., Borghi, G., Capocasa, T., Cardinali, M., Pasculli,
N., Ranzani, R., Villa, G., Zangrillo, A.: Introducing the Video call to facilitate the
communication between health care providers and families of patients in the intensive
care unit during COVID-19 pandemia. Intensive and Critical Care Nursing (2020).
7. Koscher, A., Dittenberger, S., Stainer-Hochgatterer, A.: ICT Inexperienced Elderlies:
What Would Attract Elderlies to Technology? In: Harnessing the Power of
Technology to Improve Lives (2017).
8. Ratti, M.M., Rossi, A., Delli Zotti, G.B., Sarno, L., Spotti, D.: Social support,
psychological distress and depression in hemodialysis patients. Psicologia della Salute,
112–122 (2017).
9. Robinson-Smith, G., Harmer, C., Sheeran, R., Bellino Vallo, E.: Couples’ Coping
After Stroke-A Pilot Intervention Study. Rehabilitation Nursing 41, 218–229 (2016).
7
10. Benn Orava, S., Cook, K., Brown, A.: Maintaining a positive patient experience
during COVID-19 in a rehabilitation and complex care setting. Patient Experience
Journal 7, 98–102 (2020).
11. Richards, S.H., Anderson, L., Jenkinson, C.E., Whalley, B., Rees, K., Davies, P.,
Bennett, P., Liu, Z., West, R., Thompson, D.R., Taylor, R.S.: Psychological
interventions for coronary heart disease. Cochrane Database of Systematic Reviews 25
(3), 247-259 (2017).
12. Rossi Ferrario, S., Panzeri, A.: Exploring illness denial of LVAD patients in cardiac
rehabilitation and their caregivers: a preliminary study. Artificial Organs 44, 655– 660
(2020).
13. Windle, G., Bennett, K.M.: The Social Ecology of Resilience. In: The Social Ecology
of Resilience. pp. 219–231. Springer, New York, NY (2012).
14. Panzeri, A., Ferrario, S.R., Vidotto, G.: Interventions for psychological health of
stroke caregivers: A systematic review. Frontiers in Psychology 10, (2019).
15. Goulabchand, R., Boclé, H., Vignet, R., Sotto, A., Loubet, P.: Digital tablets to
improve quality of life of COVID-19 older inpatients during lockdown, European
Geriatric Medicine, 1-2 (2020).
16. Rossi Ferrario, S., Panzeri, A., Anselmi, P., Vidotto, G.: Development and
Psychometric Properties of a Short Form of the Illness Denial Questionnaire.
Psychology Research and Behavior Management 12, 1–13 (2019).
17. Livneh, H., Antonak, R.F.: Psychosocial adaptation to chronic illness and disability: A
primer for counselors. Journal of Counseling & Development 83, 12–20 (2005).
18. Pietrabissa, G., Sorgente, A., Rossi, A., Simpson, S., Riva, G., Manzoni, G.M.,
Prochaska, J.O., Prochaska, J.M., Cattivelli, • Roberto, Castelnuovo, G.: Stages of
change in obesity and weight management: factorial structure of the Italian version of
the University of Rhode Island Change Assessment Scale. Eating and Weight
Disorders 22, 361–367 (2017).
19. Giuntoli, L., Marchetti, I., Panzeri, A., Spoto, A., Vidotto, G., Caudek, C.: Measuring
cognitive vulnerability to depression: Further evidence on the factorial and predictive
validity of negative cognitive style. Journal of Behavior Therapy and Experimental
Psychiatry 65 (2019).
20. Adelman, R.D., Tmanova, L.L., Delgado, D., Dion, S., Lachs, M.S.: Caregiver
Burden: A Clinical Review. JAMA 311, 1052 (2014).
21. Jackson, J.B., Pietrabissa, G., Rossi, A., Manzoni, G.M., Castelnuovo, G.: Brief
strategic therapy and cognitive behavioral therapy for women with binge eating
disorder and comorbid obesity: A randomized clinical trial one-year follow-up. Journal
of Consulting and Clinical Psychology 86, 688–701 (2018).
22. Rossi, A., Mannarini, S.: The Italian version of the Attitudes toward Seeking
Professional Psychological Help Scale – Short Form: The first contribution to
measurement invariance. TPM Testing, Psychometrics, Methodology in Applied
Psychology 26, 93–100 (2019).
23. Mannarini, S., Rossi, A., Munari, C.: How do education and experience with mental
illness interact with causal beliefs, eligible treatments and stigmatising attitudes
towards schizophrenia? A comparison between mental health professionals,
psychology students, relatives and patients. BMC Psychiatry 20, 11 (2020).
8
24. Mannarini, S., Rossi, A.: Assessing mental illness stigma: A complex issue. Frontiers
in Psychology 9, (2019).
25. Mannarini, S., Boffo, M., Rossi, A., Balottin, L.: Etiological beliefs, treatments,
stigmatizing attitudes towards schizophrenia. What do Italians and Israeli think?
Frontiers in Psychology 8:2289, 1–9 (2018).
26. Mannarini, S., Boffo, M., Balottin, L.: Beliefs about the patient’s role in the
psychotherapeutic relationship: A latent trait perspective. TPM Test Psychom
Methodology in Applied Psychology 20, 277–294 (2013).
27. Pietrabissa, G., Manzoni, G.M., Rossi, A., Castelnuovo, G.: The MOTIV-HEART
study: A prospective, randomized, single-blind pilot study of brief strategic therapy
and motivational interviewing among cardiac rehabilitation patients. Frontiers in
Psychology 8, 1–12 (2017).
28. Zheng, Y.Y., Ma, Y.T., Zhang, J.Y., Xie, X.: COVID-19 and the cardiovascular
system, Nature Reviews Cardiology 17(5), 259-260 (2020).
29. Manzoni, G.M., Rossi, A., Pietrabissa, G., Mannarini, S., Fabbricatore, M., Imperatori,
C., Innamorati, M., Gearhardt, A.N., Castelnuovo, G.: Structural validity,
measurement invariance, reliability and diagnostic accuracy of the Italian version of
the Yale Food Addiction Scale 2.0 in patients with severe obesity and the general
population. Eating and Weight Disorders, 1-22 (2020).
30. Dietz, W., Santos-Burgoa, C.: Obesity and its Implications for COVID-19 Mortality.
Obesity 28(6), 1005-1005 (2020).
31. Manzoni, G.M., Rossi, A., Pietrabissa, G., Varallo, G., Molinari, E., Poggiogalle, E.,
Donini, L.M., Tarrini, G., Melchionda, N., Piccione, C., Gravina, G., Luxardi, G.,
Manzato, E., Schumann, R., Innamorati, M., Imperatori, C., Fabbricatore, M.,
Castelnuovo, G.: Validation of the Italian Yale Food Addiction Scale in postgraduate
university students. Eating and Weight Disorders 23, 167–176 (2018).
32. Simpson, S.G., Pietrabissa, G., Rossi, A., Seychell, T., Manzoni, G.M., Munro, C.,
Nesci, J.B., Castelnuovo, G.: Factorial structure and preliminary validation of the
Schema Mode Inventory for Eating Disorders (SMI-ED). Frontiers in Psychology 9,
1–17 (2018).
33. Pietrabissa, G., Rossi, A., Simpson, S., Tagliagambe, A., Bertuzzi, V., Volpi, C., Fava,
G., Manzoni, G.M., Gravina, G., Castelnuovo, G.: Evaluation of the reliability and
validity of the Italian version of the schema mode inventory for eating disorders: short
form for adult with dysfunctional eating behavior. Eating and Weight Disorders 0, 1–
13 (2019).
34. Mannarini, S.: A method for the definition of a self-awareness behavior dimension
with clinical subjects: A latent trait analysis. Behavior Research Methods 41, 1029–
1037 (2009).
35. Parola, A., Donsì, L.: Time Perspective and Employment Status: NEET Categories as
Negative Predictor of Future. Mediterranean Joutnal of Clinical Psychology 7, (2019).
36. Parola, A., Donsì, L.: Sospesi nel tempo. Inattività e malessere percepito in giovani
adulti NEET . Psicologia della Salute, 44-73 (2018).
37. Balottin, L., Mannarini, S., Mensi, M.M., Chiappedi, M., Gatta, M.: Triadic
interactions in families of adolescents with anorexia nervosa and families of
adolescents with internalizing disorders. Frontiers in Psychology 7, 2046 (2017).
9
38. Faccio, E., Belloni, E., Cipolletta, S., Iudici, A., Castiglioni, M., Mannarini, S.: The
power of weight and the weight of power in adolescence: a comparison between young
and adult women. Journal of Family Studies 25(1), 46-60 (2019).
39. Parola, A.: Novel Coronavirus Outbreak and Career Development: a narrative
approach into the meaning of Italian university graduates. Frontiers in Psychology 11,
2255 (2020).
40. Gatta, M., Balottin, L., Mannarini, S., Chesani, G., Del Col, L., Spoto, A., Battistella,
P.A.: Familial factors relating to alexithymic traits in adolescents with psychiatric
disorders. Clinical Psychologist 21, 252–262 (2017).
41. Mannarini, S., Balottin, L., Munari, C., Gatta, M.: Assessing Conflict Management in
the Couple. Family Journal 25, 13–22 (2017).
42. Mannarini, S., Boffo, M., Bertucci, V., Andrisani, A., Ambrosini, G.: A Rasch-based
dimension of delivery experience: spontaneous vs. medically assisted conception.
Journal of Clinical Nursing. 22 2404–2416 (2013).
43. Sales, E.: Family burden and quality of life. Quality of Life Research 12, 33–41
(2003).
44. Armitage, R., & Nellums, L. B.: COVID-19 and the consequences of isolating the
elderly. The Lancet Public Health 5(5), e256. (2020)
45. Balestroni, G., Panzeri, A., Omarini, P., Cerutti, P., Sacco, D., Giordano, A., Pistono,
M., Komici, K., Rossi Ferrario, S.: Psychophysical health of great elder inpatients in
cardiac rehabilitation: a retrospective cohort study. European Joural of Physical
Rehabilitation Medicine. April; 56, (2020).
46. Manzoni, G.M., Rossi, A., Marazzi, N., Agosti, F., De Col, A., Pietrabissa, G.,
Castelnuovo, G., Molinari, E., Sartorio, A.: Feasibility, Validity, and Reliability of the
Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale for Adults
in Inpatients. Obesity Facts 11, 25–36 (2018).
47. Castelnuovo, G., Giusti, E.M., Manzoni, G.M., Saviola, D., Gabrielli, S., Lacerenza,
M., Pietrabissa, G., Cattivelli, R., Maria Spatola, C.A., Rossi, A., Varallo, G., Novelli,
M., Villa, V., Luzzati, F., Cottini, A., Lai, C., Volpato, E., Cavalera, C., Pagnini, F.,
Tesio, V., Castelli, L., Tavola, M., Torta, R., Arreghini, M., Zanini, L., Brunani, A.,
Seitanidis, I., Ventura, G., Capodaglio, P., D’Aniello, G.E., Scarpina, F., Brioschi, A.,
Bigoni, M., Priano, L., Mauro, A., Riva, G., Di Lernia, D., Repetto, C., Regalia, C.,
Molinari, E., Notaro, P., Paolucci, S., Sandrini, G., Simpson, S., Wiederhold, B.K.,
Gaudio, S., Jackson, J.B., Tamburin, S., Benedetti, F., Agostini, M., Alfonsi, E.,
Aloisi, A.M., Alvisi, E., Aprile, I., Armando, M., Avenali, M., Azicnuda, E., Barale,
F., Bartolo, M., Bergamaschi, R., Berlangieri, M., Berlincioni, V., Berliocchi, L.,
Berra, E., Berto, G., Bonadiman, S., Bonazza, S., Bressi, F., Brugnera, A., Brunelli, S.,
Buzzi, M.G., Cacciatori, C., Calvo, A., Cantarella, C., Caraceni, A., Carone, R.,
Carraro, E., Casale, R., Castellazzi, P., Castino, A., Cerbo, R., Chiò, A., Ciotti, C.,
Cisari, C., Coraci, D., Dalla Toffola, E., Defazio, G., De Icco, R., Del Carro, U.,
Dell’Isola, A., De Tanti, A., D’Ippolito, M., Fazzi, E., Ferrari, A., Ferrari, S., Ferraro,
F., Formaglio, F., Formisano, R., Franzoni, S., Gajofatto, F., Gandolfi, M., Gardella,
B., Geppetti, P., Giammò, A., Gimigliano, R., Greco, E., Ieraci, V., Invernizzi, M.,
Jacopetti, M., La Cesa, S., Lobba, D., Magrinelli, F., Mandrini, S., Manera, U.,
Marchettini, P., Marchioni, E., Mariotto, S., Martinuzzi, A., Masciullo, M.,
10
Mezzarobba, S., Miotti, D., Modenese, A., Molinari, M., Monaco, S., Morone, G.,
Nappi, R., Negrini, S., Pace, A., Padua, L., Pagliano, E., Palmerini, V., Pazzaglia, C.,
Pecchioli, C., Picelli, A., Porro, C.A., Porru, D., Romano, M., Roncari, L., Rosa, R.,
Saccavini, M., Sacerdote, P., Schenone, A., Schweiger, V., Scivoletto, G., Smania, N.,
Solaro, C., Spallone, V., Springhetti, I., Tassorelli, C., Tinazzi, M., Togni, R., Torre,
M., Traballesi, M., Tramontano, M., Truini, A., Tugnoli, V., Turolla, A., Vallies, G.,
Verzini, E., Vottero, M., Zerbinati, P.: What is the role of the placebo effect for pain
relief in neurorehabilitation? Clinical implications from the Italian consensus
conference on pain in neurorehabilitation. Frontiers in Neurology 9 (2018).