Introduction: Mental health patients are a group of population that has predominantly been stigmatized throughout the centuries. Aim: The aim of the present study was to explore attitudes of health professionals in the emergency department towards the mentally ill.Material and Methods: The sample of the study consisted of 278 health professionals working in Emergency Departments. A questionnaire scale O.M.I. (Opinion about Mental Illness) was used for data collection. Data analysis was performed with the statistical package Statistical Package for Social Sciences (SPSS) ver.22.Results: The correlation of five O.M.I. scale factors there is no statistically significant relationship (p-value> 0.05) with the variables sex and years of employment. Age had a statistically significant relationship (p-value=0.034) with the factor "social integration" and has no statistically significant relationship (p-value> 0.05) with the remaining factors O.M.I. scale ("Social discrimination", "social constraint", "social care" and "ground"). In association with education there is a statistically significant relationship with the agents 'social discrimination'(p-value<0.001), 'social restriction'(p-value=0.001), and "ground"(p-value=0.045) and there statistically significant relationship (p-value> 0.05) with the "social inclusion"(p-value<0.001) and "social care" specialty.The variable has a statistically significant difference (p-value <0.05) the factor "social distinction” (p-value<0.001) between doctors andnurses, in the "social restriction 'among doctors and nurses and between nurses and other disciplines and the factor "social integration"(p-value<0.001) between physicians-nurses and doctors with other specialties.Conclusions: The statistical analysis of the questionnaires (O.M.I. scale) distributed showed that the variables age, educational level, specialty affect the attitudes and perceptions of health professionals towards the mentally ill (negative stops), which form the stigma of mental illness.
Background: Dyslipidemias are one of the major modifiable risk factors for cardiovascular disease. Familial hypercholesterolemia (FH) is the most common genetic metabolic disorder; it is estimated that around 14-34 million people worldwide have FH but only 25% of FH patients have been diagnosed. Aim: The aim of the present study was to explore the prevalence of FH in Attica region, Greece.Methods: Attica region was divided into 8 regional units. A predesigned questionnaire was used to collect demographic and clinical data. Data analysis was performed by using the Statistical Package for the Social Sciences (SPSS), ver. 20.Results: The studied sample consisted of 1578 Greek inhabitants of Attica region. The majority of the sample was women (59.9%). The mean age of the studied participants was 47.1 (±14.9) years. According to Simon Broome criteria, the probability of an FH diagnosis as unlikely is determined in 98.7% of the studied sample, probable in 0.8% of the participants or definite in 0.5% of the participants, based on this data, the prevalence of FH in Attica region, Greece is 1:200. Qualitative factors found to be associated with the onset of the disease were medication (p-value = 0.001) and hypolipidemic therapy (p-value = 0.001). The quantitative factors found to be associated with disease onset were body mass index (p-value = 0.044), and systolic (p-value = 0.001) and diastolic (p-value = 0.007) pressure.Conclusions: Based on our data, the prevalence of FH in Attica region, Greece is 1:200. Early identification of contributing factors in FH development and proper treatment is vital and reduce the risk of premature and severe atherosclerotic disease.
Introduction: The implanted port catheters in chemotherapy which are connected to a Peripherally Inserted Central Catheter (PICC Ports) are used daily in clinical nursing practice, enabling the administration of intravenous fluids, blood, drugs and Total Parenteral Nutrition. The 2-octyl-isocyanoacrylate glue as an alternative intervention in preventing wound infection during PICC port insertion. Aim: The aim of the present review was to explore the use of 2-octylisocyanacrylate glue as a microbial barrier in wound trauma and in peripherally central catheter insertion. Methods: An electronic research was conducted in 4 databases. Sixty five papers focusing on the use of glue in surgical trauma closure and healing were analyzed. Results: The literature demonstrates significant benefits of the 2-octyl-isocyanacrylate glue in comparison to other tissue adhesives, when placed on skin incisions. The 2-octyl-isocyanacrylate glue seems to provide an effective barrier to microbial penetration by Gram-positive and Gram-negative motile and non-motile species. Conclusions: The use of the 2-octyl-isocyanacrylate seems to be an effective method for skin closure and healing in patients undergoing PICC Port implantation whilst causing no side effects such as allergies, skin irritation or pain during the procedure.
Introduction: When the pressure ulcer does not respond to established standard care, then international guidelines recommend the use of alternative forms of therapy such as electrical stimulation, negative pressure wound treatment, ultraviolet radiation, electromagnetic field therapy or ultrasound. Low and high frequency ultrasound is used to treat various types of chronic ulcers including venous, diabetic and pressure ulcers.Aim: The aim of the present systematic review was to investigate the effectiveness of ultrasound in promoting the healing of pressure ulcers.Method and Material: A systematic review was carried out in the electronic databases PubMed and Cochrane Library. Inclusion criteria were primary and secondary studies, whose sample were patients with pressure ulcers, regardless of age, published in English language of the last decade (2008-2018).Results: The review revealed 5 articles that met the inclusion criteria. The results of these studies showed an advantage in the use of ultrasound for the treatment of pressure ulcers in relation to the standard wound care only.Conclusions: The use of ultrasound seems to be a process which improves and accelerates the healing of pressure ulcers. The method of low and high frequency ultrasound in the treatment of chronic wounds, presents many advantages. It appears to be easy to use, painless, less stressful and better accepted by patients.
Introduction: Currently in Greece there are only two ‘stroke bays’ (SBs) and their efficacy compared to standard ward treatment has not been evaluated.Aim: To provide baseline data on stroke case-mix and compare death rates in two Greek hospitals (A+B, i.e. with & without a SB).Material and Methods: One hundrend sixty four acute stroke patients from two hospitals were consecutively selected in order to explore approaches to stroke care in three different types of care delivery settings. A descriptive design with group comparisons was employedand data gathering included patient case mix, age and length of stay (LOS), neurological status and death rates. Kaplan-Meier curves we reused for survival analysis and independent samples t test and Z test for group comparisons at p<0.05.Results: Of the 164 patients, 88 (44.4%, female) werein hospital A and 76 (42.1%, female) in hospital B. The mean age was 65.7 and 69.1 years respectively, LOS was 7.6 (3-18) and 7.3 days (1-26), while death rate was 6.8% and 10.5% respectively.Discussion: Survival analysis for the two hospitalsshowed that there are no statistically significant differences regarding death and survival rates between the two hospitals, even when one had a SB. Yet, the SB shows a statistically significant reduction in overall LOS.Conclusions: In societies where stroke units are not yet established, a SB might be an economical way of making use of (limited) available resources and raising nursing and medical standards of care by motivating the full potential of staff involved.
he customer of an aesthetics institute looks for a welcoming and safe place to be taken care of. The establishment of a friendly atmosphere and normal flow of procedures inside the beauty institute as well as providing personalized services play a major role for customers. The personality of the aesthetician and interpersonal relations based on kindness, politeness, stability, humor and dialogue are fundamental virtues for professional success. An organized customer list, recording and keeping personal data of the customer according to current legislation are helpful in solving the customer’s problem properly. The social media, advertising and marketing skills are useful for aestheticians. Strategies that look for innovative and improved ways to meet the clients’ wishes and needs are creative and potent. An aesthetics business has to choose a marketing strategy in order to be competitive. Owners of aesthetics institutes need to put their businesses in the center of special marketing procedures. In addition, adapting to his/her needs according to their sex, age and socioeconomic level is important. Personal hygiene and professional appearance of the aesthetician is equally important.
2019: it was a joint decision of the journal’s Editorial Board, to change the language from Greek to English. The Greek language is the language that is appreciated and recognized internationally as the language with an amazing and unique wealth. This change has one purpose and that is, to OPEN “out of borders”, a movement that will provide and secure opportunities of international prospect.Three years ago, in 2015, we decided to publish the HEALTH and RESEARCH JOURNAL, with the aim of publishing all MSc dissertations of postgraduate students. Today we believe that this goal needs to be modified. The journal, besides the Master's Program "Intensive Care Units" (which is the main publisher), collaborates and supports the Master's Program of “Clinical and Experimental Neurosurgery”, the Master's Program of “Hellenic Society for Ergospirometry, Exercise and Rehabilitation” and the “Hellenic Society of Nursing Research and Education” which is the co-publisher. The road has already been opened and in the near future our journal will collaborate with the National Documentation Center, which will give new prospect. We hope that this change will receive the acceptance and consent we expect. Value, reliability and scientific approach depend on the entire scientific community that will decide to participate by publishing their manuscripts. We hope the new year to bring something new to HEALTH and RESEARCH JOURNAL and to make it equal to many remarkable and reputable scientific journals.Happy New Year with peace, health and scientific achievements.The Editorial Board
Cardiovascular diseases (CVDs) are the primary cause of death around the world (17.9 million deaths per year); heart attack and stroke account for 85% of CVD deaths. According to current demographic data, 1/3 of these deaths occur in adults under the age of 70 and more than 75% in low- and middle-income countries. Recent studies have provided clear evidence that psychological factors (e.g., depression, anxiety, personality traits, social isolation, and chronic life stress) have a key role in the pathogenesis and manifestation of cardiovascular disease because they affect platelet function, plasminogen activator inhibitor and fibrinogen, inflammatory cytokines, serotonin transporter (SERT) and endothelial function. Therefore, pathophysiological mechanisms underlie the relationship between these entities and CVD, whereas alongside psychological conditions contribute to a higher frequency of adverse health behaviors, such as malnutrition, smoking and sedentary lifestyle.
Introduction: The high and continues increasing nursing workload in the Intensive Care Unit (ICU) is a remarkable increase in mortality factor of heavy ill patients.Aim: The aim of this study was a comparison evaluation between the score of Nursing Workload (NW), Nursing Activity Score (NAS) and Comprehensive Nursing Intervention Score (CNIS) in nurses who treat critically ill patients in Intensive Care Unit (ICU).Material and Methods: The studied population was 100 patients who were hospitalized in Intensive Care Units (ICU) hospitals in Athens and private clinic of Piraeus. It was used a special designed questionnaire by the researchers based on Nursing Activity Score (NAS) score and Comprehensive Nursing Intervention Score (CNIS) score. Data analysis was performed with the statistical package SPSS 17.0.Results: The 56% of study were men. The average age of the sample was 74 ± 15 years. The average Nursing Activity Score (NAS) for the first 10 days of hospitalization was 55, 4 ± 4, 9 and Comprehensive Nursing Intervention Score (CNIS) was 129, 5 ± 15, 4. Compared with indicators gravity nursing workload, with prognostic score APACHE II, SAPS II, the Glasgow scale and with laboratory markers creatinine and white blood showed that the Nursing Activity Score (NAS) and Comprehensive Nursing Intervention Score (CNIS) indicators a statistically significant difference (p = 0.005 and p <0.001, respectively) compared with patient outcome.Conclusions: The nursing workload (NW) as measured on scales Nursing Activity Score (NAS) and Comprehensive Nursing Intervention Score (CNIS). Both scales are equality and validity. Similarly, the outcome of these patients was associated with disease severity as measured by the score APACHE II and SAPS II.
Background: Patients with heart failure (HF) have impaired function of respiratory system and frequently experience dyspnea. Inspiratory muscle training (IMT) offers an alternative way of exercise with a lot of benefits for HF patients. Aim: The aim of this review was to summarize and to reveal the effects of IMT in HF patients. Methods: Electronic searches were performed using Pubmed Database, Physiotherapy Evidence Database (PEDro) and Cochrane Library. Inclusion criteria were: RCTs, patients with HF, full text articles after 2010 and at least one intervention group with IMT. Methodological quality was assessed using the PEDro (Physiotherapy Evidence Database) scale. Results: Nineteen articles met the inclusion criteria and were included in this review. In most studies training protocols involved 3 to 7 sessions per week with intensity ≤30-60% of maximal inspiratory pressure (MIP), for a total duration of 4-12 weeks. Respiratory muscle strength improved in 11/12 studies, peripheral muscle strength in 4/5 studies, exercise capacity (peak VO2, VE/VCO2 slope) in 4/10, pulmonary function (FEV1, FEV1/FVC, FVC) in 0/5, functional capacity (6MWT) in 6/8, echocardiography parameters in 1/6, quality of life and dyspnea in 9/16. Control groups followed sham IMT, usual care, no intervention, intervention without exercise, or aerobic training, which could explain in some cases the conflicting results. Conclusions: IMT is beneficial for HF patients and should be included as a complementary method in cardiac rehabilitation programs. The optimal characteristics of ΙΜΤ as well as the benefits when combined with common forms of exercise need further research.
Background: The development of enhanced recovery after surgery protocols (ERAS) for surgical intervention has contributed to reducing hospital length of stay and improved patient outcomes. Aim of the study was the assessment of the recovery time and cost-effectiveness of an ERAS protocol in oncological patients undergoing hepato- pancreato- biliary surgery (HPB) compared to conventional (CON) care.Methods: This prospective, open label, randomized trial, enrolled 283 patients who required hepatectomy or pancreatoduodenectomy. Eligible patients were stratified into hepatectomy or pancreatectomy groups then, randomly assigned to ERAS protocol (intervention) or CON care (control). The primary outcome of interest was post-operative recovery time (composite of; time to mobilization and oral intake) and secondary outcomes were cost effectiveness, dependance on post-operative opioids and post-operative complications (using the Clavien- Dindo classification). Results: The rate of complications for the patients underwent hepatectomy and treated in ERAS group was 18.18% compared to CON group, which was 40.9%. Whilst, of complications for the patients underwent pancreatectomy and treated in ERAS group was 15.94% compared to CON group, which was 38.2%.Conclusions: The ERAS protocol in this study significantly improved post-operative recovery time, reduced opioid dependance and reduced post-operative complications in patients undergoing HPB surgery.
Background: Acute kidney injury (AKI) is associated with markedly increased morbidity and mortality in critically ill patients and often necessitates the use of continuous renal replacement therapy (CRRT). The aim of the present study was to compare the predictive performance of urine neutrophil gelatinase (uNGAL), plasma cystatin C (pCysC), serum creatinine (sCr), and their combinations for CRRT requirement within the first 7 days post-admission in a general ICU.Method and material: A total of 81 consecutive ICU patients were included in the analysis. AKI was defined according to AKIN criteria. Biomarkers’ predictive abilities were evaluated by the area under the receiver operating characteristics (AUC-ROC) curves.Results and Conclusions: AKI occurred in 21% of patients and 14% of them needed CRRT 7 days post-admission. The two novel biomarkers, as well as sCr had moderate predictive abilities for CRRT requirement. The most efficient combinations (sCr+ uNGAL) and (sCr+uNGAL+pCysC) had better AUC-ROCs (0.845 and 0.84, respectively) than that of any individual biomarker (sCr, pCysC, uNGAL, with AUC-ROCs 0.81, 0.74 and 0.80, respectively). Renal biomarker combinations had better predictive characteristics for CRRT need within one week post admission as compared to each biomarker alone.
Introduction: Bloodstream infection associated with the presence of central venous catheters is the second most common hospital infection in the Intensive Care Unit (ICU). The nursing stuff is an essential part of the human resources of the ICU which contributes substantially to provide holistic and effective care to critically ill patients. The level of the nursing workload and its possible influence on the clinical course and outcome of critically ill ICU patients has been systematically studied in recent years. Mainly, was studied the connection with the care quality indicators such as mortality and infections Aim: The purpose of this study was to estimate the nursing workload in the ICU and to investigate the impact of bloodstream infection from Central Venous Catheter (CLABSI). Methods: The study sample consisted of 39 patients who were hospitalized in a multidisciplinary ICU in a 3 month period. For the detection of bloodstream infections we used the surveillance definition of CDC/NHSN for in vitro confirmed bloodstream infection (CLABSI). Measurement of nursing workload was via the NAS scale and the calculation was performed for each patient once existed or entering the ICU from baseline and constantly on a daily basis. A comparison of the quantitative variables was done with the statistical criterion Pearson’s x 2 , to compare the bisectors qualitative variables selected quantitative variables was used the t-test analysis and MannWhitney test. Results: Of the total sample, 74,4% (n = 29) were male, with a mean age 59 ± 21 years. The duration of ICU stay was 24 ± 23 days and mortality was 41%. The duration of hospitalization was 28 ± 24 days and the corresponding mortality of 46.2%. All correlations presented no statistically significant difference than the first day’s NAS in which appears the biggest difference between the values (p=0,046) but the NAS of the patients who did not develop bacteremia be more increased over those experienced. Conclusions: The nursing workload in our study did not prove as a risk factor for the occurrence of bloodstream infection in the ICU.
Introduction: Lately it has been noticed an increasing interest about the quality of life that is related to theperformance - effectiveness indicators and also to the objective and subjective state of patients’ health.Psychosocial problems are detected by quality questionnaires which may bother the healing process and help tothe disability rate and diagnosis of the disability. Meningioma is concerned as a benign tumor which is growingslowly .Usually the relapse rates are low in total surgical excision.Aim: The aim of the present review was to explore quality of life of patients surgically treated for brainmeningioma, in order to improve disease outcomes.Methodology: The methodology that was used included the review of the Greek and international literature of thelast fifteen years in the databases (Pubmed, Scopus, Google Scholar,medline). The keywords that were used tosearch for the study were: “meningioma", “quality of life”, “SF36”, “patients” Health related quality of life”.Results: Literature review has shown that the quality of life of patients with brain meningioma depends on variousfactors among others the most important are location and accessibility of the tumor. The best of the treatment isnot limited only to the surgical part required but it is a combination of radiation treatment for better results. Whenmeningioma is totally surgical resected displays minimal relaplse rates in contrast to the partial resection where itreoccurs in percentage 48% during the next five years. Meningiomas that cannot be petroclival surgically such asindicate high morbidity, mortality and poor physical function. Intraventricular meningiomas remain malfuctions ofvision, etc. Furthermore, a significant sign is the edema which may be associated with the aggressiveness of thetumor. Finally a possibility of reoccurrence factor is the number of mitoses in the pathological analysis.Conclusions: The quality of life of patients that had been operated with brain meningioma vary at relatively lowlevels and is directly related to the tumor’s localization and the choice of treatment.
The aim of the present study was to describe the demographic characteristics of patients diagnosed with primary brain tumor, the clinical features and prognostic indicators of disease progression and treatment they received.Methods: A retrospective descriptive study was conducted on a convenience sample of 47 patients who attended the radiotherapeutic department of General Hospital of Athens over three years, from May 2011 until May 2014.For analysis used the statistical program SPSS 18.0.Results: 59.6% of patients were male and 40.4% of patients were between 61 and 69 years. 85.1% of patients had glioblastomamultiforme and meningioma 8.5%. 57.5% of patients with glioblastomamultiforme were men and 50.0% of patients with meningioma. It was found that the patients with grade I-III were considerably higher percentage between 61 and 69 years as compared to patients with grade IV (p = 0,021). Patients with grade IV underwent chemotherapy significantly higher rate compared with patients with grade I-III. No significant difference was found in the course of radiotherapy among patients with grade IV and patients with grade I-III. Differed significantly Ki-67 among patients with grade IV and of patients with grade I-III patients with grade IV were higher Ki-67.Conclusion: Glioblastoma multiforme (GBM) is the most frequently diagnosed intracranial malignant tumor in adults. Typical treatment for glioblastomas, with surgical resection followed by radiation and chemotherapy with temozolomide and anti - angiogenic therapy bevacizumab , have significantly improved the overall survival.
Traumatic brain injury (TBI) is the brain injury that occurs whenever a physical force that impacts the head leads to neuropathology. The types of primary TBI are penentrating TBI or non-penetrating TBI and it can lead to intracerebral contusions, hemorrhages or extra-axial hematomas. Patients with TBI can also have skull fractures or concussions. The injury severity can be classified in many ways but the most established and common used is the Glascow Coma Scale (GCS). However, with the GCS, each of the severity criteria has limitations and might mot be an accurate predictor of TBI severity and outcome when used alone. For this reason it is often used in conjunction with other parameters (Abbreviated Injury Scale - AIS). Secondary Brain Damage is the injury that occurs to the TBI patient not at the time of the accident, but during the following minutes, hours or days. There are many mechanisms that lead to development of cerebral edema, blood-brain barrier disruption, vasospasm, increase in volume of bleeding, contusions and intracranial hypertension. These mechanisms can act either in cellular level or systemic level. The cellular mechanisms that lead to secondary brain damage include necrosis or apoptosis, mitochondrial dysfunction, excitotoxicicty, formation of free radicals, changes in cerebral glucose metabolism and inflammation. The mechanisms at systemic level include hypoxia-cerebral oxygenation, hypo or hypertension, hypo or hyper-capnia, anemia, hyponatremia and hyper or hypoglycemia. The first tool to diagnose severe TBI and secondary brain injury is neurological assessment. Neuroimaging is one of the most important ways for diagnosis. Computed Tomography (CT scan), Magnetic Resonance Imaging (MRI), cerebral angiography, transcranial Doppler, CT perfusion, Xenon CT, MRI diffusion, MRI perfusion, MRI spectrometry and Positron Emission Tomography (PET) are possible ways of imaging that not only help in the diagnosis but give important information that help in choosing the correct management. Moreover, neuromonitoring, helps in the correct management of the patient.
Background: It is stated that children who are acquainted with healthy foods early on are more likely to make healthy food choices in their lives and that parents play important roles in the devel-opment of nutritional preferences. Aim: The main purpose of the present study was to identify children's breakfast habits and what they know about this topic, and see if they transfer all this into life. Method and Material: In this study, the case study design is used because the aim is to describe and interpret from a holistic perspective children's preferences for breakfast. The study was conducted with a total of 30 children from the morning group. For one week, the children were offered a breakfast buffet containing food from each food group and what the children ate was observed. The structured individual interviews planned with 30 children were carried out with only 28 children on the grounds that two children were of Syrian origin and could not speak Turkish at an adequate level. Results: It was observed that the majority of the children (93.3%) stated that they like to have breakfast. The proportion of children who stated that they did not like to have breakfast was 3.4% while the proportion of children who were undecided was 3.3%. According to the findings obtained from the observations, the children finished all the food they put on their plates. In other words, every child tends to take as much food as he/she can eat. Conclusions: As a study conclusion, those children that stated they choose their preferred food and beverages at breakfast according to what they like know the correct foods, which they called "healthy," but do not choose them. It is thought that the reason the children gave the desired answer stems as much from the role of the researcher as it does from the wish to give an adult the "correct" answer.
Introduction: Burn injury is a severe systemic disease with social implications.Aim: The recording of patient’s clinical profile with burn injury worldwide and in Greece, the outcome and impact of the injury on the patient’s mental health and social, professional and family life.Methods: There were collected surveys and reports concerned burn victims, men and women, teenagers and adults of all types and severities of burns in the world and in Greece. The information were been searched in database of Pubmed and websites of international health agencies (American Burn Association-ABA, World Health Organization-WHO , Centers for Diseases Control and Prevention-CDC) and statistical offices (Hellenic Statistical Authority), between the years 1985-2012.Results: In U.S.A. 183.036 burned victims were reported between the years 2002-11 and in Greece 1840 in 1993-2001. The most of studies were showed strong relationship between risk of burn and age, gender, standard of living and education, the place and conditions of the injury, the lack of information and habits of patients. The coexistence of chronic diseases burdened the risk of injury and the outcome. After burn injury, patients had difficulties on professional and social reintegration, because of physical complications and mental disorders. Their psychological condition upon leaving the hospital was important prognostic feature. Researchers suggested the detection of high-risk groups to train them and organized psychosocial reintegration of burned.Conclusion: There is a reciprocal relationship between clinical profile of burned patients before injury and outcome of the disease and their mental health, social, professional and family life. The need for continuous investigation into the profile of burned within multicenter study and organization of network for psychosocial reintegration became evident.
Background: Depression is one of the major causes of morbidity and loss of productivity in the world. Regardless of age, ethnicity and gender, it is known that its impact increases after major stressful events. Other major causes are chronic diseases, such as heart failure. The condition shows greater frequency and prevalence today, because of the aging population, the growth of population dispersion and other risk factors like hypertension and diabetes as well as the increase in the life expectancy of sufferers, due to current therapeutic interventions. Thus, depression has become chronic and the challenge of fighting inevitably incurs psychosocial effects.Aim:This research paper (systematic review) aims to investigate the prevalence of depression in patients with heart failure in association with determinants.Method & Material: This is a systematic review. In particular, a literature search was conducted in the electronic databases ProQuest, PubMed, EBSCO and Google Scholar, using the key-words: heart failure, prevalence and depression.Results: A total of ten surveys met the selection criteria. According to the results on the prevalence of depression, a moderate to high prevalence among patients with heart failure is presented, as well as an increased risk of mortality and clinical manifestations. Depression increases in patients with heart failure, as age, gender and race affect it similarly compared to what has been observed in the general population. The NYHA class II and III in advanced age and people with a prior history of myocardial infarction show a strong positive correlation with depression, too.Conclusions: Mental health problems affect the entire sphere of activities of a patient. Management is feasible and guaranteed only in a controlled living environment. Nurses, having the privilege of close contact with patients, can promptly diagnose depression symptoms and intervene as members of an interdisciplinary team. In Cyprus, no other research studies exist concerning the assessment of the prevalence of depression in patients with heart failure.
Background: Early mobilization of the Intensive Care Unit (ICU) patients improves muscle strength and functional capacity. It has been demonstrated that prevents Intensive Care Unit Acquired Weakness (ICUAW) and accelerates ICU discharge. However, data on mobilization early after cardiac surgery are inadequate. This study aimed to record early mobilization and investigates the association with ICU findings in cardiac surgery patients.Material and Methods: In this observational study, 165 patients after cardiac surgery were enrolled. Of these, 159 were assessed for early mobilization and mobilization status during ICU stay. Mobilization practices were recorded from 1st post ICU admission and every 48 h until 7th day. The duration of mechanical ventilation (MV) support, ICU length of stay and clinical outcome were recorded from medical records registration. Results: Early mobilization consisted of active and passive limb mobilization, sitting in bed and transferring from bed to chair. The proportion of patients mobilized, was 18% (n = 29/159) on day 1, 53% (n = 46/87) on day 3, 54% (n = 22/41) on day 5 and 62% (n = 15/24) on day 7. ICU length of stay was reduced for mobilized patients (n = 29) on day 1 compared to non-mobilized ones (24 ± 10 vs 47 ± 73 h respectively, P = 0.001). The duration of MV was shorter in mobilized patients on day 3 (n =46) compared to bedridden, (18 ± 9 vs 23 ± 30 h respectively, P = 0.01).Conclusions: Early mobilization after cardiac surgery was found to be low with a significant trend to increase over ICU stay. It is also associated with a reduced duration of MV and ICU length of stay.
Introduction: The incidence of postoperative morbidity has increased, a fact which may lead to prolonged hospitalization of the patient in the Intensive Care Unit (ICU) and generally in the hospital.Aim: The aim of the present study was to explore the complications after cardiac surgery responsible for the prolonged stay of patients in the ICU.Material and method: The studied sample consisted of 80 patients who were hospitalized in the Intensive Care Unit General Hospital of Athens from January 2013 to June 2014. For data collection a special registration form with information coming from the medical records of patients was used. Data analysis was performed by the IBM SPSS 21.0 (Statistical Package for Social Sciences).Results: Regarding to demographic characteristics Regarding the demographic characteristics and medical history of the studied sample, the majority were male (58.7%, n=47), with a mean age of 73 years and an average hospital stay of 3.3 days. The major causes of prolonged ICU stay was respiratory failure (20%, n=16), arrhythmias (17.5%, n = 14), bleeding (15%, n=12), myocardial infarction (11.3%, n=9), and pulmonary edema (10%,n=8). Τhe bivariate analysis showed statistical relationship to the level of 0,20 (p<0,20) between the prolonged ICU stay and age, coronary artery disease as the cause of entry, coronary artery bypass, diabetes melitus and chronic obstructive pulmonary disease.Conclusion: Patients with a history of heart failure, diabetes or obstructive pulmonary disease seems to have a greater chance for a prolonged ICU stay after cardiac surgery. Early recognition of demographic and clinical factors that may lead to the prolonged ICU stay can provide very important information about how to improve perioperative care of the patient.
Introduction: The effectiveness of preoperative education in postoperative course of cardiac surgery patients has been questioned. Aim: To estimate the impact of preoperative education in satisfaction and postoperative outcomes of patients undergoing cardiac surgery. Material and Method: A quasi-experimental trial was conducted. Sixty nine patients who admitted for elective cardiac surgery were divided randomly in intervention (34) and control group (35). Intervention group received written and verbal education based on patient centered communication by specially trained nurses. Patients’ satisfaction, postoperative complications and hospital length of stay (LOS) was measured. Results: Scores on all dimensions of satisfaction were greater for intervention group (p<0,001).No difference found for complications in intensive care unit (ICU) (p=0,150) in both groups. The total complications was lower (p=0,028) in intervention group with a lower proportion of arrhythmia (p=0,011). The median LOS in ICU was shorter for intervention group (p=0,035). No difference found in median hospital LOS in either group. Conclusions: Nurse-led preoperative education increases satisfaction of patients undergoing cardiac surgery and may have an effect on LOS shortening and complications control.
Introduction: Improvement of the quality of health care and patients' satisfaction during their hospitalisation depends on many interconnected factors.Aim: This research study intends to investigate four aspects of the nursing environment (autonomy, relationships between doctors and nurses, commanding support and checking working conditions) and the effect they have on nursing care.Material and Methods: The study sample consists of 127 public hospital nurses with a mean age of 45 years (SD = 6.8 years). The questionnaire which was used was based on the revised version of NURSING WORK INDEX-REVISED (NWI-R). Data analysis was performed by the statistical package SPSS 19.0.Results: Of the total sample, 72.4% of participants agree that supervisors support their staff and 60.6% thinks that there is support from nurses for the decisions of their colleagues. Also 10.3% agree that there are enough resources that allow them to spend time with patients, while 65.3% claims that they spend their personal time on different duties. Furthermore, correlation was detected among the aspects of autonomy, relationships between doctors and nurses and ''Control over the practice setting''. The workplace affects the autonomy's percentages (p<0.020), control of working conditions (p<0.004) and was related to organisational support (p<0.020). According to the above, nurses due to lowest direction's rating have less satisfaction from their research (p<0.004).Conclusion: The nurses’ job satisfaction is significantly related to the ‘’autonomy’’ factor and affects the quality of care provided to the patient. By investing in actions and practices that increase autonomy ,improve the control of working conditions as well as the cooperation between nurses and doctors and by increasing organisational support for the employee, there is significant improvement of the quality of nursing care and increased job satisfaction.
Background: Heterotopic ossification is a musculoskeletal complication in patients in intensive care unit which expects to impair their mobility and quality of life after discharge. The aim of the study was to examine the incidence and the risk factors of heterotopic ossification in critically ill patients. Methods: One hundred-ninety seven consecutive patients evaluated through clinical and laboratory screenings for heterotopic ossification upon admission and discharge and 123 of them were eligible for the study. Symptomatic heterotopic ossification was confirmed to 9 patients (7.31%) by means of ultrasonography and radiography. Many risk factors examined by logistic regression such as age, admission of Glasgow Coma Scale score, length of stay in intensive care unit, duration of mechanical ventilation, duration in Venturi mask and in mask tracheostomy, days in coma, traumatic and non-traumatic brain injury, increased intracranial pressure monitoring, autonomic dysregulation and days in respiratory alkalosis. Results: The risk factors that predict heterotopic ossification were: age, duration of mechanical ventilation, respiratory alkalosis, days in coma, admission of Glasgow Coma Scale score, increased intracranial pressure monitoring, autonomic dysregulation, and non–traumatic brain injury. In multivariate analysis were found significant the autonomic dysregulation, the respiratory alkalosis, the increased intracranial pressure monitoring and the duration of mechanical ventilation (F=17.44, p<0.00).Conclusions: The incidence of symptomatic heterotopic ossification appears to be significant in a general intensive care unit. A few factors seem to predict the occurrence of it, confirming previous studies. Larger studies are needed to be done for better prevention and early identification of this frequent musculoskeletal complication in critical ill patients.
Background: The management of Heart Failure (HF) is the cornerstone for the appropriate therapy and the knowledge obtained concerning the disease is known to affect self-care behaviours. Aim: The aim was to test the association between self-care management, knowledge, self-efficacy for medication and quality of life in chronic HF patients.Material and Method: A cross-sectional study was conducted and four questionnaires were used: Atlanta Heart Failure Knowledge Test (AHFK), Minnesota Living with Heart Failure (HMLHFQ), Self-Efficacy for Appropriate Medication Use Scale (SEAMS), European Heart Failure Self-care Behaviour Scale (EHFScBS-9). Multiple linear regression analysis was performed to identify independently associated variables with study subscales.Results: The sample consisted of 122 Heart Failure patients (102 men-20 women) with mean age 67.1 years (SD=12.3). Scores on Fluid and sodium management, Physical activity and recognition of deteriorating symptoms were significantly greater as compared with scores on Adhering to recommendations (p<0.001), indicating that the needs concerning Adhering to recommendations were greater. Linear regression analyses showed that score on knowledge-test and New York Heart Association (NYHA) class were predictive of medication adherence factors. Better knowledge was associated with better medication adherence, while worse scores were found in subjects with NYHA class III or IV as compared to those with NYHA class I or II. Additionally, Knowledge and years of Education were associated with Self-care behaviour factors (β=0.44, SE=0.08, p<0.001). Conclusions: Patients at a higher level of HF knowledge show better adherence to the Medication. Self-care behavior and life quality are improved.
Background: The enteral nutrition (EN) is the first choice of nutritional support for critically ill patients. Despite the fact that the most common practice is choosing continuous EN, there is a controversy about which is the safest and most effective method of nutrition.Aim: The aim of this systematic review was the analysis of the effect of EN compared to PN for patients that are hospitalized in ICUs, as a function of to the cost and the time of hospitalisation, the hospital-acquired infections, complications and mortality.Material and Methods: A systematic literature search was conducted in English and Greek language, of published articles during the past 5 years. Articles were unidentified in electronic databases of PubMed, Cochrane Library and Iatrotek using keywords. Grey literature was also taken involved. Finally, 4 studies were included in the systematic review, after the application of exclusion and inclusion criteria.Results: Eight hundred thirty-eight articles (838) were recovered using keywords. The studies that were finally included and further analysed consisted of 2 systematic reviews and meta-analyses, one randomised clinical trial, a multicentre controlled randomised trial and a systematic review. The method of nutrition (enteral or parenteral) is not related to mortality. The EN is related to less blood bacterial infections and reduction in the time of hospitalization. On the other hand, it causes more gastrointestinal complications. On average, the cost of parenteral nutrition is higher than intestinal.Conclusions: The EN is indicated to be the primary nutritional support of ICU-treated patients, with the advantage of reduced haematogenous infections and organ failure, beside the fact that it still is a challenging procedure. Critically ill patients are a heterogeneous group, in which each patient needs a personalised diet, depending on the diagnosis, the time spent in the ICU and the variety of possible complications.
Introduction: The correlation between team climate and job satisfaction has been studied by researchers worldwide, but only a handful of them have dealt with the reality of Intensive Care Units (ICU). Team climate can contribute to nurses’ job satisfaction, thus increasing their efficiency and effectiveness. Especially during a pandemic, such as Covid-19, the investigation of team climate and job satisfaction is of great importance.Purpose: The purpose of this study was to investigate the correlation between team climate and job satisfaction of nurses in ICU and among the fear of Covid-19.Methodology: This is a contemporary study. The sample of the study is consisted of nurses and nurses’ assistants of a Greek public hospital ICU and special units. The Anderson & West Team Climate Inventory (TCI), the Paul E. Spector Job Satisfaction and the Fear of COVID-19 Scale were used for data collection. The statistical analysis of the data was done with the statistical program SPSS for Windows (version 21).Results: Out of the 212 nurses, 170 responded to the questionnaire (response rate 80.2%). The team climate was generally described as moderate. Especially, the dimensions of communication-innovation, team goals and the way they work assessed as moderate. Job satisfaction was described as moderate. Relationships with the manager, the nature of the work and communication, characteristics of job satisfaction, were evaluated with a high score, while payment, benefits and promotion were evaluated with low score. The fear of Covid-19 scale had low score, indicating that the feeling of fear was at low levels.Conclusions: The team climate and job satisfaction of ICUs nurses of the hospital was characterized as moderate, while the fear levels due to Covid-19 were low. Furthermore, the team climate was positively correlated with job satisfaction. In contrast, neither team climate nor job satisfaction were associated with fear of Covid-19.
Introduction: Stroke remains a heavy financial burden on health care systems around the world. Yet, health care reforms have called for sophisticated management systems in order to provide high-quality care on equal terms for the entire population within a cost-conscious environment. Aim: The main aim of this discussion paper is to define and reflect cross-culturally on the merits of the Case-Management (CM) approach for contemporary stroke care delivery.Methods: Critical reflective analysis was used for this paper’s needs, whereby readers are gradually introduced to skills of critical and reflective thinking. This can then be applied into a clinical context which may assist nurses to achieve a better understanding of their professional role within the complexities of contemporary health care delivery.Discussion: An overview for stroke care differences between Greece and USA is provided using the following critical analysis components: Situation, Experience evaluated, Personal Reflections and Opportunities for Change.Conclusions: CM in the USA aims to meet the urgent challenges of stroke care. CMs are health care professionals whose role is to serve as client advocates and to coordinate services whilst assuring financial and gate keeping functions as required. As these services are currently unavailable in Greece, despite adverse financial circumstances, efforts should be made to introduce a culturally adopted CM initiative for stroke care.
Introduction: Patient satisfaction, while influenced by many factors, is a multidimensional phenomenon, which could be used to optimize the quality of the services provided by hospitals, as well as in the patient-centered care.Aim: The aim of the present study was to explore High Dependency Unit (HDU) patients’ satisfaction from health care provided. Material and Method: The studied sample consisted of 101 HDU patients of a general hospital in Attica. Data collection was conducted through the questionnaire of Inpatient Survey Questionnaire, which included demographic data as well as questions relevant to the hospitalization characteristics. Data analysis was performed by the statistical package SPSS ver.22. Results: Patients were satisfied both by the general hospital provisions and staff. A statistically significant difference (t(99) = 2,69 , p = ,008) was found between the subscale “Room” with the majority of men to score higher these services (Μ = 3,83, Τ.Α. = 0,34) compared to women (Μ = 3,65, Τ.Α. = 0,35). Men also scored higher (t(97) = 2,40 p = ,018) the subscale “nursing staff” (Μ = 4,30, Τ.Α. = 0,21) ) compared to women (Μ = 4,17, Τ.Α. = 0,32). A statistically significant difference (t(99) = 2,37, p = ,020) was found between the subscale “food” with the majority of older patient to score higher these services (Μ = 4,06, Τ.Α. = 0,36) than the youngest patients (Μ = 3,88, Τ.Α. = 0,39).Conclusions: Patient satisfaction is a vital factor for optimizing hospital services, is influenced by multiple factors and needs further research so that there will be effective strategies which will focus on optimizing the degree at which patients’ needs are met.
Introduction: The last decades, delirium, an organic psycho syndrome frequently found in hospitalized patients in the Intensive Care Unit (ICU), has been recognized as an important factor affecting patient’s prognosis.Aim: The purpose of the present study was to evaluate the incidence of delirium in patients hospitalized in general ICU of a tertiary hospital of Attica.Material and Method: The studied sample consisted of 93 patients. a specific record form which was developed according to the needs of this study, was used for data collection.. The severity of the disease was calculated using international ICU scoring systems; Acute Physiology and Chronic Health Evaluation II (APACHEII), Simplified Acute Physiology Score III (SAPS III), Sepsis-related Organ Failure Assessment (SOFA) score and the presence of delirium was evaluated by implementing the Confusion Assessment Method for the ICU (CAM-ICU). Data analysis was performed by the statistical package Statistical Package for Social Sciences (SPSS) ver.19.Results: 62.4% (n = 58) of the studied sample were male. Of the 93 patients, 39 (41.9%) exhibited delirium; the 15 patients (16.1%) did not develop while the other 39 (41.9%) patients of the sample could not be tested for the syndrome. The incidence of the syndrome was high as the rate of premature mortality in less than 28 days. In particular, all the patients who died (n=41), the rate of premature mortality was 56% (n=23). The study failed to show a relationship of delirium with known risk factors (age, high severity of disease, infection and benzodiazepine use) patients’ outcome, ICU length of stay and duration of mechanical ventilation. No association emerged between sedatives and delirium occurrence.Conclusions: The hypothesis of the study dictate a relationship between delirium appearance and advanced age, high severity of disease, benzodiazepine use and infection based on previous research results. However, none of these relationships emerged in this study.
Background: In recent years, there has been a growing interest in understanding the role of prognostic factors in patient outcome.Aim: To investigate the role of clinical indicators, and severity-of-disease assessment scales, as prognostic factors in the outcome of multi-trauma patients in the ICU.Material and Method: The sample consisted of 65 ICU multi-trauma patients treated in a hospital in Thessaloniki city, with an average stay of 16.5 days. Clinical indicators such as Glasgow Coma Scale, heart rate, mean arterial pressure, lactic acid, hemoglobin, urine output, as well as APACHE II and SAPS II scales, were recorded on the day of admission to the ICU.Data analysis: Data were analyzed using multiple logistic regression and Mann-Whitney Test. Multiple logistic regression analysis was performed to examine the predictive capacity of specific indicators on patient outcome.Results: The results of the analysis showed that in cases where all clinical indicators changed, then patient outcome may be affected by 79,4% (Relative Risk 3.846, p<0.001). Glasgow Coma Scale (p=0.022) and hemoglobin (p=0.013) were the strongest influencing factors related to patient outcome. Mann-Whitney analysis was used to evaluate the predictive value of Apache II and SAPS II and demonstrated that both systems could significantly predict patient outcome (APACHE II=0.019 and SAPS II=0.013).Conclusion: Hemoglobin and Glasgow Coma Scale values upon multi-trauma patient admission to the ICU appear to be strong prognostic factors of patient outcome.
Ιntroduction: Primary Health Centers face a plethora of emergencies of different nature and severity and it is necessary a decision -whether or not to refer patients to the nearest hospital for further treatment and investigation- to be made.Aim: The aim of the present study was to investigate the management of emergencies in a HC of regional type near a large urban center.Material and Methods: This was a retrospective study. The data of 400 randomly selected patients admitted to the health center with acute conditions during the years 2017-2018 were recorded.Results: Out of all cases examined, 22% were rated as truly medical emergencies and 44% as not; 34% were classified as urgent; 25.9% of patients had arrived within the first hour of onset of symptoms, while 81.7% had already reached within the first 24 hours. Pain and respiratory diseases were the most common problems. In 15% of cases the patient was ambulance-transported to hospital. The proportion of ambulance referral to the nearest hospital was higher in patients with comorbidities (18.8%) than in those without (14.9%); 76% of cases were treated in accordance with evidence-based practice.Conclusions: Despite the significant progress made in treating patients in the community, it is necessary to improve management of non-emergency cases, as well as to improve the procedures for emergencies management in the HCs.
Introduction: Chronic renal failure (CRF) is a major cause of morbidity and mortality and renal replacement dialysis is necessary for the preservation of life, despite the fact that it is characterized by multiple restrictions and complications.Aim: The purpose of the present systematic review was the investigation of the absolute and relevant renal replacement therapy initiation criteria among patients with end-stage renal disease (ESRD).Material and Method: There was an extensive research at Pubmed, IATROTEK and Cinahl during the period 2000-2015. The key words that were used for data search included “CRF”, “renal replacement therapy”, “initiation criteria”, “glomerular filtration rate”, and “guidelines”. In the present review, 20 studies were included. Results: Renal replacement therapy initiation constitutes a challenge for both nephrologists and patients since there is no consensus regarding the initiation criteria. GFR should not be the only marker for the initiation of renal replacement therapy since it is influenced by multiple factors. Renal replacement therapy should start at the presence of uremic signs and symptoms or complications, and co morbidity and individualized characteristics of patients should be taken into account. The doctors’-nephrologists’ characteristics seemed to influence the time of initiation of renal replacement therapy.Conclusions: CRF patients should be monitored by an interdisciplinary team and for the decision for the renal replacement therapy initiation, a relationship of cooperation between the doctor and the patient should be encouraged.
Background: One of the most challenging problems facing the medical community, is the treatment of chronic wounds. Wound bed debridement is a crucial factor in healing any type of wound and there are new invasive methods like low frequency ultrasound frequency debridement, hydro surgery and coblation technology that look very promising alternatives to the current “gold standard’’ of sharp debridement. Method and Material: A search of ‘PubMed’, ‘Cochrane database of systematic reviews ‘and ‘Science Direct’ digital databases were made for studies between the years of 2010-2019. Material was randomized controlled trials, cohort studies and prospective or retrospective studies on the subject. Results: Our search revealed 1933 articles. After removing 118 duplicates 1815 articles were screened, a further 1568 were removed because of their type and of the remaining 247, 165 were removed after title reading. Finally, of the remaining 82 articles, 71 were rejected after full reading thus bringing the total number of the articles examined in this systematic review to 11. Conclusions: The advanced methods of mechanical debridement seem to be less time consuming, more accurate and at the same or lower cost than sharp debridement. Additionally, they offer faster healing rate while reducing the bacterial load of the wound at a greater percentage than sharp debridement.
Background: Virtual Reality (VR) is a new technology used more and more in clinical trial. Aim: The aim of this study is to investigate the effects of immersive VR as a rehabilitation approach of cognitive functions. Method and Material: A systematic literature review was conducted in the electronic databases of PubMed, Cochrane, OTseeker and PsycINFO for articles published until August 2021. The main search terms were "immersive virtual reality," and "cognitive rehabilitation". The research was strictly limited in immersive technologies and adult patients suffering from neurological disorder or a traumatic injury or elderly with cognitive decline, and no reviews are included. Totally, 16 citations reviewed. Results: All intervention studies reported improvements either in cognitive functions or in stress management and relaxation. In particular, most of the studies demonstrated improvement in attention (N=6) but also in executive functions (N=3), in memory (N=5) and in navigation skills (N=1). Regarding safety and feasibility, most of the participants in the studies completed successfully the tasks and did not report stimulation sickness. Conclusions: The available limited data indicate that immersive VR environments can a) be feasible and safe and b) have a positive impact in cognitive functions in the dynamic process of rehabilitation. Further research is warranted in large-scale longitudinal clinical trials in various patients’ groups in order to compare the effects of immersive and non-immersive VR interventions. Future studies should further investigate the long-term impact on cognitive functions in interventions using immersive VR.
ntroduction: Brain-computer interfaces (BCIs) that promote communication with individuals suffering from locked-in syndrome (LIS), are variously superior to the classic methods. These interfaces, whether intrusive or not, have evolved and are now accessible to patients, thus contributing mainly to the production of written speech, to the control of personal computers, and to the management of the patient’s environment. Aim: The aim of the present review was to evaluate the effectiveness with LIS patients of communication methods using technology. Methodology: The search of the Greek and international bibliography involved the databases: Pubmed, Cinahl, Sciverse Scopus Proquest, Researchgate, Cochranelibrary, etc. 1,652 items were found and 15 were judged appropriate for study. Results: There is a wide variety of available BCIs, depending on the minimum demands made on the user, the needs served and the time the user takes to learn them. Communication remains a time-consuming process and thus a source of great anxiety to patients. Furthermore, there is a slight superiority in the possibilities offered by intrusive BCIs. However, they are often not preferred because they require a surgical operation. Conclusions: There is an identified need to find new methods, or to modify already existing ones, for the more effective communication with patients who suffer from all forms of LIS. However, the dysfunctions in the control of the sensorimotor rhythms (due to alterations or damage to the cerebral cortex) may adversely impact the perfection of BCI technology.
Background: Stroke is considered to be the third, most frequent cause of death and the leading cause of disability in Western societies. Apart from physical problems, stroke can cause psychological and social problems, too as post Stroke Depression (PSD) which is the most common emotional disorder that usually occurs in the first months, in about 1/3 of patients surviving after stroke.Aim: To describe the frequency of post stroke depression (PSD) and its effects on functional recovery of patients.Method: A systematic review was conducted on databases MEDLINE, PUBMED, CINAHL, and the web using Google Scholar.Results: Thirty articles were retrieved, from 2000 and onwards which met the selection criteria. According to the results, PSD is a common and serious complication after stroke. Approximately 1/3 of the patients have a type of depression in the first year after stroke, with the risk increasing, the first months of the onset of stroke. The researchers suggest that there is a collaborative relationship between stroke and depression, which leads to inability to perform activities of daily living and slows the rehabilitation of patients.Conclusion: Early detection of PSD and the implementation of appropriate therapeutic interventions in rehabilitation units help to speed up the recovery process and reintegration of patients into society.
Ο εθελοντισμός ορίζεται ως: «η δραστηριότητα εκείνη που αναπτύσσεται κατά τρόπο προσωπικό, αυθόρμητο, ελεύθερο χωρίς ατομικό κέρδος από πολίτες ή ομάδες πολιτών προς το συμφέρον της ομάδας στην οποία ανήκουν ή τρίτων προσώπων ή ευάλωτων κοινωνικών ομάδων ή της τοπικής, κρατικής ή διεθνούς κοινότητας, αποκλειστικά για σκοπούς αλληλεγγύης».1 Ο εθελοντισμός συνεπάγεται μια στάση ζωής που ενστερνίζεται ιδιαίτερες αξίες, όπως η αλληλεγγύη, η κοινωνική δικαιοσύνη, η κοινωνική συμμετοχή, ενώ οι εθελοντές με τη δράση τους προωθούν θετικές στάσεις και αντιλήψεις για τα διάφορα κοινωνικά ζητήματα. Τη σημερινή εποχή, ο εθελοντισμός, αποκτά ριζοσπαστικά χαρακτηριστικά και συνιστά μια μορφή άμεσης παρέμβασης και συμμετοχής των πολιτών, ειδικά των νέων, στο πολιτικό και κοινωνικό γίγνεσθαι.
Introduction: Hemodialysis, which is the most common treatment in individuals with end stage renal disease, includes a series of limitations and modifications in daily life that adversely affect patients' physical and psychological state. Eliciting and addressing patients’ concerns is a key aspect of patient-centered treatment. Unaddressed concerns may lead to lower satisfaction and lower quality of medical care.Aim: To explore concerns of hemodialysis patients. Method and material: A Descriptive study on a convenience sample of patients undergoing hemodialysis in dialysis centers in Athens. Data was collected by the completion of a questionnaire which included the patients' concerns. Categorical variables are presented by absolute and relative frequencies (percentages).Results: In the present study were enrolled 100 patients, of whom 73% were male, 55% were>60 years old, 66% were married and 30% of primary level of education. Regarding patients' concerns, 36% of participants were bothered to spend time on dialysis center, 65% and 49% were concerned about a possible discontinue of fistula and hemodialysis machine respectively, while 59% were concerned about restrictions in social life, 39% in their role as a spouse, 71% about fluid restrictions, 55% about diet restrictions and 53% were concerned about transport "to and from" hemodialysis unit. In terms of limitations due to hemodialysis, 30% reported limitation in clothes, 69% in going for holidays and 67% in sexual life.Conclusions: Expanding nurses knowledge about patients' concerns is essential to implement individualized effective therapeutic strategies.
Background: Pressure ulcer is defined as the localised destruction of skin and the underlying tissues, caused by a combination of prolonged pressure, friction and shear forces, resulting in tissue ischemia and necrosis. In addition to prevention, treatment of ulcers has an important role. This study analyses, the effectiveness of conservative treatment methods.Aim: The aim of the present study was to investigate the efficacy of conservative treatment methods in patients with ulcers and to evaluate these methods.Material and Methods: The present study is a systematic review. The search was conducted in Greek and international bibliography on electronic databases: Pubmed, Cinahl, Sciverse Scopus Proquest, as well as in translations of major international scientific organisations such as EPUAP and NPUAP. The date of writing the articles ranges from 2010 to 2017. Articles were selected based on the title, summary, and content.Results: The results of the present study revealed the efficacy of various conservative methods of dealing with pressure ulcers based on the publication of studies in medical data bases. The treatment is multifactorial and requires special knowledge from healthcare professionals, attention and assessment of a sprawl. The ineffective treatment of ulcers can lead to death, especially if not treated on time and in the right way.Conclusions: The findings show that the treatment depends on the severity of the pressure ulcer in relation to the general condition of the patient (condition, age, diet, weight, immobility, personal hygiene). Nonetheless, it can be addressed by proper prognosis, timely assessment, and appropriate countermeasures. These require sufficient knowledge of doctors and nurses over the existing conservative therapies and what / when they should be applied.
Developing and evaluating programmes of continuing education in nursing proved to be a challenging and yet a complex task. Nurse educators and evaluators confront a number of demanding issues regarding the development and implementation of continuing education programmes. Exploration of peers’ and stakeholders’ experience in programme development and evaluation appeared to be a valuable source of knowledge in the field. The aim of the present paper is to share the experience of planning and evaluating the stage of developing support networks during the implementation of an innovative continuing educational programme in nursing. Throughout the development and evaluation of different programme stages, several issues evolved that attracted programme planners’ attention. Development of support networks, group dynamics and communication appeared to be of critical importance for the successful implementation of continuing education programmes in nursing.