
Nikolaos EfstathiouUniversity of Birmingham · School of Nursing
Nikolaos Efstathiou
PhD Nursing
About
69
Publications
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Introduction
Additional affiliations
November 2007 - present
Publications
Publications (69)
Background
One role of primary care is to support people living with and beyond cancer, the number of whom is increasing worldwide. This study aimed to identify factors affecting cancer care provision within English primary care after the start of the coronavirus pandemic, during high healthcare service demand, and a depleted workforce.
Methods
An...
It is a belief widely held that hospital chaplains have a role to play in supporting bereaved relatives of patients, but research on the subject is sparse. The aim of this study was to examine factors that apparently influenced the decision to accept or refuse the offer of chaplaincy support through a case series study of ten bereaved family member...
The European Society of Intensive Care Medicine (ESICM) has developed evidence-based recommendations and expert opinions about end-of-life (EoL) and palliative care for critically ill adults to optimize patient-centered care, improving outcomes of relatives, and supporting intensive care unit (ICU) staff in delivering compassionate and effective Eo...
Background
The number of people who are living with and beyond cancer is increasing in England. Primary care delivers cancer care via structured proactive conversations which are incentivised through the Quality and Outcomes Framework (QoF): ‘cancer care reviews’ (CCRs). Declining workforce numbers, increasing patient demand, CCR policy changes in...
Objective
Identifying research priorities is very important for palliative and end-of-life care to ensure research is focused on evidence gaps. This project aimed to identify and prioritise palliative and end-of-life care research areas within the West Midlands region in United Kingdom (UK).
Methods
A modified Delphi technique approach was used wi...
Background
Deaths in paediatric intensive care units (PICUs) are not uncommon. End-of-life care in PICUs is generally considered more challenging than other settings since it is framed within a context where care is focused on curative or life-sustaining treatments for children who are seriously ill. This review aimed to identify and synthesise lit...
Health-workers are more likely to die by suicide than their counterparts in other occupational groups. The suicide of a staff member can be widely felt by colleagues, leading to complex emotional and cognitive responses. Exposure to suicide heightens the risk of dying by suicide. We investigated the impact of a colleague suicide on National Health...
Introduction
The practice of memory-making as a means of maintaining a connection with the deceased person is a long-standing tradition¹ and an acknowledged way of facilitating grief at the time of death and beyond.² In the context of acute healthcare, memory keepsakes are an integral part of personalised end-of-life and bereavement care,³ yet a re...
Purpose:
Identifying cancer nursing research priorities is central to influencing the direction of cancer care research. The aim of this rapid review was to explore research priorities identified by oncology nurses for cancer care delivery between 2019 and 2022.
Methods:
The Preferred Reporting Items for Systematic Reviews and Meta-Analysis info...
The transition from active, invasive interventions to comfort care for critical care patients is often fraught with misunderstandings, conflict and moral distress. The most common issues that arise are ethical dilemmas around the equivalence of withholding and withdrawing life-sustaining treatment; the doctrine of double effect; the balance between...
Background
Chronic heart failure is a common condition, and its prevalence is expected to rise significantly over the next two decades. Research demonstrates the increasing multidimensional needs of patients and caregivers. However, access to palliative care services for this population has remained poor. This systematic review was to provide an ev...
Purpose
A “cancer care review” (CCR) is a conversation between a patient recently diagnosed with cancer and primary care practitioner soon after a diagnosis of cancer in the UK. This scoping review aimed to identify: methodology and validated outcome measures used to evaluate CCRs, the impact of CCRs on quality of life or symptoms, and the views of...
Introduction
Public health responses were triggered while COVID-19 was spreading. China redeployed healthcare workers to serve the most vulnerable populations and communities in the initial epicentre—Wuhan. However, it is not known how redeployment processes impacted on healthcare workers in a pandemic crisis.
Aims
To explore the experiences and n...
By completing this chapter, the reader will be able to:
Recognize and define the subject group of interest in the context of this book.
Identify the individual roles caregivers fulfill.
Relate the concept of caregiver burden to caregiving activities including post-intensive care syndrome (PICS-F).
Describe individual consequences and effects of car...
Effective child protection systems and processes require reliable and accurate data. The aim of this study was to determine what data could be extracted from hospital records in a single site that reflected a child's journey from admission with suspected abuse to the decisions regarding substantiation made by the multidisciplinary child protection...
Objectives
Malnutrition and weight loss are important risk factors for complications after lung surgery. However, it is uncertain whether modifying or optimising perioperative nutritional state with oral supplements results in a reduction in malnutrition, complications or quality of life.
Design
A randomised, open label, controlled feasibility stu...
Background
With staffing shortages affecting increasing numbers of health services globally, and predictions that shortages will worsen in the future, there is broad consensus that leaders at all levels must do more to support and develop current employees. However, the wide range of attributes of a healthy work environment identified in the litera...
Background: Primary dysmenorrhea (PD) has a significant impact on women’s lives, especially among young women who miss school and work due to painful periods. Experiences and how women manage PD have been explored to some extent, but the evidence has not been systematically collated and reviewed to allow health professionals to better understand wo...
Good child protection systems and processes require reliable and accurate data. A retrospective study of the case records of 452 children referred to a major UK children’s tertiary centre for suspected child maltreatment was undertaken to determine whether routinely collected data on a child’s journey through the child protection system, together w...
Outcomes
1. Explore the process of terminal weaning and extubation through the eyes of ICU clinicians
2. Identify factors that influence decision making and communication between clinicians and patients and their relatives related to terminal weaning and extubation
3. Describe the feelings of those involved in the process of terminal weaning and ex...
Background
Limitations of life-sustaining interventions in intensive care units (ICUs) exhibit substantial changes over time, and large, contemporary variation across world regions. We sought to determine whether a weighted end-of-life practice score can explain a large, contemporary, worldwide variation in limitation decisions.
Methods
The 2015–2...
Aim:
To systematically identify, appraise, aggregate and synthesise qualitative evidence on family members' experiences of end-of-life care (EoLC) in acute hospitals.
Methods:
A systematic review and qualitative evidence synthesis based on the Joanna Briggs Institute methodology. Primary research, published 2014 onwards was identified using a se...
Context
Aside from spontaneous death, a majority of ICU deaths occur after a decision to either withhold or withdraw life-sustaining measures, including withdrawal of ventilatory support. While terminal weaning or terminal extubation are both used, the lack of evidence on the superiority of one method over the other can create challenges for ICU cl...
Objectives: Malnutrition and weight loss are important risk factors for complications after lung surgery. However, it is uncertain whether modifying or optimising perioperative nutritional state with oral supplements results in a reduction in malnutrition, complications, and quality of life.
Design: A randomised, open label, controlled feasibility...
Background and objective
Health and social care may affect unpaid (family) carers’ health and wellbeing in addition to patients’ lives. It is recommended that such impacts (carer effects) are considered in decision-making. However, the scope of carer effects and range of decisions where carer effects should be considered is uncertain. This study ai...
Background
Given a persistent nursing shortage in Canada and a decline in new nurses entering the profession, new graduate nurses (NGNs) are being hired into positions historically reserved for more experienced staff. Critical care settings, which are areas of specialty nursing practice, are now routinely hiring NGNs in many hospitals. While eviden...
Aims:
To consider the scope and quality of mixed methods research in nursing.
Design:
Focused mapping review and synthesis (FMRS).
Data sources:
Five purposively selected journals: International Journal of Nursing Studies, Journal of Nursing Scholarship, Journal of Advanced Nursing, Worldviews on Evidence-Based Nursing, and Journal of Mixed Me...
Background
During the terminal withdrawal of life-sustaining measures for intensive care patients, the removal of respiratory support remains an ambiguous practice. Globally, perceptions and experiences of best practice vary due to the limited evidence in this area.
Aim
To identify, appraise and synthesise the latest evidence around terminal withd...
Purpose:
Following the development of a service that consisted of a "single point of contact" to coordinate end-of-life care (EoLC), including EoLC facilitators and an urgent response team, we aimed to explore whether the provision of coordinated EoLC would support patients being cared or dying in their preferred place and avoid unwanted hospital...
Bereavement can be a distressing experience and the importance of bereavement support has been recognised in policy and practice for many years. This rapid evidence assessment was undertaken to evaluate the provision and effectiveness of bereavement support in the United Kingdom (UK) and to identify gaps in service provision and areas of need with...
Health and care services for patients may improve or harm the wellbeing of their family carers. Formal consideration of these effects (also known as spillovers) in decision-making is advocated, but, to date, little is known about how they occur. This paper presents the first empirical study to determine the mechanisms by which health and care servi...
Background
Medical misconduct is an international problem. It is judged according to whether a doctor has endangered the health of the public. Little is known about the risk factors associated with medical misconduct. To inform patient safety, we undertook a focused mapping review and synthesis (FMRS) of tribunal reports retrieved from the Medical...
Background:
Brain injury can occur after cardiac arrest due to the effects of ischaemia and reperfusion. In serious cases this can lead to permanent disability. This risk must be considered when making decisions about terminating resuscitation. There are very specific rules for termination of resuscitation in the prehospital setting however a simi...
Purpose:
Despite advances in medical science, patient death and family bereavement are commonly encountered in adult intensive care units (ICUs). This is the first review to investigate the state of ICU bereavement support globally, and the availability and effectiveness of bereavement support interventions.
Methods:
A systematic review and narr...
Background
Dying at home or in a hospice are the most preferred options among the population in England. However, the lack of co-ordinated End-of-Life (EoL) services means that most patients will not die in their preferred place of death. Following the development of a new service that consisted of a single point of contact (hub) to coordinate care...
Objectives:
The primary aim of this study is to conduct a systematic review of the existing qualitative evidence on barriers and facilitators of PA for patients with hip or knee OA. Secondary objective is to explore differences in barriers and facilitators between (1) lifestyle PA and exercise and (2) PA uptake and maintenance.
Methods:
Medline,...
Improved identification of children with an increased likelihood of death can support appropriate provision of integrated palliative care. This systematic review aims to consider immobility and the associated likelihood of death in children with disabilities, living in high-income countries. Two reviewers independently searched MEDLINE, Embase, Coc...
Aims and objectives:
To describe the experiences of patients who have failed to maintain weight loss following the insertion of a laparoscopic adjustable gastric band (LAGB) for the treatment of morbid obesity.
Background:
Obesity is a global health problem resulting in physical, psychological and economic problems and presenting challenges for...
Background:
Death and dying is a reality of the clinical context of the intensive care unit. Death often follows a decision to withdraw life-sustaining treatments. Critical care nurses, are the primary care providers to patients and families at the end-of-life in the intensive care unit.
Objective:
To synthesize qualitative evidence on the exper...
Background
Withdrawal of treatment is a common practice in intensive care units when treatment is considered futile. Compassion is an important aspect of care; however, it has not been explored much within the context of treatment withdrawal in intensive care units.
Objectives
The aim was to examine how concepts of compassion are framed, utilised...
Objectives:
Consensus methods are used by healthcare professionals and educators within nursing education because of their presumed capacity to extract the profession's' "collective knowledge" which is often considered tacit knowledge that is difficult to verbalize and to formalize. Since their emergence, consensus methods have been criticized and...
Aims and objectives:
To evaluate the use of LabTutor (a physiological data capture and e-learning package) in bioscience education for student nurses.
Background:
Knowledge of biosciences is important for nurses the world over, who have to monitor and assess their patient's clinical condition, and interpret that information to determine the most...
Aims and objectives: To explore the experiences of intensive care nurses who provided end-of-life care to adult patients and their families after a decision had been taken to withdraw treatment.
Background:End-of-life care following treatment withdrawal is a common phenomenon in intensive care. Less is known about nurses' experiences of providing c...
Abstract This paper reports on the process and outcomes of a study, designed to pilot the use of interprofessional, simulation-based training in end of life care communication. Participants comprised 50 final year medicine, nursing, physiotherapy and pharmacy students. Learning methods included observation of role play and facilitated, interactive...
The purpose of this article is to discuss the challenges critical care nurses face when looking after patients needing End-of-Life (EoL) care in critical care environments.
Critical care nurses frequently provide care to patients who fail to respond to treatments offered to support and prolong life. The dying phase for individuals in critical care...
EFSTATHIOU N., COLL A.M., AMEEN J. & DALY W. (2010) European Journal of Cancer Care20, 179–186 Do Greek healthcare users and healthcare providers share cancer care priorities? Analysing the results from two Delphi studies
Traditionally healthcare providers have determined how healthcare resources should be allocated. However, in recent years, healt...
User involvement is widely promoted within the European healthcare sector as an effective means of developing patient-centred health services. In addition, user involvement is recommended as an important aspect of developing effective cancer services. Despite the acknowledged benefits of user involvement, this concept has not been fully endorsed in...
Cancer is a major problem globally and effective cancer care services are needed to lessen its burden on the community. In Greece, oncology health services provision is not located efficiently, resulting in few patients receiving high-quality care. Furthermore, shortages of health professionals and underdeveloped services such as primary care, home...
Abstract:
Aim
The stressful nature of the critical care unit for the patients has attracted the attention of researchers who have tried to identify the environmental stressors to which patients are subjected. By using tools such as the ‘Intensive Care Unit Environmental Stressor Scale’ and its adaptations researchers have tried to identify the pe...