Predictors of anxiety and depressive symptoms among Greek nurses

Introduction: The increasing needs of an aging population and the shortage of nursing personnel have a negative impact on the workload of nurses increasing the risk of developing anxiety and depressive symptoms. This research aims to evaluate the strength of occupational and demographic characteristics in predicting anxiety and depression among nurses. Methods: In this cross-sectional study, a sample of 164 Greek nurses from three hospitals employed full-time participated. Anxiety and depression were measured using the validated Greek versions of the State-Trait Anxiety Inventory – State and Trait Y forms and the Centre for Epidemiological Studies Depression scale, respectively. The statistical analysis of the data was performed using the statistical program SPSS version 19.0. The statistical significance level was set up at 0.05. Results: Younger nurses, unmarried, those without children, those with less work experience, and working in the general medical units were more vulnerable. The average number of patients per nurse during the day shift may not predict anxiety or depression scores. Strong positive correlation between state and trait anxiety (r [162] = 0.77, p < 0.001), state anxiety and depression (r [162] = 0.62, p < 0.001), and trait anxiety and depression (r [162] = 0.63, p < 0.001) was revealed. Conclusion: Anxiety and depression are prevalent among nurses. Demographic and working characteristics are strong predictors of anxiety and depression among nurses. Nursing managers should emphasize emotional interventions (cognitive behavioral therapy, training on emotional intelligence, strengthening coping skills, and development of high resilience) in supporting nurses at higher risk

Fatigue and Quality of Life after Pulmonary Rehabilitation Program

BACKGROUND. Fatigue and poor quality of life can play an important role in chronic obstructive disease and treatment outcomes. The aim of this study was to examine the levels of fatigue and quality of life (QoL) among chronic obstructive pulmonary disease patients before and after a pulmonary rehabilitation program. METHODS. In this experimental study, 31 chronic obstructive pulmonary disease patients at a large hospital of Athens were randomly followed a pulmonary rehabilitation program and completed two questionnaires pre- and post-intervention:the Fatigue Assessment Scale designed for measuring fatigue and the Missoula -Vitas Quality of Life Index-15 designed for measuring QoL. Statistical analysis of the data was performed via the Statistical Program SPSS version 19.0.The statistical significance was set up at 0.05. RESULTS. The results showed decreased levels of fatigue after the completion of the Pulmonary Rehabilitation Program compared to pre -intervention. Moreover, although QoL did not seem to change after the intervention, however the dimension "Transcendent" seemed to be increased for the majority of the participants. After the participation in the rehabilitation program a statistically significant and negative correlation was observed between mental fatigue and total score of quality of life (r= -0.436, p=0.014 <0.05) as well as between physical fatigue and the dimensions of "Interpersonal" (r= -0.470 p=0.008),"Well-Being" (r= -0.615, p=0.000), "Transcendent" (r= -0.636, p=0.000) and total score of QoL (r= -0.543, p=0.002). CONCLUSIONS. A pulmonary rehabilitation program seems to be a successful and innovative clinical prevention program leading to a lower level of fatigue for those patients who suffer from chronic obstructive pulmonary disease

Are Burnout Syndrome and Depression Predictors for Aggressive Behavior Among Mental Health Care Professionals?

This study aims to examine the possible relation between depression and burnout as predictors to aggressive behaviors among mental healthcare professionals. For the purposes of this study 72 mental health care professionals were recruited and were evaluated in three questionnaires which were provided to them online. Firstly regarding depression, the Center for Epidemiologic Studies Depression Scale (CES-D) was administered, secondly, concerning burnout, Maslach Burnout Inventory (MBI) was applied and finally, regarding aggression, the Aggression Questionnaire (GAQ) was employed. Statistical data analysis was performed using the IBM SPSS Statistics Version 19. The level of statistical significance was set at up at 0.05. The results showed that depression is considered to be a statistically significant predictor of aggressive behaviors. However, burnout was not found to be a statistically significant predictor of aggression. In addition, a statistically significant relationship was found between burnout and depression. It seems to be of essential importance for mental healthcare professionals to be provided with support and assistance in order to diminish the potential high-stress levels and in that way to overcome depression and burnout of those who work in mental health settings

The Effect of Fatigue and Pain Self- Efficacy on Health-Related Quality of Life Among Patients with Multiple Sclerosis

Health-related quality of life is a major issue among patients with Multiple sclerosis (MS). To explore the effect of fatigue and pain self-efficacy on health-related quality of life among patients with MS. Between March and May 2018, 85 MS patients from a large Hospital of Athens region completed the questionnaires: a) Missoula-VITAS Quality of Life Index-15, which examines 5 dimensions of quality of life, b) Pain Self Efficacy Questionnaire which measures the pain self-efficacy that an individual perceives, c) Fatigue Assessment Scale (FAS) which measures fatigue, d) a questionnaire about the sociodemographic elements. Statistical analysis was performed using the IBM SPSS Statistics version 21. The significance level was set up to 0.001. Fatigue might predict the dimension of quality of life "Function" while Pain Self-Efficacy might, also, predict the dimension of quality of life "Interpersonal". A strong correlation was found between the dimensions of quality of life "Well-being" and "Transcendent" and between "Interpersonal" and Pain Self-Efficacy. The total score of fatigue was strongly correlated with Physical Fatigue and very strongly correlated with Mental Fatigue. Fatigue and Pain Self-Efficacy are important predictors of the dimensions of quality of life among patients with MS. Pain in MS has to be taken into serious consideration in every patient with MS

Greek Nurses' Perception of Hospital Ethical Climate: A Cross-Sectional Study

The present study aimed to examine Greek nurses’ perceptions about hospital ethical climate and to investigate the possible difference of those perceptions regarding their demographic and work-related characteristics. The cross-sectional study design was employed in this study in which 286 nurses and nurse assistants participated. Data were collected by a sheet containing demographic and work-related characteristics and the Greek version of Oslons’ Hospital Ethical Climate Scale. IBM Statistical Package for Social Sciences 25 was used in data analysis. Frequencies, means, percentages, and standard deviations summarized the data. For the statistical differences, parametric tests were performed. Independent Samples t and Pearson correlation analysis were used to determine the relationship between the ethical climate of the hospital and the nurses’ characteristics. The p-values 0.05 were considered statistically significant. The mean age of the nurses was 44 years (SD: 8.5 years; range 24–66 years). The majority of them were women (77.3%). A percent of 57.7% of the sample was married. Most positive perceptions were concerning managers (4.01) following by peers (3.82), patients (3.69), hospital (3.29) while the least positive perceptions of the ethical climate were concerning the physicians (3.16). The factors associated with hospital ethical perception were: working experience and responsible position. The highest score of ethical climate reported to Managers subscale, while the minimum score was related to Physicians. In general, Greek nurses reported positive perceptions regarding hospital ethical climate. The positive ethical climate is associated with a better working environment, fewer nurses’ experience of moral distress, fewer chances for nursing turnover, high quality of nursing care, and fewer errors in nursing practice

O R I G I N A L P A P E R Investigation of Anxiety and Burn-Out in Medical and Nursing Staff of Public Hospitals of Peloponnese

Abstract Background: Nowadays, anxiety and burnout of medical and nursing staff is identified more and more as one of the factors that affect aspects of their personal and professional life. Aim: The aim of this research study was to investigate the self-evaluation of anxiety and burnout in medical and nursing staff of public hospitals in Peloponnese. Methodology : Two questionnaires were given to a sample of 284 doctors, nurses and assistant nurses from two hospitals: the &quot;State-Trait Anxiety Inventory&quot; (STAI) by Spielberger and the Maslach Burnout Inventory (MBI) that assesses the three dimensions of burnout: emotional exhaustion, depersonalization and lack of personal fulfillment. The statistical analysis was performed using the statistical package SPSS, version 19.0. The level of statistical significance of the results was p&lt;0.05. Results: Doctors and nurses are dominated by moderate emotional anxiety and increased burnout. The stressful situation seems to be interpreted mainly in the light of a dynamic interaction between the person and the working environment. The adverse working conditions, that characterize the health sector, seem to intensify the stress and overwhelm them emotionally and professionally. Conclusions: The anxiety and burnout of doctors, nurses and assistant nurses working at both hospitals is increased and expressed with feelings of depersonalization and emotional exhaustion. The formulation of a program of emotional support and strengthening of medical and nursing staff is required

The effect of nursing counseling on improving the level of knowledge, quality of life and adherence of patients undergoing hemodialysis to therapeutic regimen

Background: Hemodialysis is the most common method for the treatment of End Stage Renal Disease. Counseling intervention in hemodialysis patients is considered to be an important factor associated with improving the level of adherence in the treatment regimen and the quality of life of patients.Aim: The assessment of the impact of nursing counseling on changing the level of knowledge, quality of life and adherence of hemodialysis patients in the treatment regimen.Method: This is a quasi-experimental intervention study involving patients with End Stage Renal Disease conducted from November 2013 to April 2017. To measure the knowledge’s level of patients on hemodialysis the scale «Kidney Disease Questionnaire» was used. Τo measure the level of adherence, the scale «GR- Simplified Medication Adherence Questionnaire-HD» was used while for measuring the quality of life the scale «Missoula Vitas Quality of Life Index – 15» was used. The statistical analysis of the data was performed through the Statistical Program SPSS version 19.0. Statistical significance level was set up at 0,05.Results: The overall reliability of the Kidney Disease Questionnaire and GR-Simplified Medication Adherence Questionnaire-HD was high (Cronbach's Alpha 0,85 and 0,71 respectively). The mean age of the control group was 49,8 years (SD = 8,5 years) and those of the intervention group was 51.2 years (SD = 11,5 years). Both groups had a similar level of knowledge before the intervention. After the intervention, there was a significant increase in both groups, however, the increase in the intervention group was significantly higher, resulting in a significantly higher score compared to the post-intervention control group. Adherence, both before and after the intervention, was overall higher in the intervention group compared to the control group. In addition, there was a significant improvement in adherence only in the intervention group while the control group remained at similar levels. The overall quality of life before the intervention did not differ significantly between groups. After the intervention, however, the individuals of the intervention group had significantly higher scores, i.e. a better quality of life than those in the control group. Prior to the intervention, there was no significant correlation between the scale of knowledge and the dimensions of the adherence scale nor between the scale of knowledge and the dimensions of quality of life. There was, however, a significant positive correlation between the «Symptoms» dimension and the overall adherence score as well as adherence to the presence in the hemodialysis session and with the fluids and dietary behavior. After the intervention, there was no significant correlation between the change in the scale of knowledge and the changes in the dimensions of the adherence scale nor between the changes in the knowledge scale and the quality of life dimensions. There was, however, a significant positive correlation between the change in the overall quality of life and the changes in the overall adherence score as well as the adherence to the fluids and the dietary behavior. The change in the knowledge score was found to be negatively related to the years of hemodialysis. Before the intervention, the difference in the «Symptoms» dimension between men and women was indicative (p = 0,084). However, after intervention there was a significant increase only in females (p = 0,004), reaching similar levels to males (p = 0,686). The improvement in the «Symptoms» dimension was significantly higher in women than in men. There was a significant positive correlation between the participants' age and the improvement in the quality of life as a whole and the «Transcendence» dimension.Conclusions: Counseling nursing intervention is a major nursing intervention to improve the level of knowledge, compliance with the healing regimen and quality of life of patients undergoing hemodialysis.Εισαγωγή: Η αιμοκάθαρση αποτελεί την πιο συχνή μέθοδο αντιμετώπισης της Χρόνιας Νεφρικής Νόσου. Η συμβουλευτική παρέμβαση σε ασθενείς που υποβάλλονται σε αιμοκάθαρση θεωρείται ότι αποτελεί σημαντικό παράγοντα που σχετίζεται με τη βελτίωση του επιπέδου συμμόρφωσης στο θεραπευτικό σχήμα και ποιότητας ζωής των ασθενών.Σκοπός: Η εκτίμηση της επίδρασης της συμβουλευτικής νοσηλευτικής στη μεταβολή του επιπέδου γνώσεων, της ποιότητας ζωής και στη συμμόρφωση ασθενών υπό αιμοκάθαρση στο θεραπευτικό σχήμα.Μεθοδολογία: Πρόκειται για οιονεί πειραματική μελέτη παρέμβασης στην οποία συμμετείχαν ασθενείς Τελικού Σταδίου Χρόνιας Νεφρικής Νόσου από τον Νοέμβριο του 2013 έως τον Απρίλιο του 2017. Για τη μέτρηση του επιπέδου γνώσεων των ασθενών που υποβάλλονται σε αιμοκάθαρση χρησιμοποιήθηκε η κλίμακα Kidney Disease Questionnaire, για τη μέτρηση του επιπέδου συμμόρφωσης η κλίμακα GR- Simplified Medication Adherence Questionnaire-HD και για τη μέτρηση του επιπέδου ποιότητας ζωής η κλίμακα Missoula Vitas Quality of Life Index-15. Η στατιστική ανάλυση των δεδομένων έγινε μέσω του στατιστικού πρόγραμματος SPSS 19.0. To επίπεδο στατιστικής σημαντικότητας τέθηκε στο 0,05.Αποτελέσματα: H συνολική αξιοπιστία των ερωτηματολογίων Kidney Disease Questionnaire και GR-Simplified Medication Adherence Questionnaire-HD ήταν υψηλή (συντελεστής Cronbach’s Alpha 0,85 και 0,71 αντίστοιχα). Η μέση ηλικία των ατόμων της ομάδας ελέγχου ήταν 49,8 έτη (TA=8,5 έτη) και των ατόμων της ομάδας παρέμβασης 51,2 έτη (TA=11,5 έτη). Πριν την παρέμβαση οι δύο ομάδες είχαν παρόμοιο επίπεδο γνώσης. Μετά την παρέμβαση σημειώθηκε σημαντική αύξηση και στις δύο ομάδες, όμως, η αύξηση στην ομάδα παρέμβασης ήταν σημαντικά υψηλότερη, καταλήγοντας να έχει σημαντικά υψηλότερη βαθμολογία σε σύγκριση με την ομάδα ελέγχου μετά την παρέμβαση. Η συμμόρφωση, τόσο πριν όσο και μετά την παρέμβαση, ήταν συνολικά υψηλότερη στην ομάδα παρέμβασης σε σύγκριση με την ομάδα ελέγχου. Επίσης, σημειώθηκε σημαντική βελτίωση στη συμμόρφωση μόνο στην ομάδα παρέμβασης ενώ στην ομάδα ελέγχου παρέμεινε σε παρόμοια επίπεδα. Η συνολική βαθμολογία ποιότητας ζωής πριν την παρέμβαση, δεν διέφερε σημαντικά μεταξύ των ομάδων. Μετά την παρέμβαση, όμως, τα άτομα της ομάδας παρέμβασης είχαν σημαντικά υψηλότερη βαθμολογία, δηλαδή καλύτερη ποιότητα ζωής σε σύγκριση με τα άτομα της ομάδας ελέγχου. Πριν την παρέμβαση, δεν υπήρξε σημαντική συσχέτιση μεταξύ της κλίμακας γνώσεων και των διαστάσεων της κλίμακας συμμόρφωσης ούτε και μεταξύ της κλίμακας γνώσεων και των διαστάσεων της ποιότητας ζωής. Υπήρξε, όμως, σημαντική θετική συσχέτιση της διάστασης «Συμπτώματα» με τη συνολική βαθμολογία συμμόρφωσης καθώς και με τη συμμόρφωση με την παρουσία στη συνεδρία και με τα υγρά και τη διαιτητική συμπεριφορά. Μετά την παρέμβαση δεν υπήρξε σημαντική συσχέτιση μεταξύ της μεταβολής της κλίμακας γνώσεων και των μεταβολών των διαστάσεων της κλίμακας συμμόρφωσης ούτε και μεταξύ των μεταβολών της κλίμακας γνώσεων και των διαστάσεων ποιότητας ζωής. Υπήρξε, όμως, σημαντική θετική συσχέτιση της μεταβολής της συνολικής βαθμολογίας ποιότητας ζωής με τις μεταβολές στη συνολική βαθμολογία συμμόρφωσης καθώς και στη συμμόρφωση με τα υγρά και τη διαιτητική συμπεριφορά. Η μεταβολή στη βαθμολογία γνώσεων βρέθηκε να σχετίζεται αρνητικά σημαντικά με τα έτη υποβολής στην αιμοκάθαρση. Πριν την παρέμβαση ήταν ενδεικτική η διαφορά στη διάσταση «Συμπτώματα» μεταξύ αντρών και γυναικών (p=0,084). Ωστόσο, σημειώθηκε σημαντική αύξηση μετά την παρέμβαση μόνο στις γυναίκες (p=0,004), φτάνοντας σε παρόμοια επίπεδα με τους άντρες (p=0,686). Η βελτίωση στη διάσταση «Συμπτώματα» ήταν σημαντικά υψηλότερη στις γυναίκες σε σύγκριση με τους άντρες. Υπήρξε σημαντική θετική συσχέτιση της ηλικίας των συμμετεχόντων με την βελτίωση στην ποιότητα ζωής συνολικά αλλά και τη διάσταση «Πνευματικότητα».Συμπεράσματα: Η συμβουλευτική νοσηλευτική παρέμβαση αποτελεί μια σημαντική νοσηλευτική παρέμβαση για τη βελτίωση του επιπέδου γνώσεων, συμμόρφωσης στο θεραπευτικό σχήμα και ποιότητας ζωής των ασθενών που υποβάλλονται σε αιμοκάθαρση

Recording of the clinical characteristics of critically ill patients attended the ED of Provincial Hospital

Introduction: The invasive mechanical ventilation and non invasive mechanical ventilation is, nowadays, an important treatment procedure for critically ill patients. Aim: the detection of clinical characteristics and outcome of critically ill patients who undergone invasive or non-mechanical ventilation in the Emergency Department of a Provincial Hospital in Peloponnese. Results: On the total132 patients who underwent invasive or noninvasive mechanical ventilation were recorded. Eighty two(62.1%) were males and 48 (36.3%) females. Of these, 52 (39.4%) were diagnosed with Traumatic Brain Injury (TBJ), 20 (15.2%) with coronary heart disease and 18 (13.6%) with respiratory insufficiency. Invasive mechanical ventilation was applied in 75 (56.8%) patients while non-invasive mechanical ventilation was applied in 6 (4.4%).Regarding the outcome, death occurred in the ED for 88 (66.7%) patients, 30 (22.7%) were transferred to ICU and seven (5.3%) were hospitalized in Department of Internal Medicine. Also, a significant correlation (p = <0,001) was found between outcome and gender as, of the 30 patients who were transferred to ICU, 22 (73.3%) were male. Futhermore, it can be proven by thefact that of the 88 patients that died, 54 (61.3%) were also men ( p = <0.001).Conclusions: This study revealed the high numbers of patients undergoing invasive or non-mechanical ventilation at local level, in the Emergency Department of a Provincial Hospital