Psychological support and quality of life in patients with gynecological cancer

The gynecological cancer is the fourth in rate of occurrence in women and its treatment has a significant impact on their quality of life. The aim of the present study was to review the literature related to the impact of cancer on the quality of women’ life, the psychosocial adjustment of women and the possible ways of psychological support. A search was conducted using the CINAHL, Medline, Google, and PubMed. The quality of life of women facing gynecological cancer is significantly affected. Various changes in the everyday life of the patients are observed as well as psychological exhaustion, which often occurs with depressive symptoms including fear and strong anxiety leading sometimes to panic. Sexual disorders also occur, and support should be immediately provided, prior to the announcement of the bad news from a health care professional. The supportive psychotherapy group contributes to the full understanding of the different aspects of the problem. It is also important for the patient to realize that she is not alone in coping with this difficult problem. The use of specific cognitive and behavioural methods can change her way of thinking and coping with her problem by using the most efficient ways. The diagnosis of gynecological cancer can, in many cases, cause severe anxiety and depression. The role of the nurse is important in psychological support and generally in dealing with problems arising from its treatment

HEART FAILURE, DEPRESSION AND EXERCISE

Introduction: Patients with heart failure have high rates of physical disability, based on self-reported difficulty in performing daily living activities. Depression is also a disease entity that has a high co-morbidity in combination with heart failure. Beyond the usual medical care of heart failure, there is a plethora of research on the contribution of exercise to cardiovascular parameters and to the muscular system of patients with heart failure, its effect on their quality of life and relief of depression symptoms. Purpose: The purpose of this study is to highlight the positive effect of exercise on patients with heart failure experiencing depression. Methodology: The study material consisted of articles on the topic, found in Greek and international databases such as: Google Scholar, Mednet, Pubmed, Medline and the Hellenic Academic Libraries Association (HEAL-Link), using the appropriate keywords: heart failure, depression, exercise programs. Results: Depression affects the clinical course and prognosis of patients with heart failure. The coexistence of depression and chronic heart failure leads to an increase in mortality. The benefits of exercise, therefore, in patients with heart failure and depression have a positive impact on the patients' quality of life by contributing to increasing their functional status, reducing their re-admissions to the hospital and relieving the symptoms of depression. Conclusions: The high incidence of depression in patients with chronic heart failure requires measures to prevent it, such as exercise. Health professionals need to help patients understand their condition and follow therapeutic guidelines, as well as therapeutic exercise, which can improve their lifestyle and behavior, and help them prevent depression symptoms and promote their quality of life

IMMIGRATION AND MENTAL DISORDERS

Introduction: Immigration is the movement of people into a country where they will remain as its permanent residents or future citizens without having citizenship. Purpose: The purpose of this review study is to highlight the impact of immigration on the mental health of immigrants and to identify the mental disorders from which immigrants are at risk of getting ill. Methodology: The study material consisted of articles on the topic, found in Greek and international databases such as: Google Scholar, Mednet, Pubmed, Medline and the Hellenic Academic Libraries Association (HEAL-Link), using the appropriate keywords: mental illness, immigrants, treatment. Results: It is estimated that two-thirds of refugees - migrants experience anxiety and depression. Studies show that these are populations with severe social problems, unmet needs, and a range of mental health problems such as depression, panic attacks, social phobia, generalized anxiety disorder, suicidal ideation, and post-traumatic stress disorder (PTSD). Conclusions: Addressing the mental health problems of immigrants and refugees can only be holistic. It requires much more psychosocial interventions and practical solutions, always combined with culturally appropriate psychological support methods

Sleep and Health: Role of Dopamine

Introduction: Sleep is an important part of people’s lives and proper sleep is a prerequisite for good health

In-hospital informal caregivers' needs as perceived by themselves and by the nursing staff in Northern Greece: A descriptive study

<p>Abstract</p> <p>Background</p> <p>Informal care is common in many countries, especially in Greece, where families provide care in hospitals. Health education and informational needs are important factors for family members which are often underestimated by nursing staff. The aim of this study was to compare the perceptions of the nurses and the in-hospital informal caregivers about the in-hospital informal caregivers' knowledge and informational needs, as well as the factors that influence these perceptions.</p> <p>Methods</p> <p>This was a non-experimental descriptive study conducted in three general hospitals in Greece. The sample consisted of 320 nurses and 370 in-hospital informal caregivers who completed questionnaires. Descriptive statistics were analyzed using t-tests; group comparisons were conducted using ANOVA.</p> <p>Results</p> <p>The score of the questionnaire for health education and informational needs was significantly greater for informal caregivers (57.1 ± 6.9 and 26.6 ± 2.8) than for nurses (53.4 ± 5.7 and 22.4 ± 3.1) (p < 0.001). For the nursing staff, the factors that influence the informational needs of patients' caregivers were <it>level of education </it>and <it>working experience</it>, while for the caregivers the <it>level of education </it>was independently associated with the score for the health education needs. Finally, <it>age, marital status</it>, and <it>level of education </it>of informal caregivers' were independently associated with informational needs.</p> <p>Conclusions</p> <p>The in-hospital informal caregivers perceived that they have more educational and informational needs than the nurses did. The findings of this study also show that the nursing staff has to identify the needs of in-hospital informal caregivers in order to be able to meet these needs.</p

Does Audit Improve the Quality of Care?

BACKGROUND: The quality of health care and quality assurance are concepts which have been established for many years. Audit nowadays is adopted as a means of developing high quality care.AIM: This study aims to identify the perspectives of audit in practice and its relationship to quality assessment and assurance, quality improvement, and clinical effectiveness.METHODS: There were used the databases Medline and Cinahl to identify studies related to clinical audit. These databases were searched up to May 2009.DISCUSSION: Audit is used as a tool to assure and assess the quality of patient health care. It is also an educational tool as it creates a lot of opportunities for professionals to think about practice and to learn from the experience of others.CONCLUSIONS: Although that audit is a powerfull and useful tool to improve and evaluate the quality of health care, on the other hand there are many barriers that make its use difficult in everyday practice

The effect of breathing exercises in the respiratory function, postoperative course and nursing care of patients undergoing coronary artery bypass graft surgery

Patients who undergo coronary artery bypass graft surgery (CABG), known as bypass, often have complications in the respiratory system resulting in aggravation of their postoperative status. The aim of the research was to study the effect of pre-operative respiratory exercise on postoperative respiratory function in patients undergoing this procedure and evaluate the postoperative course of such patients. Fifty-one patients, aged 46-79, who were about to undergo CABG in the 1st Department of Thoracic and Cardiovascular Surgery of "AHEPA" Hospital were randomly divided into two groups. One group, consisting of 26 patients, attended a preoperative respiratory exercise training program starting from the first day of admission in the hospital until one day prior to the operation, while the other group consisting of 25 patients did not exercise at all; the latter was the control group. The program included respiratory exercises (10 inspiratory and 10 expiratory exercises each time), which were repeated ten times a day, using the Triflo II Respiratory Exerciser. The exercises were performed daily from the first day of admission in the hospital until one day prior to the operation (4-11 days). All participants underwent spirometry tests for the evaluation of the respiratory parameters FEV₁, FVC, FEF₂₅₋₇₅ and the inspiratory and expiratory mouth pressures (PImax and PEmax). The measurements were performed the first day of admission, the day before the operation, the day after discharge from the Intensive Care Unit (ICU) and the day of discharge from the hospital. Furthermore, arterial blood gas (PaO₂, PaCO₂) analysis was performed during the stay of the patients in ICU. Finally, the hours of patients' mechanical ventilatory support and hospitalization in ICU were recorded. According to the results, a significant improvement was observed in FEV₁ and FVC parameters, and marginally statistically significant improvement for FEF₂₅₋₇₅ in patients who exercised. Regarding PΙmax and PΕmax parameters that prove the respiratory muscles strength, only PΕmax demonstrated a statistically significant improvement. The arterial blood gas analysis revealed significant rise in PaO₂ without any change in PaCO₂ values. Finally, the hours of mechanical support and the days of hospitalization in ICU were reduced significantly in the group that performed the exercises. In conclusion, the implementation of respiratory exercises prior to CABG seems to improve the respiratory function and have positive effect on the postoperative course of the patients.Οι ασθενείς που υποβάλλονται σε εγχείρηση αορτοστεφανιαίας παράκαμψης (coronary artery bypass graft surgery - CABG), τη γνωστή ως bypass, αντιμετωπίζουν συχνά επιπλοκές από το αναπνευστικό σύστημα με συνέπεια την επιβάρυνση της μετεγχειρητικής τους κατάστασης. Σκοπός της έρευνας ήταν να μελετήσει την επίδραση των προεγχειρητικών αναπνευστικών ασκήσεων στη μετεγχειρητική λειτουργία του αναπνευστικού συστήματος ασθενών που υποβάλλονται στην εγχείρηση αυτή και να εκτιμήσει τη μετεγχειρητική τους πορεία. Πενήντα ένας ασθενείς, ηλικίας 46-79 ετών, οι οποίοι επρόκειτο να υποβληθούν σε εγχείρηση αορτοστεφανιαίας παράκαμψης στην Α΄ Κλινική Θώρακος Καρδιάς και Μεγάλων Αγγείων του νοσοκομείου ΑΧΕΠΑ χωρίστηκαν τυχαία σε δύο ομάδες. Η μία ομάδα αποτελούμενη από 26 ασθενείς ακολούθησε πρόγραμμα αναπνευστικής γυμναστικής προεγχειρητικά, από την πρώτη ημέρα εισαγωγής στο νοσοκομείο έως την προηγούμενη της εγχείρησης ημέρα, ενώ η άλλη ομάδα αποτελούμενη από 25 ασθενείς δεν ασκήθηκε και αποτέλεσε την ομάδα ελέγχου. Το πρόγραμμα περιελάμβανε αναπνευστικές ασκήσεις (10 ασκήσεις εισπνοής και 10 εκπνοής κάθε φορά) με το αναπνευστικό ασκησιόμετρο Triflo II, οι οποίες επαναλαμβάνονταν δέκα φορές την ημέρα. Οι ασκήσεις γινόταν καθημερινά από την πρώτη ημέρα εισαγωγής των ασθενών στο νοσοκομείο έως την προηγούμενη της εγχείρησης ημέρα (4-11 ημέρες). Όλοι οι συμμετέχοντες υποβάλλονταν σε σπιρομέτρηση για την εκτίμηση των αναπνευστικών παραμέτρων FEV₁, FVC, FEF₂₅₋₇₅ και της εισπνευστικής και εκπνευστικής πίεσης στόματος (PImax και PEmax). Οι μετρήσεις γίνονταν την πρώτη ημέρα εισαγωγής στο νοσοκομείο, την προηγούμενη της εγχείρησης ημέρα, την επόμενη της εξόδου από τη Μονάδα Εντατικής Θεραπείας (ΜΕΘ) και την ημέρα εξόδου από το νοσοκομείο. Επίσης γινόταν ανάλυση αερίων αρτηριακού αίματος (PaO₂, PaCO₂) κατά την παραμονή των ασθενών στη ΜΕΘ. Τέλος, καταγράφηκαν οι ώρες μηχανικής υποστήριξης της αναπνοής και οι ημέρες παραμονής στη ΜΕΘ. Τα αποτελέσματα έδειξαν σημαντική βελτίωση για τις παραμέτρους FEV₁ και FVC, και οριακά στατιστικά σημαντική για την FEF₂₅₋₇₅ στους ασθενείς που ασκήθηκαν. Όσον αφορά τις παραμέτρους PImax και PΕmax, οι οποίες δείχνουν τη δύναμη των αναπνευστικών μυών, στατιστικά σημαντική βελτίωση εμφάνισε μόνο η PΕmax. Από την ανάλυση των αερίων του αρτηριακού αίματος προέκυψε σημαντική αύξηση στις τιμές της PaO₂, χωρίς μεταβολή των τιμών της PaCO₂. Τέλος διαπιστώθηκε σημαντική ελάττωση στις ώρες της μηχανικής υποστήριξης και στις ημέρες παραμονής στη ΜΕΘ για την ομάδα που ασκήθηκε. Συμπερασματικά, η εφαρμογή των αναπνευστικών ασκήσεων πριν από τις εγχειρήσεις αορτοστεφανιαίας παράκαμψης φαίνεται ότι βελτιώνει την αναπνευστική λειτουργία και έχει θετική επίδραση στην μετεγχειρητική πορεία των ασθενών

CHILD SUICIDE: FAMILY’S REACTIONS

Introduction: Suicide is a major public health problem, in which relatives play an important role in the prevention of the said problem. However, suicide and suicidal behavior affect the relatives’ lives profoundly, both emotionally and socially. Aim: This study is an initial investigation of families’ emotional and behavioral responses to adolescents’ suicide Methodology: An extensive literary review of relevant articles for the period 2000-2017, was performed using Medline, PubMed and Google databases, with the following key words: “child suicide, parent’s reactions, bereavement, risk factors, warnings sign, and mental health problems”. Results: Suicide is uncommon in childhood but becomes an extremely serious issue among adolescents. Several risk factors have been identified and include the presence of psychiatric illness, a previous suicide attempt, family factors, substance abuse, sexual and physical abuse, or bullying. The death of a child of any age is extremely painful for parents. Most parents experience a profound sense of guilt, shame, pain, depression when harm comes to their child, even if through no fault of their own. The same feelings are often present and are associated with help seeking in siblings bereaved by suicide. All of these factors lead to a devastating grief that is much longer lasting than most people realize. Conclusion: Families that have experienced a suicide present severe prolonged grief with many psychological and physical symptoms such as depression, feelings of guilt, shame, pain, heart failure, hypertension, diabetes. However, the psychosocial impact on families is a very important issue who needs further investigation