67 research outputs found
Diversity and ethics in trauma and acute care surgery teams: results from an international survey
Background: Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods: The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results: Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions: Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence: Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance
Team dynamics in emergency surgery teams: results from a first international survey
Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma\u2019s causes or the patient\u2019s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods: An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients\u2019 and stakeholders\u2019 engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion: Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey\u2019s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions
Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study
Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk
Diversity and ethics in trauma and acute care surgery teams: results from an international survey
Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance
The docimologically based evaluation of knowledge in vocational education of healthcare professionals [Dokimološki utemeljeno vrednovanje znanja u strukovnom obrazovanju zdravstvenih radnika]
Diversity of teaching curriculum in vocational subjects requires the application of different didactic-methodical approaches to teaching, and thus different methods for students’ knowledge evaluation. Objective assessment of knowledge is the imperative of the quality vocational education of healthcare professionals; in the evaluation of students’ progress and final assessment of students’ knowledge, the formative and summative methods are commonly used during or after the course of a particular subject. Modern higher education insists on objectivity and scientific foundation of the evaluation process, which is the main reason why the didactic docimology has finally received a deserved place in the pedagogical practice in the last decades. The aim of this paper is to emphasize the importance of the unconditional appliance of scientific principles in students’ knowledge evaluation, critically analyze elements of the existing objective methods of assessment in vocational education of healthcare professionals, and to emphasize the social and professional significance of the student’s final grade, which should be an unambiguous indicator of acquired professional skills of a graduate student of healthcare sciences. © 2020, FACTEACHEREDUCATION. All rights reserved
Containment and therapeutic relationships in acute psychiatric care spaces: the symbolic dimensions of doors
Background: There is an increasing trend of door locking practices in acute psychiatric care. The aim of the present study was to illuminate the symbolic dimensions of doors in Greek mental health nurses’ experiences of open and locked working spaces. Results: A sequential mixed-method designexplored the experiences of nurses working in both open and locked psychiatric acute care units. Participants experiences revealed four types of doors related to the quality of recovery-oriented care: (a) the open door, (b) the invisible door, (c) the restraining door, and (d) the revolving door. Open doors and permeable spacesgenerated trust and facilitated the diffusion of tension and the necessary perception of feeling safe in order to be involved in therapeutic engagement. When the locked unit was experienced as a caring environment, the locked doors appeared to be “invisible”. The restraining doors symbolized loss of control, social distance and stigma echoing the consequences of restrictingpeople’s crucial control over spaceduring the COVID-19 pandemicin relation toviolence within families, groups and communities. The revolving door (service users’ abscondence/re-admission) symbolised the rejection of the offered therapeutic environment and was a source of indignation and compassion fatigue in both open and locked spaces attributed to internal structural acute care characteristics (limited staffing levels, support, resources and activities for service users) as well as ‘locked doors’ in the community (limited or no care continuity and stigma). Conclusions: The impact of COVID-19 restrictions on people’s crucial control of space provides an impetus for erecting barriers masked by the veil of habit and reconsidering the impact of the simple act of leaving the door open/locked to allow both psychiatric acute care unit staff and service users to reach their potential. © 2021, The Author(s)
THE INVESTIGATION OF THE PSYCHOLOGICAL BURDEN OF PATIENTS AFTER HOSPITALIZATION FOR COVID 19
OBJECTIVE: The aim: The current Cross-Sectional study investigated the psychosocial effects on recovered Covid 19 patients in a General Hospital in Greece. It was investigated the impact of Covid 19 on levels of social support, loneliness, resilience & PTSD. Furthermore, the correlation between all the above factors was studied. PATIENTS AND METHODS: Materials and methods: 107 adult patients participated. The questionnaire was fulfilled after signature of consensus form. This happened after their discharge from the hospital, without exclusion of infected on previous time. The questionnaire included 5 particular sections: a) Socio-demographic characteristics, b) social support scale, c) IES Covid 19 scale, d) UCLA scale e) CD-Risc scale. In terms of statistical analysis, the comparison between two groups of quantitative variables was conducted through Student's t-test. Related to examination of relationship between two quantitative variables was used Pearson's correlation coefficient (r). The Statistical analysis package used was SPSS 22. RESULTS: Results: The 55,1% of sample were women, married (57,9 %) and (39,3%) university graduates. Moreover, the rate of overweight was significant (39,3%). Related to psychosocial factors, observed high level of resilience (70,6), moderate level of loneliness (39,1) and 57,9% of participants showed moderate social support. At last, PTSD level as a result of Covid 19 was moderate (33,5). A strong correlation was observed between higher mental resilience and lower feelings of loneliness. CONCLUSION: Conclusions: The levels of determining factors of negative psychological effects, reveal the need for a preparation of political improvement policies in relation to mental health of rehabilitated persons, as well as the promotion of actions that would contribute to the development of a more effective supportive framework
THE IMPACT OF MENTAL HEALTH, SUBJECTIVE HAPPINESS AND RELIGIOUS COPING ON THE QUALITY OF LIFE OF NURSING STUDENTS DURING THE COVID-19 PANDEMIC
OBJECTIVE: The aim of this study is to examine the effect of psychological distress and religious coping in quality of life of nursing students during the second wave of the pandemic in Greece. PATIENTS AND METHODS: Materials and methods: A cross-sectional online survey was conducted among nursing students. Data were collected via an e-survey consisting of five parts including HADS Questionary, SF-36, B-RCOPE and Subjective Happiness scale. RESULTS: Results: From the total of 200 nursing students the 86.5% were female, 35.5% were in their first year of study, 54% were single and 65.5 were urban residents. 51.9% of the students were experiencing anxiety and 31,5% were depressed. In regard to subjective happiness, the mean value was 4.51±1.27. In addition, the majority of the students consider themselves unhappy (67.5%). Finally, in regard to SF-36 scores, we observed that PCS mean score was 68.49±13.19, MCS56.12±24.23. Depression, as well as negative religious coping, can have a negative effect on both physical and mental health components of quality of life. CONCLUSION: Conclusions: Nursing students experience very high levels of stress and anxiety during the COVID-19 pandemic and need support and guidance to better manage stress and fear in this unusual situation
The relationship between perceptions of racism and self-compassion in Greek university students
OBJECTIVE To investigate the relationship between perceptions of racism, socio-demographic characteristics and levels of self-compassion in Greek university students. METHOD A cross-sectional, online study was conducted with 251 students of two departments of the University of the Peloponnese in Tripolis. The questionnaire included sociodemographic characteristics, the Self-Compassion Scale (SCS) and the Perceived Impact of Racism scale. Data analysis was conducted with the Statistical Package for Social Sciences (IBM SPSS), version 20.0. RESULTS A total of 251 students completed the questionnaire, with an average age of 23.9±6.6 years, 173 of whom were women (68.9%). On the SCS, the participants scored the highest on the mindfulness subscale (3.11±0.90), followed by the self-criticism (2.88±0.89) and over identification (2.86±0.93) subscales. On the scale Perceived Impact of Racism scale, the highest score was recorded on the subscale of “racism” as a major problem, but with a mean score lower than the median, indicating that the participants did not recognize racism as a major problem. Regarding socio-demographic characteristics, statistically significant correlation was demonstrated between racist perceptions and gender, age, and religious beliefs. CONCLUSIONS These results confirm the findings of the current literature, showing correlation of selfcompassion with non-manifestation of racist perceptions. © Athens Medical Society
Factors Affecting Greek Nurses’ Caring Behaviors: The Role of Nurses’ Spirituality and the Spiritual Climate of Hospitals
The aim of the present study was to examine the effect of nurses’ personality, spirituality, and spiritual care in nurses’ caring behaviors. A descriptive, cross-sectional study was conducted in two hospitals, located in Athens, Greece. Data were collected by a four-part self-reported questionnaire. The results showed that work experience seems to play an important and positive role on nurses’ caring behaviors, and all personality traits, except neuroticism. Also, spirituality and spiritual climate are significant factors predicting nurses' caring behaviors. Moreover, a hospitals’ spiritual climate can positively influence all domains of nursing care (p < 0.001). Nurses spirituality (faith) and hospital spiritual climate can also positively influence nursing care. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature
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