Self-care management, knowledge, self-efficacy for medication and Quality of Life in chronic heart failure 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

CLINICAL NURSING ASSESSMENT OF SURGICAL ELDERLY PATIENTS

THE PURPOSE OF THIS STUDY IS THE NURSING ASSESSMENT OF SURGICAL ELDERLY PATIENTS TO BE USED AS A BASE OF QUALITY IMPROVEMENT OF NURSING CARE FOR SURGICAL AGEDPATIENTS IN OUR COUNTRY. THIS IS AN ACTUAL RESEARCH STUDY COMPOSED OF A SAMPLEOF 200 PATIENTS WHO WERE INVESTIGATED DURING THEIR TREATMENT. THE CRITERIA OF SELECTION OF THE ELDERLY POPULATION WERE: PATIENTS OF BOTH SEXES, OVER 65 YEARS, OF AGE, FOIUND IN THE GENERAL SURGICAL TREATMENTS, WITHOUT MOBILITY PROBLEMS PREOPERATIVELY AND THE MEDICAL DIAGNOSIS TO BE IN GENERAL SURGERY FIELD. ELDERLY PATIENTS WHO WERE UNDERGOING EMERGENCY SURGERY WERE NOT INCLUDED. THE SAME FORM OF NURSING ASSESSMENT WAS FILLED FOR EVERY PATIENTS, DURING HIS HOSPITAL STAY. THE ELEMENTS OF NURSING ASSESSMENT CONCERNS THE PHYSICAL HEALTH AND THE MENTAL HEALTH OF OUR PATIENTS. THE STATISTICAL ANALYSIS OF DATA WAS DONE WITH MULTIPLE REGRESSION AND T-TEST. THE RESULTS O#C#CTHIS STUDY LEAD TO CONCLUSIONS: 1) MALE ELDERLY PATIENTS APPEARED TO HAVE MORE PHYSICAL NEEDS, 2) THE MOST FREQUENT NURSING PROBLEMS WERE: A) THE NEED OF PATIENT TO BE SUPPORTED IN ORDER TO BE ABLE TO WALK, B) HIGH BLOOD PRESSURE, C) CATHETER SET IN THE BLADDER, D) PAIN, E) PARENTERAL DIET, F) SPECIAL DIET, G) OPEN TRAUMA, H) VOMITING, 3) THE ABILITY OF THE PATIENT TO RECOGNIZE PLACE, TIME AND PERSONS, HIS SOCIABILITY. THE NURSING ASSESSMENT SHOULD TAKE PLACE BEFORE AND IMMEDIATELY AFTER THE OPERATION. FINALLY, A FORMULATED NURSING ASSESSMENT FORM FOR SURGICAL ELDERLY PATIENTS IS PROPOSED.ΣΚΟΠΟΣ ΤΗΣ ΔΙΑΤΡΙΒΗΣ ΕΙΝΑΙ Η ΝΟΣΗΛΕΥΤΙΚΗ ΑΞΙΟΛΟΓΗΣΗ ΤΩΝ ΧΕΙΡΟΥΡΓΗΜΕΝΩΝ ΥΠΕΡΗΛΙΚΩΝ, ΩΣΤΕ Η ΜΕΛΕΤΗ ΑΥΤΗ ΝΑ ΑΠΟΤΕΛΕΣΕΙ ΒΑΣΗ ΓΙΑ ΠΟΙΟΤΙΚΗ ΒΕΛΤΙΩΣΗ ΤΗΣ ΝΟΣΗΛΕΥΤΙΚΗΣ ΦΡΟΝΤΙΔΑΣ ΤΩΝ ΧΕΙΡΟΥΡΓΗΘΕΝΤΩΝ ΥΠΕΡΗΛΙΚΩΝ ΣΤΗΝ ΠΑΤΡΙΔΑ ΜΑΣ. Η ΔΙΑΤΡΙΒΗ ΕΙΝΑΙ ΣΥΓΧΡΟΝΙΚΗ ΜΕΛΕΤΗ ΚΑΙ ΠΕΡΙΛΑΜΒΑΝΕΙ 200 ΑΣΘΕΝΕΙΣ ΚΑΤΑ ΤΗΝ ΔΙΑΡΚΕΙΑ ΝΟΣΗΛΕΙΑΣ ΤΟΥΣ. ΤΑ ΚΡΙΤΗΡΙΑ ΕΠΙΛΟΓΗΣ ΤΟΥ ΠΛΗΘΥΣΜΟΥ ΑΝΑΦΟΡΑΣ ΗΤΑΝ: ΑΤΟΜΑ ΚΑΙ ΤΩΝ ΔΥΟ ΦΥΛΩΝ, ΑΝΩ ΤΩΝ 65 ΕΤΩΝ, ΧΕΙΡΟΥΡΓΙΚΟΙ ΟΛΟΙ ΟΙ ΜΕΤΕΧΟΝΤΕΣ ΣΤΗΝ ΕΡΕΥΝΑ, ΑΠΟΥΣΙΑ ΠΡΟΒΛΗΜΑΤΟΣΚΙΝΗΤΙΚΟΤΗΤΟΣ ΠΡΟΕΓΧΕΙΡΗΤΙΚΑ ΩΣΤΕ ΝΑ ΜΠΟΡΕΙ ΝΑ ΓΙΝΕΙ ΑΞΙΟΛΟΓΗΣΗ ΤΟΥ ΕΠΙΠΕΔΟΥ ΚΙΝΗΤΙΚΟΤΗΤΑΣ ΜΕΤΑ ΤΗΝ ΕΠΕΜΒΑΣΗ, ΥΠΑΡΞΗ ΔΙΑΓΝΩΣΗΣ ΚΑΠΟΙΑΣ ΠΑΘΗΣΗΣ ΓΕΝΙΚΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ. ΔΕΝ ΛΗΦΘΗΚΑΝ ΑΣΘΕΝΕΙΣ ΥΠΕΡΗΛΙΚΕΣ ΟΙ ΟΠΟΙΟΙ ΧΕΙΡΟΥΡΓΗΘΗΚΑΝ ΕΚΤΑΚΤΩΣ. ΓΙΑΚΑΘΕ ΑΤΟΜΟ ΣΥΜΠΛΗΡΩΘΗΚΕ ΤΟ ΑΥΤΟ ΕΙΔΙΚΟ ΔΕΛΤΙΟ ΝΟΣΗΛΕΥΤΙΚΗΣ ΑΞΙΟΛΟΓΗΣΗΣ ΓΙΑ ΟΛΕΣ ΤΙΣ ΜΕΡΕΣ. ΤΑ ΣΤΟΙΧΕΙΑ ΝΟΣΗΛΕΥΤΙΚΗΣ ΑΞΙΟΛΟΓΗΣΗΣ ΑΦΟΡΟΥΣΑΝ ΤΗΝ ΣΩΜΑΤΙΚΗ ΚΑΙ ΨΥΧΙΚΗ ΚΑΤΑΣΤΑΣΗ ΤΩΝ ΑΡΡΩΣΤΩΝ. Η ΣΤΑΤΙΣΤΙΚΗ ΑΝΑΛΥΣΗ ΕΓΙΝΕ ΜΕ ΤΗΝ ΜΕΘΟΔΟ ΤΗΣ ΠΟΛΛΑΠΛΗΣ ΕΞΑΡΤΗΣΗΣ ΚΑΙ ΤΗΝ ΜΕΘΟΔΟ Τ-TEST. ΤΑ ΑΠΟΤΕΛΕΣΜΑΤΑ ΟΔΗΓΟΥΝ ΣΤΑ ΕΞΗΣ ΣΥΜΠΕΡΑΣΜΑΤΑ: 1) ΠΕΡΙΣΣΟΤΕΡΕΣ ΣΩΜΑΤΙΚΕΣ ΑΝΑΓΚΕΣ ΠΑΡΟΥΣΙΑΖΟΥΝ ΟΙ ΑΝΔΡΕΣ ΑΣΘΕΝΕΙΣ. 2) ΤΑ ΣΥΧΝΟΤΕΡΑ ΝΟΣΗΛΕΥΤΙΚΑ ΠΡΟΒΛΗΜΑΤΑ ΕΙΝΑΙ: 1) ΙΚΑΝΟΤΗΤΑ ΒΑΔΙΣΜΑΤΟΣ ΤΟΥ ΑΡΡΩΣΤΟΥ ΜΕΑΝΘΡΩΠΙΝΗ ΒΟΗΘΕΙΑ, Β) ΑΡΤΗΡΙΑΚΗ ΥΠΕΡΤΑΣΗ, Γ) ΤΟΠΟΘΕΤΗΜΕΝΟΣ ΚΑΘΕΤΗΡΑΣ ΟΥΡΟΔΟΧΟΥΚΥΣΤΕΩΣ, Δ) ΠΟΝΟΣ, Ε) ΠΑΡΕΝΤΕΡΙΚΗ ΣΙΤΙΣΗ, ΣΤ) ΕΙΔΙΚΗ ΔΙΑΙΤΑ, Ζ) ΑΝΟΙΚΤΟ ΤΡΑΥΜΑ, Η) ΕΜΕΤΟΙ, 3) ΠΡΟΣΑΝΑΤΟΛΙΣΜΟΣ ΣΕ ΧΡΟΝΟ, ΧΩΡΟ, ΠΡΟΣΩΠΑ, ΟΜΙΛΗΤΙΚΟΤΗΤΑ . Η ΝΟΣΗΛΕΥΤΙΚΗ ΑΞΙΟΛΟΓΗΣΗ ΠΡΕΠΕΙ ΝΑ ΓΙΝΕΤΑΙ ΠΡΙΝ ΚΑΙ ΜΕΤΑ #CΤΗΝ ΕΓΧΕΙΡΗΣΗ. ΠΡΟΤΕΙΝΕΤΑΙΕΝΑ ΕΝΤΥΠΟ "ΔΕΛΤΙΟ ΝΟΣΗΛΕΥΤΙΚΗΣ ΑΞΙΟΛΟΓΗΣΗΣ ΧΕΙΡΟΥΡΓΗΜΕΝΟΥ ΥΠΕΡΗΛΙΚΑ". ΝΟΣ ΑΞΙΟΛΟΓΗΣΗΣ ΧΕΙΡΟΥΡΓΗΜΕΝΟΥ ΥΠΕΡΗΛΙΚΑ"

Corruption in healthcare services and the game theory model

Introduction: It is intelligentia communis that Healthcare services, worldwide, suffer from corruption, thereby disrupting the social web of protection of the most important good, which is health. The Game Theory (GT), applied in situations of social dilemmas, highlights issues of personal benefits prioritization that eventually end up at the expense of the total as well as the individual. Aim: The aim of the present study was to explore corruption in the Greek healthcare services, to highlight its underlying causes, to record the socio-economic impact in the light of the GT. In addition the paper aims at highlighting the prevention and coping policies of this major problem. Μethods: An extensive literature review was conducted in various databases, such as “PubMed/ Medline”, “Embase”, “Cinahl”, “Cochrane”, in websites of various international organizations, Greek and foreign institutions, using, in Greek and English, key-words such as “corruption” , “fraud”, “black economy”, “Greek Health System”, “Game Theory”. The study included 195 publications, accepting finally those published in the last twenty-five years in Greek and English language. Results: Imoralisation of Healthcare Services is diminishing the principles of equality-accessibility- efficiency-effectiveness on which the modern Greek National Healthcare System (NHS) was built. Furthermore, it violates fundamental human rights. The amoralist activities involve all healthcare providers, are combined with a high level of general social corruption and have a direct, negative impact on the health status of Greek citizens, directly affecting the less privileged citizens. In recent years, healthcare system reforms have been structural and multilevel, with measures being taken to tackle and modify the actual background that has, overtime, nurtured corruption. Conclusions: Changing the citizens’ philosophy and attitude against the phenomenon of corruption, is the key to determine the effectiveness of any measure taken. In a zero-sum game, confinement of healthcare partners to the exclusive claim of their individual/corporate interests acts as a coil of distortion of the wider social development and normality. The fight against corruption requires a transition to a new “Social Contract” with eagerness, resolute determination by political leaders, multi-sectoral interventions at legal/managerial level, and coordination of the efforts of all with a sense of esprit de corps

Evaluation of Pupils&rsquo; Knowledge about Kidney Health

The purpose of this study was to investigate the level of renal function knowledge of primary school pupils in Greece. We conducted a cross-sectional study with a convenience sample of 220 pupils, coming from the 5th and 6th grades of general education schools. A questionnaire consisting of 11 questions was developed from scratch. However, based on an analysis of Cronbach&rsquo;s alpha values obtained when individual questions were deleted, two questions were removed from the analysis, and only nine remained for analysis and participated in the calculation of the knowledge score. Moreover, the gender and daily habits of pupils regarding water consumption and frequency of urination were recorded. Pupils had a high percentage of correct knowledge about the number of kidneys (95.2%), whether a child may have problems with the kidneys (85.5%) and whether a person can survive with one kidney (68.5%). Low levels of knowledge were observed in the function and role of the kidneys (36.4%), as well as the part of the body where the kidneys are located (30.9%). The median (interquartile range (IQR)) total knowledge score was 6 (5&ndash;7), with no difference detected between genders (p = 0.135). A statistically significant difference between pupils of 5th and 6th grades was found but the difference did not seem to be clinically significant (p = 0.035). The present research demonstrates that pupils&rsquo; knowledge of renal function and the protection of their kidneys needs improvement

Health executives’ perceptions on marketing in health services: an empirical study in 9 hospitals of Attica

Introduction: The international financial crisis in combination with the aging population and the appropriation of funds of health services impose the management of hospital services as a necessity for the surviving of hospitals. Aim: To examine the perceptions of upper administrative hospital executives (Nursing, Medicine and Administrative services) in the wider region of Attica, on marketing, communication, and public relations in health. Materials and method: The research tool was a questionnaire that was titled “Attitudes and perceptions of health executives on marketing in health”. Section I, included 8 questions (questions 1-8) of which 3 collected information on the sex, the age and the level of education of those questioned. Section II, consisted 21 closed questions searching about the attitudes and perceptions of the people in the sample about marketing as activity in the area of health. Population study: Four hundred and fifty (450) higher health executives from the three basic fields of service in health institutions (medical, nursing, administration) constituted the total sample in the research. Results Most executives (n=216, percentage 48%) had favorable perceptions on the application of marketing in health services, quite a few executives (n=193, percentage 42,9%) had mediocre perceptions whereas a comparatively small number of these(n=41, percentage 9,1%) recorded a negative opinion. The women and older executives appeared to have a more positive stance compared to men (p=0,021) and younger executives (p=0,000). Nurses supported more intensely than doctors that the students of nursing had to have knowledge in marketing so that they are more equipped for their career. Nursing more than medical and administration personnel agreed with the perception that supports that marketing will decrease the dominance of the medical profession in the field of health. Conclusions: People in the survey even though they had some reservations they formed a favorable attitude towards marketing and its application in the field of health An extremely high percentage of the participants in the research agreed that marketing is an activity that needs to definitely be applied by health professionals. Also the majority of the people in the sample agreed that marketing will play a major role in the future in the accomplishment of the health organization’s goals

Factors That Influence the Relationship Between Social Support and Health-Related Quality of Life of Older People Living in the Community

As the proportion of older people in Greece grows and the need for promoting healthy aging is apparent, it becomes increasingly important to investigate the relationship between social support and health-related quality of life (HRQoL) of older people in the community. A cross-sectional study was conducted in 451 older people living in the community in greater Athens, Greece, with an anonymous questionnaire, including demographics, and the EQ5D including EuroQol-visual analogue scale (EQ-VAS) and the Multidimensional Scale of Perceived Social Support. Multivariate linear regression analysis was applied to identify independent factors related to perceived social support and HRQoL. The majority of older people were women, married or widowed, living with their family or alone. Perceived social support was medium and higher from significant others and family. A statistically significant positive relationship was found between social support from significant others/friends and HRQoL, as well as between social support from friends/family/significant others and EQ-VAS. In conclusion, HRQoL of older people is influenced by the received social support

Health Related Quality of Life in a Sample of Older People who are Members of Open Care Centers for the Elderly

The consequences of demographic ageing, demographic and social-economic changes, changes in the structure of family, in the shrinkage of Welfare state, influenced the lifestyle of the older people and their social relations. The institution of Open Care Centers for the Elderly (KAPI) was created in the context of these conditions. This cross-sectional study examined the lifestyle of the older people who are member of KAPI and their association with all HRQoL dimensions. The results of this research showed that the main reason for the participants to become members of the KAPI was entertainment and/or companionship (98.4%). Additionally subjects who suffered from a chronic disease had significantly lower scores on all HRQoL dimensions, while participants who were members in the activity groups of KAPI had significantly higher scores. The elderly within the KAPI have many opportunities to meet with other persons of their age, and develop various activities and interests