Diabetic Patients are often Sub-Optimally Aware about their Disease and its Treatment

Background: Diabetes mellitus (DM) represents a continuously growing worldwide threat with major financial impact on the healthcare systems. The importance of tight glycaemic control in patients with DM type II is well established and is most effectively accomplished with the proper cooperation of both the treating physicians aswell as the treated subjects.Aims: The aim of our study was to evaluate the level of awareness of patients with DM type II about the various aspects of DM, including the nature of the disease, its precipitating factors and complications, as well as its treatment.Methodology: The patients were asked to complete anonymously a questionnaire concerning their knowledge about diabetes, its basic pathophysiology and complications, the treatment options and possible side-effects. Data were analyzed using STATA statistical software (Version 9.0).Results: Eighty patients were on oral hypoglycaemic agents (OHA), 34 on insulin while 4 were under a hybrid treatment. Among patients on OHA, 40 patients (50%) were taking a combination of them. 13.4% of the sample was aware of what DM stands for, 84.9% did not know the type of DM they were suffering from, while (85.7%) considered that obesity plays a major role in the pathogenesis of DM. Concerning the therapy of DM, only 54.83% of the patients were aware of the brand names of their antidiabetic medication, 88.2% did not know theirway of action, while 60.5% did not know the possible side effects. The majority of the sample, 60.5%, assumed that blood glucose should be measured only before meals.Conclusions: The knowledge of the subjects visiting the center for the first time was found to be inadequate. This is probably due to inadequate information, non-availability of educational material and improper guidance

The Importance of the Early Sending to the Nephrology Team within the Health Promotion

Introduction: The kidney disease is a common situation, it is accompanied by a significantmorbidity/mortality and despite the development of substitution renal functions methods (SRFM) and transplantation, the prognosis is unfavorable.Aim: The aim of the present review is the assessment of the necessity for sending to theNephrology Team (NT) in the early stage of RF.Results: Lately, it has been documented that the timely sending to the NT, can significantlyimprove the survival of patient with kidney disease. On the contrary, the delayed sending has asa result not only the non timely measure uptake for the delay of the loss of renal function, butalso the later therapy for the uremic complications.According to Eadington (1996) the sending is considered as a delayed, when the provision ofhealthcare services could be improved with the timely contact with the Nephrology Services.Both in Europe and North America, the delayed sending comes up to the 30-40% of people whoare inducted in dialysis.The benefit from the early sending to the NT, it is important and consists of the regimens forthe delay of the kidney disease development,, timely information for the patient about theSRFM, timely vascular preparation or other kind of accessibility, non-urgent dialysis initiation,patients’ training, lower financial cost, less hospitalization days, transplantation preparation andlower mortality.Conclusions: Optimal sending is the timely sending since it makes possible the diagnosis, thedelay of the development of KD and the prevention of the complications. Furthermore, givestime for the appropriate medical and psychological preparation of the patient and the initiation ofdialysis in the appropriate time.The measures which should be adopted include the improvement training and communication ofhealthcare workers and services interference, as well as the enactment of guidelines

Nicotine addiction and smoking cessation strategies

The use of tobacco was first reported in the 6th century BC, but the 20th century has been marked by the widespread use of tobacco and the establishment and expansion of large tobacco companies. The public health community did not address initially smoking as harmful and addictive, despite the fact that many other observers of human behavior (authors, psychologists, religious leaders) had stressed out its addictive characteristics. In the late 1980s, the acceptance of the addictive nature of tobacco resulted in development of healthcare services aiming at supporting people quit smoking and legislation regarding sale, distribution and advertising of tobacco products. Nicotine dependence is a chronic condition for which effective therapeutic interventions are required. Smokers, unlike other substances addicts, do not recognize their addiction and the nicotine withdrawal syndrome that they experience. For establishing the degree of dependence various tools can be used, such as the method of the 4 Cs (compulsion, control, cutting down, consequences) or validated questionnaires (CAGE, Fagerström Test for Nicotine). The main smoking cessation strategies use replacement therapy with various products (patch, gum, etc), medications (bupropion, varenicline) and/or counseling. These interventions are clinically efficient but also cost-effective, compared to prevention and treatment of diseases associated with smoking. Smoking cessation interventions should be offered to every smoker and provided by their health insurance

Views and Attitudes of Patients in Mental Facilities Regarding Smoking.

INTRODUCTION: Smoking rates amongst people with a mental health disorder are significantly higher than in the general population and there is growing evidence to show a strong association between smoking and mental health disorders. The aim of the present study was to investigate views and attitudes of mental patients regarding smoking. MATERIAL \& METHODS: The sample is composed of 356 patients treated in the Attica Psychiatric Hospital (a.k.a. "Dafni") as well as in other Units affiliated with the Hospital. The 'Smoking in psychiatric hospitals-a survey of patients' views' questionnaire was used in the form of semi-structured interviews. The PASW 18 (SPSS Inc.) package was used for the statistical analysis and statistical significance was set to p= 0.05. RESULTS: Overall, 40\% of the participants were in-patients, the rest being treated in other settings, the average length of hospital stay was 4.4 years, and the most common diagnosis (61.5.\%) was schizophrenia (F20, according to ICD-10), while almost all of the participants (97.5\%) were smokers. Most patients (58.8\%) said they had had a hard time trying to quit smoking although they had sufficient information and encouragement (≈90\%); they also reported that watching the staff smoking did not affect them inasmuch as watching other patients smoking (41 \% vs 54.8\%). 75.5\% of the patients felt that they had no particular difficulty to quit smoking. Men smoked significantly more cigarettes per day compared to females (36.70 vs 30.82, p=0.002). There were no significant differences among males and females regarding previous attempts to quit smoking. Information gathered from such studies should be taken into account when designing systematic smoking management plans in mental institutions. CONCLUSION: Although almost all mental patients smoke, they seem to be receptive to quitting smoking, since two thirds of them have already tried to quit, but one-third of the patients find smoking a little or not at all dangerous

Psychiatric nurses’ knowledge and practices towards patients’ tobacco-related habits in Mental Health Hospitals in Greece in the face of the upcoming psychiatric care reform

Introduction This study aimed to investigate how the smoking status of psychiatric nurses and nurses’ assistants might influence knowledge and attitudes towards patients’ smoking habits and clinical practice in a hospital in Athens. Methods A questionnaire-based study was contacted among psychiatric nurses and nurses’ assistants working on two major psychiatric hospitals in Athens greater area from January to March 2015. 320 nurses were current smokers and the total sample consisted of 297 psychiatric nurses and nurses’ assistants who have agreed to complete the anonymous questionnaire. Results The majority of nurses noted that psychiatric patient (yes: p = 45.5% sometimes: p = 34.3%) should be excluded from the antismoking ban. Various practices were noted among nurses concerning the assessment of patients’ smoking history, passive smoking, smoking habits and cessation plans. They stated that smoking cessation may exacerbate psychiatric symptoms (p = 45.5%) and may lead to an illness relapse (p = 45.5%). Nurses had some knowledge about the health effects of smoking (p = 96%) and they feel responsible to help patient quit smoking (p = 37.4%). They proved to be unaware of the relation between smoking, psychiatric symptoms and psychotropic medication. Conclusions The findings indicated that half of psychiatric nurses smoke in their work environment (yes: p = 37.4% and sometimes: p = 10.1%) and are against the application of the anti-smoking law in psychiatric hospitals (p = 42.4%). They believe that psychiatric patients should be handled different from other patients even though they are aware of the dangers of smoking (p = 56.6%)

Personality D type and cardiovascular disease: a literature review

Over the years, researchers have focused on identifying specific personality traits associated with specific disease manifestations. Mental health and psychological status, as well as personality characteristics, have been studied and identified as some of the prognostic factors of cardiovascular disease, along with physical ones, such as hypertension, hyperlipidemia and diabetes mellitus. This article focuses on Type D personality characteristics and the way it may affect the onset of cardiovascular disease, the prognosis and quality of life of patients. People with different personality characteristics adjust differently to disease. More specifically, people with type D personality have been found to have poor general health and suffer for a variety of health-threatening situations. Type D personality and psychological distress, in general, have been suggested as causes for poor prognosis for patients with cardiovascular disease, as these patients are less adherent to their therapy and have a number of unhealthy lifestyle habits, such as smoking and low activity levels. It seems necessary that attention should be paid to psychological characteristics and personality types, as risk or protective factors for cardiovascular disease.Na przestrzeni lat naukowcy skupili się na określeniu specyficznych cech osobowości związanych z konkretnymi objawami choroby. Zdrowie psychiczne i stan psychiczny oraz cechy osobowościowe zostały zbadane i zidentyfikowane jako niektóre z czynników prognostycznych choroby sercowo-naczyniowej, jak i fizyczne, takie jak nadciśnienie tętnicze, hiperlipidemia i cukrzyca. W tym artykule skupiono się na charakterystyce osobowości typu D oraz sposobie jego wpływu na początek choroby sercowo-naczyniowej, rokowania i jakość życia pacjentów. Osoby o różnych cechach osobowości różnią się w zależności od choroby. Dokładniej mówiąc, u pacjentów z osobowością typu D stwierdzono, że mają słabe zdrowie ogólne i cierpią z powodu różnych stanów zagrażających życiu. Typowa osobowość typu D i psychiczne cierpienia są ogólnie sugerowane jako przyczyny złego rokowania u chorych na choroby sercowo-naczyniowe, ponieważ pacjenci są mniej przyzwyczajeni do terapii i mają wiele niezdrowych nawyków związanych ze stylem życia, takich jak palenie tytoniu i niskie poziomy aktywności. Wydaje się, że należy zwrócić uwagę na cechy psychiczne i typy osobowości, jako czynniki ryzyka lub czynniki chroniące chorobę układu sercowo-naczyniowego

Looking into the effect of Diabetes Mellitus on Vascular Access in Haemodialysis Patients

Introduction: The creation and maintenance of a good vascular access is mandatory for a successful haemodialysis sessions and the survival of a Chronic Kidney Disease patient. Aim: The aim of the present cross-sectional study was to look into the vascular access complications in haemodialysed patients with or without Diabetes Mellitus (DM) and to find any possible correlation of these complications with Diabetes Mellitus. Methods: For this cross-sectional study data from patients’ records of private Dialysis Unit (n=77) and a big General Hospital in a Northern Greece city (n=33) were studied. Demographics, data on medication therapy and vascular access (area, type, dialysis parameters and complications) were recorded. Statistical analysis was performed with SPSS 20.0. Results: The sample was 66.7 (±12.5) years old, mainly male (58%, n=58) and on dialysis for 37.3 (±34.3) months. DM was the primary disease of 53% (n=53) of the patients and Hypertension for 13% (n=13),whereas the mean of comorbidities was 5,3 (±2,6). Thirty-seven patients (37%) had more than one VA created or placed. On the total of the sample (n=100) 156 VA were accessed with the 63% (n=63) of them with arteriovenous fistula (AVF), 35% (n=35) with central venous catheter (CVC) and 2% (n=2) with arteriovenous graft (AVG). A statistical significance (U=2560,5, p=0,1) was found regarding the number of VA of the two group of patients (DM=2,2 VA, non DM=1,8). On survival analysis it was found that DM increases the relative risk of “death” of a VA with odds ratio of 1,7 (95% confidence interval 1,1-2,6). Conclusions: DM, as primary disease or co-morbidity, in haemodialysis patients affects negatively the VA survival. Effective blood glucose control, management and methods of puncturing VA play a crucial role in maintaining the VA in DM haemodialysis patients