The Role of Music to Promote Relaxation in Intensive Care Unit Patients

BACKGROUND: The intensive care unit (ICU) is one of the most stressful environments for patients among various clinical settings in a hospital. ICU patients are not only compromised by illness but also faced with a wide range of stressors. Most of the time, pharmacological therapies are commonly used to control the distress, but are expensive and lead to high hospital care costs. It is thought that music can act as a nursing intervention to relieve both physiological and psychological responses and increase comfort of patients. OBJECTIVE: The aim of the study was to identify, review and evaluate the literature regarding the role of music listening to promote relaxation for patients in the ICU together with considerations for future research. METHODS: MEDLINE, PubMed, CINAHL, AMED and PsycINFO databases were searched for the terms “music therapy”, “music medicine” and “music listening”. In addition, an internet search using Google Scholar was performed. RESULTS: Literature research shows that music can influence a wide range of physiological and psychological effects and is effective in decreasing stress and facilitating relaxation responses. Different types of music and music preference of the individual patient may have a different effect. Moreover, live music is considered more important than pre-recorded music. CONCLUSION: Music therapy has been widely used in a variety of cultures for centuries to decrease patients’ perception of pain, anxiety and depression, and boost their feelings of relaxation. Music can be used as a safe and inexpensive non-pharmacologic antianxiety intervention to enhance relaxation and decrease stress in ICU patients. The key implication is to educate doctors and nurses on modern aspects of music therapy

The influence of secondary traumatic stress on the productivity of health professionals focus on ICU and psychiatric nurses

Introduction: Nurses often find satisfaction in assisting people who experience extremely stressful events, yet the stress associated with these efforts can have a negative impact on them. Secondary traumatic stress (STS) or compassion fatigue (CF) has emerged as a natural consequence of caring for clients who are in pain, suffering or traumatized. STS has been associated with higher rates of physical illness, greater use of sick leave, higher turnover, lower morale, lower productivity, negative public opinion and may eventually lead to patient care errors. Objectives: The primary aim of this study was to investigate the risk of STS among ICU and psychiatric nurses and its influence on their productivity. Additional goals of the study were: 1. The investigation of differences between ICU and psychiatric nurses as regards their a) demographic, personal and occupational characteristics, b) professional quality of life (compassion satisfaction - CS, burnout - BO and CF/STS), c) prevalence and treatment of commonly occurring health problems (chronic medical conditions), d) productivity (absenteeism, presenteeism – quality and quantity of work while on the job – and critical incidents on the job - work-related successes, failures and accidents) and 2. The investigation of the relationship between all these concepts. Methods: The sample consisted of 509 registered and assistant nurses (404 women and 105 men) with mean age 34.84±7.24, working in ICU’s (n=335) and psychiatric clinics (n=174) in Athens greater area. Study instruments included the Professional Quality of Life Scale: Compassion Satisfaction, Burnout and Compassion Fatigue/Secondary Trauma (ProQOL-CSF-R-IV) Scales, the Work Health Organization Health and Work Performance Questionnaire (HPQ) and a set of items on general information of the sample (demographic, personal and occupational characteristics). Assurances were given to nurses concerning confidentiality and anonymity. Results: The majority of participants are at the high level of risk for BO (ICU: 56.1%, psychiatric clinics: 49.4%) and STS (ICU: 57.9%, psychiatric clinics: 44.8%), while they report low potential for CS (ICU: 61.5%, psychiatric clinics: 64.9%). BO (r=-.46) and STS (r=-.14) were found to correlate with CS, and the correlation was negative. Also, there is a strong positive correlation between BO and STS (r=.60). STS was found to have a negative influence on the absenteeism over the past 7 days (p=.022) and on the presenteeism (p=.027), while the absenteeism over the past 4 weeks was found to correlate mostly with health (mental and physical) - related factors, which usually lead to greater use of sick leave, such as headaches (p=.006) and hypertension (p=.024), and with work-related factors, such as shift work (p=.003) and patient-to-nurse ratios (p=.041). Additionally, this study investigated the factors associated with BO, CS, STS and chronic medical conditions of the sample. Conclusions: Nurses must contend with not only the normal stress and dissatisfaction of work (burnout), but also with the personal feelings for people’s suffering (compassion fatigue). High prevalence of STS in the sample indicates that large numbers of ICU and psychiatric nurses may be experiencing its negative effects. STS should be a concern not only for individual providers, but also for health care administration and policy, because its presence may affect the quality of care.Εισαγωγή: Οι νοσηλευτές συχνά νιώθουν ικανοποίηση από την παροχή βοήθειας σε ανθρώπους που έχουν βιώσει εξαιρετικά στρεσογόνα γεγονότα, το στρες όμως που συσχετίζεται με αυτές τις προσπάθειες μπορεί να έχει αρνητική επίδραση στους ίδιους. Το δευτερογενές τραυματικό στρες ή κόπωση συμπόνιας, αποτελεί την φυσική συνέπεια της παροχής φροντίδας σε ανθρώπους που πονάνε, υποφέρουν ή είναι τραυματισμένοι και αφορά το «κόστος της φροντίδας» για τους επαγγελματίες υγείας. Το δευτερογενές τραυματικό στρες έχει συσχετιστεί με υψηλά επίπεδα σωματικών ασθενειών και χρήση αναρρωτικών αδειών, αυξημένο ρυθμό αλλαγής θέσεων εργασίας ή και εγκατάλειψη επαγγέλματος, χαμηλό ηθικό, μειωμένη παραγωγικότητα, αρνητική κοινή γνώμη και μπορεί τελικά να οδηγήσει σε λάθη στην φροντίδα των ασθενών. Σκοπός: Ο κύριος σκοπός της παρούσας μελέτης ήταν η διερεύνηση του κινδύνου για δευτερογενές τραυματικό στρες στους νοσηλευτές που εργάζονται σε ΜΕΘ και σε Ψυχιατρικές Κλινικές ελληνικών δημόσιων νοσοκομείων και της επίδρασης του στην παραγωγικότητα τους. Οι επιμέρους στόχοι ήταν: 1. Η διερεύνηση των διαφορών που παρουσιάζουν οι νοσηλευτές που εργάζονται σε ΜΕΘ από τους νοσηλευτές που εργάζονται σε Ψυχιατρικές Κλινικές ως προς α) τα δημογραφικά, ατομικά και επαγγελματικά χαρακτηριστικά τους, β) την επαγγελματική ποιότητα ζωής (ικανοποίηση συμπόνιας-compassion satisfaction, επαγγελματική εξουθένωση-burnout και δευτερογενές τραυματικό στρες ή κόπωση συμπόνιας - secondary traumatic stress/compassion fatigue), γ) την γενική κατάσταση υγείας τους (ύπαρξη και θεραπεία χρόνιων προβλημάτων υγείας-chronic medical conditions) δ) την αξιολόγηση της παραγωγικότητας τους (απουσία από την εργασία– absenteeism, απόδοση στην εργασία, δηλαδή ποιότητα και ποσότητα εργασίας-presenteeism και κρίσιμα γεγονότα, δηλαδή σχετιζόμενες με την εργασία επιτυχίες, αποτυχίες και ατυχήματα–critical incidents) και 2. Η διερεύνηση της συσχέτισης όλων αυτών των μεταβλητών μεταξύ τους. Υλικό και Μέθοδος: Στην μελέτη συμμετείχαν 509 νοσηλευτές (404 γυναίκες και 105 άνδρες), όλων των κατηγοριών εκπαίδευσης, ηλικίας 34.84±7.24 ετών, που εργάζονται σε ΜΕΘ (n=335) και Ψυχιατρικές Κλινικές (n=174) σε 27 δημόσια νοσοκομεία στην ευρύτερη περιοχή της Αττικής. Για την συλλογή των δεδομένων χρησιμοποιήθηκε η Κλίμακα Επαγγελματικής Ποιότητας Ζωής: Υποκλίμακες Ικανοποίησης Συμπόνιας, Επαγγελματικής Εξουθένωσης και Κόπωσης Συμπόνιας ή Δευτερογενές Τραυματικό Στρες (ProQOL-CSF-R-IV), το Ερωτηματολόγιο Υγείας και Παραγωγικότητας στην Εργασία του Παγκόσμιου Οργανισμού Υγείας (HPQ) και ένα ερωτηματολόγιο καταγραφής των δημογραφικών, ατομικών και επαγγελματικών χαρακτηριστικών του δείγματος. Η συμπλήρωση των ερωτηματολογίων ήταν ανώνυμη. Αποτελέσματα: Η πλειοψηφία των ερωτηθέντων και στα δύο δείγματα είναι σε μεγάλο κίνδυνο για επαγγελματική εξουθένωση (56.1% στις ΜΕΘ και 49.4% στις Ψυχιατρικές Κλινικές) και δευτερογενές τραυματικό στρες (57.9% στις ΜΕΘ και 44.8% στις Ψυχιατρικές Κλινικές), ενώ είναι σε χαμηλό επίπεδο για ικανοποίηση συμπόνιας (61.5% στις ΜΕΘ και 64.9% στις Ψυχιατρικές Κλινικές). Η ικανοποίηση συμπόνιας έχει σημαντική αρνητική σχέση με την επαγγελματική εξουθένωση (r=-.46) και το δευτερογενές τραυματικό στρες (r=-.14), ενώ οι δύο τελευταίες έννοιες παρουσιάζουν θετική σχέση μεταξύ τους (r=.60). Το δευτερογενές τραυματικό στρες βρέθηκε να επιδράει αρνητικά στην απουσία από την εργασία τις προηγούμενες 7 ημέρες (p=.022) και στην απόδοση στην εργασία (p=.027), ενώ η απουσία από την εργασία τις προηγούμενες 4 εβδομάδες βρέθηκε να συσχετίζεται κυρίως με παράγοντες που αφορούσαν προβλήματα με την ψυχική ή σωματική υγεία των ατόμων που συχνά οδηγούσαν σε χρήση αναρρωτικών αδειών, όπως οι πονοκέφαλοι (p=.006) και η υπέρταση (p=.024) και με εργασιακούς παράγοντες, όπως το ωράριο εργασίας (p=.003) και η αναλογία ασθενών ανά νοσηλευτή (p=.041). Επίσης, η επαγγελματική εξουθένωση βρέθηκε να συσχετίζεται με τον σχετικό αριθμό ωρών εργασίας τις προηγούμενες 7 ημέρες (p=.029). Επιπλέον, διερευνήθηκαν οι παράγοντες που σχετίζονται με την επαγγελματική εξουθένωση, την ικανοποίηση και την κόπωση συμπόνιας, καθώς και με την γενική κατάσταση της υγείας των ερωτηθέντων. Συμπεράσματα: Οι νοσηλευτές πρέπει να αντιμετωπίσουν όχι μόνο το στρες και την δυσαρέσκεια για την εργασία τους (επαγγελματική εξουθένωση), αλλά πρέπει να έρθουν αντιμέτωποι και με τα προσωπικά τους συναισθήματα για τον άνθρωπο που πονάει και υποφέρει (κόπωση συμπόνιας). Το υψηλό ποσοστό δευτερογενούς τραυματικού στρες στο δείγμα υποδεικνύει ότι πιθανώς μεγάλος αριθμός νοσηλευτών που εργάζονται σε ΜΕΘ και Ψυχιατρικές Κλινικές βιώνει τις αρνητικές συνέπειες αυτής της κατάστασης. Δεδομένου ότι το δευτερογενές τραυματικό στρες επηρεάζει και την ποιότητα της φροντίδας που παρέχεται στους ασθενείς, εκτός από τις επιπτώσεις που μπορεί να έχει στην υγεία του επαγγελματία που το βιώνει, θα πρέπει να συγκεντρώνει και το ενδιαφέρον της διοίκησης του νοσοκομείου και της πολιτείας

The Interrelationship between Diabetes Mellitus and Emotional Well-Being: Current Concepts and Future Prospects

Diabetes mellitus is a lifelong metabolic disorder that impacts people’s well-being and biopsychosocial status. Psychiatric problems and diabetes mellitus have a complex, reciprocal interaction in which one condition affects the other. In this narrative review, we provide an overview of the literature on the psychological effects of diabetes, expound on the evaluation of emotional disorders in the setting of diabetes, and suggest interventions aimed at enhancing both mental and physical health. Diabetes can make daily life complicated and stressful. Frequent blood glucose testing, taking medications on a regular basis, adhering to a tight diet plan, and exercising are some examples of the suggested daily routine of subjects with diabetes. Furthermore, comorbid diseases and typical diabetic complications can have a detrimental impact on quality of life. When mental health conditions coexist with diabetes mellitus, there is a greater likelihood of medication noncompliance, a decreased commitment to diabetes-related self-care, increased functional impairment, inadequate glycemic control, a higher risk of complications, and overall higher healthcare expenses. Thus, evaluation of the mental health status of patients with diabetes is crucial. When treating psychological issues and psychiatric disorders, a comprehensive biopsychosocial approach should be taken, and where appropriate, psychopharmacological therapies or psychotherapy should be applied. The goal of continuous education and assistance for self-care is to give individuals with the disease the information and abilities they need to control their condition over time

A Mixed-Method Study on the Assessment of Factors Influencing Nurses’ Provision of Spiritual Care

The purpose of this study was to explore factors that influence nurses’ beliefs about offering spiritual care. Study Design: A mixed-method study design, incorporating both quantitative (questionnaire) and qualitative research, was used for this study (focus group discussion). Methods: The questionnaires were completed by a convenience sample of nurses and their assistants working in two public hospitals. These questionnaires included the Greek versions of the FACIT-Sp-12, SCIPS, NEO-FFI, and the Spiritual Climate Scale, as well as a specially designed questionnaire to gather demographic, socioeconomic, and professional information about the study population (SCS). Three nurses and two nursing assistants who worked in public hospitals and were chosen through purposive sampling made up the sample for the qualitative study. In utilizing inductive content analysis methodology, a qualitative analysis was carried out. Results: Greek nurses frequently offer spiritual care to their patients, primarily existential spiritual care. It was discovered that the spiritual climate, the nurses’ positive coherence, and their educational level all exert a favorable effect on total spiritual care. Three categories and seven subcategories were used to describe the participants’ prior experiences with spiritual care. Conclusions: Greek nurses frequently offer spiritual care to their patients, and both internal and external factors influence their attitudes in this regard

Anxiety, Stress and the Resilience of University Students during the First Wave of the COVID-19 Pandemic

The COVID-19 pandemic had an impact on everyone’s daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The present study aimed to assess the psychological difficulties experienced by the university students of Greece during the first wave of the outbreak. Methods: 288 university nursing students completed an electronic questionnaire after consent. The sample included students from all years of study. The questionnaire included demographic data and questions about mental health status, resilience level, coping strategies, positive and negative emotions and an optimism assessment. Results: Depression (44.8%), anxiety (36.8%) and stress (40.3%) were experienced by the students. Females had significantly greater anxiety and stress signs compared to males (p < 0.001). The resilience score was significantly greater in males, as it was for the Positive Affect Score. Students in the fourth year of study used significantly more active/positive coping strategies than students in the first (p = 0.016) or second year of study (p = 0.005). Conclusion: Several students experienced serious mental disorders during the first period of the COVID-19 outbreak. Variables such as gender, year of study, age, positive and negative affect score, life orientation test score and coping strategies were identified as factors contributing to this situation. Special attention must be paid to female students as they mentioned negative emotions more frequently than males. Further research on the academic population could be beneficial to university administrators

Anxiety, Stress and the Resilience of University Students during the First Wave of the COVID-19 Pandemic

The COVID-19 pandemic had an impact on everyone’s daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The present study aimed to assess the psychological difficulties experienced by the university students of Greece during the first wave of the outbreak. Methods: 288 university nursing students completed an electronic questionnaire after consent. The sample included students from all years of study. The questionnaire included demographic data and questions about mental health status, resilience level, coping strategies, positive and negative emotions and an optimism assessment. Results: Depression (44.8%), anxiety (36.8%) and stress (40.3%) were experienced by the students. Females had significantly greater anxiety and stress signs compared to males (p p = 0.016) or second year of study (p = 0.005). Conclusion: Several students experienced serious mental disorders during the first period of the COVID-19 outbreak. Variables such as gender, year of study, age, positive and negative affect score, life orientation test score and coping strategies were identified as factors contributing to this situation. Special attention must be paid to female students as they mentioned negative emotions more frequently than males. Further research on the academic population could be beneficial to university administrators

Investigation of Mental and Physical Health of Nurses Associated with Errors in Clinical Practice

Background: Errors are common among all healthcare settings. The safety of patients is linked directly with nursing errors because nurses stand by them more often than any other healthcare professional. The role of mental and physical health of nurses is of great interest for a good and efficient job performance, but also for maintaining good patient care delivery. This study aimed to investigate the association between nurses’ general health and making errors during clinical practice. Methods: A total of 364 nurses completed a specially designed questionnaire anonymously and voluntarily. The sample consisted of nurses with all educational degrees. The questionnaire included demographic data and questions about general health issues, resilience status and nurses’ possible experience with errors within a hospital. Results: 65,8% of the participants stated that at least one error had happened at their workplace, and 49,4% of them reported that the error was caused by them. Somatic symptoms were found to have a positive correlation with making errors (p p < 0.001) when correlated with all aspects of general health (anxiety/insomnia, severe depression, somatic symptoms), but not with social dysfunction. Conclusion: Nurses are affected by their somatic symptoms in their daily clinical practice, making them vulnerable to making errors that compromise patient safety. A high resilience level could help them cope with unfavorable situations and prevent them from doing harm to a patient or themselves

COVID-19 Vaccination Intention Associated with Behaviors towards Protection and Perceptions Regarding the Pandemic

Background: The impressively rapid availability of different types of COVID-19 vaccines and, on the other hand, the degree of their effectiveness as opposed to the likelihood of serious or non-serious side effects place a fairly large percentage of the population at a crossroads regarding the choice to get vaccinated or not, hence threatening achievement of total immunization coverage and full immunity. This study aimed to assess COVID-19 vaccination intention in Greece regarding protection behaviors and perceptions of the pandemic. Methods: A total of 3753 participants completed a specially designed electronic questionnaire anonymously and voluntarily. The study population consisted of healthcare workers, students, members of professional societies, teachers, and professors. The questionnaire was composed of four parts pertaining to demographic data and possible changes in hygiene attitudes during the COVID-19 pandemic. Results: In total, 43.3% of the participants stated that SARS-CoV-2 poses a significant risk. The most widespread protection practice was avoiding crowded places (90.1%), followed by reducing the use of public transport (86.1%) and washing their hands with soap and water more often than usual (84.2%). Women undertook significantly more behavioral changes than men and participants of other nationalities. About half of the participants (44%) implemented seven behavioral changes. Lower personal and general perceived risk due to COVID-19 was significantly associated with lower intention to get vaccinated. Conclusion: Strong hesitancy was observed towards COVID-19 vaccination. There is a need for further studies to be conducted to investigate the benefits and safety of vaccines for the purpose of better informing the public. Healthcare personnel can and should play a key role in this process

Perceptions, Knowledge and Attitudes among Young Adults about Prevention of HPV Infection and Immunization

Introduction: Human papilloma virus (HPV) is one of the most common sexually transmitted infections and is widely known as the main causative agent for cervical cancer. The aim of this study was to investigate the perceptions, knowledge and attitudes of young Greek adults concerning prevention of HPV infection and HPV immunization. Material and Methods: This constitutes a cross-sectional online survey. A convenience sample of young Greek adults (n = 883) residing in Greece, aged 17 to more than 35 years was surveyed from December 2020 to March 2021. Two validated questionnaires were used to collect data. Results: Participants demonstrated moderate knowledge about HPV infection and vaccination, with a mean knowledge score of 53.26 (SD ± 20.65) and 38.92 (SD ± 17.58), respectively. Cronbach’s alpha value was 0.77 and 0.80. Female participants were better informed than males. Approximately 52.3% of respondents had been vaccinated and 65.5% were willing to get vaccinated in the future. Vaccination rate was significantly associated with gender (OR = 11.99; 99% CI = 6.59–21.84), knowledge about the HPV vaccine (OR = 1.04; 99% CI = 1.03–1.04) and age (OR = 0.07; 99% CI = 0.03–0.15). Reasons for vaccine refusal were insufficient information (36.8%) and fear of side effects (19%). Correlates of positive vaccination intention were knowledge about HPV (OR = 1.02; 99% CI = 1.01–1.02). Conclusions: The findings suggest that the Greek government’s continuing HPV promotion efforts and education on the risks of HPV infection among young people are likely to increase vaccination acceptance among this group