Stress Amongst Nurses at Tertiary Hospitals in Delhi

BackgroundNursing is known to be a stressful profession. Nursing staff working at the bottom of the hierarchy and in public hospitals are the ones who are more stressed out. There is a paucity of data on prevalence of stress amongst nurses in the Indian setting. The individual contribution of various stressors, operational in nurse’s personal and professional life, to the overall stress levels also needs to be studied.Method  A hospital based cross sectional study was carried out on 87 randomly selected staff nurses working in two tertiary care teaching hospitals of Central Delhi. Data was collected using pre-tested and self-administered questionnaire. Socio-demographic profile, stressors in daily life, stressors at workstation and total stress level was also assessed. The data was fed and analysed using WHO’s EPI-INFO 2005 software.Results87.4% of nurses from the sample reported occupational stress. The prevalence of occupational stress amongst nurses was 87.4%. ‘Time Pressure’ was found to be the most stressful whereas ‘Discrimination’ was the least stressful of the given possible sources of stress in everyday life. Other highly stressful sources were: handling various issues of life simultaneously with occupation such as caring for own children/parents, own work situation and personal responsibilities. ‘High level of skill requirement of the job’ was the most important stressor and ‘helpfulness of supervisors/senior sisters’ was the least significant stressor directly related to nursing profession. Other significant work related stressors were: the fact that their jobs required them to learn new things and that they had to attend to, too many patients at the same time.ConclusionHigh prevalence of stress was found amongst nurses, and suggests the need for stress reduction programmes targeting specific important stressors

Getting the SCOOP-survey of cardiovascular outcomes from oncology patients during survivorship.

BACKGROUND: Cardiovascular (CV) disease is the second most common cause of mortality and morbidity in cancer survivors (CS). Limited data exist on the knowledge and awareness of CS about CV effects of cancer therapies and its effect on lifestyle of survivors. It is important to identify gaps in CV care of CS. MATERIALS AND METHODS: A brief voluntary, anonymous, web-based questionnaire was designed to assess the awareness of CS about the interaction between CV disease, CV symptoms and lifestyle changes from cancer treatment. RESULTS: A total of 213 volunteers (181 women) with mean age of 56 years responded to the survey. Breast cancer was the most prevalent cancer diagnosis. In all, 15% reported CV disease before therapy with a higher incidence of CV disease in survivors more than 5 years from diagnosis (20% \u3e5 years versus 10%survivorship, P = 0.05). The reported use of beta blockers (9%) and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (9%) was rare despite the high incidence of CV disease. Only one-fourth of survivors were offered CV screening during treatment, whereas 36% of survivors had unanswered questions about CV symptoms from therapy. The CV symptoms adversely affected lifestyle in 27% of CS. One-fifth of survivors received exercise counseling even though half would have liked counseling. CONCLUSIONS: The survey demonstrates that CS have self-reported CV symptoms and there may be unmet needs for CV preventive services. Further work is needed to develop collaborative patient counseling and management strategies between oncology and cardiology for improving CV health and symptoms of CS

Trends and In-Hospital Outcomes of Patients Admitted with ST Elevation Myocardial Infarction and Chronic Total Occlusions: Insights from a National Database.

Chronic total occlusion (CTO) is seen in a minority of ST-elevation myocardial infarction (STEMI) patients and is implicated in poor outcomes due to double jeopardy. There is no large national data evaluating the trend and outcomes of STEMI patients who have a CTO (STEMI-CTO). We analyzed the Nationwide In-patients sample database from 2008 to 2011 and compared the trends, clinical characteristics, and in-hospital outcomes of STEMI patients with and without CTO. An increasing trend of CTO was seen in STEMI patients from 2008 to 2011. STEMI-CTO patients were younger, more likely develop cardiogenic shock, undergo percutaneous coronary intervention and thrombolysis. In this large, contemporary, national database, we also found that STEMI-CTO patients were more likely to have iatrogenic cardiac & vascular complications and undergo percutaneous mechanical circulatory support. We did not find significant difference in in-hospital deaths between STEMI-CTO patients and those without CTO

National Trends in the Incidence, Management, and Outcomes of Heart Failure Complications in Patients Hospitalized for ST-Segment Elevation Myocardial Infarction.

Objective: To analyze contemporary trends in the incidence, management, and clinical outcomes of heart failure (HF) complications in patients hospitalized for ST-segment elevation myocardial infarction (STEMI) in the United States. Patients and Methods: Using the 2003 through 2010 Nationwide Inpatient Sample databases, all patients with STEMI who were 18 years and older with acute HF were identified. Overall trends in the incidence of HF, coronary intervention, and in-hospital mortality were analyzed. Results: Of 1,990,002 hospitalizations with a primary diagnosis of STEMI, 471,525 (23.7%) had HF complication (decreasing from 25.4% [95% CI, 25.3%-25.6%] in 2003 to 20.7% [95% CI, 20.5%-20.8%]) in 2010 ( Conclusion: The incidence and in-hospital mortality of HF-complicated STEMI has decreased significantly during recent times along with increased use of percutaneous coronary intervention and diagnostic coronary angiography

Comparison of Inhospital Mortality and Frequency of Coronary Angiography on Weekend Versus Weekday Admissions in Patients With Non-ST-Segment Elevation Acute Myocardial Infarction.

Patients with myocardial infarction admitted on weekends have been reported to less frequently undergo invasive angiography and experience poorer outcomes. We used the Nationwide Inpatient Sample database (2003 to 2011) to compare differences in all-cause inhospital mortality between patients admitted on a weekend versus weekday for an acute non-ST-segment elevation myocardial infarction (NSTEMI) and to determine if rates and timing of coronary revascularization contributed to this difference. A total of 3,625,271 NSTEMI admissions were identified, of which 909,103 (25.1%) were weekend and 2,716,168 (74.9%) were weekday admissions. Admission on a weekend versus weekday was independently associated with lower rates of coronary angiography (odds ratio [OR] 0.88; 95% confidence interval [CI] 0.89 to 0.90;