Occupational Stress of Pediatric Emergency Nurses in Greece During the COVID-19 Pandemic.

During the COVID-19 pandemic, numerous studies have shown the high prevalence of occupational stress (OS) of health workers, affecting the quality of health care provided. To date, there is no study regarding OS of emergency care pediatric nurses working in Greece. This study aimed to examine the pediatric nurses' OS working in tertiary public hospitals in Greece. In this cross-sectional study, a total of 104 pediatric nurses were recruited randomly from summer 2020 to summer 2021. The Expanded Nursing Stress Scale (ENSS), which consists of 59 items grouped into nine categories, was used to assess nurses OS. The overall OS mean score was 141.04 (SD = 33.48), indicating mild stress. Among nine categories, pediatric nurses were more stressed about patients and families (mean = 22.83, SD = 5.71), as well as death and dying (mean = 19.33, SD = 5.22), whereas they were less stressed about discrimination (mean = 4.21, SD = 4.09) and problems with peer support (mean = 12.11, SD = 4.58). Sex, age, and shifts did not correlate with OS. Borderline correlation was present between age and inadequate emotional preparation for less experienced nurses (p = 0.047), while higher educated pediatric nurses were more stressed because of workload than lower educated pediatric nurses (p = 0.044). Greek pediatric nurses suffered mild OS during the COVID-19 pandemic. There is a great need for further research and implementation of supportive sustainable programs aimed to the minimization of OS and the optimization of health care provided during and after the COVID-19 pandemic.

Psychometric properties of the research competencies assessment instrument for nurses (RCAIN) in Greece.

Background and Purpose: Evidence-based practice can improve quality of care and patient and system outcomes. Healthcare professionals need certain research competencies to achieve evidence-based practice. We aimed to evaluate the psychometric properties of the self-reported 19-item Research Competencies Assessment Instrument for Nurses (RCAIN) with Greek. Methods: This cross-sectional study included in total, 520 respondents (within 33 health organizations) who completed the 5-point Likert-type RCAIN as well as the 8-item "Research Utilization by Nurses" that was used to assess construct validity. Expert scholars translated both survey questionnaires into the Greek language. A baseline one-factor model was compared against three-factor model (i.e., knowledge, skills, and application of knowledge and skills) that were developed based on the hypothetical design of the instrument. Results: Participants were females (86.4%) 50 years old or younger (91%). The RCAIN had a Cronbach's alpha coefficient of 0.937 and intraclass correlation coefficient of 0.440 (95% CI 0.403 to 0.480, p < .001). Confirmatory factor analysis revealed a 3-factor solution (i.e., knowledge, skills, application of knowledge & skills). Fit indices for the three-factor model were statistically superior when compared with the baseline model. Reliability and validity of each subscale were acceptable. Further assessment of construct validity using hypothesis testing indicated that there is a statistically significant difference in research utilization by knowledgeable or not participants. Specifically, the effect size between knowledge synthesis and instrumental research use was eta squared = 0.020, meaning that approximately 2.0% of the variance in instrumental research use scores can be explained by knowledge in methods of knowledge synthesis. The predictive validity, based on correlations between the two instruments, showed that increasing levels of instrumental research use were associated with an increasingly positive and statistically significant pattern of correlations. Conclusions: The RCAIN survey is a psychometrically sound tool for nurses. Providers, educators, and health administrators may use it for professional development and improvement of individual research competencies.

The Role of Substance P, Neurokinin A, Neuropeptide Y, and Cortisol in Assessing Neonatal Pain.

Introduction: Our aim was to investigate biomarkers of neonatal pain and their association with two pain scales. Methods: This prospective study included 54 full-term neonates. Levels of substance P (SubP), neurokinin A (NKA), neuropeptide Y (NPY), and cortisol were recorded and two pain scales (Premature Infant Pain Profile [PIPP] and Neonatal Infant Pain Scale [NIPS]) were used. Results: A statistically significant decrease in the levels of NPY (p = 0.02) and NKA (p = 0.03) was detected. A significant increase in NIPS scale (p < 0.001) and PIPP scale (p < 0.001) postpainful intervention was also detected. There was a positive correlation between cortisol and SubP (p = 0.01), NKA and NPY (p < 0.001) and between NIPS and PIPP (p < 0.001). A negative correlation was found for NPY with SubP (p = 0.004), cortisol (p = 0.02), NIPS (p = 0.001) and PIPP (p = 0.002). Conclusions: Novel biomarkers and pain scales may help in designing an objective tool for the quantification of neonatal pain in the everyday practice.

Evaluating how paediatric nurses perceive the family-centred model of care and its use in daily practice.

AIM: the study aimed to assess nurses' perceptions of family-centred care and how they applied the family-centred model of care in everyday practice. The model aims to involve families in the care of hospitalised children and to promote a cooperative relationship between parents and nurses. METHOD: 183 nurses from a paediatric hospital in Athens completed the Family-Centered Care Questionnaire-Revised, enabling researchers to collect demographic data and obtain nurses' views on a range of topics. RESULTS: participants considered a care philosophy that puts the focus on the family as important (p = 0.01). Factors that had significant correlation with whether nurses implemented family-centred care included educational level (p<0.001), experience (p = 0.006), age (p = 0.05), marital status and whether they had children (p = 0.023 and p = 0.002 respectively). CONCLUSION: although the importance of the family-centred care model is well established, nurses did not that think that it was essential to apply all its aspects in daily practice.

Assessment of quality of life in adolescent patients with cancer and adolescent survivors of childhood cancer.

PURPOSE: The aim of the study was to assess the quality of life (QoL) of adolescents with cancer and survivors of childhood cancer as well as the effect of various demographic factors upon it. DESIGN AND METHODS: The sample of the study included 82 adolescents aged 13-20 years who had been diagnosed with any type of cancer. Twenty-six of them received treatment and 56 survivors of childhood cancer had successfully completed their treatment. Data collection lasted from July 2010 to December 2012 in Children's Hematology-Oncology Unit in Athens. For data collection, Minneapolis-Manchester Quality Questionnaire of Life Instrument was used. The assessment of the QoL of adolescents undergoing treatment was performed with three measurements and that of the survivors with one. RESULTS: The QoL of adolescent patients did not significantly change during treatment and they showed a satisfactory QoL. Boys scored higher than girls (z = -1.78, p = .04 in psychological function and t = 2.27, p = .02 in body image) as far as QoL in social relations is concerned (z = -2.79, p = .002 in first measurement and z = -2.31, p = .01 in second measurement). Scores on the scale for the QoL of survivors of childhood cancer who completed treatment was 3.91. Survivors showed a higher QoL than the adolescent patients. CONCLUSIONS: This research has shown that the studied population scored a sufficient QoL, especially survivors of childhood cancer ones. Moreover, their QoL seemed to be influenced by the stage of treatment, the type of cancer, sex, age, family support, and their level of education.

Perceptions of children and their parents about the pain experienced during their hospitalization and its impact on parents' quality of life.

OBJECTIVE: The aim of the study was to assess pain levels and perceptions concerning pain by both children and their parents during hospitalization, as well as the impact of that pain upon parents' quality of life. METHODS: The sample of the study consisted of 92 pediatric cancer patients, 159 pediatric patients with musculoskeletal problems and one of their parents. The study was performed between November 2010 and May 2011. The Pediatric Pain Questionnaire (Parent Version) and the PedsQL-Family Impact Module were used for pain assessment and the quality of life by the parents. Young patients completed the pediatric version of the Pediatric Pain Questionnaire for the evaluation of pediatric pain. Pain was measured by using the Wong-Baker facial pain scale, included in both parent and child version of the Pediatric Pain Questionnaire. This rating scale is recommended for children 3 years and older. RESULTS: Young patients reported higher acute pain scores than their parents (z = -2.5, P = 0.011; 99% confidence interval: 0.008-0.013). Young patients with orthopedic disorders had higher acute and chronic pain scores in comparison to their parents' reports (z = -3.4, P = 0.001; 99% confidence interval: 0.000-0.001 and z = -2.3, P = 0.021; 99% confidence interval: 0.017-0.025, respectively). Girls reported higher pain scores than boys (z = -2.0, P = 0.047; 99% CI: 0.041-0.052). CONCLUSIONS: Parental reports tended to underestimated children's pain, especially acute pain. The sex of children, the age and the marital status affect the perceptions of both children and their parents about pain. The parental quality of life is affected especially when the pain is caused by life-threatening diseases such as cancer. However, it improves as the treatment of their children is completed with no complications.

Assessment of quality of life of children and adolescents with cancer during their treatment.

OBJECTIVE: The purpose of this study was to evaluate the quality of life of children and adolescents with any type of cancer in all phases of their treatment. METHODS: Fifty-six newly diagnosed patients diagnosed with malignancy and hospitalized in a Pediatric Hematology-Oncology Unit in Athens were included in the study. Minneapolis-Manchester Quality of Life Instrument was used for data collection from July 2010 to December 2012. The assessment of children and adolescents' quality of life who were under treatment was performed in three different stages of treatment. RESULTS: The results of the study showed that the quality of life of children and adolescents with cancer did not change notably during their treatment (F = 0.16, P = 0.86 and F = 0.03, P = 0.97). For the first measurement, at the beginning of the therapy, the score on the scale for quality of life for children and adolescents was 3.44 and 3.88, respectively, in the middle of the treatment 3.36 and 3.89, respectively, and 3.43 and 3.89, respectively, when therapy was completed. Children and adolescents diagnosed with hematologic cancer stated higher quality of life scores (z = -1.61, P = 0.05 and t = 2.64, P = 0.007). Moreover, teenage patients (F = 13.22, P = 0.001) and male patients (t = 2.31, P = 0.02 and t = 2.27, P = 0.02) expressed better quality-of-life scores. CONCLUSION: According to the results, children and adolescents with any kind of cancer have better quality-of-life scores at the end of their treatment, and when they are supported by their family.

Parents' satisfaction concerning their child's hospital care.

AIM: To explore parents' satisfaction concerning their child's care during hospitalization and its determinants. METHODS: A descriptive, non-experimental correlational design was used. The data collection was based on interviews using a 63 item questionnaire, the Swedish Pyramid Questionnaire. The parents of 206 children (hospitalized in two pediatric and two surgical units) participated in the study. RESULTS: The independent t-test results demonstrated that the parents showed greater satisfaction with staff attitudes and medical treatment, whereas they were less satisfied with the information concerning routines and the staff work environment. The stepwise multiple regression analysis revealed that adequacy of care, adequate pain management, parents' involvement in care, a trusting relationship, and staff attitudes were the most important determinants of parental satisfaction. CONCLUSION: Interventions in pediatric care should include measurements of parental and child satisfaction as a tool to assess the quality of care.

Assessment of self-reported self-esteem in healthy and diabetic children and adolescents in Greece.

BACKGROUND: The aim of the present study was to evaluate any possible negative effect of diabetes on the self-esteem of children and adolescents with diabetes. METHODS: Self-esteem was evaluated using the Culture-Free Self-Esteem Inventory (CFSEI-2) in 144 patients with Type 1 diabetes mellitus (T1DM; 7-18 years of age) treated in a diabetes center and compared against that of 136 healthy children and adolescents. RESULTS: Self-esteem was correlated with age (P = 0.017), but not with diabetes (P = 0.886). The median CFSEI-2 score for both healthy and diabetic children was 22. There was no significant correlation between self-esteem and sex, body mass index (BMI), physical exercise, HbA1c or parental educational level. According to Spearman's rank correlation coefficient (r(s)), there was a significant association between age and self-esteem (r(s) = -0.15). Conversely, although BMI (r(s) = -0.09) and treatment duration (r(s) = -0.107) had a slight negative effect on self-esteem and the duration of physical exercise (r(s) = 0.11) and parental education (r(s) = 0.07) seemed to have a positive effect, the associations did not reach statistical significance. CONCLUSIONS: Self-esteem in diabetic children is mainly affected by their age, level of physical activity and level of family support. These findings emphasize the need to discriminate between glycemic control and diabetic adjustment.