Factors associated with delayed hospital arrival among patients with acute myocardial infarction: a cross-sectional study in Greece.

BACKGROUND: It is proven that early admission to hospital contributes significantly to the successful management of acute myocardial infarction (AMI). AIM: This study aimed to examine the factors associated with delayed hospital arrival among patients with AMI. METHODS: A cross-sectional study among 477 AMI patients was conducted during a 2-year period in two large tertiary hospitals in Greece. Structured face-to-face interviews were conducted and information regarding their socio-demographic characteristics, medical history and factors that might be correlated with delayed hospital arrival were collected. RESULTS: The main factors that were found to be correlated with delayed hospital arrival among AMI patients were the absence of companion/attendant/escort present during the AMI [odds ratio (OR) 2.1, 95% confidence interval (CI) 0.98-4.4, P = 0.049], previous medical history of diabetes mellitus (OR 3.4, CI 1.6-7.2, P = 0.002), absence of dyspepsia (OR 9.2, CI 3.6-23.3, P < 0.001) and nausea/vomiting symptoms (OR 16.9, CI 4.1-69.1, P < 0.001), and also being at a distance of more than 10 km from the hospital (OR 19.6, CI 5.4-70.6, P < 0.001). CONCLUSION: A number of factors that might delay hospital arrival among patients with AMI should be taken into account in healthcare service planning. Health policy actions that will improve the accessibility to healthcare services, the restructuring of the Greek primary healthcare system and the provision of effective patient education by nurses could reduce the pre-hospital delay. LIMITATIONS: The study was conducted in two hospitals which limits the generalization of the findings. Also, the onset of AMI symptoms relied on self-report by the patients.

Surveillance for hepatitis B virus infection in pregnant women in Greece shows high rates of chronic infection among immigrants and low vaccination-induced protection rates: preliminary results of a single center study.

Epidemiological data on the prevalence of serological markers of hepatitis B virus (HBV) infection in pregnant women in Greece are limited. We evaluated the prevalence of HBV serological markers in a multinational population of pregnant women in Athens, Greece. The overall prevalence of hepatitis B surface antigen (HbsAg) was 4.1% with the highest rates among Albanian immigrants (12%). Relatively low vaccination-induced protection rates (32.5%) were observed, a finding suggesting that surveillance and immunisation programmes targeted at pregnant women are necessary.

Attitudes of nurse professionals and nursing students towards children with disabilities. Do nurses really overcome children's physical and mental handicaps?

BACKGROUND: Many health professionals and nurses, who are involved in the care of disabled children, do not exhibit the essential sensitivity and appropriate attitudes towards them, resulting in a poor quality of nursing care. AIM: The objective of this study was to investigate the attitudes of nurse professionals (paediatric nurses) and nursing students towards disabled children. PATIENTS AND METHODS: The present study is a comparative study. The sample consisted of 228 first-year nursing students, 90 post-diploma nurses attending MSc degree course and 123 nurse professionals who are employed in paediatric hospitals. After obtaining permission from the hospitals and the educational settings and informing about the subjects of the study, data were collected using the paediatric Attitude Towards Disabled Person Scale (ATDP). RESULTS: Overall nurses' attitudes appeared to be poor (mean ATDP score 61.7 +/- 14.2). However, the post-diploma nurses had significantly higher ATDP scores than first-year students and paediatric nurses (P < 0.001). In addition, first-year students had significantly higher scores than paediatric nurses (P = 0.047). Across the sample, females hold significantly more positive attitudes than males (F = 9.5, P = 0.002), while age did not have any significant effect. CONCLUSIONS: Carefully designed curricula can influence the attitudes of nursing students towards children with disabilities. Special courses for treating disabled children should be integrated to the basic nursing studies. Moreover, continuing hospital education can change paediatric nurses' attitudes towards children with disabilities.

Greek students' knowledge and sources of information regarding sex education.

BACKGROUND: Human sexuality is a complex part of life and is considered a multidimensional phenomenon. Therefore there is an increased need for adequate and comprehensive sex education, especially for teenagers and young adults. AIM: The main aim of the study was to evaluate the level of students' sexual knowledge, as well as to identify their sources of information regarding sexual life and reproduction. POPULATION AND METHOD: A cross-sectional study using a designed self-report questionnaire was performed. The study population consisted of 936 students who were attending 10 high schools and four medical schools in Attica. Data were collected after obtaining permission from the Pedagogic Institute of the Greek Ministry of Education. FINDINGS: The main sources of students' sexual information about reproduction were friends (29.1%) and parents (24.0%), whereas school was reported by 14.3% of them. The preferred sources of information, according to students' perceptions, were sex education specialists (65.6%), followed by school (39.1%), parents (32.2%) and friends (27.7%). CONCLUSIONS: The importance of school, peer and parent support upon adolescents' sexual life was revealed by the results of the study. Students' knowledge level on sex topics is not satisfactory and therefore there is a need for sex education specialists and special courses regarding sex education in Greek schools.

Modification of nursing students' performance in blood pressure measurement: an educational retraining programme.

AIM: To assess the procedure for measuring blood pressure (BP) among nursing students after the basic educational programme and after further supplementary training. METHODS: One hundred and fifty nursing students participated in the study, which was divided into two phases. During the first phase, students attended the routine educational programme in respect of the technique of measuring BP in the course of the lesson 'Basic Nursing'. During the next semester (second phase), the same students attended the lesson of 'Internal Medicine Nursing'. In the course of this lesson, a supplementary educational intervention for BP measurement was introduced for the purpose of this study. In order to perform our study, the university's written approval was given. At the end of the second phase, the 150 participants (volunteers) gave their oral consent for the anonymous publication of the results. RESULTS: The results showed an inadequate performance after the basic educational programme, but a significant improvement in the technique of measuring BP after supplementary educational intervention was achieved. This improvement was significant for all the parameters examined. CONCLUSION: Supplementary education of students may be required, as this could significantly improve their technique for the accurate measurement of BP.

The influence of varying blood and dialysate flow on haemodialysis adequacy.

The aim of this study was the exploration and correlation of the influence of variations in blood flow and dialysate flow on haemodialysis adequacy through the quantitative indexes Kt/V, TACurea and PCR. A prospective study of 48 patients subjected to haemodialysis was carried out. The collection of data included taking blood and urine samples according to the directives of DOQI, for a total of 8 months. Statistical analysis was based on the paired t-test and multiple regression analysis. The variations in blood flow and dialysate flow are positively related to the variation of the indexes Kt/V, TACurea and PCR and consequently to the haemodialysis adequacy both as isolated factors and when combined together.

Job-related stress among nursing personnel in Greek dialysis units.

The purpose of this study was to describe specific work-related factors that contribute to increased levels of stress experienced by nursing personnel, and to compare their impact on nurses and assistant nurses who work in Dialysis Units (DU) to those who work in Peritoneal Dialysis Units (PDU) in Greece. The sample of the study consisted of 682 members of nursing personnel working in DU and in PDU in Greek Hospitals. The collection of data was done by means of a questionnaire. The latter included questions about the motivation of nursing personnel for having chosen to work in these units along with questions about the stress factors related to the patients and their care, the role of the nurse in the unit, and the working conditions. According to the results of the study, the percentage of nursing personnel working in DU or PDU by their own choice was 71% and 8.3% respectively, whereas the rest of the staff were placed there irrespective of their preferences, by the Administrators. Among nursing personnel who had chosen to work in DU, the reported motives that contributed to their decision were the absence of a night shift (27.8%), and working in a closed unit. The main motive that incited nursing personnel to work in PDU was the acquisition and the application of specialized knowledge. The percentage of nursing personnel working in DU that expected high levels of job satisfaction was 77%, whereas the corresponding percentage for nursing personnel working in PDU was 65%. However, only 44% and 37% of the nursing personnel working in DU and PDU reported high levels of job satisfaction. The most important stressors related: i) To the patient: were the risk of contamination (79% DU, 84% PDU) and the death of a patient (77% DU, 80% PDU). 2) To the role of nursing personnel in the unit: were increased responsibilities (65% DU, 37% PDU), low involvement of the nursing personnel in decision making (58% DU, 54% PDU), and low professional status of nursing personnel. 3) To the working conditions: were the shortage of nursing personnel (74% DU, 99% PDU), limited material (74% DU, 57% PDU), the closed environment (75% DU, 64% PDU) and the daily work routine (78% DU, 61% PDU). In conclusion, we can say that working in DU and PDU provokes increased stress in nursing personnel, even though the implicated stress factors differ between these units.

Intrahospital transportation: monitoring and risks.

Patients' intrahospital transport is considered as part of the mediconursing care continuum, since patients frequently need diagnostic or therapeutic procedures not performed at the bedside (Waddell 1975, Rutherford & Fisher 1986). Severe complications, such as airway obstruction, artificial airway or intravenous line removal, arterial blood gas and blood pressure changes, and arrhythmias or cardiac arrest, have been described during this transportation, especially in critically ill patients (Taylor et al 1970). Risks can be diminished if the patients are appropriately selected and carefully monitored during transportation (Venkataraman & Orr 1992).

Formulation and testing of a nursing assessment form for mental patients as a basis for individualized nursing care.

The study described here was designed to develop and test a form of nursing assessment of mental patients for use as a basis for individualized holistic nursing care in any setting. Nursing assessment was made of 581 mental patients receiving care in either mental hospitals, psychiatric departments of general hospitals or in mental health centres. Subjects were observed, interviewed and asked to complete a structured assessment form. Major variables studied were physical nursing problems/needs with nine categories, psychosocial nursing problems/needs with nine categories, sex, age, and physical and psychiatric disorders. Data were analysed with frequency distribution and comparative techniques, correlational procedures, and the multiple linear regression statistical procedure. The frequency distribution of psychiatric diagnoses showed that schizophrenic disorders were the most frequent in the total sample. However, there were more depressive patients in the general hospital group. Physical nursing problems/needs were significantly related with psychosocial nursing problems/needs, affective-depressive disorders, sex and age as well as negatively related with psychotic and anxiety disorders. Psychosocial nursing problems/needs were significantly related with schizophrenic and psychotic disorders, physical disorders and with the younger age groups. It was concluded that the psychiatric nursing assessment should encompass the areas of personal characteristics, and physical and psychological problems of the patient, and thus lead to practicing psychiatric nursing, that is, holistic psychosomatic nursing.

Allocation of nursing time.

The purpose of this study was to examine the allocation of nursing time to various activities of registered and assistant nurses during the day shift. Twenty-three registered (RN) and eighteen assistant nurses (AN) working in medical and surgical wards of five large hospitals were studied. The findings have shown that the most frequent activities performed were; indirect care representing 35.6% of the time, direct care representing 23.8% of the time, personal activities representing 16.8% of the time, and direct nursing interventions representing 8.2% of the time. Cross-tabulation revealed that RNs provided direct care less frequently and indirect care more frequently than ANs (25.3 activities per RN and 27.5 per AN, 62.1 activities per RN and 32.6 per AN, respectively). Many indirect care activities were found to be the responsibility of the head nurse (64), secretary (465), and others (104). Less expected results were the minimal amounts of time spent on both education and research activities (1.3% and 0.0% respectively). Nurse managers have to free nurses from subsidiary work and to find mechanisms to distribute nursing valuable time more efficiently.

Psychosomatic nursing assessment of psychiatric patients.

This article presents the results of a research study on 547 mental patients testing a form of nursing assessment of mental patients in psychiatric and in general hospitals, as a means to assess their nursing needs and as a basis for planning, implementation and evaluation of their personalized holistic nursing care. The study showed that more depressive than schizophrenic patients went to the general hospital for help. The reverse was observed in the psychiatric hospital. The psychological nursing needs of the patients were significantly correlated with their somatic nursing needs. The psychological as well as the somatic nursing needs of the patients were significantly correlated with sex, age, somatic health state and mental health state in general, and not with their concrete psychiatric diagnosis. It is concluded that the psychiatric nursing assessment should be oriented towards the investigation of the patient's psychosomatic nursing needs rather than be based on his medical diagnosis.