Cultural Adaptation and Validation of the Spiritual Coping Strategies Scale (SCSS) for Greece.

INTRODUCTION: Spirituality constitutes a central element of all health and social care professions. The Spiritual Coping Strategies Scale (SCSS) measures both spiritual and religious coping strategiesAim: The aim of this study was to provide evidence for the reliability and validity of SCSS for Greece. METHODS: A total of 301 nurses were selected by convenience sampling and required to complete the SCSS and the FACIT-Spiritual Well-Being Scale-12 non-illness scale. Forward-translations and back-translations were conducted by two bilingual translators (English-Greek) grown up in English-speaking countries (USA, Australia) while cross-cultural adaptation followed strictly the recent WHO guidelines. The reliability and validity of the scale were evaluated by correlation analysis, t-test, and exploratory factor analysis. RESULTS: Convergent validity was investigated in comparison to FACIT-Sp-12. Meaning, peace, faith, and total spirituality were positively correlated to SCSS as expected (r = 0.22 for Meaning, r = 0.34 for Peace, r = 0.70 for Faith, and r = 0.66 for Total Spirituality), implying sufficient convergent validity. The Cronbach's α coefficients of the two subscales were 0.91 and 0.78, respectively. Additionally, the Pearson correlation r for both spiritual and religious strategies showed strong correlations between the two measurements (p < 0.001), first administration and three weeks after. CONCLUSION: SCSS has good reliability and validity among nurses in Greece.

Psychiatric Care in Acute Care Units with Locked Doors: Nursing Care Providers' Perceptions and Experiences.

Social distancing and the recent lockdown due to COVID-19 have increased the feeling of disconnection, isolation, and suffering in vulnerable individuals and have brought forward questions regarding locked acute care psychiatric units that cannot be answered by the literature. In Greece, there is no available research on how locked ward environments are perceived and experienced by mental health professionals. The aim of the present study is to illuminate nursing care providers' perceptions of psychiatric care in units with locked doors. Fifteen nursing care providers were interviewed and inductive content analysis was employed to explore their experiences of working in locked psychiatric acute care units. Negative and positive feelings about door locking did not appear to match the specific system of practice. Some participants described how locked doors influenced their professional role by placing emphasis on control rather than care while others regarded locked doors as a symbolic way of therapeutic boundary setting. Participants had positive experiences when they perceived their working environment as caring. The therapeutic benefits of locked doors were prominent when locked doors were perceived as "invisible."

Nurses' Experiences of Psychiatric Care in Acute Care Units with an Open Door Policy.

Social distancing and the recent lock down due to COVID-19 has increased the feeling of disconnection, isolation, and suffering in vulnerable individuals and has brought forward questions regarding open acute care psychiatric units that cannot be answered by the literature. In Greece, there is no available research on how open ward environments are perceived and experienced by mental health professionals. The aim of the present study was to illuminate nurses' experiences of working in a public psychiatric hospital which traditionally operates with open doors. Eleven nursing care providers were interviewed, and thematic analysis was employed to explore their experiences of working in locked psychiatric acute care units. Participants described nursing care in units with an open door policy as "acceptance," "availability of staff," "real respect for the person," "ensuring patients' rights," "listening to the person," and "negotiation and not imposition." Trust in therapeutic relationships was perceived as greatly dependent on the trust being given to patients indirectly by the open door policy. Being trusted enhanced patients' self-determination and self-confidence leading to their empowerment. Containment of an acute mental health crisis took place through medication and meaningful discussions with patients and significant others rather than locking the door of the unit. Overall, meaningful care led to professional emancipation, but compassion fatigue narratives emphasized the need for continuous education, support and clinical supervision as necessary support for mental health nurses in a system of mental health provision often reduced to the point of crisis.

COVID-19 associated pulmonary embolism with D-dimer values within the referent range: a case report and review of the literature.

OBJECTIVE: COVID-19 is associated with an increased incidence of pulmonary embolism (PE). Elevated D-dimer levels are linked to an increased risk of PE and poor clinical outcome. We reported a case of PE in a COVID-19 patient with normal D-dimer levels and conducted a review of the literature on the subject. CASE REPORT: A 38-year-old man with no prior comorbidities returned to the COVID-19 outpatient clinic 36 hours after being discharged from the hospital, where he had been treated for COVID-19 pneumonia. He reported a sudden feeling of dyspnea and chest pain. The physical examination was unremarkable. No new changes were detected on the chest X-ray. D-dimer and cardiac-specific markers values were within the referent range. The patient underwent an urgent computerized tomography pulmonary angiography which revealed signs of bilateral arterial thrombosis. He was treated with a therapeutic dose of low molecular weight heparin and discharged after 15 days, with a recommendation to use a direct oral anticoagulant. CONCLUSIONS: Healthcare professionals should be aware that PE can occur as a late complication of COVID-19. Clinical suspicion of PE should lead physicians to use additional diagnostic methods to confirm or rule out PE, even if D-dimer levels are within the referent range.