Prevalence and factors associated with compassion fatigue, compassion satisfaction, burnout in health professionals.

BACKGROUND: Constant exposure of health professionals to the pain and suffering of patients can adversely affect their emotional wellbeing. AIM: The study aimed to investigate the prevalence and the factors affecting the levels of secondary traumatic stress/compassion fatigue (STS/CF), burnout (BO) and compassion satisfaction (CS) of health professionals working in adult and paediatric Intensive Care Units (ICU) as well as in departments treating patients with serious illness in five hospitals in Crete. STUDY DESIGN: A descriptive cross-sectional survey with the use of the Professional Quality of Life Scale (ProQOL-CSF-R-IV) questionnaire. METHODS: We enrolled medical, nursing and support staff working in the adult and paediatric ICU, emergency, oncology, haematology and neurosurgical departments, haemodialysis unit and operating theatre. RESULTS: 598 health professionals completed the questionnaire (response rate 73.2%). Significantly increased levels of STS/CF were observed in non - ICU as compared to ICU staff (p = .009) females compared to males (p < .001), those who have previously experienced a traumatic event (p < .004), nurses and support staff compared to doctors (p = .007 and p = .028 respectively), and people not working in a department by choice (p < .001). CS was higher for older professionals, personnel subjected to stress reduction techniques (p < .019) and professionals working with children or mixed adults and children population (p = .009). Rolling schedule and bad working conditions negatively affected CS (p = .02, p = .001). Increased BO levels were associated with younger age (p = .029) and showed a positive correlation with STS/CF (r = .356, p < .001). CONCLUSIONS: STS/CF is common in health professionals regardless of their profession, working department or hospital level. Non-ICU staff displayed higher STS/CF levels. Working in a department by choice ameliorates CS, BO and STS/CF. RELEVANCE TO CLINICAL PRACTICE: Health professionals need to be informed about the risks of projecting patients' suffering on themselves. Hospital managers and department heads are responsible to provide appropriate support.

Long-term outcome of hypertensive patients with heart failure with mid-range ejection fraction: The significance of blood pressure control.

Heart failure (HF) with mid-range ejection fraction (HFmrEF) is a newly suggested entity in HF. Since it has been inadequately addressed, there is an urgent need to determine the profile of HFmrEF patients and the optimal approach to their management. The present study aimed to assess the long-term clinical outcomes of hypertensive patients with HFmrEF and the impact of blood pressure (BP) on their mortality and cardiovascular outcome. We performed a retrospective observational study that included 121 hypertensive patients with HFmrEF and 149 hypertensives with heart failure and preserved ejection fraction (HFpEF). The median follow-up was 84 months (22-122). Our analysis did not reveal any statistically significant difference between the two groups in total mortality (P = 0.34) or cardiovascular mortality (P = 0.54). The total mean survival time was 102.9 months (100.5-110.1), while the mean survival time was 105.3 months (80.4-90.2) in HFpEF and 97.6 months (92.7-102.6) in HFmrEF. An office systolic BP > 139 mm Hg and diastolic BP > 89 mm Hg were significantly associated with both all-cause mortality (P = 0.02 and P = 0.013, respectively) and cardiovascular mortality (P = 0.02 for both). In HFpEF patients, no significant association was found between outcome and office BP. HFpEF and HFmrEF have similar long-term outcomes. Suboptimal BP levels are a significant risk factor for an adverse outcome in HFmrEF. Our results emphasize the importance of good BP control in order to achieve better outcomes in hypertensives with impaired EF and HF symptomatology.

The experience of Greek families of critically ill patients: Exploring their needs and coping strategies.

OBJECTIVES: To explore the experiences, needs and coping strategies of families of patients admitted to adult intensive care units. DESIGN AND SETTING: A descriptive qualitative research design was chosen using an inductive thematic content analysis approach. Semi-structured interviews were conducted withfourteen family members in three hospitals of Crete. FINDINGS: Four main themes were derived from data analysis. Our results showed that family members were in turmoil having to deal with intense and alternating feelings. The protection of patient's dignity and well-being was of utmost importance mainly by maintaining proximity. Getting comprehensible information and building communication with the healthcare providers was often problematic. Three coping strategies were used: optimism, family support and spirituality. CONCLUSION: This study is a contribution to the understanding of Greek family's experiences and psychosocial needs during critical illness. A family-inclusive framework should be promoted and implemented in intensive care recognising and supporting family's role in the patient's illness and recovery.