Missed Nursing Care; Prioritizing the Patient's Needs: An Umbrella Review.

The objective of this review of reviews was to identify the reasons for missed nursing care and to shed light on how nurses prioritize what care they miss. Missed nursing care refers to essential nursing activities or tasks that are omitted or not completed as planned during a patient's care. This omission can result from various factors, such as staffing shortages, time constraints, or communication issues, and it can potentially compromise the quality of patient care and safety. Identifying and addressing missed nursing care is crucial to ensure optimal patient outcomes and the well-being of healthcare professionals. To be included, reviews had to use the systematic review process, be available in the English language, examine missed care in hospitals and at home, and include participants who were over eighteen years old. The review intended to answer the following questions: 'Why nursing care is missed?' 'How nurses prioritize what care they missed?'. An umbrella review was developed guided by the JBI methodology and using PRISMA-ScR. A total of 995 reviews were identified. According to the inclusion criteria, only nine reviews were finally evaluated. The findings indicate that care is missed due to staffing levels, organizational problems, and the working climate. Prioritization of care depends on acute care needs as well as educational and experiential background. Missed nursing care is associated with patient safety and the quality of provided nursing care. Specifically, it has negative impacts on patients, healthcare professionals, and healthcare service units. Organizational characteristics, nursing unit features, and the level of teamwork among nursing staff affect Missed Nursing Care. Individual demographic characteristics of the staff, professional roles, work schedules, and adequate staffing may potentially contribute to the occurrence of Missed Nursing Care, which is why they are under investigation. However, further consideration is needed regarding the management of patient needs and nurse prioritization.

THE RELATIONSHIP BETWEEN PSYCHOSOCIAL WORK ENVIRONMENT AND NURSES' PERFORMANCE, ON STUDIES THAT USED THE VALIDATED INSTRUMENT COPENHAGEN PSYCHOSOCIAL QUESTIONNAIRE (COPSOQ): AN EMPTY SCOPING REVIEW.

OBJECTIVE: Aim: This study was to map the relationship between psychosocial work environment and nurses' performance, on studies that used the Copenhagen Psychosocial Questionnaire (COPSOQ). PATIENTS AND METHODS: Materials and Methods: The review intended to answer following questions: 'Can COPSOQ screen completely psychosocial risks of nurses' work environment?' 'Which of these dimensions affect more nurses psychosocial world? A scoping review was developed guided by the JBI methodology and using PRISMA-ScR. CONCLUSION: Conclusions: Hospital workers, and in particular nurses, are exposed to different risk factors with the most important being psychosocial risks. These arise from problematic work planning, organization and management, as well as from an unhealthy social context of work and may lead to negative psychological, physical and social outcomes. The review highlighted the need for further research using the entire COPSOQ questionnaire in order to fully study the psychosocial risks that nurses face in their work environment.

Correlation of Cancer Caregiver's Burden, Stress, and Their Quality of Life.

OBJECTIVE: The purpose of this study is to examine the stress levels felt by family caregivers. The main objectives of this study are (a) the cross-examination of family caregiver's burden, (b) caregiver's stress levels and its impact on burden feeling, also (c) the effect of caregiving on caregiver's quality of life. METHODS: A quantitative method was developed, with the use and collection of anonymous questionnaires. Participants consisted of 121 family caregivers of patients under Home Parenteral Nutrition (HPN), along with the oversight of the company "Ygeias Erga and co." Tools that have been used for the needs of this study are a questionnaire with basic demographics: The Zarit Burden Interview (ZBI), Quality of life questionnaire (CarGQoL), and KINGSTON CAREGIVER STRESS SCALE (KCSS): Data were analyzed with SPSS 22. RESULTS: 65.3% of the participants were women with an average age of 50.7 years. 39.7% were patients' spouses and 26.4% were high school graduates. 31.7% of the participants suffered from a chronic disease, with 22.3% taking daily medication. 67.8% lived in the same house as the patient, 30.6% were taking care of the patient for 6-12 months, and 39.7% had no help from another person. 43.8% of patients were under HPN for 1-3 months. A negative correlation was found between all dimensions of the Zarit Burden Interview (ZBI) and Kingston Caregiver Stress Scale and cancer caregiver CarGQoL scale scoring. Participants, who had help from another person permanently, had a better quality of life from others with no help whatsoever. Higher stress levels were found to be correlated with worse quality of life. CONCLUSIONS: Burden increase was found to be related to stress increase. Younger participants and patients' female spouses had higher levels of stress. The present research also found that stress related to financial issues had an important role. Family caregiver support is found to be a matter of great importance, and healthcare professionals have to pay attention to their needs.

COVID-19 Pandemic and Health and Social Inequalities Worldwide: Impact and Response Measures in Greece.

OBJECTIVES: The pandemic has exacerbated pre-existing health and socioeconomic inequalities around the globe. In order to mitigate the effects of extreme isolation and containment measures, governments have taken steps to protect the health, the economy, employment, and socially vulnerable groups. The health crisis should be treated as a pretext in order to ensure universal access to health and socioeconomics.The aim of this review was the presentation of the way the pandemic contributed to the worldwide deterioration of health inequities affecting in parallel the social protection in the health, economic and educational sector along with other factors, the effects and the measures taken, in order to face the consequences of a pandemic on the social protection in Greece in comparison with other countries of Europe. METHODS: A cross-sectional bibliographic study was undertaken using keywords and phrases such as "COVID-19," "Health inequities," "Social protection," and "Social identifiers." The search was done through the search engines google scholar, PubMed, Health link, and Elsevier using either the Greek or English language. The total number of evaluated read-used articles was 30. Inclusion criteria were free full-text meta-analyses, reviews, and systematic reviews. RESULTS: The socially disadvantaged groups in the United States were found to have a lower life expectancy and higher morbidity rates than privileged social groups, as economic, health, and sociocultural precariousness are major causes of death. Patients with underlying diseases are vulnerable groups and increase the risk of coronavirus infection and quite often lead to loss of life due to complications of the disease. Greece is ranked in the 4th worst position with 61.10% in employment in all European Union (EU) countries. There is a significant increase in deaths with a percentage change from 2018 to date of 17.50%. It also holds the 3rd worst position among EU countries in the field of unemployment, while women hold the 2nd worst with a rate of 13.50%. Overworked and overindebted households due to extreme measures due to the pandemic (reduction of working time, quarantine) led to unemployment, loss of income, poverty, widening social inequalities, and deteriorating care for people with disabilities. Children due to the closure of schools and the loss of school meals are led to food insecurity. The pandemic also left many children orphaned after the death of their parents by COVID-19, with psychosocial problems exacerbated by school closures. CONCLUSIONS: The pandemic has exacerbated long-standing health and socioeconomic inequalities, stressing to governments the need to adopt political strategies that will help address them. Measures have been taken in Greece for labor protection, and unemployment benefits, such as the two-month extension of the subsidy period for the unemployed and the long-term unemployed. Minimum insurance days have also been reduced so that citizens employed in tourism, catering, and other seasonal occupations can receive unemployment benefits.

Investigation of Factors That Affect the Quality of Life After a Stroke.

Stroke, as a disease, describes a group of disorders characterized by the presence of central nervous system symptoms either as a result of ischemia (ischemic stroke) or bleeding (hemorrhagic stroke). The appearance of a stroke results in a permanent physical or cognitive disability. The stroke incidence is the third cause of death after heart disease and cancer, and is the main cause of long-term disability.The effects of a stroke on a patient's daily life, and hence on his quality of life, are intense and long-lasting. These include memory problems, speech difficulty, depression, reduced vision loss, and decreased walking ability. This limitation of the patient's motor activity has a direct negative impact on the quality of his life.To investigate the degree of this impact, a research was carried out at a hospital of Central Greece. The total sample consisted of 90 patients and the responses showed that post-stroke symptoms are significant. Consequences and treatment control of the disease on the life of the sample were the questions with the highest score showing the significant effect that a stroke has on life the patients.More specifically, the sample showed through responses that the disease affects their lives to a great extent. The pre-stroke scores on the domains of the sample are clearly higher than post-stroke. The highest difference was found in the use of the upper extremities in self-care and family roles while the lowest was found in the domain of thinking. The most affected domains were as follows: thinking, vision, and language. Alternatively, the least affected domain was family roles.

Outcomes of thulium prostatectomy with "Oyster technique" versus transurethral prostatectomy (TURP): a randomized control trial.

PURPOSE: To compare the perioperative and postoperative outcomes between Oyster prostate vaporesection using Tm-YAG laser and the conventional transurethral prostatectomy using monopolar energy. METHODS: Patients with LUTS with an accumulative size of at least 60 ml were randomly assigned to one of two parallel groups to undergo Tm-YAG laser vaporesection (Group 1) or conventional monopolar transurethral prostatectomy (Group 2). The primary endpoints were the reduction in IPSS and the increase in Qmax postoperatively. Secondary endpoints included the Hemoglobin drop, the complication rate, the changes in urodynamic parameters, the duration of hospitalization and catheterization and the changes in IIEF during the 24-month follow-up. RESULTS: In total 32 and 30 patients were enrolled in Groups 1 and 2, respectively. Patient age (p = 0.422) and prostate volume were similar among the groups (p = 0.51). The outcomes in terms of IPSS decrease and Qmax amelioration were comparable (p = 0.449 and p = 0.237, respectively). Operative and hospitalization times were lower in Group 1 (p = 0.002 and p = 0.004, respectively). Hemoglobin drop, changes in urodynamic parameters and improvement in IIEF and QoL scores did not differ among the two Groups. The average time with the catheter was 2.06 ± 0.35 and 2.5 ± 0.82 (p = 0.003) days for Group 1 and Group 2, respectively. The overall complication rate was 6.2% for Group 1 and 13.3% for Group 2. CONCLUSIONS: The Oyster technique leads to similar postoperative outcomes compared to the standard monopolar transurethral prostatectomy. The shorter catheterization, hospitalization and operation time should be considered advantages of the Oyster technique.

GREEK MILITARY NURSING OFFICERS' COMPASSION COMPETENCE AND COMPASSION LEVEL AT WORK AND THEIR PROFESSIONAL QUALITY OF LIFE.

OBJECTIVE: Aim: Of this study was to investigate the level of Military Nursing Officers'(MNOS) compassion competence and their personal level of compassion at work and their correlation with the professional quality of life. PATIENTS AND METHODS: Materials and methods This is a cross-sectional study carried out from December 2019 to May 2020 using the method of convenience sampling. The study involved 235 MNOs serving in Greek Military Hospitals. A single questionnaire containing Compassion at Work index, Compassion competence scale and ProQOL 5 was used for data collection. A total of 400 questionnaires were distributed with a response rate of 58.75%. Data analysis was performed using the statistical package SPSS 22.0. RESULTS: Results: The research showed that there was a significant positive correlation of the Compassion Satisfaction score with the com¬passion at work and compassion competence scales. So, the more compassion participants had, the more satisfaction they received from the care they put into their work. Conversely, the more compassion participants had, the less burnout they felt. Regarding secondary traumatic stress, it was found that the higher the participants' score on the dimensions of compassion in the dimension "Being non-judgmental", "Being tolerant to personal distress" and "Being empathic", the lower the secondary traumatic stress they felt. The position at hospital, the score on the compassion dimension in the dimension "Experiencing the suffering of others" were found to be independently related to the Compassion Satisfaction score. Specifically, Head Nurses had a 3.86 points lower score compared to Nurse managers. Higher values in the "Experiencing the suffering of others" dimension were related to a higher Compassion Satisfaction score. Nursing Officers who scored higher in compassion dimensions such as "Being non-judgmental", "Being tolerant to personal distress" and "Being empathic", they felt lower secondary traumatic stress. CONCLUSION: Conclusions: It is really important for Military nursing Officers to be compassionate in order to get more satisfaction from caring about their work and feel less burnout.

Practices and educational needs of Hellenic Police Officers in providing first aid/cardiopulmonary resuscitation: A cross-sectional survey.

BACKGROUND: It is well known that police officers (POs) are expected to be the first responders in emergency cases requiring First Aid (FA) such as cardiac arrest. OBJECTIVE: Description of practices and educational needs of Hellenic POs in providing FA/Cardiopulmonary Resuscitation (CPR) in case of medical emergencies and description of the equipment of professional FA kit. METHODS: An anonymous cross-sectional survey was conducted from January 1, 2016, to December 31, 2017, using a self-administered questionnaire designed to serve the purposes of this particular survey. The instrument consisted of 53 questions (multiple choice and open-ended questions) administered in a convenience sample of 700 POs of the Attica prefecture. RESULTS: A sample of 520 POs (constables and lieutenants) completed the questionnaire (response rate = 74.28%). Among the participants, 248 (47.7 %) declared that they had provided FA/CPR in the past, while among those declaring that they had never provided FA/PCR (n = 248), 153 (61.7%) said that they had experienced FA/CPR needs, but did not know what they had to do. Moreover, only 18.1% (94/520) of the POs answered that they have FA equipment in their professional equipment, which mainly includes bandages (54/94, 57.4%), while 29.7% of POs provided answers about their educational needs (313 in total) declared that they would like to be educated in bleeding control. CONCLUSION: There is a need to educate and train Greek POs in first aid and CPR in an organized and mandatory way in order to meet emergency needs.

Family Members' of Coronary, Cardiosurgery and General ICU Patients Resilience, Perceived Stress, Spirituality: a Cross Sectional Analysis.

Background: Family members' of coronary, cardiosurgery and general ICU patients are psychologically burdened, shaken, experiencing negative emotions such as fear, anxiety, sadness and despair due to the severity of the disease and possible death. Objective: To investigate family members' resilience in correlation with perceived stress and spirituality of coronary, cardiosurgery and general ICU Patients. Methods: A cross-sectional study was conducted on a random sample of 104 family members of patients (34 men and 70 women), admitted in the coronary, cardiosurgery and general ICU for greater than 48 hours. The PSS-14 was used to assess perceived stress. Resilience was investigated using CD-RISC-25 and spirituality using DSES. Also APACHE II was used to assesses the severity of the disease and the outcome of patients admitted to the ICU. Results: Resilience is significantly correlated with the scales of perceived stress (p <0.001) and daily spirituality (p = 0.019). On the contrary, the more their daily spirituality, the greater their resilience. In the present study no significant association was found between the DSES and the PSS-14. Conclusion: The main findings of the present study is the significant association between resilience and spirituality and perceived stress. Therefore, it is necessary to design interventions aiming at enhancing resilience, limiting perceived stress and promoting spirituality.

Validation of the Greek Version of Euthanasia Attitude Scale (EAS) in Greek Medical Doctors.

This study aimed to examine the reliability and validity of the Euthanasia Attitude Scale (EAS) in Greek medical doctors. A cross-sectional study design was conducted, including 120 physicians at clinical setting in 2019 (men 64.5%). A self-report questionnaire, including socio-demographic data and the Euthanasia Attitude Scale, which assesses attitudes towards euthanasia, were used for data collection. The mean (standard deviation) of the EAS were 74.62 (14.33). The Cronbach's alpha was 0.944 and the confirmatory factor analysis to investigate the validity of the EAS scale, after modification effects, revealed an acceptable adjustment for the questionnaire. The GFI index was above 0.8 and close to 0.9, and the CFI index was above 0.9, which is the acceptable limit. The RMSEA index was acceptable below 0.08. The total Gr-EAS correlated with all five factors (Pearson r = 0.400−0.973, p < 0.001). According to the findings of this study, the Euthanasia Attitude Scale is a reliable and valid measure for assessing the attitudes toward euthanasia in Greek physicians. This Greek adaptation will be valuable in future studies examining the attitude of physicians towards euthanasia.

Physicians' attitudes towards euthanasia and correlation with their spirituality.

"Suffering" patients' wishes concerning hastening their own death by means of euthanasia, raised by personal, psychological, social and other motives, are becoming increasingly common. This raises controversies and marks challenges within both the scientific community and the public. The aim of this study is to investigate physicians' attitudes towards euthanasia and its correlation with their spirituality. The final sample consisted of 93 physicians (64.5% men), whose attitudes on euthanasia who were evaluated using Euthanasia Attitude Scale (EAS) and Daily Spiritual Experience Scale (DSES). Physicians' attitudes correlate with their specialty (p=0.037), years of service (p=0.037), as well as the number of end stage patients they cared for and died within the last 12 months (p=0.016). Oncologists and other physicians with similar specialty, those with longer clinical experience and those who treat more end-stage patients to strongly oppose to the above practices. Spirituality, estimated with Daily Spiritual Experience Scale -DSES, is correlated with a negative attitude toward euthanasia (p<0.001). Finally, a considerable gap in physicians' training regarding the management of end stage patients has been highlighted. Physicians are opposed to euthanasia and they require the acquisition of competencies in end-of-life care in order to fulfill their profession's current and future demands in the domain of palliative care.

Effort Reward Imbalance and Insomnia Among Greek Healthcare Personnel During the Outbreak of COVID-19.

BACKGROUND: This study's objective was to examine associations between insomnia as measured by Athens Insomnia Scale (AIS) and perceived psychological work stress among nurses and physicians working in secondary and tertiary hospitals in Greece during the outbreak of COVID-19 pandemic. OBJECTIVE: Taking into account the small but significant differences in the development of ADHD in women, this literature review aims at identifying the special characteristics of ADHD symptoms in all stages of a woman's life from childhood to menopause. Being aware of these signs is important to provide the best quality of health care in ADHD women. METHODS: A cross-sectional study was conducted on a random sample of 268 healthcare workers (200 nurses and 68 physicians). The 8-item version of the AIS was used to assess insomnia. Perceived psychological work stress was investigated using the 23-item Effort-reward Imbalance (ERI) questionnaire based on the ERI model. RESULTS: HCWS who cared for more than 5 patients and worried about personal issues had a higher insomnia score. ER-ratio and over-commitment are significantly associated with insomnia. A significant correlation was found between worries about pandemic COVID-19 and over-commitment. CONCLUSION: Since high effort-reward imbalance (ER-ratio > 1) and overcommitment were positively associated to insomnia and the treatment of more than five patients with COVID-19 infection was impacting predictor of sleep difficulties, it is necessary to implement a reward system in which physicians and nurses will work in a less stressful environment aiming at reducing personnel's negative feelings, poor health and sleeping difficulties.