Investigation on the Attitudes and Perspectives of Medical and Nursing Staff About Euthanasia: Data From Four Regional Greek Hospitals.

INTRODUCTION: The good and benefit of the patient are the main drivers of the decisions that health professionals are asked to make. However, the definition of the good and the actions required for benefit are not always simple and self-evident. The intractable ethical dilemma of euthanasia has been the subject of extensive debates over the years, and numerous studies have been carried out in an attempt to record the attitudes and opinions of both health professionals and the general population. METHOD: This research aims to investigate the opinions and perspectives of the medical and nursing staff of the four regional hospitals regarding euthanasia and to detect the factors that advocate for and against it. Two hundred and eighteen medical and nursing staff members from four regional hospitals in Lasithi participated in the research, whose opinions and influencing factors were investigated using a questionnaire consisting of four sections. The first included demographic and general characteristics questions; the second was the Euthanasia Attitude Scale (EAS); the third was the Death Attitude Profile-Revised (DAP-R); and the last was the Daily Spiritual Experience Scale (DSES). The SPSS software version 25.0 (IBM Corp., Armonk, NY) was used to analyse the data. RESULTS: Of the total, 78.0% of the participants were women, with an average sample age of 44.5 years. 65.1% were married, 23.4% were physicians, while 76.6% were nurses. The mean Euthanasia Attitude score (70.89) is moderate, ranging from 30 to 120, with higher scores suggesting more favourable sentiments. Euthanasia was viewed positively by 24.3% of respondents. There was no significant difference in positive attitudes between medical and nursing staff. However, the nursing staff had significantly lower average levels of General Orientation for Euthanasia, for the Role of Healthcare Professionals in Euthanasia, Values & Ethics, or Daily Spiritual Experience, and conversely higher levels of scores on Patients' Rights Issues for Euthanasia or Death Acceptance. CONCLUSIONS: Health professionals were found to have moderate attitudes about euthanasia, with no significant difference between them, as well as moderate degrees of death and everyday spiritual experience. Overall, a more favourable euthanasia attitude was shown to be strongly associated with individuals who were single, divorced, or widowed, with less death acceptance or more neutral acceptance, but not with daily spiritual experience.

Assessment of Burden in Family Caregivers of Chronic Hemodialysis and Peritoneal Dialysis Patients During the Pandemic Period of COVID-19.

INTRODUCTION: In Greece, patients undergoing hemodialysis (HD) usually go to dialysis centers two or three times a week for three/four hours per session because the treatment for home is unavailable; therefore, caregivers should perform supportive transportation and care functions. PURPOSE: This study was designed to assess the burden and quality of life in caregivers of patients undergoing hemodialysis and peritoneal dialysis (PD) and to record their attitude toward Coronavirus Disease-2019 (COVID-19). METHODOLOGY: We studied caregivers of patients undergoing hemodialysis and peritoneal dialysis. A total of 80 caregivers took part (30 caregivers of patients of PD and 50 caregivers of patients of HD). The final form of the questionnaire was based on the Quality-of-Life Scale (SF-12) and the Zarit Scale, in order to record the scale of burden and the effect on them throughout the process. The Fear Due to COVID-19 Scale (FCV-19S) contributed to recording the caregivers' fear toward the pandemic of COVID-19. RESULTS: Most of the caregivers were women with an average age of about 60 years and 6-10 were the patient's wife or partners. The prevalence of the moderate or severe burden of the patients was found at 18.7%, and the few or no burden at all at 33.8%. The prevalence of fear toward COVID-19 was at very high levels, reaching 82.5% in all caregivers. CONCLUSIONS: During the pandemic period of COVID-19, the role of the caregivers of the patients, both who follow the PD method and those who have joined the HD, is particularly important. Their quality of life has been partially affected in all dimensions.

Investigating Physical Activity Habits and Sleep Disorders in the Nursing Staff of Greece During the COVID-19 Pandemic: A Multicenter Cross-Sectional Correlational Study.

INTRODUCTION: The social isolation (lockdown) used worldwide as a measure to effectively prevent the infection of COVID-19 has been shown to be responsible for the high prevalence of depression, anxiety, insomnia, and post-traumatic stress symptoms. The aim of this study was to investigate the physical activity habits and sleep disorders in the nursing staff. METHODOLOGY: This is a multicenter cross-sectional correlational study. The study population consisted of nurses and nursing assistants. Data were collected using the Greek version of the Pittsburgh Sleep Quality Index, the Fear of the COVID-19, and the Physical exercise questionnaire of the American College of Sports Medicine. Statistical analysis of data was done with IBM SPSS v. 22.0. RESULTS: A total of 1710 nursing personnel aged 42.3 ± 9.1 years were included. At the beginning of the COVID-19 pandemic, 190 (11.1%) participants were physically active, and 2 years after the beginning of the COVID-19 pandemic, active were 130 (7.6%) participants. Both at the beginning and two years after the beginning of the pandemic, the sleep dimensions that scored higher were subjective sleep quality (1.98 ± 0.2 vs. 1.98 ± 0.3), sleep onset latency (1.89 ± 1.5 vs. 1.64 ± 1.6), and sleep duration (1.55 ± 0.9 vs. 1.65 ± 0.8). The total sleep score was 8.64 ± 3.1 at the beginning of the pandemic and 8.11 ± 3.7 two years after the beginning of the pandemic. CONCLUSIONS: Nurses and nurses' assistants had less physical activity habits, slept less, and had more sleep disorders 2 years after the beginning of the pandemic in relation to the beginning of the pandemic.

Comparison of Selected Older and Younger Patients Regarding Optimal Surgical Treatment of Colorectal Cancer: A Prospective Cohort Study.

BACKGROUND/AIM: Current evidence regarding the optimal management of older colorectal cancer patients, is conflicting. Functional deficits impact long-term survival prognosis, while frailty often results to optimal treatment postponement. Thus, the characteristics of this subgroup combined with treatment deviations further perplex optimal oncological management. The study aim was to compare survival and optimal surgery rates between older and younger colorectal cancer patients. PATIENTS AND METHODS: This study was designed as a prospective cohort. All adult (³18 years) colorectal cancer patients operated, during the 2016-2020 period, in the Department of Surgery, University Hospital of Larissa, were considered as eligible. The primary endpoint of the study was the difference in terms of the overall survival between older (>70 year) and younger (<70 years) colorectal cancer patients. RESULTS: Overall, 166 patients (60 younger and 106 older) were enrolled. Although the older subgroup displayed a higher rate (p=0.007) of ASA II and ASA III patients, mean CCI scores were comparable (p=0.384). The two subgroups were similar in terms of performed operations (p=0.140). No delay in surgery was noted. Most operations were performed using an open approach (open: 57.8% vs. laparoscopic: 42.2%), under an elective status (elective: 91% vs. emergency: 1.8%). There was no difference in terms of overall complications rate (p=0.859). Overall survival was similar (p=0.227) between the older and younger subgroups (25.68 vs. 28.48 months). CONCLUSION: Older operated patients did not differ from their younger counterparts with regard to their overall survival. Due to several study limitations, further trials are required to confirm these findings.

Views and Attitudes of Blood Donors toward Blood Donation during the COVID-19 Pandemic in Thrace Region, Greece.

The COVID-19 pandemic has been going on for the last two years and it has affected our society and, amongst other things, has had a negative impact on blood donation, which has led to a significant reduction in blood supplies worldwide. The imposed restrictions in terms of physical presence and transportation, and the fear of the unknown, have aggravated the situation. In Greece, after the first cases of COVID-19 were reported, the blood supplies at the blood transfusion units (BTUs) were dramatically reduced. Although the blood transfusions were lessened during the COVID-19 pandemic period, the blood stocks at all the BTUs of the country were also reduced.

Evidence-Based Leadership: A Study of Its Application to General Hospital of the Public Health System Through the Implementation Leadership Scale.

BACKGROUND: Evidence-based practice (EBP) is about integrating scientifically proven effective methods into clinical practice by healthcare professionals in the context of patient care. This approach is being studied extensively by the scientific community because of its positive effects on patients and on the health system. The aim of the study was to investigate the degree of implementation of evidence-based leadership in Greek public hospitals. METHODS: This is a cross-sectional study. The sample of the study consisted of 213 nurses who worked to two large public hospitals of Athens, Greece. The Implementation Leadership Scale (ILS) used for data collection. The SPSS v. 24. was used to analyze the data. RESULTS: Most of participants were females (89.7%), aged 31-40 years (38.5%), married (74.8%), were RN (68.1%), and had more than 10 years of work experience (63.9%). About half of participants (40.4%) supported that the head nurse has taken in a great extent the necessary measures to facilitate evidence-based clinical care, thus positively affecting its implementation. About one third of participants (35.2%) considered that their head nurses are well informed. The more knowledge nurses have about evidence-based clinical care, the greater their prevention (r = 0.852, p < 0.05) and the more persistent they are in implementing it despite any difficulties (r = 0.796, p < 0.05). CONCLUSIONS: Knowledgeable, supportive, proactive, and persistent leadership positively influences the implementation of evidence-based practice. The hospital managers, and especially head nurses, are able to promote the implementation of evidence-based care.

Investigating the Main Causes of Conflicts and the Management Strategies That Are Used by Healthcare Professionals: The Case of General Hospital of Arta.

BACKGROUND: Employees in healthcare systems are often conflict in the workplace due to the high-pressure environment and the diversity between different departments. The aim of the study was not only to investigate the main causes of creation of conflicts but also investigate conflict management strategies health professionals use in a public hospital. METHODS: This is a cross-sectional study. An anonymous questionnaire was used on a sample of 25 physicians and 95 nurses. RESULTS: Conflicts exist between colleagues and other professional groups. The most common management strategy is to avoid conflict, and second-place behavior such as compromise and negotiation for mutual benefit come along. The results of the organizational causes of conflicts have shown that important factors are the workload, the commands received by more than one supervisor, their reward, and the fact that their present work does not look like as what they had in mind about ideal work. Finally, the results on the causes related to employee expectations have shown that significant causes in this direction are the differences in the level of education, the unfair rewards among the various professional groups are that they do not have common professional expectations with other professional groups and that professional development is not related to their expectations. CONCLUSIONS: The most popular proposals for conflicts solutions are nondiscrimination between the healthcare professionals, a fair approach to reward and punishment, communication and cooperation in the organization/hospital, establish a clear division of responsibilities, and establish professional management and the departments have to be autonomous.

Incidence of Deep Vein Thrombosis and Its Effect on Health-Related Quality of Life Among Nurses of Greek Public Hospitals: A Multicenter Study.

BACKGROUND: Vein thrombosis (VTE) is a collective term for deep vein thrombosis (DVT) and pulmonary embolism (PE). The aim of this study was to investigate the impact of DVT and its association with health-related quality of life among Greek nurses. METHODS: This is a multicenter descriptive correlation study. The sample of the study was nursing staff working in Greek public hospitals. The diagnosis of DVT was set by Hicks's clinical criteria. RESULTS: The study included 6304 nurses with a mean age of 47.4 ± 4.9 years. Diagnosed by a physician, DVT had 544 (8.6%) participants. The mean score of the overall dimension of physical health-related quality of life was 68.1 ± 21.9 and the overall score of mental health scale was 53.3 ± 10.4. The odds of DVT occurrence increased dramatically for female gender (CI: 27.76, 95% CI: 8.12-94.89, p = 0.001). Increased odds were found also for advanced age (CI: 1.21, 95% CI: 1.09-1.33, p = 0.001), advanced BMI (CI: 1.06, 95% CI: 1.02-1.10, p = 0.001), and smoking (CI: 2.72, 95% CI: 1.51-4.90, p = 0.001). Moreover, previous pregnancy (CI: 1.66, 95% CI: 1.21-2.29, p = 0.002), work experience (CI: 1.13, 95% CI: 1.03-1.23, p = 0.008), and Rhesus (CI: 2.55, 95% CI: 1.11-5.84, p = 0.027) were found to be risk factors for DVT. CONCLUSIONS: Nurses are potentially a professional group for developing deep vein thrombosis, and given the high incidence found in this study, as well as the lower proportion of nurses who were undiagnosed while meeting the clinical criteria of Hick, it is essential for nurses to check their lower extremities for DVT annually.

The Job Rotation of Nursing Staff and Its Effects on Nurses' Satisfaction and Occupational Engagement.

INTRODUCTION: Job rotation in nursing staff involves moving workers from one department to another to increase their qualities in all areas. AIM: Investigating the effects of job rotation of nursing staff on employee satisfaction and occupational engagement. METHODOLOGY: A total of 211 nurses took part in the study. A structured questionnaire with closed-ended questions was used to collect the data. The questions used were based on previous research tools. The data analysis was performed with the SPSS statistical package v.24.0. RESULTS: Τhe results regarding the correlation of job rotation, job satisfaction, and occupational engagement show that job rotation is positively related to occupational engagement and job satisfaction of nurses. The overall attitude of nursing staff toward job rotation is neutral, and they express moderate to neutral professional satisfaction, moderate degree of vigor and absorption, and moderate-to-high degree of dedication. Regarding the correlation of job rotation, job satisfaction, and occupational engagement with the demographic characteristics of nurses, it was found that the gender and years of work of nurses are not the factors that affect job satisfaction, occupational engagement, and job rotation. On the contrary, it was found that the age of nurses is a factor that only affects their work satisfaction, nursing education is a factor that only affects nurses' occupational engagement, and job position is a factor that affects nurses' occupational engagement and job rotation. CONCLUSIONS: The results highlight the importance of job rotation of nursing staff in their professional satisfaction and occupational engagement.

Attitudes of the General Population Regarding Patient Information for a Chronic and Life-Threatening Disease: A Cross-Sectional Study.

BACKGROUND: The form of communication developed between the physician and the patient and between the physician and the patient's close relatives builds the foundation for the process of announcing unpleasant news, which is related to the diagnosis of chronic disease. The aim of this study was to investigate the attitudes of the general population regarding the information of patients for a chronic and life-threatening disease. METHODS: It is a cross-sectional study. An anonymous questionnaire was used on a sample of 350 people. RESULTS: The 95.1% of participants considered that patients have the right to be fully informed about their health status and that the physician has the right to be informed. The 90.3% of the respondents argued that patients differ in their preferences. Totally, 60.3% of participants agreed that all patients would like to know the bad news about their health, while 44.5% argued that patients do not want to hear bad news about their health, and 32.3% believed that patients should be protected from the announcement of bad news. The majority of respondents (95.6%) were informed by the physician about their or their relevant chronic disease. CONCLUSIONS: The general population is of the opinion that patients should be informed about their health status. Due to the fact that each patient responds differently to the announcement of the unpleasant news, the respondents replied that the announcement of the unpleasant news should be personalized and carried out by the physician.

The Burden on Carers with Multiple Sclerosis.

BACKGROUND: The family members of patients with multiple sclerosis (MS) are called to become carers, playing a vital and difficult role in supporting the patients in their daily life. The aim of this study was to investigate the extent of the multidimensional burden on the carers of multiple sclerosis. METHODS: Data were collected from 111 carers with MS patients. The survey was conducted in Patras General Hospital. RESULTS: According to the research findings, the multidimensional burden of carers is proportional to the severity of the patient's condition. In particular, the majority of patients were in a good kinetic state, so the carers examined felt gentle with a moderate burden. On both scales, Zarit and BAKAS, it was observed that the age of the caregiver, the type of care he provides, and the patient's dependence on him increase the feeling of the burden. Positive results from care improve the caregiver's relationship with the patient, his self-esteem, and his ability to cope with stress. According to the F-COPES scale, it is observed that the relationship between the caregiver and the patient is responsible for accepting the problem; the greater the caregiver's age, the higher the percentage of those seeking help from doctors, social services. CONCLUSIONS: The burden on carers is indisputable; support from family members, social and economic support, and education may mitigate the burden of care.

Assessment of Healthcare Professionals' Knowledge and Awareness on Aspects Related to Ionizing Radiation Examinations in Athens, Greece.

BACKGROUND: Healthcare professionals involved with ionizing radiation must have sufficient knowledge of its effects on the human body in order to avoid potential risks for both patients and themselves. The aim of this study was to estimate the knowledge and awareness of healthcare professionals about the hazards of radiological examinations on their health and on their patients. METHODS: This is a cross-sectional study, and the data collection was carried out with a self-administered questionnaire. The study group included a total of 210 individuals from different professional groups: nurses, doctors, medical technicians, radiologists, and other staff working in different clinics that use radiation in their work. The study was carried out in a large hospital in Athens, Greece. RESULTS: The study population consisted of 210 subjects aged 44.7 ± 9.1 years. In a total of 23 questions, participants answered correctly to 6.4 ± 2.6 questions. The factors for predicting the correct responses were male gender (ß = -1.034, p = 0.004), frequency of contact with imaging examinations of patients requiring ionizing radiation (ß = 0.496, p = 0.007), participation in any educational process (ß = -0.918, p = 0.014), the number of published articles on radiation protection (ß = 0.720, p = 0.001), and knowledge of the principle of ALARA (ß = -0.391, p = 0.001). CONCLUSIONS: It is proposed to include a radiation protection course in the total healthcare professionals' undergraduate curricula in order to address the current knowledge gap in clinical practice.

Medication Errors and Their Correlation with Nurse's Satisfaction. The Case of the Hospitals of Lasithi, Crete.

BACKGROUND: Medication errors have been recognized as a real problem for all health systems worldwide and are the most common category of nursing errors. The aim of this study was to investigate the prevalence of medication errors and their correlation with the job satisfaction of nurses. METHOD: A prospective cross-sectional study was carried out and the sample of the study consisted of 189 nurses. To investigate medication errors, an anonymous structured questionnaire of 34 questions was used and Job Satisfaction Survey (JSS) questionnaire was used to measure job satisfaction. The IBM SPSS 25.0 program was used for statistical analysis of the data. RESULTS: 63.0% of nurses have been errors in the administration of medication, more often by the wrong time of administration (34.4%), missed dose (22.8%), and wrong dose (21.7%). The likelihood of an error is similar in all shifts, its devaluation is a non-reference reason, and if reported to a greater frequency in the attending physician. A significant difference in the frequency of errors was found only in the marital status and the job, while under the working conditions no significant variation was recorded. Job satisfaction is statistically significantly low for financial earnings and high for the management supervision. Based on the findings, the correlation between total job satisfaction and medication errors was not significant. CONCLUSIONS: Nursing medication errors continue to happen. Continuing education, formal recording, and improvement of working conditions could help prevent and minimize errors and at the same time increase the job satisfaction of nurses.

Health-Related Quality of Life and Living Costs of HIV-Infected Patients.

AIM: The aim of this study was the evaluation of health-related quality of life (HRQoL) of HIV-infected patients and the effect of their illness in their living costs. MATERIAL AND METHOD: This is a cross-sectional study and the study sample, which was a sample of convenience, included 98 HIV-infected patients from March to May 2019 at the General Oncology hospital "Oi Agioi Anargyroi" in Greece. The main tools of the survey were the Greek version of the MOS-HIV and a questionnaire used for measuring rehabilitation costs in trauma patients adjusted for the needs of the this study. RESULTS: A total of 98 patients were inducted in our study aged 49.3 ± 11.3 years, most of them males (68.3%). HRQoL was assessed in 11 individual dimensions. The highest score was found in the dimensions of role functioning (73.47 ± 36.93), physical functioning (72.53 ± 26.65), and social functioning (71.63 ± 32.3). Regarding the patients' living costs over the last month due to their illness, the highest burden comes from other expenses (152.4 ± 179.5), services provided by a psychologist (142.8 ± 170.6) and medical visits (142.8 ± 170.6). CONCLUSIONS: As the HIV infection is characterized as a chronic disease, the economic cost due to the illness needs to be studied as it affects the extent to which an HIV-infected patient can access medical care and meet emerging needs. Therefore, future research should focus in the economic dimension of the illness in relation with the quality of life of these patients and their relatives, so that new health policies may arise.

Evaluation of Anxiety and Depression in Women Undergoing Mastectomy in Greece.

BACKGROUND: To determine the levels of depression and anxiety in women undergoing mastectomy and to investigate the factors related to the onset of anxiety and depression on the eve of the surgery. METHODS: This is a prospective observational study. The sample of the study consisted of 82 women with breast cancer who are going to undergo surgery. The assessment of patient anxiety and depression was done with the HADS anxiety and depression hospital scale. RESULTS: The study sample was 82 patients aged 56.8 ± 12.9 years. Most of them were married (68.3%), had children (87.5%), were Greek (93.6%), Orthodox Christians (97.4%), housewives (28%), and retired (23.2%). In total, 70 (85.4%) participants would be subjected to single mastectomy and 12 (14.6%) both of them. More than half of respondents (51.9%) smoked, while 32.7% consumed alcohol. 51.2% had pathological stress levels and 31.7% pathological levels of depression. Participants with abnormal levels of anxiety were significantly younger (p < 0.05), smoked at a significantly lower rate (p < 0.05), and made significantly fewer cigarettes per day (p < 0.05). Participants with abnormal levels of depression were significantly younger (p < 0.05), significantly more "other" (p < 0.05) and "other" (p < 0.05) and had a significantly higher educational level (p < 0.05). CONCLUSIONS: The factors found to affect participants stress levels were young age, reduced smoking rates, and the smallest number of cigarettes per day, while the factors found to affect participants' levels of depression were the young age, the other ethnicity except for Greek, the other religion except Christianity, and the highest educational level.

Investigating Nursing Leadership in Intensive Care Units of Hospitals of Northern Greece and Its Relationship to the Working Environment.

INTRODUCTION: The relationship between leadership and the work environment has been studied by many authors at the organization level, but not specifically in intensive care units (ICUs). The aim of this study was to investigate the possible relationship between the work environment and nursing leadership in intensive care units. METHODOLOGY: This is a correlation study. The study population consisted of nurses and nursing assistants with at least 6 months of experience in ICUs of Northern Greece hospitals. Data were collected using the Greek version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Multifactor Leadership Questionnaire (MLQ). Statistical analysis of data was done with IBM SPSS v. 22.0. RESULTS: A total of 64 nurses aged 43.6 ± 6.4 years were included. In the work environment, the dimensions of nursing staff competence (2.4 ± 0.6) and relationships between nursing staff and physicians (2.4 ± 0.6) were higher, and the dimensions of nursing staff involvement in decision-making in hospital (2.3 ± 0.6), nursing authorities on the quality of healthcare (2.2 ± 0.6), and supervisor abilities and support to nursing staff (2.2 ± 0.6) had the lowest score. The highest scores on the leadership questionnaire were personalized interest (2.6 ± 0.8), and exceptional management (passive) (2.6 ± 0.9). CONCLUSIONS: The work environment was not related to nursing leadership. Nurses need individual development plans that include the type of knowledge, skills, attitudes, and values required for leadership. In this context, continuing training centers play an important role because they are responsible for training and developing leaders who are fit for work in intensive care.

Health-Related Quality of Life and Rehabilitation Costs of Patients with Amputated Limb.

AIM: The aim of this study was the evaluation of health-related quality of life (HRQoL) and rehabilitation costs of patients with amputated limb. MATERIALS AND METHODS: This is a cross-sectional study and the study sample, which was a sample of convenience, included 100 patients with amputated limb. The tools of the survey were the Short Form Questionnaire-36 (SF-36) and the Questionnaire used for measuring rehabilitation costs in trauma patients by Stergiannis et al.Results: The sample of the study consisted of 107 patients with amputation. HRQoL significantly increased (p < 0.001) between all-time points. According to the patients' answers, there were zero costs related to rehabilitation 1 year after the amputation. The type of edge amputation had significant impact on the rate of HRQoL increase. Rehabilitation costs increased over time during the first year. The mean (SD) rehabilitation cost was 1372 (2200) € at the first 6 months and 4774 (9109) € at the second half year. HRQoL was associated with age at all-time points and with costs of purchase of special pharmaceuticals, hospitalization, other expenses, number of medical visits, and cost of phone calls. CONCLUSIONS: The economic costs due to the amputation need to be studied as they affect the extent to which an amputated patient can meet his new emerging needs. Therefore, future research should focus in the economic dimension of the amputation in relation with the HRQoL of these patients and their relatives, so that new health policies may be conducted.

The Burden of Caregivers of Patients After Hip Replacement and Its Impact on the Cost of Living of the Family.

AIM: The aim of this study was the evaluation of the degree of burden of caregivers of patients with hip fracture surgery and the assessment of its impact on their cost of living. MATERIAL AND METHOD: This is a cross-sectional study and the study sample, which was a sample of convenience, included 100 caregivers of patients after hip replacement from February to May 2019 at the General Hospital of Thessaloniki "G. Gennimatas" in Greece. The main tools of the survey were the Bakas Caregiving Outcomes Scale (BCOS) Care Outcome Scale and a Questionnaire used for measuring rehabilitation costs in trauma patients adjusted for the needs of the present study. RESULTS: Of the 100 caregivers in the sample, 35% were male, 65% women and children of patients. Most caregivers worked full-time (47%), or had retired (39%). The costs incurred by the carers, which were not covered by the insurer, were, with the highest concerns, the rehabilitation center, the services of another caregiver, the services of an exclusive nurse, and physiotherapy. CONCLUSIONS: Informal caregivers often fill the gaps and shortcomings of the health systems of many countries, saving large sums of money. The state should take care of consolation leave to caregivers so that they can provide the necessary assistance to their people, thereby reducing their burden. The development of ambulatory care would offer such important and necessary respite for caregivers, having a positive impact on the care and course of the patient.

Central-Line-Associated Bloodstream Infections (CLABSIs) Incidence and the Role of Obesity: A Prospective, Observational Study in Greece.

INTRODUCTION: Although central venous catheters (CVCs) provide reliable vascular access, there are several risks linked with their use, with the rates of central-line-associated bloodstream infections (CLABSIs) being the most important ones. CLABSIs have a big impact on mortality rates and health care costs. The aim of this study was to investigate the incidence of obesity in the development of central venous catheter infections. MATERIAL AND METHOD: This is a prospective, observational study. The data were collected in the ICUs of three major hospitals in Greece, over a period of 18 months. Totally, 744 patients were included in the study. RESULTS: The study included 744 ICU patients aged 63.6 ± 16.6 years. The Apache II score and MODS score of patients were 23.3 ± 6.9 and 7.5 ± 3.8, respectively. Totally, 5.426 catheter-days were included in the study. Among the 722 CVCs, 178 (24.7%) were CLABSIs. The incidence rate of CVC-associated CLABSI was 22.48 infections per 1000 catheter-days. CLABSI was significantly predicted by the BMI (p = 0.001), by the diabetes mellitus as comorbidity (p = 0.013), by the doctors' experience (p = 0.001), by the type of CVC (p = 0.001) and CVC site (p = 0.001), by the number of efforts for CVC insertion (p = 0.009), by the catheterization's duration (p = 0.001) and by the MODS score (p = 0.001). CONCLUSIONS: Better staff training focused on care bundles preventing infections, better medical training focused on less efforts for CVC insertion, and the use of Ultrasounds during the CVC insertion may be the main factors that can lead to lower CLABSI rates in obese patients. Further research relating CLABSI rates in ICU patients and obesity is needed.

Burden and Sleeping Disorders of Family Caregivers of Hemodialysis Patients with Chronic Kidney Disease-End Stage: A Cross-Sectional Study.

BACKGROUND: Chronic illnesses with high level of disability can affect not only the patients but also the main caregiver who supports them. The aim of this study was to investigate the burden and sleep disorders of family caregivers of hemodialysis patients. METHODS: This is a cross-sectional study. The sample of the study consisted of 310 family caregivers of hemodialysis patients. The tools used were the Pittsburgh Sleep Quality Index (PSQI) for sleep disorders assessment, the Zarit Burden Interview, and the Center for Epidemiologic Studies-Depression Scale (CES-D) for burden and depression assessment, respectively. RESULTS: The total burden of caregivers was serious at 35.5%, and this rate increased to 64.8% if we added the moderate burden. About 26.7% of caregivers were positive in depressive symptoms and 20% at risk (predisposition) for depression. The factor with the greatest correlation with the overall burden was personal strain (r = 0.952, p < 0.001) followed by the role strain factor (r = 0.901, p < 0.001). About half of the respondents (51.6%) had poor quality of sleep. The factors that were strongly related to the overall degree of sleep quality were the actual sleep duration and daytime dysfunctions. CONCLUSIONS: Caregivers of hemodialysis patients face an increased risk for burden and sleep disorders development. Continuous and regular assessment of the caregivers' quality of life and the provision of psychological support may reduce the burden of caregivers and improve the emotional disorders they face.