Patients' Dreams and Unreal Experiences During Intensive Care Unit (ICU) Hospitalization.

In the intensive care unit (ICU), patients often experience fragmented memories, primarily comprising dreams and illusions. These experiences can impact psychosocial well-being, correlating with post-traumatic stress symptoms and heightened anxiety. Understanding these phenomena is crucial for holistic care. To systematically explore patients' perspectives concerning the recollection of dreams and unreal encounters during their stay in the ICU, considering pertinent clinical conditions and potential influencing factors, we conducted a comprehensive search in the PubMed/MEDLINE, Web of Science, and Scopus databases until November 20, 2023, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From an initial pool of 288 records, a thorough screening for eligibility resulted in the inclusion of nine studies for this systematic review. These selected studies underwent evaluation using either the Critical Appraisal Skills Programme (CASP) Qualitative Checklist or the Newcastle-Ottawa Scale (NOS). All studies categorized dreams into three main types: positive, distressing (including nightmares), and neutral experiences. These were further detailed based on aspects such as time, space, senses, emotions, and distinguishing between reality and unreality. Two studies found associations between dreams and conditions like Guillain-Barré syndrome (GBS), mental abnormalities, and delirium. In one study, GBS patients had more vivid dreams, hallucinations, and delusions compared to ICU control group patients; delirious patients tend to report more frequent frightening dreams. Patients in the ICU who recalled dreams often had more severe illness, longer stays, and higher ventilation frequency. Notably, a prolonged ICU stay significantly predicted the likelihood of dream recall, as consistently observed in three other studies. This suggests that patients with prolonged ICU stays, experiencing higher dream recall, underwent extended treatments. This systematic exploration of patients' perspectives on fragmented memories underscores the connections between these experiences, clinical conditions such as GBS and delirium, and extended ICU stays. Recognizing and attending to these psychological aspects in post-ICU care is critical for alleviating the enduring emotional consequences for patients.

Investigation of Healthcare Satisfaction of Roma Living in Camps or Urban Complex of Central Greece.

Background: Roma in Greece face multiple discrimination, particularly in the areas of housing, education, employment and health. Objective: The aim of this study is to explore the perceptions and beliefs of Greek Roma living both in camps and in urban neighborhoods for public health structures as well as to assess their satisfaction with health care services. Methods: The study sample consisted of 185 subjects (94 females and 91 males) with a mean age of 39.8 years (SD = 15.7). Of the people involved in the study, 80 come from the settlement of Larissa and 105 from the camp of Tyrnavos. A special survey questionnaire, "The scale of attitudes, feelings and satisfaction of Roma health services", was used for collecting the data. The statistical analysis was carried out using the SPSS statistical program. Results: The statistical indicators of the sample, taken together, indicate a moderate trend towards a negative escalation of attitudes, feelings and satisfaction of health services. Based on the t-test results for independent samples, the average score on the Roma satisfaction scale of the Larissa settlement (M = -0,41, SD = 0,74) was not found to differ, statistically significantly, from the Roma population of the Tyrnavos camp (M = -0,61, SD = 0,94), t (182) = 1,680 (p = 0,095). Conclusion: The results of this study, despite its reasonable limitations, lead to a redefinition of some views regarding the attitude of the Roma towards the public health and care system, as well as the needs created.

Professional Mental Rehearsal: the Power of "Imagination" in Nursing Skills Training.

BACKGROUND: Mental rehearsal is a form of training used by nurse educators to enhance the performance of clinical skills. The use of imagination may facilitate cognitive and affective modification and subsequently may even reduce extraneous cognitive load. OBJECTIVE: The aim of the study was to investigate the efficacy of mental rehearsal in cardiopulmonary resuscitation training of nursing students. METHODS: This is a comparative study with a random sample of 52 Nurse-Assistant students who were randomly divided into two groups. A 10-minute educational video on CPR and defibrillation was shown to both groups with the experimental group having additional time to be coached on mental rehearsal. Student performance was subsequently timed and errors/overall performance recorded. Descriptive statistics and Mann-Whitney test was used for group comparisons analysis. RESULTS: Students in the control group needed 8.5 minutes on average as compared to 6.2 minutes for the experimental group to complete cardiopulmonary resuscitation training. This equals to a difference of 2.5 minutes faster time for the experimental group (p<0.001). For overall mistakes the mental rehearsal group had 1.3 fewer mistakes on average (p=0.003). In terms of mistakes when executing cardiopulmonary resuscitation training there were 0.9 fewer mistakes in the experimental group (p=0.021). CONCLUSION: The use of mental rehearsal might be the first step in improving the teaching of nursing skills. Differences in skill acquisition in favor of mental rehearsal are important, especially when this technique is used in the teaching of life-saving skills such as cardiopulmonary resuscitation and the use of defibrillate.

Investigating Nurses Stress Response Strategies During the COVID-19 Pandemic.

BACKGROUND: Stress response strategies are a conscious effort to solve personal and interpersonal problems, aiming to minimize stress. OBJECTIVE: The aim of this study is to investigate the stress response strategies of nurses during the COVID-19 pandemic. METHODS: The sample consisted of 550 Greek nurses working in Greece and other European countries (460 women and 90 men). Ways of Coping was used as the data collection tool. Participants were invited to complete the questionnaire via online GOOGLE FORMS. The statistical processing was carried out using a descriptive and inferential analysis via the statistical package for Social Science (SPSS v.21). RESULTS: Analysis of the results shows a statistically significant difference between the two genders in the questionnaire's subscales "Search for social support" (Women=1.88, Men=1.57, p<0.001) and "Wishful Thinking" (Women=1.76, Men=1.51, p <0. Also, there was a statistically significant difference in terms of country of work regarding the following subscales: 'Search for social support' (Greece=1.85, Outside Greece=1.67, p=0.019), 'Wishful Thinking' (Greece=1.74, Outside Greece=1.51, p=0.005) and 'Problem Solving Assertion' (Greece=1.39, Outside Greece=1.13, p=0.001). CONCLUSION: Stress response strategies for nurses are fundamental in addressing the difficult situations and conditions they face due to the COVID-19 pandemic.

Shame feeling in the Intensive Care Unit patient's family members.

OBJECTIVE: To investigate the levels of internal and external shame among family members of critically ill patients. RESEARCH METHODOLOGY/ DESIGN: This prospective study was conducted in 2012/2013 on family members of Intensive Care Unit patients using the Others As Shamer Scale and the Experiential Shame Scale questionnaires. SETTING: Greek university hospital. RESULTS: Two hundred and twenty-three family members mean-aged (41.5±11.9) were studied, corresponding to 147 ICU patients. Out of these 223, 81 (36.3%) were men and 142 (63.7%) were women, while 79 (35.4%) lived with the patient. Family members who lived with the patient experienced higher internal and external shame compared to those who did not live with the patient (p=0.046 and p=0.028 respectively). Elementary and Junior High School graduates scored significantly higher than the other grades graduates in total Others As Shamer Scale, inferiority and emptiness scale (p<0.001). CONCLUSION: Intensive Care Unit patients' family members are prone to shame feelings, especially when being of low educational level. Health professionals have to take into consideration the possible implications for the patients and their care.

Symptoms of Cardiac Anxiety in Family Members of Intensive Care Unit Patients.

BACKGROUND: Studies have shown an association between intensive care unit environments and symptoms of psychological distress in family members of critically ill patients. OBJECTIVE: To investigate levels of cardiac anxiety in family members of intensive care unit patients. METHODS: From March 2012 to July 2013, on the third day after the patient's admission, 223 family members of 147 patients completed the Cardiac Anxiety Questionnaire. A total score was calculated from 3 subscales: fear and worry about heart sensations, avoidance of activities reproducing cardiac symptoms, and heart-focused attention and monitoring of cardiac activity. RESULTS: Among the family members, 142 were women (63.7%) and 81 (36.3%) were men, 150 (67.3%) were married, and 37 (16.6%) were unemployed. Their mean score for overall cardiac anxiety was 1.11 (SD, 0.64), significantly higher (P < .001) than for the general Greek population. Although all 3 subscales scores were significantly higher than for the general population, the highest score was recorded for the avoidance subscale (mean, 1.77; SD, 0.68). The relationship to the patient had a significant effect on heart-focused attention (F5 = 3.51; P = .03). The mean score for patients' siblings (2.0; SD, 0.01) differed significantly (P = .02) from the mean for other family member groups. Older adults (P = .02) and married participants (P = .05) reported higher levels of fear and worry related to cardiac stimuli, and women further reported higher levels of cardioprotective avoidance behavior (P = .02). CONCLUSIONS: A noticeable number of family members of critical care patients had moderate to severe cardiac anxiety during the hospitalization of their relatives.