Quarterly scientific journal

Rostrum of Asclepius Vol 10, No. 3 (2011): July - September 2011

Vima AsklipiouRostrum of Asclepius Vol 10, No. 3 (2011): July - September 2011

Editorial

New guidelines in adult Basic and Advanced Life Support – What have changed since 2005 | 295-298

Theodore Kapadochos

Review

The role of corporal punishment in children | 299-310

Maria Kikila , Ioannis Koutelekos

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Corporal punishment consists the most common method of discipline and it is frequently accepted as a necessary tool of parents behavior, globally. Aim: The aim of the present study was to review the literature about corporal punishment as a method of discipline. The method οf this study included bibliography research from both the review and the research literature, mainly in the pub med data base which referred to corporal punishment as a method of discipline Results: Though it is internationally recognized in human rights law that children have a right to protection from all forms of violence, including corporal punishment in all settings (home, school), however corporal punishment is still perceived as an acceptable form of "discipline", particularly at home. It is widely accepted that corporal punishment can de hardly defined accurately owing to the discrepancies among the habits and perceptions of individuals regarding childbearing in various countries. The only advantage of corporal punishment is the quick compliance of the child. Furthermore, corporal punishment does not enhance communication within the family on the contrary; it enforces the adoption of the same behavior by the children. Conclusion: Abolishing corporal punishment of children demand action at different levels, such as comprehensive changes in legislation of every country and introduction of new policy measures regarding proper guidance for those working with children and families. It also requires awareness and information of the public about children's human rights, globally.

Keywords: Corporal punishment, discipline, abuse, parents perceptions

Relationship of nursing workload with the severity and outcome of the patients in the ICU | 311-322

Nikolaos Stoufis

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The development of monitoring and measurement of nursing workload is constant and necessary not only to document the quality of health services but also to increase job satisfaction of nurses in order to reduce stress and burnout. PURPOSE: The purpose of? This review is to illustrate the complex role that nurses play in today's environment of care through the promotion of associations of nursing workload on the severity and outcome of patients in the ICU. MATERIAL AND METHOD: It became an international literature review through an internationally recognized search engine (pubmed, scopus, Mdconsult) to highlight science-based views. RESULTS: The literature review highlights the efforts being made internationally in developing methods for assessing the quality of nursing care that is commonly accepted by both the nurse and the rest of the scientific community. CONCLUSION: Modern theories approaching nursing job considering all levels identify a health care system that both matters of organization and management structure of a service and issues related to clinical severity of hospitalized patients and the needs arising from it.

Keywords: Nursing workload, Intensive Care Unit, quality of nursing care

The Delphi Technique in nursing research. Part 2: Methodological considerations | 323-338

Dimitrios Kosmidis , Sotiria Koutsouki , Dimitrios Theofanidis

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The Delphi technique (DT) has been used as an innovative method for the interaction of team of experts aiming at the growth of new knowledge and successful forecasting. In the first part presented the epistemological value and the comparative advantages of the method and its basic modifications. Although the technique is widely used, its scientific value is disputed as its structural features have not been determined in an absolute manner as yet. Relative questions concern the choice of experts, the sample size, the number of rounds and the desirable degree of anonymity and consensus. In this article a critical analysis of the application, restrictions, practical value and scientific prestige of DT are presented. The next two articles discuss the analysis of results as well as the use and usefulness of the method in nursing research, education and clinical practice.

Keywords: Delphi technique, nursing research, research methodology

Original Paper

Musculoskeletal diseases of Spine and risk factors during Dentistry: Multilevel ergonomic analysis | 339-355

Dimitra Paggou , Fotoula Babatsikou , Joan Marika Kiousi , Charilaos Koutis

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The prevalence of occupational musculoskeletal diseases (MSDs) among dentists is estimated to be high, despite the ergonomic interventions in this sector. The aim of the present study was a) the evaluation of spine MSDs in dentists and b) the assessment of risk factors related to dentist practice. Material and Method: The sample of the present study consisted of 16 dentists (n=16). The participants divided into two (2) groups, based on MSDs of the spine. A multilevel ergonomic analysis was conducted in both groups, which evaluated individual, physical and occupational risk factors during nine (9) dental procedures. For the analysis of data were used, direct methods (video, observation, amended postural analysis OWAS), indirect method (questionnaire) and quantitative methods of ergonomic analysis (computerized mediball postural stabilizer cushion). Results: The most frequent MSDs of spine among dentists in the present research are localized on low back (66,7%) and neck (8,3%). Based on OWAS analysis of 2348 working postures, statistically significant correlation was found between dentists' MSDs and factors concerning both dentists (weakness of stabilizer muscles of spine, awkward positions during working time, fatigue) (p< 0,05) as well as the nature of dental work (specific dental procedures, patient's, the position of patients, tools and dentists during the working time, certain areas of the mouth, working hours, lack of breaks, etc) (p< 0,05) respectively. Conclusions: Low back pain and neck pain are the most frequent MSDs of dentists' spine. They are related to individual and other occupational factors which could have been prevented using proper ergonomic interventions.

Keywords: Dentists, musculoskeletal diseases (MSDs), risk factors, OWAS postural analysis, ergonomic assessment

Retrospective study of therapy of acute myocardial infraction | 356-372

Maria Kitsou , Maria Polikandrioti , Christina Marvaki

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Coronary artery disease consist the main cause of disability and morbidity in many developed countries. The purpose of the present study was to compare the treatment- therapy of Acute Coronary Disease during 1998 to 2008. Method and material : The sample of the present study consisted of patients with acute coronary syndrome that were hospitalized in Intensive Care Unit of a public hospital. Data were collected by the completion of a specially designed clinical protocol for the needs of the survey. Statistical analyses (t-test, X2 test and Relative Risk.) were conducted using the Statistical Package for Social Sciences 17.0. Results : From the sample-studied during 1998, 27.5% were women and 72.5% men, with mean age 63.60 years old, while during 2008, 13.7% were women and 86.3% men with mean age 62.8 years old. Patients with final diagnosis STEMI during 2008 were more with statistically significant difference, compared to 1998, p=<0.005. Percentage of patients who had coronary intervention (PCI) during 2008 outnumbers that of 1998, with statistically significant difference, p=<0.005. During 1998, individuals <55 years old had greater possibility to follow thrombolytic treatment, whereas during 2008 this possibility for patients <55 years old was the same with those> 55 years old. Percentage of patients who had coronary intervention during 2008 was higher with statistically significant difference compared to 1998, p=<0.005. More in detail, the number of patients who had coronary intervention during 2008 was threefold compared to 1998. Regarding age, both in 1998 and 2008, patients up to 55 years old were more likely to have coronary intervention than patients >55 years old. Percentage of death was higher in 1998 with statistical significant difference compared to 2008, p=0.001.

Keywords: Αcute Coronary Syndrome, therapy, diagnosis

A pilot study about the burn out investigation of PICU medical and nursing personnel for a pediatric hospital | 373-388

Alexandros Douvanas , Marousso Mpaliou , Aristea Pandelaki , Paraskevi Pousderki , Christina Marvaki

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The last decades, physicians' and nurses' burnout have been constituted a subject of many studies. Stress can be considerable in Pediatric Intensive Care Units (PICUs) and Neonatal Intensive Care Units (NICUs), as the relationships between physicians/nursing personnel and the relatives can develop reacts of discomfort and depression to the professionals. Aim: The aim of this study was to investigate the existence or not of burnout in PICUs and NICUs in a pediatric hospital of Athens and the correlation of burnout with demographic and other social factors. Method and material: The study was conducted in a pediatric hospital of Athens. There were distributed 64 questionnaires to physicians and nursing staff and have been returned filled 48 (response rate, rr= 75%). The questionnaire that has been used was the Maslach burnout inventory (MBI, Maslach and Jackson 1984) and the statistical analysis has concluded not parametric tests using SPSS. Results: The professional burnout has been found in moderate levels as it seems by the means of the 3 dimensions of MBI. The mean scores of the emotional exhaustion were 22.02, the personal achievements 32.44 and the depersonalization 9.02. Significant statistical differences has been found between dimensions of MBI and sex (p=0,034), age (p=0,001), educational level (p=0,045), work department (p=0,004), work position (p=0,015), and years in the employment (p=0,025), at the hospital (p=0,008), in the department (p=0,018). Conclusion: As well as the professional burnout of physicians and nursing personnel working in PICU and NICU has been found between moderate to high levels, the managers of the hospitals should take it in account contributing in the improvement of personnel's quality of life in these particular departments.

Keywords: Professional burnout, physicians and nursing personnel, PICU, NICU

Nurse students approach on concepts | 389-405

Vassiliki Ioannidi , Petros Kolovos , Sofia Vasileiadou , Maria Malliarou , Antonios Travlos , Sofia Zyga

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Nurse Students' opinion regarding fundamental parameters of health while practicing health care defines their professional identity and for that reason, their opinion could give direction for the formation of their professional role and their education and training. Aim: The present study's aim is to examine nurse students' opinion, beliefs and attitude regarding the concepts of "illness", "safety in health care" and "quality in health care" while being in an educational environment which promotes cooperative class activities. Methodology: In this pilot study participated thirty six (36) undergraduate students of Department of Nursing University Peloponnese in the frame of course "Introduction in Nursing Science". Students' answers evaluated using content analysis method and the analysis was based on the latent content of students' answers. Therefore, the texts which were selected as the analysis units were afterwards shortened by using the "abstraction" method. In other words, the method that was followed included the data extraction with base of their content and afterwards those data were categorized and classified in wider subcategories. In order to quantify provided data, these subcategories were unified in wider categories-subjects which in turn unify all the individual meanings. Results: All thirty-six (36) students who filled the questionnaire answered that the meaning of illness concerns so much the physical as long as the mental status of a person. Students were then called to define the meaning of concept "safety in health care" and from their answers using content analysis method, 78 reports resulted. Students also answered in the question "what means safety in health care", that safety concerns both health care professionals and all the rest health care users. In the second category were categorized the students' answers that concerned in the way with who, at their opinion, is ensured the safety in the provided health care, in other words which are the necessary conditions that argue safety in health care. In the third category were categorized the participants' answers concerning the result of care that proves safety, that is to say, which is the evidence that proves safety existence in benefit of health care. Students were here called to answer what means in their opinion the concept "quality in health services". From their answers, who were analyzed using content analysis method and categorized in four categories-subjects, resulted 72 reports. Conclusions: Nurse students' and therefore future health professionals' answers concerning the meaning of basic concepts, such as "illness", "safety" and "quality in health care", show how sensitive they are regarding related subjects. The result reveals the way they conceive their professional role and education, their attitude in real working conditions and evolving the quality of provided services but also how well they are prepared to seek quality in health care.

Keywords: Health, care, education, illness, safety, quality

The contribution of ultrasound to the modern diagnostic and therapy | 406-416

Lambrini Kourkouta , Τhomais Alexakou , Konstantina Vagena , Agapi Papaemanouil , Dimitra Ippioti , Fotini Papoulia

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Aim: The use of ultrasound in contemporary therapeutic practice is noticed by this researching project. Material Method: It is a case of comparative research. Descriptive statistic was used for recording – processing and analyzing data as regard ultrasound which was performed in central Hospital in 2009 Athens in last semester. In especial 1773 patients, from which 1090 (61, 48%) were women and 683 (38, 52%) were men, were submitted to scheduled inspection of ultrasound upper -and- lower abdomen. Results: The 190 (17, 40%) were submitted to carotid triplex, spinals arteries, veins and arteries of lower limbs and abdominal aorta. widely in modern therapy due to its low cost, clear results and mainly because there is not any proof of detrimental biological effects from its use. Therefore ultrasound is often used in our days and is expanded with spectacular pace, as it approaches practically all the organs of the body.

Keywords: Ultrasound, disease, treatment, diagnosis, nursing

Impact of critically ill patients in regards to the boarding time from the emergency department to the intensive care unit | 417-436

George Intas , Pantelis Stergianis , Georgios Vasilopoulos , Georgios Fildisis

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Objective: To determine the association between ED overcrowding and outcomes for critically ill patients Design and Setting: We included medical and surgical pts that all of them were intubated promptly to ED of 2 general hospitals of Athens GR, for 12 months. Pts survived > 24hours were divided into 2 groups: ED boarding < 6 hrs (group A) and ED boarding ≥ 6 hrs (group B). In the ED, 196 critically ill patients with a mean age 59.6±20.9 yrs and APACHE II score 24.6±12.7 were intubated. Results: Group A = 76 pts (mean time ED boarding, LOS, mortality): 28 pts were admitted to CCU (30.7±20.4, 7.7±9.3, 42.9%), 32 to ICU (231.25±103.1, 11.9±7.8, 37.5%) and 16 to intermediate unit (191.3±33.5, 7.8±5.7, 0%). Group B = 120 pts (mean time ED boarding, LOS, mortality): 28 pts were admitted to ICU (559.28±101.6, 15.6±10.3, 58.7%) and 92 to intermediate unit (3094.4±3273.4, 19.1±14.5, 78.3%). Hospital LOS was 19.2±20.4 days for group A vs 41.5±62.7 days for group B (P<0.001), and mortality 26.8% vs 45.7% respectively (P<0.001). Delayed admission, higher Apache II, age > 61 yrs, female gender and direct admission to ICU were associated with lower hospital survival (odds ratio 0.815; 95% 0.612-0.976). Conclusions: Boarding time of critically ill from ED to ICUs is very important because it is strongly related to the hospital LOS and mortality rate.

Keywords: ED, ICU, boarding time, LOS, mortality, hospital

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