Quarterly scientific journal

Rostrum of Asclepius Vol 20, No. 1 (2021): January - March 2021

Vima AsklipiouRostrum of Asclepius Vol 20, No. 1 (2021): January - March 2021


A new beginning | 1-2

Christina Marvaki

Special Article

Physician Burnοut Syndrome: An indirect indicatοr abοut the Health System perfοrmance | 3-11

Symeon Naoum


Physicians’ Burnout Syndrome is an early indicator about the health system malfunction and it may be a useful tool for the decision makers in health sector. By monitoring physicians’ burnout, the various threats-risks can be identified and dealt with in a cost-effective manner before patient’s care be disturbed. Burnout syndrome is an important issue in doctors’ workplace and the exposure to long hours of clinical work demonstrates a dose-dependent effect with exhaustion, thus indicating the cause and effect. Burnout Syndrome is also the factor most closely associated with physicians' decisions about their withdrawal from clinical practice, either physically or psychologically, with adverse effects on access, continuity of care, patient satisfaction, productivity as well as the cost. Preventing such situations through the introduction of burnout "detectors" in the field of health is of paramount importance. Burnout "detectors" can be used to evaluate doctors’ workplace and reveal the issues/causes responsible for the Burnout Syndrome phenomenon.

Keywords: Physician burnout syndrome, physical withdrawal, burnout, health system efficiency

Preventive measures to avoid or slow down Alzheimers disease | 12-30

Despina Kenevetzidou , Nikolaos Biagis , Vasiliki Zisimopoulou , Dimitrios Papageorgiou


Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disease, with the World Health Organization designating it as a global priority. There are several risk factors for its occurrence, which are divided into two major categories: modifiable (diabetes, hypertension, body weight, sleep, smoking) and non-modifiable (age, gender, genetic factors). Many drugs of various categories have been used and tested, with no successful results in terms of prevention and treatment. The combination of medication with the management of modifiable risk factors can significantly help prevent and weaken the course of the disease. Due to the increase in the average life expectancy, in the coming years there will be a significant increase in the number of cases with AD, highlighting the need to create support and care networks for these patients.

Keywords: Alzheimers Disease, prevention, treatment

Electronic cigarette and cardiovascular diseases | 31-43

Christina Ouzouni , Konstantinos Nakakis , Konstantinos Koutsampasopoulos


Smoking is a major risk factor for cardiovascular disease. The e-cigarette has seen a dramatic increase in its use in Europe and America, and while it was originally used as a smoking cessation proposal, its role is now being challenged. The smoke produced by the electronic cigarette does not contain the combustion products produced in the traditional cigarette and thus has been characterized by many researchers as safer. Taking nicotine through the e-cigarette initially raised expectations that the e-cigarette could be an alternative option for reducing or quitting smoking, similar to nicotine replacement therapy. Especially, in smokers who want to quit smoking, the e-cigarette could help to quit smoking at six months, however, there are no studies that compare the effectiveness of its use with other treatments for smoking cessation and therefore drawing conclusions to general population is precarious. Smoking cessation is a key goal in both primary and secondary prevention of cardiovascular disease and the nurse is the cornerstone of this effort. Ongoing studies, as well as the design of new randomized control trials, are expected to provide answers about the potential risks of e-cigarette use, as well as the role its use in smoking cessation.

Keywords: Cigarette smoking, e-cigarette, cardiovascular disease, coronary disease

Original Paper

The association between animal and plant-based protein consumption with psychological distress in older adults of the Mediterranean area: epidemiological Mediterranean island study (2005-2020) | 60-80

Alexandriani Piperidi , Alexandra Foscolou , Evangelos Polychronopoulos , Demosthenes Panagiotakos


Introduction: The effects of protein consumption on overall human health and longevity remain one of the most controversial issues in nutrition science to date. Aim: To evaluate the association between dietary protein intake and psychological distress, in people aged >65 years of age, living in insular Greece. Methodology: Data from older people living in 20 Greek islands, from the MEDiterranean Islands Study (MEDIS) (n=2,221) population-based cross-sectional study were used. Anthropometric, clinical and socio-demographic and lifestyle characteristics, and protein consumption (total, animal, plant) consumed based on validated FFQ, were derived through standard procedures and questionnaires. Psychological distress was assessed as a combined variable representing symptoms of depression and anxiety. Results: Animal protein, but not plant protein intake, was associated with higher PDS following adjustment for age, sex, education level, Mediterranean diet adherence and physical activity (b±SE: 0.403 ± 0.090, p=0.003). Following analysis by Mediterranean diet adherence level, among low adherers, animal protein intake was positively associated with Psychological Distress (b±SE: 1.119 ± 0.174, p=0.008); no associations were observed in moderate or high adherence groups or as regards plant protein intake and Psychological Distress. Conclusions: The present study suggests that plant protein sources form an important part of the overall dietary pattern and that low to moderate red meat intake within a Mediterranean diet pattern may be associated with lower Psychological Distress.

Keywords: Mediterranean Diet, protein, animal protein, plant protein, psychological distress

Investigation of factors affecting quality of life in hemodialysis patients | 81-94

Ιlias Moustakis , Nikolaos Rikos , Georgios Vasilopoulos , Michael Rovithis , Christina Marvaki


Introduction: The effects of Chronic Kidney Failure have a significant impact on the quality of life of patients. Aim: The aim of the present study was to investigate the factors affecting the quality of life of dialysis patients. Methods: This is a cross-sectional quantitative study that used the specialized Kidney Disease and Quality of Life questionnaire (KDQOL-SF.). Deliberate sampling was chosen as the sampling method. The final sample of the study was 49 patients with a mean age of 57.9 years (± 12.6). Its reliability was assessed by the Cronbach a factor and the collection was done during the summer months of June to August 2019. The IBM SPSS 25.0 was used for data analysis. Frequency distributions with 95% confidence intervals calculated by bootstrap techniques. Results: The most significant positive findings regarding participants' quality of life were social support for patients, encouragement from the staff of the nephrology department, cognitive function and physical role, while lower values received work, pain, sexual and physical functionality and severe psychological condition from Kidney disease. Emotional well-being affected quality of life to moderate levels. Conclusions: This study demonstrates the need for psychotherapeutic intervention planning for patients with ongoing follow-up, specific creative work and work programs.

Keywords: Dialysis, quality of life in dialysis, quality of life and chronic kidney disease

Systematic Review

Quality of life in patients with colostomy and the effects in everyday life | 44-59

Antria Pipi , Evanthia Asimakopoulou , Alexandros Argyriadis , Panagiota Bellou – Mylona , Maritsa Gourni , Despina Sapountzi-Krepia


Introduction: Creating colostomy is a surgical option for various diseases. The colostomy is creates a variety of psychosocial effects on patients who are experiencing feelings of anger, anxiety and fear, decreasing their Quality of Life (QoL). Aim: The aim of the study is to investigate the Quality of Life of patients with colostomy. Specific objectives are to identify the factors affecting the quality of life of these patients Methodology: A systematic review was conducted, using the databases Google Scholar, Scopus, Science Direct και PubMed and covering the 2008-2018 period. The keywords «colostomy» and «Quality of life» and selection/ exclusion criteria were used to identify the appropriate articles/ studies for the review. Results: As shown by most studies, patients with colostomy struggle to live comfortably and to integrate into society as their problem affects them directly. Patients with colostomy face various social, emotional, physical, sexual and operating complications, reducing their QoL. Conclusions: It is important to take measures for the effect of colostomy on the patient psychosocial condition and provide support preoperative and postoperative. Nurses are the ones who advise and educate patients and their families to manage the colostomy, promoting the independence of patients and improving their quality of life.

Keywords: Colon cancer, patients with colostomy, quality of life

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