Quarterly scientific journal

Rostrum of Asclepius Vol 21, Suppl. 4A (2022): October- December 2022

Vima AsklipiouRostrum of Asclepius Vol 21, Suppl. 4A (2022): October- December 2022


Exploring nurses' knowledge and perceptions on environmental health and climate change | 682-691

Konstantinos Evgenikos , Martha Kelesi-Stavropoulou


ABSTRACT Introduction: Climate change is already causing and is expected to cause even more severe, significant health problems in the population in the future. Nurses are called upon to recognize their contribution as health professionals and to be properly trained to be able to adequately address them as members of the multidisciplinary team. Aim: To explore nurses' knowledge and perceptions on climate change and environmental health, and the importance of education on climate change issues affecting population health Methods: literature search of English- and Greek-language primary quantitative and qualitative studies from the last decade was conducted, using keywords in the databases Google Scholar, PubMed and SCOPUS. Results: It emerged that the majority of nurses are aware of the existence of the negative effects of climate change and its causes, but there is a lack of knowledge and inability to cope with the consequences with the corresponding skills relevant to dealing with its consequences, while they are not sufficiently aware of issues related to environmental health. The majority of nurses believe that there is a link between climate change and human health, yet they do not know in what place they could contribute to addressing it. Conclusions: Nurses' knowledge of climate change and environmental health is mostly considered inadequate, while nurses do not seem to have an adequate understanding of the multifaceted role they are called upon to play in managing the effects of climate change on human health. Contemporary and key nursing education with an environmental focus needs to be strengthened.

Keywords: Nursing, environmental health, Climate change, nursing education, nurses perceptions and knowledge, Public health

New technologies and psychotherapy: Possibilities and Concerns | 692-704

Afroditi Zartaloudi


Introduction: The internet is an effective tool for conducting psychotherapy sessions in order to overcome the barrier of imposed physical and social distance during the challenge of the abrupt appearance of Covid-19 pandemic. Purpose: Our purpose was to present how the psychotherapeutic context of online multi-family group psychotherapy is changing, the new possibilities and advantages as well as the challenges and disadvantages that arise between online and traditional psychotherapy. Material and Methodology: A literature review of studies published in the Pubmed, Scopus και Google Scholar database was conducted in English language, using the following key words. Results: The condition of distance participation in psychotherapeutic sessions contribute substantially to the appearance of new possibilities and perspectives in the provision of psychotherapeutic care. At the same time, mental health professionals should manage difficulties and challenges that arise when conducting online psychotherapy interventions. Multi-family online psychotherapy provided in patients with a history of first psychotic episode and their families could be a form of psychiatric intervention in community. Early psychosis intervention programs have not sufficiently utilized the tool of online psychotherapy, which could serve as an adjunct to traditional psychotherapeutic interventions. Conclusions: The familiarization of mental health professionals with technology and online psychotherapy could substantially contribute to this direction.

Keywords: Online therapy, first psychotic episode, multifamily group therapy

Special Article

Views of parents of children with type 1 diabetes mellitus regarding care and safety in the school environment | 705-717

Mariana Drakopoulou , Panagiota Begni , Paraskevi Apostolara


The prevalence of SDT1 is increasing annually in Europe and in Greece, with thousands of new cases every year. Properly managing a student with diabetes at school is a challenge for school nurses. The aim of this study is to explore the views of parents of children with SDT1, regarding care and safety in the school environment.A safe school environment improves the educational experience, enhances the well-being and health of students. The safety and satisfaction of parents of students with SDT1 in the school environment regarding the care their children receive has been studied internationally in recent years and demonstrates the concern of parents about the diabetic profile of children at school. Review of the literature suggests that the daily presence of the school nurse helps to significantly reduce the absences of students with diabetes, significantly increases the school performance of students, and at the same time leads to much improved management of SDT1.Ιn addition, where there is no school nurse for the care of the students with SDT1, the sense of security felt by the parents is recorded as extremely low.Nursingcare of the students with SDT1 in the school environment is strengthened, so the school becomes a safe environment and offers the same level of access to educational opportunities to all children.

Keywords: Type 1 diabetes mellitus, safety, care, school nursing, parents perceptions

Original Paper

Development dysplasia of the hip | 718-728

Dimitrios Pallis , Sara Eleni Amprachim , Konstantinos Tsivelekas , Paraskevi Koufopoulou , Aggeliki Banousi , Konstantinos Zagorianos , Stamatios Papadakis


Introduction: Developmental Dysplasia of the Hip (DDH) is the current definition which includes a wide range of severity, from mild acetabular dysplasia without hip dislocation to hip dislocation. DDH is a disorder of abnormal development resulting in dysplasia, subluxation, and possible dislocation of the hip secondary to capsular laxity and mechanical instability. Purpose: The study of the functional result of the surgical treatment in adults with DDH. Material and methods: Retrospective study that lasted from March 2015 to March 2020. Mean outpatient follow-up was at least 9 months and patients with follow-up under 6 months were excluded. Outcomes were measured using Harris Hip Score in 3 and 6 months postoperative. Results: This study included 22 patients (14 females and 8 males) with a mean age of 54.2 years. The majority of patients have fair Harris Hip Score at 3 months post-op and are fully functional in 6 months. Conclusions: DDH is the most common hip disorder in children and it is most common in females. The left hip is more commonly involved and it is bilateral in 20% of the cases. DDH is among the most common causes of premature hip arthritis. DDH is the main cause of THA in young people (21 – 29%). The surgical treatment of DDH in adults is challenging and is crucial to place the acetabular component in the true acetabulum to restore the normal hip center of rotation and biomechanics.

Keywords: DDH, dysplasia, hip arthritis, congenital hip dislocation, total hip arthroplasty.

Bloodstream infection in patients with diabetes mellitus | 729-746

Panagiota Kamitsa , Stavroula Baka



Introduction: People with diabetes have an increased susceptibility to infections and an increased risk of developing bloodstream infections (BSI). Diabetic patients are more prone to sepsis and have more complications than non-diabetics.

Aim: The aim of the present study was to investigate the role of the Quick Sequential Organ Failure Assessment Score (qSOFA) as a method for detecting precursors of poor prognosis in patients with/without diabetes mellitus.

Material-Methods: This is a prospective observational study. The sample of the study consisted of adult patients who were hospitalized in Pathological departments and had BSI. The qSOFA score was calculated daily based on the parameters and only its maximum value was recorded each day.

Results: The study included 243 patients aged 72.1±15.5 years. In all, 25.1% of patients had diabetes and 59% had complications of diabetes. The positive day of the patients was 5.2±9.4 days. The majority of patients (67.1%) had an infection from the community. Totally,72% of the microorganisms isolated were Gram negative and 28% Gram positive. The duration of hospitalization of patients was 18.1±14.5 days, while the duration of hospitalization of patients with DM was 18.5±15.6 days. Patients with nosocomial infection compared with those with community-based infection had significantly longer positivity days (13±13.1vs. 1.3±1.6,p<0.05), with a significantly higher rate of resistant strain (48, 8% vs. 28.8%,p<0.05) and had significantly longer hospital stay (27.9±18.3vs. 13.3±8.9,p<0.05), QS6 score (0.6±0.7vs. 0.4±0.6, p<0.05), QS7 (0.6±0.7vs. 0.3±0.6, p<0.05), QS8 (0.6±0.7vs. 0.3±0.6,p<0.05) and QS29 (0.8±0.8vs. 0, p<0.05). Patients who had qSOFA≤1 compared with those who had qSOFA≥2 were significantly younger (70.8±16.2vs. 76.8±11.5,p<0.05), died significantly lower (16,9%vs. 72.2%,p<0.05) and had significantly longer hospital stay (18.8±15.1vs. 15.7. 12.1,p <0.05). Diabetes mellitus was negatively associated with the scores qSOFA25(r=-0.424), qSOFA29(r=-0.575), qSOFA30(r=-0.575), qSOFA31(r=-0.564) and qSOFA33(r=-0.674).

Conclusions: Bloodstream infections remain a significant complication in people with diabetes and the awareness of health professionals has the potential to reduce morbidity through early identification, management and prevention of infections.

Keywords: diabetes mellitus

Systematic Review

The necessity of emotional intelligence in nursing during the COVID-19 pandemic | 747-772

Athanasia Grapsa , George Koulierakis


Emotional Intelligence is a barometer for the efficient professional response of employees and the effective provision of services in nursing. On the previous years, incidences of burnout have been recorded at the health sector in Greece, due to the difficult socio-economic conditions. The health crisis of the COVID-19 pandemic and the rapid increase in demand for health services pushed the already burdened Greek Health System to its limits and exhausted the health staff, causing additional physical fatigue and psychological exhaustion. Purpose: The purpose of the study was to highlight the necessity of Emotional Intelligence in the nursing profession, especially during the health crisis of COVID-19. Methodology: A systematic literature review was carried out, in electronic databases (Scopus, PubMed, Google Scholar, Elsevier, Iatrotek), using the Prisma method. A combination of specific keywords, such as "emotional intelligence", "COVID-19 pandemic", "work satisfaction', 'job performance', 'quality', 'emotional intelligence', 'pandemic', 'COVID-19', 'job satisfaction', 'job performance' was used and pre-defined inclusion and exclusion criteria of the studies were applied. Then, the collected studies were analyzed and evaluated. Results: A total of 23 studies met the inclusion criteria. The results highlighted the contribution of Emotional Intelligence as a protective factor in burnout and its positive contribution to the satisfaction and performance of nursing staff. Furthermore, its role in motivating, understanding and correctly positioning the employees was highlighted by the managers - supervisors of the nursing service. Conclusions: The emotionally intelligent leader being a democrat and a visionary, is a role model and guides employees to maximize their potential and deliver quality and safety to patients. The constant professional uncertainty and chronic psycho-stressful work situations that characterize the nursing profession make the need for training and emotional support of nurses’ imperative, regardless of position and rank.

Keywords: Emotional Intelligence, pandemic COVID-19, job satisfaction, job performance, quality of health care services, nurses.

Research Protocol

Focus on-exploring the opinions and views of nursing students concerning the quality of nursing education - Research protocol | 773-783

Areti Stavropoulou , Eleni Tsapnidou , Aikaterini Papachristou


The quality and evaluation of educational programs is a priority at a European and international level, as the effectiveness of education is associated to excellent professional practice and the sustainability of educational institutions. The aim of the present study is to investigate the nurse students´ perceptions regarding the quality of nursing education. The research design is based on the principles of qualitative research methodology as this approach is most appropriate for exploring human perceptions, experiences and feelings. The findings of the proposed study are expected to significantly contribute to the improvement of the quality of nursing education by creating realistic recommendations, adapted to the needs of the contemporary society and the current demands of the labor market. The evaluation of students' experiences is a necessary element for studying the quality of education and the formulation of recommendations that will contribute to the further development and transformation of nursing education. The effective use of this data can contribute to the development and implementation of important quality interventions in education that can be decisive for the development of knowledge and the strengthening of the skills and behaviors of students, as they prepare to enter the real world of nursing. Through honest feedback, academic teachers will be empowered to redefine the essential characteristics of quality in nursing education.

Keywords: Nursing education, nursing students, needs assessment, evaluation, quality in education, qualitative research.

Evaluation of patients with stroke after rehabilitation | 784-792

Evangelia Kakagianni , Martha Kelesi-Stavropoulou , Evridiki Kampa , Dimitrios Papageorgiou


Introduction: The stroke is the most common type of brain disease and is the first cause of functional disability for daily living activities. The stroke has a direct impact on health systems, resulting in high costs, and is considered a global public health problem due to severe disabilities, functional limitations, and a reduced quality of life for patients. Aim: The purpose of this doctoral thesis is to investigate the quality of life of patients who have undergone stroke and have followed rehabilitation. Material and Method: For the purpose of the study, an experimental study will be conducted in patients with stroke. The study sample will consist of people who have been diagnosed with a stroke and visited General Hospital of Athens. Two groups of patients will be examined. Results: The expected outcome of this doctoral dissertation will be to measure the quality of life of patients with stroke after rehabilitation compared to those who did not follow rehabilitation. It is estimated that the results of the survey will help both healthcare professionals who are expert in stroke, as well as patient caregivers in order, to better understand the physical and mental health of patients and to improve rehabilitation and care. Conclusions: The study is particularly useful in organizing rehabilitation services in all therapeutic structures in Greece, which will help prevent, early diagnose and treat dysfunctions of all patients suffering from this disease, as well as in shorter hospitalization and lower costs in the country's health units.

Keywords: stroke, Rehabilitation, physiotherapy, ergotherary

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