Quarterly scientific journal

Rostrum of Asclepius Vol 23, No. 1 (2023): January - March 2024

Vima AsklipiouRostrum of Asclepius Vol 23, No. 1 (2023): January - March 2024

Editorial

Menopause, aging and cardiovascular risk | 1-5

Vasiliki Vartela

Hot Topic

ChatGPT and Future of Medical Research Writing | 6-14

Ahmed Alkhaqani

AbstractMore

Artificial intelligence (AI) is a disruptive technology that has revolutionized various industries, including the field of research writing. Using AI-based tools in research writing brings a new level of efficiency, accuracy, and productivity to the process, allowing researchers to tap into alternative perspectives and generate fresh insights that can boost the quality of research work. In this article, we discuss the current trends and the potential benefits of open Artificial Intelligence (AI-) based tools for research writing, focusing on AI tools. In addition, we also discuss the impact of collaborative writing with AI on productivity, highlighting the benefits of AI tools in the research writing process. The current trends show that AI tools enable researchers to perform complex data analysis, generate personalized content, and identify patterns that can aid decision-making. Therefore, it is imperative for researchers to embrace AI tools, learn how to use them effectively and harness their potential to achieve better research outcomes. Open artificial intelligence-based tools are gaining momentum in research writing due to their ability to streamline the research process and enhance the quality of research outcomes. The current trends show that AI tools enable researchers to perform complex data analysis, generate personalized content, and identify patterns to aid decision-making. As these tools continue to evolve, there is vast room for future potential, which will significantly impact the research landscape. Therefore, it is imperative for researchers to embrace AI tools, learn how to use them effectively, and harness their potential to achieve better research outcomes.

Review

Opinions and Attitudes of Health Professionals on the Electronic Health Record: A literature review | 15-29

Periklis Rompolas , Panicos Masouras , Sotiris Avgousti , Andreas Charalambous

AbstractMore

Introduction:

A variety of factors shape the positive views and attitudes of health professionals in relation to the Electronic Health Record (EHR) as an application of eHealth in health systems internationally.

Aim: The investigation of the factors that shape positive or negative views and attitudes in health professionals regarding the use of EHR.

Materials and Methodology: A systematic review of the literature was conducted from 2002 to 2020 in the Greek and English languages, in the databases: Cinahl Database | EBSCO, Google Scholar, Library and Information Science - Elsevier, PubMed and Scopus. The search strategy for bibliographic databases in English or Greek included the use of keywords such as: ((“electronic health record” OR “EHR”) AND (“health professional” OR "Opinion" OR "attitude")). During the review, various sub-selection criteria of the studies were used.

Results: Out of a total of published studies, 71 met the inclusion criteria. The results showed that various factors form positive or negative views and attitudes in health professionals about the use of EHR. In both cases, they are grouped into distinct topics related to the work of health professionals, health data and information, and patient care.

Conclusions: The successful implementation of EHR as an eHealth technological innovation requires coordinated action by health policy makers. In any case, the design and implementation of the HER system must incorporate the opinions and perspectives of health professionals. 

Keywords: Electronic Health Record, Health professional, opinion, attitude

The use of containment methods in acute mental health wards: A literature review | 30-49

Evdokia Misouridou , Vasiliki Sakellaridi , Ioannis Rizavas , Emmanouel Kritsotakis

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Ιn acute psychiatric wards, containment measures are applied to ensure safety and to avoid harm. However, containment limits the autonomy of people with mental health problems.

Aim: The presentation of a) the reasons for the use of containment in psychiatric clinics, b) the attitudes of mental health professionals and people with mental health problems about the containment methods, c) the effect of coercion on the therapeutic effect, as well as d) the strategies to reduce containment and to create a positive ward atmosphere.

Material and method: A literature review containing studies published from 01/01/2000 to 31/01/2022 in English and Greek language, in the PubMed and Cochrane Library databases was conducted. The following keywords were used:coercion", “containment”, “involuntary”, “acute psychiatry”, “restraint”. “seclusion”, “mental health”, “attitudes”. Exclusion criteria were the language (expect for English and Greek) and the type of article (letter to the publisher, editorial article, and case study).

Results: 41 studies were included in the review. Psychomotor anxiety, disorientation and subsequently, violence are the most common reasons for the use of coercion. Involuntary hospitalization, male gender, diagnosis of schizophrenia and substance use are associated with more frequent use of containment methods. Intercultural and interdepartmental differences concerning the use of containment methods are reported. The attitudes of mental health professionals have shifted from a therapeutic paradigm (restrictive measures are therapeutic) to a safety paradigm (restrictive measures are a necessary evil). The use of coercion impedes the therapeutic relationship. In Greece, high rates of involuntary hospitalization and mechanical restraint are reported. The ward atmosphere is related to the extent of the use of coercion. Multifactorial approaches are needed to create a therapeutic environment and reduce coercion.

Conclusions: The use of containment may traumatize both people receiving mental health care and mental health professionals. The implementation of alternative interventions to create a therapeutic environment requires the appropriate training of the staff, but mainly the adequate staffing of the psychiatric departments.

Keywords:   psychological  interactions

Special Article

Review | 50-59

Theodosios Paralikas , Dionisios Kavadias

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ABSTRACT

Cultural factors influence the aging process, shaping perceptions of aging, social support structures, intergenerational relationships, health behaviors, and overall well-being. Most older people from ethnic minorities face inequalities in access to healthcare services, resulting in adverse health outcomes and reduced quality of life. An ethnogerontological perspective on the healthcare of the elderly offers important insights for the development of integrated care models and a holistic approach to aging communities.  The purpose of the study is to present the basic principles of ethnogerontology as well as the current trajectory of research in ethnogerontological nursing. Ethnogerontology explores the interactions between aging, ethnic communities, and culture, revealing different perspectives, traditions, and challenges faced by older people from different cultural communities. The study of nursing has a substantial knowledge base to contribute to the intersection of aging, ethnicity, and health, yet only a few ethnogerontological nursing studies are available. Most literature focuses on individual ethnocultural communities with little attention paid to discussing observations that transcend  cultural specificities and which could be unified into a coherent cross-cultural theory of elderly nursing care. Ethnogerontology recognizes the relationship between cultural diversity and the experiences of older people. Ethnogerontological nursing studies can provide important data on aging in culturally diverse communities, shaping a holistic and culturally sensitive nursing care for the elderly.

Keywords: ethnogerontological nursing, cross-cultural elderly nursing, ethnocultural gerontological nursing

Functional Somatic Syndromes and patient-doctor relationship's specificity | 60-75

Dimitra Siamioti , Maria Theodoratou

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The term Functional Somatic Syndrome (FSS) refers to a complex medical condition characterized by the presence of physical symptoms, yet clinical signs are not easily identifiable. The challenges in the doctor-patient relationship stem from physicians' lack of training in mental health issues, inadequate diagnostic criteria, and an excessive focus on the biomedical model. Furthermore, the coexistence of FSS with psychiatric disorders and the potential secondary benefits that the disease provides to the patient are factors that exacerbate these difficulties. Various communication models between doctor and patient include the biomedical model, the expanded biomedical model, the consumer model, the psychosocial model, and the biopsychosocial model, while an alternative categorization includes the active-passive model, guided cooperation and the mutual participation model, while an alternative categorization includes the active-passive model, the guided cooperation and the mutual participation model. In this study, research data is presented supporting the view that the biopsychosocial model is the optimal choice for both managing medical care and communication between doctor and patient. Establishing a relationship of mutual participation significantly contributes to the care plan for FSS patients and can be facilitated through standardized decision-making processes, as well as the development of empathetic and reassuring skills.

Keywords: Functional Somatic Syndrome, Medically Unexplained Symptoms, physician-patient relationship, communication models, biopsychosocial approach

Original Paper

Attitudes and opinions of HIV/AIDS people about the use of mobile App in HIV self-management | 76-88

Maria Panagi , George Charalambous , Eleni Jelastopulu

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ABSTRACT

Aim: Evaluation of the attitudes and opinions of people living with HIV/AIDS (PLWHA) regarding HIV management through a mobile-based self-management application.

Methodology: A cross-sectional study was conducted on PLWHA aged ≥ 18 years who are monitored at the Gregorio Clinic of the Larnaca General Hospital, the only monitoring center for people with HIV/AIDS in Cyprus. A self-administered questionnaire was used, consisting of demographic characteristics, and questions regarding attitudes of PLWHA, as well as an open-ended question to express their suggestions about the design of the mobile application. We used convenience sampling (n =200) and the study was conducted between July 15, 2020, and January 15, 2021.

Results: 89% had a smartphone (70.7% with Android OS) while 90.5% agreed to use a mobile application with which they would have appointment reminders (92%), CD4/V/L results (88%), reminders to take the next medicine (79%), nutrition advice (e.g., for patients with diabetes, high cholesterol, etc.) (79%), sending messages to medical staff with real-time communication (79%), personal passwords (78%), daily medication reminders (60%).

Conclusions: The creation and use of a self-management application on the mobile phone is an innovative program for the Gregorio clinic that most participants embraced. The proposals cover the needs and expectations of the users of the information system to be created.

Keywords: HIV/AIDS, attitudes, opinions, self-management, mhealth

Systematic Review

Investigation of postoperative infections in pediatric cardiac intensive care units | 89-112

Kalliopi Amalia Nikiforaki , Ioannis Koutelekos , Christina Marvaki , Evangelos Dousis

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Introduction: Postoperative infections in pediatric cardiac intensive care units (PCICU) are a challenge for healthcare professionals and a problem for patients and affect their quality of life. Aim: The aim of the study was to investigate postoperative infections in PCICU and specifically to determine the pathogenic microorganisms responsible for them. Material-Methods: This is a systematic review of the literature carried out from 2016 to 2022, with a search for articles using the keywords: “PCICU”, “cardiac surgery”, “nosocomial infection”, “congenital heart disease”, “risk factors” in international bibliographic databases (PubMed, Scopus and Google Scholar) as well as synonyms or combinations of words. The criteria for the inclusion of the articles in the study were: To be written in the English language, to be published in valid scientific journals in the databases PubMed, Scopus, Google Scholar, to concern children in ICU (cardiac surgery or not) after cardiac surgery, to be about the post-operative infections of these children and to mention in them the micro-organisms responsible for these infections. Results: postoperative infections occur in a large percentage of children (>4.7%) who underwent cardiac surgery, while mortality from them ranges from 13.7-35.7%. The most common infections are bloodstream infections (BSI), respiratory tract infections, urinary tract infections and surgical wound infections. The pathogens isolated from these infections are more often Gram(+) pathogens. The most frequent pathogens isolated were Staphylococcus aureus, Streptococcus spp., Candida spp., Escherichia coli, Klebsiella, Acinetobacter, Pseudomonas aeruginosa. The most frequent risk factors for the development of infections are intubation, prolonged duration of mechanical ventilation, length of stay in the PCICU and in the hospital, delayed sternal convergence, urinary catheter and body weight. Conclusions: Postoperative infections in PCICUs are a major problem in these patients, and efforts to address it should focus on greater investigation of reported risk factors.

Keywords: Postoperative infection, Central Venous Catheters, Pediatric Cardiac Intensive Care Unit

Case Study

Self-Management of Long – COVID. Assessment of Individual and Family Physical, Mental and Social Needs for Community Health Care. | 113-125

Alexandros Argyriadis , Nina Tsirmpini , Chrisi Vlachou , Agathi Argyriadi

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Introduction: The global outbreak of the SARS-CoV-2 virus and the subsequent COVID-19 pandemic have led to various health challenges worldwide. Among the emerging concerns is the condition known as Long COVID-19, which presents persistent symptoms and effects even after the initial recovery from the acute phase of the illness. Aim: This paper presents an in-depth case study of the X family, a Greek family facing the challenges of Long COVID-19, a syndrome sequel to SARS-CoV-2 infection. The study explores the physical, psychological, and social effects of Long COVID-19 on the family as well as its self-management. Method: The case study method employed in this research involves an intensive investigation of a single-family unit, providing a detailed understanding of their experiences and challenges related to Long COVID-19. This qualitative approach allows for a holistic exploration of the subject, capturing the intricate nuances of the family's journey through Long COVID-19. Results: The findings highlight the significant burden on the family due to the occurrence of the syndrome in one of its members, as well as the resolution of problems through cooperation, effective communication, and the strong emotional bonds of its members. Conclusions: In conclusion, it emphasizes the need to design a comprehensive, multifaceted plan of care tailored to the unique needs and strengths of the family and outlines potential challenges in its implementation, with a view to its wider use in the community.

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