Rostrum of Asclepius Vol 10, No. 1 (2011): January - March 2011

The current Greek hospital, included in a complex system of health, is compelled in the benefit of differentiated spectrum of health services. The increased cost, the closeness of resources and the continuously increased demands and requirements for quality, impose the adoption of an administration-management system, on one side for the confrontation of challenges and changes, on the other for the achievement of placed objectives. The present literature review attempts to analyze the processes of Greek hospital's management, thru Greek environment.

Keywords: Management, planning, public hospital, human resources

Defining patients' needs is difficult due to the inherent complexity of the concept of 'need', so it is not surprising that numerous definitions have been proposed. Aim: The aim of the present study was to review the literature about the concept of "needs of patients". The method οf this study included bibliography research from both the review and the research literature, mainly in the Pubmed data base which referred to concept of "needs of patients". Results: According to the literature, the "need" has various concepts that change, reconsider and progress by time. The results of recent studies indicate that each patient as a bio-psychosocial entity besides the biological or physical needs has also social and mental needs. According to Maslow the main needs of patients are biological, the needs of security and protection, needs of understanding and acceptance, needs of self-concept and needs of self-perception. In Nursing as need is defined the condition at which there is impairment or disability of biological or psycho-social individuals' function which as a result Lead to the discrepancy between "what things are and what the individual would like to be". Conclusions : Health-professionals should not ignore needs of patients but on the contrary should integrate satisfaction of needs as a part of therapeutic treatment.

Keywords: Patients needs, social, emotional, physical needs

Teenage pregnancy is a worldwide medical and social issue, associated with many physical, psychological and social consequences and can result in birth, miscarriage or abortion. Aim: The aim of the present study is to find those risk factors that contribute to teenage pregnancy. Results: In U.S.A., according to data from Unicef, the birth rate among teenagers touches the 52.1% and it is four times higher, than the corresponding rate recorded in the countries of Western Europe. The United Kingdom has the highest rate of teenage pregnancy in Europe and in contrast to the decline in the rate of teenage pregnancy, recorded in the remaining countries of Western Europe, this figure has remained relatively stable, especially in adolescents aged 16 years and below. In Greece, according to National Statistics Office, in 2007, we had 3.129 births by teenagers under 18, with 75 births by teenagers under 15. The main factors contributing to the incidence of teenage pregnancy are socioeconomic factors, the family, the education and the sexual behavior of teenagers. Conclusions.It is necessary the state, through the health services and the education programs, to provide modern sex education in schools, as well as programs of prevention and health education in primary health care. The cooperation of these authorities is essential, to better address the extent and consequences of teenage pregnancy.

Keywords: Teenage pregnancy, contraception, risk factors, sexual behavior, sex education

Patients with malignancies are subject to develop a unique set of urgent and life-threatening complications. These emergency problems can be the result of the disease itself, the result from the therapy directed against the cancer or the result of previously existing pathological conditions not related to cancer. In some cases, these problems are the first symptom of the tumor. Aim: The aim of this study was to review the literature regarding the oncologic emergencies. Method: The method of this study included bibliography research from both the review and the research literature, mainly in the on-line data base 'Pubmed'. Results: Tumor lysis syndrome, malignant spinal cord compression, superior vena cava syndrome, cardiovascular emergencies, acute renal failure, venous thrombosis and pulmonary embolism, metabolic emergencies, neutropenic infection, acute pulmonary problems, acute hemorrhage and hematuria are the most important oncologic emergencies. Conclusions: Early diagnosis of the oncologic emergencies and prompt interventions can be lifesaving. However, staging of the tumor, response to current treatment, overall prognosis and patient and family wishes should be assessed in order to establish an appropriate treatment plan.

Keywords: Oncologic (oncological) emergency, cancer

Patients suffered from DM, face many difficulties in compliance to medical instructions, because the DM type II may be asymptomatic at the beginning and that is the reason that recommended dietary and lifestyle changes may seem unnecessary. The aim of the study was to develop a specific instrument measuring compliance to treatment in patient with DM II and test the validity and reliability of the instrument in Greek people. Method and material: This instrument was created using 38 questions from existing questionnaires. The questionnaires used were: Summary of Diabetes Self-Care Activities, 9-item Patient Health Questionnaire, 12-item Short Form Health Survey and Diabetes Self-care Behaviours and Barriers instrument. The translation process from English into Greek was undertaken following the guidelines provided by the International Committee of this instrument. Several issues related to the best possible translation and validation of the various dimensions and levels of the instrument were taken into account. Then the instrument was tested to a representative sample of 120 individuals. Results: Using the scale reliability of the Flesch-Kincaid, the reliability of the questionnaire was 6.7. The average time for completing the questionnaire was eight minutes (SD ± 4.2 minutes). The instrument presents construct validity, discriminant ability, reliability and sensitivity to change. Conclusions: The present instrument requires considerable time to complete it. Therefore it is a reliable and valid instrument which can be used effectively in compliance of therapy measurement in Greek population.

Keywords: Reliable, validation. SD II, compliance, translation

The postpartum period requires from the new mother high Psychological Resilience, particularly when is expressed postpartum depressing symptomatology. Purpose: The aim of the present study was to investigate the relationship between psychological resilience and postpartum depression. Material – Method: 104 participants completed the Panas-X scale, the CD-RISK (Connor-Davidson Resilience Scale) and the BDI (Beck Depression Inventory). Results: Results showed that 42% of the participants were prone to experience postpartum depression according to the BDI. Moreover it was shown that psychological resilience remains unaffected during pregnancy, while it relates to low postpartum depression levels. Finally the study provides support that partner and environment support as well as positive affectivity affect psychological resilience levels. Conclusion: The Psychological Resilience and the support from companion and family can protect new mothers from depressing symptoms.

Keywords: Postpartum depression, psychological resilience, support, BDI, PANAS-X, CD-RISK

Job burnout is defined as a syndrome - a complex product of emotional exhaustion, depersonalization and reduced personal achievements that can occur to people who work extensively with many other people under considerable time pressure. Aim: The investigation and measurement of factors contributing in the creation of stress and fatigue of nursing staff so as the satisfaction and self-esteem that nurses live during their professional career. Material and methods: The study population included 167 employees of regular nursing staff working in three public hospitals of the province. Data was collected by completing anonymous structured questionnaire. The program used for entering coded data and statistical processing was SPSS 11.0. Results: Statistical analysis showed that females reported "good" and "very good" emotional status than males with a statistically significant difference, p <0.001. Also, the men surveyed were satisfied with their profession 'often' and 'very often' compared with women with a statistically important difference, p <0.005. Τhe greater the seniority of the respondents the more they say that fatigue at the during the shift. The observed difference is statistically significant at a p level of less than 0.05. Finally there was little statistically significant positive correlation between years of work and fatigue. (p=0,004). Conclusions: Health professionals are more prone to fatigue than other professional workers because they are responsible for human lives and their actions have a significant impact on these people, the workload given to them is very high.

Keywords: Anxiety, lassitude, satisfaction, nurses, hospitals, Ilia

Blood pressure (BP) measurement by the use of sphygmomanometer and auscultation of brachial artery by stethoscope is the most widespread way of measurement in daily clinical practice. The aim of the present study was to explore nurses' knowledge regarding correct way of measurement of blood pressure by the use of a sphygmomanometer. Method and material: The sample –studied consisted of individuals from all levels of nursing personnel. Data were collected by the use the completion of a specially designed questionnaire which apart from demographic variables, it included items concerning knowledge about the correct way of blood pressure measurement. Results: From the 360 participants, 88% (316) were women, while the mean age of the sample-studied was 36,1 years old. 51,4% of the sample-studied was of tertiary education. In terms of the knowledge of participants, 79,6% knew the correct preparation, 98,6% knew that arm position for blood pressure measurement should be on a pillow or a side table and the 94,8% knew the back should be supported on a chair back. 60,9% of the sample-studied knew that at first time, blood pressure (BP) should be measured in both arms, while 45,9% didn't know that BP should be measured in arm with higher measurement. 78,2% of the participants knew that the correct measurement includes the use of sphygmomanometer and auscultation of brachial artery by stethoscope. 67,9% knew that body and arm position should be in ankle of 45o degrees and that the cuff should be placed around the upper arm at the same vertical height as the heart. 59,8% knew that the cuff should be placed 2-3 cm above the point of auscultation of brachial artery. 45,1% considered that the arm cuff should be inflated manually until when the height of the column of mercury approaches 200 mmHg. 52,3% knew the correct rhythm (2-3 mmHg/sec) that the pressure in the cuff should be released. 88,4% knew the sounds corresponding to the measurement of Systolic blood pressure and 72,7% the sounds corresponding to the measurement of Diastolic blood pressure. Conclusion: For the improvement of nurses' knowledge and skills regarding correct way of measurement of blood pressure, emphasis should be given on the lifelong learning.

Keywords: Blood pressure measurement, sphygmomanometer, auscultation of brachial artery, stethoscope