Rostrum of Asclepius Vol 11, No. 4 (2012): October - December 2011

Leadership and motivation are extremely important administrative procedures in the nursing services, and these depend to a large extent the focus of nurses in achieving the goals of efficiency. Purpose: The purpose of the present study was the theoretical approach of leader΄s role and methods and techniques to motivate staff in the nursing field. Material and methods: The method followed in this review based on literatures reviews and investigate studies, which were carried out during the period 2000-2012 and international (Medline, PubMed, Cinahl) and Greek (Iatrotek) databases and greek literature on the concepts leadership and motivation to the nursing field. Keywords were used: Managment, leadership, evidence-based nursing, motivation, health servises. Results: In terms of leadership in nursing, the results showed that each strain of nursing who holds the position of leader will need to form the desired organizational climate. His role as coordinator of nursing services is particularly important. Also, the headnurse-leader is necessary to properly administer the methods and motivational techniques. Regarding motivation, methods and techniques to motivate the nursing staff include the formation of working groups (team nursing), creating an environment of learning, continuing nursing education and safe working environment. Conclusions: The headnurse-leader will be distinguished by a combination of many features to exercise effective leadership. For the motivation of nurses is important in selecting appropriate techniques and methods to perform at their maximum potential while ensuring the conditions of satisfaction from their work.

Keywords: Managment, leadership, evidence-based nursing, motivation, health servises

The human body does not constitute an independent and comprehensive unit but instead it is a framework through which the individual perceives and receives information from the outside world. Aim: The purpose of this article was the review of literature relating to the concept of body of both the patient and nurse. Material and method: the methodology applied included search of review and research papers via the electronic databases of "SCOPUS" and "JSTOR" that referred to the theoretical approaches of the human body and clinical decision making. The data collection took place in the period of 2010-2011. Results: According to the literature, the hospital converts into a space for observation and knowledge transfer for the discipline of medicine and new methods for controlling individuals and society appear, while the patient is subjected to technologies and practices that gradually bring about the alienation from his own body. At the same time, the science of medicine, through innovative ways of examining the human body, led to a new understanding of life, death and disease. Intensive Therapy Unit (ITU) as a workplace present increasing ethical and communication complexities for nurses, on one hand because the patient's body destabilises through the applications of technology and the medical file, on the other hand because nurses are invited to adopt communication strategies in order to participate to clinical decision making. The traditional roles of healthcare professionals are challenged while they try to provide high-level care in ITU, where the transition from life to death has become quite vague and difficult to discern. Conclusions: The study of the social dimensions in ITU will allow further investigation of the body techniques of nurses, and will highlight ways of strengthening nursing identity and contribution to clinical decision making.

Keywords: Human body, intensive, nursing identity, communication, decision making

In the present times when the concept of health is threatened by various dangers and medicine is characterized by rapid growth, nurses have the responsibility to inform the public, to apply preventative measures to practice, to provide education about new methods of treatment and rehabilitation and to support not only ill, but also health people. In the field of health education, nurses are regarded as important health care professionals who also play the role of instructor. Aim: the aim of this review is to present the educational role of the nurse and the basic principles that determinate the effectiveness of health education as they stem from motivation, counselling and behavioural change. Material and Method: Data was collected through selected articles and book chapters mainly for the period 2001-2010 as these were found in Greek (ΙΑΤRΟΤΕΚ) and international databases (PubMed, CΙΝΑΗL) using combinations of the following key-words: patient education, health education, role of nurses. Results: In order to provide health education, the nurses need to have general knowledge, special pedagogic skills of communication and high motivation. Health Education uses a variety of methods and techniques in order to achieve its goals e.g. lectures, individual teaching and the use of new technologies in the community, school or hospital. Conclusions: Despite the problems and existing deficiencies, nurses could provide health education in a systematic way. Nurses as health professionals have the ability to meet this goal, since the benefits for health and society are of vast importance.

Keywords: Patient, education, health education, role of nurses

Counseling is a part of professional role of nurses and a prerequisite for holistic care. Aim: The aim of the present study was to review the literature about Counseling of children that undergo surgery. Material and method: The methodology οf this study included bibliography research from both the review and the research literature, between 2005-2009 mainly in the pubmed data base which referred to Counseling of children that undergo surgery, using the key words: Counseling, perioperative treatment, holistic care . Results: In the literature it is cited that counseling is provided by well trained and balanced individuals that have communication skills. Prerequisite of effective counseling is Conversation, where the nurse-consultant after elaborate listening proposes remarks, proposals, in order to enhance self-image, self-knowledge and self-esteem of the child and improve its' personal emotional state. Perioperative counseling procedure as a part of the holistic care of children should follow and individualized approach either on preoperative and postoperative stage. Conclusion: Ultimate goal of effective counseling to children that undergo surgery is to improve the quality of provided care and increase the degree of satisfaction of hospitalized children and their families.

Keywords: Counseling, perioperative treatment, holistic care.

Keywords: Counseling, perioperative treatment, holistic care

Health professionals belong to the group of high risk to develop burn out syndrome. According to Maslach & Jackson, "emotional exhaustion", "depersonalization" and the "reduced feeling of personal accomplishment" are the three parameters that consist the burn out syndrome. The aim of the present study was to explore burn out syndrome among nursing workforce in General Hospital of Larnaka in Cyprus. Method and material: The sample studied consisted of 100 nurses coming from 10 different departments of the hospital. Data were collected by the completion of a specially designed questionnaire for the needs of the research which apart from the socio-demographic variables included Maslach burn out questionnaire. Data analysis was conducted by the statistical package SPSS 16 and the statistical method was t-test and Anova. Results: From the 100 participants, 76% were women and 24% men. The mean age of the participants was 35,8 years old. The results showed that the participants experienced median level of burnout syndrome. Men of the sample studied experienced higher level of "emotional exhaustion" with average value 19,4 and "depersonalization" with average value 7,5 whereas reduced feeling of personal accomplishment with average 39,7. Married participants had "emotional exhaustion" with average value 20,2, "depersonalization" with average 7,6 and "feeling of personal accomplishment" with average 38,5. Presence of children had positive relation with all subscales and more specifically those who had 3 and more children had 21,1 average value of "emotional disturbance", 7,9 average "depersonalization" and 40,5 average value of "feeling of personal accomplishment". Nurses with 1-5 years previous experience had 19,9 average value of "emotional exhaustion", 7,7 of "depersonalization" and 38,7 of "feeling of personal accomplishment". Statistical analysis showed no relation with socio-demographic variables of nurses with burn out syndrome. Conclusions: It is an imperative need to explore in depth burn out syndrome as well as the risk factors (personal and environmental) so that hospitals take all the necessary steps to prevent this syndrome that has detrimental effects not only on the nurses' quality of life but also on the provision of quality of care.

Keywords: Βurn out syndrome, emotional exhaustion, depersonalization, reduced feeling of personal accomplishment, nursing staff

Delirium is a common cause of acute brain dysfunction in patients treated in the Intensive Care Unit (ICU). Aim: The aim of the present study was to investigate the incidence of delirium in the ICU, to establish risk factors for its development and to determine the effect of delirium on patient's length of the stay and mortality in the ICU. Material and Methods: The sample studied consisted of 122 patients hospitalized in the ICU of a General Hospital in Attica, having completed 48 hours of stay. In order to diagnose delirium the CAM-ICU delirium scale was used. There were recorded the demographic characteristics of the sample studied, the medical history, the type of sedation, the severity of their illness during admission, the complications, the environment and psychological factors. Moreover, the length of stay, morbidity and mortality of patients were recorded. Data analysis was performed with the statistical package SPSS-ver.17. Results: 62% (n=76) of the sample studied were male. The mean age of the sample was 57±18 years. Intubation and mechanical ventilation was applied in 90% (n=110) of the studied population and seductive drugs in 90% (n=110) of the sample. Delirium frequency was 43%. Risk factors, according to the results, seems to be arterial hypertension (p= 0.009), smoking history (p=0.023), alcohol abuse (p=0.005), severity of illness in admission Apache II (p=0.033). The age and length of stay in ICU doesn't seem to affect delirium development in ICU. Finally, mortality was clearly increased (p=0.001). Conclusions: The increased frequency of delirium in ICU patients requires measures to prevent it. Factors that seem to be related to delirium development are: arterial hypertension, alcohol abuse, smoking, hyperpyrexia and the usage of sedative drugs., Delirium, also, increases mortality in ICU patients.

Keywords: Delirium, Intensive Care Unit, risk factors, length of stay, mortality

The health sector, being one of the most stressful working environments, is considered to contribute to chronic stress. Factors contributing to stress can involve employees (work overload, interpersonal relations and role conflict, vagueness of professional role, extreme expectations), patients (course of the disease, chronicity, death) and health system organization (organizational injustice, lack of participation in decision making, bad management). Aim: The aim of the present study was to investigate the anxiety levels of nursing personnel (NP). Material and Methods: The sample was 102 members of NP in medical wards in four hospitals of the National Health System (NHS) in Attica, Greece. The study took place from September 2009 to March 2010. Socio-demographic characteristics were recorded with a part of the Health Attitudes Evaluation Questionnaire which evaluates intensity, nervousness, remoteness and concern that are increasing the response to natural danger and stress. It was based on the State-Trait Anxiety Inventory (STAI I-II). Statistical analysis was done with SPSS 15.0. Results: There was satisfactory representation of genders, age groups as well as educational levels in our sample. All participants, especially women and older nurses, stated that their job demands influence negatively the time and energy that they devote to themselves (42,2%, t(100)=-3,076, p=0,003 & r=0,275, p=0,005) and their families (38,2%, t(100)=-2,359, p=0,020). On the contrary, family matters did not seem to influence their work (93,1%). Increased levels of reported anxiety were registered in all participants and were associated mostly with the female gender and older age. Finally, gender and age, but not the level their education influenced the nurses' attitudes. Conclusions: Nurses, nowadays, despite the lack of nursing staff and increased workload continue to demonstrate the appropriate zeal in patient care. Improvement of working conditions, salary and psycho-education on stress matters can improve the way NP experiences its working life.

Keywords: Perceived stress, anxiety levels, health attitudes, nursing personnel, job effect

For many years, medical errors have been a frequent phenomenon in the Health Care Systems and an important cause of mortality and morbidity, all over the world. Medical errors are on the increase both in Europe and in the United States of America which have forced them to confront the problem and take measures. In Greece, an increasing number of patients are worried about the possibility of suffering a medical error but the organisations they can turn to are just few and with limited intervention power. Aim: The aim of the present study is to present current situation of medical errors in Greece. Material and Methods: An extensive search was carried out to find the relevant authorities and the organisations where the various parties affected by the medical errors turn to. We reviewed the national and international literature as well as local audit results of the last decade. Results: The findings from our research confirmed the conclusion that the medical malpractice issue is present in the Greek Health System too, and that the invasive medical specialties seem to come up against the highest rates of adverse events. So, co-operation and trust between patients, health care professionals, hospital management, medical councils and the government are essential to get to the root of the problem.

Keywords: Medical error, adverse event, medical malpractice, quality of health care