Rostrum of Asclepius Vol 7, No. 4 (2008): October - December 2008

The epistemology of care consists the philosophical approach in an art which includes strategies enriched with feeling and offer. As well as the determination of knowledge it concludes the establishment of criteria for the evaluation of actions, which materialize having as a final purpose the alleviation of the patient. She is the enconsience and explicit use of the current best elements for a decision making, which heads to the solicitude of patients and at the same time, embody the clinical experience with the best available data of systematical epistimonical research. Her practice in everyday action depends or and off the patient and the nurse, whose theoretical education, as well as his clinical experience is basic presupposition for practicing his profession. These two elements built the structure with which the reasoning and decision makings subjects that are brilliantly necessary to the grant of care. Also the knowledge of the theories concerning the sciences of care hugs the epistemology pluralism; pursue the mutual influence of human and clinic sciences adapted as it can cover moral, senseting, experiencing personal and spiritual, over all parameters. The care either as science, or as an action, is complicated or consists of the core of the heal. It’s in the nature of human existence it is a talent and a gift as well as skill concerning us and others.

Keywords: care, critical and intellectual care, knowledge, experience and action

Over the last decades, patients’ manual handling by nurse without specific help has been established as an easy choice not only in our country but also worldwide, tending to become one of the major causes of health problems in nursing staff. Aim: The purpose of the present study was the review of the literature on modern aspects that prevail worldwide regarding the method of manual moving and handling of patients by health professionals. The method οf this study included bibliography research from both the review and the research literature which referred to the methods of manual moving and handling of patients by health professionals, as well as, to the application of a new approach, which will significantly contribute to the improvement of their task performance and to better health of nurses. Results: The majority of research studies showed that the main cause for musculoskeletal diseases is the manual moving of patients. Although, various methods have been used to control and eliminate these problems, especially due to manual moving, the application of them has not been proved able to reduce musculoskeletal diseases. Moreover, the results of the present review showed that the incorrect way of manual handling is positively related to the cause of musculoskeletal problems to nurses. The policy of abolishing manual moving has been evolved during recent years in Europe and America as well as organizing and applying systems based on a various factors, in order to reduce nurses’ musculoskeletal diseases. Conclusions: The present review confirms that nurses’ information – education on the recent facts of patients’ manual transport, as well as the application of common protocols and algorithms among various organizations, will significantly contribute to the solution of the problem.

Keywords: Musculoskeletal diseases, manual moving, information, non-moving policy, multifactor systems

Artificial airways bypass the physiological mechanism of humidification and filtration of the inspired air, increasing, therefore, the possibilities of copious secretions production. Copious secretions increase the danger for atelektasis and respiratory infections. Moreover, clots can be shaped in the interior of the endotracheal tube or thracheostomy, resulting in increased work of breathing (WOB) and reduced odds of successful extubation. It is also possible to lead progressively to complete obstruction of the endotracheal tube. Thus, the choice of a suitable humidification device during mechanical ventilation is of distinguished importance. There are various types of humidifiers. However, hydroscopic Heat and Moisture Exchangers (HMEs) with filter and Heated Humidifiers (HHs), which provide humidity in form of water vapors, are currently used. When they are used correctly, and not in the cases where they are contraindicated, HMEs’ do not have complications and they decrease the cost of hospitalization as well as the staff workload. HMEs are better choice for short duration of intubation (<96 hours) and during transports. HHs are preferred for patients with persisting hypercapnia, chronic respiratory failure and difficulty in ventilator weaning. HHs should be used for patients with prolonged duration of mechanical ventilation or patients that HMEs are contraindicated for. Neither HMEs nor HHs have been accused for increased incidences of ventilator associated pneumonia (VAP).

Keywords: Humidification, humidification boundaries, mechanical ventilation, Humidity and Moisture Exchangers, Heated Humidifiers, ventilator associated pneumonia

Rheumatoid arthritis (RA) is a chronic disease characterized by inflammation of the synovial joints, and loss of the function leading to disability. The ultimate goal in managing RA is to prevent joint damage and to maintain functional ability. Although, οver the past decade, major advances have been made in our understanding of the factors that are crucial in regulating this disease, still the managment of the disease remains difficult. Aim : Τhe aim of the present study was the evaluation of the therapeutical approch on rheumatoid arthritis.  The method οf this study included bibliography research from both the review and the research literature which referred to the relation between therapy and rheumatoid arthritis. Results : The majority of research studies showed thatthe main therapy on rheumatoid arthritis included medication therapy, modification of everyday living ensuring rest, physical exercise and finally surgical procedure. Individuals suffering from rheumatoid arthritis, apart from physical problems usually cope with mental disorders, that exert a negative indluence on their quality of life. Conclusively :Information and early screening of high risk may decrease the long-term consequnences on health. Monitoring from a group of specialists should serve as a cornerstone when planning a program of intervention.

Keywords: Rheumatoid Arthritis, Therapy, Facing Surgery, Physiotherapy, Exersices, Relaxations Techniques

Background: Spirituality is an international matter of high gravity. It is very important to understand its meaning and importance in all human reactions in order to be able to understand the world and deal with the difficulties of life. The purpose of this study is to distinguish and to make apparent the terms of religiosity and spirituality in a general population in Thessaly. Design/participants: In order to have a reliable tool of measurement of spirituality and religiosity in Greece it was used “The Royal Free Interview for Religious and Spiritual Beliefs” questionnaire. In the study, 393 Greek citizens, living in Thessaly, completed the questionnaire, generally. The choice of the sample was at random, via place of work, homes and hospitals in the area of Thessaly. Measurements/ results: The average age of participants was 36,39 years, 149 (37,9%) were men and 244 were women in a percentage of 62,1%. Moreover, 95, 9% of the sample stated that they were Christians Orthodox. It was found that in a percentage of 57,7%, the participants have as much of spiritual and religious understanding of their lives in a relevance of a 11,7 of those people who have only spiritual understanding.Ιt was also, found that, people who have a high understanding of spirituality and religiosity had higher scores in the practice of faith in contrast to those who had only a spiritual understanding. It was also interesting that those who demonstrated both religious and spiritual understanding declared that they believe there is a spiritual power or force above them influencing the international facts. This was not the case with the participants who declared only religious beliefs. 85% stated that praying plays an important role in their lives. Sixteen people stated that they have experienced a situation related to death while 165 were certain that we exist in some kind of form after death. Conclusions: Findings from this study indicate that religion and spirituality are significant and fulfilling in the lives of the participants. The process to explain the importance of spirituality is difficult and painful.

Keywords: Spirituality, Nursing care, Religiosity, Pray

The social and financial whirls that take place the last few years not only in our country, but also in the extensive surroundings, European union, significantly change the scene as regard as the definitional environment that is experienced the health of a nation. In this surrounding which is constantly changing, the emergence of the health as the essential factor for financial and social development should be one of the main goals of a well developed nation with social character. The aim of this study was the measurement of the satisfaction of the health care personnel in private and public sector when it comes to their provided services. Methodology: For the measurement was used as a tool a questionnaire that was given for fill-up in a random sample of health care personnel in nomarchy of Attiki on May 2007. The sample consisted of 120 health care personnel (doctors, nurses, stretcher bearers). From them, the 60 were health care personnel that worked in private sector (private clinics, diagnostic centers, private practices) and the other 60 were health care personnel that worked in public sector (hospitals, health stations, EKAB, IKA). Results: From the health care personnel in private sector that answered the 70% and the 55% in public sector correspondingly are satisfied for the services provided as far as the quality is concerned. From the personnel in private sector the 40% has objection about health services’ sufficiency and the 75% in public sector. In near future the health services in our country will be worse than now because of the expenditures’ raise believes the 60% of the health personnel in private sector whereas personnel in public sector believes this the 45%. Moreover, the 65% in private sector and the 55% in public sector correspondingly reports that is willing to pay for taxes so as to improve the health-care provided system. Finally, they evaluate and attach importance to the problems in health-care sector: Private sector: lack of personnel, education, control, evaluation, computerization, equipment. Public sector: lack of personnel, evaluation education, control, equipment, evaluation, computerization. Conclusively: There is necessity of such measures as the creation of a modern System of Health, in which the protection of health and not only the management of illness will come first and it will be ensured that all the citizens will have the same access in the health serviced of high quality.

Keywords: Health, National system of health, Private sector of health services, Improvement of health services

Sudden cardiac arrest is one of the leading causes of death in Europe. Bystanders’ early Cardio-Pulmonary Resuscitation (CPR) may double or triple survival rates of out-of-hospital cardiac arrest victims. Aim: To investigate nurses’ attitude, in starting or not CPR and also the most frequent reasons that deter them from engaging in. Materials and Methods: The study had a sample of 177 nurses and assistant nurses that were working in nine hospitals of Athens. Nurses filled out the same, predetermined questionnaire, voluntarily and anonymously. The collected answers were analyzed with the help of the statistical program SPSS v.16, using x2 and Kendall’s Tau-B methods. Results: From 177 participants, 78% (137) were women and 22% (40) men with mean age 31 years (±7). According to their education, 16% (28) were Assistant Nurses, 79% (140) Registered Nurses (ATEI, AEI) and 5% (9) Nurses had an MSc diploma. Nurses that had been recently trained in certified BLS courses felt more confident and were more willing to start CPR in a known victim (p=0.004) and in an unknown victim (p=0.02) comparing to nurses that had been trained a long time ago or never. Most frequent reasons nurses reported that deter them from starting CPR are the fear of a possible lawsuit (43%), the fear of harming instead of helping (30%) and the fear of infectious transmission from victim to rescuer (15%). The fear of harming correlates considerably with lower ages (the younger the nurse the more is afraid, p=0.04) and also correlates substantially with the training in a certified CPR course (the more a nurse is trained, the less is afraid, p<0.001). Accordingly, the fear of infection diminishes as long as the CPR training is repeated (p=0.03). Conclusions: According to the results, there is a necessity of continuous education and re-education of nurses, in certified Basic Life Support programs. With frequent and specialized training, nurses will show more willingness to engage in an out-of-hospital arrest situation, in a familiar or unknown victim and, moreover, fears that deter them from starting CPR are remarkably reduced.

Keywords: Cardiopulmonary Resuscitation, attitude, causes, nurses