Rostrum of Asclepius Vol 8, No. 4 (2009): October - December 2009

The demographic population ageing constitutes a world social phenomenon which is strongly presented particularly in the developed economically and industrially countries. Aim: The aim of the present study was to explore the trend of the demographic indices over time in the Greek population. Method: The method οf this study included bibliography research from both the review and the research literature, the literature search was performed on MEDLINE, SCOPUS and ESYE (1991-2007) databases and using as key words epidemiology, demographic ageing, aging, demography, fertility, morbidity, mortality. Complementary bibliography was found through other electronic search engines and by reviewing references of already found articles. Results: The literature search showed that the percentage of Greek population which aged more than 65 years old increases with fast and constant rhythm. The population of Greece is characterized by continuous reduction of natural increase, because of the reduction in indicator of birth rate and the increased in general indicator of mortality that is owed in the ageing of population. The ageing of population changes the “epidemiologic profile” of diseases all over the world and has important influence in health service management and generally in society. Conclusions: The study of demographic characteristics of the Greek population is important for understanding health status in Greece as for the present and as well as for the future.

Keywords: Epidemiology, demographic ageing, aging, demography, fertility, morbidity, mortality

The aim of the present study was to review Greek and international literature referred to the impact of the chemotherapy induced peripheral neuropathy on the quality of life of patients with cancer. Method and material: The method followed included bibliography research from both the review and the research literature which referred to the impact of the chemotherapy induced peripheral neuropathy to the quality of life to patients with cancer. Results: The results of studies indicate that the survival of patients with cancer as the only goal of the treatment is no longer sufficient. Although, the evaluation of the consequences of the chemotherapy induced peripheral neuropathy on the quality of life has not been the subject of many research studies, over the last decades quality of life has gained a significant position in the field of Oncology. Peripheral neuropathy affects the ability of patients to perform their daily activities thus influencing negatively their quality of life. Conclusions: It is demanding the adoption of a reliable and valid instrument to assess not only peripheral neuropathy, but also its’ consequences on the quality of life. Furthermore, the establishment of specialized neurological centers is a matter of great importance.

Keywords: Chemotherapy, Quality of Life, Peripheral Neuropathy

Coronary heart disease has long been recognized as the leading cause of death among middle-aged men and an equally important cause of death and disability among older women. Women with acute ischemic syndromes tend to be older than men with such syndromes. This is considered to be attributed to the protective effects of female ovarian sex hormones. Estrogen express an antiatherogenic profile via mechanisms that cause favorable modifications of lipoprotein levels, coagulation and fibrolytic system and alterations in the wall of vessels that cause vasodilation. Women are susceptible to coronary heart disease because of differences in the anatomy and physiology of their vessels. Women's coronary arteries are smaller and have more diffuse disease than men's. Ischemia can be induced in women without flow limiting stenosis because of endothelial dysfunction or coronary spasm. Usually, the way of manifestation of the disease and ECG abnormalities are not typical in women. Female patients usually delay to seek treatment for their symptoms .The way of evaluation and treatment is usually conservative in women than male counterparts. The diagnosis of the disease is overestimated in men and the treatment is more often invasive, even in the category of low risk. Reversely, women of high risk are less likely to undergo a full assessment and invasive diagnostic and therapeutic interventions are seldom. Recommendations of the American Heart Association for ischemic heart disease in women are in accordance to alterations in the way of life interventions in major risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, preventive use of medications and drugs that are not recommended. In this category of medications belong hormone replacement therapy (HRT).The last is not recommended for primary and secondary prevention of coronary heart disease in women.

Keywords: women, ischemic heart disease, estrogen, blood vessels, prevention

The fundamental concept of the policy of the health-care sector, is 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. Aim: The purpose of the present study was to evaluate the public and private hospitals in Greece. Conclusively: There is necessity and it is important to evaluate proposals and solutions for the improvement of the health services.

Keywords: Health, Public and Private sector of health services, Greece

Infertility treatment influences significantly not only the couples’ quality of life but also their psychology separately. Aim: The aim of the present study was to explore perceptions of infertility couples in regard to assisted reproductive techniques. Method and material: The sample study consisted of 110 infertile couples that seek medical help to a Center of Assisted Reproductive Techniques. A specially designed questionnaire was used for the needs of the survey, that included items related to the perceptions of infertile couples. Statistical analysis was performed by the statistical package SPSS-13. Results: Οf the 110 studied infertile couples, 44,3% followed (IVF) In Vitro Fertilization method, 37,8% artificial Insemination, 14,1% (ICSI) Intracytoplasmic sperm injection, 3,1% donor insemination and 0,7% (GIFT) Gamete Intra – Fallopian Transfer. In regard to factors that make difficult the decision to choose Assisted Reproductive Techniques, in 27,3% of the participants was the side effects deriving from therapy, in 22,7% the cost, in 7,3% the attitude of the environment, in 10,0% the psychological and in 4,5% the religious factor. The 73,6% of the studied sample reported that they would try again to have a child even if the previous effort was successful and the 94,5% reported that they would try again even if the previous effort was not successful. Regarding what they had the intention to sacrifice of their life to the birth of a child, the 58,3% reported that they would sacrifice “everything”, the 14,5% free-time, the 4,5% the entertainment, the 3,6% occupation, the 2,7% athletics and the 16,4% would sacrifice nothing. The 73,6% of the couples that had undergone an Assisted Reproductive Techniques, received no psychological support, while 26,4% received. Τhe 55,4% reported that they desired the presence of their spouse during the procedures of medical treatment, the 36,4% in some of them and the 8,2% in every medical process. The 61,8% of the studied sample reported that would accept have sperm donation and the 68,2% egg donation. Conclusions: The development of consultation is necessary for the infertile couples receiving assisted reproductive technologies

Keywords: infertility, perceptions, assisted reproductive technologies

Occupational hazards and infections of hepatitis B virus consist the most common dangers that health professionals face in their daily clinical practice. Purpose: The aim of the present research study was to explore health professional’s information regarding occupational hazards and infections of hepatitis B virus, as well as the the existence and apply of safety practice guidelines in their daily clinical practice. Method and material: The sample study included 454 nurses that were working in hospitals of private sector in Athens. Collection of data was performed by the completion of a specifically designed questionnaire for the needs of the research. Analysis of data was performed using the SPSS 16 statistical package and the method Χ2 and t-test was applied for the statistical process. Results: From the 159 nurses studied, percentage of 13% was men and 87% women. Regarding demographic variables, the average age of the participants was 31±5 years, regarding marital status, 60% was married, 37% not married and 3% divorced and finally regarding educational background, 42% of the studied population was of basic education and 44% of other technical school. The average time of work in hospital was 7,6 years. 94% of the sample study declared informed about occupational hazards and 87% declared informed about risks of exposure to Hepatitis B. Regarding the nurses’ source of information, in percentage of 46% was the responsible hospital service and followed bibliography 44%, lectures/speeches 27%, scientific conventions 23%, information leaflets distributed in hospital 22%, Mass Media 20%, the continuing training programs 13% and last of all the internet 15%. Regarding the apply of practice guidelines, 52% of the participants declared that that there was no easy access on the safety protocol and the protocol for facing Hepatitis B exposure in their working area, whereas 28% declared that they are not aware of the existence or not of such a protocol. Conclusions: Although, high percentage of nursing staff was found to be informed about occupational hazards and the risks of exposure to hepatitis B, it is of bounden duty to be established the construction and apply of protocols in daily clinical practice.

Keywords: Hepatitis Β, information, nurses, exposure protocols

Everyday problems encountered by health care personnel and the means of communication they employ for their resolution, constitute important factors of the interprofessional collaboration and smooth day-to-day running of an institution. AIM: The main aim of this study was to explore and record levels of cooperation and communication among health care professionals at a provincial hospital of Northern Greece. ΜΕΤΗΟD AND MATERIAL: A stratified sample of 83 health care professionals out of a population of 692, participated in the survey. Data were collected via a questionnaire consisting of 25 multiple choice questions which were concerning demographic data, co-operation and its dimensions, communication and workplace conflict, professionalism and ways of improving interprofessional communication. Data analysis was completed using descriptive and non-parametric statistics using the SPSS v.14 statistical package. RESULTS: 83 health care professionals completed the questionnaire. i) 51 were nurses, of whom, 27 assistant nurses, 19 doctors, 2 physiotherapists, 2 midwives and 9 students. 22,90% of them held a university degree, 37,34% had a technical college degree and the remaining 39,75% had graduated from comprehension nursing school. 84,32% of the sample considered interprofessional cooperation as working together with people of different specialty in the same field. Commonest reasons for poor communication were heavy workload (86,74%) and personnel shortages (77,09%). The greatest advantage of interprofessional cooperation was the well-balanced duty allocation (96,73%), improved quality of care (86,73%) and faster completion of nursing tasks (82,83%). CONCLUSION: Poor communication due to the heavy workload, lack of personnel and the non-clarified responsibilities, create ever growing tensions among health care staff which dramatically affects interprofessional collaboration.

Keywords: Interprofessional collaboration, Professional conflict, Communication, Burnout

Clinical training in nursing is fundamental because it transforms the theoretical knowledge of student nurses into clinical skills and practice. In addition, clinical training promotes the development of students’ critical thinking, psychomotor skills as well as patterns of professional contact for patients care. Aim of this qualitative study was to explore student nurses’ views of their clinical training. Material and method: Focus groups of 40 student nurses were held to explore their views on their clinical training and studying in a nursing school of a Technological Educational Institute. The participants were divided into four groups of ten students in order to facilitate the focus group interviews. The qualitative data derived from the interviews, was analyzed using thematic categories and coding. Results: From data analysis of the focus group interviews, five thematic categories emerged. In accordance with student nurses’ views in this study “stress and clinical learning environment” “theory practice gap”, “the role of lecturer practitioner - assessor”, “the lack of opportunities for critical thinking development”, “the search of professional patterns from staff and lectures”, were identified as the thematic categories. Conclusions: The results of the study indicated that student nurses were not particularly satisfied with the quality of their clinical training. In addition, it is apparent that the necessity to foster the role of lecturer practitioners, which they need specialized education on providing clinical training to student nurses, aiming to establish professional patterns to them.

Keywords: Student nurses, clinical training, lecturer practitioner