Research nurse and nurse researcher: differences and similarities

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Clinical indicators as prognostic factors of multi-trauma patients in the Intensive Care Unit

Background: In recent years, there has been a growing interest in understanding the role of prognostic factors in patient outcome.Aim: To investigate the role of clinical indicators, and severity-of-disease assessment scales, as prognostic factors in the outcome of multi-trauma patients in the ICU.Material and Method: The sample consisted of 65 ICU multi-trauma patients treated in a hospital in Thessaloniki city, with an average stay of 16.5 days. Clinical indicators such as Glasgow Coma Scale, heart rate, mean arterial pressure, lactic acid, hemoglobin, urine output, as well as APACHE II and SAPS II scales, were recorded on the day of admission to the ICU.Data analysis: Data were analyzed using multiple logistic regression and Mann-Whitney Test. Multiple logistic regression analysis was performed to examine the predictive capacity of specific indicators on patient outcome.Results: The results of the analysis showed that in cases where all clinical indicators changed, then patient outcome may be affected by 79,4% (Relative Risk 3.846, p<0.001). Glasgow Coma Scale (p=0.022) and hemoglobin (p=0.013) were the strongest influencing factors related to patient outcome. Mann-Whitney analysis was used to evaluate the predictive value of Apache II and SAPS II and demonstrated that both systems could significantly predict patient outcome (APACHE II=0.019 and SAPS II=0.013).Conclusion: Hemoglobin and Glasgow Coma Scale values upon multi-trauma patient admission to the ICU appear to be strong prognostic factors of patient outcome.

Advantages and disadvantages of patients’ hospitalization in Intensive Care Units

Background: An Intensive Care Unit (ICU) is a special hospital department with many advantages and disadvantages for the patient.Aim: The aim of the present systematic review was to explore the advantages and disadvantages of hospitalized ICU patients.Material and Method: A literature review in international databases (Pubmed, Cinahl, Google Scholar, Cochrane Library) was conducted. A time limited criteria was applied with respect to the publication of articles (articles published in the last 15 years). Ten articles were found that met the criteria for participation in the present review.Results: Results thematic analysis revealed the following advantages and disadvantages of ICU hospitalization: Advantages related to patients care in ICU and advantages related to team work. Disadvantages related to the ICU environment (noise, lighting) that complicate the patient's hospitalization status and cause the patient's sleep disturbances and / or delirium. Additionally, it was found that financial cost of hospitalization is a very significant disadvantage for both patient and health care providers.Conclusions: Preparation and successful implementation of significant strategies will convert disadvantages of ICU hospitalization into advantages in daily clinical practice through increased use of protocols, the maintenance of a checklist, evidenced based practice, data recording, development of interdisciplinary groups and finally the extensive application of technology for patient’ s benefit.

Τhe effect of the religious attitudes on the death attitudes and death anxiety in elderly intensive care patients: a cross-sectional study

Background: Negative death attitudes and death fear were reported at a high level among intensive care patients. Research indicates that nurses should know the factors affecting the death attitudes and death anxiety in intensive care patients to reduce these high levels of anxiety and negative attitudes. Religions have a strong relationship with death.Aim: This cross-sectional study was conducted to determine the effect of religious attitudes on death attitudes and death anxiety in elderly intensive care patients.Methods: The data of the study were collected between January 2019 and January 2020 in the intensive care unit of a university hospital in a province located in the east of Turkey. A total of 185 elderly patients participated in the study. Patient Identification Form, Ok-Religious Attitude Scale (ORAS), the Death Anxiety Scale (DAS), and Death Attitudes Profile-Revised (DAP) were used for data collection. IBM SPSS version 25.0 was used for data analysis.Results: Most of the patients (88.6%) were at high level of self-reported religious attitudes. The mean DAS score of the patients was 9.02 ± 1.64, DAP was 120.40 ± 23.70, and ORAS was 31.25 ± 2.90. According to regression analysis, the increase in ORAS scores decreased the DAS score and increased the DAP score (p <0.05).Conclusion: There was a negative relationship between religious attitudes and death anxiety and a positive relationship between religious attitudes and attitudes towards death in elderly patients in intensive care units. Nurses should evaluate the patients’ religious attitudes while they plan interventions to reduce patients’ death anxiety or to develop positive attitudes toward death in these patients.

Values in nursing and the virtues of the profession: a systematic critical review

Introduction: Values are the cornerstone of routine nursing practice. Yet, there is lack of clarity and controversies over the content of the term and its application in contemporary nursing practice.Aim: The main aim of this discussion paper to explore the concept of ‘values’ in nursing, provide insights into their application with specific relevance to nursing and contemplate on its consequences on contemporary nursing practice.Methodology: For this paper’s needs a critical literature search was undertaken within the past two decades whereby key terms and corresponding contexts were critically appraised with regards to the concepts involved. Search terms used included: nursing, values, deontology, caring, in both Pubmed and Greek databases. The Cohen's Kappa coefficient was used in order to assess inter-rater reliability.Results & Discussion: After close perusal, the search yielded 55 papers with a distinct content on values in contemporary nursing. These were categorized in 5 distinct subthemes i.e. Ethical and individual values, Professional values and virtues, The development of values, Integrity and Dignity which were subsequently addressed and discussed further. Cohen's Kappa was 0.85 (95% CI:0.776-0.922) reflecting a strong level of agreement among the two authors.Discussion: Professional values can be seen as tools that encourage nurses to become ethically sensitive professionals. Various studies on professional values in different countries have shown that the difference in the adoption and weight given to professional values is mainly due to the priorities given, rather than their nature per se. Ethical values significantly influence the scope of nursing practice, the way nurses think and act and consequently the care they provide with integrity and dignity being at the core of their practice delivery.Conclusions: Values in nursing science should be developed primarily by direct learning in basic education through raising awareness among nurses regarding ethics and the value of nursing. Integrity and respect for dignity are referred to as two of the most basic values which may affect both nursing practice and care providers. The way nurses behave is a reflection of their knowledge, experience, ability, personality and judgment. This reflects the professionalism of nurses based on agreed common values.

Early mobilization is associated with decreased mechanical ventilation and ICU length of stay following cardiac surgery

Background: Early mobilization of the Intensive Care Unit (ICU) patients improves muscle strength and functional capacity. It has been demonstrated that prevents Intensive Care Unit Acquired Weakness (ICUAW) and accelerates ICU discharge. However, data on mobilization early after cardiac surgery are inadequate. This study aimed to record early mobilization and investigates the association with ICU findings in cardiac surgery patients.Material and Methods: In this observational study, 165 patients after cardiac surgery were enrolled. Of these, 159 were assessed for early mobilization and mobilization status during ICU stay. Mobilization practices were recorded from 1st post ICU admission and every 48 h until 7th day. The duration of mechanical ventilation (MV) support, ICU length of stay and clinical outcome were recorded from medical records registration. Results: Early mobilization consisted of active and passive limb mobilization, sitting in bed and transferring from bed to chair. The proportion of patients mobilized, was 18% (n = 29/159) on day 1, 53% (n = 46/87) on day 3, 54% (n = 22/41) on day 5 and 62% (n = 15/24) on day 7. ICU length of stay was reduced for mobilized patients (n = 29) on day 1 compared to non-mobilized ones (24 ± 10 vs 47 ± 73 h respectively, P = 0.001). The duration of MV was shorter in mobilized patients on day 3 (n =46) compared to bedridden, (18 ± 9 vs 23 ± 30 h respectively, P = 0.01).Conclusions: Early mobilization after cardiac surgery was found to be low with a significant trend to increase over ICU stay. It is also associated with a reduced duration of MV and ICU length of stay.

Psychosomatic health and sympathetic nervous adaptation of health professionals and the general population during the second covid-19 wave in Greece. between-group comparisons and regression analysis

Background: Based on previous COVID-19 global literature, the second COVID-19 outbreak in Greece probably created a stressful environment for health professionals and the general population. It is likely that psychosomatic and sympathetic nervous symptoms increased in both groups.Aim: The study tests whether health professionals would present significantly higher levels of psychosomatic and sympathetic nervous symptoms, and whether several biopsychosocial criteria would predict psychosomatic symptoms overall.Material & Methods: 192 participants were recruited though the snowball strategy after the first domestic COVID-19 lockdown in Greece. Participants provided socio-demographic details, while they answered measurements regarding nervous adaptation (DASS-21), psychosomatics (PSSQ-29), resilience (NMRQ), self-efficacy (GSE) and personality (IPIP-50). The researchers performed independent t-tests, one-way ANOVAs, Pearson’s r correlation analysis and a multiple linear regression.Results: Health professionals experienced significantly less psychosomatic and sympathetic nervous symptoms compared to the general population, while none of the socio-demographic variables show between-groups differences. 10 out of 15 biopsychosocial variables were found significantly correlated with psychosomatic symptoms. The predictive model (Adjusted R2= .586) shows ‘stress’ (β= .242, p= .006), ‘anxiety’ (β= .494, p< .001) and ‘emotional stability’ (β= -.160, p= .004) to be significant predictors, excluding ‘gender’, ‘being a health professional’, ‘resilience’, ‘self-efficacy’ and ‘extraversion’.Conclusions: The findings contradict to previous studies regarding psychosomatic and sympathetic nervous symptoms in the COVID-19 era. Additionally, the prediction model is not consistent to the theories regarding resilience and self-efficacy. The present study provides much debate in the relevant fields of research.

Administration of ascorbic acid in the treatment of septic shock

Introduction: Septic shock is a common condition encountered in the intensive care unit. Sepsis is the leading cause of death with mortality ranging from 35-50%. Several factors are involved in the increasing incidence of sepsis including age, immunosuppression and antibiotic resistance. Gram+ or Gram- infections are considered leading causes of sepsis. Septic shock prognosis is significantly affected by early treatment. The hospitalization of the patient in the intensive care unit is particularly important as it is essential to support vital functions due to the complications of the shock.Aim: To investigate the action of ascorbic acid in the treatment of septic shock and the benefits of its administration. Method-Material: Randomized trials were searched in CENTRAL, EMBASE and PubMed databases. The total number of studies included was 6. The Cochrane Risk of Bias Tool Review Manager Revman 5.3 was used to control the studies. Τhe criteria for the inclusion of patients were: age more specifically over 18 years old, patients accepted to intensive care unit with septic shock, patients with septic shock who received ascorbic acid randomized studies and cohort studies and articles in English with a time limit from 2008 to the first semester of 2020.Results: The results of the studies showed that patients with septicemia and septic shock have shown beneficial effects of ascorbic acid alone or in combination with corticosteroids and thiamine in the prevention of progressive organ dysfunction and in the reduction in mortality and severity of severe sepsis. Also, there was a reduced inflammatory response observed in septic shock and attenuated levels of circulatory injury biomarker.Conclusions: Ascorbic acid has beneficial properties in septic shock and various studies have highlighted the importance of the combination of ascorbic acid and other vitamins and trace elements.

Leadership styles and job satisfaction of nursing staff in a peripheral general hospital in Greece: a survey

Background: Over time, the working conditions in hospitals are becoming more and more demanding and the nursing staff is every day called to cope with them. In this context, the effective administration by the leading executives of the Nursing Directorate plays an important role in both guiding and motivating the staff to achieve the goals as well as to improve job satisfaction in general. The aim of the present study was to explore the prevailing leadership style applied in a General Hospital, from the perspective of the nursing staff, as well as the level of job satisfaction of the nurses who serve in the organisation.Method and Material: In the period January 2020-February 2020, a survey was conducted at the General Hospital of Corfu using a questionnaire (Multifactor Leadership Questionnaire and Job Satisfaction Survey) in a random sample of 180 nurses from which 138 fully completed the questionnaire (76% response rate). Data analysis was performed by using the statistical package SPSS ver. 21.0.Results: The average value of the Transformational and Transactional leadership styles is 3.4 while that of the Passive leadership is significantly lower (2.3 average value). Moreover, the nursing staff expressed a high level of satisfaction with the supervision and the chief nurse, with its relations with the colleagues and with the nature of the work, while its dissatisfaction was mainly expressed when it comes to "Working Conditions", "Promotion", "Privileges-Benefits" and "Salary". The Transformational and Transactional leadership styles were positively related to satisfaction with the promotion (r = 0.22), with the supervision by the chief nurse (r = 0.63 and r = 0, 40 respectively) and with the nature of the work (r = 0.25 and r = 0.18 respectively). Transformational style was also positively related to the potential rewards (r = 0.18) and the relationship with colleagues (r = 0.22). Finally, the Passive leadership style was positively related to the satisfaction with the salary (r = 0.32), with the promotion (r = 0.27) and with the privileges-benefits (r = 0.41).Conclusions: The nursing staff considered that the current leadership style involves a combination of elements of the Transformational and Transactional leadership styles. As for the job satisfaction of the staff, it ranged at moderate levels. There is an urgent need for further research related to job satisfaction which can be boosted by the implementation of incentive policies and training programmes for the nurse administrators in the new forms of administration by the Nursing Directorate.

RNA-modifying enzymes as novel targets for anti-cancer therapies

No abstract available