Patients’ reported experiences and Health Related Quality of Life after discharge from Intensive Care Units

Introduction: Providing high quality care in todays’ Intensive Care Units is a challenge because of the constant increase in demand, the high functional cost and the restricted availability of resources. Evaluating both patients’ experiences and outcomes from the care provided is necessary for ensuring high quality in health care. Aim: The investigation of patient reported experiences in Intensive Care Units and the evaluation of their health related quality of life six to twelve months after discharge. Methods: It is a non-interventional cross-sectional study with retrospective data collection. The participants were 108 patients, discharged from four Intensive Care Units of three military hospitals in Athens. Telephone interviews were conducted using “Patient Empowerment Questionnaire” and “Quality of life Questionnaire” to evaluate patients’ experiences and health related quality of life respectively. Statistical analysis was conducted using the statistical package SPSS v.25.0. Results: The majority of the study population reported positive experiences with the critical care staff and normal quality of life after discharge. However, 47% reported that they could not always sleep at night and 32% did not always receive adequate pain relief. In regards to patients’ quality of life, “normal daily activities” were affected the most. Specifically, half of the patients reported inability to carry out activities requiring high level of physical effort and 1/5 expressed difficulties in walking and in mobility. Additionally, 43% reported difficulties in the job or their daily activities, have changed or completely abandoned them. Conclusions: The patients’ positive experiences and good health related quality of life after discharge gave the impression that quality of intensive care in Greek military hospitals is high. Interventions intending to achieve more adequate pain relief, better sleep at night, and prevention of critical illness’ negative impact on day-to-day activities would ensure more positive results.

The nurse’s role in the care of primary cutaneous lymphomas

Primary Cutaneous Lymphomas are a group of lymphomas that show complexity in diagnosis, clinical presentation and treatment. The aim of this review paper is to present the nurse’s role in the care of Primary Cutaneous Lymphomas, both as member of a multidisciplinary team, as well as an independent healthcare professional in the diagnosis, treatment, support of patients’ and in the management of the adverse complications. A review of the publications in Greek medical journals, nursing books, electronic databases of scientific societies and in pubmed and google scholar database, for the period from 2004 to 2018. From the papers found 53 were used. The nursing role is crucial, both in the initial diagnosis of the disease, as well as in the progress and treatment. The nurse’s role as a member of the multiprofessional team is emphafized, especially as nurse navigator. At the same time, the potential problems during treatment and the nursing interventions are presented. In conclusion, it is stated that a nurse can help solve many problems related to the understanding of symptoms and the course of the disease, but also be a supportive person for the patient and his/her caregiver. At the same time, the nurse is presented as a useful guide with the complexity of healthcare system.

Parents’ perceptions and views regarding vaccination: A pilot survey of parents-healthcare professionals and parents non-healthcare professionals

Introduction: Children’s immunization has been one of the most important public health measures in the 20th century. However, a number of parents consider the vaccines unsafe and they are skeptical about their use. Aim: The aim of the present study was to investigate parents’ perceptions and views on children’s vaccination. Methods: Twenty parents (2 male and 18 female) were included in the present pilot study which was based on semi-structured interviews. Ten parents (females) were healthcare professionals (nurses and health visitors) and ten (2 males and 8 females) were not healthcare professionals. Interview data were analyzed using the thematic analysis technique. Results: Results show that parents were concerned about vaccination safety, side effects of the vaccines, lifelong coverage of children, immune system overload, commercial purposes of vaccines and validity of information about vaccination. Comparisons between parents who were healthcare professionals and parents who had a different profession showed that the latter were more hesitant and had more misconceptions about vaccines. Conclusions: The decision to vaccinate children or not is a huge responsibility towards every child, but also towards society. Healthcare professionals are able to provide objective information to parents to take informed decisions.

Transferability of international knowledge and experience for the management of low-risk Emergencies, in on-call Primary Healthcare Centers (PHC) in Greece

Overcrowding in hospital Emergency Departments (ED) is a major problem of public healthcare systems both in Greece and internationally, leading to delay in provision of adequate and high-quality healthcare. During the COVID-19 pandemic a significant reduction in ED overcrowding was observed, as many relative urgent cases, usually at lower risk reduced their visits to the ED, in fear of a possible infection. Several healthcare systems abroad have tried to tackle with the problem, establishing or redesigning Primary Health Care (PHC) centers, both rural and urban, which would manage both low-risk emergencies of the general population, but also the routine care of patients with chronic diseases. The purpose of this article was twofold and included on the one hand the presentation of the characteristics such PHC centers treating low risk emergencies and on the other hand the preparation of a transferability plan for these centers in the PHC of the Greek healthcare system. For the study of the transferability we used a new methodology, which includes and assesses a number of criteria that should be considered to facilitate of effective health interventions from a primary context to a specific target context. The researchers identified obstacles, but also opportunities for the transferability of PHC centers that should be established to manage low-risk emergencies in the Greek healthcare system. Further research is needed to evaluate the effectiveness of such centers to improve overcrowding in hospital ED, patient satisfaction, and to ensure an effective, as well as cost-effective emergency management, for instance through a small-scale pilot program in urban centers in Greece.

The Personal Electronic Health Folder and the usefulness of electronic systems to improve health services

Continuity in patient healthcare shows significant gaps and variations, due to reduced communication between healthcare services. The information transfer to all stages of health structures is often inadequate with many variations, especially at the critical stage after discharge from the hospital, in which patients are usually more vulnerable. The major problem of the lack of interconnection between healthcare services occurs mainly among the elderly, the chronically ill and those who take a lot medication. The main effects of this problem are medication side effects, treatment overlap, poor quality of healthcare and financial costs. Enhancing communication, through the electronic interface and the use of the Personal Electronic Health Folder (P.E.H.F.), which will include the individual details of each patient and information about his clinical status, is aiming at the use of best practices for patient recovery by healthcare providers. The thorough literature review, the strategic analysis PESTEL and the control process, pointed out the need to use the P.E.H.F., to achieve substantial improvements in the quality of patient healthcare. With the practical use of P.E.H.F., the healthcare of all patients will be unquestionably, safe, effective, patient-centered, immediate and fair.

Investigating healthcare professionals’ views regarding the quality of provided healthcare services

Introduction: Quality in healthcare services means doing the right things, making continuous improvements in order to get the best results, being interested in satisfying both healthcare providers and recipients. Aim: To investigate the views of health professionals on the quality of the provided health and social care services. Methodology: A cross-sectional study was carried out on healthcare professionals working in public and private healthcare organizations in December 2017 and January 2018. In total, the study involved 155 healthcare professionals who answered 25 questions on the dimensions of quality and the way they perceive the quality of the provided healthcare to its recipients. Data were collected using a structured anonymous self-report questionnaire. Statistical analysis was performed with the SPSS 24.0 statistical package. Results: The majority of the sample was female (75%) with higher education (44.5%) holding a master’s or doctorate degree (45.2%). Participants (86%) consider integral to providing quality healthcare services a combination of appropriate patient care that was linked to a framework of continuous evaluation, control and improvement even after treatment ended. Furthermore, as healthcare quality characteristics are considered the healthcare professional’s satisfaction of their relationship with the user of the services regarding the amount of information provided to the later and the provision of personalized services (>80%). In addition, empathy of health professionals (82%), compliance with the standards and quality of procedures (68%) are qualitative parameters. Conclusions: The way healthcare professionals perceive the quality of customer/user interaction with healthcare services, empathy, personalized care and long-term utility are among the most important quality parameters of health services.

The contribution of healthcare services to quality at the end of a patient’s life cycle

Introduction: Over the last decade it has been highlighted that palliative care is important for all life- threatening diseases. Purpose: The purpose of this study was to explore the perception of end-of-life patients and their carers about existing health care structures and healthcare professionals. Methods: This study adopted a mixed research methodology using both qualitative and quantitative methods. The population of this study was end-of-life patients and their caregivers. For data collection and interviews, a questionnaire was used which was created within the research part of the project “Development of a model of quality model in health education, self-care and rehabilitation of patients with neoplasms”. Results: The study sample consisted of 46 patients. Relatively limited activity, but ambulatory, were the 32.6% of patients. About half of the patients (56.5%) had access to home care services. Patients argued that healthcare professionals can guide them to better control their pain (93.5%) and symptoms (89.1%). Most carers were women (69.6%). Emotional disturbances were recorded in 23.9% and 53.3% rated good health. To improve care, most caregivers reported psychological support, more frequent contact with the family environment, and knowledge of the existence of specific structures/services. Conclusions: It is important to develop healthcare policies, which will include the development of palliative care, especially for family caregivers of end-of-life cancer patients.

The effect of religiosity of patients with Coronary Artery Disease on in-hospital anxiety and depression

Introduction: Religious faith and spirituality often seem to affect physical and psychological functioning of patients with chronic diseases. Aim: To investigate the relationship between religiosity/spirituality of coronary patients with anxiety and depression which may be experienced during their hospitalization. Methods: A cross-sectional study was conducted involving 172 patients (23 female and 149 male) with coronary artery disease, who were hospitalized in a general hospital of Attica region with an acute coronary syndrome diagnosis. HADS scale was used for the investigation of hospital anxiety and depression and the Belief and Values Scale was used to evaluate the patients’ religious faith and spirituality. Results: Moderate levels of religiosity/spirituality and no to moderate levels of anxiety and depression were found in coronary patients. No statistically significant correlations were found between the HADS subscales and the Beliefs and Values Scale (p> 0.001), although individuals who have experienced strong spiritual experiences, experienced less anxiety and depression in hospital. There were found statistically significant correlations (p <0.001) with gender, religious beliefs, patients’ age with Belief and Values Scale. There were also statistically significant correlations (p<0.001) of HADS subscales with family status, age, smoking habits, stress and medication. Conclusion: Highly religious coronary patients are less likely to experience anxiety and depression during hospitalization, though confounders seem to interfere and make it difficult to interpret this relationship. Further research is required in order to explore the impact of religiosity on psychological distress of hospitalized coronary patients.

Advocating for vulnerable groups’ health promotion: development of institutional data

Poor health cannot be attributed only to microbiological and genetical factors. It is a much more complex situation, involving both the conditions in which people live, such as access to health care, schools and education, as well as working conditions, recreation, homes, communities and cities, as well as cultural characteristics such as social status, gender, age, nationality, values and distinctions. All of these factors affect a person’s chances of leading a flourishing and healthy life. Chances of good health are not equally distributed within society causing health inequalities. Thus, organized societies and their institutions are called upon to set health protection frameworks as a social right for vulnerable population groups. The purpose of the article is to make a comprehensive reference to the term vulnerability, as well as the regulatory framework that is formed around it in the modern society. The social challenge is a framework based on inclusive human rights, justice and democracy.