George Fildissis

Hyperventilation In Asthma: A Validation Study Of The Nijmegen Questionnaire-Nq

Abstract Introduction: The Nijmegen questionnaire (NQ) has previously been used for screening the hyperventilation syndrome (HVS) in asthmatics. However, no validity study has been reported so far. Objective: To examine the validity and reliability of the NQ in asthma patients and identify the prevalence of HVS. Methods: The NQ (n = 162) was examined for translation, construct, cross-sectional and discriminant validity as well as for internal consistency and test–retest reliability. Results: Principal component analysis and exploratory factor analysis revealed a single factor solution with 11 items and 58.6% of explained variability. These 11 NQ items showed high internal consistency (Cronbachs alpha = 0.92) and test–retest reliability (IR = 0.98). Higher NQ scores were found in the following subgroups: women versus men (p < 0.01); participants with moderate versus mild asthma (p < 0.001) or uncontrolled versus controlled asthma (p < 0.001), and participants with breath-hold time (BHT) < 30 versus ≥ 30 s (p < 0.01) or end-tidal CO2 (ETCO2) ≤35 versus >35 mmHg (p < 0.001). A cut-off score of >17 discriminated the participants with regard to the presence of HVS. The NQ showed 92.73% sensitivity and 91.59% specificity. The total NQ score was found significantly correlated with ETCO2 (r = −0.68), RR (r = 0.66) and BHT (r = −0.65). The prevalence of HVS was found 34%. Conclusion: The NQ is a valid and reliable questionnaire for screening HVS in patients with stable mild-to-moderate asthma.

Prevalence of Secondary Traumatic Stress Among Psychiatric Nurses in Greece

The aim of this study was to investigate the prevalence of secondary traumatic stress/compassion fatigue (STS/CF), burnout (BO) and compassion satisfaction (CS) in psychiatric nurses, and their risk factors. The Professional Quality of Life Scale (ProQOL R-IV) and a demographic and work related characteristics questionnaire were distributed to 174 psychiatric nurses in 12 public hospitals in Greece. The majority of participants were at the high risk category for STS/CF (44.8%) and BO (49.4%), while only 8.1% of nurses expressed high potential for CS. Awareness of the factors associated with STS may help nurses to prevent or offset the development of this condition.

Oxygenation equilibration time after alteration of inspired oxygen in critically ill patients

To determine the time required for arterial oxygen partial pressure (Pao(2)) equilibration after a change in fractional inspired oxygen (Fio(2)) in intensive care unit (ICU) patients, a prospective study in a 7-bed university ICU was performed. Forty adult patients were examined using sequential arterial blood gas measurements after a .3 alteration in Fio(2). The Pao(2) value measured at 30 minutes after a step change in Fio(2) in both periods was accepted as representative of the equilibrium value for Pao(2). The mean equilibration time was 8.26+/-5.6 minutes and 4.5+/-2.65 minutes for increases and decreases in Pao(2), respectively (P=.003). The constant k values were .44 +/- .31 minutes and .72 +/- .7 minutes for increases and decreases in Pao(2), respectively. There was no significant difference between the increase and the decrease of 90% oxygenation times in the 2 groups (P=.150 and P=.446, respectively). The study confirms that a period of less than 10 minutes is adequate for 90% of the equilibration of Pao(2) to occur after an Fio(2) change in ICU patients.

Antibiotic and O2 omissions and errors in hospitalized patients.

The aim was to investigate medication errors regarding antibiotic and oxygen therapy in 2 different hospital types, respiratory versus general, in Greece. Oxygen and antibiotic errors were 27.4% and 16.9%, respectively. Errors by physicians and nurses were nearly the same type and rates. Oxygen errors were significantly higher in the General Hospital. The study confirmed that medication processes should be reevaluated to prevent medication errors, and educational programs and protocols should be used.

Circadian disruption of ICU patients: A review of pathways, expression, and interventions

&NA; Intensive care unit patients typically exhibit pathologic wakefulness, poor quality of daytime sleep, nocturnal sleep fragmentation, and sleep patterns that feature the absence of slow wave sleep and rapid eye movement. This article offers a review of the existing literature examining circadian desynchronization in critically ill patients, highlighting contributing factors identified by scholars, and circadian abnormalities observed in these patients. It discusses potential implications for clinical practice and suggests avenues of future research. Elucidating the role of circadian rhythms in the management of critical illness can guide future chronotherapeutic approaches and optimize patient outcomes. HighlightsLight, noise, medication, and illness contribute to circadian disruption in the ICU.Circadian dysrhythmias affect sleep, melatonin levels, immunity, and neurocognition.Lighting, noise reduction, and melatoninergic interventions aim at chronoenhancement.

First Peripherally Inserted Central Catheter Under Ultrasound Guidance in a Greek Intensive Care Unit: A New Role for Greek Perianesthesia Nurses

We present a case of a 67-year-old Caucasian female who was admitted to the pulmonary clinic of a general hospital in Athens with fever and respiratory symptoms. A lung biopsy was ordered because a clinical diagnosis of interstitial lung disease was suspected. The patient was then hospitalized in the intensive care unit. Because of the fact that peripheral catheterization was impossible and the prospect of further long-term hospitalization, the patient was referred to a vascular access nursing team composed of perianesthesia nurses to advance a peripherally inserted central catheter and support the line during treatment. The peripherally inserted central catheter line was advanced with no complications, and the position of the catheter was checked using the electrocardiography method.

The effect of a nurse-led patient education program for oral anticoagulant therapy on the incidence of thromboembolic and hemorrhagic episodes after surgical heart valve replacement

Introduction: Although, the effects of patient education on the effective anticoagulant management, among patients undergoing heart valve replacement with mechanical prosthesis, have been reported, the evidence of this association remains inconclusive. Aim: To investigate the effect of a nurse-led patient education program for oral anticoagulant therapy on the incidence of thromboembolic and hemorrhagic episodes after surgical heart valve replacement. Methods: A quasi-experimental study was conducted. Patients were allocated to a) a control group (n=100), including those who received the usual education on oral anticoagulants, and b) an intervention group (n=100), with those who attended a nurse-led education program, postoperatively, including verbal courses and written material through an education booklet. We investigated the incidence of hemorrhagic and thromboembolic episodes 3 months after patients’ hospital discharge. Patients’ socio-demographic and clinical characteristics were obtained using a structured short questionnaire and through the medical and nursing patient records review. Patients’ follow up data were collected via phone interviews. Results: The baseline characteristics were similar for both groups. Patients who received nurse-led education on oral anticoagulant therapy had a significantly lower 3-month incidence of hemorrhagic episodes compared with controls (1% vs 14%, p