Sofia Zyga

Malnutrition-inflammation-atherosclerosis syndrome in patients with end-stage renal disease.

Malnutrition-inflammation-atherosclerosis (MIA) syndrome is where three dominant clinical entities which occur in patients with end-stage renal disease--malnutrition, inflammation and atherosclerosis--coexist and interact with each other. This literature review aims to present the factors which are responsible for the existence of MIA syndrome in patients with end-stage chronic kidney disease (CKD) on renal replacement therapy. Studies have shown that the main role in the pathogenesis of the MIA syndrome is played by inflammatory cytokines. The main inflammatory cytokines are tumour necrosis factor-a, interleukin-1 and interleukin-6. The following work examines these cytokines, indicating their main characteristics and the basic mode of action in patients with end-stage CKD as well as the further development of the syndrome. The existence of this syndrome is responsible for the high rates of morbidity and mortality in this group of patients who reach a level comparable with persons suffering from metastatic cancer.SUMMARY Malnutrition-inflammation-atherosclerosis (MIA) syndrome is where three dominant clinical entities which occur in patients with end-stage renal disease—malnutrition, inflammation and atherosclerosis—coexist and interact with each other. This literature review aims to present the factors which are responsible for the existence of MIA syndrome in patients with end-stage chronic kidney disease (CKD) on renal replacement therapy. Studies have shown that the main role in the pathogenesis of the MIA syndrome is played by inflammatory cytokines. The main inflammatory cytokines are tumour necrosis factor-a, interleukin-1 and interleukin-6. The following work examines these cytokines, indicating their main characteristics and the basic mode of action in patients with end-stage CKD as well as the further development of the syndrome. The existence of this syndrome is responsible for the high rates of morbidity and mortality in this group of patients who reach a level comparable with persons suffering from metastatic cancer.

GREEK RENAL NURSES’ ATTITUDES TOWARDS DEATH

SUMMARY This study aims to assess how Greek renal nurses feel about death and examine any relationships between their attitudes and demographic factors. Design: Descriptive quantitative study. The sample comprised of 49 nurses. Methodology: Voluntary and anonymous completion of the Death Attitude Profile–Revised and a demographic questionnaire. Results: 44 respondents were female and 5 were male with a mean age of 25.80 years. The mean nursing experience was 10.9 years. Nursing experience and age were the variables most likely to predict nurses’ attitudes towards death. Nurses with specific education on palliative care had less difficulty talking about death and dying and did not have a fear of death. The Hospital-based teams (known as palliative care teams, supportive care teams or symptom assessment teams) had statistically significant different relationships with fear of death and neutral acceptance scores. Conclusions: It is recommended to include education on death and care of the dying in the nursing degree course in order for nurses who are giving terminal phase patient care to be better able deal with issues that death evolves.

Assessment of Fatigue in End Stage Renal Disease Patients Undergoing Hemodialysis: Prevalence and Associated Factors.

Background: Fatigue is a common symptom referred by many patients undergoing hemodialysis. Fatigue is associated with poor health-related quality of life (HRQoL) and is an important predictor for survival of hemodialysis patients. Aim: To assess the levels of fatigue and demographic factors affecting it among patients with End Stage Renal Disease undergoing hemodialysis. Methods: This quantitative study was carried out in two Dialysis Units of Hospitals in Athens Region. Between January 2015 and June 2015, 129 hemodialysis patients completed the Greek Version of the Fatigue Assessment Scale (FAS). Demographic data of patients was recorded. For the statistical analysis IBM SPSS Statistics version 20 was used. Results: The mean FAS score was 24.99. 49 patients (38.0%) were non fatigued, 61 patients (47.3%) were fatigued, and 19 patients (13.7%) were extremely fatigued. Higher levels of fatigue were reported among hemodialysis patients residing in urban areas, in those with low educational level and unemployed. Conclusion: The findings of this study can be used in the assessment of fatigue and early identification of high-risk patients (especially of the unemployed, those who occupy with domestic works, those with low educational level and of urban citizens). Use of this knowledge by hemodialysis nurses may lead to a better understanding of the factors of fatigue in ESRD, which in turn may lead to a more effective treatment.

ACUTE RENAL FAILURE: METHODS OF TREATMENT IN THE INTENSIVE CARE UNIT

Patients who are treated in an intensive care unit (ICU) show the need of recovery of their renal function. The reason is that, in this particular cohort of patients, we have to maintain the necessary balance between body fluids, electrolytes, and acid-base, try to suspend further renal damage and purify the patients blood to better accept the given therapy. In this paper, we try to demonstrate all the methods that can be used depending on the patients condition, the therapists preferences and the hospitals capabilities.

Assessing Factors That Affect Coping Strategies Among Nursing Personnel

Introduction: The nursing profession is characterized as one of the most stressful professions. A significant number of international surveys prove that nurses experience anxiety that often is accompanied by intense symptoms that negatively affect their work performance and their psychological mood. Aim: To evaluate the ways of coping in stress adopted by the nursing staff and their relationship with sociodemographic and job characteristics. Methodology: A cross-sectional, quantitative study was conducted in seven hospitals of Peloponnese Region, Greece. The study took place between April 2013-June 2013 and 395 nurses completed the Ways of Coping questionnaire. Socio-demographic, educational and job characteristics of nurses were, also, recorded. Results: Strategies focused on the problem were adopted to a greater extent more by postgraduate nurses, head nurses, and nurses with greater working experience. Intensive Care Unit nurses mainly adopted the strategy of denial while strategies focused on emotions were mostly adopted by females. Age and marital status did not affect significantly the choice of coping strategies. Conclusions: According to our findings several demographic factors that affect coping in stressful situations can be investigated and such an investigation could offer useful research findings for consideration.

INTEGRATING CHRONIC KIDNEY DISEASE PATIENT’S SPIRITUALITY IN THEIR CARE: HEALTH BENEFITS AND RESEARCH PERSPECTIVES

Introduction: Patients who suffer from chronic renal disease face problems in many aspects of their life; problems such as physical and social as well as mental such as stress, anxiety, depression. In addition, they exhibit an amount of spiritual needs, which relate and influence the psychological adaptation to the illness. Aim: The aim of this article is to examine evidence from the international literature regarding the possible relation of spirituality and health outcomes, mostly in the complex codex of a chronic and life treathing disease such as CKD. Results: Spirituality is a very debatable issue and the term has no single and widely agreed definition. The key components of spirituality were ‘meaning’, ‘hope’, ‘relatedness/connectedness’, and ‘beliefs/beliefs systems’. Spirituality has been characterized as the quest for meaning in life, mainly through experiences and expressions of mind, in a unique and dynamic process different for each individual. For many individuals spirituality and religion are important aspects of their existence, constituting a source support contribute to wellbeing and coping with life’s daily difficulties. Conclusion: Considering, assessing and addressing chronic kidney disease patient’s spirituality and spiritual needs is necessary and it can have a positive outcome in health related quality of life, mental health and life expectancy.

Investigation of Aggravating Psychosocial Factors on Health and Predictability of Smoking and Alcohol Use in Post Adolescent Students.

Purpose of this study is to explore those factors which affect the health of students in postadolescent age, focusing on smoking and alcohol use, especially in regard to ways of predicting adoption of this behavior and its frequency to detect future users of tobacco and alcohol use but also high-risk groups, i.e. those people who are led to abuses. On the basis of the research part is the Theory of Planned Behaviour, the axes of which are to be investigated. Specifically, the factors evaluated, except for population parameters, behavioral attitudes, i.e. attitudes towards the behavior of tobacco use and alcohol regulations subjective perceptions and perceptions of control, perceived behavioral control and self-efficacy. Intention is explored to continue or start using tobacco and alcohol in the future and evaluate the behavior. The sample consisted of 138 students of postadolescent age, 18-25 years of both sexes, all of the University of Peloponnese and the Technological Educational Institute of Kalamata, Department of Sparta, Greece. The results of a series of statistical analysis, via SPSS 21.0 statistical program revealed the predictive power of perceived behavioral control and subjective norms to the intention of interpreting 64% of the variance of the latter, of the attitudes toward alcohol in relation to intention that interpret 69% of the variance, of the normative beliefs toward smoking with 69% range of interpretation to the dependent variable, of the perceived behavioral control of smoking with 72% and of the attitudes toward smoking with 77% of interpretation. The results demonstrate the significance and application in universities and technological educational institutes appropriate primary preventive interventions for students nonusers of tobacco and alcohol and appropriate programs of secondary and tertiary prevention in heavy users of tobacco and alcohol use and high-risk individual.

Psychological Distress and Resilience in Women Diagnosed with Breast Cancer in Greece

Background: Breast cancer is the most frequent type of cancer among women worldwide, especially in developed countries. To be diagnosed with breast cancer and undergo cancer treatment can be a very stressful event. It is estimated that one-third of cancer patients are dealing with psychological problems, such as anxiety and depression and resilience is a way of coping and overcome life stressors such cancer diagnosis. Purpose: The purpose of this study was to examine resilience in women diagnosed with breast cancer and its association with depression and anxiety. Methods: A cross-sectional study was conducted, 144 women diagnosed with breast cancer answered a questionnaire consisted of four parts: Sociodemographic data, the Patient Health Questionnaire Two-Item Depression Scale, the Generalized Anxiety Disorder Questionnaire and the Connor-Davidson Resilience Scale 25. Results: The majority of the sample belongs to age group 51- 60 years, with the mean age of 53.5 SD±11.7 years. The 59.5% of patients were residents of an urban area, 56.8% were married and 36.5% has 2 children. The mean value of CD-RISC25 was 65.3 SD±17.9, meaning a moderate resilience of cancer patients. The 54.5% of respondents indicated a depressed mood. The anxiety severity measured with the GAD-2, where the mean was 2.1 and 46.8% of patients suffered from high anxiety. Conclusions: According to our results, resilience can negative influence depressive symptomatology. Moreover, lower levels of depression can lead to fewer anxiety symptoms.

Workplace Bullying Among the Nursing Staff of Greek Public Hospitals.

In this quantitative, cross-sectional study, the authors identified the impact of workplace bullying on nursing staff employed at select Greek public hospitals. They conducted the study using the Negative Acts Questionnaire with a convenience sample of 841 participants employed by five Greek hospitals in the 1st Regional Health Authority of Attica. One third of the respondents reported having been psychologically harassed at work in the past 6 months. According to the results, the impact workplace bullying has on nursing staff varies depending on the existence of a supportive familial or friend environment and if nurses parent children. These findings demonstrate the value of family and friend support when coping with workplace bullying.

The Translation, Validation and Cultural Adaptation of Functional Assessment of Chronic Illness Therapy - Spiritual Well-being 12 (facit-sp12) Scale in Greek Language -

Background: According to World Health Organization (WHO), spirituality is an important domain of quality of life especially in terminal, life threatens chronic diseases. For many people spirituality and religion are not just very important dimensions of their existence, but also a source of support that contributes to wellbeing and coping with everyday difficulties of life. Aim: Aim of the study was the translation of the Facit Spiritual Well Being Scale (Facit-Sp12) in Greek language and the validation of the scale for the Greek population. Material and Methods: The Facit-Sp12 questionnaire is an anonymous self-administered questionnaire that contains twelve, four point Likert scale, closed questions (0=Not at all, 1=A little bit, 2=Some-what, 3=Quite a bit, 4=Very Much). The questionnaire was translated into Greek language and then back translated in the English in order to be checked for any inconsistencies. The sample of the study was 183 chronic kidney disease patients, undergoing hemodialysis. Exploratory factor analysis, with principal components analysis with Varimax rotation was performed for checking the construct validity of the questionnaire. The test–retest reliability and the internal consistency were also examined. Statistical analysis performed by the use of SPSS 21.0. Statistical significance level was set at p=0.05 Results: The final Greek version of the questionnaire includes all of the twelve questions. The mean age of the participants was 61.81±13.9. Three factors were exported from the statistical analysis. The Cronbach-α coefficient was 0.77 for the total questionnaire and for each subscale was 0.70 for “meaning”, 0.73 for “peace” and 0.87 for “faith”. Between the three subscales “meaning” had the highest score (mean 12.49, SD=2.865). Conclusions: The Facit Spiritual Wellbeing Scale–Facit-Sp12, is a valuable and reliable questionnaire of three dimensions that can be used for assessing spirituality and spiritual wellbeing in Greek population.