Theofanis Katostaras

Factors associated with abnormal eating attitudes among Greek adolescents.

OBJECTIVE To estimate the prevalence of abnormal eating attitudes among Greek adolescents and identify possible risk factors associated with these attitudes. DESIGN Cross-sectional, school-based study. SETTING Six randomly selected schools in Patras, southern Greece. PARTICIPANTS The study population consisted of 540 Greek students aged 13-18 years, and the response rate was 97%. MAIN OUTCOME MEASURE The dependent variable was scores on the Eating Attitudes Test-26, with scores > or = 20 indicating abnormal eating attitudes. ANALYSIS Bivariate analysis included independent Student t test, chi-square test, and Fishers exact test. Multivariate logistic regression analysis was applied for the identification of the predictive factors, which were associated independently with abnormal eating attitudes. A 2-sided P value of less than .05 was considered statistically significant. RESULTS The prevalence of abnormal eating attitudes was 16.7%. Multivariate logistic regression analysis demonstrated that females, urban residents, and those with a body mass index outside normal range, a perception of being overweight, body dissatisfaction, and a family member on a diet were independently related to abnormal eating attitudes. CONCLUSIONS AND IMPLICATIONS The results indicate that a proportion of Greek adolescents report abnormal eating attitudes and suggest that multiple factors contribute to the development of these attitudes. These findings are useful for further research into this topic and would be valuable in designing preventive interventions.

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.

Factors That Influence Greeks' Decision to Register as Potential Bone Marrow Donors

Hemopoietic stem cells can be used from bone marrow or blood or umbilical cord blood of matched siblings or appropriately matched unrelated volunteers. Today, large bone marrow registries have been established to help identify volunteer unrelated bone marrow donors for patients lacking a family donor. Despite there being almost 10 million registered potential bone marrow donors (PBMD) worldwide, only 50% of white patients have a suitable bone marrow match. Growth in the number of PBMD increases the likelihood of finding a compatible donor for a patient. The attitudes and knowledge of 250 registered PBMD and 315 not registered PBMD toward bone marrow donation, tissues and organs donation, and blood donation were surveyed, using a questionnaire with 27 items. Multivariate logistic regression identified gender (females more often than males), regular blood donation, having a relative or a friend who has already been registered as PBMD, having a relative or a friend who needs bone marrow transplantation, family discussion about tissue and organ donation, knowledge about bone marrow transplantation, information about bone marrow transplantation, and trust in health professionals were independent predictive factors influencing peoples decision to register as PBMD. Knowledge of these factors is important to target recruitment efforts.

An empirical study of comparing DEA and SFA methods to measure hospital units’ efficiency

The paper aims to examine the data envelopment analysis (DEA) and stochastic frontier analysis (SFA) results in order to facilitate a common understanding about the adequacy of these methods, defining any differences in healthcare efficiency estimation. A two-stage bootstrap DEA method and the Translog formula of the SFA were performed. Multi-inputs and multi-outputs were used in both of the approaches assuming two scenarios either including environmental variables or not. Thirty-two Greek public hospital units constitute the sample. DEA and SFA were found to yield divergent efficiency estimates due to many factors such as the nature of the environmental variables, the measurement error and other random factors. Environmental variables being hospital status and geographical position were found significantly correlating with inefficiency. The analysis concludes that the choice of the appropriate mathematical form depends on the expertise of the researcher and the purpose of the evaluation.

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.

Assessing Health-Related Quality of Life in the Greek Home Health Care Setting Comparing Cancer Patients’ and Nurses’ Assessment

The study’s aim was to evaluate the agreement between patients’ and nurses’ ratings of patients’ health-related quality of life (HRQoL) and to identify factors that affect their level of agreement. A total of 150 home health care cancer patients from Greece and all nurses (N = 5) who worked in the home health care units completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (EORTC QLQ-C30). Intraclass correlation coefficients varied between .45 and .87, indicating a moderate to excellent agreement. Median absolute difference on QLQ-C30 scores ranged from 0.00 to 16.66 points on the 0 to 100 scale. Cohen’s d varied between −0.15 and 0.59. Nurses’ higher educational level was associated with greater agreement (p = .05). Nurses assessed lower the QoL of patients who were completely disabled than the patients themselves did (p = .005). Our findings suggest that Greek home health care nurses estimate patients’ QoL in a reliable and valid way.

SFA vs. DEA for measuring healthcare efficiency: A systematic review

Abstract: Frontier techniques have been used to measure healthcare provider efficiency in hundreds of published studies. Although these methods have the potential to be useful to decision makers, their utility is limited by both methodological questions concerning their application. The aim of this paper is to search articles applying combined data envelopment analysis (DEA) and stochastic frontier analysis (SFA) in order to facilitate a common understanding about the adequacy of these methods, defining any differences in healthcare efficiency estimation and the reasons that are behind this. A systematic review of 21 such studies published the last decade was conducted. Only studies written in English were considered. Results are summarized in a form of meta-analysis in order to synthesize results and draw out further implications. Overall, DEA and SFA were found to yield divergent efficiency estimates due to many factors such as statistical noise, how inputs and outputs were defined, as well as data availability. Researchers, besides the combination of models to measure efficiency, lately have introduced environmental variables in their analyses, aiming at better understanding the relationship of these factors to efficiency and thus achieving a better decision making process. In any case the analysis concludes that there is a need for careful attention by stakeholders since the nature of the data and its availability influence the measurement of efficiency and thus it is necessary to model the behavior which generates the data by choosing the appropriate mathematical form.

Living with breast cancer: Patients’ journey within the Greek National Health System

Abstract Background: Process mapping (a patient-centred method) and recording the medical, nursing and administrative staff’s views involved in the provision of care help us understand patients’ experience regarding the constraints, delays and bottlenecks of healthcare service processes and identify areas of improvement. Patients and Methods: Time information and data were collected through time and motion study with regard to the path patients with breast cancer follow in two public hospitals (sample of 86 patients) and a semi-structured questionnaire was administered to medical, nursing and administrative staff (sample of 14 employees). Results: The amount of time required in total for the prescription process was increased up to seve7 times compared to the beneficial amount of time, and the longest delays in patients’ waiting time were observed with regard to the process of chemotherapy (more than 2 hours and 40 minutes, in some cases). About 92.3% of the staff of the two hospitals prioritized the malfunctioning of theCcentralIinformationSsystem as the most important factor and more than 75% of the study participants mentioned that several administrative and technical aspects have a negative and significant effect on the time required to prescribe the necessary medicines for the treatment of patients. Conclusions: The lack of understanding of the hospital’s processes and spatial infrastructure by most patients, the lack of an electronic patient record system and central information system are highlighted as the main issues that contribute decisively to the increase in the non-beneficial time that patients with breast cances have to spend nowadays in hospitals of the NHS in Greece.

A randomized double-blind trial of anesthesia provided for colonoscopy by university-degreed anesthesia nurses in Greece: s afety and efficacy

There are numerous studies in the literature of anesthesia administered during colonoscopy including various methods, drugs, and monitoring systems; however, none of them has studied whether a university-degreed nurse anesthesia provider (known as a certified registered nurse anesthetist in the United States) is skillful enough to provide safe anesthesia in patients undergoing endoscopic procedures. The aim of our study was to determine whether anesthesia provided by a university-degreed nurse anesthesia provider during an endoscopic procedure is comparable in terms of safety and efficacy with routine sedation practice. This randomized, double-blind study included 100 adult patients who underwent colonoscopy conducted in the Evgenidion University Hospital during a single year. Subjects were divided into 2 groups: the first group received the usual scheme of intravenous sedation with midazolam and fentanyl administered by a member of the endoscopic team that was blind to Bispectral Index (BIS) values recordings (Group 0). The second group received intravenous bolus injection of propofol bolus by a university-degreed anesthesia registered nurse based on the BIS values (Group 1). The average of the mean BIS values of Group 0 was 85.07 (SD = 8.01) and for Group 1 was 76.1 (SD = 10.88; p = .04). The parameters of “patient memory during procedure” and the satisfaction scores (as self-assessed by the patients as well as 2 gastroenterologists) were also significantly different between the patients of the 2 groups (p = .000). Comparison between the 2 groups showed that the sedation offered by a university-degreed nurse anesthesia provider was absolutely safe and effective, offering particular comfort to the patient during the intervention and contributing significantly to its successful results.

1401: Health care professionals’ attitudes toward family presence during Cardiopulmonary Resuscitation: A critical review of the literature

Conclusion: About 20% of the HF partners reported caregiver burden, especially related to the disruption of their daily activities and their physical health. Caregiver burden was not associated with age or number of comorbidities and only partly associated with the severity of HF. The assessment of caregiver burden should focus on the mental strength of partners and the need for assistance in personal care in HF patients.