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Georgiou E, Hadjibalassi M, Friganović A, Sabou A, Gutysz-Wojnicka A, Constantinescu-Dobra A, Alfonso-Arias C, Curado-Santos E, Slijepčević J, Coţiu MĂA, Llaurado-Serra M, Borzuchowska M, Režić S, Dobrowolska B. Evaluation of a blended training solution for critical care nurses' work environment: Lessons learned from focus groups in four European countries. Nurse Educ Pract 2023; 73:103811. [PMID: 37922739 DOI: 10.1016/j.nepr.2023.103811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/06/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
AIM The aim of this study was to evaluate a blended pilot training course on Healthy Work Environments (HWEs) for critical care nurses as follows: 1) to explore the experience of trainees and trainers who took part in the training; and 2) to identify the strengths and weaknesses of the training program in its potential transferability to nursing practice in Intensive Care Units (ICUs). BACKGROUND Despite the evidence supporting the association between HWEs and job satisfaction, nursing retention, and patient outcomes, nurses still have high rates of burnout, mental health problems and intent to leave. To address this challenge, a blended training was created and piloted with the aim to highlight the relevance and impact of HWEs, enhancing its transferability to daily practice. The training was based on the six standards of HWEs as proposed by the American Association of Critical Care Nurses and created within an Erasmus + project. The pilot was delivered by trainers (critical care nursing educators) to critical care nurses and included six workshops of eight hours each (48 h in total) in each country. DESIGN After the pilot testing, a qualitative approach, with focus group discussions was used. METHODS All the trainees (n=82), who had attended at least one workshop were invited to participate in the focus groups. Overall, eight focus groups were held with critical care nurses who participated as trainees (n=39) from four testing countries: Cyprus, Croatia, Spain and Poland. One international focus group was held with trainers who conducted the training (n=4). Four more trainers completed the questionnaire online. All focus group were video recorded, and transcribed verbatim. Then, the national transcripts were translated into English. An inductive thematic analysis was carried out. FINDINGS Three themes were identified: 1) Valuing the relevance of the training program and a positive learning experience; 2) A powerful insight leading to increased awareness and empowerment in personal and professional life; 3) Challenges identified in terms of training, follow up and management of change. Both trainees and trainers expressed a positive opinion with regard to the content of the training and the didactic methods used. They emphasized the strong influence of the training on their understanding of a HWEs, its impact in an ICU context and the need for action, mainly related to communication issues. CONCLUSION The proposed blended training program may be used by trainers, who can enable nurses develop the competencies required to influence their work environment, in a context of shared responsibility.
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Affiliation(s)
- Evanthia Georgiou
- Εducation Sector, Nursing Services, Ministry of Health, 1 Prodromou & Chilonos Street 17, Nicosia 1448, Cyprus.
| | - Maria Hadjibalassi
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 11 Greg. Afxentiou street, Paleometocho, Nicosia 2682, Cyprus
| | - Adriano Friganović
- University of Applied Health Sciences Zagreb, Department of Nursing, Mlinarska cesta 38, Zagreb 10000, Croatia
| | - Adrian Sabou
- Technical University of Cluj-Napoca, Faculty of Automation and Computer Science, 28 Memorandumului Street, Cluj-Napoca 400114Romania
| | - Aleksandra Gutysz-Wojnicka
- University of Warmia and Mazury in Olsztyn, Department of Nursing, School of Health Sciences, Collegium Medicum, Żołnierska 14c Street, Olsztyn 10-681, Poland
| | - Anca Constantinescu-Dobra
- Technical University of Cluj-Napoca, Faculty of Electrical Engineering, 28 Memorandumului Street, Cluj-Napoca 400114, Romania
| | - Cristina Alfonso-Arias
- Nursing Department, Universitat Internacional de Catalunya, Av. Josep Trueta s/n Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Estel Curado-Santos
- Internal Medicine and Medical Specialties, Granollers General Hospital, Av. Francesc Ribas s/n Granollers, Barcelona 08402, Spain
| | - Jelena Slijepčević
- University Hospital Centre Zagreb, Department of Anesthesiology, Reanimatology, Intensive Medicine and Pain Treatment, Kispaticeva 12, Zagreb 10000, Croatia
| | - M Ădălina-Alexandra Coţiu
- Technical University of Cluj-Napoca, Faculty of Electrical Engineering, 28 Memorandumului Street, Cluj-Napoca 400114, Romania
| | - Mireia Llaurado-Serra
- Nursing Department, Universitat Internacional de Catalunya, Av. Josep Trueta s/n Sant Cugat del Vallès, Barcelona 08195, Spain
| | - Monika Borzuchowska
- Medical University of Lodz, Department of Management and Logistics in Healthcare, Al. Kościuszki 4, Lodz 90-131, Poland
| | - Slađana Režić
- University Hospital Centre Zagreb, Department of Quality, Kispaticeva 12, Zagreb 10000 Croatia
| | - Beata Dobrowolska
- Faculty of Health Sciences, Medical University of Lublin, S. Staszica Str. 4-6, Lublin 20-081, Poland
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Mędrzycka-Dąbrowska W, Zorena K, Friganović A, Sak-Dankosky N. Editorial: Patient and medical staff safety in the 21st century. Front Public Health 2022; 10:1092149. [PMID: 36561854 PMCID: PMC9764003 DOI: 10.3389/fpubh.2022.1092149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing and Intensive Care, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland,*Correspondence: Wioletta Mędrzycka-Dąbrowska
| | - Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | - Adriano Friganović
- Department of Nursing, University of Applied Health Sciences, Zagreb, Croatia
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Lange S, Mȩdrzycka-Da̧browska W, Friganović A, Religa D, Krupa S. Family experiences and attitudes toward care of ICU patients with delirium: A scoping review. Front Public Health 2022; 10:1060518. [PMID: 36505003 PMCID: PMC9727388 DOI: 10.3389/fpubh.2022.1060518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction The family has an important role in the care of the ICU patient. Research shows that the implementation of non-pharmacological interventions to prevent delirium, including interventions with the family, can reduce the incidence of delirium. The aim of this review was to search the available literature about the experiences and attitudes of family/carers of ICU patients diagnosed with delirium during hospitalization. Methods A scoping review method was used to map terms relevant to the involvement of relatives in the care of critically ill patients with delirium. To identify studies, the following databases were searched: PubMed, Scopus, EBSCO, Web of Science, and Cochrane Library. The database search was ongoing from 15 July 2022, with a final search on 4 August 2022. Results Thirteen articles reporting on the experiences and attitudes of family/carers of ICU patients who developed delirium during hospitalization were included in the scoping review. Of the included studies, eight were qualitative studies, three were quantitative studies and two were reviews (systematic review and integrative review). The studies were conducted in North America, Europe, South Africa, and Asia. Our findings show that carers experienced adverse effects associated with delirium in ICU patients such as stress, anxiety, embarrassment, uncertainty, anger, shock. Families/relatives need both emotional and informational support from medical staff. Conclusion Relatives want to be involved in the care of the delirium patient, although this needs improvement in some aspects of care such as: lack of awareness, family/relatives knowledge of delirium, improved education, and communication with medical staff. Recognition of delirium by families is acceptable and feasible. Family involvement may induce an increased anxiety, but this aspect needs further research.
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Affiliation(s)
- Sandra Lange
- Department of Internal and Pediatric Nursing, Medical University of Gdańsk, Gdańsk, Poland
| | - Wioletta Mȩdrzycka-Da̧browska
- Department of Anaesthesiology Nursing and Intensive Care, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | - Adriano Friganović
- Department of Anesthesiology and Intensive Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
- Department of Nursing, University of Applied Health Sciences, Zagreb, Croatia
| | - Dorota Religa
- Division for Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Solna, Sweden
| | - Sabina Krupa
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, Rzeszow, Poland
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Lange S, Mędrzycka-Dąbrowska W, Friganović A, Religa D, Krupa S. Patients' and Relatives' Experiences of Delirium in the Intensive Care Unit-A Qualitative Study. Int J Environ Res Public Health 2022; 19:11601. [PMID: 36141873 PMCID: PMC9517594 DOI: 10.3390/ijerph191811601] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/06/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
(1) Introduction: Delirium is a cognitive disorder that affects up to 80% of ICU patients and has many negative consequences. The occurrence of delirium in an ICU patient also negatively affects the relatives caring for these patients. The aim of this study was to explore patients' and their families' experiences of delirium during their ICU stay. (2) Method: The study used a qualitative design based on phenomenology as a research method. A semi-structured interview method was used to achieve the aim. The responses of patients and their families were recorded and transcribed, and the data were coded and analyzed. (3) Results: Eight interviews were conducted with past ICU patients who developed delirium during hospitalization and their family members. The mean age of the participants was 71 years. Of the eight patients, 2 (25%) were female and 6 (75%) were male. The relationships of the 8 carers with the patients were wife (in 4 cases), daughter (in 2 cases), and son (in 2 cases). The average length of time a patient stayed in the ICU was 24 days. The following themes were extracted from the interviews: education, feelings before the delirium, pain, thirst, the day after, talking to the family/patient, and return home. (4) Conclusions: Post-delirium patients and their families feel that more emphasis should be placed on information about delirium. Most patients feel embarrassed and ashamed about events during a delirium episode. Patients fear the reaction of their families when delirium occurs. Patients' families are not concerned about their relatives returning home and believe that the home environment will allow them to forget the delirium events more quickly during hospitalization.
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Affiliation(s)
- Sandra Lange
- Department of Internal and Pediatric Nursing, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Adriano Friganović
- Department of Anesthesiology and Intensive Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- Department of Nursing, University of Applied Health Sciences, Mlinarska Cesta 38, 10000 Zagreb, Croatia
| | - Dorota Religa
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, 17177 Stockholm, Sweden
| | - Sabina Krupa
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, Warzywna 1A, 35-310 Rzeszow, Poland
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Friganović A, Mędrzycka-Dąbrowska W, Krupa S, Oomen B, Decock N, Stievano A. Nurses' Knowledge and Attitudes towards Biosimilar Medicines as Part of Evidence-Based Nursing Practice-International Pilot Study within the Project Biosimilars Nurses Guide Version 2.0. Int J Environ Res Public Health 2022; 19:10311. [PMID: 36011946 PMCID: PMC9408045 DOI: 10.3390/ijerph191610311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Introduction: The increasing availability of biosimilars can increase patient access to these drugs and reduce the economic burden. Nurses play a key role in the education, administration, pharmacovigilance and management of the side effects of biosimilars. The aim of this study was to assess the knowledge and attitudes of nurses towards biosimilar drugs in different countries. Methods: An international cross-sectional study was conducted from November 2021 to February 2022. The survey was carried out using Computer-Assisted Web Interview (CAWI), sent by the CAWI panel via the website. Results: The results showed that nurses with a greater level of education felt most knowledgeable about biosimilars (χ2 = 105.813, df = 2, p < 0.001). One-third of nurses with a doctorate and a second degree said biosimilars are used in their workplace (χ2 = 48.169, df = 4, p < 0.001); most nurses with a second degree said that they had never heard of biosimilars (41%). Doctorate-level nurses thought knowledge is the key factor to increasing biosimilar uptake (97%). Conclusions: Nurses are not knowledgeable about biosimilars. Most would like to participate in training on biosimilars. This is a very important topic, because biosimilars are constantly evolving in medicine.
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Affiliation(s)
- Adriano Friganović
- Department of Nursing, University of Applied Health Sciences, Mlinarska Cesta 38, 10000 Zagreb, Croatia
- Department of Anaesthesiology and Intensive Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdańsk, Poland
| | - Sabina Krupa
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Ber Oomen
- European Specialist Nurses Organization, 6821 HR Arnhem, The Netherlands
| | - Nico Decock
- Nurse Anaesthesia School, University Hospital of Lille, 111 Rue Charles Debierre, 59000 Lille, France
| | - Alessandro Stievano
- Centre of Excellence for Nursing Scholarship OPI, Tor Vergata University of Rome, Via Cracovia 50, 00133 Rome, Italy
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Kosydar-Bochenek J, Krupa S, Religa D, Friganović A, Oomen B, Brioni E, Iordanou S, Suchoparski M, Knap M, Mędrzycka-Dąbrowska W. The Perception of the Patient Safety Climate by Health Professionals during the COVID-19 Pandemic-International Research. Int J Environ Res Public Health 2022; 19:ijerph19159712. [PMID: 35955067 PMCID: PMC9368342 DOI: 10.3390/ijerph19159712] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 05/28/2023]
Abstract
The patient safety climate is a key element of quality in healthcare. It should be a priority in the healthcare systems of all countries in the world. The goal of patient safety programs is to prevent errors and reduce the potential harm to patients when using healthcare services. A safety climate is also necessary to ensure a safe working environment for healthcare professionals. The attitudes of healthcare workers toward patient safety in various aspects of work, organization and functioning of the ward are important elements of the organization’s safety culture. The aim of this study was to determine the perception of the patient safety climate by healthcare workers during the COVID-19 pandemic. Methods: The study was conducted in five European countries. The Safety Attitude Questionnaire (SAQ) short version was used for the study. A total of 1061 healthcare workers: physicians, nurses and paramedics, participated in this study. Results: All groups received the highest mean results on the stress recognition subscale (SR): nurses 98.77, paramedics 96.39 and physician 98.28. Nurses and physicians evaluated work conditions (WC) to be the lowest (47.19 and 44.99), while paramedics evaluated perceptions of management (PM) as the worst (46.44). Paramedics achieved statistically significantly lower scores compared to nurses and physicians in job satisfaction (JS), stress recognition (SR) and perception of management (PM) (p < 0.0001). Paramedics compared to nurses and physicians rank better in working conditions (WC) in relation to patient safety (16.21%). Most often, persons of lower seniority scored higher in all subscales (p = 0.001). In Poland, Spain, France, Turkey, and Greece, healthcare workers scored highest in stress recognition (SR). In Poland, Spain, France, and Turkey, they assessed working conditions (WC) as the worst, while in Greece, the perception of management (PM) had the lowest result. Conclusion: Participant perceptions about the patient safety climate were not at a particularly satisfactory level, and there is still a need for the development of patient safety culture in healthcare in Europe. Overall, positive working conditions, good management and effective teamwork can contribute to improving employees’ attitudes toward patient safety. This study was carried out during the COVID-19 pandemic and should be repeated after its completion, and comparative studies will allow for a more precise determination of the safety climate in the assessment of employees.
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Affiliation(s)
- Justyna Kosydar-Bochenek
- Institute of Health Sciences, Medical College, Rzeszow University, Warzywna St. 1, 35-310 Rzeszow, Poland
| | - Sabina Krupa
- Institute of Health Sciences, Medical College, Rzeszow University, Warzywna St. 1, 35-310 Rzeszow, Poland
| | - Dorota Religa
- Division for Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, 14152 Huddinge, Sweden
| | - Adriano Friganović
- Department of Anesthesiology and Intensive Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- Department of Nursing, University of Applied Health Sciences, Mlinarska Cesta 38, 10000 Zagreb, Croatia
| | - Ber Oomen
- The European Specialist Nurses Organisation (ESNO), 6821HR Arnhem, The Netherlands
| | - Elena Brioni
- Nephrology and Dialysis Unit, San Raffaele Hospital, 20132 Milan, Italy
| | - Stelios Iordanou
- Intensive Care Unit, Limassol General Hospital, Kato Polemidia 3085, Cyprus
| | - Marcin Suchoparski
- Admission Room District Hospital in Golub Dobrzyń, 87-400 Golub Dobrzyń, Poland
| | - Małgorzata Knap
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University of Kielce, 25-369 Kielce, Poland
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University of Gdansk, 80-211 Gdansk, Poland
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Mędrzycka-Dąbrowska W, Lange S, Religa D, Dąbrowski S, Friganović A, Oomen B, Krupa S. Delirium in ICU Patients after Cardiac Arrest: A Scoping Review. J Pers Med 2022; 12:jpm12071047. [PMID: 35887544 PMCID: PMC9320343 DOI: 10.3390/jpm12071047] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/16/2022] [Accepted: 06/24/2022] [Indexed: 01/14/2023] Open
Abstract
Introduction: The incidence of delirium in the intensive care unit is high, although it may differ according to the specific characteristics of the unit. Despite the rapid development of research on delirium in recent years, the pathophysiological mechanisms leading to the clinical presentation of delirium are still subject to hypotheses. The aim of this review was to describe the incidence of delirium in cardiac arrest survivors and the clinical impact of delirium on patient outcomes. Methods: A scoping review was conducted in the second quarter of 2022. The number of articles retrieved during each search test was limited to studies conducted between 2010 and 2020. Strict inclusion and exclusion criteria were applied. The last search was conducted in May 2022. Results: A total of 537 records was initially obtained from the databases. After discarding duplicates, selecting titles and abstracts, and then analyzing full-text articles, 7 studies met the inclusion criteria. The incidence of delirium in the cardiac arrest survivor population ranged from 8% to as high as 100%. The length of stay in ICU and hospital was significantly longer in patients with delirium than those without. Ninety-eight percent of patients had cognitive or perceptual impairment and psychomotor impairment. Of the seven studies included in the analysis, the RASS, CAM, and NuDesc scales were used to diagnose delirium. Potential risk factors that may influence the duration of delirium include age and time since resuscitation; propofol use shortened the duration of delirium. Conclusion: the incidence of delirium in ICU patients who survived CA is high. Cardiac arrest is an additional predisposing factor for delirium. In cardiac arrest survivors, the occurrence of delirium prolongs the duration of ICU and hospital stay and adversely affects functional outcomes. The most common type of delirium among this population was hypoactive delirium. A large percentage of patients manifested symptoms such as cognitive or perception impairment, psychomotor impairment, and impaired concentration and attention.
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Affiliation(s)
- Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University of Gdansk, Dębinki 7, 80-211 Gdańsk, Poland
- Correspondence:
| | - Sandra Lange
- Department of Internal and Pediatric Nursing, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland;
| | - Dorota Religa
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Sebastian Dąbrowski
- Departament of Medical Rescue, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland;
| | - Adriano Friganović
- Department of Anesthesiology and Intensive Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
- Department of Nursing, University of Applied Health Sciences, Mlinarska Cesta 38, 10000 Zagreb, Croatia
| | - Ber Oomen
- European Specialist Nurses Organisation (ESNO), 6821HR Arnhem, The Netherlands;
| | - Sabina Krupa
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, St. Warzywna 1A, 35-310 Rzeszow, Poland;
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Kurtović B, Rotim K, Sajko T, Rotim C, Friganović A, Milošević M. Intermittent tramadol vs tramadol administration via patient-controlled pump after lumbar discectomy: a randomized controlled trial. Croat Med J 2022. [PMID: 35505644 PMCID: PMC9086815 DOI: 10.3325/cmj.2022.63.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim To compare the effect of intermittent tramadol dosing vs tramadol administration via patient-controlled pump on pain after lumbar discectomy. Methods This randomized prospective study enrolled 100 patients who underwent elective LIV-LV lumbar discectomy in the neurosurgery department at Sestre Milosrdnice University Hospital Center from May 2016 to July 2017. Patients were randomized to receive either tramadol (600 mg daily) via a patient-controlled analgesia (PCA) pump or intermittently. Pain was evaluated by the Croatian version of Short-Form McGill Pain Questionnaire. Results Forty percent of patients were women. The median (interquartile range) age of the patients was 51 (40-61) years. The groups did not differ in pain at 7 pm on the day of discectomy. However, in the morning and evening on the first postoperative day and in the morning and evening of the second postoperative day, the PCA group had significantly lower pain (P = 0.023, P < 0.001, P < 0.001, P = 0.026, respectively). Conclusion This is the first study that used the Short Form McGill Pain Questionnaire to compare the effect of tramadol administration via PCA pump and intermittent administration on pain after LIV-LV discectomy in a neurosurgery department. Tramadol showed a good analgesic efficacy in lumbar spine surgery; tramadol via PCA controlled pain more effectively than intermittently administered tramadol. Australian New Zealand Clinical Trials Registry: ANZCTR12618001893291.
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Kovačević I, Majerić Kogler V, Krikšić V, Ilić B, Friganović A, Ozimec Vulinec Š, Pavić J, Milošević M, Kovačević P, Petek D. Non-Medical Factors Associated with the Outcome of Treatment of Chronic Non-Malignant Pain: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:2881. [PMID: 35270575 PMCID: PMC8910574 DOI: 10.3390/ijerph19052881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chronic pain is a global public health issue with increasing prevalence. Chronic pain causes sleep disorder, reactive anxiety, and depression, impairs the quality of life; it burdens the individual and society as a whole. The aim of this study was to examine non-medical factors related to the outcome of the treatment of chronic non-malignant pain. METHODS A cross-sectional study with two groups of patients was conducted using a questionnaire with biological, psychological, and social characteristics of patients. Since this study was cross-sectional, it was not possible to determine whether some factors were the cause or the consequence of unsuccessful treatment outcome, which is at the same time one of the disadvantages of cross-sectional studies. RESULTS The poor outcome of the treatment of chronic non-malignant pain in a multivariate binary logistic regression model was statistically significantly associated with the lower quality of life (OR = 0.95 (95% CI: 0.91-0.99; p = 0.009), and higher depression level OR = 1.08 (95% CI: 1.02-1.14; p = 0.009). The outcome of the treatment was not directly related to social support measured by the multivariate binary logistic regression model (OR = 1.04, 95% CI: 0.95-1.15, p = 0.395), but solitary life (without partner) was (OR = 2.16 (95% CI: 1.03-4.53; p = 0.043). CONCLUSION The typical patient with a poor pain management outcome is retired, presents depressive behavior; their pain disturbs general activity and sleeping. Moreover, they have a physically disturbed quality of life and require self-treatment due to the inaccessibility of doctors and therapies. The principle of treatment of patients with chronic, non-malignant pain should take into account a biopsychosocial approach with individually adjusted procedures.
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Affiliation(s)
- Irena Kovačević
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia;
| | | | - Valentina Krikšić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Institution for Home Healthcare Domnius, 10000 Zagreb, Croatia
| | - Boris Ilić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Adriano Friganović
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Department of Anaesthesiology and Intensive Medicine, University Hospital Centre Zagreb, Kišpaticeva 12, 10000 Zagreb, Croatia
| | - Štefanija Ozimec Vulinec
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Jadranka Pavić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Milan Milošević
- Andrija Štampar School of Public Health, University of Zagreb School of Medicine, 10000 Zagreb, Croatia;
| | - Petra Kovačević
- Department of Rheumatology, Physical and Rehabilitation Medicine, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia;
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia;
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10
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Friganović A, Kurtović B, Režić S, Rotim C, Živanović D, Ledinski-Fičko S. CROATIAN ADAPTATION AND VALIDATION OF THE PERCEIVED IMPLICIT RATIONING OF NURSING CARE (PIRNCA) QUESTIONNAIRE: A CROSS-SECTIONAL STUDY. Acta Clin Croat 2022; 60:389-398. [PMID: 35282480 PMCID: PMC8907950 DOI: 10.20471/acc.2021.60.03.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/08/2021] [Indexed: 11/24/2022] Open
Abstract
The aim was to perform adaptation and validation of the Perceived Implicit Rationing of Nursing Care. Implicit delaying of nursing care is an intermediate step, linking nurses with the quality of outcomes for patients and nurses, and it is the result of prioritization of health care measures within the assigned group of patients cared for by nurses. The Perceived Implicit Rationing of Nursing Care instrument is a tool used to assess the rationing of care in nursing practice. Study participants were nurses working at hospital wards in 4 university hospitals in the Republic of Croatia. The questionnaire was filled-in by 438 nurses. Data were collected between April and November 2018. After principal axis factoring, a single factor solution based on the correlation matrix was adopted. The measured construct is one-dimensional, and the extracted factor explains 47.2% of its variance. Additionally, the reliability of the whole questionnaire was determined by using the internal consistency coefficient Cronbach alpha on the Perceived Implicit Rationing of Nursing Care with 31 of 0.96 particles, which is extremely high internal consistency reliability. In conclusion, the study found a high level of reliability and validity of the translated Perceived Implicit Rationing of Nursing Care questionnaire, fully comparable to that of the original. The questionnaire can be used to assess the phenomenon of implicit care rationing in Croatian hospitals.
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Valičević G, Friganović A, Kurtović B, Rotim C, Ledinski Fičko S, Krupa S. Knowledge of Sepsis in Nursing Students-A Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:12443. [PMID: 34886169 PMCID: PMC8656564 DOI: 10.3390/ijerph182312443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Sepsis is defined as life-threatening organ dysfunction caused by an unregulated host response to infection. The emphasis is on the imbalance of homeostasis and the response to infection, as well as mortality and the importance of recognizing sepsis as early as possible. The knowledge of undergraduate nursing students is an extremely important indicator for future work in the healthcare system after graduation. The aim of this study was to investigate the levels of knowledge about sepsis among undergraduate nursing students and to compare differences in different years of study, as well as differences in their study model. METHODS A cross-sectional study was conducted on 618 nursing students at the University of Applied Health Sciences in Zagreb, Croatia. All three years of study and both full-time and part-time (employed) nursing students were included. The questionnaire "Determinants of Sepsis Knowledge" was used in the research. RESULTS The percentage and number of third-year students who correctly answered the items on Knowledge of Sepsis were statistically significant compared to the first two years of study. The percentage and number of employed students who responded correctly to the items on Knowledge of Sepsis were statistically significant compared to students who were not employed. CONCLUSIONS The ability of nursing students to recognize and respond to the deterioration in a patient's condition due to sepsis is very important, so appropriate education about sepsis is essential. We recommend a greater representation of sepsis content in the core curriculum of nursing students' education in terms of theoretical instruction and clinical and simulation exercises.
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Affiliation(s)
- Gloria Valičević
- Department of Anaesthesiology and Intensive Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Adriano Friganović
- Department of Anaesthesiology and Intensive Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
- Department of Nursing, University of Applied Health Sciences, 10000 Zagreb, Croatia; (B.K.); (C.R.); (S.L.F.)
| | - Biljana Kurtović
- Department of Nursing, University of Applied Health Sciences, 10000 Zagreb, Croatia; (B.K.); (C.R.); (S.L.F.)
| | - Cecilija Rotim
- Department of Nursing, University of Applied Health Sciences, 10000 Zagreb, Croatia; (B.K.); (C.R.); (S.L.F.)
- Andrija Štampar Teaching Institute of Public Health, 10000 Zagreb, Croatia
| | - Sanja Ledinski Fičko
- Department of Nursing, University of Applied Health Sciences, 10000 Zagreb, Croatia; (B.K.); (C.R.); (S.L.F.)
| | - Sabina Krupa
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, 35-310 Rzeszow, Poland;
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12
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Friganović A, Selič P. Levels of Burnout Syndrome in Croatian Critical Care Nurses: A Cross-Sectional Study. Psychiatr Danub 2020; 32:478-483. [PMID: 33212452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Burnout syndrome occurs in people who work in jobs which involve frequent and intense contact with people, especially healthcare workers. High dependency departments such as critical care units are very stressful environments, and this can lead to a greater incidence of burnout, especially of emotional exhaustion and poor personal accomplishment. Nurses are the largest group of healthcare workers, and so it is reasonable to expect they would have a high prevalence of burnout. SUBJECTS AND METHODS The aim of this study was to assess the prevalence of burnout in critical care nurses in Croatia and explore its association with demographic features. A cross-sectional study of 620 nurses was conducted in several university hospitals, using convenience sampling. The Maslach Burnout Inventory was administered, together with questions about the socio-demographic and work characteristics of the participants (age, gender, length of work in ICU, education, type of ICU). RESULTS The majority of the sample were female nursing staff (87.7%), aged 26-35 (38.9%). The results showed that approximately every fifth nurse (22.1%) expressed a high emotional exhaustion (EE), with lesser burden of a high depersonalisation (D) in 7.9%, yet every third nurse (34.5%) scored low on PA. Male nurses reported more depersonalisation (p=0.045), yet neither EE nor the PA dimensions differed by gender. CONCLUSION The results of this study concerning burnout are comparable to those of studies of other professions, but the results vary with regard to the sample and the working conditions of the countries.
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Affiliation(s)
- Adriano Friganović
- Department of Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,
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Abstract
Biosimilars have the potential to lower costs and increase patient access to life-saving cancer therapies. However, lack of familiarity with biosimilars can be a barrier to their adoption, limiting their health and economic benefits. As highly trusted healthcare providers, nurses play integral roles in patient education. This review aims to help prepare nurses to respond to potential questions from patients on biosimilars. The regulation, use and potential benefits of biosimilars are discussed, with a focus on biosimilars in oncology. Overall, biosimilars are highly regulated medicines that provide comparable benefits to available biologics. Nurses can influence the adoption of biosimilars through patient education and can impact the future of the field in their expanding roles within health care systems.
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Affiliation(s)
- Cornelius F Waller
- Department of Haematology, Oncology & Stem Cell Transplantation, University Medical Centre Freiburg & Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Adriano Friganović
- Department of Anesthesiology & Intensive Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.,Department of Nursing, University of Applied Health Sciences, 10000 Zagreb, Croatia
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Friganović A, Selič P, Ilić B, Sedić B. Stress and burnout syndrome and their associations with coping and job satisfaction in critical care nurses: a literature review. Psychiatr Danub 2019; 31:21-31. [PMID: 30946714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Burnout is usually defined as a prolonged response to chronic emotional and interpersonal stressors, characterrized by emotional exhaustion, depersonalization and lack of social accomplishment. Coping mechanisms and job satisfaction are associated with the incidence of burnout symptoms in a work context. SUBJECTS AND METHODS The aim of this paper was to make a systematic analysis of the literature related to nurses' stress and the incidence of burnout syndrome in intensive care nurses, and also to determine the research into associations between coping mechanisms and job satisfaction on one side, and burnout on the other side. Appropriate databases (Scopus, PubMed) were searched with the aim of finding relevant studies and articles published in the last 15 years. The keywords were burnout, coping mechanisms, job satisfaction, nurses, and intensive care. Two independent reviewers carried out a selection of the studies. RESULTS The literature review found 786 studies about burnout and its association with different variables. Twenty-nine original research papers were discovered in this review process. Open questions still remain concerning burnout and the associations between the considered variables. We also found that studies using a qualitative approach, which could provide better insight into the investigation of burnout, was insufficient in this area. CONCLUSION Burnout syndrome is serious problem for healthcare systems and affects almost all profiles of healthcare workers. Although burnout is an evidence-based public health problem, there is still no systematic approach to prevention. Prevention activities to reduce stress and the incidence of burnout should be provided for nurses, especially those in very demanding posts.
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Affiliation(s)
- Adriano Friganović
- Department of Anaesthesiology and Intensive Care, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,
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Friganović A, Kovačević I, Ilić B, Žulec M, Krikšić V, Grgas Bile C. Healthy Settings in Hospital - How to Prevent Burnout Syndrome in Nurses: Literature Review. Acta Clin Croat 2019; 56:292-298. [PMID: 29485797 DOI: 10.20471/acc.2017.56.02.13] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Healthy settings involve a holistic and multidisciplinary method that integrates actions towards risk factors. In hospital settings, a high level of stress can lead to depression, anxiety, decreased job satisfaction and lower loyalty to the organization. Burnout syndrome can be defined as physical, psychological and emotional exhaustion, depersonalization, and low sense of personal accomplishment. The aim of this literature review was to make systematic literature analysis to provide scientific evidence for the consequences of constant exposure to high levels of stress and for the methods to be used to prevent burnout syndrome among health care workers. The Medline database was searched to identify relevant studies and articles published during the last 15 years. The key words used in this survey were burnout syndrome, prevention, nurses, and healthy settings. The 6 eligible studies were included in literature review. Evidence showed nurses to be exposed to stress and to have symptoms of burnout syndrome. As a result of burnout syndrome, chronic fatigue and reduced working capacity occur, thus raising the risk of adverse events. In conclusion, the occurrence of burnout syndrome is a major problem for hospitals and healthcare system. Action plan for hospital burnout syndrome prevention would greatly reduce the incidence and improve the quality of health care.
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Affiliation(s)
- Adriano Friganović
- Department of Nursing, University of Applied Health Sciences; Clinical Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb
| | - Irena Kovačević
- Department of Nursing, University of Applied Health Sciences
| | - Boris Ilić
- Department of Nursing, University of Applied Health Sciences
| | - Mirna Žulec
- Department of Nursing, Technical College, Bjelovar
| | | | - Cecilija Grgas Bile
- Quality Control Department, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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Ilić B, Švab V, Sedić B, Kovačević I, Friganović A, Jurić E. Mental Health in Domesticated Immigrant Population - a Systematic Review. Psychiatr Danub 2018; 29:273-281. [PMID: 28949308 DOI: 10.24869/psyd.2017.273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Migration is a process during which a person moves from one cultural setting to another in order to settle for a longer period of time or permanently. The number of immigrants in the world has more than doubled since 1975, with majority of migrants living in Europe today. Migration is now being increasingly recognized as a risk factor for multiple mental-health related issues, such as schizophrenia, psychosis, anxiety disorders and others. AIM The aim of this study was to collect, systematically review and analyze relevant articles pertaining to the mental health of second-or-higher generations of domesticated immigrant population, as well as to determine common socio-cultural predisposition factors leading to the development of mental illness among the mentioned population. METHODS Systematic search of relevant and peer-reviewed electronic database ScienceDirect was performed to identify studies related to mental health and healthcare in before-mentioned immigrant population. Study selection was performed by two independent reviewers, following the agreed specific inclusion and exclusion criteria. RESULTS 2 036 records were identified through initial database search, out of which 5 studies were included in this review, after the selection process. CONCLUSION The most consistent clinical finding is an increase in the rate of diagnosis of schizophrenia and related psychoses among migrants when compared to the host population, however the relationship between migration and psychotic disorders remains unexplained. So far, biological factors, such as cannabis use or obstetric complications, have failed to account for the risk of schizophrenia among migrant groups. Socio-environmental factors are now being looked upon as potential contributing factors for psychotic disorders in migrants.
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Affiliation(s)
- Boris Ilić
- Department of Nursing, University of Applied Health Sciences, Mlinarska cesta 38, HR-10000 Zagreb, Croatia,
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