ABSTRACT
Background: Few data are available on the influence of colonoscope type on the training process and quality of colonoscopy. We conducted this prospective observational cohort study to investigate scope suitability for starting colonoscopy training, in relation to technical competence, quality indicators, and the patient's comfort during diagnostic colonoscopy. Methods: A total of 126 consecutive patients were enrolled in the study and assigned to one of 3 groups: adult colonoscope ([AC], n=41); intermediate pediatric colonoscope ([IPC], n=43); and long pediatric colonoscope ([LPC], n=42). Primary outcomes were completeness of the examination and minutes to the cecum. Secondary outcomes included patient tolerance, position change, use of abdominal compression, loop formation, kind of loop, and overall difficulty of the procedure. Results: Cecal intubation rates were not statistically different between the groups: AC/87.8%; IPC/81.4%; and LPC/92.8%. Terminal ileal intubation rate differed significantly among the 3 groups (P=0.015) with LPC having the higher rate (66.7% vs. 60.9%/AC and 37.2%/IPC). There were significant differences in positional changes (fewer with LPC/1.36 vs. AC/2.15 and IPC/2.09, P=0.027) and midazolam administered doses (lower with LPC/0.52 vs. AC/1.07 and IPC/0.93, P=0.032). Loop formation with subsequent resolution was significantly associated with more pain for the patient with all of the 3 colonoscope types. Conclusions: The LPC performs better in trainee hands than AC and IPC in terms of reaching competency, and quality indicators show less discomfort for the patients during colonoscopic procedures (lower midazolam dose and fewer positional changes). It could be considered the most suitable scope for starting high-quality colonoscopy training.
ABSTRACT
INTRODUCTION: Volunteering presupposes having free time and refers to the provision of services without the motivation of material reward, for the benefit of society. In this study, we aimed to provide insight into the impact of economic crisis on blood donors and their motivation to donate blood during that period. STUDY DESIGN AND METHODS: We asked blood donors about their blood donation activity and motivation to donate using a standardized, anonymous questionnaire (n = 3000). Descriptive analysis was performed for the consideration of donor turnout during this economic period. The results were analyzed using the χ2 test and Spearman's correlation coefficient. RESULTS: Regarding gender, 68.2% were males, while 31.8% were females. Most blood donors donated voluntarily (75.8%) and only 24.2% were replacement or family blood donors. The economic crisis has affected the inhabitants of Athens more than the inhabitants of the province (χ2 = 9.910,p = 0.007). The influence of economic crisis on the regular blood donors' quality of life was greater than the non-regular donors (χ2 = 16.227,p < 0.001). According to our results, the economic crisis reduced the quality of life, but it did not affect the frequency of blood donations in a percentage of 87,3%. Not any significant difference was found between employment status, economic crisis and blood donation. CONCLUSION: Although the economic crisis has affected the lives of blood donors, it does not seem to affect the frequency of blood donation. We suggest that blood collection services should consider specialist campaigns that focus on the altruistic motivation of donors during an economic crisis.
Subject(s)
Blood Donors , Economic Recession , Male , Female , Humans , Greece , Quality of Life , Altruism , Motivation , Surveys and QuestionnairesABSTRACT
BACKGROUND: Chronic pain is well known to be influenced by various social factors; however, the impact of financial issues on pain has not been extensively studied. OBJECTIVE: The aim of this study was to investigate the impact of the economic crisis on pain and quality of life in Greek patients suffering from chronic pain. STUDY DESIGN: The study employed a prospective, open-label design. SETTING: The study setting was the Pain Unit of Attikon University Hospital in Athens, Greece. METHODS: The study surveyed 200 randomly selected outpatients with chronic pain during two different time periods (2012 and 2016). Patients completed a structured questionnaire to assess the impact of the economic crisis on multiple aspects of pain and pain management, health care, and quality of life. Personality characteristics and stress were also evaluated using the DASS-42 and the LOT-R questionnaires. RESULTS: Most patients in both periods believed that the economic crisis led to a worsening of their symptoms (75%) and quality of life (97%). Most patients (97.5%) also believed that the intensity of their pain would have been improved if their financial status had been better. Their main concerns about the future were "the possibility of not having access to health care facilities and medication" (94.5%), "stress" (43%), and "fear of financial strain" (30.5%). Higher levels of anxiety, stress, and pessimism were associated with higher levels of pain and lower quality of life. LIMITATIONS: The study is based on a small sample size. CONCLUSIONS: This study identified impacts of the financial crisis on chronic pain and quality of life, pointing to the need for measures to solve this problem. KEY WORDS: Pain, global financial crisis, quality of life, quality of health care, psychosocial factors.
Subject(s)
Chronic Pain/psychology , Economic Recession , Quality of Life/psychology , Female , Greece , Humans , Male , Prospective Studies , Surveys and QuestionnairesABSTRACT
BACKGROUND: The LANSS and S-LANSS questionnaires represent two widely accepted and validated instruments used to assist the identification of neuropathic pain worldwide. OBJECTIVE: The aim of this study was to translate, culturally adapt, and validate the LANSS and S-LANSS questionnaires into the Greek language. METHODS: Forward and backward translations of both questionnaires were performed from the English to Greek language. The final versions were assessed by a committee of clinical experts, and they were then pilot-tested in 20 patients with chronic pain. Both questionnaires were validated in 200 patients with chronic pain (100 patients for each questionnaire), using as the "gold standard" the diagnosis of a clinical expert in pain management. Sensitivity and specificity of questionnaires were assessed, as well as the internal consistency (using Cronbach's alpha coefficient) and correlation with the "gold standard" diagnosis (using Pearson correlation coefficient). RESULTS: Sensitivity and specificity of the LANSS questionnaire were calculated to be 82.76% and 95.24%, while for the S-LANSS 86.21% and 95.24%, respectively. Positive predictive value for neuropathic pain was 96% for the LANSS and 96.15% for the S-LANSS. Cronbach's alpha was revealed to be acceptable for both questionnaires (0.65 for LANSS and 0.67 for the S-LANSS), while a significant correlation was observed compared to the "gold standard" diagnosis (rLANSS = 0.79 και tSLANSS = 0.77, respectively, P = 0.01). CONCLUSIONS: The LANSS and the S-LANSS diagnostic tools have been translated and validated into the Greek language and can be adequately used to assist the identification of neuropathic pain in everyday clinical practice.