Postoperative Analgesia Management Evaluation in the Postanesthesia Unit: An Exploratory Analysis Based on Patient and Surgery Characteristics.

PURPOSE: Several methods have been proposed for postoperative pain management, including administration of opioid analgesics, epidural analgesia, and perineural and infiltrative techniques; however, data are lacking on the relationship between pain intensity, patients' age and gender, and surgery duration. DESIGN: Prospective, observational, single-center study. METHODS: The study included patients greater than or equal to 18 years old who underwent surgery with different anesthesia types, grouped according to the American Society of Anesthesiologists' physical status classification score. The McGill Pain Questionnaire was used to assess postoperative pain intensity. The postoperative pain evaluation was performed in the first 5 minutes on entering the postanesthesia care unit (PACU), and at 30 minutes and 24 hours after the operation. RESULTS: Our results showed a significant negative relationship between pain intensity as assessed at 5 and 30 minutes postoperatively and age. Postoperative pain intensity at 24 hours was significantly lower after low-risk surgeries lasting up to 1 hour; pain intensity was also significantly lower at 30 minutes following epidural anesthesia. When nonsteroidal anti-inflammatory drugs were not administered in the PACU, pain intensity was significantly lower at 5 minutes, 30 minutes, and 3 hours. CONCLUSIONS: Postoperative analgesic administration should be conducted in accordance with age and surgery type. Additionally, epidural anesthesia can reduce the immediate postoperative pain intensity.

Barriers to the Adoption of Evidence Based Practice in Nursing: a Focus Group Study.

Background: Evidence Based Practice is considered a complex process with many factors hindering its implementation. The use of focus groups to detect barriers to its application can provide an in-depth investigation of the phenomenon. Objective: The investigation of nurses' views regarding the obstacles connected to the implementation of Evidence Based Practice. Methods: This is a qualitative study carried out using focus groups and constitutes the continuation of a quantitative study. Deliberate sampling was used to recruit a total of 31 nurses. Results: The main categories that emerged regarding the obstacles in the implementation of Evidence Based Practice in nursing, concerned the lack of logistical support, the difficulty of accessing data, the insufficient knowledge of nurses as well as their attitude, the nature of the work, the decision-making process and the impossibility of safeguarding decisions made. Conclusion: In this study, various factors were identified that affect the application of Evidence Based Practice, in the nursing environment of Cyprus. Identifying these factors can be the basis for discussions and finding ways to resolve the problems that exist by health care managers.

A Scoping Review on the Status of Female Breast Cancer in Asia with a Special Focus on Nepal.

This study aimed to provide updated evidence on the status of female breast cancer and cancer treatment facilities in Asia, with a special focus on Nepal. This review used search phrases that included, breast neoplasm or cancer, health status, epidemiology, breast cancer survivors, cancer care facilities, Asia, Nepal. Researchers examined databases from January 2011 to December 2020 (PubMed, PMC, Google Scholar, and the reference lists of included papers). Studies of any design and reviews, were included in the study, except for qualitative studies. The study findings are presented in a narrative synthesis format using Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. An initial search resulted in 974 papers, and 896 were reviewed after being checked for duplication using the Zotero software. Accordingly, utilizing the inclusion and exclusion criteria, 188 publications were selected, and after review of titles and abstracts, an additional 98 papers were removed for different reasons. Finally, the study looked at 90 female breast cancer papers. Results showed that the number of cases of breast cancer is growing all around the world, including in Asia and Nepal. Age, early menarche, late menopause, nulliparity, positive family history, excessive fat consumption, alcohol, and smoking are all frequent risk factors for breast cancer found in Asian women. Breast self-examination, clinical breast examination, and mammography screening are common methods for detecting breast carcinoma. Chemotherapy, radiation, and modified mastectomy are commonly used options for treatment. The number of breast cancer survivors is growing throughout the world, indicating better clinical care. There is a paucity of survival data in many Asian countries, including Nepal. There is also a scarcity of health workforce specialized in cancer care and treatment, as well as a few health facilities that are available to treat cancer cases in many Asian countries, including Nepal.

Acceptance of coronavirus disease 2019 vaccination by cancer patients in Cyprus: A cross-sectional study.

INTRODUCTION: The acceptance of an individual to be vaccinated following the introduction of a new vaccine is dependent on multiple factors. Governing factors directing one's decision to be vaccinated against severe acute respiratory syndrome coronavirus 2, however, are currently unknown and the present study aims at researching these factors within the population of cancer patients. METHODS: A cross-sectional self-administered survey was conducted anonymously between 22 January and 12 February 2021, during the second vaccination phase against severe acute respiratory syndrome coronavirus 2 in Cyprus. The data were collected via an online questionnaire which was formerly used by previously conducted studies. The Mann-Whitney U test was applied for the comparison of means between bivariate variables, while the Kruskal-Wallis test was used for the comparison of means in variables with more than two groups. In addition, Spearman correlation coefficients were applied to explore the correlation of continuous variables. RESULTS: The sample size consisted of a total of 211 cancer patients, 64.9% of which were women with a mean age of 52.6 ± 12.4 years. The findings of the current research indicate a moderate vaccination acceptance among cancer patients (Μ = 3.3 ± 0.7, R = 1-5). CONCLUSION: During the promotion of a vaccine against severe acute respiratory syndrome coronavirus 2 to cancer patients, particular emphasis on specific demographic characteristics, vaccination history and preferred sources of informing the individual are required. In addition, through reviewing the prospective effectiveness and possible outcomes of the specific vaccine according to cancer type and anti-cancer therapy, many of the existing concerns and reservations from cancer patients are expected to be diminished.

Factors Affecting the Application and Implementation of Evidence-based Practice in Nursing.

BACKGROUND: Even though Evidence-Based Practice is a complex process, it's application has been recognized worldwide as a lever of improvement of the provided health services. OBJECTIVE: This study investigates the factors which influence the implementation of Evidence-Based Practice and their correlation with nurses' socio-demographic characteristics. METHODS: This is a cross-sectional study for which data were collected through an anonymous questionnaire. The study sample included 302 nurses from six public hospitals in Cyprus. Data collection was conducted from April 2018 to July 2018. RESULTS: According to the nurses, the biggest obstacle for the application of Evidence-Based Practice is the lack of authority/power to change care procedures (83.8%), followed by the view that the results were not applicable in the nurses' environment (81.5%). CONCLUSION: The identification of factors affecting the implementation of Evidence-Based Practice can serve as a basis for improving the quality of healthcare, as well as for developing strategies for resolving existing problems. This study showed that there is a need to create opportunities for the use of Evidence-Based Practice by nurses.

Assessment of Knowledge and Perceptions of Health Workers Regarding COVID-19: A Cross-Sectional Study from Cyprus.

The COVID-19 disease is presently a matter of global public health concern as it could be potentially fatal. Health workers have at the moment, inadequate knowledge of prevention measures, and their erroneous practices may directly increase the risk of spread. As a result, matters are complicated further as far as the chain of infection is concerned. The present cross-sectional study was conducted with 494 Health Worker participants in Cyprus between the 1st and 20th of May and the data were collected via an online questionnaire. The survey was created using information from a previous study as well as current directives published on the WHO website. The statistical software SPSS 22.0 was used for data analysis. The ANOVA test was used for the comparison of quantitative variables, while the Kruskal-Wallis test was used in cases of non-parametric distribution. The Pearson or Spearman coefficients were used to test correlation and the levels of materiality were set to 0,05. Women constituted 66,7% of the participants and 44,8% of all participants were between the age of 30-39 years old. The majority (75,4%) of the participants were Nursing Officers and 44,5% held postgraduate qualifications. HWs appeared to have a positive perception (x̅ = 3.58, SD = 0.53, MR = 1-5) regarding the course of the pandemic and their knowledge of the virus was found to be generally satisfactory. The findings of the current study indicate that in case of a similar global public health crisis, certain educational interventions should be implemented. This could be achieved with the use of an appropriate strategy. As a result, all demographic-working strata of health professionals would be well-educated and informed.

Data on advanced glycation end-products concentrations and haemodynamic parameters following caffeine and nicotine consumption in nursing students.

This work presents data from a non-invasive interventional trial investigating the early effects of caffeine and nicotine on both the concentrations of advanced glycation end-products (AGEs) and haemodynamic parameters in 178 healthy nursing students aged between 18 and 40. These students were allocated into four groups (A, B, C and D) and the concentrations of AGEs as well as haemodynamic parameters were measured non-invasively using the AgeReader and the Finometer devices, respectively. The haemodynamic parameters that were measured included systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, inter-beat interval, stroke volume, cardiac output, ventricular ejection time, total peripheral resistance, ascending aorta impedance and total arterial compliance. According to our protocol, each beverage contained 100 mg of caffeine each cigarette contained 1.5 mg of nicotine. The present data reveal the combined effect of smoke and caffeine consumption to several hemodynamic parameters that may be related to the onset of elevated blood pressure during smoking and following caffeine consumption.

Exploration of empathy in Cyprus nursing and health care students: A mixed method study.

Developing professionals who are perceptive to the needs of patients and can respond by expressing empathetic behavior is one of the aims of health care education. The aim of this study was to explore the level of empathy in health care students through a mixed method. The quantitative approach included the use of the Jefferson Scale of Empathy and the qualitative a focus group approach to further deepen into the descriptive results. 869 health care students (RR=81%) participated in the study and the level of empathy ranged from 42 to 139 with a mean score of 100.6 (20-140 scale). Significant statistical differences were found between the disciplines (F=8.6, p-value<0.001) and gender (p-value<0.001) with nursing students and women scoring the higher levels. Two focus groups of ten participants each were conducted with 3rd and 4th year nursing students. Four themes were derived from the analysis of these data a) empathy as an imperative component of care b) contact with the clinical reality c) the influence of family and choice of studies d) gender stereotypes. There is a lack of mixed methodologies in the empathy research and this study provided the opportunity of a better understanding of the health care students' views.

Vaccination Coverage and Awareness of Hepatitis B Virus Among Healthcare Students at a University in Cyprus.

INTRODUCTION: The risk for healthcare students to get infected by transmitting infectious viruses, including hepatitis B virus (HBV), in a hospital setting is extremely high through exposure to blood and/or body secretions. AIM: The aim of this work was to evaluate both the vaccination history of healthcare students at a University in Cyprus and their serologic immunity against HBV. In addition, we assessed their knowledge and behaviors towards the transmission and prevention of hepatitis B (HB). RESULTS: Total amount of 168 students participated in this study and more than 50% of them provided complete documentation of vaccination history against HBV. Antibodies levels ×10 mIU/mL to HB surface antigen (HBsAg) were detected for the 98.8% of healthcare students while 1.2% of the participants tested positive for HBsAg and antibodies to HB core antigen indicating chronic infection. Our study also revealed significant gaps in the knowledge of healthcare students on the efficiency of the vaccine against HBV and in terms of the HBV transmission. CONCLUSIONS: More information needs to be provided to healthcare students in Cyprus regarding HBV transmission and vaccination. In addition, there is a need for intervention to provide a safer workplace environment.

Assessment of Nurse's Safe Behavior Towards Chemotherapy Management.

INTRODUCTION: The management of chemotherapy in the hospital environment has been associated with increased risk of exposure to harmful factors. The use of the designated protective area and equipment during the preparation and the administration of chemotherapy is considered the gold standard of prevention. AIM: The aim of the study was to assess nurse's behavior in one public and one private hospital during the management of chemotherapy. METHODS: A cross sectional study design, using a self-completing questionnaire was used to collect the data, the final sample consisted of n=82 nurses, employed in the oncology and haematology department of Limassol general hospital and the bank of Cyprus oncology center. RESULTS: Most of the sample had a positive attitude towards the management and preparation of chemotherapy and kept the personal protection measures 52,4%. Inadequate aeration system was found to exist in both the health care centers 17,1%. The knowledge levels of the nurses employed in the bank of Cyprus oncology center was found to be statistically higher than the nurses employed in Limassol general hospital (84,4% Vs 23,4%, p<0,001). CONCLUSION: Educational programs need to be designed and implement to update nurses with the latest safety techniques and procedures, aiming at the protection of the employees from side effects as a result from the exposure to chemotherapy. The management of the healthcare institution need to ensure that the workplace environment fulfils all the safety standards and health regulations regarding the preparation of chemotherapy. Lastly more studies need to be conducted to monitor the knowledge and attitudes levels, and the implementation of safety and health regulation from the health care organizations regarding the safe management and preparation of chemotherapy.

Conflict management among health professionals in hospitals of Cyprus.

AIM: To record the types of conflict management that health professionals in Cyprus hospitals encounter in their daily work and to explore the conflicts, their parameters and causes, and the role ambiguity faced by the hospital employees. MATERIAL AND METHODS: This is a descriptive study in which data were collected with an anonymous self-referral questionnaire. The study population consisted of 300 health professionals from six different hospitals in Cyprus. Data are presented with averages and standard deviations. RESULTS: The health professionals identified the following causes of conflicts in the workplace in descending order: heavy workload, low pay, and varying instructions from different leaders. To deal with the conflict, 73.2% of the participants reported using avoidance, 54.2% engaged in negotiation for mutual benefit, and 40.5% cited compromise as a method. CONCLUSIONS: Identifying the way in which conflicts are managed contributes to the smooth functioning of organisations, and it improves the effectiveness of the services provided. IMPLICATIONS FOR NURSING MANAGEMENT: It is generally known that the high levels of conflict in hospitals are associated with increased mistakes and low employee satisfaction and performance levels. Managers deal with conflict-management issues within organisations on a daily basis. It is therefore essential to comprehend the reasons behind conflicts and provide suitable training for the development of communication skills and conflict-management strategies.

Greek nursing students' immunization coverage: data from central continental Greece.

Nursing students are at risk of acquiring vaccine-preventable diseases. To estimate the vaccination rates for nursing students, a cross-sectional survey was conducted in a major district of central continental Greece with an anonymous and self-administered questionnaire in a sample of 432 nursing students (the response rate was 97%). The eligible nursing students completed the questionnaire after informed consent was obtained. The vaccination rates of the nursing students ranged from 65.2% for the oral polio (SABIN) vaccine and 65.7% for the hepatitis B virus vaccine to 74.6% for the diphtheria-tetanus-pertussis (DTP) vaccine. The parents' level of education did not correlate with the students' underimmunization. The t-test showed that the senior students were more knowledgeable about the compulsory vaccines. Almost half of the nursing students were somewhat satisfied with the available information on vaccination, while 9.5% were not at all satisfied and 38.5% were underimmunized. The proportion of male students who had completed the SABIN and DTP vaccination schedules was higher compared to the female students. More health education programs could increase the vaccination rates among nursing students.