Greek nurses' perceptions on empathy and empathic care in the Intensive Care Unit.

BACKGROUND: Empathy is a fundamental component of nursing practice impacting positively on the therapeutic process. Understanding the concepts of empathy and empathic care in the context of Intensive Care Units is essential for providing better care in high challenging environments. However, research on empathy in the ICU is scarce and mostly quantitative. OBJECTIVES: To explore how ICU nurses perceive the concepts of empathy and empathic care. DESIGN AND SETTING: A descriptive qualitative research design was applied using an inductive content analysis approach. Semi-structured interviews were conducted with nineteen ICU nurses in two hospitals in Greece. FINDINGS: Data analysis revealed three main themes namely: "To become one of them", "Empathic Care" and "Integration of empathic care in practice". Findings corroborated the affective, cognitive and behavioral components of empathy. Nurses underlined that understaffing, increased workload and professional burnout impeded empathic care. CONCLUSION: Empathy and empathic care in the ICU were perceived as closely related to patients' outcomes and quality care. Empathic care was arduous due to organisational issues. Despite that, ICU nurses appeared to promote empathic care in practice and sought ways to enhance it.

Relationship of PCSK9 levels with indices of vascular function and subclinical atherosclerosis in patients with familial dyslipidemias.

OBJECTIVE: Proprotein convertase subtilisin/kexin type 9 (PCSK9) levels predict cardiovascular risk. We aimed to determine the correlation of PCSK9 levels with predictors of cardiovascular risk, such as central hemodynamics and carotid intima-media thickness (cIMT), in subjects with familial dyslipidemias. METHODS: Thirty-three asymptomatic subjects (age: 45.4 ± 12.3 years, 21 men) with either familial combined hyperlipidemia or heterozygous familial hypercholesterolemia, free from hypolipidemic therapy, underwent evaluation for central hemodynamics (aortic augmentation index [AIx@75] and augmented pressure [AP]) and cIMT. PCSK9 levels were measured by ELISA. RESULTS: In the univariate model, circulating PCSK9 levels were related to age (r = 0.351, P = 0.045), AP (r = 0.442, P = 0.011), AIx@75 (r = 0.463, P = 0.007), and cIMT (r = 0.559, P = 0.011). In multivariate analysis, significant positive associations of AP, AIx@75, and cIMT with PCSK9 levels were observed after adjusting for relevant confounders (P = 0.018, P = 0.002, and P = 0.011, respectively). Patients with both high cIMT (>0.81 mm) and high AIx@75 (>20%) had significantly increased PCSK9 levels compared with subjects with both low cIMT and low AIx@75 (316 ng/ml vs. 155 ng/ml, P = 0.037). CONCLUSIONS: In familial dyslipidemias, PCSK9 levels are positively associated with predictors of cardiovascular risk, such as central hemodynamics and cIMT. These relationships may aid in the stratification of cardiovascular risk by identifying a high-risk subgroup within these entities.