Researching Nursing Students' Attitudes toward Mental Health Practice: Cultural Adaptation and Validation of the Greek Version of the Acceptability of Locking the Door Questionnaire in Acute Psychiatric Care.

The present article describes the cultural adaptation and validation of the Greek version of the Acceptability of Locking the Door Questionnaire and aims to determine students' preference regarding mental health nursing as a possible career choice. The linguistic adaptation of the original instrument was performed according to the most recent guidelines and it was then administered to 274 third-year nursing students. Results support the validity and reliability of the instrument, which can be used to assess effectively the attitudes of the intended population. Sixty per cent of students considered mental health nursing as a possible career choice. Research on students' attitudes appeared to be a strategy of creating the space for lively discussions among them and capturing their interest in mental health education and practice. Theoretical preparation and clinical placements of mental health nursing students should incorporate strategies to improve their perceptions of working in mental health settings.

Nurses' Experiences of Psychiatric Care in Acute Care Units with an Open Door Policy.

Social distancing and the recent lock down due to COVID-19 has increased the feeling of disconnection, isolation, and suffering in vulnerable individuals and has brought forward questions regarding open acute care psychiatric units that cannot be answered by the literature. In Greece, there is no available research on how open ward environments are perceived and experienced by mental health professionals. The aim of the present study was to illuminate nurses' experiences of working in a public psychiatric hospital which traditionally operates with open doors. Eleven nursing care providers were interviewed, and thematic analysis was employed to explore their experiences of working in locked psychiatric acute care units. Participants described nursing care in units with an open door policy as "acceptance," "availability of staff," "real respect for the person," "ensuring patients' rights," "listening to the person," and "negotiation and not imposition." Trust in therapeutic relationships was perceived as greatly dependent on the trust being given to patients indirectly by the open door policy. Being trusted enhanced patients' self-determination and self-confidence leading to their empowerment. Containment of an acute mental health crisis took place through medication and meaningful discussions with patients and significant others rather than locking the door of the unit. Overall, meaningful care led to professional emancipation, but compassion fatigue narratives emphasized the need for continuous education, support and clinical supervision as necessary support for mental health nurses in a system of mental health provision often reduced to the point of crisis.

Development and application of a questionnaire for assessing parent satisfaction with care.

OBJECTIVE: The development and application of a questionnaire that eventually could be used as a management tool and a means of promoting the quality of care provided in 'P. & A. Kyriakou' Children's Hospital. DESIGN: Parents' survey; during treatment of their children. SETTING: 'P. & A. Kyriakou' Children's Hospital, Athens, Greece. PARTICIPANTS: Sample of 240 parents. MAIN OUTCOME MEASURE: Parent satisfaction. RESULTS: The most important finding of the study, although normative statements cannot be made, appears to be signalling of low satisfaction with care. The general mean observed (45 on a scale of 100) is not close to the mean (76) derived from a systematic review of 221 satisfaction studies. Moreover, satisfaction appears to be very low (14/100) for the procedures of the hospital, low for the outpatient dimension (42/100) and rather satisfactory for the inpatient dimension (61/100). CONCLUSION: Data-based feedback as a management tool has been associated with improved organizational functioning. However, systematic use of this intervention within Greek hospitals has been limited. Therefore, the next phase of the project will be used as feedback to the Governing Board and the personnel of the hospital. Finally, a study will be planned to investigate the effects of implementing changes based on parents' ratings of staff performance.

Serum levels of basic fibroblast growth factor and vascular endothelial growth factor in children and adolescents with type 1 diabetes mellitus.

Diabetes mellitus is characterized by microangiopathy and increased angiogenic response in various organs. Basic fibroblast growth factor (bFGF) as well as vascular endothelial growth factor (VEGF) are both angiogenic and are involved in vascular endothelial cell growth. The purpose of this study was to determine serum levels of bFGF and VEGF, in children and adolescents (youngsters) with type 1 diabetes mellitus, and correlate them with parameters reflecting the severity of the disease. Forty diabetic youngsters without clinical evidence of complications were compared with 30 healthy control subjects (mean age +/- SD, 14.3 +/- 3.6 and 13.8 +/- 3.6 y, respectively). Diabetes duration and metabolic control (expressed by glycosylated Hb) were (mean +/- SD) 6.2 +/- 3.8 y and 9.6 +/- 1.8%, respectively. bFGF and VEGF (pg/mL) were measured in serum samples by enzyme immunoassays, and both were not significantly different between the type 1 diabetes mellitus and the control group (p = 0.952 and p = 0.559, respectively). Restricting the analysis to the type 1 diabetes mellitus group, neither the duration nor the metabolic control of the disease showed any correlation with bFGF and VEGF serum levels, whereas a significantly positive correlation was found between the two examined angiogenic factors both in the diabetic (r = 0.3464, p = 0.025) and the control group (r = 0.4619, p = 0.0013). In conclusion, serum levels of bFGF and VEGF were not found to vary significantly in diabetic youngsters in relation to controls and had no correlation with the duration and metabolic control of the disease. Nevertheless, a positive correlation was found between these two angiogenic factors both in the type 1 diabetes mellitus and the control group.

Serum angiogenin levels in children and adolescents with insulin-dependent diabetes mellitus.

Microangiopathy, one of the most important complications of diabetes mellitus in humans, is associated with increased angiogenic response and proliferative lesions in various organs. Angiogenin, a polypeptide with a molecular size of 14 kD, is a potent inducer of vascular growth. This study aimed at investigating whether serum angiogenin levels are elevated in children and adolescents (youngsters) with insulin-dependent diabetes mellitus and whether angiogenin levels are affected by duration and metabolic control of the disease. It is assumed that angiogenin levels reflect the increased angiogenesis associated with microangiopathy, whether clinically evident or not. Forty diabetic youngsters were compared with 30 healthy control subjects (mean age +/- SD, 14.3 +/- 3.6 y and 13.8 +/- 3.6 y, respectively). The patients' disease duration and glycosylated Hb were (mean +/- SD) 6.2 +/- 3.8 y and 9.6 +/- 1.8%, respectively. Angiogenin (ng/mL) was measured in serum samples by an enzyme immunoassay and was found to be significantly higher (mean +/- SE) in patients (353.3 +/- 20.0) than in control subjects (244.7 +/- 9.6) (p = 0.0002). Levels did not vary with age, but were significantly higher in females compared with male subjects (p = 0.01). In the diabetic youngsters no significant differences were noticed with respect to duration or metabolic control of the disease. In conclusion, serum angiogenin levels were found to be increased among diabetic youngsters, irrespective of the duration and metabolic control of the disease, as well as in female subjects, with or without diabetes.