Síndrome del Quemado en el personal de enfermería psiquiátrica de hospitales griegos

El del "quemado" es un síndrome de agotamiento mental y físico que aparece en individuos que, de una manera u otra, tienen que relacionarse con otras personas en su trabajo. Este síndrome consiste en a) agotamiento emocional b) despersonalización c) bajo nivel de logros personales. El objetivo del estudio fue examinar el nivel de afectación del "quemado" experimentado por el personal de enfermería que trabajaba con pacientes psiquiátricos así como aquellos factores relacionados con el trabajo que contribuyen al desarrollo de dicho síndrome. Sujetos: La muestra estaba formada por 199 miembros del personal de enfermería de cinco hospitales psiquiátricos -dos hospitales generales psiquiátricos y tres departamentos de Psiquiatría de hospitales generales- en Atenas. Se utilizó el Inventario del Síndrome del Quemado de Maslach y la Escala de Ambiente de Trabajo de Moos para valorar tanto el Síndrome del Quemado en enfermeras como los factores medioambientales. Los datos fueron analizados aplicando la regresión lineal múltiple de Stepwise. Resultados: En general, la afectación por el Síndrome de Burnout o del Quemado parece estar en niveles moderados. El agotamiento emocional del personal de enfermería que trabaja en hospitales psiquiátricos era estadísticamente relevante (p < 0,04) al ser comparado con el del personal de los departamentos de Psiquiatría de hospitales generales. La edad se relaciona de forma positiva con los logros personales (AU)

Evaluación de las técnicas de aislamiento y contención por parte de los equipos de enfermería en los hospitales psiquiátricos griegos

Objetivo: a) Investigar el tipo de restricción utilizada con el fin de eliminar el comportamiento violento de pacientes psiquiátricos, b) Explorar las actitudes del personal de enfermería frente al aislamiento y la contención y c) Determinar si hay alguna diferencia en las capacidades del personal de enfermería debido a su nivel educativo y a los años de experiencia. Método: La muestra estaba formada por 190 enfermeros/as de doce unidades psiquiátricas correspondientes a cinco hospitales diferentes en donde se distribuyó un cuestionario auto-administrado y se realizó un análisis estadístico descriptivo junto con la aplicación del test chi cuadrado. Resultados: Las restricciones realizadas con mayor frecuencia incluían las contenciones corporales (42,6 per cent), el aislamiento en la propia habitación (26 per cent), y ambas (31,1 per cent). El aislamiento o la contención se utilizan en la mayoría de los casos para la seguridad del paciente (70,5 per cent), el control de su comportamiento (23,2 per cent), y para comodidad del personal (0,5 per cent). El ochenta por ciento de los enfermeros/as está a favor de la contención mientras que un 16,8 per cent está en contra. No hubo diferencias estadísticamente significativas en las actitudes de los enfermeros/as motivadas por su nivel de formación y experiencia laboral (AU)

The effectiveness of the mental health nursing interventions in a general hospital.

The purpose of the study was to investigate: a) how mental health nursing interventions were provided to general hospital patients, who during their hospitalization presented psychological/pyschiatric problems and b) how the patients actually evaluate the effectiveness of the care given to them. We interviewed 95 medical-surgical patients, who were referred to the psychiatric consultation-liaison service of a general hospital. During the interview, a nursing evaluation of the patients' psychological problems took place, followed by appropriate mental health nursing interventions which were taken from the NOSIE scale and the standards of the Psychiatric Mental Health Nursing Practice. Anxiety was the most common problem 41.1% in the referrals. The comparison of the mean value of the patients' problems before and those after the mental health nursing interventions, showed statistically significant reduction of the problems. Also, the comparison of the mean value in the fourth assessment of the patients' problems with the mean value of the patients' opinion, showed an achievement in facilitating the verbal expression and comforting the physical and psychological symptoms to a point statistically significant.

The intensive care units in greater Athens: needs and resources.

UNLABELLED: The purpose of this study was to investigate the availability of intensive care unit (ICU) beds and the number of requests, the number and categories of nursing staff, the nursing care required, and the time spent in various nursing activities. METHODS: 19 district general hospitals were studied. The characteristics of the units and their nursing personnel were recorded. The availability of ICU beds, the frequency of bed requests, and the way of patient admission in the ICUs were studied retrospectively for 1 year and prospectively for 2 weeks. The staffing level of direct care for 36 patients was studied to determine the time required for direct nursing care. RESULTS: the distribution of intensive care beds was: GICU 108, CICU 114, PSICU 30. During 1991, 12363 patients were admitted and 12172 of them were discharged; 3 628 patients stayed less than 2 days while the average length of stay was 12.5 days. In 1992, during the 2-week period, there were 303 requests for an admission to ICUs and of these 150 requests could not be met because of lack of ICU beds. The mean staffing level was 2.3 nurses per bed (to cover the three shifts). The mean nursing time required for direct nursing care of each patient per shift was found to be 6 hours for GICU patients, 5.3 for CICU, and 6.0 for PSICU patients.

Formulation and testing of a nursing assessment form for mental patients as a basis for individualized nursing care.

The study described here was designed to develop and test a form of nursing assessment of mental patients for use as a basis for individualized holistic nursing care in any setting. Nursing assessment was made of 581 mental patients receiving care in either mental hospitals, psychiatric departments of general hospitals or in mental health centres. Subjects were observed, interviewed and asked to complete a structured assessment form. Major variables studied were physical nursing problems/needs with nine categories, psychosocial nursing problems/needs with nine categories, sex, age, and physical and psychiatric disorders. Data were analysed with frequency distribution and comparative techniques, correlational procedures, and the multiple linear regression statistical procedure. The frequency distribution of psychiatric diagnoses showed that schizophrenic disorders were the most frequent in the total sample. However, there were more depressive patients in the general hospital group. Physical nursing problems/needs were significantly related with psychosocial nursing problems/needs, affective-depressive disorders, sex and age as well as negatively related with psychotic and anxiety disorders. Psychosocial nursing problems/needs were significantly related with schizophrenic and psychotic disorders, physical disorders and with the younger age groups. It was concluded that the psychiatric nursing assessment should encompass the areas of personal characteristics, and physical and psychological problems of the patient, and thus lead to practicing psychiatric nursing, that is, holistic psychosomatic nursing.

[Role of the mental health nurse in the general hospital]. / Symbole tou noseleuti psychikes ygeias sto geniko nosokomeio.

The mental health nurse in the general hospital practices general and psychiatric nursing, as well as liaison and consultation nursing, and contributes: 1) to the promotion of the quality of the psychosocial care of the general patient for his better therapy and rehabilitation, 2) to the holistic nursing care of the psychiatric patient hospitalized for somatic diseases, 3) to the treatment of the psychological problems of the nursing personnel and the patients visitors, and 4) to the sensitization and education of nurses in themes of mental health and mental illness.

Psychosomatic nursing assessment of psychiatric patients.

This article presents the results of a research study on 547 mental patients testing a form of nursing assessment of mental patients in psychiatric and in general hospitals, as a means to assess their nursing needs and as a basis for planning, implementation and evaluation of their personalized holistic nursing care. The study showed that more depressive than schizophrenic patients went to the general hospital for help. The reverse was observed in the psychiatric hospital. The psychological nursing needs of the patients were significantly correlated with their somatic nursing needs. The psychological as well as the somatic nursing needs of the patients were significantly correlated with sex, age, somatic health state and mental health state in general, and not with their concrete psychiatric diagnosis. It is concluded that the psychiatric nursing assessment should be oriented towards the investigation of the patient's psychosomatic nursing needs rather than be based on his medical diagnosis.