Socio-economic impact of Alzheimer's disease in Greece

57ΤΕΥΧΟΣ/ISSUE 35
ΤΕΥΧΟΣ/ISSUE
35
Scientific Journal, 3 Issues per Year
Published by the Greek
Nursing Studies Association
(GNSA)
Nursing
Care AND
Research
INDEXED IN ΕΒSCO, CINAHL
ΕΚ∆ΟΣΕΙΣ
οσελότος
ISSN 22413960
• What can nurses do for... a sick health system?
• Socio-economic impact of Alzheimer’s disease in
Greece. Pilot Study
• Αντιλήψεις των φοιτητών νοσηλευτικής για τη
Νοσηλευτική Μαζικών Καταστροφών: Η σηµασία τους
για την ανάπτυξη των προγραµµάτων σπουδών
• Nurses’ exposure in allergy agents or irritant
substances. Preventive measures
• Quality of life in patients with systemic lupus
erythematosus: A literature review
• ”ΠΡΟΜΗΘΕΑΣ”: Το νέο ιατρικό εργαλείο και
ο ρόλος του στον τοµέα των µεταµοσχεύσεων οργάνων
JANUARY-APRIL 2013SCIENTIFIC JOURNAL, 3 ISSUES PER YEAR
Published by the Greek
(GNSA)

Scientific Journal, 3 Issues per Year
Published by the Greek Nursing Studies Association (GNSA)
Nursing
Care AND Research
EDITOR-IN-CHIEF
Chryssoula Lemonidou, RN, MSc, PhD, Professor
of Nursing, University of Athens
CO-EDITORS
Eleni Apostolopoulou, RN, PhD, Professor of Nursing,
University of Athens
Ioannis Elefsiniotis, PhD, Assistant Professor, Faculty of
Nursing, University of Athens
Panagiota Sourtzi, RN, MSc, PhD, Associate Professor,
Faculty of Nursing, University of Athens
EDITORIAL BOARD
Lambros Anthopoulos, Emeritus Professor, Faculty of
George Baltopoulos, PhD, Professor, Faculty of Nurs-
ing, University of Athens
Thalia Bellali, RN, MSc, PhD, Associate Professor of
Nursing, Technological Educational Institute of Thes-
saloniki
Konstantinos Birbas, PhD, Associate Professor, Faculty
Gerasimos Bonatsos, PhD, Professor, Faculty of Nurs-
ing, University of Athens
Margarita Giannakopoulou, MSc, PhD, Associate Pro-
fessor, Faculty of Nursing, University of Athens
Dafni Kaitelidou, MSc, PhD, Assistant Professor, Faculty
Ioannis Kaklamanos, PhD, Associate Professor, Faculty
Maria Kalafati, RN, MSc, PhD, Faculty of Nursing, Uni-
versity of Athens
Athina Kalokerinou, RN, PhD, Αssociate Professor of
Nursing, Faculty of Nursing, University of Athens
Evangelos Konstantinou, RN, MSc, PhD, Associate Pro-
fessor, Faculty of Nursing, University of Athens
Vassiliki Matziou, RN, PhD, Associate Professor, Fac-
ulty of Nursing, University of Athens
Pavlos Myrianthefs, PhD, Associate Professor, Faculty
Elisabeth Patiraki, RN, PhD, Professor, Faculty of
Sotiris Plakas, RN, MSc, PhD, General Hospital of At-
tika «Sismanoglion»
Olga Siskou, RN, MSc, PhD, Faculty of Nursing, Uni-
versity of Athens, General Secretary of the Greek
EleniTheodossopoulou, Associate Professor, Faculty
INTERNATIONAL EDITORIAL BOARD
John Albarran, Principal Lecturer in Critical Care
Nursing, University of the West of England, Bris-
tol, UK
Maria Katopodi, PhD, Assistant Professor, University
of Michigan, USA
Katerina Labrinou, PhD, Assistant Professor in Nurs-
ing, Cyprus University of Technology
Anastasia Mallidou, RN, MSc, PhD, Assistant
Professor, University of Victoria, Canada
Anastasios Merkouris, RN, MSc, PhD, Associate
Professor of Nursing, Faculty of Nursing, Cyprus
University of Technology
Evridiki Papastavrou, PhD, Assistant Professor in
Nursing, Cyprus University of Technology
Elisabeth D.E. Papathanassoglou, RN, MSc, PhD,
Associate Professor, Faculty of Nursing, Cyprus
University of Technology
Julie Scholes, Professor of Nursing, University of
Brighton, Brighton, UK
Riita Suhonen, RN, PhD, Profes sor, University of
Turku, Department of Nursing Science, Turku,
Finland

Contents
NursingCare AND Research
Published by the Greek Nursing Studies Association (GNSA)
Publisher and Editor-in-Chief: Chryssoula Lemonidou
Address: 123, Papadiamantopoulou st., 115 27 - Athens, GREECE
Tel.: +30 210-7461.485
e-mail: contact.ens@gmail.com
Technical publisher: Ocelotos publishing
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Public Services, Libraries, Companies, Organisations: € 30,00
Individual Subscriptions: € 20,00
© Copyright 2007 - 2012: All rights reserved. The reproduction of articles (or parts of them) is
prohibited without permission of the publisher and the writers.
Instructions to Authors��
EDITORIAL:
What can nurses do for... a sick health system?�� 69
Olga Siskou
ORIGINAL PAPERS
Socio-economic impact of Alzheimer’s disease in Greece.
Pilot Study��73
Daphne Kaitelidou, Maria Kalogeropoulou, Antonis A. Mougias,
Petros Galanis, Nick Kontodimopoulos, Panagiota Papadopoulou,
Stavros Pasaloglou, Lycurgus Liaropoulos
Αντιλήψεις των φοιτητών νοσηλευτικής για τη
Νοσηλευτική Μαζικών Καταστροφών: Η σημασία τους
για την ανάπτυξη των προγραμμάτων σπουδών�� 85
REVIEWS
Nurses’exposure in allergy agents or irritant
substances. Preventive measures��99
Angeliki Bilali, Xara Sidiropoulou, Petros Galanis
Quality of life in patients with systemic lupus
erythematosus: A literature review�� 109
Evgenia Minasidou, Thalia Bellali
”ΠΡΟΜΗΘΕΑΣ”: Το νέο ιατρικό εργαλείο και ο ρόλος του
στον τομέα των μεταμοσχεύσεων οργάνων.��117
Κωνσταντίνος Σ. Μαμμάς

62
Abstract
INTRODUCTION: Dementia is a very cost-
ly disease because of the increased resourc-
es consumed for prevention, diagnosis, treat-
ment and management of dementia. The cost
of disease goes beyond the direct health cost,
i.e. cost mainly borne by the health sector, as
the disease has significant economic and so-
cial impact on both patients themselves and
their families.
OBJECTIVES:Thisstudyattemptstheeconom-
ic evaluation of Alzheimer’s disease, consider-
ing separately each category of cost borne by
the patient and his/her family, either as an ex-
pense or as a loss of productivity.
METHODS: The study was conducted at two
care centers for patients with dementia. The
convenience sample was 46 patients. The data
were collected via a questionnaire developed
by the researchers of this study and was partly
based on the research tool CATS (Caregiver Ac-
tivities Time Survey).
RESULTS: The questionnaire that was used was
partly based on the questionnaire by Jacobsen
et al. (2011), and was tested and formulated to
be easily understood by people of all education-
al levels. The results obtained during the pilot
study were consistent with the results of other
international studies on the cost of the disease.
The total annual cost of the disease was esti-
mated at €12,140 (SD: 6,555.9) for the mild
stage, at €13,735 (SD: 7,858.7) for the moderate
stage and €22,666 (SD: 8,467.2) for the severe
stage (excluded institutionalized patients).
More specifically, in the mild form of the dis-
ease, 79% of the total cost is the opportunity
cost of the primary and the secondary caregiv-
er, 10% is the cost of medication, 3% is the cost
of medical visits and 2% is the hospitalization
cost. Respectively, in the moderate form of the
disease, 77% of the total cost is the opportuni-
ty cost of the primary and the secondary care-
giver, 10% is the cost of medication, 1% is the
cost of medical visits and 4% is the hospitaliza-
tion cost. The productivity loss of the primary
caregiver exceeds 5% and 2% of the total cost
per patient with mild and moderate Alzheim-
er’s stage, respectively, which confirms the sig-
nificant economic impact of the disease on
both patients themselves and their families.
CONCLUSIONS: In conclusion, as the patient
gets worse and goes from mild to more severe
stages, the direct and indirect health cost as well
as the loss of productivity also increase. There-
fore it is especially important when possible to
prolong the stay of patients in the early stages
of the disease.
KEYWORDS: Alzheimer’s disease, cost evalu-
ation, Greece
FUNDING: The study was partially funded
by Novartis Hellas
ORIGINAL PAPER
Socio-economic impact of Alzheimer’s disease
in Greece. Pilot Study
Daphne Kaitelidou, Assistant Professor, Faculty of Nursing, University of Athens
Maria Kalogeropoulou, RN, MSc, PhD
Antonis A. Mougias, Psychiatrist at Nestor Psychogeriatric Association
Petros Galanis RN, MSc, PhD
Nick Kontodimopoulos, MSc, PhD
Panagiota Papadopoulou, RN
Stavros Pasaloglou, MSc, MBA
Lycurgus Liaropoulos, Professor Emeritus, University of Athens

Abstract
Introduction: According to the Japan
Society of Disaster Nursing “Disaster nursing
is the systematic and flexible utilization of
knowledgeandskillsspecifictodisasterrelated
nursing, and the promotion of a wide range of
activities to minimize the health hazards and
life threatening damage caused by disasters
in collaboration with other specialized fields”.
Disaster nursing only recently has started to
exist as an autonomous scientific subject.
Aim: The study investigated senior-year
nursing students’ perceptions about disaster
nursing in Greece.
Method:Thisstudywasdesignedasqualitative
in nature and was carried out at a faculty of
nursing in spring 2010. A questionnaire with
six open-ended questions distributed to 86
senior undergraduate students in a public
health nursing class. Content analysis was
performed for the data analysis.
Results: Students considered that disaster
nursing deals with the health needs of the
population during disasters. They described
their professional role in a mass casualty
incident,highlightedtheneedtoreceiveawider
range of theoretical knowledge concerning
disaster situations. Students addressed the
need for incorporation of disaster nursing
content as obligatory in the curriculum in the
senior year. Students identified their roles as
caretakers in shelters as well as during home
care after a disaster, as health education
providers in preparing the population before
a disaster occurs, as coordinators in disaster
response and perceived that community
nurses would play the most significant role
during a disaster.
Conclusions: The study provides knowledge
about what nursing students in Greece think
about disaster nursing education. Students re-
quire that nursing curricula should include di-
saster content in order to be better prepared
to care for the people affected by disasters.
Key-words: disaster, nursing, education, curri-
cula development, qualitative study.
Nursing student’s perceptions of
disaster nursing: implications for
curricula develpment
Theodoros Pesiridis¹, Athena Kalokairinou², Panayota Sourtzi² ¹RN, MSc, PhD(c)
²Associate Professor, Department of Public Health, Faculty of Nursing, University of Athens, National
and Kapodistrian University of Athens
Submitted for publication: Correspondence: Theodoros Pesiridis 39, Patriarchou Gregoriou E’15122
Maroussi, Attica Greece Tel. +302108053663 +306944724135
E-mail: teopesiridis@gmail.com
ORIGINAL PAPER

64
Introduction
Thehistoryofmankindislinkedwithmanycat-
astrophic events, which have influenced and
sometimes changed human civilizations and
affected community development. Although
disasters keep happening, the only thing that
has changed overtime is the way we confront
them. Increasingly constant threats both from
natural and man-made disasters against pub-
lic health are generating the need to incorpo-
rate disaster related content into nursing curri-
cula. In order to contribute to saving lives and
promoting health under such diﬃcult con-
ditions, future nurses need to have the right
competencies (WHO 2008). These include the
ability to carry out their roles in all phases of
a disaster, from preparedness and mitigation
activities to response and recovery actions. To
ensure a successful initiative concerning nurs-
ing education“it is essential that nurses are ed-
ucated at all levels in regard to disasters” ac-
cording to Dr. Hiroko Minami, ICN President
(ICN 2007).
Nursing education in disaster preparedness
evolves around areas such as assessment and
critical thinking, provides the competencies
and skills needed to participate adequately
in mass casualty incidents and increases the
effectiveness of health care in disaster situa-
tions. Exposing nurses in knowledge of disas-
ter nursing the benefits for public health are
valuable as they decrease morbidity rates, the
financial loss related to disasters and improve
the health status of a community. According
to the Japan Society of Disaster Nursing “Di-
saster nursing is the systematic and flexible uti-
lization of knowledge and skills specific to disas-
ter related nursing, and the promotion of a wide
range of activities to minimize the health haz-
ards and life threatening damage caused by di-
sasters in collaboration with other specialized
fields” (Jennings-Saunders et al., 2005). In ad-
dition, the International Nursing Coalition for
Mass Casualty Education (INCMCE) has devel-
oped a set of essential competencies for nurs-
es (INCMCE, 2003).
In order to prepare nursing students and
the healthcare personnel to meet the health
needs of populations affected by disasters, ed-
ucational programs have been developed by
numerous academic institutions, hospitals,
governments, and non-government organiza-
tions (Daily 2010). In the Western world, sev-
eral nursing faculties already have incorporat-
ed disaster nursing in their curricula (Veene-
ma, 2007). Graduate programs have been de-
veloped in the United States, Europe, Australia
and Asia to prepare nurses (Fowkes et al, 2007)
as experts in disaster, dealing with issues such
as leadership, education and policy roles. Is-
tanbulUniversity,HadassahHebrewUniversity
and the University of theWest Indies are exam-
ples of schools that have incorporated disaster
education in their curricula (ICN, 2009). How-
ever, more programs are needed to prepare
nurses to undertake the education and leader-
ship roles. An electronic survey developed by
the Nursing Emergency Preparedness Educa-
tion Coalition and sent to all levels of nursing
schools in the United States in order to deter-
mine the level of disaster education included
in the curriculum. During the 2000-2001 aca-
demic year, only one-third of faculties indicat-
ed coverage of disaster preparedness content
in their curricula and only about four hours of
content in disaster preparedness was provid-
ed. Additionally, 75% of nursing schools re-
ported that nurse faculties were inadequately
prepared in the area of disaster preparedness
(Weiner, 2005). In other parts of the world, di-
saster nursing education follows a similar pat-
tern as that in the United States. In Japan, 60%
of the nursing education programs had no
disaster nursing course (Yamamoto and Wa-
tanabe, 2006). An Australian study conduct-
ed in 2010 with the aim to explore the disaster
nursing content in Australian nursing schools,
concluded that nursing students register with
little or no knowledge in the area of disaster
nursing (Usher Mayner, 2011).
Students’ evaluation of a curriculum forms an
important instrument in curriculum devel-
opment (Wahlqvist et al 2006). One method
to evaluate if academic education in disaster
training is necessary to exist in nursing cur-
ricula is to gain insights regarding student
nurse perceptions. A study conducted in the
USA by Jennings – Sanders (2005) with the aim
to investigate nursing students’ perceptions
64

65JANUARY-APRIL 2013 ΤΕΥΧΟΣ/ISSUE 35
about disaster nursing indicated that nursing
students have several gaps in knowledge and
their nursing role regarding this topic.
In Greece there is a high frequency of natural
disasters. The country is placed fifth among
the countries with seismic activity, while forest
fires and floods are not uncommon, a fact that
makes disaster nursing so important to nurses
as well to the inhabitants of Greece.
The aim of this study was to investigate and
understand Greek undergraduate nursing stu-
dents’perceptions about disaster nursing con-
tent in order to locate any gaps in the facul-
ty’s current curriculum and to suggest recom-
mendations for building an effective content
about disaster nursing. The main questions in
which this study focused were:
• What were the nursing students’ percep-
tions about Disaster Nursing?
• What the nursing students sought to learn
from content like this and what compe-
tencies should they develop - in addition
to their other skills – in order to function in
a disaster and a mass casualty incident?
• How they identified their role as future
nurses that participate in disaster situa-
tions?
• In which year disaster nursing content
should be introduced to nursing stu-
dents?
Methods
This qualitative study was carried out in spring
2010 at a university faculty of nursing. Dur-
ing a regular nursing course which was com-
pulsory for all senior nursing students, the re-
searcher explained the aim of the study and a
questionnaire distributed to all of them, ask-
ing their perceptions about disaster nursing.
The researcher had no relation with the par-
ticipants as a teacher.
Participants
A purposive sample of fourth year nursing stu-
dents enrolled in a public health course at the
University of Athens was used for the purpose
of this study. After the aim of the study was ex-
plained by the researcher, a questionnaire was
distributed to all of them, asking their percep-
tions about disaster nursing curricula. The re-
searcher had no relation with the participants
as a teacher prior to the study. Eighty six (86)
students completed the questionnaire. The
majority of the students were female (85%)
and most were civilian nursing students (84%)
andtherestwerecadetsfromthemilitarynurs-
ing academy. Only nine cadets had covered a
short training program in chemical, biological,
radiological and nuclear (CBRN) threats.
Data collection
A two-part questionnaire was used. Part A of
the questionnaire sought demographic infor-
mation such as age, gender, educational sta-
tus and prior training in disaster nursing. Al-
though the overall aim of the study was to ex-
plore nursing students’ perceptions about di-
saster nursing, the above demographic infor-
mationwasusedinordertoseekifrespondents
of different sex and prior training in disasters
between cadets and civilian nursing students
were differentiating in their perceptions. One
important aim of qualitative research is to cap-
ture human diversity in terms of influences, ex-
perience and opinions (Randall, 2004). Ideally
we sought variety in responses within each
group of students. Part B sought to explore
nursing students’ perceptions about disaster
nursing.The six open-ended questions used in
this part was the “Disaster Nursing Perception
Questionnaire” (Jennings-Sanders et al, 2005).
Following permission from the authors, trans-
lation and back-translation were used to de-
velop the Greek version of the questionnaire.
The questions were asking students the fol-
lowing:
• How would you define disaster nursing?
• What disaster nursing content should be
incorporated in your curricula?
• Do you think disaster nursing should be
added in your curricula and why?
• At what year do you think disaster nursing
should be better fitted and why?
• Describe the role of a community nurse if a
disaster occur
• Whattypeofnursedoyouthinkwouldplay

66
a significant role if a disaster occurred?
Prior to the study the researcher carried out
a pilot study with eleven post-graduate stu-
dents, who were not included to the study, in
order to check clarity of the questions and to
estimate the time needed to fill in the ques-
tionnaire.
Ethics
Questionnaires were anonymous and were
distributed following approval from the Eth-
ics Committee of the Nursing Faculty and af-
ter providing explanatory information to stu-
dents about the study and giving consent to
participate.
Data analysis
A qualitative content analysis was used for the
data analysis in order to classify the informa-
tion taken from the questionnaires into certain
categories. Qualitative content analysis goes
beyond merely counting words to examining
language intensely for the purpose of classify-
inglargeamountsoftextintoaneﬃcientnum-
ber of categories that represent similar mean-
ings (Weber, 1990). In particular, a summative
content analysis was used to look for certain
words or context within the text in order to
understand its meaning. (Hsieh Shannon,
2005; Content analysis organization, 2013).
Regarding the answers in the open questions,
data were transcribed in a word processor by
the researcher. The analysis required the fol-
lowing steps. Textual data explored inductive-
ly in order to generate categories (Satu Kyn-
gas, 2008). Categories were established fol-
lowing some preliminary examination of the
data because there were not any prior stud-
ies in Greece dealing with the perceptions of
nursing students about disaster nursing. The
written statements of students were reviewed
several times by the researcher in order to gain
a better understanding from the texts given.
A file was created for each one of the open
ended questions. Certain words or content in
text was identified and quantified. After read-
ing the texts of each answer common themes
emerged and were grouped together in cate-
gories. Each statement of the students coded
in one or more categories in order to explore
the phenomena under study. The goal of con-
tent analysis is“to provide knowledge and un-
derstanding of the phenomenon under study”
(Downe-Wamboldt, 1992, p. 314) Before pre-
senting the findings of this section it is impor-
tant to note that for some of the open ended
questions, a subject could have written more
than one response for each of the themes list-
ed. Additionally some of them did not respond
to all questions. Thus, sums of percentages for
the answers given are higher than the total
sample. Results presented in the current study
both in quantitative and qualitative manner.
Trustworthiness of the data analysis
As evidence of trustworthiness, this type of
study relies on credibility. A mechanism to
demonstrate credibility or internal consisten-
cy is to show that the textual evidence is con-
sistent with the interpretation (Weber,1990). A
second researcher counted the frequency of
specific words or content (Kondracki Well-
man, 2002) and then coded independently
the responses in order to gain coding reliabil-
ity (Weber, 1990). Researchers can check with
their participants as to their intended mean-
ing through the process of member check
(Lincoln Guba, 1985). In the first attempt the
agreement achieved between the researcher
and the second coder was high. Coding dis-
agreements between the two researchers dis-
covered in the process of assessing reliability.
The researcher decided to resolve these cod-
ing disagreements by discussing and explain-
ing the categories that had been identified in
thefirststageofcoding.Asecondstageofcod-
ing was conducted in which the agreement in-
creased after the same meaning was given for
the words disaster, mass casualty incident, ca-
tastrophe, emergency situation and natural di-
saster by both the researchers.
Results
The findings are discussed under the six main

open – ended questions. For each question
several themes have explored and main points
are illustrated by anonymous quotations fol-
lowed by codes in brackets that indicate the
civilian nurse number (CN) and the cadet (C)
number.
1. Nursing students’ perceptions about disaster
nursing
This section presents student nurses’ percep-
tions about disaster nursing on a number of
significant issues. When participants were
asked to define disaster nursing, they high-
lighted several components of the definition
accepted for this study. Eight (8) themes de-
rived from the students’ responses. Each re-
sponse depending on the content given was
categorized in one or several themes (Table 1).
There was considerable overlap and interac-
tion between the following themes.
Themes
No. of
items
%
1. Providing nursing care to
individuals, families and
communities during a disaster
52 64,19%
2. The nursing specialty that
is dealing with the needs
of individuals, families and
communities caused by disasters
17 20,98%
3. Dealing with problems caused by
disasters
16 19,75%
4. Planning for disaster prevention
and decreasing the hazards for
public health
10 12,34%
5. Providing information and health
education to individuals, families
and communities about disasters
8 9,87%
6. Providing psychological support
and rehabilitation of the injured
population caused by disasters
6 7,40%
7. Disaster planning, management
and coordination of the resources
during a disaster
5 6,17%
Irrelevant 4 4,93%
No response 6 7,40%
TABLE 1. Perceptions regarding the definition of
disaster nursing (n=81)
1.1. Thenursingspecialtythatappliestodisasters
with the aim to provide health care
According to most of the students, disaster
nursing is a nursing specialty on its own. Stu-
dents emphasized mostly on the response
phase of the disaster and not on the prepared-
ness, mitigation and recovery phase which in-
dicates that had a limited knowledge about
what a disaster is. Most of the students had
an awareness of the different needs and prob-
lems in the provision of health care during di-
sasters. Almost all of the students included the
provision of health care in the definition of di-
saster nursing.
“Disaster nursing is the specialty that deals
with the problems created by a disaster situ-
ation”(CN47)
“Disaster nursing concerns in providing pa-
tients’ transportation and health care of in-
jured during periods of crisis such a war, an
epidemic or an earthquake”(C74)
“Disaster nursing is the nursing specialty that
provides training to nurses in order to provide
care to injured people caused by mass casual-
ty incidents and to co-ordinate the health care
settings at the scene the disaster is occurring”
(CN23)
“Providing holistic care to humans (psycho-
logical and physical) in the event of a disaster
whether it concerns natural phenomena such
as earthquakes, fires, or acts of terrorism and
biological attacks”(C15)
1.2 Disaster nursing concerns also activities such
as prevention and mitigation of disasters
Some students identified that a wide range of
other activities such as health education of in-
dividuals, families and communities are also
included in disaster nursing. They expressed
that taking appropriate action may prevent a
disaster altogether or reduce the effects of the
disaster.
“It’s a nursing specialty that deals with the pre-
vention and the response when disasters oc-
cur”(CN71)
“...also concerns disaster prevention actions
such as informing citizens about what to do in
disasters”(CN63)
“…providing health care and educating the
public about disasters and their consequenc-
es”(CN1)

68
1.3 Providing psychological support and help in
the rehabilitation process
A few students reported that providing sup-
port to those with psychological needs and
survivors is also a part of disaster nursing. Al-
though students identified the psychological
dimension of disaster nursing, none of them
referred to the needs of the vulnerable popu-
lation or to those with chronic illness.
“Disaster nursing concerns first aid to people
directly affected by major disasters and the
provision of psychological support to deal
with traumatic experiences”(CN44)
“To provide nursing care in cases where disas-
ters occur and rehabilitation of those affected
by them”(CN8)
1.4 Disaster nursing involves participation in di-
saster planning and policy development
Very few students recognized that disaster
nursing have the goal of disaster manage-
ment where planning and coordination are
also priorities. They also identified that in di-
sasters they have to take quick decisions in the
face of scarce resources and to work as a team
member with other disciplines.
“Is the specialty of nursing that deals with di-
sasters and organizing in advance for the man-
agement of such events”(CN13)
“Is the field of nursing that deals with the edu-
cation of nurses so they can address the needs
of those affected by disasters and to organize
health services to the disaster site”(CN41)
“It is the application of knowledge and prac-
tice of nursing science in emergency situa-
tions such as disasters that require immediate
coordination of all involved and quick deci-
sions”(CN42)
2. Students’ perceptions about disaster nursing
content in the nursing curriculum
There were several statements given about the
content and the type of training that students
proposed. Four themes were consistently ex-
pressed by a majority of students. These four
themes were considered as the‘major’themes.
Seven themes were deemed to be ‘minor’ as
they were identified only by few students. The
major emerging themes after the analysis of
the open ended question were the following:
2.1. Theoretical knowledge and understanding
about natural and man-made disasters.
Students expressed that the current nursing
training was inadequate in providing them
with knowledge about disasters and mass ca-
sualty incidents.
“We need to be taught about the types and
classification of disasters, what to expect from
each type of disaster and the health effects on
the population.”(CN35)
Other students were more interested in gain-
ing knowledge of certain types of disasters
and they felt unprepared to deal with radio-
logical and chemical events.
“I would expect to be taught on more complex
disasters such as chemical, biological and ra-
diological disasters, terrorist attacks and how
to identify these agents”(C43)
“I would like to see a syllabus on disaster re-
sponse in general and for each type of disaster
separately a specialized plan for nursing care
such as what to do to someone who has been
infected by a chemical or radiological agent”
(CN17)
According to students, knowledge about di-
saster nursing content should be transmitted
by using media and movies in addition to lec-
tures. While others focused on the teachers’
ability to educate them on such content.
“There should be mandatory courses with vid-
eo presentations for easy understanding by
students”(CN62)
“The presentations and lectures should be
made by teachers who have knowledge in di-
saster nursing and through relevant books”
(C74)
2.2 Disaster management
Many participants highlighted the need for a
better training when coordinating and deal-
ing with mass casualty incidents. Other con-
siderations of the students were related to
team chain of command.
“I think I need to know what to do in a disas-
ter, in what order and who is giving the direc-
tions in a stressed situation with multiple ca-

sualties.”(CN32)
The students expressed their concerns about
not having any knowledge about disaster
plans issues and the laws applied to them.
“There should be a curriculum on the treat-
ment of injuries in each phase of disaster,
management issues and what legislation ap-
plies to disasters.”(CN41)
“The curriculum should contain content on
dealing with casualties in a disaster, adminis-
trative and organizational issues, circulars and
laws that apply to the management of such
situations”(CN6)
2.3. Disaster triage and development of skills us-
ingscenario-baseddisasterdrillsanddesktop
exercises.
Students felt that the faculty should take steps
to initiate disaster drills in order to develop
skills and competencies when dealing with
multiple victims after a disaster.
“I would like to see more the practical part, i.e.
to do exercises with a hypothetical number of
victims after a disaster and to learn how to dis-
tinguish who has more need of care.”(CN25)
2.4. Health psychology tailored to the health
needs of the population affected following by
a disaster.
The students’ expressed their concern about
not having any subject in health psychology in
crisis situations. The mentioned that although
they have a psychology course in their curricu-
lum it doesn’t emphasizes in developing skills
to serve the public good and promote mental
health and psychosocial well-being of those
affected by a disaster.
“Provide knowledge and skills to manage pan-
ic attacks that occur in disaster situations.”
(CN14)
“It would be beneficial to learn how to work
with communities affected by disaster in or-
der to build individual and community capac-
ity and facilitate recovery and healing.”(CN70)
The minor themes identified only by a few stu-
dents and can be summarized as followed.
Students expressed concern about not having
proper training on prevention and health edu-
cation applied to disaster conditions. Some of
the students concerned about precaution and
safety measures when dealing with techno-
logical accidents.
3. Students’ perceptions about incorporating
disaster nursing content in the nursing curric-
ulum
Most of the participants (96,11%) stressed that
disaster nursing content should be incorporat-
ed in the nursing curriculum. From those who
expected to see a content like this, 78,37% ex-
pressed that disaster nursing should be incor-
porated as a mandatory course and the rest of
the participants (21,63%) preferred to choose
disaster nursing from the nursing curriculum
as an elective one according to their interests.
The following themes identified when stu-
dents justified their answers concerning the
incorporation of disaster nursing in the curri-
cula. Few of the participants suggested that
disaster nursing could be taught within the
community nursing context.
Themes
No. of
items
%
1. Developing competencies when
dealing with disasters.
28 37,83%
2. Disasters are occurring in our
country and increasing the past few
years.
19 25,67%
3. Disaster content is interesting and
important for future nurses.
12 16,21%
4.We need to be prepared for
disasters.
10 13,51%
5. Increasing theoretical knowledge
and awareness about disasters.
8 10,81%
6. Helps nurses to identify their role
during a disaster.
5 6,75%
7. Prevention of injury and death,
mortality decrease causing from
disasters.
3 4,05%
8. Developing competencies required
to participate in humanitarian aid
missions.
2 2,70%
9. Incorporating disaster nursing into a
similar existent course.
2 2,70%
10. Nurses would learn how to protect
themselves in disaster situations.
1 1,35%
TABLE 2.Themes derived for the reasons of
incorporating disaster nursing content in to the
nursing curriculum.

70
3.1. Developing competencies when dealing with
disasters.
Students reported that disaster nursing should
be incorporated in order to develop a set of
competencies specific to the disaster situa-
tion.
“Disaster nursing content should be incorpo-
rated in the nursing curriculum in order to de-
velop skills and competencies when asked to
participate as professional nurses in a mass ca-
sualty incident”. (CN20)
“I believe that there should be such a course
even as elective one or replace a medical
course. I think there should be because it is
part of our job and we must have the skills to
respond effectively”(CN16)
3.2 Disasters are occurring in our country and in-
creasing the past few years.
For some students disaster nursing content
should be incorporated because they believed
that it is likely to face a disaster as profession-
als in the future.
“A serious number of disasters (e.g. earth-
quakes, fires) took place in Greece the past few
years and there is an increased risk to happen
again with many health effects”(CN33)
“Yes, I believe disaster nursing should be add-
ed to our curriculum because it is something
(disaster) that will certainly confront at some
point in our lives and apart from the knowl-
edge that we need to have as nurses to help
others we also need to know how to protect
ourselves”(CN20)
“Yes, should be added to our curriculum espe-
cially nowadays when natural disasters con-
stantly increasing and we are in a period of
wars occurring in various parts of the world,
we never know if the next will happen to our
country”(CN32)
3.3 It is an interesting and useful nursing subject.
For some of the participants the incorporation
of disaster nursing was an interesting and use-
ful content for nurses.
‘Yes, I think it is very interesting and useful sub-
ject because disasters will not stop happening
and improvements are needed from the nurs-
ing profession”(CN25)
“Yes it should be added because it is useful and
necessary subject to many, for example if you
are working as a nurse in a summer camp and
a disaster happens, how to provide care if you
do not know?”(CN41)
3.4 Preparedness and confidence to deal with di-
sasters.
Students felt unprepared in dealing with di-
sasters after their graduation. They reported
that adding disaster nursing content would in-
crease their preparedness when they would be
called to provide care.
“I believe it should be included in the curricu-
lum as an obligatory subject and not as part
of another course because we need to develop
the skills necessary to be prepared for any di-
saster that may be encountered in our profes-
sional careers”(CN28)
“Yes, because many of us may find themselves
in a position to deal with such situations and
we must be informed and prepared. When you
have knowledge about a topic you feel more
confident that you can do it”(CN45)
4. Students’ perceptions about the year that
disaster nursing should be introduced to
them
When participants were asked to give their
opinion about the year that disaster nursing
should be introduced to them, the majority
believed that it would be more appropriate to
be taught in the final year of studies. A simi-
lar perception was formulated by some oth-
ers, saying that it would fit better in the third
or fourth year of the curriculum.
4.1 Disaster nursing involves systematic applica-
tion of basic nursing competencies
Students expressed that disaster nursing
should be placed in the senior level because
they have formulated a deeper knowledge
in nursing and developed the competencies
needed for this topic.
“Disaster nursing should be placed in the se-
nior levels because students have a more holis-
tic knowledge and understanding of the nurs-
ing role and have developed a certain amount
of practical skills”(CN33)
“I believe it should be taught in the 4th year and

especially in the 8th semester because there is
great background knowledge from previous
years”(CN65)
“I believe it should be taught in the fourth year
that students have acquired a comprehensive
knowledge of all aspects of care.Will be able to
think critically and justify our decisions”(CN3)
4.2 Master’s degree in Disaster Nursing
Students believed also that it would be bene-
ficial for nurses the existence of a Master’s de-
gree in Disaster nursing. The program should
be designed to address the needs of nurses
and provide learning opportunities reflective
of disasters according to students.
“I think it would be preferable to create a post-
graduate program in disaster nursing”(CN2)
“Nursing faculty should develop a master’s de-
gree addressed clearly in nurses where they
can get knowledge and do practice as it hap-
pens in postgraduate programs”(C82)
5. Possible role that would be expected from a
community health nurse if a disaster would
occur
Students were asked to describe a possible role
that a community nurse would serve if a disas-
ter would occur. Most of them agreed that the
role a community health nurse would serve
was the provision of nursing care in shelters
and home visits to survivors. Aspects of the
role of a community nurse that students de-
scribed as important in disasters also includ-
ed: the collaboration with other disciplines in
the community and identified as leaders when
planning for the recovery of the community.
“Community health nurses can collaborate
with the local authorities in order to make a
recovery plan after an earthquake. They have
the necessary skills to evaluate public health
conditions in shelters and to ensure hygiene”
(CN12)
“To coordinate the provision of care and to col-
laborate with relief organizations to address
basic needs of the community (e.g. shelter,
food, water, immunization)”(CN50)
They also described that a community nurse
could participates in preventive strategies or
implement health education programs in ev-
ery community about disaster preparedness.
Community health nurses were generally con-
sidered more knowledge-able in prevention
policies.
“A community nurse is aware of the popula-
tion leaving in the community and could rec-
ognize the signs and symptoms of an epidem-
ic and inform them about the impact and how
to protect themselves”(CN73)
“I think a community nurse has an important
role to properly inform members of the com-
munity to deal with such events and to pro-
vide community-based education regarding
health implications of the disaster”(CN49)
“A nurse trained in community nursing knows
how to develop a community education plan
to increase awareness of the community’s
population about preventing consequences
from a heat stroke”(CN27)
According to students community health nurs-
es could cooperate with other health profes-
sionals and community stakeholders before
and during a disaster and could also organize
volunteer activities.
Students recognized community health nurs-
es’ability to perform triage in the scene of the
mass casualty event and to provide first aid.
Community health nurses may be the first or
among the first persons to respond to an emer-
gency or a disaster.
“Community nurses are working in health care
centers and have faster access to the point of
a disaster. They could perform a rapid assess-
ment and triage to victims and save valuable
time and lives”(CN17)
“A school nurse would provide triage and first
aid in children if an earthquake would happen
to the local settings”(C60)
6. Students’ perceptions about the type of nurse
that would play a significant role if a mass ca-
sualty incident occurred
Students were divided into two large groups
concerning this question.The majority had the
view that if a disaster occurred a community
health nurse would play the most significant
role, while many others formulated the opin-
ion that a medical/surgical nurse would suc-

72
cessfully provide health care in a disaster situ-
ation.
“I find it more useful the nurse with specializa-
tion in Community Nursing because he/she is
working in the community and is aware of the
needs and problems resulting from a major di-
saster”(CN12)
“Internal medicine and surgical nurses be-
cause they have expertise in treating injuries
and diseases”(C78)
“A specialized nurse in internal medicine and
a surgical nursing could respond better. Those
nurses can easily evaluate a victim and can in-
tervene more effectively with their skills and
competencies. The Community nurse would
be most useful in prevention”(CN66)
All nurses are expected to be able to demon-
strate their competencies and skills in a di-
saster scene was the perception of some stu-
dents.
“Allspecialtiesandallnursesareequallyusefuland
important when talking about an entire resident
population affected by a disaster. Individual
needs are special in such circumstances and we
must strive for the best. We ought to be effective
in providing care”(CN21)
“I believe that in a major disaster each spe-
cialty is required for individual reasons and all
nurses are needed and are useful”(CN65)
Discussion
This is an important first study to explore the
views of nursing students in Greece about di-
saster nursing. The way students described
disaster nursing demonstrates that although
they had not covered any formal content relat-
ed to disaster nursing and mass casualty inci-
dents prior to their participation in the current
study, they defined disaster nursing in a satis-
factory way. Through descriptions about their
nursing role in a disastrous event, came in an
agreement with the definition given by the Ja-
pan Society of Disaster Nursing, which was ad-
opted by this study. Students had the opinion
that disaster nursing is the nursing specialty
that is dealing with peoples’health needs dur-
ing a disaster. Nevertheless, only five out of
eighty one students stressed the importance
for psychological support according to Suse-
rud (1993) results, where students illustrated
the mental health needs of the affected pop-
ulation in a much lesser degree. Of particular
concern for nurse educators was the finding
that students felt that they needed to be bet-
ter prepared as well as to be able to provide
health education to individuals and communi-
ties, a finding that was not supported by the
previous studies (Jennings-Saunders, 2005).
When students were asked about the type of
disastercontentinthenursingcurriculum,they
highlighted the need for theoretical knowl-
edge about disasters and they expressed con-
cerns about their role if a disaster occurred.
This finding is similar to that reported by Sala-
zar and Kelman (2002), who indicated the im-
portance of theoretical knowledge to occupa-
tional health nurses in order to be competent
if a biological disaster occurred. Many partici-
pants stressed the need to develop practical
skills regarding triage in mass casualty inci-
dents and having mock disaster drills.
Almost all students expressed that disaster
nursing content should be incorporated in
the nursing curriculum as a mandatory course.
The main reasons given by the students were
that they were feeling unprepared to deal
with a disaster that would cause many casu-
alties. Jennings-Saunders et al (2005) findings
also supported this conclusion but for differ-
ent reasons. Students replied that “disasters
can happen at any time” and that “we are not
immune to a terrorist attack”.
Mostparticipantshadtheopinionthatdisaster
nursing content should be introduced to nurs-
ing students in senior years. Many students felt
that in order to understand a complex content
such as disaster nursing is, they should previ-
ously develop critical thinking, basic nursing
skills and theoretical knowledge. The majority
of the students suggested that disaster nurs-
ing should be incorporated as a mandatory
course, an opinion that supports the percep-
tion that all nurses should develop competen-
cies to deal with a mass casualty incident.
Almost half of the participants expressed that
community health nurses should provide

health care in shelters and home health care
if a major disaster occurred. They also high-
lighted their role as health educators through
preparing individuals and communities about
problems relating to disasters. Perhaps stu-
dents evaluated this role as significant after
experiencing the fires in Peloponnese in 2007
through the mass media, where it seemed that
communities were not prepared for a disaster
of such complexity and magnitude. Although
there was time for evacuation, people did not
know how to behave in order to survive from
the fire. Participants ranked their role as co-co-
ordinators during a disaster at a lesser position
than illustrated in literature (Spellman, 2007),
where nurses’ enduring contribution is neces-
sary in all phases of a disaster in order to be ef-
fective. Triage during a mass casualty incident
was ranked at a high position among the roles
of a community health nurse, although stu-
dents did not cover any related content nei-
ther had any mock disaster drills. This finding
may indicate students’ need to develop skills
and competencies in order to participate as
equal members of the multidisciplinary team,
when responding to a disaster.
Participants had the opinion that communi-
ty health nurses would play the most signifi-
cant role if a major disaster occurred, follow-
ing by the perception that a medical/surgical
nurse would be more effective. Some pointed
out the view that all nurses could help during
a disaster in all phases, which is also support-
ed from the Nursing Emergency Prepared-
ness Education Coalition (Stanley 2005, NEPEC
2003). It’s obvious that students believe that
community health nurses will reduce the im-
pact of a disaster, providing emergency on-
site health care in order to assure that indi-
viduals and community members have access
to safe food and water, identifying infectious
disease threats, contacting immunization pro-
grams in order to restore and promote public
health (Spellman 2007).
Limitations of the study
Although the sample size was satisfactory for
this study, it was performed in only one nurs-
ing school. A further investigation from other
nursing schools in Greece would have provid-
ed a broader understanding of students’ per-
ceptions about disaster nursing. However, the
findings are very useful for future curriculum
development.
Conclusion - Recommendations
Nursing research is limited on disaster nurs-
ing worldwide and this is the first attempt so
far in Greece. It is expected that every research
study, in addition to presenting its findings,
should propose ways of integration into the
reality of education and practice. Results from
this study support the perspective of incorpo-
rating content related to disaster nursing man-
agement into nursing curricula. The context of
disaster nursing should be applicable to the
actual needs of the country’s profile, the le-
gal and regulatory context of the country, and
the preference of existing training programs in
nursing departments (WHO, 2008).This can be
achieved by introducing disaster nursing con-
tent through the community health nursing
course, which is already a mandatory one, or
teaching disaster nursing as an autonomous
course. Nursing students would be better pre-
pared if they could practice during mock di-
saster drills (Ireland et al. 2006) in collabora-
tion with the Hellenic Red Cross and the Hel-
lenic Emergency Care Service.
After incorporating disaster nursing content in
the curriculum, nursing faculties should evalu-
ate the educational approaches in practicing
students and nurses as well as the content re-
garding mass casualty incidents and ensure
that nurses are competent to respond to pub-
lic health emergencies.
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Abstract
Introduction: Nursing occupation belongs to
high risk occupations concerning the occurrence
of occupational diseases. Nurses are often
exposed in chemical allergy agents or irritant
substances, in biological fluids and others.
Aim: To determine clinical events in nurses
after their contact with allergy agents or irritant
substances and moreover to identify the
appropriate preventive measures.
Methodology: A literature review was conduct-
ed in databases Medline, Embase, Scopus, Cinahl
and IATRONET, using the following index words:
allergy, allergy agents, irritant substances, nurs-
es, risk factor, latex, dermatitis, prevention, pre-
ventive measures και exposure.
Results: The clinical manifestations following
contact with allergy agents or irritant substances
are the following: (a) skin irritation or contact
dermatitis, (b) eye irritation, (c) allergic reaction
and (d) irritation of the respiratory system.
Contact dermatitis is the skin illness with the
higher frequency of occurrence in nurses. The
most frequent allergic reactions in nurses are
allergic rhinitis, allergic asthma, skin allergic
reactions, allergic conjunctivitis and anaphylaxis.
Meansofindividualprotectionincludeprotective
clothes and equipment
Conclusions: In Greece, nurses’ safety is
neglected in a large extent. Acquaintance with
danger is the biggest problem in hospitals.
Before the application of means of individual
protection, knowledge of risks and training of
nurses are required. Also, before the purchase of
measures of protection, knowledge of standards
is required. Prevention of occupational risks
with means of individual protection improves
effectiveness of both nurses and hospitals.
Keywords: allergy, allergy agents, dermatitis,
irritant substances, prevention
REVIEW
Nurses’ exposure in allergy agents or irritant
substances. Preventive measures
Angeliki Bilali1, Xara Sidiropoulou2, Petros Galanis3
1 RN, MSc, PhD, General Children’s Hospital “Panagiotis Aglaia Kyriakou”, Athens
2 Midwife, MSc(c), General Children’s Hospital “Panagiotis Aglaia Kyriakou”, Athens
3 RN, MSc, PhD, Center for Health Services Management and Evaluation, University of
Athens, Faculty of Nursing, Athens
Corresponding author: Petros Galanis
Address: Dikis 14, P.C. 15773, Athens
Phone number: (210) 7781044, 6944387354
e-mail: pegalan@nurs.uoa.gr
Ημερομηνία υποβολής: 16/07/2012

76
Περίληψη
Εισαγωγή: Ο Συστηματικός Ερυθηματώδης Λύ-
κος (ΣΕΛ) είναι ένα χρόνιο αυτοάνοσο νόσημα
που χαρακτηρίζεται από υφέσεις και εξάρσεις.
Η εισαγωγή νέων θεραπευτικών μεθόδων στην
αντιμετώπιση του ΣΕΛ και η μείωση της θνητότη-
τας, οδήγησαν στη χρονιότητα της νόσου. Σκο-
πός της εργασίας ήταν η διερεύνηση των παρα-
γόντων που επηρεάζουν τη Σχετιζόμενη με την
Υγεία Ποιότητα Ζωής (ΣΥΠΖ) των ατόμων με
ΣΕΛ. Μεθοδολογία: Η παρουσίαση των ευρημά-
των γίνεται με βάση το κλασικό θεωρητικό πρό-
τυπο ερμηνείας της ΣΥΠΖ που δίνει έμφαση στην
πολυδιάστατη φύση της.
Αποτελέσματα: Στις περισσότερες μελέτες φά-
νηκε ότι η κόπωση, το άγχος και η κατάθλιψη
,αλλά και η λειτουργικότητα στον κοινωνικό και
επαγγελματικό τομέα, επηρεάζουν όλες τις δια-
στάσεις της ΣΥΠΖ των ατόμων με ΣΕΛ. Επίσης, η
παρουσία της ενεργού νόσου επηρεάζει ελάχι-
στα ή καθόλου την Ποιότητα Ζωής (ΠΖ).
Συμπέρασμα: Για τους επαγγελματίες υγείας εί-
ναι σημαντικό να λαμβάνουν υπόψη όλους τους
παράγοντες που αλληλεπιδρούν μεταξύ τους και
επηρεάζουν την ΠΖ, προκειμένου να αναπτύσ-
σουν σχέδια φροντίδας και να οργανώνουν απο-
τελεσματικές παρεμβάσεις για την αντιμετώπιση
των βιολογικών, ψυχολογικών, συναισθηματικών
και κοινωνικών προβλημάτων των ασθενών με
ΣΕΛ.
ΛΕΞΕΙΣ ΚΛΕΙΔΙΑ: Συστηματικός Ερυθηματώ-
δης Λύκος, ποιότητα ζωής, βιολογικοί και ψυχο-
κοινωνικοί παράγοντες, λειτουργικότητα
ΑΝΑΣΚΟΠΗΣΗ
Abstract
Background: Systemic Lupus Erythematosus
(SLE) is a chronic, autoimmune disease
characterized by recessions and elations. The
introduction of new treatments of SLE and the
reduction of mortality have led to the chronicity
of the disease. The purpose of this paper was
to explore the factors which affect the Health -
Related Quality of Life (HRQL) of the individuals
suffering from the SLE.
Methods:Thepresentationofthefindingsisdone
using a casual pathway model interpreting HRQL
that puts emphasis on the multi-dimensional
nature of the HRQL.
Results: Most researches have concluded
that fatigue, stress, depression as well as the
functionality in the social and professional
context affects the HRQL of the patients suffering
from SLE. In addition, the presence of active
disease has a minimal or no effect on the HRQL.
Conclusion: It is important for the health
professionals to take into consideration all the
factors that interact and affect HRQL in order to
develop patient care plans and design effective
interventions and to manage the biological,
psychological, emotional and social problems of
the SLE suffering patients.
KEYWORDS: Systemic Lupus Erythematosus,
quality of life, physical and psychosocial factors,
functionality.
REVIEW
Quality of life in patients with systemic lupus
erythematosus: A literature review
BRIEF TITLE: Quality of life in SLE
Evgenia1 Minasidou, Thalia2 Bellali
1Clinical Lecturer, “Alexander” Technological Educational Institute of Thessaloniki
2 Αssosiate Professor, Nursing Department, “Alexander” Technological Educational Institute
of Thessaloniki
Corresponding Author: Evgenia Minasidou
G. Tsontou 3-5, 54629, Thessaloniki E mail: eminasid68@gmail.com

ORIGINAL PAPER
Abrstract
Aim: To describe “PROMETHEUS’’ (Intel. Prop.
ref.numb.:9796) hardware, software, process
and service in organ transplantation (OT) and
applies the quality control, on a feasibility and
reliability level, using Renal Transplantation (RT)
as a quality control model. Material Methods:
Feasibility and reliability of‘’PROMETHEUS’’in the
Coordination Process (CP) of OT assessed by forty
participants (n=40) who were divided in two
groups, the specialists and the non specialists
and comparatively simulated the telephone/
fax and the “PROMETHEUS’’ based (CP) of a RT
scenario. To determine feasibility and reliability
of the integrated Tele-Radiological (TRE) and
Tele-Pathological (TPE) evaluation of Grafts on
“PROMETHEUS’’, by a simulation of the TRE of
RG on 15 MR abdominal images by a radiologist
and of theTPE of on 130 human RG images by 26
specialists damages and lesions were assessed.
Results: There was no statistically significant
difference between the two groups regarding
feasibility and reliability of “PROMETHEUS’’ in CP.
Both groups found “PROMETHEUS’’ feasible and
reliableinallaspectsofCPwhilespecialistsfound
it significantly more reliable in the fulfillment of
all medico-legal requirements of OT (p=.007).The
integrated analysis of TRE and TPE of RG showed:
Sensitivity= 96.7%, Specificity=100% and
Accuracy=97.6%. Conclusion: “PROMETHEUS’’
seems to be a feasible and reliable novel medical
instrument in the CP and in the procurement
phase of OT: a. for minimization of the rate of
damaged organs, b. for prevention of improper
grafts from being retrieved and/or sent to the
recipienthospitalandc.forpreoperativedecision
support and transplant planning.
KEYWORDS:Telemedicine,CoordinationinOrgan
Transplantation, Tele-Radiology, Tele-Pathology,
Renal Transplantation.
“PROMETHEUS’’: A Novel Portable Medical
Instrument Applied in Organ Transplantation.
Dr Constantinos St. Mammas MD MSc PhD *
Surgeon
*Communication: Dr Constantinos St. MAMMAS MD, MSc, PhD, Surgeon,
VasSofias 92, 11528, Athens, HELLAS, tel:00302107773605, e-mail: csmammas@
med.uoa.gr.
Introduction
“PROMETHEUS’’ is a novel powerful and cus-
tomizable medical instrument invented, de-
signed, developed and tested by Dr Constanti-
nos St. Mammas (Intellectual Property: Refer-
ence Number 9796 and published in the Hellenic
Industrial Association Year Innovation Book ref.
numb.:6286).“PROMETHEUS’’is an integration of
PC and tele-communication unit providing doc-
tors and nurses with patient’s medical record,
video-conference utilities, voice, digital white-
board facilities, application sharing capabilities
and with graft’s digital macroscopic and radio-
logical images captured and transmitted in the
context of transplant coordination and organ
procurement of Adult and Children Organ Trans-
plantation (OT). The rational for the design, pro-
duction and application of“PROMETHEUS’’to the
current transplant coordination and procure-
ment architecture of OT is to provide a system-
atic ‘’projection’’method for determining appro-
priate remote assessment of the donor, interven-
tion and evaluation of the donor and the graft

78
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E-MAIL: ekdoseis.ocelotos@gmail.com
www. ocelotos. gr
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