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    Exposure of nursing trainees to aggressive behavior and influence on health outcomes and their choice of work environment
    (Maltepe Üniversitesi, 2020) Ilieva, Joana; Ilieva, Vyara; Valchanova, Radka Dolova
    Introduction: Nurses in their daily work are subjected to insults, threats, verbal or physical aggression. Aggressive behaviour in the workplace is a prerequisite for creating adverse working conditions that affect the health and well-being of workers. In healthcare settings, the aggressor may be external or internal, a patient or a relative. The working trainees, as part of the medical team, are also in direct contact with the patients and daily witnesses to aggressive behaviour. They face not only verbal aggression but also the imminent threat of physical abuse, a prerequisite for the development of emotional reactions such as anger, anxiety, helplessness, sadness and depression. Exposing nurse trainees to aggressive behaviour, tension, and anxiety is essential to their choice of workplace. Objective: The purpose of this project is to investigate the frequency and nature of violence and aggression in the work process and their impact on the trainees’assessment of starting work for a medical structure. Material and Methods: The opinion of trainees in the speciality “nurse” from MU-Varna was examined through a direct anonymous survey. The questionnaire contains 12 questions. The data was processed by statistical and graphical analysis. Results and Discussion: The results of the analyzes show that 40% of the respondents witnessed aggressive behaviour in the hospital environment, with approximately 30% referring to them. As a consequence of the aggressive behaviour, the choice of the work environment for students are also affected, with 25% preferring to work in a department where communication is not a priority concern, and approximately 17% do not want to work with elderly patients -prefer to work with children . Conclusions: A significant part of the respondents is regularly in an aggressive working environment. Aggression can be the result of various causes such as personality traits, incorrect assessment of the situation, various objective and subjective reasons. No matter who the aggressor is and what the behaviour is (physical or verbal aggression), it is a prerequisite for creating adverse working conditions. Part of the students regularly encounters aggression, which is a factor in the choice of the work environment.
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    Significance of palliative care in patients with cardiovascular diseases and the key role of the nurse
    (Maltepe Üniversitesi, 2019) Ilieva, Joana; Ilieva, Vyara; Georgieva, Yanita
    SUMMARY: Palliative care aims to achieve the best possible quality of life for patients and their families by focusing on reducing and preventing suffering. Palliative medicine uses a multidisciplinary approach, which allows palliative care teams to meet the patient’s needs. Nurses play a key role in the use of palliative care, by possessing the necessary competencies and professional skills. Cardiovascular diseases are the leading cause of mortality and disability worldwide. The data shows that in Bulgaria every 2 out of 3 people die from cardiovascular diseases. GOAL: The aim of this report is to highlight the importance of palliative care in patients with cardiovascular diseases and the role of the nurse in improving the quality of life. Material and methods: A documentary method has been used to identify the need for palliative care in patients with cardiovascular disease. A study has been conducted based on the WHO database, regarding the access to palliative care, as well as a prognosis on cardiovascular-related mortality for the period of 2015-2030. RESULTS AND DISCUSSION: Palliative care places emphasis on relieving pain and other symptoms, integrating the mental, spiritual and social aspects of care. The results of the analyses show that approximately 40 million people each year need palliative care, only 14% receive them, and 83% of the world’s population has no access to painkillers. Of these 40 million, 39% have cardiovascular diseases. In Bulgaria, more than 62-65% of mortality is cardiovascularrelated and cancers. A significant portion of these patients needs palliative care. The nurse has a place in this process when monitoring the patient’s condition, including assessing the pain and other symptoms. CONCLUSIONS: The global need for palliative care will continue to grow as a result of the increase in non-infectious diseases and the aging population. Early palliative care reduces the risk of complications and the need for frequent hospitalizations. It is necessary to overcome a number of barriers to not only administer palliative care in the provided health facilities but also in the patient’s home in order to improve the quality of life of those in need.