Beykent 2nd International Health Sciences Research Days Congress 8-10 November 2019 Plovdiv/Bulgaria

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BEYKENT 2ND INTERNATIONAL HEALTH

SCIENCES RESEARCH DAYS CONGRESS

8-10 NOVEMBER 2019 PLOVDIV/BULGARIA

ABSTRACT BOOK

Prof. Dr. Aysegul Yildirim Kaptanoglu e-ISBN: 978-975-6319-39-0

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FRIDAY 8 NOVEMBER 2019

syndrome clinical case Dr. Nevena Ivanova, (MD Specialist in Cardiology and General Medicine, Lecturer in General Medicine in the Department of Urology and General Medicine, Medical University Plovdiv Cardiologist at the Hospital “St. Caridad ")

Pediatric Practice in a Society Experiencing Population Decline and Disaster: The Roles of Telemedicine and Telecare

Prof. OYAMA Kotaro, MD, PhD (Professor and Chair Department of Pediatrics, Iwate Medical University School of Medicine) Requirements, Opportunities and

Challenges in Applying Technological Solutions in Palliative Care of Frail Older Adults

Assoc. Prof. BAMIDIS Panagiotis (Aristotle University of Thessaloniki, Greece & LIME, University of Leeds, UK)

Modern Hospice, Palliative Care and Symptom Palliation: what are the differences among them?

Prof. Paul KAZUNARI ABE (Chiba

Prefectural University of Health Sciences, Department of Rehabilitation)

Investigation of the Relationship Between Health Employees’ Perception of Work Load and Medical Error Attitudes

Assist. Prof. Ismail SECER (Beykent University) and Eda CEYLAN (Beykent University)

Measurement of Patients’ Perception Levels on Physician Emphatics Case of Special Hospitals

Lec. Emir Hasan OLMEZ (Beykent

University) and Prof. Dr. Aysegul YILDIRIM KAPTANOGLU (Beykent University)

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SATURDAY 9 NOVEMBER 2019

Palliative Care Management for Children Prof. Dr. Oguz OZYARAL (Istanbul Rumeli University) and Lec. Halil DEMIR (Istanbul Rumeli University)

Classical Composers’s Music Creativity and Their Ilnesses

MALINOVA Mal. (AMDFA Plovdiv), Prof. MALINOVA M. (Medical University Plovdiv-Bulgaria)

Medical errors in palliative care Prof. KOVACEVIK Katerina, MD, PhD Euthanasia in the Elderly KOURKOUTUA Lambrini (Alexander

Technological Educational Institute of Thessaloniki), FRANTZANA Aikaterini (European University of Cyprus)

Transplantations in the Elderly TSALOGLIDOU Areti (Alexander Technological Educational Institute of Thessaloniki)

Families of Patients in ICU: Their Needs and Satisfaction with Care

KOUKOURITOS Konstantinos ( Alexander Technological Educational Institute of Thessaloniki)

20.00 Welcome Reception

Time Theme

09.00-12.30 Clinical Issues in Palliative Care

Uncontrolled Cancer Pain as an Indication for Emergency Hospitalization in Palliative Care Department of Comprehensive Cancer Center-Vratsa

Assos. Prof. YORDANOV N, MD, PhD (Complex Oncology Center –Vratsa, MU-Pleven)

Angelini symposium: Patient Centered Treatment of Break through Pain

Prof. DESPOTOVA-TOLEVA L. MD, PhD

Can we teach Compassion? Prof. KHAN Anwar (Clinical Chair and Director of Research & Education-Waltham Forest CCG, Churchill Medical Center)

The Effectiveness of UPOINT-Guided Multimodal Therapy in Turkish Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: a Primiraly Outcomes

Lec. Muhsin BALABAN (Biruni University) and Prof. Dr. Aysegul YILDIRIM KAPTANOGLU (Beykent University)

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10.30-11.00 Coffee Break

Prevention, Diagnosis and Management of Iatrogenic Injuries to the Urinary System

KADIM M., MD, PhD, Prof. DECHEV I., MD, PhD (Pepartment of Urology and General Medicine, Medical University Plovdiv-Bulgaria, Clinic of Urology Multiprofile Medical University Hospital for Active Treatment “St. George”, Plovdiv)

Improvement of Serum Testosterone after Varicocelectomy in Infertile Men

Prof. DECHEV I., ANTONOV P., KALINOV D., GORANOV T. (Department of Urology and General Medicine, Medical University Plovdiv-Bulgaria, Clinic of Urology Multiprofile Medical University Hospital for Active Treatment “St. George”, Plovdiv) Pallitive Care for Patients with

Metastatic Prostate Cancer

P. ANTONOV, I. DECHEV, R. RALEVA (Department of Urology and General Medicine, Medical University Plovdiv-Bulgaria, Clinic of Urology Multiprofile Medical University Hospital for Active Treatment “St. George”, Plovdiv) On Some Aspects of Long-term Care in

Patients with Vascular Pathology

CHESHMEDJIEVA B. MD. PhD

Comparison of Daily Life Skills of Patients with Right Hemiparasia and Left Hemiparasia after Stroke

Lect. Guler BUYUKYILMAZ and Prof. Dr. Oguz OZYARAL, Eda ERDOGDU (Istannbul Rumeli University)

Evaluation of Orthodontic Malocclusion Risk Factors of 7 to 12 years old Turkish Children on OPTG Films

Assist. Prof. Sirin HATIPOGLU (Beykent University)

To study the Effect of the Static Equilibrium in Tennis Calisthenic

Lec. Mutlu URAL, Dr. Ahmet GONENER and Prof. Dr. Oguz OZYARAL (Istanbul Rumeli University)

12.30-14.00 Lunch

14.00-15.00 Nutrition and Dietetics

Nutritional Threatment in Palliative Care: Literature Review Lecture

Lec. Irem DURCEK, Lec. Esra SIK, Res. Asst. Funda GARGACI, Lec. Sehriban Gul OZCELIK (Beykent University)

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Nutritional Knowledge and Eating Behavior Among Male Football Players: A Qualitative Study

Assoc. Prof. Turabi YERLI, Lec. Irem DURCEK, Res. Asst. Funda GARGACI (Beykent University), Gulsah COK (Istanbul University)

The Comparison of Dietary Quality and Physical Activity on Ramadan Fasting

Res. Asst. Funda GARGACI, Assoc. Prof. Nihal Zekiye ERDEM (Medipol

University, Health Sciences Institute) Gerson therapy: Positive and Negative

Reviews in the Treatment of Cancer Patients

STAYKOVA-PIROVSKA Y. MD, PhD

15.00-19.30 Palliative Care Nursing

Use of Biosensors in Nursing: Systematic Review

Lec. Hamiyet KIZIL and Lec. Meryem YILDIZ AYVAZ (Beykent University) Evaluation of the Problems of

Gynecologic Oncology Patients While Receiving Care

Assoc. Prof. Hulya ERBABA, Lec. Hamiyet KIZIL, Lec. Meryem YILDIZ AYVAZ, Lec. Behice Belkis CALISKAN, (Beykent University)

Evaluation of Studies on Increasing the Motivation of Gynecologic Oncology Patients’ Caregivers

Assoc. Prof. Hulya ERBABA, Lec. Meryem YILDIZ AYVAZ, Lec. Behice Belkis CALISKAN, Lec. Hamiyet KIZIL (Beykent University)

Palliative Care at Home for a Patient with End-Stage Nasopharyngeal Carcinoma: A Case Report

Ms Yuki HOSOTANI, Physiotherapist

16.30-17.00 Coffee Break

Evidence-based Physiotherapy and Rehabilitation Practices in Palliative Care

Lec. Yasemin KARAASLAN, Lec. Mehmet Eren UCUZOGLU, Lec. Ozge TAHRAN, Assist. Prof. Suheyl POZANTI (Beykent University)

Home-based Palliative Care in Japan Ms Yoko FUJIWARA, MD. (The Homecare Clinic Sapporo) Palliative Approach to Oral Care Prim. SUKRIEV Ljubin Communication in Palliative Care TUNDZEVA Marta, MD, PhD From Cancer Rehabilitation to Palliative

Care: a Case Report

Ms Chigusa NAKA, Physiotherapist

The Role of the Palliative Care Team in Saiseikai Otaru Hospital

Ms Tomoyo HAYASHI, Occupational therapist

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SUNDAY 10 NOVEMBER 2019

in our Hospital

Ms Yuka YAMANAKA, Occupational therapist

Disaster into the Emergency Ward: How to triage the Patients on Long-term treatment during the disastrous event

ATLIEV K. (Medical University-Plovdiv)

Patients on long term treatment disaster preparedness

Assoc. Prof. KOSTADINOV R. (Medical University Plovdiv)

20.00 Dinner

09.00-12.30 Palliative Care Management

Importance of Palliative Health Care Management in Primary Care

Assist. Prof. Suheyl POZANTI, Lec. Aykut CAKIR, Lec. Yasemin KARAASLAN, Lec. Mehmet Eren UCUZOGLU (Beykent University) New Perspectives on modelling of

palliative-care management

Prof. Dr. Oguz OZYARAL, Lec. Halil DEMİR, Haktan CAKMAK (Istanbul Rumeli University)

Performance Based Wage System in Health Institutions

Lec. Halil DEMIR, Prof. Dr. Oguz OZYARAL (Istanbul Rumeli University), Lec. Ismail BICER (Istanbul Arel

University) and Esra DEMIR (Istanbul University)

Cost of Delivering Health Care Services at Primary Health Facilities

Lec. Alpaslan MERT and Prof. Dr. Aysegul YILDIRIM KAPTANOGLU (Beykent University)

12.30-14.00 Lunch

14.00-17.00 Communication, Ethics, Art and Other Palliative Care Iıssues The Effect of Heathcare Program on TV Assist. Prof. Musfik AKARCAN, Prof.

Dr. Oguz OZYARAL (Istanbul Rumeli University)

Social Media Use in Palliative Care Assist. Prof. Suheyl POZANTI (Beykent University), Aysel YUGRUK UCAR (Kanuni Sultan Suleyman Research and Training Hospital)

Breaking Bad News in Palliative Care Res. Asst. Okan Anil AYDIN, Res. Asst. Cisem BASTARCAN, Prof. Dr. Aysegul YILDIRIM KAPTANOGLU (Beykent University)

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Ethical Sensitivity of Health Students and Affecting Factors

Lec. Meryem YILDIZ AYVAZ, Ozge Eda YILMAZ, Assist. Prof. Gunes BOLATLI (Beykent University)

Effect of Media Literacy on Choice of Profession in Health Science Students

Assist. Prof. Hatice Dilek DOGAN, Res. Asst. Cisem BASTARCAN (Beykent University)

The Biopsychosocial Syndrome in Cancer. Supporting the family. Part I

MIHAILOVAV., LYOCHKOVA M., ALAKIDI A., VODENICHAROV V. Camera System and Privacy: Privacy

Principle Ambulance Cabin

Temel KILINCLI, Prof. Dr. Aysegul YILDIRIM KAPTANOGLU (Beykent University)

Evaluation of the Effect of Dark Triad on Motivation and Conflict of Interest in Hospitals

Assoc. Prof. Emre ISCI (Marmara University), Assoc. Prof. Secil TASTAN (Health Manager), Elif Busra SULUMEN and Prof. Dr. Aysegul YILDIRIM

KAPTANOGLU (Beykent University)

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Beykent 2nd International Health Sciences Research Days Congress

8-10 November 2019 Plovdiv/ Bulgaria

ORGANIZATION COMMITTEE

CONGRESS HONORARY PRESIDENT Prof. Dr. Murat Ferman - Beykent University Rector

CONGRESS PRESIDENT

Prof. Dr. Aysegul Yildirim Kaptanoglu - Beykent University

MEMBERS OF THE ORGANISATION COMMITTEE Prof. Dr. Aysegul Yildirim Kaptanoglu

Prof. Lyubama Despotova Toleva Prof. Paul Kazunari Abe

Prof. Shlomo Vinker Assoc. Prof. Panagiotis Bamidis

Assist. Prof. Ismail Secer Assist. Prof. Suheyl Pozanti

Lec. Hamiyet Kizil Lec. Meryem Yildiz Ayvaz

Lec. Irem Durcek

CONGRESS SECRETARY Asst. Res. Okan Anil Aydin Asst. Res. Cisem Bastarcan

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ADVISORY COMMITTEE

Prof. Bulent Katipoglu, Beykent University, Istanbul /Turkey Prof. Burak Omur Cakir, Beykent University, Istanbul /Turkey Prof. Cetin Ayhan Evliyaoglu, Beykent University, Istanbul /Turkey

Prof. Emre Isci, Marmara University, Istanbul / Turkey

Prof. Lambrini Kourkouta, Alexander Technological Educational Institute, Thessaloniki / Greece

Prof. Katerina Kovacevik, University of Belgrade, Belgrade / Serbia

Prim. Ljubin Sukriev, Association of general practice/family medicine of South-East Europe, Skopje / Macedonia

Prof. Anwar Khan, University of Buckingham, London / UK

Prof. Dr. Nikolay Yordanov, Interregional Cancer Hospital, Sofia-Vratsa / Bulgaria

SCIENTIFIC COMMITTEE

Prof. Aysegul Yildirim Kaptanoglu, Beykent University, Istanbul / Turkey Prof. Lyubama Despotova Toleva, Medical University, Plovdiv / Bulgaria

Prof. Shlomo Vinker, Tel Aviv University, Tel Aviv / İsrael Prof. Kotaro Oyama, Iwate Medical University, Morioka / Japan

Prof. Paul Kazunari Abe, Chiba Prefectural University of Health Sciences, Chiba / Japan Prof. Oguz Ozyaral, Istanbul Rumeli University, Istanbul / Turkey

Prof. Maria Malinova, Medical University, Plovdiv / Bulgaria Prof. Katerina Kovacevik, University of Belgrade, Belgrade / Serbia

Prof. Lambrini Kourkouta, Alexander Technological Educational Institute, Thessaloniki / Greece

Prof. Areti Tsaloglidou, Alexander Technological Educational Institute, Thessaloniki / Greece Prof. Koukouritos Konstansinos, Alexander Technological Educational Institute, Thessaloniki

/ Greece

Prof. Anwar Khan, University of Buckingham, London / UK

Prim. Ljubin Sukriev, Association of general practice/family medicine of South-East Europe, Skopje / Macedonia

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Prof. Despina Sapountzi-Krepia, Frederick University, Nicosia / Cyprus Prof. Ed Jacobs, West Virginia University, West Virginia / United States of America Prof. Elizabeta Popova-Ramova, University “St. Kliment Ohridski”, Bitola / Republic of

Macedonia

Prof. Ramazan Erdem, Suleyman Demirel University, Isparta / Turkey Prof. Rehat Faikoglu, Arel University, Istanbul / Turkey

Prof. Stela Georgieva, Medical University Pleven, Pleven / Bulgaria Prof. Kataro Oyama, Iwate Medical University, Morioka / Japan Prof. Maria Malinova, Medical University Plovdiv, Plovdiv / Bulgaria Assoc. Prof. Esra Karaca Ciftci, Beykent University, Istanbul / Turkey

Assoc. Prof. Emre Isci, Marmara University/ Istanbul / Turkey Assoc. Prof. Erkut Altindag, Beykent University, Istanbul / Turkey

Assoc. Prof. Isam Denna, Bingazi University, Bingazi / Libya

Assoc. Prof. Silviya Aleksandrova-Yankulovska, Medical University Pleven, Pleven / Bulgaria

Assoc. Prof. Panagiortis Bamidis, Aristotle University of Thelassaloniki, Thelassaloniki / Greece

Assoc. Prof. Rostislav Kostadinov, Medical University Plovdiv, Plovdiv / Bulgaria Assoc. Prof. Volkan Ongel, Beykent University, Istanbul / Turkey

Assist. Prof. Hassan Salman Mirza, Sultan Qaboos University, Muscat / Oman Assist. Prof. Ismail Secer, Beykent University, Istanbul / Turkey Assist. Prof. Necati Findikli, Beykent University, Istanbul / Turkey

Assist. Prof. Rebecca Spirito Dalgin, Scranton University, Scranton / United States of America

Assist. Prof. Suheyl Pozanti, Beykent University, Istanbul / Turkey Assist. Prof. Müsfik Akarcan, Rumeli University, Istanbul / Turkey

Assist. Prof. Turabi Yerli, Beykent University, Istanbul / Turkey Assist. Prof. Hatice Dilek Dogan, Beykent University, Istanbul / Turkey

Assist. Prof. Hulya Erbaba, Beykent University, Istanbul / Turkey Assist. Prof. Yasemin Karaaslan, Beykent University, Istanbul / Turkey

Assist. Prof. Mehmet Akman, Beykent University, Istanbul / Turkey Assist. Prof. Ulku Demirci, Beykent University, Istanbul / Turkey

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KEYNOTE SPEAKERS

Prof. Aysegul Yildirim Kaptanoglu, Beykent University, Istanbul / Turkey Prof. Lyubama Despotova Toleva, Medical University, Plovdiv / Bulgaria

Prof. Oguz Ozyaral, Istanbul Rumeli University, Istanbul / Turkey Prof. Anwar Khan, University of Buckingham, London / UK

Prim. Dr. Ljubin Sukriev, Association of general practice/family medicine of South-East Europe, Skopje / Macedonia

Prof. Dr. Paul Kazunari Abe, Chiba Prefectural University of Health Sciences, Chiba / Japan Prof. Maria Malinova, Medical University Plovdiv, Plovdiv / Bulgaria

Prof. Areti Tsaloglidou, Alexander Technological Educational Institute, Thessaloniki / Greece Aikaterini Frantzana, European University, Nicosia / Cyprus

Prof. Lambrini Kourkouta, Alexander Technological Educational Institute, Thessaloniki / Greece

xii WELCOME TO BHSRDC 2019 Dear Colleagues;

We are honored to announce that the Beykent 2nd International Health Sciences Research Days Congress will be held at Medical Universityof Plovdiv – Plovdiv between November 8-10, 2019 and invite you to this scientific meeting.

Beykent 2nd International Health Sciences Research Days Congress provides an ideal academic platform for health researchers to present the latest developments, research findings, ideas and applications about all aspects of health science and health culture. The purpose of this conference is to come together with scientific studies scholars working in different health care disciplines, to exchange knowledge and experiences and thus to prepare the ground for multidisciplinary health care studies. The conference will bring together leading health academic scientists, researchers and scholars in the domain of interest from around the world.

You are kindly invited to participate and take advantage of the opportunity to present your unpublished abstracts or/and full length health scientific papers.

We invite you to the scientific and social program Beykent 2nd International Health Sciences Research Days Congress with the your valuable contributions. Your submissions will be most welcome and your particular contributions highly appreciated. The hosts shall spare no effort in making your participation scientifically rewarding and meaningful and your stay in Istanbul as enjoyable as possible. We are confident that you will carry pleasant memories of this occasion. So just reserve your dates; we are looking forward to welcoming you in Bulgaria. Kind Regards…

Prof. Dr. Aysegul YILDIRIM KAPTANOGLU Congress President

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CONTENTS

PLENARY SESSION

P-01 Update on palliative care – Lyubama DESPOTOVA-TOLEVA ... 1 P-02 Chemotherapy and acute coronary syndrome clinical case - Nevena IVANOVA ... 2 P-03 Pediatric Practice in a Society Experiencing Population Decline and Disaster: The Roles of Telemedicine and Telecare - Kotaro OYAMA ... 3 P-04 Evaluation of the Effect of Dark Triad on Motivation and Conflict of Interest in Hospitals - Emre ISCI, Secil TASTAN, Elif Busra SULUMEN and Aysegul YILDIRIM KAPTANOGLU ... 4 P-05 Modern Hospice, Palliative Care and Symptom Palliation: what are the differences among them? Paul KAZUNARI ABE ... 5 P-06 Investigation of the Relationship Between Health Employees’ Perception of Work Load and Medical Error Attitudes - Ismail SECER and Eda CEYLAN ... 6 P-07 Measurement of Patients’ Perception Levels on Physician Emphatics Case of Special Hospitals - Emir Hasan OLMEZ and Aysegul YILDIRIM KAPTANOGLU ... 7 P-08 Palliative Care Management for Children - Oguz OZYARAL and Halil DEMIR ... 8 P-09 Classical Composers’s Music Creativity and Their Ilnesses – Mal. MALINOVA, M. MALINOVA ... 9 P-10 Medical errors in palliative care - Katerina KOVACEVIKJ ... 10 P-11 Euthanasia in the Elderly - Lambrini KOURKOUTUA and Aikaterini FRANTZANA11 P-12 Transplantations in the Elderly - Areti TSALOGLIDOU ... 12 P-13 Families of Patients in ICU: Their Needs and Satisfaction with Care – Konstantinos KOUKOURITOS ... 13 CLINICAL ISSUES IN PALLIATIVE CARE

P-14 Uncontrolled Cancer Pain as an Indication for Emergency Hospitalization in Palliative Care Department of Comprehensive Cancer Center-Vratsa - N. YORDANOV ... 14 P-15 Angelini symposium: Patient Centered Treatment of Break through Pain - Prof. Lyubama DESPOTOVA-TOLEVA ... 15 P-16 Can we teach Compassion? - Anwar KHAN ... 16 P-17 The Effectiveness of UPOINT-Guided Multimodal Therapy in Turkish Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: a Primiraly Outcomes - Muhsin BALABAN and Aysegul YILDIRIM KAPTANOGLU ... 17 P-18 Prevention, Diagnosis and Management of Iatrogenic Injuries to the Urinary System – M. KADIM, I. DECHEV ... 18 P-19 Improvement of Serum Testosterone after Varicocelectomy in Infertile Men – Ivan DECHEV, Peter ANTONOV, D. KALINOV, T. GORANOV ... 19

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P-20 Pallitive Care for Patients with Metastatic Prostate Cancer - Peter ANTONOV, Ivan

DECHEV, Rosista RALEVA ... 20

P-21 Camera System and Privacy: Privacy Principle Ambulance Cabin - Temel KILINCLI, Aysegul YILDIRIM KAPTANOGLU ... 21

P-22 Comparison of Daily Life Skills of Patients with Right Hemiparasia and Left Hemiparasia after Stroke - Guler BUYUKYILMAZ, Oguz OZYARAL, Eda ERDOGDU ... 22

P-23 Evaluation of Orthodontic Malocclusion Risk Factors of 7 to 12 years old Turkish Children on OPTG Films - Sirin HATIPOGLU ... 23

P-24 To study the Effect of the Static Equilibrium in Tennis Calisthenic - Mutlu URAL, Ahmet GONENER, Oguz OZYARAL ... 24

NUTRITION AND DIETETICS P-25 Nutritional Threatment in Palliative Care: Literature Review - Irem DURCEK, Esra SIK, Sehriban Gul OZCELIK ... 25

P-26: NUTRITIONAL KNOWLEDGE AND EATING BAHAVIOR AMONG MALE FOOTBALL PLAYERS; A QUALITATIVE STUDY Turabi YERLI, Funda GARGACI, İrem DURCEK, Gülsah COK……….………..26

P-27 The Comparison of Dietary Quality and Physical Activity on Ramadan Fasting - Funda GARGACI, Nihal Zekiye ERDEM ... 27

P-28 The Biopsychosocial Syndrome in Cancer. Supporting the family. Part I – V. MIHAILOVA, M. LYOCHKOVA, A. ALAKIDI, V. VODENICHAROV ... 28

PALLIATIVE CARE NURSING P-29 Use of Biosensors in Nursing: Systematic Review - Hamiyet KIZIL and Meryem YILDIZ AYVAZ ... 29

P-30 Evaluation of the Problems of Gynecologic Oncology Patients While Receiving Care - Hulya ERBABA, Hamiyet KIZIL, Meryem YILDIZ AYVAZ, Behice Belkis CALISKAN ... 31

P-31 Evaluation of Studies on Increasing the Motivation of Gynecologic Oncology Patients’ Caregivers - Hulya ERBABA, Meryem YILDIZ AYVAZ, Behice Belkis CALISKAN, Hamiyet KIZIL ... 32

P-32 Palliative Care at Home for a Patient with End-Stage Nasopharyngeal Carcinoma: A Case Report - Yuki HOSOTANI ... 34

P-33 Evidence-based Physiotherapy and Rehabilitation Practices in Palliative Care - Yasemin KARAASLAN, Mehmet Eren UCUZOGLU, Ozge TAHRAN, Suheyl POZANTI ... 35

P-34 Home-based Palliative Care in Japan - Yoko FUJIWARA ... 36

P-35 Palliative Approach to Oral Care - Ljubin SUKRIEV ... 37

P-36 Communication in Palliative Care - Marta TUNDZEVA ... 38

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P-38 The Role of the Palliative Care Team in Saiseikai Otaru Hospital - Tomoyo HAYASHI... 40 P-39 Occupational Therapy for Palliative Care in our Hospital - Yuka YAMANAKA ... 41 P-40 Disaster into the Emergency Ward: How to triage the Patients on Long-term treatment during the disastrous event – Kiril ATLIEV ... 42 P-41 Patients on long term treatment disaster preparedness – R. KOSTADINOV ... 43 PALLIATIVE CARE MANAGEMENT

P-42 Importance of Palliative Health Care Management in Primary Care - Suheyl POZANTI, Aykut CAKIR, Yasemin KARAASLAN, Mehmet Eren UCUZOGLU ... 44 P-43 New Perspectives on modelling of palliative-care management - Oguz OZYARAL, Halil DEMIR, Haktan CAKMAK ... 45 P-44 Performance Based Wage System in Health Institutions - Halil DEMIR, Oguz OZYARAL, Ismail BICER, Esra DEMIR ... 46 P-45 Cost of Delivering Health Care Services at Primary Health Facilities - Alpaslan MERT, Aysegul YILDIRIM KAPTANOGLU ... 47 COMMUNICATION, ETHICS, ART AND OTHER PALLIATIVE CARE ISSUES

P-46 The Effect of Heathcare Program on TV - Musfik AKARCAN, Oguz OZYARAL ... 48 P-47 The Use of Social Media in the Healthcare Sector - Suheyl POZANTI, Aysel YUGRUK UCAR ... 49 P-48 Breaking Bad News in Palliative Care - Okan Anil AYDIN, Cisem BASTARCAN, Aysegul YILDIRIM KAPTANOGLU ... 50 P-49 Ethical Sensitivity of Health Students and Affecting Factors - Meryem YILDIZ AYVAZ, Ozge Eda YILMAZ, Gunes BOLATLI ... 51 P-50 Effect of Media Literacy on Choice of Profession in Health Science Students - Hatice Dilek DOGAN, Cisem BASTARCAN ... 52 P-51 Gerson therapy: Positive and Negative Reviews in the Treatment of Cancer Patients – Y. STAYKOVA-PIROVSKA... 53 P-52 On Some Aspects of Long-term Care in Patients with Vascular Pathology – B. CHESHMEDJIEVA ... 54 P-53 Requirements, Opportunities and Challenges in Applying Technological Solutions in Palliative Care of Frail Older Adults - Panagiotis BAMIDIS ... 55

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PRESENTATIONS

PLENARY SESSION

P-01: UPDATE ON PALLIATIVE CARE

Lyubama DESPOTOVA-TOLEVA Bulgarian Society for Continuing Care and Palliative Medicine

Abstract

Inroduction: Palliative care is an essential component of the spectrum of Universal Health Coverage, and those who need it must not be left behind in the Political Declaration. By 2060, an estimated 48 million people (47% of all deaths globally) will die each year with serious health-related suffering, and 83% of these deaths will occur in low-income and middle-income countries. Palliative care is needed to address serious health related suffering yet less than 10% of those who need it receive it. People with palliative care needs, and their families, are often the “furthest behind.” Palliative care is a cost-effective response that improves the quality of life of people with serious illness and their families, while also strengthening health systems. In the member state negotiations in New York, we request the Government to propose and support the following language retention and amendments in red to the zero draft to strengthen the language for stronger health systems for people throughout their lives. Primary health care is crucial for people throughout the life course and through all stages of life. Integration of palliative care into primary healthcare as per the Astana Declaration is crucial for the achievement of Universal Health Coverage. One of the largest populations left behind are the 61 million people who need palliative care, of which it is estimated that 90% do not receive with the greatest inequity in low and middle income countries.

Conclusion: Ensure that no one is left behind, especially those who are vulnerable, stigmatized or marginalised among others, children, youth, women, older persons, prisoners, persons with disabilities, migrants, refugees, people on the move, people with mental health problems or pre-existing medical conditions, people with palliative care needs, regardless of race, religion and political belief or economic and social conditions.

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P-02: CHEMOTHERAPY AND ACUTE CORONARY SYNDROME CLINICAL CASE

Nevena IVANOVA Medical University Plovdiv Cardiologist at the Hospital “St. Caridad”

Abstract

Inroduction: Female of 69. Lung neoplasia in the left - broncho-alveolar adenocarcinoma-2015. The purpose of the pulmonary-pulmonis. Arterial hypertension-therapy with perindopril / indapamide 5 / 1.25mg. 1t. in the morning, usual values AN 130/70. Not a smoker. 43g. work in an electrical plant, soldering. No family history of CVD or cancer. VATS (Video-assisted thoracoscopic surgery) -2015. Resection of atypical lobby inferior pulmonis sinistra. 6 major first-line PCT courses in 21 days such as:

Acute pain in the heart area and back Shaking both hands

shortness of breath Sweating

Nausea and vomiting

Weakness in elementary effort

Results: Carboplatina / Paclitaxel 500mg. bevacizumab 1000mg. monotherapy for 21 days - 2.5 g. bevacizumab 1000mg.Tightening, chest weight and shortness of breath nausea and vomiting twice. Discontinued infusion. Metoclopramide hydrochloride i.v. Dexamethasone i.v. De-hospitalized the next day. In the first 6 months. after diagnosis of cancer significantly increases the risk of developing and complicating CHD 1.9-4.2% of patients develop OCC-85% NSTEMI. 90% of ACS is on the back ground of the progression of the cancer or during its active treatent. The mechanism of occurrence of ACS during the infusion of the chemotherapeutic drug is not completely clear. Development of acute endothelial dysfunction. Conclusion: Spasm and hypercoagulation. Bevacizumab vascular endothelial growth factor (VEGF) inhibitor -might reduce the anti-inflammatory effects of chronic VEGF exposure, leading to increased inflammation and atherosclerotic instability, and to subsequent plaque rupture and thrombus formation. CHD. Front STEMI. Single-clone coronary disease. PCI DES LADp. Hypertension. They are pulmonis sinistra. The purpose of the pulmonary-pulmonis. Situation after VATS 2015. Condition after chemotherapy kum bezacizumab. Keywords: Chemotherapy, acute coronary syndrome, clinical case

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P-03: PEDIATRIC PRACTICE IN A SOCIETY EXPERIENCING POPULATION DECLINE AND DİSASTER: THE ROLES OF TELEMEDICINE AND TELECARE

Kotaro OYAMA Iwate Medical University, School of Medicine

Abstract

Inroduction: Now Japan is faced with a low birthrate and super-aging. Today I’d like to talk about the roles of telemedicine and telecare in our country. And I will describe briefly the vital statistics and the healthcare system in Japan. Last of all, I’d like to introduce collaborative efforts to improve the quality of life of our children.

A term female infant was born following an uncomplicated pregnancy in an Iwate prefectural hospital on the Pacific Coast. Apgar scores were 8 and 9. Tachypnea and difference in SpO2 between the upper and lower limbs were identified, and the baby was admitted to the pediatric department of the same hospital at 2 hours postpartum.

Echocardiography performed by a pediatrician revealed antegrade and retrograded blood flow in the aortic arch.

The retrograde blood flow was thought to be an overlap of the ductus arteriosus with the aortic arch. Low-concentration O2 was administered for suspected transient tachypnea of the newborn. Time and distance are the greatest daily challenges faced by the people of Iwate. The Prefecture constructed the “Iwate Information Highway” in 2000.

This information infrastructure comprises a secure high-speed optical fiber network connecting major institutions, including the prefectural government buildings, hospitals, and schools. The “Iwate Medical Information Network” and the “Iwate Pediatric Support System” were created to connect major hospitals throughout Iwate and address the uneven distribution and shortage of physicians and pediatricians in 2002 and 2003, respectively.

Although both systems aimed to promote the growth of telemedicine in Iwate Prefecture, they were not initially used widely because of functional immaturity of the communication equipment. In 2014, we obtained support from the central Government to construct a new medical information sharing/telemedicine network based on a high-speed and wide bandwidth virtual private network (VPN).

Conclusion: In conclusion, pediatric care medicine is shifting rapidly from providing critical care services towards services intended to improve the quality of life and from hospital-based care to a more community-based focus. Therefore, community healthcare networks designed to serve children with chronic diseases and disabilities must be strengthened through connections with different institutions and professionals. In the era of population decline and super-aging, the use of information communication technology to share information among medicine, health and welfare services may become a new indicator of abundance.

Keywords: Pediatric Practice, Roles Of Telemedicine And Telecare, Society Experiencing

4

P-04: EVALUATION OF THE EFFECT OF DARK TRIAD ON MOTIVATION AND CONFLICT OF INTEREST IN HOSPITALS

1_{Emre ISCI,} 1_{Secil TASTAN,} 2_{Elif Büsra SULUMEN,} 3_{Aysegül YILDIRIM KAPTANOGLU} 1_{Marmara University, Health Management Department,}

2_{Health Manager,} 3_{Beykent University, School of Health Sciences, Health Management Department}

Abstract

Inroduction: Organizational behavior literature states that the behaviors of the employees towards themselves, each other and the organizational structure and system are not always positive and they sometimes exhibit some negative, destructive, undesirable behaviors that prevent productivity and efficiency. The studies indicate that such behaviors, which are called negative behaviors, have increased since 1990s due to various reasons and need to be examined comprehensively. From this point of view, the concept of the dark triad determines the extent to which organizational employees' behaviors conform to the classification of narcissism, machiavelism and psychopathy, and predicts their possible consequences. Aim: The aim of this study is to determine the degree of personality traits of narcissism, machiavelism and psychopathy, which are called dark triad, and the effects of these behaviors on motivation and conflict. Data were obtained from 200 people who had validated questionnaires from the questionnaires applied by face-to-face interviews from 4 private hospitals which were determined by convenience sampling.

Conclusion: As a result of the study, machiavelism, which is one of the dark triad dimensions, was not found to have a significant relationship with conflict and it was found that there was a very weak positive relationship with motivation (p <0.05). On the other hand, psychopathy and narcissism personality traits had a positive and weakly significant relationship on conflict and motivation (p <0.05).

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P-05: MODERN HOSPICE, PALLIATIVE CARE AND SYMPTOM PALLIATION: WHAT ARE THE DIFFERENCES AMONG THEM?

Paul KAZUNARI ABE Associate Professor, Department of Rehabilitation, Chiba Prefectural University of Health Sciences

Abstract

Inroduction: World Health Organization change their policy from specific to general. The trend depends upon study of primary care. That shows definition of palliative care. “Palliative care” was defined as “is the active total care of patients whose disease is not responsive to curative treatment and the goal of palliative care is achievement of the best possible quality of life for patients and their families.” in 1990 by the WHO. And the definition was updated to “is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.” in 2012.

Palliative care is an approach; multimodal methodology and generally; non-cancer life-threatening illness improves the quality of life. Palliative care is gaining importance every day. Because only 100 years ago, people die for infectious diseases, accidents, childbirth reasons; nowadays, mankind has causes of death such as organ failure, lung failure, liver failure, kidney failure.

Conclusion: As a result, palliative care as a primary care is a human right. And it can be said that the greatest challenges facing palliative care in the next decade are: the need for earlier treatment, difficulties in addressing the whole, inequalities in the world.

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P-06: INVESTIGATION OF THE RELATIONSHIP BETWEEN HEALTH EMPLOYEES 'PERCEPTION OF WORK LOAD AND MEDICAL ERROR

ATTITUDES

Ismail SECER, Eda CEYLAN Beykent University, School of Health Sciences, Health Management Department

Abstract

Inroduction: Hospitals are complex, high security facilities. The capacity and performance of the staff in the hospital are directly related to the quality and reliable service and efficiency of the hospital. For this reason, the investments to be made in hospitals are of great importance. The increase in the population in our country in recent years have aggravated the working conditions of hospitals and increased the workload that consequently brought mistakes after them.

Conceptually, the workload is related to the time and energy that individuals have spent to do their work, and to the efficiency in the functioning of organizations. Excessive workload may cause negative mood and may affect performance negatively, resulting in unintended malpractices.

It is considered that determining the status of hospital employees in areas that may be the cause of medical malpractices such as satisfaction, workload and stress will contribute to the provision of a quality health service. The primary work to be done in this contribution will be to determine the perceptions of the healthcare workers about the work environment, to make malpractice or to show their attitudes towards malpractice and to examine the relationship between them.

In addition to having sufficient knowledge and skills, health workers should have social and psychological qualifications. Negative workload perceptions of health workers have a negative impact on the performance of them in terms of effective and efficient use of the health services.

Conclusion: The workload of healthcare workers in hospitals has a significant impact on healthcare performance and efficiency. Health workers' expectations, prejudices, values, beliefs, attitudes and behaviors, work environment and satisfaction determine workload perception criteria. Especially in the health sector where human life is in question, workload affects the performance of the employee and as a result medical malpractice may occur. In this respect, the relationship between the workload and medical malpractice is important. Keywords: Health Employees’ Perception, Work Load, Medical Error Attitudes

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P-07: MEASUREMENT OF PATIENTS’ PERCEPTION LEVELS ON PHYSICIAN EMPHATICS CASE OF SPECIAL HOSPITALS

Emir Hasan OLMEZ1_{, Ayşegül YILDIRIM KAPTANOGLU}2 1_{Beykent University, Vocational School, Health Management Department} 2_{Beykent University, School of Health Sciences, Health Management Department}

Abstract

Introduction: This thesis aims to measure the doctors’ emphaty and the patients’ levels of perception about it in the surveys conducted to the private hospitals. The surveys were carried out with the doctors who worked in the surgical and internal medicine departments at the private hospitals, located in Silivri - Tuzla geographic region in the province of Istanbul and also with the patients who were cured there.

Methods: The Patient’s Perception scale of Physician Emphaty and Jefferson Scale of Physician Emphaty were applied to 70 physicians who worked at 35 private hospitals in Istanbul and to 420 patients who received health services from these physicians. In this study, various statistical analysis were done by SPSS 24.0 program.

Results: It is observed that the physicians who worked in the internal medicine had more empathy towards the patients. Also, it is determined that the physicians who were new to the medical profession or who were young, had higher empathy levels. The patients who received health services perceived that the surgeons had more empathy. Moreover, it is found that the empathy perception, developed by the physicians was higher towards the patients who were the health staff of good education. It is concluded that the more the doctors develop empathy with their patients, the more the patients will perceive it.

Conclusion: It is thought that the physician's empathy with the patients will be increased and the patient will get better health services not only by improving the working conditions of the physicians but also preparing the educational plans to increase the health information of the patients.

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P-08: PALLIATIVE CARE MANAGEMENT FOR CHILDREN

Oguz OZYARAL, Halil DEMIR Istanbul Rumeli University

Abstract

Introduction: As a term of palliative care is progressive patient should be made available to anyone in need of treatment and care. And also WHO Definition of Palliative Care for Children an said: Palliative care aims to improve the quality of life of patients facing life-threatening illnesses, and their families, through the prevention and relief of suffering by early identification and treatment of pain and other problems, whether physical, psychosocial, or spiritual. The principles apply to children with life-threatening illnesses and to other

pediatric chronic disorders. Palliative care begins when illness is diagnosed, and continues irrespective of whether or not a child receives disease-directed treatment. Effective palliative care requires a broad interdisciplinary approach.

Aim: The purpose of this Oral Presentation is to describe Palliative Care Management; in addition, information on process management about how to establish a palliative care team for the child, how it should be in the managerial dimension, model is proposed.

Results: The emergence of palliative care needs for children and process management were evaluated visually with various graphs and tables in our study.

The headings discussed in our article are listed as follows: 10 Things you may not know about children’s palliative care 10 Members of a CPC Multidisciplinary Care Team

10 Rights of Children With Palliative Care Needs

In this study, how process management, relationship and how to manage the relationship between child, family health care team and clinical and biomedical data is discussed.

What is the relation between Specialist Palliative Care (SPC) and End of life Care(ELC) Relation is discussed.

Conclusion: In this study, we can conclude that palliative care in children is differentiated from normal palliative care travel and becomes special. Therefore, palliative care teams for the child should be specialized teams.

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P-09: CLASSICAL COMPOSERS’S MUSIC CREATIVITY AND THEIR ILLNESSES

Mal. MALINOVA 1_{, M. MALINOVA} 2 1_{The Academy of Music, Dance and Fine Arts in Plovdiv, Department of Piano and Accordion} 2_{Medical Univertsity of Plovdiv, “Faculty of Public Health”, Department of Midwifery cares}

Abstract

Introduction: The great composers have often been seen as outlandish, eccentric or even mentally ill. But is there really a link between creativity, genius and mental illness? Some composers heard voices and melodies in their head, which they then wrote down on their blank staves. Were Haydn, Shostakovich and others like them mentally ill? Was it an impediment or, on the contrary, a valuable source of inspiration? Music lays down a more or less strict framework, depending on the periods: musical time, harmony, the linear nature of the work can be very binding.

All of these constraints force the composer to comply with an established order to write music, and follow rules specific to composition, whether or not they come naturally.

In the first are the composers who had relatively few problems during their lifetime, but suffered toward the end of their lives from diseases that did not interfere significantly with their creativity. This group includes J. S. Bach, Brahms, Haydn, Bruckner, Wagner, Reger, and Bartok.

In the second category are composers who had intermittent, prolonged medical problems that were only partially diagnosed correctly: Mendelssohn, Handel, Rossini, Bellini, and Bizet. The most fascinating and tragic group is the third one: composers who suffered from severe medical conditions, mostly misdiagnosed and mistreated, resulting in extraordinary suffering—which, however, did not prevent them from developing their creative spirit.

To this group belong Mahler, Schubert, Schumann, Wolf, Weber, Mozart, Beethoven, Chopin, Donizetti, Paganini, Maurice Ravel, George Gershwin, Vissarion Shebalin, Benjamin Britten, Alfred Schnittke.

Conclusion: Some classical composers suffered from organic diseases, while others complained of mental disturbances.

However, in spite of their disorders, the intensity of their creativity mostly remained unchanged.

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P-10: MEDICAL ERRORS IN PALLIATIVE CARE

Katerina KOVACHEVIKJ, Ljubin SHUKRIEV, Marta TUNDZEVA St. Cyril and Methodius University, Faculty of Medicine Department

Abstract

Introduction: Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. medical errors are defined that made by licensed professionals during the normal course of their practice. A medical error is the failure of the intended action to end as intended or use of the wrong plan to achieve the goal. Studies have shown that medical errors happen due to problems in communication (24%), discontinuity in care (20%), laboratory results (19%), lack of values/guidance per diagram (13%), clinical errors (8%), prescription errors (8%) and other (8%). Patients in palliative and end-of-life care are more likely to be particularly vulnerable to medical errors. The most common occurrence of medical errors occur primarily due to inexperience, wrong risk assessment, being ansure, tiredness, work overload, ımproper communication, failure to keep proper records, violations of confidentiality and weaknesses in the system.

A medical error is an adverse event that can be prevented and it occures due to things being done or not done. Understanding the reasons why a medical event or mistake has occurred is the key to developing a way of how to prevent it in the future. Process analysis by Rooney and Heuvel contain data collection, recording and showing the cause, identification of the root cause and recommendations for prevention and implementation. Incident analysis is a powerful learning method for healthcare facilities and leads to improvements in patient safety, such as the adoption of protocols or organizational changes in the area where the error has been fixed.

Building a safe healthcare system covers continuous education of medical staff, error recognition and recovery training, protocols - written by those who do the work, introduction and maintaining medical and technical standards in health facilities, health education, medical informing and other rights and obligations of patients, more adequate addressing of the problem from the point of view of health professionals, law on patient safety, medical error insurance act, medical error registry.

Conclusion: Center for family medicine, Medical Faculty, University St Cyril and Methodius Skopje Republic of North Macedonia started the project for the education of medical and nonmedical staff in nursing homes, based on the demographic changes and the needs for improvement on the quality of care for elderly. Educational program for medical and nonmedical staff working in nursing homes is based on a topic from palliative care. The analysis showed that errors in palliative care to touch similar aspects as in other areas of medicine, but there are aspects specific to palliative care mainly related to issues such as communication, teamwork, professionalism or advance care planning.

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P-11: EUTHANASIA AND THE ELDERLY

Lambrini KOURKOUTA 1_{, Aikaterini FRANTZANA} 2 1_{International Hellenic University}

2_{European University of Cyprus}

Abstract

Introduction: The care of the elderly creates a variety of medical and psychosocial problems

that often lead to insoluble ethical dilemmas, such as the issue of euthanasia in older adults. During at least, the last two decades, the debate on euthanasia has been intensifying as it is persistent in the legal form of many states, either in terms of medical liability or patients' rights.

Aim: The purpose of this Oral Presentation is to delve into the association between euthanasia and older people.

Methods: The study material is consisted of articles on the topic found in Greek and international databases such as: Google Scholar, Mednet, Pubmed, Medline and the Hellenic Academic Libraries Association.

Results: Euthanasia, as it is known, literally means good or easy, honest and happy, where

"eu" means good, nice, brave, noble, and the second part of the word gives expression to the natural "death". The term in its present meaning refers to "decent and painless" end of a person's life suffering from an incurable and painful disease; this definition was used by Francis Bacon. Nowadays, this Hippocratic view is still accepted by medical ethics. Declarations in the medical world make it clear that the doctor must respect human life from its inception. Depending on the way euthanasia is practiced, it is distinguished between active euthanasia, passive and assisted suicide. In general, the elderly person’s powers weaken and the idea of an impending death creates an unpleasant psychological state to him, no matter how much mental strength he has. During hospitalization and care of the elderly, there are many cases where elderly patients not only suffer but cannot afford to live under these conditions due to poor health conditions. So, they ask their doctor to discontinue the various interventions that are needed to support or disrupt their lives. In short, they resort to euthanasia. Acceptance of the elderly patient's refusal or request for intervention or treatment discontinuation does not constitute Physician-Assisted Suicide (PAS) or euthanasia. In PAS, the patient ends his or her own life using external means provided by the physician. In euthanasia, the doctor immediately terminates the patient's life. In both cases, e.g. a drug to kill the patient. Sometimes the doctor may knowingly reject the patient's complaints. However, he must accept the patient's right to his body and his refusal to intervene undesirable. This approach enables physicians to identify and analyze facts, identify a moral problem, and propose a solution.

Conclusion: In conclusion, people of all ages, such as the elderly, consist a point of reference in any modern culture, and both the international and domestic legal order have the priority of safeguarding and protecting their interests. Human life is a universally human good that constitutes the necessary precondition for safeguarding other human rights. After all, the right to a free and dignified life is the cornerstone on which the principles of justice and peace in modern society are based and developed.

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P-12: TRANSPLANTATIONS IN THE ELDERLY

Areti TSALOGLİDOU International Hellenic University, Nursing Department

Abstact

Introduction: Transplantation of human organs and tissues is one of the major achievements of the 20th century that has transformed the survival and quality of life of patients with end-organ dysfunction. It has been established as a routine therapeutic method allowing the recovery of body functions that had been partially replaced with mechanical support or lost to patients with organ failure. The evalution of solid organ transplantation (SOT) is marked by technical advancement, pharmacologic development, innovation in broadening the donor pool and standardization of practices related to transplantation.

Methods: In the United States the method of allocation has been developed by the United Network for Organ Sharing (UNOS), using the several criteria according to the type of organ. These criteria are local proximity, the time of waiting, immunological matching, medical urgency and the age of the patient.

Results: The process of aging is a biological process and a natural process of evolution that occurs with the passing of time in individual organisms after reproductive maturity. This situation is a universal, intrinsic, progressive and irreversible and adaptability, sensitivity, accuracy, and strength of the body progressively decrease. The average age of those receiving kidney transplants is approximately 50 years. The number of people over 65 years of age seeking and receiving organ transplants have grown and approximately 50% of patients who received cardiac transplants between 2002 and 2010 were over 50 years of age, and over 20% were older than 60 years.

Solid-organ transplantation is an effective treatment for selected older patients. However, when are forced to choose between young and old patients about which of the two categories of people the graft needs to be given, preference leans towards the young man. Advanced donor age has historically been associated with poor outcomes after transplantation, although the impact of donor age can vary by organ. In heart and kidney transplants, increased donor age is a risk factor for mortality and delayed graft function. Donor age affects both quality and longevity. Regardless of the type of organ transplant, recipient age has a substantial impact on the outcome of organ transplantation. In addition to the complex changes occurring within the immune system, there are also increasing comorbidities with aging. The aging recipient is subject to the complex interaction of the senescent immune system, immunosuppression, and comorbid conditions. In addition to malignancies, infections also become more prevalent with increasing age.

Conclusions: Any donated organ ready for transplant should be carefully distributed to a reciever to ensure the best possible outcome. This allocation should be based on the compatibility of the donated organ and receiver, the patient's waiting time on the waiting list, the medication requirement and other factors, including age, which should not be detrimental to the recipient. Each country has its own organ allocation service, which usually operates on a national distribution basis and is accountable to its national health authorities.

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P-13: FAMILIES OF PATIENTS IN ICU: THEIR NEEDS AND SATISFACTION WITH CARE

Konstantinos KOUKOURIKOS International Hellenic University

Abstract

Introduction: According to WHO, 2017, admission to the ICU is often unexpected, and the patient's condition is usually unstable. Many ICU patients were unable to communicate with healthcare staff or participate in decision- making about their treatment due to the severity of their illness. Consequently, healthcare professionals are increasingly approaching family members to speak for them and expanding the care and support provided by the patient to their family as well.

Aim: The aim of the current study is to describe the needs and experiences of family members of adults admitted to intensive care and interventions to improve family satisfaction and psychological well- being and health.

Four key themes were in the center of this study; (i) Different perspectives on meeting family needs, (ii) Family satisfaction with care in ICU, (iii) Factors having an impact on family wellbeing and their capacity to cope, (iv) Psychosocial interventions. The most important family needs identified were for information and assurance, followed by proximity, comfort, and support, respectively. Families want timely, clear and understandable information about their relative's medical condition, but without leaving room for unrealistic hope. Family members feel the need to create an alliance with healthcare staff and that this had a positive impact on their ability to handle the situation they are being faced with. Healthcare staff (medical and nursing) ranked the need for information and assurance as to the top two important needs. ICU nurses and doctors do not perceive family needs accurately, undervalue their role and/or fail to sufficiently support the family. The patient's illness severity may also mean that the time available for communication with healthcare staff is limited and the ability to engage in discussion is compromised by the patient's clinical condition. Risk factors associated with an increase in symptoms of anxiety included being female, a spouse, an unplanned ICU admission, lower educational status, poor sleep pattern, fatigue, lack of regular meetings with medical staff and failing to meet family needs. Families describe their ongoing uncertainty about whether their family member will survive or suffer permanent disability, and having the daily fear of complications arising. Relatives of the patients used the equipment for the diagnosis and treatment of diseases, etc. training on the subjects, especially increases the satisfaction of relatives. Other studies have looked at the effect of relatives assisting with the provision of care to the patient. Results from these studies suggest better family satisfaction and reduced emotional distress post-intervention, compared with the usual care group.

Conclusion: A key finding from this study is that family need have received most attention

and consistently identified the need for more information and reassurance. Families’ perceived needs were not always met by healthcare staff and this had a negative impact on family satisfaction and their psychological health and well- being. While there is some evidence that interventions based on the provision of appropriate written and oral information in ICU can effectively reduce anxiety and improve satisfaction, more empirical research is needed in this area.

14

CLINICAL ISSUES IN PALLIATIVE CARE

P-14: UNCONTROLLED CANCER PAIN AS AN INDICATION FOR EMERGENCY HOSPITALIZATION IN PALLIATIVE CARE DEPARTMENT OF

COMPREHENSIVE CANCER CENTER-VRATSA

N. YORDANOV Complex Oncology Center –Vratsa

Abstract

Background: A published meta-analysis data shows that 59% of patients undergoing active treatment, 64% of those with advanced disease, 33% of cancer survivors, suffer from poorly controlled pain. Uncontrolled pain affects patients’ comfort and negatively affects the activity, motivation and relationships in the family. We have witnessed a steady increase in the incidence of cancer in recent decades. with more than 31,000 newly registered, over 18157 people who died in 2012, 270,492 people with cancer were recorded in the country, and when it comes to cancer, everyone thinks of the characteristic symptom of the disease - the pain. The study is needed because of: The necessity to collect real and reliable information about pain as a symptom in cancer and the quality of its treatment. Because: pain treatment is not a priority in Bulgaria - it is not studied in the universities and is not part of the postgraduate qualification process. The country is seriously lagging in the development of palliative care. Aim: The aim of the study to investigate uncontrolled cancer pain as a reason for emergency hospitalization in the Palliative Care Unit of the Comprehensive Cancer Center - Vratsa. Patients and Methods: A retrospective, single-center, descriptive study based on electronic and paper-based medical records of hospitalized patients in PCU at CCC - Vratsa from 01/Jan/2018 to 30/Jun/2019.

Results: A total of 748 patients enrolled in this study, 81.28% ( 608) were planned and 18,72% (140) were ER patients. When we look at the distribution of participants, 51% is male and 49% is female. The mean age of men is 66.03 and the mean age of women is 63.21. 17,34% of patients were diagnosed with lung cancer and 13,98% were diagnosed with breast cancer. The most frequent symptoms that patient experienced were 65,24% pain, 35,29% fatigue and 21,39% nausea and vomiting. 82 (58,57%) of the 140 patients ER hospitalized patients experienced uncontrolled pain. Newly diagnosed causes for pain: 23 (16,43%) – bone mets., 6 (4,29%) – pathological fractures, 9 (6,43%) – brain mets. (headache + neurological symptoms), 9 (6,43%) infiltration or compression of nerves and plexuses (СТ-scan ; MRI scan), 5 (3,57%) nerve compression + pathological fracture (mostly of columna vertebralis). For treatment 45 (54,88%) of 82 ER pts. in pain were opioid naive, 26 (31,71%)pts. had been already prescribed opioids for pain control;ІІ- step opioids 19 pts, ІІІ- step opioids 7 pts. Of these 82pts. 11 (13,41%) had stopped prescribed opioids by themselves because of: uncontrolled side effects – 9 pts, vertigo - 1 patient, nausea and vomiting - 3 patients, constipation - 2 patients, 2 patients experienced more than one of the listed symptoms, 1 patient followed the advice of his wife to stop prescribed opioids because : "It would be dangerous - he would become a drug addict!“ and 2 patients had difficult access to opioids. Conclusion: Uncontrolled (poorly controlled) pain as cause for emergency hospitalization was found in 82 (58,57%) of the 140 patients ER hospitalized patients of all 748 hospitalized patients for the reporting period. Patients with pancreatic cancer were most often hospitalized suffering from uncontrolled ER pain, followed by patients with lung, larynx and gastric cancer. The available data do not allow us to make statistically reliable conclusions on which base to build a strategy for reducing the number of emergency hospitalizations due to uncontrolled pain.

15

P-15: ANGELINI SYMPOSIUM: PATIENT CENTERED TREATMENT OF BREAK THROUGH PAIN

Lyubama DESPOTOVA - TOLEVA Bulgarian Society for Continuing Care and Palliative Medicine

Abstract

Introduction: Integrating effective and appropriate analgesia strategies that could improve the control of cancer pain is essential. However, even though background pain is well controlled, patients frequently experience acute exacerbation of their chronic pain, known as breakthrough pain (BTP).

Purpose: This study evaluated the efficacy and safety profile of fentanyl Ethypharm (FE) in relieving BTP in opioid-treated cancer patients. The objective of the present study was to assess the efficacy and safety of FE when used to relieve BTP in opioid-treated cancer patients.

Methods: Pain is described with a hologram as seen in the figure:

This was a prospective, multicenter, double-blind, placebo-controlled, randomized study comparing FE with placebo for the treatment of BTP in cancer patients experiencing 1 to 4 episodes of BTP per day.

Results: Opioid-treated adult cancer patients, experiencing 1 to 4 episodes of BTP per day, were included in the study. After an open-label titration period to identify an optimal dose that would provide adequate pain relief for 2 consecutive episodes of BTP with an acceptable level of adverse events, patients were randomly assigned to a double-blind, placebocontrolled, crossover period with 1 of 13 prespecified sequences of 9 tablets (6 tablets of FE of the dose identified during the open-label titration and 3 placebo). Pain intensity and pain relief were recorded at 3, 6, 10, 15, 30, and 60 minutes after study drug administration.

Conclusion: This newly developed galenic formulation with a higher early systemic exposure and a shorter Tmax compared with oral transmucosal fentanyl citrate makes FE a particularly suitable formulation for the management of BTP in opioid-treated cancer patients due to the very rapid onset of action.

16

P-16: CAN WE TEACH COMPASSION?

Anwar KHAN Churchill Healthcare, Nhs, North and East London

Abstract

Introduction: Empathy and compassion are vital components of health care quality; however, physicians frequently miss opportunities for empathy and compassion in patient care. Compassionate care ties closely with respect and dignity in that individual patients, careers and relatives must be treated with sensitivity and kindness. The business of the NHS extends beyond providing clinical care and includes alleviating pain, distress, and making people feel valued and that their concerns are important.

Aim: Despite evidence that empathy and compassion training can be effective, the specific behaviors that should be taught remain unclear. We synthesized the biomedical literature on empathy and compassion training in medical education to find the specific curricula components (skills and behaviors) demonstrated to be effective.

Methods: We searched CENTRAL, MEDLINE, EMBASE, and CINAHL using a previously published comprehensive search strategy. We screened reference lists of the articles meeting inclusion criteria to identify additional studies for potential inclusion.

45 studies (total n = 3,110) met inclusion criteria. Most (85%) studies found that the tested curricula improved physician empathy and/or compassion on at least one outcome measure. We identified the following key behaviors to be effective: (1) sitting (versus standing) during the interview; (2) detecting patients’ non-verbal cues of emotion; (3) recognizing and responding to opportunities for compassion; (4) non-verbal communication of caring (e.g. eye contact); and (5) verbal statements of acknowledgement, validation, and support. These behaviors were found to improve patient perception of physician empathy and/or compassion. Conclusion: Evidence suggests that education can be useful for physician empathy and compassion. Training curricula should incorporate the specific behaviors identified in this report.

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P-17: THE EFFECTIVENESS OF UPOINT-GUIDED MULTIMODAL THERAPY IN TURKISH MEN WITH CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN

SYNDROME: A PRIMIRALY OUTCOMES

Muhsin BALABAN 1 _{Aysegül YILDIRIM KAPTANOĞLU} 2 1_{Biruni University, Department} 2_{Beykent University School of Health Sciences, Health Management Department}

Abstract

Aim: The aim of the study to evaluate the effectiveness of UPOINT-guided (Urinary, Psychological, Organ-specific, Infection, Neurologic/systemic, Tenderness of skeletal muscles) multimodal therapy in patients with chronic prostatitis/chronic pelvic pain syndrome according to the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score.

Patients and Methods: This study was conducted between January 2018 and May 2019 at Biruni University School of Medicine, İstanbul. A total of 78 patients aged 20-49 years with previous diagnosis of CP/CPSS enrolled in this study. We performed digital rectal examination, transrectal ultrasonografic investigation of the prostate, urine analysis and urine culture (Antibiograme and/or PCR evaluation), microscopic post massage prostatic fluid evaluation, perineal muscle tenderness and psicological evaluation by the BECK depression chart. We planned multimodal therapy based on each predominant positive phenotype. For organ specific domain we start to Cernilton and Quercetin. For the urinary phenotype, we ordered alfuzosin. For infection control, the antimicrobial agents according to the post massage urine culture or urine PCR study. For the psychological and tenderness of the skeletal muscle the consultation of psychiatrist and physiotherapist were planned.

Results: The mean age of the patients 34,1 (20-49) years old and the median disease of CP/CPSS diagnosis time was between 32 ( 6-120) months. Thirty one patients (40%) had calcification in the prostate gland and 11 patients had positive culture from prostatic fluid or urine culture after prostatic massage. The avarage total NIH-CPSI score and quality of life (QOL) subscores before treatment were 30.8+-4.3 and 9.1+- 1.8. After the UPOİNT based multimodal treatment the NIH-CPSI score and QOL subscores were 12.7+-1.8 (p=0.03) and 3.2+-1.4 (p=0.01), respectively.

Conclusion: The UPOİNT based multimodal therapy, including antibiotics, phytotherapy and α-blokers for CP/CPSS significantly decreasing a total NIH-CPSI score and elevating of QOL in Turkish patients .