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Papers by Ioana Silistraru

Broad Research in Artificial Intelligence Neuroscience, Feb 6, 2024

European journal of investigation in health, psychology and education/European journal of Investigation in health, psychology and education, Feb 1, 2024

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Healthcare, Sep 30, 2023

Broad Research in Artificial Intelligence Neuroscience, Feb 6, 2024

Romanian Journal of Legal Medicine, 2020

Nutrients

Background: As obesity rates continue to rise worldwide, many surgeons consider bariatric procedu... more Background: As obesity rates continue to rise worldwide, many surgeons consider bariatric procedures as a possible cure for the upcoming obesity pandemic. Excess weight represents a risk factor for multiple metabolic disorders, especially for type 2 diabetes mellitus (T2DM). There is a strong correlation between the two pathologies. The aim of this study is to highlight the safety and short-term results of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB, laparoscopic gastric plication (LGP) and intragastric balloon (IGB) as methods used in the treatment of obesity. We followed the remission or amelioration of comorbidities, tracked metabolic parameters, weight loss curves and hoped to outline the profile of the obese patient in Romania. Methods: The target population of this study was represented by patients (n = 488) with severe obesity who qualified for the metabolic surgery criteria. Starting from 2013 to 2019, patients underwent four types of bariatric proc...

The European Conference of Psychiatry and Mental Health "Galatia"

Both pathologies—obesity and depression—have high prevalence rates and have serious negative effe... more Both pathologies—obesity and depression—have high prevalence rates and have serious negative effects on the public's health. In recent meta-analyses, clinical trials, and epidemiological studies, they have been observed in people of all races. Both obesity and major depression are risk factors related to one another. In this paper, we suggest an overview of the two interconnected biological processes, including genetic influences and changes to the systems in charge of energy synthesis and consumption (hypothalamic-pituitary-adrenal axis, and inflammation, neuroendocrine regulators, and gut microbiota). Additionally, we look into how people perceive their bodies and social stigma, as well as the potential benefits of physical activity and weight-loss surgery on comorbid conditions and quality of life.

Revista de Științe Politice. Revue des Sciences Politiques, 2018

International Journal of Environmental Research and Public Health, Apr 29, 2022

While exploring the doctor-patient communication from a narrative perspective among patients suff... more While exploring the doctor-patient communication from a narrative perspective among patients suffering from cardiovascular conditions within the social context, as well as how this interpersonal conversation relates to the modern concepts of patient-centered care (PCC) or Shared Decision Making (SDM), we expose the fact that there is a noticeable shift to the paternal paradigm in the Romanian medical system, by considering the researched sample group. For this study, based on an extensive research, we considered relevant to approach the topic from the patient’s viewpoint, given that in the case of cardiovascular diseases, how the patient understands to manage his/her condition and how he/she is aware of and corrects the aggravating factors of their lifestyle results from good communication with the doctor and the medical personnel. Considering the data on cardiovascular diseases (CVDs) in Romania’s and Europe’s mortality statistics (cardiovascular conditions rank first as death caus...

ARS, 2018

Lack of trust in the medical system and medical staff is directly linked not only to the economic... more Lack of trust in the medical system and medical staff is directly linked not only to the economic and logistic conditions but it is also a consequence of the “improper” interpersonal communication between the patients and the Romanian medical staff.

Archiv Euromedica, 2021

Medical student burnout can cause emotional exhaustion and detachment from educational objectives... more Medical student burnout can cause emotional exhaustion and detachment from educational objectives. The objectives of this study were to evaluate burnout using the Maslach Burnout Inventory-General Survey for Students (MBI-GS(S)) associated with online education and pandemic restrictions. Methods: The MBI-GS (S) was administered to final-year medical students at Romania's most prominent medical faculties from June to July 2021. Descriptive statistics and the internal consistency of the MBI-GS (S) were assessed. In addition, mean MBI-SG (S) subscale scores for burnout were calculated for cynicism (CY), emotional exhaustion (EE), and academic efficacy (AE). Results: 50 medical students completed the online survey, and 42% reported self-perceived burnout. The MBI-GS(S) subscale scores were higher for cynicism (CY) (52%) and low professional efficacy (PE) (60%), and almost half of the students (48%) reported emotional exhaustion (EE). Conclusions: Recent studies have found strong ass...

The mental health challenges associated with the COVID-19 pandemic overwhelmingly affect the gene... more The mental health challenges associated with the COVID-19 pandemic overwhelmingly affect the general population. Stress and health anxiety, the risk of losing a job and working at home, online education for children, and isolation have a devastating cumulative effect. This study aims to achieve the following: i) to identify the epidemiological specifics of the perceived stress levels in the general population during the COVID-19 pandemic; ii) to evaluate the correlation between socioeconomic factors and the level of perceived stress and anxiety; iii) to analyze the correlation between the perceived stress scores and the anxiety scores in the general population. We applied Perceived Stress Score (PSS) validated questionnaire and Hamilton Anxiety Scale (HAM-A) online to a group of respondents (N=1.362), profiling the data based on demographics: age, sex, COVID-19 infection, behavior compliance to sanitary limitations, socioeconomic status, and pre-existing health issues. Results show ...

Social Change Review, Dec 1, 2017

way illness is affecting the quality of his everyday life. The final objective of effective medic... more way illness is affecting the quality of his everyday life. The final objective of effective medical care is to alleviate, if not to dismiss completely the illness and the suffering of the patients.

The present article starts from Reese's thesis (1997) according to which journalism is an activit... more The present article starts from Reese's thesis (1997) according to which journalism is an activity of collecting empirical information, in which various activities have developed (Reese, 1997: 423). The paradigm of journalism is seen by Schudson (1997) as a model that governs the collection of information. In his seminal work on journalism as profession, Schudson (1997) assessed that the true parading of journalism is revealed through practice and is based on some excellence criteria related to the impact of this activity on the public (Schudson, 1997: 8). The article has as its aim to identify the peculiarities of health journalism in Romania. We have started from the assumption that in this case, the health journalists are crossing borders with social and investigative journalism – many of them are migrating from social topics to strict medical topics coverage. Once specialised, they offer a closer and more accurate perspective of the health medical system they covered in their everyday activity. In order to see what are the main traits of health journalism in Romania, we have analysed a set of 24 interviews conducted in February-May 2014. The interviews were made with journalists working directly with the health system representatives and care providers, as well as with health authorities and institutions. The results showed that journalists had declared general negative perceptions about the medical system in Romania. They have defined the Romanian health system as a dysfunctional one (although the aim of the interviews it is not to criticise the system or the professionals), a system which is " in a profound and structural crisis ". Also, the journalists have stressed the lack of patient education in relation with their doctors-the " bribe " being seen as the cornerstone of this relation. The future of health journalism in Romania is seen in a rather positive way, due to the main educational aim of this type of journalism.

Conference Presentations by Ioana Silistraru

European Union’s statistics show that comparative recent data on life expectancy position Romania... more European Union’s statistics show that comparative recent data on life expectancy position Romania by the end of the hierarchy of European countries. 2005-2014 collected data in Europe show that only 48 percent of Romanian men reach 75 years of age, compared to 67 percent of all 28 member states data related to men, and 71 percent Romanian women reach same age, compared to 81 percent of European women. Romania stands for a vast majority of cardiovascular issues causing death both in men and women (Eurostat, 2013). World Health Organisation has listed in 2016 three major categories on aggravating factors in cardiovascular diseases in population – social and economic environment, physical environment and individual lifestyle. Addressing the latter, narrative medicine approach could impact the way the patient acknowledges the lifestyle changes one has to make in order to prevent, manage or cure cardiovascular disease. Analysing the way medical practitioners explain, participate and involve the cardiovascular patient in becoming aware of the risk and avoiding it, is part of the patient-centred care, focused on communication between the patient and his/her doctor. Through narrative approach medical practitioners not only address patient’s complaint, his obvious physical problems arising from anamnesis (Schleifer, Vannatta, 2013) but his concern about his health, described as how the patient feels about being ill and how he envisions him becoming healthy again. The study will present a qualitative analysis of interviews with cardiovascular patients and the impact of narrative medicine approach in doctor-patient communication. How important in the behavioural change of a cardiovascular patient is the way his doctor addressed his concerns, not only his illness? How the improved patient-doctor communication contributes to the concept of cardiovascular revolution? The concept (Vallin, Mesle, 2004) is one considering the decrease in mortality from cardiovascular diseases in Europe due to several factors, who include both general conditions and country-specific contexts. The cardiovascular revolution presents itself in different speeds – more accelerated in Western Europe, less in other countries, due to fundamental changes in behavioural risk factors, but also medical technology and disease prevention. Studying the narrative of patient-doctor relationship in cardiovascular filed might bring some additional valuable information to tackle the current situation.

Broad Research in Artificial Intelligence Neuroscience, Feb 6, 2024

European journal of investigation in health, psychology and education/European journal of Investigation in health, psychology and education, Feb 1, 2024

Healthcare, Sep 30, 2023

Broad Research in Artificial Intelligence Neuroscience, Feb 6, 2024

Romanian Journal of Legal Medicine, 2020

Nutrients

The European Conference of Psychiatry and Mental Health "Galatia"

Revista de Științe Politice. Revue des Sciences Politiques, 2018

International Journal of Environmental Research and Public Health, Apr 29, 2022

ARS, 2018

Archiv Euromedica, 2021

Social Change Review, Dec 1, 2017

Objectives. At present, it is widely recognized that improving quality in healthcare delivery had... more Objectives. At present, it is widely recognized that improving quality in healthcare delivery had become an extremely important topic for research. The objective of this study is to compare the types of interpersonal communication between Romanian patients and their general practitioners (GPs) with the discussions between Romanian pharmacists and the patients. Material and methods. A quantitative method based on a comparative design for analyzing a sample of 199 respondents was conducted. The questionnaire consists of ten open questions plus five socio-demographic items. Descriptive statistics was used in the analysis of the result. Results. A high percentage of the respondents (35%) did assess pharmacists as simple dealers and most of them did not communicate with the pharmacists during their encounters. At the same time, only 15% of the entire sample had discussed more than a half an hour with their GPs, the main subjects of discussions being rather " standardized " (i.e. current treatments and the general health). Conclusions. Lack of trust in the medical system and medical staff is directly linked not only to the economic and logistic conditions (lack of proper financing, massive migration of doctors, etc.) but it is also a consequence of the " improper " interpersonal communication between the patients and the Romanian medical staff. The basic conclusion of the study is that new strategies and plans for improving interpersonal communication among patients, GPs and pharmacists are needed at present in Romania.

As oddly as it could have sounded before becoming a respected discipline in clinical studies of m... more As oddly as it could have sounded before becoming a respected discipline in clinical studies of medicine, narrative medicine has gained weight after icebreakers like Rita Charon, MD. Narrative medicine is defined as medicine practiced with consideration to the stories of illness, expressed along the doctor-patient relationship. The stories of illness, as told by the patients and received by their doctors are filled with metaphors, life stories, symbols and narrative concepts. Rita Charon has been the pioneer in narrative medicine writings, explaining at the beginning of the book how she became involved in what later on it became a medical discipline, focused on delivering better medical services, with a real concern to patient suffering, paying attention to what they say, feel and develop as personal story of illness and, eventually, death. The book covers the issues of terminal illnesses and dealing with terminally ill patients, who have very particular stories as seen by them, by their families and, lastly, their caretakers and physicians. The book is structured in four parts – Part I explaining the concept of narrative medicine " What Is Narrative Medicine " , Part II is focused on the narrative of illness – " Narrative of Illness " , Part III touches the more practical aspects on how to develop narrative competence – " Developing Narrative Competence " and Part IV, about the benefits of narrative approach with the patients, " Dividends of Narrative Medicine ". As for a relatively new hybrid area of study, the first two chapters of the book focus on defining what narrative medicine is, as a necessary explanatory and quite didactic approach. Paying attention to narrative elements in personal stories could lead to better care, more efficient and more humane approach to illness and death. It is a win-win situation for both doctors and patients, but the reader should not get mesmerized with only narrative. Medicine practiced with narrative knowledge is still medicine, as we know it, only more patient-focused. Basically, it could offer a solution of how to fit all medical information one doctor receives from its patients in a very short-timed visit, while he describes how he feels, how his suffering is consuming his everyday life and what his story truly is. While explaining the benefits of narrative medicine as a better approach to patients and their stories, Charon touches the reason the understanding gap between health practitioners, patients and sometimes their families occurs. One description of the reason this gap occurs is in the second chapter " Bridging Health Care's Divides " where Charon mentions that no matter how knowledgeable the health practitioners are in their services, about the diseases they cure, they sometimes may be ignorant of the abyss their patients stand due to the fact they experience frightening signs of illness, weakness, changes and terror 1. One other differentiator in patient-doctor relationship is the imagination, or " imaginary scenario " 2 which immensely differ one from another – the doctor cannot and would not walk in his patient's shoes, while the patient is already imagining life beyond the doctor-patient encounter while fighting with fear and effects of an illness. One special mention should go to the concept of " dignity " and " dignifying " the lives of the sick people the doctor interacts with in his practice. Doctors are all together united in the effort to treat patients, which gives them the capacity to dignify the suffering and the stories of illness 3. The patient's self has to be the same or at least as inserted and associated with healthy people, to feel that he hasn't changed after falling ill and his dignity as a human being is intact. While considering the doctor-patient interaction, although trained and detached from emotions while treating a patient, the doctors themselves suffer " conflicting delusions " 4 , especially about death. While the majority of Charon book's readers are not necessarily doctors, the insight she gives on how the doctors feel are valuable and explanatory. It appears that doctors are torn apart in two conflicting delusions – the medical training they pursue have them believe at some level that they are immortal, but confronted with their patient's mortality, doctors become aware of the terminal effects of some illnesses. Doctors, being exposed to death, acquire one irrational belief that they are immortal