Corticosteroids are widely prescribed in outpatient settings or during hospitalizations in various healthcare facilities. They are indicated for numerous acute or chronic conditions, particularly autoimmune and inflammatory diseases, in Internal Medicine and Neurology. Adequate knowledge of the paramedical team regarding corticosteroid therapy is essential to improve the management of patients undergoing these treatments.

This was a descriptive cross-sectional study conducted at a psychiatric hospital over a three- week period in February 2025. All nurses working in the medical departments of the hospital (Internal Medicine and Neurology) were included, totaling 34 nurses. Intern nurses and those who did not fully complete the questionnaire were excluded.

Thirty nurses responded to the questionnaire, with a mean age of 41.7 years [25–62 years]. Twenty-one nurses (75%) worked in Neurology, and 9 nurses (25%) worked in Internal Medicine. Twenty-four nurses (80%) had over 5 years of professional experience, with 54% (n=13) having more than 10 years of experience.

More than half of the nurses (53%) stated that corticosteroids were primarily used for chronic inflammatory diseases, without specifying the effects of the treatment. Four nurses (13%) mentioned that corticosteroids were also natural hormones.

All nurses indicated that pre-therapeutic examinations were necessary, including blood pressure measurement (n=29), capillary blood glucose (n=27), weight measurement (n=24), and urine strips (n=16). The pre-therapeutic blood tests included a blood ionogram (n=19), calcium level (n=12), and lipid profile (n=8).

Corticosteroid administration was mostly done in the morning, as reported by 93% of the nurses (n=28), while 7% opted for evening administration (n=2). The most frequently mentioned routes of administration were intravenous (n=28, 93%), oral (n=27, 90%), inhaled (n=19, 63%), and intramuscular (n=16, 53%).

A high dose of corticosteroid therapy was defined by the majority (64%) as being greater than 1mg/kg/day (n=19). The initiation of this dose required hospitalization, according to 90% of nurses (n=27). Corticosteroid therapy was considered long-term if it exceeded 3 weeks for 39% of nurses (n=11), and more than 3 months for 43% (n=13).

The most frequently mentioned short-term side effects were hyperglycemia (83%, n=25), hypertension (80%, n=24), and weight gain (63%, n=19). Long-term side effects most often cited were diabetes (83%, n=25), osteoporosis (73%, n=22), and hypertension (66%, n=20). Muscular (27%, n=8), cutaneous (17%, n=5), and ocular (10%, n=3) effects were less frequently reported.

Sixteen nurses (53%) indicated that the risk of infection was increased under corticosteroid therapy. Twenty nurses (67%) preferred a gradual discontinuation of the treatment, regardless of the dose, while 10 nurses (33%) chose discontinuation based on the treatment duration.

Twenty-one nurses (75%) affirmed that there was a risk of complications in case of abrupt discontinuation of long-term treatment, with seven nurses (27%) specifying the risk of acute adrenal insufficiency.

Regarding preventive measures for side effects, 29 nurses considered blood glucose monitoring (97%), dietary changes (n=28, 93%), blood pressure monitoring (n=25, 83%), and vitamin-calcium supplementation (n=19, 63%) necessary. Regular physical activity was mentioned by only 8 nurses (27%).

Only 4 nurses felt their knowledge of corticosteroid therapy was sufficiently satisfactory for their daily practice. All recommended organizing seminars and training on the subject.

Corticosteroid therapy is widely prescribed in Internal Medicine and Neurology, primarily for chronic diseases. It is crucial that paramedical staff, especially nurses, have a good understanding of the administration methods, pre-therapeutic assessments, short- and long-term side effects, and monitoring parameters. Better mastery of these aspects would improve patient management, reduce complications, and prevent comorbidities associated with often complex diseases.