Nurses' Views on Caring for Lonely Patients During the Pandemic: A Qualitative Study.

BACKGROUND: The implementation of safety measures in hospitals due to the COVID-19 pandemic, including family visitation restrictions, forced the family to be absent during the patient's hospitalization. Nurses were confronted with new roles and responsibilities, as caring for lonely patients was a new phenomenon that emerged during the pandemic. PURPOSE: The purpose of this study was to explore the nurses' views on caring for lonely patients during the COVID-19 pandemic. METHODS: A qualitative research method based on an inductive content analysis approach was used. Data collection was carried out using semi-structured interviews. The sample consisted of 11 nurses who worked in COVID-19 wards and units. Content analysis was used to analyze the interview data. RESULTS: The analysis of the data revealed three main themes: 1) caring for the patient and the family; 2) extending conventional care; and 3) developing supportive mechanisms for better care. Caring for lonely patients brought about changes in patients's management and care and significantly affected communication patterns as well as nurses' roles and responsibilities. Providing care beyond limits, supporting care through the utilization of new technologies, and transforming organization and care were mentioned as areas of challenge for nursing practice.  Conclusions: Maintaining communication and supporting the family's involvement in patient care are considered to be equal to healing for the lonely patient. Reshaping working conditions and caring practices to meet the needs of the nurses, the patients, and their families during health crises may contribute positively to the provision of holistic care for patients and their families.

Investigation of Internalized Weight-Related Stigma: Progression to Dietary Addiction and the Role of Stress.

INTRODUCTION: Internalizing weight stigma can lead to the development of dietary addiction, as individuals seek food as a coping mechanism for the emotional distress caused by stigma. The influence of stress exacerbates this dynamic, encouraging the reliance on food as a stress-coping strategy. METHODS: Electronic questionnaires were completed in a special electronic form through an online platform. The Two-Factor Weight Bias Internalization Scale (WBIS-2F), the Yale Food Addiction Scale (YFAS), the Depression Anxiety Stress Scale-21 (DASS-21), Positive and Negative Affect Schedule (PANAS), the Life Orientation Test (LOT), the Brief Resilience Scale (BRS) were used at this study to examine the prevalence of Internal Weight Stigma (IWS) among adults in Greece, evaluate the degrees of stress/anxiety, food addiction, mental resilience, emotions, and positive life perspectives within this group, and explore the correlations between stress/anxiety, mental resilience, optimistic life attitudes, and both IWS and food addiction. RESULTS: 376 participants completed the questionnaire. The average BMI of the participants was 26.3 kg/m2 (SD = 5.9 kg/m2). Almost half of the participants (46.8%) fell within the normal weight range (18.5 ≤ BMI ≤ 24.9), while 28.2% were classified as overweight and 21.0% as obese. Interestingly, a significant majority (63.1%) perceived themselves as heavier than the normal weight range suggests. Most participants demonstrated typical levels of depression, anxiety, and stress, with percentages of 67.3%, 64.9%, and 71.3%, respectively. Resilience exhibited positive associations with optimism and positive emotions while displaying negative connections with depression, anxiety, stress, and negative emotions. Additionally, individuals with greater optimism reported fewer symptoms of despair, anxiety, and stress. CONCLUSION: The research highlights the intricate dimensions of mental well-being, emphasizing the need for a holistic comprehension encompassing demographic, psychological, and societal factors. The results indicate potential strategies for intervention to boost resilience, and optimism, and tackle issues such as food addiction, underscoring the significance of fostering a positive body image and self-esteem.

The Impact of the COVID-19 Pandemic on Childhood Obesity: A Review.

The coronavirus disease 2019 (COVID-19) pandemic has changed many families' eating habits and lifestyles. The main aim of this study was to investigate the association between COVID-19 and childhood obesity across the scientific literature. Literature reviews have shown that the current COVID-19 pandemic may play a major negative role in the global fight against childhood obesity. School closures, changes in routine, loss of structure, and loss of control were negatively associated with childhood obesity during the COVID-19 period. In addition, physical inactivity, irregular sleep, increased smartphone/TV screen time, and sedentary life may have played a significant negative role in social distress among children and adolescents. It has been argued that school closures during the pandemic have the potential to increase the prevalence of childhood obesity. Finally, family violence was predicted to increase during the pandemic, putting already vulnerable children at increased risk. The pandemic caused significant morbidity and mortality, straining healthcare systems, shutting down economies, and closing school districts. Pandemic future planning should involve stakeholders, including governments, schools, and families, who should make every effort to minimize the impact of the COVID-19 outbreak on childhood obesity.

Investigation of Nurses' Wellbeing towards Errors in Clinical Practice-The Role of Resilience.

Background and Objectives: The fatigue, stress, and burnout of nurses lead to them frequently making mistakes, which have a negative impact not only on the safety of the patients but also on their psychology. The ability to bounce back from mistakes is crucial for nurses. Nursing staff members' physical and mental health, particularly their depression, is far from ideal, and this ill health is directly correlated with the frequency of self-reported medical errors. The nurses' mental and physical health are also positively correlated with their perception of wellness support at work. This cross-sectional study aimed to investigate the status of nurses' mental and physical health regarding clinical errors and the impact of resilience on coping with these situations. Materials and Methods: A total of 364 healthcare professionals participated in this research; 87.5% of them were females and 12.5% of them were males. Most of the participants were 22-35 years old. The median number of years of employment was nine. Clinical nurses anonymously and voluntarily completed a special structured questionnaire that included questions from different validated tools in order to assess their state of physical and mental wellbeing after events of stress and errors made during their practice. Results: In total, 49.4% of the nurses had made an error on their own, and 73.2% had witnessed an error that someone else had made. At the time of the error, 29.9% of the participants were in charge of more than 20 patients, while 28.9% were responsible for a maximum of three patients. Participants who were 36-45 years old had more resilience (p = 0.049) and experienced fewer negative emotions than participants who were 22-35 years old. The participants who mentioned more positive feelings according to their mental state had greater resilience (p > 0.001). Conclusions: Errors were likely to happen during clinical practice due to nurses' negative experiences. The level of resilience among the nursing population was found to play a very important role not only in making mistakes but also in coping with errors during their daily routine. Wellness and prevention must be given top priority in all healthcare systems across the country in order to promote nurses' optimal health and wellbeing, raise the standard of care, and reduce the likelihood of expensive, avoidable medical errors. Healthcare administrations should promote prevention programs for stress occurrence in order to support nurses' wellbeing maintenance.

The Effect of Psychological Resilience and Coping Strategies on Mental Health of Nurses.

INTRODUCTION: Nursing professional is considered to be stressful with impact on nurses' mental health. AIM: The aim of this study was to investigate the effect of coping strategies and psychological resilience on anxiety and depression among nurses. METHODS: In this descriptive and cross-sectional study, 378 nurses from two hospitals (a general and a psychiatric) in Greece completed the Patient Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2), the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and the Ways of Coping Questionnaire for evaluating the depression, anxiety, psychological resilience, and coping strategies, respectively. The study was carried out between October and December of 2019. Statistical analysis was performed with JASP version 0.14.01 and significance for all statistical tests was set at 0.05 or less. RESULTS: Psychological resilience was significantly correlated with anxiety (r = -0.127, p = 0.014), Positive approach (r = -0.466, p<0.001), Seeking social support (r = -0.228, p < 0.001), Avoidance/Escape (r = -0.121, p = 0.020). Anxiety was positively correlated with Seeking social support (r = -0.112, p = 0.030), Prayer/Daydream (r = -0.132, p = 0.030), Avoidance/Escape (r = -0.164, p < 0.001), and Assertive problem solving (r =-0.195, p < 0.0010). Psychological resilience, Avoidance, and Assertive problem-solving were significant predictors of increasing of anxiety (ß = -0.128, p = 0.013, ß = 0.130, p = 0.027, ß = 0.131, p = 0.020, respectively). Avoidance (ß = 0.209, p < 0.001) and age (ß = 0.208, p = 0.029) were significant predictors of depression. CONCLUSIONS: Psychological resilience and coping strategies have a significant effect on nurses' mental health.

Perceived Social Support in Parents of Hospitalized Children During COVID-19.

It was March 2020 when the World Health Organization declared a global pandemic due to the spread of a virus known as SARS-CoV-2, which started in Wuhan (China) and spread across the world. From that time onward, all governments took specific measures to minimize virus outspread. Human beings faced several challenges in each aspect of life mainly the more vulnerable ones, such as parents with sick children who encountered not only with hospitalization but also with the negative effects posed by pandemic. PURPOSE: Purpose of this study was to explore levels of perceived social support and the associated factors in parents of hospitalized children. METHOD AND MATERIAL: In the study were enrolled 110 parents (30 fathers and 80 mothers) of hospitalized children. Data were collected by the completion of "The Multidimensional Scale of Perceived Social Support (MSPSS)," which included patients' self-reported characteristics. The statistical significance level was p < 0.05. RESULTS: From the 110 participants, 50% scored over 22, 22, and 20 (median) in support from significant ones, family, and friends, respectively. In addition, 25% of parents scored above 25, 25, and 24, respectively. With respect to the possible range of scores (4-28), these values indicate high levels of social support. Statistically significant higher levels of support from significant ones were experienced by parents who desired to be COVID-19 vaccinated (p = 0.019) and had a person at home belonging to a vulnerable group (p = 0.001). In terms of support from family, statistically significantly higher levels had parents who had been COVID-19 vaccinated (p = 0.003), who had not experienced family conflicts during pandemic (p = 0.026), and those who had a person at home belonging to a vulnerable group (p = 0.001). Regarding support from friends, statistically significant levels were experienced by parents who wished to be vaccinated (p = 0.012) and who had not experienced family conflicts during pandemic (p = 0.050). CONCLUSION: Through this unprecedented global health issue, levels of support remained high. Vaccination, having a vulnerable person at home, and intra-family conflicts were associated with support. A better understanding of support in parents with hospitalized children may help in the planning of rational and cost-effective interventions.

Assessing the Respect of Children's Rights in Pediatric Hospitals.

Background and Objectives: In 1989, the United Nations (UN) General Assembly adopted the United Nations Convention on the Rights of the Child (UNCRC), with a considerable number of the Articles of the Convention being related to the health status of children. Therefore, adhering to and assessing the implementation of the rights of children during hospitalization is a very important step towards child protection. Herein, we attempt to highlight the depth of knowledge of employees working in children's hospitals with regard to children's rights as well as the degree of adherence to the UNCRC with respect to hospitalized children. Material and Methods: The target group included all healthcare professionals working in the various general pediatric clinics of the three Children's Hospitals of the Athens metropolitan area in Greece. We conducted a cross-sectional study, with data collection carried out in February and March 2020, using a structured questionnaire consisting of 46 questions which was handed out to all personnel. For the analysis, we used the IBM SPSS 21.0. Results: A total of 251 individuals participated in the study (physicians 20%, nurses 72%, and other employees 8%). A total of 54.5% of health professionals did not know what the UNCRC is, and 59.6% of them were not even aware that their hospital had rules and a bioethical committee related to clinical research involving children. Lack of awareness or trust of health professionals is also observed for other procedures or supervisory measures such as abuse protocols, complaint control, admission control, etc. With regard to the health system, there are shortcomings or weaknesses in (a) procedures followed with regard to respect for gender and privacy, (b) information on basic services provided by pediatric hospitals (such as recreation, education and free meals during hospitalization), (c) the logistical infrastructure (such as recreational facilities and facilities for the disabled), (d) the possibility of recording complaints, and (e) hospitalizations that were not necessary. A difference emerged concerning the nurses' responses between the three hospitals, with nurses participating in relevant seminars held in one of the hospitals being significantly more informed. Conclusions: The majority of healthcare personnel seem unaware of basic principles with respect to children's rights during hospitalization as well as relevant procedures and supervisory measures. Moreover, obvious weaknesses of the health system exist with respect to procedures, services, infrastructure, and complaint recording. There is a need for improved education of health professionals with respect to the implementation of children's rights in pediatric hospitals.

The Psychological and Professional Burden Experienced by Nurses Who Worked in COVID-19 Clinics during the Pandemic: A Content Analysis.

INTRODUCTION: Since the beginning of the pandemic, nurses have played a key role in providing care for COVID-19 patients. Infection risk and fear, use of personal protective equipment, and social isolation were related to high levels of stress and extreme psychological drain among front-line healthcare providers. AIM: The aim of this study was to explore how front-line nurses experienced psychological and professional burdens during the coronavirus outbreak. MATERIAL AND METHODS: The study used a qualitative research design. Semi-structured interviews were applied as the method of data collection. Ten nurses from COVID-19 wards and units of two general public hospitals participated in the study. A content analysis approach was employed to analyze the data. RESULTS: Data analysis revealed two main categories, namely: (A) front-line experience "From fear to empowerment", and (B) caring and management "From powerlessness to adaptation". Eight sub-categories were developed and included within the corresponding main categories. The study's findings demonstrated that the pandemic caused significant psychological and professional strain on front-line nurses, with feelings of fear, anxiety, and uncertainty predominating. Nonetheless, the process of adaptation and adjustment brought about sentiments of self-actualization and empowerment. CONCLUSIONS: A thorough understanding of the psychological and professional burden experienced by the front-line nurses is crucial to ensure that nurses receive appropriate support and that quality care is sustained under highly demanding healthcare conditions.

Stress and burnout among Greek critical care nurses during the COVID-19 pandemic.

Occupational stress and burnout of health personnel during the COVID-19 pandemic, especially of the nursing population in intensive care units (ICUs), were quite frequent along with negative effects and a direct correlation with the manifestation of many physical, behavioral and psychological symptoms. For the purposes of this research, a quantitative survey was carried out, in which 153 ICU nurses of secondary and tertiary public hospitals in Greece participated. Nurses completed anonymously and voluntarily a special electronic questionnaire about stress, burnout, personal concerns about the pandemic, the consequences of the outbreak and their resilience toward COVID-19 patients' care. Specific validated scales were used in this study. Female nurses felt, to a greater extent than males, work-related burnout, especially patient-related burnout and total burnout. There was a statistically significant negative relationship between the existence of a psychological support group within a hospital and personal burnout. Participants who had experience in caring for SARS-CoV-2 patients had higher mental resilience than those without experience. As the consequences experienced by the health professionals of the reference COVID-19 hospitals were increased, so did mental resilience and stress coping strategies during the pandemic. The COVID-19 outbreak and the conditions configurated in the health system had negative effects on the psycho-emotional state of ICU nurses. The manifestation of anxiety, stress and burnout had a direct correlation with both the work and personal functionality of the nurses and the whole of the healthcare services provided. The early recognition of symptoms and their individualized management are imperative for the protection of the psycho-emotional well-being of nurses.

Anxiety, Stress and the Resilience of University Students during the First Wave of the COVID-19 Pandemic.

The COVID-19 pandemic had an impact on everyone's daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The present study aimed to assess the psychological difficulties experienced by the university students of Greece during the first wave of the outbreak. Methods: 288 university nursing students completed an electronic questionnaire after consent. The sample included students from all years of study. The questionnaire included demographic data and questions about mental health status, resilience level, coping strategies, positive and negative emotions and an optimism assessment. Results: Depression (44.8%), anxiety (36.8%) and stress (40.3%) were experienced by the students. Females had significantly greater anxiety and stress signs compared to males (p < 0.001). The resilience score was significantly greater in males, as it was for the Positive Affect Score. Students in the fourth year of study used significantly more active/positive coping strategies than students in the first (p = 0.016) or second year of study (p = 0.005). Conclusion: Several students experienced serious mental disorders during the first period of the COVID-19 outbreak. Variables such as gender, year of study, age, positive and negative affect score, life orientation test score and coping strategies were identified as factors contributing to this situation. Special attention must be paid to female students as they mentioned negative emotions more frequently than males. Further research on the academic population could be beneficial to university administrators.

Association of University Students' COVID-19 Vaccination Intention with Behaviors toward Protection and Perceptions Regarding the Pandemic.

Background and Objectives: The COVID-19 pandemic is a serious global health problem. Vaccination is suggested to be one of the most efficacious precautionary measures, in combination with other protective behaviors. The purpose of this study was to explore the association of students' intention to get vaccinated about COVID-19 with protection behaviors and perceptions about the pandemic. Material and Methods: The study sample included 1920 university students who electronically completed two validated questionnaires anonymously and voluntarily from December 2020 to January 2021. Results: Results of the multiple linear regression analysis showed that as the perceived general risk was getting lower, the number of protective behaviors significantly diminished (p < 0.001). Additionally, respondents who believed that they had minor or no personal risk had undertaken significantly fewer preventing behaviors in comparison with participants who thought they had major personal risk (p = 0.006). However, the experience of respondents with people having COVID-19 had statistically significant association with undertaking more preventing behaviors (p = 0.004). Lower general perception of risk had statistically significant association with lower determination to obtain the vaccines of COVID-19 (p < 0.001). Personally knowing someone who had the coronavirus and undertaking more behavioral changes due to the coronavirus situation were significantly related to greater determination to obtain the vaccines of COVID-19 (p = 0.005 and p < 0.001, respectively). Conclusions: The results of this study can provide universities with the appropriate information about the improvement of COVID-19 vaccination strategies.

Perceptions, Knowledge and Attitudes among Young Adults about Prevention of HPV Infection and Immunization.

INTRODUCTION: Human papilloma virus (HPV) is one of the most common sexually transmitted infections and is widely known as the main causative agent for cervical cancer. The aim of this study was to investigate the perceptions, knowledge and attitudes of young Greek adults concerning prevention of HPV infection and HPV immunization. MATERIAL AND METHODS: This constitutes a cross-sectional online survey. A convenience sample of young Greek adults (n = 883) residing in Greece, aged 17 to more than 35 years was surveyed from December 2020 to March 2021. Two validated questionnaires were used to collect data. RESULTS: Participants demonstrated moderate knowledge about HPV infection and vaccination, with a mean knowledge score of 53.26 (SD ± 20.65) and 38.92 (SD ± 17.58), respectively. Cronbach's alpha value was 0.77 and 0.80. Female participants were better informed than males. Approximately 52.3% of respondents had been vaccinated and 65.5% were willing to get vaccinated in the future. Vaccination rate was significantly associated with gender (OR = 11.99; 99% CI = 6.59-21.84), knowledge about the HPV vaccine (OR = 1.04; 99% CI = 1.03-1.04) and age (OR = 0.07; 99% CI = 0.03-0.15). Reasons for vaccine refusal were insufficient information (36.8%) and fear of side effects (19%). Correlates of positive vaccination intention were knowledge about HPV (OR = 1.02; 99% CI = 1.01-1.02). CONCLUSIONS: The findings suggest that the Greek government's continuing HPV promotion efforts and education on the risks of HPV infection among young people are likely to increase vaccination acceptance among this group.

Investigation of Mental and Physical Health of Nurses Associated with Errors in Clinical Practice.

Background: Errors are common among all healthcare settings. The safety of patients is linked directly with nursing errors because nurses stand by them more often than any other healthcare professional. The role of mental and physical health of nurses is of great interest for a good and efficient job performance, but also for maintaining good patient care delivery. This study aimed to investigate the association between nurses' general health and making errors during clinical practice. Methods: A total of 364 nurses completed a specially designed questionnaire anonymously and voluntarily. The sample consisted of nurses with all educational degrees. The questionnaire included demographic data and questions about general health issues, resilience status and nurses' possible experience with errors within a hospital. Results: 65,8% of the participants stated that at least one error had happened at their workplace, and 49,4% of them reported that the error was caused by them. Somatic symptoms were found to have a positive correlation with making errors (p < 0.001). However, the other aspects of general health, which were anxiety/insomnia, social dysfunction and severe depression, had no statistical significance with adverse events. The most common type of error reported (65,5%) was a medication adverse event. Resilience level was found to be statistically significant (p < 0.001) when correlated with all aspects of general health (anxiety/insomnia, severe depression, somatic symptoms), but not with social dysfunction. Conclusion: Nurses are affected by their somatic symptoms in their daily clinical practice, making them vulnerable to making errors that compromise patient safety. A high resilience level could help them cope with unfavorable situations and prevent them from doing harm to a patient or themselves.

COVID-19 Vaccination Intention Associated with Behaviors towards Protection and Perceptions Regarding the Pandemic.

BACKGROUND: The impressively rapid availability of different types of COVID-19 vaccines and, on the other hand, the degree of their effectiveness as opposed to the likelihood of serious or non-serious side effects place a fairly large percentage of the population at a crossroads regarding the choice to get vaccinated or not, hence threatening achievement of total immunization coverage and full immunity. This study aimed to assess COVID-19 vaccination intention in Greece regarding protection behaviors and perceptions of the pandemic. METHODS: A total of 3753 participants completed a specially designed electronic questionnaire anonymously and voluntarily. The study population consisted of healthcare workers, students, members of professional societies, teachers, and professors. The questionnaire was composed of four parts pertaining to demographic data and possible changes in hygiene attitudes during the COVID-19 pandemic. RESULTS: In total, 43.3% of the participants stated that SARS-CoV-2 poses a significant risk. The most widespread protection practice was avoiding crowded places (90.1%), followed by reducing the use of public transport (86.1%) and washing their hands with soap and water more often than usual (84.2%). Women undertook significantly more behavioral changes than men and participants of other nationalities. About half of the participants (44%) implemented seven behavioral changes. Lower personal and general perceived risk due to COVID-19 was significantly associated with lower intention to get vaccinated. CONCLUSION: Strong hesitancy was observed towards COVID-19 vaccination. There is a need for further studies to be conducted to investigate the benefits and safety of vaccines for the purpose of better informing the public. Healthcare personnel can and should play a key role in this process.