Providing care to patients with COVID-19 in a reference hospital: health care staff intentional behavior and factors that affect it.

OBJECTIVE: The investigation of intentional behavior of hospital staff to care for COVID-19 patients and the study of the factors that influences it. METHOD: This is a cross-sectional study, of 261 physicians and nurses working in a COVID-19 reference hospital. Data were collected by an anonymous questionnaire including demographic and professional characteristics and a scale measuring behavioral intention based on the Theory of Planned Behavior of Ajzen. Statistical analysis was performed by SPSS 21. RESULTS: Mean age of participants was 40.8 years old, while most of them were nurses (75.7%). Behavioral intention mean score was 18.2 (5-21), which shows high intention to care for COVID-19 patients. Bivariate analysis between independent variables showed that behavioral intention mean score was higher for those that had cared for COVID-19 patients and those that did not (19.0% vs. 16.7%, p < 0.001). Multivariate linear regression analysis identified that increased subjective norms (the perceived social pressure to perform or not the behavior) score was associated with increased behavioral intention score (p < 0.001). Also, participants that provided care for COVID-19 patients had higher behavioral intention score (p < 0.001). CONCLUSION: Healthcare staff, that cared for COVID-19 patients had high behavioral intention to continue caring for them. This finding could be used to inform policies and training for staff that will be employed in COVID-19 units.

Exploration of the relationship between stigma and burnout among Greek nurses in dementia care.

OBJECTIVE: To investigate possible correlations between stigma and burnout of nurses and non-graduate professional caregivers of elderly with dementia in nursing homes. BACKGROUND: Research on dementia stigma in health care professionals as well as its relationship with their well-being is seriously lacking. METHODS: This cross-sectional study involved a convenience sample of 171 nurses and other professional caregivers in 16 Greek elderly care units who responded to Maslah Burnout Inventory (ΜΒΙ) as well as the Family Stigma in Alzheimer's Disease Scale (FS-ADS). In order to find adjusted associations between independent variables and the stigma and burnout of professional caregivers, multiple linear regression analysis was used. RESULTS: Cognitive, emotional and behavioural attributions of the three dimensions of stigma were found to be independent predictive factors of burnout's dimensions which indicate that stigma nurses deposit on patients, contributes towards their burnout. CONCLUSION: Educational preparation of geriatric nurses should provide them with the option of seeing dementia as a normal stage of life since reducing stigma can contribute towards preventing and managing professional burnout. IMPLICATIONS FOR NURSING MANAGEMENT: In order to reduce burnout, nurse managers should design lifelong learning programs on the basis of changing the stigmatizing negative cognitive and emotional attitudes of professionals towards dementia.

A cost and clinical effectiveness analysis among moist wound healing dressings versus traditional methods in home care patients with pressure ulcers.

The aim of the study was a cost and clinical effectiveness analysis between moist wound healing dressings and gauze in a homecare set up for the treatment of stage III and IV pressure ulcers up to complete healing. In addition, we assessed the overall economic burden on the Healthcare System. Treatment method for each patient was chosen randomly by using sealed opaque envelopes. The authors monitored the healing progress and recorded treatment costs without interfering with the treatment process. The healing progress was estimated by using surface measurement transparent films. To estimate treatment costs, the authors took into account labor costs, cost of dressings, as well the cost of other materials such as cleansing gauzes, normal saline, syringes, examination gloves, antiseptics and adhesive tape. The patient group under treatment with moist wound healing dressings consisted of 27 men and 20 women aged 75.1 ± 8,6 and had an average ulcer surface of 43.5 ± 30.70 cm(2) ; the patient group under treatment with gauze comprised 25 men and 23 women aged 77.02 ± 8.02 and had an average ulcer surface 41.52 ± 29.41 cm(2) (p = 0.25, 95% CI, Student's t test). The average healing time for the moist wound healing dressings group' was 85.56 ± 52.09 days, while 121.4 ± 52.21 days for the "gauze group" (p = 0.0001, 95% CI, Student's t test). The dressing change frequency per patient was reduced in the "moist wound healing dressings group," 49.5 ± 29.61, compared with a dressing change frequency per patient of 222.6 ± 101.86 for the "gauze group" (p = 0.0001, 95% CI, Student's t test). The use of moist wound healing dressings had a lower total treatment cost of 1,351 € per patient compared with, the use of gauzes (3,888 €).

Nurses' knowledge, attitudes and behavior toward Deaf patients.

BACKGROUND: Deaf sign language users experience severe health disparities which could be decreased with the modification of some factors associated with health professionals' attitudes, knowledge and behaviors. Relevant research referring to nurses is almost inexistent. OBJECTIVE: This study aimed to examine Greek nurses' knowledge, attitudes and practices toward Deaf people and determine the factors that influence these parameters. METHODS: The sample consisted of 200 randomly selected nurses working in 2 public hospitals and 2 public health centers in Attica, Greece. Data was collected from November 2010 to May 2011, using a questionnaire inquiring for demographics, previous contact with Deaf people or other people with disabilities, relevant education, practices, feelings and self-efficacy for caring for Deaf patients, knowledge and attitudes toward them and interest in being educated in such issues. RESULTS: A lack of relevant knowledge and education was observed. Relevant education was found to be positively correlated with knowledge (rho = 0.225, p = 0.003). Self-efficacy was found to be positively correlated with the contact with Deaf people score (rho = 0.358, p < 0.001). The participants who have avoided caring for Deaf patients had a statistically significantly lower mean score of self-efficacy (p < 0.001). No correlation was found between the contact and knowledge scores and between relevant education or contact and attitudes. The majority (64.8%) were interested in attending a relevant educational program. CONCLUSIONS: Our findings support that appropriate educational programs, including contact with Deaf people, could contribute to the improvement of nurses' knowledge and behavior toward Deaf people and would be welcomed by the majority.

[Considerations on home care in Greece, Italy and Albania: similarities and differences]. / Ospedalizzazione a domicilio in Grecia, Italia e Albania: somiglianze e differenze.

Home care is the total of services of healthcare that a patient can receive in his house. Home care is a rapidly developing sector of sanitary care. Its growth is mainly due to the continuous increase of the percentage of old individuals in almost all countries of the world and at the same time is due to the need for reduction of the cost of acute or urgent healthcare. Aim of home healthcare is the provision of nursing care of high quality under medical follow-up and at the same time the provision of social and psychological support of the patient and his family. Home Care is widely widespread all over the world. Almost all countries apply some of its form, according to the organization of sanitary services of the country, the level of provided social support, its economic situation and all the other social and humanitarian particularities. The present work is focused in the analytic description of organization and operation of home service in the Health Care Systems of Greece, Italy and Albania.

Health promotion practices and attitudes among nurses in special education schools in Greece.

Published research concerning health promotion in Greek schools is limited. The aim of the study was to evaluate special education school nurses' involvement in health promotion activities, examine their attitudes toward it, and to explore the factors influencing their practices. A cross-sectional survey was carried out in 2005 by mailed questionnaires to all 45 Greek school nurses. Descriptive statistics and nonparametric tests were used. The results indicate that 37 (82%) school nurses have had moderate involvement in health promotion programs due to the existing health policies set mainly by the school personnel and the state services. Their attitude toward health promotion was positive and depended on personal health promotion practices and activities and on health policies. Pupils' participation in health promotion programs changed according to their special health needs. The lack of legislated duties and absence of a specific health promotion programming prevented school nurses from being involved. Children's special needs inhibited or promoted health promotion activities.

Attitudes and knowledge of the Greek nursing students towards older people.

BACKGROUND: The proportion of older people has increased worldwide and so are the health problems related with ageing, such as cardiovascular diseases and cancer that often need long-term nursing care. Nurses therefore, have a pivotal role in the care of older people. AIM: To evaluate the effects of education on nursing students' knowledge and attitudes towards older people in Greece. METHOD: Two hundred and twenty seven first and final year nursing students at a university and 191 first and final year nursing students at a Technological Education Institute completed a questionnaire, including demographic questions, the Kogan's Old People Scale and the Palmore's Facts on Aging Quiz I. RESULTS: Attitudes towards older people were more positive in final year students in comparison to first year ones in both schools. Knowledge was found better only in relation to physical health in the final year students, in both schools. Age and female gender were found to influence both attitudes and knowledge positively. CONCLUSIONS: Nursing education in Greece seems to influence the attitudes and knowledge of nursing students towards older people. However, revisions and improvements in curricula are needed if nursing students are to gain a more holistic perspective of older people.

Caring for a relative with dementia: family caregiver burden.

AIM: This paper is a report of part of a study to investigate the burden experienced by families giving care to a relative with dementia, the consequences of care for the mental health of the primary caregiver and the strategies families use to cope with the care giving stressors. BACKGROUND: The cost of caring for people with dementia is enormous, both monetary and psychological. Partners, relatives and friends who take care of patients experience emotional, physical and financial stress, and care giving demands are central to decisions on patient institutionalization. METHOD: A volunteer sample of 172 caregiver/care recipient dyads participated in the study in Cyprus in 2004-2005. All patients were suffering from probable Alzheimer's type dementia and were recruited from neurology clinics. Data were collected using the Memory and Behaviour Problem Checklist, Burden Interview, Center for Epidemiological Studies-Depression scale and Ways of Coping Questionnaire. FINDINGS: The results showed that 68.02% of caregivers were highly burdened and 65% exhibited depressive symptoms. Burden was related to patient psychopathology and caregiver sex, income and level of education. There was no statistically significant difference in level of burden or depression when patients lived in the community or in institutions. High scores in the burden scale were associated with use of emotional-focused coping strategies, while less burdened relatives used more problem-solving approaches to care-giving demands. CONCLUSION: Caregivers, especially women, need individualized, specific training in how to understand and manage the behaviour of relatives with dementia and how to cope with their own feelings.

A comparative analysis on musculoskeletal disorders between Greek and Dutch nursing personnel.

OBJECTIVE: To analyse cross-cultural differences between Greek and Dutch nursing personnel in association with the risk factors and occurrence and consequences (absenteeism and medical care seeking) of musculoskeletal disorders. METHODS: This study was based on questionnaire surveys among 393 nurses and caregivers in nursing homes and homes for the elderly in The Netherlands and among 351 nurses in general hospitals in Athens, Greece. Logistic regression analysis was used to analyse associations between physical and psychosocial workload, need for recovery, perceived general health and (1) the occurrence of musculoskeletal complaints in the past 12 months, (2) chronic complaints during at least 3 months, and (3) complaints which led to sickness absence and medical care seeking. RESULTS: Greek nurses reported significantly more back complaints in the past 12 months (75 vs. 62%) than the Dutch workers, but chronicity (11 vs. 12%) and sickness absence (17 vs. 15%) of these complaints did not differ. Similar differences were observed for neck complaints but not for shoulder complaints. Most Greek nurses with back complaints visited a medical specialist (40%) while Dutch nurses and caregivers sought care through a general practitioner (33%). Multivariate analyses showed that in both countries strenuous back postures (ORs 1.9 and 1.9) and especially a moderate general health (ORs 4.3 and 2.9) were the significant risk factors for back pain. CONCLUSIONS: In both countries similar risk factors were associated with the occurrence of low-back pain. Cross-national differences were less important for the risk factors and musculoskeletal complaints than for the consequences of these complaints and for medical care seeking.

Reliability and validity of the Greek version of Kogan's Old People Scale.

AIMS AND OBJECTIVES: The aim of this study was to test the psychometric properties--validity and reliability--of the Greek version of Kogan's Old People scale. BACKGROUND: The ageing of the population in most of the developed world and in Greece, challenge-nursing care, therefore, nursing education needs to be updated accordingly. Until today there have been no studies in Greece in relation to student nurses' attitudes towards older people. To have a reliable questionnaire for measuring a Greek population's attitudes towards older people the Kogan's Old People Scale was translated into Greek. DESIGN: The study was designed as a cross-sectional survey. The main reason for choosing a cross-sectional survey was the time limits for the study. A sample of 390 nursing students in Athens participated in the study. METHODS: A questionnaire was given to the students, which included the Kogan's Old People Scale. RESULTS: Results showed Cronbach's alpha coefficient 0.73 for the OP- scale and 0.65 for the OP+ scale, which are comparable to published studies until today. The six-factor solution explains the 41.5% of the variance in the sample. The scale was also found to differentiate between first and final year students on how their education in nursing is influencing their attitudes towards the older people. CONCLUSIONS: Reliability and validity supported the Greek version of the Kogan's Old People Scale as a reliable instrument. Its use in evaluating Greek nursing education programmes could help in preparing nurses capable of meeting the needs of older people. RELEVANCE TO CLINICAL PRACTICE: Nursing education--basic and lifelong--needs to be updated in order to respond to the needs of older people and a reliable instrument can help to evaluate it.

Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals.

OBJECTIVES: To investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of musculoskeletal complaints of the lower back, neck and shoulders. METHODS: In this cross-sectional study a questionnaire survey was carried out among 351 nursing personnel (response 84%) in six general hospitals in Athens, Greece. A questionnaire was used on physical and psychosocial workload, need for recovery, perceived general health and (1) the occurrence of musculoskeletal complaints in the past 12 months, (2) chronic complaints during at least 3 months, and (3) complaints which led to sickness absence. In logistic regression analysis odds ratios (ORs) were estimated for all relevant risk factors. RESULTS: Self-reported factors of physical load were associated with the occurrence of back pain (OR=1.85), neck pain (OR=1.88), and shoulder pain (OR=1.87) but these factors were not associated with chronic complaints and musculoskeletal sickness absence. Physical load showed a trend with the number of musculoskeletal complaints with ORs of 2.47 and 4.13 for two and three musculoskeletal complaints, respectively. No consistent influence of psychosocial factors on complaints, chronicity, or sickness absence was observed. A perceived moderate general health was also a risk factor, and strongest associations were observed for sickness absence due to back pain (OR=2.03), neck pain (OR=8.31), and shoulder pain (OR=6.84). CONCLUSIONS: The handling of physical loads among nurses seems to put them at risk for the occurrence of musculoskeletal disorders. The development of these complaints into chronic complaints and associated sickness absence is strongly determined by perceived general health and almost not associated with work-related physical and psychosocial risk factors. When the influence of work-related risk factors on musculoskeletal health is being investigated, the general health status of individual workers should be taken into account.