The knowledge about patient safety among undergraduate nurse students in Cyprus and Greece: a comparative study.

BACKGROUND: The Patient safety movement contributed to the reduction of preventable adverse events associated with health care. Although patient safety issues have received the attention of educators in the health care studies, there is evidence that in nursing education and the associated curricula it is not well-incorporated. This may not allow students to acquire scientific knowledge and develop strong competencies to assure patient safety throughout their professional life. The aim of the study was the exploration of the undergraduate nursing student perspectives regarding knowledge received during their training about patient safety-related issues. METHODS: A descriptive comparative study was conducted with three and four-year undergraduate nursing students from the Cyprus Republic (n = 243) and Greece (n = 367). All students were surveyed using the Health Professional Education Patient Safety Survey (H-PEPSS) to describe students' knowledge in the classroom and clinical setting. RESULTS: Students' Knowledge about patient safety was expressed significantly higher (p < 0.001) in the classroom (mean = 4.0) than the clinical setting (3.7) (1-5 scale). The knowledge in the dimension "clinical aspects" received the highest score and "working in teams" received the lowest. Also, differences were recorded between countries with Cypriot students reporting higher level of knowledge than the Greek students in most of the dimensions. CONCLUSiON: The findings revealed the gap between theory and practice and the need for collaboration between the two settings. Also, students reported relatively higher knowledge with regards to the technical aspects of patient safety. Still, they were less knowledgable about the sociocultural aspects of the patient, such as working in teams.

Translation and Validation of the Revised Professional Practice Environment Questionnaire in the Greek Language.

BACKGROUND AND PURPOSE: Professional practice environments have been correlated with quality of care, patient, and nurse outcomes. There is a lack of translated versions of established instruments such as the Revised Professional Practice Environment questionnaire and this study presents the validation of this questionnaire in Greek. METHODS: Translation, cultural adaptation, and factor analysis of the instrument were carried out. Three hundred ninety-three nurses from 5 hospitals of the Republic of Cyprus completed the instrument. RESULTS: A 7-factor solution with 39 items accounted for 55.03% variance. The overall Cronbach's alpha was .89 and ranged between .69 and .84 for the individual factors. CONCLUSIONS: The testing of the translated version of the RPPE into Greek provides support for the validity and internal consistency of the instrument.

Patient Participation in Decision Making During Nursing Care in Greece--A Comparative Study.

AIM: To describe patient participation in decision making during nursing care from patients' and nursing staff' perspectives. METHODS: The sample consisted of medical and surgical patients (n = 300) and the nursing staff (n = 118) working in the respective wards in three general hospitals. A questionnaire was used for the study; data were collected from April 2009 to September 2010. Data were analyzed by an exploratory factor analysis. RESULTS: Patient participation was recorded at a medium level during nursing care, although it was rated as important from both patients and nursing staff. Exploratory factor analysis revealed the factor structure for the planning and implementation of the nursing care. Providers and receivers of nursing care perceived participation in a similar way. Interpersonal interaction was supported from older and less educated patients, as well as from university-educated nurses. Patient participation was greater in practical aspects of care and limited in technical medical issues and supportive services. CONCLUSIONS: Patient participation, although moderate, was evident during nursing care in hospital settings. Paternalism in the decision-making process was the dominant trend, whereas interpersonal interaction between the parties was recognized as a prerequisite for planning nursing care.

Patient participation in hospital care: Nursing staffs' point of view.

The aim was to investigate nursing staff's perceptions related to patient participation and the parameters affecting it during nursing care. A cross-sectional study with both a quantitative and qualitative orientation was conducted. The sample consisted of all nursing staff working in medical and surgical wards in three Greek hospitals. A questionnaire was developed and the data were analysed with exploratory factor analysis, whereas content analysis was used for qualitative data. Nursing staff perceived participation as the process of information giving to patients, communication of symptoms by patients and compliance with the staff's orders. 'Information providing' and 'ability to influence and responsibility' were significant aspects of the content of participation, whereas the parameters affecting participation were related to patients, nursing staff and the care context. These results support patient engagement in dialogue and shared decision-making, while highlighting the need to implement participation systematically and stimulate changes in nursing care organization.

Influence of shiftwork on greek nursing personnel.

BACKGROUND: The aim of this study was to investigate the burden experienced by nursing personnel working irregular shifts in Greece and to conduct the first test of a Greek version of the Standard Shiftwork Index (SSI). METHODS: A cross-sectional survey was carried out. The SSI was completed by 365 nurses and nursing assistants working shifts, including nights. RESULTS: Female nursing personnel and those suffering from a chronic disease were most affected by working rotating shifts as they had elevated scores on the majority of the SSI scales, such as sleep, chronic fatigue, digestive and cardiovascular problems, general health questionnaire, cognitive and somatic anxiety, shift time satisfaction, engagement and disengagement strategies, languidity, flexibility, and neurotisicm. Nurses with longer working experience and those with family responsibilities also scored higher on some of the SSI scales, such as the sleep, shift time satisfaction, social and domestic disruption, disengagement strategies, morningness, and languidity scales. CONCLUSION: Shiftwork affects female nurses, those with chronic disease, older age, and domestic responsibilities more severely. Therefore management should take these factors into account when designing work schedules to alleviate the burden caused by shiftwork.

The Greek version of the 9-item European Heart Failure Self-care Behaviour Scale: a multidimensional or a uni-dimensional scale?

OBJECTIVES: To evaluate the dimensionality of the Greek version of the European Heart Failure Self-care Behaviour Scale (Gr9-EHFScBS) in a Greek-Cypriot population. BACKGROUND: EHFScBS is a valid and reliable scale which is widely used for assessing heart failure (HF) patients' self-care behaviors. METHODS: EHFScBS was translated into Greek and was administered to 128 Greek-Cypriot HF patients. The internal consistency, construct validity and discriminant validity of the scale were assessed. RESULTS: Confirmatory factor analysis failed to capture the proposed theoretical structure. Further exploratory factor analysis provided a three-factor solution accounting for 53.35% of the variance, though the scale is better used as a whole. Cronbach's alpha was moderate 0.66, but deletion of any item decreased the alpha coefficient. Discriminant validity was supported by the poor correlation between EHFScBS and Minnesota Living with Heart Failure Questionnaire scores. CONCLUSION: Even though results do not conform to the multidimensionality of the scale, assessment of the tool provided acceptable validity and reliability measures to support its usage among Greek speaking populations.

Evaluation of the psychometric properties of the Greek version of the Minnesota Living With Heart Failure questionnaire.

PURPOSE: One of the major challenges for health care professionals in heart failure (HF) management is to maintain and/or improve HF patient health-related quality of life. The Minnesota Living With Heart Failure Questionnaire (MLHFQ) is one of the most comprehensive and widely used tools for measuring health-related quality of life among patients with HF. The aim of the study was to assess the psychometric properties of the Greek version of the tool. METHODS: The MLHFQ was administered among 128 Greek-Cypriot HF patients to assess the internal consistency, content validity, and contrast validity of its Greek version. Exploratory factor analysis was undertaken to establish its construct validity. RESULTS: The factor analysis in this study provided support for a 3-factor solution explaining 64.15% of the variance (physical, emotional, and social subscales). The internal consistency for the Greek version of the MLHFQ total scale (0.95) and subscales (0.80-0.94) were found to be high. The contrast validity of the Greek version of the MLHFQ was explored through cumulative MLHFQ scores and comparisons that were able to distinguish among all different levels of HF severity, as defined by the New York Heart Association functional class grouping. CONCLUSION: This study provides support for the reliability and validity of the Greek version of the MLHFQ.

Professional autonomy, collaboration with physicians, and moral distress among European intensive care nurses.

BACKGROUND: Discretionary autonomy is a key factor in enhanced patient outcomes and nurses' work satisfaction. Among nurses, insufficient autonomy can result in moral distress. OBJECTIVES: To explore levels of autonomy among European critical care nurses and potential associations of autonomy with nurse-physician collaboration, moral distress, and nurses' characteristics. METHODS: Descriptive correlational study of a convenience sample of 255 delegates attending a major European critical care conference in 2009. Respondents completed a self-administered questionnaire with validated scales for nurses' autonomy, nurse-physician collaboration, and moral distress. RESULTS: The mean autonomy score (84.26; SD, 11.7; range, 18-108) and the mean composite (frequency and intensity) moral distress score (73.67; SD, 39.19; range, 0-336) were both moderate. The mean collaboration score was 47.85 (SD, 11.63; range, 7-70). Italian and Greek nurses reported significantly lower nurse-physician collaboration than did other nurses (P < .001). Greek and German nurses reported significantly higher moral distress (P < .001). Autonomy scores were associated with nurse-physician collaboration scores (P < .001) and with a higher frequency of moral distress (P = .04). Associations were noted between autonomy and work satisfaction (P = .001). Frequency of moral distress was associated inversely with collaboration (ρ = -0.339; P < .001) and autonomy (ρ = -0.210; P = .01) and positively with intention to quit (ρ = 0.257; P = .004). CONCLUSIONS: In this sample of European intensive care nurses, lower autonomy was associated with increased frequency and intensity of moral distress and lower levels of nurse-physician collaboration.

Burnout syndrome indices in Greek intensive care nursing personnel.

Burnout symptoms in Greek intensive care unit (ICU) nurses have not been explored adequately. The aim of this descriptive, correlational study was to investigate the prevalence and intensity of burnout symptoms in Greek ICU nursing personnel and any potential associations with professional satisfaction, as well as with demographic, educational, and vocational characteristics. Findings showed that the overall burnout level reported by Greek ICU nursing personnel was at a moderate to high degree. The most pronounced symptom of burnout was depersonalization, whereas emotional exhaustion was found to be a strong predictor of job satisfaction. This is a factor connected with the nurses' intention to quit the job. It appears that work factors have a more powerful influence over the development of burnout in comparison to personality traits.

Greek intensive and emergency care nurses' perception of their public image: a phenomenological approach.

The public image of the nurse constitutes an important factor for recruitment into the profession, retention, and also for work satisfaction. The aim of this qualitative study was to disclose the way nurses internalize their professional public image and professional worth, as well as nurses' feelings about that image. Findings showed that although nurses have made a tremendous effort to improve the public image of their profession, negative nursing stereotypes still persist. Therefore, nurses have to actively participate in policy making and enhance their educational and cultural profile through the media.

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.

A randomized controlled trial of an educational intervention on Hellenic nursing staff's knowledge and attitudes on cancer pain management.

The purpose of this randomized controlled study was to explore the effectiveness of an educational intervention on nurses' attitudes and knowledge regarding pain management and to explore associations with nurses' characteristics. A four Solomon group experimental design was employed to assess the effect of the intervention and potential effects of pre-intervention testing. One hundred and twelve nurses were randomized to two intervention and two control groups. The intervention was based on viewing a series of educational videotapes and case scenarios. The Validated Hellenic version of the Nurses Knowledge and Attitudes Survey Regarding Pain (GV-NKASRP) was used. Pre-intervention scores revealed various limitations in regard to pain assessment and management. At the pre-test, the average number of correct answers was 17.58+/-7.58 (45.1%+/-19.3% of total questions). Pre-intervention scores differed significantly among participants with different educational backgrounds (P < 0.0001). A significant effect of pain education on total knowledge scores as well as regarding specific questions was detected. Intervention group participants provided 6.11+/-5.55 additional correct answers (15.66%+/-14.23% improvement, P < 0.0001), and they exhibited significantly improved post-test scores compared to controls (26.49+/-5.24 vs. 18.75+/-4.48; P < 0.0001). A potential negative effect of pre-test on knowledge gain for specific items and for total scores was detected. These findings suggest low pre-test knowledge scores among Hellenic oncology nurses and a significant effect of the intervention.

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.