Parents' attitudes, perceptions and coping strategies regarding school bullying.

OBJECTIVES: The aim of this study was to record parents' knowledge and attitudes towards bullying experienced by their children and to explore the strategies they choose to manage bullying incidents. METHODS: A cross-sectional study was conducted. The study population consisted of parents of children who have experienced bullying in a primary or secondary school classroom. The "Parents' Strategies to Cope with Bullying" questionnaire was used to collect data. Regarding parents' coping with bullying, the strategy "Support and advice to the child" scored the highest and the strategy "Social support and information" the next highest. RESULTS: Of the parents, 44.3 % had received some information/education regarding the phenomenon of bullying with the most important source of information being reading. According to the results of multivariate linear regression, mothers more often applied the strategy "social support and information" (Coefficient b=0.9, 95 % CI for b=0.7 to 1.1, p<0.001) and parents with lower educational level more often applied the strategy "avoidance" (Coefficient b=-0.5, 95 % CI for b=-0.8 to -0.2, p=0.004). CONCLUSIONS: School bullying remains a major worldwide phenomenon over time. Although parents choose to support their children, they do not receive information and training on how to manage bullying from a formal institution, making the need for such programs imperative.

Social Support and Resilience Are Protective Factors against COVID-19 Pandemic Burnout and Job Burnout among Nurses in the Post-COVID-19 Era.

Nurses have experienced several psychological and work-related issues during the COVID-19 pandemic, including pandemic burnout and job burnout. The aim of this study was to examine the impact of social support and resilience on COVID-19 pandemic burnout and job burnout among nurses. We conducted a cross-sectional study in Greece. The study population included 963 nurses. We measured social support, resilience, COVID-19 pandemic burnout, and job burnout with the Multidimensional Scale of Perceived Social Support, Brief Resilience Scale, COVID-19 Burnout Scale, and Single-Item Burnout Measure, respectively. Nurses received high levels of social support, while their resilience was moderate. Additionally, nurses experienced moderate levels of COVID-19 burnout and job burnout. Increased social support and increased resilience were associated with reduced COVID-19 pandemic burnout. We found a negative relationship between social support and job burnout. A similar negative relationship was found between resilience and job burnout. Social support and resilience can act as protective factors against COVID-19 pandemic burnout and job burnout among nurses. Policy makers should develop and implement appropriate strategies to improve nurses' social support and resilience since they are the backbone of healthcare systems worldwide.

Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies.

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Association between Workplace Bullying, Job Stress, and Professional Quality of Life in Nurses: A Systematic Review and Meta-Analysis.

Workplace bullying affects workers' lives, causing several mental and physical health problems and job-related issues. Therefore, a summary of the evidence on the consequences of workplace bullying on workers' lives is essential to improve working conditions. The literature lacks systematic reviews and meta-analyses on the association between workplace bullying and job stress and the professional quality of life of nurses. Thus, we aimed to quantitatively summarize the data on the association between workplace bullying, job stress, and professional quality of life. We performed our study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The review protocol was registered with PROSPERO (CRD42024495948). We searched PubMed, Medline, Scopus, Cinahl, and Web of Science up to 4 January 2024. We calculated pooled correlation coefficients and 95% confidence intervals [CI]. We identified nine studies with a total of 3730 nurses. We found a moderate positive correlation between workplace bullying and job stress (pooled correlation coefficient = 0.34, 95% CI = 0.29 to 0.39). Moreover, a small negative correlation between workplace bullying and compassion satisfaction (pooled correlation coefficient = -0.28, 95% CI = -0.41 to -0.15) was identified. Additionally, our findings suggested a moderate positive correlation between workplace bullying and job burnout (pooled correlation coefficient = 0.43, 95% CI = 0.32 to 0.53) and secondary traumatic stress (pooled correlation coefficient = 0.36, 95% CI = 0.11 to 0.57). Our findings can help nursing managers and policy-makers to draw attention to workplace bullying by implementing effective interventions, so as to reduce the bullying of nurses.

Association between Organizational Support and Turnover Intention in Nurses: A Systematic Review and Meta-Analysis.

Although recent studies suggest a negative relationship between organizational support and turnover intention among nurses, there has been no systematic review on this issue. The aim of this systematic review and meta-analysis was to synthesize and evaluate the association between organizational support and turnover intention in nurses. The review protocol was registered with PROSPERO (CRD42023447109). A total of eight studies with 5754 nurses were included. All studies were cross-sectional and were conducted after 2010. Quality was moderate in five studies and good in three studies. We found a moderate negative correlation between organizational support and turnover intention since the pooled correlation coefficient was -0.32 (95% confidence interval: -0.42 to -0.21). All studies found a negative correlation between organizational support and turnover intention ranging from -0.10 to -0.51. A leave-one-out sensitivity analysis showed that our results were stable when each study was excluded. Egger's test and funnel plot suggested the absence of publication bias in the eight studies. Subgroup analysis showed that the negative correlation between organizational support and turnover intention was stronger in studies in China and Australia than those in Europe. Organizational support has a moderate negative correlation with turnover intention in nurses. However, data regarding the impact of organizational support on turnover intention are limited. Moreover, our study had several limitations, and thus, we cannot generalize our results. Therefore, further studies should be conducted to assess the independent effect of organizational support on turnover intention in a more valid way. In any case, nursing managers should draw attention to organizational support by developing effective clinical practice guidelines for nurses so as to reduce turnover intention.

Moral Resilience Reduces Levels of Quiet Quitting, Job Burnout, and Turnover Intention among Nurses: Evidence in the Post COVID-19 Era.

The aim of the study was to examine the impact of moral resilience on quiet quitting, job burnout, and turnover intention among nurses. A cross-sectional study was implemented in Greece in November 2023. The revised Rushton Moral Resilience Scale was used to measure moral resilience among nurses, the Quiet Quitting Scale to measure levels of quiet quitting, and the single-item burnout measure to measure job burnout. Moreover, a valid six-point Likert scale was used to measure turnover intention. All multivariable models were adjusted for the following confounders: gender, age, understaffed department, shift work, and work experience. The multivariable analysis identified a negative relationship between moral resilience and quiet quitting, job burnout, and turnover intention. In particular, we found that increased response to moral adversity and increased moral efficacy were associated with decreased detachment score, lack of initiative score, and lack of motivation score. Additionally, personal integrity was associated with reduced detachment score, while relational integrity was associated with reduced detachment score, and lack of initiative score. Moreover, response to moral adversity was associated with reduced job burnout. Also, increased levels of response to moral adversity were associated with lower probability of turnover intention. Moral resilience can be an essential protective factor against high levels of quiet quitting, job burnout, and turnover intention among nurses. This study was not registered.

Nurses quietly quit their job more often than other healthcare workers: An alarming issue for healthcare services.

AIM: To assess the level of quiet quitting among healthcare workers (HCWs) and identify possible differences between nurses, physicians, and other HCWs. We investigated the impact of sociodemographic variables, job burnout, and job satisfaction on quiet quitting levels. BACKGROUND: The quiet-quitting phenomenon is not new but has been frequently discussed during the COVID-19 pandemic. Interestingly, the level of quiet quitting among HCWs has not been measured yet. METHODS: We conducted a cross-sectional study with a convenience sample. We measured sociodemographic variables, job burnout, job satisfaction, and quiet quitting. We adhered to STROBE guidelines for cross-sectional studies. FINDINGS: Among our sample, 67.4% of nurses were quiet quitters, while the prevalence of quiet quitting for physicians and other HCWs was 53.8% and 40.3%, respectively. Multivariable linear regression analysis identified that the levels of quiet quitting were higher among nurses than physicians and other HCWs. Moreover, greater job burnout contributed more to quiet quitting, while less satisfaction implied more quiet quitting. HCWs who work in shifts and those working in the private sector experienced higher levels of quiet quitting. DISCUSSION: More than half of our HCWs were described as quit quitters. Levels of quiet quitting were higher among nurses. Job burnout and job dissatisfaction were associated with higher levels of quiet quitting. IMPLICATIONS FOR NURSING PRACTICE AND NURSING POLICY: Measurement of quiet quitting and identification of risk factors are essential to prevent or reduce quiet quitting levels among HCWs. Our study provides information on this field helping managers and organizations to identify quiet quitters within HCWs. Policymakers and managers should develop and implement interventions both at an organizational level and at an individual level.

Resilience and Social Support Improve Mental Health and Quality of Life in Patients with Post-COVID-19 Syndrome.

Physical and mental health problems among post-COVID-19 patients are common, even a year after infection. As there is no prior study available, we investigated the impacts of resilience and social support on anxiety, depression, and quality of life among patients with post-COVID-19 syndrome. We conducted a cross-sectional study with a convenience sample. The measures included the demographic and clinical characteristics of patients, the Brief Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Patient Health Questionnaire-4 (PHQ-4), and the EuroQol-5D-3L. The mean age of patients was 44.8 years. The total PHQ-4 score suggested that 32.8% of patients with post-COVID-19 syndrome experienced severe psychological distress, 32.8% experienced moderate distress, 23% experienced mild distress, and 11.5% had no distress. Moreover, 60.7% of patients had anxiety scores of ≥3 and 69.7% had depression scores of ≥3, indicating possible major anxiety or depression disorder. The mean EQ-5D-3L index value was 0.36, and the mean EQ-5D-3L VAS was 54.1. Multivariable analysis identified that resilience and social support reduced anxiety and depression among patients. Also, we found a significant positive relationship between resilience and social support, and quality of life. Our findings suggest that resilience and social support can be protective by reducing anxiety and depression and improving quality of life among patients with post-COVID-19 syndrome. Policymakers should develop and implement healthcare management programs to provide psychological support to these patients.

Body image, emotional intelligence and quality of life in peritoneal dialysis patients.

Background: End-stage-renal-disease is one of the most common chronic diseases, and peritoneal dialysis constitutes one of the replacement therapies. The aim of this study was to investigate the views of patients on peritoneal dialysis regarding their body image, to assess their quality of life and level of emotional intelligence. Methods: A cross-sectional study was performed with structured questionnaires. The sample of the study was the patients undergoing peritoneal dialysis and monitored by the nephrology clinics of 7 public hospitals in Greece. Results: A total of 102 completed questionnaires were collected and analyzed (68% response rate). The participants showed moderate degree of body-image dysphoria (mean = 1.29, SD = 0.94), moderate levels of emotional intelligence and experienced moderate quality of life. According to the statistical analysis, women reported worse body image (p = 0.013) and university graduates showed higher levels of emotionality (p = 0.016). The correlations between the quality of life questionnaire subscales and demographic characteristics revealed statistically significant relationships between marital status and the Physical Functionality subscale, where unmarried people had a better quality of life in this subscale (p = 0.042) and between postgraduate/doctoral degree holders and the subscale Patient Satisfaction (p = 0.035). Also, statistically significant relationships were found between occupation and the Social Interaction subscale, where those engaged in household activities and were unemployed (p = 0.022) showed better quality of life. Participants living in semi-urban areas had better quality of life on the subscale Burden of Kidney Disease (p = 0.034). Conclusion: ESRD patients on peritoneal dialysis suffer significant limitations related to disease and treatment modality. According to our findings, these affect both their body image as well as their quality of life. Improvement in emotional intelligence is the factor which plays an important mediating role in improving both body image and quality of life in patients on peritoneal dialysis.

Increased Job Burnout and Reduced Job Satisfaction for Nurses Compared to Other Healthcare Workers after the COVID-19 Pandemic.

Nurses experience high levels of job burnout and low levels of job satisfaction, while the COVID-19 pandemic has deteriorated working conditions. In this context, our aim was to compare levels of job burnout and job satisfaction among nurses and other healthcare workers (HCWs) after the COVID-19 pandemic. Moreover, we investigated the influence of demographics and job characteristics on burnout and satisfaction. We conducted a cross-sectional study with 1760 HCWs during June 2023. We used the single-item burnout measure and the "Job Satisfaction Survey". In our sample, 91.1% of nurses experienced high levels of burnout, while the respective percentage for the other HCWs was 79.9%. Nurses' satisfaction was lower than other HCWs. In particular, 61.0% of nurses experienced low levels of satisfaction, while the respective percentage for the other HCWs was 38.8%. Multivariable analysis identified that nurses, HCWs with an MSc/PhD diploma, shift workers, and those who considered their workplace as understaffed had higher burnout score and lower satisfaction score. Our results showed that the nursing profession was an independent factor of burnout and satisfaction. Several other demographic and job characteristics affected burnout and satisfaction. Policy makers, organizations, and managers should adopt appropriate interventions to improve work conditions.

Predictors of COVID-19 Vaccine Uptake in Teachers: An On-line Survey in Greece.

COVID-19 vaccines are safe at a very high rate and protect against severe disease, hospitalization, and mortality. Schools are workplaces with high transmissibility of coronavirus and teachers are at risk of infection. The study aimed to find out the predictors of COVID-19 vaccine uptake in teachers. An on-line cross-sectional survey with a convenience sample was conducted, in Greece, during December 2021. We collected demographic data of teachers and we measured their attitudes towards COVID-19 vaccination and the pandemic. The sample included 513 teachers. The majority of them was vaccinated against COVID-19 (85.8%). The most important reasons for teachers' decline in COVID-19 vaccination were their concerns about safety, effectiveness and the side effects of COVID-19 vaccine. Also, furthermore they were characterized by strong self-assessment that they will not be infected by the COVID-19, and self-assessment that the COVID-19 vaccination will be useless for those who have already been diagnosed with COVID-19. After multivariable analysis, we found that increased age (OR 1.08, 95% CI 1.02-1.14, p = 0.011), and trust in COVID-19 vaccination (OR 2.57, 95% CI 2.07-3.18, p < 0.001) were related with an increased probability of a COVID-19 vaccine uptake. Also, teachers who lived with elderly people or vulnerable groups (OR 4.81, 95% CI 1.55-14.89, p = 0.006) during the COVID-19 pandemic, demonstrated greater probability to take COVID-19 vaccine. The study highlighted the need for reliable and accurate public information on both the risks of coronavirus infection and the vaccines' safety and efficacy.

The quiet quitting scale: Development and initial validation.

Introduction: COVID-19 pandemic causes drastic changes in workplaces that are likely to increase quite quitting among employees. Although quiet quitting is not a new phenomenon, there is no instrument to measure it. Objective: To develop and validate an instrument assessing quiet quitting among employees. Methods: We identified and generated items through an extensive literature review and interviews with employees. We carried out the content validity by content experts and we calculated the content validity ratio. We checked face validity by conducting cognitive interviews with employees and calculating the item-level face validity index. We conducted exploratory and confirmatory factor analysis to investigate the quiet quitting scale (QQS) factorial structure. We checked the concurrent validity of the QQS using four other scales, i.e., Copenhagen burnout inventory (CBI), single item burnout (SIB) measure, job satisfaction survey (JSS) and a single item to measure turnover intention. We estimated the reliability of the QQS measuring Cronbach's alpha, McDonald's omega, Cohen's kappa and intraclass correlation coefficient. Results: After expert panel review and item analysis, nine items with acceptable corrected item-total correlations, inter-item correlations, floor and ceiling effects, skewness and kurtosis were retained. Exploratory factor analysis extracted three factors, namely detachment, lack of initiative and lack of motivation, with a total of nine items. Confirmatory factor analysis confirmed this factorial structure for QQS. We found statistically significant correlations between QQS and CBI, SIB, JSS and turnover intention confirming that the concurrent validity of the QQS was great. Cronbach's alpha and McDonald's omega of the QQS were 0.803 and 0.806 respectively. Conclusion: QQS, a three-factor nine-item scale, has robust psychometric properties. QQS is an easy-to-administer, brief, reliable and valid tool to measure employees' quiet quitting. We recommend the use of the QQS in different societies and cultures to assess the validity of the instrument.

Quiet Quitting among Nurses Increases Their Turnover Intention: Evidence from Greece in the Post-COVID-19 Era.

As turnover intention is a strong determinant of actual turnover behavior, scholars should identify the determinants of turnover intention. In this context, the aim of this study was to assess the effect of quiet quitting on nurses' turnover intentions. Additionally, this study examined the impact of several demographic and job characteristics on turnover intention. A cross-sectional study with 629 nurses in Greece was conducted. The data were collected in September 2023. Quiet quitting was measured with the "Quiet Quitting" scale. In this study, 60.9% of nurses were considered quiet quitters, while 40.9% experienced high levels of turnover intention. Multivariable regression analysis showed that higher levels of quiet quitting increased turnover intention. Moreover, this study found that turnover intention was higher among females, shift workers, nurses in the private sector, and those who considered their workplace understaffed. Also, clinical experience was associated positively with turnover intention. Since quiet quitting affects turnover intention, organizations, policymakers, and managers should address this issue to improve nurses' intentions to stay at their jobs.

Predictors of Real-World Parents' Acceptance to Vaccinate Their Children Against the COVID-19.

Background: As the COVID-19 pandemic continues to threaten public health, the vaccination of children against the disease appears to be a key factor to control the pandemic. Our aim was to investigate the prevalence of parents who have vaccinated their children against the COVID-19 and the factors influencing this decision. Materials and Methods: We conducted a web-based cross-sectional study in Greece during the first week of September 2021. The study questionnaire was distributed through social media and a convenience sample was obtained. Only parents with children aged 12-17 years old could participate in the study. We collected socio-demographic data of parents and we measured their attitudes towards vaccination and COVID-19 pandemic. Results: Study population included 656 parents. Regarding vaccination, 27.1% of parents had their children vaccinated against the COVID-19, while almost all children had a complete vaccination history (98.9%). The most important reasons for decline of COVID-19 vaccination were doubts about the safety and effectiveness of COVID-19 vaccines (45.3%) and fear of side effects (36.6%). Regarding the information about the COVID-19 vaccines, parents showed more trust in family doctors than in scientists and the government. We found that increased parents' age, increased trust in COVID-19 vaccines, and positive attitude of parents towards vaccination had a positive effect on children's vaccination. Conclusions: Understanding the factors influencing parents' decision to vaccinate their children against the COVID-19 is crucial to increase the COVID-19 vaccination coverage rate. Implementation of public health policies is necessary to spread knowledge about COVID-19 vaccines and to regain vaccine confidence.

Cross-sectional assessment of predictors for COVID-19 vaccine uptake: an online survey in Greece.

Objective: To estimate the percentage of the general population vaccinated against the COVID-19 and to investigate the factors associated with COVID-19 vaccine uptake. Material and methods: We conducted an online cross-sectional study in Greece during August 2021. We included individuals over 18 years of age. Independent variables included socio-demographic data of the participants and attitudes towards COVID-19 vaccination and pandemic. Our outcome variable was COVID-19 vaccination status, measured through "yes/no" answers. Results: Most participants had been vaccinated against the COVID-19 (87.8%). Multivariate analysis identified that increased age and a higher level of education were associated with an increased likelihood of COVID-19 vaccination. Also, participants working in health services, participants without a previous COVID-19 diagnóstico, and those with previous seasonal influenza vaccination history had a greater probability to take a COVID-19 vaccine. Additionally, increased self-perceived severity of COVID-19, knowledge regarding COVID-19, and trust in COVID-19 vaccines and scientists were associated with COVID-19 vaccine uptake. On the other hand, the likelihood of vaccination was lower for participants who were more concerned about the side effects of COVID-19 vaccination. Conclusions: Understanding the factors affecting individuals' decision to take a COVID-19 vaccine is essential to improve the COVID-19 vaccination coverage rate. Policymakers and scientists should scale up their efforts to increase the COVID-19 vaccination rate among specific population groups such as young people, people with a low level of education, etc.

Objetivo: Calcular el porcentaje de población general vacunada contra la COVID-19 e investigar los factores asociados a la aceptación de dicha vacuna. Material y métodos: Realizamos un estudio transversal online en Grecia durante el mes de agosto de 2021, en el que incluimos a individuos mayores de 18 años de edad. Las variables independientes incluyeron los datos sociodemográficos de los participantes y las actitudes hacia la vacunación y la pandemia de COVID-19. Nuestra variable del resultado fue la situación de vacunación contra la COVID-19, medida mediante respuestas "sí/no". Resultados: La mayoría de los participantes habían sido vacunados contra la COVID-19 (87,8%). El análisis multivariante identificó que el incremento de la edad y el mayor nivel educativo estaban asociados a un aumento de la probabilidad de vacunarse contra la COVID-19. De igual modo, los participantes que trabajaban en servicios sociales, aquellos participantes sin un diagnóstico previo de COVID-19, y aquellos con historial previo de vacuna contra la gripe estacional tenían una mayor probabilidad de vacunarse contra la COVID-19. Además, el incremento de la gravedad autopercibida de la COVID-19, el conocimiento sobre la enfermedad, y la confianza en las vacunas contra la COVID-19 y en los científicos estuvieron asociados a la aceptación de la vacuna. Por otro lado, la probabilidad de vacunarse fue menor en los participantes más preocupados de los efectos secundarios de la vacuna contra la COVID-19. Conclusiones: Comprender los factores que afectan a la decisión de los individuos sobre la vacunación contra la COVID-19 es fundamental para mejorar la tasa de cobertura de dicha vacunación. Los responsables políticos y los científicos deberán redoblar sus esfuerzos para incrementar la tasa de vacunación contra la COVID-19 entre los grupos de población específicos tales como la gente joven, las personas con un bajo nivel educativo, etc.

Predictors of COVID-19 Vaccine Uptake in Healthcare Workers: A Cross-Sectional Study in Greece.

OBJECTIVE: We assessed the uptake of a COVID-19 vaccine and associated factors in a sample of healthcare workers (HCWs). METHODS: An on-line cross-sectional study with 885 HCWs was conducted in Greece during August 2021. We measured socio-demographic data of HCWs and attitudes towards vaccination and the COVID-19 pandemic. A convenience sample was used since the questionnaire was distributed through social media and emails. RESULTS: The majority of HCWs were vaccinated against the COVID-19 (91.5%). Females and HCWs with a history of seasonal influenza vaccination had a greater probability to get a COVID-19 vaccine. Also, increased self-perceived knowledge regarding the COVID-19 pandemic and increased trust in COVID-19 vaccines were associated with COVID-19 vaccine uptake. CONCLUSIONS: Policymakers and scientists should develop novel strategies to improve COVID-19 vaccine uptake among HCWs.

Clinical and Demographic Predictors of Health-Related Quality of Life After Orthopedic Surgery With Implant Placement.

BACKGROUND: Orthopedic surgeries can rehabilitate injuries and at the same time improve the patients' quality of life. The study aimed to assess patients' health-related quality of life (HRQOL) six months after an orthopedic surgery with implant placement. MATERIALS AND METHODS: A cross-sectional study with the use of a structured questionnaire among 103 patients was conducted. The 36-Item Short Form Survey (SF-36) questionnaire was used to evaluate patients' quality of life. RESULTS: According to the findings of the multivariate linear regression analysis, low age, marital status (married in comparison to unmarried/ divorcees/widows), reduced intensity of the pain, and low educational attainment were associated with a better quality of life. Furthermore, the patients who were living with another person and the patients who underwent surgery on a part of the body other than the hip presented better quality of life. The results of the multivariate analysis explained 33%-67% of the variance of the SF-36 HRQOL. CONCLUSION: Measuring quality of life is a valuable asset that helps to reveal the frail patient groups, in which health professionals will prioritize their care and the state in turn will design primary care services to meet their needs after discharge from the hospital.

The work environment of haemodialysis nurses and its mediating role in burnout.

BACKGROUND: The work environment can contribute to the occurrence of nurses' burnout. OBJECTIVES: This study assessed the work environment of haemodialysis nurses and the extent of burnout they have suffered, and it explored the connection between work environment and burnout. DESIGN: A multicentre cross-sectional study was conducted in 53 public, hospital-based haemodialysis units in Greece. PARTICIPANTS: A total of 537 haemodialysis nurses participated. The majority consisted of females (90.8%) who possessed a university degree or a degree from a technological institute (72.6%). They had an average of 15 years of experience in dialysis. MEASUREMENTS: The Practice Environment Scale of the Nursing Work Index and the Copenhagen Burnout Inventory (CBI) were used. The demographic characteristics of the participants were also collected. RESULTS: Although the nurses rated their work environment as healthy, they were experiencing a moderate degree of burnout. The multivariate linear regression analysis with the CBI scales as dependent variables was applied. The increased nurses' participation in hospital affairs was associated with decreased personal (coefficient ß = -9.4, 95% confidence interval [CI] = -17.4 to -1.3, p = 0.023), work-related (coefficient ß = -12.9, 95% CI = -22.5 to -3.5, p = 0.008) and patient-related burnout (coefficient ß = -15.9, 95% CI = -24.5 to -7.4, p = < 0.001). The better collegial nurse-physician relationships were associated with decreased personal (coefficient ß = -10.7, 95% CI = -18.3 to -3.0, p = .007) and work-related burnout (coefficient ß = -15.1, 95% CI = -23.3 to -7.0, p = < 0.001). CONCLUSIONS: The work environment of haemodialysis nurses was associated with burnout. Its improvement is an important tool in administrations' effort to ensure the nursing staff's well-being.

How breast cancer treatments affect the quality of life of women with non-metastatic breast cancer one year after surgical treatment: a cross-sectional study in Greece.

BACKGROUND: The continuously increasing survivorship of female breast cancer makes the monitoring and improvement of patients' quality of life ever so important. While globally there is a growing body of research on health-related quality of life 1 year after surgical treatment for non-metastatic breast cancer, up-to-date information regarding Greek patients is scarce. OBJECTIVE: To measure the level of QoL of non-metastatic BC survivors in Greece 1 year after surgery. METHODS: A sample of 200 female breast cancer survivors aged 18 to 75, who followed up as outpatients in five public hospitals were included in this cross-sectional study. All recruited patients agreed to participate in the study (100% response rate). Quality of life data were collected through the EORTC QLQ-C30 as well as BR23 questionnaires. RESULTS: Cronbach's alpha for all scales of the two questionnaires was from 0.551 to 0.936 indicating very good reliability. According to the Multiple Linear Regression, older patients showed a lower future perspective (p = .031), with those living in rural areas, which was associated with more financial difficulties (p = .001). Women with tertiary education and those who had been hospitalized in a university hospital recorded better on global health status (p = .003 and .000 respectively). Patients who underwent chemotherapy reported better scores in the emotional function sub-scale (p = .025). Women with reconstruction and at least one complication appeared to have significantly better scores in future perspective and social function (p = .005, .002 respectively). CONCLUSIONS: Breast cancer survivors were found to have an overall good quality of life, functioning/symptoms scores and were satisfied with the provided care.