Health related quality of life in adult primary Ciliary dyskinesia patients in Cyprus: development and validation of the Greek version of the QOL-PCD questionnaire.

BACKGROUND: The QOL-PCD questionnaire is a recently developed Health Related Quality of Life (HRQoL) instrument for Primary Ciliary Dyskinesia. The aim of this study was to translate the adult QOL-PCD questionnaire into Greek language and to conduct psychometric validation to assess its performance. METHODS: Forward translations to Greek and backward translation to English were performed, followed by cognitive interviews in 12 adult PCD patients. The finalized translated version was administered to a consecutive sample of 31 adult, Greek speaking PCD patients in Cyprus for psychometric validation, which included assessment of internal consistency, test-retest reliability, construct and convergent validity. Internal consistency was assessed by Cronbach's alpha test in terms of the overall and sub-scales. Test-retest reliability was assessed by repeat administration of the questionnaire within 2 weeks and calculation of the intra-class correlation (ICC). Construct validity was assessed by comparing different groups of patients based on a-priori hypotheses and convergent validity was evaluated by examining associations between the QOL-PCD and SF-36 questionnaires. RESULTS: Moderate to good internal consistency was observed (Cronbach's α: 0.46-0.88 across sub-scales) and test-retest reliability assessment demonstrated good repeatability for most scales (ICC: 0.67-0.91 across subscales). Patients of female gender, older age and lower lung function exhibited lower QOL-PCD scores in general, while high correlations for most QOL-PCD scales with corresponding SF-36 scales were observed, in particular for physical functioning (r = 0.78, p < 0.05). CONCLUSION: The adult version of QoL-PCD questionnaire has been translated according to international guidelines resulting to a cross-culturally validated Greek version which exhibited moderate to good metric properties in terms of internal consistency, stability, known-group and convergent validity.

Service quality perceptions in primary health care centres in Greece.

CONTEXT: The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. OBJECTIVE: To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. STRATEGY: SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. RESULTS: The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. DISCUSSION AND CONCLUSIONS: THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services.

Validation of the Greek version of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+, version 3).

OBJECTIVES: There is a growing need for evaluation of the results of mental health services and clinical treatment in older people, but evidence for effectiveness is limited in Greece. The Health of the Nations Outcome Scales for Elderly People (HoNOS65+) are promising instruments for the assessment of mental, physical and social health in older persons. They have been translated into the Greek language but have not been validated. The aim was to assess the inter-rater reliability, intraclass correlation, concurrent validity, internal consistency and sensitivity to change of HoNOS65+ in a Greek sample of older people with mental health problems. METHOD: Two samples, one of inpatients in a psychiatric hospital and the other of older people living in the community were used. In order to test the extent to which the HoNOS65+ were sensitive to change the first sample was reassessed after two months and the second after three months. For each participant HoNOS65+ were completed by two independent raters, and the clinician rated blindly each participant on the Stockton Geriatric Rating Scale and a scale which measured behavioural, physical, cognitive and emotional status. RESULTS: In both groups (inpatients n = 50, community n = 65), the inter-rater reliability, intraclass correlation and concurrent validity were high while internal consistency of the scales taken together was low. At reassessment in 98 participants, HoNOS65+ showed changes comparable to clinician ratings. CONCLUSION: The Greek version of HoNOS65+ can achieve high levels of reliability, validity and sensitivity to change for measuring outcomes in older people with mental health problems.

Validity and reliability of the Greek version of Brown's locus of control scale (BLOCS).

Studies in different research fields have shown that locus of control is a meaningful concept. A translated measurement of locus of control in Greece is the Brown locus of control scale (BLOCS), but the translation has not been yet validated. Construct validity and reliability of the BLOCS Greek version was investigated in a sample of employees in five public institutions. Three dimensions identified in the original study were observed. A reduced scale of 20 items showed better psychometric properties: Cronbach's alphas were for the total scale .76 (McDonald's omega = .72), and internal .76, external social .73, and external other .73, comparable to the original and improved if 5 items are removed.

Psychological distress following wildfires disaster in a rural part of Greece: a case-control population-based study.

Psychological distress is common in the aftermath of a disaster. This study investigated psychological distress and morbidity in individuals who had experienced severe exposure to a wildfire disaster in a part of Greece. The study was a cross sectional case control of an adult population (18-65 years old). Face to face interviews were used in the collection of the data which were demographics, the type and number of losses and the Symptom Checklist 90-Revised for assessment of psychological symptoms. The results showed that those exposed to wildfires disaster scored significantly higher on the symptoms of somatization, depression, anxiety, hostility, phobic anxiety, and paranoia; had significantly more symptoms of psychopathology and were more distressed, compared to controls. Risk factors for potential psychiatric cases were those exposed to disaster; those who had lower education, and those who were widowed. It was concluded that wildfires may cause considerable psychological symptoms comparable to other disasters and there are reasons to create services to help and improve the mental health of those affected.

Health inequalities for women living in rural regions: the prefecture of Xanthi, Greece.

Gender equity with regard to access to health services has been set on a firm theoretical background but is far from reaching a resolution. Here we examine how geographic isolation affects the implementation of policies regarding equal access to health care by considering the case of the mountainous region of Xanthi, Greece. We determined that the characteristics of this mountainous region require additional measures to ensure truly equal access for women of all social and demographic groups. We also propose several interventions aimed at reducing health inequalities by involving the local population and broadening the target area.

Addressing the paradoxes of satisfaction with hospital care.

PURPOSE: The purpose of this paper is to assess patient satisfaction in Greek public hospitals. DESIGN/METHODOLOGY/APPROACH: In total, 367 patients participated in the study with a minimum of three days stay at the hospital. Measures included overall satisfaction, satisfaction with medical and nursing staff, satisfaction with room facilities, waiting times, extra costs. Information was also collected concerning sex, age, education, salary and length of stay in the hospital. Participants were also asked to indicate, in an open-ended question, the most positive and the most negative aspects of their care. FINDINGS: Patients' bad experience with aspects of their care was not directly reflected in low levels of satisfaction. Patients had to wait long hours to get an appointment with a doctor or after their examination to be admitted to the hospital. Many patients had to rely on a personal nurse and to pay extra money to the medical and nursing staff. They considered lack of staff as the main drawback of the hospital. However, their overall satisfaction was very high. RESEARCH LIMITATIONS/IMPLICATIONS: These results raise concerns about how patients evaluate. Patients are expected to act as consumers who carefully evaluate the aspects of care they receive. However, the aspects of care which patients take for granted when they evaluate their experience with health care providers needs to be illustrated further. Patients' relationship with health care providers may reflect trust rather than rational choice. ORIGINALITY/VALUE: This paper provides useful information on assessing patient satisfaction in Greek public hospitals which could be used elsewhere.