A Mixed-Method Study on the Assessment of Factors Influencing Nurses' Provision of Spiritual Care.

The purpose of this study was to explore factors that influence nurses' beliefs about offering spiritual care. STUDY DESIGN: A mixed-method study design, incorporating both quantitative (questionnaire) and qualitative research, was used for this study (focus group discussion). METHODS: The questionnaires were completed by a convenience sample of nurses and their assistants working in two public hospitals. These questionnaires included the Greek versions of the FACIT-Sp-12, SCIPS, NEO-FFI, and the Spiritual Climate Scale, as well as a specially designed questionnaire to gather demographic, socioeconomic, and professional information about the study population (SCS). Three nurses and two nursing assistants who worked in public hospitals and were chosen through purposive sampling made up the sample for the qualitative study. In utilizing inductive content analysis methodology, a qualitative analysis was carried out. RESULTS: Greek nurses frequently offer spiritual care to their patients, primarily existential spiritual care. It was discovered that the spiritual climate, the nurses' positive coherence, and their educational level all exert a favorable effect on total spiritual care. Three categories and seven subcategories were used to describe the participants' prior experiences with spiritual care. CONCLUSIONS: Greek nurses frequently offer spiritual care to their patients, and both internal and external factors influence their attitudes in this regard.

Assessment of the Relationship between Fear of Cancer Recurrence, Spiritual Well-Being, and Mental Health among Cancer Patients: A Cross-Sectional Study.

The purpose of this study was to examine the relationship between fear of cancer recurrence, spiritual well-being, and mental health among cancer patients. The study involved 217 patients undergoing chemotherapy. Data were collected with the following instruments: a demographic and clinical information recording form, the fear of cancer recurrence inventory, the Athens insomnia scale, the FACIT-Sp-12 scale for the assessment of spirituality, and the HADS scale for the assessment of mental health. For statistical analysis, SPSS statistical software was used, with the significance threshold set at 0.05;andtl number, t-test, one-way ANOVA, and multiple regression tests were used. The sample consisted of 217 cancer patients with a mean age of 63.7 years (SD = 11.6 years), 39.2% male and 60.8% female. The minimum value on the scale of fear of cancer recurrence was 0 and the maximum was 33 points, with a mean value of 14.1 points (SD = 8.2 points). The hospital scale of anxiety and depression was correlated, both in the dimension of anxiety and in the dimension of depression, significantly and positively with the scale of fear of cancer recurrence. Thus, greater fear of recurrence was associated with greater anxiety and depression. On the contrary, the correlations of anxiety and depression with the dimensions and the overall chronic disease treatment rating scale were significant and negative. So, greater spiritual well-being, in each domain and overall, were associated with less anxiety and depression. Finally, less fear of cancer recurrence was associated with finding greater meaning in life, greater peace, and overall greater spiritual well-being. In summary, fear of cancer recurrence is a predictor of psychological distress in cancer patients. However, spirituality can prevent the development of mental illness and FCR.

Fatigue among Greek Parents of Children with Autistic Spectrum Disorder: The Roles of Spirituality and Social Support.

The high demands of caring for and raising a child with autism spectrum disorder on a daily basis may lead parents to physical and mental fatigue. This study aimed to assess the effect of social support and spirituality on the fatigue of parents with children with autistic spectrum disorder. A cross-sectional study with a convenience sample was conducted in Schools of Special Education in Attica (Greece). The sample consisted of 123 parents who completed The Fatigue Assessment Scale (FAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale (FACIT Sp-12) to measure the levels of fatigue, social support, and spirituality, respectively. The Pearson correlation coefficient was used to investigate the relationship between the quantitative variables. To study the effect of social support and spirituality on fatigue, multivariable linear regression was applied. The mean age was 47.3 years old, 81.3% were women, and 38.9% stated "Close/Very close faith toward God". Higher levels of total MSPSS and FACIT Sp-12 were associated with lower total FAS (r = -0.50, p < 0.001 and r = -0.49, p < 0.001, respectively). Social support and spirituality were significant predictors of fatigue.

Fatigue among Patients with Type 2 Diabetes Mellitus: The Impact of Spirituality and Illness Perceptions.

Type 2 Diabetes Mellitus (T2DM) can cause fatigue, negatively affecting the daily functioning and health of individuals. The purpose of this study was to investigate the impact of spirituality and illness perceptions on fatigue among patients with Type 2 Diabetes Mellitus. In this cross-sectional, descriptive study, 100 patients with Type 2 Diabetes Mellitus completed the Fatigue Assessment Scale, the FACIT Sp-12 scale, and the Illness Perception Questionnaire-Revised assessing fatigue, spirituality, and illness perceptions, respectively. The mean age of the sample was 52.18 ± 15.53 years and 65% were insulin-treated patients. The mean score for the FACIT Sp-12 scale was 31.86 ± 7.7, for the FAS 27.0 ± 7.63, and for the Consequences and Emotional Representations of IPQ-R 25.5 ± 5.3. Statistically negative significant correlations were observed between the FACIT Sp-12 total score and the FAS subscales (r = -0.44 to -0.48, p < 0.01) and positive correlations between the "IP-Consequences and Emotional Representations" subscales and FAS scores. The total score of the FACIT Sp-12 (ß = -0.35) was a negative predictor while Consequences and Emotional Representations (ß = 0.28) were positive predictors of the total FAS Score. Participants scored moderate levels of total fatigue. Spirituality and positive illness perceptions may have a protective effect on the fatigue of patients with Type 2 Diabetes Mellitus.

Lipid Disturbances in Breast Cancer Patients during Chemotherapy.

Breast cancer is the most common cancer in women. Cardiovascular diseases are common complications after chemotherapy due to the effect of the drug on lipid levels. This study aimed to explore the changes in lipid profiles in patients with breast cancer under chemotherapy. METHODS: In this prospective study, 50 patients with breast cancer participated. Three biochemical-lipid hematological tests were performed: total cholesterol (TC), triglycerides (TGs), High-Density Lipoprotein (HDL-C), and Low-Density Lipoprotein (LDL-C) before initiation (pre-chemotherapy), at the start (first follow-up), and at the completion (second follow-up) of the first cycle of chemotherapy. Statistical significance was set at p < 0.05. Analyses were conducted using SPSS Statistical Software (version 22.0). RESULTS: Mean TC values increased significantly at second follow-up. TGs values decreased significantly from first to second follow-up. HDL-C was significantly lower at first follow-up compared with pre-chemotherapy and was similar to the pre-chemotherapy levels at second follow-up. LDL-C values were significantly higher at second follow-up compared with pre-chemotherapy measurement. Significantly positive correlations of BMI with pre-chemotherapy LDL-C, first follow-up TC, first follow-up LDL-C, second follow-up TC, and second follow-up LDL-C were found. CONCLUSIONS: There is a statistically significant increase in the levels of TC and LDL-C in breast cancer patients during chemotherapy. This study was not registered.

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.

Investigation of Anxiety and Health Locus of Control in Patients Undergoing Hemodialysis.

INTRODUCTION: Hemodialysis is the most frequent treatment modality for End-Stage Renal Disease (ESRD). However, a number of limitations and modifications accompany this treatment, affecting people's physical and psychological well-being and increasing anxiety symptoms. The aim of this study was to investigate the level of anxiety and health locus of control among dialysis patients. METHODOLOGY: One hundred and five patients on hemodialysis treatment completed a questionnaire with demographic characteristics, the State-Trait Anxiety Inventory and the Multidisciplinary Health Locus of Control Scale. RESULTS: Women had significantly higher levels of state anxiety than men (p = 0.019). Similarly, patients with primary school education had significantly higher trait and total anxiety levels than those with technological education (p = 0.002 and p = 0.033, respectively). Widowed patients exhibited significantly higher state, trait, and total anxiety levels than married (p = 0.032, p = 0.012, and p = 0.012, respectively). Participants who did not do any kind of exercise had significantly higher level of state, trait, and total anxiety than those who did (p = 0.011, p = 0.015, and p = 0.006, respectively). Respondents who did not have any self-care skills had significantly higher level of state, trait, and total anxiety than those who had (p = 0.011, p = 0.015, and p = 0.006, respectively). State, trait, and total anxiety levels were significantly (p ≤ 0.05) correlated negatively with internal locus of control and positively with "chance" locus of control scale. CONCLUSIONS: Hemodialysis patients had increased anxiety symptoms and believed that others had control over their health to a greater extent. Renal professionals need to apply effective interventions to dialysis patients in order to help them gain a better sense of control over their health and reduce anxiety symptoms.

Quality of life of patients with pressure ulcers: a systematic review.

Introduction: Patients suffering from pressure ulcers experience low quality of life, in every dimension of daily living. Aim: The aim of this systematic review was to investigate the impact of pressure ulcers on the patients' quality of life involving mental/emotional, spiritual, physical, social, cognitive dimensions, and pain. Methods: A systematic literature search of published articles in the English language during the past 15 years was conducted. Articles were identified in the electronic databases of Google Scholar, PubMed, and PsycINFO using the keywords: pressure ulcers, quality of life, emotional dimension, social dimension, physical dimension. The inclusion criteria were: articles relevant to the study topic, written in English, and published between 2004 and 2019. Articles that were secondary studies, such as reviews and meta-analyses, case studies, and articles written in a language other than English, were excluded from the study. The PRISMA method was applied. Results: Fourteen studies were included in this systematic review. Eight were quantitative studies (six cross-sectional, one longitudinal, one multicenter cohort, and one pilot study) and six qualitative (one was based on grounded theory, one pilot study, one case study of mixed methods, one phenomenological study, and one comparative study). The emerging themes were related to the mental/emotional, spiritual, physical, social, cognitive dimensions, and pain. Conclusions: Pressure ulcers have a negative impact on the patients' quality of life, especially at a psychological level. Patients' life is severely affected as they are fully dependent on their supportive environment and health services.

Translation and Validation of Nursing Students' Knowledge and Attitudes of Lesbian, Gay, Bisexual, Transgender Health Concerns Survey in the Greek Language.

Nursing students have limited knowledge of providing quality care to lesbian, gay, bisexual, and transgender individuals. The aim of this study was to explore the psychometric properties of the Nursing Students' Knowledge of and Attitudes toward Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Concerns (NKALH) survey as well as to examine whether sociodemographic variables may affect attitudes toward LGBT individuals. In this cross-sectional study which was carried out from January−March 2022, 258 nursing students from two Greek universities completed the NKALH. For survey translation, the procedure of forward and backward translation was followed. Construct validity, reliability, and internal consistency were explored via confirmatory factor analysis, the test−retest reliability method, and Cronbach's alpha index. The correlation between the dimensions of the attitude subscale was used to explore convergent validity. Analyses were carried out with the Statistical Package for the Social Sciences (SPSS), version 26.0. The level of significance was set at <0.05. Confirmatory factor analysis confirmed that the attitude subscale consists of three dimensions (Comfortable, Responsibility, Willingness to Care). The Pearson test (r) revealed strong correlations between two measurements (Comfortable r = 0.932, p < 0.001, Responsibility r = 0.938, p < 0.001, and Willingness to Care r = 0.915, p < 0.001), indicating good reliability. The Cronbach's alpha index of the total scale was 0.783, highlighting its good internal consistency. Bivariate analysis revealed that sexual orientation, religion, and age are related to knowledge and attitudes toward LGBT individuals. The NKALH survey is a valid and reliable tool to measure the knowledge and attitudes of Greek nursing students on the health concerns of LGBT individuals.

Factors influencing the duration of hospitalization of patients with schizophrenia.

Introduction: Severe mental disorders represent an important and large proportion of healthcare resource utilization and are associated with increased hospitalization rates and costs. Given the high percentage of total hospital days and costs associated with caring for people with psychotic disorders, a better understanding of the factors that determine the duration of hospitalization of patients with such disorders is imperative. Purpose: The aim of the present study was to investigate socio-demographic, clinical and psychosocial characteristics of patients with schizophrenia, admitted to a Greek public psychiatric hospital, and the relationship between these characteristics and duration of hospitalization among these patients. Methods: This is a cross-sectional study. The study sample consisted of 103 patients diagnosed with schizophrenia (F-20). The collection of data was performed by using the NEO-Five Factor Inventory, the Connor-Davidson Resilience Scale (CD-RISC25), Multidimensional Scale of Perceived Social Support, (MSPSS), Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning scale (GAF) for assessing key personality factors, psychological resilience, social support, symptom severity and the severity of the disease, respectively. Descriptive analyses and inferential statistic methods were applied. Correlation between socio-demographic, psychosocial or clinical characteristics with the length of stay were explored. In addition, linear regression analysis was performed in order to examine predicting factors for the duration of hospitalization. All statistical analysis was performed using SPSS v.25. Results: The mean age of the sample was 43.9 (SD = ±11.4) years, 67% of patients were men, and the mean length of hospitalization was 40.7 days. Factors found to be significantly associated with length of stay in the overall sample include the previous admissions (p=0.010), the type of admission (compulsory or voluntary) (p=0.017), bed rest (p=0.043) and duration of bed rest (p=0.002), and the existence of social support networks especially from friends (p=0.018). Conclusions: Our findings indicate that basic psychosocial and clinical factors were associated with the duration of hospital stay. Duration of hospitalization results from a complex interface between characteristics and activities of the health system, patient, and clinician's influence on discharge timing, which requires additional study. Our findings further warrant the need for policymakers to consider socio-demographic status, psychosocial and clinical factors when allocating resources to hospitals caring for patients with severe mental disorders.

Care and Safety of Schoolchildren with Type 1 Diabetes Mellitus: Parental Perceptions of the School Nurse Role.

Schoolchildren with type 1 diabetes mellitus (T1DM) need supervision in the management of their disorder by the school nurse, securing proper care and safety in the school environment. The aim of this study was to investigate the parents' perceptions regarding the care and safety of their children with T1DM at school. In this cross-sectional study, 356 parents of children with T1DM attending primary and secondary school (convenience sample) completed the "Parents' Opinions about School-based Care for Children with Diabetes" and the "Safety of children with T1DM at school". The majority (58.8%) noted that their children received some care from a school nurse, less than half (44.6%) declared feeling very safe concerning diabetes care, and 42.5% reported high levels of diabetes management satisfaction. Younger age of the child (p < 0.001), school nurses' advanced diabetic care skills (p < 0.001), existence of school nurse's office (p < 0.05) and higher educational level of the father were positively correlated with higher parental feelings of safety and satisfaction. The presence of a school nurse was associated with higher academic performance (p < 0.001), significantly fewer absences due to the disorder (p < 0.001) and better diabetes management (p < 0.043). The daily presence of a school nurse in school decreases absenteeism, greatly improves school performance and enhances diabetic management of schoolchildren with T1DM.

Factors Associated With Fatigue in Patients Undergoing Hemodialysis.

Background and objective Fatigue is frequently experienced by patients undergoing hemodialysis and it has a negative effect on their quality of life. The aim of this study was to investigate the factors associated with fatigue in patients undergoing hemodialysis. Methods In this quantitative cross-sectional study, 100 patients on hemodialysis participated. Fatigue was evaluated via the Modified Fatigue Impact Scale (MFIS). Participants also completed a questionnaire about demographics and clinical characteristics. The Kruskal-Wallis test, the Mann-Whitney U test, and Spearman's rho criterion were used to assess the association between fatigue score and patient characteristics. Multiple linear regression was performed to assess the effect of the characteristics on patients' fatigue. Results Statistically significant high levels of physical or mental fatigue were found in older patients (p=0.001 and p=0.001), divorced/widowed patients (p=0.001 and p=0.014), those who had children (p=0.019), those who had primary education (p=0.015), those who were not informed about their health problems (p=0.003 and p=0.006), those who had comorbid diseases (p=0.001 and p=0.001), those who believed that regular information did not help to reduce stress (p=0.005 and p=0.004), patients who had insomnia (p=0.001 and p=0.001), patients who felt tired after hemodialysis (p=0.001 and p=0.001), those who thought they had a change in body image (p=0.001 and p=0.001), those who often felt stiffness (p=0.001 and p=0.001), those who sometimes felt nausea (p=0.015 and p=0.038), and those who had limitations in the clothes they could wear (p=0.001 and p=0.001). Conclusions The findings of this study showed that physical or mental fatigue had a strong association with advanced age, comorbidities, marital status, level of education, inadequate information about the disease, insomnia, and change in body appearance. Hence, renal professionals need to properly educate dialysis patients on the complicated nature of fatigue in order to manage it effectively and improve their physical, cognitive, and social wellbeing.

Depression, Adherence, and Functionality in Patients Undergoing Hemodialysis.

Background  Patients undergoing hemodialysis face multiple problems such as difficulties in performing daily activities, low functional capacity, non-adherence to the hemodialysis regimen, and depressive symptoms that lead to poor health outcomes. The present study aimed to assess the levels of depression, adherence, and functionality in patients undergoing hemodialysis, as well as the association between the above variables. Materials and methods In this cross-sectional study, 100 patients undergoing hemodialysis from a private hospital in Athens participated. Data were collected via the Zung Self-Rating Depression Scale, the Barthel Scale/Index, and the Greek Simplified Medication Adherence Questionnaire-Hemodialysis for the evaluation of patients' depression, functionality, and adherence to hemodialysis regimen, respectively. In addition, sociodemographic and clinical characteristics were recorded. The study was conducted during the period of December 2020 to February 2021. IBM SPSS Statistics for Windows, Version 25.0 (Released 2017. IBM Corp., Armonk, New York) was used for the statistical analysis of the data. The statistical significance level was set up at 0.05. Results Of the patients, 50% scored < 38 (possible range 20-80) in the scale pof depression, and 25% of patients scored < 34. Regarding adherence, the median value was 7 (IQR: 7-7) while 77% scored 7 (possible range of 0-8). Regarding functionality, mild dependence (score 91-99) was referred by 77% of the participants, moderate dependence (score 61-90) by 17%, and severe dependence (score 21-60) was referred by 6% of the patients. A statistically significant negative association emerged between depression and functionality (r= -0.342, p=0.001) while no significant association arised between depression and adherence (r= 0.021,p=0.836) as well as between adherence and functionality (r = 0.078, p = 0.439). Statistical significantly higher scores of depression were seen in women (ß = 3.65, p = 0.001) and elderly >70 years old (ß = 3.51, CI=0.09-6.93, p = 0.044). Statistically significantly lower functionality were referred by patients >70 years old (ß = -13.58, CI: -21.68-5.49, p = 0.001) and by patients with high depression score (ß= -0.62, 95% CI: -1.06-0.20, p = 0.005). Conclusion Patients experienced moderate to low levels of depression and high levels of adherence and functionality. The higher the functionality scores, the lower the depression scores. Demographic characteristics, such as age and gender, seem to be significant predictors of depression and functionality.

Factors Associated With Insomnia in Patients Undergoing Hemodialysis.

INTRODUCTION: Insomnia is the most common sleep disorder among patients on hemodialysis and has a strong relation with fatigue, depression, low immune system, increased risk of cardiovascular problems, and low quality of life. The aim of this study was to explore the factors associated with insomnia in patients undergoing hemodialysis.  Methods: In this cross-sectional study, 100 patients on hemodialysis (75 males and 25 females) from a hemodialysis center in Greece were included. Insomnia was assessed via the "Athens Insomnia Scale (AIS)" and a questionnaire about demographic and clinical characteristics. The Kruskal-Wallis, Mann-Whitney tests, and Spearman's rho criterion were used to evaluate the association between insomnia score and patients' characteristics. Multiple linear regression was performed to assess the effect of characteristics on patients' insomnia. RESULTS: Statistically significantly high levels of insomnia were found in patients over the age of 60 years (p = 0.002), in divorced/widowed patients (p = 0.007), in patients who had comorbid diseases (p = 0.001), in patients who felt tired after hemodialysis (p = 0.001), in those who had continuous fatigue (p = 0.001) and change in body image (p = 0.003), in those who often had itching (p = 0.007) and stiffness in joints (p = 0.001) and in patients who had limitations in the clothes they could wear (p = 0.001). CONCLUSIONS: The findings of this study showed that insomnia had a strong association with increased age of patients, comorbidities, fatigue, change in body appearance, pruritus, and limitation in clothes they could wear. Therefore, there is a necessity for early assessment of sleep quality and effective treatment of sleep disorders in hemodialysis patients in order to reduce morbidity and mortality and improve the quality of their life.

The Effect of Spirituality in Quality of Life of Hemodialysis Patients.

This study aimed to assess the effect of spirituality on quality of life of end-stage renal disease patients undergoing hemodialysis (HD). A cross-sectional study was carried out in six HD Units. The sample consisted of 367 patients averaging 61.8 years of age. For the measuring of spirituality and the quality of life, the FACIT-Sp-12 and the Missoula Vitas Quality of Life Index-15, respectively, were completed. Social and demographic data were, also, collected. Spirituality and its dimensions such as Meaning in Life and Peace had a positive effect on Global QoL, Symptoms, Interpersonal and in Well-being. Spirituality can have a positive effect on the QoL of HD patients. Therefore, in the context of the holistic approach of the individual, health systems can include spiritual evaluation and care of HD patients.

The effect of hospital ethical climate on nurses' work-related quality of life: A cross-sectional study.

BACKGROUND: Hospital ethical climate (HEC) has been associated with nurses' interprofessional collaboration, moral decision-making and judgment, job satisfaction, and job burnout. OBJECTIVES: This study aimed to examine the effect of hospitals' ethical climate on nurses' quality of working life. METHODS: A cross-sectional study design was employed and 286 nurses from two hospitals in Athens participated in the study from January to February 2020. The data collected using a three-part self-administrated questionnaire were analyzed using the IBM Statistical Package for Social Sciences 25 (SPSS). RESULTS: According to the results, the staff nurses working on rotating shifts reported poorer Work-Related Quality of Life (WrQoL). Positive correlations were observed between age, control at work, and home-work interface, between the period of time the nurses were working in a specific department with the dimensions of the ethical climate scale, and between almost all the HEC aspects with WRQoL subscales. Only the domain of stress at work had fewer and less significant correlations. CONCLUSIONS: Health authorities and hospital managers should provide the necessary ground for the institutionalization of professional ethics by creating an appropriate ethical climate. A positive ethical climate may lead to a better working environment with less distress for health professionals and better quality of care for the patients.

Perceptions of Caring Behaviors among Patients and Nurses.

The concept of caring is fundamental to nursing practice. The aim of this study was to investigate patients' and nurses' caring behaviors and the possible differences between the two groups. In this descriptive and comparative study, 310 patients and 329 nurses from six general hospitals from Greece completed the Caring Behaviors Inventory-16. The mean score of Caring Behaviors Inventory-16 for patients was 78.94 (±17.85) and for nurses 80.27 (±9.36). The items "Demonstrating professional knowledge and skills" (Mean: 5.45 ± 3.62) and "Treating my information confidentially" (Mean: 5.34 ± 1.06) were the most important caring behaviors while the items "Including me in planning care" (Mean: 4.36 ± 1.56), and "Treating me as an individual" (Mean: 4.55 ± 1.46) were the least important caring behaviors for patients. For nurses, the most important caring behavior was "Treating patients" information confidentially" (Mean: 5.43 ± 0.94) and the least important was "Returning to the patient voluntarily" (Mean: 4.57 ± 3.68). Significant differences were observed in items: "Attentively listening to me/the patient" (t = -2.05, p = 0.04), "Treating me/the patient as an individual" (t = -7.82, p = 0.00), "Being empathetic or identifying with me/the patient" (t = -2.80, p = 0.00), and "Responding quickly when I/the patient call (t = -2.01, p = 0.04). Respect, privacy, and dignity were the most important caring behaviors for nurses while for patients they were knowledge, skills, and safety.

Translation, Cultural Adaptation, Validity, and Internal Consistency of the Greek Version of the Individual Workload Perceptions Scale-Revised.

INTRODUCTION: The working environment in hospitals has been characterized as very important for the improvement of the provided care and the nurses' job satisfaction. The aim of the current study was translation and cultural adaptation of the Individual Workload Perceptions Scale-Revised (IWPS-R) as well as the investigation of the validity and internal consistency of the scale. METHODS: This is a cross-sectional, descriptive study involving 365 Greek nurses from two large hospitals in Athens, Greece. Nurses completed the Individual Workload Perceptions Scale-Revised, which is a self-administered questionnaire consisting of 29 items on a five-point Likert-type scale. For the translation, the scale was first translated into the Greek language (forward translation) and then into the English language (backward translation) and culturally adapted. For the study of the construct validity, exploratory and confirmatory factor analyses were performed, while the criterion of the convergent validity was between the five factors of the scale. To study the reliability, the method of test-retest was performed while Cronbach's alpha coefficient was used to study the internal consistency of the scale. Data analysis was performed via the Statistical Package for the Social Sciences (SPSS), version 21.0 (IBM Corp., Armonk, NY). RESULTS: According to the exploratory factor analysis, the Greek version of the Individual Workload Perceptions Scale-Revised consists of five factors (Manager Support, Peer Support, Unit Support, Workload, and Intent to Stay) explaining 51.4% of the total variance. From the confirmatory factor analysis, the model was equivalent to the original factorial structure of the IWPS-R. Τhe convergent validity revealed a positive correlation between all the domains of the scale (p < 0.001). The test-retest method showed that there are no significant differences between the first and the second measurements (intraclass correlation coefficient [ICC] = 0.990, p < 0.001). The internal consistency was very good (Cronbach's alpha coefficient = 0.878). CONCLUSIONS: The IWPS-R is a reliable and valid instrument for Greek nurses to measure the perceptions of the nursing working environment.

A cross-sectional study for assessing perceived symptoms, depression and quality of life in advanced lung cancer patients.

PURPOSE: The purpose of the present study was to assess the perceived symptoms, depression and quality of life (QoL) in advanced lung cancer patients undergoing chemotherapy. METHODS: The study was cross sectional and was conducted in the oncology department of General Hospital "George Papanikolaou", Thessaloniki, Greece. The sample was convenient and consisted of 76 advanced lung cancer patients. A questionnaire including instruments such as Center for Epidemiologic Studies Depression Scale- CES-D, Revised Edmonton Symptom Assessment Scale r-ESAS, EORTC QLQ-C30 and demographic and clinical information was used to collect data. RESULTS: The most frequently observed symptoms were tiredness, shortness of breath, anxiety and well-being. The vast majority of patients (75.3%) had total score in CES-depression higher than 16. The type of residence affected ESAS emotional score (p=0.010). Gender affected the level of depression (p=0.014) and the type of lung cancer affected depression (p=0.036). The type of residence affected emotional functioning (p=0.010), the type of treatment influenced the score of global health status (p=0.007), the role functioning (p=0.032) and social functioning (p=0.024). Multivariate regression analysis was conducted to identify the predictors of overall QoL and depression. The statistically significant factors for QoL were pain (p<0.001) and tiredness (p=0.003), while the type of lung cancer (p<0.007), the type of insurance (p<0.025) and the type of treatment (p<0.041) influenced depression as well. CONCLUSIONS: Advanced lung cancer patients experienced moderate level in QoL and mild levels of symptoms. Demographic and clinical characteristics influenced depression and QoL.

Psychometric Properties of the Greek Version of the Caring Behaviors Inventory-16.

Caring is a key component of nursing. Exploring patients' perceptions of caring behaviors is essential to providing high-quality health care. This study aimed to investigate the validity, reliability, and internal consistency of the Greek version of the Caring Behaviors Inventory-16. This descriptive cross-sectional study involved hospitalized patients from six major hospitals in Greece who completed the Caring Behaviors Inventory-16 scale. This is a self-completing questionnaire whose answers range from one to six on a Likert-type scale. The overall score ranges from 16 to 96. To study the reliability of the scale, 50 patients completed the scale twice within two weeks, and then the repeatability was tested using the Pearson's r correlation coefficient and the intraclass correlation coefficient. Construct validity and internal consistency were tested among 180 patients. Construct validity was tested through the principal component analysis. The internal consistency was tested through Cronbach's alpha index. The statistical analysis was performed through the IBM Statistical Package for the Social Sciences (SPSS) Statistics Version 21.0 (Armonk, NY: IBM Corp.). The level of statistical significance was set at 5%. The study was conducted in the period October-December 2019. According to the results, the average age of patients was 58 years old and 50.6% were men. The mean value of the scale was 79.31 (standard deviation ± 15.75). The principal component analysis showed that the scale is unidimensional highlighting one factor that explains 68.24% of the total variance. Questions loadings ranged from 0.575 to 0.912 on the same factor. This means that all questions measure the same structure and are strongly concentrated in the same construction. Regarding the repeatability test, no statistically significant differences were observed between the two measurements. Pearson's r coefficient was 0.82 while the intraclass correlation coefficient was 0.91 (p<0.001) and indicate the very good reliability of the scale. Cronbach's alpha was 0.967 and indicates the excellent internal consistency of the scale. Data analysis showed that the Caring Behaviors Inventory-16 is a valid, reliable, simple, and short tool for assessing patients' perceptions of caring behaviors. Further tests are suggested to confirm the construct validity, reliability among patients, nurses, or nursing students.