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Objectives: The psychological distress of people living with diabetes is increased and associated with poorer glycemic outcomes and self-care. We aimed to examine the frequency of depression, anxiety, and diabetes-related distress (DRD) of individuals with type 2 diabetes (T2D) in primary care (PC) and their comparative associations with clinical, self-care, and socio-demographic characteristics, testing for possible different roles on glycemic control and self-care. Methods: This is a cross-sectional study of 182 adults with a T2D diagnosis of at least six months, recruited between August 2019-March 2020 and May-October 2020, from an urban PC unit. Participants were screened for symptoms of depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder-7 (GAD-7)), and DRD (Diabetes Distress Scale (DDS)). Clinical, self-care, and socio-demographic parameters were recorded. Results: The frequency of clinically significant symptoms of depression was 16.6%, (PHQ-9 score ⩾10), anxiety 17.7% (GAD-7 score ⩾10), and DRD 22.6% (DDS score ⩾2). All PHQ-9, GAD-7, and DDS scores intercorrelated, and higher scores were found to be associated with female gender, lower income, and prior diagnosis of depression. Higher PHQ-9 and GAD-7 scores were found to be associated with lower education, more hypoglycemia episodes, more blood glucose self-tests and antidepressant or benzodiazepine use. The retired/housewives scored significantly lower in GAD-7 and DDS compared to the unemployed participants. Higher DDS scores were associated with higher glycated hemoglobin, higher fasting plasma glucose, and insulin use. It was also noted that higher PHQ-9 scores were associated with lower uric acid levels and were significantly higher in the sedentary lifestyle group. Conclusion: DRD was associated with poorer glycemic outcomes while depressive symptoms were associated with lower physical activity perhaps sharing different roles for glycemic control and self-care. The psychological burden of individuals with T2D may be considered in PC.

Background Diabetes-related distress (DRD) is a common psychological issue of people living with diabetes. International guidelines advise to take DRD into consideration in diabetes care but evidence for Greece is scarce. In the present study we aimed to estimate the frequency of DRD as assessed by Diabetes Distress Scale (DDS) and to examine its connections with clinical and sociodemographic characteristics among patients with type 2 diabetes mellitus (T2D) in urban primary care (PC) in Greece. Methods This descriptive survey included adults with a diagnosis of T2D of at least six months under medication treatment attending a novel, public urban PC unit. Patients with other forms of diabetes, dementia, and psychosis were excluded. Patients were screened for DRD with DDS instrument and correlations were made between DRD and clinical and sociodemographic characteristics. Results In 135 eligible participants the frequency of moderate to high levels of DRD (DDS ≥ 2) was 24.4% and of high levels of DRD (DDS ≥ 3) was 7.4%. Emotional burden (EB) subscale was significantly correlated with younger age, insulin use, duration of insulin use, and the number of insulin injections per day. Longer diabetes duration showed significant correlation with DDS total, EB, and regimen distress. Participants with lower income, sedentary lifestyle, micro-vascular complications, more episodes of hypoglycaemia, and higher levels of glycated haemoglobin (HbA1c) experienced significantly higher distress. Conclusion DRD screening is important in urban PC and in more susceptible patients as those on more insulin injections per day, with longer diabetes duration, higher levels of HbA1c, lower income, sedentary lifestyle, and more episodes of hypoglycaemia.

METHODS: This was a pre/post-observational study examining patients' emotions before and during elective knee or hip replacement surgery for osteoarthritis in seven European Union countries to identify factors related to better emotional status at discharge. INSTRUMENTS: In addition to demographic data, information was collected on quality of life (EuroQoL five-dimension questionnaire), hospital expectations (Knowledge Expectations of Hospital Patients Scale), symptoms, and experienced emotions. ANALYSIS: Total negative emotions scores at baseline and discharge were transformed into median values. Multivariate analysis identified the baseline factors related to better emotional status at discharge. RESULTS: Patients (n = 1,590), mean age 66.7 years (SD = 10.6), had a significant reduction in the frequency of total negative emotions at discharge as compared with baseline. The multivariate model showed better health status (odds ratio [OR] = 1.012; p =.004), better emotional status at baseline (≥24 points), and shorter duration of hospital stay (OR = 0.960; p =.011) as independent factors associated with better emotional status at discharge (OR = 4.297; p =.001). CONCLUSIONS: Patients undergoing elective knee or hip replacement surgery for osteoarthritis improve their emotional status during hospitalization, with fewer negative emotions at discharge. Good emotional status, feeling of higher health status at baseline, and shorter hospitalization were independently associated with better emotional status at discharge. [ABSTRACT FROM AUTHOR]

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The ASEPSIS scoring method represents an important instrument for assessing surgical wounds for infections. The purpose of this study was to translate and validate the ASEPSIS in Greek. The ASEPSIS was translated from English to Greek, back-translated to English, and reviewed by an expert committee. Reliability and validity analyses were performed in a sample of 111 consecutive orthopaedic patients. Patients were assessed during hospitalisation (using the ASEPSIS) and at three months after discharge (by phone, through questions about wound healing). Face validity was considered to be very good. The surgical wound infection rate was 6.3% with the Centers for Disease Control and Prevention criteria and 3.6% with the ASEPSIS (i.e. score ≥21) (p < 0.001). At three months, 7.4% of the participants reported they were given antibiotics for wound infection and 5.4% needed a rehospitalisation. The ASEPSIS score was correlated to the therapeutic administration of antibiotics (p = 0.001) and the need for rehospitalisation (p < 0.001) during the follow-up. The inter-rater agreement was 90%. The Greek version of the ASEPSIS can be used by both surgeons and nurses. However, it should be used with caution until more studies are conducted with larger samples and in patients with different surgical procedures. [ABSTRACT FROM AUTHOR]

Background In Greece there is no systematic assessment of surgical wounds with the use of a validated instrument, while the ASEPSIS scoring method has been widely used internationally. Aim To examine the frequency of wound infections and their correlations both with patient background factors, as well as surgery factors, with the use of ASEPSIS. Methods In this prospective, observational study, participants undergoing orthopaedic surgeries in a large hospital in Greece were assessed during hospitalisation and the first month after discharge using the ASEPSIS wound assessment tool. The principles of the Declaration of Helsinki were applied. Non-parametric statistical analyses were performed using SPSS 20.0. Results In total, 111 patients participated; nearly half (49.5%) had a total ASEPSIS score of “0”. Almost 3 out of 4 patients (76.6%) had an ASEPSIS score under or equal to “10” (satisfactory healing) and only 3.6% had a minor or severe surgical wound infection. The ASEPSIS score was only positively correlated to longer surgery duration and longer postoperative stay. Discussion The frequency of surgical wound infections in orthopaedic patients in Greece is comparable to that described in the literature. ASEPSIS could be used for assessing patients and as a performance indicator in Greek orthopaedic departments. [ABSTRACT FROM AUTHOR]

BACKGROUND: The psychological response of injured people after traffic accidents includes stress and depression. PURPOSE: To assess orthopaedic patients' stress, depression, and satisfaction with life after traffic accidents in Greece. METHODS: Descriptive, longitudinal, correlational study. Patients' background factors, injury severity, scores on the Impact of Events Scale--Revised (IES-R), the Center for Epidemiologic Studies Depression (CES-D) Scale, and the Satisfaction With Life Quality (SWLQ) Scale were recorded. The principles of the Declaration of Helsinki were applied. RESULTS: In total, 60 patients participated in this study during hospitalization following a road traffic accident and 40 patients at 6 months after. Participants were mostly men (75%) with severe injuries (50%). The IES-R score at 6 months was significantly lower than during hospitalization. One out of 3 people had a CES-D score, which is considered of clinical signifi cance. The SWLQ scores were considered high. CONCLUSION: As posttraumatic stress and depression seem to affect a considerable percentage of people involved in road traffic accidents in Greece, these individuals should be assessed for posttraumatic stress and depression while still hospitalized. [ABSTRACT FROM AUTHOR]

OBJECTIVE The aging of the population leads to an increase in the incidence of "wear and tear" diseases such as arthritis and, consequently, to an increase in the number of planned orthopedic surgical procedures, including total joint arthroplasty (TJA). The empowering education of patients, which is an essential aspect of nursing care, has been associated with positive health outcomes. The purpose of the present study was to investigate the knowledge, expectations and the received knowledge of patients undergoing TJA of the hip or knee. METHOD A longitudinal, descriptive, correlational study was conducted, with measurements prior to surgery, at hospital discharge, and at six months after the surgery. Data were collected from patients who were undergoing knee or hip TJA in three general hospitals in Attica. The instruments used for data collection were the Hospital Patients' Knowledge Expectations and Received Knowledge Scales. The principles of the Declaration of Helsinki (2008) were followed throughout the study. Data analysis was performed using parametric tests. RESULTS The mean age of the patients was 72.32 years. The majority of patients were women (71.3%), graduates of elementary school (76.1%) and most were without vocational education (80.4%). The patients had high expectations for knowledge, particularly in the functional and biophysiological dimensions of empowering education. The patients' expectations for knowledge, as assessed by the Hospital Patients' Received Knowledge Scale at discharge from the hospital and at six months after the surgery, were not sufficiently addressed. The patients' expectations were mostly covered in the functional and biophysiological dimensions. Age was not associated with the patients' expected and received knowledge. CONCLUSIONS Patients reported that they had high expectations for their education and that these expectations were not fully covered, which hinders their empowerment. Patient education by nurses constitutes an important individualized nursing intervention and efforts for its promotion will contribute to the upgrading of the role of nursing in Greek society. In the future, it is important to offer several educational options to the patients and the initiative must be on the part of the nurses. [ABSTRACT FROM AUTHOR]

BACKGROUND: The prevalence of joint arthroplasties is increasing internationally, putting increased emphasis on patient education. PURPOSE: This study describes information and control preferences of patients with joint arthroplasty in seven European countries, and explores their relationships with patients' received knowledge. METHODS: The data (n = 1,446) were collected during 2009-2012 with the Krantz Health Opinion Survey and the Received Knowledge of Hospital Patient scale. RESULTS: European patients with joint arthroplasty had low preferences. Older patients had less information preferences than younger patients (p = .0001). In control preferences there were significant relationships with age (p = .021), employment in healthcare/social services (p = .033), chronic illness (p = .002), and country (p = .0001). Received knowledge of the patients did not have any relationships with information preferences. Instead, higher control preferences were associated with less received knowledge. CONCLUSION: The relationship between European joint arthroplasty patients' preferences and the knowledge they have received requires further research. [ABSTRACT FROM AUTHOR]

INTRODUCTION: With empowering patient education, patients and their significant others can be supported to self-manage their condition better. PURPOSE: The investigation of knowledge that significant others of patients undergoing total arthroplasty expect to receive, their preferences about information and control, and their preoperative emotions, as well as their correlation to significant others' background factors. MATERIAL AND METHODS: Descriptive and correlative survey. Data were collected from 106 significant others (convenience sample) of patients who were undergoing total arthroplasty in three hospitals in Attica, using the Expected Knowledge of Significant Others Scale, questions about significant others' emotions, and the Krantz Health Opinion Survey. The principles of the Declaration of Helsinki (2008) were followed. Data were analyzed with descriptive statistics and the appropriate statistical tests. RESULTS: The 106 significant others had mean age of 51.99 years and were mainly patients' children (53.8%). Significant others had high knowledge expectations (mean score ≥3.85), while they were experiencing anxiety, concern, and impatience frequently. Regarding their information preferences, they preferred an active role. The less significant others experienced negative emotions, the higher knowledge expectations they had. CONCLUSIONS: The education of patient and her/his significant others, as well as the emotional support during hospitalization for a surgery are important. Further research is needed on the significant others' expectations and preferences about their education during hospitalization, and the factors influencing these preferences. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Osteoarthritis is common in the elderly and the pain reduces their functional capacity. Total Joint Arthroplasty (TJA) is a common surgery, with beneficial effects for the patient. PURPOSE: To investigate the patients' quality of life regarding the surgical treatment for arthritis. MATERIAL AND METHODS: Descriptive, correlational, longitudinal study. The convenience sample was patients who underwent TJA, of knee or hip, in three general hospitals in Attica (March 2009-April 2011). The measurement instruments included the Health Related Quality of Life Aspects Questionnaire EQ5D, questions about symptoms and feelings, and the Quality of Recovery Scale. The data collection took place at admission (n=209), before discharge (n=188), and within six months following surgery (n=127). Statistical analysis was performed with parametric procedures. RESULTS: Patients' mean age was 72.32 years, in the majority women (71.3%), graduates of primary school (76.1%), and retired (57.9%). The preoperative quality of life was poor, while the majority of patients experienced negative emotions (fear, worry, sadness), and symptoms (pain, fatigue, insomnia), while at six months these were experienced less frequently. Pain was treated preventively only in 51.6% of the patients postoperatively. The patients' recovery was associated with their health- related quality of life, both at the second and the third measurement. CONCLUSIONS: Patients reported they were experiencing significant limitations in their daily life, many negative emotions, and poor quality of life, both preoperatively and in the immediate postoperative period, which were significantly improved during six months after surgery. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Current nursing care focuses on the patient, on self-management of the disease, and on empowerment. Involving patients in the decision making process is a topic of major interest during the provision of health care. PURPOSE: Investigation of total joint replacement patients' preferences about the information and the control over their treatment and self-care, about the access to knowledge, and of their satisfaction with the care in the hospital. MATERIAL AND METHODS: Descriptive study with longitudinal follow-up at two phases: before surgery and at patient's discharge from the hospital. The Krantz Health Opinion Survey, the Patients' Access to Knowledge Scale, and the Patients' Satisfaction of Care Scale were used. The analysis of data was performed with methods of descriptive statistics and parametric tests. RESULTS: Patients were unwilling to be actively involved in information acquisition and in controlling their health state. However, patients had adequate access to knowledge during their hospital stay, they were more satisfied with the nursing staff's professionalism and the care they received, while they were less satisfied with the time the nursing staff devoted to them. The higher access to knowledge the patients had, the more satisfied they were with the care. CONCLUSION: Patients had a passive role in information acquisition and in participation in their care and did not express expectations for their more active role in their care. However, they remained satisfied with the provided care. [ABSTRACT FROM AUTHOR]

Introduction: Nursing Staff (NS) working in the hospital are exposed to a variety of occupational hazards, such as physical, chemical, biological, ergonomic and psychosocial ones. The use of Personal Protective Equipment (PPE) every time that an exposure to an occupational hazard is possible is an issue of great importance. However, there is data that argue the systematic use of PPE by the NS. Purpose: To determine the knowledge, attitudes and compliance of NS to the use of PPE and the prevention of occupational hazards within the hospital setting. Materials and Methods: An electronic database search was conducted, using the key words «nurses», «knowledge», «nurses attitudes», «occupational health», «occupational safety», «safety guidelines», «compliance», «personal protective equipment». The inclusion criteria included the non- interventional studies, the publication in Greek and English language, after the year 1990, and the studies with access to full text. All research studies included in the review were about the knowledge, the attitudes and the compliance of the NS (or nursing students) and the guidelines about occupational health and safety and the use of PPE. Results: The knowledge and compliance of NS related to the preventive measures of biological occupational hazards are the most investigated to date, followed by the chemical occupational hazards. The PPE more frequently used by the NS included gloves, and less often masks and goggles. A small percentage of the NS uses PPE every time that an exposure to pathogens is possible, and PPE is used only when the patient is diagnosed with a communicable disease. The percentages of exposures to pathogens and of injuries are very high, while the percentage of NS and nursing students' compliance to prevention measures is low. Conclusions: NS appears to have wrong knowledge and low compliance to several issues about occupational hazards within hospital settings. The knowledge and compliance of the NS and also the percentage of occupational exposures and injuries could perhaps be significantly improved with systematic educational programs, according to the staff's expectations and existing knowledge. [ABSTRACT FROM AUTHOR]

Abstract: Background: There are a number of factors, such as preoperative Length Of hospital Stay (LOS), that effect treatment outcomes following proximal hip fracture. Much of this is not completely understood. Objective: To determine whether co-morbidities, complications and patients’ abnormal laboratory findings at admission have an effect on LOS and related complications during hospitalization for hip fracture treatment in a Greek hospital. Design: Prospective observational descriptive study. Setting: A high volume orthopedic ward of a general hospital in Greece, from March to October 2008. Patients: In total, 253 consecutive patients hospitalized for hip fracture treatment in an orthopedic ward of a large Greek hospital were included in the study. All complications, LOS and parameters of clinical history and treatment were recorded. Results: The mean age of the sample was 79.68years. Only 29.3% of the patients were operated within the first 2days, as the mean preoperative LOS was 3.71days, leading to a total LOS of 9.68days. Preoperative LOS increases somewhat in patients with heart failure and previous cerebrovascular accident. LOS increases when patients present with cardiac complications, respiratory complications, fever and anemia. Complications correlate with the type of patients’ co-morbidities. Abnormal laboratory findings at admission correlate to the type of preoperative complications. Discussion: LOS, mortality and complication rates in the study hospital are comparable to the findings reported in the literature. [Copyright &y& Elsevier]

Practice development enables practitioners to develop their knowledge and allows the application of evidence-based care for their patients. It happens within the practitioner's own clinical practice area and enhances personal and professional growth whilst focusing on patients' specific needs. This is important when working with patients in the rehabilitation phase following fragility hip fracture whose care should be provided by practitioners knowledgeable about the best way to approach their needs. This article, which followed the methods for a scoping review, aims to provide the practitioner with an overview of rehabilitation interventions for patients following hip fracture discussed in the literature. There is an introduction to the nature of rehabilitation and the issues raised for the patient with a hip fracture, a discussion of the existing literature, and recommendations for practice based on both that evidence and a pragmatic approach to care. Scoping reviews provide overviews of broad topic areas (Peterson et al., 2017). This gives the reader the opportunity to consider how other factors, besides research evidence, can contribute to best practice and to reflect on how their own practice needs to develop. At the end of the discussion, an overview of pragmatic recommendations for practice is provided based on the findings of the literature considered. Some points for individual reflection are also provided to help the practitioner to consider how the contents of the paper might impact on their own practice. [ABSTRACT FROM AUTHOR]

Objectives: The psychological distress of people living with diabetes is increased and associated with poorer glycemic outcomes and self-care. We aimed to examine the frequency of depression, anxiety, and diabetes-related distress (DRD) of individuals with type 2 diabetes (T2D) in primary care (PC) and their comparative associations with clinical, self-care, and socio-demographic characteristics, testing for possible different roles on glycemic control and self-care., Methods: This is a cross-sectional study of 182 adults with a T2D diagnosis of at least six months, recruited between August 2019-March 2020 and May-October 2020, from an urban PC unit. Participants were screened for symptoms of depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder-7 (GAD-7)), and DRD (Diabetes Distress Scale (DDS)). Clinical, self-care, and socio-demographic parameters were recorded., Results: The frequency of clinically significant symptoms of depression was 16.6%, (PHQ-9 score ⩾10), anxiety 17.7% (GAD-7 score ⩾10), and DRD 22.6% (DDS score ⩾2). All PHQ-9, GAD-7, and DDS scores intercorrelated, and higher scores were found to be associated with female gender, lower income, and prior diagnosis of depression. Higher PHQ-9 and GAD-7 scores were found to be associated with lower education, more hypoglycemia episodes, more blood glucose self-tests and antidepressant or benzodiazepine use. The retired/housewives scored significantly lower in GAD-7 and DDS compared to the unemployed participants. Higher DDS scores were associated with higher glycated hemoglobin, higher fasting plasma glucose, and insulin use. It was also noted that higher PHQ-9 scores were associated with lower uric acid levels and were significantly higher in the sedentary lifestyle group., Conclusion: DRD was associated with poorer glycemic outcomes while depressive symptoms were associated with lower physical activity perhaps sharing different roles for glycemic control and self-care. The psychological burden of individuals with T2D may be considered in PC., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Diabetes-related distress (DRD) is a common psychological issue of people living with diabetes. International guidelines advise to take DRD into consideration in diabetes care but evidence for Greece is scarce. In the present study we aimed to estimate the frequency of DRD as assessed by Diabetes Distress Scale (DDS) and to examine its connections with clinical and sociodemographic characteristics among patients with type 2 diabetes mellitus (T2D) in urban primary care (PC) in Greece., Methods: This descriptive survey included adults with a diagnosis of T2D of at least six months under medication treatment attending a novel, public urban PC unit. Patients with other forms of diabetes, dementia, and psychosis were excluded. Patients were screened for DRD with DDS instrument and correlations were made between DRD and clinical and sociodemographic characteristics., Results: In 135 eligible participants the frequency of moderate to high levels of DRD (DDS ≥ 2) was 24.4% and of high levels of DRD (DDS ≥ 3) was 7.4%. Emotional burden (EB) subscale was significantly correlated with younger age, insulin use, duration of insulin use, and the number of insulin injections per day. Longer diabetes duration showed significant correlation with DDS total, EB, and regimen distress. Participants with lower income, sedentary lifestyle, micro-vascular complications, more episodes of hypoglycaemia, and higher levels of glycated haemoglobin (HbA1c) experienced significantly higher distress., Conclusion: DRD screening is important in urban PC and in more susceptible patients as those on more insulin injections per day, with longer diabetes duration, higher levels of HbA1c, lower income, sedentary lifestyle, and more episodes of hypoglycaemia., (© The Author(s) 2020.)

Aims and Objectives: To examine the relationship between significant others' expected and received knowledge and their background characteristics in three Mediterranean countries (Cyprus, Greece, Spain), all of which deal with economic restrictions, have similar social support systems with the family members acting as family caregivers, and cultural similarities., Background: Significant others' role is a key element in the older patients' postoperative recovery. However, people who take care of persons older than 65 years, as persons undergoing arthroplasty, are usually old themselves and need special support., Design: Multicentre, descriptive, correlational study., Methods: Data were collected preoperatively from 189 and postoperatively from 185 significant others using the Knowledge Expectations and the Received Knowledge of Significant Others Scales during 2010-2012., Results: Approximately one-fourth of the significant others were older than 65 years. Their knowledge expectations were not adequately addressed in any of the countries; they expected to be educated more on biophysiological issues and received the lowest knowledge regarding financial issues. The highest difference between expected and received knowledge was found in Greece and the lowest in Cyprus. Significant others may be less prepared for dealing with situations at home due to the knowledge difference between expected and received knowledge., Conclusions: Significant others receive less education comparing to what they expect; therefore, they are not prepared for dealing with problematic situations during their old relative's recovery. This is especially important in Mediterranean countries, where family members often provide patient care., Implications for Practice: As health care is changing towards active participation of patients and family, it is important that nurses provide the education needed, as lower education may lead to poor patient outcomes and higher education may lead to significant others' anxiety. Nurses may keep in mind that older significant others do not report higher knowledge difference, but may have lower expectations., (© 2018 John Wiley & Sons Ltd.)

Purpose: Total joint arthroplasty is accompanied by significant costs. In nursing, patient education on financial issues is considered important. Our purpose was to examine the possible association between the arthroplasty patients' financial knowledge and their out-of-pocket costs., Methods: Descriptive correlational study in five European countries. Patient data were collected preoperatively and at 6 months postoperatively, with structured, self-administered instruments, regarding their expected and received financial knowledge and out-of-pocket costs., Findings: There were 1,288 patients preoperatively, and 352 at 6 months. Patients' financial knowledge expectations were higher than knowledge received. Patients with high financial knowledge expectations and lack of fulfillment of these expectations had lowest costs., Conclusion: There is need to establish programs for improving the financial knowledge of patients. Patients with fulfilled expectations reported higher costs and may have followed and reported their costs in a more precise way. In the future, this association needs multimethod research., (© 2016 Wiley Periodicals, Inc.)

The purpose of the study was to examine received and expected knowledge of patients with knee/hip arthroplasty in seven European countries. The goal was to obtain information for developing empowering patient education. The data were collected (during 2009-2012) from patients (n = 943) with hip/knee arthroplasty prior to scheduled preoperative education and before discharge with the Received Knowledge of hospital patient scale (RKhp) and Expected Knowledge of hospital patient scale (EKhp). Patients' knowledge expectations were high but the level of received knowledge did not correspond to expectations. The difference between received and expected knowledge was higher in Greece and Sweden compared with Finland (p < .0001, p < .0001), Spain (p < .0001, p = .001), and Lithuania (p = .005, p = .003), respectively. Patients' knowledge expectations are important in tailoring patient education. To achieve high standards in the future, scientific research collaboration on empowering patient education is needed between European countries., (© The Author(s) 2014.)

Ageing population entails a growing international problem of osteoarthritis. Best practices for education of these patients are lacking. This study focused on empowering education in Northern (Finland, Iceland, Lithuania and Sweden) and Southern Europe (Cyprus, Greece and Spain). The aim was to analyse associations between expected knowledge and background factors. The data were collected from European arthroplasty patients with the Knowledge Expectations of hospital patients- scale, (KE(hp) - scale), including bio-physiological, functional, experiential, ethical, social and financial dimensions. Patients had essential bio-physiological and functional knowledge expectations. Women expected more than men, employed less than retired, unemployed or who worked at home. Generally, patients in Northern countries expected more than in Southern countries. However, highest expectations were found in Sweden and Greece, lowest in Spain and Cyprus. There are differences in knowledge expectations based on patients' backgrounds. Development of common standards in European patient education needs further research., (© 2013 Wiley Publishing Asia Pty Ltd.)

Aims and Objectives: To identify and critically appraise studies addressing the implementation of education for children aged 2-12 years undergoing elective surgical procedures and to determine whether education is associated with improvements in children's anxiety and other emotions., Background: Children undergoing surgery often experience anxiety, which may lead to negative health outcomes, such as increased pain, feeding difficulties and sleeping problems. Education of children about their condition according to their individual needs may be correlated with reduced anxiety., Design: Systematic review., Methods: A database search in MEDLINE, PsycInfo, Cochrane Library and CINAHL was carried out during February 2011. Using the PICOS acronym, the query was organised into a searchable foreground question: the studies should evaluate (Objective) the effects of education (Intervention) compared with the standard preparation (Control) for children aged 2-12 years old undergoing elective surgeries (Population). The results would be based on randomised controlled studies (Study design). In total, 475 articles were yielded, from which 45 full-text articles were assessed for eligibility, and finally, 16 studies were included in the review., Results: In 12 of the 16 studies, children in the education groups reported lower anxiety scores. In two studies, no statistically significant effect of education was reported on anxiety. Moreover, education had an age-related effect in two studies, by being more effective to children older than four to six years and having a negative effect on younger children's anxiety. Parents of children in the education groups experienced lower anxiety., Conclusions: Education seems to be especially effective in the reduction in older children's anxiety and to have a negative effect on younger children's anxiety., Relevance to Clinical Practice: Education can be incorporated into the care provided to children aged four to six years or older undergoing elective surgical procedures, according to their individualised needs., (© 2013 Blackwell Publishing Ltd.)

Background: Heart failure is a serious chronic syndrome that is accompanied by significant physical and psychological burdens, resulting in poor quality of life., Aim: To assess the quality of life of patients with severe heart failure and its correlation with patient demographic, socio-economic and clinical characteristics., Method: We studied 199 patients with heart failure who were hospitalized in the Cardiology Department of three general hospitals of Greece during a 1-year period. Demographic and socio-economic data were obtained using a short questionnaire, while clinical data were obtained from medical record review. The assessment of the patients' quality of life was performed using Minnesota Life with Heart Failure Questionnaire (MLWHFQ)., Findings: The mean MLWHFQ score was 62.7 (±20.3). Significantly lower quality of life was found in patients with diabetes mellitus (Coefficient beta (β)=11.4; 95% Confidence Interval (CI), 5.2-17.5), hypertension (β=10.3; CI, 1.4-19.1), chronic renal failure (β=13.9; CI, 5.9-21.9), chronic respiratory failure (β=11.2; CI, 4.7-17.7), cancer (β=12.3; CI, 2.3-22.4), psychiatric disease (β=10.5; CI, 0.6-20.4) and those patients who were classified in New York Heart Association class IV (β=10.6, CI=4.1-17.0)., Conclusions: The average score of the MLWHFQ was high, and this reflects the poor quality of life of patients. Higher scores in specific patient groups show the negative influence of these factors in quality of life. The holistic care of patients with heart failure by a multidisciplinary team of healthcare professionals could improve their quality of life., (© 2012 The Authors Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.)