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This study aimed to investigate the knowledge of patients with hypertension about their condition, adherence to antihypertensive medication, and the factors influencing it. A cross-sectional study was conducted in two cardiology outpatient clinics of two tertiary hospitals, in Greece. The study included 188 patients diagnosed with hypertension. The patients' knowledge about their disease and adherence to medication were assessed by using the HK-LS and A-14 scales, respectively. Patients had sufficient knowledge levels about their disease, but significantly low levels of adherence to medication. Patients with higher knowledge levels were more adherent to medications [r(188) = 0.885, p < 0.001]. By using multivariate analysis, higher age (p = 0.018), residence in a more populous area (p = 0.041), more years with the disease (p = 0.012), and a lower number of medications (p = 0.03) were associated with higher levels of knowledge. Conversely, younger age (p = 0.036), lower educational levels (p = 0.048), fewer years with the disease (p = 0.001), and a higher number of medications (p = 0.003) were associated with lower adherence to medication. The Greek patients' hypertension knowledge was sufficient; however, adherence to medication was significantly low. Healthcare managers could utilize our findings to design targeted interventions for improving adherence to medication for these patients. [ABSTRACT FROM AUTHOR]

Background: Mortality is an important healthcare index for assessing the quality and the effectiveness of the provided nursing care. Aim: The aim of this study was to identify the risk factors for increased in-hospital mortality among cardiac surgery patients. Methods: We followed up prospectively 313 consecutive patients who were admitted to the cardiac surgery intensive care unit (ICU) of a general, tertiary hospital in Athens during a 1 year period. Data collection was performed by using a short questionnaire and two instruments, the Nursing Activities Score (NAS) and the logistic EuroSCORE for assessing the nursing workload (NWL) and the perioperative risk for each patient respectively. Results: Patients with a high 1st day NAS had an almost 3.3 times greater probability of death during their hospitalization (OR 3.3, 95%CI 1.4–8). Moreover, patients with increased perioperative risk (OR 4.2, 95%CI 1.50–12) and ICU length of stay (ICU-LOS) (OR 16.8, 95%CI 4.8–58.6) had statistically significant higher in-hospital mortality. Conclusion: Increased level of NWL, patient perioperative risk and ICU-LOS are closely associated with increased in-hospital mortality of cardiac surgery patients. The correlation between NWL and mortality represents the strong link of the nursing profession with the improvement of the effectiveness and quality of care. [ABSTRACT FROM AUTHOR]

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Background: The mass media play a crucial role in imparting information on health issues; individual and population attitudes are greatly influenced by the media regarding the prevention and overall management of disease. Aim: To investigate the attitudes and perceptions of the general population regarding the role of the mass media in the provision of information on various health issues. Method: A cross-sectional research study was conducted with a study population sample of 83 men and 117 women all residing in the Greater Athens area. The data collection was performed from January to March 2010 with the use of a specially designed questionnaire comprising 20 questions. The content of the questionnaire was based on relevant international bibliography, and the questions, the majority of which were closed, were formulated in such a way as to investigate several aspects, ad specifically: the level of influence of the mass media in informing the general population on health related issues, the preferences of the general population regarding the various ways of provision of information used by the mass media, the health related topics that the mass media explore in their programmes and the main sources of information on health related issues. The statistical analysis of the data was conducted with the test Pearson x2 (significance level p<0.05) using the Statistical Package for Social Sciences (SPSS) v. 15.0. Results: Of the study population 10% reported using the mass media as their main source of information on health related issues. The majority of the sample also indicated that more broadcasts on health issues are needed. Specifically, 86% of the sample indicated that TV programmes on health related issues should be broadcast more often, and fewer responders that more inserts on health topics should be included in newspapers and magazines. In addition, some responders mentioned the use of internet and radio as sources of information on health related issues. The percentage of the sample with a primary or secondary education that indicated that the mass media influences in a meaningful way the preferences of the population regarding disease prevention and treatment (73.5%) was considerably lower than that of those with higher education (87.1%) (p=0.015). The percentage that valued the broadcast programmes on nutrition, was higher among those with personal health problems (p=0.005). Conversely, those who pinpointed the need for more inserts on health related issues in newspapers and magazines reported less personal health related problems (p=0.018, p=0.001, respectively). Conclusions: The mass media initiatives on providing information on health related issues were considered limited and fragmental by the study participants. They expressed the need for more and better information on health related issues in the mass media. The development of a central agency to plan, broadcast and audit programmes on health related issues is recommended, to ensure that public trust is gained, and that health related information is imparted in an appropriate way. [ABSTRACT FROM AUTHOR]

Background: A timely visit to a hospital emergency department can lead to successful therapeutic intervention for acute myocardial infarction (AMI). Aim: The determination of the factors that influence the decision of patients with early AMI to seek hospital health care. Method: A one-year study (December 2006-December 2007) was made of patients with AMI hospitalized in two major General Hospitals in Greece, in which 245 patients participated (186 male, 59 female). Data were collected by use of a questionnaire covering demographic and clinical characteristics, and the time period between the onset of AMI symptoms and the arrival of the patients at the emergency department. Statistical analysis included x2 test, Fisher's exact test, Mann-Whitney test and multivariate logistic regression using the software package Statistical Package for Social Sciences (SPSS) 14.0 for windows. Results: The median time from the onset of AMI symptoms to the arrival of the patients at the emergency department was 8 hours (interquartile range: 6 hours). Factors found to be correlated with a prolonged time period between the onset of symptoms onset and arrival of the patient to the hospital were: unmarried patients (p=0.008), distance to hospital =10 km (p=0.05), absence of activities before AMI (p=0.04), absence of cholesteraemia (p=0.004), absence of dyspepsia as a non-typical symptom of AMI (p=0.001), the low intensity of pain (p=0.01) and lack of knowledge about AMI (p=0.1). Conclusions: A number of factors appear to be associated with delay between the onset of AMI symptoms and the arrival of the patients at the emergency department of a hospital. Among these, one of the modifiable factors is the lack of knowledge about the symptoms of AMI, typical and non-typical. The role of nurses in the education of general population about AMI and its symptoms is important, as it could increase the number of patients who arrive at the emergency department of a hospital early in the course of an episode. [ABSTRACT FROM AUTHOR]

Introduction: The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is an important measurement instrument for assessing the health-related quality of life (HRQOL) among heart failure patients. The purpose of this study was to translate and validate the MLHFQ in the Greek language., Methods: Three hundred forty-four consecutive adult patients from three General Hospitals, two in Athens and one in another part of the country, who were diagnosed with chronic heart failure, and 347 healthy controls were enrolled in the study from March 2009 to March 2010. The questionnaire instrument was translated from English, back-translated, and reviewed by a committee of experts. The psychometric measurements that were performed included reliability coefficients and Explanatory Factor Analysis (EFA), using a Varimax rotation and Principal Components Method. In a further step, confirmatory analysis (CFA)--known as structural equation modeling--of the principal components was conducted., Results: The internal consistency of the Greek MLHFQ version was found to be 0.97, using Cronbach's alpha coefficient. An exploratory factor analysis identified two domains that accounted for 72.5% of the variance of MLHFQ items; the area under the ROC curve was calculated at 0.942 and the logistic estimate for the threshold score of 24.50 provided the model with 95.1% sensitivity and 99.8% specificity. Additionally, the CFA demonstrated that the two-factor model offered a very good fit to our data., Conclusions: Our data indicate that the Greek MLHFQ is a reliable and valid tool for assessing HRQOL among patients with heart failure. Health professionals can use it in their clinical practice to improve their evaluation of these patients.

Aim: To evaluate the seroprevalence of hepatitis B surface antigen (HBsAg) in 13 581 women at reproductive age and the hepatitis B e antigen (HBeAg)/anti-HBe status as well as serum hepatitis B virus (HBV)-DNA levels in a subgroup of HBsAg(+) pregnant women at labor in Greece., Methods: Serological markers were detected using enzyme immunoassays. Serum HBV-DNA was determined by a sensitive quantitative PCR assay. Statistical analysis of data was based on parametric methodology., Results: Overall, 1.156% of women were HBsAg(+) and the majority of them (71.3%) were Albanian. The prevalence of HBsAg was 5.1% in Albanian women, 4.2% in Asian women and 1.14% in women from Eastern European countries. The prevalence of HBsAg in African (0.36%) and Greek women (0.29%) was very low. Only 4.45% of HBsAg(+) women were also HBeAg(+) whereas the vast majority of them were HBeAg(-)/anti-HBe(+). Undetectable levels of viremia (<200 copies/mL) were observed in 32.26% of pregnant women at labor and 29.03% exhibited extremely low levels of viral replication (<400 copies/mL). Only two pregnant women exhibited extremely high serum HBV-DNA levels (>10 000 000 copies/mL), whereas 32.26% exhibited HBV-DNA levels between 1 500 and 40 000 copies/mL., Conclusion: The overall prevalence of HBsAg is relatively low among women at reproductive age in Greece but is higher enough among specific populations. The HBeAg(-)/anti-HBe(+) serological status and the extremely low or even undetectable viral replicative status in the majority of HBsAg(+) women of our study population, suggest that only a small proportion of HBsAg(+) women in Greece exhibit a high risk for vertical transmission of the infection.