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Background: Working in an intensive care environment is known to cause stress to health care providers, especially to nursing staff, with implications for their health. The aim of this study was to investigate the job satisfaction and general health of adult and pediatric Intensive Care Unit nurses, and the sociodemographic/working factors associated with their satisfaction. Design: A multi-center cross-sectional study. Methods: Data collected using a self-report questionnaire consisted of questions about demographics, the Stamps Index of Work Satisfaction, and the General Health Questionnaire. This was distributed to nurses working in adult or pediatric Intensive Care Units. Statistical analysis done using the IBM SPSS 25.0. Results: 150 replies were included in the analyses. Mean age was 40.1 years, and mean work experience were 8.6 years. Moderate job satisfaction [3.65 (SD±0.51)]. and good overall health [24.4 (SD±12.3)]. were found. Job satisfaction was significantly correlated with anxiety/sleep problems and social dysfunction. Gender had a significant effect for the dimensions of remuneration (U = 1464.5, p = 0.034), professional prestige (U = 1480, p = 0.040) and duties (t = -2.968, p = 0.003). Job position and weekend working hours significant correlated with the autonomy subscale (U=474, p=0.014, r = -0.263, p

The impact of depression on post-menopausal women is an important public health issue but remains largely unknown. The purpose of this study was to identify the prevalence of post-menopausal depression in Greece and outline the profile of the women it affects.A sample of post-menopausal women completed an anonymous, self-administered, web-based survey which included the Beck Depression Inventory-ΙΙ (BDI-II) and questions regarding socio-demographic data.The dependent variable of interest was a BDI-II score ≥ 20 (the cut-off for moderate depression according to the BDI).Overall, 502 post-menopausal women participated in the study. The median BDI-II score was 13 (range 0-50); 136 (27.1%) of the women scored ≥ 20 and were considered screen-positive for depression. According to the multivariate logistic regression model, age 55 years (OR: 1.621; 95% CI: 1.036-2.535), not working (OR: 1.580; 95% CI: 1.013-2.465), smoking (OR: 1.656; 95% CI: 1.081-2.536) and history of depression (OR: 1.650; 95% CI: 1.045-2.604) were independently associated with post-menopausal depression. Subgroup analyses revealed that current smokers (OR: 2.514; 95% CI: 1.485-4.256) had higher odds of moderate depression, while obesity (OR: 2.455; 95% CI: 1.206-4.996), absence of healthcare insurance (OR: 4.413; 95% CI: 1.970-9.887) and a history of depression (OR: 2.253; 95% CI: 1.212-4.190) were identified as independent risk factors for severe post-menopausal depression.More than one out of four post-menopausal women were screen-positive for symptoms indicative of depression, while a personal history of depression, age 55 years, smoking and current working status were independent predictors of its emergence.

Background and Purpose:To translate and validate the influenza vaccination acceptance (MoVac-flu) and vaccination advocacy (MoV-ad) scales, in a sample of Greek health professionals (HPs).Methods:A cross-sectional study was conducted in eight representative secondary hospitals in Greece. A total of 296 HPs were administered the scales.Results:The internal consistency of the Gr-MoVac-flu and the Gr-MoV-ad scale was high, and Cronbach’s alpha was .92 for each scale. The Gr-MoVac-flu and the Gr-MoV-ad scales are not unidimensional and demonstrated two-factor structures respectively.Conclusions:The MoVac-flu and the MoV-ad scale are highly convergent validity tools that could provide rich understanding of HPs’ decision to uptake and to advocate for vaccination.

Introduction: Treatment approaches for drug addiction are classified into several general types: psychosocial interventions as a part of drug-free programs, opioid maintenance treatment programs and detoxification programs. Μethadone maintenance treatment (MMT) is one of the most common therapeutic approaches. Aim: To investigate the factors that affect drug dependent people’s subjective Quality of Life (QOL) under MMT. Methods: A cross sectional study was conducted in a convenience sample of 209 drug dependent people under MMT provided by a substitution treatment unit (OKANA). They completed a questionnaire that included: a) demographic/occupational characteristics, b) the Short Form 12-Item Health Survey questionnaire (SF-12) and c) the Symptom Checklist-90-R (SCL-90-R). Data analysis was carried out using the statistical package SPSS 24.0. Results: Mean scores for the physical (PCS) and the mental (MCS) subscale of SF-12 were 47.4(±8.8) and 38.6(±9.2) respectively, displaying lower level of drug dependent people’ QOL. High mean scores of the nine symptomatic dimensions and the three global indices of the SCL-90-R demonstrate existence between addiction and psychiatric disorder. Prolonged time period over two years under MMT was associated with deterioration in their QOL. Drug dependent people with the longest stay under MMT had higher scores in the subscales of somatization (p =0.051), the obsessive-compulsive disorder (p =0.013), the Global Severity Index (p=0.041) and the Positive Symptoms Total (p=0.033). Findings indicate that female sex, the age of initiation of drugs (younger age) and previous Conclusions: In line with drug dependent people’s subjective QOL, prolonged time under MMT was associated with poor QOL. Therefore, changing MMT program’s philosophy is essential to cover drug dependent people’s further psychosocial needs.

Job crafting (JC) is a form of proactive behavior and refers to the initiatives employees that could take to change their tasks or other job characteristics to achieve the best person-job fit. JC consists of six dimensions: seeking structural and social job resources, as well as challenges, hindering job demands, optimizing job demands, and delegating tasks. The aim of the present study was to explore the impact of self-efficacy and work engagement on healthcare professionals’ (HP) proactive behavior. A convenience sample of 295 HP working in Primary and Secondary healthcare structures of Northern Greece completed a questionnaire that included: 1) demographic/occupational characteristics, 2) the Job Crafting Scale, 3) the Generalized Self-Efficacy Scale (GSE) and 4) the Utrecht Work Engagement Scale (UWES). Increased age was found to be associated with decreased levels of seeking social job resources (p < 0.01). Education level was positively associated with increased levels of seeking structural job resources (p < 0.01), seeking challenges (p < 0.05), and optimizing job demands (p < 0.05), while job position was found to be negatively related to delegating tasks (p < 0.01). Self-efficacy was positively associated with increased levels of seeking structural resources (p < 0.001), challenges (p < 0.001), and increased levels of optimizing job demands (p < 0.001), while it was positively associated with decreased levels of delegating tasks (p < 0.05). In addition, increased work engagement was found to be associated with increased levels of seeking social job resources (p < 0.05), challenges (p < 0.01), and optimizing job demands (p < 0.01). Findings highlight the importance of self-efficacy, work engagement and individual characteristics in the realization of a resourceful work environment and HP’ adjustment in the organization. Thus, interventions that promote HP’ JC proactive behaviors should be encouraged.

The aim of the study was twofold: to estimate smoking prevalence among nurses and to compare their knowledge, perceptions and attitudes towards smoking.Given the critical role nurses have in the process of patients' smoking cessation both as counsellors and behavioural models, data are needed on their smoking rates and behaviour.A cross sectional, comparative study was conducted.A convenience sample of 847 nurses working in various psychiatric and public hospitals in Northern Greece participated in the study. Data were collected between April and June 2020 using a battery of questionnaires.Mental health nurses were less likely to consider quitting smoking within the next 6 months (P 0.001), despite the fact that they reported higher levels of the importance of stop smoking compared to ward nurses (P 0.05). However, ward nurses were more likely to quit smoking because of the cost of cigarettes (P = 0.024) and for personal reasons (P = 0.040).Prevalence of smoking in nurses is high. Training and educational programmes are needed to develop the appropriate culture of health promotion among nurses, thus provide a more active support to patients who smoke.

To assess stroke patient-reported experiences and hospital staff experiences, during hospital stay.Stroke patient-reported experiences (n=387) were recorded using the translated and culturally adapted NHS-Stroke Questionnaire into Greek and staff experiences (n=236) were investigated using the Compassion Satisfaction and Burnout subscales of the ProQOL questionnaire.Staff's mean compassion satisfaction score was 39.2 (SD=6.3) and mean burnout score was 24.3 (SD=5.6). Only 38.5% of the staff stated that there is smooth cooperation with healthcare professionals of other specialties/disciplines. Personnel working in an NHS Hospital was more satisfied and less burned-out when compared to personnel working at a University Hospital (p=0.02 and p0.001, respectively). Mean total patient-reported experiences score was 81.9 (SD=9.5). Bivariate analysis revealed statistically significant differences for total patient-reported experiences among the eight study hospitals (p0.001).Health policy planners and decision-makers must take into consideration the results of such self-reported measures to establish innovative techniques to accomplish goals such as staff-specialization, continuous training and applying formal frameworks for efficient cooperation amongst different disciplines.

To assess stroke patient-reported experiences and hospital staff experiences, during hospital stay. Methods: Stroke patient-reported experiences (n=387) were recorded using the translated and culturally adapted NHS-Stroke Questionnaire into Greek and staff experiences (n=236) were investigated using the Compassion Satisfaction and Burnout subscales of the ProQOL questionnaire. Results: Staff’s mean compassion satisfaction score was 39.2 (SD=6.3) and mean burnout score was 24.3 (SD=5.6). Only 38.5% of the staff stated that there is smooth cooperation with healthcare professionals of other specialties/disciplines. Personnel working in an NHS Hospital was more satisfied and less burned-out when compared to personnel working at a University Hospital (p=0.02 and p0.001). Conclusions: Health policy planners and decision-makers must take into consideration the results of such self-reported measures to establish innovative techniques to accomplish goals such as staff-specialization, continuous training and applying formal frameworks for efficient cooperation amongst different disciplines.

Introduction: Secondary Traumatic Stress (STS) of healthcare professionals (HP) is a negative feeling driven by fear, “suffering” and work related trauma that can be direct (primary) trauma or occurs after the secondary exposure to people who have experienced extremely or traumatically stressful events. Several researchers have supported the relationship between STS, work addiction and emotional labor (EL). EL is the process of regulating both feelings and expressions to achieve organizational expectations, or, planning, and control needed to express organizationally desired emotions during interpersonal transactions. Aim: To investigate the impact of emotional labor and work addiction on healthcare professionals’ STS. Methods: A cross sectional study was conducted in a convenience sample of 231 HP, working in 3 public and 2 private hospitals. They completed a questionnaire that included: a) demographic/occupational characteristics, b) the Discrete Emotions, Emotional Labor Scale (DEELS), c) the Professional Quality of Life Scale (ProQOL), and d) the Bergen Work Addiction Scale. Data analysis was performed using the statistical package SPSS 24.0 Results: The sample consisted of 231 HP (77.9% nursing personnel and 22.1% physicians). Participants reported median levels of STS and low levels of work addiction. HP expressed more often emotions of happiness (mean=4.29) and less often emotions of fear (mean=1.85). As far as it concerns HP’s emotions that they hide but feel, they expressed more often emotions of frustration (mean=4.02) and less often emotions of happiness (mean=2.60). Emotions that HPs are expected to show but feel different, expressed more often the feeling of satisfaction (mean=2.55) and less often the feeling of fear (mean=2.08). Findings indicate that years of experience and age predict high risk for STS. In addition, STS was positively associated with work addiction (p=0.000) and the frequency (p=0.000) HPs express their feelings. Conclusions: HP’s expression of feelings, differ from what they really felt and was found to be positively associated with increased levels of STS. Findings highlight the importance of HP’s empowerment, psychological support, as well as the need for educational interventions to increase their resilience to STS.

Recent evidence shows that psychological distress, including anxiety and depression, has an impact on the well-being and quality of life of cancer patients. A total of 76 haematological cancer patients (HCPs) were recruited from two major cancer treatment hospitals in Greece one in the capital and the other in the province and completed the Hospital Anxiety and Depression scale (HADS), the Psychological Well-Being scale (PWB), the European Organization for Research and Treatment Quality of Life Questionnaire-C30 (EORTC QLQ-C36) and demographic and clinical characteristics. Clinically significant anxiety (HADS- a > 11) and depression (HADS-d > 11) was observed in 69.7% and 53.9% of the patients, respectively. Higher anxiety, fatigue, and financial difficulties scores were significantly related to lower PWB score. Multivariate analyses revealed that increased depression was associated with decreased quality of life score (p < .001), lower cognitive functioning (p = .003) and increased fatigue (0.002) while increased anxiety was associated with decreased social and emotional functioning (p < .001), decreased well-being (p < .001) and increased financial difficulties (p < .05). Early detection of anxiety and depression signs through routine screening in HCPs may provide information about the subgroups of patients that are more vulnerable. Findings emphasize the need for appropriate interventions to address psychological distress.

Aim To report on ehealth literacy levels in nurses and to explore its associations with the nursing practice environment. Background Nurses increasingly use the Internet and associated technologies to seek health-relevant information and manage their health. Introduction High ehealth literacy is a predictor of better health outcomes in diverse populations but its levels and work-related determinants have not been adequately explored in direct-care nurses. Methods The sample for this cross-sectional study consisted of 200 staff nurses and nursing assistants in Greece. Participants reported during February-March 2019 their sociodemographic and work-related characteristics on a self-administered questionnaire which included the "electronic Health Literacy Scale"-eHEALS, and the "Practice Environment Scale of the Nursing Work Index"-PES-NWI. Crude and adjusted logistic regressions were performed. Findings In adjusted models, participants that scored higher on the "Collegial nurse-physician relationships" and "Nurse participation in hospital affairs" dimensions of the clinical environment had higher odds of reporting better ehealth literacy. The lowest item score in eHEALS was related to not being able to make health decisions using Internet information. Discussion Nurses' ehealth literacy was positively associated with some dimensions of the hospital practice environment. Nurses reported higher ehealth literacy scores in comparison to other studies; however, they were not confident in distinguishing reliable health information from Internet sources. This is quite alarming because it can directly impair the ability of nurses to provide relevant and up-to-date evidence-based care. Conclusion This is the first study to report internationally on the positive associations of a good working environment with nurses' ehealth literacy levels. Implications for nursing and nursing policy Nursing policy should address the ehealth literary of nurses and integrate it into continuing professional education initiatives. Special focus should be put on nurses' ambiguity in distinguishing which ehealth information is reliable and can guide nursing practice. This should be combined with efforts to improve the nursing clinical environment and increase nurses' participation in hospital decisions.

Background Different cultural context results in variability in health professionals' attitude toward family presence in the emergency department (ED) during resuscitation. Knowledge about emergency department health professionals' (EDHPs') attitude toward family presence during resuscitation (FPDR) in Greece can contribute to the understanding of cultural and value-related obstacles and opportunities to implement this practice. It would be useful for Greek health professionals when they have to care for citizens from other countries in which guidelines for FPDR exist to understand their difference in behavior and reaction and be more tolerant. Objectives To explore Greek EDHPs' experiences, concerns, and benefits regarding FPDR and determine the contributing factors that are associated with their positive or negative attitude about the process. Methods A convenience sample of 305 health professionals working in the ED of 9 general hospitals of the National Healthcare System in northern Greece participated in a cross-sectional study (response rate, 87.6%). Results Positive experience of FPDR was encountered in 65.9% of EDHPs. Only 2.3% reported that they work in EDs where FPDR is allowed. Hospital regional location, previous positive experience of FPDR, and competency in supporting family members during FPDR were independently associated with a positive attitude toward FPDR. Conclusions Greek EDHPs are not ready to accept FPDR practice. The establishment of formal policy similarly to resuscitation guidelines and family-centered training courses are needed to mitigate negative beliefs. Attempts to enhance positive attitude should include educational interventions providing knowledge on the benefits of FPDR.

Background and Purpose:This study aimed to examine the psychometric properties of the Revised Death Attitude Profile (DAP-R) in a sample of Greek nurses and nursing students.Methods:A convenience sample (n = 934) was used from six National Health System hospitals, and two University Schools of Nursing in central and northern Greece completed the Greek version of the DAP-R (Gr-DAP-R).Results:Principal component analysis with varimax rotation revealed a six-factor solution, including approach acceptance, death avoidance, escape acceptance, neutral acceptance, fear of death, and after death concerns. The internal consistency for each of the subscales ranged from 0.64 to 0.88. Intercorrelations between the Gr-DAP-R subscales supported the relative independence of death attitudes dimensions.Conclusions:The Gr-DAP-R can be used as a research and clinical tool in assessing death attitudes among Greek nurses.

This mixed method study investigated the short- and long-term effects of peer loss on eight adolescents after a fatal school bus accident. Phenomenological analysis of their retrospective narratives revealed three patterns (living in despair, collecting my pieces, remembering, and moving on). Quantitative findings indicate progressive decrease in post-traumatic stress symptoms severity across time; increase in positive changes in perceptions of self, others, and life between 18 and 34 months; and stable continuing bond with the deceased peers.

The study explored health related quality of life of prisoners with diabetes mellitus (DM).48 male inmates incarcerated in a Greek prison, completed a demographic and clinical traits questionnaire. Prisoners with DM and those with additional health problems had worse physical, mental health and psychological well-being outcomes (p = 0.002, p 0.001 and p = 0.014 respectively). People with DM in correctional facilities should receive specialized primary health care services either health services within the correctional institution or community liaison. The implementation of services targeting DM should be evaluated with the target of improving offenders' physical and mental health.

Senior individuals are particularly vulnerable to influenza. Research suggests that protection against the virus and its transmission in this high-risk group of the population can be achieved by active immunization against the pathogen. To explore and analyze the attitudes, knowledge and behavior of people over the age of 60 on influenza vaccination. This cross-sectional survey included people over the age of 60 who were eligible candidates for the influenza vaccine from 3 regions from Northern and 1 region from Southern Greece. A self-completed questionnaire based upon the Theory of Planned Behaviour, the Motivation for Vaccination (MoVac-flu) and the Vaccination Advocacy Scale (MovAd) was administered to the participants. Demographic characteristics and information about health status were also obtained. The final sample included 318 participants with mean age of 70.7 years. More than half of the participants (56.6%) had received a flu vaccine in 2018 while 50.8% received it annually in previous years. Behavioral (p

The impact of multiple sclerosis (MS) in quality of life (QoL) of people has been studied more than any other neurological disorder. The purpose of this article is to present the main findings of the studies carried out from 2000 to 2015, through a review of international and Greek literature. 57 studies identified (39 quantitative and 18 qualitative) worldwide. In quantitative studies investigated the level of QoL and its correlation with various factors, such as demographic and clinical characteristics of the patients, the symptoms of the disease, the degree of disability, the various treatments, mental disorders, and the existence of social support. In qualitative studies, the researchers focused on more specific issues, or in some dimensions of the lived experience of patients, which directly or indirectly affect their overall QoL. The research findings will enlighten health professionals to set empirically based treatment goals in clinical practice in order to improve the QoL of patients with MS and also to focus their research goals in new fields that appear not to be adequately studied.

Background Available studies on surrogacy are extremely limited. Findings suggest that surrogacy is experienced as problem free, with a significant number of commissioning mothers maintaining contact with the surrogates over time. Aim To explore the experiences of Greek commissioning women regarding the surrogacy arrangement and birth of a child through surrogacy. Methods The data of this study were collected from 7 intended mothers who had either a long history of infertility or serious health problems. Interviews were tape-recorded, transcribed and analysed employing content analysis. Findings The analysis of the women's accounts revealed three themes: (a) a shared journey, (b) the birth of a long-awaited child, and (c) the surrogacy disclosure. The surrogacy process became the women's affairs, with their partners offering backstage support. A very close bond was developed with the surrogates, characterised by daily contacts and care-giving behaviours. While this bond was abruptly discontinued after the child's birth, it was interiorised with all participants being grateful to their surrogate. The timing and content of the surrogacy disclosure to family and child(ren) were carefully chosen by participants, who avoided providing information when egg donation was involved. Conclusion Findings are reassuring for women who want to parent a child through a surrogate arrangement, and suggest that the availability of counselling services may help intended mothers to cope with disclosure issues.

Knowledge is an intangible asset in Organizations, and provides a comparative advantage to those who possess it. Hospitals are complex organizations with unique characteristics because of the heterogeneity of health professionals' orientation, the composite networking and the decision-making processes. A deeper understanding of knowledge management (KM) could streamline productivity and coordinate the use of resources more efficient. We conducted a systematic literature search of peer-reviewed papers that described key elements of KM using three databases (Medline, Cinahl and Health Source: nursing/academic edition) for a 10-year period (1/1/2004-25/11/2014). The included articles were subjected to qualitative content analysis. We retrieved 604 articles of which 20 articles were eligible for analysis. Most of the studies (n=13) used a qualitative methodology. The total sample size was 2155 participants. The key elements that arose were as follows: perceptions of KM, synthesis, dissemination, collaboration, means of KM and leadership. Moreover, this study identified barriers for KM implementation, like time restrictions and limited skills. Healthcare managers ought to cultivate a knowledge environment, operate as role models, provide the tools for KM and reward people who act as knowledge brokers. Opportunities for collaboration and knowledge sharing should be encouraged. Successful KM should be patient-centered to gain its maximum value. Copyright © 2015 John Wiley & Sons, Ltd.

Hospital procurement is a crucial field for any health care system, not only for economic reasons but also for reasons related to the quality and safety of the services provided. That is why the process of procurement is, in most countries, governed by a strict legal framework and policy mechanisms. This study investigates the problems and inefficiencies associated with the procurement of medical devices in public hospitals in Cyprus and formulates empirically documented proposals for improvement. Using the Delphi method, a group of 38 experts approach the procurement system in Cyprus from different angles, achieving high rates of consensus on 35 different statements on the weaknesses and problems of the current medical device procurement system, as well as presenting proposals and recommendations for improvement. The findings are highly valuable for future policy initiatives in Cyprus in the light of the economic crisis and the expected implementation of the new General Health Insurance System (GeSY), which the Government of the Republic of Cyprus and the Troika has agreed.

The purpose of our phenomenological hermeneutic study was to explore the lived experiences of Greek infertile women who achieve a pregnancy through the use of sperm, oocyte, or embryo donation or surrogate motherhood. Semistructured interviews were conducted with 15 infertile women. Findings suggest that conceiving a child through assisted reproductive technologies (ART) is lived as a highly distressing experience, comprising long waiting periods for medical results, several failed attempts, and treatment options with uncertain outcomes. The analysis of women’s accounts revealed a constitutive pattern, journeying between hope and despair, and three associated themes: (a) coping with uncertainty and treatment failures, (b) exploring options and decision making, and (c) being supported by spouse and professionals. Findings illuminate the specific meaning-based coping processes, decision-making patterns, and sources of support that help women who pursue treatment until they give birth to a child, to manage highly stressful situations and critical decisions.

Accessible summaryWhat is known on the subject The care of an adult son or daughter with psychosis is filled with overwhelming demands caused by the symptomatology and illness exacerbations. Parents display disenfranchised grief over multiple losses and report increased levels of emotional burden. Most studies use quantitative methods and rely on pre-existing theoretical frameworks to investigate, through psychometric measures, the effects of being a carer. Meaning attributions to the disorder, and changes in parent–child relations over time, are poorly understood. What this paper adds to existing knowledge This hermeneutic phenomenological study illuminates the subjective experience of parenting a son or daughter with psychosis, as it is lived and described by parents of young adults with psychosis. Findings suggest that the parents' perceptions of their child changes over the course of the disorder, leading to a redefinition of the parent–child relationship, causing alternations in attachment. Findings illuminate the parents' profound guilt over having contributed or not prevented the disorder, over not being ‘good’ parents and feeling ambivalent towards an ‘intimate stranger.’ Guilt is compensated by absolute dedication to the son or daughter's care, at the expense of their own well-being. What are the implications for practice Interventions for parents must be available as soon as possible, both during hospitalization and after discharge. Professionals should provide a therapeutic space, where parents could express intimate thoughts and feelings, address guilt, fear and resentment issues, be assisted in their parenting role as well as in the reconstruction of a sense of self and self-esteem. Professionals are invited to facilitate illness acceptance, provide accurate information, assist parents to redefine their relationship to the child and facilitate the integration of the traumatic experience into their personal and family narrative. Professionals must develop in depth awareness of their biases and attitudes, have an ongoing training on how to respond to the parents’ needs, facilitate therapeutic change and accompany families through the course of their adult child's illness trajectory. AbstractIntroduction Children who are diagnosed with psychosis often rely on their parents for prolonged care. The impact of such care is partially understood as most studies use quantitative methods and pre-existing theoretical frameworks that limit their investigation to emotional burden, and emotional responses. Aim Explore the parents’ lived experience of caring for a child with psychosis. Method A hermeneutic phenomenological design was used with a sample of 16 parents of children with psychotic disorders who were hospitalized or attended the outpatient clinic of a large psychiatric Greek hospital. Results Identified themes were as follows: (i) the psychosis experience, (ii) redefinition of the parent–child relationship over the course of the disorder and (iii) challenges of parenting a child with psychosis. Discussion ‘Caring for an intimate stranger’ reflects the parents’ overall experience, involving changes in the parent–child relationship, ambivalence towards caretaking and profound guilt, compensated by self-sacrifice parenting practices. Implications for practice: Findings highlight the necessity to train mental health professionals to provide individualized information; facilitate family communication; address the parents’ guilt, ambivalence, meaning attributions that compromise adjustment; and support them through the challenges of parenting a son or daughter with psychosis.

Objective: The objective of the present study was to explore the wish for a child among Greek individuals who had procreated through various assisted reproductive methods. Background: Research has mainly focused on the motives of people to have children, with little attention given to their desire for a child, which has been debated mostly by psychoanalysts, philosophers and anthropologists. Methods: A hermeneutic phenomenology design was used with the large study from which the present data were derived. The sample comprised 19 women who had conceived with assisted reproduction methods, and retrospectively described their overall experience, during an in-depth interview. Results: According to findings, the awareness of the wish to reproduce becomes poignant when women realise that this might not be possible to fulfil. The participants’ motives to reproduce were: (a) appropriate life conditions, and (b) acquisition of social status, whereas their desire to have a child was: (a) to be like the mother of th...

SUMMARY Background Problems of accessibility to healthcare services notably affect certain population groups such as poor and unemployed people, migrants and minorities, thus having a negative impact on their health. The aim of this study was to investigate these problems from the perspective of health professionals and to formulate empirically informed suggestions to solve the issue. Methods Primary data were collected in 2010–2011 by using a panel of 36 experienced health professionals around Greece. A two-round Delphi method was undertaken to achieve the objectives of the study. The first questionnaire investigated the factors that hinder accessibility to health services. The second round aimed at determining the relative importance of each of the factors emerging in the first round. Results The group of experts identified 345 factors in the first round, which were grouped in 55 statements. Consensus was achieved in 22 statements. The study revealed important issues, and health professionals proposed a number of actions to eliminate the accessibility problems. Conclusions The use of medical interpreters and cultural mediators, transcultural education and stronger linkages among medical facilities are important to reduce accessibility problems. Restructuring primary healthcare and better documenting of the beneficiaries could also improve the quality of provided healthcare services. Copyright © 2012 John Wiley & Sons, Ltd.

The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved parents who consented to, and 11 parents who declined organ donation. Findings suggest that the core themes that characterize their grief and the main variables that affect their grieving process are similar for both donor and non-donor parents. Consent or refusal of organ donation per se does not seem to affect the overall grieving process. It is the meaning attributed to the act of donation that affects how parents perceive the child's death and subsequently facilitate or hinder their adjustment to loss.

The purpose of this study was to explore the sources, nature, and effectiveness of mutual support among nurses who are exposed to the death of children and to compare the experiences between a group of pediatric oncology nurses and a group of critical care nurses. Semistructured interviews were conducted with sixteen pediatric oncology nurses and twenty-three critical care nurses. Qualitative analysis was used to analyze the data. Findings revealed that (1) nurses relied more on their colleagues for support than on their relatives and friends; (2) the nature of the support they sought involved informational, clinical/practical, emotional, and meaning-making support; and (3) different forms of mutual support were encouraged in the two units, depending on individual needs and the unit's goals, philosophy, and implicit rules about expected behavior in the face of death and dying. Educational and clinical implications are briefly discussed.

Background During the 90s, Greece has been transformed to a host country for immigrants mostly from the Balkans and Eastern European Countries, who currently constitute approximately 9% of the total population. Despite the increasing number of the immigrants, little is known about their health status and their accessibility to healthcare services. This study aimed to explore the perceived barriers to access and utilization of healthcare services by immigrants in Greece. Methods A pilot cross-sectional study was conducted from January to April 2012 in Athens, Greece. The study population consisted of 191 immigrants who were living in Greece for less than 10 years. We developed a questionnaire that included information about sociodemographic characteristics, health status, public health services knowledge and utilization and difficulties in health services access. Statistical analysis included Pearson’s ×2 test, ×2 test for trend, Student’s t-test, analysis of variance and Pearson’s correlation coefficient. Results Only 20.4% of the participants reported that they had a good/very good degree of knowledge about public health services in Greece. A considerable percentage (62.3%) of the participants needed at least once to use health services but they could not afford it, during the last year, while 49.7% used public health services in the last 12 months in Greece. Among the most important problems were long waiting times in hospitals, difficulties in communication with health professionals and high cost of health care. Increased ability to speak Greek was associated with increased health services knowledge (p

This cross-sectional study examined the factors associated with higher levels of posttraumatic stress disorder (PTSD) and depression symptoms in 1,468 adolescents, 6 months after a wildfire. The rate of probable PTSD was 29.4% and 20% for probable depression. Findings on predisaster, disaster-related, and postdisaster factors revealed that disaster-related factors-specifically objective and perceived threat to self and others-were associated with symptoms of PTSD but not depression. Predisaster life events, postdisaster losses, and escape-oriented coping strategies were associated with higher levels of both PTSD and depression symptoms, while control-oriented coping and perceived social support were differentially associated with symptoms of and depression. Findings have implications for the assessment and treatment of traumatized and depressed adolescents after a disaster. Language: en

Problems of accessibility to healthcare services notably affect certain population groups such as poor and unemployed people, migrants and minorities, thus having a negative impact on their health. The aim of this study was to investigate these problems from the perspective of health professionals and to formulate empirically informed suggestions to solve the issue.Primary data were collected in 2010-2011 by using a panel of 36 experienced health professionals around Greece. A two-round Delphi method was undertaken to achieve the objectives of the study. The first questionnaire investigated the factors that hinder accessibility to health services. The second round aimed at determining the relative importance of each of the factors emerging in the first round.The group of experts identified 345 factors in the first round, which were grouped in 55 statements. Consensus was achieved in 22 statements. The study revealed important issues, and health professionals proposed a number of actions to eliminate the accessibility problems.The use of medical interpreters and cultural mediators, transcultural education and stronger linkages among medical facilities are important to reduce accessibility problems. Restructuring primary healthcare and better documenting of the beneficiaries could also improve the quality of provided healthcare services.

Data Envelopment Analysis (DEA) was used to measure efficiency of residential mental health facilities. The sample consisted of 50 half-way houses, 8 nursing homes, and 32 sheltered homes. In total, 68 facilities belonged to the public sector and were 22 supervised by private non-profit organizations. Variables chosen to characterize production were: structure size (m2), staff, salaries and operational costs, and the output measure was patient numbers. An input oriented DEA model, allowing for variable returns to scale, was applied and units were ranked according to a benchmarking approach. Mean efficiency, for the whole sample, was 73.2% and 18 best practice units were found, on average, 33.1% over-efficient. The other 72 were under-performing, with 54 appearing more than 20% inefficient. The mean efficiency scores for public and private non-profit units were 68.8 and 86.6%, respectively, and significantly different (p < 0.001). Results suggest that efficiency improvements are possible with better use of resources but more research employing various data sets is required.

The aim of the study was to describe the challenges donor and non-donor parents encounter before, during, and after the organ donation decision, and to identify parents' needs and expectations from health care professionals. A further aim was to propose evidence-based recommendations for effectively introducing the option of donation, and supporting families through the grieving process. This study was undertaken as part of a larger research project investigating the experiences of Greek parents who consented or declined organ and tissue donation, using a qualitative methodology for data collection and analysis. The experiences of 22 Greek bereaved parents of 14 underage brain dead children were studied through semi-structured interviews. Parents' decision-making process was described as challenging and fraught with difficulties both before and after the donation period. Identified challenges were clustered into: (a) personal challenges, (b) conditions of organ request, and (c) interpersonal challenges. Parents' main concern following donation was the lack of information about transplantation outcomes. Findings led to a list of recommendations for nurses and other health professionals for approaching and supporting parents in making choices about paediatric organ donation that are appropriate to them, and for facilitating their adjustment to the sudden death of their underage child.

The purpose of this qualitative study, which was part of a larger study on parental bereavement, was to explore the decision-making process of parents who were invited to donate the organs and tissues of their brain dead child. Research objectives were to investigate how parents reach a decision and which factors affect consent or refusal regarding organ donation. The experiences of 22 parents of 14 brain dead children, hospitalized in two pediatric intensive care units (PICU) in Athens, were studied through semi-structured interviews. Data collection and analysis of the overall study were performed according to grounded theory methodology. Factors that influenced parents' decisions were identified and classified into (a) personal factors, (b) conditions of organ request, (c) parents' prior knowledge and experience with organ donation or serious illness, and (d) interpersonal factors. Findings can help care providers to facilitate the decision-making process and respond to parental needs while taking into account the socio-cultural context within which decisions are made. The donation request is meaningful and effective when it is integrated into an approach that offers ongoing support to parents who are faced with the unexpected death of their child.

This descriptive study explored and compared the grief responses and experiences of Greek physicians and nurses who provide care to children dying of cancer. Interviews were conducted with 14 oncologists and 16 pediatric oncology nurses. Data were subjected to a combination of qualitative and quantitative methods of analysis. For both groups, the dying process and death of children were highly stressful experiences and triggered a grieving process. Differences, however, were observed in terms of the way these two groups (a) perceived the loss of the child and (b) expressed or avoided their grief. It became apparent that health professionals' grieving process was affected by how they perceived their role, interventions, and contribution in the care of the dying child, which in turn was influenced by the social and cultural context in which care is provided to children with cancer. Findings suggest that despite the distress caused by children's death, both nurses and physicians identified specific rewards they reaped from caring for children who are terminally ill.