A Study of Factors Contributing to the Nutritional Status of Elderly People Receiving Home Care.

(1) Background: Nutrition is a critical aspect of health and well-being in the elderly population, as physiological changes associated with aging can impact nutrient utilization and dietary needs. The aim of this study was the assessment of nutritional screening and associated factors among community-dwelling elderly people. (2) Methods: This study is the first phase of an intervention trial of people aged 65 years and over who received primary health services and resided in the municipality of Archanes Asterousia in Crete, Greece. Nutritional risk was assessed using the Mini Nutritional Assessment. Diet-related factors were analyzed, including health status (oral hygiene, depression, cognitive decline, impaired functioning, quality of life), social factors (educational attainment, marital status, type of work before 60 years), and lifestyle factors (smoking, drinking, diet). (3) Results: A total of 730 elderly people were evaluated (males, 31.5%), with an average age (±SD) of 76.83 (±6.68) years. MNA was found to have a statistically significant connection with assessment of oral hygiene, mental state, Charlson comorbidity, functional independence (assessed with the Barthel scale), and quality of life. The exception was geriatric depression (GDS), with which no statistically significant association was found (p > 0.05). Nutritional risk analysis revealed 379 participants (51.9%) to be adequately nourished, 205 (28.1%) to be at risk of malnutrition, and 146 (20.0%) to be malnourished. (4) Conclusions: These results clearly demonstrated the key factors that contribute to the nutritional screening of elderly people and need to be addressed by health authorities and social services.

Evaluation of Evidence-Based Practice Competency among Greek Undergraduate Nursing Students.

For several years, the global scientific community has accepted and recognized the importance of evidence-based practice for nursing science. The main factor for the implementation of evidence-based practice is the competence of undergraduate nursing students towards evidence-based practice, so that they as active nurses are ready for its application in their clinical practice, in order to provide better care for their patients. The aim of the present study is to examine the level of evidence-based practice competency evaluated with the self-reported Evidence-Based Practice Competence Questionnaire. It is important to mention that such a study has not been conducted on nursing students in Greece, but only on registered nurses. A quantitative study based on cross-sectional design was conducted from February to June 2022 in a convenience sample of Greek undergraduate nursing students. The SPSS 26.0 program was used to perform descriptive, bivariate, and multivariate analyses. A total of 175 undergraduate students participated at the Hellenic Mediterranean University Department of Nursing (Greece), specifically from the 2nd and 3rd academic years. The mean score of the Evidence-Based Practice Competence Questionnaire for nursing undergraduate students was 3.03 ± 0.26, indicating moderate evidence-based practice. Among the Evidence-Based Practice Competence Questionnaire dimensions, mean scores of 3.03 ± 0.32 for attitude toward evidence-based practice, 3.01 ± 0.49 for skills in evidence-based practice, and 3.03 ± 0.49 for knowledge in evidence-based practice were obtained. Significant differences among participants' mean Evidence-Based Practice Competence Questionnaire scores regarding gender (p = 0.766), age (p = 0.400), academic year (p = 0.153), and training in the field of research methodology (p = 0.538) were not found. It appears that the level of readiness towards evidence-based practice is mediocre among undergraduate nursing students at a university in Greece. Therefore, it is necessary to carry out new studies in the future, so that there is a correct approach of all the elements that contribute to the readiness of nursing undergraduate students regarding evidence-based practice.

Validation of Two Instruments for the Measurement of Dehumanization and Self-Dehumanization in Healthcare Settings.

Understanding and addressing dehumanization in healthcare is crucial due to its profound impact on patient care, ethical implications on patient dignity and autonomy, and its potential to affect the psychological well-being of healthcare professionals. The primary aim of this study was to establish reliable and valid instruments measuring two different types of dehumanization, namely animalistic dehumanization (i.e., stripping one of their uniquely human characteristics) and mechanistic dehumanization (i.e., stripping one of their human nature characteristics) among healthcare professionals. In this cross-sectional validation study among healthcare professionals, we tested measures of both animalistic and mechanistic dehumanization, focusing on the dehumanization of patients (hetero-dehumanization) and oneself (self-dehumanization), respectively. All measures were developed and validated based on a concept analysis, a literature review, and an appraisal of pre-existing scales. The research was conducted among 400 nurses and medical doctors employed in Greek public hospitals. Coefficient validity ratio results showed that 100% of items were acceptable for both measures. The newly established and validated hetero-dehumanization scale encompassed two factors (factor 1: animalistic dehumanization, factor 2: mechanistic dehumanization; Cronbach's alpha was equal to 0.86 for each measure). The self-dehumanization scale was a mono-factorial measure of mechanistic dehumanization (Cronbach's alpha = 0.97). Two validated measures of (self- and hetero-) animalistic and mechanistic dehumanization measures were developed for the assessment of dehumanization among health professionals, which will form the basis for future research in this important scientific field.

Physical Activity during Pregnancy and Risk of Gestational Diabetes Mellitus: A Meta-Review.

BACKGROUND: Nowadays, pregnant women require more individualized attention in their assistance process during pregnancy. One of the aspects that requires the most focus is the suitability of carrying out physical activity. The objective of this meta-review is to find out the effects of physical activity during pregnancy on the incidence of GDM compared to women who do not perform physical activity. METHODS: A search was conducted in Cochrane, CSIC, Ebscohost, Proquest, Pubmed, Scielo, and Scopus. The search focused on systematic reviews and meta-analyses published in the last five years. The AMSTAR-2 scale was used as a quality assessment tool for the final sample. RESULTS: A total of 18 systematic reviews and meta-analyses were included. Sixteen of them found out that physical activity during pregnancy has preventive effects for GDM compared with women who lacked physical activity. Among the studies, we found a reduction in the risk of GDM of between 24% and 38% and odds ratios ranging between 0.39 and 0.83 calculated for a 95% CI. Only two studies did not find statistically significant effects. Other variables such as type and duration of physical activity, overweight and obesity, gestational age, etc., were also considered. CONCLUSIONS: Physical activity prevents the incidence of GDM. The main characteristics that enhance this preventive effect are starting at the initial stages of pregnancy and maintaining during the whole pregnancy as well as combining strength and aerobic exercise at a low to moderate intensity.

Patient Knowledge, Medication Adherence, and Influencing Factors: A Cross-Sectional Study among Hypertensive Patients in Greece.

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.

The Development and Testing of the Hippocratic Heart Failure Self-Care Scale.

BACKGROUND: The adoption of self-care behaviors among patients with congestive heart failure (CHF) is essential for the management of their health condition. However, there is a lack of tools for estimating self-care in CHF patients. We aim to develop and validate the Greek version of the Hippocratic heart failure self-care scale (HHFSCS). METHODS: The scale includes 22 items which are reviewed by a committee of experts. Individuals indicate the frequency at which they follow each self-behavior on a five-point Likert scale. Adult patients with CHF (n = 250) from a General Hospital in Athens participated in the study from June 2020 to March 2021. Reliability coefficients and an explanatory factor analysis (EFA), using a Varimax rotation and the principal component method, were used to assess the psychometric measurements. RESULTS: The Cronbach's alpha coefficient of the HHFSCS was 0.807. The exploratory factor analysis identified two domains that accounted for 88.44% of the variance in the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test-retest showed a significant and strong correlation (r = 0.973, p < 0.001). CONCLUSIONS: The HHFSCS is a reliable and valid tool for assessing self-behaviors in CHF patients. Health professionals can use it in their clinical practice to improve the management of a patient's health conditions.

Evidence-Based Practice Competency of Registered Nurses in the Greek National Health Service.

Nurses' competency toward evidence-based practice (EBP) has been extensively investigated by several studies worldwide. However, factors affecting the competence of Greek nurses working in the NHS have not been fully investigated in terms of EBP. Thus, this study aimed to explore the impact of the individual qualifications of nurses on their competence toward EBP. Data from 473 registered nurses working in 10 hospitals in the Greek National Health Service (NHS) were collected between October and December 2020 using a convenience sampling method in a cross-section design. The Greek version of the 35-item (five-point Likert scale) Evidence-Based Practice Competency Questionnaire for Professional Registered Nurses (EBP-COQ Prof) was used to assess the competence level of nurses, focusing on attitudes, skills, and knowledge, as well as the utilization of EBP in clinical practice. One-way ANOVA and Pearson coefficient tests were applied to compare the possible differences among variables (two or more groups) as appropriate. A multi-factorial regression model was applied to explore participants' qualifications, including demographics (MSc degree, gender, English language knowledge, etc.) as independent variables, and to control for potential confounding effects toward EBP competency. The p-values < 0.05 were considered statistically significant. The mean age of the 473 participants (402 women and 71 men) was 44.7 ± 9.2 years old. The mean value of competence subscales was found as follows: attitudes 3.9 ± 0.6, knowledge 3.7 ± 0.6, skills 3.1 ± 0.8, and utilization 3.4 ± 0.7. A multivariate regression analysis revealed that associates of "Master's degree" (t = 3.039, p = 0.003), "Writing an academic article" (3.409, p = 0.001), "Working in a University clinic" (2.203, p = 0.028), and "Computer Skills" (2.404, p = 0.017) positively affected "Attitudes", "Knowledge", "Skills", and "Utilization", respectively. The research data suggest that nurses working in the Greek NHS were limited in competence regarding EBP in comparison with other European countries. Therefore, vocational, educational, and training programs tailored to EBP enhancement are crucially important. This study was not registered.

Development and Validation of the CVP Score: A Cross-Sectional Study in Greece.

Although central venous pressure (CVP) is among the most frequent estimated hemodynamic parameters in the critically ill setting, extremely little is known on how intensive care unit (ICU) nurses use this index in their decision-making process. The purpose of the study was to develop a new questionnaire for accessing how ICU nurses use CVP measurements to address patients' hemodynamics investigating its validity and reliability. A cross-sectional study was conducted among 120 ICU nurses from four ICUs of Greece. Based on a comprehensive literature review and the evaluation by a panel of five experts, a new questionnaire, named "CVP Score", was created, having eight items. The construct validity and the reliability of the questionnaire were examined. Half of the study participants (51.7%) worked at a specialized ICU, and they had a mean [±Standard Deviation (SD)] ICU experience of 13(±7.1) years. The estimated construct validity of the newly developed tool was acceptable, while the internal consistency reliability as measured by Cronbach alpha was excellent (0.901). CVP Score had acceptable test-retest reliability (r = 0.996, p < 0.001) and split-half reliability (0.855). The CVP score is a valid and reliable instrument for measuring how critical care nurses use CVP measurements in their decision-making process.

Distance Learning in Nursing Education during the COVID-19 Pandemic: Psychosocial Impact for the Greek Nursing Students-A Qualitative Approach.

(1) Background: The COVID-19 pandemic posed a major threat to global health and on the educational field. The purpose of this study is to identify and illustrate the psychosocial adaptation of nursing students to the sudden and exclusive application of distance learning during the COVID-19 pandemic; (2) Methods: A qualitative interview research has been designed. Two focus groups of seven members each and six individual interviews were conducted in a sample of undergraduate nursing students in Greece from 3 March 2021, to 9 April 2021.; (3) Results: A qualitative thematic analysis of the data identified six themes: 1. Challenges; 2. Concerns; 3. Social changes; 4. Negative Emotions; 5. Evaluation; and 6. Teaching strategies.; (4) Conclusions: During its implementation, it identified gaps and weaknesses in the entire academic community. The study of the psychosocial adaptation of the academic community is considered crucial, as it can highlight the individual difficulties in distance learning and contribute to the improvement of the methods of its the improvement of its methods.

Evaluation of Drug Interactions in Hospitalized Patients with Respiratory Disorders in Greece.

Background: Patients with respiratory disorders often have additional diseases and are usually treated with more than one medication to manage their respiratory conditions as well as additional comorbidities. Thus, they are frequently exposed to polypharmacy (≥5 drugs), which raises the risk for drug-drug interactions (DDIs) and adverse drug reactions (ADRs). In this work, we present the results regarding the prevalence of DDIs in hospitalized patients with respiratory disorders in Greece. Methods: A 6-month descriptive single-center retrospective observational study enrolled 102 patients with acute or chronic respiratory disorders. Clinical characteristics and medication regimens were recorded upon admission, hospitalization, and discharge. The prevalence of DDIs and their clinical significance was recorded and analyzed. Results: Unspecified acute lower respiratory tract infection (25%), exacerbations of chronic obstructive pulmonary disease (12%) and pneumonia (8%) were the most frequent reasons for admission. Cardiovascular disorders (46%), co-existing respiratory disorders (32%), and diabetes (25%) were the most prevalent comorbidities. Polypharmacy was noted in 61% of patients upon admission, 98% during hospitalization, and 63% upon discharge. Associated DDIs were estimated to be 55% upon admission, 96% throughout hospitalization, and 63% on discharge. Pharmacodynamic (PD) DDIs were the most prevalent cases (81%) and referred mostly to potential risk for QT-prolongation (31.4% of PD-DDIs) or modulation of coagulation process as expressed through the international normalized ratio (INR) (29.0% of DDIs). Pharmacokinetic (PK) DDIs (19% of DDIs) were due to inhibition of Cytochrome P450 mediated metabolism that could lead to elevated systemic drug concentrations. Clinically significant DDIs characterized as "serious-use alternative" related to 7% of cases while 59% of DDIs referred to combinations that could be characterized as "use with caution-monitor". Clinically significant DDIs mostly referred to medication regimens upon admission and discharge and were associated with outpatient prescriptions. Conclusions: Hospitalized patients with respiratory disorders often experience multimorbidity and polypharmacy that raise the risk of DDIs. Clinicians should be conscious especially if any occurring arrhythmias, INR modulations, and prolonged or increased drug action is associated with DDIs.

Drug-Drug Interactions among Patients Hospitalized with COVID-19 in Greece.

The modulation of the pharmacological action of drugs due to drug-drug interactions (DDIs) is a critical issue in healthcare. The aim of this study was to evaluate the prevalence and the clinical significance of potential DDIs in patients admitted to the University Hospital of Heraklion in Greece with coronavirus disease 2019 (COVID-19). Cardiovascular disorders (58.4%) and diabetes (types I and II) (29.6%) were the most common comorbidities. A high occurrence of DDIs was observed, and clinically significant DDIs that may hamper response to treatment represented 40.3% of cases on admission, 21% during hospitalization, and 40.7% upon discharge. Polypharmacy and comorbidities were associated with a higher prevalence of DDIs in a statistically significant way (p < 0.05, 95% CI). Clinically significant DDIs and increased C-reactive protein values upon admission were associated with prolonged hospitalization. The results reveal that patients admitted due to COVID-19 in Greece often have an additional burden of DDIs that healthcare teams should approach and resolve.

Severity and Mortality Predictors of COVID-19 Patients with Thrombotic Events-Evidence from the "COVID-One" Hospital in Albania.

COVID-19 vaccination leads to lower infection, morbidity, and mortality rates. However, COVID-19 infection leads to the development of coagulopathy-related manifestations in the form of both venous and arterial thromboembolism. This study aimed to assess the severity and mortality predictors of COVID-19 patients with thrombotic events in hospitalized patients in Albania. This is a retrospective study conducted in the "Mother Tereza" University Hospital of Tirana. Data were retrieved from the electronic databases of the hospital and only COVID-19 cases admitted to the infectious department during August−December 2020 were selected. Patients who, at admission, had a C-reactive protein (CRP) (mg/L) more than double and a D-dimer (ng/mL) more than triple according to international standards were included in the study. We performed univariate and multivariable logistic regression analysis, calculating unadjusted and adjusted odds ratios (ORs). A p-value < 0.05 was considered statistically significant. The study population included 60 hospitalized persons with a mean age of 64.4 years. Increased lactate dehydrogenase (LDH) (OR = 2.93; 95% CI = 0.82−10.42, p-value = 0.1) and increased creatine kinase (CK) (OR = 2.17; 95% CI = 0.63−7.46, p-value = 0.22) were related with increased probability of death. Moreover, a decreased number of lymphocytes was associated with increased mortality but with no statistical significance (OR = 0.40; 95% CI = 0.11−1.40, p-value = 0.15). The survival rate was higher for patients without comorbidities (p = 0.045). These results could serve as a baseline and as a reference for healthcare personnel who provides services to hospitalized patients with COVID-19. Further studies should take into consideration the vaccination of the population as well as including more hospitals and patients.

Translation, Adaptation and Validation of the Pandemic Fatigue Scale (PFS) in the Greek Language.

The growing fatigue of citizens due to the COVID-19 pandemic has already been addressed and its results are visible and threatens citizen compliance. The aim of this study was to translate and validate the Pandemic Fatigue Scale (PFS) in the Greek language. A cross-sectional study was conducted between October 2021 to March 2022. The translation and cultural adaptation process was developed according to the research protocols among the university student population in Cyprus and tested the psychometric properties of PFS. Three hundred thirty-four subjects participated in the study through a web survey, which included general information and the study process. The internal consistency for the total PFS showed good reliability (six items, a = 0.88). A weak statistically significant positive correlation was found between the PFS and the Greek versions of Generalised Anxiety Disorder Assessment­GAD-7 (r = 0.1.96; p < 0.001) and the PFS and Patient Health Questionnaire­PHQ-9 (r = 0.173; p = 0.002) demonstrating good concurrent validity. Recovering from the pandemic, it is necessary to build systems to detect and respond to future healthcare crises. The results suggest that the psychometric properties of the Greek PFS are satisfactory. The measure of pandemic fatigue allows for identifying fatigue groups for targeted interventions and testing how pandemic fatigue might be reduced in such situations.

Translation and Validation of the Greek Version of the Evidence-Based Practice Competency Questionnaire for Registered Nurses (EBP-COQ Prof©).

(1) Background: Evidence-based nursing is the benchmark of the nursing profession. It is widely recognized that evidence enhances knowledge, skills, and competencies in nursing education and thus the quality of patient care. Although several proposals have been introduced to reinforce nurses through education in evidence-based practice (EBP) for clinical practice, there is no validated EBP competence tool to determine how nurses approach evidence-based nursing in healthcare practices in Greece. Therefore, the aim of the present study was to translate and validate the Greek version of the Evidence-Based Practice Competency Questionnaire, Professional version (EBP-COQ Prof©). (2) Methods: A cross-sectional study was conducted in a sample of registered nurses working in the public sector. (3) Results: 414 clinical nurses were recruited in total with a response rate of 75.3% and a mean age of 43 years old. Most of the nursing personnel were females, 354 (85.5%), and there were 60 (14.5%) males. Confirmatory factor analysis (CFA) showed a confirmation of the developer's four-factor design. The estimated association between items on each scale showed a strong relationship. The competence questionnaire showed a high internal consistency between the components of attitude, knowledge, skills, and utilization. (4) Conclusions: The competence questionnaire shows a strong relationship between four the components, highlighting the four factors that should be promoted to improve the use of EBP nursing practices.

Decreased Hospital Visits and Increased Mortality Rate in Emergency Department during the COVID-19 Pandemic: Evidence from Albania.

Objective: To investigate the hospital visits and mortality rate during the COVID-19 in emergency department of Vlora regional hospital in Albania and to compare with the three previous years (2017-2019). Methods: Secondary data of patients that visited emergency department of Vlora Regional hospital Albania (largest hospital in the south of the country), since January 1, 2017 till December 31, 2020. This is a retrospective study. We used the hard copy of the patients' health register records. The data extraction was conducted during March 2021 till June 2021. Eligible were all patients admitted and recorded in the registry of the emergency department. The causes of admission were categorized in 14 different disease categories. All registered patients admitted to the Vlora regional hospital were included in the study. Results: Study population included 44,917 patients during 2017-2020. Mean age of patients was 51.5 years, while 53.6% were females. The highest number of patients was in 2017 (n=12,407) and the lowest in 2020 (n=9,266). Increase of patients presented with cardiovascular, psychiatric and renal/urinary tract was observed in 2020 in comparison to 2019. Patients decreased over time with an average annual percent decrease of 7% (p-value=0.22). Joinpoint analysis revealed that mortality rate increased over time with an average annual percent increase of 34.3% (95% confidence interval=42.7% to 214.8%, p-value=0.27). Conclusions: The number of patients visiting emergency department decreased while mortality rate increased. Educating and raising awareness of patient to seek medical assistance should be a key objective of health policy makers and health personnel.

Self-Assessment of Health Professionals' Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care.

Current research often refers to cultural competence to improve health care delivery. In addition, it focuses on the cultural uniqueness of each health service user for optimal personalized care. This study aimed to collect self-assessment data from health professionals regarding their cultural competence and to identify their development needs. A mixed methods design was adopted using the Cultural Competence Self-assessment Checklist of the Central Vancouver Island Multicultural Society. This was translated into Greek, validated, and then shared with health professionals in Cyprus. Subsequently, a semi-structured interview guide was designed and utilized. This was structured in exactly the same question categories as the questionnaire. Data collection took place between October 2021 and May 2022, and convenience sampling was used to recruit 499 health scientists in Cyprus. The sample comprised doctors, nurses, psychologists, midwives, social workers, and physiotherapists. Subsequently, 62 interviews were conducted with participants from the same specialties. The results showed that (compared to other health professionals) nurses and psychologists are more sensitive to issues of cultural competence. It would appear that the more socially oriented sciences had better-prepared healthcare staff to manage diversity in context. However, there is a gap between knowledge and skills when comparing doctors to nurses; they seem to be more skilled and willing to intervene actively in cases of racist behavior or problem-solving. In conclusion, participants identified the importance of their cultural competence; they also realized the importance of optimal planning of personalized health care. There is a significant need for continuous and specialized cultural competence training for all health professions.

A Literature Review of High-Tech Physiotherapy Interventions in the Elderly with Neurological Disorders.

Neurological physiotherapy adopts a problem-based approach for each patient as determined by a thorough evaluation of the patient's physical and mental well-being. Τhis work aims to provide a literature review of physical therapy interventions in the elderly with neurological diseases (NDs) and discuss physiotherapy procedures and methods that utilize cutting-edge technologies for which clinical studies are available. Hence, the review focuses on acute NDs (stroke), deteriorating NDs (Parkinson's disease), and age-related cognitive impairment. The most used physiotherapy procedures on which clinical data are available are balance and gait training (robot-assisted or not), occupational therapy, classical physiotherapy, walking and treadmill training, and upper limb robot-assisted therapy. Respectively, the most often-used equipment are types of treadmills, robotic-assisted equipment (Lokomat® and Gait Trainer GT1), and portable walkway systems (GAITRite®), along with state-of-the-art technologies of virtual reality, virtual assistants, and smartphones. The findings of this work summarize the core standard tools and procedures, but more importantly, provide a glimpse of the new era in physiotherapy with the utilization of innovative equipment tools for advanced patient monitoring and empowerment.

Epidermolysis Bullosa: A case study in Cyprus and the nursing care plan.

PURPOSE: To present a case study with Epidermolysis bullosa (EB) in Cyprus and to determine the nursing care plan, explaining the nursing interventions and showing the importance of nursing care of patients with EB. METHODS: Literature review on EB and semi-structured interviews commenced through a direct discussion with open-ended questions to the research subject as well as to a close relative describing his feelings, experiences, and concerns about the disease. FINDINGS: Thematic analysis approach was used to identify and analyze patterns in the data. Then, data were synthesized using the standardized nursing terminology of NANDA-I and the Nursing Interventions Classification. The accuracy of the diagnoses and the appropriateness of the nursing interventions were supported by the positive health outcomes of the patient. CONCLUSIONS: Nurses should apply evidence-based practice interventions for EB wound care, pain management, nutrition, psychological and social support to these patients. IMPLICATIONS FOR NURSING PRACTICE: Although EB is classified in the category of rare diseases, the presentation of a case study in Cyprus and the nursing care plan contribute further bibliographically to the holistic and at the same time individualized nursing practice.

Assessment of COVID-19 Fear in Five European Countries before Mass Vaccination and Key Predictors among Nurses and Nursing Students.

BACKGROUND: Levels of fear have increased since the COVID-19 pandemic outbreak. The absence of a safe and effective vaccine for mass-vaccination deteriorates this situation, which has a significant impact on mental health. This study aimed to assess the feelings of fear among nurses and nursing students in five European countries. METHODS: A multicenter cross-sectional study was conducted in five European countries (Greece, Albania, Cyprus, Spain, and Kosovo) before the start of mass vaccination in Europe. Data collection was conducted in December 2020-January 2021 using an online questionnaire for nursing students and professional nurses. Fear of COVID-19 Scale (FCV-19S) was used for measuring levels of fear. IBM SPSS version 21.0 was used for statistical analysis. RESULTS: The study population included 1135 nurses and 1920 nursing students from Kosovo (n = 1085), Spain (n = 663), Greece (n = 534), Albania (n = 529), and Cyprus (n = 244). According to multivariable analysis, females (OR = 2.53, 95% CI = 1.89-3.15), married (OR = 0.86, 95% CI = 0.24-1.48), nurses (OR = 0.87, 95% CI = 0.28-1.45) and those with a chronic disease (OR = 0.86, 95% CI = 0.11-1.62) were more fearful of COVID-19. CONCLUSIONS: It is important to decrease fear in the population of nurses who are at the frontlines of the pandemic. The provision of appropriate education and training activities for nurses and students to manage their stress levels is of high importance. Future studies should focus on levels of fear after the administration of several safe and effective vaccines worldwide.

Predictive Factors for the Care and Control of Hypertension Based on the Health Belief Model Among Hypertensive Patients During the COVID-19 Epidemic in Sirjan, Iran.

BACKGROUND: Hypertension is a leading risk factor for morbidity and mortality around the world. Preventing this health problem is considered an important priority. The aim of this study was to investigate the predictive factors for care and control of hypertension (CCH) according to the health belief model (HBM), in patients with hypertension during the COVID-19 epidemic in Sirjan, Iran. METHODS: In this cross-sectional study, participants were chosen by simple random sampling. Data were collected by a valid and reliable researcher-made questionnaire from 200 patients with high blood pressure aged 30-60 years. Data were analyzed by SPSS21 and analysis based on descriptive statistics, Pearson correlation coefficients, and linear regression was conducted. RESULTS: The results of Pearson correlation coefficients showed that there was a significant correlation among almost all constructs of the Health Belief Model (HBM), but the strongest correlations were between self-efficacy and perceived susceptibility (r = 0.940, P ≤ 0.001), and between perceived barriers with perceived benefits (r = -0.615, P ≤ 0.001). According to linear regression, perceived barriers (ß = -0.291), cues to action (ß = -0.590), and knowledge (ß = 0.973) predicted more than 26% of CCH variability. Knowledge had a stronger role than other variables. CONCLUSION: The results of this study show that the constructs of the Health Belief Model can predict CCH in hypertensive patients. This model can be used as a tool for designing and implementing educational interventions to increase CCH among hypertensive patients.