The impact of delirium on clinical and functional outcomes in hospitalized patients with acute coronary syndrome.

BACKGROUND: Delirium, which is prevalent in critical care settings, remains underexplored in acute coronary syndrome (ACS) patients in the cardiac intensive care unit (CICU). AIMS: To investigate the prevalence and clinical significance of delirium in patients with ACS admitted to the CICU. STUDY DESIGN: A prospective study (n = 106, mean age 74.2 ± 5.7 years) assessed delirium using the confusion assessment method-intensive care unit (CAM-ICU) tool in 21.7% of ACS patients during their CICU stay. Baseline characteristics, geriatric conditions and clinical procedures were compared between delirious and nondelirious patients. The outcomes included in-hospital mortality, 30-day and 6-month mortality, acute adverse events and length of CICU stay and hospital stay (LOS). RESULTS: Delirious patients who were older and had a higher incidence of coronary artery disease underwent more complex procedures (e.g., pacemaker placement). Multivariate analysis identified central venous catheter insertion, urinary catheterization and benzodiazepine use as independent predictors of delirium. Delirium was correlated with prolonged LOS (p < .001) and increased in-hospital, 30-day and 6-month mortality (p < .001). CONCLUSIONS: Delirium in ACS patients in the CICU extends hospitalization and increases in-hospital, 30-day and 6-month mortality. Early recognition and targeted interventions are crucial for mitigating adverse outcomes in this high-risk population. RELEVANCE TO CLINICAL PRACTICE: This study highlights the critical impact of delirium on outcomes in hospitalized patients with ACS in the CICU. Delirium, often overlooked in ACS management, significantly extends hospitalization and increases mortality rates. Nurses and physicians must be vigilant in identifying delirium early, particularly in older ACS patients or those with comorbidities. Recognizing independent predictors such as catheterization and benzodiazepine use allows for targeted interventions to reduce delirium incidence. Integrating routine delirium assessments and preventive strategies into ACS management protocols can improve outcomes, optimize resource utilization and enhance overall patient care in the CICU setting.

Assessment of the relation between depression, frailty, nutrition and quality of life among older adults: findings from a cross-sectional study in Greece.

BACKGROUND: Quality of life (QOL) among older adults is a crucial aspect of geriatric care, particularly in the context of global demographic shifts toward ageing societies. Understanding the determinants of QOL in older adults is essential for developing effective interventions to promote well-being in this population. METHODS: This cross-sectional study conducted in Greece aimed to investigate the complex relationship between depression, frailty, nutritional status, and QOL on 90 older adults (aged ≤65). Assessment instruments including the World Health Organization Quality of Life (WHOQoL)-BREF questionnaire, Geriatric Depression Scale (GDS), Clinical Frailty Scale (CFS), and Mini Nutritional Assessment (MNA) were utilised to evaluate various dimensions of QOL, depressive symptoms, frailty, and nutritional status. RESULTS: The study revealed significant negative correlations between depression and frailty with all domains of QOL (P < 0.05), indicating that higher levels of depressive symptoms and frailty were associated with lower QOL across physical, psychological, social, and environmental dimensions. Conversely, positive correlations were found between nutritional status and all QOL domains (P < 0.05), suggesting that better nutritional status was linked to higher QOL. Multivariate logistic regression analysis further demonstrated associations between nutritional status and participant characteristics, with females being more likely to be malnourished (odds ratio (OR) = 6.56, P = 0.013), while better health status (OR = 0.34, P = 0.486) and marital status (OR = 0.02, P = 0.019) were protective against malnutrition. CONCLUSION: These findings underscore the interconnectedness of depression, frailty, and nutritional status in shaping QOL among individuals. Holistic interventions targeting mental health, physical vulnerability, and nutritional well-being are essential for promoting overall well-being and functional outcomes in this population.

Conscientious objection to caring for transgender people: An ethical right or a discriminatory attitude?

BACKGROUND: In modern society, health professionals are often asked to use their technical skills to serve purposes other than treating illnesses. In such cases, some clinicians may express ethical reluctance to fulfill their patients' preferences. Conscientious objection in health care is the refusal by providers to perform a legally valid and scientifically approved clinical intervention because of moral concerns. Although health services and staff are obliged to respect gender identity and prohibit discrimination, some clinicians may exempt themselves from caring for transgender people, citing ethical reasons. The decision of health professionals to object to medical activities related to transgender care may collide with the interests of trans people and further marginalizes the already underprivileged gender-diverse population. AIM: This discussion paper analyses the concept of 'conscientious objection' and its application in health care settings in relation to transgender-related care. FINDINGS AND CONCLUSION: In general, the right of health professionals to abstain from contested duties on moral grounds must be protected. However, claims to conscience cannot be accepted within centers specialized in gender transitioning and for services unrelated to gender affirmation such as routine and urgent care. Personal responsibility and discretion on the part of clinicians is the most appropriate way to compromise between protecting the moral integrity of health professionals and shielding trans persons' access to care. Guidance is proffered on how to resolve the apparent impasse emerging from the denial of various types of health services to transgender people.

CLINICAL AND BEHAVIORAL PRACTICES OF PRIMARY HEALTHCARE PHYSICIANS IN ANTIBIOTICS PRESCRIBING IN GREECE.

OBJECTIVE: Aim: To evaluate primary health physicians' clinical and behavioral practices towards antibiotics administration in a specific region in Greece. PATIENTS AND METHODS: Materials and methods: A cross sectional study was conducted using a questionnaire in all structures of primary health care (PHC) of the Peloponnese Region. The study was conducted in May-October 2020. RESULTS: Results: In total, 306 out of 404 primary healthcare physicians completed the questionnaire (response rate of 75.8%). Our results showed that most of physicians used to prescribing antibiotics empirically in common diseases, except for the prevention of secondary respiratory tract infection. Overall, 66.3% answered that they do not feel diagnostic uncertainty that would lead them to prescribe antibiotics. Approximately 40% of the physicians stated an increase on antibiotics use and patients demand for antibiotic prescribing, however 71.4% "rarely/never" affected by this requirement. 51.9% of the sample used to prescribed brand name antibiotics. Statistically significant differences were found between demographic and professional characteristics, and physicians' clinical and behavioral practices (p≤ 0.05). CONCLUSION: Conclusions: Our findings could provide decision makers with information on how to manage antibiotic prescribing in primary health care in the country, focusing mainly on the use of specific diagnostic tests as well as relevant guidelines and protocols for changing prescription behavior.

FEAR AND STIGMATIZATION IN THE GENERAL POPULATION DURING THE COVID-19 PANDEMIC.

OBJECTIVE: Aim: The aim of the study was to investigate the feeling of fear and stigmatization in the general population, during the pandemic. . PATIENTS AND METHODS: Materials and Methods: The study sample consisted of 1076 people attending a vaccination center in the Region of Argos, a prefecture of Peloponnese Region. The study was conducted from May 2021 to August 2021. In this study we used the Fear Investigation Scale(FCV-19S) and the COVID-19 Stigma scale. RESULTS: Results: A total of 1076 participants took part in the study. Vaccinated participants for Sars Cov-2 had higher levels of fear (U=117,569.00, p<0.001) and individuals with unspecified employment status had a higher level of fear compared to civil servants, pensioners, unemployed, private employees and freelancers (H = 17.225, p=0.004). Higher levels of fear were also seen by those who reported that they were uncertain that the COVID-19 pandemic was likely to be treated soon compared to those who believed it would be treated soon and those who did not believed this (H = 31.299, p<0.001). Vaccinated citizens showed a higher stigmatization rate of health professionals. Professional uncertainty and unemployment shows that they are a factor for increased fear. Strong social and family ties also indicate the reduced presence of stigmatization. CONCLUSION: Conclusions: An important imprint of the pandemic was the stigmatization of population's groups, such as health professionals, foreigners, as well as the infected by COVID-19. It is evident in society, that it was the fear of contracting the disease that contributed to stigmatization and isolation.

SURGICAL INTERVENTION IN PATIENTS WITH IDIOPATHIC INFLAMMATORY BOWEL DISEASE AND PERIANAL DISEASE.

OBJECTIVE: Aim: The aim of the study was to investigate the incidence of IBD in gastrointestinal surgery patients and record the disease's characteristics and treatment. PATIENTS AND METHODS: Materials and Methods: A search was carried out in the archives of the gastroenterology clinics of the University General Hospital of Ioannina and the General Hospital of Ioannina "G. Hatzikosta" in Greece. All cases of operated patients from 1980 to 2018 were examined. The duration of the study was 4 months. Data were analyzed with the SPSS program, v.28. RESULTS: Results: The total sample consisted of 1464 patients (n=1464). Most of them (915-62.5%) came from the University General Hospital of Ioannina, while the rest (549-37.5%) came from the GHI hospital "G. Hatzikosta". The mean age of the patients was 47 years (M=47.26, SD=17.34, Min=<1 month, Max=95 years). From the total sample, 58 patients (4%) suffered from IBD; most were men (42-72.41%). Their mean age was approximately 50 years (M=49.63, SD=16.48, Min=25 years, Max=77 years, range=52 years) and most belonged to the age groups of 31-40 years (11 patients- 19.6%) and 21-30 years and 61-70 years (10 patients-17.9%). The perianal disease was present in 43.1% (25 patients). The most frequent type of operation was fistula resection, ligation, curettage-biopsy (24.1%) and opening-drainage (22.4%-13 patients) and the most frequent type of anesthesia was general anesthesia (93.1%-54 patients). CONCLUSION: Conclusions: This long-term study of the patients' data followed up over time showed that the possibility of surgery in patients with IBD is mitigated through systematic monitoring and multifaceted therapeutic treatment.The perianal disease which appeared more often in men shows that it can be diagnosed early and at an early stage and with the new minimally invasive techniques the patient with IBD can be treated with a better quality of life.

MENTAL HEALTH, QUALITY OF LIFE, SPIRITUAL DRYNESS AND ACEDIA SYMPTOMS IN PATIENTS SUFFERING FROM CHRONIC DISEASES.

OBJECTIVE: The aim of the present study is to examine mental health, quality of life, acedia and spiritual dryness in patients suffering from chronic diseases. PATIENTS AND METHODS: Materials and method: Data were collected by special design instrument for the needs of the present study. Descriptive statistics and inferential statistics were applied and the analysis was carried out with IBM SPSS 26 and JASP 0.14.01. RESULTS: Results: From the total of 210 participants, 106 (50.4%) were male, the mean age was 62.9 years, and the majority of them were diagnosed with type 2 diabetes. 50 (23.8%) of the participants suffer from anxiety and 39 (18.6%) from depression. In addition, 17.1% experience phases of spiritual dryness frequently or regularly. Physical quality of life component, was associated with the following variables: live from faith, psychological wellbeing, type of disease and age. This model can predict 31.1% of the variance. In terms of psychological wellbeing, the variables living arrangement, awe/gratitude, anxiety, and spiritual dryness can interpret 41.5% of the variance. When it comes to depression, we found that wellbeing, awe/gratitude are predictors of depressive symptoms, explaining at least 14.1% of the variance. Finally, anxiety can be predicted by wellbeing, awe/gratitude, and the type of the disease, interpreting 17.2% of the variance. CONCLUSION: Conclusions: Patients suffering from chronic diseases are experiencing spiritual dryness and acedia symptoms, and those aspects can be associated with various domains of health and wellbeing.

Polypharmacy and Adherence Among Diabetic Patients in Greece.

Introduction Elderly patients are particularly susceptible to polypharmacy issues because of age-related changes in pharmacokinetics and pharmacodynamics as well as to chronic diseases resulting in a continuous increasing demand for drugs. Objective This study captures the prevalence of polypharmacy and adherence in Greece and identifies related risk factors in adult patients with diabetes. Design A cross-sectional study was conducted among patients diagnosed with diabetes mellitus attending public and private outpatients' clinics in the regions of Attica and Western Greece. Results A total of 644 outpatients filled out the questionnaire (relative risk = 91.7%). As far as the medications were concerned, 47.8% of patients had been receiving antidiabetic medication monotherapy, 38.2% combination therapy with two antidiabetic drugs, 11.8% with three drugs, and 2.2% with four drugs. The vast majority of diabetic patients adhered to their medication regimen, and fewer adhered to their physician's diet and physical activity recommendations. Statistically significant differences were found between age group and the existence of polypharmacy (P = 0.005). Additionally, 44.4% of patients with comorbidities exhibited polypharmacy, compared with 4.8% of patients who were diagnosed only with diabetes (P = 0.001). Conclusion The development of new strategies and health policies is necessary for polypharmacy and adherence among diabetic patients to be limited.

Antibiotic resistance and irrational prescribing in paediatric clinics in Greece.

INTRODUCTION: Greece is among the countries with the highest rates of antimicrobial resistance (AMR) and simultaneous antibiotic consumption. AIM: The aim of this study was to assess the perceptions and knowledge of AMR and irrational antibiotic prescribing of nurses working in paediatric hospitals in Greece. METHOD: A self-administered questionnaire was distributed to nurses in paediatric hospitals and paediatric clinics in Greece. Descriptive and multivariate statistical analyses were performed. Levels of significance were two-tailed and statistical significance was p=0.05. RESULTS: A total of 87% of participants reported irrational prescribing to be an important cause of AMR. Diagnostic uncertainty was stated by 55.5% as the main cause of irrational antibiotic prescribing and 94% suggested the use of protocols and guidelines as the main measure to control overprescribing. Parental demand for antibiotics in hospitals has increased according to 51.8% of respondents. Strong correlation was observed between social-demographic characteristics and antibiotic resistance, as well as irrational prescribing. CONCLUSIONS: Assessing nurses' knowledge and perceptions of antimicrobial resistance and irrational prescribing is vital as nurses actively participate in the antibiotics administration process and antimicrobial management in Greece. Their involvement could contribute to educate patients and parents on the public-health implications of overprescribing and antimicrobial resistance.

Evaluation of burnout levels among healthcare staff in anesthesiology departments in Greece - Is there a connection with anxiety and depression?

Introduction: Healthcare workers in anesthesiology departments often experience burnout syndrome, which may be combined with anxiety and depression. Aim: The study aimed to assess the levels of burnout among nurses and physicians working in anesthesiology departments in public hospitals in Attica and to investigate a possible correlation between burnout, anxiety, and depression. Methodology: A cross-sectional study was conducted on physicians and nurses working in anesthesiology departments in public hospitals in Attica, Greece. A questionnaire was distributed electronically using the snowball sampling method, including questions about demographic characteristics, burnout, anxiety, and depression. Results: Physicians and nurses in anesthesiology departments were found to have moderate levels of burnout, and normal/low levels of anxiety and depression. More specifically, it was found that 2% of physicians and 14.4% of nurses had extremely elevated levels of burnout. On the other hand, 6.1% of physicians and 23.7% of nurses had high anxiety, while 6.1% of physicians and 15.5% of nurses had elevated levels of depression. Females (p = 0.008), staff aged 45-55 (p = 0.021), lower educational level (p = 0.025), nurses (p = 0.001), more than 21 years of service (p = 0.001), and having children (p = 0.008) were determinants of greater levels of personal burnout. Work-related burnout correlated with having children (p = 0.017), whereas client-related burnout was significantly higher for nurses (p = 0.002). In addition, a correlation was found between anxiety, depression, and increased levels of burnout (p = 0.000). Conclusions: As physicians and nurses working in anesthesiology departments have stressful jobs and work long hours, it is important to further study their physical, emotional, and mental exhaustion as well as psychological resilience levels.

Exploration of Nursing Care for Individuals With Bipolar Disorder in a Manic Episode: A Qualitative Study.

BACKGROUND: Bipolar disorder is a mental illness that is chronic and has frequent relapses. OBJECTIVES: The purpose of the research was to study the nursing care of patients with bipolar disorder in the mania phase. METHODS: A qualitative study was employed in this study. The sample consisted of 10 nurses working in psychiatric clinics and data were collected through semi-structured interviews. Thematic analysis was applied for analysing the data. RESULTS: Of the 10 participants, 70% were female and 30% were male. The mean age was 48.7 years. All participants were registered nurses and most of them held a Master of Science degree. Their work experience ranged from 10 to 30 years. Three main themes emerged when analysing the data obtained from the interviews with the nurses, those themes were a) Echoes of Vigilance: Navigating the journey, b) Amidst the Tempest: Attending to the Patients' Complex Needs, and c) Restoring Balance: The Nurturing Hands of Bipolar Nursing Care, each of which could be divided into several sub-themes. CONCLUSIONS:  Nursing care plays an important role in symptom improvement and disease control by providing patient support, managing pharmacotherapy, preventing suicidality, and educating patients about the disease and self-management strategies.

Greek School Nurses' Confidence With Diabetes Devices.

Aim School nurses often use diabetes mellitus devices as part of the care provided to students with Type 1 Diabetes Mellitus. The aim of this study was to explore the psychometric properties of the Greek version of the Diabetes Devices Confidence Scale (DDCS). Methods In this cross-sectional, descriptive study, 143 school nurses completed the DDCS. This is a self-administered questionnaire exploring the nurses' confidence in the use of diabetes devices. The scale was translated and culturally adapted according to the WHO guidelines. The Intraclass Correlation Coefficient and Cronbach's Alpha Index were used to explore the reliability and internal consistency, respectively. The construct validity was tested via exploratory and confirmatory factor analysis (EFA, CFA). Data were analyzed via Statistical Package for the Social Sciences (SPSS), version 22.0 (IBM Corp., Armonk, NY, USA). Results Significant correlations were observed between the two administrations (p<0.001) indicating the good reliability of the scale (ICC = 0525, p<0.001) while Cronbach's Alpha was 0.966 suggesting excellent internal consistency. The EFA resulted in a unidimensional solution explaining 53.7% of the total variance. The CFA showed that the model presents good fit to the data. Conclusions The DDCS is a reliable and valid tool to test the nurses' confidence in diabetes devices.

Parents' attitudes, perceptions and coping strategies regarding school bullying.

OBJECTIVES: The aim of this study was to record parents' knowledge and attitudes towards bullying experienced by their children and to explore the strategies they choose to manage bullying incidents. METHODS: A cross-sectional study was conducted. The study population consisted of parents of children who have experienced bullying in a primary or secondary school classroom. The "Parents' Strategies to Cope with Bullying" questionnaire was used to collect data. Regarding parents' coping with bullying, the strategy "Support and advice to the child" scored the highest and the strategy "Social support and information" the next highest. RESULTS: Of the parents, 44.3 % had received some information/education regarding the phenomenon of bullying with the most important source of information being reading. According to the results of multivariate linear regression, mothers more often applied the strategy "social support and information" (Coefficient b=0.9, 95 % CI for b=0.7 to 1.1, p<0.001) and parents with lower educational level more often applied the strategy "avoidance" (Coefficient b=-0.5, 95 % CI for b=-0.8 to -0.2, p=0.004). CONCLUSIONS: School bullying remains a major worldwide phenomenon over time. Although parents choose to support their children, they do not receive information and training on how to manage bullying from a formal institution, making the need for such programs imperative.

Burden of Caregivers of Patients with Chronic Diseases in Primary Health Care: A Cross-Sectional Study in Greece.

BACKGROUND: In the world of elderly people and people with chronic diseases, caregivers give a solution to caring at home. This study aimed to evaluate the burden of caregivers of patients with chronic diseases in primary health care and identify possible demographic and other determinants of it. METHODS: This was a cross-sectional study with a convenience sample, which was conducted in two health centers. The sample comprised 291 caregivers who visited the aforementioned health centers in Patra, Greece. A composite questionnaire was utilized: the first part included demographic data and care-related information and the second included the Zarit Burden Interview and the Depression, Anxiety, and Stress Scale-21 (DASS-21). RESULTS: The highest mean score in the DASS was recorded in the depression subscale and the lowest in the stress subscale. Concerning the Zarit Burden Interview, the highest mean score was recorded in the personal strain subscale and the lowest in the management of care subscale. The highest correlation was recorded between role strain and anxiety and the lowest was between management of care and stress. Similarly, the total score in the Zarit Burden Interview correlated significantly (in a positive direction) with depression, anxiety, and stress. CONCLUSIONS: Most of the caregivers of patients with chronic diseases in primary health care experienced a moderate to severe burden (especially in the dimension of personal strain) and moderate depression. The experienced burden was positively associated with depression, anxiety, and stress. There were significant differences in the caregivers' burden according to several demographic and care-related characteristics.

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

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

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

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

Knowledge and beliefs of Greek parents towards HPV infection and vaccination - are they willing to vaccinate their sons?

OBJECTIVES: Human papillomavirus (HPV) stands as one of the prevalent sexually transmitted infections (STIs) and serves as the primary factor behind nearly all instances of cervical cancer, along with various other non-cancerous conditions like genital warts. Our objective was to explore the knowledge and beliefs of Greek parents regarding HPV infection and the vaccination of boys against HPV. METHODS: A cross-sectional study took place at a university hospital located in the Peloponnese region of Greece, from January to June 2021. The study employed convenience sampling as its methodology, and data gathering involved the distribution of self-administered questionnaires to parents who had at least one son between the ages of 9 and 18 years. RESULTS: The final sample consisted of 120 individuals. 65.8 % of parents have been informed about HPV vaccination, knew that the HPV vaccine provides immunity against genital warts (50 %), and that minimum of two doses is necessary (46.7 %). 30.8 % intended to vaccinate their boys against HPV if the vaccine were available for males. The most important reasons for vaccination were the perception that both genders share equal responsibility in the prevention of sexually transmitted infections (91.7 %) and the protection against cancer (87.6 %), whereas the fear of adverse reactions and the adequate knowledge about HPV-related diseases were most reported as reasons of the intentions to not vaccinate their sons with 31.7 % and 25.8 % respectively. CONCLUSIONS: Although parents participating in the study know about HPV, however, there are significant lack of knowledge regarding HPV infection and the vaccine effects, which can significantly affect the acceptance of vaccination for boys.

Frequency and Impacts of Verbal Abuse on Healthcare Workers in a Secondary Healthcare Structure in Greece.

BACKGROUND: Threatening and aggressive behaviors in healthcare settings constitute a significant problem that can affect not only the physical and mental integrity of staff but also patient safety and the quality of healthcare. Literature highlights verbal abuse as the most common form of non-physical violence and is estimated from 51.8% to 63.4% worldwide. PURPOSE: The purpose of the study was the investigation of verbal abuse incidence toward physicians and nurses and the differences noted between them in a regional hospital. METHODS: The study took place in a public regional hospital in southern Greece. A number of 185 nurses and 60 physicians completed the verbal abuse scale (VAS) for assessing verbal violence in the work environment; selected socio-demographic and occupational characteristics were also recorded. RESULTS: Physicians have undergone verbal abuse once a week at a percentage of 38.3%, while at the same frequency; nurses record a percentage of 12.4%. Regarding the relationship between the victim of verbal abuse and the abuser, 26.7% of the physicians answered that the abuser was another senior member of the staff, while the percentage for nurses is higher and reaches 31.9%. According to VAS items, accusing and blaming (mean±SD=3.00±0.96) is noted as the most common form of verbal abuse for physicians, judging and criticizing stands out as the most frequent (3.17±1.11) and the most stressful action (3.25±1.11) form for nurses. The most frequent behavior by the physicians is to put the verbal abuse situation in a humorous context (2.78±1.14). In contrast, nurses are trying to clarify any misunderstanding that may occur (3.10±1.00). CONCLUSIONS: Verbal abuse incidents are experienced by both physicians and nurses. They are stressful for the victims and can significantly affect work relationships and job satisfaction.

A comprehensive health effects assessment of the use of sanitizers and disinfectants during COVID-19 pandemic: a global survey.

COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value <0.001). Examination of risk factors based on multivariate logistic regression analysis showed that alcohols and alcohols-based materials were associated with skin effects (OR, 1.98; 95%CI, 1.87-2.09), per-chlorine was associated with eye effects (OR, 1.83; 95%CI, 1.74-1.93), and highly likely with itching and throat irritation (OR, 2.00; 95%CI, 1.90-2.11). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). Furthermore, formaldehyde was associated with a higher prevalence of neurological effects (OR, 2.17; 95%CI, 1.92-2.44). The use of sodium hypochlorite and per-chlorine also had a high chance of having respiratory effects. The findings of the current study suggest that health authorities need to implement more awareness programs about the side effects of using sanitizers and disinfectants during viral epidemics especially when they are used or overused.

Detection and Reporting of Adverse Drug Reactions Related to Antibiotics in Primary Healthcare in Greece.

BACKGROUND: Detection of adverse drug reactions (ADRs) is a challenging matter for healthcare professionals who contribute significantly to the pharmacovigilance system through their participation inspontaneous reporting. OBJECTIVE: The objective of this study was the detection and reporting of ADRs related to antibiotics in primary health care in the region of Peloponnese. METHODS: A cross-sectional study was conducted in all national health system primary health units of the Peloponnese region in Greece. A self-administered questionnaire was distributed to a total of 404 physicians who provided services in these settings. Descriptive and multivariate statistical analysis was performed using the SPSS 25.0. Levels of significance were two-tailed and statistical significance was set at p =0.05. RESULTS: 306 out of 404 physicians responded to the questionnaire, giving a response rate of 75.8%. 81.6% of physicians stated that they rarely observe ADRs related to antibiotic administration during their practice, 49.8% rarely report them, and 33.7% never report them. Non-serious side effects (42.5%), physicians' workload (24.1%), and the lack of knowledge about the reporting obligation (20.6%) have been declared as the main reasons of non - reporting. In addition, physicians with ≤10 years of clinical practice rarely reported that they experienced ADRs after antibiotics' administration compared to those with more work experience and specialized physicians (p= 0.001). CONCLUSION: ADRs reporting rates among physicians in primary healthcare are low. Changes in physicians' attitudes are vital and can be achieved through consistent and continuous training programs as well as the inclusion of ADRs and pharmacovigilance themes into the tertiary education curricula.