Correlation of Cancer Caregiver's Burden, Stress, and Their Quality of Life.

OBJECTIVE: The purpose of this study is to examine the stress levels felt by family caregivers. The main objectives of this study are (a) the cross-examination of family caregiver's burden, (b) caregiver's stress levels and its impact on burden feeling, also (c) the effect of caregiving on caregiver's quality of life. METHODS: A quantitative method was developed, with the use and collection of anonymous questionnaires. Participants consisted of 121 family caregivers of patients under Home Parenteral Nutrition (HPN), along with the oversight of the company "Ygeias Erga and co." Tools that have been used for the needs of this study are a questionnaire with basic demographics: The Zarit Burden Interview (ZBI), Quality of life questionnaire (CarGQoL), and KINGSTON CAREGIVER STRESS SCALE (KCSS): Data were analyzed with SPSS 22. RESULTS: 65.3% of the participants were women with an average age of 50.7 years. 39.7% were patients' spouses and 26.4% were high school graduates. 31.7% of the participants suffered from a chronic disease, with 22.3% taking daily medication. 67.8% lived in the same house as the patient, 30.6% were taking care of the patient for 6-12 months, and 39.7% had no help from another person. 43.8% of patients were under HPN for 1-3 months. A negative correlation was found between all dimensions of the Zarit Burden Interview (ZBI) and Kingston Caregiver Stress Scale and cancer caregiver CarGQoL scale scoring. Participants, who had help from another person permanently, had a better quality of life from others with no help whatsoever. Higher stress levels were found to be correlated with worse quality of life. CONCLUSIONS: Burden increase was found to be related to stress increase. Younger participants and patients' female spouses had higher levels of stress. The present research also found that stress related to financial issues had an important role. Family caregiver support is found to be a matter of great importance, and healthcare professionals have to pay attention to their needs.

COVID-19 Pandemic and Health and Social Inequalities Worldwide: Impact and Response Measures in Greece.

OBJECTIVES: The pandemic has exacerbated pre-existing health and socioeconomic inequalities around the globe. In order to mitigate the effects of extreme isolation and containment measures, governments have taken steps to protect the health, the economy, employment, and socially vulnerable groups. The health crisis should be treated as a pretext in order to ensure universal access to health and socioeconomics.The aim of this review was the presentation of the way the pandemic contributed to the worldwide deterioration of health inequities affecting in parallel the social protection in the health, economic and educational sector along with other factors, the effects and the measures taken, in order to face the consequences of a pandemic on the social protection in Greece in comparison with other countries of Europe. METHODS: A cross-sectional bibliographic study was undertaken using keywords and phrases such as "COVID-19," "Health inequities," "Social protection," and "Social identifiers." The search was done through the search engines google scholar, PubMed, Health link, and Elsevier using either the Greek or English language. The total number of evaluated read-used articles was 30. Inclusion criteria were free full-text meta-analyses, reviews, and systematic reviews. RESULTS: The socially disadvantaged groups in the United States were found to have a lower life expectancy and higher morbidity rates than privileged social groups, as economic, health, and sociocultural precariousness are major causes of death. Patients with underlying diseases are vulnerable groups and increase the risk of coronavirus infection and quite often lead to loss of life due to complications of the disease. Greece is ranked in the 4th worst position with 61.10% in employment in all European Union (EU) countries. There is a significant increase in deaths with a percentage change from 2018 to date of 17.50%. It also holds the 3rd worst position among EU countries in the field of unemployment, while women hold the 2nd worst with a rate of 13.50%. Overworked and overindebted households due to extreme measures due to the pandemic (reduction of working time, quarantine) led to unemployment, loss of income, poverty, widening social inequalities, and deteriorating care for people with disabilities. Children due to the closure of schools and the loss of school meals are led to food insecurity. The pandemic also left many children orphaned after the death of their parents by COVID-19, with psychosocial problems exacerbated by school closures. CONCLUSIONS: The pandemic has exacerbated long-standing health and socioeconomic inequalities, stressing to governments the need to adopt political strategies that will help address them. Measures have been taken in Greece for labor protection, and unemployment benefits, such as the two-month extension of the subsidy period for the unemployed and the long-term unemployed. Minimum insurance days have also been reduced so that citizens employed in tourism, catering, and other seasonal occupations can receive unemployment benefits.

Investigation of Factors That Affect the Quality of Life After a Stroke.

Stroke, as a disease, describes a group of disorders characterized by the presence of central nervous system symptoms either as a result of ischemia (ischemic stroke) or bleeding (hemorrhagic stroke). The appearance of a stroke results in a permanent physical or cognitive disability. The stroke incidence is the third cause of death after heart disease and cancer, and is the main cause of long-term disability.The effects of a stroke on a patient's daily life, and hence on his quality of life, are intense and long-lasting. These include memory problems, speech difficulty, depression, reduced vision loss, and decreased walking ability. This limitation of the patient's motor activity has a direct negative impact on the quality of his life.To investigate the degree of this impact, a research was carried out at a hospital of Central Greece. The total sample consisted of 90 patients and the responses showed that post-stroke symptoms are significant. Consequences and treatment control of the disease on the life of the sample were the questions with the highest score showing the significant effect that a stroke has on life the patients.More specifically, the sample showed through responses that the disease affects their lives to a great extent. The pre-stroke scores on the domains of the sample are clearly higher than post-stroke. The highest difference was found in the use of the upper extremities in self-care and family roles while the lowest was found in the domain of thinking. The most affected domains were as follows: thinking, vision, and language. Alternatively, the least affected domain was family roles.

GREEK MILITARY NURSING OFFICERS' COMPASSION COMPETENCE AND COMPASSION LEVEL AT WORK AND THEIR PROFESSIONAL QUALITY OF LIFE.

OBJECTIVE: Aim: Of this study was to investigate the level of Military Nursing Officers'(MNOS) compassion competence and their personal level of compassion at work and their correlation with the professional quality of life. PATIENTS AND METHODS: Materials and methods This is a cross-sectional study carried out from December 2019 to May 2020 using the method of convenience sampling. The study involved 235 MNOs serving in Greek Military Hospitals. A single questionnaire containing Compassion at Work index, Compassion competence scale and ProQOL 5 was used for data collection. A total of 400 questionnaires were distributed with a response rate of 58.75%. Data analysis was performed using the statistical package SPSS 22.0. RESULTS: Results: The research showed that there was a significant positive correlation of the Compassion Satisfaction score with the com¬passion at work and compassion competence scales. So, the more compassion participants had, the more satisfaction they received from the care they put into their work. Conversely, the more compassion participants had, the less burnout they felt. Regarding secondary traumatic stress, it was found that the higher the participants' score on the dimensions of compassion in the dimension "Being non-judgmental", "Being tolerant to personal distress" and "Being empathic", the lower the secondary traumatic stress they felt. The position at hospital, the score on the compassion dimension in the dimension "Experiencing the suffering of others" were found to be independently related to the Compassion Satisfaction score. Specifically, Head Nurses had a 3.86 points lower score compared to Nurse managers. Higher values in the "Experiencing the suffering of others" dimension were related to a higher Compassion Satisfaction score. Nursing Officers who scored higher in compassion dimensions such as "Being non-judgmental", "Being tolerant to personal distress" and "Being empathic", they felt lower secondary traumatic stress. CONCLUSION: Conclusions: It is really important for Military nursing Officers to be compassionate in order to get more satisfaction from caring about their work and feel less burnout.

THE RELATIONSHIP BETWEEN PSYCHOSOCIAL WORK ENVIRONMENT AND NURSES' PERFORMANCE, ON STUDIES THAT USED THE VALIDATED INSTRUMENT COPENHAGEN PSYCHOSOCIAL QUESTIONNAIRE (COPSOQ): AN EMPTY SCOPING REVIEW.

OBJECTIVE: Aim: This study was to map the relationship between psychosocial work environment and nurses' performance, on studies that used the Copenhagen Psychosocial Questionnaire (COPSOQ). PATIENTS AND METHODS: Materials and Methods: The review intended to answer following questions: 'Can COPSOQ screen completely psychosocial risks of nurses' work environment?' 'Which of these dimensions affect more nurses psychosocial world? A scoping review was developed guided by the JBI methodology and using PRISMA-ScR. CONCLUSION: Conclusions: Hospital workers, and in particular nurses, are exposed to different risk factors with the most important being psychosocial risks. These arise from problematic work planning, organization and management, as well as from an unhealthy social context of work and may lead to negative psychological, physical and social outcomes. The review highlighted the need for further research using the entire COPSOQ questionnaire in order to fully study the psychosocial risks that nurses face in their work environment.

BURNOUT AND DEPRESSION OF GREEK HEALTHCARE PROFESSIONALS WORKING IN REFUGEES' RECEPTION CENTERS AND ACCOMMODATION PROGRAMS.

OBJECTIVE: Aim: The investigation of health professionals' burnout and depression, working in refugees' reception centers and their possible intercorrelation. PATIENTS AND METHODS: Materials and methods: A descriptive correlation study was carried out in health professionals, who worked in refugees' reception centers and accommodation programs throughout Greece. Data were collected using an anonymous questionnaire through online Google Forms. The questionnaire contained demographics, the Copenhagen Burnout Questionnaire (CBI-Gr) and the Patient Health Questionnaire (PHQ-9). The SPSS 22.00 was used for the statistical analysis and the significance level was set at 0.05. RESULTS: Results: The sample consisted of 125 healthcare professionals working in refugees' reception centers and accommodation programs, the majority of tchem were women (62.4%), aged between 30-39 years (39.2%) nurses (24.8%) and with a master's degree (28%). A strong linear positive correlation was found between depression and burnout (r=0.542, p=0.000). A statistically significant correlation was also recorded between burnout and female gender (p=0.001), the age group of 30-39 (p=0.042) and nursing profession (p=0.003). CONCLUSION: Conclusions: A strong linear relationship between burnout and depression was revealed, a finding indicating that it is imperative to implement interventions to strengthen the resilience of health professionals working in refugees' reception centers.

THE INVESTIGATION OF THE PSYCHOLOGICAL BURDEN OF PATIENTS AFTER HOSPITALIZATION FOR COVID 19.

OBJECTIVE: The aim: The current Cross-Sectional study investigated the psychosocial effects on recovered Covid 19 patients in a General Hospital in Greece. It was investigated the impact of Covid 19 on levels of social support, loneliness, resilience & PTSD. Furthermore, the correlation between all the above factors was studied. PATIENTS AND METHODS: Materials and methods: 107 adult patients participated. The questionnaire was fulfilled after signature of consensus form. This happened after their discharge from the hospital, without exclusion of infected on previous time. The questionnaire included 5 particular sections: a) Socio-demographic characteristics, b) social support scale, c) IES Covid 19 scale, d) UCLA scale e) CD-Risc scale. In terms of statistical analysis, the comparison between two groups of quantitative variables was conducted through Student's t-test. Related to examination of relationship between two quantitative variables was used Pearson's correlation coefficient (r). The Statistical analysis package used was SPSS 22. RESULTS: Results: The 55,1% of sample were women, married (57,9 %) and (39,3%) university graduates. Moreover, the rate of overweight was significant (39,3%). Related to psychosocial factors, observed high level of resilience (70,6), moderate level of loneliness (39,1) and 57,9% of participants showed moderate social support. At last, PTSD level as a result of Covid 19 was moderate (33,5). A strong correlation was observed between higher mental resilience and lower feelings of loneliness. CONCLUSION: Conclusions: The levels of determining factors of negative psychological effects, reveal the need for a preparation of political improvement policies in relation to mental health of rehabilitated persons, as well as the promotion of actions that would contribute to the development of a more effective supportive framework.

Translation and validation of the Greek version of the Jefferson Scale of Attitudes toward Physician and Nurse Collaboration (JSAPNC).

The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSATPNC) is an established tool to assess attitudes toward physician-nurse collaboration. The aim of this study was to translate and culturally adapt the JSATPNC for use in Greece and test its psychometric properties. The final study sample included 621 physicians and nurses working in two general hospitals of Northern Greece during 2017. The study sample was randomly split into two halves; separate exploratory and confirmatory factor analyses were conducted. A regression analysis including sociodemographic variables was performed to predict the JSATPNC total score. The Cronbach's alpha was .74. A four-scale model (a) interprofessional collaboration, (b) involvement in decision-making, (c) expertise, (d) physician's dominance was extracted from the exploratory factor analysis. The confirmatory factor analysis indicated an acceptable model fit (RMSEA = .069, SRMR = .083, TLI = .875, CFI = .903). There was adequate evidence for both convergent and discriminant validity, apart from the "physician's dominance" scale; the exclusion of items 9 and 12 from this scale resulted in an alternative model with the improved model fit (RMSEA = .062, SRMR = .078, TLI = .902, CFI = .916). The test-retest intraclass correlation coefficients were all above .7. Age and profession of the respondents emerged as important predictors of the total scale score. The Greek version of the JSATPNC shows promise as a reliable and valid instrument for evaluating collaboration between physicians and nurses.

Diabetic patient assessment of chronic illness care using PACIC.

BACKGROUND: The Patient Assessment of Chronic Illness Care plus is used in order to assess whether provided care is congruent with the Chronic Care Model, according to patients. The purpose of this study was to correlate PACIC+ and the revised 5As "ask, advise, agree, assist and arrange" scoring of a sample of DM patients, with their QoL, depressive symptomatology, demographic and disease characteristics, self-management behaviours of healthy eating and physical activity. METHODS: This is a cross-sectional study where data were collected between January and April 2018 by using three questionnaires (PACIC+, SF-36, CES-D) from a sample of 90 DM patients treated at a Public General Hospital of Central Greece. Anonymous self-completed questionnaires were used to collect the data. Data was processed in the Statistical Package for the Social Sciences (SPSS). RESULTS: The mean age of the participants with DM was 52.8 years (SD = 21.2 years), with cardiovascular disease and arterial hypertension scoring as the most frequently reporting chronic comorbidities. The healthcare received by DM patients has been correlated with their QoL. More specifically SF - 36 and PACIC+ scale scores showed a positive and low correlation in several subscales. The total score of PACIC+ scale as well as the Patient activation score were increased in higher scores of vitality (p = 0.034 & p = 0.028 respectively), hence both scores correlate significantly with latter. In addition, Delivery System / Practice Design score was increased in higher scores of mental health (p = 0.01) and MCS (p = 0.03). CONCLUSIONS: The shift from hospital care focusing on the disease to a more patient-oriented approach puts forward a dynamic holistic approach to chronic diseases and the reduction of their impact. Finding evidence-based and effective strategies to promote health, prevent and manage chronic diseases such as diabetes mellitus is deemed to be crucial and necessary. PACIC+, which is a tool of a patient-level assessment of CCM implementation, can be used by countries which intend to apply changes in the way their health systems provide chronic care and specifically wish to improve the quality of chronic disease care and the QoL of their patients.

Reliability and validity of the Greek translation of the patient assessment of chronic illness care + (PACIC-PLUS GR) survey.

BACKGROUND: This study aimed to investigate the Patient Assessment of Chronic Illness Care+ (PACIC+) which is a tool to assess care for Chronic Conditions combining PACIC items with an overall 5As score derived from the '5As' model (ask, advise, agree, assist, and arrange), and is congruent with the Chronic Care Model. In addition, the study at hand aimed to translate the PACIC+ tool into Greek and test its psychometric properties to the Greek patients. METHODS: Questionnaires were collected from 268 chronic patients. Internal consistency and reliability were determined by the calculation of Cronbach's alpha coefficient. A confirmatory factor analysis (CFA) was conducted in order to test the construct validity of the questionnaire. Validity was further examined by investigating the correlation of PACIC+ with SF-36 and its association with sex and age. RESULTS: Internal consistency reliability was accepted with a Cronbach's alpha above 0.70 for all PACIC+ dimensions. CFA showed that the 10-dimensional model fitted the data well (RMSEA = 0.059, CFI = 0.91 and GFI = 0.83). Most of the correlations coefficients between PACIC+ and SF-36 dimensions were significant. A significant and negative correlation was found between PACIC+ summary score, Patients' activation and Goal Setting/ Tailoring with age. CONCLUSIONS: The Greek translation of the PACIC+ questionnaire has good psychometric properties and has proven to be a credible and valid tool to be used by Greek researchers in order to measure patients' perceived care during treatment. It demonstrated high reliability and internal consistency, extending the applicability of this instrument to Greek speaking chronic patients.

Genome urbanization: clusters of topologically co-regulated genes delineate functional compartments in the genome of Saccharomyces cerevisiae.

The eukaryotic genome evolves under the dual constraint of maintaining coordinated gene transcription and performing effective DNA replication and cell division, the coupling of which brings about inevitable DNA topological tension. DNA supercoiling is resolved and, in some cases, even harnessed by the genome through the function of DNA topoisomerases, as has been shown in the concurrent transcriptional activation and suppression of genes upon transient deactivation of topoisomerase II (topoII). By analyzing a genome-wide transcription run-on experiment upon thermal inactivation of topoII in Saccharomyces cerevisiae we were able to define 116 gene clusters of consistent response (either positive or negative) to topological stress. A comprehensive analysis of these topologically co-regulated gene clusters reveals pronounced preferences regarding their functional, regulatory and structural attributes. Genes that negatively respond to topological stress, are positioned in gene-dense pericentromeric regions, are more conserved and associated to essential functions, while upregulated gene clusters are preferentially located in the gene-sparse nuclear periphery, associated with secondary functions and under complex regulatory control. We propose that genome architecture evolves with a core of essential genes occupying a compact genomic 'old town', whereas more recently acquired, condition-specific genes tend to be located in a more spacious 'suburban' genomic periphery.

Investigation of the association between quality of life and depressive symptoms during postpartum period: a correlational study.

BACKGROUND: The onset of a major depressive episode is experienced by a large number of women in the weeks or months following delivery. Postpartum depression may deem those women experiencing it incapable of taking care for themselves, their family and their infants, while at the same time it could negatively affect their quality of life. The present study assessed the quality of life of a sample of mothers in Greece, in order to investigate the association between postpartum depression and quality of life (QoL). METHODS: 145 women in a Private-General Obstetrics and Pediatric Clinic in Greece completed the Edinburgh Postnatal Depression scale (EPDS) and SF-36 questionnaire on the third and fourth day after delivery (caesarean or normal childbirth). The data were analyzed using SPSS version 17.0. Linear and logistic regression analysis was performed in order to find the independent factors related to the quality of life and postpartum depression symptoms. RESULTS: 9.9% of the participants experienced postpartum depression symptoms. Significant associations were found between the place of residence and symptoms of postpartum depression, and more specifically, women outside of Attica indicated higher levels of postpartum depression symptoms (p = 0.008) than women living in Attica. The level of education was also found to be significantly associated with postpartum depression symptoms, since women with Primary and Secondary education experienced higher levels of postpartum depression symptoms (p = 0.005) than those with a tertiary education. Concerning quality of life, women with postpartum depression symptoms scored 24.27 lower in «Role-Physical¼, 15.60 lower in «Bodily pain¼, 11.45 lower in «General Health¼, 14.18 lower in dimension of «Vitality¼, 38.25 lower in Role - Emotional and 16.82 lower in dimension of mental health, compared to those without depression symptoms. CONCLUSION: Postpartum depression symptoms are associated with the quality of life of women after pregnancy, and therefore constitute a powerful predictor of the quality of life. Health care professionals should provide individualized care for the prevention and treatment of Postpartum Depression symptoms in order to help women improve their quality of life.

Kuopio University Hospital Job Satisfaction Scale (KUHJSS): its validation in the Greek language.

AIM: Τranslation and validation of the Kuopio University Hospital Job Satisfaction Scale. BACKGROUND: Nurses' job satisfaction is crucial for the smooth functioning of the health-care system. METHODS: A Greek translation of the scale was made and administered to 126 psychiatric nurses; 60 filled it out again after 15 days. The structural validity and internal consistency of the scale were also studied. Exploratory and confirmatory factor analyses were also conducted. RESULTS: A total of 69 (54.8%) of the participants were male and the majority (72.2%) were <40 years old. The exploratory factor analysis revealed a four-factor scale: Leadership, Working environment, Motivating factors and Team spirit (Cronbach alpha: 0.71-0.88). These factors were not identical to the factors of the Finnish version of the scale. The four-factor model created marginally fits the data and exhibits far better indices. Pearson correlation and intraclass correlation coefficient were near to 1, indicating the scale's high reliability. CONCLUSIONS: The scale's properties were very satisfactory indicating that the scale is a reliable measure of job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: The Greek version of the Kuopio University Hospital Job Satisfaction Scale can be recommended to measure nurses' job satisfaction in Cyprus and Greece.

The impact of occupational stress on nurses' caring behaviors and their health related quality of life.

BACKGROUND: Nursing is perceived as a strenuous job. Although past research has documented that stress influences nurses' health in association with quality of life, the relation between stress and caring behaviors remains relatively unexamined, especially in the Greek working environment, where it is the first time that this specific issue is being studied. The aim was to investigate and explore the correlation amidst occupational stress, caring behaviors and their quality of life in association to health. METHODS: A correlational study of nurses (N = 246) who worked at public and private units was conducted in 2013 in Greece. The variables were operationalized using three research instruments: (1) the Expanded Nursing Stress Scale (ENSS), (2) the Health Survey SF-12 and (3) the Caring Behaviors Inventory (CBI). Univariate and multivariate analyses were performed. RESULTS: Contact with death, patients and their families, conflicts with supervisors and uncertainty about the therapeutic effect caused significantly higher stress among participants. A significant negative correlation was observed amidst total stress and the four dimensions of CBI. Certain stress factors were significant and independent predictors of each CBI dimension. Conflicts with co-workers was revealed as an independent predicting factor for affirmation of human presence, professional knowledge and skills and patient respectfulness dimensions, conflicts with doctors for respect for patient, while conflicts with supervisors and uncertainty concerning treatment dimensions were an independent predictor for positive connectedness. Finally, discrimination stress factor was revealed as an independent predictor of quality of life related to physical health, while stress resulting from conflicts with supervisors was independently associated with mental health. CONCLUSION: Occupational stress affects nurses' health-related quality of life negatively, while it can also be considered as an influence on patient outcomes.

Missed Nursing Care; Prioritizing the Patient's Needs: An Umbrella Review.

The objective of this review of reviews was to identify the reasons for missed nursing care and to shed light on how nurses prioritize what care they miss. Missed nursing care refers to essential nursing activities or tasks that are omitted or not completed as planned during a patient's care. This omission can result from various factors, such as staffing shortages, time constraints, or communication issues, and it can potentially compromise the quality of patient care and safety. Identifying and addressing missed nursing care is crucial to ensure optimal patient outcomes and the well-being of healthcare professionals. To be included, reviews had to use the systematic review process, be available in the English language, examine missed care in hospitals and at home, and include participants who were over eighteen years old. The review intended to answer the following questions: 'Why nursing care is missed?' 'How nurses prioritize what care they missed?'. An umbrella review was developed guided by the JBI methodology and using PRISMA-ScR. A total of 995 reviews were identified. According to the inclusion criteria, only nine reviews were finally evaluated. The findings indicate that care is missed due to staffing levels, organizational problems, and the working climate. Prioritization of care depends on acute care needs as well as educational and experiential background. Missed nursing care is associated with patient safety and the quality of provided nursing care. Specifically, it has negative impacts on patients, healthcare professionals, and healthcare service units. Organizational characteristics, nursing unit features, and the level of teamwork among nursing staff affect Missed Nursing Care. Individual demographic characteristics of the staff, professional roles, work schedules, and adequate staffing may potentially contribute to the occurrence of Missed Nursing Care, which is why they are under investigation. However, further consideration is needed regarding the management of patient needs and nurse prioritization.

Social Support and Resilience Are Protective Factors against COVID-19 Pandemic Burnout and Job Burnout among Nurses in the Post-COVID-19 Era.

Nurses have experienced several psychological and work-related issues during the COVID-19 pandemic, including pandemic burnout and job burnout. The aim of this study was to examine the impact of social support and resilience on COVID-19 pandemic burnout and job burnout among nurses. We conducted a cross-sectional study in Greece. The study population included 963 nurses. We measured social support, resilience, COVID-19 pandemic burnout, and job burnout with the Multidimensional Scale of Perceived Social Support, Brief Resilience Scale, COVID-19 Burnout Scale, and Single-Item Burnout Measure, respectively. Nurses received high levels of social support, while their resilience was moderate. Additionally, nurses experienced moderate levels of COVID-19 burnout and job burnout. Increased social support and increased resilience were associated with reduced COVID-19 pandemic burnout. We found a negative relationship between social support and job burnout. A similar negative relationship was found between resilience and job burnout. Social support and resilience can act as protective factors against COVID-19 pandemic burnout and job burnout among nurses. Policy makers should develop and implement appropriate strategies to improve nurses' social support and resilience since they are the backbone of healthcare systems worldwide.

Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies.

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Association between Organizational Support and Turnover Intention in Nurses: A Systematic Review and Meta-Analysis.

Although recent studies suggest a negative relationship between organizational support and turnover intention among nurses, there has been no systematic review on this issue. The aim of this systematic review and meta-analysis was to synthesize and evaluate the association between organizational support and turnover intention in nurses. The review protocol was registered with PROSPERO (CRD42023447109). A total of eight studies with 5754 nurses were included. All studies were cross-sectional and were conducted after 2010. Quality was moderate in five studies and good in three studies. We found a moderate negative correlation between organizational support and turnover intention since the pooled correlation coefficient was -0.32 (95% confidence interval: -0.42 to -0.21). All studies found a negative correlation between organizational support and turnover intention ranging from -0.10 to -0.51. A leave-one-out sensitivity analysis showed that our results were stable when each study was excluded. Egger's test and funnel plot suggested the absence of publication bias in the eight studies. Subgroup analysis showed that the negative correlation between organizational support and turnover intention was stronger in studies in China and Australia than those in Europe. Organizational support has a moderate negative correlation with turnover intention in nurses. However, data regarding the impact of organizational support on turnover intention are limited. Moreover, our study had several limitations, and thus, we cannot generalize our results. Therefore, further studies should be conducted to assess the independent effect of organizational support on turnover intention in a more valid way. In any case, nursing managers should draw attention to organizational support by developing effective clinical practice guidelines for nurses so as to reduce turnover intention.

Translation and Validation of Digital Competence Indicators in Greek for Health Professionals: A Cross-Sectional Study.

BACKGROUND: it is widely accepted that living in the digital transformation era, the need to develop and update new professional skills and tools in health sectors is crucially important. Therefore, this study aimed to explore the reliability and validity of the Digital Competence Indicators tool in assessing the digital skills of Greek health professionals. METHODS: in this cross-sectional study, 494 health professionals, including doctors (175) and registered nurses (319) working in four Greek hospitals were recruited and willingly participated using a convenience-sampling method. The original framework of Digital Competence Indicators was translated from English to Greek based on guidelines for cross-cultural adaptation of questionnaires. The validity of the tool was explored using confirmatory factor analysis (CFA) to verify the fit of the model using inductive techniques. The instrument reliability was confirmed using Cronbach's alpha (α) and McDonald's Omega coefficients. RESULTS: the reliability was estimated at 0.826 (Cronbach's-α) and 0.850 (McDonald's Omega-ω). The indicators of CFA were all calculated within an ideal range of acceptance. Specifically, the CFA comparative fit index produced the following adjustment indices: x2/df = 1.152 (p = 0.037), CFI = 0.997, Lewis index (TLI) = 0.966, and root mean square error of approximation (RMSEA) = 0.018. CONCLUSIONS: The present study demonstrated that the Digital Competence Indicator instrument has high reliability, internal consistency, and construct validity and, therefore, it is suitable for measuring digital skills of health professionals.

Monitoring Humoral Response Following BNT162b2 mRNA Vaccination against SARS-CoV-2 in Hematopoietic Stem-Cell Transplantation Patients: A Single-Center Prospective Study along with a Brief Review of Current Literature.

Data on antibody response (AR) after vaccination against SARS-CoV2 in hematopoietic stem-cell transplantation setting (HSCT) were initially scarce, mainly due to the exclusion of such patients from approval studies. Shortly after the worldwide application of vaccination against SARS-CoV-2 in vulnerable populations such as patients with hematologic malignancies, limited single-center trials, including HSCT patients, were published. However, there was a great heterogeneity between them regarding the type of underlying malignancy, co-current treatment, type of vaccine, method of AR measurement, and time point of AR measurement. Herein, we present the results of a prospective study on AR after vaccination for SARS-CoV-2 using the BNT162b2 vaccine in a cohort of 54 HSCT recipients-mostly autologous from a single Unit-along with a broad review of the current literature. In our cohort, the AR positivity rate at 1 month was 80.8% and remained positive in 85.7% of patients at 3 months after vaccination. There were only nine non-responders, who were more heavily pretreated and more frequently hypogammaglobulinemic compared to responders. High antibody titers (AT), [AT ≥ 1000 U/mL], were detected in 38.5% and 30.6% of the patients at m1 and m3, respectively. A significant decline in AT between m1 and m3 was demonstrated-p < 0.0001; median AT1 and AT3 were 480.5 and 293 U/mL, respectively. A novel finding of our study was the negative impact of IgA hypogammaglobulinemia on response to vaccination. Other negative significant factors were treatment with anti-CD20 antibody at vaccination and vaccination within 18 months from HSCT. Our data indicate that HSCT recipients elicit a positive response to the BNT162b2 vaccine against SARS-CoV-2 when vaccinated at 6 months post-transplant, and vaccination should be offered to this patient population even within the post-pandemic COVID-19 era.