Protective behaviors during COVID-19 confinement measures in Greece: the role of anxiety, perceived risk and risky-choice framing.

Confinement measures at the beginning of the COVID-19 pandemic imposed major changes on the global population. The aim of this study was to explore the level to which the public adhered to protective guidelines by adopting the most appropriate behaviors at that time (such as hand washing with soap and using sanitizer gel) and to identify the determinants of these behaviors. A purposive sample of 1013 individuals was invited and voluntarily participated in the online survey. The questionnaire collected information on demographic data, hand washing, risk perception, anxiety (through the S = Anxiety scale of STAI) and risky-choice framing. Results showed increased levels of anxiety, a moderate perception of the risk of catching coronavirus and increased adoption of protective behaviors, such as handwashing and cleaning surfaces with disinfectant/antiseptic products. Multiple ordinal logistic regression models showed that being female, more educated and cleaning home with disinfectant / antiseptic products predicted handwashing with soap. Additionally, having an increased perception of getting the coronavirus, being older and cleaning the home with disinfectant / antiseptic products predicted handwashing with antiseptics. Public health interventions should take into consideration the unified cleaning pattern and the combined effect of sociodemographic variables and risk perception on the adoption of protective behaviour in the context of a health crisis which is out of people's control.

Access to the COVID-19 Vaccine.

As of 31 August 2022, 599,825,400 confirmed coronavirus disease 2019 (COVID-19) cases and 6,469,458 deaths have been reported globally [...].

Knowledge, Perceptions and Attitudes Toward HPV Vaccination: A Survey on Parents of Girls Aged 11-18 Years Old in Greece.

Objective: To investigate knowledge, perceptions and practices of parents of girls aged 11-18 years old in Greece toward HPV vaccination, and determine which factors are associated with parents' decision to vaccinate their daughters. Methods: A close-end questionnaire was constructed and telephone interviews were conducted upon informed consent. The sample was random, national, stratified by geographic region and representative of the general population of parents of girls aged 11-18. The data collected include: general knowledge, attitudes and perceptions concerning HPV and HPV vaccine, information regarding their daughters' HPV vaccination, and sociodemographic characteristics. Statistical analysis included descriptives and a logistic regression model to investigate which factors are associated with HPV vaccination. Results: Overall, 1,000 parents participated in the study, 99.4% of which knew what HPV is and 98.8% knew there is a vaccine available against HPV. Furthermore, 47% of the parents stated that their daughters had been vaccinated against HPV, while further analysis revealed that only 35% had received all the recommended doses. In the logistic regression analysis, the following variables had a statistically significant association with HPV vaccination: perceived ease of contracting HPV (OR = 1.105), level of trust in medical profession regarding information on prevention (OR = 1.205), overall perception regarding importance of children's vaccination (OR = 0.618), internet/social media as a source of parent information regarding HPV (OR = 0.886), participant (parent) age (OR = 1.125), and daughter's treating physician's recommendation for HPV vaccination (OR = 7.319). Conclusions: HPV vaccination coverage is still suboptimal. Comprehension of the obstacles toward this goal is important and the role of healthcare professionals is crucial to increase acceptance.

A cross-sectional population-based study on the influence of the COVID-19 pandemic on incomes in Greece.

The Coronavirus Disease 2019 (COVID-19) pandemic induced economic shock in Greece, which translated into a decrease in household income. Thus, the objective of this study is to measure social inequality with regard to income loss due to the COVID-19 pandemic in Greece. In addition, we aim to identify the characteristics of those experiencing income loss due to the pandemic. The study uses data from the "Public Opinion in the European Union (EU) in Time of Coronavirus Crisis. Third Round" survey. The sample consists of 1036 individuals aged between 16 and 54 years. To measure inequality, the Erreygers' Concentration Index (CI) is calculated, using social class as the ranking variable. To identify the characteristics of those experiencing income loss, a logistic regression model is fitted using the region of residence and several demographic and socioeconomic variables as potential predictors. According to the results, social inequality does not exist with regard to income loss due to the COVID-19 pandemic. Thus, our findings indicate the negative influence of the pandemic on the incomes of individuals from all social classes in Greece. According to the results of the logistic regression model, the odds of experiencing income loss are higher for residents of the Aegean Islands and Crete but also for self-employed, part-time employed, and unemployed individuals. These findings indicate the negative influence of the pandemic on Greek tourism and on sectors employing a large proportion of non-standard workers. Although inequality does not exist, a substantial proportion of those losing income due to the pandemic is in line with the global picture.

Feeling Uncertainty during the Lockdown That Commenced in March 2020 in Greece.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant uncertainty for the global population. However, since not all population groups experience the impacts of the pandemic in the same way, the objective of this study was to identify the individual characteristics associated with the feeling of uncertainty during the lockdown that commenced in March 2020 in Greece. The study used data from the "Public Opinion in the European Union (EU) in Time of Coronavirus Crisis" survey. The sample consisted of 1050 individuals aged between 16 and 54 years. According to the analysis, which was based on a logistic regression model, the emotional status of older individuals, those who experienced income and job losses since the beginning of the pandemic, and middle-class and high-class individuals, is more likely to be described as a feeling of uncertainty. In addition, the emotional status of individuals with less concern for their own health and that of family and friends is less likely to be described as a feeling of uncertainty. Although the results related to age, income, and job losses, as regards concern for health, agree with the international literature, the limited health literacy of lower-class individuals may explain the reduced likelihood of their experiencing feelings of uncertainty. The results confirm the international literature describing several aspects of uncertainty due to the COVID-19 crisis.

Studying Healthcare Affordability during an Economic Recession: The Case of Greece.

The significant deterioration of economic prosperity in Greece during the economic crisis decreased patients' ability to pay. Thus, the objective of this study is to determine the factors affecting healthcare affordability in Greece during an economic recession. This study used data from the European Union Statistics on Income and Living Conditions (EU-SILC) 2016. The sample consisted of 18,255 households. Healthcare affordability was regressed on geographic characteristics as well as several variables that refer to the households' financial condition. Region of residence, ability to make ends meet, and capacity to cope with unexpected financial expenses were found to be statistically significant. Using sample sizes of 1000 and 1096 adults, respectively, the European Quality of Life Surveys (EQLS) of 2007 and 2016 were also used as data sources. Economic crisis was expressed with a dummy variable: (1) 0: 2007, and (2) 1: 2016. Difficulty in responding to healthcare costs was regressed on survey year and several demographic, socioeconomic, and health characteristics, revealing that individuals were more likely to face difficulties in responding to healthcare costs during the economic crisis. These results confirm the mechanism on the basis of which economic crises affect healthcare access: primarily through the effects of demand-side barriers.

Subjective social status, social network and health disparities: empirical evidence from Greece.

BACKGROUND: Several studies suggest that socioeconomic status affects (SES) affects self-rated health (SRH), both in Greece and internationally. However, prior research mainly uses objective measures of SES, instead of subjective evaluations of individuals' social status. Based on this, this paper aims to examine (a) the impact of the economic dowturn on SRH in Greece and (b) the relationship between subjective social status (SSS), social network and SRH. METHODS: The descriptive analysis is based on four cross-sectional surveys conducted by the National School of Public Health, Athens, Greece (2002, 2006, 2011, 2015), while the data for the empirical investigation were derived from the 2015 survey (Health + Welfare Survey GR). The empirical strategy is based on an ordinal logistic regression model, aiming to examine how several variables affect SRH. Size of social network and SSS are among the independent variables employed for the empirical analysis RESULTS: According to our findings, average SRH has deteriorated, and the percentage of the population that reports very good/good SRH has also decreased. Moreover, our empirical analysis suggests that age, existence of a chronic disease, size of social network and SSS affect SRH in Greece. CONCLUSION: Our findings are consistent with the existing literature and confirm a social gradient in health. According to our analysis, health disparities can be largely attributed to socioeconomic inequalities. The adverse economic climate has impact on socioeconomic differences which in turn affect health disparities. Based on these, policy initiatives are necessasy in order to mitigate the negative impact on health and the disparities caused by economic dowturn and the occuring socioeconomic inequalities.

Information-Seeking Behavior of Greek Nursing Students: A Questionnaire Study.

The aim of this study was to investigate factors influencing the use of electronic journals by nursing students through identification of information needs, information resources used, and barriers to seeking information. A cross-sectional study was conducted using a specially designed structured questionnaire. Of 600 nursing students, 505 agreed to participate, indicating a response rate of 84.2%. Participants sought out nurses and doctors, printed materials, scholarly databases/e-journals, and seminars as information resources. Participants reported that they searched for information for themselves, parents, and inpatients. Most searched for information for diet or special nutrition needs and for specific diseases. The obstacles faced included lack of time and cost. Training in information literacy is important to enhance the skills of nursing students.

Economic crisis, austerity and unmet healthcare needs: the case of Greece.

BACKGROUND: The programme for fiscal consolidation in Greece has led to income decrease and several changes in health policy. In this context, this study aims to assess how economic crisis affected unmet healthcare needs in Greece. METHODS: Time series analysis was performed for the years 2004 through 2011 using the EU-SILC database. The dependent variable was the percentage of people who had medical needs but did not use healthcare services. Median income, unemployment and time period were used as independent variables. We also compared self-reported unmet healthcare needs drawn from a national survey conducted in pre-crisis 2006 with a similar survey from 2011 (after the onset of the crisis). A common questionnaire was used in both years to assess unmet healthcare needs, including year of survey, gender, age, health status, chronic disease, educational level, income, employment, health insurance status, and prefecture. The outcome of interest was unmet healthcare needs due to financial reasons. Ordinary least squares, as well as logistic regression analysis were conducted to analyze the results. RESULTS: Unmet healthcare needs increased after the enactment of austerity measures, while the year of participation in the survey was significantly associated with unmet healthcare needs. Income, educational level, employment status, and having insurance, private or public, were also significant determinants of unmet healthcare needs due to financial reasons. CONCLUSIONS: The adverse economic environment has significantly affected unmet health needs. Therefore health policy actions and social policy measures are essential in order to mitigate the negative impact on access to healthcare services and health status.

Estimates of price and income elasticity in Greece. Greek debt crisis transforming cigarettes into a luxury good: an econometric approach.

OBJECTIVE: During the past decades, smoking prevalence in Greece was estimated to be near or over 40%. Following a sharp fall in cigarette consumption, as shown in current data, our objective is to assess smokers' sensitivity to cigarette price and consumer income changes as well as to project health benefits of an additional tax increase. METHODS: Cigarette consumption was considered as the dependent variable, with Weighted Average Price as a proxy for cigarette price, gross domestic product as a proxy for consumers' income and dummy variables reflecting smoking restrictions and antismoking campaigns. Values were computed to natural logarithms and regression was performed. Then, four scenarios of tax increase were distinguished in order to calculate potential health benefits. RESULTS: Short-run price elasticity is estimated at -0.441 and short-run income elasticity is estimated at 1.040. Antismoking campaigns were found to have a statistically significant impact on consumption. Results indicate that, depending on the level of tax increase, annual per capita consumption could fall by at least 209.83 cigarettes; tax revenue could rise by more than €0.74 billion, while smokers could be reduced by up to 530 568 and at least 465 smoking-related deaths could be averted. CONCLUSIONS: Price elasticity estimates are similar to previous studies in Greece, while income elasticity estimates are far greater. With cigarettes regarded as a luxury good, a great opportunity is presented for decisionmakers to counter smoking. Increased taxation, along with focused antismoking campaigns, law reinforcement (to ensure compliance with smoking bans) and intensive control for smuggling could invoke a massive blow to the tobacco epidemic in Greece.

Barriers in access to healthcare services for chronic patients in times of austerity: an empirical approach in Greece.

OBJECTIVES: To investigate the magnitude of barriers in access to health services for chronic patients and the socioeconomic and demographic characteristics that affect them. METHODS: A cross-sectional study was conducted in 1,594 chronic patients suffering from diabetes, hypertension, COPD and Alzheimer. Logistic regression analyses were carried out in order to explore the factors related to economic and geographical barriers in access, as well as the determinants of barriers due to waiting lists. RESULTS: A total of 25% of chronic patients face geographical barriers while 63.5% and 58.5% of them are in front of economic and waiting list barriers, respectively. Unemployed, low-income and low-educated are more likely to face economic barriers in access. Moreover, women, low-income patients, and patients with lower health status are more likely to be in front of geographical barriers. In addition, the probability of waiting lists occurrence is greater for unemployed, employees and low income patients. CONCLUSIONS: Barriers in access can be mainly attributed to income decrease and unemployment. In this context, health policy measures are essential for removing barriers in access. Otherwise, inequalities may increase and chronic patients' health status will be deteriorated. These consequences imply adverse effects on health expenditure.

Recommending organized screening programs for adults in Greece: a Delphi consensus study.

OBJECTIVE: In the absence of organized screening programs in Greece, the aim of this study is to propose a set of programs, which exhibit potential to improve health system's performance. METHODS: A literature review was conducted to identify those programs fulfilling certain screening evaluation criteria. Using Delphi method programs identified were evaluated by a multi-professional expert panel who were asked to provide their consent and recommendations for the implementation, target-group, rescreening interval, primary screening method and social insurance reimbursement level. Kuder-Richardson 20 and Cronbach's α were used for assessing internal consistency and number of rounds. RESULTS: The majority of experts supported the introduction of organized screening programs for breast cancer, cervical cancer, colorectal cancer, abdominal aortic aneurysm and vascular risk assessment. Major disagreements arose on the target-group of the colorectal cancer and abdominal aortic aneurysm program concerning age-limits. Experts argued that only those fulfilling programs' eligibility criteria or those referred should be reimbursed by social insurance. CONCLUSION: Recommended screening programs provide for the first time a comprehensive and consensus based proposal for the secondary prevention policy of the country. They are expected to contribute to the reduction of the disease burden from important health problems and to the optimum allocation of resources invested in health.

Impact of economic crisis and other demographic and socio-economic factors on self-rated health in Greece.

BACKGROUND: Financial crisis and worsened socio-economic conditions are associated with greater morbidity, less utilization of health services and deteriorated population's health status. The aim of the present study was to investigate the determinants of self-rated health in Greece. METHODS: Two national cross-sectional surveys conducted in 2006 and 2011 were combined, and their data were pooled giving information for 10 572 individuals. The sample in both studies was random and stratified by gender, age, degree of urbanization and geographic region. Logistic regression analysis was used to determine the impact of several factors on self-rated health. RESULTS: Poor self-rated health was most common in older people, unemployed, pensioners, housewives and those suffering from chronic disease. Men, individuals with higher education and those with higher income have higher probability to report better self-rated health. Furthermore, the probability of reporting poor self-rated health is higher at times of economic crisis. CONCLUSION: Our findings confirm the association of self-rated health with economic crisis and certain demographic and socio-economic factors. Given that the economic recession in Greece deepens, immediate and effective actions targeting health inequalities and improvements in health status are deemed necessary.

Medication use and patient satisfaction: a population-based survey.

BACKGROUND: In recent years, there is a growing interest to assess patients' satisfaction which further triggers the existing debate on the severe methodological issues regarding the interpretation of comparative surveys results. OBJECTIVE: This cross-sectional national survey aimed to examine satisfaction of Greek households with specific aspects of medication use and their correlates. METHODS: Between November 2004 and February 2005, telephone interviews were used for collecting information about socio-demographic and health-related characteristics in a systematic sample of 1000 Greek households. Respondents were classified into three categories: chronic or short-term prescribed medication use, occasional medication use and no medication use during the 3 months preceding the survey. Satisfaction was assessed through various aspects of medication use like physician's consultation, physician's response to adverse events, consultation and advice by pharmacists, symptoms' resolution, route of drug administration, drug tolerability and drug cost. RESULTS: The prescribed drugs' use in the 3 months preceding the survey interview was 36.9%; 28.6% for subjects under chronic treatment and 8.3% under short-term treatment. During the same time period, 52.8% of the respondents reported the occasional self-use of over the counter drugs for minor symptoms. A high prevalence of hypertension, cardiovascular, musculoskeletal and endocrine disorders has been observed. In general, respondents expressed a high degree of satisfaction with all aspects of medication use examined, the only exception being costs. Age, area of residence, social insurance scheme and self-reported health status were associated with specific aspects of patient satisfaction. CONCLUSIONS: Patient satisfaction with the aspects of medication use examined seems to be influenced by demographic and social factors; this points out to the necessity of taking into account socio-cultural variations and the structure of the health-care system in policymaking.