Validation of the Self-Efficacy Questionnaire (SE-12-Gr) Assessing the Healthcare Professionals' Self-Reported Communication Skills with Older Healthcare Users in Greece.

Patients' satisfaction with their interaction with the healthcare providers has been found to correlate with adherence to therapeutic plans and better health outcomes. Healthcare providers are experiencing barriers when communicating with specific population subgroups, such as people with low health literacy, low education, and older age. Enhancing the communication skills of the healthcare providers working with older adults could facilitate their interaction with the patients. This study presents the validation of the Self-efficacy-12 (SE-12) in Greek. This is an instrument measuring healthcare providers' self-efficacy of communication skills used during their interaction with older patients. A sample of 230 healthcare providers working with older adults participated in the study. The scale showed good psychometric properties (S-CVI=.97, Cronbach a = .95, ICC = .81). A medium to high correlation was found with the generalized self-efficacy questionnaire. Exploratory Factor Analysis (EFA) yielded two factors ("Self-efficacy in communication skills and strategies" and "Self-efficacy of successful interaction") with good psychometric properties. The SE-12-GR is a brief, valid, and reliable tool for assessing self-efficacy of communication skills and it could be integrated as part of the health literacy tools for healthcare providers working with older people in Greece.

Evaluation of Online Counseling through the Working Experiences of Mental Health Therapists Amidst the COVID-19 Pandemic.

This study aimed to reflect on mental health professionals' experiences with online counseling during the COVID-19 pandemic, as well as their perceptions and recommendations for the future. The method of qualitative research with semi-structured interviews was used. The sample consisted of 17 mental health professionals working in the public or private sectors. A framework analysis revealed four main themes, namely (a) the evaluation of online counseling; (b) comparing in-person and online counseling; (c) factors influencing the effectiveness of online counseling; and (d) suggestions for the future use of online counseling. Most therapists reported that their overall experience with online counseling was positive. The main advantages cited were the accessibility for everyone and the reductions in time, money, and distance. Its primary drawbacks included less nonverbal communication, the inability to employ certain therapeutic tools, problems with confidentiality, lack of experience, and technical difficulties during online sessions. Its effectiveness depends on contextual factors and factors related to the therapeutic process itself. Organizational planning, training, and a solid implementation strategy may help ensure that this communication medium is used to its fullest potential. In addition, the possible utilization of remote counseling combined with in-person psychotherapeutic intervention methods will provide solutions for the future, especially in crisis situations.

Promoting Self-Management and Independent Living of Older Individuals with Chronic Diseases through Technology: A Study of Self-Reported Needs, Priorities, and Preferences.

Background and Objectives: Older patients' needs are rarely examined beforehand, and thus, although technology-based tools can enhance self-management, acceptability rates are still low. This study aimed to examine and compare self-reported needs, priorities, and preferences of older patients with heart failure (HF), diabetes mellitus type II (DM2), and chronic obstructive pulmonary disease (COPD) toward technology use to enhance self-management. Materials and Methods: A convenience sample of 473 participants over 60 s (60.5% females), diagnosed with HF (n= 156), DM2 (n = 164), or COPD (n = 153) was recruited. They were administered a questionnaire about the usefulness of technology in general and in specific areas of disease management. Results: Most participants (84.7%) admitted that technology is needed for better disease management. This was equally recognized across the three groups both for the overall and specific areas of disease management (in order of priority: "Information", "Communication with Physicians and Caregivers", and "Quality of Life and Wellbeing"). Sociodemographic differences were found. Cell phones and PCs were the devices of preference. The four common features prioritized by all three groups were related to 'information about disease management' (i.e., monitoring symptoms, reminders for medication intake, management and prevention of complications), whereas the fifth one was related to 'communication with physicians and caregivers (i.e., in case of abnormal or critical signs). The top disease-specific feature was also monitoring systems (of respiratory rate or blood sugar or blood pressure, and oxygen), whereas other disease-specific features followed (i.e., maintaining normal weight for HF patients, adjusting insulin dose for DM2 patients, and training on breathing exercises for COPD patients). Conclusions: Older individuals in these three groups seem receptive to technology in disease management. mHealth tools, incorporating both common and disease-specific features and addressing different chronic patients, and also being personalized at the same time, could be cost-saving and useful adjuncts in routine clinical care to improve self-management.

Views and Challenges of COVID-19 Vaccination in the Primary Health Care Sector. A Qualitative Study.

COVID-19 has affected the global community as it has severely raised population mortality and morbidity rates. Vaccination was seen as a mechanism against the spread of the pandemic. Yet, there are still several reservations about its adoption. Professionals in the field of health care have a crucial frontline role. The present study uses a qualitative research approach to examine Greek health professionals' views on vaccination acceptance. According to the key findings, health professionals largely accept vaccination. The main reasons cited were scientific knowledge, a sense of obligation to society, and protection from disease. However, there are still numerous restrictions to adhering to it. This is due to the lack of knowledge of certain scientific disciplines or to misinformation, as well as to religious or political convictions. The issue of trust is central to the acceptance of vaccinations. According to our research, the most adequate strategy to enhance immunization and ensure that it is widely accepted is to promote health educational interventions for professionals working in primary care settings.

Cultural Adaptation of a Health Literacy Toolkit for Healthcare Professionals Working in the Primary Care Setting with Older Adults.

Healthcare professionals' health literacy (HL) knowledge and skills influence their interaction with older adults. Healthcare professionals, when effectively communicating with older adults, can empower and enhance patients' skills to make informed decisions about their health. The study aimed to adapt and pilot test a HL toolkit to enhance the HL skills of health professionals working with older adults. A mixed methodology of three phases was used. Initially, the healthcare professionals' and older adults' needs were identified. Following a literature review of existing tools, a HL toolkit was selected, translated, and adapted into Greek. The HL toolkit was introduced to 128 healthcare professionals as part of 4 h webinars; 82 healthcare professionals completed baseline and post assessments, and 24 healthcare professionals implemented it in their clinical practice. The questionnaires used included an interview on HL knowledge, communication strategies, and self-efficacy using a communication scale. HL and communication strategies knowledge (13 items) and self-efficacy in communication (t = -11.127, df = 81, p < 0.001) improved after the end of the HL webinars, and improvement was retained during the follow-up after 2 months (H = 8.99, df = 2, p < 0.05). A culturally adapted HL toolkit was developed to support the needs of healthcare professionals working with older adults, taking into consideration their feedback in all phases of the development.

Health literacy continuing education courses and tools for healthcare professionals: a scoping review.

Strengthening the health literacy (HL) skills of the healthcare users is a multicomponent process involving the users, the healthcare professionals, the stakeholders, and the environment. Health organizations, universities, private initiatives, and funded projects focused on developing and implementing continuing education courses target at increasing healthcare professionals' HL. This scoping review aimed at reporting the HL continuing education courses for healthcare professionals to enhance their knowledge and skills in identifying and supporting healthcare users with limited HL, and particularly, older people. This review followed the five stages by Arksey and O'Malley framework and the guidelines by Joanna Briggs Institute for scoping reviews. Peer-reviewed papers and gray literature published between years 2000 to 2020 were included in this bibliometric search utilizing four electronic databases (PUBMED, MEDLINE, CINAHL, PSYCHINFO, and Opengrey). Twenty-seven (27) papers met the criteria, including twenty-one (21) full-texts and six (6) other records (website contents, eLearning, and funded projects). There is a lack of HL tools that address the training needs of healthcare professionals working with older adults. Tailored HL tools could benefit healthcare professionals' clinical work by improving their communication with older adults.

Secondary traumatic stress and dissociative coping strategies in nurses during the COVID-19 pandemic: The protective role of resilience.

During the COVID-19 pandemic, nurses are repeatedly exposed to acute stress at their workplace, and therefore, they are at high risk for developing mental health symptoms. The prolonged exposure of healthcare professionals may lead to Secondary Traumatic Stress (STS). STS is an aspect of "cost of care", the natural consequence of providing care to people who suffer physically or psychologically. The purpose of this study was to investigate the levels of STS in nurses during the first phase of the COVID-19 pandemic in Greece and to detect aggravating and protective factors. Participants were 222 nurses (87.4 % women; mean age 42.3 years) who completed an online survey. The questionnaire comprised of the Secondary Traumatic Stress Scale, the Brief Resilience Scale, and the Brief Coping Orientation to Problems Experienced Inventory. Nurses had high levels of STS. The hierarchical regression analyses showed that STS and its dimensions Avoidance and Arousal were positively predicted mainly by denial and self-distraction coping strategies and inversely by resilience. Resilience exhibited a protective (partial mediation) effect on the strong relationship between the dissociative coping strategies (denial, self-distraction, venting and behavioral disengagement) and STS. Trauma-informed care psychosocial interventions are needed to support the already overburdened nursing staff during the coronavirus pandemic.

Exploring Nurses' Working Experiences during the First Wave of COVID-19 Outbreak.

During the COVID-19 outbreak, nurses employed in the clinical sector faced a number of difficulties associated with excessive workload, increased stress, and role ambiguity, which impacted nurses themselves and patient care. The aim of the present study was to investigate how Greek hospital nurses working in non-COVID units experienced the virus outbreak during the first wave of the pandemic. A descriptive qualitative research design was applied using a content analysis approach. To recruit the study participants a purposive sampling strategy was used. Ten nurses participated in the study. Data collection was conducted through semi-structured interviews. Content analysis revealed three themes namely, (a) emotional burden, (b) professional commitment, and (c) abrupt changes. Six subthemes were formulated and assimilated under each main theme respectively. Organizational changes, emotional burdens and feelings of fear and uncertainty, appeared to have a crucial effect on nurses and patient care. However, the professional commitment and the nurses' effort to provide excellent nursing care remained high. Nurses demonstrated that despite the burdens caused by the COVID-19 outbreak, the pandemic era created opportunities for thoroughness and accuracy in nursing care.

What Quality of Care Means? Exploring Clinical Nurses' Perceptions on the Concept of Quality Care: A Qualitative Study.

Quality is a multidimensional issue involving various features that depend on service performance and personal assessment. Clarifying the concept of quality is essential in order to further facilitate the understanding and improvement of quality in healthcare. The purpose of this study was to investigate how clinical nurses, providing care to adult medical patients, perceive and define the concept of quality nursing care. A descriptive qualitative research design was applied. A purposive sampling strategy was used to recruit nurses from the clinical sector of a general public hospital in Athens, Greece. Ten female nurses from the medical sector participated the study. Data collection was conducted through in-depth, semi-structured interviews. Conventional content analysis was used to analyze the verbatim data. Four categories were revealed from the data analysis, namely: (a) "Quality care is holistic care", (b) "Good care is an interpersonal issue", (c) "Leadership is crucial", and (d) "Best care is our responsibility". Quality care was defined as holistic care, addressing all patient needs with competency and aiming for the best patient outcomes. It was associated with communication, teamwork, good leadership, and personal commitment. By developing an in-depth and mutual understanding about what quality means, nurse leaders and practitioners may collaborate in finding common paths to support quality interventions and enhance quality nursing care in clinical practice.

Knowledge and Use of Cervical Cancer Prevention Services among Social Work and Nursing University Students.

The present study examines: (a) the knowledge of healthcare students on cervical cancer (CC) issues and the use of related preventive services, as well as their association with the field of study and other sociodemographic characteristics; (b) the possible effect of social capital and its parameters. A cross-sectional study was conducted, using a convenience non-probability sampling technique. The final sample consisted of forty-nine social work and fifty-one nursing students. The two groups were similar regarding their sociodemographic characteristics and the knowledge and use of gynecological preventive services. However, the nursing students undertook a PAP smear check-up to a lesser extent (48.6%) compared to social work students (51.4%) (p = 0.026). The social capital scores were high for both groups, but social work students were significantly more 'Tolerant to diversity'. For the total sample, only the 'Family and friends connections' subscale correlated with knowledge about the existing gynecological preventive services. Among the main reasons explaining university students' avoidance of preventive testing were the feelings of fear and embarrassment associated with the PAP smear test. Given the significance of the future professional roles of healthcare students as information sources and leaders in women's CC preventive behavior, understanding the individual factors contributing to their own adherence is essential. It is equally important to increase their scientific knowledge through the improvement of academic curricula regarding these issues.

Empathy and Mobile Phone Dependence in Nursing: A Cross-Sectional Study in a Public Hospital of the Island of Crete, Greece.

This study examined the relationship between empathy and mobile phone dependence levels of the nursing staff in a public hospital in the island of Crete, using a cross-sectional study design. Data from 109 staff nurses and healthcare assistants (HCAs) were collected via the Greek version of the Mobile Phone Dependence Questionnaire (MPDQ) and the Toronto Empathy Questionnaire (TEQ). Multiple linear regression was used to determine the correlation between empathy and mobile phone dependency. The total mean score for TEQ was 33.9 (±5.7). Accordingly, the total mean score for MPDQ was 22.9 (±6.1). High mobile phone dependence was found in 4.7% of the participants. A statistically significant difference was found between HCAs and staff nurses, with HCAs presenting a higher mean empathy levels (TEQ) (36.5 vs. 32.6) and lower dependence levels (MPDQ) (18.9 vs. 24.5) than staff nurses. A significant correlation between empathy and dependence was found between dependence and the altruism empathy subscale, with higher dependence being correlated with lower altruism. The participants' levels of empathy do not seem to be affected by mobile phone dependence. However, empathy appears to be strongly determined by increased age and professional status. Nurses' dependence on mobile phones is a complex phenomenon that requires attention. Educational programs on empathy and information on the proper use of mobile phones by the nursing staff should be provided.

Secondary traumatic stress and vicarious posttraumatic growth in healthcare workers during the first COVID-19 lockdown in Greece: The role of resilience and coping strategies.

Despite the indisputable negative psychosocial consequences of the COVID-19 pandemic, positive consequences are also possible. Resilience and coping strategies have been assumed to contribute to these outcomes. However, findings are still scarce and inconclusive. The study aimed to examine the role of resilience and coping strategies in the secondary stress for the Greek healthcare workers (HCWs) and in the posttraumatic growth following the COVID-19 lockdown in Greece. A sample of 673 HCWs coming from Greece were recruited. A convenience and snowball mixed sampling procedure were used. A questionnaire was distributed through social networking sites, webpages, and personal contacts of the author. Participants were asked to distribute it to their own contacts. Recruitment occurred during April 5 - 30, 2000, amid the lockdown (March 23-May 03), when people were asked to follow the stringent lockdown constraint enforced by the Greek government. Sociodemographic data were collected. The Secondary Traumatic Stress Scale measured secondary traumatic stress (STS) for the HCWs. The Post-Traumatic Growth Inventory, the Brief Resilience Scale, and the Coping Orientation to Problems Experienced Inventory measured posttraumatic growth, resilience, and coping strategies, respectively. Regression analyses demonstrated that resilience and coping strategies were differentially associated with positive and negative (stress/growth) lockdown outcomes. Resilience and mostly maladaptive coping strategies predicted STS. A mixture of adaptive and maladaptive coping strategies predicted PTG. The so-called "second wave" of the outbreak that started in August 2020 indicates that the study of the psychosocial impact of the COVID-19 pandemic and lockdown and of the internal resources (resilience and coping) to deal with, is necessary. The findings contribute to a more comprehensive understanding of the coping strategies used by population subgroups (e.g., HCWs) in dealing with the COVID-19 lockdown in Greece. Enhancing internal resources through supportive services will ameliorate HCWs ability to withstand, recover, and thrive with benefits in their psychological health and well-being. Despite the indisputable negative psychosocial consequences of the COVID-19 pandemic, positive consequences are also possible. Resilience and coping strategies have been assumed to contribute to these outcomes. However, findings are still scarce and inconclusive. The study aimed to examine the role of resilience and coping strategies in the secondary stress for the Greek healthcare workers (HCWs) and in the posttraumatic growth following the COVID-19 lockdown in Greece. A sample of 673 HCWs coming from Greece were recruited. A convenience and snowball mixed sampling procedure were used. A questionnaire was distributed through social networking sites, webpages, and personal contacts of the author. Participants were asked to distribute it to their own contacts. Recruitment occurred during April 5 - 30, 2000, amid the lockdown (March 23-May 03), when people were asked to follow the stringent lockdown constraint enforced by the Greek government. Sociodemographic data were collected. The Secondary Traumatic Stress Scale measured secondary traumatic stress (STS) for the HCWs. The Post-Traumatic Growth Inventory, the Brief Resilience Scale, and the Coping Orientation to Problems Experienced Inventory measured posttraumatic growth, resilience, and coping strategies, respectively. Regression analyses demonstrated that resilience and coping strategies were differentially associated with positive and negative (stress/growth) lockdown outcomes. Resilience and mostly maladaptive coping strategies predicted STS. A mixture of adaptive and maladaptive coping strategies predicted PTG. The so-called "second wave" of the outbreak that started in August 2020 indicates that the study of the psychosocial impact of the COVID-19 pandemic and lockdown and of the internal resources (resilience and coping) to deal with, is necessary. The findings contribute to a more comprehensive understanding of the coping strategies used by population subgroups (e.g., HCWs) in dealing with the COVID-19 lockdown in Greece. Enhancing internal resources through supportive services will ameliorate HCWs ability to withstand, recover, and thrive with benefits in their psychological health and well-being.

Exploring Patients' Experiences After Chronic Kidney Disease Diagnosis: A Qualitative Study.

Chronic kidney disease (CKD) diagnosis is often associated with stress, depression, and major lifestyle changes. The aim of this qualitative study was to explore patients' experiences of living with CKD. A non-random purposeful sampling strategy was used to recruit 10 patients with CKD undergoing hemodialysis, from a tertiary care hospital in Crete, Greece. Semi-structured, face-to-face interviews were conducted with open-ended questions aiming to assess different aspects of their life after CKD diagnosis. Four main themes were revealed portraying participants' experience, including facing a new reality, 2) confronting changes, 3) finding ways to cope, and 4) continuing life.

Greek nurses' perceptions on empathy and empathic care in the Intensive Care Unit.

BACKGROUND: Empathy is a fundamental component of nursing practice impacting positively on the therapeutic process. Understanding the concepts of empathy and empathic care in the context of Intensive Care Units is essential for providing better care in high challenging environments. However, research on empathy in the ICU is scarce and mostly quantitative. OBJECTIVES: To explore how ICU nurses perceive the concepts of empathy and empathic care. DESIGN AND SETTING: A descriptive qualitative research design was applied using an inductive content analysis approach. Semi-structured interviews were conducted with nineteen ICU nurses in two hospitals in Greece. FINDINGS: Data analysis revealed three main themes namely: "To become one of them", "Empathic Care" and "Integration of empathic care in practice". Findings corroborated the affective, cognitive and behavioral components of empathy. Nurses underlined that understaffing, increased workload and professional burnout impeded empathic care. CONCLUSION: Empathy and empathic care in the ICU were perceived as closely related to patients' outcomes and quality care. Empathic care was arduous due to organisational issues. Despite that, ICU nurses appeared to promote empathic care in practice and sought ways to enhance it.

The nurses' own views about the inter-shift handover process.

Background: Nursing handovers provide critical information on the patient, requiring special communication skills and techniques between the nurses' shift-change. Aim: Current study investigates the experiences/views of nurses regarding the handover process. Methods: An observation method was applied assesing 22 interviews using a semi-structured questionnaire and an audio recording system throughout mixed content analysis. Results: Nursing handover mainly involves medical instructions, detailed records of each patient's general condition or drug administration guidelines. Nurses determined which pieces of information were significant to transfer to the next shift were the medical instructions, the patient's hemodynamic condition and the care plans implemented by the previous nurse. The information was mainly drawn from events occurring in the previous 24 h, from the medical instructions, or the doctors and the nursing outcomes, and to a lesser extent from the events of the previous shifts and the nursing folders. None of the participants had received, as they stated, any training in the handover process. Conclusions: It is highlighting the importance of organized, standardized and up-to-date handovers, and the fundamental part they play in the health care system.

Features of recording practices and communication during nursing handover: a cluster analysis.

OBJECTIVE: To record and identify the characteristics of nursing handovers in a tertiary hospital. METHOD: Observational study. Twenty-two nurses participated in 11 nursing handovers in 2015/16, using a recorded audio system and an unstructured observation form. Hierarchical cluster analysis was performed. RESULTS: Thirty characteristics were identified. The nursing handovers were based on the clinical status of patients, and all nurses obtained specialized scientific knowledge specific to the clinical environment. The information used was not based on nursing diagnoses and not in accordance with best nursing clinical practice. The following four clusters emerged among the 30 characteristics: 1) the use of evidence-based nursing practice, 2) the nonuse of evidence-based nursing practice and its correlation with strained psychological environment, 3) patient management and the clinical skills/knowledge of nurses, and 4) handover content, quality of information transferred and specialization. CONCLUSION: Multiple characteristics were observed. The majority of characteristics were grouped based on common features, and 4 main clusters emerged. The investigation and understanding of structural relations between these characteristics and their respective clusters may lead to an improvement in the quality of nursing health care services.

Features of recording practices and communication during nursing handover: a cluster analysis / Características da gravação de práticas e comunicação durante a troca de turno de enfermagem: uma análise de grupo / Características de la grabación de prácticas y comunicación durante el cambio de turno de enfermería: un análisis de grupo

ABSTRACT Objective: To record and identify the characteristics of nursing handovers in a tertiary hospital. Method: Observational study. Twenty-two nurses participated in 11 nursing handovers in 2015/16, using a recorded audio system and an unstructured observation form. Hierarchical cluster analysis was performed. Results: Thirty characteristics were identified. The nursing handovers were based on the clinical status of patients, and all nurses obtained specialized scientific knowledge specific to the clinical environment. The information used was not based on nursing diagnoses and not in accordance with best nursing clinical practice. The following four clusters emerged among the 30 characteristics: 1) the use of evidence-based nursing practice, 2) the nonuse of evidence-based nursing practice and its correlation with strained psychological environment, 3) patient management and the clinical skills/knowledge of nurses, and 4) handover content, quality of information transferred and specialization. Conclusion: Multiple characteristics were observed. The majority of characteristics were grouped based on common features, and 4 main clusters emerged. The investigation and understanding of structural relations between these characteristics and their respective clusters may lead to an improvement in the quality of nursing health care services.

RESUMO Objetivo: Gravar e identificar as características da troca de turno de enfermagem em um hospital terciário Método: Estudo observacional. Vinte e dois enfermeiros participaram de 11 trocas de turnos em 2015/16, usando um sistema de áudio gravado e um formulário de observação não estruturado. Foi realizada uma análise de grupo hierárquico. Resultados: Trinta características foram identificadas. As trocas de turno se basearam no estado clínico dos pacientes, e todos os enfermeiros obtiveram conhecimento científico especializado e específico para o ambiente clínico. A informação usada não se baseou nos diagnósticos de enfermagem e também não esteve de acordo com as melhores práticas clínicas de enfermagem. Os quatro grupos seguintes emergiram dentre as 30 características: 1) o uso de práticas de enfermagem baseadas em evidências, 2) o não uso de práticas de enfermagem baseadas em evidências e sua correlação com ambiente psicológico hostil, 3) manejo do paciente e habilidade/conhecimento dos enfermeiros e 4) conteúdo das trocas de turno, qualidade da informação transferida e especialização. Conclusão: Múltiplas características foram observadas. A maioria das características foram agrupadas com base nas características comuns e quatro grupos principais surgiram. A pesquisa e a compreensão das relações estruturais entre essas características e seus respectivos grupos podem levar a uma melhora da qualidade dos serviços de atendimento em saúde dos enfermeiros.

RESUMEN Objetivo: Grabar e identificar los rasgos del cambio de turno de enfermería en un hospital terciario. Método: Estudio observacional. Veintidós enfermeros participaron en 11 cambios de turno en 2015/16, utilizando un sistema de audio grabado y un formulario de observación no estructurado. Se llevó a cabo un análisis de grupo jerárquico. Resultados: Treinta características fueron identificadas. Los cambios de turno se basaron en el estado clínico de los pacientes, y todos los enfermeros lograron conocimiento científico especializado y específico para el entorno clínico. La información utilizada no estuvo basada en los diagnósticos de enfermería y tampoco estuvo en conformidad con las mejores prácticas clínicas de enfermería. Estos son los cuatro grupos siguientes que emergieron de las 30 características: 1) el uso de prácticas de enfermería basadas en evidencias, 2) el no uso de prácticas de enfermería basadas en evidencias y su correlación con el ambiente psicológico hostil, 3) manejo del paciente y habilidad/conocimiento de los enfermeros y 4) contenido de los cambios de turno, calidad de la información transferida y especialización. Conclusión: Múltiples rasgos fueron observados. La mayoría de las características se agruparon con base en las características comunes y cuatro grupos principales surgieron. La investigación y la comprensión de las relaciones estructurales entre dichas características y sus respectivos grupos pueden llevar a una mejora de la calidad de los servicios de atención en salud de los enfermeros.