Primary care professionals' experiences during the first wave of the COVID-19 pandemic in Greece: a qualitative study.

BACKGROUND: The coronavirus outbreak (COVID-19) tested health care systems worldwide. This qualitative study aimed to explore and understand the experiences, beliefs and concerns of Primary Care Professionals (PCPs) regarding the preparedness and response of primary care to the first wave of the pandemic in Greece, a country where a public structured primary care system has been developing. METHODS: We conducted semi-structured telephone interviews with 33 PCPs (General Practitioners, community General Internal Medicine Specialists, community Paediatricians and nurses) recruited from all regions of Greece after the first wave of the pandemic (June 2020). Interviews were transcribed verbatim, data were anonymised and analysed. Thematic analysis was applied developing a conceptual framework. RESULTS: Four main themes were identified: a) Primary care unit adaptation and issues faced during the pandemic; b) Management of suspected COVID-19 cases; c) Management of non-suspected cases; d) Consequences of the pandemic. In the first phase of the pandemic, remote management of suspected cases and their referral to the hospital were preferred as a result of a shortage of personal protective equipment and inaccessibility to coronavirus testing in primary care. Due to the discontinuation of regular medical services and the limited in-person contact between doctors and patients, chronic disease management and prevention programmes were left behind. Social and emotional consequences of the pandemic, such as workplace stigma, isolation and social seclusion, deriving from fear of viral transmission, as well as burnout symptoms and exhaustion were commonly experienced among PCPs. Positive consequences of the pandemic were considered to be the recognition of the importance of an empowered public healthcare system by citizens and the valuable insight, knowledge and experience professionals gained in times of crisis. CONCLUSIONS: Primary care has a key role to play during and after the pandemic by using its information infrastructure to identify at-risk groups, detect new cases of COVID-19, provide care according to needs, and carry out vaccination programmes. Central coordination and empowerment of primary care will increase its effectiveness, via public awareness, holistic patient management, and unburdening of hospitals.

Health-related religious rituals of the Greek Orthodox Church: their uptake and meanings.

AIM: To examine the uptake of religious rituals of the Greek Orthodox Church by relatives of patients in critical condition in Greece and to explore their symbolic representations and spiritual meanings. BACKGROUND: Patients and their relatives want to be treated with respect and be supported for their beliefs, practices, customs and rituals. However nurses may not be ready to meet the spiritual needs of relatives of patients, while the health-related religious beliefs, practices and rituals of the Greek Orthodox Christian denomination have not been explored. METHOD: This study was part of a large study encompassing 19 interviews with 25 informants, relatives of patients in intensive care units of three large hospitals in Athens, Greece, between 2000 and 2005. In this paper data were derived from personal accounts of religious rituals given by six participants. RESULTS: Relatives used a series of religious rituals, namely blessed oil and holy water, use of relics of saints, holy icons, offering names for pleas and pilgrimage. CONCLUSION: Through the rituals, relatives experience a sense of connectedness with the divine and use the sacred powers to promote healing of their patients. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should recognize, respect and facilitate the expression of spirituality through the practice of religious rituals by patients and their relatives.

Trends of tuberculin skin test positivity rate among schoolchildren in Attica, Greece.

We sought to estimate the prevalence and temporal trends of tuberculin skin test (TST) positivity rate among schoolchildren, in a suburban area of Attica, Greece. We retrospectively analysed the prevalence of the TST positivity (forearm volar surface induration >10 mm) of schoolchildren, in the catchment area of the public primary healthcare centre of Vari, over a 16-y period (1990-2005). TSTs were performed in the context of a national, government-directed TB screening programme. We retrieved 11,105 records of TSTs performed on children aged 6 and 14 y. These tests referred to 7920 and 2969 BCG unvaccinated and vaccinated children, respectively, as well as 120 children who had close contact with a TB confirmed case, and 6 children with known active or latent TB. The prevalence of TST positivity among BCG unvaccinated children was 2.0% over the whole study period; this figure declined in the second compared to the first half of the study period (2.4% vs 1.4%, p<0.001). The gradual decline in TST positivity among BCG unvaccinated schoolchildren, despite the substantial rise in the number of immigrants in Greece, over our study period, may, at least in part, be attributed to relevant national screening and prevention measures.