Psychometric Properties of the Family Stigma in Alzheimer's Disease Scale in Greek Professional Caregivers.

BACKGROUND AND PURPOSES: The present study was undertaken in order to evaluate the validity and reliability of the Family Stigma in Alzheimer's Disease Scale (FS-ADS) in the Greek population. METHODS: The Greek version of the FS-ADS as well as the Maslach Burnout Inventory (MBI) was administered to 171 healthcare professional caring for people with dementia. Exploratory factor analysis was performed to examine the factor structure of the FS-ADS. Test-retest reliability was measured by administration of the FS-ADS in 20 individuals. RESULTS: Principal component analysis revealed 5, 8 and 3 factors (subscales) for each dimension of the original questionnaire, respectively, similar to other previously reported results in the literature. The overall Cronbach's α was .899, yielding a high internal consistency. Test-retest reliability was very high (r = 0.903, p < .001). Statistically significant relationships were found between most of the FS-ADS dimensions and Maslach subscales. CONCLUSION: The findings favor the use of FS-ADS in nurses and professional caregivers in general, for measuring stigma in dementia in Greece.

Exploration of the relationship between stigma and burnout among Greek nurses in dementia care.

OBJECTIVE: To investigate possible correlations between stigma and burnout of nurses and non-graduate professional caregivers of elderly with dementia in nursing homes. BACKGROUND: Research on dementia stigma in health care professionals as well as its relationship with their well-being is seriously lacking. METHODS: This cross-sectional study involved a convenience sample of 171 nurses and other professional caregivers in 16 Greek elderly care units who responded to Maslah Burnout Inventory (ΜΒΙ) as well as the Family Stigma in Alzheimer's Disease Scale (FS-ADS). In order to find adjusted associations between independent variables and the stigma and burnout of professional caregivers, multiple linear regression analysis was used. RESULTS: Cognitive, emotional and behavioural attributions of the three dimensions of stigma were found to be independent predictive factors of burnout's dimensions which indicate that stigma nurses deposit on patients, contributes towards their burnout. CONCLUSION: Educational preparation of geriatric nurses should provide them with the option of seeing dementia as a normal stage of life since reducing stigma can contribute towards preventing and managing professional burnout. IMPLICATIONS FOR NURSING MANAGEMENT: In order to reduce burnout, nurse managers should design lifelong learning programs on the basis of changing the stigmatizing negative cognitive and emotional attitudes of professionals towards dementia.

Clinical, Social and Demographics Factors Associated with Spiritual Wellbeing in End Stage Renal Disease.

Spiritual health is one of the important aspects of health status that is often neglected. AIM: the present study aims to evaluate spiritual wellbeing in end stage renal disease patients undergoing hemodialysis and its relation to sociodemographic and clinical variables. METHODS: A convenience sample of 183 individuals undergoing hemodialysis was recruited. Measurements were conducted with the following instruments: (a) a sheet containing demographic data and clinical information such as duration of dialysis e.t.c (b) Facit Spiritual Wellbeing Scale (Facit-Sp12). Statistical analysis was contacted with SPSS v.22. Descriptive statistics were initially generated for sample characteristics. Parametric and no-parametric statistics were used for searching the relations between the variables. P values <0.05 were defined as reflecting the acceptable level of statistical significance. RESULTS: From the total of the 183 participants of the study the 69.9% were male and 30.1% female. The age range was from 26 to 88 years old, with mean 61.39 ± 14.11. The subscale "peace" is associated to gender (t = 2.150, p = 0.033), educational level (F = 2.698, p = 0.047) and duration of dialysis (F = 2.969, p = 0.033) and religious beliefs (t = -2.059, p = 0.041). The subscale "faith" is associated to gender (t = -3.428, p = 0.001), age (p = 0.006), number of children (F = 4.347, p = 0.014). Moreover, the subscale "meaning" is associated to age (p = 0.001). Finally its worth to be mentioned that comorbidity is associated to subscales "meaning" (t = -2.071, p = 0.040), "peace" (t = -2.377, p = 0.018) and the overall spiritual wellbeing (t = -1.988, p = 0.048). CONCLUSIONS: Social, demographic factors as well as clinical variables such duration of dialysis and comorbidities are affecting spiritual wellbeing in end stage renal disease.

Association of 5-HTTLPR Polymorphism with the Nursing Diagnoses and the Achievement of Nursing Outcomes in Patients with Major Depression.

The aim of this study is to investigate whether a 44-base-pair insertion/deletion polymorphism in the upstream regulatory region of the serotonin transporter gene (5-HTTLPR) is associated with the nursing diagnoses and the achievement of the desired nursing outcomes in inpatients with major depression. Thirty five patients were evaluated. The nursing diagnoses of risk for suicide and imbalanced nutrition are reported less often in homozygotes of the high-expressing gene (LA). Carriers of the low-expressing genes (LG or S) have a worse response to interventions which aim to increase low self-esteem, indicating that they may need more intensive care in order to achieve the desired outcome. Genetics in psychiatric nursing could help refine personalized care, however further studies with large sample sizes and multiple gene evaluations are needed.

Factors Affecting Mental Patients' Behaviors and Attitudes Regarding Smoking

Background: Patients with mental health problems are in high risk to develop addiction, since smoking incidence is three times higher than that of the general population. The aim of the study was to investigate the factors affecting mental health patients' smoking habits. Methods: The sample of study were 356 patients out of 403 initially approached, with 142 hospitalized in hospital facilities and 214 in community settings. The «Smoking in psychiatric hospitals" and General Health Questionnaire (GHQ-28) questionnaires were used. A principal component analysis was performed using the correlation coefficients of the various variables and an orthogonal varimax rotation, in order to interpret the seven factors emerging. Among the variables the most important factors appeared to be the type of healthcare facility, legal status, depression and age. Results: The type of healthcare facility was correlated to demographic characteristics, clinical features, psychopathology and functionality, but also to the attitudes and behaviors related to smoking. More specifically, the in-hospital patients were heavier smokers, about 90% of the patients said they would consider quitting smoking. The various variables had only a small effect on the intention to quit smoking. The comparison of the coefficients of determination of each variable, showed that age had the strongest effect (R2=0.152), while the GHQ D subscale (severe depression) had the least significant effect (R2=0.023). From all (7) factors, it appears that hospitalization was positively correlated with factor 5 and negatively with the factors 2, 3 and 6, legal status (commitment order) negatively with factors 1 and 4, while depression (or consuming antidepressants) positively factor 4 and negatively to factors 1 and 3. Finally, age was the only variable that is associated with the agent 7. Conclusions: Patients are permissive to staff's smoking in the healthcare facility and may resist attempts to restrict it. It is important that these conclusions are taken into account in any systematic attempt to limit smoking within mental health settings.

Readiness for and predictors of evidence base practice in Greek healthcare settings.

BACKGROUND: Implementation of evidence-based practice (EBP) remains limited in healthcare settings and knowledge of predictors of healthcare professionals' EBP activities is lacking. AIM: Describe nurses' readiness for EBP and identify related predictors in Greek healthcare settings we conducted a survey. RESULTS: Nurses scored high in the EBP readiness scale reflecting significant positive readiness toward EBP and consistently reported favourable attitudes toward and beliefs about EBP. However, half of them were unsure about their ability to engage in EBP despite the fact that they valued research-based practice as important. EBP specific domains including the "EBP-attitude", the "EBP-knowledge", the "Informational needs" and the "Workplace culture" and nurses' demographics as well, were found to be strong predictors of EBP readiness among Greek nurses. CONCLUSION: As nurses are now more aware of and open to the idea of EBP, diverse strategies and well-designed interventions to facilitate the desired change to practice are needed.

Readiness for and predictors of evidence-based practice in Greek healthcare settings.

BACKGROUND: Implementation of evidence-based practice (EBP) remains limited in healthcare settings and knowledge of predictors of healthcare professionals' EBP activities is lacking. AIM: To describe nurses' readiness for EBP and identify related predictors in Greek healthcare settings. RESULTS: Nurses scored high in the EBP readiness scale reflecting significant positive readiness toward EBP and consistently reported favorable attitudes toward and beliefs about EBP. However, half of them were unsure about their ability to engage in EBP despite the fact that they valued research-based practice as important. EBP specific domains including the "EBP-attitude", the "EBP-knowledge", the "informational needs" and the "workplace culture" and nurses' demographics as well, were found to be strong predictors of EBP readiness among Greek nurses. CONCLUSION: As nurses are now more aware of and open to the idea of EBP, diverse strategies and well-designed interventions to facilitate the desired change to practice are needed.

THE TRANSLATION, VALIDATION AND CULTURAL ADAPTATION OF FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY - SPIRITUAL WELL-BEING 12 (FACIT-SP12) SCALE IN GREEK LANGUAGE.

BACKGROUND: According to World Health Organization (WHO), spirituality is an important domain of quality of life especially in terminal, life threatens chronic diseases. For many people spirituality and religion are not just very important dimensions of their existence, but also a source of support that contributes to wellbeing and coping with everyday difficulties of life. AIM: Aim of the study was the translation of the Facit Spiritual Well Being Scale (Facit-Sp12) in Greek language and the validation of the scale for the Greek population. MATERIAL AND METHODS: The Facit-Sp12 questionnaire is an anonymous self-administered questionnaire that contains twelve, four point Likert scale, closed questions (0=Not at all, 1=A little bit, 2=Some-what, 3=Quite a bit, 4=Very Much). The questionnaire was translated into Greek language and then back translated in the English in order to be checked for any inconsistencies. The sample of the study was 183 chronic kidney disease patients, undergoing hemodialysis. Exploratory factor analysis, with principal components analysis with Varimax rotation was performed for checking the construct validity of the questionnaire. The test-retest reliability and the internal consistency were also examined. Statistical analysis performed by the use of SPSS 21.0. Statistical significance level was set at p=0.05. RESULTS: The final Greek version of the questionnaire includes all of the twelve questions. The mean age of the participants was 61.81±13.9. Three factors were exported from the statistical analysis. The Cronbach-α coefficient was 0.77 for the total questionnaire and for each subscale was 0.70 for "meaning", 0.73 for "peace" and 0.87 for "faith". Between the three subscales "meaning" had the highest score (mean 12.49, SD=2.865). CONCLUSIONS: The Facit Spiritual Wellbeing Scale-Facit-Sp12, is a valuable and reliable questionnaire of three dimensions that can be used for assessing spirituality and spiritual wellbeing in Greek population.

Mental Health Nursing in Greece: Nursing Diagnoses and Interventions in Major Depression.

The aim of the study was to assess nursing diagnoses and nursing interventions that were accordingly implemented during the care of inpatients with major depression in Greece. Twelve nurses working in three major psychiatric hospitals were recruited. Semi-structured interviews were used and audio-recorded data indicated that risk for suicide, social isolation, low self-esteem, sleep problems, and imbalanced nutrition are the nursing diagnoses most commonly reported. Establishing trust and rapport is the primary intervention, followed by specific interventions according to each diagnosis and the individualized care plan. The findings of the study also highlight the need for nursing training in order to teach nurses initial assessment procedures and appropriate evidence-based intervention techniques.

INTEGRATING CHRONIC KIDNEY DISEASE PATIENT'S SPIRITUALITY IN THEIR CARE: HEALTH BENEFITS AND RESEARCH PERSPECTIVES.

INTRODUCTION: Patients who suffer from chronic renal disease face problems in many aspects of their life; problems such as physical and social as well as mental such as stress, anxiety, depression. In addition, they exhibit an amount of spiritual needs, which relate and influence the psychological adaptation to the illness. AIM: The aim of this article is to examine evidence from the international literature regarding the possible relation of spirituality and health outcomes, mostly in the complex codex of a chronic and life treathing disease such as CKD. RESULTS: Spirituality is a very debatable issue and the term has no single and widely agreed definition. The key components of spirituality were 'meaning', 'hope', 'relatedness/connectedness', and 'beliefs/beliefs systems'. Spirituality has been characterized as the quest for meaning in life, mainly through experiences and expressions of mind, in a unique and dynamic process different for each individual. For many individuals spirituality and religion are important aspects of their existence, constituting a source support contribute to wellbeing and coping with life's daily difficulties. CONCLUSION: Considering, assessing and addressing chronic kidney disease patient's spirituality and spiritual needs is necessary and it can have a positive outcome in health related quality of life, mental health and life expectancy.

Prevalence of Secondary Traumatic Stress Among Psychiatric Nurses in Greece.

The aim of this study was to investigate the prevalence of secondary traumatic stress/compassion fatigue (STS/CF), burnout (BO) and compassion satisfaction (CS) in psychiatric nurses, and their risk factors. The Professional Quality of Life Scale (ProQOL R-IV) and a demographic and work related characteristics questionnaire were distributed to 174 psychiatric nurses in 12 public hospitals in Greece. The majority of participants were at the high risk category for STS/CF (44.8%) and BO (49.4%), while only 8.1% of nurses expressed high potential for CS. Awareness of the factors associated with STS may help nurses to prevent or offset the development of this condition.

The evidence-based practice readiness survey: a structural equation modeling approach for a Greek sample.

The present study reports on the translation, cultural adaptation and validation of the Evidence-Based Practice Readiness Survey into the Greek language. Back-translation strategy for cross-cultural research was used to translate the questionnaire into Greek. The psychometric measurements that were performed included: reliability coefficients and explanatory factor analysis using a Varimax Rotation and Principal Components Method. In a further step, confirmatory analysis of the principal components was conducted. The internal consistency of the Greek Evidence-Based Practice Readiness Survey version, as assessed by the Cronbach's alpha coefficient, showed satisfactory results. The value for alpha was found equal to 0.85. The explanatory and confirmatory factor analysis demonstrated a four-factor structure of the tool.

Suicidal behavior in a patient with burning mouth syndrome.

Introduction. Chronic pain of the oral cavity is a long-term condition and like all other types of chronic pain is associated with numerous comorbidities such as depression or anxiety. Case Presentation. This is a case of a 93-year-old patient suffering from chronic oral cavity pain who repeatedly stabbed his palate due to ongoing local pain, over the last few months, which he could not further tolerate. The patient was suffering from depression and also a diagnosis of "burning mouth syndrome" (BMS) was made. Discussion. Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnosis. Patients with multiple forms of pain must be considered as potential candidates for underdiagnosed depression (major) and suicidal thoughts.

Current evidence on the attitudes, knowledge and perceptions of nurses regarding evidence-based practice implementation in European community settings: a systematic review.

Evidence-based practice (EBP) is an approach that influences healthcare worldwide. Systematic research in the relevant biomedical literature was conducted using the Medline-Pubmed interface until August 2012. Six studies were included in the review. All of these studies had a cross-sectional study design, and 4 of them conducted a postal survey, using different questionnaires for data collection purposes. This review supports previous literature suggesting that community nurses have a positive attitude toward EBP. However, although EBP implementation is considered to be a professional imperative, the integration of recent evidence into clinical practice seems to be a cumbersome process.

Greek mental health nurses' practices and attitudes in the management of acute cases.

The aim of this study was to identify nurses' interventions, views, and attitudes concerning critical incidents. Using semi-structured interviews, a descriptive study was conducted among mental health nurses working in three major psychiatric hospitals. Analysis of nurses' audio-recorded data indicated that they had used a number of different interventions under six main categories: counseling, performing security practices, monitoring thinking disturbances, contacting the psychiatrist on-call, contacting the chief nurse on-call, and administering medication. The need for specialized training was noticed and problems like accountability, nurse-patient interactions, and nurse-doctor relationships were considered crucial by the mental health nurses.

Major depression across West Bank: a cross-sectional general population study.

BACKGROUND: In recent decades entire populations have been living under chronic strain, apprehension and violence. This is the case for Palestinians. Despite the increased volume of mass media attention on this situation, little is known about the psychological effects of this condition on this population. AIMS: The study was designed to investigate the lifetime and one-month prevalence of major depression episode (MDE) in a multi-stage sample of 916 adult Palestinians drawn from the Al-Aqsa Intifada. METHODS: The survey was based on personal interviews and was carried out from February to September 2007. The clinical examination used DSM-IV criteria for the detection of MDE, extracted from SCID-I. Data, suicidal behaviour, previous help seeking, medication use and exposure to trauma were also collected. RESULTS: Lifetime and one-month prevalence of MDE was found to be 24.3% and 10.6%, respectively. Male Palestinians suffered from slightly higher rates of MDE than their female counterparts, but this difference was not statistically significant. Being widowed and living in towns in West Bank also increased the likelihood to develop MDE. A comparison of prevalence rates in refugee and non-refugee populations showed no significant differences. This could be explained by the fact that though refugees were forcibly displaced, they were living among compatriots (non-refugees), thus both groups were experiencing the same sociopolitical adversities. Being also exposed to traumatic events increased the risk of suffering from MDE. CONCLUSIONS: This study provides evidence that a population under continuous strain and apprehension, living in unremitting socioeconomic deprivation, is more likely to suffer from major depression.

Posttraumatic stress disorders comorbid with major depression in West Bank, Palestine: a general population cross sectional study

Background and Objectives: The prevalence of Post Traumatic Stress Disorders(PTSD) comorbid with Major Depressive Episodes (MDE) were explored in fourareas of West Bank of Palestine in the aftermath of the second intifada. Methods: The sample consisted of 916 adult Palestinians representative of the general population. The interview was personal with the use of DSM IV criteria for PTSD and MDE (the SCID I modules). Results: The prevalence of chronic PTSD comorbid with lifetime MDE and chronic PTSDalone were found 18.7% and 26.5% respectively. Another 6.1% were diagnosed as suffering from lifetime MDE. Higher numbers of refugees were found to suffer from PTSD comorbid with MDE. The majority of respondents who reported previous suicidal behavior were comorbid cases of PTSD/MDE. The predictors differentiating between MDE alone and no diagnosis and between comorbid PTSD/MDE and no diagnosis were almost identical. Conclusions: This sample of adult Palestinians living under conditions of mass violence and continuous economic deprivation were found suffering from high rates of post PTSD and comorbid PTSD with MDE, a common finding among populations under serious traumatic exposure (AU)

Security rules and banned items in psychiatric acute admission wards in Athens, Greece.

Mental health nurses play a key role in maintaining the safety of patients, themselves, and others during hospitalization. The aim of the research was to evaluate the safety measures that are taken by mental health nurses to identify the security policies that exist in acute mental health wards. The Ward Safety and Security Rules Survey was used as a method of data collection. Descriptive analysis and content analysis were carried out in order to identify nurses' practices. The total sample consisted of 172 mental health nurses and nurses' assistants who worked in 14 acute inpatient psychiatric wards in three psychiatric hospitals in the greater area of Athens, Greece. The results show a minimum number of security features existing in the wards. Only one of the 14 wards had an intercom system. In only nine wards, there was a panic alarm in the office, and in eight, an emergency response telephone extension. A wide range of practices were noted concerning banned items and patient searches upon admission and return from leave. The results indicate the significant lack of protocols and specific safety rules to guide nurses' actions across psychiatric acute admission wards in Athens.

"On the spot" interventions by mental health nurses in inpatient psychiatric wards in Greece.

The objective of this research was to explore the "on-the spot" clinical interventions mental health nurses make in critical incidents on inpatient psychiatric wards. Mental health nurses play a key role in the management of psychiatric critical incidents. Nurses' autonomy, decision-making, and training in clinical interventions are important issues in psychiatric nursing practice. A descriptive study was conducted among mental health nurses working on inpatient wards of three major psychiatric hospitals in the greater Athens area, using semi-structured interviews. Nurses' personal views also were documented. Semi-structured interviews were conducted with 103 mental health nurses, who were encouraged to make personal remarks. The results of this study show that in the majority of critical incidents, the nurses were found to be in contact with the psychiatrist on call; physical restraints were used frequently in violent episodes; reassurance and support were common interventions; the majority of nurses would have preferred not to intervene with critical incidents; and nurses expressed a need for skills training and higher autonomy. The nurses implemented a specific number of interventions in confronting the various types of crises. The need for specialized training was noticed and problems like accountability, autonomy, and medication administration, were considered crucial by the mental heath nurses.

Nursing students' attitude change towards mental illness and psychiatric case recognition after a clerkship in psychiatry.

Attitudes towards mental illness were measured in all 92 students of the seventh semester in the School of Nursing of Athens University before (time 1) and after (time 2) the completion of 40 and 90 hours of lectures on clinical psychiatry and clerkship, respectively. The instrument used to measure attitudinal dimensions was the Cohen and Struening's Opinions about Mental Illness (OMI) scale, which yieldsfive factors and was proven to be reliable and valid in previous studies. Hypothetical case vignettes were used to assess psychiatric case recognition. In factors A, B, and D statistically significant differences in attitudes towards mental illness between time I and 2 were observed. It seems that the completion of training in psychiatry influenced the students' opinions about mental illness; they expressed less authoritarianism and discriminatory beliefs as well as positive views about social integration of mentally ill persons. The group of students who failed to recognize the case vignettes satisfactorily also expressed negative views in four out of five OMI scale factors.