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Introduction: The explosive technological development, the necessary use of the internet in everyday life, as well as globalization, are some of the parameters that shape society and, by extension, education in the 21st century. Heterogeneity in the ranks of undergraduate nursing students dominates and in turn forms a platform with different abilities, skills and experiences, which are involved in nursing education and change its result, enhancing the polymorphism of the Nursing profession. Variables such as gender and ethnicity are changing, with more men entering, but also heterogeneous populations such as immigrants, returnees, older people, placement exam students, are being added to the Nursing student population. The purpose of this review was to outline the characteristics of University Degree Nursing students and teachers in the new reality. Methodology: A bibliographic search was carried out in the electronic databases PubMed, Science Direct and Research Gate, as well as in official pages of International Nursing Organizations, with key words for the time period of the last decade. Results: The literature review highlighted the prevailing characteristics of the instructors and trainees of Tertiary Nursing Education in the modern era and how these change with the use of technological means in the educational process. Conclusions: The need for student-centered education and active teaching, reinforces the use of new technological means by teachers, while the entry of students of the Alpha generation into Tertiary Nursing reshapes the student identity, changing the traditional characteristics of all those involved in the educational process.

Background: Advanced cancer patients experience several physical or psychological symptoms which require palliative care for alleviation. Purpose: To assess the prevalence and intensity of symptoms among cancer patients receiving palliative care in a Greek hospital and to examine the association between reported symptoms and social clinical and demographic characteristics. Material-methods: This descriptive research was conducted during a six-month period using a convenient sample of 123 advanced cancer patients. All participants were assessed for their symptoms using the Edmonton Symptom Assessment System (ESAS) with a questionnaire covering demographic and clinical characteristics. Results: The mean age was 63.8± 10.8 years, with lung and breast (58.5% and 11.4%, respectively) as the most common primary cancer types. The most severe symptoms were fatigue, sleep disturbance, dyspnea, depression and anxiety. Negative correlations were revealed between age and the following symptoms: pain (r = -0.354, p = 0.001), fatigue (r = -0.280, p = 0.002), nausea (r = -0.178, p = 0.049), anorexia (r = -0.188, p = 0.038), dyspnea (r = -0.251, p = 0.005), and depression (r = -0.223, p = 0.013). Advanced breast cancer patients scored higher in pain, fatigue and dyspnea compared to those with other cancers. Conclusions: Hospitalized cancer patients in Greece experience several symptoms during the last months of their life. These are influenced by demographic characteristics. Appropriate interventions are strongly advised with appropriate recognition and evaluation of symptoms by health professionals.

Purpose: To investigate the effect of lifestyle habits in childhood Metabolic Syndrome (MTS). Design and Methods: Descriptive correlation study with 480 participants (5-12 years old) using a specially designed questionnaire was conducted. Anthropometric and biochemical analyses were performed. Results: Fifteen percent of children exhibited predisposition for MTS. Regarding sleep habits, logistic regression analysis (LRA) showed that hour of sleep -before 22: 00- was associated with decreased waist circumference (WC%) (p = .026). Midday siesta was negatively correlated with systolic (SBP) (p = .001) and diastolic blood pressure (DBP) (p = .046). In children without MTS, lack of sleep and night time sleep was positively correlated with DBP (p = .044) and fasting blood glucose (FBG) (p = .005). Regarding nutrition habits, fast food consumption was positively correlated with SBP (p = .006) and meat consumption was positively correlated with both Body Mass Index% (BMI%) (p = .038) and WC% (p = .023). LRA showed that fruit (p = .001) and legume (p = .040) consumption was associated with decreased FBG; fish consumption with decreased Low Density Lipoprotein (LDL) cholesterol (p = .031), vegetable (p = .054) and cereal consumption (p = .012) with decreased DBP. In children with MTS, fruits were associated with increased FBG (p = .034). In children without MTS, meat consumption was associated with increased LDL (p = .024), cereal with increased WC% (p = .002) and olive products with increased High Density Lipoprotein (HDL) cholesterol and BMI% (p = .037). Conclusions: The adoption of both balanced diet and sleep habits seemed to be crucial for the prevention of MTS. Practice Implications: Clinical health nurses could develop and implement preventive intervention programs in order to avoid metabolic complications in adulthood. (C) 2018 Elsevier Inc. All rights reserved.

Non-adherence to the therapeutic regimen is an increasingly growing problem especially among patients undergoing hemodialysis. The aim of this study was to modify the Greek version of Simplified Medication Adherence Questionnaire (GR-SMAQ) for patients undergoing hemodialysis (GR-SMAQ-HD) and explore its validity and reliability. Between June 2016 and November 2016 a group of patients undergoing hemodialysis (N=107) completed the Greek version of SMAQ. The study was carried out in three Dialysis Units of Hospitals of Athens and Peloponnese region, Greece. The form of GR-SMAQ was modified specifically for renal patients while four additional items were added so as the tool study all aspects of adherence to hemodialysis regimen. Construct validity was checked through exploratory factor analysis with principal Component Analysis with the Equamax method. Test-retest reliability and internal consistency were tested. Statistical analysis was performed using the IBM SPSS Statistics version 21. The significance level was set up at 5%. The Greek version of SMAQ for patients undergoing hemodialysis includes eight questions. Three factors emerged from factor analysis. Cronbach’s a coefficient was 0.742 for the whole scale and for each subscale was for Medication Adherence 0.75, for Attendance at hemodialysis session 0.856 and for Diet/Fluid restriction was 0.717. The total mean score was 6.29 (+/- 1.82). GR-SMAQ-HD is a reliable and valuable tool that can be used by hemodialysis nurses and students of nursing for detection of adherence levels in clinical practice.

Introduction: In Greece, population ageing consists one of the most important public health issue with dementia being listed among the top five commonest illnesses. The total direct and indirect health care costs are estimated to exceed 6 billion€, annually. Aim: This study aimed to examine the prevalence and the risk factors of dementia among the elderly, in urban and semi-urban population. Material and Method: The studied sample consisted of 300 subjects, of whom 171 were women and 129 were men, aged ≥60 years, all members of the Open Care Centers for Older People (OCCFOP; KAPI in Greek) of Prefectures of Attica (Municipality of AgiosDimitrios) and Fokida, during the period July 2012- December 2012. A questionnaire of socio-demographic data was used and the Mini Mental State Examination (MMSE), validated in Greek elderly population, was used to evaluate dementia. Results: The results of the study revealed that 15,3% of the sample presented dementia (13% moderate and 2,3% serious dementia). Moderate dementia prevalence appeared to be highest among women as compared to men.Additionally, the “unstandardized coefficients B” showed that the age group of 70-74 years old had an increase of 0,048 points, in the MMSE, in relation to the reference group (≥75 years old) (Β= 0,048, 95%CI -0,308,0,404, p=0,010); equally, in the MMSE scale, and cohabitation had an increase of 0,037 points, in relation to the reference group (Living alone) (Β= 0,037, 95%CI -0,251,0,325, p=0,024). Conclusions: The results of the study revealed that elderly people who cohabitate or participate in creative activities develop lower levels of cognitive disorders. Consequently, it becomes apparent that there is a strong need for the dementia prevention programs to bestrengthened with appropriately tailored psychosocial support network.

Background: Most religions offer a framework to answer existential questions concerning death and dying. The aim of this study was to find the association between Greek nurses’ religious attitudes and death attitudes. Methods: A cross-sectional analytical study took place in two General Greek hospitals. 102 Registered nurses and nurses’ aides answered an anonymous self-administered questionnaire about their religiosity and their attitude death (RR=64,3%). Analysis of data was performed with statistical methods of descriptive and inferential statistics. SPSS (version 19) was used for the analysis. Findings: The majority of the sample was orthodox. Nurses who answered that religiosity doesn’t affect their attitude towards death were found to have greater fear of death with p=0.000 and avoid death more (p=0.012). Nurses who admit that religiosity affects their attitude towards death the most, they were found to accept death more in relation to those who say that their religiosity doesn’t affect their attitude towards end-stage patients care (p=0.000). Discussion: Religiosity is a factor that correlates statistically significant with Greek nurses attitude towards death.

Purpose of this study is to explore those factors which affect the health of students in postadolescent age, focusing on smoking and alcohol use, especially in regard to ways of predicting adoption of this behavior and its frequency to detect future users of tobacco and alcohol use but also high-risk groups, i.e. those people who are led to abuses. On the basis of the research part is the Theory of Planned Behaviour, the axes of which are to be investigated. Specifically, the factors evaluated, except for population parameters, behavioral attitudes, i.e. attitudes towards the behavior of tobacco use and alcohol regulations subjective perceptions and perceptions of control, perceived behavioral control and self-efficacy. Intention is explored to continue or start using tobacco and alcohol in the future and evaluate the behavior. The sample consisted of 138 students of postadolescent age, 18-25 years of both sexes, all of the University of Peloponnese and the Technological Educational Institute of Kalamata, Department of Sparta, Greece. The results of a series of statistical analysis, via SPSS 21.0 statistical program revealed the predictive power of perceived behavioral control and subjective norms to the intention of interpreting 64% of the variance of the latter, of the attitudes toward alcohol in relation to intention that interpret 69% of the variance, of the normative beliefs toward smoking with 69% range of interpretation to the dependent variable, of the perceived behavioral control of smoking with 72% and of the attitudes toward smoking with 77% of interpretation. The results demonstrate the significance and application in universities and technological educational institutes appropriate primary preventive interventions for students nonusers of tobacco and alcohol and appropriate programs of secondary and tertiary prevention in heavy users of tobacco and alcohol use and high-risk individual.

This study aims to assess how Greek renal nurses feel about death and examine any relationships between their attitudes and demographic factors. Design: Descriptive quantitative study. The sample comprised of 49 nurses. Methodology: Voluntary and anonymous completion of the Death Attitude Profile-Revised and a demographic questionnaire. Results: 44 respondents were female and 5 were male with a mean age of 25.80 years. The mean nursing experience was 10.9 years. Nursing experience and age were the variables most likely to predict nurses' attitudes towards death. Nurses with specific education on palliative care had less difficulty talking about death and dying and did not have a fear of death. The Hospital-based teams (known as palliative care teams, supportive care teams or symptom assessment teams) had statistically significant different relationships with fear of death and neutral acceptance scores. Conclusions: It is recommended to include education on death and care of the dying in the nursing degree course in order for nurses who are giving terminal phase patient care to be better able deal with issues that death evolves.

Introduction: The international financial crisis in combination with the aging population and the appropriation of funds of health services impose the management of hospital services as a necessity for the surviving of hospitals. Aim: To examine the perceptions of upper administrative hospital executives (Nursing, Medicine and Administrative services) in the wider region of Attica, on marketing, communication, and public relations in health. Materials and method: The research tool was a questionnaire that was titled “Attitudes and perceptions of health executives on marketing in health”. Section I, included 8 questions (questions 1-8) of which 3 collected information on the sex, the age and the level of education of those questioned. Section II, consisted 21 closed questions searching about the attitudes and perceptions of the people in the sample about marketing as activity in the area of health. Population study: Four hundred and fifty (450) higher health executives from the three basic fields of service in health institutions (medical, nursing, administration) constituted the total sample in the research. Results Most executives (n=216, percentage 48%) had favorable perceptions on the application of marketing in health services, quite a few executives (n=193, percentage 42,9%) had mediocre perceptions whereas a comparatively small number of these(n=41, percentage 9,1%) recorded a negative opinion. The women and older executives appeared to have a more positive stance compared to men (p=0,021) and younger executives (p=0,000). Nurses supported more intensely than doctors that the students of nursing had to have knowledge in marketing so that they are more equipped for their career. Nursing more than medical and administration personnel agreed with the perception that supports that marketing will decrease the dominance of the medical profession in the field of health. Conclusions: People in the survey even though they had some reservations they formed a favorable attitude towards marketing and its application in the field of health An extremely high percentage of the participants in the research agreed that marketing is an activity that needs to definitely be applied by health professionals. Also the majority of the people in the sample agreed that marketing will play a major role in the future in the accomplishment of the health organization’s goals.

Non-adherence to treatment is an increasing problem for patients with end stage renal disease under haemodialysis.Aim: This study aimed to review the basic literature mentioned to the correlation between haemodialysis patient demographic characteristics and non-adherence to their treatment regimen.Method: Studies written in English published in 2002-2013 were identified through PubMed, PubMed Central, Dove press, Scopus. Clinical trials and review articles were excluded. Key- words used for search included a combination of adherence / non-adherence and haemodialysis in titles. Results: According to the literature, patient demographic characteristics are important factors for patient adherence to treatment regimen. Generally, factors associated with increased level of non-adherence to haemodialysis treatment regimen included young age, sex, race and educational level. Conclusions: Early identification of risk factors, inclusion of patients in the health care team and participation in clinical decision making, can lead to behavior adherence.

Occupational burnout is defined as a physical and mental exhaustion syndrome and is the result of chronic stress. Nurses are exposed to the physical and emotional effects of the experience of caring for a dying patient. Aim of this study was to investigate nurses’ burnout caring patients at their end of their life. Material and Method: The sample of the research constituted of 110 nursing professionals who are caring patients facing death. Data were obtained using Death Attitude Profile-Revised (DAP-R) and Maslach’s burnout inventory (MBI). Results: The factors that appeared to shape the nurses attitudes towards death were age, marital status, education level, position in the workplace, department at work and professional experience. Conclusions: Fear of death and death avoidance were found to correlate statistically significant with the subscale depersonalization and with emotional exhaustion.

Fatigue is one of the most common symptoms of haemodialysis patients and is associated with poor quality of life. Purpose: To investigate the levels of fatigue and its correlation with quality of life of haemodialysis patients. Results: Of the 134 haemodialysis patients, the majority of patients (52,9%) seemed to have low rates of fatigue (10