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Background: it is widely accepted that living in the digital transformation era, the need to develop and update new professional skills and tools in health sectors is crucially important. Therefore, this study aimed to explore the reliability and validity of the Digital Competence Indicators tool in assessing the digital skills of Greek health professionals. Methods: in this cross-sectional study, 494 health professionals, including doctors (175) and registered nurses (319) working in four Greek hospitals were recruited and willingly participated using a convenience-sampling method. The original framework of Digital Competence Indicators was translated from English to Greek based on guidelines for cross-cultural adaptation of questionnaires. The validity of the tool was explored using confirmatory factor analysis (CFA) to verify the fit of the model using inductive techniques. The instrument reliability was confirmed using Cronbach's alpha (α) and McDonald's Omega coefficients. Results: the reliability was estimated at 0.826 (Cronbach's-α) and 0.850 (McDonald's Omega-ω). The indicators of CFA were all calculated within an ideal range of acceptance. Specifically, the CFA comparative fit index produced the following adjustment indices: x2/df = 1.152 (p = 0.037), CFI = 0.997, Lewis index (TLI) = 0.966, and root mean square error of approximation (RMSEA) = 0.018. Conclusions: The present study demonstrated that the Digital Competence Indicator instrument has high reliability, internal consistency, and construct validity and, therefore, it is suitable for measuring digital skills of health professionals. [ABSTRACT FROM AUTHOR]

Background. Both fatigue and depression are common health problems in ageing. Aim. To explore the effect of depressive symptomatology on the presence of fatigue in home-care patients aged 65 years old and over. Methodology. A cross-sectional study was conducted on three "Help at Home" programs in the region of Crete, Greece. The sample consisted of 300 beneficiaries' elders. Depressive symptomatology was assessed using the Greek version of the BECK Depression Inventory scale (BECK DI) and the presence of fatigue was assessed by the Modified Fatigue Impact Scale (MFIS). Results. The majority of the participants were female (55.3%), mean age was 78.3 ± 7.4 years, 43% were aged >80 years old and 11.3% were bedridden. Fatigue incidence (MFIS score>46) was 58.7%. Depression was significantly associated with higher rates of fatigue (betas=0.687, p<0.001). Also, fatigue was respectively increased as the number of chronic diseases increased (p =0.031). Conclusions. Depression is independently associated with fatigue and thus health professionals caring for older people should be suspected of the presence of depression whether fatigue is expressed as a complaint. [ABSTRACT FROM AUTHOR]

Background: Mounting literature on stress and coping in nursing students are available; however, most of the findings are confined to a single cultural group. Aims: This study was conducted to determine the level of stress, its sources and coping strategies among nursing students from three countries: Greece, the Philippines and Nigeria. Methods: Using a descriptive, comparative research design, 547 nursing students (161 Greek nursing students, 153 Filipino nursing students, 233 Nigerian nursing students) participated in the study from August 2015 to April 2016. Two standardized instruments were used, the Perceived Stress Scale (PSS) and the Coping Behavior Inventory (CBI). Results: Findings revealed that the degree of stress and the type of stressors and coping styles utilized by nursing students differ according to the country of origin. The year of study predicted overall stress (β = -0.149, p < 0.001) while advanced age predicted overall coping (β = 0.008, p = 0.037) in the nursing students. Conclusions: Strengthening nursing students’ positive coping skills may be helpful for them to effectively deal with various stressors during their educational experiences while maximizing learning. Implementing empirically tested approaches maybe useful to prevent the recurrence of stress and lessen its impact such as stress management counseling, counseling programs, establishing peer and family support systems, and formulating hospital policies that will support nursing students. [ABSTRACT FROM AUTHOR]

Background: Levels of stress (both trait and state) have been found to significantly increase during the exam period for students as this period has been considered to be really demanding for students. Objective: This study was aimed to examine whether the exams’ evaluation might be affected by the level of state/trait or total anxiety at the time of exams. Methods: An observational pilot study was conducted among nursing students using the Greek version of the State-Trait Anxiety Inventory for adults (STAI). We enrolled 145 first-year students (mean age 19.2±2.5 years old, 81.4% female). Chi-square and Student’s t- test were used to explore associations between students’ demographics and other characteristics and exams’ evaluation, whereas the associations between student’s characteristics and courses’ rating were controlled using linear r-Spearman and multiple linear regressions. Pvalues ≤0.05 was considered statistically significant using the SPSS version 19.0. Results: The mean age of 145 students was 19.2±2.5 years old while the majority of students (81.4%) were females. According to our analysis, the total courses’ grades of students was not affected by Total Anxiety (t=- 1.26, p=0.209), but negatively affected by Trait Anxiety (t=-2.42, p=0.027). Also, both; lower levels of State Anxiety (r=-0.528, p<0.05) and Total Anxiety (r=-0.424, p<0.05) were significantly associated with higher grades in the course of Sociology. Conclusion: Total academic evaluation is mainly affected by non-academic related factors including students’ socio-economical background which has been substantially affected during a period of economic crisis. [ABSTRACT FROM AUTHOR]

Asclepius and Hippocrates focused medical practice on the natural approach and treatment of diseases, highlighting the importance of understanding the patient's health, independence of mind, and the need for harmony between the individual, social and natural environment, as reflected in the Hippocratic Oath. The aim of this study was to present the philosophy of care provision in ancient Greece and to highlight the influence of the Hippocratic ideal in modern health care practices. A literature review was carried out using browser methods in international databases. According to the literature, "healthy mind in a healthy body" was the main component of the Hippocratic philosophy. Three main categories were observed in the Hippocratic provision of care: health promotion, interventions on trauma care, and mental care and art therapy interventions. Health promotion included physical activity as an essential part of physical and mental health, and emphasized the importance of nutrition to improve performance in the Olympic Games. Interventions on trauma care included surgical practices developed by Hippocrates, mainly due to the frequent wars in ancient Greece. Mental care and art therapy interventions were in accordance with the first classification of mental disorders, which was proposed by Hippocrates. In this category music and drama were used as management tools in the treatment of illness and in the improvement of human behavior. The role of Asclepieion of Kos was highlighted which clearly indicates a holistic health care model in care provision. Finally, all practices regarded detailed recordings and evaluation of information within the guidelines. The Hippocratic philosophy on health care provision focused on the holistic health care model, applying standards and ethical rules that are still valid today. [ABSTRACT FROM AUTHOR]

Aims and Objectives: It is widely recognized that Intensive Care Unit (ICU) patients have a greater likelihood of developing pressure ulcers in comparison to hospital or home care patients. Accordingly, this study aimed to evaluate whether specific clinical characteristics could be used as clinical indicators towards pressure ulcers prevention., Method: We monitored 210 hospitalized ICU patients during a 12-month period. Pressure ulcers were assessed following the current guidelines. Clinical characteristics such as gender, age, hospitalized days, hemodialysis treatment, hematocrit, and serum albumin levels were considered as the most common predictors for pressure ulcers development. The significance of associations was controlled using multiple logistic regression after adjusting for clinical characteristics and was presented as adjusted odds ratio (AOR)., Results: The prevalence of pressure ulcers was 24.3%. Logistic regression revealed that patients with increased age AOR=1.04; (CI: 1.01-1.07) and last-long hospitalization AOR=1.17; (CI: 1.11-1.23) were significantly more likely to present pressure ulcers compared to the younger ones and patients with less length of stay, respectively. We also found that patients under hemodialysis treatment were more likely to present pressure ulcers AOR=4.09; (CI: 1.12-14.98) compared to patients that did not underwent hemodialysis and the risk of pressure ulcers development was decreased by 9% for every single unit of hematocrit value increase AOR=0.91; (CI: 0.82-0.99)., Conclusion: Our data analysis confirms that the clinical characteristics that were studied are independently associated with pressure ulcers development, and therefore, it is a crucial incentive to consider that these specific clinical characteristics are important indicators in the evidence-based practice., Competing Interests: • Conflict of interest: All authors declare that there is no financial or personal conflict of interest related to this paper.

Background: General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status., Aim: The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector., Methods: The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values < 0.05 were defined as reflecting the acceptable level of statistical significance., Results: 457 healthcare workers completed the questionnaire. The mean age of the sample was 41.8 ± 7.9 years. The Cronbach alpha coefficient for GSQ was 0.79. The total mean score of general satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, p<0.01) and therefore the two groups of healthcare workers feel different general satisfaction., Conclusions: Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients.

Introduction: Insulin-dependent patients are individuals with chronic disease who are well adapted to living and dealing with any health needs and fears arising. An important aspect in the process of adaptation to chronic illness is the provision of nursing care in the early stages of the disease, because this contributes to its acceptance and the early identification and management of potential complications., Purpose: To investigate the health needs and self-management problems faced by patients with diabetes daily, especially those who use insulin. Furthermore purpose of this study was to investigate the fears experienced by patients in the early stage of the disease, but also in its subsequent development and to study possible differences between sexes., Methodology: This is a qualitative study, using interpretative phenomenological approach. Fifteen (nine women and six men) insulin-dependent patients, recounted their personal fears and their needs, through semi-structured interviews, which took place in Central Greece. The method used for processing the results is the Mayering one., Results: The analysis of the narratives showed that patients have a variety of fears and needs associated with the diagnosis, treatment, expected consequences, prognosis and everyday life in the management of the disease. Most patients express the concept of need as desire. Care needs, psychological support and education to recognize and prevent hypoglycemia., Conclusions: Insulin-dependent patients express fears and needs in their daily lives. Nurses providing care aimed at enhancing the level of health, while putting self-care information and training them. Patients want the nurse next to them, so that information is continuous and permanent.

Medical researches as well as the study of the Earth's surface, better still, geography are interlinked with each other; their relationship dates from antiquity. The science of Geographic Information Systems and, by extension, Geomatics engineering belongs to a discipline which is constantly developing at a global level. This sector has many applications regarding medical / epidemiological research and generally, the social sciences. Furthermore, this discipline may act as a decision making tool in the healthcare sector and it might contribute to the formulation of policies into the healthcare sector. The use of GIS so as to solve public health issues has an exponential increase and has been vital to the understanding and treatment of health problems in different geographic areas. In recent years, the use of various information technology services and software has lead health professionals to work more effectively.

Introduction: Burnout is usually defined as a state of physical, emotional and mental exhaustion that results from long-term involvement in work situations that are emotionally demanding. A great deal of researches has been devoted to the understanding of factors contributing to burnout and the negative effects that burnout has in the cost and the quality of the provided healthcare., Discussion: Many researchers believe that in difficult and stressful working conditions the work environment should be changed in order to reduce burnout levels successfully. Indeed, recent studies have highlighted the role of human resources management in burnout. It has been widely recognized that human resource management policies should be at the core of any sustainable solution that aims to increase health care systems performance and efficient., Conclusion: Motivation, leadership, empowerment and confidence are very important factors that should be considered in this direction because they are strongly related with burnout levels.

Background: Both airflow limitation and obstructive sleep apnea-hypopnea syndrome (OSAHS)-related symptoms are most prevalent in the elderly population. Previous studies revealed significant associations between OSAHS-related symptoms and obstructive airway diseases in the general population. However, other studies showed that the frequency of OSAHS-related symptoms in patients with obstructive airway diseases decreases after the age of 60 and older., Aims: To investigate the prevalence of OSAHS-related symptoms (snoring, breathing pauses, and excessive daytime sleepiness [EDS]) and their relations to airflow limitation, for people over 65 years old., Methods: A full screening spirometry program was performed in a total of 490 aging participants (mean age 77.5 years - range 65-98) who were attending 16 home care settings in central Greece. Airflow limitation was assessed according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric criteria (FEV1/FVC <70%). The Berlin Questionnaire and the Epworth Sleepiness Scale were used to screen individuals for OSAHS-related symptoms. Bivariate associations were described using odds ratio (OR) with 95% confidence intervals (CI)., Results: Airflow limitation prevalence was 17.1% (male 24.2% and female 9.9%) and was strongly related to male gender and smoking status. The prevalence rates of frequent snoring, breathing pauses, and EDS were 28.1%, 12.9%, and 11.6%, respectively. However, participants with airflow limitation were less likely to report breathing pauses, frequent snoring, EDS, and obesity. Finally, frequent snoring was significantly more common in males than females., Conclusion: This study revealed decreased frequency of OSAHS-related symptoms in participants with airflow limitation suggesting that OSAHS-related symptoms and airflow limitation are not related in our elderly population.

Critical thinking is defined as the mental process of actively and skillfully perception, analysis, synthesis and evaluation of collected information through observation, experience and communication that leads to a decision for action. In nursing education there is frequent reference to critical thinking and to the significance that it has in daily clinical nursing practice. Nursing clinical instructors know that students face difficulties in making decisions related to clinical practice. The main critical thinking skills in which nursing students should be exercised during their studies are critical analysis, introductory and concluding justification, valid conclusion, distinguish of facts and opinions, evaluation the credibility of information sources, clarification of concepts and recognition of conditions. Specific behaviors are essentials for enhancing critical thinking. Nursing students in order to learn and apply critical thinking should develop independence of thought, fairness, perspicacity in personal and social level, humility, spiritual courage, integrity, perseverance, self-confidence, interest for research and curiosity. Critical thinking is an essential process for the safe, efficient and skillful nursing practice. The nursing education programs should adopt attitudes that promote critical thinking and mobilize the skills of critical reasoning.