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OBJECTIVE To explore the dynamics of dyadic interactions, as it was argued that leader-member relationships are formed and evolved as a social elaboration of interdependent dynamics that in turn shape the quality of those relationships in the specific social context. METHOD A quantitative survey was carried out in a military hospital where 53 leaders and 160 members that participated successfully established 160 leader-member pairs. RESULTS It was found that relational dynamics which exist in the military healthcare context shape the quality of leader-member relationships, influencing in turn leadership effectiveness. It was also shown that subordinates’ intentional withholding of opinions and suggestions around work issues negatively influences members’ perception of the quality of their relationship with leaders and this negative phenomenon in relationships can be eased by building up strong relational identities and increasing the frequency of leader-member meetings. CONCLUSIONS The understanding of human social constructions was reinforced by giving prominence to the existence of certain dynamics (relational identity, organizational silence and frequency of work meetings) which influence leadership relationships among military healthcare professionals. The study’s findings support the notion that enhancing self-worth through quality leader-member interactions and supporting open communication constitute a stepping-stone towards work effectiveness in healthcare organizations. [ABSTRACT FROM AUTHOR]

OBJECTIVE To measure the health-related quality of life (HRQoL) of people with mobility limitations using wheelchairs in Greece. METHOD The study was conducted in Athens with 120 people with mobility limitations using wheelchairs, selected by snowball sampling. The generic instrument for measurement of the HRQoL of people with mobility limitations, the EQ-5D questionnaire, was implemented by personal interview, during the period April-July 2011. Descriptive statistics and correlation analysis were applied to investigate the relationships between HRQoL and sociodemographic parameters and the characteristics of disability of the participants. RESUTS The majority of the sample was male (62.5%) and unmarried (68.3%); 37.5% were graduates of higher education and 15.8% were unemployed. The mean age of the participants was 34.8±16.2 years, 76 (63.3%) reported partial disability and 51 (42.5%) had congenital disability. "I have some problems" was reported by 75.8% in mobility, 52.5% in self-care, 59.2% in usual activities, 43.3% in pain/discomfort and 49.2% concerning anxiety/depression. Regardless of whether the mobility was total or partial, the disabled participants had moderate problems in all dimensions except from pain/discomfort, for which 48.7% of those with partial disability reported no pain/discomfort, while 47.7% of those with total disability felt some pain/discomfort. With increasing duration of disability there was a reduction in the percentage of the response "I have a lot of problems". Participants with congenital disability presented a better quality of life in five dimensions of EQ-5D than those with acquired disability. The EQ-5D includes a visual analogue scale (VAS), the mean value of which was 57.51±23.18. The level of education and the nature and duration of disability were negatively correlated, and the cause of disability was positively correlated with almost all dimensions of EQ-5D. CONCLUSIONS People with mobility limitations recorded a low level of quality of life according to the EQ-5D. Socio-demographic parameters and the characteristics of the disability were found to be quite a strong predictor of health status of people in Athens using wheelchairs. [ABSTRACT FROM AUTHOR]

OBJECTIVE Investigation of the ways of changing from the bureaucratic model to the participatory model of management in public hospitals, based on modern techniques and methods of organization and administration. METHOD The study was conducted using the Delphi qualitative research method with a team of 10 experts specializing in health services management, in two cycles of questions. The degree of consensus among the participants reached 90%. RESULTS Change from the bureaucratic to the participatory model of management is possible if organizational changes can be brought about in the philosophy (values and attitudes) of both the leadership and the employees and the emotional involvement of the employees in their work, and if there is effective implementation of cycles of quality, creation and development of a culture of quality and responsibility, adoption of a global budget, introduction of modern hospital technology and elimination of bureaucracy, with the support of the Ministry of Health for all these efforts. The experts consider the assignment to leadership positions based on merit in public hospitals to be equally important for a successful transition to the participative model of management. Leaders should possess formal qualifications and a thorough knowledge of the health sector, with a scientific perspective favoring the systemic approach. CONCLUSIONS The steps that the team of experts has suggested will be expected to enhance the establishment of a quality hospital culture focusing on both patient safety and satisfaction and employee satisfaction, and to transform the public hospital into a learning organization that promotes public values. Such a learning organization would be a modern organization that inspires innovative and growth-oriented organizational behavior, characterized by respect in every action of both leadership and its members. [ABSTRACT FROM AUTHOR]

OBJECTIVE To analyze the current organizational culture of general public hospitals and investigate the model of culture that the hospital executives wish to see prevailing in the next 5-year period. METHOD The survey was conducted in 20 general public hospitals of the region of Athens. The study sample consisted of 541 senior executives of the four departments of each hospital (medical, nursing, administrative, technical). The executives were asked to provide assessment using the organizational culture assessment instrument (OCAI), based on the competing values framework of Cameron and Quinn. RESULTS The dominant organizational culture in the hospitals surveyed can be described by the "bureaucratic culture" model (47.05% of respondents). The "clan culture" came second (23.76%) and the "entrepreneurial-adhocracy culture" model and the "market culture" model scored 11.79% and 17.3%, respectively. The desired culture model, in contrast, was reported to be the clan culture or participatory model (31.11%), followed by the entrepreneurial-adhocracy culture model (25.08%), the market culture model (24.42%) and, least desirable, the bureaucratic culture model (19.4%). CONCLUSIONS Currently, the general public hospitals are characterized by internal orientation, observance of rules and processes and a focus on control hierarchy, predictability and stability. The models of entrepreneurial-adhocracy culture and market culture, which both focus on the exterior macro-environment and growth for the hospital, record small percentages. As far as the future is concerned, hospital executives would like to see a change from the bureaucratic culture model of organization towards the participatory model, which would include elements of flexibility, creativity, dynamism and competitiveness that are inherent in the other two models, entrepreneurial-adhocracy and market. The focus appears to remain on the internal environment of the hospitals, but at the same time there is evidence of a wish to look also into the external environment of hospital. [ABSTRACT FROM AUTHOR]

OBJECTIVE Comparative analysis of two different methods of measuring patient satisfaction with the outpatient healthcare services in selected hospitals in the Attica-Athens area of Greece. METHOD The first study used a stratified sampling method and face-to-face interviews. The study period was February and March 2012, and 457 people were enrolled in 8 hospitals in the Attica-Athens area. The second study used a complaints box to collect questionnaires and 1,683 people responded. The study period was the same as the first study and the hospitals included were almost the same. RESULTS In the first study the mean value of patient satisfaction with the healthcare services was calculated to be 6.81, and in the second study 8.1 (t=7.5, p⩽0.001). In both of the studies the patients reported lower satisfaction with the administrative services than with the medical and nursing care. The medical care was reported by the majority of patients as good in the first study and very good in the second study. The nursing care was reported by the majority of patients as good tending to very good in the first study and as very good in the second, the differences between the studies being statistically significant. CONCLUSIONS Both of the study methodologies showed that the bureaucratic procedures and problems in organization have a significant impact on the lower evaluation of administrative services by the outpatients. The complexity of the administrative procedures and the lack of coordination have a negative influence on patients' opinions about the hospital administrative and healthcare services. The patients appear to trust the medical and nursing personnel. All the dimensions of satisfaction were ranked higher in the second study. The method of collecting the questionnaires with a complaints box in the second study, however, needs to be reconsidered, because the intervention of external factors before the final introduction of data increases the risk of modification of the results. [ABSTRACT FROM AUTHOR]

OBJECTIVE The assessment of the health-related quality of life has been internationally acknowledged during the past decades as a reliable method in the assessment of the effectiveness of medical procedures. This paper reports on the assessment of the health-related quality of life of patients who had undergone laparoscopic repair of an inguinal hernia. This assessment focused on the three main dimensions of physical, mental and social health. METHOD Data collection was carried out at the Third Surgical Clinic of "G. Gennimatas" General Hospital of Athens, in 2008-2009 with the use of the self-administered instrument "health survey SF-36", which consists of 36 questions constituting 8 scales of physical and socio-mental health. The sample consisted of 100 patients who had undergone laparoscopic repair of an inguinal hernia. The majority of the patients were men (86.9%), aged over 65 years (47%) and between 56-64 years old (25%). RESULTS The rating of the scales of the review SF-36 gave the following results: "physical functioning" 70.8 (SD 18.6), "physical role" 63.7 (SD 38.6), "physical pain" 48.5 (SD 4.7), "general health" 62.2 (SD 14.1), "vitality" 73.3 (SD 22.3), "social functioning" 68.3 (SD 26.6), "emotional role" 64.2 (SD 36.2), "mental health" 78.4 (SD 18.8). Linear regression analysis showed that 6 of the 8 scales of the health survey SF-36: "physical functioning" (B=0.860, t=5.901, p=0.000), "physical role" (B=0.658, t=3.378, p=0.002), "general health" (B=0.639, t=4.079, p=0.000), "vitality" (B=0.662, t=3.638, p=0.001), "social operability" (B=0.608, t=4.097, p=0.000), "mental health" (B=0.653, t=3.231, p=0.003) were related to the patients' satisfaction with the quality of life, while, in addition, "physical functioning" (B=-0.380, t=-2.986, p=0.005) and "social functioning" (B=-0.425, t=-3.282, p=0.002) showed an inverse relationship with age. CONCLUSIONS Patients who have undergone laparoscopic repair of an inguinal hernia appear to assess their socio-mental health (average 71.0) as more important than their physical health (average 61.3). This finding raises the issue of non-concurrence of the individual assessment of patients between the objective (physical functioning, physical role, physical pain, general health) and the subjective (vitality, mental role, social functioning, mental health) dimensions of health-related quality of life. [ABSTRACT FROM AUTHOR]

In recent years, the globe has faced a series of topics of growing concern, such as the COVID-19 pandemic, the international financial crisis, rising socio-economic inequalities, the negative outcomes of greenhouse gas emissions, which resulted in climate change, and many others. Organizations worldwide have confronted these new challenges of sustainable finance by incorporating environmental, social, and corporate governance (ESG) factors and digital transformation (DT) in their innovation business strategies. The healthcare sector represents a large share of the global economy (about 10% of global economic output), employs a large number of workers, and needs to rely more on an open innovation model where interested parties, especially patients, are going to have a say in their own well-being. Thus, it is imperative that healthcare providers be efficient, effective, resilient, and sustainable in the face of significant challenges and risks. At the same time, they must offer sustainable development goals and digital transformation to healthcare users through limited governmental resources. This study investigates the role, importance, and correlation of ESG factors and digital transformation to the sustainable finance of healthcare systems through an innovative model. The main purpose of the paper is to present the already implemented ESG and DT factors in the healthcare sector and to propose a mutual and combined implementation strategy based on common evaluation tools, methods, and actions. A set of proposed actions and strategies are presented for the sustainability and resilience of the healthcare sector.

(1) Background: The aim of this study was to identify predictors of the unmet healthcare needs during the financial and recent health crisis in Greece. (2) Methods: Time series analysis was performed for the years 2008 through 2022 using the Eurostat database. The dependent variable was the percentage of people who reported unmet need for medical care. Demographic, socioeconomic, and health data, as well as health expenditures, were used as independent variables. Correlation analysis and simple linear regression models were conducted to analyze the results. (3) Results: Unmet health needs in Greece increased from the start of the crisis until 2016, as a gradual de-escalation of the crisis was observed. However, in 2019 the country recorded the second highest level of unmet needs for medical care before the health crisis. Limitations in usual activities, reporting bad/very bad health status, being unemployed, and having low income increased the likelihood of unmet needs. Health expenditures (public or private) were also significant determinants of unmet healthcare needs. (4) Conclusions: The increased unmet health needs widen inequalities in health and healthcare access. Therefore, health policies should eliminate barriers which restrict the access to health and enhance healthcare services, developing conditions for citizens' well-being.

Objectives: The objective of this study was to investigate the needs of carers of patients suffering from chronic diseases., Material and Methods: The present study is a mixed approach, quantitative and qualitative. The study population consisted of 560 caregivers of patients with chronic diseases. The data collection was done with an improvised needs survey questionnaire, which included 57 questions. The questionnaire surveyed carers 'financial needs, social needs, psychological needs, and patients' education needs. The Cronbach-a index of the Patient Needs Survey was 0.956 and that of caregivers was 0.965. Carers' burden of care was assessed with The Zarit Burden Interview scale. The statistical analysis of the data was done with the statistical program IBM SPSS for Windows version 26.0., Results: The main diseases of the patients were chronic renal failure (22.6%), multiple sclerosis (19%), cancer (19%), diabetes mellitus (7.1%), dementia (6%), and chronic obstructive pulmonary disease (6%). The majority of patients (82.1%) had health problems for more than 24 months. Caregivers provided 12.5 ± 8.3 h of daycare and cared for patients for more than 24 months (73.2%). Caregivers seek information from health professionals (4.41 ± 1.2), need more information (4.11 ± 1.4), feel stressed about the role of caregiver (3.91 ± 1.3), time available for vacation is limited (3.89 ± 1.4), time available for entertainment is limited (3.80 ± 1.3) and they feel intimidated with the role of carer (3.76 ± 1.3). The caregivers' charge was 42.4 ± 19.6. Most caregivers reported moderate to severe burdens., Conclusion: Caregivers experience a lack of clear and comprehensible information about the treatment that caring patients receive, as well as a lack of ongoing care from health professionals., Competing Interests: There are no conflicts of interest., (© 2023 Published by Scientific Scholar on behalf of Indian Journal of Palliative Care.)

Introduction: Chronic diseases represent a huge challenge for the health systems globally due to the rapidly increasing number of patients and their long-term need for healthcare. The purpose of this study was to investigate the needs of patients suffering from chronic diseases., Methodology: This is a cross-sectional study. The study population consisted of 840 adults with chronic diseases. The data collection was done with an improvised needs survey questionnaire, which included 56 questions. Statistical analyses were performed using IBM SPSS Statistics for Windows, v.25.0, statistical significance being considered at p < 0.05., Results: The main diseases of the patients were chronic renal failure (22.6%), multiple sclerosis (19%), cancer (19%), diabetes mellitus (7.1%), dementia (6%), and chronic obstructive pulmonary disease (6%). The majority of patients (82.1%) were sick for more than 24 months. Patients seek information from health professionals (4.07 ± 1.4), feel tired (4.05 ± 1.4), have to share their feelings with other family members (4.01 ± 1.4), feel anxious about the future (3.94 ± 1.3), and feel out of control (3.80 ± 1.5)., Conclusions: Patients with chronic diseases suffer from numerous physical, mental, emotional, and cognitive problems. Paying attention to the unmet needs of patients could have beneficial effects on both patients and their caregivers., (© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

(1) Background: Relational Leadership Theory (RLT) has been gaining rising attention for the past 20 years with studies investigating multiple implications and practices of relationships within organizations. Yet, less attention has been given in healthcare settings. By virtue of the emerging need to move beyond exploring the quality of relationships and to move towards the exploitation of relational dynamics that influence leadership development in healthcare organizations, this study explores both the dyad relationships and the context in which those occur. With recent attention directed to the implementation of human-centered practices and the creation of effective networks to bring desired results, RLT is called on to advance this agenda within healthcare organizations. (2) Material and Methods: Research articles that examined leadership theories over the past thirty years were selected from computerized databases and manual searches. (3) Results: It is argued that the way and context in which relationships are formed between leaders and members is a social process that, in turn, shapes the effectiveness of the management of those organizations. Leadership is not rank-it is the relationship with the relational dynamics that play in the same context, creating evolutionary organizational processes. (4) Conclusions: This paper challenges leadership theory one step further. Exploring an organization through relational leadership theory is much like wearing the lens of 'cause and effect' in leadership behavioral studies. Therefore, this study contributes to this direction with a robust co-examination of relational dynamics that take place in the healthcare sector, showcasing a broader framework in which relational leadership is germinated and influences its outcomes.

Background: Healthcare professionals involved with ionizing radiation must have sufficient knowledge of its effects on the human body in order to avoid potential risks for both patients and themselves. The aim of this study was to estimate the knowledge and awareness of healthcare professionals about the hazards of radiological examinations on their health and on their patients., Methods: This is a cross-sectional study, and the data collection was carried out with a self-administered questionnaire. The study group included a total of 210 individuals from different professional groups: nurses, doctors, medical technicians, radiologists, and other staff working in different clinics that use radiation in their work. The study was carried out in a large hospital in Athens, Greece., Results: The study population consisted of 210 subjects aged 44.7 ± 9.1 years. In a total of 23 questions, participants answered correctly to 6.4 ± 2.6 questions. The factors for predicting the correct responses were male gender (β = -1.034, p = 0.004), frequency of contact with imaging examinations of patients requiring ionizing radiation (β = 0.496, p = 0.007), participation in any educational process (β = -0.918, p = 0.014), the number of published articles on radiation protection (β = 0.720, p = 0.001), and knowledge of the principle of ALARA (β = -0.391, p = 0.001)., Conclusions: It is proposed to include a radiation protection course in the total healthcare professionals' undergraduate curricula in order to address the current knowledge gap in clinical practice., (© 2021. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Introduction: This study aimed to assess the physical, psychological, and economic burden shouldered by severely injured two-wheel users in three European countries as well as the cost resulting from their hospitalization., Methods: A total of seven public hospitals were involved in three countries: Greece, Italy, and Germany. Participants enrolled during a 12-month period starting in April 2013. Eligibility criteria included an injury sustained at Road Traffic Crashes (RTC) irrespective of the type of vehicle, hospitalization 1 day in the Intensive Care Unit (ICU) or sub-ICU, and age 18 years or over. Patients were interviewed at 1, 6, and 12 months upon admission. The study used widely recommended classifications for injury severity (Abbreviated Injury Severity [AIS]; Maximum Abbreviated Injury Severity [MAIS]) and standardized measures such as the Disability Assessment Schedule II (WHODAS 2.0), "Impact of Event Scale" (IES-R), Center for Epidemiological Studies Depression Scale (CES-D Scale). Health Care Expenditure was assessed through the Monash University Accident Research Centre (MUARC's) framework, which included measures of 'Direct' and 'Indirect' costs. Diagnosis-related groups (DRGs) were used to estimate hospitalization costs., Results: A total of 54 two-wheel users enrolled in the study in all the countries and 32 completed all follow-up questionnaires. Physical disability increased over 12 months following the injury. Post Traumatic Stress Disorder (PTSD) symptoms of avoidance remained at high levels over the study period. PTSD symptoms of intrusion improved significantly during the second half of the year under investigation. The total annual cost of injury for the two-wheel users who were hospitalized in the selected ICU of all the partner countries for severe injury in 2013/2014, was estimated at €714,491 made up of €123,457 direct and €591,034 indirect costs. Men, aged 50-64 years and those who sustained slight injuries primarily at the lower extremities presented higher indirect costs per person. A total of €1032.092 was spent on hospitalization payments. Women, aged 65+ and those who sustained severe injuries at the central body region presented higher direct costs per person. Women, aged 50-64 years, those with severe injuries and a major injury at the central body and the upper body region presented the highest hospitalization costs per person., Conclusions: There is a need for effective strategies to early detect and treat groups at risk of being confronted with prolonged psychosocial and economic consequences., Practical Implications: A holistic understanding of the impact of injury on individuals is important in order to achieve effective treatment of psychological co-morbidities in a timely manner., (Copyright © 2018 Elsevier Ltd and National Safety Council. All rights reserved.)

The current study aimed to follow-up a group of road crash survivors for one year and assesses the impact of injury on their psychological and physical condition. All crash survivors that were admitted to the intensive or sub-intensive care units of selected hospitals in Greece, Germany and Italy over one year period (2013-2014), were invited to participate in the study and were interviewed at three different time-points as follows: (a) at one month (baseline data), (b) at six months, and (c) at twelve months. The study used widely recommended classifications for injury severity (AIS, MAIS) and standardized health outcome measures such as the Disability Assessment Schedule II (WHODAS 2.0) to measure disability, "Impact of Event Scale" (IES-R) to measure Post-Traumatic Stress Disorder (PTSD), Center for Epidemiological Studies Depression Scale (CES-D Scale) to measure depression. A total of 120 patients were enrolled in the study in all the partner countries and 93 completed all follow up questionnaires. The risk of physical disability was 4.57 times higher [CI 1.98-2.27] at the first follow up and 3.43 times higher [CI 1.43-9.42] at the second follow up as compared with the time before the injury. There was a 79% and an 88% lower risk of depression at the first and the second follow up respectively, as compared with the baseline time. There was also a 72% lower risk of Post-Traumatic Stress at the second follow up as compared with the baseline time. A number of factors relevant to the individuals, the road crash and the injury, were shown to distinguish those at higher risk of long-lasting disability and psychological distress including age, marital status, type of road user, severity and type of the injury, past emotional reaction to distress. The study highlights the importance of a comprehensive and holistic understanding of the impact of injury on an individual and further underlines the importance of screening and treating psychological comorbidities in injury in a timely manner., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Purpose: This article contains a comparative analysis and evaluation of the effectiveness of population policies in European Union (EU) countries, using multivariate analysis., Data and Methods: To study these differences, it is primarily necessary to have the relevant data. The most recent database available was developed by the OECD in 2007 and currently covers OECD countries and most EU Member States. We used multivariate analysis to categorize the indicators into the following groups: (a) economic indicators, (b) indicators reconciling work and family life, and (c) demographic indicators., Results: The results of measuring the degree of coherence of factors reveal that the four most important factors influencing the effectiveness of population policy are (i) the average maternal age at first childbirth, (ii) social protection expenditure, (iii) GDP, and (iv) public spending for benefits. Based on the data from the evaluation of the correlation matrix of variables and data, the classification of countries, according to the values of the coefficients of analysis, appears as follows: the Nordic countries (together with France and the United Kingdom), the Southern European countries and the Northern countries: Estonia, Latvia, Lithuania (by a very slight margin Romania), and Bulgaria, Poland, Slovakia (and, marginally, Malta)., Conclusions: The key comparative findings from benchmarking best practices in the context of the European experience are the following: The EU is being demographically transformed as a direct result of an increase in average life expectancy and immigration and a decrease in fertility. Demographic factors are influenced by specific features, in contrast with economic factors which seem be less stable., (Copyright © 2013 Longwoods Publishing.)