Panagiotis Prezerakos

Informal payments for maternity health services in public hospitals in Greece.

BACKGROUND Private health expenditure for consuming maternity health services has been identified as an issue within public hospitals. AIM To estimate level of private health expenditure, in the form of informal payments, for maternal services in public hospitals in Greece. METHODS The study population consisted of 160 women who had recently given birth in three provincial general hospitals and one general hospital in Athens. A three-part questionnaire was developed in order to collect financial information regarding the use of public obstetrics services in Greece. RESULTS The mean age of respondents was 29.5 (±5.6) years. There was a high rate of informal payments with 74.4% of women involved in informal transactions. Mean total private payments were €1549 (±992), representing 7.9% of the mean annual per capita income in Greece. Mean informal payment was €848 (±714). For 56.3% of the respondents, it was at the obstetricians request, on top of formal payment of €701 (±1351). Total informal payments were higher for women who gave birth in Athens (p<0.001), for Greek women compared to non Greek (p<0.001) and for deliveries that were conducted by womens personal obstetrician (p=0.001). CONCLUSION There is a large black economy in the field of obstetric services, as 74.4% of women who used public maternity services had to pay under-the-table payments corresponding approximately to the net salary of an intern physician. There is a need for the state to adopt innovative strategies and mechanisms in order to reduce informal payments for obstetric services in the public sector.

The work environment of haemodialysis nurses and its impact on patients' outcomes.

The aims of this study were to assess haemodialysis nurses’ work environment and investigate the correlation between work environment and patients’ outcomes. A cross-sectional study was conducted at the 11 public hospital-based haemodialysis units of the 5th Regional Health Authority of Greece. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess work environment. Nurses were asked to report the frequency of a series adverse events and errors. Study population consisted of 133 nurses (response rate 89.3%). The overall PES-NWI scored just < 2.5 (Mean = 2.48, standard deviation = 0.34) indicating a non-favourable haemodialysis workplace. Nurse–physician Relations, nurse manager ability and nursing foundations for quality of care were the most favourable aspects of work environment. Multivariate logistic regression analysis identified that hypotension (odds ratio (OR) = 0.3, 95% confidence interval (CI) = 0.1–0.9, P = 0.03), venous needle disconnection (OR = 0.14, 95% CI = 0.03–0.65, P = 0.012) and patient fall (OR = 0.02, 95% CI = 0.001–0.51, P = 0.018) were associated with a non-favourable work environment. Findings have important implications for improvement of haemodialysis work environment and enhancement of patients’ safety.

Workplace Bullying Among the Nursing Staff of Greek Public Hospitals.

In this quantitative, cross-sectional study, the authors identified the impact of workplace bullying on nursing staff employed at select Greek public hospitals. They conducted the study using the Negative Acts Questionnaire with a convenience sample of 841 participants employed by five Greek hospitals in the 1st Regional Health Authority of Attica. One third of the respondents reported having been psychologically harassed at work in the past 6 months. According to the results, the impact workplace bullying has on nursing staff varies depending on the existence of a supportive familial or friend environment and if nurses parent children. These findings demonstrate the value of family and friend support when coping with workplace bullying.

Systematic review of the cost-effectiveness of transcatheter interventions for valvular heart disease

Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach. Twenty-four, good to high quality, evaluations were identified, representing different viewpoints, modelling techniques and willingness-to-pay thresholds. Studies show that in high-risk patients with symptomatic aortic stenosis, TAVI may be cost-effective compared with medical management (MM) across many health care settings. In contrast, studies of TAVI compared with surgical aortic valve replacement (SAVR) yield conflicting and inconclusive results. The limited data available show that TMVR may also be cost-effective relative to MM in mitral valve disease. Existing evidence indicates that transcatheter techniques may be cost-effective options, relative to MM, in high-risk patients with valvular disease. Nonetheless, more research is needed to establish their economic value further, to investigate the drives of cost-effectiveness, and to evaluate surgical with transcatheter techniques in aortic valvular disease.

Trait Emotional Intelligence Questionnaire–Adolescent Short Form: A Psychometric Investigation in Greek Context:

This article aims to investigate the reliability and validity of the Trait Emotional Intelligence Questionnaire–Adolescent Short Form (TEIQue-ASF) score in a sample of 440 Greek adolescents. The instrument’s score demonstrated good internal consistency and was significantly correlated with core self-evaluations as well with somatic complaints, self-report psychopathology, and personal strengths. It also explained a statistically significant increase in the prediction of outcome variables beyond core self-evaluations. It is concluded that the findings of the present study provide evidence that support the interpretation and use of the TEIQue-ASF score to assess the emotional self-perceptions of Greek adolescents.

The work environment of haemodialysis nurses and its impact on patients’ outcomes: Haemodialysis work environment

The aims of this study were to assess haemodialysis nurses’ work environment and investigate the correlation between work environment and patients’ outcomes. A cross-sectional study was conducted at the 11 public hospital-based haemodialysis units of the 5th Regional Health Authority of Greece. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess work environment. Nurses were asked to report the frequency of a series adverse events and errors. Study population consisted of 133 nurses (response rate 89.3%). The overall PES-NWI scored just < 2.5 (Mean = 2.48, standard deviation = 0.34) indicating a non-favourable haemodialysis workplace. Nurse–physician Relations, nurse manager ability and nursing foundations for quality of care were the most favourable aspects of work environment. Multivariate logistic regression analysis identified that hypotension (odds ratio (OR) = 0.3, 95% confidence interval (CI) = 0.1–0.9, P = 0.03), venous needle disconnection (OR = 0.14, 95% CI = 0.03–0.65, P = 0.012) and patient fall (OR = 0.02, 95% CI = 0.001–0.51, P = 0.018) were associated with a non-favourable work environment. Findings have important implications for improvement of haemodialysis work environment and enhancement of patients’ safety.

Depressive symptoms among adolescent students in Greek high schools

Depressive symptoms in adolescence have been a subject of considerable controversy in terms of their nature, severity and identification. Therefore, the objective of this study was to examine the presence of depressive symptoms in Greek adolescent high school students and to explore the relationship between depressive symptoms and sociodemographic characteristics. For that purpose, a cross-sectional study design was conducted in two public schools in Megalopolis, Greece, from April 2012 to July 2012, using a self-administered questionnaire based on DSM-IV. The target population involved 222 high school students and the response rate was 74.75%. Data was analyzed using trend χ2 test, student’s t-test and bivariate analysis. The analysis of survey data was conducted using the SPSS (19.0). Main findings demonstrate that 3.6% had symptoms of major depressive episode. Furthermore, depressive symptoms were significantly higher in girls, while statistically significant relationships were found between students’ physical (P<0.01) and mental health (P<0.008), students’ experiences in school (P<0.02), students’ experiences with friends (P<0.008) and the frequency of depressive symptoms. Overall, the study results reveal that depressive symptoms can occur in adolescents. Early diagnosis, as well as the need for psychological care at adolescence is necessary for the prevention of major depressive disorders.