Stefanos Mantzoukas | Technological Educational Institute of Epirus (2024)

International Journal of Nursing Studies

Background Hospital staff is at high risk of developing mental health issues during the coronavir... more Background Hospital staff is at high risk of developing mental health issues during the coronavirus (COVID-19) pandemic. However, the literature lacks an overall and inclusive picture of mental health problems with comprehensive analysis among hospital staff during the COVID-19 pandemic. Objectives To ascertain the prevalence of anxiety, depression and other mental health outcomes as reported in original articles among hospital staff during the COVID-19 pandemic. Design A PRISMA 2020 and MOOSE 2000 compliant umbrella review of published meta-analyses of observational studies evaluating the prevalence of mental health problems in hospital staff during the pandemic. Review methods Systematic searches were conducted in PubMed/Medline, CINAHL, EMBASE, and PsycINFO from December 1st, 2019, until August 13th 2021. The random effects model was used for the meta-analysis, and the I2 index was employed to assess between-study heterogeneity. Publication bias using Egger test and LFK index was examined. Data was analyzed using STATA 17.0 software. AMSTAR-2 was applied for the quality assessment of systematic reviews, while we used GRADE to rate the quality of evidence. Results Forty-four meta-analyses from 1298 individual studies were included in the final analysis, encompassing the prevalence of 16 mental health symptoms. One-third of hospital workers reported anxiety (Prevalence: 29.9%, 95% CI:27.1% to 32.7%) and depression (Prevalence:28.4%, 95% CI:25.5% to 31.3%) symptomatology, while about 40% (95% CI: 36.9% to 42.0%) suffered from sleeping disorders. Fear-related symptoms, reduced well-being, poor quality of life, and acute stress symptoms had the highest prevalence among hospital staff. However, the quality of evidence in these areas varied from low to very low. Nurses suffered more often from sleep problems and symptoms of anxiety and depression than doctors, whereas doctors reported a higher prevalence of acute stress and post-traumatic disorders. The burden of anxiety, depression, and sleep disorders was higher among female employees than their male counterparts. Remarkably, acute stress and insomnia affected more than half of first-line medical staff. Conclusions The prevalence of mental health problems among hospital staff during the COVID-19 pandemic is generally high, with anxiety, depression and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses. However, there is no strong confidence in the body of evidence for each outcome assessed. Registration Not registered. Tweetable abstract The COVID-19 pandemic is having a major impact on the mental health of hospital staff. The need for support must be different for nurses and doctors @eldi12345.

Journal of Nursing Scholarship, 2021

PURPOSE To explore the relationship between shame, ageing, physical disease, and quality of life ... more PURPOSE To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people. DESIGN AND METHODS A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software. RESULTS Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women bW = -0.173, pW = .004, effect on men bM = -0.138, p​M = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (bW = -0.392, pW = .002 and bM = -0.384, pM = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033). CONCLUSION Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame. CLINICAL RELEVANCE These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.

Additional file 2.

Additional file 3.

European Psychiatry, 2011

IntroductionRoma attribute a great value at the family life. For them the family is the basic axi... more IntroductionRoma attribute a great value at the family life. For them the family is the basic axis around which their community structures and their personal relationships are developed.AimThe present study aimed to evaluate the family relationships, the personal growth and the family system maintenance in male and female Roma.Materials and methods145 individuals (105 male and 89 female), residents of the general area of Greece, participated in the present study. The measures used were: a) The Family Environment Scale (Form R-FES) and b) A questionnaire concerning socio-demographic information.ResultsThe mean age of men was 35.31 ± 11.21 years old, while the mean age of women was 32.43 ± 11.70 years old. According to the findings, the men scored higher in certain factors which were studied. In particular, they reported significantly greater Achievement Orientation (P=.000), Moral-Religious Emphasis (P = .000), Family Control (P = .000), Family Organization (P=.016) and Family Incong...

European Psychiatry, 2011

IntroductionRoma think highly of the family. Its function is influenced by Roma's distinguish... more IntroductionRoma think highly of the family. Its function is influenced by Roma's distinguished cultural system and their system of values.AimThe objective of the present study was to investigate the relationship between family relationships, personal growth, family system maintenance and sociodemographic factors in Roma.Materials and methods145 individuals (105 male and 89 female), residents of the general area of Greece, participated in the present study. The measures used were: a) The Family Environment Scale (Form R-FES) and b) A questionnaire concerning socio-demographic information.ResultsThe marital status correlated with the Cohesion in Roma family (r. = .225, P = .002), Expressiveness (r. = .188, P = .009), Conflict (r. = -.178, P = .013), Achievement Orientation, Intellectual - Cultural Orientation (r. = .184, P = .010), Family Organization (r. = .267, P = .000), Family Control (r. = -.178, P = .013), and Family Incongruence (r. = .200, P = .005). The sex correlated wi...

European Psychiatry, 2012

ABSTRACT Psychosis often leads to stigmatization and reduction of social power and prestige of th... more ABSTRACT Psychosis often leads to stigmatization and reduction of social power and prestige of the individual, hence leading further o social rejection and shame.Objective The current study assessed the role of external shame on psychiatric patients.AimThe present study aimed at evaluating external shame in psychiatric patients who where cared by the Department of Psychiatry at the University Hospital of Alexandroupolis, Greece.Method45 patients suffering from schizophrenia participated to the present study (18 men and 27 women with mean age of 44.09 SD = 11.55, ranged 19–75). The measures used were: a) the Other As Shamer scale (OAS) b), a questionnaire concerning socio-demographic information,ResultsThe average of the external shame (OAS total) was 11.11 ± 5.22, without any statistical significant difference among gender in their comparison with the t-Test (p = .864). This ismuch lower than the average normal external shame the Greek population (17.74 ± 9.02).The analysis of variance between age groups showed that age, place of residence and educational level did not affect the external shame in psychotic patients. The marital status demonstrated a significant effect on external shame of psychotic patients where the application of the Bonferonni criterion was found that a) married participants demonstrated statistical significant difference from widowed (p = .030) and b) differed significantly from divorced widows (p = .011). Indeed, the widowed psychiatric patients exhibited greater levels of external shame.Conclusion Low levels of external shame may reflect difficulties in interpersonal relationships. Our findings illuminate the external shame in psychiatric patients.

Additional file 1.

This book is concerned with the concepts of reflection, nursing knowledge and ward context. It in... more This book is concerned with the concepts of reflection, nursing knowledge and ward context. It inquires and analyzes how reflection is experienced by practicing nurses in the medical wards. The literature, the curriculum and statutory bodies of nursing accept reflection as a heuristic tool aiming at tuning the practitioner into each clinical situation, enabling the verbalization of professional judgement and clinical decision-making through conscious and rational thought processes. However, in the ward context nurses are socialized into a practice culture, which is based on power relationships, control and excessive direction. Such cultural and organizational factors have a restrictive effect on the implementation of reflection in practice. This book covers a wide range of themes such as reflection, nursing knowledge, theories on practice development and practice models, critical analysis theories, discourse and educational theories. This book will assist clinicians, educationalists...

Diversity of the nursing workforce and multiculturalism of European cities have mandated the need... more Diversity of the nursing workforce and multiculturalism of European cities have mandated the need for culturally sensitive nurses and midwives able to provide effective, engaging, high quality and socially just healthcare. The Florence Network is a professional network that aims to bring together like-minded professionals and to cultivate relationships amongst nurses and midwives from different European Union (EU) countries to create synergies on matters of common interest by transcending national and cultural barriers. A qualitative study based upon a focus group interview was conducted with six former Presidents and one present President of the Florence Network, each with a tenure of two years. The study explored the impact of the Florence Network in advancing cultural awareness and promoting educational, research and professional synergies. The outcome of the study identified that from the Presidents perspectives networks create awareness of cultural diversity, enable the deliver...

Interscientific Health Care

Journal of Advanced Nursing

AIMS To acquire an in-depth understanding of how older individuals diagnosed with acquired brain ... more AIMS To acquire an in-depth understanding of how older individuals diagnosed with acquired brain injury (ABI) experience their well-being and care when undergoing physical rehabilitation. DESIGN Systematic literature review. DATA SOURCES The electronic databases of PubMed, CINAHL, APA PsycInfo, ASSIA and SCOPUS were searched from 2005 to 2020. Extensive reference checking was also conducted. REVIEW METHODS A systematic review was conducted following PRISMA guidelines, including predominantly qualitative studies. Studies' quality was appraised using the critical apraisal skills programme (CASP) tool. RESULTS Seventeen studies met the inclusion criteria. Following methods of thematic synthesis, four overarching interpretive themes were identified: (a) Rehabilitation processes and their impact on older individuals' well-being; (b) Identity and embodiment concerns of older individuals during rehabilitation; (c) Institutional factors affecting older individuals' care and well-being experiences; and (d) Older individuals' participation in creative activities as part of rehabilitation. CONCLUSION Organizational and structural care deficiencies as well as health disparities can adversely impact older individuals' autonomous decision-making and goal-setting potentials. The discrepancy between older individuals' expectations and the reality of returning home along with the illusionary wish to return to a perceived normality, can further negatively affect older individuals' sense of well-being. Constructive communication, emotional support, family involvement in rehabilitation and creating a stimulating, enriching social environment can humanize and facilitate older individuals' adjustment to their new reality following ABI. IMPACT There is a lack of qualitative research on older individuals' ABI rehabilitation experiences, especially traumatic brain injury incidents. Further study should consider patients' concerns over their involvement in decision-making and goal setting about their care. Overall, this review reveals the need to examine further the significance of humanizing care and the factors that affect older individuals' sense of well-being.

Nursing & Health Sciences, 2009

The literature acknowledges that nursing practice can create physical and emotional stresses for ... more The literature acknowledges that nursing practice can create physical and emotional stresses for its practitioners. This study aimed to acquire an in-depth understanding of being a nurse in the Greek National Health System. Interpretive phenomenology was used and Van Manen's method of analysis was implemented. Conversational interviews were conducted with a purposive sample of nine nurses employed at the University Hospital of Ioannina in Greece. The findings produced three essential themes: a dissonance between the images and reality of nursing, emotional burnout, and psychosomatic entanglement. The dissonance between the idealization of nursing and the reality of nursing, along with the emotional crisis created by daily practice, constituted the two fundamental factors for developing psychosomatic complications. These impacted negatively on the participants' personal and professional well-being. Psychosomatic complications can be prevented by clearly delineating roles, ena...

BMC Health Services Research

Background and purpose The caregiving’s impact on informal carers’ quality of life and gender-bas... more Background and purpose The caregiving’s impact on informal carers’ quality of life and gender-based stereotypes make older individuals’ informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers’ experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020. Design and methods The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework. Results This review produced two analytical themes, the impact of gender on the caregivers’ labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional...

Nurse Education Today, 2017

Assessing clinical competence in nursing students abroad is a challenge, and requires both method... more Assessing clinical competence in nursing students abroad is a challenge, and requires both methods and instruments capable of capturing the multidimensional nature of the clinical competences acquired. The aim of the study was to compare the clinical competence assessment processes and instruments adopted for nursing students during their clinical placement abroad. A case study design was adopted in 2015. A purposeful sample of eight nursing programmes located in seven countries (Belgium, Denmark, Greece, Norway, Poland, Portugal and Italy) were approached. Tools as instruments for evaluating competences developed in clinical training by international nursing students, and written procedures aimed at guiding the evaluation process, were scrutinised through a content analysis method. All clinical competence evaluation procedures and instruments used in the nursing programmes involved were provided in English. A final evaluation of the competences was expected by all nursing programmes at the end of the clinical placement, while only four provided an intermediate evaluation. Great variability emerged in the tools, with between five and 88 items included. Through content analysis, 196 items emerged, classified into 12 different core competence categories, the majority were categorised as 'Technical skills' (=60), 'Self-learning and critical thinking' (=27) and 'Nursing care process' (=25) competences. Little emphasis was given in the tools to competences involving 'Self-adaptation', 'Inter-professional skills', 'Clinical documentation', 'Managing nursing care', 'Patient communication', and 'Theory and practice integration'. Institutions signing Bilateral Agreements should agree upon the competences expected from students during their clinical education abroad. The tools used in the process, as well as the role expected by the student, should also be agreed upon. Intercultural competences should be further addressed in the process of evaluation, in addition to adaptation to different settings. There is also a need to establish those competences achievable or not in the host country, aiming at increasing transparency in learning expectations and evaluation.

European Psychiatry, 2013

European Psychiatry, 2012

ABSTRACT Whilst shame has an important role in shaping psychopathology, nonetheless it is often a... more ABSTRACT Whilst shame has an important role in shaping psychopathology, nonetheless it is often a feeling ignored. Therefore, the etiologic role of psychosis requires further investigation.Objective This study examined the role of internal shame on psychiatric patients.AimThe present study evaluated internal shame in psychiatric patients who where cared by the Department of Psychiatry at University Hospital of Alexandroupolis, Greece.Method45 patients suffering from schizophrenia participated (18 men and 27 women with mean age 44.09 SD=11.55, ranged 19–75). The measuring tools used were: a) the Experience of Shame Scale (ESS), b) a questionnaire concerning socio-demographic information.ResultsHigh levels of internal shame were observed among patients. In specific, the average of the internal shame (ESS total) was 52.31 ± 12.76, without having statistically significant difference among gender in their comparison with the t-Test (p = .859). This is much higher than the average normal external shame in Greek population (47.09 ± 13.69). The analysis of variance between age groups showed that age, place of residence and educational level did not affect the internal shame in psychotic patients. Marital status had a significant effect on internal shame of psychotic patients where the application of the Bonferonni criterion found that unmarried participants demonstrated a statistical significant difference from those divorced (p = .020), the latter had higher levels of internal shame.Conclusion Psychiatric patients have high levels of internal shame and this shame is a constant factor in placing the individual and not a transient response to specific situations.

International Journal of Nursing Studies

Background Hospital staff is at high risk of developing mental health issues during the coronavir... more Background Hospital staff is at high risk of developing mental health issues during the coronavirus (COVID-19) pandemic. However, the literature lacks an overall and inclusive picture of mental health problems with comprehensive analysis among hospital staff during the COVID-19 pandemic. Objectives To ascertain the prevalence of anxiety, depression and other mental health outcomes as reported in original articles among hospital staff during the COVID-19 pandemic. Design A PRISMA 2020 and MOOSE 2000 compliant umbrella review of published meta-analyses of observational studies evaluating the prevalence of mental health problems in hospital staff during the pandemic. Review methods Systematic searches were conducted in PubMed/Medline, CINAHL, EMBASE, and PsycINFO from December 1st, 2019, until August 13th 2021. The random effects model was used for the meta-analysis, and the I2 index was employed to assess between-study heterogeneity. Publication bias using Egger test and LFK index was examined. Data was analyzed using STATA 17.0 software. AMSTAR-2 was applied for the quality assessment of systematic reviews, while we used GRADE to rate the quality of evidence. Results Forty-four meta-analyses from 1298 individual studies were included in the final analysis, encompassing the prevalence of 16 mental health symptoms. One-third of hospital workers reported anxiety (Prevalence: 29.9%, 95% CI:27.1% to 32.7%) and depression (Prevalence:28.4%, 95% CI:25.5% to 31.3%) symptomatology, while about 40% (95% CI: 36.9% to 42.0%) suffered from sleeping disorders. Fear-related symptoms, reduced well-being, poor quality of life, and acute stress symptoms had the highest prevalence among hospital staff. However, the quality of evidence in these areas varied from low to very low. Nurses suffered more often from sleep problems and symptoms of anxiety and depression than doctors, whereas doctors reported a higher prevalence of acute stress and post-traumatic disorders. The burden of anxiety, depression, and sleep disorders was higher among female employees than their male counterparts. Remarkably, acute stress and insomnia affected more than half of first-line medical staff. Conclusions The prevalence of mental health problems among hospital staff during the COVID-19 pandemic is generally high, with anxiety, depression and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses. However, there is no strong confidence in the body of evidence for each outcome assessed. Registration Not registered. Tweetable abstract The COVID-19 pandemic is having a major impact on the mental health of hospital staff. The need for support must be different for nurses and doctors @eldi12345.

Journal of Nursing Scholarship, 2021

PURPOSE To explore the relationship between shame, ageing, physical disease, and quality of life ... more PURPOSE To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people. DESIGN AND METHODS A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software. RESULTS Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women bW = -0.173, pW = .004, effect on men bM = -0.138, p​M = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (bW = -0.392, pW = .002 and bM = -0.384, pM = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033). CONCLUSION Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame. CLINICAL RELEVANCE These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.

Additional file 2.

Additional file 3.

European Psychiatry, 2011

IntroductionRoma attribute a great value at the family life. For them the family is the basic axi... more IntroductionRoma attribute a great value at the family life. For them the family is the basic axis around which their community structures and their personal relationships are developed.AimThe present study aimed to evaluate the family relationships, the personal growth and the family system maintenance in male and female Roma.Materials and methods145 individuals (105 male and 89 female), residents of the general area of Greece, participated in the present study. The measures used were: a) The Family Environment Scale (Form R-FES) and b) A questionnaire concerning socio-demographic information.ResultsThe mean age of men was 35.31 ± 11.21 years old, while the mean age of women was 32.43 ± 11.70 years old. According to the findings, the men scored higher in certain factors which were studied. In particular, they reported significantly greater Achievement Orientation (P=.000), Moral-Religious Emphasis (P = .000), Family Control (P = .000), Family Organization (P=.016) and Family Incong...

European Psychiatry, 2011

IntroductionRoma think highly of the family. Its function is influenced by Roma's distinguish... more IntroductionRoma think highly of the family. Its function is influenced by Roma's distinguished cultural system and their system of values.AimThe objective of the present study was to investigate the relationship between family relationships, personal growth, family system maintenance and sociodemographic factors in Roma.Materials and methods145 individuals (105 male and 89 female), residents of the general area of Greece, participated in the present study. The measures used were: a) The Family Environment Scale (Form R-FES) and b) A questionnaire concerning socio-demographic information.ResultsThe marital status correlated with the Cohesion in Roma family (r. = .225, P = .002), Expressiveness (r. = .188, P = .009), Conflict (r. = -.178, P = .013), Achievement Orientation, Intellectual - Cultural Orientation (r. = .184, P = .010), Family Organization (r. = .267, P = .000), Family Control (r. = -.178, P = .013), and Family Incongruence (r. = .200, P = .005). The sex correlated wi...

European Psychiatry, 2012

ABSTRACT Psychosis often leads to stigmatization and reduction of social power and prestige of th... more ABSTRACT Psychosis often leads to stigmatization and reduction of social power and prestige of the individual, hence leading further o social rejection and shame.Objective The current study assessed the role of external shame on psychiatric patients.AimThe present study aimed at evaluating external shame in psychiatric patients who where cared by the Department of Psychiatry at the University Hospital of Alexandroupolis, Greece.Method45 patients suffering from schizophrenia participated to the present study (18 men and 27 women with mean age of 44.09 SD = 11.55, ranged 19–75). The measures used were: a) the Other As Shamer scale (OAS) b), a questionnaire concerning socio-demographic information,ResultsThe average of the external shame (OAS total) was 11.11 ± 5.22, without any statistical significant difference among gender in their comparison with the t-Test (p = .864). This ismuch lower than the average normal external shame the Greek population (17.74 ± 9.02).The analysis of variance between age groups showed that age, place of residence and educational level did not affect the external shame in psychotic patients. The marital status demonstrated a significant effect on external shame of psychotic patients where the application of the Bonferonni criterion was found that a) married participants demonstrated statistical significant difference from widowed (p = .030) and b) differed significantly from divorced widows (p = .011). Indeed, the widowed psychiatric patients exhibited greater levels of external shame.Conclusion Low levels of external shame may reflect difficulties in interpersonal relationships. Our findings illuminate the external shame in psychiatric patients.

Additional file 1.

This book is concerned with the concepts of reflection, nursing knowledge and ward context. It in... more This book is concerned with the concepts of reflection, nursing knowledge and ward context. It inquires and analyzes how reflection is experienced by practicing nurses in the medical wards. The literature, the curriculum and statutory bodies of nursing accept reflection as a heuristic tool aiming at tuning the practitioner into each clinical situation, enabling the verbalization of professional judgement and clinical decision-making through conscious and rational thought processes. However, in the ward context nurses are socialized into a practice culture, which is based on power relationships, control and excessive direction. Such cultural and organizational factors have a restrictive effect on the implementation of reflection in practice. This book covers a wide range of themes such as reflection, nursing knowledge, theories on practice development and practice models, critical analysis theories, discourse and educational theories. This book will assist clinicians, educationalists...

Diversity of the nursing workforce and multiculturalism of European cities have mandated the need... more Diversity of the nursing workforce and multiculturalism of European cities have mandated the need for culturally sensitive nurses and midwives able to provide effective, engaging, high quality and socially just healthcare. The Florence Network is a professional network that aims to bring together like-minded professionals and to cultivate relationships amongst nurses and midwives from different European Union (EU) countries to create synergies on matters of common interest by transcending national and cultural barriers. A qualitative study based upon a focus group interview was conducted with six former Presidents and one present President of the Florence Network, each with a tenure of two years. The study explored the impact of the Florence Network in advancing cultural awareness and promoting educational, research and professional synergies. The outcome of the study identified that from the Presidents perspectives networks create awareness of cultural diversity, enable the deliver...

Interscientific Health Care

Journal of Advanced Nursing

AIMS To acquire an in-depth understanding of how older individuals diagnosed with acquired brain ... more AIMS To acquire an in-depth understanding of how older individuals diagnosed with acquired brain injury (ABI) experience their well-being and care when undergoing physical rehabilitation. DESIGN Systematic literature review. DATA SOURCES The electronic databases of PubMed, CINAHL, APA PsycInfo, ASSIA and SCOPUS were searched from 2005 to 2020. Extensive reference checking was also conducted. REVIEW METHODS A systematic review was conducted following PRISMA guidelines, including predominantly qualitative studies. Studies' quality was appraised using the critical apraisal skills programme (CASP) tool. RESULTS Seventeen studies met the inclusion criteria. Following methods of thematic synthesis, four overarching interpretive themes were identified: (a) Rehabilitation processes and their impact on older individuals' well-being; (b) Identity and embodiment concerns of older individuals during rehabilitation; (c) Institutional factors affecting older individuals' care and well-being experiences; and (d) Older individuals' participation in creative activities as part of rehabilitation. CONCLUSION Organizational and structural care deficiencies as well as health disparities can adversely impact older individuals' autonomous decision-making and goal-setting potentials. The discrepancy between older individuals' expectations and the reality of returning home along with the illusionary wish to return to a perceived normality, can further negatively affect older individuals' sense of well-being. Constructive communication, emotional support, family involvement in rehabilitation and creating a stimulating, enriching social environment can humanize and facilitate older individuals' adjustment to their new reality following ABI. IMPACT There is a lack of qualitative research on older individuals' ABI rehabilitation experiences, especially traumatic brain injury incidents. Further study should consider patients' concerns over their involvement in decision-making and goal setting about their care. Overall, this review reveals the need to examine further the significance of humanizing care and the factors that affect older individuals' sense of well-being.

Nursing & Health Sciences, 2009

The literature acknowledges that nursing practice can create physical and emotional stresses for ... more The literature acknowledges that nursing practice can create physical and emotional stresses for its practitioners. This study aimed to acquire an in-depth understanding of being a nurse in the Greek National Health System. Interpretive phenomenology was used and Van Manen's method of analysis was implemented. Conversational interviews were conducted with a purposive sample of nine nurses employed at the University Hospital of Ioannina in Greece. The findings produced three essential themes: a dissonance between the images and reality of nursing, emotional burnout, and psychosomatic entanglement. The dissonance between the idealization of nursing and the reality of nursing, along with the emotional crisis created by daily practice, constituted the two fundamental factors for developing psychosomatic complications. These impacted negatively on the participants' personal and professional well-being. Psychosomatic complications can be prevented by clearly delineating roles, ena...

BMC Health Services Research

Background and purpose The caregiving’s impact on informal carers’ quality of life and gender-bas... more Background and purpose The caregiving’s impact on informal carers’ quality of life and gender-based stereotypes make older individuals’ informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers’ experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020. Design and methods The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework. Results This review produced two analytical themes, the impact of gender on the caregivers’ labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional...

Nurse Education Today, 2017

Assessing clinical competence in nursing students abroad is a challenge, and requires both method... more Assessing clinical competence in nursing students abroad is a challenge, and requires both methods and instruments capable of capturing the multidimensional nature of the clinical competences acquired. The aim of the study was to compare the clinical competence assessment processes and instruments adopted for nursing students during their clinical placement abroad. A case study design was adopted in 2015. A purposeful sample of eight nursing programmes located in seven countries (Belgium, Denmark, Greece, Norway, Poland, Portugal and Italy) were approached. Tools as instruments for evaluating competences developed in clinical training by international nursing students, and written procedures aimed at guiding the evaluation process, were scrutinised through a content analysis method. All clinical competence evaluation procedures and instruments used in the nursing programmes involved were provided in English. A final evaluation of the competences was expected by all nursing programmes at the end of the clinical placement, while only four provided an intermediate evaluation. Great variability emerged in the tools, with between five and 88 items included. Through content analysis, 196 items emerged, classified into 12 different core competence categories, the majority were categorised as 'Technical skills' (=60), 'Self-learning and critical thinking' (=27) and 'Nursing care process' (=25) competences. Little emphasis was given in the tools to competences involving 'Self-adaptation', 'Inter-professional skills', 'Clinical documentation', 'Managing nursing care', 'Patient communication', and 'Theory and practice integration'. Institutions signing Bilateral Agreements should agree upon the competences expected from students during their clinical education abroad. The tools used in the process, as well as the role expected by the student, should also be agreed upon. Intercultural competences should be further addressed in the process of evaluation, in addition to adaptation to different settings. There is also a need to establish those competences achievable or not in the host country, aiming at increasing transparency in learning expectations and evaluation.

European Psychiatry, 2013

European Psychiatry, 2012

ABSTRACT Whilst shame has an important role in shaping psychopathology, nonetheless it is often a... more ABSTRACT Whilst shame has an important role in shaping psychopathology, nonetheless it is often a feeling ignored. Therefore, the etiologic role of psychosis requires further investigation.Objective This study examined the role of internal shame on psychiatric patients.AimThe present study evaluated internal shame in psychiatric patients who where cared by the Department of Psychiatry at University Hospital of Alexandroupolis, Greece.Method45 patients suffering from schizophrenia participated (18 men and 27 women with mean age 44.09 SD=11.55, ranged 19–75). The measuring tools used were: a) the Experience of Shame Scale (ESS), b) a questionnaire concerning socio-demographic information.ResultsHigh levels of internal shame were observed among patients. In specific, the average of the internal shame (ESS total) was 52.31 ± 12.76, without having statistically significant difference among gender in their comparison with the t-Test (p = .859). This is much higher than the average normal external shame in Greek population (47.09 ± 13.69). The analysis of variance between age groups showed that age, place of residence and educational level did not affect the internal shame in psychotic patients. Marital status had a significant effect on internal shame of psychotic patients where the application of the Bonferonni criterion found that unmarried participants demonstrated a statistical significant difference from those divorced (p = .020), the latter had higher levels of internal shame.Conclusion Psychiatric patients have high levels of internal shame and this shame is a constant factor in placing the individual and not a transient response to specific situations.