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Asmar S, Messaykeh J, Hilal N, Rida MA, Mroue K, Aouad K, Minkara F, Hajjar A, Ziade N. Drug persistence in patients with rheumatic and musculoskeletal diseases during a major economic crisis: results from a nationwide cross-sectional online survey. Rheumatol Int 2024; 44:725-736. [PMID: 38296847 DOI: 10.1007/s00296-023-05526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/22/2023] [Indexed: 02/02/2024]
Abstract
To evaluate the drug persistence in patients with rheumatic and musculoskeletal diseases (RMDs) during the current economic crisis in Lebanon and to estimate predictors of persistence. A nationwide multicentric cross-sectional study using an online questionnaire was conducted in Lebanon with patients with chronic inflammatory rheumatic diseases (CIRDs) and non-inflammatory RMDs controls between July and October 2022. Disease-modifying antirheumatic drugs (DMARDs) were categorized as conventional synthetic (cs), biological (b), subcutaneous (SC) or intravenous (IV), and targeted synthetic (ts). Persistence was defined as "number of tablets or injections taken during the past month versus prescribed". The percentage of patients who discontinued or changed treatment due to cost or non-availability was reported. Factors associated with persistence were identified using multivariable linear regression. The study included 317 patients with RMDs (286 CIRDs); mean age 49.5 years, 68% females, 58% reporting currently low economic level. Persistence at one month was low for tsDMARDs (36%) and bDMARDs (SC55%, IV63%), and acceptable for csDMARDs (88%). A persistence ≥80% was found in 23.3% of patients on tsDMARDs, 42.9% on SC bDMARDs, 45.0% on IV bDMARDs, and 74.7% on csDMARDs. During the past 6 months, 55.8% of CIRD patients discontinued or changed treatment due to non-availability (45.3%) or cost (21.2%). Persistence was positively associated with finding alternative sources such as buying abroad (36%), depending on friends or families abroad (20%), charities (10%), and negatively associated with unemployment and low financial status. Persistence was significantly compromised for essential antirheumatic drugs and was mostly driven by treatment unavailability and cost.
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Affiliation(s)
- Serena Asmar
- Hotel Dieu de France Hospital, Beirut, Lebanon.
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
| | | | - Nadeen Hilal
- Ain Wazein Medical Village, Chouf, Lebanon
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohamad Ali Rida
- Clemenceau Medical Center, Beirut, Lebanon
- Lebanese American University School of Medicine, Byblos, Lebanon
| | - Kamel Mroue
- Al Zahraa Hospital, University Medical Center, Beirut, Lebanon
| | - Krystel Aouad
- Faculty of Medicine, Saint George Hospital University Medical Center, Saint George University of Beirut, Beirut, Lebanon
| | | | | | - Nelly Ziade
- Hotel Dieu de France Hospital, Beirut, Lebanon
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
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Psarras A, Karakolias S. A Groundbreaking Insight Into Primary Care Physiotherapists' Remuneration. Cureus 2024; 16:e54732. [PMID: 38523929 PMCID: PMC10961143 DOI: 10.7759/cureus.54732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Physiotherapy in Greece, as part of primary health care (PHC), faces sound imbalances: reduced quality, productivity, and efficiency, along with rather inflexible remuneration schemes. This study is aimed at reporting the attitude and perceptions of Greek PHC physiotherapists toward their current remuneration and also at identifying any other preferable remuneration schemes. Methods A stratified proportional sampling study was undertaken, using an anonymous, electronic survey. The participants were 250 self-employed physiotherapists running their business in Central and Eastern Macedonia and Thrace, being also contracted with the National Organisation for Healthcare Provision (EOPYY). The sample size stands for 34% of the population with a circa 5% margin of error. Results Nearly 9/10 physiotherapists (84%) underline that remuneration falls short of their productivity, leading to reduced job satisfaction. Moreover, their remuneration does not motivate them to provide services of higher quality (46%), while 58% of them stated that they are forced to claim informal fees. There is no clear desire regarding the remuneration scheme, but nearly ¼ of physiotherapists revealed their preference for the cost-per-case philosophy combined with co-payments. Conclusion The majority of physiotherapists believe that their current remuneration does not reflect their productivity nor the quality of their services and, therefore, informal payments arise. The preference of physiotherapists lies between cost-per-case fees and patient co-payments, which, however, favors supplier-induced demand and access inequalities, respectively. Hence, policymakers should revise the current remuneration scheme and overcome its deficiencies without creating new ones.
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Affiliation(s)
| | - Stefanos Karakolias
- Department of Organisation Management, Marketing and Tourism, International Hellenic University, Thessaloniki, GRC
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3
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Kasimis I, Perdikaris P, Boutopoulou V, Tsanaka A, Mantziou T, Skodra A, Effrosyni V, Matziou V. Sleep Disturbance and Occupational Fatigue in Emergency Nurses of Public Hospitals in Greece: A Cross-Sectional Study. Adv Emerg Nurs J 2023; 45:230-239. [PMID: 37501276 DOI: 10.1097/tme.0000000000000473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
The emergency department (ED) is a stressful workplace for nurses, due to heavy workload and work shifts, which affect sleep quality, causing occupational fatigue. As a result, nurses burn out and turn over and quality of care is impaired. The aim of this study was to investigate sleep disturbance (SD) and occupational fatigue (OF) in emergency nurses of public hospitals in Greece. This descriptive cross-sectional study was conducted in the ED of tertiary public hospitals in Greece from September 2019 to October 2021, after the approval from the scientific and ethical committee of hospitals and the full informed consent of participants. The Standard Shift work Index (SSI) questionnaire was used, which includes 12 question groups about sleep habits and OF evaluation for shift workers, as nurses. Two hundred and ten ED nurses were recruited for the purpose of the study. In this research their quality of life, sleep completeness, and fatigue levels were studied. A moderate level of SD (total score = 70.54) of nurses was found that was related to marital status, presence of children, and underlying diseases (p = 0.012, p = 0.024, and p = 0.002, respectively). OF was assessed at low levels (score = 27.34) and was mainly related to age, with younger nurses reporting less fatigue compared with older nurses. The effect of work shifts in SD and OF of ED nurses was well documented. ED nurses' OF was correlated with increased SD, age, and marital status. Further research is needed for a better assessment and understanding of the factors that influence SD and OF of ED nurses to plan a strategy to optimize sleep patterns of work shift ED nurses.
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Affiliation(s)
- Ioannis Kasimis
- General Hospital of Ioannina "G. Chatzikosta," Ioannina, Greece (Dr Kasimis); Faculty of Nursing, Peloponnese University, Tripoli, Greece (Dr Perdikaris); National and Kapodistrian University of Athens, Athens, Greece (Dr Boutopoulou); Children Hospital "Agia Sophia," Athens, Greece (Mss Tsanaka and Dr Effrosyni); General Hospital "G. Gennimatas," Thessaloniki, Greece (Drs Mantziou and Skodra); and Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece (Dr Matziou)
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4
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Missouridou E, Mangoulia P, Pavlou V, Kritsotakis E, Stefanou E, Bibou P, Kelesi M, Fradelos EC. Wounded healers during the COVID-19 syndemic: Compassion fatigue and compassion satisfaction among nursing care providers in Greece. Perspect Psychiatr Care 2022; 58:1421-1432. [PMID: 34505638 PMCID: PMC8661928 DOI: 10.1111/ppc.12946] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/21/2021] [Accepted: 08/15/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study was to investigate compassion fatigue (CF) and compassion satisfaction (CS) in nursing care providers in COVID-19 units. METHODS A mixed-method study with 105 nurses. RESULTS 23% of participants reported high CF risk while 77% expressed high to moderate potential for CS. Adequate preparation/education, clear and accountable leadership, and team sharing of feelings, experiences, and responsibilities during the transition in the COVID-19 unit helped participants to deal with overwhelming anxiety which if unattended could bring about frustration and long-lasting feelings of powerlessness. PRACTICAL IMPLICATIONS In the face of the present and future pandemics, there is a clear need to prepare healthcare organizations and nursing care providers to cope with the emotional content of public health emergencies while protecting themselves and avoid absorbing unmanageable emotions.
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Affiliation(s)
- Evdokia Missouridou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Egaleo, Greece
| | - Polyxeni Mangoulia
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Egaleo, Greece
| | - Vassiliki Pavlou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Egaleo, Greece
| | - Emmanouel Kritsotakis
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Egaleo, Greece
| | - Evangelia Stefanou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Egaleo, Greece
| | - Polyxeni Bibou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Egaleo, Greece
| | - Martha Kelesi
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Egaleo, Greece
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5
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Missouridou E, Fradelos EC, Kritsiotakis E, Mangoulia P, Segredou E, Papathanasiou IV. Containment and therapeutic relationships in acute psychiatric care spaces: the symbolic dimensions of doors. BMC Psychiatry 2022; 22:2. [PMID: 34983447 PMCID: PMC8725636 DOI: 10.1186/s12888-021-03607-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is an increasing trend of door locking practices in acute psychiatric care. The aim of the present study was to illuminate the symbolic dimensions of doors in Greek mental health nurses' experiences of open and locked working spaces. RESULTS A sequential mixed-method designexplored the experiences of nurses working in both open and locked psychiatric acute care units. Participants experiences revealed four types of doors related to the quality of recovery-oriented care: (a) the open door, (b) the invisible door, (c) the restraining door, and (d) the revolving door. Open doors and permeable spacesgenerated trust and facilitated the diffusion of tension and the necessary perception of feeling safe in order to be involved in therapeutic engagement. When the locked unit was experienced as a caring environment, the locked doors appeared to be "invisible". The restraining doors symbolized loss of control, social distance and stigma echoing the consequences of restrictingpeople's crucial control over spaceduring the COVID-19 pandemicin relation toviolence within families, groups and communities. The revolving door (service users' abscondence/re-admission) symbolised the rejection of the offered therapeutic environment and was a source of indignation and compassion fatigue in both open and locked spaces attributed to internal structural acute care characteristics (limited staffing levels, support, resources and activities for service users) as well as 'locked doors' in the community (limited or no care continuity and stigma). CONCLUSIONS The impact of COVID-19 restrictions on people's crucial control of space provides an impetus for erecting barriers masked by the veil of habit and reconsidering the impact of the simple act of leaving the door open/locked to allow both psychiatric acute care unit staff and service users to reach their potential.
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Affiliation(s)
- Evdokia Missouridou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Saint Spiridonos 12243, Egaleo, Athens, Greece.
| | - Evangelos C. Fradelos
- grid.410558.d0000 0001 0035 6670Community Nursing Lab, Department of Nursing, University of Thessaly, Larissa, Greece
| | - Emmanouel Kritsiotakis
- grid.499377.70000 0004 7222 9074 Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Saint Spiridonos 12243, Egaleo, Athens, Greece ,Psychiatric Department, General State Hospital “Sismanoglio”, Marousi, Greece
| | - Polyxeni Mangoulia
- grid.499377.70000 0004 7222 9074 Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Saint Spiridonos 12243, Egaleo, Athens, Greece ,Psychiatric Liaison Unit, General State Hospital “Evangelismos”, Athens, Greece
| | - Eirini Segredou
- Alcohol Treatment Unit, Psychiatric Hospital of Attica, Chaidari, Greece
| | - Ioanna V. Papathanasiou
- grid.410558.d0000 0001 0035 6670Community Nursing Lab, Department of Nursing, University of Thessaly, Larissa, Greece
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6
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Missouridou E, Zartaloudi A, Dafogianni C, Koutelekos J, Dousis E, Vlachou E, Evagelou E. Locked versus open ward environments and restrictive measures in acute psychiatry in Greece: Nursing students' attitudes and experiences. Perspect Psychiatr Care 2021; 57:1365-1375. [PMID: 33258139 DOI: 10.1111/ppc.12699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/09/2020] [Accepted: 11/14/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To examine student nurses' attitudes and experiences of door policies and restrictive measures in acute psychiatric care. METHODS A mixed-method study with 274 third-year students. RESULTS Participants' attitudes towards door locking and other containment measures appeared to be more a matter of custom, practice and tradition at particular units. The therapeutic benefits of open doors was the central organizing element in open units experiences while locked doors appeared to be "invisible" when the locked unit was perceived as a caring environment. PRACTICAL IMPLICATIONS Exploring student nurses' attitudes towards crucial and debatable aspects of mental health practice contributes in cultivating a critical and analytical attitude towards the service they provide necessary for supporting a recovery mental health model and building a strong professional identity.
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Affiliation(s)
- Evdokia Missouridou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - Afroditi Zartaloudi
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - Chrisoula Dafogianni
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - John Koutelekos
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - Evangelos Dousis
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - Eugenia Vlachou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - Eleni Evagelou
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
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7
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Silva M, Antunes A, Azeredo-Lopes S, Loureiro A, Saraceno B, Caldas-de-Almeida JM, Cardoso G. Factors associated with involuntary psychiatric hospitalization in Portugal. Int J Ment Health Syst 2021; 15:37. [PMID: 33879207 PMCID: PMC8056508 DOI: 10.1186/s13033-021-00460-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/07/2021] [Indexed: 11/24/2022] Open
Abstract
Background Identifying which factors contribute to involuntary psychiatric hospitalization may support initiatives to reduce its frequency. This study examines the sociodemographic, clinical, and contextual factors associated with involuntary hospitalization of patients from five Portuguese psychiatric departments in 2002, 2007 and 2012. Methods Data from all admissions were extracted from clinical files. A Poisson generalized linear model estimated the association between the number of involuntary hospitalizations per patient in one year and sociodemographic, clinical, and contextual factors. Results An increment of involuntary hospitalizations was associated with male gender [exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 1.31; 95%CI 1.06–1.62, p < 0.05], having secondary and higher education [exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 1.45; 95%CI 1.05–2.01, p < 0.05, and exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 1.89; 95%CI 1.38–2.60, p < 0.001, respectively], a psychiatric diagnosis of psychosis [exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 2.02; 95%CI 1.59–2.59, p < 0.001], and being admitted in 2007 and in 2012 [exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 1.61; 95%CI 1.21–2.16, p < 0.01, and exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 1.73; 95%CI 1.31–2.32, p < 0.001, respectively]. A decrease in involuntary hospitalizations was associated with being married/cohabitating [exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 0.74; 95%CI 0.56–0.99, p < 0.05], having experienced a suicide attempt [exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 0.26; 95%CI 0.15–0.42, p < 0.001], and belonging to the catchment area of three of the psychiatric services evaluated [exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 0.65; 95%CI 0.49–0.86, p < 0.01, exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 0.67; 95%CI 0.49–0.90, p < 0.01, and exp(\documentclass[12pt]{minimal}
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\begin{document}$$\widehat{\upbeta }$$\end{document}β^) = 0.67; 95%CI 0.46–0.96, p < 0.05 for Hospital de Magalhães Lemos, Centro Hospitalar Psiquiátrico de Lisboa and Unidade Local de Saúde do Baixo Alentejo, respectively]. Conclusions The findings suggest that involuntary psychiatric hospitalizations in Portugal are associated with several sociodemographic, clinical, and contextual factors. This information may help identify high-risk patients and inform the development of better-targeted preventive interventions to reduce these hospitalizations.
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Affiliation(s)
- Manuela Silva
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal. .,Lisbon Institute of Global Mental Health, Lisbon, Portugal.
| | - Ana Antunes
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.,Lisbon Institute of Global Mental Health, Lisbon, Portugal
| | | | - Adriana Loureiro
- Centre of Studies on Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Coimbra, Portugal
| | - Benedetto Saraceno
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.,Lisbon Institute of Global Mental Health, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.,Lisbon Institute of Global Mental Health, Lisbon, Portugal
| | - Graça Cardoso
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal.,Lisbon Institute of Global Mental Health, Lisbon, Portugal
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Palli A, Peppou LE, Economou M, Kontoangelos K, Souliotis K, Paschali A. Economic Distress in Families with a Member Suffering from Severe Mental Illness: Illness Burden or Financial Crisis? Evidence from Greece. Community Ment Health J 2021; 57:512-521. [PMID: 32638147 DOI: 10.1007/s10597-020-00674-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/24/2020] [Indexed: 10/23/2022]
Abstract
The present study aims to explore the economic distress and pertinent coping strategies in families with a member suffering from a severe mental illness. Furthermore it endeavors to gauge the impact of illness burden and that of the Greek recession on economic distress, while disentangling their contribution. In total, 190 key relatives of people with severe mental illness were recruited from community mental health services in the region of Attica. Relatives completed a self-reported questionnaire consisting of the Index of Personal Economic Distress, the Family Burden scale and the Family Rituals scale. Information on financial strategies for tackling recession and income loss due to the recession was also gleaned. Regarding economic distress, only 15% had frequent difficulty meeting routine financial demands in their household. The preponderant strategy was spending savings (56.8%). Income category and spending less on basic needs were the main predictors of economic distress. Objective poverty indices rather than burden predicted economic distress to a greater extent.
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Affiliation(s)
- Alexandra Palli
- University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis" (U.M.H.R.I.), Athens, Greece
| | - Lily Evangelia Peppou
- University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis" (U.M.H.R.I.), Athens, Greece
| | - Marina Economou
- First Department of Psychiatry, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontoangelos
- University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis" (U.M.H.R.I.), Athens, Greece.,First Department of Psychiatry, Medical School, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Kyriakos Souliotis
- Faculty of Social & Political Sciences, University of Peloponnese, Corinth, Greece
| | - Antonia Paschali
- Department of Nursing, Section of Mental Health & Behavioral Sciences, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
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Alexopoulos P, Novotni A, Novotni G, Vorvolakos T, Vratsista A, Konsta A, Kaprinis S, Konstantinou A, Bonotis K, Katirtzoglou E, Siarkos K, Bekri ES, Kokkoris I, Como A, Gournellis R, Stoyanov DS, Politis A. Old age mental health services in Southern Balkans: Features, geospatial distribution, current needs, and future perspectives. Eur Psychiatry 2020; 63:e88. [PMID: 32921324 PMCID: PMC7576530 DOI: 10.1192/j.eurpsy.2020.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia. METHODS After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored. RESULTS A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries. CONCLUSIONS Regional disparities in resources and services for seniors' mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.
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Affiliation(s)
- P. Alexopoulos
- Department of Psychiatry, Patras University General Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Faculty of Medicine, Technische. Technische Universität München, Munich, Germany
| | - A. Novotni
- University Clinic of Psychiatry, Medical Faculty, University “Ss Cyril and Methodius”, Skopje, North Macedonia
| | - G. Novotni
- University Clinic of Neurology, Medical Faculty, University “Ss Cyril and Methodius”, Skopje, North Macedonia
| | - T. Vorvolakos
- Department of Psychiatry, Alexandroupolis University General Hospital, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupolis, Greece
| | - A. Vratsista
- Department of Psychiatry, Arta General Hospital, Arta, Greece
| | - A. Konsta
- 1 Department of Psychiatry, “Papageorgiou” General Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S. Kaprinis
- 3 Department of Psychiatry. Psychiatric Hospital of Thessaloniki, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A. Konstantinou
- Department of Psychiatry, Larissa University General Hospital, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - K. Bonotis
- Department of Psychiatry, Larissa University General Hospital, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - E. Katirtzoglou
- 1st Department of Psychiatry, “Eginition” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - K. Siarkos
- 1st Department of Psychiatry, “Eginition” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - E. S. Bekri
- Environmental Engineering Laboratory, Department of Civil Engineering, School of Engineering, University of Patras, Patras, Greece
| | - I. Kokkoris
- Division of Plant Biology, Department of Biology, School of Basic Sciences, University of Patras, Patras, Greece
| | - A. Como
- Psychiatry Division, Department of Neuroscience, Tirana University Hospital Center “Mother Teresa”, Tirana Medical University, Tirana, Albania
| | - R. Gournellis
- 2nd Department of Psychiatry, “Attikon” University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - D. S. Stoyanov
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - A. Politis
- 1st Department of Psychiatry, “Eginition” University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, USA
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Stranjalis G, Komaitis S, Kalyvas AV, Drosos E, Stavrinou LC, Koutsarnakis C, Kalamatianos T. Recent trends (2010-2018) in traumatic brain injury in Greece: Results on 2042 patients. Injury 2020; 51:2033-2039. [PMID: 32536530 DOI: 10.1016/j.injury.2020.05.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/10/2020] [Accepted: 05/29/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Recent analysis on the epidemiology of traumatic brain injury (TBI) within Europe indicates an increase in fall-related injuries and in the incidence of hospitalization among older adults as well as a decrease in contribution of road traffic accidents (RTA). Given the paucity of recent national data, we analyzed TBI-related admissions from the Athens Head Trauma Registry during the largest part of the past decade (2010-2018), a period marked by a profound national socioeconomic crisis. METHODS Demographic and clinical data of admitted TBI patients were collected and analyzed statistically. RESULTS The mean age of patients (N=2042, 68% men) was 59 years (median 64 years). Patient age showed an upward trend across the study period. Most cases were mild, while moderate and severe injuries were indicated in, 11% and 20%, respectively. Falls were the predominant cause of injury (46% of cases), followed by RTA (38%). An upward trend in the frequency of fall-related injury was apparent across the study period; RTA-related injury frequency displayed a downward trend during the second part of the study period. Assault-related injury accounted for 6%. Surgery took place in 11% of cases. In-hospital mortality (IHM) was 21%. Fall-related mortality contributed to 56% of total IHM; RTA-related mortality contributed to 30%. The mean length of hospital stay was 13 days (median: 5 days). CONCLUSIONS The present findings suggest a shift in the epidemiologic profile of TBI patients in Greece with a rise in the proportion of elderly patients, a concomitant increase in fall-related injuries and a reduction in RTA-related injury. They also highlight fall-related injury as the predominant cause of IHM. Our results point towards the urgent need for the intensification of fall prevention strategies, continuing medical education as well as public information campaigns on the risks of geriatric fall-related injury.
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Affiliation(s)
- George Stranjalis
- Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Ypsilantou 45-47, Athens 10676, Greece
| | - Spyridon Komaitis
- Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Ypsilantou 45-47, Athens 10676, Greece
| | - Aristotelis V Kalyvas
- Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Ypsilantou 45-47, Athens 10676, Greece
| | - Evangelos Drosos
- Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Ypsilantou 45-47, Athens 10676, Greece
| | - Lampis C Stavrinou
- Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Ypsilantou 45-47, Athens 10676, Greece
| | - Christos Koutsarnakis
- Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Ypsilantou 45-47, Athens 10676, Greece
| | - Theodosis Kalamatianos
- Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Ypsilantou 45-47, Athens 10676, Greece.
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11
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Basta M, Karakonstantis S, Koutra K, Dafermos V, Papargiris A, Drakaki M, Tzagkarakis S, Vgontzas A, Simos P, Papadakis N. NEET status among young Greeks: Association with mental health and substance use. J Affect Disord 2019; 253:210-217. [PMID: 31054446 DOI: 10.1016/j.jad.2019.04.095] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 03/27/2019] [Accepted: 04/21/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Prior studies have shown that young people "not in education, employment or training" ("NEET") are at higher risk for psychopathology and substance abuse. Similar studies are lacking in Southern European populations. We aimed to examine the associations of anxiety and depressive symptoms, and substance use with NEET status in a large, randomized population-based sample in Greece. METHODS A telephone structured questionnaire was conducted in a representative sample of 2771 young Greeks aged 15-24 years. Anxiety and depressive symptoms were assessed with GAD-7 and PHQ-9 scales, respectively. Substances use and several sociodemographic parameters were also examined. RESULTS In our sample 16.4% were NEETs. In multivariate analyses, NEETs compared to non-NEETs were older, with lower family income, without insurance and more likely to be married and smoke. Furthermore, NEET status was associated with a higher GAD-7 score among older NEETs and long-term NEETs (NEETs unemployed for more than a year). Moreover, being NEET among older participants was associated with severe symptoms of anxiety and moderate/severe symptoms of depression. LIMITATIONS This was a telephone survey and a clinical evaluation of the patients was not performed. Furthermore, the structured interview was not designed to detect the level of substance use or the reasons for being NEET. CONCLUSIONS NEET status is frequent among young Greeks. Older, and long-term NEETs appear to be at higher risk for presenting anxiety/depression symptoms. Whether NEET status is associated with adverse outcomes later in life requires longitudinal studies.
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Affiliation(s)
- Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Voutes, Heraklion, Crete Zip Code 71110, Greece..
| | - Stamatis Karakonstantis
- Department of Psychiatry, University Hospital of Heraklion, Voutes, Heraklion, Crete Zip Code 71110, Greece
| | - Katerina Koutra
- Department of Psychology, University of Crete, Rethymno, Greece
| | - Vassilis Dafermos
- Department of Political Science, University of Crete, Rethymno, Greece
| | | | - Maria Drakaki
- Department of Political Science, University of Crete, Rethymno, Greece
| | | | - Alexandros Vgontzas
- Department of Psychiatry, University Hospital of Heraklion, Voutes, Heraklion, Crete Zip Code 71110, Greece
| | - Panagiotis Simos
- Department of Psychiatry, University Hospital of Heraklion, Voutes, Heraklion, Crete Zip Code 71110, Greece
| | - Nikos Papadakis
- Department of Political Science, University of Crete, Rethymno, Greece
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