Purpose: To identify the effect of frailty and geriatric syndromes on the quality of life (QoL), of older adults receiving home care, taking into consideration their socioeconomic and homebound status, including multi-comorbidities. Patients and Methods: This cross-sectional study enrolled elders aged (≥65) years old, registered members of “Help at Home” programs in the Reference Region of Crete, from March to May 2019. Participants were screened using the WHOQOL-BREF for Quality of Life, geriatric syndromes such as frailty using the SHARE-Frailty Index (SHARE-Fi), the Montreal Cognitive Assessment (MoCA), for cognitive function and the Geriatric Depression Scale (GDS), for the assessment of depression. Results: The mean age of the 301 participants was 78.45 (±7.87) years old. The prevalence of frailty was 38.5%, severe depression 13.6%, cognitive dysfunction 87.8% and severe comorbidity 70.6%. Intriguingly, none of the participants (0%) was identified as free of comorbidity (CCI = 0–1). The overall QoL (ranging from 4–20) of the study participants was 13.24 (±4.09). The bivariate analysis showed that overall QoL significantly differed among older adults with frailty (15.91 vs. 11.56, p < 0.001), cognitive dysfunction (15.42 vs. 12.90, p < 0.001), depression (14.90 vs. 9.31, p < 0.001), and disability in Activities of Daily Living (13.67 vs. 10.67, p = 0.002), compared to non-frail, normal cognition and depression, and independent elders, respectively. Multiple linear regression models revealed that frail and depressive elders reported significantly lower QoL (β = −2.65, p < 0.001 and (β = −5.71, p < 0.001), compared to non-frail and older adults with no depressive symptoms, respectively, despite the fact that this association was not significant for older adults with dementia (β = −2.25, p = 0.159), even after adjusting for potential confounding effects (age, gender, comorbidity, homebound status, etc.). Conclusion: frailty and geriatric syndromes including comorbidities are important risk factors for “poor” QoL among older adults receiving home-based healthcare.

Nurses’ competency toward evidence-based practice (EBP) has been extensively investigated by several studies worldwide. However, factors affecting the competence of Greek nurses working in the NHS have not been fully investigated in terms of EBP. Thus, this study aimed to explore the impact of the individual qualifications of nurses on their competence toward EBP. Data from 473 registered nurses working in 10 hospitals in the Greek National Health Service (NHS) were collected between October and December 2020 using a convenience sampling method in a cross-section design. The Greek version of the 35-item (five-point Likert scale) Evidence-Based Practice Competency Questionnaire for Professional Registered Nurses (EBP-COQ Prof) was used to assess the competence level of nurses, focusing on attitudes, skills, and knowledge, as well as the utilization of EBP in clinical practice. One-way ANOVA and Pearson coefficient tests were applied to compare the possible differences among variables (two or more groups) as appropriate. A multi-factorial regression model was applied to explore participants’ qualifications, including demographics (MSc degree, gender, English language knowledge, etc.) as independent variables, and to control for potential confounding effects toward EBP competency. The p-values < 0.05 were considered statistically significant. The mean age of the 473 participants (402 women and 71 men) was 44.7 ± 9.2 years old. The mean value of competence subscales was found as follows: attitudes 3.9 ± 0.6, knowledge 3.7 ± 0.6, skills 3.1 ± 0.8, and utilization 3.4 ± 0.7. A multivariate regression analysis revealed that associates of “Master’s degree” (t = 3.039, p = 0.003), “Writing an academic article” (3.409, p = 0.001), “Working in a University clinic” (2.203, p = 0.028), and “Computer Skills” (2.404, p = 0.017) positively affected “Attitudes”, “Knowledge”, “Skills”, and “Utilization”, respectively. The research data suggest that nurses working in the Greek NHS were limited in competence regarding EBP in comparison with other European countries. Therefore, vocational, educational, and training programs tailored to EBP enhancement are crucially important. This study was not registered.

Purpose: To evaluate frailty and its relationship with geriatric syndromes in the context of socioeconomic variables. Patients and Methods: In this cross-sectional study, elderly people aged 65 years old and over who received homecare in the reference region of Crete, Greece, were enrolled. Geriatric syndromes such as frailty, dementia, and depression were evaluated using the SHARE-Frailty Index (SHARE-Fi), the Montreal Cognitive Assessment (MoCA), and the Geriatric Depression Scale (GDS), respectively. Level of education, annual individual income, disability in Activities of Daily Living (ADL) and homebound status were also assessed as ‘socioeconomic factors.’ Results: The mean age of 301 participants was 78.45 (±7.87) years old. A proportion of 38.5% was identified as frail. A multiple logistic regression model revealed that elderly people with cognitive dysfunction were more likely to be frail (OR = 1.65; 95% CI: 0.55–4.98, p = 0.469) compared to those with normal cognition, but this association was not significant. Although elderly people with mild depression were significantly more likely to be frail (OR = 2.62; CI: 1.33–5.17, p = 0.005) compared to those with normal depression, the association for elderly people with severe depression (OR = 2.05, CI: 0.80–5.24, p = 0.134) was not significant. Additionally, comorbidity (OR = 1.06, CI: 0.49–2.27, p = 0.876) was not associated with frailty, suggesting that comorbidity is not a risk factor for frailty. In addition, patients with mild depression were significantly more likely to report frailty (OR = 2.62, CI:1.33–5.17, p = 0.005) compared to those with normal depression, whereas elders with an annual individual income (>EUR 4500) were less likely to be frail (OR = 0.45, CI: 0.25–0.83, p = 0.011) compared to those with <EUR 4500 per year. Conclusions: Our data analysis shows that higher annual individual income and mild depression were independently associated with frailty, suggesting that a lower poverty threshold and mild depression are risk factors for frailty.

(1) Background: Worldwide, refugees may have some difficulties in accessing healthcare services. However, little is known about the factors that may predict the level of accessibility to the public healthcare system in the host countries. (2) Aim: To examine the level of accessibility of Syrian refugees to the public healthcare system in Jordan and further to identify the prediction of socioeconomic factors and barriers to healthcare access. (3) Methods: A cross-sectional study was conducted with a convenient sample of 356 Syrian refugees residing outside camps (Irbid, Ajloun, and Jarash). Data were collected using the Access to Healthcare Services Scale instrument (adopted from the Canadian Community Health Survey), which is composed of 2 sections: the general access scale (8 items) and the difficulties scale (20 items). One-way ANOVA test and independent t-test were used to examine epidemiological correlations among variables, whereas a hierarchical linear regression model was used to examine the predictability of socioeconomic factors and barriers to overall access to the public healthcare system by exploring the incremental impact of additional predictors. (4) Results: the mean age of the 356 participants was 35.22 years old, 56.5% were female, 67.4% were married, most of them 46.1% have secondary education, and non-employed 69.9%. Significant associations were observed among participants with different marital status (p < 0.001), educational level (mean 11.85 vs. 19.85, p < 0.001), working status (15.47 vs. 17.93, p < 0.001), family household number (16.42 vs. 17.0, p < 0.001), and health insurance (none: 15.50 vs. governmental 24.50, p < 0.001). Multivariate analysis revealed that the most important factors that may predict the overall access to healthcare services were: family monthly income (beta −0.19, p < 0.001), household family number (beta 0.17, <0.001), health insurance (beta −0.09, p = 0.047), and barriers (beta −0.43, <0.001), even after adjusting for potential confounding effects: sex, age, educational level, and place of residence. (5) Conclusions: Our findings indicate that socioeconomic factors and barriers may considerably predict overall access to public healthcare in Jordan. It is crucially important, therefore, for the Jordanian government and international organizations to create and develop strategic plans and programs that enhance refugees’ access to health services, positively impacting their health and wellness.

Vaccine hesitancy is an important public health issue referring to concerns about the safety and efficacy of vaccination. Within a framework, this study aimed to assess the cultural adaptation, validity, and reliability of the Greek version of the adult Vaccine Hesitancy Scale (aVHS) as well as to identify the determinants of vaccine hesitancy among a large regional population in central Greece. A cross-sectional study was conducted enrolling 300 adults who had received primary healthcare services in the Health Centers and Local Health Units of the Magnesia Region from October to December 2022. The aVHS and the Life Orientation Test-Revised (LOT-R) were used to identify vaccine hesitancy and the dispositional level of optimism, respectively. For survey translation, the procedure of forward and backward translation was followed. Also, the aVHS was tested in a pilot study with a sample of 18 responders. Construct validity and internal consistency reliability were investigated via exploratory and confirmatory factor analysis and Cronbach’s alpha coefficients, respectively. Simple and multiple linear regression analysis were used to determine predictors for vaccine hesitancy. Factor analyses indicated that the aVHS comprises two constructs (“lack of confidence” and “risk perception”) explaining 68.9% of the total variance. The Cronbach’s alpha of the total scale was 0.884, indicating its high internal consistency. Participants who lived in rural areas, had a lower annual income, and reported a lower level of optimism showed a higher lack of confidence in vaccination. On the other hand, people aged above 45 years old who had graduated from high school or elementary school and were unemployed showed greater aversion to the risks of side effects. Finally, certain socio-demographic characteristics were associated with vaccine hesitancy. Our data suggest that the aVHS is a valid and reliable instrument for measuring vaccine-related attitudes and perceptions in Greek society, providing meaningful insight into designing vaccination-related preventive interventions in the community.

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