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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 35799

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Special Issue Editors

Prof. Dr. Evridiki Kaba

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Guest Editor

Department of Nursing, University of West Attica, 12243 Athens, Greece
Interests: qualitative research; primary health care nursing; health promotion; basic nursing; evidence-based nursing
Special Issues, Collections and Topics in MDPI journals

Prof. Martha Kelesi

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Guest Editor

Department of Nursing, University of West Attica, 12243 Athens, Greece
Interests: quantitative research; systematic reviews; primary health care nursing; health promotion; basic nursing; evidence-based nursing; health management and health economics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Evidence-based practice is a conscientious, problem-solving approach to clinical practice that incorporates the best evidence from well-designed studies, patient values and preferences, and a clinician's expertise in making decisions about a patient's care. EBP provides the appropriate means for making effective and justifiable clinical decisions, for avoiding habitual practice, and for enhancing clinical performance via the use of best evidence. Thus, EBP is an essential component of safe and quality patient care. This problem-solving approach to clinical practice encourages nurses to provide individualized patient care. Nurses are encouraged to use critical thinking in evaluating treatment options based on each patient’s individual medical history, current condition, and previous outcomes. The inclusion of EBP in nursing provides nurses with the scientific research to make well-founded decisions. Through EBP, nurses can stay updated about new medical protocols for patient care. By searching for documented interventions that fit the profiles of their patients, nurses can increase their patients' chances for recovery. EBP enables nurses to evaluate research so they understand the risks or effectiveness of a diagnostic test or treatments. The application of EBP enables nurses to include patients in their care plan. Patients can have a proactive role in their own healthcare, since they can voice concerns, share their values and preferences, and make suggestions on how they want to proceed. Additionally, nurses are able to exercise their judgment and planning and provide care that takes into account the patients’ cultural and personal values and preferences. EBN practice has an impact on clinical outcomes, on the reduction of adverse events, on patient mortality and hospital stay days, and consequently on cost reductions.

This Special Issue will consider original articles, with a special focus on issues such as

Primary research that evaluates any problem-solving approaches to clinical practice;
Primary research that evaluates patients’ values, preferences, opinions, and attitudes;
Primary research that evaluates the use of any intervention to improve the health behaviors and/or mental or physical health of patients and/or other healthcare providers;
Reports of innovations and systematic reviews on interventions to improve mental and/or physical health in nurses and/or patients and their family;
Primary research that evaluates social interactions, improves patient safety, resolves environmental issues affecting health, enhances quality of life, develops theories, and explores healthcare economic issues;
Qualitative and quantitative research studies, the two types of EBP research that nurses perform, evaluate, and utilize to guide nursing interventions and improve patient care;
Original articles on evidence-based nursing education focusing on teaching approaches; problem-solving approaches; and the improvement of creative and critical thinking.

Dr. Evridiki Kaba
Dr. Martha Kelesi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

evidence-based practice
evidence-based nursing
nursing
quality of patient’s care
advanced practice nursing
problem-solving
best evidence
individualized patient care nursing research
nursing education
critical thinking
healthcare economic issues
cost reduction

Published Papers (7 papers)

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Research

14 pages, 593 KiB

Open AccessArticle

Awareness, Knowledge and Risky Behaviors of Sexually Transmitted Diseases among Young People in Greece

by Chrysa Voyiatzaki, Maria S. Venetikou, Effie Papageorgiou, Fragiski Anthouli-Anagnostopoulou, Panagiotis Simitzis, Dimitrios I. Chaniotis and Maria Adamopoulou

Int. J. Environ. Res. Public Health 2021, 18(19), 10022; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910022 - 23 Sep 2021

Cited by 12 | Viewed by 7911

Abstract

Sexually transmitted diseases (STDs) affect mainly young individuals and cause health, social, and economic problems worldwide. The present study used a web questionnaire to assess the awareness, knowledge, sexual behaviors, and common practices regarding STDs in young Greek adults. The 1833 individuals, aged 18–30 years, who responded to the study seem to be particularly knowledgeable regarding STDs such as AIDS (97.7%), warts (97%), Chlamydia (92.2%), genital herpes (89.9%), syphilis (81.9%), and gonorrhea (72.1%), whereas lower percentages were noted for trichomoniasis (39.3%), Molluscum contagiosum (12.9%), mycoplasmosis (11.6%), and amoebiasis (7.4%). Regarding oral STD transmission, participants replied correctly for genital herpes (45%), warts (35.8%), and AIDS (HIV; 33.8%), whereas 30.2% were unfamiliar with oral sexual transmission. Of the participants, 52% were not aware that STDs might cause infertility. Only 40.4% of the respondents reported always using condoms during sexual intercourse, and 48.6% had never been tested for STDs. The majority of the young population (55%) presented a moderate knowledge STD score (41–60%) and was associated with demographic parameters such as age, gender, sexual preference, number of sexual partners, and residence (p < 0.05). These findings provide important information regarding the prevention of STDs and highlight the significance of developing more effective sex education programs for young people in Greece. Full article

(This article belongs to the Special Issue Evidence-Based Nursing)

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11 pages, 337 KiB

Open AccessArticle

Design of the EBE-ST Questionnaire among Nursing Students: Multicenter Study from Eight Universities in Spain

by Ana Rosa Alconero-Camarero, Carmen Sarabia-Cobo, Montserrat Antonín-Martin, Alicia Borras-Santos, Montserrat Edo-Gual, Vicente Gea-Caballero, José Luis Gómez-Urquiza, José Rafael González-López, María Antonia Martínez-Momblán, Alfonso Meneses-Monroy, Montserrat Montaña-Peironcely, Diego Serrano-Gómez and Azucena Santillán-García

Int. J. Environ. Res. Public Health 2021, 18(11), 6145; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116145 - 07 Jun 2021

Viewed by 2810

Abstract

Background: Twenty years after the degree in nursing was introduced in Spain, the subject of evidence-based nursing is still unstructured and unestablished in most faculties. Moreover, there are hardly any rigorous studies at a national level that evaluate the current state of this competence in our faculties. Understanding the starting point is essential for the curricular design to ensure that evidence-based practice is implemented among future professionals. Aim: To design and validate an evidence-based nursing competency questionnaire for fourth-year nursing students. Methods: A specific questionnaire was developed and validated (EBE-ST). A cross-sectional survey design with psychometric validation of an instrument. Participants were 304 senior year nursing students from eight universities in Spain (2020). Results: The EBE-ST questionnaire is composed of 33 items that determine eight factors. It presents adequate reliability and validity (alpha = 0.882), measuring knowledge, attitudes and the practical application of evidence-based practice. Conclusions: We have created an instrument with good psychometric properties to measure evidence-based practice competence among senior nursing students. The heterogeneity of knowledge regarding evidence-based nursing in our country suggests that further reflection is warranted on the incorporation of this topic during undergraduate training. We have designed and validated an evidence-based nursing competency questionnaire specific to nursing students. Full article

(This article belongs to the Special Issue Evidence-Based Nursing)

14 pages, 355 KiB

Open AccessArticle

Learning Organizational Culture in Greek Public Hospitals

by Aspasia Goula, Maria-Aggeliki Stamouli, Dimitra Latsou, Vasiliki Gkioka and Niki Kyriakidou

Int. J. Environ. Res. Public Health 2021, 18(4), 1867; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041867 - 14 Feb 2021

Cited by 8 | Viewed by 4246

Abstract

(1) Background: A learning organizational culture is crucial to the safety of patients and the quality of public health care. The aim of this study was to assess the learning organizational culture and capacity of Greek public hospitals. (2) Materials and Methods: A cross-sectional analysis was carried out in six public general hospitals and stratified sampling was used as the sampling technique. A total of 480 questionnaires were distributed to health care professionals and 380 valid questionnaires were returned (78% response rate). The comprehensive form of the Dimensions of Learning Organization Questionnaire (DLOQ), which was adapted and translated into Greek, was used for data collection in this survey. (3) Results: The level of learning organizational culture and capacity in the health units are very low. All seven dimensions of the learning organizational instrument are lower than the theoretically neutral median (3.0). Health care employees believe that the hospital’s existing culture and management practices do not foster and contribute to continuing learning, which is the fundamental aspect of self-development, department development and performance improvement. (4) Conclusions: Greek public hospitals need to adopt different types of leadership practices and culture in order to be able to facilitate organizational learning. Organizational learning (OL) is based on collaborative working, a culture that encompasses learning as participation in the organizational work practice. This transformation of culture should take place at all levels of learning to enhance results. Full article

(This article belongs to the Special Issue Evidence-Based Nursing)

14 pages, 295 KiB

Open AccessArticle

Investigating Nurses’ Views on Care of Mentally Ill Patients with Skin Injuries

by Evridiki Kaba, Aikaterini Triantafyllou, Georgia Fasoi, Martha Kelesi and Areti Stavropoulou

Int. J. Environ. Res. Public Health 2020, 17(20), 7610; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207610 - 19 Oct 2020

Cited by 1 | Viewed by 2225

Abstract

Background: Individuals with mental illness are at increased risk of skin injuries. The role of nurses in skin injury prevention and management is crucial and therefore their views on wound care may provide useful information for improving the quality of the care provided. Aim: To investigate nurses’ views on care of mentally ill patients with skin injuries. Method: A qualitative research design based on the principles of grounded theory approach was followed. Unstructured interviews were conducted with seven nurses working in psychiatric wards with frequent skin injuries. Data were analyzed using the constant comparative method of analysis. Results: Two main themes were emerged from data analysis. The first main theme, namely factors affecting the care of patients with skin injuries, included seven categories: (a) shortage of hospital supplies, equipment and services (b) staff shortages, (c) lack of knowledge, (d) nurses’ resistance to change, (e) difficulty in collaborating with patients, (f) patients’ physical conditions and (g) nurses’ attitudes as an obstacle to care. The second main theme, namely nurses’ suggestions for optimizing care, included five categories: (a) need for additional staff, (b) need for increasing hospital supplies and equipment availability, (c) need for training (d) need of changing nurses’ attitudes towards care and (e) need of changing the patients’ approach to collaboration. Conclusion: The care of mentally ill patients with skin injuries is affected by multidimensional factors that have a direct impact on the quality of nurses’ work and patients’ hospitalization. Specific efforts are needed to overcome the obstacles that hinder the care provided and to improve clinical practice. Full article

(This article belongs to the Special Issue Evidence-Based Nursing)

10 pages, 697 KiB

Open AccessArticle

Pre- and Post-Operative Nutrition Assessment in Patients with Colon Cancer Undergoing Ileostomy

by Georgios Vasilopoulos, Panagiota Makrigianni, Maria Polikandrioti, Ilias Tsiampouris, Dimitrios Karayiannis, Nikoletta Margari, Lamprini Avramopoulou, Georgia Toulia and Georgia Fasoi

Int. J. Environ. Res. Public Health 2020, 17(17), 6124; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176124 - 23 Aug 2020

Cited by 10 | Viewed by 5796

Abstract

Introduction: Patients undergoing ileostomy surgery often experience electrolyte disturbances and dehydration, especially during the first post-operative period. Recently, research has also begun on how the newly constructed ileostomy affects the patient’s nutritional status. Aim: The aim of the present pilot study was to assess the nutritional status of patients before and after the construction of the ileostomy as well as nutrition-related factors. Material and Method: This was a pilot study. The sample consisted of 13 adult patients diagnosed with colorectal or colon cancer who underwent scheduled ileostomy surgery. The evaluation tool used was “Original Full Mini Nutritional Assessment (MNA)”. Patients underwent nutritional assessment before the surgery (time 0), on the 7th post-operative day (time 1), and on the 20th post-operative day (time 2). The statistical significance level was set at p < 0.05. Results: All patients had a drop in MNA score on the 7th and 20th post-operative days. Factors associated with MNA were weight loss, mobility, body mass index (BMI), number of full meals consumed per day, portions of fruits and vegetables consumed per day, and mid-arm circumference, p < 0.05, respectively. Pre-operatively, 38.5%, of patients had severe weight loss (>3 kg), 23% moderate weight loss and 38.5% minimal weight loss. Pre-operatively, 92.3% of participants were able to move on their own and 69.2% on the 20th post-operatively day. Furthermore, BMI >23 kg/m² had 84.6% of participants pre-operatively and 30.8% on the 20th post-operative day. In terms of portions of fruits and vegetables consumed per day, 30.8% of patients consumed at least 2 times, pre-operatively and no one (0%) on the 20th post-operative day. Moreover, pre-operatively all participants (100%) had arm circumference >22 cm while on the 20th post-operative day, only 38.5% of participants had arm circumference >22 cm. Conclusions: In the first 20 days after the construction of an ileostomy, the nutritional status of the patients is significantly affected. Decreased patient nutrition in both quantity and ingredients and reduced fluid intake appear to adversely affect the patient’s nutritional status. Full article

(This article belongs to the Special Issue Evidence-Based Nursing)

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13 pages, 348 KiB

Open AccessArticle

Comparison of the Level of Awareness about the Transmission of Echinococcosis and Toxocariasis between Pet Owners and Non-Pet Owners in Greece

by Christina Kantarakia, Maria E. Tsoumani, Antonis Galanos, Alexander G. Mathioudakis, Eleni Giannoulaki, Apostolos Beloukas and Chrysa Voyiatzaki

Int. J. Environ. Res. Public Health 2020, 17(15), 5292; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155292 - 22 Jul 2020

Cited by 6 | Viewed by 2356

Abstract

Ζoonotic parasitic diseases that can occur through animal contact pose risks to pets, their owners and to their bond. This study aims to assess the level of knowledge about zoonoses, specifically echinococcosis and toxocariasis, among cat/dog owners and non-pet owners in Greece. Multiple-choice questionnaires were designed to obtain data regarding the knowledge of pet and non-pet owners on echinococcosis and toxocariasis, including signs and symptoms of these zoonoses, ways of transmission and precautions that need to be taken into account in order to avoid it. A total of 185 questionnaires were retrieved and data was expressed as absolute (Ν) and relative frequencies (%). Associations between pet ownership, residence and outcome variables were evaluated using the Fisher exact test and Chi-squared test, respectively. Multifactorial linear regression analysis was used to investigate the cross-sectional association between demographic characteristics and the awareness of helminthic zoonoses. All tests were two-sided and statistical significance was set at p < 0.05. Our study revealed a disturbing lack of awareness of echinococcosis and toxocariasis (mean zoonotic knowledge score 8.11 ± 3.18) independently of pet ownership. Surprisingly, in some cases the ignorance of pet owners exceeded that of non-pet owners. Given the progressive impact of toxocariasis in public health and the high prevalence of echinococcosis in the Mediterranean region, measures should be taken to inform people about zoonoses and eliminate their putative transmission. Full article

(This article belongs to the Special Issue Evidence-Based Nursing)

14 pages, 303 KiB

Open AccessArticle

Assessment of Knowledge, Attitudes, and Practices towards New Coronavirus (SARS-CoV-2) of Health Care Professionals in Greece before the Outbreak Period

by Dimitrios Papagiannis, Foteini Malli, Dimitrios G. Raptis, Ioanna V. Papathanasiou, Evangelos C. Fradelos, Zoe Daniil, Georgios Rachiotis and Konstantinos I. Gourgoulianis

Int. J. Environ. Res. Public Health 2020, 17(14), 4925; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17144925 - 08 Jul 2020

Cited by 153 | Viewed by 9259

Abstract

Introduction: The ongoing severe acute respiratory syndrome (SARS)-CoV-2 pandemic has expanded globally. The aim of the current study is to investigate the knowledge, attitudes, and practices (KAP) of health care professionals in Greece towards SARS-CoV-2. Methods: From 10–25 February 2020, 500 health care workers were approached. Knowledge, attitudes, and practices towards SARS-CoV-2 were assessed via a personal interview questionnaire. For knowledge, each correct answer was given 1 point; attitudes, or concerns aimed at prevention of SARS-CoV-2 infection, and practices, or behaviors towards performing preventive practices, were assigned 1 point each. Points were summed and a score for each category was calculated. Results: A total of 461 health care workers returned the questionnaire and were included in the analysis (mean age ± SD: 44.2 ± 10.78 years, 74% females). The majority were nurses (47.5%), followed by physicians (30.5%) and paramedics (19%). The majority of subjects (88.28%) had a good level of knowledge (knowledge score equal to 4, or more). The majority of participants (71%) agreed with the temporary traveling restrictions ban. The uptake of a future vaccine against SARS-CoV-2 was estimated at 43%. Knowledge score was significantly associated with both attitudes score (p = 0.011) and practices score (p < 0.001), indicating that subjects with a high knowledge score demonstrated a more positive perception on preventive measures and would practice more preventive measures. Attitudes score was significantly associated with practices score (p = 0.009) indicating that subjects with a higher attitudes score are more likely to perform practices towards the prevention of SARS-CoV-2 transmission. Conclusion: There is a high level of knowledge concerning SARS-CoV-2 pandemic among Greek health care workers and this is significantly associated with positive attitudes and practices towards preventive health measures. The high level of knowledge of health professionals about SARS-CoV-2 may have contributed considerably to the successful management of the pandemic in Greece. Tailored educational campaigns aiming to increase the proportion of health care workers willing to accept a potential SARS-CoV-2 vaccine could be of paramount importance in future proactive vaccine educational campaigns. Full article

(This article belongs to the Special Issue Evidence-Based Nursing)

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