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Issue 40
1. 147ISSUE 40
SCIENTIFIC JOURNAL, 3 ISSUES PER YEAR SEPTEMBER - DECEMBER 2014
Published by the Greek
Nursing Studies
Association (GNSA)
ISSUE
40
INDEXED IN SCOPUS, ΕΒSCO, CINAHL
PUBLICATIONS
οcelotos
ISSN 22413960
• The Relationship Between Productivity and Health
Among Nursing Staff in a General Hospital
• The use and the cost of hospital services of
immigrants: The case of a public hospital in Athens
• Stomatitis in children with cancer
• “Unhealthy”integration: Inequalities of immigrants’
access to health services in Greece and policy
recommendations for their elimination
3. 149ISSUE 40
Scientific Journal, 3 Issues per Year
Published by the Greek Nursing Studies Association (GNSA)
Nursing
Care AND Research
EDITOR-IN-CHIEF
Chryssoula Lemonidou, RN, MSc, PhD, Professor
of Nursing, University of Athens
CO-EDITORS
Eleni Apostolopoulou, RN, PhD, Professor of Nursing,
University of Athens
Ioannis Elefsiniotis, PhD, Assistant Professor, Faculty of
Nursing, University of Athens
Panagiota Sourtzi, RN, MSc, PhD, Professor, Faculty of
Nursing, University of Athens
EDITORIAL BOARD
Lambros Anthopoulos, Emeritus Professor, Faculty of
Nursing, University of Athens
George Baltopoulos, PhD, Professor, Faculty of Nurs-
ing, University of Athens
Thalia Bellali, RN, MSc, PhD, Associate Professor of
Nursing, Technological Educational Institute of Thes-
saloniki
Konstantinos Birbas, PhD, Associate Professor, Faculty
of Nursing, University of Athens
Gerasimos Bonatsos, PhD, Professor, Faculty of Nurs-
ing, University of Athens
Charalambos Economou, Associate Professor, Depart-
ment of Sociology, Panteion University,
Margarita Giannakopoulou, MSc, PhD, Associate Pro-
fessor, Faculty of Nursing, University of Athens
Leonidas Grigorakos, Associate Professor, Faculty of
Nursing, University of Athens
Dafni Kaitelidou, MSc, PhD, Assistant Professor, Faculty
of Nursing, University of Athens
Ioannis Kaklamanos, PhD, Associate Professor, Faculty
of Nursing, University of Athens
Maria Kalafati, RN, MSc, PhD, Faculty of Nursing, Uni-
versity of Athens
Athina Kalokerinou, RN, PhD, Professor of Nursing, Fac-
ulty of Nursing, University of Athens
Evangelos Konstantinou, RN, MSc, PhD, Associate
Professor, Faculty of Nursing, University of Athens
Vassiliki Matziou, RN, PhD, Professor, Faculty of Nurs-
ing, University of Athens
Pavlos Myrianthefs, PhD, Associate Professor, Faculty
of Nursing, University of Athens
Elisabeth Patiraki, RN, PhD, Professor, Faculty of
Nursing, University of Athens
Sotiris Plakas, RN, MSc, PhD, General Hospital of At-
tika «Sismanoglion»
Olga Siskou, RN, MSc, PhD, Faculty of Nursing, Uni-
versity of Athens, President of the Greek Nursing
Studies Association
EleniTheodossopoulou, Professor, Faculty of Nurs-
ing, University of Athens
INTERNATIONAL EDITORIAL BOARD
John Albarran, Principal Lecturer in Critical Care
Nursing, University of the West of England, Bris-
tol, UK
Maria Katopodi, PhD, Assistant Professor, University
of Michigan, USA
Katerina Labrinou, PhD, Assistant Professor in Nurs-
ing, Cyprus University of Technology
Anastasia Mallidou, RN, MSc, PhD, Assistant
Professor, University of Victoria, Canada
Anastasios Merkouris, RN, MSc, PhD, Associate
Professor of Nursing, Faculty of Nursing, Cyprus
University of Technology
Evridiki Papastavrou, PhD, Assistant Professor in
Nursing, Cyprus University of Technology
Elisabeth D.E. Papathanassoglou, RN, MSc, PhD,
Associate Professor, Faculty of Nursing, Cyprus
University of Technology
Julie Scholes, Professor of Nursing, University of
Brighton, Brighton, UK
Riita Suhonen, RN, PhD, Profes sor, University of
Turku, Department of Nursing Science, Turku,
Finland
6. 152
GENERAL INFORMATION
1. “Nursing Care and Research” publishes, fol-
lowing peer review, articles in Greek or English,
contributing to the understanding and devel-
opment of all aspects of nursing care. The Ed-
itorial Department receives manuscripts relat-
ing to nursing practice, research, education
and management, with scientific, theoretical
or philosophical basis.
2. Papers published in the journal belong to
one of the following categories: a) research
studies, b) literature reviews and c) articles re-
lating to developments in nursing practice,
education and management. Additionally, let-
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views or comments on previously published
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months from the publication of the research
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Authors should avoid submitting two man-
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that two papers emerge from the same re-
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and must not include the other, although
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is made in the first article a brief description is
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at 00302107461485 the Non-Publication in An-
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Instructions for Authors
MISSION AND AIM OF THE JOURNAL
“Nursing Care and Research” is a peer-reviewed journal accepting manuscripts from researchers
from Greece and abroad. Its mission is to contribute to the development of nursing science and
practice in Greece as well as internationally. The aim is to promote and disseminate new knowledge
and research data for eventual application in clinical practice. To this end, nurses and other affiliated
researchers are invited to submit high-calibre manuscripts in Greek or English. The journal welcomes
original research papers, reviews, theoretical or philosophical articles, interesting clinical cases and
methodological articles from experts. Nursing Care and Research is recognized at national level (FEK
issue B 1961/23-9-2008) and is indexed at the CINHAL, EBSCO and SCOPUS International Databases.
7. 153ISSUE 40
4. Author participation in the drafting pro-
cess
All authors cited in a manuscript must have ac-
tively contributed to the conception and de-
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The authors of research studies cannot exceed
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scale multicenter studies. The authors of oth-
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All authors listed in the manuscript must have
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per. The running title will appear in Greek and
8. 154
English language and cannot exceed five (5)
words. This page does not list names of au-
thors or any other item that violates their ano-
nymity during the peer-review process.
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body of the manuscript should be 2,000-5,000
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recommended for the dissemination of small-
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ADHERING TO THE HUMAN RIGHTS CODE OF
CONDUCT
Should authors publish results of studies con-
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should indicate whether they were conducted
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of Human Rights, (Helsinki 1975) as revised in
2004. Should certain processes deviate from
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methodology section whether they were con-
ducted upon approval of the National Agency
9. 155ISSUE 40
for Medicines (EOF) in accordance with Minis-
terial Decision DYG 3/89292 Gazette V1973/31-
12-2003 (aligned with Directive 2001/20/EC).
It should also be indicated that data is histori-
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Public confidence in the peer-review process
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Authors must indicate at the end of the text
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Authors should indicate details (entity name,
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This information should be listed in a separate
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15. Acknowledgements
The funding sources section is followed by
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ing their opinion) to the drafting of the man-
uscript (apart from the authors). This section
10. 156
should acknowledge any sponsors donating
materials and tools required for the research.
16. Bibliographic References: Bibliograph-
ic references in the text should indicate the
names of the authors followed by the date in
chronological order, eg. (Lewis 1975, Barnett
1992, Chalmers 1994). When there are more
than two authors, the name of the first author
followed by et al., eg. (Barder et al. 1994), is ref-
erenced in the text but all authors should be
listed in the bibliography. When quotes are
used in the text, the page should be referred
to eg. (Chalmers 1994, p.7). All references must
be from primary sources.
The literature list follows the Harvard system,
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the book, the date, place of publication and
publisher must be provided. These references
that are said to be “in press”, shall be accepted
only if accompanied by a letter of acceptance
from the journal in question.
Examples:
Williams N. (2001). Patient resuscitation follow-
ing major thermal trauma. Nursing in Critical
Care: 6: 115-121
Muller D, Harns P, Watley L. (1986). Nursing
Children: Psychology Research and Practice.
London: Harper Row.
Lewis T, Hell J. (1992). Rhabdomyolysis and
Myoglobinuria. In: Hall J, Schmidt G, Wood L.
(eds), Principles of Critical Care, Volume 2. New
York: McGraw Hill.
Websites are refencees as follows:
National Institute for Clinical Excellence (2000)
Final appraisal determination: Drugs for early
thrombolysis in the treatment of acute myo-
cardial infarction, NICE, www.nice.org.uk/ar-
ticle.asp?a =36672. Last access on 7 October
2006.
17. Figures , Tables , Graphics , Photos :
Tables must be referred to herein as Tables,
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correct place in the body of the text. All imag-
es, including photos, must be referred to here-
in as Figures and numbered in the order they
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must also be captioned and may be accom-
panied by a legend not exceeding thirty (30)
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When material (including figures, tables, etc.)
that has already been published elsewhere ap-
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fully liable for any copyright infringement.
Peer-review process
18. All submitted work is reviewed (anony-
mously) by two (2) independent referees/re-
viewers and, if they contain complex statistical
methodologies by a statistician as well. Re-
viewers decide whether an article is a) accept-
ed, b) requires modifications or c) rejected. In
case of disagreement among the reviewers,
the Managing Editor will reach a final decision,
taking into account all reviewer comments.
If the reviewers suggest modifications, the
manuscript is returned by the journal secretar-
iat to the corresponding author for redrafting
and resubmission within six weeks from the
date the comments were made (the review
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cases can reach up to 10 weeks). During resub-
mission, authors are required to indicate the
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dance to reviewer instructions in a letter to the
Managing Editor. The modified manuscript is
forwarded to the reviewers if deemed neces-
11. 157ISSUE 40
sary, and they confirm whether or not modi-
fications comply with their recommendations.
At that point the Managing Editor reaches the
final decision to publish the article.
19. Electronic Reprint: Following publica-
tion, the corresponding author will receive an
electronic reprint of the article in PDF format.
Electronic reprints will be distributed by him/
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COPYRIGHT
20. In order to publish any article in the “Nurs-
ing Care and Research” journal, the authors are
asked to grant this exclusive right to the Soci-
ety for Nursing Studies. Along with the draft
for modifications the authors receive an Au-
thorization for Exclusive Publication form
which must be filled, signed and returned by
mail (or by email as a pdf file) to the journal,
along with the modified manuscript.
When a paper is derived from an extensive re-
search study and the same or other authors
have prepared additional papers, which have
been published or submitted for publication
in this or other journals, the corresponding
author must notify the Managing Editor so as
to ensure that third party copyright is not in-
fringed. Any impact emanating from copyright
infringement lies exclusively with the authors
of published articles and the journal will pro-
ceed with all necessary actions.
FINAL NOTE
Subscribers preparing manuscripts for publi-
cation in the “Nursing Care and Research” jour-
nal are requested to adhere to these Instruc-
tions for Authors carefully in order to avoid
delays in the publication of their work and the
publication of new volumes of the journal.
12. 158
ORIGINAL PAPER
The Relationship Between Productivity
and Health Among Nursing Staff in a
General Hospital
S. Melikidou, RN, MSc, Thriasio General Hospital
P. Sourtzi, Professor, Faculty of Nursing, University of Athens
Corresponding Author:
S. Melikidou, 32, Diogenous str., 18122, Korydallos, Greece, Tel.: 6936508766, E-Mail: smsk_05@yahoo.gr
Abstract
BACHGROUND: The health and productivity
of nursing staff affects not only the workers
themselves and their workplace but also affects
the quality and quantity of services provided to
citizens.
AIM:The purpose of this study was to investigate
the relationship between nurses productivity
and their health and work ability.
METHODS: A cross-sectional study was carried
out. The sample consisted of 188 registered
and assistant nurses from all nursing depart-
ments in a General Hospital (January-March
2013). For data collection was used question-
naire that included Demographics and Profes-
sional details, Work Ability Index questionnaire
and Work Productivity and Activity Impairment
Questionnaire. The analysis was conducted by
SPSS 18.0 and the level of statistical significance
was set at a = 0.05.
RESULTS: The mean age of nurses was 35.6
(± 6.2) years with total time of previous experi-
ence in the nursing profession 10.9 years and
in this particular hospital 7.9 years.The work
productivity loss (overall work impairment) due
to health was 16.9%.The absenteeism was about
2% and the presenteeism 17.3%. The total work
ability index showed that 67.5% of participants
had good/very good indicator of work ability
with an average working index value of 38.8
units. Also, the study showed that there was
a statistically significant negative correlation
between work ability and productivity (r = -0.50,
p 0.001).
CONCLUSIONS: The productivity and work
ability are affected by health of nursing staff and
therefore those who are in charge should be
trying to find ways to maintain work ability of
nurses that will have a positive impact not only
on nursing staff but also on provided services.
KEYWORDS: productivity, health, work ability,
nursing staff, presenteeism/absenteeism
13. 159ISSUE 40
Abstract
BACKGROUND: Parity in the access of immi-
grants to health services is a fundamental factor
in their incorporation into Greek society and in
the achievement of optimal public health.
PURPOSE:The health profile and the cost of hos-
pital services of immigrants in a public hospital
in Athens were studied.
METHOD: Data collection took place in a public
hospital of Athens. A sum of 4.297 immigrants
was imported in 2012. Also, a sample of Greek
people was randomly selected in the same hos-
pital.
RESULTS: The mean age of hospitalized immi-
grants was 55.2 years (15.8), they mainly origi-
nated from Albania (39.3%) and the vast majority
of them had health insurance (89.1%). The mean
hospital stay was 3.23 days (7.78).The most com-
mon disease categories in ICD-10 statistical clari-
fication were cancer (38.3%) and the diseases
of the genitourinary system (12.1%), as in the
Greek population but at lower rates (24.5% and
13.1% respectively). The average cost of treat-
ment came up to €841 (1790) and the total cost
of treatment of immigrants came to €3.540.011.
Also, 21.2% of these expenses remained uncov-
ered and 3,1% paid privately.
CONCLUSIONS: The differences between the
health profile of immigrants and the native pop-
ulation should be studied in depth. The State
must take into consideration the promotion of
immigrants’health.
KEY WORDS: Greece, immigrants, health profile,
cost, health services.
ORIGINAL PAPER
The use and the cost of hospital services of im-
migrants: The case of a public hospital in Athens.
G. Anastopoulos, Economist MSc, PhD, Center for Health Services Management and Evaluation, Faculty
of Nursing, National Kapodistrian University of Athens,
D. Kaitelidou, Assistant Professor, Center for Health Services Management and Evaluation, Faculty of
Nursing, National Kapodistrian University of Athens
Th. Katostaras, Associate Professor, Faculty of Nursing, National Kapodistrian University of Athens
P. Galanis, RN, MSc, PhD, Center for Health Services Management and Evaluation, Faculty of Nursing,
National Kapodistrian University of Athens
P. Sourtzi, Professor, Faculty of Nursing, National Kapodistrian University of Athens
A.Vasilopoulos, Deputy Director of Economic Services, General Hospital of Athens, «LAIKO»
M. Kalogeropoulou, RN, MSc, PhD, Center for Health Services Management and Evaluation, Faculty of
Nursing, National Kapodistrian University of Athens
O. Siskou, RN, MSc, PhD, Center for Health Services Management and Evaluation, Faculty of Nursing,
National Kapodistrian University of Athens
E. Kouli, RN, MSc, PhD, Center for Health Services Management and Evaluation, Faculty of Nursing,
National Kapodistrian University of Athens
E.Velonakis, Professor, Faculty of Nursing, National Kapodistrian University of Athens
CorrespondingAuthor:
G. Anastopoulos, Dramas 8, Thrakomakedones, 13676, anastog@gmail.com, +30 6942200407
This research has been co-financed by the European Union (European Social Fund – ESF) and Greek na-
tional funds through the Operational Program “Education and Lifelong Learning” of the National Strate-
gic Reference Framework (NSRF) - Research Funding Program: THALIS –UOA, MIS 377228.
14. 160
REVIEW
Stomatitis in children with cancer
K. Papadopoulou, Nurse RN, MSc, “Mitera” Children’s Hospital
P. Perdikaris, Nurse RN, MSc, PhD, Children’s Hospital “P A Kuriakou” Ongology Department
E. Patiraki, Professor, Faculty of Nursing, National Kapodistrian University of Athens
M. Giannakopoulou, Associate Professor, Faculty of Nursing, National Kapodistrian University of
Athens
A. Stamoulara, Nurse RN, MSc(c), “Mitera” Children’s Hospital.
V. Matziou, Professor, Faculty of Nursing, National Kapodistrian University of Athens.
CorrespondingAuthor:
K.Papadopoulou, Argyrokastou 24-26, 15773, Goudi, Athens, Greece, Tel: +306982791990,
+302130321763, e-mail: kalliopi.papadopoulou@hotmail.com
Abstract
INTRODUCTION: Oral mucositis is the most fre-
quent complication of chemotherapy in children
with cancer. It is a condition that causes a multi-
tude of clinical symptoms that affect the daily life
of the child.
PURPOSE: Review of measures for prevention
and treatment of oral mucositis in children and
adolescents with cancer.
METHODS: Systematic review of studies pub-
lished over the past 10 years in the databases
Pubmed, Cochrane, Science Direct, Trip Data-
base, using the key-words: «Prevention», «Treat-
ment» «Oral Mucositis», «Children and adoles-
cents», «Cancer». Of the total 645 articles, only 20
were included.
RESULTS: From the articles in the systematic re-
view, 5 studies the chlorhexidine gluconate so-
lution 0,12% w/v and 0,2% w/v. Surveys indicate
that the solution, seems to reduce the severity
or incidence of stomatitis. As shown by 4 arti-
cles, the use of low-intensity laser radiation can
reduce the duration of episodes. Other authors
suggest that the combination with cryotherapy
and propantheline can reduce the incidence of
stomatitis. While curcumin was shown to reduce
the severity but not the frequency of episodes.
Similarly the use of honey bees was associated
with a decrease in healing time. The use of vita-
min E can not prevent the episodes, but it is asso-
ciated with the effective management of them.
From the other hand, the use of substances such
as glutamine, gum free of sugar, benzydamine,
propolis and the factor TGF-b, were not associ-
ated with the prevention and management of
stomatitis.
CONCLUSIONS: According to the results, the
most important preventive measure against sto-
matitis remains the proper and intensive basic
dental hygiene.
KEY-WORDS: Prevention, Treatment, Oral Mu-
cositis, Cancer.
15. 161ISSUE 40
Abstract
INTRODUCTION: Inequalities in access to health
services comprise a complex problem faced par-
ticularly by immigrants in all European Union
countries. However, although it is a common
problem there is no uniform policy in the man-
agement of immigrants with respect to their ac-
cess to health services.
AIM: Policy recommendations to eliminate in-
equalities in access to health services by immi-
grants in Greece.
METHODOLOGY: Review of international and
Greek scientific literature and analysis of reports
and case studies.
RESULTS: The research experience emphasizes
that services which are open to members of
immigrant groups are included in an elliptical
system of social policy which fails to address
significant claims and fields of social protection.
The sketchy nature of the system of social pol-
icy restricts the ability to respond effectively to
the specific needs that result from the presence
of immigrant populations and the pressures on
existing structures for social services. The Hel-
lenic institutional framework for migrants’ ac-
cess to health services is largely restrictive and
in the case of those who do not have legal docu-
ments, borders on institutional exclusion from
the health system.
CONCLUSION:There is a dire need to strengthen
the legal basis for the protection of immigrants’
rights at both national and European level, to
extend the institution of intercultural mediators
in health services and to develop information
material translated into the languages of immi-
grants which would provide guidance on key
health behaviors, the treatment of diseases and
the orientation of patients within the health sys-
tem.
KEYWORDS: immigrants, inequalities, rights, ac-
cess, health services, Greece
“Unhealthy” integration: Inequalities of
immigrants’ access to health services in
Greece and policy recommendations for
their elimination
Th. Fouskas, Lecturer, New York College / Lab. Ass., TEI of Athens
Ch. Economou, Associate Professor, Panteion University
Th. Sakellaropoulos, Professor, Panteion University
K.Varsamidis, Professor, TEI of Thessaloniki
CorrespondingAuthor:
Ch. Economou, Department of Sociology, Panteion University, 136 Syngrou Ave., 17671, Athens, Greece,
Telephone: 2109201728, Email: economou@panteion.gr
This research has been co-financed by the European Union (European Social Fund – ESF) and Greek na-
tional funds through the Operational Program “Education and Lifelong Learning” of the National Stra-
tegic Reference Framework (NSRF) – Research Funding Program: “THALIS – UOA – The Detection, Tran-
scription, and Analysis of Inequalities to Healthcare Access for Immigrants Living in Greece” MIS: 377228
KA:70/3/11671.
REVIEW
