Evidence-based practice (EBP) is a key element among nurses to ensure high-quality, advanced care in contemporary healthcare systems. Nurs ing students, as future healthcare professionals, must develop competence in EBP. However, in the Albanian context, there is a lack of instruments to assess EBP competence among undergraduate nursing stu-dents. This study aimed to translate, culturally adapt and validate the Evidence-Based Practice Compe tence Questionnaire (EBP-COQ) into Albanian, and to test its psychometric properties. A cross-sectional validation study was conducted using a convenience sample of undergraduate Al banian nursing students. The translated EBP COQ was tested for reliability and construct valid ity. Construct validity was initially assessed using an exploratory factor analysis (EFA), and internal consistency was assessed using Cronbach’s alpha and McDonald’s omega. A total of 357 nursing students participated, with a mean age of 22.25 years and 82.6% female. The internal consistency of the Albanian EBP-COQ was high (Cronbach’s alpha = 0.866; McDonald’s omega = 0.855). Exploratory factor analysis identi-fied three factors: Attitude toward EBP, Perceptions toward EBP, and Knowledge and Skills in EBP. The three factors together explained 44% of the total variance, comparable to values reported in previous validation studies of the EBP-COQ. All three factors showed statistically significant positive correlations with overall EBP competence. This study has some limitations, in cluding data collection from a single university and the absence of test–retest reliability as-sess ment, which may limit the generalizability of the findings. Conclusions: The Albanian EBP-COQ shows strong validity and reliability for assessing attitudes, skills, and knowledge in EBP among nursing populations in this geographic area. This scale can be used to assess baseline competence and guide educators and researchers in design ing strategies to strengthen EBP. Additionally, it may be used to evaluate the effectiveness of EBP related courses or workshops, monitor changes in students’ competence over time, and identify factors associ-ated with EBP competence.

This study aimed to investigate the factors that predict the acceptance of distance learning among undergraduate nursing students during the COVID-19 pandemic and to examine Please check if the Citation part is missing the implications of these findings for nursing education in the post-pandemic era. A cross-sectional study was conducted in Greece with a convenience sample of undergraduate nursing students from the Hellenic Mediterranean University and the University of Patras. Data were collected between December 2020 and January 2021 using an online questionnaire. Statistical analysis was performed using IBM SPSS version 21.0. A total of 378 undergraduate nursing students (mean age: 22 years) participated in this study. The regression model predicting students' attitudes toward distance learning (ATel) was statistically significant and explained 18.3% of the variance in ATel scores (R-2 = 0.183, adjusted R-2 = 0.158). Among the psychological and experiential factors, future career concerns (beta = 0.237, p < 0.001), emotional distress related to social isolation (beta = 0.186, p = 0.001), and perceived difficulties in group work (beta = 0.140, p = 0.013) were revealed as significant predictors of the students' attitudes toward distance learning. In contrast, digital readiness, flexibility, and perceived effectiveness of distance learning were not revealed as statistically significant predictors in the multivariate model but were positively associated with students' attitudes. Demographic characteristics were not identified as statistically significant predictors of ATel scores. Psychosocial factors were significantly associated with nursing undergraduate students' attitudes toward distance learning, underscoring the importance of incorporating blended learning in higher education in the post-pandemic era to secure group interaction, effective collaboration, and students' well-being.

The phenomenon of dehumanization constitutes a critical and multifaceted issue in the healthcare sector, particularly within hospital and clinical settings. This study aims to investigate the significant correlations between demographic characteristics and dehumanization, work conditions, personality traits, professional quality of life. The primary research instrument of the study was a validated questionnaire, which included items related to the participants’ sociodemographic, educational, and professional characteristics, as well as the following scales: the Dehumanization Scale (DS), the Self-Dehumanization Scale (SDS), the Ten Item Personality Inventory (TIPI), and the Professional Quality of Life Scale (ProQOL). With regard to sociodemographic characteristics, age (mean 4.48±0.59 for older vs 4.32± 0.53 for younger health professionals, p<0.001) and professional experience (mean 4.46±0.58 for more experienced vs 4.3±0.49 for less experienced health providers, p = 0.033) could significantly account for the overall extent of dehumanization. Secondary traumatic stress mainly concerned female health professionals (20.6±8.24 for females vs 19.2±7.8 for males; p=0.019), as well as married healthcare providers (20.85±8.15 for married vs 19.1±8.05 for unmarried health professionals; p=0.005). The analysis also revealed that certain personality traits, professional burnout and secondary traumatic stress seem to be positively correlated with working experience. The findings of this study highlight the severity of dehumanization in healthcare settings and the urgent need for systematic intervention, along with the development of targeted programs by relevant authorities, aiming at promoting holistic patient care and improving the quality of life of healthcare professionals.

Background: Rapid technological progress has transformed healthcare systems through integrating electronic health (eHealth) into clinical practice. Consequently, nursing students, upcoming healthcare professionals, face new challenges arising from this digital transition. Adequate technological skills and eHealth literacy are essential to meet the requirements of contemporary healthcare environments. The aim of this study was to translate, culturally adapt, and validate a questionnaire measuring technophilia, Internet use, eHealth literacy, and nursing students’ attitudes toward technology and eHealth. Methods: A cross-sectional validation study was conducted using a convenience sample of Albanian undergraduate nursing students. After forward and backward translation, the instrument’s construct validity was examined using exploratory factor analysis (EFA). Cronbach’s alpha assessed internal consistency, and the relationships among the four constructs were explored using structural equation modeling (SEM). Results: A total of 357 undergraduate nursing students participated in the survey. EFA identified a clear four-factor structure corresponding to Technophilia, Internet Use, eHealth Literacy, and Technology and Electronic Health in Nursing Education, with all items demonstrating satisfactory factor loadings. Internal consistency of the four scales ranged from 0.692 to 0.852, indicating generally satisfactory reliability. Although the SEM model fit was below the recommended thresholds, the results provide some evidence for relationships among the constructs. Conclusions: The findings provide preliminary evidence for the reliability and validity of the adapted instrument and set a baseline for assessing Albanian nursing students’ knowledge, skills, and attitudes regarding technology and eHealth literacy. Several strategies can be developed based on this evidence to prepare nursing students for technologically advanced healthcare systems.

Background: Self-care and healthy dietary habits are fundamental components of heart failure (HF) management, yet the relationship between dietary quality and self-care remains insufficiently explored. This study investigated the association between dietary habits and self-care behaviors among patients with HF. Methods: A cross-sectional study was conducted among 137 adults with HF attending outpatient clinics in Greece. Self-care behaviors were assessed using the Hippocratic Heart Failure Self-Care Scale (HHFSCS), whereas dietary quality was evaluated using the validated Greek version of the Cardiovascular Diet Questionnaire-2 (CDQ-2). Associations between demographic characteristics, dietary quality, and self-care were initially examined using non-parametric tests. Two multivariable General Linear Models (GLMs) were subsequently performed to identify independent predictors of self-care. Results: The mean HHFSCS score was 41.0 ± 11.3, indicating a moderate level of self-care. Medication adherence and attendance at scheduled appointments showed the highest scores, whereas exercise, smoking-related behaviors, alcohol-related behaviors, and symptom monitoring demonstrated lower adherence. The mean total CDQ-2 score was −5.9 ± 3.9. In the multivariable analysis, overall dietary quality remained independently associated with self-care after adjustment for age, sex, marital status, educational level, and employment status (β = −0.511, p = 0.020). Among the individual dietary domains, only saturated fat intake remained independently associated with self-care (p = 0.015), whereas fruit consumption and unsaturated fatty acid intake were not significant predictors. Employment status also remained independently associated with self-care (p < 0.001). Conclusions: Better dietary quality, particularly lower saturated fat intake, was independently associated with improved self-care among patients with HF. These findings support integrating comprehensive nutritional assessment and individualized dietary counseling into routine HF management. Dietary behavior may serve as a practical marker of patients' overall self-management capacity and could assist healthcare professionals in identifying individuals who require additional educational and behavioral support.

Background/Objectives: Genomics plays a crucial role in healthcare, enhancing diagnostics, risk assessments, and therapeutic interventions. However, many healthcare professionals, including nurses, face challenges when it comes to integrating genomics into their practice. This study aims to evaluate the genomic knowledge of nurse practitioners in Greece by translating and validating the Genomic Nursing Concept Inventory (GNCI). Methods: A cross-sectional study involving 324 nurses was conducted in Crete, Greece. The GNCI, a 31-item questionnaire, was translated and validated for the Greek context to assess nurses’ genomics competence. Results: The Greek version of the GNCI demonstrated acceptable reliability (Cronbach’s alpha = 0.622). The confirmatory factor analysis indicated a satisfactory fit for the one-factor model. However, the mean GNCI score revealed significant knowledge gaps, with nurses answering only 30.1% of questions correctly. Notably, nurses showed a better understanding of genomic basics and mutations compared to inheritance and genomic healthcare applications. Conclusions: The present study successfully translated and validated the GNCI in Greek and highlighted important genomic-related knowledge gaps among Greek nurses, emphasizing the urgent need for more targeted educational interventions. By enhancing genomic literacy through curriculum integration and professional development, nurses could be better prepared, leading to improved patient care and healthcare outcomes in Greece.

Objective: This interventional cohort study evaluates the effectiveness of a nurse-led educational intervention designed to improve health literacy and self-management in glaucoma patients and examines correlations with demographic factors (sex, age, education level) and comorbidities. Material and Methods: A convenience sample of 312 glaucoma patients was recruited from the University General Hospital of Heraklion, Crete, between November 2022 and November 2023. The patients were randomly assigned to an intervention group (receiving nurse-led education) or a control group (receiving standard care). Health literacy was measured using the HLS-EU-16 questionnaire, while self-management levels were assessed with the Patient Activation Measure (PAM-13). Two-way repeated measures ANOVA analyzed intervention effects over time. Moreover, multiple linear regression analysis was used to test for potential correlations between variables. Results: Significant improvements were observed in both HLS-EU-16 and PAM-13 scores in the intervention group over time compared to the control group. In the post-test, the intervention group showed statistically higher health literacy scores (12.79 ± 2.64) than the control group (10.52 ± 3.60), with a mean difference in −2.27 (p < 0.001). Similarly, the PAM-13 scores were significantly higher in the intervention group (49.35 ± 10.36) compared to the control group (41.33 ± 24.12) post-test, with a mean difference of −8.01 (p < 0.001). The pre-intervention PAM-13 score was positively associated with both the HLS-EU16 score (B = 3.307, p < 0.001) and education level (B = 3.863, p = 0.037). Meanwhile, higher post-intervention PAM-13 was positively associated with greater post-intervention HLS-EU16 scores (B = 1.26, 95% CI [0.61, 1.91]). Furthermore, the participants of the intervention group exhibited significantly higher post-intervention PAM-13 scores than the control group (B = 5.36, 95% CI [1.03, 9.68]). Conclusions: The nurse-led educational intervention significantly enhanced health literacy and self-management in glaucoma patients, indicating its potential value in patient education strategies for chronic diseases.

Background: Glaucoma is one of the leading causes of blindness that can be mitigated through early recognition and effective management. Specifically, early and effective self-management outside hospitals can slow disease progression and reduce its negative daily impact. This includes adherence to medication, high levels of health literacy (requires patients to be able to find, understand, and use relevant health information), early recognition of symptoms, regular visits to ophthalmologists, etc. However, there is a lack of empirical evidence regarding levels of adherence to medication and health literacy in glaucoma patients in Greece. This study aimed to assess health literacy and self-management activation levels in glaucoma patients and explore the relationship between these factors. Materials and Methods: A total of 312 glaucoma patients were recruited from outpatient ophthalmology clinics in Heraklion, Greece, between November 2023 and May 2024 through convenience sampling. The Greek versions of the Patient Activation Measure-13 (PAM-13) and the European Health Literacy Survey Questionnaire 16 (HLS-EU-16) evaluated self-management activation and health literacy, respectively. Results: Patients exhibited low self-management activation (level 1: disengaged and overwhelmed, =40.7, SD: ±29.9) and sufficient health literacy (=10.7, SD: ±3.7). No significant association was found between health literacy and self-management activation (p = 0.602). Conclusions: Glaucoma patients had low to moderate levels of self-management activation and health literacy, without a significant association between them. Therefore, multifaceted strategies are needed to enhance these patients’ activation and health literacy. Further research, using larger, multi-center samples, is needed to clarify the link between these variables.

OBJECTIVES:To assess CT, SE, and perceptions of EE of nursing students in Greece, and explore the potential associations between them. METHODS:This cross-sectional study was conducted in a Nursing department from February to May 2024. We used the Dundee Ready Education Environment Measure (DREEM), the Critical Thinking Disposition Scale (CTDS), and the Rosenberg Self-Esteem Scale (RSE) questionnaires. RESULTS:A total of 185 nursing students participated. EE was generally positive, with moderate CT disposition and positive self-esteem. Robust regression showed a positive association between EE and CT disposition. Structural equation modeling indicated that SE mediates this association between EE and the Reflective Skepticism sub-scale of CTDS. CONCLUSIONS:Suitable interventions could be implemented to enhance the CT of nursing students through the utilization of SE and EE.

Background/Objectives: Exercise is essential for older adults to maintain or improve their physical condition. This study aimed to investigate whether improvements in physical performance, functional mobility, and balance through targeted physical function exercises could positively influence Concerns about Falling (CaF) and frailty in pre-frail community-dwelling older adults. Methods: We conducted an 18-month randomized controlled trial involving 112 pre-frail community-dwelling older adults aged 65 years or older. 55 individuals in the control group (CG) and 57 in the intervention group (IG) were assessed. The IG participated in a home-based physical function exercise program. Primary outcomes included Physical Performance (Short Physical Performance Battery, SPPB), Functional Mobility (Timed Up and Go, TUG), Balance (Berg Balance Scale, BBS), CaF (Falls Efficacy Scale-International, FES-I), and Frailty status (SHARE-FI). Assessments were conducted at baseline, 6, 12, and 18 months. Results: The IG showed significant improvements in BBS (p < 0.01, partial eta2 0.17), SPPB (p < 0.01, partial eta2 0.13), TUG (p < 0.01, partial eta2 0.14) and FES-I (p < 0.01, partial eta2 0.07) compared to the CG and their baseline after 6, 12 and 18 months of intervention. By 18 months, frailty status improved in the IG, with 12.3% classified as non-frail compared to 2.0% in the CG, while 14.5% of the CG transitioned to frailty versus none in the IG. Discussion: The intervention appears to support improvements in physical function and may contribute to reductions in CaF and beneficial changes in frailty status among pre-frail community-dwelling older adults.

Background/Objectives: Dietary recommendations are an essential part of guidelines for the best management of chronic cardiovascular diseases. The present study aimed to validate the Greek version of Cardiovascular Diet Questionnaire 2 (CDQ-2) and to assess the dietary habits among cardiovascular patients. Methods: A single-center cross-sectional observational study was conducted. The study population was cardiovascular patients that were users of a private primary healthcare clinic. The data were collected between December 2024 and January 2025. The questionnaire was translated from French, back-translated, and reviewed by a committee of experts. The MEDAS was used as a gold standard. The psychometric measurements that were performed included reliability coefficients and Explanatory Factor Analysis (EFA). Results: The total sample comprised 90 individuals. The Cronbach’s α was 0.97. A bivariate Pearson’s correlation established that there was a strong, statistically significant linear relationship between the CDQ-2 and MEDAS scores, with r(90) = 0.962 and p < 0.001. Cardiovascular patients seemed to have suboptimal dietary patterns, as indicated by the relatively low mean CDQ-2 score of 2.9 (SD = 17.2), along with a mean MEDAS score of 8 (SD = 5.2), where younger individuals (p < 0.001), males (p = 0.042), single/divorced/widowed individuals (p < 0.001), individuals with lower physical activity (p = 0.001), and active smokers (p = 0.022) demonstrated significantly poorer adherence to the optimal cardiovascular dietary status. Conclusions: The survey indicated that CDQ-2 was a valid and reliable scale to use in cardiovascular patients in Greece. Also, the patients were characterized by suboptimal dietary habits, indicating the need for personalized interventions to improve their dietary habits.

(1) Background: The integration of digital technologies such as electronic health records (EHRs), telepsychiatry, and communication platforms has transformed the mental health sector a lot compared to in previous years. While these tools enhance service delivery, they also introduce unique stressors. Despite growing concerns, there is no validated instrument specifically designed to measure the digital stress experienced by mental health professionals. (2) Methods: This study involved the development and psychometric validation of the Digital Stress Scale (DSC). The process included item generation through a literature review and qualitative interviews, expert panel validation, and a two-phase statistical evaluation. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted on responses from 423 licensed mental health professionals using EHRs and digital communication tools. The scale’s reliability and convergent validity were assessed via internal consistency and correlations with established mental health measures. (3) Results: The final DSC included four subscales: digital fatigue, technostress, digital disengagement, and work–life digital boundaries. CFA supported the factor structure (CFI = 0.965, RMSEA = 0.038), and the overall reliability was acceptable (Cronbach’s Alpha = 0.87). Descriptive analysis showed moderate-to-high levels of digital stress (M = 11.94, SD = 2.72). Digital fatigue was the strongest predictor of total stress (β = 1.00, p < 0.001), followed by technostress and work–life boundary violations. All subscales were significantly correlated with burnout (r = 0.72), job dissatisfaction (r = −0.61), and perceived stress (r = 0.68), all with a p < 0.001. (4) Conclusions: The DSC is a valid and reliable tool for assessing digital stress among mental health professionals. Findings point out the urgent need for policy-level interventions to mitigate digital overload, promote healthy work–life boundaries, and enhance digital competency in mental health settings.

Background: Dehumanization refers to the tendency of individuals or groups to attribute fewer human characteristics to other individuals or groups (referred to as hetero-dehumanization) or to themselves (referred to as self-dehumanization). This phenomenon currently seems to predominate in the medical and nursing professions. Indeed, healthcare environments facilitate latent forms of dehumanization due to their structure, organization, and inherent professional demands. This study aimed to investigate the association between hetero- or self-dehumanization and personality traits of healthcare professionals, as well as the possible key mediating role of empathy in this relationship. Methods: A total of 1150 healthcare employees were recruited for the current study with a mean age of 45.13 years. Data were collected through a questionnaire completed by health professionals. Results: Statistically significant relationships were found between self- and hetero-dehumanization and most personality traits (extraversion, agreeableness, conscientiousness). A mediation analysis revealed that empathy mediates the effects of personality traits on hetero- and self-dehumanization. Conclusions: The present study addresses the vital role of personality traits of healthcare professionals on dehumanizing oneself or patients, offering insights into improving therapeutic relationships through the cultivation of empathy.

Chronic conditions such as cancer, heart disease, metabolic syndrome, liver disease, and renal failure significantly influence patients’ social, emotional, and functional well-being, in addition to their physical symptoms [...]

Background/Objectives: Vaccination hesitancy remains a global challenge, especially after the COVID-19 pandemic. We aimed to assess the prevalence of hesitancy towards regular COVID-19 vaccinations, including booster doses (additional doses beyond the primary to sustain or improve immunity), among university students and its associated factors. Methods: We conducted a cross-sectional study involving 190 university students from Hellenic Mediterranean University in Crete, Greece. Data were collected through an electronic survey distributed from July to October 2024. The survey included socio-demographic characteristics, health status factors, prior COVID-19 infection and vaccination history (general and for COVID-19), attitudes about COVID-19 vaccination, and the Attitude Towards Adult Vaccination (ATAVAC) scale. Qualitative data were also collected by addressing themes regarding ways to overcome vaccine hesitancy. Results: The study found that 64% of participants expressed hesitancy towards receiving COVID-19 booster doses. Factors contributing to this hesitancy were female gender, current smoking, pregnancy, concerns about vaccine side effects, a lack of confidence in vaccine efficacy, COVID-19 infection history, low perceived susceptibility to infection, and reliance on media information. Additionally, increased trust in the value of adult vaccination, adhering to recommendations of treating physician/scientist opinions, and prior adherence to vaccination were positively associated with regular COVID-19 vaccinations. A thematic analysis of the qualitative data identified four key strategies to overcome student vaccine hesitancy: enhancing health literacy, validating vaccine safety through further research, alleviating pandemic-related fears, and addressing distrust in authorities and opposition to mandatory vaccination. Conclusions: Our findings provide insights into the intricate factors and barriers of COVID-19 vaccination hesitancy among university students, thus emphasizing the need for more targeted interventions.

This study aimed to translate and validate the Genomic Nursing Concept Inventory (GNCI) in Greek, analyze the genomic knowledge of nurses in Crete, Greece, and explore potential factors that could affect it. This cross-sectional study included 324 nurses from public hospitals and primary care units between July and December 2022. The GNCI is a 31-item questionnaire that evaluates genomic nursing concepts, but it has not been translated and validated in Greek. The translation process included independent forward translations, reconciliation, and back-translation. To evaluate internal consistency, Cronbach’s alpha was used, and Confirmatory Factor Analysis (CFA) was conducted to determine the fit of the model. Multiple linear regression analysis was performed to examine the associations between the demographic variables and GNCI scores. The internal consistency of the GNCI was acceptable (Cronbach’s alpha= 0.622). The CFA indicated that the one-factor model had an adequate fit (SRMR = 0.076, CD = 0.677, CFI = 0.744). The mean GNCI score was moderate (0.35±0.14). Regression analysis suggested that only gender could affect GNCI scores, with female nurses scoring higher than male nurses (p>0.001). In conclusion, the Greek version of the GNCI is a reliable tool for assessing genomic knowledge among Greek nurses.

(1) Background: Nutrition is a critical aspect of health and well-being in the elderly population, as physiological changes associated with aging can impact nutrient utilization and dietary needs. The aim of this study was the assessment of nutritional screening and associated factors among community-dwelling elderly people. (2) Methods: This study is the first phase of an intervention trial of people aged 65 years and over who received primary health services and resided in the municipality of Archanes Asterousia in Crete, Greece. Nutritional risk was assessed using the Mini Nutritional Assessment. Diet-related factors were analyzed, including health status (oral hygiene, depression, cognitive decline, impaired functioning, quality of life), social factors (educational attainment, marital status, type of work before 60 years), and lifestyle factors (smoking, drinking, diet). (3) Results: A total of 730 elderly people were evaluated (males, 31.5%), with an average age (±SD) of 76.83 (±6.68) years. MNA was found to have a statistically significant connection with assessment of oral hygiene, mental state, Charlson comorbidity, functional independence (assessed with the Barthel scale), and quality of life. The exception was geriatric depression (GDS), with which no statistically significant association was found (p > 0.05). Nutritional risk analysis revealed 379 participants (51.9%) to be adequately nourished, 205 (28.1%) to be at risk of malnutrition, and 146 (20.0%) to be malnourished. (4) Conclusions: These results clearly demonstrated the key factors that contribute to the nutritional screening of elderly people and need to be addressed by health authorities and social services.

For several years, the global scientific community has accepted and recognized the importance of evidence-based practice for nursing science. The main factor for the implementation of evidence-based practice is the competence of undergraduate nursing students towards evidence-based practice, so that they as active nurses are ready for its application in their clinical practice, in order to provide better care for their patients. The aim of the present study is to examine the level of evidence-based practice competency evaluated with the self-reported Evidence-Based Practice Competence Questionnaire. It is important to mention that such a study has not been conducted on nursing students in Greece, but only on registered nurses. A quantitative study based on cross-sectional design was conducted from February to June 2022 in a convenience sample of Greek undergraduate nursing students. The SPSS 26.0 program was used to perform descriptive, bivariate, and multivariate analyses. A total of 175 undergraduate students participated at the Hellenic Mediterranean University Department of Nursing (Greece), specifically from the 2nd and 3rd academic years. The mean score of the Evidence-Based Practice Competence Questionnaire for nursing undergraduate students was 3.03 ± 0.26, indicating moderate evidence-based practice. Among the Evidence-Based Practice Competence Questionnaire dimensions, mean scores of 3.03 ± 0.32 for attitude toward evidence-based practice, 3.01 ± 0.49 for skills in evidence-based practice, and 3.03 ± 0.49 for knowledge in evidence-based practice were obtained. Significant differences among participants’ mean Evidence-Based Practice Competence Questionnaire scores regarding gender (p = 0.766), age (p = 0.400), academic year (p = 0.153), and training in the field of research methodology (p = 0.538) were not found. It appears that the level of readiness towards evidence-based practice is mediocre among undergraduate nursing students at a university in Greece. Therefore, it is necessary to carry out new studies in the future, so that there is a correct approach of all the elements that contribute to the readiness of nursing undergraduate students regarding evidence-based practice.

Background: Chronic diseases are major causes of morbidity, disability, and death worldwide. In many cases, they are potentially preventable and treatable. Glaucoma is one of the leading causes of morbidity and blindness, the early recognition of which can help reduce the adverse outcomes of the disease. Health illiteracy among these patients and the absence of self-management of these diseases are barriers to effective management worldwide. Therefore, the present study aimed to calculate the level of health literacy and activity level of patients’ activation in self-management and to explore the link between them among patients with glaucoma in outpatient clinics. Material and methods: Convenience sampling of patients with glaucoma attending the outpatient ophthalmology clinics of a university hospital in Heraklion-Greece was performed. Convenience sampling was used to recruit 312 participants. Data were collected between November 2023 and May 2024. The Patient Activation Measure-13 (PAM-13) questionnaire, in its Greek version, was used to evaluate patients’ activation level in self-management, whereas the Greek version of the European Health Literacy Survey Questionnaire 16 (HLS-EU-16) was used to assess health literacy. Results: Participants were classified as level 1(disengaged & overwhelmed) level in self-management (= 40.7, SD: ±29.9) and a sufficient health literacy level (= 10.7, SD ±3.7). However, there was no statistically significant relationship between health literacy levels and patient activation in self-management (p=0.602). Conclusions: Glaucoma patients experience challenges with health literacy and self-management activation, though there is no significant relationship between these two parameters. Multifaceted interventions seem essential for enhancing patients’ activation. Further research involving larger sample sizes, multi-center studies, and interventional design is needed.

(1) Background: Frailty in older adults is a condition that involves an interaction of psychological, biological, and social factors. This study aimed to assess the frailty status of older adults (65 years old and above) who receive home care services. Additionally, this work aimed to explore the key factors that have a statistically significant impact on the frailty of this vulnerable population. (2) Methods: This study represents the first phase of an intervention trial involving individuals aged 65 and over who received primary healthcare services and resided in the municipality of Archanes-Asterousia in Crete, Greece. Frailty was assessed using the SHARE-Frailty Instrument, while nutritional status was evaluated with the Mini Nutritional Assessment. Diet-related factors were analyzed, including health factors (oral hygiene, depression, cognitive decline, impaired functioning, quality of life), social factors (educational attainment, marital status, type of work before the age of 60), and lifestyle factors (smoking, alcohol consumption, diet). (3) Results: A total of 730 older adults were evaluated (31.5% male), with an average age (±SD) of 76.83 (±6.68) years. The frailty status analysis revealed 108 (14.8%) to be frail, 249 (34.1%) to be pre-frail, and 373 (51.1%) to be non-frail. Statistically significant associations were found between the MNA and Barthel scores (rs = 0.822, p < 0.001). Higher nutritional evaluations (MNA) were revealed in non-frail adults (mean (±SD); 26.97 ± 1.96) compared to pre-fail (mean (±SD); 19.37 ± 3.36) and frail adults (mean (±SD); 13.08 ± 3.16), as well as in pre-fail compared to frail adults (F = 1338.08, p < 0.001). Functional independence (Barthel) significantly differed with the frailty status of older adults (H = 521.98, p < 0.001; median for non-frail: 20.00, pre-fail: 19.00, frail adults: 15.00). (4) Conclusions: This study demonstrated that good nutritional status, good oral health, functional independence, and good quality of life are strongly correlated with lower frailty. Additionally, having chronic conditions is positively associated with one’s frailty status. Educational programs for both healthcare personnel and older adults are recommended.