Exploring the Role of Self-Efficacy in Maintaining Healthy Lifestyle Habits among Patients with Cardiometabolic Diseases; Findings from the Multi-Center IACT Cross-Sectional Study.

(1) Background: Cardiometabolic disease progression can be delayed if patients engage in healthy lifestyle behaviors, adherence to which is highly influenced by psychosocial factors. The present study aimed at investigating the association of self-efficacy with the adherence level to healthy lifestyle behaviors among patients with cardiometabolic diseases in Greece. (2) Methods: 1988 patients (1180 females) with cardiometabolic diseases participated. Anthropometric, demographic, socioeconomic, clinical, and lifestyle characteristics were recorded. Patients were also asked to evaluate their efficacy to comply with healthy lifestyle behaviors. (3) Results: The majority exhibited unhealthy lifestyle behaviors. A subgroup demonstrated elevated self-efficacy in maintaining healthy habits despite facing diverse psychosocial challenges. Individuals with higher educational attainment, socioeconomic status, and rural/semi-urban residency had significantly elevated self-efficacy. Those with heightened self-efficacy exhibited significantly lower BMI and reduced prevalence of certain health conditions. Self-efficacy significantly influenced adherence to the Mediterranean diet, physical activity engagement, and smoking cessation, even in challenging circumstances. (4) Conclusions: This study represented an innovative approach in examining the role of self-efficacy in shaping health behaviors and outcomes within a Greek population. By integrating specific psychosocial circumstances into the analysis, valuable insights were provided into the contextual factors influencing self-efficacy and adherence to healthy lifestyle behaviors.

Physicians' Words, Patients' Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study.

Background: Preventive cardiology aims to educate patients about risk factors and the importance of mitigating them through lifestyle adjustments and medications. However, long-term adherence to recommended interventions remains a significant challenge. This study explores how physician counselling contributes to successful behavior changes in various aspects of lifestyle. Methods: A cross-sectional study conducted in Greece in 2022-2023 included 1988 participants. Validated questionnaires assessed patients' characteristics, dietary habits, and lifestyle choices. Results: The findings revealed that patients who received lifestyle advice from physicians demonstrated increased compliance with the Mediterranean diet and a higher involvement in physical activity. Notably, they were also less likely to be non-smokers. Importantly, physicians' recommendations had a more pronounced association with adherence level to the Mediterranean diet compared to other lifestyle behaviors. Additionally, specific dietary components like cereal, legume, and red meat consumption were significantly associated with physicians' guidance. Conclusions: This study highlights the complex relationship between patients' cardiometabolic health, lifestyle decisions, and healthcare professionals' guidance. The substantial influence of physicians on Mediterranean diet adherence underscores the necessity for a multidisciplinary healthcare approach. Collaborative efforts involving physicians, dietitians, and fitness experts can offer comprehensive support to patients in navigating the intricate landscape of cardiometabolic health.

Exploring Patient Beliefs and Medication Adherence in the Mediterranean Context: A Cross-Sectional Study in Patients with Cardiovascular Diseases and Cardiometabolic Disorders in Greece-The IACT-Study.

BACKGROUND: Evidence has shown that poor adherence to vascular medications contributes to a considerable proportion of all cardiovascular disease (CVD) events and mortality. The aim of the present work was to examine patients' beliefs/views that affect their level of adherence to the assigned medical treatment in the context of a multi-center study in Greece. METHODS: Between July 2022 and April 2023, 1988 patients (1180 females) with established cardiovascular disease or relevant cardiometabolic disorders were chosen from seven medical centers in Greece. The 4-item Morisky Medication Adherence Questionnaire gauged medication adherence and investigated patients' beliefs/views regarding treatment. RESULTS: Among participants, 51.2% showed perfect medication adherence, contrasting with 48.8% displaying poor adherence. Patients with negative medication beliefs were around three times more likely to be non-adherent (OR = 2.73; 95% CI = 2.28-3.28). Non-adherers held concerns about drug efficacy (OR = 2.34; 95% CI = 1.10-4.97) and favored alternative therapies (OR = 2.25; 95% CI = 1.75-2.91). CONCLUSION: The findings highlight the significance of addressing patient beliefs/views to improve medication adherence. The distinct Mediterranean context, influenced by cultural, socioeconomic, and clinical factors, emphasizes the need for tailored interventions. This underscores the call for contextually sensitive strategies to boost medication adherence and improve health outcomes in this unique region.

Depression and Anxiety Mediate the Associations between Nutritional Status, Functional Capacity, and Quality of Life in Patients with Cancer.

Cancer patients are at risk of malnutrition, which influences their functional status, mental health (MH), and quality of life (QoL). This study aimed to examine the associations between nutritional status, functional capacity, and aspects of QoL in cancer patients, as well as the potential mediating role of depression and anxiety in these associations. Patients with various types of cancer (n = 152) were recruited from the Attikon University Hospital, Greece. Validated questionnaires were used to assess nutritional status (PG-SGA), QoL (SF-36 and EQ-5D-3L), functional capacity (ECOG), depression, and anxiety (HADS and BEDS). Handgrip strength (HGS) was also measured. Poor nutritional status was inversely associated with functional capacity, QoL, depression, and anxiety, after adjusting for confounding factors (all P ≤ 0.05). Mediation analysis indicated a significant indirect effect of nutritional status on various parameters of functional capacity and QoL through depression and anxiety, after adjusting for age and sex. Mediated proportion ranged from 26.3-34% to 23.1-82.8% for functional capacity and QoL, respectively. A significant proportion of the effect of nutritional status on QoL and functional capacity can be partly attributed to psychological effects, highlighting the significance of integrating all aforementioned aspects in the nutritional intervention for cancer patients.

Cardiometabolic Patient-Related Factors Influencing the Adherence to Lifestyle Changes and Overall Treatment: A Review of the Recent Literature.

It is well acknowledged that most of the modifiable risk factors for Cardiovascular Diseases (CVDs) can be averted through lifestyle modifications beyond medication adherence. This review aims to critically evaluate the cardiometabolic (CM) patient-related factors that influence the adherence to lifestyle changes studied alone and/or in combination with medication. A comprehensive literature search of PubMed articles from 2000 to 2023 retrieved 379 articles. After removing the articles which were not relevant, a total of 28 cross-sectional studies was chosen (12 qualitative, and 16 quantitative). The findings confirmed that five groups of factors influence patients' adherence to overall treatment: (1) health beliefs, knowledge, and perceptions regarding the risks and challenges of disease and medication intake along with adherence process perceptions; (2) self-concept; (3) emotions; (4) patient-healthcare providers relationship/communication and (5) social and cultural interactions. It is worth mentioning that cultural issues, such as culinary particularities, ethnic identity, social life as well as patients' skills and abilities, play a profound role in the effectiveness of the recommended lifestyle modifications beyond the aforementioned common factors. The need for clear-cut culturally adapted guidelines along with personalized advice from physicians is imperative as it could improve patients' self-efficacy. These socio-psychological factors should be seriously considered as a means to increase the effectiveness of future community prevention programs.

Children's conceptions of coronavirus.

The present study aimed to examine children's conceptions of coronavirus as denoted in their verbal descriptions and drawings and whether these vary as a function of children's age and the mode of expression. Data were collected in Greece during spring 2020 and 344 children aged 4 to 10 years were first asked to verbally describe coronavirus and then to produce a drawing of it. Content analysis of data revealed the following main themes: (a) Coronavirus, (b) Medical, (c) Psychological, and (d) Social. Results showed that children from an early age present a remarkable level of understanding of coronavirus and the COVID-19 disease as a multidimensional construct, which can be designated not only through characteristics of the Sars-Cov-2 but also through its medical, social, and psychological consequences on people's lives. Moreover, children were found to emphasize different aspects of this construct depending on their age and the mode of expression.

Do Preschoolers Recognize The Emotional Expressiveness of Colors in Realistic and Abstract Art Paintings?

The present study was designed to examine preschoolers' ability to recognize the emotional expressiveness of an art painting, through its colors. To attain this aim 78 children, 3-5 years old were presented with realistic and abstract paintings conveying either happiness or sadness and were asked to choose those which matched the appropriate emotion. In total 16 paintings were used, which varied in color, while their subject matter was held as constant as possible after they had been previously rated by a group of adults to ensure that they conveyed the two emotions under investigation. Results showed that children's ability to recognize the emotional expressiveness of a painting through its colors appears at 3 years old and increases significantly at 4 and 5 years old. It was also found that the mood of happiness was more easily recognized than that of sadness, while the style of art paintings (realistic vs. abstract) did not affect children's ability to recognize emotions.

Do patients with Alzheimer's disease draw like young children? An exploratory study.

BACKGROUND: Previous studies have shown that AD patients present a stepwise regression to their cognitive functioning from a mature adult to that of an infant. OBJECTIVES: The present study aimed to compare Alzheimer's disease (AD) patients' and 4-10 year old children's drawing performance, taking into account that drawing is currently considered as a cognitive process and that AD manifests a severe cognitive impairment. METHODS: The sample consisted of 10 AD patients and 10 adult controls, as well as of 40 children, divided into 4 age groups (4-, 6-, 8-, and 10-years old). Participants were asked to draw from memory (a) six simple objects, (b) a man, and (c) a tree behind a house. RESULTS: Analysis showed an improvement with age in children's drawing performance, while controls' drawing scores were similar to those obtained by older children. On the contrary, drawing performance of AD patients significantly decreased into levels under that of the 4-year old children in drawing errors, or under that of the 8-year old children in drawing a man task and partial occlusion task. CONCLUSIONS: The observed regression in AD patients' drawing performance is discussed in relation to the cognitive deficits accompanying the disease.

Exploring children's understanding of death: through drawings and the Death Concept Questionnaire.

To investigate whether children's understanding of the concept of death varies as a function of death experience and age, 52 children aged 7, 9, and 11 years (26 had a personal death experience), drew a picture reflecting the meaning of the word death and completed the Death Concept Questionnaire for examination of Human and Animal Death. The results showed that the 2 methodological tools used offered complementary information and that children's understanding of death is related both to age and past experience. Children with death experience seem to have a more realistic understanding of death than their inexperienced age-mates. As regards to the effect of age, our findings support the assumption that the different components of death develop through different processes.

Handedness and drawing: attempting to complete the picture: a comment on Bruckner, et al. (2011).

In a recent study, Bruckner, Kastner-Koller, Deimann, and Voracek (2011) investigated the relationship between hand preference and drawing during preschool years. The present study offers interpretations in a larger framework which could contribute to the better understanding of that relationship, and provides future directions in this area.

Left- and right-handed children's drawing performance: is there any difference?

The aim of the present study was to investigate the effect of hand preference on children's drawing development. An equal number of left- and right-handed children (N = 182), aged 7 to 12 years were asked to complete four different drawing tasks. During the drawing process, directionality of horizontal, vertical, and circular strokes as well as sequencing was recorded. Each drawing was scored according to the developmental stage to which is corresponded. It was found that drawing performance improved with age, irrespectively of hand preference and sex. In other words, left- and right-handers' drawing performance across the four tasks was not found to differ significantly. The only consistent difference between the two groups involved was in the production of horizontal lines. The results are discussed in terms of implications for questions about the lack of differences in left- and right-handed children's drawing performance.

Graphic indicators of pedagogic style in Greek children's drawings.

311 Greek children's drawings of classroom life were employed to investigate the diagnostic validity of this measure in identifying teachers' pedagogic style. The sample was divided into three age groups, 6-, 8-, and 10-yr. olds, who were asked to draw pictures of themselves and their teachers in their classroom. Drawings were scored using as criteria the four graphic indicators (ratings of size, detailing, centrality, and social distance) proposed by Aronsson and Anderson in 1996. Analysis showed three out of the four indicators discriminated teacher-centered vs student-centered pedagogic style. More specifically, in the teacher-centered setting children drew the teacher of dominant size, in a central position, and as remote, while in the student-centered setting the teacher was depicted closer to the student, in a less central position, and less emphasized relative to the student. The findings are discussed with respect to the absence of age-related effects and the possibility of using children's drawings of classroom life as a measure for tapping into children's representations of pedagogic style.