Is there a Relation between Depression and Anxiety to Clinical Characteristics among Patients with T2D in Greece?

BACKGROUND: Diabetes is a chronic disease that may be related to various periods of an individual's life. AIM: The aim of the present study is the investigation of the existence of depression and anxiety among patients suffering from type 2 diabetes as well as the factors that influence these variables (depression and anxiety). MATERIALS AND METHODS: The Hospital Anxiety and Depression Scale (HADS) for mental health assessment was used in the context of the collection of the research data. The study involved 100 patients (42 men and 58 women) with an average age of 63.72 ± 9.84 years of life. RESULT: The results showed that there was a positive correlation between HbA1c value and anxiety as well as HADS questionnaire total score, and a positive correlation between blood glucose value and anxiety as well as HADS questionnaire total score. CONCLUSION: Both depression and anxiety of these patients are influenced by different clinical factors.

The Psychological Burden of Families with Diabetic Children: A Literature Review Focusing on Quality of Life and Stress.

Chronic diseases, such as childhood diabetes mellitus (DM), are a complex and continuous struggle as well as a great challenge both for the children who face the disease and for their parents. DM is characterized by the complex management of therapeutic treatments, thus causing physical and psychological complications infamily members. There are many families who, upon hearing the diagnosis of their child with DM, stand still in front of these new facts as their lives change. All these unprecedented conditions cause parents intense stress and discomfort, leading them to a mental burden, as the only thing that concerns them upon diagnosis is how the family will survive in the face of the current conditions they are experiencing as well as the future of the sick child. The purpose of this brief literature review is to present the research findings related to the psychological burden of families withchildren with DM, focusing on the quality of life and stress.

Physical Disease: A Crucial Research Area in the Context of Quality of Life and Mental Health.

The medical literature defines a chronic physical disease as any organic disorder that lasts more than three months or that entails a period of hospitalization of more than of a month, which restricts an individual's daily abilities or behaviors and causes changes to their social functions [...].

Cyberbullying and Obesity in Adolescents: Prevalence and Associations in Seven European Countries of the EU NET ADB Survey.

BACKGROUND: overweight and obese individuals may often face aggressive messages or comments on the internet. This study attempts to evaluate the association between cyberbullying victimization and overweight/obesity in adolescents participating in the European Network for Addictive Behavior (EU NET ADB) survey. METHODS: a school-based cross-sectional study of adolescents aged 14-17.9 years was conducted (n = 8785) within the EU NET ADB survey, including data from seven European countries (Germany, Greece, Iceland, the Netherlands, Romania, Poland, Spain). Complex samples and univariate and multivariate logistic regression analyses were performed. RESULTS: overall, overweight adolescents were more likely to have been cyberbullied compared to their normal weight peers (adjusted OR (Odds ratio) = 1.20, CI (confidence intervals): 1.01-1.42); this association was pronounced in Germany (adjusted OR = 1.58, CI: 1.11-2.25). In Iceland, obese adolescents reported cyberbullying victimization more frequently compared to their normal weight peers (adjusted OR = 2.87, 95% CI: 1.00-8.19). No significant associations with cyberbullying victimization were identified either for obese or overweight adolescents in Greece, Spain, Romania, Poland, and the Netherlands. CONCLUSIONS: this study reveals an overall association between cyberbullying victimization and overweight on the basis of a sizable, representative sample of adolescent population from seven European countries. Country-specific differences might reflect differential behavioral perceptions, but also normalization aspects.

Patient Knowledge, Adherence to the Therapeutic Regimen, and Quality of Life in Hemodialysis : Knowledge, Adherence, and Quality of Life in Hemodialysis.

The aim of this study was to investigate the effect of patients' knowledge on adherence to the hemodialysis regimen and Quality of Life (QoL) of patients undergoing hemodialysis as well as the effect of adherence on QoL. Also, the effect of demographic and clinical characteristics on the above three variables was studied. In this cross-sectional study conducted between March and May 2017, 321 patients on hemodialysis from six hemodialysis units completed the Kidney Disease Questionnaire, the GR-Simplified Medication Adherence Questionnaire and the Missoula Vitas Quality of Life Index-15 to measure the patient knowledge, the adherence to hemodialysis regimen, and the QoL, respectively. The statistical analysis was performed via the Statistical Program SPSS 19.0. The statistical significance level was set up at 0.05. The knowledge was independently associated with the overall QoL and its dimension-transcendence-with total adherence and its dimension-diet/fluid adherence. The total adherence was independently associated with overall QoL and its dimensions-symptoms and interpersonal. The educational level, the type of vascular access, and the daily number of pills were independently associated with the total adherence and the overall QoL. Patient knowledge may have an important effect on adherence and QoL. Adherence may have an important effect on QoL. Demographic and clinical characteristics play, also, a crucial role in the above variables. The findings can help nephrology nurses to quantify the extent of non-adherence in hemodialysis and poor quality of life.

The Effect of Fatigue and Pain Self- Efficacy on Health-Related Quality of Life Among Patients with Multiple Sclerosis.

INTRODUCTION: Health-related quality of life is a major issue among patients with Multiple sclerosis (MS). AIM: To explore the effect of fatigue and pain self-efficacy on health-related quality of life among patients with MS. METHODS: Between March and May 2018, 85 MS patients from a large Hospital of Athens region completed the questionnaires: a) Missoula-VITAS Quality of Life Index-15, which examines 5 dimensions of quality of life, b) Pain Self Efficacy Questionnaire which measures the pain self-efficacy that an individual perceives, c) Fatigue Assessment Scale (FAS) which measures fatigue, d) a questionnaire about the sociodemographic elements. Statistical analysis was performed using the IBM SPSS Statistics version 21. The significance level was set up to 0.001. RESULTS: Fatigue might predict the dimension of quality of life "Function" while Pain Self-Efficacy might, also, predict the dimension of quality of life "Interpersonal". A strong correlation was found between the dimensions of quality of life "Well-being" and "Transcendent" and between "Interpersonal" and Pain Self-Efficacy. The total score of fatigue was strongly correlated with Physical Fatigue and very strongly correlated with Mental Fatigue. CONCLUSION: Fatigue and Pain Self-Efficacy are important predictors of the dimensions of quality of life among patients with MS. Pain in MS has to be taken into serious consideration in every patient with MS.

Are Burnout Syndrome and Depression Predictors for Aggressive Behavior Among Mental Health Care Professionals?

AIM: This study aims to examine the possible relation between depression and burnout as predictors to aggressive behaviors among mental healthcare professionals. METHODS: For the purposes of this study 72 mental health care professionals were recruited and were evaluated in three questionnaires which were provided to them online. Firstly regarding depression, the Center for Epidemiologic Studies Depression Scale (CES-D) was administered, secondly, concerning burnout, Maslach Burnout Inventory (MBI) was applied and finally, regarding aggression, the Aggression Questionnaire (GAQ) was employed. Statistical data analysis was performed using the IBM SPSS Statistics Version 19. The level of statistical significance was set at up at 0.05. RESULTS: The results showed that depression is considered to be a statistically significant predictor of aggressive behaviors. However, burnout was not found to be a statistically significant predictor of aggression. In addition, a statistically significant relationship was found between burnout and depression. CONCLUSIONS: It seems to be of essential importance for mental healthcare professionals to be provided with support and assistance in order to diminish the potential high-stress levels and in that way to overcome depression and burnout of those who work in mental health settings.

Mental health, loneliness, and illness perception outcomes in quality of life among young breast cancer patients after mastectomy: the role of breast reconstruction.

PURPOSE: Το explore the relationship between mental health (depression, anxiety, and stress), loneliness, and illness perception with health-related quality of life (HRQoL) in young breast cancer patients, within a year after mastectomy, and to investigate the role of breast reconstruction. METHODS: Eighty-one women with stage II breast cancer-35 with breast reconstruction and 46 without breast reconstruction-completed the Missoula-VITAS Quality of Life Index-15, the Depression Anxiety Stress Scale 21, the UCLA Loneliness Scale, the Brief Illness Perception Questionnaire, and a questionnaire with demographic and medical information. Statistical analysis was performed using IBM SPSS Statistics version 20. RESULTS: Breast reconstruction was a significant predictor of total HRQoL and its domains. Women with breast reconstruction had better HRQoL, significantly better mental health, less stress and anxiety levels but experienced more physical discomfort and perceived higher level of physical distress compared to the ones without breast reconstruction. On the contrary, patients without breast reconstruction had higher level of loneliness, which was found to be correlated with poor HRQoL and higher levels of anxiety. Negative illness perceptions were associated with poor HRQoL for both groups. CONCLUSIONS: Breast reconstruction is not a panacea for patients in improving HRQoL.

Effect of anxiety and depression on the fatigue of patients with a permanent pacemaker.

INTRODUCTION: Permanent cardiac pacemakers (PPM) are the most common treatment for severe symptomatic bradycardia. This implanted life-saving device may involve a severe psychological burden to recipients or aggravate their symptoms such as fatigue. The aim of the study was to explore the effect of anxiety and depression on fatigue of patients' with a PPM. MATERIAL AND METHODS: The study group consisted of 250 patients with a PPM. Data collected included: a) patients' characteristics, b) the Hospital Anxiety and Depression Scale (HADS) and c) the Fatigue Assessment Scale (FAS). RESULTS: High levels of anxiety and depression were observed in 27.2% and 14.0% of the sample, respectively. Regarding the fatigue total score it was found that 25% of the participants had a score higher than 26. Accordingly, with regard to physical and mental fatigue, 25% of enrolled patients had a score higher than 20 and 8, respectively. These values indicate moderate to low levels of fatigue. Furthermore, there was a statistically significant association between anxiety/depression and the total score of fatigue as well as between anxiety/depression and physical and mental fatigue (p < 0.001 for all associations). CONCLUSIONS: Socio-demographic and patients' clinical characteristics are related to anxiety and depression. Understanding the association between psychological burden and fatigue after implantation as well as factors associated with these variables will help health professionals to provide beneficial care for PPM patients that will significantly contribute to better device outcomes.

Association of Type 1 Diabetes, Social Support, Illness and Treatment Perception with Health Related Quality of Life.

This study examines the importance of perceived social support, perception of illness and treatment on health related quality of life (HRQOL) in patients with type 1 diabetes. The purpose was to assess how type 1 diabetes, perceived social support, perception of the illness and treatment can be predictors of health related quality of life and how these factors associate. Additional purpose was to establish the reliability of Illness Index and Treatment Index among Greek population. Four questionnaires were used, the Missoula-VITAS Quality of Life Index-15 (MVQoLI-15), the Multidimensional Scale of Perceived Social Support (MSPSS), the Illness Index, and the Treatment Index. Participants were type 1 diabetics. The sample consists of 60 volunteers, 19 males and 41 females. All participants were Greeks. There was a correlation between variables of social support, treatment and illness index and the variables of HRQOL. Several domains of social support, the illness and treatment perception, are statistically significant predictors of the total HRQOL. Treatment and Illness Scales were found highly reliable among Greek population (20 items; α = 0.93). Results suggest that social support interacts with relationships, spirituality and the total QOL. Family interacts with spirituality and total QOL. This study indicates friends as the most important and positive factor towards most of the HR-QOL's subsections. Findings support that perception of the condition (II) and perception of the treatment (TI) are predictors of HRQOL. This study aims to establish the reliability of Illness and Treatment Index among Greek population.

Fatigue in Arthritis: A Multidimensional Phenomenon with Impact on Quality of Life : Fatigue and Quality of Life in Arthritis.

An important factor which influences the quality of life of patients with arthritis is the fatigue they experience. The purpose of this study was to assess the relationship between fatigue and quality of life among patients with osteoarthritis and rheumatoid arthritis. Between January 2015 and March 2015, 179 patients with osteoarthritis and rheumatoid arthritis completed the Fatigue Assessment Scale and the Missoula-VITAS Quality of Life Index-15 (MVQoLI-15). The study was conducted in Rehabilitation Centers located in the area of Peloponnese, Greece. Data related to sociodemographic characteristics and their individual medical histories were recorded. Statistical analysis was performed using the IBM SPSS Statistics version 19. The analysis did not reveal statistically significant correlation between fatigue and quality of life neither in the total sample nor among patients with osteoarthritis (r = -0.159; p = 0.126) or rheumatoid arthritis. However, there was a statistically significant relationship between some aspects of fatigue and dimensions of quality of life. Osteoarthritis patients had statistically significant lower MVQoLI-15 score than rheumatoid arthritis patients (13.73 ± 1.811 vs 14.61 ± 1.734) and lower FAS score than rheumatoid patients (26.14 ± 3.668 vs 29.94 ± 3.377) (p-value < 0.001). The finding that different aspects of fatigue may affect dimensions of quality of life may help health care professionals by proposing the early treatment of fatigue in order to gain benefits for quality of life.

A Modified Version of the Greek Simplified Medication Adherence Questionnaire for Hemodialysis Patients.

Non-adherence to the therapeutic regimen is an increasingly growing problem especially among patients undergoing hemodialysis. The aim of this study was to modify the Greek version of Simplified Medication Adherence Questionnaire (GR-SMAQ) for patients undergoing hemodialysis (GR-SMAQ-HD) and explore its validity and reliability. Between June 2016 and November 2016 a group of patients undergoing hemodialysis (N=107) completed the Greek version of SMAQ. The study was carried out in three Dialysis Units of Hospitals of Athens and Peloponnese region, Greece. The form of GR-SMAQ was modified specifically for renal patients while four additional items were added so as the tool study all aspects of adherence to hemodialysis regimen. Construct validity was checked through exploratory factor analysis with principal Component Analysis with the Equamax method. Test-retest reliability and internal consistency were tested. Statistical analysis was performed using the IBM SPSS Statistics version 21. The significance level was set up at 5%. The Greek version of SMAQ for patients undergoing hemodialysis includes eight questions. Three factors emerged from factor analysis. Cronbach's a coefficient was 0.742 for the whole scale and for each subscale was for Medication Adherence 0.75, for Attendance at hemodialysis session 0.856 and for Diet/Fluid restriction was 0.717. The total mean score was 6.29 (±1.82). GR-SMAQ-HD is a reliable and valuable tool that can be used by hemodialysis nurses and students of nursing for detection of adherence levels in clinical practice.

Factors Associated with the Social Support of Hemodialysis Patients.

BACKGROUND: Support has been gradually acknowledged as a significant factor that exerts a positive influence on hemodialysis patients' lives as well as on the outcome of the disease. The purpose was to explore factors associated with social support of hemodialysis patients. METHODS: The sample studied consisted of 258 patients undergoing hemodialysis in public hospitals in Athens, Greece during 2015. Data collection was performed by the method of the interview using a specially designed questionnaire, which included the Multidimensional Scale of Perceived Social Support for the assessment of social support from significant others, family and friends as well as patients' socio-demographic, clinical and other characteristics. RESULTS: Of the 258 participants, 53.9% were male and 65% were over 60 yr. Regard to social support, patients felt highly supported by their significant others and their family (median 6 for both subscales) and less by their friends (median 4.5 neutral support levels). In terms of patients' characteristics, statistically significant association of support from significant others and family was observed with marital status (P<0.001 and P<0.001 respectively), place of residence (P<0.001 and P<0.001 respectively) and the number of children (P=0.002 and P=0.007 respectively). Furthermore, statistically significant association of support from friends was observed with age (P <0.001), marital status (P=0.002), and place of residence (P=0.017). CONCLUSION: Socio-demographic, clinical characteristics and patients' perceptions are associated with perceived Social Support. Provision of holistic individualized care to hemodialysis patients demands assessment of social support in the daily clinical practice.

The Impact of Anxiety and Depression on the Quality of Life of Hemodialysis Patients.

PURPOSE: This study was to explore the impact of anxiety and depression on the quality of life of hemodialysis patients. MATERIAL & METHODS: The sample studied consisted of 395 hemodialysis patients. Data was collected by the completion of a specially designed questionnaire for the needs of the present study which apart from socio-demographic and clinical, it also included HADS scale to assess the level of anxiety and depression as well as the scale Missoula-VITAS Quality of Life Index (MVQOLI) to assess patients' quality of life. RESULTS: The results of this study showed that 47.8% had high anxiety levels and 38.2% had high levels of depression. The average total score of quality of life was found to be 17.14. It was also shown that the total score of quality of life presented statistically significant association with family status (p=0.007), educational level (p<0.001), the number of children (p=0.001), patients' adherence to doctors' orders (p=0.003) and proposed diet (p=0.002) and the relations of patients with healthcare professionals and the other patients (p<0.001). The multiple linear regression showed that the overall quality of life score was statistically associated with the levels of depression after adjusted for possible confounders. More specifically, it was found that total score of quality of life was 2.5 and 4.4 points lower for patients with moderate and high levels of depression, respectively, compared to patients with low levels of depression (p<0.001). CONCLUSIONS: Evaluation of anxiety and depression in conjunction with quality of life in hemodialysis patients should be an integral part of the therapeutic regimen.

Management of Pain and Quality of Life in Patients with Chronic Kidney Disease Undergoing Hemodialysis.

An important dimension that influences the quality of life of hemodialysis patients is the pain they experience. Quality of life and self-efficacy in pain can play an important role in chronic kidney disease and treatment outcomes. The purpose of the study was to examine self-efficacy in pain and quality of life among patients with end stage renal disease undergoing hemodialysis. Between April 2013 and June 2013, 224 hemodialysis patients completed the Missoula-VITAS Quality of Life Index-15 and the Pain Self-Efficacy Questionnaire. The study was conducted in four dialysis units in hospitals of the Peloponnese region. Sociodemographic data of patients and their individual medical history were recorded. Statistical analysis was performed using SPSS version 19. The more effective the self-efficacy in pain, the lower the quality of life enjoyed by hemodialysis patients. The majority of respondents described the overall quality of life as "moderate," while the self-efficacy in pain depended on comorbidity or complications that accompany the process of hemodialysis. The findings of this study can be used in the development and improvement of health services for the management of patients. Healthcare professionals should understand the concerns and treat the symptoms of patients that affect quality of life, providing thereby holistic health care.

The Impact of Kt/V Urea-Based Dialysis Adequacy on Quality of Life and Adherence in Haemodialysis Patients: A Cross-Sectional Study in Greece.

There is clear evidence of a link between dialysis adequacy (as measured by urea kinetic modeling or urea reduction ratio) and such important clinical outcomes as morbidity and mortality. Evidence regarding the relationship between dialysis adequacy and quality of life (QOL) outcomes as well as adherence is less clear. The present paper is a study protocol which is planning to answer the following research question: what is the impact of dialysis adequacy on QOL and adherence in a sample of hemodialysis patients? The final sample size will be around 100 patients undergoing hemodialysis. Each subject's QOL and adherence will be measured using the following instruments: i) the Missoula-VITAS quality of life index 25; ii) the multidimensional scale of perceived social support and iii) the simplified medication adherence questionnaire. Dialysis adequacy is expected to be related to QOL and adherence scores.

Translation and Cultural Adaptation of the Multidimensional Scale of Perceived Social Support for Greece.

Recently, there is a surge of interest in the use of the Multidimensional Scale of Perceived Social Support (MSPSS) to measure perceived social support across cultures. The objective of this study was to translate and make the cultural adaptation of the Greek version of the MSPSS. The study counted with a sample of 10 patients diagnosed with multiple sclerosis. The process involved the following steps of translation back translation and semantic evaluation. The former revealed good acceptance of the translated version of the instrument, which participants considered having items of easy understanding. After completing the process of validation in the country, the instrument will become available to Greek researchers to measure social support, as well as to compare results from Greece to that of other cultures in which the instrument has already been validated.

Perception of Pain Self-efficacy and Fatigue in Greek Patients with Multiple Sclerosis: A Study Protocol.

The examination of the perception of pain and fatigue in patients with various health problems has received increased research attention in recent years. The aim of the present study protocol is to examine levels of pain self-efficacy and fatigue in a sample of Greek patients suffering from multiple sclerosis. The association of years and severity of diagnosis with the perception of pain self-efficacy and fatigue will be also investigated. Forty patients from the 3(nd) Neurological Department, Aristotle University of Thessaloniki (Greece) will participate in this study. The measurement tools include i) the Fatigue Assessment Scale, ii) the Pain Self Efficacy Questionnaire and iii) the Expanded Disability Status Scale. Test-retest reliability of the first two questionnaires will be assessed with the same patients rating their situation in a 10 days interval from the first examination in order to examine consistency over time.

Improvement of Diabetic Patients Nursing Care by the Development of Educational Programs.

Diabetes is a major health problem with many social and economic consequences in general population. The importance of education in the diabetic patient and his family, led to the development of diabetes clinical nurse specialist. The role of diabetes clinical nurse specialist is essential and crucial to the hospitals and the community, in order to form a relationship with the diabetic patient and his/her family. In this way health is promoted to the maximum extent possible. In conclusion educational programs help patients with diabetes to obtain information about their condition and improve their self-care skills.