Coping Strategies in Greek Parents of Children with Cancer

INTRODUCTION

Childhood cancer is a life-threatening, chronic condition and treatment may extent for several years. The diagnosis of cancer in children could stress intensely their parents.

AIM

To explore coping strategies utilized by Greek parents who have children with cancer.

MATERIAL AND METHODS

Eighty-five parents of children with cancer, admitted for treatment at the in-patient unit of a Paediatric Hospital in Athens completed a questionnaire with demographic and their children's disease related characteristics and the Family Crisis Oriented Personal Evaluation Scale.

RESULTS

Sixty mothers (70.6%) and 25 fathers (29.4%) completed the questionnaire. A percentage of 29.4% of the parents included in this study considered themselves anxious. Elementary or secondary school graduates scored higher in Seeking Spiritual Support (p = 0.013). Stay-at-home or unemployed parents scored lower in the subscale of Passive Appraisal (p = 0.012). Parents who were very well informed tended to exhibit more frequently passive appraisal behavior (p = 0.004). Parents whose child had Hodgkin's lymphoma scored higher in the subscale of Acquiring Social Support (p = 0.034). Statistical significance was found between parent's strategies of Seeking Spiritual Support and the gender (girls) (p = 0.036), as well as the treatment problems (p = 0.008) of hospitalized children.

CONCLUSIONS

This study may help health professionals understand Greek families' coping strategies when they have a child with cancer. Appropriate knowledge could significantly help them in the field of planning and implementation of personalized care in order to achieve optimal therapeutic outcomes.

Anxiety and Depression in Parents of Children Undergoing Hematopoietic Stem Cell Transplant (HSCT)

Hematopoietic stem cell transplantation (HSCT) is a well-established therapy tool for several malignant and non-malignant diseases. Parents of children undergoing HSCT experience physiological distress for various reasons such as intensive caregiving, potential complications, and medically intensive process. The purpose of this study was to explore anxiety/depression in parents of children who underwent HSCT and the associated self-reported characteristics.

METHOD AND MATERIAL

In the present study were enrolled 100 parents of children who underwent HSCT. Data were collected by the completion of the "Hospital Anxiety and Depression Scale (HADs)," which also included parents' characteristics. The statistical significance level was p < 0.05.

RESULTS

Of the 100 participants, 81% and 64% of parents experienced anxiety and depression, respectively, based on HADs scores. A statistically significant association was observed between parental anxiety and gender (p = 0.017), frequency of visiting the hospitalized child (p = 0.023), whether they desired family members to remain in hospital (p = 0.033), as well as with the need for participation in daily care (p = 0.023), for help based on personal needs (p = 0.026), for scheduled meetings with parents having same problems (p = 0.006), for contact with hospital after discharge (p = 0.035), and for written information (p = 0.044). In terms of depression, a statistically significant association was observed with difficulties during the hospital stay (p = 0.034), whether they desired other family members to remain in hospital (p = 0.009), as well as with the need for opportunities or time for questions (p = 0.004), for scheduled meetings with parents having the same problems (p = 0.026), and for contact with hospital after discharge (p = 0.038).

CONCLUSION

Anxiety and depression were associated with possibility of family members to remain in the hospital as well as with the need for scheduled meetings with parents having the same problems and for contact after hospital discharge. Based on the findings presented, it is suggested that understanding parents' needs and perceptions is fundamental to the development of appropriate interventions that address their worries.

Health Belief Model (HBM) and vaccination during pandemics

Introduction

With the COVID-19 pandemic recognized as a major threat to human health, promoting vaccination is of paramount importance to public health.

Objectives

To examine the association between factors of the Health Belief Model (HBM) and intentions to be vaccinated against COVID-19, when a vaccine becomes available.

Methods

A literature review has been made through PubMed database.

Results

The HBM dimensions “perceived barriers”, “perceived benefits” and “perceived severity” were considered to be significant predictors of acceptance of vaccinations. The HBM constructs of cues to action (trust in third-party information sources), perceived severity of and susceptibility to COVID-19, and beliefs about the protection benefits of a COVID-19 vaccine, subsequently may elicit willingness to vaccinate. Individual predictors of vaccination were believing the vaccine is effective at preventing COVID-19, recalling their doctor recommending the vaccine. Common perceived barriers against vaccination included believing the vaccine could give people the virus, believing the vaccine can make individuals ill afterwards and preferring to develop immunity “naturally”. Patients who delayed and refused vaccine doses were more likely to have vaccine safety concerns and perceive fewer benefits associated with vaccines.

Conclusions

HBM is an effective tool for identifying facilitators and barriers to health behaviors. Health promotion should make use of the HBM, as the model provides a theoretically understanding of the dynamics that may enable the success of important health-related policy in the wake of COVID-19 and future pandemics and identifies the communication mechanisms that must be leveraged by governments and authorities in enforcing policy.

Disclosure

No significant relationships.

Psychological determinants associated with vaccination intentions acceptance during pandemic events

Introduction

Psychological factors, like general self-efficacy, optimism or subjective well-being, might further enhance the understanding of why certain people vaccinate while others do not.

Objectives

To identify psychological factors associated with people’s decision to vaccinate during pandemic events.

Methods

A literature review has been made through PubMed database.

Results

Psychology offers three general propositions for understanding and intervening to increase uptake where vaccines are available and affordable. The first proposition is that thoughts and feelings can motivate getting vaccinated. Low confidence in vaccine effectiveness and concern about safety correlate reliably with not getting vaccinated. The second proposition is that social processes can motivate getting vaccinated. Social norms are associated with vaccination. Recommendation by friends, mainstream media and social media affected vaccination intention. The third proposition is that interventions can facilitate vaccination directly by leveraging, but not trying to change, what people think and feel. To increase vaccine uptake, these interventions build on existing favorable intentions by facilitating action (through reminders, prompts, and primes) and reducing barriers (through logistics and healthy defaults); these interventions also shape behavior (through incentives, sanctions, and requirements). Perceived risk and effectiveness of the vaccine as well as trust in the government and health authorities was related to people’s vaccination intention.

Conclusions

There are significant associations of general individual psychological constructs with the decision to vaccinate. This may provide useful frameworks for understanding the causal mechanisms behind this relationship, which could help to develop intervention strategies to effectively promote vaccination intentions that increase vaccination rates among population.

Disclosure

No significant relationships.

Accessibility of migrants to mental health services

Introduction

Cultural barriers and prejudices of mental healthcare professionals may promote inequalities in the provision of care to immigrant population and have a negative impact in provided service quality.

Objectives

To identify barriers and facilitators of immigrants’ accessibility to mental health services.

Methods

A literature review has been made through PubMed database.

Results

Immigrants’ accessibility to mental health services may be related to social insurance problems, inadequate knowledge about their health rights, inadequate knowledge of the local language, as well as the bureaucracy of Greek State which may complicate mental health examination and treatment. The challenges faced by mental healthcare professionals in terms of diagnosis and treatment of migrants include communication difficulties due to linguistic and cultural differences as far as verbal presentation of symptoms and illness behavior is concerned. Culturally competent mental health professionals should work to erase racism and prejudice, to be familiar with cultural issues and have adequate knowledge related to cultural groups, to learn the life story of each patient separately and encourage patients to explain how their illness affects their lives, promoting a trustful communication environment in the context of healthcare provision.

Conclusions

Exploring the specific needs of migrants as well as assessing the degree of satisfaction from their access to healthcare services are essential to providing integrated mental health care for people from different culture.

Disclosure

No significant relationships.

Migrants in Greece and mental health issues

Introduction

Migration is a difficult and painful process for individuals, since they could no longer rely on the supportive structures of their own country that would help them develop resilience and mental well-being, on the one hand and, on the other hand, they may be obliged to find a new identity and adapt to a new social context.

Objectives

To identify mental health issues in migrants in Greece.

Methods

A literature review has been made through PubMed database.

Results

First-generation immigrants exhibited an increased risk of poor mental health including increased levels of depression, post-traumatic disorder and anxiety compared to local population. When immigrants come to a new country, they often experience culture shock, significantly influencing their mental health. The term “culture shock” describes feelings of weakness and a state of disorientation of individuals living in a new environment as well as the difficulties they face in the process of their adapting to the new conditions. Individuals lack a social supportive environment while experiencing lack of acceptance, as well as social discrimination, economic exploitation and racism by local society. Additionally, their cultural background can influence and differentiate the way they perceive, react and cope stressful conditions.

Conclusions

For the smooth completion of the cultural process, mutual adaption to the new conditions of both migrants and host society is needed, focusing on the understanding of different cultural heritage, as well as on the respect and recognition of rights of both sides.

Disclosure

No significant relationships.

Cultural competence of mental health professionals

Introduction

Societies nowadays, including Greece, are usually multicultural. Health professionals should therefore be properly trained to consider patients’ beliefs, attitudes and particular needs depending on their different cultural background.

Objectives

To identify the features that the culturally competent professional should have in order to understand better the nature of cultural competence and its importance to mental health professionals in early intervention of immigrants’ mental health problems.

Methods

A literature review has been made through PubMed database.

Results

The development of cultural competence is a continuous process. Culturally competent professionals should have the following features: a) Understand the concept of culture and the way individuals’ cultural background affect their feelings and their intercultural interactions. b) Choose appropriate collaboration strategies with people from different cultural backgrounds. c) Accept diversity and respect patients’ differences, demands and choices without criticism while providing them the proper care. d) Be fair and take care of all patients without any distinction regardless of the language they speak. e) Familiarize themselves with issues related to mental health and illness and encourage patients to explain how their illness affects their lives. Culturally competent mental healthcare professionals should seek more than the provision of caring without prejudice. They should respect the positive contribution of cultural origin and identity to people’s well-being, learn their life stories and develop a relationship of trust with each patient separately.

Conclusions

Cultural competence might help mental health professionals to understand and provide adequate services with respect to patients who come from a different cultural background.

Disclosure

No significant relationships.

Anxiety and depression in primary care patients suffering of rheumatoid diseases

Rheumatic diseases are chronic debilitating conditions with a known association with anxiety and depression. Individuals with rheumatic diseases experience more psychological distress as these conditions mostly follows a painful, progressively disabling course. The aim of this study was to assess the levels and explore factors associated with anxiety and depression experienced by Greek patients with rheumatic diseases. The sample consisted of 108 patients with rheumatic diseases who visited a rheumatology outpatient clinic. Data collection was conducted using a questionnaire which included patients' characteristics and the Zung Self-Rating Depression Scale (SDS) and Anxiety Scale (SAS). Of the 108 patients in the current study, 44.6% and 41.5% were assessed with depression and anxiety, respectively. Among patients exhibiting depression, 13% had severe depression, with the rest having moderate (12%) and mild (19.6%) severity of depression. Among patients exhibiting anxiety, the majority (20.2%) exhibited mild anxiety, whereas 17% of patients exhibited moderate and 4.3% severe anxiety. Higher levels of depression were experienced by those who experienced severe pain (p=0.001), those who were relapsed (p=0.008), those who had quitted their job due to health limitations (p=0.021), those who had the experience of a miscarriage (p=0.021) and those who used antidepressant or antianxiety medication (p<0.001). Higher levels of anxiety were experienced by female (p=0.011), the unemployed (p=0.047), those who experienced severe pain (p<0.001), those who were relapsed (p=0.015) and those who used antidepressant or antianxiety medication (p<0.001). Individuals with rheumatic diseases should be monitored for accompanying anxiety or depression during follow-up. Given their high prevalence, their profound impact on quality of life, and the range of effective treatments available, health care providers should be encouraged to screen all patients for both anxiety and depression. It is important to assess patients' characteristics when implementing strategies to confront with psychiatric disorders in this vulnerable population group.

Professional satisfaction of nurses in psychosocial rehabilitation services

Introduction

The increase of job satisfaction in mental health nurses, working in community mental facilities, helps them to become more efficient and understand the needs of individuals suffering from mental health problems.

Objectives

To investigate sociodemographic and job characteristics, as well as the level of professional satisfaction of nurses working in psychosocial rehabilitation facilities of the psychiatric hospital of Athens, named Dafni.

Methods

220 nurses, working in the field of psychosocial rehabilitation completed (a) a sociodemographic questionnaire, (b) Spectοr’s Job Satisfaction Survey (JSS).

Results

Nursing staff consists of mental health nurses (44.1%) and nursing assistants (55.9%) in the present study. 90% of the participants were female; while the 65% were married, the 19.5% had a university-level education and the 25% had administrative responsibilities. The 44.1% of our sample worked in hostels, 41.8% in nursing homes and 6.8% in Community Mental Health Centers. More specifically, moderate levels of total professional satisfaction were observed. Concerning the dimensions of satisfaction, low satisfaction rates were recorded in “salary”, “promotion” and in “privileges and benefits”. High satisfaction rates were recorded in “supervision by their superiors”, “cooperation between colleagues” and “the nature of their work”, while moderate satisfaction rates were reported in “communication” within facilities, as far as the explanation of tasks and objectives is concerned.

Conclusions

The results can be exploited by those with administrative and scientific responsibilities in the field of mental health in order to recognize nurses’ difficulties and solve their problems in psychosocial rehabilitation facilities.

Dying child and nurses’ mourning

Introduction

One of the most complex and emotional aspects of nursing is the interaction between the nurse and the dying child. The attitudes of nurses towards death, affect the quality of care.

Objectives

To investigate pediatric nurses’ attitudes towards death.

Methods

Methodology: 170 nurses, working in pediatric hospital departments completed a questionnaire which included sociodemographic characteristics and information related to their previous training and clinical experience regarding death issues in general and dying children’s care in particular.

Results

68.6% reported that the death of a child affects them very much, while 44.7% of the participants didn’t feel well prepared to manage death issues. Pediatric nurses were greatly affected by children’s death, expressing mainly feelings of sadness (44%), compassion (22%), guilt (22%) and anger (22%). 73% of the sample wished the hospitalized child, died when they were not present. 53.5% had been trained regarding the care of dying patients and the management of death and mourning as part of their curriculum and 21.2% had attended a relative seminar / lecture. The importance of proper and adequate education becomes particularly apparent considering that the majority of our sample either did not feel sufficiently prepared in order to deal with death and mourning, even though more than 70% of our participants had been relatively educated.

Conclusions

The incorporation of the notions of death and care at end of life in the theoretical and practical fields of nursing will improve the quality of services offered at the end of life for patients and their families.

Sociodemographic and psychological parameters of adult’s commitment to exercise

Introduction

Motivation is an important indicator of predicting an adult’s commitment to exercise so it is important to explore the reasons that may lead a person to participate in physical activity programs.

Objectives

To investigate the socio-demographic and psychological parameters that motivate adults to participate in exercise programs and athletic activities.

Methods

245 adults, being engaged in physical activity programs were given a questionnaire to collect information on socio-demographic characteristics, possible previous problems with body weight, type of exercise, frequency and main reason for their participation in exercise programs, as well as the somatometric characteristics of the participants.

Results

It is noteworthy that participants’ motive for exercise was pleasure (for 46.1% of the participants), championship (for 20.8% of the participants), health reasons (for 18.4% of the participants), weight loss (for 7.8% of the participants) and improvement of physical appearance (for 6.9% of the participants). A greater percentage of male compared to female participants were engaged to exercise due to championship reasons, while more women than men exercised to a statistically significant extent in order to improve their appearance and for health reasons.

Conclusions

Understanding the main factors that make individuals being engaged to physical activity may help health professionals to implement educational and counseling intervention programs regarding the positive effects of exercise on individuals’ mental and emotional health. Physical activity contributes to the improvement of their quality of life, which may be the most important issue for mental and public health.

Suicide in adolescence

Introduction

Suicide is one of the most common causes of death among young people worldwide. Adolescence is an important developmental period of life due to the increased risk of suicide and the prevalence of psychiatric disorders.

Objectives

To explore the suicidal ideation, intentions and risk factors of adolescents.

Methods

A clinical case study presentation will be performed.

Results

An adolescent female, aged of 16 years old, was admitted to the Department of Psychiatry for Children and Adolescents of a General Hospital, diagnosed with behavioral and emotional disorder and active suicidal ideation on ground of sexual abuse. During her hospitalization, she exhibited self-destructive behaviour by swallowing objects or causing extensive skin scarring as well as serious suicide attempts by hanging. Her emotional and behavioral status was unstable and unpredictable. The adolescent had repeatedly expressed her will to escape from an unbearable life.

Conclusions

The results of the presentation of our clinical case could contribute to the improvement of awareness regarding suicidal behavior in adolescence, which might have a significant effect on the prevention and treatment of this potentially lethal condition.

Disclosure

No significant relationships.

Social physique anxiety and physical activity

Introduction

Social Physique Anxiety is defined as an emotional response that reflects individuals’ concerns regarding the way their body may be observed or judged by others.

Objectives

To explore the relationship between physical activity and social physique anxiety.

Methods

A literature review haw been made through pubmed database.

Results

Social Physique Anxiety is negatively related to participation in physical activity and commitment to exercise. Studies examining the relationship between motivation and social physique anxiety have shown that external motivations, such as improving muscle tone and body attractiveness, are directly linked to social physique anxiety. In addition, social physique anxiety is negatively related to self-efficacy. Individuals who believe that they will be judged by others to be ineffective are less likely to be engaged in physical activity programs. Social Physique Anxiety has been linked to negative effects on mental health such as low self-esteem, smoking and eating disorders.

Conclusions

Given all the negative effects of social physique anxiety, as it is responsible for a wide range of health-related behaviors, it is important to identify physical activity-related motivational mechanisms in order to reduce the impact of social physique anxiety.

Disclosure

No significant relationships.

[Help-seeking from a Community Mental Health Centre]

Help-seeking is a multi-dimensional process. Individual, family and social factors all may be relevant in determining if and when help is sought. This study explored the possible factors affecting the help-seeking behaviour of individuals with mental health problems and their first contact with a mental health professional. Ιndividuals, who sought help from the Community Mental Health Centre (CMHC) during 2003-2007, completed a questionnaire and information was obtained on a number of variables including demographic characteristics. Women, compared to men, seek help from the CMHC at a greater frequency. Individuals with psychotic symptoms don't seek help initially from a CMHC and they used to visit other mental health services. The percentage of individuals diagnosed with psychosis, emotional and anxiety disorders, seeking help for the first time in their lives 12 months after the onset of psychopathology, was high. Delays in initiating treatment are often prolonged and the duration of untreated disorder is associated with substantial functional decline and poorer quality of life. Reduction of these delays will require clearer understanding of the contributing factors.