Psychosocial effects of intergenerational learning on primary school children and older Adults: A systematic review

In recent years there has been increasing emphasis on the importance of intergenerational learning and interaction. People of different ages engage in meaningful and mutually beneficial activities, aimed at developing knowledge, skills, and values. The aim of this systematic review was to examine the psychosocial effects of intergenerational learning in school-age children and older adults. A systematic review of both quantitative and qualitative data was performed according to the PRISMA guidelines. PubMed, Scopus, and ERIC electronic databases were searched up to 26 July 2022 using the following Population (P) -Exposure (E) - Outcome (O) elements: school-age children and older adults (P), intergenerational learning (E), and psychosocial effects (O). Reference lists of included datasets and relevant review articles were also extensively searched. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of eligible studies. A narrative synthesis was used as a framework for data analysis. Seventeen studies met the inclusion criteria. Regarding the psychosocial outcomes of participation in intergenerational activities for children and older adults, the majority of studies highlighted improvements in attitudes, well-being, happiness, and other social and psychological aspects, although methodological flaws are discussed.

Personality Traits, Burnout, and Psychopathology in Healthcare Professionals in Intensive Care Units-A Moderated Analysis

This study explored the associations between personality dimensions, burnout, and psychopathology in healthcare professionals in intensive care units (ICUs). This study further aimed to discern the differences in these relationships when considering the variables of critical care experience (less than 5 years, 5-10 years, and more than 10 years), profession (nurses versus intensivists), and the urban size of the city where the ICU is located (metropolitan cities versus smaller urban cities). This cross-sectional investigation's outcomes are based on data from 503 ICU personnel, including 155 intensivists and 348 nurses, in 31 ICU departments in Greece. Participants underwent a comprehensive assessment involving a sociodemographic questionnaire, the Eysenck Personality Questionnaire (EPQ), the Maslach Burnout Inventory (MBI), and the Symptom Checklist-90 (SCL-90). To analyze the interplay among critical care experience, burnout status, and psychopathology, a moderation analysis was conducted with personality dimensions (i.e., psychoticism, extraversion, and neuroticism) serving as the mediator variable. Profession and the urban size of the ICU location were considered as moderators influencing these relationships. Male healthcare professionals showed higher psychoticism levels than females, aligning with prior research. Experienced nurses reported lower personal achievement, hinting at potential motivation challenges for professional growth. Psychoticism predicted high depersonalization and low personal achievement. Neuroticism and psychoticism negatively impacted ICU personnel's mental well-being, reflected in elevated psychopathology scores and burnout status. Psychoticism appears to be the primary factor influencing burnout among the three personality dimensions, particularly affecting intensivists. In contrast, nurses are more influenced by their critical care experience on their mental health status.

Older adults' lived experiences of physical rehabilitation for acquired brain injury and their perceptions of well-being: A qualitative phenomenological study

AIM

To explore the experiences of older adults (65+) living with acquired brain injury regarding their sense of well-being during physical rehabilitation within the Greek Healthcare System.

BACKGROUND

With the increasing ageing population and the life-changing effects of acquired brain injury, there is a need to focus on care for older people and their potential to live well. Rehabilitation systems deserve greater attention, especially in improving the well-being of those who are using them.

DESIGN

A qualitative study design with a hermeneutic phenomenological approach was used.

METHODS

Fourteen older adults living with acquired brain injury and undergoing physical rehabilitation in Greece were purposively sampled. Semi-structured interviews were conducted to collect data and were thematically analysed using van Manen's and Clarke and Braun's methods. The COREQ checklist was followed.

RESULTS

Four themes emerged from the analysis: (1) Challenges of new life situation, (2) Seeking emotional and practical support through social interaction, (3) Identifying contextual processes of rehabilitation, (4) Realising the new self.

CONCLUSIONS

The subjective experiences, intersubjective relations and contextual conditions influence the sense of well-being among older adults living with acquired brain injury, thus impacting the realisation of their new self. The study makes the notion of well-being a more tangible concept by relating it to the degree of adaptation to the new situation and the potential for older adults to create a future whilst living with acquired brain injury.

RELEVANCE FOR CLINICAL PRACTICE

Identifying the factors that impact older adults' sense of well-being during rehabilitation can guide healthcare professionals in enhancing the quality of care offered and providing more dignified and humanising care.

PATIENT OR PUBLIC CONTRIBUTION

Older adults living with acquired brain injury were involved in the study as participants providing the research data.

Humor and Quality of Life in Adults With Chronic Diseases: A Systematic Review

Individuals grappling with chronic ailments often undergo a deterioration in their overall quality of life (QoL), encompassing psychological, social, and physical dimensions of well-being. Acknowledging that humor has demonstrated the potential to engender favorable effects on QoL, this systematic review endeavors to investigate the correlation between humor and QoL among adults contending with chronic health conditions. A comprehensive review of quantitative data was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed/MEDLINE, PsycINFO, and Cumulative Index to Nursing & Allied Health (CINAHL) were comprehensively searched from the establishment of each database up to June 22, 2023. Furthermore, reference lists of the included datasets and pertinent review articles were scrutinized exhaustively. The Newcastle-Ottawa Scale (NOS) was employed to assess the quality of eligible studies. A total of 18 studies satisfied the inclusion criteria. These studies encompassed a diverse spectrum of chronic disease categories (including cardiovascular diseases, various types of cancer, etc.) and collectively involved a participant cohort comprising 4,325 individuals. Remarkable findings surfaced, indicating a noteworthy association between distinct facets of humor-such as one's sense of humor, coping humor, humor styles, and laughter-and psychological QoL. Nonetheless, the relationship between humor and physical QoL exhibited a more intricate pattern, characterized by mixed outcomes. Despite the limited and inconsistent evidence across studies, humor appears to exhibit a positive association with QoL.

The Complex Dynamics of Decision-Making at the End of Life in the Intensive Care Unit: A Systematic Review of Stakeholders' Views and Influential Factors

A lack of consensus resulting in severe conflicts is often observed between the stakeholders regarding their respective roles in end-of-life (EOL) decision-making in the ICU. Since the burden of these decisions lies upon the individuals, their opinions must be known by medical, judicial, legislative, and governmental authorities. Part of the solution to the issues that arise would be to examine and understand the views of the people in different societies. Hence, in this systematic review, we assessed the attitudes of the physicians, nurses, families, and the general public toward who should be involved in decision-making and influencing factors. Toward this, we searched three electronic databases, i.e., PubMed, CINAHL (Cumulative Index to Nursing & Allied Health), and Embase. A matrix was developed, discussed, accepted, and used for data extraction by two independent investigators. Study quality was evaluated using the Newcastle-Ottawa Scale. Data were extracted by one researcher and double-checked by a second one, and any discrepancies were discussed with a third researcher. The data were analyzed descriptively and synthesized according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirty-three studies met our inclusion criteria. Most involved healthcare professionals and reported geographic variations in different timeframes. While paternalistic features have been observed, physicians overall showed an inclination toward collaborative decision-making. Correspondingly, the nursing staff, families, and the public are aligned toward patient and relatives' participation, with nurses expressing their own involvement as well. Six categories of influencing factors were identified, with high-impact factors, including demographics, fear of litigation, and regulation-related ones. Findings delineate three key points. Firstly, overall stakeholders' perspectives toward EOL decision-making in the ICU seem to be leaning toward a more collaborative decision-making direction. Secondly, to reduce conflicts and reach a consensus, multifaceted efforts are needed by both healthcare professionals and governmental/regulatory authorities. Finally, due to the multifactorial complexity of the subject, directly related to demographic and regulatory factors, these efforts should be more extensively sought at a regional level.

Patients' Dreams and Unreal Experiences During Intensive Care Unit (ICU) Hospitalization

In the intensive care unit (ICU), patients often experience fragmented memories, primarily comprising dreams and illusions. These experiences can impact psychosocial well-being, correlating with post-traumatic stress symptoms and heightened anxiety. Understanding these phenomena is crucial for holistic care. To systematically explore patients' perspectives concerning the recollection of dreams and unreal encounters during their stay in the ICU, considering pertinent clinical conditions and potential influencing factors, we conducted a comprehensive search in the PubMed/MEDLINE, Web of Science, and Scopus databases until November 20, 2023, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From an initial pool of 288 records, a thorough screening for eligibility resulted in the inclusion of nine studies for this systematic review. These selected studies underwent evaluation using either the Critical Appraisal Skills Programme (CASP) Qualitative Checklist or the Newcastle-Ottawa Scale (NOS). All studies categorized dreams into three main types: positive, distressing (including nightmares), and neutral experiences. These were further detailed based on aspects such as time, space, senses, emotions, and distinguishing between reality and unreality. Two studies found associations between dreams and conditions like Guillain-Barré syndrome (GBS), mental abnormalities, and delirium. In one study, GBS patients had more vivid dreams, hallucinations, and delusions compared to ICU control group patients; delirious patients tend to report more frequent frightening dreams. Patients in the ICU who recalled dreams often had more severe illness, longer stays, and higher ventilation frequency. Notably, a prolonged ICU stay significantly predicted the likelihood of dream recall, as consistently observed in three other studies. This suggests that patients with prolonged ICU stays, experiencing higher dream recall, underwent extended treatments. This systematic exploration of patients' perspectives on fragmented memories underscores the connections between these experiences, clinical conditions such as GBS and delirium, and extended ICU stays. Recognizing and attending to these psychological aspects in post-ICU care is critical for alleviating the enduring emotional consequences for patients.

Unveiling the Nexus: Depressive Symptoms and Medication Adherence in Hypertensive Patients' Self-care: A Systematic Review

Background

Hypertension, a significant public health concern, is frequently linked to emotional disorders like depression. Research shows a reciprocal link between depression and hypertension, potentially influencing patients' adherence to self-care routines.

Objective

This systematic review aimed to examine the association between depressive symptoms and aspects of self-care, with a focus on medication adherence in individuals diagnosed with hypertension.

Methods

Following PRISMA guidelines, a systematic review was conducted by searching PubMed, PsycINFO and Scopus until March 17, 2023. The included studies involved quantitative primary research conducted in English, focusing on adults (≥18 years) diagnosed with hypertension and experiencing depressive symptoms. Observational studies were assessed using the Newcastle-Ottawa Scale, and randomized controlled trials were evaluated using the revised Cochrane Risk of Bias Tool (RoB 2.0). Due to the great diversity of these studies, a narrative synthesis of the results was undertaken. Results: A total of 18 studies involving 6,131 people with hypertension, that met our eligibility criteria were ultimately included. The reported rates of depressive symptoms ranged from 4% to 43%. Of these studies, nine reported a statistically significant association, showcasing an adverse impact of depressive symptoms on medication adherence. The remaining nine did not confirm the above.

Conclusion

This systematic review highlights the diverse body of research exploring depressive symptoms and medication adherence among individuals with hypertension. The review suggests a need for increased attention to self-care practices, particularly in relation to adherence to antihypertensive medication. However, it recommends the conduction of more robust longitudinal studies to comprehensively explore this relationship.

Association of Personality Traits and Self-Care Behaviors in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Diabetes self-care is critical for individuals with type 2 diabetes mellitus (T2DM), and exploring the impact of personality traits on this domain remains pivotal. This study aimed to investigate the association between personality traits and various dimensions of self-care in people with T2DM. A Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA)-guided systematic review with meta-analysis was conducted. Two reviewers independently screened articles, extracted data, and assessed the risk of bias. Estimates were pooled using random-effects meta-analysis. Twenty-three studies, that met our inclusion criteria, revealed distinct associations between certain personality traits and various aspects of self-care. Notably, traits such as openness, conscientiousness, and agreeableness showed associations with improved foot care compliance (odds ratio (OR) = 2.53, 95% CI = 1.49-4.28; OR = 1.84, 95% CI = 1.10-3.08; and OR = 2.07, 95% CI = 1.23-3.48, respectively). Openness was also linked to better overall self-care behaviors (OR = 2.00, 95% CI = 1.17-3.41), while conscientiousness correlated with reduced smoking (OR = 0.96, 95% CI = 0.93-0.99), and agreeableness was associated with improved medication adherence (OR = 1.68, 95% CI = 1.34-2.31). Conversely, traits like extraversion and neuroticism showed associations with decreased medication adherence (OR = 0.77, 95% CI = 0.61-0.96 and OR = 0.51, 95% CI = 0.40-0.65, respectively), with neuroticism additionally linked to lower overall self-care behaviors (OR = 0.67, 95% CI: 0.55-0.81). This study emphasizes the intricate role of personality traits in shaping self-care practices in individuals with T2DM, underscoring the significance of factoring these traits into tailoring and improving diabetes self-care strategies. Nevertheless, establishing definitive causal relationships mandates further in-depth longitudinal investigations and broader meta-analyses to achieve a more conclusive understanding.

Economic Burden of ICU-Hospitalized COVID-19 Patients: A Systematic Review and Meta-Analysis

The impact of the coronavirus disease 2019 (COVID-19) pandemic on the global economy is far-reaching and difficult to assess accurately. We aimed to systematically determine the magnitude of the costs and the economic burden of intensive care for hospitalized COVID-19 patients since the onset of the pandemic by means of a systematic review. We conducted a PRISMA 2020-compliant (protocol: PROSPERO CRD42022348741) systematic review by searching PubMed, EMBASE, and Web of Science for relevant literature. We included studies that presented costs based on a primary partial economic evaluation. Using the Consolidated Health Economic Evaluation Reporting Standards checklist and the population, intervention, control, and outcome criteria, we established the risk of bias in studies at the individual level. Daily cost per ICU admission and total cost per ICU patient of the original studies extracted. A random effect model was adopted for meta-analysis whenever possible. Of the 1,635 unique records identified, 14 studies related to ICU-hospitalized costs due to COVID-19 were eligible for inclusion. Included studies represented 93,721 hospitalized COVID-19 patients. Regarding total direct medical costs, the lowest cost per patient at ICU was observed in Turkey ($2,984.78 ± 2,395.93), while the highest was in Portugal ($51,358.52 ± 30,150.38). The Republic of Korea reported the highest length of stay of 29.4 days (±17.80), and the lowest is observed in India for nine days (±5.98). Our findings emphasize COVID-19's significance on health-economic outcomes. Limited research exists on the economic burden of COVID-19 in the ICU. Further studies on cost estimates can enhance data clarity, enabling informed analysis of healthcare costs and aiding efficient patient care organization by care providers and policymakers.

Identifying the Relationship Between Economic Prosperity and Quality of Life in Chronic Obstructive Pulmonary Disease Patients

Background Chronic obstructive pulmonary disease (COPD) places a significant economic burden on national healthcare systems, and the economic effects of diseases have long been known. The study aimed to evaluate the association of parental family financial wealth with current economic prosperity and the combined effect of both on health-related quality of life (HRQOL) in a sample of patients with COPD. The moderating effect of birth order is further investigated. Methods The results of the study are based on a purposive sample of 105 COPD patients at the Larisa University Hospital pulmonology clinic (94 males and 11 females), with an average age of 68.9 (SD = 9.2). The data collection was carried out in the spring and summer of 2020. Participants completed the 36-item Short Form Survey (SF-36) and a sociodemographic questionnaire with self-reported parental and current wealth items. A mediation model with the moderation of the indirect effect of parental wealth on current wealth and the direct effect of parental wealth on HRQOL was applied to test the research hypotheses among the variables studied. Results Parental wealth was found to affect current wealth significantly, and both were involved considerably in HRQOL. Birth order had a significant moderating effect on the relationship between parental wealth and HRQOL. Among parental families with lower financial status, patients who grew up as third or later children had significantly lower HRQOL than the first or second children of these families. Neither age nor COPD duration was related to current wealth or HRQOL. Conclusions An intergenerational transmission of poverty was found in our sample. In addition, a birth order effect can provide further insight into the harsher environment that the later children of a low-income family are exposed to and the long-term implications for their HRQOL.

Impact of mental disorders on clinical outcomes of physical diseases: an umbrella review assessing population attributable fraction and generalized impact fraction

Empirical evidence indicates a significant bidirectional association between mental disorders and physical diseases, but the prospective impact of men-tal disorders on clinical outcomes of physical diseases has not been comprehensively outlined. In this PRISMA- and COSMOS-E-compliant umbrella review, we searched PubMed, PsycINFO, Embase, and Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, up to March 15, 2022, to identify systematic reviews with meta-analysis that examined the prospective association between any mental disorder and clinical outcomes of physical diseases. Primary outcomes were disease-specific mortality and all-cause mortality. Secondary outcomes were disease-specific incidence, functioning and/or disability, symptom severity, quality of life, recurrence or progression, major cardiac events, and treatment-related outcomes. Additional inclusion criteria were further applied to primary studies. Random effect models were employed, along with I² statistic, 95% prediction intervals, small-study effects test, excess significance bias test, and risk of bias (ROBIS) assessment. Associations were classified into five credibility classes of evidence (I to IV and non-significant) according to established criteria, complemented by sensitivity and subgroup analyses to examine the robustness of the main analysis. Statistical analysis was performed using a new package for conducting umbrella reviews (https://metaumbrella.org). Population attributable fraction (PAF) and generalized impact fraction (GIF) were then calculated for class I-III associations. Forty-seven systematic reviews with meta-analysis, encompassing 251 non-overlapping primary studies and reporting 74 associations, were included (68% were at low risk of bias at the ROBIS assessment). Altogether, 43 primary outcomes (disease-specific mortality: n=17; all-cause mortality: n=26) and 31 secondary outcomes were investigated. Although 72% of associations were statistically significant (p<0.05), only two showed convincing (class I) evidence: that between depressive disorders and all-cause mortality in patients with heart failure (hazard ratio, HR=1.44, 95% CI: 1.26-1.65), and that between schizophrenia and cardiovascular mortality in patients with cardiovascular diseases (risk ratio, RR=1.54, 95% CI: 1.36-1.75). Six associations showed highly suggestive (class II) evidence: those between depressive disorders and all-cause mortality in patients with diabetes mellitus (HR=2.84, 95% CI: 2.00-4.03) and with kidney failure (HR=1.41, 95% CI: 1.31-1.51); that between depressive disorders and major cardiac events in patients with myocardial infarction (odds ratio, OR=1.52, 95% CI: 1.36-1.70); that between depressive disorders and dementia in patients with diabetes mellitus (HR=2.11, 95% CI: 1.77-2.52); that between alcohol use disorder and decompensated liver cirrhosis in patients with hepatitis C (RR=3.15, 95% CI: 2.87-3.46); and that between schizophrenia and cancer mortality in patients with cancer (standardized mean ratio, SMR=1.74, 95% CI: 1.41-2.15). Sensitivity/subgroup analyses confirmed these results. The largest PAFs were 30.56% (95% CI: 27.67-33.49) for alcohol use disorder and decompensated liver cirrhosis in patients with hepatitis C, 26.81% (95% CI: 16.61-37.67) for depressive disorders and all-cause mortality in patients with diabetes mellitus, 13.68% (95% CI: 9.87-17.58) for depressive disorders and major cardiac events in patients with myocardial infarction, 11.99% (95% CI: 8.29-15.84) for schizophrenia and cardiovascular mortality in patients with cardiovascular diseases, and 11.59% (95% CI: 9.09-14.14) for depressive disorders and all-cause mortality in patients with kidney failure. The GIFs confirmed the preventive capacity of these associations. This umbrella review demonstrates that mental disorders increase the risk of a poor clinical outcome in several physical diseases. Prevention targeting mental disorders - particularly alcohol use disorders, depressive disorders, and schizophrenia - can reduce the incidence of adverse clinical outcomes in people with physical diseases. These findings can inform clinical practice and trans-speciality preventive approaches cutting across psychiatric and somatic medicine.

Investigation of Factors That Affect the Quality of Life After a Stroke

Stroke, as a disease, describes a group of disorders characterized by the presence of central nervous system symptoms either as a result of ischemia (ischemic stroke) or bleeding (hemorrhagic stroke). The appearance of a stroke results in a permanent physical or cognitive disability. The stroke incidence is the third cause of death after heart disease and cancer, and is the main cause of long-term disability.The effects of a stroke on a patient's daily life, and hence on his quality of life, are intense and long-lasting. These include memory problems, speech difficulty, depression, reduced vision loss, and decreased walking ability. This limitation of the patient's motor activity has a direct negative impact on the quality of his life.To investigate the degree of this impact, a research was carried out at a hospital of Central Greece. The total sample consisted of 90 patients and the responses showed that post-stroke symptoms are significant. Consequences and treatment control of the disease on the life of the sample were the questions with the highest score showing the significant effect that a stroke has on life the patients.More specifically, the sample showed through responses that the disease affects their lives to a great extent. The pre-stroke scores on the domains of the sample are clearly higher than post-stroke. The highest difference was found in the use of the upper extremities in self-care and family roles while the lowest was found in the domain of thinking. The most affected domains were as follows: thinking, vision, and language. Alternatively, the least affected domain was family roles.

THE RELATIONSHIP BETWEEN PSYCHOSOCIAL WORK ENVIRONMENT AND NURSES' PERFORMANCE, ON STUDIES THAT USED THE VALIDATED INSTRUMENT COPENHAGEN PSYCHOSOCIAL QUESTIONNAIRE (COPSOQ): AN EMPTY SCOPING REVIEW

OBJECTIVE

Aim: This study was to map the relationship between psychosocial work environment and nurses' performance, on studies that used the Copenhagen Psychosocial Questionnaire (COPSOQ).

PATIENTS AND METHODS

Materials and Methods: The review intended to answer following questions: 'Can COPSOQ screen completely psychosocial risks of nurses' work environment?' 'Which of these dimensions affect more nurses psychosocial world? A scoping review was developed guided by the JBI methodology and using PRISMA-ScR.

CONCLUSION

Conclusions: Hospital workers, and in particular nurses, are exposed to different risk factors with the most important being psychosocial risks. These arise from problematic work planning, organization and management, as well as from an unhealthy social context of work and may lead to negative psychological, physical and social outcomes. The review highlighted the need for further research using the entire COPSOQ questionnaire in order to fully study the psychosocial risks that nurses face in their work environment.

Impact of the COVID-19 pandemic on the mental health of hospital staff: An umbrella review of 44 meta-analyses

BACKGROUND

Hospital staff is at high risk of developing mental health issues during the coronavirus (COVID-19) pandemic. However, the literature lacks an overall and inclusive picture of mental health problems with comprehensive analysis among hospital staff during the COVID-19 pandemic.

OBJECTIVES

To ascertain the prevalence of anxiety, depression and other mental health outcomes as reported in original articles among hospital staff during the COVID-19 pandemic.

DESIGN

A PRISMA 2020 and MOOSE 2000 compliant umbrella review of published meta-analyses of observational studies evaluating the prevalence of mental health problems in hospital staff during the pandemic.

REVIEW METHODS

Systematic searches were conducted in PubMed/Medline, CINAHL, EMBASE, and PsycINFO from December 1st, 2019, until August 13th 2021. The random effects model was used for the meta-analysis, and the I² index was employed to assess between-study heterogeneity. Publication bias using Egger test and LFK index was examined. Data was analyzed using STATA 17.0 software. AMSTAR-2 was applied for the quality assessment of systematic reviews, while we used GRADE to rate the quality of evidence.

RESULTS

Forty-four meta-analyses from 1298 individual studies were included in the final analysis, encompassing the prevalence of 16 mental health symptoms. One-third of hospital workers reported anxiety (Prevalence: 29.9%, 95% CI:27.1% to 32.7%) and depression (Prevalence: 28.4%, 95% CI:25.5% to 31.3%) symptomatology, while about 40% (95% CI: 36.9% to 42.0%) suffered from sleeping disorders. Fear-related symptoms, reduced well-being, poor quality of life, and acute stress symptoms had the highest prevalence among hospital staff. However, the quality of evidence in these areas varied from low to very low. Nurses suffered more often from sleep problems and symptoms of anxiety and depression than doctors, whereas doctors reported a higher prevalence of acute stress and post-traumatic disorders. The burden of anxiety, depression, and sleep disorders was higher among female employees than their male counterparts. Remarkably, acute stress and insomnia affected more than half of first-line medical staff.

CONCLUSIONS

The prevalence of mental health problems among hospital staff during the COVID-19 pandemic is generally high, with anxiety, depression and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses. However, there is no strong confidence in the body of evidence for each outcome assessed.

REGISTRATION

Not registered.

TWEETABLE ABSTRACT

The COVID-19 pandemic is having a major impact on the mental health of hospital staff. The need for support must be different for nurses and doctors @eldi12345.

The Relationship between Friendship and Social Life of Patients With Type 2 Diabetes with Depression

Introduction

INTRODUCTION: Several studies have shown that the relationship between Diabetes and Depression is significant, but few have evaluated the relationship between this depression and patients’ social life.

Objectives

OBJECTIVE: Exploring the friendships and social life of patients with type 2 diabetes with levels of depression.

Methods

METHODS: The sample consisted of 130 Greek patients with type 2 diabetes and a mean age of 63.28 (SD = 13.89), who completed the following questionnaires voluntarily and anonymously: a) Zung Depression Scale and b) socio-demographic and self-reported questionnaire for their past and present friendships.

Results

RESULTS: Patients who had friends in the past scored lower depression rates (44.63 ± 11.53) than patients who did not have friends in the past (60.50 ± 6.36), with a statistically significant difference between them (p = 0.045), while patients who currently have friends scored lower depression rates (42.91 ± 10.86) than patients who do not currently have friends (58.81 ± 6.07), with a statistically very significant difference between them ( p = 0.000). Patients with type 2 diabetes who are not currently friends have higher levels of depression by 3.8 points compared to patients with type 2 diabetes who are currently friends.

Conclusions

CONCLUSIONS: Patients with diabetes mellitus with low levels of social life show statistically higher rates of depression and further study of this relationship is considered necessary.

Disclosure

No significant relationships.

The interaction of love in clinical care and its connection with burnout of health professionals

Introduction

The phenomenon of love in the clinical field, in other words, the practical love through specific features, is the “ultimate investment” of the well-being, both to the patient and to the health professional.

Objectives

The aim of this research study is to investigate the role of love and its connection with burnout in the context of clinical professional care.

Methods

The study was cross-sectional and was conducted from September 2020 to February 2021 at the Nursing Department of University of Ioannina, Greece. The sample of the present study was determined to be health professionals, both sex from all over Greece. The research tools which were used in the quantitative study were: 1) Socio-demographic questionnaire, 2) Measurement of social representations of love and 3) Maslach Burnout Inventory - MBI.

Results

The results of the present quantitative research showed that gender, religion, family environment, place of residence, years of work and job position of health professionals affect the love and compassion they can show and offer to their patients, and the love is related to the level of burnout they experience (p <0.05), in the context of clinical occupational care.

Conclusions

In conclusion, love, its traits and expression of the feelings of health professionals, determine the level of clinical care and the burnout of health professionals.

Disclosure

No significant relationships.

Investigating the relationship between mental health, resilience and self-compassion among Greek unemployed people

Introduction

Unemployment is considered to be one of the most stressful life events that a person may experience. There are a plethora of studies that highlighted the negative effects of unemployment on people’s overall mental health and well-being. Yet, psychological resilience and self-compassion contribute positively in coping with stressful situations and seem to be particularly supportive mechanisms when one is confronted with unemployment.

Objectives

This study intended to investigate the relationships between resilience, self-compassion and mental health in Greek unemployed people and the contribution of specific sociodemographic characteristics in this ‘equation’.

Methods

The study followed a survey design where a sample of 345 Greek unemployed participants completed an online questionnaire, examining the variables under study.

Results

According to the findings, people who reported being unemployed for more than six months showed decreased levels of mental health. Also, the unemployed with higher levels of resilience and self-compassion reported statistically significant higher levels of mental health and vice versa. Finally, self-compassion and psychological resilience were found to be statistically positive related to each other and are predictive factors of mental health with which they are statistically negative related.

Conclusions

The results of this study may contribute to the implementation of interventions aiming at improving mental health and the overall well-being of people affected by long-term unemployment.

Disclosure

No significant relationships.

Assessment of Greek Smokers’ Psychological Characteristics and Empathy While Smoking in Enclosed Public Spaces and Near Nonsmokers

Background

Smoking presents a strong association between emotional intelligence and increased anxiety and depression. Empathy is a form of perception where people feel the emotional states of others as their own. The act of smoking expresses indifference to social norms and the health of nonsmokers, which speaks to smokers’ psychology. We conducted this study to identify the impact of smoking in psychology, empathy, and smoking behavior and examine the effect of smokers’ psychological characteristics and empathy toward smoking in enclosed public spaces and in front of nonsmokers.

Methodology

A primary, quantitative, synchronous, correlational, and nonexperimental research was accomplished using validated, reliable questionnaires. We used random sampling to acquire the study population consisting of 453 employees of public dining areas, owners of public dining areas, and medical and nonmedical students at the University of Larissa, Greece. Data were collected via self-completed questionnaires on participant demographic information and smoking habits. We used SPSS Statistics for Windows, version 24.0 (IBM Corp., Armonk, NY) to analyze the data with significance set at 5%. We also used independent samples t-test, Mann-Whitney U test, Spearman’s coefficient, chi-square test, and factorial analysis of variance with significance set at 5%.

Results

We found high levels of empathy in smokers with low psychosomatic symptoms. Smoking significantly affected levels of empathy (p<.001), annoyance when they are in a place where smoking is prohibited, someone else smoking (p<.001), recommendations of someone who smokes in a nonsmoking area to quit (p<.001), and hostility (p<.001). There was a statistically significant effect of double interaction sample category and smoking on empathy (p<.001). Smoking more than 15 cigarettes affected the levels of agreement in the perception that nonsmokers around them are bothered when they smoke (p=.004) and anxiety (p=.002). Perceptions about the annoyance of nonsmokers were negatively correlated with interpersonal sensitivity (p=.003), depression (p<.001), anxiety (p=.003), hostility (p<.001), paranoid ideation (p=.005), psychoticism (p=.001), and Global Severity Index (p=.006). Annoyance, when smoking is prohibited, was positively correlated with empathy (p=.001) while negatively correlated with somatization (p=.012) and hostility (p=.013). Smoking in prohibited places was related to somatization (p=.032), hostility (p<.001), and paranoid ideation (p=.001).

Conclusions

The purpose of this study was to examine the empathy and psychopathological characteristics of smokers in Greece. Smokers presented high levels of hostility and those who smoke more than 15 cigarettes per day indicated higher levels of anxiety than those who smoke less or not at all. Lower levels of empathy appeared in smokers, regardless of occupation. Smokers presented lower levels of annoyance when they are in a place where smoking is prohibited and someone else smokes. Participants with higher somatization, hostility, and lower empathy are less bothered when they are in a place where smoking is prohibited and someone else smokes. These findings could assist the development of communication materials aimed at smokers to help them understand that others nearby do not enjoy their smoking practices, especially in an enclosed area. These findings could also facilitate feasible antismoking laws with an overall goal to reduce smoking in a population.

The effects of psychopathology and shame on social representations of health and lifestyle behaviours via free association: a graph analysis approach

BACKGROUND

There is a knowledge gap in whether psychopathology aspects can shape and mark the social representations about health and lifestyle. In this work, we investigated the association of psychopathology and shame with the centrality of the words describing eight common social representations of health and lifestyle.

METHODS

A convenience sample of 288 adults participated with an average age of 44.7, and 62.6% were women. The participants were asked to express three consecutive words associated with eight different health and lifestyle experiences by utilizing the free association method. The participants also were completed the Symptom Checklist-90-Revised (SCL-90-R), the Experiences of Shame Scale (ESS), and the Other as Shamer Scale (OAS). Canonical correlation analysis was applied to investigate the relationship between the set of the eight-word centralities and the psycho-demographic variables consisting of the subject's age and gender, the SCL 90 subscales, the OAS, and the ESS. Based on these findings, a structural equation explorative model was formed to test the unidimensionality of the five centralities construct.

RESULTS

Τhe psychological characteristics of interpersonal sensitivity, depression, external shame, and hostility were found to affect the word selection process on the social representations concerning nightlife, health, diet, lifestyle, and alcohol consumption. Participants with increased levels of depression tend to choose more centrally positioned words when the stimulus word was diet and more decentralized responses when the stimulus word was health. At the same time, higher external shame corresponded to more decentralized words for the categories of health and lifestyle.

CONCLUSIONS

Our results indicate that there is a potential interaction between the psychological state and how a social representation of health and lifestyle is constructed through selected words. Graph theory emerged as an additional tool to use to study these relations.

A systematic review of the qualitative literature on older individuals' experiences of care and well-being during physical rehabilitation for acquired brain injury

Aims

To acquire an in‐depth understanding of how older individuals diagnosed with acquired brain injury (ABI) experience their well‐being and care when undergoing physical rehabilitation.

Design

Systematic literature review.

Data sources

The electronic databases of PubMed, CINAHL, APA PsycInfo, ASSIA and SCOPUS were searched from 2005 to 2020. Extensive reference checking was also conducted.

Review methods

A systematic review was conducted following PRISMA guidelines, including predominantly qualitative studies. Studies’ quality was appraised using the critical apraisal skills programme (CASP) tool.

Results

Seventeen studies met the inclusion criteria. Following methods of thematic synthesis, four overarching interpretive themes were identified: (a) Rehabilitation processes and their impact on older individuals’ well‐being; (b) Identity and embodiment concerns of older individuals during rehabilitation; (c) Institutional factors affecting older individuals’ care and well‐being experiences; and (d) Older individuals’ participation in creative activities as part of rehabilitation.

Conclusion

Organizational and structural care deficiencies as well as health disparities can adversely impact older individuals’ autonomous decision‐making and goal‐setting potentials. The discrepancy between older individuals’ expectations and the reality of returning home along with the illusionary wish to return to a perceived normality, can further negatively affect older individuals’ sense of well‐being. Constructive communication, emotional support, family involvement in rehabilitation and creating a stimulating, enriching social environment can humanize and facilitate older individuals’ adjustment to their new reality following ABI.

Impact

There is a lack of qualitative research on older individuals’ ABI rehabilitation experiences, especially traumatic brain injury incidents. Further study should consider patients’ concerns over their involvement in decision‐making and goal setting about their care. Overall, this review reveals the need to examine further the significance of humanizing care and the factors that affect older individuals’ sense of well‐being.

Gendered experiences of providing informal care for older people: a systematic review and thematic synthesis

Background and purpose

The caregiving’s impact on informal carers’ quality of life and gender-based stereotypes make older individuals’ informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers’ experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020.

Design and methods

The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework.

Results

This review produced two analytical themes, the impact of gender on the caregivers’ labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional gender stereotypes impacts caregiving burden and coping strategies. Informal carers’ experiences entail a constant pursuit of self-agency after acquiring the caregiver role. Cultural values and their intersection with gender appear to influence caregivers’ healthy adjustment into their new caregiving identities. The flexibility to move beyond gender boundaries could mediate caregivers’ negotiations between self and society on developing their new caregiving identity. Providing intensive informal primary care to older people affects both men’s and women’s mental and physical health. Gender ideals of the feminine nurturing role further disadvantage women as they determine the caregiving arrangements, the strategies and resources to sustain the caring burden, and the adaptability to experience their new caregiving role positively. Men appear more flexible to debate their hegemonic masculinity and defend their existence in the caregiving role.

Conclusion and implications

Transgressing gender lines and expanding gender possibilities can ease the caregiving burden and strengthen caregivers coping potentials. Health professionals can empower informal careers to challenge gender binaries and expand gender possibilities by intentionally injecting the language of diversity in caring information and caring processes. The review findings outline a path for research on gender identity development in older people’s care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06736-2.

Exploring the Impact of Shame on Health-Related Quality of Life in Older Individuals

PURPOSE

To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people.

DESIGN AND METHODS

A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software.

RESULTS

Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women b_W = -0.173, p_W = .004, effect on men b_M = -0.138, p_​M = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (b_W = -0.392, p_W = .002 and b_M = -0.384, p_M = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033).

CONCLUSION

Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame.

CLINICAL RELEVANCE

These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.

Fear of pain and hostility

Introduction

Fear of pain motivates defence and protection from events that are perceived as threatening. When defence and protection are not efficient, fear may lead to aggressive acts against the perceived source of threat.

Objective

This study tested the link between fear of pain and hostility in adults.

Aim

The aim was to investigate the relationship between fear of pain and hostility.

Method

595 community individuals participated to the present study (164 men - 431 women, mean age 34, SD = 12, ranged 18–75). The measures used were: a) the Fear of Pain Questionnaire - III (FPQ-III), b) the Pain Anxiety Symptoms Scale-20 (PASS-20) c) the Hostility and Direction of Hostility Questionnaire (HDHQ) and d) the Aggression subscale of The Symptom Checklist-90-R (SCL-90-R).

Results

Women predicted significantly more aggression (t = −1.9, p = .05), while for hostility no differences with sex were observed (t = −.2, p = .80). Hostility was significantly correlated with the amount of fear of pain (r = .27, p = .001) and pain anxiety symptoms (r = .23, p = .001). Significantly correlations were also found with aggression and fear of pain (r = .27, p = .001) and pain anxiety symptoms (r = .31, p = .001). Hierarchical linear regression models revealed that, pain anxiety had a significant independent link with hostile attitude (β = .176, p = .001) and fear of pain make independent contributions to predicting aggressive behaviour (β = .090, p = .006).

Conclusion

The need for health professionals to assess hostility and aggression in fear of pain behaviors and apply relevant information to the therapeutic regimen was apparent.

Quality of life in patients with type 2 diabetes mellitus: a cross-sectional study

Purpose

The purpose of this paper is to investigate certain social and psychological parameters and to compare them with basic demographic information, such as the gender and the education, of patients suffering from Type 2 diabetes mellitus (T2DM).

Design/methodology/approach

A cross-sectional study of Type 2 diabetic patients was conducted. In total, 200 patients with T2DM were enrolled in the study. Psychological factors were assessed with questionnaires, including the Symptom Checklist 90-R (SCL-90-R), the Short-Form Health Survey (SF-36), the Life Orientation Test-Revised (LOT-R) and the Cardiac Anxiety Questionnaire (CAQ). The associations of psychological with socio-demographic factors were assessed through logistic regression analyses.

Findings

Women patients had higher levels of heart-focused anxiety psychopathology than men, and therefore, women tend to avoid activities that burden the heart. Men patients had a significantly higher index of physical functionality than women. No differences were recorded by the SCL-90R questionnaire between men and women. For the patients with elementary education, lower levels of mental health (SF-36-MCS) were observed.

Originality/value

The chronicity of the disease aggravates the psychopathology of the patients thereby creating adverse impact not only on health but also on efforts for compliance. A personalized approach by the health professionals could contribute in addressing the psychological factors that accompany T2DM.

Shame feeling in the Intensive Care Unit patient's family members

OBJECTIVE

To investigate the levels of internal and external shame among family members of critically ill patients.

RESEARCH METHODOLOGY/ DESIGN

This prospective study was conducted in 2012/2013 on family members of Intensive Care Unit patients using the Others As Shamer Scale and the Experiential Shame Scale questionnaires.

SETTING

Greek university hospital.

RESULTS

Two hundred and twenty-three family members mean-aged (41.5±11.9) were studied, corresponding to 147 ICU patients. Out of these 223, 81 (36.3%) were men and 142 (63.7%) were women, while 79 (35.4%) lived with the patient. Family members who lived with the patient experienced higher internal and external shame compared to those who did not live with the patient (p=0.046 and p=0.028 respectively). Elementary and Junior High School graduates scored significantly higher than the other grades graduates in total Others As Shamer Scale, inferiority and emptiness scale (p<0.001).

CONCLUSION

Intensive Care Unit patients' family members are prone to shame feelings, especially when being of low educational level. Health professionals have to take into consideration the possible implications for the patients and their care.

The Experience of Shame in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Introduction

It is reported in global literature that Chronic Obstructive Pulmonary Disease (COPD) may cause a wide range of psychological effects, some of them not fully explored. The aim of this study is to investigate if patients with COPD experience intense feelings of shame.

Objectives

To find differences in shame experience between males and females, and if there is a correlation of shame with other socio-economic factors.

Method

Using the “Experience of Shame Scale” questionnaire (ESS) in 191 patients with COPD (104 men and 87 women) treated in Primary Health Care services in Greece.

Results

Statistical analysis showed relatively low scores (M 39.5 sd 14.9) for the experience of shame in COPD patients. There is no statistically significant difference of shame for marital status, education level or disease stage. Statistically significant difference shown between males and females (bodily shame P: 0.001, total shame P: 0.031), and between smokers and those who quit smoking. (characterological shame: P: 0.007 behavioral shame P: 0.030, total shame P: 0.009). Also statistically significant difference appears for bodily shame among Body Mass Index (BMI) groups (P: 009) and economic status of the patients (P: 0.008).

Conclusions

Patients with COPD seem to have not heavy burden with experience of shame. Any associations of shame with some patient groups are rather expected for cultural and social reasons.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Compare “family atmosphere” in informal caregivers of patients with psychotic symptoms compared to their inclusion or not in self-help associations

Introduction

The participation of informal caregivers in the café of patients with psychotic symptoms in coordination with self-help groups have been found to reduce the expressed emotion in combination with psychoeducations interventions help create a supportive environment.

Objectives

This study investigates the differences in the family atmosphere of informal caregivers of patients with psychotic symptoms.

Aims

To compare whether or not the participation of informal caregivers of patients with psychotic symptoms in self-organized associations helps to foster a supportive family environment, hence reducing the risk of relapse.

Methods

Snowballing sampling consisting of 510 informal caregivers of patients with psychotic symptoms was used in the current study. The Family Environment Scale of Moos and Moos and socio-demographic questions were implemented to collect the data. Control Cronbach's Alpha reliability of scale gave value a = 0.795.

Results

The comparison showed that informal caregivers of patients with psychotic symptoms irrespective of their participation or not in self-help associations do not show significant differences in Family Environment Scale. Significant statistical difference between the two groups (P < 0.05) only occurred in the subcategory “organization”, as the first group (m = 4.68, df = ± 2.233) were found to have lower values compared to the other group (m = 5.21, df = ± 2.233).

Discussions

The study demonstrated that informal caregivers of patients with psychotic symptoms involved in self-help groups do not show to have a particular difference in the family atmosphere than families who do not participate in self-help associations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Assessment of empathy and psychological characteristics of smokers

Introduction

Smoking causes many life-threatening diseases and is a major risk factor for several main causes of death. Damage by smoking is also caused to those called “passive smokers”. Passive smoking has been implicated in many adverse effects on health. Very few studies deal with empathy in smokers while smoking in the presence of non-smokers.

Purpose

Estimation of empathy and psychological characteristics of Greek smokers.

Methodology

For research purposes we used questionnaires Toronto empathy questionnaire (TEQ), symptom check list 90-R, experience of shame scale (EES) and other as Shamer scale – OAS.

Results

A statistically significant difference has been observed in the TEQ to gender (2.436, 0.02), with women showing the highest value (3.4 ± 0.4), as well as in the mean in behavioral shame 2. Another statistically significant difference has been observed in behavioral shame between educational level (3.419, 0.026) and the price of characterological shame among those who reported smoking in the workplace and those who did not.

Conclusions

The sample consisted of 27 subjects with average age 24 years and standard deviation of 4 years. Smokers accounted for 48.1%, of whom 69.2% stated that smoke in their living space. Respectively, the percentage of smokers in the workplace was equivalent. The largest percentage of smokers, (13 people, 69.2%) think that non-smokers are very annoyed when surrounded by people smoking close to them. The proportion of those who said they are very much bothered when in places where smoking is prohibited but somebody smokes, is large (47.1%).

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Gypsies's beliefs about the evil eye in relation to mental illness

Introduction

The focus of Medical Anthropology is, among other things, the study of medicine as an expression of culture and involves the analysis of healing traditions, both “traditional” and biomedical.

Objectives

Greek Gypsies who have their own habitus, language, and culture.

Aims The discussion of treatment options that gypsies have or seek in order to address critical life situations outside a biomedical context.

Methods

Field research with interviews and observation.

Results

Using Geertz's analytic approach of symbolic interpretation, this paper focuses on the mobilization and transformation of religious symbols in the clinical setting: how these “converse” with biomedicine and how they participate in the process of healing. Painful life experiences drive subjects to seek recourse in remedies outside the biomedical system. At the center of these experiences are thought to be attacks from the “evil eye.” According to the subjects’ worldview, all people are potential victims of the evil eye. A person's glance can provoke the injury, illness, mental illness or even death of another. Consequently, there is a hierarchy of therapeutic choices in which first preference is given to their own means for addressing a situation—only in the case of failure do they turn to specialists.

Conclusions

The beliefs of the subjects are strongly influenced by their worldview, a historically inherited model of health and healing that, unlike the biomedical model, expresses a belief that ailments are successfully cured “wıth God”.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

The Perceptions of Greek Immigrants in Germany About the Health Illness and Pain in the Context of Mental Health

Aim

This study aims to investigate the perceptions of health, disease and pain issues among Greek immigrant, living in Germany, as they were formed through their previous experiences, their immigration routes and their experiences in a new sociocultural environment, while taking under consideration their varying cultural backgrounds.

Material-method

This research was based on the personal interpretations of ten Greek immigrant (6 women and 4 men). As to methodology, qualitative research was employed. The methodological tools used for the collection of the material were semi-structured interviews (face to face), participant observation and a field diary. Finally, the method of analysis used for the empirical material was content thematic analysis.

Results

All participants experienced immigration as an especially stressful period of their lives that changed their state of health (these changes extend from physical complaints to manifestation of depression). Most person describe life in Germany as difficult due to various problems (loss of relatives and friends’ social networks, poor language knowledge, isolation, etc.). However, the public health system's organization (regardless any flaws), which ensures their access to health services, positively contributed in changing their attitudes regarding the issues under question. Lastly, the reference to psycho-traumatic situations, transitional life phases, as well as to stimuli in the difficult everyday life feed person's meaning-makings about pain.

Conclusions

The research's results showed that health and disease are not only biologically determined phenomena. They also are socially determined situations, given that they are not only related to changes in the individual's psychology but are influenced by the broader sociocultural environment in which the individual lives and works.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Problems of Investigation of Immigrants’ Students and their Relation to Psychopathology

Introduction

The purpose of this research was to investigate the problems of first-generation immigrant students and the linkage of these problems with the psychopathology of students.

Objectives

The sample of this study included men and women students, that were second-generation immigrants aged from 18 to > 25 years.

Methods

The research tools used were: (a) Psychopathology Scale (Symptom Checklist 90-R - SCL-90) and (b) State - Trait Anxiety Inventory (STAI), (c) the orientation test life (LOT-R) d) Other As Shamer Scale (OAS), (e) Experience of Shame Scale (ESS). The statistical processing of data showedQ (a) the students immigrants have higher levels of student migrants stairways: inferior (OAS), empty (OAS), (Mistakes (OAS), Total internal shame (ESS), characterological shame (ESS), behavioral shame (ESS), bodily shame (ESS), Trait Anxiety (STAI), Somatization (SCL-90), Inter. Sensitivity (SCL-90) and Depression (SCL-90).

Results

The results of our study found high levels of psychopathology students immigrants and students migrant and interpretative this finding is explained by the lifestyle of their parents immigrants and different cultures which have to cope and adapt and their marginalization from society and official institutions, a situation that results in their exposure to a variety of risks to their mental health.

Conclusions

In addition to increased levels of psychopathology, second generation immigrants such as students and the students in our sample suffer from violence the authorities and their fellow citizens.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

The Relationship Between Coping Strategies and Sociodemographic Characteristics, Shame and Anxiety in Families of Children or Adolescences with Inflammatory Bowel Diseases: A Cross Sectional Study

Introduction

Ulcerative colitis and Crohn's disease is characterized from a complicated therapeutic management, with bodily and psychological impact to the family.

Objectives

This study examined the coping strategies among families with a child or adolescent with IBD.

Aim

The aim was to investigate possible sex differences with respect to coping strategies of the parents would correlated to overall coping strategies.

Method

The participants were biological parents of patients diagnosed with IBD. The total sample included 61 parents with a mean age 46.2 (SD = 7.4). The parents completed:

– the Family Crisis Oriented Personal Scales;

– the Other As Shamer Scale;

– the Experiences of Shame Scale (ESS);

– questionnaire concerning socio-demographic information.

Results

Mother reported higher levels of social support, accept help, passive appraisal, and overall strategies compared to fathers. The strongest difference was found in accept help (P < 0.001). The feelings of shame of the mothers and fathers of the IBD families were very similar, without statistically significant differences between the groups. The results of the MLR, after controlling for adolescents age, sex and illness duration, revealed that the older age, being a mother, being married and being employment had direct positive associations with the overall coping strategies, while ESS had direct negative associations with the overall coping strategies. The model with all seven predictors explained 68% of the total variance (R2 = 0.68, F = 6.409, P < 0.001).

Conclusions

Our findings provide more detailed information on the coping strategies of Greek families with a child or adolescence with IBD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Shame and Anxiety Feelings of a Roma Population in Greece

Shame is a crucial issue for Roma. The purpose of the present study was to evaluate the severity of shame and anxiety feelings in a Roma population living in Greece and assess the differentiation of these feelings between Roma men and women. A quota sample of 194 Roma adult men and women living in Southern Greece was retrieved. The Experiences of Shame Scale (ESS), the Other As Shamer Scale (OAS) and the Spielberg's State/Trait Anxiety Inventory (STAI) questionnaires were used. Women scored statistically significantly higher than men on ESS, whereas men scored higher on OAS scale (52.27 ± 16.91 vs 45.42 ± 9.98 and 35.93 ± 16.94 vs 30.87 ± 13.72 respectively). Women scored higher than men in both STAI subscales, however significant differences were observed only in State Anxiety scale (48.83 ± 9.26 vs 43.20 ± 9.81). OAS total score was inversely related to state anxiety, whereas ESS total score was positive related to trait anxiety, all correlations being significant at p < 0.05 level. Roma men and women exhibit high levels of shame and anxiety. Cultural, social and minority issues contribute to feelings of inferiority and anxiety experience.

Symptoms of Cardiac Anxiety in Family Members of Intensive Care Unit Patients

BACKGROUND

Studies have shown an association between intensive care unit environments and symptoms of psychological distress in family members of critically ill patients.

OBJECTIVE

To investigate levels of cardiac anxiety in family members of intensive care unit patients.

METHODS

From March 2012 to July 2013, on the third day after the patient's admission, 223 family members of 147 patients completed the Cardiac Anxiety Questionnaire. A total score was calculated from 3 subscales: fear and worry about heart sensations, avoidance of activities reproducing cardiac symptoms, and heart-focused attention and monitoring of cardiac activity.

RESULTS

Among the family members, 142 were women (63.7%) and 81 (36.3%) were men, 150 (67.3%) were married, and 37 (16.6%) were unemployed. Their mean score for overall cardiac anxiety was 1.11 (SD, 0.64), significantly higher (P < .001) than for the general Greek population. Although all 3 subscales scores were significantly higher than for the general population, the highest score was recorded for the avoidance subscale (mean, 1.77; SD, 0.68). The relationship to the patient had a significant effect on heart-focused attention (F5 = 3.51; P = .03). The mean score for patients' siblings (2.0; SD, 0.01) differed significantly (P = .02) from the mean for other family member groups. Older adults (P = .02) and married participants (P = .05) reported higher levels of fear and worry related to cardiac stimuli, and women further reported higher levels of cardioprotective avoidance behavior (P = .02).

CONCLUSIONS

A noticeable number of family members of critical care patients had moderate to severe cardiac anxiety during the hospitalization of their relatives.

Elderly person's connection of family relations with quality of life and shame in the context primary healthcare

Objectives

The elderly persons continue to invest substantially in emotional relationships.

Aim

The overall objective of this research study was to investigate the attitudes of elderly persons towards family relations.

Method

One hundred and ninety-seven healthy elderly individuals participated to the present study from different region in Greece. The age range was 66–93 years old. The questionnaire included: (a) the Family Environment Scale (Family Environment Scale, Form R-FES), (b) The Experience of Shame Scale (ESS), (c) the Other As Shamer Scale (OAS), (d) Quality of Life (SF-36).

Results

Univariate and multivariate analysis was applied for the statistical analysis of the data, which showed that: the elderly persons who are satisfied with their lives in past, they exhibit lower overall price external shame feelings of emptiness (empty – OAS) (P = .002), they perceived reaction of others when they make mistakes (Mistakes – OAS) (P = .000), conflict (Conflict – [Form R-FES]) (P = .000). Elderly persons who are satisfied with their life in this time show higher levels of orientation towards active recreational activity (Active-Recreational Orientation – R-FES) (P = .000). Elderly persons who declared that family relation is important for them exhibit lower levels of feeling vacuum (empty – OAS) (P = .009), and higher levels of orientation for achievements (Achievement Orientation) (R-FES) (P = .010), social role (SF – SF36) (P = .000), Mental Health summary Scale (SF_MCS-SF36) (P = .000).

Conclusion

From the findings of this study, it is apparent how important is the study of the quality of life in old age.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

The Internet addiction and the correlation with the socio-economic crisis in students of University of applied sciences of Thessaly (TEI of Thessaly)

Introduction

Use of the Internet lately has significantly been increased worldwide. The time users spend browsing the Internet is constantly increased resulting to serious consequences incurred in personal, professional and social life.

Aim

The purpose was to explore whether the economic crisis is affecting the use and addiction to Internet, whether the economic crisis is a risk factor in the appearance of addiction to the Internet and if the occupation and the existence of extra-curricular activities act as barriers to the development of addiction to the Internet on students.

Methods

A questionnaire was prepared based on the diagnostic tool IAT (Internet Addiction Test). The survey was conducted in June of 2014 on 632 students.

Result

It was found that 6.2% of the sample population has moderately addictive behavior and 0.5% has a serious addiction. Addiction levels to the Internet are affected by someone working while studying and his monthly income, by daily time spent by the student in activities besides school, by the time spent daily on the Internet and by the operations mostly used. Also found that the risk of developing Internet addiction is higher among students who said they had difficulty paying their bills and Internet subscription and to those who due to economic crisis would stop all their activities in order to obtain money.

Conclusions

The economic crisis is a factor that affects on Internet addiction and occupation and activities may act as a deterrent to the emergence of the phenomenon.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Nursing Care as Perceived by Nurses Working in Disability Community Settings in Greece

INTRODUCTION-AIM

The concept of nursing care in learning disability community settings has not been investigated in Greece. The aim of this paper is to investigate how nurses working in learning disability community settings perceive the meaning of nursing care.

MATERIAL AND METHODS

The sample consisted of 100 nurses and nursing assistants working in a social care hospice. Participants were asked to answer questions about socio- demographic characteristics of the sample and fill in a questionnaire of care (GR-NDI-24), the "Job-Communication-Satisfaction-Importance" (JCSI) questionnaire and the altruism scale of Ahmed and Jackson. The data analysis was realized with statistical methods of descriptive and inductive statistics. The analysis was made with the use of SPSS (version 19).

RESULTS

The majority of the sample was women (78%). The majority of participants were married (66 %), DE graduates (66%) without postgraduate studies (96.7%). The mean age of respondents was 36.98±6.70 years. On the scales of caring and altruism, the mean values were 40.89±15.87 and 28.12±4.16 respectively. Very or fully satisfied with his work was 72% of the sample. The scope of work emerges as the most important factor influencing job satisfaction. The wages and working conditions (73% and 40% respectively) are the parameters of work which gathers the most dissatisfaction, while the salary is emerging as the most important parameter, the improvement of which would provide the highest satisfaction. Marginally statistically significant difference was observed in the range between TE graduates (d=40) and those of the DE grade (d=37), p=0.053. No statistically significant differences were observed in relation to other working and demographic characteristics (p>0.05). Greater care importance was associated with greater job satisfaction (p<0.01), while the latter was associated with high levels of altruism (p<0.05).

CONCLUSION

The scope of work provides high satisfaction to nurses working in social care hospices, while the salary is not satisfactory. Nurses' aides appeared highly sensitive to care issues. A multidimensional approach to the materiality of care and job satisfaction in future research will allow to further highlight all the aspects affecting job satisfaction and performance of nurses. This will identify critical parameters of nursing care in healthcare centers for the chronically ill.

Validation of the Greek translation of the Nursing Dimensions Inventory questionnaire (NDI-35)

Context:

The concept of care is a fundamental issue in nursing science. Therefore the development and the use of tools for assessing care is an imperative for the nursing profession. The NDI-35 questionnaire is one such tool for assessing the nursing care.

Objectives:

The purpose of this paper is to adapt and use the NDI-35 questionnaire in Greek nursing practice. A translation and validation of NDI-35 questionnaire is performed.

Methods:

Exploratory factor analyses, as well as internal consistency and test–retest analyses, were conducted.

Forward translations from English were produced by three independent Greek translators and then back translations by five independent bilingual translators. The Greek NDI-35 questionnaire that was produced was administered to 200 nurses (144 women and 56 men) from tertiary and secondary health care facilities. Data were analyzed using principal component analysis and Cronbach’s alpha.

Results:

One hundred and eighty four nurses that answered the NDI-35 questionnaire were graduates from the Technological Educational Institute (T.E.I.) and 64% of the respondents had more than 15 years of professional experience. Two subscales arbitrarily called “clinical work” and “patient needs” emerged, with the mean “clinical work” subscale score being at 70.16 ±12.90 (a maximum of 85) and mean “patient needs” subscale at 21.49± 6.16. Considerable differences in scoring among different items were observed when the NDI-35 answers were compared to their Greek counterparts’. Results confirmed that: (a) the translated versions are an accurate translation of the original, (b) factor analyses established similar factor solutions as that of the English versions, (c) reliability coefficients are satisfactory (i.e., Cronbach’s α coefficients and test–retests), and (d) construct validity revealed similarities between English and Greek versions, replications consistent with past research, as well as differences explained through theoretical frameworks. Therefore, both scales were accepted as valid and reliable measures in Greek-speaking populations.

Conclusion:

Alphas and test-retest correlation suggest the Greek translated and validated NDI-35 questionnaire is a reliable tool for assessing nursing care. Factor analysis and focus group input suggest it is a valid tool. Nurses in different settings may perceive nursing care differently. The findings of the current paper are discussed in the context of nurse education and assessment of care.