Validation of the Self-Efficacy Questionnaire (SE-12-Gr) Assessing the Healthcare Professionals' Self-Reported Communication Skills with Older Healthcare Users in Greece.

Patients' satisfaction with their interaction with the healthcare providers has been found to correlate with adherence to therapeutic plans and better health outcomes. Healthcare providers are experiencing barriers when communicating with specific population subgroups, such as people with low health literacy, low education, and older age. Enhancing the communication skills of the healthcare providers working with older adults could facilitate their interaction with the patients. This study presents the validation of the Self-efficacy-12 (SE-12) in Greek. This is an instrument measuring healthcare providers' self-efficacy of communication skills used during their interaction with older patients. A sample of 230 healthcare providers working with older adults participated in the study. The scale showed good psychometric properties (S-CVI=.97, Cronbach a = .95, ICC = .81). A medium to high correlation was found with the generalized self-efficacy questionnaire. Exploratory Factor Analysis (EFA) yielded two factors ("Self-efficacy in communication skills and strategies" and "Self-efficacy of successful interaction") with good psychometric properties. The SE-12-GR is a brief, valid, and reliable tool for assessing self-efficacy of communication skills and it could be integrated as part of the health literacy tools for healthcare providers working with older people in Greece.

Coping profiles and their association with vicarious post-traumatic growth among nurses during the three waves of the COVID-19 pandemic.

AIMS: This study aimed to examine (a) changes in coping strategies and vicarious post-traumatic growth (VPTG) across three timepoints of the COVID-19 pandemic among nurses; (b) discrete groups of nurses with unique coping profiles and (c) the association of these coping profiles with VPTG across the timepoints. BACKGROUND: Although literature abounds with the negative mental health consequences of the pandemic among healthcare professionals, much less is known about the positive consequences on nurses, the coping strategies that they use, and how these change over time. DESIGN: This was a cross-sectional web-based survey at three timepoints during the pandemic. METHODS: A sample of 429 nurses completed online the Post-Traumatic Growth Inventory (PTGI) and the Brief Coping Orientation to Problems Experienced Inventory (COPE) to measure vicarious post-traumatic growth (VPTG) and coping strategies, respectively. The STROBE checklist was used to report the present study. RESULTS: Significantly higher VPTG scores were observed during the third timepoint. Different coping strategies were employed across the three timepoints. Nurses responded to the pandemic either with an active, an avoidant or a passive coping profile. Significantly higher VPTG levels were reported by the nurses of the active profile compared to those of the passive profile, whereas the difference between active and avoidant profiles was not significant. CONCLUSIONS: Notwithstanding the preponderance of the nurses with the active coping profile in achieving high VPTG, the avoidant copers had more gains (VPTG) than the passive copers, suggesting that doing something to cope with the stressor-let it be trying to avoid it-was better than doing nothing. RELEVANCE TO CLINICAL PRACTICE: The identification of distinct coping profiles among nurses and their association with VPTG is of particular use to policymakers and practitioners in developing tailored prevention and intervention efforts to help the nurses effectively manage the demands of the pandemic. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution since the study was exclusively conducted by the authors.

The Silver Lining of Posttraumatic Growth around the Dark Side of the COVID-19 Pandemic: A School-Based Intervention with Mindfulness and Character Strengths Practices among Children.

The theory of posttraumatic growth (PTG) proposes that from life difficulties positive changes can happen, such as deepened personal relationships and an awareness of new possibilities in life. PTG can occur naturally or can be facilitated. This study aimed to promote PTG through a school-based intervention of eight sessions of 45 min each with mindfulness and character strengths practices (the so-called "The exploration of happiness during the COVID-19 pandemic"). The study conducted assessments at baseline, post-intervention, and follow-up (i.e., one month after the intervention). The post-intervention results showed that the participants in the intervention group experienced an improvement in PTG, well-being, mindfulness, strengths use, and PTS symptoms compared to the children in the control group. Furthermore, these positive changes were sustained at follow-up. The findings of this study highlight that mindfulness-based strengths practices can increase positive outcomes (i.e., well-being, posttraumatic growth) and reduce negative psychological symptoms (PTS) among children. The implications for theory and practice are discussed, and detailed appendices for practitioners are provided.

Comparison of the Sensor-Augmented Pump System with the Advanced Hybrid Closed-Loop Delivery System: Quality of Life, Diabetes Distress, and Glycaemic Outcomes in a Real-Life Context.

BACKGROUND: Type 1 diabetes mellitus (T1D) is a chronic disease that requires exogenous insulin administration and intensive management to prevent any complications. Recent innovations in T1D management technologies include the Advanced Hybrid Closed-Loop delivery system (AHCL). The pioneer AHCL system provides automated basal and automated bolus corrections when needed. OBJECTIVE: This study aimed to compare the Advanced Hybrid Closed-Loop (AHCL) system and the Sensor-Augmented Pump (SAP) with Predictive Low Glucose Management (PLGM) system, in relation to glycaemic outcomes, general and diabetes-related Quality of Life (QoL), and diabetes distress. METHODS: General and diabetes-related QoL were assessed with the Diabetes Quality of Life Brief Clinical Inventory (DQOL-BCI) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF), respectively. Diabetes distress was assessed with the Diabetes Distress Scale for Type 1 diabetes (T1-DDS). RESULTS: Eighty-nine T1D adults participated in the study, mostly females (65.2%), with a mean age of 39.8 (± 11.5 years). They had on average 23 years of diabetes (± 10.7) and they were on continuous subcutaneous insulin infusion therapy. Significant differences favoring the AHCL over the SAP + PLGM system were demonstrated by lower mean glucose levels, less time above range, lower scores on DQOL-BCI, T1-DDS, and higher scores on WHOQOL-BREF. Finally, the linear regression models revealed the association of time in range in most of the above aspects. CONCLUSION: This study highlighted the advantages of the AHCL system over the SAP + PLGM system in the real-world setting in relation to general and diabetes-related QoL, diabetes distress, and glycaemic outcomes.

Dimensionality and psychometric properties of the Parent Diabetes Distress Scale -Greek (PDDS-Gr).

Type 1 diabetes (T1D) is a chronic disease characterised by insulin deficiency due to autoimmune destruction of beta-pancreatic cells. T1D, formerly known as juvenile diabetes, is the most common form of diabetes in children and adolescents. On diagnosis, parents of children with TID experience considerable stress, because they need to care for a child in a challenging and life-threatening situation that requires adherence to an intensive medical regimen, constant monitoring of, and coping with their child's condition. T1D is a complex condition that affects both children and their parents in many aspects of their daily lives. This study presents the psychometric properties of the Greek translation of the Parent Diabetes Distress Scale (PDDS), which assesses diabetes distress in parents of children with T1D. A sample of 95 parents, mainly mothers (88.4%), with a mean age of their children 12.2 years (± 3.6) and a diabetes duration of 4.7 years (± 3.4), completed the Greek translation of the PDDS. Exploratory factor analysis (EFA) revealed a five-factor model: 'Parent/child relationship distress', 'Personal distress', 'Child diabetes management distress', 'Future distress', and 'Healthcare team distress'. Confirmation Factor Analysis (CFA) confirmed the construct validity of the scale. The internal consistency indices (Cronbach alpha) for the subscales ranged from 0.69 to 0.89, while the unidimensional structure had an alpha of 0.90. Furthermore, convergent validity was shown with moderate positive correlations between the PDDS-Gr and the subscales of the DASS-21 (depression, anxiety, and stress), the child's age (in years), and the HbA1c value. Finally, parents of children with inadequate glycemic control (HbA1c ≥ 7%) presented higher scores on both the unidimensional structure and the subscales 'Parent/child relationship distress' and 'Healthcare team distress' of the PDDS-Gr. The PDDS-Gr is a valid and reliable tool for assessing diabetes distress in parents of children with T1D and can be used in both clinical and research settings.

The mental health impact of the ongoing Russian-Ukrainian war 6 months after the Russian invasion of Ukraine.

Objective: This study aimed to investigate the impact of the ongoing war in Ukraine on the mental health of Ukrainians, focusing on war-induced trauma, disturbances in self-organization, post-traumatic stress disorder, complex post-traumatic stress disorder, anxiety, stress, and depression. Methods: Data was collected from 703 participants 6 months after the full-scale invasion using a structured questionnaire that included sections on socio-demographic information, trauma-related issues, and mental health. Results: The study found that levels of depression and anxiety were relatively low, while stress and resilience were relatively high among Ukrainians affected by the war. However, those who were directly exposed to military actions, physical violence, or severe human suffering had higher levels of anxiety, depression, stress, and trauma-related symptoms. The war experience varied by gender, age, and living conditions. Participants who stayed in Ukraine had significantly lower anxiety, depression, stress, and trauma-related symptoms compared to those who moved abroad. Anxiety, depression, stress, low resilience, and subjective satisfaction with living conditions were predictors of trauma-related symptoms, including PTSD and CPTSD. Conclusion: These findings suggest that the mental health of Ukrainians affected by the war was impacted differently depending on their level of exposure to violence and their living conditions. Additionally, the study identified several predictors of trauma-related symptoms, including PTSD and CPTSD, such as anxiety, depression, stress, low resilience, and subjective satisfaction with living conditions. Future research should further explore the relationships between trauma type, sociodemographic factors, resilience, stress, anxiety, depression, and PTSD and CPTSD to better understand the mediation mechanisms underlying these relationships and to develop effective interventions to support the well-being of Ukrainians during this difficult time.

Promoting Self-Management and Independent Living of Older Individuals with Chronic Diseases through Technology: A Study of Self-Reported Needs, Priorities, and Preferences.

Background and Objectives: Older patients' needs are rarely examined beforehand, and thus, although technology-based tools can enhance self-management, acceptability rates are still low. This study aimed to examine and compare self-reported needs, priorities, and preferences of older patients with heart failure (HF), diabetes mellitus type II (DM2), and chronic obstructive pulmonary disease (COPD) toward technology use to enhance self-management. Materials and Methods: A convenience sample of 473 participants over 60 s (60.5% females), diagnosed with HF (n= 156), DM2 (n = 164), or COPD (n = 153) was recruited. They were administered a questionnaire about the usefulness of technology in general and in specific areas of disease management. Results: Most participants (84.7%) admitted that technology is needed for better disease management. This was equally recognized across the three groups both for the overall and specific areas of disease management (in order of priority: "Information", "Communication with Physicians and Caregivers", and "Quality of Life and Wellbeing"). Sociodemographic differences were found. Cell phones and PCs were the devices of preference. The four common features prioritized by all three groups were related to 'information about disease management' (i.e., monitoring symptoms, reminders for medication intake, management and prevention of complications), whereas the fifth one was related to 'communication with physicians and caregivers (i.e., in case of abnormal or critical signs). The top disease-specific feature was also monitoring systems (of respiratory rate or blood sugar or blood pressure, and oxygen), whereas other disease-specific features followed (i.e., maintaining normal weight for HF patients, adjusting insulin dose for DM2 patients, and training on breathing exercises for COPD patients). Conclusions: Older individuals in these three groups seem receptive to technology in disease management. mHealth tools, incorporating both common and disease-specific features and addressing different chronic patients, and also being personalized at the same time, could be cost-saving and useful adjuncts in routine clinical care to improve self-management.

The impact of the Russian-Ukrainian war on the mental health of Italian people after 2 years of the pandemic: risk and protective factors as moderators.

Objective: This contribution aimed at investigating the moderating role of risk (e.g., the negative influence of COVID-19 on mental health) and protective (e.g., post-traumatic growth) factors on the relationship between the concern for war and stress and anxiety/depression levels among Italian people. Methods: A questionnaire that included sociodemographic characteristics, the Perceived Stress Scale (PSS-4), the Patient Health Questionnaire (PHQ-4), the Brief Resilience Scale (BRS), the Post-Traumatic Growth Inventory (PTGI), and questions formulated ad hoc about concern for war was administered online. A sample of 755 participants (65.4% females, mean age = 32.39, SD = 12.64, range = 18-75) was recruited by convenience and snowball sampling. The researchers spread the link to the questionnaire to their acquaintances asking them to fill it out and to recruit other people. Results: Results showed that concern for war significantly augmented the levels of stress and anxiety/depression in Italian people. Being a healthcare professional or having a chronic illness negatively moderated the effect of concern for war on stress and anxiety/depression. Instead, the negative influence of COVID-19 on mental health positively moderated the effect of concern for war on stress. Moreover, the overall positive changes after trauma and four of its five scales (i.e., Relating to Others, New Possibilities, Personal Strength, and Spiritual Change), negatively moderated the effect of concern for war on anxiety/depression. Conclusions: In conclusion, concern about the Russian-Ukrainian war affects the mental health of the Italian population even if they are not directly involved in the conflict.

Six months into the war: a first-wave study of stress, anxiety, and depression among in Ukraine.

Objective: This study examines the prevalence and predictors of mental health issues, specifically anxiety, depression, and stress, among Ukrainians during the military conflict with Russia. Method: A cross-sectional correlational study was conducted six months after the beginning of the conflict. Sociodemographic factors, traumatic experiences, anxiety, depression, and stress were assessed. The study included 706 participants, both men and women, from different age groups and living in various regions of Ukraine. The data were collected from August till October 2022. Results: The study found that a large portion of the Ukrainian population shows increased levels of anxiety, depression, and stress due to the war. Women were found to be more vulnerable to mental health issues than men, and younger people were found to be more resilient. Worsened financial and employment statuses predicted increased anxiety. Ukrainians who fled the conflict to other countries exhibited higher levels of anxiety, depression, and stress. Direct exposure to trauma predicted increased anxiety and depression, while war-related exposure to "other stressful events" predicted increased acute stress levels. Conclusion: The findings of this study highlight the importance of addressing the mental health needs of Ukrainians affected by the ongoing conflict. Interventions and support should be tailored to address the specific needs of different groups, particularly women, younger individuals, and those with worsened financial and employment statuses.

Fake news during the war in Ukraine: coping strategies and fear of war in the general population of Romania and in aid workers.

Introduction: In addition to the health crisis that erupted during the COVID-19 pandemic, the war between Russia and Ukraine is impacting the mental health and wellbeing of the Romanian population in a negative way. Objectives: This study sets out to investigate the impact that social media consumption and an overload of information related to the armed conflict between Russia and Ukraine is having on the distribution of fake news among Romanians. In addition, it explores the way in which several psychological features, including resilience, general health, perceived stress, coping strategies, and fear of war, change as a function of exposure to traumatic events or interaction with victims of war. Methods: Participants (N = 633) completed the General Health Questionnaire (GHQ), the CERQ scale with its nine subscales, the Perceived Stress Scale (PSS), and the BRS scale (Brief Resilience Scale), the last of which measures resilience. Information overload, information strain and the likelihood of the person concerned spreading fake news were assessed by adapting items related to these variables. Findings: Our results suggest that information strain partially moderates the relationship between information overload and the tendency to spread false information. Also, they indicate that information strain partially moderates the relationship between time spent online and the tendency to spread false information. Furthermore, our findings imply that there are differences of high and moderate significance between those who worked with refugees and those who did not as regards fear of war and coping strategies. We found no practical differences between the two groups as regards general health, level of resilience and perceived stress. Conclusion and recommendations: The importance of discovering the reasons why people share false information is discussed, as is the need to adopt strategies to combat this behavior, including infographics and games designed to teach people how to detect fake news. At the same time, aid workers need to be further supported to maintain a high level of psychological wellbeing.

Cultural Adaptation of a Health Literacy Toolkit for Healthcare Professionals Working in the Primary Care Setting with Older Adults.

Healthcare professionals' health literacy (HL) knowledge and skills influence their interaction with older adults. Healthcare professionals, when effectively communicating with older adults, can empower and enhance patients' skills to make informed decisions about their health. The study aimed to adapt and pilot test a HL toolkit to enhance the HL skills of health professionals working with older adults. A mixed methodology of three phases was used. Initially, the healthcare professionals' and older adults' needs were identified. Following a literature review of existing tools, a HL toolkit was selected, translated, and adapted into Greek. The HL toolkit was introduced to 128 healthcare professionals as part of 4 h webinars; 82 healthcare professionals completed baseline and post assessments, and 24 healthcare professionals implemented it in their clinical practice. The questionnaires used included an interview on HL knowledge, communication strategies, and self-efficacy using a communication scale. HL and communication strategies knowledge (13 items) and self-efficacy in communication (t = -11.127, df = 81, p < 0.001) improved after the end of the HL webinars, and improvement was retained during the follow-up after 2 months (H = 8.99, df = 2, p < 0.05). A culturally adapted HL toolkit was developed to support the needs of healthcare professionals working with older adults, taking into consideration their feedback in all phases of the development.

[Depressive symptoms and insulin pump therapy in people with type 1 diabetes mellitus: A systematic review].

Type 1 Diabetes mellitus (T1DM) is a chronic, multifactorial metabolic disease that requires constant medical care. T1DM is the result of an irreversible destruction of pancreatic ß-cells, inevitably leading individuals to chronic exogenous insulin dependence. The prevalence of depression among T1DM is common and affects both the progression and management of the disease. The aim of this study is to present the depressive symptoms in people with T1DM who apply and those who do not apply the insulin pump therapy method and to highlight differences in terms of gender and age. The literature review was conducted using the databases PubMed, Science-Direct and Scopus. The inclusion criteria were the following: the studies had to be conducted in T1DM patients, study depressive symptomatology, the number of participants in the studies to be more than 70 people and to be in English. Initially, 464 articles were retrieved and 11 articles met the requirements for inclusion in the systematic review. The results of the systematic review, excluding paediatric patients with T1DM, showed that patients who apply the insulin pump therapy method were more likely to have higher prevalence and intensity of depressive symptoms, compared to users of multiple daily injections. Respectively, increased depressive symptoms in women with T1DM were presented, regardless of the method of treatment. Factors that mediate this difference in depressive symptoms are the sense of freedom and flexibility in lifestyle, fewer dietary restrictions, the sense of constant "bonding" and social stigma. Finally, mental health professionals should frequently evaluate the depressive symptoms of the T1DM patients, as it has a direct impact on the development and management of the disease.

Diabetes Mellitus Type 1 During COVID-19: Psychological Symptoms and Eating Attitudes.

BACKGROUND: Diabetes Mellitus Type 1 is a chronic metabolic disorder, the treatment of which extremely burdens the patient. The lockdown, as a measure to prevent the spreading of the 2019 coronavirus disease, was a major challenge for the general public. People with chronic diseases, such as T1D patients, have complex emotional and psychological needs and are at increased risk for both depressive symptoms and anxiety. OBJECTIVE: The aim of this study was to evaluate the impact of body mass index of T1D patients on the psychological symptoms and eating habits, as well as the prognostic factors of the psychological symptoms during the lockdown period. METHODS: Diabetes mellitus patients were invited to complete this survey from the outpatient Diabetes clinic of the General Hospital of Chania and the "AHEPA" General University Hospital of Thessaloniki in Greece. Psychological symptoms were assessed using the DASS-42 questionnaire, and eating habits were assessed using the EAT-26 questionnaire. RESULTS: Overall, 112 T1D patients were analyzed (response rate: 28.8%). Obese T1D patients appear to be at greater risk of developing psychological symptoms, such as depression, anxiety, and stress. Furthermore, disordered eating behaviors and bulimia and food preoccupation subscale are associated with psychological symptoms. CONCLUSION: The findings suggest that obese T1D patients are at greater risk of developing psychological symptoms. Moreover, when an eating disorder is triggered, negative psychological symptoms such as depression and anxiety are reduced. The results of this study may guide targeted interventions among T1D patients.

Health literacy continuing education courses and tools for healthcare professionals: a scoping review.

Strengthening the health literacy (HL) skills of the healthcare users is a multicomponent process involving the users, the healthcare professionals, the stakeholders, and the environment. Health organizations, universities, private initiatives, and funded projects focused on developing and implementing continuing education courses target at increasing healthcare professionals' HL. This scoping review aimed at reporting the HL continuing education courses for healthcare professionals to enhance their knowledge and skills in identifying and supporting healthcare users with limited HL, and particularly, older people. This review followed the five stages by Arksey and O'Malley framework and the guidelines by Joanna Briggs Institute for scoping reviews. Peer-reviewed papers and gray literature published between years 2000 to 2020 were included in this bibliometric search utilizing four electronic databases (PUBMED, MEDLINE, CINAHL, PSYCHINFO, and Opengrey). Twenty-seven (27) papers met the criteria, including twenty-one (21) full-texts and six (6) other records (website contents, eLearning, and funded projects). There is a lack of HL tools that address the training needs of healthcare professionals working with older adults. Tailored HL tools could benefit healthcare professionals' clinical work by improving their communication with older adults.

Secondary traumatic stress and dissociative coping strategies in nurses during the COVID-19 pandemic: The protective role of resilience.

During the COVID-19 pandemic, nurses are repeatedly exposed to acute stress at their workplace, and therefore, they are at high risk for developing mental health symptoms. The prolonged exposure of healthcare professionals may lead to Secondary Traumatic Stress (STS). STS is an aspect of "cost of care", the natural consequence of providing care to people who suffer physically or psychologically. The purpose of this study was to investigate the levels of STS in nurses during the first phase of the COVID-19 pandemic in Greece and to detect aggravating and protective factors. Participants were 222 nurses (87.4 % women; mean age 42.3 years) who completed an online survey. The questionnaire comprised of the Secondary Traumatic Stress Scale, the Brief Resilience Scale, and the Brief Coping Orientation to Problems Experienced Inventory. Nurses had high levels of STS. The hierarchical regression analyses showed that STS and its dimensions Avoidance and Arousal were positively predicted mainly by denial and self-distraction coping strategies and inversely by resilience. Resilience exhibited a protective (partial mediation) effect on the strong relationship between the dissociative coping strategies (denial, self-distraction, venting and behavioral disengagement) and STS. Trauma-informed care psychosocial interventions are needed to support the already overburdened nursing staff during the coronavirus pandemic.

Dimensionality and psychometric properties of the Greek version of the Τype 1 Diabetes Stigma Assessment Scale (DSAS-1-Gr).

Type 1 Diabetes Mellitus (T1D) is one of the most common chronic diseases affecting children and adolescents. The daily management of T1D requires continuous insulin therapy, as well as the inevitable adjustment of daily activities according to glycaemic control, both of which may result in experiencing T1D related stigma. A significant proportion of people with T1D have been shown to experience social discrimination and stigma, which can lead to emotional distress and act as a barrier to help-seeking behavior. This study presents the psychometric properties of the Greek translation of the Diabetes Stigma Assessment Scale-1 (DSAS-1), which assesses self-perceived stigma in people with T1D. A sample of 105 adults with T1D, mostly females (70.5%), with a mean age of 34.3 years (±11.1), and mean disease duration of 19.4 years (±10.5), completed the translated in Greek DSAS-1 (DSAS-1-Gr). Exploratory and confirmatory factor analyses were used to investigate the construct validity of the scale. In line with the original version, the results of the present study supported the three-factor model of the scale 'identity concerns', 'different treatment', 'blame and judgment'. The internal consistency indices (Cronbach alpha) of the three subscales were above α=.80 and .88 for the whole scale. Moderate correlations were found between the DSAS-1-Gr and the Diabetes Distress scale for type 1 Diabetes (T1-DDS), the Rosenberg self-esteem scale, and the DASS-21 subscales (depression, anxiety, and stress), which is indicative of convergent validity. DSAS-1-Gr correlated negatively with the diabetes duration (in years), which was indicative of discriminant validity. Finally, females presented higher total DSAS-1-Gr score than males. DSAS-1-Gr is a valid and reliable tool to be used in clinical practice to assess stigma in Greek people with T1D.

Problematic Internet, Smartphone, and SMS Use among Adults: Shared and Unique Predictors.

BACKGROUND: Although a surge of interest has recently emerged in investigating the simultaneous problematic use of various technology-based tools, the findings are still inconclusive. The present web-based survey aimed at examining whether (a) personality traits, coping strategies, and sociodemographics are associated with problematic internet, smartphone, and SMS use among Greek users and (b) personality traits mediate the relationship between maladaptive coping strategies and problematic use of the three media. STUDY DESIGN: A cross-sectional study. METHODS: A convenience and snowball sample of 1016 participants (84.4% female, mean age of 30.3 years) completed the Problematic Internet Use Questionnaire-9 (PIUQ-9), the Mobile Phone Problem Use Scale (MPPUS), the Self-Perception of Text Message Dependency Scale (STDS), the Personality Diagnostic Questionnaire 4+(PDQ-4+), and the Brief Coping Orientation to Problems Experienced Inventory (Brief COPE). RESULTS: Shared predictors between problematic use of the three technology-based tools were younger age and low educational level, the coping strategy of substance use, and the narcissistic, avoidant, and dependent personality disorders. Predictors of problematic internet and smartphone use were coping strategies of emotional support, self-distraction, and behavioral disengagement. According to structural equation models (SEM) models, cluster C personality disorders fully mediate the relationship between maladaptive coping strategies and problematic use of technology-based tools. CONCLUSION: Addressing factors that predispose (i.e., personality traits), precipitate, or maintain problematic use (i.e., coping strategies) can lead to effective and cost-saving preventive (i.e., screening of vulnerable groups) and therapeutic efforts (i.e., teaching adaptive coping strategies).

Technological Developments and Quality of Life in Type 1 Diabetes Mellitus Patients: A Review of the Modern Insulin Analogues, Continuous Glucose Monitoring and Insulin Pump Therapy.

BACKGROUND: Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease, which is characterized by an increased prevalence worldwide, which, in fact, tends to take extensive dimensions. The recent rapid development of science and technology has significantly contributed to the improvement of the management of type 1 diabetes mellitus, both in achieving the required euglycaemic regulation and reducing the psychological burden associated with the disease, consequently improving the quality of life of the patients with type 1 diabetes mellitus. METHODS: A literature review from 2010, related to the contribution of the modern insulin analogues, continuous glucose monitoring and the insulin pump, was performed using Scopus, ScienceDirect and PubMed databases. RESULTS: Studies included in the review support a direct and indirect association of technological innovations with the quality of life. The use of type 1 diabetes mellitus technology was negatively associated with the frequency of the hypoglycaemias and the value of the glycosylated hemoglobin, while at the same time, the development and use of the related technology were highly associated with an improvement in the quality of life. CONCLUSION: Patients' quality of life is an indicator of the management of type 1 diabetes mellitus, and it is just as important as glycaemic regulation. Through this review, it was concluded that a better quality of life of T1DM patients was associated with the improvement of glycosylated hemoglobin and hypoglycemic episodes.