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.

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.

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 bW = -0.173, pW = .004, effect on men bM = -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 (bW = -0.392, pW = .002 and bM = -0.384, pM = .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.

Association of Psychopathology Symptoms, Self-Compassion, and Forgiveness in Patients With Pulmonary Embolism.

Background Pulmonary embolism (PE) is a potentially life-threatening disease with both physical and psychological impacts. The psychological distress in the early phase of the disease has not been previously studied in the literature.  Methods The study sample included patients with PE with or without deep vein thrombosis. All subjects included in the study prospectively completed the Symptom Checklist-90-R (SCL-90-R) questionnaire, the Heartland Forgiveness Scale (HFS), and the Self-Compassion Scale (SCS) during their hospitalization for PE. Results Forty-four PE patients were included in the study (59.1% males). The mean age was 62.27±15.03 years. The majority (77.3%) had at least one comorbidity with 9.1% previously diagnosed with depression. The Total Global Severity Index (GSI) score for SCL-90-R was 82.42±49.70 while 36.4% of subjects had a high "Obsessive-compulsive" score, 22.7% had a high "Depression" score, and 22.7% presented a high "Hostility" score. The total HFS score was 45.54±40.42 with 54.5% of patients classified as "usually forgiving." The mean SCS score was 2.05±0.65 with 59.1% of patients presenting moderate self-compassion while 18.2% had low self-compassion. The total SCS score was correlated with the total GSI score (p=0.005, r=-0.576) and total HFS score (p=0.005, r=0.675). The SCS Self-kindness score correlated with interpersonal sensitivity (p=0.024, r=-0.479), depression (p=0.008, r=-0.551), and GSI score (p=0.049, r=-0.425). Self-judgement correlated with paranoid ideation (p=0.044, r=-0.467), hostility (p=0.007, r=-0.597), and GSI (p=0.027, r=-0.505). Isolation correlated with interpersonal sensitivity (p=0.026, r=-0.509), anxiety (p=0.014, r=-0.553), hostility (p=0.032, r=-0.494), paranoid ideation (p=0.026, r=-0.509), and GSI (p=0.015, r=-0.548). The total SCS score correlated with anxiety (p=0.041, r=-0.438). SCS Self-kindness score correlated significantly with total HFS score (p=0.002, r=0.613), forgiveness of self (p=0.011, r=0.528), forgiveness of others (p=0.008, r=0.550), and forgiveness of situations (p=0.004. r=0.587). Common humanity was significantly correlated with total HFS score (p=0.023, r=0.481), forgiveness of others (p=0.033, r=0.456), and forgiveness of situations (p=0.016, r=0.507). Mindfulness was positively correlated with HFS total score (p=0.009, r=0.544), forgiveness of self (p=0.049, r=0.424), forgiveness of others (p=0.012, r=0.525), and forgiveness of situations (p=0.013, r=0.520). Conclusions We report for the first time that patients acutely hospitalized for PE present symptoms of obsessive-compulsive disorder, depression, and hostility and exhibit moderate self-compassion. The marginal majority of PE patients are "usually forgiving" during the acute phase of the disease. Self-compassion is positively associated with forgiveness and negatively associated with psychiatric symptoms. Further studies are warranted in order to assess longitudinal differences in psychometric scores and the possible result of targeted mental health interventions at PE-specific clinical outcomes.

Closing the gap: The effect of an evidence-based intervention in increasing COPD nurses' knowledge.

BACKGROUND: Chronic obstructive pulmonary diseases (COPD) is the leading cause of respiratory failure and is associated with high morbidity and mortality rates. Nurses play a vital role in ensuring effective, safe, and person-centered care in COPD. AIM: To assess the effect of an evidence-based intervention in increasing the COPD knowledge in a sample of care nurses, staffing public primary, and secondary healthcare services infrastructures and hospitals. METHODS: An intervention that entailed a combination of an educational program and the use of an educational algorithm based on the Global Strategy for the Diagnosis, Management, and Prevention of COPD was performed. RESULTS: At the baseline, the mean total percentage of correct answers was very low (52.74%) as opposed to the other time intervals in which there was a huge increase after the session that was maintained 3 and 6 months later. The highest effect in the total knowledge score was attributed to the educational session followed by the use of the educational algorithm. CONCLUSION: The effect of the intervention on the mean score of correct answers was very strong, which is confirmed by the consistency of the high performance of nurses after 3 and 6 months, respectively.

Diabetic patient assessment of chronic illness care using PACIC.

BACKGROUND: The Patient Assessment of Chronic Illness Care plus is used in order to assess whether provided care is congruent with the Chronic Care Model, according to patients. The purpose of this study was to correlate PACIC+ and the revised 5As "ask, advise, agree, assist and arrange" scoring of a sample of DM patients, with their QoL, depressive symptomatology, demographic and disease characteristics, self-management behaviours of healthy eating and physical activity. METHODS: This is a cross-sectional study where data were collected between January and April 2018 by using three questionnaires (PACIC+, SF-36, CES-D) from a sample of 90 DM patients treated at a Public General Hospital of Central Greece. Anonymous self-completed questionnaires were used to collect the data. Data was processed in the Statistical Package for the Social Sciences (SPSS). RESULTS: The mean age of the participants with DM was 52.8 years (SD = 21.2 years), with cardiovascular disease and arterial hypertension scoring as the most frequently reporting chronic comorbidities. The healthcare received by DM patients has been correlated with their QoL. More specifically SF - 36 and PACIC+ scale scores showed a positive and low correlation in several subscales. The total score of PACIC+ scale as well as the Patient activation score were increased in higher scores of vitality (p = 0.034 & p = 0.028 respectively), hence both scores correlate significantly with latter. In addition, Delivery System / Practice Design score was increased in higher scores of mental health (p = 0.01) and MCS (p = 0.03). CONCLUSIONS: The shift from hospital care focusing on the disease to a more patient-oriented approach puts forward a dynamic holistic approach to chronic diseases and the reduction of their impact. Finding evidence-based and effective strategies to promote health, prevent and manage chronic diseases such as diabetes mellitus is deemed to be crucial and necessary. PACIC+, which is a tool of a patient-level assessment of CCM implementation, can be used by countries which intend to apply changes in the way their health systems provide chronic care and specifically wish to improve the quality of chronic disease care and the QoL of their patients.

Validation and test-retest reliability of the Royal Free Interview for Spiritual and Religious Beliefs when adapted to a Greek population.

BACKGROUND: The self-report version of the Royal Free Interview for Religious and Spiritual Beliefs has been confirmed as a valid and reliable scale, assessing the manner and nature in which spiritual beliefs are expressed. The aim of the present study was to evaluate the test-retest reliability and psychometric properties of the Greek version of the Royal Free Interview for Religious and Spiritual Beliefs. METHODS: A total of 209 persons (77 men and 132 women) with a mean age of 28.33 +/- 9.44 years participated in the study (test group). We subsequently approached 139 participants of the test group with a mean age of 28.93 +/- 9.60 years, who were asked to complete the Royal Free Questionnaire a second time two weeks later (retest group). RESULTS: The vast majority of participants (58.9%) reported both a religious and a spiritual belief, compared to 52 (25.1%) who told of a religious belief only. The internal consistency of the spiritual scale for the test group proved to be good, as standardized inter-item reliability / Cronbach's alpha was 0.83. Item-total correlations ranged from 0.51 to 0.73. They indicated very good levels of differentiation, thus showing that the questions were appropriate. Internal consistency of the spiritual scale for the retest group proved as good as for the test group. Standardized inter-item reliability / Cronbach's alpha was 0.84. Item-total correlations ranged from 0.52 to 0.75. The Pearson correlation coefficient for the total test-retest score of the spiritual scale was 0.754 (p < 0.001). CONCLUSION: The Greek version of the Royal Free Interview for Religious and Spiritual Beliefs is reliable and thus suitable for use in Greece.

Smoking in health science students with asthma.

It is expected that asthmatic students in a health science department would avoid the hazards of cigarette smoking due to the knowledge they gain through their studies. Surprisingly, health science students with asthma had a higher prevalence of smoking than their healthy colleagues.

Depression and pulmonary function in outpatients with asthma.

The purpose of this study was to examine the relation between depression, anxiety and pulmonary function in asthmatics. Thirty-eight adult asthmatic patients underwent psychometric evaluation with the DSSI/sAD questionnaire, filled in an asthma questionnaire and underwent spirometry. The majority of patients suffered from mild-persistent asthma. Twenty-six reported symptoms of anxiety and 25 reported symptoms of depression. A statistically significant reduction in FEV1 and FEV1/FVC values was observed in asthmatic patients with symptoms of depression. The mean value of FEV1 was 81.84(+/-20.83) in patients without symptoms and 63.73(+/-17.99) in patients with symptoms of depression. The mean values of FEV1/FVC were 0.85(+/-0.11) and 0.75(+/-0.10), respectively. These findings indicate a high frequency of depression and anxiety in adult asthmatic patients. A biological linkage between depression and impaired pulmonary function is proposed.

Serum CA 125 combined with transvaginal ultrasonography for ovarian cancer screening.

BACKGROUND: The aim of this study was to evaluate the combination of serum CA125 and Transvaginal Ultra Sonography (TVUS) score, as a screening procedure for ovarian cancer in premenopausal and postmenopausal women. PATIENTS AND METHODS: A retrospective case-control pilot study was conducted. The files of 120 women with ovarian neoplasia detected by TVUS and increased CA125 level, within the framework of a prevention program, were reviewed. The relationship between the above tests and epithelial malignancy was investigated using the SPSS-12 program for Windows. RESULTS: The combination of CA125 value exceeding 30U/ml and a TVUS score > or = 35 had a sensitivity of 81.7% and specificity of 100% in predicting ovarian cancer. Mathematical analysis of the logistic model of our variables revealed a mathematical model that can calculate the likelihood of ovarian cancer detection, by using a combination of CA125 > or = 30U/ml and TVUS score > or = 35. CONCLUSION: By combining TVUS and CA125, an accurate prediction for the presence of ovarian cancer may be achieved. Further investigation in a larger population is warranted.