Depression and Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator in Women.

INTRODUCTION: Cardiovascular disease remains a major cause of morbidity and premature mortality worldwide. The aim of the present study was to investigate the association of atherosclerotic cardiovascular disease (ASCVD) risk estimator with depression in women undergoing cardiological evaluation. MATERIAL AND METHOD: Three hundred women undergoing cardiological evaluation completed the Zung Self-Rating Depression Scale (ZSDS) questionnaire which included women's characteristics. RESULTS: A percentage of 57.4% of our participants exhibited ASCVD risk <5%; while the 18.3% had ASCVD risk between 5% and 7.4%, the 18.3% between 7.5% and 20%, and the remaining 6% > 20%. In terms of depression, 50% of the women had a score of less than 38 (median), according to Zung scale and mean score was 38.4. In addition, 25% of women had a score below 32. These scores indicate low levels of depression in women. Statistically significant higher rates of depression were found in women who were not involved with physical activities (p = 0.030). CONCLUSIONS: The negative impact of depression on the ASCVD risk could potentially be prevented by modifying individuals' behavior with regard to their engagement in physical activity.

Quality of Life in Patients Receiving Medical Cannabis.

INTRODUCTION: Medical cannabis has been used to relieve the symptoms of people with various chronic diseases. Despite of this, it has been stigmatized, even after its legalization in many countries. AIM: The purpose of this study was to investigate the quality of life of patients receiving medical cannabis. MATERIAL AND METHOD: One hundred patients receiving medical cannabis were given (a) a socio-demographic and clinical questionnaire, and (b) the SF-36 Health Survey scale for assessing quality of life. RESULTS: The majority of our patients who received medical cannabis to treat their neurological disorders (58%) reported decrease in their symptoms (96%), better energy and vitality (68%), ability to perform their professional duties (88%), and an improvement in sleeping and appetite (79% and 71%, respectively) after receiving medical cannabis. Our participants exhibited very few restrictions in activities due to emotional difficulties, a moderate general health status as well as moderate vitality and energy. Participants, who reported a longer period of receiving medical cannabis, reported statistically significant more energy and vitality (p = 0.000), but also better mental (p = 0.000) and general health status (p = 0.001). Furthermore, the majority of patients have disclosed medical cannabis use to their family members (85%) and enjoyed their support (93%), but they haven't revealed their medication treatment to their social environment (81%). CONCLUSIONS: Appropriate knowledge could significantly help health professionals in the field of planning and implementation of personalized nursing care in order to achieve optimal therapeutic outcomes.

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

Hematopoietic stem cell transplantation (HSCT) is a well-established therapy tool for several malignant and non-malignant diseases. Parents of children undergoing HSCT experience physiological distress for various reasons such as intensive caregiving, potential complications, and medically intensive process. The purpose of this study was to explore anxiety/depression in parents of children who underwent HSCT and the associated self-reported characteristics. METHOD AND MATERIAL: In the present study were enrolled 100 parents of children who underwent HSCT. Data were collected by the completion of the "Hospital Anxiety and Depression Scale (HADs)," which also included parents' characteristics. The statistical significance level was p < 0.05. RESULTS: Of the 100 participants, 81% and 64% of parents experienced anxiety and depression, respectively, based on HADs scores. A statistically significant association was observed between parental anxiety and gender (p = 0.017), frequency of visiting the hospitalized child (p = 0.023), whether they desired family members to remain in hospital (p = 0.033), as well as with the need for participation in daily care (p = 0.023), for help based on personal needs (p = 0.026), for scheduled meetings with parents having same problems (p = 0.006), for contact with hospital after discharge (p = 0.035), and for written information (p = 0.044). In terms of depression, a statistically significant association was observed with difficulties during the hospital stay (p = 0.034), whether they desired other family members to remain in hospital (p = 0.009), as well as with the need for opportunities or time for questions (p = 0.004), for scheduled meetings with parents having the same problems (p = 0.026), and for contact with hospital after discharge (p = 0.038). CONCLUSION: Anxiety and depression were associated with possibility of family members to remain in the hospital as well as with the need for scheduled meetings with parents having the same problems and for contact after hospital discharge. Based on the findings presented, it is suggested that understanding parents' needs and perceptions is fundamental to the development of appropriate interventions that address their worries.

Coping Strategies in Greek Parents of Children with Cancer.

INTRODUCTION: Childhood cancer is a life-threatening, chronic condition and treatment may extent for several years. The diagnosis of cancer in children could stress intensely their parents. AIM: To explore coping strategies utilized by Greek parents who have children with cancer. MATERIAL AND METHODS: Eighty-five parents of children with cancer, admitted for treatment at the in-patient unit of a Paediatric Hospital in Athens completed a questionnaire with demographic and their children's disease related characteristics and the Family Crisis Oriented Personal Evaluation Scale. RESULTS: Sixty mothers (70.6%) and 25 fathers (29.4%) completed the questionnaire. A percentage of 29.4% of the parents included in this study considered themselves anxious. Elementary or secondary school graduates scored higher in Seeking Spiritual Support (p = 0.013). Stay-at-home or unemployed parents scored lower in the subscale of Passive Appraisal (p = 0.012). Parents who were very well informed tended to exhibit more frequently passive appraisal behavior (p = 0.004). Parents whose child had Hodgkin's lymphoma scored higher in the subscale of Acquiring Social Support (p = 0.034). Statistical significance was found between parent's strategies of Seeking Spiritual Support and the gender (girls) (p = 0.036), as well as the treatment problems (p = 0.008) of hospitalized children. CONCLUSIONS: This study may help health professionals understand Greek families' coping strategies when they have a child with cancer. Appropriate knowledge could significantly help them in the field of planning and implementation of personalized care in order to achieve optimal therapeutic outcomes.

Perceived Social Support in Parents of Hospitalized Children During COVID-19.

It was March 2020 when the World Health Organization declared a global pandemic due to the spread of a virus known as SARS-CoV-2, which started in Wuhan (China) and spread across the world. From that time onward, all governments took specific measures to minimize virus outspread. Human beings faced several challenges in each aspect of life mainly the more vulnerable ones, such as parents with sick children who encountered not only with hospitalization but also with the negative effects posed by pandemic. PURPOSE: Purpose of this study was to explore levels of perceived social support and the associated factors in parents of hospitalized children. METHOD AND MATERIAL: In the study were enrolled 110 parents (30 fathers and 80 mothers) of hospitalized children. Data were collected by the completion of "The Multidimensional Scale of Perceived Social Support (MSPSS)," which included patients' self-reported characteristics. The statistical significance level was p < 0.05. RESULTS: From the 110 participants, 50% scored over 22, 22, and 20 (median) in support from significant ones, family, and friends, respectively. In addition, 25% of parents scored above 25, 25, and 24, respectively. With respect to the possible range of scores (4-28), these values indicate high levels of social support. Statistically significant higher levels of support from significant ones were experienced by parents who desired to be COVID-19 vaccinated (p = 0.019) and had a person at home belonging to a vulnerable group (p = 0.001). In terms of support from family, statistically significantly higher levels had parents who had been COVID-19 vaccinated (p = 0.003), who had not experienced family conflicts during pandemic (p = 0.026), and those who had a person at home belonging to a vulnerable group (p = 0.001). Regarding support from friends, statistically significant levels were experienced by parents who wished to be vaccinated (p = 0.012) and who had not experienced family conflicts during pandemic (p = 0.050). CONCLUSION: Through this unprecedented global health issue, levels of support remained high. Vaccination, having a vulnerable person at home, and intra-family conflicts were associated with support. A better understanding of support in parents with hospitalized children may help in the planning of rational and cost-effective interventions.

The Effect of Psychological Resilience and Coping Strategies on Mental Health of Nurses.

INTRODUCTION: Nursing professional is considered to be stressful with impact on nurses' mental health. AIM: The aim of this study was to investigate the effect of coping strategies and psychological resilience on anxiety and depression among nurses. METHODS: In this descriptive and cross-sectional study, 378 nurses from two hospitals (a general and a psychiatric) in Greece completed the Patient Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2), the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and the Ways of Coping Questionnaire for evaluating the depression, anxiety, psychological resilience, and coping strategies, respectively. The study was carried out between October and December of 2019. Statistical analysis was performed with JASP version 0.14.01 and significance for all statistical tests was set at 0.05 or less. RESULTS: Psychological resilience was significantly correlated with anxiety (r = -0.127, p = 0.014), Positive approach (r = -0.466, p<0.001), Seeking social support (r = -0.228, p < 0.001), Avoidance/Escape (r = -0.121, p = 0.020). Anxiety was positively correlated with Seeking social support (r = -0.112, p = 0.030), Prayer/Daydream (r = -0.132, p = 0.030), Avoidance/Escape (r = -0.164, p < 0.001), and Assertive problem solving (r =-0.195, p < 0.0010). Psychological resilience, Avoidance, and Assertive problem-solving were significant predictors of increasing of anxiety (ß = -0.128, p = 0.013, ß = 0.130, p = 0.027, ß = 0.131, p = 0.020, respectively). Avoidance (ß = 0.209, p < 0.001) and age (ß = 0.208, p = 0.029) were significant predictors of depression. CONCLUSIONS: Psychological resilience and coping strategies have a significant effect on nurses' mental health.

Anxiety and Depression in Hemodialysis: Sex Differences.

INTRODUCTION: Approach to hemodialysis care from a gender perspective has received a great deal of attention globally since two sexes may have different experiences and manifestations of the same disease. PURPOSE: To explore sex differences in anxiety and depression among hemodialysis patients. METHOD AND MATERIAL: In the study were enrolled 200 patients (100 men and 100 women) who underwent hemodialysis. Data were collected by the completion of "The Hospital Anxiety and Depression Scale (HADS)" which included patients' self-reported characteristics. The statistical significance level was p < 0.05. RESULTS: In men and women, anxiety was statistically significantly associated with relations with nurses (p = 0.033 and p = 0.001, respectively), concealment of hemodialysis (p = 0.013 and p = 0.001, respectively), and insomnia (p = 0.001 and p = 0.001, respectively). Only in women, anxiety was statistically significantly associated with years under hemodialysis (p = 0.002), relation with doctors (p = 0.001), and their belief that life had changed (p = 0.002), whereas only in men, anxiety was associated with help in daily activities (p = 0.001). In men and women, depression was statistically significantly associated with relations with nurses (p = 0.002 and p = 0.001, respectively) and dependency on health professionals (p = 0.001 and p = 0.002, respectively). Only in women, depression was statistically significantly associated with years under hemodialysis (p = 0.002), level of information (p = 0.022), relations with doctors (p = 0.001), concealment of hemodialysis (p = 0.001), their belief that life had changed (p = 0.001), and insomnia (p = 0.001). CONCLUSIONS: The development of an effective treatment that may alleviate anxiety and depression needs to capture how patients perceive and respond to hemodialysis.

Factors Affecting Anxiety and Depression in Caregivers of Hemodialysis Patients.

Anxiety and depression have high levels in caregivers of patients on hemodialysis and are strongly associated with demographic factors. The aim of this study was to evaluate the factors affecting anxiety and depression in caregivers of hemodialysis patients. Four hundred and fourteen (414) caregivers (98 males and 316 females) participated in this study. Depression and anxiety were assessed by the Hospital Anxiety and Depression Scale (HADS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Multinomial logistic regression was performed to estimate the factors being independently associated with anxiety and depression levels. Multiple linear regression was performed to estimate the factors being independently associated with Beck Depression Inventory and State-Trait Anxiety Inventory. From a total of 414 participants, 125 (30.2%) had depression and 215 (52%) had anxiety. The median age of respondents was 54.34 (43.9-66.28) years, with half of the sample's age ranging from 43.9 to 66.28 (IQR). Depression and anxiety were significantly associated with parents or siblings, low level of education, increased caregivers' age, retirement, poor financial condition, having children, and comorbidities. In this study, a significant proportion of caregivers were found to have high levels of depression and anxiety. Thus, a formal screening can contribute to early diagnosis and treatment of depression and anxiety in caregivers of patients on hemodialysis.

Incidence of Deep Vein Thrombosis and Its Effect on Health-Related Quality of Life Among Nurses of Greek Public Hospitals: A Multicenter Study.

BACKGROUND: Vein thrombosis (VTE) is a collective term for deep vein thrombosis (DVT) and pulmonary embolism (PE). The aim of this study was to investigate the impact of DVT and its association with health-related quality of life among Greek nurses. METHODS: This is a multicenter descriptive correlation study. The sample of the study was nursing staff working in Greek public hospitals. The diagnosis of DVT was set by Hicks's clinical criteria. RESULTS: The study included 6304 nurses with a mean age of 47.4 ± 4.9 years. Diagnosed by a physician, DVT had 544 (8.6%) participants. The mean score of the overall dimension of physical health-related quality of life was 68.1 ± 21.9 and the overall score of mental health scale was 53.3 ± 10.4. The odds of DVT occurrence increased dramatically for female gender (CI: 27.76, 95% CI: 8.12-94.89, p = 0.001). Increased odds were found also for advanced age (CI: 1.21, 95% CI: 1.09-1.33, p = 0.001), advanced BMI (CI: 1.06, 95% CI: 1.02-1.10, p = 0.001), and smoking (CI: 2.72, 95% CI: 1.51-4.90, p = 0.001). Moreover, previous pregnancy (CI: 1.66, 95% CI: 1.21-2.29, p = 0.002), work experience (CI: 1.13, 95% CI: 1.03-1.23, p = 0.008), and Rhesus (CI: 2.55, 95% CI: 1.11-5.84, p = 0.027) were found to be risk factors for DVT. CONCLUSIONS: Nurses are potentially a professional group for developing deep vein thrombosis, and given the high incidence found in this study, as well as the lower proportion of nurses who were undiagnosed while meeting the clinical criteria of Hick, it is essential for nurses to check their lower extremities for DVT annually.

Perceived Social Support in Individuals With Diabetic Foot Ulcers: A Cross-sectional Survey.

PURPOSE: Explore levels of perceived social support and the associated factors among patients with diabetic foot ulcers (DFUs). DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: Outpatients (n = 140) with DFUs attending a diabetic clinic affiliated with a public hospital in Athens, Greece, for wound care and follow-up visits after healing. METHODS: Data collection included demographic, clinical, self-report, and perceived social support, measured with the Multidimensional Scale of Perceived Social Support (MSPSS), during one-on-one interviews at the post-healing follow-up visit. RESULTS: For perceived social support, 50% of patients (average age 70 years) scored above 24, 24, and 18 (median) on the MSPSS in the categories of receiving support from significant other, family, and friends, respectively, suggesting high levels of perceived social support. Other statistically significant associations were observed for perceived social support from significant other, family, and friends and marital status (P = .001, P = .001, and P = .004, respectively), patients level of information about their health (P =.002, P =.001, and P =.001, respectively), family level of information (P = .001, P = .001, and P = .004, respectively), and how closely they followed period foot checks (P = .001, P = .002, and P = .011, respectively) and diet (P = .001, P = .001, and P = .001, respectively). CONCLUSIONS: Data from our study show that higher levels of perceived social support from significant others, family, and friends were linked to patients and others, being better informed about health status, and other self-care behaviors. Findings underscore the need for health care providers to recognize that social support is an important component of overall DFU management and may guide future interventions to determine which are most effective in enhancing socially supportive behaviors.

Depression in diabetic foot ulcer: Associated factors and the impact of perceived social support and anxiety on depression.

Diabetic foot ulcer (DFU) exerts a heavy physical and emotional burden on patients with diabetes mellitus. The purpose of the present study was to explore the impact of anxiety and perceived social support on depression of DFU patients well as patients' characteristics associated with depression. The sample of the study consisted of 180 DFU patients. Data collected by the completion of "Self-rating Depression/Anxiety Scale- Zung" (SDS/SAS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Patients had moderate levels of anxiety and depression (median: 36, 42, respectively) and high levels of perceived social support from their significant ones, their family and friends (median: 24, 24, 17, respectively). After multiple regression factors that were found to have an impact on depression after taking into account all other factors, were patient's age of above 70 years, patient's anxiety and the social support they received from their significant ones. More specifically, patients aged above 70 years had 9.51 points higher depression than patients aged <50 years of age (ß = 9.51, 95% CI: [0.76, 18.25], P = .034). Moreover, one point increase in patient's anxiety score indicated an increase of 0.71 points in patient's depression (ß = 0.71, 95% CI: [0.43, 1.00], P = .001). On the contrary, one point increase in patient's social support from their significant ones indicated a decrease of 1.52 points in patient's depression (ß = -1.52, 95% CI: [-0.25, -2.79], P = .020). Clinically, a better understanding of factors having an impact on depression on DFU may provide an essential in planning cost effective interventions.

Anxiety-Depression of Dialysis Patients and Their Caregivers.

Background and Objectives: Anxiety-depression of patients undergoing hemodialysis has a strong relation with the levels of anxiety-depression of their caregivers. The aim of this study was to evaluate anxiety-depression of dialysis patients and their caregivers. Materials and Methods: In this cross-sectional study, 414 pairs of patients and caregivers from 24 hemodialysis centers of Greece completed the Hospital Anxiety and Depression Scale (HADS). The statistical analysis of the data was performed through the Statistical Program SPSS version 20.0. The statistical significance level was set up at 5%. Results: The mean age of patients was 64 (54.06-72.41) years old and the mean duration of hemodialysis was 36 (16-72) months. The mean age of caregivers was 54 (44-66) years old. Of the total sample, 17.1% (n = 71) of patients had high levels of anxiety and 12.3% (n = 51) had high levels of depression. Additionally, 27.8% (n = 115) of caregivers had high levels of anxiety and 11.4% (n = 47) had high levels of depression. Caregivers had higher levels of anxiety when their patients had high levels of anxiety as well (42.3%). Additionally, they had higher levels of depression when their patients had high levels of depression as well (17.6%). Conclusions: The results of this study showed a significant association between the levels of anxiety and depression among patients and caregivers. There is a necessity for individualized assessment of dialysis patients and their caregivers and the implementation of specific interventions for reducing the levels of anxiety and depression among them.

Factors Associated with Hemodialysis Machine Dependency.

INTRODUCTION: Hemodialysis is one of major stresses in patients' daily lives since there is no other path for life maintenance but to accept the machine and its' related rules. PURPOSE: of this study was to explore factors associated with dependency on dialysis machine as reported by the patients. MATERIAL AND METHODS: The sample of the study included 250 patients undergoing hemodialysis. For data collection a questionnaire specially designed for the needs of the research was used. More specifically, socio-demographic and clinical characteristics as well as several other self-reported variables were collected. RESULTS: Of the 250 participants, 53.2% was men while 65.2% was aged over 60 years. The study showed that 44% of the patients reported that their life depended very much on hemodialysis machine. Statistically significant association was observed between dependency on dialysis machine as reported by the patients and gender (p=0.030), education (p=0.022), job (p=0.001) and place of residence (p=0.001). Additionally, statistically significant association was observed between dependency on dialysis machine as reported by the patients and the degree of information about their problem (p=0.001) and whether patients reported adherence to treatment guidelines (p=0.001) or followed the proposed diet (p=0.001). Finally, statistically significant association was observed between dependency on dialysis machine as reported by the patients and relations with nursing staff (p=0.001), whether patients had noticed change in body image (p=0.001), whether they faced difficulties in social (p=0.001) and family environment (p=0.030), whether they hid their problem (p=0.006), whether they needed help in daily activities (p=0.001) and whether their lifestyle had changed (p=0.001). CONCLUSIONS: Socio-demographic and clinical characteristics as well as hemodialysis patients' beliefs are associated with machine dependency. This study contributed in outlining factors affecting dependency on dialysis machine, thus reinforcing multidisciplinary health care teams to develop interventions in order to address hemodialysis patients' needs.

Factors Associated With Anxiety and Depression in Persons With Epilepsy (PWE).

INTRODUCTION: Epilepsy is a common neurological disease that is associated with increased morbidity and mortality globally. Persons with epilepsy (PWE) experience a heavy emotional burden mainly due to social stigmatization and limited opportunities in life. The purpose of this study was to explore factors associated with anxiety and depression in PWE. MATERIAL AND METHODS: In the present cross-sectional study, we enrolled 100 PWE who visited outpatient settings in a public hospital for scheduled follow-up. Data collection was carried out by the completion of the Hospital Anxiety and Depression Scale (HADS), which included participants' characteristics. The statistical significance level was p < 0.05. RESULTS: Of the 100 participants, the majority were women (65%), below 50 years old (62%), and single (40%). In terms of mental comorbidity, 58% and 48% experienced anxiety and depression, respectively. A statistically significant association was observed between anxiety and age (p = 0.002). Furthermore, a statistically significant association was observed between depression and gender (p = 0.044), age (p = 0.001), marital status (p = 0.036), educational level (p = 0.003), job (p = 0.025), residency (p = 0.041), and whether they went out at night (p = 0.009). CONCLUSION: Identifying factors associated with anxiety and depression is essential for PWE to receive appropriate support.

Measuring Importance of Physical Self-Care Behavior in Patients with Heart Failure: Validation and Reliability Analysis of 14-item IPSC Scale.

INTRODUCTION: Heart failure (HF) is a complex clinical syndrome associated with increased disability, morbidity and mortality globally. HF is characterized by recurrent exacerbations and a high rate of hospital readmissions. Self-care is a crucial component of treatment. The way patients assess the importance of self-care may shed light on planning effective individualized interventions. The aim of this study was to conduct a validity and reliability analysis of the new 14-item IPSC scale, which measures how important HF patients consider their physical self-care behavior (IPSC, Importance of Physical Self-Care). MATERIAL AND METHODS: The 14-item IPSC scale was created by the researchers to explore how important HF patients consider their physical self-care behavior. The validation of the IPSC scale included face and content validity, construct validity, internal consistency, repeatability and discriminant validity. Patients' characteristics were also included. RESULTS: In the present study, 52 hospitalized HF patients were enrolled, of whom 55.8% were female, 34.6% above 70 years old, 48.1% of NYHA class III and 32.7% suffered this illness from 6 to 10 years. The total IPSC score had a possible range of 14-56, with higher scores indicating a low importance of self-care. The descriptive statistics in the IPSC scale showed a mean score of 27.9 ± 4.9 and a median score of 29, indicating that HF patients evaluated self-care behavior as moderately important. All items were found to be statistically significantly correlated with total scale scores (p ≤ 0.05), with correlation coefficients rho > 0.250, indicating moderate to strong correlations and meaning that all items are important in the calculation of the final score (construct validity). The internal consistency of the items that constituted the total score was found to be high (Cronbach's a > 0.7). Furthermore, it was found that scores had high repeatability (p ≤ 0.001 and ICCs > 0.7). Regarding discriminant validity, a statistically significant association was observed between the importance of physical self-care behavior and both years suffering the illness (p = 0.007) and the NYHA class (p = 0.030). CONCLUSION: The 14-item IPSC scale is a reliable instrument that help nurses in clinical settings to gain a better and prompt understanding of the importance which patients invest in their physical self-care behavior.

Quality of Life in Patients Undergoing Percutaneous Coronary Intervention.

INTRODUCTION: Percutaneous coronary intervention (PCI) is a non-surgical invasive procedure to treat coronary artery occlusion. The quality of life (QoL) is a way to measure the impact of illness and additionally its treatments to traditional measures of clinical outcomes. PURPOSE: The aim of the present study was to explore the levels of QoL pre-PCI, 6 and 12 months after PCI, as well as the factors associated with the QoL pre-PCI. METHODS: In the present study, 100 patients undergoing PCI were enrolled. Data were collected through the completion of the SF-36 Health Survey (SF-36), which included participants' characteristics. The statistical significance level was p < 0.05. RESULTS: Patients had moderate levels of QoL at baseline, with a median general health score of 45 (IQR: 30-65). A gradual statistically significant increase in scores was observed in all subcategories of the patients' QoL at 6 and 12 months after PCI (p < 0.001). A greater increase in scores was observed in physical functioning, physical role, emotional role and social functionality. In terms of the pre-PCI phase, it was found that physical functionality was statistically significantly associated with educational level (p = 0.005), occupation (p = 0.026) and whether the patients had children (p = 0.041). The physical and emotional role was significantly associated with gender (p = 0.046 and p = 0.040) and educational level (p = 0.030 and p = 0.001). Energy-fatigue was significantly associated with gender (p = 0.001), age (p = 0.028), marital status (p = 0.001), educational level (p = 0.001), whether the patients had children (p= 0.012) and other diseases (p = 0.001). Emotional well-being was significantly associated with family history of coronary artery disease (p = 0.011) and the frequency of physical exercise (p = 0.001). Social functioning was significantly associated with gender (p = 0.033), marital status (p = 0.034) and educational level (p = 0.002). Pain was not found to be significantly associated with patients' demographics. General health was significantly associated with gender (p = 0.003), age (p = 0.043), educational level (p = 0.001), other diseases (p = 0.005) and the frequency of physical exercise (p = 0.001). CONCLUSION: Information about the QoL of PCI and its determinants is important to define an effective and comprehensive care plan.

Perceived Social Isolation in Heart Failure.

Patients with heart failure (HF) experience social isolation associated with an increased risk of morbidity, mortality, and elevated health care expenditures. The aim of this study was to evaluate the factors associated with perceived social isolation and to assess the impact of fatigue on social isolation. A total of 100 HF outpatients were enrolled by convenience sampling. Data were collected by completion of the Greek version of the Modified Fatigue Impact Scale (MFIS-Greek), which also included patients' characteristics and their self-report about social isolation. Of the 100 participants (68% men; mean age, 68.6 ± 7.1 years), 78% reported perceiving social isolation. Factors significantly associated with perceived social isolation were female sex (P = .001), New York Heart Association class IV (P = .001), stress about HF (P = .002), paroxysmal nocturnal dyspnea (P = .030), edema in the lower limbs (P = .001), report of receiving many medications (P = .001), change in body image (P = .032), and not following limitations in fluid and sodium intake (P = .001). The MFIS total score determined moderate to high levels of fatigue (median, 70 points; range, 21-105 points). Total fatigue was statistically significantly associated with social isolation as perceived by patients (P = .001). In conclusion, demographic and clinical characteristics as well as fatigue are associated with perceived social isolation. It is essential to evaluate social isolation in routine practice.

Quality of life in diabetic foot ulcer, grade 3: associated demographic factors.

Abstract.

Quality of life of patients with cardiac pacemaker: levels, associated characteristics, and the impact of anxiety and depression.

INTRODUCTION: Implantation of a permanent cardiac pacemaker (PPM) improves recipients' quality of life (QoL). However, psychiatric disturbance may adversely affect QoL and undermine clinical outcomes.

Depression, Adherence, and Functionality in Patients Undergoing Hemodialysis.

Background  Patients undergoing hemodialysis face multiple problems such as difficulties in performing daily activities, low functional capacity, non-adherence to the hemodialysis regimen, and depressive symptoms that lead to poor health outcomes. The present study aimed to assess the levels of depression, adherence, and functionality in patients undergoing hemodialysis, as well as the association between the above variables. Materials and methods In this cross-sectional study, 100 patients undergoing hemodialysis from a private hospital in Athens participated. Data were collected via the Zung Self-Rating Depression Scale, the Barthel Scale/Index, and the Greek Simplified Medication Adherence Questionnaire-Hemodialysis for the evaluation of patients' depression, functionality, and adherence to hemodialysis regimen, respectively. In addition, sociodemographic and clinical characteristics were recorded. The study was conducted during the period of December 2020 to February 2021. IBM SPSS Statistics for Windows, Version 25.0 (Released 2017. IBM Corp., Armonk, New York) was used for the statistical analysis of the data. The statistical significance level was set up at 0.05. Results Of the patients, 50% scored < 38 (possible range 20-80) in the scale pof depression, and 25% of patients scored < 34. Regarding adherence, the median value was 7 (IQR: 7-7) while 77% scored 7 (possible range of 0-8). Regarding functionality, mild dependence (score 91-99) was referred by 77% of the participants, moderate dependence (score 61-90) by 17%, and severe dependence (score 21-60) was referred by 6% of the patients. A statistically significant negative association emerged between depression and functionality (r= -0.342, p=0.001) while no significant association arised between depression and adherence (r= 0.021,p=0.836) as well as between adherence and functionality (r = 0.078, p = 0.439). Statistical significantly higher scores of depression were seen in women (ß = 3.65, p = 0.001) and elderly >70 years old (ß = 3.51, CI=0.09-6.93, p = 0.044). Statistically significantly lower functionality were referred by patients >70 years old (ß = -13.58, CI: -21.68-5.49, p = 0.001) and by patients with high depression score (ß= -0.62, 95% CI: -1.06-0.20, p = 0.005). Conclusion Patients experienced moderate to low levels of depression and high levels of adherence and functionality. The higher the functionality scores, the lower the depression scores. Demographic characteristics, such as age and gender, seem to be significant predictors of depression and functionality.