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.

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.

Factors associated with the perception of services by dementia informal caregivers in Greece: the role of familism.

AIM: To investigate perceptions of informal caregivers of community-dwelling persons with dementia (PwD) regarding health and social care services and their correlates using the Behavioral Model of Healthcare Utilization as the theoretical framework. METHODS: This was a cross-sectional study using a purposive sampling technique to identify, through community-based health and social care services, caregivers of PwD. Face-to-face interviews were conducted with 118 informal caregivers (78.8% female, mean age = 58.9 years) via a structured questionnaire. RESULTS: Three 'Perceptions of Services' subscales were identified: 'Availability and Adequacy of Services' (AAS), 'Physicians' Competence' (COMP), and 'Professionals' Behavior' (PB). Predisposing factors (gender, employment, familism) and enabling/impeding factors (caregiving impedes work, quality of life aspects - environment and social relationships, information about dementia) were significant correlates of the AAS and COMP subscales. Familism was negatively associated with the AAS subscale. PwD's perceived declined physical and behavioral functioning was related to worse perceptions regarding professionals' behavior (PB) toward the PwD. CONCLUSION: Understanding the factors associated with caregivers' perceptions of health and social care community services may guide the development of interventions that facilitate the appropriate use of those services, provide increased support to PwD and their caregivers, and delay potential institutionalization.

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.

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.

Recollections of Maternal and Paternal Punitive Discipline in Childhood and Violent Attitudes and Behaviors in Adulthood: A Mediation Model.

This cross-sectional retrospective study on a convenience sample of 973 Greek undergraduate students examined whether the violent socialization in childhood and the criminal history in adolescence would be mediators between parents' harsh discipline and young adults' violent attitudes and behaviors (VA/B). Structural Equation Modelling indicated that both the mothers' and fathers' punitive discipline at age 10 have an indirect impact, through the mediators, on young adults' VA/B. A direct effect was also found from mothers' and fathers' punitive discipline to violence approval and from fathers' punitive discipline to antisocial personality symptoms, and corporal punishment law attitude. The findings suggest that early experiences of harsh discipline may increase the risk of adult's violence and call for multilevel prevention and intervention programs targeting both parents and children.

Posttraumatic symptoms, posttraumatic growth, and internal resources among the general population in Greece: A nation-wide survey amid the first COVID-19 lockdown.

Scarce and inconclusive evidence exists on the mental health consequences of the COVID-19 lockdown. This study examined the psychological impact of the lockdown in Greece, resilience levels, use of coping strategies, and identified high-risk groups. A sample of 1661 participants (mean age = 39.5, SD = 12.2; 75.5% females) completed a web-based survey, which was distributed through social networking sites, webpages, and personal contacts. Posttraumatic symptoms, posttraumatic growth, resilience, and coping strategies were assessed. Different population subgroups suffered the impact of lockdown disproportionately. Healthcare workers, females, younger, less educated, and those living alone reported higher rates of posttraumatic stress symptoms. Females achieved more posttraumatic growth and were using coping strategies more frequently than men. Men, older, healthcare workers, and those with a partner were more resilient. Interventions need to be developed to target personal resources, protect vulnerable populations, facilitate posttraumatic growth, and ameliorate wellbeing and quality of life.

A prospective, cross-sectional study of the protective and risk psychological factors of successful in vitro fertilisation outcome: preliminary results in a Greek sample.

The aim of this prospective, cross-sectional study was to examine the protective and risk psychological factors associated with the successful outcome of In vitro fertilisation (IVF). Various psychological factors that may affect the IVF outcome were measured to a sample of 61 infertile women (mean age 37.2 ± 4.4), who started their first or consecutive IVF treatment cycle in an IVF Unit in Greece. Over half of the participants (50.8%) became pregnant. A binary logistic regression analysis (stepwise) was conducted on pregnancy as the outcome, with various variables as predictors. The model was statistically significant (Omnibus Chi-square = 27.324, df = 5, p < .001), explained 54.7% of the variance, and correctly classified 84.6% of the cases. Life purpose (odds ratio [OR] = 1.35, 95% CI = 1.02-1.78) and negative emotions (e.g. discontent, sorrow) (OR = 1.76, 95% CI = 1.19-2.60) were associated with increased pregnancy rates, whereas autonomy (OR = 0.57, 95% CI = 0.39-0.82), and stress (OR = 0.69, 95% CI = 0.55-0.88) were associated with decreased pregnancy rates. It has been concluded that the relationship between psychological factors and successful IVF outcome is more complex than commonly believed. The identification of the risk and protective psychological factors could contribute to increased pregnancy rates and foster the implementation of tailored therapeutic interventions.Impact statementWhat is already known on this subject? High levels of infertility stress and/or depression have been associated with lower pregnancy rates. However, little is known on the impact of emotions, personality characteristics and other psychological variables on in vitro fertilisation (IVF) outcome.What the results of this study add? A combination of commonly believed 'negative' factors (e.g. stress) and 'positive' ones (e.g. well-being) may diversely affect the IVF outcome. Otherwise believed to be positive aspects of human life (i.e. autonomy) may decrease the likelihood of pregnancy, and other factors believed to be 'negative' (e.g. negative emotions) may increase pregnancy rates.What the implications of these findings are for clinical practice and/or further research? The findings invite researchers to further examine the role of the psychological factors which could potentially affect pregnancy rates. Modifiable factors, such as well-being, stress and emotions, should guide tailored interventions aimed at increasing the pregnancy rates in infertile women.

Depression, negative relating with the oldest child, and the mediating role of resilience in community elders' psychological well-being: a pilot study in Greece.

AIM: This study examined the role of both positive and negative aspects of social relationships with partners, friends, and children on the psychological well-being of Greek elders, as well as the potential mediating role of resilience. METHODS: The sample included 100 Greek older community-dwellings recruited from three care centres. They completed questionnaires consisted of the Scales of Psychological Well-Being, the shortened Family Members' Interrelating Questionnaire, the Significant Others Scale, the Brief Symptom Inventory, and the Brief Resilience Scale. RESULTS: The findings suggested that mental health (i.e. depression), rather than physical frailty, and a negative relationship with the oldest child, rather than a lack of social support from family or friends in general, have detrimental effects in elders' well-being. In contrast, resilience has a positive effect on well-being that mediates the association between negative relating with the oldest child and well-being. Elderly parents perceived their child's relating more negatively than their own relating towards the child, and it was the child's negative relating to them, rather than their relating toward the child, that predicted their psychological well-being. An interdisciplinary approach to the care of the geriatric population is highlighted. CONCLUSIONS: To improve elders' well-being and enhance successful ageing, the determinants of well-being should be key targets of ageing research. Policy, prevention, and intervention actions should address the modifiable variables of any underlying emotional and social issues among elderly people (i.e. depression, negative relating with children, and resilience).

Stigmatic beliefs towards persons with dementia: comparing Israeli and Greek college students.

OBJECTIVES: Increasing Alzheimer's Disease (AD) awareness and decreasing stigmatic beliefs among the general public are core goals of National Dementia Strategy programs. College students are one of the most important targeted populations for achieving this goal. The aim of the current study was to examine AD public stigma among Israeli and Greek college students. DESIGN: A cross-sectional survey was conducted among college students in Israel and Greece using vignette methodology. PARTICIPANTS: Seven hundred and fifty three college students - 213 Israeli and 540 Greek - participated in the study. MEASUREMENTS: Three dimensions of stigma were assessed (cognitive, emotional, and behavioral) together with health beliefs regarding AD and socio-demographic characteristics. RESULTS: Low levels of stigma were found in both samples, with Israeli students reporting statistically significant higher levels of stigmatic beliefs than Greek students in all the dimensions, except with willingness to help. Similar to stigma in the area of mental illness, the findings in both countries supported an attributional model for AD public stigma, i.e. positive correlations were found among cognitive attributions, negative emotions, and discriminatory behaviors in both countries. Differences between the countries emerged as a significant determinant of cognitive, as well as of negative emotions and willingness to help. CONCLUSION: Our findings might help researchers and clinicians to apply the knowledge gained in the area of mental illness to the development of effective ways of reducing AD public stigma. Moreover, they allowed us to frame the understanding of AD public stigma within a socio-cultural context.

Measuring change in relating and interrelating during the early stages of psychotherapy: Comparison with a nonpatients' sample.

The study examined whether the relative short time period of two months of individual psychotherapy improved patients' psychiatric symptoms, their negative relating (i.e., destructive and undesirable interpersonal attitudes and behavior to others) and their negative interrelating (i.e., destructive and undesirable relationship with their partners). A sample of 60 outpatients, reportedly suffering mainly from a mood or anxiety disorder, were compared with a sample of 48 nonpatients and their partners, over a comparable time span. It was shown that the patients' psychopathology scores dropped significantly. Significant changes in some relating and interrelating scores also occurred, even though the therapy had not specifically addressed these issues. Unexpectedly, the partners demonstrated some degree of deterioration both in their relating and their interrelating scores.

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.

A cross-national comparison of a shorter version of the person's relating to others questionnaire.

The shorter version of the Person's Relating to Others Questionnaire (PROQ3) is half the length of the earlier PROQ2. Both questionnaires were designed to measure negative relating as organized around a theoretical structure called the interpersonal octagon. Each questionnaire has an upper, lower, close and distant scale and four intermediate scales (e.g., upper close). As would be expected, moderately high positive correlations were observed between primary scales (upper, lower, close and distant) and neighbouring intermediate scales. Correlations diminished with increasing separation around the octagon. The psychometric properties of the PROQ3 were examined within four national samples. Alpha coefficients were consistently acceptable across samples. Gender differences varied between samples. Comparisons were made between the PROQ3 and a measure of the big five (International Personality Item Pool) and between the PROQ3 and two measures based upon the interpersonal circle (Revised Interpersonal Check List [ICL-R] and Circumplex Version of the Inventory of Interpersonal Problems [IIP-C]). It is important to note that, unlike with the PROQ3, significant negative correlations were observed between opposite scales of the ICL-R and opposite scales of the IIP-C. A confirmatory factor analysis provided support for most PROQ3 scales, although some overlap between scales was demonstrated. Correlations between the PROQ3 scales and the big five scales were either non-significant (two scales) or negative. Each PROQ3 scale correlated positively and meaningfully with a short sequence of scales of both the ICL-R and the IIP-C. Psychotherapy patients had higher mean scores than non-patients on four scales but non-patients had higher mean scores on two. Over the course of psychotherapy, the patients' mean score dropped significantly on six scales but rose significantly on one.

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.

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.

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.

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.