A Systematic Review of Randomized Controlled Interventions for Parents' Distress in Pediatric Leukemia

Objective. This review aims to summarize the existing evidence concerning interventions towards reducing stress in parents with a child with leukemia and their effect in child and family wellbeing. Methods. A systematic review strategy was conducted using MEDLINE covering the period January 1980 to June 2010. Results. Seven randomized controlled trials met the inclusion criteria including in total 1045 parents participants. A variety of cognitive-behavioral interventions problem-solving skills training programs have been used for managing distress in parents and children. Outcome measures are assessed by self-report, observer report, behavioral/psychological, and physiological measures. The most prominent methodological problems were the marked heterogeneity in stress measurement and the relative absence of proper measurement and adjustment of moderating and mediating factors. The largest effect has been obtained by combined cognitive-behavioral interventions with promising but limited evidence for several other psychological interventions. Conclusions. Recommendations for future RCTs are provided, and particular attention to the quality of trial design and reporting is highlighted

Gender differences in Greek centenarians. A cross-sectional nation-wide study, examining multiple socio-demographic and personality factors and health locus of control

<p>Abstract</p> <p>Background</p> <p>Centenarians are exceptional ageing paradigms, offering valuable information on achieving longevity. Although, there are several studies examining different biomedical factors as determinants of longevity in centenarians, little is known about gender differences with respect to personality traits and health locus of control.</p> <p>Methods</p> <p>Nation -wide study carried out in Greece, between 2007 and 2010. Our final sample of analysis consisted of 400 centenarians who reported on sociodemographic, disease-related and personality factors and health locus of control (HLC). Gender differences were investigated by simple nonparametric comparisons. Bivariate correlations between personality factors and internal and external HLC were obtained.</p> <p>Results</p> <p>Women centenarians outnumbered men by a ratio of 1.68 to 1. Significant gender sociodemographic differences were noted, with men reporting less often widowhood, more often centenarian 1st degree relatives and smoking. Higher BMI score was measured in males than females. Concerning personality variables, females were more reward-dependent and adaptable than men, while men were more optimistic than women. No differences were found on health locus of control profile between the genders. Positive correlations between self-directness and spirituality with internal locus of control in men and negative correlations between optimism and external locus of control in women emerged as the main gender disparities in the correlation analyses. Self-directness in men and optimism in women were consistently correlated with the two HLC subscales.</p> <p>Conclusions</p> <p>Gender differences should be incorporated in future basic research and epidemiological studies of longevity. Informed policies on ageing and wellbeing programs should also take into account gender issues to increase efficacy by targeting health locus of control.</p

Impact of a stress management program on weight loss, mental health and lifestyle in adults with obesity: a randomized controlled trial

Aim: To evaluate the impact of a stress management program on weight loss, depression, anxiety and stress as well as on the adoption of healthy lifestyle in adults with obesity. Methods: Adults with obesity who sought help for weight loss at a medical obesity clinic were consecutively enrolled in the study and were randomly assigned to the intervention or control group. All participants received standard instructions for a healthy lifestyle. The intervention group attended an 8-week stress management program that comprised diaphragmatic breathing, progressive muscle relaxation, guided visualization and instructions about healthy nutrition/dietary habits. Anthropometric parameters were assessed and several questionnaires were completed by all participants, at the beginning and at the end of the study. Results: A total of 45 adults (mean age±SD 45.7±10.55 years) with obesity were enrolled in the study; 22 in the intervention group and 23 in the control group. Participants in the two groups were matched for age and BMI. Participants in the intervention group achieved a significantly larger reduction in BMI compared to the control group (ΔBMI -3.1 vs. -1.74 kg/m2 respectively, P&lt;0.001). In addition, they displayed ameliorated depression and anxiety scores and a reduction in the health locus of control based on chance

A QUASI-EXPERIMENTAL PILOT STUDY OF THE EFFECTS OF A STRESS MANAGEMENT & HEALTH PROMOTION PROGRAM IN CHILDREN WITH ADHD

Objective: The purpose of the present study was to investigate the effects of a stress management and health promotion program on the primary and secondary symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) as well as on other variables concerning the daily routine and lifestyle of children with ADHD. Furthermore, the effects on the levels of perceived stress and the quality of life of parents of children with ADHD were investigated.Method: The research type was quasi-experimental. Two groups were created (intervention and control group) with a total of 50 participants. Each participant in the intervention group engaged in 8 meetings over a period of two months. The intervention program included information relevant to stress and lifestyle (daily and eating habits, routine, exercise, sleep) as well as the application of cognitive behavioral therapy and stress management techniques.Results: The results are summarized as follows: significant decrease in anxiety and symptoms of ADHD, and improvement in sleep conditions, eating habits and frequency of physical exercise of the children were noted. Furthermore, a positive effect on perceived stress and quality of life of the parents of children with ADHD was observed.Conclusions: The results of the present study show that the stress management and health promotion program significantly improves both the symptoms of the disorder and the emotional state of children with ADHD, as well as their general lifestyle.  Article visualizations

Determinants of Self-Rated Health in a Representative Sample of a Rural Population: A Cross-Sectional Study in Greece

Self-rated health (SRH) is a health measure related to future health, mortality, healthcare services utilization and quality of life. Various sociodemographic, health and lifestyle determinants of SRH have been identified in different populations. The aim of this study is to extend SRH literature in the Greek population. This is a cross-sectional study conducted in rural communities between 2001 and 2003. Interviews eliciting basic demographic, health-related and lifestyle information (smoking, physical activity, diet, quality of sleep and religiosity) were conducted. The sample consisted of 1,519 participants, representative of the rural population of Tripoli. Multinomial regression analysis was conducted to identify putative SRH determinants. Among the 1,519 participants, 489 (32.2%), 790 (52%) and 237 (15.6%) rated their health as “very good”, “good” and “poor” respectively. Female gender, older age, lower level of education and impaired health were all associated with worse SRH, accounting for 16.6% of SRH variance. Regular exercise, healthier diet, better sleep quality and better adherence to religious habits were related with better health ratings, after adjusting for sociodemographic and health-related factors. BMI and smoking did not reach significance while exercise and physical activity exhibited significant correlations but not consistently across SRH categories. Our results support previous findings indicating that people following a more proactive lifestyle pattern tend to rate their health better. The role of stress-related neuroendocrinologic mechanisms on SRH and health in general is also discussed

Perceived Stress Scale: Reliability and Validity Study in Greece

Objective: To translate the Perceived Stress Scale (versions PSS-4, -10 and -14) and to assess its psychometric properties in a sample of general Greek population. Methods: 941 individuals completed anonymously questionnaires comprising of PSS, the Depression Anxiety and Stress scale (DASS-21 version), and a list of stress-related symptoms. Psychometric properties of PSS were investigated by confirmatory factor analysis (construct validity), Cronbach’s alpha (reliability), and by investigating relations with the DASS-21 scores and the number of symptoms, across individuals’ characteristics. The two-factor structure of PSS-10 and PSS-14 was confirmed in our analysis. We found satisfactory Cronbach’s alpha values (0.82 for the full scale) for PSS-14 and PSS-10 and marginal satisfactory values for PSS-4 (0.69). PSS score exhibited high correlation coefficients with DASS-21 subscales scores, meaning stress (r = 0.64), depression (r = 0.61), and anxiety (r = 0.54). Women reported significantly more stress compared to men and divorced or widows compared to married or singled only. A strong significant (p &lt; 0.001) positive correlation between the stress score and the number of self-reported symptoms was also noted. Conclusions: The Greek versions of the PSS-14 and PSS-10 exhibited satisfactory psychometric properties and their use for research and health care practice is warranted

Lifestyle and self-rated health: a cross-sectional study of 3,601 citizens of Athens, Greece

<p>Abstract</p> <p>Background</p> <p>Self-rated health (SRH) is a popular health measure determined by multiple factors. International literature is increasingly focusing on health-related behaviors such as smoking, dietary habits, physical activity, even religiosity. However, population-based studies taking into account multiple putative determinants of SRH in Greece are scarce. The aim of this study was to clarify possible determinants of SRH with an emphasis on the relationship between SRH and lifestyle variables in a large sample of urban citizens.</p> <p>Methods</p> <p>In this one-year cross-sectional study, a stratified random sample of 3,601 urban citizens was selected. Data were collected using an interview-based questionnaire about various demographic, socioeconomic, disease- and lifestyle related factors such as smoking, physical activity, dietary habits, sleep quality and religiosity. Multivariate logistic regression was used separately in three age groups [15-29 (N = 1,360), 30-49 (N = 1,122) and 50+ (N = 1,119) years old] in order to identify putative lifestyle and other determinants of SRH.</p> <p>Results</p> <p>Reporting of good SRH decreased with age (97.1%, 91.4% and 74.8%, respectively). Overall, possible confounders of the lifestyle-SRH relationship among age groups were sex, education, hospitalization during the last year, daily physical symptoms and disease status. Poor SRH was associated with less physical activity in the 15-29 years old (OR 2.22, 95%CI 1.14-4.33), with past or heavy smoking, along with no sleep satisfaction in the 30-49 years old (OR 3.23, 95%CI 1.35-7.74, OR 2.56, 95%CI 1.29-5.05, OR 1.79, 95%CI 1.1-2.92, respectively) and with obesity and no sleep satisfaction in the 50+ years old individuals (OR 1.83, 95%CI 1.19-2.81, OR 2.54, 95%CI 1.83-3.54). Sleep dissatisfaction of the 50+ years old was the only variable associated with poor SRH at the 0.001 p level of significance (OR 2.45, 99%CI 1.59 to 3.76). Subgroup analyses of the 15-19 years old individuals also revealed sleep dissatisfaction as the only significant variable correlated with SRH.</p> <p>Conclusions</p> <p>Slight differences in lifestyle determinants of SRH were identified among age groups. Sleep quality emerged as an important determinant of SRH in the majority of participants.</p

Body Mass Index and Satisfaction with Health in Contemporary Switzerland

Background: Overweight and obesity have been linked with several objective and subjective measures of health. However, results are mixed and this relationship seems to vary across populations, genders and age categories. This paper investigates the relationship between categories of the Body Mass Index (underweight, normal weight, overweight, obesity and severe obesity) and satisfaction with health