The Greek-Orthodox version of the Brief Religious Coping (B-RCOPE) instrument: psychometric properties in three samples and associations with mental disorders, suicidality, illness perceptions, and quality of life

Background: The B-RCOPE is a brief measure assessing religious coping. We aimed to assess the psychometric properties of its Greek version in people with and without long-term conditions (LTCs). Associations between religious coping and mental illness, suicidality, illness perceptions, and quality of life were also investigated. Methods: The B-RCOPE was administered to 351 patients with diabetes, chronic pulmonary obstructive disease (COPD), and rheumatic diseases attending either the emergency department (N = 74) or specialty clinics (N = 302) and 127 people without LTCs. Diagnosis of mental disorders was established by the MINI. Associations with depressive symptom severity (PHQ-9), suicidal risk (RASS), illness perceptions (B-IPQ), and health-related quality of life (WHOQOL-BREF) were also investigated. Results: The Greek version of B-RCOPE showed a coherent two-dimensional factor structure with remarkable stability across the three samples corresponding to the positive (PRC) and negative (NRC) religious coping dimensions. Cronbach’s alphas were 0.91–0.96 and 0.77–0.92 for the PRC and NRC dimensions, respectively. Furthermore, NRC was associated with poorer mental health, greater depressive symptom severity and suicidality, and impaired HRQoL. In patients with LTCs, PRC correlated with lower perceived illness timeline, while NRC was associated with greater perceived illness consequences, lower perceived treatment control, greater illness concern, and lower illness comprehensibility. Conclusions: These findings indicate that the Greek-Orthodox B-RCOPE version may reliably assess religious coping. In addition, negative religious coping (i.e., religious struggle) is associated with adverse illness perceptions, and thus may detrimentally impact adaptation to medical illness. These findings deserve replication in prospective studies

Dysregulation and containment in the psychoanalytic psychotherapy of a poorly controlled diabetic patient

Dysregulation, as a phenomenon of disruption in the psychotherapeutic setting, may be evidenced in the psychoanalytic psychotherapy of diabetic patients presenting poor metabolic and treatment control. In the case of a female patient, violations of the setting via acting out behaviors provided an opportunity for working through and understanding in depth the patient's unconscious attempts to activate traumatic childhood experiences and introduce loss and confusion into the relationship with the psychotherapist. Dysregulation was considered in connection with the patient's pathological containment function, in conflicting part self and object representations, and in relation to traumatic experiences of maternal desertion. Improvement of the patient was identified in her relationships with the psychotherapist, significant others, and the medical health providers, as well as in the overall management of her diabetic treatment. © 2008 The American Academy of Psychoanalysis and Dynamic Psychiatry

Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

Background. The study examines differences regarding quality of life (QoL), mental health and illness beliefs between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods. 144 End-Stage Renal Disease (ESRD) patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients consisted of: a) 77 in-centre haemodialysis (HD) and 58 continuous ambulatory peritoneal dialysis (CAPD/PD) patients, all currently being treated by dialysis for varied length of time. Patients were compared for differences after being grouped into those who recently commenced treatment (< 4 years) and those on long term treatment (> 4 years). Next, cases were selected as to form two equivalent groups of HD and CAPD/PD patients in terms of length of treatment and sociodemographic variables. The groups consisted of: a) 41 in-centre haemodialysis (HD) and b) 48 continuous ambulatory peritoneal dialysis (CAPD/PD) patients, fitting the selection criteria of recent commencement of treatment and similar sociodemographic characteristics. Patient-reported assessments included: WHOQOL-BREF, GHQ-28 and the MHLC, which is a health locus of control inventory. Results. Differences in mean scores were mainly observed in the HD patients with > 4 years of treatment, providing lower mean scores in the QoL domains of physical health, social relationships and environment, as well as in overall mental health. Differences in CAPD/PD groups, between those in early and those in later years of treatment, were not found to be large and significant. Concerning the analysis on equivalent groups derived from selection of cases, HD patients indicated significantly lower mean scores in the QoL domain of environment and higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression, indicating more symptoms in these areas of mental health. With regards to illness beliefs, HD patients who recently commenced treatment provided higher mean scores in the dimension of internal health locus of control, while CAPD/PD patients on long term treatment indicated higher mean scores in the dimension of chance. Regarding differences in health beliefs between equivalent groups of HD and CAPD/PD patients, HD patients focused more on the dimension of internal health locus of control. Conclusion. The results provide evidence that patients in HD treatment modality, particularly those with many years of treatment, were experiencing a more compromised QoL in comparison to CAPD/PD patients. © 2008 Ginieri-Coccossis et al; licensee BioMed Central Ltd

Relationship of quality of life, psychopathologic symptoms and ways of coping in Greek nursing staff [Relación entre calidad de vida, síntomas psicopatológicos y formas de afrontamiento en las enfermeras griegas]

Objective: Our aim was to investigate the relationship of quality of life, psychopathological symptoms and ways of coping of nursing staff in two General Hospitals in Greece. Method: This was a cross-sectional study of 302 nurses in two General Hospitals in Greece between October and November of 2015. Data collection was performed using three questionnaires: the World Health Organisation Quality Of Life BREF; the Falk Self-Reporting Questionnaire for the detection of possible psychiatric comorbidity, and the Ways of Coping Scale for Stressful Situations. Results: From a sample of 302 nurses, the poorer the mental and physical health of the nursing staff, the more their quality of life was impaired in all dimensions (physical, psychological, social and environmental) (P <.001, P =.047, P =.001). Also, while the scores in coping strategies “positive approach-positive reappraisal”, “positive approach-problem solving” and “positive approach (overall)” rose, the score in the General Scale dropped; in other words, the employees’ general health improved. Conclusion: Coping strategies such as positive approach, improved the nurses’ general health. In contrast, their mental health deteriorated when they adopted the wishful thinking/daydream and/or the escape/avoidance strategies. Finally, as their general health worsened, their quality of life was impaired in all dimensions, whereas poor mental health of nurses was associated with lower quality of life in the physical and psychological dimensions. © 2018 Elsevier España, S.L.U

Factor structure and psychometric properties of a new 39-item version of the Criteria for Recovery from Eating Disorders questionnaire (CRED-39)

Eating disorders (ED) are a group of mental disorders, which are quite difficult to treat. In studies on the recovery process of ED, patients' experience is rarely been taken into account. In addition, there seems to be a gap between patients' objective improvement, as assessed by clinicians, and patients' own subjective evaluation of their recovery. Criteria for Recovery from Eating Disorders (CRED) is a questionnaire used to investigate recovery criteria which are considered important from the patients' perspective. The purpose of the present study was to examine the factorial structure of CRED and to evaluate its psychometric properties. A sample of 138 patients in ED treatment were asked to complete the CRED along with the WHO questionnaire on quality of life (WHOQoL-BREF) and the eating disorders questionnaire (EDE-Q). Exploratory factor analysis (EFA) was used to explore the factor structure of the CRED. Internal consistency assessment was based on Cronbach's α. Convergent validity was assessed through correlations of CRED with WHOQoL-BREF and EDE-Q. The EFA led to the removal of 13 items of the original CRED and yielded a conceptually justifiable seven factor model: Body Experience, Psychological Well-being, Social Relationships, Gastrointestinal Symptoms, Bodily Functions, Eating Behaviours, and Compensatory Behaviours. Cronbach's alphas of the total questionnaire and all seven factors ranged from 0.77 to 0.88. Convergent validity to WHOQoL-BREF and EDE-Q total scores and subscales were found to be quite satisfactory. Our analysis has, thus, led us to propose the CRED-39, a 39-item version of the CRED questionnaire, which seems to be a valid and reliable tool in assessing ED patients' own view of their recovery process. CRED-39 can be used in clinical practice to address personal needs and to direct individualised interventions

Quality of life in mentally ill, physically ill and healthy individuals: The validation of the Greek version of the World Health Organization Quality of Life (WHOQOL-100) questionnaire

Objective: The World Health Organization Quality of Life (WHOQOL-100) questionnaire is a generic quality of life (QoL) measurement tool used in various cultural and social settings and across different patient and healthy populations. The present study examines the psychometric properties of the Greek version, with an emphasis on the ability of the instrument to capture QoL differences between mentally ill, physically ill and healthy individuals. Methods: A total of 425 Caucasian participants were tested, as to form 3 groups: (a) 124 psychiatric patients (schizophrenia n = 87, alcohol abuse/dependence n = 37), (b) 234 patients with physical illness (hypertension n = 139, cancer n = 95), and (c) 67 healthy control individuals. Results: Confirmatory factor analysis was performed indicating that a four-factor model can provide an adequate instrument structure for the participating groups (GFI 0.92). Additionally, internal consistency of the instrument was shown to be acceptable, with Cronbach's α values ranging from 0.78 to 0.90 regarding the four -domain model, and from 0.40 to 0.90 regarding the six-domain one. Evidence based on Pearson's r and Independent samples t-test indicated satisfactory test/retest reliability, as well as good convergent validity tested with the General Health Questionnaire (GHQ-28) and the Life Satisfaction Inventory (LSI). Furthermore, using Independent samples t-test and one-way ANOVA, the instrument demonstrated good discriminatory ability between healthy, mentally ill and physically ill participants, as well as within the distinct patient groups of schizophrenic, alcohol dependent, hypertensive and cancer patients. Healthy individuals reported significantly higher QoL, particularly in the physical health domain and in the overall QoL/health facet. Mentally ill participants were distinctively differentiated from physically ill in several domains, with the greatest difference and reduction observed in the social relationships domain and in the overall QoL/health facet. Within the four distinct patient groups, alcohol abuse/dependence patients were found to report the most seriously compromised QoL in most domains, while hypertensive and cancer patients did not report extensive and significant differences at the domain level. However, significant differences between patient groups were observed at the facet level. For example, regarding the physical domain, physically ill participants reported more compromised scores in the pain/discomfort facet, while mentally ill participants in the facets of energy/fatigue, daily living activities and dependence on medication. Conclusion: The findings of the study indicate that the Greek version of WHOQOL-100 provided satisfactory psychometric properties supporting its use within general and pathological populations and in the context of national and crosscultural QoL measurement. © 2009 Ginieri-Coccossis et al; licensee BioMed Central Ltd