ΣΧΕΣΗ ΨΥΧΙΚΗΣ ΔΥΣΦΟΡΙΑΣ, ΔΗΜΟΓΡΑΦΙΚΩΝ ΧΑΡΑΚΤΗΡΙΣΤΙΚΩΝ ΚΑΙ ΚΟΙΝΩΝΙΚΗΣ ΥΠΟΣΤΗΡΙΞΗΣ ΚΑΤΑ ΤΗ ΔΙΑΡΚΕΙΑ ΤΗΣ ΠΑΝΔΗΜΙΑΣ ΤΟΥ COVID-19 = RELATIONSHIP OF PSYCHOLOGICAL DISTRESS, DEMOGRAPHIC CHARACTERISTICS AND SOCIAL SUPPORT DURING THE COVID-19 PANDEMIC

Σκοπός της έρευνας ήταν η διερεύνηση του επιπέδου ψυχικής δυσφορίας / ΨΔ (συμπτωμάτων άγχους, κατάθλιψης, μετατραυματικού στρες / ΜΣ, και σωματοποίησης) και η σχέση του με δημογραφικά και ψυχοκοινωνικά χαρακτηριστικά, κατά την πανδημία του COVID-19. Η συλλογή των δεδομένων έγινε ηλεκτρονικά με ερωτηματολόγια αυτοαναφοράς, μέσω της μεθόδου δειγματοληψίας «χιονοστιβάδα» σε γενικό πληθυσμό. Οι συμμετέχοντες (Ν = 261) παρουσίασαν συμπτώματα άγχους, 43.3%, κατάθλιψης, 51.7%, ΜΣ, 56.3%, σωματοποίησης, 75.5%. Το φύλο, η συντροφική σχέση, η κοινωνική υποστήριξη, η απώλεια του εισοδήματος, οι οικονομικές δυσκολίες, η παρουσία διεγνωσμένης ψυχικής διαταραχής, η απουσία μόλυνσης γνωστού από τον νέο κορωνοϊό, η αντιλαμβανόμενη πιθανότητα μόλυνσης των ίδιων και τα στρεσογόνα γεγονότα επέδρασαν στην ΨΔ. Τέλος, με βάση τα τρία προφίλ, που προήλθαν από την Ανάλυση Λανθανουσών Τάξεων (Latent Class Analysis), τα άτομα χαμηλότερου κοινωνικοοικονομικού επιπέδου (ΚΟΕ) υπήρξαν πιο ευάλωτα στην ΨΔ. Επομένως, η παρούσα έρευνα τόνισε την υψηλή ΨΔ των Ελλήνων κατά την πανδημία του COVID-19, ιδιαίτερα για άτομα με συγκεκριμένα δημογραφικά και ψυχοκοινωνικά χαρακτηριστικά. Τα παραπάνω αποτελέσματα θα μπορούσαν να αξιοποιηθούν στη διαμόρφωση προγραμμάτων ψυχοκοινωνικής υποστήριξης (Kontoangelos et al., 2020) και να εμπλουτίσουν την επιστημονική γνώση πάνω στον ρόλο του ΚΟΕ σε συνθήκες υγειονομικής κρίσης (Marmet et al., 2021).  Στόχος της έρευνας ήταν η διερεύνηση του επιπέδου ψυχικής δυσφορίας (ΨΔ) (δηλ. συμπτωμάτων άγχους, κατάθλιψης, μετατραυματικού στρες (Μ       Σ), και σωματοποίησης) και η σχέση της ΨΔ με δημογραφικά και ψυχοκοινωνικά χαρακτηριστικά κατά την πανδημία του COVID-19. Η συλλογή των δεδομένων έγινε με ερωτηματολόγια αυτο-αναφοράς σε γενικό πληθυσμό. Οι συμμετέχοντες (Ν = 261) ανέφεραν ότι παρουσίασαν συμπτώματα άγχους (43.3%), κατάθλιψης (51.7%), ΜΣ (56.3%), σωματοποίησης (75.5%). Το φύλο, η συντροφική σχέση, η κοινωνική υποστήριξη, η εκτιμώμενη μείωση εισοδήματος, οι οικονομικές δυσκολίες, η παρουσία διεγνωσμένης ψυχικής διαταραχής, η απουσία μόλυνσης γνωστού από το νέο κορωνοϊό, η αντιλαμβανόμενη πιθανότητα μόλυνσης των ίδιων, και τα στρεσογόνα γεγονότα επέδρασαν στην ΨΔ. Τέλος, με βάση τα τρία προφίλ, που αναδείχθηκαν από την Ανάλυση Λανθανουσών Τάξεων, τα άτομα χαμηλότερου κοινωνικοοικονομικού επιπέδου (ΚΟΙΕ) βρέθηκαν να είναι πιο ευάλωτα στην ΨΔ. H παρούσα έρευνα τόνισε την υψηλή ΨΔ των Ελλήνων κατά την πανδημία του COVID-19, ιδιαιτέρως για άτομα με συγκεκριμένα δημογραφικά και ψυχοκοινωνικά χαρακτηριστικά.The aim of the study was to explore the level of psychological distress (PD) (i.e., anxiety, depressive symptoms, post-traumatic stress, and somatization symptoms), and the relationship of PD with demographic and psychosocial characteristics during the COVID-19 pandemic. The data collection was based on self-report questionnaires administered to general population. The participants (N = 261) reported anxiety symptoms (43.3%), depressive symptoms (51.7%), post-traumatic stress symptoms (56.3%), and somatization symptoms (75.5%). Gender, romantic relationship, social support, income loss, financial difficulties, diagnosed mental disorders, lack of infected close ones by COVID-19, high perceived probability of infection, and additional stressful events were associated with PD. Lastly, three profiles, that emerged through Latent Class Analysis, showed that the members of the lowest socioeconomic status profile were the most vulnerable to PD. Thus, this study indicated high PD among the Greek population during the COVID-19 pandemic, especially among people characterized by specific demographic and psychosocial characteristics

CORRELATES OF NEGATIVE MEMORIES THREE MONTHS AFTER BEING IN INTENSIVE CARE UNIT

The aim of this study was to investigate patients’ negative Intensive Care Unit (ICU) memories (nightmares, anxiety, pain, and difficulty in breathing), their interrelations, and their correlates (medical, demographic, and psychosocial factors). Three months after an ICU stay, 29% of 72 Greek participants reported that they had at least two types of negative ICU memories. Memories of anxiety and difficulty in breathing contributed more to a core factor of negative ICU memories than memories of nightmares and pain. Negative ICU memories were associated to intensity of weaning, length of stay in the ICU, consciousness of participants at admission to the ICU, existence of confusion or agitation in the ICU, female gender, adverse life experiences after the ICU stay, and unemployment or protracted sick leave after the ICU stay. Negative ICU memories are common and related both to ICU and post-ICU stress conditions.   

Factors predicting adherence to risk management behaviors of women at increased risk for developing lymphedema

Purpose: Lymphedema affects 20-30% of women following breast cancer treatment. However, even when women are informed, they do not necessarily adhere to recommended lymphedema self-management regimens. Utilizing the Cognitive-Social Health Information Processing framework, we assessed the cognitive and emotional factors influencing adherence to lymphedema risk management. Methods: Women with breast cancer who had undergone breast and lymph node surgery were recruited through the Fox Chase Cancer Center breast clinic. Participants (N = 103) completed measures of lymphedema-related perceived risk, beliefs and expectancies, distress, self-regulatory ability to manage distress, knowledge, and adherence to risk management behaviors. They then received the American Cancer Society publication "Lymphedema: What Every Woman with Breast Cancer Should Know." Cognitive and affective variables were reassessed at 6 and 12 months post-baseline. Results: Maximum likelihood multilevel model analyses indicated that overall adherence increased over time, with significant differences between baseline and 6- and 12-month assessments. Adherence to wearing gloves was significantly lower than that for all other behaviors except electric razor use. Distress significantly decreased, and knowledge significantly increased, over time. Greater knowledge, higher self-efficacy to enact behaviors, lower distress, and higher self-regulatory ability to manage distress were associated with increased adherence. Conclusions: Women who understand lymphedema risk management and feel confident in managing this risk are more likely to adhere to recommended strategies. These factors should be rigorously assessed as part of routine care to ensure that women have the self-efficacy to seek treatment and the self-regulatory skills to manage distress, which may undermine attempts to seek medical assistance.9 page(s

Facilitating preventive behaviors among women undergoing BCA1/2 testing

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Enhanced counselling for women undergoing BRCA1/2 testing : impact on knowledge and psychological distress - results from a randomised clinical trial

This randomised controlled trial evaluated the impact of an enhanced counselling (EC) intervention on knowledge about the heritability of breast and ovarian cancer and distress, as a function of BRCA test result, among high-risk women. Before deciding about whether or not to undergo genetic testing, participants were randomly assigned to the EC intervention (N = 69), designed to promote cognitive and affective processing of cancer risk information (following the standard individualised counselling session), or to the control condition (N = 65), which involved standard individualised counselling followed by a general health information session to control for time and attention. Women in the EC group exhibited greater knowledge than women in the control group, 1 week after the intervention. Further, at the affective level, the intervention was found to be the most beneficial for women testing positive: specifically 1 week after test result disclosure, women in the intervention group who tested positive experienced lower levels of distress than women in the control group who tested positive. The findings suggest that the design of counselling aids should include a component that explicitly activates the individual's cognitive–affective processing system.15 page(s

Enhanced counseling for women undergoing BRCA1/2 testing : impact on subsequent decision making about risk reduction behaviours

The authors evaluated the impact of an enhanced counseling intervention, designed to promote well informed decision making for follow-up risk reduction options for ovarian cancer, among high-risk women undergoing BRCA1/2 testing (N = 77). Following standard genetic counseling, participants received either an enhanced counseling session—designed to help participants anticipate their reactions to possible test outcomes and plan for postresult consequences—or a general health information control session. One week after disclosure of test results, women in the enhanced counseling group experienced a greater reduction in avoidant ideation, suggesting more complete processing of risk feedback. At the 6-month follow-up, intervention respondents reported seeking out more information about prophylactic oophorectomy and were more likely to have actually undergone preventive surgery. The results indicate that the use of enhanced counseling can play an important role in decision making about risk reduction behaviours following BRCA1/2 testing.14 page(s

Identification of cognitive profiles among women considering BRCA1/2 testing through the utilisation of cluster analytic techniques

Based on the cognitive-social health information processing model, we identified cognitive profiles of women at risk for breast and ovarian cancer. Prior to genetic counselling, participants (N = 171) completed a study questionnaire concerning their cognitive and affective responses to being at genetic risk. Using cluster analysis, four cognitive profiles were generated: (a) high perceived risk/low coping; (b) low value of screening/high expectancy of cancer; (c) moderate perceived risk/moderate efficacy of prevention/low informativeness of test result; and (d) high efficacy of prevention/high coping. The majority of women in Clusters One, Two and Three had no personal history of cancer, whereas Cluster Four consisted almost entirely of women affected with cancer. Women in Cluster One had the highest number of affected relatives and experienced higher levels of distress than women in the other three clusters. These results highlight the need to consider the psychological profile of women undergoing genetic testing when designing counselling interventions and messages.17 page(s