Efi Parpa - Academia.edu (original) (raw)
Papers by Efi Parpa
The growing interest in the mental health and quality of life of cancer patients, has been the ma... more The growing interest in the mental health and quality of life of cancer patients, has been the major reason for conducting this study. The aims were to compare advanced cancer patients' responses to Hospital Anxiety and Depression (HAD) scale with those to European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0), as well as the impact of quality of life dimensions (as measured by EORTC QLQ-C30) on the levels of anxiety and depression. The analysis, conducted in 120 advanced cancer patients, showed that the most significant associations were found between emotional functioning and HAD-T (total sum of scores) (r=-0.747; p < 0.0005), HAD-A (anxiety) (r = -0.725; p < 0.0005) and HAD-D (depression) (r = -0.553; p < 0.0005). In the prediction of HAD-T, the contribution of physical, emotional, role, and social functioning along with nausea-vomiting, dyspnea, sleep disturbance and gender is high. For anxiety, the pred...
Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2014
PURPOSE Cancer pain is the most serious symptom for patients, especially during their terminal ph... more PURPOSE Cancer pain is the most serious symptom for patients, especially during their terminal phase, when palliative medicine is needed. Our study tried to verify the usefulness of single-shot intravenous administration of Samarium (Sm)-153EDTMP in patients with bone metastases (group-A, N=53, males=25, females=28, age range: 30-69 years), as well as to compare a series of variables, using as a control group (group-B, N=37, males=17, females=20, age range: 30-69 years) with patients who were under drug treatment given from a physician specialized in palliative medicine. METHODS Both groups answered the following questionnaires: Greek Brief Pain Inventory (GBPI), Brief Multidimensional Life Satisfaction Scale (BMLSS), Hospital Anxiety Depression Scale (HADS) and ECOG performance status. RESULTS Pain severity and pain interference improvement p=0.0005 for both groups. HADS-anxiety: Samarium group, p= 0.397, drugs group p= 0.031. HADS-depression improvement for both groups p=0.031 and...
Anticancer research, 2015
AIM To evaluate prospectively disease- and treatment-related symptoms, anxiety and quality of lif... more AIM To evaluate prospectively disease- and treatment-related symptoms, anxiety and quality of life (QoL), in patients with different types of cancer undergoing external-beam radiotherapy (RT) and examine the relationship among them, at baseline and at the end of the treatment. PATIENTS AND METHODS This study included 90 patients with cancer. Patients' QoL was evaluated using the Linear Analog Scale Assessment (LASAs) questionnaire, anxiety was measured with the Spielberger state and trait inventory (STAI), while symptoms were assessed using the MD Anderson Symptom Inventory (MDASI). The assessments were carried-out at baseline and at the end of RT. RESULTS At baseline, the QoL scores were reduced (7.5±6.5) and MDASI elevated (2.35±1.7). Patients' QoL was correlated with symptoms (r=-0.684, p=0.0005). A correlation was found between STAI-trait with MDASI scores (r=0.214, p=0.046). At the second assessment, there were significant correlations between MDASI and QoL (r=-0.68, p=...
Objectives: Comparison of the effects of reflexology and relaxation on pain, anxiety, and depress... more Objectives: Comparison of the effects of reflexology and relaxation on pain, anxiety, and depression, and quality of life (QoL) of patients with cancer. Design: A stratified random sample was selected, using an experimental design. Location: An outpatient Palliative Care Unit in Attica, Greece. Subjects: 88 patients suffering with cancer. Interventions: The sample was randomly divided into two equal groups, a reflexology and a relaxation group. The number of interventions for both groups was six 30-min weekly sessions. Outcome measures: The Greek Brief Pain Inventory (G-BPI) was used to measure pain, the Greek Hospital Anxiety and Depression Scale for screening anxiety and depression, and finally the Short Form Health Survey was used to measure QoL. Measurements of the above tools were taken three times in both groups as follows: preintervention, at fourth and at sixth week of intervention. Results: Anxiety and depression for both groups exhibited a statistically significant decreas...
Journal of Palliative Care
Purpose: The present study assesses the relationship between patient dignity in advanced cancer a... more Purpose: The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. Methods: The sample consisted of 120 patients with advanced cancer. The self-administered questionnaires were as follows: the Preparatory Grief in Advanced Cancer Patients (PGAC), the Patient Dignity Inventory–Greek (PDI-Gr), the Greek Schedule for Attitudes toward Hastened Death (G-SAHD), and the Greek version of the Hospital Anxiety and Depression Scale (G-HADS). Results: Moderate to strong statistically significant correlations were found between the 4 subscales of PDI-Gr (psychological distress, body image and role identity, self-esteem, and social support) with G-HADS, G-SAHD, and PGAC ( P < .005), while physical distress and dependency was moderately correlated with depression. Multifactorial analyses showed that preparatory grief, depression, and age influen...
American Journal of Hospice and Palliative Medicine®
The objectives of the study were to evaluate the relationship between depression, preparatory gri... more The objectives of the study were to evaluate the relationship between depression, preparatory grief, and loss of dignity in patients with advanced cancer and whether depression has a mediator and/or a mediator role between preparatory grief and dignity. The participants were 120 patients with advanced cancer who completed the Greek version of the Patient Dignity Inventory, the Greek Hospital Anxiety and Depression Scale, and the Preparatory Grief in Advanced Cancer Patients questionnaire. Depression was highly correlated with preparatory grief and loss of dignity. Additionally, strong relationship was found between preparatory grief and loss of dignity. Mediation analyses revealed that preparatory grief influenced loss of dignity as well as indirectly by its effect on depression. However, there was not any affect of depression as moderator. The effect of depression on preparatory grief in patients with advanced cancer and dignity emphasizing the need for further research to confirm ...
Journal of pain and symptom management, Jan 12, 2017
The Patient Dignity Inventory (PDI) is an instrument to measure dignity distressing aspects at th... more The Patient Dignity Inventory (PDI) is an instrument to measure dignity distressing aspects at the end of life. The aims of the current study was the translation of the PDI in Greek language as well as to measure its psychometric aspects in a palliative care unit. A back-translation method was obtained at the Greek version. 120 advanced cancer patients completed the Greek version of the PDI, the Greek Hospital Anxiety and Depression Scale (Gr-HADS), The Greek Schedule of attitudes towards hastened death (SAHD-Gr) and the Greek SF-12 (Short Form Health Survey: SF-12). Confirmatory Factor Analysis failed to fit to the original instrument's structure and . EFA was conducted revealing 5 factors ('Psychological Distress', 'Body Image and Role Identity', 'Self-Esteem', 'Physical Distress and Dependency', 'Social Support'). The psychometric analysis of the PDI-Gr demonstrated a good concurrent validity and the instrument discriminated well betwee...
The American journal of hospice & palliative care, Jan 21, 2016
To investigate the psychometric properties of the Greek 13-item measure of patients' satisfac... more To investigate the psychometric properties of the Greek 13-item measure of patients' satisfaction (FAMCARE-P13) in palliative care setting. A hundred patients completed the FAMCARE-P13. Exploratory factor analysis and confirmatory factor analysis (CFA) have been conducted. Two factors' solution was revealed from CFA. The questionnaire was administered to an initial validation sample and then for test-retest in a sample of 40 patients 3 days later. The Rosenberg Self-Esteem Scale measuring global self-esteem has been also used as a gold standard for construct validity. Subscale and known groups validity have also been tested for FAMCARE-P13s' validity. A reduced 13-item version of our measure (FAMCARE-P13) possessed 2-factor structure with high reliability. Patient satisfaction was correlated with physical distress, communication and relationship with health-care providers, and caregiver satisfaction. We recommend the use of the Greek FAMCARE-P13 to assess care satisfacti...
Journal of Developmental and Physical Disabilities, 2016
In recent years intellectual disability has changed from the individual quality of life to an eva... more In recent years intellectual disability has changed from the individual quality of life to an evaluation of the quality concerning the whole family. The aims of the present study were to examine the psychometric properties of the Greek version of Family Quality of Life Scale (FQoL). A total of 180 caregivers of people with intellectual disabilities participated in the current study. The participants were all informal caregivers of adults with disabilities and comorbidities (other chronic diseases), belonging to the intimate family context (cousins, uncles, neighbours, professional in-home caregivers, neighbours, etc.). The Beach Center Family Quality of Life Scale (FQoL) was administered twice, with a 7 day interval to 44 eligible caregivers. Factor analysis yielded a three-factor solution, explaining explaining 71.63 % of the total variance. Cronbach alpha for the three factors were between 0.883 to 0.960. Construct validity showed a high correlation between FQoL factors and APGAR scores. More specifically high correlations were found between “Family interaction and support” (r = 0.855), “Family care” (r = 0.630), “Disability related support” (r = 0.683) and APGAR scores (p < 0.0005 respectively). The test/retest reliability indicated that the scales scores were remarkably consistent between the two occasions. The current results support that the Greek version of FQoL is a measure with satisfactory psychometric properties, and is a valid research tool for Greek caregivers supporting people with intellectual disabilities.
Nutrition and Cancer, 2015
The authors sought to determine the reliability and validity of psychometric properties of the Gr... more The authors sought to determine the reliability and validity of psychometric properties of the Greek Patient-Generated Subjective Global Assessment (PG-SGA) in cancer patients attending a palliative care unit. The scale was translated into Greek. The study took place in an outpatient palliative care unit and 238 cancer patients completed the nutrition assessment. For treatment effect, the index was administered to 164 patients, whereas for the test of the instrument&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s robustness to 100 patients. Both assessments took place 15 days after the baseline assessment. Ninety-three patients were well-nourished, 104 were moderately malnourished, and 41 were severely malnourished. Reliability was assessed by the internal consistency and test-retest of the instrument. Validity was assessed with construct validity using the PG-SGA items, treatment effect, and criterion validity. Weight loss, physical examination, activities and function, and symptoms were predictors to the classification. Mean values in male patients classified as severely malnourished had the lowest values in all objective parameters except serum albumin, whereas severely malnourished female patients had the lowest values in all objective parameters except serum albumin and arm muscle circumference (AMC). Values of serum transferrin, AMC, and body mass index were significantly lower in patients classified as severely malnourished. The Greek PG-SGA is a psychometrically sound assessment in Greek cancer patients.
In vivo (Athens, Greece)
The aim of this study was to explore the differences in the descriptors for neuropathic and nocic... more The aim of this study was to explore the differences in the descriptors for neuropathic and nociceptive pain in cancer patients. One hundred and eighty-six cancer patients who participated in the study completed the Greek version of the McGill Pain Questionnaire (G-MPQ) for the assessment of their pain quality. Significant differences were found between type of pain in all G-MPQ classes. Statistically significant associations were found between Present Pain Intensity and type of pain (p = 0.002). Multivariate logistic regression analyses showed that patients who selected the descriptors "pricking" and "annoying" were 2.64 times and 2.2 times, respectively, more likely to experience nociceptive rather than neuropathic pain (p = 0.020 and p = 0.015, respectively). Further analysis showed that sensory seemed to be the most significant indicator for type of pain (95%, CI: 0.911-0.974, p < 0.001). Sensory quality and some of pain descriptors may differentiate neuro...
Anticancer research, 2015
To evaluate prospectively disease- and treatment-related symptoms, anxiety and quality of life (Q... more To evaluate prospectively disease- and treatment-related symptoms, anxiety and quality of life (QoL), in patients with different types of cancer undergoing external-beam radiotherapy (RT) and examine the relationship among them, at baseline and at the end of the treatment. This study included 90 patients with cancer. Patients' QoL was evaluated using the Linear Analog Scale Assessment (LASAs) questionnaire, anxiety was measured with the Spielberger state and trait inventory (STAI), while symptoms were assessed using the MD Anderson Symptom Inventory (MDASI). The assessments were carried-out at baseline and at the end of RT. At baseline, the QoL scores were reduced (7.5±6.5) and MDASI elevated (2.35±1.7). Patients' QoL was correlated with symptoms (r=-0.684, p=0.0005). A correlation was found between STAI-trait with MDASI scores (r=0.214, p=0.046). At the second assessment, there were significant correlations between MDASI and QoL (r=-0.68, p=0.0005). The STAI-trait had a mod...
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
To investigate the differences in anxiety and self-efficacy beliefs as well as the sociodemograph... more To investigate the differences in anxiety and self-efficacy beliefs as well as the sociodemographic and clinical characteristics, between cancer and chronically-ill patients. A total of 175 patients from a pain relief and palliative care unit participated in this study. Patient sociode-mographic and clinical characteristics were recorded. Patients completed the Greek version of the Spielberger State-Trait Anxiety Inventory (STAI) and the Greek version of the General Perceived Self-Efficacy Scale (GSE). No statistically significant differences were found between the two patient populations regarding self-efficacy. Statistically significant differences were found between chronically-ill and cancer patients in the scales of "emotionality" (p<0.0005), and "self-deprecation" (p<0.0005). Statistically significant negative correlations were found between all STAI scales and self-efficacy for both cancer and chronically-ill patients (r ranged from -0.231 to -0.503)...
SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance / SAHARA , Human Sciences Research Council, 2009
Ethical issues regarding HIV/AIDS human research in the developing world remain under continuous ... more Ethical issues regarding HIV/AIDS human research in the developing world remain under continuous evaluation; a critical area of concern includes informed consent. This paper reviews several of the most important ethical and practical aspects of informed consent in HIV research in developing countries. Enhancement of overall understanding of such key issues might promote higher ethical standards of future research. The major objective was to address informed consent in human research in non-Western societies, and specifically in HIV clinical trials of affected adults. Secondary end-points included the consent complexities in HIV research involving vulnerable patient populations in resource-limited nations, such as children, adolescents and women. A systematic review of the published literature using MEDLINE and EMBASE from 1998 until December 2008 was performed, using the search terms 'HIV/AIDS', 'informed consent', 'clinical trials', 'developing world'...
Sleep, 2007
Cancer patients have been reported to complain about poor quality of sleep. This study evaluated ... more Cancer patients have been reported to complain about poor quality of sleep. This study evaluated the quality of sleep in this group, utilizing demographic data and clinical features of the cancers as assessment criteria. A secondary aim was to evaluate the correlation between the self-rated questionnaire for the quality of sleep with other instruments used in measuring pain and quality of life. A total of 102 patients with stage IV cancer completed the study and were subsequently followed for up to 10 months. Self-rated questionnaires were administered for the evaluation of quality of sleep (PSQI), quality of life Medical Outcomes Study 12-item short-form (SF-12) questionnaire, the Mental Component Summary (MSC) and the Physical Component Summary (PCS), and pain (VAS Pain). The mediation analysis model was also used to evaluate how quality of life can influence the quality of sleep through its relation to pain, the performance status of patients and analgesics (Opioids). The mean ag...
Anticancer research
To evaluate the effectiveness and improvement in quality of life (QOL) of epoetin alfa administra... more To evaluate the effectiveness and improvement in quality of life (QOL) of epoetin alfa administration supplemented with oral iron as a therapeutic regimen for patients with solid malignancies and anemia of chronic disease (ACD), not receiving chemotherapy and/or radiotherapy. A total of 100 patients with cancer-related anemia, not subjected to chemotherapy and/or radiotherapy, were randomized to receive for a maximum of 24 weeks either oral iron, equivalent to 200 mg elemental iron once daily, or epoetin alfa 40,000 IU subcutaneously once weekly plus oral iron once daily. Patients in the epoetin alfa group had, from baseline to study end, a mean increase in hemoglobin (Hb) levels of 2.4 g/dL, whereas in the control group the mean Hb level decreased by 0.1 g/dL, (p<0.001). Improvement in QOL as assessed by the LASA and the FACT-An questionnaire were greater in patients in the epoetin alfa group than in the control group (mean change, LASA-energy level: 30.4 mm vs. 0.4 mm, -daily a...
Medical oncology (Northwood, London, England), 2005
Bisphosphonates have been used successfully in the treatment of hypercalcemia and to reduce skele... more Bisphosphonates have been used successfully in the treatment of hypercalcemia and to reduce skeletal-related complications of bone metastases. Recent in vitro and in vivo evidence suggest that they may also have direct antitumor effects via induction of apoptosis, inhibition of the invasive potential of tumor cell lines in vitro, inhibition of angiogenesis, and reduction in tumor growth indirectly via effects on accessory cells. This is a randomized, open label, prospective study that examined the effect of preventive zoledronic acid treatment on the development of bone metastases in patients with recurrent solid tumors, without bone metastases at the time of randomization. Forty patients with recurrent or metastatic advanced cancer, without bone metastases, were randomized into the trial to either receive zoledronic acid or no treatment. Patients were followed up until bone metastases were established. The percentage of patients being bone metastases free at 12 mo was 60% in the zo...
The growing interest in the mental health and quality of life of cancer patients, has been the ma... more The growing interest in the mental health and quality of life of cancer patients, has been the major reason for conducting this study. The aims were to compare advanced cancer patients' responses to Hospital Anxiety and Depression (HAD) scale with those to European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, version 3.0), as well as the impact of quality of life dimensions (as measured by EORTC QLQ-C30) on the levels of anxiety and depression. The analysis, conducted in 120 advanced cancer patients, showed that the most significant associations were found between emotional functioning and HAD-T (total sum of scores) (r=-0.747; p < 0.0005), HAD-A (anxiety) (r = -0.725; p < 0.0005) and HAD-D (depression) (r = -0.553; p < 0.0005). In the prediction of HAD-T, the contribution of physical, emotional, role, and social functioning along with nausea-vomiting, dyspnea, sleep disturbance and gender is high. For anxiety, the pred...
Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2014
PURPOSE Cancer pain is the most serious symptom for patients, especially during their terminal ph... more PURPOSE Cancer pain is the most serious symptom for patients, especially during their terminal phase, when palliative medicine is needed. Our study tried to verify the usefulness of single-shot intravenous administration of Samarium (Sm)-153EDTMP in patients with bone metastases (group-A, N=53, males=25, females=28, age range: 30-69 years), as well as to compare a series of variables, using as a control group (group-B, N=37, males=17, females=20, age range: 30-69 years) with patients who were under drug treatment given from a physician specialized in palliative medicine. METHODS Both groups answered the following questionnaires: Greek Brief Pain Inventory (GBPI), Brief Multidimensional Life Satisfaction Scale (BMLSS), Hospital Anxiety Depression Scale (HADS) and ECOG performance status. RESULTS Pain severity and pain interference improvement p=0.0005 for both groups. HADS-anxiety: Samarium group, p= 0.397, drugs group p= 0.031. HADS-depression improvement for both groups p=0.031 and...
Anticancer research, 2015
AIM To evaluate prospectively disease- and treatment-related symptoms, anxiety and quality of lif... more AIM To evaluate prospectively disease- and treatment-related symptoms, anxiety and quality of life (QoL), in patients with different types of cancer undergoing external-beam radiotherapy (RT) and examine the relationship among them, at baseline and at the end of the treatment. PATIENTS AND METHODS This study included 90 patients with cancer. Patients' QoL was evaluated using the Linear Analog Scale Assessment (LASAs) questionnaire, anxiety was measured with the Spielberger state and trait inventory (STAI), while symptoms were assessed using the MD Anderson Symptom Inventory (MDASI). The assessments were carried-out at baseline and at the end of RT. RESULTS At baseline, the QoL scores were reduced (7.5±6.5) and MDASI elevated (2.35±1.7). Patients' QoL was correlated with symptoms (r=-0.684, p=0.0005). A correlation was found between STAI-trait with MDASI scores (r=0.214, p=0.046). At the second assessment, there were significant correlations between MDASI and QoL (r=-0.68, p=...
Objectives: Comparison of the effects of reflexology and relaxation on pain, anxiety, and depress... more Objectives: Comparison of the effects of reflexology and relaxation on pain, anxiety, and depression, and quality of life (QoL) of patients with cancer. Design: A stratified random sample was selected, using an experimental design. Location: An outpatient Palliative Care Unit in Attica, Greece. Subjects: 88 patients suffering with cancer. Interventions: The sample was randomly divided into two equal groups, a reflexology and a relaxation group. The number of interventions for both groups was six 30-min weekly sessions. Outcome measures: The Greek Brief Pain Inventory (G-BPI) was used to measure pain, the Greek Hospital Anxiety and Depression Scale for screening anxiety and depression, and finally the Short Form Health Survey was used to measure QoL. Measurements of the above tools were taken three times in both groups as follows: preintervention, at fourth and at sixth week of intervention. Results: Anxiety and depression for both groups exhibited a statistically significant decreas...
Journal of Palliative Care
Purpose: The present study assesses the relationship between patient dignity in advanced cancer a... more Purpose: The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. Methods: The sample consisted of 120 patients with advanced cancer. The self-administered questionnaires were as follows: the Preparatory Grief in Advanced Cancer Patients (PGAC), the Patient Dignity Inventory–Greek (PDI-Gr), the Greek Schedule for Attitudes toward Hastened Death (G-SAHD), and the Greek version of the Hospital Anxiety and Depression Scale (G-HADS). Results: Moderate to strong statistically significant correlations were found between the 4 subscales of PDI-Gr (psychological distress, body image and role identity, self-esteem, and social support) with G-HADS, G-SAHD, and PGAC ( P < .005), while physical distress and dependency was moderately correlated with depression. Multifactorial analyses showed that preparatory grief, depression, and age influen...
American Journal of Hospice and Palliative Medicine®
The objectives of the study were to evaluate the relationship between depression, preparatory gri... more The objectives of the study were to evaluate the relationship between depression, preparatory grief, and loss of dignity in patients with advanced cancer and whether depression has a mediator and/or a mediator role between preparatory grief and dignity. The participants were 120 patients with advanced cancer who completed the Greek version of the Patient Dignity Inventory, the Greek Hospital Anxiety and Depression Scale, and the Preparatory Grief in Advanced Cancer Patients questionnaire. Depression was highly correlated with preparatory grief and loss of dignity. Additionally, strong relationship was found between preparatory grief and loss of dignity. Mediation analyses revealed that preparatory grief influenced loss of dignity as well as indirectly by its effect on depression. However, there was not any affect of depression as moderator. The effect of depression on preparatory grief in patients with advanced cancer and dignity emphasizing the need for further research to confirm ...
Journal of pain and symptom management, Jan 12, 2017
The Patient Dignity Inventory (PDI) is an instrument to measure dignity distressing aspects at th... more The Patient Dignity Inventory (PDI) is an instrument to measure dignity distressing aspects at the end of life. The aims of the current study was the translation of the PDI in Greek language as well as to measure its psychometric aspects in a palliative care unit. A back-translation method was obtained at the Greek version. 120 advanced cancer patients completed the Greek version of the PDI, the Greek Hospital Anxiety and Depression Scale (Gr-HADS), The Greek Schedule of attitudes towards hastened death (SAHD-Gr) and the Greek SF-12 (Short Form Health Survey: SF-12). Confirmatory Factor Analysis failed to fit to the original instrument's structure and . EFA was conducted revealing 5 factors ('Psychological Distress', 'Body Image and Role Identity', 'Self-Esteem', 'Physical Distress and Dependency', 'Social Support'). The psychometric analysis of the PDI-Gr demonstrated a good concurrent validity and the instrument discriminated well betwee...
The American journal of hospice & palliative care, Jan 21, 2016
To investigate the psychometric properties of the Greek 13-item measure of patients' satisfac... more To investigate the psychometric properties of the Greek 13-item measure of patients' satisfaction (FAMCARE-P13) in palliative care setting. A hundred patients completed the FAMCARE-P13. Exploratory factor analysis and confirmatory factor analysis (CFA) have been conducted. Two factors' solution was revealed from CFA. The questionnaire was administered to an initial validation sample and then for test-retest in a sample of 40 patients 3 days later. The Rosenberg Self-Esteem Scale measuring global self-esteem has been also used as a gold standard for construct validity. Subscale and known groups validity have also been tested for FAMCARE-P13s' validity. A reduced 13-item version of our measure (FAMCARE-P13) possessed 2-factor structure with high reliability. Patient satisfaction was correlated with physical distress, communication and relationship with health-care providers, and caregiver satisfaction. We recommend the use of the Greek FAMCARE-P13 to assess care satisfacti...
Journal of Developmental and Physical Disabilities, 2016
In recent years intellectual disability has changed from the individual quality of life to an eva... more In recent years intellectual disability has changed from the individual quality of life to an evaluation of the quality concerning the whole family. The aims of the present study were to examine the psychometric properties of the Greek version of Family Quality of Life Scale (FQoL). A total of 180 caregivers of people with intellectual disabilities participated in the current study. The participants were all informal caregivers of adults with disabilities and comorbidities (other chronic diseases), belonging to the intimate family context (cousins, uncles, neighbours, professional in-home caregivers, neighbours, etc.). The Beach Center Family Quality of Life Scale (FQoL) was administered twice, with a 7 day interval to 44 eligible caregivers. Factor analysis yielded a three-factor solution, explaining explaining 71.63 % of the total variance. Cronbach alpha for the three factors were between 0.883 to 0.960. Construct validity showed a high correlation between FQoL factors and APGAR scores. More specifically high correlations were found between “Family interaction and support” (r = 0.855), “Family care” (r = 0.630), “Disability related support” (r = 0.683) and APGAR scores (p < 0.0005 respectively). The test/retest reliability indicated that the scales scores were remarkably consistent between the two occasions. The current results support that the Greek version of FQoL is a measure with satisfactory psychometric properties, and is a valid research tool for Greek caregivers supporting people with intellectual disabilities.
Nutrition and Cancer, 2015
The authors sought to determine the reliability and validity of psychometric properties of the Gr... more The authors sought to determine the reliability and validity of psychometric properties of the Greek Patient-Generated Subjective Global Assessment (PG-SGA) in cancer patients attending a palliative care unit. The scale was translated into Greek. The study took place in an outpatient palliative care unit and 238 cancer patients completed the nutrition assessment. For treatment effect, the index was administered to 164 patients, whereas for the test of the instrument&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s robustness to 100 patients. Both assessments took place 15 days after the baseline assessment. Ninety-three patients were well-nourished, 104 were moderately malnourished, and 41 were severely malnourished. Reliability was assessed by the internal consistency and test-retest of the instrument. Validity was assessed with construct validity using the PG-SGA items, treatment effect, and criterion validity. Weight loss, physical examination, activities and function, and symptoms were predictors to the classification. Mean values in male patients classified as severely malnourished had the lowest values in all objective parameters except serum albumin, whereas severely malnourished female patients had the lowest values in all objective parameters except serum albumin and arm muscle circumference (AMC). Values of serum transferrin, AMC, and body mass index were significantly lower in patients classified as severely malnourished. The Greek PG-SGA is a psychometrically sound assessment in Greek cancer patients.
In vivo (Athens, Greece)
The aim of this study was to explore the differences in the descriptors for neuropathic and nocic... more The aim of this study was to explore the differences in the descriptors for neuropathic and nociceptive pain in cancer patients. One hundred and eighty-six cancer patients who participated in the study completed the Greek version of the McGill Pain Questionnaire (G-MPQ) for the assessment of their pain quality. Significant differences were found between type of pain in all G-MPQ classes. Statistically significant associations were found between Present Pain Intensity and type of pain (p = 0.002). Multivariate logistic regression analyses showed that patients who selected the descriptors "pricking" and "annoying" were 2.64 times and 2.2 times, respectively, more likely to experience nociceptive rather than neuropathic pain (p = 0.020 and p = 0.015, respectively). Further analysis showed that sensory seemed to be the most significant indicator for type of pain (95%, CI: 0.911-0.974, p < 0.001). Sensory quality and some of pain descriptors may differentiate neuro...
Anticancer research, 2015
To evaluate prospectively disease- and treatment-related symptoms, anxiety and quality of life (Q... more To evaluate prospectively disease- and treatment-related symptoms, anxiety and quality of life (QoL), in patients with different types of cancer undergoing external-beam radiotherapy (RT) and examine the relationship among them, at baseline and at the end of the treatment. This study included 90 patients with cancer. Patients' QoL was evaluated using the Linear Analog Scale Assessment (LASAs) questionnaire, anxiety was measured with the Spielberger state and trait inventory (STAI), while symptoms were assessed using the MD Anderson Symptom Inventory (MDASI). The assessments were carried-out at baseline and at the end of RT. At baseline, the QoL scores were reduced (7.5±6.5) and MDASI elevated (2.35±1.7). Patients' QoL was correlated with symptoms (r=-0.684, p=0.0005). A correlation was found between STAI-trait with MDASI scores (r=0.214, p=0.046). At the second assessment, there were significant correlations between MDASI and QoL (r=-0.68, p=0.0005). The STAI-trait had a mod...
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
To investigate the differences in anxiety and self-efficacy beliefs as well as the sociodemograph... more To investigate the differences in anxiety and self-efficacy beliefs as well as the sociodemographic and clinical characteristics, between cancer and chronically-ill patients. A total of 175 patients from a pain relief and palliative care unit participated in this study. Patient sociode-mographic and clinical characteristics were recorded. Patients completed the Greek version of the Spielberger State-Trait Anxiety Inventory (STAI) and the Greek version of the General Perceived Self-Efficacy Scale (GSE). No statistically significant differences were found between the two patient populations regarding self-efficacy. Statistically significant differences were found between chronically-ill and cancer patients in the scales of "emotionality" (p<0.0005), and "self-deprecation" (p<0.0005). Statistically significant negative correlations were found between all STAI scales and self-efficacy for both cancer and chronically-ill patients (r ranged from -0.231 to -0.503)...
SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance / SAHARA , Human Sciences Research Council, 2009
Ethical issues regarding HIV/AIDS human research in the developing world remain under continuous ... more Ethical issues regarding HIV/AIDS human research in the developing world remain under continuous evaluation; a critical area of concern includes informed consent. This paper reviews several of the most important ethical and practical aspects of informed consent in HIV research in developing countries. Enhancement of overall understanding of such key issues might promote higher ethical standards of future research. The major objective was to address informed consent in human research in non-Western societies, and specifically in HIV clinical trials of affected adults. Secondary end-points included the consent complexities in HIV research involving vulnerable patient populations in resource-limited nations, such as children, adolescents and women. A systematic review of the published literature using MEDLINE and EMBASE from 1998 until December 2008 was performed, using the search terms 'HIV/AIDS', 'informed consent', 'clinical trials', 'developing world'...
Sleep, 2007
Cancer patients have been reported to complain about poor quality of sleep. This study evaluated ... more Cancer patients have been reported to complain about poor quality of sleep. This study evaluated the quality of sleep in this group, utilizing demographic data and clinical features of the cancers as assessment criteria. A secondary aim was to evaluate the correlation between the self-rated questionnaire for the quality of sleep with other instruments used in measuring pain and quality of life. A total of 102 patients with stage IV cancer completed the study and were subsequently followed for up to 10 months. Self-rated questionnaires were administered for the evaluation of quality of sleep (PSQI), quality of life Medical Outcomes Study 12-item short-form (SF-12) questionnaire, the Mental Component Summary (MSC) and the Physical Component Summary (PCS), and pain (VAS Pain). The mediation analysis model was also used to evaluate how quality of life can influence the quality of sleep through its relation to pain, the performance status of patients and analgesics (Opioids). The mean ag...
Anticancer research
To evaluate the effectiveness and improvement in quality of life (QOL) of epoetin alfa administra... more To evaluate the effectiveness and improvement in quality of life (QOL) of epoetin alfa administration supplemented with oral iron as a therapeutic regimen for patients with solid malignancies and anemia of chronic disease (ACD), not receiving chemotherapy and/or radiotherapy. A total of 100 patients with cancer-related anemia, not subjected to chemotherapy and/or radiotherapy, were randomized to receive for a maximum of 24 weeks either oral iron, equivalent to 200 mg elemental iron once daily, or epoetin alfa 40,000 IU subcutaneously once weekly plus oral iron once daily. Patients in the epoetin alfa group had, from baseline to study end, a mean increase in hemoglobin (Hb) levels of 2.4 g/dL, whereas in the control group the mean Hb level decreased by 0.1 g/dL, (p<0.001). Improvement in QOL as assessed by the LASA and the FACT-An questionnaire were greater in patients in the epoetin alfa group than in the control group (mean change, LASA-energy level: 30.4 mm vs. 0.4 mm, -daily a...
Medical oncology (Northwood, London, England), 2005
Bisphosphonates have been used successfully in the treatment of hypercalcemia and to reduce skele... more Bisphosphonates have been used successfully in the treatment of hypercalcemia and to reduce skeletal-related complications of bone metastases. Recent in vitro and in vivo evidence suggest that they may also have direct antitumor effects via induction of apoptosis, inhibition of the invasive potential of tumor cell lines in vitro, inhibition of angiogenesis, and reduction in tumor growth indirectly via effects on accessory cells. This is a randomized, open label, prospective study that examined the effect of preventive zoledronic acid treatment on the development of bone metastases in patients with recurrent solid tumors, without bone metastases at the time of randomization. Forty patients with recurrent or metastatic advanced cancer, without bone metastases, were randomized into the trial to either receive zoledronic acid or no treatment. Patients were followed up until bone metastases were established. The percentage of patients being bone metastases free at 12 mo was 60% in the zo...