Christina Darviri

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 < 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.

Aggressive behavior while driving as predictor of self-reported car crashes.

PROBLEMnIn Greece, there is a lack of scientific evidence on the relationship between aggressive behavior while driving and young drivers involvement in car crashes; this study examined this potential relationship.nnnMETHODSnThe randomly selected samples of 356 young drivers (18-24 years old) were interviewed through a questionnaire of self-reported car crash involvement, which mainly focused on their behavior on the road and the number of car crashes in which they had been involved.nnnRESULTSnThe statistical methods used were principal components analysis (PCA) and multiple regression analysis. Two factors relevant to aggressive driving emerged: (a) driving violations and (b) irritability while driving. The multivariate model suggested that driving just for fun (joyriding) and irritability were predictors of young drivers involvement in car crashes. It was found that younger age was negatively associated with young drivers involvement in car crashes. IMPACT ON GOVERNMENT AND INDUSTRY: The findings of this study can contribute in the formation of public policies aiming to prevent young drivers car crashes. These findings can also be the starting point of some health promotion interventions trying to reduce car crashes and casualties on the road. Finally, the insurance companies may be interested in applying these findings into their field of interest.

The impact of young drivers’ lifestyle on their road traffic accident risk in greater Athens area

Young drivers (18-24) both in Greece and elsewhere appear to have high rates of road traffic accidents. Many factors contribute to the creation of these high road traffic accidents rates. It has been suggested that lifestyle is an important one. The main objective of this study is to find out and clarify the (potential) relationship between young drivers lifestyle and the road traffic accident risk they face. Moreover, to examine if all the youngsters have the same elevated risk on the road or not. The sample consisted of 241 young Greek drivers of both sexes. The statistical analysis included factor analysis and logistic regression analysis. Through the principal component analysis a ten factor scale was created which included the basic lifestyle traits of young Greek drivers. The logistic regression analysis showed that the young drivers whose dominant lifestyle trait is alcohol consumption or drive without destination have high accident risk, while these whose dominant lifestyle trait is culture, face low accident risk. Furthermore, young drivers who are religious in one way or another seem to have low accident risk. Finally, some preliminary observations on how health promotion should be put into practice are discussed.

Modelling the factors related to the seatbelt use by the young drivers of Athens

Road traffic accidents in Greece are one of the major problems of the public health sector and the first cause of death in the ages 18-24. However, there are no records available for defining the determinants of road accidents and seatbelt wearing rates. The main objective of this study is to determine and clarify the relationship between young drivers intentions (motivation to use/non use seatbelt) and their behaviour (self-reported use). Additionally, the purpose of this study is to evaluate the seatbelt wearing rates among young drivers in relation to their trip-type. The sample consisted of 200 young Greek drivers of both sexes. The statistical analysis included factor analysis and multiple regression analysis. The seatbelt use was measured in relation with seven trip-types. Through factor analysis, a seven factor scale of seatbelt use and a four factor scale of seatbelt non use were created which included Greek young drivers basic motivations for wearing or not wearing a seatbelt. A model, constructed by the multiple regression analysis, revealed the factors related with the seatbelt use. The factors positively related were imitation, self-protection, and legality. The factor of discomfort is negatively associated with the seatbelt use. Furthermore, mileage was negatively related with seatbelt use. Finally, some preliminary suggestions on how prevention strategies should be implemented in Greece are discussed.

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.

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

BackgroundSelf-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.MethodsIn 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.ResultsReporting 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.ConclusionsSlight 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.

Effect of the Emotional Freedom Technique on Perceived Stress, Quality of Life, and Cortisol Salivary Levels in Tension-Type Headache Sufferers: A Randomized Controlled Trial

OBJECTIVEnTo evaluate the short-term effects of the emotional freedom technique (EFT) on tension-type headache (TTH) sufferers.nnnDESIGNnWe used a parallel-group design, with participants randomly assigned to the emotional freedom intervention (n = 19) or a control arm (standard care n = 16).nnnSETTINGnThe study was conducted at the outpatient Headache Clinic at the Korgialenio Benakio Hospital of Athens.nnnPARTICIPANTSnThirty-five patients meeting criteria for frequent TTH according to International Headache Society guidelines were enrolled.nnnINTERVENTIONnParticipants were instructed to use the EFT method twice a day for two months.nnnOUTCOME MEASURESnStudy measures included the Perceived Stress Scale, the Multidimensional Health Locus of Control Scale, and the Short-Form questionnaire-36. Salivary cortisol levels and the frequency and intensity of headache episodes were also assessed.nnnRESULTSnWithin the treatment arm, perceived stress, scores for all Short-Form questionnaire-36 subscales, and the frequency and intensity of the headache episodes were all significantly reduced. No differences in cortisol levels were found in any group before and after the intervention.nnnCONCLUSIONSnEFT was reported to benefit patients with TTH. This randomized controlled trial shows promising results for not only the frequency and severity of headaches but also other lifestyle parameters.

Stress Management and Multiple Sclerosis: A Randomized Controlled Trial

There is a well-established adverse reciprocal relationship between stress and multiple sclerosis (MS). However, stress management in these patients has been parsimoniously studied. In this parallel randomized controlled trial, relapsing-remitting MS patients were randomly assigned to undergo either an 8-week stress management program (n=31; relaxation breathing and progressive muscle relaxation, twice a day) or not (n=30). Self-reported validated measures were used to evaluate perceived stress, health locus of control, anxiety, and depression. Daily diaries of MS symptoms were also kept by patients. In patients in the intervention group, perceived stress and symptoms of depression were significantly decreased after 8 weeks of relaxation. Repeated measures analyses showed significant group-by-time interactions for both the number of weekly symptoms and the mean intensity per symptom. No other significant change was reported. We deem that our results should encourage future studies that will incorporate more objective clinical and laboratory outcomes.

Exploring Stress Levels, Job Satisfaction, and Quality of Life in a Sample of Police Officers in Greece

Background The ongoing economic crisis in Greece has affected both stress and quality of life (QoL) at all socioeconomic levels, including professionals in the police force. The aim of this study was to examine perceived stress, job satisfaction, QoL, and their relationships in a sample of police officers in Greece. Methods A cross-sectional study was conducted during the first trimester of 2011 in 23 police stations in the greater Athens area. A total of 201 police officers agreed to participate (response rate 44.6%). The General Health Questionnaire-28 (GHQ-28) was used to assess general health, and the World Health Organization Quality of Life-BREF Questionnaire and Perceived Stress Scale-14 (PSS-14) questionnaires were used to assess QoL and perceived stress, respectively. Results The PSS and GHQ subscales and total scores exhibited strong, positive, and significant correlations coefficients (r): 0.52 for somatic disturbances, 0.56 for stress and insomnia, 0.40 for social dysfunction, and 0.37 for depression, yielding an r equal to 0.57 for the total GHQ score. A higher level of perceived stress was related to a lower likelihood of being satisfied with their job; in this regard, male participants and higher ranked officers reported lower job satisfaction. The PSS and GHQ scores were inversely, consistently, and significantly related to almost all of the QoL aspects, explaining up to 34% of their variability. Parenthood had a positive effect on QoL related to physical health, and women reported lower QoL related to psychological health. Conclusion Higher levels of stress are related to an increased risk of reporting suboptimal job satisfaction and QoL. The magnitude of these associations varied depending on age, gender, and rank, highlighting the need for stress-management training.

Exploring the effects of lifestyle, sleep factors and driving behaviors on sleep-related road risk: A study of Greek drivers

PURPOSEnThe present study explored the effect of various lifestyle patterns and sleep-related factors on the sleep-related road risk. Sleep-related factors included daytime sleepiness, drowsy driving and quality/quantify of sleep.nnnMETHODSnA sample of 1366 non-professional drivers aged 19-65 was selected from the broader Athens area of Greece, using stratified random sampling. The questionnaire solicited information on the participants socio-demographic characteristics, driving background, lifestyle patterns, sleep quality and quantity, daytime sleepiness, drowsy driving behavior and sleep-related road risk.nnnRESULTSnSleep-related road risk was affected by gender, quantity of night sleep and drowsy driving behavior. Drowsy driving behavior was shown to be related to gender, daytime sleepiness, sleep quality and the lifestyle of amusement. Daytime sleepiness was correlated with sleep quality and the lifestyles of amusement and sport. Finally, sleep quality and quantity were significantly affected by the lifestyles of amusement and yuppies-workaholic.nnnCONCLUSIONnThe current study has identified a number of risk factors in sleep-related crash risk in the general population of drivers. By raising public awareness the health and safety community can play an important role in reducing, if not preventing, the consequences of this public health problem.