Xanthi Tigani

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.

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.

Self-rated health in centenarians: a nation-wide cross-sectional Greek study.

Self-rated health (SRH) is an inclusive measure of public health that is correlated with quality of life and subsequent mortality. Extensive literature has identified multiple determinants of SRH in different populations. However, such studies on centenarians are scarce and parsimonious. Our objective is to identify SRH determinants in centenarians. This is a nationwide cross-sectional study on 400 Greek centenarians that was carried out between 2007 and 2010. SRH was evaluated by a simple question with a 5-point scale. Three categories of SRH were formed (very good/good/poor), which served as the dependent variable in multinomial regression models. Various sociodemographic, disease-related, lifestyle and psychosocial variables were assessed as candidate determinants of SRH. According to our results, SRH ratings among centenarians were better than that expected according to previous studies showing worse SRH ratings with increasing age in Greece. The 22.4% of the variance in SRH among centenarians was predicted by gender, habitat region and status, financial problems, disease presence and autonomy. Among lifestyle and psychosocial variables, obesity, good relationships with children, lack of feelings of loneliness, high optimism, adaptability and an internal health locus of control profile were independently associated with good SRH. These results indicate that SRH in individuals of extreme longevity were related to specific personal psychosocial factors that contribute to healthy aging and thus support the biopsychosocial model of health promotion.

Psychosocial Dimensions of Exceptional Longevity: A Qualitative Exploration of Centenarians' Experiences, Personality, and Life Strategies:

This qualitative study provides a comprehensive account of the social and life experiences and strategies and personality attributes that characterize exceptional longevity (living to 100 or over). It is based on nine semi-structured interviews of relatively healthy and functional Greek centenarians of both sexes. The analytic approach was thematic and based on grounded theory. We found that our participants were characterized by selectiveness in their socializing with other people and tendency to avoid conflicts. Also, we found that they predominantly used the “flight” response whenever confronted with stressors. Further, they appeared to be much adaptive as they had managed to overcome adversity and adapt successfully to major life changes. These findings provide insights into three possible pathways (social selectivity, conflict avoidance, and adaptiveness) through which psychosocial factors might be associated with aging and exceptional longevity.

The Healthy Lifestyle and Personal Control Questionnaire (HLPCQ): a novel tool for assessing self-empowerment through a constellation of daily activities

BackgroundThe main goal of stress management and health promotion programs is to improve health by empowering people to take control over their lives. Daily health-related lifestyle choices are integral targets of these interventions and critical to evaluating their efficacy. To date, concepts such as self-efficacy, self-control and empowerment are assessed by tools that only partially address daily lifestyle choices. The aim of this study is to validate a novel measurement tool, the Healthy Lifestyle and Personal Control Questionnaire (HLPCQ), which aims to assess the concept of empowerment through a constellation of daily activities.MethodsTherefore, we performed principal component analysis (PCA) of 26 items that were derived from the qualitative data of several stress management programs conducted by our research team.ResultsThe PCA resulted in the following five-factor solution: 1) Dietary Healthy Choices, 2) Dietary Harm Avoidance, 3) Daily Routine, 4) Organized Physical Exercise and 5) Social and Mental Balance. All subscales showed satisfactory internal consistency and variance, relative to theoretical score ranges. Subscale scores and the total score were significantly correlated with perceived stress and health locus of control, implying good criterion validity. Associations with sociodemographic data and other variables, such as sleep quality and health assessments, were also found.ConclusionsThe HLPCQ is a good tool for assessing the efficacy of future health-promoting interventions to improve individuals’ lifestyle and wellbeing.

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

BackgroundCentenarians 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.MethodsNation -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.ResultsWomen 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.ConclusionsGender 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.

Religiosity as a predictor of mortality: A retrospective cohort study in 1519 rural citizens in Greece

Objective: Investigating the role of religiosity in mortality. Design: A retrospective cohort study (mean follow-up period 131.2 ± 30.8 months) in 1519 rural citizens in Greece (57.1% women, mean age 56.9 ± 20.4 years). Main outcome measures: Measurements included education, disease status, body mass index, lifestyle, sleep-quality and self-rated health (SRH). Religiosity was assessed as composite score of praying and church attendance. Cox proportional hazard models were used to calculate adjusted hazard ratios (aHR) for all-cause and cardiovascular mortality. Results: A total of 293 deaths were recorded, 59.2% of which had occurred due to cardiovascular diseases, followed by cancer diseases (17%). All-cause mortality was found increased for older people (aHR: 1.10, 95%CI: 1.08–1.11, p < .0001), for males (aHR: 1.44, 95%CI: 1.14–1.83, p = .002), for people reporting good SRH (aHR: .66, 95%CI: .51–.87, p = .003). Moreover, with increasing age the practice of regular exercise decreases all-causes mortality by approximately 3.5% by each year. Participants in the moderate category of religiosity were found to have decreased risk for all-cause mortality (aHR: .61, 95%CI: .46–.83, p = .001) compared to those in the low religiosity category. Cardiovascular mortality was also significantly associated with SRH and religiosity. Conclusion: Religiosity predicts mortality, in a rural population in Greece. Deciphering the mediators of religiosity and mortality relationship could facilitate future health policies.

A novel cognitive behavioral treatment for patients with chronic insomnia: A pilot experimental study

OBJECTIVES Chronic insomnia (CI) is a common sleep disorder linked to stress and various ubiquitous stress-related disorders (e.g. cardiovascular and mental diseases). Previous experimental studies exploring the effects of stress management in CI have confirmed that reducing stress, especially through cognitive methods, could ameliorate symptoms and repercussions of CI. In this 16-week experimental pilot study, we primarily examined the feasibility of a novel method, dubbed Pythagorean Self-Awareness Intervention (PSAI) in 30 CI patients. DESIGN This is a pilot experimental study. SETTING Attikon General Hospital, School of Medicine, University of Athens. INTERVENTIONS PSAI for a period of 8 weeks (8-16 weeks). MAIN OUTCOMES Feasibility data and efficacy measures for sleep quality, cognitive function, perceived stress and hair cortisol. RESULTS All eligible patient gave their consent to participate and there were no drop-outs or adverse effects. 43.3%, 30% and 26.7% of patients showed high (PSAI twice per day), moderate (at least three times per week) and low (less than three times per week) compliance, respectively. Morning lack of time and evening tiredness were the main reasons for missing home sessions. Significant improvements in sleep quality, cognitive function, hair cortisol and perceived stress were also recorded especially in patients with higher compliance. CONCLUSIONS PSAI is a feasible and possibly efficacious stress management method. Future randomized-controlled studies should explore its efficacy in CI.