Victoria Alikari

Background/Objectives: Pain is a common symptom in patients undergoing hemodialysis (HD) and may influence their quality of life. Pain self-efficacy may play an important role in self-management and adherence behaviors. This study aimed to examine the association between pain self-efficacy and adherence to the HD regimen in patients undergoing HD. Methods: In this descriptive and cross-sectional study, 199 patients undergoing HD from a single private hospital (convenience sample) in Athens, Greece, completed the Greek-Simplified Adherence Questionnaire-HD (GR-SMAQ-HD) to assess adherence and the Pain Self-efficacy Questionnaire (PSEQ) to assess pain self-efficacy. Sociodemographic and clinical data were also recorded. Bivariate analyses and multiple linear regression were performed to identify factors associated with adherence. Statistical significance was set at p < 0.05. Results: Patients demonstrated moderate levels of pain self-efficacy (mean PSEQ = 33.96 ± 9.74) and moderate adherence to the HD regimen (mean GR-SMAQ-HD = 4.78 ± 2.54). No significant correlation was found between pain self-efficacy and adherence in bivariate analysis (rho = 0.125, p = 0.221). However, in multivariate analysis, pain self-efficacy was a significant independent predictor of adherence (β = 0.056, p = 0.032). Longer duration of End-Stage Renal Disease (ESRD) (β = −0.158, p < 0.001), higher pill burden (rho = −0.237, p = 0.030) were associated with lower adherence. Marital status was also a significant predictor of adherence (β = 1.631, p = 0.016). The model explained 24% of the variance in adherence (Adjusted R² = 0.24). Conclusions: Pain self-efficacy may indirectly affect adherence to the HD regimen, although its direct effect is modest. Adherence appears to be negatively influenced by pill burden and ESRD duration, while social support may play an important role.

Background/Objectives: Patient dignity is one of the central values in nursing, equivalent to justice, freedom, and individuality. The purpose of this study was to investigate the psychometric properties of the Greek version of the Inpatient Dignity Scale (IPDS). Methods: In this descriptive, cross-sectional study, 280 patients from three Hemodialysis Units (HD) completed the IPDS, a self-completed questionnaire assessing patients’ expectations regarding dignity and patients’ satisfaction with dignity. Items are categorized into four dimensions, both for expectations and satisfaction: Respect as a Human Being, Respect for Personal Feeling and Time, Respect for Privacy, and Respect for Autonomy. For the translation into Greek, a double forward-backward translation process was followed, and subsequently, cultural adaptation was carried out. Construct validity was tested using the Confirmatory Factor Analysis (CFA) conducted in AMOS 26.0. Convergent validity was assessed through correlations with the Caring Behaviors Inventory-16 (CBI-16) and correlations between the dimensions of the IPDS. Repeatability was assessed using the Intraclass Correlation Coefficient (ICC), and internal consistency using Cronbach’s alpha. The SPSS 26.0 statistical program was used for the descriptive and correlational analyses (p < 0.05). Results: The mean age of participants was 64.8 years old. CFA revealed an acceptable fit for the questionnaire (CFI 0.92–0.93, TLI 0.91–0.94, and RMSEA < 0.08 for both expectations and satisfaction). The IPDS was significantly and positively correlated with the CΒΙ-16, indicating good convergent validity. Cronbach’s alpha was >0.70 in all dimensions of the IPDS, indicating good internal consistency. Conclusions: The Greek version of IPDS is a valid and reliable tool to measure patients’ perceived dignity.

The Editorial Office, in agreement with the authors, publishes this Erratum to rectify two post-publication issues in the article: Original Article Reference Fradelos, E. C., Faka, M., Anagnostopoulou, D., Bakalis, V., Uni, E., Toska, A., Skabardonis, K., Alikari, V., & Saridi, M. (2026). Psychiatric Symptomatology and Medication Adherence in Type 2 Diabetes: Cross-Cultural Insights from Greece. Mental Health: Global Challenges Journal, 9(1), 155–178. https://doi.org/10.56508/mhgcj.v9i1.371 Authors: Fradelos, E. C., Faka, M., Anagnostopoulou, D., Bakalis, V., Uni, E., Toska, A., Skabardonis, K., Alikari, V., & Saridi, M. Journal name Mental Health: Global Challenges Journal Volume, issue, page numbers: Volume 9; Issue 1; Page numbers: 155 – 178; Year: 2026 DOI DOI of the Original Article: https://doi.org/10.56508/mhgcj.v9i1.371 DOI of the Erratum: https://doi.org/10.56508/mhgcj.v9i1.377 Description of the Corrections 1. Correction to the Authorship What the errors were: The Authors list (Fradelos, E. C., Faka, M., Anagnostopoulou, D., Bakalis, V., Uni, E., Toska, A., Skabardonis, K., Alikari, V., & Saridi, M.) wrongly contains name of Prof. Elizabeth Unni The Acknowledgements section (We would like to thank all the patients who participated in the study) doesn’t elucidate contribution of Prof. Elizabeth Unni. The Authors' Contributions section wrongly describe the contribution of Prof. Elizabeth Unni. What the correct version should be: The authors respectfully request the removal of Ms. Elizabeth Unni from the authorship of the published article. Prof. Unni should be acknowledged in the Acknowledgements section of the article, subject to the journals approval and applicable authorship and acknowledgment requirements. Correct version of the Authors’ List: Evangelos C. Fradelos1, Maria Faka2, Dimitra Anagnostopoulou3, Vissarion Bakalis3, Aikaterini Toska1, Konstantinos Skabardonis1 , Victoria Alikari4, Maria Saridi1. 1Laboratory of Clinical Nursing, Department of Nursing, University of Thessaly, Larissa, Greece 21st Local Health Unit (TOMY) of Agios Georgios, Larissa, Greece 3Department of Nursing, University of Thessaly, Larissa, Greece 4Department of Nursing, University of West Attica, Egaleo, Greece Correct version of the Acknowledgements section: We would like to thank all the patients who participated in the study. The authors would like to express their sincere gratitude to Prof. Elizabeth Unni for granting permission to use the relevant material and for her published work, which provided valuable guidance and informed the development of the present study. Correct version of the Authors' Contributions section: Evangelos C. Fradelos: Conceptualization, Methodology, Formal analysis, Writing – original draft, Supervision, Project administration. Maria Saridi: Conceptualization, Data curation, Writing – review & editing, Supervision. Maria Faka: Methodology, Investigation, Writing – review & editing. Victoria Alikari: Methodology, Writing – review & editing. Konstantinos Skabardonis: Formal analysis, Writing – review & editing. Dimitra Anagnostopoulou: Investigation, Data curation, Writing – review & editing. Vissarion Bakalis: Investigation, Writing – review & editing. Aikaterini Toska: Investigation, Writing – review & editing. Writing – review & editing: Maria Saridi, Victoria Alikari, Konstantinos Skabardonis, Maria Faka, Dimitra Anagnostopoulou, Vissarion Bakalis, Aikaterini Toska. 2. Removal of Questionnaire Items from Table 2 What the error was: In the originally published version of the article, Table 2 in the "Results" section inadvertently reproduced the verbatim text of individual items from the copyright-protected psychometric scale. What the correct version should be: To ensure full compliance with third-party copyright restrictions and intellectual property requirements, the individual wording of the scale items has been removed from Table 2. In the corrected table, the items are designated solely by standardized item identifiers (e.g., Item 1, Item 2, etc.), accompanied by direct bibliographic citations to the original validated instrument. Correct version of the Table 2 in “Results” section: Table 2 Frequencies and Percentages of Medication Adherence Reasons Scale (MARS) Items Variable 0 1 2 3 4 5 6 7 Item 1 102 (95.3%) 5 (4.7%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 2 94 (87.9%) 5 (4.7%) 8 (7.5%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 3 102 (95.3%) 5 (4.7%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 4 99 (92.5%) 5 (4.7%) 3 (2.8%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 5 100 (93.5%) 2 (1.9%) 0 (0%) 0 (0%) 5 (4.7%) 0 (0%) 0 (0%) 0 (0%) Item 6 96 (89.7%) 5 (4.7%) 3 (2.8%) 3(2.8%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 7 90 (84.1%) 6 (5.6%) 3 (2.8%) 3(2.8%) 0 (0%) 0 (0%) 0 (0%) 5(4.7%) Item 8 101 (94.4%) 6 (5.6%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 9 96 (89.7%) 11 (10.3%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 10 105 (98.1%) 2 (1.9%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 11 102 (95.3%) 5 (4.7%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 12 73 (68.2%) 19 (17.8%) 14(13.1%) 1(0.9%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 13 91 (85.0%) 13 (12.1%) 1 (0.9%) 2(1.9%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 14 105 (98.1%) 2 (1.9%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 15 103 (96.3%) 4 (3.7%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 16 100 (93.5%) 1 (0.9%) 5 (4.7%) 1(0.9%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 17 92 (86.0%) 12 (11.2%) 2 (1.9%) 1(0.9%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 18 76 (71.0%) 18 (16.8%) 12(11.2%) 1(0.9%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) Item 19 106 (99.1%) 0 (0%) 0 (0%) 1(0.9%) 0(0%) 0 (0%) 0 (0%) 0 (0%) Item 20 4 (3.7%) 0 (0%) 0 (0%) 3(2.8%) 5(4.7%) 6(5.6%) 18(16.8) 71(66.4) Statement: Authors’ Apology for Correction The authors offer their sincere and heartfelt apologies to the journal's editorial team, Ms. Elizabeth Unni, and the...

To read the full-text Open Access article and download the PDFs, please visit our Issue portal at Paradigm (Walter de Gruyter): https://reference-global.com/article/10.56508/mhgcj.v9i1.371 Introduction: Medication adherence in type 2 diabetes mellitus (T2DM) is influenced not only by clinical factors but also by psychological and interpersonal dimensions. Understanding the reasons for non-adherence is essential for designing individualized interventions. Purpose: This study aimed to investigate medication adherence and its association with psychiatric symptomatology among community-dwelling patients with T2DM, and to translate, culturally adapt, and preliminarily evaluate the Greek version of the Medication Adherence Reasons Scale (MARS). Methodology: A cross-sectional study was conducted with 107 adults with T2DM recruited from Primary Health Care services in Larissa, Greece. Data was collected through structured face-to-face interviews. Psychiatric symptomatology was assessed using the SCL-90-R, while medication adherence reasons were evaluated with the Greek version of the MARS. Descriptive statistics, Pearson correlations, Cronbach’s alpha, and Principal Component Analysis were performed. Results: Participants reported generally low levels of reasons for medication non-adherence, with most MARS items concentrated at the lowest response category. PCA indicated a two-component solution explaining 51.5% of the total variance; however, the KMO value was marginally acceptable (0.50), suggesting cautious interpretation. Paranoid ideation showed the strongest and most consistent positive correlations with several MARS items. Depression, interpersonal sensitivity, phobic anxiety, and obsessive-compulsive symptoms were also significantly associated with selected non-adherence reasons, while somatization and hostility showed limited associations. Conclusions: Medication adherence in T2DM appears to be shaped by psychological and interpersonal factors. The findings support the integration of mental health assessment into diabetes care and highlight the need for further validation of the Greek MARS in larger samples.

Background: Social constraints are perceived as unsupportive behaviors, leading to inadequate psychosocial adjustment, while optimism can help people recover from distress and reduce any negative effects of chronic disease. The aim of this study was to investigate social constraints, psychosocial adjustment and optimism among patients on dialysis. Methods: In this study, 402 patients undergoing dialysis in Greece completed the following questionnaires: (i) the Social Constraints Scale (SCS) for the assessment of social constrains, (ii) the Psychosocial adjustment to illness scale (PAIS-SR) for the assessment of psychosocial adjustment, and (iii) the LOT-R scale for the assessment of optimism. A Mann–Whitney test was used for the comparison of continuous variables between two groups. Spearman correlation coefficients (rho) were used to explore the association of two continuous variables. Multiple linear regression analysis was used with the SCS scale. Results: Greater difficulty in psychosocial adjustment in the domestic, vocational, extended family and social environments, sexual relationships, and health care as well as greater psychological distress were significantly associated with a greater occurrence of social constraints (p < 0.001). Additionally, greater optimism was significantly associated with fewer social constraints and lower difficulty in adjusting to their disease (p < 0.001). Conclusions: Greater difficulty in all dimensions of psychosocial adjustment is associated with more social constraints, while optimism is associated with fewer social constraints and better disease adjustment.

The purpose of this study was to explore factors that influence nurses’ beliefs about offering spiritual care. Study Design: A mixed-method study design, incorporating both quantitative (questionnaire) and qualitative research, was used for this study (focus group discussion). Methods: The questionnaires were completed by a convenience sample of nurses and their assistants working in two public hospitals. These questionnaires included the Greek versions of the FACIT-Sp-12, SCIPS, NEO-FFI, and the Spiritual Climate Scale, as well as a specially designed questionnaire to gather demographic, socioeconomic, and professional information about the study population (SCS). Three nurses and two nursing assistants who worked in public hospitals and were chosen through purposive sampling made up the sample for the qualitative study. In utilizing inductive content analysis methodology, a qualitative analysis was carried out. Results: Greek nurses frequently offer spiritual care to their patients, primarily existential spiritual care. It was discovered that the spiritual climate, the nurses’ positive coherence, and their educational level all exert a favorable effect on total spiritual care. Three categories and seven subcategories were used to describe the participants’ prior experiences with spiritual care. Conclusions: Greek nurses frequently offer spiritual care to their patients, and both internal and external factors influence their attitudes in this regard.

The high demands of caring for and raising a child with autism spectrum disorder on a daily basis may lead parents to physical and mental fatigue. This study aimed to assess the effect of social support and spirituality on the fatigue of parents with children with autistic spectrum disorder. A cross-sectional study with a convenience sample was conducted in Schools of Special Education in Attica (Greece). The sample consisted of 123 parents who completed The Fatigue Assessment Scale (FAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale (FACIT Sp-12) to measure the levels of fatigue, social support, and spirituality, respectively. The Pearson correlation coefficient was used to investigate the relationship between the quantitative variables. To study the effect of social support and spirituality on fatigue, multivariable linear regression was applied. The mean age was 47.3 years old, 81.3% were women, and 38.9% stated “Close/Very close faith toward God”. Higher levels of total MSPSS and FACIT Sp-12 were associated with lower total FAS (r = −0.50, p < 0.001 and r = −0.49, p < 0.001, respectively). Social support and spirituality were significant predictors of fatigue.

The purpose of this study was to examine the relationship between fear of cancer recurrence, spiritual well-being, and mental health among cancer patients. The study involved 217 patients undergoing chemotherapy. Data were collected with the following instruments: a demographic and clinical information recording form, the fear of cancer recurrence inventory, the Athens insomnia scale, the FACIT-Sp-12 scale for the assessment of spirituality, and the HADS scale for the assessment of mental health. For statistical analysis, SPSS statistical software was used, with the significance threshold set at 0.05;andtl number, t-test, one-way ANOVA, and multiple regression tests were used. The sample consisted of 217 cancer patients with a mean age of 63.7 years (SD = 11.6 years), 39.2% male and 60.8% female. The minimum value on the scale of fear of cancer recurrence was 0 and the maximum was 33 points, with a mean value of 14.1 points (SD = 8.2 points). The hospital scale of anxiety and depression was correlated, both in the dimension of anxiety and in the dimension of depression, significantly and positively with the scale of fear of cancer recurrence. Thus, greater fear of recurrence was associated with greater anxiety and depression. On the contrary, the correlations of anxiety and depression with the dimensions and the overall chronic disease treatment rating scale were significant and negative. So, greater spiritual well-being, in each domain and overall, were associated with less anxiety and depression. Finally, less fear of cancer recurrence was associated with finding greater meaning in life, greater peace, and overall greater spiritual well-being. In summary, fear of cancer recurrence is a predictor of psychological distress in cancer patients. However, spirituality can prevent the development of mental illness and FCR.

Introduction: Medication adherence is one of the most important factors in the effectiveness of treatment, especially for patients with chronic diseases. This study aims to assess the adherence of patients with chronic diseases and investigate the parameters that influence it. It will also examine the psychometric properties of the SMAQ scale, a tool used to assess adherence. Purpose: The study's main purpose was to assess the psychometric properties of the SMAQ scale, including its reliability and validity, to evaluate the adherence of patients with medication and to analyse the factors that shape it, focusing on the influence of gender, diagnosis, level of education, marital status, and living conditions. Methodology: The study was based on a sample of patients with chronic diseases, such as cardiovascular diseases, rheumatoid arthritis, and systemic lupus erythematosus. The patient's compliance with medication was assessed using the SMAQ scale. Statistical analysis included chi-square analysis to examine the association between participant characteristics and compliance, while logistic regression analysis was also performed to assess the parameters that predict non-compliance. Results: The chi-square analysis revealed significant associations between compliance and parameters such as gender, type of disease, level of education, and marital status. Men and patients with cardiovascular diseases showed better compliance. Logistic regression indicates that diagnosis is the most important factor in predicting non-compliance. Regarding the psychometric properties of the SMAQ, the scale showed satisfactory reliability with Cronbach’s Alpha = 0.717 and stability (Intraclass Correlation Coefficient = 0.525). Confirmatory factor analysis (CFA) confirmed the unidimensional structure of the scale, with good fit values ??(CFI, TLI, GFI > 0.9). Conclusions: The results of the study provide valuable data on the factors that influence the compliance of patients with chronic diseases. The diagnosis appears to be the most important predictor of non-compliance, while the evaluation of the SMAQ scale indicates that it is a reliable and valid tool for measuring compliance. The study highlights the need for strategies that will improve compliance, especially for patients with chronic diseases who may face psychological and social challenges. Limitations of the study include the sample size and the absence of data on other psychological parameters, such as mental health, which should be addressed in future research

Nurses’ caring behaviors are affected by several determinants. The aim of this study was to explore the factors affecting nurses’ caring behaviors. Nurses (N=309) from three public general hospitals in Greece completed the Factors of Nurses’ Caring Behaviors Scale. The data analysis was carried out with the Statistical Package for the Social Sciences (SPSS), version 26.0. Demographic and occupational data were, also, recorded. The statistical significance level was set at <0.05. The total mean score on the FNCB Scale was 100.4 (SD±26). The dimensions of Workplace Circumstances (Mean: 24.6, SD±8.0) and Workload/Management (Mean: 24.5, SD±6.4) were the most important factors of caring behaviors. On the opposite, nurses perceived the dimensions of Patients’ Demographic Characteristics (Mean: 9.3, SD± 4.4) and Patients’ Clinical Characteristics (Mean: 12.5 SD±4.2) as the least important factors. Men scored higher than women in the dimension of Patients’ Demographic Characteristics (t=3.022, p=0.003). Secondary Education Graduates scored lower in the dimensions of Workplace Circumstances (Tukey, p=0.035) and Workload/Management (Tukey, p=0.033) than MSc/Ph.D. Graduates. Nurses of surgical departments scored lower in total score than ICU nurses (Tukey, p = 0.026). Workplace conditions, workload, and management seem to be the most important factors in nurses’ caring behaviors.