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Living with a chronic disease constitutes a biographical reversal characterized by change and loss. The aims of this study are to conceptualize the meaning of breast cancer, of its burden, to explore the patient's needs and expectations while being admitted to a palliative care unit, and to evaluate the fulfillment of those expectations. Two semistructured interviews were conducted, audio taped, transcribed verbatim, and subjected to the qualitative method of Interpretative Phenomenological Analysis. The first interview was conducted at the first visit of the patient to the palliative care unit, and the second after 2 weeks of receiving palliative care services. Qualitative findings indicated that the meaning of cancer can be interpreted as a transition of fading away. The transition began with redefining cancer from “my difficult moment” to “fortunately to its final destination”; struggling with the paradox of “the will to see the development of yourself and your child” and “wishing to die” while being able to “adapt” to “a balanced” day to day leaving and preparing for death. The need for interdisciplinarity is expressed.

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 the current relationship as well as the need for treatment of depression.

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 influenced psychological distress, while preparatory grief, depression, and performance status influenced body image and role identity. Conclusions: Preparatory grief, psychological distress, and physical symptoms had significant associations with perceptions of dignity among patients with advanced cancer. Clinicians should assess and attend to dignity-distressing factors in the care of patients with advanced cancer.

Purpose: To investigate the psychometric properties of the Greek 13-item measure of patients’ satisfaction (FAMCARE-P13) in palliative care setting. Methods: 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. Results: 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. Conclusions: We recommend the use of the Greek FAMCARE-P13 to assess care satisfaction of patients with advanced-stage cancer.

The aim of this study was to assess the relationship between sleep quality, pain, psychological distress, cognitive status and post-traumatic experience in advanced cancer patients. Participants were 82 advanced cancer patients referred to a palliative care unit for control of pain and other symptoms. A variety of assessment tools were used to examine the prevalence of sleep disturbance, the severity of pain and depression, hopelessness, cognitive function and quality of life. Using the Pittsburgh Sleep Quality Index (PSQI) 96% of patients were ‘poor sleepers’. Statistically significant associations were found between PSQI and the SF-12 (Short Form-12) Quality of Life Instrument (MCS, P

Background: Beck Hopelessness Scale (BHS) has been translated and validated in many languages. Aim: The validation of the English version of BHS in advanced cancer patients receiving palliative treatment in Greece. Methods: The final sample was 112 advanced cancer patients. Internal consistency, item-total correlations, and test—retest using four different approaches were calculated for the assessment of the reliability. Construct validity was used by examining correlations between BHS, Hospital Anxiety and Depression Scale (HAD-Depression) and the Schedule of Attitudes toward Hastened Death (SAHD). Known-groups validity was also assessed by detecting group differences according to disease severity as measured by the Eastern Cooperative Oncology Group (ECOG) performance status. Univariate and multivariate analyses were constructed to explore the relationship between hopelessness, depression, hastened death and the patients' demographic and clinical characteristics. Results: One factor solution was yielded accounted for 46.64% of the variance. The test—retest reliability was satisfactory ( p < 0.0005). Validity as performed using known-group analysis showed good results. Most significant correlations were found between BHS, ECOG ( p = 0.018) and gender ( p = 0.08). The strongest predictors were gender ( p = 0.050) and ECOG ( p = 0.045). Conclusions: BHS seemed to be a useful instrument to assess pessimistic attitude and hopelessness in a Greek cancer population, with valid psychometric properties.

This study investigated the traumatic distress and posttraumatic growth in 58 advanced cancer patients receiving palliative treatment in a Pain Relief and Palliative Care Unit. The patients completed the Greek version of the Impact of Events Scale-Revised and the Posttraumatic Growth Inventory. Statistically significant associations were found among Impact of Events Scale-RevisedGreek “Relating to Others” ( r = 0.311, P = .017), “New Possibilities” ( r = 0.248, P = .050), and “Appreciation of Life” ( r = 0.419, P = .001), and the Posttraumatic Growth Inventory scores ( r = 0.323, P = .013). Similarly, “Appreciation of Life” correlated significantly with “Avoidance” ( r = 0.318, P = .015), “Intrusion” ( r = 0.365, P = .005), and “Hyperarousal” ( r = 0.398, P = .002). Statistically significant associations were also found between “Relating to Others” and “Intrusion” ( r = 0.414, P = .001). The study concluded that in advanced cancer patients, the higher the impact event, the more improvement in their relationships with others, enhanced life appreciation, and more positive consequences after trauma.

None would disagree that death is the great separator. Death has many meanings, and they change with culture and society. In the Greek mythology, the dead journeyed to the Afterlife, ruled by Hades. Death was not perceived as an end in and by itself, but rather as another “world” to belong to. By Classical times there was a rise to burial rituals and commemorative practices, carried out throughout the centuries. Christian religion attempted to change the way the dead were mourned, and preached the immortality of the soul and resurrection of the dead. Nevertheless, the way people grieved and buried their dead has not changed much. The only change is a difficulty in the receptiveness of burial procedures, observed in large cities and in younger population. Today in Greece, the perceptions and practices on grief and death derive both on the ancient and the Christian Orthodox traditions.

Truth-telling to cancer patients is controversial. The aim of the present study was to investigate oncologists', radiotherapists', and palliative care specialists' attitudes and truth-telling practices in Greece. A postal survey of a representative sample of 300 oncologists, radiotherapists, and palliative care specialists was made in February 1993. A total of 228 doctors completed and returned the questionnaires. It appears that withholding the truth from cancer patients remains very common in Greece.