Breast cancer, potentially a traumatic stressor, may be accompanied by negative outcomes, such as posttraumatic stress disorder or positive changes, such as posttraumatic growth. The authors reviewed 24 studies published from 1990 to 2010 that measured posttraumatic stress disorder and posttraumatic growth in women with breast cancer, in terms of frequency rates, factors associated with posttraumatic stress disorder and posttraumatic growth, and their interrelationships. A relatively small percentage of women experienced posttraumatic stress disorder, while the majority of them reported posttraumatic growth. Age, education, economic status, subjective appraisal of the threat of the disease, treatment, support from significant others, and positive coping strategies were among the most frequently reported factors associated with these phenomena. Moreover, posttraumatic stress disorder and posttraumatic growth were not related. Future research should shed more light on posttraumatic growth and posttraumatic stress disorder among women with breast cancer, the parameters that influence them, and their possible relationship.

Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient-provider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = -.636, p < .01) and physician depersonalization (r = -.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients' satisfaction occurred at the physician level, after adjustment for patients' characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.

In this article we examine the factorial structure of the Greek version of the Zimbardo Time Perspective Inventory (ZTPI; Zimbardo and Boyd in J Personal Soc Psychol 77:1271-1288, in a sample of 337 university students, using principal axis factoring (PAF) with oblique rotation, and its dimensionality using parallel analysis. Moreover, we evaluate the internal consistency reliability, the convergent validity (through associations with mental health indicators such as dispositional optimism, self-esteem, trait anxiety, depression, and proactive coping), as well as discriminant, and differential validity of this instrument. The results indicated that the ZTPI had a 5-factor structure (past negative, past positive, present fatalistic, present hedonistic, future). Correlational analyses indicated that an aversive view of the past, and a fatalistic attitude toward life were positively and significantly associated with trait anxiety and depression, while they were negatively correlated with self-esteem, proactive coping, and dispositional optimism. Future time perspective was positively associated with proactive coping, whereas a positive attitude toward the past was negatively associated with depression and trait anxiety. Psychometric properties of the five ZTPI scales were satisfactory (Cronbach's alphas ranging from .710 to .845), thus facilitating the robust investigation of time perspective in Greek speaking populations. However confirmatory factor analyses revealed that the ''positive attitude toward the past'' dimension might not be a good indicator of time perspective. We discuss the theoretical implications of these findings for future studies of time perspective.

The study aimed to examine: (i) the association between perception of infertility controllability and coping strategies; and (ii) the association between perception of infertility controllability and coping strategies to psychological distress, applying multivariate statistical techniques to control for the effects of demographic variables. This cross-sectional study included 137 women with fertility problems undergoing IVF in a public hospital. All participants completed questionnaires that measured fertility-related stress, state anxiety, depressive symptomatology, perception of control and coping strategies. Pearson's correlation coefficients were calculated between all study variables, followed by hierarchical multiple linear regression. Low perception of personal and treatment controllability was associated with frequent use of avoidance coping and high perception of treatment controllability was positively associated with problem-focused coping. Multivariate analysis showed that, when controlling for demographic factors, low perception of personal control and avoidance coping were positively associated with fertility-related stress and state anxiety, and problem-appraisal coping was negatively and significantly associated with fertility-related stress and depressive symptomatology scores. The findings of this study merit the understanding of the role of control perception and coping in psychological stress of infertile women to identify beforehand those women who might be at risk of experiencing high stress and in need of support.

This investigation is a Greek validation of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale, an instrument derived from the MAC and designed to measure styles of coping with cancer. A sample of 225 women diagnosed with breast cancer completed this questionnaire. Statistical analyses using structural equation modeling (SEM) confirmed Watson's original five first-order factors underlying Mini-MAC items: Helplessness/Hopelessness (HH), Anxious Preoccupation (AP), Fighting Spirit (FS), Avoidance (AV) and Fatalism (F). On a higher-order level, SEM and Multidimensional Scaling revealed two second-order factors: adaptive coping (being measured by FS, AV, and F) and maladaptive coping (being measured by HH and AP). Results are discussed in terms of the theoretical framework needed to account for the relationships among Mini-MAC factors and the refinement of the applications of SEM in the study of the mental adjustment to cancer construct.

The purpose of this study was to determine whether oncology nurses experience higher levels of burnout compared to nurses working in general hospitals, and to further identify the personal and environmental factors that contribute to the development of emotional exhaustion, depersonalization and lack of personal accomplishment. Seven tools, measuring a selected set of demographic, psychological and occupational variables, were administered to 217 female nurses who worked in oncological hospitals and 226 nurses who worked in general hospitals in the area of Athens. Measures used in the study included the Maslach Burnout Inventory, the Hardiness Scale, the Ways of Coping Scale, the Life Style Scale, the Type A Behaviour Scale, a Job Stress Questionnaire and a General Information Questionnaire. No statistically significant difference was revealed in the degree of burnout experienced by nurses in oncology and those in general hospitals. Multiple linear regression analysis suggested that personality characteristics seem to predict a greater percentage of the variability of the burnout experienced than occupational and demographic variables. A sense of personal control over the things that happen in life and in the work environment was found to protect nurses from emotional exhaustion, depersonalization and lack of personal accomplishment.

These results confirm the multidimensional structure of the SF-36 and underscore the feasibility of multinational comparisons of health status using this instrument. They also support the use of eight subscale scores in parallel with three second-order summary scores rather than one overall score.

BackgroundThere is increasing evidence that psychological constructs, such as emotional intelligence and emotional labor, play an important role in various organizational outcomes in service sector. Recently, in the “emotionally charged” healthcare field, emotional intelligence and emotional labor have both emerged as research tools, rather than just as theoretical concepts, influencing various organizational parameters including job satisfaction. The present study aimed at investigating the relationships, direct and/or indirect, between emotional intelligence, the surface acting component of emotional labor, and job satisfaction in medical staff working in tertiary healthcare.MethodsData were collected from 130 physicians in Greece, who completed a series of self-report questionnaires including: a) the Wong Law Emotional Intelligence Scale, which assessed the four dimensions of emotional intelligence, i.e. Self-Emotion Appraisal, Others’ Emotion Appraisal, Use of Emotion, and Regulation of Emotion, b) the General Index of Job Satisfaction, and c) the Dutch Questionnaire on Emotional Labor (surface acting component).ResultsEmotional intelligence (Use of Emotion dimension) was significantly and positively correlated with job satisfaction (r=.42, p<.001), whereas a significant negative correlation between surface acting and job satisfaction was observed (r=−.39, p<.001). Furthermore, Self-Emotion Appraisal was negatively correlated with surface acting (r=−.20, p<.01). Self-Emotion Appraisal was found to influence job satisfaction both directly and indirectly through surface acting, while this indirect effect was moderated by gender. Apart from its mediating role, surface acting was also a moderator of the emotional intelligence-job satisfaction relationship. Hierarchical multiple regression analysis revealed that surface acting could predict job satisfaction over and above emotional intelligence dimensions.ConclusionsThe results of the present study may contribute to the better understanding of emotion-related parameters that affect the work process with a view to increasing the quality of service in the health sector.