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Anna Maria Kostka, Adriana Borodzicz, Sylwia Anna Krzemińska Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Sylwia Anna KrzemińskaDepartment of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Bartla 5, Wroclaw, 51-618, PolandEmail sylwia.krzeminska@umed.wroc.plIntroduction: The aim of the study, conducted in selected inpatient units, was to evaluate and analyse the feelings and emotions which accompany nurses during their work when they face the death of patients.Material and Methods: A total of 160 nurses were invited to participate in the study. The study group consisted of 40 nurses from each of the four departments of a municipal hospital: a surgery unit, an internal medicine unit, a hospital emergency department (ER) and an intensive care unit (ICU). A diagnostic survey method was used, including a questionnaire on sociodemographic data as well as questions designed by the author of the research related to the feelings of nurses provoked by the death of patients. To assess the level of anxiety and the ways of coping with stress related to contact with dying patients, Mini-COPE and PSS-10 questionnaires were used.Results: Compassion, sadness and helplessness are the most common types of nurses’ emotions caused by the death of patients, regardless of the nurses’ length of service and the place of work. In the study group, 53.90% of participants experienced a high level of stress. The level of anxiety in nurses from the internal medicine ward was significantly higher than in the nurses from the intensive care unit and the emergency department. The way of coping with stress is related to the period of service and the workplace of nurses.Conclusion: Nurses experience a high level of stress and strong emotions triggered by the observation of dying patients. Various styles of coping with stress can be noticed depending on job seniority and a place of employment. Due to the emotions evoked by the necessity to deal with death while performing professional duties, it is advisable to develop effective ways of coping in difficult situations.Keywords: nurses, death, emotions, feelings

Ewelina Bąk,1 Czesław Marcisz,2 Adriana Borodzicz,3 Danuta Sternal,1 Sylwia Krzemińska3 1Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland; 2Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland; 3Department of Clinical Nursing Faculty of Health Sciences, Medical University, Wroclaw, Poland Purpose: The main purpose of this study was to compare the level of health-related quality of life (HRQoL) using Nottingham Health Profile (NHP) in Polish patients with rheumatoid arthritis (RA) during therapy applying disease-modifying antirheumatic drugs (DMARDs) with conventional synthetics (csDMARDs) or with csDMARDs in combination with biological drugs (bDMARDs). The second purpose was to analyze the correlation between the domain values of NHP and the demographic and clinical parameters, functional efficiency, and mood. Patients and methods: The studies involved 212 patients with RA, divided into two groups: group I – 126 persons treated using csDMARDs, group II – 86 patients using csDMARDs in combination with bDMARDs. A diagnostic survey was used applying NHP for HRQoL, Beck Depression Inventory (BDI), and Health Assessment Questionnaire (HAQ). The 28-Joint Disease Activity Score (DAS-28) was calculated. Results: The patients with RA in both studied groups did not differ significantly in terms of all the NHP domains, values of HAQ and BDI. The DAS-28 value, the number of swollen joints, and the duration of morning stiffness were significantly smaller among patients from group II. However, in both groups, the majority of the analyzed components of NHP demonstrated significant correlations with values of HAQ and BDI and some of the domains of NHP – with DAS-28. Conclusion: The level of HRQoL, functional efficiency, and mood are comparable in patients treated conventionally and in combination with biological drugs. The HRQoL level shows correlation with the occurrence of depression symptoms, and the energy level, the sensation of pain, and physical abilities are covariates with daily activities. The intensity of the activity of RA as well as experiencing pain and the duration of morning stiffness is smaller among patients applying csDMARDs plus bDMARDs compared with patients treated only conventionally. Keywords: patients with rheumatoid arthritis in Poland, DMARDs, biological therapy, health-related quality of life, Nottingham Health Profile, Beck Depression Inventory, Health Assessment Questionnaire

Introduction . Ischemic stroke, as a sudden onset of a syndrome is the first cause of a varying degree of disability that results in lower quality of life. Aim . The aim of the study is to analyze the quality of life of people after ischemic stroke in terms of their performance in basic areas of life. Material and Methods . Evaluation of the quality of life was carried out, studying a 50-person group of patients aged 42–91 years who had an ischemic stroke within a period longer than 6 months. Their subjective evaluation of the quality of life was aeesessed by our own survey and the SF-36 questionnaire in the Polish version. The collected data, including the biopsychosocial sphere of the respondents were used to analyze the quality of life in eight key areas and were used to determine the significance of the impact of socio-demographic factors on the assessment of the quality of life. Results . Since both quality of life and its assessment are subject to constant change, and the current measurement is really only at time of the study, it has been shown however, that the quality of life in patients after stroke was significantly reduced. This is particularly evident in the area of physical functioning and felt in connection with the constraints resulting from physical health. Such a condition triggers consequences associated with the mental sphere, including the reduction of functioning. Moreover, there has been examined the impact of socio-demographic factors on the quality of life of patients after ischemic stroke and it has been found that they affect only as a set of dependencies. Although being in isolation they are not significantly dependent, however, for an individual they may not be indifferent, and when occurring in appropriate configurations they might affect one’s quality of life. Conclusions . In order to improve the quality of life of patients after ischemic stroke, the accessibility of post-stroke education is recommended for the patients after stroke, and what is salso important for their families, which has a significantly positive impact on the quality of life of both parties. If however, society can be persuaded to changes in the functioning and will prefer a healthy lifestyle through active life and healthy diet, then it will probably be possible to reduce the number of stroke incidents which in an aging society is particularly desirable. (JNNN 2016;5(2):58–68)

Introduction . With the development of civilization, there has been an increase of the percentage of head injuries cases in children. Head injuries are currently the third reason for the death of children under one year of age and first among older children. Aim . The aim of the study was the qualitative and quantitative analysis of head injuries among children admitted to the Hospital Emergency Ward in Trzebnica in 2010 as well as determination of factors, contributing to head injuries among children. Material and Methods . The statistical analysis regarded head injuries in children aged 0–18 which were reported to the Hospital Emergency Ward in Trzebnica within the period from January to December 2010. The total number of injuries reported was 315 and involved 118 girls and 197 boys. Results . The reason for accidents which resulted in children’s injuries were most often falls from height (27.0%), falls on the same level (24.4%) and hitting an object (21.6%). The reason for an accident is conditioned on the child’s age. The most common reason for injuries in children under 13 is a fall from height (30.8%) or a fall on the same level (28.5%). The accidents took place mainly during the day and in the summer period. In most cases in all age groups damage to epicrenium happened with children under 6 years of age. Conclusions . Head injuries are associated with age. They more often occur in the youngest group from 0 to 3 years as well as in the group from 13 to 18 years of age. With young children the main reasons are most commonly falls from height as well as falls on the same level. There has been observed an increase of head injuries during the holiday period. (JNNN 2014;3(3):121–128) Key Words : head injuries, children