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Introduction. In 2018, another update of the Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/ Sedation, Delirium, Immobilization and Sleep Disorders in Adult Patients Treated in Intensive Care Units (ICUs) was released. Aim. The study is aimed at presenting current recommendations concerning pain management in patients treated in ICU, and presenting the algorithm of pain assessment and monitoring in patients treated in ICU, using a Polish version of the BPS (Behavioural Pain Scale). The guidelines were prepared based on a systematic review of the literature published in the years 2013-2018. Material and methods. The search for scientific publications was carried out using electronic databases in English and Polish. The following keywords and their combinations were used in the searches: pain, assessment, monitoring, nurse, intensive care, adult patient, unable to communicate. Initially, 758 papers were identified with the use of keywords. After excluding duplicates and preliminary checking and selecting the titles of publications and abstracts, 85 papers were qualified for the analysis of full text. Conclusions. Access to effective pain treatment is a fundamental human right. Recommendations of the Polish Association of Anaesthesia and Intensive Care Nurses, concerning pain monitoring in ICU using a Polish version of the Behavioural Pain Scale (BPS), developed by the Task Force for Practice, are intended to provide a specific guideline for developing effective local pain management strategies in ICU.

INTRODUCTION Peritraumatic distress is a syndrome that involves negative emotions, such as anxiety, helplessness and horror, experienced during and shortly after a traumatic event. The intensity of peritraumatic distress is significantly linked to the intensity of post-traumatic stress syndrome (PTSD) symptoms. The aim of the study was to study the intensity of peritraumatic distress symptoms in the mothers of severely ill children and the relationship between peritraumatic distress and psychological, socio-demographic and medical coefficients in the mothers. MATERIAL AND METHODS An anonymous survey was performed in a group of 135 mothers of children with a perinatal medical history and mothers of children hospitalized in an intensive care unit and an oncology unit. The demographic questionnaire was compiled by the authors along with several standardized research tools. RESULTS Intensity of peritraumatic distress correlates strongly positively with anxiety, ρ = 0.50; P < 0.001, and moderately positively with intrusion ρ = 0.39; P < 0.00, arousal, ρ = 0.38; P < 0.001, PTSD intensification, ρ = 0.40; P < 0.001, depression, ρ = 0.49; P < 0.001. Significant predictors of peritraumatic distress include the use of such coping strategies as acceptance, β = -0.44; P = 0.001, denial, β = 0.20; P = 0.019, planning, β = -0.26; P = 0.012 and humour, β = -0.29; P = 0.048, as well as the possibility to obtain self-worth support, β = -0.07; P = 0.029 (R2 corrected = 0,32; F(5.33) = 9.43; P < 0.001). CONCLUSIONS Coping strategies are a potentially modifiable factor, thus, implementing prevention programmes concerning the strategies should be considered.

Purpose The aim of the study was: (1) to determine whether post-traumatic stress symptoms (PTSS) intensification in a spouse/partner is an essential predictor for PTSS intensification in the parents of children who were treated in the NICU during the neonatal period and (2) to indicate the relationship between psychological variables linked to stress intensification and coping styles with PTSS intensification. Design The research sample consisted of 41 couples of parents of infants aged between 3 and 11 months old, who had been treated in a NICU during the neonatal period. The Impact Event Scale – Revised was used to assess PTSS, the Perceived Stress Scale was applied to assess stress, and the Coping Inventory for Stressful Situations was used to measure the coping style. Data were analysed statistically using descriptive statistics, and hierarchical regression was performed to indicate PTSS predictors. Results PTSS intensification in men was 39.17 ± 17.17 points and in women it was 48.93 ± 18.97 points. The majority of the fathers (68.5%) and of the mothers (82.9%) scored more than 33 points in the IES-R scale, which suggests PTSD. Significant PTSS predictors in the fathers were: PTSS intensification in the partner, the level of perceived stress and emotion-oriented coping. Significant PTSS predictors in women were: avoidance-oriented style in stressful situations and PTSD intensification in the father. Conclusion Post-traumatic stress symptoms in a partner is a significant predictor for post-traumatic stress symptoms in the mothers and fathers of children previously treated in NICU. Practice implications Demonstrating a significant correlation between PTSS in a parent and their partner, as well as stress coping has crucial clinical implications both in terms of prevention and diagnosis.

Introduction The birth of a sick child, as well as the infant's subsequent hospitalization in an neonatal intensive care unit (NICU), is undoubtedly stressful for the parents of the infant. Most studies conducted in groups of parents of such children focus on the assessment of the negative changes in their functioning due to such stress. The authors were interested in positive changes in the psychological functioning of parents that may occur after traumatic experiences. These changes are referred to as post-traumatic growth (PTG). Objective The aim of this study was to examine whether parents experience post-traumatic growth and to determine the predictors of PTG in fathers and mothers, depending on the coping strategy adopted. Material and methods The study involved 82 parents, whose children were previously hospitalized in neonatal intensive care unit. The methods used included the following standardized psychological tests: the Post-traumatic Growth Inventory, the Impact of Event Scale-Revised, and the COPE Inventory. Socio-demographic and medical data were also collected. Results Analysis of the data proved that the illness and hospitalization of a child are significantly associated with the occurrence of post-traumatic growth in parents. PTG in mothers is higher than in fathers. Predictors of PTG in fathers include the use of strategies aimed at seeking emotional support and positive reinterpretation and growth, while in the group of mothers, seeking emotional support, religious coping and planning were the coping strategies used. Conclusions Research on post-traumatic growth should be expanded. Knowledge of the predictors of positive growth in a difficult situation can contribute to the widespread implementation of primary and secondary prevention of post-traumatic stress symptoms as well as increase positive changes in individuals who have experienced traumatic events.

Introduction Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) by M. Miles et al. has been developed in order to assess the stress experienced by parents of infants being treated in Intensive Care Units. The measurement of parental stress enables the evaluation of nursing care effectiveness, as well as facilitating the determination of the level of progress made by parents in coping with the difficult situation they face. Objectives The aims of the research include: (1) validation of the Parental Stressor Scale: Neonatal Intensive Care Unit into Polish and (2) initial assessment of perceptions of parental stress in a group of 151 parents of infants treated in four NICUs in Poland. Material and methods This quantitative cross-sectional study was performed among 151 parents (129 mothers and 22 fathers) of infants treated in four NICUs in central and eastern Poland. The respondents were asked to complete forms following the Parental Stressor Scale: Neonatal Intensive Care Unit, the Impact Event Scale - Revised (IES-R),and their demographics, which combined basic medical data along with socio-emographic data of both parents and children. Results The three sub-scales distinguished on the basis of the factor analysis (Infant Appearance, Parental Role Alteration, Sights and Sounds) can explain in total 54.89% of variances. Cronbach's alpha for the entire scale equals 0.92, while as follows for the particular sub-scales: Infant Appearance -.92; Parental Role Alteration -.86, and Sights and Sounds - 0.78. Conclusions The Polish version of PSS:NICU is an accurate and reliable tool for the assessment of stress experienced by parents whose infants require treatment in NICUs.

Cel pracyCelem pracy było ustalenie modelu związku pomiędzy nasileniem objawów stresu pourazowego, poziomu odczuwanego stresu oraz strategiami radzenia sobie ze stresem u matek dzieci w przeszłości leczonych w Oddziale Intensywnej Terapii Noworodka.MetodaAnonimowe badanie kwestionariuszowe objęło 62 matki niemowląt w wieku od 3 do 12 miesięcy, które w przeszłości wymagały leczenia w oddziałach intensywnej opieki noworodków. Respondentki wypełniały kwestionariusz złożony ze standaryzowanych narzędzi badawczych: Zrewidowanej skali wpływu zdarzeń (IES-R), Kwestionariusza radzenia sobie ze stresem COPE i Skali odczuwanego stresu (PSS-10).WynikiNasilenie objawów stresu pourazowego wyjaśnia model składający się z czterech zmiennych: trzech strategii radzenia sobie ze stresem (koncentracja na emocjach i ich wyładowanie, zaprzeczenie, odwracanie uwagi), oraz odczuwanego stresu. Model ten wyjaśnia niemal 40% objawów zespołu stresu pourazowego. Odczuwany stres częściowo wpływa na PTSD poprzez jedną strategię – zaprzeczenie, która także wpływa na nasilenie objawów stresu pourazowego, niezależnie od postrzeganego stresu.WnioskiKoncentracja na emocjach i ich wyładowanie, zaprzeczenie, odwracanie uwagi i poziom odczuwanego stresu są potencjalnie modyfikowalnymi czynnikami, silnie związanymi z występowaniem PTSD. Wskazane jest planowanie, realizacja i ocena skuteczności interwencji dotyczących ograniczania dysfunkcyjnych strategii radzenia sobie ze stresem i odczuwanego stresu u matek niemowląt wymagających leczenia w Oddziale Intensywnej Terapii Noworodków. W celu zminimalizowania dystresu i poprawy radzenia sobie z leczeniem dziecka konieczna jest ocena efektów różnych metod wspierania rodziców.

Introduction Child's illness and hospitalisation are difficult and stressful situations both for the patients themselves and for their parents. Supporting the ill child and their guardians is an indispensable element of caring for ill children. The Nurse-Parent Support Model developed by Margaret Miles is based on four elements, namely emotional support, appraisal support, informational support and instrumental support. Aim The aim of the research was (i) cultural adaptation and validation of The Nurse-Parent Support Tool into Polish and (ii) initial assessment of parents’ perception of nursing support given to the parents of children hospitalised in five paediatric wards in Poland. Material and method Quantitative cross-sectional study was conducted in a group of 195 parents of children hospitalised in five different hospital wards in eastern Poland. Results and conclusions Theoretical validity of the four-factor version of NPST is proved by the correlation matrix analysis and inter-correlation between the dimensions of the described tool as well as the analysis of the internal structure of the test verified on the basis of its internal validity which also confirms its reliability. However, theoretical validity of the test is not confirmed by the factor analysis whose results indicate that the tool encompasses two factors that explain 58.5% of variances. Respondents rated instrumental support provided by the nurses the highest, appraisal and informational support were rated slightly lower, and emotional support was rated the lowest. Negative correlation between the level of stress and emotional support (r = −0.35), informational support (r = −0.29) and support in general (r = −0.30) was demonstrated. Polish four-factor version of NPST is recommended only for international comparative analyses, whereas the use of two-factor version of NPST is recommended for national research programmes. The level of support given to the parents of children hospitalised in Poland seems to be unsatisfactory.

Introduction. Significant progress in the perinatal and intensive care therapy resulted in a meaningful increase of survival of extremely immature, and burdened with severe diseases neonates. Although infants are the patients of the Neonatal Intensive Care Unit, the needs of their parents should also be noticed and realized. The aim of the study was the analysis of the parents’ experiences of children hospitalized in the NICU. Material. The research material comprises 39 written contributions of parents of children hospitalized in the NICU. Method. A qualitative analysis of the text was used. Quotes of parents were classified in three categories: emotions, thoughts and support. Results. Fear, happiness, joy, uncertainty, stress and shock are the most frequently emotions appearing in the parents’ reports. The most frequently mentioned areas of cognitive reactions of parents include: realization of child’s mortality, realizing problems of the premature birth, search for the guilty, and the reformulation of looking at the world. Parents often described support they received, but also pointed to the areas where support lacked. Conclusion: As a result of intense emotions, both positive and negative tint that parents experience at birth of a premature or sick child, multi-disciplinary care is necessary in order to reduce the negative effects of experienced emotions. Support, including information support for parents of critically ill newborns is a key skill in the practice of doctors taking care of children hospitalized in NICU. Psychological support is an essential element of the holistic care of the neonate’s family.

Aims and objectives To determine the incidence and severity of post-traumatic growth in a group of parents of children hospitalised in the intensive care unit in the past. Background A premature birth or a birth with life-threatening conditions is a traumatic event for the parents and may lead to a number of changes, some of which are positive, known as post-traumatic growth. Method The survey covered 106 parents of 67 infants aged 3–12 months. An original questionnaire and standardised research tools were used in the study: Impact Event Scale – Revised, Perceived Stress Scale, COPE Inventory: Positive Reinterpretation and Growth, Coping Inventory for Stressful Situations, Post-traumatic Growth Inventory and Parent and Infant Characteristic Questionnaire. Results Due to a stepwise backward variables selection, we found three main factors that explain post-traumatic growth: post-traumatic stress symptoms, positive reinterpretation and growth and dichotomic variable infants’ survival. This model explained 29% of the post-traumatic growth variation. Similar models that were considered separately for mothers and fathers showed no significantly better properties. Conclusion Post-traumatic growth was related to a lesser extent to sociodemographic variables or the stressor itself, and related to a far greater extent to psychological factors. Relevance to clinical practice Our study highlights the fact that post-traumatic growth in the parents of neonates hospitalised in the neonatal intensive care units remains under-evaluated.