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Hanna Popowicz,1 Katarzyna Kwiecień-Jaguś,2 Jolanta Olszewska,1 Wioletta A Mędrzycka-Dąbrowska2 1Department of Obstetric and Gynaecological Nursing, Medical University of Gdansk, Gdansk, Poland; 2Department of Anaesthesiology Nursing and Intensive Care, Medical University of Gdansk, Gdansk, PolandCorrespondence: Wioletta A Mędrzycka-DąbrowskaDepartment of Anaesthesiology Nursing and Intensive Care, Medical University of Gdansk, Dębinki Str.7, 80-211 Gdansk, PolandEmail wioletta.medrzycka-dabrowska@gumed.edu.plIntroduction: Recently, interest in the problem of proper prevention and monitoring of pain, especially acute, has been increasing in relation to various age groups. Greater awareness of the problem prompts discussion about the purpose of analgesia in newborns treated with mechanical ventilation.Aim: The purpose of the systematic review was to analyze current research on the use of pain scales in newborns treated with mechanical ventilation in the Neonatal Intensive Care Unit.Methods: Medline databases: PubMed, OVID, EBSCO, Web of Science and Cochrane Library were traced using the appropriate keywords. The search was limited to studies in English. The review took into account the years 2006– 2019. Considering the criteria, 12 articles were included in further analysis, to which full access was obtained.Results: The analyzed scientific research showed differences in beliefs about the validity and credibility of the scales used. Researchers indicated that staff with practical experience in using scales in their daily practice was very skeptical of the results obtained on their basis.Conclusion: Based on this review, no explicit evidence can be obtained to support the use of one proper scale in pain assessment. It can be inferred that the COMFORT and N-PASS scales are effective for pain assessment and for determining the need for analgesics in mechanically ventilated neonates. These scales may be equally effective in assessing chronic pain, especially in mechanically ventilated children. On the other hand, the PIPP and CRIES scales are most commonly recommended for assessing acute and postoperative pain.Keywords: pain, scales, newborn, NICUs

Wstęp Obecność rodzin w czasie prowadzenia resuscytacji krążeniowo-oddechowej (RKO) powinna być niepodważalnym prawem każdego pacjenta. Takie sytuacje są obecnie jednak częściej akceptowalne w odniesieniu do pacjentów pediatrycznych niż w przypadku resuscytacji osób dorosłych. Opinie na temat obecności członków rodzin w czasie RKO są podzielone, również wśród znacznej rzeszy praktyków pielęgniarek i lekarzy. Część badaczy sugeruje, że obecność członków rodzin może przyczynić się do rozwoju syndromu wypalenia emocjonalnego. Inni wskazują, że udział w procedurze pozwala zbudować zaufanie i szacunek do zespołu medycznego oraz podejmowanych przez nich działań. Zarówno w Polsce, jak i na Litwie brak jest uregulowań prawnych z tego zakresu, a temat jest niezwykle trudny również etycznie. Cel Celem prowadzonego projektu była analiza opinii studentów studiów pielęgniarskich na temat obecności członków rodzin w czasie prowadzenia resuscytacji krążeniowo-oddechowej. Materiał i metody Badanie przeprowadzono metodą prospektywną w oparciu o autorski kwestionariusz wywiadu, obejmujący dane socjodemograficzne, a także pytania dotyczące obecności członków rodzin w czasie prowadzenia RKO, opracowane na podstawie zaleceń i wytycznych: The Emergency Nurse Association, The American Associa-tion of Critical Care Nurse. Badanie było częścią większego projektu z zakresu RKO. Zebranie materiału badawczego zajęło rok. Wyniki W badaniu wzięło udział 689 studentów studiów pielęgniarskich z Litwy (n=500; 72,6%) i Polski (n=189; 27,4%). Badana grupa była wewnętrznie zróżnicowana pod względem płci. Wiek badanych respondentów wynosił średnio 23,49 roku (SD - 6,10). Zdecydowana większość respondentów była zdania, że rodzina ma prawo towarzyszyć pacjentowi w czasie RKO. Niemniej jednak już w pytaniu dotyczącym aspektów praktycznych pracy pielęgniarki w zespole resuscytacyjnym badani respondenci opowiedzieli się, że nie życzyliby sobie obecności rodzin w czasie prowadzonych działań ratujących życie pacjenta - 72,1% (n=497). W ostatnim z pytań dotyczących barier w zakresie współuczestniczenia rodzin w czasie RKO 38,6% (n=265) badanych było zdania, że udział rodzin może przyczynić się do zwiększenia poziomu stresu, a przez to może wprowadzić chaos i zamieszanie. 29,5% (n=203) badanych uważało, że może to zakłócać pracę zespołu i zwiększać ryzyko błędów w czasie prowadzonej procedury. Pośród innych opinii respondenci wskazywali, że udział rodzin może być dla poszczególnych członków traumatycznym przeżyciem (10,3%; n=71), a także iż powinien być poprzedzony edukacją na temat prowadzonych działań i czynności w ramach udzielanej procedury. W pytaniu dotyczącym tego, kto powinien towarzyszyć rodzinom w czasie prowadzonej resuscytacji, 31,9% (n=219) respondentów wskazywało lekarza, 37,3% (n=256) delegowało te obowiązki pielęgniarce, zaś 20,3% (n=139) badanych wskazało ratownika medycznego. Wnioski Studenci studiów pielęgniarskich byli zdania, że rodzina ma prawo współuczestniczyć w RKO członka rodziny. Z przeprowadzonego sondażu wynika, że podjęty temat budzi wiele obaw wśród przyszłych pracowników systemu zdrowotnego. Znaczna cześć respondentów dostrzegała szereg barier związanych z obecnością rodzin w czasie prowadzonych czynności, opisując je jako znaczne źródło stresu, chaosu czy zwiększone ryzyko błędu medycznego. Respondenci dostrzegali potrzebę wprowadzenia edukacji rodzin w zakres prowadzonych działań, a także wskazywali, że powinna być osoba towarzysząca członkom rodzin, tzw. mentor, co jest zbieżne z wynikami i wnioskami innych autorów. Bez wątpienia temat obecności rodzin w czasie RKO wymaga dalszych badań, a także rozwiązań prawnych, które nie są obecnie dostępne we wszystkich szpitalach czy krajach. [ABSTRACT FROM AUTHOR]

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Introduction Family presence during cardiopulmonary resuscitation (FPDR) should be undoubtedly the right of each patient. The situation with families being witnesses of CPR are more accepted in pediatric patients compared to adults. Opinions about family presence during CPR still remain controversial, not only among researchers but also among specialists like doctors and nurses. Some authors suggest that family who is present at the time of the attempted resuscitation may be at high risk of emotional trauma. Other scientists suggest that being a witness of CPR may be the opportunity for a 'last goodbye' and may help build trust towards healthcare professionals. In many countries, like Poland and Lithuania, there are no legal regulations or recommendation supporting FPDR and the problem seems to be very difficult. Aim The aim of this study was to analyze the nursing students opinion and attitude towards FPDR. Material and methods We conducted a prospective study based on a survey which included sociodemographic data and questions about FPDR. The questions were based on the recommendation of the Emergency Nurse Association and the American Association of Critical-Care Nurses. The research was multicentered and it was a part of a bigger research project. It took about one year to collect the data. Results We enrolled 689 nursing students from Poland (n=189; 27.4%) and Lithuania (n=500; 72.6%). The studied group was diverse in terms of sex and the year of study. The mean age of the respondents was 23.49 years (SD 6.10). The vast majority of respondents stated that the patients family has a right to witness CPR (n=308; 44.7%). Nevertheless, when asked about the resuscitation team, most of the respondents gave a clear answer that they would rather not have family members around during CPR 72.1% (n=497). In one of the last questions regarding barriers during family presence over 38.6% (n=265) of respondents stated that FPDR may increase the level of stress among nursing personnel and lead to chaos and confusion. Twenty nine, 5% (n=203) of respondents thought that this may interrupt the work of the team and increase the risk of mistakes during the procedure. Another opinion was: FPDR may be a traumatic experience for family members (10.3%; n=71) and it should be preceded with family education about activities carried out by medical staff. In the question about who should be responsible for accompanying the families during resuscitation 31.9% (n=219) of respondents indicated a doctor, 37.3% (n=256) delegated these duties to a nurse, and 20.3% (n=139) respondents chose a paramedic. Conclusions Students are convinced that the patient and his family have the right to witness CPR. The results show that the topic is also very controversial in Poland and Lithuania and raises many doubts among future medical staff. Students indicated many barriers and claimed that family surely needs to be educated and prepared by the medical staff before they witness CPR. The family should be accompanied by a mentor during the whole period of time. Undoubtedly, the topic of FPDR requires further research as well as legal recommendation or law that are currently not available in all hospitals or countries. [ABSTRACT FROM AUTHOR]

Introduction: Music is an intriguing but relatively under-researched intervention with many potential benefits for mechanically ventilated patients. The review aimed to assess the impact of listening to music as a non-pharmacological intervention on the physiological, psychological, and social responses of patients in an intensive care unit., Methods: The literature review was conducted in the fourth quarter of 2022. The overview included papers found in Science Direct, EBSCO, PubMed, Ovid, Scopus, and original research papers published in English meeting the PICOS criteria. Articles published between 2010 and 2022 meeting the inclusion criteria were included for further analysis., Results: Music significantly affects vital parameters: decreases the heart rate, blood pressure, and breathing; reduces pain intensity. The analyses confirmed that music affects anxiety levels, reduces sleep disturbances and delirium occurrence, and improves cognitive function. The effectiveness of the intervention is influenced by the choice of music., Conclusions: There is evidence of the beneficial effects of music on a patient's physiological, psychological, and social responses. Music therapy is highly effective in reducing anxiety and pain and stabilizes physiological parameters, i.e., the heart rate and respiratory rate, after music sessions in mechanically ventilated patients. Studies show that music reduces agitation in confused patients, improves mood, and facilitates communication.

Introduction: Cancer threatens life and brings about many negative emotions in patients, which influence their satisfaction with life and contribute to a low level of their acceptance of illness. This is why the acceptance of illness is a serious problem among patients with cancer; contributes to the intensification of symptoms; and influences the patient's physical, mental, emotional, social, and spiritual condition., Aim: The purpose of this work is to assess the acceptance of illness and satisfaction with life in patients with cancer, as well as to identify social, demographical, and clinical factors that significantly differentiate their acceptance of illness and satisfaction with life., Materials and Methods: The study involved 120 patients with cancer aged 18 to 88. The study was conducted in the form of a questionnaire based on standard research tools: Acceptance of Illness (AIS), Satisfaction with Life Scale (SWLS), and Numerical Rating Scale (NRS). Social, demographical, and clinical data were collected in the original questionnaire., Results: A group of 120 patients was studied, including 55.83% ( n = 67) women and 44.16% ( n = 53) men. The average age was 56. A general acceptance-of-illness index obtained by the patients was 21.6 ± 7.32 and a general satisfaction-with-life index was 19.14 ± 5.78. The statistical analysis indicated a significant correlation between the acceptance of illness and the intensity of pain (rHO = -0.19; p < 0.05), fatigue (( Z = 1.92; p > 0.05), and diarrhoea ( t (118) = 2.54; p < 0.05). The correlation between the intensity of pain and satisfaction with life was negative (rHO = -0.20; p < 0.05)., Conclusion: The greater acceptance of illness, the greater satisfaction with life in patients with cancer. Pain, fatigue, and diarrhoea decrease the acceptance of illness. In addition, pain decreases the level of satisfaction with life. Social and demographical factors do not determine the level of acceptance of illness and satisfaction with life.

Background: Due to the progress in neonatology, in particular, in the past three decades, the mortality rate among patients of intensive care units has decreased. However, this is connected not only with newborns needing to stay longer in the unit, but also with the exposure of newborns to many painful procedures and stresses. Lack of or insufficient pain prevention has a negative impact on the sensory or locomotor development of newborns. Despite the presence of guidelines based on scientific evidence, the use of pharmacological and non-pharmacological pain-management methods in newborns is still insufficient., Aim: The aim of the study was to: identify the knowledge nurses/midwives have of recommended non-pharmacological and/or pharmacological methods, in particular, in relation to medical intervention procedures; assess the interventions for pain relief applied by midwives/nurses most often in their clinical practice; examine the role of age, general work experience, education level and years of work of medical professionals on a neonatal ward, as well as the referral level of a unit, versus the application of pharmacological and non-pharmacological methods., Methods: A descriptive and quantitative study conducted in 2019 among Polish nurses/midwives working at neonatal intensive care units., Results: The analysis of the material reflected the deficit of knowledge and the insufficient daily use of recommended pain-relief measures among the respondents., Conclusions: The interpretation of data indicates that despite the clear and easily available recommendations of scientific societies concerning the mode of conduct in particular medical procedures, medical personnel do not apply those recommendations in their everyday practice. It is necessary to plan and implement education strategies for nurses/midwives on standard pain-management interventions during painful medical procedures.

Background: Physical inactivity is one of the primary factors that leads to obesity and overweight. What is more, it is becoming an increasingly common problem among the population of those who work. The causes of obesity and the lack of physical activity are multifactorial. The aims of the study were: to (1) measure the level of physical activity among the university staff, (2) evaluate what factors have a significant influence on undertaking the physical activity and lack of., Methods: A cross-sectional study was conducted via the Internet questionnaires among university staff in Northern Poland and Pomeranian Region. Taking into consideration the climate and cultural factors in Poland, a physical activity test with the usage of IPAQ scale was performed between September and November 2018 and between March and June 2019. The data was collected on the basis of the standardized long form of the IPQA questionnaire, the GSE Scale and the interview questionnaire including questions about sex, age and health assessment., Results: The study group consisted of 276 respondents, including 143 women (51.8%) and 133 men (48.2%). The average age of the respondents was 42.22 with SD ± 11.01. The weight status was categorized with the use of BMI index. 51.3% (142) of the respondents had normal body mass, 93 (33.8%) were overweight, while 23 (8.4%) were obese. The mean BMI index was 25.23 points (SD ± 4.04). One hundred and twenty five (45.1%) respondents were the employees of the Medical University, and 54.9% were employed by the Technical University. Detailed analyses using Spearman correlation test confirmed the presence of a statistically higher level of physical activity among respondents employed at the Medical University (M 513.37; SD ± 609.13) than the employees of Technical University (M 378.38; SD ± 328.26). The odds ratio analysis shows that a low level of physical activity in the group of technical university staff has a significant correlation with the other social behavior which is the alcohol consumption., Conclusion: This study confirms that the number of points obtained in the IPAQ scale, classified the academics in the workgroup presenting low physical activity which does not exceed 600 MET-min/week. The most common form of activity in this group was walking. There was no correlation between physical activity and self-efficacy, age, marital status or the number of children., (© 2021. The Author(s).)

Background: One of the key elements of patient care is the relief and prevention of pain sensations. The importance of pain prevention and treatment has been emphasized by many international organizations. Despite the recommendations and guidelines based on evidence, contemporary research shows that the problem of pain among patients in neonatal intensive care units (NICUs) in various centers is still an important and neglected problem., Aim: The aim of this study was to assess the level of knowledge of the medical personnel and their perception of the issue of pain in neonatal patients., Methods: A quantitative descriptive study carried out in 2019. The study used a nurses' perceptions of neonatal pain questionnaire., Results: A total of 43 Polish hospitals and 558 respondents participated in the project. 60.9% ( n = 340) and 39.1% ( n = 218) of respondents were employed in secondary and tertiary referral departments, respectively., Conclusion: Our analyses indicate that despite the availability of pain assessment tools for neonatal patients, only a few centers use standardized tools. The introduction of strategies to promote and extend the personnel's awareness of neonatal pain monitoring scales is necessary.

Practicing the algorithms of basic life support (BLS) is essential in order to take adequate measures to save lives, and future nursing staff should be advanced when it comes to performing lifesaving activities. The purpose of the study was to analyse the theoretical and practical knowledge of nursing students (within the undergraduate course) with regards to the basic life support (BLS). The study has a prospective, comparative and descriptive nature. Three countries that educate nursing students within the undergraduate course participated in the project. Data was collected with the use of a questionnaire based on the guidelines of the European Resuscitation Council (ERC 2015). The study was carried out among a total of 748 respondents from three countries: Poland ( n = 189, 25.3%), Lithuania ( n = 500, 66.8%) and Spain ( n = 59; 7.9%). The average age of respondents was 23.41 (SD ± 5.90). The average score obtained by the respondents who answered the questions was 11.13 with a standard deviation of SD ± 2.29. The conducted study revealed that a substantial number of the respondents who participated in the study obtained an average result concerning theoretical and practical knowledge of BLS. It was also confirmed that the additional education in the form of first aid training courses has a major impact on improving the levels of knowledge among the students in each of the analysed country.

Background: Nurses are the largest group of employees in hospitals yet their working environment and conditions are not always optimal. Moreover, nurses may be convinced that the physical activity they perform during working hours is sufficient to maintain a healthy lifestyle., Objectives: The study aimed to measure the number of steps, the distance and the energy expenditure during a 12-hour shift in the intensive care unit and for nurse anaesthetists in selected hospitals in Poland., Methods: Data were collected via a pedometer and a socio-demographic interview. The project was multicentre, data were collected from 11.11.2013 to 04.05.2014., Results: The median number of steps taken by nurse anaesthetists within the operating room was 7404 (IQR 4461-9443) while in the ICU it was 7358 (IQR 4705-9101). During the day in the operating and recovery room, both nurse anaesthetists (IQR 3.90-6.26) and ICU nurses (IQR 3.54-6.39) reached the median distance of five kilometres. There were significant differences in the distance covered during day and night between ICU (p = 0.0003) and anaesthetic staff (p = 0.0001) as well as the number of steps (ICU p = 0.0002; ANEST p = 0.0001) and energy expenditure (ICU p = 0.0004; ANEST p = 0.0001)., Conclusion: The professional activity of nurses alone is insufficient to meet the recommendation of taking 10,000 steps daily, which would contribute to improved quality of life., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Aim: The aim of this systematic review was to summarize the present literature on cognitive dysfunctions in adults after surgical procedures., Methods: MEDLINE: PubMed, OVID, Web of Science, EBSCO databases have been searched using relevant key words. The literature on cognitive dysfunctions after surgical procedures has been reviewed and the risk factors of POCD occurrence have been analyzed., Results: The results from seven articles describing neuropsychological studies of 2,796 patients have been analyzed. The tests were conducted within a very short time after the procedure (7 days), within a short time (3 months) and within a long-term perspective (12-60 months). POCD within a very short time after the operation occurred with a different frequency: from 17 to 56% with a tendency to resolve over time (3-34.2%). POCD risk factors have been identified: advanced age, insulin resistance, a short education period. The type of surgical procedure, anesthesia or microembolization related to CPB, does not influence the occurrence of POCD., Conclusions: It seems that one should focus on searching risk factors outside the procedures, and that certain recommendations should be developed regarding perioperative proceedings which might be beneficial for patients at risk of the impairment of their cognitive functions after a surgical procedure.

Introduction: In the opinion of many researchers, nursing staff are exposed to an exceptionally high level of occupational stress. The problem of stress in the working environment of the nursing staff becomes more and more important in the context of increasing staff shortages and insufficient support from colleagues and employers. The aim of this study was to analyse stress factors indicated by the nursing staff in Poland and Lithuania, and to assess their job satisfaction., Material and Methods: Two standard research tools were used in the study: the Nursing Stress Scale and the Job Satisfaction Survey. The study involved 230 respondents from Poland and Lithuania. The sample was chosen randomly and incidentally., Results: Based on the analysis of collected materials, the greatest stress factors in the work of the nursing staff were identified, which included interpersonal conflicts between nurses and doctors and between nurses, and death and dying. The study indicated that there is a relationship between stress and job satisfaction among Polish nurses (r=-0.33;p=0.001) and Lithuanian nurses (r=0.34; p=0.001). The greater the stress, the lower the job satisfaction. Low job satisfaction was connected with low remuneration, which is still inadequate to professional duties, and the lack of promotion opportunities. The study confirmed that there were significant differences in job satisfaction among Polish and Lithuanian nurses (Z= -6.27; p<0.001)., Conclusions: The study confirmed a high level of stress and dissatisfaction among nursing staff in Poland and Lithuania.

Purpose: The purpose of this study was to identify Polish nurses' experiences and perceptions about the barriers to postoperative pain management in older adults., Design: The study was conducted using a dedicated questionnaire., Methods: Eleven hospitals participated in this study. The project involved 1,602 nurses working on surgical hospital wards. A descriptive exploratory survey and a qualitative content analysis were used., Findings: Access to journals on evidence-based practice related to pain assessment and management in elderly patients was assessed as less important by the respondents. Knowledge drawn from the media and scientific and medical journals was assessed by the respondents as unsatisfactory. The greatest barrier to nurses was that scientific articles are published in English., Conclusions: Nurses' awareness of evidence-based practice increases with their education. Among the key problems is the lack of available professional publications in the Polish literature, ignorance of English, shortage of time, and lack of support from chief physicians of the ward., (Copyright © 2017 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Background: Sleep disturbances in intensive care unit (ICU) patients have been studied worldwide for over 30 years. Factors contributing to sleep disturbances are still being identified, and therapeutic procedures aimed at the mitigation of such ailments are consequently being developed., Objectives: The aim of this study was to review the literature on sleep disturbances in intensive care unit patients., Material and Methods: MEDLINE PubMed, OVID, Web of Science, and EBSCO databases have been searched using adequate keywords., Results: Sleep disorders in ICUs were common among all of the analysed articles. Noise plays a significant role in sleep interruption (11.5 - 17% of awakenings). It was noted that the introduction of "white noise" into the ICU environment proved unsuccessful in reducing the magnitude of changing noise levels. Nursing care activities significantly disturb nocturnal rest, and 42.7 such procedures per every 12-hour night shift were registered. Aggregating nursing care interventions was suggested in order to reduce the number of stimuli experienced by the patient., Conclusion: Changes in sleep structure developing during an ICU stay may significantly contribute to sleep disorders once the hospitalisation is over., Competing Interests: Conflict of interest: None declared

Cardiac arrest (CA) due to cardiovascular disease is the leading cause of death in developed countries. It is estimated that over 350,000 people in Europe suffer from out-of-hospital cardiac arrest. According to the literature, the longer the episode of cardiac arrest, the greater the risk of cognitive impairment, especially short-term memory, as well as immediate and delayed recall. Other common dysfunctions include attention deficits and executive function disorders. The aim of this systematic review was to summarize current research on cognitive impairment in patients after sudden cardiac arrest. The electronic databases PubMed/MEDLINE, OVID, Web of Science, and EBSCO were searched using the following key words: 'sudden cardiac arrest', 'out-of-hospital cardiac arrest', 'cognitive function', 'cognitive impairment', 'functional outcome', 'cardiopulmonary resuscitation'. The most recent studies from the last 7 years (2011-2018) were included. Cognitive disorders occurred in a broad range of cases: from 13% to even 100%. In one study, cognitive deficits did not occur at all. Amongst the reviewed articles only two studies were carried out on a large group of patients. The remaining studies were conducted on a small group of respondents; therefore there was no possibility to generalize the results to the entire population. The areas in which the most cognitive impairment occurred were memory, executive functions and visual-motor skills. One of the conclusions derived from the reviewed literature is the importance of continuous training of cognitive functions, especially for people with cardiovascular risk.

Significant progress in the field of nursing has contributed to the widening of range of functions and professional duties of nurses. More frequent lack of nursing personnel has an impact on negative reception of work, it decreases sense of professional satisfaction and increases the level of burden and fatigue., Methods: The study applied the non-experimental method - a descriptive comparative study without a control group. The data was collected on the basis of Polish-language version of a Japanese questionnaire. In order to evaluate the level of physical fatigue the pedometer was used., Results: 158 respondents of a group of 160 were included in the statistical analysis. The study group was internally diversified. The research project assessed the usefulness of the multifactorial analysis in evaluating the main components of nursing fatigue. Multifactorial analysis has shown that mental fatigue concentrated with changes in activeness, motivation and physical fatigue are strongly correlated with age, professional experience and education., Conclusion: Nursing is a profession of a special character and mission. Regardless of the place of work, nursing staff should be given the possibility of pursuing their profession under conditions ensuring the sense of security and protecting them from harmful effects on health., Competing Interests: Conflicts of interest: The authors declare no conflict of interest.