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Background: Nursing students’ education process is related to the occurrence of difficult and stressful situations, especially during clinical placement. The purpose of the education is to develop critical thinking, clinical decision making and teamwork skills in students. This process should allow the students to integrate into the clinical environment and develop their professional identity. The goal of this research was to assess the relationship between perceived stress and psychosocial factors. Methods: The research was conducted in 2019 among 307 nursing students in Poland. Research questionnaires used in the study were: Perceived Stress Scale, Generalized Self-Efficacy Scale, Self-Esteem Scale, Life Satisfaction Scale, Life Orientation Test-R and Clinical Learning Environment Inventory. Results: There was a significant correlation between stress perceived by the surveyed nursing students and psychosocial components as well as teacher support and student’s satisfaction with clinical education. Satisfaction with the clinical education during the implementation of clinical activities was the highest in people experiencing a low level of stress. The highest level of teacher support was reported by people experiencing a higher level of stress. Conclusion: A higher level of perceived stress corresponded to a lower level of self-efficacy, lower life satisfaction, lower life orientation and lower self-esteem of students.

The sight and smell of larvae in the wound may cause negative visual and olfactory impressions in sensitive individuals because of decaying body parts, carrion, and suffering. However, Maggot Debridement Therapy (MDT) is highly effective, safe, and cheap in wound healing and tissue revitalization for both the patient and health systems. The aim of the study was to assess the readiness to undertake MDT in a group of qualified nurses who perform therapeutic procedures in patients treated for chronic wounds. A diagnostic survey was used. The research tool was a scientific research protocol consisting of three questionnaires (sociodemographics, MDT perception questionnaire, pictures of wounds for visual assessment). The study included 290 nurses; the mean age was over 42.6 ± 9.9 years, and the median was 44 years. The perception and readiness to implement the method in the tested sample is at the average (standard) level. The image of maggots in the wound causes negative emotions among medical personnel. The higher the knowledge of the MDT method, the greater the motivation to implement it in practice.

Introduction: The development of pneumonia in patients treated in intensive care wards is influenced by numerous factors resulting from the primary health condition and co-morbidities. The aim of this study is the determination of the correlation between nutritional status disorders and selected risk factors (type of injury, epidemiological factors, mortality risk, inflammation parameters, age, and gender) and the time of pneumonia occurrence in patients mechanically ventilated in intensive care wards. Material and method: The study included 121 patients with injuries treated in the intensive care ward who had been diagnosed with pneumonia related to mechanical ventilation. The data were collected using the method of retrospective analysis of patients’ medical records available in the electronic system. Results: Ventilator-associated pneumonia (VAP) occurred more frequently in patients over 61 years of age (40.4%), men (67.8%), after multiple-organ injury (45.5%), and those with a lower albumin level (86%), higher CRP values (83.5%), and leukocytes (68.6%). The risk of under-nutrition assessed with the NRS-2002 system was confirmed in the whole study group. The statistical analysis demonstrated a correlation between the leukocytes level (p = 0.012) and epidemiological factors (p = 0.035) and the VAP contraction time. Patients infected with Staphylococcus aureus had 4% of odds for the development of late VAP in comparison to Acinetobacter baumannii (p < 0.001), whereas patients infected by any other bacteria or fungi had about four times lower odds of the development of late VAP in comparison to Acinetobacter baumannii (p = 0.02). Patients with results in APACHE from 20 to 24 and from 25 to 29 had 13% and 21%, respectively, odds of the development of late VAP in comparison to patients with APACHE II scores ranging from 10 to 19 (respectively, p = 0.006; p = 0.028). Conclusions: The development of VAP is impacted by many factors, the monitoring of which has to be included in prophylactics and treatment.

Model opieki skoncentrowanej na pacjencie – PCC (Patient-Centered Care) w wielu krajach został uznany za standardowe podejście w opiece zdrowotnej w celu poprawy jej jakości. Istotą PCC jest respektowanie wartości, doświadczeń, potrzeb i preferencji pacjenta w planowaniu, koordynowaniu i świadczeniu opieki. Centralnym elementem tego modelu jest relacja terapeutyczna między pacjentem a osobami świadczącymi opiekę zdrowotną. Liczne badania wykazały, że wdrożenie PCC do praktyki przyczynia się do poprawy wyników opieki, lepszego wykorzystania zasobów, obniżenia kosztów i zwiększenia zadowolenia pacjentów z opieki. Celem tego artykułu jest zaprezentowanie założeń modelu opieki skoncentrowanej na pacjencie, korzyści i barier we wdrażaniu do systemu opieki zdrowotnej. The Patient-Centered Care (PCC) model has been recognised in many countries as a standard approach in healthcare to improve its quality. The essence of PCC is to respect the values, experiences, needs and preferences of the patient in planning, coordinating and providing care. Therapeutic relationship between the patient and the healthcare providers is at the core of this model. Numerous studies have shown that implementing PCC into the practice contributes to improved care results, better use of resources, lower costs and increased satisfaction of patients with healthcare. The aim of this article is to present the assumptions of the patient-centered care model as well as the benefits and barriers in implementing this model into the health care system.

Introduction: Melanoma is a malignant skin tumour. Its incidence doubles every 10 years. The sooner it is diagnosed, the better the chances for suc-cessful treatment. Therefore, the need has arisen to spread knowledge about early detection of melanoma and its prevention. Aim of the study: To assess the knowledge and the extent to which skin cancer preventive measures are followed in selected groups of inhabitants of Po-land and Australia. Material and methods: The study was conducted in a group of 267 people, 151 of whom lived in Poland and 116 in Australia. The study was carried out with the application of a diagnostic survey method. The research technique was a survey, and the research tool was a questionnaire designed by the authors. The study findings were examined by means of statistical analysis. Results: The study showed that although the average level of knowledge is good (46.4%), the extent to which the rules of melanoma prevention are applied is still unsatisfactory in the majority of population (42.3%). It was observed that Australian inhabitants had higher scores in both aforementioned cases (p < 0.001); 91.4% of respondents had at least satisfactory knowledge about melanoma and 78.4% of them took proper preventive measures, whereas in Poland it was 75.5% and 41.7%, respectively. Conclusions: In most cases the respondents have a good level of knowledge, but they do not follow the rules of melanoma prevention. Australians have more knowledge about melanoma, and they are also more likely to take preventive measures.

In patients scheduled for surgery, nutritional disorders worsen during the perioperative period, which is often a risk factor for postoperative complications. The aim of the study was to determine relationship between the preoperative nutritional status of elderly people with stomach, pancreatic and colon cancer and the incidence of postoperative complications and the length of hospital stay. The study included 143 patients with gastrointestinal cancer, aged 65–68, qualified for surgery. Mini Nutritional Assessment, body mass index questionnaires and medical records were used. Malnutrition was found in 9.8%, and a risk of malnutrition in 53.5% of the respondents. Body mass index showed overweight in 28% and obesity in 14% of the patients. Complications occurred in all types of nutritional status, the most common were those requiring intensive care unit treatment (36.8%), pancreatic and biliary fistulas (29.4%) and surgical site infections (58.2%). Gastric cancer patients at risk of malnutrition stayed longer in the hospital. Postoperative complications and longer hospital stays were observed more frequently in cases of overweight, obesity, malnutrition and its risk. Disturbances in the nutritional status, in the form of malnutrition and its risk, as well as overweight and obesity, determined more frequent occurrence of postoperative complications and longer hospital stay.

The aim of the research was to determine the influence of sociodemographic factors on older people&rsquo, s care dependency in their living environment according to the Care Dependency Scale (CDS). Methods: The research was conducted in a group of 151 older people staying in their own homes. The methods applied in the research included a sociodemographic questionnaire and scales including the Abbreviated Mental Test Score (AMTS), CDS, Katz Index of Independence in Activities of Daily Living (ADL), Lawton&rsquo, s Instrumental Activities of Daily Living (I-ADL), Mini Nutritional Assessment (MNA), and Geriatric Depression Scale (GDS). Results: Gender had a significant impact on the level of care dependency. The surveyed females obtained the medium or high level of dependency more often than males (22.4% vs. 6.1%), and the low level of dependency was significantly more frequent among men than women (p = 0.006). Moreover, the age of the respondents determined their level of care dependency. The subjects with a medium or high level of care dependency were significantly older (p = 0.001). The subjects with a low level of care dependency were more likely to be married than people with a medium/high level (p &lt, 0.001). The level of education had a significant impact on care dependency. A higher level of education correlated with a medium/high level of dependency (p = 0.003). Conclusions: The survey results confirmed that sociodemographic factors have a significant impact on the level of care dependency. When planning care in the home environment, special attention should be paid to older women, who are more likely to lose their independence than men. These women should be given additional support.

Wstęp. Główne czynniki ryzyka wielu chorób wynikają z nieprawidłowych zachowań zdrowotnych i są przyczyną m. in. rozwoju nowotworów złośliwych, w tym raka nerki. Jednym z elementów zachowań zdrowotnych jest określenie stanu odżywienia, celem wczesnego wykrycia zaburzeń i podjęcia interwencji. Cel pracy. Określenie i porównanie zachowań zdrowotnych ze stanem odżywienia pacjentów z rozpoznanym rakiem nerki. Materiał i metody. Badanie przeprowadzono wśród 100 osób, u których wykonany był zabieg operacyjny z powodu raka nerki. W badaniach zastosowano metodę analizy dokumentacji medycznej oraz sondaż diagnostyczny z wykorzystaniem narzędzia standaryzowanego – Inwentarza Zachowań Zdrowotnych. Wyniki. Wskaźnik zachowań zdrowotnych dla ogółu badanych wyniósł średnio 75,56 pkt. Najwyższe wyniki uzyskano w kategorii zachowań profi laktycznych (średnia 3,89), następnie w kategorii pozytywnych nastawień psychicznych (średnia 3,34) oraz w kategorii praktyk zdrowotnych (średnia 2,91). Najniższy wynik uzyskano w kategorii prawidłowych nawyków żywieniowych (średnia 2,49). Stwierdzono zależność pomiędzy wiekiem, BMI, a kategorią prawidłowe nawyki żywieniowe (p ≤ 0,001) oraz pomiędzy wiekiem, BMI, a kategorią praktyki zdrowotne (p < 0,001). Wnioski. W całej badanej grupie najniższe wyniki uzyskano w kategorii prawidłowych nawyków żywieniowych. Pomimo stwierdzenia w całej grupie najniższych wyników w kategorii prawidłowych nawyków żywieniowych, pacjenci w starszym wieku i z wyższym BMI uzyskali wyższe wyniki, ale w zakresie praktyk zdrowotnych uzyskali wyniki niskie. Introduction. The main risk factors of numerous diseases result from abnormal health behaviors and among others are causing development of malignant tumors, including kidney cancer. One of the elements of health behaviors is to determine the state of nutrition, in order to early detect disorders and to undertake interventions. Aim of the study. Determination and comparison of health behaviors with the nutritional status of patients with diagnosed kidney cancer. Material and methods. The study was conducted among 100 people who underwent surgery because of kidney cancer. The research used the method of analysis of medical documentation and a diagnostic survey with a tool – Health Behavior Inventory. Results. The average index of health behaviors for all respondents was 75.56 points. The highest results were obtained in the category of preventive behaviors (mean 3.89), then in the category of positive mental attitudes (mean 3.34) and in the category of health practices (mean 2.91). The lowest result was obtained in the category of proper eating habits (mean 2.49). The relationship between age, BMI, and the category of normal eating habits (p ≤.001) was observed as well as between age, BMI, and the category of a health practice (p < 0.001). Conclusions. The lowest results were obtained in the category of proper eating habits. Despite obtaining the lowest results in the category of normal eating habits in the whole group, among patients with a higher BMI and in the elderly patients, normal eating habits were found at a higher level, but their health practices remain at a low level.

Wstep. Postepujący proces starzenia sie spoleczenstwa sklania do zadania pytania o czestośc wystepowania uzaleznien, nie tylko ze wzgledu na negatywny wplyw na stan zdrowia, ale rowniez ze wzgledu na konsekwencje spoleczne. Cel. Calem pracy bylo rozpoznanie uzaleznien od alkoholu i tytoniu u osob starszych. Material i metody. Badanie przeprowadzono wśrod 100 osob po 60. roku zycia. W badaniu posluzono sie metryczką pytan demograficzno-spolecznych wlasnej konstrukcji oraz kwestionariuszami: Tolerancji Nikotyny Fagerstroma (FTND), Rozpoznawania Zaburzen Związanych z Piciem Alkoholu (AUDIT), Krotkim Alkoholowym Michigenskim Testem Przesiewowym — Wersja Geriatryczna (S-MAST-G). Wyniki. Wśrod badanych 21% palilo tyton, mezczyźni cześciej niz kobiety palili (25% vs. 17%) i wykazywali wyzszy stopien uzaleznienia. Problemy z alkoholem wykazano u co czwartej badanej osoby (23%). Mezczyźni cześciej niz kobiety wykazywali obecnośc problemow alkoholowych (p = 0,0001). Tylko mezczyźni wykazywali picie alkoholu ryzykowne i szkodliwe, ponad polowa badanych kobiet wykazala picie o niskim ryzyku (p = 0,04). Osoby niepalące tyton w wiekszości nie mialy problemow alkoholowych. Wśrod osob palących tyton wykazano problem z alkoholem (p = 0,0007) oraz objawy picia szkodliwego (p = 0,006). Wnioski. Plec stanowi predyktor w identyfikowaniu uzaleznien u osob starszych, tylko mezczyźni wykazali picie alkoholu ryzykowne i szkodliwe. Wspolwystepowanie uzaleznien od tytoniu i alkoholu stanowi problem zdrowotny osob starszych, ktorych nalezy systematycznie motywowac do zmiany zachowan oraz wspierac odpowiednią terapią.

Introduction. Despite being mandatory, the preventive vaccinations in Poland stir up numerous controversies and cause concern among parents, mostly because of potential medical complications after vaccinations. Because of the favourable epidemiological situation more and more parents are not confident whether preventive vaccinations for children are still necessary. On the other hand, scientists are warning against the recurrence of infectious diseases that have been controlled through vaccination. The ongoing discussion whether to vaccinate or not, leaves parents in dismay. On the one hand, this situation makes some parents give up vaccinating their children, on the other, promotes education and conscious decision-making processes. Aim. The aim of this study was to describe the level of the knowledge, experience and the opinion of parents of children of preschool age in the area of protective vaccination. The results can be used as educational material. Material and Methodology. The study included 102 parents of preschool children. Diagnostic survey method was applied in the research, using the author’s questionnaire. Results. Less than half of respondents (48%) knows the optimal age at which a person should be vaccinated against tuberculosis, more than half (56.9%) knows when to provide the first dose of the Polio vaccine. Approximately half of the respondents (51%) knows the diseases (measles, mumps and rubella) against which the MMR vaccine protects. The respondents know additional immunization program (82.4%). They also know such terms as the combined vaccine (90.2%) and postvaccination reaction (69.8%). The fear of vaccination was reported by approximately 5% of respondents (definitely yes). Some parents (31.7%) do not notice any concern against vaccinations, the remaining ones are worried about possible complications (30.7%), an allergic reaction and the fear of a needle prick. Parents with university education report more doubts and fears. According to 36.6% of respondents, parents should take the decision on their child vaccination, but only 6.9% have sufficient knowledge on this topic. The surveyed people who are definitely against punishment of parents who do not vaccinate children account for 19.6%. Among all of the surveyed, only one person admitted that his/her child was not vaccinated and this was his/her personal choice. The respondents benefit from recommended vaccinations (49%), mostly against rotavirus. Most of the surveyed people (69%) would vaccinate their children with recommended vaccines if they were free of charge. Conclusion. Analysis of the studies shows that parents of preschool children have an average level of knowledge about immunizations. Most respondents think that the number and the kind of mandatory vaccinations are correct. More than half of respondents believes that vaccinations of children do not endanger their lives and health. The vast majority of parents do not observe in their children the side effects after vaccination.

Demographic changes in contemporary society require implementation of proper perioperative care of elderly patients due to an increased risk of perioperative complications in this group. Preoperative assessment of health status identifies risks and enables preventive interventions, improving outcomes of surgical treatment. The Comprehensive Geriatric Assessment contains numerous diagnostic tests and consultations, which is expensive and difficult to use in everyday practice. The development of a simplified model of perioperative assessment of elderly patients will help identifying the group of patients who require further diagnostic workup.The aim of the study is to evaluate the usefulness of the tests used in a proposed model of perioperative risk assessment in elderly patients.In a group of 178 patients older than 64 years admitted for surgical procedures, a battery of tests was performed. The proposed model of perioperative risk assessment included: Charlson Comorbidity Index, ADL (activities of daily living), TUG test (timed "up and go" test), MNA (mini nutritional assessment), AMTS (abbreviated mental test score), spirometry measurement of respiratory muscle strength (Pimax, Pemax). Distribution of abnormal results of each test has been analysed.The Charlson Index over 6 points was recorded in 10.1% of patients (15.1% in cancer patients). Abnormal result of the TUG test was observed in 32.1%. The risk of malnutrition in MNA test has been identified in 29.7% (39.2% in cancer patients).Abnormal test results at the level of 10-30% indicate potential diagnostic value of Charlson Comorbidity Index, TUG test and MNA in the evaluation of perioperative risk in elderly patients.

Introduction. Diseases are not the only reason for using complementary and alternative medicine. It is also a need to maintain your health and physical well-being at the highest level possible. People with a high sense of responsibility for their own health may choose complementary and alternative medicine to meet the need of an active participation in all that concerns their health. Aim. The aim of this study was to determine the relationship between complementary and alternative medicine usage and health behaviors of adults. Material and methods. The study was conducted among 97 residents of towns and villages. The age of respondents ranged from 18 to 65 years. The research method was a diagnostic survey and the research tool was a questionnaire of own authorship. Multidimensional Health Locus of Control Scale was used also. The results were subjected to qualitative and quantitative analysis. Statistical calculations were performed using Statistica 10.0. Results and conclusions. Over 50% of respondents used complementary and alternative medicine and most of the participants were characterized by health behaviors and internal health locus of control. However, the use was not significantly more common among these people. There is a need for extensive research to understand the phenomenon of the use of complementary and alternative medicine and the role it plays in health behaviors of individuals. Nursing Topics 2015; 23 (2): 214–219