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Cultural competencies are known as a multidimensionalconstruct; however, they usually refer to an individual's sensitivity orcultural attitudes, cultural awareness, knowledge, and skills.The aim of the study was to compare the cultural competences of nurses in Poland and Lithuania based on an adaptation of the Nurse Cultural Competence Scale (NCCS).The design was a comparative cross-sectional study.A total of 383 Polish nurses and 184 Lithuanian nurses took part in the study. The questionnaires of the NCCS-Polish version (NCCS-v.PL) and the NCCS-Lithuanian version (NCCS-v.L) were used after linguistic adaptation and an evaluation of psychometric properties.As a result of the comparative analysis, a higher general level of cultural competences (based on the NCCS) was found in the Lithuanian group M-148.09 (SD = 22.85). The results show statistically significant differences among the respondents in the subscale of Nurse Cultural Competence Scale-Cultural Knowledge (NCCS-CK; p ˂ 0.001); higher competences of the nurses were found in the Group LT (M = 31.05; SD = 6.75) than in the Group PL (M = 28.82; SD = 7.82). In the group of Polish nurses (Group PL), the intensity of cultural competences was found to increase along with age (NCCS-v.P r = 0.157, p 0.05); this, however, was not observed in the Group LT (NCCS-v.LT, p 0.05).Both the nurses in Poland and in Lithuania are characterised by an average level of cultural competences. Diversity in the level of cultural competences was found in both groups depending on age, education and work experience.

Due to the multifactorial etiology of scoliosis, a comprehensive treatment plan is essential for conservative management. Physiotherapeutic scoliosis-specific exercise (PSSE) methods have lately gained popularity for the conservative treatment of scoliosis. The aim of this study was to analyze the PSSE methodologies used for conservative treatment of adolescent idiopathic scoliosis (AIS), as well as their effectiveness. The study was based on an extended literature search conducted in the PubMed, Google Scholar, PEDro, eLABA, and BioMed Central databases. A total of 123 articles were selected for this study (including articles overviewed in systematic reviews and meta-analyses) after applying the inclusion criteria. The study revealed that inappropriate management of AIS could result in serious health problems. Conservative interventions that aid in stabilizing spine curvature and improving esthetics are preferred for scoliosis treatment. Bracing has traditionally been the mainstay of treatment, but growing evidence suggests that PSSE physiotherapy allows effective management of idiopathic adolescent scoliosis. Currently, there are the following PSSE physiotherapy schools in Europe: Schroth, SEAS, BSPTS, FED, FITS, Lyon, Side Shift, and DoboMed. The methodologies of these schools are similar, in that they focus on applying corrective exercises in three planes, developing stability and balance, breathing exercises, and posture awareness. Although high-quality research supporting the effectiveness of PSSE physiotherapy in the treatment of AIS is lacking, existing evidence indicates that PSSE physiotherapy helps to stabilize spinal deformity and improve patients’ quality of life. Among the abovementioned methodologies, Schroth is the most widely studied and has been proven to be effective. However, both SEAS and BSPTS effectively stabilize and even reduce the Cobb angle of scoliosis. Data supporting the validity of other methodologies are very limited. Only the Schroth method significantly reduces the angle of trunk rotation, while both SEAS and Schroth methods greatly improve the quality of life indicators. In any case, the available evidence is insufficient to confirm the advantage of one specific physiotherapy technique over others.

Introduction. Nurses’ entitlement to write prescriptions and to provide nursing advice in primary health care can improve the quality of these services. In the process of ensuring the quality of healthcare, the desirable element of its assessment is the patient’s perspective, taking into account his expectations. Aim. Determining the scope of expected nursing advice and learning the opinions of patients regarding the writing of prescriptions by family nurses. Material and methods. A qualitative study was conducted using a semi-structured interview with 37 patients under the care of eight primary health care outpatient clinics from the Podlaskie Voivodeship. Results. The scope of advice expected from a family nurse concerns: dealing with a health problem, lifestyle and prevention, the scope of family nurse care and the operation of the healthcare system. Writing prescriptions by family nurses can improve the functioning of primary health care. Conclusions. Nursing advice perceived by patients is in line with the competences of the family nurse. Opinions on the entitlement of the family nurse to write prescriptions and prescribing medicines vary.

Background: A family nurse, next to a family doctor and midwife, plays a crucial role in the primary health care system, and a patient has the right to choose them; they are the first medical professional the patient meets when there is any problem. The present study aimed to define the level of job satisfaction among Polish family nurses and to establish its standards. Attempts were made to assess whether job satisfaction depends on the job location, form of employment, family structure, or financial situation. Method: A cross-sectional study was conducted among Polish family nurses who were professionally active in 2018. As the first step, the questionnaires were sent to all (45) County Chambers of Nurses and Midwives in Poland. The data were collected and analyzed using a standardized questionnaire “The Satisfaction With Job Scale” by A.M. Zalewska and our survey questionnaire. Results: Of 220 family nurses surveyed, 219 (99.5%) were females and one (0.5%) was male. The mean age of the study participants was 50.13 years, with a standard deviation of 8.36. The majority of nurses had secondary education (37.6%), with a qualification course (96.2%), without specialization (61%), with a nursing job seniority of 30–39 years (44.6%), and residing in a medium-sized city (43.7%). In the study group, the mean score of job satisfaction was 22.23 (on a scale of 35), and median (Me) score was 23. Conclusion: The results of the study revealed that Polish family nurses are moderately satisfied with their job. A higher level of job satisfaction was reported among family nurses with longer job seniority, who are working in the country, are owners or co-owners of a primary health care unit, live in a complete family, are single, and who declared that they could afford what they wanted to buy and possessed savings. Moreover, the level of job satisfaction was highest among the nurses who recommended other nurses to work in a primary health care unit, participated in scientific conferences, and subscribed to nursing care journals. Key words: family nurses, job satisfaction, nursing in Poland

Krzysztof Buczkowski,1 Magdalena Dachtera-Frąckiewicz,1 Dorota Luszkiewicz,1 Katarzyna Klucz,1 Jolanta Sawicka-Powierza,2 Ludmila Marcinowicz3 1Department of Family Medicine, Nicolaus Copernicus University, Torun, Poland; 2Department of Family Medicine, Medical University of Bialystok, Bialystok, Poland; 3Department of Obstetrics, Gynaecology and Maternity Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, PolandCorrespondence: Krzysztof Buczkowski Email buczkowskik@cm.umk.plPurpose: Most smokers attempt to quit smoking, but few are successful. Data regarding the reasons for this relapse and the course of the relapse process may be helpful for determining efficient methods of smoking cessation. This study aimed to identify the causes of and scenarios associated with smoking relapse after effective smoking cessation.Patients and Methods: We conducted 20 semi-structured interviews with smokers who had previously unsuccessfully attempted to quit. The data underwent qualitative content analysis.Results: Three major themes were identified: reasons for smoking relapse; smoking relapse scenarios; and perception of the influence of personal environments, including family and physicians, on refraining from smoking after cessation. The first theme comprised the following subthemes: insufficient willpower and self-discipline, contact with smokers, exposure to stressful situations, lack of family support, weight gain, and insufficient improvement in one’s mental and physical well-being. The second theme contained enjoyable social events, professional life, critical events, and encouragement to smoke from family members. The respondents frequently emphasized the large role of interaction with other smokers.Conclusion: The predominant factors underlying smoking relapse include insufficient willpower and self-discipline and exposure to stress. The most frequent relapse scenario concerned experiencing negative or positive emotions when interacting with other smokers.Keywords: smoking cessation, relapse, primary care, qualitative research

Background In some countries, including Poland, nurses have acquired autonomy from being a designated “ancillary staff” to “professional staff” only in recent decades. No prior published studies have examined, however, whether the actual nursing practice in primary health care (PHC) has evolved with the advancement of education and professional autonomy. The aim of this study is to assess the scope of practice of a PHC nurses and their actual work activities. Methods A cross-sectional study design using an investigator-developed survey was conducted in Poland, in 2018. The survey was sent to professionally active PHC nurses in Poland. Of the 225 questionnaires distributed, 202 (89.8%) were returned. Results Out of 44 work activities examined, the most often performed activity was administering medications. Less frequent activities included recognizing patients’ nursing needs and health problems and monitoring, assessing, and interpreting basic vital signs. A correlation was found between the length of work experience and the following three activities: performing nursing care, issuing referrals for specific diagnostic tests, and ordering of specific treatments, medications, and nutritional supplements. The longer was the work experience, the more often the nurses performed nursing care (r = 0.15; p = 0.035) but less often issued referrals for diagnostic tests (r = − 0.24; p = 0.001) or orders within their scope of practice (r = − 0.23; p = 0.002). Conclusion While nurses in general are most likely to carry out physician orders, junior nurses tend to be more likely to work toward professional autonomy and pursuing new challenges. PHC nurses in Poland perform work associated more with carrying out physicians’ orders and less with what they were prepared to do. Engaging nursing students in interprofessional education, dissemination of nursing research, and advocacy of nursing professional organizations on behalf of the profession may be an effective strategy to overcome the current barriers for PHC nurses to work the top of their license.

To improve the quality of care, patients' needs and expectations must be understood, and this can be achieved through learning their attitudes and expectations connected with using health services. The main aim of this study was to describe and analyse Białystok residents' expectations of family nurses. This cohort study was carried out in association with the ongoing project "Bialystok PLUS" in Poland. The respondents (n = 412) were administered a multiple-choice questionnaire concerning family nurses and the responses were analysed in association with the respondents' socio-demographic data and health self-evaluation results. Data were collected between September 2017 and September 2019. Our research found that the respondents' socioeconomic status was associated with their expectations concerning the use of prevention services offered by family nurses. A statistically significant association was found between marital status and knowledge of their family nurses. The demand for medical counselling from family nurses (concerning diet, coping with stress, physical activity) was significantly negatively correlated with age, with younger persons expecting that service more often than older persons. A significant association was also observed between respondents' age group and their opinions concerning the need for home visits by family nurses. The respondents who expected home visits by family nurses declared lower self-evaluated health compared to the other respondents. Findings suggest that services by family nurses should include an assessment of each patient's situation, including their health self-evaluation and socioeconomic status. The fact that younger persons expect family nurses to provide counselling on health matters obliges nurses to learn how to provide health information tailored to patient needs.

Understanding how nursing students in European countries perceive their future professional role is an important step in creating awareness of the diversity and similarities between countries. Investigating nursing students' perceptions of their future profession could help in the design of education and the retention of nurses.To compare nursing students' perceptions of the professional nurse's role between Belarus, Lithuania, Poland and Sweden.A cross-sectional design was implemented. The study used two scales of the Professional Nursing Image Survey, which has questions about 10 skills and abilities and 14 functions and duties of a nurse.A total of 392 final-year nursing students in four countries participated in the study. Statistically significant differences were found between countries in terms of all 10 skills and abilities and in the distribution of responses concerning functions and duties of a nurse.Nursing students in Belarus, Lithuania, Poland and Sweden perceive differently the role of a nurse in terms of some functions and responsibilities. This may influence the adaptation of nurses who enjoy freedom of movement among the countries.The knowledge gained in this study could be beneficial in improving nursing education, as it could illuminate the discrepancy between educational goals and students' perceptions of their future professional role.

Introduction: Vaccination is the most effective method of infectious disease prevention. Contemporary technologies have created the possibility of producing vaccines against many diseases. Their use has been facilitated due to the development of combined vaccines aimed at multiple microorganisms. Vaccine regimens differ between countries depending on their epidemiological and population needs. Aim of the study: Assessment of vaccination programme implementation among young patients, including with the use of combined and recommended vaccines in family doctor practices in Białystok, Poland, in 1997–2015. Material and methods: The research material constituted medical records of children aged 0–19 years who were under the care of three family doctor practices in the city of Białystok, Poland. Vaccination cards of 2,804 children born in 1997–2015 have been analysed. Results: Under the official vaccination programme 98.43% of children have been immunised; 42.0% of them received combined pentavalent or hexavalent vaccines (financed by parents) in place of free-of-charge, state-reimbursed vaccines. Recommended vaccines were received by 45.7% of children and adolescents. Recommended vaccinations were rarely used in children aged over 10 years. Among non-mandatory vaccines the most commonly used ones included acellular pertussis component vaccine, which was used to immunise 1,178 (42.0%) children, Streptococcus pneumoniae vaccine (18.1%) and rotavirus vaccine (13.0%). Due to a lack of parental consent or contraindications (temporary or permanent) 81 (2.9%) children have not received a full set of vaccinations. Conclusions: 1) The vaccination rate among children receiving mandatory vaccines is high in family doctor practices. 2) Recommended vaccines are more frequently administered to children up to 3 years of age, less frequently to preschool children and even less frequently to schoolchildren. 3) There is a need for parent education on the available effective methods of protecting children against infectious diseases.

BACKGROUND Requests by patients for antibiotics are known to strongly affect doctors' decisions to prescribe them.Objective. The aim of this study was to establish how frequently patients presenting with respiratory tract infections (RTIs) express their expectation not to be treated with antibiotics, which symptoms and physical findings are related to their perception of antibiotics not being helpful, and to what degree their expectations influence doctors' decisions. METHODS This was a direct observational study set in primary care practices in Bialystok, Poland. The observers completed a checklist while observing a patient with RTI visiting a family doctor. RESULTS Overall, 80 (5.5%) out of 1456 patients with RTIs openly requested not to be prescribed antibiotics. Patients not wanting antibiotics were prescribed antibiotics significantly less frequently [25/80 (31.3%)] than the remaining patients [765/1376 (55.6%), P < 0.001]. Univariate logistic regression revealed that cough and runny nose significantly increased the odds of patients not wanting antibiotics [odds ratio (OR) 1.8, 95% confidence intervals (CI): 1.01-3.20 and OR 1.6, 95% CI: 1.01-2.6, respectively] while the presence of tonsillar exudates significantly decreased the odds (OR 0.3, 95% CI: 0.08-0.86). Belief in a self-limited course (20%), recent treatments with antibiotics (16.3%), suspected viral aetiology (12.5%), and concerns about possible harm (12.5%) were the principal reasons for not wanting antibiotics. CONCLUSIONS A patient's wish not to be prescribed antibiotics leads to less frequent antibiotic prescribing. Antimicrobial resistance, though important from a public health viewpoint, is not seen as a priority for individual patients with infections.

Nurses' professional identities develop throughout their lifetimes, from before entering nursing education, throughout their years of study and clinical experience, and continue to evolve during their careers. Education is, however, a key period as it is during this time students gain the knowledge and skills that separate nurses as healthcare professionals from people representing their professions. In order to purposefully shape the professional identity of nursing students, there is a need of knowing the level at which students identify themselves with the profession when graduating from a university. The aim of the study is to reveal the professional identity of nursing students in Lithuania and Poland and to make recommendations for improving the study process on the basis of the results of the study. A quantitative survey was conducted in the spring of 2017. The results of the research reveal that the professional identity of nursing students is rather of high level, the decision to work as nurses is strong, but there are some gaps in understanding of roles and responsibilities of nursing.

Background Understanding the issue of job satisfaction of nurses with master of nursing degrees may help develop organisational changes necessary for better functioning of health care institutions. This study aimed to evaluate the level of job satisfaction among holders of Masters of Nursing degrees employed at health care institutions and to ascertain its determinants. Methods The cross-sectional study was carried out in randomly selected health care institutions in Poland using the Misener Nurse Practitioner Job Satisfaction Survey and an original survey questionnaire with two open-ended questions. Quantitative data were analysed using descriptive and summary statistics. Results The participants gave highest satisfaction ratings to their relationships with direct superiors and other nurses, as well as their social contacts at work. The lowest ratings were given to the pension scheme and factors connected with remuneration. A highly statistically significant relationship was found between the job classification and the level of professional satisfaction (p

Background There is increasing focus on collaboration in primary health care, but there is insufficient patient perspective on collaboration between the family nurse and family doctor. Objective To explore how patients perceive collaboration between the family nurse and family doctor in primary health care in Poland. Methods A qualitative approach and an inductive, naturalistic inquiry strategy were used. Thirty-seven patients from eight general practice clinics in the north-eastern part of Poland participated in semi-structured, face-to-face interviews. The qualitative data were examined by means of thematic analysis. The study was reported according to the consolidated criteria for reporting qualitative research (COREQ) checklist. Results Four subthemes emerged in the context of nurse–doctor collaboration, namely: (i) carrying out the doctor’s orders; (ii) visit preparation; (iii) the family nurse as a source of information and (iv) participants’ perceptions of the status of the family nurse. Nurses performing instrumental activities connected with a doctor’s orders was understood by the participants to be collaboration and prevailed in their responses. Conclusion The perception of collaboration (or lack thereof) between the family nurse and family doctor results from patients’ varied experiences and observations during their visits to a primary care clinic. The traditional model of nursing care and the hierarchical relationship, in which the doctor has the dominant role, are evident in the patients’ remarks. The autonomy of nursing could be strengthened by expanding, and highlighting, the primary care activities that a nurse can perform on her own.

AIM AND OBJECTIVES To compare the self-reported level of professionalism among nurses in Poland and Belarus and to indicate the areas in which differences in professional behaviours of nurses in both countries exist. BACKGROUND Nurses constitute the largest group of healthcare providers, and the term professionalism is closely related to nursing profession. DESIGN This investigation is a comparative survey and descriptive analysis of professional behaviours among nurses in Poland (n = 205) and Belarus (n = 236). The study was reported according to the STROBE checklist. METHODS The Professionalism in Nursing Behaviors' Inventory Image Survey adapted from Adams and Miller (2001) was used to collect the data. The questionnaire contains 46 questions addressing the following behavioural categories: educational preparation, publications, research, professional organisation, community service, competence, code for nurses, theory and autonomy. RESULTS The mean total score of professionalism was significantly different between the two countries (p

The role of informal caregivers was included in the Assumptions of the Long-Term Senior Policy in Poland for 2014–2020. The document acknowledged the necessity of diagnosing the needs of informal caregivers of elderly people and to implement systemic solutions that would enable the provision of assistance for them. In response, this study aimed to describe the situation of caregivers of patients receiving versus patients not receiving Long-Term Home Nursing Care (LTHNC, i.e., a formal program including regular visits by a nurse specializing in home care) in terms of caregiver socio-demographic characteristics, health self-assessment, work overload, satisfaction derived from being a caregiver, and the quality of perceived support. A cross-sectional study was conducted using the Carers of Older People in Europe (COPE) Index in 2015 in the north-eastern part of Poland involving 170 caregivers of patients supported with LTHNC and 86 caregivers of patients staying at home and not receiving LTHNC. We found that caregivers for patients receiving LTHNC were significantly less overloaded with care work than caregivers for patients without LTHNC support (p &lt, 0.001). LTHNC support was also related to the level of satisfaction with providing care: Caregivers for patients receiving LTHNC were significantly more satisfied with performing their role and felt greater support than caregivers for patients without LTHNC (p &lt, 0.001). Our study provides evidence for a positive relationship between LTHNC and the situation of informal caregivers of dependent elderly people at home. A formal program of visits by a nurse specializing in long-term home care may facilitate the provision by caregivers of better informal care to patients staying at home.

Aims To conduct an in-depth analysis to understand how Polish nurses perceive their profession from the perspective of the jobs they perform and their experiences connected with the work. Background Although there are general educational standards in the nursing profession, nurses worldwide perform their jobs under different systems and cultural conditions. Exploring and describing how experienced nurses view their profession can contribute to recommendations on how to promote the image of the profession and can assist in recruiting new nurses. Methods A descriptive, explorative qualitative study was conducted. Focus groups (n = 6) were organized involving nurses (n = 60) who had between 8 and 33 years of work experience. Findings Data analysis revealed four main themes and ten sub-themes: (i) the role of the nurse (idealistic view of a nurse's work before starting the job, realistic perception of the profession while doing the job); (ii) respect for a nurse (nurses’ attitudes towards one another, doctors’ attitudes towards nurses, patients’ and their families’ attitudes towards nurses); (iii) gender issues (stereotypes, favouritism towards male nurses); (iv) prestige of the profession (prestige of the nursing profession in society, remuneration, nurses’ choice of a future profession for their children). Discussion The study demonstrates that there is a huge discrepancy between the commonly held image of the nursing profession and the reality of the nurse's job. The idealistic view that it is a “clean” job in which the nurse only gives injections is not reflected in the actual duties. Conclusion and implications for nursing and health policy The findings revealed factors which influence the perception of the nursing profession in Poland, that is the system of education, professional experience and the current situation in which nurses perform their roles. Nurses’ current perception of the job may have negative consequences both for nurses themselves (e.g. burnout) and for the whole profession (e.g. negative selection). Nurses should aim to fulfil leadership roles and participate in the management of health policy so as to have greater influence on healthcare planning.

Objectives The aim of this study was to determine how pediatric patients and their parents perceive health care during hospital stays, what are their expectations of doctor behaviors, and which components of care do they consider to be the most important. Methods A qualitative descriptive study was carried out using the open interview technique. Twenty-six parents and 22 children undergoing hospital treatment participated. Results Our analysis identified two major themes: (1) doctor verbal and non-verbal behaviors, which included informing and explaining, conversations on topics other than the illness, tone of voice and other behaviors; and (2) perceived strategies used by doctors. This category included claims of doctors' intentional use of medical jargon to avoid addressing parental questions directly. Parents admitted that they did not understand medical vocabulary, but they also thought they might understand more of the medical issues if the doctor spoke using terms comprehensible to them. Conlcusions Our study shows the importance of interpersonal relationship affecting patient perception of quality of pediatric care. Parents of pediatric patients perceive that doctors behave in ways that deflect parents' questions and avoid providing them with medical information. Such behaviors include doctors excusing themselves by saying they are busy and using medical jargon. Medical students and doctors should be trained to communicate effectively with patients and their parents and develop skills to convey information in a simple and comprehensible way.

Recently, SarQoL&reg, (Sarcopenia and Quality of Life), a quality of life (QoL) questionnaire specific to sarcopenia, was successfully developed. For practical reasons, there is a great interest in validating this questionnaire in other populations. The aim of this cross-sectional study was to translate and adjust the SarQoL&reg, into Polish and to standardize the validity of this method for the assessment of sarcopenic individuals in Poland with regard to psychometric properties. The English version was used for the translation process. A total of 106 community-dwelling Caucasian subjects aged 73.3 &plusmn, 5.94 years (65.1% females) were studied, with 60 participants being diagnosed sarcopenic. The translation and cross-cultural adaptation was carried out in five phases according to specific standard guidelines. There were no major linguistic issues in the translation process. The data confirmed a good discriminant validity, i.e., significantly lower scores for all domains (reduced global QoL in sarcopenic subjects compared to non-sarcopenic ones, 54.9 &plusmn, 16.5 vs. 63.3 &plusmn, 17.1, p = 0.013), and high internal consistency (Cronbach&rsquo, s alpha coefficient was 0.92). The significant correlation of the SarQoL&reg, scores with those of other questionnaires (SF-36v2&reg, Health Survey and EuroQoL-5-Dimension) that are supposed to have similar dimensions indicated the consistent construct validity of the SarQoL&reg, PL questionnaire. No floor/ceiling effects were found. An excellent agreement was found between the test and the re-test (intraclass coefficient correlation (ICC): 0.99). The first Polish version of the SarQoL&reg, questionnaire is valid and consistent and therefore may be used with reliability for clinical and research purposes regarding QoL assessment of sarcopenic individuals. However, further research, in particular prospective studies, is needed to determine potential limitations and the suitability of the new tool for the Polish scenario and specificity.

TWstęp: Pielęgniarstwo rodzinne jest rozwijającą się specjalizacją pielęgniarską podlegającą szybkim przemianom związanym z zapoczątkowaną w 1995 r. reformą podstawowej opieki zdrowotnej w Polsce. Szeroki zakres samodzielności pielęgniarek rodzinnych w realizacji świadczeń zdrowotnych wymaga od nich ustawicznego kształcenia oraz konieczności wykorzystania w codziennej praktyce wyników badań naukowych.Celem pracy jest określenie rodzaju i zakresu badań empirycznych w obszarze pielęgniarstwa rodzinnego prowadzonych w Polsce w latach 1995–2015.Materiały i metody: Zastosowano metodę analizy i krytyki piśmiennictwa. Bazę do wyszukiwania danych stanowiła Polska Bibliografia Lekarska, baza PubMed oraz wyszukiwarka Google Scholar. Poszukiwanie prac było ograniczone do artykułów opublikowanych w latach 1995–2015 i dotyczących świadczeń realizowanych przez pielęgniarki rodzinne w Polsce.Wyniki: Ustalono, że w analizowanych pracach przewagę stanowiły badania ilościowe z wykorzystaniem techniki ankiety. Opublikowane prace mieściły się w następujących grupach badawczych: 1) pacjenci – odbiorcy świadczeń; 2) realizatorzy świadczeń, tj. pielęgniarki rodzinne; 3) lekarze rodzinni oraz opiekunowie nieformalni osób objętych opieką pielęgniarki rodzinnej z uwzględnieniem relacji pielęgniarka–pacjent.Wnioski: 1. Widoczny jest brak różnorodności metodologicznej w badaniu roli pielęgniarki rodzinnej. 2. W pracach zmarginalizowana jest rola pielęgniarki rodzinnej w opiece nad osobami w wieku rozwojowym i produkcyjnym. 3. Pielęgniarki rodzinne wykonują niewiele zadań samodzielnych wynikających z posiadanych kompetencji.

Introduction. Patient satisfaction surveys are still popular tools for obtaining feedback on the quality of health care. Nonetheless, there is a paucity of data to indicate whether health care providers even want patients to assess the quality of care delivered. Neither it is certain whether patients are interested in participating in such surveys. Aim. To present and compare the perspectives of doctors, nurses, and patients on the validity of health care customer satisfaction surveys. Material and methods. A cross-sectional survey design was used. The questionnaires were administered to doctors, nurses and patients in three hospitals of different sizes (small, medium, and large), all in the north-east of Poland. Each sample group was given 200 questionnaires; responses were received from 95 doctors (47.5%), 190 nurses (95%), and 182 patients (91%), and included in the final analyses. Results. Most respondents (doctors - 64.2%; nurses - 61.6%; patients - 87.4%) answered ‘Yes’ to the question ‘Do you think that patients should evaluate the quality of health care?’ Analysis of data allowed to identify the following main reasons why patients should evaluate the quality of health care: 1. to enhance the quality of care; 2. to recognise patients as evaluators; 3. to motivate providers to work more efficiently; and 4. to emphasise the impact of evaluation on a core value, i.e. health. Doctors and nurses outlined reasons why they did not advocate conducting patient satisfaction surveys: satisfaction surveys are redundant; negative evaluations; unwillingness to be evaluated by patients; satisfaction surveys hamper effective work with patients; surveys are not objective; survey results are not communicated to providers. Conclusions. Patient satisfaction surveys are desirable tools for evaluating the quality of health care delivery despite the fact that they frequently raise concerns amongst providers and patients. There is, therefore, a definite need for providers to experience the benefits of measuring patient satisfaction. Another important practical implication is that patients need to be convinced that their opinions do matter and contribute to improving the quality of services.

Aims and objectives To evaluate the influence of long-term at-home nursing care (LTHNC) on patient functional status. The specific aims were as follows: (1) to analyse the influence of LTHNC on patient functional status in terms of activities of daily living; (2) to evaluate the risk of pressure sores and pressure sore prevention in patients receiving LTHNC. Background LTHNC is a form of care for chronically ill persons staying at home who do not need hospitalisation, but due to their health problems they require regular nursing care that can be provided at home. Design A retrospective descriptive study. Methods A document research method was used. We collected data from the medical records of 1,058 patients receiving LTHNC at the Non-Public Health Care Centre OMNI-MED in Bialystok (Poland) for the years 2005-2012. Results Detailed analysis of scores on the Barthel Activities of Daily Living Index revealed significant improvement in patient functional status as a result of LTHNC. In patients aged 65-80, the Barthel score increased by 8.83 points, and in patients aged 64 years and younger, the score increased by 6.58 points (p 80 years), functional status improved the least, gaining a mean of 4.97 points on the Barthel scale. Overall, the demonstrated improvement of patient functional status and reduced risk of pressure sore development provide evidence that LTHNC is an effective form of care for elderly and chronically ill persons staying at home. Conclusion The findings of our study represent a positive example of the way good nursing care can benefit patients while promoting the autonomous nature of nursing. Relevance to clinical practice The results add to our understanding of the functioning of LTHNC by providing relevant scientific evidence which may contribute to the development of community nursing.

Introduction. The sedentary lifestyle is defined as prolonged sitting both at work and during leisure time, with energy expenditures of below 600 MET · min/week. The sedentary lifestyle is a well-known predictor of obesity and other components of the metabolic syndrome. The influence of the sedentary lifestyle and associated factors on nsLBP is still being discussed. Aim. The aim of this study was to assess the influence of a sedentary lifestyle and its associated metabolic predictors on the prevalence of nsLBP in nurses and paramedics. Materials and Methods. The study included 609 participants, aged 30-60 years, who were residents of north-east Poland. Data was collected using a questionnaire (based, in part, on the Nordic Musculoskeletal Questionnaire), and included details of sociodemographic profile, chronic illnesses, and a short version of the International Physical Activity Questionnaire (IPAQ). Results. Nearly half (49.59%) of the respondents reported decreased physical activity, and in the group with recurring nsLBP this figure was 67.59%. Univariate logistic regression modelling found that leading a sedentary lifestyle caused a 3.5-fold increase in the incidence of recurring nsLBP (p Conclusions. A sedentary lifestyle significantly increased the incidence of recurring low back pain, while increased physical activity had a significant effect on the presence of chronic low back pain. In the sedentary lifestyle group, conditions classified within metabolic syndrome were found to significantly increase the chances of developing nonspecific low back pain.

Professional nursing education in Poland began in 1911 in Krakow. Since then, the nursing education system has continued to change. From the establishment of the first professional nursing school, Poland experienced partition, war and the German occupation, short-lived independence, the Soviet regime and the regaining of its freedom, as well as the development of democracy processes. All of these events impacted on nurses' education. The current state of nursing training is determined by the requirements of the Council of the European Communities. Today, the challenge for nursing education in Poland is the permanent process of the country's education system's adjustment to the European Higher Education Area to ensure the quality of education and to support the mobility of students and academic teachers. Additionally, new competencies pertaining to nurse prescribing, which have been in force in Poland since 2016, will cause new changes to the under- and postgraduate programmes of nursing education. The aim of this study is to present the development of nursing education in Poland in the context of socio-political changes in the country and from the perspective of current nursing challenges worldwide.

A qualitative descriptive design using an interview guide approach was adopted to investigate the patient-nurse relationship and paediatric ward amenities from the perspective of parents and hospitalised children in Poland. The study included 26 parents or caregivers of hospitalised children (between 13 months and 15 years old) and 22 children (from 10 to 16 years old). Qualitative content analysis was used to analyse the recorded verbal data. Data from patients’ transcripts were coded and classified in terms of topics on the patient-nurse relationship and hospital care. We identified five main topics. 1. Nurse qualities; 2. Nurse verbal behaviour; 3. Nurse tone of voice and non-verbal behaviour; 4. Hospital amenities; 5. Parents’ expectations towards nurses. Our study contributes to increased understanding of parents’ and children’s experiences of paediatric hospital care.

Older patients see their general practitioners (GPs) relatively often and so recognition of their preferences can lead to improvement of quality of care in general practice. This study aimed to identify which aspects of GPs' behaviour are the most important for older people in their assessment of the quality of their visits and to explore the application of Jung's taxonomy differentiating task and affective behaviour in this context. A qualitative approach to generating data was chosen. We conducted semi-structured interviews with a sample of 30 patients aged 65 and older using GP services in two demographically diverse big cities in Poland. Participants were interviewed in 2010 according to a pre-determined topic guide. This research showed that older people assess both 'task performance' and 'affective performance' behaviours of general practitioners. There were nearly twice as many patient comments concerning affective performance behaviour relative to task performance behaviour. Older people expect that their physicians will be demonstrably friendly, kind, able to joke and have enough time for the consultation.

Background. Trust is a complex concept, difficult to study, but very important in a patient-family physician relationship. One of the measures used to assess interpersonal trust is a scale developed by Anderson & Dedrick entitled the Trust in Physician Scale (TI PS). Objectives. The aim of the study was to assess the TI PS properties in relation to the age, gender, and health status of primary health care patients consulting family doctors and trainees in north-east Poland. Material and methods . A cross-sectional study using the TI PS was conducted in primary health care units in north-east Poland. 120 patients (60 who came to see family doctors, and 60 who came to see trainees) were asked to participate in the survey. Results. The Trust in Physician Scale has good reliability in primary care patients in north-east Poland (Cronbach’s alpha coefficient was 0.90). Patients displayed statistically significant greater trust in family doctors than in trainees. A negative correlation was found between age and the trust scale (r = -0.30; p = 0.005); the younger the respondent, the higher trust in the physician, and conversely, a positive correlation between self-assessment of health and the trust scale (r = 0.3; p = 0.003). Conclusions . The Polish translation of the TI PS instrument performed well in terms of acceptability in the family medicine environment. It can be used to differentiate between the level of trust in family doctors and in trainees. A relation between age, sex, education level and self-assessment of health needs to be confirmed using a larger sample.

Rationale, aims and objectives Patient satisfaction is receiving increased attention in the evaluation of health care quality. However, qualitative methods have seldom been used to study patient satisfaction. The purpose of this study was to explore how satisfaction is understood from the perspective of patients receiving care from family doctors. Method We used a qualitative approach consisting of in-depth interviews with 36 patients attending clinics in Poland. Interviews were audiotaped and transcribed, and content analysis performed. Results There was no single definition of satisfaction among study participants; however, some core characteristics of satisfaction emerged. These characteristics were: (1) good doctor–patient interaction; (2) health improvement or resolution of health problems; (3) fulfilment of prior expectations; (4) availability of health care; (5) combination of multiple characteristics; and (6) absence of dissatisfaction. Conclusion Because patients have differing concepts of satisfaction with health care provided by family doctors, quality assessments should focus on components of satisfaction whereas questions about satisfaction itself should be avoided.

Background During doctor–patient interactions, many messages are transmitted without words, through non-verbal communication. Aim To elucidate the types of non-verbal behaviours perceived by patients interacting with family GPs and to determine which cues are perceived most frequently. Design of study In-depth interviews with patients of family GPs. Setting Nine family practices in different regions of Poland. Method At each practice site, interviews were performed with four patients who were scheduled consecutively to see their family doctor. Results Twenty-four of 36 studied patients spontaneously perceived non-verbal behaviours of the family GP during patient–doctor encounters. They reported a total of 48 non-verbal cues. The most frequent features were tone of voice, eye contact, and facial expressions. Less frequent were examination room characteristics, touch, interpersonal distance, GP clothing, gestures, and posture. Conclusion Non-verbal communication is an important factor by which patients spontaneously describe and evaluate their interactions with a GP. Family GPs should be trained to better understand and monitor their own non-verbal behaviours towards patients.

This study explored perceptions of the nursing profession held by medical students in Poland. Specifically, this study aimed to: (i) elicit medical students' opinions about the nursing profession; (ii) identify what skills and abilities they perceive as important for nurses and (iii) ascertain what nursing functions are considered a major component of the nurse's job. A cross-sectional study, based on the social construct of role theory, was conducted in medical universities from 2005 to 2006 in three cities situated in different regions of Poland: Białystok, Bydgoszcz and Kraków. A total of 900 medical students, 300 students in each region, in medical school years 1, 3 and 6 completed the Professional Nursing Image Survey. The most favourable nurse characteristics were: 'professional reliability', 'demonstration of good technical skills' and the personal characteristics of friendliness and courteousness. Medication administration, recording vital signs and administering intravenous therapy were most frequently identified as a major part of the nurses' role. In conclusion, the opinions of Polish medical students suggest that nursing therapeutic activities trump independent nursing practice activities.

Home visits by doctors and nurses are considered an important indicator of the quality of healthcare. Published data are scarce regarding the role of family nurses in providing professional home care in Central and Eastern European countries that have recently introduced reforms to their primary care systems. The objective of the present study was to describe the involvement of family nurses in home visits in the context of organizational and legal changes in service provision, that is, to analyse the role of the family nurses employed by family doctors (1998) versus family nurses working in autonomous positions (2002 and 2006). The proportion of patients in the community receiving a home visit from a family nurse, the purpose of the family nurse's home visit and patient expectations towards the family nurse were studied. A series of cross-sectional studies were conducted in a small town in northeastern Poland, based on three consecutive surveys taken at 4-year intervals (1998, 2002, 2006, surveys I, II and III, respectively). During each survey, 1000 patients were interviewed (face to face) with structured questionnaires. In 1998, family nurses were employed by family doctors, but by 2002, nurses had established their own practices and held direct contracts with the National Health Fund. A significant increase in the percentage of patients receiving home visits from a family nurse was observed between surveys I and II (12.8% and 30.0%); however, the number of respondents reporting a home visit in survey III decreased to 23.9%. Patients over 75 years of age were the major demographic group receiving family nursing at home. This study suggests that reform of the primary healthcare system in Poland has produced changes in the family nursing system. Independence, contractual obligations and self-employment of Polish family nurses have resulted in their greater participation in home visits.

Objective. The aim of the study was to determine how the time factor affected the patients' perception of the acceptability of the primary health care system and to assess their satisfaction with family physician care. Design. A series of cross-sectional studies was conducted in 1998, 2002 and 2006, using face-to-face interviews with struc- tured questionnaires. Setting. The study was performed in Gizycko, Poland, where family physician services were introduced in 1995. Study participants. Three surveys were conducted, each involving 1000 subjects. Every time, random sample was taken, after selecting a subgroup of patients using medical service within the previous week. Main measures. Acceptability of the primary health care system (accessibility, the patient - practitioner relationship, the ame- nities of care, patient's preferences), perception of the changes in primary care and overall satisfaction with family physician care. Results. Between 1998 and 2002, an improvement was noted, lasting till 2006, in such accessibility components as the possi- bility of making an appointment by phone or at a definite hour. Some aspects of the patient - doctor relationship indicate that family physician care is directed at illness rather than health-oriented. The level of patient satisfaction was high. Conclusions. Generally, patients are satisfied with primary care reform and implementation of the family physician system. However, it is easier to improve accessibility of services than physician's personal qualities and the patient- practitioner relationship. Expressive functions of a physician (listening and reassuring) and activities regarding health promotion require special attention in the process of education of family physicians.