Search

Ewelina B&aogon;k,1 Agnieszka M&lstrok;ynarska,2 Czes&lstrok;aw Marcisz,2 Monika Kad&lstrok;ubowska,1 Ewa Marcisz-Dyla,3 Danuta Sternal,1 Rafa&lstrok; M&lstrok;ynarski,4 Sylwia Krzemi&nacute;ska5 1Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland; 2Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland; 3Faculty of Management, Psychology, Katowice Business University, Katowice, Poland; 4Department of Electrocardiology and Heart Failure, School of Health Sciences, Medical University of Silesia, Katowice, Poland; 5Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Sylwia Krzemi&nacute;ska, Email sylwia.krzeminska@umed.wroc.plIntroduction: In patients after stroke, the relationship between the occurrence of kinesiophobia and the accompanying frailty syndrome, as well as the acceptance of the disease and the level of mood, has not been recognized so far. The aim of this study was to determine the prevalence of kinesiophobia in elderly Polish people after ischemic stroke, including the frailty syndrome and the associations between the prevalence of kinesiophobia and feelings of anxiety and degree of the illness acceptance.Methods: A cross-sectional study was used to achieve the study objectives. The study involved 152 hospitalized patients aged of minimum 60 (mean age 63), qualified for post-stroke rehabilitation, including 76 women and 76 men. The patients were divided into two groups, with kinesiophobia (119 persons) and without kinesiophobia (33 persons). The Tampa Scale of Kinesiophobia (TSK), the Tilburg Frailty Indicator (TFI), the Hospital Anxiety Depression Scale (HADS) and the Acceptance of Illness Scale (AIS) were used. Study results were calculated using MedCalc Software.Results: Kinesiophobia has been demonstrated in 78% of people after ischemic stroke. The values of TFI and HADS were higher in the patients with kinesiophobia (p< 0.001). In patients with ischemic stroke, it was shown that the level of kinesiophobia increased with higher anxiety (p< 0.001), higher total TFI score, (p< 0.05), and a lower level of illness acceptance (p< 0.001).Conclusion: The occurrence of kinesiophobia in elderly Polish people after ischemic stroke is common and the determinants of its development are the coexistence of the frailty syndrome, anxiety and a low level of illness acceptance. In post-stroke patients, the presence of kinesiophobia should be considered, especially in the situation of comorbid frailty syndrome. The issue of kinesiophobia in patients after stroke requires further in-depth research, especially in the field of cognitive-behavioral prevention aimed at ways to reduce this phenomenon.Keywords: kinesiophobia, elderly patients, ischemic stroke, frailty syndrome

The work is an attempt to highlight the problem related to too weak or even insufficient communication in a team integrating healthcare professionals and drawing attention to this very important aspect of caring for the patient without competing for the grandmaster’s laurel. The definition of the term Interdisciplinary Team in the medical context is very simple. It is a group of people, specialists in various fields of medicine, dealing with solving a specific problem using the resources at the disposal of each member of such a Team. Polish realities in many cases are far from this concept, which, unfortunately, may result in worse therapy outcomes. Although each of the members of this team may think that his contribution is the most important, it is only the sum of all activities that translates into success, the effect of which is regaining the health lost by the patient, and this success is achieved by not one person but a multi-person team. Currently, it is not possible to provide a patient with only one specialist with the full range of medical services guaranteeing success. Treatment is a complex process involving diagnosticians (imaging diagnostics, laboratory diagnostics), a doctor, physiotherapist, psychologist, dietitian, nurse and many other specialists without whom it is difficult to imagine any treatment activities. The group should be led by a leader, but information on the patient’s health should be available to each member of the therapeutic team, and decisions should be made on the basis of joint arrangements, so that none of the team members “pulls in their way” but contributes to mutual success, what a healthy patient is. The work raises problems such as the lack of reliability of information, points to the unfavourable phenomenon of “generalization” of disease entities and the frequent dissonance in the selection of appropriate therapeutic measures. The article indicates only a few situations that cause inconsistencies in the patient’s rehabilitation process. The rights and scope of the work of a physiotherapist on the basis of current legal documents were emphasized, the possibilities of extending the qualifications of physiotherapists were highlighted and the opportunities that would be granted to physiotherapists after obtaining additional qualifications were emphasized as well.

Purpose Patients with diabetes are at increased risk of developing depression. The aim of the study was to determine the occurrence of depressive symptoms in patients with type 1 (T1DM) and type 2 diabetes (T2DM), including the association with different independent sociodemographic and clinical variables. Patients and methods The studies were carried out on 618 people, including 115 patients with T1DM and 215 patients with T2DM and 288 people without diabetes constituting two control groups. Subjects were characterized in terms of sociodemographic, clinical and biochemical aspects, and the occurrence of depressive symptoms using Beck Depression Inventory (BDI) was determined. In the logistic regression analysis, the correlations between BDI score and with independent variables such as sex, age, body mass index, duration of diabetes, HbA1c level, diabetic complications and mean arterial pressure were examined. Results The mean BDI score was significantly higher in women and men with T1DM and T2DM compared to controls. In diabetic patients, depressive symptoms occurred more often in women than in men. Among patients with T1DM, the incidence of depressive symptoms was 17.5% of the women and 8.6% of the men and in patients with T2DM, the incidence of depressive symptoms was revealed in 28.9% of the women and in 19.8% of the men. In patients with T1DM and T2DM, the occurrence of depressive symptoms increases with age, HbA1c level and complications, and the risk of depressive symptoms turned out to be almost three times higher in women than in men with T2DM. Conclusion The prevalence of depressive symptoms in diabetic patients is higher than in non-diabetics. Depressive symptoms account for 13% of the patients with T1DM and 24.7% of the patients with T2DM. The risk of depressive symptoms in T1DM and T2DM increases with age, HbA1c level and the presence of complications, and it is gender-related in T2DM only.

Introduction. Leigh syndrome, also called subacute necrotizing encephalomyelopathy, belongs to a group of ultra-rare neurodegenerative mitochondrial diseases. It is most often caused by various genetic enzyme deficiencies. An infant with the syndrome is in need of constant care by their parents who have been appropriately trained and prepared for homecare. Aim. The aim of the study was to present issues connected with the home care of a child with Leigh syndrome and to propose a new model of a home care based on a chosen case study. Material and methods. The research employs the case study method. Used techniques include interviewing, observation, medical document analysis. Results. Homecare of a child with Leigh syndrome involves stabilising and supporting life functions and ensuring safety as well as meeting both their physiological and psychological needs. Conclusions. Present state of medicine does not allow for causative treatment. All that can be done is hindering the disease’s progress and moderating its symptoms. Complex medical care, nursing, along with rehabilitation can prolong and significantly affect the patient’s quality of life.

Sexual dysfunction is more common in women with diabetes than in women without diabetes. The aim of the study was to determine sexual function and the level of the quality of sex life in premenopausal women with controlled, uncomplicated type 1 and type 2 diabetes taking into account the stages of the menstrual cycle and mood level. The study included 163 women with type 1 and type 2 diabetes and 115 controls without diabetes. Questionnaire studies were conducted using the following surveys: Demographic and Clinical Data Survey, Female Sexual Function Index, Sexual Quality of Life—Female, and Beck Depression Inventory. Both phases of the menstrual cycle—follicular and luteal—were included. It was shown that, in women with type 1 diabetes, sexual function decreased during the luteal phase in comparison with the follicular phase (p &lt, 0.001). In the women with type 2 diabetes and in the controls, sexual function was comparable during both phases of the cycle (p &gt, 0.05). In the women with uncomplicated controlled type 1 diabetes, sexual function and the sexual and relationship satisfaction changed depending on the phase of the menstrual cycle with a decrease during the luteal phase. Sexual function and the quality of the sex life of premenopausal women with controlled type 2 diabetes were comparable during both the follicular and the luteal phases. Sexual function in menstruating women with controlled type 2 diabetes decreased with age and a worsening mood.

WstępCelem pracy była samoocena satysfakcji osób mieszkających w domach opieki w różnych krajach europejskich oraz analiza korelacji poziomu satysfakcji z jakością życia i wybranymi zmiennymi niezależnymi.Materiał i metodyBadanie pilotażowe przeprowadzono z udziałem 126 osób zamieszkałych w domach opieki w Norwegii, Anglii, Belgii, Holandii, Czechach i Polsce. Średnia wieku badanych wynosiła 79,3 roku. Autorzy zastosowali kwestionariusz ankiety własnego autorstwa obejmujący 35 pytań, w tym 6 pytań demograficznych i 29 związanych z czynnikami dotyczącymi satysfakcji i jakości życia.WynikiWiększość mieszkańców była zadowolona z pobytu w domu opieki. Poziom ich satysfakcji okazał się różny, w zależności od kraju prowadzenia badań. Średni poziom samooceny jakości życia wyniósł 4,9 (w skali 1–6). Wykazano, że poziom satysfakcji korelował z jakością życia, wiekiem, czasem trwania pobytu w domu opieki i mieszkaniem z małżonkiem.WnioskiPoziom zadowolenia mieszkańców domów opieki w wybranych krajach europejskich jest zróżnicowany i wykazuje pozytywną zmienność z jakością życia. Poziom zadowolenia mieszkańców domów opieki w niektórych krajach europejskich wykazuje pozytywną korelację z wiekiem, czasem trwania pobytu i zamieszkiwaniem z małżonkiem. Analiza porównawcza satysfakcji i jakości życia mieszkańców domów opieki społecznej w różnych krajach europejskich wymaga uwzględnienia odrębności kulturowej.

Monika Kadłubowska,1 Ewelina Bąk,1 Czesław Marcisz,2 Maria Kózka,3 Anna Michalik,1 Jolanta Kolonko,1 Bożena Krawczyk,1 Dorota Dobrzyń-Matusiak,4 Zofia Kapusta-Nowak5 1University of Bielsko-Biała, Department of Nursing, Faculty of Health Sciences, Bielsko-Biała, Poland; 2Medical University of Silesia, Department of Gerontology and Geriatric Nursing, School of Health Sciences, Katowice, Poland; 3Jagiellonian University Medical College, Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Cracow, Poland; 4Medical University of Silesia, Department of Nursing Propaedeutics, School of Health Sciences, Katowice, Poland; 5Medical University of Silesia, Department of Health Promotion and Community Nursing, School of Health Sciences, Katowice, Poland Objective: The study aimed at determining the experience of pain taking into consideration beliefs about pain control, Type A behavior pattern and sociodemographic factors in patients with chronic ischemia of the lower extremities or with rheumatoid arthritis (RA).Methods: The study enrolled 100 patients with peripheral arterial disease (PAD) and 100 patients with RA. The subjective sensation of pain was assessed using the Visual Analog Scale (VAS); beliefs about pain control were analyzed using the Beliefs about Pain Control Questionnaire (BPCQ), taking into consideration internal factors, the influence of physicians and accidental events (chance); and Type A behavior features (haste and competition) were analyzed using the Framingham Type A Scale. The multiple regression model was used to assess associations between the experienced pain and the BPCQ value, the Framingham Type A Scale and sociodemographic factors.Results: The pain intensity degree was found to be comparable in patients with PAD and with RA. The median determined using the VAS was 5.75 in both of the studied groups. In patients with PAD, lower VAS values were associated with the BPCQ – internal factors (P

Peripheral arterial disease (PAD) belongs to the commonly-occurring pathologies associated with elderly age. A simple tool for defining the severity of PAD is the ankle-brachial index (ABI). The purpose of this research was to determine independent factors of changes of ABI in elderly patients with occlusive PAD disease (PAOD) with and without diabetes. The research was carried out on 49 elderly patients with PAOD, including 29 patients with type 2 diabetes, and 20 patients without diabetes. The concentration of interleukin-6 (IL-6), E-selectin, fibrinogen, and C-reactive protein (CRP) in the blood serum was marked. In all patients, the independent factors of changes of ABI were determined with the use of the multiple logistic regression analysis. Our results show that in the group of patients with PAOD suffering from diabetes, it was demonstrated that the ABI was related to age, the duration of the symptoms of PAD, body mass index (BMI), low-density lipoprotein cholesterol, fibrinogen, and sex (determination coefficient R2 = 0.699). In patients with PAOD without diabetes, the ABI was related to age, the duration of the symptoms of PAD, the levels of CRP, E-selectin, high-density lipoprotein cholesterol, and the glomerular filtration rate(determination coefficient R2 = 0.844). We conclude that in elderly patients with PAOD with and without diabetes, the participation of independent factors related to the ABI is diversified; in patients with diabetes, the concentration of IL-6 and fibrinogen is lower, and the concentration of E-selectin is higher than in patients without diabetes.