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Marcin Pawłowski,1 Karolina Fila-Witecka,1 Julia Ewa Rymaszewska,1 Dorota Kamińska,2 Paweł Poznański,2 Hanna Augustyniak-Bartosik,2 Dorota Zielińska,2 Magdalena Krajewska,2 Piotr K Krajewski,3 Aleksandra Stefaniak,3 Jacek C Szepietowski,3 Anna Pokryszko-Dragan,4 Justyna Chojdak-Łukasiewicz,4 Sławomir Budrewicz,4 Tomasz Pawłowski,1 Dorota Szcześniak,1 Joanna Rymaszewska1 1Psychiatry Department, Wroclaw Medical University, Wroclaw, Poland; 2Nephrology and Transplantology Department, Wroclaw Medical University, Wroclaw, Poland; 3Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland; 4Department of Neurology, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Marcin Pawłowski, Email marcin.pawlowski@student.umw.edu.plIntroduction: The global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had a drastic psychological and economic impact on the global population. Having a chronic disease during the pandemic is associated with numerous limitations and challenges like regular hospital visits, access to health-care units and getting specialized treatment. In addition, chronically ill patients are at great risk of acquiring the SARS-CoV-2 virus and at experiencing a more severe course of illness, due to comorbid conditions as well as more frequent encounters with health-care workers and other patients in medical facilities. The aim of this study was to examine the psychological disturbances, during the pandemic in chronically ill patients.Methods: During the cross-sectional survey conducted between May and October 2020, 398 patients with four different chronic conditions (psoriasis, multiple sclerosis and patients who have undergone a kidney transplant or received dialysis). Study sample was examined regarding the occurrence of psychopathological symptoms (General Health Questionnaire 28) and their perceived stress levels (Perceived Stress Scale).Results: The highest scores were found in the MS group and the lowest scores were found in the kidney transplantation group in every subscale of the GHQ-28. Close to half of the studied population (48.74%, n = 193) patients scored above the cut-off for psychopathology.Conclusion: As the study was conducted during the SARS-CoV-2 pandemic in Poland, it stands to reason that the pandemic affected the psychological wellbeing of chronically ill patients. A COVID-19 infection, being quarantined and having had contact with a person who was infected, did not significantly affect the outcome measures; however, further research is needed to explore this topic.Keywords: pandemic, SARS-CoV 2, chronic kidney disease, psychopathology, multiple sclerosis, psoriasis

Joanna Kowalska,1 Justyna Mazurek,2 Joanna Rymaszewska31Department of Physiotherapy, University School of Physical Education in Wroclaw, Wroclaw, Poland; 2Department and Division of Medical Rehabilitation, Wroclaw Medical University, Wroclaw, Poland; 3Department of Psychiatry, Wroclaw Medical University, Wroclaw, PolandIntroduction: The factors that influence the rehabilitation process among older adults remain unclear. The aim of the study was to assess the acceptance of illness and related factors (socio-demographic data, cognitive status, depression symptoms and functional status) among patients living in a nursing home who are undergoing rehabilitation.Sample and methods: A total of 119 elderly patients were examined, of whom 96 were included in the research project. All participants were assessed using the following tests: Mini Mental State Examination, Acceptance of Illness Scale, Geriatric Depression Scale and Barthel Index. Tests were conducted at two time points, the first upon admission to the ward and the second after 3 months of regular rehabilitation.Results: The study group showed relatively low scores for illness acceptance. After 3 months of rehabilitation, the acceptance of illness had significantly improved, but still remained at a low level. The results showed a relationship between acceptance of illness and patients’ depression symptoms, functional status and cognitive status.Conclusions: The results suggest that assessment of the acceptance of illness among patients living in Nursing Home is important during treatment and rehabilitation process; however, further studies are necessary.Keywords: older adults, nursing home, rehabilitation, acceptance of illness, depression symptoms, cognitive status

Justyna Mazurek,1 Dorota Szcześniak,2 Katarzyna Małgorzata Lion,2 Rose-Marie Dröes,3 Maciej Karczewski,4 Joanna Rymaszewska2 1Department and Division of Medical Rehabilitation, Wroclaw Medical University, Wrocław, Poland; 2Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland; 3Department of Psychiatry, VU University Medical Centre/GGZ in Geest, Amsterdam, the Netherlands; 4Department of Mathematics, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland Introduction: In Poland we lack a multidisciplinary and coordinated system of care for people with dementia, which would take the form of an evidence-based pathway and the number of reports on the holistic approach to caring for people living with this diagnosis is very low.Aim of the study: The aim of the study was to investigate whether the Meeting Centres Support Programme (MCSP) is effective in meeting the needs of older people with dementia.Participants and methods: This was done by comparing the experiences of people with dementia themselves and that of their carers at baseline and at follow-up, after 6 months of participation in MCSP or Usual Care (UC).Results: The study included 47 people diagnosed with mild-to-moderate dementia (n=24, MCSP group; n=23, UC control group) and 42 informal carers (n=22, MCSP group; n=20, UC control group), all living in Wroclaw in Poland and involved in the European JPND-MEETINGDEM project. To assess cognitive functioning and severity of dementia, the Mini-Mental State Examination and Global Deterioration Scale were used. The needs were assessed using the Camberwell Assessment of Need for the Elderly. The most frequently reported unmet needs at baseline both by the persons with dementia and their carers included activities of daily living, psychological distress, and the need for company. Compared to the UC group the unmet needs were reduced considerably in the MCSP group providing convincing evidence that MCSP is effective in reducing unmet needs over a 6-month period.Conclusion: MCSP may be regarded as a good example of comprehensive post-diagnostic support for patients with mild-to-moderate dementia as well as their informal carers. Keywords: needs assessment, CANE, care management, health care, psychiatric services, social geriatrics, optimization, psychosocial care

Dorota Szcześniak,1 Agnieszka Kobyłko,2 Irena Wojciechowska,2 Michał Kłapciński,3 Joanna Rymaszewska2 1Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, 2Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland; 3Provincial Psychiatric Hospital in Zlotoryja, Zlotoryja, Poland Purpose: The aim of this study was to investigate the perceived level of internalized stigma among patients with severe mental illnesses and its relationship with demographic and clinical variables in Poland. Patients and methods: A study sample (n=114, mean age=42.46±14.1 years; 55% of females) consisting of patients with nonorganic psychotic disorders as well as unipolar and bipolar affective disorders was evaluated (58% of outpatients and 39% of inpatients). All patients filled in the Internalized Stigma of Mental Illness (ISMI) scale (maximum severity=4). The demographic and clinical data were collected. Results: The study population demonstrated a mild level of internalized stigma (2.23±0.5). The highest score was observed in the alienation domain (2.63±0.8) and reflected moderate severity. The lowest score was noted in the stereotype endorsement domain (2.08±0.6). Moreover, the highest degree of internalized stigma was present in participants with unipolar affective disorder and was of moderate severity (2.46±0.6), while the level was moderate in the alienation domain (2.85±0.8). The level of vocational training education was the only variable associated with higher internalized stigma (P=0.02). There were no associations between gender, employment, and marital status and internalized stigma. The duration of the disease was the only clinical factor showing a significant positive correlation with stigma internalization (r=0.23; P=0.01). The number of hospital admissions and suicide attempts was not significantly correlated with internalized stigma. Conclusion: People with severe mental illnesses in Poland experience a mild level of self-reported internalized stigma. Internalized stigmatization was most strongly associated with alienation, which indicates the need for stigma assessment procedures followed by stigma intervention programs in daily clinical practice. This is in accordance with the trend of environmental “open door” psychiatry, which could be the first step to decrease the level of stigma and internalized stigma in psychiatric patients in Poland. Keywords: severe mental illness, stigma, ISMI scale

Justyna Mazurek,1 Edyta Sutkowska,1 Dorota Szcześniak,2 Katarzyna Małgorzata Urbańska,2 Joanna Rymaszewska3 1Department and Division of Medical Rehabilitation, Wroclaw Medical University, Wroclaw, Poland; 2Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland; 3Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland Purpose: The purpose of this study was to determine the validity and reliability of the Polish version of the Questionnaire for Health-Related Resource Use in an Elderly Population [Fragebogen zur Inanspruchnahme medizinischer und nicht-medizinischer Versorgungsleistungen im Alter (FIMA)]. Patients and methods: This was a cross-sectional study conducted in a rehabilitation care unit in Poland between January and June of 2017. Sixty-one patients aged ≥65 years who had been admitted to the unit were enrolled into the study. Each participant was evaluated twice: once within 48 hours of admission (T1) and once after 2 weeks (T2). Results: The translated instrument was understood by most respondents in a selected population and it maintained a reading and comprehension level that was accessible by most respondents, even of a low education level. With the aid of the prevalence-adjusted bias-adjusted kappa (PABAK) and intraclass correlation coefficient (ICC), 100% test–retest reliability for 10 out of the 12 questions that were subjected to analysis was indicated. The most frequent health-related resource uses were appointments at the general practitioner (90.2%) and orthopedist (54.1%), medication (93.4%), and the necessity to have glasses as supportive equipment (70.5%). Conclusion: The Polish FIMA demonstrated very good test–retest reliability, good validity, and ease of use for elderly people. Further investigation is required. In the future, the routine use of this instrument could be encouraged to assess the use and demand for medical and nonmedical services among the elderly. Keywords: assessment, geriatrics, quality of care, care coordination, decision-making

ABSTRACTBackground:In the MEETINGDEM project, the Meeting Centers Support Program (MCSP) was adaptively implemented and evaluated in three European countries: Italy, Poland, and the United Kingdom. The aim of this study was to investigate overall and country-specific facilitators and barriers to the implementation of MCSP in these European countries.Methods: A qualitative multiple case study design was used. Based on the theoretical model of adaptive implementation, a checklist was composed of potential facilitators and barriers to the implementation of MCSP. This checklist was administered among stakeholders involved in the implementation of MCSP to trace the experienced facilitators and barriers. Twenty-eight checklists were completed.Results: Main similarities between countries were related to the presence of suitable staff, management, and a project manager, and the fact that the MCSP is attuned to needs and wishes of people with dementia and informal caregivers. Main differences between countries were related to: communication with potential referrers, setting up an inter-organizational collaboration network, receiving support of national organizations, having clear discharge criteria for the MCSP and continuous PR in the region.Conclusion: The results of this study provide insight into generic and country specific factors that can influence the implementation of MCSP in different European countries. This study informs further implementation and dissemination of MCSP in Europe and may also serve as an example for the dissemination and implementation of other effective psychosocial support interventions for people with dementia and their informal caregivers across and beyond Europe. [ABSTRACT FROM AUTHOR]