Importance of most frequent needs of the disabled in shaping areas of support in public health. Part. II. Disability as a consequence of dysfunction in the state of health disrupting daily functioning based on selected health and socio-demographic characteristics - interdisciplinary problems in the domain of public health.

INTRODUCTION: The disabled are a group with heterogeneous structure of causes and needs. Assessment of these causes and needs requires prospective studies in order to use the results within public health actions, indispensable for pursuing the challenges of sustained development. The aim of the study was determination of the problems and needs of the disabled in various areas of their functioning, according to such characteristics as: gender, age, causes of disability, place of residence, level of education, formal status of disability, and socio-economic standard. MATERIAL AND METHODS: The examined population were 676 disabled aged from 19-98, including 56.4% of females, and 43,6% of males; rural inhabitants constituted 38.0%. The study was conducted by the method of purposive sampling, using the following research tools: the Disability Questionnaire, and the Scientific-Research Protocol. Statistical analyses were performed by means of the statistical package IBM SPSS Statistics v. 27; the p values p<0.05 were considered statistically significant. RESULTS: The most frequently occurring problems were material difficulties, lack of rehabilitation in the place of residence, hindered access to a physician, difficulties with settling official matters, loneliness, too infrequent contacts with the family, negative attitudes of the local community towards disability, and family disagreements. Some of these problems were significantly more frequent among rural inhabitants. CONCLUSIONS: The majority of the problems hindering daily life of the disabled fell within social rather than medical categories. Age, level of education, degree of disability, legal status, and material standard were most frequent determinants of the occurrence of health and social problems according to the place of residence.

An analysis of anxiety and selected aspects of personality in women with ischemic heart disease according to P.T. Costa and R. R. McCrae theory - The role of psychosocial factors in ischemic heart disease.

INTRODUCTION: Risk factors for ischemic heart disease (IHD) are very numerous and not fully defined. In addition to classic risk factors, different factors are also distinguished, among them psychological aspects chich have rarely been subject to detailed analyses. OBJECTIVE: The aim of study was an analysis of the anxiety structure, including the five factors of personality: neuroticism (NEU), extraversion (EXT), openness (OPE), agreeableness (AGR) and conscientiousness (CON), in women with IHD. MATERIAL AND METHODS: The study involved 140 women aged 37-74 years with IHD confirmed by coronary angiography. Psychological examination was conducted using R.B. Cattell's IPAT Anxiety Scale and P.T. Costa and R.R. McCrae's NEO-FFI Personality Inventory. RESULTS: The results obtained from the IPAT Anxiety Scale showed that the study group of 140 women with IHD had the correct level of internal integrity (Q3- ). The dominant factor in the anxiety structure in 88.7% of subjects was neurotic tension (Q4+). A lack of sense of safety was indicated by 72.6% of subjects (L+), 69.3% experienced a strong tendency to self-blame and experience a sense of guilt (O + ), and over 51.6% of women with IHD expressed decreased emotional stability (C - ). The level of general anxiety was high (GA=7.3). The analysis of the five factors of personality revealed that the dominant factors in the structure of personality of women with IHD were CON in 69.3%, AGR in 46.7% and EXT in 45.2%. NEU and OPE were moderately significant factors. CONCLUSIONS: Women with IHD are characterised by a high level of anxiety, increased neurotic tension, decreased emotional stability, auto-aggression and a sense of danger and distrust. Women with IHD demonstrate a high level of factors, such as extraversion, agreeableness and conscientiousness.

PSYCHOLOGICAL RISK FACTORS FOR CARDIOVASCULAR DISEASES.

OBJECTIVE: Introduction: Cardiovascular diseases are one of the most important causes of the morbidity and mortality in the Polish and European population, accounting for nearly half of the causes of death. Prevention and treatment of cardiovascular diseases, especially in view of the predicted increase in mortality rate as a result of these diseases in the aging populations is crucial. The aim: To characterize selected psychological risk factors that predispose to the development of cardiovascular disease. RESULTS: Review and disscusion: Numerous scientific studies indicate the importance of mental and psychosocial factors in the prevention, treatment and rehabilitation patients with cardiovascular diseases. In this article the most important psychological risk factors, such as Type A and D personality, stress, depression and depressed mood, anxiety, social support and lifestyle are presented. CONCLUSION: Conclusions: Population-focused programs devoted to health promotion and informing the general public about the risk factors for cardiovascular diseases should mainly aim at improving people's lifestyle, in particular with regard to nutrition, smoking, alcohol consumption, physical activity and mental well-being.

[Old age can be joyful too].

All over world people live longer. In highly civilized societies the elderly people are half of the population. The old age crowns the whole life, it is the period when one enjoys the fruits of his labours. The man, when living on earth, completes a certain cycle which begins with the birth and is crowned with the old age. Each age is somehow beautiful but the extreme happiness is to go through the whole cycle. The old age is the specific beauty enriched with the past which had prepared it. Through their whole life one should be preparing to have successful, cheerful old age as it crowns air existence. The elderly like calmness, rest, silence and deadened sounds. Thanks to these traits they make every environment harmonious, calm and peaceful. They do it subconsciously thanks to their existence, exclusively through their own presence because these traits are the inherent part of their lives. The old age is God's grace given to man. That is why we may easily say that in their hand an old man holds their life's achievements that they will introduce to God one day.

Overt and Covert Anxiety as a Toxic Factor in Ischemic Heart Disease in Women: The Link Between Psychological Factors and Heart Disease.

BACKGROUND Long-term clinical observations have shown that anxiety disorders influence the etiopathogenesis of ischemic heart disease (IHD) in women. The aim of this study was to determine the characteristics of the structure of overt and covert anxiety, and to examine the impact of the severity of anxiety on five personality traits as described Costa and McCrae. MATERIAL AND METHODS The study involved 50 women aged 37 to 74 years, who were treated because of IHD that was confirmed by angiographic examination of the coronary vessels. Psychological studies were conducted using the IPAT Anxiety Scale (Cattell) and NEO-FFI Personality Inventory (Costa and McCrae). RESULTS From among the 50 women with IHD included in the study, 28 had higher overt anxiety scores than covert anxiety scores. Women with high overt anxiety were more emotionally changeable (C-), became impatient more easily, and expressed disappointment with life. They also worried about life problems more frequently. They had considerable suspiciousness (L+) and less trust towards the environment. They had a much stronger tendency to blame themselves (O+) and had intense internal, neurotic tension (Q4+). Women with high levels of overt anxiety had more neurotic traits (NEU), and lower openness to experience (OPE) scores. CONCLUSIONS Women with IHD were characterized by a high level of unease and anxiety. This may have resulted from lack of personality harmony, lack of personality integrity, or experienced value crises. Internal tension, auto-aggression, lowered emotional stability, and a sense of threat dominate the structure of unease and anxiety.

[Psychological rehabilitation in patients with ischemic heart disease in the last 30 years].

Cardiological rehabilitation is one of the basic methods used in the treatment of cardiovascular diseases including ischemic heart disease. Complex cardiological rehabilitation consists of clinical assessment, pharmacotherapy, kinesitherapy, psychological rehabilitation, assessment of cardiovascular risk factors prevalence, lifestyle modification and health education of patients. The paper presents methods of psychological therapy applied at different stages of psychological rehabilitation in traditional clinical procedure in patients with ischemic heart disease. In the mid 90-ties of the 20th century new, invasive diagnostic and treatment methods of cardiovascular diseases were introduced. Along with application of modern methods of invasive treatment methods of psychological rehabilitation changed towards crisis intervention.

[Changes in mental condition of women with heart failure].

Heart Failure (HF) is one of the most serious diseases of cardiovascular system. Epidemiological studies conducted in the first decade of 2000s in industrialised countries show that heart failure occurs in approx. 1-2 % of the population and significantly increases up to 10 % in people over the age of 70. Because of the increase in incidence and high mortality heart failure is one of the most important challenges for modern medicine. Objective: The aim of this study was to isolate and characterise emotional and adaptive changes observed in women treated for heart failure. Heart failure may be caused by myocardial infarction, myocarditis, cardiomyopathy, untreated hypertension, valvular heart disease, abuse of alcohol and other toxic substances. Its most serious symptoms and therefore most exhausting for patients are: shortness of breath, forced vertical position while breathing, paroxysmal nocturnal dyspnea, weakness, fatigue and generalized edema. Material and Methods: Observations and psychological examination were conducted in 64 women treated for heart failure. Women with HF were provided with help and individual supportive therapy. In conducting individual therapy the role and importance of family support was taken into account. Results: The results of conducted observations and psychological therapy showed that women with HF revealed many negative emotional states: fear, anxiety, insecurity, depressed mood, depression, impatience, anger and a sense of loss. Progressive heart failure contributed to the increase of negative emotions and lead to the development of mental crisis. The State-Trait Anxiety Inventory (STAAI) by C.D. Spielberger and The Hospital Anxiety and Depression Scale (HADS) A.S. Zigmond and R.P. Snaith were used in psychological examination. Conclusions: Conducted research and psychological observations allow to conclude that patients with heart failure require professional help and psychological intervention. Psychological therapy should be provided to patients at different stages of disease development. Techniques of psychological therapy must be focused on strengthening psychological resilience and providing help to survive mental health crisis.

[Chosen problems of mental functioning in patients with chronic systemic connective tissue diseases base on example of rheumatoid arthritis]. / Wybrane problemy funkcjonowania psychicznego u chorych z przewleklymi chorobami ukladowymi tkanki lacznej na przykladzie reumatoidalnego zapalenia stawów.

Disorders in mental functioning are indicated as the cause of all connective tissue diseases and also as their consequences. That is why psychologist's help may be very important for patients with rheumatoid arthritis. Psychological observations of patients with chronic systemic connective tissue diseases show a number of negative emotional states such as fear, anxiety, insecurity, depressed mood, depression, impatience, anger and a sense of loss These patients constantly experience pain of varying intensity and location. In many of them progressive disease leads to the advancement of mental crisis. Methods of psychological therapy must be focused on strenghtening mental resilience and helping in surviving mental crisis. Psychological therapy should concentrate on raising self-esteem, training interpersonal skills and teaching relaxation techniques to cope better with pain and suffering. Psychological therapy should support the patient in struggling with the problems caused by the disease and developing ways of adapting to life with the disease.

Pain-coping strategies in women with ischemic heart disease.

INTRODUCTION AND OBJECTIVE: The objective of the study was evaluation of the level and structure of anxiety and fear, and the characteristics of pain coping strategies used by females with ischemic heart disease (IHD). The detailed aim was assessment of the mutual relationships between the fear and pain coping strategies applied. MATERIAL AND METHODS: The study covered 75 females aged 33-80 (mean age 61; SD±9.66), hospitalized in the Cardiology Clinic who had coronary angiography performed in order to assess the state of coronary vessels. Psychological studies were conducted by means of the IPAT Anxiety Scale by R. B. Cattell and the Pain Coping Strategies Questionnaire CSQ by A. C. Rosenstiel and F. J. Keefe. RESULTS: The results obtained indicated that in the group of 75 females with IHD in the structure of anxiety and fear there dominated strong tendencies towards self-blaming and the experiencing of a sense of guilt, as well as a high level of internal tension. The strategy of the greatest importance in coping with pain among females with IHD was 'Praying and Hoping'. The strategies used with similar frequency were: 'Coping Self-Statements', 'Diverting Attention' and 'Increased Behavioural Activities'. CONCLUSIONS: In females with IHD, the application of psychotherapy is recommended, aimed at reducing the level of auto-aggression tendencies and decreasing a high level of internal tension. Psychotherapeutic activities carried out among females with ischemic heart disease should focus on the strengthening of strategies of coping with pain, such as: 'Coping Self- Statements', 'Increased Behavioural Activities', and focusing attention on serious life problems.

Passive smoking as an environmental health risk factor.

Initially, tobacco was considered as a decorative plant and only later began to be treated as a herb with special therapeutic properties. With time, it was found that tobacco had strong insecticidal and addictive properties. There also occurred reports about the negative influence of tobacco on human health. The World Health Organization (WHO) classifies smoking as a chronic, progressive disease which is also 'contagious'. It is also considered to be a neurobiotic addiction. Nicotine addiction does not cause changes in the behaviour or functioning of a smoker; however, it adversely affects his or her general health status and the health status of people within their environment. Passive smoking (so-called ETS--Environmental Tobacco Smoke), which means accompanying smokers negatively influences the health of passive smokers. Environmental tobacco smoke, on the one hand, is the result of spontaneous cigarette burning and, on the other hand, the result of the side-stream of cigarette smoke, as well as the smoke exhaled by active smokers. Health personnel should clearly and convincingly present the data concerning the adverse results of smoking, as well as the dangers of exposure to environmental tobacco smoke, thereby making their patients aware that breaking their addiction will not only be beneficial for their own health, but will also protect non-smokers in their environment from the adverse effects of exposure to environmental tobacco smoke.

[Psychological aspects of rehabilitation of the elderly people after femoral neck fracture]. / Psychologiczne aspekty rehabilitacji osób starszych po zlamaniu szyjki kosci udowej.

Mobility impairments, joint deformations, osteoporosis, weakening of sensory functions and orientation in space, which are quite common in senility expose elderly individuals to various kinds of falls and accidents. Femoral neck fractures and pertrochanteric fractures are the most frequent traumatic injuries among the elderly patients. During the post-surgical period or rehabilitation process it is of vital importance that treatment activities should enable patients to function in social and family environment in the same way as before the accident. Furthermore, it is crucial that rehabilitation procedures be of multi-faceted character - owing to the psycho-physical unity of the human being, they should not focus merely on physical treatment of the patient, but also on their psychological condition which is particularly significant in the whole treatment process. Apart from that, it is essential to consider the level of anxiety and motivation of the patient and to offer them professional psychological support and assistance.

[The interdependence of coronary pain control and level of anxiety in women with ischiaemic heart disease]. / Poczucie kontroli bólu wiencowego a poziom leku u kobiet chorych na chorobe niedokrwienna serca.

UNLABELLED: Interdependences between pain and anxiety in cardiac ischaemia are multidimensional and complex. Both of these phenomena share a lot of traits and they tend to reinforce each other at physiological level. Apart from arduousness of pain, cognitive understanding of its nature becomes an important mediating factor. One of important characteristics of the patient's attitude towards their illness is localization of pain control. The aim of the study was to analyze an interdependence between an anxiety as a state and as a trait and the localization of pain control in women with coronary heart decease. MATERIAL AND METHODS: The study included 52 female patients hospitalised at The Department of Cardiology of The Medical University of Lublin who underwent coronarography. The used methods included an interview, State - Trait Anxiety Inventory of Spielberger (STAI) and The Beliefs about Pain Control Questionnaire (BPCQ). RESULTS: The results did not confirm an often suggested opinion that internal localization of pain control reduces anxiety and activates the patient. The intensity of the internal localization of pain control correlates significantly with the intensity of the dependence of pain of activity of the doctors as well as on the anxiety as trait. It is higher in women with lower education. Perhaps better educated patients, not so ready to react with anxiety, can treat pain more realistically as a sign of a pathological process which can be understood and evaluated not so much as a catastrophe. They do not feel personally responsible for the pain, either, and are able to accept the limits of the doctor's assistance, having no unrealistic expectations with regard to the pain treatment. CONCLUSIONS: The results of the research indicate that in women with ischiaemic heart decease better adjustment to the illness and a lower level of anxiety as a trait are connected with the understanding and acceptance of their situation by the patient, rather than with too big extent of expectations towards the control of pain by the patients themselves or medical staff.

Smoking and the level of nicotine addiction in relation to the state of hard dental tissues in young adults.

Nowadays, smoking is considered to be one of the unhealthiest human behaviours. The aim of this study was to evaluate the potential influence of smoking, as well as the degree of the addiction, on the health status of hard dental tissues in young adults. The study involved 148 randomly selected young adults. Mean age of the study subjects was 20 years ± 4 months. Questionnaire survey (6-grade Fagerstrom Nicotine Tolerance Questionnaire) and clinical examination were performed and the obtained results statistically analyzed. The mean value of 6-grade Fagerstrom Nicotine Tolerance Questionnaire was 2.298 ± 1.992. Of the studied population, 88.06% had no features of biological dependency. Mean DMF and DMFs Indexes were 11.31 ± 5.06 and 16.91 ± 10.65, respectively. It was established that in the study population, over 45% of the subjects smoked. However, there was no correlation found between smoking and gender, and no cause-eff ect relationship between smoking and hard dental tissues status as defined by DMF, DMFs values and their components. It was observed that in the case of people who began smoking at an earlier age, the degree of nicotine dependency was higher. None of the study subjects demonstrated features of heavy or pharmacological nicotine dependency.

Selected social and health problems in functioning of disabled rural and urban inhabitants in the Lublin Region--similarities and differences.

The objective of the study was determination of the frequency of occurrence of selected difficulties associated with disability and social problems which disturb the functioning of the disabled in rural and urban areas in the Lublin Region. The study was conducted by trained surveyors with the use of a standardized questionnaire which covered: 1) Demographic data: age, gender, education level and marital status; 2) Information concerning biological and legal disability, degree of disability, its causes, functional limitations due to disability; 3) Information pertaining to difficulties and barriers in daily living of the disabled population. The study covered 403 disabled selected by the method of targeted sampling--147 rural and 256 urban inhabitants. Log-linear model was applied for data analysis. Unfavourable demographic characteristics of the population of the disabled in the study: mean age 63; high percentage of never-married males and females; respondents possessing elementary education level; dominant number of those occupationally inactive. The most frequent limitations associated with disability: limitations in performing household jobs (70.9%), walking difficulties (68.1%). High intensity of material difficulties, in association with low education level and high percentage of those occupationally inactive, are the evidence of socio-economic deprivation of the population examined. Differences between rural and urban inhabitants was found: in the rural environment, compared to urban areas, the following were more frequently reported: lack of possibilities of rehabilitation in the place of residence, difficulties with access to medical specialist; alcohol abuse in the family, and family disagreements. Urban population more often than rural inhabitants perceived loneliness and isolation from the closest family.

Characteristics of depressive changes and anxiety in patients with essential hypertension.

Hypertension is among the world's most widespread diseases and one of the most frequent causes of mortality in the adult population. Clinical and experimental observations indicate the importance of psychic factors in the pathogenesis of hypertension. The aim of this study was to characterize depressive symptoms as well as to analyze anxiety level in patients with essential hypertension. A group of 38 patients, 17 females and 21 males, aged 20-77, the average age being 53, treated for essential hypertension diagnosed on the basis of the generally established clinical criteria were examined with the use of A.S. Zigmond's and R.P. Snaith's Hospital Anxiety and Depression Scale (HADS) and C.D. Spielberger's, R.L. Gorsuch's and R.E. Lushene's State-Trait Anxiety Inventory (STAI) in an authorized translation by J. Strelau, M. Tyskarczyk and K. Wrzesniewski. Examination results received with the use of HADS reveal a moderate occurrence of depressive symptoms in patients with essential hypertension. The application of STAI enabled state and trait anxiety analysis. The examined patients are characterized by an increased level of A-State as well as an increased level of A-Trait. Patients with hypertension exhibit state anxiety in reaction to all kinds of direct threat factors. They also react with an increased level of trait anxiety as an acquired behavioral disposition. This leads to a conclusion that the examined patients' reaction is marked by the anxiety disproportionate in strength to the actual danger.

Selected conceptions of defining the quality of life.

The aim of the work is to present numerous conceptions defining the quality of life. Various definitions are formulated and those presented in the work seem to characterize the concept in the most specific way. They share a lot of common features. However, there are also some differences between them mainly concerning the issue whether the quality of life is a general or rather a multi-dimensional construction and what factors determine good quality of life. It has been agreed that the quality of life is variable in time, not observable or measurable, however, as a definition, it has to be precisely established and defined.

Assessment of knowledge, skills, and attitudes of nuns with regard to breast cancer prophylaxis.

The aim of the study was to verify whether nuns are aware of the need to self-examine their breasts and whether their level of knowledge and skills is sufficient to carry out the control properly. Subject to the study were nuns from various convents from the town of Przemysl. The sample consisted of 82 nuns. The research tool used was a self-constructed questionnaire. On the basis of the study, it has been found that the subjects' level of knowledge regarding breast cancer is unsatisfactory and, although the awareness of the need of self-control is high, it does not influence the regularity of performance thereof.

Selected psychological problems of patients with cardiac transplantation on a permanent pacing treatment.

The aim the study was to evaluate the psychological condition (psychological functioning) of patients after cardiac transplantation who were treated permanent pacing. The study group consisted of 8 men, aged 19-60, after cardiac transplantation. Due to persistent disorders of cardiac rhythm the patients were implanted a pacemaker. Besides the basic clinical tests the patients underwent the following psychological tests: State-Trait Anxiety Inventory (STAI) by C.D. Spielberger, Scale PIL by J.C. Crumbaugh and L.T. Maholick and The Adjective Check List ACL by H.G. Gough and Heilbrun. The applied methods allowed to define the structure and level of anxiety. They also made it possible to analyze the subjects' acceptance of life and their perception of the sense of life as well as determination of a characteristic set of mental needs. The studied subjects presented a high level of anxiety both as a condition and as a feature. No symptoms of existential neurosis were confirmed, but a high level of perception of the sense of life with correct evaluation of the value of life were revealed. Comparison of the real and the ideal concept of oneself allowed to select a set of psychological needs. The real concept of oneself was characterized by moderate needs determining the realization of the desire to succeed, moderate needs characteristic of social functioning in the direct interpersonal contacts, and moderate needs connected with the attitude towards life. In the ideal concept of oneself considerably higher intensity was noted concerning the set of needs connected with success. Clearly the need for contacts with the opposite sex was increased as well as the need for sharing one's own experiences and feeling with others. Self-control, self confidence and personal adaptation were also found to be greater.

Anxiety and fear level in patients after myocardial infarction over five years of rehabilitation.

The aim of the study was to characterise the structure of anxiety and fear in patients after myocardial infarction observed during their five-year rehabilitation. The study group comprised 114 men aged 24-63 years treated at the Chair and Department of Cardiology, Medical University of Lublin with recent myocardial infarction diagnosed according to generally accepted clinical criteria. Besides basic clinical examinations the patients were performed echocardiography and psychological examination. After completion of the first clinical therapy a five-year post-infarct outpatient rehabilitation was organised for the patients. To assess the level of anxiety and fear Cattell's IPAT Self-Analysis was used. The method lets find out that: 1. In every study period the level of general anxiety was close to the neurotic level. 2. During the whole period of five-year rehabilitation in about 60% of patients the normal level of internal integration was observed. 3. In all study periods about 30% of patients showed emotional instability. 4. In the structure of anxiety and fear about 60% of patients always showed high level of inner tension associated with a conflict between superego demands and impulsive sphere. 5. Observation of patients after myocardial infarction lasting many years has shown that the study group is not homogenous as for personality traits. The use of agglomerate analysis allowed distinguishing 7 groups of patients with the most similar personality characteristics. Individual groups of patients significantly differed from one another with regard to the structure of anxiety and fear.