The relationship between burnout, job satisfaction and the rationing of nursing care-A cross-sectional study.

AIMS: To assess the impacts of burnout and job satisfaction on the rationing of care in the professional group of nurses. BACKGROUND: The shortage of nursing staff is currently one of the most significant health care problems. It is not clear how burnout and job satisfaction affect the rationing of nursing care. METHODS: We included 594 nurses, and we used the Basel Extent of Rationing of Nursing Care-R (BERNCA-R), the Maslach Burnout Inventory (MBI) and the Job Satisfaction Scale (JSS). RESULTS: The average scores were 1.72 ± 0.87 points for the BERNCA-R, 36.08 ± 21.25 for the MBI and 19.74 ± 5.57 for the JSS. A statistically significant positive correlation between the BERNCA-R and the MBI (p < .05) and a negative correlation between the BERNCA-R and the JSS (p < .05) were observed. Independent predictors of the BERNCA-R were the result of emotional exhaustion of the MBI and the assessment of the impact of independence on job satisfaction (p < .05). CONCLUSION: Occupational burnout can decrease job satisfaction in nursing staff and result in adverse outcomes of rationing care. Nursing managers should pay more attention to individual differences in nursing-care workers linked with nursing burnout, job satisfaction and the rationing of care. IMPLICATIONS FOR NURSING MANAGEMENT: Interventions aimed at counteracting burnout are the key to improving job satisfaction in nurses.

Factors affecting the quality of life of chronic dialysis patients.

Background: Patients on hemodialysis must adjust their life plans to the treatment. They are aware of losing their health and independence. Therefore, acceptance of illness (AI) is important and allows the patient to adjust to new situation and alleviates negative emotions. Methods: The aim of study was to assess the impact of AI and other socioclinical variables on hemodialysis patients' quality of life (QoL). The study included 100 patients aged 20-85 (M = 57), treated with hemodialysis for at least 2 years. Two validated instruments were used: the Acceptance of Illness Scale (AIS) and the World Health Organization Quality of Life questionnaire. Results: High, moderate and low level of AI was found for 15, 61 and 24 patients, respectively. The QoL increased with the AI score. In physical domain, it reached 69.8 ± 12.4 in the high AIS group, 54.2 ± 15.3 in the moderate AIS group and 42.7 ± 12.3 in the low AIS group ( P < 0.001). The psychological domain scores were 70.3 ± 12.8, 57.2 ± 15.0 and 49.7 ± 11.8 ( P < 0.001), respectively. The environmental domain scores were 68.8 ± 13.3,59.0 ± 12.6 and 53.0 ± 11.6 ( P < 0.001), respectively. AIS scores were positively correlated with QoL in three domains: physical ( r = 0.549; P < 0.0001), psychological ( r = 0.505; P < 0.0001) and environmental ( r = 0.444; P < 0.0001). In multiple-factor analysis, AI was independent predictors in physical domains (ß = +0.210), psychological domain (ß = +0.402) and environmental domain (ß = +0.204). No correlation or predictive value was found for the social relationship domain, however. Conclusions: Patients on dialysis have moderate-to-low AI. AI is an independent predictor positively correlated with QoL in all domains except for social relationships. The social and psychological support for dialyzed patient might improve their HRQoL and illness acceptance.

Effects of depression and anxiety on asthma-related quality of life.

INTRODUCTION: Asthma is the most prevalent chronic disease in adults. It affects their quality of life. Studies confirm that depression and anxiety occurs in asthma patients. MATERIAL AND METHODS: The study involved 96 patients with asthma divided into two groups: patients with controlled (n = 33) and uncontrolled asthma (n = 63). The analysis of asthma control was performed on the basis of the ACT (Asthma Control Test) results. The study used SF-36 (Short Form 36) questionnaire and HADS (Hospital and Depression Scale) Scale. RESULTS: An analysis of the correlations between QoL (Quality of Life) and the level of depression revealed a decrease in QoL scores in MCS (Mental Component Score) domain in the group with controlled asthma (71.8 - patients without depression, 53.4 - patients with probable depression, and 51.4 - patients with depression; p = 0.032). A similar analysis of the correlations between QoL and the level of anxiety in this group of patients proved no correlations in PCS (Physical Component Score) and MCS domains. In the group of patients with uncontrolled asthma, anxiety and depression correlated negatively with the QoL in PCS and MCS domains. Anxiety and depression are found in asthma patients, with higher severity observed in patients with uncontrolled asthma. Female gender, the level of asthma control, asthma severity, smoking, as well as diagnoses of anxiety and depression are predictors of a significantly lower QoL in asthma. CONCLUSIONS: Anxiety and depression are found in asthma patients, with higher severity observed in patients with uncontrolled asthma. Female gender, the level of asthma control, asthma severity, smoking, as well as diagnoses of anxiety and depression are predictors of a significantly lower quality of life in asthma.

Anxiety and Depressive Symptoms, Frailty and Quality of Life in Atrial Fibrillation.

Introduction: Symptoms of atrial fibrillation (AF) can significantly affect functioning in daily life and reduce patients' quality of life (QoL). The severity and type of AF symptoms affects not only patient's QoL, but can be a cause of the development of emotional and psychological disorders. In addition, frailty syndrome (FS) plays important role from the point of view of developing disability and dependence on others, as well as reducing QoL. Aim: To assess the symptoms of anxiety and depression, to evaluate the co-occurrence of frailty syndrome and the impact of these factors on the quality of life of patients with AF. Methods: The study used a Polish adaptation of the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia part III (ASTA part III), the Tilburg Frailty Indicator (TFI) and the Hospital Anxiety Depression Scale (HADS). Results: Analysis showed that anxiety symptoms and depressive symptoms correlate significantly (p < 0.05) and positively with the physical (r = 0.24; p < 0.001, r = 0.29, p = 0.002, respectively), psychological (r = 0.34, p < 0.001, r = 0.49 p < 0.001, respectively) and total quality of life (r = 0.31, p = 0.001, r = 0.414; p < 0.001, respectively) ASTA III domains. A significant (p < 0.05) positive correlation was observed between the TFI total score and the physical (r = 0.34, p < 0.001), psychological (r = 0.36, p < 0.001) and overall quality of life (r = 0.38, p < 0.001) in ASTA III domains. Conclusions: Both FS and depressive and anxiety symptoms significantly affect QoL. Understanding the relationship between anxiety and depressive symptoms, FS and QoL may allow for a more targeted approach to the treatment and care of patients with AF.

Self-care and quality of life among men with chronic heart failure.

Introduction: Chronic Heart Failure (CHF) involves a complex regimen of daily self-care behaviors: pharmacological therapy, symptom monitoring and lifestyle modifications. Patients with CHF may have a reduced health related quality of life (HRQoL) due to various physical and emotional symptoms. HRQoL may be improved through the use of self-care interventions. Purpose: To assess the level of self-care and quality of life among men with chronic heart failure. Methods: The study was conducted among 80 men diagnosed with CHF (mean age 58 years). The study was cross-sectional. A self-administered questionnaire and analysis of medical records were used to collect baseline sociodemographic and clinical data. Self-care was assessed using the standardized European Heart Failure Self-care Behavior Scale- EHFScBS-9 and quality of life was assessed using the World Health Organization Quality of Life Bref. Results: The Patients in NYHA class II constituted the vast majority (71.25%), mean LVEF in the study group was 43.5%, and mean disease duration was 3 years. The most common comorbidities were ischemic heart disease (72.5%), hypertension (70%) and diabetes mellitus (60%). The most commonly reported non-pharmacological treatments for NS were fluid restriction (45%), moderate physical activity (42.50%) and daily weight control (41.25%). The EHFSc-9 questionnaire score averaged 50.31 points out of 100 possible (SD = 26.52). The mean score regarding perception of QoL was 2.78 points (SD = 0.91), and 40% of patients indicating poor perception of QoL. The mean score for self-rated Analysis of the results of the individual domains of the WHOQoL BREF questionnaire showed that patients rated their QoL best in the environmental domain (M = 13.28; SD = 3.11), then in the social domain (M = 12.81; SD = 2.71), and in the psychological domain (M = 12.8; SD = 3.2). In contrast, QoL in the physical domain was rated the lowest (M = 10.44; SD = 2.85). There was no significant correlation between quality of life and self-care (p > 0.05). Conclusions: Men with CHF have unsatisfactory self-care outcomes and low quality of life scores and are dissatisfied with their health. Strategies to improve selfcare and quality of life in this group are indicated.

The Influence of Frailty Syndrome and Dementia on the Convenience and Satisfaction with Oral Anticoagulation Treatment in Elderly Patients with Atrial Fibrillation.

Background: The impact of frailty syndrome (FS) and dementia on the convenience and satisfaction with oral anticoagulation (OAC) treatment in atrial fibrillation (AF) patients is not well-known. Aim: Assessment the impact of FS and dementia on the convenience and satisfaction with OAC treatment in 116 elderly (mean age 75.2, SD = 8.2) patients with AF. Methodology: A self-administered questionnaire was used in the study to collect basic socio-demographic and clinical data. Tilburg Frailty Indicator (TFI) questionnaire was used to assess the presence of FS, Mini Mental State Examination (MMSE) to assess cognitive impairment (CI), The Perception of Anticoagulant Treatment Questionnaire Part 2 (PACT-Q2) to assess convenience and satisfaction with OAC treatment, and the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) to assess quality of life (QoL). Results: Multivariable analysis as a significant, negative predictor of the convenience and satisfaction domain showed the occurrence of dementia (ß = −0.34; p < 0.001, ß = −0.41; p < 0.001, respectively) and prior major bleeding (ß = −0.30; p < 0.001, ß = −0.33; p < 0.001, respectively). Analysis showed a significant relationship between convenience and satisfaction and the overall result of the ASTA (r = −0.329; p < 0.001, r = −0.372; p < 0.001, respectively). Conclusions: Elements of geriatric syndrome, such as FS and dementia, adversely affect treatment convenience and satisfaction with OAC treatment in AF. It has been shown that better convenience and satisfaction with OAC treatment translates into better QoL. There were no differences between satisfaction and convenience and the type of OAC treatment (vitamin K antagonists (VKA) vs. novel oral anticoagulants (NOAC).

The Level of Self-Care among Patients with Chronic Heart Failure.

INTRODUCTION: In a long-term approach to the treatment of heart failure, importance is given to the process of self-care management and behaviors. The number of rehospitalizations and unscheduled medical visits can be reduced by actively engaging patients in the self-care process. METHODS: The study included 403 patients with chronic heart failure (mean LVEF 40.53%), hospitalized in the Cardiology Department. Medical record analysis and a self-report questionnaire were used to obtain basic sociodemographic and clinical data. The European Heart Failure Self-care Behavior Scale, revised into a nine-item scale (EHFScBS-9), was used to evaluate self-care behavior. RESULTS: Analysis of the EHFSc-9 self-care behavior scale showed that the mean score was 49.55 out of 100 possible points (SD = 22.07). Univariate analysis revealed that significant (p < 0.05) negative predictors of the EHFScB-9 self-care scale included: male sex (b = -5146), hospitalizations in the last year (b = -5488), NYHA class II (b = -11,797) and NYHA IV class (b = -15,196). The multivariate linear regression model showed that a significant (p ˂ 0.05) negative predictor of the EHFScB-9 self-care scale was male sex (b = -5.575). CONCLUSIONS: Patients with chronic HF achieve near optimal self-care behavior outcomes. A patient prepared to engage with self-care will have fewer rehospitalizations and a better quality of life.

The association of the level of self-care on adherence to treatment in patients diagnosed with type 2 diabetes.

AIMS: The study aimed to assess the impact of self-care on adherence to treatment in patients diagnosed with type 2 diabetes and effect of complex interaction of social, lifestyle, economic, environmental and behavioural. METHODS: The study was carried out between June 2018 and May 2019 on 324 patients (162 females, 162 males) with type 2 diabetes. To measure the levels of self-care, the Self-Care of Diabetes Index (SCODI) questionnaire was used. Adherence to treatment was assessed with the Adherence in Chronic Diseases Scale (ACDS). RESULTS: The highest scores of health behaviour were on the subscale of adherence with the mean value of 68.37, and the lowest results on the subscale of blood sugar self-monitoring, with the mean of 56.05. We found that low adherence to treatment was present in 52.47% of respondents, the moderate level in 39.20%, while only 8.33% of patients showed the high level. There were significant positive correlations between the ACDS and SCODI subscales (p < 0.05): self-care maintenance (0.436), self-care management (0.413), self-care monitoring (0.384), and self-care confidence (0.453). CONCLUSIONS: Self-care affects on adherence in patients with type 2 diabetes. The higher self-efficacy in each of the areas of functioning, the higher the level of adherence to treatment. We found that demographic variables such as female sex, education and employment status can influence self-care in managing chronic illnesses such as type 2 diabetes.

Assessment of Frailty and Occurrence of Anxiety and Depression in Elderly Patients with Atrial Fibrillation.

PURPOSE: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and its incidence increases with age. The elderly population is commonly affected by frailty syndrome (FS). FS syndrome along with anxiety and depressive symptoms are prevalent among elderly patients with AF. It is unclear whether depression contributes to AF or vice versa. The purpose of this study was to assess correlations between FS and the occurrence of anxiety and depression symptoms in a group of elderly patients with AF. PATIENTS AND METHODS: This cross-sectional study included 100 elderly patients (69 females, 31 males, mean age: 70.27 years) with AF. Standardized research instruments were used including the Tilburg Frailty Indicator (TFI) to assess FS, and two questionnaires to assess depression including the Geriatric Depression Scale (GDS), and the Hospital Anxiety Depression Scale (HADS). RESULTS: Mild FS was found in 38% and moderate FS in 29% of patients. Based on GDS scores, depression symptoms were found in 51% of patients' sample. Based on HADS scores, 20% of patients were found to have anxiety symptoms, and 28% revealed depression symptoms. Single-factor analysis demonstrated a significant positive correlation between HADS anxiety symptoms (r=0.492), HADS depression symptoms (r=0.696), and GDS score (r=0.673) on the one hand, and overall TFI frailty score on the other. Multiple-factor analysis identified overall GDS score, education, and lack of bleeding as significant independent predictors of TFI scores (p<0.05). CONCLUSION: FS is common in the population of elderly patients with AF. We found evidence for the association between symptoms of anxiety and depression and the incidence of FS in this group of patients. Due to the risk of consequences which may in part be irreversible, screening for FS is recommended.

Psychometric evaluation of the Polish version of the Arrhythmia­Specific Questionnaire in Tachycardia and Arrhythmia: a new tool for symptom and health­related quality of life assessment.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia resulting in hospitalization. The assessment of symptoms and health­related quality of life (HRQoL) can provide valuable information before, during, and after health care interventions for AF. AIMS: We aimed to perform a translation and cultural adaptation of the Arrhythmia­Specific Questionnaire in Tachycardia and Arrhythmia (ASTA), and to evaluate the reliability and validity of its Polish version. METHODS: The standard forward­backward translation procedure to translate the ASTA questionnaire into Polish was used. A total of 244 patients with AF at a mean (SD) age of 70.7 (10.7) years completed the questionnaire and were included in the study. Reliability was tested using internal consistency (Cronbach α) and validity with an item­total correlation, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS: The ASTA symptom scale had satisfactory psychometric properties (α = 0.718), and the corrected item­total correlation was sufficient for most items (0.361-0.506), except for cold sweats (0.156). The ASTA HRQoL scale showed good psychometric properties (α = 0.855). Initial CFA analyses showed that the 1- and 2­factor models had similar properties, with strong factor loadings and satisfactory goodness­of­fit values according to the comparative fit index (0.947 for the 1­factor model vs 0.988 for the 2­factor model). A comparison of the 1­and 2­factor models showed that the close fit for the root­mean­square error of approximation was better for the 2­factor model (0.387 vs 0.193). A 2­factor EFA model was produced, and for factor 1 (physical scale), the varimax low ranged between 0.470 and 0.804, and for factor 2 (the mental scale), it ranged between 0.597 and 0.873. CONCLUSIONS: The psychometric properties of the Polish version of the ASTA questionnaire were overall found to be satisfactory.

Life satisfaction, job satisfaction, life orientation and occupational burnout among nurses and midwives in medical institutions in Poland: a cross-sectional study.

OBJECTIVES: To assess life satisfaction, job satisfaction, life orientation and the level of professional burnout in a group of professionally active nurses and midwives. DESIGN: A cross-sectional study. SETTING: This study was conducted between March and October of 2017 during specialisation training at the European Centre for Postgraduate Education in Wroclaw, Poland. PARTICIPANTS: A group of 350 professionally active nurses (n=293) and midwives (n=57) were enrolled in the study. OUTCOME MEASURES: Associations between burnout and selected life-related and job-related outcomes using (1) the Satisfaction With Job Scale, (2) the Satisfaction With Life Scale (SWLS), (3) the Life Orientation Test-Revised, (4) the Maslach Burnout Inventory and the Authors' Designed Questionnaire regarding sociodemographic factors. The level of statistical significance was set at p≤0.05 (with a CI of 95%). RESULTS: The vast majority of participants were those in the ages of 41-50 years old (40.57%), women (96.86%) and people with bachelor's degree (46.29%). The average overall rate for occupational burnout was 34.67 per 100 points. Assessment of occupational burnout subscale showed that the most significant factor was emotional exhaustion at 39.14 points (SD=28.15). Job satisfaction, life satisfaction and life orientation assessed with SWLS significantly affects each of the occupational burnout subscales (p<0.05). CONCLUSIONS: The level of occupational burnout in nurses and midwives appeared to be low. It has been revealed that such determinants as life satisfaction, job satisfaction and life orientation do not allow for developing an occupational burnout.

BeGuideWell: A prospective cross-sectional study analysing the awareness and opinions of nursing students in Poland on the usefulness of European Society of Cardiology guidelines in post-graduate education programme.

BACKGROUND: The role of clinical guidelines is to provide patients with the best quality, evidence-based care. Nurses are actively involved in the development of the European Society of Cardiology guidelines. A number of the guidelines include specific recommendations relating to nursing duties and, hence, nurses require necessary knowledge and skills for their implementation. Inclusion of the guidelines in the curricula for university nursing programmes could facilitate their implementation to everyday practice. AIM: The purpose of this study was to determine the awareness and opinions of Polish nursing students who participated in a guideline-based Master of Science education programme about the usefulness of the European Society of Cardiology guidelines. METHODS: A prospective and cross-sectional research design was used and Strengthening the Reporting of Observational studies in Epidemiology guidelines were followed. A total of 188 nursing students (mean age 31.18±10.41 years) who met the inclusion criteria were invited to complete the BeGuideWell survey. This instrument included 16 questions: five on participants' demographics and 11 addressing the issues associated with the European Society of Cardiology guidelines. The Yates chi-squared test or Fisher exact test were used for statistical analysis. RESULTS: The majority of students had become familiar with the diagnostics and treatment of acute and chronic heart failure. Nearly half of the students documented that they had never heard of the European Society of Cardiology guidelines before starting the Master of Science programme. Most students found the European Society of Cardiology guidelines helpful for their university education. Most respondents stated that the guidelines were useful in their everyday practice and believed that they contributed to better quality of patient care. CONCLUSIONS: Students can become more familiar with the European Society of Cardiology guidelines during the course of their post-graduate education, preparing them to implement the European Society of Cardiology guidelines in their everyday practice.

The effect of coping strategy on quality of life in patients with NSCLC.

BACKGROUND: A cancer diagnosis is a source of emotional distress. The aim of the study was to evaluate coping strategies in patients with non-small-cell lung carcinoma and to assess how coping strategies along with other factors affect their quality of life. PATIENTS AND METHODS: A total of 185 patients with non-small-cell lung carcinoma were enrolled in this observational, cross-sectional study. Demographic and clinical data were collected. Strategies for coping with cancer were assessed using a shortened version of the Mental Adjustment to Cancer (MiniMAC) scale. Health-related quality of life was assessed using the Short Form-8 Health Survey. RESULTS: Respondents (mean age: 62.84±9.6 years) most often emerged as using a fighting strategy, whereas a sense of helplessness was the strategy used least often. Overall, 65% of the respondents were revealed to have a medium level of constructive style of coping, whereas 62% had a medium level of destructive style. The coping style of nearly 50% of the respondents was predominantly constructive. Patients whose coping style was predominantly constructive had a significantly higher level of quality of life than patients whose coping style was predominantly destructive or whose results showed a balance between the two coping styles. Lung cancer patients had higher scores on the mental functioning scale (mental component summary = 50.20±39.26) than on the physical functioning scale (physical component summary = 40.07±28.58). CONCLUSION: The majority of lung cancer patients use effective strategies for coping with the disease, which correlates with a better quality of life; a compromised quality of life is associated with a destructive coping style. Physicians should endeavor to promote positive, constructive, problem-oriented strategies of coping, especially in patients with a compromised quality of life, where the disease is advanced and when there are comorbidities.

Psychometric evaluation of the Polish version of the Adherence to Refills and Medications Scale (ARMS) in adults with hypertension.

BACKGROUND: Only 50%-75% of chronically ill patients take their medication as prescribed. The patient is found to adhere to treatment correctly and optimally if they accomplish 80% or more of the treatment plan. A questionnaire titled the Adherence to Refills and Medications Scale (ARMS) has been used in studies involving various populations and proved to be a simple instrument for measuring adherence, with good psychometric properties. OBJECTIVE: The aim of this study was to develop a Polish version of the ARMS (ARMS-P), an instrument that identifies levels of adherence in the hypertensive population, and evaluate its psychometric properties. METHODS: This cross-sectional study included 279 patients, including 166 females (mean age 66.5 years), hospitalized between September 2016 and March 2017 in the Department of Internal Medicine, Occupational Diseases, and Hypertension of Wroclaw Medical University, Poland. The 12-item ARMS was translated from English into Polish. The 12 items included in the final questionnaire comprise two subscales: adherence to taking medications (eight items) and adherence to refilling prescriptions (four items). RESULTS: Patients in the good-adherence group were younger (P=0.017; P=0.048), more likely to be professionally active (P=0.041), better educated (P=0.037), and more likely to have normal blood pressure (P<0.001). They also measured their blood pressure more often (P<0.001), and took fewer pills in a day (P<0.001). Adherent patients were also more likely to take their medication on their own (P=0.016) and read information leaflets on the medication (P<0.001). The study demonstrated that the ARMS-P questionnaire has good psychometric properties that enable its use for assessing adherence in chronically ill patients, including in particular, patients with hypertension. CONCLUSION: The psychometric properties of the questionnaire are satisfactory (reliability measured by means of Cronbach's α). The ARMS-P questionnaire proved to be suitable for use in the Polish population. The use of this screening tool for the assessment of adherence to treatment is recommended in this population of hypertensive patients.

Symptoms, acceptance of illness and health-related quality of life in patients with atrial fibrillation.

INTRODUCTION: Acceptance of illness plays a key role, allowing the patient to adapt to the disease and its treatment, and to maintain their health-related quality of life (HRQOL) despite chronic conditions. AIM: The aim of the study was to assess the relationship between severity of arrhythmia symptoms, acceptance of illness and HRQOL in patients with atrial fibrillation. METHODS: The study included 99 patients (mean age 64.6) treated for atrial fibrillation. Three standardized instruments were used: the World Health Organization Quality of Life (WHOQoL-BREF) questionnaire, the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) and the Acceptance of Illness Scale (AIS). RESULTS: Patients with high illness acceptance levels obtained better results in all WHOQoL-BREF domains: physical (57.0±8.9 vs. 51.1±12.5 vs. 42.0±6.2; p<0.001), social (62.6±19.8 vs. 52.5±20.0 vs. 45.7±16.0; p=0.019) and environmental (62.9±12.7 vs. 52.7±7.6 vs. 60.7±3.6; p<0.001), and in the ASTA HRQOL scale (10.5±5.4 vs. 16.1±7.6 vs. 20.3±0.5; p<0.001). Multiple-factor analysis showed AIS to be a statistically significant independent determinant of HRQOL in the physical domain of the WHOQoL (ß=0.242) and in the overall HRQOL assessment in the ASTA HRQOL scale (ß= -0.362). Other statistically significant independent predictors included: the negative impact of female sex on the physical (ß= -0.291) and social (ß= -0.284) domains of the WHOQOL-BREF, and the positive impact of urban residence on the physical WHOQOL-BREF domain and on symptom intensity in the ASTA symptom scale. CONCLUSIONS: Acceptance of illness is an important factor which has been shown to impact on HRQOL in atrial fibrillation. Female sex is a predictor of worse HRQOL, while urban residence improves HRQOL in the physical domain and decreases symptom intensity (ASTA symptom scale).

The acceptance of illness, the intensity of pain and the quality of life in patients with lung cancer.

BACKGROUND: Lung cancer is the major cause of cancer related deaths worldwide. The overall 5-year survival rate is very low and accounts for only 15%. Poor quality of life is considered a prognostic factor for shorter survival in lung cancer patients. The aim of the study was to examine the relationships between pain, the acceptance of illness and quality of life in patients with lung cancer. METHODS: The study included 155 patients with lung cancer with mean age of 62.23 [standard deviation (SD)=9.86] years. We used the Acceptance of Illness Scale (AIS) and the Visual Analog Scale (VAS) for pain, and the Short Form Health Survey (SF-8) for the assessment of quality of life. For statistical analysis, Spearman's rank correlation coefficient and linear regression method were used. RESULTS: Mean score of the acceptance of illness was 27.1 (SD=9.2). Mean score of the pain severity as measured by the VAS was 4.07 (SD=1.83). The acceptance of illness was significantly positively correlated with all the domains of quality of life. Both the AIS and the VAS were independent determinants of physical and mental components of quality of life. Age and World Health Organization (WHO) performance status were additional predictors of physical component of quality of life. CONCLUSIONS: The knowledge about the acceptance of illness, consequences of the decreased acceptance of illness, and factors affecting its level in patients with lung cancer is still insufficient. Relationships among acceptance of illness, quality of life, and pain should be further investigated.