Mothers' Attitudes Towards Breastfeeding in Terms of Health Safety and Professional Lactation Education: A National Survey of Women.

Introduction and Objective: An important role in building opinions and attitudes regarding breastfeeding by mothers is played by the medical staff taking care of the mother woman expecting a baby. Breastfeeding is a standard in infant nutrition. The knowledge and support of the medical staff can help a woman make the decision to breastfeed. At the same time, it creates conditions for an optimal working environment for medical staff, affecting the quality of care. The aim of the study was identify mothers' attitudes towards breastfeeding in the context of health safety and professional lactation education. Materials and Methods: Data for the study were obtained on the basis of a proprietary questionnaire and a standardized research tool, which was the questionnaire for assessing knowledge and attitudes towards breastfeeding The Iowa Infant Feeding Attitude Scale designed by Arlene De la Mora (IIFAS). The study involved 439 women who gave birth to a child in the last 5 years. Results: Extensive knowledge about the benefits of breastfeeding for the child's body is declared by 67.9% of women. The vast majority of respondents (94.1%) pointed to supporting the development of the immune system. Most women (85%) obtained information on breastfeeding from the Internet, and 58.5% from medical personnel. Most respondents (88.8%) assessed their partner's attitude towards breastfeeding as positive. The result, The Iowa Infant Feeding Attitude Scale was equal to 50.97, which proves the positive attitude of women to breastfeeding. Conclusion: Promoting the best way to feed children, which is breastfeeding, plays an important role in building mothers' opinions and attitudes about breastfeeding.

How A Patient with Resectable or Borderline Resectable Pancreatic Cancer should Be Treated-A Comprehensive Review.

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with high morbidity and mortality in which long-term survival rates remain disastrous. Surgical resection is the only potentially curable treatment for early pancreatic cancer; however, the right patient qualification is crucial for optimizing treatment outcomes. With the rapid development of radiographic and surgical techniques, resectability decisions are made by a multidisciplinary team. Upfront surgery (Up-S) can improve the survival of patients with potentially resectable disease with the support of adjuvant therapy (AT). However, early recurrences are quite common due to the often-undetectable micrometastases occurring before surgery. Adopted by international consensus in 2017, the standardization of the definitions of resectable PDAC (R-PDAC) and borderline resectable PDAC (BR-PDAC) disease was necessary to enable accurate interpretation of study results and define which patients could benefit from neoadjuvant therapy (NAT). NAT is expected to improve the resection rate with a negative margin to provide significant local control and eliminate micrometastases to prolong survival. Providing information about optimal sequential multimodal NAT seems to be key for future studies. This article presents a multidisciplinary concept for the therapeutic management of patients with R-PDAC and BR-PDAC based on current knowledge and our own experience.

Management of Metastatic Pancreatic Cancer-Comparison of Global Guidelines over the Last 5 Years.

Pancreatic cancer (PC) is usually diagnosed at an advanced stage of its development, which results in lower overall survival (OS). Prognosis is also poor even with curative-intent surgery. Approximately 80% of patients with localized PDAC have micrometastases at the time of diagnosis, which leads to a worse prognosis than in other cancers. The objective of this study is to present the progress in the treatment of metastatic pancreatic cancer based on the recommendations of oncological scientific societies, such as ESMO, NCCN, ASCO, NICE and SEOM, over the last 5 years. Combined FOLFIRINOX therapy is mostly a recommended therapy among patients with good performance statuses, while gemcitabine is recommended for more fragile patients as a first-line treatment. The newest guidelines suggest that molecular profiling of the tumor should be the first step in determining the course of treatment. The use of modern molecular therapies in patients with specific gene mutations should extend the survival of patients with this disease.

Evaluation of Health Pattern and Stress Levels among Patients Undergoing Alcohol Addiction Treatment-A Cross Sectional Study.

Alcohol consumption is linked to over 200 diseases and injuries. It is also classified as a risk factor for several types of neoplasms as well as infectious diseases (i.e., HIV and tuberculosis). In 2019, among people aged 25 to 49, alcohol use was the leading risk factor for attributable burden of disease. There are many factors that affect alcohol drinking patterns such as social and economic status, social norms, cultural customs, availability of alcohol, etc. Stress also plays a significant role in the process of developing alcohol addiction. The aim of our study was to examine health patterns and stress levels among patients undergoing alcohol addiction treatment. The study sample consisted of 104 patients who were treated in a hospital ward due to alcohol dependence. Three standardized questionnaire tools were used to measure the sense of coherence and the level of stress among those patients. The main results suggest that the level of perceived stress correlated negatively with all dimensions of sense of coherence and all indicators of health behaviors, however, age was positively correlated with positive mental attitude, proper eating habits, and health behaviors. In conclusion, it is worth noting that developing patterns for positive health behaviors will make it possible to avoid alcohol dependence or reinforce the treatment results if alcohol dependence syndrome occurs.

Evaluation of Nutritional Status and the Impact of Nutritional Treatment in Patients with Pancreatic Cancer.

Patients with pancreatic cancer who develop irreversible cancer cachexia have a life expectancy of less than 3 months. Therefore, it is extremely important to evaluate the patient's nutritional status as early as possible and to implement an appropriate nutritional intervention in order to reduce the risk of further weight loss and/or muscle loss, which affect the outcomes of cancer treatment and the correct nutritional treatment in patients with pancreatic cancer. A literature review was performed by using the PubMed and Cochrane quick search methodology. The main purpose of this review was to present the current approach to nutritional treatment in pancreatic cancer. The review included publications, most of which concerned clinical nutrition as part of the phase of treatment of patients with pancreatic cancer, nutritional and metabolic disorders in pancreatic cancer, and the period after pancreatic resection. Some of the publications concerned various nutritional interventions in patients with pancreatic cancer undergoing chemotherapy or surgical treatment (nutritional support before surgery, after surgery, or during palliative treatment). There is an unmet need for integrated nutritional therapy as a key part of the comprehensive care process for PC patients. Nutritional counseling is the first line of nutritional treatment for malnourished cancer patients, but pancreatic enzyme replacement therapy also constitutes the cornerstone of nutritional treatment for relieving symptoms of indigestion and maintaining or improving nutritional status.

Overview of Pancreatic Cancer Epidemiology in Europe and Recommendations for Screening in High-Risk Populations.

Pancreatic cancer is the seventh most common cause of death in the group of oncological diseases. Due to the asymptomatic course, early diagnosis is difficult. Currently, early detection methods are only used in high-risk groups. A literature review based on the available results of observational studies on patients with pancreatic cancer and people from high-risk groups was used to summarize the knowledge on risk factors. The GLOBOCAN 2020 data were used to assess the epidemiological situation in Europe. A summary of screening recommendations was prepared based on the available documents from medical organizations and associations. Pancreatic cancer risk factors are divided into two main groups: non-modifiable factors, e.g., hereditary factors and age, which increase the risk of developing this disease, and modifiable factors-BMI, smoking, and alcohol consumption. Hereditary factors account for 10% of pancreatic cancer cases. The highly specialized methods of early detection, (MRI, CT, or EUS) are used for screening high-risk populations. Of all the imaging methods, EUS is considered the most sensitive for pancreatic cancer and allows an accurate assessment of the size of even small lesions (<30 mm) and the extent of tumour infiltration into blood vessels. The available studies vary on the level of sensitivity and specificity of these methods for the diagnosis of pancreatic cancer. EUS, MRI, and CT are also expensive procedures and in some patients can be invasive, which is one of the arguments against the introduction of population screening programs based on imaging methods. Therefore, it is important to look for viable solutions that would improve early detection. This is important from the point of view of healthcare systems in Europe, where almost 29% of all global pancreatic cancer cases are reported.

Patient satisfaction with oncological care during the virus pandemic - SARS-CoV-2 taking into account social and demographic factors.

INTRODUCTION AND OBJECTIVE: The aim of the study was to examine the perception of medical services by oncological patients during the pandemic, identifying the key factors influencing it. The assessment of patient satisfaction with the treatment and care provided by doctors and other hospital staff provides important information on the quality of health services. MATERIAL AND METHODS: The study involved 394 patients diagnosed with cancer treated as inpatients in five oncology departments. The diagnostic survey method was used with a proprietary questionnaire and the standardized EORTC IN-PATSAT32 questionnaire. Calculations were carried out using Statistica 10.0 with p≤0.05 s considered statistically significant. RESULTS: Overall patient satisfaction with cancer care was 80.77/100. Higher values were shown for the competences of nurses than for doctors, especially for their interpersonal skills (79.34 - nurses vs. 74.13 - doctors) and availability (80.11 - nurses vs. 75.6 - doctors). It was also shown that the level of satisfaction with cancer care increased with age; women rated cancer care lower than men (p = 0.031), particularly its aspect related to the competences of doctors. A lower degree of satisfaction was observed among rural residents (p=0.042). Other demographic data, such as marital status and education, determined satisfaction with cancer care on the selected scale although it did not affect the overall level of satisfaction. CONCLUSIONS: The analysed socio-demographic factors, primarily age, gender and place of residence, determined some of the scales concerning patient satisfaction with cancer care during the COVID-19 pandemic. The results of this and other studies of a similar profile should be used in the formation of health policy, particularly in implementing programmes to improve the quality of cancer care in Poland.

Treatment Costs and Social Burden of Pancreatic Cancer.

(1) Background: Pancreatic cancer is the cancer with the third-highest mortality rate, and forecasts indicate its growing share in morbidity. The basis of treatment is inpatient chemotherapy and there is a strong focus on palliative care. (2) Methods: A literature review was conducted based on the rapid review methodology in PubMed and Cochrane databases. The search was supplemented with publications from the snowball search. Qualitative assessment of included publications was performed using AMSTAR2 modified scheme. (3) Results: The review included 17 publications, of which majority concerned direct costs related to the adopted treatment regimen. Most of the publications focused on comparing the cost-effectiveness of drug therapies and the costs of palliative treatment. Other publications concerned indirect costs generated by pancreatic cancer. They particularly focused on the economic burden of lost productivity due to sickness absence. (4) Conclusion: The increase in the incidence of pancreatic cancer translates into an increase in the costs of the health care system and indirect costs. Due to the significant share of hospitalization in the health care structure, direct costs are increasing. The inpatient treatment regimen and side effects translate into a loss of productivity for patients with pancreatic cancer. Among gastrointestinal cancers, pancreatic cancer generates the second largest indirect costs, although it has a much lower incidence rate than the dominant colorectal cancer. This indicates a significant problem of the economic burden of this cancer.

Quality of Life in Patients with Pancreatic Cancer-A Literature Review.

Pancreatic cancer is the malignant disease with the highest mortality rate, and it ranks third in the world after lung and colon cancer. Identified factors that increase the risk of developing pancreatic cancer include chronic pancreatitis, radiation therapy to the pancreatic area due to another cancer, diabetes mellitus, obesity, smoking, and age. The objective of this study was to present the current state of knowledge on the quality of life of patients diagnosed with pancreatic cancer, factors that determine QoL, and ways of coping with the disease. The low curability and low survival rates of pancreatic cancer significantly affect the quality of life of patients, often in the form of significant deterioration, especially in terms of mental changes, cognitive functions, and coping with the disease. Cognitive decline with comorbid depression is also typical for patients with this type of cancer. Research has shown that the health-related quality of life of patients with pancreatic cancer is low, so further research is needed to improve the situation in this area.

Nutritional Treatment of Patients with Colorectal Cancer.

Colorectal cancer is one of the most common cancers in Europe and the world. Cancer treatments have side effects and cause significant deterioration of the patient's nutritional status. Patient malnutrition may worsen the health condition and prevent the deliberate effects of the therapy. The aim of this review was to describe the available data about clinical nutrition in colorectal cancer patients. A large proportion of colorectal cancer patients suffer from malnutrition, which negatively affects the survival prognosis, quality of life, and oncological therapy. Therefore, monitoring nutritional status during the treatment is essential and can be used to arrange proper nutritional therapy to enhance patient responses, prevent side effects, and shorten recovery time. The principles of nutrition during anticancer therapy should mainly consider light and low-fat foods, the exclusion of lactose and gluten-containing foods in certain cases, or the introduction of special dietary products such as oral nutrition supplements and it should be tailored to patients' individual needs.

Pain Management Strategies among Cancer Patients. Normalization of the CSQ (The Pain Coping Strategies Questionnaire) Form.

INTRODUCTION: Cancer is associated with chronic pain, which significantly reduces the quality of life. The level of pain depends on the dominant pain management strategy that the patient uses. OBJECTIVE: This study seeks to evaluate the application of the Pain Coping Strategies Questionnaire among cancer patients and develop norms allowing differentiation of patients with diagnosed cancer in terms of pain management strategies. MATERIAL AND METHODS: The study involved 1187 patients diagnosed with malignant cancer, who are under outpatient care of the Maria Sklodowska-Curie Institute-Oncology Center in Warsaw. The study used the Pain Coping Strategies Questionnaire (CSQ) elaborated by A.K. Rosentel and F.J. Keefe. RESULTS: Socioeconomic variables and medical factors affect pain management strategies chosen by patients. The area most strongly differentiated by the studied variables is praying/hoping. Factors that have the greatest impact on the choice of pain management strategies for cancer patients include education, income, and radiation therapy. Sten standards were developed to determine the severity of pain management strategies used in the low-average-high categories. CONCLUSIONS: The CSQ questionnaire should be used in cancer patients, and the result of the strategy used can be a prognostic factor for the expected effects of therapy. Knowledge of the variables most strongly affecting patients' choice of strategies that are not conducive to strengthening health attitudes and the ability to determine the severity of pain management strategies on standard scales allows us to focus psychotherapeutic activities on patients who need support most.

Pain Control: Normalization of the BPCQ Questionnaire on a Group of Patients Diagnosed with Malignant Cancer.

The purpose of this article is to examine the applicability of the Beliefs about Pain Control Questionnaire (BPCQ) among cancer patients and develop norms that allow differentiation of patients with diagnosed cancer in terms of beliefs about pain control. Normalization aims to establish the value of test results in the study population. The study involved 1187 patients diagnosed with cancer in outpatient care Maria Sklodowska-Curie Cancer Center and Institute of Oncology, in Warsaw. The applied tool was the Beliefs about Pain Control Questionnaire developed by S. Skevington. The results are most strongly differentiated in each dimension of pain control by education, income, and professional status. Sten norms were developed to determine the level of beliefs about pain control in low, average, and high categories. The BPCQ assessment applies to cancer patients, and the assessment of the location of pain control in patients will allow for the identification of patients whose standard therapy should be supplemented with psychotherapeutic support.

Patient Satisfaction with Oncological Care during the SARS-CoV-2 Virus Pandemic.

Recently, the outbreak of the SARS-CoV-2 virus and the COVID-19 pandemic significantly affected the health situation of the entire society and necessitated reorganization of health care including oncology. The objective of this study was to examine the perception of medical services by cancer patients during the pandemic and to identify the key elements influencing the level of satisfaction with oncological care. Of note, 394 patients diagnosed with cancer treated in inpatient oncology wards participated in the study (Poland). The diagnostic survey method was used. A survey questionnaire developed by the authors was used and validated the EORTC IN-PATSAT32 questionnaire. The calculations were made in Statistica 10.0 (Statsoft; 2011, Dell Inc., Round Rock, TX, USA). The average general level of satisfaction with oncological care in the study group was 80.77 out of a total score of 100, representing the highest level of satisfaction. Levels of satisfaction varied according to time since diagnosis (longer time-greater satisfaction) and were lower where treatment was delayed or perceived as disorganised. Nearly half of the respondents felt the threat of the SARS-CoV-2 infection, despite the fact that most of them believed that the hospital was well prepared to diagnose and treat cancer patients during the COVID-19 pandemic. Convincing patients about the proper preparation of health care for diagnostics and therapy is an important element influencing patient satisfaction with oncological care.

Impact of Time to Initiation of Treatment on the Quality of Life of Women with Breast Cancer.

INTRODUCTION: Breast cancer is the most common malignancy in women. Due to the large number of women living with breast cancer and the increasing incidence of this cancer, it is very important to understand the factors determining the quality of life (QOL) of patients. THE AIM OF THE STUDY: The aim of the study was to determine the impact of time to initiation of treatment on the quality of life of women with breast cancer. MATERIALS AND METHODS: The study involved 324 women with breast cancer, treated at the Podkarpackie Oncology Centre in Brzozów, Poland. The study was conducted using a diagnostic survey, using a standardised questionnaire to measure the quality of life of women treated for breast cancer, i.e., the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C30 and the QLQ-BR23 module, as well as a proprietary survey questionnaire. Statistical analysis was performed using the Statistica 10.0 software (StatSoft Inc., 2011). A p value of <0.05 was considered statistically significant. RESULTS: The examined women had a reduced overall quality of life and health (M = 53.88). The quality of life was higher in women who consulted a doctor the earliest after noticing initial symptoms of the disease, i.e., up to one week (M = 57.58), compared to patients who delayed the decision (over four weeks; M = 47.8) (p = 0.002). The quality of life was also considered higher by women who received treatment within two weeks of diagnosis (M = 56.79) and was lower for patients who waited for treatment for more than two months (M = 43.68). Statistically significant relationships were demonstrated for functional scales and disease intensity. CONCLUSIONS: Women diagnosed with breast cancer had a considerably lower overall quality of life. A relatively higher quality of life was experienced by patients who consulted a doctor the earliest after discovering symptoms of the disease and those whose waiting time for treatment was shorter. In a systematic manner, the individual stages of diagnosis should be maximally reduced and breast cancer treatment initiated without delay.

Exposure to Environmental Tobacco Smoke (ETS) among Employees of Hospitality Venues in the Light of Changes in Anti-Tobacco Legislation in Poland.

Introduction: Numerous studies conducted in Europe and worldwide have indicated that employees of hospitality venues are the most exposed professional group to environmental tobacco smoke (ETS) in the workplace. The purpose of this study was to assess the exposure of employees of hospitality venues to ETS in the light of changes in anti-tobacco legislation in Poland. Materials and methods: The study consisted of two stages. The first stage was conducted in 2010, while the second in 2015. The study was conducted among employees of 300 randomly selected hospitality venues in the city of Lódz (Poland). In total, 2607 questionnaires were analysed. The study used two survey questionnaires created and recommended by the Institute for Global Tobacco Control to study exposure to ETS. Statistical analysis was made with Statistica 13.1 PL (StatSoft, Poland). Results: In the group of all nonsmoking employees, individuals exposed to ETS at work in 2010 accounted for 72.6%; while in 2015 it was 51.8%. Factors affecting exposure to ETS in the workplace included, among others: age, marital status, education, position held, presence of a smoking room on the premises, and noncompliance with the provisions of the anti-tobacco laws. Conclusions: The prevalence of tobacco smoking among employees of hospitality venues decreased in 2010-2015, however, it remained high. More than half of nonsmoking employees were exposed to ETS at work.

Quality of Life of Women with Breast Cancer and Socio-Demographic Factors.

BACKGROUND: Breast cancer treatment is an aggressive therapy that affects the deterioration of women's quality of life (QOL) in many areas. Knowledge about factors that influence the assessment of the QOL is of particular importance. The aim of the study was to analyse areas of the quality of life of women with breast cancer, taking into account social and demographic factors. METHODS: The research was carried included 324 women with breast cancer. The research was carried out using a diagnostic survey, the author's questionnaire and a standardized questionnaire for measuring the QOL of women treated for breast cancer, ie the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire (EORTC) QLQ-C30 and QLQ-QLQ module BR23. Statistical analysis uses Statistica 10.0 software. The results were considered statistically significant when the calculated probability met the inequality of p.

Causes of delays in breast cancer diagnosis in Poland.

Breast cancer is the most common malignant tumor in women. The results of breast cancer treatment to a large extent depend on the time of the primary diagnosis of the disease. AIM: The aim of this study was to determine the most common causes of the delay and the delay time in the diagnosis of breast cancer in Polish women. MATERIALS AND METHODS: The study was performed using a diagnostic survey and analysis of medical documentation from the Subcarpathian Regional Oncology Center, Poland. A total of 231 patients with diagnosed breast cancer were recruited to the study. RESULTS: Delays in diagnosing of breast cancer were found in 83.1% of all the patients. The average time from the first symptom observation by a woman to the first medical consultation was on average 61.7 days. The most common cause of the delay in medical consultation in the examined group was a fear of diagnosing cancer (31.2%). CONCLUSIONS: The examined women require permanent health education in the field of breast cancer and the importance of early diagnosis of the disease for the effectiveness of treatment and prognosis.

[Therapy delays among women with diagnosed breast cancer and chosen sociodemographic factors]. / Opóznienia w leczeniu kobiet z rozpoznaniem raka piersi a wybrane czynniki demograficzne i spoleczne.

BACKGROUND: Up to now, there have been very few studies concerning delay issues in the treatment of breast cancer in Poland. The aim of the study was to determine the time and causes of delay in the treatment of women diagnosed with breast cancer and the importance of demographic and social factors on the occurrence of delays in the implementation of therapy. MATERIAL AND METHODS: The study was conducted in 2015-2016 in the Podkarpackie Oncology Centre in Brzozów for a group of 231 women. The time criterion of the delays in the treatment of women suffering from breast cancer was more than 1 month from the first oncological consultation to therapy initiation. The diagnostic poll method and medical documentation analysis were used. Research tools included a survey questionnaire and research protocol. The collected material was subjected to the statistical analysis using the χ2 test. The values of p < 0.05 were considered statistically significant. RESULTS: Delays were noted in 62.8% of the study participants and the mean delay time took 12.6 weeks. The main causes of the delays were: fear that the diagnosis would be confirmed, long waiting time for specialist investigations and their results, age, marital status and professional activity. No statistically significant correlation was found between profession, education level and the place of residence with therapy delays. CONCLUSIONS: Delays in the treatment of breast cancer patients were noted in the majority of study participants. A correlation was observed between the delays and chosen sociodemographic factors. Med Pr. 2019;70(1):89-98.

Surgical method of treatment and level of satisfaction with life among women diagnosed with breast cancer, according to time elapsed since performance of surgery.

INTRODUCTION: In women diagnosed with breast cancer one of the methods most commonly applied in therapy is surgical treatment, which consists in a breast conserving surgery or total removal of the breast. The applied type of surgical treatment may exert an effect on the satisfaction with life of the women. OBJECTIVE: The aim of the study was evaluation of the satisfaction with life among women surgically treated for breast cancer, according to the type of surgery on the breast, and the time elapsed since its performance. MATERIAL AND METHODS: The study included 121 patients of the Sub-Carpathian Oncology Centre in Brzozów, south-east Poland, who had undergone surgical treatment due to breast cancer. The women expressed their informed consent to participate in the study. The method of a diagnostic survey was applied. RESULTS: The women obtained a mediocre result in satisfaction with life - 5.64 sten scores. Patients who had undergone mastectomy had a considerably lower level of satisfaction with life, compared to those after breast-conserving surgery (4.73 sten scores vs. 6.30 sten scores). Evaluations of the satisfaction with life in the examined group significantly differed according to the time elapsed since performance of surgery. CONCLUSIONS: There is a need for undertaking actions directed to women who have undergone surgical treatment for breast cancer within the period from 2-5 years, aimed at improving the satisfaction with life in this group of patients. In addition, special support should be provided for women who have undergone mastectomy, especially during the period of more than 1 and up to 2 years.

Satisfaction with life among women with breast cancer - selected demographic and social factors.

OBJECTIVE: The aim of the study was evaluation of satisfaction with life among women ill with breast cancer, with consideration of selected demographic and social factors. MATERIAL AND METHODS: In the study participated 121 patients from the Sub-Carpathian Oncology Centre in Brzozów, Poland, who had undergone surgical treatment due to breast cancer. The method of a diagnostic survey was used. The research instruments were an author-constructed questionnaire and the Satisfaction with Life Scale. RESULTS: Women who received surgical treatment due to breast cancer evaluated their satisfaction with life on a mediocre level. Younger patients had a lower satisfaction with life than those who were older. Women living in urban areas evaluated their satisfaction with life in more positive terms than rural women. In turn, education level, marital status and material standard had no effect on the level of satisfaction with life among the women in the study. CONCLUSIONS: According to the SWLS, women with the diagnosis of breast cancer obtained a mean result of 5.64 sten scores Younger women evaluated their satisfaction with life in more positive terms than those who were older. Women who lived in urban areas obtained a considerably higher result according to the SWLS, compared to rural inhabitants. Marital status, education level, material standard and occupational activity of the women were insignificant in the respondents' evaluation of satisfaction with life.