Assessment of Psychosocial Functioning of Polish Nurses during COVID-19 Pandemic.

(1) The COVID-19 pandemic has significantly affected the psychological well-being of people around the world. The aim of this study was to assess the levels of psychological distress of nurses (anxiety, depression, stress, insomnia) in relation to sociodemographic variables and psychosocial variables: self-assessment of health, quarantine, psychological support, presence of chronic diseases and the Impact of Events Scale (IES-R). (2) A total of 207 nurses working with COVID-19 patients at the Independent Public Clinical Hospital No. 1 of the Pomeranian Medical University in Szczecin participated in the study. The study was conducted with the diagnostic survey method, using the Athens Insomnia Scale, the Generalized Anxiety Disorder questionnaire, the Impact of Event Scale-Revised, the Patient Health Questionnaire-9, The Perceived Stress Scale and a questionnaire of our authorship. (3) Among the respondents, 40.58% suffered sleep disturbance, 36.71% had mild anxiety, 71.95% had high stress according to the PSS-10 and 31.88% had depression according to the PHQ-9. The study observed that the chances of insomnia decreased with the age of the respondents. Moreover, the form of employment of nurses significantly affected the levels of depression, anxiety and stress. (4) Education, gender and age were variables that significantly affected the severity of anxiety, depression and insomnia in the surveyed nurses working with patients with COVID-19.

Self-assessment of Rationing and Quality of Nursing Care.

BACKGROUND: Nursing care rationing has been a widespread problem in everyday nursing practice for many years. PURPOSE: The aim of this research study was to assess the prevalence of care rationing among nurses working in Poland. METHODS: The study was conducted among a population of 1310 nurses. To examine the dependencies between the sociodemographics and unfinished nursing care, the Polish adaptation of the Perceived Implicit Rationing of Nursing Care questionnaire and an investigator-developed questionnaire were used. RESULTS: The mean level of missed care was 1.16 (SD = 0.7). The significant predictors of care rationing were associated with the quality of patient care (ßstd = -.43, P < .001) and general work satisfaction (ßstd = -.15, P < .001). CONCLUSIONS: Job satisfaction and the quality of nursing care should be constantly monitored as these factors are significantly associated with the levels of care rationing.

Recurrent assessment of lymphocyte subsets in 32 patients with multisystem inflammatory syndrome in children (MIS-C).

BACKGROUND: Lymphopenia is a hallmark of multisystem inflammatory syndrome in children (MIS-C). We aimed to characterize lymphocyte subsets' shifts and their correlations with other severity markers of MIS-C. METHODS: In this prospective cross-sectional study, we performed peripheral lymphocyte phenotyping in 32 patients with MIS-C. We analyzed lymphocyte subsets at three time points of the disease: the acute (A), convalescent (B), and recovery (C) phases. Based on age-normalized lymphocyte counts, we distinguished two groups of patients: "the mild" (higher lymphocyte counts) and "the severe" (lower lymphocyte counts). In addition, we examined differences between these groups regarding other severity markers. RESULTS: In phase A, 84% of children had lymphopenia. Decreased absolute counts of CD3, CD4, and CD8 cells were observed in, respectively, 88%, 72%, and 84% of patients. The natural killer cells were decreased in 63% and CD19 in 59% of children. "The severe" group had significantly higher procalcitonin and troponin I levels and lower platelets and albumin. Moreover, "the severe" group had hypotension more frequently (73% vs. 20%, p = .008). In phase B, all lymphocyte counts increased, and 32% of children had lymphocytosis. The increase of CD3, CD4, and CD8 counts correlated with some laboratory severity markers (hemoglobin, procalcitonin, D-dimer, lactate dehydrogenase, N-terminal prohormone of brain natriuretic peptide, albumin), but not with steroid use. In phase C, most children had normal lymphocyte counts. CONCLUSIONS: Substantial shifts in lymphocyte counts during MIS-C apply most to T lymphocytes and correlate with the disease severity markers, particularly hypotension prevalence. A proportion of children with MIS-C develops transient lymphocytosis during convalescence.

Optimistic thinking, satisfaction with life and job and nursing care rationing: Multicentre study in Poland.

AIMS: The aim was to examine whether the level of optimism and job and life satisfaction is a differentiating factor from the level of implicit rationing of nursing care in a sample of Polish registered nurses. BACKGROUND: Satisfaction with life and job is reflected by greater effectiveness of nurses at work and creates a positive work environment, which in turn may modulate the level of implicit rationing of nursing care. METHODS: A cross-sectional multicentre research design was adopted, employing a representative sample of 1,010 registered Polish nurses identified between the beginning of January and the end of June 2019. Four self-report scales were used in this study: Basel Extent of Rationing of Nursing Care, Satisfaction with Life Scale, Satisfaction with Job Scale and Life Orientation Test-Revised. The results were analysed using the k-means method, Student's t test and two-way ANOVA. RESULTS: Optimistic thinking, and satisfaction with job and life exerted a significant effect on the level of implicit rationing of nursing care among Polish nurses. Nurses from the group 'pessimistic' were at higher risk of nursing care rationing than those from the group 'optimistic'. CONCLUSION: Strengthening of the personal competencies, providing support and responding to all identified needs might increase job satisfaction of nurses and hence reduce the risk of nursing care rationing. IMPLICATIONS FOR NURSING MANAGEMENT: Leadership modelling and training in positive thinking might be the methods to support nurses and to prevent nursing care rationing.

Promoting evidence-based practice - perceived knowledge, behaviours and attitudes of Polish nurses: a cross-sectional validation study.

Purpose. Evidence-based practice (EBP) is recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. The aim was to describe nurses' knowledge, behaviours and attitudes regarding EBP. Materials and methods. A cross-sectional approach was conducted during specialty state examinations in Poland in 2014 in a sample of 548 nurses. The self-completed reliable and valid evidence-based practice profile questionnaire (Australia) was used. Statistical analysis included Cronbach's α coefficient, analysis of variance, the Guttman split-half method and calculations in Statistica version 12. Results. Although the participants' beliefs about the benefits of EBP were high, their knowledge was relatively low. Statistically significant correlations were found between barriers and practice, knowledge and attitudes in relation to the level of nurses' education (p < 0.001 to p < 0.05). Total Cronbach's α coefficient was 0.970. Conclusions. Study findings highlight the importance of further supplementation of knowledge about EBP. The difficulties in using EBP in clinical practice are objective and require changes in the Polish system of nursing care. Additionally, life-long updating knowledge in the area of EBP by participation in various forms of postgraduate education can produce improvements in the knowledge, behaviours and attitudes of nurses in creating a positive EBP profile.

The prevalence and types of oral- and pharyngeal-stage dysphagia in patients with demyelinating diseases based on subjective assessment by the study subjects.

BACKGROUND: Studies show that dysphagia is a common problem in patients with demyelinating diseases. However, there are no published studies on dysphagia in this group of patients, which would include the individual phases or the safety and effectiveness of the swallowing process. OBJECTIVE: The main objective of this study was to assess the prevalence of swallowing disorders and to characterize them based on subjective assessment by the study subjects with multiple sclerosis and Devic's syndrome. METHOD: The study included 72 patients (47 F, 25 M). Patients at risk of dysphagia were identified using the DYMUS, EAT-10 and SDQ questionnaires. To assess the type of oral- and pharyngeal-stage dysphagia, questions in the questionnaires were classified into groups according to symptoms typical of each stage. RESULTS: The risk of dysphagia and the need for instrumental examination were identified in 37.5% of the study subjects. Pharyngeal-stage dysphagia (repeated swallowing, increased effort of swallowing, cough, a feeling of food sticking in the throat) was reported to occur at a significantly higher frequency. However, no differences were found between difficulty in swallowing liquids and difficulty in swallowing solid food. CONCLUSION: There is a need for further research, which should include a detailed dysphagia-oriented diagnosis, with a view to gaining a detailed insight into the pathophysiology of deglutition in this group of patients.

Psychometric properties of Authentic Leadership Self-Assessment Questionnaire in a population-based sample of Polish nurses.

AIM: The purpose of the study was to adapt and evaluate the psychometric characteristics of the Polish language version of the Authentic Leadership Self-Assessment Questionnaire intended for use among Registered Nurses. DESIGN: A cross-sectional study where the Authentic Leadership Self-Assessment Questionnaire was administered to a representative group of 3,299 Polish Registered Nurses was carried out between September and November 2017. METHODS: Linguistic-cultural adaptation of the ALSAQ was carried out according to the WHO guidelines. The following psychometric properties of the ALSAQ were evaluated: content validity (content validity index), theoretical relevance (exploratory and confirmative factor analysis), unidimensionality of subscales (principal component analysis), internal consistency (Cronbach's alpha), test-retest reliability and criterion validity. FINDINGS: The content validity analysis revealed a need to reduce the original ALSAQ version from 16-23 items. The factor structure of ALSAQ differed from the original version. A three-factor model was better fitted to the data than a four-factor model. The three distinguished subscales (moral processing, self-awareness, and relational transparency) were characterized by unidimensionality. ALSAQ has a good internal consistency (Cronbach's alpha 0.84) and test-retest analysis confirmed stability of the measurement for subscales and particular items. Moreover, the ALSAQ-P criterion validity with external variables, being of key importance for shaping the leadership skills (self-efficacy and universal moral foundations) was confirmed. CONCLUSIONS: Authentic leadership skills in nursing practice are characterized by their individual specificity, which was indicated in the ALSAQ validation. The ALSAQ can be considered a reliable and valid tool for self-assessment of leadership skills in a group of nursing practitioners. The identified standards help measuring strengths and weaknesses of authentic leadership.

Risk assessment of night-eating syndrome occurrence in women in Poland, considering the obesity factor in particular.

INTRODUCTION: Night-eating syndrome (NES) involves uncontrolled and most often repeated binge eating during the night. It is related with mood disorders as well as sleep disorders and it may cause obesity. Risks related to NES are obesity, binge eating disorder, bulimia nervosa, affective disorders, and sleep disorders. The objective of this study is to analyze eating habits in terms of the risk assessment of NES occurrence in the population of women in the Masovian Voivodeship (in Poland). PATIENTS AND METHODS: Six hundred and eleven women living in the Masovian Voivodeship participated in the study. The average age of the respondents was 22.7 years (median = 23.0; interquartile range = 3.0). The Night Eating Questionnaire (NEQ) was used to assess the risk of NES. RESULTS: In the studied group of women, 1.3% of cases (N = 12) reached a NEQ total score of ≥25, which indicates a probability of 40.7% for NES, while 0.7% (N = 4) reached a score of ≥30, which indicates a probability of 72.2% for occurrence of this syndrome. The highest average total score was observed in the group of obese people. The level of education of the participants did not significantly affect the NEQ score. A weak correlation was observed between the place of residence variable and the mood/sleep subscale (r = 0.11, P < 0.01). CONCLUSION: NES may be one of the causes of overweight and obesity; therefore, the need for further studies on this health issue is justified. It is worth pointing out that knowing the conditions responsible for the occurrence of NES, it is possible to suggest a prevention procedure for this condition.

[Attitudes of polish physicians towards extending competencies of nurses and midwives with respect to prescribing medicines].

INTRODUCTION: Due to the amendment of the Nurse and Midwife professions Act, since 1st of January 2016 Polish nurses and midwives with certain qualifications are able to prescribe medicines and referral for diagnostic tests. THE AIM: To analyse attitudes of physicians on new professional competencies of nurses and midwives regarding: prescribing medicines and referring patients for certain diagnostic tests. MATERIAL AND METHODS: In the study took part 436 physicians (245 women, 193 man). The average age was 36,6 years old (min.: 21; max.: 76; SD: 11,65; median: 31). 274 people lived in a city with over 500 thousand citizens, 70 people - city below 100 thousand citizens, 54 people - city between 100-500 thousands citizens and 14 people lived in a country. Most of people lived in masovian district. Authors prepared and validated own questionnaire, which contained statements assessed in Likert scale (1-strongly disagree, 5-stronlgy agree). It contained 22 questions about opinions of new abilities of nurses and midwives. The questionnaire was sent three times to Regional Medical Chamber in Warsaw via an online questionnaire: https://docs.google.com/forms/d/1cxiaJFPxDVphByhBTk4gDIBsm6bQsxGLVXDK-RtpGnk/ The reliability of the questionnaire used was tested in a pilot study by the coefficient α-Cronbach, which amounted to 0.937. Due to the fact that the study was performed in a group of doctors they did not require the consent of the Bioethics Committee, of Medical University of Warsaw to carry them out. The results are presented using descriptive statistics, which were obtained through statistical analysis using Microsoft Excel and StatSoft Statistica 12.0 (license Medical University of Warsaw). RESULTS: 53% of doctors claim that the new powers do not improve patient care. 35% of respondents disagreed with the opinion that the new powers will raise the prestige of professional nurses and midwives. At the same time 49% believe that prescriptions for nurses and midwives reduce the responsibilities of doctors. Only 9% agreed that the new abilities are needed in Poland. 65% of doctors have expressed the opinion that nurses and midwives should not have permission to prescriptions and 81% believe that they are not prepared for those abilities. CONCLUSION: Doctors have divided opinion about the benefits of the introduction of the nursing prescriptions for the patient. It is therefore, considered an information campaign through the mass media, or training in the workplace, where they will be presented in an objective manner the consequences of the introduction of new regulations.

NURSE PRESCRIBING. KNOWLEDGE AND ATTITUDES OF POLISH NURSES IN THE EVE OF EXTENDING THEIR PROFESSIONAL COMPETENCES: CROSS-SECTIONAL STUDY.

In Poland, since 1 January 2016 nurses who graduated from the master studies or hold a title of a specialist may ordain and prescribe specific medicines ("independent nurse prescribing" - INP). Nurses, who completed bachelor studies or hold a title of a specialist are allowed to prescribe drugs to continue the patient's treatment as ordered by a physician ("supplementary nurse prescribing" - SNP). The aim of this paper was to analyze the knowledge and attitudes of the Polish nurse specialists to their new professional rights in the independent ordaining of some drugs and drug prescribing. Participants were 902 women and 26 men. The age average was 42.4 (min. 26, max. 65, SD = 7.56, median: 43, mode: 40). 300 respondents - secondary medical education, 325 - the bachelor degree, 277 - the master degree. Own, validated questionnaire. Attitudes with answers based on the Likert scale (1-5) assessed by the nonparametric ANOVA Kruskal-Wallis test with the post-hoc analysis. The same statistical model was used in the evaluation of potential differences for the total scale of knowledge and attitudes.On average less than half of answers about the knowledge were correct (average of difficulty index was 39%). Nurses believe that the introduction of nurse prescribing will increase the nurse's control of the therapeutic process (mean: 3.22/5). No significant differences between the attitudes of respondents with different education level (p = 0.206; H = 3.160). 55% of nurses supports the introduction of INP. Respondents with the master education significantly more frequently support INP than those with secondary education (p = 0.001; z = 3.685). The knowledge of nurses on the extension of their professional rights is unsatisfactory and requires urgent complementation. The health policy makers should consider an extensive information campaign, especially in the group of nurses with advanced practice who will have prescribing competences. Nurses' attitudes to nurse prescribing are generally positive. Concerns expressed are the same as in the opinions of nurses from countries where the professional rights underwent extension earlier.

[Reliability and validity of assessment of educational outcomes obtained by students of Medical Rescue at Medical University of Warsaw].

INTRODUCTION: In the interest of preservation of high degree of objectivity of information about students' educational outcomes, a system of assessment needs to meet criteria of appropriate reliability and validity. THE AIM: Analysis of reliability and validity of the system of assessment of students' educational outcomes for courses followed by an examination and covered by a curriculum in Medical Rescue at Medical University of Warsaw (MU W). MATERIALS AND METHODS: A retrospective study enrolling a group of 421 students of eight subsequent full education cycles. Detailed data concerning grades for fourteen courses followed by an examination in the entire course of studies were collected. Reliability (Cronbach's alpha coefficient) and criteria validity (Spearman's rank correlation) were assessed. Internal consistency was estimated using a multiple regression model. RESULTS: The levels of assessment reliability for the general university, pre-clinical, and clinical scopes amounted to alpha: 0.42, 0.53, and 0.70, respectively. The strongest positive correlations between the results of pre-clinical and clinical trainings were found for the Anatomy course (r ≈ 0.30). Only in the case of the Pharmacology course it was found that students' achievements in this field were significantly correlated with all other courses of clinical training. The influence of educational outcomes in particular areas of clinical training on the final grade for the entire course of studies was diverse (ß regression between 0.04 and 0.11). While the Pharmacology course had the strongest impact on final results, the Surgery course had the least influence on students' final grades (ß = 0.04). CONCLUSIONS: 1. Sufficient reliability of the system of assessment of educational outcomes in Medical Rescue showed good precision and repeatability of assessment. 2. A low level of validity was caused by a failure to keep the appropriateness of the assessment of educational outcomes in several clinical courses. 3. Prognostic and diagnostic validity of methods used for evaluation of competencies of Medical Rescue students at WMU needs to be assessed in the future.