Validation Study of the Revised Spirituality and Spiritual Care Rating Scale (SSCRS): A Cross-Sectional Survey in Poland.

Introduction: The use of a validated scale, Spirituality and Spiritual Care Rating Scale (SSCRS) to measure nurses' perceptions of spirituality and spiritual care. Aim: The purpose of this study was to analyse selected psychometric properties of the Polish version of the SSCRS, among them the applicability of the dimensions of spiritual care in nursing, ie, spirituality, spiritual care, religiosity and personalized care, to Polish conditions. Methods: Poland-wide multicentre study with a cross-sectional validation design. The study was conducted between March and June 2019. Seven Polish Nursing Faculties accepted the invitation to participate in the study. A representative sample of 853 nurses enrolled in MSc (postgraduate) programs in nursing participated. After translation and cultural adaption of the SSCRS, the instrument underwent a full psychometric evaluation of its construct validity using (exploratory and confirmatory factor analysis), internal consistency (Cronbach's alpha and correlation analysis), reliability (test-retest analysis), known-group validity (Student's t-test) analysis. Results: The exploratory and confirmatory factor analysis demonstrated that the Polish version of the SSCRS was a three-factor model with "Activity-centred spiritual care" (9 items), "Emotional support-centred spiritual care" (5 items) and "Religiosity" (3 items) domains. The Cronbach's alpha coefficient for the whole scale was 0.902, and the alpha values for the individual domains were 0.898, 0.873 and 0.563, respectively. The three domains mentioned above seemed to provide a comprehensive understanding of spiritual care perceived subjectively by Polish MSc in nursing students. Conclusion: This study demonstrated a substantial degree of similarity in the selected psychometric characteristics of the Polish version of SSCRS and the original scale.

Selenium as a Factor Moderating Depression and Obesity in Middle-Aged Women.

The aim of this study was to evaluate the effect of serum selenium on PPAR-γ and the selected proinflammatory cytokines (IL-1ß, IL-6, TNF-α) in relation to depressive symptoms and obesity in middle-aged women. The research procedure was as follows: a survey was performed using the authors' questionnaire and the BDI, anthropometric measurements, and the analysis of blood for the levels of selenium, cytokines, and genetic analysis of the PPAR-γ polymorphism (n = 443). It was found that the BMI increased along with the concentration of IL-6. No moderating effect of selenium was observed, although the cut-off values for "p" were established for IL-ß*Se (p = 0.068) and IL-6*Se (p = 0.068), so there was a potential association with these two markers. At high selenium levels, the effect of higher IL-ß levels on a decrease in BMI was stronger, as was the effect of an increase in IL-6 levels on an increase in BMI. No effect of selenium on PPAR-γ was found in relation to depressive symptoms and obesity. Higher selenium levels may have a beneficial effect on BMI even at high IL-ß concentrations, however, at high IL-6 concentrations, this effect was not observed. Selenium levels had no impact on depressive symptoms.

Selenium as a predictor of metabolic syndrome in middle age women.

BACKGROUND: Selenium plays an important role in metabolic homeostasis. It has been suggested that it may also affect the expression and activity of PPAR-γ. The aim of study was to analyze the relationships between these variables in the context of the health of women, for whom the risk of MetS increases with age. MATERIAL AND METHODS: The study involved 390 women in middle age. The stages of study: a survey-based part; anthropometric measurements; analysis of biological material (blood) in terms of glycemia, triglyceride, HDL, and selenium levels, as well as genetic analysis of the PPAR-γ polymorphisms. RESULTS: It was found that selenium may moderate the effect of the G allele of the PPAR-γ gene on the occurrence of elevated waist circumference (OR=1.030, 95%CI 1.005-1.057, p=0.020); and the effect of the C (OR=1.077, 95%CI 1.009-1.149, p=0.026) and the G alleles (OR=1.052, 95%CI 1.025-1.080, p<0.000) on the odds of elevated blood pressure. Women in whom HDL levels were not significantly reduced, had higher selenium levels (p=0.007). CONCLUSIONS: 1. The effect of selenium on MetS and its components has not been demonstrated. 2. The effect of individual alleles of the PPAR-γ gene on MetS and its components was not demonstrated. 3. The concentration of selenium may affect waist circumference in carriers of the G allele, and arterial hypertension in carriers of the C and G alleles by affecting the expression of PPAR-γ. 4. Higher selenium concentrations increased the odds of higher HDL levels in the group of subjects meeting the MetS criteria.

Perceiving the Role of Communication Skills as a Bridge between the Perception of Spiritual Care and Acceptance of Evidence-Based Nursing Practice-Empirical Model.

Decision making using evidence-based practice (EBP) is generally universally accepted by nurses. Such acceptance may affect the personnel's behaviour towards patients, which is also demonstrated by taking into consideration the patient's preferences, including the patient's spiritual needs, in the care plan. The provision of such care requires the development of an attitude of approval and an adequate level of communicative competence, which will enable the actual implementation of the EBP. The purpose of our study was to assess the perception of spirituality and the nurse's role in providing spiritual care, as well as the perception of the significance of communication skills in the approval of EBP in professional practice. A multi-centre cross-section study was conducted on a population of 1176 participants (459 undergraduate (bachelor's programme, BP) and 717 postgraduate students (master's programme, MP)) from 10 medical universities in Poland. Three tools were used in the study to evaluate the participants' approach: Evidence-Based Practice Competence Questionnaire (EBP-COQ), The Spirituality and Spiritual Care Rating Scale (SSCRS), and Communication Skills Attitude Scale (CSAS). Structural equation modelling was used for the analysis. An analysis of structural equations revealed the presence of positive relationships of the attitude to spiritual care and the role of communicative competences with the approach to EBP regardless of the cohort. A significant difference was found related to the influence of age on the attitude towards learning communicative competences. The approval in this respect was observed to decrease with age in the MP group. Increasing approval of EBP requires strengthening the approach to activity-centred spiritual care, with the simultaneous development of a positive attitude towards learning communicative competences. The model reveals the need to integrate a humanistic approach with EBP, which can be achieved by planning different interventions in different groups of recipients: nurses, academic teachers and students.

Overall Survival in Patients with Hepatocellular Carcinoma Treated with Sorafenib: A Polish Experience.

BACKGROUND The mortality caused by hepatocellular carcinoma is expected to rise in the upcoming decade. Sorafenib has become the preferred systemic treatment option in patients with unresectable HCC. This study aimed to present the median overall survival (OS) in a group of patients with advanced HCC, treated with sorafenib in Poland between 2011 and 2019. MATERIAL AND METHODS The analyzed group of patients was qualified for treatment with sorafenib, financed by the National Health Fund, based on the guidelines of the Polish Drug Program. Kaplan-Meier method was used to plot the OS curves, and the log-rank test was used for testing. Multivariate assessment of factors (sex and age) related to the time to death of the patient was done using Cox regression. RESULTS Of the 2072 treated patients, 75% were men (1556) and 25% were women (516). The minimum age of patients in the trial group was 18 years and the maximum age was 90 years. Among the 1556 analyzed cases in males, 27.44% (427) did not end with death (by the date of completing the analysis). The percentage of one-year survival for this population was 58.16%, and the 2-, 3-, and 5-year survival rates were 34.45%, 21.81%, and 9.72%, respectively. The percentage of censored cases in the 516 females was 25.78% (133). The 1-2-, 3-, and 5-year survival for this population was 59.30%, 36.27%, 22.47%, and 11.34%, respectively. Statistical tests did not reveal a significant difference in the curve profiles by sex. There were no associations between OS and age. CONCLUSIONS Systemic treatment with sorafenib in accordance with the presented criteria allows for very good results, comparable to the results of selected groups of patients presented by other authors.

Is job seniority a protective factor against anxiety among midwives during the SARS-CoV-2 pandemic?

INTRODUCTION: Introduction. The pandemic SARS-Cov-2 outbreak necessitated the implementation of changes in everyday obstetric attendance, which demands continuity of care. Employment of sudden changes in obstetric attendance could have increased anxiety among medical personnel. OBJECTIVE: The aim of the Communication was to analyse the influence of professional experience on the level of anxiety in a group of midwives during the SARS-CoV-2 pandemic. MATERIAL AND METHODS: The analysis included 100 midwives: average professional experience: 11.51 years (max. 36; median 7,5; SD: 10.37; p<0.0001). The largest group of respondents was employed in a tertiary referral hospital (n = 40), the smallest in a medical clinic (n = 7). A preliminary study using an online questionnaire, the Generalized Anxiety Disorder Screener (GAD-7), posted on Internet fora, Facebook fan pages of The Childbirth with Dignity Foundation, and the Foundation for Midwives, using the Snowball sampling method. The Ethics Committee for Research Projects at the Institute of Psychology, University of Gdansk, approved the research project (Approval No. 35/2020). RESULTS: The average score was 9.390 (max. 21, median 8.5; SD; 5.228). The length of professional experience did not correspond to the level of anxiety (r = -0.0097; p = 0.9237). In 20 respondents, no anxiety was traced, while the smallest group indicated severe anxiety (n = 15). Professional experience did not influence the level of anxiety in either group with different level of anxiety (ANOVA test; p = 0.465). . CONCLUSIONS: Professional experience did not influence the level of anxiety. In order to prevent exacerbation of anxiety symptoms, different factors which may playa vital role in enhancing the level of anxiety must be analysed.

[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.

Validation study of the Polish version of the Evidence-Based Practice Profile Questionnaire.

BACKGROUND: Decisions about patient care in clinical practice should be made based on proven scientific evidence of efficacy and safety (i.e., evidence-based practice [EBP]). Currently, there are no available tools in Poland for assessing the knowledge and attitudes of specialists in health sciences towards EBP. Therefore, by validating the Polish version of the original English Evidence-Based Practice Profile Questionnaire (EBP2Q), we may provide an appropriate instrument for assessing EBP. METHODS: The validation group consisted of 1,362 people, including nurses and midwives taking the specialization exam, second-degree students in nursing/midwifery, and staff of selected municipal and clinical hospitals in Warsaw, Pruszkow, and Chelm. The study was conducted from March to June 2014. The following psychometric properties of the EBP2Q were assessed: reliability (Cronbach's alpha coefficient, and test-retest), validity (exploratory factor analysis, Spearman's r correlation coefficient, and assessment of inter-group differences), as well as unidimensionality of domains (principal component analysis). RESULTS: All domains of the EBP2Q were characterized by high reliability (Cronbach's alpha ranging from 0.800 to 0.972). The Polish version showed a strong similarity of factor structure with the original English EBP2Q, indicating that the condition for theoretical validity is fulfilled. Maintenance of the theoretical and discriminative validity and unidimensionality of five domains of the EBP2Q was confirmed. CONCLUSIONS: The Polish version of the EBP2Q is comparable in terms of psychometry to the original English version. This questionnaire can be used to assess knowledge, attitudes, and skills concerning EBP among students and practicing professional nurses and midwives. The future validation of the EBP2Q in other groups of specialists in health sciences may increase the scope of applicability of this tool.

[The level of nutrition knowledge versus dietary habits of diabetes patients treated with insulin]. / Poziom wiedzy zywieniowej a sposób zywienia chorych na cukrzyce leczonych insulina.

UNLABELLED: Diabetes is one of the fastest spreading XXI century diseases. One of the most important element of diabetes therapy should constitute dietary treatment resulting from thorough nutritional knowledge. AIM: The aim of study was to investigate the connection between the level of knowledge and way of feeding among patients with type 1 and 2 diabetes treated with insulin. MATERIALS AND METHODS: The research was conducted among 105 patients with type 1 and 2 diabetes treated with insulin. Knowledge level was assessed in accordance with author's questionnaire, way of feeding in accordance with 24 hour nutritional interview. Diet 5 and Statistical 10 has been used to carry out data analysis. RESULTS: The largest correctness has been demonstrated in the question about the carbohydrate content in food (60%), the lowest correctness while carbohydrate exchanges knowledge has been checked (12%). Generally, patients demonstrated medium knowledge level (41% correct answers). Good level of knowledge (>50% corrects answers) has been represented by 26%, medium level of knowledge (30-50% corrects answers) by 49%, low level of knowledge (<30% correct answers) by 25% of responders. Knowledge assessment has shown too high percentage of energy from carbohydrates and saturated fatty acids and too high consumption of cholesterol and sodium. Moreover dietary fiber and polyunsaturated fatty acids shortage has been observed in analyzing diets. Interdependence between knowledge level and way of feeding has not been found (exception: lower percentage of energy from fat in patient's with medium level of knowledge diets). CONCLUSIONS: Improper way of feeding and low level of knowledge can constitute a obstacle to achieve optimal treatment results.

[Nutrigenetics and nutrigenomics - application of „omics” technologies in optimization of human nutrition]. / Nutrigenetyka i nutrigenomika - zastosowanie technologii „omics” w optymalizacji zywienia czlowieka.

Nowadays nutrigenetics and nutrigenomics are perceived as one of the most important research areas ensuring better understanding of an impact of nutrition on human health. Since such researches are interdisciplinary in type, there is a problem with their widespread acceptance and practical clinical application of obtained results. Understanding the new ideas and hypotheses published in researches on nutrigenetics/nutrigenomics requires some knowledge of genetics, biochemistry, molecular biology, and capabilities and limitations that are associated with the use of statistical and bioinformatic analysis, and above all „omics” research technologies (genomics, transcriptomics, proteomics, metabolomics). Highly efficient genome and proteome analysis techniques allow to obtain data necessary for profiling of an individual patient. The main problem is still our insufficient knowledge of cell physiology and biochemistry. The vast amount of information is obtained with the use of „omics” technologies what makes it difficult to interpret and infer. An unquestionable advantage of this type of research is the possibility to utilize system analysis (system biology) which is important in the context of a holistic interpretation of biological phenomena. This review is an attempt to present the main hypotheses and objectives which are carried out by researchers in nutrigenetics/nutrigenomics. This article describes the most important directions of research and anticipated results that are related to the practical use of nutritional genomics as well as the critical assessment of the possible impact of future developments on public health.

ABCB1 gene polymorphisms and haplotype analysis in colorectal cancer.

PURPOSE: The aim of this study was to determine the significance of three most common single-nucleotide polymorphisms (SNPs) of ABCB1 gene in the development of colorectal cancer and to estimate the influence of these SNPs to surviving patients' treatment combination adjuvant therapy 5-fluorouracil/leucovorin. Haplotype structure of ABCB1 was analysed, and degree of linkage disequilibrium (LD) between SNPs of ABCB1 was estimated. MATERIALS AND METHODS: Tumour specimens of 95 patients with colorectal cancer and blood samples of 95 healthy cases were studied. Genotyping of ABCB1 gene was performed by automated sequencing or polymerase chain reaction-restriction fragment length polymorphism method. Comparison of frequencies of alleles/genotypes/haplotypes between the studied group (colorectal cancer samples) and the control group (blood samples) were analysed. These results were correlated with the surviving patients after treatment of adjuvant chemotherapy. RESULTS: Significant differences in ABCB1 (1236C>T) (p = 0.00043) and ABCB1 (2677G>T/A) (p = 0.04) genotype distribution and T(1236) allele distribution (CT(1236) or TT(1236) vs CC(1236); p = 0.0499, OR = 0.55, Fi-Yule coefficient = 0.14) were found. A strong LD between ABCB1 (1236C>T) and ABCB1 (2677G>T/A) SNPs (D' = 0.621, r (2) = 0.318) was detected. All SNPs were located in one haplotype block. There were significant differences in haplotype distributions between colorectal cancer patients and healthy population (p = 0.03). Significant differences in survival probability of colorectal cancer patients' treatment chemotherapy according to allele of ABCB1 (3435C>T) was observed. Survival probability of patients with wild-type C(3435) allele were higher than among patients without this allele (p = 0.04572). CONCLUSIONS: These results suggested that three studied SNPs of ABCB1 were located in one haplotype block. Differences in ABCB1 (1236C>T) and ABCB1 (2677G>T/A) genotypes and T(1236) allele distribution between investigated populations indicate significant impact of these SNPs on risk of development of colorectal cancer. Polymorphism ABCB1 (3435C>T) may be a prediction marker of cancer chemotherapy effectiveness. Differences in haplotype distributions between colorectal cancer patients and healthy population suggested that other potential SNPs, especially in regulatory region of ABCB1 gene, may influence P-glycoprotein expression and function.