Labour migration of Polish nurses: a questionnaire survey conducted with the Computer Assisted Web Interview technique.

BACKGROUND: According to data from the Organisation for Economic Cooperation and Development, Poland has one of the lowest numbers of nurses (5.2) per 1000 inhabitants among 28 EU countries. The migration of nurses from Poland has particular importance in the context of scarce human resources in this professional group, especially given the increasingly ageing population in European societies, which will entail an increased demand for nursing and care services. The aim of the study was to obtain information on the intentions of Polish nurses to migrate for work to other countries in the European region. METHODS: The study included 581 nurses, professionally active in Poland over the duration of the study. The Computer Assisted Web Interview technique was used to collect data. Nurses filled in a web-based questionnaire that was available from December 5, 2011, to March 5, 2012. The choice of respondents for the sample was based on the availability of data. An invitation to participate in the study could be viewed on selected websites from the Portal of Nurses and Midwives, the Supreme Chamber of Nurses and Midwives, and the Polish Nursing Society. The survey questionnaire was designed by the authors, which served as the primary research tool. RESULTS: Nearly one in three respondents intended to leave Poland for professional reasons. Overall, 12.4 % of respondents had already worked as a nurse abroad. The main destinations for migration included Germany, followed by England and Norway. The intended length of stay abroad ranged from 2-5 years. CONCLUSIONS: In the studied group of Polish nurses, there was great interest in seeking employment abroad. Nurses tend to go abroad mostly for long-term, repeated periods to the wealthiest countries nearest to Poland. In view of the low level of human resources in the Polish nursing sector, the migration of Polish nurses will probably have crucial implications for the quality of healthcare services in Poland in the coming years. Given the methodology applied, study findings refer solely to the study group.

Analysis of information on rheumatology from a selected Internet forum in the context of the need for telemedicine solutions.

OBJECTIVES: The aim of this study was to determine how often patients and undiagnosed people who complain of musculoskeletal system and rheumatic diseases look for knowledge contained on an Internet forum. Content analysis was used to identify the level of Internet users' activity in the rheumatology section, compared to other areas of medicine. MATERIAL AND METHODS: Material included information posted on the Internet forum established at http://medyczka.pl/. The method employed was a quantitative and qualitative analysis of the content. The method was based on qualitative assessment of the first post in each thread presented on the rheumatologic subforum, by assigning keywords, subjectively determined by the researcher, to such a post. For each keyword a specific definition was established, determining a situation in which a given keyword was used. RESULTS: The quantitative analysis qualified rheumatology in the last place in terms of Internet users' activity compared to other branches of medicine. The qualitative assessment of the rheumatologic forum indicated that the three most common keywords were joint pain (32), joints swelling (13), and schoolage (13). The three most common intentional keywords (arranged in order of their decreasing number) were diagnosis based on symptoms (29), interpretation of the laboratory test results (9), and how to deal with symptoms (8). CONCLUSIONS: The analysis leads to the conclusion that the rheumatologic subforum, along with other subforums listed above, presents a critically low level of discussion. There is a large disproportion between the number of active and passive forum users, suggesting that numerous individuals search the forum for presented information. Based on the qualitative analysis of the information stocks of the rheumatologic subforum, it was established that most of the questions posted concerned young individuals, who complained of joint pain and swelling, and asked for a possible diagnosis based on the presented symptomatology, interpretation of the laboratory test results and alleviation of disease symptoms.

The impact of endometriosis on the quality of women's life.

OBJECTIVES: Endometriosis is a disease that involves the ectopic growth of the endometrial tissue outside the uterine cavity. Its average occurrence is about 10% of women of reproductive age. Making a diagnosis of the disease is commonly long-lasting and ambiguous due to the wide variety and intensity of symptoms. The aim of the study is to determine factors affecting the quality of life of women struggling with endometriosis. MATERIAL AND METHODS: A cross-sectional study was conducted using a diagnostic survey method with the use of the author's questionnaire and the WHOQOL-BREF questionnaire. The study population included 650 people (group with endometriosis - 361 women and group without endometriosis - 289 women). RESULTS: In the group of women with endometriosis, the mean age was significantly higher (31.87 vs 24.99). Difficulties with conception were significantly more common (51.67%) in the endometriosis group compared to 5.52% in the non-endometriosis group. In each area, the quality of life of women with endometriosis was significantly lower (p = 0.000). Women with the history of the disease of over 3 years significantly more often complained of dyspareunia (p = 0.048), bladder pain (p = 0.01) and lower back pain (p = 0.029). CONCLUSIONS: Endometriosis significantly reduces women's quality of life. Factors that deteriorate the quality of life of women with endometriosis include severe pain, infertility, dyspareunia and reduced satisfaction in various spheres of life (somatic, mental, social). More research is necessary to improve the quality of life of women with endometriosis.

Parents' Knowledge of the Impact of Cystic Fibrosis on the Quality of Life of Children and Adolescents Suffering from This Disease as an Element of Patient Safety.

Parental perspective on the health, safety, and quality of life in children and adolescents with cystic fibrosis (CF). AIM OF THE STUDY: Assessment of the impact of a chronic disease such as cystic fibrosis (CF) on the quality of life and safety of children and adolescents as perceived by parents/caretakers. METHODS: The study was conducted at the Department of Lung Diseases of the Institute of Mother and Child, a branch of the Cystic Fibrosis Centre Children of Warsaw SZPZOZ in Dziekanów Lesny, the largest pediatric CF center in Poland, and in the Rodzinamuko group on Facebook. A total of 139 parents participated in the study. The study was conducted using the diagnostic survey method with the use of the Kid- & Kiddo-KINDLR questionnaire for examining the quality of life of children and adolescents and a demographic questionnaire. RESULTS: The perception of cystic fibrosis (CF) as a chronic disease varies based on parental residence and professional status. The well-being of children and adolescents with CF is tied to their parents' employment, particularly regarding schooling. Social interactions are influenced by the level of parental education. The quality of life in children and adolescents with CF is age-dependent, with younger children exhibiting higher quality of life. This age-quality of life relationship extends to physical well-being, emotional well-being, and school-related aspects. Furthermore, the emotional dimension of quality of life is affected by the child's age at the time of diagnosis. CONCLUSIONS: The Kid- & Kiddo-KINDLR QoL Questionnaire for children with cystic fibrosis is a good tool to measure parental knowledge. The study shows the need for the whole family to understand and be aware of the impact of CF on family life. Parents may be tired or may misunderstand or miscommunicate the medical team's instructions, which may affect both family life and patient safety. To ensure patient safety, parents should work with healthcare professionals at hospitals or clinics but also at home. They should also account for the family as a whole, not just for the problems of the child with CF.

Teamwork and safety climate in Polish long-term care facilities: questionnaire reliability and usability.

The Teamwork and Safety Climate Survey (TSCS) is one of the questionnaires used to measure patient safety. The questionnaire includes two scales: teamwork climate and safety climate. The objective of the study is the linguistic and cultural adaptation of the TSCS to Polish conditions and checking the reliability and usability of the tool in long-term care facilities. Firstly, the TSCS was translated into Polish. Then, a cross-sectional survey was conducted among the medical and auxiliary personnel of long-term care facilities all over Poland. The psychometric properties of the questionnaire were analysed (including Cronbach's alpha coefficient). Correlations between the areas of the questionnaire and individual variables relating to facility parameters were also calculated. Respondents (n = 558) working in 26 different long-term care facilities participated in the study. The analysis has provided four scales instead of two of the original version of the questionnaire (teamwork climate, safety climate, ability to speak up and following the rules, work organisation). Correlation analysis revealed a number of significant correlations between the scales and individual variables corresponding to the parameters of long-term care facilities and respondents themselves. In conclusion, the Polish version of the TSCS may be a useful tool to measure aspects related to patient safety culture in long-term care facilities.

A Comparative Analysis of Quality of Life in Women Diagnosed with Breast and Ovarian Cancer.

Background: Previous studies showed that cancer significantly reduces the quality of life of patients. The purpose of this study was to analyze changes in the quality of life of women diagnosed with ovarian and breast cancer after surgical treatment followed by adjuvant cancer therapy. Methods: The study covered 220 women diagnosed with ovarian (n = 89) or breast cancer (n = 131) after surgical treatment followed by adjuvant cancer therapy (chemotherapy, radiotherapy, hormone therapy). The tools used to measure the patients' quality of life were the standardized EORTC QLQ-C30 questionnaire, the QLQ-BR23 module for breast cancer and the QLQ-OV28 module for ovarian cancer. Results: The subjective assessment of the health and quality of life of the women was carried out using the EORTC QLQ-C30 questionnaire and the QLQ-OV28 and QLQ-BR23 modules. Women with breast cancer rated their health higher than women with ovarian cancer. The health assessment performed by the patients was not related to the type of cancer (p > 0.05). They experienced pain, dyspnea and weakness regardless of the cancer location. Moreover, women's health status had a clinically significant impact on their family and social life, although no statistically significant differences were found between the two groups (p > 0.05). Whilst the patients with breast cancer rated their quality of life and health higher than the patients with ovarian cancer, the differences were not statistically significant (p > 0.05). Conclusions: Changes in the quality of life of women with breast and ovarian cancer concern the physical sphere, hobbies, fatigue/rest, pain, family and social spheres, and material conditions. It is necessary to support specialists at every stage of treatment of these patients, which may improve the results of the treatment and patients' perception of health and quality of life.

Interventions to Increase Patient Safety in Long-Term Care Facilities-Umbrella Review.

INTRODUCTION: Patient safety in long-term care is becoming an increasingly popular subject in the scientific literature. Organizational problems such as shortages of medical staff, insufficient numbers of facilities or underfunding increase the risk of adverse events, and aging populations in many countries suggests that these problems will become more and more serious with each passing year. The objective of the study is to identify interventions that can contribute to increasing patient safety in long-term care facilities. METHOD: A systematic review of secondary studies was conducted in accordance with the Cochrane Collaboration guidelines. Searches were conducted in Medline (via PubMed), Embase (via OVID) and Cochrane Library. The quality of the included studies was assessed using AMSTAR2. RESULTS: Ultimately, 10 studies were included in the analysis. They concerned three main areas: promoting safety culture, reducing the level of occupational stress and burnout, and increasing the safety of medication use. Promising methods that have an impact on increasing patient safety include: preventing occupational burnout of medical staff, e.g., by using mindfulness-based interventions; preventing incidents resulting from improper administration of medications, e.g., by using structured methods of patient transfer; and the use of information technology that is more effective than the classic (paper) method or preventing nosocomial infections, e.g., through programs to improve the quality of care in institutions and the implementation of an effective infection control system. CONCLUSIONS: Taking into account the scientific evidence found and the guidelines of institutions dealing with patient safety, it is necessary for each long-term care facility to individually implement interventions aimed at continuous improvement of the quality of care and patient safety culture at the level of medical staff and management staff.

There Are Predictors of Eating Disorders among Internet Use Characteristics-A Cross-Sectional Study on the Relationship between Problematic Internet Use and Eating Disorders.

The aims of this cross-sectional study were: (i) to establish the prevalence of problematic Internet use (PIU) and eating disorders (EDs) among Polish students; (ii) to investigate potential correlations between the two phenomena; and (iii) to identify predictors of eating disorders among socio-demographic and Internet use characteristics in this population. To this end, a total of 1008 Polish students aged 18-40, completed the Problematic Internet Use Test (TPIU22), the Eating Attitudes Test (EAT-26) and a self-designed Socio-demographic and Internet Use Survey. Men received more PIU scores (p < 0.001), while women received more EAT-26 scores (p < 0.05) with a significant correlation observed between those variables (rho = 0.212; p < 0.001). The strongest predictors of EDs were as follows: preoccupation with the Internet, neglect of sleep in favor of Internet use, alleviation of negative feelings while online, higher mean number of hours spent online on weekends for academic and work-related purposes, extracurricular activity, lower height and higher BMI. An association has been demonstrated between problematic internet use and eating disorders. Somewhat surprisingly, our results suggest that people at risk of EDs use the Internet primarily to fulfill their routine duties. Nevertheless, further research is needed to establish the causality of EDs and PIU.

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.

Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: A multinational cross-sectional study.

The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49-2.95), nurse (OR 1.38; 95% CI 1.04-1.84), and 'other clinical' (OR 2.02; 95% CI 1.45-2.82); being redeployed (OR 1.27; 95% CI 1.02-1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98-2.99), anxiety (OR 4.87; 95% CI 3.92-6.06) and depression (OR 4.06; 95% CI 3.04-5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51-0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22-0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers.

Prevention of overweight and obesity undertaken by local government units in Poland.

BACKGROUND: Based on the estimates of World Health Organization (WHO), in European Union countries overweight or obesity affects more than 60% of men and over 50% of women. According to the nationwide European Health Interview Survey (EHIS) survey conducted in 2014, in Poland over 62% of men and nearly 46% of women carried excess weight in 2014. OBJECTIVE: The objective of the paper is to present health policy programmes aimed at prevention of overweight and obesity developed, implemented and funded by local government units (self-governments of voivodeships, counties, municipalities) in Poland in 2010-2016. METHODS: The study was based on a desk research. It covered data from two sources, i.e. data included in annual reports formulated by voivodes and submitted to Minister of Health concerning all health policy programmes implemented by local government units and data published online as part of reviews of draft programmes by the Agency for Health Technology Assessment and Tariff System (AOTMiT). RESULTS: In the period under review local government units implemented a total of 333 overweight and obesity prevention programmes. 18 programmes were reviewed by AOTMiT. Most programmes have been implemented in the Zachodniopomorskie and Mazowieckie Voivodeships, whereas the least in the Podlaskie, Lubelskie and Kujawsko-Pomorskie Voivodeships. Around 99% of municipalities, 97% of counties and 86% of self-governments of voivodeships did not complete any overweight and obesity prevention programmes in the period under review. CONCLUSION: Insufficient engagement of local government units in the prevention of overweight and obesity - one of the primary objectives of the National Health Programme for 2007-2015 and 2016-2020. Differences in terms of the number of programmes implemented by particular types of local government units and the financial resources employed in the implementation of the programmes. Failure to fulfil the statutory obligation to obtain a review from AOTMiT. Failure to address the actual health needs of local communities related to overweight and obesity prevention by some of the voivodeships.

The impact on quality of life of dialysis patients with renal insufficiency.

AIM: The aim of the study was the subjective assessment of the quality of life (QoL) of 140 patients treated with dialysis (peritoneal dialysis and hemodialysis). BACKGROUND: Chronic kidney disease and the methods of its treatment play an important part in shaping the QoL of patients receiving dialysis. As a result, kidney failure causes many limitations in patients' physical, mental, and social activities. METHODS: The instrument to measure the QoL was the authors' own questionnaire made on the basis of Kidney Disease and Quality of Life Short Form version 1.2 (KDQOL - SF 1.2) and their selection of areas influencing the perceived QoL of chronically ill patients. RESULTS: The research showed that patients receiving peritoneal dialysis assessed their QoL in its different dimensions as much higher than patients receiving hemodialysis. The parameter having the biggest negative impact on the QoL of patients receiving hemodialysis was an impeded possibility to continue work or studies and a change of life plans. The will to live was more highly assessed by patients receiving peritoneal dialysis as compared to patients receiving hemodialysis. CONCLUSION: In order to improve the functioning of hemodialysis patients in a manner most similar to healthy persons, the renal replacement therapy should consider patients' individual needs and expectations, ie, guarantee flexible hours of work or study and of receiving dialysis. In addition, patients treated with hemodialysis should receive psychological care, in particular those demonstrating emotional problems, in order to achieve better results in therapy and improve their QoL.