Comparison of Professionally and Parentally Administered Analgesia Before Emergency Department Admission.

BACKGROUND: Pediatric patients frequently present to emergency departments in pain. AIM: A cross-sectional prospective study was conducted to investigate the prevalence of acute pain in children attending the ED and arriving by ambulance, as well as the initial ED management of pain. We describe pediatric pain management practices in the pediatric ED, as well as parental pain relief. METHOD: Demographic data, medications, and type of transport to hospital were noted. Pain was assessed upon admission and 30 minutes after administration of analgesia. To standardize pain evaluations, only children aged 4 years or older were included in the study. A numeric rating scale was used to assess pain intensity. RESULTS: The study group consisted of 124 patients. More than 80% of the patients suffered from trauma, injuries to the extremities were the most common cause of admission, and the patient population showed male predominance (62.1%). Over half of the patients (64.51%) were transported by ambulance. Analgesia was administered in 63.5% of the ambulance cases in contrast to only 13.3% of children brought by their parents. Treatment was significantly related to severity of pain. CONCLUSIONS: Both medical emergency teams and parents administered prehospital analgesia insufficiently and without previous assessment. However, medical emergency teams used medications more often than parents. Analgesic therapy used in the emergency department resulted in significant pain reduction.

Neonatal Pictures in a NICU as a Mode of Nursing Intervention to Enhance Parent-Infant Bonding: Parents' Experience during the COVID Pandemic.

INTRODUCTION: Neonatal departments around the world have changed their policies to prevent the spread of infection during the COVID-19 pandemic. The birth of an extremely premature baby can disrupt physical contact between the mother/parent and the baby. This situation affects the bonding process between mother and child. The aim of the study was to investigate the opinions of parents who receive photographs or videos of their children electronically on the usefulness of this intervention, as well as the emotional reaction of parents to the photos or videos received, and potential ways to improve the intervention. METHODS: The study used a qualitative approach and relied on phenomenology, which is a research method used to study experience as experienced from the subjective point of view. Pilot interviews were conducted in January and February 2021, and the final study ran from March to June 2021. RESULTS: The uploaded photographs and videos provided a useful communication tool. The parents' emotions at the proposal to send photographs of the child and while viewing the first photographs were strong and marked by considerable ambivalence. CONCLUSIONS: This study showed how important it is to ensure communication between the parent and the medical staff. Despite the positive reception, in the future obtaining consent from the legal guardian for taking pictures should be considered, whether this form will be accepted, and to ensure the presence of medical staff while the parent is watching the photographs/videos, as this method of communication will not fully ensure direct skin-to-skin contact to build bonds between the parent and the infant. Neonatal intensive care units need to find strategies to mitigate the impact of separation on parental experiences and bonds should a similar situation arise in the future.

Post-Traumatic Growth in Women with Breast Cancer: Intensity and Predictors.

Experiencing a traumatic situation such as breast cancer can, beside negative consequences, have a positive impact, described as post-traumatic growth (PTG). A factor that facilitates psychological recovery when coping with stressful events is psychological resilience. The aim of the present study was to assess whether PTG occurs in a group of women with breast cancer and whether resilience is a personal trait contributing to its occurrence. The study group comprised 100 women with breast cancer, aged 31-80 years, almost half of whom were aged 61-70 years (n = 46, 46%). The Post-Traumatic Growth Inventory, the Impact of Event Scale, and the Resilience Assessment Questionnaire (KOP) were used for the study. All women manifested PTG, with a mean intensity of 76.61 ± 13.45 points. The greatest changes were observed in the subjects' appreciation of life, and the smallest in their relations with others, self-perception, and spiritual changes. The KOP scale measured a mean resilience of 103.80 ± 16.57. The results obtained confirm the co-occurrence of psychological resilience and PTG, especially personal resilience and social competences. Additionally, women subjected to additional traumatic events other than cancer manifested a higher level of PTG.

Pain Evaluation in the Paediatric Emergency Department: Differences in Ratings by Patients, Parents and Nurses.

The pain experienced by paediatric patients is rarely evaluated in emergency departments. The aim of the present study was to compare the degree of conformity in patients' pain severity when assessed by themselves (if possible), their parents and a triage nurse trained in pain evaluation. METHODS: A cross-sectional observational study was conducted at a tertiary paediatric emergency department in Eastern Poland involving children (aged six months to eighteen years), their parents and nurses. The patients had their pain assessed while collecting a medical history. For children ≥ four years of age, the Numerical Rate Scale was used by patients, parents and nurses to evaluate pain. Patients under four years of age were evaluated by parents and nurses using the FLACC scale. RESULTS: Eighty patients and their parents were enrolled in the study. For children ≥ four years, patients rated their pain significantly higher than both their parents (p = 0.03) and nurses (p < 0.001), with the latter group producing the lowest scores. For children under four years of age, parental pain assessments did not significantly differ from those of nurses. CONCLUSION: Compared to the patients themselves and their parents, nurses tended to assign lower pain scores for children. Pain should be assessed on admission to the ED and, whenever possible, by the patients themselves.

Correction: Kwiatosz-Muc et al. Personality Traits and the Sense of Self-Efficacy among Nurse Anaesthetists. Multi-Centre Questionnaire Survey. Int. J. Environ. Res. Public Health 2021, 18, 9381.

There was an error in the original article [...].

Coping with Stress in Complicated Pregnancy and Gestational Weight Gain.

Maternal obesity is one of the leading health problems in the world. Excessive gestational weight gain (GWG) can lead to many complications during pregnancy, especially when it is accompanied by diabetes. Moreover, the risk of excessive GWG in pregnant women is significant, irrespective of prenatal counseling. Studies on this subject concerning coping with stress are lacking in the literature. The present work is aimed at evaluating the styles of coping with stress and their relation to GWG in pregnant women with gestational diabetes (GDM) for whom sudden adaptation to dietary management during this period can be challenging. It was indicated that women with GDM reported high stress related to potential maternal-fetal complications and worries about compliance with dietary management. The overall weight gain of participants in pregnancy was determined in connection to their prepregnancy body mass index (BMI) and classified based on the Institute of Medicine guidelines. A standardized psychological scale was used to assess coping styles. The results showed that almost half of the participants did not meet the Institute of Medicine recommendations for weight gain during pregnancy. There were significant correlations between the styles of coping with stress and the GWG. Additionally, low correlations were indicated between emotional, avoidant, task-oriented coping styles and the age of pregnant women with GDM. Regression analysis showed that the stress-coping style that focused on emotions was the most predictive of overall weight gain. There is a need for a better understanding of psychological barriers in achieving the recommended GWG and potential limitations in providers' interventions, particularly for GDM.

Personality Traits and the Sense of Self-Efficacy among Nurse Anaesthetists. Multi-Centre Questionnaire Survey.

INTRODUCTION: Anaesthesia and intensive care units are specific workplaces. The purpose of this study was to evaluate the level of the sense of self-efficacy and the intensification of personality traits in a group of nurse anaesthetists and to develop a regression model explaining the sense of self-efficacy. METHOD: The population of the questionnaire survey included nurse anaesthetists from five hospitals in south-eastern Poland. The NEO-FFI was used in assessing their personality traits. The general self-efficacy scale was employed for the self-efficacy assessment. A total of 143 correctly filled surveys were analyzed. RESULTS: The respondents typically perceived their own self-efficacy level as upper moderate. The nurse anaesthetists participating in the study revealed a tendency to high scores in conscientiousness and extraversion, and low scores related to neuroticism. The persons characterized by high conscientiousness, extraversion and openness to experience revealed a tendency to high scores related to the sense of self-efficacy. The relationship between personality traits and experiencing the nuisance of selected stressful job factors was demonstrated. Regression analysis showed that conscientiousness and extraversion are most closely related to the sense of self-efficacy. CONCLUSIONS: It seems to be beneficial to implement occupational consulting for nurses, who are starting their work or/and taking into consideration working in anesthesiology and intensive care units. The importance of personality traits and self- efficacy in relation with well-being of medical personnel needs deeper investigations.

Self-Rated Health and Pain Problems in Mothers of Healthy Children or Children Requiring Outpatient Observation or Hospitalisation: A Pilot Cross-Sectional Study.

A child's illness or disability is a considerable stressor for the mother and a risk factor for many psychological problems and somatic diseases. The purpose of the study was to (1) assess the prevalence of poor SRH and pain, (2) compare self-rated health and pain, (3) and identify the determinants of SRH and pain in mothers of healthy children and children requiring ambulatory observation or hospitalization. The study covered 234 mothers of both healthy and unhealthy children who required outpatient observation or treatment at an intensive care unit, neonatal intensive care unit, or oncology department. To analyse the variables obtained, the following tools were used: Self-Rated Health, Numerical Rating, Interpersonal Support Evaluation List, Peritraumatic Distress Inventory, Modified Hospital Anxiety and Depression Scale, and Impact of Effects Scale-Revised. The self-assessment of health in mothers of healthy children and those in need of outpatient observation or hospitalization at units with various specialities differed in a statistically significant way. The severity of the average and maximum pain among mothers of healthy children and those with a history of disease differed statistically significantly. Poor SRH co-occurred with severe maximum pain in all of the examined groups. Both in the control group and the group of mothers of children requiring outpatient observation, poor SRH co-occurred with a high level of anxiety. Only in the control group was a correlation found between the severity of the average and maximum pain and the severity of anxiety and depression symptoms.

Peritraumatic distress in mothers of severely ill children: a cross-sectional study.

INTRODUCTION: Peritraumatic distress is a syndrome that involves negative emotions, such as anxiety, helplessness and horror, experienced during and shortly after a traumatic event. The intensity of peritraumatic distress is significantly linked to the intensity of post-traumatic stress syndrome (PTSD) symptoms. The aim of the study was to study the intensity of peritraumatic distress symptoms in the mothers of severely ill children and the relationship between peritraumatic distress and psychological, socio-demographic and medical coefficients in the mothers. MATERIAL AND METHODS: An anonymous survey was performed in a group of 135 mothers of children with a perinatal medical history and mothers of children hospitalized in an intensive care unit and an oncology unit. The demographic questionnaire was compiled by the authors along with several standardized research tools. RESULTS: Intensity of peritraumatic distress correlates strongly positively with anxiety, ρ = 0.50; P < 0.001, and moderately positively with intrusion ρ = 0.39; P < 0.00, arousal, ρ = 0.38; P < 0.001, PTSD intensification, ρ = 0.40; P < 0.001, depression, ρ = 0.49; P < 0.001. Significant predictors of peritraumatic distress include the use of such coping strategies as acceptance, ß = -0.44; P = 0.001, denial, ß = 0.20; P = 0.019, planning, ß = -0.26; P = 0.012 and humour, ß = -0.29; P = 0.048, as well as the possibility to obtain self-worth support, ß = -0.07; P = 0.029 (R2 corrected = 0,32; F(5.33) = 9.43; P < 0.001). CONCLUSIONS: Coping strategies are a potentially modifiable factor, thus, implementing prevention programmes concerning the strategies should be considered.

Neurodevelopmental outcome and early rehabilitation of premature babies - is it needed in the first 2 years of life?

INTRODUCTION AND OBJECTIVE: The aim of the study was to evaluate the neurodevelopmental outcomes of extremely premature babies at the age of 2 years, and to determine whether rehabilitation was carried out during this period. An additional aim was to determine the relationship between the use of rehabilitation and the degree of prematurity, asphyxia, birth weight, and the result of brain ultrasound. MATERIAL AND METHODS: The study included 87 premature babies born between 24-31 weeks of pregnancy. A rehabilitation specialist assessed the neurodevelopmental outcomes of the children aged 2 years. Based on the documentation, the frequency of rehabilitation and its dependence on prematurity, asphyxia, birth weight and ultrasound results were analyzed. RESULTS: Correct neurodevelopmental outcome in children aged 2 years was found in 57 (65%) children, of whom 40 (46%) did not undergo rehabilitation. Incorrect development was observed in a group of 30 children - 12 patients were diagnosed with CP (14%), and 18 (21%) had 'red flags' of development milestones, they underwent rehabilitation. There was no statistically significant relationship between the degree of prematurity, perinatal asphyxia, birth weight and rehabilitation in the first 2 years of life. Abnormal ultrasound results were more common in rehabilitated children (n = 25; 53%) than in children without rehabilitation (n = 10; 25%), p = 0.008. CONCLUSIONS: Correct neurodevelopmental outcome at the age of 2 reached two-thirds of extreme prematurities, most of which did not need rehabilitation during this period. According to the authors' knowledge, this is the first study to show the percentage of premature babies who in the first 2 years of life did not require rehabilitation and achieved normal development.

The predictive value of 'red flags' as milestones of psychomotor development of premature babies - preliminary study.

INTRODUCTION: Premature babies are a special group at risk of persistent brain damage caused by diseases, the most serious of which are cerebral palsy(CP), autism spectrum disorders (ASD) and mental retardation, among others. These conditions may occur concurrently, but appear more often as separate disease syndromes in the same group of at-risk children. Long-term observation of psychomotor development by an interdisciplinary medical team closely cooperating with parents is necessary. It is important to detect the risk of developing these diseases as soon as possible in all development spheres. MATERIAL AND METHODS: The research was conducted to demonstrate the prognostic value of 'red flags' of developmental milestones and the ability to detect early signs of risk of developing CP and ASD in extremely premature babies. In this preliminary study, 42 preterm babies, born after less than 32 weeks pregnancy participated. RESULTS: The occurrence of 'red flags'in the spheres: gross motor, fine motor and cognitive at 9 months was strongly associated with their presence at 24 months. The sensitivity and specificity were: gross motor - 0.91 (95% CI: 0.59, 1.00) and 0.94 (95% CI: 0.79, 0.99); fine motor - 0.83 (95% CI 0.36-1.00) and 1.00 (95% CI: 0.90-1.00); cognitive - 1.00 (0.40, 1.00) and 0.97 (0.86, 1.00). Other spheres had lower sensitivity but high specificity. CONCLUSIONS: The conclusion is that the 'red flags'at the 9 months milestones already predict the normal or developmental delay of premature babies, and predict the risk of CP and ASD. Due to the availability and lack of the need for specialized and costly training, it is worth considering their use in everyday life medical practice.

Is post-traumatic growth possible in the parents of former patients of neonatal intensive care units?

INTRODUCTION: The birth of a sick child, as well as the infant's subsequent hospitalization in an neonatal intensive care unit (NICU), is undoubtedly stressful for the parents of the infant. Most studies conducted in groups of parents of such children focus on the assessment of the negative changes in their functioning due to such stress. The authors were interested in positive changes in the psychological functioning of parents that may occur after traumatic experiences. These changes are referred to as post-traumatic growth (PTG). OBJECTIVE: The aim of this study was to examine whether parents experience post-traumatic growth and to determine the predictors of PTG in fathers and mothers, depending on the coping strategy adopted. MATERIAL AND METHODS: The study involved 82 parents, whose children were previously hospitalized in neonatal intensive care unit. The methods used included the following standardized psychological tests: the Post-traumatic Growth Inventory, the Impact of Event Scale-Revised, and the COPE Inventory. Socio-demographic and medical data were also collected. RESULTS: Analysis of the data proved that the illness and hospitalization of a child are significantly associated with the occurrence of post-traumatic growth in parents. PTG in mothers is higher than in fathers. Predictors of PTG in fathers include the use of strategies aimed at seeking emotional support and positive reinterpretation and growth, while in the group of mothers, seeking emotional support, religious coping and planning were the coping strategies used. CONCLUSIONS: Research on post-traumatic growth should be expanded. Knowledge of the predictors of positive growth in a difficult situation can contribute to the widespread implementation of primary and secondary prevention of post-traumatic stress symptoms as well as increase positive changes in individuals who have experienced traumatic events.

Severity of post-traumatic stress symptoms, level of experienced stress and coping strategies in mothers of children previously treated in the neonatal intensive care unit. / Nasilenie objawów stresu pourazowego i poziom odczuwanego stresu a strategie radzenia sobie ze stresem u matek dzieci w przeszlosci leczonych na oddziale intensywnej terapii noworodka.

OBJECTIVES: The aim of the study was to develop a model of the relationship between the severity of post-traumatic stress symptoms, levels of experienced stress and coping strategies in mothers of children previously treated in neonatal intensive care units. METHODS: Anonymous questionnaire survey covered 62 mothers of infants aged from three to 12 months who had previously been hospitalized in neonatal intensive care units. Respondents completed a questionnaire comprising standardized tools such as the Impact Event Scale - Revised (IES-R), COPE Inventory and Perceived Stress Scale (PSS-10). RESULTS: The severity of PTSD symptoms is explained by the model comprising four variables: three stress coping strategies (focus on and venting of emotions, denial and mental disengagement) and perceived stress. The model explains nearly 40% of post-traumatic stress symptoms. Perceived stress partly affects PTSD through one stress coping strategy - denial, which also has the effect on post-traumatic stress symptoms severity regardless of perceived stress. CONCLUSIONS: Focus on and venting of emotions, denial, mental disengagement, and the level of perceived stress are potentially modifiable factors that are strongly associated with PTSD. Planning, realization and assessment of interventions aimed at reduction of maladaptive coping strategies and perceived stress are recommended for mothers of infants requiring treatment in neonatal intensive care units. In order to minimize distress and improve coping with the treatment of the child, it is necessary to evaluate the effects of various methods of supporting parents.

Self-rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross-sectional study.

INTRODUCTION: Self-rated health (SRH) is a recognised tool for predicting morbidity and mortality. AIM: The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups. METHODS: We conducted questionnaire-based cross-sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self-Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and Interpersonal Support Evaluation List (ISEL-40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used. RESULTS: The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C. RELEVANCE TO CLINICAL PRACTICE: In order to provide mothers of severely ill children with high-quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.

Peritraumatic distress among emergency medical system employees: A proposed cut-off for the Peritraumatic Distress Inventory.

INTRODUCTION: Emergency medical system (EMS) workers are exposed to traumatic events that may lead to posttraumatic stress disorder (PTSD). OBJECTIVES: The purpose of this study was to explore and discuss the relationship between peritraumatic distress (PD) and elevated posttraumatic stress symptoms (PTSS) in EMS employees. MATERIAL AND METHODS: A cross-sectional study including 100 EMS employees was conducted. Demographic and occupational data were collected for each subject. The Polish version of the Impact of Event Scale-Revised (IES-R) was used to evaluate PTSS and the Polish version of the Peritraumatic Distress Inventory (PDI) was used to determine the level of PD experienced during and immediately after a traumatic event. RESULTS: The highest scores indicative of distress were obtained on the negative emotions subscale, and the lowest on the loss of control and arousal (LCA) subscales. A strong positive correlation was found between the severity of PD and PTSS. Among the PDI subscales, the severity of PTSS was most strongly correlated with LCA, and had the weakest correlation with sense of threat. The optimal PDI cut-off score for predicting elevated PTSS was 19. CONCLUSIONS: PD is strongly related to elevated PTSS and serves as a useful tool for screening EMS workers at risk of developing PTSD. Individuals with PDI scores of 19 or higher are good candidates for specialist consultations aimed at detecting and treating elevated PTSS.

Polish version of the Parental Stressor Scale: Neonatal Intensive Care Unit.

INTRODUCTION: Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) by M. Miles et al. has been developed in order to assess the stress experienced by parents of infants being treated in Intensive Care Units. The measurement of parental stress enables the evaluation of nursing care effectiveness, as well as facilitating the determination of the level of progress made by parents in coping with the difficult situation they face. OBJECTIVES: The aims of the research include: (1) validation of the Parental Stressor Scale: Neonatal Intensive Care Unit into Polish and (2) initial assessment of perceptions of parental stress in a group of 151 parents of infants treated in four NICUs in Poland. MATERIAL AND METHODS: This quantitative cross-sectional study was performed among 151 parents (129 mothers and 22 fathers) of infants treated in four NICUs in central and eastern Poland. The respondents were asked to complete forms following the Parental Stressor Scale: Neonatal Intensive Care Unit, the Impact Event Scale - Revised (IES-R),and their demographics, which combined basic medical data along with socio-emographic data of both parents and children. RESULTS: The three sub-scales distinguished on the basis of the factor analysis (Infant Appearance, Parental Role Alteration, Sights and Sounds) can explain in total 54.89% of variances. Cronbach's alpha for the entire scale equals 0.92, while as follows for the particular sub-scales: Infant Appearance -.92; Parental Role Alteration -.86, and Sights and Sounds - 0.78. CONCLUSIONS: The Polish version of PSS:NICU is an accurate and reliable tool for the assessment of stress experienced by parents whose infants require treatment in NICUs.

Internal consistency and accuracy of Interpersonal Support Evaluation List (ISEL-40) in mothers of healthy children and those with a medical history.

INTRODUCTION AND OBJECTIVE: The aim of the study was assessment of the internal consistency and accuracy of the Interpersonal Support Evaluation List - 40 v. GP (ISEL-40 v. GP) in a group of mothers of healthy children and in a group of mothers of children with a medical history, and presentation of the initial research results. MATERIAL AND METHODS: A group of 230 mothers were involved in the research: 57 mothers of healthy children, 26 mothers of infants with a perinatal medical history, as well as 147 mothers of hospitalized children. The method of a diagnostic survey with standardized tools, such as the Interpersonal Support Evaluation List (ISEL-40 v. GP), Hospital and Anxiety Depression Scale (HADS) and the authors' own questionnaire was utilized. RESULTS: Analysis of the research results suggests satisfactory internal consistency of the ISEL-40 v. GP in the researched group (α=0.86). It was also noticed that internal consistency of the subscales varied. The subscales of tangible support (α=0.79) and belonging support (α=0.73) obtained acceptable values. Internal consistency of self-esteem support (α=0.51) and appraisal support (α=0.62) was too low to be recommended for individual and scientific use. An attempt to modify the number of items did not come up to expectations in terms of the subscales internal consistency. Social support in mothers of healthy and ill children was moderate (29.92 - 33.45 points) and no statistically significant differences in their perception of the support were observed. CONCLUSIONS: In the research on a group of mothers of healthy and ill children it is recommended to use only a social support indicator based on the general result of the ISEL-40 v. GP. Further research aimed at verification of the theoretical structure of the Polish version of the ISEL-40 v. GP is advised.

Stress coping styles among anaesthesiology and intensive care unit personnel - links to the work environment and personal characteristics: a multicentre survey study.

BACKGROUND: High levels of stress among anaesthesiology and intensive care unit workers are commonly reported. Personnel in these units are prone to stress because of specific characteristics of their work. Their development of skills to cope with stress may affect their psychophysical condition and, consequently, patient safety. OBJECTIVES: The aim of this study was to define the coping styles of anaesthesiology and intensive care unit personnel and to evaluate the connections between the work environment as well as personal characteristics and the dominant coping styles. METHODS: Anaesthesiology and intensive care unit personnel from 15 selected Polish hospitals were surveyed using the Coping Inventory for Stressful Situations, which examines task-oriented coping, emotion-oriented coping and avoidance-oriented coping. The Perceived Stress Scale was used to assess stress levels. RESULTS: The analysis included 425 successfully completed surveys. The examined population was divided into two groups: Group N comprised 311 nurses (73.18%) and group P comprised 114 physicians (26.82%). For 167 participants (39.29%), the dominant coping style was defined. The most common style was the task-oriented coping style; it was dominant in 96 participants (22.58% of the entire examined population). This style was significantly predominant among men. The domination of some coping styles coexisted with marital status, number of children and financial situation. The occurrence of different coping styles did not significantly differ among workers at different-sized hospitals, with different job seniority or with different living locations. Perceived stress was correlated with all coping styles. CONCLUSIONS: Work-related stress among anaesthesiology and intensive care unit workers is an important problem. Further investigations of stress levels and the causes and effects of stress in this population are necessary.

Validity, reliability and factor analysis of the Polish version of the Peritraumatic Distress Inventory. / Trafnosc, rzetelnosc i analiza czynnikowa polskiej wersji Skali Dystresu Okolotraumatycznego.

OBJECTIVES: Evaluation of validity and reliability of the Polish version of the Peritraumatic Distress Inventory (PDI) and conducting factor analysis of the tool. METHODS: Cross-sectional study involved 100 employees of the Polish emergency medical system. They completed author's questionnaire, the Polish version of the Impact Event Scale-Revised and the 13-item PDI, validated in this study. RESULTS: Cronbach's alpha coefficient for the entire scale, finally including 12 items, is 0.77. A three-factor structure of the tool has been demonstrated, explaining 60.04% of the variance. This analysis revealed moderate to high values of the factor loadings of all items which form subscales with the exception of the fifth subject. On this basis it was decided to reject the fifth item. Cronbach's alpha for factor 1 (Loss of control and arousal) is 0.75, for factor 2 (Negative emotions) - 0.77 and for factor 3 (Feeling of threat) - 0.68. A strong positive correlation between distress and severity of symptoms of posttraumatic stress disorder (r = 0.70, p < 0.01) was shown. Additionally, distress strongly and positively correlated with the various symptoms of PTSD: intrusion, arousal and avoidance. CONCLUSIONS: Polish version of the PDI is a relevant and reliable distress assessment tool.

Factor analysis and validity of the Polish version of the Peritraumatic Distress Inventory in mothers of seriously ill children.

AIMS AND OBJECTIVES: The purpose of this study was to evaluate and validate the Peritraumatic Distress Inventory (PDI) in mothers of severely ill children hospitalised currently or in the past within a paediatric hospital setting. BACKGROUND: Serious illness in a child causes a sense of fear in her parents, which may occur in variously manifested stress. METHODS/SETTING/PARTICIPANTS: The participants were 135 mothers of children treated in the Intensive Care Unit (ICU), Hematology & Oncology Department, and with perinatal history, who filled out Authors' Questionnaire and the Polish version of the Peritraumatic Distress Inventory. Mothers of all children except those hospitalised in the Intensive Care Unit, additionally filled out the Hospital Anxiety and Depression Scale-Modified (HADS-M) and Impact of Event Scale-Revised (IES-R). RESULTS: Statistical analyses demonstrated a bifactor structure explaining 49.28% of the total variance. The first factor refers to the distress associated with the feeling of threat and somatic reactions, explaining 34.99% of the variance. The second factor, describing negative emotions, explains 14.99% of the variance. Cronbach's α coefficient for the whole scale, eventually consisting of 11 items, is 0.80; for the subscale Feeling of Threat and Somatic Reactions is 0.75, and Negative Emotions is 0.72. The general severity of peritraumatic distress correlates positively with the level of anxiety (ρ = 0.50; p < 0.01) and depression (ρ = 0.49; p < 0.01). CONCLUSIONS: Polish adaptation of the PDI appears to be a valuable tool for studying distress in parents of seriously ill children. RELEVANCE TO CLINICAL PRACTICE: All parents of hospitalised children are at risk of distress so personnel should pay attention to that and report to a clinical psychologist.