Stress Coping Strategies in Parents of Newborns and Infants with Congenital Cyanotic Heart Disease with Regard to Stress Levels and Negative Emotions.

BACKGROUND: Parents of children suffering from congenital heart disease experience high levels of stress and negative emotions. Therefore, recognition of parents' emotional states and their ways of coping with it is becoming more and more important. METHODS: The study group consisted of 154 parents of newborns and infants with cyanotic congenital heart disease, before and after cardiac surgery (partial or full). To assess parental negative emotions, the level of stress, and strategies of coping with it, standardized questionnaires, such as HADS-M, PSS-10, and COPE, were used. RESULTS: Stress levels in parents were high and associated with negative emotions (anxiety, depression, irritability), as well as the choice of non-constructive coping strategies, which was observed especially in younger parents. CONCLUSIONS: Assessing parents' stress levels and ways of coping with stress can improve family functioning and provide better development conditions for the child.

Toxic Stress as a Potential Factor Inducing Negative Emotions in Parents of Newborns and Infants with Cyanotic Congenital Heart Disease.

BACKGROUND: Parents who have a newborn with a congenital heart defect experience negative emotions, which may determine the emotional state of their children. METHODS: The study group included 154 parents of newborns and infants with cyanotic congenital heart disease, before cardiac surgery and after the procedure. HADS m and PSS-10 questionnaires were used to assess parental anxiety, depression, aggression, and the level of stress. RESULTS: High levels of depression, anxiety, total HADS and stress were diagnosed in a large group of parents, regardless of the stage of cardiac surgery treatment. A high level of stress was associated with a higher prevalence of emotional disturbance both in the total HADS (overall) and in all its individual domains. Anxiety and depression were more common in mothers. A high level of stress was a significant predictor of anxiety and depression in parents. CONCLUSIONS: A high level of stress was a significant predictor of anxiety and depression in parents of infants with congenital heart disease. The parents' psychological condition is one of many potential determinants over the course of their child's treatment and recovery.

Association between Suicidal Behaviors in Adolescence and Negative Emotions, the Level of Stress, Stress Coping Strategies and the Quality of Sleep.

Suicidal behaviors in adolescents stem from complex processes deeply rooted in various spheres of life and functioning. The study was aimed at assessing the relationship between selected negative emotions, the quality of sleep, the level of perceived stress as well as stress coping strategies and suicidal ideation and attempts among high school students. The examined group consisted of adolescents aged 16-18 recruited by social-media groups in Poland. The study was based on a diagnostic survey with the application of CAWI method. The other research tools applied in the study included: Hospital Anxiety and Depression Scale-Modified, Perceived Stress Scale-10, How do you cope?-Questionnaire, Athens Insomnia Scale as well as the authors' own questionnaire on suicidal ideation and suicide attempts. Anxiety, depression, aggression and insomnia as well as a high level of stress were statistically more common in girls than in boys (p < 0.001). The high level of negative emotions and insomnia, in turn, increased the risk of suicidal ideation (OR = 3.59, 95% CI: 2.13-6.06 and OR = 2.35, 95% CI: 1.60-3.46), as well as suicide attempts (OR = 6.29, 95% CI: 2.93-14.80 and OR = 3.29, 95% CI: 2.07-5.35). Additionally, high level of stress was associated with more than twice larger odds of suicidal ideation (OR = 2.26, 95% CI: 1.13-4.63). Significantly higher prevalence of suicidal ideation (p = 0.017) and suicide attempts (p = 0.016) was observed in girls. A high level of negative emotions and stress accompanied by a low quality of sleep are factors predisposing people to suicidal ideation and attempted suicide.

Hematopoietic and Lymphoid Cell Neoplasms in Children as a Factor Inducing Negative Emotions and Toxic Stress in Parents.

Parents whose children suffer from cancer experience chronic negative emotions, which may have a detrimental influence on their mental health. The aim of this study, conducted with a group of parents whose children were hospitalized for leukemia or lymphoma, was to assess stress, anxiety, depression, aggression and stress coping strategies as well as the correlations that take place between them. The study was conducted with a group of 101 parents of early school children (aged between 7 and 12) who were hospitalized for cancer in three medical centers in southern Poland. The HADS -M, PSS-10 and COPE questionnaires were used in the study. Mothers were found to experience higher levels of anxiety, depression and stress as compared to fathers. It was more common for men to resort to the strategy of substance use. Socio-demographic variables did not determine the examined emotions, the level of stress and the choice of stress coping strategies, with the exception of the strategy of suppression of competing activities. A positive relationship was found between the incidence of negative emotions and the selected strategies of coping with stress. Early diagnosis of disorders and assessment of parents' strategies of coping might help to counteract long-term consequences of trauma.

Selected predictors of parental satisfaction with child nursing care in paediatric wards in Poland-Cross-sectional study.

BACKGROUND: Assessment of parental satisfaction with child nursing is the key issue in evaluation of the care quality, enabling the adjustment of the services provided to the needs and expectations of recipients, and thus ensuring safety and achieving better long-term health effects. AIM: Assessment of parental satisfaction with child nursing in paediatric wards including its determinants. MATERIAL AND METHODS: The study covered 1030 parents of children hospitalised in paediatric and surgical wards of seven hospitals of different levels of health security in Poland. The Polish adaptation of the Empathic standardised questionnaire for assessment of the level of parents' satisfaction with nursing care, developed by Latour et al. and the self-constructed summary of socio-demographic data were applied in the study. RESULTS: More than 90% of respondents expressed high level of satisfaction with nurses' Availability, the lowest, but still high score of respondents' satisfaction was observed for Parental Participation. The highest satisfaction was observed among the parents of children at the preschool, early school and puberty stage, admitted to the hospital on the elective basis, referred for diagnostic assessment and with the length of hospital stay less than 7 and longer than 28 days. Achieving preschool age was the strongest factor which increased assessment of satisfaction in most domains. CONCLUSIONS: There is a need for optimising nursing care especially in the area of parental participation. The nursing care' quality improvement plan in paediatric departments should focus particularly on early childhood patients and their parents who are the most critical in satisfaction' assessment.

Determinants of Parental Satisfaction with Nursing Care in Paediatric Wards-A Preliminary Report.

Background: The quality of medical services for a child and their parents are tantamount to a sense of satisfaction with care. Purpose: The assessment of determinants of parental satisfaction with nursing care in paediatric wards. Methods: The study covered 336 parents of children hospitalised in paediatric departments and was based on the "EMPHATIC" questionnaire, standardized and adapted to Polish conditions. Results: The mean score of the overall parental satisfaction was high, amounting to 4.19 points. The lower level of satisfaction with nursing care was reported in parents of children under the age of 6 years, admitted in an emergency mode with a diagnosed post-trauma condition and those with higher education. The duration of hospitalisation, sex and age of parents did not have an influence on the satisfaction with care. Conclusions: The age of the child, admission mode and education of respondents are determinants of parental satisfaction with nursing care.

Potential predictors of the selected areas of the quality of life in adolescents with Crohn's disease in remission - a single-centre study.

Regardless of the phase, Crohn's disease, especially in the group of adolescents, may reduce the quality of life and prevent patients from fulfilling roles assigned to this stage of development. Aim of the study: The assessment of the quality of life and its potential predictors. Methods: The study included 65 people of both sexes with Crohn's disease aged from 13 to 18 years. The result of the evaluation of therapeutic effectiveness and the activity of the disease in the study group was below 150-220 CDAI points. The KIDSCREEN-52 questionnaire, numerical rating scale (NRS) and the questionnaire developed by the author were used in the study. The quality of life of patients oscillated slightly above the moderate level. The highest score was obtained for the "social acceptance" scale (88.24 points), while the lowest result was achieved for the "self-image" scale (40.94 points) and "physical health" scale (46.62 points). There was no statistical relationship between sex, duration of the disease, pharmacological treatment and the quality of life. A significant correlation was found between pain and mental health (p<0.001), physical health (p = 0.004) and social area (p = 0.001). The coexistence of other conditions resulting from the main disease significantly reduced the quality of life in the social area (p = 0.003). Pain and coexistence of conditions resulting from the main disease are significant predicators of the quality of life.

Evaluation of quality of life predictors in adolescents and young adults with cystic fibrosis.

BACKGROUND: Cystic fibrosis (CF) is a chronic disease that has an impact on Health-Related Quality of Life (HRQoL). OBJECTIVES: To identify demographic and clinical factors associated with HRQoL in adolescents and young adults with CF. METHODS: The sample comprised adolescent and young adult patients with CF. They completed the Cystic Fibrosis Quality of Life (CFQoL) questionnaire, which includes Physical, Social, Treatment, Chest Symptoms, Emotional Functioning, Future Concerns, Relationships, Body Image, and Career dimensions. We examined the relationships between gender, age, body weight, FEV1, pain, sleep, anxiety, depression and HRQoL. RESULTS: The sample comprised 95 patients (aged 14-25 years; female/male: 43.1/56.8%). The lowest CFQoL score was observed in Future Concerns. FEV1 and body weight were positively associated with Physical Functioning (ß = 0.21; P < 0.01) and Body Image (ß = 0.30; P< 0.01), respectively. Females perceived themselves more negatively in Future Concerns (ß = -0.26; P< 0.01), Relationships (ß = -0.17; P< 0.01) and Career Concerns (ß = -0.20; P < 0.01) than males. Pain intensity (ß = -0.37), anxiety (ß = -0.39) and poor sleep quality (ß = -0.21) were negatively associated with global CFQoL (P < 0.001). CONCLUSIONS: Pain intensity, anxiety and quality of sleep have the broadest impact on HRQoL. Regular assessment of psycho-emotional functioning, quality of sleep and pain intensity may improve a patient's well-being.

Influence of preoperative information support on anxiety, pain and satisfaction with postoperative analgesia in children and adolescents after thoracic surgery: A randomized double blind study.

AIMS/BACKGROUND: The proportion of patients who experience anxiety prior to planned surgery, even a minimally invasive one, is estimated at 50-70%. Thoracic surgery, causes significant preoperative anxiety, especially in children. The aim of this study was to determine the effect of an important component of psychological preparation for a surgery as information support on levels of anxiety, pain and satisfaction with postoperative analgesia. METHODS: The randomized double blind study including patients aged 9-18 years qualified for lateral thoracotomy or Ravitch procedure. The subjects were randomized to the control group (n=56) provided with a routine preoperative information by a nurse, and the experimental group (n=56) offered additional psychological consultation. Data were collected via the State-Trait Anxiety Inventory. RESULTS: In the experimental group, the level of state anxiety at 48 h post-surgery was significantly lower than prior to the procedure, but only in subjects with preoperative trait anxiety Conclusion: Information support from a psychologist offered prior to a thoracic surgery decrease the level of postoperative state anxiety solely in children with lower levels of trait anxiety. Higher level of postoperative state anxiety negatively affect patients' satisfaction with post-surgical analgesia. TRIAL REGISTRATION: ClinicalTrials.gov; Influence of Preoperative Support on Anxiety, Pain and Satisfaction With Postoperative Analgesia; NCT03488459, https://clinicaltrials.gov/ct2/show/record/NCT03488459?cntry=PL&city=Rabka-Zdr%C3%B3j&rank=1.

Evaluation of selected insomnia predictors in adolescents and young adults with cystic fibrosis.

AIMS AND BACKGROUND: The purpose of the study was to assess the incidence of insomnia in adolescents and young adults with cystic fibrosis and its impact on the quality of life, and to examine whether demographic and clinical factors and negative emotional states are predictors of insomnia in these patients. METHODS: The study was conducted among 95 cystic fibrosis patients aged 14-25 years. The study used a personal questionnaire survey, the Athens Insomnia Scale, the Cystic Fibrosis Quality of Life Questionnaire, the Hospital Anxiety and Depression Scale, and the Numeric Rating Scale. RESULTS: Insomnia was diagnosed in 38% of cystic fibrosis patients. In patients with insomnia, the level of anxiety (Me: 10 vs. 4; P=0.000) and depression (Me: 6.5 vs. 2; P=0.000) was significantly higher than in the good sleep quality group. The risk of insomnia increases as anxiety (OR: 4.31; 95% CI: 2.20 to 8.41) and depressive symptoms exacerbate (OR: 4.98; 95% CI: 1.84 to 13.43). Insomnia significantly worsens the quality of life in cystic fibrosis patients (ß=-0.5, P=0.000). CONCLUSION: Insomnia affects a large percentage of cystic fibrosis patients, and anxiety and depression are factors that increase the risk of insomnia. Insomnia decreases the quality of life in cystic fibrosis patients.

Child's dignity in suffering and death.

The magnitude of unfair, absurd, pointless suffering we cannot accept or understand makes it a phenomenon which defies human logic - especially when it concerns children. The source of suffering of a dying child is pain, fear, failure to satisfy the basic human needs and concern about the parents. It is also heightened by medical procedures, including treatments aimed at preventing the unavoidable death. Such actions, resulting from the fear of death and a lack of acceptance of death as the end of life burdened with suffering, pose a risk to the child's fundamental rights and violate the source of human freedom - one's inalienable dignity. Our priority should be to unconditionally respect the children's rights postulated by Korczak, to ensure that while providing holistic care for a dying child, their dignity is always considered the greatest good.

The quality of life with regard to the sexual sphere and acceptance of the disease in young adults suffering from multiple sclerosis.

Introduction: Multiple sclerosis as a disease of various dynamic and unpredictable consequences at different periods of the disease can lead to quality of life reduction. One of the guarantors for maintaining a good quality of life is accepting the disease. The aim of the study was to evaluate the quality of life, taking into account the sexual sphere and acceptance of the disease among young adults with multiple sclerosis. Material and methods: The study included 120 people of both sexes, aged from 18 to 35 years of age suffering from multiple sclerosis during remission, independent in everyday activities or requiring a minimum of help. The study used a questionnaire MSQOL-54 instrument and the AIS scale. The statistical analysis used the following: Kruskal-Wallis test, Mann-Whitney test, Chi2, Spearman coefficient. Program Statistica 7.1 was also used. The level of significance was p <0.05. Results: The overall quality of life increases with the acceptance of the disease (Spearman r-0.364; p=0.000). It has been demonstrated the existence of significant statistical positive correlation between satisfaction with the sexual sphere and acceptance of the disease (Spearman's r 0.271; p=0.005) and satisfaction with the sexual sphere and quality of life (Spearman's r 0.467; p=0.000). Conclusion: The factor determining the quality of life of patients with MS is the acceptance of the disease. Satisfaction with sexual life is a significant factor in assessing the quality of life by patients and the acceptance of their illness.

The level of knowledge about parasitic diseases and the threats resulting from their presence in the environment evaluated in a group of parents of preschool children.

Despite a significant civilization advancement, parasitic diseases still pose a serious diagnostic and therapeutic problem. Children's susceptibility to these infections stems from their immature immune system and lack of basic hygiene routines. The objective of the study was to evaluate the level of knowledge which parents of preschool children's possess about parasitic diseases in their children's environment. The study was carried out in the group of 151 parents of preschool children living both in the city and in the country. The survey was carried out by means of a diagnostic poll with the application of a self-designed research questionnaire. To make the evaluation even more objective, a special scale was created in which parents could score points for their answers (0 - wrong answer, 1 - correct answer). The total number of points ranging from 0 to 9 indicated an unsatisfactory level of knowledge, from 10 to 13 - satisfactory level, from 14 to 16 - good level and from 17 to 20 - very good level of parents' awareness. The results of the study reveal that the level of parents' knowledge about parasitic diseases is only satisfactory. A statistically significant relationship was observed between the variables such as education and sex. The higher education, the higher level of knowledge. Moreover, women were more knowledgeable in the field of parasitic diseases than men were. Financial status of the family did not influence the level of parents' awareness. Well-planned educational programmes might have a positive influence on developing proper hygiene routines in families, which, in turn, will limit the risk of spreading parasitoses in the population of children.

Quality of life in patients with cystic fibrosis depending on the severity of the disease and method of its treatment.

INTRODUCTION: Quality of life is a measure not only of disease severity and its functional impact (physical, psychological, and social functioning) but also the efficacy of novel therapies. The aim of this study was to analyze the quality of life in cystic fibrosis patients depending on the severity of the disease and methods of its treatment. MATERIAL/METHODS: The study included groups of cystic fibrosis patients: 1) after lung transplantation, 2) requiring chronic oxygen therapy, and 3) in stable clinical status. Forty-five men and women older than 18 years were enrolled. The participants were examined with the Polish version of the Cystic Fibrosis Quality of Life Questionnaire (CFQoL) adapted by Debska & Mazurek. RESULTS: Patients from analyzed groups differed significantly in terms of their quality of life in most of the subscales included in CFQoL, but not in Future Concerns and Interpersonal Relationships. DISCUSSION: Although lung transplantation markedly improves the quality of life of patients with cystic fibrosis, they still experience problems with social functioning and future concerns.

The level of negative emotions, coping with stress and social support for parents of children suffering from epilepsy.

INTRODUCTION: Child epilepsy can be source of negative emotions and stress in pa- rents. Social support is an external personal resource coupled with the process of coping with difficult situations. AIM: The aim of the study evaluation the severity of negative emotions and ways of dealing with the stress of parents of children with epilepsy in relation to the received social support. MATERIALS AND METHODS: The study was conducted in one of the children's hospitals in Malopolska, on 213 parents (148 women and 65 men) aged 21 to 66 years. The study used: HADS-M (Hospital Anxiety and Depression Scale Modified HADS-M, BSSS (Berlin Social Suport Scale), Inventory for Measurement Coping Mini-COPE and the author's questionnaire. Statistical analysis used Pearson and Spearman's correlation and Mann-Whitney test and t-test. Calculations were performed using IBM SPSS Statistics 20 Statistical significance was p ≤0.05. RESULTS: The dominant emotion that accompanied the parents was anxiety. Parents have used more strategies based on active coping, and seeking emotional support or instrumental. It has been shown there is a correlation between the level of intensity of negative emotions and social support, and also correlation between social support and ways of coping with stress. CONCLUSION: Parents expressed negative emotions but not of high severity which may be related to the choice of active coping strategies. Steps should be taken not only to assess the prevalence of negative emotions in a group of parents, but also to reduce the level of their intensity by exposing the importance of social support.

The level of perceived stress of parents of children with cancerous disease - mechanisms of dealing with stress and social support.

INTRODUCTION: Cancerous disorders are the second most common cause of death among children. Blood cancer is a stressful and traumatic situation for the child, as well as the parents. To overcome the stress of child's illness parents adopt different coping styles. In overcoming these difficulties, the invaluable role is played by social support they receive from medical staff, family or institution. AIM: To assess the feeling of stress for parents of children diagnosed with blood cancer, to determine how they choose to deal with stress in a difficult situation. MATERIAL AND METHODS: The study group consisted of 63 parents of children diagnosed with blood cancer. The study used the PSS-10 scale to assess the stress experienced by parents, 40 GP ISEL scale to assess social support, Inventory Ways to Measure Coping and the author's questionnaire. RESULTS: High perception of stress was observed among parents. It was found that the strategy based on active coping (taking action to improve the situation) got the highest scores among the strategies for coping with stress. The study showed that parents can most often count on material support. CONCLUSIONS: The feeling of stress severity among parents is high, particularly among women and people with higher education. The actions of medical team should take into account the needs of parents in raising and maintaining the resources to adapt to the difficult situation of child's disease.

Negative emotional states of patients with oncological disease and social support.

For many people diagnosed cancer and the treatment process is connected with emergen- ce and long-term existence of many negative emotions such as: depression, anxiety and stress. The aim of this study was to evaluate the intensity of negative emotional states of people diagnosed with cancer and the need for social support, as well as, exploration of the interdependence between these variables. Statistical analysis showed a significant correlation between the occurrence of disorders and border states, of both anxiety and depressive character and high level of stress in the test.

Patient's perception of the meaning of life in cystic fibrosis--its evaluation with respect to the stage of the disease and treatment.

INTRODUCTION: Cystic fibrosis (CF) is related to physical and mental barriers. The objective of this work was to evaluate and compare patients' perception of sense of life in cystic fibrosis in different stages of their disease and therapeutic methods. MATERIAL/METHODS: The study group included 45 patients divided into 3 subgroups: after lung transplantation, waiting for lung transplantation and with cystic fibrosis in stable condition. The evaluation and comparison of patient's perception of sense of life and purpose of life was performed with the Purpose in Life Test. RESULTS: All patients with CF felt their lives were meaningful and purposeful. However, their pursuits for designated aims depended on the progression of their disease. CONCLUSIONS: CF with its poor prognosis has a significant impact on patient's hierarchy of respected values and life priorities. High level of acceptance for suicidal behaviours observed in all diagnostic subgroups of patients with CF indicates a need for organized intensified psychological care.

Strategies for coping with pain presented by adolescents with hematopoietic malignancies.

INTRODUCTION: Leukaemias and lymphomas are the most common malignant diseases diagnosed among adolescents and they are associated with pain and anxiety. As a result they may affect the way patients accept their disease and determine subjective assessment of quality of life. The objective of this study was to recognise strategies for coping with pain, evaluate the process of accepting the disease and assess quality of life among adolescents diagnosed with hematopoietic malignancies. MATERIAL AND METHODS: The study group comprised 66 patients aged between 14 and 21 and diagnosed with leukaemia or lymphoma. The following measuring tools were used: the Pain Coping Strategies Questionnaire (CSQ), Zung Self-Rating Anxiety Scale (SAS), Acceptance of Illness Scale (AIS), and WHOQOL-BREF for quality of life evaluation. RESULTS: Coping self-statements and praying or hoping were the two most common strategies used by our respondents when coping with pain. In the study group the level of anxiety had no influence on pain control and the ability to reduce it. A statistically significant relation was found between the level of catastrophizing as a method of coping with pain and quality of life in the physical domain. An additional correlation was observed between quality of life in the psychological domain and the level of pain control. CONCLUSIONS: The ability of coping with pain promotes the acceptance of illness and improves patient's quality of life. The age and duration of the disease were factors affecting strategies for coping with pain. A small percentage of respondents who experienced anxiety suggests that further and deeper research is needed in this field.

[The perception of the purpose and sense of life among cystic fibrosis patients after lung transplantation]. / Postrzeganie zycia, jego celu i sensu przez chorych na mukowiscydoze po przeszczepie pluc.

Patients with cystic fibrosis keep struggling with their disease despite the improvement of their lung function after lung transplantation. Also, they often have to define and verify their purpose and sense of life once again. Therefore, an attempt to search answers to the questions: what health is, what one is expecting form his/her life, and what value this life after lung transplantation has for him/her; seems significant.