Assessment of the Level of Satisfaction with Medical Care of Patients Treated in Osteoporosis Clinics as an Indicator of the Quality of Medical Care.

The aims of this research are to assess the level of satisfaction with medical care among patients treated in osteoporosis clinics and to determine the relationship among the frequency of visits to the doctor, the duration of treatment, socio-demographic factors, and patient satisfaction with the medical care they receive. The study was conducted from August 2016 to July 2018 at osteoporosis clinics in eastern Poland. The study participants were 312 patients treated for osteopenia or osteoporosis. The authors utilized two research instruments: the PASAT POZ questionnaire and their own questionnaire. The results indicate that the duration of osteoporosis treatment is a factor that significantly influences the level of satisfaction with medical care: the longer the treatment time, the poorer the assessment of the clinic, and therefore, the lower the patient degree of satisfaction. Our analysis shows that women assess clinics more positively overall. Additionally, the higher the study participants' age, the lower the general assessment of the clinic. A further analysis showed that respondents in better financial situations and with higher levels of education tended to assess clinics more favorably. The Pareto-Lorenz analysis indicated that the key element in general assessments of specialist clinics is the doctor. It is advisable for health service providers to monitor the quality of health care they are providing and make improvements. Therefore, further research is needed, especially in relation to chronic diseases such as osteoporosis.

Coping Strategies Preferred by Patients Treated for Osteoporosis and Analysis of the Difficulties Resulting from the Disease.

Osteoporosis has been recognized as a civilization disease. This chronic condition needs a long-term management plan with a holistic approach to patients. The specificity of the patient's response to the disease and coping strategies are very important in the treatment process. The aim of this research was to analyze the strategies of coping with disease preferred by patients treated for osteoporosis, and to determine the relationship between the self-assessment of patients' health, time of treatment, sociodemographic variables, and strategies of coping with a chronic disease such as osteoporosis. The study was conducted from August 2016 to July 2018 at an osteoporosis clinic in eastern Poland. Coping Orientations to Problems Experienced (COPE) by C.S. Carver, M. F. Scheier, and J. K. Weintraub in the Polish adaptation and our own questionnaire were used. The study participants were 312 patients treated for osteoporosis. The respondents treated in the osteoporosis clinic used the strategies of seeking support and focusing on emotions to the greatest extent, and avoidance strategies the least. Sociodemographic features and self-assessment of health condition significantly differentiate the strategies of coping with the disease. The analysis showed that the higher the assessment of the individual perception of one's own health, the more often the respondents used active coping strategies.

The Role of Skin Immune System in Acne.

Acne vulgaris is a skin disease that often occurs in adolescence and in young adulthood. The main pathogenic factors are hyperkeratinization, obstruction of sebaceous glands, stimulation of sebaceous gland secretion by androgens, and bacterial colonization of sebaceous units by Cutibacterium acnes, which promotes inflammation. Little is known about the role of skin immune cells in the development of acne lesions. The aim of the study was to try to understand the role of skin immune cells in the course of acne. Recent studies have shown that there are at least four major pathways by which Cutibacterium acnes interacts with the innate immune system to induce inflammation: through TLRs, activating inflammasomes, inducing the production of matrix metalloproteinases (MMPs), and stimulating antimicrobial peptide (AMP) activity. Cells of adaptive immune response, mainly Th1 and Th17 lymphocytes, also play an important role in the pathogenesis of acne. It is worth emphasizing that understanding the role of the skin's immune cells in the pathogenesis of acne may, in the future, contribute to the application of modern therapeutic strategies that would avoid addiction to antibiotics, which would alleviate the spectrum of resistance that is now evident and a current threat.

Coping strategies observed in women with rheumatoid arthritis.

When faced with a chronic disease such as rheumatoid arthritis, the patient attempts to cope with the stressful situation by applying coping strategies. The main aim of rheumatoid treatment is not only improving health but also increasing the quality of life. The research objective was to determine the relationship among socio demographic factors, duration of the disease and its associated ailments, attitude to the disease, self-assessment of one's knowledge of RA, and the application of coping strategies in stressful situations by women with rheumatoid arthritis. The study involved 193 patients of the Clinic of Rheumatology and Systemic Connective Tissue Diseases, and the Rheumatology Unit of the Specialist Outpatient Clinic of the Independent Public Teaching Hospital No. 4 in Lublin, from November 2016 - June 2017. The Coping Orientations to Problems Experienced Inventory (COPE) Questionnaire and an author's Original Questionnaire were used in the study. Analysis of variance (ANOVA) and Tukey's range test were applied for statistical analysis. A p-value<0.05 defined the statistical differences. Analysis was performed using the commercial SPSS Statistics 19 software (IBM Corp., Armonk, NY, USA). The respondents usually use instrumental social support (11.5±1.7), focus on and vent emotions (11.4±1.9), use emotional social support (11.4±1.8), employ active coping (11.4±2.1) and positive reinterpretation and growth (11.2±1.8), and least often rely on their sense of humour (5.5±1.4) or use alcohol or drugs (5±1.1). The factors which determine the types of strategy used are age, education, the duration of the disease, ailments experienced, and attitude towards the disease. Those respondents who declared a greater knowledge of RA more often applied positive reinterpretation and growth, and more rarely used alcohol or drugs. In the treatment and rehabilitation processes it is important to reinforce in the patient positive expectations for the treatment, seek advantages and benefits in one's present health status, and educate patients about the disease, its therapy and appropriate coping strategies.

Health Evaluation in the Context of Satisfaction with Medical Services among Patients with Osteoarthritis: Descriptive Cross-Section Survey.

Osteoarthritis (OA) is one of the most common causes of rehabilitation benefits and senior disability. It generates high costs of treatment and increasing demand for medical staff and care of geriatric profile. The aim of the study was to determine the relationship between health evaluation and satisfaction with medical services among individuals with OA in rehabilitation outpatient clinics. The survey was carried out from June 2017 to May 2018, among patients being provided with services of five outpatient rehabilitation clinics in Lublin. The surveyed group comprised 328 respondents. The following tools were utilized: the List of Health Criteria (LHC), the Multidimensional Health Locus of Control Scale (version B) (MHLC), the authors' own questionnaire compiled for the study, and the Servperf Method. According to the respondents, the most important health criterion is "not to experience any ailments" (M = 1.56). In an assessment of a clinic, the respondents rated neatness (cleanliness) of the staff highest (M = 4.38) and the appearance of a building where a clinic is located lowest (M = 3.42). The better the evaluation of medical services in an outpatient rehabilitation clinic in comparison to other settings, the better the evaluation of the quality of service (rho S = 0.593; p < 0.000). The study conducted in outpatient rehabilitation clinics showed great demand for outpatient specialist care of geriatric profile. Undoubtedly, there is need for continuation and expansion of studies on patients with OA in other rehabilitation settings.

General self-efficacy level and health behaviours in women over the age of 45 years who have undergone osteoporosis treatment.

INTRODUCTION: Contemporary people do not follow the civilisation development in every life domain, their lifestyle is not always healthy. Self-efficacy is the factor that plays an important role in undertaking actions towards struggling with the disease. THE AIM OF THE STUDY: The aim of the study was to determine the relationship between the general self-efficacy level and health behaviours as well as chosen sociodemographic features in women over the age of 45 years who have undergone osteoporosis treatment. MATERIAL AND METHODS: The study comprised 151 women over the age of 45 years. The research was conducted in 2016 in health care centres in Lublin, a city in south-eastern Poland. The Generalised Self-Efficacy Scale (GSES) by R. Schwarzer, M. Jerusalem and Z. Juczynski and an original questionnaire were used as research tools. The obtained material was subjected to descriptive and statistical analysis. χ2 test, Kruskal-Wallis test, Mann-Whitney Test and Spearman's rank correlation coefficient were all applied. RESULTS: The analysis of obtained results showed that as much as 73.5% of the respondents showed very low and low generalised self-efficacy level. On the other hand, only 22.5% of the examined were characterised by high and very high generalised self-efficacy level. The longer the duration of osteoporosis treatment (rho = 0.251; p = 0.002) and the better the self-estimation of health status (rho = 0.473; p = 0.000), the higher the respondents' generalised self-efficacy level. The women's self-efficacy level declined with increasing ailments (rho = -0.190; p = 0.019). CONCLUSIONS: The generalized self-efficacy level and the health behaviours are not satisfactory.

Professional activity of Polish peri- and postmenopausal women.

INTRODUCTION: The menopausal transition as one of the stages in women's life can bring many ailments which complicate the accomplishment of professional duties. The situation of women on the Polish job market is determined by many barriers and stereotypes which impede women's access to jobs and professional promotions. MATERIAL AND METHODS: The aim of the study was to estimate the professional status and job satisfaction of women aged 40-65. The research was carried out by a survey method, a poll technique in the period from January to March 2016. An original questionnaire consisting of 35 questions was used as a research tool. RESULTS: The analysis of obtained results shows that the arithmetic mean of the age of women in full-time employment was 51.84 years whereas the arithmetic mean of the age of women in part-time or seasonal employment was 52.64. Women aged 45-60 were characterised by a significantly lower job satisfaction than women over 60 years of age. The highest percentage of women in full-time employment lived in large cities. The financial situation of working women determined their job satisfaction. Well-off respondents were more pleased with their jobs than women in a worse financial situation. CONCLUSIONS: There is a strong need of education about counteraction of gender and age discrimination on the Polish labour market. The struggle against discrimination requires support on each level of the state administration through the implementation of numerous regulations facilitating the final period and resumption of women's professional activity.

Knowledge about osteoporosis prevention among women screened by bone densitometry.

INTRODUCTION: Osteoporosis is an illness characterized by the handicapped endurance of the bones, causing an increased risk of fracture. AIM OF THE STUDY: Aim of the study was to establish the level of knowledge about osteoporosis prevention among women screened by bone densitometry and to answer the question whether the level of knowledge is dependent on socio-demographic factors. MATERIAL AND METHODS: The research was realized by means of a survey method, a poll technique in 2014. The study involved 292 women aged 51-83. The examined women were patients undergoing bone densitometry in the healthcare centres in Lublin. The osteoporosis knowledge test (OKT, revised 2011) by Phyllis Gendler was used as a research tool. Gathered material was subject to descriptive and statistical analysis. Tukey's test, t-Student test and variance analysis (ANOVA) were all applied. A statistical significance level was set at α = 0.05. RESULTS AND CONCLUSIONS: Respondents presented the basic exercise knowledge (M = 9.97) and low knowledge concerning risk factors, screening and treatment of osteoporosis (M = 7.87). The calcium knowledge remained on an average level (M = 14.03). Better educated women, city inhabitants as well as women having very good or good social and welfare conditions showed a significantly higher level of knowledge about osteoporosis prevention. Even women undergoing bone densitometry examination present insufficient knowledge about osteoporosis prevention.

Health beliefs and sense of one's own efficacy and prophylaxis of osteoporosis in peri- and post-menopausal women.

INTRODUCTION AND OBJECTIVE: Osteoporosis constitutes one of the relevant health, social and economic problems of the contemporary world which concerns 200 million women, of whom about 20-25% will experience a bone fracture. The aim of the study was to learn about the health beliefs and sense of self-efficacy in peri- and post-menopausal women regarding the prevention of osteoporosis. MATERIALS AND METHOD: A group of 300 randomly chosen women aged 45-65 who were patients of healthcare centres in Chelm, Lublin, and the surroundings of Zamosc (eastern Poland), was examined. Own Health Beliefs Scale (OHBS) associated with Osteoporosis and Own Efficacy Evaluation Scale (OSES) were used for the study. The obtained material was subjected to descriptive and statistical analysis. Tukey test, t-student test and variance analysis (ANOVA) were all applied. A P value less than 0.05 was considered statistically significant. Results were analysed using the SPSS version 19 software package. RESULTS AND CONCLUSIONS: It was stated that respondents had thought that osteoporosis is an averagely serious health problem, and they did not feel peculiarly exposed to falling ill with the disease. They attached great significance to the benefits of physical activity and correct nutrition. The perception of barriers to calcium intake and everyday exercise was moderate. Health motivation remained at the average level. Socio-demographic conditions influenced the respondents' health beliefs in a statistically significant way. Sense of self-efficacy from the aspect of taking possible action preventing osteoporosis remained on the average level; in addition, respondents more often declared the desire for a change in eating habits than resorting to physical activity.