Burnout Levels in Nurses and Associated Factors during the COVID-19 Pandemic-A Cross-Sectional Study.

Previous studies have shown that sudden changes in the nature of nursing work and their work environment related to the COVID-19 pandemic have affected the professional experience of nurses, and consequently led to an increase in professional burnout in this professional group. Thus, the aim of the study was to measure occupational burnout among nurses working during the COVID-19 pandemic in Poland. A cross-sectional study was conducted with pediatric and surgery female nurses (N = 110, mean age 51 ± 6.92) from the Provincial Specialist Hospital in Wloclawek, Poland. The participants completed the Link Burnout Questionnaire (LBQ) and the Socio-Demographic Questionnaire (SDQ). The data were analyzed using Spearman's rank correlation and Mann-Whitney U test. The study showed that high burnout affected 6.4% of nurses. The level of professional burnout for the subscales of psychophysical exhaustion, relationship deterioration, professional inefficacy and disappointment was 28.2%, 26.4%, 11.8% and 13%, respectively (mean score: 19.85 ± 6.51, 18.03 ± 5.15, 13.74 ± 4.07 and 17.61 ± 5.85, respectively). The results show that surgical nurses were statistically more likely to experience professional burnout. In sum, burnout among nurses has become a serious problem, especially considering the COVID-19 pandemic, which is why it is so important to continue research in this area. Hospital management needs to take urgent action to address the systemic and professional issues that contribute to the suboptimal mental health of nurses.

System of Work and Stress-Coping Strategies Used by Nurses of a Polish Hospital during the COVID-19 Pandemic.

The COVID-19 pandemic contributed to increased stress levels experienced by employees of the healthcare system during their professional activities. The aim of the study was to compare the stress-coping strategies used by nurses in two different systems of work (one shift/two shifts) in a Polish hospital in 2021. The study used the Polish adaptation of the Mini-COPE questionnaire and the authors' data sheet. The results indicate that regardless of experience or the place and system of work, nurses more often chose problem-focused coping strategies. Conducting screening tests among nurses will help to establish effective strategies for coping with occupational stress, thus preventing professional burnout.

Quality of Life after Surgical Treatment of Brain Tumors.

Quality of life is one of the parameters that characterize the success of brain tumor treatments, along with overall survival and a disease-free life. Thus, the main aim of this research was to evaluate the quality of life after the surgical treatment of brain tumors. The research material included 236 patients who were to undergo surgery for brain tumors. The participants completed the quality of life questionnaires EORTC QLQ-C30 (version 3.0) and EORTC QLQ-BN20 on the day of admission to the department, on the fifth day after the removal of the brain tumor, and thirty days after the surgical procedure. Descriptive statistics, Student's t-test, the Kruskal-Wallis test, the Shapiro-Wolf test, ANOVA, and Fisher's least significant difference post hoc test were performed. The mean score of the questionnaire before the surgical procedure amounted to 0.706, 5 days after surgery it amounted to 0.614, and 30 days after surgery to 0.707. The greatest reduction in the quality of life immediately after the procedure was observed in patients with low-grade glial tumors (WHO I, II) and extracerebral tumors (meningiomas and neuromas). Thirty days after surgery, an improvement in the quality of life was observed in all included groups. The greatest improvement was recorded in the group of patients operated on for meningioma and neuroblastoma, and the lowest in patients treated for metastatic tumors. Contemporary surgical procedures used in neurosurgery reduce the quality of life in patients with brain tumors only in the early postoperative period. Histopathological diagnoses of these tumors impact the quality of life of patients.

Analysis of job burnout, satisfaction and work-related depression among neurological and neurosurgical nurses in Poland: A cross-sectional and multicentre study.

AIM: This study investigated the status of job burnout, work-related depression and job satisfaction among neurological and neurosurgical nurses in Poland. DESIGN: A cross-sectional and multicentre study. METHODS: The sample consisted of 206 neurological and neurosurgical nurses, all of whom completed a self-report questionnaire designed by the authors. RESULTS: The results revealed a work-related burnout incidence of 32%, colleague-related burnout incidence of 44.2% and patient-related burnout incidence of 22.8%. Nurses working in neurological departments were statistically over three times more likely to struggle with colleague-related burnout than nurses working in neurosurgical departments were. Further, work-related burnout was higher in people aged above 54 years than those in the youngest age category. Nonetheless, 71.8% of the nurses expressed satisfaction with their work. In sum, our results indicated that job burnout is common among registered nurses and that personal (age) and workplace (type of ward, distance to work, experience and shift work) factors contributed to symptoms of burnout.

High Rate of Elder Abuse in the Time of COVID-19-A Cross Sectional Study of Geriatric and Neurology Clinic Patients.

The ongoing COVID-19 pandemic is believed to have caused a sharp increase in the incidence of elder abuse (EA), including as a result of isolation, social distance combined with increased interpersonal stressors. Thus, the aim of this study is to determine the impact of the COVID-19 pandemic on the elder abuse rates and the characteristics of risk factors. A total of 347 patients hospitalized in the Department of Neurology and Department of Geriatrics at University Hospital No. 1 in Bydgoszcz were selected as subjects for the analysis. The tools used in the study are: Authors-Designed Questionnaire, the Vulnerability to Abuse Screening Scale, the Geriatric Depression Scale and the Activities of Daily Living Scale. Descriptive statistics, chi-squared tests, Spearman's rank correlation test, and logistic regression analyses were used. In the studied population, nearly 45% of the elderly were victims of violence. This represents an increase of more than 6 percent compared to the pre-pandemic. The most common type of EA was psychological abuse (72.3%). In the final models, the risk factors include, among others, low income (OR = 3.60, 95% CI = 1.93-6.72), chronic diseases (OR = 2.06, 95% CI = 1.28-3.31), poor relationship with the family (OR = 3.26, 95% CI = 1.96-5.43), and moderate and severe depression (OR = 18.29, 95% CI = 10.24-32.69; OR = 18.49, 95% CI = 3.91-87.30, respectively). Moreover, moderate functional impairment 5.52 times more often and severe functional impairment 21.07 times more likely to predispose to EA. People who suffered from COVID-19 are 1.59 times more likely to be victims of EA (95% CI = 1.03-2.46). In this study, we saw significant increases in EA rates during the COVID-19 pandemic.

Tractography-Based Analysis of Morphological and Anatomical Characteristics of the Uncinate Fasciculus in Human Brains.

(1) Background: The uncinate fasciculus (UF) is a white matter bundle connecting the prefrontal cortex and temporal lobe. The functional role of the uncinate fasciculus is still uncertain. The role of the UF is attributed to the emotional empathy network. The present study aimed to more accurately the describe anatomical variability of the UF by focusing on the volume of fibers and testing for correlations with sex and age. (2) Material and Methods: Magnetic resonance imaging of adult patients with diffusion tensor imaging (DTI) was performed on 34 patients. The total number of fibers, volume of UF, and number of tracts were processed using DSI studio software. The DSI studio allows for mapping of different nerve pathways and visualizing of the obtained results using spatial graphics. (3) Results: The total number of UF tracts was significantly higher in the right hemisphere compared to the left hemisphere (right M ± SD = 52 ± 24; left: 39 ± 25, p < 0.05). A hook-shaped UF was the most common variant (91.7%). The UF volumes were larger in men (1410 ± 150.7 mm3) as compared to women (1325 ± 133.2 mm3) (p < 0.05). The mean fractional anisotropy (FA) values of the UF were significantly larger on the left side 0.597, while the right UF had an average of 0.346 (p < 0.05). Patients older than 50 years old had a significantly higher value of mean diffusivity (MD) (p = 0.034). In 73.5% of patients, a greater number of fibers terminated in the inferior part of the inferior frontal gyrus. (4) Conclusions: The morphological characteristics of the UF, unlike the shape, are associated with sex and are characterized by hemispheric dominance. These findings confirm the results of the previous studies. Future research should examine the potential correlation among the UF volume, number of fibers, and total brain volume in both sexes and patient psychological state.

Effectiveness of tonic and burst motor cortex stimulation in chronic neuropathic pain.

Background: Motor cortex stimulation (MCS) is an intracranial, invasive method for treatment of chronic pain. Main indications for MCS are central post stroke pain, neuropathic facial pain, phantom limb pain and brachial plexus or spinal cord injury pain. Spinal cord stimulation (SCS) with burst waveform has been proved to be more effective than tonic mode in chronic pain. Necessity to replace depleted batteries of motor cortex tonic stimulators gave us an opportunity of applying burst stimulation. The objective of the pilot study was to evaluate the effects of burst stimulation applied on motor cortex in patients with chronic pain syndromes as well as comparison to tonic mode. Materials and methods: We have evaluated 6 patients (females N=3, males N=3) belonging to the group of 14 cases (females N=5, males N=9) who had undergone surgical procedure of MCS in years 2005-2017. Selected for the study were 6 patients with thalamic pain N=3, with facial pain N=3 (anaesthesia dolorosa and neuropathic trigeminal neuralgia). The patients were subjected to both modes of stimulation then they chose which one was better in relieving pain: tonic or burst. Pain intensity was assessed with the visual analogue scale (VAS) before the replacement of implanted pulse generator (IPG) and after the stimulation with tonic and burst modes. Results: In the study, 5 out of 6 patients with MCS found burst mode more effective than tonic mode. Baseline VAS score in patients that had at least 3 months depleted battery of tonic IPG was 95 mm. After implantation of a new IPG mean VAS score on tonic stimulation was 72 mm, on burst 53 mm. Conclusions: The most preferred option of MCS in selected group of patients was burst stimulation. This study has shown, that the burst stimulation of cerebral cortex is a promising modality when tonic stimulation is not sufficient in refractory, neuropathic pain.

Depression, social factors, and pain perception before and after surgery for lumbar and cervical degenerative vertebral disc disease.

OBJECTIVES: The purpose of this study was to evaluate the effects of psychosocial factors on pain levels and depression, before and after surgical treatment, in patients with degenerative lumbar and cervical vertebral disc disease. PATIENTS AND METHODS: The study included 188 patients (98 women, 90 men) who were confirmed to have cervical or lumbar degenerative disc disease on magnetic resonance imaging, and who underwent a single microdiscectomy procedure, with no postoperative surgical complications. All patients completed two questionnaires before and after surgery - the Beck Depression Inventory scale (I-IV) and the Visual Analog Scale for pain (0-10). On hospital admission, all patients completed a social and demographic questionnaire. The first pain and depression questionnaire evaluations were performed on the day of hospital admission (n=188); the second on the day of hospital discharge, 7 days after surgery (n=188); and the third was 6 months after surgery (n=140). RESULTS: Patient ages ranged from 22 to 72 years, and 140 patients had lumbar disc disease (mean age, 42.7±10.99 years) and 44 had cervical disc disease (mean age, 48.9±7.85 years). Before surgery, symptoms of depression were present in 47.3% of the patients (11.7% cervical; 35.6% lumbar), at first postoperative evaluation in 25.1% of patients (7% cervical; 18.1% lumbar), and 6 months following surgery in 31.1% of patients (7.5% cervical; 23.6% lumbar). Patients with cervical disc disease who were unemployed had the highest incidence of depression before and after surgery (p=0.037). Patients with lumbar disc disease who had a primary level of education or work involving standing had the highest incidence of depression before and after surgery (p=0.368). CONCLUSION: This study highlighted the association between social and demographic factors, pain perception, and depression that may persist despite surgical treatment for degenerative vertebral disc disease.

Assessment and Determinants of Spinal Pain in the Course of Disc Disorders Treated Surgically.

BACKGROUND Intervertebral disc disease is defined as a complex of structural changes in the aftermath of disorders of mutual elements, the structure of which form the discus intervertebralis and the spinal canal. The present work assessed pain in patients who were surgically treated due to spinal discopathy and analyzed factors that determine the condition. MATERIAL AND METHODS The research was carried on a group of 187 patients diagnosed with discopathy of the lumbosacral and cervical segment. The data are discussed in the context of medical records and the Visual Analogue Scale used for pain assessment. We used a prospective study plan with a 3-time assessment. RESULTS The pain level observed among patients prior to the procedure (M=6.52) was higher than after 7 days (M=3.15) and 6 months from the operation (M= 3.45). The highest level of pain (M=6.88), with a relatively high consistency among the patients (SD=2.25), was observed in the case of left-side hernia (H=7.31; p=0.023). The influence of the analyzed factors on pain experience markedly increased by the third assessment (R2=0.14), and was strongly associated with the type of work performed by the patient. CONCLUSIONS Surgical operation significantly reduces pain in patients with disc disorders. The level of pain is predominantly affected by the location of the hernia and the type of work performed by the patient.

Measuring scales used for assessment of patients with traumatic brain injury: multicenter studies.

BACKGROUND: Application of adequate numeric scales is essential for assessment of a patient's condition. The scales most commonly used by the therapeutic team for assessment of a patient with traumatic brain injury (TBI) include deficit scales, functional scales, and scales assessing quality of life. The purpose of this study was to establish the relationships between the particular scales used for assessment of patients with TBI. METHODS: This multicenter study included 159 patients with TBI. The direct observation technique was used. Two measurements were made (at hospital admission and discharge) using standardized assessment scales, ie, the Glasgow Coma Scale (GCS), the Functional Capacity Scale (FCS), the Functional Index "Repty" (FIR), and the Glasgow Outcome Scale. RESULTS: Patients with mild impairment of consciousness were most numerous in the examined group at both admission and discharge, ie, 118 (78.8%) and 134 patients (89.3%), respectively. The mean score for functional capacity measured with the FCS was 34.41 points (71.7%) on the day of admission and 41.87 points (87.2%) on the day of discharge from hospital. A significant correlation was found between results obtained using the GCS and results on the FIR, on both the day of admission [R t(n-2) =7.612=0.530; P=0.00] and the day of discharge [R t(n-2) =8.998=0.595; P=0.00]. Further, a high correlation was found between the FCS and the FIR (r s= -0.854 on day of admission and r s= -0.840 on day of discharge). CONCLUSION: The majority of examined patients had mild impairment of consciousness. A moderate correlation was found between the GCS and the scales assessing activities of daily living. A high correlation was found between FCS and FIR, which may result from the similarities between the analyzed tools in the scope of their construction and application.

Analysis of the impact of selected socio-demographic factors on quality of life of asthma patients.

AIM: To evaluate the influence of selected socio-demographic factors on quality of life of patients with different degrees of asthma severity. MATERIAL AND METHODS: The study was conducted in 2009-2010 in the Clinic of Allergology, Clinical Immunology and Internal Diseases in Dr J. Biziel University Hospital No. 2 in Bydgoszcz. Patients were divided into a tested group (126) and a control group (86). The criterion for the division was the degree of asthma control according to GINA 2006. The following tools were used: the author's questionnaire containing questions about socio-demographic and clinical data, and the WHOQOL-100. RESULTS: In the tested group, a statistically significant correlation was observed between quality of life and age (p < 0.002 for the entire population), education (p < 0.05 in the group with controlled asthma, p = 0.0005 for the entire population), professional activity (p < 0.003 in the group with partially controlled asthma, p < 0.05 with uncontrolled asthma and p < 0.0001 in the entire population), marital status (p = 0.025 for the entire population) and financial situation (p < 0.0001; p < 0.0002; p < 0.009 in all groups; p < 0.0001 in the entire population). There was no significant difference between quality of life, and sex and the place of residence of the respondents. CONCLUSIONS: Age, education, professional activity, marital status and financial situation affect the assessment of quality of life in patients with asthma. Socio-demographic factors such as sex and the place of residence do not influence the assessment of quality of life in patients with asthma.

Hydrocephalus in newborns: clinical conditions and primary surgical treatment.

BACKGROUND: Hydrocephalus is a state in which excessive accumulation of cerebrospinal fluid occurs in intracranial space as a result of disorders of its circulation hydrodynamics. OBJECTIVES: The aim of this study was to analyze the clinical conditions and primary surgical treatment of hydrocephalus in the newborns examined in the study. MATERIAL AND METHODS: The data was gathered using a retrospective analysis of the medical and nursing records of 57 newborns treated for hydrocephalus at the Department of Pediatric Surgery of the Dr. A. Jurasz University Hospital in Bydgoszcz, Poland. RESULTS: In the years 2008-2009 at the Department of Pediatric Surgery of Dr. A. Jurasz University Hospital in Bydgoszcz, 57 newborns were treated for hydrocephalus. In all patients (100% of the study group) regardless of sex, age, place of residence or etiology, the doctors used surgical therapy. CONCLUSIONS: There is a connection between selected causes of hydrocephalus in the study group and sociodemographic characteristics such as the place of residence or age. Sociodemographic data (sex, age, place of residence) have no effect on the treatment of hydrocephalus in newborns. In all cases of hydrocephalus in the study, the treatment used was implantation of a drainage system. Rickham reservoirs are more rarely implanted in full-term newborns than in premature ones, while ventricle-peritoneal valves are more frequently used in full-term newborns than in premature babies. Regardless of the reason for hydrocephalus formation, the treatment is based on surgical intervention and the most common drainage system used to correct the defect is the ventricle-peritoneal valve.

The quality of health care on neurosurgical wards--work of a therapeutic team.

OBJECTIVES: The aim of the work was to get to learn opinions of patients from Kuyavian Pomeranian Voivodeship about the quality of the medical services they had been provided in regard to the work of the therapeutic team. MATERIAL AND METHODS: The research was carried out in five neurosurgical wards in Kuyavian Pomeranian Voivodeship. 455 patients underwent the research. The anonymous questionnaire--Patient's Satisfaction Questionnaire--based on available standard tools was used as a survey instrument. Permission to carry out the research was given by the Bioethics Committee of Collegium Medicum in Bydgoszcz at Nicolaus Copernicus University in Torun. The obtained results were statistically analysed using a programme called Statistica version 6,0. Statistical hypotheses were verified according to a level of relevance p < or = 0.05. RESULTS: Ward III received the highest grade--an average of 4.67, ward V - the lowest - 3.91 average (p < 0.0001). One of the criteria by which the nurses were evaluated was how well the patients were informed about the performed procedures--ward I--an average of 4.85; ward V--an average of 4.19; (p < 0.05). As far as devoting time to the patients is concerned, the highest average for the doctors was 4.80 (ward IV), the lowest - 3.92 (ward V) (p < 0.05). CONCLUSIONS: 1. The patients of the neurosurgical wards evaluated positively the quality of the care they were provided with. 2. The high level of satisfaction was visible most of all among the patients treated in the neurosurgical wards of teaching hospitals. 3. The doctors and nurses received the lowest grades for giving poor information about further treatment.