Medical and Psychological Aspects of Pregnancy in Women with Obesity and after Bariatric Surgery.

Chronic diseases are potential risk factors for pregnancy duration and neonatal outcomes. This narrative review aimed to summarize the research results on the specifics of pregnancy in women with obesity and after bariatric surgery. PubMed and Google Scholar databases were searched. Systematic reviews, meta-analyses, clinical trials, and references to identified articles from the last ten years (2013-2023) were included. Ultimately, 107 literature items were qualified. It has been shown that women with obesity planning pregnancy should reduce their body weight because obesity is a risk factor for adverse obstetric and neonatal outcomes. Bariatric surgery effectively reduces excessive body weight and the health risks in women with obesity during pregnancy and their offspring. However, at least a year interval between surgery and conception is recommended. An interdisciplinary medical team should provide patient care during pregnancy with knowledge and skills related to people after bariatric surgery. Due to the increased risk of mental disorders, especially depression, it is necessary to constantly monitor the mental state of women and provide psychological support and education on a healthy lifestyle during pregnancy and the postpartum period.

Time Goes Back-Time Perspective in Polish Men with Compulsive Sexual Behavior Disorder and Risky Sexual Behavior.

Many relationships between time perspective and a propensity to engage in risky behaviors or developing addictions have been demonstrated. The aim of our study was to determine the differences in intensity of individual time perspectives in people with compulsive sexual behavior disorder (CSBD) and risky sexual behavior (RSB). The analysis includes 425 men: 98 CSBD (age M = 37.99 years), 63 RSB (age M = 35.70 years), 264 without CSBD and RSB features constituting the control group (age M = 35.08 years). We used the Zimbardo Time Perspective Inventory, the Sexual Addiction Screening Test-Revised, the Risky Sexual Behavior Scale and a self-constructed survey. The comparative analysis showed a higher intensity of past-negative (p = 0.040), a lower of past-positive (p < 0.001) and a present-fatalistic (p = 0.040) outlook in the CSBD group compared to the control group. Compared to the participants with RSB, the CSBD group was characterized by a higher intensity of past-negative (p = 0.010), a lower of past-positive (p = 0.004) and a present-hedonistic perspective (p = 0.014). The RSB group also achieved higher results from the present-hedonistic perspective (p = 0.046) compared to the control group. The CSBD patients indicate a stronger tendency to focus on negative past compared to non-CSBD men, both taking and not taking RSB. The time perspective profiles of RSB men are similar to those who do not engage in RSB. The distinguishing feature of men with RSB without CSBD is a greater ability to enjoy current experiences.

Anxious and Angry: Early Emotional Adaptation of Medical Students in a Situational Crisis on the Example of the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic is an example of a situational crisis resulting in emotional destabilization. The aim of the study was to analyze changes in the level of anxiety and anger in medical students during the early adaptation to the situational crisis, and to estimate the risk factors for fear and anger in this group. METHODS: Participants were 949 medical students (M = 22.88, SD = 4.10) in the first stage on March 2020, and 748 (M = 22.57, SD = 3.79) in the second stage on June 2020. The STAI, STAXI-2, and our own questionnaire were used. RESULTS: First vs the second stage: anxiety state (p < 0.001), anger state (p = 0.326), and feeling angry (p < 0.05). The regression model (F(14.1681) = 79.01, p < 0.001) for the level of anxiety state explains 39% of the dependent variable variance (r2 = 0.39). The model for the anger-state level (F(6.1689) = 68.04, p < 0.001)-19% (r2 = 0.19). CONCLUSIONS: During the early adaptation to the situational crisis, the general level of anxiety decreased, but anger was at the same level. The anxiety was explained by contact with potentially or objective infected persons, and the level of anger was based on the need for greater social support.

Can Nutritional Status in Adults Be Influenced by Health Locus of Control?

The external health locus of control (HLC) is based on an assumption that obtained health results depend on the influences of external factors. As for the internal HLC-that is the effect of our own actions and capabilities. Little is known regarding how the HLC can influence body weight or the occurrence of visceral obesity. The study aimed to assess the relationship between the health locus of control and nutritional status in adults. The study included 744 adults (452 women, 292 men; 2.8% underweight, 43.8% normal weight, 29.7% overweight, and 23.7% obese). In addition to anthropometric measurement and socio-demographic data, the health locus of control, using the Multidimensional Health Locus of Control Scale (MHLC) by Wallston K, Wallston B, and DeVellis R, was assessed. The percentage of subjects with an internal HLC did not differ significantly between obese, overweight, and normal-weight groups. However, the percentage of subjects with an external HLC-dependent on the impact of others-was significantly higher in both men and women with obesity than in corresponding overweight and normal-weight groups (p < 0.01). Yet, the percentage of subjects with an external HLC subject to the impact of chance was significantly higher among overweight and obese women than in those of normal weight (p < 0.05) only. Women with overweight or obesity, with external health locus of control, experienced both the impact of others and of chance more often than women with normal weight. However, men with overweight and with obesity more often had external health locus of control influenced only by others.

"All Hands on Deck": Psychological Characteristics of Women with Experience of Oncological Disease Participating in Sailing Cruise-A Pilot Study.

BACKGROUND: In addition to searching for effective methods of treatment, interventions are sought to support well-being, quality of life, mental health, and recovery. Sailing has its specific features, including task orientation, challenges, contact with people, and nature. This specificity may be treated as a potential therapeutic factor, but it is also likely that people with certain psychological characteristics are involved in it. Therefore, the study aimed to assess some psychological features of women with cancer experience who decided to take part in the Onco-Cruise (Polish: Onko-Rejs). METHODS: Participants were 56 women (M = 46.73; SD = 9.21). We used NEO-FFI, the Zimbardo Time Perspective Inventory, and The Multidimensional Health Locus of Control Scale. RESULTS: Onco-Cruises participants were characterized by a high level of extraversion (M = 32.48; SD = 7.02; sten score M = 7.21; Mo = 7), openness (M = 31.50; SD = 6.31; sten score M = 7.41; Mo = 8), low neuroticism (M = 21.62; SD = 9.33; sten score M = 4.96), predominance of present hedonistic (M = 12.55, SD = 1.46) and future time perspective (M = 11.39; SD = 2.67), and the internal health locus of control (M = 23.25, SD = 5.43). CONCLUSION: Group sailing can be favorable for broadly understood health and cancer recovery, but people who choose this activity have certain psychological predispositions, especially indicating high needs for stimulation. Permanent features should be taken into account when proposing various interventions for oncology patients to best suit them to their natural possibilities and preferences and, thus, make them most effective.

Patient­centered care and "people-first language" as tools to prevent stigmatization of patients with obesity.

Obesity is a global health problem with serious consequences, such as diabetes, dyslipidemia, cardiovascular disease, infertility, and certain cancers. Excess body weight, mainly due to its manifestation in an individual's appearance, also affects the psychological condition. Therefore, health care providers need to make an effort to diagnose and comprehensively treat obesity. The obesity treatment should be systemic and carried out by a multidisciplinary therapeutic team consisting of a doctor, nurse, dietitian, psychologist or physiotherapist, and surgeon. The first-line therapy of obesity includes lifestyle modification and increased physical activity. Pharmacological treatment is recommended in all adult patients with a body mass index (BMI) exceeding 30 kg/m2 or those with a BMI greater than or equal to 27 kg/m2 with at least 1 obesity­related comorbidity. Bariatric surgery should be considered in adults with a BMI of 40 kg/m2 or greater, or those with a BMI greater than or equal to 35 kg/m2 with at least 1 obesity­related disease. The holistic model of obesity treatment also includes psychological therapy. The European Association for the Study of Obesity recommends psychological assistance for all individuals with previous treatment failure. Adverse or harmful actions toward people with obesity, ascribing negative traits and behaviors to them, and their marginalization in the public space are referred to as stigmatization of obesity. This phenomenon is associated with reduced compassion and willingness to help, and a feeling of dislike or even anger toward this group of patients. The consequences of stigmatization are worse mental health, poorer physical health, avoidance of health care, and the maintenance or increase of excess body weight. Therefore, talking about obesity using the principles of "people-first language," as well as implementing a patient­centered care model are important.

The Style of Coping with Stress, the Health-Related Locus of Control, and the Level of Mindfulness of Patients with Chronic Somatic Diseases in Comparison to Healthy People.

Background: Psychological factors may be involved in both the development and treatment of somatic diseases. Our study aimed to evaluate the style of coping with stress, health-related locus of control, and level of mindfulness of adult patients with the most common chronic somatic diseases compared with healthy subjects. Methods: 502 chronically ill people were examined (M = 49.27; SD = 14.25), including 288 women and 214 men. The control group consisted of 117 healthy people (M = 45.66; SD = 17.86). The diagnostic survey involved using the Coping Inventory for Stressful Situations (CISS), Multidimensional Health Locus of Control Scale (MHLC), and Mindful Attention Awareness Scale (MAAS). Results: Differences between the clinical and control groups were demonstrated for MHLC: Internal (p < 0.001), Powerful Others (p < 0.05), and Chance (p < 0.001); CISS: Task (p < 0.001) and Avoidance (p < 0.05); and MAAS (p < 0.01). Conclusion: People with chronic somatic diseases, compared to healthy people, have a stronger external and weaker internal health-related locus of control, lower level of task and avoidance style for coping with stress, and lower level of mindfulness.

Medical students in the face of SARS-CoV-2 pandemic: an estimated risk of infection and the need for social support.

OBJECTIVES: A pandemic triggers certain attitudes and behaviors, resulting in the need for adequate social support. The aim of the study was to determine the factors influencing the estimated risk of SARS-CoV-2 infection and to assess the need for social support in a group of medical students. MATERIAL AND METHODS: The survey was conducted among 981 people, including 814 women and 167 men. For this purpose, a self-assessment survey with 22 multiple-choice questions was used. The online survey was conducted on March 20-April 2, 2020, which can be considered as the first stage of the pandemic in Poland. RESULTS: The tested model for the subjective SARS-CoV-2 infection risk assessment explained 32.6% of the dependent variable variance (F(7.945) = 66.61, p < 0.001). The model for adherence to the recommendations for reducing the risk of SARS-CoV-2 transmission explained 9.5% of the variability (F(8.943) = 12.39, p < 0.001), and the model for an increased need for social support due to the SARS-CoV-2 epidemic explained 27.4% of the variability (χ2(8) = 12.17, p = 0.144). CONCLUSIONS: Factors important for estimating the risk of SARS-CoV-2 infection and the need for social support in the group of medical students were determined. The subjective assessment of the stress level, infection symptoms experienced and the field of study proved to be crucial. Int J Occup Med Environ Health. 2022;35(4):473-84.

The Influence of Selected Psychological Factors on Medication Adherence in Patients with Chronic Diseases.

BACKGROUND: Insufficient adherence to treatment is a relevant problem. This study aims to determine the impact of health locus of control, stress coping style and level of mindfulness on medication adherence in patients with a chronic illness. METHODS: The study included 768 people. The diagnostic survey involved the use of: Medication Adherence Questionnaire (MAQ), Multidimensional Health Locus of Control Scale (MHLC), The Coping Inventory for Stressful Situations (CISS), and The Mindful Attention Awareness Scale (MAAS). RESULTS: Participants were divided into two subgroups, i.e., adherent (n = 219) and non-adherent (n = 549). We observed significant differences between the subgroups in age, BMI, sex, place of residence, education, and for all MHLC subscales, two CISS subscales and MAAS. The identified medication adherence variables were: female gender (OR = 1.55), BMI (OR = 0.95), MHLC/Internal (OR = 0.95), CISS/Emotional (OR = 1.03), MAAS (OR = 0.97). CONCLUSIONS: A strong internal health locus of control, a higher level of mindfulness and a lower level of emotional-stress coping style increase the likelihood of adherence with medication recommendations in patients with chronic diseases.

Assessment of Satisfaction with Health Services among Prisoners-Descriptive Study.

AIM: The aim of the study was to assess the access of prisoners to healthcare services, as well as the level of satisfaction with the provided services and health assessment among prisoners. METHODS: The research was conducted in one of the penitentiary centers in Poland among people jailed between 1 January to 31 January 2020. The response rate of the self-administrated questionnaire was 52.05% (469/901) participants. There were 389 men and 77 women. RESULTS: Prisoners assessed access to health services including GP doctors, specialist doctors, dentists, and hospitals in 3 categories: "bad" ranged: 27.03-67.60%; "medium" ranged: 22.54-53.57%; "good" ranged: 7.02-33.96% depending on the type of arrest, but no statistical significance was demonstrated. Satisfaction with the health services defined as "bad" ranged: 25.00-61.11%; "medium" ranged: 18.97-55.56%; "good" ranged: 5.56-34.62% depending on the type of arrest but no statistical significance was demonstrated. Of 469 prisoners, 215 prisoners (45.84%) declared no addictions. The frequency of addiction does not differ depending on the place/type of punishment served (p = 0.9). In turn, 317 prisoners (68%) declared no chronic diseases. CONCLUSIONS: Most of the prisoners described access to health services as "bad", except female prisoners from a semi-open facility. In turn, satisfaction with healthcare services was most often assessed as "bad", except for temporarily arrested men and female prisoners from a semi-open facility.

Perception of body size and body dissatisfaction in adults.

Self-perception of body size seems to be not always in line with clinical definitions of normal weight, overweight and obesity according to Word Health Organization classification. The effect of self-perception of body size disturbances and body dissatisfaction may be the development of eating disorders, such as anorexia nervosa or binge eating disorder-a major risk factor of obesity development. Therefore, the study aimed to assess separately the perception of weight status and body size as well as body dissatisfaction in adults with normal weight, overweight and obesity. The study included 744 adults (452 women; 35.9 ± 12.4 years; 21 underweight, 326 normal weight, 221 overweight, 176 obese) referred to Metabolic Management Center and volunteers. Body size perception and body dissatisfaction were assessed based on Stunkards' Figure Rating Scale (FRS). Additionally, participants' were asked: 'Do you think you are: underweight/normal weight/overweight/obese?' to assess perception of weight status. Participants' weight and height were measured to calculate body mass index (BMI) after completing the FRS. Individuals within the overweight BMI range have rated themselves as underweight (1.4%), normal weight (30.8%) and obese (2.8%). Also individuals within the obesity BMI range have rated themselves as normal weight (2.6%), and overweight (41.6%). Compatibility of self-assessment of weight status with BMI category according to the measured values was moderate-Kappa coefficient was 0.59 (95% CI: 0.54-0.64). Underestimation of weight status was significantly more common among men than women. There were statistically significant differences in the distribution of body dissatisfaction according to the weight in both women and men. Normal-weight subjects less often than overweight and obese were dissatisfied with their own body size. The degree of body dissatisfaction was greater among women than among men. Adults subjects frequently underestimate their own weight status and body size. Women with overweight and obesity more often than men are dissatisfied with their own body size.

Exercise addiction symptoms and mental health during the forced exercises deprivation in greatest COVID-19 pandemic restrictions in Poland. / Objawy uzaleznienia od cwiczen a zdrowie psychiczne w sytuacji wymuszonego ograniczenia treningów w trakcie najwiekszych restrykcji w zwiazku z pandemia COVID-19 w Polsce.

OBJECTIVES: The paper describes the relationship between the symptoms of exercise addiction, behavioral strategies in situations of limited workout possibilities and mental health state in exercising individuals. METHODS: The study included 391 participants, 286 women (73.1%) and 105 men (26.9%), aged 18 to 68 years. The respondents were surveyed online after 17-19 days of barriers to routine training due to greatest COVID-19 restrictions in Poland. Subjects completed the Exercise Dependence Scale, General Health Questionnaire - 28 (GHQ-28) and questionnaires enabling the collection of demographic and clinical data as well as data related to exercise behaviors. RESULTS: The variables related to exercise addiction and some related to behavioral changes are predictors of mental health, especially in terms of anxiety, insomnia and somatic symptoms. All the introduced variables accounted for 27.4% to 43.7% of the variation in the mental health status of the subjects, depending on GHQ subscales. Breaking the restriction rules by outdoor training protected against symptoms of psychological disorders, especially in relation to somatic symptoms (Beta = -0.23; p< 0.001). Individual assessment of stress induction in a given situation was a predictor of results in all GHQ subscales, which was the strongest for symptoms of anxiety and insomnia (Beta = 0.37; p< 0.001). CONCLUSIONS: Individuals with features of exercise addiction are at risk of deterioration of their well-being during forced abstinence. In addition, the subjective level of stress induction in a given situation is an important determinant that conditions psychological well-being, especially the aggravation of depressive symptoms. People who ignore restrictions and have low levels of stress, experience lower psychological costs.

Is there a difference in body size dissatisfaction between the patients with obesity seeking and not seeking treatment for obesity?

BACKGROUND: Various factors motivate people to undertake treatment for obesity. Among others they include health benefits, willingness to please others, and dissatisfaction with one's appearance. The present study aimed to assess body size dissatisfaction in patients with obesity seeking and not seeking treatment for obesity. METHODS: Two-hundred-sixteen adult subjects (154 women, 62 men) including 80 people with BMI ≥ 30 kg/m2 starting treatment for obesity (BMI 35.7 ± 5.3 kg/m2) and 136 volunteers with obesity (BMI 34.7 ± 4.3 kg/m2) not seeking treatment for obesity, were enrolled. Body size satisfaction was assessed using the Figure Rating Scale adapted by Stunkard. RESULTS: Patients with obesity starting obesity treatment had more often a high level of body size dissatisfaction than volunteers with obesity not seeking the treatment (p <  0.001). There was a significant difference in the distribution of body size dissatisfaction in women (p <  0.05), but not in men (p = 0.47). CONCLUSION: Patients with obesity, especially women, seeking obesity treatment more often represent a high level of body size dissatisfaction than volunteers with obesity not seeking treatment for obesity. This implies the need for public health campaigns to address negative attitudes or misconceptions about obesity and its treatment. Placing more attention and emphasis on body size dissatisfaction in more vulnerable women with obesity may help to define personal motivations and goals, strengthen the doctor-patient relationship and better adapt therapeutic strategies.

Type of Physical Training and Selected Aspects of Psychological Functioning of Women with Obesity: A Randomised Trial.

OBJECTIVE: We conducted a prospective randomised trial to assess whether a specific type of regular physical training performed by women with obesity is related to obtaining specific psychological benefits. METHODS: Forty-four women qualified for the study and were divided into two groups. The applied intervention consisted of regular three-month physical exercises in the form of endurance training (group A) or endurance strength training (group B). Initially, and after the completed intervention, we examined anthropometric measurements and the level of: stress (PSS-10), general self-esteem (SES), body self-report (BSQ-34, FRS), and behaviours associated with diet (TFEQ-18). RESULTS: As a result of the intervention, both groups had significantly lower anthropometric parameters and FRS scores with regard to the current figure (gr. A:δ FRS CS -0.90 ± 0.83, p < 0.001; gr. B:δ FRS CS -0.41 ± 0.50, p = 0.01) and BSQ-34 results (gr. A:δ BSQ-34 -14.90 ± 13.5, p = 0.001; gr. B:δ BSQ-34 - 18.64 ± 25.4, p = 0.01). Additionally, an increase in cognitive restraint (δ TFEQ-18 CR1.65 ± 2.06, p = 0.01) and a decrease in emotional eating (δ TFEQ-18 EE -0.82 ± 1.28, p = 0.01) were observed in group B. There were no between-group differences in terms of the magnitude of changes achieved due to the intervention, except for asignificant improvement in the perception of their current figure (FRS) (δ FRSCS -0.90 ± 0.83, p = 0.03) in group A. CONCLUSIONS: Regular physical activity over a three-month period by women with obesity promotes the perception of their own body as slimmer and lowers body shape concerns. The change in body shape perception was more pronounced under the influence of endurance training than endurance strength training. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT04793451.

Selected psychological factors and medication adherence in patients with rheumatoid arthritis.

OBJECTIVES: The aim of the study was to determine the relationship between medication adherence (MA) and selected psychological factors in a group of patients with rheumatoid arthritis (RA). MATERIAL AND METHODS: The cross-sectional study was conducted in four rheumatology outpatient clinics in Silesia, Poland. The tests used were the Medication Adherence Questionnaire (MAQ), the Multidimensional Health Locus of Control Scale (MHLC), the Coping Inventory for Stressful Situations (CISS), and the Mindful Attention Awareness Scale (MAAS). The analysis involved 106 adult patients diagnosed with RA at least 6 months before, who were prescribed medication, with disease at any stage and with stable comorbidities. Software was used to perform analyses of frequency, basic descriptive statistics, including the Kolmogorov-Smirnov test, Student's t-test for independent samples, intergroup univariate variance, Pearson's r correlation coefficient, Spearman's rank correlation ρ coefficient, Fisher's exact test and stepwise linear regression. RESULTS: Powerful Others Health Locus of Control (PHLC), Internal Health Locus of Control (IHLC) and age of the subjects, F(3, 102) = 8.05; p < 0.001 explained 16.8% of the variation in the adherence level for the entire group. In the group of women PHLC and IHLC, F(2, 80) = 10.04; p < 0.001 were included in the model, which explained 18.1% of variation in MA. PHLC was the most significant factor in the group of women (ß = 0.55; p < 0.001) and in the entire group (ß = 0.48; p < 0.001). In the group of men, Social Diversion Style (SDS), F(1, 21) = 5.81; p = 0.02 was included in the model, which explained 17.9% of the variation in the MA level. CONCLUSIONS: The study identified some psychological predictors of adherence, which explained 16.8% of the variability. Factors increasing the likelihood of medication adherence in patients with rheumatoid arthritis include a strong belief in the power of others, low level of internal health locus of control, and advanced age.

Well-being of nurses and working conditions-Are polish nurses different from doctors and midwives in terms of professional quality of life?

Aim: The aim of the study is to assess the differences in the professional quality of life between nurses, midwives and doctors. Design: Cross-sectional study. Methods: A total of 297 participants were surveyed: 165 nurses, 101 doctors and 31 midwives. We used ProQol questionnaire with three subscales (compassion satisfaction -CS, burnout- B, compassion fatigue-CF and own questionnaire (social-demographics data). Results: Burnout and CF were average in a group of nurse and midwives, low in group of doctors. In group of nurses, a relationship was observed between compassion satisfaction and: job seniority (p < .01), basic place of work (p < .01), self-assessment of work situation (p < .01), as well as between burnout and: job seniority (p < .05), form of employment (p = .03), basic place of work (p = .002), self-assessment of work situation (p < .01). In group of midwives was only the relationship between the self-assessment of work situation and: CS (p < .01) and burnout (p < .01) were shown.

Selected psychological predictors of medication adherence in the older adults with chronic diseases.

Aim: The main goal of the study was to assess the significance of selected psychological factors related to the adherence to medication recommendations among the older adults with chronic diseases. Design: It was designed as a cross-sectional study, aimed at assessing the importance of selected psychological factors in complying with medication recommendations among older adults. Methods: The study involved 345 older adults with chronic diseases, assessed the importance of selected psychological factors, such as: health locus of control, stress coping and mindfulness in adhering to medication recommendations older persons. To answer the research questions, we performed frequency analyses, basic descriptive statistics analyses together with the Kolmogorov-Smirnov test, Student's t tests for independent samples, monofactorial analysis of variance in the intergroup diagram, analysis correlation with the Pearson correlation coefficient, Spearman's rank correlation ρ analysis and stepwise linear regression analysis. Results: The study identified psychological predictors of medication adherence, which explained 12% of the variability. An emotion-oriented coping proved to be the most important factor. Additionally, powerful other health locus of control and mindful attention were shown to have a positive effect.

The Relationship between Health Status and Social Activity of Perimenopausal and Postmenopausal Women (Health Status and Social Relationships in Menopause).

The quantity and quality of interpersonal relations (including participation in University of the Third Age-U3A) play an important role for women during menopausal changes. Women who have a social network are found to be more positive about menopause, and are less likely to be depressed. This case-control study aimed to analyze the relationship between participating in formal social groups and health status related to physical activity and climacteric and depressive symptoms. The study was conducted among 621 peri- and postmenopausal women aged 50-64 years. The women were classified into two groups: U3A and controls. The participants were selected using a multistage sampling method. The IPAQ (The International Physical Activity Questionnaire), Kupperman Index (KI), and Beck Depression Inventory were used for data collection. Significant differences between the groups were confirmed in the area of professional work (p < 0.001), free time (p < 0.001), and sitting (p < 0.05). The average KI score in the U3A group was higher (t-Student = 2.12, p < 0.05). Depressive symptoms were found in 43.49% of U3A women vs. 51.15% in controls (p < 0.01). We conclude that participation in formal social groups is associated with higher level of physical activity and reduced severity of both climacteric and depressive symptoms.

Selected psychological aspects and medication adherence in oncological patients.

OBJECTIVE: The aim of this study was to analyze the relationships between selected psychological features and adherence to therapy in oncological patients. METHODS: The study included 102 patients of oncological clinics, 66.67% of whom were female. The average (SD) age of the study subjects was 49.15 ± 18.16 years old. The following tools were used: Morisky Medication Adherence Questionnaire (MAQ-4), Multidimensional Health Locus of Control, Coping Inventory for Stressful Situations, Personal Values Inventory (LWO), and a study-specific survey questionnaire. RESULTS: High MAQ-4 scores were declared by 39.2% of the subjects, medium scores by 32.3% and low scores by 28.5%. The values were higher in female patients (P = .23), younger subjects (P < .001), and in individuals with higher education (P = .03). The greatest adherence was observed in subjects who placed their locus of control in chance (P = .022). Significant relationships were identified between the level of medication adherence and the use of avoidance strategies of coping with stress (P = .037), including the willingness to engage in social relationships (P = .04). It was demonstrated that the risk of noncompliance in the analyzed group was associated with a lower assessment of appearance (OR = 0.75) and health (OR = 0.78) on the scale of values. CONCLUSION: Medication adherence in oncological patients is related to the health locus of control, strategies of coping with stress, and the value assigned to appearance and health.

The occurrence of depressive symptoms in obese subjects starting treatment and not seeking treatment for obesity.

INTRODUCTION: The psychological profile of obese people deciding to start obesity treatment may be different from those not choosing to seek the therapy. Previous studies have shown a higher incidence of depression in obese than in normal weight people. However, data are lacking concerning the occurrence of depressive symptoms and their severity in obese subjects who do or do not decide to start treatment for obesity. Therefore, the aim of this study was to evaluate the prevalence and severity of depressive symptoms among obese people starting treatment and not seeking treatment for obesity. MATERIALS AND METHODS: Enrolled subjects were 331 adults (241 women, 90 men), including 193 obese subjects starting treatment for obesity (46.8 ± 13.2 years, BMI 37.6 ± 5.5 kg/m2) and 138 obese volunteers never seeking treatment for obesity (44.3 ± 12.5 years, BMI 34.7 ± 4.3 kg/m2). Depression levels were determined using the Beck Depression Inventory (BDI). RESULTS: The level of depression was significantly higher among those starting treatment for obesity than those never seeking treatment for obesity (13.2 ± 9.2 vs. 9.5 ± 7.9 points; p < 0.001). This difference was statistically significant in women (14.4 ± 9.2 and 11.0 ± 8.2 points, respectively; p < 0.01), but not in men (7.2 ± 6.4 and 7.3 ± 7.1 points, respectively; p = 0.95). There were more women with moderate/severe depressive symptoms in the group starting treatment than in the group not seeking treatment for obesity (44.7 and 24.4%, respectively). No such difference was observed in men. CONCLUSIONS: Obese subjects, especially women, with depressive symptoms are more likely to start treatment for obesity. LEVEL OF EVIDENCE: Level III, case-control analytic study.