The impact of endometriosis on the quality of women's life.

OBJECTIVES: Endometriosis is a disease that involves the ectopic growth of the endometrial tissue outside the uterine cavity. Its average occurrence is about 10% of women of reproductive age. Making a diagnosis of the disease is commonly long-lasting and ambiguous due to the wide variety and intensity of symptoms. The aim of the study is to determine factors affecting the quality of life of women struggling with endometriosis. MATERIAL AND METHODS: A cross-sectional study was conducted using a diagnostic survey method with the use of the author's questionnaire and the WHOQOL-BREF questionnaire. The study population included 650 people (group with endometriosis - 361 women and group without endometriosis - 289 women). RESULTS: In the group of women with endometriosis, the mean age was significantly higher (31.87 vs 24.99). Difficulties with conception were significantly more common (51.67%) in the endometriosis group compared to 5.52% in the non-endometriosis group. In each area, the quality of life of women with endometriosis was significantly lower (p = 0.000). Women with the history of the disease of over 3 years significantly more often complained of dyspareunia (p = 0.048), bladder pain (p = 0.01) and lower back pain (p = 0.029). CONCLUSIONS: Endometriosis significantly reduces women's quality of life. Factors that deteriorate the quality of life of women with endometriosis include severe pain, infertility, dyspareunia and reduced satisfaction in various spheres of life (somatic, mental, social). More research is necessary to improve the quality of life of women with endometriosis.

Undertaking Healthy Nutrition Behaviors by Patients with Type 1 Diabetes as an Important Element of Self-Care.

BACKGROUND: Self-control/self-care means the active participation of a diabetic patient in therapy. It involves making numerous decisions and undertaking actions independently. The primary activities under the patient's control include adherence to medication regimens and maintenance of a health-promoting lifestyle, especially a healthy diet. However, the sense of responsibility for one's own health, i.e., high sense of responsibility (HSR), is an important element in the treatment of diabetes and in undertaking pro-health behaviors. The study aimed at analyzing adherence to dietary recommendations in the context of HSR in patients with type 1 diabetes. METHODS: The cross-sectional study was conducted on a group of 394 adults. The assessment of adherence to dietary recommendations was performed with the present authors' Diabetes Dietary Guidelines Adherence Index (DDGA Index). The measurement of HSR was performed with the standardized Sense of Responsibility for Health Scale (HSRS). The assessment of the multifactorial influence of independent variables on the DDGA Index, including the "responsibility for health" variable, was conducted with the use of a linear regression model. RESULTS: The mean DDGA value was 18.68 (SD = 3.97). The patients significantly more often avoided unhealthy products than included recommended products into the diet at a required frequency. A positive correlation was demonstrated between HSR and adherence to dietary recommendations (ßstd. = 0.43, p < 0.001). CONCLUSIONS: The sense of responsibility for one's health plays a main role in adherence to dietary recommendations in diabetes. Our study showed that a higher sense of responsibility for health was associated with a higher level of adherence to dietary recommendations. Patients with a high sense of responsibility for one's health will be more involved in the therapeutic process, including adherence to dietary recommendations. Therefore, all education actions should comprise not only dietary knowledge transfer and shaping appropriate skills, but they should also strengthen the sense of responsibility for one's health.

A Comparative Analysis of Quality of Life in Women Diagnosed with Breast and Ovarian Cancer.

Background: Previous studies showed that cancer significantly reduces the quality of life of patients. The purpose of this study was to analyze changes in the quality of life of women diagnosed with ovarian and breast cancer after surgical treatment followed by adjuvant cancer therapy. Methods: The study covered 220 women diagnosed with ovarian (n = 89) or breast cancer (n = 131) after surgical treatment followed by adjuvant cancer therapy (chemotherapy, radiotherapy, hormone therapy). The tools used to measure the patients' quality of life were the standardized EORTC QLQ-C30 questionnaire, the QLQ-BR23 module for breast cancer and the QLQ-OV28 module for ovarian cancer. Results: The subjective assessment of the health and quality of life of the women was carried out using the EORTC QLQ-C30 questionnaire and the QLQ-OV28 and QLQ-BR23 modules. Women with breast cancer rated their health higher than women with ovarian cancer. The health assessment performed by the patients was not related to the type of cancer (p > 0.05). They experienced pain, dyspnea and weakness regardless of the cancer location. Moreover, women's health status had a clinically significant impact on their family and social life, although no statistically significant differences were found between the two groups (p > 0.05). Whilst the patients with breast cancer rated their quality of life and health higher than the patients with ovarian cancer, the differences were not statistically significant (p > 0.05). Conclusions: Changes in the quality of life of women with breast and ovarian cancer concern the physical sphere, hobbies, fatigue/rest, pain, family and social spheres, and material conditions. It is necessary to support specialists at every stage of treatment of these patients, which may improve the results of the treatment and patients' perception of health and quality of life.

Awareness and attitudes towards clinical trials among Polish oncological patients who had never participated in a clinical trial.

BACKGROUND: Participation in a clinical trial significantly shortens waiting time associated with receiving specialist care. Furthermore, it may be the case that, through clinical trials, subjects can access medicines that are not typically available in Poland. OBJECTIVES: The aim of this study was to determine the opinions of oncological patients about clinical trials. MATERIAL AND METHODS: The research has been carried out during the years 2014-2016. A proprietary questionnaire consisting of 10 closed, single and multiple choice questions about awareness and perceptions of clinical trials, and 5 questions concerning demographic information was used. A group of 256 patients with cancer (54% women, 46% men), aged 21-77 years, was surveyed. RESULTS: Respondents were statistically more likely to decide to participate in a clinical trial as oncological patients than the healthy volunteers (Pearson's χ2 test p = 0.00006). The desire to qualify for clinical trials in no way depends on the knowledge of side effects (Pearson's χ2 test p = 0.16796). CONCLUSIONS: Our study found that the patients' awareness about clinical trials varied. However, a positive attitude towards research was visible. The main identified barriers to clinical trial participation were fear of possible side effects. Most patients regarded clinical trials as useful, and considered that they are conducted to introduce new treatment/new drug.

Patient knowledge on reporting adverse drug reactions in Poland.

AIM: The aim of the study was to assess patient knowledge on reporting of adverse drug reactions. MATERIALS AND METHODS: A prospective study was conducted among 200 patients. The study was based on an original survey composed of 15 single- and multiple-choice questions. The study involved individuals who have experienced adverse reactions as well as individuals who have never experienced any adverse reactions; people over the age of 18; literate; residing in Mazowieckie Voivodeship, who have not been diagnosed with any disease that could compromise their logical thinking skills. RESULTS: The respondents who lived in the city had a greater knowledge compared to the respondents who lived in the countryside (Pearson's χ2=47.70, P=0.0013). The respondents who lived in the city were also more statistically likely to provide a correct answer to the question about the type of adverse reactions to be reported (Pearson's χ2=50.66, P=0.012). Statistically significant associations were found between the place of residence of the respondents and the correct answer to the question about the data that must be included in the report on adverse reactions (Pearson's χ2=11.7, P<0.0001).

The Impact of Ischemic Cerebral Stroke on the Quality of Life of Patients Based on Clinical, Social, and Psychoemotional Factors.

BACKGROUND: Cerebral stroke is the major cause of disability in the modern world and, given its consequences, poses serious medical and social problems. The purpose of the study was to evaluate the quality of life of patients who suffered from an ischemic cerebral stroke with respect to various areas of life, including, in particular, clinical and psychoemotional factors. The study hypothesis states that the poststroke quality of life is reduced in the general context as well as in the context of specific areas of life. It was also considered of key importance to assess how the quality of life of patients is affected by depression. MATERIALS AND METHODS: The study included 44 patients with the first ischemic cerebral stroke of moderate and mild severity according to the National Institutes of Health Stroke Scale, currently treated in the Neurology Department of the Miedzyleski Specialist Hospital in Warsaw. The quality of life was measured based on the standardized Ferrans and Powers Quality of Life Index questionnaire and the Beck Depression Inventory. RESULTS: Based on the results, it was demonstrated that the quality of life of the patients was significantly reduced on the psychological and spiritual well-being subscale and that depression is a more frequent occurrence among patients with cerebral stroke of moderate severity. CONCLUSIONS: Continued and complex posthospitalization care, including treatment for depression and increased social support, may to a significant extent reduce the negative impact of the disease on the perceived quality of life.

Cost intensity of identifying contraindications to driving a company car through psychological tests on the basis of real-world data in Poland.

OBJECTIVE: The study objective was to determine the cost intensity of identifying contraindications to fleet car driving in preventive care. BACKGROUND: The objective of a psychological examination is to identify impaired psychomotor function as well as any intellectual, cognitive or emotional incapacities, which may seriously impede safety. METHOD: Real-world data were collected from the healthcare provider in Poland. A total of 8111 anonymous records from psychomotor tests performed between January 1 and December 31, 2012 were analysed. RESULTS: The number needed to screen to identify one person with contraindications to driving was 737. An individual examination costs PLN 150, thus the estimated cost of identifying one case was PLN 110,550 (EUR 25,000). The average number of tests in a small enterprise with 20-50 fleet cars was estimated at 5-25 in a 5-year period and their cost at PLN 3750 (PLN 750 annually). CONCLUSION: Health check-ups include ophthalmological and neurological consultations; therefore, psychological examination of fleet car drivers may be considered excessive due to cost and limited preventive value. High costs may be burdensome mainly to larger companies. APPLICATION: A final decision regarding necessity of psychological testing should be preceded by medical assessment of the risk of work accidents.

Assessment of knowledge about the effects of UV radiation on health behaviors associated with sunbathing in gymnasium students.

INTRODUCTION: The health behaviors or health-related behaviors is behavior (or activity) that are part of everyday life, affecting the health of the individual. An example of the behavior of health is also sunbathing, or exposing the body to excessive solar radiation dosage. It may be positive and negative effects on health. AIM: Evaluation of knowledge about gymnasium students. The impact of UV radiation on health and health behaviors associated with sunbathing. MATERIAL AND METHODS: The study was a diagnostic survey, with author's questionnaire. The sample was comprised students from classes II and III. A total of 312 questionnaires were collected among 181 girls and 131 boys. Used purposeful sampling. Results were considered statistically significant at p < 0.05. RESULTS: There is a statistically significant relationship between the stated sunbathing to get a sun tan, and sex of the respondent (p = 0.0002). Definitely more girls (77.35%) admit that tans in the sun to get a tan as compared to boys (58.02%). CONCLUSION: It is recommended that further research aimed at checking the causes and incidence of sunburn among young people. Consideration should be given to create and implement the appropriate health programs taking about tanning that could be implemented under the School Health Promotion Program, or to supplement this knowledge on subjects such as Biology or Nature.

Acceptance of, inclination for, and barriers in genetic testing for gene mutations that increase the risk of breast and ovarian cancers among female residents of Warsaw.

AIM OF THE STUDY: To check the degree of acceptance of, inclination for, and barriers in genetic testing for gene mutations that increase the risk of breast and ovarian cancers among female residents of Warsaw. MATERIAL AND METHODS: This study involved 562 women between 20 and 77 years of age, all of whom were patients visiting gynaecologists practising in clinics in the City of Warsaw. The studied population was divided into six age categories. The study method was a diagnostic poll conducted with the use of an original questionnaire containing 10 multiple-choice questions. RESULTS: Nearly 70% of the women showed an interest in taking a test to detect predispositions to develop breast and ovarian cancer. More than 10% did not want to take such a test, while every fifth women was undecided. No statistically significant differences between the respondents' willingness to pay and education were found (p = 0.05). The most frequent answer given by women in all groups was that the amount to pay was too high. Such an answer was given by 52.17% of women with primary education, 65.22% of women with vocational education, 58.61% of women with secondary education, and 41.62% of women with higher education. CONCLUSIONS: Women with a confirmed increased risk of developing breast and/or ovarian cancer due to inter alia the presence of BRCA1 and BRCA2 gene mutations should pay particular attention to 1(st) and 2(nd) level prophylaxis.

[Professional activity of people with epilepsy]. / Aktywnosc zawodowa chorych na padaczke.

BACKGROUND: The aim of the study was to determine the occupational activity of epileptic patients. Particular attention was paid to employment of people with epilepsy, the way the workplace is informed about the disease, impact of education on employment opportunities and the relationship between clinical type of epilepsy and professional activity. MATERIAL AND METHODS: Patients were recruited from the neurological outpatient clinic in Warszawa and asked to fill in a customized questionnaire, containing questions on their socio-demographic, clinical and employment status. RESULTS: The study included 197 adult patients with epilepsy (64 professionally active and 133 inactive). As many as 47.7% of respondents declared that the disease impeded their employment, and 77.2% admitted that the occurrence of seizure at work had negatively affected their comfort. As many as 42.2% professionally active respondents had revealed the disease at work. There was a statistically significant difference between individuals with primarily generalized seizures and those with partial and secondarily generalized seizures (30.61% vs. 2.63%, p<0.05). Education had also a significant positive impact on employment (47.06% employed with university degree vs. 9.76% with primary education, p<0.05). No significant correlations between duration of the disease or number of the epileptic seizures, independent of their type and revealing the disease in the workplace, were observed (p>0.05). Neither current work status had impact on opinions about difficulties in finding a job (p>0.05). CONCLUSIONS: Epilepsy is a great obstacle to finding and maintaining employment. Less than 1/2 of patients inform the workplace about their illness, mainly due to previous negative experiences. Since education significantly enables the employment, programs aimed at promoting vocational activation of patients should facilitate access to learning.