The rhythm of chemotherapy and the felt experience of time: a front-loaded phenomenological retrospective cohort study.

It is well-known that chemotherapy brings about various adverse physical effects such as fatigue, nausea, or vomiting, and that it lowers mental well-being. It is less known that it desynchronizes patients with social environment. This study explores the temporal aspects and challenges of chemotherapy. Three groups equal in size and distinguished according to weekly, biweekly, and triweekly treatment schemes, each independently representative in terms of sex and age of the cancer population (total N = 440) were compared. The study found that chemotherapy sessions, regardless of their frequency, patients' age, and the overall length of treatment, have a very large effect on changing the felt pace of time from flying to dragging (Cohen's d = 1.6655). Most patients pay more attention to the passing of time than before treatment (59.3%), which has to do with the disease (77.4%). They also experience the loss of control over time, which they subsequently attempt to regain. The patients' actual activities before and after chemotherapy, however, are mostly the same. All these aspects create a unique 'chemo-rhythm', in which the significance of the type of cancer and demographic variables is negligible, and the mere rhythmic nature of treatment plays a central role. In conclusion, patients find the 'chemo-rhythm' stressful, unpleasant and difficult to control. It is vital to prepare them for it and help to reduce its adverse effects.

Medical grounds for suspending the professional licence of physicians and dentists by Regional Medical Councils between 1990 and 2014. / Przyczyny zdrowotne zawieszenia prawa wykonywania zawodu przez okregowe rady lekarskie w latach 1990­2014.

OBJECTIVES: The professions of physician and dentist are associated with multiple health risks. The aim of this study was to identify the medical conditions that caused limitation or suspension of the professional license of Polish physicians and dentists, and to assess their return to professional activities. METHODS: We analyzed documentation of Regional Medical Registers concerning the procedure for suspending medical licences or limiting certain medical activities, and decisions of Regional Medical Councils in 1990-2014. RESULTS: The data on 65 decisions suspending the professional license, 8 decisions limiting the license and 1 revoking the right to practice have been obtained from 8 Councils. The most frequent cause of limiting or suspending the professional license was drug and alcohol dependence (54.1%). There was no correlation between the underlying medical condition and gender or profession (physician/dentist). Among doctors aged 42-57 and 58-67 whose licence had been suspended or limited, more than 60% suffered from substance use disorder (SUD). In the group of doctors aged 41 and younger, no such case was found. Among doctors older than 67, addiction was the cause of 37.5% of decisions suspending or limiting the professional license. In no case the medical condition causing limitation or suspension of the licence was an occupational disease. SUD was more frequent in surgical than nonsurgical specialties (76.5% vs. 46.9%, p < 0.05). The doctors suffering from addictions were more likely to return to their practice (57.5%) than those suffering from other illnesses (20.5%, p < 0.05). CONCLUSIONS: The most common medical ground for limiting or suspending the professional licence was substance abuse. Number of decisions suspending or limiting the licence is relatively small and indicates a need for more efficient procedures for identification of doctors and dentists incapable of practicing due to health problems and assessment of the capacity to practice in the case of individuals who do not undertake treatment themselves and therefore are unable to assure sufficient quality of care to their patients. Moreover, although few decisions were issued, there is a need for an active addiction prevention, particularly among surgical specialists.