Having Children and Being Married Are Predictors of Burnout and Obesity Among Working Men: Effects of Latent Profile Analysis.

Emergency call-takers and dispatchers' (ECDs) work makes them vulnerable to occupational burnout and health problems. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between burnout risk factors (having children), personal resources (being married), and health consequences (overweight and obesity) among men working in these positions. The burnout syndrome was assessed among 228 Polish ECDs using The Link Burnout Questionnaire and the method of latent profile analysis (LPA). All ECDs were characterized by high levels of occupational burnout exhibited in 3 out of its 4 dimensions. The LPA allowed us to differentiate 4 patterns of burnout, taking into account socio-demographic variables, the length of employment as ECD and body weight. The need to balance the demands of professional work with having children and marital roles played an important role in predicting the level of professional burnout. There was a relationship between the dimensions of occupational burnout and age, being married, and having children. Being married was associated with a greater intensity of emotional exhaustion, and the level of exhaustion was higher if the employee had children in their care. Health consequences in the form of overweight and obesity can be associated with levels of emotional exhaustion and professional effectiveness. The application of the Person-Oriented approach presents hidden correlations between burnout predictors and health consequences.

Burnout and stress in group of psychiatrists: workload and non-professional-social predictors.

OBJECTIVES: The aim of this research is to present the search for psychosocial predictors explaining the strength of perceived stress in psychiatrists and the search for associations between stress and occupational burnout in psychiatrists. The authors also searched for associations between organizational, workload, family and non-professional - social factors and the intensity of occupational stress. MATERIAL AND METHODS: The group of 131 doctors - specialists in psychiatry, aged 27-86 years - took part in the study. The participants completed 3 questionnaires, i.e., the Sociodemographic Questionnaire, the Link Burnout Questionnaire (LBQ) and the Perceived Stress Scale (PSS-10). RESULTS: The results indicated that significant predictors of the development of occupational stress for psychiatrists were psychophysical exhaustion and lack of a sense of professional efficacy. Taking holidays (several times a year, pursuing the passions and interests), and having a stable family relationship (marriage or civil partnership) were also prominent among the predictors of stress. CONCLUSIONS: Occupational stress and burnout in the work of the surveyed psychiatrists appeared to be a high intensity phenomenon. These results indicate the need to spread preventive health care also in the work of psychiatrists. Mainly in terms of maintaining the right balance between work and rest, which can help to reduce stress levels and protect against further development of burnout syndrome. Family resources such as a stable marriage or partnership may also be a protective factor against the build-up of stress and burnout in psychiatrists (mainly female). In addition, professional resources (work experience measured by number of years of work) is also important in explaining stress levels in psychiatrists. Int J Occup Med Environ Health. 2023;36(3):379-95.

Demographic and Clinical Factors Associated with Depression in 140 Hospitalized Diabetic Patients with Distal Symmetric Polyneuropathy Evaluated Using Beck Depression Inventory and 6-Item Neuropathy Total Symptom Score Questionnaire.

BACKGROUND Diabetic distal symmetric polyneuropathy (DSPN) is one of the most common and costliest long-term complications. The pain and function limitations may lead to depression. This study aimed to assess the influence of demographic and clinical factors on the prevalence of depression among diabetic patients with distal symmetric polyneuropathy (DSPN). MATERIAL AND METHODS A total of 140 patients with diabetic DSPN completed the 21-item Beck Depression Inventory (BDI) measuring characteristic attitudes and symptoms of depression. The intensity of neuropathic complaints was assessed using the Neuropathy Total Symptom Score- 6 items (NTSS-6). Testing for peripheral neuropathy was performed. All patients completed questionnaires, which included anthropometric measures, social parameters, and medical aspects. Statistical analyses were done using STATISTICA 8 PL software. RESULTS Statistically significant relationships were found between the depression symptoms in diabetic patients and the intensity of subjective neuropathy symptoms evaluated by NTSS-6, body mass index (BMI), and education level. On average, each 1-point increase in NTSS-6 predicted a 16% increase in the risk of depression. Each 1 kg/m² increase in the BMI was associated with a 10% increase of depression risk. CONCLUSIONS The study showed the positive quantitative relationship between diabetic DSPN and depression symptoms. The BMI, severity of neuropathy symptoms, and lower level of education had a statistically significant association with the level of depression and may be useful in evaluating the risk of depression among DSPN patients.

Depressive and anxiety symptoms in adolescents with type 1 diabetes - a single-centre observational study.

INTRODUCTION: Type 1 diabetes mellitus (T1DM) significantly affects the everyday functioning of the child and its family. This study aimed to assess the prevalence of symptoms of depression and anxiety and estimate their potential association with various clinical parameters. MATERIAL AND METHODS: 59 adolescents with T1DM (age 15-18) and their parents answered validated questionnaires (Children's Depression Inventory 2, The State-Trait Anxiety Inventory) and a survey assessing everyday functioning. RESULTS: There were no significant differences in the occurrence of symptoms of depression in children and their parents (p = 0.975), but significant differences were found for anxiety. The distribution of the sten X1 and X2 values of adolescents and parents were different (p = 0.021 and p = 0.001, respectively). Girls were characterized by a higher level of depression both based on the overall score (p = 0.010) and the emotional problems (p = 0.022), and functional problems (p = 0.012). There was no significant correlation between diabetes duration time, glycaemic control, the occurrence of acute diabetes complications, and the parameters assessing anxiety and depression. Optimal glycaemic control, defined as HbA1c below 6.5% and TIR above 70%, was associated with sex (p = 0.001) and a high level of functional problems (p = 0.048). CONCLUSIONS: In the studied population, adolescent girls with T1DM presented depressive symptoms more often than boys, and anxiety symptoms in adolescents were described more frequently by parents than by the teenagers themselves. Higher HbA1c was correlated with a higher level of functional problems.

Validation of FES-I and Short FES-I Scales in the Polish Setting as the Research Tools of Choice to Identify the Fear of Falling in Older Adults.

Fear of falling is associated with a clear hazard to individual self-reliance, reduced physical activity, as well as a sense of shame and loss of self-confidence. The present study aimed to complete the applicable translation and validation protocol for the Falls Efficacy Scale-International (FES-I) tool, following its prior adaptation to ensure full compatibility with the Polish setting. The FES-I questionnaire, along with its abridged version, was translated in line with the recommended standards of the MAPI Institute, taking into account both the cultural fabric and pertinent language specifics of the country. The survey was attended by 740 individuals (N = 740; 463 women, 277 men), over 60 years old. All respondents were required to complete both the FES-I and FES-I (Short) questionnaires twice, following an intervening period, and subsequently had their responses statistically assessed. The FES-I questionnaire, along with its abridged version, may be recommended as an effective assessment tool for addressing the fear of falling issue among the older adults, consequently allowing the teams of attending physicians, physiotherapists, psychologists, or psychiatrists to complete an unambiguous diagnosis, with a view to helping the patients overcome this particular type of anxiety.

Polish version of the Depression Anxiety Stress Scale (DASS-42) - adaptation and normalization. / Polska wersja Skali Depresji Leku i Stresu (DASS-42) ­ adaptacja i normalizacja.

OBJECTIVES: This study aimed to present the Polish adaptation and preliminary normalization of the Depression Anxiety and Stress Scale - 42 (DASS-42). METHODS: The study was conducted among 1,021 participants (625 females and 396 males) aged 18-83 years (M = 30.67; SD = 13.25). It was a non-clinical sample. Second sample was a group of 49 psychiatric patients (28 females and 21 males) aged 22-76 years (M = 49.40; SD = 13.34). The reliability of the DASS-42 was measured using Cronbach's α coefficients and intraclass correlation coefficients (ICC). RESULTS: In the non-clinical sample the Cronbach's alpha coefficient was 0.93 points for the depression subscale; 0.89 points for the anxiety subscale; 0.92 for the stress subscale, and 0.96 for the DASS-42 total score. The ICC were satisfactory, between 0.37 and 0.49 points. Psychiatric patients obtained significantly higher results in all subscales and in a total score of the DASS-42 (p< 0.001) than healthy participants. It is an indicator of good concurrent validity of the method. The effect size of the differences for all questionnaire indicators was large (0.96

Obesity in adolescents may be associated with limitations in daily activities and an increased level of anxiety in patients and their parents - preliminary results of a pilot study.

Obesity is a chronic disease, that in adolescents may lead to serious consequences affecting somatic and mental health. This study aimed to assess the prevalence of depressive symptoms and anxiety in adolescents with obesity and their parents. The relationships between depressive and anxiety symptoms and the somatic consequences of obesity were also analyzed. Material and Methods: 19 patients with obesity (BMI Z-SCORE 2.1-5.5), at the age 16-17, and their parents answered validated questionnaires (Children's Depression Inventory 2, The State-Trait Anxiety Inventory), and a survey assessing everyday functioning. Results: There were no significant differences in the occurrence of symptoms of depression in children and their parents: for the overall scale score of T-score (p=0.331), for the emotional problems (p=0.281) subscale, and the functional problems (p=0.147) subscale. The comparison of the results between boys and girls revealed no significant differences. A significantly higher level of anxiety was found in parents of children who gained weight in the year preceding the study (p = 0.046), and both in children and parents of children with metabolic-associated fatty liver disease - MAFLD (p=0.022 and p=0.007). According to adolescents, obesity affects the most leisure activities. Conclusion: Obesity, like any chronic disease, can have a significant impact on the emotional state of children and adolescents as well as the possibility of realizing interests and spending free time. Much more important than depressive disorders are anxiety disorders concerning both patients and their parents.

Dynamics of suicidal frequency changes within the Poland rail system - an attempt of epidemiological analyzes. / Dynamika zmian czestotliwosci samobójstw na kolei w Polsce ­ próba analizy epidemiologicznej.

OBJECTIVES: The analysis presented in the article is the first study of suicide on railway tracks in Poland. METHODS: An epidemiological assessment was conducted, study type: case series, population-based with use of the data from the National Police Headquarters. The rates of railway suicides in Poland in the years 2007-2018 were compared to the overall number of suicides in Poland and in the Europe. RESULTS: In 2007-2018, the average share of deaths by railway suicide in the overall number of suicides committed in Poland amounted to 2.06%. Between the years: 1999 -2018 there is a growing number of railway suicide attempts and railway suicide attempts without deaths. Since 2012, an increase of suicide attempts on railway tracks, along with a constant number of suicide deaths, has been observed. In 2017 - 2018, throwing oneself under a train to end one's lifewas the third most commonly chosen method in Poland. Although it accounted for only a small percentage of all methods of suicide, it was chosen relatively more often than in other European countries. CONCLUSIONS: Poland belongs to a small group of European countries where the number of deaths by suicide has displayed an upward tendency in the course of 20 years. There is a growing number of unsuccessful railway suicide attempts. The index of deaths on railway tracks in Poland, was considerably higher than the average index for the EU.

Latent Occupational Burnout Profiles of Working Women.

According to scientific research, emergency call-takers and dispatchers (ECD) are particularly vulnerable to burnout syndrome. It can be observed that this occupation is predominantly performed by women. Moreover, the studies on occupational burnout indicate its different causes depending on employees' gender. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between particular risk factors, the level of burnout, and its health consequences in a group of women. A cross-sectional survey study was conducted on 296 women (call-takers and dispatchers) from public-safety answering points in Poland. The Link Burnout Questionnaire and a sociodemographic questionnaire were used to gather information. The method of latent profile analysis (LPA) was employed in the study. The study revealed burnout patterns without full symptoms as well as four different burnout profiles. The findings partially confirmed initial assumptions about correlations between the length of service as ECD, marital status, motherhood, burnout symptoms, and body mass index (BMI). Sociodemographic variables differentiated the examined women in terms of their emotional exhaustion and BMI. Three groups of women at risk of burnout and overweight were identified: those with the shortest job experience, those with the longest job experience, and an intermediate group. In each of these groups, symptoms indicating a possible risk of burnout-related health issues could be observed. The application of a Person-Oriented approach allowed for assessing possible correlations between burnout risk factors, its symptoms, and health consequences.

Profiles of Occupational Burnout in the Group of Representatives of High-Risk Professions in Poland.

(1) Background: Working in a high-risk profession is associated with taking on a large responsibility and risking loss of health or life. These professions include, among others, air traffic controllers, firefighters, and ECDs. People working in these professions are particularly vulnerable to experiencing high levels of stress and developing professional burnout syndrome. The aim of the conducted research was to assess the external and internal differences in the intensity of occupational burnout dimensions among representatives of high-risk occupations and to distinguish burnout profiles among them. (2) Methods: The total number of participants working in high-risk occupations who took part in the study was N = 1239, including the following job positions: air traffic controllers (n = 107), firefighters (n = 580), and ECDs (n = 558). The respondents completed the following self-report questionnaires: a structured survey and the Link Burnout Questionnaire. The following statistical tests were performed: cluster analysis, analysis of variance, and chi-square test of independence. (3) Results: The highest intensity of burnout dimensions was presented by representatives of ECDs. Profiles reflecting the types of occupational burnout were distinguished. The representatives of air traffic controllers demonstrated the following profiles: 1-low risk of burnout with a component of psychophysical exhaustion; 2-exhausted with a moderate tendency to disappointment; 3-burned out, ineffective, and uninvolved. The profiles of the ECDs were: 4-engaged, with a reduced sense of effectiveness; 5-with a reduced sense of effectiveness; 6-burned out with a low sense of effectiveness. However, the profiles of the firefighters were: 7-not burned out; 8-at risk of burnout; 9-exhausted with a tendency towards disappointment. Individuals representing the various burnout profiles differed in terms of the severity of the dimensions of occupational burnout as well as sociodemographic and work-related characteristics. (4) Conclusions: The process of occupational burnout varies among people in various high-risk occupations and due to sociodemographic characteristics. The internal differentiation of people representing high-risk professions requires different psychological interventions and preventive measures.

Reproductive problems and intensity of anxiety and depression in women treated for infertility. / Problemy prokreacyjne a nasilenie leku i depresji u kobiet leczonych z powodu nieplodnosci.

OBJECTIVES: The aim of the study was to assess the severity of anxiety and depression in women treated for infertility as compared to the severity of these clinical parameters in women without reproductive problems, and to assess the impact of emotional disorders on the ovulation cycle. METHODS: Ovulation was assessed by hormonal and ultrasound examinations. The emotional state was examined by the STAI Anxiety State and Trait Inventory and the HADS anxiety and depression scale. RESULTS: The severity of anxiety as a trait and as a state according to STAI was significantly higher in women treated for infertility than in women with confirmed fertility, as well as higher in women treated for infertility who did not get pregnant than in those who got pregnant.The severity of anxiety and depression were significantly higher in women treated for infertility than in women with confirmed fertility. Women treated for infertility who did not become pregnant had higher severity of depressive symptoms compared to women who were pregnant. In the serum of women treated for infertility, cortisol levels, both during and after ovulation, positively correlated with the severity of anxiety and depression. The same correlations were found in the group of women with confirmed fertility. CONCLUSIONS: (1) Anxiety and depression are associated with human reproductive problems. The nature and direction of the association is to beexplored. (2) Emotionaldisorders adversely affect the secretion of sex cycle hormones and endometrial growth. (3) Couples with reproductive problems require psychological support to improve the effects of infertility treatment.

Assessment of Quality of Life in Men Treated for Infertility in Poland.

The aim of this study was to assess the quality of life (QoL) of men treated for infertility in Poland. This cross-sectional study was conducted using the Abbreviated World Health Organization Quality of Life questionnaire (WHOQoL-BREF), Fertility Quality of Life tool (FertiQoL) and an author-constructed questionnaire. The study included 1200 men treated for infertility without the use of assisted reproductive technology (non-ART), intrauterine insemination (IUI) and in vitro fertilization (IVF). The control group consisted of 100 healthy men with confirmed fertility. The quality of life assessed by the WHOQoL-BREF questionnaire was significantly lower in study groups in the Environmental domain, compared to the control group (p = 0.009). Statistically significant differences were found in the case of FertiQoL subscales: Emotional, Mind-Body, Relational, and Treatment Environment, depending on applied treatment. Men whose partners were treated without the use of ART assessed their QoL significantly more negatively than those treated with IUI. Reproductive problems and type of their treatment influenced the quality of life of the affected men. Non-ART treatment, rural place of residence, and increased BMI were associated with lower QoL.

Profiles of Burnout, Job Demands and Personal Resources among Emergency Call-Takers and Dispatchers.

According to scientific research, emergency call-takers and dispatchers are particularly vulnerable to burnout syndrome. There are no data describing specific burnout patterns or allowing for the definition of subgroups of workers who are particularly at risk. The aim of this research was to apply a person-oriented approach to characterize burnout profiles using job-related variables and personal resources. A cross-sectional survey study was conducted on 553 call-takers and dispatchers aged between 19 and 65, from 14 public safety answering points in Poland. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. K-means cluster analysis was used, which allowed us to highlight three distinct burnout risk profiles: high risk of burnout, without full-blown pattern of burnout with high inefficacy, and no risk of burnout with an increased sense of disappointment. Several variables which coexisted with occupational burnout included work experience, weekly working hours, intensity of perceived stress, and self-efficacy level. The application of a person-oriented approach made it possible to identify groups of call takers characterized by a high risk of burnout syndrome, and to indicate the areas in which preventive measures, focused on each of their specific needs, should be taken.

Tokophobia and Anxiety in Pregnant Women during the SARS-CoV-2 Pandemic in Poland-A Prospective Cross-Sectional Study.

SARS-CoV-2 coronavirus emerged in the world at the end of 2019. The introduction of a number of restrictions had a significant effect on numerous aspects of human life with particular influence being exerted on pregnant women and their sense of security. The study aimed to assess the level of anxiety and its main determinants in women in the third trimester of pregnancy during the coronavirus pandemic. The study technique included the present purposely designed questionnaire, Labor Anxiety Questionnaire (KLPII), and the State-Trait Anxiety Inventory (STAI). The study was conducted in a group of 315 women in the third trimester of pregnancy. A total of 258 women (81.9%) completed the questionnaire in May 2020, and 57 of them (18.1%) completed it in October 2020. The overall analysis of the Labor Anxiety Questionnaire and the STAI inventory revealed a high level of anxiety, particularly situational anxiety, in pregnant women during the SARS-CoV-2 pandemic. The age and financial status of the women were the factors which contributed to the intensification of tokophobia. Women interviewed in October 2020 were characterized by higher tokophobia levels compared to the respondents included in May 2020. It seems justified to in-crease the vigilance in the diagnostics of possible mental disorders in the perinatal period during pandemic.

Measuring Staff Attitudes to Coercion in Poland.

Introduction: Coercion can be defined as the use of force to limit a person's choices. In Poland, coercive measures may tend to be overused. However, there is limited information regarding the attitudes of nurses toward coercion in psychiatric settings and the factors influencing any decisions to use coercion. Aims: To validate the Staff Attitudes to Coercion Scale (SACS) for a group of psychiatric nurses and psychiatrists, to compare the said with the original Norwegian SACS version, and to compare nurses' attitudes with those displayed by psychiatrists. A second aim was to understand the relationship between self-efficacy and attitudes to coercion. Method: We surveyed 351 psychiatric nurses and psychiatrists rating SACS and GSES (General Self Efficacy Scale). We validated the SACS factor structure using confirmatory principal component factor analysis, calculated the internal consistency of subscales, and analyzed the test-retest reliability and face validity of the subscales themselves. Further, we analyzed the differences in attitudes toward coercion between nurses and psychiatrists, as well as whether there was an association between GSES and the SACS subscales. We compared the means on the SACS items between three countries-Germany, Norway, and Poland. Results: The confirmatory factor analysis of the Polish version of SACS found the same factor structure with three factors as was displayed in the original Norwegian SACS, except that one item was loaded on another factor. Internal consistency was acceptable for the factors on coercion as security and the coercion as offending, and unacceptable for the factor on coercion as treatment. Test-retest reliability was excellent for all the three subscales. Face validity was high for the factor coercion as security, partly present for coercion as offending, and not present for coercion as treatment. The subscale Coercion as Treatment was rated significantly higher by nurses than by psychiatrists, but there was no difference for the two other subscales. There was no significant association between the General Self-Efficacy Scale and any of the SACS subscales. The biggest differences in attitudes toward forms of coercion was noted between Poland and Germany. Discussion: The three-factor structure of SACS was the best solution for the Polish nurses and psychiatrists. The attitudes toward coercion differed between the two groups, but a low correlation was computed for the SACS subscales and self-efficacy. There is a cultural diversity visible amongst the three countries examined. Reduction in the use of coercion is a priority worldwide. More knowledge about the process involved in using coercive measures may contribute to this. The use of coercive interventions may harm patients and threaten patients' rights. Thus, education is needed for pre-service and in-service nurses alike.

Polish Emergency Dispatchers During a COVID-19 Pandemic - Burnout Syndrome, Perceived Stress, and Self-Efficacy. Effects of Multidimensional Path Analysis.

International research has demonstrated that emergency call operators face unique risks to their mental health, in particular job stress, and occupational burnout syndrome. There is already wide knowledge about the relationship between stress, burnout and employee personal resources, which has practical application in preventing mental health. However, more research into the subtle relationships between variables is needed. The aim of the study was to check the moderation effect of differences in the intensity of latent variables on the relationship between perceived stress, self-efficacy and professional burnout. The participants were 546 call-takers and dispatchers from 14 public-safety answering point in Poland aged between 19 and 65 years. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. The method of path analysis was used. The study confirmed the existence of negative relationships between perceived stress (assessment of the current situation) and self-efficacy (a personal trait). Taking into account the moderating effect of latent variable: psychological comfort revealed a hidden relationship between stress and burnout. The stress-burnout relationship occurred only among participants with low level of psychological comfort, so it was not a proportional relationship. In the case of participants with a high level of second latent variable: power-to-affect, the hypothesis that a high level of this variable should weaken the relationship between stress and burnout was not confirmed. The level of latent variables did not affect the self-efficacy relationship with occupational burnout. Taking into account the differences in the intensity of latent variables showed their moderating effect, which often turned out to be different from the assumed one and obtained in the research of other authors. This allowed to discover the relationships that might otherwise have been overlooked and not included in burnout prevention. The results showed a high level of occupational burnout in the ECD's group during the COVID-19 pandemic: 32% of the responders reported emotional exhaustion, 53% loss of professional effectiveness.

Burnout and Perceived Stress of Polish Emergency Call Takers and Dispatchers.

A scientific research has demonstrated that emergency call operators face unique risks to job stress and burnout. It was hypothesized that perceived stress (demonstrated as resourcefulness-helplessness dimension) may mediate relationships between work environments and burnout taking into account the buffering effect of self-efficacy. The participants of the study were 546 emergency dispatchers and call-takers from 14 Polish public-safety answering points. The Link Burnout Questionnaire, the Perceived Stress Scale and the Generalized Self-Efficacy Scale were employed. The method of path analysis was used and direct and indirect interactions between the variables were identified. Shorter work experience (fewer years on this specific job position) was associated with a higher level of burnout. The greater number of shifts per month was associated with a higher level of perceived stress (higher level of helplessness). Self-efficacy was combined with perceived stress by antagonistic relationships, but the assumed buffering effect on burnout was not confirmed. It was observed that engaging the resource of one's own self-efficacy in professional work may lead to the loss of other personal resources, manifesting itself in the form of greater disappointment with the work performed.

Stress responses in high-fidelity simulation among anesthesiology students.

Simulation sessions can produce high-fidelity emergency situations that facilitate the learning process. These sessions may also generate a complex stress response in the learners. This prospective observational study assessed psychological, physiological, immunological, and humoral levels of stress during high-fidelity simulation training. Fifty-six undergraduate medicine students who took part in a medical simulation session were assigned team roles (physician, nurse or assistant). Subsequently, each participant was assessed before the scenario (T0), after the procedure (T1), and two hours later (T2). Psychological stress and anxiety were measured at T0 and T1, using the State-Trait Anxiety Inventory (STAI) and Dundee Stress State Questionnaire (DSSQ). Cortisol, testosterone, secretory immunoglobulin class A (sIgA), alpha-amylase, and oxygen saturation level were measured at T0, T1, and T2, as was the physiological response indicated by heart rate (HR) and blood pressure (BP). It was found that the onset of task performance was related to increased anticipatory worry and higher oxygen saturation. The participants reported decreased worry, followed by increased emotional distress after the simulation training (T1). Participants trait anxiety predicted the intensity of worry, distress and task engagement. In contrast, no clear relationships were found between trait anxiety and biological stress markers. Testosterone levels were growing significantly in each phase of measurement, while physiological responses (BP, HR) increased at T1 and declined at T2. The levels of stress markers varied depending on the assigned roles; however, the trajectories of responses were similar among all team members. No evidence for prolonged cortisol response (T1, T2) was found based on psychological stress at the onset of simulation (T0). Regression analysis followed by receiver operating characteristics analyses showed uncertain evidence that initial state anxiety and worry predicted the levels of sIgA. Medical students are relatively resilient in terms of stress responses to medical simulation. The observed stress patterns and interrelationships between its psychological, physiological, hormonal, and immunological markers are discussed in accordance with theoretical concepts, previous research work, and further recommendations.

Assessment of Quality of Life in Infertility Treated Women in Poland.

The aim of this study was to assess the quality of life (QoL) of infertility treated women as it can affect the effectiveness of therapy. This cross-sectional study was conducted with Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF), Fertility Quality of Life tool (FertiQoL) and an author's questionnaire. The study included 1200 women treated for infertility without the use of assisted reproductive technology (non-ART), intrauterine insemination (IUI), or in vitro fertilization (IVF). The control group was 100 healthy women who had children. The time to conceive did not significantly differ between study groups and was 3.1-3.6 years, on average. The quality of life in the WHOQOL-BREF questionnaire data significantly differed between study groups and the control (physical domain p < 0.001, psychological p = 0.009; social p = 0.004; environmental p < 0.001). A significant effect was found in 4 FertiQoL subscales: emotional, biological, partnership, and attitude towards treatment; depending on the method of treatment. Women who received non-ART treatment evaluated their QoL in significantly more negative terms in these 4 subscales, compared to those treated with IVF. The quality of life depends on reproductive problems, methods of infertility treatment, age, place of residence, and education level. Prolongation of the duration of treatment unfavourably affects the quality of life. The quality of life of women undergoing infertility treatment differs according to the mode of work and having children from a previous relationship.

Attitudes of psychiatric nurses towards aggression: A polish study.

WHAT IS KNOWN ABOUT THE SUBJECT? (SCIENTIFIC RATIONALE): Mental health care in Poland lags behind that of many other countries, and coercive measures are used on a regular basis. Scant research has been conducted in Poland regarding the treatment of psychiatric patients. The perspectives of Polish psychiatric nurses towards aggression remain unknown. WHAT DOES THIS PAPER ADD TO THE EXISTING KNOWLEDGE?: The translated and validated Attitude Towards Aggression Scale (ATAS) in Polish will serve as an instrument that gauges Polish nurses' attitudes towards aggression. The Polish nurses have unenlightened and negative attitude towards aggression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is now an instrument in Polish by which we can gauge the attitudes of mental health nurses, which must precede any educational efforts. Polish nurses showed more restrictive and antiquated attitudes about patient violence than nurses in some other parts of the world. With a shift to more positive attitudes, the use of coercion could be reduced, resulting in improved patient care. INTRODUCTION: In Poland, the mode and site of patient treatment have changed little in the past 75 years, despite therapeutic advances worldwide. There is limited information regarding attitudes of nurses towards aggression in psychiatric settings in Poland, nor has there been an instrument in Polish to measure it. AIM: To translate and validate the Attitudes Towards Aggression Scale (ATAS) for use in Poland, and to assess the attitudes of three groups of nursing personnel towards aggression. METHOD: We surveyed 980 psychiatric and general nurses as well as nursing students. We translated the ATAS into Polish, and validated it using exploratory factor analysis. RESULTS: The Polish version of the ATAS showed good psychometric properties. We found that Polish nurses perceived patient aggression extremely negatively. DISCUSSION: Polish nurses perceive aggression as destructive, negative and not to be tolerated, leading to use of restraints. Among the three groups, psychiatric nurses showed the most negative attitude towards aggression. Thus, education is needed for preservice and inservice nurses alike to address this issue. WHAT THIS STUDY ADDS TO EXISTING EVIDENCE: We now have a validated instrument to assess nurses' attitudes about aggression. We also know that Polish nurses have exceedingly negative attitudes towards aggression. IMPLICATIONS FOR PRACTICE: The Polish version of ATAS was found valid and reliable. Therefore, we can now measure the attitudes of Polish nurses towards aggression, which was not possible previously. The baseline data provide a starting point from which to determine effects of educational efforts.