Analysis of the Level of Stress and Methods of Coping with Stress among the Nursing Staff.

In general, "stress" is the reaction of the body to mental and physical demands placed on it. Stress disrupts mental balance, and reduces the ability to work and function, which negatively affects the performance of duties. The aim of this study was to analyse the level of stress and ways of coping with it among nursing staff. The study covered 220 nurses employed at the Provincial Specialist Hospital in Wloclawek. The research tool was the Perceived Stress Scale (PSS-10) and the Brief-COPE. The results of this survey showed the occurrence of average and high levels of experiencing stress in 36% and 40%of staff, respectively. Brief-COPE scale results show that substance use/gender (men) and use of emotional support/place of work (internal medicine department) are significant at p < 0.01. Considering the impact of the workplace on the use of psychoactive substances, it can be seenthat people working in the surgical ward are more likely to use psychoactive substances. Furthermore, nurses in the surgical ward find it easier to think and plan what to do when faced with a difficult life situation. Most often, the respondents with the highest work experience, i.e., the elderly, declared a return to religion. The results of the research indicate that the nursing community experiences stress to an average or significant degree. The strategies are mainly based on active coping and seeking emotional and instrumental support. Further research is needed in this field. This study was not pre-registered on a publicly accessibly registry.

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.

Does functional assessment of individuals aged 80-plus give rise to scientific discussion - considerations based on literature review.

INTRODUCTION AND OBJECTIVE: For many years, Europe has been struggling with the problem of an aging society. It is obvious that everyone would like to live longer while retaining good psycho-physical health and social activity. This, however, is influenced by many factors, such as health, which may be a form of limitation in everyday life or in performing social roles in accordance with the norms. OBJECTIVE: The aim of the study was to analyze the use of scales for functional assessment of basic and complex daily living activities in individuals aged 80+ in various EU countries. MATERIALS AND METHOD: Potentially essential articles were obtained through review and analysis of the PUBMED (MEDLINE) database by entering the following keywords: functional activities of daily living, ADL, IADL, complex activities of daily living, basic activities of daily living. Article selection was based on the following inclusion criteria set by the authors and the appointed Advisory Board. RESULTS: Assessment of independence and fitness of elderly persons in the area of basic and complex activities of daily living provides information on the quality of life of senior individuals. Analysis of research data used for comparing functional independence of senior persons on the basis of ADL and IADL scales is difficult due to the discrepancies, which may be confusing for researchers studying this area. CONCLUSIONS: The use of different methodologies for assessing functional fitness of elderly individuals makes it difficult to interpret, compare and practically apply the outcomes. Standardization of research methods used for assessment of basic and complex daily living activities in 80+ persons would enable comparing the obtained data in an interdisciplinary perspective.

A preliminary estimation of tissue factor pathway inhibitor (TFPI) and protein C in patients with intracranial tumors.

BACKGROUND: In patients with intracranial tumors, hypercoagulability is observed due to brain tissue and tumor cells being the source of tissue factor. OBJECTIVES: The aim of the study was to assess tissue factor (TF), tissue factor pathway inhibitor (TFPI) and protein C in the plasma and tumor tissue homogenate in patients with intracranial tumors. MATERIAL AND METHODS: The study included 77 patients; 24 patients were diagnosed with glioma, 20 patients with meningioma and 33 patients with metastatic tumors; mean age - 54 years. The material for the study was the plasma and tumor tissue homogenate sampled during surgery. The control group consisted of 30 controls; mean age - 51 years. In the plasma of all the participants and in tumor tissue homogenate, the concentrations of TF-Ag, TFPI-Ag and protein C activity, and the concentration of total protein were measured. The results were converted per mg of protein. RESULTS: In patients with intracranial tumors, elevated concentrations of TF-Ag, TFPI-Ag and protein C activity were noted, also after the conversion per mg of protein. A 100-fold higher concentration of TF per 1 mg of protein was found in tumor tissue compared to the patients' plasma. In tumor tissue homogenate, a lower TFPI concentration and a lower protein C activity were recorded. CONCLUSIONS: The study confirmed the essential prothrombotic properties in patients with intracranial tumors, expressed with an elevated TF level, as well as a tremendous amount of TF in tumor tissue homogenate derived from tumors. The elevated concentration of TFPI and protein C activity converted per mg of total protein should be analyzed in terms of their pleiotropic function, along with the participation in hemostasis control. It seems that the reduced protein C activity and low TFPI level are associated with the enormous TF value in tumor tissue homogenates.

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.

Tissue Factor and Tissue Factor Pathway Inhibitor in the Wound-Healing Process After Neurosurgery.

OBJECTIVES: The aim of the study was to assess the concentrations of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the blood of patients with a postoperative wound after neurosurgery. METHOD: Participants included 20 adult patients who underwent neurosurgery because of degenerative spine changes. The concentration of TF and TFPI in the patients' blood serum was measured 3 times: before surgery, during the first 24 hr after surgery, and between the 5th and 7th days after surgery. The control group comprised 20 healthy volunteers similar to the patient group with respect to gender and age. RESULTS: A statistically significant difference was observed between TF concentration at all three measurement time points in the research group and TF concentration in the control group (p = .018, p = .010, p = .001). A statistically significant difference was found between TFPI concentration at the second time point in the research group and TFPI concentration in the control group (p = .041). No statistically significant within-subject difference was found between TF concentrations before and after surgery. A statistically significant within-subject difference was found between TFPI concentrations within 24 hr after surgery and 5-7 days after surgery (p = .004). CONCLUSION: High perioperative concentrations of TF indicate not only the presence of thrombophilia but also the importance of TF in the wound-healing process. Perioperative changes in TFPI concentrations are related to its compensatory influence on hemostasis in thrombophilic conditions.

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.

The number of circulating endothelial progenitor cells in healthy individuals--effect of some anthropometric and environmental factors (a pilot study).

PURPOSE: The aim of the study was the evaluation of the number of circulating endothelial progenitor cells (CEPCs) in healthy people and the assessment of the variability of quantitative of CEPCs after 6 weeks. MATERIAL AND METHODS: The study involved 48 healthy individuals; the group consisted of 24 men and 24 women; the mean age of 34. The criterion for the patients' eligibility for the study was the absence of diabetes, thrombosis and cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Neither did the respondents take any medication that could clearly affect the value of the results. In the whole blood samples the number of circulating endothelial progenitor cells was determined using flow cytometry. During the analysis the fluorescence of 100,000 cells was measured. CEPCs were identified with immunophenotype CD45-, CD31+, CD34+, CD133+. RESULTS: In the study, the median of the number of circulating endothelial progenitor cells in the whole group was 0.41/µL. There was also recorded an increased number of CEPCs after 6 weeks, as compared to the baseline; the difference was significant. There were no differences in the number of CEPCs between the women and the men. There was found no effect on the number of CEPCs factors such as: smoking, physical activity and alcohol consumption. CONCLUSIONS: The study showed that in healthy individuals the gender had no essential effect on the number of endothelial progenitor cells. Based on the demographic and lifestyle data acquired, it is difficult to explain the increase number of CEPCs after 6 weeks.

Assessment of selected quality fields of nursing care in neurosurgical wards: a prospective study of 530 people - multicenter studies.

BACKGROUND: One of the elements influencing the assessment of nursing care quality is the assessment of the nurse's functions that determine the nurse's particular tasks. The aim of this work was to assess selected tasks involved in the nurse's caring function, which influence nursing care quality on neurosurgical wards, on the basis of patients' and nursing staff's opinions. MATERIALS AND METHODS: The research was carried out on neurosurgical wards in Poland on a group of 455 patients and 75 nurses. In order to assess nursing care quality, an author's original questionnaire (Questionnaire - Patient Satisfaction) was used. RESULTS: STATISTICALLY SIGNIFICANT DIFFERENCES CONCERNED PARTICULAR GROUPS (BOTH PATIENTS AND NURSES) IN THE ASSESSMENT OF SELECTED ISSUES: providing information about performed activities and operations (P=0.000 and P=0.040), respecting personal dignity and assuring discretion during the operations (P=0.000 and P=0.001), speed of response to patient's requests (P=0.000 and P=0.000), time availability of nurses for the patient (P=0.000 and P=0.000), providing information about further self-care at home (P=0.032, P=0.008), and nurses' attitude (kindness, courtesy, tenderness, care) to patients (patient's assessment only P=0.000). CONCLUSION: Selected tasks in the field of the caring function of nurses were assessed differently by particular groups. There were no statistically significant differences in the assessment of particular tasks in the opinions of patients and nurses, which means that both examined groups similarly assessed tasks involved in the nurse's caring function, which influence nursing care quality.