Attitudes of women after the age of 50 towards preventive screening.

INTRODUCTION: Prevention is one of the major branches of the health sector. The National Health Programme encompasses main risk factors, elimination of which may lead to a reduced incidence of illnesses in the society. At the same time, the criteria of selecting people eligible for preventive screening are established according to risk groups determined by sex, as well as age in the population of women. The perimenopausal and menopausal period contributes to occurrence of numerous systemic diseases and to an increased risk of illnesses, especially cancers. OBJECTIVE: The objective of the research was to evaluate the performance of preventive screening tests of women after 50 aimed at early detection of cervical and breast cancer. Furthermore, the research estimated frequency of pathological lesions detected and regularity of their monitoring. MATERIALS AND METHODS: The research covered 150 women after 50 years of age. The database was statistically examined with STATISTICA software. RESULTS: A low percentage of the respondents, in comparison to the risk increasing with age, had a Pap test (61.3%) and mammography (51.3%) in the last two years. In the case of women whose latest Pap test or mammography showed abnormalities and was the basis for diagnosing pathological lesions, 69.2% of them were under regular medical supervision if abnormalities were identified by a Pap test and 68.7% if lesions were detected in breast structure. CONCLUSIONS: In the examined group we observed a small percentage of women undergo Pap tests and mammography. Furthermore, medical recommendations regarding early detection of cancers are frequently ignored and disregarded by patients.

[Evaluation of the Lublin Regional Health Board contract in 2002 in the selected departments of the state hospital health service of the Lublin region. Part II. Medical staff as a criterion of contract evaluation]. / Ocena kontraktu Lubelskiej regionalnej kasy chorych w roku 2002 w wybranych oddzialach lecznictwa zamknietego spzoz województwa Lubelskiego czesc. II. Kadry medyczne jako kryterium oceny kontraktu.

The study evaluated the value of the contract of the Lublin Regional Health Board per 1 physician's and 1 nurse's post in the hospitals of the Lublin region in four basic departments. According to the usage of existing staff resources, the evaluation revealed significant differences in the average contract value per 1 physician's and 1 nurse's post in the selected departments. The differences are observed in the departments of the same and of different specialties, therefore they create different conditions for potential intensity of work in the examined units.

[Satisfaction of need for health services among pensioners with reformed health care]. / Zaspokajanie potrzeb zdrowotnych emerytów i rencistów w zreformowanej opiece zdrowotnej.

The objective of this study was to determine the demand for health services and to assess the level of satisfaction of these needs in the new, reformed health care system with reference to pensioners and old age pensioners. The survey was carried out over the period of 4 months among patients undergoing a cure in the Municipal Sanatorium in Naleczów. The group consisted of people with chronic diseases, among which cardiovascular system diseases were the leading ones. All the respondents were pension services users. The study results show that patients at older age, chronically ill or disabled, limited the realization of their health needs and did not begin proper treatment, due to difficult access to health services and bad financial situation. The changes introduced in the functioning of health system during the reform period did not trigger the improvement of medical care in the population of pensioners.

[Psychosocial and medical conditions for suicidal behaviors among children and young people in Lublin Province]. / Psychospoleczne i medyczne uwarunkowania zachowan samobójczych wsród dzieci i mlodziezy na terenie województwa lubelskiego.

UNLABELLED: Young people belong to the group especially exposed to suicidal behaviours. The period of puberty and early adolescence is full of strong emotions and feelings. Mental and emotional maturity do not follow biological one, which results in extreme moods and unstable psyche. Disturbed relations within the family or loss of hope for successful future very often evoke feeling of hopelessness inadequate to everyday life problems. that is why suicide seems to be the best solution to get rid of all problems. It is also one of the ways to demonstrate the needs of young people. The aim of the study is to recognize a number of conditions affecting the decision on committing a suicide. The method was based on statistical analysis of data stored in the District Police Headquarters in Lublin as well as death certificates in Lublin Province. Analysis included suicides among inhabitants of Lublin Province. The study comprised suicides committed between 1 January 1997-30 December 2000. RESULTS: Cases of suicides among children are the most worrying ones. They constitute 40.6% death causes among people between 10-14 years. The most frequent causes include: lack of security, understanding and love from parents. Two main groups of causes may be distinguished in people between 15-24 years. The first one includes deep experiences related to breaking up with a loving person. The second group is associated with biological side of our life that is somatic diseases, their progression and lack of prognosis for recovery. CONCLUSION: Participation of children and young people in suicides has a tendency to increase in comparison to years 1989-1996. The most frequent cause of death is pathology in family life. Normally functioning family is the most important prophylactic factor leading to suicides. It is essential to introduce suicidal prophylaxis in schools. Knowledge of presuicidal syndrome is necessary for both teachers and general practitioners.

[Health problems of the unemployed--possibilities and forms of solving them]. / Problemy zdrowotne bezrobotnych--mozliwoci i formy ich zaspokajania.

The most painful price to pay for social and economic transformations in our country is high level of unemployment, triggering all kinds of negative consequences. Health consequences that the unemployed as well as their families and the whole society suffer from play an important role in social consequences of unemployment. The aim of the study was to recognize the health problems of jobless people as well as the possibilities and forms of solving these problems. The research was carried out in April 2002 among 200 unemployed people registered in the Regional and District Labour Office in Lublin. The instrument of the research was a survey questionnaire. The results of the research showed that the lack of job and worsening standard of living had a negative influence on the general state of health of the unemployed. Long-lasting unemployment also influenced the deterioration of physical health among the respondents. The most frequent psychosomatic ailments were: headaches, stomachaches, nausea and vomiting, pains in the chest, lack of appetite, sleep disorders. Unemployment also contributed to the occurrence of mental diseases, diseases of the circulatory and digestive systems.

Attitudes of young people towards problems connected with human procreation.

The aim of the paper was to get acquainted with opinions and attitudes of secondary school students concerning the issues of human procreation. The survey was carried out in secondary comprehensive and technical schools in Lublin during the years 1999 and 2000 among 300 students aged 16-19. The survey shows that mass media play the leading role in conveying knowledge and shaping attitudes and behaviours of teenagers in the sphere of sexuality. The function of family and school in this field is realized to an insignificant extent. Media make use of issues and interests of teenagers that are natural at certain age and succeed in promoting acceptance of early sexual relationships, not showing the risk connected with them at the same time. Among the group under the survey 37% of the respondents have already had sexual initiation. Girls accounted for 41.5% of the total and boys--for 58.5%. The average age of sexual initiation among the respondents was 15.87. The declaration of love, according to the majority, gave the right to take up sexual activity. They accepted the rule that you can make sex whenever you wish and a stable partner is not necessary, which is a sign of psychological immaturity and willingness to grow up fast. The use of contraception was approved of by nearly all the respondents. The most frequent preventive methods they used were: condoms (44.8%), withdrawal method (15.3%), both characterized by easy accessibility but at the same time low efficiency. 7.6% of sexually active students do not use any method of contraception. Such behaviours create a serious risk of premature pregnancy and sexually transmitted diseases.

General practitioners' opinions on the intake of painkillers among patients.

The goal of this paper is to evaluate the consumption of painkillers among patients on the basis of the opinions of general practitioners. The most frequent ailments including pain symptoms were the cases of long-continued pain (64.3%); less frequent were acute pain syndromes in the course of a disease (35.7%). The phenomenon of the excessive use of painkillers among patients with long-continued pain syndromes is observed by the GPs. Uncontrolled self-treatment is possible owing to an easy access to this type of medicaments. The excessive use of analgesic medicines in therapy frequently results from the lack of simultaneous application of other methods of pain treatment e.g., in physiotherapy, psychotherapy. Long lasting use of various types of painkillers can lead to drug addiction. This problem is observed by over a half of the GPs (67.1%).

The demand for health education among patients with diabetes.

Education of the sick with diabetes has been a stable element of treatment for plenty of years. However, the system of trainings related to this disease is still not perfect and the knowledge of patients about this subject is insufficient. The objective of the study was to determine the demand for health education among patients with diabetes by means of evaluating the level of their knowledge. The study included 130 people suffering from diabetes at the age from 18 to 96 with the disease duration ranging from one year to above 20 years. The level of patients' knowledge about this disease was examined with the use of the survey questionnaire, especially designed for these reasons. The applied survey consisted of 54 questions of which a substantial part was concerned with general information about people suffering from diabetes. Further sections of the survey explored the knowledge about the nature of the disease, its complications, self-control, lifestyle and contained the questions concerning the sources of the acquired knowledge on this subject, participation in educational meetings and trainings concerning the issue of coping with diabetes as well as self-evaluation of the level of knowledge. The survey shows that 54.6% of the respondents cannot explain the mechanisms of type 1 diabetes, while 39.2% of the patients do not know the nature of type 2 diabetes. None of the patients was able to enumerate all the symptoms of hypoglycemia and hyperglycemia or the organs and systems most frequently affected by complications. More than 1/3 of the subjects did not know the proper nutrition rules in diabetes. None of the respondents was able to specify correctly all the control examinations and tests that should be taken at least once a year or once every six months. Only 6.1% of the patients evaluated their knowledge about diabetes at a very good degree, while 53.1% of them defined it as good. They were mostly insulin dependent patients under the care of diabetology clinics. However, as many as 40.8% of the respondents considered their level of knowledge unsatisfactory. The research results showed that the leading source of knowledge about the nature of the disease and ways of coping with it were diabetologists (61.5%), followed by nurses (33.8%) and general practitioners (26.1%). The survey results indicate the need for the increased accessibility and intensity of the educational activities in diabetological health care.

The analysis of the structure of suicidal behaviours in the region of the Lublin voivodship in the years 1997-1999.

Suicide is a phenomenon that raises particularly strong emotions of the public creating a question about the sense of life and death. The phenomenon reflects customs, personal and social approach, as well as it undergoes historical and cultural changes. The aim of the study is to find the factors that influence making the decision about suicide. The analysis was concerned with the statistical data taken from the Voivodship Police Headquarters in Lublin and with death certificates in the Lublin voivodship. The highest suicide rates were for people included in the age group between 31 and 50. The suicides more frequently were males.

Intensification of the phenomenon of violence in the family environment of teenagers.

Childhood and adolescence are the periods of life when the experience of violence accumulates. As socially weaker individuals, children and teenagers are exposed to violence. The factors that increase the risk of child maltreatment include, above all, social and cultural factors and the stress that family suffer from. The literature on this subject distinguishes four categories of child maltreatment, namely: emotional, physical, negligence and sexual abuse. The survey involved 250 representatives of high school teenagers aged 15-20, including 145 girls and 105 boys. The research method was the survey estimating the Scale of Battered Child Syndrome (for teenagers and adults). The results show that a big group of teenagers admitted to having experienced at least one of four kinds of domestic violence. The group is not uniform, however, and the socio-cultural factors that affect the kind and intensification of the phenomenon of violence have been revealed. The most frequent reasons for using violence are: low level of education, unemployment of parents and material status connected with this fact, low frequency of attendance to religious services, alcohol abuse, and place of living. On account of the intensification of the phenomenon of violence in the domestic environment and both direct and distant consequences of the phenomenon in the form of mental and physical disorders of individuals as well as the dangers for the proper development of the society that result from it, there is a need to continue doing research on this phenomenon.

Prophylaxis of breast cancer among women over 35.

In recent years, the increase in incidence of malignant tumours of breast has been observed in Poland. Every year approximately 10 thousands of new cases of breast cancer are registered. 19 per cent of all women afflicted with malignant neoplasms suffer from breast cancer. According to considerable experience of the western countries, prophylaxis combined with screening examinations is the most effective and, also, the cheapest method of fighting against neoplasm. In the face of steadily growing danger, which affects more and more women, an attempt to assess the knowledge and behaviour towards prophylaxis of breast cancer among women over 35 was made. The researches, carried out between April and November 2002, were conducted with the use of our own questionnaire basing upon literature on the subject. The poll was intended for women aged between 35 and 60. The group of 300 women, who live in the south-east part of Poland, was surveyed. A detailed analysis of the data revealed that almost 50 per cent of women know the rules of preventive actions in the spheres of breast self-control and mammography. The level of knowledge of primary prophylaxis correlates with the level of education of women. The higher is education, the greater is knowledge about the risk factors of breast cancer. The highly educated women more often and more systematic take preventive actions leading to early detection of breast cancer. The women in the 35-45 age group more regularly and more often perform monthly breast self-control. Also the fact of the prevalence of breast cancer in the members of the polled women's families raises the discipline of performed examination.

Analysis of health-promoting behaviours of 14-year-olds of selected schools of Lublin.

The health of an individual and of the community depends on many interrelated factors, including health behaviours which are one of the most important of these factors. The aim of the paper was to analyze the selected pro-health behaviours of 14-year old students. The research was carried out by means of a self-made questionnaire. The survey was conducted in the city of Lublin among 250 students of Lublin schools selected at random. The results of the survey were the basis for the following conclusions: self-evaluation of health and physical activity is perceived as good or very good; analysis of pro-health behaviours revealed insufficient knowledge among the majority of students; proper pro-health education and health promotion plays an essential role in changing such negative behaviours.

Estimation of CA 125 concentration in patients with congestive heart failure.

Tumour marker CA 125 is used in the monitoring results of treatment woman with ovarian cancer. Its diagnostic effectiveness in selected groups of patients is defined by sensitivity estimated at approximately 75% and specifity at 95%. In practice diagnostic specificity of CA 125 concentration is lower as it is limited by the increase of concentration different tumour diseases (bladder cancer) and non-tumour diseases (pericardial inflammation). The aim of the paper was to estimate CA 125 concentration in patients with congestive heart failure as well as to define the range of changes taking place according to the advancement of the disease. The research included 39 patients: 20 women and 19 men aged 45-75 with diagnosed congestive heart failure graded II-IV in the NYHA classification. It has been found that CA 125 concentration in blood serum of the patiens with congestive heart failure was on average approximately 35.4 +/- 24.8 U/ml and was included in the range from 5.6 to 874 U/ml (limit value 21 U/ml). The concentration increase above the limit value was observed in 34% of patients. Significant statistic differences in CA 125 concentration rates were dependent on the disease advancement. The highest concentration rates were observed in patients classified in group IV NYHA. The results that have been obtained allow us to draw a conclusion that right interpretation of CA 125 concentration in clinical practice (screening examinations, establishment of the level of advancement, prognostication as well as monitoring the ovarian cancer treatment) brings the necessity of taking into consideration the degree of congestive heart failure.

Prophylaxis of breast cancer among nurses in health care settings in the city of Lublin.

The goal of this project was to assess the kind, extent and knowledge about the actions undertaken by nurses in the field of primary and derivative prophylaxis of breast cancer. The research was conducted with the use of an anonymous poll. We surveyed 180 nurses from medical centres in Lublin. The data included in 150 questionnaires which were qualified for the research were statistically analyzed. Despite medical education and theoretically easier access to medical services the research showed inadequate knowledge about the disease and lack of individual preventive actions of women employed in this sector. Insufficient knowledge about the ways of primary prophylaxis of the methods of early detection of breast cancer may be the reason why health-oriented habits are not given proper attention. Only 24 per cent of the polled women perform regular monthly breast self-control. The surveyed group of nurses display a rather passive attitude towards screening tests. Out of 51 per cent of the respondents who were given a chance to have screening tests just a little more than one third took advantage of this opportunity. The reason, according to the surveyed, was too low awareness, lack of time and fear of the disease.

The influence of unemployment on functioning of the family.

The aim of the study was to determine the impact of unemployment on family welfare. It was conducted between April and June 2002 among 200 unemployed registered at the Regional Employment Bureau in Lublin. The method of choice was a questionnaire. The study results demonstrated that the most direct consequence of unemployment is financial impoverishment. Most participants claimed their income did not allow them to cover the basic needs. Managing a very limited budget, they had to give up buying new clothes, more expensive food and toilet items as well as spending money on cultural and leisure pursuits. They were unable to use paid medical services and to meet household payments deadlines. These consequences were borne not only by the unemployed themselves but also by their families. Those with school children had to cut their expenditures on education and in extreme cases the children were unable to attend junior or senior high school. The results indicate that unemployment had a negative impact on many different spheres of family life and in the long run it has a negative impact on the life of the whole society.