[Psychological examinations in occupational health services: Legal regulations. Part II]. / Badania psychologiczne w sluzbie medycyny pracy ­ regulacje prawne: czesc II.

This paper constitutes a continuation of the critical analysis of legal aspects of psychological examinations in some group of workers. In this part the appeal procedure, documentation, costs of examinations and supervision are discussed. The analysis has shown many deficiencies in regulations related to all aspects of psychological examinations. They arise from incoherence of legal regulations and the lack of regulations of some questions. This legal standing is restricted to occupational work and adversely affects the quality of supplied services. Therefore acts of law and regulations relevant to psychological examinations for the purpose of fitness-to-work certification need necessary adjustments. According to authors it is desirable to end the legal procedure amending the act of law on a profession of psychology and the self-government of psychologists, as well as to develop and implement executive regulations. Med Pr 2018;69(6):673-684.

[Musculoskeletal, hearing and skin problems related to playing the instrument]. / Dolegliwosci miesniowo-szkieletowe, sluchowe i skórne zwiazane z gra na instrumencie.

BACKGROUND: Physical demands, exposure to noise and intense contact of skin with musical instruments - inevitable in musicians' job - influence the development of musculoskeletal, hearing and skin problems. This paper aims at identifying playing-related health problems among Polish musicians and potential differences in this regard between students and professional musicians. MATERIAL AND METHODS: This questionnaire study involved 255 musicians who volunteered to participate - 104 students and 151 professional musicians having music education. The study sample included 61% of women. Mean age of the participants equaled 31 years old, mean playing experience - 23 years old. RESULTS: From 10% to 79% (depending on the affected body part) of the studied musicians experienced musculoskeletal problems. Hearing (41% - tinnitus; 43% - hearing impairment and 52% - hyperacusis) and skin problems (69% - callosities, 58% - abrasions and 26% - allergic reactions) were reported less frequently and were assessed as less severe than musculoskeletal symptoms. The studied professionals assessed their hearing problems (hyperacusis, hearing impairment and tinnitus) as significantly more severe than reported by students. Young musicians, in turn, experienced more severe abrasions than the studied professional musicians. We found no significant differences between students and professionals as regards their musculoskeletal problems. CONCLUSIONS: Playing-related health risks translate into relatively high prevalence of musculoskeletal as well as hearing and skin problems among musicians. Hence, it is essential for future studies to search for risk factors for these health problems as well as effective corrective and therapeutic measures. Med Pr 2018;69(4):383-394.

[Psychological examinations in occupational health services: Legal regulations. Part I]. / Badania psychologiczne w sluzbie medycyny pracy ­ regulacje prawne: czesc I.

In Poland psychological assessment for the purpose of fitness-to-work certification is regulated by the law. In the majority of cases, only psychologists registered with the occupational health services are authorized to conduct the assessment procedures. In this study 32 legal documents (17 acts and 15 directives) have been analyzed to identify the most problematic issues pertaining to psychological examination and to suggest certain changes in the regulations, as well as to raise the psychologists' awareness of the legal aspects of their work. Due to the number of the topics explored, the results of the study will be published as two separate, yet related articles. The first one concentrates on the qualifications of psychologists, the examination reference process, the aim and scope of the psychological assessment, and the validity of the assessment results. In part II other issues, not directly related to the diagnostic process, will be discussed. Med Pr 2018;69(5):561-572.

[Mental health status of drivers--Motor vehicle accidents perpetrators]. / Stan psychiczny kierowców--sprawców wypadków drogowych.

BACKGROUND: This study aimed at exploring the phenomenon of motor vehicle accidents (MVA). The following research questions were addressed: what are the immediate reactions to accidents among MVA perpetrators, do MVA perpetrators develop posttraumatic stress symptoms, and what are the differences between high and low symptomatic signs in terms of socio-demographics and accident features? MATERIAL AND METHODS: Post-traumatic stress disorder (PTSD) questionnaire by Watson et al. in the Polish adaptation was applied to assess PTSD and its subclinical symptoms. The information on the MVA nature, declared MVA causes, drivers' reactions after MVA, as well as on the age, education and history of driving in the study group was collected. The results of psychological examination obtained from 209 MVA perpetrators were analyzed. The examination took place at least 1 month after the accident. RESULTS: In 1/3 of the study group no physiological reactions were observed directly after the accident, while 46% of respondents experienced trembling and shaking and about 30% of subjects were crying or having tears in their eyes. Compassion for the injured and victims, guilt, helplessness and fear were the most common among immediate psychological reactions related to the accident. On the day of psychological examination 11.2% of drivers met diagnostic criteria for PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV). Drivers showing low and high PTSD symptoms did not differ in terms of age, education, and subjective perception of accident cause. Women were significantly overrepresented it the group meeting the diagnostic criteria for PTSD. CONCLUSIONS: The results of the study indicate the need to carry on systematic screening for mental health problems in drivers involved in serious MVA as a part of strategy for improving road safety.

[Good practice in occupational health services - The influence of hazardous conditions and nuisance coexisting in the work environment and at home on the course and outcome of pregnancy]. / Dobre praktyki w opiece profilaktycznej nad kobieta ciezarna w miejscu pracy - wplyw czynników szkodliwych i uciazliwosci wystepujacych w srodowisku pracy i domowym na przebieg oraz wynik ciazy.

The key activity in good practice of occupational medicine is to control, on a regular basis, the workers' health and how it is affected by the work environment and - consequently - to provide the employers and employees with advice regarding the organization, ergonomics, physiology and psychology of work. Occupational medicine practitioners should remember that certain duties are performed both at work and at home. This issue is particularly important in preventive healthcare of pregnant working women. Taking the above into consideration, we reviewed the literature with respect to nuisance and occupational risk factors, which might be associated with professional and household duties. The research indicates the need to reduce activities that require frequent bending or lifting, put a women at risk of falling or cause excess occupational stress for pregnant women. We would like to draw the doctors' attention to the possibility of exceeding a 4-hour limit of work at video display terminals and negative effects of low physical exercise and sitting for a long time both at work and at home. Since long working hours (over 40 h/week) affect the course of pregnancy negatively, total working time at work (including any additional jobs) and at home must be taken into account in the occupational risk assessment. To sum up, we emphasize that preventive healthcare of pregnant working women should mainly include education programmes. Women need to know how to perform their work safely and pay attention to the scope and frequency of household tasks (duties).

Association of resilience and psychological flexibility with surgeons' mental wellbeing.

BACKGROUND: Existing research highlights the link between certain personality traits and mental health in surgeons. However, little research has explored the important role of psychological skills and qualities in potentially explaining this link. A cross-sectional survey of UK-based surgeons was used to examine whether two such skills (psychological flexibility and resilience) helped to explain why certain personality traits might be linked to mental health in surgeons. METHOD: An online survey comprising measures of personality (neuroticism, extraversion and conscientiousness), psychological skills/qualities (psychological flexibility and resilience) and mental health (depression, anxiety, stress and burnout) was sent to surgeons practising in the UK. Mediation analyses were used to examine the potential mediating role of psychological flexibility and resilience in explaining the relationship between personality factors and mental health. RESULTS: A total of 348 surgeons completed the survey. In all 12 mediation models, psychological flexibility and/or resilience played a significant role in explaining the relationship between personality traits (neuroticism, extraversion and conscientiousness) and mental health (depression, anxiety and burnout). CONCLUSION: Findings suggest that it is not only a surgeon's personality that is associated with their mental health, but the extent to which a surgeon demonstrates specific psychological qualities and skills (psychological flexibility and resilience). This has important implications for improving surgeons' mental wellbeing, because psychological flexibility and resilience are malleable, and can be successfully targeted with interventions in a way that personality traits cannot.

[Presenteeism--(not) new phenomenon in the occupational environment]. / Prezentyzm--(nie)nowe zjawisko w srodowisku pracy.

Presenteeism, understood as being at work while ill, is not a new phenomenon. However, not long ago it has become an object of researchers' interest. Formerly, they focused mainly on absenteeism. In general, presenteesim is perceived as negative and very costly for employers. The majority of scientific studies refer to the problem of employees' productivity reduced due to their at tending work despite being ill, but the knowledge about presenteeism's causes and effects (other than decreased productivity) for both, the employee and the organisation, is still very limited. Especially in Poland there are very few scientific reports on this issue. However, the paper on presenteeism published recently (the 3/2013 issue of this Journal) defined this phenomenon as a non effective presence at work. The authors postulate to avoid pejorative connotation of this term by equating presenteeism with loss of productivity, and to separate this phenomenon from its possible negative and positive consequences. Thus, this paper aims at presenting current state of the art on this phenomenon, including such issues as definitional problems, measures and frequency of presenteeism, as well as its causes and consequences. In this paper presenteeism is presented in a wider perspective of its individual and contextual determinants.

'Ask a hundred people, you get a hundred definitions': A comparison of lay and expert understanding of stress and its associations with health.

The understanding an individual holds about stress can influence their appraisal of it and have implications for subsequent health, yet knowledge of such understanding is scarce. This study explored discrepancies between lay and expert understanding of stress and links made between stress and health. Twenty-six lay members of the local community aged 18-62 years, and seven expert stress researchers, participated in individual semi-structured interviews. Thematic analysis of the two datasets was conducted separately, then findings compared to identify similarities and differences between lay and scientific understanding. Whilst many similarities were identified, we found three important discrepancies: (i) Lay participants demonstrated a strong awareness of the indirect effects of stress on health via health behaviours; (ii) compared to experts, lay participants showed less awareness of a direct path between stress and physical health; (iii) lay participants showed less understanding of social determinants of stress and collective measures for stress management that went beyond individual responsibility. Discrepancies identified serve to highlight potential misunderstandings in lay conceptualisation of stress and its links with health. These findings have potential to facilitate the work of practitioners who serve as intermediaries to translate scientific knowledge into therapeutic benefit, through improved awareness and communication surrounding stress understanding.

Individual factors in the relationship between stress and resilience in mental health psychology practitioners during the COVID-19 pandemic.

Utilising an online survey, this study aimed to investigate the concurrent effects of pre-pandemic and COVID-19 stress on resilience in Mental Health Psychology Practitioners (MHPPs) (n = 325), focussing on the mediation effects of specific individual factors. Optimism, burnout and secondary traumatic stress, but not coping strategies, self-efficacy, compassion satisfaction, or self-compassion, mediated both the relationship between pre-pandemic stress and resilience and COVID-19 stress and resilience. Increased job demands caused by the pandemic, the nature and duration of COVID-19 stress may explain this finding. Training and supervision practices can help MHPPs deal with job demands under circumstances of general and extreme stress.

Shame, guilt, time perspective, time of imprisonment and PTSD symptoms in sentenced motor vehicle accidents perpetrators - a preliminary report. / Wstyd, poczucie winy, perspektywa czasowa, czas odbywania kary pozbawienia wolnosci i objawy PTSD u skazanych sprawców wypadków drogowych ­ doniesienie wstepne.

OBJECTIVES: The study aimed at exploration of a relationship between PTSD symptoms, traumarelated guilt (TRG), time perspective (TP), and guilt/shame proneness among perpetrators of motor vehicle accidents (MVA). We also analyzed relationships between length of imprisonment, PTSD and trauma-related guilt. METHODS: The sample consisted of 37 incarcerated perpetrators of MVA. They were asked to fill in the set of questionnaires: Zimbardo Time Perspective Inventory, Guilt and Shame Proneness Inventory, Trauma-Related Guilt Inventory). RESULTS: The results showed that 50% of the perpetrators met the DSM-5 PTSD criteria. The proneness to guilt and shame positively correlated with the trauma-related guilt. Shame susceptibility as a consequence of negative self-esteem was associated with a greater traumarelated shame. There was no correlation between guilt/shame or trauma-related guilt and PTSD. The time perspective was associated with PTSD - the stronger the tendency of the respondents to focus on the present/past, the greater the symptoms of PTSD. Focusing on the hedonistic present positively correlated with guilt related to trauma. CONCLUSIONS: In the studied population, every second perpetrator of the accident was affected by PTSD, which was associated with the past and present time perspective. Negative assessment of self and behavior intensified the guilt associated with trauma and reduced the search for justification for one's own actions in external circumstances. Time spent in prison had no effect on moral attitudes or on the moral evaluation of one's own behavior that caused harm to others. However, it was associated with experiencing stress and focusing on one's own suffering.