Quality of Life for Polish Women with Ovarian Cancer during First-Line Chemotherapy.

Ovarian cancer is the worst prognostic gynaecological cancer and represents a grave clinical and social problem. Therefore, the study aimed to assess female patients' emotional, cognitive, physical, and social quality of life. The study included 100 patients diagnosed with ovarian cancer and treated with chemotherapy in a day hospital setting at the Department of Radiotherapy and Gynaecological Oncology at the Wielkopolska Oncology Centre in Poznan. The patients were given a standard treatment regimen: paclitaxel 175 mg/m2 in a 3 h infusion and carboplatin at an AUC of 6 (5-7) following Calvert as a 1 h infusion for six cycles administered every 21 days. In addition, standardised questionnaires of the Polish version of the EORTC QLQ-C30 and QLQOV28 were used. The analysis of the collected material shows that the patients reported the highest level of general health and quality of life at the study's first stage, i.e., before chemotherapy (mean value of 59.67 points). In contrast, the patients' lowest level of general health and quality of life was observed in the fourth stage of the study (mean value of 45.04 points). The problem of side effects, such as nausea and vomiting, affected the entire study group and was more troublesome in the final stage of treatment for all patients. In the study's first stage, the mean score on the nausea and vomiting symptom scale was 16 points; in the fourth stage, the mean score was 40.07. Of the clinical factors, the symptom of fatigue was the most severe health problem for the subjects. The mean score of the fatigue scale in the study's first stage was 37.11 points, while a score of 70.33 was obtained in the fourth stage of the research. The multivariate linear regression model showed that the lack of professional activity lowers quality of life, especially combined with other side effects of chemotherapy, including hair loss in Stage IV of the study. This study shows that women with ovarian cancer undergoing chemotherapy need exceptional support from psychologists, nurses, dieticians, and physiotherapists.

Wound Pain as a Determinant of Function in Patients Hospitalised for Burns.

Burn wounds most often occur on visible parts of the body. They therefore cause fear of disfigurement and rejection by those around them. In addition, they cause pain. The main aim of this study was to analyse factors affecting the functioning of patients hospitalised for burns. The study included 57 patients hospitalised for burns. Each person was surveyed twice: on day seven after admission and on the day of discharge from the hospital. The following research tools were used: a personal questionnaire to collect clinical data and the scales of the Katz Activities of Daily Living (ADL), the short-form McGill Pain Questionnaire (SF-MPQ), the Beck Depression Inventory (BDI) and the Satisfaction with Appearance Scale (SWAP). On the discharge day, compared to day 7, there was an improvement in the patient's level of functioning in all areas analysed. Pain intensity (p < 0.0001), depression (p < 0.0001) and dissatisfaction with appearance (p = 0.0239) decreased significantly. Improvements in daily functioning were also obtained (p < 0.0001). Multiple regression was performed to estimate the effect of selected variables on patients' level of functioning. Burn area (p = 0.0126), pain level (questionnaire part B: p = 0.0004 and questionnaire part C: p = 0.0208) and gender (p = 0.0413) had a significant impact on the level of daily functioning. Pain complaints are the most crucial predictor affecting the functional status and depression levels in burn wound patients. Increased levels of depression promote dissatisfaction with one's appearance.

The Link between the Demographic and Clinical Factors and Fatigue Symptoms among Rheumatoid Arthritis Patients.

Rheumatoid arthritis (RA) is a chronic systemic disease of connective tissue with periods of exacerbation and remission. Fatigue is excessive strain throughout the body that is disproportionate or unrelated to an activity or lifestyle. Fatigue is an integral part of RA in most patients. The study aimed to assess the level of fatigue in RA patients and establish the relationship between fatigue and demographic and clinical factors. The study group consisted of 128 RA patients according to European League Against Rheumatism (EULAR) criteria. The Functional Assessment of Chronic Illness Therapy-Fatigue and -Medical Outcomes Study Short Form 36 (SF-36) vitality scores were used to assess the severity of fatigue symptoms. The analyzed variables were gender, age, disease duration, education, marital status, place of residence, work and residence status, pharmacological treatment, pain, morning stiffness, hemoglobin, C-reactive protein (CRP), rheumatoid factor (RF), compression soreness, Richie Articular Index, and DAS28 disease activity. The examined patients experience chronic fatigue-the mean value on the FACIT-F scale was 24.1 ± 9.1 points and on the SF-36 Vitality score was 14.2 ± 1.8 points. There is a relationship between the level of fatigue and pain, long-lasting morning stiffness, active disease, increased soreness of joints, and low hemoglobin values. When analyzing the symptom of fatigue, each patient should be approached individually, using the existing questionnaires or asking key questions to recognize the situation. The presence of fatigue symptoms should be considered during therapy and patient care by searching for and eliminating additional, intensifying stimuli and increasing its level.

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience in Portugal.

Healthcare-associated infections (HAI) are one of the major concerns worldwide, posing significant challenges to healthcare professionals' education and training. This study intended to measure nursing students' perceptions regarding their learning experiences on HAI prevention and control. In the first phase of the study, a cross-sectional and descriptive study with a convenience sample composed of undergraduate nursing students from Portugal, Spain, Poland, and Finland was conducted to develop the InovSafeCare questionnaire. In the second phase, we applied the InovSafeCare scale in a sample of nursing students from two Portuguese higher education institutions to explore which factors impact nursing students' adherence to HAI prevention and control measures in clinical settings. In phase one, the InovSafeCare questionnaire was applied to 1326 students internationally, with the instrument presenting adequate psychometric qualities with reliability results in 14 dimensions. During phase two, the findings supported that Portuguese nursing students' adherence to HAI prevention and control measures is influenced not only by the curricular offerings and resources available in academic settings, but also by the standards conveyed by nursing tutors during clinical placements. Our findings support the need for a dedicated curricular focus on HAI prevention and control learning, not only through specific classroom modules, innovative resources, and pedagogical approaches, but also through a complementary and coordinated liaison between teachers and tutors in academic and clinical settings.

Relationship between stress and alexithymia, emotional processing and negative/positive affect in medical staff working amid the COVID-19 pandemic.

The psychological burden of the COVID-19 pandemic may have a lasting effect on emotional well-being of healthcare workers. Medical personnel working at the time of the pandemic may experience elevated occupational stress due to the uncontrollability of the virus, high perceived risk of infection, poor understanding of the novel virus transmission routes and unavailability of effective antiviral agents. This study used path analysis to analyze the relationship between stress and alexithymia, emotional processing and negative/positive affect in healthcare workers. The sample included 167 nurses, 65 physicians and 53 paramedics. Sixty-two (21.75 %) respondents worked in COVID-19-designated hospitals. Respondents were administered the Toronto Alexithymia Scale-20, Cohen's Perceived Stress Scale, Emotional Processing Scale, and the Positive and Negative Affect Schedule. The model showed excellent fit indices (χ2 (2)=2.642, p=0.267; CFI=0.999, RMSEA=0.034, SRMR=0.015). Multiple group path analysis demonstrated physicians differed from nurses and paramedics at the model level (X2diff (7)=14.155, p<0.05 and X2diff (7)=18.642, p<0.01, respectively). The relationship between alexithymia and emotional processing was stronger in nurses than in physicians (difference in beta=0.27; p<0.05). Individual path χ2 tests also revealed significantly different paths across these groups. The results of the study may be used to develop evidence-based intervention programs promoting healthcare workers' mental health and well-being.

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience: Development and Validation of a Scale in Four European Countries.

Healthcare-associated infections are one of the major concerns worldwide. This study presents the development and the validation process of the InovSafeCare scale and aimed at identifying and measuring the ecosystem variables related to healthcare-associated infection (HCAI) prevention and control practices in European nurse students. Qualitative and quantitative approaches were used to (1) elaborate an item pool related to the educational environment, the healthcare setting environment, and the attitudes, beliefs, and performance of the nursing students regarding HCAI prevention and control and (2) analyze psychometric properties of the scale using factor analysis. The validated InovSafeCare scale was applied to undergraduate nursing students of five European Higher Education Institutions. The partial least square structural equation modeling (PLS-SEM) method with SMART-PLS3 software was used. The study sample consists of 657 nursing students, who responded a self-report inventory. From the analyzed data were identified 14 factors. The InovSafeCare scale reveals good validity and reliability of the dimensions in different European countries.

Dysfunctional Coping Mediates the Relationship between Stress and Mental Health in Health-Care Staff Working amid the COVID-19 Pandemic.

OBJECTIVE: This cross-sectional study aimed to assess the stress outcomes in health-care staff working during the COVID-19 pandemic and to explore the role of coping in the relationship between stress outcomes and mental health dimensions with Preacher & Hayes's mediation analysis. SUBJECTS AND METHODS: One hundred seventy participants including physicians (n = 41; 24.1%), nurses (n = 114, 67.1%), and paramedics (n = 15, 8.8%) with a mean age of 37.69 ± 12.23 years and an average seniority of 14.40 ± 12.32 years were administered the Toronto Alexithymia Scale-20, Cohen's Perceived Stress Scale (PSS-10), the Emotional Processing Scale, and Positive and Negative Affect Schedule. The data were analyzed by estimation of simple correlation coefficients and a Preacher and Hayes's mediation procedure. RESULTS: Participants reported elevated levels of stress (7-8 sten on the sten scale developed for the PSS-10 questionnaire). Statistically significant differences in the stress levels between nurses, paramedics, and physicians could not be determined. In contrast, significant association between mental health outcomes and the occupational category could not be found. CONCLUSION: Our observations support the assumption about a controlling role of coping in the relationship between work-related stress, alexithymia, emotional processing loneliness and positive/negative affect in medical staff working amid pandemic.

The relationship between the symptom of fatigue and the functioning of patients with inflammatory bowel diseases after surgery.

INTRODUCTION: The occurrence of fatigue in patients suffering from inflammatory bowel diseases (IBD) is influenced by pain, frequent bowel movements, stress associated with symptoms and time of their occurrence reaction of surroundings, fear for their own health, sleep disturbances, side effects of pharmacological treatment, physical and mental exhaustion, hindered social contacts and difficulties at work. AIM: To evaluate the fatigue and the assessment of functioning of patients with IBD, who were treated surgically. MATERIAL AND METHODS: To evaluate the functioning of patients, a Polish version of the Inflammatory Bowel Disease Questionnaire was used. To evaluate the occurrence of fatigue in studied subjects, a Polish version of the Functional Assessment of Chronic Illness Therapy - Fatigue Scale was used. The activity of disease was evaluated with the use of the Crohn's Disease Activity Index for patients with Crohn's disease (CD) and the Clinical Activity Index for patients with ulcerative colitis (UC). RESULTS: Before surgery, there was no significant difference between CD and UC patients, with regard to the mean FACIT-F (28.76 for CD and 28.76 for UC, p = 0.72). Also, after surgery, there was no significant difference between CD and UC patients, with regard to the mean FACIT-F (14.8 for CD and 16.0 for UC, p = 0.71). The IBD patients who underwent surgery for CD and UC had significantly lower FACIT-F scores compared to the patients before the surgery (p = 0.001 and p = 0.0001, respectively). IBD patients who underwent surgery for CD and UC had significantly better functioning and higher IBDQ total scores compared to the patients before the surgery. CONCLUSIONS: Surgical treatment significantly reduces the fatigue symptom in patients with IBD. The severity of fatigue correlates with disease activity and functioning in the respective areas.

Burden of caregivers of patients with Alzheimer's disease.

INTRODUCTION: Alzheimer's disease is a progressive, degenerative brain disease of unknown aetiology. It is characterised by a gradual deterioration of cognitive processes, especially memory, orientation and thinking. With the deepening of Alzheimer's disease, the independence of patients is increasingly limited, what results in an increased involvement of caregivers in care. Excessive duties contribute to the development of caregiver burnout. AIM: The aim of the study was to examine the level of feeling of burden in caregivers of patients with Alzheimer's disease and to determine the relationship between selected parameters and the feeling of burden. MATERIAL AND METHODS: The study included 55 people with Alzheimer's disease and their caregivers. In order to test the level of the burden, the Polish version of Caregiver Burden Scale was used. The level of self-esteem was assessed using the Polish version of the Rosenberg Self-Esteem Scale. RESULTS: The total result of the level of burden of caregivers of people with Alzheimer's disease, according to the Caregiver Burden Scale, was 2.6 points. There was a significant relationship between the feeling of burden and the caregiver's gender, the lack of free time, the number of hours devoted to day care, the number of years of patient care, the degree of a caregiver's self-assessment and the progression of the patient's disease. CONCLUSIONS: In the examined group of caregivers of people with Alzheimer's disease and according to the Rosenberg Self-Esteem Scale, the medium level of care burden and the average level of self-esteem were prevailing.

The role of demographic and clinical variables in assessing the quality of life of outpatients with rheumatoid arthritis.

INTRODUCTION: The aim of this study was to assess quality of life among patients with rheumatoid arthritis (RA) treated as outpatients. The specific question was: does the quality of life of RA patients depend on demographic variables and clinical variables? MATERIAL AND METHODS: The study included 240 patients with RA recruited from outpatients. To assess quality of life, the Arthritis Impact Measurement Scales 2 was applied. Clinical tests: VAS, Morning Stiffness, Grip Strength, Richie Articular Index. RESULTS: The analysis of life quality for the total group was carried out in the particular AIMS2 of the mean scores for arthritis pain - 7.37; walking and bending - 6.62; social activity - 5.52; level of tension - 5.17; satisfaction - 5.17; hand and finger function - 4.28; mood - 4.03; physical activity - 3.27; arm function - 3.16; household tasks - 2.67; self-care - 2.18; and support from family and friends - 1.75. The arthritis impact score was 6.01. The analysis of the correlation between clinical variables and individual AIMS2 subscales showed a statistically significant relationship between the VAS Pain, Grip Strength Measurement, Morning Stiffness and quality of life subscales (p < 0.01). VAS Pain, Morning Stiffness, and Grip Strength Measurement were the most important predictors among clinical variables of physical component, affect and symptoms (p < 0.001). Among demographic variables: age over 60 years and low education were the most important predictors of physical component (p < 0.01). CONCLUSIONS: The study results may be helpful for further health-related studies on quality of life among RA studies and in making therapeutic decisions concerning quality of life improvement.

Fatigue and sleep quality in rheumatoid arthritis patients during hospital admission.

OBJECTIVES: Rheumatoid arthritis (RA) is a systemic disease of connective tissue characterised by chronic course with periods of exacerbation and remission. Even in the early stages of the disease patients report the occurrence of fatigue and sleep disorders. Reduced sleep quality and chronic fatigue are common among patients with rheumatoid arthritis. The aim of the research was to evaluate the severity of fatigue and sleep quality assessment among patients hospitalised with rheumatoid arthritis and to determine the relation between the level of symptoms of fatigue and sleep quality and variables such as: age, gender, disease duration, marital status, applied pharmacological treatment, and pain intensity. MATERIALS AND METHODS: The study involved 38 patients (12 men and 26 women) hospitalised in the Rheumatologic Ward of the Orthopaedics and Rehabilitation Hospital of the University of Medical Sciences. The average age of the entire group was 56.26 years. Fatigue was evaluated with use of Polish version of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), while in order to evaluate sleep quality within the examined group of patients the Pittsburgh Sleep Quality Index (PSQI) was used. RESULTS: Patients with rheumatoid arthritis in the analysed group have lower sleep quality, and within subjects with such a diagnosis the fatigue is present. The relation was found between fatigue and such variables as: age, illness duration, marital status, applied pharmacological treatment, and severity of pain. Sleep quality within patients with RA is correlated by such variables as: age, gender, applied pharmaceutical treatment, and severity of pain. It was identified that patients with lower sleep quality experience increased levels of fatigue. CONCLUSIONS: There is a need to clarify which factors determine the level of fatigue and sleep quality in patients suffering from RA in future population-based research and to indicate to doctors, nurses, psychologists, and physiotherapists the significance and importance of the problem, which requires specialised and holistic care.

Health-related quality of life assessment among patients with inflammatory bowel diseases after surgery - review.

Aim of the work was to review systematically the published literature addressing whether quality of life (QoL) and health-related QoL (HRQoL) are influenced by surgery among patients with inflammatory bowel disease (IBD). Electronic databases and published articles were searched to identify relevant studies published in the years 1990-2015. Then, a multistep selection was undertaken to identify articles that met specific selection criteria, such us specific key-words (IBD, HRQoL, ulcerative colitis (UC), Crohn's disease (CD), and surgery), and the population was assessed (studies concerning patients < 18 years old were excluded). The review included 27 studies that were evaluated in the context of the influence of surgery on QoL and HRQoL. Concluding, with the increase in the incidence of IBD, monitoring of QoL is an important indicator of the health effects at each stage of the surgical treatment.

Evaluation of the quality of life of postmenopausal osteoporotic and osteopenic women with or without fractures.

INTRODUCTION: Most studies concerned with the quality of life (QoL) of women with reduced bone mineral density (BMD) focus on patients with vertebral and non-vertebral fractures. Our objective was to evaluate QoL among patients with reduced BMD regardless of their fracture history compared to women with normal BMD. MATERIAL AND METHODS: Eighty-five patients in the study group were classified as osteoporotic, with BMD results measured by densitometry and expressed by T-score ≤ -2.5 SD, 122 women were osteopenic, with -2.5 < T-score ≤ -1.0 SD, and 97 subjects were assessed as normal, with T-score > -1.0 SD. Mean ages of women according to groups were 59.90, 57.67 and 55.68, respectively. Assessment of life quality was conducted using the Polish version of the QUALEFFO-41 scale. RESULTS: The ratings in the assessment (QUALEFFO-41) of QoL were lower for osteoporotic and osteopenic women than for the normal BMD group with regard to pain (p = 0.006), social function (p = 0.001), health perception (p = 0.001), and mental function (p = 0.001). For total QUALEFFO-41 the associated factors were: secondary and higher education (OR = 0.49; 95% CI: 0.29-0.82), self-perceived deformity of the back (OR = 4.09; 95% CI: 1.88-8.93), previous fractures (OR = 2.52; 95% CI: 1.09-5.82), reduced height (OR = 2.48; 95% CI: 1.13-5.39) and anxiety (OR = 1.42; 95% CI: 1.21-1.66). CONCLUSIONS: It seems necessary to evaluate QoL of women with reduced BMD before fractures occur, to aid development of health education aiming to reduce the incidence of osteoporosis and prevent fractures.

Quality of life in patients with ulcerative colitis treated surgically.

INTRODUCTION: Ulcerative colitis belongs to the group of inflammatory bowel diseases. The specific symptoms and chronic nature of the disease significantly affect the quality of patients' lives. Quality-of-life assessment helps to define its determining factors as well as the efficiency of surgical procedures. AIM: Quality-of-life evaluation of patients with ulcerative colitis treated surgically. MATERIAL AND METHODS: A retrospective review was carried out on 35 patients with ulcerative colitis, who were treated surgically in the Clinic of General and Colorectal Surgery, University of Medical Sciences in Poznan. The research tools used to assess the quality of life consisted of: the Inflammatory Bowel Disease Questionnaire, a Polish version of the Short Form Health Survey-36, and a questionnaire. RESULTS: The mean of the IBDQ scale was 152.51, and the median was 161. In this scale, a higher score indicates better quality of life. The situation in the subjective SF-36 scale is reversed: a lower score indicates better quality of life. The mean of the SF-36 was 115.94, and the median was 58. Many discrepancies in the field (e.g. the influence of determining factors) create a niche for further studies. CONCLUSIONS: Moreover, quality-of-life evaluation may lead to better patient care, understanding their problems or treatment modifications, and finally may become a kind of therapy efficiency parameter.

[Knowledge about breastfeeding profits among primiparas]. / Wiedza o zaletach karmienia naturalnego, wsród kobiet rodzacych pierwsze dziecko.

Breastfeeding is the only way to nourish newborns and toddlers and it enables them to have an optimal health condition and growth. Both a child and a mother draw a lot of profits from breastfeeding. Woman's milk is perfectly balanced as far as quantity and quality is concerned. It has specific generic nourishment that ensures optimal psychological emotional and physical development of a child. Breastfeeding also protects infants from immunological problems and infections. Having the skills and knowledge about breastfeeding is the main factor that enables a smooth process of lactation. All the medical staff and midwives especially are obliged to promote breastfeeding and they should provide information as well as emotional and technical support for mums through the whole period of lactation. The aim of this thesis was to examine the level of knowledge about breastfeeding among first-time mothers. An anonymous survey was used as an analytic tool. The survey was specifically created for this research and it contained 30 questions. Majority of responders (98%) declared a will for breastfeeding. Also majority of women (94%) knew that their milk contains all the needed ingredients for proper development of their young. According to the pregnant women in labor (98%) breastfeeding is a key element in establishing an emotional connection with the child. Most of the responders knew the influence of breastfeeding on child's health. Minority of the questioned women (14%) attended birthing courses. The responders were equipped in knowledge on various levels. It proves the necessity of systematic and planned education for women. The system of lactation counseling should be an integral part of post-labor care in obstetrician clinics.

Effect of selected socio-demographic, clinical and biochemical factors on self-reported quality of life among post-menopausal women with osteoporosis.

INTRODUCTION: The goal of health care with relation to women with osteoporosis is the prevention of fractures, maintenance of independence, and good quality of life. OBJECTIVE: To discover how selected socio-demographic, clinical and biochemical factors affect positively or negatively the overall assessment of the quality of life, and to assess the quality of life in specific domains among women with osteoporosis. MATERIALS AND METHODS: The study group covered 85 women with osteoporosis. Self-reported quality of life was evaluated using WHOQOL-100. In order to determine factors affecting the self-reported of quality of life the logistic regression analysis was applied. RESULTS: The physical domain was associated with decreased height (OR=2.13; 95%CI 1.04-4.35), anxiety (OR=1.30; 95%CI 1.14-1.49) and depression (OR=1.32; 95%CI 1.09-1.59). The psychological domain was associated with previous fractures (OR=4.76; 95%CI 2.22-11.11), deformities of the back (OR=2.13; 95%CI 1.08-4.17) and anxiety (OR=1.16; 95%CI 1.02-1.16). The level of independence and of social domain were associated with performance of occupational activity, respectively (OR=0.93; 95%CI 0.88-0.97) (OR=0.96; 95%CI 0.88-0.98). The social domain was associated with decreased height (OR=2.38; 95%CI 1.12-5.26), deformities of the back (OR=1.28; 95%CI 1.02-4.35), BMI (OR=1.14; 95%CI 1.05-1.23), anxiety (OR=1.41; 95%CI 1.20-1.64) and depression (OR=1.23; 95%CI 1.03-1.49). CONCLUSION: The factors determining poor quality of life were decreased height, deformity of the back, previous fractures, elevated FSH level, anxiety and depression. The factors determining a good self-reported quality of life were higher level of education and occupational activity.

Multifactorial analysis of risk factors for reduced bone mineral density among postmenopausal women.

INTRODUCTION: The study aimed to determine the risk factors for reduced bone mineral density (BMD) among postmenopausal women. MATERIAL AND METHODS: Two hundred and fifty-three postmenopausal women were included to the study. The study group consisted of 85 women with osteoporosis (mean age: 59.9 years) and 168 with osteopenia (mean age: 57.8 years). Patients were assigned to groups according to their BMD measured in the lumbar spine, hip and femoral neck by dual X-ray absorptiometry. Bone formation was assessed by measuring serum osteocalcin and bone resorption by measuring serum C-terminal type I α-collagen chain telopeptide. RESULTS: Multiple regression analysis for lumbar spine showed association of age (p = 0.001), parental history of fracture (p = 0.05), use of hormone replacement therapy (p = 0.034), bisphosphonates therapy (p < 0.001), calcium and vitamin D supplements therapy (p = 0.001), oestradiol level (p = 0.007) and body mass index (p < 0.001). Multiple regression analysis for femoral neck and hip total showed association of age (p = 0.001), parental history of fracture (p = 0.049), use of bisphosphonates (p < 0.03)) use of calcium and vitamin D supplements (p = 0.039), oestradiol level (p = 0.047). All the variables together explain 40.4% of variance in BMD for the lumbar spine and 25.6% of variance in BMD for femoral neck and hip total. CONCLUSIONS: The present study demonstrated correlations between the variables and BMD, which are known and widely described in the literature. Osteoporosis and osteopenia in Polish subjects appear to be associated with several known risk factors that are well described in the literature.

[The relationship between selected biochemical parameters, clinical factors and bone mineral density in postmenopausal women with osteoporosis]. / Zwiazek pomiedzy wybranymi parametrami biochemicznym i czynnikami klinicznymi a gestoscia mineralna kosci u kobiet z osteoporoza w okresie pomenopauzalnym.

UNLABELLED: Bone loss in women occurs mainly due to postmenopausal estrogen deficiency and impaired balance between bone resorption by osteoclasts and bone formation by osteoblasts. OBJECTIVE: The aim of this study was to determine the relationship between selected biochemical parameters, bone turnover markers, clinical parameters and bone mineral density (BMD) in postmenopausal women with osteoporosis. MATERIAL AND METHODS: The study group consisted of 85 women treated at the Menopause and Osteoporosis Clinic of the Obstetrics and Gynecological Hospital in Poznan. The average age of the women was 59.9 +/- 5.20 years. Quantitative assessment of bone mass at the lumber spine and proximal femoral epiphysis was performed using DEXA technique. The study included women with BMD expressed as T-score < or = (-2.5) SD. A multifactorial regression analysis was used to determine the correlation between selected biochemical parameters, clinical factors and BMD. RESULTS: As far as biochemical parameters were concerned, the concentration of estradiol correlated with BMD. The assessed bone turnover markers did not show a correlation with BMD. The following clinical parameters correlated with BMD: age, body mass index - BMI, family history of fractures, bisphosphonates treatment, transdermal hormone replacement therapy use, and intensity of physical activity CONCLUSION: It is important to identify risk factors for osteoporosis in women, especially when planning prevention of bone loss in postmenopausal women.

[Psycho-social context of health self-esteem in elderly ex-smokers]. / Psychospoleczne konteksty samooceny zdrowia u bylych palaczy w starszym wieku.

Tobacco smoking remains still as dominating and essential risk factor of morbidity and mortality of cancer, especially in elderly people. Advanced age presents difficulties, because of changes in social status level of physical fitness, and decreased problem-solving abilities. The aim of the study was to self-evaluation of health in elderly ex-smokers post hospitalization. The study was conducted on 48 elderly ex-smokers (37 women, 11 men), using a general version of FACT-G questionnaire from USA. The analysis of the results was accomplished through Mann-Whitney and Spearman tests. Statistical differences were observed in tested subjects, with relativity level of 0,05, which related to states of physical fitness and social functions. Decreased physical and psychological abilities associated with process of aging, create a need for monitoring the finding of the study to life style, in order to achieve independence and effective smoking cessation among elderly patients.

[Knowlege about breast feeding advantages among primiparas]. / Wiedza o zaletach karmienia naturalnego, wsród kobiet rodzacych pierwsze dziecko.

UNLABELLED: Breastfeeding is the only way to nourish newborns and toddlers and it enables them to have an optimal health condition and growth. Both a child and a mother draw a lot of profits from breastfeeding. Woman's milk is perfectly balanced as far as quantity and quality is concerned. It has specific generic nourishment that ensures optimal psychological emotional and physical development of a child. Breastfeeding also protects infants from immunological problems and infections. Having the skills and knowledge about breastfeeding is the main factor that enables a smooth process of lactation. All the medical staff and midwives especially are obliged to promote breastfeeding and they should provide information as well as emotional and technical support for mums through the whole period of lactation. The aim of this thesis was to examine the level of knowledge about breastfeeding among first-time mothers. MATERIAL AND METHOD: The research was carried out from August till October 2011 in birthing rooms of Obstetrics and Gynecology Clinic Hospital for Medical University by the name of K. Marcinkowskiego in Poznan and Obstetrician Wing in Provincial Complex Hospital in Leszno. 101 randomly chosen pregnant women in labor were questioned. An anonymous survey was used as an analytic tool. The survey was specifically created for this research and it contained 30 questions. Majority of responders (98%) declared a will for breastfeeding. Also majority of women (94%) knew that their milk contains all the needed ingredients for proper development of their young. According to the pregnant women in labor (98%) breastfeeding is a key element in establishing an emotional connection with the child. Most of the responders knew the influence of breastfeeding on child's health. Minority of the questioned women (14%) attended birthing courses. CONCLUSIONS: The responders were equipped in knowledge on various levels. It proves the necessity of sys- tematic and planned education for women. The system of lactation counseling should be an integral part of post-labor care in obstetrician clinics.