Coping strategies and adherence in people with mood disorder: a cross-sectional study.

Introduction: Non-adherence to treatment recommendations is a significant problem, as it contributes to the progression of the disease and to the exacerbation of distressing symptoms. Failure to cope with the disease and elevated levels of stress, in turn, influence the choice of strategy for coping with a difficult situation, and thus adherence to recommendations. Objectives: The purpose of our study was to evaluate the impact of the subjects' stress coping styles on therapeutic adherence, life satisfaction, disease acceptance and quality of life (QoL) in people with mood disorders. Methods: This survey-based study included 102 respondents diagnosed with mood disorders, living in the West Pomeranian Voivodeship. It was performed using the sociodemographic questionnaire and standardized tools: The Coping Inventory for Stressful Situations (CISS), The Satisfaction with Life Scale (SWLS), The Short Form-36 (SF-36) Health Survey, The Adherence to Refills and Medication Scale (ARMS), and The Acceptance of Illness Scale (AIS). Results: Some 47.06% of the respondents suffered from depressive disorders, while 34.31% had depression or mixed anxiety disorder. Patients who made greater use of an emotion-focused style were found to have significantly lower life satisfaction than other patients. Moreover, this style was related to such SF-36 domains as general health, social functioning, role emotional, vitality, and mental health, as well as to physical component summary (PCS) and mental component summary (MCS). Conclusion: Treatment non-adherence is a serious challenge in the treatment of patients with mood disorders. Individuals who do not adequately follow treatment recommendations often resort to alternative activities as a mechanism for coping with difficult situations. Patients who predominantly adopt an emotion-oriented coping style tend to experience lower life satisfaction and greater difficulty accepting their condition compared to their peers. Conversely, patients who adopt a task-oriented coping style report better quality of life than those who rely on emotion-oriented coping or alternative activities.

Evaluation of Trabecular Bone Microarchitecture and Bone Mineral Density in Young Women, Including Selected Hormonal Parameters.

The absence of non-invasive methods for assessing bone material and structural changes is a significant diagnostic challenge. Dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD) testing is the gold standard for osteoporosis diagnosis. BMD and the trabecular bone score (TBS) have facilitated targeted osteoporosis prevention and treatment in clinical settings. The findings from this study indicate that BMD modulation in young women is influenced by various hormones, potentially compromising the diagnostic precision of BMD for subclinical bone demineralization. A total of 205 women aged 19 to 37 underwent anthropometric measurements and hormonal tests. BMD was determined using DXA, and TBS values were computed from the lumbar spine L1-L4 segment. The multivariate analysis findings suggest that BMD might not be determined by hormones. The relationship between TBS and TSH was statistically significant in the univariate analysis, which indicates the efficacy of further studies to determine the link between TBS and specific hormones. Analyzing the strength of the correlation between TBS and hormones in the univariate analysis shows which factors are worth considering in further analyses. This makes it possible to create better techniques that will help identify young women who are at a higher risk of developing osteoporosis.

Psychosocial Functioning of Individuals at Risk of Developing Compulsive Buying Disorder.

(1) Background: This study aimed to establish the connection between depressiveness, workaholism, eating disorders, and personality traits, according to the five-point model called the Big Five, in women with a risk of compulsive buying disorder. (2) Methods: The study was conducted on 556 Polish women from the West Pomeranian Voivodeship. The study employed the diagnostic survey method using a questionnaire technique including Personality Inventory NEO-FFI, the Buying Behaviour Scale, the Beck Depression Inventory I-II, the Three-Factor Eating Questionnaire, and a self-questionnaire. (3) Results: The analysis revealed the risk of compulsive buying being accompanied by a higher median score for depressiveness, neuroticism, Cognitive Restraint of Eating, Uncontrolled Eating, and a risk of workaholism. A lower score in the respondents in the compulsive buying risk group was observed in an assessment of agreeableness and conscientiousness. Work addiction was exhibited by 26% of people with compulsive buying disorder vs. 12% of people without it. (4) Conclusion: This study found that a high risk of compulsive buying disorder is accompanied by a high risk of moderate depressiveness, neuroticism, Cognitive Restraint of Eating, Uncontrolled Eating, and workaholism. It also confirmed the view that compulsive buying is a behavioural addiction which is a consequence of ineffective coping and being dissatisfied with one's social life.

The Effects of Breastfeeding and Gestational Diabetes Mellitus on Body Mass Composition and the Levels of Selected Hormones after Childbirth.

Breastfeeding may have a positive effect on glucose metabolism and insulin sensitivity, which may reduce the risk of developing diabetes following gestational diabetes mellitus (GDM). This study aimed to evaluate the effect of breastfeeding and GDM on the body mass composition of the studied women, the levels of leptin, ghrelin, adiponectin, resistin, and insulin, and weight loss during the 6-8-week postpartum period and 1 year after childbirth. MATERIALS AND METHODS: The study group included 42 women with a singleton pregnancy, diagnosed with GDM between the 24th and 28th week of gestation. The control group consisted of 28 non-diabetic women with a singleton pregnancy. This study was carried out at 6-8 weeks as well as at 1 year postpartum. The women were subjected to body weight measurements and body composition analysis performed using a professional body composition analyzer TANITA DC-430 S MA. Waist circumference and subcutaneous fat was measured. Blood for laboratory tests was taken in the morning, on an empty stomach. RESULTS: It was shown that, regardless of diabetes, exclusive breastfeeding had a significant impact on weight loss at 6-8 weeks postpartum (p = 0.014785) and lower insulin levels (p = 0.047). However, there was no effect of breastfeeding on the women's anthropometric measurements or hormone levels one year after delivery, except for the thickness of subcutaneous adipose tissue, which was significantly lower in breastfeeding women (p = 0.03). One year after delivery, breastfeeding women had a lower BMI (p = 0.0014), less-thick subcutaneous adipose tissue (p < 0.001), and a lower risk of obesity (p = 0.016). There were also higher insulin and ghrelin levels in both breastfeeding and non-breastfeeding women (p < 0.001), and lower resistin levels in non-breastfeeding women (p = 0.004). Women who had diabetes during pregnancy had a significantly reduced waist circumference and subcutaneous fat thickness after one year (p < 0.001 and p = 0.05, respectively). CONCLUSIONS: Having diabetes during pregnancy did not significantly affect the results of anthropometric measurements and hormone levels noted at 6-8 weeks after delivery (the only exception was the thickness of subcutaneous fat tissue, which was greater in women without GDM). This may indicate normalization of carbohydrate metabolism after childbirth; however, the observation period is too short to elucidate long-term metabolic effects. This suggests the need for further research related to GDM and breastfeeding.

Assessment of Fatty Acid Content in the Milk of Women from the West Pomeranian Region of Poland with Regard to Supplementation and the Amount of Adipose Tissue.

The total amount of fat in the milk of nursing mothers depends on maternal reserves, as well as food intake and its synthesis in the mammary glands. The aim of this study was to assess the contents of fatty acids in the milk of women from the West Pomeranian region of Poland with regards to supplementation and the amount of adipose tissue. We also wanted to find out whether these women, who have direct access to the sea and potential access to fresh marine fish, have higher levels of DHA. METHODS: We analyzed milk samples obtained 6-7 weeks postpartum from 60 women. The content of fatty acid methyl esters (FAME) in lipids was determined by gas chromatography-mass spectrometry (GC/MS) using a Clarus 600 device (PerkinElmer). RESULTS: Women using dietary supplements had significantly higher levels of docosahexaenoic acid (DHA) (C22:6 n-3) (p = 0.000) and eicosapentaenoic acid (EPA) (20:5 n-3) (p = 0.000). The levels of eicosatrienoic acid (ETA) (C20:3 n-3) and γ-linolenic acid (GLA) increased with the amount of body fat, and the level of DHA was lowest in subjects where body fat exceeded 40% (p = 0.036). CONCLUSIONS: The contents of fatty acids in the milk of women from the West Pomeranian region of Poland were similar to that reported by other authors. The levels of DHA in women using dietary supplements was also comparable to the values reported worldwide. BMI had an effect on the levels of ETE and GLA acids.

Weight Gain during and after Pregnancy in Women with Gestational Diabetes Mellitus-A Preliminary Study.

Appropriate gestational weight gain (GWG) favors fewer complications related to pregnancy, delivery, puerperium, and the condition of the fetus and newborn baby. The aim of this study was to evaluate weight gain in women during and after pregnancy, including both women with and without gestational diabetes mellitus (GDM). MATERIALS AND METHODS: The study involved 42 singleton pregnant women diagnosed with GDM between the 24th and 28th week of pregnancy. The control group consisted of 28 nondiabetic women with a singleton pregnancy. The pre-pregnancy BMI, intra-pregnancy weight gain, and postpartum body weight were assessed in the participants. RESULTS: There were no statistically significant differences in the values of intra-pregnancy weight gain. Only diabetic women who were also overweight or obese had a significantly higher percentage of weight gain during pregnancy. The analysis of the percentage of weight gain during the entire pregnancy showed differences only in the group of women with pre-pregnancy BMI over 30. CONCLUSIONS: There were no significant differences in total pregnancy or mid-pregnancy weight gain between women with and without GDM. Most of the women had too high or too low total-pregnancy and mid-pregnancy weight gain. Therefore it is necessary to control GWG and educate pregnant women about it.

The Attitudes of Polish Women towards Breastfeeding Based on the Iowa Infant Feeding Attitude Scale (IIFAS).

BACKGROUND: The Iowa Infant Feeding Attitude Scale (IIFAS), which is used for the assessment of attitudes towards breastfeeding, has been found to be reliable and valid in a number of countries, but has not yet been psychometrically tested in Polish women. The purpose of the study was to report on the cultural adaptation of the IIFAS to Polish settings and on its validation, to evaluate the breastfeeding attitudes in Polish women who recently gave birth, and to identify the determinants of these attitudes. METHODS: The study was performed in a group of 401 women in their first postpartum days. RESULTS: Cronbach's α for the scale was 0.725. Discriminative power coefficients of all questionnaire items were higher than 0.2. Subscales were strongly correlated with the total score, with a correlation coefficient of 0.803 for the "favorable toward breastfeeding" subscale (p < 0.001), and 0.803 for the "favorable toward formula feeding" subscale (p < 0.05). For the item "A mother who occasionally drinks alcohol should not breastfeed her baby", the factor loading did not reach the criterion value, and so the item was not included in further analyses. The mean IIFAS score was 63.12 (±7.34). CONCLUSIONS: The Polish version of the IIFAS is a reliable and appropriate measure of women's attitudes towards infant feeding in Polish settings, with acceptable psychometric properties and construct validity.

MEDICAL STAFF IN THE CARE OF A PREGNANT PATIENT DIAGNOSED WITH FETAL DEFECT.

OBJECTIVE: The aim: The research conducted aims at evaluating the way the medical staff functions in the care of the pregnant patient diagnosed with fetal defects. PATIENTS AND METHODS: Material and methods: 158 midwives took part in the study. The MINI-COPE standardized questionnaire and author's questions were used. RESULTS: Results: During the period when the care was provided for the pregnant patients diagnosed with fetal defects, nearly 50% of the midwives under examination complained about the decline of their wellbeing. 75,3% of the respondents seek help and advice on how to deal with a stressful situation. Ideal for providing a systemic support, the midwives most often chose a psychologist and a psychotherapist. The surveyed who reported no need for a systemic support for the medical staff at the workplace, as the causes of their attitude pointed to their diminished trust in the ward nurse and no place for honest conversations. Most of the midwives surveyed during the care of the patient with the fetal defects experienced stress and bigger mental exhaustion. Over half of the surveyed reported lack of systemic psychological support provided for the medical staff at the workplace. CONCLUSION: Conclusions: The research indicates the need to introduce courses and training on topics related to how to deal with stressful situations into the education system of medical staff.

Analysis of the impact of selected hospital practices on exclusive breastfeeding.

Introduction: Breastfeeding is the optimal method of feeding children during the first period of their life. The correct management of lactation is essential for proper breastfeeding initiation which would be continued long enough. Many factors have a huge impact on lactation, among others mode of delivery, parturition, hospital procedures and practices, such as suctioning the airway, 'skin to skin' contact, feeding the baby, and the competent support of the staff. The aim of the study was to analyze the impact of selected procedures related to childbirth and post-natal care, as well as hospital practices on lactation. Materials and methods: The study involved 145 women who gave birth in the Department of Foetal Medicine and Gynaecology Pomeranian Medical University in Szczecin located in Police, West Pomeranian Province in Poland. The research was carried out by a diagnostic survey with a self-authorship questionnaire. Conclusions: 1. Some hospital practices, such as suctioning the airway, short 'skin to skin' contact after cesarean delivery, and complementary feeding of a newborn baby with a bottle had negative impact on maintaining lactation. 2. Complementary feeding of an infant with a bottle was a frequent hospital practice. As the procedure has an adverse impact on lactation, breastfeeding should be replaced by complementary feeding in an alternative way only in justified cases. 3. Most of the patients who obtained support during lactation were breastfeeding exclusively. Competent assistance in initiating and maintaining lactation is the responsibility of the medical personnel, thus there is a necessity for their permanent development, and a constant need to modify hospital practices to ones that affect lactation favourably.

[Views and expectations of women regarding gynaecological examinations].

Introduction: It has long been known that gynaecological examination causes a lot of negative emotions for most women. The aim of the study was to learn the views of women on the issue of gynaecological examination. Materials and methods: The study involved 1200 women from the West Pomeranian and Lódz provinces in Poland. Results: The majority of non-pregnant women considered gynaecological examination to be embarrassing. The most embarrassing moment of the visit for the respondents from both groups was lying down on the gynaecological chair, and the most unpleasant stage of examination was palpation through the vagina. The greatest sense of security and mental comfort during the examination was provided by the presence of only the gynaecologist. Most pregnant respondents prefer to be examined by a male gynaecologist. Respondents would most willingly have examinations with a doctor who is nice, talkative, calm, smiling and mature. Most of the pregnant surveyed women claimed that the gynaecological examination is very necessary, while only 49% would appear for it once every 6 months. Conclusions: 1. Gynaecological examination was significantly more embarrassing and stressful for women who were not pregnant. 2. In the opinion of pregnant women, breast examination is the least embarrassing stage of the examination. 3. Pregnant women significantly more often chose a man as their gynaecologist. 4. The frequency of having a gynaecological examination depended significantly on the status of pregnancy. 5. The expectations of the surveyed women to a gynaecologist focused mainly on him/her maintaining a sense of intimacy and security, on informing the women on the procedures taken, as well as on a nice and individual approach.

Fetus papyraceus in dichorionic diamniotic twin pregnancy: a case report.

INTRODUCTION: The actual rate of multiple pregnancies is significantly larger than that observed during labor due to the fact that in the course of pregnancy intrauterine death of one or more fetuses may occur. CASE PRESENTATION: A twenty-six old woman (GII, PII) reported to hospital in 26 weeks of DC/DA twin gestation complicated by intrauterine death of one fetus in the second trimester of a spontaneous pregnancy. Pregnancy ended at term with vaginal birth of a single live fetus. After birth, entanglement of the fetal umbilical cord around the leg of the dead fetus was discovered. It was the most probable cause of death. CONCLUSIONS: Conservative management is preferred in case of intrauterine demise of one of the fetuses in DC/DA twin pregnancy. One of the reasons of fetal death may be entanglement of the umbilical cord around fetal small parts. The time of fetal death can be determined on the basis of the length of the thigh bone (Femur Length - FL).

Reasons for giving up breastfeeding and support during problems with lactation in the north-western part of Poland.

INTRODUCTION: Breastfeeding is the optimal way of feeding for neonates and infants. Its duration is of vital importance for the child's development and health. The World Health Organization recommends exclusive breastfeeding until the end of the sixth month of life. Many mothers give up breastfeeding earlier than recommended. Professional and non-professional support plays a great role in motivation to start and continue breastfeeding. The aim of this study was to determine how long infants from Szczecin, the capital city of the North-Western region of Poland, are breastfed, what are the reasons for giving up breastfeeding, and whether mothers obtain support in case of problems with lactation. METHODS: One hundred randomly chosen mothers with children aged 12-18 months, living in Szczecin, were examined. A questionnaire was administered to the mothers during a direct interview. Prior to the interview, consent of the mothers to participate in the study was obtained. RESULTS: More than 8% of the mothers gave up breastfeeding during the first month after delivery, 68% were breastfeeding till the end of the third month, 31.5% were breastfeeding till the end of the sixth month, and only 2% continued to breastfeed for one year or longer. The most frequent reasons for giving up breastfeeding were: return to work (43.4%), small volume of milk (29.3%) and child's reluctance to suck (18.5%). 62% of breastfeeding women benefited from support during lactation problems but only 6% visited an outpatient breastfeeding service or joined a breastfeeding mothers support group. Support was obtained from the family midwife (37%), pediatrician (32%), and midwife at an outpatient clinic (25.8%). Most women (74.2%) were satisfied with the support. CONCLUSIONS: (1) It is necessary to promote breastfeeding so that all women could decide to start breastfeeding after childbirth. 2. As the percentage of women who continue breastfeeding after the sixth month of the infant's life is unsatisfactory, mothers should be encouraged to breastfeed longer. (3) A system of professional lactation support for breastfeeding mothers should be developed.

[Role of the nurse and midwife in educating parents of neonates treated at intensive care units]. / Rola edukacyjna pielegniarek i poloznych wobec rodziców noworodków przebywajacych na intensywnej terapii.

INTRODUCTION: Health education is an important element in the therapeutic process of every patient. If the patient is a neonate at an intensive care unit (ICU), the parents or legal guardians become the object of education. Knowledge and skills learned by parents at neonatal ICUs are later reflected in the quality of their childcare. The nursing and midwifery staff at ICUs plays an important role in the process of parental education. The aim of this study was to define educational needs of parents of neonates in intensive care and the impact of education on future parental childcare skills. MATERIAL AND METHODS: We used the diagnostic poll method and the research tool was a questionnaire, which was addressed to parents of neonates treated at the neonatal intensive care unit of the Second University Hospital and the SPSZOZ Zdroje Hospital in Szczecin. The study was carried out in December-January of 2004/2005 and the group comprised 53 persons. The results were subjected to mathematical analysis. CONCLUSIONS: The following conclusions were drawn: (1) As all the parents wished to stay with their children at the neonatal ICU, special facilities for this purpose should be created at hospitals possessing such units. (2) Parents of neonates weighing more than 1000 g reported that their need to help their children was satisfied through participation in diagnostic, therapeutic, and nursing activities, which also gave them a sense of proximity with their offspring. extremely low birthweight to participate in the therapeutic process. (3) Parents expected to be taught by nurses and midwives and were interested in the activities of support groups. (4) Participation by parents in nursing activities is of importance for their unassisted childcare exercised later at home.

[Women's opinions regarding gynaecological examination in a hospital]. / Opinie kobiet na temat badania ginekologicznego w szpitalu.

A visit to the gynaecologist is connected with considerable embarrassment and stress for most women. AIM OF THE RESEARCH: To ascertain patients' opinions about gynaecological examination, frequency of visits, and doctors' attitudes towards patients. MATERIAL AND METHODS: A hundred women from Western-Pomeranian region underwent an anonymous examination. The women were divided into three age groups: 20-40, 41-60 and 61+. The study was carried out in two hospital clinics of the Pomeranian Medical University: the Clinic of Procreation and Gynaecology and the Clinic of Obstetric and Gynaecology, between 2006-2007. RESULTS: 70% of the respondents find the gynaecological examination embarrassing and stressful. According to patients, the most unpleasant moment during their visit to the gynaecologist is time spent in the gynaecological chair (47%) and preparation for the examination (30%), whereas the least embarrassing moment is the gynaecological examination itself (21%). However, the most embarrassing moment of the examination is vaginal examination (40%), rectal examination (33%), colposcopy (27%), and breast examination (2%). All the women stated that gynaecological examination is necessary; with 40% of them having examinations once every twelve months, 32% once every six months, 9% once every twenty-four months and 19% even more seldom. Sense of safety and psychical comfort during the examination is ensured by the presence of a qualified midwife (46%), presence of another doctor (9%), privacy (only the doctor and the patient are present) (36%). 53% of the respondents stated that the doctor ensures intimacy during the examination and 47% gave negative answer. Analysis of the doctor's gender indicated that 56% women prefer to be examined by a woman, 37% by a man, and 7% find the gender to be of no importance. The respondents would prefer if the doctor were nice, good-tempered and communicative. CONCLUSIONS: (1) Gynaecological examination is embarrassing and stressful for women and that is why patients expect the gynaecologist to ensure intimacy and sense of safety during the examination, as well as a pleasant individual approach to a patient, and presence of a midwife. (2) The most embarrassing moment is climbing to the gynaecological chair and the most unpleasant moment is the vaginal examination. (3) The fact that women go to the gynaecologist so rarely is particularly worrisome.

[Self-care and demand for social support in women with infertility]. / Ocena mozliwosci samoopieki i zapotrzebowania na zródla wsparcia spolecznego u kobiet z problemem nieplodnosci.

INTRODUCTION: The prevalence of infertility among married couples is growing. It is estimated that every fifth married couple in Poland is infertile. Infertility is often a source of significant stress for the spouses. It is therefore important to provide professional support, demonstrate interest, listen to the problem, and be present in difficult moments. Social support considerably reduces the feeling of abandonment, fosters self-care, accelerates recovery, strengthens coping, and helps modify views and habits or attitudes towards treatment. The aim of this study was to assess self-care in women with infertility and to identify the most common sources of social support. MATERIAL AND METHODS: The study group consisted of 100 women diagnosed or treated for infertility at the Department of Reproduction and Gynecology, Pomeranian Medical University in Szczecin. The diagnostic poll was done with the aid of a standardised research tool--the Social Support Scale Questionnaire by Danuta Zarzycka. The study protocol was approved by the Bioethics Committee of the Pomeranian Medical University. The study was performed between July 2005 and March 2007. CONCLUSIONS: (1) Self-care in women with infertility is adequate. (2) Women with infertility usually expect professional support from a physician; the role of the nurse is undervalued. Thus, the role of the nurse and midwife needs further promotion.

[The impact of education in birthing schools on the course of pregnancy, labor, puerperium, and neonatal care]. / Ocena wplywu edukacji w szkolach rodzenia na przebieg ciazy, porodu i pologu oraz opieke nad noworodkiem.

INTRODUCTION: Pregnancy represents a special period in the life of a woman. It is the time of many joyous, sublime, and touching moments experienced by the family although not free from anxiety, uncertainty and doubt in the minds of the future parents. It is also the time of an intense quest for answers to annoying questions and a motivating factor to search for information on the physiology of pregnancy, as well as on labor, puerperium and child care. A birthing school is nowadays the most important institution which prepares for parenting in a most professional way. This form of education is gaining widespread acceptance. This study was designed to: 1. Study the effects of participation in birthing school classes on the course of pregnancy, labor, and puerperium. 2. Search for relationships between the birthing school program and motivation of mothers to breast feeding. 3. Determine the influence of education in a birthing school on the ability of mothers to cope with problems during puerperium. MATERIAL AND METHODS: The study was done in 294 women hospitalized at the Obstetrics Ward of the Chair and Department of Obstetrics and Perinatology, Pomeranian Medical University in Szczecin, between June 2001 and December 2002. Two groups were formed: group I--"study group"--comprised 129 gravida who participated in birthing school classes during at least one pregnancy but not earlier than two years before the present study; group II--"control group"--included 165 gravida who never participated in any organized form of birthing education. A questionnaire was developed consisting of 105 questions. Answers were recorded by the researcher and the results in both groups were compared statistically. CONCLUSIONS: Participation in birthing school classes helps develop healthy attitudes during pregnancy, reduced the feeling of pain and blood loss during labor, but does not alter the duration of labor in primipara nor has any effect on problems related to puerperium. Graduates of birthing schools are better motivated to start breast feeding, less often switch to artificial feeding during puerperium, and cope better with problems encountered during puerperium.

[Analysis of some pro-health behaviors of pregnant women after a childbirth education class]. / Analiza niektórych zachowan prozdrowotnych ciezarnych po kursie w szkole rodzenia.

Nowadays the school of childbirth is one of the most important forms of antenatal education. The aim of the study was to compare some pro-health behaviours of women after courses at school of childbirth with pro-health behaviours of women without such education. A group of 129 women after courses at schools of childbirth who were hospitalized in the Chair and Department of Obstetrics and Perinatology of Pomeranian Medical University in Szczecin were introduced into the study. The control group contained 165 women who did not take part in any antenatal education. The questionnaire was a research tool; it was completed 2-5 days after childbirth and also patients' documentation was analyzed. The test results were statistically analyzed. Investigations showed that woman attending classes at school of childbirth were highly aware of pro-health behaviours during pregnancy; they often changed their lifestyle during pregnancy, they smoked less frequently, they had more appointments with their obstetricians and they earlier had their first medical visit. It seems necessary to intensify the classes of nourishing during pregnancy at schools of the childbirth, because no statistically significant differences in the increase of body mass were showed. Moreover, it is necessary to educate every pregnant woman of the hygiene, nourishing and stimulant abuse during pregnancy not only at schools of the childbirth, but also during obstetric consultation.

[Sources of women's education about the puerperium and breast feeding]. / Zródla wiedzy kobiet na temat zagadnien dotyczacych pologu i karmienia naturalnego.

Future parents have a wide range of possibilities in gaining theoretical knowledge from books, magazines, relatives' advice, doctor or midwife' consultations in outpatient clinics. The most professional ways of getting skills in that matter are birth schools. The aim of this study was to analyze the sources of knowledge about puerperium and breast feeding at birth schools in comparison to mothers who did not attend such training. The study was undertaken in the Department of Obstetric and Perinatology in Szczecin. Group I (investigated) consisted of 129 women who finished birth school training course and group II (control) consisted of 165 women with no formalized prenatal education. A questionnaire and medical histories were used in our analysis. The results showed that the birth school attendants were more likely to use a lot of education sources in the field of breast feeding and that some law aspects in puerperium and puerperium pathology need more attention because books and magazines are the main source of knowledge in that matter instead of birth schools classes.

[Sources of women's knowledge relating pregnancy and childbirth]. / Zródla wiedzy kobiet na temat zagadnien dotyczacych ciazy i porodu.

Future parents have the huge range of possibility to afford theoretical knowledge from different sources: books, periodicals, advice of close, doctor's advice or the midwife in outpatient clinic and more. One of the most professional sources of knowledge preparing to parenthood is the delivery school. The aim of investigations is the analysis of sources of women's knowledge preparing to maternity at schools of childbirth and without such form of education. Investigations were conducted on Maternity Ward at the Chair and Department of Obstetrics and Perinatology of Pomeranian Medical University in Szczecin. Investigations were having taken over 129 women after delivery school. Control group was 165 women, who did not take any antenatal education. Investigations appeared that women participating in activities of the delivery school more often read professional magazines and books, watching films preparing to birth control. This is probably the result of significantly frequent higher education in this group as well as the projection of educational films in delivery school. Moreover woman without preparation in delivery school more often had to need the help of hospital staff during delivery.