Satisfaction with life of oncology nurses in Poland.

AIM: The purpose of this project was to analyse the level of satisfaction with life amongst Polish oncology nurses compared to their system of values. BACKGROUND: There are a large number of scholarly reports on job satisfaction and occupational burnout among oncologic nurses, and hardly any impact on their level of life satisfaction. INTRODUCTION: Satisfaction with life, positive feelings and lack of negative feelings are the three important elements of subjective well-being. METHODS: A cross-sectional survey study design was used. One hundred and forty registered nurses working at oncology centres in Poland were surveyed during the 21st Annual Polish Oncology Nursing Conference. The study used a diagnostic survey method utilizing the Satisfaction With Life Scale, the List of Personal Values and an original survey questionnaire for collecting socio-demographic data. RESULTS: There was significant relationship between the level of satisfaction with life in oncology nurses and their age, work seniority, the working system and family life. DISCUSSION: Satisfaction with life and work is interconnected, and oncology nursing is characterized by significant physical and mental strain. The level of satisfaction depends on many variables, such as preferred system of values, work organization, age and work seniority. CONCLUSIONS: Age and years of work experience affect oncology nurses' satisfaction with life. Working on a shift system and having a second job lower their satisfaction with life. Nurses who identify happiness symbols in the category of happy family life present a higher level of satisfaction with life. IMPLICATIONS FOR NURSING POLICY AND PRACTICE: The low level of satisfaction with life among Polish oncology nurses is an important factor in the contemporary threats in nursing, and commitment to the improvement of the quality of life in this professional group should become a priority of shaping the image of the profession.

Psychological support of a cancer patient based on nursing care process records.

PURPOSE: The care of a cancer patient undergoes considerable changes. Patients' most important need is a demand of support in dealing with somatic, psychological, emotional and social complaints. The purpose of this research is to analyse the realization of the psychological support of a cancer patient based on nursing care process records. MATERIAL AND METHODS: The research analysis is based on 150 nursing care case histories of cancer children and adults treated in the Independent Public Clinical Hospital No 1 of the Academic Clinical Centre at the Medical University of Gdansk in such wards as: Paediatric Haematology, Paediatric Chemotherapy, Adults' Haematology, Oncology and Radiotherapy, Thoracic Surgery. Evaluation chart of nursing care histories and statistical methods were tools in this research. The nursing case history evaluation chart created for this very research is successfully used by members of nursing records team in all of 61 wards. RESULTS: The results indicate that in all analysed wards the most problematic factor for nurses was taking the patients' (children's) habits and free time planning into account while establishing the plan of action. In numerous cases a stated nursing care diagnosis was not connected with the realization of psychological support. Providing patients with the feeling of safety and contact with family was positively assessed. CONCLUSION: In the care process nurses should pay more attention to the evaluation of patients and their families' need of social support.

The problem of pain evaluation in the process of nursing care in thoracosurgical patients and in general surgery.

Postoperative pain causes numerous disorders in systemic homeostasis. It may result in various complications prolonging the period of convalescence and making the rehabilitation difficult, or even being dangerous to life. A nurse becomes irreplaceable in the process of pain evaluation just after surgical procedures since the pain intensity constitutes the basis for later treatment decisions. The aim of the research is the evaluation of postoperative pain in patients after thoracic and abdominal surgical procedures. 50 thoracosurgical patients and 50 general surgical patients were involved in the research. Patients were selected at random. A visual-analogue scale was used for pain evaluation and the categorisation table was used for the evaluation of patients' self-care ability. Statistical analysis was performed by means of STATISTICA 6 package (StatSoft, Inc). The results prove that in thoracosurgical patients pain intensity is lower and there is no dependence on the operation performed, as in the case of patients after surgical procedures within the abdominal cavity. Statistically significant differences were observed between groups of patients and the analgesic drugs used as well as pain intensity. The evaluation of patients' self-care ability does not depend on the intensity of pain declared by patients.

Level of nursing care vs life quality of patients in the terminal stage of a disease.

A patient whose treatment has been unsuccessful and a disease still develops enters a terminal stage of the disease which inevitably leads to death. In nursing the evaluation of care quality and measuring its influence on the quality of patients' life have become enormous challenges and are placed among the most crucial issues. The aim of the research is to evaluate the relationship between the quality of nursing services and the life quality of patients in the terminal stage of a disease. The research activities were carried out in five centres of palliative care, 57 nurses and 99 patients in the terminal stage of a disease were involved. The BOHIPSZO method was used to analyse the quality of care, life quality of the patients was measured by means of RSCL--The Rotterdam Symptom Checklist. The material was subject to statistical analysis. The research results show that high level of hospice nursing care positively affects the quality of life in its physical and psychological spheres.

[Evaluation of the efficacy of cyclosporine A treatment in idiopathic nephrotic syndrome in children]. / Ocena skutecznosci cyklosporyny A w idiopatycznym zespole nerczycowym u dzieci.

This study reports the results of cyclosporine A (CsA) treatment in 106 children with idiopathic nephrotic syndrome. All of them had normal renal function. In 66 CsA was added to prednisone because of primary steroid-resistancy. Remission was obtained in 31 (47%) and improvement in 23 (35%). In 12 patients (18%) CsA was ineffective. Best results were obtained in youngest children (< 2 years of age) and those with minimal change disease (78% of remission). Renal function remained normal in all children in remission, while in 30% of those with improvement GFR decreased. In all children with persistent nephrotic syndrome chronic or end stage renal failure developed. 40 children were treated with CsA because of long-lasting steroid-dependency, the lack of effect of alkylating agents and steroid toxicity. In 16 of them prednisone was discontinued and in the rest given in very low doses. The steroid-toxicity effects disappeared or became less prominent in all of them. Appearance of albuminuria with decrease of the CsA dose and/or relapses of nephrotic syndrome during or after discontinuation of CsA treatment were quite frequent. For this reason the treatment course was prolonged, in some patients up to 55 months. This may result in chronic CsA nephrotoxicity. We performed second renal biopsy during remission in 28 children. The morphological signs of nephrotoxicity (grade I according to Habib and Niaudet) were considered in 5 (18%) of them.

[Verification of indications for kidney biopsy in children with steroid-dependent nephrotic syndrome]. / Weryfikacja wskazan do biopsji nerki u dzieci ze sterydozaleznym zespolem nerczycowym.

The aim of this study was to assess if cytostatic treatment of steroidodependent nephrotic syndrome in children should be preceded by renal biopsy. The result of treatment of 75 children with steroidodependent nephrotic syndrome were analysed. They were randomized for treatment with chlorambucil and cyclophosphamide and divided into two groups. Group I includes 32 children without preceding biopsy, group II, 43 children with established histopatologic diagnosis. Remission was achieved by 25 (78%) children in group I (15 (79%) of 19 treated with chlorambucil and 10(77%) of 13 treated with cyclophosphamide) and 38 (88.4%) in group II (25 (96%) of 26 treated with chlorambucil and 13 (76%) of 17 treated with cyclophosphamide). The results of therapy in children of two groups are comparable. This would indicate that a trial of cytostatic treatment can be started without previous renal biopsy.

Structure-activity relationships of boronic acid inhibitors of dipeptidyl peptidase IV. 1. Variation of the P2 position of Xaa-boroPro dipeptides.

A series of prolineboronic acid (boroPro) containing dipeptides were synthesized and assayed for their ability to inhibit the serine protease dipeptidyl peptidase IV (DPPIV). Inhibitory activity, which requires the (R)-stereoisomer of boroPro in the P1 position, appears to tolerate a variety of L-amino acids in the P2 position. Substitution at the P2 position which is not tolerated include the D-amino acids, alpha,alpha-disubstituted amino acids, and glycine. Specificity against DPPII and proline specific endopeptidase is reported. A correlation between the ability to inhibit DPPIV in cell culture and in the human mixed lymphocyte reaction is demonstrated. A synthesis of prolineboronic acid is reported as well as conditions for generating the fully unprotected boronic acid dipeptides in either their cyclic or acyclic forms.

[Molecular markers of hemostasis activation in children with nephrotic syndrome]. / Molekularne markery aktywacji hemostazy u dzieci z zespolem nerczycowym.

Vein and arterial thrombosis is a rather rare but potentially life-threatening complication of nephrotic syndrome (n.s.). None of the specific markers of hypercoagulability state in n.s. have been identified. The aim of the study was to estimate plasma parameters of prothrombic state in children with n.s. Ten children aged from 3 to 10 yrs (mean 5.7 +/- 2.5) with recurrence of n.s. and 10 healthy controls matched for age and sex were studied. In all children with n.s. prothrombin fragments F 1+2, D-dimers (D-d), thrombin-antithrombin III complexes (TAT) and whole blood clotting time thrombin time, prothrombin time, plasma fibrinogen and platelet count were determined in the hypovolemic state (before therapy was started), in the normovolemic state (after plasma expander was used) and in the course of anticoagulation treatment (two week dicumarol therapy). In comparison with healthy controls all children with recurrence of n.s. in the hypovolemic state showed a significant (p < 0.05) increase of D-d (910 vs 500 ng/ml), TAT (14.26 vs 2.6 ng/ml), F 1+2 (5.68 vs 0.79 nmol/l), plasma fibrinogen (592 vs 272 mg/dl), platelet count (632 vs 275 x 10(9)/l) and shortening of WBCT (30.0 vs 35 s). Plasma volume expansion produced by dekstran was followed by a moderate decrease of all parameters. Two-week anticoagulant treatment had no impact on estimated haemostasis parameters.

[Evaluation of the efficacy of levamisole in corticosteroid-dependent nephrotic syndrome in children]. / Ocena skutecznosci lewamizolu u dzieci ze sterydozaleznym zespolem nerczycowym.

The efficacy of levamisole was evaluated in 22 steroid-dependent nephrotic children. All of them were treated before with glucocorticoids. In 45.5% of children, prednisone was with-drawn after levamisole treatment and the remissions obtained lasted more than six months, 18.2% of the children relapsed after prednisone withdrawal and 36.4% children did not respond to levamisole treatment. Levamisole could be recommended for steroid-dependent patients with recurrent infections, in which alkylating agents are contraindicated.

Short versus long initial prednisone treatment in steroid-sensitive nephrotic syndrome in children.

A total of 184 children aged, 13 months to 11 years, suffering from their first attack of steroid-responsive nephrotic syndrome were included in a randomized study. They were treated according to three treatment protocols. All children received 1-2 mg of prednisone/kg body weight/day (up to 80 mg daily) for 4 weeks, and thereafter 1 mg/kg body weight/48 h for the next 4 weeks. Treatment was discontinued at this point in 44 children (protocol A); in 68 (protocol B) the dose was reduced by 25% each week, tapering off to 0 at the end of the third month, while in 72 children (protocol C), after the first 2 months of initial treatment the dose was reduced by 25% each month and tapered off to 0 by the end of the sixth month. All patients completed a 2-year follow-up period after withdrawal of prednisone. Treatment results were expressed as: percentage of children relapse-free within the first 6 months and 2 years after withdrawal of treatment, and average number of relapses per patient per year. The best results were obtained in children who had been treated for 6 months; 65.3% of them remained relapse-free within the first 6 months and 50% over the entire 2-year follow-up period; the number of relapses per patient per year in this group was 0.49. The respective values for children treated 2 and 3 months were: 36.4% and 32.4% for the 6-month period; 27.3% and 20.6% for the 2-year period; the numbers of relapses per patient per year were 0.79 and 0.77, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[The influence of the initial prednisone treatment period on the adrenal function and the further course of the disease in steroid sensitive nephrotic syndrome in children]. / Wplyw okresu wstepnego leczenia prednizonem na czynnosc kory nadnerczy i dalszy przebieg sterydowrazliwego zespolu nerczycowego u dzieci.

All together 184 children with the first attack of steroid sensitive nephrotic syndrome were included in the study: 44 were treated with prednisone for two, 68 for three and 72 for six months. All of them completed a two years follow-up period. In 67 the results of treatment were correlated with adrenocortical function evaluated by basal and Synacthen stimulated cortisol levels determined before and after treatment. Treatment results were expressed as: percentage of children in sustained remission at the second year, percentage of children relapse-free within the first six months, and the whole follow-up period, and average number of relapses per patient per year. The best results were obtained in children treated for six months, while the results obtained in those treated for two and three months were significantly worse. In 67 children studied no significant correlation between suppression of adrenocortical function and either treatment duration or tendency for early relapse was found. That, the six months initial prednisone treatment period which is effective and safe, should be recommended for steroid sensitive nephrotic syndrome in children.

[The fate of young individuals with a history of myocardial infarction]. / Los mlodych ludzi po przebytym zawale serca.

The fate of young individuals (to 45 years) with a history of myocardial infarction during 12 years was analysed with the aid of a questionnaire containing questions of both social and medical character. Sudden cardiac death or the second infarction were the most frequent causes of death during the first two years following myocardial infarction. Change in the physical activity mainly involved the return to work. Only 47% of young men and 29.8% of women started full-time jobs. They mainly belonged to so-called white collars. The lack of patients' physicians permission was a main cause of the abstinence of young men from the occupation. A position within the family and social activity usually remained unchanged in the majority of patients, but every third patient greatly reduced sexual activity. Every third patients continued smoking, and did not observe recommended diet despite the systematical medical check-ups. The course of the disease is unclear in the majority of young patients. It is often deformed and requires further, detailed information on young patients' style of life.

The effect of collagen degradation products (CDP) on the central nervous system (CNS).

Rat collagen type I was digested with bacterial collagenase. The peptides obtained were submitted to gel filtration on Sephadex G-25. Two fractions differing in molecular weight (CDP I-3000 D and CDP II-1200 D) were obtained. These fractions administered to rats were found to have an inhibiting effect on the central nervous system (CNS) in Lat's test and the mobility of the animals recorded on a motimeter was found to be reduced. This effect was dependent on the peptide dose and occurred after intravenous (iv) as well as intraventricular (icv) injection.

The effect of anti-intercellular adhesion molecule-1 on phorbol-ester-induced rabbit lung inflammation.

The role of the CD18 complex of leukocyte glycoproteins in adhesion-dependent functions of human leukocytes in vitro has been well documented. A ligand, intercellular adhesion molecule-1 (ICAM-1), for at least one member of the CD18 complex has been identified. This molecule is inducible on many cell types including vascular endothelium and keratinocytes by inflammatory mediators such as IL-1, TNF, and IFN-gamma. ICAM-1 has been shown to mediate, in part, the in vitro adhesion of lymphocytes and neutrophils to endothelial cells expressing ICAM-1. In the present study we have shown that mAb's to the human CD18 complex and to human ICAM-1 cross react with rabbit cells and that both anti-CD18 and anti-CD11b but neither anti-CD11a nor anti-ICAM-1 mAb's inhibit neutrophil migration, an adhesion-dependent function, in vitro. Pretreatment of rabbits with anti-CD18 and anti-ICAM-1 but not anti-CD11a mAb inhibited by greater than 60% neutrophil migration into PMA-induced inflamed rabbit lungs. This effect of anti-ICAM-1 mAb on pulmonary neutrophil influx after PMA injection has important implications. Specifically, that ICAM-1 can function as a ligand for CD18 and can mediate, at least in part, the migration of neutrophils to inflammatory sites.