Patients' Values and Desire for Autonomy: An Empirical Study from Poland.

There is a growing body of literature concerning factors that can influence patients' perception, preferences, or expectations with regard to autonomy in making healthcare decisions. Although many factors responsible for the desire for autonomy in medical decision-making are already recognized, little is known about how the desire for autonomy is related to values, which refer to important goals of human actions. The present study was designed to determine the relationship between the desire for autonomy and basic personal values drawn on Schwartz's value theory. We conducted survey in two age groups: younger and older adults. In the group of younger adults, the desire for autonomy was associated with the need to be appreciated as a person, motivation to act independently, and the abandonment of traditional order and values, whereas in the group of older adults, with independent thinking and a lack of humility. Our study highlighted that the desire for autonomy may result from slightly different reasons in people of particular age groups. These findings might be helpful for medical professionals in developing accurate communication patterns with different age groups of patients.

Digital health and modern technologies applied in patients with heart failure: Can we support patients' psychosocial well-being?

Despite advances in the treatment of heart failure (HF), the physical symptoms and stress of the disease continue to negatively impact patients' health outcomes. Technology now offers promising ways to integrate personalized support from health care professionals via a variety of platforms. Digital health technology solutions using mobile devices or those that allow remote patient monitoring are potentially more cost effective and may replace in-person interaction. Notably, digital health methods may not only improve clinical outcomes but may also improve the psycho-social status of HF patients. Using digital health to address biopsychosocial variables, including elements of the person and their context is valuable when considering chronic illness and HF in particular, given the multiple, cross-level factors affecting chronic illness clinical management needed for HF self-care.

Verbal descriptors of the frequency of side effects: implementation of EMA recommendations in patient information leaflets in Poland.

BACKGROUND: The European Medicines Agency (EMA) recommends a description of drug side effects based on the frequency format and the associated verbal description. Although the recommendations refer to English-speaking countries, in several non-English-speaking states, official authorities have accepted the proposed recommendations on how the patient information leaflets should be designed for descriptions of side effect frequencies. OBJECTIVE: The aim of the study was to examine how manufacturers of authorized medicines in Poland implement the EMA recommendations regarding the verbal descriptors of the frequency of side effects. METHODS: A qualitative study. As a first step, we identified which of the 150 pharmaceutical companies operating in Poland had the largest market share. Then, five manufacturers were selected at random from the list of the top 15 drug manufacturers in Poland by market share of the pharmaceutical sector. Lists of medicinal products authorized for marketing in Poland were downloaded from manufacturers' websites, and then five products from each manufacturer were selected based on random sampling. The study included only prescription medicines and excluded over-the-counter medicines and dietary supplements from the sample. Subsequently, for each of the 25 drugs, relevant patient information leaflets were obtained from the manufacturers' websites. We evaluated how information on the frequency of side effects was provided in each leaflet, including the use of EMA-recommended terms (verbal descriptors such as 'very common,' 'common,' 'uncommon,' 'rare' and 'very rare') and additional notes explaining their meanings. RESULTS: For all manufacturers, word labels of the frequencies of side effects selected for the study were the same, but the additional notes explaining their meanings were different. There were various explanations of how to understand verbal descriptors of the frequency of side effects not only across different manufacturers but also across different medicines from one manufacturer. CONCLUSIONS: There is no single standard in the Polish pharmaceutical industry for implementing the EMA recommendations into the written information about the frequency of side effects. The observed differences for an explanation of how to understand a given verbal term do not favor a uniform interpretation of the verbal frequency labels meaning by patients.

Heart Failure Care: Testing Dyadic Dynamics Using the Actor-Partner Interdependence Model (APIM)-A Scoping Review.

Self-care behaviors are essential for the effective treatment of heart failure (HF), and poor self-care may lead to adverse clinical events in patients with HF. A growing body of literature addresses the need to analyze the characteristics of both patient and caregiver since they are in mutual, long-term interaction, and their reactions to events are dependent on each other. One of the most common approaches for analyzing data on HF self-care dyads is the Actor-Partner Interdependence Model (APIM). The purpose of this study was to conduct a scoping review to answer the following question: what did we learn from HF dyadic studies based on the APIM approach? Medline, Academic Search Ultimate, and CINAHL Complete databases were searched, using the terms "dyad," "dyadic," and "heart failure," for studies published between 2009 and April 2021. Fifteen studies were reviewed from a pool of 106 papers. Studies using the APIM approach revealed interrelated patient and caregiver characteristics that influence self-care and explain many complex dyadic behaviors. Our analysis provided evidence that (1) APIM is a useful analytical approach; (2) a family-oriented approach can improve the functioning of a patient with HF; and (3) social support from caregivers significantly enhances patients' adaptation to illness.

Predictors of Undergoing Colonoscopy, Does Time Horizon Matter?

When talking to patients about undergoing diagnostic colonoscopy, their doctors can present the risk of developing colorectal cancer (CRC) in different time horizons. Studies on time horizons suggest that people have different psychological associations for the near and distant future, which potentially influence their judgments and actions. The aim of this study was to examine what factors predict patients' intentions to undergo diagnostic colonoscopy. We particularly focused on examining the role of the time horizon in which the probability of developing malignant CRC was presented, when taking into account the following factors: the perception of risk (perceived susceptibility to and perceived severity of CRC), expected discomfort related to the procedure, a previous colonoscopy, and subjective numeracy. Using the Health Belief Model, we sought to determine whether the intention to undergo a preventive colonoscopy is affected by the time horizon. We hypothesized that the risk of developing CRC in a proximal time horizon would be more threatening to an individual than a distal one and would consequently increase an individual's behavioral intention to undergo a colonoscopy. We examined the effects of two different time horizons: the risk of developing a disease in the next few years and total lifetime risk. A total of 144 respondents (77 women and 67 men) aged 50-59 years participated in the study. We found that risk perception and expected discomfort significantly affected participants' intention to undergo a colonoscopy. No empirical evidence was found to confirm that presenting a person with the risk of developing malignant CRC in the coming years, as compared to their lifetime risk, increases the behavioral intention to undergo a diagnostic colonoscopy.

Verbal Descriptions Accompanying Numeric Information About the Risk: The Valence of Message and Linguistic Polarity.

The aim of this study was to investigate the effect of presenting risk on decision making and evaluations with regard to the valence (positive vs. negative) and the linguistic polarity (direct vs. indirect). Participants were presented with a message in which patients were informed about risk associated with some diagnostic medical procedures. In the presented text, before obtaining statistical information about risk (e.g., 1 in 1000), four types of the verbal descriptions were used (risk is high/risk is not low/risk is low/risk is not high). The valence of information influenced the decision and respondent's evaluation. Participants receiving a verbal description with a positive valence were more positive about the patient' decision, and more positively evaluated the doctor and patient's mood than participants receiving a description with a negative valence. Neither main nor interaction effects with linguistic polarity were found. The research does not support that indirect wording mitigates the meaning of a message on risk and highlights the strength and persistence of relying on the verbal description, particularly their affective valence.

Cyberchondria and its measurement. The Polish adaptation and psychometric properties of the Cyberchondria Severity Scale CSS-PL. / Cyberchondria i jej pomiar. Polska adaptacja i wlasciwosci psychometryczne Skali Cyberchondrii CSS-PL.

OBJECTIVES: The aim of this paper is a presentation of the adaptation process of the Cyberchondria Severity Scale (SCC) to measure cyberchondria and verification of reliability and construct validities of the test in the Polish population. METHODS: The study included 380 participants (203 women and 177 men) aged 19-68 (M = 26.5; SD = 11.1). The CSS-PL was used to measure cyberchondria, the Short Health Anxiety Inventory (SHAI) for measuring hypochondria, and the Dimensional Obsessive-Compulsive Scale (DOCS) to verify obsessive-compulsive tendencies. RESULTS: Four-factor structure of cyberchondria measured with the CSS-PL was supported. Internal consistency indices of the CSS-PL were between 0.87 and 0.95, test-retest reliability results were 0.58-0.76. This study demonstrated construct validity of the CSS-PL via its correlations with health anxiety (r = 0.31-0.56) and obsessive-compulsive symptoms (r = 0.17-0.48). CONCLUSIONS: The CSS-PL is an initial standardized version of an instrument for measuring cyberchondria and meets the psychometric criteria of reliability and validity for psychological testing tools. The CSS-PL may be used both in diagnostic and scientific research.

Body esteem and self-esteem in middle-aged women.

The aims of the study were (a) to identify predictors of body esteem and (b) to expand on previous research by examining the link between global self-esteem and body esteem in a community-based sample of women in midlife. We found that body esteem in midlife women was predicted by body mass index (BMI), optimism, self-esteem, and menopausal symptoms. Although BMI was the main predictor of body esteem in middle-aged women, global self-esteem was more strongly related to feelings about appearance and physical condition than feelings about body size.

Polish physicians' attitudes to complementary and alternative medicine.

OBJECTIVE: The aim of the study was to assess and compare attitudes, beliefs, and desire for education regarding CAM among Polish junior and senior doctors. DESIGN: A descriptive survey. SETTING: Between October 2014 and April 2015, 170 physicians were surveyed (89 senior and 81 junior doctors). The respondents were participating in vocational refresher courses for physicians or in specialist training organized by the Polish Chamber of Physicians and Dentists. METHODS: The beliefs about CAM were surveyed by a structured, self-administrated questionnaire. The additional section contained questions concerning the respondents' attitudes toward 6 CAM methods: acupuncture, energy therapy, homeopathy, chiropractice, visualization and herbal medicine. For each treatment respondents were asked to indicate whether they believed (1) it should be recommended to patients, (2) it should be accepted that patients use it, or (3) patients should be actively discouraged from using it. RESULTS: Senior doctors had more positive attitudes towards CAM than doctors who had just started their medical practice, although scepticism or uncertainty about the value of CAM was prevalent in the sample as a whole. Despite their scepticism physicians are open to conducting scientific research on CAM and discussing CAM with their patients. CONCLUSION: Given the views held by doctors that the training and activities of CAM therapists should be regulated by the Chamber of Physicians and Dentists, the integration of CAM into medical curriculum and the Polish public healthcare does not yet seem feasible. There is a need for a public debate about CAM and a legal framework regulating practice of CAM in Poland.

Psychological Resources and Self-rated Health Status on Fifty-year-old Women.

OBJECTIVES: The aim of the study is to expand knowledge about predictors of the self-rated health and mental health in fifty-year-old women. The study exploring links between self-rated mental/health and optimism, self-esteem, acceptance of the changes in physical look and some sociodemographic factors. METHODS: Participants in this study were 209 women aged 50 to 59. A single-items measures of self-rated health and mental health were used. Self-esteem was measured through the Rosenberg Self-Esteem Scale; optimism through the OPEB questionnaire; acceptance of the changes in physical look was rated by respondents on a seven-point scale. Participants were also asked about weight loss attempts, the amount of leisure time, and going on vacation during the last year. RESULTS: Predictors of the self-rated mental health in women in the age range of 50 to 59 were: acceptance of the changes in physical look, self-esteem and optimism. Predictors of the self-rated health were: optimism and acceptance of the changes in physical look. CONCLUSION: Optimism and acceptance of the changes in physical look seem to be important factors that may impact subjective health both physical and mental of women in their 50s. The role of the leisure time and vacation in instilling the subjective health requires further investigation.

Individual differences in cancer patients' willingness to use complementary and alternative medicine.

BACKGROUND: Cancer patients very often combine conventional methods of treatment with complementary and alternative medicine (CAM). It is not clear why some cancer patients are inclined to use CAM, whereas others are not. OBJECTIVES: The aim of the study was to find predictors of cancer patients' willingness to use CAM. The study investigated whether personality traits, cognitive preferences and paranormal beliefs are determinants of these patients' willingness to use CAM. MATERIAL AND METHODS: The study participants were 49 cancer patients. The Polish version of the NEO Five-Factor Inventory was used in the study to asses personality traits; cognitive preferences were measured with Nosal's Mind Types checklist (CTU-96); an Inexplicable Phenomena scale was used to examine paranormal beliefs; and willingness to use CAM was assessed with a Decision-Making Choices Questionnaire (DMCQ). RESULTS: Among the studied personality traits, extraversion, neuroticism and a lower level of openness to experience were significant predictors of cancer patients' willingness to use CAM, along with emotionality and rationality as cognitive preferences. CONCLUSIONS: Further research is required to verify the hypothesis of different roles of individual predispositions in making decisions about the use of CAM, depending on the subject's health condition.