Assessment of the Level of Life Satisfaction and Health Behaviors Among Patients with Chronic Hepatitis C.

Objectives: An important aspect of complex care of patients with chronic hepatitis C is improvement of their quality of life. In Poland, a low level of life satisfaction is observed among patients with hepatitis C. Some patients experience concerns and anxiety that they will be identified by their employers, family, acquaintances. They are afraid of losing their job or breaking up with their loved ones. This study provides an analysis of the level of life satisfaction among patients with chronic hepatitis C. Methods: Overall, 220 patients with hepatitis C completed the Satisfaction With Life Scale (SWLS) along with an author-constructed questionnaire. Results: The mean level of satisfaction with life score was 16.3±4.9. More than a half of the patients presented a low level of satisfaction (1-4 stens)-62,7%, approximately one-third of the respondents showed a mediocre level (5-6 stens), and 8,7% indicated a high level (7-10 stens). Patients who evaluated their state of health as "poor" had the lowest life satisfaction scores-mean=13.9. Conclusions: Patients with hepatitis C assessed their satisfaction with life negatively and those aged 51-60 expressed significantly lower evaluations. Women showed a slightly lower level of life satisfaction than men, which was associated with low health self-esteem.

The advantages of drinking mineral water in the rehabilitation of patients with viral hepatitis C with accompanying non-alcoholic fatty liver disease after suffering from COVID-19.

INTRODUCTION AND OBJECTIVE: Past COVID-19 significantly worsens Chronic viral hepatitis C patients with concomitant NAFLD. The aim of the study was to assess effectiveness of including mineral water in the rehabilitation complex in patients with chronic hepatitis C with concomitant non-alcoholic fatty liver disease who contracted COVID-19. MATERIAL AND METHODS: 71 patients with chronic hepatitis C with concomitant NAFLD wo contracted COVID-19 were examined. Group I (control) - 39 patients prescribed dietary nutrition and exercise therapy. Group II (main) - 32 patients, in addition to the above, received packaged 'Shayanskaya' mineral water. Methodology comprised anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, and statistical methods. RESULTS: Due to the treatment, there were significant improvements in carbohydrate and lipid metabolism, as well as the cytokine profile. CONCLUSIONS: The effectiveness was established of the use of silicon low-mineralized bicarbonate sodium mineral water in the complex rehabilitation of patients with chronic hepatitis C and suputor NAFLD after contracted COVID-19. There was a significant improvement in the clinical course of the disease and improvement in the functional state of the liver.

Assessment of Health Behaviors of Patients After SARS-CoV-2 Infection.

Objective: Past infection with COVID-19 increases the risk of occurrence of thromboembolic events in veins and arteries, respiratory failure, and damage to the heart muscle, liver, and nervous system. Pro-health behaviors of patients who had been infected with SARS-CoV-2 are the determinant of maintaining and strengthening the state of health. We assessed health behaviors of convalescent patients after SARS-CoV-2 infection and determined the relationships between these behaviors and the selected social and demographic characteristics.Methods: The study included 125 patients who had been infected with SARS-CoV-2; we used the Health Behavior Inventory (HBI), and an author-constructed questionnaire.Results: Overall, 60.8% of respondents presented a mediocre level of health behaviors (5-6 stens), 24.8% low (1-4 stens), and 14.4% high (7-10 stens). We found the highest mean value in the case of one HBI category: positive psychological attitude (3.51±0.67), followed by prophylactic behaviors (3.42±0.73), and correct eating habits (3.36±0.84). The lowest value (demonstrating the least pro-health behavior of respondents) concerned health practices (3.23±0.78).Conclusions: COVID-19 convalescent patients presented a mediocre set of health behaviors. We found statistically significant relationships between health behaviors by education and age. Persons who have had SARS-CoV-2 should receive health education in all areas of health behavior.

Military Blood Service in Poland.

Introduction: On 24 February 2022, the Russia-Ukraine military conflict unfolded just across the eastern border of the European Union. It made everyone realize how important it is to secure blood supplies to health-care units in the event of an armed conflict. This paper presents the principles of functioning of the Military Blood Donation Service and the Military Center for Blood Donation and Hemotherapy in Poland. Methods: The study used data collected in the "Military Blood Bank" information processing system and data from annual reports (2010-2021) sent to the Minister of Health of the Republic of Poland. The reports concerned, among others: demographic data on donors, reasons of permanent disqualifications, numbers of complete and incomplete donations, etc. Results: Since 2005, the number of donors registered in military blood donation centers ranged between 15 and 35 thousand/year. The most dramatic declines in donors were observed in 2010 and 2020. Successful donations accounted for more than 98% of all donations/year (except 2015), and their number varied between 20 and 32 thousand/year. Among the blood donors, men always predominated and the dominant age group (except for 2010) was 25-44 years. The reasons for permanent disqualification have varied over time: their proportions decreased for viral hepatitis and cardiovascular disease, and increased for respiratory and endocrine/metabolic diseases. Due to the COVID-19 pandemic in 2020/2021, these proportions have sometimes been reversed. Discussion: The Military Blood Donation Service has been functioning in Poland for several decades. It is specialized in supplying blood and blood products to the Armed Forces. Unfortunately, it was not possible to refer to the functioning of similar institutions in other countries. Therefore, when evaluating the functioning of Polish military blood donation, we had to rely on numerical values (eg, number of donors/year, donor profile, etc.), which prove a very good organization of blood donation centers. However, it should be noted that, as in other countries, a more active promotion of blood donation in the media is advisable in order to encourage as many young people as possible to donate blood.

Features of clinical, biochemical, and sonographic parameters in patients with chronic viral hepatitis C with concomitant non-alcoholic fatty liver disease.

INTRODUCTION AND OBJECTIVE: Introduction. Difficulties encountered in treating patients with chronic viral hepatitis C (CHC) are associated with the presence of concomitant liver pathology, namely fatty degeneration, which contributes to the progression of HCV infection. The above circumstances prompted the authorsled to thoroughly examine of this category of patients for further development of a new pathogenetically directed course of treatment. Objective. To study clinical, biochemical, and instrumental features of the course of liver disease in CHC patients with concomitant non-alcoholic fatty liver disease (NAFLD). MATERIAL AND METHODS: Tested 339 patients with chronic hepatitis C with concomitant NAFLD; and 175 patients with СНС. Methodology: anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, statistical methods. RESULTS: Conducted clinical, instrumental, and laboratory studies have shown that CHC patients with concomitant NAFLD are characterized by various disorders - a violation of the functional state of the liver, a violation of carbohydrate and lipid metabolism, an imbalance of the cytokine system, the presence of histological and non-inflammatory activity in the liver. CONCLUSIONS: The presence of concomitant NAFLD in patients with CHC aggravates the clinical picture, manifesting itself in a significant lipid metabolism disorder that provokes the rapid formation of liver fibrosis. An additional complicating factor is the development of insulin resistance, leading to persistent morphological changes in the liver parenchyma.

Evaluation of work conditions of nurses employed in a shift system in hospital wards during the COVID-19 pandemic.

BACKGROUND: Nurses work in a shift system that determines the provision of round-the-clock care of a patient in hospital conditions; however, it entails health consequences. OBJECTIVE: The aim of the study was the evaluation of work conditions of nurses engaged in shift work in hospital wards during the COVID-19 pandemic. METHODS: The study was conducted in 2020, and included 108 nurses working in a shift system in hospital wards. The research method was a diagnostic survey, using an author-constructed questionnaire. RESULTS: 88.9% nurses reported a negative effect of shift work on their physical health: 'musculoskeletal pain', 'elevated arterial blood pressure', and 'hormonal disorders' - 54.5% of respondents used pharmacological treatment. The causes of physical disorders were: 'microclimate', 'physical effort', 'noise', and 'forced body position'. Shift work exerted a negative effect on psychological health of the majority of respondents (75.0%): 'deconcentration', 'sleep disorders', 'feeling of occupational burnout' - treatment in 38.9% of respondents. Psychological health disorders were caused by: 'circadian rhythms disturbance by shift work', 'chronic stresses', and 'conflicts at work'. 69.7% of respondents reported that their shift work was disturbed by organizational factors, including: a 'badly planned work schedule', 'enhanced pace of work due to staff shortage', 'ambiguous division of duties, rights, responsibilities', 'shortages of equipment at the workplace'. CONCLUSION: The examined nurses experienced a negative effect of shift work on their physical and psychological health which, for some of them, was the cause of pharmacological treatment. Many organizational factors hindered the work of nurses in a shift system in hospital wards.

Expectations of patients with hepatitis C from family physicians - a Polish example.

INTRODUCTION: In Poland, approximately 1.9% of the general population is infected with Chronic hepatitis C (HCV), which develops in about 70-80% of infected patients who require constant care from family physicians. OBJECTIVE: The aim of the study was to define the kinds of expectations of patients with chronic HCV from family physicians. MATERIAL AND METHODS: The study included 220 patients with HCV, and was conducted using a dignostic survey, the Patient Request Form (PRF) and an author-constructed questionnaire. RESULTS: The respondents most often expected from a family physician, an explanation of the disease (9.67 scores), and obtaining information concerning examinations and treatment (9.65 scores), while to a lesser degree, emotional support (6.92 scores). Respondents with higher education to a significantly higher degree expected an explanation of the essence of the disease. Patients who were inactive occupationally significantly more frequently expected emotional support and information concerning examinations and treatment. Respondents who considered themselves disabled due to HCV, to a significantly higher degree expected emotional support and information concerning examinations and treatment. The remaining variables: age, gender, place of residence, marital status, self-reported state of health and ordered, diet had no significant effect on the expectations of patients with chronic hepatitis C from family physicians. CONCLUSIONS: Patients with HCV, to the highest degree expected an explanation of the disease and information concerning examinations and treatment, and to a lower degree - emotional support during consultations.

Assessment of Health Behaviors of Patients with Hepatitis C.

OBJECTIVES: In Poland, 1.9% of the population is infected with the hepatitis C virus (HCV). About 70%- 80% of the infected patients develop chronic hepatitis. The higher the level of health-promoting behaviors a person infected with HCV has, the higher their quality of life. The aim of this study was to assess health behaviors of patients with hepatitis C and determine the relationship with selected social and demographic characteristics. METHODS: This survey study included 220 patients infected with HCV and used the Health Behavior Inventory (HBI), and an author-constructed questionnaire. RESULTS: Overall, 40.5% of respondents reported average health behaviors (5-6 stens), with 30.9% low (1-4 stens), and 28.6% high (7-10 stens). The highest mean value was observed for 3 HBI categories: prophylactic behaviors (3.4±0.7), positive psychological attitude (3.4±0.6), and health practices (3.4±0.7). The lowest value related to few health-promoting behaviors concerned positive eating habits (3.3±0.7). CONCLUSIONS: Patients diagnosed with chronic hepatitis C presented an average level of health behavior. Significant differences in health behavior were noted by sex, age, marital status, and employment status. These patients should be provided with health education, especially regarding high-level nutrition.

Assessment of the degree of illness acceptance in patients diagnosed with hepatitis C.

INTRODUCTION: In Poland, approximately 730,000 people are infected with the hepatitis C virus (HCV). Acceptance of a chronic illness may positively motivate patients in the process of treatment. The higher the degree of illness acceptance, the lower the feeling of psychological discomfort and a lower intensity of negative emotions. OBJECTIVE: The aim of the study was assessment of illness acceptance among patients with chronic hepatitis C, and determination of the level of the relationship between social and demographic variables, and the degree of illness acceptance. MATERIAL AND METHODS: The study included 220 patients with a diagnosis of chronic hepatitis C. The research method was a diagnostic survey, while the instruments used were the Acceptance of Illness Scale (AIS) and an author-constructed questionnaire. RESULTS: Respondents most frequently accepted their illness to the mean degree (30 scores), and a low category or even the lack of acceptance (<20 scores) of respondents. Urban inhabitants significantly more often accepted their illness to a high degree, compared to rural inhabitants. Disability pensioners and retired pensioners significantly more frequently accepted their disease in the category - low degree. The remaining independent variables: gender, age, education, marital status, number of years of illness, had no significant effect on the degree of acceptance of hepatitis C. CONCLUSIONS: The majority of patients diagnosed with chronic hepatitis C accept their illness to the mean degree. Patients with hepatitis C should be covered with psychological assistance in order to change the way of perception and evaluation of their health situation in more positive terms.

Concept of Health in Opinions of Patients Diagnosed with Hepatitis C.

Objectives:The aim of this study was assessment of the value of health in opinions of patients with chronic hepatitis C. Methods: The study was conducted among 220 patients infected with HCV by the diagnostic survey method using the Health Criteria List (LHC) and the proprietary questionnaire. Results: Patients infected with HCV evaluated their health status mainly as mediocre - 50.9%. Older respondents significantly more rarely defined being healthy as "being employed, having various interests," and "feeling well." For males, health meant "eating properly," whereas for females - it was "experiencing no physical complaints." Respondents who had higher education understood health mainly as "having skills of solving own problems." Those married significantly more often mentioned "experiencing no physical complaints." Rural inhabitants significantly more frequently considered that being healthy meant "being able to associate well with others," compared to urban inhabitants. Conclusions: Valuation of health by patients infected with HCV depends on age, gender, level of education, place of residence, marital status, and duration of the disease. Arrangement according to rank allowed establishing what 'being healthy' means for patients with hepatitis C, and to what extent health is identified with goal, state, feature, and process.

[Validation of the Polish version of The Authentic Leadership Questionnaire for the of evaluation purpose of nursing management staff in national hospital wards]. / Walidacja polskiej wersji kwestionariusza autentycznego przywództwa na potrzeby oceny autentycznego przywództwa kierowniczej kadry pielegniarskiej krajowych oddzialów szpitalnych.

UNLABELLED: The Authentic Leadership Questionnaire (ALQ) is a standardized research instrument for the evaluation of individual elements of leader's conduct which contribute to the authentic leadership. The application of this questionnaire in Polish conditions required to carry out the validation process. The aim of the study was to evaluate of validity and reliability of the Polish version of the American research instrument for the needs of evaluation of authenticity of leadership of the nursing management in Polish hospitals. MATERIAL AND METHODS: The study covered 286 nurses (143 head nurses and 143 of their subordinates) employed in 45 hospitals in Poland. Theoretical validity of the instrument was evaluated using Fisher's transformation (r-Person correlation coefficient), while the criterion validity of the ALQ was evaluated using rho-Spearman correlation coefficient and the BOHIPSZO questionnaire. The reliability of the ALQ was assessed by means of the Cronbach-alpha coefficient. RESULTS: The ALQ questionnaire applied for the evaluation of authenticity of leadership of the nursing management in Polish hospital wards shows an acceptable theoretical and criterion validity and reliability (Cronbach-alpha coefficient 0.80). CONCLUSIONS: The Polish version of the ALQ is valid and reliable, and may be applied in studies concerning the evaluation of authenticity of leadership of the nursing management in Polish hospital wards.

Holistic approach to the therapeutic team in patient care.

Provision of a high standard of patient care is closely connected with the holistic approach to a patient by members of the therapeutic team. The greater detail are the problems of care of a patient discussed in during the meetings of the team, the higher the results of holistic care. Therefore, the study was undertaken to discover the scope of problems discussed during the meetings of the therapeutic team in hospitals with accreditation and without the Quality Certificate. The study covered 560 physicians and nurses from 4 hospitals with accreditation and 17 without the Quality Certificate. The research method was a diagnostic survey and the technique--a questionnaire form. The material was subject to statistical analysis. It was confirmed that the staff of hospitals possessing the Quality Certificate discussed the diagnostic, therapeutic and nursing problems during the meetings of the therapeutic team significantly more often, compared to respondents from units without accreditation.

Organizational climate as a precondition of effective work of a therapeutic team.

Organizational climate among members of a group is a significant precondition of an effectively working team. The work of a therapeutic team remains on a higher organizational level in hospitals with accreditation, compared to units without the Quality Certificate. The study was undertaken to discover whether there are any differences in the evaluation of organizational climate among the staff of hospital wards in hospitals with and without the Quality Certificate. The study covered 161 physicians and 339 nurses from 4 hospitals with accreditation and 17 units without the Quality Certificate. The study was carried out by the method of a diagnostic survey; the technique was a questionnaire form. The results of the study showed that physicians and nurses from hospitals with accreditation significantly more often evaluated the organizational climate in their wards in positive terms. The staff from hospitals without the Quality Certificate evaluated the atmosphere in their wards in more negative terms, mainly due to low salaries, lack of physician - nurse co-operation and frustration as a reaction to poor results of the health care system reform.

Selected determinants of the quality of hospital care. I. Accreditation and effectiveness of managing a therapeutic team.

In order to provide a higher level of the quality of medical services an external process of evaluation of health care units called accreditation has been implemented. Obtaining the Quality Certificate by a hospital greatly depends on knowledge and engagement of the staff in the accreditation process as well as on the effective managing of therapeutic teams by ward head/managers of clinics. Therefore, studies were undertaken to discover the knowledge of requirements concerning the possession of the Quality Certificate and how managing therapeutic teams is evaluated by physicians and nurses from hospitals with and without accreditation. The study covered 560 physicians and nurses from 4 hospitals with accreditation and 17 hospitals which did not possess the Quality Certificate. The research method was a diagnostic survey, and the technique--a questionnaire form. The material was subject to statistical analysis. Significant differences were observed in the knowledge of requirements concerning the possessing of the Quality Certificate between the staff of hospitals with accreditation, compared to the respondents from health units without the Quality Certificate. Respondents from hospitals without accreditation evaluated the effectiveness of managing therapeutic teams by ward head/managers of clinics in more negative terms, compared to the staff of hospitals which possessed the Quality Certificate.

Selected determinants of the quality of hospital care. II. Managing a therapeutic team.

The effects of teamwork depend to a large extent on the organizational skills of the manager. In health care units a physician/ward head is responsible for coordinating the work of a therapeutic team. The study was undertaken to discover to what extent doctors and nurses are aware that the ward head manages the work of the therapeutic team, and how they evaluate the skills of their managers. The study covered 161 doctors and 339 nurses from 4 hospitals with accreditation and 17 health units which did not possess the Quality Certificate. The study was conducted by the method of a diagnostic survey, and the technique was a questionnaire form. The results of the survey showed that charge nurses in hospitals with accreditation and ward heads in hospitals without the Quality Certificate significantly more often perceived the effectiveness of managing a therapeutic team by a ward head/manager of a clinic in positive terms. A greater number of negative evaluations were expressed by charge nurses in hospitals without accreditation and ward head nurses in hospitals with the Quality Certificate. It was confirmed that doctors and nurses from hospitals with accreditation significantly more frequently perceived the ward head as the manager of the therapeutic team, compared to the staff of hospitals without the Quality Certificate.

Selected determinants of the quality of hospital care. III. Scope of duties, authorization and responsibility among members of a therapeutic team.

An important precondition for an effectively working team is the distribution of competence among the members of the team. The accreditation criteria for Polish hospitals lay down a requirement concerning the formulation in a written form of the scope of duties, authorization and responsibility at individual workplaces. This conditions a high level of services provided by the members of a therapeutic team. Therefore, the study was undertaken in order to discover whether there was an explicit share of competence and if it exerted an influence on the level of performance of the scope of duties, authorization and responsibility among members of therapeutic teams in hospital wards. The study covered 55 ward head/managers of clinics, 72 ward head nurses, 106 assistant doctors and 327 charge nurses from 21 hospitals, who were employed in 4 hospitals which possessed the Quality Certificate, and in 17 hospitals without accreditation. The study was conducted by the method of a diagnostic survey, the technique being a questionnaire form. The results of comparative analysis showed that among members of therapeutic teams in hospitals with the Quality Certificate the distribution of occupational competence was significantly more often observed. The greatest number of respondents in this group possessed the scope of duties, authorization and responsibility in a written form, compared to physicians and nurses from hospitals without accreditation. Moreover, it was confirmed that the most frequent lack of the scope of duties in a written form as well as the greatest discrepancies concerning the performance of occupational tasks were noted among the members of therapeutic teams in clinical hospitals without accreditation.