Kinesiophobia in Elderly Polish Patients After Ischemic Stroke, Including Frailty Syndrome.

Introduction: In patients after stroke, the relationship between the occurrence of kinesiophobia and the accompanying frailty syndrome, as well as the acceptance of the disease and the level of mood, has not been recognized so far. The aim of this study was to determine the prevalence of kinesiophobia in elderly Polish people after ischemic stroke, including the frailty syndrome and the associations between the prevalence of kinesiophobia and feelings of anxiety and degree of the illness acceptance. Methods: A cross-sectional study was used to achieve the study objectives. The study involved 152 hospitalized patients aged of minimum 60 (mean age 63), qualified for post-stroke rehabilitation, including 76 women and 76 men. The patients were divided into two groups, with kinesiophobia (119 persons) and without kinesiophobia (33 persons). The Tampa Scale of Kinesiophobia (TSK), the Tilburg Frailty Indicator (TFI), the Hospital Anxiety Depression Scale (HADS) and the Acceptance of Illness Scale (AIS) were used. Study results were calculated using MedCalc Software. Results: Kinesiophobia has been demonstrated in 78% of people after ischemic stroke. The values of TFI and HADS were higher in the patients with kinesiophobia (p<0.001). In patients with ischemic stroke, it was shown that the level of kinesiophobia increased with higher anxiety (p<0.001), higher total TFI score, (p<0.05), and a lower level of illness acceptance (p<0.001). Conclusion: The occurrence of kinesiophobia in elderly Polish people after ischemic stroke is common and the determinants of its development are the coexistence of the frailty syndrome, anxiety and a low level of illness acceptance. In post-stroke patients, the presence of kinesiophobia should be considered, especially in the situation of comorbid frailty syndrome. The issue of kinesiophobia in patients after stroke requires further in-depth research, especially in the field of cognitive-behavioral prevention aimed at ways to reduce this phenomenon.

Analysis of self-care strategies among nurses in southern Poland - a cross-sectional survey.

OBJECTIVES: This study aimed to explore the self-care strategies undertaken by Polish nurses, and more specifically: to assess the participants' self-care strategies; to check self-medication patterns in the study group; and to analyze compliance with medical recommendations regarding pharmacotherapy. MATERIAL AND METHODS: A quantitative and cross-sectional survey was conducted to examine the phenomenon of interest. The study employed a questionnaire survey with an independently designed questionnaire as a research tool. A total of 446 registered nurses taking part in different professional training courses for nurses in January-June 2018 who agreed to participate were included in the study. RESULTS: The findings of this study reveal generally poor self-care strategies and compliance with medical recommendations among Polish nurses. The most frequent health behaviors among the surveyed nurses were caring for personal hygiene and a healthy diet. About 31% of the nurses confirmed supplements use. The most common reasons for taking supplements concerned the prevention of vitamin and mineral deficiencies (77.5%), and boosting of the immune system (49.3%). The most popular supplements included packs of vitamins (57.2%), single vitamin D3 (33.3%) and magnesium (31.2%). The vast majority of participants (79.8%) took some kind of over-the-counter drugs (OTCs) in the last 6 months, most often painkillers and flu medications, relying most frequently on the information included on the drug leaflets. The analysis showed a statistically significant relationship between declared OTC use and age, marital status, years of professional experience and economic status. Overall, 26.9% of the study participants declared the use of both supplements and OTCs, while 16.4% of the participants used neither supplements nor OTCs. CONCLUSIONS: Self-care strategies undertaken by nurses should be seen as an essential factor in their positive therapeutic relationship with patients. The ageing nursing workforce should make all of us increasingly aware that their self-care needs will increase as well. Int J Occup Med Environ Health. 2022;35(1):13-25.

Sexual Function and Sexual Quality of Life in Premenopausal Women with Controlled Type 1 and 2 Diabetes-Preliminary Study.

Sexual dysfunction is more common in women with diabetes than in women without diabetes. The aim of the study was to determine sexual function and the level of the quality of sex life in premenopausal women with controlled, uncomplicated type 1 and type 2 diabetes taking into account the stages of the menstrual cycle and mood level. The study included 163 women with type 1 and type 2 diabetes and 115 controls without diabetes. Questionnaire studies were conducted using the following surveys: Demographic and Clinical Data Survey, Female Sexual Function Index, Sexual Quality of Life-Female, and Beck Depression Inventory. Both phases of the menstrual cycle-follicular and luteal-were included. It was shown that, in women with type 1 diabetes, sexual function decreased during the luteal phase in comparison with the follicular phase (p < 0.001). In the women with type 2 diabetes and in the controls, sexual function was comparable during both phases of the cycle (p > 0.05). In the women with uncomplicated controlled type 1 diabetes, sexual function and the sexual and relationship satisfaction changed depending on the phase of the menstrual cycle with a decrease during the luteal phase. Sexual function and the quality of the sex life of premenopausal women with controlled type 2 diabetes were comparable during both the follicular and the luteal phases. Sexual function in menstruating women with controlled type 2 diabetes decreased with age and a worsening mood.

Prevalence of Depressive Symptoms in Patients with Type 1 and 2 Diabetes Mellitus.

PURPOSE: Patients with diabetes are at increased risk of developing depression. The aim of the study was to determine the occurrence of depressive symptoms in patients with type 1 (T1DM) and type 2 diabetes (T2DM), including the association with different independent sociodemographic and clinical variables. PATIENTS AND METHODS: The studies were carried out on 618 people, including 115 patients with T1DM and 215 patients with T2DM and 288 people without diabetes constituting two control groups. Subjects were characterized in terms of sociodemographic, clinical and biochemical aspects, and the occurrence of depressive symptoms using Beck Depression Inventory (BDI) was determined. In the logistic regression analysis, the correlations between BDI score and with independent variables such as sex, age, body mass index, duration of diabetes, HbA1c level, diabetic complications and mean arterial pressure were examined. RESULTS: The mean BDI score was significantly higher in women and men with T1DM and T2DM compared to controls. In diabetic patients, depressive symptoms occurred more often in women than in men. Among patients with T1DM, the incidence of depressive symptoms was 17.5% of the women and 8.6% of the men and in patients with T2DM, the incidence of depressive symptoms was revealed in 28.9% of the women and in 19.8% of the men. In patients with T1DM and T2DM, the occurrence of depressive symptoms increases with age, HbA1c level and complications, and the risk of depressive symptoms turned out to be almost three times higher in women than in men with T2DM. CONCLUSION: The prevalence of depressive symptoms in diabetic patients is higher than in non-diabetics. Depressive symptoms account for 13% of the patients with T1DM and 24.7% of the patients with T2DM. The risk of depressive symptoms in T1DM and T2DM increases with age, HbA1c level and the presence of complications, and it is gender-related in T2DM only.

Comparison of health-related quality of life in patients with rheumatoid arthritis during conventional or conventional plus biological therapy in Poland.

PURPOSE: The main purpose of this study was to compare the level of health-related quality of life (HRQoL) using Nottingham Health Profile (NHP) in Polish patients with rheumatoid arthritis (RA) during therapy applying disease-modifying antirheumatic drugs (DMARDs) with conventional synthetics (csDMARDs) or with csDMARDs in combination with biological drugs (bDMARDs). The second purpose was to analyze the correlation between the domain values of NHP and the demographic and clinical parameters, functional efficiency, and mood. PATIENTS AND METHODS: The studies involved 212 patients with RA, divided into two groups: group I - 126 persons treated using csDMARDs, group II - 86 patients using csDMARDs in combination with bDMARDs. A diagnostic survey was used applying NHP for HRQoL, Beck Depression Inventory (BDI), and Health Assessment Questionnaire (HAQ). The 28-Joint Disease Activity Score (DAS-28) was calculated. RESULTS: The patients with RA in both studied groups did not differ significantly in terms of all the NHP domains, values of HAQ and BDI. The DAS-28 value, the number of swollen joints, and the duration of morning stiffness were significantly smaller among patients from group II. However, in both groups, the majority of the analyzed components of NHP demonstrated significant correlations with values of HAQ and BDI and some of the domains of NHP - with DAS-28. CONCLUSION: The level of HRQoL, functional efficiency, and mood are comparable in patients treated conventionally and in combination with biological drugs. The HRQoL level shows correlation with the occurrence of depression symptoms, and the energy level, the sensation of pain, and physical abilities are covariates with daily activities. The intensity of the activity of RA as well as experiencing pain and the duration of morning stiffness is smaller among patients applying csDMARDs plus bDMARDs compared with patients treated only conventionally.

Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk.

BACKGROUND: Prevention strategies for pressure ulcer formation remain critical in patients with an advanced illness. We analyzed factors associated with the development of pressure ulcers in patients hospitalized in a palliative care ward setting. PATIENTS AND METHODS: This study was a retrospective analysis of 329 consecutive patients with a mean age (± standard deviation) of 70.4±11.8 years (range: 30-96 years, median 70.0 years; 55.3% women), who were admitted to the Palliative Care Department between July 2012 and May 2014. RESULTS: Patients were hospitalized for mean of 24.8±31.4 days (1-310 days, median 14 days). A total of 256 patients (77.8%) died in the ward and 73 patients (22.2%) were discharged. Two hundred and six patients (62.6%) did not develop pressure ulcers during their stay in the ward, 84 patients (25.5%) were admitted with pressure ulcers, and 39 patients (11.9%) developed pressure ulcers in the ward. Four factors assessed at admission appear to predict the development of pressure ulcers in the multivariate logistic regression model: Waterlow score (odds ratio [OR] =1.140, 95% confidence interval [CI] =1.057-1.229, P=0.001), transfer from other hospital wards (OR =2.938, 95% CI =1.339-6.448, P=0.007), hemoglobin level (OR =0.814, 95% CI =0.693-0.956, P=0.012), and systolic blood pressure (OR =0.976, 95% CI =0.955-0.997, P=0.023). Five other factors assessed during hospitalization appear to be associated with pressure ulcer development: mean evening body temperature (OR =3.830, 95% CI =1.729-8.486, P=0.001), mean Waterlow score (OR =1.194, 95% CI =1.092-1.306, P<0.001), the lowest recorded sodium concentration (OR =0.880, 95% CI =0.814-0.951, P=0.001), mean systolic blood pressure (OR =0.956, 95% CI =0.929-0.984, P=0.003), and the lowest recorded hemoglobin level (OR =0.803, 95% CI =0.672-0.960, P=0.016). CONCLUSION: Hyponatremia and low blood pressure may contribute to the formation of pressure ulcers in patients with an advanced illness.

Accuracy of self-reported and measured anthropometric data in the inpatient population.

Self-reported body mass index (BMI) is commonly used to assess nutritional status. The aim of the study was to assess the accuracy of self-reported and measured data obtained from the inpatient population. A total of 296 individuals admitted to five hospital wards were included in the study. Patients provided details of their height and weight, and measurements of height and weight were subsequently taken. BMI measurements were calculated from both the self-reported and the measured data. In general, the study participants overestimated their height and underestimated their weight. Older people and women were significantly more likely to overestimate their height, whereas better educated people were more likely to underestimate their weight. Inaccurate height and weight reporting led to BMI values being underestimated. The findings of this study support previously published research questioning the accuracy of self-reported height and weight measurements.