Work in stressful conditions in medical emergency system during the COVID-19 pandemic.

The pandemic caused a change in the way of providing healthcare services, limiting direct access to doctors, suspending planned treatments and medical consultations, but despite the risks and restrictions, the medical rescue system as a key element of health care for the society continues to function. The system provides medical assistance to patients in the most severe condition, both with a negative result for SARS-CoV-2, as well as with a positive or undiagnosed result. It is a review aimed at analyzing the most important psychological aspects of the work of emergency medical care system personnel during the COVID-19 pandemic. PubMed, Cochrane Library, and Google Scholar search were used to analyze the problem. The following keywords were used to search for information sources: paramedic, work, emergency medical care system, emergency department, ambulance service, COVID-19, pandemic, SARS-CoV-2, coronavirus. The articles were selected in terms of the psychological aspects of the work of the emergency medical care system personnel during the pandemic in 2020-2021. The psychosocial problems that come to the fore during a pandemic include increased levels of stress, anxiety, depression, burnout, emotional exhaustion, vicarious traumatization, and post-traumatic stress disorder. In the context of the increased risk of psychological problems due to pandemic, it is necessary to provide psychological support to the medical staff, both in terms of psychological support for the entire team and individually. Med Pr. 2022;73(3):241-50.

Violence in the workplace. The occurrence of the phenomenon in relation to health care workers. / Przemoc w miejscu pracy. Wystepowanie zjawiska wobec pracowników ochrony zdrowia.

Excessive workload of medical workers resulting from insufficient staffing and prolonged stress lead, among others, to burnout, which is a serious problem in the medical community. Research shows that the incidence of anxiety and stress disorders is increasing. For years, the social climate around medical staff in Poland has also been deteriorating. The media write more often about errors and omissions, and less about the daily work of medics. This leads to a decline in public confidence, as well as hate and acts of aggression. The occurrence of the phenomenon of violence against medical staff may be a factor in the development of many diseases associated with high levels of stress and should be of interest to occupational medicine services. The aim of the work is to describe the phenomenon of violence against health care workers and its impact on the working conditions and health of workers. The literature from 2010-2022 was reviewed in PubMed and Web of Science databases by entering the following entries: "violence", "aggression", "healthcare", "stress", "nurses", "doctors", "workplace". Eighty-three works on the occurrence of the phenomenon of violence against health care workers were qualified for the study. The results of the analysis indicate a shortage of studies on Polish medical entities. The phenomenon of violence against health care workers is a serious problem of public health in the world. The most common forms of workplace violence were verbal violence, physical assault, bullying, sexual harassment and racial harassment. Most often, the violence was committed by patients and their relatives, colleagues and superiors. Aggression towards medical staff is not a new phenomenon, and Poland as a country is not alone in dealing with this problem. Aggression and violence are most often observed in hospital departments, especially psychiatric departments, hospital emergency departments and emergency rooms. Patients and their families are most often regarded as the source of rude behavior. Crisis situations, such as the COVID-19 pandemic, have intensified the scale of the phenomenon. Managing a pandemic also requires establishing preventive procedures for aggression and violence. Additional factors hindering the work of medical personnel may lead to The shortage of studies on Polish medical entities indicates the need to conduct work aimed at determining the scale of the phenomenon and its causes, taking into account the division into organizational units as well as groups of patients and their relatives. Accurate determination of the scale of the phenomenon and predisposing factors will allow to take appropriate innovative preventive actions, which will contribute to limiting the negative consequences. Managers ofmedical entities should take steps to increase the number of reports. Violence has a negative impact on the mental health of medical staff and may cause irreversible physical and mental harm to those who experience it; therefore, it is very important to involve occupational health services in actions to solve the problem.

The Sense of Coherence, Self-Perception of Aging and the Occurrence of Depression Among the Participants of the University of the Third Age Depending on Socio-Demographic Factors.

PURPOSE: The aim of the study was to assess the relationship between the sense of coherence and self-perception of aging and the risk of depression among attendees of the University of the Third Age (U3A). The influence of socio-demographic factors was studied. PARTICIPANTS AND METHODS: The study involved 315 attendees of the U3A aged on average 68.4 years, age range 60-82 years old. The overwhelming majority were women (91.7%). Cross-sectional research was conducted using standardized questionnaires - the SOC-29 scale, the Geriatric Depression Scale (GDS - brief version) and the author's own questionnaire regarding self-perception of aging. RESULTS: The study participants showed an average level of sense of coherence (130.7± 23.2). The highest number of people obtained average results of sense of coherence, both in terms of global SOC (75.2%) and its components. The highest scores on the SOC-29 scale were found for the sense of comprehensibility (41.3%). The mean value of the self-perception of aging was 69.0±16.0 and indicates the lower range of results for positive attitude. Nearly ¾ (72.1%) of the respondents had a positive self-perception of aging. The values of the scale of self-perception of aging showed a statistically significant relation to the global level of sense of coherence and its components (p<0.001). In people without depression, positive self-perception of aging was significantly more frequent than among participants with depression of increasing intensity. Education was significantly correlated with the results of the SOC-29 scale, the self-perception of aging scale and the GDS scale. CONCLUSION: From the U3A research group, better educated elderly people have a higher sense of coherence and show a more positive self-perception of aging. Moreover, these people are less likely to show signs of senile depression.

Correlations between satisfaction with life and selected personal resources among students of Universities of the Third Age.

PURPOSE: The aim of the study was to identify personal resources, including health-related resources, sense of self-efficacy, attitude to life (optimism/pessimism) and self-assessment, and to determine their relationship with satisfaction with life in members of the Universities of the Third Age (U3As) in Poland. The impact of sociodemographic factors was analyzed. MATERIALS AND METHODS: The study included 320 participants of U3As; their mean age was 67.5 years and the vast majority of them were women (92.5%). The study was a screening test based on a diagnostic survey using validated scales, Satisfaction with Life Scale (SWLS), Life Orientation Test (LOT-R) and Generalized Self-Efficacy Scale (GSES), and a survey of own design. RESULTS: Men showed significantly higher mean SWLS scores than women. SWLS scores were found to correlate significantly with LOT-R (r=0.411; P<0.001) and GSES scores (r=0.451; P<0.001). The respondents' financial situation had a significant impact on their scores in all scales: SWLS (P<0.001), LOT-R (P<0.001) and GSES (P<0.001). Educational attainment of the respondents showed a significant correlation with SWLS (P=0.004) and GSES (P=0.011). CONCLUSION: In the process of preparation for successful aging, particular emphasis should be placed on the continuous development of an individual, as it leads to the improvement of their socioeconomic status. Also, promoting positive personality traits and responsibility for one's own life, including health, is of vital importance. The study is particularly important for the early identification of individuals at risk of unsuccessful aging.

Relationships Between Health Behaviors, Self-Efficacy, and Health Locus of Control of Students at the Universities of the Third Age.

BACKGROUND This study aimed to determine the relationship of health behaviors with the health locus of control and the sense of self-efficacy against the background of socio-economic factors and self-rated health among students of the Universities of the Third Age (U3As). MATERIAL AND METHODS The study included 320 U3A students, with mean age of 67.5 years. The following research tools were used: Health Behavior Inventory (HBI), Multidimensional Health Locus of Control Scale (MHLC), Generalized Self-Efficacy Scale (GSES), and an original survey of the author's own design. RESULTS Mean total HBI and GSES scores were 90.63 and 30.12, respectively. These results are satisfactory. A slight predominance of internal health locus of control was documented. A number of significant correlations were found between the HBI, GSES, and MHLC scores, except for the MHLC subscale expressing the influence of chance. Educational attainment was shown to have a significant impact on the scores for the positive attitude and proper dietary habits subscales of HBI, as well as on the GSES scores. Economic status of the participants influenced the levels of positive attitude, internal health locus of control, and self-efficacy. Furthermore, internal health locus of control was found to be modulated by subjective health of the respondents. The scores for external health locus of control and the influence of chance increased significantly with age. CONCLUSIONS The currently noticeable emphasis placed on lifelong education should serve as a good prognostic factor for health behaviors and personal health resources for years to come.

Functional assessment of geriatric patients in regard to health-related quality of life (HRQoL).

PURPOSE: The main aim of our research was to evaluate general health, functioning, and performance parameters, as well as care problems of Geriatric Clinic inpatients in relation to deficits in fulfilling needs. The assessment of health-related quality of life was also performed. PATIENTS AND METHODS: The research subjects were patients attending the Clinic of Geriatrics: 149 women and 78 men; 227 persons in total. The research was carried out using a diagnostic poll method, with the application of the Activities of Daily Living questionnaire of assessment of daily efficiency on the basis of the Katz index, the Instrumental Activities of Daily Living questionnaire, the Care Dependency Scale used to measure the level of care dependency and human needs, and the Nottingham Health Profile scale. RESULTS: The results showed that the majority of respondents achieved high and medium levels of functional capability. The main problems associated with the fulfillment of needs were difficulties with the adoption of appropriate body posture, movement restrictions, and problems related to participating in unassisted leisure activities outside the home. The general deficit in fulfilling the needs of the patients was low. The most significant problems were related to sleep disorders, restrictions in freedom of movement, loss of vital energy, and ailments resulting in the observable presence of pain. CONCLUSION: Good daily functioning of elderly patients significantly depended on their intellectual and mental efficiency. Elderly patients require a comprehensive, holistic approach to a variety of problems that occur with aging.

The analysis of aging and elderly age quality in empirical research: data based on University of the Third Age (U3A) students.

The aim of the study was to evaluate aging and elderly age quality in elderly individuals and persons entering the elderly age participating U3A continuous education courses. The research included 255 students of the U3A located in Bydgoszcz, Poland. The research included 235 women and 20 men of mean age 64.43 years. The dominant group was persons with secondary education (65.9%), and higher education (28.2%) as well as married (54.5%). All of the subjects included in the study were fully mobile. The study was conducted based on authors' original questionnaire which consisted of 24 questions and a basic personal data form surveying age, gender, marital status, level of education as well as self-reported illnesses and health problems. The research assumed the majority of positive responses as the sign of happy aging and experiencing one's own old age. Positive correlation was observed between the statement that human beings influence quality and shape of their lives, and therefore they are responsible for their own life. The higher the level of fulfilling aims in life the more frequently elderly age was perceived as a happy period. In the research data there was a relationship observed between levels of education and discrimination, i.e., the higher level of education the fewer cases of discrimination experienced: χ(2)=12.992 (df=2; p<0.01). Moreover, a very weak correlation was observed between marital status and a sense or absence of sense of emptiness in life ρ=0.128; p<0.05. The most appreciated values in life, according to the subjects were health, happiness in family and mental efficiency. The biggest worries concerned serious diseases and being dependent on other people. Most often indicated ways to lead happy elderly life were being active and open to people as well as showing optimistic attitude. The research, which was conducted on a relatively large group of people (n=255), proves positive aging direction among the elderly and persons entering late adulthood period who attend continuous education courses at U3A.

Health and nursing problems of elderly patients related to bio-psycho-social need deficiencies and functional assessment.

Elderly population is characterized by larger need for social welfare and medical treatment than other age groups. Along with aging, there is a number of emerging health, nursing, caring, psychological and social problems. Complexity of these problems results from overlapping and advancing involutional changes, multi-illness, decreased functional efficiency and other factors. The aim of the study was the assessment of health problems in geriatric patients as well as bio-psycho-social need deficiencies in a view of selected parameters of functional efficiency. The research group consisted of the Chair and Clinic of Geriatrics, 186 women and 114 men, 300 persons in total. The research was carried out using a diagnostic poll method with the application of the Activities of Daily Living (ADL) questionnaire of assessment of daily efficiency on the basis of the Katz Scale; the Care Dependency Scale (CDS) questionnaire used to measure the level of the care dependency and human needs, Norton's bed sores risk assessment scale, the Nursing Care Category (NCC) questionnaire applied to assess the need for nursing care. In most patients the results unveiled manifestations of three or more illnesses. Functional efficiency was at low and average level. Half of the subjects were endangered by risk of bed sores as well as showed high need fulfillment deficiency. The highest level of the deficiency was observed in patients in the eldest age group as well as suffering from multi-illness. Material status, education, place of residence or gender showed no significant influence on the level of need fulfillment.

The sense of coherence (SOC) as an important determinant of life satisfaction, based on own research, and exemplified by the students of University of the Third Age (U3A).

The SOC is an important determinant of life satisfaction of elderly people. It determines the level of coping with various difficult situations, which accompany an old age stage. The aim of the study was to determine the connection between the SOC levels and life satisfaction among the U3A students. Another analyzed relationship was the SOC level against the background of socio-demographic factors. The study comprised 257 students of the U3A in Poland, located in the city of Bydgoszcz. The study group consisted of 237 women and 20 men, at the average age of 64.54 ± 6.01 years. The vast majority of the study group included individuals at the secondary education level, as well as married individuals. Just over half of the group claimed to be in good health, and have no afflictions. All of the respondents were fully mobile. The study was conducted with the diagnostic poll method, using the standardized questionnaires: The Scale SOC-29, WHOQOL-Bref, and the Geriatric Depression Scale (GDS-bref version). The average value of global SOC was 128.77; the standard deviation 21.04; discrepancy 153 (minimum 50 and maximum 203). The SOC indicated significant relationship with quality of life (QoL) in the mental domain, social relationships, and environmental domain; no significant correlation in the physical domain was observed. The QOL reached about 70% of maximum result value, showing equal levels in its specific areas. A moderately decreasing (r=-0.375, p<0.01) relation η=0.376, between global SOC values and depression occurrence, as well as its non-existence was shown in the study. Individual SOC components were also negatively correlated with depression. Another observation was weak correlation between the sense of coherence and the individuals' level of education. No statistically significant effect of age, gender and marital status on the SOC levels of U3A students was found. Higher parameters of SOC and level of education shape significantly higher effects of life satisfaction, and result in better adaptation to old age stage as a phase of multiple challenges, and increasing life difficulties.

Evaluation of quality of life (QoL) of students of the University of Third Age (U3A) on the basis of socio-demographic factors and health status.

In times of the modern global societies, concern for QoL is a priority for gerontology, being an interdisciplinary field. The aim of this study was to assess the QoL of students of the U3A based on socio-demographic factors, subjectively reported diseases and/or discomfort, and well-being. The study comprised 257 students of the U3A in Poland, located in the city of Bydgoszcz. The study group consisted of 237 women and 20 men at an average age of 64.54 ± 6.01 years. The vast majority of the study group were married individuals and individuals with a secondary education. Just over half of the group stated that they are in good health and have no afflictions. All of the respondents were fully mobile. The QoL was assessed using the Polish version of the WHOQOL-Bref and the geriatric depression screening (GDS) scale. The QoL in its different areas balanced out at a medium level (average range: 13.30-13.87). The level of education of the U3A students proved to have a significant relation ith the environmental domain of QoL. No significant influence of age, gender, or marital statues on the QoL of the U3A students was found. A significant relation between subjectively reported diseases and/or discomfort with the QoL was demonstrated in the physical domain. Nearly 75% of the respondents showed no signs of depressive moods. The occurrence of depression indeed disrupted the QoL in all the studied domains, although least in the physical domain. Elderly individuals participating in permanent education display, in the face of progressive senile involution, average and at the same time stable parameters of QoL in all areas of functioning, which can be considered satisfactory, given this phase of life. The level of QoL of the U3A students significantly denotes the level of education of respondents, existing illnesses and afflictions, and the presents of depression.

Independence of elderly patients with arterial hypertension in fulfilling their needs, in the aspect of functional assessment and quality of life (QoL).

Functional efficiency is the ability to be independent in fulfilling the basic needs of everyday life. Independence in meeting these needs is important to maintain a good quality of life (QoL). Chronic diseases affecting elderly people may, to some extent, limit fulfilling numerous needs, however, the acquired ability to live with a disease enables such patients to cope well with their needs. The aim of the study was to evaluate in the examined patients the independence in meeting their bio-psycho-social needs in relation to functional efficiency and QoL. The study group was recruited among hospitalized patients in the Department and Clinic of Geriatrics, 91 women and 59 men, for a total of 150 people. The mean age of the study group was 73.4 years. The research was carried out using a diagnostic poll method with the application of The Functional Assessment of Chronic Illness Therapy questionnaire (FACIT-F version 4); Activities of Daily Living questionnaire (ADL) of assessment of daily efficiency on the basis of the Katz Scale; Care Dependency Scale questionnaire (CDS) used to measure the level of the care dependency and human needs. The results of CDS for the study group were running at high level and were dependent on the marital status and age. No impact of gender, place of residence, education, material situation and disease duration was revealed. Similarly, FACIT-F scores were higher for married patients than for widowed ones, and they were age-dependent. Most of CDS scores were at a high level, which means that the investigated patients were, to a limited extent, care-dependent in meeting their needs. In the majority of subjects, the level of daily activities was high, which proves an independent functioning. Results of CDS were dependent on FACIT-F scores in the study group.

[Analysis of depression intensification in cancer patients before and during chemotherapy]. / Analiza nasilenia stanów depresyjnych u pacjentów z choroba nowotworowa przed i w trakcie chemioterapii.

INTRODUCTION: The aim of the study was a comparative analysis of depression in cancer patients undergoing chemotherapy and patients during diagnostic process. An attempt was made to solve a research problem whether chemotherapy causes depression intensification in patients with a diagnosis of cancer. MATERIAL AND METHODS: Cancer patients before the chemotherapy treatment (n = 77, group A) were examined first. Then a group of patients undergoing standard chemotherapy in hospital was examined (n=105, group B). The tool used was Zung Self-rating Depression Scale. RESULTS: Mean of self-rating depression scale was 35.20 in group B and 32.34 in group A. 93.3% of patients in group B and 92.2% of patients in group A did not have psychopathological symptoms. Mild depression was observed by 6.7% of group B patients and 6.5% of group A patients. Only one person in group A scored 80 points, which indicated severe depression. In group B education level and physical activity highly correlated with the depression scale score. In group A it was gender that significantly differentiated the self-rating depression scores. CONCLUSIONS: Patients undergoing chemotherapy got higher scores on the self-rating depression scale which proves that they are more liable to depression. Depression was more often observed in women, people with vocational education and patients unable to continue working.