Improving Spiritual Well-Being of Polish Pain Outpatients: A Feasibility Mixed Methods Study.

Introduction: A physician in a chronic pain treatment clinic must recognize that the relationship between pain and spirituality is bidirectional. Chronic pain can decrease the level of spiritual well-being, and low spiritual well-being can also significantly intensify the perception of pain and worsen coping with it. Currently, for many scientific and medical communities, it is evident that spiritual care is an indispensable element of holistic medicine. Objective: The authors developed a non-religious spiritual care model provided by a physician at a chronic pain treatment clinic from May 2022 to February 2024. Method: The study utilized a mixed-method approach to conduct the research. The analysis consisted of twelve patients. A FACIT-Sp-12 questionnaire evaluated the individual's spiritual well-being before the intervention. The intervention involved asking patients open-ended questions about their life history, experiences, and spiritual beliefs and the physician's use of active listening and empathetic responses to what patients shared (relationship-building activities). The intervention aimed to assist patients in accepting the limitations of an incurable chronic disease, affirming the value of their lives, enhancing inner harmony, and increasing their sense of belonging to something greater. After the intervention, a re-assessment of the patient's spiritual well-being was conducted using the FACIT-Sp-12 questionnaire. Researchers collected qualitative data through a confidential survey that included the following instructions: "Please express an anonymous opinion on how you perceive the spiritual care provided by the physician". Results: There was an increase in spiritual well-being, assessed using the FACIT-Sp-12 scale, in 9 out of 12 patients. The median, as well as the average, level of spiritual well-being increased in a statistically significant way after the intervention (p < 0.05). This was primarily due to the higher value of the peace subscale of the questionnaire. Qualitative analysis revealed benefits reported by patients (personal development, gratitude, satisfaction, support, hope) resulting from physician's actions. Conclusions: Both qualitative and quantitative data showed that establishing a relationship with the doctor improves the spiritual well-being of patients. Therefore, this model can be recommended for physicians in chronic pain treatment clinics.

Supporting elderly patients in strengthening their personal and spiritual health resources.

Care for the sick, including spiritual support is sometimes called holistic medicine. The term bio-psycho-social-spiritual model is sometimes used to describe this type of therapeutic approach patient-oriented medicine. This report indicates the importance of taking into account the spiritual aspect of life due to its beneficial impact on the coping resources activated and the patient's well-being. Existential and spiritual issues are on the verge of new clinical and research interest in medicine, especially in gerontology, oncology, and palliative care. Clinicians focus not only on symptom control but also on spiritual and existential issues such as spirituality, hope, and meaning. This paper reviews the topic of spirituality in the context of illness and end-of-life care trying to define spirituality within the context of health resources of the subject. Spirituality is perceived in two of its main components: faith/religious beliefs and spiritual well-being. Especially this second construct is reviewed and described as a health resource.

Robots for Elderly Care: Review, Multi-Criteria Optimization Model and Qualitative Case Study.

This paper focuses on three areas: the first is a review of current knowledge about social and service robots for elderly care. The second is an optimization conceptual model aimed at maximizing the efficiency of assigning robots to serve the elderly. The proposed multi-criteria optimization model is the first one proposed in the area of optimization for robot assignment for the elderly with robot utilization level and caregiver stress level. The third is the findings of studies on the needs, requirements, and adoption of technology in elderly care. We consider the use of robots as a part of the ENRICHME project for long-term interaction and monitoring of older persons with mild cognitive impairment, to optimize their independence. Additionally, we performed focus group discussions (FGD) to collect opinions about robot-related requirements of the elderly and their caregivers. Four FDGs of six persons were organized: two comprising older adults, and two of the other formal and informal caregivers, based on a detailed script. The statements of older participants and their caregivers were consistent in several areas. The analysis revealed user characteristics, robot-related issues, functionality, and barriers to overcome before the deployment of the robot. An introduction of the robot must be thoroughly planned, include comprehensive pre-training, and take the ethical and practical issues into account. The involvement of future users in the customization of the robot is essential.

The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic.

BACKGROUND: Vinyasa yoga practice improves body fitness and potentially positively affects practitioners' well-being and health. Due to the diverse intensity of practice and positions customized to the practitioner's needs, it can also support cancer patients. Undertaking physical activity that has a potentially positive effect on well-being and health was particularly important during the self-isolation that followed the COVID-19 pandemic. The purpose of this study was to evaluate the impact of three-month mild and moderate intensity vinyasa yoga practice on breast-cancer patients' stress perception, self-confidence, and sleep quality during COVID-19 induced self-isolation. METHODS: Female breast-cancer patients participated in twelve-weeks of online vinyasa practice during the COVID-19 induced self-isolation period. Meetings were held once a week, where 60-min vinyasa yoga sequences were followed by 15 min of relaxation. Patients completed pre- and post-intervention surveys to evaluate changes in the following outcomes: stress perception, self-confidence, and sleep quality. Forty-one female patients enrolled in the Vinyasa course completed the pre-intervention survey, while 13 attended all the meetings and completed the post-intervention survey. RESULTS: The effect of the twelve-week yoga and relaxation practice significantly reduced sleep problems and stress of oncological patients. The participants also declared an improvement in their general well-being and self-acceptance. CONCLUSION: Dynamic forms of yoga combined with mindfulness techniques can be applied to patients treated for oncological diseases. It contributes to improving their well-being. However, in-depth studies are needed to analyze the complexity of this effect.

Enhancing Cross-Cultural Competence of Medical and Healthcare Students with the Use of Simulated Patients-A Systematic Review.

Increasing cultural and linguistic diversities of populations have created a challenge for medical educators to provide authentic learning experiences fostering cross-cultural understanding and interprofessional attitudes of students. Simulations with actors portraying patients (commonly referred to as simulated patients) are effective learning modalities to teach students to provide culturally competent care and influence the quality of patient-centered care. The aim of this systematic review was to identify and synthesize available evidence on the use of simulations with simulated patients as a learning intervention to teach cultural competence to the students of healthcare professions. The PubMed, Medline Complete, and CINAHL databases were searched for articles, which resulted in 27 papers being included in the review. Results revealed that engaging students in cross-cultural interactions with patients increases their level of cultural competence, confidence, and learning satisfaction, and therefore, simulations with simulated patients can serve as a powerful reinforcement of cross-cultural education.

The Significance of Cooperation in Interdisciplinary Health Care Teams as Perceived by Polish Medical Students.

Teamwork, as the preferred method of cooperation in healthcare, became prevalent in the 1960s, and since then has been universally recognized as a measure to improve the quality of healthcare. Research indicates that medical care based on interdisciplinary cooperation is associated with increased patient safety, lower hospitalization rates, and reduced rates of complications and medical errors. Furthermore, it enhances the coordination of care and improves patient access to medical services. This model of providing medical care also results in considerable benefits for medical professionals. These include greater job satisfaction and a reduced risk of professional burnout syndrome. AIM: The aim of the study was to explore the opinions of medical students with regard to cooperation in the interdisciplinary team, as well as the factors affecting the formation of opinions. MATERIAL AND METHODS: The study was conducted using the Polish version of the questionnaire Attitudes Towards Interprofessional Health Care Teams. The study involved 1266 participants, including students of medicine (n = 308), midwifery (n = 348), nursing (n = 316) and physiotherapy (n = 294). RESULTS: According to the opinions of the students participating in the study, the therapeutic process based on the interdisciplinary model improves the quality of medical care provided, increases patient safety, and improves communication between members of the therapeutic team. The factors affecting the assessment of cooperation in interdisciplinary medical care teams included the faculty and the year of studies, gender, as well as participation in the multidisciplinary courses. CONCLUSIONS: Students recognize the need for interdisciplinary medical teams. The training of future medical professionals should incorporate the elements of interprofessional education. This form of education allows students to develop both a professional identity and identification with their own profession, as well as encourages teamwork skills and shapes the attitude of openness towards representatives of other medical professions. However, in order to provide the students with the relevant knowledge, skills and competencies, it is essential to respect their diversity in terms of the faculty, as well as to account for the impact of gender and the year of studies which may affect their readiness to engage in teamwork.

Correlation between religion, spirituality and perception of healthcare services utilisation in Poland during COVID-19 pandemic.

Background: The worldwide transmission of SARS CoV-2 caused the COVID-19 pandemic and had an impact on healthcare provision. The disruption of reliance on the health system during the COVID-19 pandemic posed a clear threat to public trust. Religiosity, like spirituality, is believed to have a positive influence on people's lives, enabling them to cope with illness, stress, and sudden life changes. In practice, although the terms religiosity and spirituality have similar meanings and are related, they are not identical concepts. The aim of this study is to compare the perceptions of the accessibility and quality of healthcare services provided before and during the COVID-19 pandemic in Poland by religious/spiritual people compared to those for whom religion and spirituality have little or no importance in their lives. Methodology: This cross-sectional study was based on the authors' questionnaire, carried out during the third wave of the COVID-19 pandemic in Poland. Participants in the study were people living in various regions of Poland over 18 who were willing to complete the questionnaire voluntarily. The number of people sampled was two hundred and sixty-four. Convenience sampling method was used for this study. Statistical calculations were performed using Statistica 13 software from TIBCO and PQStat from PQStat Software and were based on the Kruskal-Wallis test, multiple regression model, the chi2 test of independence or the Mann-Whitney test. The result was considered statistically significant when p < α. The significance level was taken as α = 0.05. Results: Two hundred and sixty-three respondents answered the questionnaire. Among them, 181 (69%) were women, and 82 (31%) were men. It was shown that religion is more important for women than for men and women who report a high role of religion in their lives rated the quality of healthcare services better before and during the COVID-19 pandemic. It was also concluded that religious people for whom religion played a major role and those who were helped by spiritual life rated accessibility and quality higher both before and during the pandemic. Conclusions: Religious/spiritual people, through their more positive attitudes towards the world, were thought to rate access and quality of healthcare services better. Regardless of religious affiliation, the help of spiritual life during the pandemic or the importance of religion in life in all respondents, perception of healthcare services utilisation were decreased by the pandemic. This prompts thoughts on the implementation of spiritual assistance as a supportive measure to mitigate the effects of the pandemic.

Volunteering in the front line of the Ukrainian refugee crisis: A brief report from Poland.

This study aims to analyse the experiences and motivations of volunteers who supported Ukrainian refugees who fled to Poland. Our study was conducted among 196 volunteers in Poznan, Poland who answered questions regarding their experiences with voluntary service during the current refugee crisis and the reasons they became involved in volunteer efforts. We found that although the Polish state had no prior experience in welcoming refugees on a mass scale, the Russo-Ukrainian War has resulted in the emergence of "spontaneous volunteers" who have offered their help and assistance to the flood of refugees sweeping in from its eastern neighbor. We also found that because many Polish citizens believe that helping those in need should not rest solely on the government there are two main motivations to volunteer: a general willingness to help and the willingness to volunteer on behalf of Ukrainian refugees. Finally, while this study highlights that in times of crisis, most people are primarily motivated by humanistic and democratic values, including altruism and public service, emotions also play an important role in influencing people's decision to engage in voluntary service.

A Unique Glassy Cell Carcinoma (GCC) of the Cervix Diagnosed during Pregnancy-A Case Report.

Glassy Cell carcinoma (GCC) of the cervix is classified as a unique, aggressive neoplasm, with different sensitivity to chemotherapy and radiotherapy. It is such an extremely rare tumor that it is practically not observed during pregnancy. Information on the coexistence of cervical GCC with pregnancy is also unique, so it seems extremely important to disseminate it in order to develop the most effective treatment regimen. Additionally, making any decisions regarding therapeutic methods during pregnancy encounters great ethical problems. We present the case of a 26-year-old pregnant woman, 18 weeks gestation, diagnosed with GCC of the cervix, IB3 grade in the International Federation of Gynecology and Obstetrics (FIGO) scale. Despite the unfavorable prognosis, the use of chemotherapy in a pregnant patient brought on a favorable therapeutic effect, without any negative effects on the fetus. The article also presents a literature review on the epidemiology, pathology, immunohistochemistry, treatment and prognosis of this rare disease.

Suicide and Attempted Suicide in Poland before and during the COVID-19 Pandemic between 2019 and 2021.

The COVID-19 pandemic is related to changes in rates of suicide and suicide attempts in many countries, and some differences have been observed regarding the prevalence of suicidal behaviours in different age and gender groups. The aim of this study is to analyse the number of suicides and suicide attempts per 100,000 people between 2019 and 2021 in Poland. Using police and government data on suicide and suicide attempts in Poland, three age categories were investigated: 13-24 years old, 25-65 years old, and above 65 years old, and the analysis encompassed the whole population and the populations of men and women separately. Study results indicated an increase in suicide attempts in the two younger age categories (aged 7-24 years and 25-65 years) between 2021 and 2019-2020. There was an increase in suicide among women in all age categories during the study period, whilst no increase was observed in suicide in men in any age group. The differences in the prevalence of suicide and attempted suicide in Poland during the COVID-19 pandemic in different age and gender groups indicate the need for tailored suicide prevention activities.

The needs of cancer patients during the COVID-19 pandemic-psychosocial, ethical and spiritual aspects-systematic review.

The COVID-19 pandemic resulted in unprecedented changes in the functioning of the health care system, which were connected with the occurrence of new challenges for both the health care system's employees and for the patients. The purpose of the present article is to analyze the needs of persons with oncological diseases. Taking into account the multiple aspects of the term health, psychological, social, and existential needs of the patients were analyzed. This article is directed mainly at persons who remain in a direct therapeutic relation with a patient. It is to facilitate recognizing the needs of ill people and to increase sensitivity to the issue of maintaining or improving the well-being of patients which requires paying special attention to their psychological, social, and existential needs during the period of hindered access to the health care system. This systematic review takes advantage of quantitative and qualitative methods of text analysis with phenomenological analysis factored in. The COVID-19 pandemic resulted in the appearance of new problems in the population of oncological patients or it made the existing problems more severe. As a consequence, it made it significantly more difficult to meet their needs on various levels and sometimes it even made it impossible. It seems necessary to determine and introduce strategies to ensure that patients with oncological diseases have access to psychological and spiritual support in the period of the pandemic.

The Ethics of Translational Audiology.

Translational research moves promising primary research results from the laboratory to practical application. The transition from basic science to clinical research and from clinical research to routine healthcare applications presents many challenges, including ethical. This paper addresses issues in the ethics of translational audiology and discusses the ethical principles that should guide research involving people with hearing loss. Four major ethical principles are defined and explained, which are as follows: beneficence, nonmaleficence, autonomy, and justice. In addition, the authors discuss issues of discrimination and equal access to medical services among people with hearing loss. Despite audiology's broad field of interest, which includes evaluation and treatment of auditory disorders (e.g., deafness, tinnitus, misophonia, or hyperacusis) and balance disorders, this study focuses primarily on deafness and its therapies.

Quality of the Healthcare Services During COVID-19 Pandemic in Selected European Countries.

Background: There are several definitions of the quality of healthcare services. It may be defined as a level of value provided by any health care resource, as determined by some measurement. Scientists use a variety of quality measures to attempt to determine health care quality. They use special indicators or based on a patients' or healthcare professional's perception. This article aims to provide a short review of the available data on the quality of healthcare services in selected European countries during the COVID-19 pandemic. Methodology: The research was done by the use of online databases such as PubMed, Google Scholar, and Science Direct. All the studies focused on the quality of healthcare services, yet the studies used different methods to measure this quality. In addition, the results of the authors' survey on the assessment of the quality of healthcare services before and during the COVID-19 pandemic were presented. Results: Among twelve studies, four were from the United Kingdom and one each of Catalonia, Italy, Sweden, Poland, Netherlands, France, Germany, Belgium. Patients in the United Kingdom felt that the quality of services was good during the pandemic, whereas the quality declined in the other studies cited. The results of our research also revealed a decrease in the quality of healthcare services provided. Conclusions: Nevertheless the development of telemedicine has had a positive impact on the quality of healthcare services. The COVID-19 pandemic has undoubtedly affected most European countries' quality of healthcare services.

Spiritual Distress and Spiritual Needs of Chronically Ill Patients in Poland: A Cross-Sectional Study.

INTRODUCTION: Spiritual care is needed in a clinical setting to improve the patients' quality of life. Deep connection with another person and delight with the beauty of nature or art and (in some cases) with God are all transcendental experiences. They may enable patients to ascribe meaning to their life with a chronic illness, find hope and well-being despite burdening symptoms. The opposite situation: lack of inner peace, inability to accept what is happening, feeling disconnected from others is called spiritual distress. OBJECTIVES: The aim of this research is to assess spiritual distress and spiritual needs of a group of Polish chronically ill patients and find associations with independent variables in order to provide data for recommendations on spiritual care in Poland. PATIENTS AND METHODS: 204 patients treated at the University Hospital and the Cystic Fibrosis Clinic in Poznan were surveyed in 2017 and 2018 with an original questionnaire. RESULTS: Over half of the patients felt that their illness was life-threatening. A little more than half reported that faith was a resource to cope with suffering. Almost all patients showed signs of spiritual distress, and more than half expressed spiritual needs. The intensity of distress correlated only with the severity of the disease. The most important predictor of having spiritual needs was recognizing faith as a resource. CONCLUSIONS: Spiritual needs are associated with personal beliefs; however, spirituality spans beyond the religious context since spiritual distress is unrelated to the level of religious devotion. Therefore, any patient with a severe chronic disease needs basic spiritual care, which includes being treated with compassion.

Impact of Socioeconomic Status on the Perception of Accessibility to and Quality of Healthcare Services during the COVID-19 Pandemic among Poles-Pilot Study.

This pilot study was conducted on the reported hypothesis that the COVID-19 pandemic outbreak had an impact on the accessibility and quality of healthcare services and exacerbated socioeconomic inequalities. The aim was to determine whether economic status and education had an impact on the perception of access and quality to healthcare services during the COVID-19 pandemic and whether, according to patients, accessibility and quality had changed significantly compared to the pre-pandemic period in Poland. The study was based on the authors' questionnaire and the results were statistically analyzed. Two hundred forty-seven feedback responses were received with a responsiveness rate of 93 percent. Statistically significant differences were found when comparing education level and utilization of healthcare services during the COVID-19 pandemic. A comparison of gender and economic situation, and average monthly income found no statistically significant differences. The outbreak of the COVID-19 pandemic has undoubtedly affected the provision of health services in many countries around the world. One result of the pandemic crisis has been widening socioeconomic inequalities among patients.

Secretory activity of the coronary artery endothelial cells in conditions of the peritoneal dialysis.

INTRODUCTION: Endothelial dysfunction is frequent in patients treated with peritoneal dialysis and may lead to cardiac complications. We evaluated the effect of effluent dialysates and serum on the function of coronary artery endothelial cells (CAEC). METHODS: Human CAEC in in vitro culture were exposed to serum and dialysates from 24 patients treated with continuous ambulatory peritoneal dialysis (CAPD) and secretion of interleukin-6 (IL6), von Willebrand factor (vWF), tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) were measured. Modulation of the secretory activity of CAEC by Sulodexide, mixture of glycosaminoglycans: heparin sulfate and dermatan sulfate, was studied. RESULTS: Serum from CAPD patients stimulated synthesis of IL6 (+93%), vWF (+18%), and PAI-1 (+20%) and did not change t-PA secretion in CAEC. Dialysates stimulated secretion of IL6 (+89%), vWF (+29%), and PAI-1 (+31%) and did not change t-PA synthesis. Dialysates collected in 12 patients after 6 months more strongly stimulated synthesis of IL6 (+37%) and PAI-1 (+7%). Sulodexide suppressed the secretory activity of CAEC stimulated by the studied sera: IL6 (-38%), vWF (-19%), t-PA (-13%), and PAI-1 (-12%). CONCLUSIONS: Serum and the dialysate from CAPD patients induce inflammatory and prothrombotic reaction in coronary arterial endothelial cells. The general pattern of the observed effects for serum and dialysates was similar but the intensity of the effects was not identical. Sulodexide reduced these effects.

Activities based on yoga techniques in psychiatric treatment in Poland in a historical context. / Cwiczenia oparte o techniki jogi w leczeniu psychiatrycznym w Polsce w aspekcie historycznym.

The aim of this article is to analyze the use of methods related to yoga for mental health protection and treatment of psychiatric disorders. The article is dominated by a historical perspective. It covers the achievements of the precursors of the use of yoga techniques in health promotion and treatment. Contemporary biomedical analyses confirm the healthpromoting function of yoga but make much less reference to aspects related to spirituality and its importance for mental health. Due to the growing awareness of the impact of lifestyle, stress reduction and the importance of moderate physical effort on health, relaxation-motor techniques can complement therapies used in many psychiatric disorders. Analyzed historical articles confirm the positive influence of exercises based on yoga techniques on mental health. Research on the influence of yoga on the human psyche needs to be deepened, none of the presented analyses showed negative side effects of supplementing standard therapies with exercises based on different forms of yoga. To investigate the aim of the research, a historical-comparative method and discourse analysis were used. A review of the content related to the history of yoga in Poland was carried out in the context of applying exercises based on yoga technique in psychiatry. In subsequent stages of the work, the obtained content was embedded in the medical, cultural and historical context and a critical analysis was made.

Application of the Neonatal Behavioral Assessment Scale to Evaluate the Neurobehavior of Preterm Neonates.

BACKGROUND: The neonatal behavioral assessment scale (NBAS) was primarily developed to aid in the assessment of full-term neonates. The aim of this study was to detect if the NBAS was also valuable in the assessment of preterm neonates. MATERIALS AND METHODS: We assessed 112 infants at a neonatal unit using the NBAS, 4th edition. The inclusion criteria included an oxygen saturation level between 88-95% and a heartrate of 100-205 beats per minute. Infant neurobehavior was assessed using the NBAS. RESULTS: For full-term and preterm neonates, we observed that the NBAS enabled us to assess both groups of infants and gave relevant information pertaining to them. We found a significant correlation between the average week of gestation and response to touch, sensory input, peak of excitement, cost of attention, hand-to-mouth, and quality of alertness. CONCLUSIONS: The NBAS is a valuable scale for evaluating the neurobehavior of preterm neonates. The week of gestation at birth affects certain aspects of neurobehavior, such as response to sensory input, putting hand to mouth, peak of excitement, and cost of attention. The NBAS as an individually structured assessment may help in planning for early rehabilitation and intervention for this vulnerable population.

Impact of umbilical cord arterial pH, gestational age, and birth weight on neurodevelopmental outcomes for preterm neonates.

BACKGROUND: The aim of this study was to determine the impact of umbilical cord arterial pH, gestational age, and birth weight on neurodevelopmental outcomes for preterm neonates. METHODS: We examined 112 neonates. Inclusion criteria were: Saturations greater than 88%, and heart rates between 100-205 beats per minute. MEASUREMENTS: We assessed several neurodevelopmental factors as part of the Brazelton Neonatal Behavioral Assessment Scale (NBAS), 4th edition, such as asymmetric tonic neck reflex (ATNR), motor maturity, response to sensory stimuli, habituation, and state regulation. Initial assessment parameters such as APGAR score and umbilical cord arterial pH were used to assess neonates. RESULTS: We found a strong correlation between the presence of the sucking reflex and umbilical cord arterial pH (r = 0.32; p = 0.018981). Umbilical cord arterial pH was also correlated with the presence of asymmetric tonic neck reflex (r = 0.27; p = 0.047124), cost of attention (r = 0.31; p = 0.025381) and general motor maturity (r = 0.34; p = 0.011741). CONCLUSIONS: We found that the sucking reflex may be affected in infants with low umbilical cord arterial pH values. Practitioners and parents can use the NBAS to help determine neurodevelopmental factors and outcomes in preterm infants, possibly leading to safer and more effective feeding practices and interventions.

E-Learning as a Factor Optimizing the Amount of Work Time Devoted to Preparing an Exam for Medical Program Students during the COVID-19 Epidemic Situation.

The COVID-19 pandemic had a huge impact on the learning and teaching processes, particularly in healthcare education and training, because of the principal position of the cutting-edge student-patient interaction. Replacing the traditional form of organization and implementation of knowledge evaluation with its web-based equivalent on an e-learning platform optimizes the whole didactic process not only for the unit carrying it out but, above all, for students. This research is focused on the effectiveness of the application of e-learning for computer-based knowledge evaluation and optimizing exam administration for students of medical sciences. The proposed approach is considered in two categories: from the perspective of the providers of the evaluation process, that is, the teaching unit; and the recipients of the evaluation process, that is, the students.