RESUMO
INTRODUCTION: The aim of the study, conducted in selected inpatient units, was to evaluate and analyse the feelings and emotions which accompany nurses during their work when they face the death of patients. MATERIAL AND METHODS: A total of 160 nurses were invited to participate in the study. The study group consisted of 40 nurses from each of the four departments of a municipal hospital: a surgery unit, an internal medicine unit, a hospital emergency department (ER) and an intensive care unit (ICU). A diagnostic survey method was used, including a questionnaire on sociodemographic data as well as questions designed by the author of the research related to the feelings of nurses provoked by the death of patients. To assess the level of anxiety and the ways of coping with stress related to contact with dying patients, Mini-COPE and PSS-10 questionnaires were used. RESULTS: Compassion, sadness and helplessness are the most common types of nurses' emotions caused by the death of patients, regardless of the nurses' length of service and the place of work. In the study group, 53.90% of participants experienced a high level of stress. The level of anxiety in nurses from the internal medicine ward was significantly higher than in the nurses from the intensive care unit and the emergency department. The way of coping with stress is related to the period of service and the workplace of nurses. CONCLUSION: Nurses experience a high level of stress and strong emotions triggered by the observation of dying patients. Various styles of coping with stress can be noticed depending on job seniority and a place of employment. Due to the emotions evoked by the necessity to deal with death while performing professional duties, it is advisable to develop effective ways of coping in difficult situations.
RESUMO
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.
