Sleep Quality in Older People: The Impact of Age, Professional Activity, Financial Situation, and Chronic Diseases During the SARS-CoV-2 Pandemic.

BACKGROUND The SARS-CoV-2 pandemic negatively affected health and social life, notably deteriorating sleep quality in older adults. Studies report inconsistent findings on sleep disturbances during this period, influenced by various physiological, emotional, and sociodemographic factors. This study aimed to identify these determining factors. MATERIAL AND METHODS The study was conducted among 342 people 60 years of age or older participating in online classes of randomly selected Senior Clubs and the University of the Third Age in the southern regions of Poland. RESULTS Sleep problems (PSQI >5 points) were diagnosed in 250 subjects (83.6%). Logistic regression analysis showed that the quality of sleep significantly depends on: age, as people aged 66-70 were more likely to have better sleep quality than people aged 60-65 (OR=3.07), and those over 70 scored better than people aged 60-65 (OR=2.87); current job - employed people have a better chance of better sleep quality (OR=3.08) than unemployed people; financial situation, people assessing their financial situation as very good/good had a better chance of better sleep quality (OR=2.00) compared to people assessing their financial situation as very bad, bad/average; chronic diseases, people without chronic diseases had a chance of better sleep quality (OR=2.45) than people with chronic diseases. CONCLUSIONS Age, financial situation, current job, and chronic disease were the most important factors determining sleep quality in older people. The identification of factors affecting sleep quality can be used as important data to develop interventions and programs to improve sleep quality.

Psychosocial Determinants of Loneliness in the Era of the COVID-19 Pandemic-Cross-Sectional Study.

BACKGROUND: The COVID-19 pandemic affected the mental health and social behavior of people around the world. Due to epidemiological restrictions, the period of forced isolation contributed to the feeling of loneliness. The aim of the research is to identify factors and conditions associated to the feeling of loneliness in the era of the COVID-19 pandemic. METHODS: The survey was conducted among 262 people from the north-eastern Polish area, using an online survey. The diagnostic survey method was used, using the De Jong Gierveld Loneliness Measurement Scale, the Generalized Self-Efficacy Scale (GSES), the WHOQoL-Bref questionnaire. RESULTS: A statistically significant relationship was observed between the feeling of loneliness and areas of quality of life, especially psychological and social, generalized self-efficacy and marital status and way of living (p < 0.05). Higher levels of stress, social distancing, restrictions at work, health status were significantly correlated with an increase in loneliness. Remote work was associated with a lower assessment of the quality of life in the psychological field (p < 0.05). CONCLUSIONS: Higher levels of loneliness were significantly more likely to affect people living alone and not in a relationship. Higher levels of loneliness were significantly associated with lower quality of life in the social and psychological domains, lower levels of self-efficacy, and remote work.

How the Cognitive Status of Older People Affects Their Care Dependency Level and Needs: A Cross-Sectional Study.

INTRODUCTION: The decline in health and abilities as a result of the aging process leads to a growing need for care and various forms of support. The aim of this study was to find out the level and the main areas of care dependency among older persons with cognitive impairment versus those without cognitive impairment. MATERIALS AND METHODS: A cross-sectional study was conducted among 200 older persons hospitalized in the years 2017-2018 at a geriatric ward in Poland. The research took into consideration the socio-demographic variables of the older people (age, sex, marital status, mode of dwelling, health self-evaluation, and loneliness) and the results of the assessment of their functional status, including their physical functional status according to the Barthel scale and the I-ADL, locomotion, the risk of falls and pressure sores, emotional state, cognitive function status, vision, hearing, and the Polish version of the Care Dependency Scale. RESULTS: People with cognitive impairment significantly more often have poorer results in regard to ADL and I-ADL physical functions, locomotion, risk of depression, falls, pressure sores, as well as hearing and vision problems, than people with good cognitive status. The results of the study indicate that the advancing impairment of cognitive functions in older people has an impact on the level of care dependency. CONCLUSION: The results of this original research show that persons with cognitive impairment are significantly more often dependent on external assistance in regard to all the needs assessed in the CDS than people without such impairment. The spectrum and number of needs in which the older person requires help grows significantly with the advancement of cognitive impairment. Older people with cognitive impairment who live alone require special support from formal caregivers in their home environment. Identification of the level of dependency and the needs of older people with cognitive impairment is of key importance for planning caregiving resources.

Stress coping strategies used by nurses during the COVID-19 pandemic.

Introduction: The risk of getting SARS-CoV-2 infection, worries about exposing loved ones, anxiety and frustration, emotional and physical exhaustion, burn out, a feeling of being overwhelmed, and struggles and challenges with parenting are a few among many factors that affect nurses' personal lives and professional functioning. The aim of the research is to assess nurses' level of stress during the COVID-19 pandemic and their sense of self-efficacy, and to learn what coping strategies they use. Methodology/Methods: The study was carried out online and based on the diagnostic poll method, using an original survey questionnaire, the General Self-Efficacy Scale (GSES 10-40), the Mini-COPE questionnaire (0-3), and the Perceived Stress Scale PSS-10 (0-40). The respondent group was made up of nurses (n = 220) who provide health services in inpatient and outpatient health care institutions in the northeastern region of Poland. The statistical analysis was performed using the STATISTICA 13.0 package (StatSoft). The distribution of variables was checked with Shapiro-Wilk tests. The Mann-Whitney U test was used to compare two independent samples, while the Kruskal-Wallis test was used to compare more samples. The adopted statistical significance level was p < 0.05. Multivariate regression analysis was applied to determine which factors were related to the level of stress. Results: The mean age of the participants was 43.3 years. The vast majority were women (96.4). The mean work experience of the nurses was over 20 years (58.2%). A total of 62.3% worked directly with patients in hospitals, including 11.8% respondents working at COVID-19 units and 37.7% working at primary care institutions. The analyses show that the respondents represented a high level of stress (PSS-10 - 20.9), related to their work experience as a nurse (ß -0.250, p = 0.014), the number of hours worked a month (ß 0.156, p = 0.015), and self-assessed health status (ß -0.145, p = 0.037). They declared an average sense of self-efficacy (GSES - 29.1), which significantly depended on the nurses' places of employment (p = 0.044). Out of stress coping strategies (Mini-COPE), the younger nurses mentioned venting (p = 0.010), instrumental support (p = 0.011), sense of humour (p = 0.013) and self-blame (0.031). Practice nurses also chose the strategy of behavioral disengagement (p = 0.032), and nurse managers chose the strategy of planning (p = 0.018). Conclusions: The experience of the COVID-19 pandemic highlights the need to implement some strategies to protect nurses' mental health and to take extensive prevention measures in critical situations. Special attention should be given to nurses who are younger and have shorter work experience. It is also important to monitor nurses' working time and health status, and those who work at outpatient health care institutions should be given more support and information.

Usability of the COPE Index in the assessment of subjective caregiving burden of family caregivers of older people: A cross-sectional Study.

AIM: The aim of the study was to evaluate the usability of the COPE Index in the assessment of subjective caregiving burden of family caregivers providing care for older people in their home environment. METHODS: A cross-sectional study was conducted among 110 family caregivers. The criterion of including caregivers in the study was their provision of care at home for an older person who needed and received regular long-term nursing care in their home environment. The study was carried out using the COPE Index questionnaire in assessing the situation of family caregivers. The study was reported according to the STROBE checklist. RESULTS: The mean result of assessment of negative impact of care in the studied group of caregivers was 16.5 ± SD 3.0, positive impact of care - 10.4 ± SD 2.8 and the quality of support - 9.2 ± SD 1.8. A higher level of caregiving burden was found in 58.2% caregivers. The vast majority of the caregivers were women (83.6%). The care was most often provided by the elderly people's children (51.0%), less often by spouses (17.0%), siblings (10.0%), grandchildren (10.0%) and paid caregivers (10.0%). CONCLUSION: The COPE Index proved to be a useful instrument for routine application in home environment to identify care deficits. Greater caregiving burden of family caregivers of disabled older persons was associated with a higher number of nights devoted to care, growing limitations on professional life, choice to provide care, the caregiver's emotional state, the lack of support in the caregiving role, support from family members and the state of cognitive functions of the care recipient. RELEVANCE TO CLINICAL PRACTICE: This study may help identify and characterise the profile of family caregivers who are at risk of caregiving burden, and can be used to apply well-designed activities aimed at reducing their suffering and providing them support.

Factors associated with risk of care dependency in disabled geriatric patients.

INTRODUCTION: The growing number of elderly people results in the intensification of disability, reduced level of independency and quality of life as well as augmented demand on medical and social services. The aim of the study was to identify factors associated with probability of care dependency in disabled geriatric patients. MATERIALS AND METHODS: The study involved 200 patients aged 60 or over, consecutively admitted to the Geriatrics Unit. A cross-sectional quantitative study design. The study carried out using the questionnaire evaluating the patients' biopsychosocial needs and level of care dependency: the Polish version of the Care Dependency Scale (CDS). Data regarding the patients' self-care, locomotor function, emotional status, cognitive function, vision, hearing, the risk of pressure sores or falls, self-assessed health status and the sense of loneliness were obtained from medical documentation using selected elements of the CGA (Comprehensive Geriatric Assessment). RESULTS: The mean CDS score (15-75) for all the evaluated patients was 55.3 ± 15.1-43.4 ± 11.9 in the category of dependent patients and 67.5 ± 4.6 in the category of independent of care, respectively (p < 0.001). The participants' mean age was 81.8 ± 6.6 (in the dependent category, 83.3, and in the independent category, 80.2). The final model produced statistically significant independent factors: cognitive ability, Instrumental-ADL performance, locomotive ability and age. CONCLUSIONS: The progressing care dependency increased with the worsening of cognitive functions, difficulties performing I-ADL, locomotion impairment and advanced age. To support independent living of elderly people, healthcare professionals should recognise the situation in the community to carry out interventions aimed at preventing and minimising disability and delaying institutionalisation.

The impact of parents' health behaviours on their preferences regarding vaccinations in Bialystok, Poland.

BACKGROUND: Currently, as the number of vaccinated children in Poland and throughout Europe is decreasing. Many factors impact on the rate vaccination and parents' health behaviours may affect the frequency of vaccinations. The aim of the study was to assess the association of parents' health behaviors with children's vaccinations. METHODS: A cross-sectional survey was conducted from July 2015 to June 2016 to assess to assess the association of parents' health behaviors with children's vaccinations in Bialystok city, Poland. We used the the Inventory of Health Behaviours and an original questionnaire including demographic data and questions about vaccination. Three hundred parents were recruited from the Pro Medica Family Medica Center in Bialystok, Poland. RESULTS: Only 3.7% of respondents did not vaccinate their children. The level of health behaviours was average in 42.3% of the respondents, low in 33%, and high in 24.7%. Significant differences in health behaviours, mainly the level of normal eating habits (p = 0.038) and positive mental attitude (p = 0.022), were found in relation to views on the toxicity of vaccines. Participants who reported that vaccines can cause autism engaged in a higher level of prophylactic behaviours. Respondents who vaccinated their children with combined vaccines had a significantly higher level of health practices. CONCLUSIONS: Parents preferred health behaviours did not effect on children vaccination. Parents who believed in the toxicity of vaccines were more concerned about proper nutrition, had a positive mental attitude, and engaged in a higher level of preventive behaviours and health practices. Parents who did not vaccinate their children had lower levels of normal eating habits. Parents who vaccinated their children with combined vaccines had a higher level of health behaviours, especially in terms of health practices.

Factors associated with quality of life in systemic sclerosis: a cross-sectional study.

INTRODUCTION: Systemic sclerosis (SSc) is a connective tissue disease characterized by progressive fibrosis of the skin and internal organs, leading to their failure and disturbances in the morphology and function of blood vessels. The disease affects people in different ways, and identifying how the difficulties and limitations are related to quality of life may contribute to designing helpful interventions. The aim of this study was to identify factors associated with quality of life in people with SSc. METHODS: This was a cross-sectional study conducted in 11 rheumatic centres in Poland. Patients diagnosed with SSc were included. Quality of life was measured using the SSc Quality of Life Questionnaire (SScQoL). The following candidate factors were entered in preliminary multivariable analysis: age, place of residence, marital status, occupational status, disease type, disease duration, pain, fatigue, intestinal problems, breathing problems, Raynaud's symptoms, finger ulcerations, disease severity, functional disability, anxiety and depression. Factors that achieved statistical significance at the 10% level were then entered into a final multivariable model. Factors achieving statistical significance at the 5% level in the final model were considered to be associated with quality of life in SSc. RESULTS: In total, 231 participants were included. Mean age (SD) was 55.82 (12.55) years, disease duration 8.39 (8.18) years and 198 (85.7%) were women. Factors associated with quality of life in SSc were functional disability (ß = 2.854, p < 0.001) and anxiety (ß = 0.404, p < 0.001). This model with two factors (functional disability and anxiety) explained 56.7% of the variance in patients with diffuse SSc and 73.2% in those with localized SSc. CONCLUSIONS: Functional disability and anxiety are significantly associated with quality of life in SSc. Interventions aimed at improving either of these factors may contribute towards improving the quality of life of people with SSc.

Assessment of the relationship between frailty syndrome and the nutritional status of older patients.

Objective: The aim of this study was to assess the relationship between frailty syndrome and the nutritional status of older patients. Material and methods: This cross-sectional study was conducted in a sample of 120 patients hospitalized at the Geriatric Clinic between January 2017 and May 2017. The research tools were the Frailty Instrument of the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), including relevant anthropometric measurements and muscle strength measurement, and the Mini Nutritional Assessment (MNA). All the calculations were performed using the Statistica 10.0 program. The p-values lower than 0.05 were considered as statistically significant. Results: The mean age of the participants was 71 years (SD=9.03). Most participants were from urban areas. More than half of the participants (53.3%) were women. Based on the SHARE-FI, the frailty syndrome was found in 33.3% of the participants. The mean value in the MNA scale was 24.4 points (SD=3.4). The frailty syndrome was significantly correlated to gender (p<0.025), financial status (p=0.036) and MNA (p<0.01) score. A statistically significant difference was observed between gender (p=0.026), financial status (p=0.016), place of living (p=0.046) and MNA score. Conclusion: This study confirmed significant correlations between the frailty syndrome and the nutritional status of older adults. In terms of prevention and clinical application, it seems important to control the nutritional status of older people and the frailty syndrome. The above-mentioned scales should be used to evaluate patients, analyze the risk and plan the intervention for that group of patients.

[Prevention of the musculoskeletal system's dysfunction based on the example of Prevention Program of Spinal Pain Syndrome in Nursing Staff]. / Prewencja dysfunkcji ze strony ukladu miesniowo-szkieletowego na przykladzie realizacji programu Profilaktyki zespolów bólowych kregoslupa u personelu pielegniarskiego.

BACKGROUND: Most of the medical activities, which are work-related, both static and dynamic are performed by nurses in a forced position. Excessive and improper strain of the musculoskeletal system, especially when lifting and moving patients, is the cause of many injuries of the musculoskeletal system. The work presents the implementation and evaluation of the program concerning the prevention of dysfunction on the part of the musculoskeletal system, addressed to professionally active nurses. MATERIAL AND METHODS: The questionnaire was addressed to 125 professionally active nurses, working in conservative units (92%) and outpatient care (8%), suffering from musculoskeletal system dysfunctions, qualifying for the preventive program (ultimately 65 respondents joined the program). The research method was a diagnostic survey, using: the World Health Organization Quality of Life-BREF (WHOQOL-BREF) (scale results are in the range of 4-20 pts), 5-point scale to assess the frequency and intensity of pain and body mass index (BMI). RESULTS: The average age of the studied group is 46.6 years old (±8.6), work experience 24.3 (±9.8). A total of 57% of respondents reported pain in the musculoskeletal system, the vast majority of which affected the lumbar spine (89.2%). Constantly occurring complaints were characteristic for nurses, whose average age was 49.5 years (p = 0.0001) and with work experience over 27 years (p = 0.0002), with a BMI value (≥ 25) (p = 0.0038). The average quality of life results were significantly dependent on the intensity of pain (p < 0.05). CONCLUSIONS: The research shows that pain, escalating with age and duration of the professional activity is a significant factor in lowering the quality of nurses' life. The severity and frequency of experienced ailments significantly decreased after participating in kinesitherapeutic activities. Med Pr. 2019;70(2)189-99.

Mandatory and recommended vaccinations in Poland in the views of parents.

Background: Vaccinations are currently the key element in the prevention of the spread of infectious diseases. We studied parents' opinions about mandatory and recommended preventive vaccinations in Poland. Methods: A diagnostic survey using an original questionnaire was done in a group of 300 parents. Results: A total of 3.7% of parents did not vaccinate their children. 90% were aware of the threat potentially posed by infectious diseases, and 73.7% knew that breastfeeding alone does not ensure sufficient protection against them. 28% believed that it is necessary to vaccinate a child against all diseases, 51.7% that the number of vaccinations is insufficient, and 62.7% that vaccine use is safe. 40.7% thought that unvaccinated children should not be able to attend nurseries and kindergartens, as they pose a threat to other children. Postvaccinal adverse events occurred in 21.3% of children, mainly (71.9%) an increase in body temperature above 38°C. 88.3% were informed about possible vaccine-induced complications, most often by nurses (79.7%). 88% of the respondents were aware of the possibility to switch to an alternative immunization program, 92% were informed on the possible administration of recommended vaccines, and 53% took advantage of combined vaccines. Conclusions: Views on vaccinations were mostly varied, depending on the age, sex, education, and financial situation of the respondents. Most of the parents who did not vaccinate their children believed that immunity can be acquired by infection. They were in favor of a limited number of vaccinations, were more critical of the vaccination program in Poland, considered the vaccines used in Poland to be unsafe, and blamed vaccines for multiple developmental defects and autism in children. Parents whose children experienced vaccine-induced adverse reactions were more likely to have doubts before the next vaccination.

Utility of the Care Dependency Scale in predicting care needs and health risks of elderly patients admitted to a geriatric unit: a cross-sectional study of 200 consecutive patients.

OBJECTIVE: The aim of the study was to evaluate the usefulness of the Polish version of the Care Dependency Scale (CDS) in predicting care needs and health risks of elderly patients admitted to a geriatric unit. METHODS: This was a cross-sectional study of 200 geriatric patients aged ≥60 years, chronologically admitted to a geriatrics unit in Poland. The study was carried out using the Polish version of the CDS questionnaire to evaluate biopsychosocial needs and the level of care dependency. RESULTS: The mean age of the participating geriatric patients was 81.8±6.6. The mean result of the sum of the CDS index for all the participants was 55.3±15.1. Detailed analysis of the results of evaluation of the respondents' functional condition showed statistically significant differences in the levels of care dependency. Evaluation of the patients' physical performance in terms of the ability to do basic activities of daily living (ADL) and instrumental ADL (I-ADL) showed statistically significant differences between the levels of care dependency. Patients with high dependency were more often prone to pressure ulcers - 13.1±3.3, falls (87.2%), poorer emotional state - 6.9±3.6, mental function - 5.1±2.8, and more often problems with locomotion, vision, and hearing. The results showed that locomotive disability, depression, advanced age, and problem with vision and hearing are connected with increasing care dependency. CONCLUSION: CDS evaluation of each admitted geriatric patient enables us to predict the care needs and health risks that need to be reduced and the disease states to be improved. CDS evaluation should be accompanied by the use of other instruments and assessments to evaluate pressure ulcer risk, fall risk, and actions toward the improvement of subjective well-being, as well as correction of vision and hearing problems where possible and assistive devices for locomotion.

Evaluation of coping with chronic rheumatic disease, in the context of socio-demographic factors and disease duration, based on the example of patients with ankylosing spondylitis.

OBJECTIVES: Ankylosing spondylitis (AS) impairs patients' functioning, reducing their quality of life. The author of salutogenesis, Antonovsky, claims that maintaining an inner balance in a chronic disease is possible through a high sense of coherence. The aim of the current study was to identify socio-demographic factors and disease duration related to the feeling of coherence of patients with AS, acceptance of disease and risk of depression. MATERIAL AND METHODS: The study was conducted on 82 patients with diagnosed AS. The research method was a diagnostic survey using the Life Orientation Questionnaire (SOC-29), Beck Depression Inventory (BDI) and Acceptance of Illness Scale (AIS). RESULTS: In the study, the majority of the patients were male (89%), aged 42 (±11.3). The average duration of AS is 13 (±7.8) years. It was reported that with age, illness acceptance got worse (rp = -0.567, p < 0.0001), and the risk of depressive disorders increased (rp = 0.648, p < 0.0001). The longer the patient suffered from AS, the weaker was their illness acceptance (rp = -0.446, p < 0.0001) and sense of coherence (rp = -0.448, p < 0.001) whereas the risk of depressive disorder increased (rp = 0.479, p < 0.0001). A high linear correlation between illness acceptance and sense of coherence (rp = 0.638, p < 0.0001) and a very high negative correlation between overall sense of coherence and risk of depression (rp = -0.857, p < 0.0001) were observed. CONCLUSIONS: Patients with low sense of coherence demonstrated poorer adaptation to the illness and a greater risk of depressive disorders. Factors lowering the sense of coherence and illness acceptance and increasing risk of depression in the studied patients with AS were progressing illness, older age and lower education level.

Silent strain of caregiving: exploring the best predictors of distress in family carers of geriatric patients.

OBJECTIVES: The aim of this article was to identify the best predictors of distress suffered by family carers (FCs) of geriatric patients. METHODS: A cross-sectional study of 100 FC-geriatric patient dyads was conducted. The negative impact of care (NIoC) subscale of the COPE index was dichotomized to identify lower stress (score of ≤15 on the scale) and higher stress (score of ≥16 on the scale) exerted on FCs by the process of providing care. The set of explanatory variables comprised a wide range of sociodemographic and care-related attributes, including patient-related results from comprehensive geriatric assessments and disease profiles. The best combination of explanatory variables that provided the highest predictive power for distress among FCs in the multiple logistic regression (LR) model was determined according to statistical information criteria. The statistical robustness of the observed relationships and the discriminative power of the model were verified with the cross-validation method. RESULTS: The mean age of FCs was 57.2 (±10.6) years, whereas that of geriatric patients was 81.7 (±6.4) years. Despite the broad initial set of potential explanatory variables, only five predictors were jointly selected for the best statistical model. A higher level of distress was independently predicted by lower self-evaluation of health; worse self-appraisal of coping well as a caregiver; lower sense of general support; more hours of care per week; and the motor retardation of the cared-for person measured with the speed of the Timed Up and Go (TUG) test. CONCLUSION: Worse performance on the TUG test was only the patient-related predictor of distress among the variables examined as contributors to the higher NIoC. Enhancing the mobility of geriatric patients through suitably tailored kinesitherapeutic methods during their hospital stay may mitigate the burden endured by FCs.

Disabled older people's use of health and social care services and their unmet care needs in six European countries.

BACKGROUND: The national health and social care systems in Europe remain poorly integrated with regard to the care needs of older persons. The present study examined the range of health and social care services used by older people and their unmet care needs, across six European countries. METHODS: Family carers of older people were recruited in six countries via a standard protocol. Those providing care for disabled older people (n = 2629) provided data on the older person's service use over a 6-month period, and their current unmet care needs. An inventory of 21 services common to all six countries was developed. Analyses considered the relationship between older people's service use and unmet care needs across countries. RESULTS: Older people in Greece, Italy and Poland used mostly health-oriented services, used fewer services overall and also demonstrated a higher level of unmet care needs when compared with the other countries. Older people in the United Kingdom, Germany and Sweden used a more balanced profile of socio-medical services. A negative relationship was found between the number of different services used and the number of different areas of unmet care needs across countries. CONCLUSIONS: Unmet care needs in older people are particularly high in European countries where social service use is low, and where there is a lack of balance in the use of health and social care services. An expansion of social care services in these countries might be the most effective strategy for reducing unmet needs in disabled older people.

[Symptoms from the internal organs of patients with systemic sclerosis in the light of selected diagnostic tests]. / Dolegliwosci ze strony narzadów wewnetrznych chorych na twardzine ukladowa w swietle wybranych badan diagnostycznych.

UNLABELLED: Systemic sclerosis (SSc) is a chronic, progressive connective tissue disease with the different clinical course characterized by a progressive fibrosis of the skin and internal organs, leading to their failure, changes in blood morphology and blood vessels disorders. The disease most often affects the skin, the osteoarticular system, the alimentary tract, the cardio-vascular system, lungs, kidneys and the nervous system. In involved systems and organs observed symptoms are able to develop gradually relatively to disease course, leading to a permanent and irreversible health damage. The aim of study was to identify major symptoms of SSc patients and to examine the relation between patients' complaints and the results of diagnostic tests: pulmonary artery pressure (PHT), lung image (X-ray and HRCT) and cytology of broncho-alveolar lavage (BAL), oesophagus X-ray and stress ECG. MATERIAL AND METHODS: The study group consisted of 63 patients with diagnosed SSc according to the ARA criteria: 47 with limited systemic sclerosis (ISSc) (74.6%) and 16 with diffuse systemic sclerosis (dSSc) (25.4%). The basic research tool was a survey questionnaire drafted for the needs of this study, assessing the health problems of patients. The examination was performed in all patients and the results of diagnostic tests were completed in selected groups according to therapeutic purposes. RESULTS: From the all identified symptoms from the alimentary tract the most characteristic was heartburn (in 71% cases). About 60% of subjects reported difficulties with swallowing, out of which 68% were ISSc patients (p < or = 0.05). The X-ray examination of the oesophagus showed a shallow peristaltic wave in 55% patients with this complaint, and it occurred significantly more often in patients who were diagnosed as ISSc for > or = 15 years (p < or = 0.05). A positive result of HRCT was more often obtained in the group of patients with dSSc (p < or = 0.05). It has been proved that there is a significant relation between fatigue reported by patients and a positive result of HRCT and BAL (p < or = 0.05). A positive result of exercise ECG was obtained in 69% of patients with dyspnoea and 61% with fatigue (p < or = 0.05). CONCLUSIONS: Disorders of the gastrointestinal tract demonstrated particular intensity in patients with ISSc, with known shall owing of the peristaltic wave in the X-ray of the esophagus. Pulmonary changes were observed in HRCT and BAL, concerned mostly dSSc patients in whom fatigue was the major symptom. Patients who declared fatigue and dyspnoea had changes in exercise ECG, with no relation to the clinical presentation of SSc.