Factors Determining the Level of Acceptance of Illness and Satisfaction with Life in Patients with Cancer.

INTRODUCTION: Cancer threatens life and brings about many negative emotions in patients, which influence their satisfaction with life and contribute to a low level of their acceptance of illness. This is why the acceptance of illness is a serious problem among patients with cancer; contributes to the intensification of symptoms; and influences the patient's physical, mental, emotional, social, and spiritual condition. AIM: The purpose of this work is to assess the acceptance of illness and satisfaction with life in patients with cancer, as well as to identify social, demographical, and clinical factors that significantly differentiate their acceptance of illness and satisfaction with life. MATERIALS AND METHODS: The study involved 120 patients with cancer aged 18 to 88. The study was conducted in the form of a questionnaire based on standard research tools: Acceptance of Illness (AIS), Satisfaction with Life Scale (SWLS), and Numerical Rating Scale (NRS). Social, demographical, and clinical data were collected in the original questionnaire. RESULTS: A group of 120 patients was studied, including 55.83% (n = 67) women and 44.16% (n = 53) men. The average age was 56. A general acceptance-of-illness index obtained by the patients was 21.6 ± 7.32 and a general satisfaction-with-life index was 19.14 ± 5.78. The statistical analysis indicated a significant correlation between the acceptance of illness and the intensity of pain (rHO = -0.19; p < 0.05), fatigue ((Z = 1.92; p > 0.05), and diarrhoea (t(118) = 2.54; p < 0.05). The correlation between the intensity of pain and satisfaction with life was negative (rHO = -0.20; p < 0.05). CONCLUSION: The greater acceptance of illness, the greater satisfaction with life in patients with cancer. Pain, fatigue, and diarrhoea decrease the acceptance of illness. In addition, pain decreases the level of satisfaction with life. Social and demographical factors do not determine the level of acceptance of illness and satisfaction with life.

Patients' Perceptions of Experiences of Postoperative Chest Drain Tube Insertion: A Pilot Survey.

BACKGROUND: Pleural drainage is a routine procedure conducted after thoracotomy and thoracoscopy. It is used to remove air or excess fluid from a pleural cavity and enables proper lung expansion. Essential elements of care provided during hospitalization and treatment include meeting patients' growing expectations and continually improving quality while optimizing safety. AIM: This study aimed to explore patients' experiences with pleural drainage after thoracic surgery and their correlation with socio-demographic data. METHODS: A pilot survey with an exploratory design was conducted at a large teaching hospital in Poland, in the Department of Thoracic Surgery at the University Clinical Centre in Gdansk. The study involved the analysis of 100 randomly selected subjects with a chest tube drain. A self-designed questionnaire was used to collect social, demographic, and clinical data. Twenty-three questions related to experiences with pleural drainage, ailments, limitations in daily functioning, and security with a chest tube were evaluated using a 5-point Likert scale. Patients completed the questionnaire on the third postoperative day. RESULTS: Individuals fitted with a traditional water-seal drainage system felt safer than those from the digital drainage group (p = 0.017). Statistically significant differences were found in the assessment of nursing assistance (p = 0.025); the number of satisfied patients was greater in a group of unemployed people. No correlation was found between demographic and social factors and the patients' sense of security (gender: p = 0.348, age: p = 0.172, education level: p = 0.154, professional activity: p = 0.665). CONCLUSIONS: Demographic and social characteristics did not significantly affect patients' sense of safety with chest drainage types. Patients with traditional drainage felt significantly safer than patients with digital drainage. Patient knowledge of pleural drainage management was not satisfactory, with a number of patients indicating a lack of knowledge in this area. This is important information that should be considered when planning measures to improve the quality of care.

Assessment of Oral Health in Long-Term Enteral and Parenteral Nutrition Patients: Significant Aspects of Nursing Care.

Oral health is an underestimated factor affecting overall human health and quality of life. Long-term enteral or parenteral nutritional treatment requires not only regular assessment of access routes, the patient's nutritional status, and tolerance to the selected method of nutrition but also of oral health. This article discusses the connections between the influence of chewing function, salivation, and xerostomia on the health of the oral cavity of patients on long-term enteral and parenteral nutrition. In addition, the role of nurses in assessing oral health is presented as well as crucial elements of a comprehensive oral assessment in a nursing care plan. Patients receiving long-term enteral and parenteral nutrition have an increased risk of developing oral diseases. Increasing knowledge about the factors affecting oral health among nurses is crucial to provide appropriate care for patients requiring long-term nutritional treatment with omission of the natural route of food intake. Regular assessment of oral health by nurses should be an important aspect in long-term nutritional treatment recommendations.

COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) currently constitutes the leading and overwhelming health issue worldwide. In comparison with adults, children present milder symptoms, with most having an asymptomatic course. We hypothesized that COVID-19 infection has a negative impact on the continuation of chemotherapy and increases nonrelapse mortality. MATERIAL AND METHODS: This study was performed to assess the course of SARS-CoV-2 among children with hematological or oncological malignancies and its impact on cancer therapy. Records of SARS-CoV-2 infection in 155 children with malignancies from 14 Polish centers for pediatric hematology and oncology were collected and analyzed. RESULTS: SARS-CoV-2 replication was observed in 155 patients. Forty-nine patients were symptomatic, with the following being the most common manifestations: fever (31 patients), gastrointestinal symptoms (10), coryza (13), cough (13) and headache (8). In children who were retested, the median time of a positive PCR result was 16 days (range 1-70 days), but 12.7% of patients were positive beyond day + 20. The length of viral PCR positivity correlated with the absolute neutrophil count at diagnosis. Seventy-six patients did not undergo further SARS-CoV-2 testing and were considered convalescents after completion of isolation. Antibiotic therapy was administered in 15 children, remdesivir in 6, convalescent plasma in 4, oxygen therapy in 3 (1-mechanical ventilation), steroids in 2, intravenous immunoglobulins in 2, and heparin in 4. Eighty patients were treated with chemotherapy within 30 days after SARS-CoV-2 infection diagnosis or were diagnosed with SARS-CoV-2 infection during 30 days of chemotherapy administration. Respiratory symptoms associated with COVID-19 and associated with oxygen therapy were present in 4 patients in the study population, and four deaths were recorded (2 due to COVID-19 and 2 due to progressive malignancy). The probability of 100-day overall survival was 97.3% (95% CI 92.9-99%). Delay in the next chemotherapy cycle occurred in 91 of 156 cases, with a median of 14 days (range 2-105 days). CONCLUSIONS: For the majority of pediatric cancer patients, SARS-CoV-2 infection does not result in a severe, life-threatening course. Our data show that interruptions in therapy are common and can result in suboptimal therapy.

Preliminary Results of Highly Injectable Bi-Phasic Bone Substitute (CERAMENT) in the Treatment of Benign Bone Tumors and Tumor-like Lesions.

BACKGROUND: CERAMENT™|BONE VOID FILLER is an injectable and moldable ceramic bone substitute material intended for bone voids. The material consists of hydroxyapatite and calcium sulfate hemihydrate. The aim of this study is to present the first long-term results following open curettage of benign bone tumors and tumor-like lesions and void filling with this novel injectable and synthetic bone graft. METHODS: Thirty three patients were enrolled into the study between June 2013 and October 2014 .Totally, we treated 24 women and 9 men with a median age of 47 years (range: 22-74). All patients suffered from primary musculoskeletal system disorders (enchondroma 63,6%, giant cell tumor 18%, aneurysmal bone cyst 9%, fibrous dysplasia 9%, Gaucher disease 3%). We performed curettage of pathological lesions, then the bone substitute was administered by means of needle to the void. RESULTS: The average follow-up was 13 months (range: 2-13 months, median 10 months). No metastasis or recurrence had been detected. We received significant clinical improvement relating to VAS, MSTS, and oncological results. CONCLUSIONS: The results of our study report that CERAMENT can be successfully used as a bone substitute in patients with various bone diseases, as well as benign bone tumors. CERAMENT can provide an effective and long-term solution for reconstructive procedures following curettage of bone tumors and tumor like lesions.

PARP-1 expression in CD34+ leukemic cells in childhood acute lymphoblastic leukemia: relation to response to initial therapy and other prognostic factors.

Poly(ADP-ribose) polymerase-1 (PARP-1) is a nuclear protein that impacts DNA repair and apoptosis. Both experimental and ongoing clinical studies indicate that PARP-1 inhibitors are potent and promising anticancer agents. However, the outcome of treatment with PARP-1 inhibitors depends on the expression of PARP-1 protein in the tumor cells. This study aimed to assess PARP-1 expression in peripheral blood CD34+ leukemic cells before and after 12 hours of prednisone administration as well as the relation between PARP-1 expression and early treatment response to initial therapy and other prognostic factors (immunophenotype, age, initial peripheral blood white blood count [WBC], and risk factor group). The study comprised 43 children with de novo ALL. Cytospins of peripheral blood were stained with mouse anti-CD34-FITC and anti-PARP-1 antibody followed by goat anti-mouse APC-conjugated antibody. DNA was counterstained with PI (propidium iodide). Cellular fluorescence was measured by a laser scanning cytometer. Statistically significant differences in baseline PARP-1 expression with respect to early treatment response (good vs. poor), ALL immunophenotype (ALL B vs. ALL T), age (children < 1 years and > 6 years vs. children 1-6 years), initial WBC (< 20 000/µl vs. ≥ 20 000/µl), and risk factor group (SR vs. IR vs. HR) were not found. PARP-1 expression was increased 12 hours after treatment in poor early treatment responders, whereas it remained statistically unchanged with respect to ALL immunophenotype, age, initial WBC, risk factor group and early treatment response. The overexpression of PARP-1 in poor early treatment responders suggests that it may contribute to treatment failure in this group of children with ALL. Our observation - if confirmed by other studies - may form the rationale for administration of PARP inhibitors in selected subsets of ALL children.

The influence of social support from the family on health related-quality of life in persons with a colostomy.

PURPOSE: We evaluated the influence of social support on health-related quality of life (HRQOL) in persons with a colostomy, taking into account time since surgery. SUBJECTS AND SETTINGS: The study was conducted in 8 cities in Poland. The sample comprised 128 patients with a colostomy; their mean age was 66.24 years. Forty-five percent of participants had lived with a colostomy for more than 5 years, and 16% had a colostomy for less than 1 year. INSTRUMENTS: The questionnaire used in the study included 76 questions divided into 3 parts. The first part comprised 8 questions that queried demographic characteristics. Parts 2 and 3 included 2 validated scales assessing HRQOL and social support, respectively. Health-related quality of life was assessed using the Functional Assessment of Cancer Therapy-Colorectal instrument. Social support received was assessed using the Berlin Social Support Scale. In the case of both scales, the respondents were asked to assess their status during the last 7 days. METHODS: The study was conducted by an interviewer during monthly meetings of colostomy support groups as well as during hospitalization. The respondents gave their verbal answers to questions read by the interviewer or completed the questionnaires by themselves. After the questionnaire was completed, the interviewer verified completeness of answers. The outcome time elapsed since surgery was categorized as 3 subgroups: (1) respondents having a colostomy 1 year or less, (2) respondents having colostomy for more than 1 or up to 5 years, and (3) respondents having colostomy more than 5 years. RESULTS: Analysis revealed a statistically significant relationship between level of social support and HRQOL among persons with a colostomy (R = 0.361, P = .000029). Moreover, we observed that the time elapsed since colostomy surgery influenced this relationship. Level of social support and HRQOL were not significantly related in persons living with a colostomy ≤1 year (R = 0.155, P = .525). The correlation was significant in persons with a colostomy for more than 1 to but less than 5 years (R = 0.329, P = .02), and in individuals living with a colostomy for more than 5 years (R = 0.482, P = .0001). CONCLUSIONS: Persons with permanent colostomies and the higher level of social support from family reported higher HRQOL than did persons with lower levels of social support. Time elapsed since colostomy surgery exerts a positive effect on this relationship; the longer the patients live with a colostomy, the greater the influence of social support.

Psychometric properties of the Polish version of the Multidimensional Fatigue Inventory-20 in cancer patients.

CONTEXT: Multidimensional questionnaires estimating cancer-related fatigue (CRF) as a symptom cluster or a clinical syndrome primarily have been used and validated in English-speaking populations. However, cultural issues and language peculiarities can affect CRF assessment OBJECTIVES: The main aims of this study were to evaluate the psychometric properties of the Polish version of the Multidimensional Fatigue Inventory-20 (MFI-20) and to deliver to clinicians a multidimensional tool for CRF assessment in Polish-speaking patients with cancer. METHODS: After forward-backward translation procedures, the Polish version of MFI-20 was administered to 340 cancer patients. The Polish MFI-20 was appraised in terms of acceptability, reliability, and validity. Internal consistency was assessed by calculating Cronbach's alpha coefficients. Structural validity was evaluated with confirmatory factor analysis. RESULTS: The translated MFI-20 was well accepted; 90% of subjects fully completed the questionnaire. The overall Cronbach's alpha coefficient was 0.9, ranging from 0.57 to 0.81. All correlation coefficients among Numeric Rating Scale-fatigue, fatigue-related items from the European Organization for Research and Treatment of Cancer Quality of Life Core-30 questionnaire, and the MFI--20 were statistically significant (P < 0.001). Confirmatory factor analysis demonstrated good structural validity and revealed only three dimensions in the Polish version of the MFI-20-physical and mental fatigue as well as reduced motivation. CONCLUSION: The Polish version of the MFI-20 is well accepted by patients, reliable, and a valid instrument to assess CRF in Polish cancer patients.