Factors conditioning pain control and reduction in post-cesarean section parturients: a cross-sectional study.

BACKGROUND: Pain experienced by women in the perinatal period constitutes a complex and multifaceted phenomenon. The aim of the study was to assess conditions of pain locus of control and pain reduction in post-cesarean section parturients. MATERIALS AND METHODS: A cross-sectional quantitative study with convenience sampling was performed among 175 hospitalized post-cesarean section women in hospitals in Eastern Poland in accordance with the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) statement. A self-design questionnaire regarding general information and obstetrics/gynaecology medical interview, The Pain Coping Strategies Questionnaire (CSQ) and The Beliefs about Pain Control Questionnaire (BPCQ) were used. The inclusion criteria were as follows (1) age of ⩾18 years old; (2) cesarean section (CS); (3) period from the 13th hour to the end of the 72nd hour after the procedure; and (4) informed consent. The data was analyzed with IBM SPSS Statistics. RESULTS: Internal locus of control (M = 14.02) was provided the highest value by the parturients and followed by chance events (M = 12.61) and doctors' power (M = 12.18). Dominant coping with pain strategies in the post-cesarean parturients were coping self-statements (M = 19.06), praying or hoping (M = 18.86). The parturients assessed their pain coping (M = 3.31) strategies along with pain reduction (M = 3.35) at the moderate level. Higher pain control was correlated with cognitive pain coping strategies (ß = 0.305; t = 4.632; p < 0.001), internal pain control ß = 0.191; t = 2.894; p = 0.004), cesarean section planning (ß = -0.240; t = -3.496; p = 0.001) and past medical history of CS (ß = 0.240; t = 3.481; p = 0.001). The skill of reduction of pain was positively associated with cognitive pain coping strategies (ß = 0.266; t = 3.665; p < 0.001) and being in subsequent pregnancy (ß = 0.147; t = 2.022; p = 0.045). Catastrophizing and hoping were related to lower competences of coping with pain (B = - 0.033, SE = 0.012, ß = - 0.206, T = -2.861). CONCLUSIONS: The study allowed for identification and better comprehension of factors conditioning pain control and pain reduction in parturients after the cesarean section. Furthermore, a stronger belief that pain can be dealt with is found in the parturients characterized by cognitive pain coping strategies and internal pain locus of control. The skill of reduction of pain is related to cognitive coping strategy and procreation status.

Synchronously occurring endometrioid carcinomas of the uterine corpus and uterine cervix preceded by different precancerous lesions: A case study and a literature review.

The incidence of two synchronous carcinomas originating from the uterine corpus and uterine cervix, both endometrioid subtypes, is exceedingly rare. Herein, we presented synchronous early stage G1 adenocarcinoma of the uterine corpus with cervical G2 endometrioid adenocarcinoma. Although both neoplasms displayed the same histological subtype, they differed significantly according to the histological grading or clinical stage of the disease. Finally, it is worth emphasizing that both tumors were preceded by different precancerous lesions, atypical endometrial hyperplasia (AEH) and foci of endometriosis localized within the uterine cervix. Although AEH is a well-known precancerous condition of endometrioid carcinoma, the mechanisms resulting in the malignant transformation of endometriosis foci to the cervical endometrioid carcinoma are still a matter of controversy. We briefly summarized the impact of different precancerous lesions on the development of synchronous female genital tract neoplasms with the same histotype.

Satisfaction with the life of Polish women experiencing domestic violence.

Introduction: Domestic violence against a woman, inflicted by her husband/partner, disrupts the socially recognized model of partnership and family life and endangers the health and life of the victim. The aim of the study was to assess the level of satisfaction with the life of Polish women experiencing domestic violence and compare it to results of women not experiencing domestic violence. Methods: A cross-sectional study was conducted on a convenience sample of 610 Polish women divided in two groups: victims of domestic violence (Group 1, n = 305) and women not experiencing domestic violence (Group 2, n = 305). Results and Conclusions: Most Polish women experiencing domestic violence are characterized by low life satisfaction. The mean value of life satisfaction in Group 1 was 13.78, SD = 4.88, significantly lower when compared to Group 2 (M = 21.04, SD = 5.61). Their satisfaction with life is related, among other things, to the form of violence inflicted upon them by their husband/partner. Abused women with low life satisfaction are most often victims of psychological violence. The most common cause is the perpetrator's addiction to alcohol and/or drugs. Assessment of their life satisfaction is unrelated to help-seeking and to the occurrence of violence in their family home in the past.

Hospital Ethical Climate and Job Satisfaction among Nurses: A Scoping Review.

The aim of this study was to map and summarize the published research findings on hospital ethical climate and its relationship with nursing staff job satisfaction as well as strategies proposed in the literature for the improvement of hospital ethical climate and job satisfaction through the actions of nursing staff in leadership positions. A scoping review has been performed in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension scoping reviews statement (PRISMA-ScR). Three electronic bibliographic databases were searched: the SCOPUS, Medline, and CINHAL Complete using a combination of keywords with the range of years 1994-2021. A total of 15 papers out of 235 records identified were eligible for the analysis. The literature review confirmed a significant relationship between ethical climate and job satisfaction of nurses. Furthermore, the interdependence of ethical climate and job satisfaction of nursing staff affects many different aspects including patients, co-workers, an organization and research. Identifying factors that influence ethical climate and job satisfaction as well as the relationship between these variables may help to reduce the dropout concerning a change of profession among nursing staff.

Doctoral programmes in the nursing discipline: a scoping review.

BACKGROUND: This study aimed to map and summarise the state of the research regarding doctoral programs in nursing, as well as the issues debated in the context of nursing doctoral education. A Scoping Review in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension scoping reviews statement (PRISMA-ScR) was conducted. Three electronic bibliographic data bases were searched: Cumulative Index to Nursing and Allied Health Literature Complete, Medline (on EBSCO Host) and SCOPUS to identify empirical studies published between January 2009 and December 2019. The review process was based on framework identified by Arksey and O'Malley and further revised by Levac and colleagues. Analysis was performed with the use of the Donabedian framework regarding the structure of the doctorate programmes, the process, and the outcomes. RESULTS: The review included 41 articles, mostly originating in the United States (n=26) and Europe (n=8), mainly by collecting the perceptions of students and faculty members with descriptive studies. The following issues were investigated at the (a) structure level: Prerequisite for doctoral candidates, Qualifications of faculty members, Mission of doctoral programs; (b) process level: Doctoral programs contents, Doctoral programs resources and quality, Mentoring and supervision, Doing doctorate abroad; and (c) outcome level: Academic performance outcomes in doctoral programs, Doctoral graduates' competences, Doctoral students/graduates' satisfaction, Doctoral graduates' challenges. CONCLUSIONS: Doctoral programs have mainly been investigated to date with descriptive studies, suggesting more robust research investigating the effectiveness of strategies to prepare future scientists in the nursing discipline. Doctorates are different across countries, and there is no visible cooperation of scholars internationally; their structure and processes have been reported to be stable over the years, thus not following the research development in nursing, discipline and practice expectations. Moreover, no clear framework of outcomes in the short- and long-term have been established to date to measure the quality and effectiveness of doctorate education. National and global strategies might establish common structure, process and outcome frameworks, as well as promote robust studies that are capable of assessing the effectiveness of this field of education.

Perception of health, health behaviours and the use of prophylactic examinations in postmenopausal women.

BACKGROUND: Pro-health behaviours aim at disease prevention, recovery from an illness and maintenance of good health in a physical, mental and social sphere. The study had two main objectives: (a) to analyse health behaviours of postmenopausal women and their understanding of the notion of health, and (b) to analyse the relationship between individual categories of health behaviours and prophylactic activities undertaken by postmenopausal women. METHODS: A cross-sectional study was conducted among a convenience sample of 510 postmenopausal women. Three study instruments were used: an original questionnaire and two instruments designed by Juczynski: the List of Health Criteria and the Health Behaviour Inventory. RESULTS: In the view of the respondents health was primarily synonymous with a feature, because the following three associations were given the highest priority when defining health: to be healthy means 'have all body parts functioning well' (M = 1.82), 'do not experience any physical problems' (M = 1.43) and 'not be sick, only occasionally suffer from flu, cold or indigestion'. The score for health behaviours was average (M = 86.18). The highest score was achieved in the area of prophylactic behaviours. General indicator of health-related behaviours was higher in women who rated their health as very good (p < 0.05). Women whose general indicator of health-related behaviours was higher regularly performed prophylactic gynaecological examinations (p < 0.05). CONCLUSIONS: Results showed that women after menopause treat health mainly as a feature of their body and condition specific for this period of life. The analysis of postmenopausal women's health behaviours and their perception of health helped to identify areas that require the focus of medical personnel in regard to health promotion and prophylaxis. The average general indicator of health-related behaviours is positive for this group of women as it shows that they care about their health, especially in terms of prophylaxis.

Attitudes of Teenage Mothers towards Pregnancy and Childbirth.

The problem of early motherhood is still a serious medical and social problem in many countries around the world. The aim of this study was to analyze the attitudes of teenage mothers towards pregnancy and childbirth. A retrospective cross-sectional study was conducted with the use of an original questionnaire containing a test to measure attitudes on a five-point Likert scale and a Life Orientation Test-Revised (LOT-R) to assess dispositional optimism. The study involved 308 teenage mothers between 13 and 19 years of age. Attitudes of teenage mothers towards pregnancy and childbirth were more often positive (90.6%) than negative (9.4%). Sociodemographic features determining the attitudes of teenage mothers towards both their pregnancy and childbirth included their age, marital status, current occupation, and main source of income. The type of attitude adopted by teenage mothers towards pregnancy and childbirth was significantly related to the level of their dispositional optimism.

Conscientious object in nursing: Regulations and practice in two European countries.

BACKGROUND: The concept of conscientious objection is well described; however, because of its nature, little is known about real experiences of nursing professionals who apply objections in their practice. Extended roles in nursing indicate that clinical and value-based dilemmas are becoming increasingly common. In addition, the migration trends of the nursing workforce have increased the need for the mutual understanding of culturally based assumptions on aspects of health care delivery. AIM: To present (a) the arguments for and against conscientious objection in nursing practice, (b) a description of current regulations and practice regarding conscientious objection in nursing in Poland and the United Kingdom, and (c) to offer a balanced view regarding the application of conscientious objection in clinical nursing practice. DESIGN: Discussion paper. ETHICAL CONSIDERATIONS: Ethical guidelines has been followed at each stage of this study. FINDINGS: Strong arguments exist both for and against conscientious objection in nursing which are underpinned by empirical research from across Europe. Arguments against conscientious objection relate less to it as a concept, but rather in regard to organisational aspects of its application and different mechanisms which could be introduced in order to reach the balance between professional and patient's rights. DISCUSSION AND CONCLUSION: Debate regarding conscientious objection is vivid, and there is consensus that the right to objection among nurses is an important, acknowledged part of nursing practice. Regulation in the United Kingdom is limited to reproductive health, while in Poland, there are no specific procedures to which nurses can apply an objection. The same obligations of those who express conscientious objection apply in both countries, including the requirement to share information with a line manager, the patient, documentation of the objection and necessity to indicate the possibility of receiving care from other nurses. Using Poland and the United Kingdom as case study countries, this article offers a balanced view regarding the application of conscientious objection in clinical nursing practice.

Stress urinary incontinence after labor and satisfaction with sex life.

OBJECTIVES: The aim of the study was to assess the incidence of stress urinary incontinence in women after labor, its determinants,and to establish its effect on women's satisfaction with their sex lives. MATERIAL AND METHODS: The research implemented the Gaudenz-Incontinence-Questionnaire and the Sexual Quality ofLife-Female scale (SQoL-F). The principal inclusion criterion was the time of 3 to 6 months after labor. RESULTS: The research was carried out amongst 193 women. Thirty-two of the participants (16.6%) showed symptoms ofstress urinary incontinence after labor that were statistically correlated with the number of experienced labors (p = 0.044)and the newborn's weight (p = 0.016). The participants' sex life satisfaction was on average 75.47 ± 24.68. The respondentssuffering from stress urinary incontinence obtained a significantly lower (p = 0.006) average score for general sex life satisfaction(64.38 ± 26.15) when compared with women without symptoms of stress urinary incontinence (77.67 ± 23.86). CONCLUSIONS: The problem of incontinence after labor affected one in six women. Occupation, number of pregnancies,damage to the perineum during labor, and the infant's birth weight significantly dependent on the incontinence occurrenceafter labor. The onset of incontinence symptoms in women in the reproductive age has an adverse effect on theirsex life satisfaction.

Predicted difficulties, educational needs, and interest in working in end of life care among nursing and medical students.

BACKGROUND: The need to provide care for the dying patient and his/her family may occur in every medical setting. Newly graduated nurses and physicians should therefore be prepared to deliver it at a high-quality level. OBJECTIVES: To explore (a) the primary difficulties participants anticipate they will encounter whilst working with dying patients, (b) their interest in developing competencies in caring for dying patients, and (c) their interest in working in palliative/hospice settings or with dying patients in the future. DESIGN: A cross-sectional study. SETTINGS: A medical university in Poland. PARTICIPANTS: Convenience sample of nursing (=112) and medical students (=101) at the end of their undergraduate education. METHODS: Questionnaire distributed online and in hard-copy format. RESULTS: Half of the participants anticipated experiencing various emotional and professional difficulties in caring for dying individuals, especially medical students. These difficulties pertained mostly the reaction of family members to the patient's death, addressing the psychological needs of the dying person, and coping with his/her own emotions when dealing with the patient's death. Students reported that working with dying patients could cause occupational stress - more so among medical students. The majority of them showed an interest in improving knowledge regarding palliative care and also in this case this was mostly true of medical rather than nursing students. However, more than half of the participants preferred avoiding work in palliative/hospice settings, with no differences between the two groups. Participants attributed this attitude to two factors: (a) the desire to avoid negative emotions and stress that could be triggered by dealing with death and dying; and (b) because they felt they lacked the required skills and personal abilities to handle such situations. CONCLUSIONS: Undergraduate curricula that include strategies for coping with negative emotions associated with facing the process of death and dying should be developed. Interprofessional education should be encouraged, especially regarding the psychosocial aspects of end-of-life care.

Place of residence and age as variables differentiating health behaviours and perception of health by women past menopause.

INTRODUCTION: Research on the meaning of health and health behaviors is important for the development of health education programmes which should be tailored to the needs of patients. OBJECTIVE: The aim of the study is to determine whether the place of residence and age have an impact on health behaviours and the perception of health by women past menopause. MATERIAL AND METHODS: A survey method and three research instruments were employed: authors' questionnaire, the Health Behaviour Inventory and the Health Criteria List by Juczynski, and the Kupperman Index. The study was carried out among a sample of 102 women after menopause hospitalised in a hospital in eastern Poland. RESULTS: The overall health behaviour indicator (HBI) in the study group was found to reach an average value of 80.1±12.7points. A higher HBI indicator was found to be characteristic of urban rather than rural residents; however, there was no statistically significant difference (p>0.05). The age of respondents did not differentiate statistically their health behaviours (p>0.05). Women who reported their last menstruation before the age of 50 obtained higher results in the dimension of health practices (HPs) than those whose last menstruation ceased after the age of 50 (p<0.05). The respondents attributed the highest importance to health, understood as a property, a state and a goal. Statistically significant differences were observed in the importance of the statement according to which health is a process of "being able to work without tension and stress", as the respondents from urban areas assigned to it a higher average weight than those from rural areas (p< 0.05). CONCLUSIONS: A higher overall HBI, as well as indicators for particular categories, were characteristic of women from urban areas. Age did not significantly differentiate the women's health behaviours. Rural residents were dominant in the group of women who rated their health to be very good or good. The respondents attributed the highest importance to health understood as a property, state and goal.

Age discrimination in healthcare institutions perceived by seniors and students.

BACKGROUND:: Old age-based discrimination is observed as the most tolerated prejudice in society and has also been witnessed in healthcare institutions. AIMS:: The aim of this study is to explore age-based discrimination in healthcare institutions as perceived by seniors and students of Medicine and Nursing. RESEARCH DESIGN:: A multi-method study design, by involving a triangulation design. PARTICIPANTS AND RESEARCH CONTEXT:: A purposeful sample of individuals aged 65+ (n = 80) and medical and nursing students (n = 100) in the eastern region of Poland. ETHICAL CONSIDERATIONS:: Ethical approval of the research protocol was received from the Ethics Committee at the Medical University of Lublin. FINDINGS:: 'Old age' was perceived by groups of participants based on three themes: (a) positive, (b) negative and (c) neutral connotations. The negative connotations predominated. The beginning of old age was defined by the metric of age and described by showing the complexity of the ageing process involving subjective, objective and societal aspects. Experience of age discrimination in healthcare institutions was reported by 24 (30%) seniors and witnessed by 47 (47%) students surveyed and for both groups occurred mainly at the hospital level and by physicians. Only 48 students (48%) declared a willingness to work with the older people in the future, and barriers were reported at the personal and professional levels, and also in some visions of older people. CONCLUSION:: The conceptualization of old age as reported by seniors and students mainly carried negative connotations, reflecting the profoundly based stereotypes within society regarding the older people. Seniors have reported being exposed to ageism and have witnessed ageism episodes in HCIs; also, students have faced ageism episodes during their clinical education. There is a need for ethical education within medical and nursing courses to shape positive attitudes towards the older people. A positive vision of ageing should be promoted not only among young people but also among adults and older people to avoid self-stereotyping of older people and seeing old age from negative perspective.

Evaluation of the health behaviors of women in multiple pregnancies - a preliminary study.

OBJECTIVES: The aim of the paper was to assess which health behavior indicators were characteristic for women with a multiple pregnancy. MATERIAL AND METHOD: The study involved 35 women in multiple pregnancies. The inclusion criteria were: the completion of the 22nd week of pregnancy (22 Hbd, i.e., 22 weeks and 1/7) and the consent of the women to participate in the study. We used an original questionnaire devised by us specifically for our study, as well as a standardized research tool, Juczynski's Health Behavior Inventory questionnaire, for the assessment of the pregnant women's health behaviors. RESULTS: The overall rate of health behaviors was high and was on average 93.9 ± 10.8 points (7 sten scores). Indicators of the health behaviors of women in multiple pregnancies were high across all categories. However, the highest rate was observed in preventive behaviors. CONCLUSIONS: The overall rate of health behaviors of women with a multiple pregnancy and all the individual behavior category indicators were high. However, the highest rate was for preventive behaviors. The indicator values of the health behaviors of the pregnant women in the study were not dependent on the variables adopted in this paper.

Psychosocial problems of women with stress urinary incontinence.

OBJECTIVE: The aim of the study was evaluation of the influence of stress urinary incontinence on women's quality of life. MATERIAL AND METHOD: The study covered 275 women between 30-65 years of age. The study was conducted using the following tools: Gaudenz Questionnaire, King's Health Questionnaire (KHQ), Female Sexual Function Index (FIFI) Questionnaire, and a questionnaire devised by the authors of the study. RESULTS: The study shows that the disease has a negative effect on evaluation of the quality of thee women's lives. The symptoms of stress urinary incontinence had a significant influence on the feeling of emotional comfort, social and professional activity of the surveyed women - respectively p= 0.000; p=0.000; p=0.000. Nearly every third woman (28.7%) felt great mental discomfort related to the disease symptoms, 31.7% a considerable discomfort, 33.1% a moderate, and very few women (6.5 %) claimed that the disease had a minimal effect on their emotional state. About two-thirds of the surveyed women (68.7%) were sexually active, and the remaining 31.3% declared the lack of sexual intercourse. CONCLUSIONS: The occurrence of stress urinary incontinence symptoms affects the quality of life of women, especially their mental state and interpersonal contacts. Most women with the symptoms of stress urinary incontinence fulfill their sexual needs; however, many of them do not feel complete satisfaction with their sex life.

[The influence of pregnancy on sexual satisfaction among women]. / Wplyw ciazy na odczuwanie satysfakcji seksualnej kobiet.

OBJECTIVE: The purpose of study was to investigate if and to what extent pregnancy affects sexual satisfaction of women. MATERIAL AND METHOD: A group of 130 pregnant women were surveyed.Ihe women were seen for check-ups in a randomly chosen out-patient clinic for women over the period of 6 months in 2007. They responded to a questionnaire constructed for the purpose of the survey. RESULTS: More than half respondents (52.3%) presented positive attitude towards sexuality associating sex with pleasure; the rest (40.7%) perceived having sex as dutiful activity to their partners. Negative experience caused by sexual activity was mentioned by 6.9% respondents, having sex was annoying for them. The freguency of sexual contacts was evaluated as too small by 98 (75.3%) and 82 (63.1%) respondents in the first and second tnmesters respectively. Satisfactory intimate relationships before pregnancy were reported by 86.1% women however in the first trimester of pregnancy 68.5% women had highly satisfactory sex with their partners which increased by 17.6% in the second trimester CONCLUSIONS: 1. Pregnancy decreases sexual satisfaction of women during the first Trimester of pregnancy. 2. Decreased satisfaction of having sex during the first trimester of pregnancy results from adaptative processes that are manifested as lowered mood experienced at that time. 3. In the second trimester when the pregnant woman begins to feel better, her satisfaction of having sex improves.

The role of age, environmental and occupational factors on semen density.

UNLABELLED: The problem of effect of the environment on human reproduction has been in the focus of researchers' interest for many years. OBJECTIVE: To examine the relationship between semen density in males with reproduction problems, and their age, living and working conditions. MATERIAL AND METHOD: The study covered 224 males with reproduction problems. The study had a prospective character and was conducted in three stages - the first stage was carried out using the questionnaire devised by the authors; the second and the third stages consisted in the examination and evaluation of male semen density. Statistical analysis was used to search for the relationship between these groups and variables adopted in the study, i.e. age, occupation performed, place of residence, self-reported housing conditions and material standard, reporting by the males in the study of arduousness of work or health hazards perceived by the males examined, and duration of employment in such conditions. RESULTS: The males in the study were divided into three groups according to their semen density. Group I (20 × 10(6) mln/ml or more) included 62 (27.7%) respondents, Group II (below 20 × 10(6) mln/ml) covered 121 males (54.0%), while Group III (only single spermatozoa or none) - 41 males (18.3%). Male semen density are significantly correlated with men's ages and jobs as well as the general evaluations of the jobs held by the men (p<0.05). No significant relationship is observed between living conditions, arduous work conditions and occupational hazards as perceived by males, or duration of employment in such conditions, and male semen density (p>0.05). CONCLUSIONS: The results obtained encourage continuation of the studies and cover a larger group of males with reproduction problems.

[Awaiting elective gynecological surgery--opinions of patients]. / Oczekiwanie na planowana operace ginekologiczna w ocenie kobiet.

PURPOSE: To establish if and to what extend women find the time of waiting for an elective gynecological operation difficult, how it is manifested and what the conditioning factors are. MATERIAL AND METHOD: The investigation was carried out in the group of 272 women who during two months of 2008 were admitted to one of the four selected hospitals for an elective gynecological operation. A questionnaire has been designed solely for the purpose of the pilot study 25 women participated in the study. RESULTS: The respondents reported 717 concerns that occurred within the period of waiting for the surgery; the most frequent among them were fear of being diagnosed with cancer (27.6%), postoperative pain (26.7%) postoperative complications (19.1%). More than half of the respondents (58.5%) waited for the surgery for 2-3 months or longer. Every fifth woman complained about problems with being admitted to hospital and every fourth woman expected emotional support from medical staff. 91.2% respondents had searched for additional information about their disease. CONCLUSIONS: 1. Waiting for elective gynecological operation may create a difficult situation for many women what was confirmed by a vast number and nature of their concerns, frequent expectations of emotional support and search for additional information about their disease. 2. Problems with being admitted to a health care institution and long period of waiting for the operation (> 1 month) are quite common and these factors may contribute to further worsening of the quality of patients' life during the preoperative period. 3. Demographic parameters assumed for the purpose of this analysis do not differentiate the parameters tested, with the exception of the place of inhabitance factor that turned out to be associated with the expectations of emotional support. 4. The degree of hospital reference significantly differentiates tested parameters.