Specificity of quality of life assessment in people with mental disorders. / Specyfika oceny jakosci zycia u osób z zaburzeniami psychicznymi.

Quality of life is an integral element of a new perspective on health. Even though the definition and structure of the concept of quality of life are still being debated, researchers exploring the topic agree that it has both objective and subjective dimensions. When the quality of life of patients is examined somatically, the objectives formulated in the study procedure are usually easily achieved, particularly when the basic hypothesis is that good physical health generates a high quality of life. However, where mental diseases and dysfunctions are investigated, and the analysis involves a large number of variables constituting quality of life, the relationship is not so clear-cut. Consequently, in addition to methodological accuracy the researcher must put a major focus on the patients and their manifestations. The thesis stating that it is impossible to measure quality of life in this population, or worse still, that there is no need for such measurements, is indefensible, considering that people with mental disorders have the same right to a good life as healthy individuals, and achieving an improvement in their quality of life becomes an increasingly common target among anticipated therapeutic benefits. Looking at the issue from the perspective of findings obtained in multiple studies, it is evident that quality-of-life measurements are not easy, but a successful attempt may provide researchers with a source of valuable non-clinical data and even enhance their personal satisfaction.

Legal and medical aspects associated with the use of direct coercion by emergency medical teams in the light of the applicable law. / Prawno-medyczne aspekty zastosowania przymusu bezposredniego przez zespoly ratownictwa medycznego w swietle obowiazujacego prawa.

According to Article 68 sections 1 and 2 of the Constitution of the Republic of Poland everyone has the right to health protection. In line with this provision, the Act of 8 September 2006 on the State Emergency Medical Services imposes an obligation on emergency medical teams to provide assistance to "every person experiencing an emergency health condition." The catalogue of medical events and accompanying clinical situations in which emergency medical teams intervene is constantly growing. A significant percentage of such situations are calls for assistance to people with mental disorders or psychomotor agitation, often with reduced ability to recognize the nature of their actions, whose aggressive behavior is directed both to themselves and to others. Providing the managers of the basic emergency medical teams with the competence to apply and supervise direct coercive measures on their own represents asignificant increase in their powers. In addition, it is asignificant organizational improvement since, until now, emergency medical teams have not been able to intervene effectively in situations requiring assistance without the help of a physician, and have had to call in ateam of specialists. Furthermore, granting paramedics, expressis verbis, the status of 'public officers'in connection with the performance of their duties is a desirable legislative measure since it strengthens the protection of this professional group, especially because rescue operations often take place without the patient's consent or with the patient's active resistance. The article contains an overview of current legal regulations concerning the use of direct coercion by emergency medical teams.