Stigmatization among Patients with Plaque Psoriasis

The aim of the study was to analyze the level of stigmatization among patients with plaque psoriasis according to their demographic and clinical characteristics. The study included 122 patients who completed the 6-item and 33-item Feelings of Stigmatization Questionnaire and a sociodemographic survey. The analysis of the 6-item Stigmatization Scale showed a mean stigmatization score of 6.4 points. (Me = 6; s = 3.7); the mean score for the 33-item scale was 81.3 points (Me = 79.5; s = 19.9). Female patients felt stigmatized more often than males. Respondents living in the countryside had a stronger sense of stigmatization in the Sensitivity to Others' Attitudes (p = 0.0238) and Secretiveness (p = 0.0234) domains. The presence of psoriatic lesions across the entire body was the only explanatory variable significantly determining the level of stigmatization in the Positive Attitudes domain, either through the main effect or through the interaction with the patient sex. A highly significant difference was found for the feeling of being flawed domain (p = 0.044), with a mean score of 13.4 points. The issue of stigmatization in psoriasis deserves more attention, as the analysis of this problem may provide a better insight into the effect of the disease on the patient's condition, not merely in the context of its clinical manifestation.

Effect of the Lights4Violence intervention on the sexism of adolescents in European countries

Background

Sexism results in a number of attitudes and behaviors that contribute to gender inequalities in social structure and interpersonal relationships. The objective of this study was to evaluate the effectiveness of Lights4Violence, an intervention program based on promoting health assets to reduce sexist attitudes in young European people.

Methods

We carried out a quasi-experimental study in a non-probabilistic population of 1146 students, aged 12–17 years. The dependent variables were the difference in the wave 1 and wave 2 values in the subscales of the Ambivalent Sexism Inventory: benevolent sexism (BS) and hostile sexism (HS). The effect of the intervention was evaluated through linear regression analyses stratified by sex. The models were adjusted by baseline subscales scores, socio-demographic and psychological variables.

Results

In girls, we observed a decrease in BS in the intervention group compared to the control group (β = − 0.101; p = 0.006). In the wave2,, BS decreased more in the intervention group compared to the control group in girls with mothers with a low level of education (β = − 0.338; p = 0.001), with a high level of social support (β = − 0.251; p < 0.001), with greater capacity for conflict resolution (β = − 0.201; p < 0.001) and lower levels of aggressiveness (β = − 0.232, p < 0.001). In boys, the mean levels of HS and BH decreased in wave 2 in both the control and intervention groups. The changes observed after the wave 2 were the same in the control group and in the intervention group. No significant differences were identified between both groups.

Conclusions

The implementation of the Lights4Violence was associated with a significant reduction in BS in girls, which highlights the potential of interventions aimed at supporting the personal competencies and social support. It is necessary to reinforce the inclusion of educational contents that promote reflection among boys about the role of gender and the meaning of the attributes of masculinity.

Trial registration

Clinicaltrials.gov : NCT03411564. Unique Protocol ID: 776905. Date registered: 26-01-2018.

Evaluation of the lights4violence program: reduction in machismo and acceptance of violence among adolescents in Europe

Background

Machismo and acceptance of violence (AV) against women are part of the social construction of hegemonic masculinity and are related to the risk of dating violence. This study aims to analyze the effectiveness of the Lights4Violence program in reducing machismo and AV in secondary school students from different European cities.

Methods

Quasi-experimental longitudinal study using a convenience sample of 1,146 high school students from different European cities (12–17 years old) including 575 intervention group students (59.1% girls) and 571 control group students (62.7% girls). We performed linear regression models to identify the effect of the intervention, modelling the difference in means in machismo and AV (dependent variables) between wave-2 and wave-1.

Results

An interaction was identified between the group variable and the empathy variable. In wave-2, girls with high empathy at baseline in the intervention group obtained lower mean AV scores (β: -0.131; p = 0.004). However, the boys in the intervention group (reference: control group) with low empathy at baseline registered a significant increase in the mean values of machismo (β: 0.247; p < 0.001).

Conclusion

The importance of empathy is shown in the effectiveness of interventions to reduce machismo and AV in adolescents. While the Lights4Violence program focuses on promoting healthy relationships, there were some controversial results. It is possible that some children, especially those with less empathy, may have felt “challenged” during the intervention and/or assessment. This suggests the need for the development of interventions that also consider psychological processes and integrate the promotion of positive expressions of masculinity.

Skin-Disease Specific and Generic Psychometric Measures in Patients with Psoriasis

INTRODUCTION

Psychosocial problems of patients with chronic dermatoses, such as psoriasis, add to their somatic ailments, which results in the lack of illness acceptance, lowered self-esteem, deteriorated quality of life, and an array of somatic comorbidities. The aim of this study was to analyze the effect of psoriasis on the quality of life, sense of stigmatization, self-esteem, and satisfaction with life in patients with psoriasis.

METHODS

The study was based on a short survey prepared by the authors and five validated scales: Dermatology Life Quality Index (DLQI), 6-Item Stigmatization Scale, 33-Item Feelings of Stigmatization Questionnaire, Rosenberg Self-Esteem Scale (SES), and Satisfaction With Life Scale (SWLS). The study included 111 patients with psoriasis (46.8% women and 53.2% men). The inclusion criteria of the study were the diagnosis of plaque psoriasis and written informed consent to participate.

RESULTS

DLQI scores ranged between 0 and 28 points (pts) (mean 10.8 pts). Mean stigmatization scores determined with the 33- and 6-Item Stigmatization Scale were 81.6 pts and 7.5 pts, respectively. The mean SWLS score for the study group (18.5 pts) was slightly below the average. The mean score SES of 27 pts implies that the study respondents' self-esteem level was slightly above the average.

CONCLUSIONS

Satisfaction with life turned out to be significantly modulated by overall stigmatization level on the 33-Item Stigmatization Scale (the stronger the sense of stigmatization, the lower the satisfaction with life) and education (respondents with higher education presented with higher satisfaction with life than those with non-higher education).

Illness Acceptance as the Measure of the Quality of Life in Moderate Psoriasis

Introduction

Psoriasis is a chronic disease with intermittent flares and remissions. Each individual perceives the disease, its somatic effects, resultant dysfunction and related problems differently. This attitude is primarily determined by one’s characterological traits and type of illness. A primary response to the diagnosis can be denial, underestimation, acceptance or overestimation of the disease. The aim of the study was to analyze the level of illness acceptance and its effect on the quality of life in moderate psoriasis depending on sociodemographic and clinical characteristics of the patients.

Materials and Methods

The study included 186 patients with plaque psoriasis with Psoriasis Area Severity Index (PASI) scores ≤10. The inclusion criteria of the study were duration of psoriasis >2 years, age ≥18 years, and lack of other somatic or mental disorders during three months preceding the study. The study participants completed the Acceptance of Illness Scale (AIS), Dermatology Life Quality Index (DLQI) as well as an original survey containing questions about their sociodemographic characteristics and information about their disease.

Results

Mean AIS score for the study group was 24.3 pts. Patients older than 40 years presented with lower levels of illness acceptance than younger persons (p = 0.0311). Also, patients’ sex and duration of psoriasis significantly affected the acceptance of the illness, with lower AIS scores found in women (p = 0.0092) and persons with a longer history of the disease (p = 0.0362). Mean DLQI score for the study group was 13.3 pts. A lower level of illness acceptance turned out to exert an unfavorable effect on the quality of life (QOL) in psoriasis (p = 0.0015; R = −0.33).

Conclusion

In this study, patients with psoriasis presented with a moderate level of the illness acceptance, and a significant correlation was found between this parameter and QOL.

The Role of Social Support in Machismo and Acceptance of Violence Among Adolescents in Europe: Lights4Violence Baseline Results

PURPOSE

To analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries.

METHODS

Cross-sectional design. We recruited 1,555 participants ages 13-16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence-dating violence, bullying, cyberbullying, abuse in childhood-and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex.

RESULTS

Acceptance of violence was higher for those who had lower perceived social support from parents (β_girls = -154, p < .001; β_boys = -.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (β_girls = .067, p = .035; β_boys = .225, p < .001; (β_girls = .118, p < .001; β_boys = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys.

CONCLUSIONS

Machismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence.

Effect of Disease Severity on the Quality of Life and Sense of Stigmatization in Psoriatics

INTRODUCTION

Psoriasis is a chronic inflammatory disease of the skin having a profound effect on the quality of life and contributing to the sense of stigmatization in the affected patients. The aim of this study was to analyze the effect of psoriasis severity on the quality of life and sense of stigmatization in psoriatics and to investigate relationships between these measures and sociodemographic variables.

PATIENTS AND METHODS

The study included 111 patients with psoriasis. The inclusion criteria of the study were the diagnosis of psoriasis and written informed consent to participate. The study was based on a short survey prepared by the authors and four validated scales: Dermatology Life Quality Index (DLQI), 6-item Stigmatization Scale, 33-item Feelings of Stigmatization Questionnaire, and Psoriasis Area and Severity Index (PASI).

RESULTS

Mean PASI score for the study group was 14 pts. Most respondents presented with low DLQI scores, with the mean value of 10.8 pts suggesting that the disease-related ailments were not extremely burdensome for the majority of the patients. Mean stigmatization scores for the 6- and 33-item scale were 7-8 and 81-82 pts, respectively.

CONCLUSION

The severity of psoriasis was the strongest determinant of the quality of life measured with the DLQI. Also, the levels of stigmatization determined with the 6- and 33-item scale correlated significantly with PASI scores.

Relationships between the acceptance of illness, quality of life and satisfaction with life in psoriasis

INTRODUCTION

Since the skin plays a pivotal role in interpersonal relationships, a chronic dermatological condition (psoriasis), may have a profound effect on the psychological status of patients.

AIM

To analyse the effects of skin lesions on satisfaction with life, acceptance of illness and quality of life in psoriasis.

MATERIAL AND METHODS

The study included psoriatics recruited at the Dermatology Outpatient Unit of the Regional Hospital in Lomza, Dermatology Outpatient Clinic in Siemiatycze and Dermatology and Medical Cosmetology Centre in Bialystok. The study patients were examined with a demographic survey prepared by the authors, as well as with three validated scales: AIS, SWLS and DLQI. A total of 263 questionnaire sets were handed out to the participants of the study; this pool included 200 questionnaires with complete data that were eventually included in the analysis.

RESULTS

Acceptance of Illness Scale scores of the study participants ranged between 8 and 40 pts. Mean AIS scores for female and male psoriatics were similar, 23 and 25 pts, respectively. Based on the distribution of Satisfaction with Life Scale scores, 42 of the study patients presented with high levels of satisfaction with life, whereas 37 and 21 showed moderate and low satisfaction levels, respectively. Quality of life turned out to be the best among 20- to 30-year-old respondents as up to 74.19 of them had Dermatology Life Quality Index scores no greater than 10 pts.

CONCLUSIONS

Psoriatics with higher levels of illness acceptance also presented with greater satisfaction with life.

The Role of School Social Support and School Social Climate in Dating Violence Victimization Prevention among Adolescents in Europe

The aim of the article is to show the role of school social support and school social climate in dating violence victimization prevention among adolescents in Europe. Study participants were students from secondary schools (age 13-16) in Spain, Italy, Romania, Portugal, Poland and UK. The analysis in this text concern student with dating experience (n = 993) (57.2% of girls and 66.5% of boys). School social support was measured by School Social Climate, Factor 1 Scale (CECSCE) and by Student Social Support Scale (CASSS), subscales teachers and classmates. The association between school social support and different types of dating victimization (physical and/or sexual dating violence, control dating violence and fear) was measured by calculating the prevalence ratios and their 95% confidence intervals, estimated by Poisson regression models with robust variance. All the models were adjusted by country and by sociodemographic variables. The results show that the average values of all types of social support are significantly lower in young people who have suffered any type of dating violence or were scared of their partner. The likelihood of suffering physical and/or sexual dating violence decreased when school social support increased [PR (CI 95%): 0.96 (0.92; 0.99)]. In the same way, the likelihood of fear decreased when school social climate increased [PR (CI 95%): 0.98 (0.96; 0.99)].There is an association between school social support and school social climate and experiences of being victim of dating violence among adolescents in Europe. Our results suggest that in the prevention of dating violence building a supportive climate at schools and building/using the support of peers and teachers is important.

Quality of life in skin diseases as perceived by patients and nurses

INTRODUCTION

The appearance of the skin and its appendages not only reflects the general body condition, but also exerts an effect on one's self-esteem and self-image, and the way he/she is perceived by the others.

AIM

To analyse the quality of life (QOL) in dermatological diseases, assessed by the patients themselves and the nurses being their caregivers.

MATERIAL AND METHODS

The survey was completed by 300 patients diagnosed with various dermatological conditions; however, only the data from 281 surveys were considered during the analysis. All patients completed an anonymous questionnaire designed specifically for the purpose of the study. The survey included 32 questions. Moreover, the study patients were surveyed with the Dermatology Life Quality Index (DLQI). Moreover, the study included 1713 nurses employed in various healthcare institutions and providing care to patients with dermatological diseases. The survey for the nurses consisted of 32 questions.

RESULTS

Mean DLQI score for the study patients was 12.4 ±8.1 points. Based on the median, lower and upper quartile values, every fourth person presented with DLQI scores > 18 points, half of the respondents had DLQI scores no greater than 12 points, and every fourth respondent experienced good QOL (DLQI score no higher than 5 points).

CONCLUSIONS

According to the majority of patients and nurses, individuals with skin conditions are not fully able to cope with their disease and show a negative attitude towards it. The QOL of patients with skin diseases is determined by the type of the dermatological condition.

The Sense of Stigmatization in Patients with Plaque Psoriasis

BACKGROUND

Psoriasis is a systemic inflammatory disease capable of creating stigmatization in the form of social exclusion and decrement of psychological conditions.

AIM

The aim of the study was to determine the level of stigmatization in patients with plaque psoriasis.

METHODS

The study included 166 patients with plaque psoriasis (55.6% women and 44.3% men) with Psoriasis Area and Severity Index scores ≤10. The age of the study patients ranged between 18 and 72 years (arithmetic mean = 37.4; median = 38; standard deviation [SD] = 11.0). The mean age at the diagnosis of psoriasis was 21.5 years (median = 20; SD = 9.1) and disease duration varied from 2 to 59 years (arithmetic mean = 15.8; median = 15; SD = 11.3). The study patients completed the Polish version of the 6-item Stigmatization Scale and the 33-item Feelings of Stigmatization Questionnaire and a survey developed by the authors of this study, containing questions about the participants' sociodemographic characteristics (sex, age, place of residence, marital status, education, employment status) and information about their disease (location of psoriatic lesions, time elapsed since the diagnosis of psoriasis).

RESULTS

The mean score for the 6-item Stigmatization Scale for the whole study group was 7.6 out of 18 points (median = 7; SD = 3.8; minimum = 0; maximum = 17). The average score for the 33-item Stigma Feelings Questionnaire in our series was 84.5 out of 165 points (median = 88; SD = 20.9; minimum = 30; maximum = 136). A statistically significant sex-related difference was observed in the 6-item Stigmatization Scale scores, with higher stigmatization levels found in men than in women (p = 0.0082). Moreover, significantly higher levels of stigmatization were observed in countryside dwellers (p = 0.0311) and unmarried persons (p = 0.0321). Patients with a longer history of the disease (≥15 years) scored significantly higher on the 6-item Stigmatization Scale (p = 0.0217) than those in whom psoriasis lasted less long, and presented with higher, at the threshold of statistical significance, scores for the 33-item Feelings of Stigmatization Questionnaire.

CONCLUSIONS

Stigmatization awareness should be promoted among physicians and psoriatic patients to improve psoriasis management.

Postawy nauczycielek i nauczycieli wobec kształcenia na odległość w czasie pandemii COVID-19

Despite the explosion of studies on social consequences of the COVID-19 outbreak, still little is known about the situation of teachers. This research report presents results of a study on teacher’s attitudes toward distance education during the COVID-19 pandemic and their associations with selected characteristicsrelated to the teacher’s profession. The study consisted in answering questions in an online survey. Nearly eight hundred correctly completed surveys were collected. Multivariate analysis of variance (MANOVA) was applied to compare differences between the variables. The results show that the lowest averages on a Likert-type scale describe the cognitive component of attitudes, and the highest ones describe the behavioral component. Awareness of problems with the implementation of the curriculum and basic tasks of the school in the form of a distance education result in teachers’ competence increase and taking specific action. Gender and seniority are not associated with the teachers’ attitudes toward distance education. The type of school and the level of education were associated with attitudes towards distance education. Special schools teachers had the worst experience with distance education. The possible implications of these outcomes are discussed.

Acceptance of Illness, Satisfaction with Life, Sense of Stigmatization, and Quality of Life among People with Psoriasis: A Cross-Sectional Study

INTRODUCTION

Psoriasis is a complex disease with a heterogeneous presentation, which may have a profound effect on the everyday functioning of patients. As a strongly stressogenic disease, psoriasis may cause lack of illness acceptance and contribute to negative changes in self-image. Usually, psoriasis also has a detrimental effect on quality of life. The aim of this study is to determine the levels of illness acceptance, satisfaction with life, stigmatization, and quality of life in people with psoriasis, to analyze relationships among these variables, and to verify whether they are modulated by selected sociodemographic factors.

METHODS

A total of 366 people with psoriasis treated at the Dermatology and Medical Cosmetology Clinic in Białystok were included. The study was conducted using a short survey prepared by the authors and five validated psychometric scales: Acceptance of Illness Scale (AIS), Satisfaction with Life Scale (SWLS), 6-item Stigmatization Scale, 33-item Feelings of Stigmatization Questionnaire, and Dermatology Life Quality Index (DLQI).

RESULTS

Median AIS score was 24 pts, which corresponds to a moderate level of illness acceptance. The level of illness acceptance among men was significantly higher than among women. More than half of respondents assessed their satisfaction with life as low. Men showed low levels of satisfaction with life slightly more often than women. Patients living in the countryside showed high levels of satisfaction with life significantly more often than those living in cities/towns. Mean scores for the 6-item Stigmatization Scale and the 33-item Feelings of Stigmatization Questionnaire were 8.73 pts and 90.06 pts, respectively, with no significant differences between the results of male and female patients. The DLQI scores for the study group ranged between 0 and 30 pts, with the mean value of 17.81 pts corresponding to a severe deterioration of quality of life. Statistically significant differences between quality of life and all sociodemographic variables were demonstrated.

CONCLUSIONS

People with psoriasis participating in this study showed moderate levels of illness acceptance and stigmatization, low level of satisfaction with life, and moderately deteriorated quality of life. Acceptance of illness was significantly modulated by patient sex. The level of illness acceptance among men was significantly higher than among women. Furthermore, illness acceptance exerted a significant effect on satisfaction with life in psoriasis patients. Place of residence exerted significant effects on satisfaction with life (higher in countryside dwellers), sense of stigmatization (stronger in countryside dwellers), and quality of life (more severely deteriorated in city/town dwellers). Disease duration significantly affected the degree of life satisfaction, sense of stigmatization (measured using a 33-item Feelings of Stigmatization Questionnaire), and quality of life among patients with psoriasis.

Stigmatization and Quality of Life in Patients with Psoriasis

Introduction

Each dermatological condition associated with the presence of visible skin lesions can evoke the following psychological response of the patient: shame, anxiety, anger, or even depression. Psoriasis may additionally be a cause of social rejection, which significantly impairs a patient’s private life and social functioning, and may contribute to stigmatization, alienation, and deterioration of their quality of life. The aim of the study was to determine the level of stigmatization and the quality of life of persons with psoriasis in relation to sociodemographic characteristics.

Methods

The study, which included 166 patients with plaque psoriasis, was carried out with the 33-item Feelings of Stigmatization Questionnaire, Dermatology Life Quality Index (DLQI), and a dedicated sociodemographic survey.

Results

Compared with women, men had higher stigmatization scores in the “Feeling of being flawed” domain (p = 0.0362), and patients up to 30 years of age scored higher on the “Guilt and shame” domain (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\bar{x}$$\end{document}x¯ = 17.1 points) than those older than 30 years (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\bar{x}$$\end{document}x¯ = 14.6 points). Also, persons with visible skin lesions presented with higher stigmatization levels in the “Guilt and shame” domain than those without (p = 0.0028). Quality of life in persons with psoriasis did not depend on sociodemographic parameters but correlated significantly with two stigmatization domains, “Sensitivity to the opinions of others” (R = 0.31; p = 0.0030) and “Positive attitudes” (R = 0.27; p = 0.0115).

Conclusions

As stigmatization is a social problem, only greater social awareness of psoriasis may contribute to better understanding and broader acceptance of patients with this dermatosis. To help them to cope with the stigmatization and hence to improve their quality of life, persons with psoriasis should be provided with psychological counselling.

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.

[Symptoms from the internal organs of patients with systemic sclerosis in the light of selected diagnostic tests]

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.

[Exposure of medical rescuers to aggression at the workplace]

SUMMARY

Members of the medical rescue team are exposed to several dangerous and harmful factors, including emotional and physical stress, during their activities at the site of an accident. Basing on the literature it can be concluded that anxiety and low mood are present in each patient in a state of endangered life or health. The aim of study was to assess the incidence, sources, and types of aggression against medical rescuers depending on the place of work.

MATERIAL AND METHODS

This study was done in 126 medical rescuers working in the province of Podlaskie. Questionnaires assessing the degree and types of aggression against medical rescuers and the GHQ28 General Heath Questionnaire were used.

RESULTS

Rescuers working in emergency rooms and ambulances reported that aggression most often was in the form of raised voice (95%), threats (85%), attempted assault and dangerous situation (91%). According to respondents working at hospital emergency departments, raised voice is most often encountered (95% of respondents). Threats were made against 72%, dangerous situations were noted by 59%, and attempted assault was experienced by 44% of respondents.

CONCLUSIONS

Rescuers working in ambulances and emergency rooms were more often exposed to aggression than rescuers working at hospital emergency departments. The exception was raised voice by patients which was noted with the same frequency irrespective of the place of work. Aggression from superiors and coworkers was evidently more often experienced in ambulances and emergency rooms.

[Aggression as the cause of stress among physicians]

INTRODUCTION

Mental stress is inseparably connected with work. The stress reaction is favored by stagnation in life, lack of prospects for professional growth, uncertainty of stable employment, pressure to work reliably and flexibly, excessive workload, and lack of assigned duties. Interpersonal relations among members of the team represent another significant factor in the appearance and persistence of social pathology.

STUDY OBJECTIVES

Identification of forms and sources of aggression implicated in stress among physicians at the workplace.

MATERIAL AND METHODS

The study was performed in 501 physicians employed by inpatient and outpatient institutions in the province of Podlaskie. We used questionnaires assessing the intensity and type of aggression against physicians and the GHQ28 General Heath Questionnaire.

RESULTS

The patient source of stress for physicians included hostile comportment (53%) and extortion (41%). The source of stress from superiors included vulgar acts in the presence of coworkers (18%) and threats (17%). Stress was also caused by raised voice of other physicians (44%) and nurses (25%).

CONCLUSIONS

The main source of stress for physicians was aggression by patients and fellow physicians.

Health-related behaviour self-assessment of children living in a children's home; study based on own research realised in the Podlaskie Province

PURPOSE

The purpose of the study was to diagnose the health-related behaviour of children brought up in children's homes, to compare the obtained results with those obtained from a group of peers brought up in their own families.

MATERIAL AND METHODS

The study group included 180 children living in children's homes in the Podlaskie Province and in a control group composed of children brought up in their own families and living in the same places where the children's homes are located. A questionnaire of the Health Behaviour Scale, composed of 40 statements determining health-related issues was used.

RESULTS

Self-assessment of health-related behaviour in the studied youth depended on age, for which a statistical significance was shown for: health self-assessment (p = 0.011), categories of stressful situations (p = 0.047), physical activity (p = 0.028) and social support (p = 0.001); gender, for which a statistical significance was shown for the categories of usage of stimulants (p = 0.000) and place of living, in which the factor "place" was significant (p = 0.000) for all categories; and education, where p = 0.000 for the following categories: stressful situations, using stimulants, physical activity, social support and health self-assessment. Relationships between the categories of health-related behaviour were much stronger in the assessments of the children brought up in children's homes were found.

CONCLUSIONS

The self-assessment of health-related behaviour of the studied youth depended on age, gender, place of living and education. Relationships between the categories of health-related behaviour were much stronger in assessments of the children brought up in children's homes as compared to controls.

Comparative analysis of quality of life women in menopause period in Poland, Greece and Belorussia using MRS Scale. Preliminary report

PURPOSE

The aim of this study was the assessment of climacteric symptoms, the activity and quality of life of women in menopausal period from Poland, Greece and Belorussia using a Menopause Rating Scale (MRS).

MATERIAL AND METHODS

The study was conducted among women in age after 45 years, from Poland (55), Belorussia (50) and Greece (85). MRS was obtained from the Professor Heinemann from Center of Epidemiology and Health Studies in Berlin. The scoring scheme is simple, i.e. the score increases point by point with increasing severity of subjectively perceived symptoms in each of the 11 items (severity 0--no complaints, 4 scoring points--severe). The respondent provides her personal perception by checking one of 5 possible boxes of "severity" for each of the items.

RESULTS

Mild and no complaints in similar degree were reported by all women from these three countries. We found significant (p < 0.001) differences between severe complaints reported by Greek women compared with complaints respondents from Belorussia and Poland. Moderate complaints were reported more frequently by women from Poland (32.56%) and Belorussia (34%) compared with women from Greece (28.55%). Severe complaints were noted more rarely in 1.6% Greek women compared with 2.6% Belorussian and 3% Polish respondents. No significant differences between no complainants, mild, moderate, marked and severe between women from Belorussia, Poland and Greece.

CONCLUSIONS

Generally we did not observe significant differences between reported complaints by women from Belorussia, Poland and Greece.

Seasonal variation in ischaemic stroke frequency in Podlaskie Province by season

PURPOSE

The aim of the present study was to assess seasonal differences in ischaemic stroke among patients hospitalized in Department of Neurology in Białystok during 2002-2005.

MATERIAL AND METHODS

To examine the seasonal incidence of ischaemic stroke, we analyzed data from the Department of Neurology in Białystok in a retrospective study. The year was divided into four seasons: spring (March, April, May), summer (June, July, August), autumn (September, October, November), and winter (December, January, February). Seasonal differences were studied in relation to the following clinical characteristics: age, gender, history of stroke, and time of stroke onset.

RESULTS

Age of patients with ischaemic stroke ranged 19 between 101 years, a mean age was 72.4 +/- 12 years. Incidence of ischaemic stroke increased in the last years. We noted a higher incidence of ischaemic stroke in older patients (mean 74.36 years old) during winter months than in patients (71.40 years) in summer months. Gender had no effect on incidence of ischaemic stroke. Significant seasonal variation of ischaemic stroke in all years (p = 0.0010) and for 2005 year (0.0090) were found. Incidence of ischaemic stroke was depend on month of year. Significant increase of ischaemic stroke was noted in December. The lowest incidence of stroke was observed in August and September.

CONCLUSION

Incidence of ischaemic stroke increased in the last years. The present findings suggest an increase in the incidence of ischaemic stroke in winter in December.

Nursing problems of patients with systemic sclerosis

Systemic sclerosis (SSc) is a chronic autoimmune disease connective tissue and one of the most common collagen diseases. There are several clinical types of scleroderma which differ in their course, possible complications and prognosis. The most characteristic form SSc is limited and diffuse systemic sclerosis. The SSc is characterized by the progressive fibrosis of the skin and internal organs, leading to their failure, morphology and blood vessels disorders.

PURPOSE

The aim of our work is to identify the main health problems of patients suffering from systemic sclerosis depending on its clinical form: limited systemic sclerosis (ISSc) and diffuse systemic sclerosis (dSSc); to determine the influence of disease duration on symptom intensification in patients with LSSc and dSSc.

MATERIAL AND METHODS

The study group consisted of 63 patients with systemic sclerosis diagnosed according to the criteria of the American Rheumatism Association (ARA), 47 of whom had limited systemic sclerosis (ISSc) (74.6%) and 16--diffuse systemic sclerosis (dSSc) (25.4%).

CONCLUSIONS

The key thing in the complex therapy is to recognize the individual care problems of the patient, to assess his ability to cope with the disease in daily life and to plan care, support, education and help of other professionals. The main aim of individual nursing care is to alleviate ailments, prevent infections, observe life-threatening conditions and to educate the patient as regards self-care and self-observation.

Quality of life self-assessment of children living in a children's home, based on own research conducted in the Podlaskie Province

PURPOSE

The purpose of the study was to diagnose the quality of life (QoL) of children brought up in children's homes, to compare findings with results for peers living in complete families.

MATERIAL AND METHODS

In the Stage I was to determine the usefulness of tools for QoL evaluation in a group of 120 children from children's homes in the Podlaskie Province and in a group of 120 children belonging to a control group, brought up in their own families, in the same places where the children's homes were located. Selected research tools were used in Stage II, and the study was carried out in a group of 180 children in the same children's homes and a control group. We used the following survey questionnaires: the standardised CHQ-CF87 survey, standardised KINDL survey and Children's Survey based on WHOQOL-BREF.

RESULTS

Significant relationship between the quality of life self-assessment and the place of being brought up for all categories of quality of life was found. A relationship was indicated between the QoL self-assessment and the place of living, age, gender, and physical condition. The charges of a children's home assessed their QoL as significantly lower compared to children living in normal families, mostly in the following categories: health, physical domain and psychological domain, social relations and the ability to function in everyday life. In KINDL survey, strong relationships were found between assessments of QoL categories.

CONCLUSIONS

Significant relation between QoL self-assessment and where children were brought up was found. Positive relationship between QoL self-assessment and the place of living, age, gender, and children's physical condition was found.

Relations occurring between health-related behaviour categories and quality of life made by children brought up in a children's home, in the Podlaskie Province

PURPOSE

The purpose of the study was to determine relations between health-related behaviour categories and quality of life (QoL) categories made by children brought up in a children's home and to compare the results obtained with the results for a group of peers brought up by their own families.

MATERIAL AND METHODS

The study was performed on a group of 180 children living in children's homes located in Białystok, Krasne, Supraśl, Lomza, Nowa Pawłówka; and on a control group of children living with their own families in the same places where children's homes were located. The diagnostic survey method with the Health Behaviour Scale questionnaire, composed of 40 statements defining various behaviours connected with health, and the Children's Questionnaire, based on The World Health Organization Quality of Life (WHOQOL-BREF) was used.

RESULTS

Strong correlations between assessments of the Health Behaviour Scale categories and assessments of quality of life categories were found in the group of children living in children's homes, mostly in respect to the relation between health self-assessment and physical activity r = 0.77, mental activity r = 0.74 and environment r = 0.72, and between the physical domain and eating habits r = 0.70, and physical activity and the physical domain r = 0.69. The determination coefficient R2 for the study group had high values for three QoL categories: physical domain 71.5%, mental domain 69.7% and environment 70.1%.

CONCLUSIONS

Correlations between Health Behaviour Scale categories and QoL categories were found in the group of children living in children's homes compared to children living with their own families. The relationships for health self-assessment and the physical and mental domains and the environment, and for the physical domain and eating habits and physical activity were found.

Quality of life and its relationship to the degree of illness acceptance in patients with diabetes and peripheral diabetic neuropathy

PURPOSE

Assessment of quality of life, especially from the psychological point of view, is likely to be strongly influenced by the degree of acceptance of one's own illness and the resultant negative emotional reactions associated with the illness itself. The aim of the present study was to determine the relationship between quality of life and the degree of acceptance of illness in diabetic patients with and without peripheral diabetic neuropathy.

MATERIAL AND METHODS

59 patients with diabetes were included in the study; they consisted of patients both with and without peripheral diabetic neuropathy. The degree of acceptance of illness was assessed using the Acceptance of Illness Scale (AIS) and quality of life (HRQOL - health-related quality of life) was measured using the SF-36v2.

RESULTS

Quality of life in people with diabetes was reduced and related to their levels of illness acceptance. Factors affecting illness acceptance in patients with peripheral diabetic neuropathy included feelings of being a burden to their family and friends (p < or = 0.05) and the belief that people in their company are made anxious by the patient's illness (p < or = 0.05). These patients also defined their health status as being worse than that of diabetic patients without additional disease complications.

CONCLUSIONS

Quality of life and illness acceptance were found to be strongly related. In general, patients with chronic peripheral diabetic neuropathy express lower degrees of acceptance of their illness than diabetic patients without peripheral diabetic neuropathy. Their subjective assessment of health status is also significantly worse than that of diabetic patients without neuropathy.

Exposure the doctors to aggression in the workplace

PURPOSE

To evaluate the frequency, source and type of aggression towards doctors, depending on their place of work and position.

MATERIAL AND METHODS

The study was conducted among 501 doctors from the area of Podlaskie Province. To evaluate the level and type of aggression towards doctors in their workplace we used a questionnaire prepared for the needs of this study by modifying the questionnaire "The frequency and consequences of exposing nurses to workplace aggression", which had been drafted by the Institute of Labour Medicine in Lódź. The results were analysed with the application of the chi-square and the Kruskal-Wallis tests.

RESULTS

The most common form of aggression was voice raising, which happened to 80% of doctors employed in inpatient medical centres and 91% doctors from outpatient centres. More than a half of the subjects have heard threats from their patients. Verbal aggression from doctors' superiors happened most often in surgery wards (48%), neurology wards (40%), admission rooms (33%). The causes of aggression most often quoted by doctors include: staff shortages (9%), stress--tiredness (9%).

CONCLUSIONS

Workplace aggression towards doctors may be inflicted both by patients and colleagues. The aggression in the medical environment can take on different forms and create a threat in the workplace. Doctors working in hospital wards (psychiatry, surgery, neurology) are the ones who are the most exposed to aggression.

Quality-of-Life Evaluation in an Interferon Therapy After Radical Surgery in Cutaneous Melanoma Patients

Melanoma is the fastest growing solid tumor in men and women, and despite accounting for only 4% of skin cancer cases, it accounts for more than 79% of skin cancer-related deaths. The present study was designed to evaluate the impact of interferon (IFN) treatment on patients' quality of life (QOL) after radical surgery of cutaneous melanoma. The tests were carried out in a group of patients treated in the Department of Soft Tissue and Bone Cancer, Institute of Oncology, in Warsaw. The present study included 2 groups of the patients, 110 persons each. One group consisted of patients who had been subjected to radical surgery of cutaneous melanoma, and the other one consisted of 110 patients treated with a supplementary interferon alfa-2b (IFN-alpha-2b) therapy. Data were collected by means of an anonymous QLQ-C30 (version 2.0.) questionnaire elaborated and provided by the European Organisation for Research and Treatment of Cancer. The QLQ-C30 questionnaire consisted of 43 questions. The IFN-alpha-2b treatment significantly affected patients' physical condition, mental health, and social life. The emotional state of the patients was more affected during IFN-alpha-2b treatment. Somatic symptoms were also increased in those patients. The IFN-alpha-2b therapy also significantly affected family and social life. In spite of several adverse effects, the patients assessed their QOL as good. The IFN-alpha-2b treatment is troublesome for the melanoma patients. It is important that the treating physician and nurse should be aware of the 4 major categories of IFN-alpha-2b toxicity: constitutional, neuropsychiatric, hepatic, and hematologic. A number of steps can be taken to minimize the morbidity associated with IFN-alpha-2b therapy, resulting in an improvement in both QOL and patient compliance.

The importance of the health education in life quality improvement in patients with psoriasis

PURPOSE

The aim of the study was to determine the influence of the psoriatic patient knowledge of the disease on the quality of life.

MATERIAL AND METHODS

The study was carried out in 149 patients with psoriasis. All patients answered on anonymous questionnaire, in according to Psoriasis Disability Index (PDI).

RESULTS

Almost 43% patients could not show any factor which provoked their disease, 31.5% could not tell any recommendations for cure and care of the psoriatic lesions and 32.2% patients could not point out any methods to avoid psoriatic lesions spread. Almost 60% of the group admitted that their quality of life fell because of the disease. At the same time, patients who did not have enough information concerning the disease had lower quality of life index.

CONCLUSIONS

The level of the disease knowledge in the patients with psoriasis influences their quality of live. Therefore it is indicated for the patiens and their families to be involved in the proper educational program.

The education of patients with rheumatoid arthritis--the knowledge and expectation of patients-the opinions of rheumatology nurses

Rheumatoid arthritis (RA) is a chronic, progressive, immunologically dependent, systemic diseases of connective tissue, leading to disability, cripplehood or even premature death. Helping to improve the quality of life of RA patients involves teaching them how to cope with disease-related problems of everyday life, with stress and with suffering. The aim of the presented work is to determine the following: the patients' level of knowledge about rheumatoid arthritis; their educational needs; the impact of the level of knowledge on the patients' pro-health behaviours; the knowledge of nurses and their ability to recognize patients' problems; the nurse's tasks in preparing an RA patient for self-care. The subject group consisted of patients with RA diagnosed according to The American Rheumatism Association criteria and nurses from rheumatology clinics and wards. The research method used was a survey questionnaire, which had been constructed for the purpose of the research. The research results indicate a great need of patients, especially those with early rheumatoid arthritis, for education, support and help in adaptation. At the same time, the nurses, even though they do not fully fulfil their educational role, declare a willingness to participate in organized forms of health education.

Assessment of risk for pressure ulcers using the Norton scale in nursing practice

PURPOSE

The aim of our study was risk assessment for the development of pressure ulcers and thus defining a group of patients considered to be at risk of developing pressure ulcers. It also helped to define the role of the nurse in the early assessment of the risk for developing pressure ulcers.

MATERIAL AND METHODS

Risk assessment for the development of pressure ulcers was carried out in 199 patients hospitalised in The District Hospital in Bielsk Podlaski. The research was carried out with patients admitted to The Departments of General Medicine, Infectious Diseases and Long-Term Care. Risk assessment for the development of pressure ulcers was performed with the aid of the Norton scale.

CONCLUSIONS

An increased risk for the development of pressure ulcers was found in more than half of the patients examined (53.8%). Pressure sores developed in 17.6% of the patients, women being at significantly greater risk. Risk assessment for the development of pressure ulcers with the aid of one of the recommended scales facilitates the early recognition of those patients at risk of developing pressure ulcers.

The need for health education among patients with psoriasis

Psoriasis is one of the most common skin diseases with a chronic and recurrent course. The disease requires systematic treatment and appropriate care. Therefore, in the care of the patient with psoriasis, there must also be place for health education. The aim of this study was to determine the need for health education among patients with psoriasis by determining knowledge gaps occurring most frequently. Materials for this study were collected using an anonymous questionnaire created on the basis of the Psoriasis Disability Index (PDI). The study group included 149 patients with psoriasis. It has been proven in previous studies that patients with psoriasis see the need to improve their knowledge of the disease and self-care methods, and the greatest deficit of their education refers to the factors activating the process of the disease and to the methods of prophylactics in psoriasis.

[Nurses opinion on the necessity of educating psychiatric patients and their families]

AIM

To gather information on the need for educating psychiatric patients and their families by the nursing staff.

METHOD

An anonymous questionnaire was especially constructed for this study. 628 nurses who worked in different health institutions (except for psychiatric departments) were asked to answer the questionnaire.

RESULTS

Getting the patient ready for functioning in the normal world and showing him ways to cope with the illness were considered as the most important educational themes. It is disturbing to note that 14.01% of the responders did not answer this question at all. According to the nurses, the families should be educated well on how they should deal with their ill member. Most of those questioned declared a readiness to educate the ill, but only 31.8% of them felt only minimally prepared for the task. The best form of learning to be an educator were (according to 79.7% responders) training seminars in the preferable form of talks, lectures or lessons. The medical doctor should be the one who would help in the educational role.

CONCLUSIONS

The majority of the nurses believe that they are not prepared well enough for this educational function. Only 4.5% of those studied did not show any need for educating patients and their families. Training seminars for nurses should be organized, so that the nurses feel competent to educate patients and their families. Interdisciplinary teams dealing with the issue of educating patients and their families should be formed.

[Women's knowledge of health behaviors in the puerperium]

The study was conducted on one hundred women hospitalized in obstetrical departments of hospitals in Bialystok. Material was collected using anonymous inquiry in the accordance with methodology of questionnaire creation. Over half responders (55%) correctly defined puerperium, however 19% of them couldn't explain what it means. Near 1/3 women answered that bloody puerperal excrements may be present to the end of puerperal period, 41% of women answered that during puerperium they are allowed to bath and only 22% of them considered physical exercises to be profitable. 52% of responders knew that newborn child should be breastfed for six months and that breastfeeding prevents breast from incidents of occlusion. 20% of mothers considered breastfeeding to be preventive from defects of bite and dental caries.

CONCLUSIONS

1. Definition of puerperium caused problems for most of women. 2. The period of puerperium affected the mode of lifestyle and hygiene of women but most of them did not consider physical exercises to be profitable. 4. The most of women knew that breastfeeding is necessary for appropriate growth of their children.