Areas of professional life and job satisfaction of nurses

Introduction

Job satisfaction among nurses is closely related to work environment as well as organizational and professional commitment. Satisfaction is a concept derived from Latin, where "satis" means "enough," as much as is needed to fully satisfy expectations, needs, aspirations, in such a way that there is no room for complaint. Job satisfaction, on the other hand, is formulated as a positive attitude of employees toward the duties of the job, the work environment and other employees. The aim of this paper was to demonstrate how the different areas of nurses' professional life, i.e., workload, control, rewards, community, sense of justice and values, correlate with their perceived job satisfaction.

Materials and methods

A cross-sectional study was conducted in a group of 509 nurses working in a public hospital in Poland. Data were collected using a survey questionnaire, which consisted of a section containing sociodemographic data and standardized instruments: The Minnesota Satisfaction Questionnaire (MSQ) and The Areas of Worklife Survey (AWS) developed by Maslach and Leiter. Correlations were made using Spearman's rho coefficient. The calculations also used stepwise linear regression analysis after checking certain assumptions, including checking the assumption of normality of residuals and the Durbin-Watson Test.

Results

The mean score for the 20 items of the MSQ questionnaire ranged from 3.05 to 3.43 on a 5-point Likert scale. Support from the interdisciplinary team, which concerned assessing the quality of the social environment in the workplace, cooperation and showing positive feelings received the highest rating among respondents (3.51 ± 0.76). The sense of fair treatment at work averaged 3.26 ± 0.58. The area of value conflict within the organization itself or between the employee's values and those of the organization, respondents rated an average of 3.26 ± 0.65. The mean score for all areas of professional work in the surveyed group was 3.09 ± 0.45.

Conclusion

As satisfaction in particular areas of work life increases, so does the level of satisfaction in such aspects of work as achievement and a sense of fairness. The higher the level of satisfaction in the area of control, the more the sense of satisfaction with independence increases. The higher the satisfaction of respondents in the areas of values, workload and control, the higher the level of satisfaction with working conditions occurs.

Assessment of an Anticancer Effect of the Simultaneous Administration of MM-129 and Indoximod in the Colorectal Cancer Model

(1) Background: The purpose of the given study was to examine the antitumor activity of the simultaneous administration of MM-129, a 1,2,4-triazine derivative, and indoximod (IND), the kynurenine pathway inhibitor, toward colon cancer. (2) Methods: The efficiency of the co-administration of the studied compounds was assessed in xenografted zebrafish embryos. Then, the effects of the combined administration of compounds on cellular processes such as cell viability, apoptosis, and intracellular signaling pathways were evaluated. In vitro studies were performed using two colorectal cancer cell lines, namely, DLD-1 and HT-29. (3) Results: The results indicated that the simultaneous application of MM-129 and indoximod induced a stronger inhibition of tumor growth in zebrafish xenografts. The combination of these compounds intensified the process of apoptosis by lowering the mitochondrial potential, enhancing the externalization of phosphatidylserine (PS) and activation of caspases. Additionally, the expression of protein kinase B (AKT) and indoleamine 2,3-dioxygenase-(1IDO1) was disrupted under the applied compound combination. (4) Conclusions: Simultaneous targeting of ongoing cell signaling that promotes tumor progression, along with inhibition of the kynurenine pathway enzyme IDO1, results in the enhancement of the antitumor effect of the tested compounds against the colon cancer cells.

Anxiety, Stress Perception, and Coping Strategies among Students with COVID-19 Exposure

Background: Studying anxiety, stress, and coping strategies during the COVID-19 pandemic is crucial to mitigate the negative effects associated with infection risk and disease consequences. Objective: This study aimed to investigate anxiety levels, stress perception, and coping strategies in relation to the presence of illness. Material and Methods: A cross-sectional online survey was conducted anonymously among 3950 university students from Poland (1822), Lithuania (232), and the Russian exclave of Kaliningrad (1896). Due to the nearly identical application of anti-epidemic measures, the respondents were treated as a unified group. The State-trait Anxiety Inventory (STAI), Perceived Stress Scale 10 (PSS-10), and mini-COPE scale questionnaires were used. Statistical analysis included the Shapiro-Wilk test to check normality, the Mann-Whitney U test for comparative analysis between groups, the Pearson χ² test for categorical data, and Spearman coefficients for correlations between variables. Results: A significant proportion of young adults in the community exhibited symptoms of anxiety and stress during the COVID-19 pandemic. Among the 1212 men and 2738 women surveyed, 348 (28.7%) and 1020 (37.3%) individuals, respectively, were diagnosed with COVID-19 according to clinical protocols. Prolonged disease duration and more severe residual symptoms correlated with higher self-reported anxiety levels. Conclusions: The level of anxiety and stress varied depending on the duration of the disease, significantly impacting the choice of coping strategies. Overall, students displayed a proactive approach to coping activities but tended to postpone important decisions. Seeking social support was a prevalent coping mechanism, although respondents who had COVID-19 showed higher levels of concern for their own emotions, a tendency to discharge emotions through alcohol or other substances (male), and a greater reliance on religion (female). The study provides data that may be useful in developing educational and health policies focused on the mental well-being of university students and potentially other social groups.

The variables in the rationing of nursing care in cardiology departments

BACKGROUND

The rationing of nursing care is a complex process that affects the quality of medical services.

PURPOSE

An assessment of the impact of nursing care rationing on burnout and life satisfaction in cardiology departments.

METHODS

The study included 217 nurses working in the cardiology department. The Perceived Implicit Rationing of Nursing Care, the Maslach Burnout Inventory, and the Satisfaction with Life Scale were used.

RESULTS

A greater emotional exhaustion, the more frequently the rationing of nursing care (r = 0.309, p < 0.061) and the lower the job satisfaction (r=-0.128, p = 0.061). Higher life satisfaction was associated with less frequent rationing of nursing care (r=-0.177, p = 0.01), better quality of care provided (r = 0.285, p < 0.001), and higher job satisfaction (r = 0.348, p < 0.01).

CONCLUSION

Higher levels of burnout contribute to more frequent rationing of nursing care, poorer evaluation of the quality of care provided, and lower job satisfaction. Life satisfaction is associated with less frequent rationing of care, better evaluation of the quality of care provided, and greater job satisfaction.

Factors Determining the Mood and Emotions of Nurses Working in Pediatric Wards-A Pilot Study

BACKGROUND

Mood and emotions are important aspects of social interactions. In recent years, there has been a growing interest in the participation of these emotional states in the implementation of tasks resulting from specific professions. The aim of the study is to identify the factors that determine the mood and emotions of nurses working in pediatric wards.

METHODS

The pilot studies presented in the paper were carried out using the diagnostic survey method. The collected data were obtained from the authors' own questionnaire and the standardized measurement tool "Scale for Measuring Mood and Six Emotions" by Bogdan Wojciszke and Wiesław Baryła. The study included 121 nurses working in hospital pediatric wards. The survey questionnaire results were obtained online using Google Forms.

RESULTS

Self-assessment of the health condition of nurses is statistically significantly correlated with all emotions and mood (p < 0.05). The better the self-assessment of health, the greater the positive mood measured by the General Mood Scale (GMS) and Mood Scales (MS). The financial situation showed a statistically significant correlation with guilt (p = 0.048), sadness (p = 0.041), and negative mood (p = 0.035). Single people, regardless of gender, were characterized by a greater experience of love (H = 13.497; p < 0.001). The higher the education, the greater the experience of love (p = 0.009). For people with specialization, the presence of negative emotions such as anger (p = 0.039) and guilt (p = 0.049) turned out to be statistically significant. The better the health of children staying in the ward, the higher the negative mood of nurses (p = 0.035).

CONCLUSIONS

There was a statistically significant relationship between certain demographic factors, self-assessment of health conditions with the specificity of working in pediatric wards, and the experience of mood and different emotions by nurses working with pediatric inpatients.

The impact of the COVID-19 pandemic on physical activity, life satisfaction, anxiety, stress perception and coping strategies in student-athletes: A comparison between Belarus and Poland-countries with a different approach of anti-pandemic measures

Background

More than two years of the COVID-19 pandemic has changed lives of people around the world and had a profound impact on the field of sports. This has resulted in decreased physical activity (PA) and changes in mental health. The goal was to assess self-reported physical activity, life satisfaction, perceived stress, choice of coping strategies and their correlations among student athletes from two neighboring countries facing different anti-pandemic strategies.

Methods

Cross-sectional surveys using standardized questionnaires: International Physical Activity Questionnaire-Short Form (IPAQ-SF), Satisfaction With Life Scale (SWLS), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS-10), and Coping Orientation to Problems Experienced (Mini-COPE) to compare 600 students from Physical Education and Sports departments of universities in Belarus (n = 333), where restrictions were found to be less stringent than in neighboring Poland (n = 267).

Results

Minor differences in physical activities between both countries indicate that student athletes have adapted fairly quickly and found ways to keep their PA at a fairly high level. Nevertheless, higher PA was reported in the group of student athletes from Belarus. PA levels correlated with life satisfaction, anxiety and stress levels. Female students from Poland reported lower satisfaction with their lives. Their perception of stress was twice as high as that of their Belarusian counterparts. The most common coping strategy in both groups was active coping. Polish respondents less frequently used strategies of avoiding problems and seeking outside support.

Conclusion

The level of physical activity and well-being of student athletes are associated with increased mental health and coping with stress. They also contribute to prevention of affective disorders during the COVID-19 pandemic. Moreover, it is dependent on the country's anti-pandemic policies.

Nurses Coping with Stressful Situations-A Cross-Sectional Study

Nursing belongs to the group of professions particularly exposed to stress. Since the ability to cope with stress is an important aspect of mental health, the aim of this study was to identify the types of nurses' behaviours in terms of different coping styles used when dealing with work-related and psychosocial stress. The study was conducted among 1223 Polish nurses by means of a diagnostic survey, using the Coping in Stressful Situations Questionnaire (CISS), the Generalised Self-Efficacy Scale (GSES) and a questionnaire of the author's own design. Three types of nurses were distinguished: Type 1 (non-harmonious/organised)-nurses with lower professional education, longer work experience, at least average severity of stress related to working conditions, the lowest GSES scores, and worse psychophysical condition, who focused on their own emotional state when faced with stressful situations. Type 2 (harmonious)-nurses with higher education, the lowest intensity of work-related stresses, the highest GSES scores, positive self-reported psycho-physical condition, most often using the task-oriented coping style in stressful situations. Type 3 (non-harmonious/disorganised)-nurses with shorter length of service in the profession, the highest intensity of work-related stress, average GSES scores, and poorer self-reported psycho-physical condition. The presented results may provide a basis for preventive measures to minimise stress and increase competence in coping strategies, thus contributing to improved psychological and physical well-being of nurses.

Zebrafish—An Optimal Model in Experimental Oncology

A thorough understanding of cancer pathogenesis is a necessary step in the development of more effective and safer therapy. However, due to the complexity of the process and intricate interactions, studying tumor development is an extremely difficult and challenging task. In bringing this issue closer, different scientific models with various advancement levels are helpful. Cell cultures is a system that is too simple and does not allow for multidirectional research. On the other hand, rodent models, although commonly used, are burdened with several limitations. For this reason, new model organisms that will allow for the studying of carcinogenesis stages and factors reliably involved in them are urgently sought after. Danio rerio, an inconspicuous fish endowed with unique features, is gaining in importance in the world of scientific research. Including it in oncological research brings solutions to many challenges afflicting modern medicine. This article aims to illustrate the usefulness of Danio rerio as a model organism which turns out to be a powerful and unique tool for studying the stages of carcinogenesis and solving the hitherto incomprehensible processes that lead to the development of the disease.

Strategies for Coping With Stress Used by Nurses in Poland and Belarus During the COVID-19 Pandemic

INTRODUCTION

Stress is an inseparable element of nurses' work. It is also the cause of wellbeing disorders and the source of various diseases. The wellbeing and health of nurses has a direct impact on the quality of care and health outcomes for patients. An appropriate stress coping strategy can reduce the impact of stress and mitigate its negative consequences. The COVID-19 pandemic, especially in its initial period, was a source of enormous additional stress for nurses. In Poland and Belarus: two neighboring countries with common history and similar culture, the authorities took a completely different approach to fighting the COVID-19 pandemic.

AIM

The purpose of this study was to investigate and compare how nurses in Poland and Belarus cope with stress during the COVID-19 pandemic.

MATERIALS AND METHOD

The cross-sectional study was conducted among 284 nurses working in hospital in Bialystok, Poland (158) and in Grodno, Belarus (126). Mini-Cope inventory - the polish adaptation of Carver's BriefCope was used for measuring coping with stress.

RESULTS

Only 17.5% of Belarusian nurses were tested for the presence of the virus and only 4.8% were infected, while in Poland it was 50.6 and 31.0%, respectively. The most frequent used coping strategies were active strategies (active coping, planning) and the least-used were avoidance strategies (behavioral disengagement, substance use) in both countries. Polish nurses significantly more often than Belorussian used support-seeking/emotion-oriented strategies, as well as avoidance strategies. No differences were found for active coping strategies between the both groups. Contact with a patient infected with the SARS-CoV2 virus did not influence the choice of stress coping strategies by nurses in both countries. Staying in quarantine or home isolation favored more active coping strategies, especially in the case of Belarusian nurses. Taking a SARS-CoV-2 test did not statistically differentiate the choice of coping strategies in the Belarusian group. In the Polish group, nurses with a positive SARS-CoV-2 test result used both use of instrumental support and use of emotional support strategies less frequently. SARS-CoV-2 virus infection did not statistically differentiated how stressful situations were handled in Polish group.

CONCLUSIONS

Polish and Belorussian nurses used similar strategies to cope with stress in the face of the COVID-19 pandemic. The social and demographic differences between Polish and Belorussian nurses differentiated the choice of coping strategies among the respondents to a greater extent than the completely different approach of the media and authorities to the COVID-19 pandemic in the two countries. The threat of the COVID-19 pandemic does not affect the choice of stress coping strategies by nurses in Poland and Belarus. Being in quarantine or home isolation favored the use of active coping strategies among Belorussian nurses. Polish nurses, on the other hand, were more likely to turn to religion after being quarantined.

Relationships Between Sleep Problems and Stress Coping Strategies Adopted by Nurses Including Socio-Occupational Factors

Introduction: The health of nurses has a direct impact on the quality of care and health outcomes for patients. The length and quality of sleep as well as the intensity of perceived stress have an impact on the health of nurses. An appropriate stress coping strategy can reduce the impact of stress and mitigate its negative consequences. Aim: The purpose of this study was to investigate relationships between excessive sleepiness and insomnia in interaction with selected socio-occupational factors and stress coping strategies among nurses. Material and Method: The cross-sectional study was conducted among 448 nurses working in hospitals in Podlasie Province in Poland. Mini-Cope inventory - the polish adaptation of Carver's BriefCope was used for measuring coping with stress. Sleep problems were assessed using the Athens Insomnia Scale and the Epworth Sleepiness Scale. Results: The most frequent used coping strategies were active strategies (active coping, planning). The least-used were avoidant strategies (behavioral disengagement, substance use). Excessive sleepiness affected 38% of surveyed, while insomnia 33%. Excessive sleepiness was most strongly related with behavioural disengagement (R ² = 18.6%), substance use (R ² = 17.5%), humour (R ² = 13.8%) and denial (R ² = 12.0%) while insomnia with substance use (R ² = 17.5%) and self-blame (R ² = 15.9%). Nurses with tertiary education experiencing sleep problems less frequently used the strategy of humour, behavioural disengagement, substance use and religion than with lower education. Nurses working in interventional wards experiencing excessive sleepiness used the strategy of humour, religion and positive reframing less often than those working in other wards while those suffering from insomnia used the strategy of humour more often than those working in other wards. Conclusions: The implementation of avoidant and support-seeking and emotion-oriented stress coping strategies by nurses were associated with the sleep problems. Tertiary education discourages nurses with sleep problems from using avoidant coping strategies and devoting themselves to religion. Education and improvement of the quality of sleep may prevent nurses from resorting to stress coping strategies that have a detrimental effect on their health and well-being.

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.

Imperatorin as a Promising Chemotherapeutic Agent Against Human Larynx Cancer and Rhabdomyosarcoma Cells

Naturally occurring coumarins are bioactive compounds widely used in Asian traditional medicine. They have been shown to inhibit proliferation, induce apoptosis, and/or enhance the cytotoxicity of currently used drugs against a variety of cancer cell types. The aim of our study was to examine the antiproliferative activity of different linear furanocoumarins on human rhabdomyosarcoma, lung, and larynx cancer cell lines, and dissolve their cellular mechanism of action. The coumarins were isolated from fruits of Angelica archangelica L. or Pastinaca sativa L., and separated using high-performance counter-current chromatography (HPCCC). The identity and purity of isolated compounds were confirmed by HPLC-DAD and NMR analyses. Cell viability and toxicity assessments were performed by means of methylthiazolyldiphenyl-tetrazolium bromide (MTT) and lactate dehydrogenase (LDH) assays, respectively. Induction of apoptosis and cell cycle progression were measured using flow cytometry analysis. qPCR method was applied to detect changes in gene expression. Linear furanocoumarins in a dose-dependent manner inhibited proliferation of cancer cells with diverse activity regarding compounds and cancer cell type specificity. Imperatorin (IMP) exhibited the most potent growth inhibitory effects against human rhabdomyosarcoma and larynx cancer cell lines owing to inhibition of the cell cycle progression connected with specific changes in gene expression, including CDKN1A. As there are no specific chemotherapy treatments dedicated to laryngeal squamous cell carcinoma and rhabdomyosarcoma, and IMP seems to be non-toxic for normal cells, our results could open a new direction in the search for effective anti-cancer agents.

Working Excessively and Burnout Among Nurses in the Context of Sick Leaves

INTRODUCTION

Nurses are particularly at risk of being affected by professional burnout because of the unique patient - caregiver relationship, which requires strong emotional involvement.

AIM

In this study, we decided to examine the mutual correlations of working excessively and burnout - two basic occurrences affecting the mental well-being of employees - and their relationship with sick leave.

MATERIALS AND METHODS

The study was conducted among 460 nurses working in 3 hospitals in Poland. The polish version of Maslach Burnout Inventory and the Working Excessively Questionnaire developed by Paluchowski were used to conduct the survey. All the demographic data and data on sick leaves were obtained from surveys in the form of respondents' self-reports.

RESULTS

The constructed regression model shows that the tendency to work excessively, as assessed by loss of control over work (LCW), perfectionist work style (PWS), and perceived oppressiveness of the organization (OOP) measures, explains 12.4% of the variation in burnout levels. This confirms that overburden with work can be a factor contributing to the increase in burnout measures. The constructed logistic regression model showed that increase in the level of occupational burnout by 1 point, the chance of nurse having at least three sick leaves per year increases 1.029 times (i.e., by about 2.9%). None of working excessively measures affected the frequency of sick leaves.

CONCLUSION

(1) Excessive workload increases burnout symptoms, which in turn encourages nurses to take sick leave more frequently. (2) The tendency for nurses to overburden themselves with work may be seen by hospital managers as a positive phenomenon, but, based on this study, it is clear that this can only be done in the short term, whereas in the long term it will be clearly detrimental to the organization of hospitals and the quality of care.

Mental Health of the Participants of the Third Age University Program: A Cross-Sectional Study

INTRODUCTION

Population aging is a progressive demographic phenomenon observed in all countries worldwide. The progressive global process of population aging poses many threats, especially in the context of the mental health of the elderly. Third Age Universities are an essential preventive measure shown to improve the quality of life and psychological wellbeing of the elderly.

OBJECTIVES

The aim of this study was to analyze the mental status of older persons attending Third Age Universities in Poland, with particular emphasis on sociodemographic sources of variance in psychological indices.

METHODS

The study included a group of the Third Age University program participants from Poland. A total of 247 persons were enrolled, among them 215 women and 32 men. The study was carried out as a diagnostic survey, using the following validated psychometric scales: The Mood Disorder Questionnaire (MDQ), Geriatric Depression Scale (GDS), General Health Questionnaire-28 (GHQ-28), The Athens Insomnia Scale (AIS), Courtauld Emotional Control Scale (CECS), State-Trait Anxiety Inventory (STAI) and SMAST-G-Short Michigan Alcoholism Screening Test-Geriatric Version.

RESULTS

The vast majority of the respondents did not screen positively for possible bipolar disorder. However, more than 90% of the participants presented with the symptoms of mild depression, and more than one-third had manifestations of non-psychotic mental morbidity. Nearly half of the respondents had complaints associated with insomnia, and in more than one-fourth, SMAST-G score raised suspicion of problem alcohol drinking. Retired participants were shown to present with significantly higher levels of anger control than the occupationally active respondents. Respondents with poor economic status had significantly higher levels of symptoms for non-psychotic mental disorders. Men significantly more often than women showed symptoms raising suspicion of alcohol-related problems.

DISCUSSION

In conclusion, the study group was characterized primarily by the mild depressive and anxiety symptoms. The mental health of the Polish participants of the Third Age University program was significantly modulated by their socio-occupational and marital status, and financial condition. The study showed that persons with likely problem alcohol drinking differed from other respondents in terms of the occurrence of possible bipolar disorder, depression, and non-psychotic symptoms of mental disorders, state and trait anxiety levels and anger control. There is a need for further research in the field of mental health status in the Third Age Universities seniors to determine the prevalence of these phenomena on a national scale.

The Effect of Subjective Perception of Work in Relation to Occupational and Demographic Factors on the Mental Health of Polish Nurses

Introduction: Nursing is considered one of the most stressful professions in the world. The high emotional burden associated with excessive workload in qualitative and quantitative terms, exposure to existing and emerging infectious diseases, daily confrontation with the suffering of individuals and their families and low social support leads to the development of numerous stress reactions among nurses, resulting in the development of anxiety, insomnia, social dysfunction and depression. Indeed, somatic and mental stress-related disease rates are higher among nurses than in the general population. Aim: To determine the impact of subjective work characteristics on the mental health of nurses in relation to demographic and occupational factors. Material and method: The research was carried out among 558 nurses working in hospitals in Podlaskie Voivodeship, and used the Subjective Work Evaluation Questionnaire (SWEQ) and Goldberg's GHQ-28 Questionnaire. Results: As measured by SWEQ, and as self-assessed by means of the GHQ-28 questionnaire, overall stress negatively affects the nurses' health (R ² = 18.7%). Among the partial measures of the SWEQ questionnaire, work overload had strong and the lack of rewards, social relations and lack of support had weak negative effect on the overall mental health assessment of nurses (R ² = 19.2%). The responsibility measure was an exception that had a positive impact on the nurses' well-being. Among occupational and demographic factors, only higher education in relation to secondary education in interactions with the overall stress measure and unpleasant work conditions had a positive effect on the overall mental health self-assessment of nurses (R ² = 20.7%). Conclusions: The results of our study provide a clear message to the hospital management that improving the work organization and atmosphere of nurses by reducing perceived work overload and increasing the responsibility of nurses can have a positive impact on their mental health. Encouraging nurses to improve their education can result not only in an obvious improvement in staff qualifications, but also in better resistance to stressors in the workplace and, consequently, in better staff well-being. Both measures can have a positive impact on the quality of care provided by nurses and on reducing staff turnover.

Sleep disorders among educationally active elderly people in Bialystok, Poland: a cross-sectional study

BACKGROUND

Sleep disorders in an ageing society constitute a significant public health problem. It is estimated that approximately 50% of people aged 55 years and older have trouble sleeping, including initiating and maintaining sleep. The aim of this study was to determine the prevalence of sleep disorders in a group of educationally active elderly people living in Bialystok, Poland.

METHODS

The study included a total of 182 people - residents of Bialystok - aged 60 or older; 146 women (80.22%) and 36 men (19.78%). The study used three standardized psychometric scales: The Athens Insomnia Scale (AIS), The Epworth Sleepiness Scale (ESS) and The Insomnia Severity Index (ISI).

RESULTS

More than half of the respondents scored 6 or more points on the AIS, which is considered a value that indicates a high probability of insomnia symptom occurrence. A similar percentage of respondents obtained a point value on the ISI indicating the presence of insomnia. The vast majority of respondents scored below 11 points on the ESS, which means no symptoms of excessive sleepiness. There was a significant correlation between the results of the above scales in the examined group in total and also by sex.

CONCLUSIONS

Sleep disorders, particularly insomnia, constitute a significant social and health problem in the group of educationally active elderly people living in Bialystok. In light of the obtained study results, it is recommended to conduct and improve existing health education programs aimed at the elderly regarding sleep disorders to improve the quality of their sleep, and thus quality of life, and raise the awareness of the elderly about the importance of sleep in everyday life. There is a need for further research in the field of sleep disorders in the elderly to determine the prevalence of these disorders on a national scale.

Trust in Nurse Scale Developed on the Basis of the Standardized Trust in Physician Scale by Anderson and Dedrick

Introduction:

Nursing care is one of the most important areas of health services, taking place in direct contact with the patient, constituting a subsystem deciding about the general level of services.

Aim:

The aim of the study was to construct the Trust in Nurse Scale on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick.

Methods:

The study included a group of 1,200 people selected at random, 600 each from surgical and medical treatment wards. Patients did not report any problems with understanding the statements on the scale.

Results:

The internal accuracy scores were excellent, all Cronbach’s a values were well above 0.70. The Spearman’s rank correlation coefficient values were highly statistically significant (p <0.001), and correlation strength was very high (for most items r_s > 0.90).

Conclusion:

We suggest that The Trust in Nurse Scale, developed on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick, can be used in studies on patient satisfaction with nursing care.

Psychosocial Hazards in the Workplace as an Aspect of Horizontal Segregation in the Nursing Profession

The purpose of this article was to assess the influence of psychosocial hazards as a factor affecting the presence of men in the nursing profession. The article refers to the topic of particularly low representation of men among nursing staff in Poland, in comparison to what similar statistics show for other countries. The aim of the study was to assess whether the psychosocial hazards in the nursing profession constitute a significant factor in the small number of men present in this occupation. In this article psychosocial hazards are considered as all the aspects of management and work organization that may negatively affect the employee's mental and physical health. The research was conducted from September 2017 to April 2018 in the Podlaskie Voivodeship (Poland). A total of 640 respondents working as nurses in inpatient health care facilities, of which 87% were women and 13% were men, were included in the study. A standardized Work Design Questionnaire for an objective assessment of work stressfulness was used as a research tool. The research has been run by a group of experts, who explained the aim and the meaning of the particular questions to the surveyed group. Afterwards, based on the answers and observations of the responders, the experts filled in the questionnaire. The results of the study show that in almost all the evaluated aspects, the nursing profession was assessed more negatively by surveyed men than women. The most negative aspects reported by women included hazards (a score of 60), complexity (58.3), and haste (50.0), while those reported by men included haste (70.0), complexity (66.7), and hazards (65.0). As a conclusion it has been noticed, that results received from the research confirm that psychosocial hazards may have significant impact on the number of men present in the nursing profession in Poland. This study also suggests that the greater psychosocial hazards experienced by male nurses in the workplace may be an effect of the particularly low representation of men among practicing nursing staff.

Exposure to Psychoactive Compounds amongst Students of Medical University

OBJECTIVE

The aim of this study was to assess the frequency of exposure to psychoactive compounds amongst students of the Medical University of Bialystok.

METHOD

This cross-sectional study included 504 students selected by means of stratified sampling based on the university faculty, study discipline and year, and participant's gender.

RESULTS

Nearly three fourths of our respondents have contact with their student colleagues who use psychoactive compounds, or have heard that such individuals exist. Approximately one fourth of the students declared that they considered using psychoactive compounds at least once. Marijuana and hashish were the psychoactive compounds our respondents used most frequently. Median age of the first contact with these substances was 18 years. Alarmingly high fraction of respondents declared that most of psychoactive compounds included in the study is easily available and obtaining them would not take them longer than one day. Furthermore, 15% of respondents admitted to being involved in the distribution of psychoactive compounds.

CONCLUSION

The exposure of medical university students to psychoactive compounds represents similar problem as in their peers studying other disciplines. However, in view of its specific consequences (including potential threat to patients' health and life), the problem should not be underestimated.

The Reciprocal Effect of Psychosocial Aspects on Nurses' Working Conditions

Objectives: Psychosocial work risks are most often considered in the context of occupational stress. The aim of this article is to evaluate the correlations between different aspects of nurses' psychosocial working conditions.

Materials and Methods: The study was conducted using the questionnaire: Psychosocial aspects of work. A total of 789 nurses working in inpatient health care facilities in Bialystok were included in the study. Correlation analysis was performed by determining Spearman's correlation coefficient.

Results: Correlations between the primary scales, such as job demands, control, social support, well-being, and expectations of changes, were evaluated. The weakest correlation was shown between the assessment of job demands and other work aspects. The strongest correlation was found between the ability to control and social support. Perception of the need for changes was influenced by the assessment of job demands, components of the control scale and, most of all, the scale of social support. A strong correlation was found between physical and psychological well-being and support from superiors and coworkers.

Conclusions:

The state of well-being had no effects on nurses' assessment of the demands they were faced with. Nurses' well-being depended only on social support provided by their superiors and colleagues, the sense of being able to have an effect on the performed work, minimal conflicts, and absence of overload.

Management should enable adequate working conditions in order to ensure nurses' physical and psychological well-being, as both these aspects were closely correlated.

Poor social support, lack of a sense of control over one's work, conflicts, and work overload were factors that promoted nurses' expectations of changes.

Patient aggression towards different professional groups of healthcare workers

INTRODUCTION

Patient aggression affects healthcare quality and, in extreme situations, may even lead to medical malpractice. Little is known, however, about the specific distribution of health care professionals' exposure to patient aggression in various countries.

OBJECTIVE

The aim of this study was to assess the exposure of various professional groups of healthcare personnel to patient aggression, and to identify potential determinants (medical profession, age, gender, professional experience and employment at outpatient/inpatient healthcare units) of this exposure.

METHODS

The study was performed between January 2008 - December 2009 in northeastern Poland, and included 1,624 healthcare workers (493 nurses, 504 midwives, 501 physicians and 126 medical rescue workers). Exposure to eight forms of patient aggression was assessed using the MDM Mobbing Questionnaire.

RESULTS

Using a raised voice was the most frequently observed form of aggression in all groups, whereas the least frequent form of aggression encountered was the use of direct physical violence. In inpatient healthcare units, the intensity of patient aggression was encountered most by nurses and medical rescue workers, followed by physicians and midwives. In outpatient healthcare units, medical rescue workers experienced significantly higher levels of aggression when compared to other professional groups. Significant differences in mean aggression intensity experienced in inpatient and outpatient healthcare units were observed only in nurses and physicians. Furthermore, no significant effects of gender were observed on the intensity of patient aggression.

CONCLUSION

Nurses are most exposed to different forms of patient aggression, with verbal attacks being most prevalent. Nurses employed at inpatient healthcare units experienced aggression more frequently than those working in outpatient healthcare units.

Histone Deacetylase Inhibitor SAHA as Potential Targeted Therapy Agent for Larynx Cancer Cells

Objective: Laryngeal squamous cell carcinoma is one of the most common malignant tumors in the head and neck region. Due to the poor response to chemotherapeutics in patients and low survival rate, successful treatment of larynx cancer still remains a challenge. Therefore, the identification of novel treatment options is needed. We investigated the anticancer effects of suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor, on two different laryngeal cancer cell lines RK33 and RK45. We also studied the antiproliferative action of SAHA in combination with cisplatin and defined the type of pharmacological interaction between these drugs. Materials and Methods: Viability and proliferation of larynx cancer cell lines were studied by methylthiazolyldiphenyl-tetrazolium bromide method and 5-bromo-2-deoxyuridine incorporation assay, respectively. The type of interaction between SAHA and cisplatin was determined by an isobolographic analysis. Western blotting, flow cytometry and quantitative polymerase chain reaction method were used to determine acetylation of histone H3, cell cycle progression and genes expression, respectively. Apoptosis was assessed by means of nucleosomes released to cytosol. Results: SAHA alone or in combination with cisplatin inhibited larynx cancer cells proliferation, whereas displayed relatively low toxicity against normal cells - primary cultures of human skin fibroblasts. The mixture of SAHA with cisplatin exerted additive and synergistic interaction in RK33 and RK45 cells, respectively. We showed that SAHA induced hyperacetylation of histone H3 K9, K14 and K23 and triggered apoptosis. SAHA also caused cell cycle arrest by upregulation of CDKN1A and downregulation of CCND1 encoding p21WAF1/CIP1 and cyclin D1 proteins, respectively. Conclusion: Our studies demonstrated that SAHA may be considered as a potential therapeutic agent against larynx tumors.

Validity and Reliability of the Polish Version of the Tilburg Frailty Indicator (TFI)

BACKGROUND

In the last decade, studies on frailty have become increasingly frequent in the literature on aging, and also the number of available questionnaires regarding frailty has increased over the years. Therefore, the choice of which questionnaire to use is becoming more difficult.

OBJECTIVE

The aim of this study was to assess the psychometric properties of the Polish version of the Tilburg Frailty Indicator (TFI), an instrument that identifies frailty in the elderly population.

DESIGN

Setting, and Participants. The study was carried out in a community-based setting in Wrocław, Poland. Nurses and doctors (general practitioners) administered the TFI in primary care facilities. Participants included a sample of 212 community dwelling elderly aged 60 or older (mean age:70.6 SD≥7.16).

MEASUREMENTS

The validation (assessment of face validity, content validity) was carried out in accordance with the literature. The Tilburg Frailty Indicator (TFI) consists of two different parts. One part addresses the potential determinants of frailty and the other specifically addresses the components of frailty, covering its physical, psychological and social domains. Scale reliability was estimated using two methods: Cronbach's alpha, measuring the scale's internal consistency, and the test-retest method, determining the scale's absolute stability. To assess test-retest reliability, the same group was re-interviewed by the same observer within 10-14 days of the first interview.

RESULTS

The test-retest reliability showed a high level of agreement for all items of the instrument, with values ranging from 96 to 100%. The Cronbach's Alpha internal consistency was 0.74.

CONCLUSION

The Polish version of the TFI proved to be a valid and reproducible tool for assessment of Frailty Syndrome for the Polish population. We would recommend to be used as the screening tool to assess frailty.

Influence of selected sociodemographic factors on psychosocial workload of nurses and association of this burden with absenteeism at work

BACKGROUND

The aim of this study has been to determine if sociodemographic factors: age, sex and duration of employment as well as the presence of chronic comorbidities exert significant effect on subjective assessment of psychosocial working conditions of nurses. Moreover, we analyzed whether the abovementioned variables influenced the level of absenteeism at work during a year preceding the study.

MATERIAL AND METHODS

The study, conducted between December 2012 and January 2013, included 789 nurses employed at public and private healthcare institutions in Białystok. The participants were surveyed by means of the "Psychosocial Working Conditions" questionnaire.

RESULTS

Women accounted for significantly higher scores of the Desired Changes Scale and significantly lower values of the Well-being Scale as compared to men. Respondents' age and duration of employment correlated significantly with the scores of the Demands and Desired Changes Scales. Moreover, we documented significant inverse correlations between the age and tenure and the scores of the Social Support and Well-being Scales. Furthermore, duration of employment was inversely correlated with the results of the Control Scale. The respondents with chronic conditions showed significantly higher scores of the Desired Changes Scale and significantly lower values of the Control and Well-being Scales. We found an inverse correlation between the number of sick leave days and the value of the Well-being Scale, which was also the case with a subset of nurses without chronic conditions.

CONCLUSIONS

Similar to other professional groups, a nursing team management requires the use of human resources management techniques and identification of a person being responsible for coordination of the group and diagnosis of its psychosocial needs.

[MicroRNA--a new diagnostic tool in coronary artery disease and myocardial infarction]

Coronary artery disease remain one of the leading causes of mortality in the world, indicating the need for innovative therapies and diagnosis for heart disease. MicroRNAs (miRNAs) have recently emerged as one of the central players in regulating gene expression which implicatate in normal cardiac development and many pathological process of the cardiovascular system, including cardiac arrhythmia, heart failure, cardiac fibrosis, coronary artery disease and myocardial infarction. iRNA are small noncoding RNAs 18-23 nucleotides in length that regulate expression of target genes through sequence-specific hybridization to the 3' untranslated region of messenger RNAs and block translation. miRNAs are not only found intracellularly, but also detectable outside cells, including various body fluids (i.e. serum, plasma, saliva, urine). This review will highlight recent findings in the regulation of miRNA biogenesis and secretion, modulation of the cardiovascular pathological process in CAD and AMI and the potential as non-invasive biomarkers for cardiac ischemia.

[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.

Lipids' peroxidation markers in Alzheimer's disease and vascular dementia

AIM

Although a large body of evidence supports a role of oxidative stress in the etiopathogenesis of dementia, there is still a substantial lack of data regarding the biomarkers of oxidative stress characteristic of Alzheimer's disease (AD) as opposed to different types of dementia. In this study, the level of various oxidative stress parameters were measured in AD, vascular dementia (VaD), and age- and sex-matched control patients. The AD and VaD patients all had similar levels of cognitive impairment as measured by the Mini-Mental State Examination.

METHODS

Thirty AD, 19 VaD and 29 controls patients were recruited to the study. Plasma levels of malondialdehyde (MDA), total sulfhydryl (T-SH), calcium (Ca(++)) and magnesium (Mg(++)) were measured.

RESULTS

In both AD and VaD groups, the levels of oxidative stress parameters were higher compared with controls. Further, the VaD patients expressed significantly higher levels of plasma parameters of oxidative stress than AD. The difference was noted in MDA, the marker of lipid peroxidation, whereas in VaD the level of MDA was more than 2.8-fold higher than that registered in AD patients.

CONCLUSION

Vascular dementia in patients is characteristic of increased levels of oxidative stress, especially lipid peroxidation markers. This finding is relevant to determining the pathophysiology of dementia, particularly in the light of the recently suggested importance of the vascular component in dementia development, in addition to aiding in the diagnosis of VaD following clinical presentation. The study will be continued to compare the character and level of decline in both groups.

[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.

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 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.

The influence of oxidative stress on the level of malondialdehyde (MDA) in different areas of the rabbit brain

Lipid peroxidation is a process which is determined by the extent of peroxide-forming free radicals mechanism and the peroxide-removing antioxidant system. To assess the peroxidation process, products of lipid peroxidation are analysed. Products of lipid peroxidation, such as thiobarbituric acid (TBA) are defined as thiobarbituric acid reactive material. In the present study we measured lipid peroxidation in three areas of the rabbit brain: brain hemispheres, brainstem and cerebellum. Supernatant and 10% homogenate were used to determine the level of malondialdehyde (MDA) according to the Ohkawa method. We measured levels of MDA before and after oxidative stress. Our results showed an important role of oxidative stress, because levels of MDA were increased significantly in comparison to the level of control, in all different areas of the rabbit brain.