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Aim of the studyIn bipolar disorder (BD), evidence for both cognitive impairment and deficit in emotion recognition has been found. Several investigations indicate that cognition and face processing can be interrelated. In this study, we assessed the correlations between cognitive functioning and emotion recognition (face expression) in patients with BD during an acute manic and depressive episode as well as in remission using a large battery of neurocognitive tests.Subject or material and methodsTwenty-four manic subjects, 21 with bipolar depression, and 22 euthymics, age-, sex-, and education-matched were included. Cognitive functions were assessed by the Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT, Stroop Color-Word Interference Test (SCWT), California Verbal Learning Test (CVLT), Benton Visual Memory Test (BVRT), Rey-Osterreich Complex Figure Test (ROFT), d2 test and Verbal Fluency Test (VFT). For emotion recognition, the Penn Emotion Recognition Test and Penn Emotion Discrimination Test were employed.ResultsIn mania, performances on selected measures of the WCST, TMT, SCWT, CVLT, ROFT, d2 test, and VFT, achieved 19 positive correlations with better recognition of happiness. In depression, conducting these tests obtained 20 correlations with finer recognition of sadness. In remission, such performances acquired 18 correlations with greater identification of sadness (10 replicated those obtained in depression).DiscussionBetter emotion recognition in manic patients concerns mostly happiness, while in depression and remission, mainly sadness.ConclusionsBetter neuropsychological performance can facilitate emotion recognition. We hypothesize that the identification of sadness could be considered a biological marker of mood disorders.

Introduction. The Covid-19 pandemic was a crisis situation that strained the health system. It carried a high risk of negative consequences, but there are also chances that some positive aspects will emerge, known as the post-traumatic growth phenomenon. Aim. The main aim of the study was to document and analyse the positive work experience of nursing staff in Poland gained in the period of the Covid-19 pandemic. Material and Methods. A qualitative study was conducted using the empirical phenomenological approach. The study involved a group of 215 nurses from different regions of Poland, including 209 women and 6 men aged between 22 and 65 years. They worked in hospital wards and in primary care. The study was carried out using an online survey method with subjects allowed to add comments. The results were subjected to content analysis. Results. During the analysis of the material, 10 thematic categories emerged, i.e. remuneration, professional development, team integration, epidemiological principles, adaptation to new conditions, lack of visits, assistance, improvement of work organisation, staff shortages and telemedicine. Conclusions. Based on the results of this study, it was indicated that nurses observe some positive experiences in relation to working during the pandemic. The results of this study can provide a starting point for further analyses that may be used to organise the work of nursing staff. (JNNN 2022;11(3):99–104)

Background Long-term care units’ residents do not constitute a homogeneous population. Providing effective care, tailored to individual needs, is crucial in this context. It can be facilitated by suitable tools and methods, which include needs assessment along with the physical, psychological and social aspects of care. We thus applied a cluster approach to identify their putative groupings to enable the provision of tailored care. Methods The needs of 242 residents of care homes in four Polish cities (Poznan, Wroclaw, Bialystok and Lublin), aged 75–102 years (184 females), with the Mini-Mental State Examination (MMSE) score ≥ 15 points, were assessed with the CANE (Camberwell Assessment of Need for the Elderly) questionnaire. Their independence in activities of daily living was evaluated by the Barthel Index (BI), and symptoms of depression by the Geriatric Depression Scale (GDS). The results of MMSE, BI and GDS were selected as variables for K-means cluster analysis. Results Cluster 1 (C1), n = 83, included subjects without dementia according to MMSE (23.7 ± 4.4), with no dependency (BI = 85.8 ± 14.4) and no symptoms of depression (GDS = 3.3 ± 2.0). All subjects of cluster 2 (C2), n = 87, had symptoms of depression (GDS = 8.9 ± 2.1), and their MMSE (21.0 ± 4.0) and BI (79.8 ± 15.1) were lower than those in C1 (p = 0.006 and p = 0.046, respectively). Subjects of cluster 3 (C3), n = 72, had the lowest MMSE (18.3 ± 3.1) and BI (30.6 ± 18,8, p p p p p p = 0.015). There were also differences in the patterns of needs between the clusters. Conclusions Clustering seems to be a promising approach for use in long-term care, allowing for more appropriate and optimized care delivery. External validation studies are necessary for generalized recommendations regarding care optimization in various regional perspectives.

Introduction . Huntington’s disease is a neurodegenerative disease, autosomal dominant inherited, characterised by a slow death of central nervous system cells. One of the most common causes of death is suicide. Aim . The aim of the paper is to present the problems and needs of a patient with Huntington’s disease, hospitalised psychiatrically because of organic mood disorders. Case Report . The case report concerns a 60-year-old patient with Huntington’s disease who, due to suicidal thoughts and tendencies, was admitted to the psychiatric ward. The paper presents selected care problems observed in the patient. Discussion . Almost every patient with Huntington’s disease experiences psychiatric symptoms. They appear at different stages of the disease. The described patient, hospitalised psychiatrically, experienced mental and somatic problems. The main objectives of nursing care were to reduce or eliminate the identified problems, mainly to ensure safety and improve functioning. Interventions included, in particular, close observation, assistance in self-care activities, motivating the patient to exercise and perform tasks independently, care in the event of fever, education on sleep hygiene. Conclusions . Patient care problems were related to mental and somatic disorders, in particular suicidal thoughts and tendencies and fever, difficulties in sleeping, moving and passing urine. The main nursing interventions included close observation and a holistic approach in collaboration with all members of the therapeutic team. The patient was discharged in a good general condition, in a balanced mood, without suicidal thoughts. He did not attempt suicide during hospitalisation. (JNNN 2020;9(1):33–38)

This study aims to investigate whether wearing face masks (filtering facepieces, FFP class 2) with personal protective equipment (FPP2/PPE), while working a 12-h shift in a COVID-19 referral center, affects the blood saturation, heart rate (HR), and well-being of health care providers (HCPs). The study included a group of 37 HCPs. To perform continuous recordings of the SpO2 and heart rate (HR) in real time, we used a Nellcor PM10N (Covidien, Mansfield, MA, USA) portable monitoring system. SpO2, HR, and HCP well-being scales were measured during two 3-h shifts, while HCPs worked during a 12-h period. Additionally, each subject completed a questionnaire concerning their well-being. The difference in the SpO2 level between the 1st and 2nd working shifts while wearing an FFP2/PPE was small, with a median decrease in SpO2 of −1%. The scales of the well-being indicators increased within the shift. They were mainly fatigue and thirst with median scores of 2 out of 6 (range 0–4). We assume that during a 12-h period, a work scheme that consists of a 3-h shift in FFP2/PPE and a 3-h rest period (working without FPP2/PPE) is a reliable and safe solution for HCPs working in specialized COVID-19 referral hospitals.

Krystyna Jaracz,1 Barbara Grabowska-Fudala,1 Paweł Kleka,2 Maciej Tomczak,3 Anna Smelkowska,1 Aleksandra Pawlicka,4 Krystyna Górna5 1Department of Neurological Nursing, Poznan University of Medical Sciences, Poznań, Poland; 2Faculty of Psychology and Cognitive Sciences, Adam Mickiewicz University, Poznań, Poland; 3Department of Psychology, Poznan University of Physical Education, Poznań, Poland; 4Independent Researcher, Bydgoszcz, Poland; 5Department of Psychiatric Nursing, Poznan University of Medical Sciences, Poznań, PolandCorrespondence: Krystyna Jaracz, Department of Neurological Nursing, Poznan University of Medical Sciences, Poznań, Poland, Tel + 48 618612267, Email jaracz@ump.edu.plPurpose: Most stroke patients require long-term care of their family members. Excessive care burden entails several negative consequences; therefore, the severity of the burden should be periodically assessed. For this purpose, valid multidimensional measures are needed. Our study, which is a part of a larger research project, aims to translate and evaluate the psychometric properties of the Polish Caregiver Burden Scale (CBS) in relation to construct validity and internal consistency in caregivers of the patients after stroke.Patients and Methods: The sample of this cross-sectional observational study consisted of 366 informal caregivers to consecutive first-ever stroke survivors. The five-factor Polish CBS and the Hospital Anxiety and Depression Scale (HADS) were administered during the home visits at three to six months after patients’ hospitalisation. Exploratory (EFA), confirmatory (CFA) factor analyses and a net analysis were performed to investigate the internal structure and a factorial construct validity of the CBS. Correlation analyses between the CBS and the HADS were carried out to examine convergent validity. Cronbach’s alpha and item-total correlation were applied to assess internal consistency.Results: Three out of five factors identified by EFA were similar to the original indices of the CBS, while the remaining two deviated from the original structure of the CBS. The CFA five-factor model represented an acceptable fit (confirmatory fit index, CFI = 0.96, root mean square error, RMSEA = 0.04) but only after a modification. All subscale scores of the CBS were positively correlated with the HADS, supporting the convergent validity. Cronbach’s alpha coefficients for the overall scale (0.92) and all subscales (0.72– 0.87) except one (0.69) and item-total correlation results indicated good internal consistency.Conclusion: The Polish version of the CBS showed acceptable internal consistency and good convergent validity. Factorial validity and structural integrity were partially supported. The interrelationships between the CBS subdomains, their partial mutual contamination, and the scale’s non-orthogonal structure should be considered when interpreting the results of further studies using this version of the scale.Keywords: stroke, caregiver burden, reliability, validity

BackgroundRecent studies support the effectiveness of filtering facepiece class 3 respirators (FFP3) during the COVID-19 pandemic in terms of protecting both health care workers (HCWs) and patients. However, wearing FFP3 respirators together with personal protective equipment (FFP3/PPE) could increase the feeling of discomfort or could even cause hypoxia. This study aims to investigate whether wearing an FPP3/PPE during work in the intensive care unit (ICU) affects the blood saturation (SpO2), the heart rate (HR), and the well-being of HCWs, as depicted by a score scale.MethodsThe study included a group of 21 volunteers, staff nurses, students and consultants (including 16 females (76%), with a median age of 23 years (interquartile range 21-27), range 20-59 years).We applied a counterbalanced crossover design—a self-controlled trial. Each subject served as his own control and performed the test two times: they wore the FFP3/PPE for a three-hour shift in the ICU and then did not wear the FFP3/PPE for 3 hours. To record the SpO2 and HR in real time, we used a Nellcor PM10N (Coviden, USA) portable monitoring system. Additionally, every 30 minutes during the shift and control run, each subject completed a questionnaire concerning their well-being, with a score scale to evaluate for headaches, shortness of breath, perspiration, fatigue, and thirst.ResultsThe mixed model demonstrated that working with an FFP3/PPE compared to not working with an FFP3/PPE caused a significant, but still within normal ranges, influence on the level of SpO2, with a mean decrease of -1.43%. The highest reduction in the SpO2 was 2.29%, and occurred after 150 minutes of work. We also found a significant increase in the HR at 60, 90, and 120 minutes after starting work. All of the score scales of the well-being markers increased consecutively but were moderate during the shift while wearing the FFP3/PPE; the side effects were mainly fatigue, thirst, and sweating.ConclusionWe assume that a 3 hour shift rhythm –, i.e., three hours of working in the FFP3/PPE in the ICU, followed by rest or working without an FFP3/PPE is a safe and reliable solution.

This study aims to investigate whether wearing a filtering facepiece class 3 respirators with personal protective equipment (FPP3/PPE) during work in the intensive care unit (ICU) affects the blood saturation (SpO2), the heart rate (HR), and the well-being of health care workers (HCWs). This preliminary study included a group of 21 volunteers (including 16 females (76%), with a median age of 23 years). Each worker served as his own control and performed the test two times: they wore the FFP3/PPE and did not wear it for a three-hour shift in the ICU. The working with an FFP3/PPE compared to not working with an FFP3/PPE caused a significant, but within normal ranges, influence on the level of SpO2 with a mean decrease of − 1.43%. The highest reduction in the SpO2 was − 2.29% and occurred after 150 min of work. All of the score scales of the well-being markers increased consecutively but moderately during the shift while wearing the FFP3/PPE. We assume that a 3-h shift rhythm is a safe and reliable solution, i.e., three hours of working in the FFP3/PPE in the ICU, followed by rest or working without an FFP3/PPE.

Cel pracyUtworzenie polskiej adaptacji Krótkiej Skali Objawów Negatywnych (Brief Negative Symptom Scale – BNSS), ocena zgodności wewnętrznej polskiej wersji skali BNSS oraz przeprowadzenie korelacji między oceną w skali BNSS, a oceną w Skali Zespołów Pozytywnego i Negatywnego schizofrenii (Positive and Negative Syndrome Scale – PANSS) w grupie chorych na schizofrenię.MetodaPrzeprowadzono procedurę polskiej adaptacji formularza oceny (Scoresheet), obejmującego 13 punktów zorganizowanych w 6 podskal (anhedonia, brak prawidłowego dystresu, asocjalność, awolicja, blady afekt i alogia), podręcznika (Manual) oraz zeszytu szkoleniowego (Workbook) skali BNSS. Badania psychometryczne wykonano u 40 chorych na schizofrenię paranoidalną (20 mężczyzn i 20 kobiet), w wieku 44+13 lat, o długości choroby 17+10 lat i nasileniu objawów w skali PANSS 56+16 punktów, otrzymujących niezmienione leczenie farmakologiczne w okresie ostatnich 3 miesięcy.WynikiPolska wersja została zaakceptowana przez twórców skali. Analiza rzetelności wykazała wysokie wyniki wskaźnika alfa-Cronbacha zarówno dla całej skali (0,97), jak i dla poszczególnych podskal (0,74-0,93). Skala BNSS i jej podskale wykazywały wysoką istotną korelację z całkowitym wynikiem PANSS oraz z podskalą objawów negatywnych PANSS zarówno oryginalną, jak i zmodyfikowaną.WnioskiUzyskane wyniki wskazują na dobre własności psychometryczne polskiej wersji skali BNSS i na jej możliwą przydatność w badaniach objawów negatywnych schizofrenii prowadzonych w naszym kraju.

Introduction . In recent decades prognoses for stroke survivors regarding the risk of death or serious disability have improved, primarily due to stroke units, thrombolytic therapy and mechanical thrombectomy. Long-term research concerning the course of recovery and the consequences of strokes, which apart from clinical and functional indices would also include the quality of life, is relatively scarce. For this reason it is necessary to constantly update our knowledge of various aspects of the long-term process of recovery of stroke survivors. Aim . The aim of the present study was to assess health-related quality of life in a prospective manner over a period of up to five years following a stroke. Material and Methods . The study sample consisted of 27 patients (18 men and 9 women) aged between 53 and 82, mean age of 68.77 years (SD 8.16), 3 months, 12 months and 5 years after suffering from an ischaemic stroke. Quality of life was assessed using the Euro-Quality of Life Questionnaire (EQ-5D-3L), which covers five quality of life dimensions, the summary quality of life index (EQ — index), and self-assessment of health using the VAS scale (EQ VAS). Results . Quality of life impairment in various dimensions and at various time points of the study concerned from 8% to 60% of patients. Problems occurred mainly in the “pain/discomfort” dimension, and applied to more than 40% of patients during the observation period. The lowest intensity of problems was found in the “self-care” dimension, these referred to from 7% to 14.8% of patients. Mean levels of the EQ index were rather high in all assessments (> 0.80), while those of EQ VAS were moderate (between 60 and 70 points). They did not changed significantly over the period of observation. Conclusions . The quality of life of the majority of stroke patients is relatively good, although it differs for various dimensions. The quality of life in the “non-physical” dimensions is lower than in the physical dimensions. Also the quality of life of patients 3 months after a stroke does not change significantly over the next few years. (JNNN 2019;8(2):62–68)

ObjectivesYoga is an ancient form of physical activity (PA) that encompasses meditation, stretching and breathing techniques. Although the benefits of PA and associated lifestyle interventions are clear, we here addressed the paucity of evidence regarding the specific relationship between yoga and quality of life (QOL) in adults in Poland. We hypothesised that participation in PA and yoga could result in a positive impact on QOL.DesignCross-sectional, self-administered questionnaire-based survey. Both the quantitative and qualitative variables were statistically compared. Multivariate analyses were performed using linear regression. Results were determined based on age, sex and education level; a pSettingQuestionnaires were delivered to participants online, at high schools and universities, and in elderly communities in Poland.Participants714 polish citizens aged over 18 participated in the study; there are no specific entry and exclusion criteria besides age.ResultsStatistically significant differences (pConclusionsThe study shows that both regular PA and yoga practices could improve QOL; however, PAG-Y produced higher QOL scores than PA of other types. This outcome may be explained by the impact of physiological and psychological aspects within yoga practice. These results suggest that this unique combination impacts health more positively than other kinds of PA alone.

Background The concomitant use of two or more mood stabilisers (MS), second-generation antipsychotics (SGA), lamotrigine as well as antidepressants, is frequently reported in the treatment of bipolar patients The aim of this study was to investigate the pattern of pharmacological treatment with special regard to polypharmacy defined as two or more psychiatric drugs taken at the same time in the same patients with bipolar disorder discharged from psychiatric units in Poland. Method Pharmacotherapy of 127 consecutive patients (57 females and 70 males) with an ICD-10 diagnosis of bipolar disorder (BP) at the point of discharge from five psychiatric regional hospitals/units in Poland, was evaluated in 2015/2016 on the basis of medical files. The effect of treatment on mental status at discharge was examined using the Clinical Global Impression-Improvement scale (CGI-I). Results When only MS, SGA and lamotrigine, were taken into account, 78 (61%) of patients were prescribed two, 27 (21.3%) three and one patient four medications. The combination of MS and SGA was most commonly used (n = 61, 48%). Medications preferred by Polish psychiatrists at patients’ discharge were valproates (n = 69, 54%), olanzapine (n = 48, 37%), quetiapine (n = 47, 37%) and lamotrigine (n = 33, 25.9%). Thirty patients (23.6%) were prescribed lithium. No relationships were found between polypharmacy and patients’ age, duration of illness and the rate of CGI-I. However, polypharmacy was significantly associated with types of bipolar disorder, particularly with the bipolar I disorder. Conclusion The prevalence of polypharmacy especially with MS and SGA in the treatment of bipolar patients discharged from psychiatric units in Poland is high. The most significant factor predisposing to polypharmacy is a diagnosis of bipolar – I disorder. In general, our study confirms trends observed in other countries.

Multiple Sclerosis (SM) is the most common chronic inflammatory autoimmune demyelinating disease affecting the central nervous system. It affects mainly young people, aged 20–40.The onset of the disease usually takes the form or bouts followed by periods of remission. Immunomodulating treatment is a long-term therapy whose aim is to inhibit the occurrence of relapses and, in the long term-delay development of disability in a patient. The effectiveness of this treatment depends, among others, on the degree of preparation of the patient and their following the rules of the therapy. Most of the medication applied is administered by the patient at home as an injection or in the form of oral therapy. Nowadays two drugs are administered in hospitals. Since the very beginning of the treatment the patient and their family is provided with nursing care whose scope depends on the drug administered and on the condition of a patient. The procedures undertaken by the nurse include: educating the patient and their family in the preparation and administration of a drug, coping with adverse effects, monitoring the neurological and emotional condition of a patient and providing support during all treatment period. (JNNN 2018;7(4):160–165)

Introduction . Evaluation of functional limitations in patients with ischemic stroke is essential in planning suitable nursing care. The main aim of all nursing procedures taken is to ensure the safety of patients, to provide the best, individualized care fulfilling patients’ needs and to support recovery process, considering the necessary number of nursing staff and time needed for these procedures. A tool helpful in the process of diagnosis and planning care is the Northwick Park Dependency Score — NPDS. Aim . The aim of the present study is to describe the Polish version of this scale and to assess its usefulness by comparing the NPDS with the Barthel Index — considered the “golden standard” for assessing patient’s disability and dependency. Material and Methods . The study included 100 elderly ischemic stroke patients aged 60 to 99 years (mean 76.1, SD 9.07). To assess patient’s dependency and thus the need of nursing care, the NPDS Scale was used. Functional status of patients was assessed with the Barthel Index, and the neurological state using the NIHSS. Results . Most items in NPDS, are similar to the items of the BI. However, the NPDS includes additional important questions regarding cognitive functions, communication and behavioral dysfunctions. It allows to estimate the number of nursing staff and their scope of competences necessary for providing care as well as time needed for particular nursing activities. There is a strong correlation between individual modules in the NPSD and the BI sales (r ≈ 0.90). Nevertheless, these are not interchangeable. The high correlation coefficient confirms the validity of the Polish version of the NPDS. Conclusions . NPDS is a simple and useful tool in nursing care allowing to plan the activities based on objective indicators. Despite many similarities it is not a substitute for the popular Barthel Scale. Therefore, the NPDS should be promoted in the nursing environment as a possible work tool. (JNNN 2018;7(1):4–11)

Introduction This is a prospective study, first to compare the frequency of depressive symptoms in stroke survivors treated, and non-treated, with intravenous thrombolysis and second, to explore relationships between post-stroke depression (PSD) and stroke treatment modalities, taking into account other possible determinants of PSD, including post-traumatic stress symptoms. Methods Groups of 73 thrombolysed and 73 non-thrombolysed patients matched for age and gender were examined at 3 and 12 months after discharge. PSD was assessed using the Beck Depression Inventory. Post-traumatic stress symptoms (PTSS), disability and social support were assessed with the Impact of Event Scale-Revised, the Barthel Index and the Berlin Social Support Scale. Results At 3 months, PSD was present in 23.3% of the thrombolysed and 31.5% in the non-thrombolysed groups (p = 0.265). At 12 months, the frequencies were 29.2 and 20.6% (p = 0.229). Logistic regression of the combined group of thrombolysed and non-thrombolysed patients indicated that at 3 months, the adjusted predictors of PSD were disability (OR 24.35), presence of PTSS (OR 9.32), low social support (OR 3.68) and non-thrombolytic treatment (OR 3.19). At 12 months, the predictors were disability (OR 15.78) and low education (OR 3.61). Limitations The use of a questionnaire for the detection of depression, the relatively small sample size and a significant drop-out rate could limit the interpretation of these results. Conclusions (1) Thrombolysed and non-thrombolysed stroke survivors had similar frequency of depressive symptoms although the thrombolysed patients had more severe neurological deficits in the acute phase. It can be assumed that if thrombolysis had not been used, depressive symptoms would have been more frequent. (2) Lack of the rt-PA treatment was associated with three-time greater odds of screening for PSD at 3 months post-stroke, after adjustment for other PSD correlates. (3) Therefore, thrombolytic therapy seems to have a positive, but indirect, effect on patients’ mood, especially in the first months after stroke. (4) All stroke patients, irrespective of the method of treatment, should be monitored for the presence of depression.

CelCelem pracy było utworzenie polskiej wersji Skali Samooceny Objawów Negatywnych (Self-report of Negative Symptoms -SNS), ocena jej zgodności wewnętrznej oraz przeprowadzenie korelacji między oceną w skali SNS, a oceną w Krótkiej Skali Objawów Negatywnych (Brief Negative Symptom Scale – BNSS), w grupie chorych na schizofrenię.Materiał i metodyPrzeprowadzono procedurę polskiej adaptacji francuskojęzycznej wersji skali SNS obejmującej 20 punktów zorganizowanych w 5 podskal: asocjalność, spłycenie afektu, alogia, awolicja i anhedonia. Badania psychometryczne wykonano u 40 chorych na schizofrenię paranoidalną (20 mężczyzn i 20 kobiet), o nasileniu objawów w skali Positive and Negative Syndrome Scale (PANSS) 56+16 punktów, otrzymujących niezmienione leczenie farmakologiczne w okresie ostatnich 3 miesięcyWynikiPolska wersja skali SNS została zaakceptowana przez twórcę skali, prof. Sonię Dollfus. Analiza rzetelności SNS wykazała wysokie wartości wskaźnika alfa-Cronbacha zarówno dla całej skali (0,91), jak i dla poszczególnych podskal (0,61-0,85). Skala SNS i jej podskale wykazywały istotną korelację z całkowitym wynikiem BNSS, jak również wartościami jej odpowiednich podskal, co potwierdza trafność skaliWnioskiZnamienny statystycznie poziom zgodności całej skali oraz poszczególnych jej domen z wynikami skali klinicznej BNSS przemawia za adekwatnością oceny objawów negatywnych przez samego chorego na schizofrenię. Uzyskane w niniejszej pracy dobre własności psychometryczne polskiej wersji skali SNS mogą wskazywać na jej przydatność w badaniach objawów negatywnych prowadzonych w naszym kraju

The aims of this study were to examine prospectively the course of neurological and functional recovery and health related quality of life (HRQoL) in ischaemic stroke patients after intravenous thrombolysis, to assess the 1-year outcome and to determine the early predictors. A group of 53 consecutive patients were assessed at admission to the acute stroke unit (T0), before their discharge (T1), and at 3 (T2) and 12 (T3) months after hospital discharge. The National Institutes of Health Stroke Scale (NIHSS), the Barthel Index (BI) and the Stroke Specific Quality of Life Scale (SSQoL) were used to evaluate stroke severity, functional disability and health related quality of life (HRQoL). A good outcome was defined as simultaneous improvement in all three scales. At T0, 83 % of the patients had severe or moderate neurological impairment. Additionally, 77 % demonstrated very severe or severe disability when assessed by the BI. 74 and 79 % of the patients reported an acceptable HRQoL at 3 and 12 months following discharge, respectively. Neurological and functional status improved significantly over time with most changes occurring during hospitalization and the subsequent 3 months. At T3, 75.5 % of the patients had the good outcome which had been independently predicted by the level of stroke related disability at T0. A majority of the stroke survivors treated with thrombolysis achieved a good outcome. The measurement of stroke specific HRQoL, as a tool for gathering information from the patient, should be incorporated in the assessment of post-stroke recovery and outcome.

Introduction Most studies concerned with the quality of life (QoL) of women with reduced bone mineral density (BMD) focus on patients with vertebral and non-vertebral fractures. Our objective was to evaluate QoL among patients with reduced BMD regardless of their fracture history compared to women with normal BMD. Material and methods Eighty-five patients in the study group were classified as osteoporotic, with BMD results measured by densitometry and expressed by T-score ≤ –2.5 SD, 122 women were osteopenic, with –2.5 < T-score ≤ –1.0 SD, and 97 subjects were assessed as normal, with T-score > –1.0 SD. Mean ages of women according to groups were 59.90, 57.67 and 55.68, respectively. Assessment of life quality was conducted using the Polish version of the QUALEFFO-41 scale. Results The ratings in the assessment (QUALEFFO-41) of QoL were lower for osteoporotic and osteopenic women than for the normal BMD group with regard to pain (p = 0.006), social function (p = 0.001), health perception (p = 0.001), and mental function (p = 0.001). For total QUALEFFO-41 the associated factors were: secondary and higher education (OR = 0.49; 95% CI: 0.29–0.82), self-perceived deformity of the back (OR = 4.09; 95% CI: 1.88–8.93), previous fractures (OR = 2.52; 95% CI: 1.09–5.82), reduced height (OR = 2.48; 95% CI: 1.13–5.39) and anxiety (OR = 1.42; 95% CI: 1.21–1.66). Conclusions It seems necessary to evaluate QoL of women with reduced BMD before fractures occur, to aid development of health education aiming to reduce the incidence of osteoporosis and prevent fractures.

Objectives The aim of the study was to evaluate the Camberwell Assessment of Need for the Elderly questionnaire (CANE) in assessing the needs of elderly individuals living in long-term care institutions (LTCI) in Poland. Setting and Participants The needs of 173 residents were assessed. The inclusion criteria were age (at least 75 years of age) and the lack of severe cognitive impairment (Mini Mental Scale Examination score of at least 15 points). Measurements In all participants, met and unmet needs were assessed by themselves and by the nursing staff involved in care activities. Results The number of met needs assessed by the staff was higher than in the users’ opinions (p

ObjectivesThe aims of the study were: (1) to evaluate longitudinally symptomatic remission in first-episode (FE) schizophrenia, (2) to describe symptoms, social functioning and quality of life (Qol) in relation to remission status, and (3) to determine the long-term outcome of schizophrenia and its early predictors.MethodsSixty-four patients were assessed 1 month after a first hospitalization (T1), 12 months (T2), 4–6 years (T3), and 7–11 years (T4) after T1. The patients were allocated to three remission groups according to their remission status over the whole observation period, e.g. stable remission (SR), unstable remission (UR) and non-remission (NR). The PANSS, Social Functioning Scale and WHOQoL were used to evaluate the patients’ psychosocial functioning levels, symptomatic and functional remissions and satisfying QoL. A good outcome was defined as meeting, simultaneously, the criteria of symptomatic and functional remissions and satisfying QoL at T4, while failure to meet all of these criteria was defined as a poor outcome.ResultsAmong them, 17.2% patients were in stable remission, 57.8% in unstable remission and 25.0% were unremitted at all time points. The SR group had lower levels of psychopathological symptoms and reported better social functioning and QoL than the NR group. During the follow-up, the symptoms increased, social functioning slightly improved and QoL did not change. At T4, 53% of the sample had a poor outcome, which was independently predicted by the longer duration of untreated psychosis and a lack of satisfying QoL at T1.ConclusionsOur results demonstrate that: (1) the long-term course in schizophrenia is heterogeneous and that three illness trajectories exist, (2) social functioning and QoL are only partially connected with symptomatic remission (3), the risk of a poor outcome may potentially be reduced by appropriate interventions at an early stage of the illness.

Objectives To assess the prevalence of considerable burden among caregivers of stroke survivors at 6 months (Time 1) and 5 years after stroke (Time 2), to analyse changes in burden severity over time and to identify factors associated with the burden. Methods Eighty eight patient/caregiver pairs were assessed. Caregiver burden was measured with the Caregiver Burden Scale. Socio-demographic, stroke-related and psychological characteristics were analysed as potential determinants of the burden. Exact multiple logistic regression was used to identify the predictive factors. Results Considerable burden was reported by 44% of the caregivers at Time 1 and 30% at Time 2. The burden was independently associated with caregivers’ sense of coherence and amount of time spent caregiving at Time 1, and with caregivers’ anxiety at Time 2. Conclusions A significant proportion of the caregivers experienced considerable burden in the post-acute and chronic phases of stroke, although this proportion declined over time. Several characteristics were associated with the increased burden at different time points. All the independent predictors related to aspects of the carers. Practice implications Programmes including education about coping strategies and time management, as well as respite care provision, could be beneficial and might help to reduce the burden of caregiving.

Multiple sclerosis (SM) is an incurable, advancing, demyelinating illness with inflammatory background. It constitutes the most frequent cause of disability among young people, between 20 and 40 years of age. Despite the identification of multiple factors causing the disease, its pathomechanism has not been yet completely discovered. For this reason, finding an effective cure for multiple sclerosis continues to present a challenge (for modern scientists). The currently available treatment for SM aims to halt its progress and to minimalize complications related to the disease. The goal of the work was to provide an overview of the therapies currently available to those suffering from SM. Selecting an appropriate form of treatment and medication as well as preparing the patient and continuation of monitoring during the therapy constitute important elements of conducting an effective SM therapy.(JNNN 2015;4(3):130–137)

[b]Objective[/b]. To measure the intensity of depressive symptoms in the populations residing in rural areas of western Poland, and to delineate the putative association between the intensity of depression and selected socio-demographic and clinical factors. [b]Materials and method.[/b] The study covered 445 adults recruited from one family physician practice in the rural area of Wielkopolska region. The following tools were applied: Beck Depression Inventory (BDI), the WHO WHOQoL-Bref quality of life assessment scale, and a socio-demographic and clinical questionnaire elaborated by the authors. [b]Results.[/b] Depressive symptoms were observed in approx. 30% of the patients. The intensity of symptoms correlated with age, female gender, and inversely correlated with the quality of life. There was no association between depressive symptoms and level of education (counted as years of education), number of somatic illnesses, and family burden of psychiatric disorders. [b]Conclusion[/b]. Symptoms of depression were noted in approx. 30% of patients who consulted their family physician. The Beck questionnaire is a simple tool whose application could decidedly improve the recognition of depression. It is worth taking note of factors that may be connected with the intensity of depressive symptoms – gender, the number of diagnosed somatic illnesses, and the quantity of drugs administered.

Background Conflicting data regarding the efficacy of antidepressants of different mechanism of action on unexplained painful physical symptoms (UPPS) in depression have been published so far. Objective The aim of this study was to compare the impact of escitalopram (ESC), nortriptyline (NOR), and venlafaxine (VEN) on UPPS in patients with major depression. Materials and methods Sixty patients, participants in the GENDEP study, with a diagnosis of depression according to the ICD-10 criteria were randomly assigned to treatment with ESC (10–30 mg, mean dose 15.2, standard deviation [SD]±9.2) or NOR (50–150 mg, mean dose 106.2, SD±8.2). Additionally, 30 patients who were treated with VEN (75–225 mg, mean dose 181.3, SD±8.8) were included. Before inclusion (day 0) and throughout the study (days 14, 28, 42, 56), the severity of pain was monitored using the visual analog scale. Results The patients treated with ESC, NOR, and VEN did not differ in the intensity of pain at days 0, 14, 28, 42, and 56. Conclusion Our results do not support the hypothesis suggesting the superiority of VEN over ESC and NOR in the management of UPPS in major depression.

Introduction Despite the growing body of literature on the consequences of providing non-professional care to stroke survivors, the determinants of caregiving burden are still not fully recognized. Identification of significant determinants can facilitate caregiver intervention programs. The aim of this study was to evaluate the level of burden borne by caregivers of stroke patients and to identify the most important determinants of burden at 6 months after hospitalization. Material and methods Data were collected from 150 pairs of stroke patients/caregivers. Caregiver burden was assessed on the Caregiver Burden scale (CB). Several characteristics were measured as potential predictors of the burden. Special attention was paid to the caregiver's sense of coherence (SOC) and anxiety. Regression analysis was employed to test the hypothesized relationships between these variables and the burden. Results Forty-seven percentage of the caregivers reported a substantial burden (severe or moderate). Caregiver SOC (p < 0.001), anxiety (p < 0.001) and the patients’ functional status (p < 0.001) were the most important predictors of the overall burden and the most consistent predictors of the majority of aspects included in the CB scale. Caregiver health, patient's gender, time spent caregiving and social support were also factors related to the burden. The identified predictors explained 67% of the variance in the overall burden. Conclusions Clinicians and other professionals should focus on the coping abilities of caregivers, their emotional state and the level of patients’ dependency, as these are the vital and modifiable factors affecting caregiver burden following stroke.

Background:Studies on the determinants of the quality of life (QOL) after stroke bring differing results depending on the applied concept of QOL. This may lead to confusion about the contribution of various factors to the post-stroke QOL.Objective:The aim of the study was: (i) to investigate functional and psychological QOL in the individuals after the first ischemic stroke; (ii) to identify the most important correlates of QOL; and (iii) to examine the significance of depression among the other possible predictors of QOL.Methods:A hospital-based sample of 72 stroke patients was followed up to 6 months after stroke onset. QOL was assessed using the Polish version of the Quality of Life Index and the Sickness Impact Profile. A multiple regression procedure was performed to examine relationships between QOL and the study variables.Results:In spite of good recovery, the psychological and functional QOL of the examined patients was impaired, although the negative impact of stroke was greater on the objective QOL than on the subjective QOL. Stroke-related impairment, depression, functional disability and marital status predicted 80% of the variance in the functional QOL. Emotional support, depression and functional disability explained 38% of the variance in psychological well-being.Conclusions:Depression and physical disability were the most important predictors of QOL after stroke since their impact on QOL was more robust in comparison to the remaining variables. For improving QOL, a comprehensive care for patients aimed at reducing physical dependence and ameliorating depressive symptoms could be recommended.

The aim of this study was to examine the validity and reliability of the Polish WHOQOL - Bref in a sample of 908 respondents. The Bref is a generic quality of life (QoL) instrument designed for cross - cultural use. Correlational and multivariate analyses confirmed the relevancy of individual items and domains supporting the construct validity of the scale. Multiple regression analyses of the domain scores with two overall questions (dependent variable) showed that all four domains made a significant contribution in explaining the variance in overall QoL. The psychological domain made the strongest contribution (unstandardized B coefficient = 0.10, r2 = 0.41), followed by the social, environmental and physical domains. When overall health satisfaction was considered as the dependent variable, the physical domain contributed most strongly (unstandardized B coefficient = 0.21, r2= 0.43) followed by the psychological and environmental domains. Exploratory factor analyses resulted in a four factors solution with 24 items explaining 49.6% of the cumulative variance. Confirmatory factor analyses lended marginal support for the goodness of fit of the four-domain model. The physical domain was found to be strongest in differentiating between unhealthy and healthy subjects, followed by psychological and social domains. Acceptable internal consistency was shown with Cronbach's alpha coefficients being greater than 0.70 for all domains with the exception of the social domain. Further exploration of the scales validity and conceptual clarity need further testing in Polish and international samples.

Objectives – To describe global and domain-specific quality of life (QOL) after stroke and to identify the factors that are important for post-stroke QOL. Material and methods – A hospital-based sample of 72 stroke patients was followed up for 6 months after stroke onset. QOL was assessed using the Polish version of the Quality of Life Index. Regression analysis was performed to identify the variables that best predicted QOL. Results – The overall QOL of stroke patients was relatively good, although worse than that of subjects in a comparison group. The highest QOL was found in the ‘Family’ domain, and the lowest in the ‘Health and functioning’ domain. Emotional support, depression and functional disability were three separate variables explaining 38% of the variance in QOL. Conclusions – Strengthening of family support, treatment of depression and reduction of physical dependence may be the decisive factors in improving post-stroke QOL.

The assessment of social functioning and subjective quality of life in relation to symptomatic remission in schizophrenia patients after a first psychiatric hospitalization, as well as the analysis of connection between intensity of psychopathological symptoms and the level of functioning and quality of life, taking into account the status of remission and duration of illness.Sixty-four patients were assessed, at 13 months (1st examination) and at mean 8 years (2nd examination) after the first hospitalization, and compared with two control groups of healthy persons. The following scales were used: Positive and Negative Syndrome Scale (PANSS), Social Functioning Scale (SFS), WHO Quality of Life (WHOQoL--Bref) scale and Global Assessment Scale (GAS).At first examination, the score of SFS domains was not significantly different between patients in remission and without remission while the score of most domains of WHOQoL was significantly higher in patients with remission. At second examination, the scores of both SFS and WHOQoL were significantly higher in patients with remission and did not differ significantly from healthy persons. In both examinations, significant correlations between PANSS and SFS and WHOQoL scores were found, especially in patients without remission.At mean 8 years after first psychiatric hospitalization, 2/3 of the patients with schizophrenia did not get a symptomatic remission and had worse social functioning and quality of life compared to patients with remission and to healthy controls. Psychopathological symptoms correlated significantly with social functioning and quality of life, especially among patients without remission.

Despite a significant progress in prevention, treatment and management in the past decades, stroke remains the most common disabling chronic condition in adult population. It may be a source of serious temporary or permanent consequences. These consequences should be recognised and measured for defining and implementation of remedial interventions and for optimum utilisation of health care resources. The aim of this work was to present sequels of stroke, taking into account objective and subjective indices, as documented in the recent literature of the subject. Selected data on mortality and survival following stroke were presented, the up-to-date literature was reviewed and register-based prospective studies were presented on quality of life (QoL) in post-stroke patients. Systematic reviews and meta-analyses of randomised controlled trials (RCTs) were summed up, related to efficacy of interventions aimed at improving QoL of the patients. Moreover, the studies were reviewed on burden and QoL experienced by caregivers of post-stroke patients and results were summed up of RCT synthesis aimed at reducing the burden and at improving QoL in the caregivers. The analysed studies indicated that stroke exerts a long-term, negative effect on patients' QoL, promoting a decrease in this measure and burdening a significant proportion of the family caregivers. The applied till now different interventions and programmes targeted at the patients and at their carers analysed in RCTs showed no or modest effects on improving of QoL or reducing the caregiver's burden.

Background The term antipsychotic polypharmacy (APP) refers to the concurrent use of two or more antipsychotic drugs in schizophrenia. The aim of this study was to investigate the range of APP in schizophrenic patients discharged from psychiatric units in Poland, and to determine its demographical and clinical correlates. Methods Data on the pharmacological treatment of 207 patients with a diagnosis of schizophrenia, discharged from six psychiatric hospitals from September–December 2011 were recorded by experienced psychiatrists. Clinical and demographical information was obtained on each patient. The severity of symptoms at admission, and their improvement during hospitalization were assessed using the Clinical Global Impression Scale. Results At discharge, 52.7% of the patients were prescribed one, 42.5% two and 4.8% three antipsychotic drugs (AP). When two AP were applied, it was usually a combination of two second generation antipsychotics (SGA) (46%), or of both first generation antipsychotics (FGA) and SGA (48%). The SGA's olanzapine and risperidone were those most commonly prescribed. Patients treated with two or more AP had a higher number of previous hospitalizations than patients receiving antipsychotic monotherapy. Mood stabilizers were prescribed for nearly one third of the patients, while antidepressants and benzodiazepines were prescribed for fewer than 10%. Conclusions The prevalence of polypharmacy in Poland is similar to that reported in other countries. This may suggest that, in a substantial proportion of schizophrenic patients clinical response to the antipsychotic monotherapy is unsatisfactory. Further studies focusing on the efficacy and safety of strategies in the treatment of patients with schizophrenia not responding to antipsychotic monotherapy are necessary.

Multiple sclerosis (MS) is the second most common cause of disability among nervous system diseases. This disease causes reduced quality of life of patients and those caring for them. Quality of life (QoL) measures consist of at least three broad domains: physical, mental and social. In the field of medicine, researchers have often used the concept of health-related quality of life, which specifically focuses on the impact of an illness and/or treatment on patients’ perception of their status of health and on subjective well-being or satisfaction with life. Subjective factors of QoL in MS patients include perception of symptoms, level of fitness, self-image, satisfaction with family life, work, the economic situation, interaction with other people, social support and life in general. Objective factors include the clinical picture of disease, social status, social and living conditions and the number and intensity of social contacts. While many generic and specific questionnaires have been developed to assess QoL in patients with MS, including general fatigue, there is a lack of specific questionnaires assessing QoL of caregivers. In this paper, a review of selected studies on QoL and caregiver burden in MS and a summary of the most popular questionnaires measuring burden and QoL are presented. Special attention is paid to the first questionnaire specific for QoL of carers of persons with MS, CAREQOL-MS by Benito-Leon et al.

To estimate the proportion of locomotor disabilities in two elderly populations in Sweden and Poland, respectively. To estimate the perceived quality of life (QoL) in the disabled groups in samples from each country using a model developed by Carol Estwing Ferrans.The study comprised three parts: an epidemiological screening test for identification of individuals with a locomotor disability, an analysis of background data of importance and home visits with evaluations of quality of life and functional capacity. Home visits were made using the Quality of Life Index, (QLI) of Ferrans and Powers and a functional scale, the Standardized Practical Equipment (SPE). Data were collected for the period 1991-1996.In the population part of the study, with 1,380 respondents (78%) comprising elderly Swedish persons, 288 reported a locomotor disability. This can be compared with 425 among 1,045 respondents (52%) in a Polish elderly group. The tests at the home visits (Sweden, n = 89; Poland, n = 84) showed that both men and women in the Swedish group reported significantly higher scores for the total QLI (max. 30.00) with men reporting 26.68 points compared to 19.73 and women reporting 21.39 points compared to 19.40 and for three of the four subscales. Also, the Polish group scored lower for balance and mobility (SPE).The study provides an important view of the life situation measured with the QLI tool and the SPE for elderly persons with locomotor disorders in Sweden and Poland during the mid-1990s. The results are congruent with epidemiological reports on the poor health situation in Poland, particularly during that time. A new investigation among the elderly with locomotor disorders in the two countries today might provide different results.