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Stadnik-Zawalska K, Tomys-Składowska J, Zawalski P, Buczkowski K, Migdalski A. The impact of the first and the second wave of the COVID-19 pandemic on vascular surgery practice in the leading regional center: a comparative, retrospective study. Eur J Med Res 2024; 29:127. [PMID: 38365805 PMCID: PMC10870438 DOI: 10.1186/s40001-024-01720-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 02/08/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND We conducted an analysis of the vascular surgery regional center reorganization in response to the first and the second wave of the coronavirus disease-2019 (COVID-19) pandemic to see what lessons we learned from the first wave. METHODS The study included a total of 632 patients admitted to the vascular surgery department in three periods: March-May 2020, October-December 2020, and October-December 2019 as a control period. RESULTS In the pandemic periods the number of admitted patients decreased in relation to the control period. There was a reduction in performed procedures. We observed an increase in the ratio of less invasive procedures. There was a significant decline in hospitalization time in comparison to the control period. CONCLUSIONS The reduction of scheduled admissions and procedures affected vascular centers all over the world. Minimally invasive procedures were more willingly performed to shorten the hospitalization time and reduce the patient's exposure to hospital infection. It allowed us to treat more patients during the second wave. Nevertheless, an increased number of vascular patients should be expected in the future, which will result from the failure to perform elective procedures during the pandemic.
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Affiliation(s)
- Katarzyna Stadnik-Zawalska
- Department of Vascular Surgery and Angiology, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland
| | | | - Patryk Zawalski
- Jan Biziel University Hospital No. 2 in Bydgoszcz, 85-168, Bydgoszcz, Poland
| | - Krzysztof Buczkowski
- Department of Family Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland
| | - Arkadiusz Migdalski
- Department of Vascular Surgery and Angiology, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094, Bydgoszcz, Poland.
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Hajdarevic S, Högberg C, Marzo-Castillejo M, Siliņa V, Sawicka-Powierza J, Esteva M, Koskela T, Petek D, Contreras-Martos S, Mangione M, Ožvačić Adžić Z, Asenova R, Gašparović Babić S, Brekke M, Buczkowski K, Buono N, Çifçili SS, Dinant GJ, Doorn B, Hoffman RD, Kuodza G, Murchie P, Pilv L, Puia A, Rapalavicius A, Smyrnakis E, Weltermann B, Harris M. Exploring why European primary care physicians sometimes do not think of, or act on, a possible cancer diagnosis. A qualitative study. BJGP Open 2023; 7:BJGPO.2023.0029. [PMID: 37380218 DOI: 10.3399/bjgpo.2023.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND While primary care physicians (PCPs) play a key role in cancer detection, they can find cancer diagnosis challenging, and some patients have considerable delays between presentation and onward referral. AIM To explore European PCPs' experiences and views on cases where they considered that they had been slow to think of, or act on, a possible cancer diagnosis. DESIGN & SETTING A multicentre European qualitative study, based on an online survey with open-ended questions, asking PCPs for their narratives about cases when they had missed a diagnosis of cancer. METHOD Using maximum variation sampling, PCPs in 23 European countries were asked to describe what happened in a case where they were slow to think of a cancer diagnosis, and for their views on why it happened. Thematic analysis was used to analyse the data. RESULTS A total of 158 PCPs completed the questionnaire. The main themes were as follows: patients' descriptions did not suggest cancer; distracting factors reduced PCPs' cancer suspicions; patients' hesitancy delayed the diagnosis; system factors not facilitating timely diagnosis; PCPs felt that they had acted wrongly; and problems with communicating adequately. CONCLUSION The study identified six overarching themes that need to be addressed. Doing so should reduce morbidity and mortality in the small proportion of patients who have a significant, avoidable delay in their cancer diagnosis. The 'Swiss cheese' model of accident causation showed how the themes related to each other.
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Affiliation(s)
- Senada Hajdarevic
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Cecilia Högberg
- Department of Public Health and Clinical Medicine, Education and Development Östersund, Unit of Research, Umeå University, Umeå, Sweden
| | - Mercè Marzo-Castillejo
- Research Support Unit Metropolitana Sud, University Institute for Primary Health Care Research IDIAPJordi Gol, Catalan Health Institute, Barcelona, Spain
| | - Vija Siliņa
- Department of Family Medicine, Riga Stradiņš University, Riga, Latvia
| | | | - Magadalena Esteva
- Majorca Primary Care Department, Spain
- Balearic Islands Health Research Institute (IdISBa), Balearic Islands, Spain
| | - Tuomas Koskela
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Center of General Practice,Tampere University Hospital, Tampere, Finland
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Sara Contreras-Martos
- Research Support Unit Metropolitana Sud, University Institute for Primary Health Care Research IDIAPJordi Gol, Catalan Health Institute, Barcelona, Spain
| | | | - Zlata Ožvačić Adžić
- Department of Family Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia
- Health Center Zagreb-Centar, Zagreb, Croatia
| | - Radost Asenova
- Department Urology and General Practice, Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | - Mette Brekke
- Department of Health and Society, General Practice Research Unit, University of Oslo, Oslo, Norway
| | | | - Nicola Buono
- Department of General Practice, National Society of Medical Education in General Practice (SNaMID), Caserta, Italy
| | | | - Geert-Jan Dinant
- Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | - Babette Doorn
- Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | - Robert D Hoffman
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Family Medicine, Maccabi Healthcare Services, Southern District, Israel
| | - George Kuodza
- Department of Family Medicine and Outpatient Care, Medical Faculty #2, Uzhhorod National University, Uzhgorod, Ukraine
| | - Peter Murchie
- Centre of Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Liina Pilv
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Aida Puia
- Department of Family Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Aurimas Rapalavicius
- Family Medicine Department, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Michael Harris
- Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland
- College of Medicine & Health, University of Exeter, Exeter, UK
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Ocalewski J, Jankowski M, Zegarski W, Migdalski A, Buczkowski K. The Role of Health Behaviors in Quality of Life: A Longitudinal Study of Patients with Colorectal Cancer. Int J Environ Res Public Health 2023; 20:5416. [PMID: 37048030 PMCID: PMC10094031 DOI: 10.3390/ijerph20075416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/19/2023] [Accepted: 04/03/2023] [Indexed: 06/19/2023]
Abstract
Colorectal cancer (CRC) is the third most common malignancy and the second most common cancer-related cause of death worldwide. CRC incidence depends, in part, on the health behaviors that make up an individual's lifestyle. We aimed to assess the influence of health behaviors and quality of life (QoL) among patients with CRC receiving surgical treatment. In this single-center questionnaire study, 151 patients were surveyed 1 week before and 6 months after colorectal procedures (laparoscopic hemicolectomy, low rectal anterior resection, abdominoperineal resection, and others). This study demonstrated a significant decrease in alcohol consumption and physical activity following the execution of colorectal procedures. No statistically significant changes were observed in smoking or the consumption of healthy food. Global QoL did not change significantly; however, a decrease in physical and role-related functioning was observed. Significant improvements in emotional functioning were also observed. A detailed analysis showed that physical and social functioning were related to smoking, the consumption of healthy food, physical activity, and additional therapies. Emotional functioning was related to smoking, the consumption of healthy food, and complementary treatments. Six months following an operation, it was also dependent on alcohol intake. Physical functioning was the area that decreased the most in the six months after colorectal tumor surgery compared to the period before surgery. Health behaviors such as cessation of smoking, engagement in physical activity, and the consumption of healthy food contributed to a higher quality of life among patients prior to resecting colorectal cancer and six months after the procedure. Patients who received adjuvant/neoadjuvant therapy had a lower quality of life than patients who did not receive this type of therapy. The kind of surgery (laparoscopic hemicolectomy, lower anterior rectum resection, or abdominoperineal rectum resection) was not related to QoL six months after surgery.
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Affiliation(s)
- Jaroslaw Ocalewski
- Department of Health Psychology, Faculty of Psychology, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland;
| | - Michał Jankowski
- Department of Surgical Oncology, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-094 Toruń, Poland; (M.J.); (W.Z.)
- Department of Surgical Oncology, Oncology Center—Professor Franciszek Lukaszczyk Memorial Hospital, Romanowskiej, 85-796 Bydgoszcz, Poland
| | - Wojciech Zegarski
- Department of Surgical Oncology, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-094 Toruń, Poland; (M.J.); (W.Z.)
- Department of Surgical Oncology, Oncology Center—Professor Franciszek Lukaszczyk Memorial Hospital, Romanowskiej, 85-796 Bydgoszcz, Poland
| | - Arkadiusz Migdalski
- Department of Vascular Surgery and Angiology, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-094 Torun, Poland;
| | - Krzysztof Buczkowski
- Department of Family Medicine, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-094 Torun, Poland
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Ratajczak J, Kubica A, Michalski P, Pietrzykowski Ł, Białczyk A, Kosobucka-Ozdoba A, Bergmann K, Buczkowski K, Krintus M, Jankowski P, Kubica J. Determinants of Lipid Parameters in Patients without Diagnosed Cardiovascular Disease-Results of the Polish Arm of the EUROASPIRE V Survey. J Clin Med 2023; 12:2738. [PMID: 37048821 PMCID: PMC10095493 DOI: 10.3390/jcm12072738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/08/2023] Open
Abstract
To assess the determinants of lipid parameters in primary care patients without diagnosed cardiovascular disease (CVD), a cross-sectional study was conducted during 2018-2019 with a total of 200 patients. The following lipid parameters were measured: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), small, dense LDL (sdLDL-C), and lipoprotein (a) (Lp(a)). Predictors of elevated and adequately controlled lipid parameters were assessed with logistic regression analysis. Older age was related to higher risk of TC ≥ 6.2 mmol/L [OR 1.03 (95% CI 1.0-1.05)], sdLDL-C ≥ 1.0 mmol/L [OR 1.05 (95% CI 1.0-1.1)], and decreased risk of Lp(a) ≥ 50 mg/dL [OR 0.97 (95% CI 0.94-0.99)]. Patients with diabetes mellitus (DM) had increased probability of TG ≥ 2.25 mmol/L [OR 3.77 (95% CI 1.34-10.6)] and Lp(a) ≥ 50 mg/dL [OR 2.97 (1.34-6.10)] as well as adequate control of TG and Lp(a). Higher material status was related to lower risk of TC ≥ 6.2 mmol/L [OR 0.19 (95% CI 0.04-0.82)] and LDL-C ≥ 3.6 mmol/L [OR 0.33 (95% CI 0.12-0.92)]. High BMI was related to increased [OR 1.14 (95% CI 1.02-1.29)], and female gender [OR 0.33 (95% CI 0.12-0.96)] and hypertension [OR 0.29 (95% CI 0.1-0.87)] to decreased risk of TG ≥ 2.25 mmol/L [OR 1.14 (95% CI 1.02-1.29)]. Taking lipid-lowering drugs (LLD) was associated with LDL-C < 2.6 mmol/L [OR 2.1 (95% CI 1.05-4.19)] and Lp(a) < 30 mg/dL [OR 0.48 (95% CI 0.25-0.93)]. Physical activity was related to LDL-C < 2.6 mmol/L [OR 2.02 (95% CI 1.02-3.98)]. Higher abdominal circumference was associated with decreased risk of TG < 1.7 mmol/L [OR 0.96 (95% CI 0.93-0.99)]. Elevated lipid parameters were related to age, gender, material status, BMI, history of DM, and hypertension. Adequate control was associated with age, education, physical activity, LLD, history of DM, and abdominal circumference.
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Affiliation(s)
- Jakub Ratajczak
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Aldona Kubica
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Piotr Michalski
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Łukasz Pietrzykowski
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Aleksandra Białczyk
- Students’ Scientific Circle of Cardiology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Agata Kosobucka-Ozdoba
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Katarzyna Bergmann
- Department of Laboratory Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Krzysztof Buczkowski
- Department of Family Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Magdalena Krintus
- Department of Laboratory Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland
- Department of Epidemiology and Health Promotion, School of Public Health, Center of Postgraduate Medical Education, 01-826 Warsaw, Poland
| | - Jacek Kubica
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
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Kubica A, Pietrzykowski Ł, Michalski P, Kasprzak M, Ratajczak J, Siódmiak J, Fabiszak T, Buczkowski K, Krintus M, Jankowski P. The occurrence of cardiovascular risk factors and functioning in chronic illness in the Polish population of EUROASPIRE V. Cardiol J 2022:VM/OJS/J/91163. [PMID: 36385605 DOI: 10.5603/cj.a2022.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/29/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the impact of cardiovascular risk on the functioning of patients without a history of atherosclerotic cardiovascular disease. METHODS Two hundred patients diagnosed with arterial hypertension, hypercholesterolemia, or diabetes were enrolled in the study. The median age was 52.0 years (interquartile range [IQR] 43.0-60.0). The following risk factors were assessed: blood pressure, body mass index, waist circumference, physical activity, smoking, LDL-cholesterol, triglycerides, and fasting plasma glucose concentration. Total cardiovascular risk was determined as the number of uncontrolled risk factors, and with the Systemic Coronary Risk Evaluation Score (SCORE). The Functioning in the Chronic Illness Scale (FCIS) was applied to assess the physical and mental functioning of patients. RESULTS The median number of measures of cardiovascular risk factors was 4.0 (IQR 3.0-5.0). The median of SCORE for the whole study population was 2.0 (IQR 1.0-3.0). Patients with lower total cardiovascular risk as defined by SCORE and number of uncontrolled risk factors had better functioning as reflected by higher FCIS (R = -0.315, p < 0.0001; R = -0.336, p < 0.0001, respectively). Multivariate logistic regression analysis identified abnormal blood pressure, abnormal waist circumference, tobacco smoking, and lack of regular physical activity to be negative predictors of functioning. Lack of regular physical activity was the only predictor of low FCIS total score (odds ratio 9.26, 95% confidence interval 1.19-71.77, p = 0.03). CONCLUSIONS The functioning of patients worsens as the total cardiovascular risk increases. Each of the risk factors affects the functioning of subjects without coronary artery disease with different strength, with physical activity being the strongest determinant of patient functioning.
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Affiliation(s)
- Aldona Kubica
- Department of Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Łukasz Pietrzykowski
- Department of Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland.
| | - Piotr Michalski
- Department of Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Michał Kasprzak
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Jakub Ratajczak
- Department of Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Joanna Siódmiak
- Department of Laboratory Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Tomasz Fabiszak
- Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Krzysztof Buczkowski
- Department of Family Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Magdalena Krintus
- Department of Laboratory Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Epidemiology and Health Promotion, School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland
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Buczkowska M, Górski M, Domagalska J, Buczkowski K, Nowak P. Type D Personality and Health Behaviors in People Living with Obesity. Int J Environ Res Public Health 2022; 19:14650. [PMID: 36429364 PMCID: PMC9690440 DOI: 10.3390/ijerph192214650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Considering that health behaviors and personality traits play an important role in the formation of health attitudes, the main objective of this study was to evaluate the relations that occur between type D personality and health behaviors in a group of obese patients. METHODS 443 adult patients with BMI ≥ 30 kg/m2, who had been hospitalized in selected hospital facilities in the Silesian Voivodeship (Poland), participated in the study. Respondents completed three standardized questionnaires-the Multidimensional Health Locus of Control Scale, version A (MHLC-A), the Inventory of Health Behaviors (IZZ), and the Type D Scale (DS-14). RESULTS Patients with type D personality were characterized by the least effective mental attitudes and preventive behaviors, and differed significantly from the other personality types (intermediate and non-type D). Type D personality increased the risk of initiating improper health behaviors by more than five times. Regarding the sense of health control, patients with type D personality had significantly lower scores for the Internal Dimension subscale (21.3 ± 3.1) and higher for the Powerful Others Dimension subscale (24.0 ± 2.6), compared to patients with intermediate and non-type D personality. Proper health behaviors correlated with an internal sense of health control; the strongest correlation, defined as a medium, was with Preventive Behaviors (R = 0.42; p < 0.0001). CONCLUSIONS Type D personality was associated with poorer attitudes towards health. Among obese respondents with a type D personality, there was a significantly higher prevalence of those who believed that their health status was a consequence of chance events.
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Affiliation(s)
- Marta Buczkowska
- Department of Toxicology and Health Protection, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-902 Katowice, Poland
| | - Michał Górski
- Doctoral School of the Medical University of Silesia in Katowice, Faculty of Health Sciences in Bytom, Medical University of Silesia, 40-055 Katowice, Poland
| | - Joanna Domagalska
- Department of Environmental Health, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-902 Katowice, Poland
| | - Krzysztof Buczkowski
- Department of General and Oncological Surgery, City Hospital, 41-100 Siemianowice Slaskie, Poland
| | - Przemysław Nowak
- Department of Pharmacology, Faculty of Medicine, University of Opole, 45-052 Opole, Poland
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Górski M, Buczkowska M, Krzywkowska K, Całyniuk B, Górska K, Buczkowski K, Fojcik J, Grajek M, Polaniak R. Ambulophobia as a Specific Phobia—Defining the Problem Among Patients of Long-Term Care Facilities in Poland. Front Public Health 2022; 10:801109. [PMID: 35480582 PMCID: PMC9035898 DOI: 10.3389/fpubh.2022.801109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 03/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background Ambulophobia is a type of specific phobia that involves a fear of walking. This phobia mainly affects older people, who prefer not to leave their bed or home to avoid walking on uneven surfaces and reduce the risk of falling. The problem seems to be very important in terms of public health and the organization of long-term care, as Poland has one of the highest rates of elderly population growth. Objectives The aim of the study was to determine the prevalence of ambulophobia among patients of long-term care facilities in Poland and to identify factors increasing the risk of this specific phobia in the study group. Material and Methods The study was conducted between January and July 2021. Data collected from 379 patients of 16 long-term care facilities located in Poland were analyzed. The study used the diagnostic criteria for specific phobias according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, and standardized questionnaires such as MMSE, GDS-16, DOS and ADL. The χ2 test was used to test the significance of differences (p = 0.05). Results The prevalence of ambulophobia in the study group was 30.1%. Ambulophobia significantly more often concerned the female sex (37.7%) and people over 70 years of age (42,1%). Factors such as depression, Parkinson's disease, orthostatic hypotonia, a history of falling or being a witness to another person falling, and disability of at least a moderate degree increased the likelihood of ambulophobia. Conclusions Based on the obtained results, it was found that the protective factors in the development of ambulophobia are male sex, younger age, high independence, fewer drugs used per day and no previous falls or seeing another person fall.
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Affiliation(s)
- Michał Górski
- Doctoral School of the Medical University of Silesia in Katowice, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
- *Correspondence: Michał Górski
| | - Marta Buczkowska
- Department of Toxicology and Health Protection in the Occupational Environment, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Karolina Krzywkowska
- Department of Psychiatric Rehabilitation in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Całyniuk
- Department of Human Nutrition, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Karolina Górska
- Institute of Special Pedagogy, School and Teacher Education, Pedagogical University of Cracow, Cracow, Poland
| | - Krzysztof Buczkowski
- Department of General and Oncological Surgery, City Hospital of Siemianowice Śla̧skie, Siemianowice Slaskie, Poland
| | - Joanna Fojcik
- Department of Psychiatric Rehabilitation in Katowice, Medical University of Silesia, Katowice, Poland
| | - Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Renata Polaniak
- Department of Human Nutrition, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
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Buczkowski K, Dachtera-Frąckiewicz M, Luszkiewicz D, Klucz K, Sawicka-Powierza J, Marcinowicz L. Reasons for and Scenarios Associated with Failure to Cease Smoking: Results from a Qualitative Study Among Polish Smokers Who Had Unsuccessfully Attempted to Quit. Patient Prefer Adherence 2021; 15:2071-2084. [PMID: 34556977 PMCID: PMC8453429 DOI: 10.2147/ppa.s320798] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/27/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Most smokers attempt to quit smoking, but few are successful. Data regarding the reasons for this relapse and the course of the relapse process may be helpful for determining efficient methods of smoking cessation. This study aimed to identify the causes of and scenarios associated with smoking relapse after effective smoking cessation. PATIENTS AND METHODS We conducted 20 semi-structured interviews with smokers who had previously unsuccessfully attempted to quit. The data underwent qualitative content analysis. RESULTS Three major themes were identified: reasons for smoking relapse; smoking relapse scenarios; and perception of the influence of personal environments, including family and physicians, on refraining from smoking after cessation. The first theme comprised the following subthemes: insufficient willpower and self-discipline, contact with smokers, exposure to stressful situations, lack of family support, weight gain, and insufficient improvement in one's mental and physical well-being. The second theme contained enjoyable social events, professional life, critical events, and encouragement to smoke from family members. The respondents frequently emphasized the large role of interaction with other smokers. CONCLUSION The predominant factors underlying smoking relapse include insufficient willpower and self-discipline and exposure to stress. The most frequent relapse scenario concerned experiencing negative or positive emotions when interacting with other smokers.
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Affiliation(s)
- Krzysztof Buczkowski
- Department of Family Medicine, Nicolaus Copernicus University, Torun, Poland
- Correspondence: Krzysztof Buczkowski Email
| | | | - Dorota Luszkiewicz
- Department of Family Medicine, Nicolaus Copernicus University, Torun, Poland
| | - Katarzyna Klucz
- Department of Family Medicine, Nicolaus Copernicus University, Torun, Poland
| | | | - Ludmila Marcinowicz
- Department of Obstetrics, Gynaecology and Maternity Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
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Harris M, Brekke M, Dinant GJ, Esteva M, Hoffman R, Marzo-Castillejo M, Murchie P, Neves AL, Smyrnakis E, Vedsted P, Aubin-Auger I, Azuri J, Buczkowski K, Buono N, Foreva G, Babić SG, Jacob E, Koskela T, Petek D, Šter MP, Puia A, Sawicka-Powierza J, Streit S, Thulesius H, Weltermann B, Taylor G. Primary care practitioners' diagnostic action when the patient may have cancer: an exploratory vignette study in 20 European countries. BMJ Open 2020; 10:e035678. [PMID: 33130560 PMCID: PMC7783622 DOI: 10.1136/bmjopen-2019-035678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Cancer survival rates vary widely between European countries, with differences in timeliness of diagnosis thought to be one key reason. There is little evidence on the way in which different healthcare systems influence primary care practitioners' (PCPs) referral decisions in patients who could have cancer.This study aimed to explore PCPs' diagnostic actions (whether or not they perform a key diagnostic test and/or refer to a specialist) in patients with symptoms that could be due to cancer and how they vary across European countries. DESIGN A primary care survey. PCPs were given vignettes describing patients with symptoms that could indicate cancer and asked how they would manage these patients. The likelihood of taking immediate diagnostic action (a diagnostic test and/or referral) in the different participating countries was analysed. Comparisons between the likelihood of taking immediate diagnostic action and physician characteristics were calculated. SETTING Centres in 20 European countries with widely varying cancer survival rates. PARTICIPANTS A total of 2086 PCPs answered the survey question, with a median of 72 PCPs per country. RESULTS PCPs' likelihood of immediate diagnostic action at the first consultation varied from 50% to 82% between countries. PCPs who were more experienced were more likely to take immediate diagnostic action than their peers. CONCLUSION When given vignettes of patients with a low but significant possibility of cancer, more than half of PCPs across Europe would take diagnostic action, most often by ordering diagnostic tests. However, there are substantial between-country variations.
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Affiliation(s)
- Michael Harris
- Department for Health, University of Bath, Bath, Somerset, UK
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Mette Brekke
- Department of General Practice and General Practice Research Unit, University of Oslo, Oslo, Norway
| | - Geert-Jan Dinant
- Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | - Magdalena Esteva
- Balearic Islands Health Research Institute (IdISBa), Palma de Mallorca, Illes Balears, Spain
| | - Robert Hoffman
- Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Peter Murchie
- Division of Applied Health Science, University of Aberdeen, Aberdeen, UK
| | - Ana Luísa Neves
- Centre for Health Policy, Imperial College London, London, UK
- Centre for Health Technology and Services Research, Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Peter Vedsted
- Research Unit for General Practice, University of Aarhus, Aarhus, Denmark
| | - Isabelle Aubin-Auger
- Department of General Practice, Université Paris Diderot, Paris, Île-de-France, France
| | - Joseph Azuri
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Krzysztof Buczkowski
- Department of Family Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Nicola Buono
- Department of Family Medicine, National Society of Medical Education in General Practice (SNaMID), Prata Sannita, Italy
| | | | | | - Eva Jacob
- Primary Health Centre, Centro de Saúde Sarria, Sarria, Lugo, Spain
| | - Tuomas Koskela
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Davorina Petek
- Department of Family Medicine, Univerza v Ljubljani, Ljubljana, Slovenia
| | - Marija Petek Šter
- Department of Family Medicine, Univerza v Ljubljani, Ljubljana, Slovenia
| | - Aida Puia
- Family Medicine Department, Iuliu Hagieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | | | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Hans Thulesius
- Department of Research and Development, Lund University, Malmö, Sweden
| | - Birgitta Weltermann
- Institut für Hausarztmedizin, University of Bonn, Bonn, Nordrhein-Westfalen, Germany
| | - Gordon Taylor
- College of Medicine and Health, University of Exeter, Exeter, Devon, UK
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Harris M, Thulesius H, Neves AL, Harker S, Koskela T, Petek D, Hoffman R, Brekke M, Buczkowski K, Buono N, Costiug E, Dinant GJ, Foreva G, Jakob E, Marzo-Castillejo M, Murchie P, Sawicka-Powierza J, Schneider A, Smyrnakis E, Streit S, Taylor G, Vedsted P, Weltermann B, Esteva M. How European primary care practitioners think the timeliness of cancer diagnosis can be improved: a thematic analysis. BMJ Open 2019; 9:e030169. [PMID: 31551382 PMCID: PMC6773305 DOI: 10.1136/bmjopen-2019-030169] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND National European cancer survival rates vary widely. Prolonged diagnostic intervals are thought to be a key factor in explaining these variations. Primary care practitioners (PCPs) frequently play a crucial role during initial cancer diagnosis; their knowledge could be used to improve the planning of more effective approaches to earlier cancer diagnosis. OBJECTIVES This study sought the views of PCPs from across Europe on how they thought the timeliness of cancer diagnosis could be improved. DESIGN In an online survey, a final open-ended question asked PCPs how they thought the speed of diagnosis of cancer in primary care could be improved. Thematic analysis was used to analyse the data. SETTING A primary care study, with participating centres in 20 European countries. PARTICIPANTS A total of 1352 PCPs answered the final survey question, with a median of 48 per country. RESULTS The main themes identified were: patient-related factors, including health education; care provider-related factors, including continuing medical education; improving communication and interprofessional partnership, particularly between primary and secondary care; factors relating to health system organisation and policies, including improving access to healthcare; easier primary care access to diagnostic tests; and use of information technology. Re-allocation of funding to support timely diagnosis was seen as an issue affecting all of these. CONCLUSIONS To achieve more timely cancer diagnosis, health systems need to facilitate earlier patient presentation through education and better access to care, have well-educated clinicians with good access to investigations and better information technology, and adequate primary care cancer diagnostic pathway funding.
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Affiliation(s)
- Michael Harris
- Department for Health, University of Bath, Bath, UK
- Berner Institut für Hausarztmedizin (BIHAM), University of Bern, Bern, Switzerland
| | - Hans Thulesius
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Research and Development, Region Kronoberg, Sweden
| | - Ana Luísa Neves
- Institute of Global Health Innovation, Imperial College London, London, UK
- CINTESIS (Centre for Health Technology and Services Research) and MEDCIDS (Department of Community Medicine, Information and Health Decision Sciences), Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Tuomas Koskela
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Davorina Petek
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Robert Hoffman
- Department of Family Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mette Brekke
- Department of General Practice and General Practice Research Unit, University of Oslo, Oslo, Norway
| | | | - Nicola Buono
- Department of General Practice, National Society of Medical Education in General Practice (SNaMID), Caserta, Italy
| | - Emiliana Costiug
- Family Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Geert-Jan Dinant
- Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | | | - Eva Jakob
- Primary Health Centre, Centro de Saúde Sarria, Sarria, Lugo, Spain
| | - Mercè Marzo-Castillejo
- Unitat de Suport a la Recerca, IDIAP Jordi Gol, Institut Català de la Salut, Barcelona, Spain
| | - Peter Murchie
- Division of Applied Health Sciences - Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | | | - Antonius Schneider
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, München, Germany
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sven Streit
- Berner Institut für Hausarztmedizin (BIHAM), University of Bern, Bern, Switzerland
| | - Gordon Taylor
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Peter Vedsted
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | | | - Magdalena Esteva
- Research Unit, Majorca Primary Health Care Department, Balearic Islands Health Research Institute (IdISBa), Preventive Activities and Health Promotion Network, Carlos III Institute of Health (RedIAPP-RETICS), Palma de Mallorca, Spain
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11
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Buczkowska M, Buczkowski K, Głogowska-Gruszka A, Duda S, Dyaczyński M, Nowak P. Adipose tissue – the structure and its functions, with particular emphasis on the characteristics of selected adipokines and their effects on the organism. Med Og Nauk Zdr 2019. [DOI: 10.26444/monz/110429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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12
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Łach J, Dyaczyński M, Buczkowski K. Primary hyperparathyroidism on the example of a 33-year-old female patient with parathyroid adenoma. Pol Przegl Chir 2019; 92:55-61. [DOI: 10.5604/01.3001.0013.4519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Parathyroid hyperactivity is the state of over-production and PTH secretion [1]. The most common cause of primary hyperparathyroidism is parathyriod adenoma - about 80% of cases, the remaining are parathyroid hyperplasia around 15%cases [2] [3], and in 1-5% of cases, cancer [2] [3] [4] [5]. The disease is diagnosed inabout 40 people in 100,000 [5] [6] [3] [7]. The most common cause of adenoma is the mutation in gene MEN 1. Less than 5% of cases are chronichyperparathyroidism, which is a component of the MEN 1 MEN 2a endocrine adenocarcinoma syndrome [1]. Excess PTH in the body leads to increased mobilization of calcium from the bones, and henceincreased osteolysis, what also increases the absorption of calcium from thedigestive system, as well as an increased amount of phosphate excretion in the urine. Clinical picture of the disease is multiform and often runs in a latent form. Most often the diseaseoccurs in the form of osteoporosis, chronic recurrent kidney stones, and is also commonpyelonephritis on the basis of urolithiasis. The disease may be accompanied by: dysphagia, abdominal pain, metallic taste in the mouth, persistent constipation. In addition, from the systemnervous: dizziness and headaches, disturbances of consciousness. Arrhythmia the form of additional contractions and paroxysmal tachycardia. Osteolysis, osteoporosis and pathological fractures [1]. The purpose of this article is to bring closer to the reader case of 33 years old woman with primary hyperparathyroidism on the adenoma.
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13
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Harris M, Vedsted P, Esteva M, Murchie P, Aubin-Auger I, Azuri J, Brekke M, Buczkowski K, Buono N, Costiug E, Dinant GJ, Foreva G, Gašparović Babić S, Hoffman R, Jakob E, Koskela TH, Marzo-Castillejo M, Neves AL, Petek D, Petek Ster M, Sawicka-Powierza J, Schneider A, Smyrnakis E, Streit S, Thulesius H, Weltermann B, Taylor G. Identifying important health system factors that influence primary care practitioners' referrals for cancer suspicion: a European cross-sectional survey. BMJ Open 2018; 8:e022904. [PMID: 30185577 PMCID: PMC6129106 DOI: 10.1136/bmjopen-2018-022904] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES Cancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitioners' (PCPs') referral decisions is lacking.This study analyses health system factors potentially influencing PCPs' referral decision-making when consulting with patients who may have cancer, and how these vary between European countries. DESIGN Based on a content-validity consensus, a list of 45 items relating to a PCP's decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPs' referral decision-making. SETTING A primary care study; 25 participating centres in 20 European countries. PARTICIPANTS 1830 PCPs completed the survey. The median response rate for participating centres was 20.7%. OUTCOME MEASURES The factors derived from items related to PCPs' referral decision-making. Mean factor scores were produced for each country, allowing comparisons. RESULTS Factor analysis identified five underlying factors: PCPs' ability to refer; degree of direct patient access to secondary care; PCPs' perceptions of being under pressure; expectations of PCPs' role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses. CONCLUSIONS Five healthcare system factors influencing PCPs' referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.
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Affiliation(s)
- Michael Harris
- Department for Health, University of Bath, Bath, UK
- Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland
| | - Peter Vedsted
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Magdalena Esteva
- Research Unit, Majorca Primary Health Care Department, Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Peter Murchie
- Division of Applied Health Sciences—Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | | | - Joseph Azuri
- Department of Family Medicine, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Mette Brekke
- Department of General Practice and General Practice Research Unit, University of Oslo, Oslo, Norway
| | | | - Nicola Buono
- Department of General Practice, National Society of Medical Education in General Practice (SNaMID), Caserta, Italy
| | - Emiliana Costiug
- Family Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Geert-Jan Dinant
- Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | | | - Svjetlana Gašparović Babić
- Odjel Socijalne Medicine, The Teaching Institute of Public Health of Primorsko-goranska County, Rijeka, Croatia
| | - Robert Hoffman
- Department of Family Medicine, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Eva Jakob
- Primary Health Centre, Centro de Saúde Sarria, Sarria, Spain
| | - Tuomas H Koskela
- Department of General Practice, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Mercè Marzo-Castillejo
- Unitat de Suport a la Recerca, IDIAP Jordi Gol, Institut Catala De La Salut, Barcelona, Spain
| | - Ana Luísa Neves
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK
- CINTESIS (Center for Health Technology and Services Research) and MEDCIDS (Department of Community Medicine, Information and Health Decision Sciences), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Davorina Petek
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Marija Petek Ster
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Antonius Schneider
- Institute of General Practice and Health Services Research, Technische Universität München, Munich, Germany
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sven Streit
- Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland
| | - Hans Thulesius
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Birgitta Weltermann
- Institute for Family Medicine and General Practice, University of Bonn, Bonn, Germany
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Sawicka-Powierza J, Buczkowski K, Chlabicz S, Gugnowski Z, Powierza K, Ołtarzewska AM. Quality control of oral anticoagulation with vitamin K antagonists in primary care patients in Poland: a multi-centre study. Kardiol Pol 2018; 76:764-769. [PMID: 29313558 DOI: 10.5603/kp.2018.0011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/03/2018] [Accepted: 12/27/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vitamin K antagonists (VKAs) remain the mainstay of anticoagulation therapy, which requires monitoring of international normalised ratio (INR). Quality of oral anticoagulation, clinical benefits, and the risk related to VKA use are determined by the time in therapeutic range (TTR). AIM The aim of this study was to assess the therapeutic quality of oral anticoagulation and to determine the factors that affect the incidence of INR outside the recommended range in primary care patients undergoing long-term VKA therapy in Poland. METHODS A multi-centre cross-sectional analysis was carried out in 15 general practices from three voivodeships of Poland. At the planned time, INRs measured closest to the designated date in all patients were assessed in terms of being within the therapeutic range. TTR was determined as the percentage of visits with INR in therapeutic range on a given date. RESULTS Overall, 430 patients aged 70.3 ± 12.7 years (222 men aged 72 ± 12.8 years and 208 women aged 68.5 ± 12.4 years) were included in the study. In the groups with INR below, within, and above therapeutic range, the patients' age was 67.3 ± 13.4, 72 ± 12, and 70.5 ± 13 years (p = 0.001), respectively. TTR for all the participants was 55%. Statistically significant factors associated with INRs outside the therapeutic range were: age below 60 years (compared to older persons; p = 0.003), more or less frequent INR control compared to the recommended intervals of four to eight weeks (p < 0.001), and the type of the VKA used, i.e. acenocoumarol compared to warfarin (p < 0.001). Logarithmic regression analysis showed that the use of acenocoumarol compared to warfarin, increased the chances of INRs below therapeutic range (odds ratio [OR] 3.19; 95% confidence interval [Cl] 1.65-6.16), while male sex increased the probability of INR being above this range (OR 2.01; 95% Cl 1.12- 3.59). CONCLUSIONS The TTR in primary care patients on VKA therapy was 55%. Better quality of oral anticoagulation with VKA could be achieved by using warfarin instead of acenocoumarol, proper INR monitoring in the recommended interval of four to eight weeks, and tighter INR control in younger and male patients.
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Affiliation(s)
- Jolanta Sawicka-Powierza
- Department of Family Medicine, Department of Haematology, Medical University of Bialystok, Poland.
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Buczkowski K, Basinska MA, Ratajska A, Lewandowska K, Luszkiewicz D, Sieminska A. Smoking Status and the Five-Factor Model of Personality: Results of a Cross-Sectional Study Conducted in Poland. Int J Environ Res Public Health 2017; 14:ijerph14020126. [PMID: 28134805 PMCID: PMC5334680 DOI: 10.3390/ijerph14020126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/05/2017] [Accepted: 01/17/2017] [Indexed: 12/27/2022]
Abstract
Tobacco smoking is the single most important modifiable factor in increased morbidity and premature mortality. Numerous factors—including genetics, personality, and environment—affect the development and persistence of tobacco addiction, and knowledge regarding these factors could improve smoking cessation rates. This study compared personality traits between never, former, and current smokers, using the Five-Factor Model of Personality in a country with a turbulent smoking reduction process.: In this cross-sectional study, 909 Polish adults completed the Revised Neuroticism-Extraversion-Openness Personality Inventory. Our results showed that current smokers’ scores for extraversion, one of the five global dimensions of personality, were higher relative to never smokers. Neuroticism, openness to experience, agreeableness, and conscientiousness did not differ significantly according to smoking status. Facet analysis, which described each dimension in detail, showed that current smokers’ activity and excitement seeking (facets of extraversion) scores were higher relative to those of never and former smokers. In turn, current smokers’ dutifulness and deliberation (facets of conscientiousness) scores were lower than those found in former and never smokers. Never smokers scored the highest in self-consciousness (a facet of neuroticism) and compliance (a component of agreeableness). The study conducted among Polish individuals showed variation in personality traits according to their smoking status; however, this variation differed from that reported in countries in which efforts to reduce smoking had begun earlier relative to Poland. Knowledge regarding personality traits could be useful in designing smoking prevention and cessation programs tailored to individuals’ needs.
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Affiliation(s)
- Krzysztof Buczkowski
- Department of Family Medicine, Nicolaus Copernicus University in Torun, L. Rydygier Collegium Medicum in Bydgoszcz, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.
| | - Małgorzata A Basinska
- Institute of Psychology, Kazimierz Wielki University, Leopolda Staffa 1, 85-867 Bydgoszcz, Poland.
| | - Anna Ratajska
- Institute of Psychology, Kazimierz Wielki University, Leopolda Staffa 1, 85-867 Bydgoszcz, Poland.
- Department of Palliative Care, Nicolaus Copernicus University in Torun, L. Rydygier Collegium Medicum in Bydgoszcz, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.
| | - Katarzyna Lewandowska
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Dębinki 7, 80-210 Gdańsk, Poland.
| | - Dorota Luszkiewicz
- Department of Family Medicine, Nicolaus Copernicus University in Torun, L. Rydygier Collegium Medicum in Bydgoszcz, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland.
| | - Alicja Sieminska
- Department of Allergology, Chair of Lung Disease, Medical University of Gdansk, Dębinki 7, 80-210 Gdańsk, Poland.
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Buczkowski K, Marcinowicz L, Czachowski S, Piszczek E. Motivations toward smoking cessation, reasons for relapse, and modes of quitting: results from a qualitative study among former and current smokers. Patient Prefer Adherence 2014; 8:1353-63. [PMID: 25336926 PMCID: PMC4199752 DOI: 10.2147/ppa.s67767] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Smoking cessation plays a crucial role in reducing preventable morbidity and mortality and is a recognized public-health-policy issue in many countries. Two of the most important factors that affect the efficacy of quitting smoking are motivation and the ability to cope with situations causing relapse. AIM The objective of the study reported here was to investigate former and current smokers' motivations for smoking cessation, reasons for relapse, and modes of quitting. METHODS We arranged four focus groups with 24 participants (twelve current and twelve former smokers) and eleven semi-structured interviews (five current and six former smokers) with a view to understanding and categorizing their opinions on motivations and the course and process of smoking cessation. The data were next analyzed using descriptive qualitative methods. RESULTS THREE MAIN THEMES WERE IDENTIFIED: (1) motivations to quit smoking, (2) reasons why smokers sometimes relapse, and (3) modes of quitting smoking. Within the first theme, the following six subthemes surfaced: (1) a smoking ban at home and at work due to other people's wishes and rules, (2) the high cost of cigarettes, (3) the unpleasant smell, (4) health concern, (5) pregnancy and breastfeeding, and (6) a variety of other factors. The second theme encompassed the following subthemes: (1) stress and the need to lessen it by smoking a cigarette, (2) the need to experience the pleasure connected with smoking, and (3) the smoking environment both at home and at work. Participants presented different smoking-cessation modes, but mainly they were unplanned attempts. CONCLUSION Two very important motivations for smoking cessation were a smoking ban at home and at work due to other people's wishes and rules, and the high cost of cigarettes. The most common smoking-cessation mode was a spontaneous decision to quit, caused by a particular trigger factor. Relapse causes encompassed, most notably: stress, lack of the pleasure previously obtained from smoking, and the smoking environment.
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Affiliation(s)
- Krzysztof Buczkowski
- Department of Family Medicine, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
- Correspondence: Krzysztof Buczkowski, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland, Tel +48 52 346 08 01, Fax +48 52 346 08 02, Email
| | - Ludmila Marcinowicz
- Department of Family Medicine and Community Nursing, Medical University of Bialystok, Bialystok, Poland
| | - Slawomir Czachowski
- Department of Family Medicine, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | - Elwira Piszczek
- Sociology Institute, Nicolaus Copernicus University, Torun, Poland
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Buczkowski K, Marcinowicz L, Czachowski S, Piszczek E, Sowinska A. "What kind of general practitioner do I need for smoking cessation?" Results from a qualitative study in Poland. BMC Fam Pract 2013; 14:159. [PMID: 24138475 PMCID: PMC3853716 DOI: 10.1186/1471-2296-14-159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 10/11/2013] [Indexed: 02/07/2023]
Abstract
Background Cigarette smoking remains the leading preventable cause of death and disease. Thus, all activities aiming to reduce smoking play an important role in improving population health. The positive role of the general practitioner (GP) in smoking cessation could increase the success rate for quitting smoking, if compared with unassisted cessation. The aim of this study was to determine what kind of general practitioner smokers need in order to stop smoking. Methods Four focus groups with 12 current and 12 former smokers (aged 20-59, 11 women and 13 men), were arranged in the city of Toruń, Poland, with a view to describe their opinions on the GP’s role in smoking cessation. The data were subjected to descriptive qualitative content analysis. Results Two major themes emerged in the analysis: the smokers’ positive and negative experiences of the GP in smoking cessation and their expectations regarding the role of the GP in smoking cessation. The first theme embraced the following subthemes: (1) GP’s passivity, (2) routine questions about the patient’s smoking during the visit, (3) lack of time during the visit, and (4) the role model of the GP in smoking cessation. Within the second theme, the respondents identified the following subthemes: (1) bringing up the topic of smoking cessation, even in situations when the patient is unprepared for this; (2) the necessity of a tailored approach to the patient; (3) access to information and evidence confirming the harms of smoking tobacco; (4) prescription of pharmacological and other treatment; and (5) referral to specialists in smoking cessation. Conclusions Patients expect their GP to actively participate in smoking cessation through a more tailored approach to the patient’s needs. The patients’ experiences did not match their expectations: the smokers rarely got advice on smoking cessation from their GPs. Finally, they emphasized the importance of the GP as a role model in smoking cessation.
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Affiliation(s)
- Krzysztof Buczkowski
- Department of Family Medicine, Collegium Medicum, Nicolaus Copernicus University, Sklodowskiej-Curie 9, 85-094, Bydgoszcz Torun, Poland.
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Gowin E, Horst-Sikorska W, Michalak M, Avonts D, Buczkowski K, Lukas W, Korman T, Litwiejko A, Chlabicz S. The attractiveness of family medicine among Polish medical students. Eur J Gen Pract 2013; 20:121-4. [DOI: 10.3109/13814788.2013.826643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marcinowicz L, Foley M, Zarzycka D, Chlabicz S, Windak A, Buczkowski K. Polish medical students’ perceptions of the nursing profession: a cross-sectional study. Scand J Caring Sci 2009; 23:438-45. [DOI: 10.1111/j.1471-6712.2008.00638.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sieminska A, Buczkowski K, Jassem E, Tkacz E. Lack of association between serotonin transporter gene polymorphism 5-HTTLPR and smoking among Polish population: a case-control study. BMC Med Genet 2008; 9:76. [PMID: 18691405 PMCID: PMC2529278 DOI: 10.1186/1471-2350-9-76] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Accepted: 08/08/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND A better understanding of the genetic determinants of tobacco smoking might help in developing more effective cessation therapies, tailored to smokers' genotype. Insertion/deletion polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) has been linked to vulnerability to smoking and ability to quit. We aimed to determine whether 5-HTTLPR genotype is associated with smoking behavior in Caucasians from Northern Poland and to investigate other risk factors for tobacco smoking. METHODS 5-HTTLPR genotypes were determined in 149 ever smokers (66 females; mean age 53.0 years) and 158 gender and ethnicity matched never smoking controls (79 females; mean age 45.0 years) to evaluate the association of this polymorphism with ever smoking status. Analysis of smokers was performed to evaluate the role of 5-HTTLPR in the age of starting regular smoking, the number of cigarettes smoked daily, pack-years, FTND score, duration of smoking, and the mean length of the longest abstinence on quitting. Genotype was classified according to the presence or absence of the short (S) allele vs. the long (L) allele of 5-HTTLPR (i.e., S/S + S/L vs. L/L). Logistic regression analysis was also used to evaluate correlation between ever smoking and several selected variables. RESULTS We found no significant differences in the rates of S allele carriers in ever smokers and never smokers, and no relationship was observed between any quantitative measures of smoking and the polymorphism. Multivariate analysis demonstrated significant association between the older age (OR = 4.03; 95% CI: 2.33-6.99) and alcohol dependence (OR = 10.23; 95% CI: 2.09-50.18) and smoking. CONCLUSION 5-HTTLPR seems to be not a major factor determining cigarette smoking in Poles. Probably, the risk of smoking results from a large number of genes, each contributing a small part of the overall risk, while numerous non-genetic factors might strongly influence these genetic undergrounds of susceptibility to smoking.
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Affiliation(s)
- Alicja Sieminska
- Department of Allergology, Medical University of Gdansk, ul. Debinki 7, 80-952 Gdansk, Poland.
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Sieminska A, Buczkowski K, Jassem E, Lewandowska K, Ucinska R, Chelminska M. Patterns of motivations and ways of quitting smoking among Polish smokers: a questionnaire study. BMC Public Health 2008; 8:274. [PMID: 18680600 PMCID: PMC2519083 DOI: 10.1186/1471-2458-8-274] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Accepted: 08/04/2008] [Indexed: 11/24/2022] Open
Abstract
Background The majority of Polish smokers declare their will to quit smoking and many of them attempt to quit. Although morbidity and mortality from tobacco-related diseases are among the highest in the world, there is a lack of comprehensive cessation support for smokers. We aimed to investigate how Poles, including the medically ill, cope with quitting cigarettes and what their motivations to quit are. Methods Convenience sampling was used for the purpose of the study. Individuals attending several health care units were screened for a history of quit attempts. Ex-smokers were defined as smoking previously at least one cigarette/day but who have no longer been smoking for at least one month. Attempts at quitting were defined as abstaining from cigarettes for at least one day. Data on socio-demographics, tobacco use, quitting behaviors and reasons to quit from 618 subjects (385 ex- and 233 current smokers) who fulfilled these criteria were collected with the use of a questionnaire. For the comparison of proportions, a chi-square test was used. Results In the entire study population, 77% of smokers attempted to quit smoking on their own and a similar proportion of smokers (76%) used the cold turkey method when quitting. Current smokers were more likely than former smokers to use some form of aid (p = 0.0001), mainly nicotine replacement therapy (68%). The most important reasons for quitting smoking were: general health concern (57%), personal health problems (32%) and social reasons (32%). However, 41% of smokers prompted to quitting by personal health problems related to tobacco smoking did not see the link between the two. A small proportion of ex-smokers (3%) abstaining from cigarettes for longer than a year were not confident about their self-efficacy to sustain abstinence further. Conclusion The majority of Polish smokers, including patients with tobacco-related diseases, attempt to quit without smoking cessation assistance, thus there is a need for a broader professional help for them. There is also a lack of general information on hazards related to tobacco and further anti-tobacco campaigns in media are needed. Finally, former smokers should be given more attention and periodic inquiries regarding the smoking habit are worthwhile.
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Affiliation(s)
- Alicja Sieminska
- Department of Pneumonology and Allergology, Medical University of Gdansk, ul, Debinki 7, 80-952 Gdansk, Poland.
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Muszalska M, Buczkowski K. [Personality and coping with stress in the general practitioner and surgeon's profession]. Pol Merkur Lekarski 2006; 20:188-91. [PMID: 16708637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
UNLABELLED Personality variables of the professional are an essential determinant of the stress experienced by a professional and the active steps taken to cope with or counter those problems. AIM OF THE STUDY To verify this hypothesis, an analysis of the relationship between personality variables of specialists of the various fields and their individual patterns in dealing with professional demands was conducted. MATERIAL AND METHODS 30 each of general practitioners and surgeons constituted the study material, whose personality traits levels and patterns of coping behaviour and work-related attitudes (AVEM) were measured. RESULTS Comparing the results obtained in the two groups of specialists, a significant differentiation in the levels of their personality traits, as well as within patterns applicable when dealing with professional demands and strains (p < .001). Among surgeons risk pattern A (The 'Excessively-ambitious' pattern), whereas among general practitioners risk pattern B (The Resigned/burnout' pattern). CONCLUSIONS The results of the study confirm the postulate that allows for personality variables in research in coping behaviour patterns (AVEM) and in prophylactic or remedial programmes created for concrete professional groups.
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Kretowicz M, Ukleja-Adamowicz M, Strózecki P, Buczkowski K, Klucz K, Odrowaz-Sypniewska G, Manitius J. [Does any relationship exist between metabolic disturbances and some markers of renal damage in patients with untreated essential hypertension?]. Pol Arch Med Wewn 2000; 104:563-7. [PMID: 11392162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The essential arterial hypertension is the second (after diabetes mellitus) cause of chronic renal failure which means a great social and economic burden to the society. It is well known that hypertension is a metabolic syndrome resulting in tissue injury. We tried to investigate the possible influence of some metabolic disturbances on renal function in nontreated essential hypertension. We have compared 25 patients with nontreated essential hypertension (11 women, 14 men) with 14 healthy volunteers (7 women, 7 men) matched for age. The patients' group was characterized by significantly higher urine excretion of NAG (N-acetyl-beta-D-glucosaminidase) (2.75 +/- 1.69 vs 1.82 +/- 1.46 p < 0.05) and a tendency to significantly higher urine fractional sodium excretion without significant difference in albumin excretion. These findings suggest that the tubular damage is present. We noticed the negative linear correlation between mean arterial pressure and (MAP) and NAG urine excretion in the group of hypertensive patients which may reflect the renal ischemia in tubulo-interstitial pathology. Our data suggests that in nontreated arterial hypertension the renal blood flow disturbances are the important cause of the deterioration of tubular function (which are earlier to glomerular damage).
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Affiliation(s)
- M Kretowicz
- Katedra i Klinika Nefrologii i Chorób Wewnetrznych, Akademia Medyczna im. Ludwika Rydygiera w Bydgoszczy
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Gruk M, Wyciślak J, Muc J, Buczkowski K. [Triple gallbladder as a rare development anomaly of the biliary tract]. Wiad Lek 1985; 38:140-2. [PMID: 4002701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gruk M, Buczkowski K, Muc J. [Pedunculated cecal lipoma as a cause of mechanical obstruction]. Wiad Lek 1983; 36:1361-2. [PMID: 6659512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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