Analysis of the Level of Stress and Methods of Coping with Stress among the Nursing Staff

In general, "stress" is the reaction of the body to mental and physical demands placed on it. Stress disrupts mental balance, and reduces the ability to work and function, which negatively affects the performance of duties. The aim of this study was to analyse the level of stress and ways of coping with it among nursing staff. The study covered 220 nurses employed at the Provincial Specialist Hospital in Włocławek. The research tool was the Perceived Stress Scale (PSS-10) and the Brief-COPE. The results of this survey showed the occurrence of average and high levels of experiencing stress in 36% and 40%of staff, respectively. Brief-COPE scale results show that substance use/gender (men) and use of emotional support/place of work (internal medicine department) are significant at p < 0.01. Considering the impact of the workplace on the use of psychoactive substances, it can be seenthat people working in the surgical ward are more likely to use psychoactive substances. Furthermore, nurses in the surgical ward find it easier to think and plan what to do when faced with a difficult life situation. Most often, the respondents with the highest work experience, i.e., the elderly, declared a return to religion. The results of the research indicate that the nursing community experiences stress to an average or significant degree. The strategies are mainly based on active coping and seeking emotional and instrumental support. Further research is needed in this field. This study was not pre-registered on a publicly accessibly registry.

Significant Interactions between Adipokines and Vitamin D Combined with the Estimated Glomerular Filtration Rate: A Geriatric Case Study

Vitamin D deficiency is an important issue in the worldwide population, especially in older people. According to the World Health Organization data, in 2030, 1 in 6 people in the world will be 60 years old or older. The main storage site for vitamin D is adipose tissue. Further, 25(OH)D regulates the expression of adipogenic genes and apoptosis of adipocytes and directly influences the secretion of the appetite-regulating hormone-leptin. Thus, we investigated the impact of the serum concentrations of leptin, adiponectin, omentin, ghrelin, visfatin, and biochemical parameters on vitamin D and estimated glomerular filtration rate (eGFR) in geriatric females. Our studies indicate that the leptin, visfatin and ghrelin are linked with vitamin D concentration and the eGFR rate in the geriatric females. (1) Background: Vitamin D deficiency is common in older people, and researchers are looking for a link between vitamin D deficiency and the occurrence of diseases in advanced age. The study aimed to evaluate the association between serum 25(OH)D levels and clinical variables in older females. (2) Methods: We investigated the impact of the serum concentrations of leptin, adiponectin, omentin, ghrelin, visfatin, and biochemical parameters on vitamin D and estimated the glomerular filtration rate (eGFR) in 74 geriatric females. (3) Results: We observed a significantly higher concentration of creatinine and visfatin in the G2 stage (eGFR = 60-89 mL/min./1.73 m²). We performed an additional analysis to exclude the effect of vitamin D supplementation and obtained a significantly higher vitamin D concentration in the G2 stage. We found significantly lower vitamin D concentrations in older people. In addition, in a person with low levels of vitamin D, we observed significantly lower levels of albumin and ghrelin. Older patients (80 to 89 years old) had significantly lower levels of vitamin D, albumin, insulin, HOMA-IR, and ghrelin than younger patients (60 to 69 years old). Spearman's correlations performed to examine the relationship between clinical variables seemed to confirm previous results. According to ROC curve analysis, leptin concentration was the strongest predictor of vitamin D fluctuations (the area under the curve, AUC = 0.685; with 79.5% sensitivity and 51.4% specificity; p = 0.0291). However, visfatin reached the most accurate AUC^ROC = 0.651 with 84.2% sensitivity and 49.1% specificity for predicting effects on eGFR. (4) Conclusions: The results suggest that serum levels of leptin, visfatin, and ghrelin are linked with vitamin D concentration and the eGFR rate in the population of geriatric females.

System of Work and Stress-Coping Strategies Used by Nurses of a Polish Hospital during the COVID-19 Pandemic

The COVID-19 pandemic contributed to increased stress levels experienced by employees of the healthcare system during their professional activities. The aim of the study was to compare the stress-coping strategies used by nurses in two different systems of work (one shift/two shifts) in a Polish hospital in 2021. The study used the Polish adaptation of the Mini-COPE questionnaire and the authors' data sheet. The results indicate that regardless of experience or the place and system of work, nurses more often chose problem-focused coping strategies. Conducting screening tests among nurses will help to establish effective strategies for coping with occupational stress, thus preventing professional burnout.

The Effect of Frailty Syndrome on the Quality of Life of Individuals with Parkinson's Disease: A Pilot Observational and Multicenter Study on the Polish Population

Parkinson's disease (PD) is a neurodegenerative disorder involving decreased dopamine release and atrophy of dopaminergic neurons of the substantia nigra. Frailty syndrome (FS) is common in older adults, which, in combination with PD symptoms, can substantially affect the quality of life (QOL). This study aimed to assess the prevalence of FS among PD patients and to identify variables affecting their QOL with particular attention to FS. The study included 296 patients (n = 173 women) with a mean age of 70.3 ± 5.7 years suffering from PD for an average of 8.2 ± 5.6 years. Patients were classified as at least stage II according to the Hoehn and Yahr scale. The following standardized questionnaires were used in the study: Schwab and England Activities of Daily Living (SE-ADL), Parkinson's Disease Questionnaire (PDQ-39), Beck Depression Inventory (BDI), Unified Parkinson's Disease Rating Scale (UPDRS), and Tilburg Frailty Indicator (TFI). FS was found in 96% (n = 283) of the PD patients studied. No depression occurred in 30% (n = 89) of subjects, moderate depression in 48% (n = 141) of subjects, and severe depression in 22% (n = 66) of subjects. The mean score of the PDQ-39 questionnaire in PD subjects with FS was 41.6 pts (min-max: 5.2-81.5 pts; SD = 17.4 pts), which was statistically significantly higher than in subjects without FS (p < 0.05). FS has been shown to be present in most of the subjects with PD. FS occurs more frequently with a longer PD period, which is associated with reduced physical capacity and QOL. Physical activity improves QOL and reduces disease progression. FS, similar to PD, is a common cause of disability in older adults and their dependency. Predictors such as depression, advanced stage of the disease, higher education, and low professional and economic status significantly affect the QOL level of PD patients. However, the results obtained among the Polish population of PD patients do not confirm the impact of FS on the QOL, so there is a need to conduct further research on this subject.

Characteristics of Occupational Burnout among Nurses of Various Specialties and in the Time of the COVID-19 Pandemic-Review

Occupational burnout is particularly common among nurses due to their work being associated with stress, showing understanding, compassion, and commitment, along with the simultaneous need to maintain the necessary emotional distance. The aim of this review was to assess the occurrence and characterization of burnout among nurses working within neurology, geriatric care, intensive care units and with patients infected with the novel COVID-19 virus. PRISMA guidelines were used to conduct the review. The search for literature was limited to articles meeting the inclusion criteria and published from 2017 to 2022 in PubMed, Scopus, Science Direct, Google Scholar, and Wiley. A total of 768 articles from this category have been found. Ultimately, after in-depth analysis, 20 articles were included in the study. The group of respondents ranged from 49 to 3100 participants. According to the data, the percentages of nurses suffering from burnout in the presented research ranged from 14.3% to 84.7%, with the highest value of burnout among nurses who worked in the ICU during the COVID-19 pandemic. There are certain factors among nurses that significantly affect the occurrence of burnout. These include, among others, working time, age, exposure to infection and contact with infected patients, lack of training on COVID-19 prevention, providing care to an increased number of COVID-19 patients per shift, lack of personal protective equipment, lack of support of administration, lack of pay satisfaction, intrinsic motivation and turnover intention.

Reliability and validity of the polish version of the vulnerability to Abuse Screening Scale (VASS)

Our aim was to assess the psychometric properties and reliability of a Polish version of the VASS. This cross-sectional validation study involved 228 patients above 65 years of age. Authors-Designed Questionnaire, the Geriatric Depression Scale, and the Activities of Daily Living Scale were used to assess construct validity. Psychometric properties, reliability and repeatability were assessed. Cronbach's alpha coefficient for the VASS scale was 0.89. Almost all items showed a high correlation value in relation to the others (R > 0.45). A high coefficient of repeatability and narrow limits of agreement were observed in the Bland-Altman analysis. All items analyzed had excellent intraclass correlation coefficient (ICC>0.9) and weighted kappa (κ > 0.9) scores. Very strong, significant correlations with other tools confirm the accuracy of the VASS scale. Our research shows promising validity and reliability Polish version of the VASS scale to assess the risk of elder abuse and neglect.

Analysis of job burnout, satisfaction and work-related depression among neurological and neurosurgical nurses in Poland: A cross-sectional and multicentre study

Aim

This study investigated the status of job burnout, work‐related depression and job satisfaction among neurological and neurosurgical nurses in Poland.

Design

A cross‐sectional and multicentre study.

Methods

The sample consisted of 206 neurological and neurosurgical nurses, all of whom completed a self‐report questionnaire designed by the authors.

Results

The results revealed a work‐related burnout incidence of 32%, colleague‐related burnout incidence of 44.2% and patient‐related burnout incidence of 22.8%. Nurses working in neurological departments were statistically over three times more likely to struggle with colleague‐related burnout than nurses working in neurosurgical departments were. Further, work‐related burnout was higher in people aged above 54 years than those in the youngest age category. Nonetheless, 71.8% of the nurses expressed satisfaction with their work. In sum, our results indicated that job burnout is common among registered nurses and that personal (age) and workplace (type of ward, distance to work, experience and shift work) factors contributed to symptoms of burnout.

High Rate of Elder Abuse in the Time of COVID-19-A Cross Sectional Study of Geriatric and Neurology Clinic Patients

The ongoing COVID-19 pandemic is believed to have caused a sharp increase in the incidence of elder abuse (EA), including as a result of isolation, social distance combined with increased interpersonal stressors. Thus, the aim of this study is to determine the impact of the COVID-19 pandemic on the elder abuse rates and the characteristics of risk factors. A total of 347 patients hospitalized in the Department of Neurology and Department of Geriatrics at University Hospital No. 1 in Bydgoszcz were selected as subjects for the analysis. The tools used in the study are: Authors-Designed Questionnaire, the Vulnerability to Abuse Screening Scale, the Geriatric Depression Scale and the Activities of Daily Living Scale. Descriptive statistics, chi-squared tests, Spearman's rank correlation test, and logistic regression analyses were used. In the studied population, nearly 45% of the elderly were victims of violence. This represents an increase of more than 6 percent compared to the pre-pandemic. The most common type of EA was psychological abuse (72.3%). In the final models, the risk factors include, among others, low income (OR = 3.60, 95% CI = 1.93-6.72), chronic diseases (OR = 2.06, 95% CI = 1.28-3.31), poor relationship with the family (OR = 3.26, 95% CI = 1.96-5.43), and moderate and severe depression (OR = 18.29, 95% CI = 10.24-32.69; OR = 18.49, 95% CI = 3.91-87.30, respectively). Moreover, moderate functional impairment 5.52 times more often and severe functional impairment 21.07 times more likely to predispose to EA. People who suffered from COVID-19 are 1.59 times more likely to be victims of EA (95% CI = 1.03-2.46). In this study, we saw significant increases in EA rates during the COVID-19 pandemic.

The Impact of Motor Disability and the Level of Fatigue on Adherence to Therapeutic Recommendations in Patients with Multiple Sclerosis Treated with Immunomodulation

Aim: The aim of the study was to clarify whether the motor disability and the fatigue-related syndrome affect the level of compliance with therapeutic recommendations. Methods: Prospective studies were conducted among 165 patients treated under the drug program - Treatment of Multiple Sclerosis (MS) at the Department of Neurology and Clinical Neuroimmunology of the Regional Specialist Hospital in Grudziadz (Poland). The research was carried out by the method of diagnostic survey, questionnaire technique with the use of standardized research tools. The Adherence in Chronic Diseases Scale (ACDS) was used to assess the level of compliance with therapeutic recommendations. The Expanded Disability Status Scale (EDSS) was used to assess the degree of disability, and the Modified Fatigue Impact Scale (MFIS) was used to assess the degree of disability. The Chi-square test, Shapiro-Wilk test and Kruskal-Wallis were used. Results: The statistical analysis showed that there is a relationship (p=0.0055) between the patient's motor disability assessed in the EDSS scale and the level of compliance with therapeutic recommendations assessed in the ACDS scale. The higher the patient's disability level (EDSS 4.5-6.5), the lower the treatment adherence rate. The conducted research shows that the average score in the MFIS scale for individual levels of compliance with therapeutic recommendations expressed in the ACDS scale is, respectively: for the low level - 38.3 MFIS points, for the medium level - 34.4 MFIS points and for the high level- 33.2 MFIS points. The obtained results were not statistically significant (p=0.6098). Conclusion: It was found that the level of adherence to therapeutic recommendations in patients with relapsing-remitting multiple sclerosis treated with immunomodulation in the study group remained high. There is a relationship between the patient's disability and the level of adherence to therapeutic recommendations.

Are Depression and Dementia a Common Problem for Stroke Older Adults? A Review of Chosen Epidemiological Studies

Stroke is the second leading cause of death in the world. It is often associated with various long-term physical and neuropsychological consequences. The aim of this article is to present the results of research on the occurrence of dementia and post-stroke depression. Using the keywords: post-stroke dementia, post-stroke depression, post-stroke cognitive impairment, stroke, Polish and foreign bibliographic databases were searched: PubMed, Science Direct, Wiley, Google Scholar. Documents that met the eligibility criteria were selected for inclusion in this review. After the conducted analyses, 7 Polish articles and 13 English-language articles were qualified for the review. In the group of people after stroke, there is an increased risk of depression and dementia. According to the data, up to every third person can deal with one of these neuropsychiatric disorders. The presented research analyses indicate that the results obtained by the respondents, at any time after the stroke, indicate the presence of mild cognitive impairment or slight degree dementia among the majority of respondents. It was also shown that people with a stroke in the dominant hemisphere are more likely to experience post-stroke depression. Depression and post-stroke dementia are a common and significant complication of stroke that negatively affects the functional outcome. The huge focus on neuropsychiatric disorders occurring after stroke in modern research is very important because of their negative impact on recovery, quality of life and survival after stroke.

Prevalence and associated factors of elder psychological abuse- a cross- sectional screening study, based on a hospitalized community from Poland

OBJECTIVE

The aim of the present work was to exploring the prevalence, perpetrators and predictors of elder psychological abuse.

METHOD

We conducted the cross- sectional study, based on a hospitalized community. The sample consisted of 200 respondents aged ≥60. The Chi-square test and logistic regression models were used.

RESULTS

A total of 29 % respondents experienced at least one type of psychological abuse in the last 12 months. The percentage of women who statistically more often than men experienced arrogance, isolating, insulting and mocking was 71-77 %. It has been shown that the lower the monthly income, the higher the risk of psychological violence. Statistically, the highest percentage of violence in the form of arrogance, vulgarity and blackmail, threats was recorded in people aged 60-65 (48.9 % and 56.3 %, respectively). On the other hand, logistic regression analysis showed that the oldest respondents aged >70 more than three times more often than people from the youngest age category are victims of violence. The rate of arrogance, vulgarity (odd ratio (OR) 2.90;p < 0.01) and mocking (OR 3.56; p < 0.01) is statistically significantly higher, respectively, in people living in towns than in villages. People with chronic diseases are statistically more likely to experience violence in the form of isolation (OR 4.74; p = 0.04). Cohabitants, spouses or sons are the most frequent perpetrators of elder abuse and neglect.

CONCLUSION

This study reveals that statistically more often, psychological abuse is experienced by women, older adults living in urban areas and people with a low socioeconomic status and chronic disease.

Assessment of leptin-to-adiponectin ratio in prediction of insulin resistance and nutrition status in a geriatric female population

Both obesity and malnutrition leading to cachexia and sarcopenia are relevant risk factors in the development of many diseases. They also increase mortality, also prolong hospitalisations and convalescence, and undoubtedly increase the cost of treatment, mostly in the elderly populations. The aim of the study was to assess the relationship between the levels of leptin and adiponectin with regard to insulin resistance and malnutrition status by studying a senior female population and to evaluate predictors of insulin resistance and malnutrition. A total of 88 elderly females were enrolled prospectively with a median age of 75 years. Anthropometric and biochemical parameters (fasting glucose, insulin, folic acid, vitamin B12 concentrations, lipid profile, complete blood count) were recorded along with a full geriatric assessment, have been made in all participants. A comprehensive nutritional phenotype has been established. Leptin and adiponectin concentrations were measured by applying immunoassay techniques. Lipid profile and other parameters were performed by biochemical methods. We observed significant decreases of albumin, alanine aminotransferase, insulin, and triglycerides concentrations with age. The risk of insulin resistance based on HOMA-IR index was decreased with age. Significantly higher concentrations of leptin, leptin-to-adiponectin ratio (LAR), hsCRP, fasting glucose, insulin in the insulin resistant subgroup in respect of normal sensitivity insulin cases were noted. The concentrations of albumin, aspartate aminotransferase, alanine aminotransferase and total cholesterol were significantly lower in those patients at risk of malnutrition than in the well-nourished subjects. LAR reached the most accurate AUC^ROC = 0.705 for insulin resistance prediction, with a cut-off value at 3.85. The greatest diagnostic power was presented by the albumin concentration with AUC^ROC = 0.761 and then LAR 0.718 in discriminating between well-nourished patients and those at risk of malnutrition. We suggest that the leptin-to-adiponectin ratio is suitable as a marker of insulin resistance and nutritional status in the elderly.

Prevalence of elder abuse and neglect: screening in Poland families

PURPOSE

Elder abuse and neglect is one of the most important problems of social and health policy among countries around the world. Making a real and reliable assessment of the occurrence of abuse is difficult to implement. The aim of this work is to show the frequency of physical, psychological, sexual abuse and financial exploitation among older adults.

METHODS

Older adults, who were aged ≥ 60 years (N = 200) were qualified for the study. The studied population consisted of 112 women (56.0%) and 88 men (44.0%). The whole project procedure only included filling in the survey questionnaire. The verification of hypotheses was based on tests: Chi square test, Chi square test with continuity correction and logistic regression models.

RESULTS

Within the obtained own results, out of 200 older adults, 77 respondents (38.5%) experienced abuse and neglect during the last 12 months. Most of the respondents (68.8%) experienced various forms of abuse simultaneously. Among those who experienced abuse, 75.3% experienced psychological abuse, 68.8% financial exploitation, 48.1% physical abuse, and 22.1% experienced sexual abuse. The rate of physical (OR 2.48; 95% CI 1.13, 5.44; p = 0.02), verbal (OR 1.94; 95% CI 1.02, 3.67; p = 0.04), sexual (OR 4.05; 95% CI 1.13, 14.5; p = 0.03) and economic (OR 1.98; 95% CI 1.02, 3.83; p = 0.04) abuse is statistically significantly higher, respectively, in women than in men. The level of education is a risk fact for physical abuse (p = 0.02). It has also been shown that singles, people with the income < 233 EUR and people living in urban areas are most often victims of elder abuse and neglect.

CONCLUSIONS

The results suggest that elder abuse and neglect is a fairly common phenomenon. Our data also provide confirmation of other researches conducted in this area.

Application of the functional capacity scale in the early assessment of functional efficiency in patients after aneurysm embolization: Preliminary reports

BACKGROUND

While data on the long-term (e.g., 1 year and subsequent years) outcomes of intracranial aneurysms treatment is relatively well-documented mainly in the clinical aspect (comparability of treatment, mortality, and complications), little is known about the early results, in terms of the functional outcome.

OBJECTIVES

The aim of the study was to analyze the use of Functional Capacity Scale (FCS) in the evaluation of patients in the early period after endovascular treatment of intracranial aneurysms.

MATERIAL AND METHODS

The study was conducted in the Neurosurgery Clinic, University Hospital Collegium Medicum in Bydgoszcz, on a group of 118 consecutively admitted patients with the diagnosis of intracranial aneurysm, qualified for treatment using the endovascular method (embolization). The assessment was performed twice. In the clinical assessment the Glasgow Coma Scale (GCS) was used to evaluate the level of consciousness and the Hunt and Hess Scale (H&H) to assess the patient's condition. To assess the final outcome and early functional capacity Glasgow Outcome Scale (GOS), Barthel Index (BI), Modified Rankin Scale (mRS) and the new Functional Capacity Scale were used.

RESULTS

The assessment performed with the FCS was comparable to the assessment conducted with standardized tools such as BI, mRS or GOS. The clinical condition assessed with the GCS (p < 0.001) and H&H (p < 0.001) differentiates the functional condition assessed using the FCS. Statistically significant correlations were found between FCS and BI (r = -0.78), GOS (r = -0.69) and mRS (r = 0.68).

CONCLUSIONS

The study indicates that the FCS correlates with other scales used in the assessment of patients with intracranial aneurysm, which means that the proposed tool can be applied successfully in practice. However, further randomized multicenter studies are necessary in order to clarify the final conclusion.

Measuring scales used for assessment of patients with traumatic brain injury: multicenter studies

BACKGROUND

Application of adequate numeric scales is essential for assessment of a patient's condition. The scales most commonly used by the therapeutic team for assessment of a patient with traumatic brain injury (TBI) include deficit scales, functional scales, and scales assessing quality of life. The purpose of this study was to establish the relationships between the particular scales used for assessment of patients with TBI.

METHODS

This multicenter study included 159 patients with TBI. The direct observation technique was used. Two measurements were made (at hospital admission and discharge) using standardized assessment scales, ie, the Glasgow Coma Scale (GCS), the Functional Capacity Scale (FCS), the Functional Index "Repty" (FIR), and the Glasgow Outcome Scale.

RESULTS

Patients with mild impairment of consciousness were most numerous in the examined group at both admission and discharge, ie, 118 (78.8%) and 134 patients (89.3%), respectively. The mean score for functional capacity measured with the FCS was 34.41 points (71.7%) on the day of admission and 41.87 points (87.2%) on the day of discharge from hospital. A significant correlation was found between results obtained using the GCS and results on the FIR, on both the day of admission [R t(n-2) =7.612=0.530; P=0.00] and the day of discharge [R t(n-2) =8.998=0.595; P=0.00]. Further, a high correlation was found between the FCS and the FIR (r s= -0.854 on day of admission and r s= -0.840 on day of discharge).

CONCLUSION

The majority of examined patients had mild impairment of consciousness. A moderate correlation was found between the GCS and the scales assessing activities of daily living. A high correlation was found between FCS and FIR, which may result from the similarities between the analyzed tools in the scope of their construction and application.

Assessment of selected quality fields of nursing care in neurosurgical wards: a prospective study of 530 people - multicenter studies

BACKGROUND

One of the elements influencing the assessment of nursing care quality is the assessment of the nurse's functions that determine the nurse's particular tasks. The aim of this work was to assess selected tasks involved in the nurse's caring function, which influence nursing care quality on neurosurgical wards, on the basis of patients' and nursing staff's opinions.

MATERIALS AND METHODS

The research was carried out on neurosurgical wards in Poland on a group of 455 patients and 75 nurses. In order to assess nursing care quality, an author's original questionnaire (Questionnaire - Patient Satisfaction) was used.

RESULTS

STATISTICALLY SIGNIFICANT DIFFERENCES CONCERNED PARTICULAR GROUPS (BOTH PATIENTS AND NURSES) IN THE ASSESSMENT OF SELECTED ISSUES: providing information about performed activities and operations (P=0.000 and P=0.040), respecting personal dignity and assuring discretion during the operations (P=0.000 and P=0.001), speed of response to patient's requests (P=0.000 and P=0.000), time availability of nurses for the patient (P=0.000 and P=0.000), providing information about further self-care at home (P=0.032, P=0.008), and nurses' attitude (kindness, courtesy, tenderness, care) to patients (patient's assessment only P=0.000).

CONCLUSION

Selected tasks in the field of the caring function of nurses were assessed differently by particular groups. There were no statistically significant differences in the assessment of particular tasks in the opinions of patients and nurses, which means that both examined groups similarly assessed tasks involved in the nurse's caring function, which influence nursing care quality.