Having Children and Being Married Are Predictors of Burnout and Obesity Among Working Men: Effects of Latent Profile Analysis

Emergency call-takers and dispatchers' (ECDs) work makes them vulnerable to occupational burnout and health problems. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between burnout risk factors (having children), personal resources (being married), and health consequences (overweight and obesity) among men working in these positions. The burnout syndrome was assessed among 228 Polish ECDs using The Link Burnout Questionnaire and the method of latent profile analysis (LPA). All ECDs were characterized by high levels of occupational burnout exhibited in 3 out of its 4 dimensions. The LPA allowed us to differentiate 4 patterns of burnout, taking into account socio-demographic variables, the length of employment as ECD and body weight. The need to balance the demands of professional work with having children and marital roles played an important role in predicting the level of professional burnout. There was a relationship between the dimensions of occupational burnout and age, being married, and having children. Being married was associated with a greater intensity of emotional exhaustion, and the level of exhaustion was higher if the employee had children in their care. Health consequences in the form of overweight and obesity can be associated with levels of emotional exhaustion and professional effectiveness. The application of the Person-Oriented approach presents hidden correlations between burnout predictors and health consequences.

Burnout and stress in group of psychiatrists: workload and non-professional-social predictors

OBJECTIVES

The aim of this research is to present the search for psychosocial predictors explaining the strength of perceived stress in psychiatrists and the search for associations between stress and occupational burnout in psychiatrists. The authors also searched for associations between organizational, workload, family and non-professional - social factors and the intensity of occupational stress.

MATERIAL AND METHODS

The group of 131 doctors - specialists in psychiatry, aged 27-86 years - took part in the study. The participants completed 3 questionnaires, i.e., the Sociodemographic Questionnaire, the Link Burnout Questionnaire (LBQ) and the Perceived Stress Scale (PSS-10).

RESULTS

The results indicated that significant predictors of the development of occupational stress for psychiatrists were psychophysical exhaustion and lack of a sense of professional efficacy. Taking holidays (several times a year, pursuing the passions and interests), and having a stable family relationship (marriage or civil partnership) were also prominent among the predictors of stress.

CONCLUSIONS

Occupational stress and burnout in the work of the surveyed psychiatrists appeared to be a high intensity phenomenon. These results indicate the need to spread preventive health care also in the work of psychiatrists. Mainly in terms of maintaining the right balance between work and rest, which can help to reduce stress levels and protect against further development of burnout syndrome. Family resources such as a stable marriage or partnership may also be a protective factor against the build-up of stress and burnout in psychiatrists (mainly female). In addition, professional resources (work experience measured by number of years of work) is also important in explaining stress levels in psychiatrists. Int J Occup Med Environ Health. 2023;36(3):379-95.

Demographic and Clinical Factors Associated with Depression in 140 Hospitalized Diabetic Patients with Distal Symmetric Polyneuropathy Evaluated Using Beck Depression Inventory and 6-Item Neuropathy Total Symptom Score Questionnaire

BACKGROUND Diabetic distal symmetric polyneuropathy (DSPN) is one of the most common and costliest long-term complications. The pain and function limitations may lead to depression. This study aimed to assess the influence of demographic and clinical factors on the prevalence of depression among diabetic patients with distal symmetric polyneuropathy (DSPN). MATERIAL AND METHODS A total of 140 patients with diabetic DSPN completed the 21-item Beck Depression Inventory (BDI) measuring characteristic attitudes and symptoms of depression. The intensity of neuropathic complaints was assessed using the Neuropathy Total Symptom Score- 6 items (NTSS-6). Testing for peripheral neuropathy was performed. All patients completed questionnaires, which included anthropometric measures, social parameters, and medical aspects. Statistical analyses were done using STATISTICA 8 PL software. RESULTS Statistically significant relationships were found between the depression symptoms in diabetic patients and the intensity of subjective neuropathy symptoms evaluated by NTSS-6, body mass index (BMI), and education level. On average, each 1-point increase in NTSS-6 predicted a 16% increase in the risk of depression. Each 1 kg/m² increase in the BMI was associated with a 10% increase of depression risk. CONCLUSIONS The study showed the positive quantitative relationship between diabetic DSPN and depression symptoms. The BMI, severity of neuropathy symptoms, and lower level of education had a statistically significant association with the level of depression and may be useful in evaluating the risk of depression among DSPN patients.

Depressive and anxiety symptoms in adolescents with type 1 diabetes - a single-centre observational study

INTRODUCTION

Type 1 diabetes mellitus (T1DM) significantly affects the everyday functioning of the child and its family. This study aimed to assess the prevalence of symptoms of depression and anxiety and estimate their potential association with various clinical parameters.

MATERIAL AND METHODS

59 adolescents with T1DM (age 15-18) and their parents answered validated questionnaires (Children's Depression Inventory 2, The State-Trait Anxiety Inventory) and a survey assessing everyday functioning.

RESULTS

There were no significant differences in the occurrence of symptoms of depression in children and their parents (p = 0.975), but significant differences were found for anxiety. The distribution of the sten X1 and X2 values of adolescents and parents were different (p = 0.021 and p = 0.001, respectively). Girls were characterized by a higher level of depression both based on the overall score (p = 0.010) and the emotional problems (p = 0.022), and functional problems (p = 0.012). There was no significant correlation between diabetes duration time, glycaemic control, the occurrence of acute diabetes complications, and the parameters assessing anxiety and depression. Optimal glycaemic control, defined as HbA1c below 6.5% and TIR above 70%, was associated with sex (p = 0.001) and a high level of functional problems (p = 0.048).

CONCLUSIONS

In the studied population, adolescent girls with T1DM presented depressive symptoms more often than boys, and anxiety symptoms in adolescents were described more frequently by parents than by the teenagers themselves. Higher HbA1c was correlated with a higher level of functional problems.

Validation of FES-I and Short FES-I Scales in the Polish Setting as the Research Tools of Choice to Identify the Fear of Falling in Older Adults

Fear of falling is associated with a clear hazard to individual self-reliance, reduced physical activity, as well as a sense of shame and loss of self-confidence. The present study aimed to complete the applicable translation and validation protocol for the Falls Efficacy Scale-International (FES-I) tool, following its prior adaptation to ensure full compatibility with the Polish setting. The FES-I questionnaire, along with its abridged version, was translated in line with the recommended standards of the MAPI Institute, taking into account both the cultural fabric and pertinent language specifics of the country. The survey was attended by 740 individuals (N = 740; 463 women, 277 men), over 60 years old. All respondents were required to complete both the FES-I and FES-I (Short) questionnaires twice, following an intervening period, and subsequently had their responses statistically assessed. The FES-I questionnaire, along with its abridged version, may be recommended as an effective assessment tool for addressing the fear of falling issue among the older adults, consequently allowing the teams of attending physicians, physiotherapists, psychologists, or psychiatrists to complete an unambiguous diagnosis, with a view to helping the patients overcome this particular type of anxiety.

Polish version of the Depression Anxiety Stress Scale (DASS-42) - adaptation and normalization

OBJECTIVES

This study aimed to present the Polish adaptation and preliminary normalization of the Depression Anxiety and Stress Scale - 42 (DASS-42).

METHODS

The study was conducted among 1,021 participants (625 females and 396 males) aged 18-83 years (M = 30.67; SD = 13.25). It was a non-clinical sample. Second sample was a group of 49 psychiatric patients (28 females and 21 males) aged 22-76 years (M = 49.40; SD = 13.34). The reliability of the DASS-42 was measured using Cronbach's α coefficients and intraclass correlation coefficients (ICC).

RESULTS

In the non-clinical sample the Cronbach's alpha coefficient was 0.93 points for the depression subscale; 0.89 points for the anxiety subscale; 0.92 for the stress subscale, and 0.96 for the DASS-42 total score. The ICC were satisfactory, between 0.37 and 0.49 points. Psychiatric patients obtained significantly higher results in all subscales and in a total score of the DASS-42 (p< 0.001) than healthy participants. It is an indicator of good concurrent validity of the method. The effect size of the differences for all questionnaire indicators was large (0.96

CONCLUSIONS

The obtained results confirmed the satisfactory psychometric properties of the Polish version of the DASS-42. This inventory may be useful for screening in non-clinical groups and groups of psychiatric patients.

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Key Words

• DASS
• depression
• normalization

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Affiliation(s)

Marta Makara-Studzińska Uniwersytet Jagielloński Collegium Medicum, Wydział Nauk o Zdrowiu, Zakład Psychologii Zdrowia
Maciej Załuski Uniwersytet Jagielloński Collegium Medicum, Wydział Nauk o Zdrowiu, Zakład Psychologii Zdrowia
Katarzyna Adamczyk Uniwersytet Jagielloński Collegium Medicum, Wydział Nauk o Zdrowiu, Zakład Psychologii Zdrowia
Ernest Tyburski Pomorski Uniwersytet Medyczny w Szczecinie, Zakład Psychologii Zdrowia

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Assessment of Quality of Life in Men Treated for Infertility in Poland

The aim of this study was to assess the quality of life (QoL) of men treated for infertility in Poland. This cross-sectional study was conducted using the Abbreviated World Health Organization Quality of Life questionnaire (WHOQoL-BREF), Fertility Quality of Life tool (FertiQoL) and an author-constructed questionnaire. The study included 1200 men treated for infertility without the use of assisted reproductive technology (non-ART), intrauterine insemination (IUI) and in vitro fertilization (IVF). The control group consisted of 100 healthy men with confirmed fertility. The quality of life assessed by the WHOQoL-BREF questionnaire was significantly lower in study groups in the Environmental domain, compared to the control group (p = 0.009). Statistically significant differences were found in the case of FertiQoL subscales: Emotional, Mind-Body, Relational, and Treatment Environment, depending on applied treatment. Men whose partners were treated without the use of ART assessed their QoL significantly more negatively than those treated with IUI. Reproductive problems and type of their treatment influenced the quality of life of the affected men. Non-ART treatment, rural place of residence, and increased BMI were associated with lower QoL.

Profiles of Burnout, Job Demands and Personal Resources among Emergency Call-Takers and Dispatchers

According to scientific research, emergency call-takers and dispatchers are particularly vulnerable to burnout syndrome. There are no data describing specific burnout patterns or allowing for the definition of subgroups of workers who are particularly at risk. The aim of this research was to apply a person-oriented approach to characterize burnout profiles using job-related variables and personal resources. A cross-sectional survey study was conducted on 553 call-takers and dispatchers aged between 19 and 65, from 14 public safety answering points in Poland. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. K-means cluster analysis was used, which allowed us to highlight three distinct burnout risk profiles: high risk of burnout, without full-blown pattern of burnout with high inefficacy, and no risk of burnout with an increased sense of disappointment. Several variables which coexisted with occupational burnout included work experience, weekly working hours, intensity of perceived stress, and self-efficacy level. The application of a person-oriented approach made it possible to identify groups of call takers characterized by a high risk of burnout syndrome, and to indicate the areas in which preventive measures, focused on each of their specific needs, should be taken.

Tokophobia and Anxiety in Pregnant Women during the SARS-CoV-2 Pandemic in Poland-A Prospective Cross-Sectional Study

SARS-CoV-2 coronavirus emerged in the world at the end of 2019. The introduction of a number of restrictions had a significant effect on numerous aspects of human life with particular influence being exerted on pregnant women and their sense of security. The study aimed to assess the level of anxiety and its main determinants in women in the third trimester of pregnancy during the coronavirus pandemic. The study technique included the present purposely designed questionnaire, Labor Anxiety Questionnaire (KLPII), and the State-Trait Anxiety Inventory (STAI). The study was conducted in a group of 315 women in the third trimester of pregnancy. A total of 258 women (81.9%) completed the questionnaire in May 2020, and 57 of them (18.1%) completed it in October 2020. The overall analysis of the Labor Anxiety Questionnaire and the STAI inventory revealed a high level of anxiety, particularly situational anxiety, in pregnant women during the SARS-CoV-2 pandemic. The age and financial status of the women were the factors which contributed to the intensification of tokophobia. Women interviewed in October 2020 were characterized by higher tokophobia levels compared to the respondents included in May 2020. It seems justified to in-crease the vigilance in the diagnostics of possible mental disorders in the perinatal period during pandemic.

Obesity in adolescents may be associated with limitations in daily activities and an increased level of anxiety in patients and their parents - preliminary results of a pilot study

Obesity is a chronic disease, that in adolescents may lead to serious consequences affecting somatic and mental health. This study aimed to assess the prevalence of depressive symptoms and anxiety in adolescents with obesity and their parents. The relationships between depressive and anxiety symptoms and the somatic consequences of obesity were also analyzed.

MATERIAL AND METHODS

19 patients with obesity (BMI Z-SCORE 2.1-5.5), at the age 16-17, and their parents answered validated questionnaires (Children's Depression Inventory 2, The State-Trait Anxiety Inventory), and a survey assessing everyday functioning.

RESULTS

There were no significant differences in the occurrence of symptoms of depression in children and their parents: for the overall scale score of T-score (p=0.331), for the emotional problems (p=0.281) subscale, and the functional problems (p=0.147) subscale. The comparison of the results between boys and girls revealed no significant differences. A significantly higher level of anxiety was found in parents of children who gained weight in the year preceding the study (p = 0.046), and both in children and parents of children with metabolic-associated fatty liver disease - MAFLD (p=0.022 and p=0.007). According to adolescents, obesity affects the most leisure activities.

CONCLUSION

Obesity, like any chronic disease, can have a significant impact on the emotional state of children and adolescents as well as the possibility of realizing interests and spending free time. Much more important than depressive disorders are anxiety disorders concerning both patients and their parents.

Measuring Staff Attitudes to Coercion in Poland

Introduction: Coercion can be defined as the use of force to limit a person's choices. In Poland, coercive measures may tend to be overused. However, there is limited information regarding the attitudes of nurses toward coercion in psychiatric settings and the factors influencing any decisions to use coercion. Aims: To validate the Staff Attitudes to Coercion Scale (SACS) for a group of psychiatric nurses and psychiatrists, to compare the said with the original Norwegian SACS version, and to compare nurses' attitudes with those displayed by psychiatrists. A second aim was to understand the relationship between self-efficacy and attitudes to coercion. Method: We surveyed 351 psychiatric nurses and psychiatrists rating SACS and GSES (General Self Efficacy Scale). We validated the SACS factor structure using confirmatory principal component factor analysis, calculated the internal consistency of subscales, and analyzed the test-retest reliability and face validity of the subscales themselves. Further, we analyzed the differences in attitudes toward coercion between nurses and psychiatrists, as well as whether there was an association between GSES and the SACS subscales. We compared the means on the SACS items between three countries-Germany, Norway, and Poland. Results: The confirmatory factor analysis of the Polish version of SACS found the same factor structure with three factors as was displayed in the original Norwegian SACS, except that one item was loaded on another factor. Internal consistency was acceptable for the factors on coercion as security and the coercion as offending, and unacceptable for the factor on coercion as treatment. Test-retest reliability was excellent for all the three subscales. Face validity was high for the factor coercion as security, partly present for coercion as offending, and not present for coercion as treatment. The subscale Coercion as Treatment was rated significantly higher by nurses than by psychiatrists, but there was no difference for the two other subscales. There was no significant association between the General Self-Efficacy Scale and any of the SACS subscales. The biggest differences in attitudes toward forms of coercion was noted between Poland and Germany. Discussion: The three-factor structure of SACS was the best solution for the Polish nurses and psychiatrists. The attitudes toward coercion differed between the two groups, but a low correlation was computed for the SACS subscales and self-efficacy. There is a cultural diversity visible amongst the three countries examined. Reduction in the use of coercion is a priority worldwide. More knowledge about the process involved in using coercive measures may contribute to this. The use of coercive interventions may harm patients and threaten patients' rights. Thus, education is needed for pre-service and in-service nurses alike.

Perceptions of Fear, Likelihood of Victimization, and Confidence About Dangerous Situations Among University Women in Poland

Polish women have not been studied in regard to fear, likelihood, or confidence about dangerous situations, nor has there been an instrument to measure those perceptions. The purpose of the study was fourfold: first, to present the Polish translation and validation of the Perception of Dangerous Situations Scale (PDSS-P) and second, to assess Polish women's perceived fear, likelihood, and confidence about dangerous situations using the PDSS-P (41 items). The third purpose was to determine to what degree the General Self-Efficacy Scale (GSES) and/or the Hope for Success Scale (KNS) correlated with any of the three subscales of the PDSS-P. The fourth purpose was to determine the congruence of the PDSS-P to the original PDSS. Two other tools (GSES and KNS) were administered to determine concurrent validity with the PDSS. A sample of 208 women aged 19 to 27 years (M = 21.04, SD = 1.88) participated in the study. Five factors were determined for each subscale, similar to the original version of the PDSS. Women reported they were more afraid of being raped by a stranger than being murdered. Their estimation of the likelihood of some serious events occurring was not congruent with statistical realities. The women thought the least likely events to happen to them in the next year would be being raped or beaten by someone they know, or being held prisoner by someone who wanted to murder them. Confidence to manage dangerous situations was low in cases of being raped by strangers or known people, being kidnapped, or being attacked. The GSES and KNS provided useful information, in that they did not measure the same constructs as the PDSS-P.

Polish Emergency Dispatchers During a COVID-19 Pandemic - Burnout Syndrome, Perceived Stress, and Self-Efficacy. Effects of Multidimensional Path Analysis

International research has demonstrated that emergency call operators face unique risks to their mental health, in particular job stress, and occupational burnout syndrome. There is already wide knowledge about the relationship between stress, burnout and employee personal resources, which has practical application in preventing mental health. However, more research into the subtle relationships between variables is needed. The aim of the study was to check the moderation effect of differences in the intensity of latent variables on the relationship between perceived stress, self-efficacy and professional burnout. The participants were 546 call-takers and dispatchers from 14 public-safety answering point in Poland aged between 19 and 65 years. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. The method of path analysis was used. The study confirmed the existence of negative relationships between perceived stress (assessment of the current situation) and self-efficacy (a personal trait). Taking into account the moderating effect of latent variable: psychological comfort revealed a hidden relationship between stress and burnout. The stress-burnout relationship occurred only among participants with low level of psychological comfort, so it was not a proportional relationship. In the case of participants with a high level of second latent variable: power-to-affect, the hypothesis that a high level of this variable should weaken the relationship between stress and burnout was not confirmed. The level of latent variables did not affect the self-efficacy relationship with occupational burnout. Taking into account the differences in the intensity of latent variables showed their moderating effect, which often turned out to be different from the assumed one and obtained in the research of other authors. This allowed to discover the relationships that might otherwise have been overlooked and not included in burnout prevention. The results showed a high level of occupational burnout in the ECD’s group during the COVID-19 pandemic: 32% of the responders reported emotional exhaustion, 53% loss of professional effectiveness.

Burnout and Perceived Stress of Polish Emergency Call Takers and Dispatchers

A scientific research has demonstrated that emergency call operators face unique risks to job stress and burnout. It was hypothesized that perceived stress (demonstrated as resourcefulness–helplessness dimension) may mediate relationships between work environments and burnout taking into account the buffering effect of self-efficacy. The participants of the study were 546 emergency dispatchers and call-takers from 14 Polish public-safety answering points. The Link Burnout Questionnaire, the Perceived Stress Scale and the Generalized Self-Efficacy Scale were employed. The method of path analysis was used and direct and indirect interactions between the variables were identified. Shorter work experience (fewer years on this specific job position) was associated with a higher level of burnout. The greater number of shifts per month was associated with a higher level of perceived stress (higher level of helplessness). Self-efficacy was combined with perceived stress by antagonistic relationships, but the assumed buffering effect on burnout was not confirmed. It was observed that engaging the resource of one’s own self-efficacy in professional work may lead to the loss of other personal resources, manifesting itself in the form of greater disappointment with the work performed.

Suicide and Suicide Attempts in Elderly Patients: An Epidemiological Analysis of Risk Factors and Prevention

A number of elderly patients commit suicide due to the interaction of various factors, including, for example, feelings of loneliness, financial distress, alcohol abuse, chronic pain, progressive diseases, and personality disorders. The data from the EU countries with the highest rates of suicide and suicide attempts among people over 55 years of age warrant the consideration of new approaches to address this social problem.

METHODS

PubMed and other databases, including Polish National data, were used for the analyses.

RESULTS

The average European suicide-attempt rate is 18 per 100 thousand inhabitants. More cases of suicides were reported among those over 55 years of age. Suicide attempts from the year 2012 to 2014 and deaths in 2012 have been reviewed. The risk factors involved in these events, such as depression and social situations including loneliness, health condition, etc., have been discussed to suggest a plausible preventative approach for this important elderly problem.

CONCLUSION

The psychophysiology of elderly persons affected by retirement, socio-economic changes, limited personal autonomy, loneliness, lack of support by the family, and diseases ultimately may lead elderly patients to commit suicide. Thus, financial freedom, family support (respect, love, and care), proper medications, psychological and psychiatric interventions may help the elderly avoid suicidal thoughts and prevent attempts.

Effect of Excessive Body Weight and Emotional Disorders on the Course of Pregnancy and Well-Being of a Newborn before and during COVID-19 Pandemic

This study aimed to evaluate whether excessive body weight and the COVID-19 pandemic affect depression, and subsequently whether depression, excessive body weight, and the COVID-19 pandemic affect the course of pregnancy, as well as the well-being of a newborn. The research material included data retrieved from the medical records of 280 pregnant women who were provided with care by medical facilities in Lublin (100 women with normal weight, 100 overweight women, 50 with Class I and 30 with Class II obesity). They completed a Beck depression inventory (BDI) in pregnancy twice, in order to assess the risk of occurrence of postpartum depression. Pre-pregnancy BMI positively correlated with the severity of depression, both at 10–13 weeks of pregnancy (p < 0.001), and at 32 weeks of pregnancy (p < 0.001). The higher the pre-pregnancy BMI, on average the higher the severity of depression. The severity of depression was significantly higher during the pandemic than before it in women with normal body weight before pregnancy (p < 0.001), as well as in those overweight (p < 0.001) and with Class II obesity (p = 0.015). Excessive body weight before pregnancy leads to depressive disorders during pregnancy, increases the risk of preterm delivery, and exerts a negative effect on the state of a newborn. Depressive symptoms among pregnant, overweight and obese women intensified during the COVID-19 pandemic.

Confirmatory Factor Analysis of Three Versions of the Depression Anxiety Stress Scale (DASS-42, DASS-21, and DASS-12) in Polish Adults

Background: The Depression Anxiety Stress Scales (DASS) are designed to identify quickly and differentiate between the symptoms of depression and anxiety in the non-clinical population. Different versions (original and short) were validated in many cultures. Nevertheless, there are no data of factorial validity of the different versions of this scale in Polish culture. Thus, the aim of this study was to evaluate the factor structure using confirmatory factor analysis (CFA) and internal consistency of DASS-42 (original version) and two short versions (DASS-21 items and DASS-12 items) in the Polish population. Methods: The DASS-42 was administered to a non-clinical sample, broadly representative of the general Polish adult population (n = 1,021) in terms of demographic variables. The DASS-21 and DASS-12 version used in this study comprise seven and four items from each of the following corresponding three subscales of the Polish version of DASS-42. Results: There were two models that fitted best for DASS-42: (a) modified three correlated factors (depression, anxiety, and stress) with cross-loadings and (b) second order (general factor of psychological distress) and three factors with cross-loadings. There were also two models that fitted best for DASS-21 and DASS-12: (a) modified three correlated factors (depression, anxiety, and stress) and (b) second order (general factor of psychological distress) and three factors. Conclusions: All three versions of DASS appear to have an acceptable factorial structure. However, the shorter versions (DASS-21 and DASS-12) may be more feasible to use in general medical practice and also be less burdensome to participants.

Reducing aggression in psychiatric wards using Safewards-A Polish study

PURPOSE

To reduce the use of mechanical restraints, Safewards was introduced to a ward in a psychiatric hospital in Poland.

DESIGN AND METHODS

Three aspects of Safewards were applied for 8 months. The comparison time period was the same time frame of the previous year.

FINDINGS

Restraint use dropped by 24%, and the number of patients restrained dropped 34%. The duration of restraint remained at 2.8 days per episode.

PRACTICE IMPLICATIONS

Simple techniques aimed at promoting positive interactions between staff and patients can reduce the frequency of restraints.

Weather and Aggressive Behavior among Patients in Psychiatric Hospitals-An Exploratory Study

Background: The number of meteoropaths, or people negatively affected by weather conditions, is rising dramatically. Meteoropathy is developing rapidly due to ever poorer adaptations of people to changes in weather conditions. Strong weather stimuli may not only exacerbate symptoms in people with diseases of the cardiovascular and respiratory systems but may also induce aggressive behavior. Researchers have shown that patients suffering from mental illnesses are most vulnerable to changes in the weather and postulate a connection between the seasons and aggressive behavior. Methods: The goal of the study was to analyze the relationship between coercive measures and weather factors. The researchers identified what meteorological conditions prevailed on days with an increased number of incidents of aggressive behavior leading to the use of physical coercion towards patients in a psychiatric hospital in Poland. In order to determine the impact of weather conditions on the frequency at which physical coercion measures were used, the hospital’s “coercion sheets” from 1 January 2015 to 31 March 2017 were analyzed. The data were correlated with meteorological data. In order to determine the relationship between the occurrence of specific weather conditions and the number of coercive interventions (N), researchers utilized Spearman’s rank correlation analysis together with two-dimensional scatter diagrams (dependency models), multiple regression, stepwise regression, frequencies, and conditional probability (%). Results: Lower barometric pressure and foehn wind increased aggressive behavior in patients that led to coercive measures. For temperature (positive correlation) and humidity (negative correlation), there was a poor but statistically significant correlation. Conclusions: Monitoring weather conditions might be useful in predicting and preventing aggression by patients who are susceptible to weather changes

The Gender-Related Impact of a Violence Management Training Program on Medical School Students-Preliminary Results

Phenomenon: Patient aggression directed toward medical personnel, including medical school students during their internships, is an increasingly important issue. To minimize this phenomenon, violence management training programs were carried out. Approach: To assess the efficacy of a violence management training program among medical school students and evaluate changes in the perception of aggressive behavior in relation to the participants’ sense of self-efficacy and self-confidence by sex. A quasi-experimental examination of medical school students was performed before and after completion of a training program. Two hundred seventy-six students, including students of medicine, nursing, emergency medical services, and physiotherapy, participated in the study. Three standardized questionnaires were used: The Perception of Aggression Scale (POAS), the Hope for Success Questionnaire (HSQ), and the General Self -Efficacy Scale (GSES). Findings: The training program had a positive impact on the sense of self-efficacy in both men and women. However, the perception of aggressive behavior changed only in women and the impact of such intervention was higher for women. Further studies should look at the long-term outcomes.

Stress and occupational burnout in a population of Polish doctors - Organizational-professional and non-professional-social predictors

INTRODUCTION AND OBJECTIVE

Numerous studies have found that doctors are exposed to stress and burnout at work. In consequence, these processes lead to a decrease in the quality of life. The study aimed to determine whether professional burnout, understood as a cognitive existential process, is related to stress at work and if any of the four dimensions of burnout are its predictor. The study also analyzed relations between organizational-professional and non-professional-social factors and burnout and stress at work.

MATERIAL AND METHODS

318 doctors (210 women, 108 men), aged 27 - 8, participated in the study. Link Burnout Questionnaire (LBQ) was used to measure burnout, and the Perceived Stress Scale (PSS-10) to measure the variable describing the current level of stress.

RESULTS

Occupational burnout is related to stress. Two of its symptoms: exhaustion and lack of a sense of professional effectiveness, are important predictors for the sense of stress experienced by the examined group of doctors. The individuals who are in a partner relationship (but not marriage) experienced a stronger sense of non-professional effectiveness than those who were single. Being in an informal relationship is related to the level of stress and lack of a sense of professional effectiveness. The level of stress, as well as all burnout indicators, are connected with the function of a team leader and having passion. The frequency of taking leave and using social networks is related to the level of stress and burnout.

CONCLUSIONS

Problems related to burnout in doctors, and therefore people professionally involved in helping and treating, must not be underestimated, as evidenced by the results of the presented study Professional burnout of doctors leads to somatic and psychological problems. Doctors suffering from occupational burnout need support and psychological assistance the same as any other professional group.

A pregnant patient with schizophrenia - dilemmas of treatment and care. A problem still not only for psychiatrists

Pregnancy is a special period in any women's life. A pregnant woman who suffers from schizophrenia is a special patient and a huge challenge both for the psychiatrist and gynecologist. Such pregnancy is associated not only with the higher level of risk because of inappropriate diet, insufficient prenatal care and smoking but also because of the risk of possible mental degradation of a pregnant woman - occurrence or exacerbation of psychotic symptoms. Moreover, pharmaceutical treatment during pregnancy and its influence on fetus rises doubts and controversy. The aim of the study is to show three stories of pregnant patients treated for schizophrenia in a context of up to date knowledge on anti-psychotic treatment and to pay attention to the need of interdisciplinary approach to this special group of patients. Every pregnant woman suffering from schizophrenia requires individual approach in terms of treatment and care. The problem, which is still ignored, is the need of effective and constant cooperation between the doctors: a psychiatrist and a gynecologist since the very beginning of pregnancy, in order to assess the risk factors associated with pregnancy and periparturient period.

[Empathy and stress: the mediating impact of the emotional labor strategies on the example of surgical nurses]

BACKGROUND

The nurse, when performing emotional labor at work, tunes her own emotions to the patient's expectations. The self-regulation strategies which are then used weaken her mental strength and contribute to various symptoms of occupational burnout syndrome (OBS). In addition, certain positive relationships have been found between selected emotional labor strategies and increased work engagement. The skills of empathizing with the patient are the nurse's protective resource. Empathy allows to share emotions with the patient while maintaining the attitude of a neutral observer. It also helps to take actions to reduce pain and suffering, and to build a relationship of mutual trust and cooperation. The purpose of the present study, conducted in a group of surgical nurses in January‒March 2019, was to analyze a theoretical model which assumed the mediating role of emotional labor strategies in the relationship between empathy and OBS.

MATERIAL AND METHODS

The sample consisted of 84 surgical nurses employed at the University Hospital in Kraków. A cross-sectional design was used with the application of a questionnaire method. In the study, the Polish version of the <i>Link Burnout Questionnaire</i> by Jaworowska was used, together with the <i>Empathy Quotient - short</i> by Jankowiak-Siuda and the <i>Deep Acting and Surface Acting Scale</i> by Finogenow. For the statistical analysis, the IMB SPSS Statistics 24 with Hayes PROCESS version 3.4 was employed.

RESULTS

A negative correlation between the level of empathy and the severity of OBS symptoms was confirmed in the study. The use of the surface regulation strategies of emotional labor weakened the protective effect of empathy on burnout. The use of deep action processing strategies of emotional labor supported this relationship.

CONCLUSIONS

The flexible use of emotional self-regulation strategies by the medical staff deepens their personal contact with the patient, and mediates in the level of empathy and the severity of OBS symptoms. Med Pr. 2020;71(4):461-71.

Religiosity among women undergoing pregnancy termination for medical reasons: the experiences and views of Polish women

OBJECTIVES

The study aimed to determine the influence of religious and moral beliefs on contraceptive use, assisted reproduction and pregnancy termination in Polish women requesting a termination of pregnancy for medical reasons.

METHODS

Between 1 June 2014 and 31 May 2016, women deemed eligible for a termination of pregnancy for medical reasons at a Polish tertiary care centre received an anonymous questionnaire comprising 65 items. A total of 150 completed questionnaires were collected.

RESULTS

Of the respondents, 95% described themselves as Catholics, including 60% practising Catholics. The study revealed a discrepancy between respondents' beliefs and the teachings of the Catholic Church: an overwhelming majority of respondents used contraception, and 79% were in favour of in vitro fertilisation and believed the treatment should be refunded by the state. Interestingly, 66% of the respondents who attended confession did not perceive abortion as sinful.

CONCLUSION

The study detected a considerable discrepancy between declared religiosity and individual interpretations of the commandments and teachings of the Catholic Church. Despite stating they were Catholics, most women did not perceive abortion as sinful and did not follow the teachings of the Catholic Church regarding the sacraments for deceased children.

Interleukin-6 and Melatonin as Predictors of Cognitive, Emotional and Functional Ageing of Older People

BACKGROUND

The ageing process causes a number of changes in the human immune and endocrine systems. The aim of this study was to assess the relationship between cognitive, emotional and functional skills as well lifestyle, versus selected biochemical indicators of the ageing process.

METHODS

The cross-sectional study was conducted in a group of 121 people aged 60-90 residing in the Lesser Poland voivodship. The study used standardized research tools including the Barthel scale, Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE), Life Orientation Test (LOT-R) and inventory of health behaviors (IHB). In addition, the concentration of IL-6 and melatonin in the blood plasma was determined.

RESULTS

We determined the correlation between the level of IL-6 in a group of people over 75 years of age (requiring medical care), and results of the IADL scale. There was also a correlation between melatonin levels and the MMSE results in a group of people aged 60-75 who did not require constant medical care.

CONCLUSIONS

IL-6 can be treated as a predictor of functional skills of people over 75 years of age, and melatonin can be perceived as a factor for recognizing cognitive impairment in elderly people who do not require constant medical assistance.

Years of service, self-efficacy, stress and burnout among Polish firefighters

OBJECTIVES

The aim of the research was to analyze the impact of selected factors: years of service, the number of interventions, self-efficacy and stress, on occupational burnout. It was hypothesized that firefighters with more years of service and a bigger number of interventions would be characterized by higher perceived stress and burnout, and that self-efficacy would have an impact on reducing the level of perceived stress and burnout.

MATERIAL AND METHODS

The participants were firefighters (N = 576) from 12 Polish voivodeships, aged 20-58 years, with different seniority: up to 3, 4-8, 9-15 or >15 years of service. The following research tools were used: the <i>Link Burnout Questionnaire</i>, the 10-item <i>Perceived Stress Scale</i>, the <i>Generalized Self-Efficacy Scale</i>, and an independent questionnaire to gather additional information. A correlation between particular variables was carried out; the Kruskal-Wallis test was performed together with a <i>post-hoc</i> analysis to examine differences in the severity of individual variables depending on seniority, followed by a path analysis studied together with the identification of direct and indirect impacts.

RESULTS

The number of interventions did not affect the severity of experienced stress or any of the aspects of burnout. Work experience directly influenced the level of perceived stress (β = 0.219), disillusion (β = 0.076), and relationship deterioration (β = -0.156). The generalized sense of self-efficacy was found to impact both on reducing the sense of stress (β = -0.418) and on all 4 aspects of professional burnout: psychophysical exhaustion (β = -0.181), relationship deterioration (β = -0.16), the sense of professional inefficacy (β = -0.275) and disillusion (β = -0.143).

CONCLUSIONS

The results have shown that: 1) the number of interventions does not affect the severity of experienced stress or particular aspects of burnout; 2) years of service increase the severity of experienced stress and occupational burnout; 3) self-efficacy has an impact both on reducing the sense of stress and on all aspects of burnout. Int J Occup Med Environ Health. 2020;33(3):283-97.

Psychiatrists and occupational burnout syndrome - a phenomenon, a problem, a threat?

The aim of this work is to present the results of research on occupational burnout in a group of psychiatrists. The electronic databases and empirical publications from 2000-2017 were searched. In order to identify reports that met the selection criteria, the papers was critically assessed. In the presented studies it was shown that the burnout syndrome is most often presented in accordance with the theoretical model proposed by Christina Maslach (including the dimension of depersonalization, emotional exhaustion and the feeling of lack of personal achievements). Risk factors include, among others: too long working hours, low earnings, negative self-image, specificity of treated patients, conflicts with colleagues, satisfaction with the work performed, insufficient supervision of work.

[The reciprocal relationship between occupational burnout, emotional labor and work engagement in healthcare specialists]

BACKGROUND

Emotional labor (EL) is a competence balancing work engagement (WE) and authenticity in relationships with the patients with a depletion of psychophysical and emotional recourses. The main purpose of the study was to examine the reciprocal relationships between EL, WE and the level of occupational burnout syndrome (OBS) in a group of Polish nurses. The article presents the results of a study aimed at verifying how hiding feelings (HF) and the deep acting of emotions (DA) in contacts with patients serve as moderators in the relationship between WE and the OBS level.

MATERIAL AND METHODS

A cross-sectional study was conducted using the quantitative methodology with a correlation design. All the participants completed 3 standardized questionnaires (Polish versions): the<i> Link Burnout Questionnaire</i>, the <i>Deep Acting and Surface Acting Scale</i>, and the <i>Utrecht Work Engagement Scale</i>. The research sample was randomly selected in one of the hospitals in Kraków. Data saturation was completed upon obtaining a set of 100 correctly completed questionnaires. The study covered 100 nurses (age: M±SD = 36.91±10.12 years, seniority M±SD = 14.77±10.89 years). For the analysis of the data, the IMB SPSS Statistics 24 with Hayes PROCESS version 3.1 was employed.

RESULTS

The study has revealed that there is a negative relationship between WE and OSB, and a positive relationship between HF and OBS. The results have indicated that as the level of WE drops, the importance of HF for explaining the increase in OBS rises. If a low WE coincides with frequent HF, the risk of OBS increases.

CONCLUSIONS

Work engagement is a construct distinct from, and negatively related to, burnout. A high level of identification and engagement in the work may protect people who hide their emotions from the risk of OSB. Emotional labor may lead to a variety of negative consequences, at the same time forming a personal resource of a medical worker. Med Pr. 2019;70(6):711-22.

Hope in Hospitalized Patients with Terminal Cancer

Hope is of great importance for patients diagnosed with cancer, especially those that are terminally ill. The diagnosis often puts an end to the realization of personal, social, and professional goals. The aim of this study was to characterize the hope of hospitalized patients diagnosed with cancer in the terminal phase of the disease. The research tool used in the study was Block’s hope test (NCN-36; NCN- Nadzieja Chorych Nowotworowych—Hope of Cancer Patients), designed for patients with life-threatening diseases. The results showed that the patients were characterized by a moderate level of global hope. The highest levels of hope were noted in the spiritual-religious area and the lowest levels of hope concerned curing the disease. Patients exhibited varied levels of hope and varied internal structures of hope. They presented four different types of hope: optimistic, moderate, religious, and weak. Optimistic hope was found most frequently in patients diagnosed with a terminal phase of cancer, while weak hope was represented by the smallest group of these patients.

Do Polish doctors suffer from occupational burnout syndrome? An attempt to find an answer - Pilot study

INTRODUCTION AND OBJECTIVE

A nationwide survey, carried out in Poland in 2013, showed that 42% of an examined group of doctors reported occupational burnout syndrome (OBS). The phenomenon of OBS among medical personnel shows a relationship with perceived stress scale (PSS) scores. The aim of the study was to estimate the prevalence of OBS in a group of Polish doctors, and the relationship with selected risk factors and personal resources.

MATERIAL AND METHODS

A cross-sectional study using quantitative methodology was used with the application of a questionnaire method and correlation design. Questionnaires were administered to 318 doctors (42 different specialties) working in medical facilities in Poland. All participants in the study completed two standardized questionnaires: Link Burnout Questionnaire (LBQ), Perceived Stress Scale (PSS), and responded to the questions on a proprietary questionnaire. ANOVA variance analysis and analysis of regression was performed.

RESULTS

The results of the measurement of four aspects of occupational burnout: psychophysical exhaustion (PE), commitment to relationships with patients (CP), effectiveness in performed work (EW), and existential expectations (EE), were in the medium and high levels range. Every second medical doctor who participated in the research declared a high degree of occupational burnout in each of the aspects of OBS. The high level of PSS scores, the large number of duties per month, the short work experience (years of employment) and the low number of holiday leaves, were the predictors of occupational burnout in the group of doctors taking part in the study.

CONCLUSIONS

The prevalence of the signs of OBS among Polish doctors is consistent with the results of research in other countries. Failures in the interventions taken to reduce stress seem to co-exist with the severity of signs of burnout.

Quality of Life and Social Support in Women with Urinary Incontinence

Background:

Urinary incontinence (UI) is a serious medical and social problem for about one-third of women in the world population. It is one of the most common chronic diseases of women. Despite significant improvement in the diagnosis and treatment of this illness, women continue to struggle with the stigma associated with incontinence. Research conducted in the last few years shows the importance of social support in respect of the illness.

Aim:

The purpose of this study was to determine how people perceive the disease and the influence of social support to deal with UI.

Materials and Methods:

The study involved 200 women in the age range of 34-78 with a diagnosis of incontinence. All women agreed to fill out an anonymous questionnaire, Acceptance of Illness Scale (AIS) and Disease-Related Social Support Scale (DSRSS). The obtained results were subject to statistical analysis.

Results:

The greater the social support, the lesser the tendencies to judge the condition in terms of harm. Material support among respondents makes it easier for them to distance themselves from UI. Women having a sense of spiritual, emotional, and global support information found it easier to come in terms with UI.

Conclusion:

There is a relationship between the perception of disease for women, and social support received by women. Awareness of the availability support in disease allows peaceful thinking about a situation as difficult as UI.

Role of Social and Informational Support while Deciding on Pregnancy Termination for Medical Reasons

Background: Poland is a country with restrictive laws concerning abortion, which is only allowed if the mother’s life and health are in danger, in case of rape, and severe defects in the fetus. This paper specifies the forms of support expected by women considering termination from their family, people in their surroundings and professional medical personnel. Methods: Between June 2014 and May 2016 patients eligible to terminate a pregnancy for medical reasons were asked to complete an anonymous survey consisting of sixty questions to determine patient profile and forms of support expected from the society, family and professional medical personnel as well as to assess informational support provided. Results: Women do not take into consideration society’s opinion on pregnancy termination (95%). The majority of the respondents think that financial support from the state is not sufficient to provide for sick children (81%). Despite claiming to have a medium standard of life (75%), nearly half of the respondents (45%) say that they do not have the financial resources to take care of a sick child. The women have informed their partner (97%) and closest family members (82%) and a low percentage have informed friends (32%). Nearly one third (31%) have not talked to the attending gynecologist about their decision. Conclusions: The decision to terminate a pregnancy is made by mature women with a stable life situation—supported by their partner and close family. They do not expect systemic support, as they believe it is marginal, and only seek emotional support from their closest family. They appreciate support provided by professional medical personnel if it is personal.

Relationship between antipsychotic medication, obesity and cognitive functions

Introduction: The purpose of this study was to examine whether the combination of atypical and typical antipsychotic medications is related with metabolism and cognitive functions in the same manner and degree as taking medications of one kind only, i.e. atypical or typical.

Material and methods: The participants of the study comprised of 91 adults with diagnosed mental illness (F-20-F69). The participants were divided into groups on the basis of the kind of administered medications: T+A (typical and atypical medications), A (atypical medications), T (typical medications), P (antidepressants, sedatives, normothymic/antiepileptic drugs). In the study, Short Test of Mental Status (STMS), Verbal Fluency Test (VFT), Rey Auditory Verbal Learning Test (RAVLT) were used for the purpose of examining cognitive functions.

Results: The kind of antipsychotic medications taken by the patients did not differentiate the group in relation to BMI (p<0.13), nor in relation to the level of general cognitive function (p<0.72) or verbal fluency (p<0.34). Both atypical antipsychotic medications and the combination of atypical and typical medications were related to the occurrence of abdominal obesity (p<0.01). An increase in waist circumference decreased an ability of abstract reasoning (p<0.005). When it comes to the body mass index, waist circumference negatively correlated with the delayed memory (p< 0.03, p<0.004).

Discussion: Both the combination of atypical and typical antipsychotic medications and atypical medications are associated with the occurrence of abdominal obesity. The deposition of fat tissue in the abdomen negatively correlated with an ability to learn.

Conclusions: The future studies might explain the interactions between antipsychotic medications, obesity and cognitive function.

The quality of life of farmers with chronic obstructive pulmonary disease (COPD)

Introduction and objective. COPD is a medical state characterized by chronically poor airflow, and typically worsens over time. Farmers have an increased risk of COPD because of being exposed to ammonia, hydrogen sulfide, inorganic dust, and organic dust. The quality of life of the ill depends on biomedical as well as psychosocial factors, the impact of which has not been a frequent subject of studies among COPD patients. The aim of the study was to indicate the factors that have negative and positive influence on the quality of life of farmers suffering from COPD. Materials and method. The study was conducted among 84 farmers treated for COPD in the Department of Pneumology, Oncology and Allergology of the Medical University in Lublin, Poland. The differences between the farmers concerned: severity of the disease, level of education and income, frequency of smoking tobacco and drinking alcohol, kinds of support they receive from their families, and the level of depression and anxiety experienced by the patients. Results. The study revealed that most patients suffered from depressive and anxiety disorders, and the level of depression higher among the patients who smoked more. Lack of family support had significant influence on exacerbation of the patient's depressive and anxiety symptoms. Patients who had recently experienced a critical situation presented with more severe COPD symptoms, lower quality of life and a higher level of depression. Higher income of the patients had positive influence on their quality of life. Farmers addicted to alcohol suffered from a higher level of anxiety.

Original paper. Assessment of the need for information about planned gynecologic surgery

The objective of the study was to assess the level of patients' need for information about the planned gynecologic surgery.

Material and Methods. The number of 173 patients preparing to undergo planned gynecological procedure were qualified for the study. The participation in the survey was entirely voluntary. Each patient was asked to fulfill the survey conducted using the Amsterdam Preoperative Anxiety and Information Scale- APAIS that enables the estimation of the patient’s need for surgery-related information. Furthermore patients’ clinical and demographic data was collected. Results were analyzed using appropriate statistical tools: the Shapiro-Wilk W-test (for distribution of the studied parameters) and the Mann-Whitney U-test (for comparing two independent groups). P value less than 0.05 was considered statistically significant.

Results. It was shown that premenopausal women have a greater need for information about the planned surgery than postmenopausal patients (p<0.05). Patients, who have never been operated, displayed a significantly greater need (p=0.04) for information about their planned surgery in relation to women who have already undergone surgery. The patient’s age, the phase of the menstrual cycle, the education level, the marital status, as well as the preoperative diagnosis and the type of the planned surgery did not affect the level of the preoperative information requirement (p>0.05).

Conclusions. The high level of the need for information about the planned surgery characterizes premenopausal patients and those operated for the first time.

Impact of emotional disorders on semen quality in men treated for infertility

OBJECTIVE

Semen quality depends on factors such as lifestyle, environment, and hormone secretion.

OBJECTIVE

The purpose of the study was to assess the correlation between emotional disorders and the secretion of selected hormones, and to assess the impact of these disorders on semen quality.

METHODS

The study covered 60 fertile and 112 subfertile males. The sperm was obtained by masturbation, and examined directly after liquidation according to the 2010 criteria of the World Health Organization. The research instruments used were: the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). A morning blood sample (5 mL volume) was obtained and sent to an authorized laboratory to assess serum levels of testosterone, LH, FSH, prolactin, SHBG, DHEA-S and cortisol.

RESULTS

In the group of infertility patients, higher BDI scores were correlated with significantly decreased testosterone levels (p=0.001), and increased prolactin and cortisol (p<0.001); statistically significant negative correlations were also found between BDI score and SHBG and DHEA-S (p<0.001) levels. Higher STAI-1 and STAI-2 in the low-fertility group were associated with higher mean prolactin and cortisol levels (p<0.001). Sperm count was shown to be correlated with BDI, STAI-1 and STAI-2 scores (p<0.001). Semen volume also correlated with BDI, STAI-1 and STAI-2 scores (p<0.001).

CONCLUSION

Depression and anxiety in subfertile males are associated with lower secretion of SHBG and DHEA-S, and higher secretion of cortisol and prolactin. Depression and anxiety in male patients cause decreased semen volume and sperm density.

On the border of deep spirituality and psychosis… A case study

This article is a case study of a 28-year-old patient diagnosed with F23. The report is preceded by an extensive literature review describing the situation of the mentally ill, in which psychiatry intermingles with spirituality and the sacrum.

The aim of the study was to investigate the relationship between religion/spirituality and schizophrenia as well as to draw attention to the complex problem of differential diagnosis of religious and spiritual problems. When is psychiatric treatment enough and when is intervention of a priest really essential?

The authors discuss the problem of mental disorders in connection with religion and spirituality in the clinical context. The article shows that it is very important that the processes of diagnosis and treatment take into account the patients’ individual traits, beliefs, values and spirituality.

Relationship between diabetic neuropathy and occurrence of depression among diabetic patients

Diabetes itself, by its nature, can aggravate the symptoms of depression. One of its main complications is peripheral diabetic neuropathy (PDN). Based on the literature the presence of the relationship between the PDN and depression is confirmed. The symptoms connected with instability while walking and reduction of everyday activities were the strongest predictors of the intensification of depression symptoms. The relationship between the neuropathic ulcers and depression is considered as ambiguous. Additional problems in diagnosis and evaluation is the polyetiologic character of the disease, damage to the nerve fibers of different thickness, variety of methods of the diagnosis and differences in the prevalence of diabetic neuropathy (26%-50%). The presence of the described differences may be connected with diagnostic methods and the fact of the modification of perceived symptoms such as pain by the depression itself. One of the results of difficulties in describing the relationships and diagnosis are problems, described in the literature, with the selection of patients requiring treatment of PDN.

[Analysis of medical and psychological certificates concerning drivers who drove after alcohol use]

BACKGROUND

The aim of the study is to present the health predispositions to drive, assessed during certifying people referred to the Regional Centre for Occupational Medicine in Kielce due to drunk driving or driving after using alcohol. The article mainly presents the results regarding the prevalence of alcohol dependence and other psychiatric disorders in this group. We analyzed health condition at 3 year intervals in the years 2004, 2007 and 2010, adding the population of those who were examined in 2011.

MATERIAL AND METHODS

A total of 5701 people were involved, both men and women. Drivers test cards along with the results of biochemical tests and specialist consultations were analyzed. The analysis of the results was performed using the statistical package PQStat 1.4.2.324.

RESULTS

Certificates with health contraindications to drive were issued to 6.7% of investigated individuals. Very significant correlation between alcohol dependence syndrome and the level of γ-glutamyl transferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were confirmed. Alcohol dependence was diagnosed in 3.8% of the group.

CONCLUSIONS

The health state of the drivers met the required certification criteria necessary for obtaining a driving license in more than 93% of the group. The study revealed many diseases in the group of investigated drivers, including 3.8% of alcohol dependence and 5% of mental disorders. The threat of losing driving license has become an important factor motivating drivers to undertake therapy. However, it seems advisable to develop principles for treatment monitoring and exchange of information between the certifying physician and the treating psychiatrist or psychologist.