Aleksandra Kołtuniuk

The prevalence of risk factors for cardiovascular diseases among Polish surgical patients over 65 years

Background Cardiovascular diseases (CVDs) are the leading cause of mortality among adults in Poland. A number of risk factors have significant influence on CVD incidence. Early identification of risk factors related to our lifestyle facilitates taking proper actions aiming at the reduction of their negative impact on health. Aim The aim of the study was to compare the prevalence of CVD risk factors between patients aged over 65 years and patients of other age groups in surgical wards. Material and methods The study was conducted for assessment and finding the distribution of major risk factors of CVD among 420 patients aged 18–84 years who were hospitalized in surgical wards. Interview, anthropometric measurements, blood pressure, and fasting blood tests for biochemical analysis were conducted in all subjects. Statistical analysis of the material was performed using Student’s t-test, chi-square test, Fisher’s exact test, Mann–Whitney U-test, and analysis of variance. Results While abdominal obesity (83.3%), overweight and obesity (68%), hypertension (65.1%), hypercholesterolemia (33.3%), and low level of physical activity (29.1%) were the most common CVD risk factors among patients over 65 years old, abdominal obesity (36.2%), overweight and obesity (36.1%), and current smoking were the most common CVD risk factors among patients up to the age of 35. In the age group over 65, the least prevalent risk factors for CVD were diabetes mellitus (14.8%), depressive episodes (13.6%), abuse of alcohol (11.4%), and smoking (7.8%). In the group under 35 years, we have not reported any cases of hypercholesterolemia and a lesser number of patients suffered from diabetes and HTN. Conclusion Distribution of the major risk factors for CVD is quite high in the adult population, especially in the age group over 65, which can result in serious problems of health and increased rates of chronic diseases, especially CVDs.

The influence of depression, level of functioning in everyday life, and illness acceptance on quality of life in patients with Parkinson's disease: a preliminary study

Background Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease, and its incidence will increase as the global population ages. Due to the multitude of symptoms, this disease clearly has a significant impact on decreasing quality of life for those with PD. We aimed to evaluate the effect of selected variables on quality of life in people with idiopathic PD treated pharmacologically. Materials and methods This study was conducted among 50 patients with PD aged 47–85 years. The diagnostic survey method was applied to collect data with the use of the authors’ questionnaire and standardized questionnaires, including, Parkinson’s Disease Questionnaire (PDQ), Beck Depression Inventory, Instrumental Activities of Daily Living Scale, and Acceptance of Illness Scale. The results were statistically analyzed. Results Analysis of the study material showed that people who were more self-reliant were characterized by lower intensity of depressive symptoms (ρ=−0.567, P=0), were more likely to accept their illness (ρ=0.611, P=0), and assessed quality of life better in each of the studied domains of the PDQ. Illness acceptance correlated with the occurrence of depressive symptoms (ρ=−0.567, P=0) and significantly affected quality of life. Conclusion Factors such as depression, disease acceptance, and functional capacity have a significant impact on the subjective assessment of quality of life in patients with PD. Evaluation of these factors should be taken into account in the therapeutic process, to minimize their negative impact on quality of life in patients with PD.

Knowledge and selected variables as determinants of the quality of life and general health of patients with rheumatoid arthritis

BACKGROUND Rheumatoid arthritis (RA) is an incurable disease resulting in progressive disability, which is associated with the loss of productivity and the inability to earn money, which might lead to a financial burden on the patients family. Undoubtedly, the clinical picture of the disease and its consequences lead to the reduction of the quality of life. OBJECTIVES The aim of this study is to evaluate the influence of selected factors on the subjective assessment of the quality of life and general health of patients with RA. MATERIAL AND METHODS The study was conducted among 270 patients with RA treated at the Department of Rheumatology and Internal Medicine. The quality of life and general health were assessed with the use of the SF-36 and the GHQ-30 questionnaires. RESULTS In the study group, a statistically significant correlation between the results of the SF-36 and the GHQ-30 questionnaires was observed. It has been shown that the level of role limitations due to physical health problems (RP) is mostly affected by interpersonal relationships based on GHQ-30 questionnaire (p = 0.002), general health (GHQ-30) (p = 0.001) and subjective health condition (SF-36) (p < 0.001). In contrast, general health (GHQ-30) is positively affected by education (p = 0.003) and professional activity (p = 0.001), and negatively affected by a positive family history of RA (p = 0.002), frequent hospitalization (p = 0.008) and poor subjective health condition (p < 0.001). CONCLUSIONS People with poor subjective health condition are characterized by more limited activity due to physical health and lower general health condition. General health (GHQ-30) in patients with rheumatoid arthritis is influenced by education, place of residence, professional work, family history of RA and subjective health status.

The influence of sleep disorders on the quality of life in patients with chronic low back pain

INTRODUCTION Low back pain (LBP) is one of the most common pain syndromes, and its prevalence has increased significantly in the past three decades. OBJECTIVES The aim of this study was to evaluate the effects of insomnia and daytime sleepiness on the quality of life (QOL) of patients suffering from chronic back pain. MATERIAL AND METHODS It is a cross-sectional study conducted among 100 people (aged 25-75 years - mean age 49.53 ± 10.92) treated in a neurological clinic for chronic back pain lasting longer than 3 months. The diagnostic survey method was applied for the purposes of this study with the use of: the authors questionnaire and standardised questionnaires that is Visual Analogue Scale (VAS), Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS) and Polish version of WHO Quality of Life-BREF questionnaire (WHOQOL-BREF). The results were statistically analysed. RESULTS Analysis of the study material showed that 83% of patients suffered from insomnia (scored 6 or more points on the AIS) and 29% experienced mild daytime sleepiness. People who were more sleepy during the day were characterised by lower perception of the QOL (r = -0.034, p = 0.029) and lower perception of general health (r = -0.035, p = 0.04). Analysis of multiple variables (using linear regression) showed that independent predictor of the QOL in all domains is the result of the AIS questionnaire (p < 0.05). CONCLUSIONS Sleep disorders - both insomnia and daytime sleepiness - are a common health problem experienced by people with LBP. Insomnia is an important predictor affecting the QOL in people with LBP.

Sociodemographic Factors Affecting the Disease Acceptance and the Quality of Life in Patients With Parkinsonʼs Disease: A Preliminary Study

Purpose Parkinson’s disease (PD) significantly affects functioning of patients, thereby lowering their quality of life. The aim of this study was to evaluate the influence of sociodemographic variables on illness acceptance and quality of life in patients with idiopathic PD. Design This is a cross-sectional research study. Methods The study was conducted with 50 patients with PD. The diagnostic survey method was applied for the purposes of this study with the use of the Parkinsons Disease Questionnaire, the Acceptance of Illness Scale, and a study-specific demographic questionnaire that included questions about sociodemographic data. Multivariable logistic regression was derived to define independent predictors of quality of life. Findings Men assessed quality of life in the bodily discomfort domain as significantly worse than women (p = .0214). Age negatively and significantly affected the assessment of quality of life in particular domains. Professionally active respondents significantly more often accepted their disease than others (p = .0070). Conclusions and Clinical Relevance Being professionally active, living in urban areas, and having higher education and higher financial status increase subjective assessment of quality of life in patients with PD. Knowing the impact of sociodemographic variables on quality of life allows rehabilitation nurses to plan nursing and rehabilitation activities more effectively and in line with the capacity of a patient and caregivers.

Adherence to disease-modifying therapies in patients with multiple sclerosis

Background Multiple sclerosis (MS) is a chronic, inflammatory progressive demyelinating disease of the central nervous system. MS is one of the main causes of disability among young adults, and its management is a serious challenge for the healthcare system. Purpose The main purpose of this study was to examine adherence to first-line disease-modifying therapy (DMT) in MS patients using the self-report Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ). Materials and methods The participants consisted of 226 MS patients (166 women and 60 men) who were treated with first-line immunomodulatory DMT. This study used a questionnaire designed by the authors, which contained questions about sociodemographic data, and the Polish version of the MS-TAQ. Results The overall adherence was 76.5% according to the first criterion (missed ≥1 injection or tablet). There were no statistically significant differences due to sociodemographic variables between adherent and nonadherent patients. However, patients taking Avonex® significantly more often belonged to the adherent group (P=0.042). The most frequently mentioned reasons why nonadherent patients forget to take the drug included the following: too busy in their daily activities, indisposition to take the drug, unwillingness to take the drug, interference with daily activities, and dissatisfaction with the drug. The degree of adherence among MS patients treated with immunomodulatory drugs is high; however, some patients do not take medications regularly. Conclusion Due to the utility of the MS-TAQ, the caregivers of MS patients are able to quickly and easily assess the occurrence of side effects, ways to cope with them, and the occurrence of barriers to taking medication.

The influence of gender on selected risk factors for chronic non-communicable diseases in patients hospitalized in surgical wards: A cross-sectional study

BACKGROUND Chronic non-communicable diseases (CNCDs) are the leading cause of mortality in the world. Identification of risk factors and the implementation of preventive measures can effectively reduce the chance of disease and death due to CNCDs. OBJECTIVES The aim of this study was to analyze selected risk factors of CNCDs in women and men hospitalized in surgical wards. MATERIAL AND METHODS The study group included 420 patients aged 18-84 years who were hospitalized in surgical wards. All participants were interviewed prior to anthropometric measurements, blood pressure, and fasting blood tests. A statistical analysis of the material was performed with the use of Students t-test, χ2 test, Fishers exact test, Mann-Whitney U test, and analysis of variance (ANOVA). RESULTS The analysis of the study material showed abdominal obesity in 63% of patients, more likely in women (p < 0.001); increased total cholesterol values in 30% of patients, more frequently in women (p = 0.025); blood pressure values ≥140/90 mm Hg in 28% of patients, more frequently in men (p < 0.001); alcohol abuse (≥5 points in the Michigan Alcoholism Screening Test, MAST) in 12.6% of patients, more frequently in men (p < 0.001). CONCLUSIONS Both women and men are at risk of developing CNCDs; however, women should pay more attention to psychological counseling and the prevention of obesity and hypercholesterolemia, while men should be educated on how to prevent hypertension and alcohol abuse.

The use of International Classification for Nursing Practice (ICNP) in Postoperative Care of a Patient Diagnosed with a Spinal Cord Tumor

Introduction. Spinal canal tumors are divided into intradural or extradural. Depending on the location, their symptoms differ and the prognosis depends on many variables. The magnetic resonance imaging (MRI) is used as a diagnostic tool facilitating diagnosis of proliferative lesions of the spinal canal, and the surgical treatment is most commonly used treatment for tumors located in the spinal canal. Case Report. A 58 year-old patient diagnosed with Intradural extramedullary schwannoma located on the left side of the spinal canal at the L3 level was admitted to the Neurosurgery Clinic based on a referral for surgical treatment. Before surgery, the patient complained about pain in the lumbar region radiating to the lower limbs, feeling of numbness and tingling of the lower left limb for about 2 months and recurring constipation. Discussion. Patient care after surgery on the spinal cord must be comprehensive. Nursing and therapeutic care should be adopted to the individual needs of the patient following the recommendations. Conclusions. The case of the patient after surgical removal of the spinal canal tumor indicated the difficulties the patient struggled with. Main nursing care activities provided the patient with assistance in meeting his physiological needs, performing daily activities and helping to return to good physical condition. The acquired knowledge contributed to improving the daily functioning and coping with difficult situations. All the actions taken in this field brought the intended effect. (JNNN 2017;6(3):120–125)

The Impact of Ilness Acceptance on Quality of Life of Patients with Multiple Sclerosis — Preliminary Study

Introduction. Multiple Sclerosis (MS) is a disease that often changes the life of a patient and his or her immediate family. The lack of aetiology, young age and the inability to control the dynamics of disease development and the lack of complete cure are factors impeding the acceptance of the disease. Aim. Evaluation of the effect of disease acceptance on quality of life (QOL) of MS patients. Material and Methods. The study was conducted among 128 people (93 women and 35 men) with MS using a shortened quality of life questionnaire of The World Health Organization (WHOQOL-BREF), as well as the Acceptance of Illness Scale (AIS) and the Author’s Own Survey (AOS). The research project was approved by the Bioethics Committee of Wrocław Medical University (no. KB-444/2016). The research material was subjected to statistical analysis using the Statistica program version 13.1. Results. Analysis of the research material revealed that only one in three respondents was satisfied or very satisfied with their health condition, the lowest respondents rated the quality of their lives in the somatic domain, every fourth respondent does not accept his or her own disease, the higher the level of disease acceptance, the higher the score obtained in the WHOQOL-BREF questionnaire. Conclusions. The level of disease acceptance significantly affects QOL patients with MS. (JNNN 2017;6(4):157–162)

Opieka pielęgniarska nad pacjentem z miastenią — opis przypadku

Introduction . Myasthenia gravis is an autoimmune disease caused by disruption in normal neuromuscular transmission due to the reduction in the number of the acetylcholine receptors. Patients with myasthenia gravis require an individual and comprehensive nursing care to meet the needs of both biological and social nature. Properly undertaken nursing interventions improve the quality of life of patients and allow them to function independently in a daily life. An important issue is cooperation not only with the very patient, but also with their family. Case Report . A case of 57-year-old patient with myasthenia gravis, the dominant muscle weakness in both lower and upper limbs. The weakening of facial muscles and tongue, dysphagia and problems with food intake led to malnutrition and poor health condition. The onset of disease was at the age of 26, on the first day after giving birth. Discussion . Care for patients with myasthenia gravis must be comprehensive, and nursing-therapeutic care should meet individual patient’s needs in accordance with applicable guidelines. Conclusions . The case of the patient with myasthenia gravis allowed to identify the difficulties she struggled with. The main activities of nursing care provided the patient with the feeling of safety, better psychomotor activity and assistance in self-care activities. The knowledge about disease and its complications helped to improve daily functioning and coping with difficult situations. All measures taken in this regard proved to be effective, as they reduced anxiety and weakened the sense of isolation and loneliness. (JNNN 2017;6(2):88–97)