Ewa Humeniuk

State of Health and Quality of Life of Women at Advanced Age

Background Evaluation of the state of health, quality of life, and the relationship between the level of the quality of life and health status in a group of women at an advanced age (90 years of age and older) in Poland. Material/Methods The study was conducted in 2014 in an all-Polish sample of 870 women aged 90 years and older. The research instruments were: the authors’ questionnaire and several standardized tests: Katz Index of Independence in Activities of Daily Living (Katz ADL), Abbreviated Mental Test Score (AMTS), and the World Health Organization Quality of Life (WHOQOL)-BREF. The results of the study were statistically analyzed using significant t-test for mean and regression analysis. Results The majority of women at an advanced age suffered from chronic pain (76%) and major geriatric problems such as hypoacusis (81%), visual disturbances (69%) and urinary incontinence (60%); the minority of women at an advanced age suffered from falls and fainting (39%), stool incontinence (17%), severe functional impairment (24%), and cognitive impairment (10%). On a scale of 1 to 5, women at an advanced age assessed positively for overall quality of life (mean 3.3), social relationships (3.5), and environment (3.2), but negatively for general health, physical health, and psychological health (2.7, 2.7, and 2.8, respectively). The presence of chronic pain and geriatric problems, including urinary and stool incontinences, falls and faint ing, visual disturbances and hypoacusis, significantly decreased overall quality of life; general health, physical health, psychological health, social relationships, and environment. Overall quality of life, general health, physical health, psychological health, social relationships, and environment was correlated with functional and cognitive impairments. Conclusions Quality of life of women at an advanced age decreased if chronic pain, major geriatric problems, or functional or cognitive impairments occurred.

Quality of pregnant women's diet in Poland - macro-elements.

Introduction The objective was to assess the quality of pregnant womens diet in Poland concerning macro-elements and to analyze reasons for low or high quality diets. Material and methods Five hundred and twelve pregnant women in their 20th to 30th week of pregnancy took part in the research conducted by means of a 7-day observation of diet. Consumed products were analyzed by means of DIETETYK software developed by the Polish National Food and Nutrition Institute. Obtained macro values were averaged. The results were compared with the recommendations from the World Health Organization, European Union and Polish National Food and Nutrition Institute and analyzed statistically (χ2 test). Results The pregnant women consumed an average of 1898 ±380 kcal daily. Average value of macro components supplied with the diet did not deviate from EU and NFNI nutrition recommendations: protein – 72.1 g/person daily, fats overall – 72.8 g, polyunsaturated fatty acids – 10.93 g, cholesterol – 283 mg, carbohydrates – 257 g. The study proved a significant relation between a higher quality diet of pregnant women and tertiary or secondary education (p = 0.05) as well as urban residence (p = 0.01). Conclusions Pregnant womens diet in Poland is not significantly different from diet quality of pregnant women from other countries. A lower quality diet was observed among women who smoked during pregnancy and lived in rural areas.

Interaction between C-reactive protein and cognitive functions according to APOE gene polymorphism in post-menopausal women

Introduction A potential factor increasing the risk of the development of cognitive impairment with age is apolipoprotein E (APOE) ε4 carrier status. A subsequent factor which may increase the risk of development of cognitive impairment at an older age is the concentration of C-reactive protein (CRP). The objective of the study was to examine the relationship between cognitive functions and the concentration of CRP in post-menopausal women who were carriers of particular apolipoprotein E gene (APOE) polymorphisms. Material and methods A group of 402 women was recruited to the study. The inclusion criteria were: minimum two years after the last menstruation, follicle-stimulating hormone (FSH) concentration 30 U/ml, no dementi signs on Montreal Cognitive Assessment (MoCA). The computerized battery of the Central Nervous System Vital Signs (CNS VS) test was used to diagnose cognitive functions. APOE genotyping was performed by multiplex PCR. The blood plasma CRP levels were determined. Statistical analysis was performed using Statistica software. Results The level of neurocognitive index (NCI) and cognitive functions in post-menopausal women depends on apolipoprotein E gene polymorphism (p < 0.001) and the concentration of CRP (p < 0.05). A negative correlation was found between CRP and NCI (p = 0.018), and the reaction time (p = 0.008) of women with APOE ε2/ε3. A positive correlation was observed between CRP and visual memory (p = 0.025) in women with APOE ε3/ε3, and verbal memory (p = 0.023) in women with APOE ε3/ε4 or ε4/ε4. Conclusions Apolipoprotein E gene polymorphism may modify the relationship between CRP concentration and cognitive functions in post-menopausal women.

Level and conditioning of knowledge about breast cancer displayed by women in perimenopausal age

INTRODUCTION Women aged 50-69 are the most likely to develop breast cancer. Knowledge about breast tumours as well as regular examination are two of the key factors which reduce the risk of the disease, and increase both the success of treatment and chances of survival. OBJECTIVE The aim of the paper was to assess knowledge about risk factors, symptoms, screening, early diagnosis and breast cancer treatment among women in perimenopausal age. MATERIALS AND METHOD 400 women aged 45-60, residing in the Lublin region of eastern Poland participated in the research. The primary research tool was a questionnaire with 35 questions checking knowledge about symptoms, screening and early diagnosis, as well as breast cancer treatment. Particulars were also part of the questionnaire. RESULTS Over 50% of women obtained average results with regard to general knowledge, 40% obtained high results and 6% low results. Subjective assessment of the womens knowledge was statistically significantly (p<0.001) different from the objective assessment. The research confirmed a significant relationship between knowledge and education (p<0.01), and place of residence (p<0.001). The group examined displayed considerably limited knowledge about risk factors, symptoms, screening, as well as breast cancer early diagnosis and therapy. Over a half of the women in perimenopausal age had average general knowledge, while only 40% - high. CONCLUSIONS Over half of the women in perimenopausal age had average general knowledge, while only 40% - high. Subjective assessment of knowledge differed statistically significantly from the objective assessment. Women with higher education and living in rural areas displayed a higher level of general knowledge about breast cancer. The study did not identified any relationship between level of knowledge about breast cancer and age, financial situation or health of women in perimenopausal age.

Ocena zachowań żywieniowych chorych na nowotwór.

Wstep. Wielu autorow donosi, iz tzw. niehigieniczny styl zycia, zwlaszcza zaś nieprawidlowy sposob odzywiania moze indukowac wystąpienie chorob nowotworowych. Cel. Ocena zachowan zdrowotnych dotyczących przestrzegania zalecen dietetycznych chorych na nowotwor w odniesieniu do czynnikow socjalnych i demograficznych. Material i metoda. Grupe badaną stanowilo 100 osob chorych na nowotwor. Posluzono sie metodą sondazu diagnostycznego, techniką ankietową. Wykorzystano wybrane pytania Inwentarza Zachowan Zdrowotnych (IZZ) Zygfryda Juczynskiego zaliczane do kategorii Prawidlowe Nawyki Żywieniowe (PNŻ) i autorską ankiete, badającą regularnośc odzywiania wśrod pacjentow onkologicznych. Analizy materialu badawczego dokonano przy uzyciu pakietu statystycznego STATISTICA 12 i programu Microsoft Office Excel . Wyniki. Ankietowani posilali sie przewaznie 3-4 razy dziennie (53%). Zalecaną przez IŻŻ liczbe 5 posilkow deklarowalo 35% badanych. Badania nie wykazaly istotnego związku miedzy liczbą dziennie konsumowanych posilkow, a zmiennymi socjo-demograficznymi i typem nowotworu, czasem trwania oraz rozpoznania choroby. W ogolnej ocenie analizowana proba uzyskala przecietne rezultaty w kategorii Prawidlowe Nawyki Żywieniowe (3,36). Ankietowani deklarowali najlepsze zachowania zywieniowe wobec unikania spozycia soli (3,44), konsumpcji duzej ilości warzyw i owocow (3,41), a takze dbania o prawidlowe odzywianie (3,38). Wnioski. Mimo nasilającego sie spolecznego przekonania, ze dbanie o kondycje zdrowotną jest wazne, deklaracje Polakow dotyczące troski o stan wlasnego zdrowia nie korelują dodatnio z praktykami zdrowotnymi.

Satysfakcja pacjentów makroregionu lubelskiego z usług wybranych poradni specjalistycznych świadczeń zdrowotnych

Wstep i cel pracy. Obserwuje sie w ostatnim czasie duze zmiany w obrebie postrzegania roli pacjenta, ktory z biernego odbiorcy świadczen zdrowotnych przyjąl postawe klienta, opiniującego i oceniającego realizowane uslugi. Celem pracy bylo określenie wplywu wybranych czynnikow na poziom satysfakcji pacjentow makroregionu Lubelskiego ze świadczen lekarza specjalisty. Material i metody badan. Grupe badaną stanowilo 144 pacjentow poradni, udzielających specjalistycznych uslug medycznych. Posluzono sie metodą sondazu diagnostycznego, techniką ankietową. Narzedziem badawczym byl autorski kwestionariusz, sluzący do oszacowania stopnia zadowolenia ze świadczen specjalistycznej opieki zdrowotnej. Do analizy materialu badawczego wykorzystano program SAS Enterprise Guide . Przyjeto poziom istotności p<0,05. Posluzono sie testami Chi 2 Pearsona, t-Studenta i r-Spearmana. Wyniki. Zadowolenie ze świadczen specjalistycznej opieki zdrowotnej determinowane bylo stosunkiem lekarza do pacjenta, jego reakcją na zglaszane przez pacjenta potrzeby i prośby, oceną poświeconego pacjentowi czasu i uwagi, skutecznością porady. Na poziom satysfakcji nie wplywal rodzaj wizyty. Wnioski. Na zadowolenie pacjentow wplywa wiele roznych elementow. Spelnianie oczekiwan pacjentow rzutuje na jakośc uslug zdrowotnych niosąc za sobą szereg pozytywnych konsekwencji.

Existential attitudes as predictors of burnout in Polish nurses employed in rural primary healthcare settings

Introduction. Existential attitudes distinguished by G. Reker express the meaning of life and affect the way individuals perceive themselves, the reality as well as their ability to cope with challenges. Thus, it can be assumed that life attitudes also determine burnout understood as a syndrome of psychological symptoms that occur in professionally active people due to chronic occupational stress. Objective. The aim of the study is to examine which existential attitudes determine burnout in nurses employed in rural primary healthcare settings in Poland Material and methods. The study sample comprised 120 nurses employed in rural primary healthcare settings in Poland. The Life Attitude Profile – Revised (LAP-R) adapted by R. Klamut and The Link Burnout Questionnaire (LBQ) adapted by A. Jaworowska were used in the research. Results. The stronger the belief of the surveyed nurses concerning life goals they possess and the more internally coherent they are, the lower psychophysical exhaustion they experience. Whereas, psychophysical exhaustion rises with an increase in the need for introducing changes in life. Relationship deterioration and disillusion decrease with the level of engagement in seeking new goals in life. The sense of professional ineffectiveness drops if the belief of the nurses that they possess life goals gets stronger. Moreover, the stronger the meaning of life becomes, the stronger the professional ineffectiveness of

Interest in screening examinations among cancer patients

Abstract Aim. To determine the influence of socio-demographic variables on attendance rate at screening examinations in cancer patients. Material and methods. The research group comprised of 100 cancer patients. The method applied in the research was a diagnostic survey. The research instrument was the authors‘ own questionnaire specially compiled to measure cancer patients‘ interest in screening examinations. The research material was analysed with the statistical packet STATISTICA 12 and Microsoft Office Excel software. Significance level was assumed at p<0.05 to determine statistically significant differences and dependencies. A Chi2 test was used in the research. Results. The surveyed patients mostly did not participate in screening examinations aimed at diagnosing cancer (66%). Their Age (p=0.05), gender (p=0.003) and place of residence (p=0.04) determined their participation rate in screening tests. The patients‘ marital status (p=0.47), education (p=0.85) and economic status (p=0.13) did not affect their willingness to attend screening examinations. Conclusions. The process of cancer incidence and death rate limitation requires greater participation of the population in prevention programmes.

Psychosocial determinants of disease acceptance in selected mental disorders

INTRODUCTION AND OBJECTIVE Every mental disorder may cause a number of negative consequences in the personal lives of the patients and their families as well as in their social relations. Acceptance of the disease is a crucial factor in the process of coping with the problems resulting from it. Acceptance of the disease may significantly influence the reduction of negative emotional reactions it causes. Consequently, it may contribute to better adaptation of the patients and hence may facilitate the process of recovery. The study attempts to define the socio-psychological conditioning of the degree of disease acceptance among patients treated for psychical disorders. MATERIAL AND METHODS Opinion surveys were carried out in 2013 among a group of 240 patients treated in Mental Health Clinic in Chełm, eastern Poland. The study applied Acceptance Illness Scale - AIS B. Felton, T. A. Revenson, G.A. Hinrichsen, adapted in Poland by Z. Juczyński, as well as a socio-demographic questionnaire. RESULTS The analysis of the obtained results revealed a similar level of acceptance of such diseases as anxiety disorders (24.41±8.52), depression (22.80±7.51) and personality disorders (23.89±7.89). The medical records of all patients fitted among the low average. CONCLUSIONS The greatest problem in the researched group related to the social consequences of the psychical disorders. Those questioned were afraid of the negative reactions of others and of being a burden to their families. The level of acceptance was not correlated with independent variables (age, gender, education, place of residence, general well-being).

Existential attitudes and Occupational burnout syndrome in nurses

Abstract Aim. The aim of the study was to determine the relation between existential attitudes and occupational burnout in nurses. Material and methods. The research sample consisted of 120 nurses. Life Attitudes Profile - Revised (the LAP-R) adapted by R. Klamut and Link Burnout Questionnaire (the LBQ) adapted by A. Jaworowska were used in the research. Results. Psycho-physical exhaustion and relationship deterioration correlate negatively with life goals, internal consistency, life control, death acceptance and positively with existential void and goal seeking. Sense of professional failure and disillusion present a conversely proportional relation with goal, coherence, life control as well as an inversely proportional relation with existential void and goal seeking. Conclusions. The analyses performed in the course of the research proved that existential attitudes accompany burnout in nurses. The obtained results of the authors’ own research present cognitive value and can be used to develop both prevention and aid programs aimed at enhancing the quality of personal and professional functioning of nurses.