Irena Maniecka-Bryła

Self-rated quality of life of city-dwelling elderly people benefitting from social help: results of a cross-sectional study

BackgroundThe percentage of people aged 65 or older living in Poland is 13.6%, but 17.2% in Łódź. The aim of the study was to identify factors correlating with the self-rated quality of life of elderly inhabitants of cities applying for social help, on the basis of a cross-sectional study.MethodsThe study was conducted in Łódź, a large Polish city, between September 2011 and February 2012 in a group of people applying for help in the Municipal Social Welfare Centre. Four hundred and sixty-six respondents aged 65 or older were included in the study. The tool used in the study was an interview questionnaire. The respondents answered questions on their demographic situation, living conditions, financial, health and social situation. The authors also applied the WHOQOL-BREF Questionnaire, the Activities of Daily Living Scale (ADL) and the Geriatric Depression Scale (GSOD). For statistical purposes, the authors used single- and multiple-factor regression and the Statistica 9.0 Program. The results were presented as an odds ratio (OR) with a 95% confidence interval (CI); the adopted significance level was p < 0.05. The authors applied the Pearson’s x2 test in order to evaluate the structure of the studied group and the subpopulation, who were aged 65 or older and using social help, throughout the city.ResultsLogistic regression confirmed that a high quality of life depends on the following variables: university education (OR = 2.31; p < 0.05), an income which is sufficient to live (OR = 1.63; p < 0.05), no heart palpitations (OR = 2.32; p < 0.05), stable blood pressure (OR = 2.32; p < 0.05), no headaches (OR = 1.55; p < 0.05), no pain in the chest (OR = 1.51; p < 0.01), no shortness of breath (OR = 1.51; p < 0.01), no tiredness (OR = 2.08; p < 0.05), a score on the Geriatric Depression Scale pointing to a lack of suspected depression (OR = 9.88; p < 0.001 if the person does not suffer from depression and OR = 6.33; p < 0.001 if there is uncertain depression) as well as not using nursing services, a score on the ADL Scale confirming the person’s fitness and participation in family gatherings.ConclusionsA subjective evaluation of the quality of life of the elderly depends on many factors. An identification of these factors might be helpful in implementing steps aimed at improving the quality of life of elderly people who, as a consequence, will need less social help: particularly nursing services.

Years of life lost due to malignant neoplasms characterized by the highest mortality rate.

Introduction The analysis of premature deaths measured with years of life lost between the studied and referential populations helps to emphasize the social and economic aspect of a loss caused by deaths due to malignant neoplasms. The aim of the study was to analyze years of life lost by inhabitants of the Lodz province due to malignant neoplasms. Material and methods The study material included a database which contained information gathered from 313,144 death certificates (including 66,899 people who died of malignant neoplasms) of inhabitants of the Lodz province who died between 1999 and 2008. The SEYLLp (Standard Expected Years of Life Lost per living person) method was used to determine years of life lost. Jointpoint models were used to analyze time trends. Results In males the diseases which mostly contributed to death were tracheal, bronchial and lung malignant neoplasms (SEYLLp = 170.7) and cancer of the large intestine, rectum and anus (SEYLLp = 47.5). In females the principal diseases were tracheal, bronchial and lung malignant neoplasms (SEYLLp = 61.6), breast cancer (SEYLLp = 60.4) and cancer of the large intestine, rectum and anus (SEYLLp = 42.3). The years of life lost were growing in the period under study. Conclusions The number of years lost due to malignant neoplasms in the Lodz province between 1999 and 2008 was growing. The main reasons for deaths in females were tracheal, bronchial and lung malignant neoplasms as well as breast cancer and in males – cancer of the large intestine, rectum and anus as well as prostate cancer.

Factors associated with self-rated health (SRH) of a University of the Third Age (U3A) class participants

INTRODUCTION A U3A is a way of making elderly people active. Our study aims to investigate the association between socioeconomic variables, selected symptoms, disorders and the SRH of participants of classes at the U3A. MATERIALS AND METHODS The study was conducted in 2011 in a group of participants of classes at the U3A in Plock, Poland. The authors examined 250 people aged 60 or older. A survey questionnaire was the study tool. Statistica 9.0. was used for statistical analysis, including ordinal regression models. RESULTS Being younger (65-69) increases the chance of returning a good SRH score to over five times compared to being 75 and over (odds ratio (OR)=5.30, confidence interval (CI)=1.76-15.97), p<0.01). The chance of a good SRH score is almost four times more likely in subjects with a disposable income which satisfies basic needs compared to that which does not (OR=3.97, CI=1.12-14.04, p<0.05). Furthermore, lack of symptoms and disorders have a strong influence on good SRH (no leg edema - OR=4.06, CI=1.63-10.12, p<0.01; no headache - OR=2.75, CI=1.34-5.62, p<0.01; no toothache - OR=4.32, CI=1.12-16.68, p<0.05; no hypertension - OR=1.78, CI=1.02-3.14, p<0.05; no degenerative disease - OR=1.88, CI=1.08-3.27, p<0.05). Feeling happy raised the chance of reporting good SRH by almost three times (OR=2.91, CI=1.35-6.27, p<0.01). CONCLUSIONS A subjective evaluation of health by the elderly constitutes an important indicator of their health and quality of life. It can become a basis for implementing activities of gerontological prophylaxis and leveling out health inequalities.

The burden of premature mortality in Poland analysed with the use of standard expected years of life lost.

BackgroundDespite positive changes in the health of the population of Poland, compared to the EU average, the average life expectancy in 2011 was 5 years shorter for males and 2.2 years shorter for females. The immediate cause is the great number of premature deaths, which results in years of life lost in the population. The aim of the study was to identify the major causes of years of life lost in Poland.MethodsThe analysis was based on a database of the Central Statistical Office of Poland, containing information gathered from 375,501 death certificates of inhabitants of Poland who died in 2011. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (SEYLL per death) measures were calculated to determine years of life lost.ResultsIn 2011, the total number of years of life lost by in Polish residents due to premature mortality was 2,249,213 (1,415,672 for males and 833,541 for females). The greatest number of years of life lost in males were due to ischemic heart disease (7.8 per 1,000), lung cancer (6.0), suicides (6.6), cerebrovascular disease (4.6) and road traffic accidents (5.4). In females, the factors contributing to the greatest number of deaths were cerebrovascular disease (3.8 per 1,000), ischemic heart disease (3.7), heart failure (2.7), lung cancer (2.5) and breast cancer (2.3). Regarding the individual scores per person in both males and females, the greatest death factors were road traffic accidents (20.2 years in males and 17.1 in females), suicides (17.4 years in males and 15.4 in females) and liver cirrhosis (12.1 years in males and 11.3 in females).ConclusionsIt would be most beneficial to further reduce the number of deaths due to cardiovascular diseases, because they contribute to the greatest number of years of life lost. Moreover, from the economic point of view, the most effective preventative activities are those which target causes which result in a large number of years of life lost at productive age for each death due to a particular reason, i.e. road traffic accidents, suicides and liver cirrhosis.

Years of life lost due to external causes of death in the lodz province, Poland

Background The aim of the study is the analysis of years of life lost due to external causes of death, particularly due to traffic accidents and suicides. Materials and Methods The study material includes a database containing information gathered from 376,281 death certificates of inhabitants of the Lodz province who died between 1999 and 2010. The Lodz province is characterized by the highest mortality rates in Poland. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (per death) indices were used to determine years of life lost. Joinpoint models were used to analyze time trends. Results In 2010, deaths due to external causes constituted 6.0% of the total number of deaths. The standardized death rate (SDR) due to external causes was 110.0 per 100,000 males and was five times higher than for females (22.0 per 100,000 females). In 2010, the SEYLLp due to external causes was 3746 per 100,000 males and 721 per 100,000 females. Among males, suicides and traffic accidents were the most common causes of death (the values of the SEYLLp were: 1098 years and 887 years per 100,000 people, respectively). Among females, the SEYLLp values were 183 years due to traffic accidents and 143 years due to suicides (per 100,000 people). Conclusions A decrease in the number of years of life lost due to external causes is much higher among females. The authors observe that a growing number of suicides contribute to an increase in the value of the SEYLLp index. This directly contributes to over-mortality of males due to external causes. The analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes.

Cross‐cultural adaptation and translation of a quality of life tool for new mothers: a methodological and experiential account from six countries

AIM To examine the challenges and solutions encountered in the translation and cross-cultural adaptation of an English language quality of life tool in India, China, Iran, Portugal, Brazil, and Poland. BACKGROUND Those embarking on research involving translation and cross-cultural adaptation must address certain practical and conceptual issues. These include instrument choice, linguistic factors, and cultural or philosophical differences, which may render an instrument inappropriate, even when expertly translated. Publication bias arises when studies encountering difficulties do not admit to these, or are not published at all. As an educative guide to the potential pitfalls involved in the cross-cultural adaptation process, this article reports the conceptual, linguistic, and methodological experiences of researchers in six countries, who translated and adapted the Mother-Generated Index, a quality of life tool originally developed in English. DATA SOURCES Principal investigator experience from six stand-alone studies (two published) ranging from postgraduate research to citywide surveys. DISCUSSION/IMPLICATIONS FOR NURSING: This analysis of a series of stand-alone cross-cultural studies provides lessons about how conceptual issues, such as the uniqueness of perceived quality of life and the experience of new motherhood, can be addressed. This original international approach highlights practical lessons relating to instrument choice, and the resources available to researchers with different levels of experience. Although researchers may be confident of effective translation, conceptual and practical difficulties may be more problematic. CONCLUSION Instrument choice is crucial. Researchers must negotiate adequate resources for cross-cultural research, including time, translation facilities, and expert advice about conceptual issues.

Pregnancy and Delivery in Women with Uterine Malformations

BACKGROUND Uterine defects are the most common malformations of the female reproductive system. They can lead to many obstetric complications, e.g. preterm delivery, intrauterine growth restriction, oligohydramnios and operational delivery. OBJECTIVES Our aim was to analyze the impact of different types of uterine defects on pregnancy outcomes. MATERIAL AND METHODS The study involved 94 pregnant women with different types of uterine defects hospitalized at the Department of Fetal--Maternal Medicine and Gynecology, RIPMMH in Łódź, between 1994 and 2012. The patients were divided into 5 groups on the basis of diagnosed defects: arcuate (n=6), bicornuate (n=50), duplex (n=29), septate (n=5) and unicornuate uterus (n=4). In order to avoid correlated data in statistical analysis, our research did not consider the total number of pregnancies and births but the number of patients. The first pregnancy of each patient, if completed after 22-week gestation, was studied and analyzed. RESULTS Preterm delivery was the most common complication in pregnancy (55 women, 58.5%). The caesarean section was performed in 73 (78%) women. IUGR was diagnosed in 16% of cases. Placental abruption occurred in 13 (14%) and cervical insufficiency in 10 cases (11%), respectively. Prenatal diagnostic showed abnormalities in 12 fetuses (13%). The Apgar score from 0 to 4 points was assigned to 9 newborns (9.6%), 5-7 to 20 children (21.3%) and 8-10 points to 75 cases (69.1%). Normal birth weight (>2500 g) was determined in 51 newborns (54.3%). CONCLUSIONS Women with uterine defects are subject to an increased risk of complications in pregnancy and delivery, including premature births, low birth weights, births by cesarean section.

Determinants of premature mortality in a city population: An eight-year observational study concerning subjects aged 18–64

BackgroundPremature deaths constitute 31.1% of all deaths in Łódź. Analysis of the causes of premature deaths may be helpful in the evaluation of health risk factors. Moreover, findings of this study may enhance prophylactic measures.Material and MethodsIn 2001, 1857 randomly selected citizens, aged 18-64, were included in the Countrywide Integrated Noncommunicable Diseases Intervention (CINDI) Programme. In 2009, a follow-up study was conducted and information on the subjects of the study was collected concerning their health status and if they continued to live in Łódź. The Cox proportional hazards model was used for evaluation of hazard coefficients. We adjusted our calculations for age and sex. The analysis revealed statistically significant associations between the number of premature deaths of the citizens of Łódź and the following variables: a negative self-evaluation of health — HR = 3.096 (95% CI: 1.729–5.543), poor financial situation — HR = 2.811 (95% CI: 1.183–6.672), occurring in the year preceding the study: coronary pain — HR = 2.754 (95% CI: 1.167–6.494), depression — HR = 2.001 (95% CI: 1.222–3.277) and insomnia — HR = 1.660 (95% CI: 1.029–2.678). Our research study also found a negative influence of smoking on the health status — HR = 2.782 (95% CI: 1.581–4.891). Moreover, we conducted survival analyses according to sex and age with Kaplan-Meier curves.ConclusionsThe risk factors leading to premature deaths were found to be highly significant but possible to reduce by modifying lifestyle-related health behaviours. The confirmed determinants of premature mortality indicate a need to spread and intensify prophylactic activities in Poland, which is a post-communist country, in particular, in the field of cardiovascular diseases.

Fifteen-year mortality trends in Poland analysed with the use of standard expected years of life lost, 2000–2014

The aim of the study is an evaluation of years of life lost by inhabitants of Poland according to the most important causes of mortality and identification of trends in the period 2000–2014. The study material included a database which contained information gathered from 5,601,568 death certificates of inhabitants of Poland. In order to calculate years of life lost, the SEYLLp index (Standard Expected Years of Life Lost per living person) was applied. We also calculated AAPC (Average Annual Percentage Change). The SEYLLp index (per 10,000 population) in Poland decreased from 2503.4 in 2000 to 2193.2 in 2014 among males (AAPC = −0.8%, p < 0.05) and from 1430.2 in 2000 to 1269.4 in 2014 among females (AAPC = −0.6%, p < 0.05). In 2014, the top 5 causes of years of life lost were: cardiovascular diseases (721.4 per 10,000 males and 475.6 per 10,000 females), malignant tumours (575.5 and 418.3), unintentional injuries (202.2 and 46.8), intentional injuries (114.6 and 16.3) and digestive diseases (120.2 and 58.3). Due to negative trends, there is a need to implement preventative measures, aimed at reducing mortality caused by respiratory infections in both males and females, malignant tumours in females and diabetes mellitus and intentional injuries in males.

Standard expected years of life lost due to tuberculosis in Poland

SETTING Central European countries such as Poland have higher tuberculosis (TB) morbidity and mortality than Western European Union countries. OBJECTIVE To evaluate changes in mortality due to TB during the period 1999-2012 in Poland and years of life lost due to the disease. DESIGN Information obtained from 5 219 205 death certificates in Poland during the period 1999-2012 was used for the study. Crude (CDRs) and standardised (SDRs) death rates due to TB were analysed. Standard expected years of life lost per living person (SEYLLp) was also calculated. RESULTS In Poland, TB and related complications contributed 0.23% of total deaths from 1999 to 2012. The SEYLLp was 3.46 per 10 000 population in 1999 and 1.88 in 2012. It was respectively 5.75 and 3.12 for males, and 1.31 and 0.72 for females. The SEYLLp index decreased over the period (annual per cent change [APC] -4.27%, P < 0.05); the decrease was greater in females than in males (APC -4.75%, P < 0.05 vs. APC -4.15%, P < 0.05). CONCLUSION Despite an improvement in the epidemiological situation, TB remains the most common single cause of death due to an infectious agent in Poland.