Maciej Górkiewicz

Factors identified with higher levels of career satisfaction of physicians in Andalusia, Spain

The satisfaction of physicians is a worldwide issue linked with the quality of health services; their satisfaction needs to be studied from a multi-dimensional perspective, considering lower- and higher-order needs. The objectives of this study were to: i) measure the career satisfaction of physicians; ii) identify differences in the dimensions of career satisfaction; and iii) test factors that affect higher- and lower-order needs of satisfaction among physicians working in Andalusian hospitals (Spain). Forty-one percent of 299 eligible physicians participated in a study conducted in six selected hospitals. Physicians reported higher professional, inherent, and performance satisfaction than personal satisfaction. Foreign physicians reported higher levels of personal and performance satisfaction than local physicians, and those who received non-monetary incentives had higher professional and performance satisfaction. In conclusion, physicians in the selected Andalusian hospitals reported low levels of personal satisfaction. Non-monetary incentives were more relevant to influence their career satisfaction. Further investigations are recommended to study differences in the career satisfaction between foreign and local physicians.

The Functional Condition and Physical Mobility among Patients Provided with Long-Term Institutional Care

Introduction:The increase of dysfunction in the functional condition and a decrease in physical mobility lead to independence limitation and increased demand for health care services. Aim of the study: The aim of the research was to evaluate the association between functional condition and physical mobility and selected demographic variables of patients provided with long-term institutional care. Material and Methods:The study group consisted of persons provided with long-term institutional care. The following standardized research tools were used in this study: the Cognitive Assessment Scale, the Edmonton Functional Assessment Tool and the Barthel Index. Results:Studies have shown that with increasing dysfunction of the functional condition of mobility decreases patients. The analysis showed no significant correlation of functional condition with age and gender of the respondents. Conclusions:The results indicate a need systematic assessment of the functional condition of patients, which determines adjustment of care to the capabilities and needs of the patients.

Gromadzenie subiektywnych samoocen nastroju pacjentów w zakładach opieki długoterminowej za pomocą wywiadu twarzą w twarz z zastosowaniem standardowych skal psychometrycznych

Wstep. Opieka nad osobą starszą opiera sie na trzech podstawowych komponentach: wspomaganie w wypelnianiu czynności zycia codziennego, wspomaganie w przestrzeganiu zalecen terapeutycznych, wspomaganie w przezwyciezaniu nastrojow lekowo-depresyjnych. W niniejszym studium polozono nacisk na ocene nasilenia nastrojow lekowo-depresyjnych u poszczegolnych pacjentow. Postuluje sie, ze oprocz ocen personelu opiekunczego nalezy, w miare mozności, korzystac z samoocen pacjentow, ktore są pozyskiwane drogą wywiadu twarzą w twarz. Cel. Celem pracy bylo potwierdzenie przypuszczenia, ze samooceny pacjentow poddanych opiece dlugoterminowej wnoszą dodatkową, uzupelniającą informacje do ocen personelu sprawującego opieke, sporządzanych tylko na podstawie obserwacji pacjentow. Material i metody. Badania objely 207 osob (135 kobiet i 72 mezczyzn) przebywających w placowce opieki dlugoterminowej w Krakowie (Polska) w roku 2014. Dane pozyskano z zastosowaniem trzech standardowych kwestionariuszy: skali Barthel oceniającej zdolnośc do czynności zycia codziennego, Skali Obserwacyjnej Przygnebienia i Leku (SOPL) oraz skali sklonności do depresji (CES-D). Statystyczna analiza obejmowala potwierdzenie rzetelności i trafności danych oraz badanie korelacji pomiedzy wynikami badan kwestionariuszowych. Wnioski. Rzetelnośc skali CES-D potwierdzają wartości wspolczynnika alfa Cronbacha: alfa = 0,82 i alfa = 0,85 (odpowiednio dla kobiet i mezczyzn), a trafnośc diagnostyczną — istotna korelacja skali CES-D i SOPL-depresja: R = 0,50; p < 0,001. Roznice pomiedzy skalami CES-D i SOPL-Depresja potwierdza fakt, ze skala Barthel jest istotnie skorelowana z SOPL-depresja, R = –0,18 (p = 0,01); ale nie jest istotnie skorelowana z CES-D, R = –0,08 (p = 0,24). Wyniki badania uzasadniają postulat, zeby do badan kwestionariuszowych angazowac nie tylko personel opiekunczy, lecz takze pacjentow, odpowiednio do ich zdolności umyslowych. Problemy Pielegniarstwa 2015; 23 (4): 439–445

The Center for Epidemiologic Studies Depression Scale (CES-D): Is It Suitable for Use with Older Adults?

Abstract With the aim of verifying the suitability of the CES-D scale for use in long-term care institutions for older adults, the CES-D questionnaire was used to collect patient-reported assessments, and two well-known psychometric instruments – the Hospital Anxiety and Depression Scale (HADS) and the Barthel Index of Abilities of Daily Living – were used to collect nurse-reported assessments, based on observations of patients’ behaviours. With regard to possible frequent cases of cognitive impairment and/or insufficient motivation to give sensible responses to CES-D questions, the patient-reported responses were collected from patients during one-on-one sessions with a nurse. The reliability, concurrent validity, and the trustworthiness of the obtained data were supported with proper values of the Cronbach’s alpha coefficient, 0.70 < alpha < 0.85, with significant correlation between CES-D and HADS-Depression, R = 0.50, p < 0.001, and with significant correlation between scores of particular CES-D items vs. final CES-D evaluations of depression, proved by significance p < 0.001 for 18 of 20 CES-D items. These findings supported the effectiveness of the one-on-one session methodology in questionnaire surveys for older adults. The postulation that cases of self-reported depression included somewhat different information about the patient than nurse-reported depression concerning the same patient was supported with the evidence that, in spite of the significant correlation between the Barthel Index and HADS-Depression, R = −0.17, p = 0.016, and in spite of the significant correlation between CES-D and HADS-Depression, the correlation between the Barthel Index and CES-D, equal to R = −0.08 was insignificant at p = 0.244. The findings of this study, considered jointly, support the valuableness of the CES-D scale for use in one-on-one surveys for older adults.

Multi-criteria Ranking Under Pareto Inclusive Criterion of Preference: An Application in Ranking Some Fungi Species with Respect to Their Toxicity

Abstract This study aims at demonstrating the usefulness of the Pareto in- clusive criterion methodology for comparative analyses of fungi toxicity. The toxicity of fungi is usually measured using a scale of several ranks. In practice, the ranks of toxicity are routinely grouped into only four conventional classes of toxicity: from a class of no toxicity, low toxicity, and moderate toxicity, to a class of high toxicity. The illustrative material included the N = 61 fungi samples obtained from three species: A. ochraceus, A. niger and A. flavus. In accordance with the Pareto approach, four partial criterions of the worst toxi- city were defined, a single criterion used for each conventional class of toxicity. Finally, the odds ratios (OR) were calculated separately for each partial cri- terion, and the significance of the hypotheses OR = 1 was estimated. It was stated that A. ochraceus fungi are distinctly more toxic than the two remaining ones with respect to the all considered four partial criterions, with significance equal to p = 0.04, p = 0.04, p = 0.007 and p = 0.005, respectively. Thus, the suggested method illustrated its utility in the case under study.

Dwa argumenty za opcją odpowiedzi Nie-wiem oprócz opcji Tak/Nie w anonimowych testach zrozumienia zależności przyczynowo-skutkowych

Two Arguments for Options I-don’t-know Except Options Yes /No in Anonymous Questionnaire Survey on Understanding the Causal Relations

1477 Stress and Other Risk Factors of the Heart's Diseases in Policemen

Purpose: Many factors impact quality of life (QoL) of patients on long-term oral anticoagulation therapy (OAT). There is a lack of clinical studies investigating the management of therapeutic regime and the QoL for patients on OAT. The purpose of this study was to evaluate common impact factors and impact factors for aggravation of QoL for patients with ischaemic heart disease (IHD) and chronic atrial fibrillation (AF) on OAT. Method: Research was done in Kaunas University of Medicine Cardiology Clinic and Outpatient Cardiology Clinic. The Quality of Life Indexn (QoLI) Cardiac Version-IV by Ferrans and Powers was applied and the questionnaire bThe Management of Oral Anticoagulant Therapy: the patient’s point of viewQ was administered to the intervention group of 157 patients with IHD and AF on OAT. Results: The mean value of QoLI for patients with IHD and AF on OAT was 18.97F0.26 on the scale from 0 to30. The mean value for the Health and functioning subscale— 17.42F0.31, for Social-economic status subscale— 19.39F0.28, for Psychological/spiritual component subscale (PSPSUB)—19.12F0.37 and Family subscale (FAMSUB) 22.9F0.30. Men had overall higher QoLI than women ( pb0.05) and differences were found not only within the PSPSUB ( pb0.05) but also in the FAMSUB. Both gender had the high scores in the FAMSUB and the lowest in the HFSUB. The most common impact factors for QoLI were education, family status, family income, bleeding complications, life style and undisclosed patients knowledge about OAT and blood tests. Gender, family status, assessment of patients health as bpoor healthQ, deficient patients knowledge about proper OAT management and proper interval of blood tests according to logistic regression analysis were aggravating impact factors for QoL for patients with IHD and chronic AF. Conclusion: The results of this study suggest that limited patients knowledge about proper OAT management is the most common impact factor for aggravation of QoLI for patients with IHD and AF on OAT. This study supports the important role of anticoagulation education program for improvement of patients QoL.