Mariola Głowacka

Tissue Factor and Tissue Factor Pathway Inhibitor in the Wound-Healing Process After Neurosurgery:

Objectives: The aim of the study was to assess the concentrations of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the blood of patients with a postoperative wound after neurosurgery. Method: Participants included 20 adult patients who underwent neurosurgery because of degenerative spine changes. The concentration of TF and TFPI in the patients’ blood serum was measured 3 times: before surgery, during the first 24 hr after surgery, and between the 5th and 7th days after surgery. The control group comprised 20 healthy volunteers similar to the patient group with respect to gender and age. Results: A statistically significant difference was observed between TF concentration at all three measurement time points in the research group and TF concentration in the control group (p = .018, p = .010, p = .001). A statistically significant difference was found between TFPI concentration at the second time point in the research group and TFPI concentration in the control group (p = .041). No statistically significant within-subject difference was found between TF concentrations before and after surgery. A statistically significant within-subject difference was found between TFPI concentrations within 24 hr after surgery and 5–7 days after surgery (p = .004). Conclusion: High perioperative concentrations of TF indicate not only the presence of thrombophilia but also the importance of TF in the wound-healing process. Perioperative changes in TFPI concentrations are related to its compensatory influence on hemostasis in thrombophilic conditions.

Measuring scales used for assessment of patients with traumatic brain injury: multicenter studies

Background Application of adequate numeric scales is essential for assessment of a patient’s condition. The scales most commonly used by the therapeutic team for assessment of a patient with traumatic brain injury (TBI) include deficit scales, functional scales, and scales assessing quality of life. The purpose of this study was to establish the relationships between the particular scales used for assessment of patients with TBI. Methods This multicenter study included 159 patients with TBI. The direct observation technique was used. Two measurements were made (at hospital admission and discharge) using standardized assessment scales, ie, the Glasgow Coma Scale (GCS), the Functional Capacity Scale (FCS), the Functional Index “Repty” (FIR), and the Glasgow Outcome Scale. Results Patients with mild impairment of consciousness were most numerous in the examined group at both admission and discharge, ie, 118 (78.8%) and 134 patients (89.3%), respectively. The mean score for functional capacity measured with the FCS was 34.41 points (71.7%) on the day of admission and 41.87 points (87.2%) on the day of discharge from hospital. A significant correlation was found between results obtained using the GCS and results on the FIR, on both the day of admission [R t(n-2) =7.612=0.530; P=0.00] and the day of discharge [R t(n-2) =8.998=0.595; P=0.00]. Further, a high correlation was found between the FCS and the FIR (rs= −0.854 on day of admission and rs= −0.840 on day of discharge). Conclusion The majority of examined patients had mild impairment of consciousness. A moderate correlation was found between the GCS and the scales assessing activities of daily living. A high correlation was found between FCS and FIR, which may result from the similarities between the analyzed tools in the scope of their construction and application.

Selected Aspects of Nurses' Burnout Compared to Other Employees of Social Welfare Homes

Introduction: The staff of social welfare home is exposed to the phenomenon of occupational burnout due to the specificity and characteristics of social welfare homes functioning. In social welfare homes there are people covered by 24-hour nursing and rehabilitation care, which required a significant amount of work on the part of the staff of such a centre. Nurses in their work constantly encounter situations which result in experiencing professional stress, which in turn results from the contact with another person waiting and requiring professional care and assistance. Due to specific conditions of the profession, nurses are particularly exposed to occupational burnout. As members of an interdisciplinary therapeutic team in social welfare homes, they spend most of the time with the residents, which promotes emotional exhaustion. The aim of the research was to present selected aspects of professional burnout of nurses compared to other welfare home employees. Methods: The methods used in the research consisted of the diagnostic survey method and estimation method; research techniques: surveying and estimation scale technique, as well as PSS-10 (perceptible stress scale) and DS-14 (scale for D-type measurement) questionnaires were used. Results: The study showed a statistically significant relationship between the intensity of stress between groups of social welfare homes staff, among whom there were nurses. The highest intensity of stress was observed in the occupational group of physiotherapists and nurses, followed by the medical caregivers/caregivers in the social welfare homes, social workers and occupational therapists/cultural and educational workers. Conclusions: Nurses and medical caregivers/caregivers at SWH are the representatives of the therapeutic team most exposed to the occurrence of burnout syndrome. It is important to be aware of the threat existence and have a decisive attitude to counteract the phenomenon of occupational burnout.

Ocena stanu umysłowego — wybrane narzędzia pomiarowe w neurogeriatrii

Complete Cerebral Assessment (CGA) involves the assessment of a neurological patient in four basic areas where performance capacity, physical health, mental health, as well social and environmental factors are taken into account. Specially prepared research tools (scales, questionnaires) can be used to assess individual CGA components, which significantly facilitate it and influence its credibility. In addition, they allow to verify changes in patient’s condition over time, in the category of improvement or deterioration, and also help in the exchange of quantitative (clinical) information between health care providers. Based on the literature, there have been discussed the most frequently applied scales used to assess the mental state of neurogeriatric patients. There have been presented data of metrics such as Mini-Mental State Examination (MMSE), Abbreviated Mental Test Score (AMTS), Clock Drawing Test (CDT), Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), and Beck Depression Inventory (BDI). ( JNNN 2017;6(3):130–133 )

Problemy pielęgnacyjne pacjentów z chorobą Parkinsona — opis przypadku

Introduction . Parkinson’s disease is considered to be one of degenerative disorders of the central nervous system. It is classified as an incurable, progressive disease leading to significant deficits in self-care. It is regarded, just after Alzheimer’s disease, as a disease of the elderly, which relates to the central nervous system (CNS). The mechanisms being the basis of this disease have not been completely understood. Case Report . The case study refers to a 72-year-old woman diagnosed with Parkinson’s disease and comorbid dizziness. This work has presented nursing diagnosis and the nursing process. There have been defined patient’s problems, the purpose of the care and its implementation by planning activities. There has been also made an assessment, which is a comparison of the results of the care obtained with the objectives assumed. This work is a description of the case of a theoretical patient. Discussion . One of the most important persons taking care of a patient with PD is the nurse. In the proces of hospital treatment hospital nurse becomes the closest person to the patient. Therefore, she is required to maintain a professional therapeutic contact with the patient. The role of the nurse is primarily to motivate the patient to take actions which will lead to a slowdown in the progress of the disease (ie. encouragement to participate in activities with a therapist, to talk to a psychologist, exercise with a physiotherapist). The patient described has a problem with low self-esteem and a critical attitude towards herself. It is difficult for her to establish contacts and maintain relationship with another person. Such signals should be noticed by the nurse. The nurse is required to respond adequately to the aforementioned symptoms. Conclusions . Parkinson’s disease is defined as a primary degenerative process of the extrapyramidal system. In its course it is characterised by a slow and degenerative process. The patient described by us is fully aware of her state of health as well as of the nature of the disease. This involves a significant decrease of mood, apathy and fear. She cannot accept her condition and the developing deficit of self-care resulting from the progress of the disease. In the case of our patient after discharge from hospital there was recommended further therapy with a psychologist and participation in classes conducted by an occupational therapist and a physiotherapist. (JNNN 2016;5(4):156–161)

Innowacyjny model monitoringu losów zawodowych absolwentów kierunku pielęgniarstwo realizowany przez uczelnie wyższe przy ścisłej współpracy z Okręgowymi Izbami Pielęgniarek i Położnych

W procesie ksztalcenia na kierunku pielegniarstwo istnieje koniecznośc uwzglednienia szczegolnej specyfiki pracy wykonywanej przez przyszly personel medyczny, wyrazającej sie w odpowiedzialności za najwazniejszą wartośc, jaką jest zycie i zdrowie czlowieka. Dlatego tez od kazdej uczelni wyzszej, realizującej w niniejszym przedmiocie procesy edukacyjne, wymaga sie zapewnienia szczegolnej dbalości i najwiekszej jakości. Temu procesowi mogą pomoc, zbierane podczas procesu monitoringu losow zawodowych absolwentow, szczegolowe informacje pozwalające: w sposob zewnetrzny odnieśc efekty procesu ksztalcenia do realiow i potrzeb pracodawcow, dokonac zobiektywizowanej oceny poziomu i sposobu nauczania, czy tez podjąc probe efektywnego doskonalenia programu ksztalcenia. Celem pracy bylo zaprezentowanie zalozen wypracowanego, nowego modelu monitorowania przez uczelnie wyzsze losow zawodowych absolwentow kierunku pielegniarstwo, wyrozniającego sie nowatorskim rozwiązaniem w zakresie pozyskiwania do szczegolowej analizy oceny jakości, efektywności i rynkowości ksztalcenia danych gromadzonych w Centralnym Rejestrze Pielegniarek i Poloznych. Opracowane rozwiązania organizacyjne, prawne i techniczne pozwalają ograniczyc powszechnie wystepujący problem związany z trudnościami w uzyskiwaniu opinii ze strony absolwentow. Problemy Pielegniarstwa 2015; 23 (4): 537–543

The Influence of Age Advancement and of Comorbidities on the Functional Capacity of Patients After the Incident of Ischemic Stroke

Introduction. The occurrence of ischemic strokes, particularly with people over 65 years of age, results from the presence of comorbidities that may adversely affect both the early and late prognosis as well as functional capacities of patients. Aim. The aim of the study was to evaluate the efficiency regarding basic daily activities performed by patients after the incident of the ischemic stroke, depending on the advancement of their age and the on the presence of comorbidities. Material and Methods. The study was carried out among 65 patients hospitalised due to the ischemic stroke in the neurology ward of the Provincial Hospital in Plock. The analysis of the functional capacity of patients, with the use of the Barthel Scale Questionnaire, was performed twice: on the first day of their hospitalisation and on the day of discharge from the hospital ward. Results. The functional capacity of the patients within the period of hospitalization after the incident of ischemic stroke was improving as a result of treatment, rehabilitation and care. However, both on the day of admission to the ward, as well as at discharge, the patients aged over 65 had the lowest scores on the Barthel Scale Questionnaire. The presence of comorbidities, particularly among older respondents, contributed to the deterioration of patients’ functional capacity. Conclusions. 1). Patients after the incident of ischemic stroke, despite the improvement regarding their functional capacity, require assistance in the performance of daily activities. 2). Age advancement contributes to the reduction of the functional capacity of respondents after the incident of ischemic stroke. 3). Comorbidities of the incident of ischemic stroke as well as the prior episode of stroke significantly contribute to the decrease the functional capacity of respondents. (JNNN 2015;4(3):102–108)

Rola pielęgniarki w leczeniu zespołów bólowych kręgosłupa

The development of civilization has led to the increasing prevalence of spinal problems. Lifestyle in the form of long hours of sitting or standing significantly affect the reduction in spinal mobility and promotes complaint back pain. Its structure is closely related to the functioning of the human being. Back pains are varied in terms of pathogenesis uprising. A common feature is pain that occurs in the lumbar area — the cross and the cross — the hip, with varied backgrounds and character. Treatment is based on conservative methods, such as drug treatment and rehabilitation, and surgery. An important role is played by prevention of backaches distributed among learners and workers. This article aims to highlight the role of nurses over patients with spinal pain syndromes in various stages of treatment. The nurse must take care individually and holistically. It is based mainly on alleviating pain and help the patient because of the temporary reduction in physical activity, which impedes the proper functioning. It is aimed at the comprehensive preparation of the patient and his family for self-care. (JNNN 2014;3(1):39–43)

Evaluation of Patients with Dysfunction of the Extra-Pyramidal System — Selection of Measuring Tools in Neurogeriatria

Summary The group of diseases with extra-pyramidal disorders includes inter alia Parkinson’s disease. It is one of the most common progressive, degenerative diseases of the central nervous system occurring in mature and older people. First symptoms of the disease occur in most cases after fifty years of age. The disease is generated by the loss of dopaminergic cells in the substantia nigra manifested clinically in the mobility slowdown, muscle rigidity and tremor at rest. The clinical use of various measuring tools (scales, indexes, indicators, tests, etc.) for the diagnosis of patients with dysfunction of the extra-pyramidal system has been increasingly applied. Based on the literature there were discussed scales most commonly used in the assessment of patients with dysfunction of the extra-pyramidal system including mainly those with Parkinson’s disease. There were presented data regarding such measuring scales as: Hoehn and Yahra’s (HY Scale), Webster’s (Webster Rating Scale — WRS), Unified Parkinson’s Disease Rating Scale (UPDRS), Northwestern University scale (Northwestern University Disability Scale — NUDS), Columbia University scale (Columbia University Rating Scale — CURS), Schwab and England’s independence scale (Schwab and England ADL Scale — S-E ADL), the short scale of Parkinson’s disease evaluation (Short Parkinson’s Evaluation Scale — SPES), the scale of daily activities in Parkinson’s disease (Parkinson’s Disease Activities of Daily Living Scale — PDADL) as well as life quality scales, including the PDQL (Parkinson’s Disease Quality of Life Questionnaire) and PDQ-39 (Parkinson’s Disease Questionnaire). (JNNN 2014;3(2):88–92)

Ocena stanu chorego z dysfunkcją układu pozapiramidowego — wybrane narzędzia pomiarowe w neurogeriatrii

The group of diseases with extra-pyramidal disorders includes inter alia Parkinson’s disease. It is one of the most common progressive, degenerative diseases of the central nervous system occurring in mature and older people. First symptoms of the disease occur in most cases after fifty years of age. The disease is generated by the loss of dopaminergic cells in the substantia nigra manifested clinically in the mobility slowdown, muscle rigidity and tremor at rest. The clinical use of various measuring tools (scales, indexes, indicators, tests, etc.) for the diagnosis of patients with dysfunction of the extra-pyramidal system has been increasingly applied. Based on the literature there were discussed scales most commonly used in the assessment of patients with dysfunction of the extra-pyramidal system including mainly those with Parkinson’s disease. There were presented data regarding such measuring scales as: Hoehn and Yahra’s (HY Scale), Webster’s (Webster Rating Scale — WRS), Unified Parkinson’s Disease Rating Scale (UPDRS), Northwestern University scale (Northwestern University Disability Scale — NUDS), Columbia University scale (Columbia University Rating Scale — CURS), Schwab and England’s independence scale (Schwab and England ADL Scale — S-E ADL), the short scale of Parkinson’s disease evaluation (Short Parkinson’s Evaluation Scale — SPES), the scale of daily activities in Parkinson’s disease (Parkinson’s Disease Activities of Daily Living Scale — PDADL) as well as life quality scales, including the PDQL (Parkinson’s Disease Quality of Life Questionnaire) and PDQ-39 (Parkinson’s Disease Questionnaire). (JNNN 2014;3(2):88–92)