Self-regulation in the process of recovery from alcohol addiction according to Julius Kuhl's theory

Aims: The main aim of this study is to analyse the dynamics in self-regulation functions in connection with the treatment of people with alcohol addiction. Another goal is to compare two groups of people after a period of 1 year: those who maintained abstinence and those who relapsed. Method: The studies were designed as longitudinal studies (three assessments) with quasi-experimental procedure (without a control group). The first assessment was performed during a 2-week period of treatment, the second one was performed at the end of the basic stage of treatment and the third one after 1 year. The data were collected in 12 centres treating addictions with similar treatment programmes on a group of 977 patients with a diagnosis of alcohol addiction (males 76%, females 24%). Self-regulation functions were assessed with Inventory SSI-K, where they are defined based on Kuhl’s Personality Systems Interactions theory. A semistructured interview was performed twice: at the beginning of treatment, in order to diagnose alcohol addiction disorders, and after 1 year of treatment, to analyse the indicator of recovery, which was defined as maintaining abstinence. In the evaluation of the dynamics of self-regulation functions, a two-way analysis of variance (ANOVA) was used. Conclusions: Treatment and abstinence influence changes in self-regulation functions. The effects of these changes are mainly observed in people who maintained abstinence 1 year from starting their treatment, which indicates a stronger ability to act according to their own needs, facilitating the development of the ‘Self’

Stress associated with undergraduate medical courses : a translation and validation of the Perceived Medical School Stress Instrument into Polish and its adaptation to the Polish environment

Medical students are more susceptible to depression than other students. Moreover, students with the symptoms of depression statistically more often abuse drugs and have suicidal thoughts and anxiety. The level of stress and the factors that lead to in among medical students at Polish universities have not yet been measured. The aim of this study was to translate to Polish and validate the Perceived Medical School Stress Instrument (PMSS-PL) and to measure the resulting version’s psychometric abilities. Materials and Methods: We validated the Polish translation of PMSS in accordance with the recommendations published by the Translation and Cultural Adaptation group of the Quality of Life Special Interest group of the International Society for Pharmacoeconomics and Outcomes Research. The Perceived Stress Scale (PSS-10) was used as an external test to validate the PMSS-PL questionnaire. A total of 430 undergraduate medical students at the Medical College of Jagiellonian University took part. Results: The mean PMSS-PL score was 36.43 and it varied from 13 to 65. The mean PSS-10 was 21.35. The internal reliability, as indicated by Cronbach’s alpha, was 0.803, which means there was internal reliability between PSS-10 and PMSS-PL. Moreover, all questions from PMSS-PL had a positive discri-mination power, so each question correlated positively with the other questions in PMSS-PL. Conclusions: PMSS-PL may be used to psychometrically analyze the stress load on undergraduate medical students at Polish universities. The PMSS-PL may also be used as an external test for validating and calculating the reliability and accuracy of other psychometric instruments

Analysis of experiences in patients with cardioverter defibrillator after an episode of electrical storm

Artykuł przedstawia wyniki badań, których celem była analiza doświadczenia burzy elektrycznej u osób z ICD (kardiowerter- -defibrylator) przy uwzględnieniu nasilenia lęku dotyczącego tej sytuacji. Badania oraz interwencje psychologiczne przeprowadzono na Oddziale Intensywnej Opieki Kardiologicznej. Ciekawe wyniki badań nasuwają wiele refleksji do spożytkowania w okolicznościach udzielania pomocy psychologicznej tego typu pacjentom.Objectives: Cardioverter-defibrillator (ICD) reduces the risk of sudden cardiac death and ensures a feeling of safety in the patient. In some patients, an electrical storm can be a source of difficulties in adaptation process, requiring psychological interventions. The electrical storm is a rare, but psychologically burdensome situation in patients with ICD. The aim of the study was the analysis of the experiences of electrical storm in patients with cardioverter defibrillator taking into account the severity of state anxiety. Methods: The study and the psychological intervention were conducted in the first three days after the ICD electric storm in the Intensive Cardiology Care Ward. Data was analyzed on the basis of narrative interview and thematic analysis. The severity of state and trait anxiety was also assessed with the use of STAI questionnaire. Results: All the patients were characterized by a medium to high level of anxiety as personality trait. In response to electrical storm two groups were found: a high - and medium-level of anxiety group. In the high-level of anxiety group, the statements had anxious and/or depressive characteristics, while in the medium-level of anxiety group the statements indicated an acceptance of the ICD treatment. Conclusions: The main result of the analysis is the distinction of two theme groups identified on the basis of the statements concerning the electric storm experience. In the high-level of anxiety group, lack of acceptance of this method of treatment and anxious statements were found more often, whereas the statements of the medium-level of anxiety group presented better adaptation

Changes in cognitive functions and quality of life in patients after transcatheter aortic valve implantation

Introduction: Transcatheter aortic valve implantation (TAVI) has emerged as a therapeutic option for patients with severe aortic stenosis (AS). However, an association between cognitive functions (CF) and health-related quality of life (HRQoL) in TAVI patients is still unclear. Aim: To assess the long-term changes in CF and HRQoL in elderly patients with AS after TAVI. Material and methods: A total of 259 patients who underwent cardiological and psychological TAVI qualification were enrolled and divided into the normal (n = 174) and impaired cognition group (n = 85). CF and HRQoL characteristics assessed at baseline and 13 months were compared between groups. The analysis of multiple linear regression was performed to identify the association between HRQoL and CF and to assess the influence of TAVI on HRQoL. Results: There was no difference in CF between baseline and follow-up. However, an improvement in attention functions and memory skills in the cognitively impaired group was noted at follow-up. In addition, HRQoL scores increased in both groups. An independent predictor associated with HRQoL was global CF (β = –213, p = 0.01), which explained 7% of CF variation. Improvements in all five dimensions of HRQoL, from 4.8% in self-care and up to 33.6% in pain/discomfort, were found. At follow-up, 60% of TAVI patients had improved health, 12% had worse health, 4% showed no change and 24% had a “mixed” change. Conclusions: TAVI is associated with positive changes in the functioning of elderly patients at long-term follow-up

Quality of life and depressive symptoms in transcatheter aortic valve implementation patients - a cross-sectional study

Quality of life is an important factor influencing mood. In any group of elderly people undergoing valve implementation or surgical aortic valve replacement, one in three will have depressive symptoms. The aims of this study were as follows: 1. to evaluate the impact of health-related quality of life on depressive symptoms in elderly patients undergoing TAVI, and 2. to analyze beliefs about TAVI. Methods: A total of 131 elderly people (mean age: 82.1 ± 6.1 years) scheduled to receive TAVI completed the Geriatric Depression Scale, EQ-5D-3L, and Mini Mental State Examination. A total of 43 patients completed the questionnaires after the treatment. The narrative interview analyses were performed based on 20 randomly selected patients after TAVI. Results: The mean level of general depression before TAVI was 4.19 ± 2.83, and after it was 3.12 ± 2.52 (p = 0.02), and the frequency decreased from 20% to 3%. An increase in the level of activity and number of interests and a decrease in life satisfaction were identified. The higher the general quality of life was, the lower the levels of depressiveness before and after TAVI were (r = 0.26 vs. r = 0.48; p < 0.05). Conclusions: Patients differed in their depressive symptoms, as well as their intensity and frequency, before and after TAVI. These results underscore the importance of screening for depression at baseline and reassessing changes in depressiveness during follow-up