Analiza wpływu wybranych czynników anestezjologicznych na stan neurobehawioralny noworodka

Introduction. An increasing percentage of children are born through C-sections. Both mother and child are exposed to potential obstetric, anesthesia and neonatal complications. Hypoxia associated with obstetric or anesthetic complications can lead to fetal hypoxia, and induce adaptation difficulties in the postpartum period or permanent developmental disorders. Knowledge of issues related to the perioperative care of the mother and child will minimize complications and provide high-quality care.Aim. The aim of the study was to analyze the impact of opioids in analgesia and hypotension during C-section on neonatal neurobehavioral state.Material and Methods. The study involved 102 mothers and their babies born by C-section. The study was approved by the Bioethics Committee of PUM. The inclusion criterion was the lack of systemic diseases in the mother and the gestational age over 36 weeks. All mothers were subarachnoidally anesthetized for the labor. Newborns after two days of life were assessed by NBAS (Neonatal Behavioral Assessment Scale).Results. Neonatal reflexes in the study group were normal. Newborns of mothers who were added fentanyl to anesthesia, did not differ in behavior from the others (p>0.05). After adding Morphini Sulfas 0.1% Spinal to anesthesia there were observed statistically significant differences in the behavior of newborns, compared to infants whose mothers did not receive it, in terms of sound stimulus habituation (p=0.04) in favor of those whose mothers received MF Spinal intrathecally. Children of mothers anaesthetized without the addition of MF Spinal presented higher self-calming abilities than the others (p=0.03). The ability of calming down differed infants of mothers whose blood pressure declined during anesthesia (p=0.04).Conclusions. Subarachnoid anesthesia with opioid supplementation for C-section as well as an anesthesia-related decrease in blood pressure slightly affected neurobehavioral state of infants born by C-section comparing to those whose mothers had not received opioids intraspinally and had not experienced a blood pressure decrease. (JNNN 2016;5(3):92–98)Wstęp. Drogą cięcia cesarskiego rodzi się coraz większy odsetek dzieci. Niezależnie od przyczyn, z jakich zostało wykonane, zarówno matka, jak i dziecko narażeni są na potencjalne powikłania położnicze, anestezjologiczne, neonatologiczne. Niedotlenienie związane z powikłaniami położniczymi, czy anestezjologicznymi może prowadzić do niedotlenienia dziecka płodowego, a tym samym wpłynąć na trudności adaptacyjne w okresie poporodowym czy trwałe zaburzenia rozwojowe. Znajomość zagadnień związanych z opieką okołooperacyjną nad matką i dzieckiem pozwoli na minimalizację powikłań i zapewnienie wysokiej jakości opieki.Cel. Celem badań była analiza wpływu podaży opioidów w analgezji oraz obniżenia ciśnienia tętniczego podczas cięcia cesarskiego na stan neurobehawioralny noworodka.Materiał i metody. Badaniem objęto 102 pary noworodków i ich matek, które urodziły przez cięcie cesarskie. Na badanie uzyskano zgodę Komisji Bioetycznej PUM. Kryterium włączenia stanowił brak chorób układowych u matek oraz wiek ciążowy powyżej 36 tygodnia ciąży. Wszystkie matki znieczulane były do porodu podpajęczynówkowo. Szczegóły dotyczące znieczulenia uzyskano z karty znieczulenia. Noworodki po ukończeniu 2 doby życia zostały ocenione skalą NBAS (Neonatal Behavioural Assessment Scale) zgodnie z zasadami przeprowadzenia badania.Wyniki. Odruchy noworodkowe w badanej grupie były prawidłowe. Stan neurobehawioralny w większości badanych pozycji nie wykazywał różnic między badanymi. Noworodki matek, którym do leków znieczulenia dodano Fentanyl, nie różniły się zachowaniem od pozostałych (p>0,05). Po dodaniu Morphini Sulfas 0,1% Spinal do znieczulenia przewodowego zaobserwowano istotne statystycznie różnice w zachowaniu noworodków w porównaniu do dzieci, których matki jej nie otrzymały w zakresie habituacji bodźca dźwiękowego (p=0,04) na korzyść tych, których matki otrzymały dokanałowo MF Spinal. Dzieci matek znieczulanych bez dodatku MF Spinal prezentowały samouspokajanie się na wyższym poziomie od pozostałych (p=0,03). Umiejętność uspokajania się różniła noworodki matek, u których obniżyło się ciśnienie tętnicze podczas znieczulenia (p=0,04).Wnioski. Opieka nad matką i dzieckiem powinna być zindywidualizowana w oparciu o potrzeby matki i dziecka wynikające z samopoczucia matki i stanu neurobehawioralnego dziecka. (PNN 2016;5(3):92–98

Exploring factors influencing depression among Polish nurses during the COVID-19 pandemic

ObjectivesThe COVID-19 pandemic has been recognized as an international public health emergency. The aim of our study was to identify contributors to nurses’ depression.MethodsThis survey-based study was conducted in the Pomeranian Medical University Hospital no. 1 in Szczecin and involved 207 nurses. The following standardized research instruments were applied: the World Assumptions Scale, the Athens Insomnia Scale, the Impact of Event Scale - Revised, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder, the Perceived Stress Scale, and a questionnaire of our own authorship.ResultsThe study showed that 72.95% of the subjects experienced severe stress, and 40.58% suffered from insomnia. In addition, 65.7% of the respondents had anxiety symptoms of varying degrees of severity, and 62.8% had depressive symptoms of mild to severe severity. The mean score on the IES-R scale, reflecting a psychological impact of the COVID-19 pandemic, was 34.25. The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. Anxiety levels and insomnia significantly affect the prevalence of depression among nurses.ConclusionThe COVID-19 pandemic has been recognized as an international public health emergency. The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. It is important to conduct further research after the COVID-19 pandemic has ended

Personality traits and risk of eating disorders among Polish women: the moderating role of self-esteem

ObjectivesPersonality traits should be taken into account when diagnosing individuals with disordered eating behaviors in the hope of better understanding their etiology and symptom progression and when planning treatment. The objective of this study was to attempt to determine the moderating role of self-esteem in the relationships between personality traits included in the Big Five model among Polish women and estimated risk of eating disorders.MethodsThe study was conducted among 556 Polish women from Zachodniopomorskie Voivodeship. The average age of the women under study was 34 years. A diagnostic survey was used as the research method, and the empirical data were collected using the following research tools: The NEO Five-Factor Inventory (NEO-FFI), Rosenberg Self-Esteem Scale (SES), ORTO – 15 Questionnaire, The Three-Factor Eating Questionnaire (TFEQ-13), and the authors’ original questionnaire. A multivariate linear regression analysis was conducted to examine the influence of selected independent variables. The assumptions for the linear regression model were satisfied, as indicated by the Ramsey Regression Equation Specification Error Test, White’s test, and the Jarque-Bera test.ResultsOnly the personality trait of neuroticism exhibits a statistically significant effect on the “Cognitive Restraint of Eating,” “Uncontrolled Eating,” and “Emotional Eating” scores (p < 0.001). The moderation effect was demonstrated between self-esteem and the personality trait of conscientiousness on the “Cognitive Restraint of Eating” scale score. There is a moderation effect between self-esteem and the personality trait of extraversion on the “Uncontrolled Eating” subscale score. There is a moderation effect between self-esteem and the personality trait of conscientiousness on the “Uncontrolled Eating” scale score.ConclusionSelf-esteem was not a predictor of the occurrence of risk of eating disorders while playing a moderating role in the relationship between certain personality traits and estimated risk of eating disorders. A higher level of neuroticism was identified as an important predictor of higher results for orthorexia, Cognitive Restraint of Eating, Uncontrolled Eating, and Emotional Eating. It was also demonstrated that the orthorexia risk index decreased with increased extraversion and openness to experience. The results of this study suggest that eating behaviors and psychological factors should be included in psychological interventions in the treatment of eating disorders. The clinical goal can be considered to be an improvement in non-normative eating behaviors, such as a reduction in overeating episodes or eating less frequently in the absence of a hunger feeling. In order to assist these individuals in their attempts to achieve healthy behaviors, variables related to mental functioning can be then identified as important goals to support individuals in their efforts to change health behaviors by achieving better mental well-being

Stężenie cynku w surowicy krwi kobiet w wieku postmenopauzalnym

Introduction: Demographic facts and forecasts about lengthening life expectancy motivate to systematize the knowledge of health problems experienced by women at the age of 50 and older. It refers to the whole health policy including health economics. Longer female life spans cause that an increasing number of women suffer from health problems associated with the perimenopausal period, and become health care recipients. Also a shift of retirement age is the reason to take interdisciplinary actions for women’s health and quality of life. This study describes a decline in the levels of many bioelements in hair, urine and blood serum, which progresses with age. It not only correlates with a decrease in the synthesis and secretion of estrogen, but also environmental pollution, unhealthy lifestyle and the use of substances. Aim of the study: The aim of this study was to determine the correlation between serum zinc levels in postmenopausal women and such variables as the use of substances (cigarettes, alcohol) and menopausal hormone therapy (MHT). Material and method: The study was conducted among 152 healthy women being 1-16 years after menopause. The women were divided into study group (MHT users) and control group (MHT non-users). A sub-division criterionwas the use of substances (cigarettes, alcohol). Serum zinc levels were determined in all women. Results: The use of substances significantly contributed to the lowering of serum zinc levels in postmenopausal women. MHT users had statistically higher average zinc levels in blood serum, which referred both to smokers and consumers of alcohol and those who did not use these substances. Conclusions: 1. The use of substances (cigarettes, alcohol) contributes to the lowering of zinc levels in blood serum. 2. MHT positively affects serum zinc levels in postmenopausal women regardless of whether they use substances (cigarettes, alcohol) or not.Wstęp: Fakty i prognozy demograficzne dotyczące stałego trendu wydłużania się średniej długości życia, stają się pilnym postulatem do opracowywania oraz usystematyzowania problemów zdrowotnych kobiet w wieku 50+. Dotyczy to całokształtu polityki zdrowotnej, także w aspekcie ekonomiki zdrowia. Wydłużanie czasu życia kobiet sprawia, że coraz liczniejsza ich populacja doświadcza problemów zdrowotnych związanych ze zjawiskami okresu około-menopauzalnego, co odzwierciedla się dynamiką wzrostu korzystania z opieki zdrowotnej. Opisywane przez Autorów procesy obniżania się stężenia wielu biopierwiastków we włosach, moczu i w surowicy krwi postępują wraz z wiekiem. Zmiany te korelują nie tylko z obniżeniem syntezy i sekrecji estrogenu, ale także zatruciem środowiska oraz niewłaściwym stylem życia, w którym pierwszoplanowym problemem jest rozpowszechnienie stosowania używek. Cel pracy: Określenie zależności pomiędzy stosowaniem używek (papierosy, alkohol) a stężeniem cynku w surowicy krwi u kobiet po menopauzie, oraz wpływu menopauzalnej terapii hormonalnej (MTH) na to stężenie. Materiał i metoda: Badanie przeprowadzone zostało wśród 152 zdrowych kobiet w wieku od 1 roku do 16 lat po menopauzie. Badane podzielono w zależności od tego czy paliły papierosy lub/i spożywały alkohol. U wszystkich oznaczono stężenie cynku w surowicy krwi. Kryterium podziału stanowiło także stosowanie, bądź nie MTH. Wyniki: Stosowanie używek wpływało istotnie na obniżenie stężenia cynku w surowicy krwi kobiet po menopauzie. Kobiety stosujące MTH miały statystycznie wyższe średnie stężenie cynku w surowicy krwi, zarówno te, które paliły papierosy i piły alkohol jak i te, które nie stosowały tych używek. Wnioski: 1. Intensyfikacja edukacji zdrowotnej, mającej na celu zaniechanie stosowania używek może wpłynąć korzystnie na stężenie cynku w surowicy krwi kobiet w wieku postmenopauzalnym, co za tym idzie poprawę ich stanu zdrowia. 2. Upowszechnienie stosowania MHT wpływać może korzystnie na stężenie cynku w surowicy krwi u kobiet po menopauzie zarówno u kobiet stosujących jak i nie stosujących używki (papierosy, alkohol)

Analysis of Sociodemographic, Psychological, and Genetic Factors Contributing to Depressive symptoms in Pre-, Peri- and Postmenopausal Women

Depressive symptoms that are faced by women in the pre-, peri-, and postmenopausal periods are determined by a wide array of sociodemographic, psychological, and biological variables. The aim of our study was to identify factors that contribute to depressive problems at this stage of life. The study included 815 healthy Polish women aged 45–60 years. The survey part was conducted using the Beck Depression Inventory (BDI), the State–Trait Anxiety Inventory (STAI), the Neuroticism–Extroversion–Openness Five Factor Inventory (NEO-FFI), and a self-developed questionnaire. Genetic analysis was also performed. Depressive symptoms were observed in 25.5% of participants. 70% of the women were postmenopausal. No statistically significant differences in the severity of depressive symptoms were demonstrated with regard to genetic variables (p > 0.05). Reproductive capacity (p < 0.001), employment (p < 0.001), and being married (p < 0.018) were found to reduce the incidence of depressive symptoms. The contribution of personality and anxiety as a trait to depressive symptoms varied. Conclusions: The factors predisposing pre-, peri-, and postmenopausal women to depressive symptoms include lower education, lack of a life partner, unemployment, high anxiety, and neurotic personality. No evidence was found for the contribution of genetic factors to depressive symptoms in the examined women

Analiza porównawcza zastosowania ampułkostrzykawki i sprzętu tradycyjnego w aspekcie czynności pielęgniarskich

One of therapeutic nursing activities is administering drugs through various routes, including injections. A properly performed injectionrequires adherence to rules, the knowledge of procedures, as well as the choice and use of suitable equipment. A pre-filled syringe isa modern tool for drug administration. This is a combination of a syringe and an ampoule filled with a drug, thanks to which a medicine canbe given immediately, and without the necessity of using the drug preparation procedure by health care workers.The use of pre-filled syringes is advantageous both to patients, medical staff, and medical centres. Since the time of drug preparationprocedure is shortened, the stress experienced by patients is lower. What is more, the use of pre-filled syringes saves plenty of time, and issafer both for patients and health workers, especially if predefined needles and automatic needle guard (ANG) are applied (fewer manualadjustments — a lower risk of infection). Also the possibility that a patient will be administered improper dose of a medicine as a result of itsloss during the preparation is eliminated. The exposure to risks and complications, which may occur while preparing medicines, is reduced,so patients do not have to pay additional financial and health costs. Moreover, the employment of pre-filled syringes is more economic andenvironmentally friendly due to the fact that significantly less municipal and medical waste is produced during giving injections.Nursing Topics 2013; 21 (1): 98–107Jednym z elementów działalności terapeutycznej pielęgniarki jest podawanie leków różnymi drogami, między innymi drogą wstrzyknięć.Prawidłowo wykonana iniekcja wymaga przestrzegania zasad, znajomości procedur, a także wyboru i zastosowania odpowiedniego sprzętu.Nowoczesny rodzaj sprzętu mający zastosowanie do podawania leków to ampułkostrzykawki. Jest to połączenie ampułki z lekiemi strzykawki, dzięki któremu możliwe jest natychmiastowe podanie leku bez konieczności zastosowania procedury przygotowywania lekuprzez pracownika ochrony zdrowia.Wśród zalet zastosowania ampułkostrzykawek należy wziąć pod uwagę zalety dla pacjenta, personelu, placówki ochrony zdrowia.Lek znajdujący się w ampułkostrzykawce nie wymaga specjalnego przygotowania przez personel, a procedura przygotowywania wstrzyknięciajest skrócona, pacjent w związku z tym nie jest narażony na dodatkowy stres, poprzez zmniejszenie narażenia na niebezpieczeństwoi powikłania mogące wystąpić w trakcie przygotowywania leku, pacjent nie ponosi dodatkowych kosztów finansowych i zdrowotnych, a takżesą niwelowane efekty niepożądane wynikające z nieprzestrzegania zasad przez personel. Zastosowanie ampułkostrzykawki to bezpieczeństwodla pacjenta i personelu, zwłaszcza przy zastosowaniu igły predefiniowanej i systemu ANG, to ogromna oszczędność czasu dla personelu(mniejsza liczba manipulacji — mniejsze narażenie na zainfekowanie), a także mniejsze narażenie pacjenta na otrzymanie nieprawidłowejdawki leku w wyniku jego utraty w czasie przygotowywania. Zastosowanie ampułkostrzykawki daje również oszczędności ekologiczno-ekonomiczne,ponieważ wytwarza się o wiele mniej odpadów komunalnych i medycznych w trakcie przygotowywania wstrzyknięcia.Problemy Pielęgniarstwa 2013; 21 (1): 98–10

The influence of the levels of personality traits on the quality of life of late reproductive age women

Background . The topic that is increasingly discussed is the contribution of personality traits to many aspects of life, including maintenance and restoration of health. Since health status is an essential element of quality of life, the latter may be significantly influenced by personality. Objectives . The aim of this study was to determine how personality traits influence the quality of life of late reproductive age women. Material and methods . The study included 345 late reproductive age healthy women selected according to a standardized classification STRA W. They were women at the age of 42.3 ± 4.5 years from the West Pomeranian Voivodship. Personality traits were measured using Costa and McCrae’s NEO–Five Factor Inventory adapted into Polish by Zawadzki, Strelau, Szczepaniak and Śliwińska. Quality of life was assessed by the 36–Item Short Form Health Survey (SF-36). Results . Personality traits which had the highest levels were openness to experience and agreeableness. Bodily fitness as well as physical and emotional functioning were assessed highest by the study participants. In the study group, neuroticism, extroversion, conscientiousness, agreeableness and openness to experience correlated with the majority of quality of life variables. Conclusions . 1. Health-related quality of life is shaped by personality factors, which are relatively stable throughout life. 2. High neuroticism considerably contributes to health-related quality of life. 3. The awareness of the fact that personality traits influence the quality of women’s lives will enable a family doctor to optimize diagnostic and therapeutic interventions