Środki przymusu bezpośredniego w perspektywie pacjentów i personelu medycznego. Perspektywa w kontekście wielokulturowości

The psychiatric hospital is a distinct cultural circle, governed by its own rules and regulations. This means interfering with the patient’s privacy and the violation of his bodily integrity. The characteristic fea- ture of the psychiatric ward is the so-called. “paternalism” manifested by legitimate interference in the patient’s personal space, for his good. In health care, the notion of “coercion measures” is most often associ- ated with a psychiatric patient, in which case direct coercive measures are required.The aim of the study was to analyse the perception of coercive measures by two groups of patients and the medical staff. The study involved 307 persons, 136 staff members and 171 patients who com- pleted the MAVAS questionnaire, to assess attitudes towards aggres- sion and coercive measures at the ward.Research shows that the differences exist in the perception of ag- gression and legitimacy of coercion between patients and medical staff. Patients emphasize that their aggression in the ward is closely related to the conditions in the hospital, perceived by them as difficult, while the team members highlight that the assault is highly related to pa- tients sickness. Systemic changes are necessary to address divergent di- vergences that have a significant impact on the quality of healthcare.Szpital psychiatryczny, stanowi swego rodzaju odrębny krąg kulturo- wy, rządzący się swoimi zasadami i przepisami. Oznacza to między innymi ingerowanie w prywatność chorego, a także, co szczególnie problematyczne, naruszanie jego nietykalności cielesnej. Charaktery- styczną cechą oddziału psychiatrycznego jest tzw. „paternalizm” prze- jawiający się uprawnionym ingerowaniem w przestrzeń osobistą pa- cjenta, z uwagi na jego dobro. W opiece zdrowotnej pojęcie „przymus” kojarzy się najczęściej z pacjentem psychiatrycznym, u którego w określonych sytuacjach, konieczne jest zastosowanie środków przy- musu bezpośredniego.Celem badania była analiza sposobów postrzegania środków przy- musu przez dwie grupy – chorych oraz personel medyczny. W bada- niu wzięło udział 307 osób, 136 członków personelu oraz 171 pacjen- tów, którzy wypełniły kwestionariusz MAVAS, służący ocenie postaw wobec agresji i środków przymusu na oddziale.Z badań wynika, że pomiędzy pacjentami i personelem medycz- nym występują duże rozbieżności w zakresie spostrzegania agresji i zasadności stosowania środków przymusu bezpośredniego. Pacjen- ci podkreślają, że ich agresja na oddziale ściśle wiąże się z warunkami w szpitalu, postrzeganymi przez nich jako trudne, podczas gdy perso- nel uwydatnia chorobowe przyczyny agresji pacjentów. Wskazane są zmiany systemowe, minimalizujące istniejące na oddziałach rozbież- ności, które mają znaczny wpływ na jakość opieki zdrowotnej

Nurses experiencing aggression at workplace

Zawód pielęgniarki obciążony jest ryzykiem doznawania agresji ze strony pacjentów i ich rodzin. Dane Amerykańskiego Związku Pielęgniarek pokazują, że 57% pielęgniarek doświadczyło agresji słownej i gróźb, natomiast z badań polskich wynika, że zagrożenie bezpieczeństwa osobistego stanowi dla ponad 70% pielęgniarek najbardziej obciążający czynnik. Dla analizy częstotliwości zachowań agresywnych doświadczanych w pracy przeprowadzono badania 208 pielęgniarek i pielęgniarzy z wykorzystaniem autorskiej ankiety. Okazało się, że 70% badanych skonfrontowało się z jakąś formą agresji w pracy ze strony przede wszystkim pacjentów, ich rodzin, a nawet członków personelu (15%). W tej grupie aż 36% doznało agresji fizycznej, z czego 18% w ciągu ostatniego roku. Przeważająca większość respondentów po agresywnym incydencie nie szukała pomocy, mimo że aż 20% z nich zauważyła negatywny wpływ tego zdarzenia na swoją pracę. W podsumowaniu zawarto konkluzje dotyczące możliwości wsparcia pielęgniarek w ich radzeniu sobie z agresją w pracyFunctioning as a professional nurse bears the risk of experiencing aggression from patients and their families. According to the data of American Nurses’ Association, 57% of nurses have been subjected to verbal aggression and/or threats at workplace. Similar research conducted in Poland, showed that for over 70% of nurses personal safety at work was the most important concern. In order to assess the frequency of aggressive behavior at work, 208 male and female nurses were asked to participate in the study by filling in a questionnaire prepared by the researchers. It turned out that 70% of participants, throughout their professional career, were at some point confronted with some forms of aggression mainly either from patients and/or their families, or from other medical personnel (15%). In the research group of interest, 36% of participants experienced physical aggression, with 18% of them being victimized over the period of last year. Moreover, great majority of victims, directly after the incident, did not seek any professional help, despite the fact that 20% noticed the negative influence of the episode on their work effectiveness and/or quality. In the Summary and Conclusions it has been stated that some aggression management and support services should be made available for nurses to help them deal with workplace aggression

The use of board games in healthcare teaching

Modern healthcare education has occurred in an era of great challenges, but also of great opportunities. Learners have become accustomed to being bombarded by multiple stimuli to the point where traditional education often seems boring and monotonous. For this reason, modern teaching methods based on information technology are increasingly being used. Gamification, the use of game elements in a non-entertainment context, is becoming increasingly popular in education. These include board games. The literature on board games highlights many areas in which board games can be effective within healthcare settings. Board games differ from electronic ones primarily because of the element of social interaction, although some electronic games exist in the form of puzzles or competition with the game mechanism itself. The biggest advantages of board games include improving communication and active learning based on interaction with other players. Board games cannot substitute traditional teaching, but they can help students to master particularly difficult concepts. Games help to organise knowledge, engage and motivate students to learn difficult material, but also encourage students to take responsibility for their learning. Games in medical education, when properly used, can be valuable tools for an instructor. They create a non-threatening environment that supports mutual learning. A properly prepared game, tailored to the subject, allows mastery of the material in less time than in a traditional lecture

Gry poważne i gry planszowe a przemiany kulturowe

The impact of computer games on human functioning has become the sub­ject of many studies and scientific reports. With the development of technol­ogy, games have transcended boards and become part of the video entertain­ment industry. However, technology did not end traditional games. It was only a matter of time before games were extended to other areas of life. Because games were so popular, educators found that students engage quickly with educational games. The article explains the aspects of serious games (SG), which are defined as digital games used for purposes other than entertain­ment. It describes the areas in which games can be used in the educational process, their effectiveness, and controversies regarding their use.Wpływ gier komputerowych na funkcjonowanie człowieka jest przedmiotem wielu badań i doniesień naukowych. Wraz z rozwojem technologii gry wykro­czyły poza ramy konwencji planszowych i stały się częścią przemysłu medial­nego i rozrywkowego. Postęp technologiczny nie oznacza jednak końca trady­cyjnych gier. Jest tylko kwestią czasu, zanim strategie i zachowania typowe dla gier komputerowych rozprzestrzenią się na inne dziedziny życia społecznego. Ponieważ gry cieszą się tak dużą popularnością, współcześni pedagogowie odkrywają, że uczniowie łatwo angażują się w gry edukacyjne. Artykuł objaś­nia aspekty gier poważnych (SG), które definiuje się jako gry cyfrowe wyko­rzystywane do celów innych niż rozrywka. Niniejszy tekst zakreśla obszary, w których gry mogą być wykorzystywane w procesie edukacyjnym, ich sku­teczność oraz kontrowersje związane z ich wykorzystaniem

The gender-related impact of a violence management training program on medical school students : preliminary results

Phenomenon: Patient aggression directed toward medical personnel, including medical school students during their internships, is an increasingly important issue. To minimize this phenomenon, violence management training programs were carried out. Approach: To assess the efficacy of a violence management training program among medical school students and evaluate changes in the perception of aggressive behavior in relation to the participants’ sense of self-efficacy and self-confidence by sex. A quasi-experimental examination of medical school students was performed before and after completion of a training program. Two hundred seventy-six students, including students of medicine, nursing, emergency medical services, and physiotherapy, participated in the study. Three standardized questionnaires were used: The Perception of Aggression Scale (POAS), the Hope for Success Questionnaire (HSQ), and the General Self -Efficacy Scale (GSES). Findings: The training program had a positive impact on the sense of self-efficacy in both men and women. However, the perception of aggressive behavior changed only in women and the impact of such intervention was higher for women. Further studies should look at the long-term outcomes

Weather and aggressive behavior among patients in psychiatric hospitals : an exploratory study

Background: The number of meteoropaths, or people negatively affected by weather conditions, is rising dramatically. Meteoropathy is developing rapidly due to ever poorer adaptations of people to changes in weather conditions. Strong weather stimuli may not only exacerbate symptoms in people with diseases of the cardiovascular and respiratory systems but may also induce aggressive behavior. Researchers have shown that patients suffering from mental illnesses are most vulnerable to changes in the weather and postulate a connection between the seasons and aggressive behavior. Methods: The goal of the study was to analyze the relationship between coercive measures and weather factors. The researchers identified what meteorological conditions prevailed on days with an increased number of incidents of aggressive behavior leading to the use of physical coercion towards patients in a psychiatric hospital in Poland. In order to determine the impact of weather conditions on the frequency at which physical coercion measures were used, the hospital’s "coercion sheets" from 1 January 2015 to 31 March 2017 were analyzed. The data were correlated with meteorological data. In order to determine the relationship between the occurrence of specific weather conditions and the number of coercive interventions (N), researchers utilized Spearman’s rank correlation analysis together with two-dimensional scatter diagrams (dependency models), multiple regression, stepwise regression, frequencies, and conditional probability (%). Results: Lower barometric pressure and foehn wind increased aggressive behavior in patients that led to coercive measures. For temperature (positive correlation) and humidity (negative correlation), there was a poor but statistically significant correlation. Conclusions: Monitoring weather conditions might be useful in predicting and preventing aggression by patients who are susceptible to weather changes

Factor structure and psychometric properties of Polish version of Parental Bonding Instrument (PBI) among adults and adolescents

Parental Bonding Instrument (PBI) by Parker et al., is a widely known and used tool in studies on the assessment of parenting behavior in adult, adolescent and child populations. This tool has had many translations and adaptations globally. In Poland, the factor structure and psychometric properties of PBI have not been studied so far. The aim of the presented research was to perform such an analysis both in the group of adults and adolescents. The data from four research projects, in which the 25-item version of the PBI translated into Polish was used, were analyzed. Data from 698 participants in total, including 473 adults and 225 adolescents were collected. Exploratory factor analyzes was performed for both mother and father version. A study of the reliability of individual factors, stability over time (test-retest) and an analysis of criterion validity were carried out. Both in the group of adults and adolescents, obtained a three-factor structure, acceptable reliability and stability over time. Moreover PBI correlated with another Polish tool in line with the adopted hypotheses, showing satisfactory criteria validity

Trening empatii jako metoda zapobiegania zachowaniom agresywnym w grupie dzieci w młodszym wieku szkolnym – Doniesienia wstępne

Praca dotyczy problemu wpływu treningu empatii na poziom agresji u dzieci w wieku 6–9 lat. Przedmiotem badań jest określenie poziomu agresji u tychże, przeprowadzenie treningu empatii, a następnie ponowne zbadanie poziomu agresji. Agresję badano zmodyfikowaną wersją kwestionariusza „Moje życie w szkole”, opracowanego przez Tiny Arora i zaadoptowanego w wersji polskiej przez Tomasza Kołodziejczyka. Trening obejmował osiem ćwiczeń, których celem było rozwinięcie umiejętności związanych z empatią. Badania empiryczne zrealizowano wśród dzieci w wieku 6–9 lat, czyli uczniów klas 1–3 szkoły podstawowej. W grupie badanej znalazło się sto dzieci: 52 dziewczynki, 48 chłopców. Przeprowadzona analiza statystyczna potwierdziła związek pomiędzy treningiem empatii a poziomem agresji w badanej grupie. Nie potwierdzono natomiast hipotezy o związku płci i skuteczności treningu. Zarówno u chłopców, jak i u dziewczynek trening empatii przyniósł rezultaty, chociaż w grupie chłopców były one lepsze. Trening empatii okazał się skuteczny. Zmniejszył poziom agresji w badanej grupie stu dzieci w wieku 6–9 lat w ciągu jednego tygodnia. Badanie nasunęło szereg wątpliwości i przemyśleń dotyczących jego wykonania i skłoniło do refleksji nad udoskonaleniem przyszłych prób badawczych. Pewne jest jednak, że trening empatii obniża poziom agresji i może stanowić skuteczne narzędzie w radzeniu sobie z agresją w szkole.The work concerns the issue of the infl uence of the training on the empathy and the aggression in group of children 6–9 years old. The subject of the research was to determine the level of aggression in group of children 6–9 years old, conducting training of empathy, and re-examination of the level of aggression. Aggression was examinated by modifi ed version of questionnare ‟My life in school” created by Tiny Arora, with polish adaptation by Tomasz Kołodziejczyk. The empathy training included eight exercises, the aim of which was to develop skills related with empathy. There was 100 students of elementary school in the study group, 52 girls and 48 boys. A conducted statical analysis confirmed the correlation between the empathy training and the level of aggression in whole study group. However, a hypothesis about relationship between sex and effectiveness of training weren’t confi rmed. Both boys and girls empathy training brought results, although it was more effective in first group. The empathy training was proven to be effective. It reduced the level of aggression in the study group of 100 children 6–9 years old. These findings prompted to number of doubts and thoughts about its implementation and encouraged to reflect on the improvement of future research trials. It is certain, however, that empathy training reduces aggression and can be an effective tool in dealing with aggression at school

The Perception of aggression towards the medical personnel of psychiatric wards in Poland and in Norway : a comparative analysis

Background and objectives: Psychiatric hospitals are unique in character. In their work the personnel frequently encounter aggression on the part of patients and their families. A difficulty in describing the impact of aggression on the quality of care lies in the fact that countries differ in terms of their approach to treatment, education systems, as well as the standards and algorithms of dealing with aggression that occur within a health care facility. The objective of the present study was to find out whether there are any differences in the attitudes and perception of patients’ aggression prevalent amongst groups of personnel from Poland and Norway. This issue has yet to be discussed in the subject literature; however, it should be assumed that such differences exist, so the question pertains to their direction and intensity. Methods: Two tools were used to identify the attitudes of the medical personnel towards aggression: POAS (Perception of Aggression Scale) and ATAS (Attitudes Towards Aggression Scale). The research comprised 280 people – the personnel of psychiatric wards from the psychiatric hospital in Bergen, Norway (n= 140 ) and from the psychiatric hospitals in Żurawica and Jarosław in Poland (n= 140 ). Results: Statistically significant differences were demonstrated between the attitudes and perception of aggression by the medical personnel in Poland and in Norway (p> 0.001). The Norwegian personnel more frequently perceive aggression as positive behaviour, associated with the protection of one’s own territory. On the other hand, the Polish staff more often regard aggression as negative, offensive and intrusive behaviour. Conclusions: The perception of aggression towards the medical staff of psychiatric wards in Poland and Norway differs

Czy ozdrowieńcy COVID-19 to przyszli pacjenci psychiatrów i psychologów? Szybki przegląd literatury naukowej

Studies of patients treated for viral respiratory diseases have shown a higher level of PTSD, psychological stress,obsessive-compulsive disorders, insomnia, suicidal thoughts, psychoactive substance abuse and social anxietythan in the general population. Probably COVID-19 would cause similar, long-term health consequences in thegroup of survivors.The research aims to evaluate the mental health problems of COVID-19 survivors. The databases MEDLINE (byPubMed), EMBASE and SCOPUS were searched. The articles published between 1st of January and 30 of December2020 were analysed.Out of 142 articles, 40 papers were analyzed, fifteen of them were research articles, four a systematic review,and 21 were a literature review. The analysis confirmed the occurrence of mood disorder, PTSD, a decrease ofcognitive functions, quality of life and life independence in the group of COVID-19 survivors. The results areconfirmed both in comparative and cohort studies. Age, psychiatric treatment history, life independence andtreatment in the ICU should be perceived as risk factors of worsening mental disorders, deterioration of cognitivefunctions and loss of life independence because of COVID-19. Those consequences are based on physiological,psychological and social pathomechanisms.Physical and mental problems should be expected in a group of COVID-19 survivors. It requires taking preventiveactions during the patient’s stay in an infectious disease hospital and creating multi-specialist therapeuticprograms. There is a need for future randomized screening and comparison studies in this issue.Badania pacjentów leczonych z powodu wirusowych chorób oddechowych pokazały wyższe niż w populacji ogólnej rozpowszechnienie objawów stresu potraumatycznego i psychologicznego, zaburzeń obsesyjno-kompulsywnych, snu, myśli samobójczych, nadużywania substancji psychoaktywnych oraz lęku społecznego. COVID-19 prawdopodobnie będzie powodował u osób wyleczonych podobne, długotrwałe konsekwencje zdrowotne. Celem badań była ocena rozpowszechnienia problemów z zakresu zdrowia psychicznego osób ocalałych z pandemii COVID-19. Przeszukano bazy danych: MEDLINE za pomocą wyszukiwarki PubMed, EMBASE oraz SCOPUS. Wyszukiwaniem objęto artykuły opublikowane w roku 2020 od 1 stycznia do 30 grudnia. Spośród 142 artykułów przeanalizowano 40 prac, z których 15 stanowiły doniesienia z badań, 4 miało charakter przeglądu literatury, natomiast 21 pracy poglądowej. Analiza potwierdziła przypuszczenia na temat rozpowszechnienia objawów zaburzeń nastroju, stresu potraumatycznego, spadku sprawności funkcji poznawczych oraz obniżenia jakości życia i samodzielności życiowej w grupach ocalonych z COVID-19. Wskazują na to zarówno dane z badań porównawczych, jak i kohortowych. Wiek życia, wcześniejsze leczenia psychiatryczne oraz samodzielność życiowa, leczenie odbywające się na oddziale intensywnej terapii traktuje się jako czynniki ryzyka utrwalania zaburzeń psychicznych, deterioracji funkcji poznawczych oraz utraty samodzielności życiowej. U podstaw zaburzeń leżą zarówno patomechanizmy fizjologiczne, jak i psychologiczne i społeczne. Należy spodziewać się występowania objawów zaburzeń fizycznych i psychicznych u osób, których leczenie COVID-19 zostało zakończone. Fakt ten wymaga działań prewencyjnych już podczas pobytu pacjenta w szpitalu zakaźnym oraz tworzenia wielospecjalistycznych programów terapeutycznych. Konieczne jest kontynuowanie badań z randomizacją przesiewowych i porównawczych