Strategie radzenia sobie ze stresem wśród personelu medycznego na sali operacyjnej

Introduction. Stress is a constant presence in the work of health care professionals who come into contact with sick and suffering people every day. Medical personnel must possess both professional knowledge, skills, and social competence to best help patients. Coping strategies for stress among medical professionals can vary. One factor that may influence the strategies chosen is personality. Type D personality combines traits of negative emotionality and social inhibition. This personality type predisposes to experiencing increased levels of stress. Aim. The purpose of this study was to determine the level of stress and coping strategies among operating theatre staff. Material and Methods. 100 operating theater employees were surveyed. The study group consisted of nurses/nurses, paramedics, doctors. Questionnaires were used in the study: Perceived Stress Scale (PSS-10), Inventory for the Measurement of Coping with Stress (Mini-COPE), Type D Scale (DS-14) and self-administered questionnaire. Results. Almost half of the subjects (47%) reported high levels of stress and 35 subjects (35%) reported medium levels of stress. The most common coping strategies used to manage stress were active coping, planning, positive reevaluation, acceptance and seeking emotional support. 41% of the respondents demonstrated a Type D personality. Negative emotionality was more strongly indicated than social inhibition. Conclusions. The highest levels of stress are mainly experienced by young women, not in a relationship, with short work experience. Systemic psychological support should be introduced, especially targeted at this group. Due to the shortage of medical staff, measures to prevent professional burnout should also be implemented. A possible solution could be classes or trainings before starting work. Their aim would be to prepare for stressful moments in future work and to teach the most effective ways of coping with stress. (JNNN 2022;11(2):59–64).Wstęp. Stres jest nieustanie obecny w pracy pracowników ochrony zdrowia, którzy każdego dnia mają kontakt z ludźmi chorymi i cierpiącymi. Personel medyczny musi posiadać zarówno fachową wiedzę, umiejętności jak i kompetencje społeczne, aby jak najlepiej pomagać pacjentom. Różne mogą być strategie radzenia sobie ze stresem wśród pracowników medycznych. Jednym z czynników, który może mieć wpływ na wybierane strategie jest osobowość. Osobowość typu D łączy cechy negatywnej emocjonalności i hamowania społecznego. Ten typ osobowości predysponuje do odczuwania zwiększonego nasilenia stresu. Cel. Celem pracy było określenie poziomu stresu oraz strategii radzenia sobie ze stresem wśród pracowników bloku operacyjnego. Materiał i metody. Przebadano 100 pracowników bloku operacyjnego. Badaną grupą stanowili pielęgniarki/pielęgniarze, ratownicy medyczni, lekarze. W badaniach wykorzystano kwestionariusze: Skalę Odczuwanego Stresu (PSS-10), Inwentarz do Pomiaru Radzenia Sobie ze Stresem (Mini-COPE), Skalę do pomiaru typu D (DS-14) oraz ankietę własną. Wyniki. Niemal połowa badanych (47%) wykazuje wysoki poziom stresu a u 35 badanych (35%) stwierdzono średni poziom stresu. Najczęściej stosowanymi strategiami radzenia sobie ze stresem były: aktywne radzenie sobie, planowanie, pozytywne przewartościowanie, akceptacja i poszukiwanie wsparcia emocjonalnego. 41% respondentów wykazało osobowość typu D. Negatywna emocjonalność była mocniej zaznaczona niż hamowanie społeczne. Wnioski. Najwyższy poziom stresu odczuwają głównie młode kobiety, nie będące w związku, o krótkim stażu pracy. Należałoby wprowadzić systemowe wsparcie psychologiczne szczególnie ukierunkowane na tę grupę. Z uwagi na niedobory kadrowe pracowników medycznych należy również wdrożyć działania zapobiegające wypaleniu zawodowemu. Możliwym rozwiązaniem mogłyby być zajęcia czy szkolenia jeszcze przed podjęciem pracy. Ich celem byłoby przygotowanie do stresujących momentów w przyszłej pracy i nauczenie najefektywniejszych sposobów radzenia sobie ze stresem. (PNN 2022;11(2):59–64)

Poziom wypalenia zawodowego a poczucie koherencji wśród pielęgniarek pracujących na Oddziale Anestezjologii i Intensywnej Terapii

Introduction. Burnout syndrome, associated with loss of energy and enthusiasm, is an extremely important issue, especially for nurses working in the Department of Anesthesiology and Intensive Care, who constantly observe human suffering and high patient mortality in their work.Aim. The main aim of this study was to evaluate the influence of a sense of coherence on the level of professional burnout of nurses working in the department of anesthesiology and intensive care.Material and Methods. The study involved 89 subjects (71 women and 18 men) working in the Department of Anesthesiology and Intensive Care at the University Clinical Hospital in Wrocław. Questionnaires were used: The Sense of Coherence Questionnaire: SOC — 29, Maslach Burnout Inventory MBI, Job Satisfaction Scale SSP, Perceived Stress Scale PSS — 10 and a questionnaire of own authorship.Results. The mean score on the sense of coherence scale was 120.64, so the respondents presented an average level of sense of coherence. 43.82% of the respondents had a high level of emotional exhaustion. 48.31% had high levels of depersonalization. 69.66% of respondents showed low level of job satisfaction and 58.43% presented high levels of stress. The average level of job satisfaction was indicated by the mean score obtained by the respondents in SSP scale (19.6 points). Sense of coherence correlates positively (r > 0) with job satisfaction and negatively (r < 0) with emotional exhaustion and depersonalization. Relationship analysis revealed correlations between: gender, marital status and job burnout, marital status and perceived stress, job tenure and job satisfaction, and perceived stress and job satisfaction.Conclusions. A correlation was observed between a sense of coherence and occupational burnout and stress level and job satisfaction. The probability of professional burnout is higher in men and those who are not in a relationship. The results indicate that people who are in a relationship were found to cope better with stress. Job satisfaction is lowest in employees with job tenure, ranging from 6 to 10 years. (JNNN 2022;11(1):8–13)Wstęp. Zespół wypalenia zawodowego, który wiąże się z utratą energii i entuzjazmu, jest niezwykle ważnym zagadnieniem, szczególnie w odniesieniu do pielęgniarek/pielęgniarzy pracujących na Oddziale Anestezjologii i Intensywnej Terapii, którzy w swojej pracy nieustannie obserwują ludzkie cierpienie i wysoką śmiertelność pacjentów.Cel. Głównym celem pracy była ocena wpływu poczucia koherencji na stopień wypalenia zawodowego pielęgniarek/pielęgniarzy pracujących na oddziale anestezjologii i intensywnej terapii.Materiał i metody. W badaniu wzięło udział 89 osób (71 kobiet i 18 mężczyzn) pracujących w Klinice Anestezjologii i Intensywnej Terapii Uniwersyteckiego Szpitala Klinicznego we Wrocławiu. Zastosowano kwestionariusze: Orientacji Życiowej SOC — 29, Wypalenia Zawodowego MBI, Skalę Satysfakcji z Pracy SSP, Skalę odczuwanego stresu PSS — 10 oraz kwestionariusz ankiety własnego autorstwa.Wyniki. Średni wynik poczucia koherencji wyniósł 120,64 punktów, a zatem respondenci prezentowali przeciętny poziom poczucia koherencji. Wyniki 43,82% badanych wskazywały wysoki poziom wyczerpania emocjonalnego. U 48,31% osób poziom depersonalizacji był wysoki. 69,66% badanych wykazało niski poziom satysfakcji zawodowej a 58,43% prezentowało wysoki poziom stresu. Na przeciętny poziom zadowolenia z pracy wskazuje średni wynik uzyskany przez badanych w skali SSP (19,6 punktu). Wyniki w skali poczucia koherencji korelują dodatnio (r > 0) z satysfakcją zawodową oraz ujemnie (r < 0) z wyczerpaniem emocjonalnym i depersonalizacją. Wykazano korelacje pomiędzy: płcią i stanem cywilnym a poziomem wypalenia zawodowego, stanem cywilnym i poziomem odczuwanego stresu, stażem pracy a satysfakcją z wykonywanego zawodu oraz poziomem odczuwanego stresu i zadowoleniem z wykonywanej pracy.Wnioski. Zaobserwowano korelację między poczuciem koherencji i wypaleniem zawodowym oraz pomiędzy poziomem stresu i zadowoleniem z wykonywanej pracy. Prawdopodobieństwo wystąpienia wypalenia zawodowego jest większe u mężczyzn oraz osób niebędących w związku. Wyniki badań wskazują, iż osoby będące w związku lepiej radzą sobie ze stresem. Satysfakcja z wykonywanej pracy jest najmniejsza u pracowników ze stażem pracy od 6 do 10 lat. (PNN 2022;11(1):8–13

Uszkodzenie nerwu udowego w przebiegu neuroboreliozy — opieka pielęgniarska. Opis przypadku

Introduction. Neuroborreliosis is an insidious disease. It is often confused with other neurological diseases. Diagnosis is possible when the following are present: neurological symptoms indicative of neuroborreliosis, pleocytosis in CSF, and production of antibodies to Borrelia burgdorferi in CSF. Aim. To assess the health situation and determine the nursing needs of a patient with femoral nerve damage during neuroborreliosis. Case Report. A 31-year-old woman was admitted to the Department of Neurology as an elective patient. On the basis of the clinical picture, elevated levels of protein and lymphocytic cells in the examination of cerebrospinal fluid and the demonstrated intrathecal synthesis of antibodies against Borrelia diagnosed neuroborreliosis with damage to the left femoral nerve. Observation, interview, and analysis of medical records were used to identify nursing problems correctly. The scales used were: the NRS Rating Scale (pain intensity), Lovett Scale (muscle strength assessment), Hospital Anxiety and Depression Scale Questionnaire (a modified version of the HADS scale to assess anxiety and depression), AIS Scale (to assess insomnia), Baxter Scale (to monitor and assess the risk of complications associated with venous cannulation). Conclusions. Dorothea Orem’s nursing theory is appropriate for a patient with neuroborreliosis. The patient’s main problems are: experiencing pain, difficulty in movement, and mental deterioration. The disease and related treatment and hospitalization influence bio-psycho-social deterioration. Holistic nursing management should be adapted to the patient’s changing condition. Care includes activities aimed at nullifying the effects of the disease, providing emotional support, and education regarding proper rehabilitation management and prevention of Lyme disease. (JNNN 2022;11(4):174–179)Wstęp. Neuroborelioza jest chorobą podstępną. Jest często mylona z innymi chorobami neurologicznymi. Rozpoznanie jest możliwe w sytuacji, gdy występują: objawy neurologiczne wskazujące na neuroboreliozę, pleocytoza w płynie mózgowo-rdzeniowym, produkcja przeciwciał przeciwko Borrelia burgdorferi w płynie mózgowo-rdzeniowym. Cel. Ocena sytuacji zdrowotnej i określenie potrzeb pielęgnacyjnych pacjentki z uszkodzeniem nerwu udowego w przebiegu neuroboreliozy. Opis przypadku. 31-letnia kobieta została przyjęta w trybie planowym do Kliniki Neurologii. Na podstawie obrazu klinicznego, podwyższonego poziomu białka i komórek limfocytarnych w badaniu płynu mózgowo-rdzeniowego oraz wykazanej intratekalnej syntezie przeciwciał przeciwko Borrelii rozpoznano neuroboreliozę z uszkodzeniem lewego nerwu udowego. W celu właściwego określenia problemów pielęgnacyjnych posłużono się obserwacją, wywiadem oraz analizą dokumentacji medycznej. Zastosowano skale: NRS Rating Scale (natężenie bólu), skalę Lovetta (Ocena siły mięśniowej), Kwestionariusz Szpitalnej Skali Lęku i Depresji (zmodyfikowana wersja skali HADS, do oceny lęku i depresji), Skalę AIS (ocena bezsenności), skalę Baxtera (monitorowanie i ocena ryzyka powikłań związanych z kaniulacją żył). Wnioski. Teoria pielęgnowania Dorothei Orem jest odpowiednia w przypadku pacjentki z neuroboreliozą. Główne problemy chorej to: odczuwanie bólu, trudności w poruszaniu się oraz pogorszenie stanu psychicznego. Na pogorszenie stanu bio-psycho-społecznego wpływa choroba oraz związane z nią leczenie i hospitalizacja. Holistyczne postępowanie pielęgniarskie powinno być dostosowane do zmieniającego się stanu zdrowia pacjentki. Opieka obejmuje działania mające na celu niwelowanie skutków choroby, udzielanie wsparcia emocjonalnego, edukację odnośnie prawidłowego postępowania rehabilitacyjnego oraz profilaktyki boreliozy. (PNN 2022;11(4):174–179

Characteristics and clinical correlates of white matter changes in brain magnetic resonance of migraine females

Objective: White matter hyperintensities (WMHs) were often found in migraine patients. The aim of study was to characterize WMHs, assess their prevalence, determine relationship to clinical symptoms and homocysteine levels in migraine females. Methods: 69 women 38 with migraine without aura (MO), 31 with migraine with aura (MA) who underwent brain MRI with 1.5T scanner were enrolled. TheWMHsnumber, location and size in FLAIR sequence were evaluated. Migraine severity was measured by pain intensity, number of attacks per month and MIDAS scale. Results: WMHs were found in 39.1% females. There was no WMHs and migraine typecorrelation. The total WMHs number was higher in MO ( p = 0.027). Patients with WMHswere older ( p = 0.025), have higher BMI ( p = 0.042), suffered longer ( p = 0.001), more often had positive pregnancy history ( p = 0.010) and less frequent prodromal symptoms. The age of onset, migraine's severity and homocysteine did not correlate with WMHs. No effect of antimigraine medication and oral contraceptive pills (OCP) was found. Both in MO and MA groupsWMHswere located only supratentorially. In MO femalesWMHswere mainly located in one cerebral hemisphere ( p = 0.024) whereas in MA were found bilaterally. WMHs were most commonly located in the frontal lobes. In MOlesions were small ≤3 mmand present in almost all MO patients ( p = 0.027).Conclusion: WMHs are present in more than one third of migraine females, regardless of aura. WHMs are located supratentorially, subcortically and in the frontal lobes. Older age, longer disease's duration, obesity and positive history of pregnancy are main risk factors for WMHs. Symptomatology and migraine severity, hyperhomocysteinemia, OCP and antimigraine medications do not increase WMHs

Association between Artificial Light at Night Exposure and breast and prostate cancer risk – the review

Introduction and purpose: Light is one of the defining features of life on the Earth, allowing certain biological processes to be subordinated to its presence and absence. With the introduction of artificial light, the human natural biological clock was dysregulated. Apart from that, the studies showed a connection between exposure to artificial light at night (ALAN) and carcinogenesis. The aim of this review was to present currently available knowledge in the online database PubMed about Association Between Artificial Light at Night and Breast and Prostate Cancer Risk Brief description of the state of knowledge: The article covers clinical and population-based control studies which indicate to ALAN exposure can lead to increased incidence of breast and prostate cancer by disruption of circadian rhythms in several mechanisms involving suppression of melatonin production, dysregulation of sleep–activity pattern and disruption of circadian genes. Conclusions: The review support an assumption that breast and prostate cancer incidence is a consequence of ALAN exposure. Further studies should clarify the relationship between ALAN exposure and other types of cancer. Besides, ALAN exposure levels should be measured more precisely than by satellite pictures analysis to reliably conduct studies proving the relation between ALAN exposure and risk of cancer development

Gut Microbiome as a Novel Treatment Strategy for Psoriasis

Introduction and purpose: Psoriasis is a skin disease that develops following chronic inflammatory signaling and keratinocyte hyperproliferation. The pathogenesis of psoriasis is compound and not yet fully understood. Several studies concerning gut microbiota composition and its role in disease pathogenesis recently demonstrated significant alterations among psoriatic patients. This study aims to highlight the latest scientific evidence regarding the gut microbiome alterations of psoriatic patients, as well as the state of knowledge in terms of microbiome-targeted therapies as promising preventive and therapeutic tools for psoriasis. Brief description of the state of knowledge: The current state of knowledge indicates that the main causes of psoriasis may be a genetic predisposition, as well as many immunological and environmental factors, including dysbiosis of the intestinal microflora. The article covers clinical and experimental studies which indicate that gut microbiota dysbiosis concerning diversity as well as the composition of the microbiome is the potential causal factor of psoriasis and the gut microbiota may serve as a promising prevention/therapy target for psoriasis patients. Conclusions: This review highlighted a strong link between psoriasis and the gut microbiota, to add new knowledge for discovering the relationship between the altered intestinal microbiota in psoriasis patients. Despite all of these interesting findings, there are a lot of limitations and challenges that future studies should face. More precise and greater studies need to be done to fully understand the potential of microbiota-aimed therapies

What are the conclusions of the recent studies about administrating vitamin C in sepsis? The review

Introduction and purpose: Sepsis is defined by the Sepsis-3 definition as life-threatening organ dysfunction caused by a dysregulated host response to infection1. Common manifestations of sepsis are fever, tachycardia, tachypnoea, confusion, hemodynamic dysfunction, and worsening of tissue perfusion. Sepsis may cause septic shock. The immune system produces reactive oxygen species which can also have an adverse influence on vasoconstruction5. There is a decrease in vitamin C levels in the plasma of patients with multiple organ failure6. Vitamin C plays a role in the synthesis of catecholamines and has antioxidant properties. The usage of vitamin C in sepsis patients has been arousing expectations for many years. Brief description of the state of knowledge: The current state of knowledge indicates that there is no beneficent effect of ascorbic acid on the population which suffered from sepsis. What is more, there is some proof that administrating that vitamin can be noxious and factor into brain functions19. There are also suggestions that it could increase mortality8. Conclusions: Recent studies do not recommend ascorbic acid as a treatment for sepsis. There is not out of the question that in some subpopulations due to pathogens or failed organs administrating vitamin C would benefit. Further research on this topic needs to be followed up

The relation between adipose-derived stem cells and wound healing process - the review

Introduction and purpose: Wound healing is a process including complex overlapping stages requiring many components. Adipose tissue is an organ that is responsible for maintaining homeostasis through inflammatory responses, signal transmission, energy expenditure connected with different organs. Fat tissue is a rich and readily available source of multipotent stem cells. Adipose-derived stem cells (ADSCs) have the potential in tissue regeneration because of their self-renewal and ability to differentiate in various types of cells. This review discusses ADSCs in terms of basic knowledge, methods of acquisition, prospects for use in healthcare, focusing mainly on the potential application in the wound healing process. Brief description of the state of knowledge: The article contains current knowledge about biology, specific properties of adipose-derived stem cells and also shows the relationship to the wound healing process. The review presents research that points to the possibility of using ADSCs in future medicine. Conclusions: Adipose-derived stem cells may constitute a prominent role in tissue regeneration owing to the secretion of various cytokines, the ability to differentiate into multiple lineages, their immunomodulatory effects, and the ease of cell obtaining. Further studies are required to explore the accurate mechanism of ADSCs action and their long-term safety in clinical application. Stem cell therapy brings new hope for the repair of chronic and refractory wounds and skin defects