Composition of emergency medical services teams and the problem of specialisation of emergency medical services physicians in the opinions of occupationally active paramedics

Introduction: Emergency medicine includes prevention, prehospital care, specialised treatment, rehabilitation, and education. Aim of the research: The objective of the analysis was to determine the opinions of paramedics concerning the problem of the composition of emergency medical services (EMS) teams and specialisation of EMS system physicians according to their education level and sense of coherence. Material and methods: The study was conducted among 336 occupationally active paramedics working in EMS teams delivering prehospital care in selected units in Poland. The study was conducted at Ambulance Stations and in Hospital Emergency Departments, which within their structure had an out-of-hospital EMS team. The study was conducted by the method of a diagnostic survey, and the research instrument was the Orientation to Life Questionnaire SOC-29 and a questionnaire designed by the author. Results: The respondents who had licentiate education relatively more frequently indicated paramedics with licentiate education level as persons most suitable to undertake medical actions (26.32%) rather than physicians (21.05%). Paramedics with 2-year post-secondary school education relatively more often mentioned physicians (33.07%) than those with licentiate education (17.32%). As many as 89.58% of the paramedics reported the need for a physician in the composition of the EMS team delivering prehospital care, while only 10.42% of them expressed an opinion that there should be teams composed of paramedics only. According to 30.65% of respondents, EMS team delivering prehospital care should include a physician with the specialty in emergency medicine, whereas 8.04% of respondents reported the need for a physician, irrespective of specialisation. However, 42.56% of the paramedics expressed an opinion that a physician is needed only in a specialist team with a specialisation in emergency medicine. The opinions of the paramedics concerning the need for a physician in an EMS team delivering prehospital care, which also considers the problem of specialisation, significantly differ statistically according to the sense of manageability, meaningfulness, and global sense of coherence. Conclusions: The assessment of the composition of a paramedical team depends on the level of education of paramedics. The need for a doctor in a team, as well as for specialization in emergency medicine, has been proven by the levels of obtained SOC and its components, together with the relations observed in groups assessing the studied problems

The influence of the sense of coherence and the level of education on the motives and satisfaction with the choice of becoming a professional paramedic

Wstęp. Jedną z ważniejszych decyzji, przed którą staje człowiek jest wybór zawodu, który może być wynikiem zimnej kalkulacji bądź wynikiem posiadanych uzdolnień, zainteresowań i zamiłowań. Cel. Celem badań było ustalenie, jakie czynniki miały wpływ na decyzję o wyborze zawodu ratownika medycznego i określenie zadowolenia z dokonanego wyboru w zależności od rodzaju posiadanego wykształcenia i poczucia koherencji. Materiał i metody. Badania przeprowadzono wśród 336 czynnych zawodowo ratowników medycznych. W realizacji pracy wykorzystano metodę badawczą sondażu diagnostycznego techniką badań ankietowych audytoryjnych, realizowanych z zastosowaniem autorskiego kwestionariusza ankiety. Wyniki. Rodzaj wykształcenia w sposób istotny statystycznie nie różnicował badanych obszarów. Najistotniejszym motywem wyboru dla większości badanych ratowników medycznych było zainteresowanie medycyną ratunkową, powołanie do niesienia pomocy, a także możliwość wykonywania ciekawej pracy. Ratownicy medyczni są zadowoleni z dokonanego wyboru zawodu w istotnej statystycznie zależności od poczucia koherencji. Wnioski. Wykształcenie i poczucie koherencji nie były czynnikami różnicującymi motywy wyboru zawodu. W świetle obniżonego poziomu poczucia sensowności zasadne wydaje się monitorowanie tej zmiennej w badanej grupie. W celu weryfikacji kandydatów, należy wprowadzić test psychofizyczny. Problemy Pielęgniarstwa 2014; 22 (4): 490–495Introduction. One of the most important decisions every person has to make is the choice of profession, which may be a result of cool calculation or talents, interests and passions one possesses. Aim. The aim of the research was to establish what factors influenced the decision to choose the paramedical profession as well as to determine the level of satisfaction resulting from this choice, depending on a kind of education and the sense of coherence a person has. Material and methods. The research has been conducted among 336 paramedics who lead active working lives. The study is based on a diagnostic, auditorium survey, with the use of the author’s questionnaire. Results. A kind of education did not diversify the examined areas in a way significant statistically. For most of the respondents the most important reason for choosing the career was an interest in paramedical medicine, a vocation for giving first aid and a possibility of having an interesting job. Paramedics are satisfied with the choice of career they have made, which is dependent on their sense of coherence in a way significant statistically.Conclusions. Education and the sense of coherence have not been the factors diversifying the motives for choosing one’s career. In the light of a lowered level of the sense of meaning monitoring of this variable in the examined group seems justified. In order to verify candidates a psychophysical test should be introduced.Nursing Topics 2014; 22 (4): 490–49

The sense of coherence in a group of paramedics in the context of selected socio-demographic variables

Wprowadzenie. Poczucie koherencji (SOC) zdefiiowane zostało jako względnie stała orientacja, wyznaczająca okre- ślony sposób spostrzegania świata, jako przewidywalnego, sterowalnego oraz wartego wysiłku i zaangażowania. Materiał i metodyka. Przebadano 336 ratowników medycznych czynnych zawodowo, pracujących w wyjazdowych zespołach ratownictwa medycznego na terenie Polski. Badania realizowano w Stacjach Pogotowia Ratunkowego i Szpitalnych Oddziałach Ratunkowych. Poczucie koherencji oceniono za pomocą kwestionariusza SOC – 29. cel pracy. Celem pracy było ustalenie czy zmienne socjodemografizne różnicują poczucie koherencji i jej składowe w grupie ratowników medycznych. Wyniki. Ogólne poczucie koherencji nie różnicowało kobiet i mężczyzn w grupie ratowników medycznych. Istotna róż- nica zaznaczyła się w podskali zrozumiałości, przy p = 0,020. Z analizy pozostałych danych demografiznych przy użyciu r Spearmana, przy p < 0,05, wynika, że wiek i staż pracy ankietowanych w sposób istotny statystycznie różnicował zrozumiałość. Średni poziom poczucia koherencji dla ratowników medycznych z wykształceniem policealnym wynosił 141,64, przy N = 259 i był nieco niższy w stosunku do grupy z wykształceniem licencjackim, gdzie uzyskano 144,17, przy N = 77. Wnioski. Poczucie koherencji okazało się być stałą zmienną osobowościową u ratowników medycznych. Mniej stabilne było poczucie zrozumiałości.Introduction. The sense of coherence (SOC) has been defied as relatively constant orientation determining a specifi way of perceiving the world as something predictable, controllable, worth effrt and commitment. Material and methodology. 336 paramedics who lead active working lives have been examined. They all work in paramedical teams reaching patients in need in Poland. The research has been conducted in Ambulance Stations and Hospital Emergency Services. The sense of coherence has been established with the use of SOC-29 Questionnaire. The aim of the study. The aim of the study was to establish whether socio-demographic variables diversify the sense of coherence and its components in a group of paramedics. The results. The general sense of coherence has not been diffrent among women and men in a group of paramedics. A signifiant diffrence has been noticeable on the comprehensibility subscale, with p = 0,020. On the basis of the analysis of the rest of the demographic data, with the use of r Spearman, with p < 0,05, it has appeared that the respondents’ age and work experience has diversifid comprehensibility in a way signifiant statistically. The average level of the sense of coherence in paramedics with college education has amounted to 141,64, with N = 259 and has been slightly lower in comparison with the group with undergraduate education, where the level has amounted to 144,17, with N = 77. conclusion. The sense of coherence has turned out to be a constant variable of a paramedic’s personality. The sense of comprehensibility has been less constant

Metabolic syndrome and professional aptitude

The development of civilisation has resulted in a growing problem of metabolic diseases, including metabolic syndrome. Scientific studies show that this disease is an epidemic of the 21st century. Metabolic syndrome is a collection of mutually related metabolic factors, such as obesity, impaired glucose tolerance, lipid disorders, arterial hypertension, and pro-inflammatory and prothrombotic state, increasing the risk of the development of atherosclerosis and type 2 diabetes, and their cardiovascular complications. Considering the scale of the prevalence of metabolic syndrome, the causes of its development and diagnostic criteria are the main contemporary directions of scientific research. The study presents an analysis of the relevant literature with respect to terminology, diagnostic criteria, and pathogenesis of metabolic syndrome. The second section of the study discusses the degree of epidemiological risk due to metabolic syndrome and its individual components among the adult Polish population. The effect of this phenomenon on professional competence is also taken into consideration

The prevelance of metabolic syndrome on the sample of paramedics

Objectives The term metabolic syndrome (MetS) refers to the coexistence of interlinked risk factors of metabolic origin, contributing to the development of arteriosclerotic cardiovascular diseases as well as type 2 diabetes and their cardiovascular complications. The aim of the study is the assessment of the prevalence of MetS among paramedics of the Świętokrzyskie Center of Emergency Medical Services, depending on the adopted diagnostic criteria. Material and Methods The study included 140 paramedics (2 women and 138 men), aged 23–60 years old (median = 43 years, average age = 41.5 years, standard deviation = 10.8 years). The age distribution of the subjects was significantly different from the normal distribution (p-value < 0.0001). The oldest age group (50 years old and above) was overrepresented by nearly a half compared to the youngest group (up to 29 years old). Metabolic syndrome was defined on the basis of the International Diabetes Federation (IDF) criteria from 2005 and IDF in agreement with the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) from 2009. Results According to the IDF/2005 criteria, in which the necessary condition is the diagnosis of central obesity, MetS was recorded in 26.4% of the subjects (37 people). This is statistically significantly less often than the IDF/AHA/NHLBI/2009 definition of p = 0.001 – 35%. The frequency of the MetS occurrence was statistically significantly related to the age of the subjects and the age groups. Conclusions The prevalence of the MetS in the subject group is evaluated to be significant. The prevalence of MetS is diversified by the applied diagnostic criteria with age being the factor increasing its frequency. The most common factor influencing the prevalence of MetS is blood pressure and waist circumference. Int J Occup Med Environ Health 2018;31(6):741–75

Dietary Patterns in Relation to Metabolic Syndrome among Adults in Poland: A Cross-Sectional Study

In several populations the associations between diet and the risk of metabolic syndrome have not been fully examined yet. The aim of the study is to identify the main dietary patterns among Polish adults and the evaluation of the relationships of these patterns with metabolic syndrome and its components. The study was conducted on a group of 7997 participants, aged between 37 and 66 years old. Dietary patterns were identified by factor analysis. Metabolic syndrome was defined according to the International Diabetes Federation. Three dietary patterns were identified and designated as: “Healthy”, “Westernized” and “Traditional-carbohydrate”. In the adjusted model, a higher score in the “Westernized” pattern aligns with a higher risk of abnormal glucose concentration (ptrend = 0.000), but with a lower risk of abnormal High-Density Lipoprotein Cholesterol HDL-cholesterol concentration (ptrend = 0.024). Higher scores in the “Traditional-carbohydrate” pattern were connected with the risk of abdominal obesity (ptrend = 0.001) and increased triglycerides concentration (ptrend = 0.050). Our results suggest that adherence to the “Traditional-carbohydrate” dietary pattern, characterized by higher intakes of refined grains, potatoes, sugar and sweets is associated with a higher risk of abdominal obesity and triglyceridemia. A “Westernized” dietary pattern on the other hand, is related to hyperglycemia. The study results can be used for community-based health promotion and intervention programs to prevent or better manage chronic diseases

Sleep duration and the risk of metabolic syndrome – a cross-sectional study

Introduction: It has been stated that besides the traditional elements of lifestyle such as diet and physical activity, an additional factor, namely sleep, is involved in metabolic processes, hormonal functions, and energy homeostasis. Aim of the research: To examine relationships between self-reported sleep duration and the risk of metabolic syndrome (MetS) and its components, both for men and women. Material and methods: The study involved 10,367 individuals, aged 37 to 66 years. The definition of MetS applied in this paper was developed by the International Diabetes Federation (IDF). Logistic regression was applied to assess the risk (odds ratio – OR) of MetS and its components. Results : There was no relationship observed between short sleep duration (≤ 6 h) and the risk of MetS. Long sleep duration (≥ 9 h) was connected with a higher risk of MetS only in the unadjusted model (OR = 1.11). After adjusting for confounders, a significant association was found between long sleep duration and a higher risk of abdominal obesity in the test group as a whole (OR = 1.16), as well as in the men in the group (OR = 1.22). In women, both with short (OR = 1.08) and long (OR = 1.12) sleep duration, the risk of increased concentration of glucose was found. Conclusions : Our study did not confirm the existence of an association between inadequate sleep duration and the risk of MetS, defined in accordance with IDF criteria. Sleep duration, however, is connected with some of the MetS components. It is therefore necessary to conduct further, long-term tests in this regard

Risk factors of cardiovascular diseases in paramedics

Introduction : Cardiovascular diseases are the most life-threatening in Poland and constitute the most frequent cause of death. Aim of the research : The evaluation of the frequency of the occurrence of cardiovascular disease risk factors among paramedics of the ŚCRMiTS (Świętokrzyskie Centre of Emergency Medical Services) in Kielce. Material and methods : The subject study group involved 140 paramedics of the ŚCRMiTS in Kielce, excluding the doctors. The evaluation of their condition of health included the following measurements: blood pressure, biochemical analyses: fasting lipidogram, fasting glycaemia, anthropometric measurements, and a questionnaire interview. Results : The average body mass index of the group was above the norm and equalled 28.2 ±4.1 kg/m 2 . The average blood pressure equalled: systolic – 133.8 ±14.9 mm Hg, diastolic – 83.1 ±9.2 mm Hg. The average fasting glucose concentration was 95 ±33.8 mg/dl in the subject population. The average total cholesterol concentration of the group was 198.6 ±36.6 mg/dl, high-density lipoprotein fraction concentration – 48.4 ±10.5 mg/dl, low-density lipoprotein fraction – 121 ±33.8 mg/dl, triglycerides concentration – 168.9 ±120.7 mg/dl. Fifteen risk factors were analysed altogether. Conclusions : Cardiovascular disease risk factors are a significant risk for the subject group of paramedics and they generate a disadvantageous picture of a health profile. A vast majority of the subjects had an abnormal body mass, exceeded values of blood pressure, and had bad lipidogram parameters. The spread of risk factors and the degree of exceeding reference norms increases with age. It would be justified to prepare preventive measures aimed mainly at the reduction of body weight and the decrease of other modifiable risk factors for cardiovascular diseases

The need for constant training of paramedics in comparison with other regulated professions

Wstęp. Obowiązujący system kształcenia ratowników medycznych w Polsce dotyczy kształcenia 2-letniego policealnego i 3-letniego wyższego zawodowego, a obowiązek doskonalenia zawodowego polega na zbieraniu punktów edukacyjnych. Cel pracy. Celem podjętych badań była ocena potrzeby i obowiązującej formy ustawicznego kształcenia ratowników medycznych. Materiał i metody. Badania przeprowadzono wśród 336 ratowników medycznych czynnych zawodowo, pracujących w wyjazdowych zespołach ratownictwa medycznego w losowo wybranych placówkach na terenie Polski. W realizacji pracy wykorzystano metodę badawczą: sondażu diagnostycznego techniką badań ankietowych audytoryjnych, realizowanych z zastosowaniem autorskiego kwestionariusza ankiety. Wyniki. W ocenie ratowników medycznych istnieje potrzeba podnoszenia kwalifikacji zawodowych, a obowiązująca forma doskonalenia zawodowego oceniana liczbą uzyskanych punktów edukacyjnych nie znalazła uznania w badanej grupie. Samodoskonalenie nie jest równie wystarczające, aby zapewnić prawidłowość postępowań ratowniczych. Wnioski. Dopełnienie przez ratownika medycznego obowiązku doskonalenia zawodowego poprzez zbieranie punktów edukacyjnych nie jest wystarczającą formą kształcenia ustawicznego. Dążenie do doskonalenia tego procesu skłania do ujednolicenia systemu kształcenia i stworzenia możliwości kształcenia uzupełniającego. Ustawiczne kształcenie pozwoli ratownikom medycznym potwierdzać i uaktualniać swoje umiejętności.Introduction. The obligatory system of training of paramedics in Poland involves two years of training after one has finished secondary school and three years of professional training in a college. Every paramedic is also required to develop one&#8217;s professional career through collecting educational points. Aim of the study. The aim of the research was making an appraisal of the need and form of the obligatory, constant training of paramedics. Materials and methods. The research has been conducted among 336 Polish paramedics who lead active working lives and who work in paramedical teams reaching patients in need. They have been chosen randomly. The study is based on a diagnostic, auditorium survey, with the use of the author&#8217;s questionnaire. Results. According to the paramedics there is a need for improving professional qualifications but the form of this obligatory development, which is based on educational points, has not gained recognition in the examined group. Self-improvement is not sufficient to ensure correct lifesaving actions. Conclusion. The form of constant professional training with the use of educational points is not efficient enough. The improvement of this process requires unifying of the system of education and creating a possibility of supplementary training. Constant training will let paramedics prove and update their skills