Children with epilepsy against their healthy peers and those with headaches: Differences–similarities

Introduction Epilepsy, like most chronic diseases, affects bio-psycho-social functioning of children and adolescents. The aim of this work was to assess functioning of children with epilepsy compared with the group of healthy children and those with headaches carried out by children themselves and their mothers. Material and methods The study included 209 children with epilepsy and 173 children with headaches and 182 healthy students and their mothers. The research tool was Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL™ 4.0) questionnaire. Results Quality of life of healthy children was rated the highest in all areas by both children and mothers. In younger and older children, difference was demonstrated between the assessment of the quality of life of healthy children and the ones with epilepsy or healthy children and the ones with and headaches in all areas of the PedsQL™ 4.0 questionnaire (p<0.05). Children with epilepsy had the most difficulties in subscale School Functioning in their own and their mothers’ opinion. Healthy children and their mothers rated the subscale Emotional Functioning lowest. Conclusions The functioning of children with epilepsy in the assessment of children and their mothers was the closest to the functioning of children with headaches. Quality of children's life assessment by children with epilepsy and by healthy children differed between the group of girls and boys and between older and younger children in all PedsQLTM 4.0 questionnaire areas. A medium response compatibility between children with epilepsy and their mothers was shown in individual questions

Perception of illness by patients treated with haemodialysis

Introduction: Perception of illness is the way in which a condition is perceived, which reflects the patient’s attitude towards illness and treatment.Aim: The aim of the research was to understand the perception of illness among patients treated with haemodialysis. The specific goal was to determine the factors affecting the perception of the illness and their interrelationships.Material and methods: The study included 98 people treated with haemodialysis as part of the international project “Health, coping, and quality of life in people with chronic kidney disease and in their families”. As research tools the following were used: the Barthel Index, Instrumental Activities of Daily Living Scale (IADL), Edmonton Symptom Assessment Scale – Revised (ESAS – R), and the Brief Illness Perception Questionnaire (Brief IPQ) Scoring Instructions.Results: The perception of illness in the study group was significantly influenced by the intensity of physical symptoms (p = 0.007), especially dyspnoea or fatigue. Whereas, the following areas of the perception of illness: Consequences, Treatment control, Timeline, Illness concern, and Comprehensibility were mainly affected by functional efficiency, age, and education level. A worse perception of illness was observed with the increase in IADL dependency, younger age, and lower education level.Conclusions:1. Perception of illness in the study group was at a moderate level.2. Perception of illness in the study group was most strongly influenced by the intensity of symptoms,especially dyspnoea and fatigue.3. Functional efficiency, age, and education significantly affected the perception of illness

Perception of illness by patients treated with haemodialysis

Introduction: Perception of illness is the way in which a condition is perceived, which reflects the patient’s attitude towards illness and treatment. Aim: The aim of the research was to understand the perception of illness among patients treated with haemodialysis. The specific goal was to determine the factors affecting the perception of the illness and their interrelationships. Material and methods: The study included 98 people treated with haemodialysis as part of the international project “Health, coping, and quality of life in people with chronic kidney disease and in their families”. As research tools the following were used: the Barthel Index, Instrumental Activities of Daily Living Scale (IADL), Edmonton Symptom Assessment Scale – Revised (ESAS – R), and the Brief Illness Perception Questionnaire (Brief IPQ) Scoring Instructions. Results: The perception of illness in the study group was significantly influenced by the intensity of physical symptoms (p = 0.007), especially dyspnoea or fatigue. Whereas, the following areas of the perception of illness: Consequences, Treatment control, Timeline, Illness concern, and Comprehensibility were mainly affected by functional efficiency, age, and education level. A worse perception of illness was observed with the increase in IADL dependency, younger age, and lower education level. Conclusions: 1. Perception of illness in the study group was at a moderate level. 2. Perception of illness in the study group was most strongly influenced by the intensity of symptoms, especially dyspnoea and fatigue. 3. Functional efficiency, age, and education significantly affected the perception of illness.publishedVersio

Threats to Health and Well-being Perceived by Older people in Poland and Portugal

Introduction: According to the OECD, Portugal and Poland rank below average in several well-being measures such as income and wealth, and health status. Investigating how people perceive the threats to health in these two countries, is an important issue to address priority needs. To meet this need, the objective of this paper was to compare the perceptions of the threats to the health and well-being among the Polish and Portuguese older persons and explore differences between the countries in respect of patterns of self-rated health. Material and Methods: A Cross-sectional study with two convenience samples from primary health care services of Poland and Portugal was conducted; 480 adults aged 65 and over (247 Portuguese) were included. The EASYCare standard assessment of 2010 was applied under a joint project of both countries. The association between ‘self-rated unhealthy’ and socio-demographic and threats to health variables was examined using logistic regression. Results: In both countries about two thirds of the older persons self-rated their health as unhealthy. Having more than enough finances was associated with a significant lower odds of being unhealthy compared with those without enough finances at the end of the month (Portugal: OR = 0.25, 95% CI 0.10 to 0.63; Poland: OR = 0.33, 95% CI 0.12 to 0.88). Visual problems, bodily pain, memory loss, feeling bored or lonely and reporting shortness of breath during normal activities was consistently associated with fair or poor self-rated health. Discussion: These findings provide important information regarding the health profile of older people which can help in the development of people-centred health systems where their lives and well-being can be improved. Conclusion: The unhealthy perception of older people was consistently associated with indicators of major health threats

Validity of the EASYCare Standard 2010 assessment instrument for self-assessment of health, independence, and well-being of older people living at home in Poland

EASYCare Standard 2010 is a brief instrument identifying concerns in health, functional independence, and well-being, from older persons’ perspective. It has not previously been validated for self-assessment. Our aim was to determine whether self-assessment (EC1) can give comparable results to an evaluation performed by professionals (EC2), for older people living at home. The study included community-dwelling individuals (aged at least 60 years, n = 100; 67 females) without dementia (abbreviated mental test score [AMTS] above 6). It comprised two assessments (self and professional), including summarising indexes: Independence score [IS], Risk of breakdown in care [RBC], Risk of falls [RF], performed within a period between 1 and 2 weeks. Additionally, during EC1, reference tests of physical and mental function (Barthel Index: 96.3 ± 6.5, Lawton scale: 6.7 ± 2.0, geriatric depression scale: 3.0 ± 2.7, AMTS: 10.2 ± 1.0) were applied to test for concurrent validity. Cohen’s kappa values (self-assessment vs. professional assessment) across all EASYCare domains were high (0.89–0.95). Results of all summarising indexes derived from self-assessment correlated strongly with reference tests. No differences were found in IS and RBC between EC1 and EC2 (8.6 ± 12.0 vs. 9.0 ± 12.7 and 1.0 ± 1.1 vs. 1.2 ± 1.4). Results of RF were higher in EC2 (1.0 ± 1.1 vs. 1.1 ± 1.4; p = 0.005), due to a different response to the item “Do you feel safe outside your home?” We conclude that self-assessment with EASYCare Standard in older people without severe functional impairment living at home can deliver valid results, similar to those obtained through professional assessment, thus providing an efficient system for assessment of relatively independent individuals

The Camberwell Assessment of Need for the Elderly questionnaire as a tool for the assessment of needs in elderly individuals living in long-term care institutions

AbstractObjectivesThe aim of the study was to evaluate the Camberwell Assessment of Need for the Elderly questionnaire (CANE) in assessing the needs of elderly individuals living in long-term care institutions (LTCI) in Poland.Setting and ParticipantsThe needs of 173 residents were assessed. The inclusion criteria were age (at least 75 years of age) and the lack of severe cognitive impairment (Mini Mental Scale Examination score of at least 15 points).MeasurementsIn all participants, met and unmet needs were assessed by themselves and by the nursing staff involved in care activities.ResultsThe number of met needs assessed by the staff was higher than in the users’ opinions (p<0.0001), whereas the number of unmet needs was lower (p<0.001). However, the average percentage of the agreement between the user and the staff was as high as 86.2%. The areas characterized by the lowest agreement were Company (65.3%), Memory (75.7%), Eyesight/hearing/communication (70.5%) and Psychological distress (70.5%).ConclusionsDespite a high percentage of agreement reached between the staff and user assessments of needs in our study, we were able to identify the areas of discrepancies between these two perceptions of needs. These can be treated as signals pointing to those aspects of care that should be addressed

Functioning of Women with Migraine Headaches

Background. Migraines are one of the most commonly occurring ailments affecting the nervous system. The aim of this research paper was to evaluate the effect migraines have on the everyday functioning of women. Method. The study involved women with diagnosed migraine headaches (IHS-2004) undergoing treatment at a neurological clinic. In order to evaluate the influence of headaches on the everyday functioning of women, a MSQ v.2 questionnaire was used, whereas pain severity was assessed on a linear VAS scale. Results. Among the clinical factors, the most influential was the frequency of headaches. Headache duration was particularly significant for women below the age of 40. Pain severity cited at 8–10 pts on the VAS significantly disrupted and limited everyday functioning. On the emotional function subscale, the most influential factors were age, education, and the frequency of headaches. Conclusions. On account of headache frequency emerging as the most significant influencing factor, it is of the utmost importance to inform patients of the value of taking prophylactic measures. Central to this is the identification of factors that trigger the onset of migraines. This approach would greatly aid the individual in choosing the appropriate treatment, either pharmacological or others

The functioning of patients on haemodialysis. Age as the main determinant of functional condition

Introduction. Chronic kidney disease (CKD) is a progressive disease, and in spite of the progress of medicine, the care of specialized medical staff, and the patient’s efforts, many of them develop its end-stage. The use of renal replacement therapy, haemodialysis, has provided patients with an opportunity to prolong their life, but due to complications, it leads to the deterioration in the quality of life.Aim. To identify factors affecting the functioning of haemodialysis patients.Materials and methods. The study involved 98 patients on haemodialysis, 37 women and 61 men. The average age was 59.65 ± 15.51 years. The research tool was the Barthel Index, IADL and ESAS-R scale, i.e. a scale of experiencing symptoms that may be associated with haemodialysis.Results. The mean renal replacement therapy period was 42.76 ± 50.30 months. The most common cause of haemodialysis was chronic glomerulonephritis (21.43%), diabetic nephropathy (18.37%), polycystic kidney disease (12.24%) and hypertensive nephropathy (9.18%). In the study group, the average score on the Barthel Index scale was 90.10 ± 14.82, while the IADL score was 20.24 ± 4.72 points. Women showed a slightly higher ability in basic and complex daily living activities. People up to 60 years of age showed a slightly higher ability. According to the ESAS-R scale (7–10 points), fatigue and drowsiness were the most intense symptoms. People older than 60 years of age more often experienced pain (p = 0.048), malaise (p = 0.203), appetite disorders (p = 0.232), other problems (p = 0.042).Conclusions. In spite of their older age, the patients showed quite good motor skills. The differences between men and women in the assessment of the severity of somatic symptoms slightly disappear in the elderly. Women showed a slightly higher ability in both basic and complex daily living activities. Older people experience more haemodialysis-related symptoms

Needs of older persons living in long-term care institutions: on the usefulness of cluster approach

Background Long-term care units’ residents do not constitute a homogeneous population. Providing effective care, tailored to individual needs, is crucial in this context. It can be facilitated by suitable tools and methods, which include needs assessment along with the physical, psychological and social aspects of care. We thus applied a cluster approach to identify their putative groupings to enable the provision of tailored care. Methods The needs of 242 residents of care homes in four Polish cities (Poznan, Wroclaw, Bialystok and Lublin), aged 75–102 years (184 females), with the Mini-Mental State Examination (MMSE) score ≥ 15 points, were assessed with the CANE (Camberwell Assessment of Need for the Elderly) questionnaire. Their independence in activities of daily living was evaluated by the Barthel Index (BI), and symptoms of depression by the Geriatric Depression Scale (GDS). The results of MMSE, BI and GDS were selected as variables for K-means cluster analysis. Results Cluster 1 (C1), n = 83, included subjects without dementia according to MMSE (23.7 ± 4.4), with no dependency (BI = 85.8 ± 14.4) and no symptoms of depression (GDS = 3.3 ± 2.0). All subjects of cluster 2 (C2), n = 87, had symptoms of depression (GDS = 8.9 ± 2.1), and their MMSE (21.0 ± 4.0) and BI (79.8 ± 15.1) were lower than those in C1 (p = 0.006 and p = 0.046, respectively). Subjects of cluster 3 (C3), n = 72, had the lowest MMSE (18.3 ± 3.1) and BI (30.6 ± 18,8, p < 0.001 vs. C1 & C2). Their GDS (7.6 ± 2.3) were higher than C1 (p < 0.001) but lower than C2 (p < 0.001). The number of met needs was higher in C2 than in C1 (10.0 ± 3.2 vs 8.2 ± 2.7, p < 0.001), and in C3 (12.1 ± 3.1) than in both C1 and C2 (p < 0.001). The number of unmet needs was higher in C3 than in C1 (1.2 ± 1.5 vs 0.7 ± 1.0, p = 0.015). There were also differences in the patterns of needs between the clusters. Conclusions Clustering seems to be a promising approach for use in long-term care, allowing for more appropriate and optimized care delivery. External validation studies are necessary for generalized recommendations regarding care optimization in various regional perspectives