ORIGINAL PAPER OCCURRENCE OF ANNOYING SYMPTOMS OF PATIENTS WITH CANCER

Abstract Aim: To determine symptoms those occur by patients with cancer. Design: A cross-sectional survey. Methods: The sample of research consisted of 100 patients with cancer. We used Memorial Symptom Assessment Scale (MSAS) to evaluate the symptoms. This Scale determines 32 symptoms in three subscales (physic, psychic symptoms, and complete distress) focused on frequency, intensity and distress of symptoms of Likert Scale 1-4. Results: The research results demonstrate that in terms of frequency, intensity and distress the patients most frequently suffer pain (4.30 ± 3.30), despite of all the pain treatment options. The other symptoms that patients encountered include nausea (3.52 ± 2.70), restless sleep (3.92 ± 3.48), anxiety (3.81 ± 3.55) and feelings of sadness (1.30 ± 0.22). In terms of disease severity, we had greater incidence of symptoms in patients with stage 3 -cancer metastatic disease (p ≤ 0.05). Our research also confirmed the correlation between the occurrence of symptoms and duration of illness. Greater incidence of symptoms has been reported in patients with longer lasting disease, in most cases, endstage disease (p ≤ 0.05). Conclusion: A key part of palliative care is minimizing of annoying physical, psychological, social and spiritual symptoms of patients. Assessment of the annoying symptoms in clinical practice allows the planning and implementation of effective interventions to promote quality of life of patients and their families in palliative care

Miejsce fizjoterapii w zapobieganiu i leczeniu osteoporozy

Osteoporoza w ostatnich latach stała się ważnym problemem zdrowotnym i społeczno-ekonomicznym porównalnym z innymi chorobami cywilizacyjnymi. Jest to choroba należąca do osteologii i najważniejszym powikłaniem jest złamanie proksymalnej części kości udowej, kręgu kręgosłupa lub przedramienia. Osteologia jest nauką, która zajmuje się rozwojem i chorobami kości i dziedziną, która w ostatnich latach bardzo się rozwija. Osteoporoza nie jest nieuchronną konsekwencją starzenia, wręcz odwrotnie – jest to schorzenie spełniające kryteria choroby: 1. Osteoporoza jest jednoznacznie zdefiniowana jako choroba i jej kryteriami już nie są złamania. 2. Udało się dobrze objaśnić mechanizmy patofizjologiczne utraty masy kostnej przy osteoporozie. 3. Zwiększone ryzyko złamań można wcześnie zdiagnozować poprzez pomiar masy kostnej. 4. Są znane skuteczne środki zapobiegania i leczenia osteoporozy. Fizjoterapia i odpowiednia aktywność fizyczna mają niezastąpioną rolę w prewencji i leczeniu osteoporozy i złamań osteoporotycznych. Mechanizmy aktywności fizycznej w prewencji konsekwencji osteoporozy są następujące: w młodym wieku odpowiednia aktywność fizyczna zwiększa szczytową masę kostną (peak bone mass), w okresie menopauzy zwalnia zwiększoną utratę masy kostnej i w starszym wieku poprawia siłę mięśni, koordynacyjne zdolności i stabilność, dzięki czemu może zmniejszyć częstość występowania i powagę upadkówIn the recent years osteoporosis has become a substantial health and social-economic problem reaching the level of other civilization diseases. The most significant complication of this osteology illness is the fracture of a thigh bone proximal part, vertebra or forearm. Osteology, a field of study remarkably evolving nowadays, is the science exploring development of bone mass and bone diseases. Osteoporosis is not an inevitable consequence of aging, on the contrary it is a physical disorder that meets all criteria of an illness: 1. Osteoporosis is clearly defined as an illness and its criteria are not only fractures. 2. Science clarified pathophysiological processes of osteoporosis bone mass reduction. 3. Increased peril of fractures can be early diagnosed by measuring bone mass content. 4. There are well known measures for prevention and therapy of osteoporosis. Physiotherapy and appropriate physical activity have their unique place in prevention and treatment of osteoporosis and osteoporotic fractures. Mechanisms of physical activity in prevention of osteoporosis consequences are as follows: physical activity increases the peak bone mass in young age and it slows down the increased loss of bone mass during the menopause and in older age it improves muscle strength, coordination capabilities and stability whereby it can decrease the incidence and severity of fall

Health literacy of primiparae in the first six months of maternity: review

Aim: The aim was to synthesize themes and influencing factors of personal dignity experienced among patients with multiple sclerosis (MS) in the context of health care. Design: A qualitative narrative review with regard to PRISMA statements was used as a study design. Methods: The CASP Qualitative checklist was chosen for critical appraisal and thematic synthesis for synthesis of findings was adopted. Narrative the electronic databases: Academic Search Complete; Health Source: Nursing/Academic Edition; Humanities International Complete; MEDLINE were used for search. 230 studies were retrieved. 4 studies met the reviewers’ inclusion criteria and were included into the study. Results: Three synthesized themes – Ill body, changed healthy identity and personal integrity (8 subthemes); Fighting spirit and patient’s factors (8 subthemes) and Social factors (8 subthemes) – seem to be relevant for dignity of patients with MS. Narrative review shows tendency that patients with MS are in the danger of loss of dignity. Conclusion: Focused on personal dignity of people with MS brings possibility to have non-psychiatric approach to patients’ personality fully consistent with the patient-centred approach in the context of health care. Results will be used as a framework for ethical reflection, interventions focused on how to improve or maintain personal dignity of patients with MS. Based on the critical appraisal, researchers should pay more attention to reflexivity. According to study limitations, a systematic review is needed

Factors influencing the effectiveness of clinical learning environment in nursing education

Aim: The purpose of the cross-sectional descriptive study was to investigate how nursing students evaluate particular factors of clinical learning environment during their professional placement in hospitals. We explored which factors of clinical environment contribute significantly to students' evaluation of it. Design: A descriptive cross-sectional study. Methods: The sample included 503 nursing students in their second or third year of study at six Slovak universities. A valid and reliable questionnaire, the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale (CLES+T), was used to evaluate the student nurses' experiences and clinical placement. The data were analysed using descriptive statistics, Pearson's chi-square test, multifactorial ANOVA procedure and Pearsons' correlations, and p-value < 0.05 was taken to indicate statistical significance for all comparisons. Results: A significant proportion of students experienced a traditional model of group supervision. Supervision method, supervisory session frequency, and duration of clinical placement had a significant impact on their evaluation of clinical environments. Conclusion: Supervision methods are a significant factor influencing student evaluation of their clinical placement environment. Compared to other European studies, we found a less frequent application of individual supervision and that the Slovak university setting is dominated by a traditional group model of supervision. The study offers a valuable insight into the analysis of factors contributing to improvements in clinical learning environment and models of clinical or workplace training

ASSESSMENT OF NURSING STUDENT PERFORMANCE IN CLINICAL SETTINGS – USEFULNESS OF RATING SCALES FOR SUMMATIVE EVALUATION

Aim: The aim of the study was to investigate the use and effectiveness of a valid and reliable rating scale for summative clinical evaluation of student performance. Design: A descriptive cross-sectional study. Methods: The study was carried out at two Slovak universities in the academic years of 2015 and 2016. The study sample included performance evaluations of 82 students made by different lecturers using the the Nursing Student Clinical Performance Evaluation Scale (NSCPES), before the practical component of their final examinations. The students’ performances were repeatedly evaluated by five lecturers. This evaluation was compared with the grade point for the students’ clinical performance obtained in the practical component of their final examinations. The data were analysed using descriptive statistics, Pearson’s chi-square test, Cohenʼs Kappa, factor analyses, and the p-value < 0.05 was taken to indicate statistical significance for all comparisons. Results: Significant positive correlations were noted between two evaluations – before the final examinations using the NSCPES rating scale, and standard clinical assessment during the final examinations (r = 0.334; p ≤ 0.01). The value of Cohen's Kappa was very low (0.04) and insignificant (p = 0.32), indicating low agreement between the two evaluations. The Slovak version was not conceptually consistent with the original version. In the Slovak version, two originally independent domains (professionalism and ethical principles) were merged into one variable – responsibility and professionalism. Conclusion: The multidimensional nature of clinical practice necessitates the use of a complex of assessment measures. A valid and reliable tool may allow an objective evaluation of nursing student performance in clinical settings. The Nursing Student Clinical Performance Evaluation Scale is useful for summative evaluation of student performance, allowing teachers  and clinical mentors to rate performance over time, and to note patterns of performance. Keywords: assessment, clinical practice, education, nursing, rating scale, reliability, validity

Measuring Subjective Quality of Life in Czech and Slovak Nurses: Validity of the Czech and Slovak Versions of Personal Wellbeing Index

The aim of this study was to investigate the psychometric properties of the Slovak and Czech versions of the Personal Well-beingIndex (PWI) in population of nurses. The sample for study consisted of 1043 hospital staff nurses from 12 hospitals in the Czechand Slovak Republics. The data were collected using a set of questionnaires that included the Positive Affect Scale, the NegativeAffect Scale, and PWI. The PWI demonstrated good psychometric properties in terms of its factor structure, reliability, convergentand construct validity

Psychometric Testing of Perceived Implicit Rationing of Nursing Care (PIRNCA)

AimsTo evaluate the psychometric properties of the Perceived Implicit Rationing of Nursing Care (PIRNCA) instrument and to report the prevalence of rationed care at university and faculty hospitals.DesignA cross‐sectional study.MethodsThe study was carried out at two university and five faculty hospitals in the Slovak Republic. Participants were 895 Registered Nurses recruited by the purposive sampling method between December 2017–July 2018. Data were collected using the PIRNCA instrument. Construct validity and reliability of the instrument were tested.ResultsThe prevalence of rationed care at university and faculty hospitals was identified as being 42.1%. Furthermore, 87.6% of nurses reported rationing one or more nursing care activities. Using both statistical methods when evaluating the PIRNCA resulted in the confirmation that the tool is valid and reliable.ConclusionRationed care is a common phenomenon at university and faculty hospitals. The PIRNCA is a suitable instrument to measure the phenomenon in adult acute care units because of its high reliability and validity. We recommend using the instrument in different contexts, not only for specific conditions that were presented for this study.ImpactRationed care at university and faculty hospitals has never been reported. Psychometric properties of the instrument that measures nurses´ perception of rationed care have never been evaluated by using different approaches. The most frequently rationed nursing care activities are those that nurses are competent to initiate on the basis of their knowledge and skills – the independent ones. The PIRNCA is a valid and reliable instrument. Hospital management can use the instrument to explore the prevalence of rationed care, followed by the application of prevention strategies. Our findings represent the base for further exploration of rationed care using the PIRNCA.</p

Hospital safety climate from nurses' perspective in four European countries

Background: Nursing shortages, the substitution of practical nurses for registered nurses, an ageingworkforce, the decreasing number of nurse graduates and the increasing migration of young nurses areimportant factors associated with the hospital safety climate in Central European countries.Aims: The aim of the study was to investigate nurses’ perceptions of the safety climate in four selectedcentral European countries (Croatia, the Czech Republic, Poland and Slovakia) and to determine therelationship between safety climate and unfinished nursing care.Methods: A cross-sectional study was used. The sample consisted of 1353 European nurses from fourcountries. Instruments used were the Hospital Survey on Patient Safety Culture and the Perceived ImplicitRationing of Nursing Care. Data were analysed using descriptive statistics and multiple regression analyses.Results: Significant differences were found between countries in all unit/hospital/outcome dimensions.‘Perceived Patient Safety’ and ‘Reporting of Incident Data’ were associated with aspects of ‘OrganizationalLearning’ and ‘Feedback and Communication about Error’. Higher prevalence of unfinished nursing care isassociated with more negative perceptions of patient safety climate.Conclusions: Cross-cultural comparisons allow us to examine differences and similarities in safetydimensions across countries. The areas with potential for initiating strategies for improvement in all fourcountries are ‘Staffing’, ‘Non-punitive Response to Error’ and ‘Teamwork across Hospital Units’.Implications for nursing and health policy: ‘Feedback and Communicating about Error’ and‘Organizational Learning - Continuous Improvement’ were the main predictors of ‘Overall Perception ofPatient Safety’ and ‘Reporting of Incident Data’. Therefore, nurse managers should focus on how to empower nurses in these areas in order to foster a no-blame culture and effective reporting. In addition, itis important for policymakers to update nursing education standards in order to address patient safety

Unfinished nursing care in four central European countries

Aim: The main aim of the research was to describe and compare unfinished nursing care in selected European countries. Background: The high prevalence of unfinished nursing care reported in recently published studies, as well as its connection to negative effects on nurse and patient outcomes, has made unfinished care an important phenomenon and a quality indicator for nursing activities. Methods: A cross-sectional descriptive study was undertaken. Unfinished nursing care was measured using the Perceived Implicit Rationing of Nursing Care questionnaire (PIRNCA). The sample included 1,353 nurses from four European countries (Croatia, the Czech Republic, Poland and Slovakia). Results: The percentage of nurses leaving one or more nursing activities unfinished ranged from 95.2% (Slovakia) to 97.8% (Czech Republic). Mean item scores on the 31 items of the PIRNCA in the total sample ranged from 1.13 to 1.92. Unfinished care was significantly associated with the type of hospital and quality of care. Conclusion: The research results confirmed the prevalence of unfinished nursing care in the countries surveyed. Implications for Nursing Management: The results are a useful tool for enabling nurse managers to look deeper into nurse staffing and other organizational issues that may influence patient safety and quality of care