Building health literacy in a Polish region: protocol for the POWER project in Lower Silesia

There is a high prevalence of premature mortality and unhealthy lifestyle behaviours in Lower Silesia in Poland (regional capital is the city of Wroclaw). One plausible reason is low health literacy among this population. Health literacy is one of the most important elements of public health and health promotion endeavours. It can be conceptualised as abroad range of cognitive and social skills as well as knowledge needed by an individual to maintain good health, prevent or manage diseases, and effectively engage with healthcare professionals and resources. The Health Promotion Foundation (HPF), in collaboration with regional institutions and organisations, initiated in 2017 a broad initiative to improve health in this region. The overarching aim of the wider programme is to improve the quality of care among primary care patients. The project stream led by HPF aims to improve knowledge and health-related competences in the population of primary care patients in Lower Silesia. It involves (1) needs assessment based on the analysis of data on health status and neds from 50 participating primary care clinics, followed by (2) development of tailored face-to-face workshops that will be delivered by trained public health students, (3) who will be mentored using train-the-trainer approach. It is anticipated that the project will impact on three main areas in the long term. First, it will lead to creation of a package of workshops that could be delivered to other primary care patients. Second, it will create opportunities for students majoring in public health in the region to become directly involved in activities focused on health education and promotion. Three, it is anticipated that the project will lead to improvements in health and wellbeing among the participating patient groups. The present report describes the scope and method of the project

The influence of depression, level of functioning in everyday life, and illness acceptance on quality of life in patients with Parkinson's disease: a preliminary study

Joanna Rosińczuk, Aleksandra Kołtuniuk Department of Nervous System Diseases, Faculty of Health Science at Wrocław Medical University, Wrocław, Poland Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease, and its incidence will increase as the global population ages. Due to the multitude of symptoms, this disease clearly has a significant impact on decreasing quality of life for those with PD. We aimed to evaluate the effect of selected variables on quality of life in people with idiopathic PD treated pharmacologically. Materials and methods: This study was conducted among 50 patients with PD aged 47–85 years. The diagnostic survey method was applied to collect data with the use of the authors’ questionnaire and standardized questionnaires, including, Parkinson’s Disease Questionnaire (PDQ), Beck Depression Inventory, Instrumental Activities of Daily Living Scale, and Acceptance of Illness Scale. The results were statistically analyzed. Results: Analysis of the study material showed that people who were more self-reliant were characterized by lower intensity of depressive symptoms (ρ=–0.567, P=0), were more likely to accept their illness (ρ=0.611, P=0), and assessed quality of life better in each of the studied domains of the PDQ. Illness acceptance correlated with the occurrence of depressive symptoms (ρ=–0.567, P=0) and significantly affected quality of life. Conclusion: Factors such as depression, disease acceptance, and functional capacity have a significant impact on the subjective assessment of quality of life in patients with PD. Evaluation of these factors should be taken into account in the therapeutic process, to minimize their negative impact on quality of life in patients with PD. Keywords: quality of life, Parkinson’s disease, PDQ-39, IADL, BDI, AI

The prevalence of risk factors for cardiovascular diseases among Polish surgical patients over 65 years

Aleksandra Kołtuniuk, Joanna Rosińczuk Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland Background: Cardiovascular diseases (CVDs) are the leading cause of mortality among adults in Poland. A number of risk factors have significant influence on CVD incidence. Early identification of risk factors related to our lifestyle facilitates taking proper actions aiming at the reduction of their negative impact on health.Aim: The aim of the study was to compare the prevalence of CVD risk factors between patients aged over 65 years and patients of other age groups in surgical wards.Material and methods: The study was conducted for assessment and finding the distribution of major risk factors of CVD among 420 patients aged 18–84 years who were hospitalized in surgical wards. Interview, anthropometric measurements, blood pressure, and fasting blood tests for biochemical analysis were conducted in all subjects. Statistical analysis of the material was performed using Student’s t-test, chi-square test, Fisher’s exact test, Mann–Whitney U-test, and analysis of variance.Results: While abdominal obesity (83.3%), overweight and obesity (68%), hypertension (65.1%), hypercholesterolemia (33.3%), and low level of physical activity (29.1%) were the most common CVD risk factors among patients over 65 years old, abdominal obesity (36.2%), overweight and obesity (36.1%), and current smoking were the most common CVD risk factors among patients up to the age of 35. In the age group over 65, the least prevalent risk factors for CVD were diabetes mellitus (14.8%), depressive episodes (13.6%), abuse of alcohol (11.4%), and smoking (7.8%). In the group under 35 years, we have not reported any cases of hypercholesterolemia and a lesser number of patients suffered from diabetes and HTN.Conclusion: Distribution of the major risk factors for CVD is quite high in the adult population, especially in the age group over 65, which can result in serious problems of health and increased rates of chronic diseases, especially CVDs. Keywords: cardiovascular diseases, risk factors, elderl

Evaluation of health care service quality in Poland with the use of SERVQUAL method at the specialist ambulatory health care center

Stanisław Manulik,1 Joanna Rosińczuk,2 Piotr Karniej3 1Non-Public Health Care Institution, “Ambulatory of Cosmonauts” Ltd. Liability Company, 2Department of Nervous System Diseases, Faculty of Health Science, 3Department of Organization and Management, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland Introduction: Service quality and customer satisfaction are very important components of competitive advantage in the health care sector. The SERVQUAL method is widely used for assessing the quality expected by patients and the quality of actually provided services.Objectives: The main purpose of this study was to determine if patients from state and private health care facilities differed in terms of their qualitative priorities and assessments of received services.Materials and methods: The study included a total of 412 patients: 211 treated at a state facility and 201 treated at a private facility. Each of the respondents completed a 5-domain, 22-item SERVQUAL questionnaire. The actual quality of health care services in both types of facilities proved significantly lower than expected.Results: All the patients gave the highest scores to the domains constituting the core aspects of health care services. The private facility respondents had the highest expectations with regard to equipment, and the state facility ones regarding contacts with the medical personnel.Conclusion: Health care quality management should be oriented toward comprehensive optimization in all domains, rather than only within the domain identified as the qualitative priority for patients of a given facility. Keywords: health care service quality, patients’ expectations, qualitative priorities, outpatient health care facilitie

Sociodemographic and clinical factors affecting the quality of life of patients with chronic obstructive pulmonary disease

Joanna Rosińczuk,1 Maria Przyszlak,2 Izabella Uchmanowicz3 1Department of Nervous System Diseases, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland; 2Center of Postgraduate Education for Nurses and Midwives, Warsaw, Poland; 3Division of Nursing in Internal Medicine Procedures, Wroclaw Medical University, Wroclaw, Poland Background: COPD remains a significant challenge for contemporary medicine. It is one of the most common respiratory illnesses and leads to disability as well as deteriorating patient’s quality of life (QOL). Objective: The objective of this study was to determine the impact of selected sociodemographic and clinical factors on QOL and level of illness acceptance (LIA) of patients with COPD.Design: This study was a cross-sectional, prospective, observational study.Patients and methods: The study involved 100 patients (34 women and 66 men) suffering from COPD for at least half a year, treated in the Allergology Clinic at the Department of Internal Medicine, Geriatrics and Allergy, Wroclaw Medical University in Poland. Standardized questionnaires such as Short Form-36 Health Survey, Saint George’s Respiratory Questionnaire, Acceptance of Illness Scale, and COPD Author’s Questionnaire were used to assess QOL and LIA.Results: Among the most significant results, there were no statistically significant differences between the patients’ sex and their QOL and LIA (P>0.05). It has been observed that with an increase in the age of patients, a statistically significant decrease in LIA is observed, especially after 60 years of age (P=0.001). It was found that the higher level of education of the patients was statistically significant in the higher QOL (P<0.05) and in the greater LIA (P<0.05). Interestingly, there was no statistically significant effect of active smoking and overweight on QOL and LIA (P>0.05). Conclusion: Sex of COPD patients does not affect their QOL or LIA, nonetheless, the age decreases the level of QOL and LIA. Higher education improves QOL scores; however, factors such as dyspnea, longer duration of illness, comorbidities, oxygen therapy undertaking, and family burden of respiratory disease affect deterioration of QOL. Keywords: chronic obstructive pulmonary disease, sociodemographic factors, clinical factors, quality of life, QOL, the level of illness acceptance, LIA, chronic illness acceptance, observational study, SF-36, Saint George’s Respiratory Questionnair

Sociodemographic factors affecting the quality of life of patients with asthma

Bartosz Uchmanowicz,1 Bernard Panaszek,2 Izabella Uchmanowicz,1 Joanna Rosinczuk3 1Department of Clinical Nursing, 2Department and Clinic of Internal Diseases, Geriatry and Allergology, 3Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland Background: In recent years, there has been an increased interest in the subjective quality of life (QoL) of patients with bronchial asthma. Patients diagnosed with asthma experience a number of problems with regard to everyday activities and functions, which adversely affects their health-related QoL. Aim: The aim of this study is to analyze the sociodemographic factors affecting the QoL of patients with asthma. Patients and methods: The study comprised of 100 patients (73 females and 27 males) aged 18–84 years (mean age 45.7 years) treated in the Department and Clinic of Internal Diseases, Geriatrics and Allergology, Wroclaw Medical University. All patients with asthma who met the inclusion criteria participated in the study. We used medical record analysis and two questionnaires: the asthma quality of life questionnaire (AQLQ) and the asthma control test. Up-to-date sociodemographic data were collected from all participants, including sex, age, marital status, education, and sources of income. Results: The sociodemographic variables that correlated positively with QoL in all domains of the AQLQ were professional activity and higher education level of respondents. Factors that negatively influenced the AQLQ domains were older age and lack of professional activity. Conclusion: This study shows that age, physical work, and lack of professional activity decreased the QoL in this patient group. It was found that higher education contributes to better QoL scores. Keywords: bronchial asthma, health related quality of life, sociodemographic factor

Clinical factors affecting quality of life of patients with asthma

Bartosz Uchmanowicz,1 Bernard Panaszek,2 Izabella Uchmanowicz,1 Joanna Rosińczuk3 1Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland; 2Department and Clinic of Internal Diseases, Geriatrics and Allergology, Wroclaw Medical University, Wroclaw, Poland; 3Department of Nervous System Diseases, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland Background: In recent years, there has been increased interest in the subjective quality of life (QoL) of patients with bronchial asthma. QoL is a significant indicator guiding the efforts of professionals caring for patients, especially chronically ill ones. The identification of factors affecting the QoL reported by patients, despite their existing condition, is important and useful to provide multidisciplinary care for these patients.Aim: To investigate the clinical factors affecting asthma patients’ QoL.Methods: The study comprised 100 patients (73 female, 27 male) aged 18–84 years (mean age was 45.7) treated in the Allergy Clinic of the Wroclaw Medical University Department and Clinic of Internal Diseases, Geriatrics and Allergology. All asthma patients meeting the inclusion criteria were invited to participate. Data on sociodemographic and clinical variables were collected. In this study, we used medical record analysis and two questionnaires: the Asthma Quality of Life Questionnaire (AQLQ) to assess the QoL of patients with asthma and the Asthma Control Test to measure asthma control.Results: Active smokers were shown to have a significantly lower QoL in the “Symptoms” domain than nonsmokers (P=0.006). QoL was also demonstrated to decrease significantly as the frequency of asthma exacerbations increased (R=−0.231, P=0.022). QoL in the domain “Activity limitation” was shown to increase significantly along with the number of years of smoking (R=0.404; P=0.004). Time from onset and the dominant symptom of asthma significantly negatively affected QoL in the “Activity limitation” domain of the AQLQ (R=−0.316, P=0.001; P=0.029, respectively). QoL scores in the “Emotional function” and “Environmental stimuli” subscale of the AQLQ decreased significantly as time from onset increased (R=−0.200, P=0.046; R=−0.328, P=0.001, respectively).Conclusion: Patients exhibiting better symptom control have higher QoL scores. Asthma patients’ QoL decreases as time from onset increases. A lower QoL is reported by patients who visit allergy clinics more often, and those often hospitalized due to asthma. Smoking also contributes to a lower QoL in asthma patients. Keywords: clinical factors, bronchial asthma, quality of lif

Impact of incarceration in Nazi concentration camps on multimorbidity of former prisoners

Robert K Jablonski,1 Jerzy Leszek,2 Joanna Rosińczuk,3 Izabella Uchmanowicz,4 Bernard Panaszek11Department and Clinic of Internal Diseases, Geriatry and Allergology, 2Department of Psychiatry, 3Department of Nervous System Diseases, Department of Clinical Nursing, 4Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, PolandObjective: To show the extent to which the health of former prisoners was affected by incarceration in extermination camps after 5 and 30 years of leaving the camp, and to determine the etiological factors underlying particular dysfunctions.Methods: Medical records of former prisoners developed in 1950 (n=250) and 1975 (n=120) were then, after several decades, retrospectively analyzed and compared with the control group, randomized and matched according to age, sex, occupation, and environment. None of the subjects in the control group was a prisoner either at a concentration camp or at any other prison or detention facility.Results: Multimorbidity affected mainly the central nervous system (CNS). Five years after leaving a camp, CNS dysfunctions were observed in 66% of former prisoners. Skeletal (42.4%) and cardiovascular system (34.4%) dysfunctions were the second and third most frequent dysfunctions. Thirty years after leaving a camp, the most prevalent coexisting conditions were also found within the CNS (80%), cardiovascular system (58.33%), and skeletal system (55%). Five and 30 years after leaving a camp, multiorgan lesions were found in 21.6% and 60% of survivors, respectively. Multimorbidity was more frequent in a group of prisoners who underwent the state of apathy and depression or who had been incarcerated longer than 24 months. The rate of CNS diseases was four times higher, and the rate of cardiovascular diseases or skeletal system dysfunctions was two times higher, in the study group after 30 years of leaving a camp compared with the control group.Conclusion: The consequences of incarceration in concentration camps manifesting as multimorbidity, premature aging, and dramatic increase in mortality rate are observed in the majority of former prisoners. The multimorbidity mostly affected older prisoners who stayed at a camp for a longer time period.Keywords: concentration camp syndrome, cachexia, low-grade systemic inflammatio