Volumen 124 (2014): Edición 4 (December 2014)

Introduction. Transplantation surgery, involving transplantation of cells, tissues and organs, constitutes a common medical practice that saves the lives of a great number of patients.

Aim. The purpose of the present paper is to provide a comparative analysis of the legal regulations regarding transplantation that are in practice inside three European countries: Poland and Germany - EU Member States - and Switzerland - a non-EU state. The considerations made herein are meant to find an answer to the question whether the provisions of law regarding transplantation in the specified European countries regulate the legal situation of the donor and the recipient in a similar manner.

Material and methods. The paper is based on the following source documents: The Cell, Tissue and Organ Recovery, Storage and Transplantation Act of July 1, 2005; The Act on Donation, Recovery and Transplantation of Organs and Tissues of November 5, 1997 (Transplantation Act - TPG); Federal Act on Transplantation of Organs, Tissues and Cells of October 8, 2004. In our work, we applied two methods, the first being comparative, and the second being dogmatic-legal. The latter consists of analyzing the provisions regarding transplantation as found within the three selected European countries.

Results and Discussion. Under Polish, German and Swiss law alike, the recovery of cells, tissues and organs is allowed from an adult, who, under the Polish and German Acts, has full capacity to enter into legal transactions, and who, under the Swiss Act - is an adult who is mentally competent. Of note is that a minor might only be a donor in ex vivo transplantation provided that precisely specified requirements are met. Of additional note is that, under the German and Swiss Acts, recovery of tissues and organs from a human cadaver donor is allowed only if this person gave consent for such recovery prior to their death; under the Polish Act, this is allowed unless the deceased person expressed their objection when alive.

Conclusion. As far as ex vivo transplantation is concerned, the legal solutions regarding transplantation in Poland, Germany and Switzerland regulate the legal situation of the donor and the recipient of a transplant in a similar way, although there are a few significant differences. As for ex mortuo transplantations - the legal solutions applied in each country greatly differ.

Introduction. The patients in situations of “being ill” have to face not only pain and disabilities, but also problems in their social relationships. Perceptions of illness are results of reactions to the changes in the existential situations, and that these correspond to determined illness coping strategies.

Aim. The aim of the research was to determine the relationships between perception of illness and social support, with the indicators of the adequacy of the renal replacement treatment and the level of urea as a biomarker of disease offset.

Material and methods. The study was conducted on a group of 150 patients who were on chronic hemodialysis, and who were suffering from end stage renal disease. The patients were treated at on of the several Fresenius Medical centres. As a group, average Kt/V value was 1.45 (SD=0.22) and the URR ratio 71.78 (SD=5.95). Moreover, average urea concentration before HD equaled to 133.78mg% (SD=39.68) and after hemodialysis - 38.22mg% (SD=14.60). The research procedure was based on a questionnaire study. This applied three standardized scales: the Imagination and Perception of Illness Scale (IPIS), the brief Illness Perception Questionnaire (IPQ-Brief) and the Berlin Social Support Scale (BSSS).

Results. Patients who exhibited higher values of urea concentration in the blood serum measured before HD, perceived their disease (IPIS scale) as causing more motivation loss to carrying out specific activities, as well as mental and physical sphere destruction, pessimism and lost control over the disease. What is more, higher values of urea reduction ratio (URR) positively correlate with the loss of control over the disease (r=-0.20, p=0.024). Moreover, patients characterized by higher values of urea concentration in the blood serum before hemodialysis, evinced greater need for social support (BSSS).

Conclusions. The need for social support among ESRD patients treated by hemodialysis does not correlate with dialysis adequacy indicators. Furthermore, the level of urea marked before hemodialysis exhibits an interdependence with psychological determinants of illness perception and social support.

Introduction. Self-efficacy is one of the most important determinants of behavior of adults and adolescents. The degree of self confidence attributable to oneself in order to overcome the difficulties of life and to achieve one's goals, both in healthy subjects and patients, determines the size of the effort and perseverance in taking action. According to The World Health Organization till 2020, chronic diseases will be the major cause of disability, and can be one of the most costly health problems. Therapy of chronic illness on the threshold of adult life requires, in addition to a comprehensive medical approach, the patient's active participation in the implementation of the treatment process. Therefore, the potential of young people entering adult life with the burden of diagnosed disease may indicate the direction of education of the chronically ill adolescents.

Aim. The aim of this study was to assess the potential of young people, both healthy and diagnosed with a chronic disease, to overcome difficulties of life.

Material and methods. The study used a questionnaire and KompOs scale (Personal Competence Scale), a standardized test in the field of Health Psychology. The study included 80 subjects aged 15-18 years, 40 patients with inflammatory bowel disease treated in the IP-CZD in Warsaw and 40 healthy students from Rzeszow. The study used a questionnaire and KompOs scale (Personal Competence Scale), a standardized test in the field of Health Psychology. It allows the evaluation of such features in subjects such as strength and endurance needed to take action and then to continue it.

Results. For young people despite of their health state the age of majority is mainly associated with a sense of autonomy, pursuing the job and the sense of responsibility for themselves and their families, without arousing fear in any of those groups. Parents of adolescents with IBD, however, still show too excessive protectiveness, and only 32.5% of children has a different view on that in comparison with 82.5% a group of healthy children. The sum of the results obtained on a scale KompOs, in both studied groups is at the same level of average values, (6 sten). The differences can be seen in correlation with sociodemographic characteristics such as: place of residence, financial situation or fertility families. Youth without chronic disease burden had the average level of self-efficacy (sten 6), whereas young patients diagnosed with IBD had a higher sense of efficacy (sten 7). Children with IBD, residing in large cities, have a higher average number of points in both the overall scale and subscales KompOs like (strength, endurance) than their healthy peers.

Conclusions. Young people with non-specific inflammatory bowel disease have a greater sense of strength and perseverance than their peers. The statistical significance between the number of points was obtained in the KompOs scale in the city of <100 thousand. The financial situation of families is different in both groups, especially in the persistence subscale.

Introduction. In recent times, patient outcome measurement has developed from being narrowly focussed upon levels of symptomatology and service use, to being a broader assessment of the impact of illness and treatment on the individual. Thus, it can be said that quality of life has become as significant as life expectance. This has brought about a transition in the assessment of treatment. Quality of life (QOL) is a multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life as it is being led. With regard to healthcare, a cross-sectional comparison of palliative care needs is crucial in understanding differences in the patients' quality of life. Hence, an analysis of programme implementation within different types of healthcare institutions is significant in evaluating current medical care standards. Our study analyzed the satisfaction level and quality of life of patients with Chronic Obstructive Pulmonary Disease (COPD), and after myocardial infarction (MI). Different types of healthcare institutions were evaluated.

Aim. To evaluate patients' satisfaction and quality of life in selected healthcare institutions in southern-eastern Poland.

Material and methods. The quality of life of patients with Chronic Obstructive Pulmonary Disease (COPD) was analyzed through the medical documentation obtained from different types of healthcare institutions. Among these are the pulmonary outpatient department in Moczary, as well as a GP Practice and a Nursing Home in this location. The quality of life of patients after myocardial infraction was analyzed through a survey study conducted at “Polonia” hospital spa in Rymanów Zdrój (the cardiology department).

Results and conclusions. The post-myocardial infarction incident patients had began to care more about their health condition and the quality of life they led. Moreover, their satisfaction level from received treatment and medical care indicated that the cardiological services implemented in southern-eastern Poland has proceeded in a good direction. Of note, these patients were systematically under specialist control. In contrast, among patients with COPD, only those under everyday care in the Nursing Home in Moczary received a similar systematic treatment, thus, COPD patients in Moczary lead a poor quality of life. This indicates a need to re-evaluate the current programmes and services provided by health care institutions in this region.

Introduction. Cardiovascular diseases are the leading cause of premature death in Europe. In Poland, the percentage mortality is 2, 5 times higher than in Western European countries.

Aim. To assess patients' knowledge of the need for diet and physical activity after cardiac surgery. Material and methods. The study involved a group of 150 patients after cardiac surgery. The research was conducted at the Department of Cardiac and Vascular Surgery, University Clinical Centre in Gdansk. The study used a questionnaire of our own design.

Results. Over half of the respondents stated that they had an average amount of knowledge with regard to healthy eating, while one in four had a less than average level of knowledge, and 16% opined that they had a superior knowledge of the same. These results are dependent on age and degree of formal education, and to adherence to dietary recommendations of gender, to financial situation and marital status. With regard to average dietary adherence, more women than men properly identified products harmful to human health. These last results bore little correlation to place of residence or degree of formal education. In addition, slightly more than half of the respondents (55.3%) practiced some sort of physical activity, but up 44.7% does not do any. More active were women and younger people (of both sexes), and those with higher degrees of formal education.

Conclusions. Knowledge of patients with regard to diet after cardiac surgery is dependent on age and degree of formal education, and to adherence to dietary recommendations of gender, to financial situation and marital status. However, formal education and place of residence does not have a significant impact on the level of knowledge of products that are harmful to human health and behavior. Both sex, place of residence and degree of formal education have an impact on level of physical activity in general, as well as on its individual manifestations. More active are women, younger people and those with higher formal education.

Introduction. Rational nutrition of women during pregnancy has a great influence on the developing fetus. In the properly developing pregnancy, woman should eat 3-4 quality meals per day. What is more, for the proper development of the fetus, as well as the placenta, uterus and the mammary gland, it is necessary to consume high-value protein products. Moreover, vitamins and mineral compounds are important due to the serious implications that arise if not properly provided.

Aim. The aim of the paper is to assess the nutritional practices, the level of knowledge held by pregnant women with respect to proper nourishment practices, and to define the influence of level of formal education achieved upon this issue.

Material and methods. The research involved 87 pregnant women who were under the care of the outpatient women's health centre and high-risk pregnancy unit of the Regional Specialist Hospital in Biała Podlaska.

Results and discussion. According to most of the female respondents, information concerning proper nutrition of pregnant women is not generally available. Because of this, in completing the questionnaire, more than half of the subjects stated that they often consume white bakery products, white rice and refined pasta - with insufficient consumption of brown bread, rice and wholemeal pasta. Furthermore, while the respondents seem to consume the proper amount of potatoes, barely 8% consume other vegetables with the advised frequency. Moreover, only 31% of the respondents take-in fruits in necessary quantities. However, a majority of them frequently consume milk, yoghurt, cheese, kefir and buttermilk; plus, more than half of the respondents drink at least 1-2 litres of various kinds of liquids per day. Our results also reveal that they very rarely consume fresh fish, poultry and red beef meat, preferring cooked products. Indeed, the respondents stated that they consume meat and fish mainly in a fried form, while 52.9% of the women take-in fast food products. Of note, the surveyed women prefer animal fats. In addition, nearly 70% of the subjects consume too many eggs. Furthermore, more than 40% consume an excessive amount of sugar and sweets. To conclude, the proper amount of meals is consumed by only 52.7% of the respondents, no matter their formal education level.

Conclusions. Many abnormalities were found while verifying negatively the hypothesis, according to which, level of formal education achieved has an impact on the increase of consciousness in terms of proper nourishment during the pregnancy.

Introduction. Performance management is a crucial concept in the broader field of human resource management. In accordance with its principles, in defining a professional role, its aim must be included. In addition, key results areas and crucial competencies must be stated. The professional role of a nurse with regard to pregnancy and pre-natal care, is defined by way of the set of functions fulfilled. The role of a midwife and her competencies are, however, in this situation, much broader.

Aim. The aim of the conducted research was to determine the roles played by both nursing and midwifery staff in ensuring a healthy pregnancy and delivery by way of their patients' assessment.

Material and methods. The research was conducted in the Obstetrics and Gynaecology unit, in the Regional Specialist Hospital in Biała Podlaska, and it involved 40 pregnant women.

Results and discussion. Our study reveals that what the subject women need the most from the nursing and midwifery staff, is emotional support. What is more, the dominant majority connects their expectations as to the fulfilment of the roles played by nursing and midwifery staff to an increase in information support.

Conclusion. The obtained results allow a defining of the aim of the professional roles of nurses and midwives in supporting and assisting the pregnant, as well as identifying their key results areas and crucial competencies from the patients' point of view. In comparing our own study results to that involving patients' opinions (gained by way of a study conducted in the obstetrics and gynaecology unit, by the quality care assessment section of the Regional Specialist Hospital in Biała Podlaska), it can be stated that there is continuous positive growth in the quality of service provided by nurses and midwives.

Introduction. Vaccinations against varicella and pneumococcal infection are an important form of prevention of infectious diseases and their possible complications.

Aim. Assessment of the vaccination control of children against varicella, and pneumococcal infection based on selected institutions of family practice physician.

Material and methods. There were verified 807 immunization cards of children from three vaccination offices, selected at random from the area of the southeastern Poland, i.e. the provinces of Lubelskie, Podkarpackie and Świêtokrzyskie. Based on the results of quantitative analysis of medical records of vaccination carried out in these institutions through 2007-2012, the number of children vaccinated against varicella, and pneumococcal infection was assessed.

Results. The largest number of vaccinated children (against pneumococcal infection - 148 children and 84 against varicella among 335 subjects reporting in the facility) was confirmed in health care unit in Lublin. In health care unit in Podkarpackie the number of vaccinated children against pneumococcal infection was 84 and against chicken pox - 52 among 256 children using the medical services. In health care unit in Świêtokrzyskie, 65 children were vaccinated against pneumococcal infection and 34 against varicella among 216 subjects reporting at the institution. The vast majority of these vaccines (431 - including three centers) was paid by parents.

Conclusions. 1. In all of the centers, a higher proportion of children was vaccinated against pneumococcal infection than chickenpox. 2. There was not a marked increase in the number of children vaccinated against varicella and pneumococcal infection during the analyzed period.

Introduction. Poland is among the top ten countries of the European Union displaying the highest intensity of smoking.

Aim. To evaluate the frequency and intensity of smoking, the strength of nicotine addiction and the motivation to discontinue smoking, among students of the Academy of Physical Education.

Material and methods. First, a survey involving an anonymous questionnaire (which included both the Fageström and Schneider tests), was conducted within a population of 276 students. Next, this was analyzed statistically using the Statystica 7.1 program.

Results. The initial results of this research showed that 29, 71% of all respondents smoke cigarettes. Moreover, the applied Fageström test revealed that the test population was either: slightly addicted (44, 72% of all respondents), moderately addicted (34, 84% of all respondents), or heavily addicted (17.44%).

Conclusions. The prevalence of smoking among students of the Academy of Physical Education remains alarming. Furthermore, the negative health behaviors contribute to an adverse overview of the health of the questioned students.

Introduction. Alcohol is found to contribute to everyday life of young people. Frequent heavy drinking, violent behavior under influence of alcohol are typical for youths. Unreasonable over-consumption of alcohol might have direct impact on their health in adulthood, as initially controlled amount of alcohol drinking can gradually lead to abuse and further, to alcohol addiction.

Aim. The aim of the study was to evaluate the prevalence of alcohol consumption and to notify knowledge of the harmful effects of alcohol on human body.

Material and methods. The study was conducted among 276 fifth-year students (including 206 men and 70 women). Students filled out an anonymous questionnaire containing AUDIT test.

Results. Risky model of alcohol consumption was observed among 75.72% of students whereas alcohol-addicted group accounted for 1.81%. The remaining group of students (22.47%) was reported as harmful alcohol consumption model. Beer was the most often consumed alcohol.

Conclusions. Abstinence from drinking alcohol is a rarely observed phenomenon among students of the Academy of Physical Education. Future PE teachers should be urgently motivated to educate and to encourage youths about healthy life style.

Introduction. As these define the status of the patient during the provision of health services, patients' rights are a very important component of Poland's medical law. The observance of these rights is a prerequisite for the proper performance of the nursing profession. Theoretical and practical preparation in this area is thus already a necessity in the students' education process.

Aim. The aim of the study was to analyze the opinions and attitudes of nursing students with respect to problems in the field of the observance of the rights of patients in Poland.

Material and methods. The study was built upon the opinions expressed by 375 students (362 women and 13 men) of the first and second year. These were full-time and part-time students in master's studies in nursing, of the Faculty of Health Science, Medical University of Warsaw. The study employed a qualitative and quantitative analysis of the content of essays.

Results. The results of the study indicate that 59 percent of the respondents report being frequent witnesses of violation of patient's rights. In particular, that which noted were the rights to privacy and dignity (98%), to receive sought-after information (91%) and to suitable health-care (85%). Another right seen to have been violated in the respondents' workplace was the patient's right to the maintenance of the confidentiality of patient-related information by medical personnel (77%). The respondents, while seeing violation of the patient's rights by other employees, declared their own adherence to these rights in their own professional practice.

Conclusions. 1. The majority of the study group repeatedly witnessed violation of patients' rights. It would, therefore, be advisable to monitor the observance of the rights of patients by medical personnel, and to see to the professional liability of those who flagrantly breaking the law. 2. Research findings indicate that ethics should be given more emphasis in teaching future health professionals in the course of their medical studies. 3. The analysis of the available literature and our own study show that the share of medical personnel in providing information about the patients' rights is minimal. It would be advisable for medical personnel to be given an opportunity to acquire new skills and competences in this field. 4. Awareness of the existence and knowledge of the patient's rights, not only among medical students and health professionals, but also among patients, is crucial to their observance by the former and their exercise by the latter. It should, therefore, be spread and raised. 5. Training and thematic courses in patient's rights should be provided in order to enable medical personnel to acquire new skills and competences in this field, with the end result of improving their observance of patient's rights. 6. A qualitative analysis constitutes an innovative and effective way of carrying out research and interpreting research findings, being a valuable and reasonable method of conducting a survey, and in exploring the attitudes of students and health-care workers towards patient's rights.

The article presents the role of government and non-government organisations in promoting knowledge on Alzheimer's disease in Poland and the European Union. There is a detailed analysis of the EU documents and non-government organisations in promoting knowledge on Alzheimer's disease in Germany, France and Holland. There is a discussion on the National Alzheimer's Plan on the basis of an example of introducing such a plan in Finland. Additionally, the rules of helping people suffering from Alzheimer's disease and their attendants in Poland are presented.