Care In Poland Research Articles

Attitudes of psychiatric nurses towards aggression: A polish study.

Mental health care in Poland lags behind that of many other countries, and coercive measures are used on a regular basis. Scant research has been conducted in Poland regarding the treatment of psychiatric patients. The perspectives of Polish psychiatric nurses towards aggression remain unknown. WHAT DOES THIS PAPER ADD TO THE EXISTING KNOWLEDGE?: The translated and validated Attitude Towards Aggression Scale (ATAS) in Polish will serve as an instrument that gauges Polish nurses' attitudes towards aggression. The Polish nurses have unenlightened and negative attitude towards aggression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is now an instrument in Polish by which we can gauge the attitudes of mental health nurses, which must precede any educational efforts.Polish nurses showed more restrictive and antiquated attitudes about patient violence than nurses in some other parts of the world. With a shift to more positive attitudes, the use of coercion could be reduced, resulting in improved patient care. In Poland, the mode and site of patient treatment have changed little in the past 75years, despite therapeutic advances worldwide. There is limited information regarding attitudes of nurses towards aggression in psychiatric settings in Poland, nor has there been an instrument in Polish to measure it. To translate and validate the Attitudes Towards Aggression Scale (ATAS) for use in Poland, and to assess the attitudes of three groups of nursing personnel towards aggression. We surveyed 980 psychiatric and general nurses as well as nursing students. We translated the ATAS into Polish, and validated it using exploratory factor analysis. The Polish version of the ATAS showed good psychometric properties. We found that Polish nurses perceived patient aggression extremely negatively. Polish nurses perceive aggression as destructive, negative and not to be tolerated, leading to use of restraints. Among the three groups, psychiatric nurses showed the most negative attitude towards aggression. Thus, education is needed for preservice and inservice nurses alike to address this issue. We now have a validated instrument to assess nurses' attitudes about aggression. We also know that Polish nurses have exceedingly negative attitudes towards aggression. The Polish version of ATAS was found valid and reliable. Therefore, we can now measure the attitudes of Polish nurses towards aggression, which was not possible previously.The baseline data provide a starting point from which to determine effects of educational efforts.

How Innovation Cooperation Supports the Improvement of Health Care in the CEE Region: The Case of ECMO for Greater Poland

Purpose: The main aim of this article is to present the development of innovation cooperation in the biopharmaceutical industry in the Central and Eastern Europe (CEE) region. Design/Methodology/Approach: The authors present the role of R&D Innovation Ecosystem in the biopharmaceutical industry in the improvement of patient care in Poland. The article presents the results of qualitative research – focus group interview with representatives of the “ECMO for Greater Poland” program within the research grant of the National Science Centre (Poland) entitled “Analysis of Open Innovation Alliances and Strategic Partnerships in the Biopharmaceutical Industry in Poland and CEE countries”. Findings: The authors present their own observations, contributions to the creation process and successful “ECMO for Greater Poland” program development. Practical implications: It should be considered that nowadays due to pandemic COVID-19 the cooperation of all entities in the whole biopharmaceutical R&D innovation ecosystem is even more challenging and with high level of complexity. Originality/value: R&D cooperation between academia, institutions and business can significantly increase the likelihood of creating better medical therapy for patients.

A checklist-based method for improving COPD care for the elderly in general practice: study protocol for a cluster randomized controlled trial using electronic health records

BackgroundThe third most frequent chronic condition, and the fourth most common cause of death, in Poland is chronic obstructive pulmonary disease (COPD). The diagnosis and treatment of COPD is the responsibility of the general practitioner (GP); the GP also serves as gatekeeper, referring patients to the other levels of public health care system when necessary. Undertreatment of COPD can result in a greater frequency of exacerbations and hospitalizations. Elderly patients require special attention due to the increased prevalence of COPD and systemic comorbidities. However, both the occurrence of exacerbations and the quality of life of the patients may be improved by developing and implementing guidelines for practice and ensuring their adherence. This proposal concerns the development of a checklist-based educational program to assist general practitioners in managing COPD patients.MethodsNo less than eighty-four general clinics in the Lodz region, Poland (28 clusters in each of three study arms), will be identified, randomized, and included in the trial. The trial will be based on anonymized data in electronic health records within the national public health care system.The educational intervention program will consist of GPs in two intervention arms being provided with a COPD management checklist: those in the first intervention arm with receive the checklist once at the beginning, while those in the second with receive it twice. The third (control) arm receives standard care without the checklist.The study used the International Code of Diseases (ICD)-10 for COPD. The primary aim is to determine the effect of interventions delivered to general practitioners (GPs) in primary health care. These interventions are aimed at decreasing the hospitalization of elderly patients with medical code J-44 (COPD) as the main reason for hospital admission.DiscussionThe results of this trial will be directly applicable to primary care in Poland and add new data to the growing body of evidence regarding interventions aimed at improving chronic illness care.Trial registrationThis trial has been registered with the Clinical Trials Protocol Registration System. Please see in ClinicalTrial.gov identifier (NCT Number): NCT04301505. Registered on 10 March 2020.

Polycystic Ovary Syndrome and Endometriosis as Reasons for Women's Admission to Outpatient Specialist Care in Poland-A Retrospective Analysis.

This study aimed at presenting selected aspects of outpatient specialist care for women diagnosed with polycystic ovary syndrome (PCOS) or endometriosis. The study was carried out using a retrospective analysis of the services provided under Outpatient Specialist Care (AOS) for women, based on data from the National Health Fund (NFZ). The study included data on women with PCOS or endometriosis based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) in Poland from 2016 to 2018. The average age of women in the study group with PCOS was 25.31 (±7.02) years and, for those with endometriosis, 38.21 (±10.79). AOS patients with diagnosed PCOS most often made 2–3 visits (34.60%) to a specialist doctor, and those with diagnosed endometriosis most often made one visit (39.95%). Significant differences between patients with PCOS and endometriosis using AOS were found concerning the women’s age, the year, season, place of treatment, type of clinic, mode of admission, number of visits, and their place of residence or macroregion. With increasing age, women with PCOS made more visits to AOS, and women with endometriosis made fewer visits to the AOS specialist.

Модели и правовое регулирование здравоохранения в Польше и Италии

Goal – the paper assessed (main objective) the assumptions of the selected models and legislation regulating health care in the studied countries and examined their impact on the implementation of the constitutional guarantee of access to health services (specific objective). Research methodology – the descriptive method was mainly used, with elements of system‑legal and formal‑legal analysis, as well as cause‑and-effect analysis. Score/results – main hypothesis was negatively verified (the assumptions of adopted models of health care in Poland and Italy lead to the improvement of constitutional guarantee of access to health services), while the specific one was positively verified (adopted conditions have a significant impact on the functioning of health care in Italy and Poland, in particular during the COVID‑19 pandemic). Originality/value – organise and systematise the healthcare reality described.

QUALITY OF SERVICES PROVIDED BY SILESIAN HEALTHCARE INSTITUTIONS DURING THE COVID-19 PANDEMIC – RESULTS OF THE SURVEY

Purpose: The purpose of this article is determine the level of medical services quality provided by medical clinics during the COVID-19 pandemic. Design/methodology/approach: The research was based on analyzing the results of a survey conducted among patients of Silesian clinics. First, a survey sheet was designed using the SERVQUAL model. The next step was to conduct a study in clinics in Silesia. As part of the study, 50 patients’ survey votes were received and analyzed. Findings: Respondents rate the state of health care in Poland as good, telehealth should be reserved for those in quarantine, and should be conducted only when prescriptions are being written, not when diagnosing a patient, respondents pointed out that medical facilities provided meeting conditions that did not expose patients to COVID-19 infection, hence it seems unjustified to use tele advice for patients not under compulsory quarantine. Research limitations/implications: The main research limitation is the number of feedback surveys received. If there were more votes, the research sample could be even more credible. Practical implications: The study was conducted in times of a real epidemiological threat. The results of the study show how, in a group of 50 patients, the key aspects related to the provision of medical care in Silesian healthcare institutions are perceived. Social implications: Patients’ observations regarding the functioning of the health care system in times of a pandemic and the key aspects related to ensuring access to this care are extremely valuable tips that may improve the standard of medical care in Poland also during possible future pandemic waves. Originality/value: Carrying out a literature analysis indicated that there were no studies conducted among patients so far. Thus, the research gap was defined. The authors decided to conduct the study directly among patients by sending the sheets to medical clinics.

The midwife’s role in lactation care in Poland

The midwife’s role in lactation care in Poland

Czas oczekiwania na postawienie diagnozy i rozpoczęcie leczenia w przypadku złośliwego nowotworu piersi oraz wpływ pomiaru na poprawę standardu realizowanych świadczeń

Waiting Times for Diagnosis and Treatment in Breast Cancer and the Impact of Measurement on the Improvement of the Standard of Services Provided Mortality rates for malignant breast cancer are rising in Poland. This is a subject of growing concern and a focus of public debate about cancer care in Poland. The following paper presents a case study—an attempt to measure and analyze waiting times for diagnosis and treatment in breast cancer. The survey was carried out in one of the regional cancer care centers in Poland. The data were collected solely from hospital information systems. The overall waiting time (mammography to treatment) was median 35,5 days. Waiting time since diagnosis (results of core needle biopsy to treatment) was median 27,5 days. The analysis has been conducted twice. In between the center implemented several organizational changes. They resulted in shortening of waiting time for mammogram description—from 4 to 1 day (median) also the waiting times for core needle biopsy result has been shortened—from 6 to 4 days (median). However, the overall waiting time has not changed significantly.

Developing and Testing an Instrument to Evaluate Integration in Health Care

The aim of this study is to identify the attributes of integration in health care and to build a cluster of indicators to assess the degree of integration based on the elements diagnosed. The study adopted a qualitative mixed-method approach to collect data. First, two rounds of a Delphi study involving health care experts were conducted. Next, an individual in-depth interview (IDI) with the manager of a selected health care network was performed. Our findings suggest that quality-oriented health care integration can be described by nine clusters of indicators: Formal integration, Information integration, Supporting the patients and their environment, Clinical decision support, Patient-centred care, Managing the patient’s "treatment pathway", Cross-sectoral cooperation, Coordination of activities, and Soft elements fostering trust and commitment.The proposed framework can be used to evaluate the stage of the integration of health care programmes. Therefore, it can be treated as a methodical background for decision support systems (DSS) in health care settings. Moreover, it could be helpful in assessing the quality orientation of health care entities and networks, especially as regards the issues of chronic patients. To the author’s best knowledge, the present study is the first empirical research into the indicators of quality-oriented health care in Poland.

Changes in maternity care in Poland perceived by midwives working in the SARS-CoV-2 pandemic. A preliminary study

Changes in maternity care in Poland perceived by midwives working in the SARS-CoV-2 pandemic. A preliminary study

Problems related to gynaecological and obstetric care in Poland—selected issues

Problems related to gynaecological and obstetric care in Poland—selected issues

The actual number of children and young people in institutional care in Poland and the challenges of the deinstitutionalization process

Celem artykułu jest zaspokojenie zapotrzebowania na dane dotyczące liczby dzieci i młodzieży przebywających w instytucjonalnych formach opieki całkowitej w Polsce. Dane te są konieczne do ustalenia skali niezbędnych do podjęcia działań, aby możliwe stało się przejście od opieki instytucjonalnej do opieki rodzinnej, świadczonej w środowisku lokalnym. Głównym problemem związanym z analizowaniem uwarunkowań deinstytucjonalizacji w zakresie wspierania dzieci i młodzieży oraz z planowaniem tego procesu jest całkowite pomijanie – zarówno w profesjonalnym dyskursie, jak i w statystykach – osób przebywających w instytucjach długoterminowej opieki całkowitej nienależących do systemu pieczy zastępczej. W artykule przedstawiono konsekwencje takiego podejścia oraz zaprezentowano wyniki oszacowania liczby osób w wieku 0–24 lat przebywających w instytucjach świadczących długoterminową opiekę w systemach pomocy społecznej, edukacji i zdrowia. Z przeprowadzonych badań wynika, że skala instytucjonalizacji dzieci i młodzieży w Polsce jest znacznie niedoszacowana, gdyż w 2019 r. w zależności od przyjętych kryteriów kwalifikacji instytucji, co do typu świadczonej opieki, znajdujące się w nich dzieci i młodzież stanowiły 20–35% wszystkich osób umieszczonych poza rodzinami pochodzenia. Dolną granicę tego oszacowania wyznacza udział dzieci i młodzieży umieszczonych w placówkach systemu pieczy zastępczej (blisko 17 tys. osób), a górną – suma wszystkich osób w wieku 0–24 lat przebywających w instytucjach opieki całkowitej, w tym m.in. w domach pomocy społecznej czy instytucjach opiekuńczo-leczniczych (niemal 30 tys.).

Quality of Pharmaceutical Services in Independent Pharmacies and Pharmacy Chains in Poland from the Patient Perspective.

IntroductionPatient satisfaction is a key factor in the evaluation of the quality of healthcare services. Measuring patient satisfaction is common in outpatient, specialist, and hospital healthcare, and is also significant in relation to pharmaceutical services. The pharmacy market in Poland has been undergoing transformations for many years. Legal regulations implemented in 2002 resulted in a rapid growth of pharmacy chains and a decrease in the number of independent pharmacies. This situation may have translated into changes in the quality of pharmaceutical services.ObjectiveThe objective of this study was to evaluate patient satisfaction with services provided in independent pharmacies and pharmacy chains in Poland.Patients and MethodsA total of 163 patients using randomly selected community pharmacies in Poland were enrolled in the study. A modified Community Pharmacy Patient Questionnaire (CPPQ) was used.ResultsThe patients highly valued pharmaceutical services provided in Polish pharmacies. The level of service was slightly higher in pharmacy chains. The lowest-rated area was the provision of information on medications, with independent pharmacies higher-rated in this respect. The patients were open to additional services in pharmacies and supported the development of pharmaceutical care.ConclusionIndependent pharmacies and pharmacy chains ensure a similar level of services for patients in Poland. Pharmacy staff should place a special emphasis on providing patients with comprehensive information on medications. The development of pharmaceutical care in Poland will require appropriate legislative preparation.

Impact of SARS-CoV-2 pandemic on bariatric care in Poland: results of national survey

BackgroundThe SARS-CoV-2 pandemic has reached Poland on March 4th, 2020 and undoubtedly affected all areas of life and medical care, including bariatric care. The study was planned to identify the impact of the SARS-CoV-2 pandemic on bariatric care in Poland.MethodsThe online survey was designed and distributed to bariatric surgeons. The questionnaire was divided into three parts: demographic characteristics of participants and their bariatric centers, examining the impact of the pandemic on the bariatric care and last part with questions about planned care after the pandemic.Results49 surgeons participated in the survey. 27 (55%) participants worked in hospitals transformed into COVID-dedicated units. Only 9 (18%) respondents declared uninterrupted bariatric surgery during a pandemic. 91% of surgeons declared continuation of bariatric care with telemedicine techniques. All participants declared a high willingness to resume bariatric surgery after the SARS-CoV-2 pandemic and responded that bariatric procedures should resume immediately when World Health Organisation (WHO) announces the end of a pandemic regardless of oncological treatment. 90% of respondents believe that the pandemic will not affect the safety of bariatric procedures in the future.ConclusionsAccess to bariatric care during the pandemic is limited and redirected to telemedicine. Surgeons are ready to resume bariatric operations immediately after the pandemic, but its end is difficult to determine. In surgeons’ opinion pandemic will not affect the safety of bariatric surgery in the future. The extended waiting list and financial aspects will be the main issues after the pandemic.

Surgical care in Poland after COVID-19 outbreak: a national survey.

B a c k g r o u n d: During COVID-19 pandemic, it is necessary to collect and analyze data concerning management of hospitals and wards to work out solutions for potential future crisis. The objective of the study was to investigate how surgical wards in Poland are managing during rapid development of the COVID-19 pandemic. M e t h o d s: An anonymous, online survey was designed and distributed to surgeons and surgery residents working in surgical departments during pandemic. Responders were divided into two groups: Group 1 (responders working in a "COVID-19-dedicated" hospital) and Group 2 (responders working in other hospitals). Results: Overall, 323 responders were included in the study group, 30.03% of which were female. Medical staff deficits were reported by 21.15% responders from Group 1 and 29.52% responders from Group 2 (p = 0.003). The mean number of elective surgeries performed weekly prior to the pandemic in Group 1 was 40.37 ± 46.31 and during the pandemic was 13.98 ± 37.49 (p < 0.001). In Group 2, the mean number of elective surgeries performed weekly before the start of the pandemic was 26.85 ± 23.52 and after the start of the pandemic, it was 7.65 ± 13.49 (p <0.001). There were significantly higher reported levels of preparedness in Group 1 in terms of: theoretical training of the staff, equipping the staff and adapting the operating theater to safely perform procedures on patients with COVID-19. Overall, 62.23% of responders presume being infected with SARS-CoV-2. C o n c l u s i o n s: SARS-CoV-2 pandemic had a significantly negative impact on surgical wards. Despite the preparations, the number of responders who presume being infected with SARS-CoV-2 during present crisis is high.

Post-myocardial transitional care in Poland - single centre experience with novel Coordinated Comprehensive Care programme – clinical and laboratory follow-up

Abstract Background Cardiac rehabilitation (CR) is an inherent part of the transitional care after acute myocardial infarction (AMI). Polish health care system has created a novel Coordinated Comprehensive Care Program after AMI, which ensures outpatient follow-ups, further invasive treatment and free-of-charge CR for all patients after acute MI. Purpose The aim of the study was to analyze the impact of CR on clinical and laboratory characteristics of the patients who completed the recommended programme. Methods 118 participants were enrolled. They were divided into two groups, depending on the criterium of completion (rehabilitation group) or non-completion (no rehabilitation group) of the CR. The clinical and laboratory data at discharge and after 12 months were collected and analyzed in both groups. Results The majority of the patients (n=83, 70,3%) underwent CR. This group was younger in comparison to patients who did not participate in CR (63.0±8.6 vs. 69.8±8.7 years; p&amp;lt;0.01). Index hospitalization was significantly shorter in rehabilitation group (7 vs. 8 days, respectively; p&amp;lt;0,04). LDL-C reduction was observed in both groups, but only rehabilitation group presented statistically significant reduction (median LDL at discharge 108,5 vs. 67,0 mg/dl at follow-up; p&amp;lt;0.01). No rehabilitation group had LDL-C non-significantly decreased (p=0.16). NT-proBNP decreased in both groups over 12 months, but only rehabilitation group had significant reduction (median 590,0 pg/ml at discharge vs. 199,0 at follow-up; p&amp;lt;0.01). Laboratory follow-up is summarized in Figure 1. BMI increased in both groups, with statistical importance in rehabilitation group (p&amp;lt;0,01). Conclusions Post-myocardial rehabilitation is more frequently prescribed to younger patients with shorter index hospitalisation. Clinical and laboratory parameters improve more in the group that underwent CR programme and this might warant more effort on increasing CR accessibility and patient enrollement. The phenomenon of weight gain in patients after acute myocardial infarction independently from undergoing rehabilitation program or not needs further research. Figure 1. 12-month laboratory follow-up. Funding Acknowledgement Type of funding source: None

Differences in acute ischaemic stroke care in Poland: analysis of claims database of National Health Fund in 2017.

Selected and basic indicators of acute ischaemic stroke care in Poland are reported cross-regionally based on the analysis of claims data of the National Health Fund (NFZ) in 2017, the most reliable source of healthcare funding in the country, being a single public payer. For research purposes, a selection algorithm based on the diagnosis coded as I63 according to the International Classification of Diseases (ICD-10) was used to identify all ischaemic stroke patients in the claims database provided by the NFZ. Stroke units and other centres providing treatment for acute ischaemic stroke patients were examined. The analysis showed marked differences between provinces in terms of stroke unit treatment availability. The crude and standardised rates of acute ischaemic stroke admissions to stroke units varied between provinces. Moreover, substantial differences were observed for the thrombolysis implementation rate, access to rehabilitation, hospital stay and early prognosis. As the leading cause of disability and the second leading cause of death in developed countries, stroke requires a well-organised, evidence-based healthcare system provided for both acute treatment and rehabilitation. Continuous monitoring of healthcare is crucial to identify weaknesses and areas for improvement.

The Role of Housing Policy in Long-Term Care in Poland

ABSTRACT Population aging poses challenges to societies with regard to the provision of care for dependent seniors. One of the spheres broadly discussed in terms of long-term care is housing policy. The focus of this article is the analysis of housing policy in Poland, with respect to demographical changes, and the ever increasing burden aging causes (i.e., problems with seniors’ ability to perform self-care and age in place). The analysis was based on the existing data and the sizable transdisciplinary body of international comparative housing policy literature. The effectiveness of housing policy in the context of care services depends on its integration with the social assistance and health care system and the size of the housing stock, along with the family’s caring potential.

Percutaneous closure of atrial septal defect: a consensus document of the joint group of experts from the Association of Cardiovascular Interventions and the Grown-Up Congenital Heart Disease Section of the Polish Cardiac Society.

Atrial septal defect is the most common congenital heart lesion in adults. Although atrial septal defect closure is recommended in those with right heart enlargement or paradoxical embolism, data informing such indications in adults are quite limited. This population has many unique characteristics and needs. In recent years, significant progress has been made with regard to diagnostic modalities that facilitate the diagnostic workup of these patients. However, the decision‑making process, especially in selected adult patients population (advanced age, various concomitant diseases, poor LV function [both systolic and diastolic], pulmonary hypertension, concomitant arrhythmias or multiple defects, or deficient rims) is still not easy. Available data are predominantly focused on imaging endpoints and short‑term morbidity and mortality rather than long‑‑term. The evidence base for outcomes with or without defect closure comes from various studies with different observation periods. Moreover, the clinical experience in diagnosing and treating that subgroup of patients is inhomogeneous between individual physicians (cardiologists, imaging specialists, operators) and between small and large experience centers. In the view of the above, the joint group of experts from the Association of Cardiovascular Interventions and the Grown‑Up Congenital Heart Disease Section of the Polish Cardiac Society developed the following consensus opinion in order to standardize the principles of diagnosis, indications for treatment, methods of performing procedures, and tenets of postoperative care in Poland.

LEGAL ASPECTS OF MEDICAL REFORM’S IMPLEMENTATION: POLAND’S EXPERIENCE FOR UKRAINE

The academic paper has analyzed the experience of implementing the reform of the health care system in Poland, taking into account the legal regulation of the measures taken.The attention is focused on the basic stages of the medical reform, as well as the features of each stage. The legal aspects of the process of reforming the health care system in Poland have been investigated; they determine the sources and methods of financing health services, the level of quality of health care and the functioning of the health care system in general. The individual components of the health care system related to compulsory health insurance have been described. Based on the analysis, it has been proved that in practice there is no single universal model of financing the health care system. The experience of the functioning of health care in Poland has shown that the experience of reforming the health care system in Poland can be successfully implemented in the practice of medical reform in Ukraine, provided that the historical, economic and cultural features of the country are taken into account. It has been concluded that in order to improve measures to reform the medical system of Ukraine it is necessary to develop and implement measures aimed at the development of health insurance and medical self-government. Introduction of health insurance in Ukraine will help improve medical services, improve the management of the entire health care system and its financing.