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The application of “the patient satisfaction assessment” as a method for assessing hospital management efficency


Introduction. When assessing the effectiveness of hospital management through measures of patient satisfaction, it is possible to go beyond the frameworks of the social efficiency assessment, obtaining generalized assessments of an institution. They are based on the answers to the question if patients would be willing to recommend the institution to a member of the family or a friend. Next point is establishing correlation relationships between these assessments and other measures of effectiveness, for example the value of contracts concluded with the National Health Fund (NFZ).

Aim. The aim of the article is to determine the usefulness of the patient satisfaction survey as a method enabling the assessment of the management efficiency of a given medical facility in terms of the selected parameters.

Material and methods. The source of the research material are the reports on the patient satisfaction assessments carried out among the patients of the Provincial Specialist Hospital in Biała Podlaska in the years 2008-2013. It was hypothesized that the higher the value of the contract with the NFZ, the greater patients’ satisfaction expressed in their generalized assessments in the given years and, on the contrary, the more positively assessed by patients hospital, among other things due to the quality of the health services, the higher the value of contracts concluded with the NFZ by the given institution. At the same time, on the basis of the data from 2013, it was decided to check whether the opinions expressed by the patients are characterized by objectivism or whether they may be dependent on the hospital ward where the satisfaction survey was carried out - for this purpose the Chi-square independence test was used. The necessary calculations as the part of the statistical analysis were made using the Microsoft Excel spreadsheet.

Results and discussion. The results of the research are a part of the general trend of patient satisfaction surveys, considered as an important source of information on the level of medical services.

Conclusions. The patient satisfaction survey can be considered as a method which enables the assessment of the management efficiency of a given medical facility in terms of the selected parameters.

Open access
Communication and perioperative care of elderly patients


Communication is one of the basic human needs, it builds trust and facilitates people-to-people contacts. This is widely understood exchange of information as well as feelings, it is both; discussion and argumentation.

The basis for effective treatment is proper communication between the medical staff and the patient. Nurses, medical careers working with elderly people are often in a situation where it is difficult for them to communicate with the patient. Ignorance of the physiology of human aging, difficulties and diagnostic limitations may lead to errors of medical personnel.

The objective of the article is to draw attention to the role of communication among nurses, supported by medical caregivers, who deal with an elderly patient in pre-, peri- and postoperative period, as well as to point out that nursing staff is insufficiently involved in creating standards of medical care.

Lack of training, outlines and guidelines in the field of communication and geriatrics, in the treatment and care of elderly patients result in ignorance, intuitive, incomplete and accidental action, without intentional continuity, what may result in deterioration of care and may contribute to an increase in perioperative mortality of older people.

Open access
Emigration as a way to a better future? – plans for international migration among students of the Medical University of Lublin


Introduction. Completing medical studies provides many opportunities. The professional qualifications of doctors are recognized in most hospitals in the European Union and the freedom of movement is conducive to migration abroad. Financial conditions also encourage searching for work in other countries.

Aim. The main purpose of this paper is to present the problem of international migration through the eyes of students of the Medical University of Lublin. We carried out an analysis of the motives and activities which lead students to look for work abroad.

Material and methods. The study was conducted in 2018 using the diagnostic survey method. The 3rd-6th year students of the medical faculty were given the task to fill out an online questionnaire. As many as 63.2% of the 87 respondents were women. The questionnaire included 10 questions regarding the demographic situation of the respondents, their willingness and motives to take up work abroad in the future, and also the actions they are taking to reach that goal (e.g. learning foreign languages).

Results. After completing their medical studies, 32 respondents (36.8%) plan to start working outside of Poland. It was found that men declare a desire to emigrate more often than women (p=0.002). The motivation of people deciding to stay, turned out to be the proximity of their family home, while emigration was motivated mainly by financial reasons (32 people, 100%) and more specialization opportunities (28 people, 87.5%). Germany was the most frequently mentioned migration destination by the respondents. There was a strong relationship between the foreign language which the respondents were learning and their planned direction of emigration (p=0.029, V=0.643).

Conclusions. Foreign emigration is considered by an increasing number of medical students. Third year students also take into account working abroad. Due to the issue of migration, it is necessary to look for strategic actions that will ensure the proper functioning of healthcare in Poland.

Open access
The impact of carbohydrate intake on the behavior and cognitive functions of children and adolescents


Introduction. Although carbohydrates are the most commonly studied nutrients regarding their influence on cognitive functions, there is no unequivocal agreement on whether this influence really exists and what its manifestations are.

Aim. This study is a literature review of research on the association between sugar intake, behavior and cognitive functions in children population.

Material and methods. The analysis of the studies on the carbohydrate intake and its impact on behavior and cognitive functions of children and adolescents on the basis of MEDLINE database was conducted. The studies were found in PubMed Internet search engine. The following words were implemented in various combinations: “sugar”, “carbohydrate”, “glycemic index”, “GI”, “glucose” as well as “cognition”, “cognitive”, “learning”, “memory”, “attention”, “behavior”, “hyperactivity”. The number of 27 publications was chosen and the information they contained was analyzed.

Results. Despite multiple studies on the impact of carbohydrate intake and their glycemic index on cognitive functions, there is still no agreement on this issue. Multiple studies indicate the association between glycemic index and cognitive processes. The positive impact of low GI breakfast intake on the concentration and memory is relatively frequently emphasized. The concept that indicates the association between sugar intake and hyperactive behavior among children also has not been unequivocally confirmed in the analyzed studies – contrarily – some of them indicated lack of such relationship. The placebo effect may be the explanation for the above concept. The association between the number of carbohydrates in diet and sleep disorders also has not been proved.

Conclusions. Although there are no unequivocal scientific foundations to limit the intake of simple sugars and consume polysaccharides with low GI to improve behavior and cognitive functions, such actions are consistent with a healthy diet and should be recommended for children and adolescents.

Open access
The influence of the sensitivity of the trapezius muscle on the changes within the bioelectric tensions of the masticatory muscles


Introduction. Pathological muscle tone can cause changes in the facial skeleton, including tension headaches, tinnitus, temporomandibular joint dysfunctions. The complexity of pathologies and their spectrum may also indicate changes beyond the facial skeleton. The aim of the study was to determine the possible correlation between the pressure pain threshold of the trapezius muscle and the bioelectrical tension on the masticatory muscles.

Aim. The aim of the study was to determine the possible correlation between the pressure pain threshold of the trapezius muscle and the bioelectric tension on the masticatory muscles.

Material and methods. The number of 36 women applied for the study. They were all examined using an algometer within a trapezius muscle to determine the pressure pain threshold. The electromyographic study was carried out in accordance with the SENIAM guidelines. The resting activity of selected masticatory muscles (temporal and masseter) was recorded for 10 sec. The study involved an 8-channel BioEMG IIITM surface electromyography apparatus with BioPak Measurement System (BioResearch Associates, Inc. Milwaukee, WI, USA). Statistical analysis was carried out using the r-Pearson test. The level of significance was set at 5%.

Results. After comparing the bioelectric tension of the masticatory muscles and the pressure pain threshold, left-sided correlation was observed (p<0.05). Both in the right-hand and general comparison, the results did not reach the required level of statistical significance (p>0.05).

Conclusions. The pressure pain threshold seems to be linked to the bioelectrical muscle tone of the masticatory muscles. To confirm this observation, further research into a larger and more diverse group of participants is recommended.

Open access
Organization of dental care – caries prophylaxis in children and teenagers in Poland


Dental caries in children and teenagers is a social problem and an important element in public health. It stems from its high prevalence and the consequences of not implementing proper treatment are serious. Younger and younger children suffer from dental caries. When it is not treated, the consequences tend to be serious and costly. Pathogenesis of dental caries, methods of treatment and its prevention have been described based on available literature.

The decline in frequency of its appearance will be beneficial for both the sick and society. It will be possible thanks to an early introduction of caries prophylaxis. What is more, a change of mindset and lifestyle is highly recommended as well, not to mention the fact that full and easy access to dental care seems to be essential. All of the factors mentioned above are strictly connected with the proper organization of dental care providing special treatment for children and teenagers in Poland. Its scale should be wide and should cover such activities like teaching to brush one’s teeth properly, access to fluoridation or treatment provided in public dental surgeries located, for example, on school grounds. Current organization of dental care is dealing better and better with the issue concerned, however, to minimalize the risk of caries in children further changes should be introduced.

Open access
Psychological support of students with national identity transformations


Introduction. The research of the development of national identity of student’s youth is important for a deeper understanding of the factors of psychological security preservation, stability of nations and psychological health of their representatives. The recent intensification of globalisation, integration and migration processes in the European space makes especially relevant the problem of development of positive national identity among its youth citizens and the correction of transformations in this process. Therefore, the development of effective psychological support of student’s youth with transformed national identity is necessary.

Aim. The article aims at conducting theoretical and empirical research of transformed types of national identity among students of higher educational institutions displaying national hypoidentity (national nihilism), national indifference or national hyperidentity (national egoism, national isolationism, national fanaticism); as well as at developing and organising their psychological support.

Material and methods. The study involved full-time first – fourth year students of higher education institutions from different regions of Ukraine who ensured the representativeness of sample. The age range of 17-21 to which the respondents belong is sensitive regarding the development of national identity. To reveal the type of students’ national identity, psychodiagnostic methods (“Types of ethnic identity” by G. Soldatova, S. Ryzhova) and methods of assessing the positivity and uncertainty of ethnic identity were applied (by A. Tatarko, N. Lebedeva), and methods of mathematical statistics were applied to assess the obtained data.

Results. Empirical research of 309 students of higher educational institutions demonstrated that 53 students had the transformed types of national identity that required correction in the process of organised psychological support. After all, the transformations of national identity primarily threaten the psychological health of the personality.

Discussion. Psychological support of students with national identity transformations (national hypoidentity, national indifference and national hyperidentity) should be directed towards the development of their positive national identity. To do this, such support should be organised separately for students with national hypoidentity and national indifference promoting the development of their positive attitude towards the representatives of their nation, and for students with national hyperidentity promoting the development of their tolerant attitude towards the representatives of other nations.

Conclusion. Most students of higher educational institutions develop positive national identity (norm). A small number of students have deviations from the norm displaying the transformation of their national identity. The main purpose of psychological support of students with national identity transformations is the development of positive national identity.

Open access
Renal-cell carcinoma – novel concepts of classification


Renal cancer, according to the Polish National Cancer Registry, was the cause of 4% of cancer cases in men and 3% of cases in women in 2010. Most often it affects men over 65, although it may also concern infants. In 2010, the number of reported cases for men was 2,700 and 1,900 for women. For the last three decades – up to 1990, the incidence of kidney cancer has increased significantly. Currently, it remains at the stable level of morbidity. One of the most significant issues of modern diagnostics and treatment of renal cancer is the problem of its heterogeneity brin-ging many difficulties in systematization and categorization of this neoplasm. The World Health Organization Classification of Renal Tumors has been published in 2004 and is currently supplemented with new classification units, which, according to ISUP (International Society of Urological Pathology), should be considered as separate groups of kidney epithelial cancers.

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Acute radiation-induced oral mucositis in patients subjected to radiotherapy due to head and neck cancer


Oral mucositis is a common side effect of radiation therapy for head and neck cancer. Severe mucositis is followed by symptoms, such as extreme pain, mucosal ulceration and consequent limitations in swallowing and achieving adequate nutritional intake. Mucositis may also increase the risk of local and systemic infection and significantly affect quality of life and cost of care. Severe oral mucositis can lead to the need to interrupt or discontinue cancer therapy and thus may have an impact on cure of the primary disease. In spite of all the advances made in understanding the pathophysiology of oral mucositis, there is still no prophylactic therapy with proven efficacy and known risk factors. This review will discuss oral mucositis epidemiology, impact and side effects, pathogenesis, scoring scales and prevention.

Open access
Bone Mineral Status of Young Men With Different Levels of Physical Activity


Introduction. The study sought to assess bone mineral content (BMC) and bone mineral density (BMD) in men with different levels of physical activity during the period of reaching peak bone mass

Material and methods. The research included wrestlers (n = 31) and students of the University of Physical Education (n = 88) aged 18-24. The state of the bone tissue was assessed with the use of the bone densitometry (DEXA) method (lumbar spine L2-L4). Data concerning the physical activity levels and nutritional behaviours of the study participants were gathered in a diagnostic survey carried out using a specially prepared questionnaire.

Results. The analysis of the results revealed that as there were no statistically significant differences in nutritional behaviours between men from particular groups, physical activity proved to be the factor which significantly differentiated the groups under investigation in terms of their bone mass. The highest mean values of the bone parameters analysed were achieved by the wrestlers, who demonstrated a high level of physical activity.

Open access