IntroductionManagement of ingrown toenails encompasses a wide range of methods, from conservative to surgical approaches, which vary in terms of final aesthetic outcomes and overall patient satisfaction.AimThis study aimed to assess patient aesthetic satisfaction following surgical correction of nail folds preceded by conservative nail plate reconstruction.Materials and methodsA total of 550 procedures were performed in 340 patients, involving plastic surgery of the nail folds combined with conservative nail plate reconstruction. Patients evaluated their satisfaction with the aesthetic and functional outcomes of the operated toes.ResultsThe final aesthetic appearance of the treated toes was rated as good (34.4%) or very good (59.4%) by approximately 95% of patients. Significant relationships were observed between the final aesthetic outcome and post-treatment effectiveness (p = 0.003), severity of ingrown toenail prior to treatment, need for additional cosmetic and conservative procedures (p = 0.008), patient age (p < 0.0001), and type of occupation (p = 0.0016).ConclusionPlastic surgery of the nail folds combined with conservative nail plate reconstruction achieved favorable final aesthetic outcomes for the toes and nail plates, contributing to high patient satisfaction.

Ethical principles serve as the foundation of healthcare practice, guiding medical professionals in their interactions with patients and shaping healthcare policies worldwide. However, the interpretation and application of these principles can vary significantly across different cultural and socio-political contexts. Understanding these variations is essential for enhancing cross-cultural healthcare practices. The aim of this review was to identify and show the differences and similarities in understanding and implementation of four ethical principles in Poland, Ukraine, India and Thailand. The PubMed database was searched for articles, which resulted in 16 papers about the principle of non-maleficence, 36 papers about the principle of justice, 79 on autonomy and 16 on beneficence, all of which were included in the review. The results revealed ethical dilemmas encountered in routine healthcare practice, highlighting both commonalities and distinctions across the analyzed countries. This analysis offers valuable insights into how ethical challenges are addressed within diverse healthcare systems, contributing to a deeper understanding of the needs of both patients and medical personnel.

Background:Problems with feeding are widespread in pre-term infants, but they also occur in full-term infants. Feeding skill is the first coordinated function a child acquires, providing him with nutrients and sensory stimulation needed for further proper development. The aim of the retrospective observational case-control study was to observe factors that may influence feeding problems in infants aged 0-3 months. The observed factors included the presence of oral reflexes, the differences in muscle tension, the advancement of motor development, the spontaneous movements, as well as the gestational age, and the pH value of the umbilical cord arterial. Methods:The study involved 60 infants. The study and the control groups included 30 infants each. Feeding problems were the major inclusion criteria for the study group. The infants' reflexes were checked, the muscle tone was palpated, the presence of general movements was visually assessed using Prechtl's method, then the Sensitivity Assessment of the Stomatognathic Complex (SOWKUT) questionnaire and Albert Infant Motor Scale (AIMS) scale were evaluated. Through the perinatal interview with the patient's parent, information regarding the pH of the umbilical cord arterial value was obtained. Results:The study involved 60 infants born between 24 and 41 gestational age (median and standard deviation: 35 ± 4.81). At the time of the study, their postconceptual age was 44 ± 7 weeks. The results showed that infants with problems regarding eating performance have their oral reflexes more often impaired, and their muscles more often show increased symmetrical tension, especially the frontal, orbicularis oris, and masseter muscles. The influence of delayed motor development, sensory hypersensitivity, and early gestational age on the occurrence of feeding problems was observed. No correlation was observed between the umbilical cord arterial's pH values and the feeding issues. Conclusions:Feeding problems are multifactorial, which implies that infants should be provided with quick intervention and necessary therapy. It will allow the babies to develop correctly and reduce the risk of future problems.

IntroductionIn response to the unprecedented impact of the COVID-19 pandemic on healthcare systems and social life worldwide, this study examines the role of religion in shaping perceptions of healthcare access in Poland during and after the pandemic.MethodsThe research is based on anonymous surveys conducted among adult Poles during the third wave of the pandemic and in the post-pandemic period, with participants divided by the timing of their responses. The research employed a cross-sectional survey design with a validated questionnaire. Data collection occurred during the third wave of the pandemic and the post-pandemic period. The questionnaire incorporated demographic questions and assessed the significance of religion in respondents' lives using a Visual Analogue Scale (VAS) for healthcare accessibility.ResultsParticipants (n = 541) were recruited through online and paper-based surveys, meeting the inclusion criteria of being aged 18 or older and residing in Poland. Findings indicate that Roman Catholic respondents rated healthcare accessibility higher than non-religious individuals, potentially due to social and community support. However, statistical analysis revealed no significant differences in actual healthcare access among groups, suggesting systemic factors played a larger role.DiscussionThese results highlight religion as a source of emotional support rather than a determinant of healthcare access.

Background/Objectives: Ingrown toenails are a common podiatric condition that can significantly impair the quality of life of affected patients. The aim of the study was to assess the impact of plastic surgery of the nail folds, preceded by conservative nail plate reconstruction, on the quality of life of patients with ingrown toenails. Methods: The DLQI was assessed before (n = 108) and after treatment (n = 107). The procedure combined plastic surgery of the nail folds with conservative nail plate reconstruction. Results: A significant improvement was observed in DLQI scores (p < 0.0001) between baseline (DLQI1) and at least 6 months post-procedure (DLQI2). Quality of life improved in all assessed domains, with an average score reduction of 10.09 points. Thirteen patients did not achieve the minimal clinically important difference (MCID). Significant differences in DLQI2 outcomes were also observed by age (p = 0.009) and gender (p = 0.025). Conclusions: Plastic surgery of the nail folds combined with conservative nail plate reconstruction proved effective in improving quality of life in patients with ingrown toenails.

Changes in Polish demographic data with a growing number of culturally and linguistically diverse patients stipulate new directions in medical education to prepare future physicians to work effectively across cultures. However, little is known about Polish medical students’ willingness to gain cross-cultural knowledge and skills, desire to get engaged in interactions with patients from diverse cultural backgrounds, expectations and needs concerning cross-cultural training as well as challenges they face in the path to cultural competence. Therefore, in this study, we conducted and thematically analysed fifteen semi-structured interviews with medical students to broaden our understanding of medical students’ perception of cross-cultural competence enhancement. The conducted thematic analysis allowed for the development of four themes, which showed that Polish medical students perceived skills and knowledge necessary to facilitate culturally congruent care as indispensable to form quality patient-doctor relations, believed that lack of cultural sensitivity may lead to dangerous stereotype formation and insufficient competence may be the source of stress and anxiety resulting in confusion and lack of confidence. Finally, numerous suggestions have been made by participants on how to improve their cross-cultural competence. Students emphasized, however, the role of medical education with active and experiential learning methods, including simulation-based training, in the process of equipping them with the knowledge and skills necessary to provide best quality care to culturally diverse patients. Our analysis indicated that Polish medical students seem to hold positive attitudes towards cultural competence development and view it as an important component of physician professionalism.

Introduction: A physician in a chronic pain treatment clinic must recognize that the relationship between pain and spirituality is bidirectional. Chronic pain can decrease the level of spiritual well-being, and low spiritual well-being can also significantly intensify the perception of pain and worsen coping with it. Currently, for many scientific and medical communities, it is evident that spiritual care is an indispensable element of holistic medicine. Objective: The authors developed a non-religious spiritual care model provided by a physician at a chronic pain treatment clinic from May 2022 to February 2024. Method: The study utilized a mixed-method approach to conduct the research. The analysis consisted of twelve patients. A FACIT-Sp-12 questionnaire evaluated the individual’s spiritual well-being before the intervention. The intervention involved asking patients open-ended questions about their life history, experiences, and spiritual beliefs and the physician’s use of active listening and empathetic responses to what patients shared (relationship-building activities). The intervention aimed to assist patients in accepting the limitations of an incurable chronic disease, affirming the value of their lives, enhancing inner harmony, and increasing their sense of belonging to something greater. After the intervention, a re-assessment of the patient’s spiritual well-being was conducted using the FACIT-Sp-12 questionnaire. Researchers collected qualitative data through a confidential survey that included the following instructions: “Please express an anonymous opinion on how you perceive the spiritual care provided by the physician”. Results: There was an increase in spiritual well-being, assessed using the FACIT-Sp-12 scale, in 9 out of 12 patients. The median, as well as the average, level of spiritual well-being increased in a statistically significant way after the intervention (p < 0.05). This was primarily due to the higher value of the peace subscale of the questionnaire. Qualitative analysis revealed benefits reported by patients (personal development, gratitude, satisfaction, support, hope) resulting from physician’s actions. Conclusions: Both qualitative and quantitative data showed that establishing a relationship with the doctor improves the spiritual well-being of patients. Therefore, this model can be recommended for physicians in chronic pain treatment clinics.

Teamwork, as the preferred method of cooperation in healthcare, became prevalent in the 1960s, and since then has been universally recognized as a measure to improve the quality of healthcare. Research indicates that medical care based on interdisciplinary cooperation is associated with increased patient safety, lower hospitalization rates, and reduced rates of complications and medical errors. Furthermore, it enhances the coordination of care and improves patient access to medical services. This model of providing medical care also results in considerable benefits for medical professionals. These include greater job satisfaction and a reduced risk of professional burnout syndrome. Aim: The aim of the study was to explore the opinions of medical students with regard to cooperation in the interdisciplinary team, as well as the factors affecting the formation of opinions. Material and methods: The study was conducted using the Polish version of the questionnaire Attitudes Towards Interprofessional Health Care Teams. The study involved 1266 participants, including students of medicine (n = 308), midwifery (n = 348), nursing (n = 316) and physiotherapy (n = 294). Results: According to the opinions of the students participating in the study, the therapeutic process based on the interdisciplinary model improves the quality of medical care provided, increases patient safety, and improves communication between members of the therapeutic team. The factors affecting the assessment of cooperation in interdisciplinary medical care teams included the faculty and the year of studies, gender, as well as participation in the multidisciplinary courses. Conclusions: Students recognize the need for interdisciplinary medical teams. The training of future medical professionals should incorporate the elements of interprofessional education. This form of education allows students to develop both a professional identity and identification with their own profession, as well as encourages teamwork skills and shapes the attitude of openness towards representatives of other medical professions. However, in order to provide the students with the relevant knowledge, skills and competencies, it is essential to respect their diversity in terms of the faculty, as well as to account for the impact of gender and the year of studies which may affect their readiness to engage in teamwork.

This paper focuses on three areas: the first is a review of current knowledge about social and service robots for elderly care. The second is an optimization conceptual model aimed at maximizing the efficiency of assigning robots to serve the elderly. The proposed multi-criteria optimization model is the first one proposed in the area of optimization for robot assignment for the elderly with robot utilization level and caregiver stress level. The third is the findings of studies on the needs, requirements, and adoption of technology in elderly care. We consider the use of robots as a part of the ENRICHME project for long-term interaction and monitoring of older persons with mild cognitive impairment, to optimize their independence. Additionally, we performed focus group discussions (FGD) to collect opinions about robot-related requirements of the elderly and their caregivers. Four FDGs of six persons were organized: two comprising older adults, and two of the other formal and informal caregivers, based on a detailed script. The statements of older participants and their caregivers were consistent in several areas. The analysis revealed user characteristics, robot-related issues, functionality, and barriers to overcome before the deployment of the robot. An introduction of the robot must be thoroughly planned, include comprehensive pre-training, and take the ethical and practical issues into account. The involvement of future users in the customization of the robot is essential.

Chronic pain affects all aspects of a patient's life: physical, psychological, social, and spiritual. Religiosity is a common, but not the only, way to fulfil spiritual needs and engage in spiritual activities. Based on the analysis of the definition of spirituality provided by the Polish Society for Spiritual Care in Medicine, and by comparing it with statements from patients at the Pain Treatment Clinic, conclusions were drawn about 4 non-religious aspects of spirituality. Chronic conditions often influence how a patient interprets the meaning and purpose of their life and how they experience relationships with other people. Morality, understood as a system of beliefs about the surrounding world and the values and goals that stem from them, can also change through the experience of chronic pain. Reference to what transcends a person and the ability to go beyond one's limitations may enable the acceptance of adverse events, even those such as the loss of physical ability. In Poland, where an increasing number of patients do not identify with any specific religion, there is a need to develop a model of spiritual care that physicians can provide in a non-religious manner.

BACKGROUND:Vinyasa yoga practice improves body fitness and potentially positively affects practitioners' well-being and health. Due to the diverse intensity of practice and positions customized to the practitioner's needs, it can also support cancer patients. Undertaking physical activity that has a potentially positive effect on well-being and health was particularly important during the self-isolation that followed the COVID-19 pandemic. The purpose of this study was to evaluate the impact of three-month mild and moderate intensity vinyasa yoga practice on breast-cancer patients' stress perception, self-confidence, and sleep quality during COVID-19 induced self-isolation. METHODS:Female breast-cancer patients participated in twelve-weeks of online vinyasa practice during the COVID-19 induced self-isolation period. Meetings were held once a week, where 60-min vinyasa yoga sequences were followed by 15 min of relaxation. Patients completed pre- and post-intervention surveys to evaluate changes in the following outcomes: stress perception, self-confidence, and sleep quality. Forty-one female patients enrolled in the Vinyasa course completed the pre-intervention survey, while 13 attended all the meetings and completed the post-intervention survey. RESULTS:The effect of the twelve-week yoga and relaxation practice significantly reduced sleep problems and stress of oncological patients. The participants also declared an improvement in their general well-being and self-acceptance. CONCLUSION:Dynamic forms of yoga combined with mindfulness techniques can be applied to patients treated for oncological diseases. It contributes to improving their well-being. However, in-depth studies are needed to analyze the complexity of this effect.

Increasing cultural and linguistic diversities of populations have created a challenge for medical educators to provide authentic learning experiences fostering cross-cultural understanding and interprofessional attitudes of students. Simulations with actors portraying patients (commonly referred to as simulated patients) are effective learning modalities to teach students to provide culturally competent care and influence the quality of patient-centered care. The aim of this systematic review was to identify and synthesize available evidence on the use of simulations with simulated patients as a learning intervention to teach cultural competence to the students of healthcare professions. The PubMed, Medline Complete, and CINAHL databases were searched for articles, which resulted in 27 papers being included in the review. Results revealed that engaging students in cross-cultural interactions with patients increases their level of cultural competence, confidence, and learning satisfaction, and therefore, simulations with simulated patients can serve as a powerful reinforcement of cross-cultural education.

Care for the sick, including spiritual support is sometimes called holistic medicine. The term bio-psycho-social-spiritual model is sometimes used to describe this type of therapeutic approach patient-oriented medicine. This report indicates the importance of taking into account the spiritual aspect of life due to its beneficial impact on the coping resources activated and the patient’s well-being. Existential and spiritual issues are on the verge of new clinical and research interest in medicine, especially in gerontology, oncology, and palliative care. Clinicians focus not only on symptom control but also on spiritual and existential issues such as spirituality, hope, and meaning. This paper reviews the topic of spirituality in the context of illness and end-of-life care trying to define spirituality within the context of health resources of the subject. Spirituality is perceived in two of its main components: faith/religious beliefs and spiritual well-being. Especially this second construct is reviewed and described as a health resource.

Facial aesthetic medicine is a young component of aesthetic medicine that raises a lively polemic on a number of issues on both medical and ethical grounds. The main focus of (non‑therapeutic) aesthetics turns to the improvement and correction of the face and neck to get from what is good to an even better, more beautiful, aesthetically pleasing, younger face. However, when qualifying a patient for aesthetic treatments, it is important to approach the issue holistically, to pay attention to all aspects: psychological state, social and cultural conditions and a holistic attitude towards life. Any worrying symptoms should not be underestimated. Thus, the practitioner of aesthetic medicine should always bear in mind two very topical truths of ancient origin: primum non nocere and salus aegroti suprema lex.

Objectives: The outbreak of the COVID-19 pandemic impacted many aspects of life among various professionalgroups. Healthcare workers were the first line of help and the most vulnerable to being infected with the SARS-CoV2 virus. The efforts to counter the impact of the pandemic were not helped by shortages of staff and personal protective equipment, which affected the doctors’ comfort as well as the patients’ access to quality healthcare services. This study investigates the perception of healthcare services during the COVID-19 pandemic from the perspective of medical doctors living in Poznań, Poland. Material and methods: The questionnaire was distributed in paper form among doctors and dentists. Responses were received from 72 respondents, including 63 women and 9 men. The survey was conducted during Poland’s third wave of the COVID-19 pandemic. Results: Statistically significant correlations were found between access and quality of healthcare services; appointment time and online mode of admission; access to PPE and quality of healthcare services; work comfort and access to PPE; and work comfort and quality of healthcare services. Conclusions: The work of doctors and dentists during the COVID-19 pandemic has changed their perceptionsof the accessibility and quality of healthcare services. The opinions of doctors and other healthcare providers, as the professional group closest to the hardships of the pandemic, should be highlighted and widely considered.

Streszczenie Klauzula sumienia została wprowadzona do obszaru prawnych regulacji międzynarodowych w związku z uchwałą Rady Europy o nr 1763 z dnia 7 października 2010 r. Zgodnie z treścią dokumentu istnieje przyzwolenie odstąpienia od wykonania określonego świadczenia medycznego ze względu na zastrzeżenia moralne (religijne lub światopoglądowe) zgłaszane przez przedstawicieli opieki zdrowotnej. W przepisach polskiego prawa medycznego powołanie się na zasadę klauzuli sumienia jest dozwolone, ale wyłącznie dla lekarzy, pielęgniarek i położnych. Farmaceuci są pozbawieni tej możliwości. Jednak wykonywanie niektórych czynności zawodowych budzi zastrzeżenia etyczne wśród farmaceutów. Autorzy artykułu postanowili zbadać opinię farmaceutów zarówno na temat klauzuli sumienia oraz określonych regulacji prawnych, które zdaniem respondentów powinny podlegać zmianom legislacyjnym. Celem pracy jest zaprezentowanie wyników z przeprowadzonych badań, które zostały zrealizowane w 2020 r. na terenie Wielkopolskiej Okręgowej Izby Farmaceutycznej w Poznaniu. Słowa kluczowe: wolność sumienia i wyznania, klauzula sumienia, farmacja, antykoncepcja, Polska

INTRODUCTION:Spiritual care is needed in a clinical setting to improve the patients' quality of life. Deep connection with another person and delight with the beauty of nature or art and (in some cases) with God are all transcendental experiences. They may enable patients to ascribe meaning to their life with a chronic illness, find hope and well-being despite burdening symptoms. The opposite situation: lack of inner peace, inability to accept what is happening, feeling disconnected from others is called spiritual distress.OBJECTIVES:The aim of this research is to assess spiritual distress and spiritual needs of a group of Polish chronically ill patients and find associations with independent variables in order to provide data for recommendations on spiritual care in Poland.PATIENTS AND METHODS:204 patients treated at the University Hospital and the Cystic Fibrosis Clinic in Poznan were surveyed in 2017 and 2018 with an original questionnaire.RESULTS:Over half of the patients felt that their illness was life-threatening. A little more than half reported that faith was a resource to cope with suffering. Almost all patients showed signs of spiritual distress, and more than half expressed spiritual needs. The intensity of distress correlated only with the severity of the disease. The most important predictor of having spiritual needs was recognizing faith as a resource.CONCLUSIONS:Spiritual needs are associated with personal beliefs; however, spirituality spans beyond the religious context since spiritual distress is unrelated to the level of religious devotion. Therefore, any patient with a severe chronic disease needs basic spiritual care, which includes being treated with compassion.

Glassy Cell carcinoma (GCC) of the cervix is classified as a unique, aggressive neoplasm, with different sensitivity to chemotherapy and radiotherapy. It is such an extremely rare tumor that it is practically not observed during pregnancy. Information on the coexistence of cervical GCC with pregnancy is also unique, so it seems extremely important to disseminate it in order to develop the most effective treatment regimen. Additionally, making any decisions regarding therapeutic methods during pregnancy encounters great ethical problems. We present the case of a 26-year-old pregnant woman, 18 weeks gestation, diagnosed with GCC of the cervix, IB3 grade in the International Federation of Gynecology and Obstetrics (FIGO) scale. Despite the unfavorable prognosis, the use of chemotherapy in a pregnant patient brought on a favorable therapeutic effect, without any negative effects on the fetus. The article also presents a literature review on the epidemiology, pathology, immunohistochemistry, treatment and prognosis of this rare disease.

The aim of this article is to analyze the use of methods related to yoga for mental health protection and treatment of psychiatric disorders. The article is dominated by a historical perspective. It covers the achievements of the precursors of the use of yoga techniques in health promotion and treatment. Contemporary biomedical analyses confirm the healthpromoting function of yoga but make much less reference to aspects related to spirituality and its importance for mental health. Due to the growing awareness of the impact of lifestyle, stress reduction and the importance of moderate physical effort on health, relaxation-motor techniques can complement therapies used in many psychiatric disorders. Analyzed historical articles confirm the positive influence of exercises based on yoga techniques on mental health. Research on the influence of yoga on the human psyche needs to be deepened, none of the presented analyses showed negative side effects of supplementing standard therapies with exercises based on different forms of yoga. To investigate the aim of the research, a historical-comparative method and discourse analysis were used. A review of the content related to the history of yoga in Poland was carried out in the context of applying exercises based on yoga technique in psychiatry. In subsequent stages of the work, the obtained content was embedded in the medical, cultural and historical context and a critical analysis was made.