Objective The aim of the study was to analyze bacterial flora in venous leg ulcers, empiric and targeted antibiotic therapy, and factors influencing healing time. Materials and methods Data from 30 patients with venous leg ulcers were retrospectively analyzed. Collected data included: sociodemographic data, wounds information, number of comorbidities, results of the microbiological examination, and empiric and targeted antibiotic therapy. To compare the empiric and targeted treatment in terms of their compatibility, the group of patients was divided into the four subgroups: NEA (no empiric antibiotics), NA (no antibiotics), ETA+ (compatibility of empiric and targeted antibiotic), ETA− (no compatibility of empiric and targeted antibiotic). Results The average ulcer healing time was 163.4 ± 97.1 (range 51.0 to 426.0) days and increased by 28 days with each additional bacterial strain in the ulcer (p = 0.041). Healing time did not differ between the four groups. Staphylococcus aureus and Pseudomonas aeruginosa were the most frequent bacteria. Amoxicillinium/acidum clavulanicum was the most common empirical antibiotic and amoxicillinium/acidum clavulanicum, and levofloxacinum was the most common targeted antibiotic. Conclusions Venous leg ulcer healing time was prolonged with each subsequent bacterial strain in the ulcer, and it was independent from systemic antibiotic therapy.
Organ transplantation has become the treatment of choice for end-stage organ failure, including renal and liver failure. The benefits of patient employment after transplantation are numerous, but factors determining the ability to work among these patients are not clearly defined. The growing interest in these factors has strong practical implications for organizations creating vocational rehabilitation programs. Given the interconnection between psychological and physical functioning in patients after transplantation, the present study examined the impact of anxiety on vocational rehabilitation and its relationship with functional tests. A total of 100 patients after liver or kidney transplantation underwent functional tests, including the 6-minute walking test and 30-second chair stand test (30”CST), and psychological tests, specifically the Inventory of Physical Activity Objectives, Work Ability Index, and State-Train Anxiety Inventory. Working ability was affected by psychological factors. State and trait anxiety exhibited inverse relationships with subjective readiness to occupational activity ( P < .001, r = -.59 and P < .001, r = -.56, respectively). The level of anxiety was negatively related to the results of the 30”CST. State-Train Anxiety Inventory, State Anxiety subscale and State-Train Anxiety Inventory, State-Trait Anxiety subscale vs 30”CST: P < .001, r = -.43 P < .001, r = -.44). Thus, state and trait anxiety influence perceived work ability and partially functional status. These observations may indicate the potential benefits of including psychologists in interdisciplinary teams for physical and especially vocational rehabilitation of patients after liver or kidney transplantation.
Research indicates that while nurses are aware of the benefits of physical activity (PA), their adherence to PA is low. The results of workplace interventions that increase PA are inconsistent. The study aim was identification the sociodemographic, professional, and incentive factors influencing nurses’ PA and investigation its relationship with the level of PA that they report. This study was based on observational cross-sectional research conducted among professionally active nurses working in a clinical setting (n = 350). The self-reported questionnaire was used to collect sociodemographic and employment data and motivators and barriers of participating in PA. The level of PA was assessed using International Physical Activity Questionnaire. The analysis revealed significant differences in the Total Physical Activity Score (TPAS) depending on the variables related to professional activity (working in a management position: p = 0.015; workplace: p = 0.01; shift type: p ≤ 0.002). Cluster analysis revealed that the most important statement in the group division about motivation was fear of the pain occurring after exercise. Nurses who were more motivated to be active showed a higher level of leisure-time PA than less motivated nurses. The recommendation of PA in the nursing population should be focused on increasing the leisure time PA, ensuring the appropriate time to recovery, and compliance with the principles of work ergonomics to prevent musculoskeletal disorders.
ObjectiveThe aim of the present study was to assess the employment rate among kidney and liver transplant recipients in Poland and identify the predictors of employment.SettingsThe study was based on a self-prepared questionnaire containing five parts: demographic data and professional, medical, physical and psychological factors. This is a multicentre study involving four hospitals in Poland.ParticipantsThe investigated group consisted of 285 individuals (92 women and 185 men; 8 no sex given) aged between 18 and 45 years who underwent kidney or liver transplantation 1–5 years prior. Because of missing data, 279 questionnaires were considered regarding employment status after transplantation and 277 when sex differences were considered.ResultsA total of 120 patients (43%) worked full-time, 42 (15%) part-time and 117 (42%) remained unemployed, with a higher employment rate post-transplantation among men than women (60% vs 55%, p=0.04). More women performed white collar work (74% vs 41%, p=0.0003) and had to modify their working position than men (22% vs 7%, p=0.0118). Factors determining employment after transplantation included higher level of education (OR=27.08; p=0.0096), employment 1 year prior to transplantation (OR=11.05; p<0.001) and good psychological adaptation (OR=4.23; p<0.001). Men working the year before transplantation had higher education (OR=9.66; p=0.0356). Among men, more kidney recipients worked compared with liver recipients (OR=3.567; p=0.0417). Among women, age determined employment status (OR=0.89; p=0.0234).ConclusionHigher education is the most important predictor of employment after transplantation. Therefore, rehabilitation programmes including vocational activity should be directed to increase the level of education, both pretransplantation and post-transplantation if possible.
Introduction: Regular physical activity results in many health benefits, however many studies indicate that the level of activity of patients after transplantation is low. The purpose of the study was to assess the level of daily physical activity in patients after liver (LTx) or kidney transplantation (KTx) and the usefulness of a selfmonitoring method in increasing their daily physical activity. Material and methods: Patients after LTx or KTx (n=100) has been enrolled to the study and were randomly assigned to either an intervention (IG) or control group (CG). Ninety-four participants completed the 3 month period of observation. Participants assigned to IG were monitoring their daily physical activity using a pedometer and were required to complete a diary of daily number of steps. The level of physical activity was also assessed by International Physical Activity Questionnaire (IPAQ). In the statistical analysis the parametric and non-parametric tests has been used in consistency with data distribution. A value of P ≤ 0.05 was considered significant. Results:The average daily number of steps in pre/posttest in both study groups was less than 7600. A significant relationship between the average daily number of steps and daily Total Physical Activity Score TPAS/day [MET-min/day] (p<0.001; r=0.57). The study did not revealed any effects of intervention. Conclusions: Daily physical activity in patients after KTx or LTx is low, but it does not differ from healthy populations (<7500 steps). In post-transplant comprehensive medical management, long-term physical activity recommendations could be included on a par with the early post-surgery physiotherapy.
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