Renata Wolfshaut-Wolak

Introduction: Work is an essential aspect of human life. However, high expectations from employers and clients, combined with time pressure and chronic stress, can contribute to burnout among employees in service professions. Aim of the Study: This study aimed to compare the prevalence of burnout syndrome between two occupational groups—corporate office workers and active nurses—and to assess the influence of socio-demographic factors on the level of burnout in both groups. Materials and Methods: The study was conducted among 330 participants, including 126 nurses (38%) and 204 corporate employees (62%). Data were collected using a standard questionnaire and the Maslach Burnout Inventory. The study period spanned from November 2018 to October 2019, and questionnaires were distributed via email. Results: The findings revealed that both corporate employees and nurses experience occupational burnout. Both groups predominantly exhibited moderate to high levels of emotional exhaustion (nurses: 66.67%, q2 = 20.5; corporate employees: 73.53%, q2 = 31.5) and low to moderate levels of personal accomplishment (nurses: 78.57%, q2 = 32.0; corporate employees: 87.75%, q2 = 27.0). Corporate employees showed significantly higher depersonalization scores (q2 = 13.50) compared to nurses (q2 = 5.0). The prevalence of burnout in both groups was influenced by socio-demographic factors, including having children, their place of residence, education, earnings, and job-related factors such as vacation availability, the frequency of work shifts, work systems, overtime, and overall job satisfaction. Conclusions: Service-oriented professions that involve caregiving and direct interpersonal interactions face comparable risks of occupational burnout. Despite differences in the nature and conditions of work, as well as tasks performed, both corporate employees and active nurses are vulnerable to burnout. High salaries were not confirmed as a protective factor against occupational burnout. Additionally, environmental factors, particularly those related to working conditions, played a significant role in the development of burnout syndrome, alongside individual factors.

Introduction: Work is an important part of human life. However, high expectations from employers and customers as well as time pressure and chronic stress can lead to the development of burnout in employees of service professions. Aim of the study: The aim of the study was to compare the prevalence of burnout syndrome in two occupational groups: corporate office workers and active nurses, and to assess the influence of socio-demographic factors on the level of burnout in both groups. Material and methods: The study was conducted in a group of 330 people, including 126 nurses (38%) and 204 corporate employees (62%). The material was collected using a standard questionnaire and the Maslach Burnout Inventory (MBI). The study was conducted from 11.2018 to 10.2019 and questionnaires were obtained by email. Results: The results of the study showed that both corporate employees and nurses suffer from occupational burnout. Both groups showed a predominance of average and high values of emotional exhaustion - nurses 66.67% ( q2= 20.5), corporate employees 73.53% (q2=31.5), and a low and average sense of self-achievement - nurses 78.57% ( q2=32.0), corporate employees 87.75% (q2=27.0). Corporate employees showed significantly higher scores of depersonalization q2=13.50 than the surveyed nurses q2=5.0. The incidence of burnout in both groups was influenced by socio-demographic factors such as having children, place of residence, education, earnings, and factors directly related to performing one’s job (having a holiday, frequency of work shifts, work system, working overtime, and overall perceived job satisfaction). Conclusions: Groups of service occupations, related to providing care and requiring direct interpersonal contact with clients, are at comparable risk of occupational burnout. Despite the different nature and conditions of work and the tasks performed, both corporate employees and active nurses are vulnerable to burnout. It was not confirmed that high salary could be a protective factor against occupational burnout. Moreover, in addition to individual factors, environmental factors, among others those related to working conditions, also played an important role in the development of occupational burnout syndrome.

The study examined the relationship between socio-demographic and occupational factors and the level of occupational burnout using the dimensions of emotional exhaustion (EE), depersonalization (DEP), and personal accomplishment (PA). It examined 560 nurses working in hospitals and primary healthcare units. We used: Maslach Burnout Inventory and a questionnaire including socio-demographic (sex, age, marital status, education, parental status) and occupational (period of employment, workplace, managerial functions, additional employment) factors. An average respondent was 38.13 (SD = 10.16) and had a BA degree (56.0%). The respondents reported average values of the EE (22.8), a low level of DEP (Me = 6), and a low PA (27.63). Nurses working on the intensive care unit had a chance of a high level of DEP that was 75% lower (OR = 0.25, 95% CI = 0.13–0.50) than nurses working in conservative treatment units. Additional employment increased the risk of a high level of DEP (OR = 2.86, 95% CI = 1.70–4.84). The chance of low PA was 64% lower in the case of nurse managers (OR = 0.36, 95% CI = 0.13–0.998) than other nurses. Education, period of employment, additional employment, and managerial position had a significant influence on the level of occupational burnout. An analysis of nurses’ work overload and additional employment can be an interesting research area.

Background: The relationship between chronic periodontitis (CP) and increased risk for cardiovascular disease (CVD) is known but quantitative assessments and mechanisms are not fully understood. The aim of this study was to assess the relationship between past myocardial infarction (MI) and the severity of CP, and the level of serum antibody titer against Porphyromonas gingivalis gingipains. Methods: The study sample consisted of 97 patients after MI and 113 high risk controls with no history of coronary heart disease (CHD) matched with age, sex and place of residence (urban vs. rural). Data on the history of CHD and presence of risk factors were collected. Periodontal status was assessed using the Community Periodontal Index (CPI), clinical attachment loss (CAL), bleeding on probing (BOP) and pocket depth (PD). Results: After adjustment for potential confounders patients with BOP = 20–50% and BOP > 50% had more than four times higher odds of past MI (OR = 4.56; 95% CI 2.03–10.27). Patients with CPI code = 4 had a three times higher odds of past MI (OR = 3.18, 95% CI 1.01–10.06). CAL ≥ 6 was related to higher odds of past MI (OR = 1.28, 95% CI 1.11–1.49). Patients with moderate antibody titer levels had an almost 3 times higher odds of past MI (OR = 2.82, 95% CI 1.02–7.84). Conclusions: There was an association between CP and past MI, which was independent of classical CVD risk factors and confirmed by an association between past MI and immunological reaction against P. gingivalis gingipains. Background: The relationship between chronic periodontitis (CP) and increased risk for cardiovascular disease (CVD) is known but quantitative assessments and mechanisms are not fully understood. The aim of this study was to assess the relationship between past myocardial infarction (MI) and the severity of CP, and the level of serum antibody titer against Porphyromonas gingivalis gingipains. Methods: The study sample consisted of 97 patients after MI and 113 high risk controls with no history of coronary heart disease (CHD) matched with age, sex and place of residence (urban vs. rural). Data on the history of CHD and presence of risk factors were collected. Periodontal status was assessed using the Community Periodontal Index (CPI), clinical attachment loss (CAL), bleeding on probing (BOP) and pocket depth (PD). Results: After adjustment for potential confounders patients with BOP = 20–50% and BOP > 50% had more than four times higher odds of past MI (OR = 4.56; 95% CI 2.03–10.27). Patients with CPI code = 4 had a three times higher odds of past MI (OR = 3.18, 95% CI 1.01–10.06). CAL ≥ 6 was related to higher odds of past MI (OR = 1.28, 95% CI 1.11–1.49). Patients with moderate antibody titer levels had an almost 3 times higher odds of past MI (OR = 2.82, 95% CI 1.02–7.84). Conclusions: There was an association between CP and past MI, which was independent of classical CVD risk factors and confirmed by an association between past MI and immunological reaction against P. gingivalis gingipains.

INTRODUCTION Patients with established coronary artery disease (CAD) are at high risk of recurrent cardiovascular events. OBJECTIVES The aim of the study was to identify factors related to control of hypercholesterolemia in patients after hospitalization for CAD. PATIENTS AND METHODS The study included consecutive patients from 5 hospitals with cardiology departments serving one city in southern Poland. Patients were hospitalized for an acute coronary syndrome or for a myocardial revascularization procedure. Interviews and examinations were conducted 6 to 18 months after hospitalization. RESULTS Overall, 83.6% of the patients were taking statins; 2.1%, fibrates; and 0.5%, ezetimibe. A statin at a high dose (>= 40 mg of atorvastatin or >= 20 mg of rosuvastatin) was taken by 36.1% of the participants. Younger age and index hospitalization in a teaching hospital were significantly associated with a higher probability of taking a statin. Overall, 28.1% of the patients had good control of hypercholesterolemia (low-density lipoprotein [LDL] cholesterol levels <1.8 mmol/l), whereas 71.9%, 38.6%, 24.4%, and 10.3% had LDL cholesterol levels of 1.8 mmol/l or higher, 2.5 mmol/l or higher, 3.0 mmol/l or higher, and 4.0 mmol/l or higher, respectively. Younger age, high blood pressure, and high fasting glucose levels were related to a higher probability of having LDL cholesterol levels of 1.8 mmol/l or higher, while younger age, shorter period of education, professional inactivity, lack of cardiac rehabilitation, and high blood pressure were related to the probability of LDL cholesterol levels of 4.0 mmol/l or higher. CONCLUSIONS The frequency of statin use is affected by age and health care-related factors, while control of hypercholesterolemia after hospitalization due to CAD is dependent mainly on patient-related and clinical factors.

Central and peripheral blood pressure (BP) and periodontal disease (PD) are considered to be related to the risk of cardiovascular disease. However, there is scarce evidence on the association between chronic PD and BP. The aim of the study was to assess the relation between chronic PD, antibodies against Porphyromonas gingivalis (P.g.) gingipains and central and peripheral BP in high-risk patients with previous myocardial infarction. We examined 99 patients (71 men and 28 women) 6 to 18 months after myocardial infarction. The periodontal status was assessed using the Community Periodontal Index (CPI). BP was measured noninvasively using the Mobil-O-Graph device. Antibody titers against P.g. gingipains were determined by an enzyme-linked immunosorbent assay. The association between CPI and BP was assessed using logistic regression models. The mean age of participants was 60.5 ±8.7 years. After the adjustment for age, sex, smoking, diabetes, number of antihypertensive drugs, hypercholesterolemia, body mass index, and left ventricular ejection fraction, an association was found between central and peripheral BP and the CPI. Patients from the CPI 3 + 4 group were found to have almost 3 times higher odds of central BP of 130/90 mmHg or higher and more than 3 times higher odds of peripheral BP of 140/90 mmHg or higher compared with patients from the CPI 1 + 2 group. The severity of PD was associated with increased central and peripheral BP. The association between BP and PD may partially explain the cardiovascular risk related to chronic PD. Proteolytic activity of P.g. gingipains was not associated with BP.

Participation in cardiac rehabilitation programs (CRPs) improves prognosis in patients with coronary artery disease (CAD). However, not much is known about the effectiveness of CRP in real life. The aim of this analysis was to identify factors related to the referral to CRP following hospitalization for CAD and estimate the effectiveness of the programs in real life. Medical records of 1061 consecutive patients aged ≤80 years, hospitalized due to an acute coronary syndrome or for a myocardial revascularization procedure in 5 hospitals serving the city and surrounding counties, were reviewed and 611 patients were interviewed 6–18 months posthospitalization. Of 611 patients participating in the interview, 212 (34.7%) were referred following the hospitalization to a center providing CRP. Age, hospitalization in a teaching hospital, and index diagnosis were independently related to being granted a referral. Among the referred patients, 86.3% participated in the CRP. Participation in CRP was related to the lower probability of having high total cholesterol (23% vs 32%, P < 0.05), fasting glucose (11% vs 18%, P = 0.05), Hb_A1c (8% vs 16%, P = 0.05), and body mass index (27% vs 37%, P < 0.05). Generally, the effect of the CRP was significant in participants with a higher education, but not in those with a low education level. Other factors were not significantly related to the effectiveness of CRP. This study shows that CRPs are effective, but underused in Poland. The participant's education level may influence the effectiveness of CRP. Therefore, in order to increase the impact of CRP, the content of such programs should vary depending on the education level of the participants.

Background: The highest priority in preventive cardiology was given to patients with estab­lished coronary artery disease (CAD). The aim of the study was to assess the implementation of guidelines for secondary prevention in everyday clinical practice by evaluating control of the main risk factors and the cardioprotective medication prescription rates for patients, following their hospitalization for CAD. Methods: Five hospitals with cardiology departments serving the city and its surround­ing districts in southern part of Poland participated in the study. Consecutive patients aged ≤ 80 years, hospitalized from January 1 2010 to April 31 2012 due to an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6–18 months after hospitalization. Results: The medical records of 595 patients (mean age: 62.8 ± 9.0 years, 397 men and 198 women) were reviewed and included in the analyses. Proportions of medical records with available information on risk factors were high with the exception of total cholesterol levels as well as weight and height measurements, which were available in less than 80% of the hospital records. The prescription rate at discharge for antiplatelets was 99%, beta-blockers (BB) — 85%, angiotensin converting enzyme inhibitors (ACEI) or sartans — 85%, and lipid-lowering drugs — 94%. Patients scheduled for coronary artery bypass grafting were significantly less often prescribed BB, ACEI or sartans, and lipid-lowering drugs. The proportion of patients with high blood pressure (≥ 140/90 mm Hg) 6–18 months after hospitalization was 47%, with high LDL cholesterol level (≥ 1.8 mmol/L) 73%, and with a high HbA_1c level (≥ 7.0%) 14%, whereas 20% of participants were smokers and 80% were overweight. The proportion of patients taking an antiplatelet agent 6–18 months after hospitalization was 90%, BB — 82%, ACEI — or sartan 78%, and lipid-lowering drug — 82%. Overall, 33.9% of the study participants declared that they had been advised to participate in a rehabilitation/secondary prevention program following their hospitalization and 30.5% participated in a rehabilitation/secondary prevention program. However, only 28.2% took part in at least half of the planned sessions. Using a multivariate analysis we showed that, in general, risk factors control and the prescription rates of cardioprotective medications were related to the patients’ age, education, and participation in a rehabilitation/secondary prevention program following their hospitalization due to CAD. Conclusions: Our data provide evidence that there is a considerable potential for further reduction of cardiovascular risk in CAD patients. Our results suggest that increasing patient participation rates in rehabilitation/secondary prevention programs may improve the imple­mentation of the secondary prevention. Background: The highest priority in preventive cardiology was given to patients with estab­lished coronary artery disease (CAD). The aim of the study was to assess the implementation of guidelines for secondary prevention in everyday clinical practice by evaluating control of the main risk factors and the cardioprotective medication prescription rates for patients, following their hospitalization for CAD. Methods: Five hospitals with cardiology departments serving the city and its surround­ing districts in southern part of Poland participated in the study. Consecutive patients aged ≤ 80 years, hospitalized from January 1 2010 to April 31 2012 due to an acute coronary syndrome or for a myocardial revascularization procedure were recruited and interviewed 6–18 months after hospitalization. Results: The medical records of 595 patients (mean age: 62.8 ± 9.0 years, 397 men and 198 women) were reviewed and included in the analyses. Proportions of medical records with available information on risk factors were high with the exception of total cholesterol levels as well as weight and height measurements, which were available in less than 80% of the hospital records. The prescription rate at discharge for antiplatelets was 99%, beta-blockers (BB) — 85%, angiotensin converting enzyme inhibitors (ACEI) or sartans — 85%, and lipid-lowering drugs — 94%. Patients scheduled for coronary artery bypass grafting were significantly less often prescribed BB, ACEI or sartans, and lipid-lowering drugs. The proportion of patients with high blood pressure (≥ 140/90 mm Hg) 6–18 months after hospitalization was 47%, with high LDL cholesterol level (≥ 1.8 mmol/L) 73%, and with a high HbA_1c level (≥ 7.0%) 14%, whereas 20% of participants were smokers and 80% were overweight. The proportion of patients taking an antiplatelet agent 6–18 months after hospitalization was 90%, BB — 82%, ACEI — or sartan 78%, and lipid-lowering drug — 82%. Overall, 33.9% of the study participants declared that they had been advised to participate in a rehabilitation/secondary prevention program following their hospitalization and 30.5% participated in a rehabilitation/secondary prevention program. However, only 28.2% took part in at least half of the planned sessions. Using a multivariate analysis we showed that, in general, risk factors control and the prescription rates of cardioprotective medications were related to the patients’ age, education, and participation in a rehabilitation/secondary prevention program following their hospitalization due to CAD. Conclusions: Our data provide evidence that there is a considerable potential for further reduction of cardiovascular risk in CAD patients. Our results suggest that increasing patient participation rates in rehabilitation/secondary prevention programs may improve the imple­mentation of the secondary prevention.

The evidence concerning the quality of secondary prevention of coronary artery disease (CAD) in Poland in recent years is scarce. To compare the implementation of secondary prevention guidelines into everyday clinical practice between 2006-2007 and 2011-2012 in patients after hospitalisation due to CAD. Five hospitals with departments of cardiology serving a city and its surrounding districts in the southern part of Poland participated in the study. Consecutive patients aged ≤ 80 years, hospitalised from April 1, 2005 to July 31, 2006 (first survey) and from April 1, 2010 to June 30, 2011 (second survey) due to acute coronary syndrome or for a myocardial revascularisation procedure were recruited and interviewed 6-18 months after hospitalisation. Medical records of 640 patients were reviewed and included in the first survey and 466 in the second survey. The proportion of medical records with available information on smoking did not differ between the surveys, whereas the proportion of medical records with available information on blood pressure and total cholesterol was lower in patients hospitalised in 2010-2011. The prescription rate of β-blockers at discharge decreased from 90% to 84% (p < 0.05), whereas the prescription rates at discharge of other drug classes did not change significantly. The proportion of patients with high blood pressure (≥ 140/90 mm Hg) one year after hospitalisation decreased in 2011-2012 compared to 2006-2007 (from 48% to 35%, p < 0.05), whereas the proportion of subjects with high LDL cholesterol, high fasting glucose, and obesity did not change significantly. We did not note a significant difference in the smoking rate. The proportions of patients taking an antiplatelet agent (90% vs. 91%), a β-blocker (87% vs. 79%), an ACE inhibitor or a sartan (79% vs. 76%), a calcium antagonist (22% vs. 25%), a diuretic (35%vs. 45%), and a lipid-lowering drug (86% vs. 87%) one year after discharge did not change significantly (all p > 0.05). We noted a modest improvement in the implementation of CAD secondary prevention guidelines in everyday clinical practice: blood pressure was better controlled, although the control of all other main risk factors did not change significantly. Our data provides evidence that there is a considerable potential for further reduction of cardiovascular risk in CAD patients.