Aleksandra Krawczyk

Aim. The aim of this article is to present a care plan for a pregnant woman undergoing continuous amnioinfusion, based on an individual case study. Material and methods. The case study method was employed. A patient with preterm premature rupture of membranes is described. The care plan included interview techniques, medical documentation analysis, observation and C-HOBIC clinical nursing indicators. The case description was prepared according to CARE guidelines, utilizing ICNP® terminology integrated with WHO-FIC. Results. Significant challenges during continuous amnioinfusion resulted from prolonged hospitalization and reduced physical activity, generating increased need for emotional support, attentive communication and adequate therapeutic management. The patient experienced concerns regarding pregnancy risks, medical interventions and mental well-being deterioration, which complicated self-care. Applied nursing interventions resulted in complaint reduction. Conclusions. The presented care plan enabled implementation of individualized interventions, significantly facilitating the patient adaptation to new circumstances. Effective interdisciplinary collaboration positively influenced patient well-being. The study emphasizes the importance of evidence-based care that adequately responds to complex requirements of women at risk of preterm birth. This case study fills an important literature gap by providing a comprehensive, standardized care plan for a relatively rare obstetric complication.

Introduction: Pregnancy-related anxiety is a distinct form specifically focused on perinatal concerns, including the course of pregnancy, childbirth and parenthood. Despite its clinical significance, pregnancy-related anxiety remains underrecognised in routine antenatal care. Poland has one of the highest caesarean section rates in Europe, with maternal fear of childbirth and anxiety-driven preferences for operative birth identified as major contributing factors. The aim of this study is to evaluate whether an individual, midwife-led psychoeducational intervention delivered in the second and third trimester reduces pregnancy-related anxiety. Materials and methods: This is a two-arm, parallel-group randomised controlled trial with a 1:1 allocation ratio. A total of 74 low-risk pregnant women with elevated pregnancy-related anxiety (PRAQ-R2 score ≥30 points) will be recruited from antenatal clinics, childbirth education schools and online platforms. The intervention group will receive four to six individual psychoeducational sessions delivered by a trained midwife between 24 and 34 weeks of gestation, focusing on childbirth education, pain management, communication skills, birth planning and anxiety management techniques. The control group will receive standard antenatal care and an informational booklet. The primary outcome is the reduction in pregnancy-related anxiety levels measured via the Pregnancy-Related Anxiety Questionnaire – Revised 2 between 34 and 37 weeks. Secondary outcomes include actual mode of birth and childbirth satisfaction, as well as maternal and neonatal health outcomes. Data will be collected at three time points and analysed using intention-to-treat principles. Discussion: This trial will provide initial evidence on the effectiveness of a scalable, midwife-delivered psychoeducational intervention tailored to the Polish perinatal context. If proven effective, the programme could improve maternal psychological wellbeing and strengthen the role of midwives in antenatal mental healthcare. The findings may inform future policy changes and perinatal care standards in Poland and other countries with similarly high caesarean section rates and fragmented maternity care systems. Clinical trial registration: ClinicalTrials.gov , identifier NCT07323459.

Background/Objectives: Pediatric pain management remains a significant clinical challenge, with contemporary biopsychosocial models increasingly emphasizing humanized care and non-pharmacological strategies. This study aimed to culturally adapt and evaluate the psychometric properties of the Polish version of the HUPEDCARE-Q (Humanisation of Pediatric Care in Pain Management with a Non-Pharmacological Approach) questionnaire among healthcare professionals and students. An additional objective was to explore differences in knowledge, attitudes, and self-reported practices across different age groups and stages of professional development. Methods: An observational, cross-sectional study was conducted. The cross-cultural adaptation process included independent forward translations, reconciliation, back-translation, and an expert panel review. Data were collected using online surveys. Construct validity was evaluated through confirmatory factor analysis (CFA), while internal consistency reliability was assessed using McDonald’s omega coefficient and the Kuder–Richardson Formula 20 (KR-20). Group differences were analyzed utilizing the Mann–Whitney U test. Results: Because the original factor structure exhibited a suboptimal fit to the data, a revised and reduced Polish version was proposed, which demonstrated significantly improved fit indices (CFI = 0.91 for the attitudes and knowledge domains; CFI = 0.99 for the pain management domain). Exploratory bivariate analyses showed higher knowledge and attitudes scores among older participants and working professionals, whereas no statistically significant differences were observed in self-reported pediatric pain management practices. Conclusions: The revised Polish short-form adaptation of the HUPEDCARE-Q showed improved model fit and domain-specific psychometric performance, with strong internal consistency for the pediatric pain management domain, acceptable reliability for the knowledge domain, and moderate reliability for the attitudes domain. Therefore, the instrument should be interpreted as a preliminary screening and assessment tool rather than as a fully established measure with uniformly strong reliability across all domains. The observed discrepancy between higher knowledge and attitude scores and the absence of significant differences in self-reported practices may suggest that knowledge and attitudes alone are not sufficient to explain differences in self-reported pediatric pain management practices.

Introduction: The postpartum period involves significant physical and psychological changes that can impact a woman's sexual health. Anxiety experienced prior to resuming sexual intercourse after childbirth is a common yet understudied issue that may affect relationship satisfaction and overall wellbeing. While multiple biopsychosocial factors likely contribute to this anxiety, their interactions and particularly the role of self-esteem remain insufficiently understood. The aim of this study is to identify factors associated with anxiety before first postpartum sexual intercourse and to examine the relationship between self-esteem and sexual activity resumption among Polish women. Methods: We conducted an observational, cross-sectional study among 350 Polish women up to 12 months postpartum. Data were collected via an anonymous online questionnaire, which included socio-demographic characteristics, delivery details, sexual health aspects and self-esteem assessed using the Rosenberg Self-Esteem Scale (RSES). Logistic regression analysis was applied to identify significant predictors of postpartum sexual anxiety. Results: Higher maternal age (OR = 0.93) and more frequent previous sexual activity (OR = 0.78) were associated with reduced odds of anxiety. Conversely, higher education level (OR = 1.55), more time elapsed since delivery (OR = 1.14) and perceived delivery difficulty (OR = 1.31) significantly increased the risk of anxiety. Women with higher self-esteem reported more frequent sexual activity and lower anxiety levels. The final model showed moderate predictive accuracy (AUC = 0.65–0.70) and explained 7%−12% of variance. Discussion: Multiple factors, including maternal age, education, delivery experience and self-esteem level, are associated with anxiety prior to first postpartum intercourse. The findings highlight the importance of comprehensive perinatal care aimed at both physical recovery and psychological wellbeing. Healthcare providers should incorporate assessment of sexual health concerns and self-esteem issues into routine postpartum care to better support women during this transition.

Wernicke Encephalopathy is a rare neurological disorder caused by thiamine deficiency, which can occur in pregnant women with severe hyperemesis gravidarum. This case report describes a 21-year-old primigravida with severe hyperemesis gravidarum leading to Wernicke Encephalopathy, due to thiamine deficiency. The patient experienced cognitive disturbances, followed by neurological symptoms of nystagmus, limb ataxia and postural instability. Following the diagnosis, intravenous thiamine replacement therapy was administered, resulting in gradual neurological improvement. This case underscores the importance of early identification and treatment of thiamine deficiency in pregnant patients with hyperemesis gravidarum to prevent irreversible neurological damage.

Background/Objectives: Breastfeeding is a cornerstone of infant nutrition, promoting optimal development and health benefits for both mother and child. Despite high initiation rates in Poland (97%), exclusive breastfeeding (EBF) drops sharply, reaching only 4% by six months postpartum. The aim of this study is to identify factors associated with breastfeeding practices and barriers to exclusive breastfeeding (EBF) among Polish women during the postpartum period, with particular emphasis on the role of medical personnel support and maternal stress levels. Methods: A cross-sectional observational study, adhering to STROBE guidelines, was conducted from January to May 2023. The study included 1092 Polish women, surveyed using the Computer-Assisted Web Interview (CAWI) methodology. The women exclusively breastfeeding accounted for 79% (n = 863) of the study group. The remaining women supplemented their child with modified milk (n = 229; 21%). Statistical analyses were performed using IBM SPSS Statistics (Version 26.0), and logistic regression to assess associations between variables and breastfeeding outcomes. Results: Logistic regression analysis indicated that in the women experiencing low or medium stress, none of the analysed support factors significantly influenced the likelihood of exclusive breastfeeding discontinuation. However, women experiencing high stress, receiving counselling for effective breastfeeding (OR = 0.467; 95% CI: 0.232–0.941; p = 0.033) and assistance with proper breastfeeding (OR = 0.424; 95% CI: 0.220–0.819; p = 0.011) were associated with a lower likelihood of introducing formula feeding. The main reported reasons for early breastfeeding cessation included breast health issues, mental exhaustion, lack of medical support and infant-related difficulties. Conclusions: The findings allow us to underscore the urgent need for targeted interventions to improve breastfeeding rates in Poland. New evidence indicates that women experiencing higher levels of stress require increased support from medical personnel in order to breastfeed exclusively.

Background: Preterm birth is a major global health issue, associated with increased neonatal morbidity and mortality. Mothers of preterm infants face unique challenges, particularly with regard to lactation, due to the complexities of preterm neonatal care. Social support has been recognized as a factor in promoting successful breastfeeding, especially in vulnerable groups such as mothers of preterm infants. Objective: This study aimed to explore the psychosocial factors influencing breastfeeding in mothers following preterm birth, with a particular focus on the role of social support in early lactation success. Methods: A cross-sectional observational study was conducted between December 2022 and March 2023 at a tertiary referral hospital in Poland. The study included 130 women (71 mothers of preterm infants and 59 mothers of full-term infants) in the early postpartum period. Data were collected through a self-administered questionnaire and the Polish version of the Berlin Social Support Scales (BSSS). Lactation success was assessed based on the mother’s ability to initiate and maintain breastfeeding or expressed milk production. Statistical analyses included Mann–Whitney U tests, Pearson’s Chi-Square, and logistic regression to determine the association between social support and lactation outcomes. Results: The study revealed that mothers of preterm infants exhibited a greater need for social support compared with those who delivered at term. Social support, particularly perceived emotional and practical support, appeared to be significantly associated with successful early lactation. Women who received adequate social support were more likely to initiate breastfeeding early and maintain lactation. Conclusions: Psychosocial factors, particularly social support, play a critical role in the success of lactation among mothers of preterm infants. These findings underscore the need for comprehensive support systems for mothers of preterm infants to promote breastfeeding and improve neonatal health outcomes.