Evaluating quality of life in traumatic brain injury patients

Małgorzata Wiśniewska, Wiesław Tomaszewski, Ireneusz M. Kowalski, Teresa Wiśniewska

Małgorzata Wiśniewska, Wiesław Tomaszewski, Ireneusz M. Kowalski, Teresa Wiśniewska – Evaluating quality of life in traumatic brain injury patients. Fizjoterapia Polska 2006; 6(1); 13-21

Abstract

Background. According to the World Health Organization (WHO), quality of life (QOL) depends on how individuals perceive their position in life, in the context of the culture and value system in which they live, taken together with their own individual goals, standards, expectations and fears. As a result of traumatic brain injury (TBI), all aspects of the patient’s QOL undergo change to some extent. Neurosurgical treatment, followed by the long hard work of rehabilitation, speech therapy, psychotherapy – all these factors can contribute to significantly improved QOL, which can be measured using questionnaires developed for this purpose. Material and methods. The clinical material consisted of 30 patients (14 female, 16 male) ranging in age from 11 to 50 years, hospitalized in the Department of Rehabilitation at the UMK Collegium Medicum University Hospital in Bydgoszcz. All these patients filled out two widely used questionnaires pertaining to QOL: the WHOQOL-Bref and the SF-36. Results. Both the women and the men in the study population indicated a high QOL in the context of their immediate environment, but a low QOL in respect to social life. Conclusions. The WHOQOL-Bref is more suitable than the SF-36 for the evaluation of QOL in TBI patients, because the former contains questions pertaining to different aspects of life.

Key words:
questionnaire, coma, rehabilitation
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Influence of auto-therapy on efficiency of treatment of group pain backbone

Teresa Wiśniewska, Ireneusz M. Kowalski, Małgorzata Wiśniewska

Teresa Wiśniewska, Ireneusz M. Kowalski, Małgorzata Wiśniewska – Influence of auto-therapy on efficiency of treatment of group pain backbone. Fizjoterapia Polska 2006; 6(2); 138-142

Abstract

Background. The authors worked out the therapeutic programme for the backbone pain syndromes of the lumbar spine, broadened by the programme of auto-therapy- that is the set of exercises designed for everyday, independent practice at the home. Authors took into consideration the fact that a certain group of muscles has the tendency of staying in the contracture which causes the disorder of muscular balance to happen. As a result it gives a feeling of discomfort and if such state tends to last longer can be cause pain of the backbone syndromes. The programme created for patients, was a result of the conducted research concerning norms of the elasticity of muscles, and its task was to restore the disturbed muscular balance. Making patients aware of their responsibility and taking part in that therapeutic success through the introduction of auto-therapy allows to accelerate the process of recovering. The main aim of the authors of this therapeutic programme was to stimulate the patients to the independent, systematic work to improve oneself everyday. The systematic care of the muscular balance guarantees full recovery of the backbone pain syndrome. Material and methods. In the programme participated 40 patients at the age from 28 to 56 years. All the patients were characterized by similar ailments, among which predominated the constant pain or appearing in certain situations. Patients were divided into two research groups. The first group was improved according to the basic programme under the therapist direction, meanwhile second group except for the basic programme mounted the programme extended by independent practices made at the home, that is so called auto-therapy. Results and Conclusions. The extension of the basic programme by auto-therapy, that is the independent self-work in home conditions allows the acceleration of the treatment of the backbone pain syndrome. Moreover maintaining patient’s muscular balance reduces the risk of quick recurrences of pain ailments. (He is liberated active part and for the efficiency of the therapy patient responsibility the additional energy which strengthens the patient both from the physical side, how and psychical side). What strengthens the patient is the energy triggered by an active participation and the patient’s responsibility for the effectiveness of the therapy. This energy ameliorates both patient’s physical and psychical side.

Key words:
auto-therapy, muscle balance, backbone pain syndrome
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The importance of quality in the practice of physiotherapy. The case of the Regional Specialised Paediatric Hospital in Kielce

Wojciech Kiebzak, Małgorzata Starczyńska, Zbigniew Śliwiński, Ireneusz M. Kowalski, Lucyna Robak, Marek Kiljański, Marek Woszczak, Magdalena Jaskólska-Pisiewicz

Wojciech Kiebzak, Małgorzata Starczyńska, Zbigniew Śliwiński, Ireneusz M. Kowalski, Lucyna Robak, Marek Kiljański, Marek Woszczak, Magdalena Jaskólska-Pisiewicz – The importance of quality in the practice of physiotherapy. The case of the Regional Specialised Paediatric Hospital in Kielce. Fizjoterapia Polska 2007; 7(2), 133-144

Abstract

Background. The aim of this paper was to show that procedures used within the framework of therapeutic management at the Regional Specialised Paediatric Hospital in Kielce improve the quality of service, which is the main condition for the hospital to remain on the market of health service providers. The high quality of services has been confirmed by the recent conferring of an accreditation certificate which requires that the hospital operate on the basis of a number of documented procedures, instructions and standards. The therapeutic activities of the hospital are based on a set of instructions providing detailed guidelines concerning the management of particular medical conditions. Material and methods. The study included children who were hospitalized or treated on an outpatient basis. Patient management was based on a set of instructions. An anonymous questionnaire concerning the quality of treatment and the level of satisfaction with the service was distributed among the children’s guardians and parents. Results. In the first and the second half of the year 2005, 95% and 86% of parents respectively assessed service quality as very good. 92% of parents gave the rating of very good in the first half of the year 2006 and 79% did so in the second half of the year. These results confirmed the high quality and efficacy of as well as satisfaction with the treatment received by the children. Conclusions. The observance of specified instructions during the therapeutic process improves the quality of service and minimizes the possibility of medical malpractice.

Key words:

quality, standard, instructions, rehabilitation treatment

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