Functioning of chronically ill patients receiving long-term care in Poland

Bożena Majchrowicz^1*Krystyna Kowalczuk²Alicja Kłos³Katarzyna Tomaszewska³

• ¹Collegium Medicum, Institute of Nursing, University of Rzeszów, Rzeszów, Poland
• ²Department of Integrated Medical Care, Medical University of Białystok, Białystok, Poland
• ³Department of Nursing, Institute of Health Protection, The Bronisław Markiewicz Academy of Applied Sciences, Jarosław, Poland

Introduction: Chronic diseases and disabilities require the implementation of multidimensional supportive measures – medical, social, and organizational. In Poland, home care plays a key role, enabling individuals with chronic illnesses to remain in their natural environment, which improves quality of life, independence, and social interaction. Aim: The aim of the study is to characterize the functioning of individuals with chronic diseases in the context of long-term care and to analyze selected determinants of this functioning. This assessment is important, as it enables the identification of factors that influence the quality of life and independence of patients receiving this form of care. Material and methods: The study was conducted among patients receiving long-term home nursing care in south-eastern Poland. The diagnostic survey method was applied, using a questionnaire that included questions on sociodemographic data as well as standardized research tools: the Barthel Index, the Functioning in Chronic Illness Scale (FCIS), and the Beck Depression Inventory (BDI) - tools with established reliability and validity in chronically ill populations. For statistical analysis, the Mann– Whitney U test and Spearman's rho correlation coefficient were used. Statistical significance was set at p ≤ 0.05. Results and conclusions: The mean score obtained during the last assessment was 19.38 (SD = 13.51), with a median of 15.00 points, indicating a low level of independence among the respondents. The overall functioning in chronic illness (FCIS) reached an average score of 59.02 (SD = 10.12). The mean severity of depressive symptoms in the study group was 19.2 ± 6.9 points on the Beck Depression Inventory, corresponding to moderate symptom severity. The study demonstrated significant associations between the level of patient independence, the occurrence of depressive symptoms, and functioning in the course of chronic disease. Most respondents presented a low level of independence, which translated into limited coping abilities, reduced functioning, and a considerable impact of illness on their daily lives and attitudes. Moreover, a substantial proportion of respondents exhibited moderate. The findings confirm the need for comprehensive, multidimensional care for patients with chronic diseases.