Background: There is limited data available on the spiritual dimension of palliative care in Eastern Europe. In countries such as Poland, investigating spirituality and its essential aspects is further complicated because in a predominantly Catholic country, spirituality is mistakenly thought to be identical to religiousness. Aim: This study investigated the connection between spiritual transcendence, meaning in life, altruism, and the quality of life of cancer patients in end-of-life care in an Eastern Europe Country (Poland). Design: This cross-sectional study was based on 4 surveys. The Quality of Life Questionnaire MQOL-R, the Scale of Spiritual Transcendence, the Purpose in Life Questionnaire PIL-6, and the Altruism Scale were used. Setting/Participants: Data from 41 oncology patients receiving end-of-life care at home and in a stationary hospice was obtained. Results: Results indicate that there is a significant positive correlation between transcendence, spiritual growth, and global quality of life. There is also a positive correlation between altruism and the meaning of life, as well as between the meaning of life, spirituality and quality of life, while altruism is positively associated exclusively with spirituality. Conclusion: This study revealed that spiritual transcendence can be understood, according to Piedmont's theory, as a personality trait that allows the patients to cross the boundaries of their existence and identify subjectively important values in their life. It can be examined and developed not only in the context of the need but also as a predisposition and a resource of personhood.

Introduction: Medical cannabis’ importance in Poland increased dramatically following its legalization as the 12th country in Europe in 2017. However, no studies have been published to give insight into Polish physicians’ opinions about medical cannabis. Objectives: To investigate physician’s opinions about cannabinoids’ utility in clinical practice, concerns regarding their safety profile, and their clinical experience with cannabinoids. Methods: The survey using a self-developed tool was conducted online; participants were physicians with or without specialist training. Participation was voluntary. Physicians were recruited through personal networks, palliative care courses, and Medical Chambers. Results: From June to October 2020, we recruited 173 physicians from 15/16 voivodeships. The largest age group (43.9%; n = 76) was 30–39 year-olds. A similar proportion declared they never used cannabis and did not receive any training regarding cannabinoids (60% for both). Only 15 (8%) ever prescribed medical cannabis, although about 50% declared knowing suitable patients for such therapy, and 53.8% had at least one patient proactively asking for such treatment in the last 6 mo. The most common indication chosen was pain: chronic cancer-related (n = 128), chronic non-cancer (n = 77), and neuropathic (n = 60). Other commonly chosen conditions were alleviation of cancer treatment side-effects (n = 56) and cachexia (n = 57). The overall safety profile of THC was assessed as similar to most commonly used medications, including opioids; NSAIDs and benzodiazepines were, however, perceived as safer. Conclusions: Polish physicians favored the legalization of medical cannabis. However, it is of concern that a limited number have any experience with prescribing cannabis. The creation of clear guidelines to advise physicians in their routine practice and education about pain management and the risks related to the consumption of recreational cannabis for medical conditions are needed.

Failure to alleviate cancer pain may deteriorate mental functioning, increase depression symptoms, result in the clinical diagnosis of demoralization syndrome nonadherence of treatment, functioning discipline, which together, may precipitate desire for euthanasia. Increased incidence of pain in patients with advanced or terminal disease has been reported to range from 39% to 66.4% depending on the stage of the cancer being experienced. Further, the progressive aging of societies and increased life expectancy in cancer patients has changed the dynamics of modern treatment processes. Despite their efficacy, the use of opioids as an analgesic treatment during terminal disease has been affected by the quality, availability, and negative reputation of these scheduled drugs. This review aims to describe the specific factors and limitations of opioid pain management from the perspective of patients and their caregivers. Further, we aim to identify and discuss the key factors which determine the success or failure of opioid use for the treatment of pain with links to internationally recognized recommendations and current research. Failure to alleviate cancer pain may deteriorate mental functioning, increase depression symptoms, result in the clinical diagnosis of demoralization syndrome nonadherence of treatment, functioning discipline, which together, may precipitate desire for euthanasia. Increased incidence of pain in patients with advanced or terminal disease has been reported to range from 39% to 66.4% depending on the stage of the cancer being experienced. Further, the progressive aging of societies and increased life expectancy in cancer patients has changed the dynamics of modern treatment processes. Despite their efficacy, the use of opioids as an analgesic treatment during terminal disease has been affected by the quality, availability, and negative reputation of these scheduled drugs. This review aims to describe the specific factors and limitations of opioid pain management from the perspective of patients and their caregivers. Further, we aim to identify and discuss the key factors which determine the success or failure of opioid use for the treatment of pain with links to internationally recognized recommendations and current research.

In many countries, the consumption of illicit opioids is rising, becoming a major public health issue called the "opioid crisis". Many reasons contribute to this phenomenon. One of them is opioid misuse, defined as the use of legally prescribed opioids for a purpose different than pain treatment. This matter has not been well studied in Poland, where the opioid crisis has not been identified so far. This study was conducted among patients admitted for elective surgery with opioid-based postoperative pain treatment. The frequency of opioid misuse was found to be 10.8% in a sample comprising 92 patients. The group of individuals with potential opioid use disorder had a more frequent history of inadequately controlled postoperative pain compared to the group of non-misusers (p = 0.023). Furthermore, this group asked to receive additional pain treatment almost six times more often than the control group (p < 0.000). Also, patients declaring opioid misuse reported substantial differences concerning their knowledge and opinions about pain treatment and opioid analgesics: supporting the administration of opioids for pain when needed, finding opioids less harmful, and supporting messages that opioids are safe, effective, well-tolerated, easy to cutoff more often than control. There is an urgent need for the education of patients to avoid the spreading of the opioid crisis.

Introduction The COVID-19 pandemic has been a great threat to facilities providing inpatient care to chronically/terminally ill patients or elderly people. This unprecedented situation has called for radical and previously untried solutions including restrictions or a complete ban on visiting...