WstępCelem tego systematycznego przeglądu było podsumowanie obecnej literatury na temat upośledzenia funkcji poznawczych u osób dorosłych po zabiegach operacyjnych.Materiał i metodyPrześledzono bazy MEDLINE: PubMed, OVID, Web of Science, EBSCO, używając odpowiednich słów kluczowych. Dokonano przeglądu literatury na temat zaburzeń poznawczych po zabiegach operacyjnych oraz analizy czynników ryzyka wystąpienia POCD.WynikiPrześledzono wyniki z siedmiu artykułów opisujących badania neuropsychologiczne 2796 pacjen-tów. Testy przeprowadzane były w bardzo krótkim czasie od zabiegu (7 dni), krótkim czasie (3 miesięcy) oraz odległej perspektywie (12 – 60 miesięcy). POCD w bardzo krótkim czasie po operacji występowało z różną częstością: od 17 do 56% z tendencją do ustępowania w miarę upływu czasu (3 – 34,2%). Zidentyfikowano czynniki ryzyka POCD: zaawansowany wiek, insuliooporność, krótki okres kształcenia. Rodzaj operacji, znieczulenia oraz mikrozatorowość związana z użyciem CPB nie wpływają na występowanie POCD.WnioskiPatomechanizm powstawania pooperacyjnych zaburzeń poznawczych nie jest do końca znany, jed-nak wydaje się, że należy skupić uwagę na poszukiwaniu pozaproceduralnych czynników ryzyka oraz opracować zalecenia postępowania okołooperacyjnego, co mogłoby być korzystne dla pacjen-tów zagrożonych upośledzeniem funkcji poznawczych po zabiegach operacyjnych.

Introduction. Conflicts are an inherent part of work within any organisation. They can arise between members of an interdisciplinary team (or between teams representing different departments), between patients and team members/family members, and patients’ families and team members. Various conflict situations among employees may occur, therefore it is very important to identify their causes and take preventive or targeted corrective measures. The aim of this study was to review the available literature concerning conflicts arising in ICUs—their types, methods of expression as well as their management and mitigation. In addition, we reviewed the available literature on the impact of the pandemic on the ICU environment caring for COVID-19 patients. Methods. The databases were searched. Single key words or their combinations using AND or OR operators were entered. Eventually, 15 articles were included in our review, which included two identical papers. Results. Conflicts occurred occasionally or rarely; researchers describing ethical conflicts demonstrated a moderate level of exposure to conflicts. The pandemic created many challenges and ethical dilemmas that are a source of ethical conflict. Conclusions. As conflict by nature remains inevitable, adequate procedures in conflict management should be developed and the leadership of managing personnel should be reinforced, because team members frequently expect guidance from their supervisors. The importance of training in interpersonal communication and crisis situation management in healthcare should therefore be emphasised.

Epidural analgesia is a well-recognised method of labour pain relief. It is associated with the parturient's higher satisfaction when compared to parenteral opioids. EA does not directly increase the caesarean section delivery rate, yet it can lead to instrumental deliveries (vacuum-assisted, obstetrics forceps) and a need to pharmacologically support the uterine contractile function. Further studies are required to evaluate the effect of EA on the course of labour, and methods of minimising its adverse effects.

Evaluation of sleep quality and sleep-disturbing factors in patients in an Intensive Care Unit (ICU). Over 8 months, 83 persons were examined as part of the recruitment of patients hospitalised in the ICU. The interviewer conducted interviews with the patients on the third day following their discharge from the ICU. Patients had to successfully complete the Short Portable Mental Status Questionnaire. The patients whose results reflected their normal mental status were administered the Richards-Campbell Sleep Questionnaire to evaluate the quality of sleep. A modified Freedman questionnaire was then administered. It was discovered that factors which disturb sleep most include the measurement of vital signs (3.28/10) and light (3.18/10) (1 = no disturbance, 10 = significant disturbance). It was also determined that the higher the VAS reported during the first day in the ICU, the higher the importance of pain in sleep disturbance in the ICU, Z = − 2.65; p < 0.05. The study results indicate that sleep disturbance in an ICU results from many factors. A comprehensive approach to a patient's night rest is required. A reduction of sleep-disturbing factors could result in an improvement of the quality of sleep in an ICU. What remains to be done is to turn the attention of the medical staff working in an ICU to the importance of sleep and raise their awareness of the factors which may affect it.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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