Our research is conducted within the framework of national cooperation between universities. Project strengths are best represented by cross-sectional studies and a randomized controlled trial (RCT) conducted among older people living in local communities and receiving institutional care. The cross-sectional studies we carried out in 2015-2020 were aimed at assessing the disability, functioning and health of older people living in a community in south-eastern Poland. Research carried out in cooperation with the Medical University of Lodz showed that, among people aged 71-80, the highest average level of disability occurred in the performance of daily activities, participation in everyday life, maintaining good contacts with others and in the field of mobility. A higher degree of disability occurred in people with a place of residence that was not adapted to their functional needs, as well as those who were not able to use the help of other people [1].

To assess disability, functioning and health, we used the WHO Disability Assessmeent Schedule 2.0 (WHODAS 2.0), a questionnaire recommended by the World Health Organization (WHO) and created on the basis of the International Classification of Functioning, Health and Disability (ICF). By participating in the ICF Council at the CSIOZ in Warsaw, together with experts from all over Poland and cooperation with WHO, we translated the WHODAS questionnaire into Polish and adapted it culturally. Our WHODAS validation showed high psychometric values of the tool. Research using WHODAS 2.0 is also the first research in Poland introducing ICF to be used in science and practice. After the publication of our article, it is possible to use the WHODAS 2.0 scale more widely in nationwide disability assessment studies based on ICF and to compare results internationally [2].

The next study, carried out in cooperation with the National Institute of Public Health and Lazarski University in Warsaw, showed a relationship between the occurrence of depression, chronic diseases and disability among people aged 60-80. We indicated that early diagnosis and treatment of depression in seniors should be the basis for developing diagnostic and rehabilitation standards for the older people burdened with many comorbidities [3].

In a randomized study of the effectiveness of multi-component physical exercise combined with education on healthy lifestyles, we showed a significant improvement in the results of tests assessing the balance, mobility and functional fitness of seniors. We have confirmed the health benefits of using an exercise programs combined with education. The results achieved were the basis for the development of further health programs [4].

In the RCT conducted among older people covered by institutional care, we assessed the impact of physical exercise program combined with motivation. We showed a significant improvement in functional efficiency, activation in free time and improvement of the health condition of the older people living in nursing homes. The study confirmed the effectiveness of the program developed by us, easy and cheap to use in nursing homes [5].

2. Evidence of research contribution

Ćwirlej-Sozańska A., Sozański B., Wiśniowska-Szurlej A., Wilmowska-Pietruszyńska A., Kujawa J. Assessment of Disability and Factors Determining Disability among Inhabitants of South-Eastern Poland Aged 71-80 Years. BioMed Research International. 2018: ID 3872753.

https://www.hindawi.com/journals/bmri/2018/3872753/

Ćwirlej-Sozańska A., Wilmowska-Pietruszyńska A., Sozański B. Validation of the Polish version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) in an elderly population (60-70 years old). International journal of occupational safety and ergonomics. 2018;24 (3):386-394.

http://dx.doi.org/10.1080/10803548.2017.1316596

Ćwirlej-Sozańska A., Wiśniowska-Szurlej A., Sozański B., Fal A., Wilmowska-Pietruszyńska A. The Relationship Between Depression, Chronic Illnesses and Disability Among Community-Dwelling Women and Men Aged 60–80 Years: A Cross-Sectional Analysis. International Journal of Gerontology. 2019;13(4):286-292.

http://www.sgecm.org.tw/DB/ijge/11/208.pdf?v=2020/5/8

Ćwirlej-Sozańska A., Wiśniowska-Szurlej A., Wilmowska-Pietruszyńska A., Drużbicki M., Sozański B., Wołoszyn N., Guzik A. Evaluation of the Effect of 16 Weeks of Multifactorial Exercises on the Functional Fitness and Postural Stability of a Low-Income Elderly Population. Topics in Geriatric Rehabilitation. 2018; 34 (4): 251-261.

https://www.nursingcenter.com/journalarticle?Article_ID=4823344&Journal_ID=515682&Issue_ID=4823146

Wiśniowska-Szurlej A., Ćwirlej-Sozańska A., Wołoszyn N., Sozański B, Wilmowska-Pietruszyńska A. Effects of Physical Exercises and Verbal Stimulation on the Functional Efficiency and Use of Free Time in an Older Population under Institutional Care : A Randomized Controlled Trial. Journal of Clinical Medicine. 2020;9(2)477.

https://www.mdpi.com/2077-0383/9/2/477

3. Characteristic of societal impact

Apart from scientific effects, the cross-sectional and intervention studies conducted by the Team have a wide social impact. An innovation in the research methodology was the application of the International Classification of Functioning of Health and Disability developed by the World Health Organization. The international tool made it possible to apply a unified disability assessment, compare its level between populations and identify areas of physical and social functioning that should be considered in the planning of healthcare for seniors. An important social achievement in the implementation of the ICF classification in Poland was the implementation, by the team members together with the Polish Society of Public Health (PTZP), of training: "Application of the International Classification of Disability and Health Functioning (ICF) in health care" raising the competences of administrative staff and managing medical entities in Poland [1].

Another achievement was the co-participation in the translation of the Polish version of ICF and the translation and validation of the Polish version of the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) based on ICF in cooperation with the Council for the Implementation of ICF in Poland operating at the Center of Health Information Systems (CSIOZ) in Warsaw . The translated ICF classification and WHODAS 2.0 questionnaire, after obtaining WHO approval, will be used in subsequent population and clinical studies by Polish scientists and in clinical practice of health protection [2].

The study of the effectiveness of multi-component physical exercises combined with the education of seniors on the subject of healthy lifestyles has allowed the development of an intervention program aimed to improvement of the functional status and health of the older people. The results of the study were an introduction to the development of a course for seniors "Healthy Lifestyle" in the project "Systematic informal education of the University of Rzeszów as a space for the development of UTW-UR students" worth PLN 1 813 585.20, implemented in cooperation with the University of the Third Age (UTW) established at University of Rzeszów. The course includes a program of multi-component physical and cognitive exercises for the older people, educational seminars, individual consultations on a healthy lifestyle and EEG neurobiofeedback training for seniors. The result of ongoing work is the preparation of recommendations for seniors published on the UTW website [3]. The results of the implemented program will be prepared in the form of model programs and recommendations for seniors.

Our scientific research has also enabled us to participate in the following projects:

"Professionalization of assistant and care services for dependent persons - new standards of education and care" implemented as part of the Operational Program Knowledge Education Development 2014-2020 co-financed from the European Social Fund (POWR. 02.08.00-00-0018 / 17-00), in cooperation with the Cardinal Stefan Wyszyński University in Warsaw. The main objective of the project was to assess the degree of dependence based on the ICF classification and to provide assistant and care services for 400 dependent persons in Poland [4].
"HoCare2.0" organized by the Rzeszów Regional Development Agency (RARR). The project is implemented in cooperation with partners from Germany, Italy, the Czech Republic, Hungary and Slovakia. The result of the project is the development and implementation of innovative solutions in the field of home care for the older people. The project is co-financed by the European Regional Development Fund under the Interreg Central Europe program.

The team's most important achievements include the implementation of 9 projects, actualized in 2017-2019, thematically related to the impact described as part of maintaining and developing the research potential of the University of Rzeszów with a total value of PLN 119 873, establishment of the Rzeszów Branch of the Polish Society of Public Health, membership in the European Association of Public Health, membership in the Council for the implementation of ICF in Poland, training 420 health care workers as part of the implementation of the ICF classification in Poland, validation and translation of the WHODAS 2.0 scale, development of health programs for people living in local communities and living in social care homes and participating in a national project "Professionalisation of assistance and care services for dependent persons - new standards of education and care" and in the international project "HoCare2.0". During the last 4 years, one member of the team has obtained the title of doctor of health sciences, while the remaining persons systematically increase their scientific and social achievements in order to achieve further promotions.

4. Evidence of societal impact

http://www.ptzp.org/pl/projekty/projekt-icf (2018)
https://www.csioz.gov.pl/interoperacyjnosc/klasyfikacje/ (2018)
https://urutw.wordpress.com/ (2019)
http://www.aio.uksw.edu.pl/pl/node/413 (2018)
https://www.interreg-central.eu/Content.Node/HoCare2.0.html (2019)

5. Justification of interdisciplinarity and break trough of the research

The interdisciplinary nature of our scientific activity is confirmed by close cooperation with scientists from other scientific disciplines (medical sciences) and cooperation with various social organizations (UTW, DPS), government (CSIOZ) and local government (RARR), as well as other universities in Poland (Lazarski University, Medical University of Lodz) and public health associations (PTZP).

The implementation and use in our scientific and clinical research of the International Classification of Functioning, Health and Disability (ICF), in cooperation with WHO, is a breakthrough in the development of science. In the era of dynamic aging of the society, our health programs and recommendations are of key importance for public health and the development of research related to this area. The new areas of improving physical and mental health of the older people (e.g. EEG neurobiofeedback), that we explore, are an important contribution to the development of Polish science.

Scientific achievements of individual team members from the discipline of Health Sciences for the years 2017-2020:

Dr n. med. Agnieszka Ćwirlej-Sozańska: 34,597 Impact Factor; 1135 MNiSW; Index Hirscha=3

Dr n. o zdr. Agnieszka Wiśniowska-Szurlej: 34,658 Impact Factor; 1176 MNiSW; Index Hirscha=3

Dr Bernard Sozański: 32,753 Impact Factor; 1051 MNiSW; Indeks Hirscha=3