Journal of Nursing Theory and Practice

[A Bit of History]

SÖVÉNYI Ferencné

JULY 30, 2012

Journal of Nursing Theory and Practice - 2012;25(04)

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Journal of Nursing Theory and Practice

[The working conditions of paramedical professionals in general, paediatric and combined medical practices in Hungary]

HIRDI Henriett Éva, KÁLMÁNNÉ SIMON Mária, BALOGH Zoltán

[Aim of the study: To assess the working conditions of paramedical professionals in general, child and family practices, and to compare the data with the results of the survey conducted by the Hungarian Chamber of Paramedical Professionals (MESZK) in 2006 and by the National Institute of Primary Care (OALI) in 2004. Methodology and sample: The cross-sectional survey was conducted between 13 May 2012 and 30 June 2012 among paramedical professionals working in general, child and family practices, selected using a random, sampling method (N=812). The data gathering took place using a web-based, anonymous, self-completion questionnaire. The authors analysed the gathered data with Microsoft Excel 2007 software, employing a descriptive and mathematical statistical methods. Results: Based on the results of the survey it was concluded that the primary task of the nurses (95%) was the preparation of reports and data submissions, and keeping the electronic patients records system up-to-date accordingly. Their second most common activity (94%) is participation in the performance of tasks related to patient care. 67% of the nurses that responded perform health education, health awareness and advisory activities, primarily in relation to the topics of healthy nutrition, recommended screening tests and the spread of infectious diseases. The nurses are generally satisfi ed with their physical working conditions (72%), their job security (77%), their work schedule (77%) and their co-workers (83%), but they expressed the least satisfaction (73%) with their fi nancial compensation. Conclusions: Everyday experience and the results of the research show that the situation of paramedical workers, in terms of the activities they perform, their income, the allocation of holiday leave, and substitution, has not improved at all in comparison to the fi ndings of the 2006 survey. A signifi cant proportion of the nurses would like to perform more substantive and professionally challenging tasks, but their working environment does not allow this.]

Journal of Nursing Theory and Practice

[Comparison of somatic and psychological health of health care workers in Csongrád County between the years of 2008 and 2012]

NÉMETH Anikó, IRINYI Tamás

[Aims of the study: To asses the changes in psychosomatic status, burn-out level and judgment of own health of health care workers in Csongrád County since 2008. Furthermore we investigated how much they intend to continue working in their current position judging from psychological and somatic point of view. Methodology and sample: Both cross-sectional studies were carried out by the means of self-designed self-report questionnaires sent to registered members of MESZK living in Csongrád County in 2008 and 2012. Results: The judgement of own health got worse since 2008, but in psychosomatic symptoms there was a non-signifi cant improvement. The incidence of headaches decreased signifi cantly. The points on the burn-out scale increased signifi cantly which implies worse psychological condition. Conclusions: The population of health care workers is aging and it is characterised by worsening psychological state.]

Journal of Nursing Theory and Practice

[The nursing challenges related to gestational diabetes]

MENG Zsuzsa, VÁRADYNÉ HORVÁTH Ágnes, OLÁH András

[Aim of the study: To assess how age and BMI affect the result of the OGTT, and to study the data on blood sugar levels. Methodology and sample: Retrospective, quantitative, cross sectional, with non-random sampling. GDM patients aged 16- 50 years were surveyed (n=123 persons), with analysis of the data relating to multiparas (n=51) and primiparas (n=72). The research took the form of an analysis of medical and nursing documents. Results: In a study of the BMI and the 2-hour OGTT results, and in a study of age and BMI, signifi cance was observed in the case of the multiparas. Comparing the 0’ OGTT values with the empty-stomach blood sugar results from the 1st control test following the diagnosis of GDM, signifi cance was observed in both groups. Conclusions: Based on the fi ndings of the research it can be concluded that a higher BMI is generally associated with more advanced age, and that it has an unfavourable impact on the results of the OGTT. It is necessary to repeat the reclassifi cation in the later stage of the pregnancy, in the 6th week following birth, and upon cessation of breastfeeding.]

Journal of Nursing Theory and Practice

[25 Years in Patient Care. Always Find and Hope]

HUDOBA Mihályné

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[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

Lege Artis Medicinae

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

Lege Artis Medicinae

[A short chronicle of three decades ]

KAPRONCZAY Katalin

[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

Clinical Neuroscience

Autonomic nervous system may be affected after carpal tunnel syndrome surgery: A possible mechanism for persistence of symptoms after surgery

ONDER Burcu, KELES Yavuz Betul

After carpal tunnel surgery, some patients report complaints such as edema, pain, and numbness. Purpose – The aim of this study was to evaluate autonomic nervous system function in patients with a history of carpal tunnel surgery using sympathetic skin response (SSR). Thirty three patients (55 ±10 years old) with a history of unilateral operation for carpal tunnel syndrome were included in the study. The SSR test was performed for both hands. Both upper extremities median and ulnar nerve conduction results were recorded. A reduced amplitude (p=0.006) and delayed latency (p<0.0001) were detected in the SSR test on the operated side compared to contralateral side. There was no correlation between SSR and carpal tunnel syndrome severity. Although complex regional pain syndrome does not develop in patients after carpal tunnel surgery, some of the complaints may be caused by effects on the autonomic nervous system.

Clinical Neuroscience

Simultaneous subdural, subarachnoideal and intracerebral haemorrhage after rupture of a peripheral middle cerebral artery aneurysm

BÉRES-MOLNÁR Anna Katalin, FOLYOVICH András, SZLOBODA Péter, SZENDREY-KISS Zsolt, BERECZKI Dániel, BAKOS Mária, VÁRALLYAY György, SZABÓ Huba, NYÁRI István

The cause of intracerebral, subarachnoid and subdural haemorrhage is different, and the simultaneous appearance in the same case is extremely rare. We describe the case of a patient with a ruptured aneurysm on the distal segment of the middle cerebral artery, with a concomitant subdural and intracerebral haemorrhage, and a subsequent secondary brainstem (Duret) haemorrhage. The 59-year-old woman had hypertension and diabetes in her medical history. She experienced anomic aphasia and left-sided headache starting one day before admission. She had no trauma. A few minutes after admission she suddenly became comatose, her breathing became superficial. Non-contrast CT revealed left sided fronto-parietal subdural and subarachnoid and intracerebral haemorrhage, and bleeding was also observed in the right pontine region. The patient had leucocytosis and hyperglycemia but normal hemostasis. After the subdural haemorrhage had been evacuated, the patient was transferred to intensive care unit. Sepsis developed. Echocardiography did not detect endocarditis. Neurological status, vigilance gradually improved. The rehabilitation process was interrupted by epileptic status. Control CT and CT angiography proved an aneurysm in the peripheral part of the left middle cerebral artery, which was later clipped. Histolo­gical examination excluded mycotic etiology of the aneu­rysm and “normal aneurysm wall” was described. The brain stem haemorrhage – Duret bleeding – was presumably caused by a sudden increase in intracranial pressure due to the supratentorial space occupying process and consequential trans-tentorial herniation. This case is a rarity, as the patient not only survived, but lives an active life with some residual symptoms.