Journal of Nursing Theory and Practice

[Aggression management programme for healthcare workers]


AUGUST 28, 2014

Journal of Nursing Theory and Practice - 2014;27(04)

[Aim of the study: Introducing a programme for aggression prevention and assessing the experiences of its first session in Budapest. Sample and methods: The study was conducted with the involvement of 30 healthcare workers, using a self-administrative questionnaire and a focus group session. The self-administrative questionnaires were used to evaluate the quality of the programme, while the aim of the focus group was to reveal its further details. Results: The training was met by positive responses both in connection with the material and the preparedness of the instructors. During the focus group, numerous sensitive points came to light about the programme, and further suggestions were given this way helping the improvement. Conclusions: The objective and subjective results of the study both support the need for a training that helps prevent aggression. However, further changes are needed in order to increase its effectiveness. ]



Further articles in this publication

Journal of Nursing Theory and Practice

[Examination of effects of the nurses shiftworks with application of Standard Shiftwork Index - pilot study]

FUSZ Katalin, KOVÁCS KALIC Károly, KÍVÉS Zsuzsanna, MÜLLER Ágnes, OLÁH András

[Aim of the study: Several physiological processes are disturbed in shift workers. The authors’s aim was to complete a pilot study as part of the validation process of Standard Shiftwork Index (SSI) and to examine the effects of shiftwork on the quality of sleeping and on psychical and somatic status. Sample and methods: The survey was implemented at the hospitals of the University of Szeged in 2011, with the participation of not randomly selected nurses working in shiftwork, night- or dayshifts (N=211). SSI was complemented with further respective questions. Results: Those working in dayshift suffer less from sleep disorders than nurses working in nightshift or shiftwork (p=0,002, p=0,005), and have better health status (p=0,001, p=0,003), furthermore feel themselves less tired (p=0,011, p=0,039). The nightshift workers had gastrointestinal complaints more frequently (p=0,044, p=0,006), as well as nurses working in nightshift suffer from more chronic diseases than dayshift workers (p=0,004) and shift workers (p=0,003). In case of shift workers the weekly amount of cigarettes having smoked (p=0,008) and the consumption of caffeinated refresher beverages (p<0,001) were significantly increased since the beginning of their shiftwork. Conclusion: Health status of nurses working in nightshifts and shiftwork are more relapsed, their health attitude is worse than in case of dayshift workers. As the continuation of this examination the authors try to find out which variations of shiftwork can be considered less exhausting.]

Journal of Nursing Theory and Practice

[Investigation of graduate students’ health behavior in high school of the small town]


[Aim of the study: To investigate graduate students’ addictions, their attitude towards healthy living and to find connection between the above and their parents’ and teachers’ lifestyle. Sample and methods: Investigating graduate students’ (n=100) and their teachers’ (n=29) lifestyles in a high school of a small town in Békés County. The results were analyzed by using SPSS programme (Cross tabulation analysis, Chi-Square Test). Results: While the students’ and their parents’ addictions are worse than the Nation’s average, the teachers’ tends to be better. 79 % of the parents and 54 % of the students does not do any sports on a daily basis. The parents and teachers can’t improve the students’ lifestyle efficiently. Students with good academic grades seem to lead healthier life. 60 % of the students with C, D grades (worse grades) smoke, while it’s 28 % of those with A and B (better grades). Conclusions: For efficient health education we need dedicated professionals who are able to involve parents to reach the best result. It’s a joint task to show the youngsters the way leading to a healthy life, as well as to give them the ability to be responsible in their choices.]

Journal of Nursing Theory and Practice

[Healthcare and social aspects of nursing in relation to the rare Pompe disease]

TÓTH Mónika, VÁRDI Katalin Borbála

[Aim of the study: Pompe disease is a rare mitochondrial disease, which is treated with enzyme replacement therapy. The authors examined the lifestyles of patients diagnosed with Pompe disease, and their knowledge regarding the illness. They compared this with the results of the regular checkups performed during the care process, in order to assess the patients’ compliance. Sample and methods: The research was conducted among patients suffering from Pompe disease, treated at the Rehabilitation Department of the Törökbálint Institute of Pulmonary Medicine (N=14). The survey of the patients’ knowledge took place in the form of personal interviews. The findings related to the regular enzyme replacement therapy were recorded and collated in the course of interviews conducted by telephone with the nurses of the centres administering the treatment. The data was processed using Microsoft Excel software. Results: In 2012 in Hungary the number of patients diagnosed with Pompe disease was 14 (12 adults, 2 children). The time elapsed from emergence of the first symptoms to the precise diagnosis in the case of all known patients (except in the case of one screened child) was an average of 13.4 years. Ten of the patients were receiving enzyme replacement therapy. The survey revealed that the conditions of the patients receiving the enzyme replacement therapy did not deteriorate. In the case of the female child, the decrease in CK levels was accompanied by growth and movement consistent with her age, and an improvement in vocalisation. Conclusions: For patients diagnosed with the once fatal Pompe disease, enzyme replacement therapy now offers the opportunity of a full life; and complementary treatments not only boost the effectiveness of the enzyme replacement, but also improve the patients’ subjective quality of life.]

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Journal of Nursing Theory and Practice

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NOVÁK Szabina, NAGY Edit

[The balance parameters and the loading symmetry was assessed in a subject with anterior cruciate ligament deficiency. A 14 days intensive training was performed mainly with eyes closed in closed kinematic chain exercises, loading the affected limb. Stabilometry and the assessment of loading symmetry was performed. The sway path was calculated in two direction. The sway path comparisons did not revealed significant differences only a tendency of decrease in anteroposterior direction. Interestingly we found an increased loading of the affected limb after our intensive training, with a mismatch between the subjective perceived symmetry and the objective symmetry data. The changed symmetry perception might be explained with the change in proprioceptive information processing induced by the training. In the future further examinations with higher case number are necessary to support this result. ]

Clinical Neuroscience

[The future in danger: a survey of the changes in the number of neurologists and a prognosis for 2010 in Hungary]

BERECZKI Dániel, CSIBA László, KOMOLY Sámuel, VÉCSEI László

[Lack of neurologists has become an obvious problem recently in Hungary, not only in small hospitals, but in major health care centers and also in university hospitals. With the current survey we set forth to estimate the number of board certified neurologists, and to evaluate the foreseeable changes in the next decade. In the beginning of 2010 there were 1310 physicians in Hungary with an official license to practice neurology. During 2009 neurological performance at least once during the year was claimed to the National Health Insurance Fund by 948 board certified neurologists. The number of those neurologists who are routinely involved in neurological patient care was estimated to be around 750. The lack of the young generation is characteristic for the age distribution of neurologists. In nine out of the 19 counties of Hungary the number of neurologists below the age of 35 is one or nil. In the ten-year period of 2000-2009 the annual mean number of new board certifications in neurology was 22. This number is much lower than that needed to replace those who get employed abroad and who leave the system for other reasons. The number of neurologists in the age range of 40-60 years will drop to 2/3 of the current number by 2020 even if emigration of neurologists will completely halt. If emigration will continue at the current rate and the number of those in neurological training will not increase considerably, then by 2020 only about 300 neurologists will have to cover neurological services throughout Hungary. As this number is insufficient for the task, and the tendency is clearly foreseeable, the health care government should urgently react to this situation to ensure an acceptable level of neurological services in the near future for the population of Hungary.]

Journal of Nursing Theory and Practice

[Occurrences involving aggression among healthcare workers ]


[Aim of the study: Evaluation of prevalence and manner of verbal and psychical aggression, as well as measuring its emotional impact on the healthcare workers. Sample and methods: A total of 453 healthcare workers were involved in a national cross-sectional study using self-administrative questionnaires. Data were analyzed by descriptive methods, Chi square and Wilcoxon test using SPSS 19. A p-value of <0, 05 was accepted as statistically significant. Results: 86,1% of the participating healthcare workers (n=453) have reported being subject of aggression (verbal and/or psychical) during their work. Of the participants’ sociodemographic parameters, age was found to be a significant factor in incidents involving aggression, which had a statistically significant negative emotional impact. It was also established, that those healthcare workers who have been subject to aggression received more support from their colleagues than from their institution after the incident. Conclusions: Occurrences involving aggression in healthcare is a common phenomenon. The authors’s results show that there is an urgent need to develop an aggression management programme for all healthcare workers since they can encounter aggressive patients on all fields of medicine. ]

Clinical Neuroscience

[Neurology! Adieau? (Part 1)]


[The neurological practice suffered considerable changes during the last twenty years. The recent therapeutic methods and the acceptance of the ideology of evidence based medicine, which is based on confidence in statistics, changed the reasoning of the neurologists. Therapy protocols intrude into the field of individual medicine, and doctors accept treatment schemes to alleviate responsibility of their decisions. In contrast with this, recent achievements in pharmacogenetics emphasize the importance of individual drug therapies. The protocol of intravenous cerebral thrombolysis does not require defining the origin of cerebral ischaemia in the acute stage, therefore, this procedure can be regarded as human experiment. According to the strict protocol thrombolysis might be indicated only in 1-8% of patients with cerebral ischaemia. According to the Cohrane database more trials are needed to clarify which patients are most likely to benefit from treatment. Because of the change in therapeutic principles transient ischaemic attack has been newly defined as “acute neurovascular syndrome”. Multiplication of neurological subspecialties has been facilitated by the development of diagnostic tools and the discovery of effective new drugs. The specialization led to narrowing of interest and competency of clinicians. Several new neurological scientific societies were founded for the representation of specific disorders. In Hungary, between 1993 and 2000 nine scientific societies were grounded within the field of clinical neurology. These societies should be thankful to the pharmaceutical industries for their existence. In some European countries in 2007 only three neurological subspecialties were accepted, which are neurophysiology, neuro-rehabilitation and childneurology. Neuro-radiology is in the hands of general radiologists, the specialization is not granted for neurologists. Because of the subspecialization the general professionalism of neurologists has diminished. Among young neurologists the propedeutic skills suffered most seriously. Subspecialisation of teachers also interferes with the practice oriented teaching of medical students and residents.]

Clinical Neuroscience

[Neurology! Adieau? (Part 2)]


[Teaching of neurologists is indisposed worldwide. University tutors are engaged in teaching, research and patient-care. This triple challenge is very demanding, and results in permanent insecurity of University employees. To compensate for the insufficient clinical training, some institutes in the USA employ academic staff members exclusively for teaching. The formation of new subspecialties hinders the education and training of general neurologists. At the present four generations of medical doctors are working together in the hospitals. The two older generations educate the younger neurologists who have been brought up in the world of limitless network of sterile information. Therefore their manual skills at the bedside and knowledge regarding emergency treatment are deficient. Demographics of medical doctors changed drastically. Twice as many women are working in neurology and psychiatry than men. Integrity of neurology is threatened by: 1. Separation of the cerebrovascular diseases from general neurology. Development of "stroke units" was facilitated by the better reimbursement for treatment and the interest of the pharmaceutical companies. The healthcare politics assisted to split the neurology into two parts. The independent status of “stroke departments” will reduce the rest of clinical neurology to outpatient service. 2. The main argumentation to segregate the rare neurological diseases was that their research will provide benefit for the diseases with high prevalence. This argumentation can rather be considered territorial imperative. The separation of rare diseases interferes with the teaching of differential diagnostics during neurological training. The traditional pragmatic neurology can not be retrieved. The faculty of neurology could retain its integrity because of the improvement of diagnostic methods and the more and more effective drugs. Nevertheless, even the progression of neurological sciences induces dissociation of clinical neurology. Neurology shall suffer fragmentation if the professional authorities fail to control the separation of subspecialties, if teaching of future neurologists, including practical knowledge and skills of diagnostic decision making, is not supported.]