Journal of Nursing Theory and Practice

[Code of Ethics - Council of the Hungarian Health Care Professionals]

JUNE 20, 2014

Journal of Nursing Theory and Practice - 2014;27(03)

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Journal of Nursing Theory and Practice

[Advanced, evidence-based care - The care of the mechanically ventillated patient]

FULLÉR Noémi, OLÁH András

[The care of the mechanically ventillated patient is a complex nursing duty what requires comprehensive knowledges from the professionals. The appearance of the nosocomial conditions, costs of the care and days of the care can be decreased by the proper evidence based nursing practice. Many research papers and guidelines were developed at the international literature regarding the mechanically ventillated patients but the well-founded books or studies are missing in Hungary. With this paper the aim is to emphasize the importance of the evidence based nursing practice part of the critically ill patients what is necesary for the eligible care and should be a part of a well-trained health care professional’s knowledge. ]

Journal of Nursing Theory and Practice

[Assessing the knowledge of patients after cataract surgery]

MELEG Tiborné, BÍRÓ Gyöngyi, NÉMETH Anikó

[Aim of study: Examining the knowledge of patients about ophthalmic screenings, their disorder, the necessary lifestyle changes and on how to use eye drops properly. Sample and methods: This cross-sectional study was conducted at the ophthalmology department of the hospital in Kecskemét using a self-developed questionnaire. Inpatients were involved during the period from June to September in 2013. Results: The studied patient population knew the importance of ophthalmic screenings, but they had inappropriate information about the right way to use eye drops and about the nature of cataract and the operation. Although the majority of the responders were informed by an expert, they had much false information about the necessary lifestyle changes. Conclusions: One of the most important task of nurses working at ophthalmology departments is to correct the false beliefs of patients and to replace them with correct and clear information, especially about their disorder and lifestyle changes.]

Journal of Nursing Theory and Practice

[The decaying health status of nurses]

NÉMETH Anikó, BETLEHEM József, LAMPEK Kinga

[Aim of the study: Investigating the changes in health status, medicine usage and frequency of taking sick-leaves among nurses. Sample and methods: Two cross-sectional studies were conducted in six Hungarian teaching hospitals in 2003 and in 2010 involving full time worker inpatient care nurses who were asked to complete a questionnaire developed by the researchers. Results: The self evaluated health status of nurses worsened since the first survey. Significantly more nurses suffered from chronic diseases and more of them are taking medicines regularly than in 2003. The biggest increment was measured in the rate of people with digestive and musculoskeletal disorders, with allergies, varicose veins and migraine. The number of days on sick-leave decreased significantly and there are more nurses who do not take sick-days when they are sick. Sleep disturbances, head and back aches also occur more often. Conclusions: Based on our data the nurse population is getting older and nurses suffer from numerous chronic diseases.]

Journal of Nursing Theory and Practice

[The nursing of history - the history of nursing]

BEZERÉDI Gábor

[The purpose of nursing is always the same: to restore a patient’s health, and provide help during his or her illness. Findings demonstrate that nursing already had an important role thousands of years before Christ. Broken bones, healed skull trepanations and joint diseases can be discovered in early findings. Caring for injured members of the same species cannot be seen, but in the case of elephants and dolphins, who provide company to the suffering member. The rest of the animals simply let the injured die. The author reviews the history of this remarkable activity, and introducing it from the beginning to our days, with particular regard to the milestones in Hungary.]

Journal of Nursing Theory and Practice

[The trials and tribulations of district nurses past and present]

BAKONYI Zoltánné

[The author wishes to highlight, for healthcare management, the work of paramedical professionals active in this field. She draws attention to the still largely untapped reserves of specialist knowledge possessed by these health workers. She suggests a method by which the currently underrated field of nursing could receive greater recognition, both in terms of working conditions and professional status. In this way nurses could more effectively provide a higher standard of care to patients registered with their practice, in the case of both acute and chronic diseases. A further aim of the paper is to present the structure and operation of the nursing practices that she envisions.]

All articles in the issue

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Clinical Neuroscience

[The connection between the socioeconomic status and stroke in Budapest]

VASTAGH Ildikó, SZŐCS Ildikó, OBERFRANK Ferenc, AJTAY András, BERECZKI Dániel

[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

Clinical Neuroscience

Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey

ÜNSAL Ünlü Ülkün, ŞENTÜRK Salim

Microdiscectomy (MD) is a stan­dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in­terlaminar lumbar discectomy (PELD) is another surgical op­tion that has become popular owing to reports of shorter hos­pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD). Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups. The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist’s costs), hospital stay, anesthetic drugs and materials, laboratory wor­kup, nur­sing care, and postoperative me­dication diffe­red significantly among the two main groups (PELD-MD) (p<0.01). This study demonstrated that PELD is less costly than MD.

Clinical Neuroscience

[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.]