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)



Further articles in this publication

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 nursing of history - the history of nursing]


[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

[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

[The decaying health status of nurses]


[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 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

Related contents

Hypertension and nephrology

[About the care of patients with hyperuricaemia and gout]

[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]

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.]

Clinical Neuroscience

Neuroscience highlights: Main cell types underlying memory and spatial navigation

KRABOTH Zoltán, KÁLMÁN Bernadette

Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.

Clinical Neuroscience

The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis

ALTAY Servet, GÜRDOGAN Muhammet, KAYA Caglar, KARDAS Fatih, ZEYBEY Utku, CAKIR Burcu, EBIK Mustafa, DEMIR Melik

Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. This study was conducted with patients hospitalized in CICU of a tertiary university hospital between 01 August 2017 and 01 August 2018. Files of all patients were examined in details, and demographic, clinic and laboratory parameters were recorded. Patients confirmed with psychiatry consultation were included in the groups of patients who developed delirium. Patients were divided into groups with and without delirium developed, and baseline features, inhospital and follow up prognoses were investigated. In addition, patients were divided into four groups as <65 years old, 65-75 yo, 75-84 yo and> 85 yo, and the incidence of delirium, related factors and prognoses were compared among these groups. A total of 1108 patients (mean age: 64.4 ± 13.9 years; 66% men) who were followed in the intensive care unit with variable indications were included in the study. Of all patients 11.1% developed delirium in the CICU. Patients who developed delirium were older, comorbidities were more frequent, and these patients showed increased inflammation findings, and significant increase in inhospital mortality compared to those who did not develop delirium (p<0.05). At median 9-month follow up period, rehospitalization, reinfarction, cognitive dysfunction, initiation of psychiatric therapy and mortality were significantly higher in the delirium group (p<0.05). When patients who developed delirium were divided into four groups by age and analyzed, incidence of delirium and mortality rate in delirium group were significantly increased by age (p<0.05). Development of delirium in coronary intensive care unit is associated with increased inhospital and follow up morbidity and mortality. Delirium is more commonly seen in geriatric patients and those with comorbidity, and is associated with a poorer prognosis. High-risk patients should be more carefully monitored for the risk of delirium.

Clinical Neuroscience

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


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.