Journal of Nursing Theory and Practice

[Doris, the woman who made a difference]

SÖVÉNYI Ferencné

JUNE 30, 2018

Journal of Nursing Theory and Practice - 2018;31(03)

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Journal of Nursing Theory and Practice

[Survey of patient education among patients with hip arthroplasty]

BÉKÉS Brigitta, KIRÁLY Edit, BALOGH Zoltán

[Aim of the study: To analyse the training level of patients underwent hip replacement therapy in different periods of their health care. Methods: Traumatology and orthopaedic departments, ambulances and musculoskeletal rehabi-litations took part in the research. A self-made questionnaire was distributed among doctors and health professionals who cured these patients directly. The received data was analysed with the IBM SPSS Statistics 20. program. ANOVA test, 2-sample T-test and Chi-squared test were applied to analyse the coherences. P<0,05 was defined as the value of the significance limit. Results: 86 health care professionals participated in the survey. The overwhelming majority of them (45%) reported that unstructured, postoperative patient education was characteristic. Their education was dominated by communication techniques (n=68), while among the instrumental methods the use of information leaflets was dominated (n=13). Their activity was limited by the time lag and work overload (76%). Analysing the training levels, it was found that information about lifestyle changes and post-operative mobilization was significantly underused. Conclusion: Significant insufficiency were found in the education of the patients in terms of organization, and in the teaching methods and topics which were further aggravated by the mentioned hindering factors. ]

Journal of Nursing Theory and Practice

[Nursing career of the high-school students]

TISÓCZKI Evelin, BALOGH Zoltán

[Aim of the research: The aim of the study is to analyze the trends of student orientation in the age and compulsory education process by age group. In our research, we would like to answer the question of how much „popularity” the health care profession as a professional area among students participating in Hungarian public education. If you feel this area of expertise close to you, what kind of vision you have. Research and sampling methods: A self-constructed questionnaire was administered during 24 Oct 2017 - 13 Jan 2018. In all counties of Hungary, the authors sent it to at least one of the training sites and filled up with me (N=329). These training sites are involved in healthcare training. Data were analysed with SPSS 15.0 for Windows statistical program. Chi square, Mann-Whitney tests were applied (p <0,05). Results: Out of the 159 people (48%), 170 (52%) in the family have healthcare workers. When performing the controls of the distributions, we can conclude that there is no significant difference in the distribution between the two groups, so there is the same number - that is, statistically significant difference - of the proportion of those willing to choose the health care path. In terms of career choice, 276 (86%) of respondents believe it is likely to be oriented towards the health care path, with 46 people (14%) planning their life is in another direction. Seven of its principal did not answer the question. By completing the Mann-Whitney test, we can conclude that there is no significant difference between the two groups in the medians, so there is no difference - that is, statistically significant difference - with respect to career choice as a nursing profession’s esteem. Of the 329 participants, 215 (65%) replied that they would like to work as a nurse, while 114 (35%) responded that they would not choose this job. Conclusion: Don’t influence significantly the career entrant if there is a healthcare worker in the family. Who stand in front of career choice don’t influence significantly the appreciation but is more motivated by sympathy and helplessness toward another person.]

Journal of Nursing Theory and Practice

Reliability and Validity of the Turkish Version of the Brief Scales for Coping Profile in Textile Workers

ORNEK Koseoglu Ozlem, TEMEL Yavuz Guler

The aim of this study is to adapt the BSCP (Brief Scales for Coping Profile) scale to Turkish and to investigate its psychometric properties among textile workers. Methods: This a psychometric study with cross-sectional design. After translation procedures, the BSCP was administered to workers. Content validity of the BSCP was investigated with the CVI index and reliability was investigated with Cronbach’s Alpha. The construct validity was investigated with exploratory and confirmatory factor analysis. Results: The psychometric properties of the original BSCP were supported by the Turkish version of the BSCP. According to the exploratory factor analysis, the BSCP had six subscales. The reliability of the BSCP subscales’ values were 0.692, 0.712, 0.661, 0.756, 0.786, and 0.777 respectively. Conclusion: The Turkish version of the BSCP showed acceptable reliability and validity which is the first adapted scale in Turkey for evaluating workers’ coping profiles. The scale will be a good option to provide basic data about workers’ coping profiles which may be used for prolonging stress management skills and health promotion programs by occupational health and psychiatric nurses, physicians, psychologist and safety experts.

Journal of Nursing Theory and Practice

[The importance of the hand hygiene compliance development in the light of prevention of nosocomial infections]

SAJTI Anikó, CSERNUS Mariann

[Good hand hygiene is the most effective means of preventing healthcare-associated infections, as contaminated hands are the greatest risk of spreading infections. It is critical that the infection control professionals emphasise the importance of good hand hygiene practices and help the health care professionals on the five steps of hand hygiene. The author presents in the case study that the numbers of positive urinary microbiological samples were decreased with systematic hand hygiene examination with direct methods and continuous feedback of experiences among the staff of the intensive care unit. For further development four sensory, alcoholic hand scrubbers with spraying automats were fitted by the management of the unit. Data obtained directly from observation further analysis is our goal a comprehensive study for the profession, which can serve as a positive example later to launch compliance development programs in other hospitals. ]

Journal of Nursing Theory and Practice

[The effect of sensory deficit induced by anterior crutiate ligament injury on postural control]

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. ]

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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.

Clinical Neuroscience

Cyanocobalamin and cholecalciferol synergistically improve functional and histopathological nerve healing in experimental rat model

ALBAY Cem, ADANIR Oktay, AKKALP Kahraman Asli, DOGAN Burcu Vasfiye, GULAEC Akif Mehmet, BEYTEMUR Ozan

Introduction - Peripheral nerve injury (PNI) is a frequent problem among young adults. Hopefully, regeneration can occur in PNI unlike central nervous system. If nerve cut is complete, gold standard treatment is surgery, but incomplete cuts have been tried to be treated by medicines. The aim of the study was to evaluate and compare clinical and histopathological outcomes of independent treatment of each of Vitamin B12 (B12) and Vitamin D3 (D3) and their combination on sciatic nerve injury in an experimental rat model. Materials and methods - Experimental animal study was performed after the approval of BEH Ethics Committee No. 2015/10. 32 rats were grouped into four (n=8) according to treatment procedures, such as Group 1 (controls with no treatment), Group 2 (intraperitoneal 1 mg/kg/day B12), Group 3 (oral 3500 IU/kg/week D3), Group 4 (intraperitoneal 1 mg/kg/day B12+ oral 3500 IU/kg/week D3). Sciatic Functional Index (SFI) and histopathological analysis were performed. Results - SFIs of Group 2, 3, 4 were statistically significantly higher than controls. Group 2 and 3 were statistically not different, however Group 4 was statistically significantly higher than others according to SFI. Axonal degeneration (AD) in all treatment groups were statistically significantly lower than in Group 1. AD in Group 4 was significantly lower than in Group 2 and 3; there was no significant difference between Group 2 and 3. There was no significant difference between Group 1,2 and 3 in Axonolysis (A). But A of Group 4 was significantly very much lower than all others. Oedema- inflammation (OE-I) in all treatment groups were significantly lower than in Group 1; there was no significant difference between Group 2 and group 4. OE-I in Group 2 and 4 were significantly lower than in Group 3. There were no significant differences between Group 1, 2 and 3 in damage level scores; score of Group 4 was significantly lower than of Group 1. Conclusions - B12 and D3 were found effective with no statistically significant difference. But combined use of B12 and D3 improve nerve healing synergistically. We recommend combined use of B12 and D3 after PNI as soon as possible.

Clinical Neuroscience

Retinal morphological changes during the two years of follow-up in Parkinson’s disease

ATUM Mahmut, DEMIRYÜREK Enes Bekir

The study aims to investigate the relationship between the progression of idiopathic Parkinson’s disease (IPD) and retinal morphology. The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson’s Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p=0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.

Clinical Neuroscience

Valproic acid associated pleuropericardial effusion: case report

DEMIR Figen Ulku

Introduction - Valproic acid is an effective antiepileptic and mood stabilizer used in the treatment of many neurological and psychiatric disorders. Although there are frequently seen side effects, effusions between layers of pleural and pericardial membranes are rare to be seen. Case - Pleuropericardial effusion was detected in a 23 years old woman who was under valproic acid treatment because of epileptic seizure. After 1 year of valproic acid treatment, patient complained of dyspnea. As all the researches intended on etiology were usual, valproic acid has been thought to be responsible for the matter. Control examination after 1.5 months regarding the end of treatment revealed complete recovery of pleuropericardial effusion. Discussion - Pleural and pericardial effusions are rarely seen complications related to the use of valproic acid. It must also be kept in mind that valproic acid causes a potential for such side effects which can be blamed etiologically when the other possibilities for patients are excluded.

Clinical Neuroscience

Matrix metalloproteinases and their tissue inhibitors in relapsing remitting multiple sclerosis: Possible markers and treatment agents

SANLI Arzu, OZTURK Musa, SOYSAL Aysun, DOVENTAS Yasemin, BASOGLU Fulya, GOZUBATIK-CELIK R. Gokcen, BAYBAS Sevim

Matrix metalloproteinases (MMPs), which are synthesized by many cell groups and responsible for the destruction of matrix proteins, and endogen tissue inhibitors of MMPs (TIMPs) have a role in the pathogenesis of Multiple Sclerosis (MS) by affecting the blood-brain barrier. We aimed to investigate the role of MMPs and TIMPs in the immunopathogenesis and in the course of multiple sclerosis (MS). We enrolled 25 relapsing remitting MS patients, who had a definite MS diagnosis according to McDonald criteria and 25 healthy subjects similar for age and gender as control group. MMP-9- and TIMP-1 levels were measured twice in patient group (one time during an attack and one in remission) and once in healthy subjects. MMP-9- and TIMP-levels of patients during attack and remission period and MMP-9/TIMP-1 ratio were found significantly higher than in the control subjects. In patient group MMP-9 and TIMP-1 levels and MMP-9/TIMP-1 ratio during attacks were not significantly different than during remission period. However, when subdivided according to their number of attacks, patients with 2 attacks had significantly higher levels during attack period comparing to remission period (p<0.05); in case of patients with more than 2 attacks did not have a statistically significant difference in attack and remission periods. Matrix metalloproteinases are important actors in MS immunopathogenesis, particularly in the early period and inhibitor agents for these enzymes can be used as a treatment option.