Journal of Nursing Theory and Practice

[European Council of Nursing Regulators]

BALOGH Zoltán

FEBRUARY 28, 2013

Journal of Nursing Theory and Practice - 2013;26(01)

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Further articles in this publication

Journal of Nursing Theory and Practice

[Non-healing (chronic) wounds on lower limbs]

DARÓCZY Judit

[The incidence of chronic wounds is high (5-7% of the population); these include ulcers developing due to venal and arterial circulation failure, diabetes, tumours and pathological pressure. Chronic wounds represent serious economic and communal/individual social problems. Their treatment takes place at every level of healthcare: primary care, home nursing, specialist clinics, acute inpatient care and rehabilitation wards. Treating the wounds requires specialist expertise. Continuous training is essential, not only for doctors but also for nurses. Doctors and nurses have to work together in order to treat the wounds. The author sets out to describe the physiological basics of the healing of the wounds, the clinical properties of the wounds, and the principles of their professional treatment. ]

Journal of Nursing Theory and Practice

[Complications of diabetes on the foot, the treatment of diabetic foot ulcers]

RÉDLING Marianna

[Diabetic foot syndrome is an array of symptoms with a complex pathomechanism, the complications of which (if treated late) can make it necessary to amputate the limb. Approximately 15% of diabetes patients can expect foot sores to develop in the course of their illness. The author presents the vascular complications of diabetic that underpin the development of diabetic foot syndrome, the tests serving to diagnose them, and the typical clinical manifestations and complications of diabetic foot ulcers. The most important factors in the successful treatment of diabetic foot sores are summarised: normalisation of the general medical condition; alleviation of chronic pressure points; ensuring arterial circulation; infection control; regular and appropriate mechanical debridement; wound treatment in keeping with the given phase of healing; patient education; prevention of relapse. The author places particular emphasis on the screening tests, treatment methods and patient education tasks that can be performed by specialist nurses. ]

Journal of Nursing Theory and Practice

[Aspects of the treatment plan for chronic foot wounds on the basis of practical experience ]

IGNÁTH Györgyi

[When treating chronic wounds the nurse works responsibly as a member of the team, and this cannot be limited to simply following the doctor’s instructions and appropriately dressing the wound. During the treatment of the patient the nurse has to make assessments and observations, carry out tests, evaluate the results, and warn the doctor in good time of any symptoms that depart from the typical healing process that is to be expected in the treated wound. The author presents the principles and methods applied in the practice of wound treatment, highlighting the nurse’s tasks and scope of authority in this regard. ]

Journal of Nursing Theory and Practice

[Evidence in the presentation of factors influencing the development of pressure ulcers]

CSERNUS Mariann

[The development and healing of pressure ulcers depends on a combination of several factors. The factors related to the patient (physical impacts, biological and psychosocial factors), as well as the influencing factors arising in relation to the lingering wound (e.g. the content, situation, size and blood supply of the sore, the condition of the wound bed, the presence of infection, the response to treatment) are all closely related to the patient’s general condition and the underlying disease. An important role is also played by the factors associated with the healthcare personnel (ability, professional qualifications, attitude), and the healthcare system (level of technical and economic advancement, preventive and wound care equipment, quality assurance, training). The author has set out to give a detailed description of these factors, supported by professional evidence. ]

Journal of Nursing Theory and Practice

[Preventive strategies applied in decubitus prevention in Hungary and Slovakia]

DARNAYOVÁ Monika

[The incidence of decubitus ulcers affects nurses working not only in Slovakian hospitals, but those in Hungary too. The proportion of patients with bedsores in a given institution partly depends on the nurses, since improper nursing has a major role in the development of this syndrome. By the same token, a low incidence of pressure ulcers is the best proof of high-quality nursing. The main motivation for the research was to gain an insight into the methods of decubitus prevention applied in the two countries. The purpose of the study was to show the current state of the prevention carried out in the two institutions, how a preventive attitude is instilled, what kind of assessment scale is used, what the protocols contain, what kind of aids are available for us, and how documentation is maintained.]

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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

[Health status and costs of ambulatory patients with multiple sclerosis in Hungary]

PÉNTEK Márta, GULÁCSI László, RÓZSA Csilla, SIMÓ Magdolna, ILJICSOV Anna, KOMOLY Sámuel, BRODSZKY Valentin

[Background and purpose - Data on disease burden of multiple sclerosis from Eastern-Central Europe are very limited. Our aim was to explore the quality of life, resource utilisation and costs of ambulating patients with multiple sclerosis in Hungary. Methods - Cross-sectional questionnaire survey was performed in two outpatient neurology centres in 2009. Clinical history, health care utilisation in the past 12 months were surveyed, the Expanded Disability Status Scale and the EQ-5D questionnaires were applied. Cost calculation was conducted from the societal perspective. Results - Sixty-eight patients (female 70.6%) aged 38.0 (SD 9.1) with disease duration of 7.8 (SD 6.7) years were involved. Fifty-five (80.9%) had relapsing-remitting form and 52 (76.5%) were taking immunomodulatory drug. The average scores were: Expanded Disability Status Scale 1.9 (SD 1.7), EQ-5D 0.67 (SD 0.28). Mean total cost amounted to 10 902 Euros/patient/year (direct medical 67%, direct nonmedical 13%, indirect costs 20%). Drugs, disability pension and informal care were the highest cost items. Costs of mild (Expanded Disability Status Scale 0-3.5) and moderate (Expanded Disability Status Scale 4.0-6.5) disease were 9 218 and 17 634 Euros/patient/year respectively (p<0.01), that is lower than results from Western European countries. Conclusion - Our study provides current inputs for policy making and contributes to understanding variation of costof- illness of multiple sclerosis in Europe.]

Clinical Neuroscience

The prevalence of sarcopenia and dynapenia according to stage among Alzheimer-type dementia patients

YAZAR Tamer, YAZAR Olgun Hülya

Aim - In this study, the aim was to identify the prevalence of sarcopenia and dynapenia according to disease stage among Alzheimer-type dementia (AD) patients and collect data to suggest precautions related to reducing the disease load. Method - The study was completed with 127 patients separated into stages according to Clinical Dementia Rating Scale (CDR) criteria and 279 healthy volunteers aged 18-39 years and 70-80 years abiding by the exclusion criteria who agreed to participate in the research. Our prospective and cross-sectional study applied the CDR and mini mental test (MMSE) to patients with disorder in more than one cognitive area and possible AD diagnosis according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association) diagnostic criteria. The patient and control groups had skeletal muscle mass index (SMMI), muscle strength and physical performance assessed with sarcopenia diagnosis according to European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria. Results - In our study, in parallel with the increase in disease stage of AD patients, the prevalence of sarcopenia (led by severe sarcopenia) and dynapenia was higher compared to a control group of similar age. Conclusion - In chronic, progressive diseases, like AD, identification of changes in parameters, like muscle mass and strength and reductions in physical performance in the early period, is important for identification and to take precautions in the initial stages considering the limitations of the preventive effects of treatment applied after diagnosis of AD.

Clinical Neuroscience

[Dopamine agonists in Parkinson’s disease therapy - 15 years of experience of the Neurological Clinics from Tîrgu Mureș. A cross-sectional study ]

SZÁSZ József Attila, CONSTANTIN Viorelia, MIHÁLY István, BIRÓ István, PÉTER Csongor, ORBÁN-KIS Károly, SZATMÁRI Szabolcs

[Background and purpose - There is relatively few data regarding the usage of dopaminagonists for the treatment of Parkinson’s disease; furthermore, there are no publications regarding Central- and Eastern-European countries. The aim of the study was to evaluate the use of dopamine agonists as a therapeutic option amongst Parkinson’s disease patients admitted to the Neurological Clinics of Tîrgu Mures during the last 15 years. Methods - In our study we investigated the data of all Parkinson’s patients treated at our clinics between the 1st of January 2003 and the 31st of December 2017. We analyzed the particularities of dopamine agonists’ usage based on the therapeutic recommendations from the final report of these patients. Regarding time since the diagnosis, we divided the patients in two groups: less than or equal to 5 years and more than 5 years. Results - During the studied period a total of 2379 patients with Parkinson’s disease were treated at the Clinics. From the 1237 patients with disease duration under 5 years 665 received dopamine agonists: 120 as monotherapy, 83 together with monoamine oxidase inhibitors and in 234 cases associated with levodopa. The remaining 228 patients were treated with a triple combination of levodopa, dopamine agonists and monoamine oxidase inhibitors. In patients suffering from Parkinson’s disease for more than 5 years, in 364 cases out of 653 a dopamine agonist was part of the therapy. Conclusion - The usage of dopamine agonists was similar to the data presented in other studies. We consider that clinicians treating the disease should, with the necessary prudence, use the available and recommended dopamine agonist with the utmost courage to their maximum therapeutic potential.]

Clinical Oncology

[Pharmacological treatment of metastatic melanoma]

OLÁH Judit, GYULAI Rolland

[Malignant melanoma belongs to the group of relatively easily manageable tumors; if detected and removed early, it rarely metastasizes. Although the visible nature of the primary tumor provides opportunity for early diagnosis, there is a signifi cant portion of patients who receive proper management only with substantial delay. The fact that there are annually 300-400 patients with metastatic disease in Hungary, can be mostly attributed to public unawareness about melanoma, and consequent delay in seeking medical treatment. Metastatic melanoma remains - even today - an incurable disease. Molecular genetic research, however, resulted in revolutionary changes in melanoma management. Today, apart from the classic pathological prognostic factors, information regarding specifi c molecular modifi cations (such as in the expression of the BRAF, NRAS, c-KIT genes and proteins) are inevitable for the setting up of a personalized oncological treatment plan. By targeting members of the MAPK signal transmission pathway (using BRAF- and MEK-inhibitors), signifi cant improvement could be achieved in metastatic melanoma. Similarly, new drugs targeting specifi c immune checkpoint regulators (such as CTLA-4 and PD-1/PD-1L) provide previously unprecedented survival benefi t for melanoma patients. In this review the most recent developments in the fi eld of melanoma management are summarized.]