Journal of Nursing Theory and Practice

[Examination of the quality of life in case of patient with the Multiple Sclerosis]

SZABÓ Julianna

JUNE 30, 2015

Journal of Nursing Theory and Practice - 2015;28(03)

[Aim of the research: To assess the impact of Multiple Sclerosis on quality of life and to consider whether there is a significant difference in the understand of the disease and the subjective assessment of quality of life in those subjects living in rural eastern Hungary and those living in Budapest. Research and sampling methods: the following questionnaires were use in the study: - Standard Test Questionnaire (SF-36) Social Support Questionnaire, and the Short Marital Stress Scale (abbreviated). Socio-demographic and disease indices were also utilized. These questionnaires were distributed to patients who have a diagnosis of Multiple Sclerosis. The patients attended the Neuro-immunology outpatients departments in the Budapest University’s St.Imre Teaching Hospital Specialist Multiple Sclerosis Centre and Josa Andras Hospital in Nyíregyháza (N=100), between August 2013 and January 2014. Results: It was found that due to the limiting nature of the disease the patients reported a significant effect on their physical condition. They were able to care for themselves in every day activities, but reported a limitation in leisure - time activities. Families play a decisive role in social contact. These results were confirmed by the patients’ observations. Those patients, who have the support of their spouses, report an increase in their health and wellbeing. There was little evidence of animosity towards those without Multiple Sclerosis.Those in Budapest achieved higher values in most dimensions, except social function and vitality, compared with those living in the country. Conclusions: The Researcher observed that relief organisations for the assistance and support of those with Multiple Sclerosis did not seem to meet the needs of the patients. Multiple Sclerosis is a chronic disease affecting all dimensions of Quality of Life. Need to strengthen the positive indicators of Quality of Life in those who are living with the disease and support families caring for those affected and enabling the maintenance of proper social relations and of social usefulness. ]

COMMENTS

0 comments

Further articles in this publication

Journal of Nursing Theory and Practice

[Influencing factors in the rehabilitation of periprotetical infection of the hip and knee joint replacement]

FÜLÖP Annamária, FARKAS Péter, SOMLAI Krisztián, CSERNUS Mariann

[Aim of the research: The aims of the authors were to compare the clinical proceeding of periprosthetic infection with comorbidities and age, respectively. They were investigated the proportion of prothesis removal to achieve healing in case of periprosthetic infection and the influence of certain comorbities to infection elimination. Research and sampling methods: In the study, clinical and follow up data was collected retrospectively through 3 years from 46 patients treated due to hip and knee joint periprosthetic infection. For statistical analysis, SPSS program was used. Results: According to the examination, loss of function in joints occurs in 82% of cases, although 50% of the infected prostheses can be salvage primarily based on patient follow up data. In case of diabetic patients, positive tendency was observed between the days of hospitalization or age and the chance of loss of function. Significant difference (p=0.022) was determined between the leucocytosis at the time of admission and the loss of function. Conclusions: There is no clear prognostic factor, which can enhance a patients group, who has failed to commit everything to keep the prosthesis observance. ]

Journal of Nursing Theory and Practice

[Practical role of nurses in early recognition in sepsis and curing process]

TÓTH Zoltánné

[Aim of the research: The aim of my research is to show detailed analysis of clinical categorizing of sepsis and clarifying its diagnostic difficulties. The study shows the elements of diagnostic and monitoring methodology during attendance including the importance of triage. Research and sampling methods: The research was done in a III progressive level hospital in the capital at the Emergecy Department emphasizing one group of illness: sepsis. 81 patients were analysed according to the 2013 data turnover. The method of the research is based on different document analysis and data gathering. In parallel with it, in the following parts of the study I was examining the competences of nurses with different qualifications at the department who were doing triage activity during attendance.Evaluation of the summarized results was created by SPSS 14.0 programme. Results: It was proved from the summarized data that triage activity done by nurses with septic patients was not influenced neither by professional experience nor by qualification of the nurses. More than half of the patients at the departments was not given the correct classification so they were not given the therapy in time. Conclusions: Nurses at the emergency department do not have the necessary knowledge on classification system of triage , that is why each nurse at the department must have the opportunity to improve their knowledge on triage or those not having it must acquire both theoretical and practical knowledge. ]

Journal of Nursing Theory and Practice

[History of operating room nursing profession]

PÉCZELI András

[Complete personal and material condition are foundations of operation. Surgical assistant (scrub nurse) is indispensable part of surgical group of workers who has significant role in direct operation beside preparation and after operation periods. Qualified scrub nurse instrumentation to surgeon who operates and to his assistant which required perfect knowledge of every means and materials. Technical development result in change of surgery’s repertoire: new tipes of procedures and devices. Surgical assistants have to be abreast with developments, with changing working environment, qualification and laws. Author represent the history of surgical assistant work from the begining to nowadays. Author demonstrate advent of surgical assistant profession, change of vocational training and attached laws, exercises of scrub nurse at the present time and in the past. ]

All articles in the issue

Related contents

Clinical Neuroscience

[Examining the psychometric properties of a new quality of life questionnaire in migraineurs]

MANHALTER Nóra, PALÁSTI Ágnes, BOZSIK György, ÁFRA Judit, ERTSEY Csaba

[Background - The deleterious effect of primary headaches on the sufferers’ quality of life (QOL) has been abundantly documented using both generic and headache-specific instruments. The currently used questionnaires focus on a limited number of factors and therefore may not be sensitive enough to detect the effect of headache type and headache characteristics on QOL, despite the obvious clinical differences. We have devised a comprehensive questionnaire that may be more sensitive to the burden of headache. Objective - To assess the psychometric properties of the new questionnaire on a group of migraineurs. Patients and method - We studied 117 migraineurs who completed the validated Hungarian version of the SF-36 generic QOL measure and our new, 25-item questionnaire. Reliability was assessed by internal consistency, measured by Cronbach’s a of all items. Content validity was exam- ined by calculating the correlation of the items with subscales of the SF-36 measure. The correlation of the patients’ migraine characteristics with the questionnaire’s items was used to assess criterion validity. Results - The questionnaire was quick and easy to administer. The questionnaire demonstrated good reliability, with Cronbach’s alpha being 0.893. Content validity was adequate; most “physical” items of the new questionnaire showed significant correlations with the bodily pain and role physical SF-36 subscales and most “psychical” and “social” items were correlated with mental health and social functioning SF-36 subscales. Criterion validity was adequate, with headache severity being correlated with most of the items. Discussion - In this study the new headache-specific quality of life instrument showed adequate psychometric properties.]

Clinical Neuroscience

[Earlier and more efficiently: the role of deep brain stimulation for parkinson’s disease preserving the working capabilities]

DELI Gabriella, BALÁS István, KOMOLY Sámuel, DÓCZI Tamás, JANSZKY József, ASCHERMANN Zsuzsanna, NAGY Ferenc, BOSNYÁK Edit, KOVÁCS Norbert

[Background – The recently published “EarlyStim” study demonstrated that deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD) with early fluctuations is superior to the optimal pharmacological treatment in improving the quality of life and motor symptoms, and preserving sociocultural position. Our retrospective investigation aimed to evaluate if DBS therapy was able to preserve the working capabilities of our patients. Methods – We reviewed the data of 39 young (<60 years-old) PD patients who underwent subthalamic DBS implantation at University of Pécs and had at least two years follow-up. Patients were categorized into two groups based on their working capabilities: Patients with active job (“Job+” group, n=15) and retired patients (without active job, “Job-” group, n=24). Severity of motor symptoms (UPDRS part 3), quality of life (EQ-5D) and presence of active job were evaluated one and two years after the operation. Results – As far as the severity of motor symptoms were concerned, similar (approximately 50%) improvement was achieved in both groups. However, the postoperative quality of life was significantly better in the Job+ group. Majority (12/15, 80%) of Job+ group members were able to preserve their job two years after the operation. However, only a minimal portion (1/24, 4.2%) of the Job- group members was able to return to the world of active employees (p<0.01, McNemar test). Conclusion – Although our retrospective study has several limitations, our results fit well with the conclusions of “EarlyStim” study. Both of them suggest that with optimal timing of DBS implantation we may preserve the working capabilities of our patients.]

Lege Artis Medicinae

[End of the line? Addenda to the health and social care career of psychiatric patients living in Hungary’s asylums]

KAPÓCS Gábor, BACSÁK Dániel

[The authors are focusing on a special type of long term psychiatric care taking place in Hungary outside of the conventional mental health care system, by introducing some institutional aspects of the not well known world of so called social homes for psychiatric patients (asylums). After reviewing several caracteristics of institutional development of psychiatric care in Hun­gary based on selected Hungarian and in­ternational historical sources, the main struc­tural data of present Hungarian institutional capacities of psychiatric health and social care services are shown. Finally, the authors based on own personal experiences describe several functional ascpects of the largest existing asylum in EU, a so­cial home for long term care of psychiatric pa­tients. By the beginning of the 20th century, Hungarian psychiatric institutions were operating on an infrastructure of three large mental hospitals standing alone and several psychiatric wards incorporated into hospitals. Nevertheless, at the very first session of the Psychiatrists’ Conference held in 1900 many professionals gave warning: mental institutions were overcrowded and the quality of care provided in psychiatric hospital wards, many of which located in the countryside of Hungary, in most cases was far from what would have been professionally acceptable. The solution was seen in the building of new independent mental hospitals and the introduction of a family nursing institution already established in Western Europe; only the latter measure was implemented in the first half of the 20th century but with great success. However, as a result of the socio-political-economic-ideological turn following the Second World War, the institution of family nursing was dismantled while different types of psychiatric care facilities were developed, such as institutionalised hospital and outpatient care. In the meantime, a new type of institution emerged in the 1950s: the social home for psychiatric pa­tients, which provided care for approximately the same number of chronic psychiatric patients nationwide as the number of functioning hospital beds for acute psychiatric patients. This have not changed significantly since, while so­cial homes for psychiatric patients are perhaps less visible to the professional and lay public nowadays, altough their operational conditions are deteriorating of late years. Data show, that for historical reasons the current sys­tem of inpatient psychiatric care is proportionately arranged between health care and social care institutions; each covering one third. Further research is needed to fully explore and understand the current challenges that the system of psychiatric care social- and health care institu­tions are facing. An in-depth analysis would significantly contribute to the comprehensive improvement of the quality of services and the quality of lives of patients, their relatives and the health- and social care professionals who support them. ]

Clinical Neuroscience

[The quality of life of the cluster headache patients during the active phase of the headache]

DIÓSSY Mária, BALOGH Eszter, MAGYAR Máté, GYÜRE Tamás, CSÉPÁNY Éva, BOZSIK György, ERTSEY Csaba

[Introduction - Cluster headache (CH), which affects 0.1% of the population, is one of the most painful human conditions: despite adequate treatment, the frequent and severe headaches cause a significant burden to the patients. According to a small number of previous studies, CH has a serious negative effect on the sufferers’ quality of life (QOL). In the current study, we set out to examine the quality of life of the CH patients attending our outpatient service between 2013 and 2016, using generic and headache-specific QOL instruments. Methods - A total of 42 CH patients (16 females and 26 males; mean age: 39.1±13.5 years) completed the SF-36 generic QOL questionnaire and the headache- specific CHQQ questionnaire (Comprehensive Headache- related Quality of life Questionnaire), during the active phase of their headache. Their data were compared to those of patients suffering from chronic tension type headache (CTH) and to data obtained from controls not suffering from significant forms of headache, using Kruskal-Wallis tests. Results - During the active phase of the CH, the patients’ generic QOL was significantly worse than that of normal controls in four of the 8 domains of the SF-36 instrument. Apart from a significantly worse result in the ‘Bodily pain’ SF-36 domain, there were no significant differences between the CH patients’ and the CTH patients’ results. All the dimensions and the total score of the headache-specific CHQQ instrument showed significantly worse QOL in the CH group than in the CTH group or in the control group. Conclusion - Cluster headache has a significant negative effect on the quality of life. The decrease of QOL experienced by the patients was better reflected by the headache-specific CHQQ instrument than by the generic SF-36 instrument. ]

Clinical Neuroscience

[Treatment of dystonia by deep brain stimulation: a summary of 40 cases]

DELI Gabriella, BALÁS István, KOMOLY Sámuel, DÓCZI Tamás, JANSZKY József, ILLÉS Zsolt, ASCHERMANN Zsuzsanna, TASNÁDI Emese, NAGY Ferenc, PFUND Zoltán, BÓNÉ Beáta, BOSNYÁK Edit, KULIFFAY Zsolt, SZIJJÁRTÓ Gábo

[Background - Bilateral pallidal deep brain stimulation (DBS) is an established treatment option for primary generalized and segmental dystonia. In the present study we evaluated the results of our dystonia patients treated by DBS. Methods - The surgical results of forty consecutive dystonia patients underwent DBS implantation were analyzed (age: 43.7±17.7 years; sex: 22 men; etiology: 24 primary and 16 secondary dystonia; topography: 24 generalized, 12 segmental and four hemidystonia; disease duration: 16.1±9.3 years). Severity of dystonia measured by Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and health-related quality of life measured by EQ-5D scale were obtained preoperatively and compared to the scores obtained at postoperative six months and subsequent yearly follow-ups. The average follow-up lasted 2.5 years (median, 0.5-8 years). In all cases the BFMDRS scores were re-evaluated by a rater blinded to the treatment. Treatment responsiveness was defined as an at least 25% improvement on the BFMDRS scores. Non-parametric Mann-Whitney, McNemar and Kruskal-Wallis tests were applied to test statistical significance. Results - Severity of dystonia improved from 31 to 10 points (median, 68% improvement, p<0.01) in the primary dystonia group, whereas in secondary dystonia these changes were statistically insignificant (improvement from 40 to 31.5 points, 21.2%, p>0.05). However, the health-related quality of life significantly improved in both groups (primary dystonia: 0.378 vs. 0.788 and secondary dystonia: 0.110 vs. 0.388, p<0.01). Significantly more patients in the primary dystonia group responded to DBS treatment than those in the secondary dystonia group (83.3% vs. 37.5%, p<0.01). Conclusion - Our results are in accordance with previously published international findings demonstrating that DBS is a highly effective and long-lasting treatment option for primary dystonia. DBS is considerably less efficient in secondary dystonia; however, it still has a high impact on the quality of life presumably due to its pain-relieving effect.]