Journal of Nursing Theory and Practice

[Hungarian Cancer Society - Nursing Section]

APRIL 30, 2015

Journal of Nursing Theory and Practice - 2015;28(02)

COMMENTS

0 comments

Further articles in this publication

Journal of Nursing Theory and Practice

[The role of self-help groups in the treatment of alcoholism]

PRÍMA Erika

[Alcoholism is one of the best-known addictions. The results of both international and national surveys illustrate the health consequences of the excessive consumption of alcoholic beverages, and its link with alcoholic disease and the associated dangers, but we still find a high proportion of people who show unrestrained consumption. Is there a genuine desire to recover, is there motivation, and where should one look for help? Such assistance could take the form of a self-help group, where addicts who want to quit, those in the various stages of recovery, or those who have already recovered, can meet up. The aim is to achieve and maintain abstinence, and prevent a relapse. The author presents the process and benefits of self-help, from the perspective of addiction. Her study proves that the treatment of alcoholism requires a complex approach, and one in which we can ascribe a key role to self-help groups.]

Journal of Nursing Theory and Practice

[The international practice and acceptation concept on Hungary of the Advanced Practice Nurse (APN) training on the MSc level]

OLÁH András, MÁTÉ Orsolya, BETLEHEM József, FULLÉR Noémi

[In Hungary it was a niche and a reasonable developement according to the international trends to start the BSc nursing programme in 1989 - then the MSc nursing programme in 2000 -. However the structure of the nursing specialities’ education was not reviewed with the increase of the level of nursing education, so all of the nursing specialities’ education happens under BSc level. Also did not happened the determination of the nursing competencies on each educational level. These causes just contribute to have decreased number of nursing students within the BSc programmes and the numbers of nurses who intent to leave the profession are also increased. Migration of nurses, increased costs of the health care system, aging society, lack of physicians and the special knowledge of nurses to use for diagnostical and therapeutical equipements are challanges too beside these problems regarding the nurses. However, international literature says that with the employment of well-educated BSc, MSc nurses with expanded competencies the the problem of the lack of the physicians, waiting times, costs of the care, patients’ mortality may be decreased, patient’s satisfaction increases and because of the expanded nursing competencies the migration and nurses intent to leave are decreased. That is why it is reasonable to create BSc/MSc nursing specialities and expand nursing competencies in Hungary as well according to the international trends. Authors of this paper draw up a possible recommendation for the Hungarian implementation.]

Journal of Nursing Theory and Practice

[An in-depth look at chest pain, for ambulance nurses]

MOSKOLA Vladimír, HORNYÁK István

[Ambulance nurses often deal with complaints of chest pain, both when working independently and when on call in an emergency ambulance or quick response vehicle. It is essential that they know as much as possible about any life-threatening symptoms, and are as up-to-date with the latest skills when attending patients. This also helps teamwork and efforts to ensure an improvement and the proper treatment of the patient’s condition (in the context of an ambulance nurse’s duties). This all requires a knowledge of differential diagnosis, which gives a broad outline of the diseases that could potentially underlie the chest pains suffered by a patient who calls an ambulance. The more in-depth theoretical knowledge also promotes an understanding of the importance of intervention by ambulance crew/doctors in the case of certain diseases, the importance of the time factor, and the reason for urgency even if the patient’s condition does not appear serious at first glance. In the light of these factors the authors have undertaken to provide readers with new, evidence-based knowledge.]

Journal of Nursing Theory and Practice

[Intracystic brachytherapy of cystic brain tumors by image fusion method- intracavital beta irradiation of 90-Yttrium solution]

BALLÁNÉ PERDUK Anikó, JULOW Jenő

[Aim of the research: The authors aimed to gain acceptance, effectiveness testing and the timetable of the shrinking of the cysts for the treatment procedure of patients with cystic craniopharyngeoma. The procedure utilizes intracavitary beta irradiation by 90Y colloidal solution. Image fusion was used for the first time for the guidance and control of the intra cystic irradiation of brain tumors. The authors also examined the use of the image fusion for brachytherapy of brain tumors before, during, and months or even years after surgery and to patient follow up. Research and sampling methods: 130 craniopharyngeoma cyst was irradiated with the Yttrium-90 colloidal solution in 84 patients. The internal wall of the cyst were getting a load of 180-300 Gy. The volumes of the cysts were followed almost over 30 years by the control of CT-MRI image fusion. For the planning of the irradiation the authors developed their own software and BrainLab was used for the CT-MRI-PET image fusion. For the mathematical and statistical calculation Matlab and MedCalc soft wares were utilized. Results: The results were from 130, 90Y β stereotactic intracavitary irradiation of cystic craniopharyngiomas. As per cystic CRF volume the volume reduction exceeded 80 %. The mean survival rate following 90-Y irradiation was 7.5 years. Large-scale shrinkage of craniopharyngioma cysts were observed significantly, following 6 months. Conclusions: According to long term clinical experience the intracavitary 90 Yttrium brachytherapy is a relatively non-invasive and effective mode for the recurrent cystic craniopharyngeoma therapy. Procedures where isotope get implanted, qualify in all aspects of a minimally invasive therapy.]

Journal of Nursing Theory and Practice

[The effect of work uncertainty on burnout and health of nurses]

NÉMETH Anikó, LANTOS Katalin, BÁRSONYNÉ KIS Klára

[Aim of the research: To measure how work uncertainty effects on burnout, psychosomatic symptoms and subjective health conditious. Research and sampling methods: In this cross-sectional study the authors have conducted a group of nurses (N=29) at Mátra Health Institute in 2013-2014. The survey was designed by the authors. Results: The burnout becomes higher as the uncertainty at the workplace rises (p=0,038; r=0,387). The degree of the burnout correlates with the subjective negative health status (p<0,001; r=-0,650) and with the appearance of psychosomatic symptoms (p=0,003; r=0,530). The most common psychosomatic symptoms are the backache and dorsal pain, weakness, weariness, headache and sleeping problems. Conclusions: The uncertainty influences only the degree of the burnout, and it had no any effect on other variables) ]

All articles in the issue

Related contents

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

JARABIN András János, KLIVÉNYI Péter, TISZLAVICZ László, MOLNÁR Anna Fiona, GION Katalin, FÖLDESI Imre, KISS Geza Jozsef, ROVÓ László, BELLA Zsolt

Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Clinical Neuroscience

[Advanced Parkinson’s disease characteristics in clinical practice: Results from the OBSERVE-PD study and sub-analysis of the Hungarian data]

TAKÁTS Annamária, ASCHERMANN Zsuzsanna, VÉCSEI László, KLIVÉNYI Péter, DÉZSI Lívia, ZÁDORI Dénes, VALIKOVICS Attila, VARANNAI Lajos, ONUK Koray, KINCZEL Beatrix, KOVÁCS Norbert

[The majority of patients with advanced Parkinson’s disease are treated at specialized movement disorder centers. Currently, there is no clear consensus on how to define the stages of Parkinson’s disease; the proportion of Parkinson’s patients with advanced Parkinson’s disease, the referral process, and the clinical features used to characterize advanced Parkinson’s disease are not well delineated. The primary objective of this observational study was to evaluate the proportion of Parkinson’s patients identified as advanced patients according to physician’s judgment in all participating movement disorder centers across the study. Here we evaluate the Hungarian subset of the participating patients. The study was conducted in a cross-sectional, non-interventional, multi-country, multi-center format in 18 countries. Data were collected during a single patient visit. Current Parkinson’s disease status was assessed with Unified Parkinson’s Disease Rating Scale (UPDRS) parts II, III, IV, and V (modified Hoehn and Yahr staging). Non-motor symptoms were assessed using the PD Non-motor Symptoms Scale (NMSS); quality of life was assessed with the PD 8-item Quality-of-Life Questionnaire (PDQ-8). Parkinson’s disease was classified as advanced versus non-advanced based on physician assessment and on questions developed by the Delphi method. Overall, 2627 patients with Parkinson’s disease from 126 sites were documented. In Hungary, 100 patients with Parkinson’s disease were documented in four movement disorder centers, and, according to the physician assessment, 50% of these patients had advanced Parkinson’s disease. Their mean scores showed significantly higher impairment in those with, versus without advanced Parkinson’s disease: UPDRS II (14.1 vs. 9.2), UPDRS IV Q32 (1.1 vs. 0.0) and Q39 (1.1 vs. 0.5), UPDRS V (2.8 vs. 2.0) and PDQ-8 (29.1 vs. 18.9). Physicians in Hungarian movement disorder centers assessed that half of the Parkinson’s patients had advanced disease, with worse motor and non-motor symptom severity and worse QoL than those without advanced Parkinson’s disease. Despite being classified as eligible for invasive/device-aided treatment, that treatment had not been initiated in 25% of these patients.]

Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

Clinical Neuroscience

[Decisional collisions between evidence and experience based medicine in care of people with epilepsy]

RAJNA Péter

[Background – Based on the literature and his long-term clinical practice the author stresses the main collisions of evidence and experience based medicine in the care of people with epilepsy. Purpose – To see, what are the professional decisions of high responsibility in the epilepsy-care, in whose the relevant clinical research is still lacking or does not give a satisfactory basis. Methods – Following the structure of the Hungarian Guideline the author points the critical situations and decisions. He explains also the causes of the dilemmas: the lack or uncertainty of evidences or the difficulty of scientific investigation of the situation. Results – There are some priorities of experience based medicine in the following areas: definition of epilepsy, classification of seizures, etiology – including genetic background –, role of precipitating and provoking factors. These are able to influence the complex diagnosis. In the pharmacotherapy the choice of the first drug and the optimal algorithm as well as the tasks during the care are also depends on personal experiences sometimes contradictory to the official recommendations. Same can occur in the choice of the non-pharmacological treatments and rehabilitation. Discussion and conclusion – Personal professional experiences (and interests of patients) must be obligatory accessories of evidence based attitude, but for achieving the optimal results, in some situations they replace the official recommendations. Therefore it is very important that the problematic patients do meet experts having necessary experiences and also professional responsibility to help in these decisions. ]

Clinical Neuroscience

[Vinpocetin in neurological diseases]

SZAPÁRY László, KÉSMÁRKY Gábor, TÓTH Kálmán, MISNYOVSZKY Melinda, TÓTH Tímea, BALOGH Ágnes, NAGY Krisztián, NÉMETH György, FEHÉR Gergely

[Introduction - Stroke is the third leading cause of death worldwide (following cardiovascular and cancer mortality) and associated with serious disability for the vast majority of patients. There is no salvage therapy for irreversibly damaged brain areas, improving the circulation of the surrounding hypoperfused territories may be associated with benefitial clinical states. Cerebral hypoperfusion may play a role in the pathogenesis of other kind of neurological diseases, improvement of global circulation may have a preventive effect on these conditions. Aims - The aim of our study was to review the experimental and clinical articles focusing on the role of vinpocetin in different neurological conditions. Results - Vinpocetin appears to have several different mechanisms of action that allow for its antiinflammatory, antioxidant, vasodilating, antiepileptic and neuroprotective activities in experimental conditions. On the other hand, several meta-analysis of the existing studies in acute stroke examining short and long term fatality rates with vinpocetin was unable to assess efficacy. In chronic cerebrovascular patients, vinpocetin improves impaired hemorheological variables, has significant vasodilating properties, improves endothelial dysfunction, neuroimaging studies showed selective increase in cerebral blood flow and cerebral metabolic rate, all of which are potentially beneficial in cerebrovascular disease and may improve cognitive functions. Summary - Based on the above mentioned results vinpocetin plays an important role both in basic research and in clinical management of different neurological diseases.]