Journal of Nursing Theory and Practice

[Impact of post hip-replacement motor functions on the patient’s subjective state of health and perception of surgical success]

KIRÁLY Edit, GONDOS Tibor

JULY 30, 2012

Journal of Nursing Theory and Practice - 2012;25(03)

[Research aim: The authors analyse the extent to which the change in motor function infl uences the patients’ sense of illness fi ve years after the implantation of an artifi cial hip replacement. Methodology and sample: The retrospective follow-up survey was conducted in the Jávorszky Ödön Hospital in Vác through analysis of the electronic patient database and the returned questionnaires. A total of 109 patients who had received artifi cial hip replacements were included in the survey. The authors analysed the objective motor organ indicators (movement of the hip joint, use of mobility aids) based on the patients’ subjective sense of illness five years after the surgery, and the patients’ opinions about the operation. Results: In the 5th postoperative year the patients’ motor function had signifi cantly improved, and the use of mobility aids had signifi cantly decreased. In terms of the patients’ sense of illness, no signifi cant difference was found between the studied motor organ indicators of those who considered themselves to be healthy and of those who regarded themselves as ill. Conclusions: A successful hip replacement signifi cantly improves the patients’ motor function in the 5th postoperative year, but this has little bearing on the sense of illness. In this period the nursing staff should concentrate on other factors if they want to improve the patients’ quality of life.]

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Journal of Nursing Theory and Practice

[The nursing aspects of the use of Point of Care Testing laboratory diagnostics]

BERNHARDT Szilvia

[Aim of the study: The author’s aim was to present the Point of Care Testing (POCT) laboratory diagnostic methods used during the treatment of emergency cases, on the basis of feedback from paramedical professionals. The survey also investigated the opportunities using the procedure more widely, in keeping with the specifi c professional requirements of the various departments. Methodology and sample: The data was gathered in Budapest, at various departments of the Hungarian National Defence Hospital. A name-based sampling method was used, and the quantitative research involved a prospective cross-sectional, descriptive correlation study using an internet-based questionnaire survey. Results: Based on the opinions of paramedical professionals at the surveyed departments, a signifi cant difference was demonstrated in the ranking of the types of POCT clinical tests. The procedure proved to be exceptionally useful in the treatment of acute cases, although the perception of its effectiveness differed between departments. Conclusions: Priority needs to be given to propagating the theoretical aspects and deepening the practical skills related to POCT clinical procedures. Based on a complex survey of several departments, the POCT procedures proved to be quick, accurate and economical, provided that the paramedical professionals have the appropriate theoretical grounding.]

Journal of Nursing Theory and Practice

[Intention to leave the profession among health care workers in Csongrád County]

NÉMETH Anikó, IRINYI Tamás

[Aims of the study: The study assessed the intent to leave the profession among health care providers in Csongrád County and investigated on which fi eld and country they intend to work; its connection with burn-out and psychosomatic symptoms has also been analyzed. Methodology and sample: This is a cross-sectional study carried out through a self-designed self-report questionnaire sent to registered members of MESZK living in Csongrád County. Results: Bad psychosomatic status correlates with the intent to leave the health care system (p<0.000) and the fear of losing the job (p<0.003). Those who are not afraid of losing their jobs are not to leave the health care system (p<0.000). Workers with severe psychic condition are planning most likely planning to leave their profession. Conclusions: The fear of losing employment and the thought of leaving the profession is an everyday phenomenon among health care workers. This shows strong connection with bad psychosomatic status and burn out.]

Journal of Nursing Theory and Practice

[Comparison of the cost-effectiveness of vacuum assisted closure, as an innovative procedure, and traditional wound treatment, in the light of quality aspects]

LAKATOSNÉ PRIPKÓ Judit

[Recent decades have seen expansion in the literature and fi ndings related to the healing of wounds, and many new options for promoting wound healing have become available. The innovative wound treatment procedure known as vacuum assisted closure can be used for a wide range of indications, and can ensure the optimal conditions for the start of the wound healing processes. The study reveals the cost implications of negative pressure therapy through a study of the treatment of two patients, and also presents the components of the quality aspects identifi ed at Hatvan hospital, as defi ned in the Donabedián model, the PDCA cycle of the applied vacuum-assisted wound treatment, and the impact of the revealed components on the quality and costeffectiveness of the patient care. The author emphasises that the use of even the latest technologies can only effectively ensure the development of healthcare if combined with the commitment of managers and workers to assure quality, and if the fundamental principles of quality improvement are integrated into the structure and process of healthcare provision.]

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

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[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]

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[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.]

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.]

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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. ]