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

JUNE 30, 2015

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

[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. ]

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Journal of Nursing Theory and Practice

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

SZABÓ Julianna

[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. ]

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. ]

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. ]

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[GOALS - Diabetes mellitus is considered as a risk factor concerning surgical interventions as well. Connection between incisional abdominal hernias and diabetes mellitus were investigated in this prospective four years study. The primary aim was to evaluate the proportion of recurrencies, the secondary aim was determining the ratio of surgical complications in the investigated two groups (Group I: non diabetic, group II: diabetic patients). PATIENTS AND METHOD - The results of the incisional and abdominal hernia operations performed between 01. 01. 2011. and 31. 12. 2014. were investigated. Data for study was gained from the consecutively and obligatorily registered database of the authors’ institution. The type of reconstruction, elective or acute character of surgery, primary or recidive operation, the patients’ body mass index (BMI), as well as among complications the seroma and fistula formations, the reoperations and postoperative infections were registered. Patients with type I and type II diabetes mellitus were not differentiated. The HgbA1c was investigated separately in elective and acute operations. RESULTS - There were 56 (8.94%) diabetic patients (39 male, 17 women, avr. age 54.3 years) out of all 626 patients operated on incisional and/or abdominals wall hernias. Total recurrency rate was 19.6% during the average 32 months (6-66 months) follow-up period. The recurrency rate in diabetic patients was 50.0% (48.7% in women, 52.9% in men). Non-diabetic patients’ recurrency ratio were only 8.3% (11.2% and 5.4% in men and women, respectively). Median BMI is significantly higher in patients with diabetes than in those of non diabetics (35.4kg/m2 vs 27.75kg/2). Ratio of the elective and acute operations were 69.6% and 28.6%, respectively. The most frequently used operations technique was the direct transversal abdominal wall suture (14.3%) and the direct suture plus synthetic mesh implantation (64.3%). Eleven (19.7%) diabetic patients with incisional hernia were reconstructed with a so-called autologous tension free dermal flap. In 2 (18.2%) out of 11 patients were registered recurrency. Seroma and haematoma formation was occured in four patient (36.4%) and in one (9.1%), respectively after dermal flap reconstructions. Mean recurrency time after surgery in non-diabetic and in diabetic patients was 12.3 months and 9.2 months, respectively. The average HgbA1c level was significantly higher (8.1% in electively operated patients than in those acutly operated ones (9.8%). There were two lethal (0.36%) postoperative complications in this study. CONCLUSION - Considering the recurrency ratio of the incisional hernias and the postoperative complications, diabetes mellitus is a significant risk factor compared the data to non-diabetic patients. Seroma and haematoma formations, postoperative complications ratio are significantly higher in patients with diabetes than in those of non-diabetic. Appearance of recurrencies require significantly shorter time in patients with diabetes mellitus The rate of recidive and postoperative complication after the autolog, dermal, traction free abdominal wall reconstructions made by authors was lower, than in abdominal hernias reconstructed in other ways (direct suture, direct suture plus xenograft).]

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