Journal of Nursing Theory and Practice

[Jubilee Celebration of Hungarian Nurse Directors Association]

KÓNYA Anikó

OCTOBER 30, 2017

Journal of Nursing Theory and Practice - 2017;30(05)

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Journal of Nursing Theory and Practice

[The Prastige and Values of Nurses and Caregivers employed in the Social Service System]

SZŰCS Anett

[Aim of the study: During the study my target was to identify the career motivations, prestige of caretakers and nurses working in the Gödöllő social services and get acquainted with the most important values in their life. Sample and methods: Descriptive type research, number of elements are 81 (n=81). Summarization of the data was executed by Microsoft Office Excel 2007. Results: The employees took part in the research considered their profession as relatively low prestigious, although they would choose again this profession if they could decide again. Supporting professionals consider health, family, friendship and affection as the most important value in their life. Conclusions: The nursesand caretakers interviewed by me consider their choice of career successful in spite of its low prestige and they like their profession. Recognition the values of the employees is an important objective, because the identified values determine the quality of the work they perform.]

Journal of Nursing Theory and Practice

[Post-operative external Fixation in Adult and Pediatric Hand Surgery from a Nurse’s perspective]

TÓSAKI Mónika, HAJDUNÉ NÉMETH Anna Csilla

[Performing postoperative nursing duties on hand surgical patients is a special field of nursing. Our goal is to demonstrate what special - observational and other - duties are rquired of an adult/pediatric hand surgical nurse.We also would like to broaden the knowledge of our nursing staff, because due to our shortage of workstaff we are often forced into substituting positions, and patient safety requires us to be practiced in this field. We will give an overview of the most common fixating techniques, post-operative nursing duties and most common complications.]

Journal of Nursing Theory and Practice

[Impacto de la altura en el embarazo y en el producto de la gestación]

GUSTAVO F. Gonzales

Journal of Nursing Theory and Practice

[Importance of the Hyponatraemia in the Emergency Care]

PÓHR Kitti, KÖCSE Tamás, MESTERHÁZI András, BIERER Gábor, KARAMÁNNÉ Pakai Annamária

[The aim of the study: Hyponatraemia is the most common electrolyte abnormality in hospitalized patients. Certain drugs (eg, diuretics, antidepressants, and antiepileptics) have been implicated as established causes of either asymptomatic or symptomatic hyponatraemia. Studies proved correlation between hyponatremia and hospital mortality. Hyponatraemia remains asymptomatic in most cases, but if left untreated, it can cause life-threatening situations. Our aim was to examine the frequency of hyponatraemia in our hospital and its impact on the emergency care. Methods: A total of 75 patients were enrolled in the study with purposive sampling. We used descriptive and mathematical statistics with SPSS 22.0 software package for processing non-parametric statistical data. Results: Patients transferred by ambulance or arriving at the ER department came with dizziness, vomiting / diarrhea symptoms. Admission causes, were characteristic symptoms of hyponatraemia as well as non-specific neurological symptoms (headache, dizziness, confusion, unconsciousness) were found (n = 29). In addition, a common complaint of vomiting / diarrhea (n = 12), abdominal pain (n = 10). In particular, the complaint leading to a significant proportion of patients with hyponatraemia was not typical, but it was kind of trauma (n = 12). Nearly half of the patients (n = 36) were revenant. The most common diagnosis was hypertension (34%). 52% were taking medication that typically cause hyponatraemia. There were significant increase in the incidence of hyponatraemia in cases where the patient was taking diuretics. Conclusions: The diagnosis of hyponatraemia is based on the recording history, physical examination, and laboratory tests. Preventive approach would reduce the number of hospital stays due to hyponatraemia, and this may indeed improve patients’ life expectancy. The disease itself is easily remedied, it can cause critical condition due to disregard.]

Journal of Nursing Theory and Practice

[Health Assessment of Taxi Drivers in the city of Miskolc]

GAJDOS Attila, HIRDI Henriett Éva

[The aim of the study: The authors’ objective was to reveal the state of health and lifestyle of taxi drivers. Methods: The cross-sectional survey was conducted in 2017 among taxi drivers in Miskolc (N=100), selected using a random, sampling method. The data gathering took place using paper-based, anonymous, self-completion questionnaire. The proprietary questionnaire used was based on the questionnaire used in the National Population Health Survey (OLEF) for the standard survey of health behaviour. The authors analysed the gathered data with Microsoft Excel Excel 2016, using a descriptive statistical method. Results: The average health value of taxi drivers was 3.39 on a scale of five grades. 79% of the drivers are overweight or obese. 56% have a chronic disease affecting one or more organ systems. Examining their state of health based on the psychosomatic symptoms scale, the respondents most frequently indicated back and lumbal pain, and sleep disorders. The Epworth somnolence scale caused by 8% slightly abnormal sleeping disorder. To filter OSAS study-aid by the responders 34% was the test positive. Conclusions: The results of survey revealed that the health condition of respondents is unsatisfying. Based on the results they can state, that taxi drivers health is worse in many ways than an average Hungarian adult. On the whole it can be concluded that health behavior of taxi drivers needs to be changed. ]

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Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

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Neuroscience highlights: Main cell types underlying memory and spatial navigation

KRABOTH Zoltán, KÁLMÁN Bernadette

Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.

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

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[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.]

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The effects of the level of spinal cord injury on life satisfaction and disability

GULSAH Karatas, NESLIHAN Metli, ELIF Yalcin, RAMAZAN Gündüz, FATIH Karatas, MÜFIT Akyuz

Introduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients’ disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.

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[Association between cyclothymic affective temperament and hypertension]

NEMCSIK János, BATTA Dóra, KŐRÖSI Beáta, RIHMER Zoltán

[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]