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

[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

[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

[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. ]

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

[Hand Disinfection: the simplest method for preventing Nosocomial Infections]

SZEGEDI Bojtorné Ágnes

[It’s quintessential that health workers have primary role in the development of the healthcare associated infections. Personal hygiene always had a different role. In Hungary hand disinfection became important thanks to Ignac Semmelweis. The nurse-training became a national matter so the related education became unified. The National Public Health and Medical Officer Service’s Methodological Letter describes the detailed regulation of hand disinfection. The compliance is mandatory to every health worker. It’s strictly regulates how the health workers has to disinfect their hand and regulates which tool has to be used for hand disinfection and how they should take care of their hand. Researches were trying to disclose the reason of the neglection of hand disinfection. The literature says tackling the issue is a long proccess. Thus everyone has a role in the change, but the health workers has the biggest and most important role in it.]

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Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

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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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Electrophysiological investigation for autonomic dysfunction in patients with myasthenia gravis: A prospective study

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Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission. Autonomic dysfunction is not a commonly known association with MG. We conducted this study to evaluate autonomic functions in MG & subgroups and to investigate the effects of acetylcholinesterase inhibitors. This study comprised 30 autoimmune MG patients and 30 healthy volunteers. Autonomic tests including sympathetic skin response (SSR) and R-R interval variation analysis (RRIV) was carried out. The tests were performed two times for patients who were under acetylcholinesterase inhibitors during the current assessment. The RRIV rise during hyperventilation was better (p=0.006) and Valsalva ratio (p=0.039) was lower in control group. The SSR amplitudes were lower thereafter drug intake (p=0.030). As much as time went by after drug administration prolonged SSR latencies were obtained (p=0.043).Valsalva ratio was lower in the AchR antibody negative group (p=0.033). The findings showed that both ocular/generalized MG patients have a subclinical parasympathetic abnormality prominent in the AchR antibody negative group and pyridostigmine has a peripheral sympathetic cholinergic noncumulative effect.

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[The connection between the socioeconomic status and stroke in Budapest]

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[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]