Journal of Nursing Theory and Practice

[Madeleine Leininger passed away]

PAPP Katalin

OCTOBER 20, 2012

Journal of Nursing Theory and Practice - 2012;25(05)

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Further articles in this publication

Journal of Nursing Theory and Practice

[The opinions of paediatric nurses on cooperation with children and their parents in hospital; the factors affecting such cooperation]

MIKLÓSI Mónika, GALAMBOSI Elvira, PERCZEL FORINTOS Dóra

[Aim of the study: To explore pediatric staff nurses’ perception of collaboration with hospitalized children and their parents and to study underlying factors. Methodology and sample: In a prospective longitudinal design, parents of children admitted to hospital for planned surgical intervention (n=91) filled out a questionnaire packet before hospitalization assessing demographical and socio-economical characteristics, as well as mental health status of children and parents. Staff nurses were asked to estimate parents’ and children’s collaboration during hospitalization (n=131). Results: Nurses’ ratings about parents’ collaboration were higher than their ratings about children’s collaboration. Child’s gender, age, parent’s level of education, family characteristics and length of hospital stay had an impact on the perception of collaboration with parents. Child’s age and prosocial behavior were related to the perception of collaboration between nurses and children. Conclusions: Nurses’ perception of children’s and parents’ collaboration was related to demographical and socio-economical factors. Identifying these factors may help to promote partnership among nurses, parents and hospitalized children. ]

Journal of Nursing Theory and Practice

[The importance of transcultural nursing in the health care in Hungary]

BALOGH Zoltán

Journal of Nursing Theory and Practice

[Congratulations]

Journal of Nursing Theory and Practice

[Epidemic among health care providers: burnout]

IRINYI Tamás, NÉMETH Anikó

[Aims of the study: To track the changes since 2008 in the degree of burnout among health care workers in Csongrád County, and to examine its connections with the evaluation of own health, frequency of psychosomatic symptoms, the intent to leave the profession, and the measure of fear from becoming unemployed. 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: The number of burned-out health care workers increased since 2008. Burnout correlates with physical health (p<0.000), the intention to leave the profession (p<0.000), and the fear of losing the job (p<0.000). A significant increase could be observed by nurses starting their career. Conclusions: Burnout prevention trainings would be important also by career starters, which could also prevent profession leaving. ]

Journal of Nursing Theory and Practice

[A faraway land: nursing in a “small” Swedish hospital]

FUCHS Rita

[The author is currently working as a degree nurse in Örebro County, Sweden. In Sweden she has a greater degree of professional autonomy, which allows her to make use of all the theoretical knowledge and practical skills acquired at college. For performing certain tasks the doctor’s written authorisation is not required; nurses proceed in accordance with their competencies and the rules set out in the given protocol. She sets out to give an insight into the day-to-day work of nurses at her hospital, by describing the documents that are used, briefly outlining the training system, and the authority exercised by the nurses. Keywords: nurse, nursing training, nursing documentation, competency]

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BÉLY Miklós, KRUTSAY Miklós

[In medical practice there are a number of “truths etched in stone” that are passed on from textbook to textbook and learned by generations before they become obsolete. This short study aims to eliminate a misbelief from the diagnosis of gout that is related to the histological detectability of urate deposits. According to the generally accepted thesis, urate crystals obtained from patients with gout are dissolved in formalin solution, therefore, tissue samples should be fixated in alcohol. The authors have found that urate crystals can be detected on conventionally mounted, native (unstained) sections, despite formalin fixation, whereas the great majority of urate crystals are dissolved during haematoxylin-eosin staining. Therefore, for the detection of urate crystals the tissue samples should be examined on native, unstained sections.]

Clinical Neuroscience

[Regulatory mechanisms in focal cerebral ischemia. Perspectives in neuroprotective treatment]

NAGY Zoltán, SIMON László, BORI Zoltán

[Permanent or temporary disruption of cerebral blood flow rapidly depletes brain regions of their limited energy reserves (glycogen, glucose, oxygen, ATP) leading to an energy crisis. Tissue damage occurs due to the energy crisis. The central part of the damage, the ischaemic “core” region is surrounded by zones of the shell-like penumbra. Necrotic, as well as apoptotic cell death could be identified in the penumbra. Going away from the ischaemic core different neurochemical processes are occuring by space and time.“Immediate early response” genes (c-fos, fos-B, c-Jun, krox 20, 24) are activated, heatshock proteins (hsp 70, 72, HSF, HSE, HIF), cytokines (TNF-α, IL-1β), inflammatory factors (COX), adhesion and glial factors (ICAM-1, ELAM-1, P-selectin), vasoactive factors (IL -6, -10, PAF), reactive oxigen radicals and connected factors (O2, OH, NO, NOS, SOD) are produced within minutes and hours. Cell deaths, necrosis and apoptosis due to the activation of calpains, caspases and nucleases occur in days. In parallel, growth factors and plasticity proteins (BDNF, NGF, TGF-β, VEGF, PDGF, GAP-43) are activated as a basis of functional rehabilitation.]

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[Variations to the Kreutzer Sonata – Leo Tolstoy Passed Away 100 Years Ago]

KISS László

Clinical Neuroscience

Long-term follow-up results of concomitant chemoradiotherapy followed by adjuvant temozolomide therapy for glioblastoma multiforme patients. The importance of MRI information in survival: Single-center experience

LUKÁCS Gábor, TÓTH Zoltán, SIPOS Dávid, CSIMA Melinda, HADJIEV Janaki, BAJZIK Gábor, CSELIK Zsolt, SEMJÉN Dávid, REPA Imre, KOVÁCS Árpád

Introduction - Glioblastoma multiforme (GBM) is the most common malignant primary anomaly of central nervous system. The GBM infiltrates the nearly sturctures from the initial tumor and its metastatic attribution is well known. The aim of our single-centered retrospective study was to introduce the importance of postoperative medical imaging confirmation of total tumor resection for patient with GBM combined concomitant and adjuvant chemoradiotherapy on a 10 year long patient follow up. Methods - From January 2006 to April 2015 we registered 59 patients with newly diagnosed GBM at the University of Kaposvár Health Center Institute of Diagnostic Imaging and Radiation Oncology. The histological diagnosis was confirmed by a proficient neuropathologist (World Health Organisation WHO; grade IV astrocytoma). According to histological status if the ECOG performance status of patients allowed it the mutidisciplinary oncoteam recommended adjuvant chemoradiotherapy all features strictly by Stupp protocol. (60 Gy dose on the gross tumor volume and 2-3 cm margin for the clinical target volume with parallel 75 mg/m2 TMZ. Four weeks after monotherapial phase patients had to recieve 6 cycles of TMZ first cycle with 150 mg/m2 up to 200 mg/m2). The irradiation was carried out by a conformal three dimensional planning system. Results - 59 patients with the median age of 63 (range 17-84) year. Our sample counted 34 male patients and 25 woman patients. 14 patients underwent gross total tumor resection while, 39 patients underwent partial resection and the rest from our sample 6 patients passed through biopsy. Statistical analysis showed a lengthier survival among males than females, with a median survival of 13 months for males and females, the OS of 26.209 for males, meanwhile 15.625 for females. However, the difference is not considerable (log-rank p=0.203). Our study found that the estimated survival of patients at least 50 years old is significantly shorter at a median survival of 12 months (log rank p=0.027) than that of patients below 50 years of age at a median survival of 23 months. The longest estimated median survival was calculated with patients of ECOG '0' condition (16 months). However, no significant difference was found in the estimated survival of patients of different ECOG conditions (log-rank p=0.146). Based on the extent of surgery, complete resection resulted in the longest average survival of 36.4 months, followed by 21.5 months among patients with biopsy, and 15.8 months among patients with partial resection. Different surgical procedures, however, did not result in significant differences in survival (log-rank p=0.059). The overal survival of patients who had complete resection confirmed by MRI compared with the overal survival of patients with residual tumor confirmed by MRI as well we can estimate that there is significant difference between these two groups (p=0,004). Conclusion - Despite complex and intense treatment, recurrence is inevitable and causes relatively rapid death. In our analysis complete resection, as defined from the neurosurgeon’s report and postoperative MRI, resulted in an independently significant improvement in OS. Our results are the evidences that the treatment of patients with glioblastoma multiforme in Hungary is at least on the same level as any other developed European countries.

Hungarian Radiology

[Portal embolisation prior to liver resection]

MÓZES Péter, MÉSZÁROS György, TÓTH Judit, SÁPY Péter

[INTRODUCTION - By partial embolisation of the vena portae the number of the patients suitable for radical liverresection can be enhanced, the safety of the operation can be increased, the subsequent results improved. The method is based on the experience that when blocking the circulation of the portal system in special segments of the liver, the other part of the organ tries to substitute the functional deficiency by hypertrophy. Vena portae embolisation is justified in cases when the liver substance remaining after the planned operation is critically small. PATIENTS AND METHODS - The authors carried out vena portae embolisation at Debrecen University Medical and Health Science Centre since October 2003 on six patients. Assessments were made studying the volume of the whole liver, the lobe affected by embolisation and that of the unaffected lobe, by CT-volumetry. The average age of the patients (four men and two women) was 63 years (51-67 years). The hepatic tumour was an extended metastasis localised to one lobe in five cases, and HCC in one of the patients. In each case we carried out closing the right lobe’s portal system. RESULTS - In five cases the left lobe showed increase following the portal embolisation of the right lobe intended to be removed. On the average four-six weeks passed between the two CT-examinations. The growth of the left lobe was an average of 42% (min. 11.8%, max. 75.6%). CONCLUSION - In selected patients the embolisation of the vena portae system of the tumorous liver-segments is a suitable method for enlargening the size of the liver substance remaining after an extensive resection.]