Journal of Nursing Theory and Practice

[Pearls of Nursing History: Remembering Florence Nighingale]

PERKÓ Magda, SÖVÉNYI Ferencné

MAY 30, 2017

Journal of Nursing Theory and Practice - 2017;30(03)

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Journal of Nursing Theory and Practice

[Double taboo: disabled people, sexual needs during the care in the hospital]

FORRAI Judit

[This paper presents the situation and perceptions of nurses regarding sexuality related to disabled patient care in hospital. The nurses have difficulty dealing with issues of sexuality, and the reasons for this were complex and interrelated. Patient care is influenced by nurses’ perceptions of sexuality. Nurses basically could discuss of sexuality with their patients however, the sexuality is a fundamental part of being human. A person’s sexuality or sexual health can be temporarily or permanently altered by illness or treatment. Nurses are well suited to deal with patients’ needs regarding sexuality, because nurses are in constant contact with patients and because of the intimate nature of care that nurses could provide the sexual care, information’s and education on this field. Professional boundaries are the spaces between the nurse’s “power” and the patient’s vulnerability. The power of the nurse comes from the nurse’s professional position and access to sensitive personal information. Nurses should make every effort to respect the power imbalance and ensure a patient- centered relationship.]

Journal of Nursing Theory and Practice

[Development the mental and physical health of the healthcare staff]

MISZORY Erika Viktória

[Objectives: To analyse, whether the mental and physical health of the healthcare staff can be influenced by movement therapy. Methods: Between May and July 2016 we held multiple movement therapy sessions within the healthcare staff of the the Hungarian Army Medical Center, Musculoskeletal Rehabilitation Institute in Hévíz. With the help of the so called General Health Questionnare I collected information about the mental state of the participants. This questionnaire included 12 questions and had to be filled out by each and every person alone. From the physical variables perspective I collected information from the staff in regards to the mobility of their spine. Microsoft Excel was used for the analysis of the data and to prove the significance of the variables, I used the T-probe method. Results: Majority of the participants has both internal medicine and musculosceletal problems, symphtoms and diseases. Though the psychic stress on them can be clearly seen, it can be treated with movement therapy efficiently. On the other hand, I could not find any significant change in the variables related to the spine-movements. Conclusions: With the help of regular movement therapy the mental state of the staff can be efficiently infleunced and improved. Further studies suggested a greater number of elements, for detected the physical changes.]

Journal of Nursing Theory and Practice

[The Council of Nursing and Maternity Nurses of the Health Professional College is full again]

MÉSZÁROS Magdolna

[For the expectation of the health care organizations and professionals, the medical professional councils are established in April, 2017. The Council of Nursing and Maternity Nurses includes 15 members. The session of the council was held 5th of May, 2017, where Dr. habil. András Oláh was elected for the president within its members. The nomination is maintained for the period of 4 years. Lots of task and recommendation was already framed by its members on the first meeting.]

Journal of Nursing Theory and Practice

[The relationship of work-related conflicts and burnout among health care workers]

IRINYI Tamás, LAMPEK Kinga, NÉMETH Anikó

[The aim of the study was to investigate the relationship of work-related conflicts and burnout; furthermore to reveal the types of reactions to work-related conflicts. Material and Methods: The survey was conducted between June and August of 2016 using a self-constructed online questionnaire. Data were analyzed with SPSS 23.0; Kolmogorov-Smirnov, Shapiro-Wilk, Kruskal-Wallis and Mann-Whitney tests (Bonferroni correction) and Spearman’s rank correlation were applied (p<0.05). Results: Only 4.6% of the 1201 responders had never experienced any work-related conflicts. Burnout is present on some level by 44.2% of them. In the case of a conflict 62.2% tries to settle the problem with the source of the conflict; 41.2% talks back and one-third gets angry and unsettled. The severity of burnout and the frequency of work-related conflicts are correlated (r=0.390; p<0.000). Conclusions: The longer someone is suffering from psychic disturbances the more conflicts he/she experiences on the job. Participants usually used self-defence techniques.]

Journal of Nursing Theory and Practice

[Social Values versus Nurses’ Values? Coherency of value research]

ÁRVAINÉ Honti Ágnes

[Those who are selected for BSc nursing training, have special values and value systems. The values can be approached, if we answer for the question, what is valuable to us. The values are incorporated into the personality during socialization and human interactions. Those who choose a helper occupation, have a special value preference, which predicts the success of the career. The author discuss the social values, the values that are necessary to a helper occupation and the values of those attending nursing training, summarizing the results of the main professional statements and research in connection with the theme.]

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Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

Clinical Neuroscience

Autonomic nervous system may be affected after carpal tunnel syndrome surgery: A possible mechanism for persistence of symptoms after surgery

ONDER Burcu, KELES Yavuz Betul

After carpal tunnel surgery, some patients report complaints such as edema, pain, and numbness. Purpose – The aim of this study was to evaluate autonomic nervous system function in patients with a history of carpal tunnel surgery using sympathetic skin response (SSR). Thirty three patients (55 ±10 years old) with a history of unilateral operation for carpal tunnel syndrome were included in the study. The SSR test was performed for both hands. Both upper extremities median and ulnar nerve conduction results were recorded. A reduced amplitude (p=0.006) and delayed latency (p<0.0001) were detected in the SSR test on the operated side compared to contralateral side. There was no correlation between SSR and carpal tunnel syndrome severity. Although complex regional pain syndrome does not develop in patients after carpal tunnel surgery, some of the complaints may be caused by effects on the autonomic nervous system.

Clinical Neuroscience

Simultaneous subdural, subarachnoideal and intracerebral haemorrhage after rupture of a peripheral middle cerebral artery aneurysm

BÉRES-MOLNÁR Anna Katalin, FOLYOVICH András, SZLOBODA Péter, SZENDREY-KISS Zsolt, BERECZKI Dániel, BAKOS Mária, VÁRALLYAY György, SZABÓ Huba, NYÁRI István

The cause of intracerebral, subarachnoid and subdural haemorrhage is different, and the simultaneous appearance in the same case is extremely rare. We describe the case of a patient with a ruptured aneurysm on the distal segment of the middle cerebral artery, with a concomitant subdural and intracerebral haemorrhage, and a subsequent secondary brainstem (Duret) haemorrhage. The 59-year-old woman had hypertension and diabetes in her medical history. She experienced anomic aphasia and left-sided headache starting one day before admission. She had no trauma. A few minutes after admission she suddenly became comatose, her breathing became superficial. Non-contrast CT revealed left sided fronto-parietal subdural and subarachnoid and intracerebral haemorrhage, and bleeding was also observed in the right pontine region. The patient had leucocytosis and hyperglycemia but normal hemostasis. After the subdural haemorrhage had been evacuated, the patient was transferred to intensive care unit. Sepsis developed. Echocardiography did not detect endocarditis. Neurological status, vigilance gradually improved. The rehabilitation process was interrupted by epileptic status. Control CT and CT angiography proved an aneurysm in the peripheral part of the left middle cerebral artery, which was later clipped. Histolo­gical examination excluded mycotic etiology of the aneu­rysm and “normal aneurysm wall” was described. The brain stem haemorrhage – Duret bleeding – was presumably caused by a sudden increase in intracranial pressure due to the supratentorial space occupying process and consequential trans-tentorial herniation. This case is a rarity, as the patient not only survived, but lives an active life with some residual symptoms.

Clinical Neuroscience

[Zonisamide: one of the first-line antiepileptic drugs in focal epilepsy ]

JANSZKY József, HORVÁTH Réka, KOMOLY Sámuel

[Chronic administration of antiepileptic drugs without history of unprovoked epileptic seizures are not recommended for epilepsy prophylaxis. Conversely, if the patient suffered the first unprovoked seizure, then the presence of epileptiform discharges on the EEG, focal neurological signs, and the presence of epileptogenic lesion on the MRI are risk factors for a second seizure (such as for the development of epilepsy). Without these risk factors, the chance of a second seizure is about 25-30%, while the presence of these risk factors (for example signs of previous stroke, neurotrauma, or encephalitis on the MRI) can predict >70% seizure recurrence. Thus the International League Against Epilepsy (ILAE) re-defined the term ’epilepsy’ which can be diagnosed even after the first seizure, if the risk of seizure recurrence is high. According to this definition, we can start antiepileptic drug therapy after a single unprovoked seizure. There are four antiepileptic drugs which has the highest evidence (level „A”) as first-line initial monotherapy for treating newly diagnosed epilepsy. These are: carbamazepine, phenytoin, levetiracetam, and zonisamide (ZNS). The present review focuses on the ZNS. Beacuse ZNS can be administrated once a day, it is an optimal drug for maintaining patient’s compliance and for those patients who have a high risk for developing a non-compliance (for example teenagers and young adults). Due to the low interaction potential, ZNS treatment is safe and effective in treating epilepsy of elderly people. ZNS is an ideal drug in epilepsy accompanied by obesity, because ZNS has a weight loss effect, especially in obese patients.]

Clinical Neuroscience

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.