Journal of Nursing Theory and Practice

[Practice of the Hepatitis B vaccination with non-responder patients in our Centre]

GÓZ Lászlóné1, KÖRTVÉLYESINÉ Bari Krisztina2, BECS Gergely2, SZABÓ P. Réka2, BALLA József2, KÁRPÁTI István2, MÁTYUS János2, UJHELYI László2, BEN Thomas2

DECEMBER 25, 2015

Journal of Nursing Theory and Practice - 2015;28(06)

[Introduction: End-stage renal disease patients under dialysis have impaired immune system and are more susceptible to infection, even those infections that can be prevented by vaccination (e.g. hepatitis B). If the antibody titer (anti-HBs) remains <10 IU/ml after two consecutive vaccinations, patients are classified as non-responders. Reasons for unsuccessful vaccinations include technical, immunological (e.g. multigene haplotypes) reasons. They are often also associated with chronic diseases. Aim of the research: To re-vaccinate patients after unsuccessful intramuscular vaccination to achieve immunity. Research and sampling methods: Intracutaneous vaccination can be a viable alternative for successful immunity. 6 months after re-immunisation, anti-HBs titer>10 IU/mL indicate a successful immune response. Results: 22 haemodialysed patients received intracutaneous hepatitis B vaccination with the total dosage of 6 μg. An anti-HBs titer elevation (21-100 IU/ml) was observed in 15 cases (68.18%). In those cases, where we failed to achieve successful immunity, we identified malignancies, immunosuppression, amyloidosis, psoriasis diabetes mellitus, or coeliac disease as a possible reason. Conclusions: The rate of successful immunisations against HBV infections can be improved by means of intracutaneous vaccination. ]


  1. FMC-DEKK Debrecen Extracorporalis Szervpótló Centrum
  2. FMC Debrecen



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[Prevention of type-2. diabetes in the light of gestational diabetes mellitus (GDM)]


[Aim of the research: The main objective of the present study is to call women’s attention to the importance of preventive medical screenings and to increase the participation rate by emphasizing preconceptional care. Other aims include: Maintaining good health of pregnant and non-pregnant women; Ensuring a smooth antenatal period and the delivery of healthy infants; Primary prevention before the occurrence of GDM; Emphasizing the importance of secondary prevention for clients with already developed GDM; Highlighting the necessity of lifestyle change; Motivating patients to participate at follow-up checkups as tertiary prevention. Research and sampling methods: Questionnaire involving pregnant women of age 20-45 years (n=104) The questionnaires are uniform, each containing the same questions. Data collection was supported by antenatal care staff at Szent Margit Hospital where great emphasis is placed upon the early detection of GDM. Results: Age, body weight, education level and social background correlate with the occurrence of GDM as well as with the outcome of GDM-affected pregnancies. Due to the regular prenatal care including regular GDM care, the outcome of GDM-affected pregnancies is complaint-free, spontaneous delivery and postpartum period. Conclusions: It is essential that pregnant women receive adequate information about the importance of GDM prevention and its early diagnosis. The significance of educating pregnant women to adopt a healthy lifestyle must be given top priority. ]

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[The place and role of physiotherapy in total joint replacement surgery patients improve their quality of life]


[Aim of the research: The objective of investigation was to survey the efficiency of the rehabilitation of the patients operated with complete knee endoprosthesis (TKR) nursed in the Rehabilitation Centre and whether the bath course with the applied complex physiotherapy and the spring water of induce any change in the life quality of the patients and whether the efficiency of the physiotherapy can be measured. Research and sampling methods: prospective, quantitative, describing research, with non-random, convenience sampling method. 50 TEP-operated patients have filled in the self-filling questionnaires and participated in the examination of the walking time. The examination was performed between 03/01/2013-12/01/2013 in the Musculoskeletal Rehabilitation Centre of the Gunaras. The patients have filled in the WOMAC, SF-36, BDI, questionnaire compiled by us. Additionally we have measured the walking speed on flat ground and during climbing stairs. The patients have taken a bath in 36C spa for 3 weeks, 7-times a week for 20 minutes and 5-times a week they have received electrotherapy, physiotherapy and hydrotherapy. Results: The majority of the participants of the investigation belonged to the age group of 71-75. The patients avail themselves of the treatments regularly, once or twice a year, which are evaluated by women as more efficient than by men (p <0,001). After the treatments the extent of depression has significantly reduced (p <0,001). There was a significant improvement in the walking speed (p < 0,001), in the SF-36 (TF, PCS) dimensions and we have detected a significant relation between physical and mental health (p <0,001). The movement range of the patients has significantly improved (WOMAC, p=0,001). Between the result of the SF-36 and WOMAC questionnaires we have found also a significant relation (p=0,001), with the improvement of the physical function the life quality has also improved. Conclusions: The results have shown, that the application of the spring water and physiotherapy have proven as efficient treatment in the life quality improvement of the patients operated with complete knee prosthesis. ]

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[Aim of the research: To evaluate the efficacy of the treatment and incidence of complications in diabetes type 1 and 2 patients treated with peritoneal dialysis. Research and sampling methods: During a retrospective study with 85 diabetic PD patients (19 type 1 patients and 66 type 2 patients) was compared data of 22 years with regard to the following parameters: Glucose metabolism, body weight, changes in residual urine clearance values, distribution of quantity and glucose content of the solutions used, incidence of infections, and average duration in PD programme before transferring to haemodialysis. Results: All patients, irrespective of their type of diabetes: spend the same time in PD on average, gained body weight during PD. Diabetes type 1 patients: had a lower residual urine clearance, had HbA1c values decreasing during PD, reported peritonitis less frequently, had a higher incidence of catheter-related infections. Diabetes type 2 patients: had a better glucose metabolism, had a higher body weight from the beginning of therapy, required PD solution with higher glucose concentration. Conclusions: Diabetes patients, irrespective of the type of diabetes, can successfully be treated with PD, but require more attention because of their underlying disease and associated complications. ]

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