Journal of Nursing Theory and Practice

[Puerperal Fever from Hippocrates to Semmelweis ]

SALAVERRY GARCÍA Oswaldo1,2

AUGUST 30, 2018

Journal of Nursing Theory and Practice - 2018;31(04)

AFFILIATIONS

  1. Centro Nacional de Salud Intercultural, Instituto Nacional de Salud. Lima, Perú.
  2. Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, Perú

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Journal of Nursing Theory and Practice

[Career Model of Primary Care Workers]

HIRDI Henriett Éva, BALOGH Zoltán

[The aim of the study: To assess the working conditions and level of job satisfaction of health professionals in primary care, and to explore key elements for a succesful career model. Methods: The cross-sectional survey was conducted between 12 March 2018 and 06 April 2018 among health professionals working in primary care, selected using a random, sampling method. The data gathering took place using a web-based, anonymous, self-completion questionnaire. For data analysis they used SPSS version 25.0 with Chi square test (p<0,05). Results: The sample size of the research comprised of 3740 persons, the average age was 44.87 years. The heath professionals are generally satisfied with their work schedule (74.8%), but they expressed the least satisfaction (81.5%) with their financial compensation. According to these survey results, pay is significant. 96.2% of respondents would like to be compensated according to new government-regulated pay scales. Conclusions: It can be stated that increasing the job satisfaction of health professionals and to elaborate the career model of them would be of crucial importance. Key elements of a successful career model offers benefits that are essential for health professionals retention: direction and motivation. ]

Journal of Nursing Theory and Practice

[Study based on special care needs of elderly people in Nursing Home run by Church ]

BADÓ Erika, BALOGH Zoltán

[Aims: The changes from the introduction of the care needs of elderly people in Nursing Home run by Church, set year 2011 against year 2016. Methods: The sample was taken from the residents of Filadelfia Integrated Social Institution in 2011 (N=118), in 2016 (N=122) and from the nurses who worked there in 2011 and also in 2016 (N==18). The survey was conducted through a self-constructed online questionnaire. The Nursing Documentation was reviewed during the document analysis. Data were analyzed with SPSS using Chi square and Fisher’s tests. Results: It can be concluded that the numbers of care needed people increased, like living with dementia (p=0,001), using catheter (p=0,001), handicapped (p=0,001), using long term painkillers (p=0,005). Fluctuation and the decrease of the numbers of professional stuff are typical. Conclusions: For the care needs of elderly people, higher level care is needed with professional stuff qualifications. ]

Journal of Nursing Theory and Practice

[Faces from the Hungarian Nursing Hall of Fame: the exemplary careers of two Hungarian recipients of the Florence Nightingale Medal]

SÖVÉNYI Ferencné, PERKÓ Magdolna, FEDINECZNÉ VITTAY Katalin, BOROS Károlyné

[In their pervious article, authors described how the Florence Nightingale Medal came to existence and provided a list of Hungarian nurses whose achievements were honoured by the Medal between 1920 and 2003. In this contribution, they review the lives and careers of Baroness Gizella APOR and Ms. Ilona DURGÓ, two Hungarian nurses who were awarded the Medal in 1920 thus being among its first recipients globally.]

Journal of Nursing Theory and Practice

[Work Values Preference among hospital midwives]

GEBRINÉ ÉLES Krisztina, SÁRVÁRY Andrea, SÁRVÁRY Attila, TAKÁCS Péter, LAMPEK Kinga

[The Aim of the Study: The aim of the research was to explore the structure of work values among midwives. Material and Method: Cross sectional study was used with Super‘s Work Values Inventory from 13 hospitals across Hungary. Our questionnaire was divided into 370 midwives, 224 were evaluated. We calculated mean and standard deviation in descriptive statistical analysis. We did factor analysis; variance analysis and post-hoc LSD (Least Significant Difference) test. Results: The most preferred work values were altruism, finances and hierarchy. The level of education influenced the hierarchy of work values. The factor analysis separated two secondary factors: working condition and the self-realisation. There was a significant difference between midwives with OKJ education level and midwives with BSc degree (p=0,014), and other qualifications (p=0,033). Conclusions: Our results suggest that a higher level of education gives the foundation of professional competencies which enable the employee to take conscious consideration of other employee’s views in health care. ]

Journal of Nursing Theory and Practice

[Academic and Practical Skills of Supraglottic Airway Management among Nurses ]

SÓS András

[Aim of the study: The research goal is to measure supraglottic airway management academic and practical skills of working nurses considering education level and workplace. Methods: The research was conducted between 1 December 2015 and 15 March 2016 among nurses in one Hungarian hospital and nurses in ambulance service. The online questionnaire was volunteer and anonym. The results (N=90) were processed in Microsoft Excel 2013. Results: The none device method results shows that the OKJ nurses reached 76%, the practical nurses 74,4% and the nurses with diploma reached 78,3%, they got nearly the same results. Looking the airway management with devices OKJ nurses reached 60%, the practical nurses 74,3%, and nurses with diploma got 79,1%. In both cases the ambulance nurses got the highest result which is reached above 90%. Conclusion: The results shows that the workplace is strongly and the education level is barely affects the supraglottic airway management skill.]

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IVÁDY Balázs, LIPTAI Zoltán, ÚJHELYI Enikő, BALÁZS György

[Background and objective - No recent publications are available about pneumococcal meningitis in Hungarian children. The aim of this study was to collect data of epidemiological, clinical and prognostic features of pneumococcal meningitis in children treated at Szent László Hospital, Budapest, Hungary. Methods - We conducted a retrospective review of medical charts and follow-up records of patients aged 1 to 18 years admitted to our Pediatric and Pediatric Intensive Care Units due to pneumococcal meningitis between 1st Jan 1998 and 30th Jun 2007. Results - 31 children with 34 cases of pneumococcal meningitis were admitted to our hospital in the study period. Two children developed recurrent illness. The mean age was 6 years, 26% were under 1 year of age. The mean duration of hospital stay was 21 days, 97% required intensive care. Frequent clinical symptoms were fever (100%), nuchal rigidity and vomiting (78%), altered mental status (71%), Kernig's and Brudzinski's signs (58%) and seizures (41%). Otitis media, sinusitis, mastoiditis were present in 44%, 58%, 41%, respectively. Subdural effusion, parenchymal cerebral lesion and sinus thrombosis were documented in 5, 3 and 2 cases, respectively. One third of the patients recieved ceftriaxon, two thirds were administered ceftriaxon and vancomycin. Adjunctive therapy with dexamethason was given to 91% of the children. 70% of patients required mechanical ventillation. 9 patients (25%) required endoscopic sinus surgery. In 13 cases (38%) mastoidectomy, in 5 children (15%) neurosurgery was performed. The case fatality rate was 23.5%. 8 (23.5%) patients had mild or moderate, 1 child (3%) developed severe neurological sequelae. Conclusion - Pneumococcal meningitis in children remains a source of substantial morbidity and mortality in childhood. The long hospital stay, the frequent need for intensive care and severe neurologic sequelae emphasize the importance of early diagnosis, early treatment and prevention with pneumococcal conjugate vaccines.]

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[Decriminalizing Home Birth – An Interview with Imre Szebik MD, Bioethicist Physician of the Semmelweis University Institute of Behavioural Sciences]

NAGY Zsuzsanna

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[Fourth-year medical students’ views about informal payment in Hungary]

HORVÁTH Ferenc, TEREBESSY András, BALÁZS Péter

[Introduction - Scientific evaluation from ethical, legal and economical aspects of gratuity (informal) payment in the Hungarian health care system was initiated first in the 1980s and was completed by the end of the 1990s. Since then, there are no unanswered scientific questions regarding the evaluation of this phenomenon; however, theoretical studies did not have any practical consequences. Healthcare policy has been experimenting with indirect initiatives, relying on the changing behaviour of all involved partners. Parallelly, in the past two decades opinion polls were published on the sum and allocation of informal payments as well as empirical surveys on the attitudes of stakeholders. Among these surveys, we consider it particularly important to study the views of medical students who are not yet directly interested in gratuity business but who have already gained some clinical experiences. Material and methods - Our study was conducted among fourth-year medical students at Semmelweis University in the 2009/2010 and 2010/11 academic years. 701 students completed the self-administered questionnaire; the answer rate was 84.5%. Conclusions - We established that students closely follow the debate about gratuity, they have well-defined expectations regarding the policy on physicians’ income policy, and their attitudes do not indicate any encouraging views that would favour the future success of the indirect policy on informal payment.]

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[Type 2 diabetes in children and adolescents: early complications]

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[INTRODUCTION - The prevalence of type 2 diabetes mellitus in children and adolescents is increasing worldwide. PATIENTS AND METHODS - Authors have investigated the prevalence of type 2 diabetes mellitus and of impaired glucose tolerance among the patients of the 1st Department of Pediatrics at the Semmelweis University between January 1989 and September 1998. RESULTS - During this period, 161 children with impaired glucose tolerance and 34 patients with type 2 diabetes mellitus were diagnosed. There was a female predominance. 53% of the patients were already in puberty. The majority of the patients were obese. Serum triglyceride and cholesterine levels exceeded normal values as compared to age matched healthy children. Ambulatory blood pressure monitoring revealed relative nocturnal hypertension. 35% of the patients also had microalbuminuria. CONCLUSION - In type 2 diabetes mellitus the early signs of late complications can be detected in the young. It reveals the importance of establishing the diagnosis of this disease as soon as possible.]

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[WEGENER’S GRANULOMATOSIS PRESENTING AS MASTOIDITIS: A DIAGNOSTIC CHALLENGE]

NAGY Pál, SZABÓ László, DOMJÁN Gyula, GADÓ Klára, BALOGH Károly

[INTRODUCTION - Wegener's granulomatosis has an uncertain pathomechanism, but is probably autoimmune in origin. In typical cases the mucosa of the nose, paranasal sinuses and of the lower respiratory tract, as well as the lungs and the kidneys are affected. Patients present with sinusitis, recurrent pneumonia or renal disease associated with microhaematuria, pyuria or azotaemia. Fever, polyarthralgia or polyarthritis may also occur. The underlying pathologic changes are necrotizing vasculitis, granulomas and parenchymal necrosis. The diagnosis is based on a combination of the clinical picture, microscopic findings and immunofluorescent demonstration of cANCA. CASE REPORT - A 27-year-old woman presented with symptoms of unilateral mastoiditis. In the following 7 months she underwent 7 operations in 4 hospitals for a locally progressive, destructive process of uncertain etiology showing a septic course. The clinical picture was not specific, the cANCA test was not definitive, and the histologic findings were initially interpreted as nonspecific inflammation. Repeated biopsies, multiple reviews of the microscopic specimens, consultations, differential diagnostic considerations, and, finally, the success of the treatment with corticosteroids and cyclophosphamide led to the diagnosis of Wegener’s granulomatosis. Currently the patient has been in remission for 32 months. CONCLUSION - The definitive diagnosis of Wegener’s granulomatosis, particularly of its localized or limited form, may be problematic despite well-defined diagnostic criteria. Setting up the correct diagnosis may take months or years. In case of unusual respiratory or otological symptoms, and in view of ineffective medical or surgical treatment, Wegener’s granulomatosis has to be considered. An atypical clinical picture, inconclusive histologic, radiologic and laboratory findings warrant the need for close collaboration of various specialists. This is particularly important since state-of-the-art therapy of Wegener’s granulomatosis promises a favourable prognosis.]