[Survey of Medication Habits in Hypertensive Adults]
VARGA Bernadett1, FUSZ Katalin2, CSIMA Melinda3, LUKÁCS-HORVÁTH Marianna4, DEÁK András5, STROMAJER-RÁCZ Tímea6
APRIL 30, 2020
Journal of Nursing Theory and Practice - 2020;33(2)
VARGA Bernadett1, FUSZ Katalin2, CSIMA Melinda3, LUKÁCS-HORVÁTH Marianna4, DEÁK András5, STROMAJER-RÁCZ Tímea6
APRIL 30, 2020
Journal of Nursing Theory and Practice - 2020;33(2)
[Hypertension is the best known risk factor in development of cardiovascular diseases and stroke. Survey has assessed –in hypertensive patients over 40, - the illness representation, lifestyle and medicine taking habits. Quantitative, cross-section descriptive research was conducted in 2017 with online questionnaire among hypertensive people over 40 (n=267) using shortened version of Brief Illness Perception Questionnaire, Morisky Medication Adherence Scale (8-item) and our questionnaire. Therapy adherence is typical for older individuals in surveyed population. (r= 0,26; p<0,001). Who were advised by general practitioners (GP) to implement lifestyle changes show more inclination following therapy. (p=0,032). Those with higher blood pressure (r-0,18; p=0,003) has harder time living with hypertension. (r=0,15; p=0,014). Quality of living with hypertonia and therapy adherence can be influenced by health behaviour and the information provided by general practitioners (GP). Beside the, general practitioners (GP) advanced practice nurse can have significant role in increasing the level of health behaviour and therapy adherence. ]
Journal of Nursing Theory and Practice
Journal of Nursing Theory and Practice
[The International Nurses Day is organized every year on May 12. This year is special, because Florence Nightingale, who is one of the nurses’ ideal, will have the 200th anniversary of her birth. The nurse’s life, who is also known as the „lady with the lamp”, wasn’t easy, because she needed to face many things/issues. However, she achieved the respect of the nurse profession and the appreciation of the nurses. She has also fought for women rights and studied a lot – thanks for those, she worked out statistic methods that nowadays we still use. As a result/because of her memorandums, she allocated many statistical coherences that are still valid. She confirmed with numerical dates, how big the connection between death and hygiene circumstances is. To her advice, more nursing educations were started, as well as the hospital systems were reformed by her. One of her greatest work is the Notes on nursing, which is counted until today as the number one handbook of nursing.]
Journal of Nursing Theory and Practice
[Introduction: Cancer diseases pose a serious public health issue nowadays, as they are among the leading causes of death. As today it is possible to live with this disease for a long time, the quality of life, which is greatly affected by pain, becomes a very important factor. Objective: The purpose of the research is to investigate and explore potential existing problems in the field of cancer pain relief in Hungary and to propose solutions to these problems. In our questionnaire survey, we asked patients suffering from tumors who were in pain and living their lives at home. The research was an anonymous cross-sectional study using descriptive and comparative statistical methods. The average age of respondents was 55 and most of them were women. Answers showed that primary tumors appear mostly in breasts (n=25) or the lungs (n=13). Metastasis developed by almost 30% of the patients. 42% of the respondents experienced severe pain (VAS ≥7 point), which they estimated to last for 1-2 (n=40) or rather 4-5 hours daily (n=30). Almost two third of the respondents were using products containing NSAID (n=64). The number of mild (n=18) versus strong painkiller (n=15) users were almost equal. There was a significant difference between groups of patients experiencing “mild-medium” (p=0,01) versus “mild-strong” pains (p=0,004) due to the usage of medication containing stronger opioids. From this revealed that individuals with greater pain used potent analgetics. More than half of the patients use some sort of sleep or relax aid as a supplement to their medication. Patients with metastasis (n=28) use strong (n=7) as well as mild analgesics (n=10) in greater numbers than those without metastasis. The results reveal that in Hungary, relatively few patients with cancer diseases use strong opioid-containing drugs despite of the fact that their pains are severe. Therefore, a nearly precise estimate of pain levels would be important. Fear of side effects is often unjustified and cannot limit the choice of appropriate therapy. ]
Journal of Nursing Theory and Practice
[In the morbidity statistics, breast cancer is ranked first in both developed and developing countries. To map the quality of life after surgery of women with malignant breast cancer, which mainly involved the comparison of different age groups and changes in social relations. The survey was conducted in November 2017 at the National Institute of Oncology using a questionnaire method, in which 70 people participated. Based on age-disaggregated data, the over-60s reported more psychiatric symptoms than the younger group. During the course of their illness, many of the socially altered women in their lives were living alone and reporting a lower quality of life. In the absence of family support, it would be extremely beneficial to increase the opportunities available for women to reintegrate into society as soon as possible. ]
Journal of Nursing Theory and Practice
[Internationally the role of Advanced Practice Nurses (APN) has grown a lot in the treatment for high blood pressure. The tasks of Advanced Practice Nurses with an advanced degree include the observation, following, diagnostics, medicinal treatment, health education, education of patients, coordination of care, checking of performance and improvement of quality. In Hungary the family doctors do the care of people with hypertonia in the primary care. Because of the number of patients who must be treated every day comes less time per capita in the care. For a high number of acute patients must be cared and for this reason less time remains for the care of chronic patients. In Hungary the education for Advanced Practice Nurse (APN) with an advanced degree has started in autumn 2017. The first of these nurses will get out of the education in February 2019. Due to their education they will be able to care acute illnesses in practices of family doctors and in communities of practice. Besides they will be able to explore, care and follow chronic patients. ]
Hypertension and nephrology
[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]
Lege Artis Medicinae
[Diuretics have remained the cornerstone of the antihypertensive treatment since their widespreading in the 1960s. According to the 2018 ESC/ESH Guidelines for the management of arterial hypertension, in the absence of evidence from direct comparator trials and recognizing that many of the approved single-pill combinations are based on hydrochlorothiazide, this drug and thiazide-like indapamide can be considered suitable antihypertensive agents. In the 2018 Hungarian guidelines indapamide is named as the most efficacious diuretic in the treatment of patients with hypertension. The aim of the publication is redefining thiazide- and thiazide-like diuretic use in the treatment of hypertensive patients, with particular attention to presently available hydrochlorothiazide and indapamide, and their combination drugs in Hungary.]
Lege Artis Medicinae
[Chronic obstructive pulmonary disease is a very common comorbidity of hypertension and it is often unrecognised by physicians. The factors involved in the pathomechanism of both diseases should be realised when choosing treatment. Among factors, hypoxia, increased tone of sympathetic nervous system and activation of renin-angiotensin-aldosterone system should primarily be considered. Vascular wall damage and endothelial dysfunction has an important role in both conditions. The goals of treatment are elimination of risk factors, optimizing the blood pressure, the consequential prevention of cardio-cerebrovascular, renal and pulmonary damage; finally prolonging the patients’ life and improving their quality of life as well. Both hypertension and COPD significantly worsen the condition of COVID-19 patients since they increase the severity of the disease and the rate of in-patients’ and their mortality. In the treatment of hypertension among COPD and COVID-19 patients there must be emphasized the medication inhibiting of renin-angiotensin-aldosterone system, such as angiotensin-converting enzyme inhibitors or angiotensin-II AT1 receptor antagonists. Special attention concerned the beneficial effect of mineralocorticoid receptor antagonist spironolactone. Other antihypertensive drugs (calcium channel blockers, thiazide-like diuretics, high selectivity β1 receptor antagonists) may supplement the treatment if necessary. Long-acting β2 receptor agonists, muscarinic receptor antagonists and inhalation corticosteroids may be administered in double or triple combination also in hypertension and COPD as well. It is important to note, that statin therapy and also vitamin D3 improve the condition of COVID-19 patients.]
Hypertension and nephrology
[Purpose: Monitoring the effectiveness and safety of the fix combination formulation Egiramlon® therapy containing ramipril and amlodipin in patients, suffering from mild or moderate hypertension despite antihypertensive treatment. Patients and methods: Open, prospective, phase IV clinical observational study, which involved 9169 patients (age >18) with mild or moderate hypertension [TUKEB No: 16927- 1/2012/EKU (294/PI/12.)]. Ramipril/Amlodipin 5/5, 5/10, 10/5, 10/10 mg combinations were administered/ titrated in three visits, during the four months period according to the physician’s decision Blood pressure was measured by validated blood pressure sphygmomanometry and ABPM (Meditech, Hungary). The dosis of the fix combination formulation was determined individually during the visits by the 923 doctors involved in the study. The target blood pressure value was 140/90 mmHg, but in case of high risk patients population (diagnosed cardiovascular disease, diabetes), 130/90 mmHg target value was determined. Results: In 70.1% of the patients had no protocoll deviation. Patients data and examination results were processed according to this 6423 patient population. The average age of the patients were 60.2 year, in 50-50% sex distribution. The average duration of the treated hypertension was 9.8 years and the average blood pressure value was 157/91 mmHg. Till the end of the study, systolic blood pressure has decreased with 26.4 mmHg and diastolic pressure with 11.8 mmHg. An average 5.5 bpm heart rate frequency decreasing was observed at the end of the study. As a result of the treatment 52.4% of the patient population has reached the target blood pressure value.]
Lege Artis Medicinae
[Hypertension prevalence and cardiovascular risk gradually with age. However this aging process seems to take a more rapid course in some individuals, as reflected in the Early Vascular Aging (EVA) syndrome. Age and high blood pressure are the two main determinants of arterial stiffness which is the core of EVA: the impaired elasticity of the media layer of large elastic arteries (mainly the aorta), a process that can be measured by pulse wave velocity. In elderly hypertensives, large arteries stiffen and systolic and pulse pressures increase, due to wave reflections. Arterial stiffness has predictive value for future CV e.g. events, coronary artery disease, stroke, and vascular dementia and even all-cause mortality. The concepts of EVA (Early Vascular Aging) and SUPERNOVA (Supernormal Vascular Aging, the opposite phenotype of EVA) help to understand why early target-organ damages develop in some individuals and why others remain much more “younger” than their chronologic age. New drugs are being developed to treat EVA when lifestyle intervention and conventional risk factor controlling drugs are not enough.]
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