Lege Artis Medicinae

[What turns labour pain into suffering? The individual ways of coping]

RADOS Melinda, MÉSZÁROS Judit

DECEMBER 15, 2017

Lege Artis Medicinae - 2017;27(10-12)

[INTRODUCTION - Pain is not only a sensory experience, but includes emotional, motivational and cognitive dimensions, thus women’s perceptions of labour pain are largely influenced by individual attitudes. The distinction between pain and suffering sheds light on valuable information. Our aim was to study the relationship between women’s labour pain and their sense of suffering, and the effects of epidural analgesia on their judgements of pain, stress and satisfaction. SAMPLE AND METHOD - 342 women participated in our study. Their pain was assessed with the Numerical Rating Scale, sense of suffering with the shortened Perceived Stress Scale, which were followed by questions of epidural analgesia administration, its perceived effects and satisfaction. RESULTS - Women’s feelings of pain and sense of suffering show a strong positive correlation (R=0,283, p<0,001); but with the increase of these dimensions their satisfaction decreased (R=-0,162 and R= -0,444 respectively, p<0,001). The administration of epidural analgesia did not have a significant effect on their judgements of pain, stress and satisfaction. Perceived stress had the strongest determining influence on satisfaction (b=-0,534, p<0,001). CONCLUSIONS - According to our results on pain relief, we suggest the wider use of various non-pharmacological methods. Alleviation of maternal fear and suffering through non-judgemental, patient and supportive attitude of caregivers is of paramount importance.]

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Lege Artis Medicinae

[Feeding and eating in infancy and early childhood part I. - data on breastfeeding in the large-sample “For Healthy Offspring” project]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[INTRODUCTION - Breastfeeding is the ideal and natural source of nutrition for infants, is associated with a reduced risk of many diseases in infants and mothers. It has a positive impact on the mother-infant relationship and also has considerable economic and environmental benefits. Subjects and methods - In the “For Healthy Offspring” Project parents of 1164, 0-3-year-old children completed a ques-tionnaire about breastfeeding and their feeding routine. The sample is not representative of the general population, but the sociodemographic and housing variables indicate an adequate spectrum. RESULTS - Breastfeeding was perceived by 60% of mothers enjoyable, while 20% of them had a negative experience with it. More than 50% of mothers had some breastfeeding difficulties, but it did not have a significant correlation with the negative perception of breastfeeding. The most common problem was the perception of inadequate milk supply. Among the studied variables maternal smoking, lower maternal education and the lack of antenatal breastfeeding education had the strongest correlation with the duration of breastfeeding. CONCLUSIONS - Adequate antenatal education on breastfeeding, proactive support of women and promptly attending their breastfeeding difficulties increases the duration of exclusive and any breastfeed-ing, helps mothers to reach their breastfeed-ing goals and to perceive breastfeeding enjoyable.]

Lege Artis Medicinae

[The Faith of Faithlessness ]

BÁNFALVI Attila

Lege Artis Medicinae

[Factors influencing anisocytosis among inpatients with chronic kidney disease]

MOLNÁR D. László, KISS István, SZAKONY Szilvia, AMBRUS Csaba

[The coefficient of variation of RDW (RDW-CV) is a predictor of mortality in several patient cohorts. RDW and other factors were analyzed in an earlier report as potential predictors of inpatient mortality. In this paper, determinants of RDW were examined in a sample of hospitalized patients with chronic kidney disease not yet on dialysis using both frequentist and bayesian ANCOVA models. For the non-informative Bayesian model no prior knowledge about the model parameters was assumed. For the informative Bayesian model prior knowledge from previous experience was applied. Calculations were performed in R with the faraway, car and MCMCPack programme packages. Male gender identity, higher mch and mcv were strongly associated with higher RDW. Blood glucose concentration, white blood cell count, blood hemoglobin concentration, platelet count, age and glomerular fil-tration rate showed inverse relationship with RDW levels. ]

Lege Artis Medicinae

[Editor’s Commentary to Attila Bánfalvi’s Publication ‘The Faith of Faithlessness’ ]

KAPÓCS Gábor

Lege Artis Medicinae

[Differential diagnosis of anemia and abdominal pain - case report of a lead poisoned family]

NÉMETH Aliz, LISKA Zsófia, TÖRÖK Eszter, NÁDAI Mária, SCHANDL László, KIS János Tibor

[The authors describe a patient’s case, who was hospitalized with stomach pain. During the study of the patient, a microscopic examination of the blood vessel helped the diagnosis. Basophil eruptions of red blood cells raised the suspicion of lead poisoning, which was confirmed by a high lead level in the serum. The source of the lead poisoning was a lead covered jug, in which the family stored a homemade syrups that is popular among Hungarians. At several members of the family, who had been consumed the syrup, we measured high non-symptomatic lead levels. The patient and his family were successfully treated with a chelating therapy. The au-thors summarize the symptoms of lead poisoning through a case report. Call the attention that excessive lead exposure in Hungary is rarely recognized, and the symptoms are often misleading.]

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[The state of health of Roma in Nagykálló ]

ARATÓ Miklósné

[Aim of the study: To assess the unique lifestyle characteristics and state of health of the Roma minority living in a closed community. The author assumed that the Roma have a different attitude towards their own health and to the healthcare supply system. Sample and method: At the Sántha Kálmán Mental Health Centre and Specialist Hospital, in May 2012 a unique blood donation day was organised for the Roma population. As a part of the program, besides the medical tests, a questionnaire-based survey was conducted. (N=100) The author processed the data using Microsoft Excel, and presented the results with descriptive statistical methods. Results: Of the more than 100 who volunteered, 38 were able to give blood. Among the respondents the majority of women were aged 41-50 years (39%), and most of the men were in the 31-40 age bracket. More than half of the respondents (57%) consume alcohol regularly or occasionally, while 47% of them smoke. Some 39% of those surveyed consider their own state of health to be bad. Some 56% of the respondents are satisfied with the provision of healthcare, despite the fact that almost half of them have experienced some kind of discrimination during their care. Conclusions: The bad state of health of the Roma is related to the lower quality of life, the low level of education, alcohol consumption and smoking. The Roma are aware of the screening tests and consider them important; indeed, some of them also regularly give blood, but the communication targeting them is not effective. The Roma population experience discrimination more frequently then the other members of society. It is imperative that training in tolerance towards the Roma be incorporated into healthcare education. It is also necessary to improve the supportive relationship with healthcare. One means of achieving this could be the inclusion of Roma in healthcare efforts.]

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[From life events to symptoms of anxiety and depression: the role of dysfunctional attitudes and coping]

MÉSZÁROS Veronika, AJTAY Gyöngyi, FODOR Kinga, KOMLÓSI Sarolta, BOROSS Viktor, BARNA Csilla, UDVARDY-MÉSZÁROS Ágnes, PERCZEL FORINTOS Dóra

[The aim of the present study was a systematic path-analytical investigation between the effects of life events, dysfunctional attitudes and coping strategies in relation with the exhibited depressive and anxiety symptoms in patients with mental disorders. Methods - Self-report data of 234 patients from our outpatient psychotherapy unit were analyzed. Life events, dysfunctional attitudes, coping strategies as well as symptoms of anxiety and depression were assessed by self-administerd questionnaires. Statistical methods included structural equation modelling, which enables the estimation of the magnitude and strength of individual variables within an overarching casual model, thus yielding a complex view on the possible processes underlying the development of the clinical symptoms of anxiety and depression. Results - Our findings indicate that both the number of negative life events and their subjectively experienced intensity contributed to the increase of dysfunctional attitudes. The presence of dysfunctional attitudes decreased the use of problem-focused coping strategies and increased the use of emotion-focused coping strategies. The use of problem-focused coping decreased symptom occurrence and emotion-focused coping strategies increased the frequency of symptoms of anxiety and depression. Our findings suggest that dysfunctional need for achievement and perfectionism directly increase the probability of depressive symptom manifestation. The attitude of external locus of control showed a significant relationship with anxiety symptoms through emotion-focused coping strategies and directly as well. Conclusion - Restructuring dysfunctional attitudes and developing problem-focused coping strategies are an important part of psychotherapeutic interventions aiming to decrease anxiety and depressive symptoms.]

Lege Artis Medicinae

[Who are the happy female physicians in Hungary?]

GYŐRFFY Zsuzsa

[BACKGROUND - The female Physicians’ well-being and happiness has become the latest researching field of the “Physicians studies”. In Hungary the researches haven't focused on this subject. Our aim was to examine the subjective well-being of the Hungarian female Physicians. METHODS - Representative, cross-sectional, quantitative survey on a representative sample of female Physicians (N=408). Modified version of WHO Well- Being Index was performed to measure of subjective Well-Being. RESULTS - We have found that the key to the Hungarian female Physicians’ wellbeing is the “time”. Significantly higher rate of well-being is associated with reduced work-hours (8 hour or less, p=0.000), and duty hours (p=0.042), having one hour free time daily (p=0.021) and they satisfied with the time of doctor-patient interaction (p=0.021). The higher rate of Well-Being scores haven't associated with age, marital status, number of children and the speciality. CONCLUSION - Similarly to the national trends, the Hungarian female Physicians' well-being is depending on the work and the satisfaction with work. The satisfied healer is the key of the health system therefore the future studies and the prevention and intervention have to focus on the Physicians’ well-being.]