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Journal of Nursing Theory and Practice

MAY 30, 2017

[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

DECEMBER 30, 2016

[The examination of the factors which are the underlying causes of the intrauterine fetal death]

ZUBOR Mónika, SZABÓ László, KARÁCSONY Ilona Hajnalka

[The aim of the study: Nowadays the most common obstetric complication is the stillbirth. The affected families suffer spiritually as well. The aim of our research was to identify those most common maternal factors which lead to the intrauterine death of the fetus. Material and methods: The retrospective research was carried out between January of 2007 and December of 2014 in Markusovszky Educational Hospital in Szombathely. During the non-random, targeted sampling, the research was carried out with the help of an essay which included the data of 50 people. Beside the descriptive statistics the authors also used Chi-squared test with the help of the Microsoft Excel program (p<0,05). Results: If we take into account the frequency of stillbirth, there is significant relationship between singular pregnancies and twin pregnancies (p<0,05). Among women from different ages there is a significant relationship between the frequency of endocrine diseases and stillbirth as well (p<0,05). According to the results the most common cause of the intrauterine death was hypoxia (32,6%). Conclusion:With the identification of high risk pregnancies at an early age and with the prevention the complications we could reduce the number of stillbirths.]

Clinical Neuroscience

MAY 30, 2017

[Non-contrast brain ct based systemic thrombolysis of two wake up ischemic stroke patients in rural settings]

POZSEGOVITS Krisztián, RENCZ László, CSÚSZ Lajos, SZABÓ Géza

[Background and presentation - Conventionally the acute ischemic stroke patients who wake up with symptomes (WUS - wake up stroke) cannot benefit from systemic thrombolysis due to the uncertainty of the exact onset time of the cerebrovascular event. Perfusion brain imaging could be used as patient selection tool but the method is not available in many settings. Simple non-contrast CT scan is easily accessible and reliable as it shows the different stages of the evolving ischemia with high accuracy. Early brain CT scan results of WUS patients have the same characteristics as the ones who are surely within therapeutic window. The intravenous thrombolysis with recombinant tissue plasminogen activator (rTPA) of WUS patients seems to be similarly successful as the ones with known onset time, the treatment does not come with excess complications, higher rate of symptomatic intracranial hemorrhage was not found in previous reports. Purpose - In this report we present two systemic thrombolysis cases of acute ischemic stroke patients who woke up with stroke symptoms. Methods - In 2014 and 2015 we performed systemic thrombolysis for one wake up stroke patients, respectively. Both patients had large vessel occlusion. Indication was based on favourable non-contrast brain CT scan results. Results - Treatment of these two patients with rTPA proved to be safe, no hemorrhage occurred after treatment. Conclusion - We presented two acute ischemic stroke patients with symptomes at early wake up who were treated intravenously with recombinant tissue plasminogen activator based on non-contrast CT alone without complications and some moderate improvement at 90 days in the settings of a rural town hospital in a middle income country.]

Clinical Oncology

MAY 20, 2016

[The role of hospice in the management of cancer patients]

TORGYIK Pál

[There is the relationship between the oncological treatment and hospice care proved by the data on morbidity and mortality. Cancer treatment is just partially effective since besides the growing incidence of new patients (90 091 in 2013) in Hungary, the mortality rate is still high (33 278 people in 2013). Revealing the diagnosis of tumorous disease causes an incredible shock for the patients, therefore oncopsychologists have to join to the oncological treatment at a very early stage. They give psychological support to both the patients and their families. By relieving stress and helping to combat the disease, the patients could accept and gradually face to the new situation. The patient keeps hoping as long as the treatment is effective and his/her health does not begin to decline. Today, in most cases the effi cacy of the treatment is just temporary and the patient will reach the stage where only the palliative and hospice care can help to maintain an acceptable but provisional quality of life. A new movement started for the terminally ill patients to keep their dignity. Hospice is an integral part of health care with 205 beds, and 75 home hospice care units (in Hungary). To get into the hospice care we describe the patients’ path including the terminal state, agony and death. We also explain the palliative medical and psychological care as well as the other forms of care at home and in the domestic or hospital care carried out within a team-work. The activity of these two types of care must be integrated and mutually supported. Finally we are going to talk about the problems that prevent the acceptable operation in this system.]

Hypertension and nephrology

APRIL 08, 2017

[First experiences with percutaneous renal denervation in management of resistant hypertension]

SCHULCZ Domonkos, NAGY Ferenc Tamás, THURY Attila, BAJCSI Dóra, FEJES Imola, LETOHA Annamária, CONSTANTINOU Kypros, UNGI Imre, ÁBRAHÁM György, LÉGRÁDY Péter

[Percutaneous transluminal radiofrequency renal denervation is a promising new therapeutic method for the treatment of primary resistant hypertension. The intervention decreases the systemic sympathetic over activation and thus arterial blood pressure. In the 1st Department of Medicine of the University of Szeged, 9 resistant hypertensive patients (2 male, 7 female; mean age: 55.0±4.0 years) had all the conditions were required for renal denervation at the time of interventions were performed. We measured the blood pressure together with the heart rate of the patients on the day preceding the intervention, right after the intervention, at discharge from hospital, then at months 6, 9 and 15. The mean blood pressure was 178/107±7/5 mmHg before the intervention. After denervation mean blood pressure decreased right after the intervention, at discharge from hospital, as well as at months 6, 9 and 15, respectively -15/-17 mmHg; -36/-16 mmHg; -19/-9 mmHg; -27/-21 mmHg and -15/- 16 mmHg. Besides decreasing of blood pressure, the antihypertensive drug therapy also decreased, however, it was not the primary aim of the intervention. No denervation- related intra- or perivascular complications were detected. The findings of our study proved the efficacy and safety of renal denervation in the treatment of primary resistant hypertension, of course with an appropriate patient selection. Our study was not relevant to determine whether this method is accompanied with a significant decrease of cardiovascular morbidity and mortality. Answers may come only based on randomized sham controlled studies with great case numbers.]

Journal of Nursing Theory and Practice

AUGUST 30, 2016

[The evolution of skull reconstruction surgical techniques and it’s impact on patient’s care and the effect on patients from the nursing perspective]

VARGEK Anikó

[Background: Facts support that decompressive craniectomy allaviates life-threatening acute high intracranial pressure and it is performed worldwide. Less attention has been paid to the late negative consequences of the widely open cranium. Hence there is a need for timely closure of the defect and precise cranioplasty. Objective: The goal of the present study was to compare the clinical results and patient care data gained by a novel cranioplasty method, the so called computer-aided design and computer-aided manufacturing (CAD/CAM) technique, versus conventional operative procedures. Patients and Methods: Seventy patients were operated on by conventional reconstructive methods (n=70) in our department between 2004 and 2006. These patients served as the control group. Sixty patients had got cranioplasty with individually prepared cranial implants using the CAD/CAM technique (n=60) in 2011 to 2013. The total number of the investigated patient population was n=130. Age distribution of the group varied from 17 to 80. Retrospective neurological and patient care data were collected and compared at the two surgical technique. Results: More precise coverage of the cranial defect and acceptable cosmetic result were achieved in every case operated on with the CAD/CAM surgical technique. The ratio of patients with persistent vegetative-state decreased, and the neurological outcome improved following surgery using the CAD/CAM method. The patient care was easier and rehabilitation procedure was more favourable at the CAD/CAM population. Iatrogenic infection and wound- healing complications were less frequent at the department between 2011 and 2013. The quality of patient care have been improving considerably by regular education and continuous development of nursing standard. Patients need for hospital stay decreased, therefore health economic aspects and cost-benefit ratio improved at the Department of Neurosurgery in the Péterfy Hospital. Conclusion: This study demonstrates an improvement in neurological outcome and easier patient care following CAD/CAM reconstructive surgery of cranial defects in status of normalized intracranial pressure. Results support the extended use of the method in the XXI. Century. ]

Journal of Nursing Theory and Practice

AUGUST 30, 2016

[Nursing care workers to assess job skills calicivirus caused by the accumulation of tasks required hospital infections]

KASZONYINÉ ENGI Erika

[Introduction: Author presents the results of surveys of knowledge-prepared nurses’ll need to Calicivirus infections at hospitals accumulation, which was conducted in 7 (a mix of invasive and non-invasive track) ward nurses skilled and unskilled workers. Aim of research: to find out which questions need to put the emphasis on nurses hospital hygiene education to subjects of age, prevention and early detection of infections from spreading which is an important part of the hospital wards enteric outbreaks may occur. Research and sampling methods: The research used an anonymous questionnaire method. The survey was conducted between January 04 2016 and whether 29 or not. The target population for the selection of the author of the favored classes of patient care, on which the last 6 years due to Calicivirus outbreak occurred, which was reported in the NNSR database. Results: 158 nurses participated. The obtained results show that nurses have the knowledge and experience to an infection caused by a Calicivirus, but there are also gaps in knowledge, particularly in the event of hospital infections overlapping actions to be taken to curb the epidemic. Conclusion: Keep the enteric infections also with regard to the knowledge acquired basic education level, especially since the hospital departments favor the spread of these infections are due to sanitary facilities shared by the patient’s condition resulting from lower personal hygiene and multi-bed wards. ]

Clinical Neuroscience

JANUARY 20, 2017

Eating behaviors among the participants of an inpatient weight loss treatment

CZEGLÉDI Edit

Background and purpose - Eating behaviors play a crucial role in the development and maintenance of excess weight. The aim of the study was to explore the predictors and changes in eating behaviors among overweight and obese patients. Methods - The sample of the 6-month prospective survey consisted of patients who participated in the inpatient weight loss treatment program in the Lipidological Department of the Szent Imre Hospital (baseline: N=339, 19% men; follow-up: N=175, 16% men). The mean age was 50.2 years (SD=13.47), the mean BMI was 38.6 (SD=7.58) at baseline. Measures: self-reported anthropometric data, Three-Factor Eating Questionnaire Revised 21-Items, CES-D Depression Scale. Results - According to the results of Multiple Indicators and Multiple Causes analysis, older age predicted greater cognitive restraint (b=0.12, p=0.047). Women were more prone to emotional eating than men (b=0.21, p<0.001). Higher levels of education predicted greater uncontrolled eating (b=0.16, p=0.007) and emotional eating (b=0.12, p=0.039). Depression showed a positive relationship with emotional eating (b=0.19, p=0.001), and mediated the relationship between gender and emotional eating (b=0.04, p=0.009), and BMI and emotional eating (b=0.03, p=0.015). Those whose weight loss was at least 5% showed a greater improvement in the eating behaviors than those whose weight loss was below 5% (cognitive restraint: t(168)=-4.765, p<0.001, uncontrolled eating: t(168)=-2.442, p=0.016, and emotional eating: Z=-2.011, p=0.044). Conclusions - Results reveal certain determinants of eating behaviors that enhance or obstruct successful long term weight loss and highlight the role of eating behavior changes in weight loss. These mark intervention points for the optimization of results achievable by weight loss treatments.

Clinical Neuroscience

NOVEMBER 30, 2016

[Recommendation for treatment options in advanced Parkinson's disease]

ASCHERMANN Zsuzsanna, DIBÓ György, KLIVÉNYI Péter, KOVÁCS Norbert, KOVÁCS Tibor, TAKÁTS Annamária, GERTRÚD Tamás, VARANNAI Lajos

[The treatment of advanced Parkinson’s disease is challenging for both physicians and caregivers. The device-aided therapies need expertise and dedicated hospital centers. In this summary we have concluded the available data and recommendation for the treatment options in advanced Parkinson’s disease and adopt them to the daily care in Hungary. ]