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Lege Artis Medicinae

SEPTEMBER 20, 2011

[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.]

Lege Artis Medicinae

FEBRUARY 22, 2007

[ASSESSMENT OF THE QUALITY OF LIFE AND THE ATTITUDES TO AGEING OF ELDERLY PEOPLE]

TRÓZNAI Tibor, KULLMANN Lajos

[BACKGROUND - The WHOQOL-OLD questionnaire was developed in a multicultural way. The authors were involved in this work as members of the international task force. In order to improve services for the elderly by learning their attitudes to ageing, an Attitudes to Ageing Questionnaire (AAQ) was also developed by the working group. In the present study the authors assessed a sample of Hungarian elderly people by these two methods. Answers by elderly persons related to their quality of life, social and health conditions, as well as their attitude to ageing were analysed. PERSONS AND METHOD - A total of 333 (190 unhealthy and 143 healthy) persons over sixty years of age filled in the questionnaires either by themselves or through verbal interview. The participants’ compliance with the research was generally good. The study sample reflected the general features of the Hungarian elderly population. For statistical analysis the Microsoft SPSS for Windows version 11.0 programme was used. RESULTS - Better health condition, better mood, and a better ability for self-care improve the quality of life. Better attitudes to ageing are associated with better quality of life. CONCLUSIONS - The use of the WHOQOLOLD questionnaire is recommended in the daily practice to assess elderly Hungarians’ quality of life. The results highlight the significance of mental health in the development of the elderly persons’ attitude to ageing. The use of the new questionnaires may help change negative stereotypes related to ageing.]

Lege Artis Medicinae

JUNE 20, 2011

[Committed physicians, emotional resonance for a better physician-patient relationship]

LAZÁNYI Kornélia, SZLUHA Kornélia

[With the advent of holistic medicine in the second half of the 20th century, the range of behavioural patterns that are expected from healthcare workers has also changed. Nowadays, numerous references in literature put emphasis on the potential positive impact of personal interactions between physician and patient on the healing process and overall well-being of patients. However, it does not come naturally to all workers with caring professions to seek personal interactions with their patients or display appropriate emotions. Some will have to make deliberate efforts, perform emotional labour, to achieve that goal. A healthcare worker’s commitment to healing and caring may make it easier for him/her to perform emotional labour. Emotional labour and commitment of 84 healthcare workers involved in oncology, and organizational factors with impact thereupon, were studied to explore the potential relationship between commitment and emotional labour. PANAS-X questionnaires were used to quantify emotional labour, while commitment and influencing factors were surveyed by means of explicative questions. Our findings confirmed a correlation between commitment and genuine acting as corroborated by literaure data. It was demonstrated that committed healthcare workers’ spontaneous emotions were more in compliance with what their patients expected them to display, and even their behavioural patterns were more in tune with the patients’ expectations. Confirmation as an organizational factor and colleague/ patient attitudes were found to have the strongest impact on commitment. It is essential that selection criteria for healthcare workers include examination for an altruistic caring attitude. Even more importantly, operators and managers of healthcare institutes should make efforts to create a good working environment and offer regular confirmative feedbacks for improved commitment by their employees.]

Clinical Neuroscience

FEBRUARY 20, 2002

[Contemporary interpretation of rehabilitation]

KULLMANN Lajos

[The study selects some changing and developing aspects of the contemporary considerations of rehabilitation and relates them closely to neurological rehabilitation. Functional diagnostics aims at the assessment of impairments and functioning. Several internationally recognized methods of neurological rehabilitation have already been adapted in Hungary. Author emphasises the use of International classification of functioning, disability and health, officially accepted by the Assembly of the World Health Organization in 2001. Its use for functional diagnostics is also possible. The everyday practice of teamwork is still problematic. Its implementation in rehabilitation is inevitable. The neurological rehabilitation is a special field where the cooperation of many teammembers is needed. The attitude to human beings in rehabilitation is different from medicine at large. It considers man not only as biological but also as social beings with own life history, thus helping to achieve compliance and increasing autonomy. The author mentions the possibility for the cooperation with organisers of the independent living movement. The separation of quality of life and health status assessments is suggested. Attention is called to the requirements of the adaptation of assessment methods and an initial account of own experiences is given.]

Lege Artis Medicinae

OCTOBER 18, 2006

[THE PRESENT STATE AND CURRENT PROBLEMS OF HUNGARIAN PSYCHIATRY]

TÚRY Ferenc, HARMATTA János

[The changes in attitude that occurred in general medicine 2 to 3 decades ago had a fundamental impact on psychiatry by giving it a greater emphasis due to the wider acceptance of the bio-psycho-social model. In parallel with this change an English-speaking professional dominance took over the former German-French traditions. Hungarian psychiatrists keep pace with the development of psychiatry, with remarkable achievements in some areas. In everyday patient care and clinical practice, however, severe difficulties are encountered. The paper reviews the trends in practice, education, research, and also the development of professional organizations. Certain ethical implications of the sociocultural changes and future trends of national psychiatry are also summarized.]

Lege Artis Medicinae

APRIL 20, 2001

[Reducing lung cancer mortality through prevention]

KOVÁCS GÁBOR, OSTOROS Gyula, PATAKI Géza

[Effective therapy for lung cancer is yet unknown and the role of prevention has continuously increased. In practice, primary prevention of lung cancer means the reduction of smoking either by cessation or by patient education. Screening for lung cancer, considered as a secondary prevention measure, has long been debated. The previously negative attitude for screening has slowly changed in the past years. New studies have been organised recently to make screening more effective. In high risk groups, helical CT-scans with low dose X-ray exposure are preferred and the effectivity of sputum citology completed with immunocytochemical tests is under investigation. Determining the risk group, we focus on age, smoking history, airway obstruction and certain tumour markers. With the help of traditional chest X-rays approximately one third of new cases of lung cancer are discovered in Hungary. Our reasonable target is to identify 60-70% of the new NSCLC cases by risk group screening (age>40 years, smoking>20 P.Y., decrease of FEV1>15%, family lung cancer history and previous asbestos exposure) and by organising population screening more effectively.]

Lege Artis Medicinae

MARCH 21, 2006

[THE INVESTIGATION OF THE FREQUENCY OF BODY BUILDING AND THE PREVENTIVE FACTORS OF EATING DISORDERS IN YOUNG MALES]

LUKÁCS Liza, TÚRY Ferenc, ARGALÁSZ Attila, MURÁNYI István

[INTRODUCTION - The risk of eating disorders is higher among young women where a slim body ideal dominates. In contrast, the male body ideal is based on the athletic type. The aim of the present study was to assess the relevance of the athletic ideal as a risk factor in certain professional subcultures of young men with respect to intensive workout and body dissatisfaction. These can be important risk factors of muscle dysmorphia in certain populations. METHOD - Body and eating attitudes, as well as workout habits of 1232 military and “general” college male students were studied using questionnaires. The Eating Disorder Inventory was used for all subjects, and general demographic data and information on their bodybuilding practice were also obtained. RESULTS - General college students had a significantly higher mean body mass index than military students (23.9 vs. 23.5 kg/m2). The prevalence of those engaged in bodybuilding was surprisingly high among the military students (64.5%). Comparisons between and within groups also showed significantly different scores on several subscales of the Eating Disorder Inventory. CONCLUSION - The findings suggest that male military college students tend to have protective factors against the psychopathological features of eating disorders.]

Lege Artis Medicinae

SEPTEMBER 20, 2005

[TRAVEL MEDICINE IN GP PRACTICE]

FELKAI Péter, KOVÁCS Erzsébet

[The authors describe the basic ideas of travel medicine, as a newly introduced interdiscipline of the medical science in Hungary. Recently, this segment is considered to be the part of Insurance Medicine, on the other hand the methods and the practice of the travel medicine is based on the other medical specialities’ knowledge. Due to the growing number of travellers in our country as well as the consequences of the joining Hungary to EU, travel medicine could play an important role in the improvement of the Hungarian travellers’ attitude to their health care status, the prevention against the emerged infectious diseases, and in the medical assistance for the international tourism. Travel medicine also a good guideline for the fit-for-travel considerations, made by the GPs. Hungary with its advantageous geographical position appears to be an excellent stopover for any medical evacuation from East European or other surrounding countries. That is why we would like to establish a first travel medicine facility in central Europe. It is expectable that the Hungarian travellers require more and more information regarding to their health care possibilities and prevention during their trip. The first authentic person is being asked by the patients’ are GPs. The GP’s tasks are: diagnosis and the treatment of travel related diseases, the pre-travel advices. All the mentioned factors are a new challenge for the GPs in Hungary.]

Lege Artis Medicinae

JULY 10, 2001