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Journal of Nursing Theory and Practice

OCTOBER 30, 2019

[The challenges of education in gestational diabetes ]

SEBESTYÉN Anett Katalin

[The aim of the author is to draw attention to difficulties of pregnant women’s education who suffer from gestational diabetes. Due to the global increase of gestational diabetes, this topic’s importance and actuality is getting more relevant. The key of the successful diabetes treatment is the education. In the course of that it is important to choose a strategy, with that the patient can get as much special skills as she can and will be able to keep the ideal and progressive balance of metabolism. Through to the personal education here is a chance to put an end to the patient’s fears, to increase their motivation and to encourage them. ]

Hypertension and nephrology

FEBRUARY 20, 2020

[Thinking globally - the significance of the joint treatment of risk factors]

BENCZÚR Béla

[Hypercholesterolemia and hypertension - as the key risk factors of ischemic heart disease - are strongly linked to the increasing prevalence of cardiovascular mortality and morbidity. These risk factors are related to each other and half of the hypertensive patients have elevated cholesterol, as well. The recent European hypertension guidelines recommend statin treatment in dyslipidemic and/or subjects at high risk including diabetic or CKD-patients. Reaching blood pressure target if we can hold the patient under 1.8 mmol/l LDL-level results in 60% reduction of the risk of CAD and 17% reduction of stroke. This aim can only be reached if patients regularly take their prescribed medications although statinadherence is the poorest in our country. One of the main tools of improving adherence beyond education is the use of fix-dosed combination.]

Journal of Nursing Theory and Practice

JUNE 30, 2019

[Understanding the past may help to shape the future (’Medical tasks, delegation and nursing’ - the past, present and the way forward)]

SÖVÉNYI Ferencné

[The history of nursing in Hungary has an aspect that has often been addressed but never looked into to the required depth and detail. This aspect concerns the regulation by law of certain specific relations between medicine and nursing from the mid-twentieth century to date. This issue has now come to the fore due partly to amendments to the legal framework and partly to changes in nursing education. ]

Journal of Nursing Theory and Practice

JUNE 30, 2019

Nurses‘ competences in preventive cardiology

IVANA Chloubová, VALÉRIE Tóthová

Introduction: The nurse education in the Czech Republic is based on the recommendations of the European Union, respecting the outcoming knowledge and skills of general nurses, formulated in basic competence criteria. Cardiovascular diseases rank among the main causes of death not only in many developed countries, but also in developing countries. Accent should be put on prevention of these diseases and the nurses should provide for efficient education. Goals and methods: The goal of the article consists in presenting the results of the analysis of the available sources focused on nurse education and the resulting competences in the field of cardiology, as well as in describing the system of health-educational activities of nurses in preventive cardiology in selected EU countries. The methods of research and structured interview were used. Results: The nurse‘s task in prevention of cardiovascular diseases consists in educating the public on influenceable risk factors which have significant impact on the incidence of cardiovascular diseases, but also on people‘s quality of life. It is important to alert the people to changes in their own risk behaviours and to motivate them to activities leading to improved life style. Conclusion: It can be concluded that the nurses in preventive cardiology make use of the competences acquired through pregradual studies. However, the current practice requires increasing competences within postgradual education.

Lege Artis Medicinae

DECEMBER 10, 2019

[Health risk awareness among healthcare professionals]

SZOBOTA Lívia, BALOGH Zoltán

[INTRODUCTION - The aim of our study was to assess how aware healthcare professionals are of the risks and dangers they are faced with while performing their jobs. MATERIAL AND METHOD - Data collection was done quantitatively with a survey filled out by the subjects themselves from among medical/healthcare professionals who are currently working multiple shifts or medical professionals who are in leadership positions and are currently continuing their higher education beside their employment. Data analysis was done with the help of Microsoft Excel and SPSS using the Pearson chi-squared test and the Mann Whitney test (p<0.05) as well as descriptive statistical methods. RESULTS - The 134 healthcare professionals taking part in the study were not fully aware of the health risks they are faced with. CONCLUSION - The people who provided answers were not clear on workplace dangers and risks. On the whole, it can be determined that the cooperation of occupational health and workplace safety is necessary in order to avoid damage to the health of healtcare professionals.]

Clinical Neuroscience

NOVEMBER 30, 2019

A clinical study of an online educational programme for chronic pain patients

GALAMBOS Wellingerné Krisztina, SZOK Délia, CSABAI Márta

Background - The research of alexithymia - the inability to express or understand emotions - has recently become of great importance in clinical practice, mainly in the field of doctor-patient and psychologist patient communication. Many studies have proven the correlation between alexithymia and the development of functional somatic symptoms, i.e. somatization. Purpose - The aim of this clinical study was to examine the emotion-recognition and emotion communication patterns of patients suffering from chronic pain (e.g., headache, low back pain, arthralgia, neuropathy). Moreover, the participants received access to the Hungarian adaptation of a new international online educational site (www.retrainpain.org) dealing with pain management. Methods - Data were collected from the Headache and Chronic Pain Outpatient Clinic, Department of Neurology, Faculty of Medicine, University of Szeged, Hungary (tertiary care - Group 1) and from a general practice in district 2, Budapest, Hungary (primary care - Group 2) from March, 2017 to April, 2018. Patients received a test package containing a pain-specific questionnaire, then the Difficulties in Emotion Regulation Scale (DERS), the Toronto Alexithymia Scale (TAS-20), and the shortened Hungarian version of the WHO-Well-being (WBI-5) had to be completed. After filling out the questionnaires, all patients got access to the Hungarian adaptation of the www.retrainpain.org website. Results - Altogether 92 patients participated in the study (Group 1 n=50; Group 2 n=42). Based on the TAS-20 re­sults, 35 patients reached a pathological score (≥60 points), which indicates the diagnosis of alexithymia. The mean TAS-score was lower in Group 2 (primary care) than in Group 1 (tertiary care) (p=0.003). The DERS disclosed pathological results in 19 cases (p=0.009). As regards the www.retrainpain.org chapters, we received feedback only from 25 out of 92 patients (27%) (Group 1 n=20; Group 2 n=5). Conclusions - Although the examined patients have been suffering from different chronic pain syndromes for years and 50% of them confirmed that symptoms placed at least moderate or heavy burden on their everyday life, the available educational programme was studied only by a smaller proportion of patients than expected. Additionally, those who surveyed the Hungarian adaptation of the www.retrainpain.org website were mainly patients from primary care (Group 2), in spite of the fact that patients from specialized medical care (Group 1) had worse subjective conditions. Our future objective is to extend our database with follow-up results and to improve patients’ response willingness.

Journal of Nursing Theory and Practice

APRIL 30, 2019

[A Systematic Review of nurses knowledge of Incontinence-Associated Dermatitis ]

KÓSZÓ Lilla, NAGY Erika, PAPP Anita Tímea

[Background: Due to the growing incidence of incontinence, Incontinence-Associated Dermatitis (IAD) is one of the most important health problems nowdays. The most significant challange is the differentiation of IAD and ulcer pressure. Missclassification in practice causes suboptimal prevention and therapy. Thus, in order to provide optimal care, nurses need to be able to properly differentiate between the two illnesses. Objectives: The airm of this analysis was to identify how nurses can classify IAD from ulcer pressure, and how differentiation could be taught to nurses. Method: A systematic review was done wih ’pressure ulcer and ’classification’ and ’nurse’ search words using 3 databases, the Pubmed (NLM), the Science Direct and the Web of Science as basic sources. We relied on articles that were published before September 2018. From the total of 1268 records 7 studies met all the inclusion and exclusion criterias and were chosen for analysis. Results: We counted weighted arithmetic from the results of the studies. In total 4062 nurses participated in the clinical trials. Their weighted mean score was 33,2%. 2132 nurses got some types of education, The weighted mean score of their pre-test was 37%, while their post-test reached 66%. Conclusion: Differentional diagnosis between pressure ulcers and IAD is complicated. However, studies all agree that education in this field produces good results.. ]

Journal of Nursing Theory and Practice

APRIL 30, 2019

Socioeconomic status and health status: mortality and morbidity

DABES Meshik Alphonsus, PAPP Katalin

There is no situation that the individual’s socioeconomic status (SES) play a huge role in the individual’s health outcomes and the health care they receive. Socioeconomic status is mostly measured by education, income and occupation. People of higher SES tend to have more knowledge on health and health behaviours, and that determined their accessibility, acceptability and affordability of health care services. Arpey et al 2017, opined that people of lower SES are more likely to have worse self-reported health, lower life expectancy, and suffer from more chronic conditions when compared with those of higher SES. In this study, I want to analyse the relationship between socioeconomic status and health status considering mortality and morbidity among people of lower SES and higher SES using current literatures review. Base on this study it is clearly understood that there is a clear disparity in health status between lower socioeconomic status and higher socioeconomic status population. This health inequality is as a result of differences in economic, social and cultural factors. Health inequalities is avoidable and unfair because it is as a result of an unjust distribution of the underlying social determinants of health such as, unequal opportunities in education and/or employment which are the core determinants of persons socioeconomic status. Therefore, in order to reduce the inequality in health among higher and lower SES group, there should be equal distribution and opportunity for both groups to access education and employment.

Lege Artis Medicinae

OCTOBER 20, 2019

[Experiences with the Hungarian version of the Sexual Risk Behavior Beliefs and Self-efficacy Scales ]

EÖRSI Dániel, CZEGLÉDI Edit

[INTRODUCTION - One of the most em­phasized areas of school health education is sexual safety. For risk reduction, adolescent’s beliefs and self-efficacy about sexual safety are decisive; however, no Hungarian measurement tool for this construction was available before. The aims of the present study were to adapt the Sexual Risk Behavior Beliefs and Self-efficacy Scales (SRBBS) to Hungarian, to explore the gender differences, and to assess predictors of condom use among high school students. METHOD - 9th and 10th class high school students in a north-Hungarian city were involved in our cross-sectional study (N = 649; 52.5% boys; mean age: 16.7 years; SD = 1.01 years). Measures: SRBBS questionnaire, sexual behavior issues. RESULTS - The psychometric analysis of SRBBS has yielded encouraging results. The theoretical factor structure is largely supported, the internal consistency of the scales is adequate and its test-retest reliability is mostly acceptable. 35.5% of the participants had sexual intercourse during their lifetime and 65.8% had used condoms at the last occasion. The boys (OR = 2.17, p = 0.021) and those who had more positive attitude towards condom use (OR = 1.24, p = 0.002) were significantly more likely to use a condom during the last act than girls, and subjects with less favorable attitude towards condom use. CONCLUSIONS - SRBBS questionnaire should be introduced into domestic research to measure the effectiveness of health check-ups and school health education programs. ]

Hypertension and nephrology

SEPTEMBER 10, 2019

[Hungarian Hypertension Registry. Different methods and effects of increasing physician-patient cooperation on target blood pressure]

SZEGEDI János, KÉKES Ede, KISS István

[The life expectancy, the mortality and the development of complications of hypertensive patients are fundamentally influenced by the treatment, the effectiveness of care and physician-patient cooperation, the achievement of target blood pressure. Based on the database of the Hungarian Hypertonia Registry, we present three examples of the effect of different solutions for physician-patient cooperation on increasing the blood pressure target. During the two years between 2005 and 2007, we used a complex, versatile method of increasing the patient’s adherence in treated hypertensive patients (17,114 males and 21,772 women), with information, education, home-blood pressure diary, and continuous, regular physician- patient communication (sms, green phone line, website). The target blood pressure was significantly increased from 38.8% to 43.9%, and the rate of growth was higher in women. The increase was also significant in the elderly (over 70 years). In the first quarter of 2011, we launched a wide-ranging education and patient support campaign for 28,018 hypertensive patients under the ‘Everywhere Good, Best Home!’ subprogram for promoting of home blood pressure measurement and its use in therapy. 81.3% of the patients had completed the diaries under ther observation period, the full completion of the diaries was 91.3%. At the end of the third month, the target blood pressure of 135/85 mmHg for HBPM increased from baseline 21.2% to 48.8%. Growth was significant (P <0.001). In the year 2015-2016 we started a one-year, multicentric, prospective, observational study, in which 7735 patients aged 18-64 years were included from the database of Hungarian Hypertension Registry. In the non-active group (3313 people), treated hypertensive patients were controlled according to the traditional care program so far, while the active group members (4422) participated in an intensive care program with telemedicine (smart phone application) and other helping opportunities. The control was done at the end of 3, 6, 9, and 12 months after the start. In the active group, blood pressure dier was done by smart phone and every month, in the non-active group, paper logging was done every 3 months. In the active group, the blood pressure dieries were filled with smart phone every month and in nonactive group the paper dieries only every 3 months. Patient adherence was high in both groups (around 70%) and in the active group was greater than in the nonactive group. Target blood pressure (<140/90 mmHg) in the active group increased from 53.8% to 73.4% and in the non-active group from 49.9% to 68.1%. Studies have shown that patient interaction is determined by good communication between the care team and the patient, success of home blood pressure monitoring. The communicative ability of the care team (physician-nurse pharmacist) greatly influences the achievement of the therapeutic target. Modern telecommunications is another useful option.]