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Lege Artis Medicinae

SEPTEMBER 30, 2020

[How can the specialists be contacted? Ways of communication in the specialist-patient consultation]

MOLNÁR Regina, PAULIK Edit, SÁGI Zoltán, KÖVES Béla

[Consulting the specia­list means face-to-face meetings traditionally. Nowadays patients do not need to go to the outpatient clinic to see the doctor since many new communication options have already been available. The aim of our study was to explore how typically doctors and patients use other options (as phone call or e-mail) beside face-to-face appointments in the outpatient clinic. We conducted a focus group interview with specialists and health workers and an in-depth interview with the chief nurse of an outpatient clinic in Budapest. The specialist-patient consultation is mostly face-to-face in the specialist’s office in the presence of the nurse, whose role is complex and pivotal. Fur­ther­more, the landline phone is an essential device, as the patients can reach the specialist or nurse in their office hours. The application of e-mail or mobile phone is incidental. The website of the outpatient clinic provides practical information to patients. Traditional postal letters, leaflets, and publications are also typical for providing information. The doctors’ opinion was rather heterogeneous about the pa­tients’ Internet usage and about the on­line contact with patients. Beside increasing the capacities the deliberate and organized introduction and application of technical de­vices, may reduce the overburdening of health professionals.]

Journal of Nursing Theory and Practice

OCTOBER 30, 2019

Use of Imogene King’s Nursing Model in the Care for a Patient with Heart Arrhythmias


Objectives: To discover the benefits of implementation of Imogene King’s nursing model into nursing care in a patient with arrhythmias. To find out how these patients are limited in saturation of their own needs and what are the most severe limitations for patients with arrhythmias. Material and methods: Qualitative research using semi-structured interviews. The interview with patients with arrhythmia was conducted in accordance with the structure of King’s nursing model. Results: The research group consisted of 20 respondents; 13 men and seven women. All respondents expressed satisfaction with their cooperation with staff. The respondents described a change in the subjectively perceived state, the psychic state, and emotions. Conclusions: Assessment of the subjectively perceived quality of life of patients with arrhythmias using the King’s interaction model allows nurses to see the patient from the holistic point of view and plan and provide individualized care.

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

NOVEMBER 15, 2019

[Specialists’ opinions about the introduction of colorectal cancer screening ]


[ INTRODUCTION - The number of new cases of colorectal cancer is over 10 000 and there are around 5000 deaths per year in Hungary. A nationwide colon cancer screening program was launched in 2018. AIMS - Concerning the upcoming national screening, our aim was to explore attitudes, preferences and knowledge of specialists (family medicine, gastroenterology, surgery, oncology, pathology) who will be engaged in screening, diagnosis and treatment of colorectal cancer. METHOD - Before the start of the program we conducted semi-structured interviews with 20 representatives of specialties mentioned above. Interview-questions focused on knowledge (epidemiology, screening methods, program-related), preferences (screening method, protocol) and impact of the program on medical practice. Quan­ti­ta­tive and qualitative methods were used for analysis. RESULTS - Incidence of colon cancer was well known but its mortality in Hungary was underestimated. The public health significance of colorectal cancer scored 7 on a 10-point Likert scale and all participants agreed with introduction of the program. 12 people knew the chosen protocol (two-stage), only a single person mentioned one-stage (colonoscopy), and 7 had no information. 16 people prefer colonoscopy as the best screening method. 11 support two-stage protocol, 5 do not support but accept it, 4 would only accept the one-stage approach. 13 people think their duties will increase considerably. CONCLUSIONS - Our review partners consider colorectal screening in Hungary as an initiative to be supported. They expect increase of workload in their everyday medical practice and assume that the current endoscopic capacity will be overburdened. The majority prefers two-stage protocol because of cost-effectiveness while arguing that the colonoscopy has a bad reputation among the general population, nevertheless they consider colonoscopy as the best method of screening. ]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2019

[Efficient employee performance appraisal systems]

SÁRGA Norbert Zétény

[A well-functioning performance appraisal system and information obtained from it will provide support for executive decisions. Developing the performance appraisal system, not only the definition of performance is a key factor, but also the steps to be taken to shape it; such as the purpose for which the performance appraisal system is to be used, the method of evaluating who the members of the evaluation system are. This paper presents the various evaluation techniques and methods; the importance and effective application of the written and oral evaluations as well as the evaluation interview. Furthermore, the difficulties encountered in the evaluations and the evaluation mistakes are described. ]

Lege Artis Medicinae

MAY 20, 2017

[The impact of telemedicine on the development of doctor-patient relationship based on interviews conducted among physicians]

BÁN Attila

[Introduction - The doctor-patient relationship has always been an essential part of health care, however, in parallel with the integration infocommunication technologies in health care the doctor-patient communication is also transforming. Therefore, the aim of the study is to examine the effect of telemedicine on this relationship. Methods - During the study, we applied qualitative research methods and a total number of 58 semi-structured interviews (45 men, 13 women) were conducted among physicians having experience in telemedicine. The majority of the interviewees were radiologist, general practitioners, and internists. The interview questions concerned that what characterises the doctor-patient relationship in telemedicine. Results - The interviews pointed out that in teleradiology the doctor-patient relationship depersonalises and almost terminates. In this respect, the problem is often the incomplete clinical information about the patient. In turn, telemonitoring can bring a quality change in the doctor-patient communication and through remote contact the patients’ satisfaction, the sense of security, and the doctor-patient relationship will be further enhanced. Conclusions - In accordance with the academic literature - based on the research results - there is no clear evidence that telemedicine would affect doctor-patient communication only positively or only negatively. In some areas of telemedicine, this relationship is reducing (e.g. teleradiology) while in other areas it could be fur-ther strengthened (e.g. telemonitoring).]

Journal of Nursing Theory and Practice

OCTOBER 30, 2016

[Prenatal care and the role of midwifery in Europe and in Hungary]

SZÖLLŐSI Katalin, KÖVI Rita, SZABÓ László

[Aim of the study: To provide a picture about the prenatal care practice and assess the attitude of obstetrics and midwives about the new prenatal care system in Hungary. To compare the Hungarian prenatal care system with that of other countries in the European Union (Finland, England). Procedure and Sample: We used self-developed questionarre with 50 midwives, 40 pregnants and interview with 5 midwives and 5 obstetricians. To compare the prenatal care systems in the EU we used the experienses of a study trip in Finland and informations from international databases. Results: 8% of the midwives work in prenatal care, 32% of participants are not interested in this field. In their view the new system is not elaborated yet, they need more professional survellance. Obstetricians acknowledge the competence of midwifery, however they suggest to gain more practical knowledge on the field. 75% of participating pregnant women would have chosen the prenatal care of obstetricians. The role of midwives in prenatal care is significant in Europe. The Hungarian system is unique, which is approached to the european practice by introduce the new prenatal care system. Discussion: The new Hungarian prenatal care system has several loops in its structure and effectiveness from the view of midwives and obstetricians.]

Lege Artis Medicinae

JUNE 20, 2016

[Changes of diabetes deaths in Hungary from 2000 to 2009]

VOKÓ Zoltán, ZSÓLYOM Adriána, JERMENDY György

[INTRODUCTION - Official mortality statistics underestimate the etiological role of diabetes in mortality. METHODS - With the use of attributable risk ratio we estimated the proportion of total mortality and mortality under age 65 years due to diabetes in Hungary in 2000-2009. We corrected the analysis for the co-occurrence of diabetes and hypertension. The prevalence figures of diabetes were taken from the National Health Interview Surveys 2000, 2003 and 2009; the relative mortality figures in patients with diabetes from the Canadian Chronic Disease Sur­veillance System of the Public Health Agency Canada; and the Hungarian age-, and sex-specific mortality figures from the Demographic Yearbooks of the Central Statistical Office. RESULTS - The total mortality decreased by 15%, mortality under age 65 years by 16% in the studied period in Hungary. Mean­while diabetes attributable mortality corrected for hypertension decreased by only 6%, premature mortality increased by 4%. As a consequence, the proportion of diabetes attributable mortality within total mortality increased from 4.6% to 5%, premature mortality from 4.3% to 5.5% by 2009, as the prevalence of diabetes increased from 6.9% in 2000 to 8.2% in 2009. Diabetes attributable mortality is approximately 2.5 times higher than the figures in the official mortality statistics. CONCLUSION - Diabetes and its main risk factors, overweight and obesity due to unhealthy diet and physical inactivity are one of the most important public health challenges nowadays. The burden of diabetes and its complications is already enormous. Mortality attributable to diabetes is much higher than it is reflected in the official mortality statistics. ]