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Journal of Nursing Theory and Practice

AUGUST 30, 2015

[The effects of night shifts on nurses]

OFORI-ATTAH Barbara, NÉMETH Anikó

[Aim of the research: The present study aimed to investigate the effects of night shifts on the somatic and psychic health, sleeping habits and substance use of nurses. Research and sampling methods: A self constructed questionnaire was administered online in October 2014 (N=396). Data were analyzed with SPSS 19.0 using descriptive statistics, chi-square and unpaired two-sample t-tests program (p<0.05). Results: Nurses having night shifts evaluated their health as worse (p=0.031), backache (p=0.019) and heartburn (p=0.029) were reported more frequent. They consume significantly more cigarettes (p=0.011). They experience more work related stress (p=0.002) and sleep disorders (p=0.006). Regarding burn-out (p=0.438) and chronic diseases (p=0.061) there was no significant difference between nurses with and without night shifts. Conclusions: Night shifts affect the health and substance use of nurses and disturb their biorhythms. ]

Clinical Neuroscience

SEPTEMBER 30, 2015

[High prevalence of burnout and depression may increase the incidence of comorbidities among Hungarian nurses]

ÁDÁM Szilvia, CSERHÁTI Zoltán, MÉSZÁROS Veronika

[Background and purpose - Poor mental health among health care professionals may have a significant impact on public health. There is limited information about the prevalence and potential consequences of burnout and depression among nurses in Hungary. The objective of this study is to explore the relationship between burnout as well as depression and somatic symptoms as well as comorbidities among nurses in Hungary. Methods - Cross-sectional study with self-administered questionnaires among 1,713 nurses. Burnout and depression were assessed by the Maslach Burnout Inventory (MBIHSS) and the Shortened Beck Depression Questionnaire, respectively. Somatisation was measured by the Patient Health Questionnaire (PHQ-15). Correlates of burnout and depression were assessed by logistic and linear regression analyses. Results - The prevalence of depressive symptom and clinical depression was 35% and 13%, respectively. The prevalence of moderate and high level emotional exhaustion, depersonalisation, and decreased personal accomplishment was 44%, 36% and 74%, respectively. We identified burnout and depression as a predictor of high prevalence of subjective somatisation. Whilst burnout showed a strong association with increased prevalence of hypertension, depression predicted almost all examined diseases, in particular, cardiac and cerebrovascular diseases, as well as neoplasms. Conclusion - We found high prevalence of burnout and depression among nurses in Hungary. As depression has been shown to be associated with higher prevalence of comorbidities than burnout, its consequences may be more significant. Appropriate prevention, diagnosis, and adequate treatment of burnout and depression may decrease the prevalence of ensuing comorbidities.]

Clinical Neuroscience

JULY 30, 2015

Mental health of physicians - nationwide representative study from Hungary

GYŐRFFY Zsuzsa, GIRASEK Edmond

Background and aim - Somatic and mental health and stress factors of physicians became an issue of growing interest in both national and international researches. Our aim is to give an overviewing analysis of Hungarian physicians’ mental health state. Methods - Representative, cross-sectional, quantitative survey on a representative sample of Hungarian physicians (n=4784). The control group was formed by the population group of a national survey conducted by “Hungarostudy 2013” (n=2000). Results - Suicidal thoughts (18.8% vs. 9.6%, p<0.001), the scores of Somatic Symptom Scale (PHQ-10, 20.4% vs. 13.6%, p<0.001) were significantly higher among physicians. The suicidal attempts (1.9% vs. 3.5%, p=0.053) and BDI depression scores (7.9% vs. 29.5%, p<0.001) were significantly higher in the control group. High Perceived Stress Scale (PPS) scores occurred in 43.3% of the physicians sample, and 43.4% of them had high scores in the Athenian Insomnia Scale (AIS). The young (<35) female physicians showed significantly higher rates of suicidal thoughts, higher scores of PHQ and PPS. In the young female cohort, the AIS scores were significantly higher than of the other physicians. Conclusions - Mental health of physicians (sleep disorders, suicidal thoughts and psychosomatic symptoms) showed poorer results than the population data. BDI scores and the rate of suicidal attempts showed favourable trends. The next step in the physicians’ mental health researches is to investigate the most decisive risk factors, and to work out the prevention tools.

Journal of Nursing Theory and Practice

AUGUST 28, 2014

[Examination of effects of the nurses shiftworks with application of Standard Shiftwork Index - pilot study]

FUSZ Katalin, KOVÁCS KALIC Károly, KÍVÉS Zsuzsanna, MÜLLER Ágnes, OLÁH András

[Aim of the study: Several physiological processes are disturbed in shift workers. The authors’s aim was to complete a pilot study as part of the validation process of Standard Shiftwork Index (SSI) and to examine the effects of shiftwork on the quality of sleeping and on psychical and somatic status. Sample and methods: The survey was implemented at the hospitals of the University of Szeged in 2011, with the participation of not randomly selected nurses working in shiftwork, night- or dayshifts (N=211). SSI was complemented with further respective questions. Results: Those working in dayshift suffer less from sleep disorders than nurses working in nightshift or shiftwork (p=0,002, p=0,005), and have better health status (p=0,001, p=0,003), furthermore feel themselves less tired (p=0,011, p=0,039). The nightshift workers had gastrointestinal complaints more frequently (p=0,044, p=0,006), as well as nurses working in nightshift suffer from more chronic diseases than dayshift workers (p=0,004) and shift workers (p=0,003). In case of shift workers the weekly amount of cigarettes having smoked (p=0,008) and the consumption of caffeinated refresher beverages (p<0,001) were significantly increased since the beginning of their shiftwork. Conclusion: Health status of nurses working in nightshifts and shiftwork are more relapsed, their health attitude is worse than in case of dayshift workers. As the continuation of this examination the authors try to find out which variations of shiftwork can be considered less exhausting.]

LAM KID

FEBRUARY 20, 2014

[Bone metabolism and the 10-year probability of hip fracture and a major osteoporotic fracture using the country specific FRAX algorithm in men with type 2 diabetes mellitus]

PETHŐ Zsófia, KULCSÁR-JAKAB Éva, UGO Onyeka, MOLNÁR Zsuzsanna, KALINA Edit, BALOGH Ádám, PARAGH György, ANTAL-SZALMÁS Péter, KÁPLÁR Miklós, BHATTOA HARJIT Pál

[Objectives: Was to evaluate 10-year probability of hip fracture and a major osteoporotic fracture using the FRAX algorithm, vitamin D status, bone mineral density (BMD) and biochemical markers of bone turnover in men over 50 years of age with type 2 diabetes (T2DM). We compared FRAX-predicted 10-year fracture probability, levels of 25-hydroxyvitamin D (25-OH-D), markers of bone turnover and bone mineral density at L1-L4 (LS) and femur neck (FN) in 68 men with T2DM with an age- and gender-matched group (n=68). The mean (range) age of the T2DM group was 61.4 (51-78) years. The prevalence of hypovitaminosis D (25-OH-D <75 nmol/L) was 59%. The mean (range) FRAX hip fracture and FRAX major osteoporotic fracture was 0.7 (0-2.8)% and 3.2 (0-8.5)%, respectively. BMD at the FN (0.974 gm/cm2 vs. 0.915 gm/cm2; p = 0.008) and LS (1.221 gm/cm2 vs. 1.068 gm/cm2; p < 0.001) was significantly higher in the T2DM cohort as compared to the healthy age matched males. 25-OH-vitamin D (67.7 nmol/L vs.79.8 nmol/L; p < 0.001), crosslaps (0.19 μg/L vs. 0.24 μg/L; p = 0.004) and osteocalcin (13.3 μg/L vs. 15.7 μg/L; p = 0.004) were significantly lower in the T2DM group. There was no difference in FRAX-related fracture probability between the two groups. The increased BMD in T2DM and the lack of inclusion of T2DM as a risk factor in the FRAX algorithm are probable explanations for the discordance between literature-observed and FRAX-related fracture probabilities.]

LAM KID

MAY 30, 2014

[Determining sclerostin level in healthy men]

MOLNÁR Zsuzsanna, WAMWAKI John, PETHŐ Zsófia, KALINA Edit, FÖLDESI Róza, BALOGH Ádám, ANTAL-SZALMÁS Péter, BHATTOA Harjit Pál

[The aim of this study is to evaluate the relationship of serum sclerostin levels with age, cystatin C, bone mineral density (BMD) and biochemical markers of bone turnover in healthy Hungarian men over 50 years of age. We determined serum levels of sclerostin and examined its relationship with age, cystatin C, osteocalcin, C-terminal telopeptides of type-I collagen, procollagen type 1 amino-terminal propeptide, 25- hydroxyvitamin D, parathyroid hormone, and L1-L4 (LS) and femur neck (FN) BMD data available from 194 randomly selected ambulatory men belonging to the HunMen cohort. In the study population as a whole (n=194; age (median, range): 59 (51-81) years), statistically significant correlation was found between sclerostin and age (r=0.211; p=0.003), cystatin C (r=0.246; p=0.001), FN-BMD (r=0.147; p=0.041) and LS BMD (r=0.169; p=0.019). Compared with middle-aged men (age: ≤ 59 years, n=98), elderly men (age > 59 years, n=96) had significantly higher serum sclerostin levels (67.8±15.9 pmol/l vs. 63.5±14; p=0.047). Among men with normal (T score >-1,0) FN-BMD, the elderly had significantly higher serum sclerostin levels as compared with the middle-aged (70.4±17 pmol/l vs. 63.9±11.5 pmol/l; p=0.019). Furthermore, among the elderly men cystatin C was the only significant predictor of serum sclerostin levels (standardized regression coefficient (béta) = 0,487; p<0,001). Our results show that in the studied healthy elderly cohort sclerostin levels significantly increase with age, along with the deterioration of kidney function as determined by plasma cystatin C levels. ]

LAM KID

MARCH 30, 2014

[The EFEZUS study: Estimation oF the Effectiveness of Zoledronic acid in Use in Steroid-induced osteoporosis in real life]

KISS Csaba György, SURMANN Ágnes, DRESCHER Edit

[The Hungarian EFEZUS study (Estimation oF the Effectiveness of Zoledronic acid in Use in Steroid-induced osteoporosis in real life) was a multicentre, prospective, non-interventional, open-label, one-year-long study, in which we assessed the effect of zoledronic acid on bone mineral density and on the markers of bone turnover in osteoporosis developing after treatment with glucocorticoids. The mean baseline lumbar BMD was 0.762 g/cm2 and by the end of 12 month it increased to 0.818 g/cm2 (p<0.0001). The mean BMD measured at the femoral neck during visit 1 was 0.675 g/cm2, and it increased to 0.711 g/cm2 by visit 2 (end of study) (p<0.0005). The levels of bone turnover markers (cTX, nTX) significantly decreased between visits 1 and 2 (p<0.05). The mean cTX level at visit 1 was 421.2 ng/l (SD: 309 ng/l), which decreased to 253.3 ng/l (SD: 188.1 ng/l) by visit 2. The mean change in the levels of nTX was 0.65 µg/l (SD: 0.36 µg/l) and 0.39 µg/l (SD: 0.28 µg/l), respectively. There was no major change in serum and urine calcium levels. Five adverse events were reported by 4 patients during the study. ]

Clinical Neuroscience

NOVEMBER 30, 2013

[Psychosis as a process - New implications of staging models of schizophrenia]

HALMAI Tamás, TÉNYI Tamás

[The article discusses contributing factors in the pathogenesis of schizophrenia. In the last fifteen years, the emphasis has shifted from curative to prodromal and premorbid characteristics of later schizophrenia patients. Nevertheless, most studies are limited to the area of early detection and intervention of schizophrenia with much fewer focusing on actual prevention. A more general preventive approach not limited to psychotic condition is clearly underestimated. Following a review of current literature on prodromal approaches and identified premorbid markers of schizophrenia, the article outlines a possible trajectory of later psychotic condition with detectable, distinct stages from birth on. Based on this extended staging model involving neurotoxic impact and early prefrontal-limbic dysfunction, it argues for a refined, phase-specific treatment protocol including preventive interventions. Accepting a model of schizophrenia as an illness with detectable, phase-specific signs and symptoms from infancy on leads to the need to implement preventive interventions. Through this approach, we could, in the optimal case, be able to identify early signs of neuromotoric and cognitive dysfunction not specific for psychosis. Furthermore, it would be useful to lay greater emphasis on the detection of these early signs in the training of health care professionals. This approach calls for a close cooperation between psychologists, psychiatrists, neuropsychologists and special education experts and a change in the way we view psychotic illness.]

Clinical Neuroscience

JULY 30, 2013

[Minor physical anomalies in autism]

TÉNYI Tamás, JEGES Sára, HALMAI Tamás, CSÁBI Györgyi

[Background and purpose - Minor physical anomalies are mild, clinically and cosmetically insignificant errors of morphogenesis which have a prenatal origin and may bear major informational value for diagnostic, prognostic and epidemiological purposes. Since both the central nervous system and the skin are derived from the same ectodermal tissue in utero, minor physical anomalies can be external markers of abnormal brain development and they appear more commonly in neurodevelopmental disorders. In a recently published meta-analysis Ozgen et al. have published the results of seven studies - all have used the Waldrop Scale which contains 18 minor physical anomalies - and reported on the higher prevalence of minor physical anomalies among patients with autism. There are only a very few data on the individual analysis of the prevalence of minor physical anomalies in autism. Methods - In our study we have studied the prevalence of 57 minor physical anomalies in 20 patients with autism and in 20 matched control subjects by the use of the Méhes Scale. Results - The prevalence of minor physical anomalies was significantly higher in the autism group (p<0.001). The individual analysis of the 57 minor physical anomalies showed the significantly more frequent apperance of four signs (primitive shape of ear p=0.047, abnormal philtrum p=0.001, clinodactylia p=0.002, wide distance between toes 1 and 2 p=0.003). No correlation was found between the four significantly more common minor physical anomalies. Conclusion - The higher prevalence of minor physical anomalies in autism supports the neurodevelopmental hypothesis of the disorder and the individual analysis of minor physical anomalies can help to understand the nature of the neurodevelopmental defect.]