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Clinical Neuroscience

JANUARY 30, 2020

The effects of the level of spinal cord injury on life satisfaction and disability

GULSAH Karatas, NESLIHAN Metli, ELIF Yalcin, RAMAZAN Gündüz, FATIH Karatas, MÜFIT Akyuz

Introduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients’ disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.

Journal of Nursing Theory and Practice

JUNE 30, 2019

[Postoperative pain management today in Hungary - Part 2 ]

LOVASI Orsolya, LÁM Judit

[According to the literature, the practice of postoperative pain relief in Hungary is an area to be developed. Postoperative pain is a key issue for patients. Surveys show that more than 59% of patients are worried about postoperative pain. Their concerns are not baseless, as recent studies have consistently shown that pain has not been properly treated after surgery. It has also been shown that postoperative pain can lead to a deterioration in the quality of life of patients. The aim of our study was to assess the degree of postoperative pain in patients and their satisfaction with pain relief. We conducted interviews based on personal inquiries with a total of 168 patients, with the involvement of certain surgical departments of three Hungarian institutions. Based on our results, we found that patients report remarkable pain after surgery, so the practice of postoperative pain relief is in many cases unsatisfactory. Comparing the results and the international literature, postoperative analgesic practice can be considered as an area to be developed. ]

Journal of Nursing Theory and Practice

JUNE 30, 2019

[The role of nurses and their tasks in early sepsis management]

VÁRADI Annamária, FEHÉR Gábor, FÖMÖTÖR Péter

[The Surviving Sepsis Guideline (SSG) is a document that proposed new solutions in the diagnostics and treatment of sepsis. The methods identified were the 100% oxygen therapy, fluid resuscitation, blood culture and microbiological analysis, empiric combination antibiotic therapy, lactate monitoring, comparison of PCT and CRP, and surgical opening. Using the above mentioned methods has proven to improve the quality of sepsis treatment and the safety of patients. Sepsis -6 protocol has been highlighted by the authors as a process that is easy to implement in terms of cost while remaining highly beneficial. This recommendation should also be well known for nurses that do not work in emergency units. This will help recognise sepsis at an early stage, and provide guideline in the analytical examination and the possibilities within the competence. ]

Lege Artis Medicinae

DECEMBER 10, 2019

[Why did I survived? Treatment of acute stress reaction after a road accident]

SZABÓ József, SIPOS Mária

[INTRODUCTION - Survivors and witnesses of traffic accidents often experience an acute stress reaction. Immediate or at least fast psychological support, relieving the subjective suffering is very important in the respect of preventing psychological crisis, post-traumatic stress disorder or depression and the associated increasing risk of suicide. CASE REPORT - We present the case of a 27-year-old male patient who was the victim of a traffic accident and was partly responsible for it. He lost his mother in the accident, his sister was injured, and there was a casualty in the other affected car. He applied for a psychiatric appointment one week after the accident. He complained of insomnia, loss of appetite, sadness, weakness, anxiety. The treatment consisted of low-dose anxiolytic therapy, recommended in case of need, and a psychological support via acute stress protocol (G-tep) of EMDR therapy. Both short-term feedback from his family doctor and psychiatry outpatient follow-up after three weeks showed significant symptomatic improvement. CONCLUSIONS - In the last one and a half year, he has not applied for psychiatrical treatment. According his general practitioner there were no new psychological problems during this time. Our work has been successful in terms of immediate relief of suffering and prevention of psychological crisis and PTSD.]

Lege Artis Medicinae

DECEMBER 10, 2019

[Family medicine as a career. Medical students’ attitudes and vocational choice motivations]

MOHOS András, VARGA Albert, MARKÓ-KUCSERA Mária, KALABAY László, TORZSA Péter

[INTRODUCTION - The large number of vacant general practices is a burning issue in Hungary. The entering of new colleagues into the general practitioner speciality training does not pose a real solution to the human resources crisis in this field. Our aim is to assess medical students’ attitudes and knowledge about general practice. SAMPLE AND METHOD - Cross-sectional survey with self-completed questionnaires at the University of Szeged, with the participation of 94 fourth and fifth year medical students in 2016 and 78 first and fourth year medical students in 2017. RESULTS - In 2016 1% of students planned for sure, and 16% planned probably to work as a general practitioner in the future. In 2017 3.9% of first-year students planned definitely to be a general practitioner, and 15.4% planned that probably. Among fourth-year students 0% of students planned for sure, and 19.2% planned probably to work as a general practitioner in the future. Whatever the presence of family medicine in undergraduate training influenced the medical students’ opinion about the profession positively (0.4-1.3 on a scale based on the direction and strength of the effects of certain factors ranging from -5 to +5). Those who were interested in family medicine considered the situation of healthcare significantly worse (p=0.027), than those who were not interested. To make the profession more attractive the following factors may play the most important role: the more intense presentation (I: 37%) of general practice in undergraduate training, improving the prestige of family medicine (IV: 31%), high-quality work (IV: 39%). CONCLUSIONS - Few medical students plan to work as general practitioner in the future. The most effective way to raise interest in family medicine is to increase the students’ knowledge and awareness of this specialisation, and the more intensive presentation of family medicine in undergraduate training is a key issue.]

Lege Artis Medicinae

DECEMBER 10, 2019

[Introducing a new, personalized multistep cognitive behavioral therapy for obesity]

CZEGLÉDI Edit

[Two thirds of Hungary’s adult population live with excess weight. Obesity itself is a chronic disease that is a risk factor for many other chronic diseases, and therefore adequate treatment is of public health impor­tance. Although behavioral therapy is one of the evidence-based approaches to treating obesity, its long-term effectiveness is not well-established. That is why intensive work has been done over the past decades to furth­er develop behavioral therapy. A recent example of this is a multi-step treatment program that can be implemented in a number of settings of the health care system regardless of the excess weight and the presence of comorbid conditions of obesity. This treatment program is based on classical behavioral treatments and new cognitive-behavioral treatments of obesity and, in addition to the acquisition of long-term lifestyle-changing skills, contributes to the treatment of obesity through the development of a mind-set for long-term weight control. The purpose of this study is to present the program.]

Lege Artis Medicinae

SEPTEMBER 10, 2019

[Working capacity assessment: a literature review]

MÁK Kornél, FEHÉR Gergely, GOMBOS Katalin, PUSCH Gabriella, KOLTAI Katalin, BANK Gyula, KÓSA Gábor, VARJASI Gábor, TIBOLD Antal

[INTRODUCTION - Although work capacity assessment (WCA) has high social and economical impacts, national medical standards are lacking in Hungary. AIM - The aim of our literature search based review was to gather evidence and international standards on WCA. RESULTS - There are different methods in WCA, from questionnaire forms to computer-based evalution, the latter seems to be the most effective. Apart from physical WCA, additional cardiovascular risk profile and psychoscocial evaluations are recommended. Despite of intesive research of the topic, evidence-based standards do not exist. CONCLUSION - There is an increasing demand on evidence-based WCA. ]

Hypertension and nephrology

SEPTEMBER 10, 2019

[Kidney diet and the patient compliance issue ]

LADÁNYI Erzsébet

[There have been significant developments in the field of nephrology and dialysis as for the science and technology are concerned in the past decades. However, CKD patients still show high mortality and morbidity. From among the several factors determining the long-term outcome of CKD patients metabolic disorder and malnutrition play an important role. Malnutrition is often not diagnosed or is not paid enough attention to in the complex treatment of CKD patients. It is important to make both the patients and clinical staff more aware of proper nutrition and importance of prevention and treatment of malnutrition, respectively. The early diagnosis and treatment of malnutrition is of utmost importance in CKD patients. The long term renal failure and the accompanying malnutrition have a negative impact on their long term outcome and quality of life. Since the malnutrition causes a lot of complications, it is indispensable for dietitians and nephrologists to work closely together. Patient compliance is a determining factor in the successful implementation of renal diet.]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2019

[Faces from the Hungarian Nursing Hall of Fame: the exemplary career of Katalin Durgó recipient of the Henry Dunant Meda]

BOROS Károlyné, FEDINECZNÉ VITTAY Katalin, PERKÓ Magdolna, SÖVÉNYI Ferencné

[In this part of their series on outstanding figures in Hungary’s nursing history authors present the life of Ms. Katalin Durgó, a Red Cross volunteer nurse-midwife, whose lifelong services to promote the humanitarian cause of the Red Cross were acknowledged by awarding to her, at the age of 83 years, the Henry Dunant Medal, the highest award of the Red Cross Movement. Ms. Durgó was the 5th awardee globally, the first ever Hungarian recipient and the second person to have been decorated in their lifetimes. Following her self-sacrificing and fearless work in the war theatres of WWI, Ms. Durgó worked as a local midwife in rural Hungary delivering one thousand babies as testified by her Midwife’s birth logbook. She carried out her work with a strong sense of conscientiousness, punctuality, untiring diligence, devotion and solid professional knowledge and skills; her personal and professional lives are shining examples for today’s nursing generation. ]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2019

[Who helps the caregivers? - Psychosocial characteristics of nurses in dementia care ]

STALLER Judit, KOVÁCS Zsuzsanna, PÁLVÖLGYI Miklós

[The aim of the study: Studies underline the increasing burden of dementia people. Hungarian social care system is also facing dementia care challenge. In case of developing of social sector, it is beneficial to research the psychosocial status of nurses working in dementia care. Material and method: N=130 professional caregivers in dementia care filled out self- administered questionnaires. Standardized health-psychological scales were evaluated: SWLS, Rahe’s Life Meaning, Beck’s Inventory of Measuring Depression, Maastricht Vital Exhaustion, Freudenberger’s Burn Out Inventory. Results: Caregivers have fatigue, dissatisfaction and tendency of quitting profession. Scales show high burn-out, exhaustion and depression and show correlations. Depression correlates with vital exhaustion (r=0.549), depression moves with burn out r=0,528. SWLS correlates opposite with Vital Exhaustion: r = - 366. Coherence and SWLS shows statistically significance correlation: r=0,455. Conclusion: Indicators apply nurses are in risk conditions. More focus on workplace satisfaction, psychosocial care and stress management training is essential. .]