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Clinical Neuroscience

JANUARY 30, 2019

[Multiple ischemic stroke in Osler-Rendu-Weber disease]

SALAMON András, FARAGÓ Péter, NÉMETH Viola Luca, SZÉPFALUSI Noémi, HORVÁTH Emese, VASS Andrea, BERECZKY Zsuzsanna, TAJTI János, VÉCSEI László, KLIVÉNYI Péter, ZÁDORI Dénes

[Hereditary hemorrhagic teleangiectasia (HHT, Osler-Rendu-Weber disease) is an autosomal dominantly inherited disorder caused by the mutation of several possible genes and characterized by malformations of the arteriovenous system in multiple organs. The clinical diagnosis is based on the Curaçao criteria ((1) spontaneous, recurrent epistaxis; (2) teleangiectasias in characteristic sites (lips, oral cavity, nose, fingers); (3) visceral lesions (gastrointestinal, pulmonary, cerebral, spinal); (4) affected first degree relative). The aim of this study is to present the first genetically confirmed Hungarian case of hereditary hemorrhagic teleangiectasia with multiple ischemic strokes. Our 70-year-old woman has been suffering from severe epistaxis since her childhood and presented gastrointestinal bleeding during her adulthood as well. The characteristic skin lesions developed in the 5th decade of life. She was admitted to our department with loss of consciousness and fluctuating speech and swallowing problems. MRI of the brain supplemented with angiography revealed multiple arteriovenous malformations and multiple subacute ischemic lesions. The EEG demonstrated slowing of electric activity in the left frontal lobe. The neuropsychological assessment showed deficits in anterograde memory and executive functions. The diagnostic work-up for other characteristic alterations identified an arteriovenous malformation in the left lung. The genetic analysis demonstrated a heterozygous mutation in the 7th exon of the ENG gene at position 834 resulting in a thymine duplication and an early stop codon by a frame shift. The present case is largely similar to those already described in literature and draws the attention to the importance of multidisciplinary collaboration in the care of HHT patients.]

Journal of Nursing Theory and Practice

AUGUST 30, 2018

[Career Model of Primary Care Workers]

HIRDI Henriett Éva, BALOGH Zoltán

[The aim of the study: To assess the working conditions and level of job satisfaction of health professionals in primary care, and to explore key elements for a succesful career model. Methods: The cross-sectional survey was conducted between 12 March 2018 and 06 April 2018 among health professionals working in primary care, selected using a random, sampling method. The data gathering took place using a web-based, anonymous, self-completion questionnaire. For data analysis they used SPSS version 25.0 with Chi square test (p<0,05). Results: The sample size of the research comprised of 3740 persons, the average age was 44.87 years. The heath professionals are generally satisfied with their work schedule (74.8%), but they expressed the least satisfaction (81.5%) with their financial compensation. According to these survey results, pay is significant. 96.2% of respondents would like to be compensated according to new government-regulated pay scales. Conclusions: It can be stated that increasing the job satisfaction of health professionals and to elaborate the career model of them would be of crucial importance. Key elements of a successful career model offers benefits that are essential for health professionals retention: direction and motivation. ]

Journal of Nursing Theory and Practice

AUGUST 30, 2018

[Work Values Preference among hospital midwives]

GEBRINÉ ÉLES Krisztina, SÁRVÁRY Andrea, SÁRVÁRY Attila, TAKÁCS Péter, LAMPEK Kinga

[The Aim of the Study: The aim of the research was to explore the structure of work values among midwives. Material and Method: Cross sectional study was used with Super‘s Work Values Inventory from 13 hospitals across Hungary. Our questionnaire was divided into 370 midwives, 224 were evaluated. We calculated mean and standard deviation in descriptive statistical analysis. We did factor analysis; variance analysis and post-hoc LSD (Least Significant Difference) test. Results: The most preferred work values were altruism, finances and hierarchy. The level of education influenced the hierarchy of work values. The factor analysis separated two secondary factors: working condition and the self-realisation. There was a significant difference between midwives with OKJ education level and midwives with BSc degree (p=0,014), and other qualifications (p=0,033). Conclusions: Our results suggest that a higher level of education gives the foundation of professional competencies which enable the employee to take conscious consideration of other employee’s views in health care. ]

Journal of Nursing Theory and Practice

JUNE 30, 2018

[Survey of patient education among patients with hip arthroplasty]

BÉKÉS Brigitta, KIRÁLY Edit, BALOGH Zoltán

[Aim of the study: To analyse the training level of patients underwent hip replacement therapy in different periods of their health care. Methods: Traumatology and orthopaedic departments, ambulances and musculoskeletal rehabi-litations took part in the research. A self-made questionnaire was distributed among doctors and health professionals who cured these patients directly. The received data was analysed with the IBM SPSS Statistics 20. program. ANOVA test, 2-sample T-test and Chi-squared test were applied to analyse the coherences. P<0,05 was defined as the value of the significance limit. Results: 86 health care professionals participated in the survey. The overwhelming majority of them (45%) reported that unstructured, postoperative patient education was characteristic. Their education was dominated by communication techniques (n=68), while among the instrumental methods the use of information leaflets was dominated (n=13). Their activity was limited by the time lag and work overload (76%). Analysing the training levels, it was found that information about lifestyle changes and post-operative mobilization was significantly underused. Conclusion: Significant insufficiency were found in the education of the patients in terms of organization, and in the teaching methods and topics which were further aggravated by the mentioned hindering factors. ]

Journal of Nursing Theory and Practice

JUNE 30, 2018

[Nursing career of the high-school students]

TISÓCZKI Evelin, BALOGH Zoltán

[Aim of the research: The aim of the study is to analyze the trends of student orientation in the age and compulsory education process by age group. In our research, we would like to answer the question of how much „popularity” the health care profession as a professional area among students participating in Hungarian public education. If you feel this area of expertise close to you, what kind of vision you have. Research and sampling methods: A self-constructed questionnaire was administered during 24 Oct 2017 - 13 Jan 2018. In all counties of Hungary, the authors sent it to at least one of the training sites and filled up with me (N=329). These training sites are involved in healthcare training. Data were analysed with SPSS 15.0 for Windows statistical program. Chi square, Mann-Whitney tests were applied (p <0,05). Results: Out of the 159 people (48%), 170 (52%) in the family have healthcare workers. When performing the controls of the distributions, we can conclude that there is no significant difference in the distribution between the two groups, so there is the same number - that is, statistically significant difference - of the proportion of those willing to choose the health care path. In terms of career choice, 276 (86%) of respondents believe it is likely to be oriented towards the health care path, with 46 people (14%) planning their life is in another direction. Seven of its principal did not answer the question. By completing the Mann-Whitney test, we can conclude that there is no significant difference between the two groups in the medians, so there is no difference - that is, statistically significant difference - with respect to career choice as a nursing profession’s esteem. Of the 329 participants, 215 (65%) replied that they would like to work as a nurse, while 114 (35%) responded that they would not choose this job. Conclusion: Don’t influence significantly the career entrant if there is a healthcare worker in the family. Who stand in front of career choice don’t influence significantly the appreciation but is more motivated by sympathy and helplessness toward another person.]

Clinical Neuroscience

SEPTEMBER 30, 2018

A multidisciplinary clinical approach to facioscapulohumeral muscular dystrophy

CAKMAK Öztop Özgür, EREN Ilker, ASLANGER Ayca, GÜNERBÜYÜK Caner, KAYSERILI Hülya, OFLAZER Piraye, SAR Cüneyt, DEMIRHAN Mehmet, ÖZDEMIR Gürsoy Yasemin

Background - Impaired shoulder function is the most disabling problem for daily life of Fascioscapulohumeral muscular dystrophy (FSHD) patients. Scapulothoracic arthrodesis can give a high impact to the functionality of patients. Here we report our experience with scapulothoracic arthrodesis and spinal stenosis surgery in FSHD patients. Patients and methods - 32 FSHD patients were collected between 2015-2016. Demographical and clinical features were documented. All the patients were neurologically examined. The Medical Research Council (MRC) and the FSHD evaluation scale was used to assess muscle involvement1. Scapulothoracic arthrodesis and spinal stenosis surgeries were performed in eligible patients. Results - There were 16 male and 16 female (mean age 34.4 years; range 12-73) patients. 6 shoulders of 4 patients aged between 2132 years underwent scapulothoracic arthrodesis (two bilateral, one left and one right sided). Only one 63 years old female patient with severe hyperlordosis had spinal fusion surgery. All of the patients undergoing these corrective surgeries have better functionality in daily life, as well as superior shoulder elevation. Conclusion - Until the emergence and clinical use of novel therapeutics, surgical interventions are indicated in carefully selected patients with FSHD to improve arm movements, the posture and the quality of life of patients in general. Scapulothorosic arthrodesis is a management with good clinical results and patient satisfaction. In selected cases other corrective orthopedic surgeries like spinal fusion may also be considered.

Journal of Nursing Theory and Practice

APRIL 30, 2018

[The psychological Well-being and Burnout among Ambulance Personnel]

IVÁNKOVITS László

[The aim of the study: The aim of the presented study was to investigate the psychological well-being and burnout among ambulance personnel of the Hungarian National Ambulance Service. Our goal was to identify the ambulance specific stressors that negatively affect the psychological health of personnel and lead to burnout. Material and method: The quantitative, cross-sectional study included 1979 ambulance personnel. Level of burnout was measured by Pines-Aronson Burnout Inventory. SPSS version 17.0 was used for statistical analyses. Types of analyses included Khi square test, ANOVA and correlation analysis. Level of significance was defined at p<0.05. Results: The 40% of ambulance personnel are affected by job-related stressors. The heightened and constant state of readiness does not let time for discussing work-related experiences. There was significant correlation between burnout level, years worked at NAS, and the evaluation of workplace circumstances and climate. Conclusion: Due to the results of the present study we created different possibilities of prevention and intervention that can help handle the symptoms of burnout among ambulance personnel.]

Journal of Nursing Theory and Practice

APRIL 30, 2018

[Safe Handover - Opportunities to improve Patient Handover]

SINKA Lászlóné Adamik Erika, BÖCSKEI Anna, VASS Zsolt, GÖBÖLY Ágnes

[Mistakes, errors made in the patient handover process can result in severe outcomes, but with appropriate measures it is possible to decrease their numbers. Therefore, we considered it important to develop a methodology which would help us analysing our internal processes. Getting to know the current situation well provides the opportunity to implement those changes into our daily work which focus on the actual problems, and which could lead to measurable improvements in our everyday work processes. ]

Lege Artis Medicinae

AUGUST 30, 2018

[Depression, anxiety and suicidal behavior. Recognition and care]

RIHMER Zoltán, BLAZSEK Péter, HARGITTAY Csenge, KALABAY László, TORZSA Péter

[Depression and anxiety disorders are major problems both in psychiatric and in general practice because of their frequency and recurring character. Owing to their common complications (suicide, suicide attempts, secondary alcoholism / drug disease, increased cardiovascular and cerebrovascular morbidity and mortality, loss of work, social isolation, etc.) they are the cause of significant individual, family and social burdens. In our paper we review the clinically revealable suicide risk and protective factors that can be observed in depression and anxiety disorders as well as the main aspects of the recognition and care of suicidal patients. With available medicines and non-pharmacological therapies, the vast majority of depressive and anxiety patients can be successfully treated and in most cases we can prevent suicidal behavior associated with these diseases. Besides psychiatrists general practitioners as well play a significant role in preventing suicidal behavior and in the recognition of suicide risk. ]

Lege Artis Medicinae

AUGUST 30, 2018

[The Galilei of Bertolt Brecht and László Németh]

KELEMEN Gábor, ERDŐS Márta

[The trial of Galileo, who abjured his scientific convictions in the face of the Inquisitions was the most persistent and disturbing artistic theme of both Bertolt Brecht’s and Németh Laszlo’s writing careers. All three of them attended medical school. Galileo and Brecht never graduated whilst Németh’s medical work was subordinated to the art which became his vocation. The authors examine the genesis of Brecht’s and Németh’s dramas on Galileo, the possible effect of their medical studies or practice and their illnesses on their plays, and compare the work of the artists. This paper shows the process of their evaluating and re-evaluating their works and their struggle for further development of their artistic vision. Brecht’s and Németh's dramas, together with their formations and effects, can illuminate our understanding of the historically changing perpectivity of the scientific and artistic truth. ]