Cieľ: Cieľom štúdie bolo preskúmať, ako sestry vnímajú svoju úroveň dôstojného prístupu k pacientom v domovoch sociálnych služieb (DSS) a identifikovať, či existujú významné vzťahy medzi úrovňou dôstojného prístupu k pacientom v DSS a demografickými znakmi (vek sestier, dĺžka praxe, vzdelanie a pod.). Metodika: Výskumný súbor tvorilo 106 sestier pracujúcich v domovoch sociálnych služieb v zriaďovateľskej pôsobnosti Trnavského samosprávneho kraja. Výskum prebiehal v období december 2011 až február 2012. Na zistenie úrovne dôstojného prístupu sme využili autorizovaný dotazník: Posudzovanie etických problémov – dôstojný prístup k pacientovi. Tvorí ho 5 subškál (informovanosť pacientov; autonómia; dodržiavanie dôvernosti a ochrany informácií; princíp spravodlivosti; intimita). Štatistická analýza bola realizovaná softvérom SPSS, verzia 15.0. Výsledky: Svoju úroveň dôstojného prístupu k pacientom v domovoch sociálnych služieb hodnotili sestry ako primeranú. Medzi vnímanou úrovňou dôstojného prístupu sestier a demografickými údajmi boli nízke korelácie. Signifikantne vyššiu úroveň dôstojného prístupu sme zistili u sestier s vyšším vzdelaním (Bc.). Najnižšiu úroveň dôstojného prístupu k pacientom v domovoch sociálnych služieb sme zaznamenali v subškále zameranej na autonómiu pacienta. Záver: Na základe poznania týchto výsledkov môžeme podporovať zmeny, ktoré budú prispievať k zvýšenej kvalite poskytovanej ošetrovateľskej starostlivosti v domovoch sociálnych služieb., Aim: The aim of the study was to examine nurses’ perception of their own level of dignified approach to patients in social care homes and to identify potential statistically significant relationships between the level of dignified approach to patients in social care homes and demographic data (nurses’ age, duration of clinical experience, education etc.). Methods: The sample consisted of 106 nurses working in social care homes run by the Trnava Region. An authorized questionnaire called Assessment of Ethical Issues – Dignified Approach to a Patient was used to determine the level of dignified approach. The questionnaire consisted of five subscales (patient awareness; autonomy; respecting confidentiality; principle of justice; intimacy). Statistical analysis was carried out using the SPSS version 15.0 software. Results: The level of dignified approach to patients in social care homes was self-assessed by nurses as adequate. There was a low correlation between the perceived level of dignified approach to patients and demographic data. Nurses with higher education (bachelor’s degree) demonstrated significantly higher levels of dignified approach. The lowest level of dignified approach was found in the subscale focused on patient autonomy. Conclusion: Based on the knowledge of these results, changes may be promoted that will contribute to increased quality of nursing care provided in social care homes., Silvia Lelkešová, Ingrid Juhásová, and Literatura 19
Tento článek se zaměřuje na dostupnost zdravotní péče pro migranty v Německu v širších souvislostech současné migrace. Rozebírá legální nárok jednotlivých kategorií migrantů na zdravotní péči: migrantů s legálním pobytovým statusem, žadatelů o asyl a iregulérních migrantů. Zvláštní pozornost je věnována přístupu dětí ke zdravotní péči. Článek rovněž předkládá vybrané příklady dobré praxe ke zlepšení dostupnosti zdravotní péče a k začleňování migrantů do mainstreamového zdravotnického systému v Německu. - mecku, The article is focused on healthcare availability for migrants in Germany regarding broad context of current migration. A legal claim for healthcare of particular categories of migrants (e.g. migrants with residency status, asylum applicants and irregular migrants) is debated. A special attention is granted to healthcare availability for children. The article shows some examples of good practice in healthcare availability improvements and migrants ́ integration into mainstream health system in Germany., Karolína Dobiášová, Helena Hnilicová, Nikola Šimandlová, Petr Háva, and Literatura
The subject of liability for damage to client caused during performance of social services in residential establishments becomes increasingly relevant. As opposed to the liability for damage caused during performance of health services, this subject is rather underappreciated by general members of the legal profession. For this reason RILSA produced a study „Legal aspects of liability for damage caused to a client while providing a social-health care in residential establishment for social services“ that aimed to find out the level of knowledge among the providers of residential social services in the area of liability for damage. To find out the level of legal knowledge of providers of residential social services, a question form was distributed randomly in the Czech Republic. We found out, that providers of residential social services know about the existence of liability for damage and that they are insured. But in the case of significant incurred damage or in the case of more damages within one year the insurance coverage limit might not be sufficient. However, the knowledge of legal terms of liability for damage eventually caused to their clients is limited and current way of obtaining the knowledge by individual study is insufficient., Daniela Bruthansová, Věra Jeřábková, and Literatura
Cieľ: Výskum bol zameraný na identifikáciu drţania diéty u adolescentných respondentov a niektorých príčin jej drţania vo vzťahu k pohlaviu a veku. Metodika: Na získanie empirických dát boli pouţité vybrané poloţky sebaposudzovacieho meracieho nástroja s názvom Mapovanie stravovacích návykov medzi adolescentmi (The Project EAT Survey, Neumark- Sztainer et al.). Výskumnú vzorku tvorilo 387 adolescentných respondentov, toho času študentov prvých a štvrtých ročníkov stredných škôl. Výsledky: Podľa výsledkov výskumu ţeny častejšie drţia diéty (redukčné alebo pre jej udrţanie) či uţ v minulom roku (p = 0,002) aj v terajšej dobe (p = 0,000). Sú nespokojné so svojou hmotnosťou (p = 0,000) a postavou (p = 0,009). Respondenti vo veku 18 - 20 rokov uviedli, ţe si ich členovia rodiny doberali alebo si robili posmech z ich hmotnosti (p = 0,000). Vyššie percento ţien zaţilo negatívne hodnotenie ich hmotnosti zo strany členov rodiny (27,5 %) a vrstovníkov (33,5 %). Záver: Sestra v klinickej praxi môţe byť nápomocná pri identifikovaní drţania diét u adolescentov a jej príčin z hľadiska prevencie dopadu drţania diét na telesné a duševné zdravie adolescenta a pri realizácii uţ cielených intervencií, napr. edukácie v rámci takto obsahovo zameranej prevencie., Aim: The research was aimed at identifying dieting among adolescent respondents and some of the reasons for its keeping in relation to sex and age. Methods: For obtaining empirical data selected items of self-assessing measuring tool called Mapping dietary habits among adolescents were used (The Project EAT Survey, Neumark-Sztainer et al.). The research sample consisted of 387 adolescent respondents, previously high school students (of the first and fourth study year). Results: According to results of research women more frequently keep a diet (in order to lose weight or keep it the same) in last year (p = 0,002) as well as at present-day period (p = 0,000). They are not satisfied with their weight (p = 0,000) and figure (p = 0,009). Respondents aged 18-20 years reported that their family members have teased or made fun of their weight (p = 0,000). A higher percentage of women had experience a negative evaluation of their weight on the part of the family members (27,5 %) and peers (33,5 %). Conclusion: A nurse in clinical practice can be helpful in identifying dieting among adolescents and its causes in order to prevent the impact of diets on physical and mental health of adolescent and in the implementation of already targeted interventions, e.g. education in the context of the following content targeting prevention., Michaela Miertová, and Literatura 40
Cíl: Posoudit efekt samoléčby a autodiagnózy dysmenorey u studentek univerzity v Maiduguri. Metody: 289 studentek trpících dysmenorhoeou z celkového počtu 25 000 studentek univerzity v Maiduguri ze státu Borno, Nigerie, bylo randomizováno k léčbě dysmenorey. Studentky byly vybrány na základě dotazníku, který vyplnily v lednu 2011. Výsledky: Střední věk ± směrodatná odchylka (SD) účastnic byl 22.50 ± 3.12 roku. 112 (38.8 %) užívalo analgetika a nefarmakologické prostředky k tišení bolesti, buď současně, nebo následně (p < 0.001). Nejčastějšími nemedikamentózními prostředky byly horká lázeň (15.2 %) a ohřívací dečka umístěná na podbřišek (5.5 %). Nejčastějšími léky byly nesteroidní antirevmatika (NSAID) užívané při nástupu menstruace. V 72 % byla léčba účinná, ve 4.2 % nebyla. Většina účastnic se medikovala sama a nezabývala se možnými vedlejšími účinky (p < 0.001). Většina účastnic (63 %) utratila 300 Nigerijských Naira a méně (1.9 US Dolarů a méně) za léčbu dysmenorey. Závěry: Výsledky potvrdily, že NSAID byly nejčastěji užívané medikamenty k léčbě dysmenorey, ale většinou bez znalosti potencionálních vedlejších účinků. Proto doporučujeme zapojení profesionálních zdravotníků do tohoto procesu., Objective: This study was performed to evaluate self-medication for the treatment of self-diagnosed dysmenorrhoea among a group of University of Maiduguri female students. Methods: The population of this randomized study was 289 female students suffering from dysmenorrhoea out of over 25 000 students attending a college of medicine and eight non-medical faculties of university of Maiduguri in Borno state, Nigeria. The students were interviewed using a self-administered pre-tested structured questionnaire in January, 2011. Results: The Mean ± Standard Deviation (SD) of age of the participants was 22.50 ± 3.12 years. Significant number 112 (38.8%) of participants use drugs to remedy menstrual pains followed by non-drug therapy while few combine both the drug and non-drug therapy for the pain management (p < 0.001). The most common non drug remedies employed by the participants were taking a hot bath (15.2%) and placing a heating pad on abdomen (5.5%). However, the most common drugs used by the participants were Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) which were usually taken orally at the onset of menstruation. Among the participants that used drug, 72% found it effective while 4.2% reported ineffectiveness. Significant majority of the participants usually self-prescribed their drugs, and were ignorant of the common side effects of these drugs (p < 0.001). Most participants (63%) spent 300 Nigerian Naira and below (1.9048 US Dollar and below) on drugs for dysmenorrhoea every month. Conclusion: The results confirmed that NSAIDs were the most common drugs used for dysmenorrhoea treatment, but frequently used without knowledge of potential side effects due to self-medication. Therefore, we recommend educational intervention by health care professionals., Roland Nnaemeka Okoro, Helen Malgwi, Cyprian Kingsley Ngong, Glory Ogechi Okoro, and Literatura 30
In order to study cardiac pathology in different subtypes of ischemic stroke we examined 165 stroke patients. The 1st group included 90 (54.5%) patients with hemodynamic stroke, the 2nd one - 75 (45.5%) patients with cardioembolic stroke. Control group consisted of 45 individuals without cerebrovascular diseases. Cardiac pathologies with the prevalence of various types of ischemic heart disease were observed in all groups. The parameters of left ventricular stroke volume and ejection fraction were lower in patients with hemodynamic stroke than in other groups, but were within normal limits. Potential sources of cardiogenic embolism were found in all groups: in the 1st group at 74.4%, in the 2nd one at 100%. Thus, most patients with ischemic stroke have different heart defects related to the subtypes of ischemic stroke., Natalya Dadamyants, and Literatura
The disabling nature and lifelong impact of multiple sclerosis (MS) imposes considerable socioeconomic burden despite its relative low prevalence compared to other chronic diseases. This is the first study of MS in the Slovak Republic that provides information about healthcare and social expenditures including costs of productivity loss caused by reduced work capacity of patients with MS. Retrospectively direct and indirect costs of MS were investigated by prevalence based "bottomup" approach. The societal and health insurance perspective was used to perform the overall economic burden caused by MS in Slovakia. The human capital method was used for the calculation of indirect costs, as this is the most common method applied in published studies. As not all detailed data on expenditures were available, the missing data were collected in the retrospective patient research. Total annual costs in 2010 for 6.100 dispensed patients with MS in Slovakia were 54.723.592. Indirect costs (31.728.757) prevailed over direct costs (22.994.834). The highest part of both costs were 25.207.512 and 12.641.052 for loss productivity due to patients sickness and invalidity pensions and diseasemodifying drugs respectively. The average cost per patient independently of disease severity was 8.971. MS causes a high economic burden, with a strong predominance of indirect costs. Documenting and quantifying this burden among patients with MS in different disease stages through costofillness study can lead to better disease management and it can provide valuable information for future cost analysis and for decisionmaking process., Mária Pšenková, Stanislava Mackovičová, Alexander Palúch, Tatiana Foltánová, Lenka Petrová, and Literatura
Objectives: The aim of this study was to elucidate the role of dopamine receptor D2 / ankyrin repeat and protein kinase domain containing 1 (DRD2/ANKK1) TaqIA allelic polymorphism in the HPVinduced cervical carcinogenesis. Methods: 1. Effect on the risk of cervical precancer: After an 8year followup, out of 214 women with persisting highrisk HPV infection, 102 developed highgrade cervical dysplasia or cervical intraepithelial neoplasia (CIN) grade III, while 112 did not. The subjects were genotyped for the DRD2/ANKK1 TaqIA polymorphism by PCRRFLP, and the allelic distributions were compared between groups with and without highgrade dysplasia. 2. Prognostic value: Two hundred and thirty nine women with cervical precancer/cancer were followed for 5 years. Complete remission was achieved at 182 women. To assess the prognostic value of the TaqIA polymorphism, genotype frequencies were compared between patients reaching and not reaching complete remission. Results: The frequency of A1/A1+A1/A2 genotypes was higher among women who developed highgrade cervical dysplasia (OR: 1.87, 95% CI: 1.053.33; p=0.034) than in the other group. Occurrence of the A1 allele was more frequent among women who did not reach complete remission (OR: 2.00, 95% CI: 1.073.74; p=0.030) than in women with complete remission. Conclusions: This is the first report on the possible involvement of DRD2/ANKK1 TaqIA polymorphism in cervical carcinogenesis. The A1 allele seems to increase the risk of cervical precancer, and it may also be associated with a worse prognosis in women with HPVinduced cervical cancer. The results need further validation in largescale molecular epidemiological studies., József Cseh, Zsuzsa Orsós, Emese Pázsit, Erika Marek, András Huszár, István Ember, István Kiss, and Literatura
Aldosterone blocker Spironolactone has antiinflammatory, antiproliferative and antioxidative effects, that is why pathogenetically it is expedient to use it in complex therapy of rheumatoid arthritis. Material and methods: 46 patients with RA took 2550 mg/day of Spironolactone during 12 months as an addition to standard therapy, the comparison group consisted of 47 patients that got only standard therapy, all the patients were fully examined prior and post the treatment. Results: complex RA therapy leads to improved VAS, HAQ, the antioxidative potential index F; decreased blood concentrations of TNFα, ICAM1, FGF and VEGF in contrast to standard therapy. Complex therapy made reduced the DAS 28 more > 0.6. Conclusions: applying of Spironolactone in complex therapy of rheumatoid arthritis contributes to more pronounced improvement in indices of articular syndrome and patients life quality, reduce of antiinflammatory, antiproliferative and angiogenic cytokines, and more effectively reduces the activity of the disease comparing to standard therapy., Elena Komarova, Borys Rebrov, and Literatura