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Nursing challenges in palliative care
No full textPalijativna medicina predstavlja granu medicine u kojoj je potrebna aktivna i potpuna skrb o pacijentima s uznapredovalom progresivnom bolešću. Palijativna skrb stavlja naglasak na vrijednost života na način da se unaprijedi kvaliteta života, a usmjerena je na cjelokupan pristup kod pacijenata u zadnjem stadiju bolesti. Cilj ovog rada je prikazati probleme s kojima sa medicinske sestre/tehničari susreću prilikom provedbe aktivnosti palijativne zdravstvene njege. Holistički pristup koji u obzir uzima tjelesno, psihološko i duhovno stanje izrazito je bitan palijativnim pacijentima. Takav pacijent zahtijeva kontinuiranu 24 satnu brigu koja može trajati nekoliko dana do nekoliko godina. Dobro znanje, komunikacijske vještine i empatija medicinskog i nemedicinskog osoblja olakšavaju svakodnevnu brigu za takve pacijente. Multidisciplinarni tim koji se brine o pacijentu sačinjavaju stručnjaci iz medicinskog i nemedicinskog područja, a sačinjavaju ga najčešće: liječnik, medicinska sestra, psiholog, fizioterapeut, socijalni radnik, dijetetičar, svećenik i volonteri. Komunikacija je ključ uspješnog tima, a zadaća medicinske sestre prilikom provođenja palijativne skrbi je prepoznati određene znakove i simptome i na vrijeme reagirati kako bi se riješili isti te pružiti pacijentu psihološku, socijalnu i duhovnu potporu. Najveći izazov u sustavu palijativne skrbi je sama organizacija, odnosno nedostatak resursa. Pravilna komunikacija i etički odnos prema pacijentu, obitelji pacijenta i timu također predstavlja jedan od izazova palijativne skrbi. Medicinske sestre se često susreću i sa sindromom izgaranja na poslu zbog količine odgovornosti i konstantnog emocionalnog angažmana.Palliative medicine is a part of medicine that requires active and complete care for patients with advanced progressive disease. Palliative care emphasizes the value of life in a way that improves the quality of life, and focuses on the overall approach of patients in the final stages of the disease. The aim of this paper is to present the problems that nurses encounter during the implementation of the palliative care process. A holistic approach that takes into account physical, psychological and spiritual condition is extremely important for palliative patients. Such a patient requires continuous 24-hour care that can last from a few days to several years. Good knowledge, communication skills and empathy of medical and non-medical staff facilitate the daily care of such patients. The multidisciplinary team caring for the patient consists of experts from the medical and non-medical fields, and consists of the most common: doctor, nurse, psychologist, physiotherapist, social worker, dietitian, priest and volunteers. Communication is the key to a successful team, and the task of the nurse in palliative care is to recognize certain signs and symptoms and react in time to address them and provide the patient with psychological, social and spiritual support. The biggest challenge in the palliative care system is the organization itself, ie the lack of resources. Proper communication and ethical attitude towards the patient, the patient’s family and the team is also one of the challenges of palliative care. Nurses also often experience burnout syndrome at work due to the amount of responsibility and constant emotional engagement
THE VALUE OF ULTRASOUND IN THE DIAGNOSIS OF SHOULDER PAIN
No full textSustavnim pregledom različitih izvora literature nastojalo se doći do zaključaka o vrijednosti ultrazvuka u dijagnostici bolnog ramena. Sindrom bolnog ramena uključuje čitav niz patoloških situacija poput rupture rotatorne manšete, subakromijalnog sraza, sindroma smrznutog ramena, kalcificiraućeg tenditisa, itd. Po prijavi bolnosti, pacijent se obično za početak podvrgava kliničkom pregledu pri čemu liječnik uzima detaljnu anamnezu. Nakon kliničke procjene obično je potrebno dijagnostičko snimanje. Jedna od često korištenih metoda u dijagnostici bolnog ramena je ultrazvuk, no kvaliteta same dijagnostike uvelike ovisi o znanju i sposobnostima liječnika ili tehničara koji pregled izvodi. Za razliku od CT, MRI i RTG dijagnostike, UZV se može provoditi u stanju mirovanja pacijenta s rukom u određenim položajima, u ovisnosti o dijelu ramene strukture koja se pregledava, ali i dinamički odnosno dok pacijent izvodi pokrete rukom. UZV je u širokoj primjeni kod dijagnostike mekanih struktura ramena, baš kao i MRI koji se još uvijek smatra glavnim alatom. Međutim, u usporedbi s ostalim metodama, UZV se pokazao bržim i dostupnijim rješenjem za pacijente jer ima izrazito nisku cijenu, nije invazivan, brzo se provodi i daje podatke u stvarnom vremenu. Najučinkovitiji se pokazao u procjeni površinskih tkiva, međutim, ne može prikazati unutarnje zglobne strukture. Koristi ga se u procjeni različitih patologija ramena, no najbolje rezultate pokazao je kod otkrivanja ruptura rotatorne manšete, kalcificirajućeg tendonitisa i potpune rupture tetive duge glave bicepsa, dok je, primjerice, za procjenu njezine parcijalne rupture osjetljivost ultrazvuka puno slabija u odnosu na MRI dijagnostiku.A systematic review of various literature sources led to conclusions about the value of ultrasound in the painful shoulder diagnosis. Painful shoulder syndrome includes a number of pathologies such as rotator cuff ruptures, subacromial collision, frozen shoulder syndrome, calcifying tenditis, etc. After reporting pain, the patient usually undergoes a clinical examination. Diagnostic imaging is usually required after clinical evaluation. One of the frequently used methods in the diagnosis of painful shoulder is ultrasound, but the quality of the diagnosis itself largely depends on the knowledge and skills of the technician who performs the examination. Unlike CT, MRI and X-ray diagnostics, ultrasound can be performed at rest of the patient with the hand in certain positions, depending on the part of the shoulder structure that is imaged, but also dynamically or while the patient performs hand movements. Ultrasound is widely used in the diagnosis of soft shoulder structures, just like MRI which is still considered the main tool. However, compared to other methods, ultrasound has proven to be a faster and more affordable solution for patients because it has an extremely low cost, it is not invasive, it is quickly implemented and provides real-time data. It has been shown to be most effective in assessing superficial tissues, however, it cannot show internal joint structures. It is used to assess various shoulder pathologies, but it has shown the best results in detecting rotator cuff ruptures, calcifying tendonitis, and complete rupture of the long biceps tendon, while, for example, to assess its partial rupture, ultrasound sensitivity is much lower than MRI diagnostics
ATTITUDES OF NURSES-TECHNICIANS OF RESPIRATORY INTENSIVISTIC CENTER OF CLINICAL HOSPITAL CENTER SPLIT ON VACCINATION AGAINST COVID-19 DISEASE
No full textCILJ ISTRAŽIVANJA: Istražiti koji su stavovi medicinskih sestara/tehničara Respiracijsko-intenzivističkog centra Kliničkog bolničkog centra Split o cijepljenu protiv virusa Covida 19, analizirati utječu li sociodemografska obilježja na stavove o cijepljenu protiv koronavirusne bolesti te ispitati jesu li medicinske sestre/tehničari koji su preboljeli bolest skloni odbijanju cijepljenja.
MATERIJALI I METODE: Prospektno istraživanje je provedeno u Respiracijsko-intenzivističkom centru KBC-a Split u vremenskom razdoblju od 31.03. 2021. do 01.06.2021. godine. U istraživanju je sudjelovalo ukupno 124 ispitanika, od koji su 108 bile medicinske sestre, a 16 medicinskih tehničara. Istraživanje je provedeno pomoću anonimnog upitnika.
REZULTATI: U Respiracijsko-intenzivističkom centru Kliničkog bolničkog centra Split provedeno je istraživanje stava medicinskih sestara i tehničara o cijepljenju protiv bolesti COVID-19. U istraživanju je sudjelovalo 108 medicinskih sestara i 16 medicinskih tehničara, većinom dobi između 19 i 30 godina. Analizom rezultata anketnih upitnika došlo se do spoznaje kakav je stav medicinskih sestara i tehničara o cijepljenju protiv koronavirusne bolesti. Rezultati istraživanja su pokazali da se veći dio ispitanika Respiracijsko-intenzivističkog centra KBC-a Split već cijepio protiv bolesti COVID-19 (n=55; 44,35%), te ih je 4,23 puta više u odnosu na zastupljenost ispitanika koji se sigurno ne bi cijepili. Ispitivanjem je utvrđeno postojanje razlike u zastupljenosti prema stavu o cijepljenju (p<0,001).
ZAKLJUČCI: Većina medicinskih sestara i tehničara zaposlenih u Respiracijsko-intenzivističkom centru Kliničkog bolničkog centra Split su već cijepljeni protiv bolesti COVID-19, shvaćaju ozbiljnost bolesti i njenog utjecaja na populaciju u cjelini te su skloni savjetovati i preporučiti cijepljenje svojim bližnjima. Iako su preboljeli koronavirusnu bolest, većina medicinskih sestara i tehničara Respiracijsko-intenzivističkog centra KBC-a Split je sklono cijepljenju protiv bolesti COVID 19. Demografski podaci ne utječu na stav o cijepljenu protiv bolesti COVID-19. Zaposlenike Respiracijsko-intenzivističkog centra KBC-a Split od cijepljenja najviše odvraća brzina razvoja cjepiva i u skladu s tim, strah od mogućih nuspojava.AIM: Investigate the attitudes of nurses / technicians of the Respiratory Intensive Care Center of the Clinical Patient Center Split about vaccination against Covida 19 virus, analyze whether sociodemographic characteristics affect attitudes about vaccination against coronavirus disease and examine whether nurses / technicians who have survived the disease are prone to.
MATERIALS AND METHODS: The prospective research was conducted in the Respiratory and Intensive Care Center of the Clinical Hospital Center Split in the period from 31.03. 2021 to 01.06.2021 years. A total of 124 subjects participated in the study, of whom 108 were nurses and 16 medical technicians. The research was conducted using an anonymous questionnaire.
RESULTS: A study of the attitudes of nurses and technicians on vaccination against the COVID-19 disease was onducted at the Respiratory Intensive Care Center of the Clinical Hospital Center Split. The study involved 108 nurses and 16 medical technicians, mostly aged between 19 and 30 years. The analysis of the results of the survey questionnaires revealed the attitude of nurses and technicians about vaccination against coronavirus disease. The results of the research showed that the majority of the respondents of the Respiratory-Intensive Care Center of the Clinical Hospital Center Split have already been vaccinated against the COVID-19 disease (n = 55; 44.35%), and they are 4.23 times more than the number of respondents they certainly would not be vaccinated. The study revealed a difference in representation according to the attitude towards vaccination (p <0.001).
CONCLUSIONS: Most nurses and technicians employed at the Respiratory Intensive Care Center of the Clinical Hospital Center Split have already been vaccinated against the COVID-19 disease, understand the severity of the disease and its impact on the population as a whole and tend to advise and recommend vaccination to their loved ones. Although they have recovered from coronavirus disease, most nurses and technicians at the Respiratory Intensive Care Center of KBC Split are prone to vaccination against the COVID 19 disease. Demographic data do not affect the view of vaccination against the COVID-19 disease. Employees of the Respiratory-Intensive Care Center of KBC Split are most deterred from vaccination by the rapid development of vaccines and, accordingly, the fear of possible side effects
CT COLONOGRAPHY
No full textUvod: Kompjutorizirana tomografska kolonografija dijagnostička je metoda koja se razvijala više od desetljeća i postoji veliki broj provedenih studija u svrhu opisivanja njenih mogućnosti. Upotrebom CT uređaja novih generacija te softverskim napredcima omogućena je analiza debelog crijeva u relativno kratkom vremenu. S druge strane, visoka osjetljivost za detekciju polipa te otkrivanje abnormalnosti sluznice CTC čine zanimljivom i poželjnom metodom.
Cilj rada: U ovome radu cilj je odrediti prednosti te nedostatke CT kolonografije, a ujedno i njenu ulogu prilikom probira karcinoma debelog crijeva.
Rasprava: U usporedbi s kolonoskopijom CTC predstavlja manje invazivnu tehniku za koju nije potrebna sedacija. Osim prednosti, CT kolonografija povezana je s nekim nedostatcima. Pregledom istraživanja dokazan je vrlo mali postotak komplikacija koje se mogu javiti tijekom postupka, a glavno ograničenje CTC predstavlja ionizirajuće zračenje. Unatoč tome, proglašena je sigurnom i prihvatljivom metodom. Upravo zbog toga koristi se za brojne indikacije, a važna je njegova uloga za otkrivanje kolorektalnog karcinoma. Zbog činjenice da karcinom debelog crijeva predstavlja veliki problem u svijetu, njegova učestalost i smrtnost pokušava se smanjiti koristeći metode probira. U odnosu na druge tehnike, CTC nudi sigurniju i točnu procjenu stanja debelog crijeva. Iako kolonoskopija predstavlja zlatni standard, ukoliko je kontraindicirana ili nemoguća za izvesti, CTC je prihvatljiva alternativa.
Zaključak: CT kolonografija u konačnici predstavlja idealnu ravnotežu zbog minimalne invazivnosti, a visoke osjetljivosti. Napretkom tehnologije, CT uređaja i softvera, značajno će rasti i osigurati svoje mjesto u zdravstvu.Introduction: Computed tomographic colonography is a diagnostic method that has been developed for more than a decade and there are a large number of studies conducted to describe its capabilities. The use of new generation CT devices and software advances have enabled the analysis of the colon in a relatively short time. On the other hand, high sensitivity for polyp detection and detection of CTC mucosal abnormalities make it an interesting and desirable method.
Aim: In this paper, the aim is to determine the advantages and disadvantages of CT colonography, as well as its role in screening for colon cancer.
Discussion: Compared to colonoscopy, CTC is a less invasive technique that does not require sedation. In addition to the advantages, CT colonography is associated with some disadvantages. A review of the research proved a very small percentage of complications that can occur during the procedure, and the main limitation of CTC is ionizing radiation. Nevertheless, it has been declared a safe and acceptable method. That is why it is used for numerous indications, and its role in detecting colorectal cancer is important. Due to the fact that colon cancer is a major problem in the world, its incidence and mortality are trying to be reduced using screening methods. Compared to other techniques, CTC offers a safer and more accurate assessment of colon status. Although colonoscopy is the gold standard, if it is contraindicated or impossible to perform, CTC is an acceptable alternative.
Conclusion: CT colonography ultimately represents an ideal balance due to minimal invasiveness and high sensitivity. With the advancement of technology, CT devices and software, it will grow significantly and secure its place in healthcare
INFLUENCE OF NURSES IN PATIENT EDUCATION ON INTENSIVE INSULIN THERAPY
No full textPrema Svjetskoj zdravstvenoj organizaciji šećerna bolesti (ŠB) je karakterizirana kao kronična metabolička bolest i veliki javnozdravstveni problem obilježen povišenom razinom glukoze u krvi tj. hiperglikemijom što može dovesti do raznih oštećenja krvnih žila, živaca, srca ili bubrega. Pravovremenim i holističkim pristupom liječenju ŠB možemo uvelike smanjiti rizik nastanka akutnih i kroničnih komplikacija te postići bolju kvalitetu života i produljiti očekivano trajanje istog. Prema Američkom udruženju za dijabetes (ADA) ŠB možemo podijeliti u 4 kategorije: ŠBT1, ŠBT2, specifični tipovi šećerne bolesti i gestacijski dijabetes. Na ŠB mogu ukazivati mnogi simptomi od kojih su najčešći dehidracija, poliurija, nikturija, polifagija, ketoacidoza itd...Cilj ovog rada je objasniti značaj tj. ulogu medicinske sestre / edukatora u edukaciji bolesnika na intenziviranoj terapiji inzulinom. Važno je pacijentu objasniti što je to inzulin, na koji način i zašto se primjenjuje, te ga upoznati o komplikacijama ŠB, načinima prehrane u skladu s intenziviranom inzulinskom terapijom te tjelesnoj aktivnosti koju smije provoditi pri ovakvom načinu liječenja. Najvažnije od svega je primjerena i prilagođena komunikacija medicinske sestre pacijentu, što je ključ uspješno provedene edukacije.According to the World Health Organization (WHO), diabetes ic characterized as a chronic metabolic illness and a major public health matter. It is recognizable by an elevated blood glucose level, or hyperglycemia, which can lead to numerous issues related to blood vessels, nerves, heart or kidneys. With a timely and holistic approach to the treatment of diabetes, we can greatly reduce the risk of acute and chronic complications and achieve a better quality of life and extend the expected duration. According to the American Diabetes Association (ADA), diabetes can be divided into 4 categories: type 1 diabetes, type 2 diabetes, specific types of diabetes and gestational diabetes. Many symptoms can indicate diabetes, some of the most common are dehydration, polyuria, nocturia, polyphagia, ketoacidosis, etc. The aim of this paper is to explain the role of the nurse in the education of patients on intensified insulin therapy . It is important to explain to the patient what insulin is, on wich way does it work and what it is aplied for. Above all to inform patients about the complications of diabetes, ways of eating in accordance with IIT, and the physical activity he is allowed to carry out with this type of treatment. The most important thing of all is appropriate and adapted communication between the nurse and the patient, which is the key to successfully conducted education
Molecular diagnostics of SARS-CoV-2 virus
No full textCilj rada: Cilj ovog rada bio je teorijski prikazati i razjasniti karakteristike i građu virusa SARS-CoV2, opisati trenutno dostupne dijagnostičke metode za analizu virusa i prikazati najbolju dijagnostičku tehniku, RT-PCR molekularnu metodu.
Materijali i metode: U ovom radu opisan je postupak molekularne metode dijagnostike SARS-CoV-2 dijagnostike na BIO-RAD CFX96 RT- PCR uređaju uz korištenje reagensa LiliF Master Mix kit za pripremu reakcijske smjese, koji se koriste u Nastavnomzavodu za javno zdravstvo Splitsko-dalmatinske županije
Rezultati: Svi uzorci moraju imati detektiranu IPC (Internu kontrolu) koja dokazuje da je postupak obrade uzorka dobro napravljen, te se može pristupiti interpretaciji nalaza. Pozitivan nalaz na virus SARS-CoV-2 označava prisutnost tri detektibilna gena: E,RdRp i N, dok za negativan rezultat geni nisu eksprimirani.
Zaključak: Najbrža, najosjetljivija i najisplativija dijagnostička metoda za detekciju i kvantifikaciju novonastalog virusa jest RT-PCRObjectives: The aim of thisstudy wasto theoretically present and clarify the characteristics and structureof the SARS-CoV-2 virus, to describe the currently available diagnostic methods for the analysis of the virus and to present the best diagnostic technique, the RT-PCR molecular method.
Methods: This manuscript describes the procedure of the molecular method for SARS-CoV-2 detection on the BIO-RAD CFX96 RT-PCR instrument using LiliF Master Mix kit reagents for the preparation of the reaction mixture, which are used at the Teaching Public Health Institute of Split-Dalmatia County.
Results: All samples must have a detected IPC (Internal Control), which proves that the sample processing procedure was done well, and the interpretation of test results can be accessed. A positive test for SARS-CoV-2 virus indicates the presence of three detectable genes: E, RdRp and N, while for a negative result the genes are not expressed.
Conclusion: The fastest, most sensitive and most cost-effective diagnostic method for the detection and quantification of newly emerging SARS-CoV-2 virus is RT-PCR
Instrumental techniques in detecting COVID-19 infection
No full textCilj: Opisati instrumentalne tehnike i objasniti njihovu primjenjivost u otkrivanju COVID-19 infekcije.
Materijal i metode: Opisan je postupak izvođenja RT-qPCR reakcije od izolacije RNA do detekcije kao i RT-LAMP metode. Prikladni materijal potrebni za postupke RT-qPCR-a i RT-LAMP-a su također opisani.
Rezultati: Jačina fluorescencije PCR amplikona se predočava elektroferogramom na kojem se prikazuje na apscisi broj ciklusa reakcije, a na ordinati jačina fluorescencije. Ct vrijednost je obrnuto proporcionalna količini virusa mjerenog uzorka. Za RT-LAMP metodu će se na ekranu aparata pokazati pozitivan, negativan ili neispravan rezultat.
Zaključak: RT-qPCR je zlatni standard u detekciji COVID-19 infekcija zbog svoje visoke preciznosti i osjetljivosti. RT-LAMP će se u bliskoj budućnosti više koristiti zbog brzine detekcije i jednostavnosti uporabe. Sekvenciranje je ključ u identificiranju različitih podtipova SARS-CoV-2.Objectives: To describe instrumental techniques and explain their applicability in the detection of COVID-19 infection.
Material and methods: The procedure for performing the RT-qPCR reaction from RNA isolation to detection is described, as well as the RT-LAMP method. Appropriate material required for RT-qPCR and RT-LAMP procedures are also described.
Results: The fluorescence intensity of the PCR amplicon is represented by an electropherogram showing the number of reaction cycles on the abscissa and fluorescence intensity on the ordinate. The Ct value is inversely proportional to the amount of virus in the measured sample. For the RT-LAMP method, a positive, negative or invalid result will be displayed on the device screen.
Conclusion: RT-qPCR is the gold standard in the detection of COVID-19 infections due to its high precision and sensitivity. RT-LAMP will be used more in the near future due to its speed of detection and ease of use. Sequencing is the key to identifying the different subtypes of SARS-CoV-2
POSITRON EMISSION TOMOGRAPHY PET/CT WITH F18 CHOLINE
No full textU diplomskom radu opisan je dijagnostički postupak Pozitronska emisijska tomografija PET/CT. Prikazane su fizikalne karakteristike uređaja PET/CT, (pozitronski raspad, anihilacijsko zračenje, pozitronski radionuklidi). Fuzija slike kao glavni element kvalitetne dijagnostičke slike. Opisuje se radiofarmak za Pozitronsku emisijsku tomografiju, indikator sinteze membranskih lipida: 18F-FCH (Florkolin).
Opisana su dva dijagnostička postupka Pozitronske emisijske tomografije, PET/CT s kolinom kod karcinoma prostate i PET/CT s kolinom kod pacijenata s primarnim hiperparatireoidizmom.
Karcinom prostate najčešća je zloćudna neoplazma u muškaraca te treći uzrok smrtnosti od karcinoma u zemljama Europske unije. Nakon provedene inicijalne terapije, u oko 20-50% pacijenata dolazi do biokemijskog povrata bolesti. U radu se ističe korist nuklearno-medicinske metode F-18-kolin PET/CT-a u procjeni aktivnosti bolesti u bolesnika nakon provedene inicijalne terapije karcinoma prostate, a pod sumnjom na biokemijski povrat bolesti. Primarni hiperparatireoidizam (PHPT) čest je endokrini poremećaj s procjenama prevalencije od jednog do sedam slučajeva na 1000 odraslih. Oko 85% PHPT uzrokovano je solitarnim adenomom paratireoidnih žlijezda, rjeđe (oko 15%) multiplom bolešću paratireoidnih žlijezda (MGD), a rijetko (1%) karcinomom paratireoidnih žlijezda.Diagnostic procedure of positron emission tomography (PET/CT) is discussed in this paper.
(The aim of this paper is to discuss details of a positron emission tomography (PET/CT) diagnostic procedure.)
Physical characteristics of the PET/CT scanner, positron decay, electron–positron annihilation process, and specific positron emitting radionuclides are presented. Fusion of PET and CT tomograms is emphasized, as one of the key elements of image quality. Radionuclide discussed in this paper is F-18-FCH (fluorocholine), a positron emitting radionuclide consisting of methylcholine, used as an indicator of increased cell membrane phospholipid synthesis.
Two most common F-18-choline PET/CT diagnostic procedures are reviewed in this paper, F-18-FCH PET/CT in prostate cancer patients and F-18-FCH PET/CT in patients with primary hyperparathyroidism.
Prostate cancer is the most common malignancy in men and a third cancer-related cause of mortality in the European union. Following initial therapy, biochemical relapse of the disease occurs in 20 – 50 % of patients. The value of the functional nuclear medicine method F-18-FCH PET/CT specifically in patients after primary therapy with suspected biochemical relapse of prostate cancer is indicated in this study.
Primary hyperparathyroidism (PHPT) is a common endocrine disorder, with a prevalence of 1 – 7 cases in every 1000 adults. More than 85% of PHPT are caused by a solitary parathyroid gland adenoma, 15% are caused by a multiple parathyroid gland disease (MGD), and a rare cause of PHPT (1%) is a parathyroid gland carcinoma. F-18-FCH PET/CT is increasingly used in the diagnosis of PHPT
Viewpoint and knowledge of nurses from Clinical Hospital Center Split about transfusion treatment
No full textCilj istraživanja: Cilj ovog rada je ispitati znanja i stavove medicinskih sestara o transfuzijskom liječenju, utvrditi postojanje statistički značajne razle u znanju o transfuzijskom liječenju između medicinskih sestara srednje i više stručne spreme. Također, nastojali smo utvrditi postojanje statistički značajne razlike u znanju između medicinskih sestara s obzirom na njihovo radno iskustvo, tj. radni staž u struci i odjela na kojem rade.
Metode: Istraživanje je provedeno u vremenskom periodu od 18.05.2021 do 08.06.2021. pomoću anketnog upitnika sastavljenog uz pomoć mentorice Doc.dr.sc. Dejane Bogdanić dr.med. Anketa se sastoji od 9 pitanja različitog tipa kojeg su ispitanici samostalno ispunjavali. U radu se koriste metode grafičkog i tabelarnog prikazivanja kojima se prezentira struktura odgovora na anketna pitanja. Numeričke vrijednosti se prezentiraju upotrebom metoda deskriptivne statistike, i to aritmetičke sredine i standardne devijacije. U slučaju odstupanja razdiobe od normalne koristi se medijan i interkvartilni raspon. Normalnost razdiobe je prethodno provjerena Kolmogorov-Smirnov testom. Znanje se prezentira upotrebom postotne bodovne skale s rasponom vrijednosti od 0 do 100% gdje ispitanici koji nisu znali odgovor na niti jedno pitanje dobivaju 0, a ispitanici koji su znali sve odgovore dobivaju 100%. Raspon točnih odgovora se prezentira i upotrebom minimalne i maksimalne vrijednosti. Kod ispitivanja hipoteza se koristi Hi kvadrat test, te Kruskal-Wallis test. Analiza je rađena u statisitčkom softwareu STATISTICA 12 (TIBCO Software Inc., Palo Alto, California).
Rezultati istraživanja: Istraživanjem je utvrđeno da najveći broj ispitanika ima završenu srednju stručnu spremu, te da je prosječna dob ispitanika 39 godina. Srednja vrijednost radnog staža je 17 godina. Najveći broj ispitanika je zaposlen na Klinici za unutarnje bolesti, a prema broju krvi i krvnih derivata koji se najviše primjene u tjednu na radilištu je 2-5 doza. Istraživanjem je pokazalo da medicinske sestre pripremaju pacijenta, krvni derivat i sistem za transfuziju, te da u 83% slučajeva one i same uključuju transfuziju. U 66% slučajeva liječnik dolazi samo po pozivu. Velik broj ispitanika smatra da je potrebno uvesti dodatnu edukaciju zaposlenika o primjeni krvi i krvnih derivata. Velik broj ispitanika ispitanika se slaže da darivanje krvi ne šteti zdravlju i ne slabi imunološki sustav. Manji postotak ispitanika (40%) ispitanika smatra da je transfuzijsko liječenje sigurno i učinkovito, a 25% ispitanika je svjesno da se primjenom krvnih derivata pacijent može zaraziti heptitisom ili nekom drugom krvlju prenosivom bolesti. Ispitanici imaju pozitivne stavove o transfuzijskom liječenju, te su iskazali visoku razinu znanja na sva postavljena anketna pitanja gdje je srednja vrijednost ispravnih odgovora 80%. Najveću razinu znanja posjeduju ispitanici sa Klinike za onkologiju (85%), a najmanje znanja imaju zaposlenici Klinike za ženske bolesti i porode (57%), što govori u prilog da zaposlenici koji se više susreću s transfuzijom krvi posjeduju veću razinu znanja.
Zaključci: U našem istraživanju smo pokazali da ispitanici (medicinske sestre KBC Split imaju visoku razinu znanja o transfuzijsko, liječenju. Također, utvrdili smo da je potrebna dodatna edukacija na Klinici za ženske bolesti i porode, te dodatna edukacija liječnika o potrebi praćenja transfuzijskog liječenja. U istraživanju smo dokazali da razina znanja ovisi o stručnoj spremi, ali ne i o godinama radnog staža.Aim of the research: The aim of this study was to examine the knowledge and attitudes of nurses about transfusion therapy. To determine whether there is a statistically significant difference in knowledge about transfusion treatment between nurses of secondary education and above. To determine whether there is a statistically significant difference in knowledge between nurses with regard to their work experience, ie work experience in the profession.
Methods: The research was conducted in the period from 18.05.2021 to 08.06.2021. using a questionnaire compiled with the help of a mentor Doc.dr.sc. Dejane Bogdanić dr.med. The survey consists of 9 questions of different types that the respondents filled in independently. The paper uses methods of graphical and tabular presentation which present the structure of answers to the survey questions. Numerical values are presented using the methods of descriptive statistics, namely arithmetic means and standard deviations. In case of deviation from the normal distribution, the median and interquartile range are used. The normality of the distribution was previously checked by the Kolmogorov-Smirnov test. Knowledge is presented using a percentage point scale with a range of values from 0 to 100% where respondents who did not know the answer to any question get 0, and respondents who knew all the answers get 100%. The range of correct answers is presented using both the minimum and maximum values. The Hi square test and the Kruskal-Wallis test are used to test the hypotheses. The analysis was performed in the statistical software STATISTICA 12 (TIBCO Software Inc., Palo Alto, California).
Research results: The research established that the largest number of respondents have completed secondary education, and that the average age of respondents is 39 years. Thus, we can conclude that the respondents are younger. The average length of work experience is 17 years. The largest number of respondents is employed at the Clinic for Internal Medicine, and according to the number of blood and blood derivatives that are used in a week at the worke place is 2-5 doses. Research has also shown that nurses prepare the patient, blood derivative and transfusion system, which in 83% of cases they apply themselves. In 66% of cases, the doctor comes only by call. A large number of respondents believe that it is necessary to conduct additional education of employees on the use of blood and blood derivatives. A large number of respondents agree that donating blood does not harm health and does not weaken the immune system. A smaller percentage of respondents (40%) believe that transfusion treatment is safe and effective, and 25% of respondents are aware that the use of blood derivatives can infect a patient with hepatitis or some other transfusion transmissible disease. Respondents have positive attitudes about transfusion treatment, and expressed a high level of knowledge on all survey questions where the mean value of correct answers is 80%. Respondents from the Oncology Clinic have the highest level of knowledge (85%), and employees of the Clinic for Women's Diseases and Obstetrics have the lowest level of knowledge (57%), which suggests that employees who are more likely to have experience in applying blood transfusion have a higher level of knowledge.
Conclusion: In our research, we showed that the respondents (nurses of KBC Split) have a high level of knowledge about transfusion treatment. Also, we determined that additional education is needed at the Clinic for Women's Diseases and Obstetrics, and additional education of doctors on the need to monitor patients transfusion treatment. In the research, we proved that the level of knowledge depends on education, but not on years of work experience
Kinesitherapy for people with osteoporosis
No full textKineziterapija označava metodu fizikalne terapije koja u svrhu liječenja koristi pokret. Predstavlja jedan od najboljih nefarmakoloških načina liječenja osteoporoze. Vježbanjem se direktno utječe na porast mišićne mase te na postizanje veće mineralne gustoće kostiju. Također, ciljevi kineziterapije kod osteoporoze su uspostava, održavanje ili povećanje opsega pokreta, mišićne snage i izdržljivosti te poboljšanje ravnoteže. .Nadalje, poboljšanje posture te korekcija deformiteta. Najvažniji cilj jest prevencija prijeloma koji se kod osteoporoze događaju pri minimalnim traumama.
Vježbe koje se primjenjuju kod osteoporoze su vježbe snage, vježbe s otporom, vježbe istezanja te vježbe ravnoteže. Vježbe snage i opterećenja imaju pozitivan utjecaj na porast vršne koštane mase. Studije pokazuju i povećanje mineralne gustoće kostiju lumbalne kralježnice i femoralnog vrata uslijed prakticiranja vježbi snage i vježbi s otporom. Bavljenje tjelesnom aktivnošću, odnosno sportom se preporuča i mladima kako bi prevenirali potencijalnu pojavu osteoporoze. Osteoporoza je kronična metabolička bolest koju karakterizira smanjena mineralna gustoća kostiju i narušena mikroarhitektura. Najčešća komplikacija jesu prijelomi i to atraumatski prijelomi kuka, kralježaka te distalne trećine radiusa. Posljedice su bolnost, nesposobnost i smanjena kvaliteta života. Rizične skupine za oboljenje su osobe starije životne dobi, najčešće žene poslije menopauze uslijed pomankanja hormona estrogena što dovodi do povećane aktivnosti osteoklasta (stanica odgovornih za razgradnju kosti). Osteoporoza se dijeli na primarnu i sekundarnu. Primarna obuhvaća postmenopauzalnu, senilnu te idiopatsku osteoporozu. Prema definiciji WHO-a pacijentu se dijagnosticira osteoporoze ako su vrijednosti za 2.5 standardnih devijacija ispod prosječne koštane mase izmjerene denzitometrijom. Na bolest se može djelovati preventivno te je liječiti farmakološkim i nefarmakološkim putem. Nefarmakološko liječenje obuhvaća fizikalnu terapiju (s naglaskom na kineziterapiju), edukaciju te korištenje ortopedskih pomagala i uzimanje suplemenata. Uz adekvatnu prehranu i suplementaciju, te primjenom kineziterapije kao fizikalnog modaliteta postiže se bolja kvaliteta i tjelesna sposobnost pacijenata oboljelih od osteoporoze.Kinesitherapy means a method of physical therapy that uses movement for the purpose of treatment. It represents one of the best non-pharmacological ways of treating osteoporosis. Exercise directly affects the increase in muscle mass and the achievement of higher bone mineral density. Also, the goals of kinesitherapy in osteoporosis are to establish, maintain or increase range of motion, muscle strength and endurance, and improve balance. .Furthermore, improvement of posture and correction of deformities. The most important goal is the prevention of fractures that occur with minimal trauma in osteoporosis. Exercises used in osteoporosis are strength exercises, resistance exercises, stretching exercises and balance exercises. Strength and load exercises have a positive effect on the increase in peak bone mass. Studies also show an increase in bone mineral density of the lumbar spine and femoral neck as a result of practicing strength and resistance exercises. Engaging in physical activity, i.e. sports, is also recommended for young people in order to prevent the potential occurrence of osteoporosis. Osteoporosis is a chronic metabolic disease characterized by reduced bone mineral density and impaired microarchitecture. The most common complication is fractures, namely atraumatic fractures of the hip, vertebrae and the distal third of the radius. The consequences are pain, disability and reduced quality of life. Risk groups for the disease are older people, most often women after menopause due to the lack of estrogen hormone, which leads to increased activity of osteoclasts (cells responsible for bone breakdown). Osteoporosis is divided into primary and secondary. Primary includes postmenopausal, senile and idiopathic osteoporosis. According to the WHO definition, a patient is diagnosed with osteoporosis if the values are 2.5 standard deviations below the average bone mass measured by densitometry. The disease can be prevented and treated pharmacologically and non-pharmacologically. Non-pharmacological treatment includes physical therapy (with an emphasis on kinesitherapy), education and the use of orthopedic aids and taking supplements. With adequate nutrition and supplementation, and the use of kinesitherapy as a physical modality, a better quality and physical capacity of patients suffering from osteoporosis is achieved