Self-reported cultural competence among Czech and Slovakian nurses: A comparative correlation study

AIM

This study aimed to compare the level of cultural competence among nurses working in clinical practice in Slovakia and the Czech Republic.

BACKGROUND

Demographic changes have greatly affected the health sector in Slovakia and the Czech Republic. By identifying the level of nurses' cultural competence, many of the complications encountered in caring for patients from different cultures can be avoided. However, few studies have explored the cultural competence of nurses in clinical practice in these countries.

METHOD

This study was cross-sectional, descriptive, and comparative. It followed the STROBE checklist and used the Cultural Competence Assessment Tool questionnaire to collect data. Descriptive and inferential statistical tests were utilized for data analysis, using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0.

RESULTS

The sample comprised 424 nurses, with 202 from the Czech Republic and 222 from Slovakia, primarily female. Most nurses in both countries have not received cultural diversity training. Nevertheless, nurses in both countries indicate the necessity of conducting a cultural impact assessment of patients' health. Cultural diversity training significantly increases the level of cultural competence in nurses.

DISCUSSION

Lower cultural competence scores can negatively impact nursing care for patients from different cultures, leading to additional cultural challenges.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The findings highlight the need for enhanced cultural competence among nurses. Nurses need to learn and utilize cultural information to help maximize healthcare for patients from different cultures. By providing nurses with cultural knowledge and skills, they will be able to deliver more effective and culturally competent care to patients from varied cultural backgrounds.

Perceptions of nurses on the scope of culturally competent care in critical care: A qualitative study

BACKGROUND

The cultural competence of nurses is crucial in providing nursing care for patients from different cultures. The absence of cultural competence can negatively impact the entire course of care; however, implementing cultural competence in critical care unit can be complicated.

AIMS

This study aimed to determine nurses' perceptions regarding cultural competence in critical care units.

STUDY DESIGN

This study used a qualitative design with semi-structured interviews with nurses (n = 10) working in critical unites. Data were collected from February to June 2022 and then categorized and evaluated. Atlas.ti was used for the inductive thematic content analysis.

RESULTS

Three key areas identified were as follows: (1) nurses and culturally competent care in critical care, (2) cultural challenges in practice and (3) suggestions for improving culturally competent care. The participants expressed that culturally competent care in critical care units has specific limitations because of the nature of the intensive care units (ICUs). Additional learning included opportunities to improve culturally competent care, such as raising cultural awareness, developing language skills and promoting culturally competent care.

CONCLUSIONS

Providing culturally competent care in critical care units is an understudied area. Identifying barriers and cultural challenges is one strategy nurses can use to improve culturally competent ICU care.

RELEVANCE TO CLINICAL PRACTICE

Creating cultural awareness by training nurses in their own culture, in cultural diversity, and in overcoming prejudices and stereotypes is an essential step towards increasing cultural competence. Understanding nurses' perceptions on this topic can provide valuable insights into the challenges and opportunities for providing culturally sensitive care in a critical care setting.

Increased prevalence of the COVID-19 associated Neanderthal mutations in the Central European Roma population

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and subsequent COVID-19 has spread world-wide and become pandemic with about 7 million deaths reported so far. Interethnic variability of the disease has been described, but a significant part of the differences remain unexplained and may be attributable to genetic factors.

AIM

To analyse genetic factors potentially influencing COVID-19 susceptibility and severity in European Roma minority.

SUBJECTS AND METHODS

Two genetic determinants, within OAS-1 (2-prime,5-prime-oligoadenylate synthetase 1, a key protein in the defence against viral infection; it activates RNases that degrade viral RNAs; rs4767027 has been analysed) and LZTFL1 (leucine zipper transcription factor-like 1, expressed in the lung respiratory epithelium; rs35044562 has been analysed) genes were screened in a population-sample of Czech Roma (N = 302) and majority population (N = 2,559).

RESULTS

For both polymorphisms, Roma subjects were more likely carriers of at least one risky allele for both rs4767027-C (p < 0.001) and rs35044562-G (p < 0.00001) polymorphism. There were only 5.3% Roma subjects without at least one risky allele in comparison with 10.1% in the majority population (p < 0.01).

CONCLUSIONS

It is possible that different genetic background plays an important role in increased prevalence of COVID-19 in the Roma minority.

Analysis of medication administration in relation to food and beverages in inpatients

Proper medication administration in relation to beverage or food is one of the essential tools to achieve the pharmacotherapy goals. It is not known whether this is also considered in the care of inpatients. The aim of this study was to describe and analyse the current practice of medication administration in relation to food and beverages to patients hospitalized in four hospitals in the Czech Republic. This study was conducted based on the results of the first phase of a prospective observation study focused on the safety of medication administration performed by nurses. All data, including the timing of medication administration in relation to food and the data on beverages used, were obtained by the method of direct observation. The team of observersaccompanied the nurse during medication administration. The appropriateness of the medication administration in relationto food/beverages was assessed according to the summary of product characteristics and the published literature. In total, the administration of 5718 oral medications and 198 insulins were analysed. Unproper food timing wasobserved in 15.7% of oral medication administrations and 26.8% of insulin administrations. The highest number ofunproper food timing occurred in the proton pump inhibitors, antihypertensives, and prokinetics. Tea (63.4%) was the most used beverage. Errors with clinically serious impact have been observed in some groups of drugs. The necessity of a systemic approach in management of medication administration is required including interdisciplinary cooperation.

Social predictors of breastfeeding and the impact of interventions on breastfeeding of preterm infants: A longitudinal study

INTRODUCTION

The multifaceted benefits of breastfeeding for mothers and infants include enhanced neurodevelopment and immune function in preterm infants. However, more research is needed to understand the unique factors affecting breastfeeding practices in preterm infants. This study aimed to identify key social predictors of breastfeeding in preterm infants and assess the effectiveness of specific interventions on their feeding practices during the first six months postpartum.

METHODS

A prospective, monocentric, longitudinal study involving a cohort of 201 preterm infants was executed at the Neonatology Department, Ceske Budejovice Hospital, Czech Republic, from January 2020 to January 2023. The STROBE guidelines were used.

RESULTS

The study results elucidated a transition from breastfeeding to bottle feeding and formula within the infants' first six months. Notable social predictors of breastfeeding encompassed factors such as the number of children in the household, the mother's marital status, and the nature of housing. Certain interventions, including immediate skin-to-skin contact between mother and child, and initiation of nutritive feeding within the first half-hour post-birth, significantly influenced the probability of breastfeeding.

CONCLUSIONS

The data underscored that social predictors and nursing interventions substantially shape the breastfeeding practices of preterm infants during the first six months postpartum. Inequities in health outcomes among premature infants can be effectively curbed through comprehensive care models that account for socioeconomic factors influencing breastfeeding.

Developing the better and effective nursing education for improving transcultural nursing skills cultural competence and cultural sensitivity assessment tool (BENEFITS-CCCSAT)

BACKGROUND

A clear need for the development of new comprehensive, reliable, sensitive and valid measurement tools to adequately asses the cultural competence and cultural sensitivity of nursing students exists. This study aimed to develop a new measurement tool to assess the nursing students' cultural competence and sensitivity.

METHODS

This cross-sectional, instrument development study's first phase included postgraduate nursing students (n = 60) for the piloting study, and the second one included undergraduate nursing students (n = 459) for the main survey. This study used two data collection forms: The Student Descriptive Information Form and the Better and Effective Nursing Education for Improving Transcultural Nursing Skills Cultural Competence and Cultural Sensitivity Assessment Tool (BENEFITS-CCCSAT) draft. The content validity index was calculated using the Davis method. Cronbach's α coefficient and the item total correlation were calculated during the reliability analysis. The Kaiser-Meyer-Olkin (KMO) coefficient test, Bartlett significance test, and explanatory factor analysis (EFA) were used to evaluate the validity of the assessment tool.

RESULTS

Scale validity and reliability analyses showed that the BENEFITS-CCCSAT included 26 items and five sub-dimensions: respect for cultural diversity; culturally sensitive communication; achieving cultural competence; challenges and barriers in providing culturally competent care; and perceived meaning of cultural care.

CONCLUSION

The BENEFITS-CCCSAT appears to be a valid and reliable instrument for measuring the cultural sensitivity and cultural competence of nursing students. This can be of great use, especially before attending clinical areas, and can offer both students and faculty reliable information to promote reflective and critical thinking, especially in areas where improvement is needed.

THE HEALTH SYSTEM OF THE FIRST CZECHOSLOVAK REPUBLIC AND ITS ROLE IN COMBATING CONTAGIOUS DISEASES IMMEDIATELY AFTER THE FIRST WORLD WAR (THE 1920s)

A complex epidemiological situation marked the health system at the time of the establishment of the Czechoslovak Republic. Reducing the number of infectious diseases was an essential task of the State Administration of Health. It required new legislation and various steps directed at reducing infectious diseases. Serious infectious diseases, such as scarlet fever, diphtheria, typhoid, dysentery, smallpox, and malaria, were among the most significant health problems in Czechoslovakia. In 1920, Act No. 412 Coll. regarding compulsory smallpox vaccination was issued, as well as government Regulation No. 298, which describes vaccination obligations and stipulated proper isolation of patients with infectious diseases. Other steps that led to improvements included establishing the National Institute of Health and mobile disinfectant units. Conclusion: The systematic development of new legislation contributed to the new Republic's proficiency at the task and the gradual reduction in the number of infectious diseases.

Self-reported medication administration errors in clinical practice of nurses: a descriptive correlation study

BACKGROUND

Medication administration errors (MAE) are a worldwide issue affecting the safety of hospitalized patients. Through the early identification of potential causes, it is possible to increase the safety of medication administration (MA) in clinical nursing. The study aimed to identify potential risk factors affecting drug administration in inpatient wards in the Czech Republic.

MATERIAL AND METHODS

A descriptive correlation study through a non-standardized questionnaire was used. Data were collected from September 29 to October 15, 2021, from nurses in the Czech Republic. For statistical analysis, the authors used SPSS vers. 28 (IBM Corp., Armonk, NY, USA).

RESULTS

The research sample consisted of 1205 nurses. The authors found that there was a statistically significant relationship between nurse education (p = 0.05), interruptions, preparation of medicines outside the patient rooms (p < 0.001), inadequate patient identification (p < 0.01), large numbers of patients assigned per nurse (p < 0.001), use of team nursing care and administration of generic substitution and an MAE.

CONCLUSIONS

The results of the study point to the weaknesses of medication administration in selected clinical departments in hospitals. The authors found that several factors, such as high patient ratio per nurse, lack of patient identification, and interruption during medication preparation of nurses, can increase the prevalence of MAE. Nurses who have completed MSc and PhD education have a lower incidence of MAE. More research is needed to identify other causes of medication administration errors. Improving the safety culture is the most critical challenge for today's healthcare industry. Education for nurses can be an effective way to reduce MAEs by enhancing their knowledge and skills, mainly focusing on increasing adherence to safe medication preparation and administration and a better understanding of medication pharmacodynamics. Med Pr. 2023;74(2):85-92.

Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011–2021

Aim

Training for the development of cultural competence is often not part of the professional training of nurses within the European Economic Area. Demographic changes in society and the cultural diversity of patients require nurses and other medical staff to provide the highest quality healthcare to patients from different cultural backgrounds. Therefore, nurses must acquire the necessary cultural knowledge, skills, and attitudes as part of their training and professional development to provide culturally competent care to achieve this objective.

Objective

This review aims to summarize existing methods of developing cultural competence in nurses working in clinical practice.

Design

A scoping review of the literature.

Method

The following databases were used: PubMed, ScienceDirect, ERIH Plus, and Web of Science using keywords; study dates were from 2011 to 2021.

Results

The analysis included six studies that met the selection criteria. The studies were categorized as face-to-face, simulations, and online education learning methods.

Conclusion

Educational training for cultural competence is necessary for today’s nursing. The training content should include real examples from practice, additional time for self-study using modules, and an assessment of personal attitudes toward cultural differences.

Safety of drug administration from the perspective of hospitalized patients in selected hospitals of the South Bohemia Region

Drug administration is one of the riskiest areas of healthcare provision, accompanied by several possible mistakes. Patient and family involvement is crucial for patient safety in a hospital environment. The research study aimed to evaluate the subjective perception of the safety of the drug administration process from hospitalized patients point of view and their involvement in drug administration. A structured questionnaire of its own design was used to obtain data. Three hundred twenty-nine respondents from 4 hospitals in the South Bohemian Region in the Czech Republic were included in the research, including patients hospitalized in the internal medicine, surgery, and follow-up and rehabilitation care departments. We found different perceptions and individual understandings of the safety of the drug delivery process by other groups of patients. Interest in participating in drug administration also varies between groups of patients. Women control the medication given to them by the nurse to a much greater extent than men. Patients under the age of 60, patients with higher professional and university education, and patients from the surgical department would like to be more involved in deciding which aplikovadrugs to use. Patients with a low level of education want to involve their family members more in their treatment decisions. Both healthcare professionals and patients should be led by hospital management to increase patient involvement in the hospitalization process.

Evaluation of medication errors in the hospital environment

INTRODUCTION

Healthcare is inherently associated with a risk to patient health. One risk is associated with medication-related errors, which are commonly reported adverse events. By analyzing the root causes of medication errors, effective preventive measures can be proposed to reduce their likelihood. This study aimed to identify the reasons of medication administration errors, determine the number of medication administration errors reported, and describe the barriers hindering reporting.

METHODOLOGY

The study used a standardized Questionnaire Medication Administration Error Survey (MAE survey) that was quantitatively analyzed. The study involved 112 nurses from four hospitals in the South Bohemian Region.

RESULTS

Risk factors that increase the likelihood of medication administration errors include similarity of drug names (3.7 ± 1.3) and packaging (3.9 ± 1.5), frequent prescription changes for patients (3.2 ± 1.5), illegibility of written prescriptions (3.1 ± 1.6), a lack of clarity of medical records (2.6 ± 1.5). Only a proportion of medication administration errors are reported by nurses (16% to 21%). The reluctance of nurses to report medication administration errors is linked to fear of being blamed for the deterioration of the patients health (3.3 ± 1.7), fear of the doctors reaction to a medication administration error (2.6 ± 1.4), and repressive responses from hospital management to reported misconduct (2.9 ± 1.5).

CONCLUSION

Measures to reduce the likelihood of medication administration errors include building a non-punitive system for reporting adverse events and medication errors, introducing electronic prescription systems, promoting open communication within the team, involving clinical pharmacists in the pharmacotherapy process, and regular comprehensive training of nursing staff.

Impact of Selected Geriatric Syndromes on the Quality of Life in the Population Aged 60 and Older

Background: Geriatric syndromes represent a critical domain in the population more than 60 years old. Basic syndromes include frailty, sarcopenia, loss of body mass, and a mild cognitive disorder. These are significant problems which can affect the quality of life. In our study, the Rapid Geriatric Assessment (RGA) tool was used to assess the geriatric syndromes, and the WHOQOL-BREF was used to assess the quality of life to survey 498 respondents from a population aged 60 and older. In all the assessments, the distribution of variables was tested, a nonnormal distribution of variables was identified, and subsequently, nonparametric tests were performed to identify the differences between groups. The study showed that the domain of physical health and the psychological domain were most affected. The results have shown that individual geriatric syndromes affect certain domains of the quality of life of the population above 60 with various intensity.

Increased prevalence of the CVD-associated ANRIL allele in the Roma/Gypsy population in comparison with the majority Czech population

Cardiovascular disease (CVD) is a major cause of death around the world, with highest prevalence reported in minority Roma/Gypsy populations living in developed countries. Whether these differences are caused by unhealthy lifestyles or genetic factors remain unknown. The aim of our study was to examine the genotype frequencies of the rs10757274 polymorphism in the 9p.21 locus within ANRIL (antisense non-coding RNA in the INK4 locus), a long non-coding RNA located in the vicinity of the CDKN2A/2B inhibitors loci. ANRIL is understood to be the strongest genetic determinant of CVD in Caucasians. Using PCR-RFLP, we analysed the ANRIL rs10757274 polymorphism in 298 non-Roma (50% male) and 302 Roma/Gypsy (50% male) adult (39.5 ± 15.1 years and 39.2 ± 12.8 years, respectively) subjects. We found that frequencies of the ANRIL GG, GA and AA genotypes were 20.1%, 52.4% and 27.5% in the majority population and 32.9%, 47.9% and 19.2% in Roma/Gypsy subjects, respectively. The distribution of genotypes was deemed significantly different at P < 0.001. Within the Roma/Gypsy population, we detected increased prevalence of the CVD-associated GG genotype. Increased prevalence of CVD among Roma/Gypsies subjects may be significantly linked to genetic background.

Causes and interventions of medication errors in healthcare facilities

A medication error is one of the most common causes of patients complications or death in healthcare facilities. In the United States, 7,000 out of 9,000 patients die because of medication errors each year. Known factors are generally divided into four groups - human factor, intervention, technical factor, and system. Our study includes 17 studies from the OVID, Web of Science, Scopus, and EBSCO databases, in the range of 2015-2020. After a selection of professional publications, 2 categories were created - factors leading to medication errors and interventions to reduce medication error and testing their effectiveness. It has been found that human factor always plays a role, often supported by a poorly set-up system. The most mistakes are made in documentation, administration technique or accidental interchange of patients. The most frequently mentioned factors include nurses overload, high number of critically ill patients, interruptions in the preparation or in the administration of medications, absence of the adverse event reporting system, non-compliance with guidelines, fear, and anxiety. Another evidence of medication error is in the application of intravenous drugs, where an interchange of drugs or patients due to interruption occurs as well. Sufficient education of nurses and an adequate system of preparation and administration of drugs, for example using bar codes, are considered as an appropriate intervention.

Five genetic polymorphisms of cytochrome P450 enzymes in the Czech non-Roma and Czech Roma population samples

Objectives Cytochromes P450 play a role in human drugs metabolic pathways and their genes are among the most variable in humans. The aim of this study was to analyze genotype frequencies of five common polymorphisms of cytochromes P450 in Roma/Gypsy and Czech (non-Roma) population samples with Czech origin. Methods Roma/Gypsy (n=302) and Czech subjects (n=298) were genotyped for CYP1A2 (rs762551), CYP2A6 (rs4105144), CYP2B6 (rs3745274) and CYP2D6 (rs3892097; rs1065852) polymorphisms using PCR-RFLP or Taqman assay. Results We found significant allelic/genotype differences between ethnics in three genes. For rs3745274 polymorphism, there was increased frequency of T allele carriers in Roma in comparison with Czech population (53.1 vs. 43.7%; p=0.02). For rs4105144 (CYP2A6) there was higher frequency of T allele carriers in Roma in comparison with Czech population (68.7 vs. 49.8%; p<0.0001). For rs3892097 (CYP2D6) there was more carriers of the A allele between Roma in comparison with Czech population (39.2 vs. 38.2%; p=0.048). Genotype/allelic frequencies of CYP2D6 (rs1065852) and CYP1A2 (rs762551) variants did not significantly differ between the ethnics. Conclusions There were significant differences in allelic/genotype frequencies of some, but not all cytochromes P450 polymorphisms between the Czech Roma/Gypsies and Czech non-Roma subjects.

Five genetic polymorphisms of cytochrome P450 enzymes in the Czech non-Roma and Czech Roma population samples

Objectives Cytochromes P450 play a role in human drugs metabolic pathways and their genes are among the most variable in humans. The aim of this study was to analyze genotype frequencies of five common polymorphisms of cytochromes P450 in Roma/Gypsy and Czech (non-Roma) population samples with Czech origin. Methods Roma/Gypsy (n=302) and Czech subjects (n=298) were genotyped for CYP1A2 (rs762551), CYP2A6 (rs4105144), CYP2B6 (rs3745274) and CYP2D6 (rs3892097; rs1065852) polymorphisms using PCR-RFLP or Taqman assay. Results We found significant allelic/genotype differences between ethnics in three genes. For rs3745274 polymorphism, there was increased frequency of T allele carriers in Roma in comparison with Czech population (53.1 vs. 43.7%; p=0.02). For rs4105144 (CYP2A6) there was higher frequency of T allele carriers in Roma in comparison with Czech population (68.7 vs. 49.8%; p<0.0001). For rs3892097 (CYP2D6) there was more carriers of the A allele between Roma in comparison with Czech population (39.2 vs. 38.2%; p=0.048). Genotype/allelic frequencies of CYP2D6 (rs1065852) and CYP1A2 (rs762551) variants did not significantly differ between the ethnics. Conclusions There were significant differences in allelic/genotype frequencies of some, but not all cytochromes P450 polymorphisms between the Czech Roma/Gypsies and Czech non-Roma subjects.

Different prevalence of T2DM risk alleles in Roma population in comparison with the majority Czech population

Background

The Czech governmental study suggests up to a 25% higher prevalence of type 2 diabetes mellitus (T2DM) in the Roma population than within the majority population. It is not known whether and to what extent these differences have a genetic background.

Methods

To analyze whether the frequencies of the alleles/genotypes of the FTO, TCF7L2, CDKN2A/2B, MAEA, TLE4, IGF2BP2, ARAP1, and KCNJ11 genes differ between the two major ethnic groups in the Czech Republic, we examined them in DNA samples from 302 Roma individuals and 298 Czech individuals.

Results

Compared to the majority population, Roma are more likely to carry risk alleles in the FTO (26% vs. 16% GG homozygotes, p < .01), IGF2BP2 (22% vs. 10% TT homozygotes, p < .0001), ARAP1 (98% vs. 95% of A allele carriers, p < .005), and CDKN2A/2B (81% vs. 66% of TT homozygotes, p < .001) genes; however, less frequently they are carriers of the TCF7L2 risk allele (34% vs. 48% of the T allele p < .0005). Finally, we found significant accumulation of T2DM‐associated alleles between the Roma population in comparison with the majority population (25.4% vs. 15.2% of the carriers of at least 12 risk alleles; p < .0001).

Conclusion

The increased prevalence of T2DM in the Roma population may have a background in different frequencies of the risk alleles of genes associated with T2DM development.

Distribution of ADH1B genotypes predisposed to enhanced alcohol consumption in the Czech Roma/Gypsy population

OBJECTIVE

The aim of the study was to analyse the frequencies of rs1229984 genotypes within the alcohol dehydrogenase (ADH1B) gene in a Gypsies/Roma population and compare them with other populations and with ethanol consumption.

METHODS

We analysed the ADH1B (rs1229984; Arg47→His; c.143G>A) genotype using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) in two ethnically different groups - Gypsies/Roma (N = 301) and Czechs (N = 300) where one day alcohol consumption was recorded.

RESULTS

ADH1B genotype/allelic frequencies did not significantly differ between the populations (p = 0.32). The frequency of minor A allele carriers was slightly higher in Gypsies/Roma (14.7%) than in Czechs (11.9%). The prevalence of subjects reporting alcohol intake on the previous day was non-significantly lower in Gypsies/Roma (10.5% vs. 16.4%), as was the amount of alcohol consumed the day before the examination in ethanol consumers (36.1 ± 18.3 g vs. 43.0 ± 27.2 g).

CONCLUSIONS

The frequency of rs1229984 genotypes in the ADH1B gene within the Gypsies/Roma population corresponds with frequencies obtained in North India/Central Asia, the putative country of this ethnic origin. Our results suggest that the minority Gypsies/Roma population consume slightly less alcohol than the Czech majority population.

Selected Risk Factors of Falls in Hospitalized Patients: A Case-Control Study

THEORY

Patients falls have a multifactorial character and typically have multiple causalities.

GOAL

The goal of the study was to identify risk factors for falls of hospitalized patients.

METHODOLOGY

This was a case-control study. The study included 222 patients who experienced a fall during their hospitalization (cases) and 1,076 patients who did not fall during their hospitalization (controls). The study involved four hospitals in the South Bohemian Region of the Czech Republic. The study took place during the 2017 calendar year.

RESULTS

The average age of patients who experienced a fall was 77.9 years. The group of cases included 5-times more patients with a history of falls than the controls. Patients who fell were in higher risk of falls than patients in the control group at hospital admission. The group of cases also had a higher prevalence of confused and restless patients; however, the group did not include a statistically significantly higher number of incontinent patients, patients with eating and drinking disorders, or patients with intravenous therapy than the control group.

CONCLUSION

Interventions aimed at prevention of falls should be included in care plans, especially for older patients, patients who have fallen in the past, patients who have movement restriction, patients with cognitive dysfunction, and patients with increased need of assistance with basic daily activities.

Stress within preventive cardiology

INTRODUCTION

The mental, physical and social stress and pressure of present day influences the incidence of cardiovascular diseases (CVD). Studies suggest that some psycho-social factors significantly increase the risk of CVD. But they are not paid the necessary attention. The goal of the study consisted in ascertaining how citizens assess their own mental health, how they perceive the influence of stress on CVD, how physicians and nurses work with them in the area of stress and how efficient their activity is. Research set and methods: The data ware collected via a non-standardized questionnaire leaded with face-to-face controlled interviews face-to-face. The analysis was carried out by the SASD 1.4 program with 1st degree and 2nd degree sorting. The goodness-of-fit &#967;2 was applied. The independence test at the level of significance &#945; = 0.05, &#945; = 0.01, &#945; = 0.001 was calculated. We approached 2&#8239;306 randomly chosen citizens by quota selection. 314 citizens (13.6 %) refused the participation. The set consisted of 1&#8239;992 citizens (86.4 %) aged from 40 to 80 and more years, including 937 (47 %) men and 1055 (53 %) women. The relation of selected sociometric parameters was observed.

RESULTS

The citizens aged 40 and more years assess their mental status as good (85 %), at the scale from 6 to 10, (1 the worst, 10 the best mental status). With increasing age, the mental status is assessed as worse at a significantly higher degree (p &lt; 0.001). The mental status is assessed worse as the physical condition, with values 9 and 10. Out of the total number of the citizens approached, 87.9 % agree that stress influences the origination of CVD. Citizens from lower age groups (40-59 years) tend to think it (p.

Clinical pharmacist involvement in fall management in a polymorbid geriatric patient with a history of recurrent falls

Patient falls represent a significant burden on healthcare facilities, particularly by prolonging hospitalization and increasing the cost of subsequent healthcare. In most cases, fall is caused by a combination of several modifiable and unmodifiable risk factors. The pharmacotherapy, which is often unreasonably administered in relation to patient health condition and drug combination, belongs among the modifiable risk factors. In this case report, the potential effect of pharmacotherapy on the patient fall-related risk as well as clinical pharmacy service that can contribute to reducing the risk of falls by engaging of clinical pharmacist in a multidisciplinary team with focus on the risks of pharmacotherapy and their management are shown.

Assessing the awareness of Czechs, age 40+, on the link between lifestyle choices and risk factors for cardiovascular diseases

OBJECTIVES

Cardiovascular diseases constitute the main cause of disability and premature death worldwide. Those diseases will continue to endanger health unless the public understands clearly and completely which risk factors contribute to the development of these diseases and what they can do to avoid these risks. This article assesses the understanding of risk factors that can lead to the development of heart and vessel diseases.

METHODS

A non-standardized questionnaire was used for data collection. The respondents expressed their opinions on influenceable factors using a five-degree Likert scale. The research set included 1,992 respondents. Data were statistically analyzed using the SASD program, version 1.4.12. To calculate the level of dependence of the selected characteristics, the Wallis, and Spearman correlation coefficients were calculated. The goodness-of-fit χ2 was applied as well.

RESULTS

The results show that 66.8% of respondents go walking for at least 30 minutes on 5 or more days per week. Respondents from lower age groups reported significantly more (p < 0.001) walking. The comparison of mean values showed that Czech citizens aged 40 or more years express the highest agreement with the statement that they could prevent heart and vessel diseases by modifying their eating habits. The results further showed that 25.8% of Czech citizens smoked and that men smoked significantly more (29.6%) than women (22.5%). More than one-half (60.1%) reported drinking alcohol occasionally; the remaining respondents reported drinking alcohol 3-4 times a month or more often. Men reported drinking beer significantly more often (p < 0.001) than women, while women reported drinking wine significantly more often (p < 0.001) than men.

CONCLUSIONS

Respondents aged 40 or more years were aware of some, but not all, of the risk factors that can influence the development of cardiovascular diseases. They accepted that they could prevent heart and vessel diseases by modifying their eating habits, however, their opinions regarding exercise differed from professional recommendations. Two-thirds of the respondents stated that smoking could also influence heart and vessel diseases. The study suggests that primary care providers need to put more effort into educating their patients regarding steps that can be to influence their own health.

Cultural Features Influencing Eating, Overweight, and Obesity in the Roma People of South Bohemia

This article describes the important cultural specifics that impact on treatment of overweight and obesity for the Roma people of South Bohemia. Methods: Data on health and nutrition were collected using a semi-structured interview of 302 Roma adults (quantitative phase). A further 25 participants received in-depth interviews regarding their eating and lifestyle habits and perceptions about obesity and overweight (qualitative phase). Height and weight were measured with calibrated scales and stadiometer. Qualitative data were analyzed with the “grounded theory” method. Results: The participants reported a relatively high consumption of high-sugar drinks and foods compared to fruits and vegetables. Lifestyle factors increasing risk of overweight identified from the qualitative interview included unemployment, socially isolating housing, poor transport, poverty, inactivity, tobacco smoking, and for women weight gain after childbirth. Also identified was the need for better health literacy. Conclusions: Effective health education may help to address risk factors for overweight and obesity in Roma peoples. Other measures include improved socioeconomic status and housing security, and improved health literacy of the Roma people.

International study on nurses' views and experiences of compassion

BACKGROUND

Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics.

AIM

The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses.

METHODS

An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire.

RESULTS

The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion.

CONCLUSION

Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers.

LIMITATIONS

Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses.

IMPLICATIONS FOR NURSING POLICY

Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).

Frequency of adult type-associated lactase persistence LCT-13910C/T genotypes in the Czech/Slav and Czech Roma/Gypsy populations

Lactase non-persistence (leading to primary lactose intolerance) is a genetically dependent inability to digest lactose in adulthood. As part of the human adaptation to dairying, the human lactase LCT-13910C/T mutation (which propagates adult expression of lactase) developed, spread and participated in the adaptation to dairying. This variant is associated with lactase activity persistence, and its carriers are able to digest lactose. We compared the frequencies of lactase 13910C/T (rs4988235) genotypes in Czechs/Slavs (N = 288) and Czech Gypsies/Roma (N = 300), two ethnically different groups where this polymorphism has not yet been analysed. Allelic frequencies significantly differed between the populations (p < 0.0001). In Czechs/Slavs, the lactase persistence T allele was present in 76% of the individuals, which is in agreement with frequencies among geographically neighbouring populations. In the Czech Gypsy/Roma population, only 27% of the adults were carriers of at least one lactase persistence allele, similar to the Indian population. In agreement with this result, dairy product consumption was reported by 70.5% of Czechs/Slavs and 39.0% of the Czech Gypsy/Roma population. Both in the Czech Gypsy/Roma and in the Czech/Slavs populations, the presence of carriers of the lactase persistence allele was similar in subjects self-reporting the consumption of unfermented/fresh milk, in comparison to the others.

Exploring Nurses' Meaning and Experiences of Compassion: An International Online Survey Involving 15 Countries

PURPOSE

In recent years, there has been much focus on compassion in nursing care, and concern has been raised in a number of reports and media stories regarding decreased compassion. The aim of this study was to explore similarities and differences in the understanding and demonstration of compassion in nursing practice across 15 countries.

DESIGN

A total of 1,323 nurses from 15 countries responded to questions in relation to compassion, via an international online survey.

RESULTS

The data revealed the impact of sociopolitical influences on perceptions of compassion, and the conscious and intentional nature of compassion.

DISCUSSION AND CONCLUSION

The study demonstrated shared understandings of the importance of compassion as well as some common perceptions of the attributes of compassionate care. The differences reported were not as significant as had been expected.

IMPLICATIONS FOR PRACTICE

Further research is needed to explore the country and culture differences in the enactment of compassion.

Retrospective analysis of falls in selected hospitals of the Czech Republic

INTRODUCTION

Hospitals strive, over the long term, to reduce the incidence of falls of hospitalized patients. Falls are monitored, analyzed, and regularly evaluated and corrective and preventive actions are established based on the findings. To establish preventive actions, it is essential to determine the circumstances under which the patient fell and in what type of health care facility.

OBJECTIVES

The goal of the study consisted in retrospectively analyzing falls in selected hospitals of the South Bohemian Region in 2014 and 2015.

METHODS

Our retrospective analysis of 1101 patient falls was reported by the health care staff from 4 hospitals of the South Bohemian Region. The data from the reported incidents (i.e., falls) from individual hospitals were encoded and entered in a database using the SASD statistical program and subsequently subjected to statistical analysis.

RESULTS

The highest frequency of falls was found on internal wards, 565 (51.3%) with the second highest frequency found on subsequent care wards, 267 (24.3%). The study showed that the risk of falls increases with patient age; more than 60% the hospitals, in the monitored period, involved patients over 70 years of age. Falls occurred most frequently in patient rooms and in bathrooms. Statistically significant relationships were identified between the type of ward and the time of the fall, between the type of the ward and the location of the fall, between patient age and the time of the fall, between patient age and the location of the fall, between the time of fall and the location of fall, and between the location of fall and the patient mobility before the fall.

CONCLUSION

Intensive monitoring of patient falls and the circumstances under which the falls occurred are needed to fully understand the epidemiology of hospital falls.

Opinions regarding the effectiveness of non-pharmacological measures in prevention of cardiovascular disease in the Czech Republic

OBJECTIVE

Cardiovascular diseases are the most common cause of deaths. Cardiovascular mortality is influenced by several factors that can be changed by our behaviour. The goal of this study was to survey the opinions of physicians and nurses on the topic of preventative cardiovascular risk factors.

METHODS

The inquiry was carried out using a standardized structured interviewer-respondent interview (face-to-face). The final form of the interview was based on the results of a pre-investigation. The study was anonymous, participation was voluntary, and the actual interview did not contain any controversial ethical questions. To meet these goals, a non-standardized questionnaire for nurses and physicians was developed. The questions evaluated the interest, coping difficulties, and efficiency of multimodal interventions in practice. The study sample included 1000 physicians and 1000 nurses. The results were statistically evaluated.

RESULTS

The survey of physician and nurse opinions showed that patients were primarily interested in interventions in the area of nutrition, weight loss, and coping with pharmacotherapy; however, the overall lack of interest in smoking cessation was a surprising result. Physicians and nurses viewed smoking cessation as the most difficult risk factors to influence, followed by nutrition changes, and weight loss. It was noteworthy that more than half of the interviewed physicians and nurses were of the opinion that behavioral interventions were only sometimes or rarely effective.

CONCLUSION

The results of our study show that nurses and physicians largely agree on behavioral risk factors and how to influence them. Nurses and physicians in Czech health care generally agree that patients are interested in influencing the above risk factors, being least interested in exercise and smoking cessation. Nurses and physicians also consider smoking reduction and weight loss as particularly difficult risk factors to manage. Results from this study will contributed to the overall goal of preparing and implementing short-term and long-term interventions in preventive cardiology.

Areas of health-education of physicians and nurses in care for cardiac patients from the perspective of citizens of the Czech Republic

OBJECTIVES

The goal of this article was to assess the delivery of patient health-education, relative to cardiovascular disease from the perspective of physicians and nurses, as well as from the perspective of citizens living in the Czech Republic.

METHODS

The article is based on data acquired from the "Intervention procedures in preventive cardiology" grant project. To evaluate patient health education, non-standardized questionnaires intended for physicians (n = 1000) and nurses (n = 1000) were used. A combination of a non-standardized questionnaire and a standardized questionnaire (SF-36) was used to assess citizen (n = 1992) viewpoints. The actual investigation took place from April 1 to April 20, 2016 and was implemented over the entirety of the Czech Republic. Data were analyzed using the SASD v. 1.4.12 program. Both first and second degree sorting was used. The degree of dependence of selected characteristics was established based on the Chi-square test and the T-test.

RESULTS

A bit more than half (53.1%) of the physicians indicated that nurses carried out patient education regarding influenceable risk factors associated with cardiovascular diseases, while 71.6% of nurses reported carrying out this duty. The overwhelming majority of physicians (97.1%) and nurses (92.3%) report informing patients about how to improve their health condition. Citizen respondents reported that topics such as nutrition, exercise, smoking cessation, stress reduction, and the drug side effects use were discussed with them more frequently by physicians than by nurses. Citizen respondents reported that nutrition was discussed most frequently with them, while the issue of smoking cessation was discussed the least frequently.

CONCLUSION

Our analysis showed that physicians engage in patient education more frequently than nurses. At the same time, results suggest that a relatively significant number of physicians and nurses rarely or never educate regarding risk factors associated with cardiovascular diseases.

Patient misidentification in nursing care

GOAL

The goal of the study was to assess the opinions of nurses regarding patient safety associated with patient misidentification. The investigation was focused on actual patient misidentification as well as loss of patient materials (e.g., blood samples, X-rays, etc.). These are problems often associated with patient identification methods and/or confusing patients with the same surname assigned to the same ward. The risks of misidentification incidents pose a considerable threat to patient health especially when the confusion extends to the operating room. Our objective was to identify the potential causes of patient misidentification and offers solutions to correct the issue.

METHODS

A survey as part of a sociological investigation was carried out through the use of questionnaires. The selected sample included, in accordance with the needs of the project and methodology of the Institute for Health Care Information and Statistics of the Czech Republic, registered nurses working shifts on inpatient wards. The study took place across the Czech Republic between Sept. 15 and 30, 2013. The sample consisted of 772 registered nurses.

RESULTS

The potential for patient misidentification (PM) was described as negligible by 73.8% of respondents. Only 9.1% of nurses admitted problems associated with patient misidentification. Respondents reported that the greatest potential for patient misidentification was associated with patients having the same surname staying on the same ward. An absolute majority of nurses responded that patient identification wristbands were the most frequently used method to prevent PM. Over 90% (90.6%) of nurses reported that patient ID wristbands were used for all patients. Almost 80% (77.4%) reported the use of positive verbal identification in addition to ID wrist bands. Respondents reported (76.2%) that the most frequently used method to avoid PM in the operating room involved a review of patient documentation. Almost the same number of repondents (74.1%) reported the use of verbal confirmation as a method to avoid PM. Another mechanism included verification of the surgical procedure. ID wristbands and completion of an 'identification protocol' rank among other options mentioned most frequently by respondents.

CONCLUSION

The study shows that registered nurses regard patient misidentification as a very rare and unlikely event. Nonetheless, statistics suggest otherwise and education, changes in protocols, and new technologies are needed to improve the precision of patient identification.

Selected aspects of "safety culture" in hospitals of the Czech Republic

THEORETICAL BACKGROUND

Patient safety is a strategic goal of managers of all health care facilities in the Czech Republic. The development of a safety culture in the facility helps to ensure high quality health care. GOAL OF THE SURVEY was to assess the safety culture with regard to patient safety and team cooperation. A partial goal was to confirm the hypothesis that team cooperation among health care staff significantly influences patient safety.

METHODOLOGY

772 nurses took part in a quantitative survey. The respondents were nurses working shifts in inpatient departments of hospitals in the Czech Republic.

RESULTS

Patient safety was described as excellent by 17.5% of nurses. It is described as very good by 60.2% of nurses and described as acceptable by 20.5% nurses. 78% of respondents agreed with the statement that patient safety was never neglected at the expense of increased workload. More than 10% of nurses reported that there were problems with patient safety. 19.8% of respondents were reported that efforts to prevent errors were not practiced at their clinic, and, therefore, and only chance had prevent more errors from occurring. According to 64.9% of respondents, the staff on the wards supported each other and a similar number of respondents reported that they showed respect for each other (60.2%). Respondents reported that intra-ward support increased the degree of patient safety.

CONCLUSION

Results from the survey show that team cooperation is a precondition for providing safe patient care, which cannot be underestimated and must be refined and improved through good hospital management.

Genetic and biochemical characteristics in the Roma minority in the South Bohemia Region

OBJECTIVE

At present, health characteristics of Roma minority within the Czech Republic are generally unknown. Therefore we examined a Roma population for some anthropometrical, biochemical and genetic parameters.

DESIGN

Groups include Roma aged above 18 years (men, women), with permanent residence in the South Bohemia Region. The Roma group (302 individuals) was selected using the snowball sampling method--the same method was used to select the non-Roma control group (78 individuals) for total cholesterol and blood sugar reference values. The main non-Roma control group was selected using the quota selection method (298 individuals). All participants completed a life style questionnaire, had their body measurements taken, were weighed, had their blood pressure and heart rates measured, had a capillary blood sample taken.

RESULTS

The non-Roma population had a lower Body Mass Index (BMI) (25.86 ± 4.23 vs. 27.45 ± 6.48 kg/m², p = 0.0004). The difference in BMI and weight was found to be associated with the MC4R gene. The values of systolic and diastolic blood pressure, total cholesterol, blood sugar did not differ with regard to the tested polymorphisms. We did not find any difference in the prevalence of MC4R or TMEM18 between groups.

CONCLUSION

Despite educational efforts to introduce healthier life styles into the Roma population, there has been only limited success; as a result, Roma are very likely to suffer from premature complications of atherosclerotic processes, mostly due to theirs life style. Intensive further research is needed to improve the health conditions of the Roma minority, while still respecting their cultural differences.

Evaluation of selected indicators of overweight and obesity of Roma minority in the region of South Bohemia

OBJECTIVES

The objective of our correlation study was to compare selected indicators of overweight and obesity of Roma and non-Roma (majority) populations in the South Bohemia Region or the Czech Republic.

METHODS

The following indicators were chosen for evaluation of overweight and obesity: body height and weight, waistline measurement, waist/height index, waist/hips index, BMI, total fat and blood pressure. 600 participants were examined and interviewed in total, including 302 Roma and 298 non-Roma participants. Each of the participants had a personal examination performed by a general nurse, under hygienic-epidemiological conditions. The criteria for inclusion of participants into the study were consent with examination and age greater than 18 years.

RESULTS

The statistical analysis showed that, at a level of significance of p < 0.001, the following values differed between the Roma and non-Roma population of the South Bohemia Region: waist/height index, waistline, total fat, body mass index (BMI), systolic and diastolic blood pressure. Differences in the incidence of the waist/hips index were significant at p < 0.01. Correlations of incidence with indicators of overweight and obesity in Roma were registered in relation to both age and gender of participants. The results show that overweight and obesity indicators were recorded more frequently in Roma female respondents. Although the results are unique, the conclusions cannot be generalized for Roma throughout the Czech Republic.

CONCLUSION

The conclusions of the above findings will be implemented in strategic materials for community planning in the South Bohemia Region. The goal will be to offer services aimed at supporting a healthy life style for Roma living in the South Bohemia Region of the Czech Republic.

The importance of self-management in the prevention and treatment of excessive weight and obesity

OBJECTIVES

The aim of this research into 'self-management' was to determine to what extent respondents were aware of their status as overweight or obese. For respondents who indicated that they were overweight or obese, the goal was to determine whether they tried to lose weight, what steps they took to control their, and what specific methods they used.

METHODS

Information was collected using semi-structured interviews from May 31, 2014, to January 30, 2015. Data processing was performed using statistical analysis of the social data SASDM 01/04/10 software. The total study group consisted of 600 respondents, including 302 from the Roma minority, and 298 from the non-Roma majority population (control group). Respondents were selected specifically from South Bohemia Region of the Czech Republic. The sample from the Roma minority was constructed using the snowball method (Snowball Sampling). The control sample of non-Roma was selected through quota sampling.

RESULTS

The results indicate that the respondents from both the Roma minority and the non-Roma control group generally recognized when they were overweight or obese, or they were aware of it to a much lesser extent than objective indicators revealed. More than two thirds of the respondents who admitted they were overweight or obese (N = 143) reported that they had suffered from overweight or obesity since they were young adults. Significantly more members of the majority population had tried to lose weight using self-management, whereas the level of effort was significantly less among members of the Roma minority (P = 0). Nevertheless, Roma respondents significantly more often reported (P < 0.01) that they had agreed on a specific weight loss plan with a doctor.

CONCLUSION

The results of our research show that in the context of prevention, it is important to promote self-managed skills, habits and other characteristics that can play an important role in the prevention and treatment of obesity and overweight.

Prevention of patient falls in hospitals in the Czech Republic

THEORY

The prevention of patient falls is one of the safety goals set forth by the Ministry of Health of the Czech Republic.

GOAL

A sociological survey was carried out to (1) determine to what extent nurses identify the risk of patient falls at admission, (2) if the risk is reassessed and at what intervals, (3) what preventive measures were taken, and (4) in what way are patient falls reported.

METHODOLOGY

A representative sample consisting of general nurses working shifts on inpatient wards at hospitals in the Czech Republic was surveyed. Altogether 772 nurses took part in the study.

RESULTS

The survey showed that at admission, most nurses assessed the risk of falls (91.6%). Nonetheless, it should stand as a stark warning that nearly one fifth of the respondents (16.2%) did not reassess the risk of falls after admission! On the other hand, it can be perceived as a positive that most nurses (70.1%) use a multifaceted program of preventive measures for at risk patients and immediately reported fall events to the doctor in charge (71.4%). During statistical testing, the predication that a working atmosphere supporting a culture of patient safety would significantly decrease the probability of patient falls and increases the willingness of nurses to use preventive programs in daily practice.

CONCLUSION

Results from the survey showed that a system to minimalize fall risks has been successfully introduced into the hospitals of the Czech Republic. The system is based on the recommendations of the Ministry of Health of the Czech Republic.

The nurse's role in preventive care in the field of community nursing

OBJECTIVES

According to published reports from the WHO, health care is undergoing a transformation that reflects the increasing importance of community care based on social, group, and individual needs. Community health care is provided by multidisciplinary teams, with nurses occupying irreplaceable positions. Nurse competencies constitute significant potential in the area of community based preventive care as well as the more traditional roles in treatment and recovery.

METHODS

Data was obtained from health care professionals and the public through a structured interview. The study population included 1,007 physicians, 1,005 nurses and 2,022 laypersons. Respondents were selected randomly with the aid of quotas. The parameters for the selection of health care workers (nurses and physicians) were constructed based on registration data from the Institute of Health Information and Statistics. Layperson selection was based on data from the Czech Statistical Office. The Statistical Analysis of Social Data program (version 1.4.4) was used to process the data, which was in the form of 1st and 2nd degree contingency tables. The dependence level was determined based on χ2 and other testing criteria (according to the character of the signs).

RESULTS

The results show that respondents perceive the concept of a "community nurse" as a nurse working independently in local neighborhoods and communities. Results also showed that work in senior care, followed by home care, and care for chronically ill patients were the most preferred. A role for nurses in health care education centers was only supported by 13.1% of physicians, 13.8% of nurses, and 6.8% of laypersons. The results also reveal that community nursing is perceived by both health care professionals and laypersons as fieldwork (i.e. work not based in a hospital or clinic environment), yet, at the same time, it was perceived as work that dealt with people needing health care. The results also reflect the opinion that the establishment of an independent nurse in the workplace (in the form of preventive care) could lead to an increase in the quality of care for employees (65.7% of physicians and 70.8% of nurses), an improvement in workplace health education (33% of physicians and 34.7% of nurses) and would provide support for healthy work environments (31.4% of physicians and 30.4% of nurses).

CONCLUSION

Our results lead us to conclude that the health care system in the Czech Republic needs to better utilize the potential of trained nurses in the field of community health care. Additionally, steps need to be taken to increase job opportunities and staffing for nurses wanting to work in community health and preventive care.

The reflection of the quality of life of people with Crohn's disease in nursing

OBJECTIVES

To determine the quality of life of patients with Crohn's disease and to determine if this is reflected by the quality of nursing care.

METHODS

For the purpose of this research, we used a generic standardized questionnaire of the quality of life, published by the World Health Organization (WHOQOL-100). The questionnaire was distributed among 100 patients with Crohn's disease and among 1456 and members of healthy population. To analyze the results, we used the SPSS program and appropriate statistical methods.

RESULTS

The comparison of the domain scores of population standards in the Czech Republic and the respondents with Crohn's disease revealed a difference in the domain "physical condition", where the mean value was at the limit of the lower interval of the standard, and in the domain of "independence".

CONCLUSION

The results given in this study define the possibilities of nurses and their functioning associated with altered quality of life. An evaluation of the most affected areas allows nurses to determine an appropriate intervention. Providing nursing care, in accordance with the latest knowledge, must be based on the quality of life. This newly incorporated area offers healthcare professionals a new dimension for assessing and determining subsequent interventions.

Quality of life in patients with chronic diseases

OBJECTIVES

A quality of life assessment is of great importance for patients with chronic diseases, because problems caused by specific diseases impact specific areas of their lives. The goal of this work was to determine, in which areas select diseases (rheumatoid arthritis, Crohn's disease, ischemic disease of the lower extremities and chronic obstructive pulmonary disease) affect patients' quality of life.

METHODS

The Czech version of the WHOQOL-100 instrument and specific standardized questionnaires for individual diseases: EuroQol, EQ-5D-5L, IBDQ, PAQ were used to assess quality of life. This paper presents the results of the WHOQOL-100 questionnaire. In total, 5 research samples were put together. The first sample consisted of 200 respondents with rheumatoid arthritis (RA); the second sample included 100 respondents with inflammatory bowel disease (IBD); the third sample was comprised of 404 respondents with ischemic disease of the lower extremities (IDLE); the fourth sample consisted of 449 respondents with chronic obstructive pulmonary disease (COPD); and the fifth sample was represented by 1,456 healthy respondents. The acquired data were then statistically analyzed. A statistical data analysis was performed in two steps. In the first step descriptive statistical analyses were performed in the SASD program (absolute and relative frequencies of respondents' answers, median values and variability characteristics). In the second step differences in means of the subjectively-perceived quality of life in patients with individual diseases and in control group were tested using the Mann-Whitney U test and the non-parametric Wilcoxon pair test. These analyses were computed in the SPSS (Statistical Package for the Social Sciences) program.

RESULTS

The results show that a statistically significant difference in average domain score values was found between the healthy population and patients diagnosed with RA in the domains of "physical health", "level of independence", "environment", and "spirituality/religion/personal beliefs". A statistically significant difference was found in all domains for patients with IDLE and COPD. A statistically significant difference was found in four domains for patients with IBD, namely those of "physical health", "level of independence", "social relationships" and "spirituality/religion/personal beliefs".

CONCLUSION

All therapeutic and nursing interventions that can contribute to improving QoL in poorly performing domains should be utilized.

The hospitalized patient as a partner in the survey on safe care in the Czech Republic

OBJECTIVES

The study examined the extent to which patients in the Czech Republic are involved in decisions regarding their treatment and whether they are interested in ensuring safety during hospitalization.

METHODS

Patients were interviewed to determine their perspectives regarding the previously stated objectives. The sample consisted of 514 patients who had been admitted to hospital for a minimum of three days.

RESULTS

It is clear that patients in the Czech Republic are unaware of safety issues associated with provided care, but 52.2% of respondents expressed a desire to be more involved in decisions pertaining to their treatment. Widowed patients, as well as those hospitalized for more than six days, expressed less of a desire for such involvement. Half of the patients enrolled in the study stated that health care professionals had encouraged them to ask questions about their treatment. With regard to errors associated with surgical reversals, 58.3% of respondents stated that nursing staff had performed checkups to avoid confusion in surgery. Another patient safety issue is nosocomial infection acquired through improper hand-washing techniques of medical personnel. 73.5% of patients said they would not have the courage to ask medical staff (doctors or nurses) whether they had washed their hands prior to examination.

CONCLUSION

Patients in the Czech Republic are unaware of the safety issues associated with provided care, but more than half expressed a desire to be more involved in decisions that pertain their treatment.

S100P, a peculiar member of S100 family of calcium-binding proteins implicated in cancer

S100P belongs to several members of the S100 family of calcium-binding proteins, associated with malignant phenotype. Altered levels of S100P expression have been described at different stages and types of cancer. Transcriptional regulation involves different pathways activated by glucocorticoids, growth factors and bone morphogenic factor via the corresponding receptors. Signals coming from these pathways appear to be transmitted through ERK1/2 (extracellular-signal regulated kinase) and mediated presumably by STAT, SMAD, NFkB transcription factors. The secreted form of S100P can bind to extracellular ligand-binding site of RAGE (receptor for advanced glycation end-products), and via activation of ERK/MAPK pathway can influence gene expression, cell proliferation and survival. In addition, S100P interacts and modulates the activity of several targets with multiple binding modes and simultaneous coordination of further target proteins in larger multiprotein complexes, e.g. scaffolding proteins -IQGAP1 and ezrin, known to promote and regulate signal transduction pathways. The majority of S100P binding partners are proteins involved in cytoskeletal dynamics, and their physical interactions with S100P lead to defects in cellular morphogenesis and tissue disruption, the acquisition of uncontrolled migratory and invasive features. Finally, the evidence for S100P role in cancer metastasis opens a new direction for the future research efforts.

Birth after cesarean section

Background

The number of incoming expectant women who have previously experienced cesarean section has increased. This work sought to find the frequency and connections between vaginal deliveries, cesarean sections, and iterative cesarean sections from 2004 to 2008.

Material/Methods

In all, 828 women with previous cesarean sections were included. From this group, 8282 vaginal deliveries were performed. During these years, 828 women had a history of the cesarean section; in these women, iterative cesarean sections were indicated. To evaluate knowledge of educational material designed for women being prepared for the iterative delivery, we used information compiled on experience from 2002 to 2003; the same approach was used to evaluate the nursing process on interventions and diagnoses of cesarean sections.

Results

From 2004 to 2008, 11 279 deliveries were performed in the Perinatological Center in České Budějovice; this was significant (P<.001). The same result was obtained in the relation for the total number of deliveries and those performed by the iterative cesarean section. The number of iterative cesarean sections in women who had already experienced the cesarean section (828) and delivered by cesarean section again is 620. Other data were not significant. Only 2 to 3 pregnancies next to the first cesarean section were statistically significant in 2004 and 2005.

Conclusions

If a trial of labor after cesarean does not proceed to vaginal birth, the woman will need support and encouragement to express feelings about another cesarean birth.

Nursing education in the Czech Republic

The report is focused on the transformation process in pregraduate education of nurses in the Czech Republic. The all-society changes taking place in the last decades of the 20th century have opened the way for implementation of changes in the Czech nursing as well. Nursing is becoming an independent scientific discipline, the role of the nurses and their position in the society are changing and the professional preparation is gradually shifting to colleges and universities. After 15 years of effort to implement the planned transformation changes in nursing education, the Czech Republic's joining of the European Union has helped us. In connection with fulfillment of Bologna declaration, Master study in nursing has been gradually developing in education of nurses in the Czech Republic as well. In order to create a structured study in nursing according to the above mentioned declaration, a postgraduate doctor program must be implemented too. The implementation of all types of university education of nurses is very important and it will positively contribute to the development of nursing in our republic as a full-bodied scientific discipline and to the creation of its high-quality scientific-research base.