Kategorija: Izdanja

Utjecaj komunikacije zdravstvenih djelatnika na razvitak boli, agitacije i delirija kod bolesnika u jil

Influence of medical personnel communication skills on pain, agitation and delirium development among intensive care unit patients

SAŽETAK

Visoka razina buke u JIL–u može biti značajan problem, kako za pacijente, tako i za osoblje. Ona je direktni suradnik sa mnogobrojnim čimbenicima za mnogo negativnih učinaka za pacijenta i osoblje, poput poremećaja spavanja, iritabilnosti, agitacije i delirija. Nefarmakološka prevencija i liječenje bolesnika s delirijem je učinkovita komunikacija i interakcija, a odnosi se na poticanje i orjantaciju bolesnika u svojoj okolini, te uspješnu komunikaciju. Naše riječi i naš izgled su naše ogledalo, one ističu kompetentnost i kredibilitet te imaju odlučujući utjecaj na bolesnike .Vještine komuniciranja sa naglaskom na empatiji, osjetljivost za pacijente vrlo su bitne kvalitete zdravstvenog osoblja u JIL- u te čimbenici koji direktno utječu na učestalost i nastanak ICU delirija. Razumjeti, ohrabriti, podržati i poštivati bolesnike koji borave u JIL- u trebao bi biti usmjerenje u komunikaciji zdravstvenog osoblja. Sprječavanje nastanka boli, agitacije i delirija zahtjeva multikomponentalne intervencije te dobru suradnju i komunikaciju članova tima. Zdravstvene djelatnike potrebno je stoga obrazovati za vođenje dobre komunikacije s pacijentima te međusobno u timu.

KLJUČNE RIJEČI: komunikacija, bol, agitacija, delirij

SUMMARY

High level noise in the Intensive Care Unit (ICU) may present significant problem for ICU patients, as well as for medical personnel working in the same environment. The level of ICU noise is in close relation with various negative effects on the patients and medical personnel, such as sleep disorders, iritability, agitation and delirium. Effective communication and close interaction represent a corner stone of a non – pharmacologic prevention and treatment of patients in delirium. Our words mirror us, asserting our compentencies and credibility, with a strong effects on our patients. Medical personnel good communication skills, emphasysing empathy and sensibility towards our patients, are important and have a direct influence on frequency of delirium development in the ICU. The goal od effective communication in the ICU is understanding, supporting and respecting each patient per se. Multiprofessional approach in pain management, together with agitation and delirium prevention, with good communication and cooperation within everyone in the medical team is fundamental.

In future it is essential to put more emphasis on education of building strong communicational skills towards ICU patients, as well as among team members.

KEY WORDS: communication, pain, agitation, delirium

Nastavi čitati Utjecaj komunikacije zdravstvenih djelatnika na razvitak boli, agitacije i delirija kod bolesnika u jil

Applying the isokinetic and the isokinetic diagnostics at the injures of ligamentum anterior cruciate-acl

SUMMARY

Injury to the ligaments of the knee lately is growing among athletes. In the sports literature the term sports knee is more present than before. Fresh injuries of the ligament apparatus essentially represent a serious distortion of the knee, which if improperly are treated can cause serious damage to the kinematics of the knee. According Bousget heavy distortion of the knee means: isolated ACL injury; isolated failures of the last internal angle or popliteus, isolated failures of the last internal angle with desinsertion of the meniscus and at least two or more violations of the capsule of the ligament apparatus of the knee.

The world trends show a significant quantitative increase in the sport and recreation activities dealing with people during their leisure time. Unfortunately, such attempts often result in more damage than good, because they are performed spontaneously, usually without a plan and program, and especially without adequate supervision and preparations of the bones, wrists, muscular and cardiorespiratory system.

Therefore, in such activities sometimes it comes even to severe consequences such as heart attack, stroke, but in most cases the problems usually are associated with the locomotors apparatus. So often we find stretched and ruptured muscles and tendons, wrists problem in terms of ruptured ligament, degenerative damage (mostly cartilage) and in the worst cases even stress fractures of the bones. Therefore, it would be nice firstly to strengthen muscles, to enable the wrists, tendons and bones and only then to start with activity. One extremely effective method for this is isokinetic exercise, whereby the muscles are actively strength without danger of overload of the wrists. That is important in the prevention, because it brings into balance the antagonistic groups i.e. we prepare optimally entire bone-muscle system for the planned recreation.

Isokinetic exercise is the most beneficial for people that have already led to some pathological changes, primarily damage to the joints (injuries, degenerative inflammatory diseases, etc.). After completing the isokinetic treatment it is extremely important that before to proceed with some kind of planned physical activity, as the resulting muscular force would better maintained, and cardiorespiratory system would be developed more.

KEY WORDS: ACL, BIODEX, Isokinetic, diagnostics, knee, injures

Nastavi čitati Applying the isokinetic and the isokinetic diagnostics at the injures of ligamentum anterior cruciate-acl

Kolorektalni karcinom s aspekta medicinske sestre

Nurses knowledge and perception toward colorectal cancer

SAŽETAK

UVOD: Kolorektalni karcinom nalazi se na trećem mjestu po učestalosti među svim zloćudnim novotvorevinama u svijetu, ali isto tako to je jedan od rijetkih tumora čiju pojavu možemo na vrijeme spriječiti.

CILJ ISTRAŽIVANJA: utvrditi učestalost kolorektalnog karcinoma na hirurškom odjelu Regionalnog medicinskog centra dr Safet Mujić. Ujedno cilj ovog istraživanja je ustanoviti ulogu i značaj medicinske sestre u provedbi zdravstvene njege ovih bolesnika.

ISPITANICI I POSTUPCI: Provedena je retrospektivna studija na hirurškom odjelu Regionalnog medicinskog centra Dr Safet Mujić Mostar. Ispitanici su bili bolesnici s verificiranom patohistološkim nalazom kolorektalnog karcinoma koji su hospitalizirani na odjelu u razdoblju od 1.1.2011. do 31.12.2013. Broj ispitanika bio je 131.

REZULTATI: Muškaraca je bilo 70 (53,4%) dok je žena bilo 61 (46,6%) (P=0,431). Srednja životna dob ispitanika je 69,5±5,8 godina. Najmlađi ispitanik ima 48, a najstariji 89 godina. Srednja životna dob muškaraca bila je 68,9±6,1 godina, dok je u žena iznosila 71,3±5,4 što se nije pokazalo statistički značajnim (P=0,506). Najčešće izvođena operacija je niska anteriorna resekcija koja je učinjena kod ukupno 47 (35,9%) pacijenata, dok je najmanje učestalo izvođena operacija bila resekcija kolon transversuma koja je učinjena svega kod 7 (5,3%) pacijenata (p<0,001). Najčešće zastupljen stadij kolorektalnog karcinoma bio Dukes B u 48 (36,6%) pacijentata, odnosno Dukes C u 44 (33,6%) pacijenta. (p<0,001). Prosječna dužina hospitalizacije ispitanika iznosila je 13,4 dana, od čega su prosječno 2,7 dana proveli u jedinici intenzivnog liječenja.

ZAKLJUČCI: U perioperacijskom procesu zdravstvene njege bolesnika s kolorektalnim karcinomom ključnu ulogu imaju medicinske sestre-tehničari, te o kvaliteti njihovog posla direktno ovisi i konačni uspjeh liječenja.

SUMMARY

INTRODUCTION:Colorectal cancer is the third most common malignant neoplasms among all of the world, but also it is a rare tumor whose occurrence can be prevented in time.

AIM: To determine the incidence of colorectal cancer in the surgical department of the Regional Medical Center Dr Safet Mujić. Also, the aim of this study was to determine the role and importance of nurses in implementing the health care of these patients.

PATIENTS AND METHODS: We conducted a retrospective study on the surgical ward Regional Medical Center Dr Safet Mujić Mostar. Subjects were patients with histologically verified colorectal cancer who were hospitalized in the department during the period from 1.1.2011. to 31.12.2013. The number of respondents was the 131.

RESULTS: Males were 70 (53.4%), while women were 61 (46.6%) (P=0.431). The mean age of respondents was 69.5 ± 5.8 years. The youngest participant is 48 and the oldest 89. The mean age of men was 68.9±6.1 years, whereas in women was 71.3±5.4 which did not prove to be statistically significant (P=0.506). The most commonly performed surgery is a low anterior resection, which was performed in a total of 47 (35.9%) patients, whereas the least frequently performed operation involves resection of the colon transversuma that was done only in 7 (5.3%) patients (p<0.001). The most frequent stage colorectal cancer was Dukes B in 48 (36.6%) pacijentata or Dukes C in 44 (33.6%) patients (p<0.001). The average length of hospitalization of patients was 13.4 days, of which an average of 2.7 days in the intensive care unit.

CONCLUSIONS: In the perioperative process health care of patients with colorectal cancer have a crucial role nurses-technicians, and the quality of their work depends directly on the ultimate success of treatment.

Nastavi čitati Kolorektalni karcinom s aspekta medicinske sestre

Psihičke reakcije bolesnika u perioperativnom periodu

Psychological reactions of patients in the perioperative period

SAŽETAK

UVOD: Hirurška intervencija uobičajeno dovodi do straha. Operacija je uvijek naglašeni emocionalni ulazak u sferu nepoznatog i nema čovjeka s normalnim psihološkim odbranama koji ne osjeti nelagodu pri odlasku na bilo koju operaciju. Cilj ovog istraživanja je ispitati postojanje psihičkih reakcija pacijenata koji su primljeni na operativni tretman, mogućnost iznalaženja mjera u prevladavanju mogućeg preoperativnog i postoperativnog straha, izrada plana uvođenja promena i strategija u prevladavanju preoperativnog i postoperativnog straha i praćenje njegovog ostvarivanja.

METODE: Istraživanje je sprovedeno u hiruškoj jedinici za anesteziju i reanimaciju Univerzitetske bolnice u Foči u periodu od 01.05.2013. godine do 31.05.2013. godine. U istraživanju je korišten kraći deskriptivni upitnik sa podacima o ispitaniku i upitnik samoprocjene za depresiju.

REZULTATI: Najveći broj pacijenata je par dana pred operaciju imao smanjeno interesovanje za događaje oko sebe, osjećaj praznine, neraspoloženje, probleme sa snom , umor. Najveći broj pacijenata nije imao umanjen apetit, slabost koncentracije, usporenost, suicidalne ideje. Od 20 naših ispitanika 3 pacijenta nisu pokazivala tjelesne simptome, dok njih 17 je navodilo veći broj tjelesnih simptoma iz područja svih organskih sistema. Kod 4 pacijenta pronađen je rezultat koji odgovara za uobičajenu opštu populaciju, blagi oblik depresije je pronađen kod 11 pacijenata, dok je umjereno blagi oblik depresije pronadjen je kod 5 pacijenata.

ZAKLJUČAK: Dobro osmišljena i obavljena psihološka preoperativna priprema predstavlja ne samo važan faktor pozitivnog operativnog ishoda i uspešnog postoperativnog oporavka bolesnika, već i trajniji zalog njegovog racionalnog odnosa prema zdravlju i bolesti.

KLJUČNE REČI: Strah od operacije, ličnost bolesnika, psihološka priprema

SUMMARY

INTRODUCTION: Surgical intervention usually leads to fear. The operation has always been emphasized emotional entry into the sphere of the unknown and there is no man with normal psychological defenses that do not feel any discomfort when visiting any operation.

OBJECTIVE: The aim of this study is to examine the existence of psychological reactions of patients who were admitted to the surgical treatment, the possibility of exploring measures to overcome possible preoperative and postoperative fear, development of a plan to introduce changes and strategies to overcome the preoperative and postoperative fear and monitoring its implementation.

METHODS: The research was conducted in the surgical unit for anesthesia and resuscitation at University Hospital in Foča during the period from 01.05.2013. until 31.05.2013. year. The study used a descriptive short questionnaire with information on the subject and self-assessment questionnaire for depression.

RESULTS: The majority of patients a few days before the operation had diminished interest in the events around them, a feeling of emptiness, indisposition, sleep problems, fatigue. The majority of patients had decreased appetite, weakness of concentration, slow, suicidal ideas. From all examined patients 15% of them showed no physical symptoms, while 85% were showed greater number of physical symptoms in the field of all organ systems. Twenty percent of all examined patients has no signs of depression, a mild form of depression was found in 55% of patients, while the moderately mild form of depression was found in 25% of patients.

CONCLUSION: A well-designed and conducted psychological preoperative preparation is not only an important factor for positive operational outcomes and successful post-operative recovery of patients, but also more durable pledge its rational relationship to health and disease.

KEY WORDS: Fear of surgery, patient personality, psychological preparation

Nastavi čitati Psihičke reakcije bolesnika u perioperativnom periodu