Katarína Žiaková

Quality of life and treatment satisfaction in the context of diabetes self-management education

The aim of this study is to identify and compare factors affecting quality of life and treatment satisfaction in people attending the structured educational programme for patients with intensified insulin therapy. A sample of 104 patients was recruited from diabetes specialized centre between November 2006 and March 2007. For measure patients quality of life, the Audit Diabetes Dependent Quality of Life questionnaire and for measure patients satisfaction with their treatment regimen, the Diabetes Treatment Satisfaction Questionnaire status version was used. Treatment satisfaction has different variables or predictors from quality of life. Quality of life was affected by the number of reported diabetic late complications, type of insulin regimen, age and diabetes duration. Type of insulin regimen, the frequency of blood glucose self-monitoring and perceived frequency of hyperglycaemia demonstrated the significant association with treatment satisfaction. Our findings might help health-care professionals have a deeper understanding of the factors affecting quality of life and treatment satisfaction and thereby aid in the design of strategies to maintain or improve quality of life and treatment satisfaction.

Job satisfaction and subjective well-being among Czech nurses

The aim of the present study was to investigate the relationship between domains of the job satisfaction and components of subjective well-being in nurses. A convenience sample of hospital nurses was recruited from six hospitals in Czech Republic. Data were collected using a set of questionnaires that included the McCloskey/Mueller Satisfaction Scale, the Positive Affect Scale, the Negative Affect Scale and the Personal Well-being Index. We confirmed low association between job satisfaction and subjective well-being of nurses. Satisfaction with extrinsic rewards, co-workers and family/work balance accounted for only a small percentage of variance in cognitive component of subjective well-being. Positive affect was predicted by interaction opportunities and scheduling. Negative affect was predicted by interaction opportunities and scheduling and intention to leave the actual workplace. Low percentage of the variance suggests that subjective well-being is not strongly influenced by job satisfaction.

Predictive validity of the Braden scale, Norton scale and Waterlow scale in Slovak Republic

Cieľ: Zistiť mieru predikcnej validity skal na posudenie rizika vzniku dekubitov (Bradenovej skala, Nortonovej skala, Waterlowej skala) v slovenskom klinickom prostredi. Design: prospektivna studia. Metodika: 100 pacientov hospitalizovaných v case od aprila do augusta 2014 na oddeleni dlhodobej starostlivosti bolo posudených pomocou skaly Bradenovej, Nortonovej a Waterlowej. Vstupným kriteriom pre zaradenie do výskumneho suboru bolo: vek viac ako 18 rokov, pri prijme na oddelenie nebol u pacienta pritomný dekubit. Predikcna validita skal na posudenie rizika vzniku dekubitov bola hodnotena na zaklade hodnot senzitivity, specificity, pozitivnej a negativnej prediktivnej hodnoty a hodnoty plochy pod ROC krivkou. Výsledky: Incidencia dekubitov v tejto výskumnej studii je 14 %. Senzitivita, specificita, pozitivna prediktivna hodnota, negativna prediktivna hodnota pre skalu Bradenovej je (cut-off bod 15) 85,71 %, 53,48 %, 23,07 %, 95,83 %, pre skalu Nortonovej (cut-off bod 12) 85,71 %, 48,83 %, 21,42 %, 95,45 % a pre skalu Waterlowej (cut-off bod 13) 85,71 %, 30,23 %, 16,66 %, 92,85 %. Hodnota plochy pod ROC krivkou bola 0,696 pre skalu Bradenovej, 0,672 pre skalu Nortonovej a 0,579 pre skalu Waterlowej. Zavery: V nasej výskumnej studii dosiahla najlepsie hodnoty predikcnej validity s malými rozdielmi skala Bradenovej, na druhom mieste skala Nortonovej a na poslednom mieste skala Waterlowej.

Predictive validity of the Braden Scale, Norton Scale, and Waterlow Scale in the Czech Republic

The aim of this study was to determine the predictive validity of the Braden, Norton, and Waterlow scales in 2 long-term care departments in the Czech Republic. Assessing the risk for developing pressure ulcers is the first step in their prevention. At present, many scales are used in clinical practice, but most of them have not been properly validated yet (for example, the Modified Norton Scale in the Czech Republic). In the Czech Republic, only the Braden Scale has been validated so far. This is a prospective comparative instrument testing study. A random sample of 123 patients was recruited. The predictive validity of the pressure ulcer risk assessment scales was evaluated based on sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve. The data were collected from April to August 2014. In the present study, the best predictive validity values were observed for the Norton Scale, followed by the Braden Scale and the Waterlow Scale, in that order. We recommended that the above 3 pressure ulcer risk assessment scales continue to be evaluated in the Czech clinical setting.

Factors influencing the effectiveness of clinical learning environment in nursing education

Cieľ: Cieľom deskriptivnej prierezovej studie bolo zistiť ako studenti osetrovateľstva hodnotia vybrane faktory klinickeho prostredia v priebehu osetrovateľskej praxe v zdravotnickych zariadeniach. Zisťovali sme vzťahy medzi vybranými faktormi klinickej výucby a hodnotenim klinickeho prostredia studentmi. Design: Deskriptivna prierezova studia. Metody: Výskumu sa zucastnilo 503 studentov druhých a tretich rocnikov studijneho programu osetrovateľstvo zo siestich univerzit v ramci SR. Na hodnotenie klinickeho prostredia bol použitý validný a reliabilný dotaznik Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale (CLES+T). Rozdiely v hodnoteni klinickeho prostredia sme zisťovali Pearsonovým chi-kvadratovým testom, viacfaktorovou analýzou rozptylu (ANOVA). Na zistenie zavislosti medzi premennými sme použili Pearsonov korelacný koeficient. Výsledky boli spracovane na hladine statistickej významnosti α ≤ 0,05. Výsledky: Významna casť studentov uvadzala skusenosti s tradicným modelom skupinovej supervizie. Metoda supervizie, frekvencia superviznych stretnuti a dĺžka klinickej praxe na pracovisku mali signifikantný vzťah k hodnoteniu klinickeho prostredia. Zaver: Metoda supervizie predstavuje signifikantný faktor ovplyvňujuci hodnotenie klinickeho prostredia studentmi. V porovnani s europskymi studiami sme zistili nižsiu mieru implementacie individualneho supervizneho vzťahu studenta s mentorom. V ramci univerzit na Slovensku dominoval tradicný skupinový model supervizie. Uvedene výsledky umožňuju analýzu faktorov významných pre zabezpecenie kvality klinickej výucby.

PREDICTIVE VALUE OF THE MORSE FALL SCALE

Aim: The goal of this study was to analyse relevant research studies focusing on the testing of the predictive value of the Morse Fall Scale measuring device on hospitalized patients. Design: Literature review. Method: Search for full text research studies in Web of Science, Scopus, ScienceDirect, and Summon Discovery Tool (licensed electronic information databases), based on pre-established criteria, and key words, from 1989 to 2016. Results: Sensitivity values ranged from 31% to 98%, and specificity values ranged from 8% to 97% in 14 analysed studies. The predictive value of the tool in validation studies varies depending on the tested cut-off value, the type of clinical ward, the frequency of assessment, the size and age of the sample, and the length of hospitalisation; therefore, the validity of the results from one study cannot by extrapolated to the entire hospitalized population of patients. Conclusion: The predictive values of the Morse Fall Scale are not stable; they vary in clinical conditions according to various factors. When implementing a tool for a specific clinical ward, an optimum cut-off score must be established to ensure that preventative strategies do not require unnecessary effort on the part of the staff, and do not increase hospital costs. Keywords: falls, hospital, Morse Fall Scale, sensitivity, specificity, review.

Inter-rater reliabilita položiek Bradenovej škály, Nortonovej škály, Waterlowej škály

Background: Worldwide, approximately 40 pressure ulcer risk assessment scales are available. Despite of this amount, the psychometric properties were tested only for some. Aim: To determine inter-rater reliability of items of selected pressure ulcer risk assessment scales (Braden Scale, Norton Scale and Waterlow Scale). Methods: The data were collected from April to August 2014 in one long-term care department. The sample consisted of 32 patients. An intra-class correlation coefficient (ICC) was used to determine the inter-rater reliability. Results: The inter-rater reliability of Braden Scale ranged between ICC = 0.846 for the item “activity” and ICC = 0.645 for the item “nutrition“. The highest inter-rater reliability of Norton Scale reached for item “incontinence” (ICC = 0.931), the lowest for item “physical condition” (ICC = 0.849). The highest inter-rater reliability of Waterlow Scale is observed for items “sex” (ICC = 1), “surgery/trauma” (ICC = 1). The lowest inter-rater reliability reached item “weight loss score” (ICC = 0.497). Conclusions: The highet inter-rater reliability reached items of Norton Scale, followed by items of Braden Scale. The lowest inter-rater reliability reached items of Waterlow Scale. We recommend further testing of pressure ulcer risk assessment scales in czech clinical settings.

Experience of nurses with in-patient aggression in the Slovak Republic

Cieľ: Cieľom studie bolo zistiť skusenosť sestier z ložkových oddeleni vybraných nemocnic vo vsetkých regionoch Slovenska s agresiou hospitalizovaných pacientov v obdobi posledneho roka. Design: Praca ma charakter kvantitativnej prierezovej studie. Metodika: Výskumný subor tvorilo 1 042 sestier s priemernou dĺžkou praxe 19,23 (± 10,96) rokov, z chirurgických, internistických, psychiatrických pracovisk a pracovisk intenzivnej starostlivosti. Zber udajov bol realizovaný pomocou sebaposudzovacej skaly Výskyt Agresie Pacientov voci Sestram (VAPS). Výsledky: V obdobi posledneho roka bolo konfrontovaných s agresiou pacientov 97,4 % sestier. So slovnou agresiou malo skusenosť 96,8 % sestier a s telesnou agresiou 83,3 % sestier. Najcastejsiu skusenosť s agresiou pacientov mali sestry pracujuce na pracoviskach psychiatrie a intenzivnej starostlivosti. Statisticky významný rozdiel bol vo výskyte agresie pacientov voci sestram na zaklade prevadzky. Sestry pracujuce vo viacsmennej prevadzke uvadzali vyssiu frekvenciu výskytu agresie pacientov oproti sestram v jednosmennej prevadzke. Nepotvrdil sa statisticky významný vzťah medzi vekom, dĺžkou praxe, vzdelanim sestier a ich skusenosťou s agresiou pacientov. Zaver: Studia poukazuje na skusenosti sestier s roznymi formami agresie pacientov, poskytuje dokazy o aktualnosti problemu. Výsledky možu byť východiskom pre systematicke hodnotenie faktorov vzniku a manažment agresie. Implementacia preventivnych strategii v klinickej praxi je nevyhnutna.

OCCURRENCE OF ANNOYING SYMPTOMS OF PATIENTS WITH CANCER

Aim: To determine symptoms those occur by patients with cancer. Design: A cross-sectional survey. Methods: The sample of research consisted of 100 patients with cancer. We used Memorial Symptom Assessment Scale (MSAS) to evaluate the symptoms. This Scale determines 32 symptoms in three subscales (physic, psychic symptoms, and complete distress) focused on frequency, intensity and distress of symptoms of Likert Scale 1–4. Results: The research results demonstrate that in terms of frequency, intensity and distress the patients most frequently suffer pain (4.30 ± 3.30), despite of all the pain treatment options. The other symptoms that patients encountered include nausea (3.52 ± 2.70), restless sleep (3.92 ± 3.48), anxiety (3.81 ± 3.55) and feelings of sadness (1.30 ± 0.22). In terms of disease severity, we had greater incidence of symptoms in patients with stage 3 – cancer metastatic disease (p ≤ 0.05). Our research also confirmed the correlation between the occurrence of symptoms and duration of illness. Greater incidence of symptoms has been reported in patients with longer lasting disease, in most cases, endstage disease (p ≤ 0.05). Conclusion: A key part of palliative care is minimizing of annoying physical, psychological, social and spiritual symptoms of patients. Assessment of the annoying symptoms in clinical practice allows the planning and implementation of effective interventions to promote quality of life of patients and their families in palliative care.

THE USE OF NURSING DIAGNOSES IN CLINICAL PRACTICE

Cil: Na zakladě analýzy odborne literatury v oblasti osetřovatelske diagnostiky zjistit chybovost a cetnost použivaných osetřovatelských diagnoz v klinicke praxi a faktory ovlivňujici přesnost a výskyt osetřovatelských diagnoz. Metodika: Jako zdroj byly použity databaze (1993-2013); PubMed, ProQuest, Google Scholar. Po použiti zařazovacich a vyřazovacich kriterii bylo ke zpracovani použito 39 zdrojů; korelacně-prediktivni studie (9), retrospektivni studie s využitim zaznamů pacientů (7), průřezove studie (4), systematicke přehledy (3), kohortove studie (3), randomizovanou studii (1), longitudinalni analýzu (1). Udaje byly ziskavany take z výukových textů (7), přehledových clanků (2) a odborných polemik (2). Výsledky: Při sledovani výskytu chybovosti osetřovatelských diagnoz se casto opakuji stejne problemy jak ve formulaci, tak i v přesnosti stanovených osetřovatelských terminů. Nedostatky se vyskytovaly v identifikaci urcujicich znaků a zejmena souvisejicich faktorů. Převažovaly diagnozy týkajici se dysfunkcnich tělesných potřeb a absentovaly diagnozy z oblasti psychosocialni a spiritualni. Z analýzy literarnich zdrojů vyplynulo, že mezi faktory, ktere ovlivňuji přesnost a výskyt osetřovatelských diagnoz v praxi patři sestry a jejich vzdělani a zkusenosti v osetřovatelske diagnostice, způsob organizace osetřovatelske pece, technologie osetřovatelske dokumentace a institucionalni podpora zejmena v adekvatnim personalnim zabezpeceni. Zavěr: Pro poskytovani ucinne, efektivni a bezpecne pece je nutne, aby manažeři jednotlivých zdravotnických zařizeni zaměřili strategii celostně na system, to znamena vzajemne propojeni jednotlivých casti; lide, prostředi, proces a technologie.