Study of the Opinion of Medical Specialists and Social Workers Regarding Medico-Social Assistance Organization for Older Adults and Elderly People in Home Settings

According to the National Statistical Institute, an older adult person has an average of 4-6 illnesses. In most of the cases chronic illnesses lead to vital function disturbance, partial or overall loss of self-service, moving, socialization, and working ability. All these factors impose system organization of constant medical and social cares.The last counting census dated 01 February 2011 determines a vast increase of individuals with 50% and more disability. These individuals have needs of complex medico-social assistance, mostly these of the most vulnerable group – solitary older adults, elderly people and disabled individuals.Research Objective: The aim of this article is analysis of the opinion of medical specialists and social workers regarding medico-social assistance organization for older adults and solitary elderly people in home settings as a basis for optimization of offered services and needed resource.Subjects and Methods: The research object is the opinion of medical specialists and social workers on the needs, current situation and organization of medico-social help for older adults and solitary elderly individuals in home settings.The applied methods include: sociological inquiry (anonymous); statistical processing and graphical interpretation of the analyzed results.Results and Discussion: The research results prove the inefficiency of the current system, necessity of change of forms and organization leading to better medical and social services in home settings.Conclusion: Specialist opinion regarding organisation of medical-social assistance for adults and old people confirms the necessity of offering, experimenting and using new mixed forms of the assistance offered in home settings

OBSTETRICAL COMPETENCE WHEN IMPLEMENTING A MODEL OF CARE IN THE PUERPERIUM

The concept of competence (lat. competents - "capable") is defined as a dynamic set of knowledge, skills, attitudes and relations that are acquired in the learning process. The academically prepared midwife has knowledge, skills and competencies adequate to European requirements, she is a leading professional in providing effective prenatal and postnatal care.In the maternity wards of our hospitals, the midwife has the duty to care for the recovery of the mother and the newborn, to observe, explain and encourage all attempts at independence of the young mother. After the woman is discharged from the medical facility, obstetric care for women after childbirth in Bulgaria is passive in nature.In recent years, a number of publications have commented on the imperfections of the current organization of obstetric care after childbirth in our country due to the missing regulation on the mandatory participation of a midwife in providing care in the puerperium. Different models of maternity care, care for the health and well-being of pregnant women and newborns, care during pregnancy, birth and post-natal care have been developed worldwide, each with their own distinctive characteristics based on local, cultural or social traditions and knowledge. Usually the obstetrician-gynecologist is the leading medical specialist, but in some models the midwife is the leading one. This responsibility may also be shared between obstetricians and midwives.The purpose of our study is to determine to what extent the midwifery competencies defined in Ordinance No. 1 of 08.02.2011 are present in midwifery care in the puerperium.A documentary method was used, as various literary sources analyzing the problem were examined. Observation of parts of an experimental program conducted with parturient women for continuing obstetric care after childbirth

Nursing cares at fast - track (laparoscopic and robotic ) surgery

 Introduction: The concept of accelerated surgical recovery after laparoscopic surgery, also called ERAS aims at faster discharge from the hospital and faster recovery of the body after various volumes of surgical interventions without increasing complications or mortality. The application of nursing care with the fast recovery method postoperatively can reduce postoperative complications and pain, shorten the hospital stay, so that the quality of rehabilitation is significantly improved.Aim: To study the application of rapid recovery syrgery (RRS) by surgical nurses (SN) and to reveal the possibilities for its optimization..Material and methods: In nine large hospitals in Bulgaria the opinion of doctors and senior nurses (122) on the application of RRS by SN was studied; self-assessment of SN (147) who are working according to the rules of RRS. Applied methods - documentary analysis, structured interview and direct anonymous poll.Results: A high degree of knowledge of the rules and experience in practicing RRS from SN is established, as well as the need for additional nursing documentation related to postoperative care - algorithms for work and introduction of a checklist. Suggestions for improvement of the SN work protocol have been made

Preventon of childhood diabetes in school environment: awareness of families

INTRODUCTION: Diabetes is the most common metabolic disease in school-age children. The families of these children need information about the specifics of the disease. Given the incidence rate of the disease on one hand, and factors such as the trend for unhealthy eating habits in children and the decrease in physical activity, on the other, prevention should play a key role when working with parents. This could be of great importance for the decrease of the morbidity rate. Thus, support for the parents by healthcare professionals would be appropriate in the school environment.AIM: To assess the knowledge of families about diabetes in school-age children, and to promote the prevention and prophylaxis of the disease with the involvement of nurses.MATERIALS AND METHODS: A survey has been conducted amongst parents of school children. The level of awareness about the disease and the needs of the families have been assessed.RESULTS: Families are not always educated well enough about diet (68%), physical activity (43%), and the role of heredity (48%) as a factor in the development of diabetes. The most trusted healthcare professionals are usually the school nurse, the family physician and the psychologist.CONCLUSION: The support with regard to prevention of diabetes would facilitate the families and will aid in improving the lifestyle of school-age children. The data from our study reveal the level of awareness of families regarding diabetes in school environment and stimulate support to prevent the disease

Study Of General Practitioners’ Opinion On Diabetes Mellitus-Related Complications In Children

Introduction: Diabetes mellitus is the most common metabolic disorder. It presentis with the inability of the body to control blood sugar levels. In Bulgaria 10 out of every 100,000 children and one or two sucklings are diagnosed with diabetes yearly. Their treatment requires a proper approach with the participation of general practitioners.Purpose of the study: To study the opinion of general practitioners on the diabetes mellitus complications in children.Scope and methods: A survey has been conducted among 750 general practitioners in Varna, Sliven and Sofia to determine their opinion on complications in children with diabetes mellitus. Statistical processing of the research results was completed using SPSS v. 20.0: analysis of variance, comparative and correlation analysis.Results: A significant number of medical professionals (71.3%) report that diabetes mellitus–related complications are often identified. One of the most common complications is nephropathy (32.2%), retinopathy (25.2%) and the combination between polyneuropathy and retinopathy (22.1%). According to 25.4% of medical experts, it is the responsibility of the parents to monitor the health condition of children with diabetes mellitus, while 60.4% of respondents believe that responsibility shall be shared between the General Practitioner, the endocrinologist and the family.Conclusion: The results from our study show that at present, the control of the disease is not good, which results in complications and disability problems in children at an early age. Medical professionals describe different types of team approach that to be used to monitor children with diabetes mellitus, involving not only specialists but also the family and this shows the necessity of creating models of cooperation and training

EMERGENCE AND PERSPECTIVES FOR THE DEVELOPMENT OF PALLIATIVE CARE IN BULGARIA

Abstract: Palliative care is undergoing rapid development with medical advances in the control of chronic pain as well as the accompanying symptoms of the disease. Over the years, palliative care has not received the attention it deserves, but today the focus is increasingly on it because of the unfoldedpotential it holds.Objective: To review the development of palliative care, to identify the problems and outline the prospects in Bulgaria.Material and methods: The study was conducted in 2022. A documentary method was used to research national and international literature, documents and regulations concerning the problem.Discussion: The beginnings of palliative care began as hospice care, often provided by caregivers in religious institutions. Caring for the sick and alleviating people's suffering are values that are present in every religion, but Christianity is especially important. The path of origin and development of hospiceand palliative care is long, with the beginning dating back to ancient times, flourishing in the Middle Ages, followed by a decline for a short period of time, to unfold with new force in the 17th century in France. Cicely Saunders' contribution to the development and consolidation of the hospice work is indisputable.She develops and implements a concept of hospice care, including ways to alleviate patients' suffering, respecting people's wishes and needs at the end of life. In 1990, the WHO developed a strategy for the integration of palliative care into health systems, updated in 2007, including four main elements. Inrecent years, indicators have been developed and used to evaluate palliative care practices around the world. The situation in our country is worrisome, because palliative care is extremely necessary and at the same time insufficient, marked by a number of unsolved problems waiting for their solutions.Conclusion: Guaranteeing quality palliative care requires the need for increased public awareness, training of medical professionals and commitment from the state

Study Of The Need For Home-Based Medical And Social Assistance For Older Adults And Elderly People

The number of older adults (people above 65 years) is increasing globally, while simultaneously the number of elderly people (individuals more than 80 years) is becoming higher and higher. This requires solving specific economic problems, and urgent resolution of tasks related to the development and provision of health and social services.Тhe most vulnerable population group consists of solitary older adults, elderly people and disabled. In the organization of medico-social help of solitary older adults and elderly people it is necessary to assess their residual capacity and take into account the complexity of their medical and social care needs.Aim: The aim of this article is to study and identify the most important medical and social care needs of solitary older adults and elderly people.Materials and Methods: The subject of the study is the need for medical and social services and the assessment of the most needed ones for the older adults and the elderly living alone at home. Methods used: sociological survey (anonymous poll); statistical processing and graphical interpretation of the results obtained.Results and Discussion: The results of the study show that it is necessary to take into account the complex nature of their needs, differentiating the needs arising from the age and the individual characteristics of the person.Conclusion: The currently available system of medical and social help cannot respond in accordance with the needs of solitary older adults and elderly people in home settings

Expert assessment of practical approaches to optimize the participation of nurses in obtaining informed consent from the patient

INTRODUCTION: Nurses are an important resource to the health system and occupy a significant place in providing effective and quality healthcare. At the same time, obtaining informed consent is an important aspect in the nurses` work. Therefore, the opinion survey and the evaluation of experts on developing practical approaches aim to optimize the participation of nurses in the process of informed consent and have a great scientific and practical significance.AIM: To study the opinion and evaluation of experts on developing practical approaches to optimize the participation of nurses in the process of obtaining informed consent.MATERIALS AND METHODS: We have attached an analysis of the literature and used a documentary and an expert assessment method. An expert assessment of our own developed practical approaches was performed in the period March-September, 2015. It involved 50 experts - chief and senior nurses at the St. Marina University Hospital and used a questionnaire method of interviewing. Its aim was to optimize the participation of nurses in the process of informed consent of the patient.RESULTS: The majority of the experts approved the presented algorithm for obtaining informed consent from the patient and confirmed that the algorithm can be applied in the working process of the nurses. With regard to the presented data sheet for obtaining informed consent for intravenous injection (invasive nursing manipulation) the experts expressed concerns about the possible difficulties in putting it into practice, citing the shortage of nursing staff and time. A significant majority of experts, however, approved the technical sheet and evaluated it as applicable in nursing practice.CONCLUSIONS: The results of the expert assessment lead to the conclusion that the proposed practical approaches are applicable in nursing practice and will help to optimize the process of informed consent, respect the patient‘s right to informed consent, the professional comfort and safety of nurses

Conservative management of intracanal separated endodontic instruments - treatment decisions and related factors

INTRODUCTION: Intracanal separation of endodontic instruments is an adverse event that may not only hinder the endodontic treatment, but may also have an influence on the long-term prognosis and longevi­ty of the tooth.MATERIALS AND METHODS: After studying a series of related articles and publications we have re­viewed and compared the different conservative treatment options for the management of intracanal frac­tured instruments.RESULTS: Conservative management methods are leaving the fragment in situ and filling the coronal frag­ment of the root canal, bypassing the fractured instrument or completely removing it from the root canal. Each of these options has its advantages, disadvantages, special indications and every treatment decision is accompanied by possible risks and difficulties. Each case is different and the prognosis depends mainly on the location of the fragment, the root canal system (RCS) anatomy and morphology and, of course, on mak­ing the right treatment decision for managing the accident.CONCLUSION: Separation of endodontic instruments in the root canal (RC) does not necessarily lead to endodontic failure and even in cases when the instrument cannot be removed choosing the adequate treat­ment procedure can strongly benefit the long-term prognosis of the tooth involved

The need and satisfaction of the patients of hospice services in Varna Region

Introduction: In the context of the severe demographic situation in our country, the problem of the hospice movement stands out. In an ageing society, people who need hospice care are constantly increasing. Chronically sick patients, especially those with progressive disease, pose a serious problem because they need specific care. Some such care is provided in hospices, which in our country prove to be inadequate.Purpose: To investigate the need and satisfaction of patients from hospice services in Varna region.Material and Methods: The survey was conducted in the first quarter of 2017 and covers 85 people, the users of hospice services offered in some of the hospices in Varna. Sociological methods were used: document analysis, survey method and statistical methods.Results and Discussion: Respondents are of different educational attainment and social status over a broader age range. There are residents of Varna, the surrounding settlements and other big cities in the country. Some of the respondents were staying in different hospices and considered that they were insufficient for the city of Varna. Almost everyone knows the administrative organization and the internal order of the hospice, they are happy with the medical service but have some recommendations for improving the lifestyle. Patients of hospice services are responsible for searching and choosing a hospice service to enter by using different sources of information