17 research outputs found
Multiple sclerosis and thyroid gland diseases
Multiple sclerosis (MS) often presents with accompanying diseases. Thyroid gland pathology is not a rare finding in MS patients. Among a hospital cohort of 305 MS patients, 16 females with five thyroid gland diseases were diagnosed during a 14-year period. There were six cases of diffuse goiter, four of postoperative hypothyroidism, three of thyroid adenoma, two of autoimmune thyroiditis, and one of hyperthyroidism. Age characteristics of the patients varied for the specific diseases. We emphasize the need for regular monitoring of the thyroid function in MS patients
Individual training for self-injection of disease-modifying medications in multiple sclerosis patients - a guarantee for successful treatment
ΠΡΠ²Π΅Π΄Π΅Π½ΠΈΠ΅: ΠΠ‘ Π΅ Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΎ ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΈΠ·ΠΈΡΠ°ΡΠΎ Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½Π΅, ΠΊΠΎΠ΅ΡΠΎ Π΅ ΡΡΠ΅Π΄ Π½Π°ΠΉ-ΡΠ΅ΡΡΠΎ ΡΡΠ΅ΡΠ°Π½ΠΈΡΠ΅ ΠΏΡΠΈΡΠΈΠ½ΠΈ Π·Π° ΡΠ΅ΡΠΈΠΎΠ·Π½ΠΎ ΡΠΈΠ·ΠΈΡΠ΅ΡΠΊΠΎ ΡΠ²ΡΠ΅ΠΆΠ΄Π°Π½Π΅ ΠΏΡΠΈ Π²ΡΠ·ΡΠ°ΡΡΠ½ΠΈ Π² ΡΡΡΠ΄ΠΎΡΠΏΠΎΡΠΎΠ±Π½Π° Π²ΡΠ·ΡΠ°ΡΡ. ΠΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»Π½ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π·Π° ΡΠ°ΠΌΠΎΠΈΠ½ΠΆΠ΅ΠΊΡΠΈΡΠ°Π½Π΅ Π½Π° ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΈ, ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠ°ΡΠΈ Ρ
ΠΎΠ΄Π° Π½Π° Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½Π΅ΡΠΎ, Π΅ Π³Π°ΡΠ°Π½ΡΠΈΡ Π·Π° ΡΡΠΏΠ΅ΡΠ½ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π° ΡΠΊΠ»Π΅ΡΠΎΠ·Π° (ΠΠ‘). Π¦Π΅Π»: ΠΠ° ΡΠ΅ ΠΏΡΠΎΡΡΠΈ ΠΌΠ½Π΅Π½ΠΈΠ΅ΡΠΎ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ ΠΠ‘, ΠΏΡΠ΅ΠΌΠΈΠ½Π°Π»ΠΈ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»Π½ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π·Π° ΡΠ°ΠΌΠΎΠΈΠ½ΠΆΠ΅ΠΊΡΠΈΡΠ°Π½Π΅ Π½Π° ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΈ, ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠ°ΡΠΈ Ρ
ΠΎΠ΄Π° Π½Π° Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½Π΅ΡΠΎ (ΠΠΠ₯Π), ΠΎΡΠ½ΠΎΡΠ½ΠΎ Π΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΠ° ΠΌΡ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π΅ ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ ΡΡΠ΅Π΄ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ ΠΠ‘ (n=50) ΠΏΡΠ΅Π· ΠΌΠ΅ΡΠ΅Ρ ΠΎΠΊΡΠΎΠΌΠ²ΡΠΈ 2016 Π³., ΠΏΡΠ΅ΠΌΠΈΠ½Π°Π»ΠΈ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»Π½ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π·Π° ΡΠ°ΠΌΠΎΠΈΠ½ΠΆΠ΅ΠΊΡΠΈΡΠ°Π½Π΅ Ρ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΈ, ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠ°ΡΠΈ Ρ
ΠΎΠ΄Π° Π½Π° Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½Π΅ΡΠΎ ΡΡΠ΅Π· ΠΏΡΡΠΊΠ° ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»Π½Π° Π°Π½ΠΊΠ΅ΡΠ°. ΠΠ·ΠΏΠΎΠ»Π·Π²Π°Π½ΠΈΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈ ΡΠ° Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°Π»Π΅Π½, ΡΠΎΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ (Π°Π½ΠΊΠ΅ΡΠ°), ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ ΠΈ Π³ΡΠ°ΡΠΈΡΠ΅Π½ Π°Π½Π°Π»ΠΈΠ·. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π°Π½Π΅: ΠΠ½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈ ΡΠ° 50 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π° ΠΠ‘, ΠΏΠΎΡΠ΅ΡΠ°Π²Π°ΡΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠ°Π½Π° ΠΊΠΎΠΌΠΈΡΠΈΡ ΠΊΡΠΌ Π£ΠΠΠΠ βΠ‘Π²Π΅ΡΠ° ΠΠ°ΡΠΈΠ½Π°` ΠΠΠ - ΠΠ°ΡΠ½Π°. ΠΡΠΈΡΠΊΠΈ Π°Π½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠ° ΠΏΡΠ΅ΠΌΠΈΠ½Π°Π»ΠΈ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠ° ΡΠ΅ΡΡΡΠ° - ΡΠΏΠ΅ ΡΠΈΠ°Π»ΠΈΡΡ ΠΏΠΎ ΠΠ‘. ΠΠΎΠ²Π΅ΡΠ΅ ΠΎΡ ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Π°ΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ (58%) ΡΠ° ΡΠ΅ Π½ΡΠΆΠ΄Π°Π΅Π»ΠΈ ΠΎΡ Π½Π°Π΄ ΡΡΠΈ Π²ΠΈΠ·ΠΈΡΠΈ Π·Π° ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΡΡΠΈ 80% ΠΎΡ ΡΡΠ°ΡΡΠ½ΠΈΡΠΈΡΠ΅ Π² Π°Π½ΠΊΠ΅ΡΠ½ΠΎΡΠΎ ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ ΠΏΠΎΡΠΎΡΠ²Π°Ρ, ΡΠ΅ ΠΏΡΠΈ ΠΏΡΠΎΠ±Π»Π΅ΠΌ ΡΠ΅ ΠΎΠ±ΡΡΡΠ°Ρ ΠΊΡΠΌ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠ°ΡΠ° ΡΠ΅ΡΡΡΠ°, ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡ ΠΏΠΎ ΠΠ‘. ΠΠ·Π²ΠΎΠ΄ΠΈ: ΠΡΠΈΡΠΊΠΈ Π°Π½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈ, Π±Π΅Π· ΠΈΠ·ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅, ΡΡΠΈΡΠ°Ρ, ΡΠ΅ Π½Π΅ Π±ΠΈΡ
Π° ΡΠ΅ ΡΠΏΡΠ°Π²ΠΈΠ»ΠΈ ΡΡΡ ΡΠ°ΠΌΠΎΠΈΠ½ΠΆΠ΅ΠΊΡΠΈΡΠ°Π½Π΅ΡΠΎ Π±Π΅Π· ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ·ΡΠΎΡΠ½ΠΈΠΊΡΡ Π½Π° ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ Π·Π° Π½Π°Π»ΠΈΡΠΈΠ΅ Π½Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠ° ΡΠ΅ΡΡΡΠ° - ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡ ΠΏΠΎ ΠΠ‘, ΠΊΠΎΡΡΠΎ ΠΌΠΎΠΆΠ΅ Π΄Π° ΠΏΡΠΎΠ²Π΅Π΄Π΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ΡΠΎ ΠΏΠΎ ΡΠ°ΠΌΠΎΠΈΠ½ΠΆΠ΅ΠΊΡΠΈΡΠ°Π½Π΅, ΠΎΡΡΠ°Π·ΡΠ²Π° Π°ΠΊΡΡΠ°Π»Π½Π°ΡΠ° ΡΠΈΡΡΠ°ΡΠΈΡ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: ΠΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»Π½ΠΎΡΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π·Π° ΡΠ°ΠΌΠΎΠΈΠ½ΠΆΠ΅ΠΊΡΠΈΡΠ°Π½Π΅ Ρ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΈ, ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΠ°ΡΠΈ Ρ
ΠΎΠ΄Π° Π½Π° Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½Π΅ΡΠΎ, Π΅ Π΅Π΄Π½Π° Π½ΠΎΠ²Π° ΡΠ°Π·Π»ΠΈΡΠ½Π° ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡ ΠΎΡ Π·Π΄ΡΠ°Π²Π½ΠΈ Π³ΡΠΈΠΆΠΈ ΠΈ ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ° ΠΏΠΎΠ΄ΠΊΡΠ΅ΠΏΠ°, ΠΊΠΎΡΡΠΎ Π±ΠΈ Π±ΠΈΠ»Π° ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠ΅Π½Π° ΠΎΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠ° ΡΠ΅ΡΡΡΠ° -ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡ ΠΏΠΎ ΠΠ‘. ΠΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ Π² ΡΠΈΡΡΠ°ΡΠΈΡ Π½Π° Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΎ Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½Π΅ ΠΊΠ°ΡΠΎ ΠΠ‘ ΠΈ ΡΡΡ
Π½ΠΎΡΠΎ ΠΏΡΠΎΠ΄ΡΠ»ΠΆΠΈΡΠ΅Π»Π½ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π·Π°Π²ΠΈΡΡΡ ΠΈ ΠΎΡ ΡΠΎΠ±ΡΡΠ²Π΅Π½ΠΎΡΠΎ ΠΈΠΌ ΡΠΌΠ΅Π½ΠΈΠ΅ Π΄Π° ΡΠ΅ ΡΠΏΡΠ°Π²ΡΡ. ΠΠ°ΡΠΎΠ²Π° ΠΎΡΠ΅ ΠΏΠΎ-Π³ΠΎΠ»ΡΠΌΠ° Π·Π½Π°ΡΠΈΠΌΠΎΡΡ ΠΌΠΎΠΆΠ΅ Π΄Π° ΡΠ΅ ΠΎΡΠ΄Π°Π΄Π΅ Π½Π° ΠΏΠΎΡΡΠΈΠ³Π½Π°ΡΠΎΡΠΎ ΡΡΠ²ΡΡΠ²ΠΎ Π·Π° ΡΠΈΠ³ΡΡΠ½ΠΎΡΡ ΡΠ»Π΅Π΄ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»Π½ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π·Π° ΡΠ°ΠΌΠΎΠΈΠ½ΠΆΠ΅ΠΊΡΠΈΡΠ°Π½Π΅ Π½Π° ΠΠΠ₯Π.Introduction: Individual training for self-injection of disease-modifying medications is a guarantee for successful treatment in patients with Multiple Sclerosis (MS). MS is a chronic disabling disease, which is among the most common causes of serious physical disability in working-age adults. Aim: The aim of this paper is to investigate the opinion of patients with MS, who have undergone inductive self-injection training to modify the course of the disease. Materials and Methods: A study through a direct individual survey was conducted among patients (n=50) in October 2016 who had undergone individual self-injection training for medications modifying the course of the disease (MMCD). The used methods were documentary, sociological (questionnaire), statistical and graphical analysis. Results and Discussion: Fifty patients with an MS diagnosis visiting a specialized commission at St. Marina University Hospital, Varna were interviewed. All of the surveyed patients have received training with a nurse, an MS specialist. More than half of the patients (58%) needed more than three study visits. Nearly 80% of the survey respondents indicated that they contacted an MS specialist nurse, if there was a problem.Conclusion: All respondents, without exception, consider that they would not cope with self-injection without training. The information about the presence of a nurse specialist on MS who can carry out self-injection training reflects the current situation. Individual training for self-injection of disease-modifying medications is a new and different need for health care and psychological support that would be met by a nurse specialist on MS. Patients with a chronic disease such as MS and their long-term treatment depend on their own ability to cope with it. Therefore, even greater significance can be attributed to the attainment of a certain sense of security after individual self-injection of MMCD
Continuing education of nurses from outpatient care - prerequisite for improving quality of life in patients with chronic diseases
ΠΡΠ²Π΅Π΄Π΅Π½ΠΈΠ΅: ΠΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΈΡΠ΅ Π³ΡΠΈΠΆΠΈ Π·Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΈ Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½ΠΈΡ ΠΊΠ°ΡΠΎ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π° ΡΠΊΠ»Π΅ΡΠΎΠ·Π° ΡΠ° ΠΏΡΠ΅Π΄ΠΏΠΎΡΡΠ°Π²ΠΊΠ° Π·Π° ΠΏΠΎΠ²ΠΈΡΠ°Π²Π°Π½Π΅ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎΡΠΎ Π½Π° ΠΆΠΈΠ²ΠΎΡ ΠΊΠ°ΠΊΡΠΎ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅, ΡΠ°ΠΊΠ° ΠΈ Π½Π° ΡΠ΅Ρ
Π½ΠΈΡΠ΅ ΡΠ΅ΠΌΠ΅ΠΉΡΡΠ²Π°. Π’Π΅Π·ΠΈ Π³ΡΠΈΠΆΠΈ ΡΠ΅ ΠΏΠ»Π°Π½ΠΈΡΠ°Ρ ΠΎΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈ ΡΠ΅ΡΡΡΠΈ, ΠΊΠΎΠΈΡΠΎ ΡΠ°Π±ΠΎΡΡΡ Π² ΠΈΠ·Π²ΡΠ½Π±ΠΎΠ»Π½ΠΈΡΠ½Π°ΡΠ° ΠΏΠΎΠΌΠΎΡ. Π¦Π΅Π»: ΠΠ° ΡΠ΅ ΠΏΡΠΎΡΡΠΈ ΠΌΠ½Π΅Π½ΠΈΠ΅ΡΠΎ Π½Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈ ΡΠ΅ΡΡΡΠΈ ΠΎΡ ΠΈΠ·Π²ΡΠ½Π±ΠΎΠ»Π½ΠΈΡΠ½Π°ΡΠ° ΠΏΠΎΠΌΠΎΡ ΠΎΡΠ½ΠΎΡΠ½ΠΎ Π΅ΡΠ΅ΠΊ-ΡΠΈΠ²Π½ΠΎΡΡΡΠ° Π½Π° ΡΠ΅ΡΡΡΠΈΠ½ΡΠΊΠΈΡΠ΅ Π³ΡΠΈΠΆΠΈ Π·Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΈ Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½ΠΈΡ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π΅ ΠΏΡΠΎΡΡΠ²Π°Π½Π΅ ΡΡΠ΅Π΄ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈ ΡΠ΅ΡΡΡΠΈ ΠΎΡ ΠΈΠ·Π²ΡΠ½Π±ΠΎΠ»Π½ΠΈΡΠ½Π°ΡΠ° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠ° ΠΏΠΎΠΌΠΎΡ (ΠΠΠΠ) (n=50) Π² ΠΏΠ΅ΡΠΈΠΎΠ΄Π° Π΄Π΅ΠΊΠ΅ΠΌΠ²ΡΠΈ 2015 - Π°ΠΏΡΠΈΠ» 2016 Π³. ΠΠ·ΠΏΠΎΠ»Π·Π²Π°Π½ΠΈΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈ ΡΠ° Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°Π»Π΅Π½, ΡΠΎΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ (Π°Π½ΠΊΠ΅ΡΠ°), ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ ΠΈ Π³ΡΠ°ΡΠΈΡΠ΅Π½ Π°Π½Π°Π»ΠΈΠ·. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π°Π½Π΅: ΠΠ½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈ ΡΠ° 50 ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈ ΡΠ΅ΡΡΡΠΈ, ΡΠ°Π±ΠΎΡΠ΅ΡΠΈ ΠΏΡΠΈ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ (64%) ΠΎΡ ΠΠΠΠ ΠΈ ΠΏΡΠΈ ΠΠΠ (36%). ΠΡΠ΅Π²Π°Π»ΠΈΡΠ° ΠΏΡΠΎΡΠ΅Π½ΡΡΡ Π½Π° Π°Π½ΠΊΠ΅ΡΠΈΡΠ°Π½ΠΈ (88%), ΠΊΠΎΠΈΡΠΎ ΡΡΠΈΡΠ°Ρ, ΡΠ΅ Π΅ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄ΠΈΡΠ½ΠΎ ΠΎΠΏΡΠ΅ΡΠ½ΡΠ²Π°Π½Π΅ ΠΈ ΠΎΠ±ΠΎΠ³Π°ΡΡΠ²Π°Π½Π΅ Π½Π° ΠΏΡΠΎΡΠ΅ΡΠΈΠΎΠ½Π°Π»Π½ΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ΅ΡΠ΅Π½ΡΠ½ΠΎΡΡΠΈ. ΠΠΈΡΠΎΠΊ Π΄ΡΠ» ΠΎΡ ΡΠ΅ΡΠΏΠΎΠ½Π΄Π΅Π½ΡΠΈΡΠ΅ (96%) ΠΏΠΎΠ΄ΠΊΡΠ΅ΠΏΡΡ ΠΈΠ΄Π΅ΡΡΠ° Π·Π° ΠΏΡΠΎΠ΄ΡΠ»ΠΆΠ°Π²Π°ΡΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅, a 92% ΠΈΠ·ΡΠ°Π·ΡΠ²Π°Ρ Π³ΠΎΡΠΎΠ²Π½ΠΎΡΡ Π·Π° ΠΈΠ½Π²Π΅ΡΡΠΈΡΠ°Π½Π΅ Π½Π° Π²ΡΠ΅ΠΌΠ΅ Π·Π° ΠΏΡΠΎΠ΄ΡΠ»ΠΆΠ° Π²Π°ΡΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅, ΠΊΠ°ΡΠΎ ΠΏΡΠ΅Π΄ΠΏΠΎΡΠΈΡΠ°Π½Π°ΡΠ° ΡΠΎΡΠΌΠ° Π΅ ΠΊΡΠ°ΡΡΠΊ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠ°Π½ ΠΊΡΡΡ (58%). ΠΠ·Π²ΠΎΠ΄ΠΈ: ΠΡΠΎΠ΄ΡΠ»ΠΆΠ°Π²Π°ΡΠΎΡΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π½Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈ ΡΠ΅ΡΡΡΠΈ Π² ΠΠΠΠ Π΅ ΠΊΠ»ΡΡΠΎΠ² Π΅Π»Π΅ΠΌΠ΅Π½Ρ ΠΎΡ ΠΏΠΎΠ²ΠΈΡΠ°Π²Π°Π½Π΅ΡΠΎ Π½Π° ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎΡΠΎ Π½Π° ΠΆΠΈΠ²ΠΎΡ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΈ Π·Π°Π±ΠΎΠ»ΡΠ²Π°Π½ΠΈΡ. ΠΠ΄Π΅ΡΡΠ° Π·Π° ΠΏΡΠΎΠ΄ΡΠ»ΠΆΠ°Π²Π°ΡΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π½Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡΠ΅ ΡΠ΅ΡΡΡΠΈ Π½Π°ΠΌΠΈΡΠ° ΠΏΠΎΠ΄ΠΊΡΠ΅ΠΏΠ° ΠΎΡ ΠΏΠΎΡΡΠΈ Π²ΡΠΈΡΠΊΠΈ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π΅Π½ΠΈΡΡ ΠΈΠ·Π±ΠΎΡ Π½Π° ΡΠΎΡΠΌΠ°ΡΠ° Π½Π° ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π²Π΅ΡΠΎΡΡΠ½ΠΎ ΠΎΡΡΠ°Π·ΡΠ²Π° Π½Π΅ ΡΠ°ΠΌΠΎ ΡΠΎΠ±ΡΡΠ²Π΅Π½ΠΎΡΠΎ ΠΌΠ½Π΅Π½ΠΈΠ΅, Π½ΠΎ ΠΈ Π»ΠΈΡΠ½ΠΈΡΠ΅ Π²ΡΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ. Π‘ΠΈΠ»Π½ΠΈΡΡ ΡΡΡΠ΅ΠΌΠ΅ΠΆ Π·Π° ΠΏΡΠΎΠ΄ΡΠ»ΠΆΠ°Π²Π°ΡΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ ΡΠ΅ Π΄ΠΎΠΊΠ°Π·Π²Π° ΠΎΡ ΠΈΠ·ΡΠ°Π·Π΅Π½Π°ΡΠ° Π³ΠΎΡΠΎΠ²Π½ΠΎΡΡ ΠΎΡ ΠΌΠ½ΠΎΠ·ΠΈΠ½ΡΡΠ²ΠΎΡΠΎ Π·Π° ΠΈΠ½Π²Π΅ΡΡΠΈΡΠ°Π½Π΅ Π½Π° Π²ΡΠ΅ΠΌΠ΅ ΠΈ ΡΠΈΠ½Π°Π½ΡΠΎΠ²ΠΈ ΡΡΠ΅Π΄ΡΡΠ²Π°. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: ΠΠΏΠΈΡΡΡ Π² ΡΠ΅Π΄ΠΈΡΠ° Π΅Π²ΡΠΎΠΏΠ΅ΠΉΡΠΊΠΈ Π΄ΡΡΠΆΠ°Π²ΠΈ ΠΏΠΎΠΊΠ°Π·Π²Π°, ΡΠ΅ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡΠ΅ ΡΠ΅ΡΡΡΠΈ ΡΠ° Π·Π°Π΅Π»ΠΈ ΡΠ²ΠΎΠ΅ΡΠΎ ΠΌΡΡΡΠΎ Π² ΠΌΡΠ»ΡΠΈΠ΄ΠΈΡΡΠΈΠΏΠ»ΠΈΠ½Π°ΡΠ½ΠΈ ΠΏΡΠ°ΠΊΡΠΈΠΊΠΈ. Π’ΠΎΠ·ΠΈ ΠΏΡΠΎΡΠ΅Ρ Π² ΠΡΠ»Π³Π°ΡΠΈΡ Π΅ Π² Π½Π°ΡΠ°Π»Π΅Π½ Π΅ΡΠ°ΠΏ. ΠΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡΠ΅ ΡΠ΅ΡΡΡΠΈ ΠΎΡ ΠΠΠΠ ΡΡΡΠ±Π²Π° Π΄Π° ΠΏΡΠΈΠ΄ΠΎΠ±ΠΈΠ²Π°Ρ Π½ΠΎΠ²ΠΈ Π·Π½Π°Π½ΠΈΡ ΠΈ ΡΠΌΠ΅Π½ΠΈΡ, Π·Π° Π΄Π° ΠΌΠΎΠ³Π°Ρ Π΄Π° ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΈΡΠ°Ρ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΈ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΡ Π·Π° ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΠΈ ΡΠ΅Ρ
Π½ΠΈΡΠ΅ Π±Π»ΠΈΠ·ΠΊΠΈ.Introduction: Complex care for patients with chronic diseases such as multiple sclerosis is a prerequisite for improving the quality of life of both patients and their families. These cares are planned by nurses, working in outpatient care. Aim: The aim of this paper is to investigate the opinion of outpatient care nurses about the effectiveness of nursing care for patients with chronic diseases. Materials and Methods: A survey was conducted among outpatient nurses (n=50) between December 2015 and April 2016. The used methods were documentary, sociological (questionnaire), statistical and graphic analysis. Results and Discussion: Fifty nurses were interviewed and 64% of them work with a neurologist in outpatient care and 36% work for general practitioners. Most of the respondents (88%) considered that periodic refreshing and enrichment of professional competencies is necessary. Almost all of the respondents (96%) support the idea of continuing education and 92% express their willingness to invest time in continuing education. The preferred form is a short specialized course (58%). Conclusion: Continuing education for nurses in outpatient care is a key element in improving the quality of life of patients with chronic diseases. The idea of continuing education for nurses finds support from almost everyone. The presented choice of form of education probably reflects not only their opinion but also their personal abilities. The strong pursuit of continuing training is evidenced by the willingness of the majority to invest time and money. Experience in many European countries has shown that nurses have taken their place in multidisciplinary practices. This process in Bulgaria is at an early stage. Outpatient care nurses need to acquire new knowledge and skills to be able to organize comprehensive training events for patients and their relatives
FEELING OF HAPPINESS IN PATIENTS WITH MULTIPLE SCLEROSIS AND COMORBIDITY
Purpose: As the feeling of happiness in multiple sclerosis (MS) is not investigated in Bulgaria yet, we decided to reveal some essential features of this non-motor symptom in multiple sclerosis patients with and without comorbidity.
Material/Methods: We examined 80 MS patients, 56 females and 24 males, at a mean age of 49 years. Forty of them presented with multiple sclerosis alone, and 40 did with multiple sclerosis and accompanying diseases. Health-related quality of life was assessed by means of Short Form-36 questionnaire and Multiple Sclerosis Quality of Life Questionnaire with 54 items.
Results: We established a lower frequency of feeling of happiness reported in MS patients with comorbidity. There were statistically significant positive correlations between the health status self-assessment and MS influence upon the feeling of happiness (R=0.428; p<0.01) as well as between MS influence upon social activities and the feeling of happiness (R=0.539; p<0.01). There were statistically reliable negative correlations between depression and feeling of happiness (R=-0.591; p<0.01) as well as between health-related quality of life scores and feeling of happiness in MS patients (R=-0,565; p<0,01). There was a statistically significant difference concerning the feeling of happiness (p<0.001) between the patients with MS only and those with MS and comorbidity.
Conclusion: Multiple sclerosis alone and with comorbidity exerts an unfavourable influence on individual patientβs feeling of happiness. The presence of this common non-motor symptom in MS patients needs more comprehensive research
Some Aspects Of The Feeling Of Happiness In Patients With Multiple Sclerosis
Happiness is an emotional state that reflects the positive feelings and satisfaction of life. We examined the subjective feeling of happiness with a questionnaire (MSQOL-54) including a self-assessment of happiness in 80 MS patients with and without accompanying diseases at an average age of 42.95 Β± 10.39 years between 2002 and 2015. The results were processed statistically by correlation analysis. There were statistically significant positive correlations between both the self-assessments of the health status and the sense of happiness of MS patients, as well as between the impact on public activities and the sense of happiness of these patients. There were also statistically significant negative correlations between depression and the sense of hap-piness in MS patients as well as between health-related quality of life assessments and the feeling of happi-ness of these patients
Sexual Disturbances in Patients with Multiple sclerosis
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that is accompanied by different concomitant diseases. We have investigated the frequency of sexual disorders as an element of individual quality of life with a questionnaire (MSQOL-54) in 80 MS patients at an average age of 42.95 Β± 10.39 for the period between 2002 and 2015. Forty of them had between one and seven accompanying diseases. There were problems in both group of patients concerning specific indicators of sexual function expressed to varying degrees. Sexual disturbances further aggravate the vitality not only of MS patients, but also of those with MS and concomitant diseases and require timely diagnosis and treatment
Diagnostic challenges in a patient with cognitive and motor disturbances: is it Huntington's disease?
Huntingtonβs disease (HD) is a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a personβs physical and mental abilities usually during their prime working years and there is no cure. HD is known as the quintessential family disease because every child of a parent with HD has a 50% chance of inheriting the faulty gene. Symptoms usually appear between the ages of 30 to 50, and worsen over a 10- to 25-year period. Ultimately, the weakened individual succumbs to pneumonia, heart failure or other complications. Everyone has the gene that causes HD, but only those that inherit the expansion of the gene will develop HD and perhaps pass it on to each of their children. Every person who inherits the expanded HD gene will eventually develop the disease. Over time, HD affects the individualβs ability to reason, walk and speak. Hereby, we describe the case of a 35-year-old patient with HD presenting with cognitive and motor disturbances to underline the diagnostic challenges and differential diagnostic options.
AMYOTROPHIC LATERAL SCLEROSIS AND EFFECTS OF VIBRATIONS
Amyotrophic lateral sclerosis (ALS) is a severe and fatal neurodegenerative disorder affecting both the upper and lower motor neurons. We present the clinical cases of four patients with ALS and vibration syndrome. All patients had over 20 years of exposure to general and local vibrations and common subjective complaints: pain, paresthesia, twitching and weakness of limb muscles. Evidence of ALS syndrome was demonstrated by the abnormal neurological examination (pseudobulbar syndrome and pyramidal signs) as well as by neurophysiological studies (peripheral motor neuron degeneration). We discuss the possible relationship between the exposure to general and local vibrations and the ALS syndrome in our patients, and the role of vibrations as a possible risk factor for the disease. Occupational contact with chemicals and pesticides is also discussed as a risk factor
Comorbidity of Structural Epilepsy and Multiple Sclerosis: MRI, 18FFDG PET/CT and EEG Investigations
There is accumulating evidence of a mutual relationship between multiple sclerosis and structural epilepsy. Comorbidity of these severe neurological disorders is reported in numerous recent publications in the available foreign literature. Modern diagnostic tools include comprehensive neurological examinations as well as computed tomography, electroencephalography and 18FFDG positron emission tomography. In this paper we report the case of a female patient with multiple sclerosis and structural epilepsy