Quality of Life in Patients with Diabetic Foot Ulcer in the Visegrad Countries

AIM AND OBJECTIVES: The aim of the present study was to identify the quality of life of patients with diabetic foot ulcers in the Visegrad countries. BACKGROUND: The diabetics with foot ulcers are principally evaluated on the basis of physical parameters, but this does not always reveal much about the patient's experience of life with ulceration. DESIGN: The cross-sectional study. METHODS: The standardized generic questionnaire World Health Organisation Quality of Life Bref was used. The sample was made up of 525 participants and the calculations were performed using the IBM SPSS statistical program. RESULTS: The significant negative correlations between demographic data such as age, duration of diabetes mellitus, duration of diabetes ulceration treatment and a lower level of quality of life were found across the sample. The statistically significant differences according to clinical characteristics such as Wagner classification, frequency of foot ulcers, present peripheral vascular diseas and pain in terms of quality of life were also revealed. Significant differences of quality of life among Visegrad countries were revealed: Hungary's participants had a worse quality of life than others, while Slovak participants expressed lower satisfaction with their health than Czech. CONCLUSIONS: Socio-demographic factors and clinical characteristics influence the quality of life of patients with diabetic foot ulcer. Significant differences between patients of Visegrad countries were found in all domains of quality of life: physical, psychological, social and environmental. RELEVANCE TO CLINICAL PRACTICE: The quality of life of patients with diabetic foot ulcer reflects the conditions and health care system in each of the Visegrad countries. We have to respect socio-demographic factors and clinical characteristics in nursing care. This could have an impact on managing patient care not only with regard to their diabetic foot ulcer but also with regard to the patient as a personality with their own problems in relation to physical, psychosocial and environmental conditions. This article is protected by copyright. All rights reserved

Patients' and nurses' perceptions of individualised care: An international comparative study

Aim. The aim of this study was to compare patients' and nurses' perceptions of individualised care in five European countries, the Czech Republic, Cyprus, Finland, Greece and Hungary. Background. Individualised nursing care has been studied from both patients' and nurses' perspectives, but to date, there are no studies comparing these perspectives internationally. Methods. A cross-sectional comparative survey design was used. Data were collected from nurses (n=960; response rate, 79%) and patients (n=1315; response rate, 78%) in 71 surgical units from 26 acute hospitals in 2009. Data were collected using two Individualised Care Scales (ICS-Nurse and ICS-Patient) and analysed statistically using descriptive and inferential statistics. Results. Differences in patients' and nurses' assessments of individualised nursing care were found between each country. Nurses, compared with patients, assessed that they supported patient individuality more often. The Mean nurses ranged from 3·61 (SD 0·90, Greece)-4·31 (SD 0·53, Hungary), and the Mean patients ranged from 3·05 (SD 1·09, Greece)-3·79 (SD 1·00, Cyprus). To a large extent, the care provided was individualised as defined by the Mean nurses 3·75 (SD 0·92, Greece)-4·36 (SD 0·49, Hungary) and the Mean patients 3·41 (SD 0·95, Greece)-4·18 (SD 0·79, Cyprus). In Cyprus and Finland, patients' assessments of the individuality in their care corresponded well with nurses' assessments. Clear between-country differences in both patients' and nurses' assessments were found in both subscales of the ICS. Conclusions. An in-depth analysis of the European between-country differences is required to define the causes of differences that may be due to the differing content of education, the organisation of nursing work, ideology and values assigned to individualised care and health care systems and processes in each country. Relevance to clinical practice. Obtaining both patients' and nurses' assessments of individualised care may facilitate the further development of individualised nursing care and be used to help to harmonise European health care processes and nursing care. © 2011 Blackwell Publishing Ltd

Tumour Necrosis Factor Alpha G -> A-238 And G -> A-308 Polymorphisms In Juvenile Idiopathic Arthritis

Objectives. To study G-->A -238 and G-->A -308 polymorphisms in the promoter region of the tumour necrosis factor (TNF) alpha gene in patients with juvenile idiopathic arthritis (JIA). We analysed whether there were any associations between these polymorphisms and the type of JIA and/or the clinical course of the disease in two populations. Methods. The first group consisted of 51 Turkish JIA patients and the second consisted of 159 JIA patients from the Czech Republic. Healthy individuals (93 and 100) from each country served as controls. Subgroups of JIA were defined according to the Durban criteria. The course of the disease was defined on the basis of the physician's global evaluation of disease activity, the swollen and tender joint count and the erythrocyte sedimentation rate. Results. In both JIA cohorts, the distribution of genotypes was not significantly different among the types of JIA. The G-->A -238 polymorphism did not have an effect on the patients' outcome in either group. The G-->A -308 polymorphism was significantly associated with a poor outcome in the Turkish group (P=0.005) but there was no association in the Czech patients. Some features of JIA in Turkish patients differed from those in Czech patients. Conclusions. Genetic differences may accompany the phenotypic differences found in the Turkish group. Although larger numbers of patients are clearly needed to verify this, we suggest that the G-->A -308 polymorphism may be operative in defining disease outcome in selected groups.WoSScopu

Patients' decisional control over care: A cross-national comparison from both the patients' and nurses' points of view

Background: Patients' decisional control over care is the ability or power for patients to decide what their involvement will be in healthcare decisions. There is evidence of limited agreement between the perceptions of patients and the perceptions of nurses and/or caregivers with regard to the degree of patient involvement in the planning and performance of their care. Aim: To analyse and compare patients' and nurses' perceptions of patients' decisional control over their own care. Method: A multisite cross-sectional comparative survey design was employed. Data were collected from hospitalised surgical inpatients (n = 1315) and their caregivers (n = 960 nurses) in five European countries. The Individualised Care Scale part B was used for collecting data from both the patients and nurses. Ethical standards were followed throughout the study. Results: Significant between-country differences were found between patients and nurses. In all countries, both patients and nurses regarded that decisional control over care had been actualised (ICS-B: M = 3.75-4.47 and 3.48-4.33, respectively), but there were significant differences in their perceptions regarding four of the six items of the decisional control factor of the ICS-B. Conclusions: The results show that there are disparities between patients' and nurses' perceptions of patient involvement in care, probably due to cultural issues that need further exploration. Clinical relevance: The disparities between patients' and nurses' perceptions on patients' decisional control over their care should be taken into consideration as a potential cause of patient dissatisfaction with nursing care. © 2016 Nordic College of Caring Science