Cerebral stroke - preclinical diagnosis and in conditions of the hospital accident ward

AdmissionThe cerebral stroke is a direct distress of the health and the life. The patient with the suspicion of stroke requires urgent intervention irrespective of the course of manifestations and their degree of the intensity. During the help at the preclinical stage an evaluation of practical parameters and registering direction and dynamics of changes are most important in this respect. As part of dealing on the Hospital accident ward with the sick person with the stated cerebral stroke one should verify and implement changes in applied curing by team members medical lifeguards.Purpose of researchAnalysis of diagnostic and therapeutic standards is a purpose of the work applied with patients with the cerebral stroke at the preclinical stage and as part of the care on the Hospital accident ward. Materials and methodsInformation taken from medical documentation of course of the process of diagnostics and curing 130 patients with the diagnosed cerebral stroke at medical institutions in the province constitutes research material Lublin. Analysis of medical documentation covered years 2013 up to 2016.DiscussionThe most frequent object manifestations stated at patients from the examined group: giddiness, headache, disequilibrium, nausea and/or the vomiting, the dysphagia, visual disturbances, pareses and hypoesthesias. According to analysis results and with literature at sick persons with the cerebral stroke a computed axial tomography and a magnetic resonance, as well as additional examinations are made examinations leading the way.ConclusionsAccording to the analysis of the results amongst early complications they observed: cerebral oedema, widen/ing moving the arrangement of the cellular brain, the secondary ischaemia of the haemorrhagic stroke. All described disorders of the awareness were diagnosed in the early phase of the cerebral stroke i.e. 4-5 hours from the beginning of the riot of any neurological warning signals

Nursing care of a premature newborn hospitalized in the neonatal intensive care unit

Pacjent leczony na oddziale intensywnej terapii noworodka (OITN) jest niezwykle wymagający w zakresie pielęgnacji, a jej jakość ma znaczenie decydujące dla rokowania. Im mniejszy i młodszy wiek od poczęcia, tym częściej występuje bezpośrednie zagrożenie dla życia i większa umieralność. Pielęgniarki i położne to ważni członkowie zespołów terapeutycznych. Ze względu na specyfikę populacji wcześniaków, pielęgniarki powinny znać występujące u nich odrębności fizjologiczne oraz czynniki utrudniające wcześniakom adaptację do życia pozałonowego. W niniejszym artykule przedstawiono główne problemy pielęgnacyjne wcześniaków oraz zasady opieki nad pacjentami przebywającymi w oddziale intensywnej terapii noworodka. Szczególną uwagę poświęcono pielęgnacji skóry, ponieważ spełnia ona nie tylko funkcję bariery przed nadmierną utratą wody, ochronną czy termoregulacyjną, ale jednocześnie bierze udział w komunikacji z noworodkiem. W badaniach dowiedziono, że pozytywne bodźce dotykowe stymulują rozwój ośrodkowego układu nerwowego, pomagają uspokoić dziecko oraz zapewniają mu poczucie bezpieczeństwa.A patient treated in the Neonatal Intensive Care Unit (NICU) requires a specialized nursing care and its quality plays a significant part in prognosis. The smaller and younger the patient, the morefrequent life-threatening conditions occur and the higher the mortality rate. Therefore, nurses and midwives are important members of healthcare team who are supposed to be well-educated on both the physiological differences and factors which hinder prematures from adopting to the external environment. The article focuses on the main problems and rules concerning nursing care of prematures in the NICU. Skin care is of vital importance. The integument protects the body from dehydration and injury, is part of the temperature-regulating mechanism of the body as well as acts as a sense organ. Thus, it plays a role in communication with the newborn. The research shows that positive stimuli influence the development of the central nervous system and have a calming effect providing a sense of security

Polish version of the Parental Stressor Scale: Neonatal Intensive Care Unit

Introduction Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) by M. Miles et al. has been developed in order to assess the stress experienced by parents of infants being treated in Intensive Care Units. The measurement of parental stress enables the evaluation of nursing care effectiveness, as well as facilitating the determination of the level of progress made by parents in coping with the difficult situation they face. Objectives The aims of the research include: (1) validation of the Parental Stressor Scale: Neonatal Intensive Care Unit into Polish and (2) initial assessment of perceptions of parental stress in a group of 151 parents of infants treated in four NICUs in Poland. Material and methods This quantitative cross-sectional study was performed among 151 parents (129 mothers and 22 fathers) of infants treated in four NICUs in central and eastern Poland. The respondents were asked to complete forms following the Parental Stressor Scale: Neonatal Intensive Care Unit, the Impact Event Scale – Revised (IES–R),and their demographics, which combined basic medical data along with socio-emographic data of both parents and children. Results The three sub-scales distinguished on the basis of the factor analysis (Infant Appearance, Parental Role Alteration, Sights and Sounds) can explain in total 54.89% of variances. Cronbach’s alpha for the entire scale equals 0.92, while as follows for the particular sub-scales: Infant Appearance -.92; Parental Role Alteration -.86, and Sights and Sounds – 0.78. Conclusions The Polish version of PSS:NICU is an accurate and reliable tool for the assessment of stress experienced by parents whose infants require treatment in NICUs

Hospitalization of a child in the Neonatal Intensive Care – parents’ experiences

Introduction. Significant progress in the perinatal and intensive care therapy resulted in a meaningful increase of survival of extremely immature, and burdened with severe diseases neonates. Although infants are the patients of the Neonatal Intensive Care Unit, the needs of their parents should also be noticed and realized. The aim of the study was the analysis of the parents’ experiences of children hospitalized in the NICU

POST-TRAUMATIC STRESS DISORDER IN PARENTS OF CHILDREN HOSPITALIZED IN THE NEONATAL INTENSIVE CARE UNIT (NICU): MEDICAL AND DEMOGRAPHIC RISK FACTORS

Background: Post-traumatic stress disorder (PTSD) among parents of neonates hospitalized in the Neonatal Intensive Care Units (NICU) stays an underestimated problem. We determined the incidence of PTSD in parents and pointed out medical and demographic risk factors for PTSD in neonates hospitalized in the NICU. Subject and methods: The study involved 39 mothers and 27 fathers of 42 infants aged 1 to 16 months who were hospitalized in the NICU of a Children’s University Hospital during the neonatal period. As a measure of PTSD we used the Polish version of the Impact of Event Scale-Revised (IES-R). The current level of stress was measured using the Perceived Stress Scale (PSS-10). The author’s questionnaire contained demographic and medical information on the infants hospitalized in the NICU and their parents. Data were statistically analyzed. Results: The incidence of PTSD and levels of stress did not differ in the group of mothers and fathers. There was a statistically significant difference in the severity of PTSD symptoms in general (p=0.006) and the severity of symptoms of intrusion (p=0.009) and arousal (p=0.015), which were more pronounced in mothers of children hospitalized in the NICU than in their fathers. In the multivariate models perceived stress was the only predictor that significantly affected the rate of PTSD symptoms in parents. Conclusions: Since PTSD is a very common problem in parents of children hospitalized in the NICU and estimating the risk of its occurrence on the basis of collected data is not possible, the parents of all those children should be considered at high risk

Internal consistency and accuracy of Interpersonal Support Evaluation List (ISEL-40) in mothers of healthy children and those with a medical history

Introduction and objective The aim of the study was assessment of the internal consistency and accuracy of the Interpersonal Support Evaluation List – 40 v. GP (ISEL-40 v. GP) in a group of mothers of healthy children and in a group of mothers of children with a medical history, and presentation of the initial research results. Material and methods A group of 230 mothers were involved in the research: 57 mothers of healthy children, 26 mothers of infants with a perinatal medical history, as well as 147 mothers of hospitalized children. The method of a diagnostic survey with standardized tools, such as the Interpersonal Support Evaluation List (ISEL-40 v. GP), Hospital and Anxiety Depression Scale (HADS) and the authors’ own questionnaire was utilized. Results Analysis of the research results suggests satisfactory internal consistency of the ISEL-40 v. GP in the researched group (α=0.86). It was also noticed that internal consistency of the subscales varied. The subscales of tangible support (α=0.79) and belonging support (α=0.73) obtained acceptable values. Internal consistency of self-esteem support (α=0.51) and appraisal support (α=0.62) was too low to be recommended for individual and scientific use. An attempt to modify the number of items did not come up to expectations in terms of the subscales internal consistency. Social support in mothers of healthy and ill children was moderate (29.92 – 33.45 points) and no statistically significant differences in their perception of the support were observed. Conclusions In the research on a group of mothers of healthy and ill children it is recommended to use only a social support indicator based on the general result of the ISEL-40 v. GP. Further research aimed at verification of the theoretical structure of the Polish version of the ISEL-40 v. GP is advised