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Východiská: Štúdia mapuje prvé skúsenosti s pôso- bením školských zdravotníckych pracovníkov na Slovensku v oblasti kompetencií výchovy k zdraviu a ochrany a podpory zdravia, ktoré im vyplynuli z Odporúčaného postupu MZ SR. Súbor a metódy: Prieskum sme realizovali pomocou dotazníka vlastnej konštrukcie, ktorý distribuovalo MZ SR. Základný súbor tvorili školskí zdravotnícki pracovníci na Slovensku (n = 92), z ktorých 87 bolo sestier, 3 zdravotnícki záchranári a 2 verejní zdravot- níci. Na dotazník odpovedalo 67 z oslovených, čo bola 73 % návratnosť. Výsledky: Zistili sme, že všetci školskí zdravotnícki pracovníci sa v prvom roku implementácie preventív- neho postupu MZ SR na rozvoj prevencie v prostre- dí škôl a školských zariadení zaoberali jeho imple- mentáciou najmenej v jednej zo sledovaných troch nosných oblastí štandardu 1. odporúčané monitorin- gy a skríningy, 2. výchovno-vzdelávacie programy na rozvoj zdravotnej gramotnosti a 3. spolupráca so zdravotníckymi pracovníkmi a externými subjektmi. 42 školských zdravotníckych pracovníkov kontinuálne počas celého obdobia svojho pôsobenia aktívne vy- hľadávalo osoby v riziku zdravia, zdravotne oslabe- ných a chorých, 30 zaviedlo pravidelné výchovno- -osvetové prednášky na zdravotné témy (27 z nich dokonca ako prierezové do bežného vyučovania blo- kovo integrované tematické celky v zmysle odporú- čania), 13 nadviazalo spoluprácu s rodičmi, 11 vyko- návalo ranný filter, 11 nadviazalo spoluprácu so zdravotníckymi pracovníkmi a inými subjektmi z ex- terného prostredia, jeden si vytvoril vlastný monito- rovací dotazník na všetky odporúčané položky skrí- ningu, 1 inicioval vytvorenie izolačnej miestnosti s vybavením a lekárničkou v prostredí školy. Školskí zdravotnícki pracovníci poskytli v sledovanom obdo- bí v prostredí 92 škôl a školských zariadení prvú po- moc 854-krát, čo je priemerne 13 poskytnutí prvej pomoci na jednu školu alebo školské zariadenie. Záver: Zo štúdie vyplynulo, že prevencia vykonávaná školskými zdravotníckymi pracovníkmi dáva zmysel všetkým zainteresovaným – deťom a mladistvým, pedagogickým zamestnancom, riaditeľom škôl aj sa- motným školským zdravotníkom a už v prvom roku implementácie priniesla konkrétne výsledky v podo- be podpory zdravia detí, ktoré sú špecifikované vo výsledkoch štúdie. Na podporu vlastnej odbornej čin- nosti v oblasti ochrany a podpory zdravia ako aj re- alizovanej zdravotnej výchovy a osvety by školskí zdravotnícki pracovníci potrebovali zabezpečiť meto- dické materiály a učebné pomôcky najmä na reali- záciu interaktívnych výchovno-vzdelávacích aktivít a ďalšie materiálno-technické vybavenie – hlavne zdravotnícky materiál na poskytovanie zdravotnej sta- rostlivosti v prostredí školy alebo školského zariade- nia, pravidelne organizované stretnutia k výmene skúseností, podporu MZ SR a MŠVVaŠ SR v imple- mentácii štandardu a v komunikácii a byť súčasťou školských podporných tímov.

Background: The study maps the first experiences with the work of school health professionals in Slovakia in the field of health education and health protection and promotion competencies, which resul- ted from the Recommended Procedure of the Ministry of Health of the Slovak Republic. File and methods: We carried out the survey using a questionnaire of our own design, which was dis- tributed by the Ministry of Health of the Slovak Republic. The basic set consisted of school health professionals in Slovakia (n = 92), of which 87 were nurses, 3 rescue professionals and 2 public health professionals. 67 of the respondents answered the questionnaire, which was a 73 % return rate. Results: We found that in the first year of implemen- tation of the preventive procedure of the Ministry of Health of the Slovak Republic for the development of prevention in the environment of schools and school facilities, all school health workers were en- gaged in its implementation in at least one of the monitored three supporting areas of the standard 1. recommended monitoring and screenings, 2. educa- tional programs to develop health literacy and 3. co- operation with health workers and external entities. 42 school health workers continuously during the entire period of their work actively searched for per- sons at risk of health, health-impaired and sick, 30 introduced regular educational and educational lec- tures on health topics (27 of them even as cross- -sectional thematic units integrated into regular te- aching in the sense of the recommendation), 13 established cooperation with parents, 11 performed the morning filter, 11 established cooperation with health professionals and other entities from the ex- ternal environment, one created its own monitoring questionnaire for all recommended screening items, 1 initiated the creation of an isolation room equip- ped with a first-aid kit in the school environment. During the monitored period, school health workers provided first aid 854 times in the environment of 92 schools and school facilities, which is an average of 13 first aid per school or school facility. Conclusion: The study showed that the prevention carried out by school health professionals makes sen- se to all involved - children and adolescents, teaching staff, school principals and school health professio- nals themselves, and already in the first year of im- plementation it brought concrete results in the form of children’s health support, which are specified in the results of the study. To support their own pro- fessional activity in the field of health protection and promotion as well as health education and aware- ness, school health workers would need to provide methodological materials and teaching aids, especial- ly for the implementation of interactive educational activities and other material and technical equipment - mainly medical material for providing health care in the environment of a school or school facility, re- gularly organized meetings to exchange experiences, support of the Ministry of Health of the Slovak Republic and the Ministry of Education and Culture of the Slovak Republic in the implementation of communication and being part of school support te- ams.

Článek

A patient's non-adherence to the treatment of diabetic foot ulcers: longitudinal case study

Ošetřovatelské perspektivy. 2023 ; 6 (1) : 51-66. [pub] 20230629

ISSN 2570-785X
Medvik
Zdroj

Introduction: On average, diabetic foot ulcerations heal within 3 to 6 months. By adhering to treatment measures this period can be shortened and re-ulcerations prevented. Aims: To analyze the causes and risk factors of re-ulcerations/recurrences/relapses of diabetic foot ulcers (DFU) on 1 case, to assess the effects of the applied treatment measures, and to suggest more effective methods to maintain motivation to treatment and successful healing of diabetic ulcerations.Methods: A case study of a client diagnosed with DFU who was monitored, treated and educated in a vascular-surgical outpatient ward for 11 years (2010-2021). For data collection we used monitoring, tests and scales, an interview, a medical documentation analysis including laboratory, physical, clinical and anthropometric indicators, and a DFU photo documentation.Result: A long-term DFU treatment (local surgical and wound therapy, pharmacological, short education about regimen measures) caused the client's loss of motivation and non- adherent behavior manifested by his nonadherence to the prescribed regimen measures (diet, relieving the ulcers), worsening of laboratory indicators (HbA1c), physical indicators (hypertension), clinical indicators (nonhealing scum of the wound, re-ulceration, infection), anthropometric indicators (BMI), insufficient treatment efficacy, and worsening of the prognosis of DFU (amputation). The fact that there were no physical inspections during the covid pandemic made this condition even worse.Conclusion: Despite a long DFU treatment the client's DFU did not heal. Such a long- term patient must not only be educated but also led and supported, positively motivated to undergo treatment and to adhere to the regimen measures through life values, individual lifestyle, and open partnership with healthcare professionals.