Sports activities of 60 above Hungarian elderly-explaining and predicting impact of exercise on health.

BACKGROUND: The proportion of elderly is on the rise both in Europe and in Hungary. The challenge is to increase the number of years spent in good health as well as to improve quality of life of those 60 years and above. This study focuses on the impact of physical activity on this age group. METHODS: A nationally representative sample of 2000 respondents were surveyed in an age range of 15-74. Our data concerns those being 60-74 years of age. The focus of our investigation was level and impact of physical activity in the group above. First, we used Chi-squared tests and correspondence analysis to identify the deviation in the answers of different groups in our sample. After we built a hierarchical linear regression model to get a deeper understanding of the impact of physical activity for elderly. RESULTS: Those reporting no physical/sports activity at all have to do with the negative culture of exercising. Only 9.3% reported being engaged with any sports; 72% reported no regular exercising throughout their lives. The relationship between sport activity and self-reported health was significant (p = 0.009, Cramer's V = 0.2). Elderly were characterized by walking, hiking and less intense sports. CONCLUSIONS: Those who actively exercised in this research reported better health outcomes than those who stopped or had never been engaged in any sports. We conclude that of all variables tested, physical activity was most effective to improve personal health of the elderly in this sample. Compared to European data on physical activity of elderly populations, Hungary seems to fall behind and needs to consider concentrated efforts to improve the future health of its senior populace.

Multicausal analysis on psychosocial and lifestyle factors among patients undergoing assisted reproductive therapy - with special regard to self-reported and objective measures of pre-treatment habitual physical activity.

BACKGROUND: National, regional and global trends in prevalence of infertility indicate its public health importance, however it effects various life dimensions of individuals and couples as well. Lifestyle habits may counteract with these factors. The aim of the study was the multicausal analysis of psychosocial and lifestyle factors undergoing assisted reproductive therapy (ART) with special regard to pre-treatment habitual physical activity (PA). METHODS: In a cross-sectional, observational cohort study on ART patients (N = 60, age 34.6 ± 5.2 years, BMI 24.2 ± 4.9 kg/m2) with follow up on outcome measures a detailed description was given on PA patterns (ActriGraph GT3X, GPAQ-H) and on general and infertility related distress (BDI-13, FPI). RESULTS: Respondents reported normal mood state (BDI-13) but moderately high infertility-related distress (FPI) in Social- and very high distress in Sexual Concern. It was revealed that time spent with recreational PA (RPA) could counteract with infertility-related distress (Social Concern R = -0.378, p = 0.013; Relationship Concern R = -0.365, p = 0.019). In the presence of clinical pregnancy GPAQ-H RPA MET was significantly higher (p = 0.048), in the non-pregnant group cumulative values and work-related PA were higher. Correlations could be found between RPA time and the number of oocytes (R = 0.315, p = 0.045), matured oocytes (R = 0.339, p = 0.030) and embryos (R = 0.294, p = 0.062) by women who reached at least 150 min RPA (GPAQ-H). Multivariate linear regression revealed that the number of oocytes was positively influenced by the GPAQ-H recreation MET (R2 = 0.367; F = 10.994, p = 0.004; B = 0.005, p = 0.004, B Constant = 4.604). Regarding the number of embryos (R2 = 0.757, F = 17.692, p < 0.001, B Constant = 1.342) positive relationship was found with GPAQ-H RPA MET (B = 0.004, p < 0.001) and negative with BMI (B = -0.167, p = 0.038). It was disclosed (R2 = 0.958, F = 408.479, p < 0.001) that higher Very Vigorous Activity (ActiGraph) was accompanied with higher hCG (B = 63.703, p ≤ 0.001). However, time spent with moderate PA (GPAQ-H) (B = 0.002, SE = 0.001, Wald = 3.944, p = 0.047, OR = 1.002) was significantly associated with live births. CONCLUSIONS: Amount of PA alone did not have a positive effect on outcome of ART. Type and intensity seemed to be more significant. Existing differences in response to infertility due to recreational PA suggest the importance of the development of a specific intervention. The robust overestimation of PA in self-reports highlights the need to improve physical literacy of women undergoing ART.

Association with subjective measured physical activity (GPAQ) and quality of life (WHOQoL-BREF) of ageing adults in Hungary, a cross-sectional study.

BACKGROUND: It is well known that physical activity (PA) has health benefits. This study aimed to examine physical activity carried out by the senior (over 50) participants and its relation to their quality of life (QoL). METHODS: Surveillance of PA and QoL was measured by using questionnaires (GPAQ, WHOQoL-BREF) in this study. Descriptive data were presented as means and standard deviations (SD) for continuous variables and as percentages for categorical variables. Multivariate linear regression analysis was conducted. The significance level was set at p ≤ 0.05. RESULTS: Overall, 250 participants were recruited, the mean age of the study population (n = 243) was 70.2 (SD 7.1) years. The results clearly showed that the Hungarian participants aged over 50 years were more likely to do PA if they had university degree and lower age (p ≤ 0.001) and used more active transportation (p = 0.035) if they had low education. The results of WHOQoL-BREF showed that the Hungarian individuals have better QoL if they have university degree (p ≤ 0.001) and lower age (p ≤ 0.001). Using multivariate linear regression analysis to examine the effect of PA patterns on QoL adjusted for demographic variables (age, education, BMI, place of living), the result showed significant correlation between WHOQoL-BREF dimensions and GPAQ (p ≤ 0.001). CONCLUSION: Higher amount of PA among aging population can result in better QoL in all dimensions.

The effect of a community-based e-health program to promote the role of physical activity among healthy adults in Hungary.

BACKGROUND: Physically active lifestyle can prolong the years spent without chronic diseases and is strongly associated with good mental and physical health. The goal of the study was to examine the physical activity patterns of the healthy adults and the effectiveness of a community-based e-health program. METHODS: The study sample comprised of 633 participants. Analyses were based on the E-Harmony health program that was conducted in Hungary in 2014-2015. The longitudinal study measured the physical activity patterns of the healthy adult population, and a 12-month community-based internet and media program was evaluated for the target group to improve the physical activity level and related knowledge. We examined the effectiveness of the program by the International Physical Activity Questionnaire - Hungarian validated long version adjusting for socio-demographic parameters, also across multivariate linear regression analysis using SPSS 24.0 software. Confidence interval of 95% was used and the level of significance was p < 0.05. RESULTS: The total physical activity of the study sample was 5129.9 (SD = 4488.1) MET min/week. Male participants scored higher in total activity but the results showed no statistical significance. Our participants were sitting 2211.6 (SD = 1592.8) min /week on average (daily average was 315.9 (SD = 227.6) minutes); the results showed no statistically significant difference by gender. We found weak but significant relationship between the active lifestyle and anthropometric data, especially according to leisure time activities and sedentary behaviour (p < 0.001). Based on the multivariate linear regression models the socio-demographic parameters significantly affected the physical activity level of participants. After the 12-month community-based e-health program, 10.34% changes occurred in the total physical activity level (p < 0.001). CONCLUSIONS: To our knowledge, ours was the first community-based e-health program in Hungary to improve the physical activity level of the healthy adult population. Based on our results this web-based e-health program can be an adequate tool to promote healthy lifestyle. The study could provide appropriate information for the further health interventions and policy making. Further research is necessary to determine the special risk groups and to develop an applicable e-health program for such specific subgroups.

Discriminating low-, medium- and high-burnout nurses: Role of organisational and patient-related factors.

AIM: To discriminate low/medium/high burnout in nurses by work and patient-related indicators and explore what factors characterize these categories best. METHODS: Cross-sectional, online survey with a representative sample of nurses. Measures assessed burnout, intragroup conflict, job insecurity, overt aggression and impact of patient aggression on nurses. RESULTS: Top nurse managers experienced more burnout than middle managers or staff, middle managers also reported greater burnout than staff. Those who had never suffered aggression experienced greater burnout but less intragroup conflict and job insecurity. Staff differed on job insecurity from top and midlevel managers. The first discriminant function differentiated high burnout from medium and low; this function was characterized by exhaustion, aggression and intragroup conflict. The second function differentiated medium burnout from others; job insecurity, years worked, over aggression and overtime dominated this function. CONCLUSIONS: Burnout affects managers and staff differently; top managers may be more susceptible to burnout than reported before. Low, medium and high burnout groups require tailored interventions because of their different characteristics. IMPLICATIONS FOR NURSING MANAGEMENT: In the future, burnout assessment should focus on both organisational and care related factors. Determining levels of burnout will guide managers to improve the right aspects of practice and work environment.

[Violence against health care providers and its correlations with sociodemographic and workplace-related factors]. / Az egészségügyi szakdolgozókat ért agresszív cselekmények kapcsolata szociodemográfiai és munkahelyi tényezokkel.

INTRODUCTION: Violence against health care providers is getting more awareness nowadays. This topic is in the focus of international scientific attention also, although in Hungary exact data is lacking. AIM: The present study aimed to assess the correlations between violent acts against health care workers and their effects with different sociodemographic and workplace-related factors. METHOD: A quantitative cross-sectional online survey was conducted enrolling 1201 health care providers. Data were analysed trough chi-square, Kolmogorov-Smirnov, Mann-Whitney and Kruskal-Wallis tests, where appropriate. RESULTS: Verbal and physical aggression was experienced more frequently by nurses who were males, above the age of fifty, working in in-patient care or in 12 hours shifts or constant night shifts. The same groups of health care providers suffered more from the negative emotional consequences of violent acts. CONCLUSIONS: Aggression is a serious problem in the Hungarian health care system, therefore employees have to be prepared for these acts. Orv. Hetil., 2017, 158(6), 229-237.

[Satisfaction of parents raising children under 7 years of age with general practitioners in Hungary]. / A hétévesnél fiatalabb gyermeket nevelo szülok háziorvosokkal való elégedettsége Magyarországon.

INTRODUCTION: Development of children's primary care may only take place through proper monitoring of both providers and recipients. AIM: The aim of the study was to investigate the parental satisfaction with the doctor of 0-7 years old children. METHOD: The research took place in Budapest and five Hungarian counties in "Early Childhood (0-7 years) Programme 6.1.4/12/1-2012-0001". There were 980 parental questionnaires were evaluated and 93 parents participated in ten focus group interviews (n = 93). RESULTS: Answers indicated that parents were most satisfied with the information received from the physician of their child (score 3.8), and they were least satisfied with the waiting time and the time of consulting hours (score 3.4). The results of focus group interviews were similar to those obtained from the questionnaire survey. CONCLUSIONS: Participating parents are "rather satisfied" or "satisfied" with the physician of their child. Evaluation of the results forms basis to create indicators for primary care improvement.

Nurse preferences of caring robots: A conjoint experiment to explore most valued robot features.

AIM: Due to the COVID pandemic and technological innovation, robots gain increasing role in nursing services. While studies investigated negative attitudes of nurses towards robots, we lack an understanding of nurses' preferences about robot characteristics. Our aim was to explore how key robot features compare when weighed together. METHODS: Cross-sectional research design based on a conjoint analysis approach. Robot dimensions tested were: (1) communication; (2) look; (3) safety; (4) self-learning ability; and (5) interactive behaviour. Participants were asked to rank robot profile cards from most to least preferred. RESULTS: In order of importance, robot's ability to learn ranked first followed by behaviour, look, operating safety and communication. Most preferred robot combination was 'robot responds to commands only, looks like a machine, never misses target, runs programme only and behaves friendly'. CONCLUSIONS: Robot self-learning capacity was least favoured by nurses showing potential fear of robots taking over core nurse competencies.

Impact of sense of coherence and work values perception on stress and self-reported health of midwives.

OBJECTIVE: The aim of the research was to explore how sense of coherence (SOC) and work values (WVs) impact on stress and perceived health of midwives. Sense of coherence, by definition, reflects a person's view of life and capacity to respond to stressful situations. A further goal was to evaluate the mediating effect of WVs between stress and health. DESIGN: A cross sectional, correlational design was used. SETTING: Participants were randomly selected from 13 hospitals across Hungary. PARTICIPANTS: The final sample included 228 midwives. METHODS: Main measures included Sense of Coherence Questionnaire, stress subscale from the Demand-Control-Support scale, Super's Work Values Inventory and Subjective Health Test developed by the authors. Statistical analyses determined correlation coefficients, difference by independent t-test, and linear regression. FINDINGS: Participants reported high level of stress, showed average SOC and subjective health. The most preferred work values were altruism (Mean = 12.40), economic returns (Mean = 12.11) and supervisory relations (Mean = 11.99). SOC and health were positively (r = 0.47, p < 0.001), while SOC and stress were negatively associated (r = -0.36, p < 0.001). WVs indirectly mediated the relationship between health and stress (r = -0.55, p < 0.001). Midwives who worked less than 5 years in practice did not differ on health, stress, WVs and SOC from those who had been working longer. Going from worst to best perceived personal health increased intention to stay in midwifery by 32% in the linear regression model. KEY CONCLUSIONS: In this study we documented relatively greater levels of stress and average levels of health and SOC among midwives. This paper confirmed that SOC had a positive impact on stress and health specifically for midwives. Uniquely, work values indirectly influenced the relationship between stress and health. IMPLICATIONS FOR PRACTICE: Improving SOC and WVs advance the health of midwives which will reduce the probability of leaving the profession.

[Correlations of alternative medicine, health status and health care in Hungary]. / Az alternatív medicina, az egészségi állapot és az egészségügyi ellátás összefüggései Magyarországon.

INTRODUCTION: Alternative medicine has a growing popularity in Hungary as well as in other Western countries. However, we are in lack of accurate empirical data on the use of this kind of care and its relationship toward official health care system. AIMS: This paper focuses on the questions of the use of, prospective willingness to use, and attitudes toward alternative medicine with regard to the demographic background, general health status and habits of visiting doctors. METHOD: The source of data is a Baranya county health survey from 1999 (N = 2357). The statistical method of analysing data is regression analysis. RESULTS: Alternative medicine is popular mostly in groups of people with younger age, higher level of education and income. Preferring alternative care is connected to having more chronic, non-fatal illnesses while the number of fatal illnesses on one hand and activity restriction on the other have no significant role. Positive relationship to alternative medicine is connected to more overall visits of doctors but less of GP-s. CONCLUSIONS: Regarding the demographic background and health status alternative medicine in Hungary appears similar to what publications from Western countries have already enlighted. Data on utilization of official health care can refer to the possibility that alternative medicine might serve as an alternative of primary care but not of secondary care.

[The treatment of bone metastases with bisphosphonates--the patients' view]. / A csontáttétek kezelése bisphosphonat-készítményekkel...ahogy a betegek látják.

The Hungarian bisphosphonate market has been increasing for years; last year the number of patients was approximately 3200-3500. We decided to start a research among patients having malignant disease with bone metastases, in order to find out how patients evaluate the drugs, how they are informed and what is the role of doctors and nurses in compliance. Nearly 300 patients filled questionnaires and we have made 16 in-depth interviews. The average age of patients was 57 years. More than 60% of patients were younger than 60 and the male-female ratio was 1:2. We found that more than one quarter of the patients arrived to their doctor from farther than 50 km and 70% of them meet their doctor at least once a month. The results showed that 95% of patients would prefer oral treatment (tablets or capsules), and 75% of the patients would choose tablets, if they were asked. Most of the patients wanted to be informed primarily by doctors. Nurses were the hostesses of emotional problems. Doctor-patient relationship was characterised by paternalism. Female patients were more open to nurses, they talked over smaller problems emerging during the treatment and the same occurred with some male patients, too. Only 5% of patients received the treatment of their choice. Patients want to be involved more actively in the planning of their treatment process than doctors think, they expect that doctors should prefer their interest. Cancer patients are frequently underinformed and they expect more help to solve their psychological problems.

Results of nutritional screening in institutionalized elderly in Hungary.

Dietetics contributes to life-long, sustainable health and optimal life quality of people. The knowledge of the nutritional state can be informative and normative in order to optimize personal care. The aims of this study were to summarize the relevant legislative considerations of nourishing the elderly in different long-term residential social institutions and to screen the nutritional state of those living there. No investigation of this type has ever been carried out in Hungary or in central eastern Europe before. We used the malnutrition universal screening tool (MUST) screening program for the evaluation of nutritional status. Our survey was done in 20 Hungarian nursing homes in 2006. The sample (n=1381) was representative of regional distribution and number of residents. In our study population 38.2% of the patients were endangered in point of malnutrition. The results of our survey call attention to the elevated number of elderly people at risk of malnutrition in nursing homes. As malnutrition has serious consequences regarding also quality of life, nutritional screening of nursing home residents is not only a basic economical interest, but is also in full harmony with the idea "not only to feed, but to nourish" and it is a basic moral duty.

'Doctors by Fax' or cleaner production: the problem of prevention in post-communist Hungary.

In 1989, approximately half of the medical visits in Hungary were to factory doctors. Two thousand physicians in the National Health Service were assigned to factories and all medical students served in factories as part of their training. There were certainly problems in the system, but workers preferred the factory doctors to other physicians based in communities or districts; and factory physicians knew about workplace hazards, knew what production processes looked like, and were mandated to deal with work environment problems as well as provide other kinds of patient care. With the reform of the National Health Service, the role of factory physician was eliminated, although companies could institute their own medical services (and sometimes employed the previous medical staff). Later legislation required companies to have access to occupational medical services, but critics have called the new system "Doctors by Fax." We discuss the adequacy of the new legislative requirements (including mandatory health and safety committees) and report on new issues in worker health and safety that have emerged post "reform." Finally, the possibility of linking the prevention of occupational disease and injury prevention to "cleaner production" in Hungary is discussed.