The Occurrence of Anxiety, Depression, and Distress among Professionals Working in Emergency Care.

Maintaining mental health is essential for professions with higher stress levels and challenging environments, including emergency specializations. In this study, the occurrence of distress, anxiety, and depression among a group of ambulance and hospital emergency care professionals was assessed (n = 202). A cross-sectional, quantitative, descriptive online survey was conducted, including the internationally validated Beck depression inventory (BDI), the perceived stress scale (PSS-14), and the State-Trait Anxiety Inventory (STAI). Statistical analyses involved descriptive statistics, the χ2-test, Mann-Whitney U test, Kruskal-Wallis test, Dunn-Bonferroni test, logistic regression (LR), Cramer coefficient (Cramer's V), Kolmogorov-Smirnov test, and Spearman's rank correlation coefficient (rs). Based on the results, female professionals are more likely to have depressive symptoms (OR = 2.6, 95% CI = 1.3-5.1), perceived stress (OR = 1.2, 95% CI = 1.2-4.1), and anxiety (OR = 2.1, 95% CI = 1.0-4.1) than male professionals. Perceived stress levels decreased proportionally with increasing years spent working in healthcare (OR = 7.4, 95% CI = 7.1-8.3). Extended work shifts of 12 or 24 h increase the risk of perceived stress and anxiety in emergency care workers (p = 0.02). Customized stress management interventions are needed to mitigate the amplified mental strain associated with gender, working years, and longer shifts in the emergency care sector to sustain their mental health and well-being.

A randomized controlled simulation trial comparing video-assisted with telephone-assisted and unassisted cardiopulmonary resuscitation performed by non-healthcare university students.

Our randomized controlled simulation study aimed to compare the CPR quality, time-related factors, attitude and self-assessment of non-healthcare university students (aged 18-25) compared video-assisted (V-CPR, n = 50) with telephone-assisted (T-CPR, n = 49) and unassisted (U-CPR, n = 48) CPR in a simulation setting. Regarding to chest compression depth, no difference was found between the three groups (p = 0.065): 41.8 mm, SD = 9.9 in the V-CPR; 35.9 mm, SD = 11.6 in the T-CPR; and 39.4 mm, SD = 15.6 in the U-CPR group. The mean chest compression rate was the best in the V-CPR group (100.9 min-1, SD = 17.1) which was superior to the T-CPR (82.4 min-1, SD = 35.4; p = 0.005), and the U-CPR (84.2 min-1, SD = 30.6; p = 0.013) groups. The overall proportion of correct hand position was the highest in the V-CPR group (48, 96%), compared to the T-CPR (28, 57.1%; p = 0.001), and the U-CPR (34, 70.8%; p = 0.001) groups. V-CPR led to a delay in the time to the first chest compression compared with the U-CPR group (77.5 s, SD = 19.2 vs. 31.3 s, SD = 13.3, p < 0.001). Although V-CPR technology holds the potential to improve overall CPR quality, the importance of appropriate chest compression depth should be emphasized in training for laypeople and dispatchers, as well. Our study was registered at ClinicalTrials.gov (NCT05639868, 06/12/2022).

[Help from a distance - The present and the future of video-assisted cardiopulmonary resuscitation]. / Segítség a távolból ­ A videoasszisztált újraélesztés jelene és jövoje.

Quick and high-quality cardiopulmonary resuscitation has an important role in the survival of out-of-hospital cardiac arrest. In the majority of the cases, the victim is detected by a layperson. Usually, the ratio of giving help is lower than expected. Dispatcher-assisted cardiopulmonary resuscitation can improve the helping attitude and the quality of cardiopulmonary resuscitation by giving instructions during the emergency call. Telephone-assisted cardiopulmonary resuscitation is widely available worldwide. In addition, video-assisted cardiopulmonary resuscitation provides the possibility of not only voice-based but also video-based communication. This can provide real-time feedback from the scene, the victim and the bystander. Previous simulation studies showed the advantages of video-assisted cardiopulmonary resuscitation. The technology is available in some countries in the real-life health care system. Despite positive effects, we need to examine also less studied aspects which can influence the effectiveness of the technology such as camera position, quality of the video, environmental factors, and the knowledge and attitude of dispatchers and bystanders related to video-assisted cardiopulmonary resuscitation. Clarifying these factors is important because the availability of technology in itself is not a guarantee of successful implementation. In conclusion, the establishment of a national CPR register is suggested. The introduction of the V-CPR method requires studies conducted in a domestic environment. It is recommended to form a professional consensus working group, involving all relevant experts to develop V-CPR guidelines. Orv Hetil. 2023; 164(1): 11-18.

Teaching cards as low-cost and brief materials for teaching basic life support to 6-10-year-old primary school children - a quasi-experimental combination design study.

AIM: Teaching Basic Life Support (BLS) in schools is a key initiative to improve the survival rates after out-of-hospital cardiac arrest. Low-cost training materials can reach a wider population. Our aim was to compare the effectiveness of using teaching cards with the traditional instructor-led and combined methods on BLS skills and attitude and to evaluate the long-term effects after two months. METHODS: A quasi-experimental combination design study. Two hundred sixty-three schoolchildren aged 6 to 10 years were assigned to three groups with different methods to teach BLS: teaching card group (n = 100), traditional instructor-led teaching group (n = 91), combined teaching group (n = 72). BLS skills and attitude were measured and compared before the training (T0), after the training (T1), and two months later (T2). RESULTS: BLS skills improved in every group at T1 compared to T0 (p < 0.001) and remained higher at T2 than at T0 in almost all cases (p < 0.001). Skill performance was similar in most of the skills between the three groups at T1. The best skill scores acquired were calling the ambulance and the correct hand position by chest compression. Positioning the head during check the breathing was more effective in the traditional group (48.4%) and combined group (61.1%) than in the teaching card group (19.0%) (p < 0.001) at T1. However, some skills improved significantly in the teaching card group at T2: check breathing for 10 s (p = 0.016); positioning the head by check breathing (p < 0.001); and positioning the head by ventilation (p = 0.011). Attitude did not change significantly in any of the groups (p > 0.05). Furthermore, the level of attitude was inferior in the teaching card group compared with the traditional (p = 0.005), and the combined groups (p = 0.049). CONCLUSION: Using low-cost materials for teaching BLS for young schoolchildren can improve their skills, however, could not improve attitudes. Teaching cards were not inferior compared to traditional and combined methods in some skills but inferior in others. Therefore, hands-on training opportunity is still important. Teaching cards are useful for long-term learning. To learn correctly the whole sequence of BLS is difficult for 6 to 10 years-old children, however, they are able to learn more BLS-related skills separately.

Understanding Health Literacy among University Health Science Students of Different Nationalities.

An adequate level of health literacy is essential for clear communication between patients and health care workers. The internationalization of universities is increasing in the field of health care. The aims of our research were to measure (1) the level of health literacy and its correlation among university students and (2) the relationship between the different instruments measuring health literacy. A cross-sectional study was conducted in the 2020/2021 academic year. The questionnaire included questions on sociodemographic status, study data, health status, and health literacy level. According to the HLS-EU-Q16 health literacy questionnaire, more than half of the students had a limited HL level in disease prevention (52.4%) and health promotion (58.4%) subindexes. Nationality was found to be an influencing factor (p < 0.001). According to the NVS, 80.1% of the students had an adequate HL level. A significant correlation was found between the results and nationality (p = 0.005). None of the Chew questions demonstrated a correlation with nationality (q1 p = 0.269, q2 p = 0.368, q3 p = 0.528). Nationality is a key factor in the level of subjective and functional health literacy. We need to measure both types of levels to see the real results.

Health Literacy in Early Childhood: A Systematic Review of Empirical Studies.

Early childhood plays a key role in the formation of healthy habits and the establishment of health literacy. Nonetheless, there are only a few research studies focusing on the health literacy level of children under the age of eight. The aim of our systematic review is to explore empirical research on health literacy related to early childhood. The research was conducted in accordance with the PRISMA protocol. This systematic review examines 12 studies published between 2013-2022. Results show that research focuses on different domains of health literacy for children. In relation to children's food literacy, children understand the relationship between health and nutrition and they realize the health impact of obesity. The habits connected to oral health are strongly associated with parents' knowledge of and behaviours around oral health. Results related to health care situations show that children are able to be actively involved in decision-making processes in connection with their health. Exploring young children's health literacy is essential in order to be able to plan health promotion interventions, embedded into early childhood education. Picture-based messages or story-based messages supported by illustrations can help measure health literacy in early childhood and can support the formation of health literacy.

How effective are chest compressions when wearing mask? A randomised simulation study among first-year health care students during the COVID-19 pandemic.

BACKGROUND: The resuscitation guidelines provided for the COVID-19 pandemic strongly recommended wearing personal protective equipment. The current study aimed to evaluate and compare the effectiveness of chest compressions and the level of fatigue while wearing two different types of mask (surgical vs. cloth). METHODS: A randomized, non-inferiority, simulation study was conducted. Participants were randomised into two groups: surgical mask group (n = 108) and cloth mask group (n = 108). The effectiveness (depth and rate) of chest compressions was measured within a 2-min continuous chest-compression-only CPR session. Data were collected through an AMBU CPR Software, a questionnaire, recording vital parameters, and using Borg-scale related to fatigue (before and after the simulation). For further analysis the 2-min session was segmented into 30-s intervals. RESULTS: Two hundred sixteen first-year health care students participated in our study. No significant difference was measured between the surgical mask and cloth mask groups in chest compression depth (44.49 ± 10.03 mm vs. 45.77 ± 10.77 mm), rate (113.34 ± 17.76/min vs. 111.23 ± 17.51/min), and the level of fatigue (5.72 ± 1.69 vs. 5.56 ± 1.67) (p > 0.05 in every cases). Significant decrease was found in chest compression depth between the first 30-s interval and the second, third, and fourth intervals (p < 0.01). CONCLUSION: The effectiveness of chest compressions (depth and rate) was non-inferior when wearing cloth mask compared to wearing surgical mask. However, the effectiveness of chest compressions decreased significantly in both groups during the 2-min chest-compression-only CPR session and did not reach the appropriate chest compression depth range recommended by the ERC.

Changes of first-aid attitude during the COVID­19 pandemic / Az elsosegélynyújtási attitud változása a COVID-19-járvány idején.

Összefoglaló. Az új típusú koronavírus (SARS-CoV-2 ) okozta járvány hirtelen megnövekedett betegszámai és halálozásai komoly kihívás elé állították az egészségügyi ellátás minden színterét. A magas idofaktorú kórképek ellátásában a laikusok által végzett elsosegélynyújtás alapveto fontosságú a beteg túlélése és maradandó egészségkárosodásának elkerülése szempontjából. Az áttekintés célja rávilágítani arra, hogy a SARS-CoV-2 okozta járvány idején az elso észlelok által megkezdett azonnali beavatkozások késlekedése mögött az elsosegélynyújtói attitud változása feltételezheto. A társadalmilag fontos elsosegélynyújtás fenntartása érdekében az Európai Újraélesztési Tanács is módosította az elsosegélyre, az alapveto, eszköz nélküli újraélesztésre vonatkozó irányelveit, továbbá ajánlásokat fogalmazott meg a járvány idején a biztonságos elsosegélynyújtás oktatásával kapcsolatban. A hazai adaptáció érdekében a jelen áttekintés összefoglalja a legfontosabb eljárásrendi szempontokat, kiegészítéseket, és kitér azok gyakorlati alkalmazhatóságára is. Az eljárásrendek változásának legfobb célja, hogy a segítségnyújtói szándékot a koronavírus-járvány elotti motiváltsági szintre lehessen visszahozni és azt tovább fokozni szakszeru oktatási anyagok és korszeru módszerek révén. Orv Hetil. 2021; 162(15): 571-578. Summary. The sudden increase in the number of patients and deaths from this novel type of coronavirus (SARS-CoV-2) pandemic poses a serious challenge to all arenas of health care delivery system. The care of high-time dependent-factor illnesses is essential for the survival of a patient and the need for avoiding impairment of health. The purpose of the review is to highlight that a change in first-aid attitudes can be assumed behind the delay in immediate interventions initiated by first responders during the SARS-CoV-2 pandemic. To maintain socially important first aid, the European Resuscitation Council amended its guidelines on first aid, basic life support and made further recommendations at the time of pandemic on first-aid education, too. For effective domestic adaptation, the present overview summarises the most important aspects of guidelines and their supplements and also covers their practical implementations. The main purpose of the change in guidelines is to bring the willingness of the first responders back to the level before the coronavirus pandemic, and to further enhance it with professional educational materials and modern methods. Orv Hetil. 2021; 162(15): 571-578.

Health literacy among participants from neighbourhoods with different socio-economic statuses in the southern region of Hungary: a pilot study.

BACKGROUND: Health literacy (HL) has a deep impact on people's decisions about their health and health care system. Measurement and improvement of HL level is essential to develop an appropriate health care system. The aim of the study was to (1) conduct a pilot study among the population of Baranya County in Hungary with different socio-economic statuses, (2) evaluate the HL level and (3) found the correlations between socio-economic data, emergency departments' visits, medical history and HL. METHODS: In a cross-sectional study conducted in 2019 with 186 participants, socio-economic status, health status, HL level and knowledge about the triage system were measured. The questionnaire included questions on socio-economic status, previous chronic diseases, and satisfaction with the emergency care system as well as the standardised European Health Literacy Survey Questionnaire (HLS-EU-Q47). Descriptive statistical analysis (mean, SD, mode) and mathematical statistical analysis (ANOVA, chi2 test, Pearson Correlations, Two sample t-test) were applied. SPSS 24.0 statistical software was used to analyse the data. Relationships were considered significant at the p < 0.05 level. RESULTS: One hundred and eighty-six people were involved in the research, but 45 of them were excluded (N = 141). The participation rate was 75.8%. There were significant differences in HL levels by gender and educational level (p = 0.017), health education (p = 0.032) and presence of children in the household (p = 0.049). Educational level (p = 0.002) and type of settlement (p = 0.01) had strong impacts on economic status. We found that 46.1% of the participants had limited comprehensive HL (cHL) level. This proportion was slightly lower for the disease prevention sub-index (33.3%). The average cHL index score was 34.8 ± 8.7 points, the average health care sub-index score was 34.6 ± 9.7 points, the average disease prevention sub-index score was 35.8 ± 9.9 points, and the average health promotion sub-index score was 34.2 ± 9.4 points. 46.1% of the examined population in Hungary had limited HL level. CONCLUSIONS: Socio-economic status has a strong influence on HL level. It is not enough to improve awareness but we need to improve knowledge and cooperation with the doctors and health care system.

[Do we know the limits? - Overview of cases related to acut alcohol intoxication in emergency department]. / Tudjuk, hol a határ? ­ A Sürgosségi Betegellátó Osztályt akut alkoholintoxikáció miatt felkereso betegek ellátásának elemzése.

Introduction: According to WHO data, more than 2 million people die because of alcohol consumption during one year. One part of these people are displayed in the emergency departments. There are those who are just about to be detoxicated, those who suffered alcohol-related accidents or alcohol-related internal illness. Aim: To find out how many alcohol-influencing patients are being in the emergency care system and how much of the financing are used for these patients. Method: Our research was conducted at the Department of Emergency Medicine, Clinical Centre, University of Pécs. The research period was between January 1 and December 31, 2016. Our sample was made up of patients who were exposed due to alcohol in the emergency room (n = 1326). We made document analysis. We analysed data using statistical software SPSS 22.0. Results: 78% of the patients were male. The mean age of the sample was 49.78 ± 14.215 years. 71.1% of patients had a home, but 28.9% were homeless. According to the Triage scale, 608 patients were in category T5 because they needed only detoxification. In terms of the level of consciousness, 93.7% of patients had 14 or 15 points according to the Glasgow Coma Scale. 14.6% of patients did not expect a medical examination. Within the framework of incoming and outpatient care, the provision of these patients is profitable. Conclusion: The diagnosis and care of the injuries is done in accordance with the domestic guidelines. Contrary to expectations, the care of these patients is profitable for the emergency department, although only fixed costs were included. Orv Hetil. 2019; 160(43): 1698-1705.

'The (second) year of first aid': a 15-month follow-up after a 3-day first aid programme.

AIM: First aid education in early childhood can be an effective method to increase the number of trained bystanders. Our aim was to evaluate the long-term effects of a 3-day first aid programme for all primary school-age groups (7-14 years old). METHODS: This study was a 15-month follow-up of our previous investigation. Five-hundred and twenty-four primary school children were involved in this study. Measurements were made on the following topics: adult basic life support, using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance. Data collection was made with a self-made questionnaire and skill test. RESULTS: Knowledge and skills were significantly higher after 15 months than before training (p<0.01). However, these results were significantly worse than immediately and 4 months after training (p<0.01). Based on the questionnaire, more than three-quarters knew the emergency phone number 15 months after training. Approximately two-thirds of the children could use the correct hand position in cardiopulmonary resuscitation, the correct compression-ventilation ratio and an AED, and half of them could perform correct recovery position at 15 months. Correct assessment of breathing was similar in a situation game than before training. Self-efficacy improved significantly after training (p<0.01) and remained improved after 4 and 15 months when compared with before training (p<0.01). CONCLUSION: Participants could remember some aspects of first aid long term. However, knowledge and skills had declined after 15 months, so refresher training would be recommended. Self-efficacy towards first aid improved after training and remained high after 15 months.

'The year of first aid': effectiveness of a 3-day first aid programme for 7-14-year-old primary school children.

AIM OF THE STUDY: Bystanders can play an important role in the event of sudden injury or illness. Our aim was to evaluate the effects of a 3-day first aid course for all primary school age groups (7-14 years old). METHODS: 582 school children were involved in the study. Training consisted of three sessions with transfer of theoretical knowledge and practical skills about first aid. The following most urgent situations were addressed in our study: adult basic life support (BLS), using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance. Data collection was made with a questionnaire developed for the study and observation. Students were tested before, immediately after and 4 months after training. Results were considered significant in case of p<0.05. RESULTS: Prior to training there was a low level of knowledge and skills on BLS, management of the unconscious patient, use of an AED and management of bleeding. Knowledge and skills improved significantly in all of these categories (p<0.01) and remained significantly higher than the pre-test level at 4 months after training (p<0.01). Younger children overall performed less well than older children, but significantly improved over the pre-test level both immediately and 4 months after training (p<0.01). Prior first aid training was associated with knowledge of the correct ambulance number (p=0.015) and management of bleeding (p=0.041). Prior to training, age was associated with pre-test knowledge and skills of all topics (p<0.01); after training, it was only associated with AED use (p<0.001). There was a significant correlation between the depth of chest compression and children's age, weight, height and body mass index (p<0.001). Ventilation depended on the same factors (p<0.001). CONCLUSION: Children aged 7-14 years are able to perform basic life-saving skills. Knowledge retention after 4 months is good for skills, but thinking in algorithms is difficult for these children.

[At what age can children perform effective cardiopulmonary resuscitation? - Effectiveness of cardiopulmonary resuscitation skills among primary school children]. / Hány éves kortól képesek a gyermekek újraéleszteni? ­ A hatékonyság felmérése általános iskolás gyermekek körében.

INTRODUCTION: In cardiac arrest life can be saved by bystanders. AIM: Our aim was to determine at what age can schoolchildren perform correct cardiopulmonary resuscitation. METHOD: 164 schoolchildren (age 7-14) were involved in the study. A basic life support training consisted of 45 minutes education in small groups (8-10 children). They were tested during a 2-minute-long continuous cardiopulmonary resuscitation scenario using the "AMBU CPR Software". RESULTS: Average depth of chest compression was 44.07 ± 12.6 mm. 43.9% of participants were able to do effective chest compressions. Average ventilation volume was 0.17 ± 0.31 liter. 12.8% of participants were able to ventilate effectively the patient. It was significant correlation between the chest compression depth (p<0.001) and ventilation (p<0.001) and the children's age, weight, height and BMI. CONCLUSIONS: Primary school children are able to learn cardiopulmonary resuscitation. The ability to do effective chest compressions and ventilation depended on the children's physical capability. Orv. Hetil., 2017, 158(4), 147-152.

[Adult advanced life support knowledge among ambulance officer/paramedic students in Hungary]. / Mentotiszthallgatók felnott emelt szintu újraélesztéssel kapcsolatos ismeretei Magyarországon.

INTRODUCTION: Resuscitation knowledge is necessery for emergency care workers. AIM: The aim of the authors was to investigate the advanced life support knowledge of paramedic students in Hungary. METHOD: The research has been executed at University of Pécs - Faculty of Health Sciences, Semmelweis University - Faculty of Health Sciences, and University of Debrecen - Faculty of Health Care. 97 students (n = 97) were involved in the study from third and fourth grades. Data were recorded with a self-fill-in questionnaire. RESULTS: Average scores were 67.79%. There was no significant difference between women and men (p = 0.725). Younger age improved significantly scores (p = 0.003). Full-time students completed the test significantly better than part-time students (p = 0.004). There was no significant difference between the students from different locations (p = 0.254). CONCLUSIONS: It would be appropriate to increase the number of resuscitation courses and to tighten the exams. The authors propose that it would be reasonable to examine the students' practical skills. Orv. Hetil., 2016, 157(37), 1476-1482.

[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.

Cross-sectional survey on self-reported health of ambulance personnel.

BACKGROUND: The high job stress among ambulance personnel is a widely known phenomenon. PURPOSE: to asses the self reported health status of ambulance workers. METHODS: An anonym self-fill-in questionnaire applying SF-36 was used among workers from the northern and western regions of Hungarian National Ambulance Service. RESULTS: Based on the dimensions of the SF-36 questionnaire the respondents considered their "Physical Functioning" the best, while "Vitality" was regarded the worst. The more time an employee have been worked at the HNAS the worse his health was in the first four dimensions like, "Physical Functioning", "Role-Physical", "Bodily Pain", "General Health": p < 0.001. Those working in secondary part-time jobs considered their health in all dimensions worse. The respondents who did some kind of sports hold their health in all dimensions better (p < 0.001). The workers with higher BMI regarded their health status worse, in four dimensions: "Physical Functioning": p = 0.001; "Role-Physical": p = 0.013; "General Health": p < 0.001; "Role-Emotional": p = 0.05. CONCLUSIONS: The workers health status proved to be insufficient according to the subjective perception and measurable parameters. According to the subjective perception of health and measurable parameters of health status of workers proved to be insufficient. Poor physical health can lead indirectly to psychological problems, which may lower the quality of the work and can lead to high turn-over.

[Knowledge about basic life support in European students]. / Európai fiatalok alapszintu életmentési ismeretei.

INTRODUCTION: Better knowledge and skills of basic life support can save millions of lives each year in Europe. AIM: The aim of this study was to measure the knowledge about basic life support in European students. METHOD: From 13 European countries 1527 volunteer participated in the survey. The questionnaire consisted of socio-demographic questions and knowledge regarding basic life support. The maximum possible score was 18. RESULTS: Those participants who had basic life support training earned 11.91 points, while those who had not participated in lifesaving education had 9.6 points (p<0.001). Participants from former socialist Eastern European countries reached 10.13 points, while Western Europeans had average 10.85 points (p<0.001). The best results were detected among the Swedish students, and the worst among the Belgians. CONCLUSIONS: Based on the results, there are significant differences in the knowledge about basic life support between students from different European countries. Western European youth, and those who were trained had better performance.