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Aim: The aims were to summarize studies on the effectiveness of interventions to reduce adverse events of the medication error type and, based on the studies, to identify recommendations for preventing medication errors in intensive care units (ICUs). Design: A descriptive review. Methods: To find relevant resources, the SCOPUS and EBSCO electronic databases were searched using the following search words: prevention, medication errors, intensive care unit. Both primary and secondary studies on prevention of medication errors in ICUs were selected. Results: A total of eight primary studies and three systematic reviews were included. The studies showed considerable variability and differed in methods, numbers of monitored events or ways of data collection. The assessed interventions were pharmacist involvement, automated infusion devices, reporting medication errors, strategies to limit interruptions during drug administration, electronic health records together with support systems for clinical decision making, nurse education in drug administration and creating checklists. Conclusion: The assessment of selected studies suggests that to a certain extent, all of them showed certain medication error reduction. Due to numerous limitations, however, it is impossible to select and recommend a single approach.

Aim: The aim was to synthesize themes and influencing factors of personal dignity experienced among patients with multiple sclerosis (MS) in the context of health care. Design: A qualitative narrative review with regard to PRISMA statements was used as a study design. Methods: The CASP Qualitative checklist was chosen for critical appraisal and thematic synthesis for synthesis of findings was adopted. Narrative the electronic databases: Academic Search Complete; Health Source: Nursing/Academic Edition; Humanities International Complete; MEDLINE were used for search. 230 studies were retrieved. 4 studies met the reviewers' inclusion criteria and were included into the study. Results: Three synthesized themes - Ill body, changed healthy identity and personal integrity (8 subthemes); Fighting spirit and patient's factors (8 subthemes) and Social factors (8 subthemes) - seem to be relevant for dignity of patients with MS. Narrative review shows tendency that patients with MS are in the danger of loss of dignity. Conclusion: Focused on personal dignity of people with MS brings possibility to have non-psychiatric approach to patients' personality fully consistent with the patient-centred approach in the context of health care. Results will be used as a framework for ethical reflection, interventions focused on how to improve or maintain personal dignity of patients with MS. Based on the critical appraisal, researchers should pay more attention to reflexivity. According to study limitations, a systematic review is needed.

Aim: The analysis of high-risk pregnancy, in order to determine what demographic and other factors are most commonly reported in women with high-risk pregnancy, and what relationships are among the variables recorded. Design: The method used was a retrospective observational study of cases. Methods: The study included 1,256 women at the Rimavská Sobota obstetrics and gynaecological unit hospitalized with a high-risk pregnancy in the two years. The method used was a retrospective observational study of cases. For processing were used statistic methods. Results: The average age of the sample was 24.45 years. 584 respondents (46.50%) were without education. 316 respondents (25.16%) did not go to prenatal counselling at all, or irregularly. The most significant dependences were demonstrated within the following variables - between the time of onset of respondents' problems and the presence of associated diseases, the time of onset of the problems and the number of spontaneous abortions suffered in the past, between termination of current pregnancy by abortion in respondents and prenatal counselling visits and between termination of current pregnancy by abortion and previous high-risk pregnancies. Conclusion: The results of the study confirmed the importance of prenatal care for women during pregnancy. Effective education focusing on reproductive health for girls of school-age, implemented by nurses, could also help to solve the problems identified.

Aim: The aim of the study is to evaluate the effectiveness of a gender equality course in changing undergraduate midwifery students' attitudes towards domestic violence and gender roles. Design: A one-group before-after quasi-experimental design was used. Methods: First-year undergraduate midwifery students (n = 64) were pre- tested and post- tested for their attitude to domestic violence and gender roles using "The Attitudes Towards Domestic Violence Scale", and "The Gender Roles Attitudes Scale". Data were collected from a health science faculty in Giresun, Turkey. The pre- and post-test results were compared using a paired samples t-test. Results: While the mean score of the attitudes towards domestic violence was 55.23 ± 5.84 before the gender equality course, it increased to 57.71 ± 5.07 after the course. The increase in scores was statistically significant (p < 0.001). For attitudes to gender roles, the mean total score increased from 154.65 ± 14.16 to 164.72 ± 13.65 after the course (p < 0.001). Conclusion: The gender equality course helped students develop more positive attitudes towards domestic violence and gender roles. We achieved the aim of the study. We recommend that gender equality courses be integrated into the midwifery curriculum.

Aim: The aim of this study was to compare the perception of selected stressors acting on the Czech intensive care unit (ICU) of Czech patients, their families and attending nurses. Design: A descriptive comparative study. Methods: Stressor perception was measured by a Czech version of the standardised questionnaire, The Environmental Stressor Questionnaire (ESQ). The sample group consisted of 90 people. Data were obtained via pairing (patient - relative - nurse). The family and the attending nurses evaluated stressors by empathising with the patient. Results: When evaluating the data obtained, it was ascertained that the relatives and attending nurses perceive stressors acting on the ICU as worse than patients themselves do. The overall level of stressor perception in the relatives was statistically significantly higher than in the patients (z = -3.72; p < 0.001). A statistically significant difference was also confirmed with regard to perception of stressors between attending nurses and patients (z = - 2.23; p < 0.001). Conclusion: Both the relatives and attending nurses perceive stressors in the intensive care unit as worse than the patients themselves do. The negative impacts of stressors can be reduced by implementing new approaches in nursing care.

Aim: The pilot study aimed to determine the association between burden and depression in caregivers caring for dementia patients. Design: Quantitative research; a cross-sectional study. Methods: Data were collected using a set of standardized questionnaires. Patients' performance in activities of daily living was assessed using the Barthel scale. The subset for caregivers included the Zarit Burden Interview, Caregiver Strain Index and Beck Depression Inventory. Results: The pilot study sample comprised 100 lay caregivers of dementia patients. More than 50% of caregivers of patients with moderate to severe dementia experienced moderate to severe burden as compared with those caring for individuals with mild or minimal depression. The median burden scores were 54 and 38 in caregivers with and without depression, respectively. There was no statistically significant difference in burden scores with respect to depression. There were positive correlations between depression measured with the Beck Depression Inventory and both Zarit Burden Interview scores (0.4898) and Caregiver Strain Index scores (0.3379). Conclusion: The pilot study results confirm that caregivers are at risk for the development of depression associated with burden of care for dementia patients. It is essential to pay attention to carers, testing them regularly to assess both caregiver burden and the development of depression.

Aim: The aim of the study was to describe experience with falls, fear of falling, perceptions of the consequences of falls and how the fear of falling affects daily life in community-dwelling older adults. Design: The study used a qualitative design to describe the lived experiences of community-dwelling older adults with the fear of falling. Methods: Semi-structured interviews were conducted individually with six participants who reported the fear of falling. Results: Five main areas emerged from data analysis: development of the fear of falling, feared consequences of falling, activities curtailment, fall prevention behavior and meaning of social support in daily life. The fear of falling was described as a negative experience, directly linked to fall consequences such as physical injury, incapacitation, loss of autonomy, fear of dependence and experience of humiliating conditions. To maintain a certain level of independence in daily life, the participants chose to avoid falls by activity curtailment, organizing their lives more carefully and getting support from others. Conclusion: All participants identified that they had discovered their fear of falling after experiencing falls. The fear of falling was associated with feared consequences of a potential fall and had an impact on their daily life. The participant also mentioned other contributors to their fear of falling, including ill health and aging.

Aim: Aim of the study was to examine the intensity of childbirth-related fear, its components and relationship with selected variables (age, parity, and delivery history) among pregnant women in Slovakia. Design: The study was designed as a descriptive cross-sectional study. Methods: A cross-sectional study, 156 pregnant women participated in the research (age 29.7 ± 4.73). The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ, version A) was used to assess the intensity of childbirth-related fear. A short questionnaire of our own design was used to measure the components of child-related fear. Correlation analysis, ANOVA, and linear regression were employed. Results: The average intensity of child-related fear in the research sample was 68.8 (± 11.6), extreme fear was identified among 9.6% of pregnant women. Child-related fear and age were significantly negatively correlated (R = -0.16; p = 0.05). Results of ANOVA showed significant differences in intensity of fear according to delivery history (F = 4.58; p = 0.005). In the linear regression model, parity and delivery history were shown to be significant predictors of fear of childbirth. The most prevalent components of childbirth-related fear were pain (21.2%), prolonged labor (19.2%), and use of forceps or vacuum extraction (17.6%). Conclusion: Being a primipara, or perceiving a previous labor as complicated were significant factors influencing the fear of childbirth in our sample. The identification of the components and related factors of childbirth-related fear is important in planning effective intervention strategies aimed at anxiety prevention during pregnancy, and contributes to improvement in the quality of life of pregnant women.

Aim: The aims of the literature review were to identify and analyze factors affecting job satisfaction of midwives. Design: A literature review. Methods: Included in the literature review were full texts of papers published in English language from 1990 to 2014. The search for relevant data was performed using the electronic databases CINAHL, Medline, Science Direct and Wiley Online Library. From a total of 43 studies found, 11were analyzed as quantitative studies that fulfilled the specified criteria. Results: Job satisfaction of midwives is affected by a lack of support from the management of healthcare facilities, low salary, understaffing, insufficient time for professional activities, work-family imbalance, high workload, physical demands, inadequate professional development, working environment, stress and low autonomy at work. Midwives showed signs of exhaustion, fatigue, hostility and depression, contributing to job turnover. Conclusion: The literature review presents the factors influencing job satisfaction of midwives. This is affected by many variable determinants, which create a feeling of job satisfaction of midwives, but can also lead to job dissatisfaction and, consequently, high turnover.

Aim: The aim of the research study is to identify the selected indicators of mental health, such as meaning of life, experience of well-being, hope, and feelings of loneliness and depression in the elderly participating in the University of the Third Age, in relation to their age and gender. Design: A quantitative descriptive study. Methods: The selection of respondents was deliberate. The sample consisted of 147 seniors with a mean age of 67.4 (± 4.9) years enrolled at the University of the Third Age at Jessenius Faculty of Medicine, Comenius University. Data were collected by means of self-assessment scales - the Life Meaningfulness Scale, Snyder's Hope Scale, the Emotional Habitual Subjective Well-being Scale, the Loneliness Scale, and the Geriatric Depression Scale. Results: Seniors considered their life meaningful, and expressed a high level of hope. Their emotions were predominately positive. We identified low levels of loneliness and found no indication of depressed mood. We identified significant differences between men and women in evaluation indicators of mental health only in the frequency of positive emotions. Conclusion: The study indicates the presence of salutogenic factors affecting the mental health of the sample of seniors in the process of active aging. The results could form the basis for implementing preventive strategies in clinical nursing practice.

Aim: The aim of the following review was to search for existing registers of pressure ulcer (PU) incidence operating and collecting data on national level. Design: Type of study - review. Methods: Articles focusing on the subject of national PU registers were searched for by means of a systematic trawl through various databases using relevant terms. The search was limited to articles in English issued between 2010 and 2015 in the electronic databases SCOPUS and Nursing OVID. Articles focused on local datasets or registry as a part of local electronic health records were not included as well as studies which do not describe the dataset or the usability of data collection. Results: In total, six papers were found fulfilling the established criteria. Conclusion: According to information available from the literature review, it was recognised that only one register of PUs currently exists at the national level - the Registry of Ulcer Treatment (RUT) in Sweden. It can be assumed that registers exist in other countries, but that the information is not available on electronic databases. After a detailed inspection of the articles, it appears the information derived from the studies could provide a useful picture of the data that should be collected, and at what time during the treatment period (initial and final assessment of the patients and local symptomatology of the wound/pressure ulcer) it should be collected.

Aim: The aim of this article is to describe, analyze and compare the assessment tools used to evaluate risk of falling in pediatric nursing. Design: Review - literature review. Methods: Electronic licensed and freely accessible databases (Bibliographia Medica Čechoslovaca, MEDLINE, Web of Science, PubMed a Scopus) were used to obtain data. Instruments for measuring risk of falling in languages other than Czech, Slovak or English, and scales unsuitable for measuring risk of falling in pediatric nursing were excluded from the analysis. Results: From analysis of the collected information, the most suitable tool for assessment of risk of falling in pediatric nursing seems to be the Humpty Dumpty measuring scale. Conclusion: At present there are many assessment tools that can be used to evaluate the risk of falling in pediatric nursing, but most are available in English. Czech pediatric nursing continues to lack measuring tools with verified psychometric properties.

Aim: The aim of this literature review was to search for qualitative studies focusing on the concept of caring in nursing, to analyse them and to synthesize knowledge that concerns the definition of the concept of caring in nursing from the point of view of nurses and patients. Design: Review. Methods: Qualitative studies were searched for systematically in the electronic databases Academic Search Complete (EBSCO), CINAHL, Medline, Science Direct, and the Wiley Library Online, according to set criteria and defined key words for the period 1970-2015. Seven selected articles were analysed after selection of documents with the aid of a sorting chart. Results: Nurses understand caring in nursing as a relationship with patients which is characterised on the nurses' part by an individual and empathetic approach, attentiveness, experience and sensitivity. Through caring, active communication takes place, providing information which reduces anxiety and leads to the breaking down of barriers. This relationship helps protect patients' autonomy, dignity and comfort. It requires experience on the part of nurses, and it is influenced by the environment. The nurses' personal qualities (what professional knowledge, attitudes and skills they have) and their availability, reliability, and emotional and physical support are important to patients. Conclusion: The concept of caring is a content specific interpersonal process which is characterized by the professional knowledge, skills, personal maturity, and interpersonal sensitivity of nurses, which result in the protection, emotional support, and the meeting of bio-psycho-social needs of patients. The results of the overview study could contribute to an explanation and understanding of the nature of caring as a fundamental feature of the discipline of nursing.

Aim: The study aimed to assess the methodological quality of selected clinical practice guidelines (CPGs) for preventing risk of falling in adult patients in acute and long-term institutional care. Design: Descriptive study using qualitative research techniques. Methods: CPGs were systematically searched in databases of clinical guidelines, systematic reviews, electronic databases, and websites of organizations and professional societies, based on predefined criteria and keywords fo the period 2000-2015. After sorting and analysing 53 documents, the methodological quality of seven selected CPGs were assessed with the AGREE II generic instrument. Results: All CPGs obtained highest domain scores in the dimensions Clarity and Framework, and Purpose, while the lowest standardized scores were achieved by the Applicability and Editorial independence domains. The Rigor of development and Stakeholder Involvement domains achieved an average score. A total of three recommended guidelines showed high methodological quality: Falls. Assessment and prevention of falls in older people - 572 b., 84 % (NICE, 2013); Preventing Falls and Harm From Falls in Older People. Best Practice Guidelines for Australian Hospitals - 556 b., 84 % (ACSQHC, 2009); and Prevention of falls and fall injuries in the older adult - 559 b., 82 % (RNAO, 2005). Conclusion: Assessing the methodological quality of clinical guidelines using the AGREE instrument is one of the key steps in the process of their adaptation for other socio-cultural and organizational conditions. It would be possible to adapt and use all of the three most highly-rated CPGs to reduce risk of falling of inpatients in the Czech organizational and socio-cultural context.

Aim: To determine the incidence rate of forms of inpatient aggression towards nurses who working on psychiatric wards; to identify their attitude to patient aggression, to the factors that condition the occurrence and management of aggression. To determine the differences between nurses in relation to educational training aimed at the issue of patient aggression. Design: Quantitative cross-sectional study. Methods: Selection of respondents was deliberate. The sample comprised 223 nurses with an average of 21.27 (± 11.41) years of clinical practice. Data collection was implemented by means of the self-assessment scales: Violence and Aggression of Patients Scale (VAPS), Attitude Towards Aggression Scale (ATAS), The Management of Aggression and Violence Attitude Scale-Likert (MAVAS-L). Results: 98.58% experienced inpatient aggression in the course of the previous year. Negative attitudes to patient aggression predominated in the sample. Nurses expressed strongest agreement with the idea that internal factors foster patient aggression. Regarding methods of aggression management, nurses expressed strongest agreement with the use of medical therapy and restraints. They held a neutral attitude towards the use of non-physical methods. The age of nurses had an effect on how strongly they agreed with the importance of internal factors in prompting patient aggression and with the use of medical therapy and restraints. Conclusion: A high percentage of nurses have had personal experience of various forms of patient aggression. Negative attitudes to aggression predominated in our sample of nurses, emphasizing the influence of internal factors. The attitude of nurses towards patient aggression influences the selection of aggression management strategies.

Aim: To assess the impact of selected demographic (age, sex), socio-economic (marital status, education, income) and health factors (functional status, anxiety, depression) on quality of life (QOL) of seniors in the Košice region. Design: Cross-sectional study. Methods: QOL was assessed by the WHOQOL-BREF and WHOQOL-OLD questionnaires, functional status was assessed by the Barthel test Activities of Daily Living (ADLs), anxiety by the Beck Anxiety Inventory, and depression by the Zung Self-Rating Depression Scale. Relations between variables were assessed by Pearson correlation coefficients. Linear regression analysis was used to evaluate QOL predictors. Results: In a sample of a hundred and two elderly people, the best QOL was found in the domain of social relationships, death and dying, and intimacy. The worst QOL was found in physical health, social participation, and past, present and future activities. QOL was reduced particularly by depression, poly-morbidity, and life without a partner. The maintenance of independence in ADLs had a positive impact on most QOL domains. Conclusion: The results indicate the necessity of creating opportunities for the development and maintenance of social contacts, the involvement of seniors in various leisure activities and in different programs or voluntary activities. The screening for and treatment of depression and anxiety is very important in improving quality of life in older adults, as is maintaining and improving self-care in ADLs.

Aim: The aim of the research was to map the specifications of communication of death with a child in the family of healthy members. Design: Qualitative research. Methods: A qualitative methodology was selected for initial orientation in a hitherto unexplored area. The method of semi-structured interview was aimed at mothers of preschool children aged between five and six, within their immediate family with no terminally ill family members. 14 mothers were selected by combining improbability sampling methods. A cluster method, simple enumeration method and method of searching for patterns were used to analyse the data. Results: The obtained data describe family discussion about death. They describe mother and child as well as the circumstances in which thematic discussion takes place. The results indicate the strength of children's interest in the topic of death, which is accompanied by the tendency of the majority of mothers to convey such information to the child. Conclusion: The theme of death in family discussion with preschool children has proved topical. Despite the fact that contemporary society continues to perceive death negatively, family members should be prepared to explore the topic with their children.

Aim: The goal of the pilot study was to compare the quality of life of patients with multiple sclerosis in the Presov region with or without the support of a self-help group. Design: The character of this pilot study on patients with MS was related to the use of self-help groups and their impact on the assessment of the quality of life of the respondents, with the help of a questionnaire (WHOQOL-BREF). Methods: The research was carried out in the Prešov region with the help of the standardized WHOQOL-BREF questionnaire. Ninety-one patients with MS participated in the pilot study (46 respondents attended a self-help group and 35 did not). Results: The groups, when compared, aided by the statistically evaluated WHOQOL-BREF domains, were found to show significant differences in their evaluation of quality of life in three domains: domain one: physical health; domain two: surviving; domain three: social relations. Better scores were achieved in these domains by those who attended a group. In the physical sphere, we noticed significant differences in sleep quality, and sexual satisfaction (p < 0.001), while in social and economic areas, there were significant differences in satisfaction with personal relationships (p < 0.001), and economic circumstances (p < 0.01), self-contentment (p < 0.01), and coping with negative feelings (p < 0.05). Conclusion: Patients with multiple sclerosis can live normal lives provided they are supported by their families, friends, health care professionals, and self-help groups.

Aim: The aim of the study was to explore the experience of staff nurses from selected hospitals in all regions of Slovakia of inpatient aggression in their past year of practice. Design: A quantitative cross-sectional study. Methods: The sample consisted of 1,042 nurses with a mean number of years of work experience of 19.23 (SD 10.96) from medical, surgical, and psychiatric wards, and emergency and intensive care units. Data collection was conducted by the self-reference instrument, the Violence and Aggression of Patients Scale (VAPS). Results: Over the past year, 97.4% of nurses have been confronted with patient aggression. 96.8% of nurses have experienced verbal aggression and 83.3% physical aggression. Nurses working in psychiatric and intensive care wards have experienced the most frequent episodes of patient aggression. A statistically significant difference was confirmed in the prevalence of patient aggression towards nurses based on their pattern of shift work. Nurses working in multiple-shift operation reported a higher frequency of patient aggression compared with those working single-shifts. The relationship between age, years of work experience, and level of education, and experience of patient aggression was not proved to be significant. Conclusion: The study highlights nurses' experience of different forms of patient aggression and provides confirmation of the current relevance of this issue. The results may become the basis for a systematic evaluation of the causative factors and the management of aggression. The implementation of preventive strategies in clinical practice is crucial.

Aim: The objective of the study was to investigate the effect of psychosocial training, with a focus on increasing social and coping skills, on the levels of burnout and engagement in students in various healthcare professions. Design: A quasi-experimental design was used in the present study. Methods: 97 students (20.2 ± 1.49; 95.9% female) of psychology, nursing and midwifery participated in the research (50 students in an experimental group receiving psychosocial training, and 47 students in a control group). To measure burnout, the School Burnout Inventory (SBI), Antonovski Sense of Coherence Scale (SOC), Utrecht Work Engagement Scale (UWES) and Baruth Protective Factors Inventory (BPFI) were employed. Data were statistically analyzed using correlation analysis, Student's t-test, and the ANOVA with LSD post hoc tests. Results: A statistically significant decrease in burnout syndrome (95 % CI: 5.26; 11.94), and an increased sense of coherence (95 % CI: -11.48; -3.37) and resilience (95 % CI: -7.92; -1.70) were found in the experimental group of students after psychosocial training, while no significant changes were observed in the control group. Research assumptions regarding engagement were not confirmed. Conclusion: The research study has shown that psychosocial training as a method has a positive effect on burnout syndrome and related personality characteristics among students of the healthcare professions, and is thus a relevant and appropriate method of burnout prevention.

Aim: The aim of this study was to find out the prevalence and risk factors of white coat hypertension (WCH) in children. Methods: We realized the retrospective study and analyzed records of 140 children (36 girls, 104 boys) with high blood pressure measured in cardiology outpatients' clinic, to whom a 24-hour ambulatory blood pressure monitoring (ABPM) was made and the type of hypertension was specified. Hypertension was diagnosed when systolic and/or diastolic blood pressure measurements with auscultatory technique were ≥ 95th percentile for sex, age and height. White coat hypertension (WCH) has been defined as mean blood pressure (BP) readings in outpatients' clinic being located in the hypertensive range while 24-hour ambulatory blood pressure monitoring is in the normal range. Results: In the group of 140 children the presence of WCH was confirmed in 51 children (36,4 %) - 13 girls and 38 boys. WCH occurred in 36,1 % of girls and 36,5 % of boys in the total sample of respondents. Systolic BP in cardiology outpatients' clinic reached the value above the 95th percentile, diastolic BP below the 90th percentile. The most patients with WCH were 15 - 19 years old (80,4 %) and in 3rd - 90th percentile of BMI (72,5 %). Patients prevailed negative family history of hypertension (54,9 %) and fewer visit (2-4 times) of cardiology outpatients' clinic. Blood pressure of children was measured exclusively by a nurse in this outpatients' clinic. Conclusion: Determination of the prevalence of WCH and its risk factors in children is important because of prevailing opinion that WCH in children is predisposition in permanent hypertension. Based on the detection of risk factors, we can implement prevention of WCH.

Celiac disease is an autoimmune disease with highly polymorphic image of clinical course, which still belongs among neglected diagnosis, on which, often during the atypical course of the disease is not thought of. By estimate of 40-50 thousand of the Czech population suffer from the disease, but only 10% of them know about their illness. Aim: The aim of the study was to point out what socio-economic impact has disease with celiac on the patient and to find out what is the compliance of patients with celiac disease. Methods: A quantitative survey was used. Data were collected using questionnaire with 22 questions from 139 respondents in October 2008. Results: Celiac affects patients the most in leisure activities (24,1%) in the economic field (23,7%) and in personal life (21,5%) in the social field (15,2%) and business sector (13, 9%). Most of the respondents has no possibility of gluten free diet in the workplace, deliberate violation of occasional dieting was reported by 9 persons. More then half of interviewees considered the information from health care employees immediately after diagnosis as insufficient. Conclusion: Celiac disease is a serious socio-economic problem due to the high cost of gluten free foods and their low availability, particularly away from home. It is advisable to create high quality educational materials, both for the sick and the ones who are caring for individuals or groups (family, patient, team of cooks for school and work sites, etc.) that could make life easier for patients with celiac disease.