Aim: The aim of the paper was to describe chosen aspects of quality of life in patients with venous leg ulcers treated at home in the Turiec region, and to find differences in assessing quality of life in relation to degree of adherence to external compression therapy. Design: A quantitative cross-sectional study. Methods: There were 61 patients with venous leg ulcers at 68.59 ± 9.49 years of age, with an average length of wound treatment of 6.34 ± 5.51 years. The adapted self-assessment questionnaire, the Freiburg Life Quality Assessment wound module (FLQA-w), was used to gain empirical data. Results: The findings revealed that the worst score was achieved in the category of everyday life (3.61 ± 0.93). Statistically significant differences were found between the group of respondents who apply bandages on a daily basis and those who did not use them at all. Regular bandage application is closely connected with positive assessment of wound therapy (p = 0.043), psychosocial life (p = 0.023), verbalisation of well-being in various categories (p = 0.001), assessment of state of the wound (p = 0.032), assessment of health condition (p = 0.019), and overall quality of life (p = 0.014). Length of wound treatment is related to assessments of quality of life. Conclusion: Non-healing wounds, the associated therapy and financial means required to treat them, and the pain resulting from them, are connected with physical difficulty, experience of negative emotions, and, thus, the worsening of patientsʼ quality of life. The results of the study could form the basis for further studies on similar issues.

Background: Dignity is a fundamental concept in healthcare. The symptoms of multiple sclerosis have a negative effect on dignity. Understanding of lived experience of dignity in people with multiple sclerosis is crucial to support dignity in practice. Research aim: The aim was to explore the sense of dignity experienced by people with multiple sclerosis. Research design and participants: An interpretative phenomenological analysis design was adopted, using data collected through face-to-face interviews with 14 participants. Ethical considerations: The study was approved by the faculty Ethical Committee (No. EC 1828/2016). Findings: Four interconnected superordinate themes emerged from analysis: Loss of a fully-fledged life: Violating the dignity-of-self; To accept and fight: Promoting the dignity-of-self; Contempt and rudeness: Indignity-in-relation; and Those who know and see, help: Promoting dignity-in-relation. The loss of former fully-fledged life has a dramatic impact on integrity and impaired dignity-of-self. Accepting illness and changed identity impaired by multiple sclerosis was the step that the participants considered to be important for reacquiring the sense of dignity. The participants encountered misunderstandings, prejudices, embarrassment, insensitive remarks, labelling, unwillingness and impersonal treatment as indignities. Acceptance of their condition, needed support, the feeling of being part of a group, sensitivity and the sharing of problems had a positive effect on their dignity. Discussion: Continual changes in functional ability threaten an individual’s identity and were experienced as violations of dignity. Based on this, participant’s dignity-of-self was not a moral, but much more existential value. Acceptance of changed identity and fighting spirit were important for restoring their dignity-of-self. The misunderstandings, prejudices and unwillingness had a negative impact on their dignity-in-relation. On the other side, support from others in fighting promoted their dignity-in-relation. Conclusion: Dignity is manifested as a complex phenomenon of lived experience of people with multiple sclerosis and also an umbrella concept for providing good quality of person-centred care.

Aim: The goal of this study was to analyse relevant research studies focusing on the testing of the predictive value of the Morse Fall Scale measuring device on hospitalized patients. Design: Literature review. Method: Search for full text research studies in Web of Science, Scopus, ScienceDirect, and Summon Discovery Tool (licensed electronic information databases), based on pre-established criteria, and key words, from 1989 to 2016. Results: Sensitivity values ranged from 31% to 98%, and specificity values ranged from 8% to 97% in 14 analysed studies. The predictive value of the tool in validation studies varies depending on the tested cutoff value, the type of clinical ward, the frequency of assessment, the size and age of the sample, and the length of hospitalisation; therefore, the validity of the results from one study cannot by extrapolated to the entire hospitalized population of patients. Conclusion: The predictive values of the Morse Fall Scale are not stable; they vary in clinical conditions according to various factors. When implementing a tool for a specific clinical ward, an optimum cutoff score must be established to ensure that preventative strategies do not require unnecessary effort on the part of the staff, and do not increase hospital costs.

A B S T R A C TPurpose: The aim of the study was to perform a fall risk screening and to identify the risk factors for falling in hospitalized patients with neurological disease aged up to and over 65 years. Design: A quantitative prospective cross-sectional study. Methods: The sample consisted of 103 patients who were hospitalized in the neurological unit. Empirical data was recorded in the research protocol, which included selected fall risk factors and the Morse Fall Scale (MFS). Results: Significant fall predictors in patients older than 65 years were: secondary diagnosis (p = 0.000), poly-pharmacotherapy (p = 0.000), number of medications taken over 24 hours (p = 0.000), a vision disorder (p = 0.005), continence disorder (p = 0.008), female sex (p = 0.005), the use of an ambulatory aid (p = 0.008), sleep disorders (p = 0.025), and hearing disorders (p = 0.033). The mean MFS total fall risk was 45.7 ± 20.2. In the sample of patients at high risk of falling, there were significant predictors of the falls: disorders of gait and balance (p = 0.000), the use of an ambulatory aid (p = 0.000), a history of falling (p = 0.001), age (p = 0.004), poly-pharmacotherapy = 0.008), continence disorder (p = 0.019), and vision disorder (p = 0.027). Conclusion: The identification of fall risk factors is the basis for the implementation of targeted nursing interventions to prevent and reduce falls. S Ú h R N Cieľ: Realizovať skríning rizika pádu a identifikovať rizikové faktory pádu u hospitalizovaných pacientov s neurologickým ochorením vo veku do a nad 65 rokov. Dizajn: Kvantitatívna prospektívna prierezová štúdia. Metodika: Súbor tvorilo 103 pacientov hospitalizovaných na neurologickom oddelení. Empirické údaje boli zaznamenávané do výskumného protokolu, ktorý obsahoval vybrané rizikové faktory pádu a nástroj Morse Fall Scale (MFS). Výsledky: Signifikantné prediktory pádu u pacientov starších ako 65 rokov boli pridružená diagnóza (p = 0,000), polyfarmakoterapia (p = 0,000), počet užívaných liekov * Korespondenční autor: Mgr. Michaela Miertová, PhD., Jesseniova lekárska fakulta UK, Ústav ošetrovateľstva, Malá hora 5, (Print) • ISSN 1804-7122 (Online) Kľúčové slová: Neurológia hospitalizovaní pacienti Pády Riziko Skríning Morse Fall Scale O š e t ř O v a t e l s t v í Článek citujte takto: Miertová M, Bóriková I, Tomagová M, Žiaková K. Risk factors of falling in patients with neurological diseases. Kontakt 2018; 20(3): e217-e222; http://dx.

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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: To determine the correlation between pharmacotherapy and high risk of fall based on the Morse Fall Scale (MFS score ≥ 45) in acute and long-term care settings. Design: A quantitative cross-sectional descriptive correlation study. Methods: The study was conducted at a University Hospital in Martin (UHM) and a selected long-term care facility (LTC) in Martin (Slovakia) June-October 2016. The pharmacotherapeutic data were obtained from the health documentation of the respondents. The fall risk was assessed by using the MFS screening tool within 24-48 hours of admission to the facility. Results: For the group of UHM patients (n = 63), the mean MFS score for fall risk was high (60.6 ± 22.4), and the correlation (p = 0.030) between the number of medications administered in 24 hours and high risk of fall was significant. For the group of LTC patients (n = 89), the mean MFS score for fall risk was moderate (35.4 ± 15.9). The correlations were not significant. Conclusion:Pharmacotherapy is an important fall risk factor; therefore, it is necessary to determine it within the assessment of overall fall risk. The risk management of pharmacotherapy is an effective and important multifactorial intervention in programmes of fall prevention in acute and long-term care.