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Quality of life after laryngectomy
Gliedné Tillmann, E.

It is very difficult for patients after larnygectomy to cope with the loss of the larynx. This procedure results in the loss of functions such as verbal communication, the passage of air is changed and disturbances in body image arise that increase the feeling of loss. Changes might affect sexual relationships due to the changed body image, which might give rise to decreased self-esteem. This paper discusses these issues through the presentation of a case.

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Attitudes of nurses and allied health personnel and access to healthcare
Zrínyi, M., Balogh, Z.

Objectives: Development of an instrumentation that specifically measures the attitude of nurses and health professionals toward homeless people regarding access to care.

Methods: The sample included 181 nurse students and 39 ambulance officer students of a major health faculty from Budapest, Hungary. Respondents replied to a 58-item, Likert-type self-report scale.

Results: Responses in general showed neutral or slightly positively skewed attitudes. Ambulance officers and men had less favorable attitudes toward the homeless. Most respondents identified homelessness a social problem as opposed to a healthcare issue. Several subjects would deny providing healthcare for the homeless and wouldn't be a homeless person's health advocate in the health system. Although the instrument showed acceptable reliability, validity couldn't be confirmed.

Conclusions: Several ethical problems have been revealed which deserve further attention. To establish reliability of the measure, extended research is proposed.

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Human resources in nursing
Gyurisné Pethõ, Zs.

In Hungary, balanced human resources planning has become almost impossible in one of the key areas of health care, i.e. nursing, due to shortages of nursing and allied health personnel. Amounting to about 30%, nursing shortage is made even more severe by the fact that nurses are not likely to enter the system in substantial numbers due to inappropriate motivation, while external motivating factors continue to woresen the situation. This paper aims to call the attention of health policy-makers to the critical situation in terms of nursing shortage. It is stressed that this situation needs to be addressed urgently, as a long-term solution is not only an economic issue.

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The contribution of hospitals to improving population health
Watson, J.

Health services and hospitals across Europe need to change if they are to mmet the challenges of EU Accession, cost containment and the health policy agenda set out in Health21: The health for all policy of the member countries of the WHO European Region. This paper, which is an edited version of a presentation made at the Health Promoting Hospitals Conference, Budapest/Hungary, 17 October 2001, seeks to answers three questions: 1) What is the relationship between hospitals and population health; 2) What are the main challenges faced by hospitals in the context of EU accession; 3) How can hospitals contribute to action on the wider determinants of health.

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