An assessment of early rehabilitation of patient following cardiac surgery
Fekete, E. et al.

For patients to regain, as early as possible, their physical activity and reintegrate into society following heart surgery, a didactically designed and individually tailored rehabilitation program is required.
Objective: to conduct a prospective study aimed at assessing patients' level of exercise performance following coronary bypass surgery in the early postoperative stage (2-14 postoperative days).
Patients and method: Two patient groups were involved: an EC-group, n=33 and an OPCAB group, n=32. To assess loadability, cardio-respiratory fitness training, walking and stair-climbing tests were used. Investigations were carry out to identify any potential difference between the level of exercise performance of the two groups and to define the pre- and perioperative parameters that might influence early mobilization. Data were analysed by SPSS statistical program package. Logistic regression was used to assess the perioperative factors that influenced accomplishment of load tests.
Findings: No difference in the level of exercise performance was seen between the two groups. From the perioperative parameters, age and perioperative myocardial infarction had an impact on loadability. The patient's age was found to be of decisive importance in all three tests (training: p=0.0259; walking-test: p=0.0046; stair-climbing test: p=0.0018), while perioperative myocardial infarction decreased exercise performance in the case of walking (p=0.0047) and stair-climbing (p=0.0161) tests.
Conclusions: Patients' performance was better by the end of the first postoperative week as compared to their results prior to surgery. The level of exercise performance was found to be influenced primarily by complications and their age rather than the type of surgery.

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Describing co-morbidity of diabetic patients in chronic hemodialysis treatment with ICED scores
Varga, A.

Objective assessment of morbidity factors influencing the main illness helps identify potential risks of mortality. This study presents morbidity findings of 10, newly admitted diabetic hemodialysis patients using the ICED (Index of Coexistent Diseases) scoring technique. Of the 10 subjects, 4 were identified as category 3 patients by the ICED scheme, an additional 3-3 subjects fell into categories 2 and 1 using the scoring system, respectively. Using patients' medical records and nurse assessments appear adequate for the identification and treatment of patients with increased risks for mortality.

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Ethical dilemmas in nursing: rehabilitation following larynx removal
Gliedné Tillmann, E.

Malignant diseases of the larynx significantly contribute to mortality and morbidity statistics. Patients surviving larynx removal require increased care and attention due to altered biological functions. The current emphasis is on satisfying physical care needs, however, social and psychological aspects of care are equally important to help patients cope with and adapt to a drastically transformed ego and lifestyle. Patients are entitled to full rehabilitation and, should they become terminally ill, have the right to die in dignity.

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Curriculum development for the bachelor's degree nursing program: an overview of past experiences
Nagy, E.

Political and economic transitions in Hungary provided an opportunity for favourable developments in society. One major problem of health care delivery was the underdeveloped status of nursing services. Progress has been achieved through reforms in nurse training and education. The Bachelor of Science in Nursing program was introduced in Hungary both as full-time and part-time programs. Curricula followed European standards and requirements. Experiences of the past period serve as a basis for overview, for further development of curricula in order to enhance the image of the nursing profession.

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