Bulikaitė, Virginija

Introduction: Eating disorders (ED) and disordered eating behaviors are common in youth with type 1 diabetes (T1D) and may impact metabolic control and quality of life. Objectives: To evaluate differences in ED symptoms based on subjective health perception in adolescents and young adults with T1D. Methods: A cross-sectional study included 57 individuals aged 14–25 years with T1D. Participants were divided into two groups based on self-rated health (good vs poor). ED symptoms were assessed using the Eating Disorder Examination Questionnaire (EDE-Q 6.0), which evaluates behavioral frequency and attitudinal subscales over the past 28 days, a higher score reflects either greater severity or frequency. Group comparisons were performed using appropriate statistical tests. Results: Participants with poor self-rated health had significantly higher ED psychopathology. Eating concern (0.5±0.72 vs.1±2.1, p<0.001), shape concern (1.1±1.2 vs 2.8±1.5, p<0.001), weight concern (1.1±1.2 vs 2.6±1.7, p<0.001), and total EDE-Q score (1.1±1.1 vs 2.4±1.5, p<0.001) were all significantly higher. They also reported more binge eating episodes (3.9±6.6 vs 6.5±6.4, p=0.013), episodes with loss of eating control (1.1±3.5 vs 6.3±8.7, p<0.001), and more binge eating days (0.7±0.9 vs 5.4±7.0, p<0.001). Importantly, no significant differences were observed between groups in objective disease-related parameters, including diabetes duration, age at diagnosis, BMI, HbA1c, and time in range. Conclusions: Poor subjective health perception in youth with T1D is strongly associated with increased ED symptomatology, independent of metabolic parameters. Screening for ED should include patient-reported health perception as a potential risk indicator.

Introduction: Disordered eating behaviors in T1D may influence metabolic outcomes, yet their relationships with clinical parameters remain insufficiently characterized. Objectives: To analyze correlations between eating disorders (ED) symptoms and metabolic as well as clinical parameters in youth with T1D. Methods: A cross-sectional analysis of 57 individuals aged 14–25 years with T1D was performed. ED symptoms were assessed using the EDE-Q 6.0 questionnaire. Correlations between EDE-Q scores and BMI, HbA1c, time in range, insulin dose, disease duration, and age at diagnosis were analyzed using correlation coefficients. Results: Higher BMI was significantly associated with increased ED psychopathology, including restraint (r=0.382, p=0.004), eating concern (r=0.314, p=0.018), shape concern (r=0.354, p=0.007), weight concern (r=0.364, p=0.006), total score (r=0.383, p=0.004), binge eating with loss of control (r=0.326, p=0.017), and binge eating days (r=0.389, p=0.004). Compulsive exercise also correlated with BMI (r=0.351, p=0.009). Higher HbA1c was negatively associated with compulsive exercise (r=- 0.363, p=0.032). Time in range was negatively correlated with shape concern (r=-0.350, p=0.029), weight concern (r=-0.327, p=0.042), and binge eating frequency (r=-0.372, p=0.021). Conclusions: ED symptoms in youth with T1D are significantly associated with BMI and glycemic metrics. Higher ED severity correlates with higher BMI and poorer glycemic profiles, highlighting the importance of integrated metabolic and psychological assessment.

Introduction

Adolescents and young adults with type 1 diabetes mellitus (T1DM) are at an increased risk of developing eating disorders (ED) compared to their healthy peers. ED in T1DM patients ranges from 7.0% to 39.3% and is associated with poor glycemic control and impaired psychosocial well-being.

Objectives

To assess the relationship between eating disorder severity and perceived stress in adolescents and young adults with T1DM attending a specialised transition-age diabetes camp.

Methods

Levels of perceived stress and ED were assessed in 29 adolescents and young adults with T1DM (age: 17.1 ± 2.0 years; T1DM duration: 8.9 ± 4.5 years; age at diagnosis: 8.1 ± 4.1 years; HbA1c: 7.5 ± 1.4%; BMI: 23.7 ± 3.9 kg/m2) attending the diabetes camp for transition-age patients. The Perceived Stress Scale (PSS) was used to measure stress levels (higher scores indicate greater perceived stress), and the Eating Disorder Examination Questionnaire (EDE-Q) was used to assess ED severity (higher scores indicate more severe ED symptoms).

Results

Participants were divided into two groups based on PSS scores: low perceived stress (<20, n = 14) and high perceived stress (≥20, n = 15). Those with high perceived stress had significantly higher EDE-Q scores in restraint (P = .004), eating concern (P < .001), shape concern (P < .001), weight concern (P = .002), and global score (P < .001). Additionally, they reported more binge eating episodes with loss of control per month (P = .016). BMI was correlated with EDE-Q restraint (r = 0.377, P = .048), eating concern (r = 0.581, P = .001), global score (r = 0.447, P = .017), and number of compulsive exercise episodes per month (r = 0.389, P = .041). PSS scores were correlated with EDE-Q restraint (r = 0.470, P = .012), eating concern (r = 0.628, P < .001), shape concern (r = 0.628, P < .001), weight concern (r = 0.567, P = .002), and global score (r = 0.652, P < .001).

Conclusions

Adolescents and young adults with T1DM and high perceived stress exhibit higher levels of eating disorder symptoms compared to those with low perceived stress.

Diabetic foot ulcers affect approximately one-third of people with diabetes during their lifetime and are a major cause of disability, amputation, and premature death. Preventing foot ulcers requires effective patient education. International guidelines have highlighted the central role of nurses in teaching routine foot care practices. However, nurse-led education varies considerably across healthcare systems, and it remains unclear which educational elements are consistently neglected internationally. This study aimed to identify common challenges in nurses’ self-reported implementation of foot care education for persons with diabetes across six countries.

Slauga yra sudėtinė sveikatos priežiūros dalis, apimanti sveikatos ugdymą, stiprinimą ir išsaugojimą, ligų ir rizikos veiksnių profilaktiką, sveikų ir sergančių asmenų fizinę, psichikos, socialinę ir dvasinę priežiūrą. Tačiau slaugytojai turi turėti daug slaugos ir sveikatos priežiūros žinių ir mokėti atlikti įvairias procedūras, išmanyti technologijas, taikyti kritinį mąstymą ir vadovautis naujausiais mokslo įrodymais. Mokslu grįsta praktika - tai klinikinis sprendimų priėmimo metodas, kuriame atsižvelgiama į daugelį mokslinių šaltinių, įskaitant empirinius įrodymus ir analizę, paciento pageidavimus ir pasirinkimus, turimus išteklius, gydymo aplinkybes, kvalifikuoto slaugytojo klinikinę kompetenciją. Įrodymų naudojimas slaugos praktikoje yra ne tik būdas užtikrinti slaugos profesionalumą, bet ir būtinas visuomenės sveikatos gerinimo komponentas. Slaugos mokslo ir praktikos vystymasis, mokslu grįstos slaugos praktikos taikymas paskatino atnaujinti klinikinių įgūdžių vadovėlį. Vadovėlyje aptariamas slaugytojų ir pacientų bendravimas slaugos procese, pateikiami slaugos ir paciento priežiūros procedūrų atlikimo reikalavimai, tokie kaip rankų higiena, paciento higiena, asmens apsaugos priemonių naudojimas, slaugant pacientus, kuriems taikoma izoliacija, paciento antropometrijos vertinimas, pagrindinių gyvybinių funkcijų vertinimas, paciento padėties keitimas, naujagimio priežiūra, aplikacijų naudojimas, vaistų vartojimas, injekcijos, infuzijos, tyrimų paėmimas, paciento kvėpavimo funkcijos, maitinimo, šalinimo funkcijos užtikrinimas bei mirusiojo sutvarkymas ir dokumentų parengimas. Knyga skirta slaugos programos studentams, taip pat studijuojantiems ir kitose sveikatos priežiūros studijų programose, tokiose kaip akušerija, ergoterapija, kineziterapija, burnos higiena, medicina. Tikimės, kad knyga bus naudinga ir dirbantiems klinikinėje praktikoje. Dėkojame visiems, kurie įžvelgė reikalingumą ir būtinybę slaugos klinikinių įgūdžių atnaujinimui ir rado laiko bendradarbiauti rengiant vadovėlį.

Metodika. Atliktas kiekybinis tyrimas, atliekant vienmomentinę, anoniminę, tikslinę apklausą. Tyrimas vykdytas Lietuvos sveikatos mokslų universiteto Kauno ligoninės terapinio ir chirurginio profilio skyriuose. Tyrimui naudotas tyrėjų sudarytas klausimynas. Apklausos duomenys analizuoti statistine programa SPSS 24. Skirtumas statistiškai reikšmingas, kai p<0,05. Rezultatai. Tyrime dalyvavo 70 bendrosios praktikos slaugytojų, dirbančių terapinio ir chirurginio profilio skyriuose. Chirurginio profilio slaugytojai reikšmingai daugiau kartų pamainos metu plovė rankas (22,91±11,4), lyginant su terapinio profilio slaugytojais (17,12±9,8) (p<0,05). Chirurginio profilio slaugytojai rankų odos pažeidimus pastebėjo reikšmingai dažniau (82,2 proc.) nei terapinio profilio skyriuose dirbantys slaugytojai (48,0 proc.) (p<0,05). Daugiau nei pusei chirurginio profilio skyriuose dirbančių slaugytojų rankų odą dirgino antiseptikas (51,1 proc.) ir reikšmingai dažniau, lyginant su terapinio profilio slaugytojais, rankų plovimas muilu (44,4 proc.) bei medicininių pirštinių mūvėjimas (26,7 proc.). Terapinio ir chirurginio skyrių slaugytojai, kurie pastebėjo savo rankų odos pažeidimus, statistiškai reikšmingai daugiau kartų pamainos metu plovė rankas (23,65±13,9), jas dezinfekavo (23,71±9,1) bei keitė vienkartines pirštines (23,20±9,5), lyginant su odos pažeidimų nepastebėjusiais slaugytojais (p<0,05). Išvados. Chirurginio ir terapinio profilio slaugytojai, kurie gydymo įstaigoje reikšmingai daugiau kartų pamainos metu plovė, dezinfekavo rankas bei keitė vienkartines medicinines pirštines, pastebėjo reikšmingai daugiau rankų odos pažeidimų, lyginant su slaugytojais, nepastebėjusiais odos pažeidimų.

TEMOS AKTUALUMAS 1 tipo cukrinis diabetas (1TCD) yra lėtinė liga, reikalaujanti nuolatinės glikemijos kontrolės ir intensyvios savikontrolės, kuri ypač paauglystėje ir jauname amžiuje gali būti susijusi su reikšmingais psichologiniais iššūkiais. Pastaraisiais metais vis dažniau atkreipiamas dėmesys į valgymo sutrikimų, ypač diabulimijos, paplitimą šioje pacientų grupėje. DARBO TIKSLAS (-AI) Įvertinti skirtingų lyčių ir skirtingo kūno masės indekso pacientų, sergančių 1TCD, su 1TCD susijusią gyvenimo kokybę ir valgymo sutrikimų požymių lygį. [...].

Objectives To assess the knowledge of nurses and adolescents with diabetes about the use of insulin pumps. Materials and Methods 40 nurses and 80 diabetic adolescents aged 14-19 years completed anonymous questionnaires. Statistical analysis of the data was performed using descriptive statistics, frequencies analysis, non-parametric tests (MannWhitney U test) for two samples, t-test for two independent samples, and Chi-square (χ²) value. Results Nurses and adolescents with diabetes answered questions about the technical characteristics of the insulin pumps used in Lithuania, insulin dosing, the choice of insulin injection site, and the advantages and disadvantages of insulin pumps. The knowledge of nurses and adolescents with diabetes about the use of insulin pumps was quite similar, but nurses were much more likely to want to update their knowledge than adolescents (p<0.05). Nurses wanted to update their knowledge every 6 months, whereas adolescents wanted to update their knowledge every 12 months or less. 75% of nurses and 77.5% of adolescents knew that the catheter should be changed every 3 days and the insulin reservoir should be changed at least once a week. Nurses and adolescents with diabetes reported the same disadvantages of the insulin pump. Problems with catheters and the resulting increase in glycaemia were the most frequently mentioned. Some adolescents refuse to use an insulin pump because it can be seen by other people. Although nurses and adolescents differed in their assessment of the advantages of the insulin pump, most mentioned the reduced risk of hypoglycaemia. Conclusions Most nurses and adolescents with diabetes thought that the insulin pump helps to manage diabetes better, but most adolescents did not feel that using the device encourages more interest in the disease and health care.

Objectives To reveal patients’ experiences after lower limb amputation focusing on their psychological, physical, and social challenges and adaptations. Materials and Methods A qualitative research methodology was utilized. Data were collected through semi-structured interviews conducted with 15 patients aged 45-75 years undergoing rehabilitation at the Physical Medicine and Rehabilitation Department. Participants had undergone their first prosthetic fitting following a unilateral lower limb amputation. Results Before the amputation, patients were insufficiently informed about their chronic diseases and complications, despite undergoing vascular surgeries and suffering from circulatory disorders, non-healing wounds, gangrene, and severe pain. Emotional states prior to the procedure ranged from joy and relief to anxiety, anger, and unwillingness to live. Post-amputation, patients faced significant challenges, including phantom and postoperative pain, complex wound healing, restricted mobility, and physical dependence. They sought to regain lost independence but faced difficulties using prosthetics, wheelchairs, and performing daily activities like cooking and dressing. Environmental barriers such as inaccessible inpatient facilities, high thresholds, stairs, and small public spaces further hindered recovery. Socially, patients experienced stigmatization, a reduced circle of friends, and societal exclusion. However, emotional, and physical support from family and friends was critical. A lack of respectful communication and empathy from medical staff was noted, particularly in hospitals and rehabilitation settings. Conclusions Lower limb amputation profoundly impacts patients’ lives. Effective rehabilitation strategies must address not only physical recovery but also psychological and social reintegration. Increased emphasis on emotional support and adaptive infrastructure is vital to improving patients’ quality of life

Klinikinė praktika yra viena iš sudedamųjų slaugos rengimo dalių. Klinikinės praktikos tikslas – suteikiant teorinių ir praktinių žinių tobulinti slaugos profesinius įgūdžius. Praktikos metu siekiama ugdyti studentų kritinį mąstymą, gebėjimą bendrauti su pacientais, dirbti savarankiškai bei komandoje, gebėjimą tirti pacientą ir savarankiškai sudaryti slaugos ir priežiūros planą. Šis praktikos dienynas skirtas Slaugos studijų programos I kurso studentams klinikinėms praktikoms dokumentuoti. Jis pildomas kiekvieną dieną praktikos vietoje. Praktikos dienyne pateikiami klinikinės praktikos įgūdžių ir užduočių kriterijai. Studijų plane pirmaisiais studijų metais numatytos dvi studentų praktikos: • įvadinė praktika, kurios metu studentai susipažįsta su sveikatos priežiūros įstaiga, jos struktūra, veiklos principais, bendravimo ypatumais su sveikais ir sergančiais pacientais bei sveikatos priežiūros komandos nariais. • Praktika I skirta studentų klinikiniams įgūdžiams įtvirtinti ir gebėti dirbti asmens sveikatos priežiūros specialistų komandoje.