Our present issue provides with varied reading for all those who are interested and honor us with their attention. However, within the thematic wealth there are two articles to deal with a significant problem, namely, that what physical and psychic burden is laid on altruist family members by home care of incurable patients; so this topic has a somewhat prominent role.
In our poem column this time a two-volume poetess (Time ghetto, 2002; Drown into pen, 2004), Eszter Lárai (1963) is introduced who presents her lyric part-cycle
my mother’s silence of the poem-cycle titled
of girlhood’s complaints.
Our first article could even be considered as a case-study, but its lyric style shows more. Rozina Palotás who currently studies catholic theology and attends at a pastoral care course serves one day weekly at the Institute of Casualty and Emergency. Barely a week after her father-in-law died at their home she recollects the way that was come by the patient and his family in these days that were hard for everyone and she puts her feelings down on paper. Feelings that are shot by the pain of bereavement and loss but also an incomparable, grief relieving happiness above all that is given only to those who are scorched by the mystic sacrament of passing from life.
Attitude of the family and the dying person is of exemplary relevance and it is especially true because we know that this way is not so easy to come for the most people. The study of the hospice head-physician, Csaba Simkó draws the attention on the difficulties that he faces day by day during his work. Home care of the severely ill often is hampered not only by lifestyle and financial problems but badly processed psychic traumas, insufficient - due to misunderstanding - communication between the patient and family also often leads to conflicts. The study summarizes all the information that those choosing home care should keep in mind in order to make this last period together
easier and less problematic for both themselves and the patient.
The study of the psychologist Alexandra Fleischer discusses the problems that may emerge during the period of bereavement after losing a family member. Based on the data from a GP’s office in Zugló she investigates changes in the psychic and physical condition of elderly people who have recently lost their spouse, and she draws her conclusions by involving a control group. Beside obvious increase in the number of psychic problems somatic diseases as consequences are not that significant and their increasing number might be connected with altered social relationship network of the survivors. It is also remarkable that among elderly men suicidal thoughts emerge much more intensively than in case of their female peers with similar history.
In his latest emergency medicine historic article Gábor Debrődi drafts the development of Hungarian organized rescue care and reviews all the regulations and instructions that specify the method of patient transport. He specially emphasizes the issue of transport of the dead since it was far from being performed in accordance with uniform principles in the era of various local ambulance societies. In the capital ambulance didn’t provide this service while it was included in the duties of some provincial societies as it is testified by the attached photos.
Our present issue is closed by a linguistic article, Sándor András Kicsi gives valued supplements to the semantic examination of the words coffin and cross.
We wish all our Readers a meaty and useful reading!
(my mother’s silence)
Severely ill in the family
In his study the author reveals the difficulties of home care of the severely ill and the reasons of frequent communication problems through reviewing many cases in a manner that is understandable by laymen as well. Besides loss-phases that affect the patient and traumas caused by the change of self-image to the extent of some basic practical advices he deals with some important issues of dialogue between the patient and family and psychic problems of the caregivers. In spite of its short extension, the article is written to facilitate successful home care of incurable patients.
Investigation of psychic and somatic diseases connected to loss
According to literature data, losing a spouse entails an increase and acceleration in the surviving spouse’s somatic and psychic symptoms. The aim of my examination done in the fall of 2003 was to study through the analysis of medical data (e.g. number of visits) of a smaller, homogenous sample if losing a spouse indeed leads to an increase in the number of somatic and psychic symptoms and if it entails a higher mortality in comparison with the fitted control.
I have reviewed the medical data (consultations, prescriptions and number of specialist referrals) of 62 persons (31 mourners and 31 controls) altogether. Among mourners all studied variables were significantly (p<0.05) higher as compared with those of the control group. The results confirm study data that demonstrate negative effect of loss on psychic and physical health but it is important to emphasize that other factors that were not controlled during the study might be in the background as well.
Bereavement protocol means an attitude and manner of care that would minimize negative effects of loss. Interventions aimed to reduce psychic distress following loss might have a favorable effect on psychic and physical mortality and mortality on the long run - that is why mapping of risk factors and early intervention is very important. Unfortunately this is a neglected part of health care and health-information even today - the study draws the attention on its importance.
Early patient-transport methods in emergency medicine history
The study introduces the development of organized rescue in Hungary in the last tierce of the 19th century and its Austrian premises, specially emphasizing the history of patient transport. It gives an insight to the patient transport practice of Vienna policemen-ambulance men, then in that of the Viennese Volunteer Ambulance Society formed in 1881 which was followed by Budapest Volunteer Ambulance Society, founded in 1887 and pays special attention to the regulations on the transport of the dead of various ambulance organizations.
Coffin and Cross