End of life.

Dying, but not the death, is an essential problem. The more we believe that death ends everything, the more we fear from death. A human spirit only hardly copes with this fact. All religions want to cut this fear. They highlight that present life continues and human spirit lives further on, in another postmortem dimension. Authors evaluated death of 142 patients, among which 45 (32%) died at home, 74 (52%) in hospital, 34 (24%) died among family relatives and 56 (39%) without the presence of relatives. Most of the dying patients wish to stay with their family or relatives at the end of life (end of life decision). If this wish cannot be fulfilled, then a palliative care seems to be the most suitable alternative for an individual in terminal stage in modern society. In the Presov region, there is a lack of hospices and palliative care does not cover the needs of terminally ill patients (Tab. 6, Ref: 41).

Some indicators of quality of life in senior age in two regions international comparative study--the Czech Republic and the Slovak Republic.

Some characteristics of quality and way of life were examined in the group of persons aged over 60 years. One group was in the West region of the Czech Republic--1028 people living in the city of Plzen. The other group was in the East region of Slovakia--125 senior citizens from the town of Presov. The investigations were carried out in general practitioners' offices in 2005/2006. The groups consisted of patients visiting GPs. The reason of their visits was usually a general check of their health state and prescription of medications. An anonymous questionnaire was used. Students of medicine asked the respondents. They tried to find out some characteristics of seniors* life style and other aspects of seniors' life determining the quality of life. Diet, free time activities, physical activity, way of life, including smoking and alcohol consumption were investigated. Some questions were aimed on the respondents opinion about their way of life, their worries and wishes (Tab. 11, Ref. 10). Full Text (Free, PDF) www.bmj.sk.

[Geriatric view on the health and disease in old age--changes in the paradigm?]. / Geriatrický pohled na zdraví a nemocnost ve stárí--zmena paradigmatu?

Article is aimed at the health status of seniors, their prognosis and namely at the conception of health and disease in old age. It calls attention to the paradigm changes that should overcome the predominating concentration on the disease and stress the functional status and the quality of life of the patient. Concepts of geriatric fragility, geriatric deterioration and geriatric syndromes are delimitated. Health potential based on the stamina, vitality and creative adaptability is accepted and its relation to Antonovian concept is given. Conclusion is given to the outlines of necessary systemic changes in the health care of seniors in order to adjust it better to their actual requirements.

[Characteristics of the quality of life of medical students]. / Vybrané charakteristiky kvality zivota studentu medicíny.

Lifestyle is one of the most important determinants of health. The authors are interested in the characteristics of medical students' life and they used the anonymous questionnaire study. The sample was 152 persons and this study is continuing. The article presents some information about nutrition, negative events (smoking, alcohol, and drugs), sports activities and sleep. The investigated data are indicators of using knowledge by medical students in their extra-school activities (healthy lifestyle). From the current data there is the fact that nutrition habits and day regime are not so ideal. The fact about consumption of drugs, alcohol, smoking habit and sleeping time is nearly satisfied.

[Problem situations between health personnel and patients (results of an analysis of patient complaints)]. / Problémové situace mezi zdravotníky a pacienty (výsledky jednoho rozboru stízností pacientu).

Many problem situations arising between patients and medical officers have their source in the psyche of the persons involved. The aim of this study is to analyse psychological factors which may cone in these situations, and an attempt to describe, interpret and categorize them. We took as our starting point an analysis of protests submitted by patients (or their relatives) which were discussed by the management of the Faculty Hospital in Pilsen during the period of one year. We dealt with finished cases where the issue of the protest was of a psychological nature. Problem situations often arise under the influence of the following factors: personality features, the handling of information, maladaptation to a disease or situational factors. Majority of problem situations can be understood, prevented, and--if they arise--can be effectively handled. Pre-graduation and continuous education in this areas should provide a significant aid.

[General physicians at the beginning of health services transformation]. / Praktictí lékari na pocátku transformace zdravotnictví.

The authors assessed in 68 general practitioners by means of questionnaires selected data on the position in medical practice, satisfaction with it, on the extent, forms and opportunities of further training. All respondents systematically extended their education and training, 97% were keen to master and use new procedures. 37% were satisfied with their practice. They worked on average 50 hours per week and examined on average 236 patients per week in their surgery. On average they referred 11% of their patients to a specialist. Health authorities should participate more in the solution of some problems of general practitioners.

[Characteristics of the health status of people 60 years of age and older living in a large town]. / Nekteré charakteristiky zdravotní situace sedesátiletých a starsích osob zijících ve velkém meste.

In a group of 795 subjects aged above 60 years the author assessed from the medical documentation the state of sense organs, the degree of affected locomotor capacity, helplessness and lack of self-sufficiency and some other characteristics of the health status. Disorders of the sense organs (eyesight and hearing) were significantly more frequent in subjects of advanced age than in early old age. There were no sexual differences in their incidence. The poorer health status of women is consistent with more frequently impaired locomotor activity, helplessness and lack of self-sufficiency, as compared with men. These old people (in particular women of advanced age) require assistance of another person and more frequent visits of health workers in their homes. With advancing age the number of persons using some health appliance increases. More than half the women of advanced age were thus affected. The main task as regards the care of old people is to prevent dependence, lack of self-sufficiency and a permanent stay in an institution. Therapeutic and preventive care provided to old people by the health community doctors should pursue this aim.

[Comparison of the utilization of therapeutic and preventive care in men and women over 60 years of age living in a large city]. / Srovnání spotreby lécebne preventivní péce u muzu a zen nad 60 let zijících ve velkém meste.

The authors investigated the consumption of health care in 1428 subjects above 60 years old. Selected indicators were evaluated in relation to sex. Women visited doctors more frequently in the surgery, and made more frequently use of the demiciliary service. The majority of evaluated indicators of health care consumption was higher in women than in men. Examinations at specialized policlinical departments and hospital admissions were more frequent in men. This is associated with the severity of complaints from which the old people suffer. In this context preventive measures are very important as well as improvement of the health consciousness of old people.