Ńďîíńîđčđŕíî
îň: Dreyfus Health Foundation
DHF, 205 East 64 Street, Suite 404
New York, NY 10021
E-mail: Postmaster@thf.org
Fax #
212-371-2776
News:
April – August 2002
Meetings
On May 17th, there
was a meeting at the Bulgarian Red Cross Headquarters in Sofia. The
Director, Assoc. Prof. Gladilov and the
Director of the International Department. Dr. Stoimenova presented the activities
of the organization.
Dr. Jan Sobotka presented the programs of
DHF in Europe and the Middle East.
Mrs. Yanka Tzvetanova presented the DHF
programs in Bulgaria coordinated by the Association for Better Health, and
collaboration with organizations in Bulgaria.
Dr. Daniel Levine, Director of Children’s
Help Net Foundation (CHNF) talked about the programs of CHNF in Romania,
Moldova and Bulgaria. CHNF has already donated computers for a children’s
computer club in a school in Pleven, and is now starting a new program –
computers for medical professionals. Possibilities were discussed for future
collaboration.
On May 19th, Dame Sheila Quinn, Shelagh Murphy, Dr. Jan
Sobotka and Mrs. Yanka Tzvetanova attended a meeting of the Pleven Regional
Branch of Association of Managers and Professionals in Nursing.
Dr. Sobotka presented the programs of DHF
in the world, and what had been accomplished by the nursing PSBH program in
Bulgaria and other countries in Eastern Europe.
Dame Sheila Quinn, DHF Consultant for
nursing programs addressed the meeting, and Shelagh Murphy, acting board member
of International Council of Nurses (ICN), presented ICN, and conditions for
national unions to join ICN.
Site Visits
On May 17th, Dr.
Daniel Levine, Dr. Jan Sobotka, Dr. Katarzyna Broczek and Mrs. Yanka Tzvetanova
visited the computer club, equipped with computers donated by Children’s Help
Net Foundation (CHNF). The computer club is a project, originally started as a
PSBHI (Pleven Initiative – 1999) project in Ivan Vazov Comprehensive School in
Pleven, to reduce stress in children who had lost a parent.
The now functioning computer club covers
60 underprivileged children (aged 7 -12), and the school provides computer
training.
On June 12th,
international facilitators - Dame Sheila Quinn (UK), Pamela Hoyt (USA,
Coordinator for Nursing Programs), Shelagh Murphy (UK), Fatmeh Atiyeh (Jordan),
Paul Florea (Romania) and local facilitators visited projects in Gabrovo
Regional Hospital.
Projects from September 2001 PSBH workshop were seen, implemented
by Kalina Parashkevova, Desislava Lazarova, Neila Maknin, Zdravka Kyuchukova,
Raina Gencheva. Most projects were concerned with patient education, and Mrs.
Raina Gencheva’s project aimed at improving the conditions in the pediatric
ward by setting up a children’s playroom. The latter is one of the most
successful projects in the hospital, especially so in attracting funds and
collaboration with hospital staff and NGOs.
Follow-up Workshop
PSBH Follow-up Workshop (May 18, 2000)
The workshop in Pleven was attended by
participants from 2001 August 30-September 1st PSBH workshop, and 22
participants attended. Five participants could not attend and sent their
project status reports to the Association for Better Health.
In this issue, you will find more details
on these projects.
Workshops
PSBH Workshop for Nurses (May 20 -22, 2002)
Participants were addressed by Assoc.
Prof. K. Ignatov, Rector of Medical University – Pleven, Dame Sheila Quinn –
Nursing Program Consultant for DHF, and Dr. Jan Sobotka – Coordinator for DHF
programs for Europe and the Middle East.
Prof. Faisal Ibrahim, Dean of Medical
Faculty of Medicine of Upper Nile University, Sudan, Assoc. Prof. Boris
Kornovski of Medical University –Varna, Deputy Mayor of Varna, Mrs. Marina
Cholakova – Vice-president of Varna Anti-Drug Association attended part of the
workshop.
The workshop was organized by the
Association for Better Health and the University Hospital in Pleven.
The team of international facilitators
(Dame Sheila Quinn, Jan Sobotka, Shelagh Murphy, Dr. Daniel Levine, Dr.
Katarzyna Broczek) and the local facilitators (Assoc. Prof. Maria Alexandrova,
Dr. Angelika Velkova, Dr. Kamen Kamenov, Mrs. Yanka Tzvetanova, Mrs. Makretta
Draganova, Mrs. Polya Zhivkova) helped participants to prepare their projects.
The following projects were prepared:
§ Setting up an emergency intensive care unit at the clinic of narcology for treatment of addicted persons (Alexander Alexandrov)
§
Organizing alternative forms of treatment
(occupational therapy) for female patients with acute psychoses (Andriana
Chakalova)
§
A program for patients undergoing radiotherapy on
proper skin care, diet and leukocyte control (Anelia Zlateva)
§
A program for cancer patients and their relatives
on pain control (Vilyana Stoeva)
§
A training program for diabetic patients on
prevention of foot injuries (Galina Viteva)
§
Reorganizing the activities of paramedical staff
to provide more time for proper nursing care (Darya Genova)
§
An educational program to reduce stress among
patients referred for hemodialysis (Dechka Miteva)
§
An educational program for stroke patients and
their families to prevent decubital ulcers after discharge from hospital
(Dimirinka Mircheva)
§
Setting up daycare service for psychiatric female
patients at the clinic of acute psychoses (Evlambia Racheva)
§
An educational program for farmers on proper
handling of chemicals used in agriculture ( Iskra Velkova)
§
An educational program for early detection and
timely treatment for tuberculosis ( Yordanka Valkova)
§
Building up a support group for nurses working in
a hemodialysis center (
§
Yordanka Nikolova)
§
Prevention of postoperative infections in patients
after laryngectomy (Katya Christova)
§
An educational program for diabetic patients to
improve follow-up and control of blood sugar level (Katy Hinkova)
§
Improvement of rehabilitation in patients after
hip joint replacement (Keti Georgieva)
§
Improvement of rehabilitation procedures in
patients of the clinic of orthopedics (Krassimira Tzoneva)
§
Shortening the rehabilitation period for stroke
patients (Kremena Mircheva)
§
A program for social reintegration of multiple
sclerosis patients (Maria Stankova)
§
An educational program for patients undergoing
chemotherapy for oncological conditions to improve life quality (Meliana Al
Shargabi)
§
Health education for glaucoma patients of the eye
clinic in Pleven and their relatives (Mitka Ilieva)
§
Training of nursing staff to improve cost
effectiveness of treatment( Pavlina Zhekova)
§
Health education for patients to maintain proper
hygiene of tracheostoma canule (Petya Angelova)
§
Training proper inhalation techniques to patients
with chronic obstructive pulmonary disease and asthma (Petya Simeonova)
§
Training courses for nurses working at the lung
disease clinic (Snezhana Petkova)
§
Prevention of alcohol intoxications in 400
children aged 1114 (Stefka Kancheva)
§
Health education for newly diagnosed diabetic
patients (Tzvetelina Ivanova)
June 2002
PSBH Workshop for Nurses (June 1315, 2002)
The workshop was organized by the
Association for Better Health, in close collaboration with Dr. Antoaneta
Stoikova (deputy director) and Mrs. Nelly Todorova (head nurse) of Gabrovo
regional hospital. Nurses, physio-therapists, lab technicians, midwives from
Gabrovo Regional Hospital, and nurses from the Pulmonary Disease Hospital in
Gabrovo participated. A couple of doctors also attended.
The 48 participants worked in five groups with
the international facilitators Dame Sheila Quinn and Shelagh Murphy (UK),
Pamela Hoyt, Nursing Programs Coordinator from DHF (USA), Fatmeh Atiyeh
(Jordan), Paul Florea (Romania), and the local facilitators Assoc. Prof. Maria
Alexandrova, Dr. Angelika Velkova, Mrs. Yanka Tzvetanova, Mrs. Polya Zhivkova,
Mrs. Nelly Todorova.
Miss Mariana Glouhova, a representative of
the Red Cross – Bulgaria participated as an observer,
Projects were mostly concerned with
patient education, improvement of working conditions for the staff, improvement
of quality of nursing care, health protection for hospital staff. The following projects were prepared:
§
A program to reduce in-hospital infections in a
surgical ward (Albena Boteva)
§
Introduction of local anesthesia in lumber
puncture for patients at the neurological ward (Bisera Uzunova)
§
Increasing the levels of reliability of tests
performed at the microbiology laboratory (Assia Peikova)
§
Shortening of recovery period for pediatric ward
patients through improvement of dietary regimen (Daniela Simeonova)
§
Health education for 800 inhabitants of Gabrovo on
proper actions in cases of exogenous poisoning (Dimitar Dimitrov)
§
Training asthma patients for proper use of
inhalants (Donka Georgieva)
§
Health education on proper diet and regimen for
hepatitis B patients (Donka Encheva)
§
Motivation of patients to undergo bronchoscopy
(Ivo Stanchev)
§
Training for relatives of 20 stroke patients for
proper care in the home (Emil Damyanov)
§
Health education for patients operated on for
glaucoma and cataract to reduce postoperative complications (Galina Nedyalkova)
§
Stress reduction in patients planned for
fibrocolonoscopy (Galya Christova)
§
Health education for parents of children with
asthma (Ganka Nedelcheva)
§
A program to improve hygiene in a surgical ward
(Genka Kamenova)
§
Training patients with chronic obstructive
pulmonary disease to use a spirometer at home (Irina Tapova)
§
Health education program for acute myocardial
infarction on proper exercise regimen in the acute stage (Kalina Parashkevova)
§
Training of relatives to prevent decubital ulcers
in stroke patients (Kamelia Dragieva)
§
A program to promote health protection of
personnel working in an X-ray department (Kremena Dimitrova)
§
Health information campaign on the hospice
services offered to chronic and terminal patients from Gabrovo region (Lubka
Dimitrova)
§
Prevention of infections among medical staff in a
pulmonary hospital (Lubka Haralambieva )
§
A program to increase number of blood donors in
Gabrovo (Margarita Tzanova)
§
Shortening the hospital stay of maternity ward
patients (Maria Petkova)
§
Reduction of stress levels in children admitted
for treatment at the ENT ward (Maya Petkova)
§
Reduction of risk in oxygen therapy given to
newborns (Maya Dyukendjieva)
§
Prevention and control of nosocomial infections in
the pulmonary hospital in Gabrovo (Michaela Dimitrova)
§
Providing information for oncololical
patients to ensure timely admission
for radiotherapy (Milena Nedelcheva)
§
A training program to reduce low-back pain among
personnel in the neurology ward (Milena Pencheva)
§
An educational program on hormone replacement
therapy for hysterectomized women aged 35-45(Natalia Milkova)
§
Patient education to prevent complications in
diabetic patients (Neila Maknin)
§
Antismoking program for children aged 1114
attending a middle school in Gabrovo (Nelvena Christova)
§
Training paramedical staff to prevent nosocomial
infections (Nikolina Christova)
§
A training program to improve communication skills
of nurses in a tuberculosis ward (Petya Hadjinukiforova)
§
Education of disabled people to inform them on the
social services provided for them (Petya Vitanova)
§
Health education for hypertensive patients aged
25-50 (Petya Stancheva)
§
Reduction of stress among patients referred for
fibrocolonoscopy (Radka Milcheva)
§
Building up data base on newly diagnosed patients
with lung diseases (Radostina Petrova)
§
Organizing activities for children treated at the
pediatric ward to reduce stress levels (Raina Gencheva)
§
Health education for patients with increased serum
lipid levels (Reneta Ilisanova)
§
An educational program for timely detection and
treatment of osteoporosis in 100 women (Roumyana Ivanova)
§
Improvement of accuracy of diagnostic procedures
in the clinical laboratory (Snezhinka Tomova)
§
Reduction of nosocomial infections in a
neurological ward (Stella Koleva)
§
Health education for patients of the intensive
care unit in Gabrovo to reduce rehospitalization rates (Svetla Grancharova)
§
Health education for families of tuberculosis
patients (Tatiana Dimitrova)
§
Improving registration process and follow-up of
patients in the surgical ward (Temenuzhka Stancheva)
§
Health education for hypertensive patients (Yulia
Popova)
§
Health education for hepatitis B patients
(Dimitrinka Ivanova)
Varna PSBH Workshop for Nurses (June 17 – 19th)
The participants (52) were mostly school
nurses. There were six nurses from St. Marina University Hospital, including
the head nurse, Mrs. Angelina Zhelyazkova.
The workshop was organized by the Association for Better Health, in close
collaboration with Dr. Dilyan Droumev, Director of the Health Department of
Varna municipality, and the Municipal Center for Drug Abuse Prevention.
International facilitators - Dame Sheila
Quinn, Pamela Hoyt, Shelagh Murphy, Fatmeh Atiyeh, Paul Florea and local
facilitators - Assoc. Prof. Maria Alexandrova, Dr. Angelika Velkova, Mrs. Yanka
Tzvetanova, Mrs. Polya Zhivkova, and Mrs. Gergana Momova helped the
participants prepare their plans of action. As might be expected, most projects
were oriented to school health, and all the hospital nurses presented finalized
plans of action. The projects prepared were:
§
Health education for teenagers on STIs and the
risks of early pregnancy (Albena Christova)
§
A training program for paramedical staff to reduce
in-hospital infections in a surgical ward of the Varna regional hospital
(Angelina Zhelyazkova)
§
Health education for teenagers on the risks of
alcohol abuse (Anelia Parousheva)
§
A program to reduce stress in children attending
an art school in Varna (Blagoika Petkova)
§
Antismoking program for children aged 15
(Dimitrichka Ovcharova)
§
Organizing continuous postgraduate training for
nurses (Dora Vasileva)
§
An antismoking program for children aged 15
(Elenka Peikova)
§
An educational program for mothers accompanying children
at the pediatric ward to reduce in-hospital infections (Galina Ganeva)
§
Health education on reduction of body weight in
patients after acute myocardial infarction (Greta Demerdjieva)
§
Health education for Rroma children to reduce the
number of carriers of head lice (Ivanka Georgieva)
§
Training basic hygiene skills to Rroma children
(Ivanka Panayotova)
§
Anti-drug education for 60 children aged 15-18
(Katya Stankova)
§
Prevention of spinal deformities in 70 children
aged 7-8 (Koharik Kouyuomjiyan)
§
A program to improve on the skills of 8 theatre
nurses of the regional hospital in Varna (Krassimira Dimitrova)
§
A physical education program for children with
mild spinal deformities and incorrect posture (Margarita Mihova)
§
Antismoking program for children aged 14-16 (Maria
Vlaikova)
§
A training program for parents of disabled
children (Mariika Angelova)
§
Increasing the knowledge on the dangers of early
pregnancy among girls aged 14-15 (Milena Yovcheva)
§
A program to reduce violence among and to
schoolchildren aged 17 (Minka Christova)
§
An educational program on the dangers of drug use
and abuse for children aged 15 (Nanka Dimitrova)
§
A program to improve on social integration and
follow-up of 14 psychiatric patients (Nadya Kostadinova)
§
Reduction of traumatism in children aged 15
attending a vocational school (Nedka Gospodinova)
§
Organizing exercise sessions and diet education
for overweight children aged 9-14 (Nedyalka Mitkova)
§
An educational program on the dangers of alcohol
abuse (Nelly Markovitch)
§
A program to reduce weight in obese children aged
7-14 in an elementary school in Varna (Nikolinka Miteva)
§
A health education program to improve knowledge on
the dangers of drug use for children aged 15 (Radka Mileva)
§
An educational program to promote save sex and
preservation of reproductive health of girls aged 16-18 (Rositza Filipova)
§
Antismoking program for primary school teachers
(Roumyana Eftimova)
§
An educational program on the dangers of alcohol
use and abuse for children aged 13-15(Roumyana Andonova)
§
Education on proper diet and physical exercise to
reduce weight in obese children (Rousinka Todorova)
§
A program to reduce aggression-related traumatism
in children aged 12-14 (Sabka Arabova)
§
Antismoking program for middle school children (11-14)
(Sasha Ilieva)
§
A program to increase immunization rates in 360
children aged 7-14 (Sminka Koleva)
§
Reduction of traumatism due to aggressive behavior
in children aged 11-12 (Stanka Manolova)
§
Remedial gymnastics for children with neuroses and
high blood pressure (Todorka Popova)
§
An educational program on sexual health for
children aged 12 (Tzanka Ivanova)
§
Health education on basic hygiene for Roma
children aged 7-8 years (Velichka Georgieva)
§
Health education for 100 teenage girls to prevent
bulimia and anorexia (Violĺta Borisova)
§
An educational program for children aged 12 on the
physiological changes in puberty (Yanka Andreeva)
§
Education on proper diet for girls aged 17-19 to
reduce somatic incidents due to improper slimming diets (Yordanka Gacheva)
§
A program to reduce the number of children aged
8-9 with spinal deformities and incorrect posture (Zlatka Ivanova)
Announcements
Follow-up workshops for projects from
Sofia PSBH 2001 and Stara Zagora PSBHI 2001 workshops will take place in the autumn.
Participants will be notified about the exact date, time and venue.
Those interested to get more detailed
information on Dreyfus Heath Foundation programs worldwide may look at
www.dhfglobal.org
To see photos from workshops and projects,
please check the web-site of the digest: www.livebg.net/psbh-digest. You may
have a look at previous issues of the digest as well. More about the program
may be found at www.dhf-bg.org.
Write to us at: abh-psbh-bg@el-soft.com,
or to the address of the Association for Better Health: 1, St. Kl. Ochridski
Str., 5800 Pleven, Bulgaria, for Yanka Tzvetanova, PSBH/CBH coordinator
Management of Nipple Discharge
Dr.
Georgi Baichev, I. Daskalova
Oncology
Centre, Medical University – Pleven
Summary Nipple discharge in non-lactating breast is
an important complaint in patients. It
indicates pathologic changes based on endocrinological or local abnormalities.
Although most common discharges have a benign etiology, 10-15% of cases are
associated with cancer.
A combination of diagnostic tests,
including breast examination, exfoliative cytology and galactography, can help
the clinician to establish the diagnosis and plan proper management. Depending
on the underlying breast pathology, a central or single lactiferous duct excision
is the procedure of choice.
Key words: nipple
discharge, galactorrhea, breast cancer.
Summaries on Implemented/Completed Projects from the August’2001 PSBH
Workshop
Health education on proper diet for diabetic patients
Mrs. Kalina Parashkevova (Gabrovo)
The
project was implemented in September 2001, and is to be completed in September
2002.
Two
nurses were trained to work on it.
Brochures were prepared with information
on the principles of diet recommended to diabetics, and given to patients
treated at the ward.
Reduction of stress levels among patients scheduled for surgery in the
Loukovit hospital
Mrs. Pavlinka Petrova (Loukovit)
A
team was built to work on the project.
A program for working with the patients
was made, and each patient was acquainted with the daily regime at the ward and
the facilities.
All patients were given brochures
containing basic information about the intervention, and the nurses had talks with
them and answered questions
All patients filled in a simple test for
assessment of the level of stress.
The
project was completed in March 2002. The test showed reduction of stress levels
in 80% of the patients treated in the ward.
Health education for insulin-dependent diabetic patients: diet and exercise
regimen, prevention of complications
Mrs. Neila Maknin (Gabrovo)
The project covered 19 patients. All of them got a
booklet, specially adapted and containing information on diabetes control, and
prevention and/or postponing the complications of the disease.
The
project continues, and more patients will be included.
Teaching self examination of the breast to women in Belene
Mrs. Rositza Ivanova (Belene)
A
brochure was printed and distributed among the women.
The
team includes a nurse, a surgeon and a gynecologist.
The
project is to be completed in December 2002.
Reduction of stress in children admitted for treatment at the pediatric
ward in Gabrovo
Mrs. Raina Gencheva (Gabrovo)
A
team was built, and the activities planned were discussed and coordinated with
the hospital managers. Fund raising was organized, and firms in Gabrovo
approached. A psychometric test to assess the children while at the ward was
prepared by a psychologist.
With
the support of sponsors from Gabrovo-based firms - Shell – Bulgaria,
Proekt-Stroi Ltd, Lion Ltd, Simat Ltd. Emona Ltd, and many volunteers, the team
managed to set up a children’s corner in a sunny room in the ward. Toys, books,
a TV, materials for drawing were purchased. Children from primary schools in
Gabrovo provided many of the toys.
For
four months, the children have been busy drawing, coloring, arranging puzzles,
preparing postcards, watching cartoons, listening to fairy tales and playing
various games.
With each child a psychometric test was
done, and the parents filled in a questionnaire.
The results from trying to give the
children an opportunity to spend their time at the hospital playing very much
like at home will be assessed for the first six months – January-June 2002.
The goals and the activities of the
project team were made known to the public through the local media: Gabrovo
Cable TV, and Gabrovo Today Newspaper.
Early diagnosis of cervix carcinoma in one general practice
Dr. Emanuil Manoilov
A
list was made of women (18- 75), registered with the practice and supposed to
undergo an examination and a PAP-smear test.
A
brochure was prepared and distributed, explaining the necessity for such
check-ups, and the importance of early diagnosis.
Consultations
with a cytologist were made, and the personnel were trained.
Results: 25% of the women were examined.
No pathological changes were found.
Comments:
it is difficult to motivate the women to undergo the examinations.
Organizing training for nurses newly appointed at 2nd Clinic of Neurology
Mrs. Diana Arsova (Pleven|)
In
collaboration with the head of the clinic, the doctors and the senior nurse,
the following was accomplished:
-
lectures were prepared on the diseases treated at the clinic;
-
registration cards and standard
procedure protocols were prepared;
-
a nursing procedure protocol for prevention of decubital ulcers was prepared;
-
a standard procedure protocol for catheterization was prepared;
- instructions for preparation for lumbar
puncture were prepared;
- a program for the nurses who will train
the newly appointed ones was prepared.
Criteria
were set for evaluation of the results from the training at the end of the
first and the sixth month.
Organizing a screening program for early detection of breast and cervix
cancer
Mrs. Valentina Besheva (Pleven)
Oncologists
from the University Center of Oncology in Pleven examined 250 employees of the
Academy of Economy in Svishtov.
Comments:
the numbers of patients diagnosed with ovary cancer are increasing, and the age
of those diagnosed with malignant tumors is decreasing. This necessitates the
promotion of prophylactic check-ups.
The
project team plans to include more patients in the program.
Prevention of in-hospital infections in the intensive care unit
Mrs. Erka Andreeva (Pleven)
A
program to realize the project was made and a team was built, lectures and
materials prepared. Training sessions for nurses and orderlies were started.
Results are checked every three months,
and measures are taken if necessary.
The hospital authorities, the hospital
epidemiologist and the staff of the intensive care unit supported the project
team.
An educational program on the risks in alchemic
heart disease
Dr. Lidia Tzoneva (Belene)
The program activities are addressed to
100 patients with ischemic heart disease, aged 40-65, and 73 have been selected
so far. These have been hospitalized and treated in hospital. Brochures have
also been given to them, containing information on risk factors.
Follow-up to evaluate the project ill be carried
out in collaboration with the hospital and the general practitioners.
Promotion of early diagnosis of breast and cervix cancer among female employees of “Yana” Ltd – Pleven
Mrs. Pavlina Angelova (Pleven)
The
aims of the project team (a doctor and a nurse) were:
-
to teach the women self-examination of the breast for early detection of
pathological changes
-
to establish co-operation with the Oncology Center in Pleven for performing
PAP-smear tests
The
project was presented to the management of the firm; leaflets with information
on breast and cervical cancer were prepared and distributed. Talks with a
specialist were organized, and a video was seen.
The
questionnaire filled at the beginning and the end of the program showed there
was an increase of the level of knowledge of the role of early detection for
the treatment and outcome of both conditions.
A program on pain control for the families of terminal cancer patients
Mrs. Penka Manolova (Pleven)
The
program is to cover 36 patients and their families. So far, ten have been
included.
Talks were organized with the relatives,
and additional information on opiates used in pain control was given to the
relatives of each patient. The relatives also signed an agreement to return the
medicines they had not used back to the consulting room for chronic pain
control.
Evaluation
will be made on the basis of questionnaires.
The
head of the clinic Assoc. Prof. Deliiski and the head nurse Mrs. Besheva were
very supportive. The pain-control consulting room is now bigger, and procedures
can be made there. A nurse was appointed, and now the patients from Pleven can
be visited in their homes.
Health education for patients with acute myocardial infarction
Mrs. Vessela Yotova (Pleven)
The
project team includes a cardiologist and four nurses. Brochures were prepared
and given to the patients, and patients are approached individually while at
the ward. individual talks. The general practitioners were informed about the
project.
A
questionnaire will be filled by the patients, and re-hospitalizations related
to the condition will be used to evaluate the results, comparing the data
before, and one year after the implementation of the project.
Organizing prophylactic check ups in one general practice for women aged
18-75, and men aged 45-75 for timely diagnosis of breast, cervix and prostate
cancer
Mrs. Marineta Petkova (Pavlikeni)
The patients were invited to undergo the
check ups using the local media – radio, TV, and by sending them individual
letters.
Questionnaires,
brochures and an information table were prepared for the waiting room.
Results so far: 504 (80%) of the women,
and 372 (80%) of the men have turned up. By August, the rest 20% of the
patients will be examined.
The
annual check-ups are to be introduced as a routine practice.
A program to motivate female patients registered in one general practice
(age range 18-75) to turn up for cervix and breast cancer check-ups
Dr. Evgeni Petkov (Pavlikeni)
Health
talks were given to the patients, an inquiry was made and brochures prepared
and distributed. Gynaecologists were invited as consultants to the project.
Of
the 302 women examined, four were diagnosed with cervix cancer, and breast
cancer was found in two.
The
rest 20% of the women are to be examined by the end of August 2002.
Health education for diabetics to reduce rehospitalization rates
Mrs. Vessela Kancheva (Loukovit)
A
lecture course was organized for five nurses from the internal disease ward. A brochure
was prepared, an information corner set up, and additional blood sugar
measuring instruments provided.
The
project was presented to the general practitioners, and brochures were put in
the waiting rooms.
Lectures
prepared by an endocrinologist were broadcasted twice a week for two months by
the local “Delta” radio.
While the patients are in the ward, nurses
talk to them and their relatives, and brochures with instructions on blood
sugar control are given to them on discharge.
Early diagnosis of carcinoma colli uteri among patients (aged 20-65) in one
general practice in the second consulting and diagnostic center in Pleven
Dr. Julia Ivanova (Pleven)
The
project team includes a GP, a midwife, a gynecologist, a cytologist and an
oncologist.
A
brochure entitled “Cervical cancer: early symptoms, risk factors and modern
treatment“ was prepared and distributed, and talks were given to the patients
registered in the practice.
The
following check-ups were performed:
-
1000 women underwent a PAP-smear test and mammography;
-
2 women with PAPIII were consulted by an oncogynecologist.
The
project is coordinated within the programs of the national health insurance
fund.
Reduction of stress in cancer patients planned for chemotherapy
Mrs. Zdravka Kichoukova (Gabrovo)
A
brochure was prepared, and the patients filled in questionnaires.
The project has covered 25 patients by
April 2002, and will be completed in December 2002.
The
inquiry has shown that the patients find the information program helpful.
Health education on the necessity for regular gynecological check-ups for
women aged 19-75
Dr. Blaga Lyubenova (Belene)
A
brochure was prepared and distributed.
By
April 30, 2002, 417 (14%) of the 3164 women included in the project have
undergone a gynecological examination and a PAP-smear test. In two of them,
precancer changes were diagnosed.
The
general practitioners have collaborated actively, referring the women for a
check-up.
Reduction of anxiety in patients planned for endoscopy
Mrs. Desislava Lazarova (Gabrovo)
The
project was presented to the team of the ward, and materials to be included in
the brochure were found, approved by the staff, and adapted for the purposes of
the project.
Illustrations
were made, and caricatures were added.
The
brochures were given to the patients, and copies were left in the ward, so that
more people had a chance to see them. Brochures have helped some of the
patients to feel less stressed.
The
project continues, and will cover more patients.
Teaching safety precautions to student lab technicians at the Nursing College in Pleven
Mrs. Ivanka Stoikova, trainer (Medical College Pleven)
The project was presented to the director, and a team was built of three trainers
and a doctor. The target group of 46 students was formed after studying the
attitudes of the students and their expectations.
The
teaching program prepared was on five basic topics:
-
safety precautions in investigations of blood samples;
-
safety precautions for working with gases, acids and bases;
-
safety precautions in investigations of urine samples;
-
safety precautions in centrifuging in the lab;
-
preparation of lab utensils and materials – cleansing, disinfecting, and use of
individual protection devices.
Five
brochures with instructions for work in the clinical laboratory were prepared
and printed. All these were placed on an information board in the lecture
halls.
The
practical training was conducted in April and May 2001.
At the end of the training course, the students’ theoretical knowledge and practical skills were tested.
Projects from Varna Antidrug PSBH Workshop – May 2000
(Summaries)
Education for youth community non-formal leaders to help peers cope with drug
addictions
Mr. Ilyan Rizov
The project goal was to organize education
on the dangers of drug addiction for 15 children (13-14 years old) from the
„Dobri Chintulov“ Primary School, preparing them for peer-educators. The first
step was to select the target group (6 girls and 9 boys).
The education
program included teaching basic communication skills, conflict management,
assertivity etc., and training them how to refuse when offered to experiment or
take drugs and improving their skills for peer-consultation on problems related
to drug abuse .
Additional
topics were included in the program, such as interaction skills for work with
boys and girls from different ethnic groups.
During
the school year, these peer educators took part in anti-drug programs, and were
assisted by the Center for Drug Abuse Prevention in Varna.
Harm-reduction (hepatitis B/C and HIV) program for heroin addicts
Dr. Borislav Stanchev (Varna)
The
need for such a program was estimated by key interviews, taken from 67 heroin
addicts, who were also hepatitis B/C carriers. The key interviews were
conducted using a semi-structured questionnaire and a card on the European
Council „MULTY CITY NETWORK project.
The
aim of the program was to motivate drug users to undergo treatment for
hepatitis C if necessary, be vaccinated for hepatitis B, and to train them to
avoid risks of infections when taking psychoactive substances.
Of
the 67 heroin addicts interviewed, 50% were admitted for treatment of hepatitis
C, and about 60% got hepatitis B vaccine.
The program has its own rules, such as
conditions for joining or leaving, ways of establishing and maintaining
contacts, rules to collect, store and dispose of needles and syringes
Future
plans:
- to
equip a room for a needle exchange program, provide consumables, prepare
brochures on harm-reduction techniques;
-
to recruit and train volunteers;
-
to provide monitoring and assessment;
-
to make the program sustainable;
-
to coordinate the activities with other institutions and NGOs.
Prevention of tobacco smoking among students from the Nursing College in
Varna
Dr. Nikolai Temnyalov
Meetings,
discussions and interviews with 45 third-year student nurses were organized,
and in April 2001, nine of them volunteered to be included in the program.
Functional
assessment of breathing of all nine participants was made free of charge by the
specialists at the lung disease clinics of the University Hospital and the
regional hospitals in Varna.
The
participants then took anti-nicotine tablets - 3 to 8 tablets a day (the doses
recommended depended on the needs of each participant).
All
of them got brochures with instructions how to take the medicine, and copies of
articles on the harmful effects of smoking.
The
results: all nine girls quit smoking. In December 2001, spirography showed
improvement of breathing in all of them.
Plans:
to keep in contact with the participants after the leave the college.
Participants
will be followed up after leaving the college.
Health educational program on the harms of drug use for children in three
schools in Varna
Dr. Elena Geneva
Workshops
and discussions were organized with three groups of children aged 12-14, attending
health-promotion schools in Varna (“Yordan Yovkov” and “Nicola Vaptzarov”
middle schools).
The
meetings took place at the Hygiene and Epidemiology Station, the Museum of
Natural History and the “Human Health” video club.
The
program included:
1. Health education workshops on
- definition, nature and types of psychoactive
substances;
- effects of psychoactive substances on the human
organism;
- attitudes to drug use and types of behavior in
young people;
- discussions.
2. A meeting with a specialist from the
Department of Psychiatry of Varna Medical University.
3. Watching a video (“The vicious Circle”)
with stories of young people related to their experiences and problems.
4. Small group discussions of cases and
problem-solving sessions. Presentations of ideas and solutions suggested in
each group.
All
the children got folders with health-education materials on psychoactive
substances, their effect on the human body, a brochure on marijuana and a
poster.
The
project was implemented by the health promotion department in Varna. Special
thanks to Mrs. Snezhana Ilieva and Mrs. Maria Stefanova (pedagogical advisors), and to Mrs. Toni
Mileva (medical University – Varna).
Increasing the sensitivity of parents’ to their children’s experimentation
with psychoactive substances
Mrs. Gergana Momova
We
interviewed over 400 subscribers of MSAT Cable TV, parents, of children aged
13-18. Three groups of questions were included in the questionnaire. Leaflets
were prepared and distributed.
The
analysis of the inquiry showed that the sensitivity of parents varied, and in
some it was as low as 44%, ad though 90% are worried, parents still remained
passive, because they do not know how to behave or act.
The
media people, on their part, do not realize what role the media could play in
solving the drug use problem. There is
“gap” between school and parents, and this gap could be filled with prevention
programs.
Meetings
were organized to give basic information on psychoactive substances,
discussions and possibilities for treatment.
Video
materials are to be prepared and broadcasted by MASAT TV.
Educational program for journalists on drug use and abuse problems
Mrs. Svetlana Koeva
The
Varna Drug Use Prevention Center organized training for journalists from four
TV stations, two radios and six newspapers on the following topics:
- current problems of drug use and abuse;
- tendencies in drug use;
- social and demographic characteristics of drug
use and abuse in Varna region;
- major anti-drug projects of the Drug Use
Prevention Center in Varna.
Future
plans: to prepare and distribute educational and information materials on drugs
and the harmful effects of use and abuse, and advertising institutions and organizations
where consultations and treatment can be obtained.
Publishing a specialized magazine „The freedom to choose“ for teachers and
social workers in the city of Varna in order to carry out preventive work with
young people who take drugs
Mrs. Petromila Atanassova
The
members of the „Intellect“ club gathered information, materials, research
results in order to facilitate and promote the educational process in the „The
freedom to choose“ magazine for 2001.
We
presented the issue at a press conference in the Youth Center in Varna. The
first issue was advertised in national and local newspapers. The magazine is
distributed free of charge to schools, NGOs, government and municipal
organizations.
We
managed to organize exchange of information among school-teachers,
sociologists, social workers, school directors and the Department of the
Ministry of Education and Science in Varna.
As a result of our work we prepared an
alternative project on the subject: „Achieving adaptive behavior in situations
of violence among high grade students” which projects was approved by the Varna
Directorate of Youth activities and Sports.
Future
plans: to continue collecting and analyzing statistical data on drug use and
other problems, scientific articles and opinions. We hope to be able to
continue with producing and distributing the magazine.
Giving basic knowledge on psychoactive substances and their harmful effects
to elementary school children
Mrs. Evgenia Koleva
The
project included 308 children from „Vasil Levski“ Elementary School and 300
children from „Christo Botev“ Elementary School. There are no drug-dependent
children in these schools.
Once
a week, the class teachers organized discussions on the healthy life styles.
During
the whole school year, various competitions and activities were organized:
drawing competitions – „The Earth is My Home“, essay writing: „My School“, „My
Town“, „My Street“, „My Friends“.
School
newspapers were prepared: „Time break“ and „Young Mathematician“.
A
concert with 100 % participation of the pupils from all ethnic groups was
organized.
Future
plans: to provide for printing guidebooks for teachers and individual student‘s
books on problems of drug use. The level of knowledge of children on the
problem will be measured before and after the anti-drug education.
„Free youth territory“ Club
Mrs. Roumyana Ivanova
The
target group includes 108 children (age: 12-13 years).
Premises were provided for carrying out
group work with parents, teachers, representatives from the police and social
workers who work in the „Mladost“ housing estate in Varna („Geo Milev“
Comprehensive School and „Dobri Chintulov“ and „Ivan Rilski“ Elementary
Schools). The local stadium is also used for our activities.
Three social workers, a journalist, a
poet, a teacher in folk music, a psychologist and a sports teacher work on the
project as volunteers
In their free time, the children were
engaged with the preparation of the various social events: celebrating the National
Liberation Day, presentation of collections of poems, skateboard competition in
July.
Plans:
- to provide for one more room so that there will
be enough possibilities for communication between the different generations;
- to organize sports and tourist activities more
often;
- to carry out an inquiry among the target group
participants and assess the levels of addiction and proneness to drugs;
- to discuss the activities and the future steps
on the project with parents, teachers, social workers and representatives from
the police.
Increasing the level of knowledge on the harms of drugs among children from
different minority groups in Odessos municipality
Mr. Fidan Assenov
We
started working on the project in May 2000.
The inquiry we carried out among 150
children (aged 8-18) showed that:
-
only 11 children did not take drugs;
- 65
children aged 15-19 were intravenous heroin users;
-
there was one child aged 8 who took heroin intravenously.
The
project team included two parents, a social worker, a pedagogue, and a
psychologist.
In
August we distributed leaflets and brochures, advertising the project
activities, and invited the drug users to join the training groups. The
activities in the training groups were conducted by a teacher and a social
worker, and the main goal was to get the children learn about the harms caused
by drug use.
Two
training groups were formed: one for children aged 12-15, and another – for
children aged 15-18. The training sessions took 5 months.
Results:
- the
number of users has decreased by 60%;
- 20%
of the users were sent for treatment abroad ( Spain, Italy);
- unfortunately,
5% died of overdose
- 10%
of the target group emigrated;- the
eight-year –old user is now healthy.
Although
our project did not get support from the local government institutions, we
achieved a lot with our project. We plan to continue working with the children.
Psychological work on drug abuse prevention among the stuff of the
Bulgarian Marine
Mrs. Meglena Deresheva
We
created and began the implementation of a complex program called „Prevention of
alcohol and drug abuse in the Bulgarian Marine“. We selected our target groups
and began psychological work with the participants.
The
group work consisted of talks and seminars aiming to change the attitude to the
problem and the formation of responsibility for one’s own health. On the basis
of this work we managed to identify the participants to work with individually.
With
the senior staff, we conducted training aimed at building skills for early
detection of drug seeking behavior and individual approach to such soldiers.
Plans
for the future:
- to
carry out inquiries with the target groups;
- to
provide and distribute different informational materials - books, videos,
brochures, leaflets;
- to
analyze the results and identify priorities for future activities.
Decreasing the numbers of drug users among high school students (15-18) in
attending „Constantine Preslavski“ Arts School in Varna
Mrs. Albena Valcheva
We
started with an inquiry to assess the attitudes and level of knowledge of
parents and students on psychoactive drugs. Training sessions were organized
for teachers and class teachers: these sessions were to help them acquire
skills at recognizing drugs and identifying drug-users.
Plans: to prepare
brochures on the effects of psychoactive substances, and implement
peer-education.