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Impact of a hospital palliative care team on costs and quality of care of patients at the end of life.
Křemenová, Zuzana ; Rychlík, Ivan (advisor) ; Merta, Miroslav (referee) ; Bužgová, Radka (referee)
This dissertation thesis describes the end-of-life care in hospital setting and compare the dying phase with and without specialist palliative care support. The second part of the thesis focus on quality of care improvement by using patient reported outcome measures (PROMS). To increase the quality of symptom assessment in palliative care the routine use of PROMS is recommended. Aims The first study aimed to compare costs of terminal hospitalization and quality of care between the group of patients with and without support of a palliative care team. The second study aimed to provide translation, cultural adaptation and validation of IPOS- renal measure, which is patient reported outcome measure used for patients with advanced chronic renal disease. Methods The first study was a descriptive retrospective case-control study. We explored the difference in daily hospital costs between patients who died with and without the support of the hospital palliative care team. As secondary outcomes, we compared the groups over the duration of the terminal hospitalization, intensive care unit days, intravenous antibiotics, MR/CT scans, oncologic treatment, preferences and limitation of care and family support. In the second study the IPOS-renal was translated to Czech and culturally adapted using cognitive...
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Needs of parents of children with multiple disabilities at an early age for individualized early intervention
Vencová, Barbora ; Květoňová, Lea (advisor) ; Vítková, Marie (referee) ; Bužgová, Radka (referee)
Introduction: The arrival of a child with multiple disabilities (MD) in a family is a difficult situation. Increased stress of parents of (MD) is often related to the non-fulfillment of the needs, leads to frustration and deprivation that can result in serious health problems. The aim is the subjectively defined and described life with a child (MD), focusing on the needs of these parents resulting from the daily care of the child. Aim: Identify, describe and analyze the needs of parents of children with MD at an early age. Methods: Qualitative approach using the biographical narrative method. The research design is a case study. Methodological triangulation: three methods of collecting data: biographical curve, in-depth interview, Cantril's ladder. Results: all cases were compared with each other. 12 parents' needs were identified. The Cantril's ladder method found significantly unmet needs: Need for rest and Need for medical care. Conclusion: The main contribution of the work is to understand the individuality and needs of parents of children with multiple disabilities, as a possibility to provide purposefully individualized early intervention, to streamline the process of planning, implementation and evaluation of provided care and thus contribute to the quality of life of the whole family.
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