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The role of pediatric nurse and midwife in the laboratory screening of newborns
CHVÁTALOVÁ, Lenka
Newborn laboratory screening represents a pro-active blanket search for diseases in their early, pre-clinical stages. It uses an analysis of a dried blood drop on filtration paper. The blood is taken under specific conditions from all newborns born on the territory of the Czech Republic. The blood samples are collected by midwives and pediatric nurses, who are responsible for correct execution of the test. In 2009 the number of screened diseases increased from nine to thirteen. The samples are accompanied with double NCR cards to record all data about the newborn and the conditions of blood collection, including an NCR copy of demographical data. The midwife or pediatric nurse shall instruct the mother who should be present during the blood collection. In the theoretical part the author deals with the history of newborn screening, characteristics of the newborn screening and its principles, tested diseases, preparation, procedure and care after the test. The practical part used a combination of quantitative and qualitative research survey. The quantitative survey used inquiring with a questionnaire technique. The objective number 1 of the survey was to map the knowledge of pediatric nurses/midwifes about laboratory screening of newborns. The objective 1 was fulfilled. The hypothesis formulated in connection with the objective was: Pediatric nurses and midwives are familiar with the principles of laboratory screening. The hypothesis was confirmed. The research technique used for the qualitative survey was an in-depth interview. The objective number 2 was to map obstacles to the laboratory screening of newborns from the viewpoint of pediatric nurses and midwives. The objective 2 was fulfilled. The research question formulated in connection with the objective was: What are the obstacles to the collection of samples for laboratory screening of newborns? The research question was answered. The most frequent obstacles are poor blood flow, necessity to make more than one puncture and the fact that one prescribed drop of blood may not be sufficient for the testing. This bachelor degree thesis may serve as a source of information and study material for students of midwifery. The results of the research may be used as a teaching material at the University of South Bohemia.
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Pregnant women and their perception of nursing care provided by midwifes during their stays at the Department of Gynekology and Obstetrics.
VONDRÁKOVÁ, Alena
Hospitalisation is a very stressful moment in everyone?s life. It is even more stressful for a pregnant woman. Woman?s worries about her healthy pregnancy development and child?s life become even greater at such time. Pregnant women are more sensitive and receptive to people and environment that surround them. Out of all medical staff, midwives spend the largest portion of time with pregnant women. Midwives utilize not only their nursing skills while providing nursing care to their clients, but also provide support and take care of clients? emotions. The theoretical part of the bachelor?s thesis at hand focuses on descriptions of physical and mental changes during pregnancy, and provides explanations of risk and pathological pregnancies. Subsequently, it provides information on psychosomatics during pregnancy, indications for hospitalisation during gravidity, and nursing care during the stay of a pregnant woman in hospital. This thesis identified two objectives. The first objective was to find out how hospitalised pregnant clients perceive the nursing care provided by midwives. The second objective was to observe whether the pregnant clients trust the medical staff. Based on these two objectives, five research questions were developed. Information needed for data processing and meeting the objectives was gathered by qualitative research using the technique of interview that was held with nine pregnant women. The data were collected in three different hospitals: a regional hospital, a district hospital (both in the South Bohemian Region), and a university hospital in Prague. Research corpus comprised of nine pregnant women that had been hospitalised with risk pregnancies at the department of gynecology for a period longer than 10 days. The research was carried out on the basis of the two defined objectives and five research questions. Both of the identified objectives have been met. The clients assess the nursing care provided by midwives positively and they trust the medical staff. The research questions were answered in full and necessary information was retrieved. The interviewed respondents would most preferably welcome antenatal courses held during their hospitalisations; more information given during their treatment process; and better quality communication with the medical staff. The author would welcome the idea that this thesis helps the other medical staff in better understanding of emotions, feelings and perceptions experienced by hospitalised pregnant women, which may in result help diminish some of the negative effects observed while staying in hospital.
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Prenatal diagnosis by imaging methods
VLČEK, Martin
The bachelor degree thesis focuses on imaging methods in prenatal diagnostics. The theoretical part informs the readers about the current situation in this field, including invasive and noninvasive examination methods. The theoretical part is concluded with a chapter on prenatal detection of heart disease by means of screening examination of pregnant women. The objective of the thesis was to highlight the activities of a radiological assistant, to describe his/her activities during the use of various modalities and possibilities in diagnostics of congenital heart diseases, both prenatally and perinatally. One hypothesis was formulated, concerning the activity of a radiological assistant in diagnostics of congenital heart diseases during the prenatal period. The quantitative research was designed based on the number of examined fetuses and newborns in the teaching hospital (Fakultní nemocnice) in Motol and in the Center of Medical Genetics (Centrum lékařské genetiky s.r.o.) in České Budějovice in the course of 1 year. In 59 fetuses examined with magnetic resonance the following 3 congenital heart diseases were detected most frequently: 7 cases of agenesis of corpus callosum, 6 cases of ventriculomegalia and 7 cases of congenital cystic adenomatoid lung malformation. None of the examined mothers was diagnosed with placenta defects or pathological changes on the fetus heart. The formulated hypothesis has been confirmed. At present, congenital heart diseases are not routinely prenatally examined by means of magnetic resonance due to the too robust technology and insufficient quality of the imaging. The prominent role is still being played by ultrasonic examinations performed by gynecologists and obstetricians. The thesis and the research results may be used by cardiologists, gynecologists, obstetricians, as well as radiologists.
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Informedness of women about suppository uterine cancer
POCHOPOVÁ, Jana
ABSTRACT Informedness of women about suppository uterine cancer Cervical cancer is globally one of the most important female cancers. Annually in total about half million of women fall ill with this disease and over 250 thousand of women dies. The situation in the Czech Republic is also by no means satisfactory - every year 400 deaths are recorded. However, it is a type of cancer which can be quite successfully prevented. This issue is very topical today, therefore I chose as a topic for my bachelor thesis: {\clqq}Awareness of women about cervical cancer{\crqq}. The theoretical part consists of the most important information on this disease, diagnostics, therapies and prevention possibilities. In the practical part I tried to find out a degree of the awareness of this disease at girls and women and a frequency of attendances at the gynecological examinations. The research part was realized by a quantitative way, I chose an interrogation method, a questionnaire technique. Respondents were students from secondary schools in Žďár nad Sázavou and their mothers. The total survey obtained information from 90 girls and 75 mothers. A goal of my thesis was to map an awareness of women about cervical cancer, a partial goal was to find out an interest of women in a vaccination. Both intentions were met. At the beginning three hypotheses were set: 1. An awareness of this disease depends on an age, 2. Women are interested in the vaccination, 3. Women go for regular gynecological examinations. Only last hypothesis was confirmed from the three ones. The thesis and results can be used to improve the awareness of women and girls of this disease and to realize an importance of regular preventive examinations. It also may lead to greater media coverage of other prevention options, such as the vaccination and a healthy lifestyle. Then the practical part of the thesis can serve to schools, which could, based on the obtained data, focus on a better quality in educational activities for their students.
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Physiotherapy in skoliosis
KOLIBÍKOVÁ, Šárka
Abstract The title and focus of my bachelor thesis is Physiotherapy in Scoliosis. This topic has been selected intentionally since it is related to me personally, having had problems with my back since childhood. Scoliosis is a three-dimensional spinal deformity. Besides frontal plane, there are also sagittal and transversal plane variations, described as vertebral rotation and torsion. The curve can be simple, double, or even triple in some cases of idiopathic scoliosis. The main goal in scoliosis therapy is to prevent further progression of scoliotic changes, or, if possible, to improve the defect of the spinal position. The other important factor with an effect on scoliosis is substitution of incorrect postural and movement patterns with correct ones. An individual approach to each subject is applied during exercises. Many special therapeutic gymnastic methods have been developed with potential positive effects on scoliosis, but without leading to its healing, such as the methods of: Klapp, von Niederhöffer, Gocht-Gessner, Ludmila Mojžíšová, Roswita Brukow, Schroth, Scharrl, hippotherapy, Reflex Locomotion (Vojta therapy), therapy based on basal programs, exercises on balls, electric stimulation, corset therapy{\dots} If the traditional approach to treatment is not successful or the patient came late with an already significantly developed deformity, corrective surgery and stabilisation is necessary. A decision on surgery is a key moment for both the physician and patient or child{\crq}s parents. Surgery aims to straighten the curve as much as possible and to keep this erection permanently. In my research, I used the Schroth based method. It is a special method for treatment of multicurved profile dislocation and static changes of the scoliotic body. One of the key roles is the usage of corrective pads, pillows or foam balls which are placed in such a way as to help the best possible correction of the curvature. Patients perform their exercises in this position, with targeted breathing gymnastics {--} derotation by breathing. Relaxation and stretching exercises are also useful in this method. I have conducted "research" in two adolescent patients with diagnosed scoliosis. The exercise group was active for half a year, every two weeks. Therapy by Mrs. Schroth is very demanding and requires extensive synergy and motivation of the patient. Results of my study indicate that both patients have achieved correction of their scoliotic posture. They have a better perception of their body and there is a visual cosmetic improvement, which is also an important result.
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Newborn hearing screening in the hospital České Budějovice.
ČÁCHOVÁ, Jana
This bachelor{\crq}s thesis deals with the screening of hearing of newborns in the Hospital of České Budějovice a. s. The results of the screening of hearing of all the children born in the Hospital in České Budějovice from 1.1. 2007 to 31.12. 2008 are stated here. The screening was performed by the method of establishment of presence of transiently evoked oto-acoustic emissions by Echo Check and Echo Screen devices. During the examination of newborns, the Hospital of České Budějovice a.s. and the Faculty of Health and Social Studies of the University of South Bohemia co-operated closely. The examined newborns were divided into two groups. The first of them, physiological newborns (not endangered group) are children, hospitalized at the station of physiological newborns. These children were born without apparent risks and their adaptation after the birth succeeded without complications. The second group, pathological newborns, (endangered group) are children hospitalized in the stations for pathological newborns; each of them has at least one of the following risks: positive family anamnesis, prenatal infection, weight under 1500 g, perinathal hypoxia, controlled and supporting ventilation, long-term oxygeno-therapy, jaundice VT or limit jaundice, neuro-infection, aminoglykosides, glykopeptides, diuretics, inherent impediments of the head and neck. The target of the thesis was the timely finding of hearing impediments of babies born in the Neo-nathological Department of the Hospital of České Budějovice a.s. This target was reached successfully. It follows from the results of this thesis that the share of endangered newborns with the absent transiently evoked oto-acoustic emissions at least on one ear is higher in the group of endangered newborns in comparison with non-endangered newborns, and there is a higher share of hearing defects in the group of pathological newborns in comparison with the physiological newborns. The postulated hypotheses were confirmed by these findings. This bachelor{\crq}s thesis shows the feasibility of the blanket screening in our conditions and its necessity for the timely discovery of hearing impediments and malfunctions.
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Problematika karcinomu čípku, zdravotně sociální dopady onemocnění
MÜLLEROVÁ, Jana
The objective of the bachelor thesis focused on this topic was monitoring of the system of prevention and therapy of precanceroses and cervical cancer, including the medicosocial impacts of the disease in a population of Czech women. The studied cohort consisted of women living in the South Bohemian region, Central Bohemia and Prague who underwent the complex treatment of cervical cancer. The experimental part of the thesis was performed using questioning strategy along with data collection using an anonymous questionnaire. Surprisingly, the research implies that most of the women became ill with cervical cancer despite undergoing the gynecological examinations regularly before disease onset. Thus, this prophylactic method was unable to prevent them from the disease development. The amount of information regarding the risk of internal genital cancer is insufficient, even if provided by a gynecologist. The strongest distress associated to the disease was represented by the course of treatment itself, both in somatic and psychic sphere. In half of the cases, the negative impact of treatment on the psyche of the women was confirmed. More than half of the women that underwent the treatment do not work. At the same time, it was revealed that the consequences of the disease have negative effects on intimate life with the partner, however, the partnerships didn{\crq}t break up. The results imply that it is necessary to evaluate and improve the interpretation quality of colposcopic and cytologic examinations at the level of local ambulances. At the moment, the planned vaccination seems to be the best measure in prevention of the disease. It is necessary to promote the level of awareness about the issue, preferably within the framework for sexual health education of girls in the primary schools and consequently during the preventive visits in gynecological ambulances. Based on physician {--} psychologist cooperation, the psychological distress in the course of treatment can be managed by providing psychological counseling already during the hospital treatment. The earlier return of the patient to work can be achieved by integrating the patients into the complex rehabilitation process. Cervical carcinoma represents a serious illness and it should be in the interest of our society to improve and perfect the system of its awareness and prevention.
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Health education in relation to prevention cancer breast.
VÍTKOVÁ, Adéla
Health Education in relation to Breast Cancer Prevention was not a topic chosen coincidentally. The fact that I encountered this illness in my own family contributed to my decision. I read over and collect a lot of information. There is an inexhaustible amount of publications, references, associations, commercial and medial projects, though the breast cancer diagnosis is on the top position of mortality causes not only in the Czech Republic but worldwide. In the course of collecting all data I found out that there exists the only prevention - early diagnostics and screening, on which I focused in the second part of my thesis. Health Education is the ideal instrument for preventive education programme and its further promotion. That is why I hope that comprehensive elaboration of this topic will be used as a methodological source.
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Healthy life style education focused on colon and rectum cancer prevention
BARTONĚK, Jaroslav
This work is engaged in colon and rectum cancer which is much more obvious problem in the Czech Republic than in the rest of European countries. This work is focused on its prevention and a diagnostic of this serious disease. The healthy lifestyle habits and an advance anamnesis can reduce death risk to a great extent. There is a project called ``The colon and rectum cancer prevention {--} a drop of blood saves a life{\crqq} as a part of this work which is destined for upper {--} primary pupils. The purpose of this work is consistent with the first objective of the National Oncology Program of the Czech Republic. This program is focused on professional education support of tumor prevention in Czech schools, an increased public awareness of tumor prevention, a decrease of smoking by youth and women, and also an abatement of the fluctuations of nutrition and lifestyle. This goal has been fulfilled. There is a question of whether the results of this program reflect the true situation. If this type of education project is undertaken by primary schools in the Czech Republic we will have to wait some years to see the results.
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INFECTION AS A RISK FACTOR DURING PREGNANCY
HRUBEŠOVÁ, Martina
The thesis Infection as a risk factor during pregnancy is divided into two parts {--} theoretical and practical {--} and has a character of a research study. The theoretical part deals with aspects of infections during pregnancy. The main attention is paid to the questions of pregnant women colonized with group B Streptococci (GBS, Streptococcus agalactiae) which may cause a large scale of infectious diseases in newborns, including the life threatening sepsis. This part of the thesis is divided into seven chapters. They provide brief information on the etiological agent, risk factors, clinical picture of the disease, current possibilities of the disease diagnostics. The present day system of the optimal procedure of screening to identify women colonized with GBS and the procedure of the intrapartal antibiotic prophylaxis are also mentioned in the theoretical part. The objective of the practical part is to find the percentage of newborn infants delivered by mothers colonized with GBS who are also colonized with GBS despite their mothers having been treated by the intrapart antibiotic prophylaxis. The hypothesis I assumes that the intrapart antibiotic prophylaxis was administered to women colonized with GBS more than 4 hours before delivery. The hypothesis II presumes that newborns of GBS positive mothers who had been administered the antibiotic prophylaxis at least 4 hours before delivery were not colonized with GBS. The quantitative research was used to verify or reject the hypotheses. It was carried out by the retrospective analysis of medical records of women who gave birth between 1 June 2006 and 8 August 2007 at the maternity hospital in České Budejovice and had been colonized with GBS. The purpose of this thesis is to evaluate the antibiotic prophylaxis carried out in the maternity hospital in České Budejovice and to introduce the conclusions into practice and training.
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