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St. Michael's Hospice
Krmaš, Jan ; Kalivoda, Tomáš (referee) ; Kalousek, Lubor (advisor)
The topic of the master thesis is new medico-social facility hospice St. Michaela. The purpose of the object is the maximizing of improvement in the quality of life of dying, severely ill and incurable patients, with the use of palliative care. The construction follows the Complex of Regional Hospital Náchod. Together with as a retirement home Náchod completes a support network of health and social care. The building is designed as a four-building storey and is partially embedded into the sloping terrain. Floors are divided into individual facilities and together constitute a functional unit. In the basement is the technical room, warehouses, garages and kitchen facilities. On the ground floor are then socio-public rooms and facilities. On the second floor is located hedmaster of hospice and accommodation area. The third floor is devoted to the accommodation area. The proposed structure made of brick longitudinal system, supplemented by concrete basement walls. The horizontal structure is made of filigree ceiling panels. Stairs are designed as a precast concrete and steel. Individual roof structures is made from unwalkable, walkable and vegetation compositions. The cladding consists of ventilated facade of glass and wooden panels. Foundations are designed from the lineal foundation.
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The Meaning and Availability of Care and Support for the Dying and their Families
VODIČKOVÁ, Jana
This work concerns with dying issues, with the last stage of life. My aim was to establish the biggest problems of the dying people, what they face at this stage of life at the state of such a big physical and mental strain, and afterwards even their caring cognates who provide their help and care. In the first part are described terms which are related to these issues. The second part considers qualitative survey, through this survey I would like to find out the sense of needs and information concerning the help for a dying person and his family.
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Issue of death and dying through eyes of workers in hospice facilities
PLIČŽKOVÁ, Iva
The theoretical part of the bachelor thesis describes the basic theme of death and dying in order to support the practical part as best as possible. The first chapter covers the topic of death and dying in general. Besides the basic definitions it contains the phases of dying according to Kübler-Ross, the topic of suffering in human life and the taboo of death. An inseparable part of the thesis is an excursion into the history of the perception of death. The end of the first chapter deals with the current state of dying in the Czech Republic. The second chapter deals with palliative care and the hospice movement. The chapter provides a basic division, mission and goals, and of course the topic of euthanasia is also mentioned here. The last chapter briefly describes the burnout syndrome among helping professions including hospice workers. The practical part begins by defining the goal of this thesis. The goal of this thesis is as follows: To map the opinions and attitudes of helping workers in hospices in context to their perception of death suffering and the factors that influence them. To achieve this goal four research questions have been established and subsequently answered during the research. Because of the nature of the thesis the qualitative research method has been chosen. Both individual and group semi-structured interviews have been chosen as the methods for gathering data. The communicational partners for the research were 11 hospice workers from the Jihočeský and Vysočina regions. Three areas emerged from the interviews: The reason for choosing this thesis in the palliative area; the perception of death, dying and suffering, and the prevention of the burnout syndrome. The reasons why somebody would choose to work in a hospice are very varied. The mentioned reasons included the experience of losing a loved one, coincidences when looking for work or transfers from hospital workers. As a clear positive the respondents mentioned a great difference between the quality of service offered by hospices against the quality offered by hospitals. In regards to the respondents opinions on death, most of the respondents consider death as a natural part of life, the possibility of an afterlife has however also been mentioned. A death of a young person or a child is a notable stress factor for all of the respondents. The most complicated area was the purpose of suffering where the respondents gave no clear answer. In regards to euthanasia the majority of the respondents were against legalizing it, mostly because of the quality and expanding palliative care. Another topic covered by the interviews was the presence of the child when someone is dying, the taboo of death or the influence of religion on working in this field. The last part of the practical part dealt with the strategies the workers in palliative care use to deal with work related stress and how do they prevent being burnout. Teambuilding had a positive feedback. The individual methods of preventing burnout then included nature, culture, talking to friends and especially strictly separating personal life and work.
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Euthanasia as a conflict of ethical and legal principles
KRŠÍKOVÁ, Hana
The diploma thesis deals with the problem of euthanasia, especially with its legal and ethical aspects. The legal aspects are discussed with respect to human rights, to the legislative system of the European countries that legalized euthanasia, and to the potential dangers connected with the legalization of mercy killing. The chapters considering ethical aspects draw on essential ethical values and their application in the connection with euthanasia. A particular ethical theory, utilitarianism, is briefly described, and attention i also given to the current development of the social consciousness from the moral concern to the emphasis on efficiency. The discussion of both legal and ethical aspects involves the opinions of the supporters as well as the opponents of euthanasia. In the conclusion the thesis refers to the possible conflict between the ethical and legal norms, which can be initiated by the legalization of euthanasia.
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Quality of life of dying persons
SÝKOROVÁ, Zuzana
The Bachelor thesis deals with the issue of subjective quality of life of people with terminal illness. It concentrates exclusively on individual determinants of quality of life. The thesis is divided into two parts theoretical and empirical. In the theoretical part the terms related to the issue are explained, i. e. history and development of the approach to the dying, health and disease, pain, needs of the dying, dying with dignity, palliative care, quality of life. The empirical part was carried out in the form of qualitative research. Data collection was based on the method of semistructured interviews with six respondents, the analysis follows the SEIQoL concept. The aim of the thesis is to learn the subjective quality of life of clients of palliative care.
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Palliative care in hospital and hospice
RAŠKOVÁ, Eva
This master thesis covers the palliative care in a hospice and a hospital. A lot of seriously ill patients suffering from incurable diagnoses die in hospitals. Therefore the nursing staff come into a close contact with patients near the end of their life.The nurses are in a close contact with the patients. The nurses sense emotions and suffering of dying patients. They sense also feelings of patients in case when improper cure and treatment are applied. Taking care of dying patients is stressing situation. The care covers not only the patient himself but it also includes the communication with the patients´ family and later the bereaved families.The hospital environment is primarily targeted to acute care. The palliative care is at the periphery. In The Czech Republic the palliative care is emerging in hospices mainly. That is the reason why the hospices may serve as a source of inspiration for improvements of the palliative care in other medical institutions.The first part of the theory section describes the main principles of a palliative care. The next part deals with mutual relations between the dying patient, the disease, between the nurse and the family and relatives of the dying patient. The last part deals with the ethical problems in the dying patients nursing, describes the environment where the palliative care is provided and researches the palliative care standards. There are three main goals of the work. The first goal is to compare the level of palliative care standards in different types of medical institutions. The second goal is to evaluate the possibility of providing of the palliative care in the different types of the medical institutions. The third goal is to suggest possibility of the hospital palliative care improvements according to results of the surveys.In the research part an analysis of written documents was performed. The quantitaive part of the research used an anonymous survey. We created two surveys to perform the research. The first survey was targeted to the nursing management and their view of the palliative care provided in the different types of medical institutions.The survey was distributed to 238 relevant medical institutions by electronic means. It consists 6 questions. 3 of them were closed questions, remaining 3 were semiclosed. The survey was opened by 78 respondents of different institutions. 26 respondents took part and finished the survey. According to answers of 26 nursing managers 18 of them agreed to cooperate further and participate in more detailed survey targeted on the nurses who work directly with patients and provide the palliative care. The second survey consisted of 26 questions and 13 of them were closed and 13 semiclosed. The survey was finished by 150 respondents from different medical institutions: hospitals, long term care hospitals and hospices. The data of the both surveys were statistically evaluated.We established 4 hypothesis. H1: The presence of palliative standard depends on the type of medical institution. The hypothesis is valid. H2: The palliative care standards are focused mainly on the basic physical needs providing and less to the spiritual and psycho-social needs providing. The hypothesis was not sufficiently proven. H3: The possibility to provide palliative care by nursing staff depends on the type of medical institution. The hypothesis is valid. H4: From the point of view of nursing staff the palliative care providing depends on the environmental conditions. The answers of the nursing staff take us to the conclusion that the environment influences providing the palliative care. The results of the research shows, that the palliative standards in the medical institutions exist. The standards are focused mainly on providing basic physical needs. There is an evidence that the quality palliative care can be provided in case when the conditions are adequate.
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Euthanasia in Europe since the World War II. to the present
PTÁČKOVÁ, Lucie
The aim of the thesis is to describe the historical development of society opinion on euthanasia including comparison of euthanasia during the 2nd World War and the present. Introduction of the thesis focuses on definition of terms associated with euthanasia and assisted suicide. It also describes the influence of racist theories which in the era of National Socialism ultimately resulted to genocide. The thesis also deals with terms such as racial hygiene, palliative care and the emergence of eugenics as a means to ensure suitable and healthy genotype. Influence of psychiatry as a scientific discipline, which was in the beginning of the euthanasia evolution, is also important. The main part of the thesis is to describe the creation and implementation cases of euthanasia in Nazi Germany, including its ideological context. Next part contains description of the development of society as a whole discussion of euthanasia in the post-war years until the first cases of assisted suicide was revealed in the United States in the 80s. The thesis tries to describe in detail the developments of legalization of euthanasia, including the latest information, such as the chapter on the Swiss clinic Dignitas assisted suicide. This work tries to answer the question whether there is no theory of evolution called slippery slope in comparison of social attitudes to euthanasia at the time of Nazism and presents. This could be mainly due to a decline of moral values of society, which results to people behaviour that can be once viewed as a purpose of negotiation on euthanasia. In conclusion there are results of comparison of possible scenarios, including further development of euthanasia.
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The motivation of nurses for working in hospices
NĚMCOVÁ, Hana
The thesis is divided into the theoretical and practical parts. The theoretical part deals with the hospice movement both in the world and in the Czech Republic. Hospice history, palliative care and the current state of hospice care are described in the individual chapters. The other topics of the thesis are the process of dying, the medical staff in a hospice, the role of nurses in palliative care and the motivation including the motivation of nurses. In the practical part there is the qualitative research by means of the method of questioning and the technique of semi-structured in-depth interviews with the nurses in Hospic sv. Lazara in Plzeň (Saint Lazare Hospice in Pilsen).
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Palliative care nursing vs. Student of Faculty of Health and Social Studies
LUDAČKOVÁ, Helena
This bachelor thesis deals with the issues of palliative care in relation to students of the Faculty of Health and Social Studies, namely to students of the programme General Nurse and Nursing. The thesis intentionally does not detail specialized palliative care, the problems of hospices and further specialized facilities. Here the palliative care works well and a lot has been written about that. Nevertheless most of the students take their practical placements at hospital wards or are employed in hospitals. This is why the thesis mostly deals with general palliative care, which should be a part of every healthcare facility. Actually in the Czech Republic, like in other European countries, an acute hospital is the most frequent place of death (60%). In long-term care hospitals the percentage is 9%. The theoretical part deals with the world and Czech history of palliative care and its development up to these days. It briefly describes both the levels of palliative care, general and specialized, as they are recommended nowadays. The thesis also mentions competences of nurses in palliative care and some specific problems and needs of incurably ill patients. These needs are divided into physical, psychical, social and spiritual although they are sometimes strongly linked. The thesis had two goals. The first goal was to map the awareness of palliative care among students; the other goal was to find out what experience the students have with palliative care and what kind of feelings this topic evokes in them. Quantitative research was used in the research part, an anonymous questionnaire was chosen as the data collection technique. The respondents answered 30 questions. 12 questions were closed, 9 questions were open and 9 semi-closed. Students of the first to third years of the bachelor programme General Nurse, Nursing branch from full-time and combined courses, and students of master programme of Nursing, specialization Nursing in Selected Clinical Fields, also from both course types of both years were addressed.
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Opinions of some Experts on Euthanasia
ŠTĚRBOVÁ, Lada
The theme of this bachelor's thesis is euthanasia. This theme is very complicated and attends mankind practically since its genesis. Euthanasia has been rather often discussed in mass media lately. From time to time, a scanadalous case appears and divides the society. There was a recent case of Eluana Englar from Italy or Terri Schiav. Of course, these are not only isolated cases in the world but is their solution right or moral? The point of view really matters here. For example, in the case of Eluana Englar, the Italian prime minister's opinion on the patient's death was absolutely different from the Italian president's verdict. The president, on the contrary, enforced her death, at the request of Eluana's husband. There are many terminally ill and dying patients in the world. Their right to the free decision has already been respected in some countries. The acceptance of some forms of euthanasia is passionately discussed in some other countries. The Czech Republic is one of such countries. There was an enourmous discussion about the legalisation of euthanasia in the Czech Republic in 2008. Václava Domšová, a Czech senator, introduced a bill to legalise euthanasia in the Czech Republic before Czech parliament. Her bill was not passed then, but I suppose, it will not last long and this bill will be introduced by someone else. The issue of euthanasia disconcerts perhaps everybody in all civilized countries in the world. Euthanasia law was already passed in the Netherlands, Belgium, Switzerland, the state of Washinghton and Oregon. The pro-euthanasia movement, as well as the anti-euthanasia movement are active almost in all countries in the world. Both the opponents and supporters of euthanasia have their own arguments. These arguments, together with opinions of doctors, sociologists, politicians an are mentioned in this thesis. The thesis presents arguments for and against the legalisation of euthanasia. For example, the right to patients' free decision speaks in favour of euthanasia. Proponents of euthanasia rights claim, that everyone has a right to decide about their health and life. For that reason, it is necessary to respect their wish. Another argument mentions lasting pain during the terminal stage of a disease, as well as suffering of a dying patient. Some specialists' articles claim, that euthanasia is commonly performed in our country nowadays, but only on the basis of doctors' decision. Therefore, it is necessary to legalise euthanasia law, which would specify application rules of a reguest for euthanasia. These rules should specify the conditions for euthanasia applicants. The applicants must be terminally ill, in the terminal stage of a disease and must suffer from lasting pains. They must apply in written and repeatedly. The application should be notarially authentic and filed in patient's health record. The application should also be revocable. A medical commission should examine the application and declare, if the patient complies with all the given requirements. The decision about euthanasia should also include the psychiatrist's opinion. The arguments against the legalisation of euthanasia express the possiblity of misuse euthanasia against the aged and the sick. They refer to the Dutch model, in which provably not only people with unbearable pains die. Also lives of the patients who suffer more mentally than physically are ended there. Another argument speaks about the success of lenitive medicine in the field of pain supression. The development of this medical discipline could mean a large shift in the issue of euthanasia. According to specialists, if a patient doesn't feel pain, he or she never requests for euthanasia. Another argument mentions the influence of patient's health and mental state on his or her decision. The main symptom of people in depression is their desire to die.
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