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Psychosocial problematics of dialysis patients
Majková, Anna ; Ondrušová, Jiřina (advisor) ; Válková, Monika (referee)
MAJKOVA, Anna. Psychosocial problematice of dialysis patients. Prague 2023. Bachelor thesis. Charles University in Prague. Faculty of Hussite Theology. Department of Psychosocial Sciences and Ethics. Thesis supervisor MUDr. Jirina Ondrusova, PhD. The bachelor thesis deals with psychosocial problems of dialysis patients. The theoretical part describes the function and failure of kidneys, treatment options for CKD - hemodialysis, peritoneal dialysis and transplantation. It also discusses the quality of life of dialysis patients, its dimensions, factors that influence it and its measurement. The fourth chapter describes the psychological and social aspects faced by CKD patients. The last chapter describes palliative care in CKD patients, its types, psychological and ethical aspects, and social work. In the practical part, I chose a qualitative method to collect data using a semi-structured interview. The aim is to describe the psychosocial issues of dialysis patients and to find out to what extent dialysis affects quality of life.
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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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Hospice Care in the Eyes of the Public
HAVLÍČKOVÁ, Hana
This bachelor thesis deals with the issue of hospice care. Its goal is to compare the perception of hospice care of those people who had some personal experience with it and those who have not dealt with it. Another goal is to find out how this experience affects their perspective of dying. To achieve these goals the quantitative research strategy has been used. The method of data collecting has been realized via questionnaires. The researching cohort consisted of individuals whose relatives used the services of sv. Jan N. Neumann Hospice in Prachatice and also of the individuals who have not used such services. 89 respondents have participated on these questionnaires. The hypotheses were tested by the contingency table, chi-squared test and the T-test. The results of the research have shown that the experience with hospice care affects the potential selection of hospice care for the respondent himself or for his relatives. It also affects the appropriateness of hospice care for the last days of a dying person, and it projects into the appraisal of deceasing in hospice. The experience with hospice care also affects the arrangements for death - those with no experience are more likely unprepared. On the other hand, the experience with hospice care has not affect the appraisal of deceasing at home as a proper place for dying. It does not even have an impact on whether the respondents think or talk about their own mortality. The experience with hospice care also does not affect their opinion about the necessity of increasing the support and the public awareness about this type of care. It also does not affect the amount of fear or anxiety about respondent's death. With the issue of awareness about hospice care those respondents who had previous experiences with hospice care proved more knowledge. Nevertheless, it is still necessary to encourage the public awareness about hospice care.
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Dying and Death in Nursing Homes from the Perspective of Social Workers
BALÍKOVÁ, Lucie
The aim of the bachelor's thesis was to find out what attitudes social workers in nursing homes take towards the dying and death of their clients and how social workers deal with the subject of dying and death. In practical part, the main research questions were answered: What attitude do social workers take to dying and death in nursing homes? What stress coping strategies are used by social workers in nursing homes when faced with the death of clients? A qualitative research strategy using semi-structured interviews has been chosen to achieve the objective. The research set consisted of a total of seven social workers of nursing homes on the territory of the South Bohemia Region. The research files were selected by random selection. An open-coding method was used to evaluate the data obtained. Research has shown that the attitude of social workers in nursing homes towards the dying and death of their clients has changed considerably since their careers began. It is clear from the research that social workers did not experience dying and death before taking up the practice, only in the family circle. It is therefore understandable that, for many of them, the death of their first client was a "shock." Social workers who have been involved in research have learned to work with this topic over time during their experience. Thanks to forms of help from organisations where they practice their profession, they no longer experience the stress associated with it. The most frequently listed forms were supervision, informal support and palliative care training. This Bachelor thesis can serve as information material not only for future and current social workers who encounter the subject of dying and death, but also for the general public.
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Communication in the Context of the Family System in Palliative Care from a Social Worker's Perspective - a Review of English Language Studies
ANDERSSONOVÁ, Tereza
Since the Czech literature does not describe the changes or the course of communication within the family in the situation of dying of one of their members, I realized this literature review in which I formulated the following objectives: 1) to identify the topics of communication in the English-language foreign literature, 2) to describe the content of the identified topics and 3) to draw possible implications for Czech palliative care and further research on this topic. To achieve the objectives, I used the methodology of a good enough literature review. Based on criteria indicating the focus of the thesis on communication in the family in the situation of dying of one of their members, I searched the EBSCO database for 492 articles. Of these, 37 articles were selected for review after the application of the inclusion criteria. The findings can be summarized by stating that despite the relatively small number of research studies, they describe both the areas and characteristics of communication, the factors and roles that influence communication, and the effects of such communication (reduced anxiety, depression, and less complicated grieving in the aftermath of a member's death). It is in this identification of themes and their content that the main contribution of the thesis lies. In particular, I consider the findings related to the chronemic pressure that emerges as the death became significant, with the influence of not only non-specific factors (the rules of communication in the family before the announcement of the fatal diagnosis), but also specific ones (such as cultural influences of the relationship to death, or pseudo-motherhood - the tendency to take over activity and control for the dying person, or fear/uncertainty about discussion related to spirituality). For palliative social work in the Czech Republic, the text may be particularly useful concerning the identified areas of communication as well as factors that may influence communication.
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Use of the diary of nursing care for patients in the terminal stage of the disease
STEHLÍKOVÁ, Eva
The bachelor thesis deals with the possibilities of using the diary of nursing care for patients in the terminal stage of the disease. This theoretical bachelor thesis is based on research of sources taken from Czech and foreign literature, including database sources. The work focuses on general palliative care and the terminal stage and is divided into several sections. The needs of a dying person are described in detail here, both biological, psychosocial, and spiritual. The work also focuses on the dying stages, according to Kübler-Ross, which are described here in detail. The central chapter focuses on palliative communication, which is of special importance. Medical staff, including nurses, are not trained in how to talk to the family of a dying or deceased person. The following sub-chapters are devoted to the central topic of using a nursing diary for terminally ill patients abroad. The creation of a nursing diary in various countries of the world is described here in detail, as well as its acceptance in practice. It also includes a description of the diary, how it looks in certain healthcare facilities, and its possibilities. The effect of using a diary in practice on the quality of care provided is also discussed. The data show that the diary was very beneficial, especially to the families of the patients who kept the nursing diary. The diary helped families to better come to terms with the death of a loved one during the grieving process. The author's view on the issue is described at the end of the work. In response to the data, a proposal for a nursing diary in the Czech version was created to contribute to the development of palliative nursing care within the Czech Republic.
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Use of assessment scales for palliative patients
SLÁDKOVÁ, Michaela
The thesis deals with evaluating scales used in palliative patients. Palliative care has become a quickly developing field of study. To ensure individualized high-quality care for palliative patients, it is important for the nurse to be able to work according to the latest nursing procedures, which include, among other things, work with evaluating scales. The aim of this bachelor thesis is to find out whether nurses use specific evaluating scales in palliative patients and in what way these evaluating scales are of use to a nurse taking care of a palliative patient. The theoretical part of this thesis helps the reader get a basic preview of the issue of evaluating scales in palliative care. First, the history and division of palliative care are described. Further, the way of how palliative care works in the Czech Republic is outlined, what roles nurses hold in palliative care as well as what needs patients in palliative care have. The second chapter deals with tools used for evaluating the needs of palliative patients. The empirical part of this thesis was carried out via a qualitative research survey. Processing was done using a semi-structured interview with 10 nurses at chosen hospice facilities. First, the nurses´ identification was carried out. The interview itself consisted of 14 open-ended questions organised so that research questions would get answered. Data found out via survey was further processed using the open-coding ´pen-and-paper´ method and dividided into 4 logical categories further divided into sub-categories. A difference was found out between nurses from mobile hospice care and bed hospices in terms of the type of evaluating scales used. Evaluating scales serve nurses as an indicator of care and a quick review of problems in palliative patients. Further, information obtained via evaluating scales is consulted with doctors who may, thanks to this information, adjust their patient´s healthcare plan.
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Ethical dilemmas in social work with the dying
KOHELOVÁ, Veronika
This thesis focuses on the ethical dilemmas that arise when accompanying terminally ill people. The solution of ethical problems must always be approached individually. We must always take into account the ethical principles of the patient and his/her family, and we must do everything possible to preserve the highest quality of human life. Furthermore, the thesis describes the benefits of palliative care in the dying process and the importance of listening to the needs of the patients.
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Palliative nursing care for a patient with pancreatic cancer
ŠAŠKOVÁ, Karolína
The bachelor's thesis, which is called Palliative nursing care for a patient with pancreatic cancer, is divided into two parts - for the theoretical and practical part. In the theoretical part, I deal with the definition of "palliative nursing care", its history, the difference between general and specialized palliative nursing care, the goals of palliative care are described, the role of the nurse is described, and the specifics of palliative nursing care are discussed. The second part of the theoretical part focuses on the definition of pancreatic cancer, etiology, risk factors, clinical picture, diagnosis and TNM classification. In the practical part of the bachelor's thesis, the results of qualitative research are presented, where I find answers to research questions that are important for the research goals. The aim of this work is to find out what are the specifics of nursing in the terminal stage, whether nurses make differences in nursing in certain stages of the disease, how they maintain mental health and whether they have the opportunity to fulfill the patient's spiritual wishes. The research is carried out through a semi-structured interview, which is conducted with the nurses of the internal medicine and oncology departments. The research shows that the specifics of palliative nursing care depend on the nurses' emotions, nursing care in certain stages of the disease is conditioned by the cooperation of the patient, and that mental hygiene is very important for nurses and its fulfillment is achieved through physical activities. Finally, it is found that the fulfillment of the patient's spiritual needs depends on the availability of the given need. This work provides readers with information regarding palliative nursing care for patients with pancreatic cancer in practice. It helps to understand the burden that nurses experience both psychologically and physically when caring for palliative patients. In addition, this information can offer nurses ideas and advice on maintaining mental health and possible changes in the approach to palliative care.
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The needs of callers to the emergency number 155 in the event of an acute deterioration of the condition of a patient with an advanced incurable, life-threatening or life-shortening disease
Brýdlová, Helena ; Bosá, Monika (advisor) ; Mertl, Jiří (referee)
The graduation thesis looks at the interconnection of parts of the health and social systems in areas that are linked by palliative care. The palliative care patient, and with them the informal carer, uses different trajectories through the health and social systems, looking for moments that are empowering or, conversely, limiting in good practice in the delivery of palliative care. The theoretical part looks at the different areas of the health and social care system, which should work very closely together and be intertwined, but it turns out that even the separate disciplines have their shortcomings, making it even more difficult to link these systems together. The aim of the theoretical part is to introduce the different segments in the social and health fields, with a link to palliative care. The aim of the empirical part was to investigate, through qualitative research, the reasons for relatives or close friends of the patient (i.e., informal caregivers) to call the emergency medical services (EMS) for their loved ones who were terminally ill, to identify their needs. The resulting findings led to two outcomes from a social and a health care perspective. From the social perspective, the importance of engaging communication and how information is delivered to informal caregivers and supporting...
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