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Pectoris angina as a symptom of acute myocardial infarction in urgent care
ŠVORC, Jaroslav
This dissertation deals with the topic of stenocardia as the symptom of an acute myocardial infarction in prehospital emergency care. The goal of my work is to map the time lag from the first symptoms of an acute myocardial infarction to giving an urgent non-hospital first aid. The introductory part summarizes basic terms of anatomy and physiology of the considered system. The theoretical part of my work includes an ischemic disease and the most frequent risk factors which patients bear. The theoretical part is mainly dedicated to an acute myocardial infarction, i.e. its origin, symptoms, diagnostics, and treatment. The final part deals with issues concerning education of a patient from a medical rescuer's point of view. My work also involves a research part including the file of patients with diagnosed acute myocardial infarction. I nave got the data using retrospective analysis of the outgoing cards of the patients of the Medical Rescue Service Team of Ústí Region, with diagnoses of an acute myocardial infarction. The data has been processed into a table from which other graphs and tables in research part result. It observes the time lag from the first symptoms of an acute myocardial infarction to calling for help and giving an urgent non-hospital first aid. I also follow the main symptoms of an acute myocardial infarction (pain, propagation of pain). The research part results into conclusion, that the majority of patients calls for Medical Rescue Service Team within 3 hours after appearing the first symptoms of stenocardia. The patients mainly call for help within 1 hour after the first problems appear in this 3 hours interval.
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Influence of chronic backache on everyday-life activities
TŮMOVÁ, Hana
Despite developing medical technology and pharmacology, the number of people suferring from back pains has been rising. Almost 80% of adult population experience the pains in their life time. Chronic back pain implies both physical and mental problems which strongly affect common activities of patients. Subsequently the back pain is reflected into the patient´s behaviour as a whole. The aim of this Bachelor´s work was to map common activities which are affected by chronic back pains and to find out any differences which can be noticed between men and women patients. There were two research questions developed: 1. Which common patients´ activities are affected by chronic back pains? 2. Do men and women patients with chronic back pains differ while dealing with common daily activities? The research was carried out through qualitative research technique of semi-structured interview. The research data required were collected from patients of the Hospital of Rudolf and Stefanie in Benešov from December 2009 to February 2010. Eight patients with chronic back pains were polled (4 men and 4 women), all of them after the spinal operation. The data obtained were presented casuistically and summarised into tables. The research goal was completed. Based on the research survey the following hypotheses were developed: H1: Chronic back pains affect common daily activities of patients after the spinal operation. H2: Chronic back pains after the spinal operation limit the patients when applying for jobs. H3: Chronic back pains affect leisure time activities of the patients. H4: Chronic back pains affect more women than men when they do their housework. H5: Women are trying to prevent back pains more often than men.
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Specifics of nursing care of a child patiens with oncological pain.
ČAŇKOVÁ, Helena
The topic of the thesis is: Specifics of nursing care of a child patient with oncologic pain. Children{\crq}s pain is a phenomenon surrounded by many myths and false information. It is also not sufficiently assessed and treated and often bagatelized by both nurses and doctors. Nurses play irreplaceable role in pain treatment, they are with the child patient more frequently then the doctor and are in close touch with the child{\crq}s parents. The care of a suffering child is a serious task in nursing. Treatment of a patient in pains requires a complex, holistic approach. Nurses, even if they diagnose pain properly, do not set an adequate nursing care plan and do not carry it out. Nurses have to defend interests of the sick child and must not let him/her suffer. The data was obtained by quantitative and qualitative research. The quantitative research was carried out by the technique of anonymous questionnaire. The questionnaire was made for the parents of children with oncologic disease. The qualitative research was carried out by the technique of semi-structured in-depth interview. The research sample consisted of nurses working at the Department of children{\crq}s oncology One of the aims of this thesis was to outline the problems in nursing care of a child patient with oncologic pain from the point of view of the parents. We observed if the parents had been informed about their child{\crq}s pain, if they know what symptoms they should watch in their child, if they know all the aspects of pain to be assessed and treatment methods to relieve the pain and also how nurses respond to their child{\crq}s pain. For this aim, a following hypothesis has been set forth: The parents of children patients with oncologic pain are educated about the possibilities of nursing care focused on relieving the pain. This hypothesis was confirmed by statistic testing. Another aim of this thesis was to find out the specifics of nursing care of a child patient with oncologic pain. Nurses think that the specifics of nursing care of a child patient with oncologic pain are not different from any other care of a child in pains. They just state that an oncologic disease is associated with pains caused by the disease itself or by diagnostic or therapeutic procedures. Therefore they consider a specific feature the fact that the pain is observed more intensively and the staff is more precise in relieving the pain. It is obvious from the research that it would be effective for both parties, both for the nurses and the parents, to use educational materials on pain intended for them. I suppose that if there were such materials available, the parents would not need to contact nurses repeatedly. There was also a positive finding in the research that 92.5% of parents stated that nurses respond to children{\crq}s pain within 10 minutes. Further, that nurses believe that the child has pains, which was stated by 98.2% of the parents.
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Cardiac surgery patient with surgical wound dehiscence
BENDULOVÁ, Adriana
Dehiscence or wound spacing is characterized by failure of wound healing and it is a very serious postoperative complication that occurs most frequently in patients who suffer from an associated disease. It usually develops between the fifth and ninth postoperative day. The cause of dehiscence is an infection in the wound, which is caused by proliferation of bacterial strains. The thesis on "Cardiac surgery patient with surgical wound dehiscence{\crqq} is focused on theoretical and practical parts. The theoretical part deals with the development of cardiac surgery and important personalities, medical indications for a cardiac surgery, cardiac surgery, surgical wound healing, surgical wound complications and nursing care of patients with dehiscence. The practical part was carried out by a quality - quantitative survey. The research sample for the qualitative research, which was conducted by the semi-structured interview technique with open questions, consisted of four cardiac surgery patients with wound dehiscence. The research sample for the quantitative research, which was carried out through anonymous questionnaires, consisted of 100 nurses working in cardiac surgery centers, Czech Republic, and 30 cardiac surgery patients with wound dehiscence. The results were processed into tables, graphs and diagrams. This work may serve as a resource for the interpretation of the subject matter or as a source of information for Cardiac Surgery Centers to improve the needs satisfaction in patients with wound dehiscence.
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Nurses´ care of patients with the epidural catheter.
BROŽOVÁ, Miroslava
The bachelor thesis research is focused on nursing care of patients with epidural catheter in cancer pain treatment from the perspective of nursing staff and patients. The pain accompanying this disease presents a serious problem. In recent years we have been witnessing the rising use of regional analgesia techniques with the potential to achieve cancer pain relief. This also has significantly improved the patient´s comfort and raised the standard of nursing care of patients with chronic pain. The thesis is divided into two parts, theoretical and practical. The objective of the thesis was to make a survey study on nursing care of cancer patients with epidural catheter and to determine the nurses´ knowledge of treatment principles in patients with epidural catheter. Another objective was to find out patients´ expectations after the epidural catheter introduction and to identify how the epidural catheter introduction affects patients with cancer pain. The practical research is based on data collection by using anonymous questionnaires. The questions were closed and half-open. The introductory questions had an identifying character, other questions were focused on specifics of nursing care. Qualitative survey was conducted by questioning, interview techniques. The respondents were oncological patients with epidural catheterization. The research was carried out in the health facilities mentioned below with the permission of the head nurse. The research sample consisted of six patients. Another sample for the research study consisted of nurses working in a standard department and in the outpatient pain department. 120 copies of questionnaires were distributed. The research sample was composed of nurses working in Motol Faculty Hospital, Rudolf and Stefanie Hospital in Benešov, Mulačovy Hospital Plzeň and Plzeň Faculty Hospital. The objective of the thesis is to confirm the hypothesis according to which nurses working in the outpatient pain department have better knowledge of nursing care of patients with epidural catheter than nurses working in standard departments. After the research conduction and evaluation, the hypothesis was confirmed. The objectives have been met.
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Bio-psycho-social preparation for pain during a diagnostic or terapeuty procedure for children.
KABELOVÁ, Alena
At a time of the increasing number of diagnostic and therapeutic interventions in children, it is important to respond to the presence of pain and to prepare children to this fact in the nursing care process. The aim of the thesis was to give a survey of preparation of children of selected age groups for the pre sence of pain during diagnostic and therapeutic procedures. The investigation was conducted quantitatively through a questionnaire survey in the period from February to March 2010. Questionnaires were addressed for nurses in paediatric departments. The outcomes of the research have shown that children are being prepared for the pain presence. Nurses use different methods of preparation. Children of all age categories are being prepared for pain presence.
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Standard of non-pharmacological relieve and evaluation of pain by newborn and suckling children
PAVLÁSKOVÁ, Ilona
The importance of this thesis lies in finding about the current state of pain assessment and palliation at neonatal and infant wards of selected hospitals, in finding out about the extent of use of standardized rating scales for pain, in identifying the obstacles in pain assessment and non-pharmacological pain palliation, and particularly in the development of a standard for pain assessment and pain palliation for neonatal and infant hospital wards.
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Role of a nurse in the care of patients with post-puncture cephalalgia after an operation in spinal anaesthesia
KŘIVKOVÁ, Jana
The objective of this diploma paper was to answer the question whether nursing for patients after an operation in spinal anaesthesia has any effects on the occurrence of post-puncture cephalalgia and on the satisfaction of patients with spinal anaesthesia. The paper is divided into two parts: a theoretical one and a practical research one. The theoretical part sums up the current knowledge of spinal anaesthesia; it provides anatomic and physiological aspects, possible complications and the importance of nursing in this type of anaesthesia. It deals with the syndrome of post-puncture cephalalgia in detail, the mechanism of its origin, typical symptoms, its treatment, and the importance of nursing for patients suffering from this syndrome. With regard to the importance of education in nursing jobs, one chapter of the theoretical part deals with education and educational process. The research part consists of qualitative as well as quantitative surveys. The research was carried out with a group of patients who were hospitalized at the surgical and gynaecological departments of Domažlická nemocnice a.s. (Domažlice Hospital Ltd.) and have undergone an operation in spinal anaesthesia. The quantitative survey was done using a questionnaire that contained 27 questions. Seventy-eight patients, selected at random, took part in this research stage. The objective of the qualitative survey was to find out the following: whether patients were aware of the aspects of spinal anaesthesia, whether they have experienced any complications in relation to the administration of spinal anaesthesia, how have they been informed, and what was their overall satisfaction with spinal anaesthesia. The qualitative part involved 10 patients who had been divided randomly into two groups: a group with ``standard{\crqq} education and a group with above-standard education using a purpose-made brochure. A semi-standardized interview, consisting of 18 questions, was carried of with each patient. The patients in the latter group were also asked additional questions aimed at the benefit of the informative brochure and the completeness of the presented information. The former group was asked whether they would be interested in a brochure focusing on spinal anaesthesia. Based on the results of this survey, the basic research question of the paper can be answered. Nursing does have positive effects on the occurrence of complications and on the satisfaction with spinal anaesthesia. A detailed result analysis shows that patients do not feel any subjective need to be educated by a nurse and they are not interested in the brochure. Most of the patients think they are informed sufficiently and they do not want more information. However, the results of the qualitative survey into the group educated by a nurse show a higher informedness about the method, lower occurrence of complications, higher satisfaction, better observance of recommended regimen measures, and highly reduced level of stress in relation to spinal anaesthesia. The educative brochure was accepted by the educated patients as beneficial and useful. Based on the above-listed results, the informative brochure, being an integral part of this paper, will be introduced as a standard education tool for patients undergoing an operation in spinal anaesthesia at Domažlická nemocnice a.s.
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Physiotherapy at treatment of chronic pain
VAŇKOVÁ, Denisa
The title of my bachelor thesis is "Physiotherapy at Chronic Pain Treatment". In my thesis I have focused on chronic back pain. Ambulatory practice indicates the above by general diagnosis as vertebral algic syndrome (VAS). First part of my work consists of processing of theoretical basis related to the problem. Main sections focus on pain, function of the spine, vertebral algic syndrome, spine examination methods, physiotherapeutic procedures and prevention of VAS origination. The research part of my work includes two case reports with diagnosis of chronic vertebral algic syndrome. The objective of the theoretical part of the work was to focus from the physiotherapist's view on most common causes of chronic pain, namely vertebral etiology. This part is also aimed at analyzing basic causes of VAS, processing of current information for diagnostic, therapeutic and preventive procedures related to VAS. The objective of practical part of the work was to find out, based on the case reports, whether the physiotherapy relieves the patient from pain. In the practical part of the thesis I applied the method of qualitative research, case study. The research was carried out in Malvazinky Rehabilitation Center and in Medicentrum Chodov. The tested set consisted of two probands diganosed with chronic vertebral algic syndrome. The diagnoses were given by the doctor treating the probands. Results have been prepared in the form of case reports. Both monitored patients showed a relief from pain and rehabilitation objectives set in advance have been met. Providing that the patients shall practise self-therapy and pay attention to measures preventing origination of problems. The thesis may serve as a theoretical document for medical science students. For physiotherapists it may serve as an inspiration when preparing rehabilitation plans for chronic back pain treatment.
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Health Related Quality of Life (HRQoL) in patients with phantom pain
BEŤÁKOVÁ, Zuzana
Health Related Quality of Life (HRQoL) in patients with phantom post-amputation pain Phantom pain is pain that relates to surgically or traumatically amputated parts of human body, usually already in its integrity. Pathophysiological mechanism allowing occurrence of phantom pain has not been discovered yet. It is a very complex, multifactorial phenomenon. In case phantom pain becomes a chronic disorder, it decreases subjecťs quality of life. The bachelorľs thesis titled "Health Related Quality of Life (HRQoL) in patients with phantom post-amputation pain" is divided into two parts. The theoretical part dwells on pain, its origins, types, ethics, and research done in the area of pain. The theoretical part also deals with amputation, origins, and help provided in social sphere of an individual. The last section of the theory is concerned with quality of life. The practical part introduces the objective of the thesis and defines hypotheses, which marks the actual beginning of the research. The chapter named "Methodology" provides a description of the research procedure and tools used in order to confirm or rule out the defined objective and hypotheses. The following chapter titled "Outcomes" comprises of graphs and tables showing resulting values and their verbal descriptions. Information collected in the research is confronted in the discussion. The aim of the thesis was to find out whether phantom pain influences quality of life in patients in case it develops within 1 month following the amputation or months after the amputation; and to observe whether younger subjects show better tolerance of phantom post-amputation pain. The data retrieved from selected subjects were collected by a method of interview. The objective was reached by using the method of standardized questionnaire SF-36 on Health Related Quality of Life, which focuses on 8 domains. In conclusion, the research showed that subjects over 65 years of age have better quality of life in domains SF - social function and P - Pain. In all 6 remaining domains, subjects under 65 years of age showed better quality of life. The research also came to the conclusion that if the pain starts 1 month and later from the amputation, such subjects show better quality of life in 7 out of 8 domains than subjects who start suffering from the pain within 1 month following the amputation. The only exception is the domain of SF - social function.
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