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The need of confidence and safety at selected pediatric departments
ŠKRAŇKOVÁ, Jana
Hospitalization means a lot of changes for a child. A child does not feel well, is isolated from home, friends, and comes to a new unknown environment full of white coats, fear, and different illnesses. After coming to hospital, a child loses the feeling of safety and is afraid. Fulfilling the child´s needs of certainty and safety is crucial for the child´s healthy development that is why the thesis deals with this topic. The aim of the thesis is to map to what extend the needs of safety and certainty of children are fulfilled in chosen departments. The thesis aims to find out in what way the asked children adapt to the hospital environment and to map the nurses´ approach to the children in the context of fulfilling the needs of safety and certainty as well. In the theoretical part, classification of children´s needs is described and the needs of certainty and safety are characterized. This part deals with adaptation of a child to the hospital environment and cooperation with the family, the role of parents during child´s hospitalisation, and the issue of hospitalism. For the empirical part, qualitative research was chosen via a method of semi-structured interviews with hospitalized children and nurses. The research sample was created by 17 children of younger school age and 6 nurses in the same ratio from three children´s department of Motol University Hospital. When interviewing children, we were finding out how they feel at hospital, what they experience, if they have visitors, if they are not afraid, and how they are informed about the diagnosis, check-ups, and the length of hospitalization. We were interviewing nurses about ensuring the needs of certainty and safety, decreasing fear and pain, common hospitalization of parents and children, and preparation of children for check-ups. On the basis of the analysis of results, we made a conclusion that the needs of safety and certainty are fulfilled to a great extend at children. Children generally adapt to the hospital environment well. Nurses treat them with love and try to devote themselves to them, encourage them and substitute their parents if they are not hospitalized with them. We think, however, that they do no devote enough time to psychosocial anamnesis and that is why an adaptation questionnaire was created which will serve nurses after admitting a child to hospitalization.
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The need for security and safety in connection with a planned surgery with the patient's perspective and nurses
BOHDALOVÁ, Jaroslava
A planned operation performance always affects patient´s needs for assurance and safety. It is important to provide necessary information connected with the planned operation performance itself so that the patient can feel assure and safe. The key role for the patient and her/his needs for assurance and safety is in general nurse´s hands because she is the closest person to the patient and can help to inspire her/his needs for assurance and safety with konfidence best through the aid of her knowledge and skills that she should have as well as through the aid of her attitudes. The target of the thesis was to find out how a planned operation performance affects patient´s needs for assurance and safety and how a general nurse inspires patient´s needs for assurance and safety connected with a planned operation performance with confidence. The following research questions were stated: How does a planned operation performance affect patient´s needs for assurance and safety? How does a general nurse affect patient´s needs for assurance and safety connected with a planned operation performance to inspire her/him with confidence? What is insufficient in filling patient´s needs for assurance and safety before a planned operation performance? How can a general nurse help a patient control her/his fear and state of anxiety related to a planned operation performance? The method qualitative research with the use of depth interview was used to figure out the investigation. The respondents were willing to record the interview which were verbally rewritten and then subjected to the contents analysis by the method paper and pencil. From the research it is clear that a planned operation performance affects patient´s needs for assurance and safety in a negative way disregarding to her/his previous experience. Patient´s worries and negative feelings can be eliminated by a general nurse who treats her/him as equal, taking up an individual approach, informing her/him about all performances and proceedings, having a calming and welcoming way of communication, using empathy and listening as well as trying to meet patient´s wishes according to her possibilities. The research reveals the advantage of patients´ readiness for planned operation performances. Patients can learn it in the framework of educational proceeding in the out-patients´ department at the same time when they learn that they are going to be operated. The research also shows that general nurses do not have enough knowledge in the sphere of therapeutical communication. The results indicate that it would be suitable to start educating patients as soon as it is known how their disease will be solved and treated in order to reduce the negative impact of surgical treatment to patients´ needs for assurance and safety. General nurses should complete their knowledge and skills to be able to help patients to cope with their difficult life-situation. On the basis of the research investigation and after the consultation with the senior nursing officer, the training course will be organized. The topic of the training course will concentrate on communication with patients before planned operation performances with a view to therapeutical communications and therapeutical interviews. Other discovered facts, for example, the lack of information provided to patients and possibilities regarding better patients´ readiness for planned operation performances will surely be solved by the hospital management.
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Need of certainty and safeness at patients in gynecology and obstetrics
VEČEŘOVÁ, Jana
For security and safety, it is necessary to avoid risk and danger. They represent needs of trust, reliability, stability, freedom from fear, economical provision. It is necessary to divide need for security and safety in need of avoiding risk, preserving of health, trust, self-sufficiency, information and orientation, stimulations, property and possession accumulation, peace and tranquillity, hope and belief. Degree of feeling of security and safety affects the biological side of human organism. It is affecting functions of the individual organ systems by influencing the central nervous system. Insecurity works as a stressful factor and it affects the adaptation mechanism of the organism. Fear, anxiety, anger and grief belong among psychical reactions to dissatisfaction of safety need. Type and intensity of the reaction are always individual. The aim of this work was to find out, whether the needs of security and safety are satisfied for female patients in the gynaecological-maternity ward and which factors affect satisfaction of these needs. Two hypotheses were determined in the beginning. The first hypothesis says: Needs of security and safety of female patients in the gynaecological-maternity ward are satisfied. The second hypothesis was determined as follows: Approach of medical staff affects the satisfaction of needs of security and safety of female patients in the gynaecological-maternity ward. The first hypothesis was testified by the research {--} needs of security and safety of female patients in the gynaecological {--} maternity ward are satisfied. The second hypothesis was testified as well {--} the research proved that staff approach shares in the satisfaction of needs of security and safety. The research was realized by quantitative method by means of answer sheets, which I have chosen, because it enables to provide a huge number of empiric data in relatively short time period and also it enables for the questioned patients to be anonymous. The answer sheets were distributed in the standard wards: conservative gynaecology, peri-surgical gynaecology, risk gravidity and childbed in hospital České Budějovice a. s. during June in 2007. 86 filled-in answer sheets were processed in total. Work will be used within education at Jihočeská Univerzita and published in the internet.
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