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Systematic evaluation of quality of palliative care in the Czech Republic
Žáčková, Lucie ; Loučka, Martin (advisor) ; Vosečková, Alena (referee) ; Dobríková, Patricia (referee)
In both the social work and health sector, there is an increasing emphasis on monitoring and improving the quality of care and services provided. In both areas, quality standards are already established in wider practice and attention is therefore focused on monitoring the quality of services and care at a system level. However, this requires the availability of appropriate tools. This also applies to palliative care, which is developing rapidly in the Czech Republic and whose need will continue to increase as a result of the prolongation of life expectancy. The theoretical part of this dissertation shows, through the example of palliative care, the deeper interconnection of the social and health spheres. It occurs thanks to its holistic approach to the patient and the irreplaceable role of social workers in a multidisciplinary team. There is also a growing demand in palliative care for systematic quality monitoring and improvement of care and services. The theoretical part summarizes knowledge regarding the development and use of quality indicators, presents examples of systematic quality measurement in palliative care abroad and compares their strengths and weaknesses. The empirical part deals with the creation and subsequent pilot implementation of a methodology for assessing the quality of...
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Preventing Terminal Hospitalization in Nursing Home for Older Adults
Pechová, Karolína ; Loučka, Martin (advisor) ; Kubalčíková, Kateřina (referee) ; Dobríková, Patricia (referee)
This dissertation deals with the topic of terminal hospitalizations of residents of nursing homes for older adults and was written within the framework of the doctoral study of Social Work at the Faculty of Humanities, Charles University. The aim of the thesis is to understand the factors that lead to terminal hospitalization of residents of nursing homes for older adults. The research design is mainly descriptive in nature and exploratory to a lesser extent. The thesis consists of peer-reviewed articles, three of which have been published in peer- reviewed journals, and a fourth is currently under review. The first article is a directed documentary analysis. It focuses on analyses of a public policy document for older adults, tracking how elements of palliative or end-of-life care are emerging in those documents in the 13 most rapidly aging populations. It provides insight into the system in which terminal hospitalizations are happening. The next two articles focus on terminal hospitalizations of nursing home residents. The second study is qualitative; the article summarizes the findings of an analysis of 27 semi-structured interviews conducted with general nurses, social workers in nursing homes and general practitioners who had their patients in nursing homes. The third article (under review)...
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Prognostic awareness in advanced cancer patients
Vlčková, Karolína ; Loučka, Martin (advisor) ; Světlák, Miroslav (referee) ; Vevera, Jan (referee)
Being aware of the severity of their medical condition is a key precondition for patients with advanced disease to be involved in advance care planning. This thesis aims to describe the phenomenon of prognostic awareness and identify factors that are related to prognostic awareness in patients with advanced cancer. The author of this dissertation thesis participated in a three-year project, which was supported by the Czech Science Foundation (IMPAC study, grant number 17-26722Y), which aims to map the preferences of patients with advanced disease and further describe factors related to prognostic awareness and assess its stability over time. The secondary goal was also to describe how patients with a serious diagnosis and their loved ones evaluate their participation in a research study. In the introductory chapter of this thesis, we describe the concept of prognostic awareness, methods of measuring it and the goals of this work. The dissertation thesis includes 4 publications that are focused on this topic and 1 publication that responds to the secondary goal of this dissertation thesis. The publications are followed by a discussion in which we deal with all our findings in the context of the latest evidence available on this topic. Our results prove that prognostic awareness is a complex...
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Degree of patient's privacy and intimacy
Vodvárková, Karolína ; Hemelík, Martin (advisor) ; Loučka, Martin (referee)
Bachelor work deals with preserving privacy and intimacy of patients while providing nursing care. The work consists of practical and theoretical section. In the theoretical part are defined terms as privacy, intimacy, human needs or comfort zones. It clarifies the rules of law and ethic standards, that are attached to this issue. Also deals with the role of nurse and patient and with their relation. Describes situations in nursing care, when the nurses interfere patient's privacy and brings examples of steps to protect them. The practical part is based on my research. With the help of combined method maps the matter of respecting privacy and intimacy from the patient's point of view on ODP and CHIR B in the ÚVN VFN in Prague. Describes certain situations and behaviour, that the respondents considered important. KEYWORDS: privacy, intimacy, right for privacy, nurse's ethic code, nursing care, decency, patient's opinion
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The Needs of Parents during End-of-Life Care for Terminally Ill Child
Poláková, Kristýna ; Loučka, Martin (advisor) ; Uhlíř, Marek (referee)
This thesis "The Needs of Parents during End-of-Life Care for Terminally Ill Child" deals with the needs of families in which a child had died from a serious illness. The main goal of this thesis is to map the needs of parents caring for a terminally ill child during the course of the illness, the time of dying, and after the death of the child. The thesis also analyses the source of risk factors occurring while parents cope with care provision. The theoretical part of this thesis focuses on the loss of a child. The opening chapter is devoted to paediatric palliative care, including an assessment of the current situation in the Czech Republic. Based on the available sources, grief theories are described. Furthermore, the effect of the death of a child on the family is mapped, including the impact on the parent's relationship and the way parents cope with their grief. The last section of this part covers the possible reactions of parents to their loss. The empirical part detects the needs of parents caring for a terminally ill child. It maps the mechanisms which help parents to cope when caring for their child or dealing with their loss. It also identifies the risk factors influencing on the ability to cope with the care provision. The data were collected using qualitative research techniques. The...
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Implementation of palliative care in hospital setting
Kovaříková, Julie ; Loučka, Martin (advisor) ; Uhlíř, Marek (referee)
This thesis deals with the implementation of palliative care in hospitals and perceives the topic in context of change management in health facilities. In the Czech Republic, this type of care is still at its beginning in hospitals and its implementation is a big challenge. The aim of the thesis is to find out what factors influence the implementation of palliative care in hospitals. In the first part of the text, the theoretical bases concerning palliative care and change management are outlined. The empirical part introduces a qualitative survey identifying barriers that had to be overcome during the implementation of palliative care in hospitals and factors that were instrumental in the implementation. Within the survey, 66 interviews with members of multidisciplinary teams from 17 hospitals were made. All the hospitals participated in the Together until the end programme of the Avast Foundation. The assessment of the survey results focuses on recommendations for hospitals that decide to extend or launch the palliative attitude in their premises and on challenges for the future of palliative care in the Czech Republic. The survey was carried out under the supervision of the Center for Palliative Care and it was used as the final assessment of the Together until the end programme that mapped the...
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Degree of patient's privacy and intimacy
Vodvárková, Karolína ; Hemelík, Martin (advisor) ; Loučka, Martin (referee)
Bachelor work deals with preserving privacy and intimacy of patients while providing nursing care. The work consists of practical and theoretical section. In the theoretical part are defined terms as privacy, intimacy, human needs or comfort zones. It clarifies the rules of law and ethic standards, that are attached to this issue. Also deals with the role of nurse and patient and with their relation. Describes situations in nursing care, when the nurses interfere patient's privacy and brings examples of steps to protect them. The practical part is based on my research. With the help of combined method maps the matter of respecting privacy and intimacy from the patient's point of view on ODP and CHIR B in the ÚVN VFN in Prague. Describes certain situations and behaviour, that the respondents considered important. KEYWORDS: privacy, intimacy, right for privacy, nurse's ethic code, nursing care, decency, patient's opinion
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Implementation of palliative care in hospital setting
Kovaříková, Julie ; Loučka, Martin (advisor) ; Uhlíř, Marek (referee)
This thesis deals with the implementation of palliative care in hospitals and perceives the topic in context of change management in health facilities. In the Czech Republic, this type of care is still at its beginning in hospitals and its implementation is a big challenge. The aim of the thesis is to find out what factors influence the implementation of palliative care in hospitals. In the first part of the text, the theoretical bases concerning palliative care and change management are outlined. The empirical part introduces a qualitative survey identifying barriers that had to be overcome during the implementation of palliative care in hospitals and factors that were instrumental in the implementation. Within the survey, 66 interviews with members of multidisciplinary teams from 17 hospitals were made. All the hospitals participated in the Together until the end programme of the Avast Foundation. The assessment of the survey results focuses on recommendations for hospitals that decide to extend or launch the palliative attitude in their premises and on challenges for the future of palliative care in the Czech Republic. The survey was carried out under the supervision of the Center for Palliative Care and it was used as the final assessment of the Together until the end programme that mapped the...
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Supervision as a possible support for hospice employees
Pižlová, Martina ; Tollarová, Blanka (advisor) ; Loučka, Martin (referee)
This dissertation originates in research project Potřeby a podpora pracovníků poskytujících paliativní péči v hospicích (FHS_P19_2014_068) (Paliative Hospices Care Staff Needs and Support) which was implemented in 2015. The dissertation deals with needs of hospices staff. These are derived from demands and requirements placed on the staff and correlate with their workload. I express management strategies and attitudes related to staff support. In the theoretical part of the dissertation I survey organization culture and ways and means of staff care. One of the care forms may be supervision. I focus on its possible form (shape) and supervisor's function. The empirical part of the dissertation is based on the research performed in two hospices. I focus on facility description and provided care. It is based on conversations with staff and management of these facilities. I try to depict the way management views the staff support, demanding situations they are exposed to and their idea of management support. Last but not least I focus on the supervision area, the way the staff perceives it, to what extent they see it as a contribution (benefit) and what do they expect of it. Powered by TCPDF (www.tcpdf.org)
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The first case of integration of specialized palliative care in nursing home for the elderly
Pochmanová, Karolína ; Tollarová, Blanka (advisor) ; Loučka, Martin (referee)
In my thesis I focus on integration of the palliative care in the retirement home describing it through the practical cooperation of two organisations - The Homecoming and Domov Sue Ryder. In the theoretical part I deal with the term of palliative care first, and I also introduce the specifications of the geriatric palliative care. In the subsequent part I describe the residential institutions of social care and professions that are employed in them, as well as, the multi-disciplinary team offering specialised palliative care. I also present the term of shared care existing abroad together with the foreign models of palliative care integration in the retirement homes already used in Austria and Great Britain. The conclusion of the theoretical part explores the actual project of palliative care integration called that is currently taking place in the Czech Republic. In the practical part I offer the description of an actual cooperation, for which I used the notes put down by the employees of The Homecoming after each visit; interviews with the employees of the Sur Ryder home and The Homecoming; a so-called timeline created for each shared care patient; experience from the meetings; my own experience from the meetings and educational activities; formal and informal discussions; guidelines and...
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