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The biologic treatment of patiens with Inflammatory bowel diseases
BARTYZALOVÁ, Martina
The thesis titled Biological Therapy in Patients with Inflammatory Bowel Diseases deals with the needs of clients with Crohn's disease and ulcerative colitis prior and after biological therapy. The role of nurses in biological therapy centres, including the application of this therapy, was also investigated. Crohn's disease and ulcerative colitis are inflammatory bowel diseases. They are chronic inflammatory diseases of the gastrointestinal tract, which are accompanied by ample extraintestinal symptoms. This thesis also deals with biological therapy that involves the administration of highly effective substances of biological nature that inhibit specific sites of inflammatory reactions. This therapy is provided in centres of biological therapy and is used not only in gastroenterology but also in rheumatology and oncology. Teams of experts work in biological therapy centres; the task of these teams is to provide a comprehensive holistic health care. The thesis is divided into a theoretical part and an empirical part. The theoretical part focuses mainly on Crohn's disease, ulcerative colitis and biological therapy that helps patients suffering from these diseases. The methodological section employed qualitative research using in-depth semi-structured interviews with patients suffering from idiopathic inflammatory bowel diseases and with nurses who deal with these patients when applying biological therapy. Since head nurses from gastroenterology departments did not wish to record the interviews with a recorder, they were recorded in writing and transcribed subsequently. The questions dealt with the issues of biological therapy in connection with inflammatory bowel diseases. All the acquired data was processed with the Atlas.ti programme, which is designed for encoding, processing and interpretation of large amounts of textual and graphic qualitative data. Based on the research, an educational brochure for patients suffering from inflammatory bowel diseases was complied as well as educational materials for nurses starting work in biological therapy centres. Furthermore, the results can be used by nurses in practice and nursing students too.
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The problems of nursing care in children with stomia of small and large intestines
BARTYZALOVÁ, Martina
The bachelor thesis is aimed at the problematics of the children patiens with stomia. Stomia is the taking out of the small or large intestine out of the body. The most often indications with insomia is to remove the large intestine, inborn development defect and the necrotising enterocolitidis (NEC). The most often reasons for the by-passing with the colostomy are also the development defects and the Hirschsprung desease. Children with the stomia are few in the Czech Republic. They are mainly newly-borns or suckling infants, with whom stomia is tempoval. Children with this desease are usually taken care of by the parents in the home invironment. The parents are dependant on the assistance of a stomia nurse, which educates them and informs about everything connected with the illness. The goal of the bathelor thesis is to map the needs of the children with stomia of the small and large intestine and specify the needs of the nursing care. The work was also aimed at the task of the stomia nurses caring for the children with stomia. A qualitative research with the method of questioning was applied together with the discussion method with the parents of the sick children and the stomia nurses, who have already had experience with caring for the children with the stomia disease. All in all ten parents have been contacted, six of which have participated in the interview. Fourteen stomia nurses have been contacted, but due to little experience with treating the stomia children just three of them have been interviewed. The respondents came from various parts of the Czech Republic. As for the specifics of the nursing care we were interested in three aspects of the nursing care. The first sphere was skin care, where it was found out that the parents of the children with ileostomy should pay special care to the skin in the place around stomia. It is caused by the fact that ileostomy takes out watery and agressive substance, which causes skin damage in the place of stomia. Another important fact was that the patents use common children cosmetics, which is considered to be absolutely unsuitable for the children with stomia. It is also important to mention that due to a wide choise of stomia amendments the nursing care is on a much higher level than before. As for catering it was found out that newly-borns and suckling infants should be breast feaded and with the ileostomics the stool should be was thickened by adding rice puding without milk. The third sphere was evacuation. Childer with stomia evacuate in a specific way with the help of bags and systems. It was found out that the most suitable system for children with stomia was the simple one. The other goal was to map the needs of stomia children. From the research it was found out that stomia has a negative effect on the quality of life of both the children and their parents. Stomia affects the life socially but mainly mentally. As for the mental aspects it was found out that the services of psychiatrists are not used. It is also supported by the fact that just one parent out of six uses consultations with the stomia nurse regularly, who should be their main support. It was also found out that every child cried while stomia was treated. From the social side it was found out that children with stomia can be isolated from other children at kindergartens and schools. Stomia also restricts children when doing sport and other activities. As for the fysiological needs, they have already been mentioned in the specifics of the nursing care. The last goal was to find out what role in treating children stomia the stomia nurse plays. It was found out that the education of the stomia nurse is very important for the parents of the children with stomia but their opinions do not coincide. Some nurses say that they educate the parents before and after the operation, but we have found out that it was not true. Very few parents were educated before and after the operation.
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