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Problems of urostomy aids from the perspective of patients with urostomy and nurses.
FABINGEROVÁ, Dana
This diploma thesis investigates the issue of urostomy aids from the perspective of the patients with a urostomy and stoma nurse specialists. A urostomy is a surgical procedure which diverts the normal flow of urine from the kidneys and ureters into a specially created stoma. It is one of the techniques of solving urine derivation after the surgical removal of the bladder. The most common indications for this surgery is indisputably a malignant tumour of the urinary bladder. Creating a urostomy is the fundamental turning point and change in the patient´s life. The patient has to learn how to live with a urostomy not only from a physical point of view, but also from the perspective of its great psychological response significance. The right choice and correct use of urostomy aids is crucial for the patients with a urostomy and significantly affects quality of their life. Given these circumstances, the patient with a urostomy should be provided with wide range of urostomy aids. The thesis is divided into the theoretical and empirical part. The theoretical part is described in seven chapters. The empirical part of the thesis includes qualitative research. Data were collected from semi-structured interviews with the patients with a urostomy and stoma nurse specialists. For each group of respondents, several categories and subcategories were formed. These were further described in detail. The collected data were presented in diagrams. Three objectives were defined in the thesis. The first objective examined the level of patient´s knowledge of urostomy aids. The second objective investigated the patient´s possibilities concerning the use of urostomy aids. Based on the initial results of the research, the third objective focused on development of an educational plan specializing in urostomy aids and its verification in practice. This plan will be dedicated to the urostomy nurse specialists when working with the patients. Following these objectives, four research questions were formed. Research question no. 1: What is the level of patient´s knowledge of urostomy aids? Research question no. 2: What are the possibilities of the use of urostomy aids by the patients with a urostomy? Research question no. 3: What is the level of nurse´s knowledge of urostomy aids? Research question no. 4: How the urostomy nurse specialists educate the patients with a urostomy? The results of the qualitative survey demonstrate that the level of patient´s knowledge of urostomy aids is insufficient, despite the contrary opinion provided by the stoma care nurses. Lack of their knowledge is however not related to their contact with the stoma nurse specialist. The results did not confirm that the patients with a urostomy frequenting stoma nurse specialists for regular checks would be better informed than those who do not follow the regular checks. Furthermore, the survey reveals that possibilities of the use of urostomy aids by the patients are very limited. Stoma nurse specialists do not introduce urostomy aids supplied by all companies on our market to the patients and thus they do not provide an option for individual choice of these aids. This situation occurs despite the fact that stoma nurse specialists demonstrated a very good knowledge of urostomy aids. The results of this investigation also confirm that the education carried out by stoma nurse specialists is acceptable and understandable for the patients with a urostomy. The proof is demonstrated by their satisfaction with this education. The outcome of this thesis focuses on the educational plan designated for stoma nurse specialists caring for the patients with a urostomy. The given educational plan was developed based on the results of the research and is particularly focused on the presentation of all available urostomy aids within the postoperative education.
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Inform the patient before transurethral resection of the bladder from the perspective of the patient and nurse.
FABINGEROVÁ, Dana
The subject of following bachelor essay is Patient´s Notification - giving information - before transurethral resection of urinary bladder from both - patient´s and nurse´s point of view. As the incidence of malignant diseases not only of urinal tract keeps growing, this topic is becoming more and more pressing. The patient´s education and sharing of information with him is an integral part of daily routine of nursing staff. Satisfactory knowledge contributes to contentment of the patient and thus to successful healing process. In Czech republic bladder tumours account for every 6.malingant disease by men and for every 13.such disease by women. One of the methods used for treating superficial tumours is transurethral resection of the bladder combined with regular cytoscopic dispensarization of the patient. The bachelor essay consists of two parts - theoretical and empirical. The theoretical part deals with nursing care of patients who are subjects of transurethral resection of the bladder because of bladder tumour. It describes in detail the attributes of malignant disease of a bladder, it´s symptoms, treatment, precautions and prognosis. The surgical method of treating superficial bladder tumours (transurethral resection of the bladder) as well as cytoscopic examination of the bladder is thoroughly explained also in this part of the essay. Apart from that the theoretical part pays attention to pre- and post-surgery nursing care of patients indicated to above mentioned treatment. Next chapter talks about giving information to patients, educating them and about knowledgeable consent from a patient before surgery. Five goals were set up for this work. First, to map a range of information, given by urology nurses to the patient, before transurethral resection of the bladder. Second, to find out the most used form of giving such information. Third, to discover how satisfied were the patients with the information. Fourth , to find differences in the content of the information advised to the patient before the first and before any repeated surgery. Fifth goal was to distinguish the variances in the way the patients were satisfied with the information before the first and before any repeated surgery. Empiric part of the essay determines three hypothesis. According to the first hypothesis we presume that verbal notification is most often used for giving information to the patient before transurethral resection of the bladder. Second hypothesis says that those patients who are being prepared for repeated surgery are more satisfied with given information than those who hear such information for the first time. Third hypothesis lets us assume that the range of information given before first surgery is wider that before any repeated surgery. In order to verify each hypothesis a quantitative research was set up. It´s results confirmed first hypothesis, the second hypothesis was disproved. Third hypothesis was also not validated through the results of the research. For the research was chosen quantitative method of data collection from the patients as well as from the nurses, using anonymous questionnaires. These questionnaires were disposed to the patients indicated for transurethral resection of the bladder at Urology in hospital in České Budějovice and Písek. Graphs were created for presentation the results of above mentioned research. Discovered results are being compared in discussion with special bibliography. Presumed output of this bachelor essay was to expand - if needed - the content of knowledgeable consent from a patient before surgery that is given to every patient before transurethral resection of the bladder. As the results of our research clarified that almost 100% patients are fully satisfied with information given to them, we feel that it is pointless to expand the knowledgeable consent from a patient before surgery.
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