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The influence of physiotherapy on improving general state of patients suffering from Multiple sclerosis
ČERVINSKÁ, Klára
The bachelor thesis summarizes present knowledge of the disease Multiple sclerosis and its ways of treatment. The aim of the thesis, is to build up a suitable complex physiotherapeutical treatment, which would have a positive effect on a general state of patients suffering from MS. The thesis consists of two parts. The first part is devoted to etiopathogenesis, symptoms of the illness, diagnostics, pharmacological therapy and the importace of rehabilitation treatment. The second experiential part contains a case study of two patients suffering from different forms of the illness. It describes their present health state, the course of the rehabilitation treatment and its evaluation. Furthermore performed examinations, medical history and a suggestion of a longterm rehabilitation treatment are also presented in this part. The research took place in the Multiple Sclerosis centre in Prague. The effect of the physical therapy was evaluated by measurement of physical condition and a kinesiological analysis. The thesis also involves a questionnaire in which the patients evaluate influence of physiotehrapy on their general state from their point of view. Rehabilitation has an effect on the state of patients particularly in correction of posture, breath stereotype and affecting balance. Physiotherapy helps the patients to influence some of the symptoms of the disease and therefore improve everyday-life activities. However the effect is only shortlasting. Consequently it is necessary to exercise on a long term basis and to adapt the therapy according to the progressive character of the disease.
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Nurse and Evaluating the Range of Neurosurgical Intensive Care Unit
Ševčíková, Sylvie ; Eislerová, Iva (advisor) ; Heczková, Jana (referee)
This diploma thesis investigates to what degree the evaluative and measuring techniques are used when assessing separate areas of condition of a neurosurgical patient in intensive care. The reason why I have chosen this topic was the increasing demands on nurses' performance and medical documentation as well. The rating scales method enables in a standard and proved way to assess the patient's condition and document the gained data. The rating scale, when used properly, can also make nurses' work easier. The first part of this diploma thesis focuses on definitions important to this topic. The second part is focused on processing scales used for the neurosurgical patient in intensive care. I have chosen the most used methods which are used for assessment of the patient's consciousness and the extent of sedation, assessment of severity of thrombophlebitis, pressure ulcer risk assessment, assessment of nutritional status, pain and fall risk assessment, evaluation of muscle strength and final evaluation of the patient's condition. In the practical part the anonymous questionnaire was used for investigation. There were 105 questionnaires from eight wards of three different hospitals evaluated. Key words: rating scale, neurosurgical patient, intensive care unit, risks to the patient, evaluation of the patient
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Experiance of the midwife in care of woman by childbirth of dead fetus.
ČERNÁ, Lenka
Intrauterine fetal death is a serious medical and nursing problem. Midwifes in the delivery room do not come across this diagnosis often, so the women in labour should be looked after by sufficiently experienced and educated midwives, who are well aware of the problem and are able to satisfy the needs of the woman in all its complexity. The theoretical part of the Study describes the causes of intrauterine fetal death, the symptoms, the complications, the diagnostical and therapeutical procedures. From the nursing point of view the Study focuses on midwives? care of the woman prior to the delivery, during labour, in the puerperium and in the subsequent ambulatory care. It also deals with the importance of farewell ritual with the child and with the psycho-social aspects of this problem. I have included a chapter on civil legal requirements that arise from this situation. The aim of this Study was to compare nursing care of women with stillbirth in selected maternity hospitals. I compare the midwives´ approach, ways and means of saying goodbye to the child and try to ascertain the level of awareness of the legal requirements relating to this situation amongst the midwives.Qualitative methodological approach was selected for the research. The investigation was conducted through semi-structured non-directive interviews. The results of the interviews were processed, analyzed and arranged into transparent schemes with a description. The research group consists of eight respondents from five different workplaces. The respondents were selected on the condition that they had been working in the delivery room and have experience with the care of a woman with stillbirth. Upon completing this research, the first research question could be answered. The nursing care of the woman with stillbirth is in all the facilities comparable. The midwife monitors the condition of the woman in labour and the course of the labour. All facilities make an effort to ensure the woman?s privacy, allow the partner?s presence and focus on good analgesia. Empathetic and sensitive approach to the woman is matter of course. The second research question was also answered. It was established that the farewell with the child is not facilitated in most of the monitored delivery rooms. At most workplaces the midwives do not actively offer the farewell with the child to the woman although they believe that this ritual bears great importance. The third research question can be answered that the midwives? awareness of the civil legal formalities in this area is not very high. Almost all respondents knew about the possibility to name and bury the stillborn child, but the midwives? knowledge about the maternity benefits and death allowance is not sufficient. The results of the research show that it is important to focus on improving the awareness of midwives in the care of a woman with stillbirth. The solution would be to organize a seminar on this topic. In the seminar, the midwives would acquaint themselves with the appropriate approach to the woman in labour, the possibilities of communication, about the importance of the farewell ritual with the child, the possible ways of this ritual and the information about the naming, burial and the maternity benefit. Another suitable method would be to create a training leaflet that would summarize the basic information related to this issue. This work could contribute to raising awareness amongst the midwives and thereby women in labour would receive not only professional care of their basic biological needs but also the adequate support in the psycho-social field. Midwives would become competent accompanying persons in this, for the woman very challenging time of life.
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Nutrition of patients in oncology departments
FOUSKOVÁ, Diana
The title of my bachelor thesis is Nutrition of Patients in Oncology Departments. In the theoretical part, I focused on the characteristics of malnutrition cancer, its symptoms, types of tumor malnutrition, its causes and consequences. Then I mentioned and described the various changes in metabolism of an oncology patient and a diagnosis of malnutrition. In the next part I described various types of nutritional support. In the theoretical part, I also focused on cancer therapy, where I described types of cancer treatment, various side effects of cancer therapy associated with intake of food and beverages and for every undesirable side effect I stated dietary recommendations. In the last part I mentioned risk factors and prevention of cancer. The goal of the practical part of my bachelor thesis was to determine the nutritional status of hospitalized patients in oncology departments in the context of anticancer therapy. I responded to three research questions: 1. "How does the antitumor therapy affect quality and quantity of consumed food?" 2. "How often must parenteral and enteral nutrition be applied to these patients?" 3. "How does the antitumor therapy affect the patient's weight?" The method quantitative and qualitative research was used for processing of the research part. The research was conducted by creating a week's records of diet, which were recorded by hospitalized patients in two departments of oncology. The research sample consisted of 50 oncology patients. Week's records of diet were recorded by 30 patients at University Hospital in Olomouc and by 20 patients at the University Hospital in Motol, Prague. The results were processed by Nutriservis software. Values of energy, protein, fat and carbohydrates calculated by Nutriservis software were compared with the recommended values corresponding with weight and age of the patient. I also examined the number of cases of parenteral and enteral nutrition and weight loss during cancer therapy by having records of the patient's weight at the beginning of anticancer treatments and their current weight. All patients were in the second half of anticancer treatment. I learned this information from patient documentation. To be allowed to have a look into the patient's documentation I prepared informed consent form, which I had consequently signed by the patients. The processed data are interpreted using tables and graphs, which are always accompanied by commentary. I have divided patients into groups according to diagnoses for evaluation. The results show that most patients have an inadequate intake of energy and essential nutrients. Food intake of patients has shown to be dependant on the type of tumor. Patients with carcinomas of the upper digestive tract, colon and carcinomas of liver, gall bladder and pancreas have larger deficiency of energy, proteins, fats and carbohydrates in comparison to patients with genital carcinomas. Patients with carcinomas of the kidney and urinary tract have also shown a significant deficit of energy, protein, fat and carbohydrates. The nutritional support was very common, particularly to patients to whom the tumor caused obstruction of some part of their digestive tract. As for carcinomas of the upper digestive tract, PEG is implemented to most patients. Very common was providing of sipping as an addition to their normal diet and in case of major nutrition complications parenteral nutrition was also often applied. The weight loss was apparent on most the patients. How significant was the weight loss depended on the type of tumor. Adequate intake of energy, nutrients and drinks during anticancer treatment is very important for patients. In the case of formation or developement of tumor malnutrition or developement of complications associated with food intake, nutritional support should be ensured timely according to patient's individual condition.
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Design of computer tomograph
Bojková, Eva ; Lehocký, Peter (referee) ; Zvonek, Miroslav (advisor)
The graduation thesis is engaged in the design of computed tomography (CT). It is a piece of medical equipment which helps to define the diagnosis of a patient. The first part of the project is a research into contemporary stage and production of CT systems. Consequently the new design of computed tomography is designed in a way to maximise ergonomical, technical and aesthetic quality.
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Nutritive and metabolic aspects at anorexia mentalis.
Vlčková, Magdaléna ; Hronek, Miloslav (advisor) ; Fikrová, Petra (referee)
The thesis deals with the problem of nutritional and metabolic aspects of anorexia nervosa. The general introduction, which consists of the definition of anorexia nervosa according to the International Classification of Diseases, and its characteristics by various authors, is followed by a chapter dedicated to the aetiology of anorexia nervosa, its pathogenesis, incidence, prevalence and therapy. The next chapter concentrates on a malnutrition: various ways of its division and the methods of telling the nutritional state of the patient. Individual methods are described and stratified; the rates which might indicate malnutrition and which may partly imply the anorexia nervosa. In relation to this, the thesis is also concerned with the problem of body energetics observation, especially the energy expenditure. Another chapter pays attention to the mechanisms influencing a food intake on the central level as well as on the peripheral level (hormones and mediators which inhibit or potentiate the food intake). The cardiac section describes the pathophysiology of individual organ systems in relation to the anorexia nervosa (what consequences arise from this disease, concerning the central nervous, cardiovascular, respiratory, excretory, gastrointestinal, endocrine and immune system. The following chapter...
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Precaution of catarct surgery complication: Intraoperative Floppy Iris Syndrome
Damdinragchaa, Selenge ; Ernest, Jan (advisor)
Billowing iris syndrome ( Intraoperative floppy iris syndrome , IFIS ) is a condition that predisposes to the formation of perioperative complications during surgery cataracts. The syndrome is characterized by insufficient mydriasis before surgery, constriction of the pupil during surgery , inability to extend her stretching, unusual elasticity of the pupillary margin and surging and billowing iris with tendencies to prolapse . The syndrome was first detected in 2005 patients treated for prostatic hyperplasia treated with α1 blocker tamsulosin ( Flomax , Omnic ) . Following a worldwide three-year research demonstrates that IFIS may be adversely effect and other α1 -blockers , such as antihypertensives , antipsychotics and antidepressants . It turns out that the best prevention of complications during cataract surgery field IFIS is especially well collected by pharmacological history ophthalmologist and close collaboration with urologists and other specialists. good awareness allows you to get time to select another operating procedure
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The Role of Nurse in the Prevention of Disease of Civilisation
PAVLOVÁ, Martina
The current state Prevention is a complex care of a patient when we are trying to prevent from the occurrence or development of a disease, or when we want to prevent from its consequences and mitigate them. Recommendations for prevention set by a doctor must be on a scientific basis, and they must be a part of all branches of medicine. Their effectiveness depends on the cooperation between patients and medical staff. The basic and most efficient method of prevention is the health promotion and health education, which is closely associated with it. The term health promotion involves a set of activities and precautions for the purpose of making health better and sustaining it. Diseases of civilisation (hereinafter "DoC") are groups of diseases which are distinguished by their association to our lifestyles. Human body is more and more threatened from unfavourable influences of external environment, such as the quality of atmosphere, work environment and environment itself, the lack of physical movement, unhealthy diet, smoking, and alcohol consumption. The list of diseases of civilisation varies and changes together with our society and the development of our lifestyles. Among the most common or frequent diseases of current time are cardiovascular diseases, which involve atherosclerosis, hypertension, myocardial infarction, stroke, coronary artery disease and obesity. Furthermore, between civilization diseases include diabetes mellitus type 2 or cancer, etc. The goal of the thesis There are two goals set for this paper. The first goal was to find out what the role of a nurse in the prevention of diseases of civilisation was. The second goal was to find out what the above mentioned role of a nurse was from the point of view of patients. Methodology For the purpose of the research part of this thesis, qualitative research using semistructured interviews was carried out. Respondents were divided into two groups; the first one consisted of eight nurses working at internal medicine and neurological department of the hospital in České Budějovice and a nurse working in a private office of a general practitioner for adult patients. The second group consisted of eight patients of the above mentioned health facilities. Results According to our findings, nurses and patients have different oppinions on the role of a nurse. Nurses in disease prevention see themselves as an equivalent to a doctor when undertaking this practice and giving guidance. The patient speaks only to the nurse who emphasized what they were told by the doctor and reiterated the main points. They make available to them leaflets and brochures or Internet resources. In contrast, most patients see a nurse as a more important source of information than the doctor. Patients have the feeling that the doctor does not have enough time or does not want to be botherd with questions. Rather the patient turns to his nurse, which they sees as more appropriate and someone to whom they can confide in without bothering. Summary The goal of the thesis was to focus on prevention, DoC, and the role of a nurse in the prevention of such diseases, as well as to study this issue, look at it from the point of view of patients and nurses via the interviews carried out in this paper, and to analyse such information. Based on this analysis are published recommendations for nurses and patients.
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Nutritional care about immobile patient on standard department of internal type
AMBLEROVÁ, Michaela
Nutritional care for immobile clients at a standard department of internal type becomes still more important, because nutritional care is important for maintaining good health and supporting quality of life. Nutritional status of immobile clients is very important to diagnose as early as possible in order to avoid all risks of potential complications. Adequate nutrition is also very important to maintain good mental health. The central objective of this work was to explore the specifics of nursing care in the field of nutritional care for immobile client at a standard department of internal type. Following this goal, three research questions were set up: How is the nutritional status of patients at a standard department of internal type assessed? What are the possibilities of application of nutrition for immobile client at a standard department of internal type? What are the specifics of nursing care in the fields of nutrition of immobile client at a standard department of internal type? The empirical part of the thesis was processed using qualitative research, which was realized through semi-structured interview technique. The interview contained 3134 questions, which focused on nutrition care for immobile clients on standard unit of internal type. The research sample consisted of nurses working in the standard department of internal type in the České Budějovice Hospital, a.s. Overall, this study leads to two findings, both positive and negative. Within the positive findings we can say that nurses provide adequate care in the application of nutrition per os. Negative findings relates to the fact that the interviewed nurses provide only basic care in case of the introduction of enteral and parenteral nutrition. They do not know more detailed specifics of enteral and parenteral nutrition. Based on this finding, we think it would be useful to organize regular seminars and trainings for nurses to expand their knowledge about this type of care, or at least remind it. This thesis can serve as an informational material for nurses in practice or students of other health professions. This work can serve also as a basis for further research.
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Role of the nurse in screening for depression in the elderly.
VRZALOVÁ, Monika
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.
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