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Foreknowledge of patients with total hip replacement at orthopedic department of Jinřichův Hradec hospital a.s.
DOUDOVÁ, Klára
Basic theoretical background: Because this thesis mainly deals with the awareness of clients, it was necessary in the beginning to mention the importance of the communication in a medical environment. Communication takes place between two or more people. During communication, people communicate necessary information, feelings, attitudes, talking about relationships and moods. There are several communication rules that one should follow, however, it depends on the individual, whether follow it or not. Communication skills can be developed gradually for they are important to us and in our personal lives. If a person loses the ability to communicate, it can lead to danger to his relationships with others. For healthcare professionals, it is very important social skill ( Mikuláštík 2003). Main aim of the thesis: To verify the information rate of clients in preoperative phase of total hip arthroplasty and in postoperative care. Discover also whether patients after total endoprosthesis have possibility of aftercare (rehabilitation, spa treatment). From these targets were developed following questions : In what areas are the clients in preoperative stage informed? How are clients reporting in a post-operative care ? What options of aftercare patients after total endoprosthesis have? Methodology: For the research was used the qualitative survey data collection. A qualitative investigation was approved by head nurse of the hospital, where the research has been done. The interviews was realized at home of clients. Survey was conducted through semi-structured interviews, interviews were anonymous. The data were collected in March 2015 in the set of seven respondents. Despite the fact that interviews were realized in the clients' home, we needed approval for the research from the head nurse. Especially because the subsequent care for patients after total prosthesis was also investigated. It was therefore important to identify initially the applicable patients in the hospital and up to a certain time after the surgery to interview them.
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Epidural catheter for orthopedic wards - the benefits for patients and nurses?
MAŠÁTOVÁ, Milada
Epidural analgesia causes a temporary cessation of nerve conduction via administration of low concentration of local anaesthesia, or opioid, into epidural space. The resulting temporary discontinuation of nerve conduction is called central neuroaxial anaesthesia and it facilitates the process of surgical intervention. An epidural catheter is usually inserted during epidural desensitisation. It helps to control the amount of administered anaesthesia and hence to respond to surgery progress, but it also enables to keep the catheter within the epidural space for the following postoperative analgesia, which will promote timely postoperative rehabilitation and pain management.The research project was conducted on basis of quantitative and qualitative investigation. The quantitative research was performed via questionnaires directed at the nursing staff, and the qualitative research took form of semi-structured interviews with patients. The quantitative investigation was conducted in fourteen health care facilities in the Czech Republic. Respondents of the quantitative research were nurses working in orthopaedic departments, multidisciplinary ICU or ARO (Anaesthesiology Resuscitation Dept.), who provided care to patients after TKR or THR with an epidural catheter insitu. Qualitative research respondents were patients hospitalised in orthopaedic departments for TKR or THR, with epidural catheter insitu and who agreed to participate at the interview. Quantitative research data were processed in Excel 2010 and presented in graphs, frequency and contingency tables, whereas the qualitative research data were processed using charts of the Smart Art program. After the agreement with the management of health care facilities, this dissertation will promote education and aid situation improvement. The Standard of Nursing Care Assisting a Patient with Epidural Catheter during Insertion and Care will be an outcome of this project. Moreover, we will design a patient information booklet and a quality of care indicator that will focus on monitoring of complications occurrence such as infections in patients with epidural catheter. The findings may help to design a training course specialised in nursing care provision to those patients and also to provide basis for further research.
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The importance of regular fitness activities before planned orthopedic surgery
KOTLABOVÁ, Sandra
The bachelor thesis deals with the influence of regular fitness activities before the scheduled orthopedic surgery. The thesis discusses the use of special methods of physiotherapy and physical therapy to help patients prepare for their surgery and post-operative rehabilitation. The most common scheduled orthopedic surgery in the Czech Republic is a total hip joint prosthesis, it is applied up to 10 000 refunds anually. The total hip joint prosthesis is followed by a less frequent knee joint prosthesis. Implementation of any suitably chosen fitness activity before the surgery may be very useful and desirable for the patient.The current knowledge of the anatomy and biomechanics of bearing joints of the lower limb - knee and hip is summarized in the theoretical part of the thesis. This part also describes the joint compensation in detail. After that, there is mentioned the development of compensations in the course of history, as well as the different types of prosthesis and inserted components. Last but not least, there are described surgical approaches of implantation of the compensation. The theoretical part also includes appropriate physiotherapeutic procedures and methods of physical therapy that can be applied in a pre-operative period. The aim of this thesis is to explore whether regular fitness activities applied before the surgery have an impact on the course of post-operative rehabilitation. The qualitative research method was used to achieve the objectives in the practical part. The collect the data there were used case reports, interview, observation and photographic documentation. Three patients participated in the research, all diagnosed with osteoarthritis of the joint, two of them of the hip joint and one of them of the knee joint. Not a single one of those patients was cured by the conservative treatment, so they all were recommended for surgical treatment consisting of the replacement of the damaged joint. At the first meeting the medical history and the kinesiological analysis were taken. After evaluating the input data, patients were acquainted with therapeutic method. The therapy continued for one month, three times a week. After ending the therapy, the output kinesiology analysis was taken. Each of the patients told her subjective opinion about the course of the therapy and the changes experienced after treatment. All data were recorded and subsequently evaluated. During the therapy local findings were threated at the first place. Specifically the limited joint mobility, swelling of soft tissues around the joints and shortened or weakened muscles. They were used sensomotor techniques that are suitable for correction of flat foot or hallux valgus. The stabilization techniques PNF and activation HSS were used to strengthen the entire trunk and to restore the stabilizing function of the diaphragm. This was followed by the strengthening of the upper limbs to prepare them for future walking on crutches. The last point after the treatment of local findings was the setting of the joint in proper movement stereotype. When the therapy was finished, patients reported a mild pain relief and greater stability of their limb and the entire body. The collected data show also an improvement of the muscle strength of damaged joints for at least half a degree The indicator of the progress is the comparison of the goniometric examination before and after the therapy. The joint mobility was incresed. Surgical procedures were carried out without any complications and subsequent rehabilitation was with no problem for our patiens.
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Possibilities of physiotherapy in patients with complications after total hip endoprosthesis in
FEREBAUEROVÁ, Martina
There is an increase of number of the total hip joint prosthesis arthroplasties in last years and also the patient age limit is falling down. This leads (for prosthesis determined lifetime) also to the increasing of the number of re-surgeries because of aseptic release. This kind of surgery is for patient more strenuous than primary surgery and so brings higher risks of the possible complications. Complications are not rare even after the primary surgery of the total hip joint prosthesis arthroplasy. Most frequented complication is higher mentioned aseptic release, which results from the organism reaction to the abrasive PE particles, which fall off the worn joint. Next highly frequented complication is the infection in the total prosthesis area, where the cause could be local or global. The next feared complication is the luxation of the prosthesis after total hip arthtroplasty. This luxation is very soring and the nerve damages are possible. The nerve damage is potential also due the surgery. Next complications: thrombosis embolism, different length of the limbs, active scar tissues, lymphedema, heterotopic ossification, periprosthetic fractures, mechanical damage of the artificial hip components. According to the time of complication occurrence may be complications sorted as: pre-surgery, early, late. Target of this work is mapping of the physiotherapeutic procedures used at the patients with the complications after the total hip joint prosthesis arthroplasty. Next target is the processing of casuistries and physiotherapeutic plan forming by chosen complications. As research array were chosen three probands with different complications. The first proband is patient after re-implatation of total hip joint arthroplasty because of infection, second proband is diagnosed different limb length, third is patient with the active scar tissue. Therapy has been treated by every single proband individually and was fitted individually according to patients diagnosis. Due whole therapy was the unit for comprehensive physical training and physiotherapeutic procedures set to contemporary probands condition. This consists of theoretic part and practical part. Theoretic part deals with topics as hip joint anatomy, hip joint aloplastic and complications, which could because of aloplastic occurred, re-implantation of total prosthesis athroplatsty and in meant problematic used physiotherapeutic procedures. The qualitative research was chosen for the practical part of work. Results are worked out as casuistries using the methods of interview, spectating, secondary data analysis and kinesiological testing. The physiotherapeutic plan design is based to initial kinesiological test. Therapy was treated according to this plan. The output kinesiological test was worked out in the end of therapy and after results evaluation was designed long-term physiotherapeutic plan. The therapy was treated 4-5 weeks to every patient. The results say that by all patients came improvement of the movement extent in the operated hip joint, also to the pain reduce or pain elimination, increasing of the muscle power and the walking stereotype. However, some of the pathological movement stereotypes and muscle shorting still remain or were just partially reduced. Altogether, with the total hip joint prosthesis arthroplasty patients with different complications are connected strong muscular dysbalances and disrupted stereotypes of movement and walking. These changes are caused by antalgic position in the joint. Shortly, if the hip joint is long-term affected, then will be the affect evinced on the global deportment.
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Quality of life in patients before and after total hip replacement
ŠIDÁKOVÁ, Alena
The objective of this thesis is to assess quality of life of patients before and after total hip replacement. To determine HRQoL {--} Health Related Quality of Life I used standardized questionnaire SF-36 which assesses eight basic qualities (domains) of life. This thesis has 2 parts: a theoretical part and a practical part. Anatomy of the hip, total hip replacement, quality of life in general and quality of life in chronic diseases are described in the theoretical part. The practical part was prepared using quantitative research, the technique of anonymous questionnaire SF-36. The respondents were clients of the orthopaedic outpatient clinic of hospital in Klatovy. The final sample comprised 18 women and 11 men. Results were recorded in electronically. The Department of Clinical Pharmacology of hospital in České Budějovice provided evaluation of the results. Data obtained about probands were compared with results of Oxford Healthy Life Survey and also with each other. The results were made into well-arranged graphs and charts. The structure of charts is uniform, the value from research and the value from Oxford (always 100%) are stated next to each other. Results obtained from the practical part can be used to supplement education materials which relate to this issue. The results are very encouraging. Quality of life after total hip replacement has improved. Especially in the domain of bodily pain (P) where the probands reached the results of 86.79%. The difference between Oxford {--} 100 % (healthy population) is therefore only 13.21 %. Probands achieved best result in domain General health perceptions (GHP) 141.38 %. Two hypotheses were stated in the introduction. Hypothesis 1 was: Quality of life of patients will improve after total hip replacement. Hypothesis 2 was: Consumption of analgesics will decrease after the surgery. Both hypotheses were confirmed. Obviously, the results in some domains will remain lower compared to healthy population but the overall quality of life of patients after total hip replacement has improved. The objective of the thesis was accomplished. Resources used are listed in the conclusion of the thesis. Appendix includes for example the questionnaire SF-36 or information leaflet with obtained data (pain reduction, improvement in certain domains of quality of life etc.) which will be used to educate patients in waiting rooms in outpatient clinics.
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Physiotherapy after total hip joint replacement
ŠUHÁJKOVÁ, Pavla
Pain in a hip joint can dramatically affect the chance of having active life. The recent years have seen a significant progress in the results achieved while implanting artificial hip joints. This type of operation is simultaneously becoming increasingly more often especially when we take into consideration the increasing age of population. Implanting total hip joint replacement results in improving the quality of life, which can only be achieved through interdisciplinary collaboration of doctors, complex rehabilitation treatment, and positive approach of the subject alone. The aim of this bachelor?s thesis was to process case reports of patients after total hip joint replacements and to put together rehabilitation plans for these subjects. With the established objective in mind, the author summarizes outcomes dealing with the issues relating to total hip joint replacement, physiotherapy, occupational therapy, and spa treatment following such operation. The research part of the bachelor?s thesis was accomplished by qualitative research. Data were collected by observing, interviewing and analysing documents. The data were gathered by individual in-depth interview and using case reports, which included author?s own observations, a draft of rehabilitation plan and implementation of the therapy, and subsequent outcomes from the assessment of therapy. The research corpus comprised of two patients who underwent a planned total hip joint replacement because they had been suffering from advanced primary coxarthrosis. The research was carried out at an in-patient orthopaedic department of the Hospital Pelhřimov in March 2011, when the subjects were being hospitalised. Quality and appropriately managed rehabilitation allows quicker improvement in the patient?s health following the operation. It is used as a prevention of complications, it improves engagement of functional potential in the operated joint and it consolidates appropriate motion stereotypes. The outcomes of the research confirm that such pre-operational and post-operational rehabilitation carried out during the stay in hospital leads to a decrease or complete removal of pain, an increase in joint?s mobility and muscular power, getting used to walking on flat surfaces and up and down staircases, and the level of independency in everyday activities.
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Effectiveness of early Physiotherapy After the Operation Total Acetabulofemoral Articulation
MALECHOVÁ, Kateřina
In the bachelor thesis called Effectiveness of an early physiotherapy after an operation of the total hip joint replacement, there are theoretical bases related to the given issue in the first part. In the research part there are worked up case studies of two clients who had the same disease, were operated in the orthopaedic ward at the Hospital of České Budějovice and a total hip joint endoprosthesis was made to them. The aim of the thesis is a complex evaluation of physiotherapy methodologies at the patients after an operation of the total hip joint endoprosthesis and an evaluation what could be improved in this issue, so that the postoperative rehabilitation could be a little more efficient. At each patient during the hospitalization were differences in the success of the therapy. In conclusion it is possible to say, that an important role in the effectiveness of the postoperative treatment is a completing of a preoperative rehabilitation. The patient, who completed the preoperative rehabilitation, better managed a verticalization, walking and self-sufficiency after the operation in contrary to the patient who did not complete the preoperative rehabilitation. The significant problem was that she would have had to commute for the preoperative rehabilitation and it was a problem for the patient. Patients waiting for the operation of the hip joint replacement are often constrained by a pain while walking and they are discouraged by a thought to commute to the preoperative rehabilitation. I propose to carry out the preoperative rehabilitation already during the hospitalization, several days before the operation. The thesis can serve as a theoretical study background for students from Medical universities or it can become, in terms of physiotherapy, an inspiration in a clinical practice at physiotherapists engaged in those issues.
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Osteoarthrosis large joints of legs in context of physiotherapy
KAŇKOVSKÁ, Martina
My Bachelor thesis' name is Ostheo-arthrosis large joints of legs in context of physiotherapy. I particularly dealt with problems of the origin, treatment and prevention of an ostheo-arthrosis. The first theoretical part contains theoretical basis which are associated with this illness. The main chapters are focused on an anatomic part, the definition of the terms gonarthrosis and coxarthrosis, causes, diagnose, treatment and prevention. The practical part includes two casuistries of patients after the operation of a total hinge substitute. The aim of the theoretical part was to inform about problems of ostheo-arthrosis and its prevention and confirmation of the physiotherapy influence during the follow-up development of the hinge functionality after the operation. The aim of the practical part was to find out on the basis of the casuistries if the physiotherapy treatment could help with improvement of a hinge moveabillity. The method of a qualitative research was used for the practical part. The research was made in the Hospital Jihlava at the sick-bed orthopaedic detachment. The tested set includes two cases of patients with diagnoses gonarthrosis and coxarthrosis. These diagnoses were made out by the attending physician of the patients. The results are processed in forms of casuistries. There was a real improvement in operated hinge moveability by both of the patients. My thesis could be useful as a theoretical basis for students of medical branches of universities. It could be useful for physiotherapists, as well. It could be an inspiration as a suggestion of rehabilitating plan for patients of these diagnoses.
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Providing the patient´s privacy after total hip replacement operation
RŮŽIČKOVÁ, Michaela
Abstract In our company the emphasis in the field of nursing care has increasingly been focused on preservation of a patient`s dignity and intimacy. In daily activities in a pacient the privacy and intimacy the patient may be affected which causes different reactions of such a patient. One might say that even after the routine procedure such as total hip replacement it is very important that the patient has enough privacy. The aims of this study were to assess how the intimacy in the postoperative care is ensured in patients undergoing total hip replacement at the intensive care units and to find out the level of knowledge of the nurses as for adherence to intimacy after total hip replacement. The research group consisted of patients who were hospitalized at the intensive care and standard units in the Hospital České Budějovice, a.s. (PLC), Faculty Hospital Olomouc and Military Hospital Olomouc. The second research group consisted of the nurses who worked at the intensive care and standard units in the Hospital České Budějovice, a.s. (PLC), the Hospital Šumperk, a.s., Faculty Hospital Olomouc and Military Hospital Olomouc. The research investigation was performed by the method using two ananymous questionnaires. The first defined hypothesis was confirmed. The patients at the intensive care units are more satisfield as for their intimacy compared to the patients at the standard units. The second hypothesis was also confirmed. The nurses have not enough time to ensure intimacy of the patient after total hip replacement. The third hypothesis was confirmed. The nurses have enough information of how to take care of the intimacy in the postoperative period. The fourth hypothesis was not confirmed. The nurses at the intensive care unit do not care about the intimacy with a higher interest compared to the nurses at the standard unit. The findings of this investigation show that the patients after total hip replacement at the intensive care unit are more satisfield with the provision of intimacy in the postoperative care compared to patients at the standard unit. Although the nurses do not have enough equipment to ensure the intimacy of a patient in the postoperative care, they know how to take care of intimacy in the postoperative care.
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The differencis of nurse treatment by Patients with TEP(total hip replecament) and with CCEP(cerviko capital replecament).
BUKÁČKOVÁ, Kristýna
This bachelor thesis focuses on the differences in nursing care of patients after TEP (total endoprosthesis) and after CCEP (cervical-capital endoprosthesis). The reason that led me to deal with this subject was the fact that I consider the knowledge of this matter as well as observing its principles by nurses for necessary. The objective of the thesis was to find out whether nurses know the difference in the nursing care of patients after TEP and CCEP, and whether they observe the differences in the nursing care. These objectives were fulfilled in the bachelor thesis. Two hypotheses were laid down. Hypothesis 1: Nurses know the difference in nursing care of patients after TEP and CCEP. Hypothesis 2: Nurses observe the difference in nursing care of patients after TEP and CCEP. The hypotheses were confirmed. The theoretical part of the thesis is focused on the anatomy and physiology of the hip bone and the historical development of endoprostheses. Further, the subject of the TEP and CCEP is dealt with here. It contains descriptions of the differences in the nursery care that nurses should put a lot of emphasis on and observe them. In the research part, the quantitative investigation by means of the questioning method, in the form of a questionnaire, and the qualitative research by means of the method of participating hidden observation, were chosen to verify the hypotheses. In practice, this thesis may be used in seminars, in which even the results of investigations may be dealt with, thus increasing the quality of the nursing care of patients after TEP (total endoprosthesis) and CCEP (cervical-capital endoprosthesis).
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