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Health and social issues in patients ventilated at home
FENEŠOVÁ, Lucia
An outstanding progress in pulmonary ventilation was documented recently when artificial pulmonary ventilation was introduced for home care. In-home pulmonary ventilation is meant for patients who suffer from serious progressive diseases. In most cases, such state is irreversible and obstructs patient`s ability to breathe consciously. Those patients benefit a lot from the newly introduced ventilation. It helps them live a regular life in natural background for a few more years. The target of the thesis was to identify the most frequent health and social issues in patients ventilated at home; to determine advantages of home care and possible risks in ventilated patients; and to elaborate a nursing standard to be followed when taking care of ventilated patients at their homes. The qualitative research was carried out by means of two half-structured interviews. One interview was made with 5 pre-selected nurses working for a home-care agency; the other interview was made in the same agency with 5 patients on artificial pulmonary ventilation that are looked after by the same agency. The outcome of the interviews is that the most frequent health problem in ventilated patients reported both by patients and nurses is obstruction of tracheostomic cannula. Another finding was that ventilated patients do not feel socially isolated which is in total contradiction to what the nurses claimed. The interviews taken with the patients showed that in-home care benefits mainly from the fact that the patients are at home, and the risk of receiving home care is that such care is dependant basically on one person and is time consuming. The objectives of the thesis have been met. The outcomes of the research will be made available to the company named Home health-care services Eva Šafránková, which was the venue of the research. The nursing standard can be used as a source of additional information for ventilated patients and to improve care provided to patients ventilated at their homes. It is recommended that nurses should further educate themselves in pulmonary ventilation. Training seems to be an appropriate solution in this case. Nurses would certainly also benefit from a visit to a place providing artificial pulmonary ventilation. Another recommendation is to carry out a follow-up research that would observe advantages of artificial pulmonary ventilation provided at home compared with benefits of artificial pulmonary ventilation provided in health care centres.
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Esential principles affecting quality provided by nursing care in nurses at home care agencies
RAJTMAJEROVÁ, Pavla
The name this work is The Basic Principles that Affect the Nursing Care of Nurses in the Home Care Agencies. Its target was to find out whether observing the basic principles of a complex home care can, according to nurses, affect the quality of the nursing care. The above principles are: a principle of the support of the society health renewal, a principle of human rights observance, a principle of procedure standardization, a principle of the continuous education of the team members, a principle of ethical aspects and a principle of complexness. Within this work we focused mainly on the last three principles. There is the history of the home care in the present state, its developement and forms of such care, the individual principles have been analysed and the most important ones have been described in detail. A non-standard questionnaire has been used for the research, intended for nurses in the home care agencies. It has been distributed mainly in South Bohemian region and a few questionnaires also in the West Bohemian region. The research showed that all the set hypotheses have been confirmed. The nurses agree that the continuous education, standards application and observation of ethical principles affect the quality of the nursing care. This work can be used as a basis for teaching the communal nursing in all types of communal institutions, which deal with such problems. Further it can serve as a source of interesting information for nurses, who start working in home care agencies. It can also be used for presentations in seminars or conferences for nurses.
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Consequences of population ageing on the development of its social and health needs.
PRYLOVÁ, Pavla
The main factors which influence these social and health facilities during the planning of social and health services are a demographic prognosis, the social structure of its inhabitants, the informal support and solidarity within the family, and also the geographic profile of the region, urbanization, human settlement and the extent of municipality. The planning of social and health services has to follow modern principles in social services which are widely used in Western Europe. The goal of this thesis is to undertake research in the capacity and quality of health and social services and the use of these services by seniors in the region. The next goal is to see if modern European principles are applied in the social and health services in the region. This research was carried out though the analysis of documents and methods of questioning. This research has shown that there is a lack of institutional social and health services in the region. Also modern European principles have not been applied in the social and health services.
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The influence of the client´s home environment on the quality of nursering care provided by a home care agency
VONEŠOVÁ, Petra
Home care in its full extent respects client`s integrity with his/her own social environment. The task of home care is to secure nursing care corresponding to client`s actual needs respecting his/her health condition. Home environment and presence of close people have an immediate impact on human psyche playing a significant role in the healing process. Absence of nosocomial infections is an advantage of providing a client with nursing care in his/her home environment; however, social environment being sometimes unsatisfactory, unwillingness to alter the home environment according to the actual needs and not following the healing regime can be a disadvantage. The aim of the thesis was to find out the way client`s home environment influences the quality of the nursing care provided by Agentura domácí péče (Home Care Agency). The research was carried out using the method of a qualitative research, by half-standardized interviewing nurses and clients of Agentura domácí péče. Five nurses working for Agentura domácí péče were the first research sample. Four clients being provided with the home care regularly several days per week for a period of several years were the other research sample. Clients` case reports were compůeted with observation of their own environment while interviewing.The research suggests that the quality of the provided nursing care is influenced by several factors {--} mainly by collaboration of the client and his/her family, by the condition of the home environment and by collaboration with the attending physician. Concerning the nurses, their theoretical knowledge and practical skills are of high importance. Two hypotheses were established based on the results. H1: In order to secure continuous home nursing care, collaboration with family is essential. H2: The quality of the nursing care provided by nurses of home care agency is influenced by the condition of the home environment.In conjunction with the research, specifications of home care were clarified and possible problems a nurse providing nursing care in the home environment can face were mapped.
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Guestion of nursing care in patiens with urinary catheter in their home environment {--} educational aktivity of nurses
JANÁKOVÁ, Šárka
This thesis focuses on patients with permanent urinary catheters, as well as on nurses who educate the patients when discharged from hospital to home care. The educating role of a nurse in this situation is particularly important. The nurses providing education to patients include those employed by hospitals, as well as by home care agencies and senior citizen homes. Not every patient is able to take care of the urinary catheter him/herself and therefore nurses from home care agencies are made available to assist. The nurses should educate the patients about all aspects of catheter application, e.g. the reason of application, complications (urinary infection, pull-out etc.), catheter maintenance (hygiene and aids, replacement of the collection bag etc.), catheter replacement (max. 21 days after the application), monitoring the urine color etc. The nurse should also ensure that the patient is educated in a quiet and agreeable place and, particularly, they should dedicate a sufficient time to each patient so that nothing is neglected. The first objective of this thesis was to find out whether nurses at the urology department educated patients with urinary catheters when they were discharged from hospital to home care. The second objective focused on nurses employed by home care agencies and senior citizens homes to check whether they got involved in education activities while taking care of patients with urinary catheters. The third objective was to find out whether patients with urinary catheters, when discharged from hospital to home care, were educated about how to take care of their urinary catheters. The objectives were assigned their individual hypotheses. The first hypothesis examined whether nurses employed at the urology department educated patients with urinary catheters about catheter replacement when the patients were discharged from hospital to home care. The hypothesis has been confirmed. The second hypothesis again focused on nurses employed at the urology department and investigated whether they educated clients with urinary catheters , when the patients were discharged from hospital to home care, about how to prevent urinary infections; the research has shown that the nurses indeed educated the patients in this field. The third hypothesis focused on nurses employed by home care agencies and senior citizens homes and investigated whether they educated clients with urinary catheters about how to prevent urinary infections. Also the third hypothesis has been confirmed. The fourth hypothesis concerned the patients and it investigated whether they felt informed about how to take care of their urinary catheters and whether they were able to recognize symptoms of urinary infections. It has been found out that although the patients are familiar with some symptoms of the infections, they are not familiar with all of them and therefore it is impossible to deem the hypothesis confirmed. The method used to meet the objectives of the quantitative research was that of anonymous questionnaires for nurses and patients. The questionnaire for nurses contained 21 questions and the questionnaire for patients contained 23 questions. The data were collected from March to May 2009. 100 questionnaires were distributed to nurses and 80 were returned, which means the response rate of 80 %. Out of 50 questionnaires distributed to patients 30 were returned, which means the response rate of 60 %. This thesis demonstrated that not all nurses provide a sufficient education in all aspects necessary for the patients. Also, not all the patients feel sufficiently educated in this field.
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Caring for Senior Citizens with Dementia
PRŮCHA, Vlastimil
The thesis deals with the manifestation and results of aging and old age from the point of view of the elderly and their experience of this stage of life and also from the viewpoint of the family and society around them. Further attention is drawn to the importance of the connection of health and social care for citizens with health problems, and the significance of social work in caring for senior citizens is emphasised. Other parts deal with the notion of dementia, with particular focus on Alzheimer{\crq}s disease. Basic problems are outlined which are connected with a citizen dealing with dementia and information is given which can help the family and all those who are involved in helping the patient. In the conclusion I evaluate the significance of permanent care and I consider the needs of non-institutional care and emphasise the importance of a caring family, humanity and understanding, which are important for the quality of life of those with dementia. This is the aim of my thesis.
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Providing of Home Care Services in Česká Lípa region after releasing patient from inpatient treatment
BUDNIKOVOVÁ, Eva
Abstract Ensuring of Respite Care Services in the Česká Lípa Region after Releasing of Patients from Hospital The goal of this thesis is to map the scope, the quality and further relationships of respite care in the Česká Lípa region in case of patients released from hospitals for whom a respite care is indicated, to find shortcomings of the systém and to propose optimal solutions of problems. There were two hypotheses set: H1: Sufficient respite care services are not provided to clients at weekends, H2: Consecutive respite care is not duly indicated by physicians to all clients released from hospitals who need it. The theoretical part of the thesis describes characteristics of respite care, its meaning and the process of ins development. The research was carried out trough the questioning method, using questionnaires and anasysis of documents. The other part of the thesis presents the results of performed quantitative research. These results were acquired by means of evaluation of questionnaires. The anasysis of acquired data confirmed both the supposed hypotheses. The discussion elucidates some problems related to the given theme and the conclusion of the thesis recommends some measures to improve the quality and continuity of providing the respite care services in the Česká Lípa region. The results of the thesis may inspire the existing as well as newly established respite care agencies to increase the quality of respite care.
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Knowledge of outsider public about services which is offer of home care agency
LENKOVÁ, Klára
Home care is a modern form of health and social care which has been provided in the Czech Republic since 1990. It is focused on persons who would be hospitalized if it were not for home care. The costs are fully covered by health insurance. Those who make use of this service are people of all ages, with various diagnoses and medical indications. Home care is focused mainly on health support and maintenance, health restoration and self-administration development, pain management of incurable patients and terminal care to ensure patients meeting their death fearless and reconciled. The objective of this thesis is to learn more about the public awareness of services provided by home care agencies. The other objective is to find out if nurses working for these agencies promote the home care service well enough. The data collection was carried out by the questionnaire method and the method of public inquiry. The first sample was a group of people living in the South Bohemian region aged 18 49 years. The second sample was a group of people living in the South Bohemian region aged over 50. These two groups were supposed to fill in the same type of a questionnaire. The third sample were nurses working in home care agencies in the South Bohemian region who were handed out inquiry sheets. The hypothesis I {--} the public are not informed enough about services provided by home care agencies {--} was confirmed. The hypothesis II {--} there are differencies in awareness of the public in relation to the age of respondents -was confirmed. The hypothesis III {--} nurses promote home care services only among their patients {--} was not confirmed. It is advisable to hospitalize patients only when it is inevitable. In other cases there is an option to make use of home care services. The aim of my thesis was to bring up a survey of services provided by home care agencies and give some suggestions for the awareness of the public to be enhanced.
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Handicapped Clients in Domestic Environments
PRŮCHOVÁ, Alice
This thesis deals with relationships with the physically disabled. In the context of national and international documentation. Lists of social care contributions and the social services offered to clients in the domestic environment are presented. Terms are explained regarding handicaps and systems of complete rehabilitation. The focus is on domestic care and its development towards a unification of offered services in the home. The quality of care in the home is praised. The conclusion summarizes all the presented remarks and theme of the thesis. The aim of the work is to present and clarify the concept of the disabled client in the home and present practical examples of carrying out this care.
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Community Care Senior Service Development in the Regional Charity Organization in Sušice in 2002-2006
BRUZLOVÁ, Ivana
My bachelor treatise deals with factors that will influence offering social services to seniors in future. One of the factors is the attitude of the society towards seniors, another one is readiness and ability of families to give care to their relatives. The last mentioned factor is the state support of creating acceptable conditions for the development of community care senior service. In the conclusion of my treatise I have described the development of community care senior service in the Regional Charity Organisation in Sušice in 2002-2006 as well as contributing affects.
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