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The treatment of pain in patients in terminal stage on the ward of follow-up care from the nurse point of a view
KUNEŠOVÁ, Martina
This bachelor's thesis is focused on chronic pain in dying patients at the aftercare department. The theoretical part focused on chronic pain description and its division, chronic pain treatment possibilities, characterization of a terminal stage and work done by nurses at the aftercare department. This part is supposed to present the most important information concerning chronic pain in dying patients. The practical part provides results of a gualitative research. This research had four objectives. The first objective was to identify the benefits of nursing care provided to dying patients with chronic pain in palliative care. The second objective focused on the attitude of nurses towards the patients in the terminal stage. The third objective was to identify the nursing methods used during the provision of care to a patient with pain in palliative care. The fourth objective was to assess the knowledge of nurses working at the aftercare department regarding the up-to-date treatment of pain in palliative care. Four research questions were established based on these four goals: What is the benefit of nursing care in treatment of pain in palliative care? What is the attitude of nurses towards the patients in the terminal stage? Which new nursing methods possibilities can palliative care provide to patients with pain? What information on treatment of pain in palliative care do nurses have? The research was performed using an in-depth structured interview, which is a method of the gualitative research. The research samlpe consisted of eight practice nurses working at the Aftercare Department in Nemocnice České Budějovice a. s. The interview was aimed at information on benefits of nursing care, the attitude of nurses towards dying patients, nursing procedures used and also knowledge of the nurses working at the aftercare department. The interviews were recording in writing. The records were analysed and coded using an open coding method. Six categories were established as follows: Nursing care procedures in treatment of chronic pain in dying patients, Effectiveness of chronic pain treatment in dying patients, Benefits of nursing care, Attitude of nurses towards dying patients with chronic pain, Collaboration with families and Nurses' knowledge. It was found out during the research that the benefit of nursing care is enormous, the care brings satisfaction of patients, safety, communication, sufficient amount of information, ensuring of basic needs, contact, information on current changes in the state of health, offer of better care, psychological support, better collaboration between nurse and a patient and a family, and also promixity of personnel. Thereforte, I think it is possible to consider the nursing care to be very beneficial. Furthermore, the following attitudes of nurses towards the dying patients were discovered: Trust or distrust of nurses in ability to display pain, active interest by nurses, approach to patients and communication. The research also discovered the following nursing procedures used in treatment of chronic pain in dying patients: positioning, heat application, cold application, massages and refraining from needless manipulation. The knowledge of nurses regarding the current treatment of pain in palliative care contains extensive information on principles of analgesic and opiate administration, which are applied by the nurses working at the aftercare department. A practical output of this thesis is a handbook called Administration of Opiates and Usage of Intoxicants Record, which is intended for use by practice nurses.
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Problems of practical teaching of nurses from the perspective of students and nurses
VLČKOVÁ, Darina
The education of nurses, as well as other non-doctor medical workers, has seen significant changes in the course of the past twenty years. In compliance with current legislation, the studies of general nurses only take place at universities and colleges these days.The schooling of nurses consists of theoretical and practical education. Both of them mingle and supplement each other during the complete course of the studies. Theoretical part consists of general as well as special subjects which are followed by practical schooling. This takes place at and ambulatory, ward, one-day and home-based sanitary facilities.Three aims of dissertation were set at the beginning of the research. First was to find about factors which influence the cooperation of students and nurses during the practical session. Second was based on finding factors with influence on nurse's conduct of the practical session. The last aim was to find about factors which motivate and de-motivate students during the practical session.For the purpose of gaining the data, two groups were established. First was the group of seven female students studying the combined form of subject field ?general nurse? at ZSF JU, all of them having received medical education before. Second was the group of nurses working at České Budějovice Hospital, Inc. For the purpose of data collection, the qualitative method of inquiring through semi-standardized interviews was chosen. The answer to the question ? what factors most often influence the cooperation of students and nurses during the practical session? ? was defined by their cooperation, chiefly by the way of their mutual conduct. This was the essential factor pervading all areas of the research.The other important factor applies to the groups of five or more female students where nurses did not have enough time for the students. The other important question was: what influences nurses' conduct of the practical session? As the main positive influence, the interest of students to learn new things as well as their dilligence was cited. The main obstacle in this process, according to nurses, is the lack of time which is devoted to students in order to teach them or show them the aspects of the profession. Demands and challenges of the profession also contribute to the factor cited above. The last but not least factor is the negative influence of large group of students being part of the same shift at the department. And the factors that motivate students during the practical session? It is obvious that the key factor is the possibility to gain information and enough capacity to perform medical actions. At the same time, the students expect helpful and accomodating personnel possessing enough time and patience which should be devoted to them. On the contrary, the factors which de-motivate students are negative attitude and conduct of nurses at departments, too many students grouped into a shift and few opportunities to perform expert medical action. All interviews suggest that improvement could be accomplished through permanent presence of mentors or expert tutors from the faculty who would have enough time for students.It is suggested that data and information from research could be used at clinical facilities for the purpose of practical sessions. The persons responsible for practical sessions could use those data and information to make the practice and cooperation more effective. Information could be used as a base for seminar for shift nurses who get in touch with students on a daily basis. Furthermore, the outputs of research could serve as recommendations for students which could lead to their improvement. Above all, the research serves as a topic for reflection and insight into both worlds.
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Influence of accreditation on patient
KRASNIČANOVÁ, Lucie
Nowadays the accreditation of hospitals is very current topic. During the last years there has been a change in the way of life of society. Within the provided services, the number of patients seeking higher quality medical facilities with specialist care rises. The basic lead for patient is the information about accreditation of the medical facility. The accreditation of the hospital is guarantee for patient that procedures used in the hospital comply with the prescribed standards. Standardization of care provides a unified approach to the patient and leads to safer and higher quality care. Thesis objectives Objective 1: To find out how the selected hospitals introduce "Program of improving the quality and safety of the services provided in a hospital accredited (JCI)" Objective 2: To explore the impact of accreditation (JCI) on patient satisfaction and quality of feedback. Objective 3: To define the benefits of accreditation at the hospital with JCI against the facility without JCI from the patient's perspective. Research questions 1) How does patient perceive the level of care, its accessibility and continuity in the accredited facility? 2) How does patient perceive the complex care of team of trained personnel (doctors, nurses, educational nurses, nutritional therapists)? 3) How does patient evaluate the awareness about all care related to his/her health during hospitalization? 4) What difference in care is there for patient at the hospital with accreditation from the other facility without it? Methodology To obtain the necessary information, a qualitative research was carried out and the methods of questioning with the technique of semi-structured interview on a pre-prepared set of questions were used. A total of 6 patients hospitalized in Hospital Na Homolce were interviewed. The hospital management was informed about the research in writing. Results and Conclusion The interviews revealed that the patients were provided by nursing care according to general or functional method during the hospitalisation in JCI accredited hospital. The care was available according to the patients? needs in terms of time and organisation. In one case a bed wasn?t arranged. The situation was resolved by agreement of staff with the patient. An important part of patient admission to the accredited hospital was staff presentation to patients, which was done, except for one patient. Furthermore, all patients agreed that a physician in the department had attended them every day. The cooperation of the multidisciplinary team worked well according to the patients, they particularly appreciated the work of a psychologist. Patients saw differences in the care in the security measures and in terms of availability, the interviews revealed that two respondents had experienced a long waiting time to scheduled surgery at a hospital without accreditation. The patients evaluated positively the level of provided nursing care. The results of the survey show that most of patients were aware of the differences in provided care. There is surely an influence of education of the nurses in the communication with patients, when was found out that it is needed to develop the communication more. The output of this thesis is a proposal of practical seminar for nurses, which should contain basic information about an effective communication with the patient, particularly aimed to feedback.
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Problems of development of social infrustructure in Mongolia and South Korea
Zrníková, Pavla ; Adamcová, Lenka (advisor) ; Němcová, Ingeborg (referee)
ZRNÍKOVÁ, Pavla: Problems of development of social infrustructure in Mongolia and South Korea. [Bachelory work], University of Economics. Faculty of International Relations; Department of World Economy. Supervisor: doc. PhDr. Lenka Adamcová, CSc. Prague : Faculty of International Relations, Prague, 2009, p. The aim of this bachelor work is to compare problems of the development of social infrustructure in Mongolia and South Korea. The author focuses on the two most important spheres of social infrastructure -- health care and education. Majority of differences in development of education and health service in these two countries result from significantly dissimilar economic development that is responsible for poverty of Mongolian people as well as for mental illnesses of exhausted Koreans. The bachelory work is divided into three chapters. The first one is dedicated to Mongolia and its specific problems leading to education and health care of low quality. In the second part the author presents problems of health care and demanding education system in South Korea. The third and the last part compares the causes of malfunction of the social infrastructure in the two countries.
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Importance of Supervision for Health care professionals in Inpatient Hospitals.
CIKLEROVÁ, Monika
Abstract The theoretical part of this thesis focuses on health care issues related to the work of health care professionals in the context of a current legislation. In this part the work of health care professionals is linked to the ethical principles and pressures on the emotional, mental, physical and social levels. The work focuses on the possible symptoms of exhaustion and fatigue on these levels. The emphasis is put on a personal development and coping with emotions so the health care professional is able to provide his or her clients and patients with relevant support. Supervision also develops its potential as a system of control and improving the quality of the provided care. It also helps to achieve the necessary health care quality standards in all respects. This system of a complex support and care for an individual worker as well as team of professionals is rooted predominantly in the development of psychotherapy. In its empirical part this thesis deals with the reasons which prevent supervision to be fully accepted and generally adopted as a system of support for health care professionals. The research in the Regional Hospital in Příbram tries to find and identify possible barriers to the development of supervision and thus contribute to greater interest in its implementation. According to the research findings the main barriers involve inadequate experience and awareness of senior professionals about possibilities and purpose of supervision, their concerns about high financial expenses, the need to devote extra time to this method and last but not least the necessity to study and apply a large amount of professional methods and information to work. The last two mentioned criterions also reduce space which could health care professionals otherwise use for meeting their own needs and self -care. In terms of conditions supervision in health care institution would have to meet, the thesis comes to a conclusion that the possible supervisor should be well-informed about health care sector or experienced in own medical practice. In this respect he or she would be authentic and trustworthy for the supervised health care staff. This thesis also finds out that hospital management strongly supports supervision but so far has not recorded any interest in its implementation among the employees. However, findings of the survey aimed at health care professionals from the selected hospital departments show that more than 50% of respondents regard supervision in health care as needed. The specific need of support for health care professionals is found predominantly in inadequate recognition and appreciation of their work and in the feeling that their work does not bring them joy. In this respect the respondents to a large extent described somatic problems such as frequent headaches, difficulties in digestion and breathing and sleep disorders. According to the research there are good conditions for implementation supervision in a health care institution. However, first it is necessary to ensure that both hospital management and health care professionals are provided with good and sufficient information. The goal of this thesis is to support implementation of supervision among health care professionals in inpatient wards. It is intended for the health care professionals as well as for hospital management. Its aim is to promote the idea that only a person who is healthy, self confident and meets his/her own needs is able to cure well and help others.
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Designing mass modification of client contact records and theirs consolidation within financial institution
Převrátil, Martin ; Kunstová, Renáta (advisor) ; Jeřábek, František (referee)
This master thesis deals with management request towards informatics department within front company that provides wide range of financial services. Demand refers to client contact data, particularly correspondence addresses and calls for possibility to mass change such records. There are several relatively separated tasks which need to be discussed in order to fulfill the request. First part introduces the company and analyze current situation. Then continue by describing correspondence addresses issue and supports with reasons for the inevitable change. Company's information system architecture is outlined with emphasis on central database that is being formed. This part also further describes options how data can be stored. Middle part contains reason--based choice where correspondence records should be maintained in company's data architecture. Implementation plan with chosen storage pattern is formed here and connected changes in system are highlighted. As a last processes connected to correspondence addresses mass modification are described and drawn with selected notation. After that user graphic interface is designed as a place where the self request will be served.
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Burnout
Newaldová, Monika ; Mellanová, Alena (advisor) ; Pečenková, Jaroslava (referee) ; Rybářová, Marie (referee)
Key words: burnout, stress, medical personnel, pedagogic personnel, burnout prevention Baccalaureate thesis deals with burnout of medical and pedagogic personnel. It refers to symptoms, incidence and prevention of burnout and compares burnout incidence among both the groups, respectively. Thesis is divided in theoretic and experimental part. Surveyed sample is formed by pedagogic personnel, medical personnel of district nurse, psychiatric department nurse and remedial gymnast. Stress is put on the accompanying signs and factors of the burnout.
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Study of the novel phtalocyanines for the vascular-targeted photodynamic therapy of tumors
Brázdová, Petra ; Macháček, Miloslav (advisor) ; Šimůnek, Tomáš (referee)
Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biochemical Sciences Candidate: Petra Brázdová Supervisor: Mgr. Miloslav Macháček Title of diploma thesis: Study of the novel phthalocyanines for the vascular-targeted photodynamic therapy of tumors Cancer is one of the leading causes of death in developed countries, therefore a big effort is devoted on research of novel anticancer drugs. Photodynamic therapy (PDT) is currently a well-established method in this area, but targeting its effect on tumor vasculature has not been considered until recently. In comparison with PDT, vascular-targeted photodynamic therapy (VTP) takes the advantage of a much shorter interval between administration of the photosensitizer (PS) and irradiation (drug-light interval) and thus turning the effect of cytotoxic agents to tumor vasculature. It is intended to disrupt the oxygen and nutrients supply to malignant cells and thus cause their damage and death. Aim of this work is to evaluate the efficacy of newly synthesized PSs from the group of phthalocyanines and azaphthalocyanines using the VTP protocol under in vitro conditions. The PSs used in this study have been investigated recently with classical PDT protocol, in which they have demonstrated very promising activity against tumor cells...
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