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The Nursing Care as an Instrument of Prevention of Complications in a Patient in Stroke Centre
HULÍNSKÁ, Silvie
In the diploma thesis called Nursing Care as a Complication Prevention Tool in the Patient Stroke Center, we dealt with various aspects of nursing care in the stroke center. The development of nursing research in the stroke center lags behind the development of rapidly growing medical knowledge. With the development of medical care, nursing care should respond flexibly. The research intent was to get comprehensive information on preventing complications in patients in the stroke center using nursing care. We have investigated the complications that may arise in patients with acute stroke and how they can be affected by nursing care. We have set three goals: to find out what stroke complications can be influenced in the acute phase by nursing care, to identify nursing activities by nurses in stroke centers to prevent complications and to identify obstacles and limits of preventive nursing care in the stroke center. These objectives correspond to five identified research questions. We were interested in the opinions of the staff on the provided nursing care and we also wanted to know the perception of the care provided by the patients themselves. We have tried to identify key nursing care sites, identify weaknesses and possible shortcomings, and have sought to find the basis for possible improvement in care. The qualitative research strategy was chosen to achieve the objectives of the thesis. The technique of data collection was an individual depth semi-structured interview with ten respondents. The interviews were subjected to qualitative analysis using the ATLAS.ti program. By coding, a total of 104 codes have been identified, grouped into 20 categories. We identified 18 complications that can occur with a stroke patient. For all these complications, we have found interventions to be prevented or alleviated. The results also show that nurses working in the stroke center should have specialized education for intensive care rather than college education. Specialized education in neurological issues, which nurses can acquire through post-graduate stroke seminars and exercises, is also suitable. We have identified systemic barriers to nursing care, including lack of material, lack of time and lack of staff. As obstacles on the part of nursing staff we have identified nursing indifference, poor mood, poor collaboration with the patient, hurried care, physical limitations (back pain, fatigue), lack of awareness, knowledge or skills and inadequate teamwork. As obstacles on the part of the patient we have evaluated speech disorders, perception disorder, unconsciousness, faulty adaptation, lack of cooperation, lack of understanding, distrust, negation, aggression, restlessness, disorientation, apathy, depression, overvaluation of own abilities, conflict with the patient's family. During the research, other interesting facts emerged that do not directly relate to the goals and research questions.
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Hippotherapy as a supporting therapy in patients with stroke
ČERVENÁ, Kateřina
This bachelor thesis deals with hippotherapy as supportive therapy of patients with stroke. Our starting platform is from the practical experience of therapists hippotherapy's centers Pirouette and available literature. The work is traditionally divided into theoretical and practical. The theoretical part provides an overview of current knowledge and is divided into two chapters, which dealing with the issue of stroke and hippotherapy. There are explained basic concepts necessary for insight into the problems of work. As part of subchapter about of stroke describing its dividing, the causes, consequences, and treatment. In hippotherapy I deal with the principles of hippotherapy effect and its impact to humans, both physically and mentally. In the research part describes the objectives of the work and the research itself. For the purposes of work I chose the design of qualitative research - a case study, which was carried out on three probands after a stroke. The probands were selected from the "Centre of hippotherapy Pirouette" Havlíčkův Brod, where it was from the end of September 2014 to mind January 2015 performed a practical application of hippotherapy under the expert guidance of a certified therapist. Data collection was conducted three complex processing of case studies using the technique of observation (kinesiology analysis of motor skills), secondary data analysis and interview with probands. The aim of this thesis is to map the effect of hippotherapy for patients with stroke and the develop specific hippotherapy's procedures in these patients. The purpose why the work was created, is an effort to improve awareness about hippotherapy as supporting methods for patients after stroke and objectification many years of practical experience hippotherapy's center "Pirouette". The outputs of this work can also be further utilized as educational material for students of physiotherapy and hipoterapeuty alone or as a basis for further research in this area.
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