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Comparison of intercultural competences of nursing staff in the Czech Republic and German-speaking areas
TÝLEOVÁ, Tereza
The increasing migration of population in the 21 century causes development of multicultural societies. With the increasing number of foreigners in individual countries it is possible to also presume an increasing number of patients/clients from different cultures in medical facilities. These facts require modern attitude to nursing, developing of transcultural nursing, implementing multi- and transcultural education in the health care education and propagation of multicultural conception of nursing between the nursing personnel. The result of these necessary changes should be the ability to provide effective nursing care which is culturally adjusted to the patient/client that would also take their specifics, customs and traditions of their culture into account and that would saturate all their biological, psychological, social and spiritual needs according to their race, nationality or belief. This thesis deals with multicultural nursing and confronts cultural competence of the nursing staff in Czech Republic with that in German-speaking countries. This thesis aim is to state the level of multicultural competence of the nursing staff and explore conditions provided to the nursing personnel of the hospital for giving culturally adapted care to patients-foreigners. The results of the research give an overview of the state of culturally competent care in comparable medical facilities in Czech Republic, Germany, Austria and Switzerland. They will also give a feedback to the questioned hospitals. Such information may alert their management to possible lack of knowledge of their nursing personnel and help them direct its further education. The theoretical part of the theses defines the basic concepts regarding culture, ethnic groups, race or nation, formulates the difference between the terms "multicultural" and "transcultural" nursing, multicultural education and culturally competent care, compile the most common sections of specific cultural needs of the individuals. In short it also processes J. Campinha-Bacote's model of cultural competence in health care delivery, the Papadopoulos, Tilki and Taylor Model for developing cultural competence and the Purnell Model for cultural competence. It also shortly deals with nursing frameworks for acquiring cultural data, such as the Sunrise model from M. Leininger, the Giger and Davidhizar Transcultural assessment model and Bloch's ethnic/cultural assessment guide. The empirical part processes and evaluates data obtained during the quantitative research. The accumulation of the data was conducted through anonymous questionnaires that were distributed between the nursing personnel of internal and surgical wards of the hospitals in Czech Republic and in German-speaking countries. In Czech Republic these were hospitals in Prague and in Tábor, in Germany a hospital in Dortmund and one in Cottbus, in Austria the hospitals in Salzburg and in Weiz and in Switzerland a hospital in Aarau and one in St. Gallen. The collection of the data was conducted either on-line or by way of printed questionnaire forms. The acquired data were valorized and sorted into diagrams and tables for further clarity. From the respondent´s answers follows that the queried medical facilities in Czech Republic do not provide sufficient conditions for their workers to give culturally competent nursing care on such a level, as it is at the facilities questioned in the German-speaking areas. The results also show that language skills of the nursing personnel in these hospitals in Czech Republic are worse than those in the German-speaking countries. With the level of multicultural competence the situation is similar; in this field Czech nursing personnel does not match their foreign counterpart. It is necessary to remark that this research sample of two hospitals from each of the countries is insufficient for the results to be applied on the whole Czech Republic or German speaking countries.
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Lifestyle of patients with peripheral arterial disease before and after surgery
REZKOVÁ, Helena
Theoretical background: Peripheral arterial disease is a serious disease of Loir limb arteries which originates from atherosclerosis. The theoretical part deals with the lifestyle. There are mentioned basic risk factors of chronic forms. Further described are the pathophysiology changes generated on the basis of atherosclerosis and related causes for the origin of the disease. Subsequently there are explained methods of classification, developed clinical symptoms, diagnosis and therapy. This section also looks at the role of a nurse in the care of patients with peripheral arterial disease. Objectives: The aim of this work was to evaluate how patients with peripheral arterial disease changed their lifestyle after invasive vascular surgery. There were provided the following research questions: How do patients with peripheral arterial disease approach to the prevention of risk factors? What is in patients with peripheral arterial disease the main impuls for the possible change of their lifestyle? What influences surgery patient's attitude to risk factors for peripheral arterial disease? How crucial is a lifestyle change in patients after surgery for peripheral arterial disease? Methods: The theoretical part is processed using expert sources. The empirical part of the theses was processed using qualitative research. The chosen technique for data collection was semi-structured interviews with patients, with prepared open questions. The research was done in several phases - the first interview was conducted at the patient admission department (before surgery), followed by the next phase after three months, and 6 months after surgery. The interviews were recorded on a prepared form, then transcribed into electronic form and analyzed by open coding method. Results: The research showed that surgery can sometimes be triggered by changes in the patient's lifestyle. The first interviews in the preoperative period focused on how respondents felt, what was their lifestyle before surgery for atherosclerotic changes of the lower extremities. One of the questions was focused on patient knowledge about risk factors for the development of PAD and possible prevention. The second phase of interviews took place 3 months after the surgery. It dealt with the question about the respndents´ lifestyle, the respondents in the postoperative period, whether there were any changes. Some positive changes occurred in eating and there were some changes in doing physical activity. The third stage was carried out six months after surgery, again in order to detect changes in lifestyle. Minor changes came in smoking habits, the issue of diet and physical aktivity. Questions were also focused on the psychological level. We found out who helped patients and what was most motivating in implementing changes. In the conclusion/summing up question the patients marked themselves ow they managed to make a change. Conclusion: The number of patients with peripheral arterial disease and other cardiovascular diseases is increasing. The basis is the start to modify risk factors, namely tobacco use,dietary habits, physical activity. The medical staff members participate on changes in patients´ lifestyle by appropriate education. The problem occurs when the patient despite the support of close people can not cope to carry a twist in their life. There should a medical staff member offer a professional help to deal with this important step. Practical use: The aim is to draw attention to the expansion of education about lifestyle changes for patients diagnosed with PAD also in the postoperative period. Patients who are released to home care should receive enough information that would convince them to change their attitude towards their health, and that surgery is only one of the ways to prevent further attacks and complications. Results can improve communication with patients and focus on increasing their awareness and possibly offer assistance.
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Stress situations and nursing personnel
MAREŠOVÁ, Lucie
This thesis deals with the stressful situations in the profession of the nursing staff. The occupation of the nurse belongs to the most demanding ones. In this occupation, the nurse is permanently affected by many stressors of different types. She faces death, the suffering, dying and incurably ill people very often. She is there in times of pain, agony and suffering. Personal encounters with these difficult situations require highly professional approach but most of all, they present immense work stress for the nurse. The theory section describes mainly the stressful situations that are the most common and most difficult in the work of the nursing staff. The next part of the theory section describes possible consequences of the stressful situations and methods of managing them including the support by the management. This thesis has two objectives. The first objective was to map the manners used by the nursing personnel to cope with the stressful situations brought by their profession. The second objective was to find out the difference in the coping with the stressful situations between the hospital staff and hospice staff. The research section of this thesis contains the quantitative research done using the technique of an anonymous questionnaire with 20 question prepared by ourselves. The questionnaire was distributed to the nursing staff of all categories in the hospital and hospice care. It was completed by 269 respondents in total. The data was statistically processed using systems Microsoft Excel 2010 and Software R, version 3.0.2 (Chi-squared test, Fisher´s exact test, and Wilcoxon test). We determined four hypotheses. H1: Manners of coping with the stressful situations depend on the qualification of the nursing staff reached; not confirmed. H2: Manners of coping with the stressful situations are influenced by the length of practice of the staff; not confirmed. H3: Manners of coping with the stressful situations differ between the hospital staff and hospice staff; confirmed. H4: The nursing staff views their own mental hygiene as more efficient than the support from the management concerning the coping with the stressful situations; confirmed. The research results show that the nursing staff faces the stressful situations very often. They see as the heaviest stress the care of the suffering and aggressive patient, conflicts with the patient´s family, conflicts at work and workload. The manners of coping with the work burden which proved as the best for them are relax, rest and sleep. There were no differences proved in the manners of coping with the stress among respective members of the nursing team. Nevertheless, the coping with the work burden of the nursing staff in the hospital and hospice care is different. A minimum of the respondents notices any support during the stressful situations from the employer. On the other hand, certain support by the management could be viewed in the form of trainings, supervision or contribution to a "recovery" which are granted to the respondents from the employer according to their answers. However, the respondents would prefer, as the support by the management, the increase in pay or more days off. The respondents view as insufficient the preparation of the graduates for the future stressful situations in their profession, as well. They would recommend mainly various trainings dealing with the stress and its management. A good solution to alleviate the work burden of the nursing staff and quality enhancement of the services provided could be investments into better work conditions, both in terms of sufficient human and material resources and the very organization of the work processes.
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Communication as a Part of Everyday Nursing Care at ICUs.
FROLÍKOVÁ, Miloslava
Communication as a Part of Everyday Nursing Care at ICUs Bachelor?s Thesis, worked up and focused on the topic of ?Communication as a Part of Everyday Nursing Care at Intensive Care Units? is engaged in problem area of contemporary communication. In the work?s theoretical section we have dealt with general characteristics of both verbal and non-verbal communication as well as an appropriate communication at the intensive care units with adult or children patients has been described inclusive particularities thereof and its contingent difficulties, too. This section also involves a concept of basal stimulation and its subsequent integration into the nursing attendance at the intensive care units. The work also deals with a nurse?s role within education of the ICU in-patients? family. Objectives and hypotheses are introduced in further section of the Bachelor?s Thesis. The first objective was aimed at identification of possible differences while using communication skill at the ICUs of various medical scopes. The second objective was focused on finding out of prospective utilization of the basal stimulation concept for the purpose of nursing attendance as a communication chance. The third objective set a goal to identify what communication way was preferred by the ICU nurses while providing nursing care. Pursuant to these objectives of the Thesis hypotheses were defined. Hypothesis 1 (H1) anticipated that the communication skill was differentiated according to the scope of the intensive care unit. Hypothesis 2 (H2) supposed that an important element affecting any communication was medical performances frequency. Hypothesis 3 (H3) assumed that the important element affecting any communication was frequency of nursing interventions. Hypothesis 4 (H4) envisaged that time necessity while providing nursing attendance at the ICUs influenced the efficiency of the basal stimulation application with patients. Hypothesis 5 (H5) anticipated that verbal communication was preferred more with patients at the ICUs according to the medical scope. A quantitative method was used for the research investigation of the Bachelor?s Thesis by help of interrogatory investigation. Nameless questionnaires were set and distributed to nurses at the intensive care units of various scopes in the Faculty Hospital Plzeň . It was found out through the research investigation that hypothesis 2 (H2), hypotheses 4 and 5 (H4, H5) were confirmed and hypothesis 1 (H1) and hypothesis 3 (H3) weren?t confirmed. However, all three objectives were fulfilled. At the end of the Bachelor?s Thesis it is especially recommended for providing nursing care at the intensive care units regardless of their medical scope to respect any intimacy of the patients while executing nursing interventions and any efforts to get higher quality of communication skill at treatment of an unconscious patient, to provide education both of theoretical but first of all practical elements of the basal stimulation concept with the nursing staff.
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Rate burden explored the sick with Alzheimer disease
Houdková, Milada ; Štefančíková, Mariana (advisor) ; Rybářová, Marie (referee) ; Šlaisová, Ivana (referee)
72 ANNOTATION Author: Milada Houdková Institution: Institute for social medicine LF UK in Hradec Králové Department of nursing, Title of the work: The intensity of the burden of providing care for the sick with Alzheimerovou diseases Head of work: PhDr. Mariana Bažantová Number of pages: 101 Numer of enclosures: 3 Year of vindication: 2010 Key words: strain, stress, Burnout, caregivers, Alzheimer's disease The thesis describes and discusses the physical and emotional strain experienced by nurses and caregivers caring for Alzheimer's patients. The theoretical part focuses on Alzheimer's disease, its stages, symptoms, treatment and nursing care for Alzheimer's patients. It also describes the strain experienced by nurses and caregivers, and provides several suggestions for preventing related stress and burnout. The empirical section describes the work methodology and presents relevant research. The research was conducted using qualitative methods, the data collection was carried out by semi-standartized interviews, and the results were evaluated using open coding. The thesis analyzes the strain subjectively perceived by nurses and caregivers, focusing on emotions, everyday life of nurses and caregivers, possibilities in combining professional and personal lives, and awareness of the burnout syndrome...
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The renovation of historical parks near the small feudal residences on the example of the study of the renovation of the castle garden in Doudleby nad Orlici in Eastern Bohemia.
Faltysová, Lenka ; Buttry, Ivana (advisor) ; Jakub, Jakub (referee)
The aim of this work is the processing methodology and presentation process how to restore monuments of garden art. On the example of the revitalization of the castle garden immovable cultural monument Castle Doudleby nad Orlicí, based on the study of literature, similar interventions and the analysis and interpretation of various types of archival material the current quality of historic garden was evaluated. It is based on field survey, which consists of dendrological research, analyzing the authenticity of trees and appreciation of all the collected documents, historical sources and professional literature. Concept recovery of castle garden is based on the expert authority´s binding point of view of the state care of historical monuments.
Renaissance castle in Doudleby nad Orlici is located in the eastern part of the town on a slightly raised hill on the right bank of the River Divoká Orlice. There was a wooden medieval fortress with the farmyard on this place in the 13th century. Sr Mikuláš from Bubno started to build a hunting lodge in the Renaissance style as villa in 1588, which was finished in 1590. The significance of Renaissance residence, which complement the early Baroque elements from the late 17th century, is enhanced by the opulent and impressive sgraffito - carpet pattern covering all external and internal frontage, restored in 1886 by Kirchner. The tall chimneys are the part of decoration in the courtyard decorated with sgraffito as well. The chateau complex is formed along its circuit of farm buildings and residential buildings. Building of castle itself is separated by a park with old trees and newer lawns (Hieke, 1984).
Castle park in Doudleby nad Orlicí was founded in 1809 in compositional continuity of the Renaissance castle building. The park forms one organic complex with the castle. The promoter strived, like in the castle rooms, to demonstrate here his wealth, his sense of art and his botanical-dendrological knowledge. The park is designed as a narrow disposition in landscape style and it is composed as a long vista to the castle. The area of the landscape park is 3.76 hectares nowadays.
The literature search is especially dedicated to the Renaissance and its relationship to the garden art. The monument care in the Czech Republic and the activity of professional organization of the monument care of the National Heritage Institute in Josefov is introduced in this section.
The methodological guide describes the used bolsterings and resulting outputs on the basis of them are implemented of such measures, which will help to improve the health and vitality of existing promising trees and new plantings of trees, which are consistent with the original composition with emphasis on the rehabilitation and upgrading of historical value of the object. Treatment of trees and supplementary planting will be done within the frame of total revitalization of the castle park.
The practical unit describes the current status of vegetation monuments of garden art. The inventory trees is the essential tool for analyzing the current status of vegetation monuments of garden art. Inventory, which should provide quality base for a draft recovery, should also be addressed in certain parts with characteristics of individual species (Krejčiřík, 2015).
The results of field investigation were completely recorded in the graphical output.
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Selected economic context of social care services
Čechová, Ilona ; Pikola, Pavel (advisor) ; Jaromír, Jaromír (referee)
Summary
In the theoretical part of the thesis Selected Economic Aspects of Social Care Services, I present a definition and an overview of the statutory regulation of social care services in the historical perspective and from the viewpoint of the valid law. The subsequent section, which is the core segment of the theoretical part of my thesis, sets forth a specification and a general outline of all social care services available in our jurisdiction.
The chapter about the funding of social services identifies the available financial resources, and the range of options associated with the payment of social care services. The services and particularly the financing methods constitute a frequent topic for discussion among all main initiators (promoters, movers) of social services.
In the practical part of the thesis, I present an identification of financial resources of one selected social service provider, and an analysis of its income from transfers, users payments for meals, from the accommodation and care allowances, and other revenue generated from 2005 to 2015. This part of the thesis also shows a comparison of the amount of individual transfers and payments from users, including per-user care allowance per year and month in the period from 2005 to 2015. The analysis is then used to identify the system for subsidy allocation, to draw conclusions on specific findings, and to present some recommendations. The last section of the practical part compares the selected social service provider with other organizations providing the same services in the year 2014.
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The prepartion for accreditation with the intention on the safety at work and the occupational hygiene and the future medical personnel level knowladge in this section
Nejedlá, Zuzana ; Holubová, Václava (advisor) ; Dvořáčková, Ivana (referee) ; Drašnar, Jan (referee)
The topic of my final project is "The prepartion for accreditation with the intention on the safety at work and the occupational hygiene and the future medical personnel level knowladge in this section". This is a theoretical and research project. In my theoretical part I have described the accreditation as a proccess, which is neccesary for quality patient care. I have focused on the changes which our hospital goes through during the preparation of the accreditaion proccess including the claims on safety at work and occupational hygiene. Research part has focused on finding the level of future medical personnel mainly in the safety at work sphere via questionnaire. These students become the part of the medical team during the practical lessons and it is necessary to keep safety work rules and in this way they safe themselves and others. Subsequently, this final project has been concentrated on the concept of the corrective measures during the safety training for students and occupational hygiene.
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Quality of life of patients using home parenteral nutrition
HOLOUBKOVÁ, Martina
This diploma thesis deals with the issue of life quality of patients taking home parenteral nutrition. Its intention is to present the achieved life quality scores in the individual domains of physical and mental health in comparison with general population and to point out the differences in what dimensions the life quality of these patients is particularly affected. The theoretical section describes the present situation of the issue of home parenteral nutrition in the CR and the system of the care about the patients. The chapter about indications and contraindications to HPN is elaborated in more detail. The possibilities of the long-term vascular accesses, the care about them are also mentioned here, and particularly the role of a nurse in patient education in transferring parenteral nutrition to the domestic environment. The problems with long-term parenteral nutrition resulting from mechanic, metabolic and septic complications are also outlined. Parenteral nutrition failure is the most serious problem, which is why a chapter on small intestine transplantation as the last resort to save a patient with combined failure of intestine and nutrition is included. The second part of the theoretical section describes the life quality. I wanted to define the nature of this unambiguously graspable a term, determinants affecting life quality are also mentioned here. The possibilities of life quality measurement and assessment and particularly the follow-up use of the obtained data are mostly summarized here. Goals and hypotheses: Two goals were set to meet the main purpose of the thesis: Goal 1: To find whether the life quality of patients on HPN differs from that of the general public. Goal 2: To find the spheres in which the life quality of patients on HPN is mostly affected. A zero hypothesis was set to achieve the goals: Life quality of patients on HPN does not differ from that of the general public. There is no statistically significant difference between men and women. Eight alternative hypotheses to each life quality domain followed: H1: Patients on HPN show lower life quality score compared to the general public in the sphere of physical functions. H2: Patients on HPN show lower life quality score compared to the general public in the sphere of physical roles' limitation. H3: Patients on HPN show lower life quality score compared to the general public in the sphere of emotional roles' limitation. H4: Patients on HPN show lower life quality score compared to the general public in the sphere of emotional limitation of social functions. H5: Patients on HPN show lower life quality score compared to the general public in the sphere of pain. H6: Patients on HPN show lower life quality score compared to the general public in the sphere of general mental health. H7: Patients on HPN show lower life quality score compared to the general public in the sphere of vitality. H8: Patients on HPN show lower life quality score compared to the general public in the sphere of general health perception. A quantitative method of collected data analysis was applied to the research implementation. The research was based on the standardized questionnaire SF-36 supplemented with questions dealing with identification of respondents, time consumption of their treatment and their consequent satisfaction at the beginning. The questionnaire was distributed to patients using home parenteral nutrition in specialized nutrition centres of the Thomayer Faculty Hospital in Prague, Faculty hospitals in Brno and Hradec Králové and also by electronic means through the website of the citizen association Life without Intestine. The obtained data were statistically evaluated and processed into illustrative tables and graphs.Detailed mapping of the problems of life quality and highlighting of the neglected spheres of life quality of patients using HPN are the outputs of the thesis. The results will be presented to the members of the workgroup for HPN within their.
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