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Coping strategies in children´s fear and pain in relation to nursing care
PROCHÁZKOVÁ, Zuzana
For the nurse, taking care of hospitalized children is important not only pediatric nursing knowledge, personal and social preconditions, but also the theoretical and practical competency of methods and techniques, which are used for identification and effective influencing of pain and fear. The aim of this thesis was to identify the main sources of fear of the hospitalized preschool and young school age children and to find out the effective methods and principles of the cooperation with children, alternatively with their accompanying parents in order to moderate the fear of the small patient. Then the thesis tried to chart the nursing diagnostic and evaluation procedure of the pain and get the most used nursing methods of non-pharmacological pain relief. To obtain the necessary data, the qualitative research was used with a semi-structured interview as a research instrument. The first research group consisted of 12 nurses, the second group consisted of 12 children ´s patients of preschool and young school age. The majority of the asked nurses thinks, that children´s patients are afraid especially of non-familiar environment, then of the awaited pain and of the solitude without parents. However, the most patients said, that they were afraid especially of pain, then of non-familiar environment, restriction of their needs, hostile attitude of the medical staff and of the other neighbouring patients. They were also frightened of the death and of the darkness. Most reported nurses mean, that the most effective solution of the children ´s fear is the friendly attitude of the medics. They also mentioned the fact of taking the focus off the fear and the presence of the parents is also beneficial. The nurses ´ answers were in conformity with patients opinion in two fields - friendly attitude of the medics and taking the focus off the fear. Then the children mentioned abiding of their specifics in connection to falling asleep and the demand of beying treated by the same sister or by few same sisters. All respondents also talked about the benefit of parents presence. Regarding the principles of the cooperation, nurses answered the importance of united medical procedures, especially the proper way of information transfer. Then the respondents nurses mentioned the psychical and emotional support for children and their accompaniments, the atmosphere of confidence and the value of well done education. Also the need of calm, silence and privacy was stated. Unlike nurses, children and their parents regarding to principles of the cooperation prefer the psychical and emotional support, then the importance of enough information was mentioned. The fourth research question bears on the methods used for children pain monitoring. The nurses said, that the intentional interview with the patients or with the parents was used as a main technique, that was stated by patients as well. Research question number five said: What are the most used nursing methods of non-pharmacological pain relief at children? Most responded nurses mentioned the distraction of children attention from the painful incentive, then the importance of physical methods, relief position and purposeful preparation for the unpleasant intervention. Nurses also named the helpful contribution of the parents, relaxing exercises and the method of imagination. Regarding the pain treatment, it was noted, that all patients prefered the analgesic therapy. Then they quoted the distraction of their attention from the painful incentive, the friendly attitude of the medics, using the ice compress and the relief position. In the pain acute phase, children required mostly calm, comfort and privacy. All children also considered the presence of parents as very helpful. The theoretical and empirical part of the thesis are suitable for being studied by nurses taking care of children and it can be helpful for nursing quality improvement at children ´s wards in hospitals.
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Nursing care management of patients after intrapleural chemical pleurodesis
KIESEWETTEROVÁ, Renáta
The pleurodesis is a treatment method for patients suffered from the symptomatic malignant pleural effusion. The goal of the pleurodesis is to close a pleural area by connection of visceral and parietal pleura in order to reduce or terminate production of pleural effusion. The sterile talc powder is the world's most used agens within a practice. After a parental analgesic is the powder (as a sllury) either applicated into a pleural cavity through the chest drainage or surgically dispersed over the treated (via abrasion, decortication) pleural space during the thoracoscopy/thoracotomy. This diploma thesis focuses on the treatment technique of bedside talc-pleurodesis through the chest drainage. The nurse has an irreplaceable role in the whole process from a preparation of patient to assistance by intrapreural application, to care of patient after the operation or serves as a physical support during potential complications. The aim of the presented work is to detect priorities in nursing care and find out whether patients need increased care after intrapleural therapy. The qualitative research method was chosen for the analysis where semi-structural interview with open questions were used. We created case reports analysed with the adaptive model of Callista Roy as well. The research sample contained patients chosen with respect to specialization of researched problem. We set two basic focal stimuli according to the analysis of respondents´ reactions. These stimuli serve as a basis for determination of priority parts of the nursing care by patients after bedside pleurodesis. We defined the need to be without pain and the need to ensure safety and certainty as a central focus of the nursing care. Among secondary fields of nursing care were identified sleep disturbances and limited mobility, which leads to reduction of self-care in getting dress, hygiene as well as in defection and miction. We found out within the second goal identical intensity of the nursing care before and after bedside talc-pleurodesis. This statement is based on comparison of interventions before and after aplication analysed via adaptive model by Roy. Nevertheless, causes of interventions were modified to a certain extent. The main goal of diploma thesis was to map requirements for high-quality nursing care related to bedside talc-pleurodesis via chest drainage. The work should extend theoretical basis not only for nurses in clinical practice.
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Pick´s disease and the specifics of the nursing care of a patient with this disease
KOPKAŠOVÁ, Lenka
Pick's disease is a degenerative-atrophic process that primarily affects the frontal and temporal lobes of the brain. Besides Alzheimer's disease, it is a lesser known form of dementia which affects people of younger age. Although the exact range of Pick's disease occurrence varies in the literature, the average reported age is between 50-60 years. The disease can change eating habits, cause emotional swings, inappropriate behaviour and sloppy appearance of the patients. The behaviour to others is often selfish, the patients are unable to listen to others and ignore their surroundings. Pick's disease is also characterized by inappropriate sexual behaviour. Globally, the number of dementia patients is still growing and according to expert guesses the increase will continue. Nursing care for patients with dementia is therefore becoming a very actual topic as dementia is called a quiet epidemic of our century. Nurses in their departments quite frequently encounter patients suffering from dementia of various origins at different stages of disability and the staff at healthcare facilities often regard these people as a burden. The aim of this thesis, which is called Pick's Disease and Specifics of Nursing Care for Patients with this Disease, is, based on the theoretical knowledge, to map definitions and diagnosis of Pick's disease, to define the needs of such a patient, and to list the most common problems in the nursing care. It focuses on people with dementia within medical facilities. For proper understanding of the problem, the thesis starts with the anatomy and physiology of the brain and the description of cognitive functions which are affected by the dementia syndrome and the definition of dementia. Based on the studied literature, dementia is divided according to various criteria. It has been found out that dividing dementia is not entirely uniform, but the essential facts and overall opinions of the authors do not diverge. Pick's disease belongs to a group of frontotemporal dementia and its position in this group has changed over time, as it is recorded in the literature. The thesis includes recommendations resulting from the studied literature in the approach to patients with dementia and emphasizes personal communication with the patients and empathetic and humane approach. Although medicine cannot prevent dementia, an early diagnosis of a specific type of dementia and correctly targeted treatment can increase the quality of life not only of the patients but also of their families. I have chosen this topic because I find it very current and interesting. During my nursing practice at the Surgery Department and Aftercare Department, I have met patients suffering from dementia and I did not know how to properly and efficiently communicate with them. For the theoretical part of my work, the methods of explanation, synthesis and induction on the basis of Czech and foreign information sources have been used. The most frequently quoted Czech authors in my thesis are doc. MD. Roman Jirák, PhD., the head of the center for diagnosis and therapy of Alzheimer's disease at the psychiatric clinic of the General University Hospital in Prague, the 1st Medical Faculty of Charles University. This thesis can serve as an informational and educational source both for nurses and the general public who may experience the disease within their families. It would be considered a great success if it helped nurses or family members to diagnose Pick's disease or other dementia at an early stage.
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Central bearing warehouse ZKL in Brno - construction technological project
Karabcová, Eva ; Zálešák, Vít (referee) ; Biely, Boris (advisor)
The content of this work is the implementation of the construction technological project of central bearing warehouse ZKL in Brno. The building serves for storage purposes predominantly. This thesis contains general information about construction, content construction technological project, technology report of storage and residential proposal of mechanical assembly, technological prescription for prefabricated scaffold and cladding panels construction Kingspan, report of healthand safety on the construction site, technology report description transportation, inspection and test plans and environmental plan. Budget and time schedule of the main object, calculation, time and financial plan of whole building is contained in supplements. In pursuance of second task, the thesis compares financial and time point of view of two technologies of making stairways.
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Nursing process in patiens undergoing endoscopic examination methods.
FORŠTOVÁ, Eliška
In recent decades the endoscopy plays an important role in detection and subsequent treatment of diseases, through which the pathological changes in all hollow organs can be viewed and controlled either by physiological or artificial pathway. A great emphasis is put on care which is provided by the medical personal during the endoscopy. The first aim of the thesis was to find out how patients are prepared for the selected endoscopy and how they tolerate this preparation as well as the course and care after the examination and what information patients have about the steps after the endoscopy. The second aim was to find out how nurses prepare patients for the selected endoscopy and take care of them during and after those examinations. The research part of this thesis was processed as a form of qualitative research, a half-designed interview was chosen as a technique of data collection. There were two groups of researched ? patients who have undergone some of the selected endoscopy and nurses who took care of patients before, during and after the examination. The main results, which are summarized in the tables, include findings about the care which was provided to patients and nurser´s activities associated with the correct preparation before, during and after the examination. These tables are based on results of both reports. The results present that the patients are very well prepared by the nurses for selected endoscopy although these examinations are very stressful for the patients. That relates with their perception of care during the nursing process. Neither patients nor nurses can remember the complete set of acts associated with the preparation, the course and the nursing process after the endoscopy. In conclusion, nothing was neglected during the nursing process, including an information guideline after the endoscopy. Based on these results, an information booklet has been prepared which could have great benefits for patients undergoing selected endoscopy ? especially colonoscopy which is the most common endoscopy. The information booklet contains information about a suitable diet (without any left-overs) and food selection that the patient should follow before colonoscopy.
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