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Total two-year evaluation (2009 - 2010)of pilot project examination of thyroid gland function in group of pregnant women
Řehoř, Jiří ; Springer, Drahomíra (advisor) ; Límanová, Zdeňka (referee)
In the years 2009 and 2010 the pilot project investigating the function of the thyroid gland took place in 13 cities of the Czech Republic. In the context of the screening of congenital developmental defects the levels of TSH, FT4 and anti-TPO in serum were by women in the first trimester of pregnancy investigated, after signing informed consent. For the determination of analytes there were different analyzers used, which laboratories possess and are able to carry out the necessary examinations. Most of analyzers the reference intervals for TSH, FT4 and anti-TPO has set up from the manufacturer. These reference intervals are suitable for the normal population, neither less for pregnant women. Data from this project was evaluated using the newly calculated reference intervals for pregnant women, which are for the group of investigated women much more appropriate. From the total file of 3,484 pregnant women, it was thanks to these new reference intervals captured about 100 pregnant women with increased levels of TSH more, than in the use of reference intervals of producers. The comparison of reference intervals from the manufacturer with the newly calculated reference intervals for pregnant women managed to surface FT4 to find out about 126 more women below the surface of the new reference interval, than...
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Labour versus fear and anxiety
KOSTKOVÁ, Tereza
This bachelor´s thesis is focused on women´s experience of fear and anxiety during the childbirth. It combines both theoretical and empirical aspects of the topic. The theoretical part summarizes history of midwifery and history of psychoprophylaxis, defines the childbirth, describes physical and mental condition and changes in women during various stages of labour. The following chapter provides general characteristics of fear and anxiety, their signs and consequencies. The next part contains description of reasons, potential manifestations and effects of experiencing fear and anxiety during pregnancy and their possible impact on the childbirth. It is followed by a chapter dealing with prevention of, and solutions to fear and anxiety during the childbirth. The theoretical part also deals with various personalities of women in labour and opportunities to choose between different types of childbirth. The final chapter of the theoretical part summarizes specifics of midwife tasks in the delivery room. The research part of the bachelor´s thesis concentrates on finding out what is the extent of women´s experience of fear and anxiety in labour and what reasons they indicate as reasons of their fear and anxiety. We tried to establish whether there are any dependencies in experiencing the fear and anxiety by women in labour and whether it is possible to assess in advance which women will experience more fear and anxiety in labour. We attempted to identify what can help women in labour to overcome or be relieved of their feeling of fear and anxiety, and thus, whether or not such feeling can be prevented or at least alleviated. We were also detecting how the women in labour get their information of pregnancy and which information they consider the most beneficial. And whether or not their partners´ presence in labour may effect their actual experience.
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The impact of problematic breastfeeding on woman's psyche
MELÁNOVÁ, Hana
The Bachelor thesis deals with the issue of breastfeeding and consequential complications in connection with women's psyche. The theoretical part consists of two main areas. In the first one the physiology of lactation is described, the principles of initiation of breastfeeding after a birth so as to ensure the optimal start and further course of lactation and also the most common problems that may occur during breastfeeding. The second area focuses on the psyche of women after childbirth and deals with the psychological disorders. The research part of the Bachelor's thesis dealt with the experience of women with problematic breastfeeding in relation to their body. There were set two basic objectives. The first one was to determine the impact of the problem with breastfeeding on the psyche of women and the second one was to find out, whom women solve problems with breastfeeding with. Two research questions came out of these two goals. The first examined the manner how breastfeeding problems affect the psyche of women. The second, with whom women address the problem of breastfeeding and where they usually seek for help. For the implementation of the research investigation was used the method of qualitative research investigation. Data collection was carried out by a structured interview. The content analysis was performed, then the processing of the acquired data was made by categorization. The answers of respondents were arranged in one category (The way of Nutrition-Breastfeeding) and 8 subcategories (the choice of the way of nutrition, family, Opinion, women's Awareness, a preparation for breastfeeding, a breastfeeding, an access to Course/PA, breastfeeding problems, feelings of women). The most important fact were processed for clarity to diagrams and categorization tables. In the description of results direct testimony of respondents were used. Research file consists of women in a period of 6 months after childbirth, where problems with breastfeeding appeared. All 8 women voluntarily agreed to participate in this research. The talks took place in the domestic environment of women in the agreed time during the March 2015. The women came from the District of Strakonice, Prachatice and Písek. From the research investigation it is obvious that women are aware of the benefits that breastfeeding brings and therefore they prefer breastfeeding as the best way of a child's nutrition. But the preparation for breastfeeding is often underestimated already in the pregnancy, thus women are not prepared to any complications. This work showed that the psychology of women after childbirth is very fragile and problematic breastfeeding, when mothers cannot adequately and fully feed their babies with breast milk, is a situation that has a negative impact on their mental state. Women almost identically felt that as their failure, which was accompanied by disappointment, sadness, hopelessness, exhaustion, stress, etc. One could say that the rate of psychological problems was directly proportional to the desire for long-term breastfeeding of a child. The interview with respondents revealed several factors that negatively affected the course of lactation as a lack of theoretical and practical training on breastfeeding in pregnancy, information about breastfeeding in women in general, a lack of support from health care professionals in maternity hospitals, exaggerated expectation from nursing women or improper communication with the mothers in case of an assistance in overcoming the difficulties after the release from the hospital and also a lack of support from the family side. The solution lies in particular in the awareness of women and their families, support of self esteem of women during pregnancy, the prevention of potential problems and high-quality breastfeeding advice either in a maternity hospital or in a home environment. When women faced an issue of breastfeeding and looked for help, all of them mentioned they used almost
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Welfare of women during pregnancy and maternity
Koktová, Alena ; Štangová, Věra (advisor) ; Vysokajová, Margerita (referee)
The thesis the Welfare of women during pregnancy and maternity deals with benefits which are connected with pregnancy, childbirth and maternity. The payment is based on more laws, especially act of on sickness insurance and act of state social support. I also didn't forget to mention some important international organisations, which affect in the area of social security and also the modification of security within European Union. I tried to treat my theme in different way, unlike it had been treated before. I proceed chronologically during description of individual benefits, this mean that I started with Compensatory benefit in pregnancy and maternity and I finished with parental allowance. This also corresponds with the structure of my thesis. I chose this method, because in my opinion this way of treating of the problem becomes more understandable. The thesis consists of introduction, eight chapters and the conclusion. In the introduction I mentioned reasons why I have chosen the theme and basic information concerning the social security law in Czech Republic. The first chapter is about progress of Social security law, especially in the area of present-day Czech Republic. The first chapter is divided into the 3 subchapters and the last one is also divided into another three sections. On the...
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Rating supplements and dispensing of food supplements / / in pregnant women in selected pharmacies in 2006 and 2007
Nerudová, Klára ; Hronek, Miloslav (advisor) ; Jílek, Petr (referee)
The selective abstrakt: Rigorous work The classification supplementary and dispensation of feed supplement for gravid women from selected pharmacy in the years 2006 and 2007 treat of suitability for supplementary usage during gravidity. In this work I also evaluate individual supplement`s for gravidity period that are used in the years 2006 and 2007 in the Czech market. Result of my rigorous work is recommendation for give priority to healthy and mixed fare during gravidity before vitamin supplement. This kind of recommendation is valid just for normal physiological conditions for all kinds of vitamins and minerals except of folic acid that they shoud be used before planned pregnacy. The products Centrum materna, Calibrum mami or Calibrum babyplan I can recommend each time if they have incomplete nutritive-supply.
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Programmed labour as seen through the eyes of the women giving births in Jindřichův Hradec maternity hospital
MACHOVÁ, Jitka
The objective of today´s obstetrics is to turn childbirth into an exceptional family event. One of the methods currently employed in obstetrics is the choice of programmed labour, which introduces artificially induced uterine activity that is to terminate physiological term pregnancy at ideal time and under ideal conditions for everybody, the mother, fetus/newborn, woman in labour´s relatives, and nursing staff. Programmed labour is a highly controversial issue because it involves childbirth induction on the ground of non-medical indications. The programmed labour is supported as well as opposed by both, medical professionals and general public. The objective of this bachelor´s thesis was to find out how the programmed labour is perceived by women who have chosen to terminate their pregnancies on a programmed basis; what knowledge of programmed labour they have and what experience with it they have. The empirical part is based on a qualitative research. The data were gathered by semi-structured interview, which was held with selected women in labour at the Department of Gynecology and Obstetrics of the Hospital Jindřichův Hradec. Selection criterion was defined as women in programmed labour. Holding the interviews with individual respondents resulted in completion of case reports. These served as a research base for categorisation tables, which comprise of important outcomes of the research. The research was carried out in terms of defined objectives and research questions. All objectives defined in the thesis were met; questions were answered and information retrieved. Based on the research outcomes, six hypotheses were proposed. The main outcome of the research is that the respondents have knowledge of the term "programmed labour". Also, they are aware of some of the advantages relating to mental area and they are satisfied with choosing programmed labour. What these women are not aware of is the disadvantages of programmed labour. Following the research, a draft of informed consent was made up for women in labour so that they receive full information about programmed labour and can agree with pre-induction and induction of the childbirth. In order to secure provision of quality nursing care during a programmed labour, guidelines containing standard procedure of nursing care provided to women in programmed labour were created. Both materials are to be used in the delivery room of the Hospital Jindřichův Hradec.
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Quality and quantity of motion activities during pregnancy
OŠMEROVÁ, Lucie
The thesis is aimed at physical activities exercised by pregnant women, for whom the physiological pregnancy is in progress. The theoretical part characterizes physiological, risk and pathologic pregnancy. The pregnancy symptoms, physical and psychological changes connected to pregnancy are also characterized. Next part is based on the importance of physical activities, the impact on a women's health and the impact on an unborn baby. The thesis describes the appropriate physical activities for pregnant, such as walking, swimming, dancing, cycling, yoga, special exercise and so on. Moreover, it mentions inappropriate physical activities, such as downhill skiing, tennis, squash and skating. The thesis also includes the contraindication of physical activities for pregnant. The practical part of the thesis is aimed at finding out preference of physical activities for pregnant, their opportunities to exercise the physical activities nearby and it also explores if the pregnant are informed by their gynaecologist about some appropriate possibilities of exercising physical activities. The quality research was chosen for this thesis. The research survey took place via controlled interviews, which were recorded on a recording device and then the results were transcribed into a written form. The interviewed women were addressed through the centres for pregnant and gynaecologic clinics of South Bohemian Region. The survey took place from the 3rd of March to the 18th of March 2016. The interviews, which were composed of sixteen questions, were provided by sixteen pregnant women. The information from all the respondents was used to create Mind Maps. In total there were eight categories, which show a total of nine Mind Maps. The aim was to explore how the pregnant women perceive the physical activities and what is the awareness of possibilities to exercise physical activities. There were three research questions. First of them was: In what kind of physical activity are the pregnant interested the most? The second question was: What are the possibilities for the pregnant to exercise physical activities nearby? The last question was related to providing some information to pregnant by their gynaecologist: Are the pregnant informed by their gynaecologist about the possibilities to exercise physical activities? According to information from all questioned pregnant women, the most preferred exercise was walking. The exercise for pregnant and yoga are also favourite. Futhermore, the respondents mentioned riding a stationary bicycle, gymnastic ball exercise and agility. As well as this, the pregnant exercise enough and they also think so. The pregnant women also list swimming, yoga, ball exercise, Pilates, running and Nordic walking as some other possibilities to exercise. According to interviews, the pregnant women are not enough informed by their gynaecologists about the possibilities of physical activities. Despite the currency, this issue is still incomprehensible. The survey could be a good source of information mainly for gynaecologists or midwives. The survey could improve providing some information for pregnant women about possibilities of physical activities, which would not endanger both the pregnant and an unborn baby.
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Maternity in later age or phenomenon of the present time
Zadražilová, Jana ; Miskolczi, Martina (advisor) ; Antovová, Michaela (referee)
The bachelor´s work concerns with maternity in late age and lays the goal to draft present trends showing in the Czech Republic, using qualitative research to reveal the opinions and experience of women facing the mentioned problem and find out how much they are influenced in decision about the time of birth of the child by the partner. The work brings basic historical overview of changes in family behaviour, theoretical approaches that try to explain these changes and moreover it devotes also to occurence of evolutional defects at children of older mothers, also older fathers and rising interest about methods of assisted reproduction in connection with still rising age of mothers. Using the analysis of the trends of fertility from the year 1989 was found that it got to decrease of total fertility and specific rate of fertility is still moving to higher age of women but with lower intensity. The average age of women is still rising and with this also the number of performed cycles of assisted reproduction. In the same time also the occurence of inborn defects at the age of women 35 and more is relatively high. Thanks to qualitative research were in most of cases confirmed the arguments for postponement of maternity got from the professional literature. Moreover was found low level of knowledge about the occurence of inborn defects at children of older expectant mothers and relying on the methods of assisted reproduction in case of inability to become pregnant. The attitude of the partner in deciding about the time to have the first baby is either the same as the woman partner or the attitude of the woman is in this matter primary. In question of having a baby or not is deciding the attitude of the partner.
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Psychosocial Problems in Pregnant Women : Anxiety and Fear during Pregnancy
Tisová, Markéta ; Mellanová, Alena (advisor) ; Marková, Eva (referee)
This theoretical and empirical work addresses experience with anxiety and fear during pregnancy of primiparae. In the theoretical part the pregnancy is defined. Physical, psychical and social changes are described as well as adjustment of women to pregnancy. Further on there are general characteristics of the concept of anxiety and fear with their demonstrations and results. In the next part there is the description of anxiety and fear in pregnancy, their reasons, possible demonstrations and results of anxiety and fear in pregnancy. The research project of my graduation work was focused at the detection of how far the primiparae experience fear and anxiety during pregnancy and what reasons and cause are indicated. We tried to find out if there are any correlations between fear and anxiety in pregnant women and if there is any possibility to estimate in advance which group of women would experience fear and anxiety more. We also tried to find out what helps the pregnant women to get rid of these fears and anxiety or how can these feelings be reduced and if there is any possibility to prevent these feelings. Next we wanted to know how the primiparae get the information about pregnancy and which information is considered most appropriate.
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Experiance of the midwife in care of woman by childbirth of dead fetus.
ČERNÁ, Lenka
Intrauterine fetal death is a serious medical and nursing problem. Midwifes in the delivery room do not come across this diagnosis often, so the women in labour should be looked after by sufficiently experienced and educated midwives, who are well aware of the problem and are able to satisfy the needs of the woman in all its complexity. The theoretical part of the Study describes the causes of intrauterine fetal death, the symptoms, the complications, the diagnostical and therapeutical procedures. From the nursing point of view the Study focuses on midwives? care of the woman prior to the delivery, during labour, in the puerperium and in the subsequent ambulatory care. It also deals with the importance of farewell ritual with the child and with the psycho-social aspects of this problem. I have included a chapter on civil legal requirements that arise from this situation. The aim of this Study was to compare nursing care of women with stillbirth in selected maternity hospitals. I compare the midwives´ approach, ways and means of saying goodbye to the child and try to ascertain the level of awareness of the legal requirements relating to this situation amongst the midwives.Qualitative methodological approach was selected for the research. The investigation was conducted through semi-structured non-directive interviews. The results of the interviews were processed, analyzed and arranged into transparent schemes with a description. The research group consists of eight respondents from five different workplaces. The respondents were selected on the condition that they had been working in the delivery room and have experience with the care of a woman with stillbirth. Upon completing this research, the first research question could be answered. The nursing care of the woman with stillbirth is in all the facilities comparable. The midwife monitors the condition of the woman in labour and the course of the labour. All facilities make an effort to ensure the woman?s privacy, allow the partner?s presence and focus on good analgesia. Empathetic and sensitive approach to the woman is matter of course. The second research question was also answered. It was established that the farewell with the child is not facilitated in most of the monitored delivery rooms. At most workplaces the midwives do not actively offer the farewell with the child to the woman although they believe that this ritual bears great importance. The third research question can be answered that the midwives? awareness of the civil legal formalities in this area is not very high. Almost all respondents knew about the possibility to name and bury the stillborn child, but the midwives? knowledge about the maternity benefits and death allowance is not sufficient. The results of the research show that it is important to focus on improving the awareness of midwives in the care of a woman with stillbirth. The solution would be to organize a seminar on this topic. In the seminar, the midwives would acquaint themselves with the appropriate approach to the woman in labour, the possibilities of communication, about the importance of the farewell ritual with the child, the possible ways of this ritual and the information about the naming, burial and the maternity benefit. Another suitable method would be to create a training leaflet that would summarize the basic information related to this issue. This work could contribute to raising awareness amongst the midwives and thereby women in labour would receive not only professional care of their basic biological needs but also the adequate support in the psycho-social field. Midwives would become competent accompanying persons in this, for the woman very challenging time of life.
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