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Rehabilitation Nursing in CVE Patients in Home Care
CHALOUPKOVÁ, Veronika
The thesis deals with application of nursing rehabilitation in patients after stroke at home care. The thesis further describes cerebrovascular accidents, rehabilitation nursing and home care agencies (HCA). The research reveals correlations between nursing quality and additional education of HCA nurses.
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The Role of Nurse in the Prevention of Disease of Civilisation
PAVLOVÁ, Martina
The current state Prevention is a complex care of a patient when we are trying to prevent from the occurrence or development of a disease, or when we want to prevent from its consequences and mitigate them. Recommendations for prevention set by a doctor must be on a scientific basis, and they must be a part of all branches of medicine. Their effectiveness depends on the cooperation between patients and medical staff. The basic and most efficient method of prevention is the health promotion and health education, which is closely associated with it. The term health promotion involves a set of activities and precautions for the purpose of making health better and sustaining it. Diseases of civilisation (hereinafter "DoC") are groups of diseases which are distinguished by their association to our lifestyles. Human body is more and more threatened from unfavourable influences of external environment, such as the quality of atmosphere, work environment and environment itself, the lack of physical movement, unhealthy diet, smoking, and alcohol consumption. The list of diseases of civilisation varies and changes together with our society and the development of our lifestyles. Among the most common or frequent diseases of current time are cardiovascular diseases, which involve atherosclerosis, hypertension, myocardial infarction, stroke, coronary artery disease and obesity. Furthermore, between civilization diseases include diabetes mellitus type 2 or cancer, etc. The goal of the thesis There are two goals set for this paper. The first goal was to find out what the role of a nurse in the prevention of diseases of civilisation was. The second goal was to find out what the above mentioned role of a nurse was from the point of view of patients. Methodology For the purpose of the research part of this thesis, qualitative research using semistructured interviews was carried out. Respondents were divided into two groups; the first one consisted of eight nurses working at internal medicine and neurological department of the hospital in České Budějovice and a nurse working in a private office of a general practitioner for adult patients. The second group consisted of eight patients of the above mentioned health facilities. Results According to our findings, nurses and patients have different oppinions on the role of a nurse. Nurses in disease prevention see themselves as an equivalent to a doctor when undertaking this practice and giving guidance. The patient speaks only to the nurse who emphasized what they were told by the doctor and reiterated the main points. They make available to them leaflets and brochures or Internet resources. In contrast, most patients see a nurse as a more important source of information than the doctor. Patients have the feeling that the doctor does not have enough time or does not want to be botherd with questions. Rather the patient turns to his nurse, which they sees as more appropriate and someone to whom they can confide in without bothering. Summary The goal of the thesis was to focus on prevention, DoC, and the role of a nurse in the prevention of such diseases, as well as to study this issue, look at it from the point of view of patients and nurses via the interviews carried out in this paper, and to analyse such information. Based on this analysis are published recommendations for nurses and patients.
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Nutritional care about immobile patient on standard department of internal type
AMBLEROVÁ, Michaela
Nutritional care for immobile clients at a standard department of internal type becomes still more important, because nutritional care is important for maintaining good health and supporting quality of life. Nutritional status of immobile clients is very important to diagnose as early as possible in order to avoid all risks of potential complications. Adequate nutrition is also very important to maintain good mental health. The central objective of this work was to explore the specifics of nursing care in the field of nutritional care for immobile client at a standard department of internal type. Following this goal, three research questions were set up: How is the nutritional status of patients at a standard department of internal type assessed? What are the possibilities of application of nutrition for immobile client at a standard department of internal type? What are the specifics of nursing care in the fields of nutrition of immobile client at a standard department of internal type? The empirical part of the thesis was processed using qualitative research, which was realized through semi-structured interview technique. The interview contained 3134 questions, which focused on nutrition care for immobile clients on standard unit of internal type. The research sample consisted of nurses working in the standard department of internal type in the České Budějovice Hospital, a.s. Overall, this study leads to two findings, both positive and negative. Within the positive findings we can say that nurses provide adequate care in the application of nutrition per os. Negative findings relates to the fact that the interviewed nurses provide only basic care in case of the introduction of enteral and parenteral nutrition. They do not know more detailed specifics of enteral and parenteral nutrition. Based on this finding, we think it would be useful to organize regular seminars and trainings for nurses to expand their knowledge about this type of care, or at least remind it. This thesis can serve as an informational material for nurses in practice or students of other health professions. This work can serve also as a basis for further research.
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Communication of medics with the parents of a child patient.
ŽÁKOVÁ, Nikola
The theoretical part is divided into eleven chapters. The first chapter deals with the definition of communication. The second chapter describes the kinds of communication, including verbal and nonverbal. The third chapter discusses the communication skills of nurses. In the fourth chapter we expanded on the communication of the nurse with a child patient. The fifth chapter describes the basics of communication between nurses and parents of child patients. The sixth chapter discusses a situation where the nurse communicates with parents of a disabled and dying child. The seventh chapter describes the communication of nurses at the pediatric department. The eighth chapter contains the specifics of the children's department. In the ninth chapter is divided into childage. The tenth chapter discusses communication as a part of nursing care. A final chapter describes the process of hospitalization of children and their parents. The thesis is divided into theoretical and empirical parts. Much of the theory is described above whereas the empirical section describes the results of the research. Objectives and research questions The first objective of this thesis was to investigate how the nurse communicates with the parents of a child patient. The second objective was to determine whether a parent understands the information given by the sister and the final objective was to determine any errors that the nurse makes when they communicate with parents of child patients. Research questions: 1. How the nurse communicates with the parent of a child patient? 2. How does the nurse inform parents of a child patient? 3. How a parent of a child patient assesses the clarity of the information provided by the nurse? 4. What mistakes nurse makes in communication with the parents of a child patient? Methodics For the research a survey was chosen to provide qualitative information, which was obtained via interviews. The second methodology used in this work is called participant observation. Data for the first part of the survey was obtained through semi-structured interviews with the parents of hospitalized children. Interviews were conducted on the basis of questions prepared in advance. If necessary, the interview was supplemented with other issues. The interview was to determine how children were admitted to the children's department, what information reached parents about the examination of the child, and also the overall impression of the nurses on the ward. We asked parents about the verbal and nonverbal communication of sisters. They described the errors they found in the communication and behavior of nurses. The second part of the research was anonymous on the pediatric ward of the hospital where nurses evaluated verbal and nonverbal communication skills. The research group The research set for the first part of the survey consisted of seven mothers of children hospitalized in the pediatric ward. The mothers were in different hospitals in the Czech Republic. The research set for the second part of the investigation, which was carried out by observation technique, consists of six nurses employed at the pediatric ward of a state hospital. Nurses were selected randomly. They are of different ages and they have different length of practice and other training.
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Oxygen therapy after cardiothoracic surgery from the point of view of nurses and patients
VRCHOTOVÁ, Klára
Cardiac surgeries are very serious surgical procedures with considerable specific features. This bachelor thesis focuses on oxygen therapy from the viewpoints of nurses and patients. Its theoretical part describes physiology of breathing and the oxygen therapy as such. It describes individual sources of oxygen and indications for oxygen administration. It also describes principles to be observed during oxygen administration. Specific aids are used for oxygen administration, particularly oxygen masks or oxygen goggles. Quality pulmonary rehabilitation is also necessary to make oxygen therapy more effective. Pulmonary rehabilitation is particularly important for patients after a cardiac surgery and it should be practiced even before the surgery. This approach is critical because in the post-surgery period the therapy makes it possible for the patient to breathe and to expectorate properly. Pulmonary rehabilitation is practiced with patients by general nurses at the cardio surgery ward, as well as by physiotherapists. There are various techniques available to determine efficiency of oxygen therapy and pulmonary rehabilitation. The techniques may be classified as invasive and non-invasive; the most frequently used non-invasive method is pulse oxymetry and the most frequently used invasive technique is blood collection for ABR. Two objectives were set for the thesis. The first objective was to map knowledge of nurses about how to provide care to patients treated with oxygen therapy. The second objective was to determine how the patients feel after a cardiac surgery. Two hypotheses and two research questions were formulated. The first hypotheses were: Nurses working at the resuscitation care station have more knowledge about oxygen therapy than nurses working at the intermediate care station. The second hypothesis was: Nurses working at the resuscitation care station have more knowledge about pulmonary rehabilitation than nurses working at the intermediate care station. The first research question was: How do the patients feel during oxygen therapy and pulmonary rehabilitation? The second research question was: How are the patients after a cardiac surgery informed about oxygen therapy and pulmonary rehabilitation? In the research part of the bachelor thesis I have used both quantitative and qualitative research methods. Quantitative processing of data was used for questionnaires filled out by nurses working in the hospitals Nemocnice České Budějovice a.s., Nemocnice na Homolce in Prague and in the faculty hospital Královské Vinohrady in Prague. The method was used for evaluation and assessment of knowledge of nurses working at the resuscitation and intermediate care wards. Quantitative methods were used for processing of data obtained through semi-structured interviews with patients after a cardiac surgery. The data were transcribed and coded using a pencil and paper method. The data were categorized based on the identified codes. Two categories were created: oxygen therapy and pulmonary rehabilitation. Each of the categories was further divided into three sub-categories. Two categories were created for the research oxygen therapy and pulmonary therapy. Three sub-categories were subsequently created for the oxygen therapy and the pulmonary therapy. The quantitative research has shown that the knowledge of nurses about oxygen therapy is higher among the nurses working at the resuscitation care ward. However, the situation is different in case of their knowledge about pulmonary rehabilitation. In this case the knowledge of nurses working at the intermediate care ward was higher. The processed data from the qualitative research have shown that patients do have sufficient information about post-surgery oxygen therapy, as well as about pulmonary rehabilitation. For all patients in the post-surgery period after a cardiac surgery the frequency of pulmonary rehabilitation was higher than 1 per day.
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Specifics of nursing care in patients after transapical aortic valve implantation.
VOTRUBOVÁ, Nataliya
Transcatheter aortic valve implantation (TAVI) is a new and an attractive method in cardiology and as well as in cardiac surgery. It is constantly evolving method which has been developed as an alternative to standard open surgery, especially in patients with severe symptomatic aortic stenosis with unacceptably high perioperative risk or patients who are not suitable for conventional open heart surgery because of age and comorbidities.A teamwork is very importantfor this new method and approach. The choice for TAVI is discussed by the institutional multidisciplinary heart team, typically consisting of interventional cardiologists, imaging-specialists, cardiac surgeons and anaesthesiologists. The first implant in a human being was performed by Cribierin 2002. In Czech Republic this method was first used in 2008. Transcatheter aortic valve implantation (TAVI) was accepted as a minimally invasive alternative to open surgery. This method does not require the use of cardiopulmonary bypass, and cardiac arrest. Other several benefits includinglower risks of bleeding and stroke events, better wound healing, less pain, as well as more rapid early recovery due to preservation of continuity of the sternumthat result in shorter durations of stay in the hospital, earlier rehabilitation and faster returns to normal life. In the presented work was used a combination of qualitative-quantitative methods of investigation. The data was obtained by using the quantitative research. The main technique was using the questionnaires designed for nurses working at the Department of Cardiac Surgery, Hospital Czech Budejovice, a. s. These results were backed up by the implementation of qualitative research, which investigated the patients and physicians view on monitored issues. Questioning method using a semi structured interview technique was used for qualitative research. The results of the survey were processed using descriptive statistics charts in LibreOffice Calc and using diagrams created in LibreOffice Writer. Qualitative results of the research were transcribed from audio recordings and coded, and the base code was created nine categories of interviews with clients/patients and three categories of interviews with doctors. The aim of this work was to explore the specific problem of nursing care about the clients / patients after transapical aortic valve implantation. On the base of our obtained data it is evident, that the client/patient after TAVI may be positioned sideways, the use of surgical drains are less frequently, so the care about the surgical wounds is simpler, patients report less pain in the surgical wound and postoperative rehabilitation and recovery is shorter. H1 - The nurses take care about the clients/patients after transapical aortic valve implantation in the same way as about the clients/patients after open aortic valve replacement, without realizing the differences between the patients treated with different approaches, was not confirmed. The nurses'sees/reported major differences in invasiveness and extent of providing care, rehabilitation, convalescent, in the duration of the hospitalization and better cosmetic effect. The results of the research can serve as a basis for creating the standards of nursing care or educational material for clients/patients. It is also possible to present the results of this work at a specialized seminar for non medical healthcare workers and results can also increase the quality of nursing care about the clients/patients after transapical aortic valve implantation.
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The role of nurses and their impact on the care of patients with total hip arthroplasty.
SLABÁKOVÁ, Květoslava
Total hip replacement is one of the most extensively and highly effective operating methods in orthopaedics. The patients are brought back the self-sufficiency, life without the pain and noticeably motion restriction. Irreplaceable function here is a role of the nurse, who helps the patient to return back to his common life...The aim of this work was to find out, how the patients feel the role of the nurse and its influence to given nursing care before and after the total hip replacement as the less fulfilled. There were following research questions set: How the patients feel the role of the nurse before and after the total hip replacement? How the patients before and after the total hip replacement feel the interpretation of the nurse roles? How the patients before and after the total hip replacement feel the role of the nurse and its influence to given nursing care. Which of the nurse roles are felt by the patient as the unsatisfactory in postoperative care? The patients before and after the total hip replacement feel through the everyday nurse activities the nurse in her role of the caregiver and education giving person, following the nurse vindicator and the nurse bearer of changes. The patients feel the care thanks these roles as a quality, holistic and continual. Nevertheless was the role of the education giving named as the least fulfilled. In connection with these research results was created a manual, a Guide book for the patients before and after the total hip replacement. This Guide book was given to testing purposes. This Guide book was appreciated by the patients very positive despite a large amount of information, which were surprising for many of them. We gained some data, which gave the impulse to complete the information in the Guide.The created Guide book can´t replace the effective communication of the patient with the medical staff, which could be always the most suitable "source" of information.
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Palliative care is provided by patient's family at home
KUČEROVÁ, Tereza
The thesis, titled Palliative Care Provided by Patient's Family in Home Environment, discusses the specific care needs of a terminally ill patient in his/her own home. Caring for an ill person in a home environment is beginning to be a growing trend in home care, but also it is an increasingly common wish of the patients themselves. The family is therefore required to have enough theory and practical knowledge in order to deliver a highly demanding personal care for their close family members. The aim of the thesis is to summarize the current situation of delivering palliative care in home environment in Czech Republic whilst concentrating on the specific needs of the patient and the needs of their family. The objectives of the research were to determine whether family members were introduces to the specifics of palliative care of terminally ill patients; to map their skills in delivering palliative care in home environment and to reveal the most common issues that family members come across in that home environment. The final objective was to map out services in regions of Central Bohemia and Liberec that are accessible to family members whilst caring for a terminally ill patient. The research part of the thesis was completed employing a method of qualitative investigation using semi-structured interviews with patient's family members and nurses providing hospice care in home environment. It emerged from the analytical interviews that the family's knowledge level regarding support for palliative care in home environment is very limited and in hospitals families are only given minimal or no support or information. As a final document for the thesis an informative educational brochure was created based on the results of aforementioned research, primarily targeting patient's family; its core objective is to improve information and collate the specifics of care that would allow the patient a dignified end to their life.
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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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