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Nutritional care of children at pediatric clinics and hospitals
METELCOVÁ, Jana
The main goal of this work called Nutritional Care in Children's Hospital and Hospital facilities is to verify whether the nutritional standards created for older child patients meet the needs and are checked and if their physiological needs are fulfilled in chosen hospitals. The next objective is to evaluate the satisfaction of the hospitalised patients with the meals given to them by hospitals. The theoretical part of this work deals with nutritional care, therapeutic care and nutritional needs of adolescents. It further deals with nutritional risks and marginally mentions technological processes regarding meal preparation. The method of qualitative research was used by using questionnaires filled in by chosen children patients who were then interviewed. Children aged 10 to 14 were supposed to be on diet number 13, half of them were boys and the other half were girls. The research was conducted in the children's ward in the hospital in Jindřichův Hradec in December 2015 and in the same type of ward in the hospital in České Budějovice in February 2016. The initial number of respondents was five patients in each ward, then using snow ball sampling method their number increased into ten in each ward. The weekly menu according to which the meals were distributed was obtained from the catering facilities of the hospitals. By using the program "Nutriservis Profi" the contents of nutrients in the meals were obtained. The results gathered from the program "Nutriservis Profi" were compared with recommended values for particular age group defined by The Czech Society for Nutrition, so meeting the physiological needs of the patients could be evaluated. From the results it was found that both hospitals have problems with supplying enough fibre content, phosphorus and calcium in meals for children's patients. There is also sodium, potassium, cholesterol and vitamin C surplus in the menus. Thanks to the internship in both hospitals in Jindřichův Hradec and České Budějovice meeting the physiological needs of the children could be evaluated. Considering the fact that the previous evaluation revealed some imperfections, therapists from both hospitals should concentrate more on checking nutritional values in meals, consequently it was recommended to focus more on the variety of the menus and their improvement. There were also inadequacies in attendance at the children's ward. There was a comparison of the results from both hospitals, based on questionnaires and interviews from the children's point of view. Based on the data, children hospitalized in Jindřichův Hradec were more satisfied with the meals. In the conclusion there is a summary of the research and suggested suitable improvements for hospitals. There is a model menu for diet number 13 in the attachment which could be used by hospitals.
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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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Nurses Suffering from Psoriasis
ONDRÁČKOVÁ, Andrea
Psoriasis is a non-infectious inflammation with the genetic disposition. It is a chronic inflammatory disease connected with the accelerated reproduction of skin cells whose cause has not been recognized yet. According to various sources it afflicts 2-3% of the Central European population in different forms including the most serious cases which can affect with the intensive inflammation the entire skin surface. There are several types of psoriasis and they differ with the intensity and the symptoms. The disease shows a red marked area covered with silver white scales of dead cells. Psoriasis does not belong to cases which endanger our life but it enormously influences the physical, psychic and social aspects of the life. The content of the Bachelor work is focused on the issue of psoriasis at general nurses who work in this medical profession. The work is divided into two parts ? theoretical and practical. The theoretical part contains available information on psoriasis from history, disease characteristics, nurse´s role during the nursing process and selected types of treatment. Further, it involves summary of nurses diagnoses of people suffering from psoriasis and the issues of life quality which is undoubtedly affected a lot. In the research ? empiric part of the work the inquiry was carried out with the qualitative method. Data were collected by using the technique of an anonymous, individual, in-depth and non-standardized interview with respondents ? general nurses suffering with psoriasis. The aim of the work was to find out how psoriasis influences the nurses´ professional life. The research questions dealt with the general information about the nurse as a patient, with work limitations, stigmatisation from patients and the staff and with the influence of the medical environment on worsening psoriasis symptoms. The research showed that psoriasis does not influence quality nursing care and that this disease influences the private life more than the professional one. The results of the research compile an information leaflet from which patients can find out, that they do not have to be afraid of nurses suffering from psoriasis and that their disease does not affect their nursing care. Another contribution of the work lies in a printed article which enables the general public to get the information.
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Identifikace a kvalifikovaný odhad nákladů na léčbu cévní mozkové příhody v ČR na základě farmakoekonomické analýzy a návrh alternativního řešení
Pokorná, Hana
Background: Stroke is the second most frequent cause of death in developed countries and the most frequent cause of permanent disability. This way this illness creates high costs for society which should be minimized as much as possible. One of the possibilities is to administer cost-saving drugs which are at the same time from the medical point of view of the top quality and their economic effectiveness can be identified by means of pharmacoeconomic analysis. Objective: The objective of the work is to identify and carry out a quantified estimate of costs connected with the stroke treatment in the Czech Republic. Next is the necessary to confront the results with the alternative solution to the treatment (taking drug Xarelto instead of Warfarin) and to carry out comparison of the both the possibilities from the quantitative point of view. Methods: Costs of stroke treatment are evaluated from the social point of view. From their determination COI method with type of bottom-up approach has been picked out which includes all-life cost-of-illness. For comparison of costs both the treatment vari-ants the Cost-Minimization Analysis (CMA) has been chosen, the results of which shows net cost savings. Data are taken from non-public data of the provider (St. Anne 's Uni-versity Hospital Brno), Institute of Health Information and Statistics of the Czech Republic, Czech Statistical Office, foreign studies and consultations with neurologists as well. Results: Total social costs of treatment of stroke were 12 991 273 843,65 CZK. COI method was used to calculate average costs for one patient with Warfarin in the amount of 1 203 423,68 CZK, in case of alternative treatment with Xarelto in the amount of 1 465 963,32 CZK. Relaps creates the biggest item of the costs. CMA method was used to identify savings when Warfarin is administered in the average amount of 262 539,64 CZK per patient. The hypothesis that Xarelto is more effective from the economic point of view has not been confirmed. Conclusion: Because of high cost of Xarelto, this drug has not beaten the economic effectiveness of Warfarin with lower quality. It is possible to search for savings in other items of identified costs as well.
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