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The issue of communication between medical staff and the patient
Herodesová, Denisa ; Marádová, Eva (advisor) ; Kovaříková, Miroslava (referee)
The diploma thesis focused on the issue of communication between the medical staff and the patient deals with attitudes, knowledge and ethical isssues of communication between the doctor and the patient. The target group is the medical staff of the hospital ward and also the specialized outpatient service. The theoretical part explains the importance of communication between medical staff and the patient in a particular health care system. It also explains why ethics is important in relation to communication. All theoretical knowledge is based on available literary sources. The practical part describes the preparation, implementation and results of the research. Individual steps are taken to identify the current situaton in the issue. It has been found that attitudes and knowledge in patient communication vary. Furthermore, it was found that current educational programs and teaching plans of selected schools meet the level of school curriculum, but the practical teaching of communication skills is neglected. KEYWORDS: ethics, communication, patient, medical staff, medical facility
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Types of patient's information needs
KOSOVÁ, Michaela
These days human being can find itself swamped with tons of information. It is neccessary to think over provided information given by a health care system and its efficiency. The thesis named Types of patient´s information needs is divided into a theoretical part and a practical part. Materials about nursing, medicine, psychology, sociology and a law issued in the Czech Republic and abroad were used to get necessary information about current condition of problematics. Two goals were set based on acquired knowledge. The first goal was to get to know about what type of information were requested and needed by patients and which they missed from nurses and doctors in ambulances and hospitals. The second goal was to double check if a personal perceiving of a given information corresponds with the real diagnosis. With respect to thesis goals, 9 research questions were formulated. Information regarding examined topic were acquired through research and investigation. As the means of collecting the data an interview was chosen. 23 interviews with patiens were done and the analyzed according to the Strausse theory. It was found, that patiens involved in this interview, take care about their health condition and that the information, which they perceive as important, are given to them by the medical staff. The information they have makes them more comfortable and they view it as a very important. It was as certained, that patients are very sensitive about the way the medical staff communicates with them and that their personality plays part in this process. The purpose of this thesis is to give an impulse to reinforce informing the patiens in a written form, but mainly to reinforce their personal contact with a doctor. Is is obvious, that the information and the way they get it is very important for patients.
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Medical staff´s awareness of emergencies in selected health care facilities
DVOŘÁK, Ladislav
The aim of this bachelor thesis is to evaluate the extent to which health care personnel from selected South Bohemia region health care facilities is prepared to emergency situation. The research has been conducted in 7 largest health care facilities in South Bohemia region at Hospital České Budějovice, Plc., Hospital Tábor, Plc., Hospital Jindřichův Hradec, Plc., Hospital Český Krumlov, Plc., Hospital Strakonice, Plc., Hospital Písek, Plc., Hospital Prachatice, Plc.. Since within these health care facilities, there are present thousands of patients on daily basis, there is, without any shadow of doubt, need for each member of health care personnel to be well informed not only about possible emergency situations but also about how general public is warned when an emergency situation takes place and also how to behave when these emergency situations happen. The theoretical framework focuses on emergency situations. It contains the definition of emergency situations as it is defined by Act 239/2000 Coll., on Integrated Rescue System, where the emergency situations are outlined and there are also mentioned the causing factors. Based on the information from Regional emergency plan there are described some emergency situations in further detail. For example these emergency situations can be floods, that are one of the most common emergency situation from the past years in South Bohemia region, emergency situations caused by radiation, conflagrations, leakage of dangerous chemical substances, disease outbreaks or terrorism, which is the threat that is to be taken more and more seriously based on current development in Europe. The theoretical framework also describes health care facilities. There is described the term of "health care facility" as defined by Act 372/2011 Coll., on Health Care Services Quality. In order to emphasize the importance of public protection in health care facilities, there is also a summary of the number of health care facilities in the Czech Republic. The next chapter of theoretical framework mentions more detailed information about individual hospitals selected for the research on health care personnel knowledgeableness. To answer the research question "How familiar is health care personnel from selected health care facilities from the area of South Bohemia region with the cause of emergency situation?" a large questionnaire study has been conducted from each of the 7 selected hospitals. The results have been evaluated and depicted using Microsoft Excel software. The statistical evaluation has been done by using ANOVA method that compared the relation between respondents' final score and individual criteria (gender, age, highest educational level within hospital where respondent worked). The results of the survey show that the average familiarity of health care personnel is capped at 72.74 %. The researcher set 80% passing limit which means that the level of familiarity is unsatisfactory. The questions category, with the lowest score (59.24%), is population protection. Since 79.5 % of respondents do not know what the warning signal "General warning" sounds like, there is a need for regular training of health care personnel on Public protection. In the areas where there are regular trainings provided by law there are significantly better results. To give an example, in the area of fire protection, there have been 74.37 % of questions answered correctly on average. Whilst this is still below the passing rate (80%), as defined by researcher, the results are significantly better when compared with other question areas, which shows that regular training increases employees´ knowledge. Other results showed the correlation between individual characteristics and overall performance. In conclusion, the health care personnel does not have satisfactory amount of information, which means that there is a need to set rules and framework for regular trainings on public protection for health care professional.
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The reasons for the devaluation of human medical personnel.
KASALOVÁ, Ivona
This thesis looks into reasons for devaluation of patient by medical staff. Main objective of the paper is to point at risk factors and summarize present knowledge about devaluation in hospitals. Devaluation manner is behavior, which decreases patient personality and his self-confidence, ignores his needs, opinions and requirements. Actually we had three main tasks in this thesis. To find out, if patients are more devaluated by mistakes in direct medical care and more specifically, if they are more often victims of denying taking care about their biological needs and if patients older than 60 years are more frequent devaluated than others. We focused on demarcation of single characteristics and aspects of this well known risk in behavior, mainly occurred by secondary medical staff. Essential knowledge of this topic are in the theoretical part, which assign attainment about devaluation and evaluation from other researches. Exploration survey was done by two methods. First was statistical research, in which medical staff answers about questions in non-standardized questionnaire. Outcome of this survey was making of tables and after their elaboration into column and sector graphs. Second research method was directed structured interview with hospitalized patients. For elaboration was used Q-methodology and answers of respondents were summarized into graphs. We had three hypotheses. H1: Hospitalized patients are more devaluated by mistakes in direct medical care than by badly interpreted communication. H2: If there are mistakes in direct medical care more often is devaluation by denying taking care about biological needs. H3: Devaluation is more problem of patients older than 60 years. Thank to research we know that hospitalized patients are not more devaluated by making mistakes in direct medical care. However if this mistakes appears denying of taking care about patient biological needs is more often type of devaluation. Third and last hypothesis didn't prove that patient older than 60 years are more frequently devaluated than others. Main benefits of this thesis are summary of knowledge about this behavior and deeper look into this problematic. Simultaneously findings that main devaluation in providing direct care is denying taking care about patient biological needs, which formulate in 1943 A. H. Maslow, is crucial. Legacy of this American psychologist is more than recent and shouldn't be ignored in today's medical practice. Overall thesis collects information from different Czech and foreign resources and completely and clearly describes risks and consequences of devaluation.
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Factors influencing the satisfaction of patients with provided nursing care
MORONGOVÁ, Adéla
Current state: The satisfaction of patients is an important factor for the quality of nursing care. Nursing care should be mainly focused on meeting the needs of patients and many other factors. This greatly affects the patient's subjective feeling of satisfaction or dissatisfaction with either the proper nursing care, or other factors. The patient is an active participant in the treatment, not a passive recipient of nursing care. Measuring the satisfaction of patients is one of the requirements for the accreditation of hospitals. Research objective: The aim of the research was to determine the satisfaction of patients with the provided nursing care. Another objective was to demonstrate a statistically significant relationship between the satisfaction with nursing care and the impact factors: sex, age, education, environment and the routine on a standard ward, communication with patients and nurses attitude of nurses to patients. Methodology: The research was realized using quantitative methods. For my research I used a standardized questionnaire called Quality seen by patients - evaluation of inpatient care, which included 34 questions. The questionnaire for the assessment of patient satisfaction was compiled into several areas: satisfaction of patients with the hospital stay, with the nursing care provided, with leaving the hospital, with the general assessment of the health care provider. The survey covered the period from January to March 2015 at the standard surgery and internal medicine department in the hospitals of České Budějovice and Český Krumlov. For the survey I selected the patients who were hospitalized in these departments for at least 3 days. The data obtained by a quantitative research were later tested by SPSS software. For statistical testing we selected the chi-square and the tick chart. The significance level was set at 5%. Participants: As part of the survey, a total of 200 patients were approached. 100 patients were interviewed in the hospital of České Budějovice in surgery and internal medicine departments. The remaining 100 questionnaires were distributed to patients in the hospital of Český Krumlov, again on the internal and surgical wards. The total return of the questionnaires was 100% (200). Results: The research shows that men are less satisfied with the received care than women. An important factor in patient satisfaction showed to be the education of the respondents. University-educated patients were significantly less satisfied with nursing care than respondents with secondary and primary education. Another examined factor was the sleep schedule. Approximately one fifth of the surveyed patients (22%) stated that noise caused by other patients was disturbing. The respondents who indicated that were disturbed by the noise in the department, rated the satisfaction with nursing care significantly worse. Conversely, the patients expressed satisfaction with the wake-up time. In the area of the patient satisfaction with the cleanliness of the rooms and toilets, the research survey showed that satisfaction decreases significantly if the patients are not satisfied with the cleanliness of the toilets and rooms. The environment, in which the patients are hospitalized, greatly influences their satisfaction with nursing care. Another important factor for the patient satisfaction is also the communication and the attitude of the nurses to them. If the attitude of the nurses is compassionate, soothing and they pass information to the patients in an understandable way, the patients have more confidence and are more satisfied. This is true when the patients meet their needs and feel that they are treated with dignity and respect. Conclusion: The research shows that these factors affect the satisfaction of patients with nursing care and in the context of these results the importance of highly individualized care is increasing. Nurses must significantly contribute to improving patient satisfaction.
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Human devaluation by medical staff
DRÁBIKOVÁ, Martina
The thesis deals with the issue of devaluation of persons by medical and paramedical employees. Health service is the field in which the human dignity should be respected. The devaluation of men/women occurs during social contacts and even in health service, situations leading to devaluation may occur due to unconscious and unaware communication. For mutual contacts of the (para)medical employee and the patient, not only a good knowledge of psychology, but first of all the ability to apply adequately communication skills in practice is necessary. The patient should not represent for medical staff only diagnosis, but first of all he/she should be seen as a human being. Behavior of (para)medical employees should be supporting and strengthening, it should not only contribute to a quick recovery, but also to the psychological balance and well-being of patients. Three goals were postulated for the purposes of this thesis. The first goal was to find out if the devaluation of men/women by a (para)medical employee occurs during the hospitalization. It follows from the results of the research that situations of patient devaluation by the medical employee occur really. The purpose of the second goal was to find out the ways of person devaluation during the hospitalization. It follows from the investigation that the devaluation may take place in different ways. The research questions cover practically with this goal. The most frequent way of devaluation is unsuitably conducted communication of medical employees. The third goal was to find out if the medical staff has an impact on the devaluation of man. Patients do not have experience with an arrogant behavior but consider it as devaluing. It was found out by the investigation that the personal staff has an affects the devaluation of man because individual members of the nursing team contributes to the devaluation of the patient. These, was confirmed by the answers of patients in quantitative research. The respondents believe that the number of the medical staff rather does not support evaluation of the patients. It can be concluded that the personal staff in some way affects the devaluation.
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Undesirable effects in nursing care
MARKOVÁ, Ladislava
Adverse events in nursing care are currently much discussed topic. In providing of nursing care we meet with some kind of adverse events every day. But not always we come to realize that it is an adverse event. The number of adverse events grows up every year and this topic becomes more current. The target of this bachelor thesis titled Adverse events in nursing care was to obtain enough information about the discussed topic of adverse events. Practical part of bachelor thesis was prepared by form of quantitative research carried out by using questionnaire survey. Based in the results from questionnaire survey were confirmed or unconfirmed given hypotheses. Ascertained results were summarized in the graphs of which analysis confirmed the hypothesis no.2 The average age of clients who suffer most with the adverse events is from 65 to 75 years. Hypothesis no. 3 The most common adverse events are falls. Hypothesis no. 4 The most commonly used methods of prevention are barriers and warning devices. Hypothesis no. 5 Adverse events occurring more in internal wards. Hypothesis no. 1 The frequency of adverse events increased in 2011, compared to other years based on the processed research results, was not confirmed. As emerged from the research, to the topic of adverse events is not attached such seriousness as it should and sometimes are adverse events underestimated by medical staff. The results of the research will be presented and consulted with the hospital´s main nurse, who could works with it within the meaning of the organizing various seminars, information meetings with my contribution and participation.
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Interpreter as a part of team in nursing of patient
KASOVÁ, Simona
Abstract: Many foreign-language minorities live in the territory of the Czech Republic; therefore nursing care of other nations in healthcare facilities is not unusual. Mutual communication and understanding influence greatly the quality of nursing care for foreign patients. If a nurse does not know the needs of her foreign patient because of ineffective communication, she is unable to satisfy these needs and thereby provide quality nursing care. This thesis, focusing on topic Interpreter as part of a team taking care of foreign patients, describes, in its theoretical part, the movement of foreigners in the Czech Republic, the principles and elements of intercultural communication for healthcare professionals, interpreters work and involvement in multicultural nursing, and also some interesting facts concerning the communication of certain nationalities. The second part of this thesis consists of quantitative research, which is accompanied by a qualitative survey, through structured interviews with foreigners living in the Czech Republic. The quantitative research was conducted using questionnaires for nurses working in hospitals of South Bohemia. The thesis objective, to identify nurses knowledge needed to ensure a successful and good communication with foreign patients, has been met. Hypotheses for the objective were set as follows: H1 Nurses are already experienced with treating of patients foreigners. H2 Nurses have experiences in communication with members of foreign language minorities. H3 Nurses have some knowledge of the practices of successful communication with foreign patients. H4 Nurses know the contacts to people who they can address if an interpreter is necessary. H5 An interpreter is included in the nursing team treating a foreign patient. On the basis of research results, first two hypotheses have been confirmed; the other hypotheses have not been confirmed by the research. The results of this thesis could serve as an indicator of the need to educate nurses in a multicultural nursing. They could also point out in practice to the suitability of involving an interpreter in a nursing team treating members of foreign-language minorities.
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CENTER FOR DEAF MOTHERS BY THE INSTITUTE FOR THE CARE OF MOTHER AND CHILD
TOMÁNKOVÁ, Barbora
My Bachelor Thesis is called Centre for deaf mothers attached to the Institution for Mother and Child Care which was created as a unique project five years ago on the basis of negative experience of deaf mothers during their pregnancy and childbirth. The aim of my work was to describe the activity of the Centre for deaf mothers attached to the Institution for Mother and Child Care, care for expectant deaf mothers, methods of communication of medical staff with deaf mothers. Further, my thesis concentrated on the interest of medical staff in sign language classes, possibilities of education in the given issues and work conditions. The important goal of my work was also description of subjective feelings of deaf mothers who gave birth in the given health-care facility. My work is divided into two parts, into a theoretical and a practical part. In the theoretical part I briefly deal with division of hearing defects, communication from the general point of view, forms of communication of the deaf including communication systems, principles of communication with the deaf. In the practical part, I used methods and techniques of a qualitative research. As a technique of field data collection, I used a method of interviewing, and the technique being a semi-controlled interview with medical staff (physicians and midwives) and with deaf mothers who gave birth in the given health-care facility in the period from the formation of the Centre until the end of the year 2008. Results of the qualitative research which this thesis has produced: 1)Medical staff are insufficiently motivated on the part of the employer by attending sign language courses. 2)Medical staff think that every deaf person can read our lips. 3)According to deaf mothers who have given birth in the the Institution for Mother and Child Care (ÚPMD) in the last two years, the approach of the medical staff is the same as in other health-care facilities. 4) Medical staff do not distinguish a type of hearing impairment among deaf clients , and therefore, they choose inappropriate communication .
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The communication of medical staff with client from the view of client.
KOLÁŘOVÁ, Markéta
I have divided my bachelor thesis ``Communication of Medical Staff with Clients{\crqq} into several chapters. The first chapter ``Current Situation{\crqq} explains term ``communication{\crqq} and clarifies the communication process in general. Further in my thesis I address communication between a medical worker and a client (patient) from concrete points of view. I examine e.g. the relationship between a client and a medical worker, principles of correct communication in interaction between medical staff and clients, productive behaviour and dialog in health service. Last but not least, this chapter is focused on devaluation elements in communication and non-productive behaviour of medical staff. Objectives and hypotheses are set in the following chapter. The first objective of my thesis is to ascertain the subjectively perceived level of communication skills of the medical staff towards their clients from the view of the clients in Nemocnice Rudolfa a Stefanie Benešov (Hospital of Rudolph and Stephanie in Benešov). The second task is to assess the effect of communication skills of the medical staff on the awareness of their clients of the diagnosis, examination and the course of therapy. The hypotheses are set as follows: ``Clients consider the communication level of the medical staff to be low,{\crqq} and ``Awareness of clients is directly proportional to the level of communication.{\crqq} In order to achieve the objectives and verify the hypotheses, I decided for a quantitative research using the questionnaire method. The basic set of respondents comprises 65 adult clients of Nemocnice Rudolfa a Stefanie Benešov from the age of 18 to 65 years. The return rate of the questionnaires amounted to 98 %. I have managed to fulfil both the set objectives on the basis of the conducted research. The respondents considered the level of communication of the medical staff to be very good. Provision of information by the medical staff was also assessed as very good. Thus awareness is directly proportionate to the level of communication of the medical staff. The first hypothesis ``Clients consider the communication level of the medical staff to be low{\crqq} has not been confirmed. I raised the hypothesis on the basis of my personal experience and am very glad that the research has disconfirmed the hypothesis. The second hypothesis ``Awareness of clients is directly proportional to the level of communication{\crqq} has been confirmed. The obtained results may be used by both the medical staff and the clients of the hospital.
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