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Benefits of nursery school for Children with autism spectrum disorder in sel-care
Mitašová, Marie ; Šiška, Jan (advisor) ; Šumníková, Pavlína (referee)
The bachelor thesis concerns benefits of a nursery school for children with autistic spectrum disorder with focus on development of self-care. The thesis concentrates on characteristics of autistic spectrum disorders and it's interconnection with practical aspects of developing self-care skills in a nursery school. Individual chapters describe the definition, diagnostics and related triad of problem areas, the spectrum of individual autistic disorders and the most frequently used methods and strategies of training and education of childrenwith autistic spectrum disorders. The second part of the thesis provides space for individual areas of self-care, cultivated in the nursery school. Individual chapters demonstrate detailed descriptions of practising self-care habits and skills, applied in daily routines of the nursery school. The thesis bases on published works in the area of autistic spectrum, as well as on practical experience of the author, obtained in several years of practice as a teacher in a special class for children with autistic spectrum disorders in a nursery school. Keywords: autistic spectrum disorders, self-care, nursery school, self-care habits and skills
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The issue of acceptance of self-care about stoma after intestinal surgery.
MOCKOVÁ, Jana
Basic theoretical background: Stoma as a part of the surgical treatment of digestive tract diseases usually radically affects the life of the patient and his relatives. The patient has to face not only the severe diagnosis but also the result of the surgery concerning one of the most intimate human spheres. A significant part in the return to a full life is the acceptance of the stoma by the patient and his ability of being active when taking care of stoma. The theoretical part in the introduction describes the Theory of self-care deficit. The second part of the theoretical work summarizes basic information regarding the issue of derivation of intestinal stoma and the issue of acceptance of the changed body image and self-care. Objectives and hypotheses: The aim of this work is to find out differences in the acceptance of stoma and care for stoma among patients after intestinal surgery. To achieve the objective of the work, there were set three hypothesis. H1: Patients with a permanent stoma experience major changes in the psychosocial area than patients with temporary stoma. H2: In the postoperative period, women approach practising the stoma care differently than men. H3: Patients under 55 have more information about living with stoma than older patients. Methodology: The research part of the work has been carried out through quantitative research. The form of data gathering was an anonymous questionnaire. The only criterion of the selection of the respondents was the state of health after the intestinal surgery with the subsequent stoma. During the search of the respondents were addressed organizations joining the patients with stoma, stoma and proctologic ambulances of selected hospitals, hospices and homes for elderly people. The obtained data were processed by descriptive statistics in graphs by the help of Microsoft Office Excel 2010. Further on, the statistical evaluation of hypotheses was carried out. Hypotheses were tested by chi-square test in a PivotTable, the average values were compared by T-test. The chosen significance level was 5 %. Conclusion: The work provides a comprehensive look at the issue of acceptance of stoma self-care after intestinal surgery. Creating of stoma, regardless of age or sex of the patient and also regardless of its eventual duration radically influences the patient's life. This is necessary to remember all the time from the long lasting preoperative preparation to aftercare when the stoma patient should be provided by comprehensive care by nurses. The nurse should also help the patient to return to a normal life.
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Nurse assistance in personal patient heath care education
ČERNÍKOVÁ, Jitka
The topic of my thesis is "Nurse Assistant in Patients Self-Care Education". Education in Nursing has certainly an irreplaceable position. Amputation means removing the peripheral portion of the body, mostly of a limb.Education is a very important element and an integral part of the nursing process, which aims to prevent the disease, teaching or restoration of health and plays a major role in improving the quality of life of the individual. Education of patients after lower limb amputation begins on the first day after surgery and ends with the release client for home care. An interaction between the nurse and the client after leg amputation is very important part of the education.To meet the client's effort to be educated is the responsibility of the nurse to try to gradually engage the client in education. If the client is unable to cooperate with the nurse, she tries to engage the client´s family into the education.Nursing care for patients after amputation of the lower limbs is extensive. In the early period after surgery, nurse teaches the client's breathing and then the fitness exercises. Nurses educate clients after leg amputation especially in the training of care stump, walking on crutches with help of another person, and then walk on crutches without the support of another person and in the final stage to walk with a prosthesis attached. The aim of this work was to identify methods of education of clients while practicing self-care. With this objective, related research question is "What are the educational methods used by clients during training while practicing self-care." To obtain the necessary data was carried out through non-standardized interview with nurses working at the departments where nurses caring of clients after amputation of the lower limbs in a hospital of České Budějovice a.s.To meet the objectives of the thesis on "Nurse Assistant in Patients Self-Care Education" was chosen qualitative investigation. Data collection was chosen semi-structured interview, containing twelve questions. .The interview was conducted with randomly selected nurses who work in a hospital of České Budějovice. Six interviews were carried out.The research sample was consisted of nurses working in a hospital of České Budějovice. These nurses work at the surgical department and department of aftercare and were asked to their objective data: age, length of experience.Research was conducted with the approval of the head nurse of České Budějovice hospital. After reaching the head nurse, followed cooperation with the senior department nurse of surgical department and department of aftercare.The results of the research investigation are clear to show that there was to meet the predetermined goal. The research question was to acquire the necessary response.The research showed that nurses in educating clients, after lower limb amputation during training stump care and practice walking on crutches, use the oral methods of instruction and practical demonstrations. Instruction and practical demonstration is performed by nurses using the spoken word, exceptionally, a written word.Survey of this thesis answers the research question that educational methods are distinguished according to whether the education is for practicing care stump or practice walking on crutches.To determine the results of the research was used qualitative data collection by interview. The interview contained twelve questions. There were six interviews carried out with the nurses from the hospital of České Budějovice, working in the surgical ward and aftercare department. The results show that there has been compliance with predetermined objectives and the research question we got the answers you need.An information material was developed, based on the results of the research, designated to nurses working in the hospital of České Budějovice, taking care of clients after leg amputation.
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The use of self-care deficit theory client CMP
PAULÍKOVÁ, Martina
Theory Stroke, a cerebrovascular disease, causes severe disability and failure of self-sufficiency for nearly of half of the patients. Nursing focuses on respecting the individuality of each patient, supports the return and consolidation of a good health, promotes self-sufficiency and searches for the needs of the patient. Conceptual model of D. E. Orem assumes the ability of each human to take care of self. Although partially, or not capable of self-care at all, it is necessary to fill up the deficit by nursing care. Objectives The first objective was to state the options to how to fill up the deficit of self-care by patienst after stroke. The second objective was to determine, whether the patient´s living environment has an impact the development of self-care. Research questions Q1: Does the home environment stimulate the acceleration of the return of self-care ability by patients after a stroke? Q2 : Does the respondent perceive the issue of own disability equaly as the surrounding? Q3 : Is it more beneficial for the patient to perform self-care with deficiency, or to receive perfect execution of it by others? Q4 : Does the patient perceive the subsequent therapy (physiotherapy, occupational therapy) as a faster way to return to sufficient self-care? The research part of the thesis was carried out by a qualitative survey, conducted as a individual semi-structured thematic interviews with respondents devided into two groups. One group consisted of patients after a stroke and a second group of caregivers. Total of 8 patients, 4 males and 4 females, were interviewed. The research was completed in three sessions, each at intervals of four to six weeks. The information received were processed by open coding method, analytical induction development of technology showdown and narrative analysis. Results Using data received from interviews with respondents it was possible to answer all the research questions. The first research question examined was, whether the home environment stimulates the acceleration of the return of self-care ability by patients after a stroke. According to interviews and objective evaluation, the domestic environment has improved overall condition and faster return to individual self-care. Although, aftercare provided enough nursing and rehabilitative care, patient very much appreciated mental stimulation given by the home environment. The second research question focused on whether the respondent perceives own disability equaly as the surrounding. The interviews showed most of the patients perceive their health and subsequent disabilities better than its surroundings. The third research question examined whether it is more beneficial for the patient to perform self-care with deficiency, or to receive perfect execution of it by others. The results indicated more benefits by performing own self-care, even with mistakes that encourage practising, thereby repeating and consolidating manners. Most of the respondents refused any help. The fourth research question focused on patient´s perception of the subsequent therapy (physiotherapy, occupational therapy) as a faster way to return to sufficient self-care. The interviews showed that the respondents did not realize the importance of aftercare, considered it to be routine and as a part of the treatment. Yet, increased physiotherapy activities results into a quicker adjustment of self-sufficiency. Conclusion The temporal evolution of self-sufficiency of patients after a stroke and the attitudes of caregivers are described in this thesis. The results are presented in a form of mental map. This might be used by the patients after stroke, nursing staff or official home caregivers and informal caregivers, as well.
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Verification of knowledge about self-management in patients with heart failure
VOJTĚCHOVÁ, Veronika
Congestive heart failure (CHF) is a disease with increasing incidence, which requires an adequate and costly management. Repeated hospitalisations due to decompensated CHF contribute to disease progression and herald dismal prognosis. An important goal of heart failure clinics is reduction in number of hospitalizations due to decompensated CHF. The main approaches to reach this aim seem to be effective diagnostics and treatment of CHF, and importantly, education of patients and their families. We aimed to evaluate knowledge of CHF patients regarding self-care in secondary prevention of CHF. We constructed three hypotheses and three research questions to reach the goal of the project. The theoretical part described recommended life-style interventions, pharmacologic and non-pharmacologic CHF management, and specifically, the role of nurses in education of patients with CHF. The practical part described the methods of analysis, the study group and the process of evaluation. To fulfil the study goal, we performed collection of data using qualitative and quantitative methods of research. The qualitative part of the research project included a non-standardized questionnaire for patients with CHF. A total of 260 questionnaires were distributed in six heart failure clinics. 183 completed questionnaires were returned and analysed. The obtained data were evaluated using descriptive statistical methods. Pearson´s chi-test and Student´s t-test were applied to test the hypotheses. Collection of qualitative data was performed using the technique of a semi-structured interview based on pre-prepared questions. The study respondents included general nurses from out-patient heart failure clinics. Six of nine contacted nurse respondents agreed to participate. Answers were recorded on Dictaphone. Data were analysed using the method of "card display". The quantitative part tested the following hypotheses: 1. CHF patients know symptoms and signs of decompensated CHF. 2. CHF patients follow the life-style recommendations. 3. CHF patients perform daily self-monitoring of their weight, blood pressure and pulse. Our study revealed insufficient knowledge of patients regarding symptoms of possible CHF decompensation. This finding was alarming because suboptimal knowledge of symptoms of decompensated CHF may cause inadequate response of the patient and may delay initiation of treatment. Assessment of compliance with life-style measures revealed that most patients did not use tobacco products and had a limited alcohol consumption. Most individuals reported a regular use of heart failure medication and knew the timing of the next follow-up in their heart failure clinic. Life-style measures included also some dietary restrictions modified by the current nutritional status. Respondents preferred recommended food over inappropriate foodstuffs, however, they did not follow neither the salt restriction nor the optimal frequency of meals. Most respondents did not report a regular exercise A significant ignorance was found in the process of self-monitoring. Most respondents did not monitor their body weight, blood pressure and pulse. The qualitative assessment evaluated the following questions: 1. Do we educate the CHF patients appropriately? 2. Are we able as nurses to pass correct information to CHF patients? 3. How is the process of education implemented in practice? Based on the above mentioned methods, we found that the process of education is a domain of doctors. Nurses have only a limited role in education of CHF patients...
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Nursing care for patient with polytrauma
SKLÁŘOVÁ, Lucie
Multiple traumas mean a present injury of at least two body systems. The patient with the multiple traumas is, because of the threatening failure of one or more organs, alternatively systems, placed on the intensive care unit. The nursing of the patient is therefore systematic, continual and its part is the monitoring of the conditions and saturation of basic needs. The nursing care on the intensive care unit is dependent on their health conditions and it permanently changes. A nurse usually takes over the whole care of the patient and they are dependent on her. Therefore the nurse must know all the patient´s needs and provide them regard to their self-sufficiency. Self-sufficiency is the level of independence during the daily routine. To its evaluation we use Barthel test of basic daily activities. In literature the word self-care is used as an identical term. The empiric part of the bachelor thesis is focused on self-sufficiency, self-care of a patient and activation of the nurses. The goal of the research is to find out the difference in the amount of care for a patient with multiple traumas on the Intensive care unit and a standard ward in connection with the level of self-care. To fulfil the goals three research questions were set. The research questions are: How do the nurses judge the self-sufficiency of a patient with multiple traumas on the intensive care unit and a standard ward? How do they provide the nursing care at a patient with multiple traumas in a standard ward? How do they provide the nursing care at a patient with multiple traumas on the intensive care unit? The qualitative research with the help of semi-structured interview was used to answer the questions and fulfil the goals. The research was taken on the traumatologic intensive care unit and in the standard ward. 5 respondents and one patient were from the intensive care unit and other 5 respondents and two patients were from the standard ward. The answers for the first research question were identical at all respondents. The evaluation of the patient´s self-sufficiency is according to Barthel test. The answers of most respondents point at the fact that the test in not practical and suitable. The results of the second and third research question can be comprehended in one conclusion. Regarding the fact, that the nurses from the intensive care unit and the standard ward made comments in the same way. The nursing care is always provided regarding the self-sufficiency of a patient. They support a patient mentally to make him more self-independent. They use different accessible tools for practice. With the help of the research questions we reached the goals. We found out that the difference in the extent of provided care is in the amount of activities which are done by nurses for the patient on the intensive care unit and in the standard ward. The nurses provide a patient with more activities logically on the intensive care unit. It is due to the conditions of a patient which are acute at the beginning. Even though, the nurses try to activate a patient as much as possible. By contrast, the nurses in a standard ward have the chance to increase patient´s self-sufficiency in more activities. They endeavour patients to be self-sufficient in hygiene, catering, walking and excretion. In these activities patients should be helped by physiotherapists. As it is agreed by the nurses from the intensive care unit as well as the nurses from the standard ward, this approach does not really work and so the only ones who activate a patient are the nurses and hospital attendants. The work should serve the nurses to clarify the importance of multiple traumas and deepen their knowledge of discussed problems.
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Proximal Femoral Fractures - Nurse Problem with Aging of Population
ŠTECÁKOVÁ, Martina
This bachelor thesis deals with the nursing issue of proximal femoral fracture in the context of aging of population. Recently there has been an increase in the number of cases of proximal femoral fracture in the elderly people above all. Age and general state of health influence significantly the entire postoperative period and self- sufficiency of the patient. The objective of the thesis was to research factors related to proximal femoral fracture, to find out about mobility and at the same time about self-sufficiency of the respondents before and after the trauma. Then, to point out the areas of self-care in which the client has the largest deficit, how the client manages the individual areas and whether his own efforts and efforts of the nursing staff can help him to return to the normal life. These objectives were achieved in the thesis. Four hypotheses were set. Hypothesis 1: Proximal femoral fracture in clients above 65 occurs more with women than with men, was verified. Hypothesis 2: Proximal femoral fracture occurs most frequently with clients living alone after the fall at home, was also verified. Hypothesis 3: Clients who are fully mobile and self-sufficient before the trauma, usually return directly to their original environment immediately after the discharge from the trauma department, was not verified. Hypothesis 4: Self-care in hygiene in the postoperative period is the most difficult task for the respondents, was not verified. The theoretical part deals with anatomic structure, vascular and neurological supply of proximal femur. The other part describes particular types of fractures together with clinical picture and treatment possibilities. Then old age with all its aspects is described. An important area is the nursing part, focused on preoperative preparation and postoperative care. To verify the hypotheses, quantitative research was chosen. A standardized interview was designed for patients. An anonymous questionnaire was designed for nursing staff. Further on, content data analysis was applied. The results of the work point to the deficit in the area of self-care, which influence ability of the elderly to return to the normal life. If nursing staff and physiotherapist were familiarized with these results by means of a workshop initiated by the management of the Clinic of Orthopaedics and Traumatology, it might lead to the improvement of the nursing care and it also might become a stimulus for more intensive rehabilitation. Mapped self-care deficits will be then used to create educational material to facilitate the provision of particular services by home care agencies that will compensate for these deficits when the patient returns to his home.
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The Satisfaction of Patients with Peritoneal Dialysis in the Provision of Nursing Process
JANSOVÁ, Miroslava
Peritoneal dialysis is a method of treatment of chronic renal failure. The principle of this method is the exchange of substances between blood and dialysis solution soaked into the abdominal cavity. The absolute indication for the dialysis is the impossibility to establish vascular access for hemodialysis. It is primarily indicated for patients as a treatment for cardiovascular diseases which may cause hemodynamic instability during extracorporeal circulation. Individual preferences of the patient also play an important role. The contraindications are extensive adhesions in the abdominal cavity and inflammatory bowel diseases. This method has recently become common practice at most dialysis centers. It provides patients with more freedom as well as more independence from a medical center and its staff. The qualitative data collection technique was used for the research survey. The qualitative research took the form of non-standardized interview. The research group consisted of six patients from dialysis centers and hospitals in Tábor and České Budějovice. Objective 1 was to find out whether peritoneal nurses provide patients with sufficient information. The research has shown that the patients had been informed about the method before as well as during the treatment. Objective 2 was to find out how nurses support the patients´ self-care. The research has shown that the nurse had supported patients´ self-care by providing them with information regularly, checking during the exchange of dialysis solution and by reeducating them. Objective 3 was to find out whether a nurse helps to reduce social isolation of patients with peritoneal dialysis by providing a health visiting service. The research has shown that patients had highly praised this service, feeling encouraged to become more active thanks to the health visiting service. The work of nurses caring for these patients is rather independent and individualized. The success of treatment largely depends on high quality work of a nurse, on her educational and communication skills. We hope that the results obtained will be an example for other health professionals caring for these patients. The brochure could help patients with renal failure to decide when selecting a method of treatment.
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Post-operative self-sufficiency monitoring of a polytraumatic patient
STRAKOVÁ, Lucie
The therapy of patients with polytrauma takes a lot of time. Associated complications can often occur. In the course of recovery after numerous operations is dramatically limited the dynamics of patient, his survivability capacity to shift for oneself is low. In this period is very important to be engaged in the regularly self-sufficiency training, every day activities, fitnessand breathing exercises. The well-timed post-operative mobilisation and a self-sufficiency training help to improve a general health conditition. It is necessary to support motivation and self-confidence of patient.
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Client{\crq}s motivation {--} a part of everyday nursing activities
KREJČOVÁ, Martina
If clients are to be motivated, they have to be made desirous of achieving an objective, confident of their abilities, and capable of imagining the possibilities opened up to them after the objective is accomplished. This Bachelor paper aims to find out how the clients of senior-citizen facilities are motivated for self-care. Degenerative changes encountered in seniors often deteriorate their self-care performance. The older the people get, the more difficult it seems for them to find reasons why they should keep themselves active. A nurse, therefore, has to encourage in them the proper attitude through which the seniors will be able to maintain or even improve their level of self-reliance. This paper is to map the motivation mechanisms at work in the clients of senior-citizen facilities operating in the Region of South Bohemia and to examine the way in which the nurses motivate the clients for self-care and self-reliance. The data were generated through a qualitative survey of two different non-standardized types of interviews. The first type of interview was carried out with nurses working at the nursing homes at Kaplice, Máj and a senior-citizen facility of the Staroměstská Center of Social Services. The second type of interview was conducted with randomly selected clients of the facilities. The survey revealed the way in which the nurses motivated the clients for self-care, as well as the motives, both personal and factual, behind such efforts encountered in the clients. Moreover, the nurses` attitudes were investigated about how the nursing process could be used to motivate the clients for self-care, and the clients` needs were examined as they related to the self-care motivation induced by the nursing process. Conclusions of the paper can provide a source of information for both managers of the facilities and the nurses delivering the care. Future investigation should seek a method in which the nursing process can better motivate the clients for self-care, and possibly it should focus on the nursing documentation. Nurses providing care at the senior-citizen facilities strive to motivate the clients to resume their self-assistance capabilities and keep the capabilities workable. The clients appreciate their efforts.
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