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Monitoring prevalence of pressure ulcers as a quality indicators of nursing care on national level.
MÜLLEROVÁ, Nina
Abstract The diploma thesis is focused on the application of a national methodics for prevalence monitoring and comparison of pressure sores (decubitus ulcers) incidence in health care facilities in the Czech Republic. Pressure sores are a global problem and their incidence should be prevented by preventive measures and high-quality nursing care. However, despite all the provisions, we are not successful in the prevention of their incidence. It is necessary to define standardized quality indicators of the nursing care, to compare the results, and to share the information with specialists, which would result in continuous quality improvement (benchmarking), and to support good practice. In the world the quality indicators monitoring of health care is quite common, in the Czech Republic the process has been only developing. In the area of Czech nursing care only the falls in health care facilities are monitored on the national level. The methodics for the monitoring of pressure sore incidence has not been established yet on the national level. In 2003 the first comparison of four teaching hospitals was carried out in the incidence of pressure sores by means of the method of prevalence investigation. In 2005 the data collection methodics was elaborated during the solution of the grant project IGA MZ Č NO 77723-3. Six teaching hospitals were compared for the prevalence of pressure sores, with division into four specialty groups: internal medicine, surgical, intensive and follow-up care. In 2008 a project of quality and safety of the Ministry of Health was implemented, with a view to elaborate uniform methodics for prevalence investigation and comparison of a standard indicator in the area of pressure sores at the national level, regardless of the type of a health care facility. At the meeting of the Work Group for Health Care Quality of the Ministry of Health of the Czech Republic I recommended to include the indicator in the National Set of Health Care Indicators. The work aims at the verification of the applicability of the new methodics and software in practice, and at the facilitation of their implementation into practice. It is focused on the opinions of the project participants on the developed software, on its application into practice and on the challenges that should be tackled during the implementation into practice. In order to get the necessary information, we have chosen a method of qualitative investigation using a semi-structured interview. Eight respondents, direct participants in the project, were interviewed. According to the results of the interviews, health facilities pay much attention to the pressure sores monitoring. The investigations are carried out by means of an incidence and prevalence method. The monitoring of pressure sores incidence has not been included in clinical information systems yet, and it is carried out in several different ways. The interest in comparison between hospitals (benchmarking) is considerable. The results of the investigation are used above all for the purpose of improvement of measures preventing the incidence of pressure sores, of the improvement of quality of nursing care, and of reducing the workload of nurses. The extent of the economic impact of the pressure sores incidence on health facilities is not clear. If we want to facilitate the application of national methodics of monitoring the pressures sores prevalence to practice and the use of application software, we should ensure adequate awareness of health care managers, training of teams of health professionals, coordinators and editors, who will go on to work with the national methodics. The monitoring of the national quality indicator in the area of pressure sores is another shift in the implementation of goals of the Ministry of Health concerning the quality of care and safety of the patients.
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The incidence, prevalence, letality and fatality from cancers in the Czech Republic
Křížová, Jana ; Mazouch, Petr (advisor) ; Malečková, Romana (referee)
In the past few decades, the Czech Republic took place significant changes in mortality rates. The objective of this study is to determine the development of cancer in the Czech Republic over the last forty years. Indicators of morbidity and mortality are being used. Emphasis is placed on the current development of all cancers in this country and further detail on those cancers that affect most of our population. In the very end, based on the results of the mortality tables, are analyzed the changes in life expectancy depending on the elimination of the deaths of some cancers. This model can use as an idea of how many years would, on average, our population lingered longer, if the cancer did not cause of death.
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The prevalence of the overweight and obesity of pupils on the second grade of the elementary school in the region of Třebíč.
SOUČKOVÁ, Jana
I have engaged in the prevalence of overweight and obesity at pupils of the second grade in elementary schools in the district Trebic in my bachelory work. At first I had studied theoretical knowledge refering to overweight and obesity. I have devoted to this knowledge in the theoretical part of my bachelory work. I had contacted several schools in the Trebic region. They had mostly satisfied me. After meeting with headmasters of selected schools I had handed round the letter to parents of students, which were acquainted with the topic of thesis and approval or disapproval, that their child participates in the survey. I had implemented research measurement with the consent of parents of these students. Using the values of BMI, waist and age measurements, I had examined the prevalence of overweight and obesity at pupils of seventh and eight classes. Then I worked with these results in the practical part of my thesis. I have compared the prevalence of overweight and obesity by girls and boys, but you can also find overall amounts of prevalence overweight and obesity by all surveyed pupils.
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The prevalence of overweight and obesity in older school-age children at the primary schools in the region of Tabor.
BUZKOVÁ, Aneta
In this bachelor thesis I dealt with the prevalence of overweight and obesity by children on the second degree at the primary school in the region of Tabor. The thesis highlights the problems of increasing weight by children. It is divided into the theoretical and practical part. In the theoretical part I try to give comprehensive information on the topic, summarizing the basic knowledge related to the obesity by preadolescents, and give the overview of possible related complications. The thesis also provides insight into the possibilites of treatment. The practical part is then focused on charting the occurrence of overweight and obesity by the children of age 12-14 years. Research measurements are generally attended by 182 pupils of both sexes from four primary schools and one secondary school. To the evaluation of participation of obese individuals and overweight individuals was used Body Mass Index (BMI), which I compared with the percentage graphs of BMI.
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Prevalence of Childhood Obesity and Associated Problems
SLAVÍČKOVÁ, Klára
Obesity is a major concern not only of the Czech Republic, but of all developed countries of the world. It is therefore a global pandemic, against which it is necessary to introduce effective measures. According to epidemiological studies, the countries of Central and Eastern Europe are among the states with the highest prevalence of obesity. In most European countries, the prevalence of obesity in women is higher than in men, by about 3-6%. But a big issue is childhood obesity, which predisposes individuals to obesity also in adulthood. This results in an increased risk of premature morbidity and mortality due to complications of obesity. In obese children the risk of musculoskeletal diseases and cardiovascular and respiratory systems is increased. Obesity often leads to disorders of sexual development, skin complications and changes in the psyche. According to the World Health Organization, there are about 43 million overweight or obese children in the world. The treatment of childhood obesity is not simple. It is necessary to establish a long-term strategic plan, based on the lifestyle change focused on nutrition and eating habits, physical activity and strengthening the self-confidence of the child. This diploma thesis was carried out by the quantitative research through the secondary data analysis. The research group consisted of children registered at the general practitioner for children and adolescents, Šárka Mičanová, M.D. The main goal of my thesis was to survey the prevalence of obesity and overweight in children at this selected pediatric office. Four hypotheses were stated for the research. Hypothesis No.1, children with a high BMI at the age of 5 years show the signs of obesity also at the age of 15-17-years, has not been confirmed. Hypothesis No.2, in childhood, obesity originating in alimentation prevails over obesity of endocrinological origin, has been confirmed. The hypothesis that obesity prevalence has increased in recent years has not been confirmed. The last hypothesis presuming that levels of biochemical markers in children with overweight and obesity do not differ from those of children with a normal weight has not been confirmed.
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The prevalence of overweight and obesity for pupils in the 2nd degree of primary school in Ceske Budejovice
ČERMÁKOVÁ, Markéta
This thesis deals with the prevalence of overweight and obesity among students in primary schools in the Ceske Budejovice. The main objektive is determine the prevalence of overweight and obesity in the selected file location. In the first part was prepared the literature review, which aims to define obesity and its related concepts. Based on the review of the literature and scientific publications that are listed in the bibliography, have been developed clear characteristic of obesity and its problems especially in childhood. The practical part is devoted to research the prevalence od overweight and obesity among students in primary schools in the locality. Based on the cooperation of selected schools and parents was carried out anthropometric observations measuring a total of 188 pupils. Mesured was height and weight, waist circumference and skin folds under the hyoid bone. Based on the data was drawn clear presentation of the results to determine the prevalence of overweight and obesity for pupils in the 2nd degree of primary school in Ceske Budejovice.
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Prevalence Study of Occurence of Nosocomial Gastro-enteritis of Virus Etiology in the Bohnice Asylum in Years 2003-2009.
NUSLOVÁ, Aneta
The degree work is concentrated on the problems of the epidemic as to acute viral gastro-enteritides of nosocomial nature occurring in the Mental Home Bohnice in the years 2003 {--} 2009. I chose for my work the methodology of quantitative research in the form of an epidemiological descriptive study with the technique ``data collection and analysis{\crq}q. The infectious diarrhoeal affections are very current all the time and great importance in developing and even in advanced countries of the world. About 5 {--} 10 million people are dying of diarrhoea often connected with undernourishment in developing countries of Asia, Africa and Latin America per year, whereof 4,6 millions are children aged up to 5 years. The infection diarrhoeal affections in advanced countries of the world are important mainly as to their high frequency because they represent the second most frequent infection just behind the infection of air passages. The theoretical part of the work is concentrated on general characterization of the acute viral gastro-enteritis, on the process of spreading, on the most frequent aetiologic agents and on the new possibilities of diagnosis and therapy. The attention is also paid to the observance of antiepidemical measures and rules fixed in the hygienic and antiinfectious regimen, that prevent further spreading of the diseases in the case that an epidemic has broken out. In this connection, the basic profile and structure of the Mental Home Bohnice is also presented inclusive of important facts concerning the hospitalized patients. These patients form a very specific group of persons in respect to the occurrence of epidemics caused by viral diarrhoeal diseases as they are hospitalized in an isolated environment often for long term and their heath condition depends on psychiatric diagnosis. The performed investigation resumes the general judgement on the problems of epidemics caused by the acute viral gastro-enteritides in the Mental Home. It determines the most frequent aetiologic agents giving rise to this disease and analyzes these epidemics in relation to the age and sex of the patients. Another aim of the work was to explain the seasonal nature of the epidemics and to evaluate the efficiency of antiepidemical measures taken in this establishment. It is necessary to conclusion that the epidemical occurrence of viral gastro-enteritides was registered in Mental Home Bohnice even before the year 2003, but the aetiologic agents could not be specified in greater detail owing to the possibilities of virologic diagnostics being at disposal at that time.
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Epidemiology of multiple sclerosis
FOŠUM, Pavel
There are approximately 2.5 million cases of multiple sclerosis [MS] in the world. Each year, around 10,000 new cases of MS are diagnosed. There are approximately 0.1%. in the Czech Republic and that means that there are approximately 15,000 people with this disease. Multiple sclerosis is a progressive neurological inflammatory disease of the central nervous system in pathogenesis. The auto-immune mechanisms are appliedinvolves; both the affect the myelin and damaged axons. This damage is responsible for the permanent disability of MS. The main objective of this thesis was to use quantitative research to describe the occurrence of MS in the Regions of South Bohemia and Usti, and within objective to estimate the true prevalence of multiple sclerosis in the South and the Usti Regions. MUDr. Príkaszký and I used the method of descriptive epidemiological studies on the technique of data collection, as well as the analysis and the comparison of two sources using the double-capture method. As a research area, we used a set of patients with multiple sclerosis. The data were gathered in two regions of the Czech Republic: Usti nad Labem Region and South Bohemia. We investigated the number of patients from neurologists and MS centers in both regions.There is also the data on health insurance included with the Ústí Region in this research. According to the data, we estimated the prevalence of neurologists in South Bohemia to be 79.20 per 100,000 people. The MS Center at the hospital in Ceske Budejovice has registered 512 patients: 388 women and 124 men. The values of the MS Centre in Ceske Budejovice received from the neurologists are a total of 882 patients, which is a prevalence of 138.6 patients per 100,000 of the population. Regarding the Usti Region, the prevalence reported by neurologists is 208.2 per 100 000 people. The MS Center at the hospital in Teplice, has registered 1139 sick 730 women and 409 men. According to health insurance data in their database, of 1187 people listed with a diagnosis of G.35, 333 are men and 854 are women. This represents an estimate of the prevalence 305/100000 of the people who are registered in the NGA. We calculated the prevalence of illnesses from those sources in both of these regions is higher than the general estimates. When comparing the data source of health insurance and the model file from the MS center of Ústí Region, we calculated the overall sensitivity of 91.7% within a health insurance group. The calculation of the estimated prevalence has been reached by using the method of double-capture of those sources that provided an estimate of 2,681 patients in the Usti Region. The models of this data are mainly demonstrated as a possible approach to the estimate of the prevalence of this chronic disease in the case of multiple sclerosis. The information has been obtained from the collection of data. The results of this study can be used by other workers who have the same objective as this study.
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Smoking of senior Citizens
DVOŘÁKOVÁ, Linda
This thesis deals with "Smoking of senior Citizens". Smoking of tobacco is the most significant reason of illnesses and early death in the Czech Republic. Reduction of smoking is a basic condition for decrease of deaths caused by tumour and cardiac diseases.The goal of the thesis is to monitor prevalence of smoking in senior citizens and detect their awareness of smoking. 206 respondents at the age of sixty and above paricipated in this research. 50 % of these people vrote that they had never snoked. 20 % of informants were active smokers, at the time of this survey, and 55 % of senior citizens wrote that they considered nicotine addiction to be a disease.The author tries to verify the hypothesis concerning smoking of senior citizens who suffer from chronic disease. 44 % of the respondents, who were active smokers at the time of the survey, suffered from chronic disease. The researcher uses the next hypothesis because she wants to confirm the fact that senior citizens have a positive attitude to prohibition of smoking in the restaurants and in public areas. The research verified this hypothesis - 72 % of the informants had a positive attitude to prohibition of smoking in public.
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