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The issue of treating patient with polytrauma
DVOŘÁKOVÁ, Barbora
Polytrauma is an injury of one or more organic systems or body areas the mutual combination and extent of which may lead to direct death threat. Polytrauma stands on the first step of the mortality ladder particularly among those of 1 45 years of age. Not only timely emergency care, but also professional quality of the care play important role here. Treatment of a patient with polytrauma requires quality performance of physically and psychically demanding work The aim of the thesis was 1: To find out whether nurses at an ARD, an ICU and a standard department have knowledge of nursing care of a patient with polytrauma. 2: To find out the specifics of nursing care of a patient with polytrauma at an ARD, an ICU and a standard department. 3: To find out the differences in nursing care of a patient with polytrauma at an ARD, an ICU and a standard department. Research questions: 1. Where do ARD nurses see the biggest problems of nursing care of a patient with polytrauma? 2. Where do ICU nurses see the biggest problems of nursing care of a patient with polytrauma? 3. Where do nurses from a standard department see the biggest problems of nursing care of a patient with polytrauma? 4. How do ARD nurses care of a patient with polytrauma? 5: How do ICU nurses care of a patient with polytrauma? 6: How do nurses from a standard department care of a patient with polytrauma? 7: What opportunities for education in nursing care of a patient with polytrauma do ARD nurses have? 8: What opportunities for education in nursing care of a patient with polytrauma do ICU nurses have? 9: What opportunities for education in nursing care of a patient with polytrauma do nurses from a standard department have? Qualitative research was applied to preparation of the thesis. Non-structured interview and involved observation were the data collection methods. The research was performed at an anaesthesia and resuscitation department, at an intensive care unit and at a standard traumatology department. The research was anonymous. The research has shown that ARD and ICU nurses as well as those at the standard department are aware of treatment of patients with polytrauma. We observed that they cared about patients' needs and all activities they perform comply with nursing care standards. They are aware of complications that might occur in a polytraumatized patient. We have also found that mainly the difference in communication with a patient belongs to the specifics of the above mentioned departments. The results also show that the care provided at the ARD and the ICU is acute, while the standard department mostly provides subsequent care. We found that the biggest difference in treatment of patients with polytrauma at the above departments is in communication with a patient. Communication is at the minimum at ARD, where work with monitors prevails. Nurses of the ICU and the standard department cope with different problems. These are lack of space and electronic equipment at the ICU. The care of a patient with polytrauma who is not self-sufficient and requires permanent care and attention of a nurse is physically and psychically demanding at a standard department. It is not sufficient according to the nurses. The problem is in their opinion in high number of patients, lack of beds, extensive attention to some patients and last but not least the growing administration conducted by nurses. This brings the problems in nurse-patient communication at a standard department. The nurses are aware of the fact that effective communication has positive impact on patient recovery as it moderates pain and confusion and helps against anxiety and stress, helps relieve pain, reduce complications and accelerate convalescence. It would be interesting to prepare a seminar for the ARD, ICU and standard department healthcare staff to improve nursing care of a patient with polytrauma in relation to that.
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Nursing care of geriatric patient
MUŠKOVÁ, Simona
Current status Old age is late phase of the ontogenetic proces, which completes the human life and carries with itself a lot of changes. These changes are inevitable for each of us (Čevela, Kalvach, Čeledová, 2012). When we speak of geriatric patient, we mean a patient older than 75 years. This is the classification of World Health Organisation (WHO). Aging leads to loss of physical and mental strength and to somatic changes some of which are highly visible at first sight (Haškovcová, 2010). General nurse with knowledge about the issues of geriatric patients can get them the optimal nursing care to be able to support their bodily functions and maintain functional fitness. Evaluating the abilities of geriatric patient, then enables general nurse to set reasonable care and then perform preventive and therapeutic interventions (Pokorná, 2013). Aim of the study The aim was to map the issue of nursing care for geriatric patients in acute beds and beds for long-term care from the perspective of nurses and also from the perspective of patients. Four research questions (RQ) were then assembled for these goals. RQ 1: How nurses perceive the problems of nursing care for geriatric patients in acute beds? RQ 2: How nurses perceive problems of nursing care for geriatric patients on long-term care beds? RQ 3: How geriatric patients perceive nursing care received from nurses in acute beds? RQ 4: How geriatric patients perceive nursing care received from nurses on long-term care beds? Methods For the empirical part of the bachelor thesis was used qualitative research. For the purpose of the data collection were used interviews, which consisted of pre-built key questions and according to willingness of the individual respondents to share their opinions were inserted additional questions. The survey consisted a total of 20 respondents, of which 10 respondents were from the Department of aftercare and 10 respondents from the orthopedic department. Of these ten respondents were 5 nurses and 5 patients in each ward. The research was carried out in the hospital bed area of the department of aftercare and orthopedic department. The interviews were transcribed verbatim and then categories were created to methodology, which showed what troubled the patients during hospitalization the most, and what nurses see as the biggest challenge when working with geriatric patients. The results By the nurses from the department of aftercare, patient immobility, lack of cooperation with disoriented patients, problems with emptying, usually constipation, change in the environment as a factor disturbing the sleep of the patient, not keeping the drinking regime, despite the patient claiming otherwise and not least the patient's hearing loss that nuisance communication between staff and patient and finally the patient's hearing loss that nuisance communication between staff and patient are seen as the biggest problems. Nurses from the orthopedic department see the biggest problem in the movement impairment of the patients, the pain that patients experience after surgery and the stress that accompanies the patient before surgery. Furthermore, problems with emptying, difficulty sleeping, patient's non-compliance and hearing loss. All interviewed patients complained the most about the lack of privacy during hospitalization, especially during their personal hygiene, about the fellow patients who disturb their sleep, as well as the lack of communication on the part of nurses. Furthermore, patients from the department of aftercare most complained about lack of information told to them when received at the department. Patients from the orthopedic department were complaining about the way in which personal hygiene is performed.
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The experiences of adults with disabilities with the provision of coordinated rehabilitation in the institutionally care and in their natural environment.
MIHALÍK, Petr
The diploma thesis deals with the issue of providing all elements of the comprehensive rehabilitation of handicapped people. The goal of this thesis was to determine, what experiences adult handicapped people have in terms of being taken care of in their home environment and in an institution. Another goal was to try and find out what criteria are important for the way they evaluate these. And, the last goal of the thesis was to propose an effective model of taking care of these people given obtained results and given financial capacities of the state and today's regulations. The theoretical part shows the section and development of care provided to handicapped people from the beginning of humanity until today including valid legal regulations. The following part describes briefly the issue of a coordinated rehabilitation and the efforts to ensure the legal regulation thereof in the Czech Republic. The last chapter of the theoretical part is devoted to the D.R.A.K. Association, the clients of which are the relevant research set. For the research itself the qualitative research strategy was chosen. The data were acquired using semi-structured interviews with clients, their family members and those who care for them in the D. R. A. K. Association. Acquired data were processed using the qualitative contents analysis of interviews. The set of participants included nine clients, members of the D.R.A.K. Association, the target group of which are adult handicapped people. Next, I spoke with five family members and three experts from D. R. A. K. Results are divided into three chapters according to research questions. The first chapter contains answers of clients, how they perceive the difference when being taken care of in an institution (D.R.A.K. Association) and in the natural environment (at home). The second chapter of results describes criteria, which are decisive and important for clients and have emerged during interviews.
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The communication between a nurse and a patient with autistic spectrum disorders.
VANŽUROVÁ, Lucie
This bachelor thesis deals with the problem of communication between a nurse and a patient with autism spectrum disorder (then only "ASD"). The theoretical part of this thesis contains basic information concerning not only verbal, but also non-verbal communication in nursing which is very significant for the communication process for persons with ASD. In this part, there is described the role of a nurse in communicating with a patient possessing normal communication skill in context of findings concerning the patients who have impaired communication abilities. The patients with ASD belong into this group. There is an essay in this thesis which solves the autism spectrum disorders, their definition, classification, causes, diagnosis and possible treatment. This essay describes the symptoms of a patient with the above named disorder in communication and trying to find possible solutions to overcome communication barriers between actors of communication. A nursing conception Kathryn E. Barnard provides a solution of communication barriers in nurses' work, whose performance is discussed in a separate chapter. We also try to show the methods that may help the nurse in this very specific communication. The empirical part of the thesis presents the results of a qualitative research survey implemented by using a semi-structured interview. The main aim of this research was to explore the specifics of communication between a paediatric nurse and a patient with autistic spectrum disorder. This goal is related to the second aim, it is to find out the level of nurses' knowledge in terms of communication with a patient. The third goal is mapping of the experience of family members of children with autism spectrum disorders in communication. Research questions were created in connection with the aims of the thesis. 1) What are the specifics of the communication with a patient suffering from ADS? 2) What is the level of knowledge of selected paediatric nurses in communication with a patient with ADS? What difficulties do the nurses have in communication with patients with ADS? 4) What experiences have the family member in communication with a nurse? With regard established goals, two research groups were established; the first one was formed by a group of nurses with experience in paediatrics and the second one was made by family members of children suffering from autism spectrum disorder. The snowball sampling method was used in order to find suitable respondents, especially in the second group of respondents. The results were subjected to a thorough analysis using open coding by using the method of "pencil and paper". The survey revealed that the selected nurses in most cases have basic information about the issue. The statements of family members are in conflict with nurses' statements. This is because it shows the fact that the general awareness of nurses is not so straightforward and that there are situations where communication does not happen in a manner which would correspond to communication skills of patients with ASD. Selected nurses have, in most cases enough information, but they are not able to put these information into practice.The results of our research cannot be generalized to all nurses working in paediatrics. This is confirmed by family members, who describe, unlike nurses, both pleasant and unpleasant experience associated with communication with the nurse. Given the fact that awareness of nurses is mainly linked to their personal interest in the issue, it cannot be said that the theme of specifics of communication between a nurse and a patient with ASD is treated with ample space under the training of nurses. We ourselves in the course of making this thesis encountered with difficulties associated with insufficient literary sources, which would focus on the issue of communication in nursing process with patients suffering from ASD.
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Medical communications with oncological disease patients.
SLABOVÁ, Markéta
The aim of this thesis is to find out the current state of communication between paramedic and patients with cancer. This work created a manual which is going to be a hand book for nurses who encounter them selves with serious or incurable sick people. In this hand book can nurses find principles of communicaton with oncological patients. The theoretical part contains information about problematic of communication, types of communication or purpose of communication. It also contains issues of oncological diseases, their causes, diagnoses, treatment and an increase in the Czech Republic and in the South Bohemian Region. Theoretical part also deals with process of approach and communication with oncological patients and with posssibilities of care for incurable sick people. Empirical part is based on research of several issues which should accomplish two elected objectives. The research questions are answered using qualitative research through halfstructured interviews by nurses and oncological patients. Data were congregate during February and March 2016 in two South Bohemian hospitals. After the processing of interviews in Microsoft Office Word were created identification data of respondents and nurses. The objectives of bachelor thesis were approached witch qualitative research. The analysis of interviews was done by using categorization of data and subsequent encoding. Data analysis showed that patients are satisfied with the communication and attitude of medics. Nurses are against burnout syndrom very resistant.
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Phenomenon of stigmatization in communication between nurse and the patient
TROJANOVÁ, Hana
This bachelor thesis is focused on phenomena of stigmatization in communication between a patient and a nurse. A term of stigmatization represents thinking in stereotypes and a general attitude with a predetermined vision, which is usually not based on reality. These prejudices appear in the field of communication. It is about connecting negative features and treating with inappropriate naming. Acting like this can lead to social isolation. This bachelor thesis maps a problem of stigmatization and possible using of so-called "stickers" in communication between a patient and a nurse within a nursing process. The research survey was focused on the awareness of nurses about the term of stigmatization and also it was investigated what attitude nurses occupy towards patients who could be, thanks to their difference, much more compromised by this phenomena. That was the reason why the research survey included obese patients, patients with psychic disorders, also homeless clients, national minorities, patients recovering from alcohol or drug addiction and last but not least those who have any kind of physical disability. In this bachelor thesis we focus also on how these clients perceive the cooperation with nurses during the hospitalization, if they registered any differences in communication with them and other patients and we will be also interested if they have met with the use of stigmatizing terms and in what form.
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Cooperation of doulas and midwives during childbirth.
HORÁČKOVÁ, Martina
The bachelor thesis deals with the cooperation of doulas and midwives during childbirth. Childbirth is an emotionally challenging situation and for primiparas it is completely new and unknown. This may cause fear, stress, tension and feelings of discontent in a woman. The people who take care of a mother during childbirth make an effort to limit those negative feelings to a minimum or obviate them. Nowadays, a woman in labour is taken care of by physicians and midwives. However, we can also meet a dula who accompanies a woman to give birth and she cares for her in the mental and physical respect. The aim of all the people involved should be a mutual, respect-based cooperation. Thoughtfulness, understanding, efforts to meet the mother´s wishes, positive attitude and creating mutual trust is a prerequisite for a good cooperation between a woman and a midwife. Likewise, the cooperation of doulas and midwives is a prerequisite for a calm course of giving birth. In the thesis, two goals and four research questions were set. The theoretical part is working out the question who a doula is and it talks about their training, professional competencies, it deals with services that a doula provides and describes help of a doula during childbirth. It also informs about organisations which provide education for a doula in the Czech Republic. It also focuses on the work and competencies of midwives, talks about their education, describes the role of midwives in antenatal preparation, summarizes the care for women during childbirth and the postpartum period. The qualitative form of research was chosen for the research survey. Data collection was performed using a semi-structured interview. There were two files chosen for the research. The first group consisted of 9 midwives aged from 31 to 60 years old, who work in a delivery room and have different lengths of practice. The other group consisted of 6 doulas aged from 40 to 47 years old with experience in accompanying women to give birth. Based on the interviews three main categories and semantic subcategories were identified. The first category called "PA Knowledge about a doula" is elaborated into two subcategories dealing with the reason for presence of doulas in a delivery room and knowledge of PA about education and competencies of doulas. In the second category called "Views on doulas", we set two subcategories and found opinions of midwives on a birth plan and on a cooperation with doulas. In the third category called "Activities of doulas", we formed five sub-categories. This category further elaborates on doulas´ job description, on the decision why the respondents became doulas, on a doula training and skills, focusing on cooperation of a doula with a woman and talking about cooperation of doulas with midwives. The survey showed that the majority of midwives gladly accept the doulas´ presence in a delivery room as they can be really helpful with the care of a mother. Midwives especially welcome the presence of a doula in a delivery room when taking care of more than one mother at a time. However, it is a medical escort of a woman, so it is expected by midwives that the proposed method of childbirth will be respected, the competence of health professionals will not be interfered and mothers will not be influenced by a doula. Work of a midwife and a doula during childbirth is entirely different, so there should be no rivarly. They should complement each other. Under such circumstances of mutual respect, the cooperation is successful. In the research we also found that midwives´ awareness of doula´s education is not great and all the knowledge is limited only to the Internet resources. Eight midwives have read about the competencies of a doula enshrined in the Ethical Code. The thesis results could serve as a source of information for midwives working in a delivery room, especially for the newly hired ones but also for doulas accompanying women to give birth.
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Problems of Children Crohn's disease
TENKLOVÁ, Monika
Crohn's disease is a chronic inflammatory disease that affects the entire gastrointestinal tract in all its layers.The theoretical part deals with the characteristics of the disease, its causes, symptoms, complications, treatment and psychological aspects. It also touches on the needs of children and communication with a chronically ill child.At first, this work set out to achieve two goals: mapping the provision of nursing care to children with Crohn's disease in hospitals and determining the impact of Crohn's disease on the everyday life of a child. A third goal, gathering respondents' views on the possibilities of community nurses in collective institutions, was encountered during the research and was added.The empirical part was carried out using qualitative research method using semi-structured interviews both with health professionals working at pediatric wards, as well as children with Crohn's disease and their parents.Survey results show that children with Crohn's disease come in contact with health workers at various departments of health facilities. The most common early symptoms of Crohn's disease in children included abdominal pain, diarrhea with blood or mucus and failure to thrive. The most common areas affected were the gastrointestinal tract, the small intestine, the colon in one case and the rectum in another.Some workers did not know which tests or treatments their hospital prescribes to the children.They report pain as the main nursing challenge, but this did not reflect in nursing practice.In all departments, except one, there was no material on Crohn's disease, which would have been helpful to the workers.Interviews with children and parents, as well as with health workers confirmed that the disease has a socio-cultural impact on the child and those around it. The results of this diploma thesis were presented at three conferences and will be published.
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Barriers in communication between nurse and terminally ill peadiatric patient
IMRAMOVSKÁ, Simona
Nursing care for paediatric terminally ill patients in the Czech Republic is continuously evolving and developing. It is important for the nurses to learn to use suitable communication. Theoretical part of this work includes information on terminal stages of illnesses in children and the corresponding care that should be provided. It further focuses on communication with the child and his/her parents. The theoretical background for this work is the conceptual Callista Roy Adaptation model for nursing applied on a paediatric terminally ill patient. The main aim of this work was to focus on revealing features in nurse communication with a child patient with regard to his/her medical diagnosis. We have focused on mapping medical diagnosis for paediatric patients in terminal stage of their illness that evoke communication barriers in nurses involved with the patients. Further step of this research was obtaining the information about the type of barriers the nurses evolve. Another aim was to create educational material for nurses based on information obtained from the research that would lead to improved communication between the nurse and the terminally ill child. A personal aim was also set in this work to gain necessary information and experience for the starting carrier as a paediatric nurse. Five research questions were posed to reach the aims of this work aimed at identifying communication barriers with regard to medical diagnosis child patient in the terminal stage of the disease, barriers in communication with a child patient in the terminal stage of the disease, evaluation of the quality of nurse communication with terminally ill child patients, use of communication aids in nursing care for these patients and we also wanted to know what changes in the communication with the terminally ill children the nurses experienced since the beginning of their working practice. The practical part is divided into two qualitative research investigations. In the first phase of this research eleven nurses working at paediatric oncology wards and eight nurses from hospice care aimed at child patients participated. Half-structured interview technique was used for the research. Based on the practical aim, second phase of the research consisted of evaluation of the impact educational material created as a result of the first phase of the research had on the nurses. The first phase of the research showed that the communication barriers are evoked in nurses by the following diagnoses: bone tumours, brain tumours and multiple sclerosis. Further barriers found in nurses regarding communication with terminally ill patients included: children above 12 years of age, lack of knowledge about suitable communication and about the patient, unsolved issues with own mortality, fear and embarrassment of possible mistakes and the patient personality. Nurses use many means of communication. Nurses noticed changes in communication that happened during their carrier; they mentioned more reassurance, more knowledge, better assessment of the children and suitable timing. They also feel better during the time of mourning, understanding the role of the parents; they feel more humble and respectful towards life itself. Nurses evaluate their level of communication with child patients very positively and have a will to educate themselves further. The nurses showed signs of psychological load. It was also revealed that a psychologist is not functional or altogether missing in their place of work. The second phase of the research showed that nurses welcomed and appreciated the educational material created for them, they found it useful in their nursing practice, they evaluated it as useful for beginner nurses. Based on this material a children book was purchased for the ward. The recommendation for practice is the use of the Callista Roy Adaptation model for nursing. I have personally gained both wide theoretical knowledge and experience from the interviewed nurses.
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Business developer - current status and perspective
NĚMCOVÁ KOVÁČOVÁ, Zdeňka
The thesis deals with the evaluation of the impact of the performance of three groups of business representatives in Coca-Cola HBC Czech Republic, Ltd. on corporate revenues, sales volumes. Compares the cost of three groups of dealers. Based on the outputs multi criteria analysis of the impact of the performance of groups of business representatives on criteria of internal solution is proposed the use of sales representatives in the future in order to increase the company's bottom.
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