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The nursing care of newborns with Hyperbilirubinaemia
KUCHAŘOVÁ, Petra
This thesis is focused on the nursing care of newborns with neonatal jaundice. Given the focus of the work, the theoretical part describes the newborn, bilirubin, neonatal jaundice, its diagnosis, treatment, nursing care during hospitalization and neonatal care after discharge to home care. The research was conducted with nurses or midwives in the neonatal wards during the months of March and April 2018. A qualitative method was used to conduct the research section. The data collection was conducted through semi-structured interviews. The interviews were conducted after prior arrangement and with the approval of the head nurses. The interview contained 12 open questions. Data analysis was performed by hand coding, also called the pencil and paper method. Responses by individual respondents were identified by codes that were then categorized under different subcategories. As a supplementary method of research, observation was used. It contained 8 open questions and an observation sheet, all of which were done after prior agreement and consent of the mothers of newborns. One goal was set for this thesis: to map the nursing care of newborns with neonatal jaundice. Based on this goal, a research question focused on how midwives and pediatric nurses care for newborns with neonatal jaundice. The research showed that all respondents have an overview of the issue, and that the information they have is subsequently carried out into practice. The results of this research can serve as informative material for midwives and nurses who want to improve their care of newborns with neonatal jaundice, or who are currently preparing to work in this profession.
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The role of nurses in community care for newborn.
BROŽÍKOVÁ, Radka
This diploma thesis examines the role of paediatric nurses caring for newborns in the community. It aims to determine if and how newborn care in the home environment takes place and the role of the paediatric nurse. The research is based on one of the primary objectives set out by the member states of the WHO to improve the health of the entire population in the twenty-first century with the focus on community care and its development. The theoretical part is dedicated to the definition of community care and its history in the Czech Republic. We initially focus on how childcare at home was provided in the past. This is followed by a description of the current situation regarding care of a newborn and the mother during the first weeks following birth, both here and abroad. We evaluate the role of the paediatric nurse in terms of nursing care for newborns and research the duties that the nurse carries out within the clinic, family, and community.We have set out two objectives and five research questions. The first objective was to identify nursing care problems encountered by mothers at home and how they solve these problems. The second objective was set out in order to explore how nurses become involved in the community care of a newborn. We have chosen a qualitative method for the research part of the thesis. Data was collected through semi-structured interviews. Subsequently, a qualitative analysis and categorization of collected data was conducted. Two research sample groups were created in the first phase. The first consisted of mothers with newborns, i.e. children from birth to 28 days. The second group consisted of paediatric nurses who work in outpatient care with children and adolescents. The second phase of the research addressed paediatric nurses working in the neonatal clinic, which is run by the hospital's paediatric department. The result of our thesis is the finding that community care provided by the paediatric nurse in the field, in a natural environment and with the cooperation of the entire family and community, as defined, is almost nonexistent. The long-established system of primary care directs all nursing work into the surgeries of the paediatric practitioner, and only the first visit to the newborn, but not in all cases, is conducted at home. This system is insufficient to cover all the specifics of childcare. The needs of the newborns and their parents are becoming more urgent and in the first weeks following the birth the mothers only very slowly begin to gain healthy self-esteem and confidence in their maternal abilities, hence the need for an individual approach and help in the proper care of their baby. They feel there is a lack of information and they do not know how to deal with the needs of their newborn. The most problematic issue described is breastfeeding. The addressed nurses are of the same opinion and also consider breastfeeding as the most common focus of their intervention, and therefore, the most important part of their work.We have discovered that the skills and competencies of the paediatric nurses are sufficient to enable them to become a relevant element in the comprehensive care of newborns within the community. The interventions delivered by the nurse are fully integrated into paediatric nursing.The parents of newborns would, according to our survey, prefer a home visit from health professionals, particularly if it concerns the first contact with the baby and family. The out-patient care does not provide enough time and space to pursue common nursing issues, therefore, home visits are an essential part of the care that should be offered to the mother and baby. Community nurses would help to coordinate the services provided to families as well as help solve the nursing issues that mothers encounter in the first weeks of their child's life. A paediatric nurse would, therefore, become a partner to the parents in a joint effort to ensure the healthy development of their child.
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The role of nurses in the care of overweight or obese adolescents
SOROKANETS, Viktorie
This thesis is focused on the role of a pediatric nurse in the care of overweight and obese adolescents. A pediatric nurse plays a key role in promoting the health of children and adolescents in primary care. A nurse is in many cases the first person the family or a child confide their worries and health concerns in. A pediatric nurse is a person whose professional focus is determined by the needs of children; he or she is an expert who should seize every opportunity for consultation on healthy lifestyles of children and parents; he or she is an essential and irreplaceable member of the team caring for a child or an adolescent (Sikorová, 2012). This thesis consists of two parts. The theoretical part is focused on obesity itself, it describes pathogenesis, complications and consequences, as well as prevention and treatment. In the next chapter we focus on the role of the nurse in the pediatrician's office. There we described the role of nurses in the examination of an obese or overweight adolescent, the awareness of a nurse and adolescent in the field of childhood obesity, the principles of communication of nurses with the obese adolescent and his or her education. At the end of the theoretical part the psychosocial impacts on obese adolescents, such as social isolation, discrimination and the risk of developing eating disorders, are described. The second half of the thesis is empirical. Research was carried out in two ways. The first part of the research was realized in the form of a quantitative survey, in which nurses in general pediatricians offices were approached using electronic questionnaires. The questions in the questionnaire were focused on the education of nurses in the field of childhood obesity, education of adolescents, cooperation with families and other professionals. The research group therefore consisted of pediatric nurses who pursue their profession in the Czech Republic. In the second part of the research the method of questioning, namely the interview technique was used. It was a semi-structured interview with obese adolescents. Each interview consisted of 24 questions and lasted an average of 20 - 25 minutes. Interviews with adolescents were focused on the knowledge of the term Body Mass Index, health and psychological consequences, their personal lives, relationships with peers and partners, the possibility of using the services of a nutritional consultant. We contacted 15 respondents aged 16 to 20 years, all were from South Bohemia. In case of minor adolescents parental agreement with the research had to be acquired. The questionnaire was accessible online and its completion was not time consuming; however out of approximately 400 distributed questionnaires only 154 returned fully completed. The return of questionnaires was approximately 40 % and reflects the ratio of completed and mailed questionnaires. At the beginning two goals were set. The purpose of the first objective was to explore the role of nurses in the approach to obese adolescents. The results showed that nurses are trying to educate themselves in the field of child obesity, they are interested in the issue of childhood obesity, what is more they are trying to educate the overweight adolescents in good nutrition. Furthermore, they also aim to cooperate with the child's family and even with other professionals, such as an endocrinologist, cardiologist, nutritionist etc. The second objective was to determine how obese adolescents perceive themselves. Opinions obviously differed, some children did not admit to being overweight/obese, while others saw themselves as the "fatsoes", "whales" ugly and useless, and that nothing suits them". Some suffer from depression, others try not trouble themselves with it. To fulfill the purpose of quantitative research 3 hypotheses were set. H1: Nurse educates adolescents about healthy eating. The hypothesis was statistically confirmed because research showed that nurses really do educate teenager.
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Means and measures of brest´s problems during brestfeeding period
HAVELKOVÁ, Zuzana
Breastfeeding is irreplaceable mode of child's nutrition. Its importance is proved in general and its irreplaceability as well. Profit of breastfeeding goes to a mother and a child too. During the proces of breastfeeding women may face different breast problems. The task for the competent healthcare staff is to propose suitable solution and enable them to continue breastfeeding in full. The qualified person is midwife and child ward nurse as well. The Thesis deals with a role of the above mentioned staff considering breastfeeding and solving breast problems. The Thesis consist of two parts, a theoretical and a practical ones. The theoretical part is divided into three main chapters. The first one named Breastfeeding focuses on introduction in a set area. Given knowledge is necessary for enhancing breastfeeding and solving its problems. The second chapter deals with single difficulties with breast and their solving. The third one describes midwives' profession and its role in a field of breastfeeding. The practical hal fis devoted to women with breast difficulties during childbed and also to midwives and pediatric nurses, who are in charge during such women hospitalization. For given research we set three aims. The first is to chart the situation, prevaling issues with breast while breastfeeding. The second is to find out the amount of stress put to prevent breast' problems in this period from the childbed women point of view. The last one is to trace the solving of such problems in County Hospital Jindřichův Hradec and Regional Hospital České Budějovice. The quality research was chosen with means of self made partly structured dialogue. People to respond were deliberately chosen. One set consisted of ten nurses from childbed ward, who are responsible of solving breast problems during mothers' hospital stay.There were four pediatric nurses and one midwife from each hospital. České Budějovice hospital's nurses were from Physiological newborn ward and Jindřichův Hradec hospital's nurses were from Childbed ward. The mode of selection was influenced by tradition, that help with breastfeeding is given mainly by pediatric nurses only seldom by midwives. The other set was made of mothers, who experienced problems with breast during breastfeeding period. Five of them delivered their babies in České Budějovice's and five in Jindřichův Hradec's hospitals. Research survey has been taking place since February till April 2015. Data given went through qualitative analysis. On basis of given research guestions we came to conclusion that the main problem which troubles women in childbed were mastitis and wounded and flat nipples. Improvement of breast problem prevention should help in prenatal field. Within hospitalization pediatric nurses and midwives put a stress in prevention concerning only women chosen by them. Negative judgement on prevention of breast problems came from experienced women in childbed. It is important, that person concerned has an equivalent approach to all the women when it comes to prevention. Problems solving was mainly positively evaluated. Although they found very important besides given advices also the higher emphasis for psychice side of mather. The output of the Thesis was creation of a leaflet which deals with prevention and solution of breast problems. The leaflet might be obtained inantenatal care and gidance centers.
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View of nurses on the health - care reform
ABRMANOVÁ, Michaela
This thesis analyses the reforms of health and social care in the Czech Republic, focusing on the impacts of the reform measures on providers and consumers of health care. Health reforms are currently very up to date, but have not yet been adequately processed and published. Health care of the modern state which Czech republic undoubtedly is must provide affordable and quality health care to all children and people of the society. There is however a necessary role of the state as the representative of the entire health system and relevant legislation. In this thesis we studied the prepared government reforms. The aim of this work was to understand this difficult area and bring this issue further primarily to medical professionals. The results of the research can serve professionals in health social area and be published in scientific journals. The thesis contains a theoretical and empirical part. In the theoretical part we focused on health care systems after 1989, the need for a new reform, the economic development, the health legislation and we also mentioned problems of the current health care system in the Czech Republic. In more detail, we focused on the amended laws related to the new changes in the healthcare system of the Czech Republic. Regarding the reform measures of the Ministry of Labour and Social Affairs, we focused on the change in the institutional child care and thus a possible replacement of nurseries foster care. For the empirical part research was chosen qualitative method of semi-structured interview with nurses. The research sample consisted of 20 university educated nurses who work mainly on children's wards in hospitals in Czech Budejovice, Tabor, Czech Krumlov and General University Hospital in Prague. In the thesis we stated six goals and six research questions. First, we wanted to determine nurses opinions on the big planned new health and social reform. Furthermore, we were interested in awareness nurses would planned changes in the health and social sphere with other goals we wanted to see what would nurses would like to change in the health system of the Czech Republic, how well informed Theky are about the changes in health care since 1989, what they know about the problems of institutional care and what their opinion on the possible cancelation of nurseries and they replace ment of institutional care by foster care is. From the research it was shown that the specifics of the health reform were seen by the respondents from different point of views. During the qualitative investigation it was found that the knowledge of university educated nurses regarding the planned health reforms was not fully sufficient. With the year of 2014 crucial changes occurred in the Czech health system. In particular, we do not pay medical fees for inpatient stay (1st. January 2014). By the media discussed many medical fees majority of the respondents was aware of but they didnt know the other reforms. In this thesis we focused on the lack of (un) awareness of nurses of planned the health reforms. Our hope is to convince the wider professional public that basic knowledge of politics in the Czech Republic is a very important issue.
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A retrospective look at the development competence of pediatric nurses on inpatient department
ŠIMKOVÁ, Zuzana
This thesis deals with not only a question of competence of nurses and their children's development, but also in terms of preparation of professional nurses. The nursing skills are necessary competence to perform the nursing profession. Represent this area of knowledge, skills and attitudes that are acquired through education. One of the ways to qualify nurses to the profession, is today a university course. The second method is a specialized education, provided that the candidate meets the conditions for admission and received his professional competence to practice nurses. Determination of the competencies of nurses in the Czech Republic is governed by Law No. 96/2004 Coll. Acquisition and recognition of eligibility for non-medical professions and for activities related to providing health care and amending certain related acts, the last decree on the activities of health workers and other professionals, No. 55/2011 Coll. The thesis is divided into theoretical and practical part. The theoretical cross section contains the history of pediatrics and nursing, selected chapters from health legislation and development of children's ward in České Budějovice Hospital. For the practical part, I chose a qualitative research method of interviewing and pediatric nurses. The research sample consisted of 10 nurses who work or have worked on the inpatient pediatric ward. There were set three goals in this work. The first task was to determine the development of competencies nurses. The second objective was to determine the extent of the authority nurses at present. In the last part of my job I surveyed whether nurses are aware of their general competence. The research showed that their competencies developed. A large share of this development has the technological development in medicine, new insights in treatment and use of modern diagnostic methods and increasing nursing education. Results of this research can serve for professionals in pediatric congresses and publication in professional journals.
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Child's nurse task in education of newborn's artificial nutrition
ZAJÍCOVÁ, Lucie
It is now after leaving the hospital breast-fed infants and 4.5% only 34% of infants are breastfed for longer than six months. If the mother is unable or unwilling to breastfeed her child, comes the work of children's nurses, which should comprehensively educate mothers on the artificial feeding. This work focuses on the problem of feeding the newborn. Its task is to map the role of pediatric nurses in the education of artificial infant feeding, as well as identify the reasons for mothers to stop lactation and the transfer of their children - infants to artificial feeding. We tried to find out what are the errors in the application of artificial infant feeding, which is committed by mothers, and whether it is possible to eliminate these errors led education process of children's nurses. The research part of our work was the method of quantitative-qualitative research. For qualitative research, data collection technique was used semistructured interview. The interview was anonymous. Quantitative research was conducted through interviews. The questionnaire was anonymous. It contained 23 questions. Research files of qualitative research, mothers are mothers who use feeding their newborn infants artificial nutrition products. This set of nine respondents were selected in the Region. The research sample consisted of quantitative research for pediatric nurses, working in the department of physiological neonatal hospital South Bohemia. The results of our work we want to move the broader public, mothers who have decided, at its discretion, that are unwilling or unable to breast-feed. We created educational material to make the children's nurses working at the department of physiological and pathological newborn, as well as nurses in primary care.
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Importance of home visits in primary child care
KARDOVÁ, Kateřina
I have focused my Bachelor Thesis with the topic of ``Importance of home visits in primary child care{\crqq} on the importance and frequency of home visits of health care workers and on the visits of social workers to the family within the program of family recovery. The first goal of my Bachelor Thesis is to map the frequency of home visits of health care workers during newborn and older period of the child. The second goal of my Thesis is to map the frequency of family recovery. I worked with the method of quantitative research at processing the Thesis. I used anonymous standardized questionnaire as tool. I handed out the questionnaires to parents of children in playrooms, mother centres and outside playgrounds. The hypothesis 1 states that the visit service of health care workers in the family is under 30% during the newborn and older period of the child. To verify the second hypothesis I processed the second questionnaire to be filled out by organizations performing family recovery. Also the second hypothesis stating that the method of social work {--} family recovery {--} is insufficient in the Czech Republic was confirmed. My Bachelor Thesis can be used as impulse to increase the frequency of home visits of health care workers, not only in case of children in newborn period but also in case of older children because the research shows that parents would be interested in such service. Within family recovery, this Thesis can be used to start working with the child and the child{\crq}s family in time, so that the family is recovered and the child can stay in his or her original family and need not be placed to some institutional care facility.
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Interpersonal relationship development between children's nurse and mother in the neonatology department by means of the H. E. Peplau model
AMBROŽOVÁ, Helena
The dissertation objective on the theme {\clqq}Interpersonal relationship development between children's nurse and mother in the neonatology department by means of the H. E. Peplau model`` is to chart individual phases utilization in the process, professional relationship development between children´s nurse and mother according to the H. E. Peplau model. Further through created documentation to find out differences at the approaches during professional relationship connecting between children´s nurse and mother in the neonatology department in the Hospital JSC in České Budějovice. To meet these objectives the dissertation is divided into theoretical part which focuses on differences at the care of developed and underdeveloped infant, nursing model H. Peplau including its application into practice. The second, practical part is divided into quantitative and qualitative parts. The quantitative part concentrates on factors finding out which influence professional relationship between children´s nurse and mother in compliance with the H. E. Peplau model and concurrently specifies individual nurse roles changing during professional relationship children´s nurse and mother. The data of the quantitative research part have been learned by means of questionnaire disquisition. By the dissertation results summarizing I found out facts regarding H. E. Peplau model individual phases utilization at the children nurse {--} mother relationship establishing in neonatology. Hypothesis 1 {\clqq}Children nurses with own children establish faster the professional relationship with mother`` {--} has come true. Hypothesis 2 {\clqq}Children nurse practice length influences the ability to establish the professional relationship with mother`` {--} has come true. Hypothesis 3 {\clqq}Children nurses undertake the role of the mentor in most cases`` {--} hasn´t come true. The data of the qualitative research part were identified by observation, conversation with children nurse, creating of the documentation own proposal at the mothers of prematured children hospitalized by ROOM IN system and its application in practice. Mothers were divided into two groups, the common way of the interpersonal relationship establishing with mother was used in the first group, the way of the interpersonal relationship establishing with mother according to the H. E. Peplau model was applied in the second one. At the quasiexperiment it has been identified the interpersonal relationship establishing with mother proceeds better at the nursing H. E. Peplau model utilisation. The dissertation knowledge can be partly utilised by neonatology department of the Hospital JSC in České Budějovice, in particular by children nurses to master the abilities for professional relationship establishing with mother and to provide subsequently mother and child with the complex nursing care. Further to students and other interested people in this issue.
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