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Clinical evaluation of postural balance functions in patients with chronic obstructive pulmonary disease
Hrdý, Tomáš ; Smolíková, Libuše (advisor) ; Špaňhelová, Šárka (referee)
Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic respiratory diseases. Impairments in exercise capacity, kinesiology and skeletal muscle function are well established in these patients. Recently presented data also suggests impairments in postural balance and increased risk of falls in patients with COPD. The aim of this study is to examine postural balance functions in a group of patients and compare the results with a control group. Methods: Twelve patients (the average age 65,6 ± 7,1, 5 women, 7 men) with COPD hospitalized at the Pulmonary Clinic at the Faculty Hospital, Prague Motol and 10 healthy control subjects (the average age 58,6 ± 5,2, 7 women, 3 men) participated in this study. Participants were measured by The Activities-specific Balance Confidence Scale (ABC) and The Balance Evaluation Systems Test (BESTest). Results: COPD patients scored significantly worse (0,0099, p < 0,05) on the ABC scale total score compared to healthy controls, 78,38 ± 21,14 for COPD versus 97,78 ± 3,88 for controls. The total score and the six subsystem categories score of the BESTest were lower in COPD patients, but not significantly, compared to controls. Conclusion: Patients with COPD showed a lower degree of balance confidence and postural balance functions....
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Evaluation of balance in osteoporotic patients
Brožová, Kamila ; Sodomková, Gabriela (referee) ; Radvanský, Jiří (advisor)
In this days the osteoporosis is getting to the centre of interest because of its increasing. It is the worldwide problem. Physical activity is one of the main factors affecting the course of disease. Suitable physical activity is possible to reduce a risk of falls, fractures with following, frequently fatal complications. Finding the ma in problems lowering balance ability of endangered population groups and subsequently targeted physical program it possible to include in preventive program of safety locomotion and give support to enhance quality of life for endangered persons. Powered by TCPDF (www.tcpdf.org)
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Evaluation quality of the treatment of the most common injuries in medical first aid.
LEVKO, Marina
The theoretical part of this bachelor thesis deals with the medical first aid service (emergency) and its current status in the Czech Republic with a focus on the South Bohemian region. I also describe the difference between the ambulance and the emergency because patients often mislead those two terms. The theoretical part focuses too on the trauma issue. Children and teenagers are the most endangered by suffering a trauma. That is why I describe the problematic of children in premedical care. The objective of the thesis was to find out the number of the most common children traumas on the three departments of the medical first aid service in the South Bohemian region and evaluate the quality of treatment. I was trying to meet the goals through a data collection from the three departments of the emergency service in the South Bohemian region from 2013 to 2014. The research was conducted through qualitative and quantitative data analysis. Based on the available documentation on emergency, I was retrospectively finding out the number of all patients treated on the emergency. From this data I subsequently learned the numbers of treated children with a trauma in years 2013 and 2014. All the data learned are worked out into charts to make them more transparent. The qualitative form of the research was done by the method of casuistry analysis. By analysing the casuistries I was also finding out what were the most common children traumas treated on the emergency, its diagnosis and the process of the treatment of each of the children patients in years 2013 and 2014. Two research questions were stated for this thesis. What are the most common traumas which are treated on emergencies and what is the way to treat such traumas and whether it corresponds with lege artis. For better orientation, the data learned about the most frequent children traumas treated on the emergency are put into graphs. After the evaluation of results I found out that the most common children traumas on all three departments of the emergency in years 2013 and 2014 were: injury caused by a sharp object then fall or a blunt impact to an object and burns of I. and II. degree burns. Those results matches with the results presented in other works dealing with the most frequent children traumas. The casuistry analysis implies that all the three departments of the emergency treat the most common types of a light injury the same way, in comparison with the reference literature in all the cases the procedure of treatment was correct. In cases when the trauma was not possible to be solved on the emergency, because of need of a laboratory or projecting medical examination which are not available on emergency, the ambulance was called to a patient, or the patient was redirected to another specialised department to be provided with safe and lege artis diagnosis. While evaluating the quality of the treatment I also focused on the evaluation of the medical documentation which is, on the emergency, represented by the book of daily records. On the emergency 1 and 2 I have met a serious failure with managing this book. Those failures were recorded only within the casuistries dealing with the treatment of adults. When evaluating the quality of treatment of children patients I have not met any wrong or partly filled documentation. To make the transparency better and have the unified form it would be adequate to keep the books in an electronic way at all three emergencies. This is where we are confronted by financial background of the emergency services. In the Czech republic there have not been institutionalized the form of the emergency, its function neither the network of emergencies, have not been specified by any law yet. If the function, provision, availability and the financial background of the emergency is united it would have a positive impact even to patients who this service is meant for.
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Injury prevention related to falls of the residents of Home for the elderly.
SOUKUPOVÁ, Hana
The diploma thesis is structured into a theoretical part and an empirical part. The theoretical part consists of four chapters. The empirical part of the diploma thesis is based on qualitative research. The data were collected via semi-structured interviews with the senior citizens and the nurses. The replies were processed into clearly arranged charts and categories with brief descriptions. Another research method applied was observation. The interviews were followed by a detailed analysis of the documentation, which involved the analysis of the medical records of the senior citizens with a focus on medical diagnosis, chronic medication, and processing of the fall risk and its evaluation. The diploma thesis pursued three objectives by means of four related research questions. The first objective was to ascertain the extent of the clients' awareness of fall risks. The second objective was to assess the discomfort associated with usage of the special device preventing hip joint injuries resulting from falls during common everyday activities of the senior citizens. Finally, the third objective was to obtain the opinions of the healthcare staff on working with clients wearing special devices preventing the hip joint injuries. Four research questions were formulated in connection with these three objectives. Research question No. 1: What is the quality of information provided by the healthcare staff as part of the preventive intervention regarding the falls? Research question No. 2: How willing are the clients to accept changes contributing to fall prevention? Research question No. 3: To what extent is the comfort of the client affected by using special devices preventing fall-related hip joint injuries? Research question No. 4: To what extent is the work of the healthcare staff affected if their clients use devices preventing fall-related hip joint injuries? The results of the qualitative research suggest that the extent of information provided by the healthcare staff as part of the preventive intervention regarding the falls is insufficient in terms of awareness of the risky places. In particular, the research revealed that the nurses fail to sufficiently monitor the effects of chronic medication which may contribute to psycho-motor inhibition of the senior clients. As far as mobility aids are concerned, the nurses offer these devices sufficiently. The nurses demonstrated very good knowledge of all the mobility aids which may facilitate self-reliance of the senior clients. Another problematic issue is the safety of the rooms, particularly in terms of various protrusions and unevenness in the bathrooms. The results of the research do not show any unwillingness of the clients to accept changes contributing to fall prevention. Nevertheless, two of the respondents failed to engage in the activities and maintain physical fitness by regular exercise in the Retirement House. Furthermore, the results do not show any limitation of the clients' comfort resulting from using special devices preventing fall-related hip joint injuries. Finally, according to the research the healthcare staff does not feel restricted in any way when working with senior clients using such device. The results of the research will be used for repeated meetings with the senior clients and particularly with the nurses. The management of the Retirement House, together with the healthcare staff, are working on a new educational material which would indicate risky places with increased probability of falls. These results could be beneficial also for other facilities where healthcare staff takes care of senior citizens. Last but not least, the results are of interest also to the health insurance companies which could provide this special device with at least partial subsidy as part of the primary prevention programme.
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Fall prevention and affecting the quality of gait among the elderly by increasing the afferent signals from the foot
PETRŮ, Ivana
This thesis examines the influence of afferent information coming from the feet to the quality of walking. Bipedal locomotion is a movement that follows people since the first year of life. In childhood, it is a sign of our progressive growth and maturation of the nervous system and in old age it is similar. Often it is the walk that determines the ability of seniors to take care of themselves. With age, it is physiological that the walk changes. Whether it is depending on the diseases, which in elderly age often merge into chronicity, or for example pathological patterns of movement which the body can not compensate so well anymore. Impaired mobility, which goes hand in hand with walking, brings the risk of falling. Fall is one of the most serious injuries for seniors and its consequences can seriously jeopardize self-sufficiency and mobility of seniors. The risk of falling appears just for older people who are no longer able to adapt quickly to changes. The foot is a significant part of the stabilization system of the body. It mediates the first contact with the pad and informs us about its properties. This information is then transmitted to the upper decks of the central nervous system, which then better adapts movement to the pad surface. The amount of afferent information depends on many factors. The most important is the shoe that absorbs a large amount of afferent information from the foot and feet can not fully perform their function of gathering the information. In the theoretical part of my thesis, I discussed changes in physiological, social and psychological, the person goes through the aging process. Then I dealt with falls and their causes, consequences and prevention. In the third chapter I worked sole topic, its construction and the most frequent pathology. And in the last part I focused on walking, its development stages, types, and how should ideally look like. The aim of my thesis is to evaluate how much influence will stimulating the soles of the feet have for walking. Stimulation soles lasted for three months in the form of soft technology and mobilization leg joints, hardening feet hot and cold water, skin stimulation (sifting through the legs in a container with legumes), practicing active (small) foot and eventually coaching momentum and coordination feet by painting or writing with feet (pencil between 1st and 2nd finger). Another aim of my thesis is to identify preventive measures against falling for individual seniors. For this it is necessary to focus on the weaknesses of the individual and to assess its risk of falling. Long-term therapy should be designed so that it is manageable for seniors with regard to his health and ability. In the practical part was used qualitative research. As data acquisition techniques were used anamnesis, kinesiology analysis, examination of walking, fine motor skills and foot examinations of perception. Research was attended by four seniors, three women and one man in age ranges 70-80 years. Therapy carried every week for three months, in the end each proband completed twelve therapies. Each therapy lasted about 30-45 minutes. The results show that it has improved balance especially when standing. Patients gain more stability, two at Romberg III lost titubation and their endurance during solo standing increased. The walk improved, especially in the coordination. In unison, all patients improved fine motor skills of their feet. At the initial examination, only one patient managed to pick up a pen with both feet. At the output, all patients managet it. This work can be used by physiotherapists and other health professionals in nursing homes and similar facilities. It can also be used to increase brand awareness of senior's family members or as injury prevention in the home environment.
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Injuries of children at home
POCHYLÁ, Petra
The theoretical part of this thesis is oriented at an actual issue of accidents involving children in home environment, their prevention and a correct provision of first aid by a non-professional at these types of selected accidents. The practical part of this thesis was led by a qualitative form of research, a method of a semicontrolled interview. The interview given was led by chosen caring people, who gave first aid to children with a home environment injury. The whole process of the interview was recorded at a digital record book and then rewritten to a text form, with the approval of the respondents. The respondents were chosen on the basis of a survey. The final information from the interviews were analyzed and subsequently summarized into results. Six respondents were registered into the research part. Six basic questions were given to the respondents. The questions were chosen to find out information about an injured child, an injury character, a procedure of caring person while giving first aid, or other professional care and permanent effects. While preparing the research part, I was expecting that most of the respondents would manage to give first aid, however, according to the results, half of the parents didn't know how to deal with giving first aid. Non- professional first aid, provided at the right time and done correctly, is one of the basic and essential steps to reverse the injured person back into the normal quality of life. This is why, all people should be able to give first aid without special equipment and tools. The aim of my thesis was to monitor the process of the caring person while giving first aid for selected accidents involving children in home environment. I gave myself one fundamental research question: What was the process of the caring person while giving first aid for accidents involving children in home environment? At the final evaluation and comparison of my results, I achieved the results, in most examined facts, which are presented in other different studies dealing with similar issues- children's injuries and giving first aid for accidents involving children.
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Undesirable effects in nursing care
MARKOVÁ, Ladislava
Adverse events in nursing care are currently much discussed topic. In providing of nursing care we meet with some kind of adverse events every day. But not always we come to realize that it is an adverse event. The number of adverse events grows up every year and this topic becomes more current. The target of this bachelor thesis titled Adverse events in nursing care was to obtain enough information about the discussed topic of adverse events. Practical part of bachelor thesis was prepared by form of quantitative research carried out by using questionnaire survey. Based in the results from questionnaire survey were confirmed or unconfirmed given hypotheses. Ascertained results were summarized in the graphs of which analysis confirmed the hypothesis no.2 The average age of clients who suffer most with the adverse events is from 65 to 75 years. Hypothesis no. 3 The most common adverse events are falls. Hypothesis no. 4 The most commonly used methods of prevention are barriers and warning devices. Hypothesis no. 5 Adverse events occurring more in internal wards. Hypothesis no. 1 The frequency of adverse events increased in 2011, compared to other years based on the processed research results, was not confirmed. As emerged from the research, to the topic of adverse events is not attached such seriousness as it should and sometimes are adverse events underestimated by medical staff. The results of the research will be presented and consulted with the hospital´s main nurse, who could works with it within the meaning of the organizing various seminars, information meetings with my contribution and participation.
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Risk factors endangering people at old age
TESAŘOVÁ, Petra
This work is concentrated on risk factors endangering the man in his old age time and a special risk of falls. The aim of my work was to find out what kind of risk the seniors feel as heavy and how the dynamics disorders affect the life of seniors. It was determined three hypotheses. H1: Seniors feel the physical factors as heavy, H2: The dynamics disorders cause subsequently their isolation from the society, H3: The seniors are not sufficiently informed about the precausion of falls and possible following complications. The aims of work were completed, the first and second hypotheses were confirmed, the third hypothesis could not be either overcome nor confirmed. The results of work will be used for professional seminars and meetings with seniors.
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The dangers in the treatment of old age patients hospitalized in the long-term disease department in the hospital České Budějovice a.s.
FALUŠIOVÁ, Helena
Abstract In the thesis the course of nursing care for seniors with the focus on malnutrition, falls, immobilization syndrome and the decubitus ulcers development is studied. For the quantitative part of the research two aims were stated: Aim 1: To find out whether nurses know the precautionary mechanisms to prevent risks in taking care for seniors and Aim 2: To find out whether nurses comply with precautionary mechanisms to prevent risks in taking care of seniors. The following hypotheses were stated: Hypothesis 1: Nurses know the precautionary measures to prevent risks in taking care of seniors and Hypothesis 2: Nurses comply with the precautionary measures to prevent risks in taking care of seniors. To confirm the hypotheses, the method of an anonymous questionnaire for nurses, which was supplemented by the method of participant observation of nurses in providing nursing care, was used. After evaluating the results of the quantitative part of the research we have come to the conclusion that nurses, although aware of preventive measures, do not always follow the standard procedures. We believe that aim 1 and aim 2 were met. Hypothesis 1 was confirmed. Hypothesis 2 Hypothesis 1 wasn?t confirmed. Another part of the thesis was a qualitative survey that was conducted by interviews with seniors. For the qualitative part of the survey aim 3 was stated: To identify the views of seniors on the ways how to avert certain risks in their hospital. The following research questions were stated: Question 1: According to the senior´s view, how do nurses in the after-care department use possibilities to prevent malnutrition? Question 2: What are the seniors´ opinions on nursing care aimed at preventing falls during their hospitalization in the after-care department? Question 3: What are the seniors´ opinions on nursing care aimed at preventing immobilization syndrome and the decubitus ulcers development? Question 4: How do nurses manage the care of the seniors´ psychological well-being that is important to their recovery? The objective 3 was met. The survey has shown the areas in which changes would be appreciated by seniors, where and how nurses should improve their approach to patients. The purpose of the thesis was to help identify bottlenecks in nursing care for seniors, to find out whether nurses are active at their work, if they have a human approach and provide quality care. We believe that the results of the thesis can serve as an educational material for nurses working not only at the after-care beds, but also in the acute beds wards because seniors are present in all clinical wards. To be able to prevent the risks in taking care of seniors effectively, it is necessary for nurses to be aware of the risks and to pay adequate attention to them.
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