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Cooperation of neonatal nurses and parents of premature newborns in the perinatal centres in the Czech Republic.
MEDONOSOVÁ, Kateřina
This diploma thesis addresses the issue of prematurely born children. It focuses on the cooperation between neonatologic nurses in perinatal centers and the parents of the newborns. There are 3 goals of this thesis: 1. To explore and describe the level of cooperation and support of the parents and their involvement in the care of the premature newborns in perinatal centers in the Czech Republic. 2. To find out which priorities and expectations of the parents of the premature newborns are. 3. To contribute with these results to the improvement of mutual relationship between a medic and a parent. To achieve the goals described above the methods of quialitative and quiantitative research were used in the empirical part of the thesis. The quantitative research was carried out in perinatal centers in the Czech Republic using questionnaires filled by the nurses who work there. The qualitative research was carried out by questioning the mothers of the premature newborns using individual thematic semi-standardized interview. The results of the research will be provided to all perinatal centers in the Czech Republic that cooperated and can be used to improve the quality of cooperation between neonatologic nurses and parents of premature newborns.
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Caring for High-Risk Newborns after Release from Hospital Treatment: A Parent's Perspective
MACUROVÁ, Štěpánka
My Bachelor?s thesis focuses on the issue of children with a development risk, and deals mainly with the care provided to these children after they are released from hospital. The thesis is divided into a theoretical and practical part. The theoretical part defines important used terms. In the Perinatology chapter, general provisions are described as well as the system of perinatologic centres. To understand the topic, it is necessary to know the classification of infants and understand the manifestations and consequences of premature birth, so the second chapter provides basic information about neonatology. A separate chapter deals with the definition of chronological age and corrected age. These are important to secure proper monitoring of the child?s development. The development of prematurely born children differs from the development of children born in the standard term, and this fact must be taken into consideration. Nutrition is an important aspect for proper development. Recent trends especially stress breastfeeding of the child by its own mother. Information about nutrition and breastfeeding and the specifics of nutrition for prematurely born children are described in a separate chapter of the thesis. The following chapter deals with the issues related to releasing children with a development risk from hospital, and the care following their release. The care provided by a development care centre is emphasised. The last chapter provides a selection of the most common diagnoses experienced by prematurely born infants. The practical part contains qualitative research carried out by means of a semi-structured interview. The interviewed sample contains ten mothers of prematurely born children or children with other development risks. Respondents were women that I know, who regularly visit a development care centre with their children. A key selection criterion was the corrected age of the child, which had to be less than 24 months. The goal of the research was to evaluate the activity of the development care centre from the parents? perspective. A single research question was asked: Which deficiencies do the parents see in the activity of the development care centre. The collected data was analysed and lead to a clear conclusion and answer to the research question laid down in the thesis. The results of my research clearly justified the activity of development care centres, which are usually part of large maternity wards. The centres are accepted very positively in all aspects. The interviews also showed some deficiencies, which were described in the discussion and summarized in the conclusion. Since neonatology care is constantly improving, the ratio of surviving children with an extremely low or low birth weight is much higher than in the past. It is necessary to take into account that care does not end after the child is released from hospital. Premature birth carries many risks, which threated the child?s development. It is thus necessary to secure continuous care and monitor the child after release from hospital into home care. This topic has recently been often discussed. The mental development of the child is as important as the child?s physical development. It has been proved that prematurely born children may have some psychological problems. The conclusion summarizes the deficiencies that mothers find in the activities of development care centres, and describes recommendations that should lead to improvement of this care. These include a need for greater engagement of nutrition and breastfeeding counsellors, improved education of nurses employed in community care and improvement of the quality of cooperation with children?s physicians. I would recommend my thesis to the expert and general public. It could also be of use to students of nursing ? midwives, children?s nurses and others who are interested in the issues of children with a development risk.
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Specificities of nursing newborn children with partum cranial injuries
KOBLIHOVÁ, Jitka
Birth injuries of the new-born infants might be caused either by mechanical or anoxic traumas that occur during the birth. The injuries might be a result of insufficient attention or inadequate efforts of the obstetrician but might as well occur completely independently of the obstetrician´s activities. The character and extent of birth injuries are very wide and vary from the insignificant ones that are cured completely without any consequences to those that leave long-term consequences and that may even end in the death of the new-born infant. Cranial injuries of the new-born infants include: caput succedaneum (swollen scalp), cephalohaematoma, petechiae, suffusion, eye injuries, scalpel-incised wounds, parietal bones fractures, spinal cord injuries and intracranial haemorrhage. This Baccalaureate thesis surveys the knowledge of the nursing staff as far as birth cranial injuries are concerned and concentrates also at specific aspects of nursing new-born infants who suffer from caput succedaneum (swollen scalp) and cephalohaematoma. The theoretical part comprises the most important pieces of medical knowledge in nursing new-born infants with birth cranial injuries. The first goal of this thesis was to map the level of knowledge of the birth cranial injuries among the nursing staff. In compliance with this goal a hypothesis was stipulated: ?Members of the nursing staff are well-informed about birth cranial injuries.? This hypothesis was verified and confirmed. It was found out that members of the nursing staff have good knowledge about birth cranial injuries, their predispositions and prevention. A quantitative research was carried out using the questioning method (the questionnaire technique was used). The research was carried out at the Neonatal Departments of the hospitals Nemocnice České Budějovice, a.s, Nemocnice Písek, a. s. and Nemocnice Strakonice, a.s. The second goal of this thesis was to map the specific aspects of nursing new-born infants who suffer from caput succedaneum (swollen scalp) and cephalohaematoma. In compliance with this goal a research question was stipulated: ?What are the specific aspects of nursing the new-born infants who suffer from caput succedaneum and cephalohaematoma?? It was found out that nursing new-born infants with caput succedaneum and cephalohaematoma does not comprise many specific aspects. The most important thing is to nurse such infants carefully and with caution, to position their heads on the side without caput succedaneum or cephalohaematoma, to check regularly the bilirubin level, to observe carefully the cephalohaematoma or caput succedaneum (its colour, size, localization) and to watch the behaviour of the new-born, mainly whether it shows any signs of pain. The research was carried out in a qualitative way using the question method ? the depth interview technique. The research file consisted of two nurses and two midwives from the Neonatal Department of the České Budějovice Hospital, a.s. The research has revealed that the nursing staff at neonatal departments is well informed about birth cranial injuries and that the nursing methods applied at new-born infants who suffer from caput succedaneum and cephalohaematoma do not differ much from the methods used in case of physiological infants. The output of the thesis is an educative material concerning birth cranial injuries that is intended for the nursing staff at neonatal departments.
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Organization of the neonatal transport servis from the view of nurses
SCHWARZOVÁ, Lucie
Even though it has been managed to concentrate deliveries of premature infants to the perinatal centres thanks to the ?in utero? (before-delivery) transports in recent years, there are still a certain number of newborn infants who are born outside the centres and, thus, it is required to transport them to the specialized departments. The transport of a newborn infant is characterized with special therapeutic procedures and it requires different equipment for providing intensive or resuscitation care and it is provided by transport service for newborn infants that is an integral part of the regional system of the differentiated care of newborn infants. The objective of the diploma thesis is: Objective 1: To characterize current provision of neonatal transport services. Objective 2: To map the role of nursing staff when providing neonatal transport service. Objective 3: To find out if nurses deliver care by nursing process when providing neonatal transport service. A hypothesis and research questions were defined on the basis of these results. Hypothesis 1: Presence of a nurse when providing neonatal transport service is important. Research question 1: What is the role of a nurse when providing neonatal transport service? Research question 2: How is the nursing process applied when providing neonatal transport service? The investigation proved the hypothesis and the research questions were answered. The goal of the thesis was met. The standard ?Nursing Care of Newborn Infants during Transport? is the result of the diploma thesis.
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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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Contribution of children nurse{\crq}s work to community nursing both within the Czech Republic and abroad
PĚTIVLASOVÁ, Alena
My dissertation is aimed at the following questions: System of children care, organization of health-care policy in the Czech Republic, competencies and abilities to children care, document Health for Everybody in 21st Century, community nursing, nurse interventions in particular age categories, and my own research proceedings. The research section of the work contains both quantitative and qualitative research procedures. The data were collected of a questionnaire and semi-structured interview. The examined set of a qualitative research consisted of 9 respondents {--} 5 nurses and 4 medical practitioners for children and youth. The quantitative data were collected with an interview method. The questionnaires were designed for the unprofessional public {--} parents of children who are up to 18. The examined set of the questionnaire research consisted of 73 respondents (100%). The research proceeded from mid June 2008 to the end of July 2008 and its results have been processed into category tables and graphs in the program of Microsoft Office Excel 2007. I especially try to find the opinion of children nurses and children medical practitioners on introduction of a community children nurse in the Czech Republic and specify the functions that a community children nurse can perform in the Czech Republic when working with children community. I also try to find locations at which the community children nurse could work, and obstacles hampering to establish this new working position within the Czech Republic. Last but not least, I am interested in the public interest in the nurse{\crq}s affect to health protection and care for children. So far, there has not been a community nurse position established as an independent community professional in health protection and care for children within the Czech Republic. However, in other countries, community nurses work in the state interest and they form a part of the public health-care system. They are rewarded for their work, which is highly appreciated, from the public budget. Development of the community health-care is a WHO priority, and it has already established its firm position in the Czech health-care conception. As the main advantage of introduction of a community nurse I consider the fact, that both children and parents would have a better chance to use a wider variety of health-care services at school, in their household or at the doctor{\crq}s consulting room. Community nurse{\crq}s activities could help to inform families and to improve the health-care edification level. They could also assist the families that need highly intensive health and social care. Because of independent work of community nurses, nurse{\crq}s profession would become more attractive and nurse{\crq}s social position would improve.
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