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Kinesiotherapy and physical therapy in peripheral facial nerve palsy
Duchatschová, Iveta ; Horká, Bohumila (advisor) ; Věchtová, Bohuslava (referee)
Author: Iveta Duchatschová Institute: Medical Faculty of Charles University in Prague Název práce: Kinesiotherapy and physical therapy in peripheral facial nerve paresis Supervisor: Mgr. Bohumila Horká Number of parties: 83 Number of attachments: 0 Year of defence: 2012 Key words: peripheral palsy, facial nerve, kinesiotherapy, physical therapy, regimen measurements, cranial nerves, facial muscles The thesis summarizes basic knowledge of Peripheral facial nerve palsy. The theoretical part deals with the anatomy of facial nerve, aetiology of paresis, epidemiology of this disease, clinical symptoms, medical examination and possible treatments. The individual methodologies from the physiotherapy that may be applied in different combinations during the medial rehabilitation procedures in order to achieve the best possible effects are analysed in more detail. Another point of the thesis is the regimen measurements that the patients should follow in order to prevent potential complications or deterioration. The theoretical knowledge is followed by practical part, which examines the case study of two patients with facial nerve palsy diagnosis. It focuses on the medical examination of the state of the disease done by physiotherapist, therapy used in these particular cases and results that the therapy...
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Specificity in the provision of nursing care before and after thyroid surgery.
HAUSEROVÁ, Kateřina
After diabetes mellitus we encounter thyroid disease as the most common disease of the endocrine glands. The most common diseases of endocrine glands are inflammations, tumors, struma or thyroid enlargement, thyroid hyperfunction and hypofunction. Indications for surgery are among others malignant and benign thyroid diseases. In the postoperative care both general and specific principles are applied, which are conformed to the condition of the patient, the type of surgery and the surgeon requirements. Providing the right nursing care should also help the prevention of possible postoperative complications. The bachelor thesis named "Special features in providing nursing care before and after thyroid surgery" is divided into two parts, theoretical and empirical. The theoretical part of the bachelor thesis deals with thyroid anatomy and physiology and its surroundings, its need for iodine, it describes individual thyroid diseases, thyroid disease diagnosis and treatment. Furthermore, it also deals with the nursing care before and after thyroid surgery, the emergence of possible complications and last but not least it deals with home care after the patient is discharged from hospital. The aim of this bachelor thesis was to detect the pecularities of providing nursing care before and after thyroid surgery and to determine regime measures and the knowledge of these in patients after thyroid surgery at the surgical department. Research questions were created to achieve the objectives. Q1: What are the pecularities of the nursing care before thyroid surgery? Q2: What are the pecularities of the nursing care after thyroid surgery? Q3: What are the regime measures in patients after thyroid surgery? Q3: What knowledge do the patients have about the regime measures after thyroid surgery? To obtain necessary data a semistructured interview method was used. To process this thesis a qualitative research was carried out. Semi-structured interviews were used as a technique for data collection. Categorization was compiled on the basis of interviews. A research survey was carried out in the surgical ward, where there are patients with thyroid disease. The research showed that the nurses are aware of care principles and they are sufficiently informed about treating a patient with thyroid disease. The interview showed the principles of nursing care, which should be followed throughout the whole period of hospitalization of patients with thyroid disease. In the interviews the nurses emphasized the differences in providing nursing care in a patient before and after thyroid surgery. Furthermore the research showed that nurses would be in favour of further training seminars that would deal with the given issue, about treating a patient with thyroid disease. Awarness and knowledge of the regime measures was also recognized in patients after thyroid surgery. Based on the data obtained from the interviews with patients, those report that their awareness and also knowledge of regime measures after thyroid surgery is minimal and insufficient. The result of the bachelor thesis was to determine the principles of care for patients with thyroid disease. Principles of nursing care were detected in patients before and after thyroid surgery. Furthermore, regime measures were identified in patients after thyroid surgery and also the knowledge of those regime measures in patients after thyroid disease. This bachelor thesis outlines the pecularities in nursing care of patiens with thyroid disease, policy of regime measures after a patient's discharge from hospital and keeping to those is among others a condition for early patients recovery and his return to a normal life. Based on the findings of the research and of available sources a flier will be created about the principles of nursing care for patients after thyroid surgery. The bachelor thesis will also serve as
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The issue of compensation of a heart valve from the perspective of the patient
MUNDLOVÁ, Anna
A heart valve replacement is one of the most technically difficult cardiac surgeries. For the patient, it means a mental and physical health intervention. Heart valve surgery is currently the second most common cardiac surgery - accounting for up to 20% of the total number of cardiac surgeries. The goals and objectives of a heart valve replacement are to improve patients' quality of life and their medical prognosis. The heart valve replacement is carried out only in cases when we cannot perform the heart valve plastic surgery and thereby replace the entire heart valve with an artificial one. Heart valve prosthetics can be mechanical - patients with this kind of prosthetics are then warfarinized for life or they can also be made of biological material (bioprosthetics). Patients with bioprostehtics require only a three month long anticoagulant therapy. Temporary postoperative complications may occur such as dyspnoea, gastric and intestinal atony or aggravation of pulmonary functions. Among the rarer complications are rhythm disorders, thrombosis of prosthetic heart valve, and last but not least infective endocarditis. The patients, after the heart valve replacement, are at a greater risk of complications, therefore they are obliged to always have their patient at risk of infection endocarditis card with them (see appendix 4). After the operation the patients are informed about the lifestyle changes they are to follow within their daily routine, the information is delivered by doctors and nurses. The task of the nurses is to inform the patient about the lifestyle changes together with doctors. Good understanding and observance of these lifestyle changes help to improve patients' life after the heart valve replacement. This bachelor thesis is divided into an empirical and theoretical part. The theoretical part focussing on the problems connected with the heart valve replacement, valvular imperfections, perioperative nursing, patients' lifestyle changes and their quality of life.
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Verification of knowledge about self-management in patients with heart failure
VOJTĚCHOVÁ, Veronika
Congestive heart failure (CHF) is a disease with increasing incidence, which requires an adequate and costly management. Repeated hospitalisations due to decompensated CHF contribute to disease progression and herald dismal prognosis. An important goal of heart failure clinics is reduction in number of hospitalizations due to decompensated CHF. The main approaches to reach this aim seem to be effective diagnostics and treatment of CHF, and importantly, education of patients and their families. We aimed to evaluate knowledge of CHF patients regarding self-care in secondary prevention of CHF. We constructed three hypotheses and three research questions to reach the goal of the project. The theoretical part described recommended life-style interventions, pharmacologic and non-pharmacologic CHF management, and specifically, the role of nurses in education of patients with CHF. The practical part described the methods of analysis, the study group and the process of evaluation. To fulfil the study goal, we performed collection of data using qualitative and quantitative methods of research. The qualitative part of the research project included a non-standardized questionnaire for patients with CHF. A total of 260 questionnaires were distributed in six heart failure clinics. 183 completed questionnaires were returned and analysed. The obtained data were evaluated using descriptive statistical methods. Pearson´s chi-test and Student´s t-test were applied to test the hypotheses. Collection of qualitative data was performed using the technique of a semi-structured interview based on pre-prepared questions. The study respondents included general nurses from out-patient heart failure clinics. Six of nine contacted nurse respondents agreed to participate. Answers were recorded on Dictaphone. Data were analysed using the method of "card display". The quantitative part tested the following hypotheses: 1. CHF patients know symptoms and signs of decompensated CHF. 2. CHF patients follow the life-style recommendations. 3. CHF patients perform daily self-monitoring of their weight, blood pressure and pulse. Our study revealed insufficient knowledge of patients regarding symptoms of possible CHF decompensation. This finding was alarming because suboptimal knowledge of symptoms of decompensated CHF may cause inadequate response of the patient and may delay initiation of treatment. Assessment of compliance with life-style measures revealed that most patients did not use tobacco products and had a limited alcohol consumption. Most individuals reported a regular use of heart failure medication and knew the timing of the next follow-up in their heart failure clinic. Life-style measures included also some dietary restrictions modified by the current nutritional status. Respondents preferred recommended food over inappropriate foodstuffs, however, they did not follow neither the salt restriction nor the optimal frequency of meals. Most respondents did not report a regular exercise A significant ignorance was found in the process of self-monitoring. Most respondents did not monitor their body weight, blood pressure and pulse. The qualitative assessment evaluated the following questions: 1. Do we educate the CHF patients appropriately? 2. Are we able as nurses to pass correct information to CHF patients? 3. How is the process of education implemented in practice? Based on the above mentioned methods, we found that the process of education is a domain of doctors. Nurses have only a limited role in education of CHF patients...
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Awareness of patients with liver cirrhosis
MLEZIVOVÁ, Petra
Liver cirrhosis is disease caused by restructuring of healthy liver to the pathological tissue. It is an irreversible disease, but it can be positively affected by the adjustment of life style and diet in the meaning of its course, prognosis and complications. Awareness of patients with liver cirhosis is ofe of key aspects influencing not only the treatment, bat also life of the patients. Nurses have irreplaceble part in diagnostics, treatment and also in education of patients about change of life style and diet provisions. Bachelor's thesis is divided in theoretical and empirical part. Theoretical part is focused on pathogenesis, classification, clinical signs, diagnostics, complications and treatment of liver cirhosis. First goal of the thesis was to determine the knowledge of the liver cirrhosis patient about heir disease. Second goal to find out what is the level of adherence to diet measures. Related to these goals, there are four main research tasks: What information do the liver cirrhosis patinets have about their disease? What is the source of information for patients with liver cirrhosis abot their disease? How are the liver cirrhosis patients informed about life style measures? What are the life stayle measures that liver cirrhosis patients stick to? Bachelor's thesis was processed by a qualitative research, using method of interviewing. Technique used was gathering of data by semi-structured interview with patients with liver cirrhosis. Qualitative data were organized to categorization groups. Research sample included 6 patients with the diagnosis of liver cirhosis. Results of research proved, that patientsd with liver cirrhosis have information abou their disease. The knew what had been the cause of hospital admission, symptoms of tehir disease, complications, some were also aware of the fact that complications could be life threatening. Only aspect with low awarness level was knoledge of character and course of the disease. Results also show that all patients were informed by physician after the diagnosis was made. Vast majority of patient do not seek for inforamtion about liver cirhosis themselves. research also showed, that patients were informed about life styles measures not only by doctors, but also by nurses. Nurses informed patients mainly about diet measures. Patients were informed mainly verbally, but some also received information leaflets. All patients found information provided understandable. Majority of patients stich to life style measures. In the field of diet, it is restriction of salt and smoked meat products. They eat more often, small portions. Majority reduced volume of alcohol or stopped drinking at all. They do not perform physically demanding activities. They try to attend physicians regularly. They all try to stick to measures, but everyone of them has some weakneses. Only one respondent ignores life style measures. This thesis was focused on information provided to patients with liver cirrhosis. Level of awareness of this patient is important part of their treatment. Education is one of the key roles of nurses. Nurses therefore need to have sufficient amount of information about diet and life style measures in patients with liver cirrhosis. This thesis could be used as form of information booklet not only for nurses, but also for common people who get in touch with liver cirrhosis patients. Based on results of this thesis, we creted the leaflet, that summarizes basic data about disease as wel as about life style and diet measures.
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The influence od educational to maintenance of secondary prevention rules of myocardial infarction
ŠÍMOVÁ, Martina
This bachelor thesis deals with the effects of educational plans on the compliance with the principles of the secondary prevention of myocardial infarction. The theoretical background covers atherosclerosis, acute myocardial infarction, the secondary prevention of myocardial infarction and the educational process in nursing. Prior to elaborating the practical part of the thesis we had established two objectives. Objective 1: To find out whether the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Objective 2: To compare whether the patients educated without an educational plan comply with the principles of the secondary prevention of myocardial infarction in the same way as the patients with an educational plan. A qualitative form of research had been chosen for this thesis, semi-standardized interview in particular. The analysis of the data gained was subsequently carried out. Two objectives had been established in the thesis. Objective 1: To find out whether the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Through the analysis of the obtained data we found out that the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Objective 2: To compare whether the patients educated without an educational plan comply with the principles of the secondary prevention of myocardial infarction in the same way as the patients with an educational plan. Having compared the results we found out that the patients with an educational plan comply with the principles of the secondary prevention more consistently than the patients educated without an educational plan. The objectives of the thesis were met.
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Specific features of nursing care of obese patients with diabetes mellitus type 2
KLÍMOVÁ, Pavlína
The occurrence of diabetes mellitus type 2 and obesity in the population has been continually increasing. This phenomenon has been obvious particularly among ever younger age groups. At the end of 2010 the number of registered type 2 diabetics in the Czech Republic was 739 859. The percentage of obese adult population in the Czech Republic is approximately 35 %. This means that the Czech Republic holds a leading position in obesity occurrence. Treatment of obesity and diabetes mellitus type 2 are based on the same principles. Meanwhile, weight reduction improves compensation of diabetes. The care of obese diabetics is highly specific and therefore requires a closer attention. It is important to emphasize which of the specific features of the care are the most significant. Specific features in the care of obese patient with diabetes mellitus type 2 include particularly education about dietary measures, physical activity and complicating conditions about which type 2 obese diabetics should be informed. The following two objectives were established based on the above-mentioned facts. The first objective was to map specific features of nursing care of obese patients with diabetes mellitus type 2. The second objective was to map the knowledge of obese diabetics about the regimen measures associated with their disease. Both the objectives have been met. The research efforts were divided into two parts. A qualitative survey was used to meet the first objective through a structured interview method. The interviews were conducted with seven nurses from the South Bohemian region involved in the care of those patients. The interview investigated specific features of the care of obese type 2 diabetics. A quantitative questionnaire survey was used to meet the second objective. The questionnaire was intended for obese type 2 diabetics. The number of distributed questionnaires for the research survey was 100. The purpose of the questionnaire was to verify knowledge of and adherence to regimen measures among the patients. The surveyed patients were selected in surgeries of specialist physicians, two hospitals and a senior citizen home in the South Bohemian region. The results have shown that patients are familiar with regimen measures associated with their disease and that they adhere to them. Further, the results have shown that specific features in the nursing care of obese patients suffering from diabetes mellitus type 2 include particularly education of nurses about dietary measures, education about physical activity and education about acute conditions connected with acute complications of diabetes and about anti-stress techniques or psychotherapy.The thesis will serve as a document monitoring specific features of the care of obese patients with diabetes mellitus type 2 and will help not only to students interested in the topic but also to all other interested individuals. Another output of the thesis is an information leaflet intended for type 2 obese diabetics.
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Acquiantance of university students and adult epileptics with problems related to epilepsy
DOUBKOVÁ, Ivana
This work is primarily aimed at awareness of the academically educated students and epileptics of the problems related to the epilepsy. The first aim is to monitor, whether the academically educated students have the information about the epilepsy problems and primarily, whether they should lend the first aid to the epilepsy patients. The other aim was to find out the awareness of the epileptics of the regime measures connected to their diseases and whether these patients keep these measures. There were set two hypotheses. The first one was related to the awareness of the academically educated students of lending the first aid during and at the end of the epileptic seizures. The other one was focused on the awareness of the epileptics of the regime measures and whether they keep them. Both of the hypotheses were confirmed. Research was made in a quantitative way. The first group was formed of the epileptics older than 18 years, who were monitored in the neurological outpatients' department in the South Bohemia district. The other group was formed of the students of the Pedagogical Faculty of the University of South Bohemia in České Budějovice. It was found out, that the epileptics have the information about regime measures available, but that they don{\crq}t keep them. Further it was found out, that students of the Pedagogical Faculty have information on lending the first aid available
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Need of Instructing Patients after Operation of Varicose Veins.
HROMÁDKOVÁ, Alena
The paper is entitled the Need of Instructing Patients after Operation of Varicose Veins. It deals with the general issue of the disease, the role of a nurse in the treatment of patients after the operation of varicose veins and the instructions given as an inseparable part of the nursing care.The paper follows 4 essential objectives. Objective 1: Finding out what information patients have after the operation of varicose veins. Objective 2: Finding out what information the patients need. Objective 3: Finding out, in which way nurses in a surgery department instruct patients after the operation of varicose veins. Objective 4: Creating an instructional brochure for patients after the operation of varicose veins, based on the information obtained.There were 4 research questions asked. 1. What information do patients have after the operation of varicose veins? 2. What information do patients need after the operation of varicose veins? 3. In which way do nurses instruct patients after the operation of varicose veins? 4. Do nurses perceive instructions as an inseparable part of the nursing care?The research was carried out at Pelhřimov hospital, subsidized organization, with the consent of the head nurse. The research group consisted of 10 patients after the operation of varicose veins who were interviewed before leaving the hospital for home care, and 8 nurses from the aseptic section of the surgery department. All the respondents were asked using the technique of a non-standardized interview with questions prepared in advance. Based on the analysis of the respondents' answers, an informative brochure was drafted which was then tested by a questionnaire. It was found out that the brochure would be advantageous for the surgery department.The objectives of the paper were met. Improvement in the process of instructing patients after the operation of varicose veins could be reached by introducing an informative brochure. Not only patients, but also nurses working at a surgery department could benefit from the brochure.
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