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Survey report on the condition assessment of the Church of the Holy Spirit truss in Telč
Kloiber, Michal ; Bláha, Jiří ; Hrivnák, Jaroslav ; Buzek, Jaroslav ; Kunecký, Jiří ; Hasníková, Hana
The survey described in this report contains the condition assessment of the truss of the Church of Holy Spirit in Telč. The stimulus for the survey report was an order from the parochial congregation ČCE in Telč. The order included a request to assess the condition and identify the extent of wood-decaying damage to the truss of the Church of the Holy Spirit in Telč, focusing on the location of the critical spots, the classification of the damage degree, the determination of the extent of hidden damage using non-destructive devices, and the specification of the wood damage cause, including drawing of the results in the documentation on the current truss condition. Based on the results, specific procedures of repair measures were proposed and the elements proposed for the reconstruction were sketched in the documentation.
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Specifications of nursering care of patiens with complications after direct SKG/PTCA
BLÁHOVÁ, Ilona
Abstract In the Czech Republic there is no doubt about the tendency of gradual increase in median life expectancy, which is significantly affected by the fact that mortality from cardiovascular diseases, especially from acute coronary syndromes, has been decreasing. Besides the provable effect of a healthy lifestyle, diet and, by all means, a quality and effective pharmacotherapy, a significant development in the field of interventional cardiology contributes to this accomplishment. The number of coronographies, coronary angioplasties and implanted stents have multiplied, and today the invasive coronarographic diagnostics and percutaneous myocardial revascularization belong to the the most common diagnostic and therapeutic methods in treatment of acute forms of ischemic heart diseases. An obvious prerequisite for such a rapid development in the field of intervention coronary angiography was the establishment of a sufficiently dense network of catheter laboratories and specialized facilities, which provide a highly professional and intensive care for patients. This thesis is focused on three basic objectives: ? To survey and characterize differences in nursing care concerning various complications in patients after SKG / PCI ? To survey bio / psycho / social impacts of complications after SKG / PCI on a patient ? To identify and summarize personal and material prerequisites and requirements to ensure quality nursing care for these complicated conditions The research was conducted by using a qualitative methodology. The methods used were observation, non-standardized interviews and medical and nursing records analyses. The research survey samples on which the investigation was focused were patients with the acute coronary syndrome hospitalized in the coronary care unit in the Cardio Center in České Budějovice, their family members and also the nursing staff providing the comprehensive nursing care. The outcomes of this survey were eleven descriptive case reports characterizing the occurrence of the most frequent complications in patients with ACS after SKG / PCI. To ensure clarity, each case study is complemented by a thought map with an account of the most important nursing interventions in the management of specific acute conditions. The paper also contains a framework analysis of bio / psycho / social impacts of complicated situations on patients. It is interesting to compare this matter from the perspective of nurses and patients, which is seen in correlation graphs. The section describing the organizational and personnel provision is introduced with the characteristics of the medical process and it also contains the list of medical personnel with their qualifications and the length of experience in the Coronary care unit in České Budějovice. Summarization of the instrumental medical equipment is also based on the analysis of previous cases and is accompanied by photographs of the equipment typical and indispensable for the care of patients in the Coronary care unit, which primarily has an informative and complementary character to get an integrated view of the Coronary care unit running and the nursing staff work.
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High normal pressure and hypertension of children and adolescents
KRÁLOVÁ, Kateřina
In children and adolescents, high normal blood pressure is often present. People with high normal blood pressure show a short time prerequisite to the formation of arterial hypertension. Hypertension occurs most often in children as asymptomatic. Increased blood pressure in children is most often discovered during preventive examinations by a general practitioner for children and adolescents. This thesis contains information about the anatomy and physiology of the cardiovascular system, a blood pressure measurement sister, evaluation of blood pressure, high normal pressure, high blood pressure in children, the role of nurses in primary care pediatricians in the area of communication and education, and treatment of high normal pressure and hypertension. Objectives The first goal was to explore how children adhere regime measures for the prevention of high normal pressure and hypertension. It used this research question: How children adhere regime measures for the prevention of high normal pressure and hypertension? The second objective was to determine the role of nurses in the care of children with high normal pressure and hypertension. The second research question is: What is the role of the nurses in taking care of children with a normal high pressure and hypertension? Methods used In the research part of the thesis, we used the method of qualitative research, questioning method and technique-depth interviews. The interviews were recorded on a Dictaphone and then transcribed literally. Four sisters and three mothers did not wish to be recorded, so they were interviewed at polling literally written on paper. For research, two research files were created. The first sample consisted of six nurses, who were working in GP surgery for children and adolescents in the South Region. Second survey consisted of six people selected from among parents of children with high normal pressure and hypertension, also from South Bohemia. Results The transcribed interviews were investigated by open coding method, pencil and paper. Resulted in 9 categories: Cardiovascular disease, role of the nurse, pressure measurement, blood pressure, hypertension, pressure measurement, recommendation, Lifestyle, Leisure. Individual categories were assigned to subcategories, which are encoded core data. Conclusion The first research confirms nurses working in a pediatrician's office for children and adolescents, the most common cardiovascular disease in the general hypertension. They argue that the role of nurses in primary care pediatricians is properly measure blood pressure and make the education of children and parents in the area. The respondents concurred in the principles of how to properly measure blood pressure measurement are available for at least three cuff sizes. Informants have basic information about high normal pressure and hypertension, and said that, in the offices of primary care pediatricians to conduct checks blood pressure of preventive examinations or troubled child. Informants reported that blood pressure control and education on blood pressure occurs, but in the second research study showed that children and adolescents do not comply with the recommended recommendations in this area, perhaps because they are less motivated. Neither sister nor the parents have not mentioned, they would receive educational aids such as brochures and sample menus.The second research showed that parents most often found elevated blood pressure in primary care pediatricians, either for reasons of preventive examinations or difficulty a child. On the control measurements came at least three times. Respondents agreed on the recommendations they received in the office GPCY such as reducing the weight of the child, regular physical activity, restriction of salt and proper diet the child, but not all children and adolescents comply with these recommendations. The research results will be provided to the journal Pediatrics practice.
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Experiences of health workers with acupressure
ROUBÍČKOVÁ, Radka
The abstract of the diploma thesis is focused on the acupressure and its influence of backache of medical staff. We chose the theme of acupressure because it is a non-invasive treatment method which can be practiced by everyone in the comfort of the home and no aid is necessary to have, just the basic knowledge and training how to perform acupressure. Acupressure is not physically or time consuming and that is why it is considered as a suitable means as an additional treatment of pain and other health disorders. It can improve nursing care. The theoretical part deals with pain and pain of medical staff who are the highest risk group of backache in the lumbar region. The backache is the most frequent cause of incapacity for work. Furthermore, in the theoretical part we deal with acupressure, one of the methods of alternative medicine. For the processing of the theoretical part, we used the available foreign and Czech literary sources. The empirical part of the diploma thesis is a quantitative method. The results obtained from the research were processed in the overview tables and case reports. For the thesis we set two research objectives. The first objective was to find out the experience of medical staff with acupressure. The second objective was to verify the influence of the techniques of acupressure for backache of medical staff. On the basis of the aim two hypotheses were created. The first hypothesis should show whether the backache will be softened by application of the acupressure techniques. The second one shows whether there is the difference in approach of nurses and doctors to perform acupressure.
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Effect of a graduate of field of study Special Education - tutorship in practice of providers of social care
SALABOVÁ, Jana
Theoretical part of the thesis is divided into 4 main chapters. First one deals with the helping professions generally, their definitions and definition of the Special education - Tutorship branch of study per se.It also briefly touches the subject of readiness of the future graduates to deal effectivelly with the challenges of a career in the field of social services. Chapter number two is called Special education and it defines the subject of special education itself, it's purpose and inner structure. Third chapter focuses on social services. It brings up it's definition and types and forms of social services.It also contains the examples of the institutions which fall into this category and it's providers. Chapter number four, which happens to be the last one in the theoretical part of the thesis, covers the role and purpose of graduates of the special education - tutorship studies. It brings up the definition of a social worker, necessary prerequisites as well as beneficial personality traits and feautures. In a subchapter of chapter four is a short description of a pedagogue tutor. Definition who he actually is, who are proper candidates for this position, what are desired personality traits we look for in tutors and the actual content and purpose of their work in institutions providing social services. The end of chapter four is dedicated to a position of a social worker. His activities, the position and definition of a personal assistant and again personality traits needed for a successful career in this field. The objective of the practical part of the thesis is to describe working of Special education - tutorship studies graduates in practice. Particularly their experiences "from the field", how do they evaluate the level of skill of fresh graduates during their first encounters with the reality, how satisfied are they with their choice of a career so far and what was their motivation to pursue such career. Practical part of the thesis includes qualitative research. To meet the above objectives, data collection technique had been chosen using a structured interview with the respondents, who were graduates of Special education tutorship studies. You can tell by the results of this thesis that graduates in the field of social services apply mostly to lower positions as a social service workers, even though they are qualified to perform as a social workers. The age of clients with whom the respondents work ranges from childhood to senior. The motivation that led those questioned respondents to the decision to choose the area of social services varies. Some reported that they were influenced by the actual practical experience during their studies at the university, when both the work itself and their enthusiasm for the target group played role. Others expressed they had previous experience working with people with disabilities or they just wanted to acquire new experiences. Also, involvement of a family member and their previous education was a motivation. Job satisfaction is evident from observed data, and it also contributes to work done accurately and responsibly. Personal benefits for the respondents according to findings are usually their usefulness at work, new experiences they are getting and last but not least advances of their clients. As the biggest advantage the respondents usually mention variability of their work, target group and the clients in itself and the fact, that their work is highly satisfying and they basically work in a very pleasant team of individuals. On the other hand, not exactly satisfying financial reward and challenging working hours are mentioned as disadvantages. Special education - tutorship studies - the branch they've studied, is by the majority of respondents considered to be beneficial for them and they especially highlight practical impact of practice they completed during their studies and which included visits to various relevant institutions.
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Specifics of nursing care in patients after transapical aortic valve implantation.
VOTRUBOVÁ, Nataliya
Transcatheter aortic valve implantation (TAVI) is a new and an attractive method in cardiology and as well as in cardiac surgery. It is constantly evolving method which has been developed as an alternative to standard open surgery, especially in patients with severe symptomatic aortic stenosis with unacceptably high perioperative risk or patients who are not suitable for conventional open heart surgery because of age and comorbidities.A teamwork is very importantfor this new method and approach. The choice for TAVI is discussed by the institutional multidisciplinary heart team, typically consisting of interventional cardiologists, imaging-specialists, cardiac surgeons and anaesthesiologists. The first implant in a human being was performed by Cribierin 2002. In Czech Republic this method was first used in 2008. Transcatheter aortic valve implantation (TAVI) was accepted as a minimally invasive alternative to open surgery. This method does not require the use of cardiopulmonary bypass, and cardiac arrest. Other several benefits includinglower risks of bleeding and stroke events, better wound healing, less pain, as well as more rapid early recovery due to preservation of continuity of the sternumthat result in shorter durations of stay in the hospital, earlier rehabilitation and faster returns to normal life. In the presented work was used a combination of qualitative-quantitative methods of investigation. The data was obtained by using the quantitative research. The main technique was using the questionnaires designed for nurses working at the Department of Cardiac Surgery, Hospital Czech Budejovice, a. s. These results were backed up by the implementation of qualitative research, which investigated the patients and physicians view on monitored issues. Questioning method using a semi structured interview technique was used for qualitative research. The results of the survey were processed using descriptive statistics charts in LibreOffice Calc and using diagrams created in LibreOffice Writer. Qualitative results of the research were transcribed from audio recordings and coded, and the base code was created nine categories of interviews with clients/patients and three categories of interviews with doctors. The aim of this work was to explore the specific problem of nursing care about the clients / patients after transapical aortic valve implantation. On the base of our obtained data it is evident, that the client/patient after TAVI may be positioned sideways, the use of surgical drains are less frequently, so the care about the surgical wounds is simpler, patients report less pain in the surgical wound and postoperative rehabilitation and recovery is shorter. H1 - The nurses take care about the clients/patients after transapical aortic valve implantation in the same way as about the clients/patients after open aortic valve replacement, without realizing the differences between the patients treated with different approaches, was not confirmed. The nurses'sees/reported major differences in invasiveness and extent of providing care, rehabilitation, convalescent, in the duration of the hospitalization and better cosmetic effect. The results of the research can serve as a basis for creating the standards of nursing care or educational material for clients/patients. It is also possible to present the results of this work at a specialized seminar for non medical healthcare workers and results can also increase the quality of nursing care about the clients/patients after transapical aortic valve implantation.
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A historical view of the army nurse profession.
PAVLÍKOVÁ, Andrea
The thesis deals with the profession of a military nurse. We can assert that the official study of military, non-medical health-care related qualifications and its use in practice not only for military purposes dates back to the fifties of the last century. However, women as health care professionals, consequently in uniforms, have always been an actual issue. The development of health care activities always existed, however, we must not neglect influence of scientific and medical findings. The historical timeline of development of medical care in the battle field was recorded and ranges from pre-historical healing. The way of Christian medicine was negatively influenced by the Catholic Church. The dark period of the Middle Ages had actually wrested medical performance from the hands of specialists and the suffering were left to the "tender" mercies of the priests. The following part of the thesis concerns modern medicine where enlightenment reforms were exercised. Some of the original six-month courses for military surgeons were organised in this period of time; they weretransformed into Military Surgical Academy, out of which the famous Josefinum originated. A expression of humanity which supported a form of health care of war veterans was demonstrated by constructing buildings for invalid people. The second half of the nineteenth century is characterized by the phenomenon of the presence of nuns in military hospitals. This study goes further in depth of professionally organized healthcare right in the battle field, which dates back from the era of wars in the Crimea.This stage describes the transformation of caring into nursing which requires the necessity of specialized preparation of persons providing nursing practice. In addition, Henry Dunant engraved himself into the history of the profession of a nurse, as the founder of the Red Cross, who first trained health care professionals for working within armed intentions of the state. The continuation of this action sketches out the process of providing first aid in principal armed conflicts of the twentieth century. It describes the functioning of commander operated military health service of that time. WWI drove Czech medical staff to both sides of the front where they provided medical help to the injured. Nurses of the WWII already performed their duties in uniforms as the rightful members of the army. The thesis also mentions post-war usage of military health care professionals in secret foreign missions and their specialized erudition.Last but not least, it marginally discusses contemporary possibilities of modern health care service of the Army of the Czech Republic. The goal of the endeavours of writing this thesis was to chart out clearly the development of the profession of a military nurse within the historical context, focusing mainly on women coming from Czech regions. In order to make the history background concerning specific female participants of the world war conflicts understandable to the reader, this paper reports, in broader extension, peculiar medical and nursing findings, already from the era of prehistoric civilisations. The history study method were applied for the purpose of the theoretical thesis. The methodology is based on searching, studying, sorting and the consecutive systematic objective describing of the events from the past times with the intention to propose comprehensive report on the subject given. It was necessary to study inexhaustible amount of sources to obtain awareness of historical connections. Factual information was derived by analysing of primary and mainly secondary documents. The thesis sketches out histories of military health care and the profession of a military health care professional stemmed from the exploration of appropriate written sources and conclusion of the basic findings. The intentions of the work are not only to clarify the past but also to contribute to solutions of every-day issues.
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Coping strategies in children´s fear and pain in relation to nursing care
PROCHÁZKOVÁ, Zuzana
For the nurse, taking care of hospitalized children is important not only pediatric nursing knowledge, personal and social preconditions, but also the theoretical and practical competency of methods and techniques, which are used for identification and effective influencing of pain and fear. The aim of this thesis was to identify the main sources of fear of the hospitalized preschool and young school age children and to find out the effective methods and principles of the cooperation with children, alternatively with their accompanying parents in order to moderate the fear of the small patient. Then the thesis tried to chart the nursing diagnostic and evaluation procedure of the pain and get the most used nursing methods of non-pharmacological pain relief. To obtain the necessary data, the qualitative research was used with a semi-structured interview as a research instrument. The first research group consisted of 12 nurses, the second group consisted of 12 children ´s patients of preschool and young school age. The majority of the asked nurses thinks, that children´s patients are afraid especially of non-familiar environment, then of the awaited pain and of the solitude without parents. However, the most patients said, that they were afraid especially of pain, then of non-familiar environment, restriction of their needs, hostile attitude of the medical staff and of the other neighbouring patients. They were also frightened of the death and of the darkness. Most reported nurses mean, that the most effective solution of the children ´s fear is the friendly attitude of the medics. They also mentioned the fact of taking the focus off the fear and the presence of the parents is also beneficial. The nurses ´ answers were in conformity with patients opinion in two fields - friendly attitude of the medics and taking the focus off the fear. Then the children mentioned abiding of their specifics in connection to falling asleep and the demand of beying treated by the same sister or by few same sisters. All respondents also talked about the benefit of parents presence. Regarding the principles of the cooperation, nurses answered the importance of united medical procedures, especially the proper way of information transfer. Then the respondents nurses mentioned the psychical and emotional support for children and their accompaniments, the atmosphere of confidence and the value of well done education. Also the need of calm, silence and privacy was stated. Unlike nurses, children and their parents regarding to principles of the cooperation prefer the psychical and emotional support, then the importance of enough information was mentioned. The fourth research question bears on the methods used for children pain monitoring. The nurses said, that the intentional interview with the patients or with the parents was used as a main technique, that was stated by patients as well. Research question number five said: What are the most used nursing methods of non-pharmacological pain relief at children? Most responded nurses mentioned the distraction of children attention from the painful incentive, then the importance of physical methods, relief position and purposeful preparation for the unpleasant intervention. Nurses also named the helpful contribution of the parents, relaxing exercises and the method of imagination. Regarding the pain treatment, it was noted, that all patients prefered the analgesic therapy. Then they quoted the distraction of their attention from the painful incentive, the friendly attitude of the medics, using the ice compress and the relief position. In the pain acute phase, children required mostly calm, comfort and privacy. All children also considered the presence of parents as very helpful. The theoretical and empirical part of the thesis are suitable for being studied by nurses taking care of children and it can be helpful for nursing quality improvement at children ´s wards in hospitals.
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Nursing care management of patients after intrapleural chemical pleurodesis
KIESEWETTEROVÁ, Renáta
The pleurodesis is a treatment method for patients suffered from the symptomatic malignant pleural effusion. The goal of the pleurodesis is to close a pleural area by connection of visceral and parietal pleura in order to reduce or terminate production of pleural effusion. The sterile talc powder is the world's most used agens within a practice. After a parental analgesic is the powder (as a sllury) either applicated into a pleural cavity through the chest drainage or surgically dispersed over the treated (via abrasion, decortication) pleural space during the thoracoscopy/thoracotomy. This diploma thesis focuses on the treatment technique of bedside talc-pleurodesis through the chest drainage. The nurse has an irreplaceable role in the whole process from a preparation of patient to assistance by intrapreural application, to care of patient after the operation or serves as a physical support during potential complications. The aim of the presented work is to detect priorities in nursing care and find out whether patients need increased care after intrapleural therapy. The qualitative research method was chosen for the analysis where semi-structural interview with open questions were used. We created case reports analysed with the adaptive model of Callista Roy as well. The research sample contained patients chosen with respect to specialization of researched problem. We set two basic focal stimuli according to the analysis of respondents´ reactions. These stimuli serve as a basis for determination of priority parts of the nursing care by patients after bedside pleurodesis. We defined the need to be without pain and the need to ensure safety and certainty as a central focus of the nursing care. Among secondary fields of nursing care were identified sleep disturbances and limited mobility, which leads to reduction of self-care in getting dress, hygiene as well as in defection and miction. We found out within the second goal identical intensity of the nursing care before and after bedside talc-pleurodesis. This statement is based on comparison of interventions before and after aplication analysed via adaptive model by Roy. Nevertheless, causes of interventions were modified to a certain extent. The main goal of diploma thesis was to map requirements for high-quality nursing care related to bedside talc-pleurodesis via chest drainage. The work should extend theoretical basis not only for nurses in clinical practice.
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Poliomyelitis and contemporary issues of its eradication
PETRÁŇOVÁ, Monika
This diploma thesis deals with the issue of the eradication of infectious polio and its current problems. Polio is a highly infectious disease of viral origin. The most effective form of protection from the disease is vaccination. The main aim of this work was to determine the major issues in polio surveillance in the Pilsen region at present. Intermediate goals were determined in relation to the main aim: to ascertain the awareness of practicing paediatricians about the principles of poliomyelitis surveillance with an emphasis on diagnosing and reporting cases of acute palsy and further to ascertain the quality of the cooperation between the locally competent public health authority and practicing paediatricians in the field of poliomyelitis surveillance. The work is divided into two parts, theoretical and practical. The practical part was elaborated using a qualitative method based on semi-structured interviews with practicing paediatricians and with the locally competent public health authority. The research was participated in by 9 practicing paediatricians and one public health authority worker from the Pilsen region, with an average length of practice of 20 years. The resulting data was then evaluated by a coding method and divided into schemes according to Švaříček and Šeďová (2007). Three research questions were defined based on the set aims: RQ1: What do practising paediatricians see as the prime problems in polio surveillance? RQ2: How many cases of acute palsy do practising paediatricians record and subsequently report to the competent public health authority? RQ3: What is the quality of the cooperation between practising paediatricians and the locally competent public health authority? The research revealed that, according to the practising paediatricians, the problem in poliomyelitis surveillance is refusal of the vaccination and the associated decreasing immunisation coverage of the population. The next most commonly reported problem was population migration. Furthermore, it was found that not one practising paediatrician recorded or reported cases of acute palsy in their surgery. Only one respondent encountered acute palsy 10 years ago. The answer to the last research question is also apparent from the information obtained. More than half of the respondents agreed that so far there is no cooperation on this issue. Although four respondents stated that the cooperation is at a high level and is of very good quality.
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