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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 in a hygienic and epidemiological regime from the patient's perspective.
KŘEPELOVÁ, Lenka
Considering contemporary lifestyle and possibility of travelling imported infections accrued and some illnesses come back that have not occurred nearly at us more. Not only haemorrhagic fevers and other highly infectious illnesses but also hospital multiresistant bacterial strains that mean high risk for patients constitute a threat. The number of nosocomial infectious grows still. The patient is in the case of suspicion or already diagnosed infectious illness isolated and treated in the infectious department or in the tribal department in the room with increased hygienic-epidemiologic regime. The patient is saved in a single room, the possibility of visits is reduced and the staff uses personal protective equipment. The man is holistic being and it can come due to isolation to lack of satisfaction of his/her bio-psycho-social needs. The aim of this thesis is to identify unsatisfied bio-psycho-social needs of patients in increased hygienic-epidemiologic regime and to describe changes in needs of the patient depending on the time of hospitalisation. The theoretic part describes the problematics of infectious illnesses, system of the care for the patient with infectious illness and changes in human needs in the period of the illness. The empiric part of the thesis deals with unsatisfied bio-psycho-social needs of isolated individual through quantitative research. The research suite was made up of 10 patients who were hospitalised in the room with increased hygienic-epidemiologic regime. The survey was carried out in the Hospital Jihlava by semistructured interview and the results of the survey were processed by opened coding by method paper and pencil. It is emphasized that the most needs of the patient have biological, psychical, social and even spiritual aspects. The rate of satisfaction with caregiving depends on the health condition and personality of the patient. Not small influence has the length of the hospitalisation, too. It was found out during the survey that the patients have not enough information about specifics of the care in the infectious department and that is why there is often a misunderstanding of necessity of barrier measures. It is possible to avoid useless misunderstanding through timely and suitable education. It was created an educational material with the title "Guide for patients hospitalised in the infectious department of Hospital Jihlava" for this purpose. Employees of the infectious department of Hospital Jihlava were informed with results of the research during a workshop, too.
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Nutritional care of children at pediatric clinics and hospitals
METELCOVÁ, Jana
The main goal of this work called Nutritional Care in Children's Hospital and Hospital facilities is to verify whether the nutritional standards created for older child patients meet the needs and are checked and if their physiological needs are fulfilled in chosen hospitals. The next objective is to evaluate the satisfaction of the hospitalised patients with the meals given to them by hospitals. The theoretical part of this work deals with nutritional care, therapeutic care and nutritional needs of adolescents. It further deals with nutritional risks and marginally mentions technological processes regarding meal preparation. The method of qualitative research was used by using questionnaires filled in by chosen children patients who were then interviewed. Children aged 10 to 14 were supposed to be on diet number 13, half of them were boys and the other half were girls. The research was conducted in the children's ward in the hospital in Jindřichův Hradec in December 2015 and in the same type of ward in the hospital in České Budějovice in February 2016. The initial number of respondents was five patients in each ward, then using snow ball sampling method their number increased into ten in each ward. The weekly menu according to which the meals were distributed was obtained from the catering facilities of the hospitals. By using the program "Nutriservis Profi" the contents of nutrients in the meals were obtained. The results gathered from the program "Nutriservis Profi" were compared with recommended values for particular age group defined by The Czech Society for Nutrition, so meeting the physiological needs of the patients could be evaluated. From the results it was found that both hospitals have problems with supplying enough fibre content, phosphorus and calcium in meals for children's patients. There is also sodium, potassium, cholesterol and vitamin C surplus in the menus. Thanks to the internship in both hospitals in Jindřichův Hradec and České Budějovice meeting the physiological needs of the children could be evaluated. Considering the fact that the previous evaluation revealed some imperfections, therapists from both hospitals should concentrate more on checking nutritional values in meals, consequently it was recommended to focus more on the variety of the menus and their improvement. There were also inadequacies in attendance at the children's ward. There was a comparison of the results from both hospitals, based on questionnaires and interviews from the children's point of view. Based on the data, children hospitalized in Jindřichův Hradec were more satisfied with the meals. In the conclusion there is a summary of the research and suggested suitable improvements for hospitals. There is a model menu for diet number 13 in the attachment which could be used by hospitals.
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Pick´s disease and the specifics of the nursing care of a patient with this disease
KOPKAŠOVÁ, Lenka
Pick's disease is a degenerative-atrophic process that primarily affects the frontal and temporal lobes of the brain. Besides Alzheimer's disease, it is a lesser known form of dementia which affects people of younger age. Although the exact range of Pick's disease occurrence varies in the literature, the average reported age is between 50-60 years. The disease can change eating habits, cause emotional swings, inappropriate behaviour and sloppy appearance of the patients. The behaviour to others is often selfish, the patients are unable to listen to others and ignore their surroundings. Pick's disease is also characterized by inappropriate sexual behaviour. Globally, the number of dementia patients is still growing and according to expert guesses the increase will continue. Nursing care for patients with dementia is therefore becoming a very actual topic as dementia is called a quiet epidemic of our century. Nurses in their departments quite frequently encounter patients suffering from dementia of various origins at different stages of disability and the staff at healthcare facilities often regard these people as a burden. The aim of this thesis, which is called Pick's Disease and Specifics of Nursing Care for Patients with this Disease, is, based on the theoretical knowledge, to map definitions and diagnosis of Pick's disease, to define the needs of such a patient, and to list the most common problems in the nursing care. It focuses on people with dementia within medical facilities. For proper understanding of the problem, the thesis starts with the anatomy and physiology of the brain and the description of cognitive functions which are affected by the dementia syndrome and the definition of dementia. Based on the studied literature, dementia is divided according to various criteria. It has been found out that dividing dementia is not entirely uniform, but the essential facts and overall opinions of the authors do not diverge. Pick's disease belongs to a group of frontotemporal dementia and its position in this group has changed over time, as it is recorded in the literature. The thesis includes recommendations resulting from the studied literature in the approach to patients with dementia and emphasizes personal communication with the patients and empathetic and humane approach. Although medicine cannot prevent dementia, an early diagnosis of a specific type of dementia and correctly targeted treatment can increase the quality of life not only of the patients but also of their families. I have chosen this topic because I find it very current and interesting. During my nursing practice at the Surgery Department and Aftercare Department, I have met patients suffering from dementia and I did not know how to properly and efficiently communicate with them. For the theoretical part of my work, the methods of explanation, synthesis and induction on the basis of Czech and foreign information sources have been used. The most frequently quoted Czech authors in my thesis are doc. MD. Roman Jirák, PhD., the head of the center for diagnosis and therapy of Alzheimer's disease at the psychiatric clinic of the General University Hospital in Prague, the 1st Medical Faculty of Charles University. This thesis can serve as an informational and educational source both for nurses and the general public who may experience the disease within their families. It would be considered a great success if it helped nurses or family members to diagnose Pick's disease or other dementia at an early stage.
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Use of e-learning education of universal nurses in Militari university hospital - University hospital Prague
JANKŮ, Kamila
The diploma work submitted is called The Use of E-Learning Education of Nurses in the Central Military Hospital Military University Hospital Prague. The theoretical part of the diploma work deals especially with the significance of e-learning, distance learning, history of education of nurses in the Czech Republic and e-learning in health care. In addition, the work includes information of the Central Military Hospital and describes its present circumstances and use of e-learning in the working process. 5 aims and 4 hypotheses were set for the quantitative research. The first aim was to determine the time demands of the e-learning courses study. The second aim was to determine the attitude of general nurses to e-learning education. The third one focused on contribution of e-learning education for general nurses and for the hospital management. The last aim focused on satisfaction of general nurses with the form, contents and diversity of e-learning courses. The fourth aim was used to determine reasons leading for development of e-learning courses for general nurses. Four hypotheses were determined: H1: It takes less time to complete e-learning course studies than regular studies. H2: Nurses younger than 30 years of age prefer e-learning education unlike nurses older than 30. H3: The effectiveness of regular studies is better than the effectiveness of e-learning education. H4: E-learning courses are not as financially demanding as regular courses. The data collection technique consisted in our own anonymous non-standardized questionnaire containing 32 items. The research file consisted of 212 general nurses working in clinical departments of the Central Military Hospital. An additional method was based on a dialogue with the Education Team Manager of the Central Military Hospital. The research results related to the hypotheses show that completing e-learning course studies does not take less time than completing a regular course. Nurses younger than 30 years of age do prefer e-learning education contrary to nurses older than 30. The effectiveness of regular courses in contrast to e-learning education has not been confirmed as well as the fact that financial demands of an e-learning course are lower than financial demands of a regular course. Further, nurses prefer regular forms of studies, mostly with their passive participation in an educational event; however, they find completion of e-learning courses more convenient. Most respondents also expressed a positive opinion on the form, contents and diversity of e-learning courses. Courses include enough information for preparation of a final test and nurses find the number of courses necessary for periodical evaluation adequate. What they consider limiting is the impossibility to retake the final test; they mostly suggested it should be allowed to take the final test twice or three times. The research implies that a higher percentage of the respondents spend as much time as they want studying. Nurses still prefer regular forms of studies with passive participation to the e-learning form. Most nurses have a positive opinion on the current contents of courses in the form of a text format. The course topics are mostly based on suggestions by members of the Non-Medical Professions Education Team of the Central Military Hospital. The research results will be presented at the next regular meeting of members of the Non-Medical Professions Education Team of the Central Military Hospital. Procedures for improvement of the form of the current courses will be presented and proposed as well as the possibility to develop communication between the author and students, the limiting impossibility to retake final tests and the suggestions concerning the number of possibilities to retake them.
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Nové postupy biomonitoringu cizorodých látek ve vodním prostředí
ČERVENÝ, Daniel
Within the presented work, several approaches of biomonitoring were studied. A well-established method for human health risk assessment was applied to evaluate the quality of fish from open waters in the Czech Republic. As this work is targeted on sport fishermen, who frequently consume their own catches, besides the publication in scientific journal, a brochure with results of this study was distributed via the Czech Fishing Union. Health risks for consumers related to the consumption of wild fish were found strongly species and locality dependent. As there is no risks related with the consumption of carp (Cyprinus carpio) at all investigated sites, frequent consumption of predatory fish should be avoided at some fishing grounds. The use of passive samplers has become more and more attractive in the last two decades. As these devices are able to mimic the biological uptake of chemicals, their potential for replacing fish as bioindicators in routine biomonitoring programmes is evident. In our study, the comparison between analysis of fish tissues and POCIS extracts from selected sampling sites confirms this idea about interchangeability of these indicators in the case of PFASs as target pollutants. Moreover, no metabolic transformation of contaminants present in water take place in passive samplers contrary to living organisms, thus these reflect the actual contamination at the locality more precisely. The use of passive samplers completely fulfils the internationally accepted principles of Replacement, Reduction, Refinement (the three R´s). Another promising approach using YOY fish as bioindicators was evaluated within the present study. Multispecies samples of YOY fish homogenate was found as a better indicator for wide range of pollutants than muscle tissue of adult fish within one species from the same locality. As all inner organs and tissues are presented in analysed samples, more target pollutants in higher concentrations are detected compared to the muscle of adults. Besides the higher sensitivity in pollutants detection and quantification, practical and economic benefits are of concern in the case of the YOY fish approach. The YOY fish approach also particularly fulfil the three R´s strategy, as sampling of this age group of fish has a smaller impact on the environment than the sampling of adults. In case of mercury, that was found as a limiting contaminant for the consumption of fish from open waters in the Czech Republic, a nonlethal method of finclips sampling can be used for the monitoring of this compound in aquatic environments. Besides the monitoring, our optimised method for the estimation of muscle tissue concentrations could be used for human health risk assessment as well. The difference between real muscle concentrations and concentrations estimated using our method differs less than 10% in most of the investigated localities. Benthic organisms are an important part of the food web in aquatic environments, but insufficient information about its contamination is available. In another study included in this thesis, first evidence about bioaccumulation of certain pharmaceuticals in benthic organisms was described. Although, pharmaceuticals are generally considered to be not accumulative in organisms, our study proved that certain pharmaceuticals have bioaccumulation potential. From this finding, it is evident that not only the concentrations of pharmaceutical dissolved in water but also the diet represents an important exposure pathway of contamination by these compounds for organisms (fish) inhabiting aquatic environments.
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Some Robust Distances for Multivariate Data
Kalina, Jan ; Peštová, Barbora
Numerous methods of multivariate statistics and data mining suffer from the presence of outlying measurements in the data. This paper presents new distance measures suitable for continuous data. First, we consider a Mahalanobis distance suitable for high-dimensional data with the number of variables (largely) exceeding the number of observations. We propose its doubly regularized version, which combines a regularization of the covariance matrix with replacing the means of multivariate data by their regularized counterparts. We formulate explicit expressions for some versions of the regularization of the means, which can be interpreted as a denoising (i.e. robust version) of standard means. Further, we propose a robust cosine similarity measure, which is based on implicit weighting of individual observations. We derive properties of the newly proposed robust cosine similarity, which includes a proof of the high robustness in terms of the breakdown point.
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The assessment of equine housing systems in terms of welfare
Morávková, Kateřina ; Hofmanová, Barbora (advisor) ; Majzlík, Ivan (referee)
Nowadays, the conditions of animals' breeding are better than they were in the past and bigger emphasis i sput on their compliance and improvement. To secure/provide a good welfare is not an easy task for the breeders. Generally, we know how good welfare should look like, but we do not know, if the animal is satisfied. Various studies and experiments of good and bad life conditions appear. On the other hand, there still are lots of things about the welfare topics, which could be discovered and explored. Other question is, if a bad welfare has something common with animals' cruelty, or does not. One of categories, which is welfare focused on is stablig. When horse breeding and stabling, we should consider their native lifestyle and behaviour. We should do this, if we want to secure a good welfare. In many of cases there is a problem, because as it has been said, there is no strict rule, what is a good and bad welfare. Some horses can be satisfied in a box, and the other can feel bad in the box -- they can have depression and they will feel best when they are out with other horses. Every system and style of stabling has its pluses and minuses. Some of the systems seem to be less suitable for horses, but it depends on the horses' character. But horses do not chooses their kind of stabling, it is choosen by the breeder. The stabling has been solved for centuries, and it must have been solved in the past, it is in the peresent, and it will be in the future. But we still come with new and improved ways of stabling. A modern guy can not imagine, that nowadays stabling should be the same as it was in the past. Today, we do not know, if this way of stabling was found as a good type of welfare and if horses were satisfied with it. It is a question, if better welfare is a box stabling or a styling out. For working horses the best stabling is the lashing one, where horses work in a wood and they want a lot of relax -- through this kind of stabling the rest can be enabled. But according to the law foals can not be roped. To stable the horse with the rope for 22 is a breach of a welfare. So we must alway take the reasons of stabling into consideration and if an exgerrated care about stabling does not verge on a horse's satisfaction. Through the behaviour and understading the horses a guy should be able to recognize, if the horse is fully satisfied and the welfare is arranged in the best way. It should be a reward for the breeders, if the horse has the good lifestyle.
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Effect of feeding flaxseed on the quality of goat milk fat
Malá, Kateřina ; Fantová, Milena (advisor)
Type of feed, its quality, form of adjustments and feeding technique influence the composition and quality of milk. The share of milk components is highly variable, depending on nutrition and animal health. The greatest changes occurring in milk fat content. Milk fat is responsible for the natural flavor of milk. However, in terms of the modern world, human, saturated fatty acids contained in milk fat is considered negative active ingredient with the subsequent development of cardiovascular disease and the development of atherosclerosis in humans. Currently, therefore a growing demand for polyunsaturated fatty acids in milk as a healthy alternative. For this reason, an effort to influence the composition or the content of fatty acids in the milk of dairy animals. One way to significantly increase the content of desired MUFA and PUFA acids in milk fat is the use of oils and oilseeds in the ration. Very positive influence flaxseed, which among other things contains high levels of linolenic acid.
The aim of this work is to analyze and evaluate the milk fat of goats, which are fed with linseed in extruded form compared with a control group of goats without complementary food. It can assume that feeding flaxseed to increase milk fat content, including omega-3 and omega-6 fatty acids.
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The influence of time in feed enrichment with unsaturated fatty acids to selected parameters of pig carcass value with regard to the fatty acid composition of intramuscular fat
Pantoflíček, Jiří ; Čítek, Jaroslav (advisor) ; Miloslav, Miloslav (referee)
The thesis aims to evaluate the impact of aliment with higher contents of unsaturated fatty acids, consumed for a different period of time, to utilitarian attributes of pigs before a slaughter, with respect to the composition of fatty acids in the intramuscular fat of tested animals.
The factors that influence the quality of meat are interior, exterior and technological. Among the qualitative markers of quality of meat we rank the share of meat and fat, acidification rate, color, viscosity, contents of intramuscular fat (marbling), smell, taste, juiciness and delicacy. Together with hygienic and nutritive attributes, consumers and processors consider these technological and sensory aspects to be the most important.
The ultimate goal of this thesis is to compare the impact of different length of feeding soy oil on parameters of pork meat quality and growth.
However, the interference of growth attributes was inconclusive and the test result came similar in different groups of tested pigs.
What was influenced by adding the soy oil into the feed is the fatty acids profile. The contents of fatty acids remained unchanged in every test group. Over time the content of monounsaturated fatty acids decreased. The most significant change occurred in representation of polyunsaturated fatty acids, which increased in the test groups with longer period of feeding with enriched feed, mostly at the expense of monounsaturated fatty acids.
The differences between the test groups of pigs were statistically inconclusive; therefore the soy oil enrichment did not worsen the technological parameters of meat and fat quality.
The longer period of feeding the soy oil enriched feed led to significant increase in polyunsaturated fatty acids. According to the findings, adding the soy oil into the feed will have no effect at all if done short time before the slaughter.
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