|
Comparison of intercultural competences of nursing staff in the Czech Republic and German-speaking areas
TÝLEOVÁ, Tereza
The increasing migration of population in the 21 century causes development of multicultural societies. With the increasing number of foreigners in individual countries it is possible to also presume an increasing number of patients/clients from different cultures in medical facilities. These facts require modern attitude to nursing, developing of transcultural nursing, implementing multi- and transcultural education in the health care education and propagation of multicultural conception of nursing between the nursing personnel. The result of these necessary changes should be the ability to provide effective nursing care which is culturally adjusted to the patient/client that would also take their specifics, customs and traditions of their culture into account and that would saturate all their biological, psychological, social and spiritual needs according to their race, nationality or belief. This thesis deals with multicultural nursing and confronts cultural competence of the nursing staff in Czech Republic with that in German-speaking countries. This thesis aim is to state the level of multicultural competence of the nursing staff and explore conditions provided to the nursing personnel of the hospital for giving culturally adapted care to patients-foreigners. The results of the research give an overview of the state of culturally competent care in comparable medical facilities in Czech Republic, Germany, Austria and Switzerland. They will also give a feedback to the questioned hospitals. Such information may alert their management to possible lack of knowledge of their nursing personnel and help them direct its further education. The theoretical part of the theses defines the basic concepts regarding culture, ethnic groups, race or nation, formulates the difference between the terms "multicultural" and "transcultural" nursing, multicultural education and culturally competent care, compile the most common sections of specific cultural needs of the individuals. In short it also processes J. Campinha-Bacote's model of cultural competence in health care delivery, the Papadopoulos, Tilki and Taylor Model for developing cultural competence and the Purnell Model for cultural competence. It also shortly deals with nursing frameworks for acquiring cultural data, such as the Sunrise model from M. Leininger, the Giger and Davidhizar Transcultural assessment model and Bloch's ethnic/cultural assessment guide. The empirical part processes and evaluates data obtained during the quantitative research. The accumulation of the data was conducted through anonymous questionnaires that were distributed between the nursing personnel of internal and surgical wards of the hospitals in Czech Republic and in German-speaking countries. In Czech Republic these were hospitals in Prague and in Tábor, in Germany a hospital in Dortmund and one in Cottbus, in Austria the hospitals in Salzburg and in Weiz and in Switzerland a hospital in Aarau and one in St. Gallen. The collection of the data was conducted either on-line or by way of printed questionnaire forms. The acquired data were valorized and sorted into diagrams and tables for further clarity. From the respondent´s answers follows that the queried medical facilities in Czech Republic do not provide sufficient conditions for their workers to give culturally competent nursing care on such a level, as it is at the facilities questioned in the German-speaking areas. The results also show that language skills of the nursing personnel in these hospitals in Czech Republic are worse than those in the German-speaking countries. With the level of multicultural competence the situation is similar; in this field Czech nursing personnel does not match their foreign counterpart. It is necessary to remark that this research sample of two hospitals from each of the countries is insufficient for the results to be applied on the whole Czech Republic or German speaking countries.
|
|
Role of the nurse in screening for depression in the elderly.
VRZALOVÁ, Monika
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.
|
|
The role of nurses and their impact on the care of patients with total hip arthroplasty.
SLABÁKOVÁ, Květoslava
Total hip replacement is one of the most extensively and highly effective operating methods in orthopaedics. The patients are brought back the self-sufficiency, life without the pain and noticeably motion restriction. Irreplaceable function here is a role of the nurse, who helps the patient to return back to his common life...The aim of this work was to find out, how the patients feel the role of the nurse and its influence to given nursing care before and after the total hip replacement as the less fulfilled. There were following research questions set: How the patients feel the role of the nurse before and after the total hip replacement? How the patients before and after the total hip replacement feel the interpretation of the nurse roles? How the patients before and after the total hip replacement feel the role of the nurse and its influence to given nursing care. Which of the nurse roles are felt by the patient as the unsatisfactory in postoperative care? The patients before and after the total hip replacement feel through the everyday nurse activities the nurse in her role of the caregiver and education giving person, following the nurse vindicator and the nurse bearer of changes. The patients feel the care thanks these roles as a quality, holistic and continual. Nevertheless was the role of the education giving named as the least fulfilled. In connection with these research results was created a manual, a Guide book for the patients before and after the total hip replacement. This Guide book was given to testing purposes. This Guide book was appreciated by the patients very positive despite a large amount of information, which were surprising for many of them. We gained some data, which gave the impulse to complete the information in the Guide.The created Guide book can´t replace the effective communication of the patient with the medical staff, which could be always the most suitable "source" of information.
|
|
Palliative care is provided by patient's family at home
KUČEROVÁ, Tereza
The thesis, titled Palliative Care Provided by Patient's Family in Home Environment, discusses the specific care needs of a terminally ill patient in his/her own home. Caring for an ill person in a home environment is beginning to be a growing trend in home care, but also it is an increasingly common wish of the patients themselves. The family is therefore required to have enough theory and practical knowledge in order to deliver a highly demanding personal care for their close family members. The aim of the thesis is to summarize the current situation of delivering palliative care in home environment in Czech Republic whilst concentrating on the specific needs of the patient and the needs of their family. The objectives of the research were to determine whether family members were introduces to the specifics of palliative care of terminally ill patients; to map their skills in delivering palliative care in home environment and to reveal the most common issues that family members come across in that home environment. The final objective was to map out services in regions of Central Bohemia and Liberec that are accessible to family members whilst caring for a terminally ill patient. The research part of the thesis was completed employing a method of qualitative investigation using semi-structured interviews with patient's family members and nurses providing hospice care in home environment. It emerged from the analytical interviews that the family's knowledge level regarding support for palliative care in home environment is very limited and in hospitals families are only given minimal or no support or information. As a final document for the thesis an informative educational brochure was created based on the results of aforementioned research, primarily targeting patient's family; its core objective is to improve information and collate the specifics of care that would allow the patient a dignified end to their life.
|
|
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.
|
|
Lifestyle of patients with peripheral arterial disease before and after surgery
REZKOVÁ, Helena
Theoretical background: Peripheral arterial disease is a serious disease of Loir limb arteries which originates from atherosclerosis. The theoretical part deals with the lifestyle. There are mentioned basic risk factors of chronic forms. Further described are the pathophysiology changes generated on the basis of atherosclerosis and related causes for the origin of the disease. Subsequently there are explained methods of classification, developed clinical symptoms, diagnosis and therapy. This section also looks at the role of a nurse in the care of patients with peripheral arterial disease. Objectives: The aim of this work was to evaluate how patients with peripheral arterial disease changed their lifestyle after invasive vascular surgery. There were provided the following research questions: How do patients with peripheral arterial disease approach to the prevention of risk factors? What is in patients with peripheral arterial disease the main impuls for the possible change of their lifestyle? What influences surgery patient's attitude to risk factors for peripheral arterial disease? How crucial is a lifestyle change in patients after surgery for peripheral arterial disease? Methods: The theoretical part is processed using expert sources. The empirical part of the theses was processed using qualitative research. The chosen technique for data collection was semi-structured interviews with patients, with prepared open questions. The research was done in several phases - the first interview was conducted at the patient admission department (before surgery), followed by the next phase after three months, and 6 months after surgery. The interviews were recorded on a prepared form, then transcribed into electronic form and analyzed by open coding method. Results: The research showed that surgery can sometimes be triggered by changes in the patient's lifestyle. The first interviews in the preoperative period focused on how respondents felt, what was their lifestyle before surgery for atherosclerotic changes of the lower extremities. One of the questions was focused on patient knowledge about risk factors for the development of PAD and possible prevention. The second phase of interviews took place 3 months after the surgery. It dealt with the question about the respndents´ lifestyle, the respondents in the postoperative period, whether there were any changes. Some positive changes occurred in eating and there were some changes in doing physical activity. The third stage was carried out six months after surgery, again in order to detect changes in lifestyle. Minor changes came in smoking habits, the issue of diet and physical aktivity. Questions were also focused on the psychological level. We found out who helped patients and what was most motivating in implementing changes. In the conclusion/summing up question the patients marked themselves ow they managed to make a change. Conclusion: The number of patients with peripheral arterial disease and other cardiovascular diseases is increasing. The basis is the start to modify risk factors, namely tobacco use,dietary habits, physical activity. The medical staff members participate on changes in patients´ lifestyle by appropriate education. The problem occurs when the patient despite the support of close people can not cope to carry a twist in their life. There should a medical staff member offer a professional help to deal with this important step. Practical use: The aim is to draw attention to the expansion of education about lifestyle changes for patients diagnosed with PAD also in the postoperative period. Patients who are released to home care should receive enough information that would convince them to change their attitude towards their health, and that surgery is only one of the ways to prevent further attacks and complications. Results can improve communication with patients and focus on increasing their awareness and possibly offer assistance.
|
|
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.
|
|
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.
|
|
The need for security and safety in connection with a planned surgery with the patient's perspective and nurses
BOHDALOVÁ, Jaroslava
A planned operation performance always affects patient´s needs for assurance and safety. It is important to provide necessary information connected with the planned operation performance itself so that the patient can feel assure and safe. The key role for the patient and her/his needs for assurance and safety is in general nurse´s hands because she is the closest person to the patient and can help to inspire her/his needs for assurance and safety with konfidence best through the aid of her knowledge and skills that she should have as well as through the aid of her attitudes. The target of the thesis was to find out how a planned operation performance affects patient´s needs for assurance and safety and how a general nurse inspires patient´s needs for assurance and safety connected with a planned operation performance with confidence. The following research questions were stated: How does a planned operation performance affect patient´s needs for assurance and safety? How does a general nurse affect patient´s needs for assurance and safety connected with a planned operation performance to inspire her/him with confidence? What is insufficient in filling patient´s needs for assurance and safety before a planned operation performance? How can a general nurse help a patient control her/his fear and state of anxiety related to a planned operation performance? The method qualitative research with the use of depth interview was used to figure out the investigation. The respondents were willing to record the interview which were verbally rewritten and then subjected to the contents analysis by the method paper and pencil. From the research it is clear that a planned operation performance affects patient´s needs for assurance and safety in a negative way disregarding to her/his previous experience. Patient´s worries and negative feelings can be eliminated by a general nurse who treats her/him as equal, taking up an individual approach, informing her/him about all performances and proceedings, having a calming and welcoming way of communication, using empathy and listening as well as trying to meet patient´s wishes according to her possibilities. The research reveals the advantage of patients´ readiness for planned operation performances. Patients can learn it in the framework of educational proceeding in the out-patients´ department at the same time when they learn that they are going to be operated. The research also shows that general nurses do not have enough knowledge in the sphere of therapeutical communication. The results indicate that it would be suitable to start educating patients as soon as it is known how their disease will be solved and treated in order to reduce the negative impact of surgical treatment to patients´ needs for assurance and safety. General nurses should complete their knowledge and skills to be able to help patients to cope with their difficult life-situation. On the basis of the research investigation and after the consultation with the senior nursing officer, the training course will be organized. The topic of the training course will concentrate on communication with patients before planned operation performances with a view to therapeutical communications and therapeutical interviews. Other discovered facts, for example, the lack of information provided to patients and possibilities regarding better patients´ readiness for planned operation performances will surely be solved by the hospital management.
|
|
Patients satisfaction with the provided services. An important indicator of the quality of health care facilities.
MALANÍKOVÁ, Jana
My master's thesis which topic is "Satisfaction of patients with the services provided. An important indicator of quality of medical equipment " is mainly focused on satisfaction of patients with the services provided in the Hospital České Budějovice, a.s. Furthermore, the mapping focused on overall satisfaction with care in the already mentioned Hospital České Budějovice and on exploring whether patients evaluate the quality of information provided by a medical doctor in this hospital affirmatively and whether they are satisfied with care of local nurses. The satisfaction of patients is an important indicator of the quality of care provided, which has an impact on their status of basic human needs. One main purpose was determined: Monitoring the satisfaction of patients with the services provided in the Hospital České Budějovice, a.s. and this purpose was fulfilled. Quantitative research was executed, to its realization the interview method was used. By means of the technique of standardized anonymous questionnaires on the basis of the above-mentioned purpose,the 3 following hypothesis were verified: 1) Patients are satisfied with the overall care in the Hospital České Budějovice, a.s. 2) Interviewed patients evaluate the quality of information provided by a medical doctor in the Hospital České Budějovice, a.s. affirmatively 3) Interviewed patients are satisfied with the care of nurses in the Hospital České Budějovice, a.s. I processed the data to confirm or refute the pre-established hypotheses. The evaluation of the data was carried out using statistical nonparametric methods, Chi-square test and the chosen level of significance of p=0.05. The results of the research have been clearly processed into the tables and graphs. The program Microsoft Office Excel 2010 was used to process the results.
|
guest ::
