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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.
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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.
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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.
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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.
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Is it possible in clinical practice to perform selection of unrelated donors based on KIR genotypes for AML patients?
FRYČOVÁ, Michaela
Acute myeloid leukemia (AML) is an aggressive malignant disease, during which is for most of the patients only possible treatment the curative allogeneic stem cell transplantation. Besides reaction of the graft against the host is a fundamental limiting factor of the successful transplantation the relapse of the disease. According to several recent published studies, the results of transplantation in patients with AML may be influenced except the HLA genes by others so-called non - HLA genes. Especially there is mounting evidence influence of the donors KIR genes (Killer -cell Immunoglobulin - like receptors) in protection against the relapse after transplantation. HLA and KIR genes are coded on different chromosomes (HLA- sixth chromosome and KIR chromosome 19), therefore are segregated independently and HLA identical donors with recipients usually have different compositions of the KIR genes. Cooley et al. (2010) demonstrated that the specific motifs composition of centromeric and telomeric B haplotypes of KIR genes helps to protect against relapse and increases the chances of complete cure AML. In cases where there are multiple HLA identical unrelated donors (UD) then logically the composition KIR genes by the individual donor could be a criterion in selecting the most appropriate donor, therefore, the one with the greatest potential to protect over the relapse . Based on this study and other data the genetic screening of KIR was started with potential donors, if it was possible to choose from several 10/10 or 10/09 HLA identical UD for the patient. Genotyping was performed by PCR-SSP methodology using commercially available kits. It was performed gene classification 160 preferably identical HLA donors for 55 selected patients with AML. The presence of KIR haplotypes A and B as well as their combinations was determined from the type and number of the KIR genes. All genotypes were entered into the calculator, which allows you to enter up to five potential donors and obtain their assigned into one of three categories according to content KIR B. Groups , "neutral" , "better" , "best" , refer to the appropriate protection against relapse. KIR gene classification in the search for donors revealed 43 donors with AA haplotypes, 90 donors with AB haplotypes and 27 donors with BB haplotypes . After assigning state of the presence KIR B was discovered 107 " neutral " donors , 35 "better " donors and the 18 "best " donors . At 40 (~ 73 %) patients were available donors with the different states of the presence of KIR B. These patients represent a group of patients where the selection criterion of the presence B KIR gene at the donor could be used. We confirmed that the additional selection of HLA-matched unrelated donor on the basis of the content B of KIR genes is feasible. Selection such donor for transplantation may improve the outcome of patients with AML.
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Charity Projects of Organizations Providing Care for Children with Disabilities in South Bohemia
LANDOVÁ, Lenka
The bachelor thesis "Charity Projects of Organisations Providing Care for Children with Health Disability in the Region of South Bohemia" deals with those projects that were founded by non-profit organisations and that provide care for children with health disability in the Region of South Bohemia. The aim of this thesis is to chart the charity projects of above mentioned organisations and to find out what is a proper and effective way to create them and what methods and procedures are used by non-state, non-profit organisations. The first research inquiry refers to a successful implementation of these projects. The result will be not only a realisation what kind of projetcs were created by the above mentioned organisations but also what is important for an organisation itself. Within the bounds of the second research inquiry I find out wheather there is an optimal procedure for the implementation of the charity projects of non-state, non-profit organisations. A qualitative method was used for a research part of this thesis. I used a method of a half-structured interview, a technique of a personal interview. A research group was selected for bringing the research into practice, which includes nine organisations seleceted from non-state, non-profit organisations providing a care for health disabled children in the Region of South Bohemia. It is more difficult for non-state, non-profit organisations it this field to obtain enough finances for providing services and for obtaining necessary aids than for state non-profit organisations because of different ways of fundraising . A non-state, non-profit organisation has several possibilities how to obtain necessary material and non-material sources. There are charity projects that offer means of selfless help; provided they are successful, they help the organisation to obtain necessary sources. It emerged from the research that it was very important for non-state, non-profit organisations to get a multi-source fundraising and supporters of their projects, mainly donors and sponsors, to obtain available care for children with heath disability. On the basis of the research, it is possible to state that non-state, non-profit organisations providing care for children with health disability, implemented many successful projects. The results of this thesis can be used in the way of an informative material for setting a complete view of a solution of the problems of the above mentioned organisations projects.
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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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Management styles and their relation to the satisfaction of employees
GRAMANOVÁ, Kamila
Abstract - Leader empowering behaviours and their relation with worker's satisfaction Current state: Nurse's work is physically and mentally demanding. Adequate knowledge and skills are also needed. Nurse managers whose leader empowering behaviours administer to good functioning of medical institutions have therefore a crucial role. In these days a monitoring of job satisfaction is an upcoming matter. According to that we can look for drawbacks and problems and take corrective actions. There is a 9th year of the nationwide research of safety and satisfaction of employees of Czech hospitals. Aim: The first aim of the research was to find out what leader empowering behaviours are used the most by nurse managers. The second aim was to find out how leader empowering behaviours influence satisfaction with work conditions of nurses. Two hypotheses were given. The first hypothesis postulated that nurse managers use democratic empowering behaviours the most. The second hypothesis postulated that satisfaction with work conditions of nurses is changeable, depending on leader empowering behaviours. Methodology: A quantitative method of data capture was chosen. Non-standardised questionaires with 30 closed questions were given out. There were four questions at the beginning to identify respondents. Other set of 15 questions was focused on recognition of leader empowering behaviours. Satisfaction with work conditions was monitored in the last set of questions. Results of the research were processed into graphs and tables. Research set: The research set included nurses working under nurse managers in inpatient wards in České Budějovice a.s. hospital. The questionaire was appropriately filled in by 112 nurses, corresponding 74,7% recoverability. This was used to complete the aim of this thesis. Results: Results of the thesis were divided into two sets. The first set of questions aimed on leader empowering behaviours of managers under whom the questioned nurses of particular departments work. Democratic empowering behaviours were evaluated the most used, according to the first hypothesis. The second set of questions aimed on satisfaction with work conditions. The highest job satisfaction was reached with democratic empowering behaviours. Autocratic, liberal and nonspecific empowering behaviours were used in minimal degree and nurses reported lower job satisfaction among these behaviours. Therefore the second hypothesis was also confirmed. Conclusion: The research pointed out that leader empowering behaviours are one of the factors that influence job satisfaction. It is positive thing that an interest and research in this area increased in the last decade. Periodic evaluation of job satisfaction enables monitoring the direction of its values. According to the survey, a newsletter with recommendations for nurse managers was formed. This newsletter pointed out pros and cons of leader empowering behaviours.
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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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The use of (nano)oxides for metal and metalloid stabilization in contaminated soils
Michálková, Zuzana ; Komárek, Michael (advisor) ; Luke, Luke (referee)
The main objective of the thesis was to evaluate the potential of selected Mn and Fe (nano)oxides for the stabilization of metals and metalloids in contaminated soils. The research was focused basically on three materials - commercial nanomaghemite (Fe III), nanomagnetite (Fe II,III) and a synthetic amorphous Mn oxide (AMO). The main aim of the work was to provide a complex view on the chosen stabilizing amendments regarding not just their direct influence on contaminants mobility and stabilization mechanisms, but also their stability and alterations in soil conditions together with influence on soil microorganisms and higher plants. Firstly, adsorption properties of the tested materials towards Cd, Cu, Pb and As were investigated. In this context, the most effective material showed to be the AMO reaching one to two orders of magnitude higher adsorption capacities than Fe III and Fe II,III under given experimental conditions. Interestingly, the rate of As(V) adsorption onto AMO was increasing with increasing pH as a result of high pHzpc of the AMO (8.1) and significant dissolution of this phase at lower pH values. As a next step, the influence of (nano)oxides on metal(loid)s mobility and other physico-chemical soil characteristics after application to contaminated soil was examined. Again, the AMO proved to be the most efficient in reducing mobile pools of Cd, Cu, Pb, Zn and As. On the other hand, Fe III and Fe II,III addition had generally less significant effects on contaminants mobility. AMO application further resulted in an increase of soil pH connected with AMO dissolution and unwanted decomposition of soil organic matter. When (nano)oxides alterations in soil conditions were observed, MnCO3 coatings were identified on AMO surface while no significant changes were recorded for Fe III and Fe II,III. As the MnCO3 formation was connected with increased AMO stability, AMO particles synthetically covered with MnCO3 coating (denoted as SM AMO) were prepared. Although the SM-AMO had a lower mass loss in soil than pure AMO, the stabilizing efficiency was almost the same for both materials. The differences in surface composition of both materials were decreasing with time as MnCO3 naturally precipitated on the AMO surface in soils while the SM AMO coating was gradually dissolving. When investigating the effect on soil microbiota, AMO efficiently promoted soil microbial activity while no significant changes were observed in the case of Fe III and Fe II,III. The AMO was also able to reduce the uptake of Cd, Pb and Zn by sunflower (Helianthus annuus L.), eliminate Zn phytotoxicity symptoms and increase biomass yield. On the other hand, toxic levels of Mn released from the AMO in an acidic soil were found in sunflower tissues. AMO application is thus recommended for contaminated neutral or slightly alkaline pH with a higher cation exchange capacity in order to avoid unwanted release of Mn. Finally, various types of AMO-biochar composite sorbents were recently prepared and field experiment focused on stabilization of Cd, Pb, Zn and As using studied materials is currently under preparation. The combined results from the thesis highlight the importance of a complex experimental approach dealing with all parts of the contaminated soil environment in order to obtain complete information about the efficiency and usefulness of any newly developed stabilizing amendment.
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