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The attitude of nursing branch students at South Bohemia University - Health Care and Social Studies Faculty to paliative care.
MAŠKOVÁ, Vlasta
Thesis title: Approach to palliative care among nursing care students of the Faculty of Health and Social Studies of the South Bohemian University. This bachelor thesis is dedicated to students undergoing their practical training in St. Jan Nepomuk Neumann Hospice in Prachatice. I decided to choose this topic for several reasons. Hospices are often discussed nowadays, they are massively publicized and numerous charity events are held for hospices. Nevertheless people do not have confidence in hospices, they are afraid of them. This might be the first reason. The other one is my own experience with students coming to the hospice for their practical training. I work in the hospice as a ward sister and am in everyday contact with the students. Unfortunately most of the students are persuaded at the beginning of their training that death comes every day to this ?house?. They have fear and cannot imagine how to cope with this situation during a fortnight stay?! The aim of our research was to find out whether the present studies influence the attitudes to the incurably ill among the students. Whether their attitudes change after the theoretical and practical training. We set two basic questions to reach the goal. 1: How does theoretical schooling of palliative care influence the attitudes of students to the care for the incurably ill in the hospice? 2: How does practical training of palliative care influence the attitudes of students to the care for the incurably ill in the hospice? The research was implemented in two phases: before the start of theoretical schooling of palliative care and after the practical training in the hospice. We used the experiment method; a deep interview with student was the questioning technique. The research sample consisted of 5 full-time students of the Faculty of Health and Social Studies of the South Bohemian University, specialization of general nurse. After processing the responses we found out that the attitude to the care for the dying had not changed a lot after theoretical schooling. The students feel lack of theoretical information that would help them eliminate the fear of unknown situation, fear of pain, fear of everyday confrontation with death and dying people. They also do not feel prepared for communication with the close relatives of the dying people. They are convinced that there is not enough time for such a complicated topic like care for incurably ill people in the schooling. Practical training in the hospice changes the attitudes of the students to the incurably ill. They were provided more information on the palliative-hospice care. They assess their own attitudes to the care of the terminally ill more positively and they no longer talk about fear and uncertainty. They would like to have more personal experience with communication with the patients and their families. The goal of the research was met. The present studies do influence students? attitudes to palliative care of the incurably ill in a hospice. However the fear of this not really new field still prevails. Changes only occur after practical training. The research results may be used for grasping the students? feelings, for possible modification of the didactics and methodology of theoretical and practical training in palliative care. The elaborated informational brochure might also help students choose practical placement and make the start of the practical training in an inpatient hospice easier.
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Care for the terminally ill people in a home environment
VACHOVÁ, Marie
Bachelors work is conceived in a theoretical and practical scope. Theoretical part of my bachelors work is partially dedicated to utilization of hospice and palliative care, and care for the terminally ill in a home environment. Part of my work is committed to the role of social worker, and his/her support for home care providers. The research part is based on interviews with relatives, who provided hospice care at home. Interviews with them are used to analyze motivation for such decisions. In this part are also included the results evaluation, discussion and conclusion. Bachelors work is supplemented by attachments.
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Dying and Death as Regarded by the Social Welfare Institutions Workers.
RUDOLFOVÁ, Martina
The theses deal with the last period of the person´s life and the possibilities of the care focused on the spiritual, psychic, physical and social aspect of the issue. It offers possibilities of ethical way how to cope with this life´s stage having the help of social workers, family and also the dying person. The practical part compares opinions of the hospice workers with the views of the workers from old people´s homes with respect to this issue. It also points at the demnad of the work and some of its difficulties.
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Support for Nurses in Death Cases at Resuscitation Units and Intensive Care Units
LAYEROVÁ, Helena
At Resuscitation Units and Intensive Care Units nurses face the issue of dying and death every day. Very often they are in contact with the dying and their immediate family and they are expected to have professional approach and provide comprehensive care. Stress that the nurses experience in these situations results into mental, emotional and physical exhaustion, and can be manifested by psychosomatic problems. Preparation of nurses to these situations and support of their management is therefore a key factor for the management of this demanding profession. The theoretical part of the thesis contains a description of the current state of the issue, characterizes resuscitation and intensive care, and deals with the issue of death and dying in Resuscitation Units nad Intensive Care Units, managing situations associated with death and the support of nurses in these situations. The work has four goals. The first objective is to determine what method of preparation of nurses is in practice ensured in Resuscitation Units and Intensive Care Units for the performance of high-quality nursing care for dying patients. Another objective is to determine whether and how the nurses are prepared and trained in the field of management of situations connected with the death of a patient in Resuscitation Units and Intensive Care Units. The third objective is, whether there is and what is the form of assistance to nurses in RU and ICU provided by the team and the management of the Department in case of deaths of patients, and the fourth objective is to determine what form and manner of support nurses expect and require. Research part of the thesis was carried out by quantitative investigation using an anonymous questionnaire. Respondents were answering 38 questions, 13 questions were closed, 21 half open and 4 were open. The support is most frequently understood as a psychological support, good teamwork, communication, supervision and representation where necessary. Management is expected primarily to provide support through education, ensuring supervision, corresponding financial support and professional psychological assistance where necessary. On the basis of this work?s results a proposal for the course for paramedical professions working in RS and ICU called ?Course of the Strategy of Difficult Situations Management in the Care for the Dying and Their Close Family in Intensive and Urgent Care?, was made.
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Palliative Care Confronted with Euthanasia and Consequent Meaning of Social Work
PROTIVÍNSKÁ, Lucie
The study deals with fundamental issue of palliative care which is defined as active and complete care of the patient with sickness unresponsive to curative care, it shows the possibilities of palliative care and its ways to achieve the most possible quality of patient´s and his family´s life. The ideal is to relieve symptoms such as physical pain, psychical, social and the spiritual one also. The study focuses mainly on the mission and the tasks of medical profession as well as on the social work during the care of uncurable patient and of his family. There are some reflexions about dying and death in the first chapter, and in that context it´s not possible to avoid the problematic of euthanasia which has as many fervent proponents as opponents. The fourth chapter deals with this ethic dilemma. The meaning of social work in palliative care emerged from the confrontation of the euthanasia with the palliative care is treated in the fifth chapter.
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Hospice care in aware laic society on Prachatice
TALAFOUSOVÁ, Marcela
The bachelor work deals with issue of Hospice care and accompanying of dying. The work is divided into two parts. Theoretical part is written on the base of science literature and contains 4 chapters. The first chapter deals with all phenomenons related with death. It describes each stage of the process of dying and closer to the position of today´s society to death. The second and the vastes chapter considers Hospice care, its history, forms and funding. It is also focused on importance of volunteers, social workers and pastoral assistants as multidisciplinary team in Hospic. The third chapter represents palliative care, which is the main pillar of Hospice care. The forth chapter is focused on accompanying, communication and care of soul of dying and his family. The second pratical part comes from the theory and is based on research. There are determined two goals of the social research (if the laic society from Prachatice and near surrounding is aware of hospice care and if the businessman are willing help to Hosic of sv. Jan N. Neumann in Prachatice.). There are defined two hypotesis. In research were used questionnaires for two groups of respondents, for laic public and for businessmen. The total number of respondents was 145.
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The problems of the introduction of euthanasia in the Czech republic
KOHOUTOVÁ, Kristýna
This bachelor thesis deals with the problem of the introduction of euthanasia in the Czech Republic. The theoretical part is divided into five chapters. Characterizes the concept of euthanasia, its forms, as well as palliative care and the basic arguments of advocates and opponents of euthanasia. It deals with the practice of euthanasia in the Netherlands and the situation in the Czech Republic. The practical part contains an analysis and comparison of views and attitudes on the problems of euthanasia between medical staff working at the LDN České Budějovice and hospice staff working in Hospic sv. Jana N. Neumanna in Prachatice.
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Fear of Death, its Interdisciplinary Characteristic and Dialog Research Method
MUSILOVÁ, Magdalena
Fear of death is related to the way we live, affects individuals and affects the attitude of a whole society. The thesis is divided into theoretical and practical parts. In the theoretical part, a definition of concept of ethics and bioethics can be found as well as a discussion of the differing perceptions of the value of human life, basic information about euthanasia and the possibilities for palliative and hospice care. Furthermore, different views on the fear of death are noted as are presented by representatives of several areas - anthropologists, psychologists, theologians and sociologists. In the next part an interdisciplinary overview of the fear of death is compiled, which forms the theoretical basis for the practical part of the work. In this part a qualitative research was carried out through half structured interviews on fear of death. Comparing the results with outcomes from the theoretical part, it was found that death is a taboo topic in a society and that the fear of death is natural. In line with the used literature, most respondents have a great fear of the process of dying itself than of the death itself. From this point of view it was uncovered, that there is a relatively low awareness of the possibilities of palliative care between respondents.
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Needs of dying people in Štrasburk Hospice
MIKŠOVÁ, Libuše
The title of the bachalor{\crq}s thesis is: The needs of dying people in Štrasburk Hospice. It deals with the issue of how to accommodate needs of dying people. A dying human being has needs of various kinds: biological, psychological, social and spiritual. Palliative care in hospices is characterised by the fact it provides the client, i.e. the dying man/woman, with complex treatment which is focused on satisfying all of the said needs. The goal of such care is to accomplish the best possible quality of life in clients and their families. The theoretical part dwells on palliative care and palliative medicine, history of hospices, the status quo in palliative care in hospices around the Czech Republic, and particular details of the care provided in hospices. Later, it explains in detail the terms of suffering, pain, dying, and death. It takes a perspective of human needs and subsequently the needs of dying man, it includes a detailed summary of individual needs. Futher on, it discusses the issues of tellin people the truth, how tu attend the dying people, and pastoral care/counselling. The research part of the thesis is based on the qualitative survey using the methods of questioning and technique of non-standardized, semi-controlled interview. Another additional method introduced in the research was involved observation. The research group contained 9 clients of the Štrasburk Hospice. The objective was to monitor the fulfilment of a holistic approach to hospice clients and to find out which of their needs are saturated only thanks to hospice care and, while dying, which needs are considered most important by the clients. The outcome of the survey showed that the hospice provides a complex care which includes meeting the biological, psychological, social, and spiritual needs of the clients. Fulfilment of the spiritual needs could be improved in some aspects. It was also concluded that among the needs saturated only thanks to the hospice care, sufficient privacy ended first as the most valued service provided, staff attitude was the second most valued quality, and better surroundings ended third. The most essential needs from clients` perspective are: not to be left alone, stay close to their families and friends, not to suffer from pain.
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Influence of Basal Stimulation on a Possibility of Transition to the Reconciliation Phase according to Elisabeth Kübler Ross
HLAVÁČKOVÁ, Kateřina
While the numbers of incurable patients continues to rise, it follows that the nursing care of incurable and dying people is getting more important. Naturally the dying patient is the most exacting patient of all from the nurses point of view, and needs individual care and empathy. This work of mine is called {\clqq}Influence of Basal Stimulation on a Possibility of Transition to the Reconciliation Phase according to Elisabeth Kübler Ross``. It has been divided into two parts, theoretical and practical. The theoretical part consists of five chapters: The Basal Stimulation which is the art of being in contact with the patient, The Terminal Stage, The Needs of the Dying Person, The Palliative Care, and finally The Usage of Basal Stimulation as part of the Palliative Care. The second practical part consists of qualitative research, which has two goals. The first goal was to assure whether utilisation of the concept of Basal Stimulation influences the adaptation and life of the terminally ill patient in order to focus upon the transition from depression phase to the phase of acceptance. The second goal was to ensure that the influence of Basal Stimulation manifests itself upon the patient in the expression of discomfort in comparison to the effect prescribed medication and common nursing care administered in the hospice. Fundamental research was established upon the following basic questions: 1. Should the application of the basal Stimulation concept influence the transition to the acceptance phase according to Elizabeth Kübler Ross? 2. Should the use of the basal stimulation generally increase the overall comfort ot the terminally ill patient? 3. Whether the concept of basal stimulation assists to deepen the interaction between the patient and his/her nearest next of kin? I chose eight patients whose behaviour and reactions I closely observed. Half of them were cared for utilising the concept of basal stimulation at Jan Nepomuk Neumann Hospice in Prachatice. The second half were cared for in Štrasburk Hospice in Prague using the common nursing practices of that hospice. The observation was carried out with the cooperation of nurses working in both hospices. The results which were obtained were noted for all eight case reports. The case studies compare against the following research the phases of depression to acceptance. For a more complex perception of the observed clients each case study is completed by medical and nursing diagnosis. The results of the entire research lead us to following hypothesis: The presence of the next of kin and their participation in the care of the ill are conducive to holistic care for the dying person just like it is to every human being. I suggest that these results which the research has given should be used in medical schools, in the departments of palliative care for the advancement in the education of health workers who care for dying patients. I also recomend that the basal stimulation concept be applied to the standards of nursing care in the department of palliative care.
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