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The treatment of pain in patients in terminal stage on the ward of follow-up care from the nurse point of a view
KUNEŠOVÁ, Martina
This bachelor's thesis is focused on chronic pain in dying patients at the aftercare department. The theoretical part focused on chronic pain description and its division, chronic pain treatment possibilities, characterization of a terminal stage and work done by nurses at the aftercare department. This part is supposed to present the most important information concerning chronic pain in dying patients. The practical part provides results of a gualitative research. This research had four objectives. The first objective was to identify the benefits of nursing care provided to dying patients with chronic pain in palliative care. The second objective focused on the attitude of nurses towards the patients in the terminal stage. The third objective was to identify the nursing methods used during the provision of care to a patient with pain in palliative care. The fourth objective was to assess the knowledge of nurses working at the aftercare department regarding the up-to-date treatment of pain in palliative care. Four research questions were established based on these four goals: What is the benefit of nursing care in treatment of pain in palliative care? What is the attitude of nurses towards the patients in the terminal stage? Which new nursing methods possibilities can palliative care provide to patients with pain? What information on treatment of pain in palliative care do nurses have? The research was performed using an in-depth structured interview, which is a method of the gualitative research. The research samlpe consisted of eight practice nurses working at the Aftercare Department in Nemocnice České Budějovice a. s. The interview was aimed at information on benefits of nursing care, the attitude of nurses towards dying patients, nursing procedures used and also knowledge of the nurses working at the aftercare department. The interviews were recording in writing. The records were analysed and coded using an open coding method. Six categories were established as follows: Nursing care procedures in treatment of chronic pain in dying patients, Effectiveness of chronic pain treatment in dying patients, Benefits of nursing care, Attitude of nurses towards dying patients with chronic pain, Collaboration with families and Nurses' knowledge. It was found out during the research that the benefit of nursing care is enormous, the care brings satisfaction of patients, safety, communication, sufficient amount of information, ensuring of basic needs, contact, information on current changes in the state of health, offer of better care, psychological support, better collaboration between nurse and a patient and a family, and also promixity of personnel. Thereforte, I think it is possible to consider the nursing care to be very beneficial. Furthermore, the following attitudes of nurses towards the dying patients were discovered: Trust or distrust of nurses in ability to display pain, active interest by nurses, approach to patients and communication. The research also discovered the following nursing procedures used in treatment of chronic pain in dying patients: positioning, heat application, cold application, massages and refraining from needless manipulation. The knowledge of nurses regarding the current treatment of pain in palliative care contains extensive information on principles of analgesic and opiate administration, which are applied by the nurses working at the aftercare department. A practical output of this thesis is a handbook called Administration of Opiates and Usage of Intoxicants Record, which is intended for use by practice nurses.
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Use of acupuncture in rehabilitation of vertebrogenic algic syndrome
NOVÝ, Filip
The topic of my thesis is a description of the possibilities of using acupuncture in the treatment of VAS. The thesis is divided into two parts, theoretical and practical. In my work, I focus on the current state of knowledge about acupuncture: the history of acupuncture, Eastern philosophy, its principles, acupuncture meridians and points. In terms of modern rehabilitation, I focus in the theoretical section on the issue of trigger points (TrPs), which have a highly significant position in modern studies on acupuncture. The second part of the theoretical work is concentrated on the phenomenon of pain, which is an important element in understanding VAS and the operating principles of acupuncture. In the third part I attempt to describe and compare modern techniques and alternative acupunctures used in the treatment of VAS. To address the efficiency and reliability of the techniques I analyzed data from reputable international studies. The practical part begins with a list of the methods employed and a definition of research objectives and research questions. The aim of the research was to consider the possibilities of the use of acupuncture in the treatment of VAS and, by means of a questionnaire, to assess its analgesic effect.
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Centers for pain treatment and the work proportions of nurse there.
FORŠTOVÁ, Eliška
Pain is one of the first symptoms that alert you to the various diseases. It affects and reduces the quality of patient?s life and their physical, mental and emotional abilities. It depends on man how feels the pain, how succumbs to it or how much affects him. But the pain cannot be clearly quantified. The medical staffs often underestimate patient´s intensity, character and process of pain. As a result, the patients are more reserved in relation to the medical staffs. Unfortunately, there is an increase of dissatisfaction which is in conflict with the progress of their treatment. And there should be the nurses for contact with patients when they want it. Especially the nurses are the mediator between the patient and the doctor; thereby they perform the important roles in the health care centres. On the other hand, the patient care is very difficult. Therefore it was important to determine the quantity of nurse´s work in the pain management institutions, particularly the pain management clinics, an affect their psyche, an attitude to patients, their view of the pain management institutions, including information about the pain management clinics processing, the methods and the provided care. There were determined six aims: to find out the most common diagnosis and methods of pain treatment in the pain management institutions, as well as how nurses perceive the patients and care for their mental status in the pain management clinics, the daily routines which the nurses recommend to the patients and finally find out information about the pain management institutions in the Czech Republic. Based on the aims there were determined six research questions. Firstly, what is the most common diagnosis in the pain management clinic? Secondly, what are the most common methods for pain treatment? Thirdly, how are successful the methods of pain treatment by nurses? Fourth, how nurses perceive the patients of pain treatment clinics? Fifthly, how nurses care for patient´s mental status in the pain treatment clinic? Sixthly, what daily routine nurses recommend to the patients with pain treatment? The results showed that patients have often the chronic back pain in the pain management clinics in Pardubice region. In addition, there are the post-traumatic conditions, the pain associated with shingles, the post-operative pain, the joint pain and the pain associated with cancer.
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Nursing classification systems NANDA International, NIC, NOC and their use in pain management in children after orthopedic surgery
DYMÁKOVÁ, Kateřina
The aim of Graduation thesis is utilisation of classifying systems NANDA International, NIC and NOC by solving of nursing issue Acute pain at children after orthopaedical major surgeries. Part of successful and well adjusted treating of pain is its careful recording into medical documentation. For the goal of creating of the documentation there could be used international classification systems NANDA Intermational, NIC and NOC, with their aid it is possible to complete comprehensive aid, which describes each step of the treatment praxis. The first goal of the thesis was to map awareness of the nursing staff of systems mentioned. The second goal was creating of an aid using separate parts of system NANDA International, NIC and NOC aimed to diagnostics, solving and evaluation of the Problem of Acute pain at children after major surgeries. The last goal was verifying of beneficial effect of the new created documentation in praxis. The first research specimen was build by 58 nurses from four hospitals in Czech Republic working in children's departments. It was approached 8 hospitals altogether, nursing staff of four of them participated in the survey. The second research specimen was build by nurses from Children department in Hospital Pribram. The third part of research was built by 5 children admitted to hospital. The criterion for their attendance was their major surgery operation and their diagnosis Acute Pain. We used the half structured questionnaire for collecting of figures, models method and ideas of content analysis of documents and quasi experiment. Particular steps of research were realised as following: In the period of time February 2013 till March 2013, 60 questionnaires were distributed. Return was 100%. Cooperation with nurses from hospital Pribram lasted from 1. 3. 2013 until 29. 3. 2013. The medical documentation was created during this period of time, the method was tested and evaluated from nurses point of view. We found out, the nurses are familiar with system NANDA International but not aware of other two systems mentioned above. It was researched on statistical basis dependency between awareness of the specific classifications and the highest education grade and age of the nurses was considered, as well. During our stay in Hospital in Pribram, the practical aid was created aimed to evaluation and solving of the issue Acute Pain after orthopedical surgeries. This aid was tested in the same department then. A record was taken into amended forms by children after major surgeries. Concerning forms aimed for nursing praxis there were recorded not only intensity, characters and localisation of the pain, there were recorded which significant marks and connected factors from NANDA International Taxonomie II were possible to observe by particular children. There were recorder information which activities were used for children into forms containing interventions and activities drawn from from classification NIC. Last but not least, the pain was considered on the daily basis using classification NOC. As we found out from discussions with nurses cooperating during the research, more than a half of them perceive the use of the above mentioned aid very contributive. One idea appeared, the aid is needed in the Czech nursing practice. From this point of view, it would be beneficial to pay attention to this issue in the future.
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Specifics of Perioperative nursing Care of Seniors from the Point of View an Anaesthesia Nurse
VRÁNOVÁ, Magdaléna
The theoretical part of the thesis is focused on nursing care of seniors during perioperative period from the point of view of an anaesthesia nurse. It is divided into a general and a special part. The general part deals with nursing care approach to a senior, with psychosocial aspects of hospitalization, his/her needs, communication barriers and educational specifics. It also covers the issues of operation in old age, psychosomatic changes and their consequences for anaesthesia care. The theory in the specialized part is divided into preoperative, intraoperative and postoperative care in relation to anaesthesia administration.The first goal of the bachelor thesis was to examine the importance of anaesthesia department from senior?s view. The second goal was to determine the importance of anaesthesia department from the view of an anaesthesia nurse and the third goal was to map nursing care of a senior at an operation theatre in relation to anaesthesia.Qualitative research form, the questioning method was applied to information collection. Non-standardized interview with general nurses and seniors was the data collection technique. The research results show that an anaesthesia department is beneficial from seniors? view.It has also been found that nurses consider the anaesthesia department useful particularly for seniors. The benefit for the nurses themselves has still certain imperfections, particularly in sharing information on nursing care with an anaesthesia nurse. The research in nursing care at the operation theatre shows that anaesthesia nurses participate in the continuity of perioperative care of a senior just partially. They are aware the specifics of care about seniors in intraoperation period and differentiate satisfaction of the needs. The thesis might serve as educational material for nurses involved in perioperative care and nurses in specialization education. Documentation was elaborated from the conclusion of the empirical part upon the found drawbacks, particular ideas of the nurses and in compliance with the procedures recommended by the informed public. A brochure Anaesthesiology Guide was elaborated to make cooperation between a nurse and a senior easier.
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Nursing care of patient with ulcus cruris
VYHŇÁKOVÁ, Lucie
This bachelor thesis focuses in nursing care of a patient with ulcus cruris. Varicose ulcer is a chronic skin defect localized on lower limbs. Its occurrence is most often linked to a venous and arterial system disease. Number of patients with this disease has been growing in recent years. The increasing population age is probably the reason as it is known that the disease usually affects individuals over 70 years of age (Pospíšilová, 2004). This fact surely increases growing demands to nursing care, particularly the spheres typical for this diagnosis. The most frequently mentioned problems became the ground of the thesis goals. It is divided into two parts: theoretical and practical. The theoretical part explains the basic issues of the disease. With regard to the urgency of the topic the research part was focused on specific nursing care and related nursing care problems in patients with ulcus cruris. Two goals were set with regard the topic and the intended direction where the thesis might have been oriented. The first goal was to map the specifics of nursing care of patients with ulcus cruris and to find out what the most frequent problems occurring in these patients were. Three research questions were based upon the goals prepared this way. Replies to these questions were obtained upon qualitative data collection performed from February to March 2013 in the České Budějovice Hospital. The selection of respondents was intentional. The research sample consisted of 7 respondents selected from among hospitalized patients and 7 respondents selected from among nurses. Two anonymous semi-structured interviews were prepared for the research purposes, one for the selected patients being treated for this disease and the other for the selected nurses caring about patients with this disease. The first research question dealt with the nursing care specifics. The research itself has shown that the care about the defect itself, which is based on the redressing method, is the basic specific. This has to be performed under strict aseptic conditions to prevent introduction of microorganism into the wound. Removal of residues of ointments and old skin and consequent application of new healing materials are the basic point of this intervention. The research has shown that all these materials have to be applied directly to the defect itself, not to its surrounding. Non-adherence to this would cause aggravation of the wound conditions. Care about pain, which has proven to be the most frequent nursing care problem in these patients during the research, relates to the redressing. The second research question was aimed at the most frequently occurring nursing care problems. The fact that also wound secretion and odour bother the patients apart from the pain was found. These nursing care problems lead to another problem of high importance, which is social isolation. The patients cannot or do not want to socialize and shut themselves away from the world because of the disease. In some instances ties with families are reduced or even completely broken. And so individuals inflicted this way depend on the care of homecare agency nurses or practitioners and dermatologists. In the worst instances they have to rely on themselves. In such an instance the mentality gets disturbed, which is adversely reflected in somatic condition of the individual. A reply to the third research question, i.e. mapping the issues of nursing care nurses have to deal with most frequently results from the care specifics and the most frequent nursing care problems. These issues are redressing of defects, care about pain, education of patients, nourishment care and hygiene. An information brochure, which should serve particularly to the patients suffering from this disease, was prepared upon the results of the thesis.
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Dying process and needs of dying persons.
SMILKOVÁ, Božena
The thesis studies the process of dying with a special focus on the needs of dying persons, aiming to provide a complete outline of typical needs. The first section compares and contrasts the process of dying in the past and the present, identifies the stages of the dying process and addresses the psychological issues of hope and human dignity. The next section clearly outlines the needs of dying persons, in particular it discusses the issues of pain management, conversations about truth, accompanying a dying person and understanding the meaning of life and suffering. In order to see how these needs are met, the thesis looks at hospice care, in comparison to euthanasia requested by the ill person.
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Public education on the preventive options in medical rehabilitation
SEGEŠ, Patrik
This bachelor?s thesis focuses on the topic of public education concerning the possibilities of the prevention in the context of medical rehabilitation. The thesis consists of two major parts, a theoretical and a practical one. The primary focus is the prevention of vertebrogenic disorders as a large percentage of the patients visit the rehabilitation centre because of these particular syndromes. In the theoretical part I elaborate on the anatomy and kinesiology of the vertebral column, the muscle system as well as prevention in the context of medical rehabilitation, pathophysiology of formation of vertebrogenic dysfunctions, motion stereotypes and pain. The main goal of this part is to specify the meaning of the prevention in terms of physiotherapy. In the second part of my bachelor?s work I examine in depth the methods which were used for the therapy and prevention of three patients suffering vertebrogenic dysfunctions. These constituted the research sample for practical part of this thesis. The aim of the research is to suggest particular therapeutic solutions and changes in motion stereotypes of patients as well as their further education concerning the possibilities of prevention within the field of medical rehabilitation and evaluate the effects of such therapy.
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Women's pains after gynecological operations.
HUFEISLOVÁ, Jolana
The first aim of this bachelor?s thesis was to determine whether clients are informed about possibilities of painkilling after hysterectomy. The results show that clients are informed about possibilities of pharmacological, non-pharmacological and alternative treatment of post-operation pain. This bachelor?s thesis also aimed to study the level of clients? contentment with attitude of the nurses to problems with post-operation pain. The survey showed that clients are content with midwives? procedures when soothing post-operation pain. The survey part of the thesis was carried out in form of questionnaires. The collection of data was performed from January to March 2012. The author of the thesis approached clients indicated for a hysterectomy type of gynaecological operation. The clients were hospitalized at the Gynaecological post-operation ward and the Ward of conservative gynaecology at the University Hospital in Pilsen. The survey group was formed by 110 respondents. The results of the survey will be compiled into an information leaflet that will be available to clients not only at the gynaecological post-operation ward but also at the consulting rooms, so the clients are informed well ahead of the planned surgery. The results of the thesis can also be used in order to improve the quality of post-operation pain soothing process within the framework of the nursing process.
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The role of nurses to reduce patients suffering
DAŇKOVÁ, Patricie
The bachelor thesis deals with participation of a nurse in relief of patient suffering.The present state of the issues of nursing care of a suffering patient is a part of the text. The research part of the thesis was based on qualitative research, where the techniques of nonstandardized interview and observation of patients and nurses in Kutna Hora Hospital were applied. The aim of the work was to find out how a nurse participates in suffering relief in patients, to examine the techniques a nurse applies to relief of suffering, to learn how a patient perceives a nurse in relieving his/her suffering. The research has shown the spheres where patients often suffer, where and how the approach of nurses may beimproved.The thesis wanted to find the weak points in providing nursing care to the suffering, to map whether nurses are active in their work, have humane approach and provide quality care.The thesis will be made available to the Hospital management, it may be a complementary source of information for those who study these issues and the research results may serve as educational material for nurses working not only at the aftercare wards but also at acute care beds as suffering occurs in patients of all the clinical fields. Nurses may only participate in suffering relief efficiently if they know it and pay due attention to it.
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