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PHYSIOTHERAPY OF PREGNANCY AND PUERPERIUM
PITNEROVÁ, Alžběta
The bachelor thesis is focused on physiotherapy during the time of pregnancy and puerperium. Both pregnancy and birth have a significant influence on the expectant mother. During the nine months, woman undergoes a great amount of changes both from the physical and the mental side. This bachelor thesis deals foremost with changes that affect the physical side of the expectant mother. They include changes on genital organs, on cardiovascular, blood and respiratory system, gastrointestinal tract, skin and last but not least on the locomotory system. With exercise in gravidity, we try to influence these changes and, therefore, avoid any occurrence of eventual difficulties. Exercising during gravidity has not only a great importance to prevention but also to the preparation of an expectant mother to the delivery and for acceleration of return of the mother into the shape before conception. The expectant mother should be careful when choosing a suitable sport and she should always consult her attending gynaecologist. Recommended sports and methodologies include gravid yoga, pilates, belly dance, Moses method, exercise on a big ball, Alexander's technique, hydrokinesiotherapy and gynaecological gymnastics. The theoretical part includes a description of anatomy of genital organs and pelvis, creation of an individual, description of physical changes during pregnancy and puerperium and also characteristics and selection of individual suitable sport activities and methodologies. The goal of this bachelor thesis was to find such suitable physiotherapeutic procedures and methods, apply them to particular expectant mothers and verify their effects. For the practical part of research, the method of qualitative research and personal cases studies were used. Three pregnant women participated in the research. Therapy took place once per week for the period of several months. While having free conversation with the clients during the said period, I obtained the information I have incorporated into the individual casuistries. The therapy was completed by the final examination, which proved a positive effect of the exercise not only on the health conditions of expectant mothers, but also on their mental well-being, which was especially important for mothers.
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Physioterapeutic impact on apparatus of movement during pregnancy and preparation to the labour
KOTRŠALOVÁ, Jana
This bachelor work was aimed at the effect of individual physiotherapy on apparatus of movement during pregnancy and preparation to the labour. The first objective of my research was to find out whether the women who underwent individual physiotherapy in their pregnancy, in addition to the above stated courses, suffered minor problems connected with the locomotive apparatus before and during the parturition than the women who did not undergo individual therapy. I also addressed parturition, particularly duration of the first delivery period and pains during the delivery. Both objectives of my research have been attained. The anamneses of the women were obtained, kinesiological analyses were made and for one of the women a short-term plan was elaborated according to which the therapy was undertaken; subsequently the final analysis of the obtained results was performed. Two hypotheses have followed from my research. According to my first hypothesis, individually controlled physiotherapy undertaken during pregnancy can positively influence the locomotive apparatus of every pregnant woman. The second hypothesis claims that individual physiotherapeutic care has no significant effect on the course of the parturition.
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Epidural anesthesia during labour nowadays
LAŠTOVKOVÁ, Aneta
Current Obstetric Epidural Analgesia Labour pain belongs to every physiological childbirth. Enormous pain, however, was proved to affect a woman in labour and a child negatively so satisfactory pain relief should be provided. Current obstetric analgesia aims at/seeks for/strives after observing a physiological childbirth process. Epidural analgesia is the safest and most effective method of labour pain relief available today. Epidural analgesia is used in case of pain in labour and delivery, on request of the woman in labour and in prolonged delivery. Epidural analgesia could be also provided in preeclampsy, breech delivery, multiple pregnancy, premature delivery and cardiotocographic abnormalities. Although epidural analgesia is very popular and safe, no complication should be omitted. Good hospital care provided by obstetricians, anesthesiologists and nurse midwives could prevent most complications. Obviously, professional care in labour with epidural analgesia can only be provided by well-educated and experienced obstetric staff. The theoretical part of the thesis deals with information concerning delivery pain and pain relief methods. Together with epidural method, its indication, contraindication and complications, also spinal anatomy is mentioned in this part. All professional and communicative steps of midwife care about the woman in labour with epidural analgesia are described here. To fulfil the aim of the thesis, qualitative and quantitative research strategies were used. The women in labour with and without epidural analgesia were observed for collecting data in qualitative method. The same clients were consequently asked about their information and attitudes to epidural analgesia. Altogether eight casualties were formed. To collect data for quantitative method, the questionnaire of thirteen questions was prepared and send out to maternity hospitals. Eighty-six questionnaires were sent out and twenty- eight (25, 7 %) were sent back. The main aim of the thesis was to find out how available the epidural analgesia in labour is in our maternity hospitals. The next aim was to monitor the women in labour with and without epidural analgesia. The aims were accomplished through the research questions: How available is epidural analgesia used in labour in Czech maternity hospitals? What diffferences are there in labour with and without epidural analgesia? This work can be applied as a source of information for midwife students and nurses.
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Childbirth formerly and today
SVOBODOVÁ, Kateřina
This bachelor paper deals with the development of obstetrics since the very beginnings when all connected with birthgiving was tinged with something ``mysterious, empirical{\crqq} up to the present day when obstetrics is grounded on many facts. The care for the birthgiving woman is continuously innovated. First, the birthgiving woman was taken care of by older women of her family who had already given birth to their children and had therefore experience they could pass further. Nowadays it is the midwives who take care of the woman during her delivery. As well as in the past women close to the birthgiving woman the midwives are with the woman and they try to make the delivery easier for her. The development is still progressing but there is still the fact that a delivery is a situation when health is at stake, for both the newborn and the woman. The survey aimed at drawing an outline of the development of the care provided to the birthgiving woman. The methodology of the paper is a semi conducted interview. The first variant of the interview was prepared for woman who gave birth 50 years ago, 20-25 years ago and for woman who gave birth 7 years ago. The second variant was prepared for midwives without the difference of age. When interviewing women having given birth 20-25 years ago I was very surprised by their unified opinion. They agreed on the fact that the care for them and the attitude of the medical personal was inadequate to them. They were very malcontent. Mostly they complain about the first stage, when they had to lie on the bed, mostly with a drip-feeding. On the other hand women having given birth 50 years ago were satisfied with the care they had during their delivery. The greatest satisfaction is however declared by women who gave birth 7 years ago, who consider the medical personnel obliging and regardful. Especially they speak about the possibility of movement which was not allowed to women 20 years ago. The interviews with midwifes confirm that the development in obstetrics is progressing. Midwives who entered their employment after 1990 claim that competencies are increasing while older midwives claim the contrary, they say that at the beginning of their carreer their competences were greater than they are today. However all midwives agree that women nowadays are more informed on delivery than they used to be. Unfortunately, they are sometimes overinformed so that they do not know what to choose. Therefore the midwives recommend prenatal courses organised by the materninty clinic where it is the midwife of the particular clinic who informs women on possibilities and procedures which are recommended and carried out at the clinic. The survey has therefore shown, that the care for birthgiving woman is improving. And women are very satisfied at present.
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Prevention of Precipitous Labour and Possibilities of Its Encompassment before Hospital Care
SÁKOVÁ, Erika
This thesis is aimed at mapping the possibilities of precipitate birth prevention outside medical institutions and the possibilities of its managing by ambulance service members. The term prevention covers a set of theoretical, organizational knowledge and practical skills in pre {--} hospital deliveries. The results of this thesis points out that the secondary health {--} care staff is theoretically prepared to assist at birth, but in practice they are not so sure. It is thinkink as subject matter for their dispersion They are able to attend the newborn after birth.
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Low informatik about the process of child bearing
PISCHEKOVÁ, Markéta
The bachelor thesis describes current problematics of information provided to the first-time-paras on the childbirth course. The birth today is an issue very much promoted in the media, being particularly interesting for the pregnant women as well as for the whole society. Paras can find the new findings in magazines concentrating on this topic, in books designed directly for the pregnant women or, for example, in the antenatal courses lead by midwives. The most accessible source of information of today is Internet, where the expectant mothers can find all knowledge, starting with theoretical one and ending up with consultations of experts or chat with other paras. Thanks to the high level of general public awareness on the childbirth course, alternative ways of childbirth become more common. From the analysis of data it ensued that state of first-time-paras{\crq} awareness and their interest to get new information grows up disregarding the fact, if they are before or after the childbirth. It is the training institutions for medical staff in gynaecology and midwifery that has the significant influence on this result. The knowledge got here can be used in the areas of gynaecology and midwifery, either in primary care of obstetricians, or in midwifery institutions, as well as during training of students
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Course of antepartum preparation
KASTENMAJEROVÁ, Lucie
This bachelor{\crq}s work is divided into practical and theoretical section. The theoretical part describes history of antenatal preparation and its current conception. Next it deals with courses of antenatal preparation, mission of midwife in their leading and with preparation of persons who accompany the mother to the childbirth. The objectives was managed to fulfill. First hypothesis - pregnant women don{\crq}t have enough information about antenatal preparation courses - wasn{\crq}t confirmed. Second hypothesis {--} courses of antenatal preparation are financially accessible for pregnant women {--} was confirmed. Third hypothesis {--} courses of antenatal preparation are accessible for the women in their area of living {--} was confirmed.
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Knowledgeableness of patients before and after an operation of the intervention
PRSKAVCOVÁ, Hana
Based on the information within the Bachelor{\crq}s thesis titled {\clqq}Knowledgeableness of patients before and after an operation of the intervention``, which was aimed at the knowledge women have about pre-operative care before planned and acute caesarean section and about post-operative care, hypothesis 1. Women consider themselves to be well informed before the planned caesarean section. According to my research, this hypothesis was confirmed. Hypothesis 2. Before the caesarean section, women do not feel to be properly informed about the surgery. However, research did not confirm this second hypothesis. Hypothesis 3. Women that underwent the caesarean section are comfortable with the way they have been informed about the operation. The quantitative research method through questionnaires was used for data collection. The questionnaire contained 24 queries and was anonymous. The questionnaires were determined for women after the caesarean section and were issued at the Puerperium ward of the general hospital in České Budějovice. A total of 114 questionnaires were handed out and 111 of them were returned filled out, from which 103 of these were used within the final processing procedure. The results clearly show that women consider themselves as sufficiently informed before planned as well as acute caesarean section and consider themselves sufficiently informed of post-operative care.
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Satisfaction of women in childbed with nursing care on obstetric auditorium
MAŠKOVÁ, Jitka
The nursing care has in the care for health unreplaceable position. The attribute of the present nursing are individualized care and an independent working of the obstetricians centred on the prevention and on the support of the patients health. The satisfying and the dissatisfying of the patients needs reverberates in their consciousness as subjectively felt content or discontent with the care. The effort of the obstetricians has been the focus on the client. The new philosophy of the health services is to meet patients wishes and achieve therethrough their contentment. The patient{\crq}s satisfaction with the nursing care is an important information which predicate about the functioning of the individual departments in the health care institutions. {\clqq} The patient{\crq}s notifications is an valuable advice as well as an important motivating step to the improvement of the care quality.{\crqq} The nursing sees the patient with all the negative as well the positive sides and therethrough the patient{\crq}s contentment is understood as the priority objective wich cannot be marginalized. The satisfied patients have more confidence in the physicians in the nurses. They also much better cooperate during the labour. The objective of this thesis has been to state if the patients are satisfied with the nursing care on the labour ward. The supposal saying that ``The patients are satisfied with the nursing care on the labour{\crqq} ward has been stated. The supposal should be confirmed or disproved on the basis of the executed research. Hereat has been chosen the quantitative research in the questionnaire form. The question forms have been given to the mothers after the physiological labour on the confinement department in the hospital in České Budějovice, Tábor and Jindřichův Hradec. For research it has been used the set of 145 properly filed questionnaire forms. The research has proved that from the total number of questioned mothers 145 (100 %) the number of 142 mothers (97,9 %) were satisfied ewith the nursing care on the labour ward. The supposal has been confirmed by the research, the patients are satisfied with nursing care on the labour ward. The thesis shall be used within the tuition in the University of South Bohemia, published in the specialized publications and on the internet. An absolute majority of the patients has been satisfied with the nursing care on the labour ward. It is very pleasant conclusion of this thesis. In formed times to the patient has been often dictated what should or should not be done and therethrough the possible effect on the labour has been limited. Present is many respects different. It is more disposed for the changes in the nursing and puglic health in general. There is bigger space for the cooperation between the obstretricians group and the patient. It creates the safe enviroment in which both the patients and the nursing taff feel considerably better.
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Both parents´ retrospective view of a labour in the presence of fathers
MATYÁŠOVÁ, Monika
Assistance in childbirth differed in various cultural communities and historical periods. However, childbirth was always a family matter in which father participated either directly or indirectly. The last ten years revealed that the role of a man was absolutely irreplaceable in the relationship between mother, a new-born child and father, and that the role reflected itself in the relationship not only with mother {--} the mate but also with the child. The objective of the bachelor thesis was to ascertain to what extent the father's attendance to the childbirth was a spontaneous wish of both the parents, and to what extent it was rather a wish of the woman in childbed. On the basis of my own experience, the following hypothesis was determined: ``Father{\crq}s attendance to the childbirth is predominantly a spontaneous wish of both the parents.{\crqq} In order to verify the hypothesis, I used the form of a quantitative research. The data were collected using the questionnaire containing 16 questions for mothers and 16 questions for fathers. The questions for both the groups of informants were identical. The questionnaire was anonymous. The research group consisted of the mothers giving birth to their child in the hospital in České Budějovice (a joint stock company) and their mates attending to the childbirth. The research group comprised 56 pairs of informants. The results of the thesis reveal that the mate{\crq}s attendance to the childbirth is largely a spontaneous wish of the parents-to-be. It is obvious that as early as during the pregnancy the fathers-to-be search for the information on gravidity and childbirth. They enjoy the pregnancy together with their mates and do not assume an uninterested attitude to the gravidity of their mates. Active preparation of the pairs for the childbirth is also apparent. Assessment of negatives and positives of father{\crq}s attendance to the childbirth is subjective and very individual. If the mate{\crq}s attendance to the childbirth is a common wish of both the parents-to-be, the delivery of their child is an invaluable experience in their life.
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