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Historical development of nephrology nursing practice and the need of standards in this field
KESZIOVÁ, Andrea
Nursing care in nephrology brings certain specifics both for the patient and for the nursing staff concerned. For each member of a nephrology multidisciplinary team that participates in identification and meeting bio-psycho-social and spiritual needs of dialysed patients, the quality nursing care provision and the patients´ safety assuring should be the rule. To assure quality care provision in a health care facility, it is necessary to define the professional level of quality, i.e. to introduce processual nursing standards at the national level for all dialysis centers. The objective of this thesis was to make a survey of historical milestones in the development of nephrology nursing in the Czech Republic (in the former Czechoslovakia), from its beginning to present days. In individual parts of the theoretical section various contexts of nursing issues (historical, legal, social, relational, educational) and their interaction are described. The thesis also is focused on detection the importance of aspects influencing the quality of provided nursing care in nephrology and realization of analysis the use and compliance with the existing local nursing standards in individual dialysis centers in the Czech Republic. Another objectives of this thesis were detection of satisfaction rate with existing national standards for nephrology nursing care and to make up a proposal of a national processual standard of nursing care provided to adult dialysed patients. To obtain data the mixed methods research was used. The practical part offers, through conclusions of the quantitative research, explanations of many facts by confirmation or refutation of hypotheses arisen from the qualitative research. The nursing research was conducted through a questionnaire survey in dialysis centers in the Czech Republic. The respondents were head nurses - nursing care managers working in these units. Interviews with representatives of the biggest professional organization of nurses {--} the Czech Nurses Association were also carried out as another research procedure. The survey outcomes have clearly demonstrated the need to introduce national processual standards of nursing care in nephrology practice. Description of the present state is the first step for its improvement. The way out from the current situation is the development of general national processual standards for individual areas of care for nephrology patients and subsequent introduction of them into clinical practice in all dialysis centers in the Czech Republic. One of the components of the thesis is a proposal of the national processual standard of nursing care for a dialysed patient with acute or permanent central venous catheter (CVC). This standard could serve as a model for the development of other national standards of nursing care in nephrology.
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The issue of providing nursing care to patients in a net bed
PRCHALOVÁ, Jitka
While providing nursing care, in exceptional cases it is necessary to use restrictive measures to calm down a patient by applying physical restraints. However, since these are methods that seriously interfere with the patient´s personal liberty, it is necessary to observe certain principles in such a way that the methods minimize the risk of various complications, which may be both mental and physical, but also legal. Therefore, the indication for the use of these measures is especially the patient´s behavior that involves significant imminent danger or harm to the patient and others. The aim of our study was to determine what is the most frequent indication for putting the patient to a net bed enclosure in traumatological and psychiatric wards, to find out whether nurses have at their disposal the standards developed in relation to restraints, to find out what nurses regard as advantages and disadvantages in placing patients into net bed enclosures, to identify how nurses see the public´s attitude to the issue of the use of bed net enclosures and to determine the public opinion on the use of net bed enclosures. It can be seen from the results that over several years the approach to this issue of both the public and the medical management has changed and there is a readiness to use physical restraints or net bed enclosures properly and in accordance with human rights and human dignity. This thesis may be used as a theoretical basis for training students of non-medical disciplines or in training nurses on the issue related to the restraints. Furthermore, it could be used as a guide for the public to get the notion how the restraints and net bed enclosures are being used, how much attention is being paid to human dignity and personal liberty. This thesis also provides an overview of how the issue has evolved over time and what level it has reached at present. The issue of net bed enclosures and restraints in general is very "sensitive". Over the past ten years this issue has undergone many changes, has aroused indignation, but also understanding. Forms of restraints will certainly be the subject of a lot of negative or positive discussions in the future. It is important that nurses consider the patients, in which restraints have been applied, as their partners, that they meet all their needs and do their best to provide comfort taking into consideration their individualities.
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Cardiac Surgical Patient in the RES Room and the Approach of a Nurse to Nursing Care
KAFKOVÁ, Zuzana
In the past years, the cardiac surgery performance was very demanding. The limited range of medical performances, imperfect procedures and techniques resulted in frequent postoperative complications and high postoperative mortality. Over time, surgical techniques, heart replacements, extracorporeal circulation and postoperative care have improved. This makes it possible today to operate on much older patients, where surgeries previously were nor feasible. The diploma thesis on the topic Cardiac surgical patient in the RES room and the approach of a nurse to nursing care is dedicated to the patient after heart surgery. It deals with meeting the patient's needs in the RES room and what the patient perceives while staying in the resuscitation unit and what he /she needs from a nurse. In the empirical part of this thesis two objectives were stated. To determine what a cardiac surgical patient perceives and what he /she needs in the RES room, and to find out whether it is possible to improve the quality of patient-oriented care. Based on these objectives, hypotheses and research questions were established. The objectives were successfully achieved, the hypothesis was confirmed and the questions answered. The research was conducted using qualitative quantitative research methods in the RES units of the cardiac surgery department, where the patients with heart disease are operated on. For the quantitative research the questionnaire interview method was selected. The qualitative research method was used to carry out semi-conducted interviews with the patients.
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The Specifics of Nursing Care of Anaemic Clients
ROKŮSKOVÁ, Pavla
The topic of this bachelor thesis is ``The Specifics of Nursing Care of Anaemic Clients{\crq}q. Anaemia is one of the most common diseases associated with haemopoiesis. It is mostly revealed as a secondary finding accompanying other diseases. Since the occurrence of this disease is rather common, the probability of providing care to an anaemic patient is large. The research part of this bachelor thesis is processed by means of qualitative research methods. The objective of the thesis was to ascertain the specifics of nursing care of anaemic patients and their unsatisfied needs as identified by them. The data were collected by means of semi-structured interviews. The interviewed persons were the nurses working in the hematologic outpatient ward and the internal ward and the anaemic clients attending the hematologic outpatient ward. The questions asked in the semi-structured interviews are based in particular on technical literature and on the conceptual nursing model of M. Gordon. The research results are processed in case reports, categorization tables and basic charts. The categorization tables contain the most interesting data obtained from the conducted interviews. The main results of the research include the ascertained specifics of nursing care in the area of blood taking, changes in the food composition and the movement regime, and application of transfusions and medication. The other results of the research include ascertainment of unsatisfied needs of anaemic clients. The unsatisfied needs of the clients are reported in particular in the area of physiological needs where the greatest troubles are caused by prevalent tiredness accompanying this disease. On the basis of the research results a hypothesis for further research has been proposed. This thesis is intended especially for the professional nursing community. The results of the research draw attention to the needs felt by the clients and to the specifics of nursing care provided to these clients. The benefit of the thesis consists in the opportunity to utilize the obtained findings for study purposes and in provision of nursing care to anaemic clients.
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Client{\crq}s motivation {--} a part of everyday nursing activities
KREJČOVÁ, Martina
If clients are to be motivated, they have to be made desirous of achieving an objective, confident of their abilities, and capable of imagining the possibilities opened up to them after the objective is accomplished. This Bachelor paper aims to find out how the clients of senior-citizen facilities are motivated for self-care. Degenerative changes encountered in seniors often deteriorate their self-care performance. The older the people get, the more difficult it seems for them to find reasons why they should keep themselves active. A nurse, therefore, has to encourage in them the proper attitude through which the seniors will be able to maintain or even improve their level of self-reliance. This paper is to map the motivation mechanisms at work in the clients of senior-citizen facilities operating in the Region of South Bohemia and to examine the way in which the nurses motivate the clients for self-care and self-reliance. The data were generated through a qualitative survey of two different non-standardized types of interviews. The first type of interview was carried out with nurses working at the nursing homes at Kaplice, Máj and a senior-citizen facility of the Staroměstská Center of Social Services. The second type of interview was conducted with randomly selected clients of the facilities. The survey revealed the way in which the nurses motivated the clients for self-care, as well as the motives, both personal and factual, behind such efforts encountered in the clients. Moreover, the nurses` attitudes were investigated about how the nursing process could be used to motivate the clients for self-care, and the clients` needs were examined as they related to the self-care motivation induced by the nursing process. Conclusions of the paper can provide a source of information for both managers of the facilities and the nurses delivering the care. Future investigation should seek a method in which the nursing process can better motivate the clients for self-care, and possibly it should focus on the nursing documentation. Nurses providing care at the senior-citizen facilities strive to motivate the clients to resume their self-assistance capabilities and keep the capabilities workable. The clients appreciate their efforts.
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Eventualities of Implementation of Canistherapy into the Social Services System
BURSOVÁ, Zuzana
The long-awaited Welfare Services Act came in force in 2007. The act is the first act which is based on a free choice of help, a free choice of a type of service and primarily, it stems from a person{\crq}s individuality and their needs. The act defines basic kinds and forms of welfare services and it redounds to the creation of needed room for services transformation focused on their own development. Canistherapy is a kind of zootherapy which can support an individual{\crq}s health and it is based on a mutual interaction between a person and a dog. It makes use of a globally standardized client relations method, it stems from a person{\crq}s individual needs and it can be applied to a wide variety of targeted groups of clients.
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Problematics of nursing care about women with extrauterine pregnancy
ŽÁKOVÁ, Markéta
Problematics of nursing care about women with extrauterine pregnancy This work is concerned with the problems of nursing care for women with extrauterine (ectopic) pregnancy. The section on theory provides a brief summary of female sex organ anatomy and physiology, ectopic pregnancies, their types, symptoms, diagnostics, and therapy. The subsequent section deals with the psychology of women. The following chapter deals with patient needs, and communication, while the last section is about the process of providing nursing care to women with ectopic pregnancy. The objective of this contribution was to define the priorities in biopsychosocial needs of women with ectopic pregnancy. Four research questions have been specified. These research questions were used to find the priorities of women who experienced ectopic pregnancy in terms of their biopsychosocial needs, and how these needs were met as part of the nursing care provided to them. An answer was also sought to the question whether the nursing care plan answers the priorities in biopsychosocial needs of the clients and what nursing problem (a nursing diagnosis) is most common in these women. The work employed quality research, in the form of non-standardized interviews with the patients. An analysis of the written documents was then carried out. These documents included both medical and nursing documentation. The information collected in the interviews and analysis of written documents was subsequently analysed in the form of case histories. An analysis of nursing documentation was carried out, and its results were compared with the priorities in the biopsychosocial needs of the clients. The research sample consisted of five women in reproductive age admitted to the Department of Gynaecology and Obstetric with the diagnosis of ectopic pregnancy. All interviews with the patients were held before their discharge to home care. It was found that patients with ectopic pregnancy regard the satisfaction of their needs in the area of psychology as their priority. Another finding was that these needs were satisfied only marginally and insufficiently as part of the nursing care. The nursing care plan does not correspond to the priorities in biopsychosocial needs of the clients and the most common nursing diagnosis that should be made is anticipator grieving. The present work may serve as a guide for midwifes whom it should enable to provide nursing care that results in full satisfaction of the needs regarded by women with ectopic pregnancy as their priority.
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Respect for the wishes of the patient's pre-out - the ethical context
PLVANOVÁ, Veronika
This diploma paper ``Respecting Patient{\crq}s Needs Expressed in Advance{\crqq} is divided into a part containing theoretical ground and a practical part. The theoretical part outlines the basic principles of ethics and then moves towards patients{\crq} needs and wishes, their rights, and the issue of wishes expressed in advance. The domain of wishes expressed in advance is based on the principle of patient{\crq}s autonomy and it is laid down in the Convention on Human Rights and in biomedicine. The situation in the Czech Republic is made difficult by the fact that this domain has not been governed by laws and it does not have any tradition in the Czech environment. The practical part utilizes the method of qualitative research {--} a semi-controlled interview. First, I created short casuistries for selected patients and, afterwards, I spoke to them about individual topics. I had selected 11 questions that guided the interviews. My group of respondents consisted of patients hospitalized at oncology departments or leaving for outpatient chemotherapy in Nemocnice Jihlava (a hospital in Jihlava). I interviewed ten patients. The objective was to find out about the patients{\crq} informedness about their rights and about their options of expressing wishes during hospitalization. It was also intended to learn about the things the patients would like to decide upon and whom they would like to authorize to make decisions on their behalf should they become unable to express their wishes themselves. The research questions and the division of the general questions into three areas helped to the reach individual objectives. The first area comprised patients{\crq} rights most of the respondents were aware of. The most important ones included: telling the truth about their disease and treatment, the option to select and terminate their treatment, familiarity with medical staff. Another section dealt with wishes. Most of the patients hoped that a right approach of medical staff will reveal the patients{\crq} wishes without the necessity of expressing them. None of the selected respondents has ever thought about the issue of wishes expressed in advance. The final block contained questions dealing with the options of choosing a person representing patients in decision making. The patients frequently chose their family members (partners, children). In practice, the knowledge obtained through the research could be used for publication in specialized literature and to prepare instructional materials for patients as well as medical staff.
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Old Age as a Phenomenon of Disadvantaged and Suppression of Human Rights and Needs of Women
HOLÁ, Michaela
The method of secondary analysis of data was used in the theoretical part of my diploma thesis. I analysed literary and electronic sources in the way that the result represents the completed view on the old age with its many haracteristic changes, and the view on the life of seniors in their background (in family or an istitution). Consequently, I focused on human rights and needs and their possible suppression in senior population. The main theme of this thesis represents the maltreatment of seniors and ageisms. The practical part is focused on information and their obtaining with the help of a qualitative method. I used the method of interviewing, the technique of half-directed conversation. These were provided by the women at the age of 70-80. The women left the Hospital of České Budějovice maximally 10 days before the interview. The questions looked like the interview with instruction. Five more conrete hypothesis were cretated as a result of the analysis of gained data.
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