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Comprehensive system of rehabilitation in younger individuals after stroke
BEČVÁŘOVÁ, Lucie
Title of the bachelor thesis is Comprehensive rehabilitation in younger individuals after stroke. The aim of this thesis was to determine the subjective perception of individuals´ needs after stroke. The theoretic part is divided into two main chapters. The first one contains brief information about the disease, its types, anatomy and physiology background and symptoms. The second chapter deals with the issue of comprehensive rehabilitation and its parts. Particular approaches are defined and described in detail, health professionals working in this area are also mentioned here. The research part was processed by a method of qualitative research strategy. Semi-structured interview technique and observation were used. The research set included 5 respondents - four men and one woman. Past history of stroke and age of individuals between 45 and 55 years were the inclusion criteria for this research. Interview was held according to scenario questions, where I focused on two areas. First section included information about the respondent, his disease and treatment in the way of comprehensive rehabilitation. In the second part, respondents were asked how their life had changed after the experience of stroke. The interview was audio-recorded and then verbatim transcribed. One of the respondents did not wish to be audio-recorded, thus written notes were taken during the interview. Interviewing results are presented in a narrative format. By conducting this research I tried to answer the following question: What are the needs of individuals at various stages of stroke recovery? Need of self-sufficiency was mentioned by all respondents. In early stage, it was mainly coping with basic activities such as food intake, control of excretion, verbal expression and movement. In the later phase of treatment, there are increasing demands on self-care, understanding ability, memory and social interaction. Individuals often went through an intensive therapy. After returning back to their home environment, the need of self-realization, activation and meaningful ways to spend a free time are the most significant issues. This work should provide more information on the given topic.
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Identifikace a kvalifikovaný odhad nákladů na léčbu cévní mozkové příhody v ČR na základě farmakoekonomické analýzy a návrh alternativního řešení
Pokorná, Hana
Background: Stroke is the second most frequent cause of death in developed countries and the most frequent cause of permanent disability. This way this illness creates high costs for society which should be minimized as much as possible. One of the possibilities is to administer cost-saving drugs which are at the same time from the medical point of view of the top quality and their economic effectiveness can be identified by means of pharmacoeconomic analysis. Objective: The objective of the work is to identify and carry out a quantified estimate of costs connected with the stroke treatment in the Czech Republic. Next is the necessary to confront the results with the alternative solution to the treatment (taking drug Xarelto instead of Warfarin) and to carry out comparison of the both the possibilities from the quantitative point of view. Methods: Costs of stroke treatment are evaluated from the social point of view. From their determination COI method with type of bottom-up approach has been picked out which includes all-life cost-of-illness. For comparison of costs both the treatment vari-ants the Cost-Minimization Analysis (CMA) has been chosen, the results of which shows net cost savings. Data are taken from non-public data of the provider (St. Anne 's Uni-versity Hospital Brno), Institute of Health Information and Statistics of the Czech Republic, Czech Statistical Office, foreign studies and consultations with neurologists as well. Results: Total social costs of treatment of stroke were 12 991 273 843,65 CZK. COI method was used to calculate average costs for one patient with Warfarin in the amount of 1 203 423,68 CZK, in case of alternative treatment with Xarelto in the amount of 1 465 963,32 CZK. Relaps creates the biggest item of the costs. CMA method was used to identify savings when Warfarin is administered in the average amount of 262 539,64 CZK per patient. The hypothesis that Xarelto is more effective from the economic point of view has not been confirmed. Conclusion: Because of high cost of Xarelto, this drug has not beaten the economic effectiveness of Warfarin with lower quality. It is possible to search for savings in other items of identified costs as well.
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Activity of the radiographer at the emergency department.
PIŠTĚKOVÁ, Martina
A patient with urgent condition which threatens his life or health requires special approach of a radiology assistant to executed diagnostic performances. In this bachelor thesis, I describe procedures in case of these conditions. Because the given topic is quite extensive, I preferred a detailed description of the most serious conditions. I chose the topic because of its timeliness. The number of patients with urgent condition has an upward character for sure because of accelerated life pace and related traumas as well as diseases of civilization. My work describes three researches. The first one finds out the share of different investigations in the radiodiagnostic department as regards patients with urgent condition per one year in one hospital. The second one is related to the refresher courses of radiology assistants in relation to patients with urgent condition. The third one investigates algorithms of investigations in the radiodiagnostic department in different medical facilities. The bachelor thesis is divided into a theoretical and practical part. The theoretical part explains the term "urgent condition" and basic description of the approach to a patient in the given situation. I mention brief principles of cardiopulmonary resuscitation. I analyse individual modalities used in the radiodiagnostic department. Other subchapters are focused on the description of concrete conditions and sequence of investigations. The practical part begins with the chapter called "Targets, Hypothesis". It is concentrated on the description of the main role of my work which is discovery of radiology assistants´ approach to patients with urgent condition and the situation in education of radiology assistants in the Czech Republic. Some parts compare the condition with the situation in other countries of the European Union. The chapter called "Discussion" is devoted to the general evaluation of researches. It mentions also the important role of radiology assistants when treating patients with urgent condition. The "Conclusion" evaluates meeting of targets of this thesis and outlines possible solutions.
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Physiotherapy for Stroke Patients in Chronic Stage Using the Methods of the Neurophysiological Basis
HANZALOVÁ, Jitka
The topic of the thesis is the physiotherapy based on neurophysiological methods for chronical stage stroke patients. The stroke is a lesion of a part of the brain tissue which develops suddenly from lack of blood perfusion in the area. The clinical manifestation of stroke can differ widely depending mainly on localization, extent, graveness and duration of the reduced blood perfusion or encephalorragia. This results in need of special rehabilitation programme made for each patient individually. The main principle of physiotherapy based on neurophysiological methods is prospering from plasticity of the neural tissue which is preserved in spite of severe injury of the brain. These methods influence control mechanisms in central nervous system by activation of various neural receptors. This therapy affects the patient complexly, it is not aimed at analytic muscle training. The purpose of this thesis was to prove and to evaluate the significance of the neurophysiological methods based physiotherapy for chronical stage stroke patients. The thesis consists of theoretical part and practical part. The theoretical part resumes information on the stroke, its risk factors, complications, consequences etc. The next part briefly describes some of the neurophysiological methods which can be used for the stroke rehabilitation. These particular methods were then utilized in the practical part during physiotherapy sessions with concrete patients. The theoretical part also informs about other means of complex rehabilitation which can be used for treating chronical stage stroke patients. The practical part records physiotherapeutical treatment with the patients. In the practical part of the thesis qualitative research method was used and following methodics: anamnesis, entering examination, special examination by Chedoke for hemiplegia scoring, the records of each therapy session and evaluating the effect of the therapy, which show that physiotherapy for stroke patients is meaningful in chronical stage as well and that the methods and concepts used are suitable. The thesis may serve as a source of information for healthcare professionals and other people taking part in care of the chronic stage stroke patient.
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Comprehensive Nursing Care for Clients after Cerebrovascular Accidents
KOVAŘÍKOVÁ, Jaroslava
Cerebrovascular accidents (CVA, a stroke) mean a major burden for both the patient and his family and caregivers. It is necessary to focus intensively on the care for patients already diagnosed with a stroke. Provision of quality nursing care of patients increases patients´ chance of their recovery and return to the normal life. Based on these facts, the bachelor thesis "Comprehensive nursing care for clients after a stroke" was prepared and presented. The objective was to find out what theoretical knowledge and practical skills are required from nurses who look after the clients after CVA. The theoretical part of the thesis is focused on the description of CVA and the issue of the nursing care. The research part is based on the quantitative data collection. The research methods applied were: a semi-structured interview, an involved observation and a survey. The research sample consisted of ten clients after CVA who had been hospitalized in Hospital for follow-up care in the town of Humpolec and ten nurses who looked after these clients. Based on the information obtained from the interviews with clients, case studies were compiled, which revealed specifics of nursing care and these were formulated into individual nursing problems. Clients after CVA mostly need help with mobility, food and drink intake, at discharge, hygiene and tidying up. The attention to the issue of speech therapy should be paid. The involved observation and the survey revealed theoretical knowledge and practical skills, which nurses looking after the CVA clients should have. As to the question whether the nursing staff has enough knowledge and skills to provide quality nursing care for clients after CVA, it was found out, that there are some gaps both in theoretical knowledge of CVA and in practical skills of provided nursing care for these clients. As for the theoretical knowledge, the gaps were found out in the approach to clients after CVA and in describing the principles of communication in clients with aphasia. As for the practical skills, gaps in speech therapy were revealed. Gaps were also revealed in the support of the self-sufficiency of the clients. Self- sufficiency is not supported in the maximum possible extent. The results of this work can contribute to improvement of nursing care for clients after CVA. The output of this bachelor thesis is a nursing care plan with emphasis on the most frequent nursing diagnosis.
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The role of the nurse in the prevention of immobilization syndrome after stroke at the department of neurology.
HOLUBCOVÁ, Eliška
Bachelor?s thesis The Role of a nurse in prevention of immobilization syndrom after stroke at the Deprartment of Neurology dwells on the problem of nursing care and prevention of immobilization syndrom of the patients after stroke. The theoretical part of the thesis is aimed at prevention, treatment and examination, which the patient has to go through after stroke and the role of the nurse during these performances. The immobilization syndrom is also described in detail at the thesis. At the conclusion of the theoretical part the author concentrates on the treatment which ought to be performed as a prevention of the immobilization syndrom of the patient after stroke. One of the chapters deals with health care, nutrition, defecation, skin care, mental state and communication with the patient after stroke. The practical part of the bachelor?s thesis focuses especially on qualitative research performed just at the Department of Neurology. The aim of the above mentioned research was to evaluate the role of the nurse in the care of the patient after stroke at the Department of Neurology. In the research the author stated the following question: What is the role of the nurse in the prevention of immobilization syndrom of the patient after stroke? This part also includes interviews with nurses conducted just at the Department of Neurology and the same nurses were also observed during nursing care. The results of the research show that the nurse plays crucial role in the care of the patient after stroke, either as a provider of nursing care or as a communicator, and to a smaller extent as an educator. The thesis also contains a map of nursing care, which describes the correct process during the care of cavity. The nurse can influence the course of disease by correctly performed nursing performances, such as dehydration, malnutrition and dekubital ulcer.
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Rehabilitation Treatment of Patient with Stroke
BŘEZOVSKÁ, Lucie
This bachelor thesis is on the topic of rehabilitative nursing of stroke patients. It is analysing how the issue is dealt with in the rehabilitation department and Department of Neurology. The bachelor thesis is divided into two separate chapters, theoretical and practical. The theoretical part focuses on the causes, symptoms, diagnosis and Treatment of patients after a stroke and the current state of rehabilitative care. One of the parts of rehabilitative care is the collaboration of the nurse and the multidisciplinary team. Furthermore, the thesis describes the possible complications that may occur from the stroke. These complications include mainly pressure sores and immobilization syndrome. Rehabilitative treatment of patients with strokes include positioning, communication, passive movements, active movements, verticalization, breathing exercises. Other methods used in rehabilition nursing, application of heat and cold and basal stimulation. The thesis also includes chapters dealing with nursing management, medical documentation and evaluating the scale of a patient after a stroke. For the practical part there was a set goal, determine the working conditions for nurses who provide the patients rehabilitative treatment after a stroke. There were four main hypotheses defined, which were the subject of an anonymus questionnaire: Hypothesis - H1: There are only positioning aids available for nurses to provide rehabilitative treatment. Hypothesis - H2: Nurses are documenting the rehabilitative treatment regularly used in the nursing process. Hypothesis - H3: Nurses state that the problem of providing rehabilitative care is the lack of time. Hypothesis-H4: Results of rehabilitative nursing care are monitored by the nursing management. As additional research investigation case reports have been formulated with the Barthel index in four patients. Results of the research shows that nurses are using not only positioning aids, but other available tools as well. Rehabilitative care nurses regularly document treatments, especially in nursing documentation. Nurses stated that there is lack of time for providing rehabilitative nursing and nurses state that the treatment is monitored by nursing management.
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Observation of non invasive and invasive screening cerebral vessels from the radiologic assistants view.
NOVOTNÁ, Dana
The subject my thesis was ? Observation of non invasive and invasive screening cerebral vessels from the radiologic assistants view". In the theoretical parts I explore the disorder of blood - vessel in cerebral occurrence (CMP) and its diagnosis. It is about the acute illness caused by closure of some of the cerebral arteries and resulting in vapidity brain (ischemic) or bleeding to the brain (haemorrhage). It ranks among the most frequent causes death in developed countries. The practical part includes research of usage non invasive and invasive depict methods in brain and cerebral vessels diagnostics. I processed quantitatively the statistical data which I gained from the Radio-diagnostic Ward in hospital in Ceske Budejovice. The result of this emerges from superiority of non-invasive screening above invasive one. In the non- invasive depict methods in diagnosis of CMP most often uses computation tomography (68 %), which for a certainty will distinguish ischemic from haemorrhage. Magnetic resonance (7 %) is more sensitive method at ischemic diagnostics. Another method is the ultra-sonography (13 %), in which we can assess the level of stenos/occlusion screened vessel. As the only vice invasive methods is catetrizac angiography (12 %), which is considered as the golden standard in displaying the blood - vessel bed. Its advantage is the possibility to join endovascular intervention. The next aim was to compare the role of radiologic assistant during single screening. It was necessary to find common point in practical activities of the radiologic assistant at both types o screening and to show the differences in specific substance and the work demands.
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