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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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THE AWARENESS OF PUBLIC OF THE POSSIBILITES OF PALIATIVE CARE IN THE CZECH REPUBLIC
MALÍKOVÁ, Gabriela
I have chosen the topic of my bachelor thesis "Awareness of general public about possibilities of palliative care in the Czech Republic" on purpose after a many- year- experince as a volunteer in some hospices in CR. In the thesis possibilities of palliative care in the Czech Republic are presented which can be used in case of need by citizens. The chapter of current situation of the given problems explains principles of palliative care and objectives of palliative medicine. It adverts to possible methods of providing care to the dying. Futher it is determinated providing this care in context of multidisciplinary team and to whom. The base element of palliative care is a family with a dying member. That is why this thesis is setting emphasis on accompanies not only dying but also immediate persons. The significant role in this direction represents counselling. Legislative aspect dealing with providing palliative care in the Czech Republic is also not omitted. The aim of the thesis was to find out knowing about palliative care and its present possibilities at general public. Respondents formed an accidentally chosen sample from grown-up population from regions of Moravia Slesia and South Bohemia. The chosen methodology was quantitative research, the method of questioning and techniques of questionnaire. The questionnaire was distributed online among respondents in the form of web pages. It contained 21 questions. The hypothesis was set as follow: "Respondents with university education have more information about possibilities and way of utilization of palliative care than respondents with secondary education and lower one." Whereas the hypothesis was confirmed. The bachelor thesis can be used as groundwork for establishment dealing with extension service of the given problems or hospices themselves which would like to deal with extension service. Further this bachelor thesis can be used by experts who are engaged in social or health counselling and further this thesis can use relatives of the seriously ill, who could better knowing use in care of their close ones.
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Helping hand in crossing over
LASCHOVÁ, Daniela
The thesis deals with palliative and hospice care. The thesis is divided into two parts - theoretical and practical. In the theoretical part there are provided with basic information about palliative care, it describes aspects of palliative care in terms of spiritual, social, psychological and physical. There are also recorded information on facilities that provide palliative care, their characteristic, mission and goals. The thesis is also reported on problems of dying, suffering and death. The work also records a pastoral and social care about dying seniors, a description of a multidisciplinary team of hospice care. The practikal part of the thesis is reported on a detection rate of awareness of palliative and hospice care at the clients of caritas Týn nad Vltavou. Next the research found out the respondents opinion of dignified dying in a domestic care
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Nursing care as provided to ante finem patients
JANSOVÁ, Markéta
The subject of death and dying is still considered a taboo in our society. It is awkward and anachronistic since our times require people full of life and vigor. The terminally ill are often snubbed by the society. Though being well aware of the unfavorable prognosis, many a doctor tries to treat the patients to the very last moment, and he or she perceives the death as a personal defeat. In 1967 Cicely Saunders, an English doctor familiar with the dismal conditions of dying in the then society, founded in London the St. Christopher's Hospice, the first modern facility of this kind. The philosophy of this effort has been perpetuated in the Hospice of the Agnes of Bohemia established in 1995 as the first hospice in the Czech Republic. The Bachelor Paper aimed to assess the possibilities of providing the ante finem care by health-care personnel at a hospital and a hospice. The Paper investigated these hypotheses: H1 - Health-care workers provide the ante finem patients with health care in conformity to the standards applicable to both types of the facilities; H2 - Approach of the personnel to the care is dependent on their emotional stability; H3 - Health-care personnel in hospitals are not aware that the art of accompanying is a part of the nursing process. The surveyed sample was compiled of nurses on the staff of the Internal Medicine Ward and the Post-Treatment Ward of hospitals in České Budějovice, Jihlava and Třebíč and the hospices in Prachatice, Červený Kostelec and Brno. The data were gathered through a questionnaire. Altogether 170 questionnaires were distributed and 136 out of them were processed in the final assessment. As follows from the assessment results, the care provided to the terminally ill patients in hospitals is affected primarily by time pressures and by the fact that the nursing staff are not fully aware of the possibilities that palliative care offers, while in hospices the conditions available for the palliative care have a quality basis. Results of the Paper will be given to one of the hospitals and two hospices specified above, where they can inspire some new ideas about possible improvement in providing the palliative care.
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Comparison of paliative care by clients in hospice establishment and oncology department
KADLECOVÁ, Ivana
Comparison of palliative care for patients in a hospice and at an oncology ward This thesis was focused on the various aspects of palliative care for oncological patients. Palliative care and its principles have been defined and it seems crucial to apply these principles not only in hospices but also at hospital wards where there are patients indicated for palliative care. The objective of this thesis was to find out whether the care provided to hospice clients and to dying patients at hospital oncological wards corresponds to the methods and procedures defined for palliative care and to find out whether there are any significant differences between the nursing care provided to the dying in a hospice and the dying at an oncology hospital ward. Four survey questions were formulated and the question dealt with maintaining palliative care standards, differences in providing palliative nursing care for the dying at the individual institutions, whether the dying clients{\crq} needs are answered in a holistic and humane way, and the nurses{\crq} approach to the dying at the individual institutions. The carried out research is a qualitative one. The research part {--} data collection {--} was carried out in the form of uncontrolled interviews with selected members of nursing teams in a hospice and at an oncology ward. Observations and case reports were used in case of several patients in at the individual institutions. The research was carried out in St Stephen Hospice in Litoměřice and at the oncology ward of an undisclosed health care institution by which information was provided in exchange for absolute anonymity. The research part resulted in the finding that the palliative care provided in the hospice corresponds to the methods and procedures defined for palliative care. There are efforts at the oncology ward to provide as perfect care for their dying patients as possible but this care does not correspond to the methods and procedures defined for palliative care. There are problems in providing palliative care especially in inadequate spatial conditions, equipment, shortages, high workloads, and strictly specialized focus of the personnel and these clients need very individual care that cannot be frequently provided under everyday operating conditions at a standard ward that concentrates primarily on curative care. The results of this thesis will be provided to those who may be interested in the various aspects of palliative care.
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Intergenerational opinions on euthanasia
EXNEROVÁ, Jitka
I have chosen the topic of euthanasia for my bachelor´s thesis. I find the topic fairly problematic and it is frequently discussed in the media as well. On the other hand, there is palliative medicine which is rarely spoken about. In my thesis I wanted to highlight the possibilities of palliative care which seem to be neglected in our society and to underline possible risks of euthanasia. Moreover, I wanted to find out which factors influence the opinions on euthanasia in individual age groups. I was interested in the way people look upon euthanasia and palliative care. The thesis includes a theoretical and a practical part. The theoretical part deals with euthanasia, palliative care, pain, suffering, dying and death. In the practical part there are examples of abbreviated dialogues connected with this topic. In order to gain necessary information I have chosen the method of qualitative research and that of a narrative and semicontrolled dialogue. All the dialogues were recorded on a dictaphone with the consent o feach addressed person and then transferred into written form. They were abbreviated and preserved in colloquial language form for the sake of their authenticity. Some people wanted me to ask them questions. I have found out that palliative care still presents an unknown quantity for most people and the word hospice makes them feel scared, they have distorted ideas. On the contrary, they are pretty familiar with the word euthanasia, almost all of them have come across it and know what it is about. I have decided on four age categories. I have addressed at least one woman and one man from each category to be able to hear the opinion of both sexes. Respondents were chosen by chance. During the research I have found out that the intergenerational opinions on euthanasia are becoming less contradictious. I suppose that the goals of my thesis have been reached. Taking the information which has been found out into consideration it would be of great benefit if the media and the responsible organisations would provide our society with more information about the possibilities of palliative care.
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Care for the Dying in Hospice Facilities
PTÁČEK, Jan
This Thesis deals with the issue of illness and dying, and the care for the dying in different hospice facilities. In describes typical features of palliative medicine, it´s practical use in hospices and also the lack thereof in current Czech Medicine. The legislative side of this issue is discussed in this thesis as well.
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