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Bio-psycho-social preparation for pain during a diagnostic or terapeuty procedure for children.
KABELOVÁ, Alena
At a time of the increasing number of diagnostic and therapeutic interventions in children, it is important to respond to the presence of pain and to prepare children to this fact in the nursing care process. The aim of the thesis was to give a survey of preparation of children of selected age groups for the pre sence of pain during diagnostic and therapeutic procedures. The investigation was conducted quantitatively through a questionnaire survey in the period from February to March 2010. Questionnaires were addressed for nurses in paediatric departments. The outcomes of the research have shown that children are being prepared for the pain presence. Nurses use different methods of preparation. Children of all age categories are being prepared for pain presence.
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Standard of non-pharmacological relieve and evaluation of pain by newborn and suckling children
PAVLÁSKOVÁ, Ilona
The importance of this thesis lies in finding about the current state of pain assessment and palliation at neonatal and infant wards of selected hospitals, in finding out about the extent of use of standardized rating scales for pain, in identifying the obstacles in pain assessment and non-pharmacological pain palliation, and particularly in the development of a standard for pain assessment and pain palliation for neonatal and infant hospital wards.
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Role of a nurse in the care of patients with post-puncture cephalalgia after an operation in spinal anaesthesia
KŘIVKOVÁ, Jana
The objective of this diploma paper was to answer the question whether nursing for patients after an operation in spinal anaesthesia has any effects on the occurrence of post-puncture cephalalgia and on the satisfaction of patients with spinal anaesthesia. The paper is divided into two parts: a theoretical one and a practical research one. The theoretical part sums up the current knowledge of spinal anaesthesia; it provides anatomic and physiological aspects, possible complications and the importance of nursing in this type of anaesthesia. It deals with the syndrome of post-puncture cephalalgia in detail, the mechanism of its origin, typical symptoms, its treatment, and the importance of nursing for patients suffering from this syndrome. With regard to the importance of education in nursing jobs, one chapter of the theoretical part deals with education and educational process. The research part consists of qualitative as well as quantitative surveys. The research was carried out with a group of patients who were hospitalized at the surgical and gynaecological departments of Domažlická nemocnice a.s. (Domažlice Hospital Ltd.) and have undergone an operation in spinal anaesthesia. The quantitative survey was done using a questionnaire that contained 27 questions. Seventy-eight patients, selected at random, took part in this research stage. The objective of the qualitative survey was to find out the following: whether patients were aware of the aspects of spinal anaesthesia, whether they have experienced any complications in relation to the administration of spinal anaesthesia, how have they been informed, and what was their overall satisfaction with spinal anaesthesia. The qualitative part involved 10 patients who had been divided randomly into two groups: a group with ``standard{\crqq} education and a group with above-standard education using a purpose-made brochure. A semi-standardized interview, consisting of 18 questions, was carried of with each patient. The patients in the latter group were also asked additional questions aimed at the benefit of the informative brochure and the completeness of the presented information. The former group was asked whether they would be interested in a brochure focusing on spinal anaesthesia. Based on the results of this survey, the basic research question of the paper can be answered. Nursing does have positive effects on the occurrence of complications and on the satisfaction with spinal anaesthesia. A detailed result analysis shows that patients do not feel any subjective need to be educated by a nurse and they are not interested in the brochure. Most of the patients think they are informed sufficiently and they do not want more information. However, the results of the qualitative survey into the group educated by a nurse show a higher informedness about the method, lower occurrence of complications, higher satisfaction, better observance of recommended regimen measures, and highly reduced level of stress in relation to spinal anaesthesia. The educative brochure was accepted by the educated patients as beneficial and useful. Based on the above-listed results, the informative brochure, being an integral part of this paper, will be introduced as a standard education tool for patients undergoing an operation in spinal anaesthesia at Domažlická nemocnice a.s.
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Physiotherapy at treatment of chronic pain
VAŇKOVÁ, Denisa
The title of my bachelor thesis is "Physiotherapy at Chronic Pain Treatment". In my thesis I have focused on chronic back pain. Ambulatory practice indicates the above by general diagnosis as vertebral algic syndrome (VAS). First part of my work consists of processing of theoretical basis related to the problem. Main sections focus on pain, function of the spine, vertebral algic syndrome, spine examination methods, physiotherapeutic procedures and prevention of VAS origination. The research part of my work includes two case reports with diagnosis of chronic vertebral algic syndrome. The objective of the theoretical part of the work was to focus from the physiotherapist's view on most common causes of chronic pain, namely vertebral etiology. This part is also aimed at analyzing basic causes of VAS, processing of current information for diagnostic, therapeutic and preventive procedures related to VAS. The objective of practical part of the work was to find out, based on the case reports, whether the physiotherapy relieves the patient from pain. In the practical part of the thesis I applied the method of qualitative research, case study. The research was carried out in Malvazinky Rehabilitation Center and in Medicentrum Chodov. The tested set consisted of two probands diganosed with chronic vertebral algic syndrome. The diagnoses were given by the doctor treating the probands. Results have been prepared in the form of case reports. Both monitored patients showed a relief from pain and rehabilitation objectives set in advance have been met. Providing that the patients shall practise self-therapy and pay attention to measures preventing origination of problems. The thesis may serve as a theoretical document for medical science students. For physiotherapists it may serve as an inspiration when preparing rehabilitation plans for chronic back pain treatment.
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Health Related Quality of Life (HRQoL) in patients with phantom pain
BEŤÁKOVÁ, Zuzana
Health Related Quality of Life (HRQoL) in patients with phantom post-amputation pain Phantom pain is pain that relates to surgically or traumatically amputated parts of human body, usually already in its integrity. Pathophysiological mechanism allowing occurrence of phantom pain has not been discovered yet. It is a very complex, multifactorial phenomenon. In case phantom pain becomes a chronic disorder, it decreases subjecťs quality of life. The bachelorľs thesis titled "Health Related Quality of Life (HRQoL) in patients with phantom post-amputation pain" is divided into two parts. The theoretical part dwells on pain, its origins, types, ethics, and research done in the area of pain. The theoretical part also deals with amputation, origins, and help provided in social sphere of an individual. The last section of the theory is concerned with quality of life. The practical part introduces the objective of the thesis and defines hypotheses, which marks the actual beginning of the research. The chapter named "Methodology" provides a description of the research procedure and tools used in order to confirm or rule out the defined objective and hypotheses. The following chapter titled "Outcomes" comprises of graphs and tables showing resulting values and their verbal descriptions. Information collected in the research is confronted in the discussion. The aim of the thesis was to find out whether phantom pain influences quality of life in patients in case it develops within 1 month following the amputation or months after the amputation; and to observe whether younger subjects show better tolerance of phantom post-amputation pain. The data retrieved from selected subjects were collected by a method of interview. The objective was reached by using the method of standardized questionnaire SF-36 on Health Related Quality of Life, which focuses on 8 domains. In conclusion, the research showed that subjects over 65 years of age have better quality of life in domains SF - social function and P - Pain. In all 6 remaining domains, subjects under 65 years of age showed better quality of life. The research also came to the conclusion that if the pain starts 1 month and later from the amputation, such subjects show better quality of life in 7 out of 8 domains than subjects who start suffering from the pain within 1 month following the amputation. The only exception is the domain of SF - social function.
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Cleft As a Stigma
GAJEROVÁ, Eva
The thesis deals with the impact of orofacial cleft (cleft lip and palate) on family psychosomatics within the psycho-social-ethical framework. It summarises the history, classification and treatment of cleft disorders, followed by an analysis of real-life problems occuring in the process of taking care of a baby with orofacial cleft, specifies terms frequently used when discussing orofacial cleft as a stigma: stigma and stigmatisation, norm and normality, beauty and ugliness.The phenomena of fear and pain, difficulty in communication with the child{\crq}s and the parents{\crq} immediate social surroundings and, the barriers between experts and the parents are dealt with in the thesis. The thesis focuses on orofacial cleft anomalies in connection with Christian ethics. It analyses the relation of abortion and orofacial disorders and the role of hope in the process of taking care and upbringing of a child suffering from this disorder.
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The application of opioids in crews of medical rescue service
MATOUŠEK, Jan
The aim set by this bachelor thesis is to survey the application of opioids in the emergency crews. To meet this objective, I posed two research questions. Research question Nr. 1: Are patients informed about the application of opioids? Research question Nr. 2: Do paramedics find out the effects of opioids administered to patients? Patients are entitled by law to information about administering any medicaments, according to Health Care of the Population Act. The back check of effects of medicaments administered is important for the check-up of the efficiency of the dose administered as well as the danger of undesired effects. Opioid substances are derived from morphine. Morphine, which is found in the juice of opium poppy, has been used throughout history to produce euphoric effects and especially as an analgesic. The reason for using analgesics is pain, and for that reason I explain here what pain is, how it is classified, measured and especially how it is soothed. Opioids are substances used for soothing severe pains for which non-opioid analgesics are insufficient. However, using these substances may result in addiction, and therefore manipulation with them is strictly controlled by law. To achieve the objective I conducted quantitative research, and data were collected by a secondary data analysis, the method of questioning and interview technique. Drawing on the research results that were obtained by observing paramedics and from interviews with their patients, it appears that it is necessary to inform patients that they are being administered an opioid substance. There are exceptional states when patients are not able to perceive such information and their consent to administering the medicine can be supposed. It was observed that paramedics make a back proof of the effects of the medicaments administered, and it was also found out that there are paramedics who, in the event that the dose of medicament is inefficient, do nothing more.
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The life of patients with chronic pain
BOHDALOVÁ, Helena
The pain, especially chronic pain, can influence many aspects of life. It is not only physical factors, but also psychic and social factors that can affect its perception. The long-term pain can handicap the patients not only in the somatic area, but can also have a negative effect on social and psychological position in society, family or at work. Nowadays, chronic pain seems to become more common, its severity is increasing and that is why there is also a progress in the field of treatment methods. The treatment of chronic pain is often very complicated and full recovery can hardly be achieved. Above all, the main goal is to decrease the intensity o pain, improve patient{\crq}s quality of life and to assist in increasing patient{\crq}s independency. The aim of the proposed thesis was to describe the quality of life of the patients with chronic pain, treated in the ambulatory departments for the treatment of pain and to verify the hypothesis that the patients with chronic pain present with lower scores of quality of life in comparison with the domain scores of the common population. The quantitative research on quality of life of patients with chronic pain was evaluated using the WHOQOL-BREF questionnaire by the World Health Organization that is intended for evaluation of quality of life. The questionnaire inquiry was performed during the period from November 2008 to February 2009 an two workplaces {--} at the Ambulatory department for the treatment of pain in České Budějovice (private facility) and at the Ambulatory department for the treatment of pain of Nemocnice České Budějovice, a.s. The cohort contained data form 73 respondents. The cohort was further subdivided into age and gender categories. The average raw scores of single domains and two independent items were calculated, evaluating the overall quality of life and satisfaction with health. The basic descriptive statistics was calculated and correlation analysis was performed. Furthermore, the differences between the gender and age categories were calculated. The thesis revealed the lower scores of quality of life in respondents with chronic diseases in comparison to the domain scores of the common population. Furthermore, significant relations were observed between the Physical Health Domain and independent item Quality of Life, respectively between the domain Enjoyment and item Quality of Life. The comparison of the domain scores in men and women did not reveal any statistically significant differences, there were only minute differences between the age categories. The perception of quality of life in the patients with chronic pain is tightly associated with their enjoyments, as confirmed by the results of the correlation analysis. Therefore, I would recommend the more thorough psychosomatic approach for the treatment of pain at the ambulatory departments for chronic pain, but also in the offices of general practitioners, who are the first to meet the patients suffering from pain and frequently it is them, whose education about adequate treatment is crucial.
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The Standardisation of Procedures in Pain and Nursing Care Assessment in Patients with Pain in Hospitals
PILNÁČKOVÁ, Jitka
The topic of this Bachelor Thesis is called ``The Standardisation of Procedures in Pain and Nursing Care Assessment in Patients with Pain in Hospitals``. Its objective was to find out whether nurses observe the Nursing Care Standard of patients with pain. The research survey was realised by means of a questionnaire and an audit survey at the České Budějovice Hospital, a.s. The questionnaire was given to nurses of all surgery branches, between the 26th January to the 6th February 2009. The audit was carried out in the accident and plastic surgery department on the 23rd February 2009, and in the orthopaedic department on the 2nd March 2009. The audit survey was assessed according to Control criteria concerning the audit of the Nursing Care Standard No. 041 ``Pain``. We laid down 4 hypotheses. Hypothesis 1: Nurses of surgery branches do not use the visual analogue scale for patients with pain, was refuted. Hypothesis 2: Nurses do not record the effect of medicaments in the documentation after administering a medicament influencing pain, was confirmed. Hypothesis 3: Nurses of surgery branches use the application of heat and coldness to alleviate pain, was also confirmed. Hypothesis 4: Nurses do not know the pain treatment strategy according to WHO, was refuted. In connection with these facts we proposed correction measures. To improve this situation, special lectures on pain assessment, informing nurses and physicians about the importance of pain assessment and using this information, could help. More frequently conducted audits of Nursing Care Standard No. 041 ``Pain`` could improve the quality of requirements laid down by this Standard. With regard to the latest information about creating standards and about the questions concerning care of persons suffering from pain, we drew up the Standard Care Procedure Nursing Care of patients with pain. This standard will be offered, along with the results of the survey, Control criteria concerning the audit of the Nursing Care of patients with pain and the DySSSy standard method (Dynamic Standard Setting System) to the deputy in charge of nursing care Mgr. Jiřina Otásková, MBA.
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Problems of treating of sicks with the compartment syndrom on crus injuries
WICHTOVÁ, Zdeňka
Compartment syndrome is a syndrome of clinical signs that arise due to the increased blood pressure within a confined space. For some time, this pressure increase is balanced by the flexibility of fascia. But when the mechanism becomes exhausted, the development of ischemia occurs and the compartment syndrome turns up. The treatment is aimed at saving the extremity and the patient. The role of a nurse is to closely observe the patient´s overall condition and clinical symptoms of the compartment syndrome, to carry out auxiliary examinations, to assist in taking the intrafascial pressure in the affected part of the body and to take part in the demanding treatment of the complication. A nurse is in a constant contact with the patient, provides him/her with education and support and notifies the doctor of all alterations in the patient´s condition. The objective of the thesis was to learn if nurses are informed enough on the causation of the compartment syndrome on the crus injury. The other objective was to find out if nurses are familiar with the specifics of the care for patients with the compartment syndrome on the crus injury. Three hypotheses were stated: H I: Nurses have knowledge of causes of the compartment syndrome on the crus injury. This hypothesis was confirmed. H II: Nurses are not able to recognize the onset of the compartment syndrome on the crus injury on due time. This hypothesis was rejected. H III: Nurses have knowledge of specifics of the nursing care in patients with the compartment syndrome on the crus injury. The research was conducted by the quantitative method. The data necessary to achieve the objectives were gathered by the questionnaire method. The research was anonymous and it was voluntary to fill in the questionnaires. The research was conducted in the České Budějovice hospital in the Orthopaedic unit and in the Department of Accident and Plastic Surgery. The findings of the research may be useful to medical staff members in practice or in workshops.
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