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Promoting of self-sufficiency by hemiplegic patients after a brain stroke
JIRKŮ, Lenka
Nowadays, cerebral apoplexy is no longer a disease that only attacks elderly people, but increasingly, persons at a productive age. The consequences of this didease are diverse and vary according to the affected person, both in extent and severity. This is why this disease fundamentally changes the way of life of both the diseased and their families.The teoretical part of my bachelor thesis is focussed on the disease itself. The reader of this thesis will learn more about the nature and the substance of this disease. This thesis describes the types of cerebral apoplexy, the risk factors, the diagnosis and the methods of treatment. If further describes the princilpes of methods for nursing people suffering cerebral apoplexy,emphasising their self-suffuciency, rehabilitation a rehabilitation targets.The socond part of my bachelor thesis was research work. The applied method was based on a survey in which two types of questionnaries were deployed, one for respondents working in inpatient wards in medical facilities and one for respomdents working as home carers. This part focussed on acquiring information and discovering differences in providing support to hemiplegic patients after cerebral apoplexy to help them to becouse self-suffucient in personal hygiene and to collaborate wiht a physiotherapist, both in an inpatient ward and during home care. The result should contribute to better nursing care provided to patients after cerebral apoplexy.
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Cerebrovascular Accident and Subsequent Resocialization
DVOŘÁKOVÁ, Tereza
This thesis is focused on resocialisation of persons after cerebrovascular accident - stroke. In this research I have focused concretely on interviews with people who had experienced a stroke. The thesis is divided into a theoretical part and a practical part. The theoretical part deals with anatomical-physiological basis of stroke, risk factors, disease characteristics, symptoms, causes, first aid, the description of different types of stroke and comprehensive rehabilitation, specifically with medical, social, pedagogical and working means of rehabilitaion. In the practical part methods and techniques of qualitative research were used. The questioning method and the semi-structured interview technique were applied. The target group was 10 people who had experienced a stroke. Interviews were processed into case studies - case reports. In the case studies, information from people who had undergone the disease was summarized. The aim of my thesis was to determine and compare the opportunities for selected social groups to return to normal life after a stroke. In the discussion, the obtained information was summarized and hypotheses arising from the research were presented. The supposed use of my thesis could be mapping possibilities of resocialization for persons who have suffered a stroke. The thesis could contribute to the quality improvement of education in this subject and also to help educate the public. Other possibilities how to make use of this thesis are to create a procedure that could be applied in resocialization of persons after stroke.
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Prevention and therapy of spasticity in patients after cerabral apoplexy
TÁBORSKÁ, Žaneta
Spasticity is a manifestation of many neurological diseases, for example an infantile cerebral palsy, a traumatic injury of brain and spinal cord, a multiple sclerosis and a stroke. A genesis of the spasticity is not yet completely clarified and many definitions try to explain it. The spasticity can deepen a disability of patients even with a minimal paresis. The spasticity has a different clinical picture at various diseases of the central nervous system, but even at different patients with the same diagnosis, it also varies in the course of time at one and the same patient. The biggest problem in the treatment of the spasticity is the fact that the treatment, efficient at one patient, can completely fail at the other. A goal of this thesis was to give an overview of current options in a treatment of the spasticity. Therapeutic approaches to reduce the spasticity are usually a part of special kinesio-therapeutic methodologies, which are for example an anti-spastic positioning, a volitionary relaxation, passive movements, an anti-spastic placing (Bobath´s conception), relaxation techniques (PNF), an application of splints, a long-term effect of the heat, an icing and others. On the contrary, it is intensified by pain, pressure sores, a sub-luxation position most often of the shoulder joint, a psychical stress, urinary tract infections etc. In the theoretical part I focused on a control of the muscle tone, pathophysiology, clinical symptomatology, diagnostics and especially prevention and the treatment of the spasticity. In the practical part I investigated an effectiveness of an anti-spastic therapy through the qualitative research. For the data collection it was used an anamnesis, observations (kinesiological analysis), case reports and a secondary data analysis. The research was made at two probands with a brain damage on the vascular basis. I was finding out an effectiveness of selected therapies for individual probands {--} and at the same time its suitable combination. I focused on the area of the upper extremity. At the first patient there was a success, by a suitable combination of individual methods, to positively affect the spasticity and an active momentum of the upper extremity. At the second patient in a chronic stage of spasticity it was managed to influence it always only for a short term and results varied considerably in the course of time. The treatment of the spasticity must be preceded by a thorough knowledge of pathophysiological mechanisms, a neurophysiology and above all a complex kinesiological analysis. The therapeutic approach should be always individual, to respond appropriately to changes in the clinical picture and to use suitable combinations of therapeutic approaches. If the treatment of the spasticity is successful, it positively affects the motor deficit and reduces the patient's disability.
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Special physiotherapeutic procedures as a part of the recovery for patients after stroke
KŘIVÁČEK, Jan
The thesis deals with {\clq}qSpecial physiotherapeutic procedures as a part of the recovery for patients after stroke.`` While in the most developed countries there was, in last 10 - 20 years, recorded a significant decline in a mortality of stroke thanks to a consistent prevention, the Czech Republic still belongs among countries with the high mortality. Nevertheless a large part of strokes is a result of an improper lifestyle in a combination with a lack of the physical activity and other factors. Just a use of an aerobic training is often a neglected part of the convalescence, although there is an obvious link of the cardiovascular performance with a function of the neuro-musculo-skeletal apparatus as well as psychological features. A goal of this bachelor thesis was to verify a relevance and effectiveness of the aerobic training as a part of physiotherapy at patients after stroke. The thesis deals, in the theoretical part, with an etiology, risk factors, a prevention and a clinic symptomatology of stroke and individual approaches to a subsequent complex rehabilitation. Then there are pointed out principles of a stress diagnosis, a reaction of the organism to the stress, changes of cardiovascular, ventilatory functions and the aerobic training.In the experimental part I used a quantitative research with methods: an interview,anamnesis, status praesens, evaluation of hemiplegia after Chedoke, a direct observation, case reports and a secondary data analysis. The research was conducted at patients after stroke hospitalized in Neurological a Rehabilitation wards of the Hospital in České Budějovice. Results of the research showed a certain trend of measured values within a meaning of the adaptability to the training programme and a positive contribution to the overall rehabilitation process. The thesis could be used as a study and information material for the general public as well as for students of medical and paramedical disciplines, last but not least as a preventive measure against stroke.
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The knowing of laic community about high- risk factors, prevention and symptoms of vascular brain stroke
VYCHYTILOVÁ, Renata
Cerebrovascular accident (CVA, ictus) is a critical state in neurology, when due to disturbance in the blood supply to the brain the local or total damage of brain functions occurs. Only one third of patients with this diagnosis are completely cured. The possibilities how to improve this situation is first of all an early hospitalization of ill in their acute stadium of the disease and an appreciation of preventive care significance. The main risk factors are: age, heredity, high blood pressure, atherosclerosis, diabetes mellitus, smoking, alcohol, drugs, obesity, stress, lack of physical activity, improper nutrition. The crucial significance for prevention is the regulation of life-style, e.g. sufficient physical activity, proper nutrition and the absence of smoking. Also regular check-ups which can reveal high blood pressure, high level of cholesterol and diabetes mellitus in time are important. The prevention also includes the education focused on CVA symptoms and the need to act quickly in this case because time is crucial for the treatment of ictus. The objective of the thesis is to find out the informedness of laic public on the risk factors, prevention and symptoms of cerebrovascular accident. The hypotheses concerning the knowledge of risk factors, prevention and symptoms of cerebrovascular accident were stated. For this thesis the method of questioning by the technique of a questionnaire was chosen. The questionnaire was compiled on the basis of information gained from the professional literature; it was anonymous, designed for laic public and contained 25 closed, open and semi-closed questions, which offered the choice of particular answers and the possibility to fill in respondents{\crq} opinions. The observed group was laic public in Vysočina Region. On the whole 200 respondents were addressed during February and March 2010. The criterion for the choice of respondents was laic (non- medical) public who did not experience CVA irrespective of age and education. The rate of questionnaire return was 83% out of the total number. 22 questionnaires were excluded because they were incomplete. On the whole the data from 145 questionnaires were elaborated. The hypotheses were proved; the objective of the thesis was fulfilled. Good informedness in the area of risk factors and prevention and insufficient knowledge on the symptoms of ictus were found out. The results will be published at seminars designed for medical workers in in-patient and out-patient institutions. They might contribute to better informedness of public. Further, the results will be used as the basis for the seminar on the problems of CVA and its prevention, designed for laic public.
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Options of physiotherapy treatment in patients after stroke.
KUBÁTOVÁ, Radka
The topic of this thesis is Options of physiotherapy treatment in patients after stroke. The objective of the thesis is to survey physiotherapy-nursing care for patients after stroke and to describe current possibilities and quality of physiotherapy care for patients after stroke The thesis deals with possibilities of physiotherapy treatment and cooperation between nursing and physiotherapy staff. One of the targets is description of physiotherapy care for patients after stroke which is documented by patients{\crq} medical records. The other target is physiotherapy care monitoring supported by the quantitative research using the questionnaire method. The aim of this thesis was to develop an appropriate methodology to be used as an instrument for physiotherapy care for patients who had sustained acute stroke. Another objective was to determine the level of cooperation and awareness of staff members involved in the physiotherapy-nursing process. To meet the objectives the method of quantitative research was used. The methods of participated observation, semi-standardized interview and documents evaluation were included. Complementary data were obtained by the quantitative research using the questionnaire method. The research was conducted in patients after stroke who were hospitalized at the neurological department in Ceske Budejovice hospital. Additional quantitative research, using the questionnaire method, was conducted at the neurological and internal departments in hospitals in Ceske Budejovice, Cesky Krumlov and Pribram. On the basis of the research results, methodology of physiotherapy care for patients after stroke in acute condition was developed and the lack of awareness and cooperation of physiotherapy and nursing staff was found. The thesis will be used as a study and information material for all members of the medical staff involved in treatment of patients after stroke, but also for general public. Information can be forwarded through lectures, leaflets, etc.
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Nurse´s view on speech disorders of patiens cured from stroke
TALÁROVÁ, Libuše
This bachelor thesis deals with cerebrovascular accidents (CVA)and their serious effects on the pacient. Special attention has been paid in this thesis to speech disturbances that are the second most frequent effect of CVA. The objective of the survey was to find out whether nursing staff are informed about the speech disturbance issue, are willing to work with the client according to clinical speech therapis´ts recommendations, and whether the nursing staff have adequate conditions for work with the client. All of the objectives mentioned above have been achieved. Quantitative methods have been used for the survey, namely the analysis of the speech disturbance number to the CVA number from July 2008 to February 2009, and a questionare for the nursing staff. The survey was carried out in internal diseases and neurology departments of the Blansko Hospital. The results of investigation showed that nurses do not have information about disorders of speech and that each deparment should be designated at least one worker who was trained by clinical speech therapist and in cooperation with him, he devoted himself to the care of patients.
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Self - support in patients after the stroke
VANĚK, Filip
My thesis deals with the change of self-sufficiency of a patient after a vascular brain damage (VBD). The research covered nurses working at a neurology ward, aftercare wards, nurses working for homr-care agencies and patients after. I chose this topic as VBDs represent a serious medical-social problem and secondarily also an economic problem. At present they represent the third most frequent cause of death in the Czech Republic as well as in other developed countries. This is why they deserve increased attention, which has not been paid to them in practice so far.
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Period hospitalization cancerning autarchy development of patient cured from stroke.
KALUŽOVÁ, Lenka
Stroke (celebrovascular accident CVA) is caused by a disturbance of the blood supply to the brain and today represents a medical, social and economic problem. It is the third most frequent cause of death and the most common cause of mental and physical handicap nowadays. In the thesis mechanisms of stroke development are introduced, risk factors that are involved in the disease development are described. Manifestation of stroke according to specific types of disablement is also mentioned. The research was conducted by a quantitative method. Self-sufficiency of patients was evaluated using a standardized test of self-sufficiency (Bartel´s test) and observation techniques. The Bartel´s test was made at the patient´s admission as well as his (her) discharge from hospital. Patients from the research database were monitored every day of hospitalization and their success or failure in training self-sufficiency were processed in twelve casuistics. The presupposed objective of this work was to determine the average time of patient´ hospitalization required to achieve self-sufficiency in daily activities. The results of the thesis result in the following hypotheses: 1. In younger patients the average period of hospitalization is longer than in elder ones. 2. The return to self-sufficiency is faster when nurses support patients to exercise daily activities by themselves. 3. Faster return to self-sufficiency is achieved in patients with prospects of being discharged from hospital to home care.
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Ergoterapie u osob po cévní mozkové příhodě ve VRÚ Slapy nad Vltavou
ŠTĚPÁNKOVÁ, Jitka
The topic of my bachelor thesis is the application of ergotherapy among persons with a handicap due to cerebrovascular accident in the Military Rehabilitation Institute (VRÚ) in Slapy nad Vltavou. The aim of my thesis is to describe the benefits of ergotherapy in clients after a cerebrovascular accident. My thesis therefore deals with the following problems: A) Characterization of ergotherapy applied to persons after a cerebrovascular accident, B) Description of ergotherapeutical methods used in VRÚ Slapy nad Vltavou, C) Evaluation of ergotherapy effects on persons after a cerebrovascular accident, considering especially their self-sufficiency, motor disorders, sensitivity and symbolic functions.
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