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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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Sensation and pain tolerance in the range of cultural vision
ČUTOVÁ, Jana
For the Diploma work we chose the theme: ``Algesia and pain tolerance across cultures``. We chose it because due to globalisation and migration of inhabitants cultures from the whole world reside in the Czech Republic. We decided for three the most numerous cultural groups in the Czech Republic, which are Czechs, Romanies and Vietnamese. These cultures, despite living in one territory, have a different history, different customs and traditions and approach differently to health and disease. They perceive pain differently, it has a different importance for them and they use different ways of calming the pain. To get to know these cultures closer in the area of pain and to describe differences between Czechs, Romanies and Vietnamese is the essential for a good quality professional and especially multicultural care. For better lucidity and coherence we divided the theoretical part into four sections. The first one is devoted to basic information about pain, its history, factors that affect algesia and its treatment. Other sections are focused gradually on each culture separately. We mention brief history of the relevant culture, pain treatment in the past and especially pain symptoms in the relevant culture, algesia and tolerance of pain. For the empirical section there were defined three targets and five hypotheses. We should find out and compare the differences in calming pain in Romany, Vietnamese and Czech culture in domestic and hospital environment. We should further find out whether the designated cultures consider pain a part of their lives and the last target was to find out the effect of pain on normal activity leading to initiation of activities for pain calming. The targets were established based on the assumption that members of nation minorities in the Czech Republic, in this work specially Romanies and Vietnamese, prefer non-pharmacological ways of calming pain to the pharmacological ones and that Czechs do not consider pain a part of their life unlike members of the nation minorities in the Czech Republic. Other assumption was that a church person bears pain better than an atheist. And last two assumptions were that Romanies have lower pain tolerance than Czechs and that Vietnamese higher. The research was carried out at a selected sample of representatives of all three cultures in form of questionnaires. On the basis of results it is possible to say that the work targets were met. The first two hypotheses were not proved and the last three were.
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Epidural anesthesia during labour nowadays
LAŠTOVKOVÁ, Aneta
Current Obstetric Epidural Analgesia Labour pain belongs to every physiological childbirth. Enormous pain, however, was proved to affect a woman in labour and a child negatively so satisfactory pain relief should be provided. Current obstetric analgesia aims at/seeks for/strives after observing a physiological childbirth process. Epidural analgesia is the safest and most effective method of labour pain relief available today. Epidural analgesia is used in case of pain in labour and delivery, on request of the woman in labour and in prolonged delivery. Epidural analgesia could be also provided in preeclampsy, breech delivery, multiple pregnancy, premature delivery and cardiotocographic abnormalities. Although epidural analgesia is very popular and safe, no complication should be omitted. Good hospital care provided by obstetricians, anesthesiologists and nurse midwives could prevent most complications. Obviously, professional care in labour with epidural analgesia can only be provided by well-educated and experienced obstetric staff. The theoretical part of the thesis deals with information concerning delivery pain and pain relief methods. Together with epidural method, its indication, contraindication and complications, also spinal anatomy is mentioned in this part. All professional and communicative steps of midwife care about the woman in labour with epidural analgesia are described here. To fulfil the aim of the thesis, qualitative and quantitative research strategies were used. The women in labour with and without epidural analgesia were observed for collecting data in qualitative method. The same clients were consequently asked about their information and attitudes to epidural analgesia. Altogether eight casualties were formed. To collect data for quantitative method, the questionnaire of thirteen questions was prepared and send out to maternity hospitals. Eighty-six questionnaires were sent out and twenty- eight (25, 7 %) were sent back. The main aim of the thesis was to find out how available the epidural analgesia in labour is in our maternity hospitals. The next aim was to monitor the women in labour with and without epidural analgesia. The aims were accomplished through the research questions: How available is epidural analgesia used in labour in Czech maternity hospitals? What diffferences are there in labour with and without epidural analgesia? This work can be applied as a source of information for midwife students and nurses.
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GET INFORMATION ORDINARY PUBLIC ABOUT POSSIBILITIES OF TREATMENT OF THROE
LOPOUROVÁ, Klára
BC thesis ``Get information ordinary public about possibilities of treatment of throe`` is divided in two parts. Theoretical part contains the analysis of the problem throe on the basis of literature. This part concern throe, its pathophysiology, kinds, psychological and social sphere, throe evaluation, Christian view of throe perception, treatment of throe from analgetic therapy to alternative therapy. Practical part evaluated the familiarity with ordinary public about possibilities of treatment of throe and what sort of treatment of throe they use.
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Monitoring of the pain of the patient after the operation from nurse´s view
ŠIMÁČKOVÁ, Alexandra
The bachelor paper aims at monitoring pain during the post surgery period and it is concentrated on the attitude of nurse to it. When a nurse is capable of finding out pain, its quality and intensity in the shortest time possible, he/she promotes the comfort of a patient, improves his/her psychical state and can thus help significantly to successful healing of the surgery wound and total improvement of the health condition of the patient. A nurse{\crq}s active attitude to pain monitoring is in her/his own interest. She/he should be able to offer alternative ways of calming pain and to opt for an individual attitude to every patient. The theoretic part describes the origin of pain, its kinds, the nursing attitude towards it and different modes of monitoring of pain.Within the practical part we have set up two goals: to find out whether nurses monitor pain by patients after surgery and whether they use in practice the evaluating scale of pain. On this basis we have set up three hypotheses. H1: nurses at post surgery units monitor pain in patients having been operated on; H2: Nurses have no knowledge on scales evaluating pain; H3: Pain in patients hospitalized at post surgery units is not evaluated according to the evaluating scale. A quantitative method of research was chosen in the form of questioning and data collection using anonymous questionnaires.
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