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Role of the nurse in screening for depression in the elderly.
VRZALOVÁ, Monika
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.
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The role of nurses and their impact on the care of patients with total hip arthroplasty.
SLABÁKOVÁ, Květoslava
Total hip replacement is one of the most extensively and highly effective operating methods in orthopaedics. The patients are brought back the self-sufficiency, life without the pain and noticeably motion restriction. Irreplaceable function here is a role of the nurse, who helps the patient to return back to his common life...The aim of this work was to find out, how the patients feel the role of the nurse and its influence to given nursing care before and after the total hip replacement as the less fulfilled. There were following research questions set: How the patients feel the role of the nurse before and after the total hip replacement? How the patients before and after the total hip replacement feel the interpretation of the nurse roles? How the patients before and after the total hip replacement feel the role of the nurse and its influence to given nursing care. Which of the nurse roles are felt by the patient as the unsatisfactory in postoperative care? The patients before and after the total hip replacement feel through the everyday nurse activities the nurse in her role of the caregiver and education giving person, following the nurse vindicator and the nurse bearer of changes. The patients feel the care thanks these roles as a quality, holistic and continual. Nevertheless was the role of the education giving named as the least fulfilled. In connection with these research results was created a manual, a Guide book for the patients before and after the total hip replacement. This Guide book was given to testing purposes. This Guide book was appreciated by the patients very positive despite a large amount of information, which were surprising for many of them. We gained some data, which gave the impulse to complete the information in the Guide.The created Guide book can´t replace the effective communication of the patient with the medical staff, which could be always the most suitable "source" of information.
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Lifestyle of patients with peripheral arterial disease before and after surgery
REZKOVÁ, Helena
Theoretical background: Peripheral arterial disease is a serious disease of Loir limb arteries which originates from atherosclerosis. The theoretical part deals with the lifestyle. There are mentioned basic risk factors of chronic forms. Further described are the pathophysiology changes generated on the basis of atherosclerosis and related causes for the origin of the disease. Subsequently there are explained methods of classification, developed clinical symptoms, diagnosis and therapy. This section also looks at the role of a nurse in the care of patients with peripheral arterial disease. Objectives: The aim of this work was to evaluate how patients with peripheral arterial disease changed their lifestyle after invasive vascular surgery. There were provided the following research questions: How do patients with peripheral arterial disease approach to the prevention of risk factors? What is in patients with peripheral arterial disease the main impuls for the possible change of their lifestyle? What influences surgery patient's attitude to risk factors for peripheral arterial disease? How crucial is a lifestyle change in patients after surgery for peripheral arterial disease? Methods: The theoretical part is processed using expert sources. The empirical part of the theses was processed using qualitative research. The chosen technique for data collection was semi-structured interviews with patients, with prepared open questions. The research was done in several phases - the first interview was conducted at the patient admission department (before surgery), followed by the next phase after three months, and 6 months after surgery. The interviews were recorded on a prepared form, then transcribed into electronic form and analyzed by open coding method. Results: The research showed that surgery can sometimes be triggered by changes in the patient's lifestyle. The first interviews in the preoperative period focused on how respondents felt, what was their lifestyle before surgery for atherosclerotic changes of the lower extremities. One of the questions was focused on patient knowledge about risk factors for the development of PAD and possible prevention. The second phase of interviews took place 3 months after the surgery. It dealt with the question about the respndents´ lifestyle, the respondents in the postoperative period, whether there were any changes. Some positive changes occurred in eating and there were some changes in doing physical activity. The third stage was carried out six months after surgery, again in order to detect changes in lifestyle. Minor changes came in smoking habits, the issue of diet and physical aktivity. Questions were also focused on the psychological level. We found out who helped patients and what was most motivating in implementing changes. In the conclusion/summing up question the patients marked themselves ow they managed to make a change. Conclusion: The number of patients with peripheral arterial disease and other cardiovascular diseases is increasing. The basis is the start to modify risk factors, namely tobacco use,dietary habits, physical activity. The medical staff members participate on changes in patients´ lifestyle by appropriate education. The problem occurs when the patient despite the support of close people can not cope to carry a twist in their life. There should a medical staff member offer a professional help to deal with this important step. Practical use: The aim is to draw attention to the expansion of education about lifestyle changes for patients diagnosed with PAD also in the postoperative period. Patients who are released to home care should receive enough information that would convince them to change their attitude towards their health, and that surgery is only one of the ways to prevent further attacks and complications. Results can improve communication with patients and focus on increasing their awareness and possibly offer assistance.
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Nursing care management of patients after intrapleural chemical pleurodesis
KIESEWETTEROVÁ, Renáta
The pleurodesis is a treatment method for patients suffered from the symptomatic malignant pleural effusion. The goal of the pleurodesis is to close a pleural area by connection of visceral and parietal pleura in order to reduce or terminate production of pleural effusion. The sterile talc powder is the world's most used agens within a practice. After a parental analgesic is the powder (as a sllury) either applicated into a pleural cavity through the chest drainage or surgically dispersed over the treated (via abrasion, decortication) pleural space during the thoracoscopy/thoracotomy. This diploma thesis focuses on the treatment technique of bedside talc-pleurodesis through the chest drainage. The nurse has an irreplaceable role in the whole process from a preparation of patient to assistance by intrapreural application, to care of patient after the operation or serves as a physical support during potential complications. The aim of the presented work is to detect priorities in nursing care and find out whether patients need increased care after intrapleural therapy. The qualitative research method was chosen for the analysis where semi-structural interview with open questions were used. We created case reports analysed with the adaptive model of Callista Roy as well. The research sample contained patients chosen with respect to specialization of researched problem. We set two basic focal stimuli according to the analysis of respondents´ reactions. These stimuli serve as a basis for determination of priority parts of the nursing care by patients after bedside pleurodesis. We defined the need to be without pain and the need to ensure safety and certainty as a central focus of the nursing care. Among secondary fields of nursing care were identified sleep disturbances and limited mobility, which leads to reduction of self-care in getting dress, hygiene as well as in defection and miction. We found out within the second goal identical intensity of the nursing care before and after bedside talc-pleurodesis. This statement is based on comparison of interventions before and after aplication analysed via adaptive model by Roy. Nevertheless, causes of interventions were modified to a certain extent. The main goal of diploma thesis was to map requirements for high-quality nursing care related to bedside talc-pleurodesis via chest drainage. The work should extend theoretical basis not only for nurses in clinical practice.
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The need for security and safety in connection with a planned surgery with the patient's perspective and nurses
BOHDALOVÁ, Jaroslava
A planned operation performance always affects patient´s needs for assurance and safety. It is important to provide necessary information connected with the planned operation performance itself so that the patient can feel assure and safe. The key role for the patient and her/his needs for assurance and safety is in general nurse´s hands because she is the closest person to the patient and can help to inspire her/his needs for assurance and safety with konfidence best through the aid of her knowledge and skills that she should have as well as through the aid of her attitudes. The target of the thesis was to find out how a planned operation performance affects patient´s needs for assurance and safety and how a general nurse inspires patient´s needs for assurance and safety connected with a planned operation performance with confidence. The following research questions were stated: How does a planned operation performance affect patient´s needs for assurance and safety? How does a general nurse affect patient´s needs for assurance and safety connected with a planned operation performance to inspire her/him with confidence? What is insufficient in filling patient´s needs for assurance and safety before a planned operation performance? How can a general nurse help a patient control her/his fear and state of anxiety related to a planned operation performance? The method qualitative research with the use of depth interview was used to figure out the investigation. The respondents were willing to record the interview which were verbally rewritten and then subjected to the contents analysis by the method paper and pencil. From the research it is clear that a planned operation performance affects patient´s needs for assurance and safety in a negative way disregarding to her/his previous experience. Patient´s worries and negative feelings can be eliminated by a general nurse who treats her/him as equal, taking up an individual approach, informing her/him about all performances and proceedings, having a calming and welcoming way of communication, using empathy and listening as well as trying to meet patient´s wishes according to her possibilities. The research reveals the advantage of patients´ readiness for planned operation performances. Patients can learn it in the framework of educational proceeding in the out-patients´ department at the same time when they learn that they are going to be operated. The research also shows that general nurses do not have enough knowledge in the sphere of therapeutical communication. The results indicate that it would be suitable to start educating patients as soon as it is known how their disease will be solved and treated in order to reduce the negative impact of surgical treatment to patients´ needs for assurance and safety. General nurses should complete their knowledge and skills to be able to help patients to cope with their difficult life-situation. On the basis of the research investigation and after the consultation with the senior nursing officer, the training course will be organized. The topic of the training course will concentrate on communication with patients before planned operation performances with a view to therapeutical communications and therapeutical interviews. Other discovered facts, for example, the lack of information provided to patients and possibilities regarding better patients´ readiness for planned operation performances will surely be solved by the hospital management.
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Role of physical activity in the prevention of childhood obesity
VRTALOVÁ, Jana
The thesis deals with physical activity in the prevention of childhood obesity. It is focused on children, namely pupils of the eighth and ninith grades of elementary school. Obesity is responsible for more human lives than both of the world wars and if we want this epidemic of obesity and problems associated with inactivity minimized, we have to start where it is most efficient and that is with children. The main objective is to explore physical activity in a selected group of pupils. Partial aim is to determine the prevalence of overweight and obesity in the investigated group of students using somatometric measurements in the selected location. Another objective is to determine how many of childrens parents did sports in the past or actualy do sports. The final goal is to prepare educational material for students about the importance of physical activity. The work is divided into two parts theoretical and practical. The theoretical part was compiled as a secondary data analysis. Sources of data and information originated from the Czech Republic and abroad in the form of scholarly books, journals and electronic resources. The contents of the theoretical part is focused on explenation of terms such as obesity, its consequences, complications, ways to prevent obesity, physical activity, appropriate kinds of physical activity and its effects on the human body. Distinctive part is the chapter dealing with the myths of obesity some of them are really surprising. The second part is practical part and includes its own research. The investigation was conducted in a primary school Komenského alej in Žatec for pupils of the eighth and ninth grades. File featured 107 pupils. The research was conducted as a quantitative survey complemented by measurements of somatometric indicators. The data were collected using a custom non-standardized questionnaire. The questionnaire contained 14 questions and two columns separated by line for recording the exact weight and height. We checked these data at pre-agreed periods.
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Students´ motivation for the work in social sphere
DUCHOŇOVÁ, Kristýna
The topic of this bachelor thesis is the motivation of students to work in the social sphere. Selecting a domain is an important milestone in the life of each of us, the aim of the work is to determine what factors affect the young person during the election field with a social focus and how his motives during his studies and during his practical experience varies.The work is divided into two parts, theoretical and practical. The theoretical part describes the social work and its history, definition, ethical standards and goals. The work deals with the role of a social worker and describes his competence. Presents preconditions for occupational choice and the factors that influence this choice. It also deals with motivation, defines it and acquaints us with concepts such as motive, value or need. Work is affected by motivation theories and recalls the hierarchy of needs of Maslow. In the seclusion does not stay the work motivation in helping professions, questionable motives or burnout, which occurs currently in the social sphere more frequently than in other sectors. The practical part is focused on quantitative research, when the survey begins with primary school pupils who have just chosen their future focus. This part aims to determine what percentage of these students opted for the social sphere and what lead to this decision. Further quantitative research conducted among high school and college students who attend branch with a social focus. Here, the work reveals the most common and most important motives of students, satisfaction with the chosen field of study and their expectations of future studies and career. Here we will also learn how many students want after graduation stay in the field. In the practical part there is also a qualitative research, which complements the whole job. Semi-structured interviews are conducted with students, but also with a social worker. These respondents describe us closer their motivation for working in the social sphere. According to the results which this research brought, it can be stated that most of the students choose a subject with a social focus to have the opportunity to help the others. But is true that many students are choosing a school prematurely and are influenced by the place of residence, their friends or the nature of the study, most of these people don´t know what they can expect from the field and are often discouraged during their studies. From this work could in practice benefit pupils and students who decide for the field of social affairs. For teachers working in schools where the research took place,could this work serve as a feedback. Especially the part which describes the differences between expectations and reality can be used.
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Methodist School-Based Prevention and his Role in Practical Elementary School and Special Elementary School
HAVLÍČKOVÁ, Markéta
The diploma thesis focuses at a theme of Methodology of school prevention and its role at the specialised primary school. The theoretical part is split into four main chapters which refers to the education system of children with need of special educative care in the Czech Republic. It defines socially pathological aspects including risk behaviour with its prevention. The last chapter describes primary prevention at schools using a minimal preventive program and work of a methodologist of school prevention. The practical part contains a quality-type research based on semistructural interviews with methodologists of school prevention at chosen specialised primary schools. The first task of my diploma thesis is to find out what advise parents need and ask for the most. The other task is to find out what aspects a methodologist of school prevention has to take into consideration during issuing a minimal preventive program. The questions have been asked in the way to find out how cooperation at the level of prevention between parents and specialised primary school works, and who else among school staff except of a methodologist participates in the issuing a minimal prevention program. I have contacted sixteen specialised primary schools in the South Bohemia region for the interview. Ten have replied, but only six of them were willing to cooperate further. Two of the schools are located in the regional city, the other four are from smaller cities of similar sizes. Interviews were carried out with methodologists of school prevention and questions were focused at the cooperation at the level of prevention between parents and specialised primary school, and possible influence of location of the school which could be reflected in the minimal prevention program.
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Management styles and their relation to the satisfaction of employees
GRAMANOVÁ, Kamila
Abstract - Leader empowering behaviours and their relation with worker's satisfaction Current state: Nurse's work is physically and mentally demanding. Adequate knowledge and skills are also needed. Nurse managers whose leader empowering behaviours administer to good functioning of medical institutions have therefore a crucial role. In these days a monitoring of job satisfaction is an upcoming matter. According to that we can look for drawbacks and problems and take corrective actions. There is a 9th year of the nationwide research of safety and satisfaction of employees of Czech hospitals. Aim: The first aim of the research was to find out what leader empowering behaviours are used the most by nurse managers. The second aim was to find out how leader empowering behaviours influence satisfaction with work conditions of nurses. Two hypotheses were given. The first hypothesis postulated that nurse managers use democratic empowering behaviours the most. The second hypothesis postulated that satisfaction with work conditions of nurses is changeable, depending on leader empowering behaviours. Methodology: A quantitative method of data capture was chosen. Non-standardised questionaires with 30 closed questions were given out. There were four questions at the beginning to identify respondents. Other set of 15 questions was focused on recognition of leader empowering behaviours. Satisfaction with work conditions was monitored in the last set of questions. Results of the research were processed into graphs and tables. Research set: The research set included nurses working under nurse managers in inpatient wards in České Budějovice a.s. hospital. The questionaire was appropriately filled in by 112 nurses, corresponding 74,7% recoverability. This was used to complete the aim of this thesis. Results: Results of the thesis were divided into two sets. The first set of questions aimed on leader empowering behaviours of managers under whom the questioned nurses of particular departments work. Democratic empowering behaviours were evaluated the most used, according to the first hypothesis. The second set of questions aimed on satisfaction with work conditions. The highest job satisfaction was reached with democratic empowering behaviours. Autocratic, liberal and nonspecific empowering behaviours were used in minimal degree and nurses reported lower job satisfaction among these behaviours. Therefore the second hypothesis was also confirmed. Conclusion: The research pointed out that leader empowering behaviours are one of the factors that influence job satisfaction. It is positive thing that an interest and research in this area increased in the last decade. Periodic evaluation of job satisfaction enables monitoring the direction of its values. According to the survey, a newsletter with recommendations for nurse managers was formed. This newsletter pointed out pros and cons of leader empowering behaviours.
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Strategie oplozování u ryb s vnějším oplozením
SIDDIQUE, Mohammad Abdul Momin
Morphological properties, species specific differences, development, and function of egg envelopes are of importance for a better understanding of fertilization strategies as well as for captive reproduction. We reviewed morphology and the developmental stages of egg envelopes, mechanism of polyspermy block, and also the role of micropyle and cortical granules in polyspermy block for acipenserid eggs. The structure of the egg envelope is similar among the acipenserids, comprising an external envelope (thecal cells, basal lamina, and follicular epithelium), a five-layered oocyte envelope (adhesive layer, alveolar layer, epilayer, and zona radiata externa and interna) and a layer of oocyte matrix and cortical granules. The development of acipenserid egg envelope within the ovary comprises five stages, with further changes following fertilization. Moreover, we standardized the terminology used to describe the egg membranes which can minimize the confusions and be helpful for future work on acipenserids eggs as well as for other fish species. The sperm to egg ratio (required to fertilize eggs) and effects of pre-incubation of eggs in freshwater before fertilization were studied to standardized fertilization protocols for sterlet Acipenser ruthenus. Pre-incubation time had no effect on fertilization success at 430,000:1 and 43,000:1 sperm to egg ratios, while it was significant at the 4300:1 and 430:1 ratios. The use of adequate experimental suboptimal sperm to egg ratio revealed a positive effect of pre-incubation time, such that at the 430:1 ratio, 0.5 min pre-incubation increased the fertilization rate than 10 min. Transmission electron microscopy showed that pre-incubation of eggs in water for <10 min did not trigger a cortical reaction, suggesting that a low sperm to egg ratio 0.5 to 1 min pre-incubation of eggs in freshwater prior to fertilization can enhance fertilization rate of sterlet (minimally do not change fertilization). The effects of pre-incubation in seawater and the duration of egg receptivity were determined for fresh and over-ripe sea bass eggs. Our results revealed a significant effect of pre-incubation time for both the fresh (P < 0.01) and over-ripe eggs (P < 0.01). The fresh eggs had a higher fertilization success than over-ripe eggs. Fertilization success of eggs significantly declined for both of these treatments after 3 min of pre-incubation clearly indicated that sea bass eggs are able to be fertilized by sperm for up to 3 min after release into seawater. Effects of pre-incubation of eggs and activation medium on the percentage of eyed embryos for Ide Leuciscus idus were examined. At the eyed-egg stage, pre-incubation time was significant for the freshwater activation medium (P < 0.001), such that the percentage of eyed embryos declined across the pre-incubation time gradient. Activating medium had a significant effect on the percentage of eyed embryos for each pre-incubation time (P < 0.05). More precisely, freshwater produced the lowest percentage of eyed embryos at all pre-incubation times, whereas saline water and Woynarovich solution produced the highest percentage of eyed embryos at 0 s and 30 s before incubation. Examination of sperm traits showed no impact of activating medium on computer assisted sperm analysis parameters. Our results suggested that saline water or Woynarovich solution improve fertilization rate in Ide during fertilization. In conclusion, this thesis provides basic knowledge on gamete biology, role of egg receptivity period, effects of pre-incubation of eggs and different activating medium which can be useful to understand the fertilization strategies of different externally fertilizing fishes as well as standardize their fertilization protocol for captive reproduction.
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