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Communication of medics with the parents of a child patient.
ŽÁKOVÁ, Nikola
The theoretical part is divided into eleven chapters. The first chapter deals with the definition of communication. The second chapter describes the kinds of communication, including verbal and nonverbal. The third chapter discusses the communication skills of nurses. In the fourth chapter we expanded on the communication of the nurse with a child patient. The fifth chapter describes the basics of communication between nurses and parents of child patients. The sixth chapter discusses a situation where the nurse communicates with parents of a disabled and dying child. The seventh chapter describes the communication of nurses at the pediatric department. The eighth chapter contains the specifics of the children's department. In the ninth chapter is divided into childage. The tenth chapter discusses communication as a part of nursing care. A final chapter describes the process of hospitalization of children and their parents. The thesis is divided into theoretical and empirical parts. Much of the theory is described above whereas the empirical section describes the results of the research. Objectives and research questions The first objective of this thesis was to investigate how the nurse communicates with the parents of a child patient. The second objective was to determine whether a parent understands the information given by the sister and the final objective was to determine any errors that the nurse makes when they communicate with parents of child patients. Research questions: 1. How the nurse communicates with the parent of a child patient? 2. How does the nurse inform parents of a child patient? 3. How a parent of a child patient assesses the clarity of the information provided by the nurse? 4. What mistakes nurse makes in communication with the parents of a child patient? Methodics For the research a survey was chosen to provide qualitative information, which was obtained via interviews. The second methodology used in this work is called participant observation. Data for the first part of the survey was obtained through semi-structured interviews with the parents of hospitalized children. Interviews were conducted on the basis of questions prepared in advance. If necessary, the interview was supplemented with other issues. The interview was to determine how children were admitted to the children's department, what information reached parents about the examination of the child, and also the overall impression of the nurses on the ward. We asked parents about the verbal and nonverbal communication of sisters. They described the errors they found in the communication and behavior of nurses. The second part of the research was anonymous on the pediatric ward of the hospital where nurses evaluated verbal and nonverbal communication skills. The research group The research set for the first part of the survey consisted of seven mothers of children hospitalized in the pediatric ward. The mothers were in different hospitals in the Czech Republic. The research set for the second part of the investigation, which was carried out by observation technique, consists of six nurses employed at the pediatric ward of a state hospital. Nurses were selected randomly. They are of different ages and they have different length of practice and other training.
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Oxygen therapy after cardiothoracic surgery from the point of view of nurses and patients
VRCHOTOVÁ, Klára
Cardiac surgeries are very serious surgical procedures with considerable specific features. This bachelor thesis focuses on oxygen therapy from the viewpoints of nurses and patients. Its theoretical part describes physiology of breathing and the oxygen therapy as such. It describes individual sources of oxygen and indications for oxygen administration. It also describes principles to be observed during oxygen administration. Specific aids are used for oxygen administration, particularly oxygen masks or oxygen goggles. Quality pulmonary rehabilitation is also necessary to make oxygen therapy more effective. Pulmonary rehabilitation is particularly important for patients after a cardiac surgery and it should be practiced even before the surgery. This approach is critical because in the post-surgery period the therapy makes it possible for the patient to breathe and to expectorate properly. Pulmonary rehabilitation is practiced with patients by general nurses at the cardio surgery ward, as well as by physiotherapists. There are various techniques available to determine efficiency of oxygen therapy and pulmonary rehabilitation. The techniques may be classified as invasive and non-invasive; the most frequently used non-invasive method is pulse oxymetry and the most frequently used invasive technique is blood collection for ABR. Two objectives were set for the thesis. The first objective was to map knowledge of nurses about how to provide care to patients treated with oxygen therapy. The second objective was to determine how the patients feel after a cardiac surgery. Two hypotheses and two research questions were formulated. The first hypotheses were: Nurses working at the resuscitation care station have more knowledge about oxygen therapy than nurses working at the intermediate care station. The second hypothesis was: Nurses working at the resuscitation care station have more knowledge about pulmonary rehabilitation than nurses working at the intermediate care station. The first research question was: How do the patients feel during oxygen therapy and pulmonary rehabilitation? The second research question was: How are the patients after a cardiac surgery informed about oxygen therapy and pulmonary rehabilitation? In the research part of the bachelor thesis I have used both quantitative and qualitative research methods. Quantitative processing of data was used for questionnaires filled out by nurses working in the hospitals Nemocnice České Budějovice a.s., Nemocnice na Homolce in Prague and in the faculty hospital Královské Vinohrady in Prague. The method was used for evaluation and assessment of knowledge of nurses working at the resuscitation and intermediate care wards. Quantitative methods were used for processing of data obtained through semi-structured interviews with patients after a cardiac surgery. The data were transcribed and coded using a pencil and paper method. The data were categorized based on the identified codes. Two categories were created: oxygen therapy and pulmonary rehabilitation. Each of the categories was further divided into three sub-categories. Two categories were created for the research oxygen therapy and pulmonary therapy. Three sub-categories were subsequently created for the oxygen therapy and the pulmonary therapy. The quantitative research has shown that the knowledge of nurses about oxygen therapy is higher among the nurses working at the resuscitation care ward. However, the situation is different in case of their knowledge about pulmonary rehabilitation. In this case the knowledge of nurses working at the intermediate care ward was higher. The processed data from the qualitative research have shown that patients do have sufficient information about post-surgery oxygen therapy, as well as about pulmonary rehabilitation. For all patients in the post-surgery period after a cardiac surgery the frequency of pulmonary rehabilitation was higher than 1 per day.
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A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
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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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Coping strategies in children´s fear and pain in relation to nursing care
PROCHÁZKOVÁ, Zuzana
For the nurse, taking care of hospitalized children is important not only pediatric nursing knowledge, personal and social preconditions, but also the theoretical and practical competency of methods and techniques, which are used for identification and effective influencing of pain and fear. The aim of this thesis was to identify the main sources of fear of the hospitalized preschool and young school age children and to find out the effective methods and principles of the cooperation with children, alternatively with their accompanying parents in order to moderate the fear of the small patient. Then the thesis tried to chart the nursing diagnostic and evaluation procedure of the pain and get the most used nursing methods of non-pharmacological pain relief. To obtain the necessary data, the qualitative research was used with a semi-structured interview as a research instrument. The first research group consisted of 12 nurses, the second group consisted of 12 children ´s patients of preschool and young school age. The majority of the asked nurses thinks, that children´s patients are afraid especially of non-familiar environment, then of the awaited pain and of the solitude without parents. However, the most patients said, that they were afraid especially of pain, then of non-familiar environment, restriction of their needs, hostile attitude of the medical staff and of the other neighbouring patients. They were also frightened of the death and of the darkness. Most reported nurses mean, that the most effective solution of the children ´s fear is the friendly attitude of the medics. They also mentioned the fact of taking the focus off the fear and the presence of the parents is also beneficial. The nurses ´ answers were in conformity with patients opinion in two fields - friendly attitude of the medics and taking the focus off the fear. Then the children mentioned abiding of their specifics in connection to falling asleep and the demand of beying treated by the same sister or by few same sisters. All respondents also talked about the benefit of parents presence. Regarding the principles of the cooperation, nurses answered the importance of united medical procedures, especially the proper way of information transfer. Then the respondents nurses mentioned the psychical and emotional support for children and their accompaniments, the atmosphere of confidence and the value of well done education. Also the need of calm, silence and privacy was stated. Unlike nurses, children and their parents regarding to principles of the cooperation prefer the psychical and emotional support, then the importance of enough information was mentioned. The fourth research question bears on the methods used for children pain monitoring. The nurses said, that the intentional interview with the patients or with the parents was used as a main technique, that was stated by patients as well. Research question number five said: What are the most used nursing methods of non-pharmacological pain relief at children? Most responded nurses mentioned the distraction of children attention from the painful incentive, then the importance of physical methods, relief position and purposeful preparation for the unpleasant intervention. Nurses also named the helpful contribution of the parents, relaxing exercises and the method of imagination. Regarding the pain treatment, it was noted, that all patients prefered the analgesic therapy. Then they quoted the distraction of their attention from the painful incentive, the friendly attitude of the medics, using the ice compress and the relief position. In the pain acute phase, children required mostly calm, comfort and privacy. All children also considered the presence of parents as very helpful. The theoretical and empirical part of the thesis are suitable for being studied by nurses taking care of children and it can be helpful for nursing quality improvement at children ´s wards in hospitals.
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Nursing care in a hygienic and epidemiological regime from the patient's perspective.
KŘEPELOVÁ, Lenka
Considering contemporary lifestyle and possibility of travelling imported infections accrued and some illnesses come back that have not occurred nearly at us more. Not only haemorrhagic fevers and other highly infectious illnesses but also hospital multiresistant bacterial strains that mean high risk for patients constitute a threat. The number of nosocomial infectious grows still. The patient is in the case of suspicion or already diagnosed infectious illness isolated and treated in the infectious department or in the tribal department in the room with increased hygienic-epidemiologic regime. The patient is saved in a single room, the possibility of visits is reduced and the staff uses personal protective equipment. The man is holistic being and it can come due to isolation to lack of satisfaction of his/her bio-psycho-social needs. The aim of this thesis is to identify unsatisfied bio-psycho-social needs of patients in increased hygienic-epidemiologic regime and to describe changes in needs of the patient depending on the time of hospitalisation. The theoretic part describes the problematics of infectious illnesses, system of the care for the patient with infectious illness and changes in human needs in the period of the illness. The empiric part of the thesis deals with unsatisfied bio-psycho-social needs of isolated individual through quantitative research. The research suite was made up of 10 patients who were hospitalised in the room with increased hygienic-epidemiologic regime. The survey was carried out in the Hospital Jihlava by semistructured interview and the results of the survey were processed by opened coding by method paper and pencil. It is emphasized that the most needs of the patient have biological, psychical, social and even spiritual aspects. The rate of satisfaction with caregiving depends on the health condition and personality of the patient. Not small influence has the length of the hospitalisation, too. It was found out during the survey that the patients have not enough information about specifics of the care in the infectious department and that is why there is often a misunderstanding of necessity of barrier measures. It is possible to avoid useless misunderstanding through timely and suitable education. It was created an educational material with the title "Guide for patients hospitalised in the infectious department of Hospital Jihlava" for this purpose. Employees of the infectious department of Hospital Jihlava were informed with results of the research during a workshop, too.
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Diets for food allergies
DOBRUSKÁ, Klára
I have chosen topic Diet with Food Allergy as a topic of my bachelor thesis. This illness is quite common these days. It affect infants mostly but allergy of cow´s milk protein of children under three years disappears itself mostly. There is increasing amount of causes when patient suffers more allergies. Number of people who have the most serious reaction the anaphylactic shock, icreeases. It can end with death. Doctors recommend to patients to strictly follow the elimination diet which is basic treatment of this illness. The most accurate diagnosis of illness (immunological or not) is another important factor for effective treatment. I have chosen three aims for this bachelor thesis. First to find out if patients are informed about their illness. Second to map eating habbits of people with food allergy. Third the evaluation of correctness of daily menus. I used approach of guality research. Research group consisted of six respondents with different food allergy. Those respondents wrote down their weeks menus. Menus were evaluated with program Nutriservis and it was assessed if it follows recommended dietary value. Suitable intake of energy and essential nutrients was calculated for every respondent. It was evaluated if respondents follows priciples of rational diet and if their diet contains sufficient amount of minerals and vitamins. Questionnaires were another key point of this research. Questionnaires were about illness know-how of patients and who has instructed them about it. It was found out the patients hasn´t got enough information about their illness and half of them has no idea which essential nutrients, minerals and vitamins could lack in their diet. It resulted from menus simultaneously that five of six respondents do not follow principles of rational diet and eat very monotonously. Only one respondent follows strictly elimination diet others violate diet exceptionally. Respondets would appreciate other research would focus on creation of special centres and training of doctors and nutritional therapist who would be focused on food allergies. Spreading the information about illness not only to patients but to public also is really important. Another important point is to increase amount of books about food allergies at the market.
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Patients satisfaction with the provided services. An important indicator of the quality of health care facilities.
MALANÍKOVÁ, Jana
My master's thesis which topic is "Satisfaction of patients with the services provided. An important indicator of quality of medical equipment " is mainly focused on satisfaction of patients with the services provided in the Hospital České Budějovice, a.s. Furthermore, the mapping focused on overall satisfaction with care in the already mentioned Hospital České Budějovice and on exploring whether patients evaluate the quality of information provided by a medical doctor in this hospital affirmatively and whether they are satisfied with care of local nurses. The satisfaction of patients is an important indicator of the quality of care provided, which has an impact on their status of basic human needs. One main purpose was determined: Monitoring the satisfaction of patients with the services provided in the Hospital České Budějovice, a.s. and this purpose was fulfilled. Quantitative research was executed, to its realization the interview method was used. By means of the technique of standardized anonymous questionnaires on the basis of the above-mentioned purpose,the 3 following hypothesis were verified: 1) Patients are satisfied with the overall care in the Hospital České Budějovice, a.s. 2) Interviewed patients evaluate the quality of information provided by a medical doctor in the Hospital České Budějovice, a.s. affirmatively 3) Interviewed patients are satisfied with the care of nurses in the Hospital České Budějovice, a.s. I processed the data to confirm or refute the pre-established hypotheses. The evaluation of the data was carried out using statistical nonparametric methods, Chi-square test and the chosen level of significance of p=0.05. The results of the research have been clearly processed into the tables and graphs. The program Microsoft Office Excel 2010 was used to process the results.
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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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