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Specifics of nursing care for patients with diabetic foot syndrome undergoing larvae Lucilia sericata treatment - from the perspective of the patient
POLÁKOVÁ, Daniela
Abstract The bachelor thesis titled Specific Aspect of Nursing Care of Patients with Diabetic Foot Syndrome Undergoing Treatment with Lucilia Sericata Larvae ? From Patients? Perspective is divided into a theoretical part and a practical part. The theoretical part focuses on the historical development of Lucilia sericata larvae in medicine, the present use of larvae in medicine, and the analysis of the standard surgical treatment procedure and the larval therapy. The following section of the theoretical part describes the role of nurses in the standard surgical treatment and the larval therapy. The thesis also analyses diabetes mellitus and its complications, and especially the diabetic foot syndrome. The first objective of the thesis has been to determine how much information patients have about the treatment with Lucilia sericata larvae. The second objective has been to present the specific aspects of the care of patiens undergoing treatment with Lucilia sericata larvae. The third objektive has been to determine patients? needs when undergoing the treatment with Lucilia sericata larvae. The fourth objective has been to find out the awareness of nurses of the procedure of nursing care during the treatment with Lucilia sericata. The last, fifth, objektive has been to Compaq the surgical treatment and the alternative treatment from the perspective of patients. In order to find out the results, four patients and four nurses in the surgical ward at the hospital in Slaný were contacted. The research part includes four case reports and four transcribed interviews with the patients who undewent the treatment with Lucilia sericata larvae. The patients answered the prepared sets of questions in inteeviews. Afterwads, interview with four sisters who work in the surgical ward at the hospital in Slaný were conducted. All the patients included in our research group were satisfied with the alternative treatment with Lucilia sericata larvae, although the outcome of the treament of one of them was not satisfactory. Our research suggests that treament with Lucilia sericata larvae has a positive effect on patients and,in addition,according to the findings, the alternative treatment is cheaper and shorter than the traditional surgical procedure. In practice, the thesis could be used as an information and educational material for the method of treatment with Lucilia sericata larvae for patients as well medical staff.
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Lifestyle of diabetic
HYNKOVÁ, Jana
Diabetes is said to be an epidemic of 21st century. Although death rates from diabetes are decreasing, the treatment results are still not satisfactory. Today, every tenth Czech is affected by diabetes, but according to doctors, a quarter of patients do not even know about the existence of their disease.In my thesis I focus on the lifestyle of diabetics. I am mainly concerned about their diet. Another important thing was to find out if they eat regularly, and whether the portions are eaten at regular time intervals throughout the day, as the regular and balanced diet is more important in diabetic patients than in anyone else.My survey has clearly proved that stress significantly worsens the quality of life of patients with diabetes mellitus. On the other hand, there is no evidence that a healthy diet and physical activity significantly improve health condition of patients with diabetes mellitus.
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Verification of glucose assessment analytical method
ILLEOVÁ, Kateřina
The topic of laboratory accreditation as well as validation and verification of analytical methods has been very current in recent years. Because of the serious impact of analytical results of the measurement on practice, it is required that the results of the analytical measurements were as accurate as possible. This paper deals with the verification of the analytical method determination of glucose, as proof of achieving optimum measurement uncertainties. The verification of spectrofotometric glucose determination was performed using the Cobas Integra 800 analyzer by enzymatic hexokinase method. For the measurement in time the control materials of internal quality control were used and for the measurement in series the control materials of external quality control were used. From the measured values we specified the necessary statistical data (the arithmetic mean, standard deviation, the coefficient of variation, bias, yield) and using these we specified the values of combined and extended uncertainty. The combined uncertainties of both samples shouldn't be higher than 10 %, according to the SEKK association. The combined uncertainty of our first sample was 6.81 % and the second one had 6.45 %. The extended uncertainty of the first sample was 13.62 % and the second one had 12.90 %. From these data, we can conclude that the verification of analytical methods for the determination of glucose succeeded.
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Physiotherapy at high amputations as a complication of diabetes mellitus
HAJNÁ, Štěpánka
A topic of this bachelor thesis is "Physiotherapy at high amputations as a complication of diabetes mellitus." Diabetes mellitus is a chronic, etiopathogenically heterogeneous disease. It arises from the lack of an insulin action at its absolute or relative absence and it is accompanied by a complex metabolic disorder of sugars, fats and proteins. Long-term vascular complications, which can lead to an amputation, gradually develop on the basis of this disease. An introductory part of the current state is focused on the characteristic of diabetes mellitus, its classification, risk factors, pathogenesis, course and its complications. The other part is focused on the problem of amputations and the last part of the current state is focused on used examination methods and physiotherapeutic procedures. A goal of the research part was to evaluate a usage of physiotherapeutic methods at patients with the high amputation as a complication of diabetes mellitus and a possibility to integrate these patients into a life in the highest possible quality. I used, for the practical part of the bachelor thesis, methods of the qualitative research, the case study and an analysis of personal documents. The tested sample consisted of two patients with the high amputation, which was indicated because of complications of diabetes mellitus. The patients were monitored during their hospitalization in the rehabilitation ward or in the successive care ward of the hospital in České Budějovice. The results have been worked up in the form of case reports. The health status of all patients was at least partially improved and it came about their better integration into the society. It is therefore possible to say that rehabilitation goals were met. The bachelor thesis can be used in the actual work of physiotherapists or as a basis for their further scientific research. Then it can be used by patients themselves or by their close people in dealing with this handicap.
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Use of Educational Projects in Care of Diabetics
LEOPOLDOVÁ, Lenka
The topic of my thesis is {\clqq}Application of education plans to care of diabetics``. Diabetes mellitus is a disease characterized by a disorder of metabolism of sugars, but also proteins and fats, which leads to increased glycaemia and glycosuria. Education is understood as guiding to independent coping with diabetes and better cooperation with medical staff. It is an inevitable and irreplaceable part of successful diabetes treatment. The thesis is aimed at mapping application of educational plans to care of diabetics. The thesis has a theoretical and a research parts. The theoretical part deals with information on diabetes mellitus, education in general and its specifics for diabetics. The research part involves a quantitative data collection method, namely observation and semi standardized interview. The research took place in a diabetology centre and in a diabetologist{\crq}s office. 10 diabetics, 6 men and 4 women participated. The observation was performed during a diabetic{\crq}s visit to a diabetologist{\crq}s office and involved 18 points divided into 7 areas aimed at the education process phase, education implementation form, education forms, diabetic{\crq}s theoretical and practical skills, educational environment and others. Interviews were performed after the medical consultations. The interview contained 37 questions, 18 of which offered choice of reply and possibility to ask an additional question. The remaining 19 questions were open. The interview questions focused on treatment regime, satisfaction, knowledge and skills of diabetics. The first goal was to find out how education benefits a diabetic. The second goal was to map whether diabetics can use the obtained information and skills in their everyday life. The third goal was to learn about educational forms and methods used by the diabetologist and in the diabetology centre. The fourth goal was to create an educational plan and test it in practice. The goals of the thesis were met. All the research questions were answered. The research part thus shows that education is beneficial for diabetics, they apply the obtained information and skills to their lives, the educational methods and forms are identical in the diabetology centre and at the diabetologist. The thesis may be utilized as evaluation of effectiveness of education performed for diabetics and the basic content of diabetes mellitus and education.
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The nursing care for the patients with "diabetic leg" after using SONOCA 180 in combination with the damp healing technic
VÍTÁMVÁSOVÁ, Kateřina
Abstract The Bachelor Thesis ?Treatment for ?diabetic foot? after application of SONOCA 180 apparatus in combination with wet healing technique? is divided into a theoretical and a practical part. The theoretical part analyses the development of wound healing from history to present. It also describes diabetes mellitus disease, its classification and complications. The issue of diabetic foot syndrome we are dealing with in the Thesis is related to diabetes mellitus. The disease may be treated traditionally or applying modern methods, which include the ultrasound apparatus SONOCA 180 and wet healing of wounds. This ultrasound technique combined with wet healing of wounds is the main topic of our thesis. The practical part involved a qualitative research method ? semi-controlled interview and case studies of patients with diabetic angiopathy, who were treated by the SONOCA 180 apparatus combined with wet healing of wounds. We applied the method to a patient with diabetic angiopathy, who had been treated traditionally. We first prepared the case studies and then we talked to them about selected topics. We prepared 14 questions that directed our interviews. Patients hospitalized at the surgery ward or visiting the surgery outpatient room of České Budějovice Hospital were the respondents; we spoke to 4 patients A semi-controlled interview was conducted with 5 nurses of the surgery ward of České Budějovice Hospital. The interview consisted of 10 questions and dealt with the topics of diabetic foot syndrome treatment, SONOCA 180 ultrasound method combined with wet healing of wounds. The aim of the work was to discover the effect of SONOCA 180 application in combination with wet healing on treatment of wounds. The second goal was to find out the differences in healing after standard treatment and after application of this technique and to find out the opinion of patients on the technique. The research among the respondents showed that SONOCA 180 greatly contributes to healing of wounds, but it has individual effect on each patient. SONOCA 180 provided quicker healing of wounds than the traditional method, but the treatment as a whole also depends on the patient?s health condition, the appearance of the treated defect and the phase of healing. Our Thesis might serve in practice as a guide for closer familiarization with the SONOCA 180 apparatus in combination with wet healing of wounds and thus provide the clients with the diabetic foot syndrome with more information on this method, and medical staff with wider knowledge of this new technique. This is why a brochure (Annex 15) was prepared to inform patients and medical staff on the SONOCA 180 apparatus and wet healing of wounds.
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Kinesiotherapy of diabetes mellitus
CHALUPSKÁ, Tereza
My bachelor thesis is focused on kinesiotherapy in diabetes mellitus with focus on type 2 of the disease. Diabetes mellitus is a chronic whole-life disease leading to high morbidity, disability and mortality. A patient with high glycaemia level fluctuation and variable inadequate body mass (and further decompensation indicators) overburdens his/her organism and does not contribute to postponement of occurrence of cardiovascular, neuropathic, nephropathic, retinopathic and other problems. Adequately selected kinesiotherapy help people with diabetes mellitus compensate this disease. The theoretical part deals with diabetes mellitus in general and discusses physical activities focused on diabetes mellitus. The practical parts processes four case reports (women with diabetes mellitus type 2 diagnose) in the form of qualitative research. The first three respondents take regular exercises in groups divided according to physical and mental ability. The fourth respondent does not participate in any physical activity in the groups. Anamneses were found out through semi controlled interviews. Check-up results (dynamic examination of spine, anthropometrical examination, goniometrical examination, examination of shortened muscle groups, examination of weakened muscle groups, hypermobility examination, neurological examination, measurement of heart rate and blood pressure, determination of glucose concentration and HbA1c) were collected by direct observation. The aim of the work was to provide a theoretical outline of kinesiotherapy possibilities in diabetics, to map the forms of physical activities among diabetics and to evaluate efficiency of the individual physical activities of diabetics. Personal interest and active approach to physical activity regime are the main preconditions to successful kinesiotherapy in individuals suffering from diabetes mellitus. In the instance of individual and purely personal goal a suitable form of physical activities can be found for diabetics and thus contribute to compensation of the disease.
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The specific approach to diagnostic imaging methods in patients with diabetes mellitus
KLIMEŠOVÁ, Jitka
Diabetes mellitus occurs as a result of absolute or relative lack of insulin. It is a chronic disease which can lead to damage of other systems and organs. Number of patients with diabetes mellitus undergoing medical examinations or interventional therapy by the diagnostic imaging methods has been increasing. It brings higher demand on technical parameters of the methods and more exact work of medical staff. Examinations connected with administering contrast media can cause many complications to these patients and the routine examination can be changed into the dangerous one. The position of a radiological assistant has become more responsible. The aim of this Bachelor´s work was to outline diagnostic options while examining patients with diabetes mellitus and consider using diagnostic imaging methods as the administration of diagnostic contrast media can be risky for the patients. Twenty six per cent (236 patients) out of 918 patients with diabetes mellitus type 1 or type 2 who visited the Diabetological Centre and the Department of Radiology of the Hospital in České Budějovice were examined by some of the diagnostic imaging methods. Adult diabetic patients underwent these radiological examinations: 188 skiagraphies of lungs, 119 skiagraphies of skeletons and 18 examinations under skiascopic control. Forty-four patients were examined by the sonography, 10 by the mammography, 110 by the computed tomography, 9 by the magnetic resonance and 10 patients by the angiography. Most diabetic patients were examined by common skiagraphy of arms and legs, sculls, vertebral columns due to injuries, fractures and degenerative changes. Skiagraphies of heart and lungs were indicated before and after operations or they preceded applying an insulin pump. The other numerous group was made up by patients with tumours. They were mostly examined by computed tomography. Fifty-seven patients developed complications caused by diabetes. The examinations of carotid arteries, cerebral arteries, arteries and varicose veins in the legs were carried out by sonography, computed tomography and magnetic resonance. In six cases diagnostic angiography was followed by percutaneous transluminal angioplasty. The use of contrast media in 64 patients was also considered. In all cases non-ionic contrast media of low or medium osmolarity in the volume of 80 {--} 125 ml were used. The findings compared with those presented in literature proved the hypothesis that radiological assistant work requires a specific approach towards the diabetic patients.
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