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Degree of difficulty in performing activities of daily living in patients with rheumatoid arthritis
KAAS, Jiří
Theoretical foundation: Rheumatoid arthritis is a chronic system disease manifesting itself particularly by inflammatory joint impairment. The main problems confronting daily the patient include pains of the motor system and fatigue. The disease has typically long, progressive development, and although it does not cause directly the patients' death, it reduces their life by some ten years on average. The serious character of the disease consists in the fact that the motor abilities of the individual are gradually impaired. At the beginning the patients must avoid major physical activity, often give up their hobbies and sometimes even their jobs. In the most serious cases, the disease may even prevent the patients from performing basic self-service activities. Goal of the thesis: The goal of the thesis consists in mapping the level of problems of rheumatoid arthritis patients at performing daily activities. Hypotheses - H1: Rheumatoid arthritis patients feel discomfort when performing common daily activities, H2: Rheumatoid arthritis patients make use of supporting and compensation aids when performing common daily activities, H3: Rheumatoid arthritis patients make use of another person's assistance when performing common daily activities. Methodology: The research part of the thesis was implemented based on quantitative inquiry within the grant Project No. 120/2012/S ?Reflection of life quality in nursing?. The actual research made use of HAQ standardized questionnaire, distributed among the rheumatoid arthritis patients. The size of the research set was set at 200 rheumatoid arthritis patients from all over the Czech Republic. The respondents were chosen based on quota selection, striving to observe the proportion of men to women at 3:1, i.e. 150 women and 50 men. When searching the respondents, organizations associating patients with the respective diagnosis were first approached. All results obtained were statistically processed in the SASD (Statistical Analysis of Social Data) program. Descriptive statistics were used. Results: The results can be divided into three areas, by the related hypotheses. The first part of the results gave information on the degree of discomfort felt by the individuals when performing specific common daily activities. It was found out that the patients see the most difficult activity in taking down an item from a place above their head and bathing in the bathtub. The second area brought information on the aids used to perform common daily activities. The respondents named dressing aids or handgrips at the bathtub most frequently. The third and last area brought the answer to the question what activities require another person's help. The patients named reaching or opening of things most frequently. But an essential part of the patients stated not to need any help of another person in common daily activities. Based on the results, the hypotheses were evaluated as follows: H1 - Rheumatoid arthritis patients feel discomfort when performing common daily activities - confirmed, H2 - Rheumatoid patients make use of supporting and compensation aids when performing common daily activities - confirmed and H3 - Rheumatoid arthritis patients make use of another's person when performing common daily activities - not confirmed. Conclusion: The thesis provides a detailed and comprehensive view on the issues of performing common daily activities in rheumatoid arthritis patients. The results can be used both by practical nurses and by students of nursing and related disciplines. The thesis can also constitute foundation for further research. The thesis results will be also presented and published.
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The position of nurses in internal expert outpatients{\crq} departments.
ŠŤASTNÁ, Věra
This bachelor thesis deals with the position of nurses in internal expert outpatients{\crq} departments. The current position of nurses in the internal outpatients{\crq} departments is special and demanding. We cannot imagine how the health care service would work without them. An outpatients{\crq} nurse has several tasks that she should master and carry out smoothly {--} it is the role of an educator, an attorney, a manager, a provider of health care, a mentor, a researcher and a carrier of all changes. The relation between the doctor and the nurse is also highly important; it should be friendly, considerate and mutually respectful, and their cooperation should be based on equal rights. Internal outpatients{\crq} department provide health care to patients with various diseases of internal organs. Nurses are a significant part of the medical team. The departments serve as places of the first contact of the client with the medical staff. Professional approach and communication with the patient are expected. A quality medical and nursing care is unthinkable without communication between the client and the nurse. Patients vary in their behaviour and reactions but certain manifestations of behaviour are common to certain groups of people. The objective of my work is to find out the position of nurses in selected internal expert outpatients{\crq} departments. In order to fulfil this objective I applied the qualitative research. The method of collection of data consisted in half-structured interviews with 35 standardized questions carried out with nurses in selected internal outpatients{\crq} departments. The interviews were completely anonymous. Three nurses were interviewed in every selected internal outpatients{\crq} department. The whole research was carried out in the Motol University Hospital in Prague. 9 nurses took part in the research (3 nurses from the department of diabetology, 3 nurses from the department of endocrinology and 3 nurses from the rheumatologic department). The interviews with nurses from individual outpatients{\crq} departments were the basis of case histories. Those served as the research groundwork for elaboration of 11 categorizing charts that summarize the most important results of the research. Thanks to our research findings and meeting the objective of our research we found out that the position of nurses in selected expert internal outpatients{\crq} departments is good though financially undervalued. High demands, mainly in the sphere of communication with patients and other medical staff, are placed on them. The research further showed that the nurses mainly work as educators and their job description mostly consists in administrative and nursing work. They have adequate working conditions. They also provide information to patients orally as well as by means of practical demonstrations. On the other hand, nurses in outpatients{\crq} departments suffer from more displays of stress.
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