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The Role of a Nurse in after care about bariatric patient
DUŠIČKOVÁ, Tereza
Current status Obesity is a disease characterized by the increased proportion of fat in the body over a certain limit (Müller 2009). According to the World Health Organization in 2014, more than 1.9 billion people suffered from overweight, of which more than 600 million people were obese (WHO 2015). Subject The aim of the work is the definition of competence nurses have in the aftercare of bariatric patients. Determination of preparation, care, patient awareness and procedures for patients undergoing bariatric treatment. And findings of specific needs of bariatric patients undergoing treatment for obesity. Three research questions have served towards these targets: What competences do nurses have in the aftercare of bariatric patients? How are patients informed throughout the bariatric treatment? What are the needs of patients undergoing bariatric treatment of obesity? Methods Qualitative research techniques were used to obtain the necessary data for the practical part. The practical part was realized through individual semi-structured interviews with nurses working on surgical wards and patients who had undergone bariatric treatment. At the beginning of each interview, the nurse and the patient were apprised of the reason of the research conducted and were assured of anonymity in the processing of the dialogue. The central theme was the assertion of nurses in the subsequent care of bariatric patients and to determine the specifics of these patients. Participants The sample consisted of nine nurses working in a specialized center, where bariatric procedures are performed and seven patients who had undergone bariatric surgery. The survey was conducted from February to March 2015 Results: Before the operation patients undergo surgical, internal, nutritional and psychological examinations. Blood is collected for hematological and biochemical laboratory tests. Among other examinations clients go through gastroenterology, pulmonary testing, also examination in a sleep laboratory and swabs are taken from the throat and nose. Before the particular operation clients should reduce weight on a doctor's recommendation. It was also found that patients are informed about the preoperative and postoperative care, as well as about the need for dispensarisation, the frequency of follow-ups and possibilities of participation in bariatric clubs and associations. Nurses cover the following competences. Before the surgery, the nurse educates the clients about the preoperative and postoperative care, takes their blood, fulfills what the doctor prescribes and motivates the patient. After the surgery, the nurse provides general nursing care, monitors physiological functions, and educates patients about their diet and carries out the doctor´s prescriptions. The nurse must know the dietary restrictions, when it is determined by the general procedure, which varies in some detail according to the type of surgery and the patient's condition. The research showed that nurse cares more about the biological needs of the patients, rather than their psychosocial needs. Patients lack psychological support and motivation in aftercare. Patients undergoing bariatric treatment need to prepare for surgery (weight loss) and acquire post operation eating habits. Their other needs are psychological support and motivation conveyed by nurses. Conclusion: As the number of people suffering from overweight and obesity at present is constantly growing, obesity treatment becomes a necessity. Currently, bariatric surgery is widely used for patients suffering from obesity of the II. and higher degree, so it is advisable to know the needs, knowledge, practices in patient care before and after such an operation and, ultimately, which competences do nurses have during them.
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The resuscitation issue from the perspektive of a nurse working in the subsequent care hospital
HOLÍKOVÁ, Sandra
Cardiopulmonary resuscitation is a complex of procedures that are carried out at an acute stage when afflicted patient?s life functions have been failing and the resuscitation is aimed at his/her life saving. These efforts to save a man are as old as the mankind itself. Over time those procedures were getting better and they were given a certain order i.e. method. Nowadays those procedures are summarized in the so called ?Guidelines? that are accepted as established rules to carry out the resuscitation. This work?s title sounds ?Resuscitation Problems Perceived by a Nurse Working in Subsequent Care?. Theoretical part of the work is divided into four main chapters. The first section explains the definition of subsequent care. It describes a sort of provided care, an indication of admission to a bed of subsequent care and patient types who are admitted to these departments. The second section is concerned with a geriatric patient who is admitted to those beds the most frequently. The third section is focused on the resuscitation itself. The history of resuscitation is described here in brief, its dividing, particular components at the resuscitation performance, legal responsibility of employees working in health service in relation to the resuscitation and principal alterations in Guidelines 2010. The last section is aimed at solution of the resuscitation particularity with older people. Practical part is consequently focused on a research of status of nurses? resuscitation knowledge. An investigation was executed based on research which was composed of a questionnaire, an observation and an internal audit. The goal of the work was to find out whether nurses were familiar with the cardiopulmonary resuscitation procedures and further to ascertain whether nurses adhered to the principles of cardiopulmonary resuscitation. To match the above goals hypotheses were set, i.e. hypotheses being engaged in nurses? knowledge concerning the resuscitation. Those hypotheses were confirmed in term of the theoretical viewpoint. However, they were disconfirmed in term of the practical viewpoint. The nurses know the theoretical resuscitation procedures and aids very well but they aren?t able to utilize this knowledge practically. The hypothesis was confirmed that the nurses keep the aids applied for resuscitation at their disposal. Appropriate results were worked up into graphical appearance by help of charts. Information resulting from this work will provide service to management of the Subsequent Care Hospital Hospice Horaždovice s.r.o1. Based on those findings, the resuscitation standard was worked up which should improve the nurses? knowledge of resuscitation. The biggest shortcomings were discovered in the area of breathing practice and airways safeguarding. At the same time, the regular nurses training of resuscitation will be better focused thereon in this hospital. Just big shorts were found out in the practical area of resuscitation performance. 1
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Specific use of art therapy in the aftercare center
PODZIMKOVÁ, Petra
This work focuses on the concept of art therapy in Aftercare center, in the service of dealing with follow-up care for people who are recovering from addiction, especially on non-alcohol drugs. Given topic is treated in the theoretical and practical. The theoretical part of the paper summarizes the basic definitions related to drug addiction and dependent personality description, followed by an after-care services and focuses on the principles and goals of treatment of addiction. In the treatment of addiction is the default selected using psychotherapy and expressive psychotherapy - art therapy. Art therapy is described as a field, along with historical context, the definition of guidelines that define the field and determining the place of art therapy in the treatment of addiction. The introduction of practical work is described in detail Aftercare center Prevent, focusing on the course and composition of the art therapy program and representation in it. Then are presented work in the background in art therapy Aftercare center Prevent. The main place of work is to present specific case studies of clients with analysis and interpretation of artifacts that illustrate ways of working within art therapy group with respect to the method Rožnov art therapy. The conclusion summarizes the specifics of the use of art therapy in the type of equipment described and obvious benefits for the field of art therapy.
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PROBLEMS OF PATIENT RESOCIALIZATION IN PSYCHIATRIC HOSPITAL ČERVENÝ DVŮR
DVOŘÁKOVÁ, Lucie
This bachelor thesis called The Issues of Rehabilitation of the Psychiatric Hospital Cerveny Dvur patients deals with both the rehabilitation of the Cerveny Dvur patients and system of the rehabilitation care provided after the stay in this hospital. The thesis is divided into two parts, a theoretical and practical one. The theoretical part contains basic concepts concerning the issues of rehabilitation, specific problems during the rehabilitation which can appear after the return to a normal life, the issues of relapse or recurrence and finally the information about the psychiatric hospital Cerveny Dvur where the research was realized. The main goal of the practical part was to chart the rehabilition of the Cerveny Dvur patients with the emphasis on sub-goals such as the system of the care provided after the stay in this hospital as well as the reasons for the abstinence violation. There were three research issues defined which were focused on the functioning of the aftercare, risk factors during the rehabilitation and the most frequent reasons for the abstinence violation. The research itself was carried out qualitatively since the data were obtained by the method of semi-structured interviewing. Seven patients and three therapists of Cerveny Dvur took part in it and the research was realized just at this hospital. During the discussion I was comparing the results of this research with professional publications. Finally I establish hypothesis and give some recommendations to solve the problems resulting from the research. I think that it is necessary to devote more time to these issues and also not to underestimate the aftercare.
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ACCULTURATION OF INDIVIDUAL WITH BEHAVIOUR DISORDER - PROGRAMME "BOROUK"
NÁPRAVNÍKOVÁ, Lenka
Socialization of an individual with behavioural disorder {--} programme ,,Borouk University Decree (Diploma) Work Abstract The aim of the thesis is to monitor situations of clients with problems of behavioural disorder, who was allowed from a hospital and protective training in Educational Institution and Canteen {\clqq}Husův dům`` in Dvůr Králové na Labem, and an evaluation of the socializational programme {\clqq}Borouk``. In a practical part of the thesis the author chose a quatitative research, in which she analysed data of clients allowed from 2001 to 2005. The programme {\clqq}Borouk`` is evaluated on the basis of data about resocialization of those clients. There is a case study enclosed in the text. In the closing part of the thesis, the programme {\clqq}Borouk`` is evaluated as a suitable programme, which helps clients with the behavioural disorder to socialize. The results show that a wide range of aspects of lifes of a group of examined clients were improved. In spite of their suitable integration and related elimination of negative social phenomenons, it is necessary to provide the clients with behavioural disorder with lifelong assistance and support. Diploma work supervisor: Author: Jiří Hartl, M. A. Bc. Lenka Nápravníková (Personal signature (Personal signature attached {--} illegible) attached {--} illegible) České Budějovice 2007
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Assesment of needs of clients of Aftercare Centre Prevent in Ceske Budejovice.
ŠNOKHOUS, Jan
The study presents an assessment of needs of clients of the Aftercare Centre Prevent in Ceske Budejovice and investigates which needs are perceived by the clients as significant. Theoretical part deals with needs in terms of selected motivation theories and describes work with drug addicts, mainly in tertiary prevention sphere. The term of aftercare is discussed in this section, together with components of aftercare programmes and the Aftercare centre Prevent in Ceske Budejovice itself. Included is also a comparison of the main needs theories and actual needs of drug addicts. The practical part includes characteristics of the sample of participants, methodology of Needs Assessment data gathering, and results of the analysis based on the well established theory by Strauss and Glaser. The outcome of the study is a set of categories reflecting basic needs of drug addicts during the process of aftercare, which is coherent with their perceptions.
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The after-care management of patients with cardiac arrhythmia after a discharge out of the cardiac care unit.
JANÁSOVÁ, Věra
Heart rhythm disorders alias arrhythmias rank among the most frequent heart diseases. They result from a disorder of generation or conduction of electric impulses at the heart. There are often arrhythmias of which one is not conscious and which may be detected in long-term ECG monitoring. Patients{\crq} problems mostly arise from rhythm disorders that are paroxysmal or permanent. These may endanger the patient{\crq}s life. Subjective troubles reported by patients include uncomfortable heart palpitation, fatigue, breathlessness, distress, shorter breath, dizziness or even unconsciousness; sometimes patients may feel unpleasant chest pain. These subjective feelings are very uncomfortable for a person suffering from heart arrhythmia and can make it impossible for him/her to manage routine daily activities. The task of a nurse is to help a patient overcome this difficult period and instruct him/her of a healthy lifestyle as a prevention of heart diseases. In this respect, cooperation between the nurses in hospitals and the nurses in cardiologic out-patient departments is important. Four hypotheses were raised. The first hypothesis was to confirm that the care of patients with heart arrhythmia after their discharge to home-care is sufficient in respect of their needs. This hypothesis was confirmed. The second hypothesis was to confirm that the patients are sufficiently instructed on prevention of recurrence of heart arrhythmias. This hypothesis was not confirmed. The third hypothesis was to confirm that patients know the impacts of heart arrhythmias on their overall health state, and was not confirmed. The fourth hypothesis was to confirm that patients are aware of other options of the care after discharge from hospital. This hypothesis was not confirmed. In the practical part of the thesis I used a quantitative research. The research was conducted in hospitals in České Budějovice, Jihlava, Plzeň and Prague, in the form of anonymous questionnaires distributed to patients in cardiologic out-patient departments. The results have been processed in charts and tables in the SPSS programme. The objectives were fulfilled. The appendix to the thesis contains a brief proposal suggesting on what the nursing care should be focused after a patient{\crq}s discharge from hospital. The results will be offered to deputy managers for the nursing care and to nurses in cardiologic out-patient departments.
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