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Primary, Secondary and Tertiary Prevention in Children with Coeliac Disease.
PAPOUŠKOVÁ, Helena
Celiac disease is a lifelong disorder characterised by permanent intolerance to gluten and typical inflammatory changes in the small intestine. These changes lead to malabsorption of all nutrients, minerals, vitamins and water. The first attack of this disorder mostly occurs in childhood because the small intestine is greatly stressed by other nutrition supply. The only effective treatment is a lifelong gluten-free diet. This thesis, called Primary, secondary and tertiary prevention in children with celiac disease, consists of two parts; a theory part for which both professional publications and internet have been used and an empirical part, that comprises research itself with its results. The research target of this thesis was the sector of celiac disease occurring in children. Within the research, there were determined four objectives. The first objective was about to find out how primary, secondary and tertiary prevention is provided to children with celiac disease in GP ambulances for children and teenagers. Another task was to trace what profits the regime education brings to parents of children having celiac disease. We also dealt with the impact of the disease on the life of the child, his/her family and surrounding society. Then we investigated whether respondents take the help from outside, state support, institutions and in-kind assistance. In the empirical part of the thesis we used a method of qualitative research. For this research we chose a method of questionings through individual semi-structured interviews with two groups of respondents. The first group was made of nine nurses working in GP ambulances for children and teenagers having celiac disease. The second group was formed by nine children with celiac disease and their parents. The outcome of the research indicates that for quality health care supply it is important to obtain family anamnesis, carry out regular physicals in stated intervals within growth measurement monitoring and breastfeeding education and add other nutrition to diet. Monitoring suspicious symptoms, such as failure to thrive, inexplicable weight loss, growth retardation, abdominal pain, recurrent diarrhoea, digestive discomfort, dermatitis, stomatitis, anaemia, can soon detect celiac disorder. The secondary prevention is expressed by the work of nurses, such as biological material analysis, education, advice, help and support. Great urgency is given to risk factor monitoring, such as diabetes mellitus, Down syndrome, thyroid disorder, or genetic predispositions. The tertiary prevention is focused on the adaptation support of the child and his/her family to this chronic disorder, normal growth, and whole constitution examining and complication prevention. The outcomes indicate that the biggest problem of celiac people is financial burden of gluten-free food and also frequent limits in out-of- home eating. The financial burden of the diet influences, for example, vacation planning. It is necessary for the society to respect their disease, for example, canteens and teachers should have knowledge of the diet restrictions and provide suitable feeding. Furthermore, our findings show that only few families use financial support, because they are afraid of negative allowance examination because of their comfortable income. They mainly use allowance from Health Insurance Companies. On the grounds of the acquired information has been created an informative handout for the parents of the children with the celiac disease. The results of our research will be provided to the nurses who work in general practitioner ambulances.
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Coeliac disease and its impact in the life of a child at younger school-age.
MIKEŠOVÁ, Annemarie
Celiac sprue or celiac disease leads to a lifelong adherence to the diet, i.e. to a total exclusion of gluten from the diet. In celiac disease antibodies are released, that act autoimmune and affect the inherent small intestinal tissue, while the detachment of antibodies is caused by the presence of gluten in food. In pathological process the disorder of the morphology of small intestinal walls occurs, causing the reduction of intestinal villus height, which are physiologically present on every intestinal mucosa. In a critical state the subtotal or total atrophy of intestinal villi rises means their partial or complete disappearance. This damage of mucosa results in chronic inflammatory processes, which cause malabsorption.Celiac sprue is a chronic, autoimmune disease developing either on genetic background or due to the immune response.The basic and only treatment consist in longlife exclusion of gluten from the diet., i.e. the suppression of toxic protein occurring in cereal grain. Celiac sprue belongs to the incurable diseases and preventing the complications, which may occur in relation to a bad regime, is a matter of course. Nowadays the importance is attached to prevention, which is divided into three basic levels: primary, secondary and tertiary. The primary prevention is crucial, it is when the incidence of the disease is sought out. The time, when the gluten gets into the child´s body for the first time, has a great influence on the development of the disease. The main goal of this thesis was to map the issue of celiac disease of early-school-age children with a focus on the specifics of nursing using the literature available. The celiac disease issue was searched out in bibliographic publications and on the Internet. Based on the stated objective, the synthesis method, explanation or data demonstration was chosen for this bachelor thesis. Economic point of view is regarded as a fundamental issue of the disease. It turned out that only a small number of czech health insurance companies provides a catering allowance to celiac patients. It was found out, that in many EU states so called community care provided by community nurse, exists. There is no trend like this in Czech republic despite the fact, that this field can be studied in the master study. The nurse is an unsubstitutable member and fundamental pillar of a multidisciplinary team. She also has significant competencies in patient care and constitutes an irreplaceable place in nursing. The output of this theoretical thesis is to create a comprehensive view of the range of problems related to celiac disease of early-school-age children.
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Attitudes and habits towards eating in secondary school pupils and high school students in the Česká Třebová neighbourhood
VOSTŘÁK, Vít
The main aim of the present bachelor's thesis is to identify attitudes and habits towards eating in secondary school pupils and high school students in Česká Třebová neighbourhoods. The first part is a review of theory and it is dedicated to the definition of pubescents and adolescents, their eating attitudes and habits, healthy eating, common eating disorders and obesity. Another fundamental chapter is the one concerned with diets and with the prevalence of dieting in children. High attention is paid to the gluten-free diet and weight reducing diets. A questionnaire survey has been used to monitor the situation in the neighbourhood of Česká Třebová. The questionnaire contains inquiries related to regularity in eating, fluid intake, healthy eating, diets, home cooking, eating at school canteens and at fast food restaurants as well. The results of each question have been evaluated chronologically. A general review of eating attitudes and habits as well as their comparison according to the educational stage and sex of the participants have been provided.
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Gluten-free diet and the possibility of enriching the diet coeliacs
BLAŽKOVÁ, Klára
This thesis deals with the gluten-free diet and its possible enrichment. It is divided into two parts. The first part includes chapters such as history of gluten-free diet, basics of a gluten free diet, the first step in the introduction of a gluten-free diet, gluten-free food labeling legislation and the use of alcohol on a gluten-free diet. The practical part is focused on enriching the diet celiac patients. I focused on the preparation of bakery products for celiac, I have designed and practically tested recipes gluten-free pizza, buckwheat corpus, gluten-free sourdough seedcake and gluten-free cake with homemade pudding and caramel. The finished gluten-free products were submitted after baking consumers who rated their sensory quality. If necessary, an adjustment was made to the recipe and re-perform sensory evaluation. The prepared products were evaluated positively. Selected coeliacs decided suggested products to include in their diet.
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Subjective opinion of people suffering from coeliac on availability of products for people with coeliac on the Czech market
NOVOTNÁ, Tereza
This bachelor thesis deals with subjective opinion of the people suffering from celiac disease on the availability of products for celiacs on Czech market. At the beginning, there were two main objectives. The first main objective was to explore whether the products available on the market in the Czech Republic cover the needs of celiac patients. The second objective was to explore whether the patients are satisfied with these products. The research questions were set as follows: "In which stores patients prefer to do their shopping?", "Are patients satisfied with the price of products compared to their quality?" and "How patients evaluate the sensory aspects of food?" The theoretical part of my thesis describes celiac disease with all its difficulties. It briefly describes the process of its recognition and its current occurrence in the Czech Republic and some foreign countries. It also describes the clinical picture and the types of forms of celiac disease at a patient, complex diagnostic procedures when there is a suspicion of this fatal disease, malnutrition risk, associated diseases and possible complications. Last but not least, it is concerned with the gluten-free diet, which is the only current treatment for celiac disease. Along with that, the thesis is dedicated to raw materials and food for celiacs: accessibility, large financial cost coverage of gluten-free diet, product labelling and legislation. In order to develop the research part, the method of qualitative research was chosen, specifically, a semi-structured interview. The interview contained thirteen questions, so as to achieve the objective of the thesis and so that the research questions given in advance were answered. The research sample included five celiac patients, both men and women in the age range of 18 to 49 years. Data were being collected from January 2013 to April 2013. The results of this work show that patients prefer to combine shopping in the so-called "healthy food stores" where the shop assistants have more knowledge on the issue and are able to help them to choose the most suitable products, and shopping in large stores and the "gluten-free" departments there. Respondents also claim that in supermarkets, the shop assistants are not able to help and often do not even know what the celiac disease is. All respondents also shop in their area of living, which proves the increasing availability of gluten-free products, which is sufficient to cover the common needs of celiac patients. The market situation in the Czech Republic in the last ten years has changed dramatically to the better and there is no specific food that respondents would completely miss in the stores. When shopping, the respondents look for specific, pre-tested products. On the contrary, patients are less inclined to on-line shopping. Another significant criterion for selecting gluten-free food is also its price. The financial demands of a gluten-free diet are a big problem, because gluten-free raw materials and food are from 4 to 10 times more expensive than the same commodity containing gluten. Patients are therefore often forced to break the rules of their diet, because they simply do not have the finances for the gluten-free products. Sensory aspect of gluten-free products is also not evaluated very positively by the patients. The problem is seen mainly in bakery products such as bread, rolls and buns. The structure of these products is not suitable, as it often crumbles and breaks, or, on the other hand, is sticky. They would also like to extend the range of pastries to avoid stereotypes in their diet. Another sensory aspect of bakery products-taste was not evaluated positively as well. However, they do not see the difference in warm food and mostly in home-made sweet pastries such as cakes or pies.
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Analysis of educational materials for patients with coeliac disease
ZIMMELOVÁ, Hana
The Dissertation deals with educational materials for patients with celiac disease. It describes general requirements for teaching materials and the didactical principles suitable for educational materials for patients with celiac disease. It presents a draft criteria for assessment of web sites intended for people suffering of celiac disease. Five Czech, as well as foreign Internet-based resources, have been selected and assessed for compliance with the criteria given by technical properties, contents, page structures, criteria evaluating credibility of the sites and educational criteria. All the sites assessed can be used for education of patients with celiac disease, but they are rather information sites with a low content of educational characteristics.
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Nursing Care for a Client with Celiac Disease
KAŠPAROVÁ, Marie
I chose {\clq}qNursing Care for a Client with Celiac Disease`` as the subject of my bachelor´s work to outline this problem and to point out the difficulties celiacs face. Celiac disease is a hereditary autoimmune disease of the small intestine, which is caused by the intolerance of proteins contained in grain gluten. On the mucous membrane of the small intestine, mucous villi disappear. Typical difficulties include a disorder of the digestion of compound sugars and insufficient absorption of proteins, fats, vitamins and iron. Celiac disease cannot be cured, however, it can be treated successfully. The only, and at the same time quite sufficient curative measure is a complete elimination of gluten from food {--} gluten-free diet. The work is divided into two parts. The first part is theoretical, where I go into the substance of the disease, its diagnostics and therapy. The research part has been processed in a qualitative method. The goal of the work was to evaluate the possibilities of people suffering from this disease and their way of life. When doing interviews, I interrogated patients of all ages. For the purposes of this work I used the casuistry of individual celiacs. I focus on the course of the disease, troubles before and after the diagnosis being determined or the experience of patients with catering out of home. Furthermore, I assess the way of instruction (the form it was carried out and by whom), as well as the financial aspects of a particular family. Another part of the research is focused on state registered nurses. The aim of this research is to determine the role of nurses in caring for clients with celiac disease. In gastroenterological centres, care for those suffering from celiac disease takes the form of a complex approach. This approach enables frequent diagnostics, therapy and dispensarisation. It leads to improvement in the state of health and quality of lives of sick celiacs. The awareness of people of celiac disease is very low. However, more and more attention is paid nowadays to the problems of celiac disease, both from the point of view of cure and research, and on the part of the producers and dealers of gluten-free foods.
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Coeliac disease as a health, nutritional and social problem.
ZIMMELOVÁ, Hana
Coeliac disease is a serious, life endangering disease that affects both children and adults. Diagnosing the disease is very straightforward, it is sufficient to conduct specialised blood tests and, if the results are positive, to carry out a biopsy of the small intestine. Despite being relatively simple to diagnose, the disease remains undetected in most patients for various reasons. Curing it is a rather uncomplicated process, merely requiring the removal of gluten from patients{\crq} diets. However, this is not as easy as it sounds in today{\crq}s society. Gluten is used in a number of industrially manufactured foodstuffs. Furthermore, a gluten-free diet is financially demanding, and the government does not subsidise special dietary foods anywhere near as much as those of other European nations. The net result is not only intense labour as regards food preparation at home, but there is a psychological effect due to the severity of disease, as well an impact socially as patients have to face the financial demands of the diet. Unfortunately, culinary staff tends to be poorly informed about the disease, added to which there is a need to prepare meals in a special manner. Hence, the main goal of this thesis was to conduct research on the literature available and put together a simple instruction manual, intended as a convenient aid for nutritional therapists and even people newly diagnosed with coeliac disease.
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Quality of life of Adults with Celiac Disease
ILKÓOVÁ, Václava
The thesis for this baccalaureate work theoretically and practically deals with issues of the lives of adults with Celiac Disease. The aim of my work was to find out how this disorder affects people{\crq}s lives in terms of health, as well as their psychological, economic and social conditions. In the theoretical part of this thesis, I described the origin, symptoms, signs, epidemiology and treatment of Celiac Disease. I have also discussed associated health and social problems. In the practical part I used a questionnaire, according to the quantitative method of research. The investigated group comprised 82 adults with Celiac Disease (71 women, 11 men), who were determined by random selection. All of the data I have obtained has been transferred into diagrams and results were expressed as percentage values. The questions were aimed at respondents{\crq} dealings with their specific problems. I found that people with Celiac Disease in the Czech Republic do suffer from health problems, but not as much as from the many restrictions in their eating habits and social life, which may lead to some resulting psychological problems. In addition, the Gluten-Free Diet is very expensive for a majority of people, who have no financial compensation from the state, while in many countries in Europe such compensation is common. Regarding the Czech governments{\crq} approach to those who suffer with celiac disease, while they are in the process of reaching European standards, the role of support groups in all mentioned problems is important. Accordingly, the results of my work will be submitted to the Czech Society for Gluten-Free Diet.
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