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Quality of life of seniors hospitalized in long-term care.
DOLEJŠOVÁ, Markéta
The basic theoretical basis: According to demographic development the average and maximum lifespan prolongs. Therefore global population spends a bigger part of adulthood in their old age. This phenomenon is irreversible and brings significant changes into global geriatric nursing and we need to take note of the care that is provided to old patients. The seniors form an irreplaceable and a more and more considerable part of population, they create a varied group with individual needs, priorities and demands in sickness as in health. It is the very polymorbidity of senior patients which is often the reason for a long-term hospitalization. Nowadays, for these purposes more and more beds are built in long-term care facilities (LTCF) which are officially defined as specialized medical institutions which provide care to patients whose health states cannot be substantially improved by any medical treatment as they worsen without a continuous care. The life quality of seniors and the quality of the provided care in these facilities are the main long-term care level indicators. The goals of the thesis: 1) Ascertain the life quality of seniors hospitalized in long-term care institutions. The research questions: 1) How does the hospitalization of seniors in LTCF influence their subjectively perceived quality of life? 2) In which areas do seniors hospitalized in LTCF feel the difference of life quality in LTCF and at home? 3) How are the patients in LTCF satisfied with the quality of health care? 4) Within the rise of seniors' life quality in LTCF, in which areas should the nurse improve the provided care? Methods employed: For the empirical part of the thesis the qualitative analysis of gathered data method was used. The data accumulation was implemented by semi-structured interviews with clients-patients hospitalized in LTCF. The instructions for the interviews were adopted from a QOL Research Unit life quality model of the university in Toronto. This model emphasizes the individual's relations towards the surroundings and the possibilities of maintaining and improving skills. It is divided into 3 categories - existence, togetherness and adaptability. Interview transcriptions create a part of the thesis on an enclosed CD. For illustrative purposes, the results of the research were transformed into mind maps using the XMind software. There are also annotations with respondents' quotations concerning individual map as a part of the thesis. The results: The analysis of in-depth interview gathered information brought several factors which are highly subjective and have a logical level of individuality. The results concerning the research of the seniors' life quality dimensions are more or less in agreement with the basic division found in professional literature. However, they bring a further view on these dimensions and introduce subjective opinions, wishes and evaluation of seniors who found themselves in unknown environment of LTCF. The positive influence of nurses, which often impact the satisfaction of seniors in a medical institution, proved its importance. However, it was the area of communication skills of medical staff which was mentioned as lacking or insufficient. Also the fields of free time activities, seniors' adaptation in LTCF and social isolation were found to be neglected. Conclusion: The long-term care becomes, thanks to demographic development, the most rapidly evolving kind of health care. The emphasis on life quality of hospitalized seniors, as their biggest consumers, should be a matter of course for every medical and social facility. The contribution of the thesis is in detailed mapping of the issue of life quality in LTCF, warning against lack in health care and the neglected fields of life quality.
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Quality Management System for Long-Term Care (LTC) in the Czech Republic
Waageová, Alena ; Veber, Jaromír (advisor) ; Holmerová, Iva (referee)
The aim of this thesis is to analyze Long-Term Care in the Czech Republic, to design a Quality Management System for Long-Term Care, and to demonstrate its practical application in Gerontological Centre. A Quality Management Handbook for Long-Term Care represents an additional aim of this thesis; it is designed for Health and Social organizations having a similar spectrum of activities. This work relies on document analysis - available scientific studies on long-term care, and literature focused on quality management. A significant part of the text is supported by our own practical experience and is reinforced by consultations with experts in senior care. ISO systems, TQM approaches, Standards of social services, and National accreditation standards for subsequent and long-term care SAK ČR (United Accreditation Commission of Czech Republic) have been used as a starting point for the proposed Quality Management System. The proposed system has a broad scope, including resources, processes and outputs. The systems used in practice have some common parts; therefore the proposed model may be easily modified to accommodate the specific requirements of individual certification authorities.
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