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Work in social integration process of adults with intellectual disability.
SVITÁKOVÁ, Iveta
In my bachelor thesis, I dealt with the use of work activities in the process of social integration of adults with mental disabilities, the aim was to create, implement and evaluate regular work activities intended to a specific group of adults with mental disability and focused primarily on the development of social integration. The thesis is structured into six chapters. The first of them is focused on the definition of mental disability, characteristic of adulthood as an important developmental period in human life, and on adulthood of individuals with mental disabilities with a goal to find and identify the specifics that were needed to be taken into account when working with this target group of people. The following section is devoted to the social integration, its determinants and the environment in which it operates. I continued with the outputs in the third chapter, where I focused on key competencies, which them are the necessary basis for social integration, especially social and personal skills and communication skills, necessary basis. Targeted professional development can be realized through educational activities, but has to respect the specificities of the participants and voluntary participation. Both of these assumptions can be fulfilled within the leisure education using adequate pedagogical methods. For this reason, I decided to focus my attention on these areas at the end of the chapter. The fourth chapter is devoted to work and work activities, namely the definition of concepts, their characteristics and importance and role of work activities in human life, or a person with mental disability. Based on all acquired theoretical knowledge and using previous experience with the target group in the fifth chapter, I designed a specific training program based on the work and activities focused on the development of selected key competences. The educational program volunteered four participants, but I have decided to follow the development of competencies of three participants because one participant attended the program very irregularly. The program has been implemented three times a week, two and a half hours for seven months (from October 2015 to May 2016) in the premises of the training centre Mo-zai-ka. At the beginning of the realisation of the created educational program, the participants agreed that we will adhere and develop good habits necessary for good relations within the group and the results of the work. On a basis of the individual characteristics of the participants, I prepared the work, which should also contribute to the development of social and personal and interpersonal skills. I have continuously monitored and recorded them. During the implementation of the program, I put emphasis on repetition, patient negotiations with participants and creating a friendly atmosphere. After completing the training program, I evaluated the development of competencies in three selected participants. On that basis, I concluded that the biggest change was in the communicative competence. I also experienced a change in social and personal competencies, however, results varied widely among individual participants. Yet, I believe that the goal of the thesis was achieved. These results show that education in leisure time, based on work activities may lead to the development of social and personal and interpersonal skills that are for adults with mental disabilities necessary in the process of social integration. This thesis can be an interesting source of inspiration for the realisation of similar programs aimed at social integration of persons with mental disabilities.
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The reflection of František Bakule's work in a relation to a current special educational practice
BALÍKOVÁ, Tereza
František Bakule was a significant Czech teacher during the first half of the 20th century. He was known as the first director of the "Jedlicka Institute in Prague" as well as the founder of so-called "Bakule´s Institute" as well as one of the few representatives of the "Czech alternative approach towards education" which is very well recognized all around the world. His legacy and teachings, however, are currently not being developed on the systematic level and neither they are being put into practise by Czech professional mainstream educational community. We also need to mention that is not used by even the stream of special education, in contrast to many foreign alternative pedagogical trends, which are gaining popularity and are generally applied with success. The aim of this thesis is therefore to analyse the work of Frantisek Bakule through the prism of contemporary school educational environment with emphasis on the education of students with disabilities. The first chapter is devoted to outlining the life journey of Frantisek Bakule, particularly focusing on the major milestones that influenced the formation of his personality, his ideas, inspiration and motivation which was reflected in his teachings and then in his very own coherent concept of education. To be specific, we are introduced to his family background and a significant part is then devoted to description of Frantisek´s experience as a teacher, including stages of operating in Jedlicka´s Institute and in his own "Bakule´s institute". The second part is then focused solely on Bakule´s specific educational concept. First, the core principles of the concept are defined. Later parts then talk about Bakule´s original curriculum and a his proposal of an ideal classroom environment. The text also contains a detailed description of how Bakule approached several subjects, which were at the core of his teaching concept, namely "Work activities", "Music education" and "Arts". Original teaching practices are analysed by using current teaching methodology and terminology. Due to the identified aim and goals of the thesis, the third chapter analyses the current concept of education of the above, according to Bakule´s core areas and principles. The text is designed specifically to be subsequently reflecting the work of Frantisek Bakule from the perspective of today's teaching methods, namely the methods of special education. The idea is to define common points and possible differences and uncover hidden inspirational potential, which is then the main content of the fourth and final chapter. Based on the analysis and all its subsequent reflections, the final chapter tells us that although Bakule´s educational goals don´t differ too significantly from the current concept embedded in the relevant framework of educational programs, to achieve such goals we are currently using very different techniques and methods in comparison to Bakule´s ways. Even though Bakule himself tested and verified all of his concepts in practice, which can be very simply described as "do not teach students about life and work, but through life and work", and these concepts also have been proven correct by various subsequent results of psychological researches, the current system still doesn´t draw from them too much. From all the above it is quite obvious that the legacy of life´s work of Frantisek Bakule is currently not utilized nor it is being appreciated by our professional pedagogical community. On the other hand, we need to note that it may also be due to the level of fragmentation in which his concept and materials were preserved to the present days.
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A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
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Comparison of intercultural competences of nursing staff in the Czech Republic and German-speaking areas
TÝLEOVÁ, Tereza
The increasing migration of population in the 21 century causes development of multicultural societies. With the increasing number of foreigners in individual countries it is possible to also presume an increasing number of patients/clients from different cultures in medical facilities. These facts require modern attitude to nursing, developing of transcultural nursing, implementing multi- and transcultural education in the health care education and propagation of multicultural conception of nursing between the nursing personnel. The result of these necessary changes should be the ability to provide effective nursing care which is culturally adjusted to the patient/client that would also take their specifics, customs and traditions of their culture into account and that would saturate all their biological, psychological, social and spiritual needs according to their race, nationality or belief. This thesis deals with multicultural nursing and confronts cultural competence of the nursing staff in Czech Republic with that in German-speaking countries. This thesis aim is to state the level of multicultural competence of the nursing staff and explore conditions provided to the nursing personnel of the hospital for giving culturally adapted care to patients-foreigners. The results of the research give an overview of the state of culturally competent care in comparable medical facilities in Czech Republic, Germany, Austria and Switzerland. They will also give a feedback to the questioned hospitals. Such information may alert their management to possible lack of knowledge of their nursing personnel and help them direct its further education. The theoretical part of the theses defines the basic concepts regarding culture, ethnic groups, race or nation, formulates the difference between the terms "multicultural" and "transcultural" nursing, multicultural education and culturally competent care, compile the most common sections of specific cultural needs of the individuals. In short it also processes J. Campinha-Bacote's model of cultural competence in health care delivery, the Papadopoulos, Tilki and Taylor Model for developing cultural competence and the Purnell Model for cultural competence. It also shortly deals with nursing frameworks for acquiring cultural data, such as the Sunrise model from M. Leininger, the Giger and Davidhizar Transcultural assessment model and Bloch's ethnic/cultural assessment guide. The empirical part processes and evaluates data obtained during the quantitative research. The accumulation of the data was conducted through anonymous questionnaires that were distributed between the nursing personnel of internal and surgical wards of the hospitals in Czech Republic and in German-speaking countries. In Czech Republic these were hospitals in Prague and in Tábor, in Germany a hospital in Dortmund and one in Cottbus, in Austria the hospitals in Salzburg and in Weiz and in Switzerland a hospital in Aarau and one in St. Gallen. The collection of the data was conducted either on-line or by way of printed questionnaire forms. The acquired data were valorized and sorted into diagrams and tables for further clarity. From the respondent´s answers follows that the queried medical facilities in Czech Republic do not provide sufficient conditions for their workers to give culturally competent nursing care on such a level, as it is at the facilities questioned in the German-speaking areas. The results also show that language skills of the nursing personnel in these hospitals in Czech Republic are worse than those in the German-speaking countries. With the level of multicultural competence the situation is similar; in this field Czech nursing personnel does not match their foreign counterpart. It is necessary to remark that this research sample of two hospitals from each of the countries is insufficient for the results to be applied on the whole Czech Republic or German speaking countries.
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Palliative care is provided by patient's family at home
KUČEROVÁ, Tereza
The thesis, titled Palliative Care Provided by Patient's Family in Home Environment, discusses the specific care needs of a terminally ill patient in his/her own home. Caring for an ill person in a home environment is beginning to be a growing trend in home care, but also it is an increasingly common wish of the patients themselves. The family is therefore required to have enough theory and practical knowledge in order to deliver a highly demanding personal care for their close family members. The aim of the thesis is to summarize the current situation of delivering palliative care in home environment in Czech Republic whilst concentrating on the specific needs of the patient and the needs of their family. The objectives of the research were to determine whether family members were introduces to the specifics of palliative care of terminally ill patients; to map their skills in delivering palliative care in home environment and to reveal the most common issues that family members come across in that home environment. The final objective was to map out services in regions of Central Bohemia and Liberec that are accessible to family members whilst caring for a terminally ill patient. The research part of the thesis was completed employing a method of qualitative investigation using semi-structured interviews with patient's family members and nurses providing hospice care in home environment. It emerged from the analytical interviews that the family's knowledge level regarding support for palliative care in home environment is very limited and in hospitals families are only given minimal or no support or information. As a final document for the thesis an informative educational brochure was created based on the results of aforementioned research, primarily targeting patient's family; its core objective is to improve information and collate the specifics of care that would allow the patient a dignified end to their life.
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Coping strategies in children´s fear and pain in relation to nursing care
PROCHÁZKOVÁ, Zuzana
For the nurse, taking care of hospitalized children is important not only pediatric nursing knowledge, personal and social preconditions, but also the theoretical and practical competency of methods and techniques, which are used for identification and effective influencing of pain and fear. The aim of this thesis was to identify the main sources of fear of the hospitalized preschool and young school age children and to find out the effective methods and principles of the cooperation with children, alternatively with their accompanying parents in order to moderate the fear of the small patient. Then the thesis tried to chart the nursing diagnostic and evaluation procedure of the pain and get the most used nursing methods of non-pharmacological pain relief. To obtain the necessary data, the qualitative research was used with a semi-structured interview as a research instrument. The first research group consisted of 12 nurses, the second group consisted of 12 children ´s patients of preschool and young school age. The majority of the asked nurses thinks, that children´s patients are afraid especially of non-familiar environment, then of the awaited pain and of the solitude without parents. However, the most patients said, that they were afraid especially of pain, then of non-familiar environment, restriction of their needs, hostile attitude of the medical staff and of the other neighbouring patients. They were also frightened of the death and of the darkness. Most reported nurses mean, that the most effective solution of the children ´s fear is the friendly attitude of the medics. They also mentioned the fact of taking the focus off the fear and the presence of the parents is also beneficial. The nurses ´ answers were in conformity with patients opinion in two fields - friendly attitude of the medics and taking the focus off the fear. Then the children mentioned abiding of their specifics in connection to falling asleep and the demand of beying treated by the same sister or by few same sisters. All respondents also talked about the benefit of parents presence. Regarding the principles of the cooperation, nurses answered the importance of united medical procedures, especially the proper way of information transfer. Then the respondents nurses mentioned the psychical and emotional support for children and their accompaniments, the atmosphere of confidence and the value of well done education. Also the need of calm, silence and privacy was stated. Unlike nurses, children and their parents regarding to principles of the cooperation prefer the psychical and emotional support, then the importance of enough information was mentioned. The fourth research question bears on the methods used for children pain monitoring. The nurses said, that the intentional interview with the patients or with the parents was used as a main technique, that was stated by patients as well. Research question number five said: What are the most used nursing methods of non-pharmacological pain relief at children? Most responded nurses mentioned the distraction of children attention from the painful incentive, then the importance of physical methods, relief position and purposeful preparation for the unpleasant intervention. Nurses also named the helpful contribution of the parents, relaxing exercises and the method of imagination. Regarding the pain treatment, it was noted, that all patients prefered the analgesic therapy. Then they quoted the distraction of their attention from the painful incentive, the friendly attitude of the medics, using the ice compress and the relief position. In the pain acute phase, children required mostly calm, comfort and privacy. All children also considered the presence of parents as very helpful. The theoretical and empirical part of the thesis are suitable for being studied by nurses taking care of children and it can be helpful for nursing quality improvement at children ´s wards in hospitals.
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Nursing care management of patients after intrapleural chemical pleurodesis
KIESEWETTEROVÁ, Renáta
The pleurodesis is a treatment method for patients suffered from the symptomatic malignant pleural effusion. The goal of the pleurodesis is to close a pleural area by connection of visceral and parietal pleura in order to reduce or terminate production of pleural effusion. The sterile talc powder is the world's most used agens within a practice. After a parental analgesic is the powder (as a sllury) either applicated into a pleural cavity through the chest drainage or surgically dispersed over the treated (via abrasion, decortication) pleural space during the thoracoscopy/thoracotomy. This diploma thesis focuses on the treatment technique of bedside talc-pleurodesis through the chest drainage. The nurse has an irreplaceable role in the whole process from a preparation of patient to assistance by intrapreural application, to care of patient after the operation or serves as a physical support during potential complications. The aim of the presented work is to detect priorities in nursing care and find out whether patients need increased care after intrapleural therapy. The qualitative research method was chosen for the analysis where semi-structural interview with open questions were used. We created case reports analysed with the adaptive model of Callista Roy as well. The research sample contained patients chosen with respect to specialization of researched problem. We set two basic focal stimuli according to the analysis of respondents´ reactions. These stimuli serve as a basis for determination of priority parts of the nursing care by patients after bedside pleurodesis. We defined the need to be without pain and the need to ensure safety and certainty as a central focus of the nursing care. Among secondary fields of nursing care were identified sleep disturbances and limited mobility, which leads to reduction of self-care in getting dress, hygiene as well as in defection and miction. We found out within the second goal identical intensity of the nursing care before and after bedside talc-pleurodesis. This statement is based on comparison of interventions before and after aplication analysed via adaptive model by Roy. Nevertheless, causes of interventions were modified to a certain extent. The main goal of diploma thesis was to map requirements for high-quality nursing care related to bedside talc-pleurodesis via chest drainage. The work should extend theoretical basis not only for nurses in clinical practice.
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The need for security and safety in connection with a planned surgery with the patient's perspective and nurses
BOHDALOVÁ, Jaroslava
A planned operation performance always affects patient´s needs for assurance and safety. It is important to provide necessary information connected with the planned operation performance itself so that the patient can feel assure and safe. The key role for the patient and her/his needs for assurance and safety is in general nurse´s hands because she is the closest person to the patient and can help to inspire her/his needs for assurance and safety with konfidence best through the aid of her knowledge and skills that she should have as well as through the aid of her attitudes. The target of the thesis was to find out how a planned operation performance affects patient´s needs for assurance and safety and how a general nurse inspires patient´s needs for assurance and safety connected with a planned operation performance with confidence. The following research questions were stated: How does a planned operation performance affect patient´s needs for assurance and safety? How does a general nurse affect patient´s needs for assurance and safety connected with a planned operation performance to inspire her/him with confidence? What is insufficient in filling patient´s needs for assurance and safety before a planned operation performance? How can a general nurse help a patient control her/his fear and state of anxiety related to a planned operation performance? The method qualitative research with the use of depth interview was used to figure out the investigation. The respondents were willing to record the interview which were verbally rewritten and then subjected to the contents analysis by the method paper and pencil. From the research it is clear that a planned operation performance affects patient´s needs for assurance and safety in a negative way disregarding to her/his previous experience. Patient´s worries and negative feelings can be eliminated by a general nurse who treats her/him as equal, taking up an individual approach, informing her/him about all performances and proceedings, having a calming and welcoming way of communication, using empathy and listening as well as trying to meet patient´s wishes according to her possibilities. The research reveals the advantage of patients´ readiness for planned operation performances. Patients can learn it in the framework of educational proceeding in the out-patients´ department at the same time when they learn that they are going to be operated. The research also shows that general nurses do not have enough knowledge in the sphere of therapeutical communication. The results indicate that it would be suitable to start educating patients as soon as it is known how their disease will be solved and treated in order to reduce the negative impact of surgical treatment to patients´ needs for assurance and safety. General nurses should complete their knowledge and skills to be able to help patients to cope with their difficult life-situation. On the basis of the research investigation and after the consultation with the senior nursing officer, the training course will be organized. The topic of the training course will concentrate on communication with patients before planned operation performances with a view to therapeutical communications and therapeutical interviews. Other discovered facts, for example, the lack of information provided to patients and possibilities regarding better patients´ readiness for planned operation performances will surely be solved by the hospital management.
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Nutritional care of children at pediatric clinics and hospitals
METELCOVÁ, Jana
The main goal of this work called Nutritional Care in Children's Hospital and Hospital facilities is to verify whether the nutritional standards created for older child patients meet the needs and are checked and if their physiological needs are fulfilled in chosen hospitals. The next objective is to evaluate the satisfaction of the hospitalised patients with the meals given to them by hospitals. The theoretical part of this work deals with nutritional care, therapeutic care and nutritional needs of adolescents. It further deals with nutritional risks and marginally mentions technological processes regarding meal preparation. The method of qualitative research was used by using questionnaires filled in by chosen children patients who were then interviewed. Children aged 10 to 14 were supposed to be on diet number 13, half of them were boys and the other half were girls. The research was conducted in the children's ward in the hospital in Jindřichův Hradec in December 2015 and in the same type of ward in the hospital in České Budějovice in February 2016. The initial number of respondents was five patients in each ward, then using snow ball sampling method their number increased into ten in each ward. The weekly menu according to which the meals were distributed was obtained from the catering facilities of the hospitals. By using the program "Nutriservis Profi" the contents of nutrients in the meals were obtained. The results gathered from the program "Nutriservis Profi" were compared with recommended values for particular age group defined by The Czech Society for Nutrition, so meeting the physiological needs of the patients could be evaluated. From the results it was found that both hospitals have problems with supplying enough fibre content, phosphorus and calcium in meals for children's patients. There is also sodium, potassium, cholesterol and vitamin C surplus in the menus. Thanks to the internship in both hospitals in Jindřichův Hradec and České Budějovice meeting the physiological needs of the children could be evaluated. Considering the fact that the previous evaluation revealed some imperfections, therapists from both hospitals should concentrate more on checking nutritional values in meals, consequently it was recommended to focus more on the variety of the menus and their improvement. There were also inadequacies in attendance at the children's ward. There was a comparison of the results from both hospitals, based on questionnaires and interviews from the children's point of view. Based on the data, children hospitalized in Jindřichův Hradec were more satisfied with the meals. In the conclusion there is a summary of the research and suggested suitable improvements for hospitals. There is a model menu for diet number 13 in the attachment which could be used by hospitals.
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Narcolepsy and other seizure disorders
TONDLOVÁ, Andrea
The thesis deals with the issue of seizure disorders from the perspective of special neurology. In terms of content, it is focuses on two major areas. The first part is theoretical in nature and has descriptions of the individual disorders, their clinical manifestations, diagnoses and current treatments. It is focused on the following seizure disorder group with regard to one of the objectives of the work: epilepsy, tetany, Meniere's syndrome, migraine and more specifically narcolepsy. These findings are supplemented with information on current knowledge regarding the treatment and diagnoses of these diseases, which make the lives of thus disables people very difficult and prevent them from leading their lives the way they could if they were in full health. The aim of the work is not just a theoretical description of the currently available knowledge of these diseases from literature, but also a practical confrontation thereof from experiences, which in this case result from the true stories of people suffering from seizure disorders. A specific seizure disorder has been selected for this second part of my thesis, which needs to be talked about more in order to become better known. It is a disorder that is interchangeable with regard to its symptoms, which are similar to other disorders, and it is difficult to diagnose or is only diagnosed after an inconveniently long time - i.e. Narcolepsy . The thesis therefore deals with the issue of narcolepsy in most detail, with regard to the practical focus in the next section, where in addition to aforementioned basic knowledge, the author describes the activities and the importance of sleep laboratories and centres as institutions involved in treatment. In order to penetrate into the issue of this disorder even more deeply, she adds the aforementioned anonymous stories of people affected in this way. This part is also complemented with illustrative images of the sleep laboratory and the stories of these people as a better visual complement of the thesis for the reader. A descriptive analysis (comparison) of each symptom was chosen as a comparative method of the aforementioned thesis objective (to compare the theoretically given symptoms of narcolepsy with the symptoms of individuals suffering from this disease), in which the goal was to choose the common symptoms these people which make their lives difficult and compare these data with information (symptoms of narcolepsy) found in contemporary literature. In conclusion, we visit the most important information from scientific literature, the views of the professional community on the current research and studies on narcolepsy, i.e. the specifically examined causal links of applying the Pandemrix vaccine (against swine flu) and narcolepsy and a summary of the results of other studies investigating the etiology of this disease. The aim of this section is to present the reader with, and identify, the current developments in narcolepsy research. An evaluation of the historical development of interest in sleep disorders and an evaluation of the conclusions drawn by comparing symptoms specified in professional literature on narcolepsy with actual symptoms of people suffering from this disease are also included. The aim is to provide the reader with a bio-psycho-social view of a person with this disease, which is not always emphatically discussed in every piece of professional literature. The result of the entire thesis is a summary of the current state of knowledge of these diseases and a reflection on the research of the current possible causes of narcolepsy. It continues to compare the theoretical background of the narcolepsy disorder with the experience of living with this disease, including stories of selectively chosen individuals suffering from narcolepsy.
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