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Influence of Basal Stimulation on a Possibility of Transition to the Reconciliation Phase according to Elisabeth Kübler Ross
HLAVÁČKOVÁ, Kateřina
While the numbers of incurable patients continues to rise, it follows that the nursing care of incurable and dying people is getting more important. Naturally the dying patient is the most exacting patient of all from the nurses point of view, and needs individual care and empathy. This work of mine is called {\clqq}Influence of Basal Stimulation on a Possibility of Transition to the Reconciliation Phase according to Elisabeth Kübler Ross``. It has been divided into two parts, theoretical and practical. The theoretical part consists of five chapters: The Basal Stimulation which is the art of being in contact with the patient, The Terminal Stage, The Needs of the Dying Person, The Palliative Care, and finally The Usage of Basal Stimulation as part of the Palliative Care. The second practical part consists of qualitative research, which has two goals. The first goal was to assure whether utilisation of the concept of Basal Stimulation influences the adaptation and life of the terminally ill patient in order to focus upon the transition from depression phase to the phase of acceptance. The second goal was to ensure that the influence of Basal Stimulation manifests itself upon the patient in the expression of discomfort in comparison to the effect prescribed medication and common nursing care administered in the hospice. Fundamental research was established upon the following basic questions: 1. Should the application of the basal Stimulation concept influence the transition to the acceptance phase according to Elizabeth Kübler Ross? 2. Should the use of the basal stimulation generally increase the overall comfort ot the terminally ill patient? 3. Whether the concept of basal stimulation assists to deepen the interaction between the patient and his/her nearest next of kin? I chose eight patients whose behaviour and reactions I closely observed. Half of them were cared for utilising the concept of basal stimulation at Jan Nepomuk Neumann Hospice in Prachatice. The second half were cared for in Štrasburk Hospice in Prague using the common nursing practices of that hospice. The observation was carried out with the cooperation of nurses working in both hospices. The results which were obtained were noted for all eight case reports. The case studies compare against the following research the phases of depression to acceptance. For a more complex perception of the observed clients each case study is completed by medical and nursing diagnosis. The results of the entire research lead us to following hypothesis: The presence of the next of kin and their participation in the care of the ill are conducive to holistic care for the dying person just like it is to every human being. I suggest that these results which the research has given should be used in medical schools, in the departments of palliative care for the advancement in the education of health workers who care for dying patients. I also recomend that the basal stimulation concept be applied to the standards of nursing care in the department of palliative care.
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The Challenges of Providing Nursing Care to Delirant Clients in Intensive Care Units
VONDRÁKOVÁ, Radka
The theme of this undergraduate thesis is The Challenges of Providing Nursing Care to Delirant Clients/Patients in Intensive Care Units. The thesis pursues three objectives and elaborates three hypotheses. The first objectives was to assess the challenges of providing nursing care to delirant patients at the ICU of the České Budějovice Hospital, from the nurses{\crq} perspective. The second objective was to examine the nurses{\crq} knowledge of the specific challenges of providing nursing care to delirant patients at the ICU of the České Budějovice Hospital. The third objective was to ascertain whether nurses were acquainted with the principles of using inhibition as a means of controlling situation, according to the nursing standards of the České Budějovice Hospital. The first hypothesis was based on the presumption that nurses taking care of delirant patients feel exhausted. The second hypothesis was based on the presumption that nurses use inhibition as a standard means of controlling situations involving delirant patients. The third hypothesis was based on the presumption that university-educated nurses have a better knowledge of patients{\crq} delirant condition than nurses with lower education. For the purposes of my research, which I conducted in January and February 2009, I applied a quantitative method using a questionnaire. The questionnaire was distributed among the nurses working at the ICU of the České Budějovice Hospital. The resulting data were recorded in the form of diagrams. The validity of all the hypotheses has been confirmed and the outlined objectives have been reached. In the closing part of my thesis, I recommend that a seminar be organized for all the nursing staff of the České Budějovice Hospital, where nurses would be presented with the complexity of delirium problems, as well as mental hygiene and relaxation techniques. Furthermore, it was suggested to perform an audit of the nursing care standard no. 37 at the České Budějovice Hospital. The hardest recommendation to meet was to ensure adequate staffing of the ICU. However, solutions for this particular problem lie beyond the limits of my undergraduate thesis, as shortage of nursing staff is a nationwide problem. My last recommendation calls for improving the theoretical preparation of non-medical students by including specific practical care of delirant patients.
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