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SPECIFIC FEATURES OF PSYCHOANALYTICAL NEEDS OF PATIENTS AFTER MYOCARDIAL INFARCTION.
MERUNKOVÁ, Michaela
The diseases of the vascular system are the most important cause of the death generally (up to 30% of the world-wide mortality). The myocardial infarction represents 13% of all the death cases due to cardiovascular illnesses. Men often suffer myocardial infarction already after 40th year of life, as for women, it appears after the climax. After the 60th year of age the myocardial infarction is equally frequent in case of both sexes. In the last years also the myocardial infarction in case of people younger than thirty-five years is not a rarity. In the bachelor{\crq}s thesis the method of quantitative research by the technique of questioning was applied. In the questionnaire, there are in total 30 questions. 17 of them were closed and 13 half-open. The questionnaires were distributed to patients of the cardio-surgical and cardiological ambulance of the Hospital in České Budějovice, a.s. during their first check after the myocardial infarction. In total 100 questionnaires were distributed and 86 questionnaires were applied for processing the data. The data collection was performed during January, February and March 2009. The thesis focused on specifics of the psychological and social needs of the patient after myocardial infarction. The target of the thesis was to find out where the patients after myocardial infarction look for social support (target 1). Determination of the most frequent problems of the patient after myocardial infarction (target 2). To find out moreover if the saturation of higher needs of patients after the surgical solution of myocardial infarction differs from that of the patients healed in a conservative way (target 3). Three hypotheses were determined based on these goals. First hypothesis: For the patients after myocardial infarction the most frequent support is their family. This hypothesis was confirmed by the research. The most respondents stated as the most important social support their wife or husband, other family members and last but not least a common-law husband or wife. Second hypothesis: The change of life style is among the most frequent problems of the patient after myocardial infarction. This hypothesis was confirmed by research. The change of the life style was stated by 56% of respondents as the most important problem. In spite of the sufficient education the patients have not enough motivation or firm will to change their hitherto life. Third hypothesis: The saturation of higher needs is achieved sooner in the group of patients healed in a conservative way than in the group of patients healed in a surgical way. It followed from the results of the research that the type of myocardial infarction healing may be reflected in the return of the patients into the normal life, however, it has no influence on the occurrence of the stress, fear, sadness and hopelessness after myocardial infarction. This hypothesis was refuted by the research. It follows from the results of the research that it would be suitable to continue the co-operation after the release for the home treatment. To help them to find a suitable way for the change of the lifestyle, to learn them to treat themselves carefully. To motivate for the co-operation not only them, but also their close surroundings, mainly the family. As the family is the most support for them and it could facilitate the deciding of patients in some items and to support them positively.
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THE ASPECTS OF THE WORK OF NURSES- DEMOTIVATING ELEMENTS WITHIN THE WORK OF NURSES
HEPLOVÁ, Monika
The present paper deals with aspects of the profession of a nurse and the demotivating elements in the profession which makes up the most numerous group in the health care system. The mission of a nurse in the society is to help individuals, families and groups to satisfy their actual needs and to reach their maximum physical, mental and social possibility in agreement with the environment that she lives in. The system of providing health care is changing as well as the relationship of the society to health care workers. General nurses undertake responsibility for direct provision of nursing care, they work independently and they are responsible for the provided care. Their role changes to a full-value team member, to a physician's partner in performing the profession. We were interested in how nurses perceive the change. What are the biggest demotivating factors in the profession and on the contrary what is the motivation not to leave this demanding occupation.
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Patient awareness of anesthesia prior to a planned surgery through the eyes of the patients and the anesthesiology nursesnurse.
HERMANNOVÁ, Blanka
Patient awareness of anesthesia prior to a planned surgery through the eyes of the patients and the anesthesiology nurses Abstract This Bachelor{\crq}s thesis focuses on the research and evaluation of the level of patient awareness of the progress of anesthesia prior to a planned surgery. The awareness of anesthesia is evaluated from the point of view of the patient and the anesthesiology nurse. The scope of the thesis also includes the issue of proper communication with the patient and the importance of winning his trust to the medical personnel during the general preparation for the surgery as well as in the course of his hospitalization. It also shows the patient{\crq}s opinions on the acquisition of information on anesthesia, which would certainly alleviate his fear of the surgery. This Bachelor{\crq}s thesis is primarily based on a quantitative survey of opinions of patients and anesthesiology nurses, conducted in the form of anonymous questionnaires in which both groups expressed their views on the specific hypotheses. The key purpose of the thesis is to confirm the hypotheses, which assume that patients are not given sufficient information on their anesthesia, in spite of their interest in obtaining better knowledge of the anesthetic process. Hypothesis 2, i.e. ``Patients are interested in information from the anesthesiology nurse,{\crq}q cannot be confirmed because, based on the survey, patients prefer doctors to anesthesiology nurses as the source of information. On the basis of the survey, the thesis confirms hypothesis 1, i.e. ``Patients are not informed about the progress of anesthesia by the anesthesiology nurse.{\crq}q The low share of anesthesiology nurses in the patient{\crq}s education prior to a planned surgery is demonstrated by the opinions of the participating anesthesiology nurses, whose share is extremely low and mostly involves situations just before the planned surgery, when the patient is already lying in the surgery room. As regards hypothesis 3, i.e. ``Anesthesiology nurses are not interested in informing the patients of the progress of anesthesia prior to a planned surgery,{\crq}q it is confirmed that anesthesiology nurses are really not interested in educating the patients for many reasons, such as their large workload, lack of time, insufficient motivation and unsatisfactory financial reward. As a possible solution, we have suggested a patient education standard for anesthesiology nurses and an information leaflet for patients, which could help them understand the progress of preparation for anesthesia and the possibilities of anesthesia in general. In no case should the leaflet substitute personal education by an anesthesiology nurse; its purpose is only to serve as on instruction for the patient to prepare questions which he would like to ask before the surgery.
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The role of nurse about information of patients in ambulantion care in Hospital Ceske Budejovice
POSEKANÁ, Věra
Communication is an essential part of provided nursing and medical care. Nurses, who are able to communicate efficiently, can easier initiate changes in patients and these changes lead to the support of their health. Patients´ awareness is a current problem and a weak part of medical care. Nurses should provide information clearly, patiently and reasonably with respect to the circumstances and patient{\crq}s state. Despite the fact that the patient spends in the ambulatory department only for a short period of time and the nurse has only limited possibilities. More stress should be put on the content of information, which is provided to the patient after examination or before going home. Changes which would help improve outpatient care regard the whole system of medical care. There are limited possibilities how to solve this problem, but if every nurse were able to communicate correctly with the patient, eventually with his or her relatives, this might help the patient to overcome the first fright, anxiety or uncertainty. The objective of this Bachelor{\crq}s thesis was to find whether the nurse has sufficient time and possibilities to inform the patient according to the needs and current status in the area of ambulatory care. The second objective was to find whether patients feel that they are given necessary amount of information, which is necessary for success of the nursing care. In the research three hypotheses have been set: H1: The nurse in the ambulatory care does not have enough time to educate patient {--} has been verified; H2: The nurse in the ambulatory care does not have sufficient space to educate the patient {--} has been verified; H3: Patients would welcome more additional information from the nurse in the ambulatory department {--} has not been verified. The quantitative research was performed in a form data collection through the questionnaire. The objectives of this thesis were fulfilled. The research was made at Hospital in České Budějovice at ambulatory wards of selected departments. The results can provide information about satisfaction and dissatisfaction of patients and nurses with the current situation to the hospital{\crq}s management and can be used as a support for changes or improvements in particular departments.
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Utilization of aids for handling of non-self-sufficient patients at departments of intensive medicine.
JANTAČOVÁ, Dana
Departments of intensive medicine often hospitalize patients with self-sufficiency disorders in routine daily activities. Nurses working in those departments have to handle such patients on daily basis, as a part of providing quality nursing care. To make their work easier there are more or less available aids, however, they are not always fully used. The reasons include complexity of the use, unavailability of the aids in hospitals or saving time for other duties. This thesis is divided into two parts. The first part considers the theoretical side of the issue. We have focused on patients at departments of intensive medicine, who are dependent on assistance provided by nurses. Nurses function primarily as attendants. The theoretical part also describes the most common aids used for handling of non-self-sufficient patients. The second part of the thesis focuses on research. We have conducted surveys in selected hospitals in the Czech Republic at departments of intensive medicine. The survey used anonymous questionnaires for nurses working at intensive medicine departments. The objectives of the thesis were as follows: To find out whether nurses at departments of intensive medicine use all aids for handling of non-self-sufficient patients; to find out which aids are used most frequently by nurses at departments of intensive medicine for handling of non-self-sufficient patients and to find out whether nurses at departments of intensive medicine are able to use correctly the available aids for handling of non-self-sufficient patients. To achieve the objectives, three hypotheses were established H1: Nurses at departments of intensive medicine do not use all aids for handling of non-self-sufficient patients. H2: The aid most frequently used by nurses at departments of intensive medicine is a positioning mat. H3: Nurses at departments of intensive medicine are able to use correctly the available aids for handling of non-self-sufficient patients. The objectives of the work have been met and three hypotheses were confirmed in the survey. This thesis may serve as an information material for nurses interested in nursing in intensive medicine. Further, it may serve for manufacturers of aids for handling of non-self-sufficient patients; it presents opportunities for improvement of the most frequently used aids and for simplification of work with aids used by the nurses less frequently.
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Guestion of nursing care in patiens with urinary catheter in their home environment {--} educational aktivity of nurses
JANÁKOVÁ, Šárka
This thesis focuses on patients with permanent urinary catheters, as well as on nurses who educate the patients when discharged from hospital to home care. The educating role of a nurse in this situation is particularly important. The nurses providing education to patients include those employed by hospitals, as well as by home care agencies and senior citizen homes. Not every patient is able to take care of the urinary catheter him/herself and therefore nurses from home care agencies are made available to assist. The nurses should educate the patients about all aspects of catheter application, e.g. the reason of application, complications (urinary infection, pull-out etc.), catheter maintenance (hygiene and aids, replacement of the collection bag etc.), catheter replacement (max. 21 days after the application), monitoring the urine color etc. The nurse should also ensure that the patient is educated in a quiet and agreeable place and, particularly, they should dedicate a sufficient time to each patient so that nothing is neglected. The first objective of this thesis was to find out whether nurses at the urology department educated patients with urinary catheters when they were discharged from hospital to home care. The second objective focused on nurses employed by home care agencies and senior citizens homes to check whether they got involved in education activities while taking care of patients with urinary catheters. The third objective was to find out whether patients with urinary catheters, when discharged from hospital to home care, were educated about how to take care of their urinary catheters. The objectives were assigned their individual hypotheses. The first hypothesis examined whether nurses employed at the urology department educated patients with urinary catheters about catheter replacement when the patients were discharged from hospital to home care. The hypothesis has been confirmed. The second hypothesis again focused on nurses employed at the urology department and investigated whether they educated clients with urinary catheters , when the patients were discharged from hospital to home care, about how to prevent urinary infections; the research has shown that the nurses indeed educated the patients in this field. The third hypothesis focused on nurses employed by home care agencies and senior citizens homes and investigated whether they educated clients with urinary catheters about how to prevent urinary infections. Also the third hypothesis has been confirmed. The fourth hypothesis concerned the patients and it investigated whether they felt informed about how to take care of their urinary catheters and whether they were able to recognize symptoms of urinary infections. It has been found out that although the patients are familiar with some symptoms of the infections, they are not familiar with all of them and therefore it is impossible to deem the hypothesis confirmed. The method used to meet the objectives of the quantitative research was that of anonymous questionnaires for nurses and patients. The questionnaire for nurses contained 21 questions and the questionnaire for patients contained 23 questions. The data were collected from March to May 2009. 100 questionnaires were distributed to nurses and 80 were returned, which means the response rate of 80 %. Out of 50 questionnaires distributed to patients 30 were returned, which means the response rate of 60 %. This thesis demonstrated that not all nurses provide a sufficient education in all aspects necessary for the patients. Also, not all the patients feel sufficiently educated in this field.
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Providing the patient´s privacy after total hip replacement operation
RŮŽIČKOVÁ, Michaela
Abstract In our company the emphasis in the field of nursing care has increasingly been focused on preservation of a patient`s dignity and intimacy. In daily activities in a pacient the privacy and intimacy the patient may be affected which causes different reactions of such a patient. One might say that even after the routine procedure such as total hip replacement it is very important that the patient has enough privacy. The aims of this study were to assess how the intimacy in the postoperative care is ensured in patients undergoing total hip replacement at the intensive care units and to find out the level of knowledge of the nurses as for adherence to intimacy after total hip replacement. The research group consisted of patients who were hospitalized at the intensive care and standard units in the Hospital České Budějovice, a.s. (PLC), Faculty Hospital Olomouc and Military Hospital Olomouc. The second research group consisted of the nurses who worked at the intensive care and standard units in the Hospital České Budějovice, a.s. (PLC), the Hospital Šumperk, a.s., Faculty Hospital Olomouc and Military Hospital Olomouc. The research investigation was performed by the method using two ananymous questionnaires. The first defined hypothesis was confirmed. The patients at the intensive care units are more satisfield as for their intimacy compared to the patients at the standard units. The second hypothesis was also confirmed. The nurses have not enough time to ensure intimacy of the patient after total hip replacement. The third hypothesis was confirmed. The nurses have enough information of how to take care of the intimacy in the postoperative period. The fourth hypothesis was not confirmed. The nurses at the intensive care unit do not care about the intimacy with a higher interest compared to the nurses at the standard unit. The findings of this investigation show that the patients after total hip replacement at the intensive care unit are more satisfield with the provision of intimacy in the postoperative care compared to patients at the standard unit. Although the nurses do not have enough equipment to ensure the intimacy of a patient in the postoperative care, they know how to take care of intimacy in the postoperative care.
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Demans put on nurses work when providing nursing care on hemodialysis department.
KADLEČKOVÁ, Aneta
Abstrakt In our Bachelor Diploma Work we dealt with the problems of the difficult of the work of nurses in the department of haemodialysis. We have chosen this topic because of the growing higher demands made on the nurses. It can be said that the profession of a nurse is very demanding, they are even jeopardized both by the psychological and physical influences. Because of that there are several advices the nurses should know and observe them. The professional literature encourages the nurses in the department of haemodialysis to find at lest a short moment to learn how to rest and to relax. Unfortunately it is not like that in reality. In the theoretical part we focused on the haemodialysis characteristics, on its indications, contra-indications, on the nursing care in this department and naturally on the psychological and physical impacts on the nurses in the department of haemodialysis. For the research investigation I used a semi-structured discussion. It contained 21 questions, the nurses had to answer. The data collection took place during March 2009. The total numer of enquired nurses was 16. The topic was based on the three targets. To find out what demands have been made on the treatment care for the patiens in the department of haemodialysis, to find out, what impact the care has on nurses in the department of haemodialysis and to find out whether the nurses in the department of haemodialysis suffer from the burn-out syndrome. Based on my Bachelor Diploma Work we would like to organize a seminary for the nurses, working in the department of haemodialysis, focused on the burn-out syndrome and correct relaxation.
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Preparing and administering medicaments by hand or by an instrument
ŠEBENDOVÁ, Jana
I found out in this thesis the way nurses handle medicaments. What preparing and administering medicaments is like, and whether they prefer their own hands or an instrument in their work. This subject started to attract me for the reasons of an untraditional view of nurses{\crq} everyday work because they get in contact with preparing and administering medicaments several times a day. It was also interesting to compare the theoretical part with the practical aspects of the matter. In the theoretical part I outlined the entire knowledge nurses are to have not to endanger themselves or the patients in the course of handling medicaments. Nurses have to know the terminology related to medicaments, further what forms of medicaments there are, what effects may be expected, they are also supposed to know the manner of the application of medicaments, the manner of preparing and administering medicaments, what mistakes nurses may meet with when working with medicaments and what roles nurses have when administering medicaments. I am focusing especially on administering medicaments orally. The objectives of my thesis was to survey in what way nurses conduct hand hygiene before preparing and administering medicaments, whether they use aids intended for handling medicaments, in what way medicaments are prepared and administered to patients. To obtain results, I used the qualitative research. In total, 2 techniques were used. The first technique was hidden observation based on an observation list prepared beforehand, with activities connected with the subject in question. This observation was completed with a second technique {--} a structured conversation with open questions. Both the observation and the structured conversation were conducted in the intern section of the České Budějovice Hospital, a.s. The results may be given to the management of the hospital in which the research was conducted. They may also serve as a basis for a new standardisation of the subject in question.
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The issue of nursing care of patients with meningitis
JEDLIČKOVÁ, Eva
The aim of the bachelor essay was to find out whether nurses respect the rules of a barrier nursing regime when treating patients suffering from meningitis, and to discover the specific features of the care of these patients. The determined hypothesis was supposed to confirm whether nurses respect the rules of a barrier regime when taking care of such patients. To specify data, we determined a research question which was supposed to find out what type of specific care patients suffering from meningitis need.
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