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Unemployment and its impact on number of elective surgeries at surgery department
HÁLOVÁ, Magdaléna
SUMMARY A surgery ward is one of the crucial departments in the České Budějovice Hospital. It provides a highly specialized care not only to patients from the district of České Budějovice, but also to people from the whole South-Bohemian region. Nearly 4,000 patients are treated in this ward every year. In my work I focused on a group of people who are able to work, but at the time of hospitalization they had no job and were registered in the employment agency and they came to the surgical ward for optional surgeries. The reasons why they did so could be as follows: they either neglected the care of their health due to a large amount of tasks at work, or they postponed the surgery since they were worried that they could lose their job due to a long sick leave. The objective of the work was to identify the influence of employment on decisions of clients to undergo surgeries. Questionnaires were used to gather data; they were distributed to patients hospitalized in the surgical ward of Nemocnice České Budějovice a.s. (the České Budějovice Hospital). The hypothesis which assumed that people registered in the employment agency for a short time have more surgeries than people registered in the employment agency for a long time was confirmed in the degree work. The second hypothesis assuming that people registered in the employment agency have more optional surgeries than employed people was confirmed as well. The third hypothesis where I assumed that the fees charged for hospital stays would influence the length of hospitalization of unemployed people was not confirmed since political changes resulted in the conclusion of a donation agreement between Nemocnice České Budějovice, a.s. and the South-Bohemian region; the agreement enables people to take advantage of the South-Bohemian region{\crq}s donation to cover the hospital fees starting from 1 February 2009. The results of my work could be used as arguments in solving the unemployment policy.
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Meet the needs communication near clients with dysacousia on ORL
HOLAROVÁ, Erika
The work was elaborated on the topic: Satisfaction of communication needs in patients with hearing disorder at ORL. Hearing disorders are most frequent diseases. Hearing goes impairing from puberty in human. In order that the nurse working at ORL can understand patients with hearing disorders, she must first understand their thinking and experiencing. Communication with such patients is very various and depends on the degree of seriousness of the hearing disorder with which the patients arrive to the hospital. The satisfaction of communication needs is integral part of nursing process. If the nurse conducts a conversation with the patient, she must pay attention not only to what the patient tells her, but she pays attention also to his nonverbal expression because it can indicate more than his verbal expression to the nurse. The nurse always selects suitable form of communication, which contributes to understand the patient. We have elaborated two types of questionnaires, for nurses and for patients. Both types included basic identification questions and further questions were directed so that we could find out whether the communication needs are being satisfied. From the data results obtained from the nurses, we found out that communication with patients with hearing disorders is not satisfied. It is confirmed also by the results of the questionnaires we had handed out to the patients. The hypotheses of our work was: The communication needs is more satisfied to clients with hearing disorders at ORL wards than at ORL outpatients department. This hypotheses is confirmed through the data obtained from the patients and the nurse. The work can be used for education of nurses of the Faculty of health and Social Studies and for improvement of nursing care performed by nurses working at the ORL ward and outpatients department.
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Problem of knowledge of a patient indicated for colonoscopy
ČERNÁ, Miroslava
The colonoscopic examination is no only a diagnostic method, but also a therapeutic method applied in gastroenterology. The colonoscopic examination is performed by the flexible endoscope and it is possible to examine the whole mucous membrane of the large intestine and to perform here also minor surgical operations. The necessity for the colonoscopic examination is as perfect as possible defecation of intestines, however, also this depends on the sufficient knowledge of the patient of the examination performance and preparation. This examination is quite stressing and strenuous for the patients. The target of the thesis was to find out the difference in knowledge of clients indicated for colonoscopy within hospitalization and clients coming as outpatients. 2 hypotheses were postulated: Hypothesis 1: {\clqq}The scope of information of dietary measures before colonoscopy provided to hospitalized clients is different than the scope of information provided to ambulatory clients``. The hypothesis 2: {\clqq}The scope of information about the procedure of the examination before the colonoscopy provided to hospitalized clients is different than the scope of information provided to ambulatory clients``. The method of questioning - technology of a questionnaire was applied to the collection of data. The questionnaire was completely anonymous and was determined for patients indicated to colonoscopic examination. The questionnaire included 22 closed and half-closed questions. 130 questionnaires were distributed in the gastro-enterologic ward in the Hospital of České Budějovice a.s. After returning the questionnaires and elimination of the incompletely filled in and empty questionnaires, the examined group consisted of 106 respondents, thereof 53 were ambulatory respondents and 53 hospitalized respondents. The target of the thesis was achieved. It followed from the results that both hypotheses were confirmed, there is really a certain difference in knowledge before the colonoscopic examination between the ambulatory and hospitalized respondents. In both hypotheses, the ambulatory respondents were informed better. This bachelor´s thesis points out the importance of giving the information to the patients and of co-operation between the patient, nurse and physician. To improve the knowledge of patients indicated for colonoscopy I created the draft of a leaflet, summarizing information the patient should know before this examination. The results of this thesis will be provided to the head and management of gastro-enterologic ward of the Hospital České Budějovice a.s. Its topic could be of help to the medical staff in better informing the patients.
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A Chinese patient in the Czech health care service
SCHOLZ, Pavel
The name of this thesis is: "A Chinese patient in the Czech health care service". China with approximately 1.3 million inhabitants belongs to the largest countries in the world. Migration and tourism of inhabitants of the Folk Republic of China and Republic of China towards the Central European region, is higher year by year. Simultaneously, with increasing accumulation of the Chinese minority group members in the Czech Republic, even the number of provided health care for this minority group of inhabitants is rising. Different conception of health and disease markedly affects the approach and understanding of the patient/client from another culture both from professional point of view and from the view of patient/client. Medical personnel should be aware of main differences in behaviour of the members of minority group and their population, and not only in connection with provided health care. This research work is worked out by means of qualitative research methods. Working out of nursing care peculiarities which the members of Chinese minority want to respect was the research goal of this thesis. Collection of data was carried out by means of a half-structured interview in members of the Chinese minority group in the Czech Republic. The content of questions of the half-structured interview is based notably on conceptual, nursing models developed by Gordonová, M., Leiningerová, M., and a model developed by Gigerová, J. {--} Davidhizerová, R. The five research questions were specified for the goal accomplishment. The results of research were treated by means of casuistics and a slightly modified approach of general analysis by Ritchie and Spencer. Established nursing care peculiarities in the area of blood taking, and information of physician´s diagnosis, especially towards the family, and apprehension of medicament addiction, and even the pain and answer to it belong to leading results. Description of how the members of Chinese minority group understand the Czech nursing and a nurse as a provider of professional nursing care also belongs to other results. The hypotheses decided on further research use were suggested on the basis of results of this thesis. This thesis and its results are determined to the professional health care purposes and for direct provision of nursing care in health service facilities in the Czech Republic. One of the outcomes of this thesis is also a propsal of the nursing care standard in members of Chinese minority group living in the Czech Republic, and, hereafter, an information summary book for nurses concerning trans-cultural specificity of the Chinese patient/client in the Czech health services.
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Patients´ contentment as an indicator quality of nursing care
PERLÍKOVÁ, Jana
The thesis deals with patients´ satisfaction as an indicator of nursing care quality. Theoretical part is divided into five chapters and is focused on theoretical bases of nursing, quality of care, patients´ satisfaction, characteristics of investigated work place and patients´ laws. In the research part I deal with patients´ satisfaction with nursing care at internal wards in Hospital České Budějovice, Inc. A quantitative investigation was proved, for data collecting a method of questioning, technique of questioning was used. Research sample was created by 160 hospitalized patients. By means of investigation were proved following working hypotheses. H 1: addressed patients are satisfied with complex nursing care, H 2: addressed patients are satisfied with nursing staff, H 3: addressed patients valuate medical care positively, H 4: addressed patients valuate hospital stay positively. On the base of questionnaires we can say that all working hypotheses were confirmed. The aim of the thesis - to find out patients´ satisfaction with nursing care at internal wards in Hospital České Budějovice, Inc. was fulfilled. It is important to follow patients´ experience with nursing care and at the same time to be interested in their satisfaction as it is irretrievable source of information stating the nursing care quality from the view of patients {--} users of the care. We think that information from this thesis can be used by all medical workers and other staff participating in medical care and satisfying patients´ needs. The thesis can be also used by broad public. It can be also used as a teaching material for students who want concern this topic. As contemporary medical trend is mainly satisfied patient, more attention should be devoted to patients´ satisfaction.
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The need of sleep by patients with cardiovascular disease in ICU
KABEŠOVÁ, Jitka
Lately, attention has been focused on sleep problems. Poor quality sleep, insomnia or intentional sleep shortening are risk factors for cardiovascular disease development, overweight, diabetes and mental disorders. During hospitalization in the ICU the sleep quality in patients usually worsens not only because the disease itself but also owing to other factors, such as fear, anxiety, lack of information on the disease, unfamiliar environment or noisy monitors. The theoretical part is divided into five basic chapters as follows: sleep characteristics, the issue of sleep, cardiovascular disease, meeting sleep needs in patients in the cardiologic Intensive Care Unit and the intervention of a nurse in meeting sleep needs in the sleep laboratory. I set two objectives in my thesis: The first objective: to learn if sleep needs in patients in the cardiologic Intensive Care Unit are met. The second objective: to identify factors influencing the fulfilment of sleep needs in patients in the cardiologic Intensive Care Unit. Two hypotheses were suggested: The hypothesis I: sleep needs in patients hospitalized in the cardiologic Intensive Care Unit are not met, The hypothesis II: the most percieved factor influencing sleep in patients in the cardiologic Intensive Care Unit was the change of environment. To achieve the objectives I used the questionnaire method. The research set included patients hospitalized in the cardiologic Intensive Care Unit in the České Budějovice hospital, Inc. The obtained data analysis shows that sleep needs in patients hospitalized in the cardiologic Intensive Care Unit are not met. The most stressful factors are: the change of environment, monitor noisiness, lights switched on at night, uncomfortable beds and anxiety. The hypotheses were confirmed. The objectives of my thesis were accomplished. In the closing part of my thesis I suggest some solutions to improve patients´ feelings and meet their sleep needs, such as dim lights at night, turned down monitoring apparatuses alarm, patients activation during the day, a calming dialogue with the patient, bed making and airing the room before night. I also enclose some attachments treating the issue of sleep needs.
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Knowledge of the Family with Alzheimer´s Disease Patient about Communication Specifics
ČERNÁ, Irena
Alzheimer´s disease belongs to the most common forms of dementia. The occurence of this disease rises with increasing life expectancy of population. The more serious the disease is the lower and more difficult is the possibility of patients to communicate with other people. Close relatives usually bear this situation with difficulties. The nurse should both be involved in the treatment and education of patients´ families. The aim of this work was to find out if family members are informed on specifics concerning communication with the patients and are interested in getting more information. The first hypothesis was based on the fact that family members do not know how to communicate with their close relatives suffering from Alzheimer´s disease and the second hypothesis was that family members are interested in getting more information on mutual communication. Quantitative research methods such as questioning and questionnaires for collecting data were used to analyse the work. Ninety-six respondents were asked. All of them were family members of Alzheimer´s disease patients who have been accommodated in Prácheň sanatorium in Písek and in Loucký mlýn. All data collected were analysed and projected into graphs. As a result, the first hypothesis was rifuted and the second was proved. The conclusions of this work will be used for further education of family members of Alzheimer´s disease patients. It will be organised professional seminars in both sanatoria, in Písek and Loucký mlýn. This way I would like to contribute to better communication between patients and their families.
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Patient radiation load and possibility of reduction by percutaneous coronary interventions
KVASNICOVÁ, Miroslava
Abstract More than 100 years have passed since physicist W.C.Röntgen discovered X rays and their use in medicine. Knowledge about their harmful effects led to gradual im-plementing of protection rules. Attention of experts gradually focused on persons exa-mined or treated by ionizing radiation, as so-called medical exposition represents the most important part of person´s irradiation from artificial sources of radiation at all. De-finition of medical irradiation was accepted by Act No.18/1997 Coll. (Atomic Act) and extended in novel of the Act (No.13/2002 Coll.). Medical irradiation is not limited but two principles of radiation protection govern {--} principle of reasoning and principle of optimalization. I focused my attention on radiation load of patients during selective coronaro-graphy which still remains gold diagnostic standard for coronary arteries examination. I measured and evaluated the radiation dose of patients at two angiography machines in Teaching Hospital in Motol. They are angiography machines PHILIPS Integris Allura (made in 2002) at Institution of Imaging Methods and PHILIPS Integris HM 3000 (ma-de in 1993) at Cardiovascular Centre for Adults. Some technical parameters of these machines differ, e.g. the size of image amplifier. Since 2003 to 2007 10,087 patients at Cardiovascular Centre for Adults and 7,760 patients at Institution of Imaging Methods were examined by selective coronarography. I analyse all equipment of angiography work place, including technical of X-ray angiomachine, radiological standards, protection against radiation, requirements for imaging system, parameters impacting the quality of X-ray image, possibilities of lowering radiation load in patients. Hypothesis is based on idea that radiation load can be lowered by setting suita-ble exposition parameters and collimators. Methodology consists of measurements of exposition dose in 100 patients at Institution of Imaging Methods and at Cardivascular Centre. I compare the dose at both work places on the base of different size of image amplifier, different frequency of scanning and advert to different dose in different projection. Other part consists of mea-surements on phantoms, in which I compare the dose acquired in patients. I watch fur-ther parameters impacting the level of radiation load. Acquired results are mutually compared and statistically elaborated and valuated by {$\omega$}2-test. Evaluated data can serve for creating of radiologic standards which will contribute to staff education how to ma-nipulate sources of X-ray radiation to make the dose for a patient and for staff as low as possible.
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Need for self-actualization in patients during hospitalization
VACHTOVÁ, Ivana
Human personality is a dynamic and organized set of characteristics which are in a special relation. Personatity is thought to be determined largely by either genetics and heredity, or by environment and experience, or both. The personal needs are dependent on sex, age, education and differ in different generations. The personality is developed through interaction of life situation, life conditions and the place. Self-fulfillment means to fulfill one´s potencial. It refers to ability to realize one´s own needs and plans. According to Maslow the need of self-actualization belongs to growth needs. Self-realization evokes feelings of happiness and joy. It surpasses everyday routine, it is a spiritual need. The first objective of my thesis was to examine the need of self-realization in hospitalized patients. The second objective was to compare the needs of patients hospitalized in intensive care units to those of patients admitted to planned medical interventions and to those of patients in long-term care facilities. The third objective was to find out nurses´ attitude to hospitalized patients with needs of self-realization. To find relevant data patients hospitalized in intensive care units, patients in long-term care facilities and patients with planned medical interventions were addressed. Nurses taking care of those patients were also asked to take part in the research . Data were collected by the questionnaire method. The hypothesis I suggests that patients treated in intensive care units prefer the treatment which leads to feelings of security and alleviates pain. This hypothesis was confirmed. The hypothesis II suggests that patients admitted to planned medical intervention have more intensive needs of self-realization than patients treated in intensive care units. This hypothesis was not confirmed {--} patients expecting interventions feel the same need of security and pain management as patients hospitalized in intensive care units. The hypotesis III that patients admitted to planned interventions have more intensive needs of self-realization than patients staying in long-term care facilities was not confirmed. According to the data collected, patients in long-term care facilities need pain management and feelings of security, but they also need to be respected as personalities. They prefer to have the strength to fight the disease to the need of having the bed properly made. The hypothesis IV that nurses do not show enough interest in hospitalized patients´needs of self-realization was not confirmed. Nurses are informed enough about patients´ needs. They usually try hard to find the time to talk to patients. The results should make nurses be more aware of the need of lifelong learning despite their enormous workload and care for their own mental and physical health by following principles of mental hygiene. Key words: needs self- fulfillment patient environment relations communication
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Adhering to the treatment regimen in a patient with asthma {--} the role of a nurse
HRBKOVÁ, Jana
Adhering to the treatment regimen in a patient with asthma {--} the role of a nurse Asthma bronchiale is one of the diseases affecting a significant portion of the world population. It is estimated that 300 million people suffer from this disease on our planet. In economically developed countries asthma bronchiale is one of the most frequent chronic diseases with the prevalence of 10-15 %. The asthma prevalence and the prevalence of sensibilization against various allergens is increasing mainly in young population aged 6 to 7. The estimated prevalence in the Czech Republic is 8 %. Asthma represents considerable medical, social and economic stress for the patient, for his (her) family, but also for the whole society, from the viewpoint of absence from work or from school and also from the viewpoint of direct expenditures of the treatment and preventive care. Despite the fact that asthma currently remains a life-long incurable disease, it is a disease the symptoms of which may be mitigated. It is very important to adhere to the treatment regimen because this influences the course of the disease. The objectives of my thesis was to find out if patients follow the treatment regimen, if nurses educate patients and in what way. Three hypotheses were set: H I: patients do not follow the treatment regimen, H II: nurses educate patients to follow the treatment regimen, H III: the most frequent way how nurses educate patients is passing over information materials. The questionnaire method was used to achieve the objectives. The research set was formed by 60 respondents who were given out the questionnaires by a nurse. The data analysis shows that: H I {--} patients do not follow the treatment regimen {--} was rejected, H II {--} nurses educate patients to follow the treatment regimen {--} was confirmed and H III {--} the most frequent way how nurses educate patients is passing over information materials {--} was rejected. The results of my research show that patients are given enough information concerning their disease. Most of the patients follow the treatment regimen. But there are still reserves in nurses´ involvement in patients with asthma education.
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