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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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Possibilities of separate activity of radiologic assistant on the field workplace
VICHROVÁ, Olga
This bachelor thesis with in the range of independent work of radiologic assistant in different types of field departments. The teoretical part describes tha systém of field departments and the work of the radiologic assistant in this department. There are physical notes necessary for the introduction of the problem, there is also a description of the analogue system, division and description of the process. The final part of the work deals with teleradiology that in the future can expedite the work of radiologic assistants in their field departments. The aim of this work was to estimate the benefit of data digitizing the work of radiologic assistant in different field departments. It was estimate that there will be improvement in the technical and organizational part of work. Two hypoteses were determined. First hypotesis assumed that digitizing will expedite and improve the quality of work of the radilogic assistant. The second hypotesis assumed that digitizing will improve the care of patients. Both the hypoteses were confirmed. The outcomes were gained by comparison of time and economic savings in the of radiologic assistants in two different types of medical centres. This work proves that data digitizing can reduce the time of diagnostic process, and can improve the quality of care of patients. It also speeds-up and expedites the work of radiologic assistant, and for large medical centres it is also economic gain.
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Comparison of paliative care by clients in hospice establishment and oncology department
KADLECOVÁ, Ivana
Comparison of palliative care for patients in a hospice and at an oncology ward This thesis was focused on the various aspects of palliative care for oncological patients. Palliative care and its principles have been defined and it seems crucial to apply these principles not only in hospices but also at hospital wards where there are patients indicated for palliative care. The objective of this thesis was to find out whether the care provided to hospice clients and to dying patients at hospital oncological wards corresponds to the methods and procedures defined for palliative care and to find out whether there are any significant differences between the nursing care provided to the dying in a hospice and the dying at an oncology hospital ward. Four survey questions were formulated and the question dealt with maintaining palliative care standards, differences in providing palliative nursing care for the dying at the individual institutions, whether the dying clients{\crq} needs are answered in a holistic and humane way, and the nurses{\crq} approach to the dying at the individual institutions. The carried out research is a qualitative one. The research part {--} data collection {--} was carried out in the form of uncontrolled interviews with selected members of nursing teams in a hospice and at an oncology ward. Observations and case reports were used in case of several patients in at the individual institutions. The research was carried out in St Stephen Hospice in Litoměřice and at the oncology ward of an undisclosed health care institution by which information was provided in exchange for absolute anonymity. The research part resulted in the finding that the palliative care provided in the hospice corresponds to the methods and procedures defined for palliative care. There are efforts at the oncology ward to provide as perfect care for their dying patients as possible but this care does not correspond to the methods and procedures defined for palliative care. There are problems in providing palliative care especially in inadequate spatial conditions, equipment, shortages, high workloads, and strictly specialized focus of the personnel and these clients need very individual care that cannot be frequently provided under everyday operating conditions at a standard ward that concentrates primarily on curative care. The results of this thesis will be provided to those who may be interested in the various aspects of palliative care.
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Enlightenment problems of the patient with the pancreatitis
LOUDOVÁ, Veronika
Education is an important and significant part of treatment and the nursing process. The objective of education of patients with pancreatitis is for them to realize that a change of lifestyle and eating habits will lead to improved overall health condition and quality of further life. The objective of the thesis was to find out if nurses do educate patients with pancreatitis, how they educate the patients, if they tailor educational plan to needs of individual patients and what they consider to be the greatest problem of education of a patient with pacreatitis.
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Problems of morning waking up patients in the hospital and it´s influence on a patient
BERÁNKOVÁ, Barbora
The thesis deals with problems of morning waking up of patients in the ward and its influence on a patient. Morning waking up of patients is a situation faced by everyone who find themselves in a hospital {--} both a hospital employee and a patient. It is an everyday activity, although it may be one of great problems for hospitalized patients. The first aim of my thesis was to find out how morning waking up is perceived by patients hospitalized in a standard hospital ward. The second aim was to identify negative factors connected with morning waking up of patients hospitalized in a standard hospital ward. The third aim was to learn whether nurses working in a standard hospital ward respect the needs of their patients concerning morning waking up. The aims were fulfilled with the help of a questionnaire. A group monitored was formed by patients of an internal ward block. Three hypotheses were determined for these aims. Hypothesis one confirms that hospitalized patients are satisfied with morning waking up in a standard ward. Hypothesis two confirms that the most frequent factor concerning morning waking up with patients hospitalized in a standard ward is the time of waking them up. Hypothesis three confirms that nurses working in a standard ward respect the patient´s needs concerning morning waking up. The results will be handed over to senior executives of the ward where the research was carried out. They will have an opportunity to consider the problem of morning waking up of patients in their ward and, as the case may be, they can improve the situation.
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