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Nursing care of geriatric patient
MUŠKOVÁ, Simona
Current status Old age is late phase of the ontogenetic proces, which completes the human life and carries with itself a lot of changes. These changes are inevitable for each of us (Čevela, Kalvach, Čeledová, 2012). When we speak of geriatric patient, we mean a patient older than 75 years. This is the classification of World Health Organisation (WHO). Aging leads to loss of physical and mental strength and to somatic changes some of which are highly visible at first sight (Haškovcová, 2010). General nurse with knowledge about the issues of geriatric patients can get them the optimal nursing care to be able to support their bodily functions and maintain functional fitness. Evaluating the abilities of geriatric patient, then enables general nurse to set reasonable care and then perform preventive and therapeutic interventions (Pokorná, 2013). Aim of the study The aim was to map the issue of nursing care for geriatric patients in acute beds and beds for long-term care from the perspective of nurses and also from the perspective of patients. Four research questions (RQ) were then assembled for these goals. RQ 1: How nurses perceive the problems of nursing care for geriatric patients in acute beds? RQ 2: How nurses perceive problems of nursing care for geriatric patients on long-term care beds? RQ 3: How geriatric patients perceive nursing care received from nurses in acute beds? RQ 4: How geriatric patients perceive nursing care received from nurses on long-term care beds? Methods For the empirical part of the bachelor thesis was used qualitative research. For the purpose of the data collection were used interviews, which consisted of pre-built key questions and according to willingness of the individual respondents to share their opinions were inserted additional questions. The survey consisted a total of 20 respondents, of which 10 respondents were from the Department of aftercare and 10 respondents from the orthopedic department. Of these ten respondents were 5 nurses and 5 patients in each ward. The research was carried out in the hospital bed area of the department of aftercare and orthopedic department. The interviews were transcribed verbatim and then categories were created to methodology, which showed what troubled the patients during hospitalization the most, and what nurses see as the biggest challenge when working with geriatric patients. The results By the nurses from the department of aftercare, patient immobility, lack of cooperation with disoriented patients, problems with emptying, usually constipation, change in the environment as a factor disturbing the sleep of the patient, not keeping the drinking regime, despite the patient claiming otherwise and not least the patient's hearing loss that nuisance communication between staff and patient and finally the patient's hearing loss that nuisance communication between staff and patient are seen as the biggest problems. Nurses from the orthopedic department see the biggest problem in the movement impairment of the patients, the pain that patients experience after surgery and the stress that accompanies the patient before surgery. Furthermore, problems with emptying, difficulty sleeping, patient's non-compliance and hearing loss. All interviewed patients complained the most about the lack of privacy during hospitalization, especially during their personal hygiene, about the fellow patients who disturb their sleep, as well as the lack of communication on the part of nurses. Furthermore, patients from the department of aftercare most complained about lack of information told to them when received at the department. Patients from the orthopedic department were complaining about the way in which personal hygiene is performed.
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Effect of iron overload on the induction of apoptosis in mammalian cells
Kabíčková, Tereza ; Balušíková, Kamila (advisor) ; Klíma, Martin (referee)
Iron cations are an important metal ions required to number of essential cell functions. On the other hand, ferrous iron can be very toxic as well. When surplus iron is present in cells, it can catalyze the formation of reactive oxygen species (especially hydroxyl radicals) by Fenton reaction. Iron homeostasis is predominantly regulated by very strict mechanisms on the level of iron uptake into the body. Moreover, iron absorption, transport and storage within the body can be also regulated using complex mechanisms which differ on the level of individual cells and on the level of whole organism. Deregulation of iron homeostasis causing an iron overload and generation of reactive oxygen radicals can evoke serious cell damage leading up to apoptotic cell death. Excess iron storage and subsequent development of oxidative stress can affect lot of different tissues in the body. The organ damages such as fibrosis, cirrhosis, hepatocellular carcinoma, heart failure, loss of β cells and glucose intolerance or diabetes mellitus in patients with iron overload are very often seen. Nevertheless, the apoptosis induced by iron overload has not been well elucidated yet. There are no complex informations about the precise mechanism by which oxidative stress affects different cell types or whether there are other...
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Special access of the radiology assistant to interventional procedures in diagnostics of oncological patients
CANDROVÁ, Daniela
In my work I deal with the peculiarities in approach of a radiology assistant to interventions in diagnostics of oncological patients. Biopsy has a special importance in diagnostics of neoplasm. It is essential for histological and cytological diagnostics. The aim of this work was to find out the incidence of bioptic interventions on oncological patients during one year at radiology department at České Budějovice hospital plc, and to compare the advantages and disadvantages of used modalities. The work proceeds from the presumption that the number of interventions carried out under the sight control without the use of ionizing radiation methods is growing. In the theoretical part of my work appear descriptions of bioptic methods of intervention radiology regarding oncology and its methods, biopsies, screening methods used at biopsy (ultrasound controlled biopsy, computer tomography controlled biopsy, magnetic resonance controlled biopsy, skiascopic controlled biopsy), instrumentarium, especially the needles used for tissue extraction (puncture and bioptic needles), characteristics of oncological patients, the principle of tumour disease, carcinogenesis, oncologically changed tissue, and basic diagnostics of oncology disease. The practical part reveals the number of biopsies performed in 2012 at České Budějovice hospital plc, under computer tomography, ultrasound and mammography machine control, and the number of other interventions on oncological patients, namely localization of impalpable breast lesion, percutaneous drainage of the urinary tract under skiascopic control. Standard methods regarding these interventions and biopsies are described focusing on the advantages and disadvantages of their use for different organs in the body. I also described radiology assistant?s work and created photo documentation of given interventions. In 2012, 96 biopsies were performed under any of the mentioned diagnostic screening methods at radiology department of České Budějovice hospital. They represent 0,06% of the total of 171 466 diagnostic interventions at this department in the respective year. At the same time they represent 3,4% of the total of 2844 interventions of the ČB radiodiagnostic department of that period. From the whole number of 96 biopsies, 79% were performed on oncological patients. No biopsies were performed under magnetic resonance or skiascopic- skiagraphic control. Since the formation of a tumour is supposed to be the main somatic risk which an individual after a low intensity radiation faces, I supposed that the number of bioptic samples taken under sight control without the use of non ionizing radiation is rising, which significantly contributes to radiation protection. It is not univocally assigned which screening method is the best for biopsy. Usually we chose the biopsy that can screen best the site in different organs and that allows the safest, the fastest and the economically most convenient procedure. The chosen method should allow the doctor chose the site for sample extraction. The choice also depends on the habits and the technical equipment of given hospital. In view of the fact that according to this work computer tomography is the most commonly used method for bioptic extractions, and under magnetic resonance control no biopsies are performed, the prestige and importance of a radiology assistant grows up, because their presence at modalities using ionizing radiation is commonly indispensable. The hypothesis of my work has not been proved. Concrete results do not support the operative hypothesis of y work. However, I can recommend concessive long-term type and multicentrically elaborated sample studies. I would be grateful if this work provided an information base for radiology assistants´ training and for interventions in the diagnostics of oncologically ill people.
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Software pro rozvrhování operací a evidence nástrojů pro nemocniční zařízení
Tupec, Pavel ; Šerý, Ondřej (advisor) ; Kruliš, Martin (referee)
Nowadays in most medical facilities is daily schedule of operations mainly created manually or with minimal support of software tools. Result of this is occasional ineffectivity of operation schedule and primarily huge time consumption for surgery chief who could use his time for more important things related to his work. Another reason for creating this application is that information about patients, operations, wards and diagnosis are stored decentralized in different applications and systems, which makes working with them more difficult. Target of this application is implementation application for creating operating schedules in hospital facilities with assurance of necessary instruments, wards and instrument evidence. Where all data about all necessary entities will be stored and managed centralized. Purpose of final program is make schedule creating more effective and partially automatized operation planning.
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Parental Stress and Coping Following the Birth of a Preterm Infant
TOMÁNKOVÁ, Barbora
The degree work deals with the parents of pre-maturely-born children. The part dedicated to theory handles the issue of the immaturity of prematurely-born children including the latest trends in nursing the given children. The other issue tackled in this part is the family and its specifics concerning a prematurely-born child and the choices of how to enhance the family. This part also focuses on the communication with and the expertise of people working in the field involved in the care of premature children and their parents. The target of the work has been to discover and reflect upon what the mothers of prematurely-born children are experiencing, what needs they may have in the field of communication with and expertise of the healthcare staff and to define what enhancing therapy interventions are at the disposal of parents while their children are hospitalized. To achieve the targets of my work, quality research has been conducted and the method employed was asking questions and a semi-standardized interviewing technique of the mothers of prematurely-born children and the people working in the field. In addition, the document?s contents analysis was completed. The research files were formulated by the people working in the field from the obstetric facility ?The Institute for Mother and Child Care? and by the mothers of prematurely-born children who gave birth at the above healthcare facility. Another intention of the research was to confront the views of mothers of prematurely-born children with the approach of the people working in the field. Resultant from the analysis of the above testimonies, hypotheses have been inferred. The work points out the necessity of a tender approach, of providing emotional support and also empathetic communication from the side of the healthcare staff. Further, the healthcare staff should be trained on how to provide timely-crisis enhancement to the parents. The expertise of the staff is also important in providing the complex follow-up mental and social support to the parents. The outcomes of the degree work may be applied as a feedback for the particular healthcare facility and/or generally to improve the care quality for parents of prematurely-born children.
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Ebola as a medical and social problem
Gantsetseg, Purevsuren ; Hladká, Petra (advisor) ; Kordulová, Pavla (referee)
Introduction: The aim of bachelor thesis is about the preparedness of health care facilities. The unexpected epidemic of Ebola 2014 in West Africa has become an international concern and the preparedness of health care facilities, prevention and control of this disease have become a major issue of concern. Methodology: For the development of the thesis, we chose a qualitative method, a form of research was an interview. The questions were designed in our own creation. The interview was conducted by epidemiological workers in surveyed health care facilities. The main objective of the research was to determine, what the methodologies in health care facilities are during admission and stay of a patient with Ebola. Results: From our analysis, the survey indicates that the organizational structure of hospital care ensures that patient with Ebola are handled according to the Government decree no. 15/2013 and health care facilities proceed according to the directive for unified procedure. In the development of an extraordinary incident, this is subjected to the International Health regulations in relation to the occurrence of highly dangerous infectious diseases in a health care facility. Another finding is that health professionals are familiar with the procedures in care of an Ebola patient by developed...
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Patients'Recruitment Issues in Clinical Trials
Hrubá, Dagmar ; Doskočil, Ondřej (advisor) ; Štegmannová, Ingrid (referee)
This thesis examines patient recruitment in clinical trials. It is a current and pressing issue, which is not sufficiently embedded in the thinking of doctors and patients, their patterns of communication, and more broadly in the traditional doctor-patient relationship, which continues to be burdened by post-socialist paternalism. The formal framework and ethics have been developed relatively recently, and their application causes confusion to all participants regarding how to proceed in specific situations. In addition, the choice of topic, and especially the form of dealing with the topic, was motivated by the relative lack of academic resources and publications in the field. The theoretical section of the thesis defines clinical research and its phases, and introduces basic terminology and documents closely linked to clinical research. In addition, it focuses on research ethics, thoroughly examining the issue of informed consent - a fundamental document necessary for recruiting a patient in a clinical trial. Finally, one chapter of the thesis focuses on the issue of medical literacy, the level of which is integral to the participants' understanding of the importance of clinical research, and directly affects participants' decision-making. The empirical section is divided into two parts. The...
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An Analysis of Speech Problems in Persons with Parkinson?s Disease
Šimonková, Ivona ; Housarová, Blanka (advisor) ; Voldřichová, Michaela (referee)
The thesis deals with the diagnosis of impaired communication ability of patients suffering from Parkinson's disease. The theoretical part surveys the up to now knowledge of Parkinson's disease, speech problems connected with Parkinson's disease and specific possibilities of logopaedic diagnosis. In the practical part the speech of people suffering from Parkinson's disease is assessed. Dysarthric speech impairments are assessed in relation to the length of Parkinson's disease. Test 3F (used for diagnosing dysarthric patients) is used to examine a group of people suffering from Parkinson's disease. The people are divided into three groups according to the length of their disease.
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Position Analysis of the Health Insurance Companies in the Health Service System in CR
Přikrylová, Jana ; Písař, Pavel (advisor) ; Czesaný, Slavoj (referee)
The object of the Bachelor's work is to analyze the present position of the health insurance companies in the health system of the Czech Republic. First of all I characterize the particular health service systems existing in the world in my work. Further I am concerned with the health service system in this country, with its development, financing and, especially, with the role of the health insurance companies in this system. A special attention is devoted by me to the health insurance which is the main income of the health insurance companies; and to its redistribution. I analyze problems of the public health insurance system as well as of the health insurance companies. In a further part I deal with the health insurance system in U.S.A. where the health insurance is voluntary and therefore it is set up on a commercial base, whereas the public general health insurance in CR is compulsory. I compare advantages and disadvantages of the health service systems in CR and U.S.A. and on base of this analysis I will prove that the Czech medical service is instable economically; that it comes to wasting as the patient has no choice to choose the care according to the quality and price; it comes to reduction of the availability of medical services; the patients have no possibility of paying extra money for a service of higher quality even if they have enough money for that. At the end on the basis of the analysis of functioning of both these systems I indicate which way the reform of the medical service in this country could proceed.
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