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Education of patients with myocardial infarction within secondary care
RYBÁŘOVÁ, Jana
Myocardial infarction is the acute form of the coronary artery disease. The most common triggering effect is the rupture of an aterosclerotic plaque in a epicardial coronary artery that supplies heart with blood. The cardiovascular disease mortality in the Czech Republic is about 600 deaths per year per 100 000 persons. Also young people at productive age are being stricken by heart attack {--} as myocardial infarction is commonly known. To treat myocardial infarction effectively, it is necessary for the patient to follow all the principles of secondary care. The main demand is quitting smoking, changes in patient´s diet, reducing weight and increasing physical activity. The method of education is used to prevent the patient from recurrence of heart attack. The patient establishes new emotional and personal attitudes to his or her health. In the theoretical part of my thesis information on the anatomy and physiology of the heart, as well as general facts on the origin, symptoms and treatment of myodardial infarction are given. The issue of secondary prevention is dealt with at full length. The principles of the educational process, the appropriate communication with the patient and the choice of educational aids are mentioned. To meet the targets of the thesis the quantitative research was chosen. To collect relevant data I used the questionnaire method. The research was anonymous both for nurses and patients. There were 30 questions in questionnaires for nurses and 22 questions in questionnaires for patients. The research was conducted in March 2008 in the cardiology departments in hospitals in České Budějovice and Pardubice and in consulting rooms of cardiologists and internists in České Budějovice and Pardubice. I handed out 100 questionnaires to patients and 50 questionnaires to nurses. 79% patients and 98% nurses filled them in and sent them back to me. The objectives of the thesis was to examine if patients who have undergone myocardial infarction follow regimen instructions and if nurses give them enough information. The objectives were achieved. I formulated the following hypotheses in the practical part: H I: Patients are not informed by nurses about the principles of secondary care after undergoing myocardial infarction. This hypothesis was confirmed. H II: Patients do not follow the regimen instructions. This hypothesis was confirmed. H III: Nurses do not provide education for patients. This hypothesis was confirmed. The analysis of the data obtained shows that patients are informed about the principles of regimen but they do not always abide by them. The education provided by nurses is often done by handing over educative brochures and leaflets. The results of my research are applicable in practice. In the theoretical part patients who underwent myocardial infarction find a lot of useful information on the regimen {--} the plan to improve and maintain health. Nurses may learn how to provide the education effectively. This thesis can contribute to better awareness on the issue of secondary care for patients after myocardial infarction.
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The realization of educational program at patient with diagnosis of cardiac infarction
MATUCHOVÁ, Mária
This Bachelor´s work deals with educational programmes for patients with recognised myocardial infarction. Even if the circulatory system mortality rate has been decreasing steadily, it remains quite high compared to other EU states. Thousands of people can be successfuly treated thanks to developing diagnostic and therapeutic opportunities. On the other hand, no treatment is effective enough without active clients´ cooperation. Higher attention, however, should be paid to the prevention. Medical and nursing staff care is to focus on patients´ treatment and their education so that they could cooperate actively in realisation, prevention and treatment processes. A client can get basic pieces of information during his stay in hospital and he takes them up again while being a client of out-patient cardiologic departments. Usually, educational process is not organised very well which provides bad or no continuity of medical and nursing care. The aim of this research survey has been to find out the sources which the clients use for getting information, and what attention is paid to educational programmes. The hypotheses assumed at the beginning are as follows: Clients are mostly informed by nurses and find most information in magazines and brochures. Clients, with a prevailing number of women, realise the educational programme. The research survey has had theses findings.The first two hypotheses has been disproved while the other two were proved. Clients get most information verbally which means that they prefer personal communication. Concerning the other two hypotheses, the educational programme is observed by most patients with a prevailing number of women. So the hypotheses has been proved. The findings obtained from this Bachelor´s work are very useful because the education of cardiac patients within and outside health care facilities can significantly help reduce the number of myocardial infarction patients.
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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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Analysis of effectiveness of preventive interventions in patients with ischemic heart disease
ZLATINSKÁ, Sandra
Preventive interventions represent an important part of treatment of ischemic heart disease (IHD). Proper observation of preventive interventions results in faster recovery, earlier resumption of normal lifestyle and particularly prevention of early or late complications. The objective of this bachelor thesis was to determine how effective are the preventive interventions provided by healthcare personnel in the secondary prevention of ischemic heart disease. To meet the objective, the following four research questions were formulated: 1. Is the secondary prevention in patients with IHD effective? The secondary prevention is not effective as the respondents failed to change their lifestyles and they continued to manifest high rates of behavioral risk factors for IHD. 2. Do the patients with IHD observe recommendations given within the preventive interventions? Results of the research survey indicate that the respondents are aware of the IHD risk factors, however, they observe only certain secondary prevention recommendations. 3. What prevents the patients from observing regimen principles set by the secondary prevention? The patients find it difficult to change their established lifestyles which need to be altered in order to observe the principles. Results of the research survey indicate that the respondents find it particularly difficult to change their eating habits and sedentary lifestyle. 4. Is the observation of preventive measures dependent on the period of time after the disease attack? Interviews conducted with 10 respondents treated for different periods of time after the disease attack failed to confirm this hypothesis. Results of the research survey indicate that differences in observation of preventive interventions among the respondents were negligible. 10 respondents with ischemic heart disease were selected as a research sample. The data were collected by means of a qualitative research using two structured interviews with open questions. The first round of interviews with IHD patients was conducted in January 2009 at the cardiology department of the hospital in České Budějovice. The second round of interviews was conducted after the hospitalization treatment stage {--} three month after the patients were discharged from the hospital. This thesis may enhance the knowledge of healthcare workers in secondary prevention of IHD and become a basis for further investigations in this field.
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Physiotherapy procedure in recovery of patients after myocardial infarction
POSPÍŠIL, Martin
In the theoretical part of my thesis I processed theoretical data associated with this issue. This part contains a description of the anatomy and the functions of the cardiovascular system and the issue of myocardial infarction. The part includes classification, pathology and the mechanism of myocardial infarction occurrence. The thesis also covers clinical manifestations of the disease, diagnostic procedures and methods of treatment. The comprehensively curative rehabilitation programme is divided into four stages, i.e. hospital physiotherapy, early post-hospitalization physiotherapy, stabilization, and maintenance long-term physiotherapy. In the practical part of the bachelor thesis a method of a qualitative research was used. The results were processed in the form of case reports. The research was conducted in the cardiovascular physiotherapy ward of St. Anne{\crq}s University Hospital in Brno. The tested set consisted of two patients. The first patient attends the 2nd stage of the cardio-physiotherapeutic programme. The second patient who experienced a myocardial infarction approximately 4 years ago attends the 3rd stage of the cardio-physiotherapeutic programme. The objective of the thesis was to assess the benefit of the cardiovascular physiotherapy in patients who had experienced a myocardial infarction. The heath state of both the patients has been positively influenced. Both the patients state that their subjective problems associated with the state after the acute myocardial infarction have been removed owing to the cardiovascular physiotherapy. In objective terms, the increase in the muscular strength and the positive impact on the characteristics of the transport system may be evaluated.
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