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Degree of difficulty in performing activities of daily living in patients with rheumatoid arthritis
KAAS, Jiří
Theoretical foundation: Rheumatoid arthritis is a chronic system disease manifesting itself particularly by inflammatory joint impairment. The main problems confronting daily the patient include pains of the motor system and fatigue. The disease has typically long, progressive development, and although it does not cause directly the patients' death, it reduces their life by some ten years on average. The serious character of the disease consists in the fact that the motor abilities of the individual are gradually impaired. At the beginning the patients must avoid major physical activity, often give up their hobbies and sometimes even their jobs. In the most serious cases, the disease may even prevent the patients from performing basic self-service activities. Goal of the thesis: The goal of the thesis consists in mapping the level of problems of rheumatoid arthritis patients at performing daily activities. Hypotheses - H1: Rheumatoid arthritis patients feel discomfort when performing common daily activities, H2: Rheumatoid arthritis patients make use of supporting and compensation aids when performing common daily activities, H3: Rheumatoid arthritis patients make use of another person's assistance when performing common daily activities. Methodology: The research part of the thesis was implemented based on quantitative inquiry within the grant Project No. 120/2012/S ?Reflection of life quality in nursing?. The actual research made use of HAQ standardized questionnaire, distributed among the rheumatoid arthritis patients. The size of the research set was set at 200 rheumatoid arthritis patients from all over the Czech Republic. The respondents were chosen based on quota selection, striving to observe the proportion of men to women at 3:1, i.e. 150 women and 50 men. When searching the respondents, organizations associating patients with the respective diagnosis were first approached. All results obtained were statistically processed in the SASD (Statistical Analysis of Social Data) program. Descriptive statistics were used. Results: The results can be divided into three areas, by the related hypotheses. The first part of the results gave information on the degree of discomfort felt by the individuals when performing specific common daily activities. It was found out that the patients see the most difficult activity in taking down an item from a place above their head and bathing in the bathtub. The second area brought information on the aids used to perform common daily activities. The respondents named dressing aids or handgrips at the bathtub most frequently. The third and last area brought the answer to the question what activities require another person's help. The patients named reaching or opening of things most frequently. But an essential part of the patients stated not to need any help of another person in common daily activities. Based on the results, the hypotheses were evaluated as follows: H1 - Rheumatoid arthritis patients feel discomfort when performing common daily activities - confirmed, H2 - Rheumatoid patients make use of supporting and compensation aids when performing common daily activities - confirmed and H3 - Rheumatoid arthritis patients make use of another's person when performing common daily activities - not confirmed. Conclusion: The thesis provides a detailed and comprehensive view on the issues of performing common daily activities in rheumatoid arthritis patients. The results can be used both by practical nurses and by students of nursing and related disciplines. The thesis can also constitute foundation for further research. The thesis results will be also presented and published.
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Creation of a center for patients with rheumatoid arthritis and psoriatic arthritis
ŠTOKROVÁ, Veronika
The name of this bachelor thesis is: Establishing a centre for people suffering from rheumatoid and psoriatic arthritis. Rheumatoid arthritis is a chronic, system, inflammatory illness of joints that results in destructions and deformities of joints. It is a characteristic feature of this illness symmetrically that it affects more joints at the same time, which are, in the majority of cases, small joints. Psoriatic arthritis is an inflammatory illness of joints which is accompanied by psoriasis. Psoriatic arthritis affects mainly distal interphalangeal joints of the hands, which makes it basically different from the rheumatoid arthritis. The thesis is divided into two parts. The theoretical part dealt with rheumatoid and psoriatic arthritis, priority needs of people suffering from these troubles, and a possible centre for these patients. The empirical part of my thesis was compiled in the form of qualitative research. The technique of collecting data was a semi-structured interview, which was conducted with 8 respondents suffering from rheumatoid and psoriatic arthritis, and 5 nurses working at rheumatologic surgeries. The interviews with the particular respondents and nurses were processed into case histories. The most interesting data were processed in the form of categorising tables. The thesis aimed at the following: to find out whether people suffering from these diseases are interested in establishing a centre for clients suffering from rheumatoid and psoriatic arthritis, to underline the benefits of such a centre for people suffering from rheumatoid and psoriatic arthritis, to underline possibilities of activities held at the centre for people suffering from rheumatoid and psoriatic arthritis, and to underline possibilities of involving nurses at the centre for people suffering from rheumatoid and psoriatic arthritis. We posed the following research questions: How much are people suffering from rheumatoid and psoriatic arthritis interested in establishing the centre? What do people suffering from rheumatoid and psoriatic arthritis view the benefits of the centre in? What are the possibilities of involving nurses at the centre for people suffering from rheumatoid and psoriatic arthritis? Which activities can be realised at the centre? The results of the research examination show that people suffering from rheumatoid and psoriatic arthritis are interested in establishing a centre. They view the benefits of the centre especially in seeing and testing compensation aids, and another benefit for them would be attending expert seminars held by a physician in cooperation with a nurse or, under circumstances, with students. The nurse in the centre would deal with the education, and another possible activity could be holding seminars or cooperation with a physician in basic examinations. The activities that can be realised in the centre are exercises under professional supervision of a physiotherapist, visiting a physician, testing compensation aids or making use of professional advice by an occupational therapist. The results of my bachelor thesis can serve as a foundation for creating a centre for people suffering from rheumatoid and psoriatic arthritis.
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Influence of biological therapy on the level of self-sufficiency in patients with rheumatoid arthritis
JELENOVÁ, Michaela
Rheumatoid arthritis is a chronic autoimmune disease manifested mainly by stiffness and pain in joints. The main trouble of the disease lies in deterioration of patients´ quality of life resulting form painful syndromes and impaired function of joints. This progressive disease often leads to disability and invalidity, therefore rheumatic arthritis is an important therapeutic and social problem due to demanding nursing and social care and financial requirements. Significant changes in rheumatic arthritis treatment have occurred recently. Biological treatment has become a new therapeutic method. Data suggesting that this kind of therapy may slow or even halt the x-ray progression of the disease have been obtained.
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Promotion of self-sufficiency in patients with rheumatoid arthritis in selected daily activities at the home environment
TÜRKOVÁ, Věra
Promotion of self-sufficiency in patients with rheumatoid arthritis in selected daily activities at the home environment The topic of my bachelor thesis is promotion of self-sufficiency in patients with rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory autoimmune disease the main symptom of which is damage of mainly small joints, muscles, ligaments, but it may also manifest itself in internal organs of the body. This leads to significant motion limitation and thus greatly deteriorates the quality of life and self-sufficiency of affected people. Since it is women who suffer from this disease most, we concentrated on the area of cooking, eating and personal hygiene. The role of nurses is to lead patients to self-sufficiency. There are more possibilities how to provide the patients with limited self-sufficiency with support, but the thesis is focused on the aids to promote self-sufficiency in cooking, eating and personal hygiene. To carry out the research survey we stated six goals. The first goal was to find out what aids to promote self-sufficiency the patients with rheumatoid arthritis have at their disposition for cooking food and eating. The second objective was to determine what aids to promote self-sufficiency the patients with rheumatoid arthritis have at their disposition in the area of personal hygiene. The third objective was to determine what aids to promote self-sufficiency the patients with rheumatoid arthritis miss in the area of cooking and eating. The fourth goal was to find out what aids to promote self-sufficiency the patients with rheumatoid arthritis miss in the area of personal hygiene. The fifth objective was to create a brochure to promote self-sufficiency of patients with rheumatoid arthritis in cooking, eating and personal hygiene. The sixth goal was to apply the booklet on patients with rheumatoid arthritis. The goals of the thesis were met. At the turn of February and March 2011 the qualitative research survey was conducted. For data collection the method of questioning, the non-standardized interview technique was used. Using pre-prepared questions we interviewed the respondents with rheumatoid arthritis who are treated on an outpatient basis. Based on information and available aids mapping, a booklet to promote self-sufficiency in patients with rheumatoid arthritis was created and subsequently tested. The research group consisted of six respondents suffering from rheumatoid arthritis. The respondents were selected according to predetermined criteria, which were the suffering from rheumatoid arthritis, disease stages II., III., IV, when self-sufficiency is strongly influenced and monocyclic, polycyclic and progressive course of rheumatoid arthritis is present. The research sample for an inquiry was selected by the same criteria, and it consisted of 10 respondents. The thesis revealed which specific aids are available to patients with rheumatoid arthritis and which are missing. Based on obtained information and the aids mapped, a booklet to promote self-sufficiency of patients with rheumatoid arthritis in the area of cooking, eating and personal hygiene was created. We believe that steps to improve self-sufficiency in patients with rheumatoid arthritis in the areas of cooking, eating and personal hygiene at home environment involve the booklet provision to outpatient and inpatient departments of rheumatology. To address the widest possible population of rheumatics with damaged self-sufficiency and on the basis of positive responses to the booklet, we accepted the offer to publish a series article about promotion of self-sufficiency in patients with rheumatoid arthritis in the magazine ?REVMATIK?. In our opinion, positive contribution could also be organization of an information seminar on aids to promote self-sufficiency for patients and nurses in rheumatology units and for members of the Rheumatism - league and students of ZSF.
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Availability of rehabilitation and compensation aids for persons with rheumatoid arthritis.
KUBALOVÁ, Zuzana
The bachelor degree thesis ?Availability of rehabilitation and compensation aids for persons with rheumatoid arthritis? has a research character. The thesis is divided into theoretical and practical parts. The theoretical part deals with a comprehensive characterization of rheumatoid arthritis. Further, it presents methods of diagnostics and treatment of the disease. It also outlines issues relating to the needs of patients afflicted by the disease. It also includes a chapter dealing with compensation and rehabilitation aids that improve quality of life and integration of the patients into the society. The practical part deals with availability of compensation and rehabilitation aids on the current market, along with a financial participation of the patients. Three objectives have been set relating to the topic. The first objective was to map the offer of compensation and rehabilitation aids in connection with the demand on the side of persons suffering from rheumatoid arthritis. The second objective was to find out which compensation and rehabilitation aids have been used most frequently. The last objective was to investigate whether persons suffering from rheumatoid arthritis are willing to financially participate on purchase of the compensation aids. I am convinced that the set-up objectives of the bachelor degree thesis have been met. The method selected to deal with the issues and to achieve the mentioned objectives was quantitative research. We used inquiring by means of a questionnaire. The research has confirmed both the following hypotheses: Patients with rheumatoid arthritis most frequently use compensation aids for walking and The financial participation of rheumatoid arthritis patients on purchase of compensation aids depends on each patient´s working activity. Findings and results of the thesis may be beneficial for students of the following years in specializations dealing with rehabilitation and psycho-social care of children, adults and seniors with special needs. Moreover, the thesis may serve as an impulse for companies distributing compensation aids to take into account requirements of persons with rheumatoid arthritis.
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Accident prevention in patients with rheumatoid arthritis.
SNOPKOVÁ, Zuzana
The topic of the bachelor thesis is fall prevention in patients suffering from rheumatoid arthritis. The topic would like to highlight fall prevention that is very important in patients with this disease. Rheumatoid arthritis is a chronic inflammatory disease of connective tissues of the whole organism. The main manifestations of the disease are affected joints, muscles and ligaments. This leads to significantly reduced mobility of joints. However, it can gradually affect other organs of human body, such as heart, respiratory system etc. The quality of life of these patients depends on at what stage of the disease the patient is. The disease gradually limits the clients´ ability of self-care and increases their dependence on close family and friends. Morning stiffness often appears and swelling around the affected joints increase the risk of falling. The purpose of the treatment is to suppress pains, eliminate stiffness, increase muscle strength and improve function of the muscle. Fall prevention in clients with rheumatoid arthritis is an integral part of the treatment. A fall is an unpleasant experience for a client. It might belong to incidents that worsen and prolong the treatment. Thus, a fall might belong to situations that should be prevented. Due to everyday morning stiffness the clients are under permanent threat of a fall and that is why the treatment and prevention of a fall are very essential. Three objectives were chosen for the practical part of the thesis. The first objective was to find out what measures to prevent a fall the clients with rheumatoid arthritis use. The second objective was to map what preventive procedures are used by nurses in medical facilities to prevent a fall of clients with rheumatoid arthritis. The third objective was to find out what measures preventing a fall would be appreciated by the clients with rheumatoid arthritis. A qualitative method of research was applied. 5 clients with rheumatoid arthritis were one examined group. These respondents were chosen on the basis of pre-set criteria- these were: rheumatoid arthritis, stage of the disease III. and IV. and past history of hospitalization. 5 nurses taking care of clients with rheumatoid arthritis in a medical facility were the other examined group. The method of questioning, the technique of a non-standardized interview was applied. The thesis revealed what kind of aids would be clients appreciated to prevent falling. On the basis of the collected data a draft was designed how to prevent falling in a medical facility for clients with rheumatoid arthritis and for nurses who take care of them. Then a set of ten preventive measures was created for clients with rheumatoid arthritis to prevent falling. These aids might be used in hospitals as a recommendation for nurses how to behave to prevent the clients with rheumatoid arthritis from falling and the nurses should provide clients with complex information how to prevent falling.
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Cooperation students ZSF with members Screws League like double - sided contribution.
SVATOŠOVÁ, Iveta
The theoretical part of this bachelor thesis is divided into five chapters: Rheuma League (RL), Most Common Rheumatic Disorders in RL members, Investigational Methods in Rheumatology, Comprehensive Therapy of Rheumatoid Arthritis (RA), and Education as Part of the Cooperation. Three objectives have been formulated. Objective 1: to map the cooperation of ZSF undergraduates as part of their academic training with RL members. Objective 2: to map the benefit of the cooperation as part of academic training for ZSF undergraduates and RL members. Objective 3: to point out further potentialities of cooperation between ZSF undergraduates and RL members. This work was conducted in the form of a qualitative investigation (survey) and framed 4 research questions: 1. What are the methods of cooperation between ZSF undergraduates and RL members as part of academic training? 2. What is the contribution of the cooperation with RL members as part of academic training for a ZSF undergraduate? 3. What is the perception by RL members of their participation in the academic training? 4. What further potentialities does the cooperation of undergraduates of ZSF with RL members have? The research (survey) was implemented using the polling method, the technique of non-standardized interviews. The interviews were conducted with ZSF undergraduates and selected Rheuma League members in České Budějovice. Based on the analysis of responses given by the undergraduates and RL members answers to the 4 research questions were obtained. Answer to question 1: The cooperation of undergraduates with RL members consists in the participation of RL members in tuition classes, examination of diseased joints by the students, in discussions on health problems, compensation aids, findings obtained in the investigated patients related to their disease. Answer to question 2: For a ZSF undergraduate, the cooperation with a RL member results in enrichment of her or his knowledge, passing on experience, verification of the undergraduate's practical knowledge obtained so far on the locomotion apparatus, obtaining feedback and realization of the patients' needs. Answer to question 3: RL members perceive their participation in the academic training process as obtaining new information and mental (emotional) support. Answer to question 4: Potential fields of future cooperation of the undergraduates with Rheuma League members include the cooperation as part of the academic training process in various fields of study, but also cooperation with students in other fields of study, more intense personal encounters, and field trips. The results of the survey show that it would be beneficial to organize the so-called Rheuma Days for patients with rheumatism, health care workers and lay public, and to open a new education center for patients with rheumatism patronized by ZSF JU.
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Nursing care and compensation aids and their usage in patients suffering from rheumatoid arthritis
RAZIMOVÁ, Lada
The present thesis deals with the issues related to rheumatoid arthritis, the nursing needs of patients suffering from rheumatoid arthritis, the roles of a nurse while taking care of such patients, the collaboration of the nurse with physiotherapist, ergotherapist, and use of compensation aids by the patients while conducting private or self-service activities. The thesis has 4 defined goals. Goal 1: To find out whether the patients suffering from rheumatoid arthritis are familiar with compensation aids. Goal 2: To identify the areas of self-care where the patients suffering from rheumatoid arthritis need to use the compensation aids. Goal 3: To determine the availability of compensation aids for the patients suffering from rheumatoid arthritis. Goal 4: To find out whether the patients suffering from rheumatoid arthritis do have information about the compensation aids in hygienic care. All goals were met. Based on the goals, 4 hypotheses were defined. H 1: Patients suffering from rheumatoid arthritis are familiar with compensation aids. This hypothesis has been confirmed. H 2: Patients suffering from rheumatoid arthritis use compensation aids most often in hygienic care. This hypothesis has not been confirmed. H 3: Compensation aids for patients suffering from rheumatoid arthritis are easily available. This hypothesis has been confirmed. H 4: Patients suffering from rheumatoid arthritis have all the necessary information about compensation aids used in hygienic care. This hypothesis has been confirmed too. The survey was carried out at rheumatology clinics and at the League against Rheumatism. The data were collected in a quantitative research using the method of interview and the technique of questionnaire. All in all, 170 questionnaires were distributed among the patients. The research group contained 131 respondents. Analyzing the respondents{\crq} answers, it was found out that the patients suffering from rheumatoid arthritis are familiar with the compensation aids in hygienic care, defecating, catering, dressing, walking, and such aids are affordable and available to them. Most patients suffering from rheumatoid arthritis do not need or do not use such aids. Following the outcome of the thesis and the issues related, an information leaflet came into existence and is distributed to the patients suffering from rheumatoid arthritis in order to provide them with useful information or links. The leaflet distribution through rheumatology clinics seems to be very efficient. The outcome of the thesis is to give more background information to the clients of the League against Rheumatism. Subsequently, the thesis might serve as an additional material for students in nursing training.
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Treatment of Patients in a Specialized Establishment - a Centre for the Cure of Rheumatological Disorders in the South Bohemian Region
Valentová, Monika ; Střítecký, Rudolf (advisor) ; Augustinová, Sevda (referee)
Rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis belong among serious disorders, that effect joints and connective tissue. The patients suffer from pain and stiffness. Disease modifying drugs are an important part in the management of rheumatical disorders. When disease modifying drugs are failing, than biologic treatment is applied. For biologic treatment are registred etanercept (Enbrel), adalimumab (Humira), rituximab (MabThera), abatacept (Orencia) and infliximab (Remicade). In the Czech Republic was established the National registry of rheumatic disorders. There is a need of long term observations of patients, who have biologic treatment, to evaluate safety and socioeconomic data of the biologic treatment.
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