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Problematics of transferring the patient onto home artificial pulmonary ventilation
HRBKOVÁ, Lenka
Home artificial lung ventilation (DUPV) is very current topic these days. It provides great hope for the possible return of a patient permanently dependent on artificial lung ventilation back to the home environment. Due to injuries or the development of the disease, some patients are permanently dependent on the support of artificial lung ventilation (UPV). Staying at home with the support of DUPV brings many benefits for these patients. The theoretical part of the diploma thesis is divided into six parts. The first part is devoted to a historical view of the development of artificial lung ventilation. The second part describes the respiratory system. The third part is devoted to artificial lung ventilation, where in the subchapters the indications for connection to UPV, physiological goals, clinical goals and also the subsequent intensive care are analyzed in more detail. The third part comprehensively describes DUPV. The subchapters are devoted to indications for connecting the patient to DUPV, there are described organizations dealing with DUPV. It describes the application for the implementation of DUPV, preparation before the patient goes home, provided nursing care and equipment and medical supplies necessary for implementation. The fourth part focuses on an overview of social benefits and the fifth part on the implementation. Two goals were set for the diploma thesis: 1. To find out, with what problems, including artificial nursing care, do patients face with artificial lung ventilation. 2. Identify what problems, including nursing care, patients experience with home artificial lung ventilation. To meet the objectives, three research questions were created: 1. What problems, including nursing care, occur to patients dependent on artificial lung ventilation in the Follow-up Intensive Care unit? 2. What problems, including nursing care, occur to patients dependent on home artificial lung ventilation? 3. What are the changes in the quality of life and nursing care of patients dependent on ventilator in the hospital and patients dependent on ventilator at home? The empirical part of the diploma thesis is processed in the form of a qualitative research survey. The method of semi-structured interview with NIP general nurses of an unnamed district hospital, caregivers and patients at DUPV was chosen. The method of self-observation and examination of decurses was also used. The interviews were conducted on the basis of pre-arranged questions with four nurses, three caregivers and three patients. The "pencil and paper" method and the open coding method were used to analyze the interviews. For grater clarity, the categories and subcategories were visualized in graphic diagrams. They were also used to compile three case studies. The results of the research survey show that general nurses deal with nursing care, respiratory care and also listen appropriately to the needs of patients. The most common problem that was mentioned was the implementation of personal hygiene, due to the mental and physical dufficulty for patients. Furthermore, problems with defecation, immobility and problems with gestures and communication. An unpleasant problem was also the irritation of the airways during suction. Patients 'and carers' responses show that the most common problem is dependence on the carer for personal hygiene and excretion. Also problems with falling asleep. Social isolation and deteriorated possibility of communication are also problems. A change in the quality of life and nursing care of UPV-dependent and DUPV-dependent patients at home was also found. The answer to this question is that a hospital stay is physically and mentally demanding. It has been said that being at home is real luck. The opportunity to be with family and be able to do everything by yourself. I believe that the work could serve to improve the awareness of family members of patients at DUPV. The work could be used to collaborate in a GAIA grant project.
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Specifics of nursing care for patients with spinal muscular atrophy
HRBKOVÁ, Lenka
This thesis is focused on defining the specifics of nursing care for patients with disease spinal muscular atrophy. SMA is classified as an incurable genetic disease that causes progressive muscle atrophy and deformity of the body but sensory perception and intellect remain preserved. The incidence of the disease in the neonatal and childhood prevails, however the outbreak of the disease in adulthood is not any exception. Suitable nursing care is of great importance in maintaining the health of the patients for the longest possible time and delaying the onset of worsening health. The thesis is divided into theoretical and empirical part. The theoretical part deals with SMA disease, incidence, classification, treatment options and nursing care. In connection with the theme of this thesis, we choosed three targets. 1.: Map out the specifics of nursing care of pediatric patients with spinal muscular atrophy from the perspective of nurses. 2.: Map out the specifics of nursing care of adult patients with spinal muscular atrophy from the perspective of nurses. 3.: Comparison of the specifics of nursing care of pediatric and adult patients with spinal muscular atrophy. We used qualitative research method using a semi-structured interview to achieve our goals. To assess quality goals, we used the following research questions: How nurses specify the nursing care provided to a pediatric patient with spinal muscular atrophy? How nurses specify the nursing care provided to an adult patient with spinal muscular atrophy? With which needs of patients suffering with spinal muscular atrophy have the most experienced nurses experience? The research group consisted of six respondents, three of which respondents had experience with care of pediatric patients and the other three with care of adult patiens. As a processing technique we used open coding, through pencil and paper. The information obtained was divided into categories. The research shows that for nurses caring for pediatric patients the age is important at first occurrence of the disease as that influences the possibility of communication. Prevails ensure physiological needs. For nursing care, throughput of the tracheostomy cannula and status check of the oral cavity is important. In terms of nutrition the nurses prefer serving food through the PEG. They also agreed on the need for positioning. Emptying urine is ensured by the PMK or urinating in diapers. The nurses agreed on serving laxatives and manual defecation. The survey of nurses caring for adult patiens explains that the most common barrier is a state of consciousness, mental status and impaired verbal and nonverbal communication. For the needs of the nurses they state the physiological needs, as well as the fulfillment of psychological needs. In the nursing care of respiratory ways nurses report caring for tracheostomy cannula and a suctioning. In the case of nutrition they prefer per os (orally) and after that they use the help of NGS or NJS. The most common way of serving the diet they indicate the PEG. In case of immobility of the patient they all agree on positioning. For emptying urine they use PMK, one also mentioned epicystostomy. For defecation they agree on serving of laxatives, enemas and manual defecation. The results of our survey highlight the differences in nursing care provided to children and adults. The most relevant in the category of barriers in communication, is the age of the children and adults state of consciousness, the willingness and the ability to communicate. Adult patients desire to fulfill even higher requirements,while with children it is about fulfilling the physiological and social needs. In the nursing care, significant differences are not found. The results obtained in the practical part, I would like to use the knowledge to broaden awareness of nurses who have experience in caring for patients with SMA and to better inform the general public about this rare and often fata
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Marketing strategy Fotovýběr
Hrbková, Lenka ; Sedláček, Jiří (advisor) ; Slaba, Jiří (referee)
This thesis describes the steps leading to the promotion Web site Fotovýběr and building the company's name. The aim is through marketing tools to increase awareness about the services offered and to propose such a marketing strategy for the future will ensure an adequate supply of site visitors, ie potential customers. At the beginning of the analysis is devoted to the company and its current activities, then I suggest specific marketing practices and finally evaluate the results and prospects for the future. The thesis should help the company Fotovýběr optimize their marketing activities.
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The economic development of Greece from joining the euro to 2009
Hrbková, Lenka ; Karpová, Eva (advisor) ; Antal, Jarolím (referee)
This bachelor thesis describes the development of economy in Greece, focusing on the development after joining the euro. It compares the economic development before joining the euro with the development after the joining with regard to the current situation. Development of the Greek economy is currently very hot topic, especially because the economic situation in Greece is not favorable. The biggest problem is the growing debt and deficit in public finances. Regarding that Greece is a member of the euro area its development has a significant negative impact on what is happening across the monetary union and in particular on the stability of European currency. Future development in Greece could significantly affect the future of the euro area, and therefore is the current development so monitored.
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