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Evolving needs of patients with chronic obstructive pulmonary disease
KAŠPAROVÁ, Iveta
Nowadays chronic obstructive pulmonary disease (COPD) is considered to be a global and all society problems. COPD interferes in all aspects of patient´s life. It implicates limitations to physical aspect which is the cause of psychological and social effects. The disease changes the present way of patient´s life, the patients have to change their lifestyle, adapt themselves and learn new habits which can also mean changes of their needs during the COPD. The thesis deals with the problems of COPD patient´s needs. The thesis is divided into two main parts. The theoretical part focuses on characteristic of the disease, classification and hierarchy of human needs, the effects of COPD on biological, psychological, social and spiritual needs and next on the nursing care for patients with COPD. The practical part of the thesis includes the processing and next the evaluation of the dates obtained during the research. The aim of the thesis was to findout how the patient's needs differ in particular stadium of the disease. To get the aim there were determined six research questions:1) What is the knowledge level of COPD patients? 2) How different are their needs in particular stadium of the disease? 3) Which needs predominate in individual stadium of the disease? 4) Which activities can COPD patients do? 5) Which limitations and problems do COPD patients have? 6) Which needs does a COPD patient have in the field of home oxygen therapy? The method of qualitative research was used for the research. The technique of non-standardized interview was used for the data gathering. The research complex was formed by 15 COPD patients from the first to the third stadium of the disease. There were five patients in each chosen stadium. The evidence of the individual patients were divided according to their specific stadium into particular categories: knowledge of the disease, respiration, sleep, lifestyle, profession, check-ups. The research shows that the need changes did not directly depend on the level of the disease stadium, but mainly on the patient´s facing up to the disease, their total state of health and based on their individual needs. The firstand second stadium patients gave as the most common need to have their medicines permanently at their disposal, next the bigger need of sleep and rest and last but not least the need of being more independent. The progress of needs in the third stadium was different according to using of home oxygen the therapy or not. The patients who use home oxygen therapy coincided that the therapy helped them to improve their life. Now the main need is to increase their independence in household activities and to besurrounded by their family. Some COPD patients have demonstrable common symptom of depression which consequently influences physiological needs such as sleep, rest, independence and also their total self-realization. The need changes significantly affected the field of life habits, regime,lifestyle and leisure time activities. First of all there has been the absence of cigarettes and alcohol among their life habits and regime. There have been some limitations such as fishing, riding a bike, mushroomingin leisure time activities. The lifestyle was affected the changes in family and work life. The patients often suffer from dyspnoea, which subsequently limits walking, household activities, self-service,for example: shopping, meal preparing, dressing or doing personal hygiene. Despite various limitations the patients do various activities like walking dogs, strolling, reading books, watching TV, visiting clubs and other interesting culture events. The research results pointed to insufficient level of knowledge of the COPD patients. Due to the low level of the patients´ knowledge of the disease an information material with basic information about the disease was prepared.
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Work of a nurse in an osteology out-patient ward
KAŠPAROVÁ, Iveta
Osteoporosis is defined as a metabolic system bone disease, which is characterised by reduced content of bone matter. This disease is considered the most frequent disease. Osteology departments are mostly visited by older clients, but younger clients are nowadays not exceptional either. The nurse plays an important role in the osteology outpatient department / clinic. In addition to nurse duties such as administrative or treatment work, the nurse should be able to communicate, listen, or possibly give advice to clients. Thus she becomes a consultant, assistant as well as a defence counsel. The thesis was aimed to determine the nurse job specification in an osteology outpatient clinic. The research was carried out using the qualitative method and data were collected from semi-structured interviews with 7 respondents in selected osteology outpatient clinics, of which 5 nurses are from the osteology outpatient clinic in České Budějovice and the remaining two nurses are from the osteology outpatient clinic in Prague. The interviews were consequently processed into case reports. Those case reports became the basis for evaluation of the results sorted in categorization tables. The most significant results of the research proved that nurses must only be trained in a specialized course if their job sheet includes densitometric examination. This densitometric examination, or sampling of biological material for bone markers and education with respect to application of medication using a fosteon pen are ranked amongst special activities not performed in other special outpatient departments. Some osteology nurses confirmed that their job sheet also includes to educate clients, most often verbally, and provide reference materials or practical demonstration. This bachelor thesis can primarily be used for nurses who are interested to work in an osteology outpatient department in the future.
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