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Analysis of Pharmacotherapy by patients with diagnosis of COPD
Kartali Kaouni, Marilena ; Vlček, Jiří (advisor) ; Matoulková, Petra (referee)
Title: Analysis of Pharmacotherapy by patients with diagnosis of COPD Student: Marilena Kartali-Kaouni Tutor: Prof. RNDr. Jiri Vlcek, CSc Department of Social and Clinical Pharmacy, Charles University in Prague, Faculty of Pharmacy in Hradec Kralove Background: " Chronic Obstructive Pulmonary Disease (COPD) is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases". Tobacco smoking is the major risk factor in the development of COPD. COPD is a leading cause of morbidity and mortality worldwide. Aim: 1st from the current literature to understand the nature of COPD and obtain information about the aetiopathogenesis of the disease, diagnosis options and summarize the current view of strategies for achieving the goals of treatment. 2nd in a pilot study to analyze drug therapy in COPD patients visiting a pharmacy in Greece. Methods: 56 prescriptions with the diagnosis of COPD were collected during a period of 8 months from a Greek pharmacy. Information from the prescriptions with regard to COPD medications prescribed (active substances, trade names, strength, dosage scheme, pack size), patients characteristics (age and gender) and prescribing...
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Resting energy expenditure in patients with chronic obstructive pulmonary disease
Jenšík, Martin ; Kovařík, Miroslav (advisor) ; Hronek, Miloslav (referee)
1 Abstract Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Student: Martin Jenšík Supervisor of master thesis: PharmDr. Miroslav Kovařík Ph.D. Title of master thesis: Resting energy expenditure in patients with chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is step by step moving ahead in public and scientific interest due to its fast rising in mortality rate. Contemporary studies observed a phenomena that patients with COPD have increased resting energy expenditure (REE) that leads to loss of fat free mass and total weight. Our goal was to confirm or disprove this hypothesis. Our research ran in Department of research and development at University hospital Hradec Králové. In our study participated 30 patients, 26 men and 4 women, mean age 67 ± 8 let. Every patient was once examined after twelve-hour fasting. We determined REE and substrate utilization by method of indirect calorimetry. We confirmed increased REE from the average value of REE - 122 ± 14 % predicted by Harris - Benedict equation. None patient was hypometabolic, 7 were normometabolic and 23 hypermetabolic. Substrate utilization did not differ contrary to physiological values. Furthermore we discovered correlation among fat mass, fat free mass,...
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Body schema in patients with chronic obstructive pulmonary disease
Bartošová, Kristýna ; Smolíková, Libuše (advisor) ; Máček, Miloš (referee)
Diploma thesis "Body schema in Patients with Chronic Obstructive Pulmonary Disease" is an experimental work which deals with body schema perception. As a part of the thesis there are particular tests of body schema included, which examine difference between control group and group of patients with chronic obstructive pulmonary disease. Research part of the work deals with current findings about body schema and with findings about chronic obstructive pulmonary disease. There is more detailed analyze of musculoskeletal questions in patients with chronic obstructive pulmonary disease included. In an experimental part of the thesis there are comments on results of the body schema tests. The tests are focused on stereognosis, on position sense, on perception of self body size and on the ability to achieve isolated movement. Powered by TCPDF (www.tcpdf.org)
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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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Air pollution - invisible threat?
Šitinová, Kristina ; Zajíček, Miroslav (advisor) ; Louda, Jiří (referee)
This paper examines the influence of air pollution on humans. Suggesting the possible consequences of each action of air pollutants on human health but also the possible economic impacts of air pollution. It primarily exploers the effects of concentration of suspended particulate matter (PM10) on the incidence of chronic obstructive pulmonary disease. The response variable in the regression model serves to determine the effect of PM10 on the incidence of chronic obstructive pulmonary disease was a percentage share of patients with chronic obstructive pulmonary disease among the clients of the General Health Insurance Company in individual regions of the Czech Republic. Explanatory variables were the mean annual concentration of PM10 and gross added value per capita. The model suggests that there is a statistically significant positive correlation between the incidence of chronic obstructive pulmonary disease in the Czech Republic and PM10 concentrations.
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Education of patients with chronic obstructive pulmonary disease within effective curative regime
CHALUPOVÁ, Petra
This thesis is divided into two parts and is dedicated to the education of clients with the chronic obstructive pulmonary disease in the effective treatment regime. The theoretical part is trying to comprehensively summarize the issue of COPD, deals with the definition of the disease, risk factors, symptoms, diagnosis, treatment and nursing care in this disease. Due to the important risk factor of smoking the other part is focused on the tobacco dependence and the associated problems of smoking which is cessation methods and a possible use of motivational interviewing in the treatment of tobacco dependence. Another area is education of clients with COPD. The empirical part of our work presents the results of the qualitative research approach. The main objective of our research was to uncover phenomenas in the effective education of clients with COPD within the nursing care in the Sanatorium of tuberculosis and respiratory diseases in the Hospital in Czech Budejovice, (hereinafter referred to as "pulmonary clinic" or "department"). Therefore, it was determined the main objective which is base for both objectives - academic and practical. These objectives were developed and subsequently we set the following particular objectives. Objective One: Determine whether the education of clients with the chronic obstructive pulmonary disease is effective. Objective Two: Identify the areas in which nurses educated clients with the chronic obstructive pulmonary disease. Objective Three: Determine the client's satisfaction with the education of nurses. Objective Four: Find out the nurse's knowledge of motivational interviewing. Based on these objectives, research questions were appointed. To meet the objectives of the research method was used the semistructured interview with nurses and to strengthen the validity also with clients with COPD. The research group thus was consisted of two groups - with five nurses working in the pulmonary rehab, and eight clients who were at the above mentioned department hospitalized. From the results of the survey was found out that the education in the pulmonary clinic begins with pedagogic diagnostics during the client's intake using methods of the individual interview, where nurses are finding clients' existing knowledge on the use of inhaled medications, then the education focuses on a proper diet and the respiratory rehabilitation. It was found out that the proper use of inhalation aids clients largely forget and during the further hospitalization they learn it again. As a possible solution to this problem, we recommend offering educational materials not only clients, but also to their families. Clients do not mention a diet at all. In our opinion they do not consider it important and they forget everything they learned. It was found out that all nurses use in educating the feedback to evaluate the effectiveness of the educational process. This suggests that the education that takes place in this department is effective only for the part of clients during their hospitalization, but after being released into the home environment of the clients, the knowledge is forgotten because there is no re-education in their home environment. There is no education regarding the smoking cessation in the pulmonary hospital. Nurses recommend clients a treatment center for the tobacco dependence. All clients agree that nurses have always enough time for the education and all are satisfied with the transfer of knowledge and skills in the pulmonary clinic. Given that nurses do not have sufficient knowledge, how we found, regarding the therapeutic method of motivational interviewing, we propose to take a course. We believe that the inclusion of motivational interviewing methods into practice would help to improve the quality of nursing care within the education in the pulmonary clinic.
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Quality of life in patients with COPD
KLÍMOVÁ, Pavlína
Theoretical foundation Chronic obstructive pulmonary disease ranks among the most serious diseases in the population. The COPD prevalence is assumed at up to 7,7%. As the name shows, it is a chronic disease characteristic with typical symptoms including particularly cough, expectoration and noticeable dyspnoea. The symptoms may get worse above their common level in the course of the disease, which we call exacerbation. The presence of unpleasant breathing problems affects different life areas, restricting the individual when performing everyday activities. The patient's psyche is affected as well, including potential incidence of anxieties or depressions. Finally, the patient's subjectively perceived quality of life is significantly worsened. Goal of the thesis The goal of this thesis is to ascertain the areas in which COPD affects the quality of life. Hypotheses H1: COPD patients feel breathing problems. H2: COPD patients feel restrictions in the sphere of common daily activities. H3: COPD patients feel restrictions in the sphere of physical activity. H4: COPD patients feel restrictions in social sphere. H5: COPD patients experience negative feelings. H6: COPD patients perceive their quality of life as bad. Methodology The research investigation was implemented based on quantitative inquiry within the grant Project No. 120/2012/S "Reflection of life quality in nursing". The data collection was performed under use of quantitative method; the research investigation took place with the help of questionnaire technology. Two questionnaires were used: St. George's Respiratory Questionare Czech (SGRQ) and WHOQOL 100 generic standardized questionnaire. The questionnaires were distributed to persons with diagnosed chronic obstructive pulmonary disease. The selection set was made up through quota selection that was observed. The quotas consisted in COPD diagnosis and the respondents' gender. The proportion of men and women was specified at 500 persons, 294 men and 206 women from that number. The research set consisted of 296 men and 207 women, i.e. 503 respondents in total. The investigation took place through addressing general practitioners, specialized outpatients' departments and chest disease wards. Results The results were processed with the help of the SASD program (statistic analysis of social data). The results can be divided into three groups. The first group includes the results characterizing the structure of the research set; the second group includes the graphically represented results, and the third group includes the results processed with the help of descriptive statistics. The last two groups include results from both questionnaires used. The results allowed us obtaining information on perception of breathing problems by the patients, on the sphere of common daily activities, on problems in the sphere of movement, on social sphere, on experiencing of negative feelings and on subjective perception of quality of life. Based on the results, the hypotheses were evaluated as follows: H1: COPD patients feel breathing problems confirmed, H2: COPD patients feel restrictions in the sphere of common daily activities - confirmed, H3: COPD patients feel restrictions in the sphere of physical activity not confirmed, H4: COPD patients feel restrictions in social sphere - not confirmed, H5: COPD patients experience negative feelings confirmed, and H6: COPD patients perceive their quality of life as bad - not confirmed. Conclusion The thesis provides comprehensive view of the spheres affecting the quality of life of patients with chronic obstructive pulmonary disease. It may be used not only for nurses but also for the whole multidisciplinary team caring for the patient. The thesis may be used also as study material for nursing students. The results of the research investigation will be further presented at conferences and published in professional journals.
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Creation and testing of educational program: Health education and prevention of non-infectious disorders (asthma, chronic obstructive pulmonary disease)
CHUDÁRKOVÁ, Kateřina
The bachelor thesis deals with the design and applicability of an educational program intended for students of the master course Education with a focus on health education. The educational program is aimed at health education and the prevention of non-infectious diseases asthma and chronic obstructive pulmonary disease. In the introductory theoretical section I analyse concepts like health, prevention, lifestyle and disease. The central theme focuses on the chronic obstructive pulmonary disease, asthma and smoking, which has a decisive role in the development of both diseases. In the practical section I verify the applicability of the educational program by comparing the input and output tests, which give evidence about the level of knowledge on the topic in question of randomly chosen students of the course Education with a focus on health education. The results of the practical investigation confirm the feasibility of the program in practical use and its considerable impact on deepening students' knowledge in the studied topic.
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Specifics of nursing care for clients with chronic obstructive pulmonary disease.
DVOŘÁKOVÁ, Romana
The chronic obstructive pulmonary disease is characterized by the restriction of air flow in the bronchi. It is a combination of two diseases: chronic bronchitis and pulmonary emphysema. Because the symptoms of both diseases blend, the joint name ?chronic obstructive pulmonary disease? is used. It is a neutrophil inflammation that causes irreversible changes. The most common cause of the disease is smoking tobacco products.The aim of this bachelor?s work is to determine the specifics of nursing and refer to the specific needs of patients. If nurses should provide high-quality care, they must be aware of these specifics when treating patients with this particular disease. The role of the nurses in this area is very important as they must approach patients individually. The nurses provide specific nursing care and educate patients. The theoretical part of the work focuses on the characteristics of the disease, its causes, treatment or prevention and nursing activities performed by nurses. The practical part of the work was processed in the form of qualitative research by means of a semi-structured interview. The research sample was represented by patients from pulmonary hospitals and pulmonary departments of hospitals in the Plzeň region and the Central Bohemian region. In total, eight respondents participated in the research. According to interviews, case reports were executed based on which categorized tables were executed with the most interesting data.It arises from the results that the chronic obstructive pulmonary disease brings various problems, and a patient and nurse must be able to solve them and be aware of them. Further, it is obvious that informedness of patients, and the wider public, could be more detailed because this disease stands on the first place in the list of civilization diseases and there are increasingly more patients with this disease. Thus, a brochure was executed based on the results with the aim to provide information about chronic obstructive pulmonary disease.This information brochure can be used for study purposes or for patients with this disease.
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