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Objective and subjective factors in the evaluation of outcomes of breast reconstruction after mastectomy
Tichá, Pavla ; Sukop, Andrej (advisor) ; Nejedlý, Aleš (referee) ; Třešková, Inka (referee)
For patients undergoing mastectomy, breast reconstruction provides an opportunity to restore their personal and social lives. During the last decade, there has been an upward trend in the number of successfully completed breast reconstructions. Reconstruction can be achieved by a number of methods which differ by their indication criteria as well as in their results. In addition to the objective analysis of clinical data, an integral part of the evaluation of these results should be a subjective evaluation of patient satisfaction with the surgery outcome and quality of life in the form of self- assessment questionnaires. Our specific objectives were to compare early postoperative and long-term clinical outcomes as well as patient-reported outcomes in terms of satisfaction and health-related quality of life (HRQoL) in patients undergoing implant-based reconstruction, abdominal-based autologous reconstruction, and combined reconstruction.
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Role of nurses in postoperative care in patients with lung cancer.
PLECEROVÁ, Jana
At present time the lung/ bronchial carcinoma is the most frequent malignant disease but not only in our country but worldwide. It is an insidious disease that at the beginning is asymptomatic (i.e. without clinical symptoms), however it has an extraordinary unfavourable prognosis. The lung/ bronchial carcinoma is painless disease therefore the sick people (adversely affected by lung/ bronchial carcinoma) do not suffer from any significant health trouble for very long time. In a later stage some of the patients realize the fact, that they are facing some health troubles. They find out that something go wrong as far as their health condition is concerned, the most frequent case is reported as breathlessness or difficulties in breathing in general. Their difficulties in breathing is frequently attributed to their weight, physical strain, stress, workload, work environment they work in. These patients usually make an appointment with the physician not sooner than they observe further manifestations of the illness which testifies to advanced stage of the illness, however. These symptoms often are the following: haemoptysis, rhonchus/hoarseness, chronic cough, dysphagia, pains, loss of weight. The lung carcinoma is frequently discovered on a random basis within a preoperative preparation for another surgical intervention i.e. the centre of lung carcinoma is identified when heart and lungs are X-rayed. The very sad moment of this disease (lung carcinoma) is the fact that overwhelming majority of the patients bring about this insidious illness or contract the illness themselves. The reason is smoking. Present youth regard smoking fashionable and modern. They feel and perceive smoking as their need to try something new and majority of them persist with smoking. They become smoking addict and only small percentage of them seek a help or assistance of an expert in making people give up smoking. In the past we encountered the diagnosis of lung carcinoma with the patients whose age fell in between 60 (sixty) and 70 (seventy). At present time the patients with such a diagnosis are rather younger. Their age fall within the interval 40 (forty) and 50 (fifty). I can express my belief that the public should be not only better informed but also keep informed about the life-threatening lung carcinoma, malignant lung tumour, ways and means of healing, primary and secondary prevention and help and assistance in making people to give up smoking. The public should be informed and be kept informed about risk factors that lead to the origin and development of this insidious disease. The media should do whatever possible to present statistics, research investigations dealing with the origin and development of lung carcinoma, case reports regarding patients with this diagnosis. Several years ago, there were cigarette packets provided with various pictures on them presenting risks of smoking as well as possible complications and troubles accompanied with smoking including lung carcinoma. Unfortunately, this campaign did not achieve such effect as it had been expected. This diploma work has been worked out by focusing on theory. Its goal is to present the problem of lung carcinoma, malignant lung tumours in the Czech Republic and in the world. The crucial area of the diploma work is devoted to the surgical therapy of the lung carcinoma, malignant lung tumours that is subject of permanent development and still brings new pieces of knowledge in the field of therapy of lung malignity. Another aim of this diploma work is to clarify, map out and visualize the position and role of nurses in postoperative care for the patients with lung carcinoma/ tumour. The conclusion of the diploma work focuses on specific questions and requirements of the palliative care and its models. This diploma work makes it possible to get an overall view of the specialized field of malignant lung tumours, their statistics, the numbers of which has been rising.
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The incidence of postoperative infectious complications in neurosurgical ICU
Brindová, Jana ; Mrákava, Vlastimil (advisor) ; Hocková, Jana (referee)
This thesis examines in detail the nature of postoperative infectious complications in patients who underwent brain tumor surgery. It deals with the incidence of these complications and their severity, depending on various factors and suggests the most appropriate nursing procedures used in the care of a patient in whom these complications occurred. For the structure of the work is divided into two parts - theoretical and empirical. The theoretical part deals with the issues examined in terms of the medical field Neurosurgery (closer diagnoses, conditions, operations and other procedures, and complications to occur after these operations or expected performance), analyzes a nursing practice and patient care on neurosurgical ICU, and finally closely examines infections and nosocomial diseases, including a description of the most common types, their agents, diagnosis and treatment. The second, empirical part focuses on the problems from a practical point of view. With the help of set of case studies it closer which specific complications are most commonly found on the neurosurgical ICU in patients after surgery of brain tumors, what are the most common methods of treatment and nursing procedures which are most used in the care of patients with these complications. In conclusion summarizes the...
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Importance of enzymatic solutions (Enzymel) in postoperative treatment of upper respiratory tract wounds
Šimurdová, Marcela ; Tomová, Šárka (advisor) ; Nikodemová, Hana (referee)
Bakalářská práce Význam Enzymelu v pooperačním ošetřování ran v horních cestách dýchacích 1 Abstract Healing surgical wounds in upper respiratory tract is often difficult and painful due to constant presence of food (contamination), movements during talking and continuous presence of aggressive saliva. Most of the surgery clinics use natural solutions especially chamomile to accelerate healing and to remove patient's postoperative problems. Gel Enzymel parodont, which contains proteolytic enzymes and its application limits bacteria production and accelerates healing of the surgical wounds, hasn't been used in a clinical treatment in surgical ORL yet and its effects on healing haven't been studied. The theoretical part of this study is focused on a brief introduction of selected surgical procedures in upper respiratory tract and the corresponding nursing process including a summary of possible complications in the postoperative period. The empirical part of the thesis contains a summary of the results of non-standardized questionnaire survey, which was conducted on selected patients of the ORL (ENT) Clinic of Motol University Hospital. Using a surrogate survey of a selected group of patients (80 in total), data were obtained to compare the effectiveness of the investigated agents, especially in the area of...
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Nursing care of patients with the compartment syndrome
KRČMOVÁ, Tereza
The bachelor thesis "Nursing Care of a Patient with Compartment Syndrome" surveys the specialities of a nursing care about a patient with this syndrome. As the care of such a patient is highly specific, a nurse is supposed to have enough information about this issue. The theoretical part deals especially with preventive precautions, syndromes, diagnostics, treatment, perioperative period, complications and furthermore also a care after releasing a patient for home care. The empiric part is based on a qualitative survey construct. A data collection is based on half-structured interviews. The aim of the thesis was: 1. To find out specialities of the care of a patient with this diagnosis. 2. To reveal possible complications concerning a patient with a developing compartment syndrome. From the results of a survey research emerged that despite small faults, the questioned nurses provide the patients with a high quality nursing. It was found out that the nurses highly appreciate preventive precautions with which they try to prevent a compartment syndrome development. According to obtained information, the nurses contact a doctor immediately in case of alarming symptoms. The doctor deals with the diagnostic and following treatment measures. It was detected that the provided care is varied because a nurse takes care of a patient both before and after the operation. Furthermore, it was revealed that a care of a patient after fasciotomy does not differ substantially from a common care provided by nurses for other patients.
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The effect of planned bowel resection on mobility and quality of life take care
Dvořáková, Dominika ; Kulhavá, Miluše (advisor) ; Jankovcová, Kateřina (referee)
Introduction: Thesis is focused on monitoring of the quality of life of the patients, who undego planned bowel resection. Czech population is over a long period weighted by malign disease of colorectum. Patients with this diagnosis undergo efective procedure of surgical remove of tumour. With this surgical intervention is also connected with follow-up hospitalization at the unit of intensive care, which can be a great load for patient and can affect the return into the common life and its quality. Methodology: The methodology of the research is the monitoring study. To this study there were put these, who passed planned bowel resection because of the occurence of colorectal tumor, in the period from May 2018 - January 2019. To gain data we use the questionnaire of the quality of life (SF-36), the questionnaire evaluated anxiety status and depression (HADS), evaluating the level of fatigue (MAF), the questionnaire evaluating the basic daily activities (ADL, IADL) and tests to evaluace the physical aktivity (30-Second Chair Stand Test, 6-MWT - six minutes walking test). To compare the quality of life a the physical aktivity, we use three time periods - T1 (the period before hospitalization), T2 (the period of discharge from the hospital), T3 (the period after 3 months from the surgical intervention)....
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The incidence of postoperative infectious complications in neurosurgical ICU
Brindová, Jana ; Mrákava, Vlastimil (advisor) ; Hocková, Jana (referee)
This thesis examines in detail the nature of postoperative infectious complications in patients who underwent brain tumor surgery. It deals with the incidence of these complications and their severity, depending on various factors and suggests the most appropriate nursing procedures used in the care of a patient in whom these complications occurred. For the structure of the work is divided into two parts - theoretical and empirical. The theoretical part deals with the issues examined in terms of the medical field Neurosurgery (closer diagnoses, conditions, operations and other procedures, and complications to occur after these operations or expected performance), analyzes a nursing practice and patient care on neurosurgical ICU, and finally closely examines infections and nosocomial diseases, including a description of the most common types, their agents, diagnosis and treatment. The second, empirical part focuses on the problems from a practical point of view. With the help of set of case studies it closer which specific complications are most commonly found on the neurosurgical ICU in patients after surgery of brain tumors, what are the most common methods of treatment and nursing procedures which are most used in the care of patients with these complications. In conclusion summarizes the...
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The problems of Pediatric Thoracic Surgery from the view of respiratory Physiotherapy
Světlíková, Adéla ; Smolíková, Libuše (advisor) ; Bitnar, Petr (referee)
The bachelor thesis is focused on pediatric surgery in thoracic area and its dilemma. The theoretical part contains knowledge about anatomy, physiology and kinesiology of developing organism. It is followed by overview of the most common diagnoses indicating thoracic surgery, describing each of those surgeries individually. The biggest issue of entire pediatric thoracic surgery is the risk of postoperative complications, which is also discussed in the thesis. This part is then followed by discussing means of physiotherapy. The informations are divided into several parts, each describing means of physiotherapy used in different time sequences. Practical part contains general means of examination and physiotherapic approach depending on patient's age. The last part is devoted to casuistry, which clearly demonstrates issues related to pediatric thoracic surgery from the physiotherapeutic point of view.
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Physiotherapy at Patiens after Breast Cancer
POCHOPOVÁ, Jana
The breast cencer is the world's most common cancer among women. It affects about 6 % of them and it is registered approximately 600 thousand new cases of the disease every year. The situation is not so satisfactory as well in the Czech Republic. It has been contained about 6500 new cases a year in recent years and about 2000 women die of this disease. The breast cancer is one of the disease which unfortunately can not be predicted or prevented. Despite this it is a type of cancer which can lead in most cases to cure the patient if it is soon detected. It is used the self-examination method for the soon detection of cancer which women should regularly realize and especially mammography screening. The treatment of breast cancer is linked to the emergence of certain problems that complicate subsequent convalescence of the patient. If it appears there are options how to fight them. It can be also prevented or at least significantly reduced. The issue of breast cancer is still very actual and it is the reason why I chose topic "Patients' physiotherapy after breast cancer treatment." for this bachelor thesis. This work consists of a theoretical and practical part. The theoretical part defines the basic concepts related to cancer, its development and anatomy. It also deals with the issue of breast cancer from etiology of the disease, the influence of risk factors and diagnosis to therapy. It also describes the risk of postoperative complications related to surgical procedure on the breast and removal lymph node and the possibility prevent these problems or fight effectively with appropriate therapy. Practical part of work includes monitoring of postoperative changes on patients with surgical procedure on breast and the therapy description focused on the prevention of formation of complications linked to surgical procedure or removal of already existing problems. The collection of primary data was carried out qualitative way through case studies, it was chosen the methodology of interview, observation (kinesiology analysis) and analysis of personal health documents. The research group consisted of two patients diagnosed with breast cancer who underwent surgical procedure at the Department of Surgery Hospitals Czech Budejovice, a. s. The goal in this work was determined to describe the effect of physiotherapy in the prevention of postoperative problems related to surgical procedure for cancer removal. Together with the aim of work the following research question was determined: What are the contributions of physiotherapy in the prevention of postoperative symptoms in patients with breast cancer? In both patients the therapy managed to achieve a functional and painless movement of the shoulder joint and the upper limbs on the affected side, free mobility in the thoracic region and improved breathing stereotype. There has been a release of abbreviated and strengthening of weak muscle groups. We also managed to release the postoperative scars, while the patients were instructed how to treat them in the future. Contribution physiotherapy is therefore positive. Patients were also educated on the need for regular exercise even after warming up arms and got recommendations for the care of the upper limb, diet, hygiene, sports or doing housework. The results of the research part showed that the implementation of physiotherapy in patients after surgery for breast cancer has a positive effect in the prevention of postoperative complications, thereby has accomplished the goal of the work. Bachelor thesis will be used by physiotherapists for completion of information about the possibilities of rehabilitation after breast cancer treatment and also as educational material for patients and others interested in this issue.
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Comparison of post-operation course in women after abdominal or vaginal hysterectomy and after laparoscopically assisted vaginal hysterectomy.
HUDÁ, Zuzana
The bachelor thesis is divided to two parts (theoretical and practical). In the theoretical section I engage with three kindes of hysterectomy, with its indications, complications and with the following treatment of the patient after the intervention. I further desribe the psyche of the patient and her life after the operation. Hypthesises and goals have been set in the practical section of this work. I tried to disprove or aprove these hypothesises on the basis of research. It follows from the outcome of the research that the postoperative condition after hysterectomy differes individualy from patient to patient.
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