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Paliative care from the point of view of non-medical healthcare workers
Štětinová, Natálie ; Klokočková, Šárka (advisor) ; Nikodemová, Hana (referee)
This bachelor thesis describes dying from the view of nurses and compares implementing principles of paliative care of the dying patient lying on a hospital bed with care in a hospice. The goal of this work was to find out how nurses with practice in both types of institutions look at this care and what differences between them they recognize. The theoretical part involves definitions of basic notions and introduces the the whole themes of dying to the reader. Also basic principles, thoughts and values, that paliative medicine has and practices, will be mentioned. Further it submits basic information about history of this specialization in our country and also in the world, approaches typical expressions and problems of a dying patient and explains what specifics the hospice institutions have and what kind of care they provide. For the comparison, there will be also described how the paliative care for the patient in the terminal phase laying on a hospital bed is implemented. The basis for this part will be mainly appropriate literature and internet sources. For the empirical part the method of qualitative research was chosen. It works with informations gained from interviews with four nurses that have the experience with a dying patient from their earlier practice in a hospital and who are taking...
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The effect of footwear on deformity of the foot in a woman - the role of the nurse in prevention
MLEJNKOVÁ, Natálie
The topic of this diploma thesis is "Influence of footwear on foot deformities in women - the role of nurses in prevention". The theoretical part is devoted to the foot anatomy, it describes the issue of heels on the foot and represents the Giraffe certification. The practical part of the qualitative research shows the role of nurses in preventing foot deformities for patients. This thesis has two goals. To find out what footwear affects the deformities of the legs in women and to find out what role the nurse plays in preventing this issue. The research questions are 1. What is the importance of wearing high-heeled shoes for women and how will this be reflected later? 2. What role do nurses attribute to the prevention in this issue? Data collection was collected by semi-structured interviews with nurses in the orthopaedic ward and orthopaedic clinics. The research sample consists of 20 respondents, the choice was deliberate and formed by snowball sampling. In February 2019, data was collected, which was subsequently terminated at the moment of theoretical saturation. The interview covered themes: wearing high-heeled shoes, leg deformities caused by high-heeled shoes, nurse-led prevention and education. The results show that only a fraction of nurses adhere to the role of a nurse who helps patients prevent leg deformities. The rest of the nurses leave prevention and education to doctors. This diploma thesis presents as a work output a poster, which can be an information material for nurses from the orthopaedic clinics and beds. The output of the thesis is an educational poster that will reflect the entire nursing issue in prevention (the role of a nurse, the deformity of the feet caused by high-heeled shoes, etc.).
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The specifics of nursing care in a child with a middle ear inflammation
KANDĚROVÁ, Marie
Current situation: Besides the issues of nursing care and areas that are directly associated with the inflammation of the middle ear, the research deals with these areas - diagnostic procedures, aetiology, treatment and prevention. Medial ear inflammation usually develops from the respiratory system inflammation. The inflammation of the middle ear has several complications that can interfere with the healthy development of the baby, among those complications are hearing disorders and speech disorders. Objective of the thesis: The aim of the thesis was to describe the specifics of nursing care of a child suffering from the medial ear inflammation and to evaluate the knowledge of nurses regarding the problem of this disease. Methodology and research sample: A qualitative research was selected for the research, achieved by the technique of non-standardized interviews with a total of eight nurses working at a paediatrician's, in the specialized ENT surgery and at a children's ward in the hospital. The selection of a nursing sample was deliberate. Open coding technique "pencil and paper" carried out the analysis of the data obtained. The results were then interpreted by the technique "cards explanation". Results: Among the specifics of nursing care for children with the middle ear inflammation are: maintaining the cleanliness of the ear canal and airways including the nose. Observing the overall condition of the child, monitoring the secretion from the auditory duct. The ability to assist during the diagnostic therapeutic and curative process and also the interventions in nursing diagnoses, acute pain (00132), ineffective airway passage (00031), hyperthermia (00007), or risk of infection (00004). Nurses from children's ward are well informed in all areas concerning the middle ear inflammation (characteristics of the disease, pathogenesis, treatment, prevention and general nursing care). According to the nurses's statements, it is obvious that the premature intervention of the nursing activities in the primary preventive care includes the early identification of the primary symptoms of middle ear inflammation in children with this health problems and to educate the parents about the prevention of this disease. Nurses working along with specialists have logically demonstrated good knowledge of specific healing practices such as the application of the drug to the ear canal or paracenthesis. Nurses in nursing homes focus on planning and implementing comprehensive nursing care for a child with this disease. Conclusions and recommendations for practice: The nurses, who were questioned, have proved good knowledge of nursing care for children with the middle ear inflammation. An integral part of their competencies is the education and involvement of parents in the treatment and prevention of children's middle ear inflammation. Part of the thesis is a suggestion for recommendations concerning the early recognition of the first symptoms of the middle ear inflammation in children and the prevention of their recurrence.
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Nurse as a support of long - term hospitalized senior
TUŠLOVÁ, Michaela
This thesis "Nurse as a support of long-term hospitalized senior" is divided into a theoretical and an empirical part. It deals with the issue of long-term hospitalization of seniors at the aftercare department, especially with the nurses' support to seniors and their interrelationships. Three main goals were appointed. It was examined how the seniors perceive nurses who takes care of them. Then in which areas nurses are supportive and which techniques they try to use to be a support for seniors. Ten nurses working in aftercare department and five hospitalized seniors of aftercare department participated in this research. There were used methods such as a qualitative research, a method of questioning and a technology of semi - structured interviews. Collected information were analyzed and encoded, was used open encoding, pen and paper method. In the context of categorization, there six categories and ten subcategories were created. From the results of the thesis there is evident that nurses try to be a support. According to the research results, insufficiencies are evident. Most seniors perceive the nurses positively. In majority, gratitude toward nurses was perceived by seniors. Some seniors met with negative behavior, with devaluing addressing, even with conflict situation. Nurses support seniors in psychological aspects, take care of their basic needs, they also try to keep them self-sufficient. The results show, that most nurses acts with respect, try to ensure privacy and be helpful. Was created brief educational material. Then the material could be published in the form of a leaflet or as an article in the academic magazine. It could help nurses to find the proper attitude to seniors.
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The communication between a nurse and a patient with autistic spectrum disorders.
VANŽUROVÁ, Lucie
This bachelor thesis deals with the problem of communication between a nurse and a patient with autism spectrum disorder (then only "ASD"). The theoretical part of this thesis contains basic information concerning not only verbal, but also non-verbal communication in nursing which is very significant for the communication process for persons with ASD. In this part, there is described the role of a nurse in communicating with a patient possessing normal communication skill in context of findings concerning the patients who have impaired communication abilities. The patients with ASD belong into this group. There is an essay in this thesis which solves the autism spectrum disorders, their definition, classification, causes, diagnosis and possible treatment. This essay describes the symptoms of a patient with the above named disorder in communication and trying to find possible solutions to overcome communication barriers between actors of communication. A nursing conception Kathryn E. Barnard provides a solution of communication barriers in nurses' work, whose performance is discussed in a separate chapter. We also try to show the methods that may help the nurse in this very specific communication. The empirical part of the thesis presents the results of a qualitative research survey implemented by using a semi-structured interview. The main aim of this research was to explore the specifics of communication between a paediatric nurse and a patient with autistic spectrum disorder. This goal is related to the second aim, it is to find out the level of nurses' knowledge in terms of communication with a patient. The third goal is mapping of the experience of family members of children with autism spectrum disorders in communication. Research questions were created in connection with the aims of the thesis. 1) What are the specifics of the communication with a patient suffering from ADS? 2) What is the level of knowledge of selected paediatric nurses in communication with a patient with ADS? What difficulties do the nurses have in communication with patients with ADS? 4) What experiences have the family member in communication with a nurse? With regard established goals, two research groups were established; the first one was formed by a group of nurses with experience in paediatrics and the second one was made by family members of children suffering from autism spectrum disorder. The snowball sampling method was used in order to find suitable respondents, especially in the second group of respondents. The results were subjected to a thorough analysis using open coding by using the method of "pencil and paper". The survey revealed that the selected nurses in most cases have basic information about the issue. The statements of family members are in conflict with nurses' statements. This is because it shows the fact that the general awareness of nurses is not so straightforward and that there are situations where communication does not happen in a manner which would correspond to communication skills of patients with ASD. Selected nurses have, in most cases enough information, but they are not able to put these information into practice.The results of our research cannot be generalized to all nurses working in paediatrics. This is confirmed by family members, who describe, unlike nurses, both pleasant and unpleasant experience associated with communication with the nurse. Given the fact that awareness of nurses is mainly linked to their personal interest in the issue, it cannot be said that the theme of specifics of communication between a nurse and a patient with ASD is treated with ample space under the training of nurses. We ourselves in the course of making this thesis encountered with difficulties associated with insufficient literary sources, which would focus on the issue of communication in nursing process with patients suffering from ASD.
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Education of patients with ulcerative colitis
VEČEŘOVÁ, Iva
My bachelor thesis focused on " Education of patients with ulcerative colitis " has been split in theoretical part and practical part. The theoretical part has been focused on characteristicsof ulcerative colitis and education. This part has been split in nine chapters. The chapters describe anatomy and physiology of colon, definition of the disease, its causes, symptoms and complications. Furthermore, the chapters have been focused on examination methods and treatment of ulcerative colitis and nursing care. The last chapter of the theoretical part has been devoted to education. There were two aims defined for the bachelor thesis; to describe methods of educating the clients suffering from ulcerative colitis and to determine efficiency of education for a patient suffering from ulcerative colitis (in the course of 3 months after the first education). Based on the specified aims, three investigation questions were asked. What is the effect of the suggested education on health status of a client suffering from ulcerative colitis? Does observance of diet measures affect relapse of the disease? How do reasonable physical strain and psychical stress affect the disease? The practical part of the thesis has been processed through qualitative research. The research was made with respondents with the diagnoses of ulcerative colitis and with nurses who work at gastroenterologic ward in the hospital in České Budějovice, a.s. The research was split in three parts. The first part included interviewing of eight respondents with the diagnoses of ulcerative colitis. The interview was semi-structured. This included eighteen questions focused on the progress of the disease, education of the respondent, diet measures and influence of physical strain and psychical stress on the disease. Then, each respondent was educated through the education. The second part included interviewing of three nurses from gastroenterologic ward in the hospital in České Budějovice, a.s. The interview was semi-structured, too. It included sixteen questions which are very similar to allow better comparison with the patients. The third part was focused on check of knowledge and efficiency of former education of three respondents. This was a structured interview. It included five questions. These were focused on present status of the disease, evaluation of observance and efficiency of the low-residue diet and the basis of mental hygiene. The interviews were taken in calm home environment. Results of the research showed that the respondents have lack of information most frequently in the field of physical strain and psychical stress and often in the field of low-residue diet. However, the respondents are mainly well-educated about the definition of the disease and about treatment. In my opinion, my bachelor thesis is helpful because it has proven that correct education may have positive effect on the progress of the disease. The thesis might be also used as education material and it might help improve education of clients with the diagnoses of ulcerative colitis.
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Interactive processes in the care of the patient in a surgical department.
RŮŽIČKOVÁ, Lenka
This bachelor's thesis deals with the problematic of interaction processes while treating a patient on a surgical ward. It is divided into two parts. Topics of social interaction and social communication, together with the most frequent positive and negative interactions are discussed in the theoretical part. Further on, factors influencing interaction between a nurse and a patient, and specifics of treatment on a surgical ward, are being dealt with. Four goals were set for research described in this bachelor's thesis. The first goal is to find out, whether nurses do realize the mutual interaction between patients and them. The second goal is focused on the most frequent positive interactions in treatment of a patient on a surgical ward. The third goal is to get information on the most frequent negative interactions at taking care of a patient on a surgical ward. The last goal was set on patients' evaluation of nurses' interactive behavior. Based on these goals, four research questions were raised. For the empirical part, qualitative approach was chosen, and collecting of data was performed in three phases. The main design of the qualitative research for this thesis was a semi-structured interview, and observation. The test sample were seven nurses working on a Surgical Ward C of FN Plzeň hospital, and seven patients hospitalized on the same ward at time the of the research. The intention of the semi-structured interview with the nurses was to find out, what knowledge they have on interactions, and interactional processes in nursing care, and if the realize the interaction between them and their patients. Through observation we tried to find, what are the most frequent positive and negative interactions, the nurses make when taking care of a patient on a surgical ward. Based on the observation results, a method of semi-structured interview, where the patients evaluated the surgical ward nurses' interactional behavior, was carried out, as the next step of this research. The nurses' interview results were analyzed and processed using the coding method. Several charts with complete or incomplete quotations taken from the interviews were added for better clarity. The interviews show, the nurses don't have sufficient information on interaction and interactional processes, but are able to identify and sometimes even recognize the positive and negative interactions they make when taking care of a patient, but most of the time only after they have left the patient. All the information acquired through observation were written into the observation sheet, and basic data on interaction were sorted in charts to obtain clear arrangement. Rest of the information were described and compared with quotations from following interviews with the patients. These interviews and observations show, that unlike the observer, the patient can see particularly the positive interactional behavior of a nurse. And in case the patients saw some negative interactions, they were trying to pardon it regarding the work overload of those nurses. The observation also points that arising of negative interactions from the nurses' side is caused partly by the nurses having several shifts in a row, by performing the same tasks again and again through the day, by personal preference of a nurse to the specific task, and partly also by the patient himself. From the data obtained and evaluated during the first phase of the research can be concluded, the nurses have very little knowledge on interactions and interactional processes in nursing care. The other phases show, that even though the nurses do have a certain "interactional behavior" encoded in them, we presume that if they had the opportunity to acquire more information, and particularly the opportunity to see themselves in certain situations, they would realize where they make mistakes, and they could work on preventing them in future.
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The Specific of Nursing Care in Patient Undergoing the Examination of Bone Marrow
ČOUDKOVÁ, Marie
Haematology is a medical field. It is the study ofblood cells. It studies blood cells from the point of their morphology, quantity and function. The clinical haematology focuses on the irregularities in a patient´s blood and studies how the irregularitiesdiffer from the patient´s normal physiological condition. Due to this work haematology can help with diagnosis of other diseases. In haematology many investigative methods are used. One of them is aspiration and biopsy of bone marrow which is a hematopoietic tissue daily producing a large number of blood cells. Unless the formation of blood cells is sufficient enough, the disabled person may be at risk of their life. When the function of bone marrow is affected the patient may be impinged by serious infections, anemia risk or bleeding tendency. Bone marrow is examined for suspicion of haematological or oncology illnesses. Therefore, it has a very important rolein diagnosis of these. It is performed bya prolonged fever, mainly among the people who have a bad immune system. For blood collection are used investigative methodswhich consist ofaspiration and percutaneous bone marrow biopsy. These physical examinations provide some pieces of information about the condition and the ability of the blood cells´ production of bone marrow. Very important part of this physical examination is a specific nursing care. This bachelor´s thesis is focused on the specific nursing care of the patients who undergo the examinations of bone marrow. This thesis mainly includes the methods of bone marrow harvest, how the patients are informed about the examination of bone marrow,the patients´ nursing care after the operation and the role of a nurse at the haematological ward. The introduction of the theoretical part involves physiology of bone marrow and the study of haematology. The other parts discuss indication for bone marrow examination, haematological and oncological illnesses, bone marrow aspiration or percutaneous biopsy of bone marrow. The large part of the thesis deals with bone marrow aspiration, the process of the operation and the nursing care. It also focuses on percutaneous biopsy of marrow bone where the meaning of the examination and the process of bone marrow harvest operation are explained. At the end of the theoretical part a collection of hematopoietic stem cells from particular peripheral blood in mentioned. The aim of the bachelor thesis was to find out certain specifics of nursing care of the patients who undergo the examination of bone marrow. The following research questions were selected: What are the specifics of nursing care of the patients who undergo trepanobiopsy? What are the specifics of the patients who undergo aspiration (sternal puncture)? What are a preparation and assistance of a nurse during the examination of bone marrow? Which roles does the nurse have during the examination of bone marrow? How are the patients informed about the bone marrowexamination? The practical part includes results from a quantitative survey which was a semi-structured interview. The resulting interviews were written and then were processed by a certified coding technique. The research group comprised six nurses working in the haematological ward and six patients who have undergone the examination of bone marrow. Regarding the gathered results, an information brochure was put forward as a part of the thesis (see Annex number 5) and was oriented especially at patients undergoing the bone marrow examination. The brochure will be proposed for practical use at haematological wards.
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Comparison of nursing care about patients with peritoneal dialysis and hemodialysis
JANOUŠKOVÁ, Jaroslava
The number of patients with kidney disease is increasing worldwide. Such diseases include chronic kidney failure that needs dialysis treatment. Problems associated with providing nursing care to patients in a dialysis program are extensive and specific. Starting the treatment with a peritoneal dialysis or a haemodialysis causes a great psychological burden to patients. It noticeably affects not only patients' lives but also lives of their family and friends. Patients in the regular dialysis program are facing many health and social problems. Mutual trust between a nurse and a patient on dialysis to a certain extent influences the course of the treatment. Balanced and satisfied patient can live a better and more valuable life. The goals of the thesis: 1) To determine whether a comparably high quality nursing care is provided to patients with haemodialysis and peritoneal dialysis 2) To determine whether the approach to the provision of nursing care to the patients with haemodialysis and peritoneal dialysis is comparable. 3) To determine whether comparable forms of education and communication are used in providing nursing care for the patients with haemodialysis and peritoneal dialysis. Research questions: 1) Is the nursing care provided to the patients with haemodialysis and peritoneal dialysis of comparable quality? 2) A the approach to the provision of nursing care for patients with haemodialysis and peritoneal dialysis comparable? 3) Are comparable forms of education and communication used in providing nursing care for the patients with haemodialysis and peritoneal dialysis? Methods used: In the empirical part of the thesis a qualitative research was used to process data. The research was conducted through a non-standardized interview. Three sets of questions were created for the three groups of respondents, i.e. the respondents with peritoneal dialysis, respondents with haemodialysis and nurses who take care of patients with haemodialysis and peritoneal dialysis. The criterion for the selection of respondents was their willingness to cooperate. The nature and purpose of the research was explained to the addressed respondents. From the interviews with patients it was determined how they perceive the provided nursing care, the nurses' approach, and the way of interaction during haemodialysis and peritoneal dialysis. Interviews with nurses were focused on comparability and demands of nursing care for patients with haemodialysis and peritoneal dialysis, as well as on the used forms of communication and the way how to approach these patients. Results: The results of the research show that the care provided to patients with peritoneal dialysis as well as with haemodialysis is perceived by the responding patients with peritoneal dialysis, with haemodialysis and nurses as of the same quality. Peritoneal dialysis and haemodialysis each have their specificities and a different way of execution. Both are provided in differing environments. Peritoneal dialysis is done by the patient himself in their own social environment. During haemodialysis, nursing care is provided to the patient by nurses in a haemodialysis centre. As comparable is perceived by all respondents the nurses' approach to the patients, i.e. to each patient individually. In conclusion, the results imply that nurses during the contact with the patients with peritoneal dialysis and with haemodialysis use comparable forms of communication and education. Conclusion: At the present time there is an attempt to perform dialysis treatment to benefit the patient as much as possible. Peritoneal dialysis and haemodialysis are considered as equivalent substitute for renal function. They differ only in the principle and the method of executing. Nursing care provided to patients with peritoneal dialysis and with haemodialysis is perceived by the respondents as of comparable quality. The results of this thesis can be the basis for further research.
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Attitude toward death and psychical stress of nurses at work stations with an increased risk of death.
VONEŠOVÁ, Petra
The diploma thesis deals with the issue of dying and death within the job of a nurse. Nurses very often see dying and death. Death rate also depends on type of the ward. A healthy person usually does not think about death, but being ill one is uncertain and starts to ask many questions, which may also include questions about dying and death. Meeting a dying person is psychically demanding for the medical staff as well as for the family, friends and the dearest. The medical workers are expected to be professional and empathic. It is a question if the nurses are prepared to face the death and if they can cope with the physical and psychical stress. Long-term excessive psychical stress may result in numerous diseases. A nurse must know how to avoid such negative impacts. The theoretic part of the thesis describes the present status, explains specificities of palliative treatment within intensive care, within care for chronically ill patients and in paediatrics, it specifies attitudes and their functions in connection with difficult life situations. Furthermore, the theoretical part deals with psychical stress imposed on nurses in connection with dying and rules of communication in a multi-disciplinary team within palliative care. There are four objectives of the thesis. The first objective is to find out whether nurses feel ready to meet death after finishing qualification studies. Another objective is to find out whether death rate in the workplace affects psychical stress imposed on the nurses and their attitude to death. The third objective is to find out whether the nurses think that the information and experience gained during studies affected their attitude to death and professional skills of care for dying patients. The research part made use of quantitative research. Data collection was made through anonymous questionnaires. Respondents answered 35 questions. Out of that, 17 questions were closed and 18 questions were semi-closed. The research survey was completed with statistical survey. Nurses, who work in wards with higher risk of death, were contacted. We have made up four hypotheses. H1: Nurses? attitude to death depends on the level of education was not confirmed. The results of research and statistic survey showed that there is no difference in attitude in connection with the level of education reached. H2: Nurses? attitude to death depends on experience with death in personal life was not confirmed either. The respondents? answer showed that their attitude to death is mostly influences by experienced acquired in practice. H3: Death rate reduces psychical stress of nurses, was confimed. The respondents said they had still the same feelings and at most they answered that they did not feel anything, or they did not think about their feelings and they consider the death to be a part of their occupation. H4: Subjective readiness of nurses to meet death does not depend on finishing of qualification studies, but it depends on exeprience acquired in practice. The last hypothesis was confirmed by research and statistic survey, as well. The research and tests of hypothesis have revealed that sufficient attention has not been paid to the issue of care for dying patients within studies. Nurses acquire their experience mostly in practice. Furthermore, the survey showed that it is an important thing to teach the nurses to communicate effectively and to feel empathy. The conclusion, that nurses are more stressed with conflicts at the workplace, bad inter-personnel relationships, low wages than with care for dying patients, is alarming . Thus the labour force is wasted unnecessarily and it is obvious that the occupation of a nurse has not been appreciated properly, yet. Such factors influence quality of the work done and may cause the burn-out syndrome.
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