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Nursing care of patients with myasthenia gravis.
HŮLOVÁ, Jiřina
The bachelor thesis deals with the issue of nursing care for a patient with myasthenia gravis. The goal of this thesis is to map the nursing care for a patient with myasthenia gravis. Two research questions were formulated, which identified the specifics of nursing care for a patient with myasthenia gravis in a standard department and the specifics of nursing care for these patients on an artificial lung ventilator. In the theoretical part, there the characteristics of the disease, clinical picture of the disease, the disease progression, including the occurrence of myasthenic crisis is given. Nursing care for a patient with myasthenia gravis is described in more detail. The empirical part contains a description of realized qualitative research. The research technique was semi-structured interview, data were analyzed using the open coding method, paper-pencil technique. The interview contained 31 questions divided into four main parts, focusing on nurses' knowledge of myasthenia gravis disease, specifics of nursing care for a patient with myasthenia gravis, risks and regimen measures in a patient with myasthenia gravis and patient education, including cooperation with family. In the case of nurses from acute care beds (ARO / ICU), the interview was extended by the fifth area mapping the specifics of care for a patient with myasthenia gravis in the acute department. The research group consisted of ten nurses, four of whom work in the ICU or ARO departments. Then, 5 categories were created by analyzing the interviews, some of which are subdivided into sub-categories. The presentation of the results is presented using these categories; if relevant, direct statements of informants are presented, specifying the specifics of nursing care for patients with myasthenia gravis in standard departments or departments of ARO / ICU. The findings show that considering this topic there is the need to pay attention to bedsores, hygiene, catering, and very important is education of patients and their relatives. Nursing care at the standard departments and departments of ARO / ICU varies, the difference can primarily be seen in the emphasis on acute care departments in the respiratory tract, prevention of pressure ulcers that can also occur in the airways, prevention of nosocomial infections. At the ARO / ICU, nurses must also be more prepared for the sudden deterioration in the patient's condition, which is followed by subsequent nursing care, there an endotracheal tube, or a tracheostomy cannula is used. Following the findings, it is also advisable to recommend health care providers to develop a nursing standard for a patient with myasthenia that is not available in any of the standard departments where the research was conducted. The contribution of the bachelor thesis can be seen in depicting the complexity of nursing care for patients with myasthenia gravis, including an indication of areas to which nurses must pay increased attention, pointing out the differences in the provision of nursing care for patients with myasthenia gravis in standard and ARO / ICU departments. The results of the thesis can be used by nurses who take care of these patients, but above all they can be a guide for nurses who do not yet have experience with these patients. These findings can be used by these nurses when they are forced to provide nursing care to these patients.
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