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Reasons to refuse or to withold chronic dialysis treatment
Beranová, Petra ; Maffei Svobodová, Ludmila (advisor) ; Dynáková, Šárka (referee)
(v AJ) Introduction: The literature indicates that progressive aging of the population leads to increasing number of elderly patients with chronic kidney failure, initiating long-term dialysis treatment. ERA - EDTA (European Renal Association - European Dialysis and Transplant Association was issued in 2016 for treatment of elderly patients with advanced kidney disease. For easier orientation in the issue to withold or withdraw from dialysis therapy recommendations have been made in 2010 Renal Physicians Association (RPA). The issue of chronic kidney disease is also dealt with nurses organization The European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA). Aim: The aim of this research was to point out the reasons, for which patients with chronic kidney failure decide to withold or withdraw from dialysis therapy. Methodology: The thesis was performed through a qualitative research. Data were collected by individual guided interviews. The research sample included five participants. Four individuals decided to withold or withdraw from dialysis therapy and were further followed in the pre-dialysis nephrology outpatient clinic. One participant, who initially had started dialysis therapy acutely, later repeatedly stopped it and started it again with the...
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Physiotherapy of dialyzed patients
MUŽÁTKOVÁ, Alena
The bachelor thesis focuses on physiotherapy of dialyzed patients. Hemodialysis is one of the options for patients with a chronic renal insufficiency. It is a therapeutic method that replaces basic functions of kidneys to remove metabolic products from blood. Patients with renal failure are the most frequent group of patients treated for a vital organ failure. Physical activity may positively influence their physical and mental health. The most important benefit of physical activity for dialyzed patients is the overall improvement of physical fitness. Further, it also helps to keep or to improve muscular strength and joint mobility and to relax and to stretch overstrained muscles. Regular exercising may improve self-sufficiency of the patients and support their independence of assistance of other persons. Self-sufficiency is particularly important for old patients so that they can continue living in their familiar environment. The objective of the thesis is to map psychomotoric condition of dialyzed patients and to propose an exercising unit for them. The theoretical part of the thesis deals with chronic renal failure in general and physical activities conducted during the disease. The practical part contains qualitative research of case reports of patients included in a regular dialysis program. The respondents were interviewed with a semi-standardized interview about their case histories. Further, they underwent dynamic tests of spine, anthropometric measurements, goniometric examination, examination of shortened and weakened muscular groups, Barthel test of basic everyday activities and 2-minute Step Test. The respondents were involved in a program with regular exercising for 10 weeks, including exercising at home based on previous instructions and exercising on a rehabilitation treadmill during hemodialysis. The main preconditions of successful physiotherapy of dialyzed patients are personal involvement and proactive approach to regular physical activity. A suitable form of physical activity may contribute to improvement of their physical fitness and mental condition. The patients, however, need to be consistent and exercise regularly on a truly long-term basis.
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Cooperation of nurce and patient in nefrology ambulance
ŠŤASTNÁ, Věra
This bachelor's thesis deals with the cooperation between nurses and patients in selected nephrological outpatients' departments. The results of this research investigation can influence the nurses' and patients' behaviour and manners in nephrological or other outpatients' departments in a highly positive way, thus contributing to the improvement of their mutual cooperation. Nephrological outpatients' departments provide care to all patients with renal dysfuction, and patients suffering from chronic renal insufficiency undergo a permanent medicamentous treatment there. Nephrological outpatients' departments represent a very important intermediate stage of pre-dialysis period dealing with a complex preparation of the patients before supplementary therapeutic methods (hemodialysis, peritoneal dialysis) are used. Nurses working in this outpatients' department is an absolutely essential element as they have to get the patient acquainted with the measures of treatment aiming at mitigating the impact of the kidneys' dysfunction and to motivate the patient to participate in treating their disease. Therefore, it is important for the nurses and the patients to share mutual trust and cooperation. The aim of this research investigation was to find out about the cooperation between a nurse and a patient in a nephrological outpatients' department. In order to find out about the cooperation between a nurse and a patient a qualitative form of the research investigation based on a semi-structured dialogue has been used. Consequently casuistries have been created on the basis of the dialogues with the individual respondents. Based on the casuistries classification tables have been compiled where the most important results of the research are summarized. There were 6 research questions specified at the very beginning of the research investigation. All of the questions have been answered. After the research questions had been answered, we arrived at the conclusion that the cooperation between a nurse and a patient in nephrological outpatients' departments was generally very good. We would like to present the results of this bachelor's thesis in professional conferences or seminars. The results of this research investigation could help the nurses in nephrological outpatients' departments and also in other outpatients' facilities to improve the mutual cooperation and communication in their outpatients' departments. And consequently to improve the nursing care for the patients.
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