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Permanent Vascular Access in Dialysis Patients from the viewpoint of Nurses and Patients.
ŠVÁBOVÁ, Veronika
The issue of chronic renal failure and cannulation of permanent venous accesses in patients treated at haemodialysis centres is a topical and widespread problem of these days. According to generally accessible resources the incidence of terminal stage of renal failure, and thus the necessity to treat a patient by means of elimination methods, is very high, it reaches four individuals per thousand inhabitants according to the statistics. It is obviously a widespread nursing problem. The theoretical part of the thesis is divided into a summary and description of the present situation in chronic renal failure, particularly a brief insight into the chronic renal failure and its causes and syndromes. It also deals with the topic of the present treatment possibilities with stress on patient treatment at nephrologic outpatient clinics and in haemodialysis centres. The next chapter of the thesis describes the development from haemodialysis history up to the present advanced elimination methods. The present elimination methods bring the necessity of functional provision of venous access, particularly cannulation of AV fistulas, it is a very frequent nursing operation provided by nurses treating chronically affected patients at haemodialysis centres. This chapter is concluded by general knowledge of the techniques of cannulation of permanent venous accesses, possible occurrence of complications during the cannula penetration itself in relation to the physical phase of nursing treatment about patients with chronic renal failure. The practical part of the thesis was aimed at discovering or possible confirmation of the hypotheses discussed in the theoretical part. The practical research was based on searching for problems among dialyzed patients related to the permanent venous access, on finding the approach of nurses working at dialysis centres to cannulation of permanent accesses and on mapping the access of patients with permanent venous access to nurses with short time experience at a dialysis centre. Research questions were determined for this purpose and were processed within qualitative research into case reports upon depth interviews with nurses working at the dialysis centres of České Budějovice Hospital, Český Krumlov Hospital and Písek Hospital and their patients. The research data were processed into charts, where responses from patients and those from nurses were assessed separately. Occurrence frequency of the individual answers was particularly monitored in the individual output tables, however the responses were not processed by means of standard statistic methods because of the chosen methodology and thus a low number of respondents, but the output data served for drawing conclusions and preparing recommendations for application of nursing methods. The thesis conclusion summarizes the obtained knowledge and recommends possible procedures of solving the problems of cannulation of permanent venous accesses in patients with chronic renal failure treated at haemodialysis centres.
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Health Related Quality of Life (HRQoL) of dialysis patients, with regard to age
VANCLOVÁ, Romana
The dissertation entitled ?Health Related Quality of Life (HRQoL) in Dialysed Patients with Respect to Age? contains a theoretical and practical part. The theoretical part describes chronic kidney disorder and the treatment of this disease. It mentions the causes, repercussions and complications of this disease. It also suggests the form of treatment as the method of replacing the function of the kidneys which includes haemodialysis, peritoneal dialysis and transplantation. I have attempted to elaborate their principle, history and current form, benefits, negative aspects and complications. The practical part describes the actual research. Health Related Quality of Life (HRQoL) was ascertained in a group of patients undergoing haemodialysis at one dialysis centre. Questionnaire SF 36 was used which allows for a quantified assessment of the quality of life in eight domains. The results were statistically assessed and clearly depicted using tables and graphs. The quality of life was compared in the monitored group with the general population and also based on age and gender. The results found show a reduced quality of life of dialysed patients compared with the standard population. A difference was also found in the assessment of the quality of life in some age groups. No difference in results was proved with regard to gender.
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Effect of peritoneal dialysis on everyday activities of people
BOŘILOVÁ, Lucie
The Paper investigates the effects that peritoneal dialysis may have on everyday lives of patients. Clients suffering the chronic renal failure multiply, and the peritoneal dialysis is the first option in line to treat the condition. Since the numbers of clients treated by peritoneal dialysis grow, nurses meet such people increasingly also outside the Dialysis Centers. The method heavily relies on nursing care. Peritoneal dialysis is a treatment intended to do the duty of kidneys instead of kidneys. It works on the principle of swapping substances between the blood and the dialyzing solution through the patient's own peritoneum. The technique of peritoneal dialysis works for patients of all ages. The clients opt for this procedure appreciating its minimal requirements for technical skills, the possibility of home treatment, and the avoidance of commuting and the stress of frequent visits to health-care facilities. The method makes the patients feel more independent, self-reliant, and gives them elbowroom for adjustments to their daily blood-cleaning schedule and other activities. The "cure" itself is applied by the clients, and the clients have to demonstrate a degree of responsibility. The Paper was to make an inquiry into the issues of peritoneal dialysis. It should communicate the main information on peritoneal dialysis to nurses, and help the clients make a decision on the method of treatment.
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Quality of Life of Haemodialysed Seniors in Prachatice Region
ZELENKOVÁ, Božena
In the bachelor thesis I deal with the quality of life of haemodialysed seniors in Prachatice region and many aspects that change and affect their lives. The first part of my thesis is a professional one and it describes an anatomical structure of reins, their physiology and in general also diseases leading to an acute or chronic renal failure, especially the diabetes mellitus 2nd type. The professional part is concluded by a treatise on methods of the renal function replacement, so called a method of the blood purification {--} the haemodialysis. In the second, practical part, I focused on the research of the quality of life. I chose the following set criteria: a retirement, an age over 65 years, a renal failure due to the diabetes mellitus 2nd type. For detecting the quality of life I used the method of SEIQoL with the technique of an observation and a questioning. There were selected five respondents who meet the given criteria, the group consists of two men and three women in the age range 66-83 years. The research showed that a common feature of the respondents is the fact of declaring a higher quality of life in comparison with their intended degree of a satisfaction with their life. The respondents also agree that their health problems are multiplied by secondary phenomena accompanying the haemodialysis. Furthermore, it shows how important is a need of a social support for the respondents, their desire for a self-realization and a meaningful fulfilment of their leisure time.
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